bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative transcriptome analysis of the rice leaf folder (Cnaphalocrocis medinalis) to heat acclimation
Authors: Quan Peng-Qi , Li Ming-Zhu , Wang Gao-Rong , Gu Ling-Ling , Liu Xiang-Dong
Published: June 2020

Background

The rice leaf folder Cnaphalocrocis medinalis Güenée is a serious insect pest of rice in Asia. This pest occurs in summer, and it is sensitive to high temperature. However, the larvae exhibit heat acclimation/adaptation. To understand the underlying mechanisms, we established a heat-acclimated strain via multigenerational selection at 39 °C. After heat shock at 41 °C for 1 h, the transcriptomes of the heat-acclimated (S-39) and unacclimated (S-27) larvae were sequenced, using the unacclimated larvae without exposure to 41 °C as the control.

Results

Five generations of selection at 39 °C led larvae to acclimate to this heat stress. Exposure to 41 °C induced 1160 differentially expressed genes (DEGs) between the heat-acclimated and unacclimated larvae. Both the heat-acclimated and unacclimated larvae responded to heat stress via upregulating genes related to sensory organ development and structural constituent of eye lens, whereas the unacclimated larvae also upregulated genes related to structural constituent of cuticle. Compared to unacclimated larvae, heat-acclimated larvae downregulated oxidoreductase activity-related genes when encountering heat shock. Both the acclimated and unacclimated larvae adjusted the longevity regulating, protein processing in endoplasmic reticulum, antigen processing and presentation, MAPK and estrogen signaling pathway to responsed to heat stress. Additionally, the unacclimated larvae also adjusted the spliceosome pathway, whereas the heat-acclimated larvae adjusted the biosynthesis of unsaturated fatty acids pathway when encountering heat stress. Although the heat-acclimated and unacclimated larvae upregulated expression of heat shock protein genes under heat stress including HSP70, HSP27 and CRYAB, their biosynthesis, metabolism and detoxification-related genes expressed differentially.

Conclusions

The rice leaf folder larvae could acclimate to a high temperature via multigenerational heat selection. The heat-acclimated larvae induced more DEGs to response to heat shock than the unacclimated larvae. The changes in transcript level of genes were related to heat acclimation of larvae, especially these genes in sensory organ development, structural constituent of eye lens, and oxidoreductase activity. The DEGs between heat-acclimated and unacclimated larvae after heat shock were enriched in the biosynthesis and metabolism pathways. These results are helpful to understand the molecular mechanism underlying heat acclimation of insects.
How methodological frameworks are being developed: evidence from a scoping review
Authors: McMeekin Nicola , Wu Olivia , Germeni Evi , Briggs Andrew
Published: June 2020

Background

Although the benefits of using methodological frameworks are increasingly recognised, to date, there is no formal definition of what constitutes a ‘methodological framework’, nor is there any published guidance on how to develop one. For the purposes of this study we have defined a methodological framework as a structured guide to completing a process or procedure. This study’s aims are to: (a) map the existing landscape on the use of methodological frameworks; (b) identify approaches used for the development of methodological frameworks and terminology used; and (c) provide suggestions for developing future methodological frameworks. We took a broad view and did not limit our study to methodological frameworks in research and academia.

Methods

A scoping review was conducted, drawing on Arksey and O’Malley’s methods and more recent guidance. We systematically searched two major electronic databases (MEDLINE and Web of Science), as well as grey literature sources and the reference lists and citations of all relevant papers. Study characteristics and approaches used for development of methodological frameworks were extracted from included studies. Descriptive analysis was conducted.

Results

We included a total of 30 studies, representing a wide range of subject areas. The most commonly reported approach for developing a methodological framework was ‘Based on existing methods and guidelines’ (66.7%), followed by ‘Refined and validated’ (33.3%), ‘Experience and expertise’ (30.0%), ‘Literature review’ (26.7%), ‘Data synthesis and amalgamation’ (23.3%), ‘Data extraction’ (10.0%), ‘Iteratively developed’ (6.7%) and ‘Lab work results’ (3.3%). There was no consistent use of terminology; diverse terms for methodological framework were used across and, interchangeably, within studies.

Conclusions

Although no formal guidance exists on how to develop a methodological framework, this scoping review found an overall consensus in approaches used, which can be broadly divided into three phases: (a) identifying data to inform the methodological framework; (b) developing the methodological framework; and (c) validating, testing and refining the methodological framework. Based on these phases, we provide suggestions to facilitate the development of future methodological frameworks.
Effectiveness of SMS messaging for diarrhoea measurement: a factorial cross-over randomised controlled trial
Authors: Rego Ryan , Watson Samuel , Ishengoma Philbert , Langat Philemon , Otieno Hezekiah Pireh , Lilford Richard
Published: June 2020

Background

Text messaging systems are used to collect data on symptom prevalence. Using a text messaging system, we evaluated the effects of question load, question frequency, and financial incentive on response rates and reported infant diarrhoea rates in an infant diarrhoea survey.

Methods

We performed a factorial cross-over randomised controlled trial of an SMS surveying system for infant diarrhoea surveillance with treatments: financial incentive (yes/no), question load (1-question/3-question), and questioning frequency (daily/fortnightly). Participants progressed through all treatment combinations over eight two-week rounds. Data were analysed using multivariable logistic regressions to determine the impacts of the treatments on the response rates and reported diarrhoea rates. Attitudes were explored through qualitative interviews.

