bluuebunny/crossref_metadata_2025 huggingface dataset:
Mutational spectrum of autosomal recessive limb-girdle muscular dystrophies in a cohort of 112 Iranian patients and reporting of a possible founder effect
Authors: Mojbafan Marzieh , Bahmani Reza , Bagheri Samira Dabbagh , Sharifi Zohreh , Zeinali Sirous
Published: January 2020

Background

Limb-girdle muscular dystrophies are a group of genetically heterogeneous diseases that are inherited in both autosomal dominant (LGMDD) and autosomal recessive forms (LGMDR), the latter is more common especially in populations with high consanguineous marriages like Iran. In the present study, we aimed to investigate the genetic basis of patients who are suspicious of being affected by LGMDR.

DNA samples of 60 families suspected of LGMD were extracted from their whole blood. Four short tandem repeat (STR) markers for each candidate genes related to LGMD R1 (calpain3 related)- R6 (δ-sarcoglycan-related) were selected, and all these 24 STRs were applied in two sets of multiplex PCR. After autozygosity mapping, Sanger sequencing and variant analysis were done. Predicting identified variants’ effect was performed using in-silico tools, and they were interpreted according to the American College of Medical Genomics and Genetics (ACMG) guideline. MLPA was used for those patients who had large deletions.

Fresh muscle specimens were taken from subjects and were evaluated using the conventional panel of histochemical stains.

Results

forty out of sixty families showed homozygote haplotypes in CAPN3, DYSF, SGCA, and SGCB genes. The exons and intron-exon boundaries of the relevant genes were sequenced and totally 38 mutations including CAPN3 (n = 15), DYSF (n = 9), SGCB (n = 11), and SGCA (n = 3) were identified. Five out of them were novel. The most prevalent form of LGMDs in our study was calpainopathy followed by sarcoglycanopathy in which beta-sarcoglycanopathy was the most common form amongst them. Exon 2 deletion in the SGCB gene was the most frequent mutation in this study.

We also reported evidence of a possible founder effect in families with mutations in DYSF and SGCB genes. We also detected a large consanguineous family suffered from calpainopathy who showed allelic heterogeneity.

Conclusions

This study can expand our knowledge about the genetic spectrum of LGMD in Iran, and also suggest the probable founder effects in some Iranian subpopulations which confirming it with more sample size can facilitate our genetic diagnosis and genetic counseling.
Statistical analysis plan for the 5-year and 10-year follow-up assessments of the FIDELITY trial
Authors:   for the Finnish Degenerative Meniscal Lesion Study (FIDELITY) Investigators, Sihvonen Raine , Kalske Roope , Englund Martin , Turkiewicz Aleksandra , Toivonen Pirjo , Taimela Simo , Järvinen Teppo L. N.
Published: January 2020

Background

The research objectives of the 5-year and 10-year assessments in the Finnish degenerative meniscal lesion study (FIDELITY) are twofold: (1) to assess the long-term efficacy of arthroscopic partial meniscectomy (APM) in adults (age 35 to 65 years) with a degenerative meniscus tear and (2) to determine the respective effects of APM and degenerative meniscus tear on the development of radiographic and clinical knee osteoarthritis (OA).

Methods and design

FIDELITY is an ongoing multi-center, randomized, participant and outcome assessor blinded, placebo-surgery-controlled trial in 146 patients. This statistical analysis plan (SAP) article describes the overall principles for analysis of long-term outcomes (5-year and 10-year follow up), including how participants will be included in each analysis, the primary and secondary outcomes and their respective analyses, adjustments for covariates, and the presentation of the results. In addition, we will present the planned sensitivity and subgroup analyses.

Discussion

To assess the long-term efficacy of APM on knee symptoms and function we are carrying out a long-term (5-year and 10-year) follow up of our placebo-surgery-controlled FIDELITY trial according to statistical principles outlined in detail in this document. As our second primary objective, whether APM (resection of torn meniscus tear) accelerates or delays the development of knee osteoarthritis in patients with an arthroscopically verified degenerative tear of the medial meniscus, a pre-registered follow-up is also carried out.

Trial registration

ClinicalTrials.gov, NCT00549172 (Arthroscopy in the Treatment of Degenerative Medial Meniscus Tear). Registered on 25 October 2007 (NCT00549172). ClinicalTrials.gov, NCT01052233 (Development of Knee Osteoarthritis After Arthroscopic Partial Resection of Degenerative Meniscus Tear). Registered on 20 January 2010.
Efficacy of compatible acupoints and single acupoint versus sham acupuncture for functional dyspepsia: study protocol for a randomized controlled trial
Authors: Guo Le , Huang Xin , Ha Li-Juan , Zhang Jing-Zhou , Mi Jia , Sun Ping-Hui , Han Xi-Ying , Wang Ying , Hu Jing-Lin , Wang Fu-Chun , Li Tie
Published: January 2020

Background

Acupoint selection is a key factor in the treatment of diseases and has not been well studied. The aim of this trial is to explore the differences in efficacy between compatible acupoints and a single acupoint for patients with functional dyspepsia (FD).

