bluuebunny/crossref_metadata_2025 huggingface dataset:
Self-reported depression and social support are associated with egocentric network characteristics of HIV-infected women of color
Authors: Messer Lynne C. , Quinlivan E. Byrd , Adimora Adaora , Roytburd Katya
Published: April 2020

Background

We explore the social network characteristics associated with depressive symptoms and social support among HIV-infected women of color (WOC).

Methods

Network data were collected from 87 HIV-infected WOC at an academic Infectious Disease clinic in the United States (US) south. With validated instruments, interviewers also asked about depressive symptoms, social support, and treatment-specific social support. Linear regression models resulted in beta coefficients and 95% confidence intervals for the relationships among network characteristics, depression, and support provision.

Results

Financial support provision was associated with lower reported depressive symptoms while emotional support provision was associated with increased reported social support. Talking less than daily to the first person named in her network, the primary alter, was associated with a nearly 3-point decrease in reported social support for respondents. Having people in their social network who knew their HIV status was also important.

Conclusions

We found that both functional and structural social network characteristics contributed to perceptions of support by HIV-infected WOC.
When investigating depression and anxiety in undergraduate medical students timing of assessment is an important factor - a multicentre cross-sectional study
Authors: Thiemann Pia , Brimicombe James , Benson John , Quince Thelma
Published: April 2020

Background

Symptoms of depression and anxiety experienced by undergraduate medical students have become a prominent concern. Evidence about students’ depression and anxiety including prevalence, trajectory during medical education, gender differences and comparisons with age-matched peers is conflicting. However few studies of medical students’ mental health specify the precise time of assessment. Proximity to examinations may be relevant. Precise identification of the time of data collection might help explain contradictory findings and facilitate provision of more timely support.

Methods

This study addressed whether:

Proximity of final examinations affected students’ depression and anxiety symptoms

Males and females differed in this respect.

We analysed data provided by 446 final year students from 6 UK medical schools. These students were a subset of data provided by 14 UK medical schools which participated in an online survey comparing first and final year students and in which final year response rates exceeded 30%. We used the Hospital Anxiety and Depression Scale to assess symptoms of depression and anxiety and the norms to indicate potentially clinically relevant cases. We grouped students into those for whom final exams were imminent i.e. within 2 months of completing the survey (n = 164) and those for whom exams were more distant or had been taken (n = 282). We used parametric and non-parametric tests to compare both groups and gender differences in respect of depression and anxiety sum scores and cases rates.

Results

For both depression and anxiety male and female students facing imminent final exams recorded greater prevalence and significantly higher mean scores. The effect size of differences for anxiety were large. No substantial gender differences were found for depression. Regardless of the timing of final exams female students recorded both significantly higher mean scores and clinically relevant rates for anxiety.

Conclusions

Proximity to final exams negatively affected the mental health of both male and female final year students. The study suggests that there may be times in the undergraduate medical curriculum when additional or targeted support is needed. It also highlights the need for research to provide a greater specificity of context when investigating medical students’ mental health.
Efficacy of quality improvement and patient safety workshops for students: a pilot study
Authors: Shah Kevin P. , Goyal Shreya , Ramachandran Vignesh , Kohn Jaden R. , Go Jonathan A. , Wiley Zachary , Moturu Anoosha , Namireddy Meera K. , Kumar Anjali , Jacobs Ryan C. , Stampfl Matthew , Shah Jesal R. , Fu Justin , Lin Weijie V. , Ho Brandon , Wey Grace , Lin Sophie Y. , Caruso Andrew C. , Gay Lindsey Jordan , Stewart Diana E. , Andrabi Sara
Published: April 2020

Background

While the Association of American Medical Colleges encourages medical schools to incorporate quality improvement and patient safety (QI/PS) into their curriculum, medical students continue to have limited QI/PS exposure. To prepare medical students for careers that involve QI/PS, the Institute for Healthcare Improvement chapter at an allopathic medical school and school of allied health professions initiated self-directed learning by offering student-led workshops to equip learners with skills to improve the quality and safety of healthcare processes.

Methods

In this prospective cohort study, workshops were hosted for medical students between 2015 and 2018 on five QI/PS topics: Process Mapping, Root-Cause Analysis (RCA), Plan-Do-Study-Act (PDSA) Cycles, Evidence Based Medicine (EBM), and Patient Handoffs. Each workshop included a hands-on component to engage learners in practical applications of QI/PS skills in their careers. Change in knowledge, attitudes, and behaviors was assessed via pre- and post-surveys using 5-point Likert scales, and analyzed using either the McNemar test or non-parametric Wilcoxon signed-rank test. Surveys also gathered qualitative feedback regarding strengths, future areas for improvement, and reasons for attending the workshops.

Results

Data was collected from 88.5% of learners (n = 185/209); 19.5% of learners reported prior formal instruction in these topics. Statistically significant improvements in learners’ confidence were observed for each workshop. Additionally, after attending workshops, learners felt comfortable teaching the learned QI/PS skill to colleagues (mean pre/post difference 1.96, p < 0.0001, n = 139) and were more likely to pursue QI/PS projects in their careers (mean pre/post difference 0.45, p < 0.0001, n = 139). Lastly, learners demonstrated a statistically significant increase in knowledge in four out of five skills workshop topics.

