bluuebunny/crossref_metadata_2025 huggingface dataset:
A program utilizing community pharmacists to improve diabetes education in the Kingdom of Saudi Arabia
Authors: Khan Yasmin , Imershein Sarah , Maryniuk Melinda , Armian Haleh , Turkistani Sarah Anwar , Bayoumi Aly H , Al-Harbi Mohammed Yahia , Hsu William C
Published: August 2019

Objective

The aim of this program was to demonstrate that retail community pharmacists could successfully recruit, engage and counsel people with diabetes by serving as a trusted source of diabetes information. We evaluated the outcomes of this clinical program in preparation for a wider roll out.

Methods

Joslin Diabetes Center collaborated with Nahdi Medical Company, a large retail pharmacy chain in Saudi Arabia, to offer a ‘Let’s Talk About Diabetes’ (LTAD) program. LTAD consists of four 1: 1 counselling sessions, approximately 20 min each, scheduled over a 2–4 month period with a focus on medications, lab results, glucose monitoring and doctor visits. Twenty-five pharmacists completed diabetes education certification and intensive on-site training to deliver the LTAD program.

Results

The 25 program pharmacists in 11 locations enrolled 2639 individual customers into the program. Of these, 1582 participated in at least one session and 1137 (71.9%) participated in at least one LTAD session and completed follow-up surveys. There were 380 customers with paired HbA1C results which demonstrated a reduction from 8.50% (69 mmol/mol) to 7.32% (56 mmol/mol) (P < 0.001). There were improvements in diabetes awareness, attitudes towards diabetes and medication adherence.

Conclusion

The evaluation of this community program suggests that a pharmacy-led diabetes education program is feasible in Saudi Arabia.
Ferroelastic domain switching and R‐curve behavior in lead zirconate titanate (Zr/Ti = 52/48)‐based ferroelectric ceramics
Authors: Chen Yu , Xu Jiageng , Xu Qian , Xie Shaoxiong , Wang Qingyuan , Zhu Jianguo
Published: August 2019

In this work, ferroelastic domain switching and R‐curve behavior in lead zirconate titanate (Nb/Ce co‐doped Pb(Zr0.52Ti0.48)O3, ab. PZT‐NC)‐based ferroelectric ceramics were investigated, using the indentation‐strength‐in‐bending (ISB) method. Firstly, Vickers indentation test examined the notable fracture anisotropy of PZT‐NC ceramics between the poling direction and its perpendicular direction, and the crack open displacement (COD) profiles in the two directions were also theoretically calculated from the indentation fracture mechanics. And then two kinds of ferroelastic domain switching modes (in‐plane and out‐of‐plane) were used for explaining such anisotropic propagation behavior of indentation cracks. The subsequent three‐point bending test illustrated the dependence of fracture strength on indentation load and the rising crack growth resistance curves (R‐curves) in two directions. The resulted R‐curves were fitted by the Hill's type Growth Function successfully, giving the reasonable values of crack extension exponential (n), plateau fracture toughness (Kmax), and initial fracture toughness (Kini). The in‐plane ferroelastic domain switching was identified as a more significant toughening mechanism for PZT‐NC ceramics than the out‐of‐plane switching due to more switchable domains.
From individual to joint species distribution models: A comparison of model complexity and predictive performance
Authors: Caradima Bogdan , Schuwirth Nele , Reichert Peter
Published: August 2019

Aim

Species distribution models (SDMs) are widely used to study geographic distributions of taxa in response to natural and anthropogenic environmental conditions. For a community, common approaches include fitting individual SDMs (iSDMs) to all taxa or directly modelling community properties such as richness. However, the parameters of iSDMs are difficult to identify for rare taxa, and community properties do not reveal taxon‐specific responses. Individual models can be combined into a hierarchical multispecies distribution model (mSDM) that constrains taxon‐specific parameters according to overarching community parameters, or a joint model (jSDM) in which interdependencies between taxa are jointly inferred. We compare how individual, hierarchical multispecies and joint SDMs differ in quality of fit, explanatory power and predictive performance, and analyse how these properties depend on the prevalence of taxa.

Taxa

Presence–absence observations of 245 benthic macroinvertebrate taxa identified at a mixed taxonomic resolution.

Location

Four hundred and ninety‐two sites in rivers throughout Switzerland.

Methods

Individual, hierarchical and joint hierarchical generalized linear models (GLM) were developed for all taxa. Parameters were estimated using maximum likelihood estimation or Bayesian inference with Hamiltonian Markov chain Monte Carlo simulations. Predictive performance was assessed with cross‐validation. In addition, the predicted family and species richness of the models was compared with a GLM for richness.

Results

Individual models show a slightly higher quality of fit largely due to overfitting for rare taxa. The mSDM achieves a similar quality of fit and explanatory power, mitigates overfitting for rare taxa and considerably improves predictive performance over the whole community. The joint models further improve the quality of fit, but decrease predictive performance and increase predictive uncertainty.

