bluuebunny/crossref_metadata_2025 huggingface dataset:
Electrocardiographic characteristics of distal His bundle pacing in a patient with left bundle branch block
Authors: Gu Min , Hu Yiran , Hua Wei , Niu Hongxia , Zhou Xiaohong , Zhang Shu
Published: November 2019

This case demonstrates the feasibility of placing the pacing lead helix at the His bundle distal to the region of left bundle branch block and reveals three types of electrocardiographic characteristics of distal His bundle pacing during correction of left bundle branch block in a patient. As the pacing lead helix was placed distal to the block, left bundle branch block correction was achieved by pacing with a low and stable capture threshold.
Purpuric nail striae as the initial manifestation in multisystem Langerhans cell histiocytosis
Authors: Prayogo Rizky Lendl , Rahmayunita Githa , Agustin Triana , Sirait Sondang P. , Arisanty Riesye
Published: November 2019

Nail involvement in Langerhans cell histiocytosis (LCH) is very uncommon. We describe a 9‐month‐old boy with longitudinal purpuric bands, onychodystrophy, and paronychias on his fingernails and toenails, which antedated manifestations of recurrent bilateral spontaneous pneumothorax and elevated transaminases. The diagnosis of nail LCH was then confirmed by immunohistochemistry demonstrating positive S100 and CD1a staining in the epithelium of nail bed tissue. This case report affirms that nail involvement may be the initial manifestation of multisystem LCH and could portend an unfavorable prognosis.
Use and misuse of a common growth metric: guidance for appropriately calculating and reporting specific growth rate
Authors: Crane Derek P. , Ogle Derek H. , Shoup Daniel E.
Published: November 2019

Growth is an important metric in fisheries and aquaculture. Growth of small fish over relatively short periods of time is commonly modelled with an exponential function using instantaneous growth rate (g). Instantaneous growth rates are logarithmic and inherently difficult to interpret, but specific growth rates (SGR) express growth as the intuitively understandable per cent change in size per unit of time. A simple metric of SGR (G) is easily computed by exponentiating g, subtracting 1 and multiplying by 100. However, several prominent fisheries publications suggest that SGR should be calculated by simply multiplying g by 100 (we call this G*). A search of the fisheries literature found that the number of papers that used SGR for fish increased significantly from 1830 papers in 2009 to 3170 papers in 2018. An extensive review of 300 papers from this search found that 92.6% were related to aquaculture and only 3.3% of all papers correctly used G to calculate SGR. We algebraically show that G* is fundamentally different than G and cannot be interpreted as a per cent change in weight per unit of time. Furthermore we demonstrate, with three examples from the literature, that using G* as if it were the same as G leads to biologically meaningful underestimates of true growth rates and estimated weights. Given these results and the simplicity with which G can be computed from g, we recommend that fisheries scientists abandon the pervasive practice of incorrectly measuring SGR as 100 times the instantaneous growth rate.
States' interests as limits to the power of finance: Regulatory reforms in early local government financialization in the US and UK
Authors: Trampusch Christine , Fastenrath Florian
Published: November 2019

Through a comparison of typical and deviant cases, this study probes and refines the augmented power model which argues that the structural power of the financial industry fosters its instrumental power in influencing regulatory reforms under certain scope conditions. It shows the industry's success in influencing policymakers to authorize municipalities to use derivatives and thereby to financialize their debt management in the US (typical case). The failure of banks to acquire such a law in the UK (deviant case) reveals a hitherto little‐noticed condition under which this power explanation collapses: states' fiscal and monetary constitution. We demonstrate that analyzing the operation of finance power requires a precise consideration of how states' fiscal and monetary constitution structures governments' responses to financial industry's regulatory preferences. Moreover, we conclude that synthesizing business power research with literature on the mutual dependence between states and finance helps to explain patterns of state financialization.
Oral health status in pediatric patients with cerebral palsy fed by oral versus enteral route
Authors: Cardona‐Soria Sandra , Cahuana‐Cárdenas Abel , Rivera‐Baró Alejandro , Miranda‐Rius Jaume , Martín de Carpi Javier , Brunet‐Llobet Lluís
Published: November 2019

Aims

Cerebral palsy (CP) is a chronic, nonprogressive disorder affecting movement, posture, and tone, caused by injuries in the central nervous system during the early stages of life. Patients with CP have swallowing disorders, which make oral feeding difficult and necessitate the use of external feeding devices. The objective of this research was to study the oral health status of pediatric patients affected with CP fed by either oral or enteral route.

Methods

A cross‐sectional observational clinical study of the oral health of two groups of patients with CP, fed either orally or enterally (via percutaneous endoscopic gastrostomy, PEG).

Results

Patients fed by enteral route via PEG presented lower caries scores (DMFT: PEG: 1.09, non‐PEG: 2.81) and higher percentages of supragingival dental calculus than the oral feeding group (PEG: 86%, non‐PEG: 57.6%).

