bluuebunny/crossref_metadata_2025 huggingface dataset:
Sex Classification by Resting State Brain Connectivity
Authors: Weis Susanne , Patil Kaustubh R , Hoffstaedter Felix , Nostro Alessandra , Yeo B T Thomas , Eickhoff Simon B
Published: May 2019

A large amount of brain imaging research has focused on group studies delineating differences between males and females with respect to both cognitive performance as well as structural and functional brain organization. To supplement existing findings, the present study employed a machine learning approach to assess how accurately participants’ sex can be classified based on spatially specific resting state (RS) brain connectivity, using 2 samples from the Human Connectome Project (n1 = 434, n2 = 310) and 1 fully independent sample from the 1000BRAINS study (n = 941). The classifier, which was trained on 1 sample and tested on the other 2, was able to reliably classify sex, both within sample and across independent samples, differing both with respect to imaging parameters and sample characteristics. Brain regions displaying highest sex classification accuracies were mainly located along the cingulate cortex, medial and lateral frontal cortex, temporoparietal regions, insula, and precuneus. These areas were stable across samples and match well with previously described sex differences in functional brain organization. While our data show a clear link between sex and regionally specific brain connectivity, they do not support a clear-cut dimorphism in functional brain organization that is driven by sex alone.
Regional Specialization and Coordination Within the Network for Perceiving and Knowing About Others
Authors: Aglinskas Aidas , Fairhall Scott L
Published: May 2019

Seeing familiar faces prompts the recall of diverse kinds of person-related knowledge. How this information is encoded within the well-characterized face-/person-selective network remains an outstanding question. In this functional magnetic resonance imaging study, participants rated famous faces in 10 tasks covering 5 domains of person knowledge (social, episodic, semantic, physical, and nominal). Comparing different cognitive domains enabled us to 1) test the relative roles of brain regions in specific cognitive processes and 2) apply a multivariate network-level representational similarity analysis (NetRSA) to gain insight into underlying system-level organization. Comparing across cognitive domains revealed the importance of multiple domains in most regions, the importance of social over nominal knowledge in the anterior temporal lobe, and the functional subdivision of the temporoparietal junction into perceptual superior temporal sulcus and knowledge-related angular gyrus. NetRSA revealed a strong divide between regions implicated in ``default-mode” cognition and the fronto-lateral elements that coordinated more with ``core” perceptual components (fusiform/occipital face areas and posterior superior temporal sulcus). NetRSA also revealed a taxonomy of cognitive processes, with semantic retrieval being more similar to episodic than nominal knowledge. Collectively, these results illustrate the importance of coordinated activity of the person knowledge network in the instantiation of the diverse cognitive capacities of this system.
Prevalence of and Risk Factors for Anal High-grade Squamous Intraepithelial Lesions in Women Living with Human Immunodeficiency Virus
Authors: Stier Elizabeth A , Lensing Shelly Y , Darragh Teresa M , Deshmukh Ashish A , Einstein Mark H , Palefsky Joel M , Jay Naomi , Berry-Lawhorn J Michael , Wilkin Timothy , Wiley Dorothy J , Barroso Luis F , Cranston Ross D , Levine Rebecca , Guiot Humberto M , French Audrey L , Citron Deborah , Rezaei M Katayoon , Goldstone Stephen E , Chiao Elizabeth
Published: May 2019

Background

Women living with human immunodeficiency virus (WLHIV) have disproportionately high rates of squamous cell carcinoma of the anus compared with the general population of women. Anal high-grade squamous intraepithelial lesions (HSILs) precede anal cancer, and accurate studies of HSIL prevalence among WLHIV in the United States are lacking.

Methods

The AIDS Malignancy Consortium 084 study was a multicenter national trial to evaluate the prevalence of and risk factors for anal HSIL in a US cohort. Eligible participants were WLHIV aged ≥18 years with no history of anal HSIL. Study participants had an examination including collection of cervical/vaginal and anal specimens, followed by high-resolution anoscopy with biopsy.

Results

We enrolled 256 women with evaluable anal pathology. The mean age was 49.4 years, 64% women were non-Hispanic black, 67% were former or current smokers, and 56% reported ever having anal sex with a man. The median CD4 T-cell count was 664 cells/μL. The prevalence of anal histologic HSIL (hHSIL) was 27% (95% confidence interval [CI], 22%–33%). There was a strong concordance (240/254) between local and consensus pathologists for hHSIL vs less than hHSIL (κ = 0.86 [95% CI, .79–.93]). Current CD4 count of ≤200 cells/μL was the strongest predictor of consensus anal hHSIL diagnosis (adjusted odds ratio [aOR], 10.34 [95% CI, 3.47–30.87]). History of anoreceptive intercourse was also associated with hHSIL (aOR, 2.44 [95% CI, 1.22–4.76]).

Conclusions

The prevalence of anal hHSIL in WLHIV in the United States was 27% in this study where all participants received high-resolution anoscopy and biopsy.
Dose, Timing, and Type of Infant Antibiotic Use and the Risk of Childhood Asthma
Authors: Donovan Brittney M , Abreo Andrew , Ding Tan , Gebretsadik Tebeb , Turi Kedir N , Yu Chang , Ding Juan , Dupont William D , Stone Cosby A , Hartert Tina V , Wu Pingsheng
Published: May 2019

Background

Aspects of infant antibiotic exposure and its association with asthma development have been variably explored. We aimed to evaluate comprehensively and simultaneously the impact of dose, timing, and type of infant antibiotic use on the risk of childhood asthma.

