bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing unfamiliar voice and face identity perception using identity sorting tasks
Authors: Johnson Justine , McGettigan Carolyn , Lavan Nadine
Published: June 2020

Identity sorting tasks, in which participants sort multiple naturally varying stimuli of usually two identities into perceived identities, have recently gained popularity in voice and face processing research. In both modalities, participants who are unfamiliar with the identities tend to perceive multiple stimuli of the same identity as different people and thus fail to “tell people together.” These similarities across modalities suggest that modality-general mechanisms may underpin sorting behaviour. In this study, participants completed a voice sorting and a face sorting task. Taking an individual differences approach, we asked whether participants’ performance on voice and face sorting of unfamiliar identities is correlated. Participants additionally completed a voice discrimination (Bangor Voice Matching Test) and a face discrimination task (Glasgow Face Matching Test). Using these tasks, we tested whether performance on sorting related to explicit identity discrimination. Performance on voice sorting and face sorting tasks was correlated, suggesting that common modality-general processes underpin these tasks. However, no significant correlations were found between sorting and discrimination performance, with the exception of significant relationships for performance on “same identity” trials with “telling people together” for voices and faces. Overall, any reported relationships were however relatively weak, suggesting the presence of additional modality-specific and task-specific processes.
Modified Tension-Slide Technique for Endoscopy-Assisted Flexor Hallucis Longus Tendon Transfer
Authors: Lucar-Lopez Gustavo , Ballester-Alomar Manel , Jimenez-Obach Albert , Navarro-Cano Ester , Villamizar Maria Angelica , Guevara-Noriega Kerbi Alejandro
Published: June 2020

The rupture of the Achilles tendon (AT) usually occurs in high-caliber athletes, but low-demand patients are also are risk, mainly if they are under corticoids or quinolones. The diagnosis of the AT rupture is usually neglected, and this could result in a worse prognosis for the patient if not treated in an appropriate time. For these patients or for those with high surgical risk, an option of minimally invasive surgery remains attractive. Classical techniques consist of direct repair or augmentation with the tendon of the flexor hallucis longus as well as nonanatomical tendon transfers which can generate issues with the donor site. We present a pioneering technique that is analogous to that used for the surgical treatment of distal rupture of the biceps tendon, which consist of a transfer technique of flexor hallucis longus by extracortical fixation interference screw associated to a direct tendon reinsertion performed through a bone tunnel on the superior and posterior aspect of the calcaneus using an extracortical drilling system and an interference screw within the calcaneal tunnel. The arthroscopic approach may be technically challenging, and a high-level of arthroscopic skills are required to complete the procedure but after a learning curve it represents a feasible a safe technique.

Levels of Evidence:Therapeutic, Level IX: Evidence from opinion of authorities and/or reports of expert committee
Vascular imaging of the spine in the US Medicare population: Catheter and MR angiography volumes from 2004 to 2016
Authors: Atsina Kofi-Buaku , Cox Mougnyan , Sedora Roman Neda I , Pukenas Bryan , Parker Laurence , Levin David C , Hurst Robert W
Published: June 2020

Aims

The purpose of our study was to analyze utilization trends and physician specialty distribution in spinal catheter angiography and magnetic resonance angiography in the Medicare fee-for-service population.

Methods

Data from the CMS Physician/Supplier Procedure Summary Master Files for 2004 to 2016 were used for this study. The Current Procedural Terminology version 4 codes for spinal magnetic resonance angiography (72159) and spinal catheter angiography (75705) were used to analyze the volumes of these procedures. Using Medicare’s 108 specialty code, we compared procedure volumes among physician specialties. Data analysis was performed using SAS version 9.3 for Windows.

Results

The volume of spinal catheter angiography performed was 4758 in 2004, peaked at 6869 in 2012, and dropped to 6656 in 2016. Overall, the volume of spinal catheter angiography increased by 40% from 2004 to 2016. Radiologists performed the majority of these procedures (3736 or 56.1%) in 2016, followed by neurosurgeons (2456 or 36.9%), and neurologists (346 or 5.2%). The spinal magnetic resonance angiography volume fluctuated between 0 and 1 from 2004 to 2009, then precipitously increased to 40 in 2010, peaked at 133 in 2011, and declined to 81 in 2016. The volume of spinal magnetic resonance angiography procedures increased by 8000% from 2004 to 2016, with radiologists performing the majority of them.

Conclusion

Our results show that spinal catheter angiography volumes continue to rise in the Medicare fee-for-service population, and are largely performed by radiologists, neurosurgeons, and neurologists. Although spinal magnetic resonance angiography volumes have started to increase, they comprise only a small fraction of studies performed for vascular evaluation of the spine.
An overview of prevalence, determinants and health outcomes of polypharmacy
Authors: Khezrian Mina , McNeil Chris J. , Murray Alison D. , Myint Phyo K.
Published: June 2020