Methods

This randomized controlled trial will be conducted in the First Affiliated Hospital of Changchun University of Chinese Medicine in China. Two hundred and sixteen FD patients will be randomly assigned to the compatible acupoints group, single acupoint group, or sham acupuncture group. This trial will include a 1-week baseline period, a 4-week treatment period, and a 4-week follow-up period. During the 4-week treatment period, patients will receive 20 sessions of acupuncture (weekly cycles of one session per day for 5 consecutive days followed by a 2-day break). The primary outcome will be a change in the Nepean Dyspepsia Life Quality Index from baseline to after the 4-week treatment period. Secondary outcome measures will include the dyspeptic symptom sum score, Overall Treatment Effect questionnaire, and 36-item Short Form survey. Adverse events also will be recorded. Ultraweak photon emission and metabolomics tests will be performed at baseline and at the end of treatment to explore the mechanisms of the differences between compatible acupoints and a single acupoint.

Discussion

The results of this trial will allow us to compare the difference in efficacy between compatible acupoints and a single acupoint. The findings from this trial will be published in peer-reviewed journals.

Trial registration

Acupuncture-Moxibustion Clinical Trial Registry, AMCTR-IPC-18000176, registered on 4 March 2019; Chinese Clinical Trial Registry, ChiCTR1900023983, registered on 23 June 2019.
Virtual Reality Social Prediction Improvement and Rehabilitation Intensive Training (VR-SPIRIT) for paediatric patients with congenital cerebellar diseases: study protocol of a randomised controlled trial
Authors: Butti Niccolò , Biffi Emilia , Genova Chiara , Romaniello Romina , Redaelli Davide Felice , Reni Gianluigi , Borgatti Renato , Urgesi Cosimo
Published: January 2020

Background

Patients with cerebellar malformations exhibit not only movement problems, but also important deficits in social cognition. Thus, rehabilitation approaches should not only involve the recovery of motor function but also of higher-order abilities such as processing of social stimuli. In keeping with the general role of the cerebellum in anticipating and predicting events, we used a VR-based rehabilitation system to implement a social cognition intensive training specifically tailored to improve predictive abilities in social scenarios (VR-Spirit).

Methods/design

The study is an interventional randomised controlled trial that aims to recruit 42 children, adolescents and young adults with congenital cerebellar malformations, randomly allocated to the experimental group or the active control group. The experimental group is administered the VR-Spirit, requiring the participants to compete with different avatars in the reaching of recreational equipment and implicitly prompting them to form expectations about their playing preference. The active control group participates in a VR-training with standard games currently adopted for motor rehabilitation. Both trainings are composed by eight 45-min sessions and are administered in the GRAIL VR laboratory (Motekforce Link, Netherlands), an integrated platform that allows patients to move in natural and attractive VR environments. An evaluation session in VR with the same paradigm used in the VR-Spirit but implemented in a different scenario is administered at the beginning (T0) of the two trainings (T1) and at the end (T2). Moreover, a battery of neurocognitive tests spanning different domains is administered to all participants at T0, T2 and in a follow-up session after 2 months from the end of the two trainings (T3).

Discussion

This study offers a novel approach for rehabilitation based on specific neural mechanisms of the cerebellum. We aim to investigate the feasibility and efficacy of a new, intensive, social cognition training in a sample of Italian patients aged 7–25 years with congenital cerebellar malformations. We expect that VR-Spirit could enhance social prediction ability and indirectly improve cognitive performance in diverse domains. Moreover, through the comparison with a VR-active control training we aim to verify the specificity of VR-Spirit in improving social perception skills.

Trial registration

ISRCTN, ID: ISRCTN 22332873. Retrospectively registered on 12 March 2018.
Simultaneous reduction of flow and fraction of inspired oxygen (FiO2) versus reduction of flow first or FiO2 first in patients ready to be weaned from high-flow nasal cannula oxygen therapy: study protocol for a randomized controlled trial (SLOWH trial)
Authors: Kim Min Chul , Lee Yeon Joo , Park Jong Sun , Cho Young-Jae , Yoon Ho Il , Lee Choon-Taek , Lee Jae Ho , Kim Eun Sun
Published: January 2020

Background

High-flow nasal cannula (HFNC) oxygen therapy has been widely used in critically ill patients. Despite the effectiveness of HFNC as a treatment, optimal methods to withdraw HFNC after recovery from preexisting conditions have not been investigated to date. In this study, we will evaluate the safety and efficacy of simultaneous reduction of flow and fraction of inspired oxygen (FiO2) compared with sequential reduction of either flow first or FiO2 reduction first in patients with HFNC.

Methods/design

This is a prospective, investigator-initiated, randomized controlled trial with three experimental intervention groups. A total of 100 adult patients receiving HFNC and satisfying weaning criteria will be enrolled and randomly assigned to one of the following groups: flow reduction (FR) first, FiO2 reduction (OR) first, or simultaneous reduction (SR). In the FR group, flow will be reduced first by 10 L/min/h. When it reaches 20 L/min, FiO2 will then be reduced by 0.1 /h until it reaches 0.3. In the OR group, the FiO2 will be gradually reduced first by 0.1 /h until it reaches 0.3, then flow will be reduced by 10 L/min until it reaches 20 L/min. Finally, in the SR group, both the flow and FiO2 will be gradually reduced simultaneously by 10 L/min and 0.1/h, respectively. Weaning will proceed only when patients satisfy the weaning criteria at every weaning point. When the HFNC weaning-off targets are reached (20 L/min and 0.3 for flow and FiO2, respectively), the patient will be transferred to conventional oxygen therapy (mainly low-flow nasal prongs). The primary outcome is the time to successful weaning from HFNC for 24 h. Secondary outcomes will include the success or failure rate in weaning off HFNC and changes in arterial blood gas analyses, intolerance rate, length of hospital stay, and in-hospital mortality.