Results

For the 141 participants, the mean response rate was 47%. In terms of percentage point differences (ppd), daily questioning was associated with a lower response rate than fortnightly (− 1·2[95%CI:-4·9,2·5]); high (3-question) question loads were associated with a lower response rate than low (1-question) question loads (− 7·0[95%CI:− 10·8,-3·1]); and financial incentivisation was associated with a higher response rate than no financial incentivisation (6·4[95%CI:2·6,10·2]).

The mean two-week diarrhoea rate was 36·4%. Daily questioning was associated with a higher reported diarrhoea rate than fortnightly (29·9[95%CI:22·8,36·9]); with little evidence for impact by incentivisation or question load.

Conclusions

Close to half of all participants responded to the SMS survey. Daily questioning evoked a statistically higher rate of reported diarrhoea, while financial incentivisation and low (1-question) question loads evoked higher response rates than no incentive and high (3-question) question loads respectively.

Trial Registration

The protocol was prospectively registered on ISRCTN on the 20th of March 2019 under number ISRCTN11410773.
Increased incidence of metachronous gastric neoplasm after endoscopic resection in patients with synchronous gastric neoplasm
Authors: Shin Ga-Yeong , Cho Hye Jin , Park Jae Myung , Lim Chul-Hyun , Cho Yu Kyung , Choi Myung-Gyu
Published: June 2020

Background

Recurrence risk is a major concern after endoscopic resection (ER) of gastric neoplasms. This study was to compare metachronous risk in patients with and without synchronous neoplasms after complete ER.

Methods

After ER for gastric neoplasms, patients were divided into those with and without synchronous neoplasm. The metachronous risk of gastric neoplasms was compared between the two groups.

Results

After ER of 678 cancers and 891 adenomas, synchronous neoplasm was found in 11.8% of cancers and 11.4% of adenomas. In the multiple (n = 182) and the single group (n = 1387), metachronous neoplasms occurred in 18.1 and 8.6%, respectively (HR 2.40; 95% CI, 1.62–3.34). When the pathology of the recurred lesion was limited to cancer, metachronous risk was also significantly higher in the multiple than in the single group (HR, 2.2; 95% CI, 1.17–3.85). In the recurred pathology of the multiple group, cancer development was frequently observed in patients with cancer compared to those with only adenomas in the synchronous lesion (67.0% vs. 13.0%, respectively; P = 0.023).

Conclusions

This study demonstrated that metachronous risk was significantly higher in patients with synchronous gastric neoplasms after ER. Therefore, meticulous examination is important in patients with synchronous neoplasm.
Serum albumin and activities of daily living in Chinese centenarians: a cross-sectional study
Authors: Han Ke , Wang Shengshu , Jia Wangping , Cao Wenzhe , Liu Miao , Yang Shanshan , Wang Jianhua , He Yao
Published: June 2020

Background

Objective deterioration in activities of daily living (ADLs) exists among older population, and particularly worsens with age. Considering the criterion standard of positive aging and longevity, little information focusing on centenarians is available. This study set out to explore the relationship between serum albumin and ADLs among centenarians in long-lived areas.

Methods

This population-based cross-sectional study investigated a full sample of Chinese centenarians in Hainan, the longest-lived area of China (n = 1002). We assessed serum albumin levels and basic and instrumental activities of daily living (BADLs and IADLs).

Results

Of 1002 participants included in the analysis, 287 (28.64%) had BADL disabilities and 648 (64.67%) had IADL disabilities. The median level of serum albumin was 38.5 g/L (interquartile range, 36.2–41.3). The multivariable analyses controlling for socio-demographic characteristics, lifestyle, morbidities, and other influential factors showed that albumin level was associated with the total score of BADL (standard β = 0.335, P < 0.001) and IADL (standard β = 0.206, P < 0.001). With the increasing of albumin level, the risk of ADLs disability decreased (BADL: odds ratios [OR] = 0.835, 95% Confidence interval [CI]: 0.797–0.876; IADL: OR = 0.863, 95%CI: 0.824–0.905). In the stratified analyses, similar results were found in both sex, but were more prominent in women.

Conclusions

Higher levels of serum albumin was a protective factor for the decline of ADLs in centenarians. This association can be observed in both genders and is more pronounced in women.
Impact of lower body mass index on risk of all-cause mortality and infection-related death in Japanese chronic kidney disease patients
Authors: Yamamoto Tae , Nakayama Masaaki , Miyazaki Mariko , Sato Hiroshi , Matsushima Masato , Sato Toshinobu , Ito Sadayoshi
Published: June 2020

Background

Several studies have reported that lower body mass index (BMI) is associated with high mortality in patients with chronic kidney disease (CKD). Rate of infection-related death in CKD patients is increasing. However, the relationship between BMI and infection-related death is unclear.

Methods

Overall, 2648 CKD outpatients (estimated glomerular filtration rate < 60 mL/min and/or presenting with proteinuria) under the care of nephrologists were prospectively followed for 5 years. Patients were stratified by quartile of BMI levels. Data on all-cause mortality before progression to end-stage kidney disease (ESKD) and the cause of death were collected.