Conclusion

Few medical students have formal instruction in QI/PS tools. This pilot study highlights advantages of incorporating an innovative, student-directed modified ‘flipped classroom’ methodology, with a focus on active experiential learning and minimal didactic instruction.
Virotheranostics, a double-barreled viral gun pointed toward cancer; ready to shoot?
Authors: Keshavarz Mohsen , Sabbaghi Ailar , Miri Seyed Mohammad , Rezaeyan Abolhasan , Arjeini Yaser , Ghaemi Amir
Published: April 2020

Compared with conventional cancer treatments, the main advantage of oncolytic virotherapy is its tumor-selective replication followed by the destruction of malignant cells without damaging healthy cells. Accordingly, this kind of biological therapy can potentially be used as a promising approach in the field of cancer management. Given the failure of traditional monitoring strategies (such as immunohistochemical analysis (in providing sufficient safety and efficacy necessary for virotherapy and continual pharmacologic monitoring to track pharmacokinetics in real-time, the development of alternative strategies for ongoing monitoring of oncolytic treatment in a live animal model seems inevitable. Three-dimensional molecular imaging methods have recently been considered as an attractive approach to overcome the limitations of oncolytic therapy. These noninvasive visualization systems provide real-time follow-up of viral progression within the cancer tissue by the ability of engineered oncolytic viruses (OVs) to encode reporter transgenes based on recombinant technology. Human sodium/iodide symporter (hNIS) is considered as one of the most prevalent nuclear imaging reporter transgenes that provides precise information regarding the kinetics of gene expression, viral biodistribution, toxicity, and therapeutic outcomes using the accumulation of radiotracers at the site of transgene expression. Here, we provide an overview of pre-clinical and clinical applications of hNIS-based molecular imaging to evaluate virotherapy efficacy. Moreover, we describe different types of reporter genes and their potency in the clinical trials.
Knockdown of lncRNA NEAT1 suppresses hypoxia-induced migration, invasion and glycolysis in anaplastic thyroid carcinoma cells through regulation of miR-206 and miR-599
Authors: Tan Xiangrong , Wang Peng , Lou Jianlin , Zhao Jiazheng
Published: April 2020

Background

Anaplastic thyroid carcinoma (ATC) is one of the most aggressive and lethal malignancies. Long non-coding RNAs (lncRNAs) are being found to play crucial roles in ATC progression. Herein, we focused on the role of nuclear paraspeckle assembly transcript 1 (NEAT1) on ATC progression under hypoxia and underlying mechanisms governing it.

Methods

The expression levels of NEAT1, miR-206 and miR-599 were assessed by quantitative real-time polymerase chain reaction (qRT-PCR). Cell migration and invasion abilities were detected using transwell assays. Glucose consumption and lactate production were determined using a corresponding commercial assay kit. Western blot was performed to evaluate the level of hexokinase 2 (HK2). The targeted interplays between NEAT1 and miR-206 or miR-599 were confirmed by dual-luciferase reporter and RNA immunoprecipitation (RIP) assays. Xenograft model was established to observe the effect of NEAT1 on tumor growth in vivo.

Results

Our data indicated that NEAT1 was highly expressed in ATC tissues and cells, and hypoxia induced NEAT1 expression in ATC cells. NEAT1 depletion repressed ATC cell migration, invasion and glycolysis under hypoxia. Mechanistically, NEAT1 acted as a molecular sponge of miR-206 and miR-599. Moreover, the repressive effects of NEAT1 knockdown on ATC cell migration, invasion and glycolysis under hypoxia were mediated by miR-206 or miR-599. Additionally, NEAT1 knockdown weakened tumor growth in vivo.

Conclusion

In conclusion, our study suggested that a low NEAT1 expression suppressed the migration, invasion, and glycolysis in ATC cells under hypoxia at least partially through modulating miR-206 and miR-599, providing new therapeutic strategies for ATC treatment.
Health related quality of life in chronic kidney disease; a descriptive study in a rural Sri Lankan community affected by chronic kidney disease
Authors: Senanayake Sameera , Gunawardena Nalika , Palihawadana Paba , Senanayake Shanika , Karunarathna R. , Kumara Priyantha , Kularatna Sanjeewa
Published: April 2020

Introduction

The current epidemic of chronic kidney disease (CKD) in Sri Lanka is ascribed to the exponential increase in the number of CKD patients, which cannot be attributed to any known etiology (CKDu). The aim of this study is to describe the health related quality of life (HRQOL) and the associated factors among CKD/CKDu patients in a rural district in Sri Lanka.

Methods

A community based cross-sectional study included 1174 CKD/CKDu patients. Kidney Disease Quality of Life-Short Form was used to assess the HRQOL, while Centre for Epidemiologic Studies Depression Scale, General Health Questionnaire (GHQ) 12 and CKD Symptom Index – Sri Lanka were used to assess presence of depression, psychological distress and symptom burden respectively. Three summary scores; kidney disease (KDSC), physical (PCS) and mental (MCS) are derived from Kidney Disease Quality of Life-Short Form (KDQOL-SF™).