A high rate of polypharmacy is, in part, a consequence of the increasing proportion of multimorbidity in the ageing population worldwide. Our understanding of the potential harm of taking multiple medications in an older, multi-morbid population, who are likely to be on a polypharmacy regime, is limited. This is a narrative literature review that aims to appraise and summarise recent studies published about polypharmacy. We searched MEDLINE using the search terms polypharmacy (and its variations, e.g. multiple prescriptions, inappropriate drug use, etc.) in titles. Systematic reviews and original studies in English published between 2003 and 2018 were included. In this review, we provide current definitions of polypharmacy. We identify the determinants and prevalence of polypharmacy reported in different studies. Finally, we summarise some of the findings regarding the association between polypharmacy and health outcomes in older adults, with a focus on frailty, hospitalisation and mortality. Polypharmacy was most often defined in terms of the number of medications that are being taken by an individual at any given time. Our review showed that the prevalence of polypharmacy varied between 10% to as high as around 90% in different populations. Chronic conditions, demographics, socioeconomics and self-assessed health factors were independent predictors of polypharmacy. Polypharmacy was reported to be associated with various adverse outcomes after adjusting for health conditions. Optimising care for polypharmacy with valid, reliable measures, relevant to all patients, will improve the health outcomes of older adult population.
Changing workplace geographies in the COVID-19 crisis
Authors: Reuschke Darja , Felstead Alan
Published: June 2020

COVID-19 has fundamentally changed workplace geographies with large proportions of people working at home during the ‘Great Lockdown’. This commentary argues that working at home has emerged as a key policy response and one in which inequalities are embedded. We outline the nature of these social and spatial inequalities by examining existing evidence and data for the Global North, and consider some of the economic and policy challenges ahead.
Paint a Better Mood? Effects of Makeup Use on YouTube Beauty Influencers’ Self-Esteem
Authors: Tran Alison , Rosales Robert , Copes Lynn
Published: June 2020

Although 90% of women between the ages of 18 and 29 report using makeup, research on the motivation and effects of makeup use on self-esteem is lacking. The purposes of this qualitative study is to (1) understand the effects of intrinsic and extrinsic motivation to use makeup on self-esteem, (2) explore whether makeup use may serve as a buffer for low self-esteem, and (3) explore the impact of sociocultural scripts and hegemonic beauty on self-esteem in ethnoracially diverse YouTube beauty influencers. Jacobsen’s Aesthetics of Psychology framework was used to classify narratives of nine female beauty influencers aged between 21 and 40 years from the United States and Great Britain, who self-identified as Black, Hispanic, and White. Makeup use may have a more direct effect on self-esteem if internally motivated and viewed as a mechanism for creativity, mastery, agency, and human connection. Likewise, makeup use may indirectly buffer low mood/self-esteem for those who are externally motivated to use makeup in order to avoid guilt, enhance ego, and promote audience confidence. Results elucidate the importance of motivation to use makeup and its implications for positive mood regulation/enhanced self-esteem through the development of mental health interventions involving makeup application. Findings illuminate the experiences of women in media and public domains and are particularly salient for women of color who may be more extrinsically motivated to use makeup due to hegemonic beauty standards, as Black beauty influencers reported industry disparities in pay/salary, sponsorships, and subscriber count compared with young, White influencers.
Emerging Adult Perceptions of Cannabis Use Based on Age and Sex of User
Authors: Harris-Lane Laura , Winters Emily , Harris Nick
Published: June 2020

In Canada, emerging adults consume more cannabis than any other age-group. This study examined emerging adults’ perceptions of dangerousness, perceptions of negative impacts, and level of disapproval associated with regular cannabis use. An experimental vignette design was utilized to examine the extent to which perceptions differ depending on the age and sex of the user. Participants ( N = 656) were randomly assigned to one of six vignettes and were asked to rate 7 items of perceived dangerousness, perceived negative impacts, and level of disapproval. Significant main effects of age were found on 6 of 7 items, where cannabis use by a 14-year-old was viewed as more dangerous than cannabis use by a 21- and 28-year-old. However, cannabis use by a 21-year-old was not viewed as more dangerous than cannabis use by a 28-year-old. Female cannabis use was perceived as more dangerous than male cannabis use with respect to social life.
Controversies with nonoperative management for adolescent idiopathic scoliosis: Study from the APSS Scoliosis Focus Group
Authors: Cheung Jason Pui Yin , Cheung Prudence Wing Hang , Shigematsu Hideki , Takahashi Shinji , Kwan Mun Keong , Chan Chris Yin Wei , Chiu Chee Kidd , Sakai Daisuke ,   APSS Scoliosis Focus Group
Published: June 2020

Purpose:

To determine consensus among Asia-Pacific surgeons regarding nonoperative management for adolescent idiopathic scoliosis (AIS).

Methods:

An online REDCap questionnaire was circulated to surgeons in the Asia-Pacific region during the period of July 2019 to September 2019 to inquire about various components of nonoperative treatment for AIS. Aspects under study included access to screening, when MRIs were obtained, quality-of-life assessments used, role of scoliosis-specific exercises, bracing criteria, type of brace used, maturity parameters used, brace wear regimen, follow-up criteria, and how braces were weaned. Comparisons were made between middle–high income and low-income countries, and experience with nonoperative treatment.

Results:

A total of 103 responses were collected. About half (52.4%) of the responders had scoliosis screening programs and were particularly situated in middle–high income countries. Up to 34% obtained MRIs for all cases, while most would obtain MRIs for neurological problems. The brace criteria were highly variable and was usually based on menarche status (74.7%), age (59%), and Risser staging (92.8%). Up to 52.4% of surgeons elected to brace patients with large curves before offering surgery. Only 28% of responders utilized CAD-CAM techniques for brace fabrication and most (76.8%) still utilized negative molds. There were no standardized criteria for brace weaning.