Methods

Singleton, term-birth, non–low-birth-weight, and otherwise healthy children enrolled in the Tennessee Medicaid Program were included. Infant antibiotic use and childhood asthma diagnosis were ascertained from prescription fills and healthcare encounter claims. We examined the association using multivariable logistic regression models.

Results

Among 152 622 children, 79% had at least 1 antibiotic prescription fill during infancy. Infant antibiotic use was associated with increased odds of childhood asthma in a dose-dependent manner, with a 20% increase in odds (adjusted odds ratio [aOR], 1.20 [95% confidence interval {CI}, 1.19–1.20]) for each additional antibiotic prescription filled. This significant dose-dependent relationship persisted after additionally controlling for timing and type of the antibiotics. Infants who had broad-spectrum-only antibiotic fills had increased odds of developing asthma compared with infants who had narrow-spectrum-only fills (aOR, 1.10 [95% CI, 1.05–1.19]). There was no significant association between timing, formulation, anaerobic coverage, and class of antibiotics and childhood asthma.

Conclusions

We found a consistent dose-dependent association between antibiotic prescription fills during infancy and subsequent development of childhood asthma. Our study adds important insights into specific aspects of infant antibiotic exposure. Clinical decision making regarding antibiotic stewardship and prevention of adverse effects should be critically assessed prior to use during infancy.
First Recognized Human Bite in the United States by the Asian Longhorned Tick, Haemaphysalis longicornis
Authors: Wormser Gary P , McKenna Donna , Piedmonte Nicholas , Vinci Vanessa , Egizi Andrea M , Backenson Bryon , Falco Richard C
Published: May 2019

We present the case summary of the first human recognized to have been bitten by the Haemaphysalis longicornis tick in the United States, which occurred in New York State. Subsequent field studies confirmed that this tick was present in multiple geographic locations near the patient’s residence, including on manicured lawns.
Gut Resistome After Oral Antibiotics in Preschool Children in Burkina Faso: A Randomized, Controlled Trial
Authors: Oldenburg Catherine E , Hinterwirth Armin , Sié Ali , Coulibaly Boubacar , Ouermi Lucienne , Dah Clarisse , Tapsoba Charlemagne , Cummings Milo E , Zhong Lina , Chen Cindi , Sarkar Samarpita , Bärnighausen Till , Lietman Thomas M , Keenan Jeremy D , Doan Thuy
Published: May 2019

We evaluated the effect of systemic antibiotics (azithromycin, amoxicillin, cotrimoxazole, or placebo) on the gut resistome in children aged 6 to 59 months. Azithromycin and cotrimoxazole led to an increase in macrolide and sulfonamide resistance determinants. Resistome expansion can be induced with a single course of antibiotics.
Impact of 13-Valent Pneumococcal Conjugate Vaccine on Meningitis and Pneumonia Hospitalizations in Children aged <5 Years in Senegal, 2010–2016
Authors: Faye Papa M , Sonko Mouhamadou A , Diop Amadou , Thiongane Aliou , Ba Idrissa D , Spiller Michael , Ndiaye Ousmane , Dieye Baidy , Mwenda Jason M , Sow Ahmed I , Diop Boly , Diallo Aliou , Farrar Jennifer L
Published: May 2019

Background

Senegal introduced a 13-valent pneumococcal conjugate vaccine (PCV13) in October 2013, given at 6, 10, and 14 weeks of age. We document trends of meningitis and pneumonia after the PCV13 introduction.

Methods

From October 2010–October 2016, hospitalization data for clinical meningitis and pneumonia in children aged <5 years were collected from logbooks at a large, tertiary, pediatric hospital in Dakar. We used a set of predetermined keywords to define hospitalizations for extraction from hospital registers. We conducted a time-series analysis and compared hospitalizations before and after the PCV13 introduction, accounting for seasonality. The initial PCV13 uptake period (October 2013–September 2014) was considered to be transitional and was excluded.

Results

Over the 7-year period, 1836 and 889 hospitalizations with a discharge diagnosis of pneumonia and meningitis, respectively, occurred in children aged <5 years. In children aged <12 months, a small, significant reduction in pneumonia was observed post-PCV13 (−3.8%, 95% confidence interval [CI] −1.5 to −5.9%). No decline was observed among children aged 12–59 months (−0.7%, 95% CI −0.8 to 2.2%). Meningitis hospitalizations remained stable for children aged <12 months (1.8%, 95% CI −0.9 to 4.4%) and 12–59 months (−0.5%, 95% CI −3.6 to 2.6%).