Results

The median follow-up time was 3.9 years (interquartile range, 1.7–5.0); 114 patients died and 308 started renal replacement therapy. The leading causes of death were as follows; cardiovascular (41%), infection-related (21%), and malignancy-related (18%). Advanced age and lower BMI were the significant risk factors for all-cause mortality before progression to ESKD. Advanced age was statistically associated with respective causes of death, while lower BMI was associated with infection-related death only. CKD stage had no significant impact on all-cause or individual mortality.

Conclusions

Low BMI was associated with significant risk of all-cause mortality and infection-related death, which may indicate the novel clinical target to improve CKD outcomes.
Failure of preventive treatments in migraine: an observational retrospective study in a tertiary headache center
Authors: Delussi Marianna , Vecchio Eleonora , Libro Giuseppe , Quitadamo Silvia , de Tommaso Marina
Published: June 2020

Background

Although the criteria for acute migraine treatment and prevention have been well described, there are still unmet needs, general underuse and low benefits of preventive drugs.

The aim of the present study was to retrospectively observe the short-term effect of preventive treatment in a cohort of migraine patients attending a tertiary headache center, using data from electronic medical records.

Methods

This was an observational retrospective cohort study based on data collected in a tertiary headache center. Data were extracted from an electronic dataset collected from January 2009 to December 2019. The main selection criteria were as follows: age of 18–75 years; diagnosis of migraine without aura (MO), migraine with aura (MA) or chronic migraine (CM); a control visit 3 months after the first access; and prescription of preventive treatment with level of evidence 1 as reported by Italian guidelines. As the primary outcome, we considered the change in the frequency of headache at the follow-up visit. Then, as secondary outcome measures, we used disability scores, intensity of headache, and allodynia. As predictive factors, we considered age, migraine duration, sex, headache frequency, allodynia, anxiety and depression at baseline, and comorbidity with fibromyalgia.

Results

Among the 6430 patients screened, 2800 met the selection criteria, 1800 returned to the follow-up visit, 550 withdrew because of adverse events, and 1100 were included the analysis. One hundred thirty-four patients had a frequency reduction of 50% or more. Flunarizine was used for less severe migraine, with a better effect compared to those of other drugs (odds ratio: 1.48; p: 0.022). Low headache frequency and absent or mild allodynia predicted a better outcome.

Conclusions

The mild effect of preventive drugs on migraine features and even the number of patients who were lost to follow-up or dropped out because of adverse events confirm that in severe and chronic patients, the first line of prevention can only delay a more focused therapeutic approach.
Inpatient versus outpatient induction of labour: a systematic review and meta-analysis
Authors: Dong Susan , Khan Maria , Hashimi Farahnosh , Chamy Caroline , D’Souza Rohan
Published: June 2020

Background

As the number of indications for labour induction continue to increase, the focus has shifted to performing these procedures in an outpatient setting. This study aims to systematically review published data from randomized controlled trials that compare outpatient with inpatient labour induction, to ascertain the role of outpatient labour induction for low-risk pregnancies.

Methods

We conducted a systematic review wherein we searched MEDLINE, EMBASE, Biosis Previews®, and International Pharmaceutical Abstracts from inception to January 2020 to identify randomized controlled trials that reported on maternal, fetal and resource-related outcomes following outpatient versus inpatient labour induction. Pooled incidences and mean differences were calculated using random-effects meta-analysis. Risk-of-bias was assessed using the Cochrane Risk of Bias tool. Subgroup analysis was conducted based on the method of induction.

Results

Of the 588 records identified, 12 publications, representing nine independent randomized controlled trials conducted in Australia, Europe and North America, were included. These reported on 2615 cases of labour induction (1320 outpatients versus 1295 inpatients). Overall, apart from a higher number of suspicious fetal heart rate tracings [RR = 1.43 (1.10, 1.86)] and a shorter mean length of hospital stay [MD = 282.48 min (160.23, 404.73) shorter] in the outpatient group, there were no differences in delivery method, adverse outcomes or resource-use between the two arms. On subgroup analysis, when comparing the use of balloon catheters in both arms, those induced as outpatients had fewer caesarean deliveries [RR = 0.52 (0.30, 0.90)], a shorter admission-to-delivery interval [MD = 370.86 min (19.19, 722.54) shorter], and a shorter induction to delivery interval [MD = 330.42 min (120.13, 540.71) shorter].

Conclusion

Outpatient labour induction in resource-rich settings is at least as effective and safe, in carefully selected patient populations, when compared with inpatient labour induction. Whether outpatient labour induction results in lower rates of caesarean deliveries needs to be explored further.

Trial registration

This systematic review was prospectively registered in Prospero (CRD42019118049).
Texture analysis of MR images to identify the differentiated degree in hepatocellular carcinoma: a retrospective study
Authors: Feng Mengmeng , Zhang Mengchao , Liu Yuanqing , Jiang Nan , Meng Qian , Wang Jia , Yao Ziyun , Gan Wenjuan , Dai Hui
Published: June 2020

Background

To explore the clinical value of texture analysis of MR images (multiphase Gd-EOB-DTPA-enhanced MRI and T2 weighted imaging (T2WI) to identify the differentiated degree of hepatocellular carcinoma (HCC).