Discussion

This study will be the first clinical trial to investigate the safety and efficacy of three different methods of weaning in adult patients receiving HFNC. Once this study is completed, we expect to be able to suggest the better strategy for withdrawal of HFNC based on the results.

Trial registration

ClinicalTrials.gov, NCT03845244. Registered on 19 February 2019.
Prevalence of Blastocystis sp. infection in several hosts in Brazil: a systematic review and meta-analysis
Authors: Zanetti Andernice dos Santos , Malheiros Antonio Francisco , de Matos Tatiane Amorim , Longhi Fabiana Gulin , Moreira Luciana Melhorança , Silva Samuel Laudelino , Castrillon Solange Kimie Ikeda , Ferreira Silvana Margarida Benevides , Ignotti Eliane , Espinosa Omar Ariel
Published: January 2020

Background

Blastocystis sp. affects a wide variety of animals and is the most common protozoan in human fecal samples with potential pandemic distribution. In the present study, a systematic review and meta-analysis were conducted to determine the prevalence and distribution of Blastocystis sp. in different classes of hosts in Brazil.

Methods

Studies that analyzed hosts of various classes, including humans, domestic animals, wild animals or captive animals, were considered. The pooled prevalence of Blastocystis sp. infection was estimated by random effects models.

Results

For humans, similar prevalence rates were found for males (31.0%, 95% CI: 17.0–45.0%; weight 10%) and females (28.0%, 95% CI: 16.0–41.0%; weight 10%); the state of Mato Grosso do Sul showed the highest prevalence, with 41.0% positivity (95% CI: 36.0–46.0%; weight 2.9%). The prevalence among immunocompromised patients was 5.0% (95% CI: 3.0–7.0%; weight 10%), and the most common cause of immunosuppression was hemodialysis, with 23.0% (95% CI: 17.0–29.0%; weight 12.4%). Among classifications according to interaction with humans, wild and domestic animals presented values of 19.0% (95% CI: 7.0–31.0%; weight 42.6%) and 17.0% (95% CI: 13.0–21.0%; weight 29.6%), respectively. Among these animals, mammals (39.0%, 95% CI: 21.0–56.0%; weight 47.3%) and birds (18.0%, 95% CI: 10.0–27.0%; weight 39.3%) exhibited the highest prevalence. Phylogenetic analysis of Blastocystis sp. revealed greater genetic diversity for clades of subtypes (STs) ST1, ST2 and ST3.

Conclusions

The overall prevalence of Blastocystis sp. in the Brazilian human population was 24%, which reflects the reality in the South, Southeast and Midwest regions, where prevalence rates of up to 40% were found. Among animals, mammals and birds exhibited the highest prevalence.
Molecular profiling for precision cancer therapies
Authors: Malone Eoghan R. , Oliva Marc , Sabatini Peter J. B. , Stockley Tracy L. , Siu Lillian L.
Published: January 2020

The number of druggable tumor-specific molecular aberrations has grown substantially in the past decade, with a significant survival benefit obtained from biomarker matching therapies in several cancer types. Molecular pathology has therefore become fundamental not only to inform on tumor diagnosis and prognosis but also to drive therapeutic decisions in daily practice. The introduction of next-generation sequencing technologies and the rising number of large-scale tumor molecular profiling programs across institutions worldwide have revolutionized the field of precision oncology. As comprehensive genomic analyses become increasingly available in both clinical and research settings, healthcare professionals are faced with the complex tasks of result interpretation and translation. This review summarizes the current and upcoming approaches to implement precision cancer medicine, highlighting the challenges and potential solutions to facilitate the interpretation and to maximize the clinical utility of molecular profiling results. We describe novel molecular characterization strategies beyond tumor DNA sequencing, such as transcriptomics, immunophenotyping, epigenetic profiling, and single-cell analyses. We also review current and potential applications of liquid biopsies to evaluate blood-based biomarkers, such as circulating tumor cells and circulating nucleic acids. Last, lessons learned from the existing limitations of genotype-derived therapies provide insights into ways to expand precision medicine beyond genomics.
Combatting joint pain and inflammation by dual inhibition of monoacylglycerol lipase and cyclooxygenase-2 in a rat model of osteoarthritis
Authors: Philpott Holly T. , McDougall Jason J.
Published: January 2020

Background

Endocannabinoids are showing great promise as effective mediators for controlling joint inflammation and pain. One strategy that could be harnessed to promote endogenous cannabinoid function is to inhibit the enzymatic break down of endocannabinoids locally in the joint. KML29 is an inhibitor of monoacylglycerol lipase (MAGL) activity which has been shown to promote increased 2-arachodonylglycerol (2-AG) levels in the circulation and in peripheral tissues. It is also known that 2-AG can be metabolised via the cyclo-oxygenase-2 (COX-2) pathway leading to the production of pro-inflammatory prostaglandins, which may counteract the effects of 2-AG. Therefore, this study examined the effect of KML29 alone as well as in combination with low-dose celecoxib (CXB) on joint pain and inflammation in the monoiodoacetate (MIA) model of osteoarthritis (OA) pain.

Methods

Injection of MIA (3 mg) into the knee joints of male Wistar rats was used to model OA pain, inflammation, and nerve damage. Pain behaviour was assessed by von Frey hair algesiometry, and inflammation was evaluated using intravital microscopy to measure leukocyte trafficking in the synovial microvasculature.