Results

Mean age of the study population was 58.3 years (standard deviation (SD) 10.7). Median KDSC (58.4; inter-quartile range (IQR) 54.2–63.4), was higher than the median scores of PCS (35.0; IQR 26.2–41.9) and MCS (58.4; IQR 54.2–63.4). Multiple linear regression revealed low income, advanced stages of CKD, symptom burden, being positive for depression and psychological distress were significantly associated with low HRQOL.

Conclusion

The HRQOL of the CKD patients in this rural Sri Lankan population was found to be poor. Superior socio-economic status, less physical and psychological symptom burden were found to be independently associated with better HRQOL. Periodical screening of the CKD patients for depression and psychological distress and measures to alleviate symptom burden seem to be important to improve the HRQOL of these patients.
Sexual and reproductive health (SRH): a key issue in the emergency response to the coronavirus disease (COVID- 19) outbreak
Authors: Tang Kun , Gaoshan Junjian , Ahonsi Babatunde , Ali Moazzam , Bonet Mercedes , Broutet Nathalie , Kara Edna , Kim Caron , Thorson Anna , Thwin Soe Soe
Published: April 2020

The novel coronavirus disease (COVID-19) outbreak was first declared in China in December 2019, and WHO declared the pandemic on 11 March 2020. A fast-rising number of confirmed cases has been observed in all continents, with Europe at the epicentre of the outbreak at this moment.

Sexual and reproductive health (SRH) and rights is a significant public health issue during the epidemics. The novel coronavirus (SARS-CoV-2) is new to humans, and only limited scientific evidence is available to identify the impact of the disease COVID-19 on SRH, including clinical presentation and outcomes of the infection during pregnancy, or for persons with STI/HIV-related immunosuppression. Beyond the clinical scope of SRH, we should not neglect the impacts at the health system level and disruptions or interruptions in regular provision of SRH services, such as pre- and postnatal checks, safe abortion, contraception, HIV/AIDS and sexually transmitted infections. Furthermore, other aspects merit attention such as the potential increase of gender-based violence and domestic abuse, and effects of stigma and discrimination associated with COVID-19 and their effects on SRH clients and health care providers. Therefore, there is an urgent need for the scientific community to generate sound clinical, epidemiological, and psycho-social behavioral links between COVID-19 and SRH and rights outcomes.
Single-center experience of simultaneous bilateral uni-portal video-assisted thoracoscopic surgery for multiple ground-glass opacities
Authors: Qu Rirong , Hao Zhipeng , Zhang Yang , Bie Lei , Fu Xiangning , Zhang Ni
Published: April 2020

Background

There is an increasing incidence rate of ground-glass opacity (GGO), especially for multiple GGOs (≥2). Whether it is safe and feasible to have bilateral simultaneous surgical resection remains unknown. The purpose of this study is to summarize the experience of surgical resection of patients with multiple GGOs in our Hospital in recent years, and to discuss the above questions.

Methods

Clinical datas of patients who underwent one-stage bilateral uni-portal VATS resections of multiple pulmonary ground glass opacities and had routine pathological examination were collected from May 2016 to May 2019 in our hospital.

Results

A total of 34 patients underwent simultaneous bilateral surgical resection of multiple GGO lesions, 28 were women,6 were men, the average age of total patients was 57.9 ± 6.7 years. All patients underwent bilateral uni-portal video-assisted thoracoscopic surgery (Uni-portal VATS), the average intraoperative blood loss was 100.9 ± 67.7 ml, the average operation time was 140 ± 74.8 min, the average thoracic drainage time was 2.8 ± 3.1 days, and the average postoperative hospital stay was 4.2 ± 4.3 days. Postoperative complications including: 2 cases of infection, 3 cases of atrial fibrillation, and 5 cases of persistent air leakage for more than 3 days. All of them improved after treatment, and there were no serious complications and deaths in perioperative period. A total of 76 GGO lesions were resected, with a total malignancy rate of 81.6%, including 40 were pure GGO, of which 28 were malignant (70%), and the average diameter of them were 9.6 ± 3.8 mm; 36 were mixed GGO, of which 34 were malignant (94.4%), the average diameter of them were 15.6 ± 6.6 mm.Mean postoperative follow-up was 28.4 (range, 3–39) months. There was neither recurrence nor deaths at final follow-up.

Conclusion

The malignancy rate of multiple GGOs is high. Therefore, when the lung function is allowed,one-stage bilateral uni-portal VATS can be considered. According to experience of main surgeon and the frozen biopsy, either sub-lobar resection or lobectomy was acceptable. The risk of postoperative complications and the prognosis were optimal.
The effect of massage on feeding intolerance in preterm infants: a systematic review and meta-analysis study
Authors: Seiiedi-Biarag Leila , Mirghafourvand Mojgan
Published: April 2020

Background

Feeding intolerance in premature infants is one of the main causes of their long-term hospitalization in NICUs. Massage therapy is a cost-effective intervention that has a positive impact on the health of infants and their parents. This systematic review investigates the effect of massage on feeding intolerance in preterm infants.