Main conclusions

We show that even a relatively simple mSDM combines many of the analytical capabilities of iSDMs and improves predictive performance. Increasingly complex mSDMs and jSDMs provide additional analytical possibilities, but depending on the data and research questions, different levels of complexity may be appropriate.
Vertical integration and disruptive cross‐market R&D
Authors: Lin Ping , Zhang Tianle , Zhou Wen
Published: August 2019

We study how vertical market structure affects the incentives of suppliers and customers to develop a new input that will enable the innovator to replace the incumbent supplier. In a vertical setting with an incumbent monopoly upstream supplier and two downstream firms, we show that vertical integration reduces the R&D incentives of the integrated parties, but increases that of the nonintegrated downstream rival. Strategic vertical integration may occur whereby the upstream incumbent integrates with a downstream firm to discourage or even preempt downstream disruptive R&D. Depending on the R&D costs, vertical integration may lower the social rate of innovation.
Coastal zone use and migratory behaviour of the southern population of Mugil liza in Brazil
Authors: Mai Ana C. G. , Albuquerque Cristiano Q. , Lemos Valéria M. , Schwingel Paulo R. , Ceni Gian‐Franco , Saint'Pierre Tatiana D. , Vieira João P.
Published: August 2019

We analysed the ratios Sr:Ca and Ba:Ca in the otoliths of 55 adults of the southern population of Mugil liza in Brazil (Paraná to Rio Grande do Sul) to investigate its coastal zone use and migratory behaviour. All individual M. liza analysed had Sr:Ca and Ba:Ca values indicating that their birth was in the marine environment, which is consistent with the southern population migration to spawn in the ocean,. Juveniles exhibited at least three coastal use and recruitment strategies (contingents): the majority (89%) of M. liza juveniles migrated toward brackish water. They entered the estuary before completing the first year of life (64%) or after (25%) their first year of life. The remaining 11% did not appear to enter brackish or freshwater water as a nursery or at any point in their life cycle. Some adults returned to the estuary after spawning in the ocean but others (of both sexes) never returned to the estuary after spawning, remaining in the marine environment. The pattern of juvenile habitat use in the Brazilian southern population of M. liza seems to be recurrent throughout the extent of its distribution as a consequence of the reproductive spawning aggregation behaviour, which mixes all contingents (with marine or estuarine preferences).
A novel protein‐based autologous topical serum for skin regeneration
Authors: Anitua Eduardo , Troya María , Pino Ander
Published: August 2019

Background

As skin ages, a functional decrement occurs. To avoid future vulnerability to dermatologic diseases, an optimal cutaneous regeneration is mandatory. Biological therapies based on blood‐derived autologous proteins are gaining attention of scientists and dermatologists.

Objectives

A novel 100% autologous topical serum has been developed using plasma rich in growth factors technology. The physicochemical characterization and the biologic potential of the novel formulation have been studied.

Methods

Rheological and mechanical properties and the biological capacity of the formulation were characterized. Human dermal fibroblast culture and 3D organotypic skin explants were used as in vitro and ex vivo cutaneous models, respectively.

Results

The autologous topical serum presented an optimal spreadability index and appropriate shear thinning behavior that allowed an easy handling and rapid integration within the cutaneous tissue. The formulation has a high growth factor load with the ability to progressively penetrate into the dermal/epidermal layers of the skin. It is biocompatible and promotes cell proliferation and chemotactic activity. The autologous topical serum promotes the biosynthetic activity of cells by the stimulation of collagen and hyaluronic acid expression.

Conclusions

These findings present an in situ and easy to prepare autologous topical serum based on the patient's own blood with physicochemical and bioactive properties that may be used for skin regeneration purposes.
Risk Factors and Outcomes of Recurrent Pregnancy Loss in Japan
Authors: Morita Keiko , Ono Yosuke , Takeshita Toshiyuki , Sugi Toshitaka , Fujii Tomoyuki , Yamada Hideto , Nakatsuka Mikiya , Fukui Atsushi , Saito Shigeru
Published: August 2019

Aim

To clarify the risk factors and pregnancy outcomes for each risk factor of recurrent pregnancy loss (RPL) in Japan.

Methods

Using a prospective RPL database collected from 16 facilities in Japan, the prevalence of risk factors for RPL, their treatments and pregnancy outcomes were examined.

Results

Of 6663 patients registered in our database, 5708 patients had RPL. All examinations for risk factors were performed for 1340 patients (23.5%). The prevalences of positive antiphospholipid antibodies (aPL), malformation of the uterus, thyroid dysfunction, parental karyotype abnormality, factor XII deficiency, protein S deficiency and unknown risk factors were 8.7%, 7.9%, 9.5%, 3.7%, 7.6%, 4.3% and 65.1%, respectively. Although factor XII deficiency and protein S deficiency are not recognized as risk factors for RPL in general, low‐dose aspirin (LDA) or unfractionated heparin + LDA therapy improved live birth rates. In transiently aPL‐positive patients, the live birth rate with LDA therapy was similar to that with heparin + LDA. For unknown risk factors of RPL, the live birth rate in normal fetal karyotype in the none treatment group was similar to that in all other treatments group (81.3% vs 86.0%). Of 5708 RPL patients, pregnancy outcomes were known for 2261 patients and 1697 patients (75.1%) had at least one live birth.