Results

Intra-articular injection of MIA produced mechanical hypersensitivity as measured by von Frey hair algesiometry. Local injection of KML29 (700 μg) reduced joint pain at day 14 post-MIA induction, and this analgesic effect was blocked by the cannabinoid receptor antagonists AM281 and AM630 (P < 0.0001; n = 6). During the acute inflammatory phase of the MIA model (day 1), a significant reduction in withdrawal threshold (P < 0.0001; n = 6–8) and leukocyte trafficking was seen after treatment with KML29 + CXB (P < 0.0001; n = 6–8). Early treatment of MIA-injected knees (days 1–3) with KML29 + CXB ameliorated the development of mechanical secondary allodynia (P < 0.0001; n = 8) in the later stages of the MIA model.

Conclusions

Combination therapy of KML29 plus CXB reduced joint pain and inflammation. Thus, dual inhibition of MAGL and cyclooxygenase-2 pathways could be a useful approach to alleviate joint inflammation and pain in OA joints.
Hemiarthroplasty in a patient with femoral neck fracture and pyoderma gangrenosum: a case report and review of the literature
Authors: Antoni Anna , Trautinger Franz , Heinz Thomas , Hajdu Stefan
Published: January 2020

Background

Pyoderma gangrenosum is a rare ulcerating skin disease of unknown etiology, making its coincidence with orthopedic trauma a rare challenge. Patients are at risk of progression of the existing lesions and development of new lesions upon skin injury when surgical procedures are performed. To our knowledge, this is the first report in the literature of disease unrelated surgery during active pyoderma gangrenosum.

Case presentation

We present a case of femoral neck fracture in a Caucasian patient with concurrent pyoderma gangrenosum localized in the axilla. Hemiarthroplasty was safely performed after disease activity was reduced with systemic corticosteroids. Tissue-protective wound closure was used together with perioperative corticosteroids and antibiotics. No signs of pyoderma gangrenosum developed at the surgical wound site, and the axillary lesions showed constant improvement until healing with scar tissue.

Conclusions

In our patient, the preoperative steroid treatment, perioperative antibiotics, and soft tissue protective surgical technique led to successful management of this rare coincidence.
Implementation of a Patient Reported Experience Measure in a Dutch disability care organisation: a qualitative study
Authors: van Rooijen Marjolein , Lenzen Stephanie , Dalemans Ruth , Moser Albine , Beurskens Anna
Published: January 2020

Background

Patient Reported Experience Measures are promoted to be used as an integrated measurement approach in which outcomes are used to improve individual care (micro level), organisational quality (meso level) and external justification (macro level). However, a deeper understanding of implementation issues of these measures is necessary. The narrative Patient Reported Experience Measure “Dit vind ik ervan!” (English “How I feel about it!”) is used in the Dutch disability care sector, but insight into its’ current use is lacking. We aimed to provide insight into experiences with the implementation and current ways of working with “Dit vind ik ervan!” as an integrated measurement strategy.

A descriptive qualitative study was done at a disability care organisation. Data were collected by nine documentations, seven observations, 11 interviews and three focus groups. We applied deductive content analysis using the Consolidated Framework for Implementation Research as a framework.

Results

Our analysis revealed facilitators and barriers for the implementation of “Dit vind ik ervan!”. We found most barriers at the micro level. Professionals and clients appreciated the measure’s narrative approach, but struggled to perform it with communication vulnerable clients. Some clients, professionals and team leaders were unfamiliar with the measure’s aim and benefit. On the meso level, implementation was done top-down, and the management’s vision using the measure as an integrated measurement approach was insufficiently shared throughout the organisation.

Conclusions

Our study shows that Patient Reported Experience Measures have the potential to be used as an integrated measurement strategy. Yet, we found barriers at the micro level, which might have influenced using the measurement outcomes at the meso and macro level. Tailored implementation strategies, mostly focusing on designing and preparing the implementation on the micro level, need to be developed in co-creation with all stakeholders.
The role of diagnostic hysteroscopy in diagnosis of incomplete uterine septum/significant arcuate uterine anomaly in infertile patients in the era of transvaginal 3D ultrasound scan
Authors: Abuzeid O. , LaChance J. , Zaghmout O. , Corrado J. , Hebert J. , Ashraf M. , Abuzeid M. I.
Published: January 2020

Background

To determine the accuracy of measurement of internal indentation length on transvaginal 3D ultrasound scan (TV 3D US) in detecting patients with an incomplete uterine septum (IUS) or a significant arcuate uterine anomaly (AUA) based on the actual length as measured on diagnostic hysteroscopy. We compared the mean internal indentation length on TV 3D US and on diagnostic hysteroscopy in patients with IUS or a significant AUA.

Results

This is a retrospective study of 546 patients who were found to have IUS (134) or significant AUA (412) on diagnostic hysteroscopy and who had TV 3D US prior to surgery. The mean internal indentation length measured in millimeter on hysteroscopy was significantly higher than the mean internal indentation length measured on TV 3D US in patients with IUS (16.7 + 5.5 vs 5.5 + 4.2; P < 0.001), in patients with significant AUA (12.9 + 2.8 vs 3.9 + 4.6; P < 0.001), and in the overall population (13.8 + 4.0 vs 4.3 + 4.5; P < 0.001). The same findings were obtained when the comparison was limited to patients who had moderate significant internal indentation length (10–14 mm) and those with significant internal indentation length (15–25 mm).