Methods

A search was carried out in English databases including Medline (via PubMed), Scopus, Cochrane Library, Google Scholar, Embase (via Ovid) and Persian databases including SID and Magiran for articles published until November 2019 with language restrictions (English or Persian) but no time restrictions. The risk of bias in the studies was assessed using the Cochrane guidelines. The results of the meta-analysis were reported as mean difference, and the heterogeneity of the studies was evaluated using I2. GRADE approach was used to assess the quality of the evidence.

Results

Of the 528 reviewed articles, eight were eligible for this study and finally six studies were included in the meta-analysis. According to the meta-analysis conducted on 128 preterm infants, the mean gastric residual volume (MD = − 2.11; 95% CI: − 2.76 to − 1.45,P < 0.00001) and mean frequency of vomiting (MD = − 0.84; 95% CI: − 1.37 to − 0.31;P = 0.002) were significantly lower in the massage therapy group compared to the control group. The mean abdominal circumference (MD = − 1.51; 95% CI: − 4.86 to 1.84;P = 0.38) and mean gastric residual number (MD = − 0.05; 95% CI: − 0.34 to 0.24;P = 0.74) were lower in the massage therapy group compared to the control group, although not in a statistically significant manner.

Conclusion

Massage therapy significantly reduces the gastric residual volume and vomiting in preterm infants. Given the limited number of reviewed studies, the small number of neonates examined, and the short intervention periods, it is recommended that clinical trial be conducted with accurate methodology, longer interventions and larger sample sizes to ensure the effect of massage on feeding intolerance in these infants.
The clinical relevance of oliguria in the critically ill patient: analysis of a large observational database
Authors:   for the ICON Investigators, Vincent Jean-Louis , Ferguson Andrew , Pickkers Peter , Jakob Stephan M. , Jaschinski Ulrich , Almekhlafi Ghaleb A. , Leone Marc , Mokhtari Majid , Fontes Luis E. , Bauer Philippe R. , Sakr Yasser
Published: April 2020

Background

Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output < 0.5 ml/kg/h) in acutely ill patients and its association with the need for renal replacement therapy (RRT) and outcome.

Methods

International observational study. All adult (> 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis.

Results

Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient—oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged—oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent—oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19–1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97–1.34], p = 0.103).

Conclusions

Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.
A double-blind, randomized, crossover trial protocol of whole hemp seed protein and hemp seed protein hydrolysate consumption for hypertension
Authors: Samsamikor Maryam , Mackay Dylan , Mollard Rebecca C. , Aluko Rotimi E.
Published: April 2020

Background

Primary hypertension accounts for almost 95% of all cases of high blood pressure and is a major modifiable risk factor for cardiovascular diseases. Lifestyle interventions have been shown to prevent hypertension. One of the prominent potential therapeutic lifestyle strategies to prevent or manage hypertension is increasing dietary protein as a macronutrient or as bioactive peptides. An emerging plant-based protein source that may have anti-hypertensive properties is hemp seed.

Methods/design

A randomized, double-blind, crossover clinical trial will be conducted on 35 hypertensive participants aged 18–75 years, with a BMI between 18.5 and 40 kg/m2, systolic blood pressure (SBP) between 130 and 160 mmHg and diastolic blood pressure (DBP) ≤ 110 mmHg. The trial will be conducted for a period of 22 weeks and will consist of three treatment periods of 6 weeks, separated by 2-week washout periods. The treatments will be consumed twice a day and consist of 25 g casein, hemp seed protein (HSP), or HSP plus HSP hydrolysate (HSP+). The primary outcome of this trial is 24-h SBP, measured on the first day of first phase and the last day of each phase. Office-measured blood pressure, pulse-wave velocity and augmentation index and anthropometrics will be determined at the first and last days of each period. Also, body composition will be assessed by dual x-ray absorptiometry (DXA) scan on the first day of the first phase and within the last 2 days of each treatment period. Blood samples will be collected on the first and last 2 days of each treatment phase whereas urine samples will be collected on the first day of the first phase plus the last day of each phase to be analyzed for specific biomarkers.

Discussion

This trial protocol is designed to evaluate the hypotensive potential of consuming whole HSP, and HSP+, in comparison to casein protein. This study will be the first trial investigating the potential anti-hypertensive benefit of dietary hemp protein plus bioactive peptide consumption in humans.

Trial registration

National Clinical Trial (NCT), ID: NCT03508895. Registered on 28 June 2018. Retrospectively registered on the publicly accessible Registry Databank at ClinicalTrials.gov (http://ClinicalTrials.gov).
A randomised controlled trial of therapist-assisted online psychological therapies for posttraumatic stress disorder (STOP-PTSD): trial protocol
Authors: Ehlers Anke , Wild Jennifer , Warnock-Parkes Emma , Grey Nick , Murray Hannah , Kerr Alice , Rozental Alexander , Beierl Esther T. , Tsiachristas Apostolos , Perera-Salazar Rafael , Andersson Gerhard , Clark David M.
Published: April 2020

Background

Over the last few decades, effective psychological treatments for posttraumatic stress disorder (PTSD) have been developed, but many patients are currently unable to access these treatments. There is initial evidence that therapist-assisted internet-based psychological treatments are effective for PTSD and may help increase access, but it remains unclear which of these treatments work best and are most acceptable to patients. This randomised controlled trial will compare a trauma-focussed and a nontrauma-focussed therapist-assisted cognitive behavioural Internet treatment for PTSD: Internet-delivered cognitive therapy for PTSD (iCT-PTSD) and internet-delivered stress management therapy (iStress-PTSD).