Conclusion

The risk factors and pregnancy outcomes for each risk factor of RPL are useful for clinicians and patients. Factor XII deficiency and protein S deficiency may be risk factors of RPL.
Implications of feeding frequency, prey size and condition, and intraspecific competition for the commercial aquaculture of the nudibranch Berghia stephanieae
Authors: Monteiro Estela A. , Güth Arthur Z. , Banha Thomás N. S. , Sumida Paulo Y. G. , Mies Miguel
Published: August 2019

Marine ornamental aquaculture is a growing industry. Although most species are cultured for aesthetic purposes, there is increasing interest in organisms that provide functional services. Nudibranchs provide an example in which they act as biological controls by consuming aquaria pests. Berghia stephanieae is a commercially relevant nudibranch that feeds on Exaiptasia anemones, which overgrow sessile invertebrates. However, information pertaining to B. stephanieae feeding habits remains unaddressed. Therefore, this study investigated the following: (a) the effect of feeding frequency on fecundity, (b) optimum prey size, (c) the ability to feed on prey fragments, and (d) the influence of intraspecific competition. Distinct feeding frequencies were tested and embryos produced were quantified; growth of nudibranchs offered different anemone sizes was measured; whole and fragmented anemones were offered, with preference recorded; and growth and mortality of juvenile nudibranchs were recorded in the absence and presence of adult conspecifics. Results show that feeding daily produced the highest number of embryos. Juveniles fed on medium‐sized anemones showed the highest growth rate. Smaller juveniles were unable to feed on whole anemones and preferred fragmented anemones. Juvenile growth and survival decreased in the presence of adults. To maximize production, breeders must feed broodstock daily, provide medium‐sized anemones or fragments, and segregate juveniles from adults.
Validating a pain assessment tool in heterogeneous ICU patients: Is it possible?
Authors: Emsden Christian , Schäfer Ursi Barandun , Denhaerynck Kris , Grossmann Florian , Frei Irena Anna , Kirsch Monika
Published: August 2019

Background

Non‐communicative adult ICU patients are vulnerable to inadequate pain management with potentially severe consequences. In German‐speaking countries, there is limited availability of a validated pain assessment tool for this population.

Aim

The aim of this observational study was to test the German version of the Critical‐Care Pain Observation Tool (CPOT) in a heterogeneous adult ICU population.

Methods

The CPOT's feasibility for clinical use was evaluated via a questionnaire. For validity and reliability testing, the CPOT was compared with the Behavioural Pain Scale (BPS) and patient's self‐report in 60 patients during 480 observations simultaneously performed by two raters.

Results

The feasibility evaluation demonstrated high satisfaction with clinical usability (85% of responses 4 or 5 on a 5‐point Likert scale). The CPOT revealed excellent criterion validity [agreement between CPOT and BPS 94.0%, correlation of CPOT and BPS sum scores r = 0.91 (P < .05), agreement of CPOT with patient self‐report 81.4%], good discriminant validity [mean difference of CPOT scores between at rest and non‐painful stimulus 0.33 (P < .029), mean difference of CPOT scores between at rest, and painful stimulus 2.19 (P < .001)], for a CPOT cut‐off score of >2 a high sensitivity and specificity (93% and 84%), high positive predictive value (85%), and a high negative predictive value (93%). The CPOT showed acceptable internal consistency (Cronbach's α 0.79) and high inter‐rater reliability [90% agreement, no differences in CPOT sum scores in 64.2% of observations, and correlation for CPOT sum scores r = 0.72 (P < .05)]. Self‐report obtained in patients with delirium did not correlate with the CPOT rating in 62% of patients.

Conclusion

This is the first validation study of the CPOT evaluating all of the described validity dimensions, including feasibility, at once. The results are congruent with previous validations of the CPOT with homogeneous samples and show that it is possible to validate a tool with a heterogeneous sample. Further research should be done to improve pain assessment and treatment in ICU patients with delirium.

Relevance to clinical practice

The German CPOT version can be recommended for ICUs in German‐speaking countries.
Histological and genetic analysis of anaplastic pleomorphic xanthoastrocytoma suspected of malignant progression over a 12‐year clinical course
Authors: Fukushima Hiroko , Nakano Yoshiko , Ishii Naomi , Nozuchi Nozomi , Okuno Takahiro , Yamasaki Kai , Okada Keiko , Fujisaki Hiroyuki , Kunihiro Noritsugu , Matsusaka Yasuhiro , Sakamoto Hiroaki , Honda‐Kitahara Mai , Ichimura Koichi , Hara Junichi , Inoue Takeshi
Published: August 2019

We report a case of anaplastic PXA for which histological study and molecular analysis were performed at the time of the first resection and two recurrences. A 15‐year‐old girl had a temporal lobe tumor that had been followed as a cystic lesion from three years of age without histopathological examination. The first and second surgical specimens exhibited typical histological features of PXA such as nuclear and cytoplasmic pleomorphism. In addition, microvascular proliferation was observed in the second surgical specimen. On the other hand, nuclear pleomorphism was unclear in the third surgical specimen and it was mainly composed of spindle cells. Palisading necrosis was observed. Mitotic figures and the Ki‐67 proliferation index gradually increased. BRAF V600E and TERT promoter mutation were detected in the first, second, and third surgical specimens. In addition, PTEN mutation and CDNK2A deletion were detected in the third surgical specimen. Considering the histopathological and genetic changes over time, we concluded that our case of anaplastic PXA underwent malignant progression.
Mitigating the Double‐Blind Effect in Opaque Selling: Inventory and Information
Authors: Li Qing , Tang Christopher S. , Xu He
Published: August 2019