Conclusion:

There are highly variable practices related to nonoperative treatment for AIS and may be related to availability of resources in certain countries. Relative consensus was achieved for when MRI should be obtained and an acceptable brace compliance should be more than 16 hours a day.
A Novel Scoring Instrument to Assess Donor Site Morbidity After Anterior Cruciate Ligament Reconstruction With a Patellar Tendon Autograft at 2-Year Follow-up Using Contemporary Graft-Harvesting Techniques
Authors: Hacken Brittney A. , Keyt Lucas K. , Leland Devin P. , LaPrade Matthew D. , Camp Christopher L. , Levy Bruce A. , Stuart Michael J. , Krych Aaron J.
Published: June 2020

Background:

Donor site morbidity after anterior cruciate ligament (ACL) reconstruction with a bone–patellar tendon–bone (BTB) autograft is clinically significant, but evidence with contemporary techniques is lacking.

Purpose:

To (1) evaluate donor site morbidity at a single institution using modern techniques of BTB autograft harvest at 2-year follow-up, (2) develop a 10-question donor site morbidity instrument, and (3) compare this instrument against traditional outcome tools.

Study Design:

Case series; Level of evidence, 4.

Methods:

We analyzed the 2-year follow-up outcomes of 200 consecutive patients who underwent ACL reconstruction with a BTB autograft performed by 2 surgeons at a single institution. The surgical technique utilized modern and consistent BTB autograft harvest, including graft sizing, patellar tendon and peritenon closure, and patellar and tibial donor site bone grafting. There were 187 patients included, with 13 patients undergoing revision ACL reconstruction excluded. An original 10-question scoring instrument evaluating donor site morbidity was administered to each patient (score, 0-100) and compared against each patient’s International Knee Documentation Committee (IKDC) and Lysholm scores.

Results:

Overall, 13.9% of patients were noted to have anterior knee pain with activity at 2-year follow-up. Moreover, 3.7% of patients reported an inability to kneel on hard surfaces but had no problems on soft surfaces; 5.9% of patients reported mild discomfort but were able to kneel on all surfaces. Additionally, 75.4% of patients had a perfect (100/100) donor site morbidity score. The mean donor site morbidity score at 2-year follow-up was 98.3 ± 3.4. There was a very strong correlation between the IKDC and Lysholm scores but only a strong and moderate correlation when the donor site morbidity score was compared with the IKDC and Lysholm scores, respectively.

Conclusion:

Donor site morbidity after ACL reconstruction with a BTB autograft was less frequent than reported in the existing literature. Some patients developed anterior knee pain; therefore, an informed discussion is advised. IKDC and Lysholm scores may not capture donor site symptoms after surgery. The 10-question donor site morbidity instrument may provide a more accurate assessment.
Comparing paediatric- and adult-onset linear morphoea in a large tertiary-referral scleroderma centre
Authors: Saracino Amanda M , George Christina , Nihtyanova Svetlana I , Denton Christopher P
Published: June 2020

Background:

Linear morphoea is a severe morphoea subtype associated with extracutaneous manifestations, potentially permanent disfigurement and functional impairment. Linear morphoea is more prevalent in paediatric patients, and knowledge of disease in adults is limited. The objective of this study was to compare paediatric- and adult-onset linear morphoea, in an exclusively adult population.

Methodology:

This was a retrospective cohort study of adult patients with linear morphoea seen over a 3-year period at a single-site adult tertiary-referral Connective Tissue Disease centre. Clinical markers of disease severity and course, including anatomical distribution, extracutaneous manifestations, cutaneous symptoms, associated autoimmunity, inflammatory blood parameters, Dermatology Life Quality Index scores, treatment requirements and modified Localised Scleroderma Activity Tool were assessed and compared in paediatric- and adult-onset linear morphoea.

Results:

Of 298 patients with morphoea seen during the study period, 135 had linear morphoea and 133 were included in the study. Most were female (78.9%), the mean age was 36.5 years and almost half (43.6%) had adult-onset disease. Disease was similarly severe between groups with regard to anatomical distribution, cutaneous symptoms (n = 89, 66.9%), extracutaneous manifestations (n = 76, 57.1%), antinuclear antibody–positivity (n = 40, 40.4%), raised erythrocyte sedimentation rate (n = 27, 25.0%) and associated autoimmune diagnoses (n = 15, 11.3%). Prescribed treatments were similar between groups; 73.7% receiving methotrexate and almost one-third (32.3%) requiring more than one steroid-sparing agent. Those with paediatric-onset had more disease-related damage, with a mean modified Localised Scleroderma Skin Damage Index score of 19.5 (95% confidence interval: 17.0–22.0) versus 8.1 (95% confidence interval: 4.4–11.8; p < 0.001). Significantly more patients with adult-onset linear morphoea had quiescent disease (p = 0.0332), and even after correcting for disease duration, paediatric-onset patients still had 2.6 times greater odds of active disease (odds ratio = 2.59, 95% confidence interval: 0.9–7.6; p = 0.083).