Conclusions

We used data from 1 hospital to detect a small, significant reduction in all-cause pneumonia hospitalizations 2 years post-PCV13 introduction in infants; the same trend was not measurable in children aged 12–59 months or in meningitis cases. There is a need for continued surveillance to assess the long-term impact of sustained PCV13 use and to monitor how pneumococcus is causing disease in the meningitis belt.
Semalytics: a semantic analytics platform for the exploration of distributed and heterogeneous cancer data in translational research
Authors: Mignone Andrea , Grand Alberto , Fiori Alessandro , Medico Enzo , Bertotti Andrea
Published: May 2019

Each cancer is a complex system with unique molecular features determining its dynamics, such as its prognosis and response to therapies. Understanding the role of these biological traits is fundamental in order to personalize cancer clinical care according to the characteristics of each patient’s disease. To achieve this, translational researchers propagate patients’ samples through in vivo and in vitro cultures to test different therapies on the same tumor and to compare their outcomes with the molecular profile of the disease. This in turn generates information that can be subsequently translated into the development of predictive biomarkers for clinical use. These large-scale experiments generate huge collections of hierarchical data (i.e. experimental trees) with relative annotations that are extremely difficult to analyze. To address such issues in data analyses, we came up with the Semalytics data framework, the core of an analytical platform that processes experimental information through Semantic Web technologies. Semalytics allows (i) the efficient exploration of experimental trees with irregular structures together with their annotations. Moreover, (ii) the platform links its data to a wider open knowledge base (i.e. Wikidata) to add an extended knowledge layer without the need to manage and curate those data locally. Altogether, Semalytics provides augmented perspectives on experimental data, allowing the generation of new hypotheses, which were not anticipated by the user a priori.

In this work, we present the data core we created for Semalytics, focusing on its semantic nucleus and on how it exploits semantic reasoning and data integration to tackle issues of this kind of analyses. Finally, we describe a proof-of-concept study based on the examination of several dozen cases of metastatic colorectal cancer in order to illustrate how Semalytics can help researchers generate hypotheses about the role of genes alterations in causing resistance or sensitivity of cancer cells to specific drugs.
PTSD Biomarker Database: deep dive metadatabase for PTSD biomarkers, visualizations and analysis tools
Authors: Domingo-Fernández Daniel , Provost Allison , Kodamullil Alpha Tom , Marín-Llaó Josep , Lasseter Heather , Diaz Kristophe , Daskalakis Nikolaos P , Lancashire Lee , Hofmann-Apitius Martin , Haas Magali
Published: May 2019

The PTSD Biomarker Database (PTSDDB) is a database that provides a landscape view of physiological markers being studied as putative biomarkers in the current post-traumatic stress disorder (PTSD) literature to enable researchers to explore and compare findings quickly. The PTSDDB currently contains over 900 biomarkers and their relevant information from 109 original articles published from 1997 to 2017. Further, the curated content stored in this database is complemented by a web application consisting of multiple interactive visualizations that enable the investigation of biomarker knowledge in PTSD (e.g. clinical study metadata, biomarker findings, experimental methods, etc.) by compiling results from biomarker studies to visualize the level of evidence for single biomarkers and across functional categories. This resource is the first attempt, to the best of our knowledge, to capture and organize biomarker and metadata in the area of PTSD for storage in a comprehensive database that may, in turn, facilitate future analysis and research in the field.
Home Literacy Environment and Emergent Skills in Preschool Children With Hearing Loss
Authors: Reynolds Gabriella , Werfel Krystal L
Published: May 2019

Home literacy practices reported by parents of preschool children with hearing loss were compared to those reported by parents of their peers with typical hearing. Parents completed a questionnaire from Boudreau, D. (2005. Use of a parent questionnaire in emergent and early literacy assessment of preschool children. Language, Speech, and Hearing Services in Schools, 36, 33–47. doi:10.1044/0161-1461(2005/004)) assessing home literacy practices across areas such as parent facilitation of literacy and time spent reading per week. As part of a larger study, children completed language and emergent literacy assessments. Parents of both groups reported similar amounts of time spent reading to their children and scored similarly on report of parent facilitation of literacy, even though children with hearing loss scored lower on measures of emergent literacy. However, parents of children with typical hearing reported that their children had higher engagement and interest in books than children with hearing loss. Additionally, only child engagement with books was correlated with emergent literacy skills and only for children with hearing loss. The results suggest that parent facilitation of literacy alone is not correlated with emergent literacy scores; children must take an active role in their reading development. Children with hearing loss must be active participants during shared book reading. It is therefore essential to develop ways to actively engage children with hearing loss during reading activities.
Determinants and prognostic value of cardiac magnetic resonance imaging-derived infarct characteristics in non-ST-elevation myocardial infarction
Authors: Feistritzer Hans-Josef , Nanos Michael , Eitel Ingo , Jobs Alexander , de Waha-Thiele Suzanne , Meyer-Saraei Roza , Freund Anne , Stiermaier Thomas , Abdel-Wahab Mohamed , Lurz Philipp , Reinstadler Sebastian J , Reindl Martin , Klug Gert , Metzler Bernhard , Desch Steffen , Thiele Holger
Published: May 2019

Aims

The prognostic significance of cardiac magnetic resonance (CMR)-derived infarct characteristics has been demonstrated in ST-elevation myocardial infarction (STEMI) cohorts but is undefined in non-ST-elevation myocardial infarction (NSTEMI) patients. We aimed to investigate determinants and the long-term prognostic impact of CMR imaging-derived infarct characteristics in patients with NSTEMI.

Methods and results

Infarct size (IS), myocardial salvage index (MSI), and microvascular obstruction were assessed using CMR imaging in 284 NSTEMI patients undergoing percutaneous coronary intervention (PCI) in three centres. CMR imaging was performed 3 [interquartile range (IQR) 2–4] days after admission. The primary clinical endpoint was defined as major adverse cardiac events during median follow-up of 4.4 (IQR 3.6–4.9) years. Median IS was 7.2% (IQR 2.2–13.7) of left ventricular (LV) myocardial mass (%LV) and MSI was 65.7 (IQR 39.3–84.9). Age (P ≤ 0.003), heart rate (P ≤ 0.02), the number of diseased coronary arteries (P ≤ 0.01), and Thrombolysis In Myocardial Infarction (TIMI) flow grade before PCI (P < 0.001) were independent predictors of IS and MSI. The primary endpoint occurred in 64 (22.5%) patients. CMR-derived infarct characteristics had no additional prognostic value beyond LV ejection fraction in multivariable analysis.