Opaque selling is a marketing strategy under which firms sell end‐of‐the‐season inventory of different products as a single opaque good and customers find out the specific products they actually get only after they have made the purchase. Opaque selling entails a “double‐blind” process: customers do not know the inventory level of each product, and the seller does not know their product preferences. This double‐blind process can result in customer dissatisfaction when customers do not receive the products they were hoping for, and the seller is unable to allocate the right product to the right customer. To reduce customer dissatisfaction arising from the double‐blind process, we examine whether the seller should: (i) reveal its inventory information to customers, (ii) solicit each customer’s product preference, or (iii) charge customers a higher price for removing product uncertainty; that is, sell specific goods and opaque good at the same time. To examine these issues, we analyze a model in which a firm sells two products as a single opaque good. We show that revealing inventory information or soliciting customer preferences results in higher customer surplus, but lower revenue for the firm. We then consider the case when the firm sells specific goods and opaque good at the same time. We show that relative to the case of selling only the opaque good, the firm’s revenue is strictly higher and customer surplus may be higher or lower. Specifically, when the price of specific goods is product dependent, selling specific goods and opaque good at the same time benefits the firm the most when the inventory levels of the two products are relatively balanced and their valuations are strongly skewed. When the price of specific goods is product independent, however, the firm gains the most when the inventory levels are relatively balanced but their valuations are not too strongly skewed. We also identify conditions under which the customer surplus is higher.
Phylogenetic relationships and virulence assays of Fusarium secorum from sugar beet suggest a new look at species designations
Authors: Webb K. M. , Shrestha S. , Trippe R. , Rivera‐Varas V. , Covey P. A. , Freeman C. , de Jonge R. , Secor G. A. , Bolton M.
Published: August 2019

Fusarium spp. are responsible for significant yield losses in sugar beet (Beta vulgaris) with Fusarium oxysporum f. sp. betae most often reported as the primary causal agent. Recently, a new species, F. secorum, was reported to cause disease in sugar beet but little is known on the range of virulence within F. secorum or how this compares to the virulence and phylogenetic relationships previously reported for Fusarium pathogens of sugar beet. To initiate this study, partial translation elongation factor 1‐α (TEF1) sequences from seven isolates of F. secorum were obtained and the data were added to a previously published phylogenetic tree that includes F. oxysporum f. sp. betae. Unexpectedly, the F. secorum strains nested into a distinct group that included isolates previously reported as F. oxysporum f. sp. betae. These results prompted an expanded phylogenetic analysis of TEF1 sequences from genomes of publicly available Fusarium spp., resulting in the additional discovery that some isolates previously reported as F. oxysporum f. sp. betae are F. commune, a species that is not known to be a sugar beet pathogen. Inoculation of sugar beet with differing genetic backgrounds demonstrated that all Fusarium strains have a significant range in virulence depending on cultivar. Taken together, the data suggest that F. secorum is more widespread than previously thought. Consequently, future screening for disease resistance should rely on isolates representing the full diversity of the Fusarium population that impacts sugar beet.
A Time Varying Approach to the Stock Return–Inflation Puzzle
Authors: Li Xiaoye , Zhao Zhibiao
Published: August 2019

In the large literature on the stock return–inflation puzzle, existing works have used constant coefficient linear regression models or change point analysis with abrupt change points. Motivated by the time varying stock return–inflation relationship and the drawbacks of change point analysis, we propose to use the recently emerged locally stationary models to model stock return and inflation. Although the model exhibits non-parametric time varying dependence structure over a long time span, it has local stationarity within each small time interval. Detailed empirical analysis is conducted and comparisons are made between various approaches. We find that the stock return–inflation correlation is negative during early sample periods and turns positive during late sample periods, but the turning time point is different for the total inflation rate and core inflation rate.
Cover Image, Volume 17, Issue 3
Authors: Peralta Santiago , McCleary‐Wheeler Angela L. , Duhamel Gerald E. , Heikinheimo Kristiina , Grenier Jennifer K.
Published: August 2019

The cover image is based on the SHORT COMMUNICATION Ultra‐frequent HRAS p.Q61R somatic mutation in canine acanthomatous ameloblastoma reveals pathogenic similarities with human ameloblastoma by Santiago Peralta et al., https://doi.org/10.1111/vco.12487.

image
‘One step closer’: Acceptability of a programme of plasma donation for fractionation from men who have sex with men
Authors: Caruso Jessica , Germain Marc , Godin Gaston , Myhal Geneviève , Pronovost Frédérick , Morin Michel , Otis Joanne
Published: August 2019

Background and objectives

In Canada, Héma‐Québec is considering the possibility of allowing men who have sex with men (MSM) to donate plasma for fractionation combined with a mandatory quarantine period. This study aims to assess the acceptability and operational feasibility of the programme in the targeted population.

Materials and methods

Seven focus groups with MSM (N = 47) were conducted in Montréal, regarding their beliefs underlying attitudes, subjective norms and perceived behavioural control relating to intention to participate in a programme of plasma donation for fractionation. A theoretical thematic content analysis was realized.

Results

Participants brought up benefits of the programme. Some are altruistic (help others, save lives, contribute as citizens), while others are linked to what it could bring to their community (progress, opportunity to include MSM in blood donation programmes, acknowledgement of MSM's contributions to the well‐being of others). However, even if the programme is in accordance with their altruistic values, it clashes with their values of equality and social justice. Many disadvantages were raised (discrimination and stigmatization of MSM, the fact that their blood is presented as being not as good as the blood of others). Facilitating factors and barriers to participation were put forward in terms of programme characteristics and sites where donations would be made.

