bluuebunny/crossref_metadata_2025 huggingface dataset:
Evidence supporting the use of a subjective staff evaluation to assess the benefit of rehabilitation in hemodialysis patients undergoing inpatient rehabilitation
Authors: Shimoda Takahiro , Alston Helen , Chai Angelique , Jassal Sarbjit V.
Published: November 2020

Background

We questioned whether the introduction of a subjective evaluation of patient-specific goals, could be used as a valid method to assess the effectiveness of inpatient rehabilitation.

Methods

In this prospective cohort study, all admissions to the UHN hemodialysis rehabilitation service between April 2013 and August 2016 were included. We introduced a system of subjective assessment, performed by the team at the time of admission and discharge. We evaluated Functional Independence Measure (FIM®) score and KDQoL for objective measures of physical function and patient-reported quality of life.

Results

A total of 201 patients were included. The median FIM score at discharge correlated well with the subjective staff evaluation. FIM score changes for those with evaluations for Success, Partial success, and Not Successful were 28 [interquartile range (IQR) 20–34], 24 [IQR18–31], 16 [IQR 11–34] respectively. The median PCS at discharge for those deemed to have Success was 37.4 [IQR31.0, 44.7], and for those with Partial success & Not Successful 28.8 [IQR 22.4, 39.2]. There was no correlation with MCS scores (55.2 [IQR 51.2, 60.2], 58.4 [IQR 50.1, 63.1] respectively).

Conclusions

These results suggest the subjective staff evaluation is a brief but valid assessment of patient outcome for dialysis patients undergoing inpatient rehabilitation.
COVID-19 and maintenance hemodialysis: a systematic scoping review of practice guidelines
Authors: Akbarialiabad Hossein , Kavousi Shahin , Ghahramani Aria , Bastani Bahar , Ghahramani Nasrollah
Published: November 2020

Background

Coronavirus Disease 2019 (COVID-19) has substantially impacted the provision of medical services. During the pandemic, many medical services, including facilities providing care to patients with end stage renal disease faced challenges in safeguarding patients and staff while providing clinical care. This study aims to identify the extent, range, and nature of articles related to COVID-19 and maintenance hemodialysis to understand the research gaps and propose recommendations for future research.

Methods

Using the terms: “Dialysis” OR “RRT” OR “Renal replacement therapy” AND “SARS-COV-2” OR “COVID-19” OR “novel coronavirus” OR “2019-nCov”, we performed a multi-step systematic search of the literature in the English language in Pubmed, Scopus, Embase, and Web of Science published from December 1, 2019, to May 13, 2020. Two authors separately screened the title and abstracts of the documents and ruled out irrelevant articles. We obtained a full report of the papers that met our inclusion criteria and screened the full texts. We conducted a descriptive analysis of the characteristics of the included articles and performed a narrative synthesis of the results. We conducted this scoping review in accordance with the PRISMA-ScR Checklist.

Results

We included 22 articles in this scoping review. Perspectives (n = 9), editorials (n = 4), and case series (n = 5) were the most common types of articles. Most articles were from Italy and the United States. Seventeen (77.3%) of the articles focused on the topic of recommendation for outpatient hemodialysis units. While many of the recommendations overlapped in several articles, there were also many unique recommendations.

Conclusions

most of the articles are based on single-center experience, which spontaneously developed best practices. Many of these practices have formed the basis for policies and guidelines that will guide future prevention of infection and management of patients with End Stage Renal Disease (ESRD) and COVID-19.
Comparison of two different optical coherence tomography angiography devices in detecting healthy versus glaucomatous eyes – an observational cross-sectional study
Authors: Kee A. R. , Yip V. C. H. , Tay E. L. T. , Lim C. W. , Cheng J. , Teo H. Y. , Chua C. H. , Yip L. W. L.
Published: November 2020

Background

To understand the differences between two different optical coherence tomography angiography (OCTA) devices in detecting glaucomatous from healthy eyes by comparing their vascular parameters, diagnostic accuracy and test-retest reliability.

Methods

A cross-sectional observational study was performed on healthy and glaucoma subjects, on whom two sets of OCTA images of optic disc and macula were acquired using both AngioVue (Optovue, USA) and Swept Source (Topcon, Japan) OCTA devices during one visit. A novel in-house software was used to calculate the vessel densities. Diagnostic accuracy of the machines in differentiating healthy versus glaucomatous eyes was determined using area under the receiver operating characteristic curve (AUROC) and test-retest repeatability of the machines was also evaluated.