Conclusion

In this prospective, multicentre NSTEMI cohort reperfused by PCI, age, heart rate, the number of diseased coronary arteries, and TIMI flow grade before PCI were independent predictors of IS and MSI assessed by CMR. However, in contrast to STEMI patients there was no additional long-term prognostic value of CMR-derived infarct characteristics over and above LV ejection fraction.

Clinicaltrials.gov

NCT03516578.
Preaching Regicide in Jacobean England: John Knight and David Pareus
Authors: Serjeantson Richard
Published: May 2019

On 14 April 1622, John Knight, a theology student at Broadgates Hall, Oxford, delivered a Palm Sunday sermon before his University. In it, Knight defended the thesis that subjects defending themselves on grounds of religion would be justified in taking up arms against their sovereign. This study reconstructs the content of, political context for, and reaction to Knight’s sermon. In establishing the importance for Knight’s sermon of non-English authorities, above all the authoritative Palatine theologian David Pareus and the Lausanne theologian Guillaume Du Buc (Bucanus), it demonstrates that justifications of armed resistance to sovereign powers were widely known in pre-civil war England, but that their expression in English was effectively controlled.
Effect of micro-osteoperforation on the rate of orthodontic tooth movement—a systematic review and a meta-analysis
Authors: Shahabee Mostafa , Shafaee Hooman , Abtahi Mostafa , Rangrazi Abdolrasoul , Bardideh Erfan
Published: May 2019

Background

The micro-osteoperforation can be used to increase the rate of tooth movement, simplify complex orthodontic movements, and also help adjust the anchorage but there are conflicting reports on the effectiveness and adverse effects of this intervention.

Objectives

The aim of our systematic review and meta-analysis was to evaluate the effects of micro-osteoperforation on the rate of tooth movement in patients undergoing orthodontic treatment.

Search methods

A comprehensive search of MEDLINE, ISI web of science, EMBASE, Scopus, and CENTRAL online databases for studies measuring the effects of micro-osteoperforation on the rate of orthodontic tooth movement from inception to February 2019 was performed.

Selection criteria

Based on the PICO model, human studies which evaluated the effects of MOP on the rate of tooth movement in patients undergoing orthodontic treatment were selected for this review.

Data collection and analysis

The relevant data from the eligible studies were extracted using piloted custom extraction forms. The data were combined and analysed using inverse-variance random-effect meta-analysis and the mean difference was used for comparing the outcome measures.

Results

Six randomized clinical trials were finally included in this meta-analysis. The rate of canine retraction per month was significantly higher in the MOP group [mean difference (MD) = 0.45 mm, 95% CI = 0.17–0.74]. These results were similar with regard to different malocclusions, the jaw on which it was performed, and MOP methods. The patients did not report any significant differences in terms of pain severity levels after MOP. With regard to the adverse effects, one study reported higher amounts of root resorption among patients undergoing MOP.

Conclusions

The rate of tooth movement was increased after performing MOP but in at least one study higher root resorption was observed. Therefore, the use of MOP can be recommended after weighing the benefits and disadvantages this intervention can bring for each patient.

Registration

The protocol for this review was registered via crd.york.ac.uk/prospero with the ID CRD42019115499.
Sudden death in cardiac sarcoidosis: an analysis of nationwide clinical and cause-of-death registries
Authors: Ekström Kaj , Lehtonen Jukka , Nordenswan Hanna-Kaisa , Mäyränpää Mikko I , Räisänen-Sokolowski Anne , Kandolin Riina , Simonen Piia , Pietilä-Effati Päivi , Alatalo Aleksi , Utriainen Seppo , Rissanen Tuomas T , Haataja Petri , Kokkonen Jorma , Vihinen Tapani , Miettinen Heikki , Kaikkonen Kari , Kerola Tuomas , Kupari Markku
Published: May 2019

Aims

The present study was done to assess the role of sudden cardiac death (SCD) among the presenting manifestations of and fatalities from cardiac sarcoidosis (CS).

Methods and results

We analysed altogether 351 cases of CS presenting from year 1998 through 2015 in Finland. There were 262 patients with a clinical diagnosis and treatment of CS, 27 patients with an initial lifetime diagnosis of giant cell myocarditis that was later converted to CS, and 62 cases detected at autopsy and identified by screening >820 000 death certificates from the national cause-of-death registry. The total case series comprised 253 females and 98 males aged on average 52 years at presentation. High-grade atrioventricular block was the most common first sign of CS (n = 147, 42%) followed by heart failure (n = 58, 17%), unexpected fatal (n = 38) or aborted (n = 12) SCD (14%), and sustained ventricular tachycardia (n = 48, 14%). Severe coronary artery disease was found at autopsy concomitant with CS in four of the 38 cases presenting with fatal SCD. Of all deaths recorded till the end of 2015, 64% (n = 54/84) were unexpected SCDs from CS that had either been silent during life or defied all attempts at diagnosis. The Kaplan–Meier estimate (95% CI) of survival from symptom onset was 85% (80–90%) at 5 years and 76% (68–84%) at 10 years.