Method

One hundred four participants were enrolled in this retrospective study. Each participant performed preoperative Gd-EOB-DTPA-enhanced MR scanning. Texture features were analyzed by MaZda, and B11 program was used for data analysis and classification. The diagnosis efficiencies of texture features and conventional imaging features in identifying the differentiated degree of HCC were assessed by receiver operating characteristic analysis. The relationship between texture features and differentiated degree of HCC was evaluated by Spearman’s correlation coefficient.

Results

The grey-level co-occurrence matrix -based texture features were most frequently extracted and the nonlinear discriminant analysis was excellent with the misclassification rate ranging from 3.33 to 14.93%. The area under the curve (AUC) of the combined texture features between poorly- and well-differentiated HCC, poorly- and moderately-differentiated HCC, moderately- and well-differentiated HCC was 0.812, 0.879 and 0.808 respectively, while the AUC of tumor size was 0.649, 0.660 and 0.517 respectively. The tumor size was significantly different between poorly- and moderately-HCC (p = 0.014). The COMBINE AUC values were not increased with tumor size combined.

Conclusions

Texture analysis of Gd-EOB-DTPA-enhanced MRI and T2WI was valuable and might be a promising method in identifying the differentiated degree of HCC. The poorly-differentiated HCC was more heterogeneous than well- and moderately-differentiated HCC.
Cardio-toxicity among patients with sarcoma: a cardio-oncology registry
Authors: Shamai Sivan , Rozenbaum Zach , Merimsky Ofer , Derakhshesh Matthew , Moshkovits Yonatan , Arnold Joshua , Topilsky Yan , Arbel Yaron , Laufer-Perl Michal
Published: June 2020

Background

Chemotherapy induced cardio-toxicity has been recognized as a serious side effect since the first introduction to anthracyclines (ANT). Cardio-toxicity among patients with breast cancer is well studied but the impact on patients with sarcoma is limited, even though they are exposed to higher ANT doses. The commonly used term for cardio-toxicity is cancer therapeutics related cardiac dysfunction (CTRCD), defined as a left ventricular ejection fraction (LVEF) reduction of > 10%, to a value below 53%. The aim of our study was to estimate the prevalence of CTRCD in patients diagnosed with sarcoma and to describe the baseline risk factors and echocardiography parameters among that population.

Methods

Data were collected as part of the Israel Cardio-Oncology Registry (ICOR), enrolling all patients evaluated in the cardio-oncology clinic at our institution. The registry was approved by the local ethics committee and is registered in clinicaltrials.gov (Identifier: NCT02818517). All sarcoma patients were enrolled and divided into two groups - CTRCD group vs. non-CTRCD group.

Results

Among 43 consecutive patients, 6 (14%) developed CTRCD. Baseline cardiac risk factors were more frequent among the non-CTRCD group. Elevated left ventricular end systolic diameter and reduced Global Longitudinal Strain were observed among the CTRCD group. During follow-up, 2 (33%) patients died in the CTRCD group vs. 3 (8.1%) patients in the non-CTRCD group.

Conclusions

CTRCD is an important concern among patients with sarcoma, regardless of baseline risk factors. Echocardiography parameters may provide an early diagnosis of cardio-toxicity.
Levels of cytokines in the aqueous humor guided treatment of refractory macular edema in adult-onset coats’ disease
Authors: Wang Yewei , Fan Hua , Gao Ke , He Wei , Tao Yong
Published: June 2020

Background

Two cases with refractory macular edema secondary to adult-onset Coats’ disease underwent unsatisfactory treatment by intravitreal injections of anti-vascular endothelial growth factor (VEGF) drugs and retinal photocoagulation.

Case presentation

The authors highlight the guiding effect of the measurement of cytokines in the aqueous humor for the treatment of adult-onset Coats’ disease with refractory macular edema. In the two cases, typical Coats’ disease changes, including telangiectasis, subretinal exudation and macular edema were observed. Initial treatment consisted of intravitreal anti-VEGF drugs and retinal laser photocoagulation; however, the response was poor. Then, the aqueous humor was acquired and the cytokine concentrations were measured (Flow Cytometry Analysis, Beijing Giantmed Medical Diagnostics Lab). When the cytokine levels were tested every time there would be quality control, with a fixed concentration of cytokines samples to detect before the results reported. A low level of VEGF and a high level of inflammatory cytokines were found. Then, treatment was switched to intravitreal injection of dexamethasone implant (Ozurdex®) (Allergan, Inc., Irvine, Calif., USA), which resulted in resolution of the refractory macular edema and improvement of visual acuity in both cases.

Conclusions

For refractory macular edema secondary to adult-onset Coats’ disease, measurement of the levels of VEGF and inflammatory cytokines can help clinic doctors precisely investigate the molecular mechanism of macular edema and thereby find a suitable treatment.
Optical coherence tomography angiography (OCTA) findings in Serpiginous Choroiditis
Authors: Macedo Sergio , Pohlmann Dominika , Lenglinger Matthias , Pleyer Uwe , Joussen Antonia M. , Winterhalter Sibylle
Published: June 2020

Background

To describe changes in the retina/choroid in patients with Serpiginous Choroiditis (SC) by Optical Coherence Tomography Angiography (OCTA) in a multimodal imaging approach.