Conclusion:

Linear morphoea in adults can be a severe disease with extracutaneous, autoimmune and systemic features. Adults with paediatric-onset disease appear to have more severe cumulative damage, greater functional impairment and ongoing disease activity. This patient subgroup may require particularly close monitoring and more aggressive therapy.
The Value of Sonography Education Faculty in an Academic Emergency Ultrasound Program
Authors: Grimmett Stacy , End Bradley , Quedado Kimberly , Kraft Clara , Minardi Joseph
Published: June 2020

Within the West Virginia University (WVU) Department of Emergency Medicine (DEM), education related to point-of-care ultrasound (POCUS) has been under the jurisdiction of the POCUS director in the emergency department. To facilitate sonography education and extend the capabilities of the POCUS director, a dedicated sonography education faculty member (SEFM) was hired. A SEFM is an experienced sonographer who brings technical knowledge, experience, and pedagogical skills. In addition, the SEFM is able to assist with administrative and operational aspects of a POCUS program, including image archival, disinfection protocols, and quality guidelines. From the sonographer’s prospective, the position has been challenging and fulfilling, and there remain countless opportunities for growth. From the POCUS director’s perspective, the SEFM has been instrumental in strengthening the residency program and other educational offerings.
Validation of an algorithm for automated classification of migraine and tension-type headache attacks in an electronic headache diary
Authors: Roesch Aaron , Dahlem Markus A , Neeb Lars , Kurth Tobias
Published: June 2020

Background

This study evaluates the accuracy of an automated classification tool of single attacks of the two major primary headache disorders migraine and tension-type headache used in an electronic headache diary.

Methods

One hundred two randomly selected reported headache attacks from an electronic headache-diary of patients using the medical app M-sense were classified by both a neurologist with specialisation in headache medicine and an algorithm, constructed based on the ICHD-3 criteria for migraine and tension-type headache. The level of agreement between the headache specialist and the algorithm was compared by using a kappa statistic. Cases of disagreement were analysed in a disagreement validity assessment.

Result

The neurologist and the algorithm classified migraines with aura (MA), migraines without aura (MO), tension-type headaches (TTH) and non-migraine or non-TTH events. Of the 102 headache reports, 86 cases were fully agreed on, and 16 cases not, making the level of agreement unweighted kappa 0.74 and representing a substantial level of agreement. Most cases of disagreement (12 out of 16) were due to inadvertent mistakes of the neurologist identified in the disagreement validity assessment. The second most common reason (3 out of 16) was insufficient information for classification by the neurologist.

Conclusions

The substantial level of agreement indicates that the classification tool is a valuable instrument for automated evaluation of electronic headache diaries, which can thereby support the diagnostic and therapeutic clinical processes. Based on this study’s results, additional diagnostic functionalities of primary headache management apps can be implemented. Finally, future research can use this classification algorithm for large scale database analysis for epidemiological studies.
Campylobacter bacteriophage DA10: an excised temperate bacteriophage targeted by CRISPR-cas
Authors: Hooton Steven , D’Angelantonio Daniela , Hu Yang , Connerton Phillippa L. , Aprea Giuseppe , Connerton Ian F.
Published: June 2020

Background

Lytic bacteriophages that infect Campylobacter spp. have been utilized to develop therapeutic/decontamination techniques. However, the association of Campylobacter spp. and bacteriophages has been the focus of several strands of research aimed at understanding the complex relationships that have developed between predators and prey over evolutionary time. The activities of endogenous temperate bacteriophages have been used to evaluate genomic rearrangements and differential protein expression in host cells, and mechanisms of resistance to bacteriophage infection in campylobacters such as phase variation and CRISPR-mediated immunity.

Results

Temperate bacteriophage DA10 represents a novel excised and infective virus capable of replication in a restricted set of C. jejuni and C. coli hosts. Whole genome sequencing reveals that DA10 (35,379 bp) forms part of a novel group of temperate bacteriophages that have limited distribution among database host genome sequences. Analysis of potential host genomes reveals a robust response against DA10 and DA10-like bacteriophages is driven by CRISPR-mediated immunity with 75% of DA10 ORFs represented as ~ 30 bp spacer sequences in numerous Campylobacter Type II-C CRISPR arrays. Several DA10-like homologues have been identified in a small sub-set of C. jejuni and C. coli genome sequences (ranging from near complete integrated prophage sequences to fragments recognisable in the sequence read archive).

Conclusions

A complete intact DA10-like prophage in C. jejuni CJ677CC520 provides evidence that the associations between host and DA10-like bacteriophages are long-standing in evolutionary timescales. Extensive nucleotide substitution and loss can be observed in the integrated DA10-like prophage of CJ677CC520 compared to other relatives as observed through pairwise genome comparisons. Examining factors that have limited the population expansion of the prophage, while others appear to have thrived and prospered (Mu-like, CJIE-like, and lytic Campylobacter bacteriophages) will assist in identifying the underlying evolutionary processes in the natural environment.
Population attributable risk estimates of risk factors for contrast-induced acute kidney injury following coronary angiography: a cohort study
Authors: Lei Li , Xue Yan , Guo Zhaodong , Liu Bowen , He Yibo , Song Feier , Liu Jin , Sun Guoli , Chen Liling , Chen Kaihong , Su Zhiqi , Pan Li , Huang Zhidong , Huang Yulu , Huang Xiuqiong , Chen Shiqun , Chen Jiyan , Liu Yong
Published: June 2020

Background

Contrast-induced acute kidney injury (CI-AKI) is a common complication with poor outcomes following coronary angiography (CAG) or percutaneous coronary intervention (PCI). However, no study has explored the population attributable risks (PARs) of the CI-AKI risk factors. Therefore, we aimed to identify the independent risk factors of CI-AKI and estimate their PARs.