Conclusion

Data in this study suggests that the mean internal indentation length in patients with IUS or AUA can be underestimated on TV 3D US. A diagnostic hysteroscopy is the only gold standard to make the correct diagnosis in these patients.
Evaluation of the predictive value of thorax trauma severity score (TTSS) in thoracic-traumatized patients
Authors: Zahran Mohamed Reda , Elwahab Amr Abd El Monem Abd , El Nasr Mohamed Mahmoud Abo , El Heniedy Mohamed Ahmed
Published: January 2020

Background

Thorax trauma severity score (TTSS) combines patient-related parameters with the anatomical and physiological parameters, and it can be easily calculated in the emergency room. The validity of this score in the Egyptian population has not been tested; therefore, the objective of this study was to evaluate the prognostic role of TTSS to predict the outcome of thoracic trauma in the Egyptian patients in two centers.

Results

The study included 284 male patients (94.7%) with a mean age of 41 years. Fifty-six patients (18.7%) had conservative management, 216 had morbidity (72%), and 28 patients died (9.3%). One hundred forty-eight patients (49.3%) had a thoracostomy tube, and thoracotomy was required in 4 patients (1.3%). Respiratory rate above 20 cycles/min at admission was associated with mortality (n = 28 (9.3%); p < 0.001). One hundred thirty-six patients had TTSS between 0 and 5 points; 56 of them were discharged and 80 of them were admitted to the inpatient ward with a good prognosis. Twenty-four patients had TTSS between 21 and 25 points; all the 24 patients had a fatal prognosis. A cut-off value of 7 points or more of TTSS was 100% sensitive and 97.73% specific to poor and fatal prognosis, and it was significantly associated with acute respiratory distress syndrome and the need for mechanical ventilation (n = 64; p < 0.001; AUC = 0.998).

Conclusion

The outcome of thoracic trauma patients could be predicted based on the thorax trauma severity score. A score of 7 points or above was associated with increased morbidity, and a score of 20 points or above predicted a fatal prognosis and prolonged mechanical ventilation.
Theoretical description of large deformations in criss-cross composites (with application to Tensylon®)
Authors: Mostovykh Pavel S.
Published: January 2020

A theoretical model of an anisotropic material, Tensylon®, under large strains is proposed. This model is capable to describe the material’s response in in-plane tension at different angles to the fibrils. At 0° and at 90°, i.e., along the fibrils in either “criss” or “cross” plies, it quantitatively predicts the experimentally observed elastic behaviour until failure. At 45° to the fibrils, it quantitatively describes the experi- mental data in the elastic and plastic domains. The description remains accurate up to strains of 35%, that corresponds to 30÷40% of deforma- tion gradient components. The infinitesimal strains model would give at least 25% of error under such circumstances.
Some competing nonresponse adjustment estimators
Authors: Traat Imbi
Published: January 2020

The nonresponse adjustment estimator, derived in this paper by standard regression tools, is surprising by its form. The weights of the new estimator, called the f-estimator, are (general) inverses of the respective weights in the classical linear calibration estimator and propensity adjusted estimator. In a simulation experiment on real data, the new estimator is the best for several study variables.
Same day cancellations of elective operations in a tertiary hospital in south-east England: a review of 11 000 patients in 1 year
Authors: Boyapati Raghuram P , Mehta Jahnavi , Norris Paul
Published: January 2020

Cancellations of elective operations have negative consequences, both for patients and the NHS. For the latter, reducing waiting times for surgical procedures remains a pressing concern, as does maintenance of adequate staffing. This study aimed to identify factors contributing to the cancellation of elective operations on the day of the procedure in order to suggest measures that could be taken to reduce these incidents. The retrospective details of just over 11 000 patients awaiting theatre admission for elective operations over a period of 1 year were obtained. The reasons behind last-minute operation cancellations were categorised as either patient factors or hospital factors. Data analysis suggested that the number of cancellations could be reduced by scheduling appointments with a senior doctor closer to the operation date.
Stress and coping strategies among NHS executives in sustainability and transformation partnerships
Authors: Brown Craig , Hendy Jane , Wang Catherine L
Published: January 2020

This study investigated stress experienced by NHS executives and their coping strategies following the development of sustainability and transformation partnerships (STPs). Lazarus and Folkman's (1984) transactional model of stress and coping was used to identify a range of stressors and coping strategies deployed by NHS executives to mitigate stress. An inductive qualitative approach was adopted using interview data, aiming to distinguish potentially harmful stressors from benign stressors and to discuss emotion-based and problem-based coping strategies. Finally, the authors strived to make clear recommendations for NHS England to develop leadership capability regarding inter-role conflict and the development of a regional culture of resilience among system-level executives.
Healthcare management and the 2020 Nightingale bicentenary celebrations
Authors: Peate Ian
Published: January 2020

Nursing and midwifery will be in the spotlight throughout 2020, which has been declared the international year of the nurse and midwife by the World Health Organization. In conjunction with this, the Nightingale bicentenary celebrations are also taking place globally this year. Healthcare managers worldwide are encouraged to look back on the contribution that Florence Nightingale made to contemporary healthcare management and healthcare practice, as well as reflecting on the crucial role of nurses and midwives today.
A compression device versus compression stockings in long-term therapy of lower limb primary lymphoedema after liposuction
Authors: Karafa Marian , Karafová Anna , Szuba Andrzej
Published: January 2020

Objective:

Primary lymphoedema is rare and in most cases develops in the lower extremities. In some cases, conservative treatment is insufficient and can be supported by surgical procedure. The aim of this case study was to show the difference in the effectiveness of a compression wrap device and compression stockings in the treatment of primary lymphoedema.