Methods

Prospective, monocentric study of 24 eyes of 12 consenting patients diagnosed with SC, who underwent OCTA, which was analyzed and compared to other methods such as enhanced depth imaging-OCT, fluorescein angiography, indocyanine green angiography, and fundus autofluorescence.

Results

The study group consisted of 9 patients with peripapillary SC, 1 macular SC, and 2 atypical cases. All eyes presented an inactive SC confirmed by standard imaging. OCTA demonstrated the lesions tridimensionally in great detail. There was no difference in the angioarchitecture among the 3 forms of SC. A loss of the choriocapillaris/retinal pigment epithelium left a “window-defect”, where the vessels of larger caliber of the choroid became recognizable and their appearance inverted (“white-on-black”). A relationship between the presence of segmentation errors (SE) in the slabs and low visual acuity was established with a one-way ANOVA.

Conclusions

OCTA was able to non-invasively assess vascular lesions of the choroid/retina in patients with SC with a high degree of correlation to other diagnostic modalities. Consequent long-term assessments could lead to a better understanding of disease progression.
Speed and accuracy of saccades in patients with glaucoma evaluated using an eye tracking perimeter
Authors: Tatham Andrew J. , Murray Ian C. , McTrusty Alice D. , Cameron Lorraine A. , Perperidis Antonios , Brash Harry M. , Fleck Brian W. , Minns Robert A.
Published: June 2020

Background

To examine the speed and accuracy of saccadic eye movements during a novel eye tracking threshold visual field assessment and determine whether eye movement parameters may improve ability to detect glaucoma.

Methods

A prospective study including both eyes of 31 patients with glaucoma and 23 controls. Standard automated perimetry (SAP) and eye tracking perimetry (saccadic vector optokinetic perimetry, SVOP) was performed. SVOP provided data on threshold sensitivity, saccade latency, and two measures of accuracy of saccades (direction bias and amplitude bias). The relationship between eye movement parameters and severity of glaucoma was examined and Receiver Operating Characteristic curves were used to assess ability to detect glaucoma.

Results

Patients with glaucoma had significantly slower saccades (602.9 ± 50.0 ms versus 578.3 ± 44.6 ms for controls, P = 0.009) and reduced saccade accuracy (direction bias = 7.4 ± 1.8 versus 6.5 ± 1.5 degrees, P = 0.006). There was a significant slowing of saccades and saccades became less accurate with worsening SAP sensitivity. Slower saccades were associated with increased odds of glaucoma; however, the AUC for saccade latency was only 0.635 compared to 0.914 for SVOP sensitivity.

Conclusion

Patients with glaucoma had significant differences in eye movements compared to healthy subjects, with a relationship between slower and less accurate eye movements and worse glaucoma severity. However, in a multivariable model, eye movement parameters were not of additional benefit in differentiating eyes with glaucoma from healthy controls.
A randomized controlled trial of a virtual reality based, approach-avoidance training program for alcohol use disorder: a study protocol
Authors: Mellentin Angelina Isabella , Nielsen Anette Søgaard , Ascone Leonie , Wirtz Janina , Samochowiec Jerzy , Kucharska-Mazur Jolanta , Schadow Friedrich , Lebiecka Zofia , Skoneczny Tomasz , Mistarz Nicolai , Bremer Thomas , Kühn Simone
Published: June 2020

Background

The approach-avoidance training program (AATP) has shown preliminary promise as an add-on to standard treatment for alcohol dependence. However, knowledge is lacking as to whether the effectiveness of AATP can be enhanced further when performed in a typical drinking situation. The main aim of this study is to investigate whether approach-avoidance training implemented in a virtual reality bar environment is superior to the classical joystick PC-version of the AATP.

Methods

The study will be implemented as a randomized controlled trial. A total of 204consecutively enrolled alcohol use disorder (AUD) patients, recruited from alcohol inpatient clinics in Germany, Poland and Denmark, will be randomized into one of three groups at the start of standard alcohol treatment: group A) stimuli-relevant AATP + treatment as usual (TAU); group B) stimuli-relevant AATP in virtual reality + TAU, and group C) TAU only (control group). Treatment outcomes will be assessed at pre-treatment, post-treatment and 3-month follow-up. Repeated-measures ANOVA will be applied to compare the trajectories of the groups over time on drinking, craving and impulsiveness outcomes. It is hypothesized that the two experimental groups will achieve better treatment outcomes compared to group C and that group B will achieve better outcomes than group A.

Discussion

This study is the first trial examining the effectiveness of stimuli-relevant AATP delivered in a VR environment. The use of VR has shown promise in enhancing the effectiveness of other psychological treatments and since AATP has already been shown effective as add-on treatment, it is of interest to investigate whether these effects can be further enhanced by implementing the program in more ecologically valid environments. If proven effective, the AATP-VR can, like the AATP, be implemented easily and cheaply as add-on treatment or continued care to enhance the effectiveness of current evidence-based treatment.