Conclusion

Oral health status differed in pediatric patients with CP fed enterally via PEG and those fed orally. Specific preventive measures in both groups will be required to minimize the risk of complications.
Students’ achievement motivation in Finnish and Chinese higher education and its relation to perceived teaching‐learning environments
Authors: Hernesniemi Elina , Räty Hannu , Kasanen Kati , Cheng Xuejiao , Hong Jianzhong , Kuittinen Matti
Published: November 2019

This cross‐cultural study of Finnish and Chinese students set out to compare the levels of achievement motivation (AM) in order to investigate whether the differences in them might be explained by the different cultural response styles and whether these response styles could be controlled for with a method which includes response style variables as covariates in ANCOVA. This study also scrutinizes relationships between perceived teaching‐learning environments (TLE) and AM within each cultural group. The survey sample consisted of 3,035 Finnish and 2,309 mainland Chinese university students. Finnish students were found to rate the level of AM markedly higher than do Chinese students. It was determined that the method applied for response style controlling is not suitable for cross‐cultural studies, even though it is recommended for this use. A modification of the method, which is based on robust statistical tools, was found not to change this conclusion, but it can nevertheless be used to obtain useful information about the effects of response style differences. The results also show that similar relationships between AM and TLE could be identified in the data of both groups. However, for the Finnish group AM is related to perceived suitable workload, whereas for the Chinese group it is related to teacher encouragement.
Accounting for time‐dependent treatment use when developing a prognostic model from observational data: A review of methods
Authors: Pajouheshnia Romin , Schuster Noah A. , Groenwold Rolf H. H. , Rutten Frans H. , Moons Karel G. M. , Peelen Linda M.
Published: November 2019

Failure to account for time‐dependent treatment use when developing a prognostic model can result in biased future predictions. We reviewed currently available methods to account for treatment use when developing a prognostic model. First, we defined the estimands targeted by each method and examined their mechanisms of action with directed acyclic graphs (DAGs). Next, methods were implemented in data from 1,906 patients; 325 received selective β‐blockers (SBBs) during follow‐up. We demonstrated seven Cox regression modeling strategies: (a) ignoring SBB treatment; (b) excluding SBB users or (c) censoring them when treated; (d) inverse probability of treatment weighting after censoring (IPCW), including SBB treatment as (e) a binary or (f) a time‐dependent covariate; and (g) marginal structural modeling (MSM). Using DAGs, we demonstrated IPCW and MSM have the best properties and target a similar estimand. In the case study, compared to (a), approaches (b) and (e) provided predictions that were 1% and 2% higher on average. Performance (c‐statistic, Brier score, calibration slope) varied minimally between approaches. Our review of methods confirmed that ignoring treatment is theoretically inferior, but differences between the prediction models obtained using different methods can be modest in practice. Future simulation studies and applications are needed to assess the value of applying IPCW or MSM to adjust for treatments in different treatment and disease settings.
Characterization of the novel HLA‐DRB3*03:37 allele by sequencing‐based typing
Authors: Cargou Marine , Andreani Marco , Giustiniani Paola , Guidicelli Gwendaline , Visentin Jonathan
Published: November 2019

HLA‐DRB3*03:37 differs from HLA‐DRB3*03:01:01:01 by one nucleotide substitution in codon 205 in exon 4.
The Struggle for Control: How do Norwegian TV-Celebrities Deal With Critical Media Exposure?
Authors: Duckert Fanny , Karlsen Kim Edgar
Published: November 2019

Ten Norwegian TV-hosts, all nation-wide celebrities, were interviewed about their experiences with critical media exposure. How did they perceive their relationship with the press?  What were the main sources of stress? How did they cope? All expressed a strong focus on impression management and self-presentation. The majority described an independent and often playful interaction with the press, in order to keep control over their programs and their privacy.All had experienced negative media exposure. Sources of stress were one-sided presentations, evil informers, personal attacks, and harming their family. They experienced both direct effects by the media coverage, and indirect effects through interaction with other people.The majority used problem-focused coping strategies, actively influencing the media coverage; emotion-focused strategies, regulating their thoughts and feelings; and meaning-focused strategies, allowing reflection. Proactive self-presentation work helped maintain and protect their identities.Two of the participants reported using more defensive strategies, and had suffered more intensely.
A new genus and new species of eriophyoid mites (Prostigmata: Eriophyoidea) from Thailand with supplementary description of two species

Authors: Konvipasruang Ploychompoo , Chandrapatya Angsumarn , Amrine J.W.Jr.
Published: November 2019

One new genus, one new species, one new record and one new combination of the eriophyoid mites from Thailand were described. They are Rotsukhona loureirii gen. nov., sp. nov. on Tetracera loureiri (Finet & Gagnep.) Pierre ex W. G. Craib, Vareeboona mangiferae (Keifer 1946) new record on Bouea oppositifolia (Roxb.) Adelb and Vimola artocarpae (Mohanasundaram 1981) new combination on Artocarpus heterophyllus Lamarck.
Advising in Kinesiology: Challenges and Opportunities
Authors: Smith Derek T. , Broman Tannah , Rucker Marcus , Sende Cecile , Banner Sarah
Published: November 2019

Effective academic advising in kinesiology is paramount to student success, contribution of the discipline to global health, and preparation of the workforce’s future leaders. Enrollment growth in kinesiology and its curricular breadth impose challenges that are unique from many other academic majors. The American Kinesiology Association convened a preworkshop titled “Advising in Kinesiology: Challenges and Opportunities” in January 2019 to begin dialogue related to advancing effective advising practices in kinesiology. Twenty-six attendees, all of whom were engaged in advising in different roles, participated in presentations and group discussions. This paper summarizes the preworkshop primary findings and offers some best-practice considerations. While it is clear that effective advising is positioned to advance the quality of kinesiology programs and our graduates, there is a dearth of supporting evidence, and addressing this through research is a needed priority.
Faculty Morale: A Perspective for Academic Leaders
Authors: Hebert Edward
Published: November 2019