Method:

Before and after liposuction the patient was treated on an outpatient basis every day for three weeks. This consisted of complex decongestive therapy (CDT) including manual lymph drainage, tailored exercises, skin and nail care, compression therapy and intermittent pneumatic compression. After CDT, the patient was provided with a flat-knit compression garment. Measurements were taken at one week and at three months of wearing the compression garment. The oedema severity was measured by summary calculation method. For both healthy and swollen limbs, the sum of circumferences taken at nine fixed measuring points was determined. The difference between these sums expressed in percents was presented as a relative metric coefficient of leg lymphoedema (RMCL).

Results:

At the start of therapy, the difference in circumference between the healthy and swollen limb was 21.85%. After CDT (RMCL: 13.46%), the patient was provided with a flat-knit compression stocking (class 3). After one week, the RMCL was 15.92%, while after three months RCML was 20.84%. Because fluid retention was observed the patient was again treated with CDT (RMCL: 13.89%). The patient was provided with compression stocking (class 4). After one week of wearing, the RMCL was 15.77%, while after three months RMCL was 20.26%. As the results proved unsatisfactory, the patient was treated with CDT (RMCL: 13.60%) and a combination of two class 4 compression stockings was used. After one week, RMCL was 14.91%, while after three months RMCL was 19.25%. As the effects of oedema reduction were insufficient, the patient was treated again with CDT (RMCL: 13.89%) and advised to replace one of the stockings with a CirAid device (adjustable compression wrap). After one week, RMCL was 14.18% and after three months RMCL was 14.76%. The patient then qualified for liposuction (RMCL: 7.81%). At three months after surgery, the compression stocking was replaced by an adjustable compression wrap, to reduce the difference in circumference between healthy and swollen limbs (from 21.85 % to 8.68%).

Conclusion:

This case study shows that in primary oedema one class of compression garment is not always sufficient, nor is the combination of two garments with varying degrees of compression. In some cases, the situation requires the use of non-elastic leg binders such as a CircAid device which, thanks to its greater stiffness, helps improve clinical outcomes.
Effects of anticoagulant drugs on wound healing process in a rat model: a comparative study
Authors: Çevirme Deniz , Savluk Ömer Faruk , Başaran Eylül Kafalı , Aksoy Rezzan , Elibol Ahmet , Baş Tolga , Keser Sevinç , Adademir Taylan , Yılmaz Bayram
Published: January 2020

Objective:

This study aims to compare the efficacy of enoxaparin, rivoraxaban and dabigatran on wound healing using a rat model.

Method:

Sprague-Dawley female rats (n=56), 10–12 weeks old, weight 245±30g, were used in this study. The rats were divided into four equally-sized groups. A type 1 (secondary wound healing) and type 2 (primary wound healing) wound was opened surgically on each rat in each group. Anticoagulent drugs enoxaparin, rivoraxaban and dabigatran and physiological saline solution were administered to Groups 1, 2, 3 and 4, respectively. After wound healing was scored tissue samples were taken from euthanised rats at days five and 10 and examined histologically. Since time was used as a classification (days five and 10), a time effect was included.

Results:

There was no statistically significant difference in total score distribution in rats between type 1 secondary wounds for days five and 10 (p>0.05). There was no statistically significant difference in the overall score distribution in rats between type 2 primary wounds for days five and 10 (p>0.05).

Conclusion:

In addition to the use of low molecular weight heparin with well-known anticoagulation activity, the new generation oral medications are used efficiently in thromboembolic diseases. However, there was no evidence observed in this study that these drugs could be either beneficial or harmful to wound healing.
Responsible prescribing for cosmetic procedures
Authors: Sines David
Published: January 2020

This article describes the context and challenges that relate to prescribing in the non-surgical aesthetic sector and sets out the Joint Council for Cosmetic Practitioners position regarding responsible prescribing of prescription-only medicines used in aesthetic practice. The guidance lines up with that set down by the majority of the professional healthcare regulators and by the Royal Pharmaceutical Society. With regard to delegated prescribing, prescribers are reminded that patients remain under the oversight of the prescriber, requiring them to be familiar with the patient through an initial face-to-face consultation and diagnostic assessment of the patient's suitability for treatment. This applies to the routine/planned/repeat administration of medicines that are used specifically for cosmetic purposes, such as botulinum toxins, injected local anaesthetic or topical adrenaline, and the emergency use of medicines, such as hyaluronidase. Prescribers are also reminded of their obligation to address the existence of competing interests and to place the needs of the patient first, being transparent about their actions. Readers are also directed to relevant legislation and professional guidance that is applicable to the sector.
Simulation framework for evaluating lightweight spectral cameras in drone-based aquatic sensing applications
Authors: O’Shea Ryan E. , Laney Samuel R.
Published: January 2020