Trial registration

ClinicalTrials.gov ID:NCT04283305

Registration date: 24.02.20
Migrants’ and refugees’ health status and healthcare in Europe: a scoping literature review
Authors: Lebano Adele , Hamed Sarah , Bradby Hannah , Gil-Salmerón Alejandro , Durá-Ferrandis Estrella , Garcés-Ferrer Jorge , Azzedine Fabienne , Riza Elena , Karnaki Pania , Zota Dina , Linos Athena
Published: June 2020

Background

There is increasing attention paid to the arrival of migrants from outwith the EU region to the European countries. Healthcare that is universally and equably accessible needs to be provided for these migrants throughout the range of national contexts and in response to complex and evolving individual needs. It is important to look at the evidence available on provision and access to healthcare for migrants to identify barriers to accessing healthcare and better plan necessary changes.

Methods

This review scoped 77 papers from nine European countries (Austria, Cyprus, France, Germany, Greece, Italy, Malta, Spain, and Sweden) in English and in country-specific languages in order to provide an overview of migrants’ access to healthcare. The review aims at identifying what is known about access to healthcare as well as healthcare use of migrants and refugees in the EU member states. The evidence included documents from 2011 onwards.

Results

The literature reviewed confirms that despite the aspiration to ensure equality of access to healthcare, there is evidence of persistent inequalities between migrants and non-migrants in access to healthcare services. The evidence shows unmet healthcare needs, especially when it comes to mental and dental health as well as the existence of legal barriers in accessing healthcare. Language and communication barriers, overuse of emergency services and underuse of primary healthcare services as well as discrimination are described.

Conclusions

The European situation concerning migrants’ and refugees’ health status and access to healthcare is heterogeneous and it is difficult to compare and draw any firm conclusions due to the scant evidence. Different diseases are prioritised by different countries, although these priorities do not always correspond to the expressed needs or priorities of the migrants. Mental healthcare, preventive care (immunization) and long-term care in the presence of a growing migrant older population are identified as priorities that deserve greater attention. There is a need to improve the existing data on migrants’ health status, needs and access to healthcare to be able to tailor care to the needs of migrants. To conduct research that highlights migrants’ own views on their health and barriers to access to healthcare is key.
Protocol of a population-based prospective COVID-19 cohort study Munich, Germany (KoCo19)
Authors: Radon Katja , Saathoff Elmar , Pritsch Michael , Guggenbühl Noller Jessica Michelle , Kroidl Inge , Olbrich Laura , Thiel Verena , Diefenbach Max , Riess Friedrich , Forster Felix , Theis Fabian , Wieser Andreas , Hoelscher Michael ,   the KoCo19 collaboration group, Bakuli Abhishek , Eckstein Judith , Froeschl Günter , Geisenberger Otto , Geldmacher Christof , Heiber Arlett , Hoffmann Larissa , Huber Kristina , Metaxa Dafni , Pletschette Michel , Rothe Camilla , Schunk Mirjam , Wallrauch Claudia , Zimmer Thorbjörn , Prückner Stephan , Fuchs Christiane , Hasenauer Jan , Castelletti Noemi , Zeggini Eleftheria , Laxy Michael , Leidl Reiner , Schwettmann Lars
Published: June 2020

Background

Due to the SARS-CoV-2 pandemic, public health interventions have been introduced globally in order to prevent the spread of the virus and avoid the overload of health care systems, especially for the most severely affected patients. Scientific studies to date have focused primarily on describing the clinical course of patients, identifying treatment options and developing vaccines. In Germany, as in many other regions, current tests for SARS-CoV2 are not conducted on a representative basis and in a longitudinal design. Furthermore, knowledge about the immune status of the population is lacking. Nonetheless, these data are needed to understand the dynamics of the pandemic and hence to appropriately design and evaluate interventions. For this purpose, we recently started a prospective population-based cohort in Munich, Germany, with the aim to develop a better understanding of the state and dynamics of the pandemic.

Methods

In 100 out of 755 randomly selected constituencies, 3000 Munich households are identified via random route and offered enrollment into the study. All household members are asked to complete a baseline questionnaire and subjects ≥14 years of age are asked to provide a venous blood sample of ≤3 ml for the determination of SARS-CoV-2 IgG/IgA status. The residual plasma and the blood pellet are preserved for later genetic and molecular biological investigations. For twelve months, each household member is asked to keep a diary of daily symptoms, whereabouts and contacts via WebApp. If symptoms suggestive for COVID-19 are reported, family members, including children < 14 years, are offered a pharyngeal swab taken at the Division of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, for molecular testing for SARS-CoV-2. In case of severe symptoms, participants will be transferred to a Munich hospital. For one year, the study teams re-visits the households for blood sampling every six weeks.

Discussion

With the planned study we will establish a reliable epidemiological tool to improve the understanding of the spread of SARS-CoV-2 and to better assess the effectiveness of public health measures as well as their socio-economic effects. This will support policy makers in managing the epidemic based on scientific evidence.
Is retrospective assessment of health-related quality of life valid?
Authors: Lawson Andrew , Tan Aidan C. , Naylor Justine , Harris Ian A.
Published: June 2020

Background

Health-related quality of life (HRQoL) is a commonly used health outcome. For many acute conditions (e.g. fractures), retrospective measurement of HRQoL is necessary to establish pre-morbid health status. However, the validity of retrospective measurement of HRQoL following an intervening significant health event has not been established. The aim of this study was to test the validity of retrospective measurement (recall) of HRQoL by using a test-retest design to measure reliability and agreement between prospective and retrospective patient-reported HRQoL before and after an intervening health event (elective orthopaedic surgery).