Conclusion

Together fatal and aborted SCD constitute 14% of the presenting manifestations of CS. Nearly two-thirds of all fatalities from CS are caused by undiagnosed granulomas in the heart.
Risk of stroke and other adverse outcomes in patients with perioperative atrial fibrillation 1 year after non-cardiac surgery
Authors: Conen David , Alonso-Coello Pablo , Douketis James , Chan Matthew T V , Kurz Andrea , Sigamani Alben , Parlow Joel L , Wang Chew Yin , Villar Juan C , Srinathan Sadeesh K , Tiboni Maria , Malaga German , Guyatt Gordon , Sivakumaran Soori , Rodriguez Funes Maria-Virginia , Cruz Patricia , Yang Homer , Dresser George K , Alvarez-Garcia Jesus , Schricker Thomas , Jones Philip M , Drummond Leanne W , Balasubramanian Kumar , Yusuf Salim , Devereaux P J
Published: May 2019

Aims

To determine the 1-year risk of stroke and other adverse outcomes in patients with a new diagnosis of perioperative atrial fibrillation (POAF) after non-cardiac surgery.

Methods and results

The PeriOperative ISchemic Evaluation (POISE)-1 trial evaluated the effects of metoprolol vs. placebo in 8351 patients, and POISE-2 compared the effect of aspirin vs. placebo, and clonidine vs. placebo in 10 010 patients. These trials included patients with, or at risk of, cardiovascular disease who were undergoing non-cardiac surgery. For the purpose of this study, we combined the POISE datasets, excluding 244 patients who were in atrial fibrillation (AF) at the time of randomization. Perioperative atrial fibrillation was defined as new AF that occurred within 30 days after surgery. Our primary outcome was the incidence of stroke at 1 year of follow-up; secondary outcomes were mortality and myocardial infarction (MI). We compared outcomes among patients with and without POAF using multivariable adjusted Cox proportional hazards models. Among 18 117 patients (mean age 69 years, 57.4% male), 404 had POAF (2.2%). The stroke incidence 1 year after surgery was 5.58 vs. 1.54 per 100 patient-years in patients with and without POAF, adjusted hazard ratio (aHR) 3.43, 95% confidence interval (CI) 2.00–5.90; P < 0.001. Patients with POAF also had an increased risk of death (incidence 31.37 vs. 9.34; aHR 2.51, 95% CI 2.01–3.14; P < 0.001) and MI (incidence 26.20 vs. 8.23; aHR 5.10, 95% CI 3.91–6.64; P < 0.001).

Conclusion

Patients with POAF have a significantly increased risk of stroke, MI, and death at 1 year. Intervention studies are needed to evaluate risk reduction strategies in this high-risk population.
Vernakalant for cardioversion of recent-onset atrial fibrillation: a systematic review and meta-analysis
Authors: McIntyre William F , Healey Jeff S , Bhatnagar Akash K , Wang Patrick , Gordon Jacob A , Baranchuk Adrian , Deif Bishoy , Whitlock Richard P , Belley-Côté Émilie P
Published: May 2019

Aims

To evaluate the efficacy and safety of vernakalant for the cardioversion of atrial fibrillation (AF).

Methods and results

We reviewed the literature for randomized trials that compared vernakalant to another drug or placebo in patients with AF of onset ≤7 days. We used a random-effects model to combine quantitative data and rated the quality of evidence using the GRADE (Grades of Recommendation, Assessment, Development and Evaluation). From 441 total citations in MEDLINE, EMBASE, and CENTRAL (December 2018), we identified nine trials evaluating 1358 participants. Six trials compared vernakalant to placebo, two trials compared vernakalant to ibutilide, and one trial compared vernakalant to amiodarone. We found significant methodological bias in four trials. For conversion within 90 min, vernakalant was superior to placebo [50% conversion, risk ratio (RR) 5.15; 95% confidence interval (CI); 2.24–11.84, I2 = 91%], whereas we found no significant difference in conversion when vernakalant was compared with an active drug (56% vs. 24% conversion, RR 2.40; 95% CI 0.76–7.58, I2 = 94). Sinus rhythm was maintained at 24 h in 85% (95% CI 80–88%) of patients who converted acutely with vernakalant. Overall, we judged the quality of evidence for efficacy to be low based on inconsistency and suspected publication bias. There was no significant difference in the risk of significant adverse events between vernakalant and comparator (RR 0.95; 95% CI 0.70–1.28, I2 = 0, moderate quality evidence). Vernakalant is safe and effective for rapid and durable restoration of sinus rhythm in patients with recent-onset AF.

Conclusion

Vernakalant should be a first line option for the pharmacological cardioversion of patients with haemodynamically stable recent-onset AF without severe structural heart disease.
Alcohol use among conflict-affected persons in Ukraine: risk factors, coping and access to mental health services
Authors: Ramachandran Anu , Makhashvili Nino , Javakhishvili Jana , Karachevskyy Andriy , Kharchenko Natalia , Shpiker Marina , Ezard Nadine , Fuhr Daniela C , Roberts Bayard
Published: May 2019

Background

There are approximately 1.5 million internally displaced persons (IDPs) in Ukraine as a result of the conflict in eastern Ukraine. Exposure to violence, forced displacement and increased mental disorders are potential risk-factors for alcohol use disorder (AUD). The aim of this study was to estimate the prevalence of and risk factors for AUD among Ukrainian IDPs and investigate the relationship between AUD, mental health service utilization and coping behaviours.