Optical remote sensing of aquatic environments using aerial drones is becoming more feasible as lightweight, low-power, spectral cameras increase in availability. Use of these cameras in such applications involves complex trade-offs in optical design and in deployment strategies, and simulations provide a means to examine this multidimensional design space to identify specific limitations on performance for a given measurement scenario. In this paper, such a simulation framework is developed, and its use in two realistic aquatic remote sensing scenarios is explored. Such a framework can provide insight into not only uses of existing camera systems, but also aspects of optical design or hardware that would lead to improved accuracy when using such cameras aerially over natural water bodies.
High temporal and spatial resolution single-shot digital holography with Fresnel domain filtering using witch’s hat illumination
Authors: Kishiwaki Daichi , Nisaka Kenichi , Nomura Takanori
Published: January 2020

High-resolution, single-shot on-axis digital holography is proposed. Generally, an on-axis configuration samples carrier fringes with higher spatial resolution compared to an off-axis configuration. However, the reconstructed image is obtained with unnecessary images of a conjugate image and a zero-order beam. The proposed method uses a phase-modulated illumination beam and image processing to eliminate these unnecessary images. Since time-division and parallel phase-shifting methods are not required, the proposed method has higher temporal and spatial resolutions. During image processing, the conjugate image is removed by filtering on the Fresnel domain while keeping most of the information of the object image intact. The usefulness of the proposed method is confirmed by a numerical simulation and an optical experiment.
O contexto político importa: o legado democrático como condicionante dos efeitos da educação sobre o compromisso democrático dos latino-americanos
Authors: Fuks Mario , Avila Casalecchi Gabriel
Published: January 2020

A escolaridade é considerada um dos principais fatores na explicação do comportamento político. Nos estudos sobre legitimidade democrática, a escolaridade é um forte determinante do apoio à democracia: quanto maior a escolaridade, maior é o apoio à democracia. Essa relação, no entanto, verifica-se em todo e qualquer contexto? Nesse artigo, argumentamos que o efeito da escolaridade sobre o compromisso com a democracia varia de acordo com o legado democrático dos países da região. Utilizando dados do Barômetro das Américas, observamos que, de forma geral, a escolaridade aumenta a probabilidade de um latino-americano adotar uma atitude de compromisso com a democracia. Entretanto, esse efeito é maior nos países de legados democráticos mais sólidos e duradouros. O artigo discute as implicações desses resultados para a consolidação das democracias latino-americanas.
Efficacy of Tenapanor in Treating Patients With Irritable Bowel Syndrome With Constipation: A 12-Week, Placebo-Controlled Phase 3 Trial (T3MPO-1)
Authors: Chey William D. , Lembo Anthony J. , Rosenbaum David P.
Published: January 2020

OBJECTIVES:

Tenapanor is a first-in-class, minimally absorbed, small-molecule inhibitor of the gastrointestinal sodium/hydrogen exchanger isoform 3. This phase 3 trial assessed the efficacy and safety of tenapanor 50 mg b.i.d. for the treatment of patients with constipation-predominant irritable bowel syndrome (IBS-C).

METHODS:

In this phase 3, double-blind study (ClinicalTrials.gov identifier NCT02621892), patients with IBS-C were randomized to tenapanor 50 mg b.i.d. or placebo b.i.d. for 12 weeks followed by a 4-week randomized withdrawal period. The primary efficacy variable was the proportion of patients who reported a reduction in average weekly worst abdominal pain of ≥30.0% and an increase of ≥1 complete spontaneous bowel movement from baseline, both in the same week, for ≥6 weeks of the 12-week treatment period.

RESULTS:

Of the 629 randomized patients with IBS-C, 606 (96.3%) were included in the intention-to-treat analysis set (tenapanor: n = 307; placebo: n = 299) and 533 (84.7%) completed the 12-week treatment period. In the intention-to-treat analysis set (mean age 45 years, 81.4% women), a significantly greater proportion of patients treated with tenapanor met the primary endpoint than patients treated with placebo (27.0% vs 18.7%, P = 0.020). Abdominal symptoms and global symptoms of IBS also improved with tenapanor (P < 0.05 vs placebo). Diarrhea was the most commonly reported adverse event, resulting in study drug discontinuation in 6.5% and 0.7% of patients receiving tenapanor and placebo, respectively, during the 12-week treatment period.

DISCUSSION:

Tenapanor 50 mg b.i.d. improved IBS-C symptoms and was generally well tolerated, offering a potential new treatment option for patients with IBS-C.
Трайбы и транспарентность: перспективы цифровых механизмов самоорганизации в российской науке
Authors: Космарский Артем Анатольевич , Картавцев Владимир Владимирович , Подорванюк Николай Юрьевич , Боде Михаил Михайлович
Published: January 2020

В работе рассматриваются возможности применения в России новых цифровых инструментов самоорганизации ученых и управления наукой. С учетом международной практики авторы выработали четыре экспериментальные модели децентрализованного самоуправления и группового принятия решений в науке, предположительно применимые для имплементации принципов цифрового управления (e-governance) в отечественной академической среде, и предложили их к обсуждению российским ученым в формате фокус-групп. Основным результатом обсуждения стала концептуализация системы отношений между членами научного сообщества в России при помощи социально-антропологической метафоры трайба. Авторы приходят к выводу, что предпосылками любых форм цифровизации отечественной науки должно стать как понимание партизанских практик ученых, так и установление в отношениях науки, общества и государства базового уровня видимости (понимания, кто что делает), подотчетности и делиберативности (обсуждаемости решений).