Methods

We analyzed 3450 consecutive patients undergoing CAG/PCI from a prospective cohort in Guangdong Provincial People’s Hospital. CI-AKI was defined as a serum creatinine elevation ≥50% or 0.3 mg/dL from baseline within the first 48 to 72 h after the procedure. Independent risk factors for CI-AKI were evaluated through stepwise approach and multivariable logistic regression analysis, and those that are potentially modifiable were of interest. PARs of independent risk factors were calculated with their odds ratios and prevalence among our cohort.

Results

The overall incidence of CI-AKI was 7.19% (n = 248), which was associated with increased long-term mortality. Independent risk factors for CI-AKI included heart failure (HF) symptoms, hypoalbuminemia, high contrast volume, hypotension, hypertension, chronic kidney disease stages, acute myocardial infarction and age > 75 years. Among the four risk factors of interest, the PAR of HF symptoms was the highest (38.06%), followed by hypoalbuminemia (17.69%), high contrast volume (12.91%) and hypotension (4.21%).

Conclusions

These modifiable risk factors (e.g., HF symptoms, hypoalbuminemia) could be important and cost-effective targets for prevention and treatment strategies to reduce the risk of CI-AKI. Intervention studies targeting these risk factors are needed.
Incorporating the patient-centered approach into clinical practice helps improve quality of care in cases of hypertension: a retrospective cohort study
Authors: Buawangpong Nida , Pinyopornpanish Kanokporn , Jiraporncharoen Wichuda , Dejkriengkraikul Nisachol , Sagulkoo Pakorn , Pateekhum Chanapat , Angkurawaranon Chaisiri
Published: June 2020

Background

Treating hypertensive patients by integrating the patient-centered approach would influence the practice and outcome of treatment. Our purpose was to determine whether the implementation of a patient-centered approach in health care delivery can improve adhering to guidelines and the quality-of-care.

Methods

A retrospective study was conducted using secondary data from the electronic medical records of the patients treated in the two primary care outpatient settings at the Family Medicine (FM) and Social Security (SS) clinics. A key feature of the FM clinic is the incorporation of a patient-centered approach in its service delivery. Individual information regarding initial assessment and treatment at the follow-up visits was reviewed for 1 year. Comparison of adherence to treatment guidelines between the two primary care clinics was performed by using chi-square, Fisher’s exact test or a t-test. To explore the difference in blood pressure and BP control between the two clinics, linear and logistic regression analysis respectively were performed with an adjustment for CV risk score in 2016 as a key confounder.

Results

The evidence included 100 records from each clinic, showed variation between the two primary care sites. The FM clinic had more complete records regarding family history of hypertension, assessment for secondary causes, prescription for lifestyle modification and appropriate adjustment of medication. Higher levels of blood pressure control were recorded in the FM clinic, specifically systolic pressure 2.92 mmHg (p = 0.073) and diastolic pressure 5.38 mmHg (p <  0.001) lower than those recorded in the SS clinic. There was a 2.96 times higher chance for BP goals to be achieved in patients in receipt of hypertensive care at the FM clinic (p = 0.004).

Conclusions

Adopting a patient-centered approach in service delivery could improve the quality of care for hypertension patients in primary care in Thailand.
Weekly paclitaxel plus ramucirumab versus weekly nab-paclitaxel plus ramucirumab for unresectable advanced or recurrent gastric cancer with peritoneal dissemination refractory to first-line therapy—the P-SELECT trial (WJOG10617G)—a randomised phase II trial by the West Japan Oncology Group
Authors: Hirata Kenro , Hamamoto Yasuo , Ando Masahiko , Imamura Chiyo K. , Yoshimura Kenichi , Yamazaki Kentaro , Hironaka Shuichi , Muro Kei
Published: June 2020

Background

Ramucirumab (RAM) with weekly paclitaxel (wPTX) is a standard second-line therapy for advanced or recurrent gastric cancer. Nanoparticle albumin-bound paclitaxel (nab-PTX), an albumin-bound form of PTX, was developed to improve the therapeutic index of taxane treatment. However, the ABSOLUTE trial showed the non-inferiority of weekly nab-PTX (w-nab-PTX) to wPTX with respect to overall survival (OS) as second-line therapy for advanced or recurrent gastric cancer, and subgroup analysis of patients with peritoneal dissemination showed favourable OS and progression-free survival (PFS) in the w-nab-PTX arm compared to those in the wPTX arm. This study evaluated whether w-nab-PTX plus RAM is more effective than wPTX plus RAM for patients with peritoneal dissemination.