Results

A total of 80 healthy and 38 glaucomatous eyes were evaluated. Glaucomatous eyes had reduced mean vessel density compared to healthy controls in all segmented layers of the optic disc and macula using AngioVue (p ≤ 0.001). However, glaucomatous eyes had higher mean vessel density on optic disc scans using Swept Source, with lack of statistically significant difference between healthy and glaucomatous eyes. The AUROC showed better diagnostic accuracy of AngioVue (0.761–1.000) compared to Swept Source (0.113–0.644). The test-retest reliability indices were generally better using AngioVue than Swept Source.

Conclusions

AngioVue showed better diagnostic capability and test-retest reliability compared to Swept Source. Further studies need to be undertaken to evaluate if there is any significant difference between the various machines in diagnosing and monitoring glaucoma.
Using the drug repositioning approach to develop a novel therapy, tipepidine hibenzate sustained-release tablet (TS-141), for children and adolescents with attention-deficit/hyperactivity disorder
Authors: Saito Takuya , Yamashita Yushiro , Tomoda Akemi , Okada Takashi , Umeuchi Hideo , Iwamori Saki , Shinoda Satoru , Mizuno-Yasuhira Akiko , Urano Hidetoshi , Nishino Izumi , Saito Kazuhiko
Published: November 2020

Background

Asverin® (tipepidine hibenzate) has been used as an antitussive for > 50 years in Japan. Studies revealed that tipepidine modulates monoamine levels, by inhibiting G-protein-activated inwardly rectifying potassium (GIRK) channels, expecting the potential therapeutic effects of tipepidine for attention-deficit/hyperactivity disorder (ADHD) in recent years. In this study, TS-141, a sustained-release tablet of tipepidine, was developed for the treatment of ADHD through a drug repositioning approach.

Methods

The sustained-release profile of TS-141 in healthy adults was investigated, and tipepidine exposure in the plasma after the TS-141 administration was compared to that of Asverin in the phase I study. Phase II study was conducted to examine the effects of TS-141 30 (once a day), 60 (once a day), 120 mg (60 mg twice a day), or placebo, that is within the exposure in the maximum dosage of Asverin, in children and adolescents with ADHD, and was designed as an 8-week treatment, randomized, parallel group, double-blind, placebo-controlled trial recruiting 6–17-year-old children and adolescents diagnosed with ADHD. A total of 216 patients were randomized according to the CYP2D6 phenotype. The primary end-point was ADHD Rating Scale IV-J changes. Furthermore, effects of CYP2D6 phenotype on the efficacy in the subgroup analysis were investigated.

Results

TS-141 had the sustained-release profile, and the CYP2D6 phenotype had effects on the plasma exposure of tipepidine. ADHD RS-IV-J scores in all TS-141 dosages decreased from their baseline scores; however, no significant difference was observed in ADHD RS-IV-J score changes between the placebo and TS-141-administered groups. In patients with intermediate metabolizer CYP2D6, ADHD RS-IV-J score changes in the 120 mg group tended to be larger than that in the placebo group.

Conclusions

ADHD RS-IV-J changes on TS-141 may depend on the interaction between the TS-141 dose and CYP2D6 phenotype, suggesting that further clinical trials should be conducted with careful consideration of polymorphism. Drug repositioning approach of TS-141 was attempted at the same dose as that of antitussive; however, dose setting according to the indication was necessary.

Trial registration

Phase I study: JapicCTI-205235 (Registered 25 March 2020), Phase II study: JapicCTI-163244 (Registered 9 May 2016), https://www.clinicaltrials.jp/cti-user/trial/Show.jsp
Percutaneous endoscopic unilateral laminotomy and bilateral decompression under 3D real-time image-guided navigation for spinal stenosis in degenerative lumbar kyphoscoliosis patients: an innovative preliminary study
Authors: Ho Tsung-Yu , Lin Chung-Wei , Chang Chien-Chun , Chen Hsien-Te , Chen Yen-Jen , Lo Yuan-Shun , Hsiao Pan-Hsuan , Chen Po-Chen , Lin Chih-Sheng , Tsou Hsi-Kai
Published: November 2020

Background

The aim of this study is to introduce a new method of percutaneous endoscopic decompression under 3D real-time image-guided navigation for spinal stenosis in degenerative kyphoscoliosis patients without instability or those who with multiple comorbidities. Decompression alone using endoscope for kyphoscoliosis patient is technical demanding and may result in unnecessary bone destruction leading to further instability. The O-arm/StealthStation system is popular for its ability to provide automated registration with intraoperative, postpositioning computed tomography (CT) which results in superior accuracy in spine surgery.