Faculty morale plays an important role in academic life. Morale influences faculty behavior, productivity, and quality of teaching; ultimately affects student learning and program quality; and is predictive of faculty turnover. It is an often overlooked but worthy challenge for academic leaders. This article examines faculty morale, its meaning, and factors that influence it and explores strategies for promoting it in a university department. Faculty morale is a cognitive, emotional, and motivational approach toward the work of the department and may be reflected by a sense of common purpose, group cohesion, and a sense of personal value in the organization. Research shows that faculty morale is affected by various aspects of work life including workload, supportive resources, and recognition. However, evidence also suggests that 2 of the strongest variables influencing morale are relationships with colleagues and perceptions of the abilities and actions of the department leader. Strategies are suggested for promoting faculty morale that are derived from the research, a survey of department chairs, and experience.
Recognizing the Impact of Bias in Faculty Recruitment, Retention, and Advancement Processes
Authors: Russell Jared A. , Brock Sheri , Rudisill Mary E.
Published: November 2019

Bias, an automatic—usually unconscious and unintentional—inclination, preference, or favoring of an individual or group over another, is an inherent aspect of an individual’s academic leadership and decision-making processes. Bias alone is not a detriment to building an inclusive and supportive environment for faculty. However, oftentimes an academic unit leader’s biases result in the justification, rationalization, and facilitation of exclusionary processes and practices toward faculty, particularly those from diverse and underrepresented backgrounds. This article discusses the impact of bias, specifically implicit bias, on academic leadership. Moreover, the impact of a leader’s biases toward diversity attributes (e.g., gender, sexual orientation/affinity, age, ethnicity, race) of faculty are highlighted. Specifically, key areas of academic leadership are explored: faculty recruitment (hiring), retention (evaluation), and advancement (promotion and tenure). Recommendations, promising practices, and strategies for minimizing the impact of implicit bias are provided.
Reproducing human and cross-species drug toxicities using a Liver-Chip
Authors: Jang Kyung-Jin , Otieno Monicah A. , Ronxhi Janey , Lim Heng-Keang , Ewart Lorna , Kodella Konstantia R. , Petropolis Debora B. , Kulkarni Gauri , Rubins Jonathan E. , Conegliano David , Nawroth Janna , Simic Damir , Lam Wing , Singer Monica , Barale Erio , Singh Bhanu , Sonee Manisha , Streeter Anthony J. , Manthey Carl , Jones Barry , Srivastava Abhishek , Andersson Linda C. , Williams Dominic , Park Hyoungshin , Barrile Riccardo , Sliz Josiah , Herland Anna , Haney Suzzette , Karalis Katia , Ingber Donald E. , Hamilton Geraldine A.
Published: November 2019

A rat, dog, and human Liver-Chip designed using microengineered Organs-on-Chips technology recapitulates species-specific drug toxicities.
Antibodies go with the lymphatic flow
Authors: Hickman Heather D.
Published: November 2019

Lymph flow through Peyer’s patches enhances mucosal antibody production.
Differences in the Pharmacokinetics of Gentamicin between Oncology and Nononcology Pediatric Patients
Authors: Llanos-Paez C. C. , Staatz C. E. , Lawson R. , Hennig S.
Published: November 2019

Dosing gentamicin in pediatric patients can be difficult due to its narrow therapeutic index. A significantly higher percentage of fat mass has been observed in children receiving oncology treatment than in those who are not. Differences in the pharmacokinetics of gentamicin between oncology and nononcology pediatric patients and individual dosage requirements were evaluated in this study, using normal fat mass (NFM) as a body size descriptor.
Hemagglutinin Stability Regulates H1N1 Influenza Virus Replication and Pathogenicity in Mice by Modulating Type I Interferon Responses in Dendritic Cells
Authors: Russier Marion , Yang Guohua , Briard Benoit , Meliopoulos Victoria , Cherry Sean , Kanneganti Thirumala-Devi , Schultz-Cherry Stacey , Vogel Peter , Russell Charles J.
Published: November 2019

Diverse influenza A viruses circulate in wild aquatic birds, occasionally infecting farm animals. Rarely, an avian- or swine-origin influenza virus adapts to humans and starts a pandemic. Seasonal and many universal influenza vaccines target the HA surface protein, which is a key component of pandemic influenza viruses. Understanding the HA properties needed for replication and pathogenicity in mammals may guide response efforts to control influenza. Some antiviral drugs and broadly reactive influenza vaccines that target the HA protein have suffered resistance due to destabilizing HA mutations that do not compromise replicative fitness in cell culture. Here, we show that despite not compromising fitness in standard cell cultures, a destabilizing H1N1 HA stalk mutation greatly diminishes viral replication and pathogenicity
in vivo
by modulating type I IFN responses. This encourages targeting the HA stalk with antiviral drugs and vaccines as well as reevaluating previous candidates that were susceptible to destabilizing resistance mutations.
300,000 yr history of water-table fluctuations at Wind Cave, South Dakota, USA—Scale, timing, and groundwater mixing in the Madison Aquifer
Authors: Paces James B. , Palmer Margaret V. , Palmer Arthur N. , Long Andrew J. , Emmons Matthew P.
Published: November 2019

Deposits of calcite coating the lower passages of Wind Cave in the southern Black Hills of South Dakota were precipitated under phreatic conditions. Data from samples associated with a new cave survey and hydrologic studies indicate that past water tables within Wind Cave reached a maximum height of 45 m above modern levels but were mostly confined to 25 m or less. Uranium-series ages for basal layers deposited on weathered wall rock indicate subaerial conditions in this part of the cave persisted between 1000 and 300 ka. Ages and elevations of wall coatings and cave rafts establish a 300,000 yr paleohydrograph indicating that water-table highstands occurred during interglacial or interstadial-to-early glacial periods and lowstands occurred during full-glacial and stadial episodes.