Conclusion

The findings suggest some interest in the programme of plasma donation for fractionation, but this is significantly tempered by the fact that differential treatment for MSM would continue and that their demands regarding access to whole blood donation are still unmet.
Effects of affricate's aspiration on realization and perception of lexical tones in Standard Chinese
Authors: Cao Chong , Zhang Jinsong
Published: August 2019

Consonants in /CV/ (i.e., a consonant + a vowel) syllables usually have potential influence on onset fundamental frequency (i.e., onset f0) of the following vowel. Previous research on effects of consonant's aspiration on onset f0 has mainly considered the stops. This study investigates not only the effects of aspiration with evidence from affricates, but also the effects of different language speakers (Japanese vs Chinese), on the onset f0 of the following vowel. Through examining acoustic data of f0 realization and perception data of two physical continua of f0 contours, it is observed that the onset f0 following aspirated affricates was higher than that following unaspirated affricates, but the magnitudes of differences varied with tones. Perception data of two physical continua indicated that a tone carried by aspirated affricates (or unaspirated affricates) tended to be perceived as the tone which has relatively lower (or higher) onset f0. Both the realization and perception performance of Japanese speakers resembled that of Chinese speakers, which may further confirm the hypothesis that the f0 perturbation caused by aspiration belongs to phonemic processing instead of phonological processing.
A Nascent Sport for Development and Peace Organization’s Response to Institutional Complexity: The Emergence of a Hybrid Agency in Kenya
Authors: Dixon Marlene A. , Svensson Per G.
Published: August 2019

Sport for development and peace (SDP) agencies increasingly deal with complex institutional demands. In this article, the authors present an in-depth case study of how a nascent SDP organization created from within a local community in Kenya responded to institutional complexity through a series of pivotal moments that shaped the nature of the SDP agency. Throughout the formative stage in its life course, organizational leaders faced increased institutional complexity as they grappled with a series of incompatible prescriptions and demands from multiple institutional logics. The case organization—Highway of Hope—responded to this complexity through a process of organizational hybridity. Five pivotal decision points were identified and analyzed to explore how they shaped the organization over its early stages of existence. Our findings provide guidance for advancing our understanding of hybridity processes in SDP, both theoretically and practically.
Iridescence-controlled and flexibly tunable retroreflective structural color film for smart displays
Authors: Fan Wen , Zeng Jing , Gan Qiaoqiang , Ji Dengxin , Song Haomin , Liu Wenzhe , Shi Lei , Wu Limin
Published: August 2019

A monolayer array of air-cushioned polymer microspheres produces smart retroreflective structural colors.
Replication of Coxiella burnetii in a Lysosome-Like Vacuole Does Not Require Lysosomal Hydrolases
Authors: Miller Heather E. , Hoyt Forrest H. , Heinzen Robert A.
Published: August 2019

Coxiella burnetii
is an intracellular bacterium that causes query, or Q fever, a disease that typically manifests as a severe flu-like illness. The initial target of
C. burnetii
is the alveolar macrophage. Here, it regulates vesicle trafficking pathways and fusion events to establish a large replication vacuole called the
Coxiella
-containing vacuole (CCV). Similar to a phagolysosome, the CCV has an acidic pH and contains lysosomal hydrolases obtained via fusion with late endocytic vesicles.
Evaluation of the Modified Two-Tiered Testing Method for Diagnosis of Lyme Disease in Children
Authors: Lipsett Susan C. , Branda John A. , Nigrovic Lise E.
Published: August 2019

Conventional two-tiered testing (CTTT) for Lyme disease includes a first-tier enzyme immunoassay (EIA) followed by a supplemental immunoblot, and modified two-tiered testing (MTTT) relies on two different sequential EIAs without the inclusion of an immunoblot. MTTT has shown promising results as an alternative strategy for the diagnosis of Lyme disease in adults but has not yet been evaluated in children.
Sclerosing mucoepidermoid carcinoma with eosinophilia of thyroid
Authors: Iftikhar Haissan , Awan Muhammad Sohail , Ghaloo Shayan Khalid , Fatima Saira
Published: August 2019

Sclerosing mucoepidermoid carcinoma of the thyroid was first reported in 1991. This tumour type may develop as associated to Hashimoto thyroiditis. There are two variants of mucoepidermoid carcinoma of thyroid. The conventional and the sclerosing variants. Sclerosing mucoepidermoid carcinoma with eosinophilia of thyroid (SCME) has recently been recognised as a separate disease entity by the WHO. We report a case of SCME in a 62-year-old male patient who presented with a painless anterior neck swelling. Total thyroidectomy was performed, and no adjuvant treatment administered. The patient remained disease free up until 10 months of follow-up. Approximately 40 cases are reported in literature. We report the second case of SCME in Asian men. Sclerosing mucoepidermoid carcinoma with eosinophilia of thyroid should be differentiated from the conventional mucoepidermoid carcinoma. Patients should also be advised of long-term follow-up for surveillance.
Effectiveness and safety of Chinese herbal medicine xuanbi antong granules for the treatment of borderline coronary lesions: study protocol for a randomised, double-blinded, placebo-controlled, multicentre clinical trial
Authors: Huang Mingyan , Chen Guang , Guan Qingya , Liu Chao , Zhao Qing , Li Jun , Yao Kuiwu , Zhang Zhenpeng , He Haoqiang , Li Yi , Lin Fei , He Xinhui , Liu Yongmei , Xiong Xing-jiang , Zhang Yuqing , Han Mei , Wang Jie
Published: August 2019