Methods/design

The study is a single-blind, randomised controlled trial comparing iCT-PTSD, iStress-PTSD and a 13-week wait-list condition, with an embedded process study. Assessors of treatment outcome will be blinded to trial arm. Two hundred and seventeen participants who meet DSM-5 criteria for PTSD will be randomly allocated by a computer programme to iCT-PTSD, iStress-PTSD or wait-list at a 3:3:1 ratio. The primary assessment point is at 13 weeks, and further assessments are taken at 6, 26, 39 and 65 weeks. The primary outcome measure is the severity of PTSD symptoms as measured by the PTSD Checklist for DSM-5 (PCL-5). Secondary measures of PTSD symptoms are the Clinician Administered PTSD Scale for DSM-5 (CAPS-5) and the Impact of Event Scale-Revised (IES-R). Other symptoms and well-being will be assessed with the Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder Scale (GAD-7), WHO (Five) Well-Being Index, Work and Social Adjustment Scale (WSAS), Endicott Quality of Life Scale (QoL), and Insomnia Sleep Index (ISI). Health economics analyses will consider quality of life, productivity, health resource utilisation, employment status and state benefits, and treatment delivery costs. Process analyses will investigate candidate mediators and moderators of outcome. Patient experience will be assessed by interview and questionnaire.

Discussion

This study will be the first to compare the efficacy of a trauma-focussed and nontrauma-focussed therapist-assisted online cognitive behavioural treatment for people with posttraumatic stress disorder.

Trial registration

ISRCTN16806208. Registered prospectively on 5 January 2018.
Pilot test of an online training module on near-infrared spectroscopy monitoring for the randomised clinical trial SafeBoosC-III
Authors: Hansen Mathias Lühr , Rasmussen Marie Isabel , Rubin Snorre , Pellicer Adelina , Cheng Guoqiang , Xu Xin , Zhaoqing Yin , Zoffmann Vibeke , Greisen Gorm
Published: April 2020

Background

SafeBoosC-III is an international randomised clinical trial to evaluate the effect of treatment of extremely preterm infants during the first 3 days of life based on cerebral near-infrared spectroscopy (NIRS) monitoring versus treatment and monitoring as usual. To ensure high quality of the trial intervention as well as of patient care, we have developed a multilingual web-based training program to train relevant staff and test their competence. As we enter an under-explored area of e-learning, we have conducted a pilot study on the first of the five modules comprising the web-based training program to test the feasibility of developing such a program for an international trial with limited resources.

Methods

The module in this study focuses on the principles and practice of NIRS monitoring. The pedagogical idea was to integrate training and certification. One-hundred doctors and nurses from five Neonatal Intensive Care Units across China, Spain and Denmark were invited to participate in the pilot study. Upon completion of the NIRS module, participants were invited to evaluate their experience by completing an online survey. Data from closed-ended questions were analysed using descriptive statistics while data from open-ended questions underwent thematic analysis.

Results

In total, 81 of 100 invited staff members entered the training module and completed the online survey. The median time and the number of questions to pass the module was 15 minutes and seven questions, respectively. Most staff found the academic level of the learning material and quiz appropriate (85% and 93% of all staff members, respectively), as well as agreeing that the module was relevant to prepare them to ‘use the NIRS device’ (90%). Thematic analysis revealed issues such as a discrepancy between learning material and quiz questions, lack of clarity, and technical issues.

Conclusion

We provide evidence of the feasibility of developing a multilingual web-based training program for an international trial, despite challenges such as low budget, language barriers and possibly differences in the clinical training of staff. Exploring the integration of training and certification for international trials, the positive results of this study motivate further developments.

Trial registration

ClinicalTrial.gov, NCT03770741. Registered 10 December 2018.
Social functioning outcomes in men and women receiving medication-assisted treatment for opioid use disorder
Authors: van Reekum Emma A. , Rosic Tea , Hudson Jacqueline , Sanger Nitika , Marsh David C. , Worster Andrew , Thabane Lehana , Samaan Zainab
Published: April 2020

Background

Social functioning (SF), the ability to engage with life and fulfill roles may be a salient “patient important outcome” in addiction treatment. It is not known if medication-assisted treatment (MAT) impacts SF in opioid use disorder (OUD). There is a growing evidence to suggest that men and women are impacted differently by OUD. This study is the largest to date to study sex differences in OUD and explore associations between MAT and SF.

Methods

Data were collected from 2736 participants with OUD, enrolled in MAT for varying lengths of time, in outpatient clinics across Ontario. SF was defined according to the Maudsley Addiction Profile’s domains of (1) employment, (2) criminal activity, and (3) interpersonal conflict. Using logistic regression analysis, we examined sociodemographic and clinical factors associated with domains of SF.