Methods

A nation-wide cross-sectional survey of 2203 IDPs was conducted. Data were collected on AUD [using alcohol use disorder identification test (AUDIT)], mental health disorders, utilization of health services and coping behaviours. Multivariable logistic regression was used to identify risk factors for AUD, and to estimate the odds ratios for the association between alcohol use and utilization of health services and coping behaviours.

Results

Of 2203 IDPs surveyed, 8.4% of men and 0.7% of women screened positive for AUD (AUDIT >7). Among current drinkers, AUD was present in 14.9% of men and 1.8% of women. Age, cumulative trauma exposure and anxiety were significantly associated with AUD in multivariable analysis. Alcohol users were 43% less likely to access health services for mental health compared with non-users. AUD was associated with more negative coping behaviours.

Conclusions

AUD is present within the male Ukrainian IDP population. Alcohol use was significantly associated with lower utilization of mental health services and more negative coping behaviours. AUD screening and low-intensity treatment services should be expanded for IDPs in Ukraine, particularly if integrated into mental health and psychosocial support programmes.
Investigating the process of evidence-informed health policymaking in Bangladesh: a systematic review
Authors: Dodd Madeleine , Ivers Rebecca , Zwi Anthony B , Rahman Aminur , Jagnoor Jagnoor
Published: May 2019

Over the last four decades, Bangladesh has made considerable improvements in population health, this is in part due to the use of evidence to inform policymaking. This systematic review aims to better understand critical factors that have facilitated the diffusion of scientific evidence into multiple phases of health policymaking in Bangladesh. To do this an existing policy framework designed by Shiffman and Smith in 2007, was used to extract and synthesize data from selected policy analyses. This framework was used to ensure the content, context and actors involved with evidence-informed policymaking were considered in each case where research had helped shape a health policy. The ‘PRISMA Checklist’ was employed to design pre-specified eligibility criteria for the selection of information sources, search strategy, inclusion and exclusion criteria, and process of data extraction and synthesis. Through our systematic search conducted from February to May 2017, we initially identified 1859 articles; after removal of duplicates, followed by the screening of titles, abstracts and full-texts, 24 articles were included in the analysis. Health policy issues included the following topics: maternal and child health, tobacco control, reproductive health, infectious disease control and the impact and sustainability of knowledge translation platforms. Findings suggested that research evidence that could be used to meet key targets associated with the Millennium Development Goals (MDGs) were more likely to be considered as a political (and therefore policy) priority. Furthermore, avenues of engagement between research organizations and the government as well as collective action from civil-society organizations were important for the diffusion of evidence into policies. Through this article, it is apparent that the interface between evidence and policy formulation occurs when evidence is, disseminated by a cohesive policy-network with strong leadership and framed to deliver solutions for problems on both the domestic and global development agenda.
Process and Product Innovations from a Statewide Capacity-Building Initiative for Substance Use Treatment and Recovery
Authors: Iachini Aidyn , Seay Kristen , DeHart Dana , Petiwala Aliza , Browne Teri
Published: May 2019

Statewide behavioral health collaborative capacity-building initiatives are designed to support substance use agencies in strengthening their behavioral health services delivery and implementing evidence-supported practices. This study explored the types of innovations resulting from one such statewide behavioral health initiative, as well as the facilitators and barriers to implementing these innovations, from the perspective of the substance use agencies involved in the initiative. Data were collected through semistructured interviews with 67 agency stakeholders and 93 agency progress reports. Results indicated that 161 innovations emerged through this project for the substance use agencies, including staffing; policy, procedure, and technology; partnerships; training and media products; and service innovations. Agency facilitators included collaboration/partnership, project buy-in, and quality of agency staff. Barriers to implementation included lack of collaboration or partnerships, agency infrastructure or climate, lack of project buy-in, and funding and billing issues. The article concludes with a discussion on implications for social work practice in behavioral health.
Cardiovascular disease risk in the siblings of women with polycystic ovary syndrome
Authors: Karthik Subramaniam , Vipin V P , Kapoor Aditya , Tripathi Archana , Shukla Manoj , Dabadghao Preeti
Published: May 2019

STUDY QUESTION

Do the siblings of Asian Indian women with polycystic ovary syndrome (PCOS) manifest increased cardiovascular disease (CVD) risk by carotid intima-media thickness (CIMT) and brachial artery flow-mediated dilatation (FMD)?

SUMMARY ANSWER

Siblings had functional endothelial dysfunction (FMD was reduced) when compared to age and BMI-matched controls while sisters but not brothers had structural endothelial dysfunction (CIMT was increased).

WHAT IS KNOWN ALREADY

Siblings of women with PCOS have increased metabolic risk but it varies with ethnicity. Among Asian Indians the only previous study has shown reduced FMD in brothers.

STUDY DESIGN, SIZE, DURATION

This study was a tertiary care hospital-based cross-sectional case control study in the outpatient department of the endocrine clinic over 18 months. In total, 41 brothers and 35 sisters of women with PCOS (diagnosed by 2003 Rotterdam criteria) were recruited.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Age (±2 years), sex and BMI- (±1 kg/m2) matched controls were selected. Cases and controls underwent clinical and biochemical investigations. Cardiologists performed doppler ultrasonogram to determine CIMT and FMD in a blinded fashion.