Introduction

As the early stage of coronary heart disease (CHD), borderline coronary lesion (BCL) is defined as a 30%–70% diameter stenosis. Previous studies have demonstrated that BCL may progress to acute coronary syndrome easily. However, routine medications available for the treatments of BCL have some limitations. Xuanbi antong granule (XAG) has been used for the treatment of BCL in China for many years. Previous studies have shown that XAG has effectiveness in improving clinical symptoms and quality of life in patients with CHD. This study aims to evaluate the effectiveness and safety of XAG in patients with BCL.

Methods and analysis

This is a multicentre, randomised, double-blinded, placebo-controlled clinical trial. A total of 300 participants will be randomly assigned to the intervention group and the placebo group. Based on routine medications, the intervention group will be treated with XAG and the placebo group will be treated with XAG placebo. All participants will receive a 6-month treatment and then be followed-up for another 6 months. The primary outcomes are the changes of target plaque characteristics (including target plaque volume, degree of stenosis, CT value and calcification score) measured by dual source CT angiography. The secondary outcomes include blood lipid indicators, efficacy of angina symptoms, Seattle Angina Questionnaire, high-sensitivity C-reactive protein and occurrence of major adverse cardiac events. All the data will be recorded in electronic case report forms and analysed by SPSS V.20.0.

Ethics and dissemination

This study has been approved by Research Ethics Committee of Guang’anmen Hospital, China Academy of Chinese Medical Sciences in Beijing, China (No. 2017–083-KY-01). Written informed consent will be obtained from all participants. The results of this study will be disseminated to the public through academic conferences and peer-reviewed journals.

Trial registration number

ChiCTR-IOR-17013189; Pre-results.
Glutathione infusion before primary percutaneous coronary intervention: a randomised controlled pilot study
Authors: Tanzilli Gaetano , Truscelli Giovanni , Arrivi Alessio , Carnevale Roberto , Placanica Attilio , Viceconte Nicola , Raparelli Valeria , Mele Rita , Cammisotto Vittoria , Nocella Cristina , Barillà Francesco , Lucisano Luigi , Pennacchi Mauro , Granatelli Antonino , Dominici Marcello , Basili Stefania , Gaudio Carlo , Mangieri Enrico
Published: August 2019

Objective

In the setting of reperfused ST-elevation myocardial infarction (STEMI), increased production of reactive oxygen species (ROS) contributes to reperfusion injury. Among ROS, hydrogen peroxide (H2O2) showed toxic effects on human cardiomyocytes and may induce microcirculatory impairment. Glutathione (GSH) is a water-soluble tripeptide with a potent oxidant scavenging activity. We hypothesised that the infusion of GSH before acute reoxygenation might counteract the deleterious effects of increased H2O2generation on myocardium.

Methods

Fifty consecutive patients with STEMI, scheduled to undergo primary angioplasty, were randomly assigned, before intervention, to receive an infusion of GSH (2500 mg/25 mL over 10 min), followed by drug administration at the same doses at 24, 48 and 72 hours elapsing time or placebo. Peripheral blood samples were obtained before and at the end of the procedure, as well as after 5 days. H2O2production, 8-iso-prostaglandin F2α (PGF2α) formation, H2O2breakdown activity (HBA) and nitric oxide (NO) bioavailability were determined. Serum cardiactroponin T (cTpT) was measured at admission and up to 5 days.

Results

Following acute reperfusion, a significant reduction of H2O2production (p=0.0015) and 8-iso-PGF2α levels (p=0.0003), as well as a significant increase in HBA (p<0.0001)and NO bioavailability (p=0.035), was found in the GSH group as compared with placebo. In treated patients, attenuated production of H2O2persisted up to 5 days from the index procedure (p=0.009) and these changes was linked to those of the cTpT levels (r=0.41, p=0.023).

Conclusion

The prophylactic and prolonged infusion of GSH seems to determine a rapid onset and persistent blunting of H2O2generation improving myocardial cell survival. Nevertheless, a larger trial, adequately powered for evaluation of clinical endpoints, is ongoing to confirm the current finding.

Trial registration number

EUDRACT 2014-00448625; Pre-results.
Global patterns in price elasticities of sugar-sweetened beverage intake and potential effectiveness of tax policy: a cross-sectional study of 164 countries by sex, age and global-income decile
Authors: Muhammad Andrew , Meade Birgit , Marquardt David R , Mozaffarian Dariush
Published: August 2019

Objective

To quantify global relationships between sugar-sweetened beverage (SSB) intake and prices and examine the potential effectiveness of tax policy.

Design

SSB intake data by country, age and sex from the Global Dietary Database were combined with gross domestic product and price data from the World Bank. Intake responsiveness to income and prices was estimated accounting for national income, age and sex differences.

Setting

164 countries.

Population

Full adult population in each country.