Isotopes of Sr, U, C, and O from dated calcite samples were obtained to evaluate potential shifts in paleo-groundwater composition. For comparison, Sr and U isotopic compositions were determined for modern groundwater from 18 sites previously classified into five hydrogeologic domains. Isotope data for different domains tend to cluster in separate fields, although several fields overlap. Compositions of Calcite Lake (informal name) water reflect modern recharge to shallow aquifers. In contrast, speleothem data indicate that paleo-groundwater highstands were not supported by increased infiltration associated with local recharge, or by upwelling from deeper Proterozoic sources. Instead, cave water was similar to deeper, warmer groundwater from the Madison Aquifer discharging at modern artesian springs flanking the southern Black Hills. Highstands were likely influenced by large-scale hydraulic processes associated with recharge to the Madison Aquifer under the Laurentide ice sheet on the northeast side of the Williston Basin, causing increased hydrostatic pressures in confined aquifers on the south side of the basin.
Association between genetically determined leptin and blood lipids considering alcohol consumption: a Mendelian randomisation study
Authors: Shen Luqi , Cordero José F , Wang Jia-Sheng , Shen Ye , Li Shengxu , Liang Lirong , Zou Zhiyong , Li Changwei
Published: November 2019

Objectives

The objective of this study was to evaluate the association of genetically determined leptin with lipids.

Design

We conducted a Mendelian randomisation study to assess a potential causal relationship between serum leptin and lipid levels. We also evaluated whether alcohol drinking modified the associations of genetically determined leptin with blood lipids.

Setting and participants

3860 participants of the Framingham Heart Study third generation cohort.

Results

Both genetic risk scores (GRSs), the GRS generated using leptin loci independent of body mass index (BMI) and GRS generated using leptin loci dependent of BMI, were positively associated with log-transformed leptin (log-leptin). The BMI-independent leptin GRS was associated with log-transformed triglycerides (log-TG, β=−0.66, p=0.01), but not low-density lipoprotein cholesterol (LDL-C, p=0.99), high-density lipoprotein cholesterol (HDL-C, p=0.44) or total cholesterol (TC, p=0.49). Instrumental variable estimation showed that per unit increase in genetically determined log-leptin was associated with 0.55 (95% CI: 0.05 to 1.00) units decrease in log-TG. Besides significant association with log-TG (β=−0.59, p=0.009), the BMI-dependent GRS was nominally associated with HDL-C (β=−10.67, p=0.09) and TC (β=−28.05, p=0.08). When stratified by drinking status, the BMI-dependent GRS was associated with reduced levels of LDL-C (p=0.03), log-TG (p=0.004) and TC (p=0.003) among non-current drinkers only. Significant interactions between the BMI-dependent GRS and alcohol drinking were identified for LDL-C (p=0.03), log-TG (p=0.03) and TC (p=0.02).

Conclusion

These findings together indicated that genetically determined leptin was negatively associated with lipid levels and the association may be modified by alcohol consumption.
Communicating biopsy results from breast screening assessment: current practice in English breast screening centres and staff perspectives of telephoning results
Authors: Williamson Sian Z , Johnson Rebecca , Sandhu Harbinder K , Ellard David R , Jenkins Jacquie , Casey Margaret , Kearins Olive , Taylor-Phillips Sian
Published: November 2019

Objective

To record how breast screening centres in England deliver all biopsy results (cancer/non-cancer) from the breast assessment visit.

Design

Online survey of 63 of 79 breast screening centres in England from all regions (East Midlands, East of England, London, North East Yorkshire & Humber, North West, South East, South West, West Midlands). The survey contained quantitative measures of frequency for telephoning biopsy results (routinely, occasionally or never) and optional qualitative free-text responses. Surveys were completed by a staff member from each centre.

Results

There were no regional trends in the use of telephone results services, (X² (14, n=63)=11.55, p=0.64), Centres who telephoned results routinely did not deliver results sooner than centres who deliver results in-person (X² (16, n=63)=12.76, p=0.69).

When delivering cancer results, 76.2% of centres never telephone results and 23.8% of centres occasionally telephone results. No centres reported delivering cancer results routinely by telephone. Qualitative content analysis suggests that cancer results are only telephoned at the patient request and under exceptional circumstances.

When delivering non-cancer results, 12.7% of centres never telephoned results, 38.1% occasionally telephoned results and 49.2% routinely telephoned results. Qualitative content analysis revealed different processes for delivering telephone results, including patient choice and scheduling an in-person results appointment for all women attending breast assessment, then ringing non-cancer results unexpectedly ahead of this prebooked appointment.