Благодарность. Исследование выполнено при финансовой поддержке РФФИ и АНО ЭИСИ в рамках научного проекта №19-011-31522 («Цифровые механизмы управления и самоорганизации научного сообщества как необходимые условия научно-технологического прорыва»). Авторы благодарят Михаила Соколова (Европейский университет в Санкт-Петербурге) и анонимного рецензента журнала за ценные замечания по тексту статьи.
Может ли вовлеченность студентов во внеучебные мероприятия способствовать развитию мягких навыков?
Authors: Щеглова Ирина Александровна
Published: January 2020

Такие навыки, как критическое мышление и работа в команде, приобрели особую важность в XXI веке. Они считаются основополагающим условием успеха на рынке труда и важным аспектом учебной программы в университете. Во всем мире педагоги и политики в сфере образования ищут пути развития и совершенствования этих навыков у студентов, например, вовлекая их в различные мероприятия, реализуемые на базе университета. Цель данного исследования — оценить вклад участия студентов во внеучебных мероприятиях в развитии навыков межличностного общения и работы в команде.

Данное исследование было проведено в рамках проекта «Студенческий опыт в исследовательском университете» (SERU). В выборку вошли студенты-бакалавры разных направлений подготовки, проходящие обучение в российском национальном исследовательском университете в 2016/2017 учебном году (N = 3 344 респондентов). Для оценки вклада студенческой вовлеченности во внеучебные мероприятия в развитии навыков межличностного общения и работы в команде используется бинарная логистическая регрессия. Полученные результаты подтверждают наличие статистически значимых различий в приросте навыков межличностного общения и работы в команде у студентов, участвующих во внеучебной деятельности и не участвующих.

Задача данной работы — показать, что вовлечение студентов в деятельность, выходящую за рамки образовательного процесса, происходящего в аудитории, но тесно связанную с ним, способствует росту их человеческого и социального капитала до уровня, требуемого высшим образованием. Вовлечение студентов во внеучебную деятельность университетом способствует развитию у них навыков межличностного общения и работы в команде. Полученные результаты призваны мотивировать преподавательский и административный состав университета на создание и продвижение площадок, на которых студенты могли бы лучше понять изученный материал, соотнести имеющиеся и полученные знания, а также практиковать новые навыки.
Общественное мнение и политическое участие: возвращаясь к работам Дж. Брайса
Authors: Шаблинский Антон Ильич
Published: January 2020

В современных дискуссиях о функциях опросов общественного мнения можно выделить две линии рассуждения. Одни авторы доказывают, что опросы должны с точностью передавать предпочтения и нужды граждан и работать как инструмент контроля народных представителей. За этим подходом кроется определенное видение демократии как правления элит в соответствии с интересами граждан, и общественного мнения как суммы индивидуальных предпочтений избирателей. Джордж Гэллап — одна из ключевых фигур, стоящих за первым подходом. Вместе с тем существует альтернативное видение, согласно которому общественное мнение есть процесс принятия демократических коллективных решений. В нашей статье мы сначала разбираем ограничения первого подхода. Мы демонстрируем, что второй подход помогает увидеть, как контролирующая функция опросов превращается в аккламационную. Далее мы показываем, что второй подход намного ближе к теории общественного мнения Джеймса Брайса, чем подход Джорджа Гэллапа и авторов, наследующих ему.
Благополучие и неблагополучие семьи и ребенка в нарративах специалистов по профилактике безнадзорности и правонарушений несовершеннолетних Санкт-Петербурга
Authors: Захарова Юлия Петровна , Любимова Александра Игоревна
Published: January 2020

В статье представлены результаты подготовительного этапа лонгитюдного исследования, посвященного жизненным траекториям семей и детей, находящихся в контакте с системой профилактики безнадзорности и правонарушений несовершеннолетних г. Санкт-Петербурга. Ввиду недостаточной определенности критериев, регулирующих работу с семьей, в нормативно-правовой документации значительную роль в дальнейшей траектории семьи и несовершеннолетнего начинает играть субъективная оценка ситуации специалистом. Для понимания оснований этой оценки мы провели серию из 11 полуструктурированных экспертных интервью со специалистами Санкт-Петербурга, представляющими разные органы, входящие в систему профилактики безнадзорности и правонарушений несовершеннолетних. При оценке благополучия специалисты использовали как объективные, так и субъективные критерии, которые соответствуют современным научным и практическим тенденциям в понимании этого явления. В ходе интервью подтвердилась гипотеза о высокой субъективности принятия решений и значительной роли специалиста в развитии дальнейшей жизненной траектории семьи. Специалисты продемонстрировали понимание благополучия, созвучное современным представлениям о данном феномене. Они убеждены, что благополучие и неблагополучие семьи определяет благополучие или неблагополучие ребенка, проживающего в ней. Медиаторами благополучия и неблагополучия являются ресурсы (внутренние, внешние) семьи и ребенка. В представлении специалистов семья, соответствующая существующим в обществе нормам, — залог благополучия ребенка. Сообразно этим убеждениям, неблагополучная семья, а именно семья, отклоняющаяся от норм, формирует неблагополучие ребенка. Необходимо дальнейшее исследование критериев и стадий (не)благополучия и выделение индикаторов, позволяющих специалисту ориентироваться в принятии решения о возможностях дальнейшей работы с семьей или ребенком.

Благодарность. Исследование выполнено в рамках проекта «Социальные траектории детства в современной России», поддержанного грантом Российского научного фонда № 16-18-10372.