Results

There were 1544 men (56%) and 1192 women (44%) in this study, and ages varied from 17 to 76 years for men and 18 to 69 years for women. At study entry, participants had been on MAT for a median of 2 years. Compared to men, women reported more psychological (mean MAP score 14/40, SD = 9.55, versus 11/40, SD = 8.64; p < 0.001) and physical symptoms (mean MAP score 17/40, SD = 7.70 versus 14/40, SD = 7.74; p < 0.001). More women reported unemployment(74% versus 58%; p < 0.0001) and interpersonal conflict (46% versus 35%; p < 0.0001). Men were more likely than women to report criminal activity (11%, versus 8%; p = 0.001). Psychological symptoms increased the risk of worse SF, across domains, for men and for women. Every year on MAT was associated with a 7% increase in the odds of women engaging with criminal activity (OR = 1.07, 95% CI 1.02, 1.12, p = 0.006).

Conclusions

Men and women had different SF profiles and psychological symptoms scores while on MAT. The length of time on MAT increased the risk of criminal activity in women, and overall, duration of MAT was not associated with improvement in SF. This may suggest that MAT alone may not support continual improvements in SF in OUD.
Analytical approach for fractional extended Fisher–Kolmogorov equation with Mittag-Leffler kernel
Authors: Veeresha P. , Prakasha D. G. , Singh Jagdev , Khan Ilyas , Kumar Devendra
Published: April 2020

A new solution for fractional extended Fisher–Kolmogorov (FEFK) equation using the q-homotopy analysis transform method (q-HATM) is obtained. The fractional derivative considered in the present work is developed with Atangana–Baleanu (AB) operator, and the technique we consider is a mixture of the q-homotopy analysis scheme and the Laplace transform. The fixed point hypothesis is considered for the existence and uniqueness of the obtained solution of this model. For the validation and effectiveness of the projected scheme, we analyse the FEFK equation in terms of arbitrary order for the two distinct cases. Moreover, numerical simulation is demonstrated, and the nature of the achieved solution in terms of plots for distinct arbitrary order is captured.
One step ahead? The use of foresight by Czech and Slovak non-governmental organizations
Authors: Šerá Komlossyová Eva , Schlossarek Martin , Macková Lucie , Medová Nikola
Published: April 2020

Non-governmental organizations (NGOs) are generally recognized as important actors in societies, fulfilling diverse sets of roles. Given the nature of their work and the complexity of the fast-changing contexts in which they operate, foresight techniques can potentially be useful in helping them prepare for future disruptions and maximize the positive influence of their work over future developments. The possibilities for and benefits of the application of foresight approaches and techniques are increasingly being discussed in various private and public organizations, especially with the aim to innovate and grow. However, little attention has been given to the question of how NGOs use foresight and whether their work benefits from it. The paper presents results of a survey conducted among Czech and Slovak NGOs active in development cooperation, humanitarian assistance, and environmental protection fields, filling the existing research gap by analyzing their application of foresight processes and the benefits foresight brings to them. The paper concludes that future-oriented processes in Czech and Slovak NGOs are of a rather informal and non-institutionalized nature, given the insufficient knowledge of foresight concepts and limited human capacities of NGOs. Nevertheless, they positively influence their creativity and growth.
Factors influencing patient and health care delays in Oropharyngeal Cancer
Authors: Nieminen Markus , Atula Timo , Bäck Leif , Mäkitie Antti , Jouhi Lauri , Aro Katri
Published: April 2020

Background

The incidence of human papillomavirus (HPV)–associated oropharyngeal squamous cell carcinoma (OPSCC) is increasing. Patients with HPV-associated and HPV-unassociated OPSCC differ in many aspects, which may also impact their diagnostic and management timelines. This study aims at studying the patient, primary health care (PHC) and specialist-care (SC) delays and possible differences between these two patient groups in seeking medical care.

Methods

We reviewed all new patients with OPSCC treated between 2016 and 2018 at our institute, which covers a referral area of 1.6 million people. We collected data on patients’ symptoms and factors influencing why they sought medical care using a patient-reported questionnaire and hospital records. We compared delays based on patient and tumor characteristics.

Results

In our study population of 83 patients, the median patient delay was 30 days (range, 0–366), with a median PHC delay of 15 days (range, 0 days–2.5 years), and a median SC delay of 54 days (range, 12–231). The SC delay was further divided into diagnostic hospital delay and treatment delay, each with a median length of 16 days (range, 0–237) and 29 days (range, 0–73), respectively. Furthermore, we found that p16 status did not associate with delays. A longer patient delay associated with specific tumor factors, such as a larger primary tumor and a lower UICC 7th edition stage. Patients that had multiple visits or did not have a follow-up visit scheduled at the initial appointment had longer PHC delays. Treatment delay was significantly longer for patients scheduled for (chemo-)radiotherapy than for those undergoing surgery with or without (chemo-)radiotherapy.