Conclusions

In the National Health Service Breast Screening Programme, breast assessment results that are cancer are routinely delivered in-person. However, non-cancer breast assessment results are often routinely delivered by telephone, despite breast screening policy recommendations. More research is needed to understand the impact of telephoning results on women attending breast assessment, particularly women who receive a non-cancer result. Future research should also consider how women themselves might prefer to receive their results.
Economic evaluation of a novel genetic screening test for risk of venous thromboembolism compared with standard of care in women considering combined hormonal contraception in Switzerland
Authors: Sutherland C Simone , Ademi Zanfina , Michaud Joëlle , Schur Nadine , Lingg Myriam , Bhadhuri Arjun , Pache Thierry D. , Bitzer Johannes , Suchon Pierre , Albert Valerie , Hersberger Kurt E. , Tanackovic Goranka , Schwenkglenks Matthias
Published: November 2019

Aim

The aim of this study was to assess the cost effectiveness of the Pill Protect (PP) genetic screening test for venous thromboembolism (VTE) risk compared with standard of care (SoC), for women considering combined hormonal contraceptives (CHCs) in Switzerland.

Methods

A two-part microsimulation model was developed to estimate VTE events, costs and quality-adjusted life years (QALYs) associated with the PP and SoC strategies. In the first portion of the model, a cohort of 1 million Swiss first-time seekers of a CHC were simulated. It was determined whether each women would receive a CHC or non-CHC by using prescribing patterns elicited from a modified Delphi study. These results formed the basis of the SoC strategy. For the PP strategy, a PP test was included and the results considered in addition to SoC practice. Each woman then entered a Markov model that captured morbidity and mortality over a lifetime. The risk of having a VTE was derived from the risk algorithm that underpins the PP test. The remaining model inputs relating to population characteristics, costs, health resource use, mortality and utilities were derived from published studies or national sources. The model was validated and calibrated to align with population-based studies. Extensive uncertainty analyses were conducted.

Results

From a Swiss health system perspective, the PP strategy in comparison with the SoC strategy generated an additional CHF 231, and gained 0.003 QALYs per woman, leading to an incremental cost-effectiveness ratio of CHF 76 610 per QALY gained. Assuming a threshold of CHF 100 000 per QALY gained, the PP strategy is likely to be cost effective. Our results were generally robust to variations in the parameter values.

Conclusions

The PP test may be cost effective in Switzerland for screening women seeking CHCs for their risk of VTE based on the current evidence.
Evolving rifampicin and isoniazid mono-resistance in a high multidrug-resistant and extensively drug-resistant tuberculosis region: a retrospective data analysis
Authors: Mvelase Nomonde Ritta , Balakrishna Yusentha , Lutchminarain Keeren , Mlisana Koleka
Published: November 2019

Objectives

South Africa ranks among the highest drug-resistant tuberculosis (DR-TB) burdened countries in the world. This study assessed the changes in resistance levels in culture confirmedMycobacterium tuberculosis(MTB) in the highest burdened province of South Africa during a period where major changes in diagnostic algorithm were implemented.

Setting

This study was conducted at the central academic laboratory of the KwaZulu-Natal province of South Africa.

Participants

We analysed data for all MTB cultures performed in the KwaZulu-Natal province between 2011 and 2014. The data were collected from the laboratory information system.

Results

Out of 88 559 drug susceptibility results analysed, 18 352 (20.7%) were resistant to rifampicin (RIF) and 19 190 (21.7%) showed resistance to isoniazid (INH). The proportion of rifampicin resistant cases that were mono-resistant increased from 15.3% in 2011 to 21.4% in 2014 while INH mono-resistance (IMR) showed a range between 13.8% and 21.1%. The multidrug-resistant tuberculosis (MDR-TB) rates increased from 18.8% to 23.9% and the proportion of MDR-TB cases that had extensively drug-resistant tuberculosis remained between 10.2% and 11.1%. Most drug resistance was found in females between the ages of 15 and 44 years and the northern districts bordering high MDR-TB regions had the highest MDR-TB rates.

Conclusion

Our findings show increasing RIF mono-resistance (RMR) and a substantial amount of IMR. This highlights a need for an initial test that detects resistance to both these drugs so as to avoid using RIF monotherapy during continuous phase of treatment in patients with IMR. Furthermore, addition of INH will benefit patients with RMR. Although DR-TB is widespread, HIV and migration influence its distribution; therefore, TB control strategies should include interventions that target these aspects.
Methodological quality of public health guideline recommendations on vitamin D and calcium : a systematic review protocol
Authors: Dai Zhaoli , Kroeger Cynthia M , McDonald Sally , Page Matthew J , McKenzie Joanne E , Allman-Farinelli Margaret , Raubenheimer David , Bero Lisa
Published: November 2019

Introduction

Current recommendations for vitamin D and calcium in dietary guidelines and bone health guidelines vary significantly among countries and professional organisations. It is unknown whether the methods used to develop these recommendations followed a rigourous process and how the differences in methods used may affect the recommended intakes of vitamin D and calcium. The objectives of this study are (1) collate and compare recommendations for vitamin D and calcium across guidelines, (2) appraise methodological quality of the guideline recommendations and (3) identify methodological factors that may affect the recommended intakes for vitamin D and calcium. This study will make a significant contribution to enhancing the methodological rigour in public health guidelines for vitamin D and calcium recommendations.