Main outcome measures

A consumer demand modelling framework was used to estimate the relationship between SSB intake and prices and derive own-price elasticities (measures of percentage changes in intake from a 1% price change) globally by age and sex. We simulated how a 20% tax would impact SSB intake globally. Tax policy outcomes were examined across countries by global income decile for representative age and sex subgroups.

Results

Own-price responsiveness was highest in lowest income countries, ranging from −0.70 (p<0.100) for women, age 50, to −1.91 (p<0.001) for men, age 80. In the highest income countries, responsiveness was as high as −0.49 (p<0.001) (men, age 20), but was mostly insignificant for older adults. Overall, elasticities were strongest (more negative) at the youngest and oldest age groups, and mostly insignificant for middle-aged adults, particularly in middle-income and high-income countries. Sex differences were mostly negligible. Potential intake reductions from a 20% tax in lowest income countries ranged from 14.5% (95% CI: 29.5%, −0.4%) in women, 35 ≤ age < 60, to 24.9% (44.4%, 5.3%) in men, age ≥60. Intake reductions decreased with country income overall, and were mostly insignificant for middle-aged adults.

Conclusions

These findings estimate the global price-responsiveness of SSB intake by age and sex, informing ongoing policy discussions on potential effects of taxes.
Implementation strategies for interventions to improve the management of chronic kidney disease (CKD) by primary care clinicians: protocol for a systematic review
Authors: Kamath Celia C , Dobler Claudia C , Lampman Michelle A , Erwin Patricia J , Matulis John , Elrashidi Muhamad , McCoy Rozalina Grubina , Alsawaz Mouaz , Pajouhi Atieh , Vasdev Amrit , Shah Nilay D , Murad M Hassan , Thorsteinsdottir Bjorg
Published: August 2019

Introduction

There is a considerable implementation gap in managing early stage chronic kidney disease (CKD) in primary care despite the high prevalence and risk for increased morbidity and mortality associated with CKD. This systematic review aims to synthesise the evidence of efficacy of implementation interventions aimed at primary care practitioners (PCPs) to improve CKD identification and management. We further aim to describe the interventions’ behavioural change components.

Methods and analysis

We will conduct a systematic review of studies from 2000 to October 2017 that evaluate implementation interventions targeting PCPs and which include at least one clinically meaningful CKD outcome. We will search several electronic data bases and conduct reference mining of related systematic reviews and publications. An interdisciplinary team will independently and in duplicate, screen publications, extract data and assess the risk of bias. Clinical outcomes will include all clinically meaningful medical management outcomes relevant to CKD management in primary care such as blood pressure, chronic heart disease and diabetes target achievements. Quantitative evidence synthesis will be performed, where possible. Planned subgroup analyses include by (1) study design, (2) length of follow-up, (3) type of intervention, (4) type of implementation strategy, (5) whether a behavioural or implementation theory was used to guide study, (6) baseline CKD severity, (7) patient minority status, (8) study location and (9) academic setting or not.

Ethics and dissemination

Approval by research ethics board is not required since the review will only include published and publicly accessible data. Review findings will inform a future trial of an intervention to promote uptake of CKD diagnosis and treatment guidelines in our primary care setting and the development of complementary tools to support its successful adoption and implementation. We will publish our findings in a peer-reviewed journal and develop accessible summaries of the results.

PROSPERO registration number

CRD42018102441.
VOC biomarkers identification and predictive model construction for lung cancer based on exhaled breath analysis: research protocol for an exploratory study
Authors: Li Wenwen , Dai Wei , Liu Mingxin , Long Yijing , Wang Chunyan , Xie Shaohua , Liu Yuanling , Zhang Yinchenxi , Shi Qiuling , Peng Xiaoqin , Liu Yifeng , Li Qiang , Duan Yixiang
Published: August 2019

Introduction

Lung cancer is the most common cancer and the leading cause of cancer death in China, as well as in the world. Late diagnosis is the main obstacle to improving survival. Currently, early detection methods for lung cancer have many limitations, for example, low specificity, risk of radiation exposure and overdiagnosis. Exhaled breath analysis is one of the most promising non-invasive techniques for early detection of lung cancer. The aim of this study is to identify volatile organic compound (VOC) biomarkers in lung cancer and to construct a predictive model for lung cancer based on exhaled breath analysis.

Methods and analysis

The study will recruit 389 lung cancer patients in one cancer centre and 389 healthy subjects in two lung cancer screening centres. Bio-VOC breath sampler and Tedlar bag will be used to collect breath samples. Gas chromatography-mass spectrometry coupled with solid phase microextraction technique will be used to analyse VOCs in exhaled breath. VOC biomarkers with statistical significance and showing abilities to discriminate lung cancer patients from healthy subjects will be selected for the construction of predictive model for lung cancer.

Ethics and dissemination

The study was approved by the Ethics Committee of Sichuan Cancer Hospital on 6 April 2017 (No. SCCHEC-02-2017-011). The results of this study will be disseminated in presentations at academic conferences, publications in peer-reviewed journals and the news media.

Trial registration number

ChiCTR-DOD-17011134; Pre-results.
Measuring coordination between women’s self-help groups and local health systems in rural India: a social network analysis
Authors: Ruducha Jenny , Hariharan Divya , Potter James , Ahmad Danish , Kumar Sampath , Mohanan P S , Irani Laili , Long Katelyn N G
Published: August 2019

Objectives

To assess how the health coordination and emergency referral networks between women’s self-help groups (SHGs) and local health systems have changed over the course of a 2-year learning phase of the Uttar Pradesh Community Mobilization Project, India.