Method

Participants were recruited from the pre-admission clinic of a metropolitan hospital. Participants were assessed for their HRQoL using the EQ-5D-5L at two time-points; prospectively at 2 weeks prior to their date of surgery and then retrospectively (recalling their pre-operative health) following elective hip or knee joint replacement surgery. Prospective measurements were compared with retrospective measurements for the five domain scores (nominal data) using intra-class correlation and for the EQ-Index score and EQ-Visual Analogue Scale (VAS) score (continuous data), using Pearson’s correlation. Agreement was tested in continuous variables using Lin’s coefficient of concordance (pc) and Bland-Altman plots.

Results

One hundred seventy-four patients consented to participate. Eighty-eight paired prospective and retrospective scores were collected and there was a median between-test period of 15 days. At a group level, the prospective measurements were similar to the retrospective measurements; the modes and means of the five domain scores were not different and the mean differences (MD) between the scores for EQ-Index (MD = 0.02, on a scale of 0–1) and EQ-VAS (MD = 0.53, on a scale of 1–100) were negligible. However, the correlation of paired scores was varied; the range of domain score correlations was 0.52 to 0.74, the concordance was substantial for the EQ-Index scores (pc = 0.76, 95% CI = 0.66, 0.84) and moderate for the EQ-VAS scores (pc = 0.46, 95% CI = 0.28, 0.61).

Conclusion

Agreement between prospective and retrospective measurements was high at a group level and moderate to substantial at an individual level. Retrospective measurement of HRQoL using the EQ-5D-5L in an orthopaedic clinical context is a valid alternative to using reference data to estimate baseline or pre-morbid health status.
The impact of limb loading and the measurement modality (2D versus 3D) on the measurement of the limb loading dependent lower extremity parameters
Authors: Jud Lukas , Roth Tabitha , Fürnstahl Philipp , Vlachopoulos Lazaros , Sutter Reto , Fucentese Sandro F.
Published: June 2020

Background

Deformity assessment and preoperative planning of realignment surgery are conventionally based on weight-bearing (WB) radiographs. However, newer technologies such as three-dimensional (3D) preoperative planning and surgical navigation with patient-specific instruments (PSI) rely on non-weight bearing (NWB) computed tomography (CT) data. Additionally, differences between conventional two-dimensional (2D) and 3D measurements are known. The goal of the present study was to systematically analyse the influence of WB and the measurement modality (2D versus 3D) on common WB-dependent measurements used for deformity assessment.

Methods

85 lower limbs could be included. Two readers measured the hip-knee-ankle angle (HKA) and the joint line convergence angle (JLCA) in 2D WB and 2D NWB radiographs, as well as in CT-reconstructed 3D models using an already established 3D measurement method for HKA, and a newly developed 3D measurement method for JLCA, respectively. Interrater and intermodality reliability was assessed.

Results

Significant differences between WB and NWB measurements were found for HKA (p < 0.001) and JLCA (p < 0.001). No significant difference could be observed between 2D HKA NWB and 3D HKA (p = 0.09). The difference between 2D JLCA NWB and 3D JLCA was significant (p < 0.001). The intraclass correlation coefficient (ICC) for the interrater agreement was almost perfect for all HKA and 3D JLCA measurements and substantial for 2D JLCA WB and 2D JLCA NWB. ICC for the intermodality agreement was almost perfect between 2D HKA WB and 2D HKA NWB as well as between 2D HKA NWB and 3D HKA, whereas it was moderate between 2D JLCA WB and 2D JLCA NWB and between 2D JLCA NWB and 3D JLCA.

Conclusion

Limb loading results in significant differences for both HKA and JLCA measurements. Furthermore, 2D projections were found to be insufficient to represent 3D joint anatomy in complex cases. With an increasing number of surgical approaches based on NWB CT-reconstructed models, research should focus on the development of 3D planning methods that consider the effects of WB on leg alignment.
Design of custom-made navigational template of femoral head and pilot research in total hip resurfacing arthroplasty
Authors: Liang Jinlong , Zhao Yonghui , Gao Xinjian , Fang Xuewei , Xu Yongqing , Lu Sheng
Published: June 2020

Background

To develop a novel custom-made navigational template for accurate prosthesis implantation in total hip resurfacing arthroplasty (THRA) by computer-aided technology.

Methods

The template was produced based on data preoperatively acquired from computed tomography (CT) scan. The position of the drill guide was obtained according to the anatomical axis of the femoral neck which was defined by the point of the femoral head center and another point of the femoral neck center. The final direction of the drill guide was confirmed by a valgus angle. The surface of the template was constructed based on the inverse of the femoral neck surface. Then the template was made of acrylate resin by using rapid prototyping (RP) technique. Finally, all the templates were verified in 17 cadavers arranged for THRA and postoperative medical images were employed to evaluate the accuracy and validity of the template.

Results

The templates had achieved a high fitting with the femoral neck surface, and there were no guide failures. Postoperative evaluation revealed that the Kirschner-wires pass through the center of the femoral head and femoral neck, presenting a relative expected and acceptable valgus angle to the central axis of the femoral neck. The lateral offset showed the relative valgus angle achieved as expected, the horizontal offset showed that no obvious antero-posterior deviation occured. The comparison between the preoperative Neck-shaft angle (NSA) and the postoperative Stem-shaft angle (SSA) showed there is no significant difference(P > 0.05).