Methods and analyses

We will conduct a systematic review to evaluate vitamin D and calcium recommendations for osteoporosis prevention in generally healthy middle-aged and older adults. Methodological assessment will be performed for each guideline against those outlined in the 2014 WHO handbook for guideline development. A systematic search strategy will be applied to locate food-based dietary guidelines and bone health guidelines indexed in various electronic databases, guideline repositories and grey literature from 1 January 2009 to 28 February 2019. Descriptive statistics will be used to summarise the data on intake recommendation and on proportion of guidelines consistent with the WHO criteria. Logistic regression, if feasible, will be used to assess the relationships between the methodological factors and the recommendation intakes.

Ethics and dissemination

Ethics approval is not required as we will only extract published data or information from the published guidelines. Results of this review will be disseminated through conference presentations and peer-reviewed publications.

PROSPERO registration number

CRD42019126452
Dyslipidaemia prevalence and associated risk factors in the United Arab Emirates: a population-based study
Authors: Mahmoud Ibrahim , Sulaiman Nabil
Published: November 2019

Objectives

To determine and describe the prevalence and pattern of dyslipidaemia and its associated risk factors among an adult Emirati population.

Design

Population-based, cross-sectional study.

Setting

Adults living in the Northern Emirates.

Participants

824 adult participants (51.8% men, 48.2% women, mean age 42.8±13.4 years old).

Primary outcome measures

Fasting blood samples were collected, blood pressure and waist circumference were measured.

Results

The overall dyslipidaemia prevalence was 72.5%, with 42.8% of the participants showing high total cholesterol (TC) level, 29% showing high triglyceride (TG) level, 42.5% showing low high-density lipoprotein cholesterol (HDL-C) level, 38.6% showing high low-density lipoprotein cholesterol (LDL-C) level and 72.3% showing high cholesterol ratio. The regression models showed that gender was a significant predictor of a high TG level, low LDL-C level and high cholesterol ratio. Middle-aged individuals (30–59 years old) had a significantly higher risk of having high TC, TG and LDL-C levels than young (<30 years old) and elderly (≥60 years old) individuals. Diabetes mellitus was a significant predictor of low TC, high TG and low HDL-C levels, while central obesity was a significant predictor of a high TG level, low HDL-C level and high cholesterol ratio. Smoking was a significant predictor of a high TG level only in men.

Conclusions

The prevalence of dyslipidaemia was considerably high among the local adult Emiratis. The identified dyslipidaemia predictors were gender, age, smoking, central obesity and diabetes. Further studies are recommended to assess other important risk factors and aggressive preventive measures in the United Arab Emirates.
Economic evaluation of cognitive behavioural therapy for insomnia (CBT-I) for improving health outcomes in adult population: a systematic review protocol
Authors: Natsky Andrea Natalie , Vakulin Andrew , Chai-Coetzer Ching Li , Lack Leon , McEvoy R. Doug , Kaambwa Billingsley
Published: November 2019

Introduction

Insomnia is associated with a number of adverse consequences that place a substantial economic burden on individuals and society. Cognitive behavioural therapy for insomnia (CBT-I) is a promising intervention that can improve outcomes in people who suffer from insomnia. However, evidence of its cost-effectiveness remains unclear. In this study, we will systematically review studies that report on economic evaluations of CBT-I and investigate the potential economic benefit of CBT-I as a treatment for insomnia.

Methods and analysis

The search will include studies that use full economic evaluation methods (ie, cost-effectiveness, cost-utility, cost-benefit, cost-consequences and cost-minimisation analysis) and those that apply partial economic evaluation approaches (ie, cost description, cost-outcome description and cost analysis). We will conduct a preliminary search in MEDLINE, Google Scholar, MedNar and ProQuest dissertation and theses to build the searching terms. A full search strategy using all identified keywords and index terms will then be undertaken in several databases including MEDLINE, Psychinfo, Proquest, Cochrane, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Web of Science and EMBASE. We will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for protocol guidelines in this review. Only articles in the English language and those reporting on adult populations will be included. We will use standardised data extraction tools for economic evaluations to retrieve and synthesise information from selected studies into themes and summarised in a Joanna Briggs Institute dominance ranking matrix.

Ethics and dissemination

No formal ethics approval will be required as we will not be collecting primary data. Review findings will be disseminated through a peer-reviewed publication, workshops, conference presentations and a media release.

PROSPERO registration number

CRD42019133554.
Serum hepcidin and iron status parameters in pregnant women and the association with adverse maternal and fetal outcomes: a study protocol for a prospective cohort study
Authors: Amstad Bencaiova Gabriela , Vogt Deborah Ruth , Hoesli Irene
Published: November 2019

Introduction

Hepcidin production is normally upregulated by iron stores, and in obesity has been shown to be overexpressed and correlated with low iron status. The increased hepcidin may restrain the iron release from the cells by affecting the expression of ferroportin, which probably associates with the development of diabetes complication. First, we investigate the difference of serum hepcidin and iron parameters between obese and non-obese pregnant women; second, we examine the correlation between serum hepcidin and adverse maternal and neonatal outcomes in pregnant women.