Methods

The P-SELECT trial (WJOG10617G) is a prospective, open-label, multicentre, randomised phase II study evaluating wPTX plus RAM (arm A) versus w-nab-PTX plus RAM (arm B). Key eligibility criteria include the following: 1) histologically proven adenocarcinoma, 2) unresectable or recurrent gastric cancer, 3) peritoneal dissemination, 4) intolerance or refractory to first-line therapy including fluoropyrimidines, and 5) ECOG Performance Status (PS) 0–2. Patients are randomised to either arm at a 1:1 ratio stratified by institution, PS, and severity of ascites. PTX (80 mg/m2; days 1, 8, and 15) and RAM (8 mg/kg; days 1 and 15) are administered every 4 weeks in arm A, while nab-PTX (100 mg/m2; days 1, 8, and 15) instead of PTX is administered in arm B. The primary endpoint is OS, and the main secondary endpoints are PFS, objective response rate, safety, neuropathy-specific quality of life, and biomarkers. To maintain a probability of ≥70% to ensure the hazard ratio for OS in arm B is lower than 0.90, 105 subjects are required. The study was initiated in October 2018 and is being conducted in 58 centres of the West Japan Oncology Group.

Discussion

The results of this study will determine whether w-nab-PTX plus RAM has the potential to be a preferred therapeutic option for advanced and recurrent gastric cancer with peritoneal dissemination, compared to wPTX plus RAM.

Trial registration

This study was prospectively registered in the Japan Registry of Clinical Trials (jRCTs031180022, October 1, 2018).
Timing of rapid weight gain and its effect on subsequent overweight or obesity in childhood: findings from a longitudinal birth cohort study
Authors: Li Yi-Fan , Lin Shio-Jean , Chiang Tung-liang
Published: June 2020

Background

Rapid weight gain (RWG) has been recognized as an important determinant of childhood obesity. This study aims to explore the RWG distribution among children at six-month intervals from birth to two years old and to examine the association of RWG in each interval with overweight or obesity development in preschool- and school-aged children.

Methods

Data were obtained from the Taiwan Birth Cohort Study, which is a nationally representative sample of 24,200 children who participated in a face-to-face survey. A total of 17,002 children had complete data both for weight and height at each of the five measurement time periods. Multivariable logistic regression models quantified the relationship between RWG and childhood overweight or obesity.

Results

A total of 17.5% of children experienced rapid weight gain in the first six months of age, compared to only 1.8% of children from 18-24 months. RWG was significantly associated with an increased risk of developing overweight or obesity at 36 months (RWG birth-6 months: OR = 2.6, 95% CI: 2.3–2.8; RWG 18–24 months: OR = 3.7, 95% CI: 2.9–4.6), 66 months (RWG birth-6 months: OR = 2.2, 95% CI: 2.0–2.4; RWG 18–24 months: OR = 2.3, 95% CI: 1.8–2.8), and 8 years of age (RWG birth-6 months: OR = 1.7, 95% CI: 1.6–1.9; RWG 18–24 months: OR = 2.4, 95% CI: 2.0–3.0).

Conclusions

Childhood RWG increased the risk of subsequent overweight or obesity, regardless of the specific time interval at which RWG occurred before the age of two years. The results reinforce the importance of monitoring childhood RWG continuously and show the risks of childhood RWG with respect to the development of overweight or obesity at preschool and school ages.
The validity and reliability of the Patient Health Questionnaire-9 for screening depression in primary health care patients in Botswana
Authors: Molebatsi Keneilwe , Motlhatlhedi Keneilwe , Wambua Grace Nduku
Published: June 2020

Background

The lack of locally validated screening instruments contributes to poor detection of depression in primary care. The Patient Health Questionnaire-9 (PHQ-9) is a brief and freely available screening tool which was developed for primary care settings; however, its accuracy may be affected by the population in which it is administered. This study aimed to determine the validity and reliability of PHQ-9 for screening depression in a primary care population in Botswana.

Methods

Data was collected from a conveniently selected sample of 257 adult primary care attendants. The Mini International Neuropsychiatric Interview (MINI) depression module was used as a gold standard to assess criterion validity.

Results

Sensitivity and specificity of the PHQ-9 for screening for major depression were 72.4 and 76.3 respectively at a cut off score of nine or more. The area under the ROC curve was 0.808. The PHQ-9 demonstrated good internal consistency with a Cronbach alpha of 0.799. Criterion validity was demonstrated by significant correlation (r = 0.528, p < 0.001) between PHQ-9 and the MINI. Significant negative correlation between PHQ-9 scores and all four domains of the WHO quality of life questionnaire- brief version scores demonstrated good convergent validity.

Conclusions

The PHQ-9 is a reliable and valid instrument to screen for depression in primary care facilities in Botswana. Primary care clinicians in Botswana may use the PHQ-9 to screen for depression with a cut –off score of nine. Further studies should focus on integrating routine depression screening in primary care.
Monetary incentives and peer referral in promoting digital network-based secondary distribution of HIV self-testing among men who have sex with men in China: study protocol for a three-arm randomized controlled trial
Authors: Lu Ying , Ni Yuxin , Li Xiaofeng , He Xi , Huang Shanzi , Zhou Yi , Dai Wencan , Wu Dan , Tucker Joseph D. , Shen Guangquan , Sha Yongjie , Jiang Hongbo , Huang Liqun , Tang Weiming
Published: June 2020

Background

Human immunodeficiency virus (HIV) testing is a crucial strategy for HIV prevention. HIV testing rates remain low among men who have sex with men (MSM) in China. Digital network-based secondary distribution is considered as an effective model to enhance HIV self-testing (HIVST) among key populations. Digital platforms provide opportunities for testers to apply for HIVST kits by themselves, and secondary distribution allows them to apply for multiple kits to deliver to their sexual partners or members within their social network. We describe a three-arm randomized controlled trial to examine the effect of monetary incentives and peer referral in promoting digital network-based secondary distribution of HIVST among MSM in China.