MAIN RESULTS AND THE ROLE OF CHANCE

FMD was decreased in brothers [median 12.3% interquartile range (5.1, 19) versus 18.4% (12.6, 21.5), P = 0.002] and in sisters [10.8% (5.8, 17.2) versus 14.7% (11.4, 18.2), P = 0.027] when compared to controls. CIMT was higher in sisters [median 0.4 mm (0.35, 0.5) versus 0.3 mm (0.3, 0.4), P= 0.002] when compared to controls but not in brothers. Metabolic syndrome was more common in brothers (27% versus 5% in controls, P = 0.007) even after matching for age and BMI. Insulin resistance (homeostatic model assessment for insulin resistance and acanthosis) was higher in brothers as compared to controls. Dehydroepiandrosterone sulphate was significantly elevated in brothers.

LIMITATIONS, REASONS FOR CAUTION

There may have been referral bias of patients with PCOS in a tertiary care institute, and the radiological assessment was performed by two cardiologists serially on different time frames over the study duration. Power was only 50% in CIMT for brothers.

WIDER IMPLICATIONS OF THE FINDINGS

Siblings of women with PCOS had higher CVD risk over and above the already pre-existing higher metabolic risk associated with Asian Indian ethnicity and therefore the siblings require vigilant management. Endothelial dysfunction and insulin resistance seems to be a heritable trait of PCOS independent of obesity, which if confirmed in other ethnicities would have important implications.

STUDY FUNDING/COMPETING INTEREST(S)

Funded by Intramural Research Grant (PGI/DIR/RC/943/2013) from the Sanjay Gandhi Postgraduate Institute of Medical Sciences. No competing interests.
The Evolution of CAM Photosynthesis in Australian Calandrinia Reveals Lability in C3+CAM Phenotypes and a Possible Constraint to the Evolution of Strong CAM
Authors: Hancock Lillian P , Holtum Joseph A M , Edwards Erika J
Published: May 2019

Australian Calandrinia has radiated across the Australian continent during the last 30 Ma, and today inhabits most Australian ecosystems. Given its biogeographic range and reports of facultative Crassulacean acid metabolism (CAM) photosynthesis in multiple species, we hypothesized (1) that CAM would be widespread across Australian Calandrinia and that species, especially those that live in arid regions, would engage in strong CAM, and (2) that Australian Calandrinia would be an important lineage for informing on the CAM evolutionary trajectory. We cultivated 22 Australian Calandrinia species for a drought experiment. Using physiological measurements and δ13C values we characterized photosynthetic mode across these species, mapped the resulting character states onto a phylogeny, and characterized the climatic envelopes of species in their native ranges. Most species primarily utilize C3 photosynthesis, with CAM operating secondarily, often upregulated following drought. Several phylogenetically nested species are C3, indicating evolutionary losses of CAM. No strong CAM was detected in any of the species. Results highlight the limitations of δ13C surveys in detecting C3+CAM phenotypes, and the evolutionary lability of C3+CAM phenotypes. We propose a model of CAM evolution that allows for lability and reversibility among C3+CAM phenotypes and C3 and suggest that an annual life-cycle may preclude the evolution of strong CAM.
Motives and Side-Effects of Microdosing With Psychedelics Among Users
Authors: Hutten Nadia R P W , Mason Natasha L , Dolder Patrick C , Kuypers Kim P C
Published: May 2019

Background

Microdosing with psychedelics has gained considerable media attention where it is portrayed as a performance enhancer, especially popular on the work floor. While reports are in general positive, scientific evidence about potential negative effects is lacking aside from the prevalence and motives for use. The present study addressed this gap by surveying psychedelic users about their experience with microdosing including their dosing schedule, motivation, and potential experienced negative effects.

Methods

An online questionnaire was launched on several websites and fora between March and July 2018. Respondents who had consented, were 18 years of age or older, and had experience with microdosing were included in the analyses.

Results

In total, 1116 of the respondents were either currently microdosing (79.5%) or microdosed in the past (20.5%). Lysergic acid diethylamide (10 mcg) and psilocybin (0.5 g) were the most commonly used psychedelics with a microdosing frequency between 2 and 4 times per week. The majority of users, however, were oblivious about the consumed dose. Performance enhancement was the main motive to microdose (37%). The most reported negative effects were of psychological nature and occurred acutely while under the influence.

Conclusion

In line with media reports and anecdotes, the majority of our respondents microdosed to enhance performance. Negative effects occurred mostly acutely after substance consumption. However, the main reason to have stopped microdosing was that it was not effective. Future experimental placebo-controlled studies are needed to test whether performance enhancement can be quantified and to assess potential negative effects after longer term microdosing.
Health students’ knowledge and infectious disease exposure: findings from a cross-sectional study in Namibia
Authors: Rennie Timothy W , Udjombala Bubbles , Chipeio Melody , Kraeker Christian , Hunter Christian J
Published: May 2019

Background

Namibia has recently introduced a number of health training programmes that expose students to infectious disease risks such as human immunodeficiency virus (HIV) and tuberculosis (TB). We explored the knowledge of students in relation to HIV and TB and whether or not there was evidence of exposure.

Methods

We conducted two cross-sectional surveys of Namibian health students (medicine and pharmacy) in 2018.

Results

There was a strong association between knowledge and exposure to HIV, but not TB (i.e. explicit exposure versus latent). Regression analysis suggested the time-related risk (age/year of study) to be predictive of knowledge in both studies. The training rotation in the respiratory unit predicted TB knowledge and post-exposure prophylaxis predicted HIV knowledge.