Methods and analysis

This is a mono-centre, prospective cohort study with a study (obese) and a control group (non-obese women). In the first trimester, 188 singleton pregnancies will be recruited. Thereof, we expect 75 with a body mass index (BMI) ≥30 kg/m2and 113 with a BMI 18.5–30 kg/m2. Serum hepcidin, iron and haematological parameters will be measured at 11–14, 24–28, 32–36 weeks of gestation and at time of delivery. Blood pressure, weight, BMI and smoking status will be examined at all visits. We will assess the composite endpoints adverse maternal outcomes (including pre-eclampsia, gestational hypertension, gestational diabetes mellitus, haemorrhage, placenta abruption) and adverse neonatal outcomes (preterm birth, intrauterine growth restriction, preterm premature rupture of membranes, Apgar score <7 at 5 min, stillbirth, neonatal death).

Recruitment has started in April 2019.

Ethics and dissemination

This study received ethical approval from the ethics committee in Basel. The results of the study will be published in a peer-reviewed journal, and presented at national scientific conferences.

Trial registration number

NCT03792464.
Evidence of potential overdiagnosis and overtreatment of attention deficit hyperactivity disorder (ADHD) in children and adolescents: protocol for a scoping review
Authors: Kazda Luise , Bell Katy , Thomas Rae , McGeechan Kevin , Barratt Alexandra
Published: November 2019

Introduction

Worldwide, attention deficit hyperactivity disorder (ADHD) diagnosis rates in children and adolescents have been increasing consistently over the past decades, fuelling a debate about the underlying reasons for this trend. While many hypothesise that a substantial number of these additional cases are overdiagnosed, to date there has been no comprehensive evaluation of evidence for or against this hypothesis. Thus, with this scoping review we aim to synthesise published evidence on the topic in order to investigate whether existing literature is consistent with the occurrence of overdiagnosis and/or overtreatment of ADHD in children and adolescents.

Methods and analysis

The proposed scoping review will be conducted in the context of a framework of five questions, developed specifically to identify areas in medicine with the potential for overdiagnosis and overtreatment. The review will adhere to the Joanna Briggs Methodology for Scoping Reviews. We will search Medline, Embase, PsycINFO and the Cochrane Library electronic databases for primary studies published in English from 1979 onwards. We will also conduct forward and backward citation searches of included articles. Data from studies that meet our predefined exclusion and inclusion criteria will be charted into a standardised extraction template with results mapped to our predetermined five-question framework in the form of a table and summarised in narrative form.

Ethics and dissemination

The proposed study is a scoping review of the existing literature and as such does not require ethics approval. We intend to disseminate the results from the scoping review through publication in a peer-reviewed journal and through conference presentations. Further, we will use the findings from our scoping review to inform future research to fill key evidence gaps identified by this review.
Association between potentially inappropriate medications at discharge and unplanned readmissions among hospitalised elderly patients at a single centre in Japan: a prospective observational study
Authors: Komagamine Junpei , Yabuki Taku , Kobayashi Masaki
Published: November 2019

Objective

To determine the prevalence of potentially inappropriate medication (PIM) use at admission and discharge among hospitalised elderly patients and evaluate the association between PIMs at discharge and unplanned readmission in Japan.

Design

A prospective observational study conducted by using electronic medical records.

Participants

All consecutive patients aged 65 years or older who were admitted to the internal medicine ward were included. Patients who were electively admitted for diagnostic procedures were excluded.

Main outcome measures

The primary outcome was 30-day unplanned readmissions. The secondary outcome was the prevalence of any PIM use at admission and discharge. PIMs were defined based on the Beers Criteria. The association between any PIM use at discharge and the primary outcome was evaluated by using logistic regression.

Results

Seven hundred thirty-nine eligible patients were included in this study. The median patient age was 82 years (IQR 74–88); 389 (52.6%) were women, and the median Charlson Comorbidity Index was 2 (IQR 0–3). The proportions of patients taking any PIMs at admission and discharge were 47.2% and 32.2%, respectively. Of all the patients, 39 (5.3%) were readmitted within 30 days after discharge for the index hospitalisation. The use of PIMs at discharge was not associated with an increased risk of 30-day readmission (OR 0.93; 95% CI 0.46 to 1.87). This result did not change after adjusting for patient age, sex, number of medications, duration of hospital stay and comorbidities (OR 0.78; 95% CI 0.36 to 1.66).

Conclusion

The prevalence of any PIM use at discharge was high among hospitalised elderly patients in a Japanese hospital. Although the use of PIMs at discharge was not associated with an increased risk of unplanned readmission, given a lack of power of this study due to a low event rate, further studies investigating this association are needed.

Trial registration number

UMIN000027189.
Pure tone audiometry and cerebral pathology in healthy older adults
Authors: Parker Thomas , Cash David M , Lane Chris , Lu Kirsty , Malone Ian B , Nicholas Jennifer M , James Sarah , Keshavan Ashvini , Murray-Smith Heidi , Wong Andrew , Buchannan Sarah , Keuss Sarah , Sudre Carole H , Thomas David , Crutch Sebastian , Bamiou Doris-Eva , Warren Jason D , Fox Nick C , Richards Marcus , Schott Jonathan M
Published: November 2019

Background

Hearing impairment may be a modifiable risk factor for dementia. However, it is unclear how hearing associates with pathologies relevant to dementia in preclinical populations.

Methods

Data from 368 cognitively healthy individuals born during 1 week in 1946 (age range 69.2–71.9 years), who underwent structural MRI,18F-florbetapir positron emission tomography, pure tone audiometry and cognitive testing as part of a neuroscience substudy the MRC National Survey of Health and Development were analysed. The aim of the analysis was to investigate whether pure tone audiometry performance predicted a range of cognitive and imaging outcomes relevant to dementia in older adults.