Methods

Three hundred MSM in China will be enrolled through a digital platform for data collection. The eligibility criteria include being biological male, 18 years of age or over, ever having had sex with another man, being able to apply for kits via the online platform, and being willing to provide personal telephone number for follow-up. Eligible participants will be randomly allocated into one of the three arms: standard secondary distribution arm, secondary distribution with monetary incentives arm, and secondary distribution with monetary incentives plus peer referral arm. Participants (defined as “index”) will distribute actual HIV self-test kits to members within their social network (defined as “alter”) or share referral links to encourage alters to apply HIV self-test kits by themselves. All index participants will be requested to complete a baseline survey and a 3-month follow-up survey. Both indexes and alters will complete a survey upon returning the results by taking a photo of the used kits with the unique identification number.

Discussion

HIV testing rates remain suboptimal among MSM in China. Innovative interventions are needed to further expand the uptake of HIV testing among key populations. The findings of the trial can provide scientific evidence and experience on promoting secondary distribution of HIVST to reach key populations who have not yet been covered by existing testing services.

Trial registration

The study was registered in the Chinese Clinical Trial Registry (ChiCTR1900025433) on 26, August 2019, http://www.chictr.org.cn/showproj.aspx?proj=42001. Prospectively registered.
An 8 week open-label interventional multicenter study to explore the lung clearance index as endpoint for clinical trials in cystic fibrosis patients ≥8 years of age, chronically infected with Pseudomonas aeruginosa
Authors: Sutharsan Sivagurunathan , Naehrig Susanne , Mellies Uwe , Sieder Christian , Ziegler Jörg
Published: June 2020

Background

Forced expiratory volume in 1 second (FEV1) is the only parameter currently recognized as a surrogate endpoint in cystic fibrosis (CF) trials. However, FEV1 is relatively insensitive to changes in the small airways of patients with milder lung disease. This pilot study aimed to explore the lung clearance index (LCI) as a marker for use in efficacy trials with inhaled antibiotics in CF.

Methods

This open-label, single-arm study enrolled CF patients with Pseudomonas aeruginosa infection, who were treated with tobramycin (28-day on/off regime). FEV1, LCI and bacterial load in sputum (CFU) were assessed at baseline, after 1, 4 and 8 weeks of treatment.

Results

All patients (n = 17) showed elevated LCI of > 11 despite 3 patients having normal FEV1 (> 90% predicted) at baseline. Overall, LCI improved in 8 (47%) patients and FEV1 in 9 (53%) patients. At week 4, LCI improved by 0.88, FEV1 increased by 0.52%, and P. aeruginosa reduced by 30,481.3 CFU/mL. These changes were however statistically non-significant. Six adverse events occurred in 5/17 (29.4%) patients, most of which were mild-to-moderate in severity.

Conclusions

Due to the low evaluable sample size, no specific trend was observed related to the changes between LCI, FEV1 and CFU. Based on the individual data from this study and from recently published literature, LCI has been shown to be a more sensitive parameter than FEV1 for lung function. LCI can be hypothesized to be an appropriate endpoint for efficacy trials in CF patients if the heterogeneity in lung function is limited by enrolling younger patients or patients with more milder lung disease and thus, limiting the ventilation inhomogeneities.

Trial registration

The study is registered with ClinicalTrials.gov, identifier: NCT02248922.
Barrel-shaped design of the forearm free flap for lower lip reconstruction: a pilot case-control study
Authors: Lin Nan-Chin , Lin Shih-Lung , Tsai Kuo-Yang
Published: June 2020

Background

Radial free forearm flaps is indicated patients with total or near-total defects in their lower lip. The purpose of our study was to evaluate a simple and effective barrel-shaped design of the radial free forearm flap for lower lip reconstruction and to compare its clinical outcomes with those of a conventional rectangular shaped free forearm flap.

Methods

Twenty-two patients with a lower lip carcinoma who underwent radial forearm free flap reconstructive surgery were enrolled in this study between January 1, 2012, and December 31, 2017. A barrel-shaped design of radial forearm free flap for reconstruction was used in 8 patients (case group), and a rectangular design was used in 14 patients (control group). The patients’ quality of life was evaluated preoperatively and postoperatively in all the patients using the European Organization for Research and Treatment of Cancer Quality of Life (EORTC-HN35) questionnaire. We analyzed the differences in the EORTC QLQ-HN35 scores pre- and postoperatively between the case and control group.

Results

The patients in the case group had better outcomes in swallowing, speech, social eating, social contact, and dry mouth than the control group at 1-year follow-up (P < 0.05).