Design

A pretest, post-test programme evaluation using social network survey to analyse changes in network structure and connectivity between key individuals and groups.

Setting

The study was conducted in 18 villages located in three districts in Uttar Pradesh, India.

Intervention

To improve linkages and coordination between SHGs and government health providers by building capacity in leadership, management and community mobilisation skills of the SHG federation.

Participants

A purposeful sampling that met inclusion criteria. 316 respondents at baseline and 280 respondents at endline, including SHG members, village-level and block-level government health workers, and other key members of the community (traditional birth attendants, drug sellers, unqualified rural medical providers, pradhans or elected village heads, and religious leaders).

Main outcome measures

Social network analysis measured degree centrality, density and centralisation to assess changes in health services coordination networks at the village and block levels.

Results

The health services coordination and emergency referral networks increased in density and the number of connections between respondents as measured by average degree centrality have increased, along with more diversity of interaction between groups. The network expanded relationships at the village and block levels, reflecting the rise of bridging social capital. The accredited social health activist, a village health worker, occupied the central position in the network, and her role expanded to sharing information and coordinating services with the SHG members.

Conclusions

The creation of new partnerships between traditionally under-represented communities and local government can serve as vehicle for building social capital that can lead to a more accountable and accessible community health delivery system.
Acupotomy versus acupuncture for cervical spondylotic radiculopathy: protocol of a systematic review and meta-analysis
Authors: Chen Bin , Zhang Cai , Zhang Ren-Pan , Lin An-Yang , Xiu Zhong-Biao , Liu Jing , Zhao Hong-Jia
Published: August 2019

Introduction

Cervical spondylotic radiculopathy (CSR) is the most common pattern of cervical spondylosis, which is a serious and common degenerative disease. Both acupotomy and acupuncture have been widely used clinically to treat CSR in China with satisfied efficacy. However, there is no systematic review comparing the effectiveness of these two therapies. The aim of this study is to compare the therapeutic efficacy and safety between acupotomy and acupuncture for patients with CSR to provide evidence for clinical practice.

Methods and analysis

The following electronic databases will be searched: Web of Science, PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure , China Biology Medicine disc, Wanfang Database and Chinese Scientific Journal Database (VIP). The randomised controlled trials of acupotomy versus acupuncture with/without additional treatment for CSR will be searched in the databases from their inception to December 2018 by two researchers independently. Visual analogue scale, symptom score and neck disability index will be assessed as the primary outcomes. The total effective rate, curative rate, adverse events and amount of rescue medication used will be assessed as the secondary outcomes. The Review Manager 5.3 will be used for meta-analysis and the evidence level will be assessed by using the method for Grading of Recommendations Assessment, Development and Evaluation. Continuous outcomes will be presented as the weighted mean difference or standardised mean difference with 95% CI, whereas dichotomous data will be expressed as relative risk with 95% CI. If the included studies have existing heterogeneity (p<0.05), then a random-effects model will be used. Otherwise, we will calculate using a fixed-effects model.

Ethics and dissemination

Ethical approval is not required because no primary data are collected. This review will be published in a peer-reviewed journal and will be presented at an international academic conference for dissemination.

PROSPERO registration number

CRD42019117348.
Randomised controlled trial conducted in injecting equipment provision sites to compare the effectiveness of different hepatitis C treatment regimens in people who inject drugs: A Direct obserVed therApy versus fortNightly CollEction study for HCV treatment—ADVANCE HCV protocol study
Authors: Inglis Sarah K , Beer Lewis JZ , Byrne Christopher , Malaguti Amy , Robinson Emma , Sharkey Christian , Gillings Kirsty , Stephens Brian , Dillon John F
Published: August 2019

Introduction

Hepatitis C is a blood-borne virus (HCV) that can seriously damage the liver and is spread mainly through blood-to-blood contact with an infected person. Over 85% of individuals who have HCV in Scotland became infected following injecting drug use. Since people who inject drugs (PWID) are the main source of new infections, theoretical modelling has suggested that treatment of HCV infection in PWID may effectively reduce HCV prevalence and accomplish elimination. This protocol describes a clinical trial delivering HCV treatment within injecting equipment provision sites (IEPS) in Tayside, Scotland.

Methods and analysis

PWID attending IEPS are tested for HCV and, if they are chronically infected with HCV and eligible, invited to receive treatment within the IEPS. They are randomised to one of three treatment regimens; daily observed treatment, treatment dispensed every 2 weeks and treatment dispensed every 2 weeks together with an adherence psychological intervention (administered before treatment begins). The primary outcome is comparison of the rate of successful treatment (SVR12) in each treatment group. Secondary analyses include assessment of adherence, reinfection rates, viral resistance to treatment and interaction of the treatment with illicit drugs.

Ethics and dissemination

The ADVANCE (A Direct obserVed therApy versus fortNightly CollEction) HCV trial was given favourable opinion by East of Scotland Research Ethics Committee (LR/17/ES/0089) prior to commencement.

Trial registration numbers

European Clinical Trials Database (EudraCT) (2017-001039-38) and ClinicalTrials.gov (NCT03236506).