Conclusions

Although delays remained short for the majority of OPSCC patients, long delays require further evaluation and improvement of management. Awareness of presenting symptoms among cancer risk patients and prompt referral practice or a follow-up visit at PHC represent key factors to shortening these delays. Ultimately, the causes for delays in SC appear multifactorial and require institutional quality control.
18F-fluorodeoxyglucose–positron emission tomography/computed tomography for the diagnosis of polymyalgia-like illnesses: a retrospective study
Authors: Horikoshi Hideyuki , Nakanishi Takashi , Tamura Katsumi , Kimura Fumihiko , Itoh Kenji
Published: April 2020

Background

Various inflammatory conditions may present with musculoskeletal symptoms similar to those of polymyalgia rheumatica (PMR). We investigated findings on 18F-fluorodexoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) images that may differentiate PMR from polymyalgia-like illnesses.

Methods

We analyzed data from 25 patients with new-onset polymyalgia-like illnesses who fulfilled Bird’s diagnostic criteria for PMR and had undergone FDG–PET/CT scan. To assess the uptake by major joints and synovial bursae, particularly at PMR-specific sites (shoulder, sternoclavicular, and hip joints, interspinous bursae, ischial tuberosities, and greater trochanters), we used visual scoring system to score FDG uptake: 0, no uptake (same as bone); 1, slight uptake; 2, moderate uptake (same as the liver); 3, greater uptake than the liver; and 4, uptake as strong as in the cerebellum.

Results

The final diagnoses were PMR in 17 patients and non-PMR in eight patients (three malignancies, two infections, one cholesterol crystal embolism, one ANCA-associated vasculitis, and one undefined diagnosis). Although the serum MMP-3 levels were significantly higher in patients with PMR, C-reactive protein and erythrocyte sedimentation rate mean values did not differ between the two groups. In PMR-specific sites, FDG accumulations were observed in all cases of PMR, with a high PET-positive score of 2.00 (range, 0–3), but it was low in non-PMR cases, with a PET-positive score of 1.00 (range, 0–3).

Conclusions

The FDG accumulation patterns in polymyalgia-like illness differ from those in PMR, despite the similar clinical presentations of both conditions. An FDG–PET/CT scan is useful for differentiating PMR from other polymyalgia-like illnesses.
Ancient rip current records and their implications: an example from the Cretaceous Ukra Member, Kutch, India
Authors: Sarkar Subir , Koner Amlan
Published: April 2020

Poorly-sorted conglomerate patches rich in granules or sturdy fossils or both, and reddish mud matrix within the interstices stand out amidst fine-grained siliciclastic shelf sediments of the trangressive systems tract (TST) of the Lower Cretaceous Ukra Member, Kutch Basin, India. The siliciclastic shelf sediments contrast the conglomerates with their remarkable lateral extension. The fossils belong to a low-diversity group of sedentary bivalves that can be traced into the shoreface facies assemblage. The shelf sandstones are almost always sculpted by wave structures, especially hummocky cross-stratification while textures in the conglomerates suggest that the sediment settling was generally from suspensions. Textural variations in conglomerates reflect an immediate variation in flow viscosity prior to the downloading. The current structures obtained from the conglomerates record offshoreward palaeocurrent, in contrast to the shore-parallel palaeocurrent in the TST. The hummocky cross-stratified (HCS) beds are interpreted as seasonal storm deposits, while the conglomerate patches are taken as rip current deposits induced by waves of much longer periods. The glauconite-rich shale that alternates with conglomerates is probable fair-weather products. The conglomerates could not be recognized either in the coarse-grained shoreface deposits occupying the lower part of the overall fining-upward TST or in the coarsening-upward and glauconite-depleted highstand systems tract (HST). In contrast to the TST, the HST is dominantly tide-imprinted, having shore-normal palaeocurrent direction. It appears that intensification of waves and weakening of tides during transgression favored strong rip currents generation, which had presumably caused severe damage to the sea coast and to the shell banks growing preferably at the necks of the rip current channels. Rapid lateral facies transitions in the shoreface deposits at the basal part of the TST suggest enhanced irregularity in the coastline, possibly because of the mega cusps indented upon it. Frequency and intensity of storms enhanced during periods of global warming caused the transgression of the Early Cretaceous Ukra Sea.
The effectiveness and cost-effectiveness of integrating mental health services in primary care in low- and middle-income countries: systematic review
Authors: Cubillos Leonardo , Bartels Sophia M. , Torrey William C. , Naslund John , Uribe-Restrepo José Miguel , Gaviola Chelsea , Díaz Sergio Castro , John Deepak T. , Williams Makeda J. , Cepeda Magda , Gómez-Restrepo Carlos , Marsch Lisa A.
Published: April 2020

Aims and method

This systematic review examines the effectiveness and cost-effectiveness of behavioural health integration into primary healthcare in the management of depression and unhealthy alcohol use in low- and middle-income countries. Following PRISMA guidelines, this review included research that studied patients aged ≥18 years with unhealthy alcohol use and/or depression of any clinical severity. An exploration of the models of integration was used to characterise a typology of behavioural health integration specific for low- and middle-income countries.