Conclusions

The use of a barrel-shaped design free forearm flap for lower lip reconstruction is an effective procedure and can achieve better results than the use of rectangular free forearm flap.
Treatment outcomes of Kugel repair for obturator hernias: a retrospective study
Authors: Hosoi Yoshie , Asano Hiroshi , Fukano Hiroyuki , Shinozuka Nozomi
Published: June 2020

Background

We examined the validity and applicability of the Kugel repair approach for obturator hernias, whereby we placed a Kugel patch through the preperitoneal space after placing a short 5-cm skin incision just medial to the anterior iliac spine and 2 cm cranial to the expected origin of the internal inguinal ring.

Methods

We studied patients who underwent surgical Kugel repair for obturator hernias at the Department of General Surgery, Saitama Medical University between 2007 and 2017. We examined the operating time, length of hospital stay, postoperative complications, and mortality rate.

Results

Fifty-eight patients with obturator hernias presented with symptoms of small bowel obstruction. A Kugel approach was used in 53 patients and a midline approach was used in 5 patients with preoperative peritonitis. Of the 53 patients managed using the Kugel approach, 39 did not require intestinal resection; a mesh was used in all these patients. In the remaining 14 patients, intestinal resection was required and performed using the same approach; subsequently, a mesh was used successfully in 6 of these 14 patients. The overall median operating time was 47 min; the corresponding values for procedures with and without intestinal resection were 39 and 68 min, respectively. In terms of postoperative complications, operative mortality was not noted among patients without intestinal perforation; however, superficial surgical site infection developed in 2 patients. Among the 5 patients with preoperative peritonitis who underwent exploratory laparotomy via a midline incision, intestinal perforation was detected during surgery, and all patients required intestinal resection; none of the patients had received a mesh, and 2 patients died after surgery.

Conclusions

The Kugel repair approach was possible even in patients with obturator hernia requiring intestinal resection. However, for patients with perforations, open surgery should be performed after securing the surgical field through a midline incision.
Prevalence of monarch (Danaus plexippus) and queen (Danaus gilippus) butterflies in West Texas during the fall of 2018
Authors: Brym Matthew Z. , Henry Cassandra , Lukashow-Moore Shannon P. , Henry Brett J. , van Gestel Natasja , Kendall Ronald J.
Published: June 2020

Background

The monarch butterfly (Danaus plexippus) is a conspicuous insect that has experienced a drastic population decline over the past two decades. While there are several factors contributing to dwindling monarch populations, habitat loss is considered the most significant threat to monarchs. In the United States, loss of milkweed, particularly in the Midwest, has greatly reduced the available breeding habitat of monarchs. This has led to extensive efforts to conserve and restore milkweed resources throughout the Midwest. Recently, these research and conservation efforts have been expanded to include other important areas along the monarch’s migratory path.

Results

During the fall of 2018, we conducted surveys of monarch eggs and larvae through West Texas. We documented monarch and queen butterfly (Danaus gilippus) reproduction throughout the region and used the proportion of monarch and queen larva to estimate the number of monarch eggs. Peak egg densities for monarchs were as high as 0.78 per milkweed ramet after correction for the presence of queens. Despite our observations encompassing only a limited sample across one season, the peak monarch egg densities we observed exceeded published reports from when monarch populations were higher.

Conclusions

To our knowledge, this is the first study to correct for the presence of queens when calculating the density of monarch eggs. This research also provides insight into monarch utilization of less well-known regions, such as West Texas, and highlights the need to expand the scope of monarch monitoring and conservation initiatives. While the importance of monarch research and conservation in the Midwest is unquestionable, more comprehensive efforts may identify new priorities in monarch conservation and lead to a more robust and effective overall strategy, particularly given the dynamic and rapidly changing global environment.
Evaluating the effect of healthcare providers on the clinical path of heart failure patients through a semi-Markov, multi-state model
Authors: Gasperoni Francesca , Ieva Francesca , Paganoni Anna Maria , Jackson Christopher H , Sharples Linda
Published: June 2020

Background

Investigating similarities and differences among healthcare providers, on the basis of patient healthcare experience, is of interest for policy making. Availability of high quality, routine health databases allows a more detailed analysis of performance across multiple outcomes, but requires appropriate statistical methodology.

Methods

Motivated by analysis of a clinical administrative database of 42,871 Heart Failure patients, we develop a semi-Markov, illness-death, multi-state model of repeated admissions to hospital, subsequent discharge and death. Transition times between these health states each have a flexible baseline hazard, with proportional hazards for patient characteristics (case-mix adjustment) and a discrete distribution for frailty terms representing clusters of providers. Models were estimated using an Expectation-Maximization algorithm and the number of clusters was based on the Bayesian Information Criterion.

Results

We are able to identify clusters of providers for each transition, via the inclusion of a nonparametric discrete frailty. Specifically, we detect 5 latent populations (clusters of providers) for the discharge transition, 3 for the in-hospital to death transition and 4 for the readmission transition. Out of hospital death rates are similar across all providers in this dataset. Adjusting for case-mix, we could detect those providers that show extreme behaviour patterns across different transitions (readmission, discharge and death).

Conclusions

The proposed statistical method incorporates both multiple time-to-event outcomes and identification of clusters of providers with extreme behaviour simultaneously. In this way, the whole patient pathway can be considered, which should help healthcare managers to make a more comprehensive assessment of performance.