Results

There was some evidence that poorer pure tone audiometry performance was associated with lower primary auditory cortex thickness, but no evidence that it predicted in vivo β-amyloid deposition, white matter hyperintensity volume, hippocampal volume or Alzheimer’s disease-pattern cortical thickness. A negative association between pure tone audiometry and mini-mental state examination score was observed, but this was no longer evident after excluding a test item assessing repetition of a single phrase.

Conclusion

Pure tone audiometry performance did not predict concurrent β-amyloid deposition, small vessel disease or Alzheimer’s disease-pattern neurodegeneration, and had limited impact on cognitive function, in healthy adults aged approximately 70 years.
Volume variation may be a relevant metric in the study of aneurysm pulsatility: a study using ECG-gated 4D-CTA (PULSAN)
Authors: Dissaux Brieg , Ognard Julien , Cheddad El Aouni Mourad , Nonent Michel , Haioun Karim , Magro Elsa , Gentric Jean Christophe
Published: November 2019

​Background and purpose

Intracranial aneurysms are a frequently occurring disease, with an estimated prevalence of 2–5% in the general population. They usually remain silent until rupture occurs, with a mortality rate of 35–50% and a high rate of morbidity, including long-term disability. However, preventative treatments have their own risk of complications and morbi-mortality rates, including stroke and hemorrhage. ECG-gated four-dimensional CT angiography (4D-CTA) allows the acquisition of time-resolved three-dimensional reconstructions. The aim of our study was to evaluate different intracranial aneurysm metrics over the cardiac cycle using ECG-gated 4D-CTA.

​Materials and methods

ECG-gated 4D-CTA datasets were acquired in patients presenting with intracranial aneurysms. Seven aneurysm metrics, including aneurysm height, aneurysm length, ostium width, aspect ratio, ostium area, volume, and volume-to-ostium ratio, were analysed over different cardiac phases. Intra-reader agreement, inter-reader agreement, and inter-cycle agreement were calculated through the intraclass correlation coefficient.

​Results

Twenty-one aneurysms from 11 patients were considered for inclusion. Post-processing failed for three aneurysms, and 18 aneurysms were finally analysed. There was good intra-reader agreement for each metric (ICC >0.9). Agreements among three consecutive cardiac cycles were calculated for six aneurysms and were especially good for the volume metric (ICC >0.9). Volume variation appears to be the most relevant metric and seems especially perceptible for aneurysms larger than 5 mm.

​Conclusions

Quantification of aneurysm volume changes during the cardiac cycle seems quantitatively possible and reproducible, especially for aneurysms larger than 5 mm. Further studies need to be conducted to validate this parameter for intracranial aneurysm assessment.
Resistome analyses of sputum from COPD and healthy subjects reveals bacterial load-related prevalence of target genes
Authors: Ramsheh Mohammadali Yavari , Haldar Koirobi , Bafadhel Mona , George Leena , Free Robert C , John Catherine , Reeve Nicola F , Ziegler-Heitbrock Loems , Gut Ivo , Singh Dave , Mistry Vijay , Tobin Martin D , Oggioni Marco R , Brightling Chris , Barer Michael R
Published: November 2019

Background

Antibiotic resistance is a major global threat. We hypothesised that the chronic obstructive pulmonary disease (COPD) airway is a reservoir of antimicrobial resistance genes (ARGs) that associate with microbiome-specific COPD subgroups.

Objective

To determine the resistance gene profiles in respiratory samples from COPD patients and healthy volunteers.

Methods

Quantitative PCR targeting 279 specific ARGs was used to profile the resistomes in sputum from subjects with COPD at stable, exacerbation and recovery visits (n=55; COPD-BEAT study), healthy controls with (n=7) or without (n=22) exposure to antibiotics in the preceding 12 months (EXCEED study) and in bronchial brush samples from COPD (n=8) and healthy controls (n=7) (EvA study).

Results

ARG mean (SEM) prevalence was greater in stable COPD samples (35.2 (1.6)) than in healthy controls (27.6 (1.7); p=0.004) and correlated with total bacterial abundance (r2=0.23; p<0.001). Prevalence of ARG positive signals in individuals was not related to COPD symptoms, lung function or their changes at exacerbation. In the COPD subgroups designated High γProteobacteria and High Firmicutes, ARG prevalence was not different at stable state but significantly declined from stable through exacerbation to recovery in the former (p=0.011) without changes in total bacterial abundance. The ARG patterns were similar in COPD versus health, COPD microbiome-subgroups and between sputum and bronchoscopic samples independent of antibiotic exposure in the last 12 months.

Conclusions

ARGs are highly prevalent in sputum, broadly in proportion to bacterial abundance in both healthy and COPD subjects. Thus, COPD appears to be an ARG reservoir due to high levels of bacterial colonisation.
Time to change
Authors: Nelson‐Pratt Adrian
Published: November 2019

Adrian Nelson‐Pratt explains how an understanding of the way in which you are spending your time makes it possible to claw back wasted hours and secure a better balance in your life.
Shomari Lyon
Authors: Plant Kate ,   Shomari's many friends
Published: November 2019

A larger‐than‐life character with an immense variety of talents and an infectious laugh.