Conclusion

The novel custom-made navigational template of femoral head can effectively assist surgeons for accurately implanting the femoral head components to the desired position in THRA.
Neutrophil: lymphocyte ratio is positively associated with subclinical diabetic cardiomyopathy
Authors: Huang Xiaoli , Qin Zihan , Xu Min , Zhang Feifei , Jiang Xiaohong , Hua Fei , Tao Lichan
Published: June 2020

Background

Subclinical diabetic cardiomyopathy (DCM) occurs frequently in asymptomatic subjects with Type 2 diabetes mellitus (T2DM). The direct association between the immune system and DCM with effective biomarkers has been demonstrated in previous studies.

Methods

Five hundred seven subjects with T2DM were recruited from April 2018 to October 2019 and divided into T2DM with cardiac dysfunction (DCM) group and T2DM without cardiac dysfunction (non-DCM) group. The relationship between the quartiles of Neutrophil: lymphocyte ratio (NLR) and subclinical DCM was evaluated by using adjusted logistic regression models.(covariates: age, sex, BMI, duration of diabetes, and hyperlipidemia).

Results

Blood NLR was significantly upregulated in DCM group compared to non-DCM group (P = 0.05). Then the adjusted odds ratio (95% CI) of the highest NLR quartile was 14.32 (2.92–70.31) compared with the lowest quartile of NLR after multiple adjusted (P < 0.001). However, there was no significant relation between neutrophil and lymphocyte counts and the occurrence of DCM in T2DM patients.

Conclusions

This study demonstrated that NLR was associated with the occurrence of subclinical DCM, suggesting that NLR may be a biomarker for predicting DCM with effectiveness and accuracy.

Trial registration

Chinese Clinical Trial Registry (ChiCTR1900027080). Registered 30 October 2019. Retrospectively registered: www.medresman.org
Insights into the oral health crisis amongst pre-schoolers in Aotearoa/New Zealand: a discourse analysis of parent/caregiver experiences
Authors: Roguski Michael , McBride-Henry Karen
Published: June 2020

Background

The oral health of pre-schoolers is garnering international as a crisis as good oral health is a key precursor to positive health outcomes. Internationally, and within Aotearoa/New Zealand, responses been restricted to those based in a medical model and the commercialisation of oral health. Absent from existing commentary are the lived realities of parents/caregivers beliefs, attitudes and responsiveness, or lack of, to the oral health of pre-schoolers.

Methods

The researcher undertook a discursive analysis of parents/caregivers narratives to understand the barriers to engaging in effective protective behaviours. The 15 focus groups were conducted in urban and rural locations across Aotearoa/New Zealand.

Results

A discursive analysis revealed several pervasive discourses, including ‘second chance’ and ‘enjoyment’ discourses, and systems-related deficits that act as barriers to engaging in good oral healthcare practices.

Conclusions

The analysis demonstrates the benefit of placing the lived experiences of parents/caregivers as central to the development of oral health interventions. There is a need to link oral health data with primary care data and to distribute accurate oral health information to support parents’/caregivers’ decision making. This research reveals several pervasive discourses and systems-related deficits that provide a fertile ground for future public health responsiveness.
No apparent association between lecture attendance or accessing lecture recordings and academic outcomes in a medical laboratory science course
Authors: Doggrell Sheila Anne
Published: June 2020

Background

The effect of availability of lecture recordings on academic outcomes is not clear and it is not known whether these recordings change the association between lecture attendance and academic outcomes. Few surveys of lecture attendance or lecture recordings use by students are linked to academic outcomes. The aims were (i) to determine any association between lecture attendance and academic outcomes for students who had access to lecture recordings, (ii) to determine any association between accessing lecture recordings and academic outcomes and (iii) to use a survey to determine why students attend lectures and/or access lecture recordings in a course in medical laboratory science.

Methods

Consenting students signed in when attending lectures and/or completed an online survey. Pearson’s correlation coefficients were calculated to determine whether there was an association between attending lectures or accessing lecture recordings and academic outcomes.

Results

Consent rates were high for both the sign-in (90%) and survey (64%). The main findings were that in 2017 and 2018: (i) the average lecture attendance was 39 and 27%, respectively, (ii) there was no association between lecture attendance and academic outcomes, (iii) there was no association between accessing lecture recordings and academic outcomes. Survey respondents were almost equally divided between those attending lectures weekly, sometimes or not. Reasons for attending lectures included greater perceived learning and interaction with staff and other students, while reasons for not attending related to inconvenience or other commitments. Lecture recordings were accessed to clarify, revise or catch up on content, or as an alternative to attending lectures. One-third of students provided additional feedback on accessing lecture recordings, and the most common themes were ‘flexibility’ and ‘useful’. Lecture slides (PowerPoints), independently of lecture recordings, were used extensively by the students.

Conclusions

From this study, it does not seem that either lecture attendance or accessing lecture recordings are major determinants of academic outcomes for most students. As students vary in their lecture attendance and use of online resources including lecture recordings and lecture slides, academic staff should continue to provide a range of resources for students.