Results

Fifty-eight articles met inclusion criteria. Studies evidenced increased effectiveness of integrated care over treatment as usual for both conditions. The economic evaluations found increased direct health costs but cost-effective estimates. The included studies used six distinct behavioural health integration models.

Clinical implications

Behavioural health integration may yield improved health outcomes, although it may require additional resources. The proposed typology can assist decision-makers to advance the implementation of integrated models.
Perinatal mental health around the world: priorities for research and service development in Africa
Authors: Ng'oma Mwawi , Bitew Tesera , Kaiyo-Utete Malinda , Hanlon Charlotte , Honikman Simone , Stewart Robert C.
Published: April 2020

Africa is a diverse and changing continent with a rapidly growing population, and the mental health of mothers is a key health priority. Recent studies have shown that: perinatal common mental disorders (depression and anxiety) are at least as prevalent in Africa as in high-income and other low- and middle-income regions; key risk factors include intimate partner violence, food insecurity and physical illness; and poor maternal mental health is associated with impairment of infant health and development. Psychological interventions can be integrated into routine maternal and child healthcare in the African context, although the optimal model and intensity of intervention remain unclear and are likely to vary across settings. Future priorities include: extension of research to include neglected psychiatric conditions; large-scale mixed-method studies of the causes and consequences of perinatal common mental disorders; scaling up of locally appropriate evidence-based interventions, including prevention; and advocacy for the right of all women in Africa to safe holistic maternity care.
Impact on Quality of Documentation and Workload of the Introduction of a National Information Standard for Tumor Board Reporting
Authors: Ebben Kees C. W. J. , Sieswerda Melle S. , Luiten Ernest J. T. , Heijns Joan B. , van der Pol Carmen C. , Bessems Maud , Honkoop Aafke H. , Hendriks Mathijs P. , Verloop Janneke , Verbeek Xander A. A. M.
Published: April 2020

PURPOSE

Tumor boards, clinical practice guidelines, and cancer registries are intertwined cancer care quality instruments. Standardized structured reporting has been proposed as a solution to improve clinical documentation, while facilitating data reuse for secondary purposes. This study describes the implementation and evaluation of a national standard for tumor board reporting for breast cancer on the basis of the clinical practice guideline and the potential for reusing clinical data for the Netherlands Cancer Registry (NCR).

METHODS

Previously, a national information standard for breast cancer was derived from the corresponding Dutch clinical practice guideline. Using data items from the information standard, we developed three different tumor board forms: preoperative, postoperative, and postneoadjuvant-postoperative. The forms were implemented in Amphia Hospital’s electronic health record. Quality of clinical documentation and workload before and after implementation were compared.

RESULTS

Both draft and final tumor board reports were collected from 27 and 31 patients in baseline and effect measurements, respectively. Completeness of final reports increased from 39.5% to 45.4% ( P = .04). The workload for tumor board preparation and discussion did not change significantly. Standardized tumor board reports included 50% (61/122) of the data items carried in the NCR. An automated process was developed to upload information captured in tumor board reports to the NCR database.

CONCLUSION

This study shows implementation of a national standard for tumor board reports improves quality of clinical documentation, without increasing clinical workload. Simultaneously, our work enables data reuse for secondary purposes like cancer registration.
Open Health Imaging Foundation Viewer: An Extensible Open-Source Framework for Building Web-Based Imaging Applications to Support Cancer Research
Authors: Ziegler Erik , Urban Trinity , Brown Danny , Petts James , Pieper Steve D. , Lewis Rob , Hafey Chris , Harris Gordon J.
Published: April 2020

PURPOSE

Zero-footprint Web architecture enables imaging applications to be deployed on premise or in the cloud without requiring installation of custom software on the user’s computer. Benefits include decreased costs and information technology support requirements, as well as improved accessibility across sites. The Open Health Imaging Foundation (OHIF) Viewer is an extensible platform developed to leverage these benefits and address the demand for open-source Web-based imaging applications. The platform can be modified to support site-specific workflows and accommodate evolving research requirements.

MATERIALS AND METHODS

The OHIF Viewer provides basic image review functionality (eg, image manipulation and measurement) as well as advanced visualization (eg, multiplanar reformatting). It is written as a client-only, single-page Web application that can easily be embedded into third-party applications or hosted as a standalone Web site. The platform provides extension points for software developers to include custom tools and adapt the system for their workflows. It is standards compliant and relies on DICOMweb for data exchange and OpenID Connect for authentication, but it can be configured to use any data source or authentication flow. Additionally, the user interface components are provided in a standalone component library so that developers can create custom extensions.

RESULTS

The OHIF Viewer and its underlying components have been widely adopted and integrated into multiple clinical research platforms (e,g Precision Imaging Metrics, XNAT, LabCAS, ISB-CGC) and commercial applications (eg, Osirix). It has also been used to build custom imaging applications (eg, ProstateCancer.ai, Crowds Cure Cancer [presented as a case study]).

CONCLUSION

The OHIF Viewer provides a flexible framework for building applications to support imaging research. Its adoption could reduce redundancies in software development for National Cancer Institute–funded projects, including Informatics Technology for Cancer Research and the Quantitative Imaging Network.