Conclusions

Knowledge of TB and HIV appears mostly related to the duration of study in health students. Exposure or specific experience may enhance knowledge. Future training in infection control may be better focussed on improving knowledge in earlier years.
Role stress, social support and occupational burnout among physicians in China: a path analysis approach
Authors: Ma Hui , Qiao HuiFen , Qu HaiTao , Wang Hui , Huang Yun , Cheng Hao , Teng ChangJun , Diao KaiLi , Zhang XiangRong , Zhang Ning
Published: May 2019

Background

Occupational burnout in physicians is prevalent and can have many negative effects. The purposes of this study were to explore the prevalence of occupational burnout and to analyze the effects of social support and role stress on occupational burnout among Chinese physicians.

Methods

Using multistage-stratified cluster random sampling, physicians were selected to participate in the study and completed three questionnaires: the Chinese Maslach Burnout Inventory; the Cross-Cultural Role Conflict, Ambiguity and Overload Scale; and the Social Support Rating Scale. A path analysis was run to test the effects of role stress and social support on occupational burnout.

Results

Of 2530 physicians, 864 (34.2%) were experiencing moderate occupational burnout and 140 (5.5%) were experiencing severe occupational burnout. The path analysis results indicated that role conflict had direct positive effects on emotional exhaustion (EE) and depersonalization (DP), and role ambiguity had direct positive effects on DP and decreased personal accomplishment (DPA). Coworker support had direct negative effects on EE and positive effects on DP, family support had direct negative effects on DP and DPA. Coworker support mediated the effects of role ambiguity on EE and DP, and family support mediated the effects of role ambiguity on DP and DPA.

Conclusions

These findings suggest that occupational burnout is common in Chinese physicians, and that role stress and social support play important roles in occupational burnout. Interventions that aim to reduce role stress and increase social support can be effective approaches to prevent occupational burnout among physicians.
Reduction of inappropriate medication in older populations by electronic decision support (the PRIMA-eDS project): a survey of general practitioners’ experiences
Authors: Rieckert Anja , Teichmann Anne-Lisa , Drewelow Eva , Kriechmayr Celine , Piccoliori Giuliano , Woodham Adrine , Sönnichsen Andreas
Published: May 2019

Objective

We sought to investigate the experiences of general practitioners (GPs) with an electronic decision support tool to reduce inappropriate polypharmacy in older patients (the PRIMA-eDS [Polypharmacy in chronic diseases: Reduction of Inappropriate Medication and Adverse drug events in older populations by electronic Decision Support] tool) in a multinational sample of GPs and to quantify the findings from a prior qualitative study on the PRIMA-eDS-tool.

Materials and Methods

Alongside the cluster randomized controlled PRIMA-eDS trial, a survey was conducted in all 5 participating study centers (Bolzano, Italy; Manchester, United Kingdom; Salzburg, Austria; Rostock, Germany; and Witten, Germany) between October 2016 and July 2017. Data were analyzed using descriptive statistics and chi-square tests.

Results

Ninety-one (n = 160) percent of the 176 questionnaires were returned. Thirty-two percent of the respondents reported that they did not cease drugs because of the medication check. The 68% who had discontinued drugs comprise 57% who had stopped on average 1 drug and 11% who had stopped 2 drugs or more per patient. The PRIMA-eDS tool was found to be useful (69%) and the recommendations were found to help to increase awareness (86%). The greatest barrier to implementing deprescribing recommendations was the perceived necessity of the medication (69%). The majority of respondents (65%) would use the electronic medication check in routine practice if it was part of the electronic health record.

Conclusions

GPs generally viewed the PRIMA-eDS medication check as useful and as informative. Recommendations were not always followed due to various reasons. Many GPs would use the medication check if integrated into the electronic health record.
Facing Up To Risk
Authors: Fried Barbara H
Published: May 2019

By banishing decision-making in the face of uncertainty (risk) to the margins of tort theory, nonconsequentialist legal philosophers have obscured the quotidian, unavoidable, and ubiquitous tradeoffs we face in almost every arena of life. This article explores the historical antecedents of the marginalization of risk in contemporary moral philosophy, and details how legal philosophers have deflected the challenge that risk poses to any nonconsequentialist theory of tort liability.
ATP11B deficiency leads to impairment of hippocampal synaptic plasticity
Authors: Wang Jiao , Li Weihao , Zhou Fangfang , Feng Ruili , Wang Fushuai , Zhang Shibo , Li Jie , Li Qian , Wang Yajiang , Xie Jiang , Wen Tieqiao
Published: May 2019

Synaptic plasticity is known to regulate and support signal transduction between neurons, while synaptic dysfunction contributes to multiple neurological and other brain disorders; however, the specific mechanism underlying this process remains unclear. In the present study, abnormal neural and dendritic morphology was observed in the hippocampus following knockout of Atp11b both in vitro and in vivo. Moreover, ATP11B modified synaptic ultrastructure and promoted spine remodeling via the asymmetrical distribution of phosphatidylserine and enhancement of glutamate release, glutamate receptor expression, and intracellular Ca2+ concentration. Furthermore, experimental results also indicate that ATP11B regulated synaptic plasticity in hippocampal neurons through the MAPK14 signaling pathway. In conclusion, our data shed light on the possible mechanisms underlying the regulation of synaptic plasticity and lay the foundation for the exploration of proteins involved in signal transduction during this process.