Methods

In this study, we presented four cases. All patients were over seventy years old female with variable degrees of kyphoscoliosis and multiple comorbidities who could not endure major spine fusion surgery. Percutaneous endoscopic unilateral laminotomy and bilateral decompression under 3D real-time image-guided navigation were successfully performed. Patients’ demographics, image study parameters, and outcome measurements including pre- and post-operative serial Visual analog scale (VAS), and Oswestry Disability Index (ODI) were well documented. The follow-up time was 1 year.

Results

Pre- and post-operative MRI showed average dural sac cross sectional area (DSCSA) improved from 81.62 (range 67.34–89.07) to 153.27 (range 127.96–189.73). Preoperative neurological symptoms including radicular leg pain improved postoperatively. The mean ODI (%) were 85 (range 82.5–90) at initial visit, 35.875 (range 25–51) at 1 month post-operatively, 26.875 (range 22.5–35) at 6 months post-operatively and 22.5 (range 17.5–30) at 12 months post-operatively (p < 0.05). The mean VAS score were 9 (range 8–10) at initial visit, 2.25 (range 2–3) at 1 month post-operatively, 1.75 (range 1–2) at 6 months post-operatively and 0.25 (range 0–1) at 12 months post-operatively (p < 0.05). There was no surgery-related complication.

Conclusions

To the best of our knowledge, this is the first preliminary study of percutaneous endoscopic laminotomy under O-arm navigation with successful outcomes. The innovative technique may serve as a promising solution in treating spinal stenosis patients with lumbar kyphoscoliosis and multiple comorbidities.
Morphometric study of suprascapular notch and scapular dimensions in Ugandan dry scapulae with specific reference to the incidence of completely ossified superior transverse scapular ligament
Authors: Adewale Adesanya Olamide , Segun Okeniran Olatayo , Usman Ibe Michael , Monima Ann Lemuel , Kegoye Eric Simidi , Kasozi Keneth Iceland , Nalugo Halima , Ssempijja Fred
Published: November 2020

Background

Understanding of suprascapular notch (SSN) anatomy and relationship with scapular dimensions are vital in diagnosis, prevention, and assessment of suprascapular nerve entrapment syndrome. The study aimed to assess morphometry of suprascapular notch and scapular dimensions in Ugandan dry scapulae with specific reference to scapulae with completely ossified superior transverse scapular ligaments.

Methods

This was a cross-sectional analytical study conducted on 50 Ugandan dry scapulae. SSN types and prevalence of completely ossified superior transverse scapular ligament among dry scapulae were quantified and compared with previous data. Scapular dimensions were assessed by measuring scapular length (A), scapular width (B), glenoid length (C), and glenoid width (D). One-way ANOVA was used to compare scapular dimensions of scapulae with different SSN types, and Spearman’s correlation coefficient was used to evaluate the correlation coefficient of scapular dimensions amongst groups.

Results

Superior transverse scapular ligament (STSL) was completely ossified in 8% of cases. There was no significant (P > 0.05) difference between scapular dimensions of scapulae with completely ossified STSL compared to scapulae with other SSN types. Scapulae with completely ossified STSL showed strong negative (r = − 0.89137, r = − 0.877) correlations for its A, B respectively compared against D, this finding was not true to scapulae of other SSN types. Also, there were strong positive or negative (r > 0.7, r > − 0.7) correlations: for A, types I and III compared to type VI; for B, types I, III compared to VI; for C, type IV and VI; and for D, type III and VI.

Conclusions

The prevalence of completely ossified STSL is moderately high in the Ugandan population. Characteristics of the scapula (scapular dimensions) are not ‘vital’ but rather important or relevant for shoulder pathology with specific reference to suprascapular nerve entrapment syndrome due to completely ossified superior transverse scapular ligaments. Further correlation analyses of scapular dimensions of different SSN types in different populations are important.
Comparison of ultrasound-assisted and pure fluoroscopy-guided extracorporeal shockwave lithotripsy for renal stones
Authors: Chang Tsung-Hsin , Lin Wun-Rong , Tsai Wei-Kung , Chiang Pai-Kai , Chen Marcelo , Tseng Jen-Shu , Chiu Allen W.
Published: November 2020

Background

In this study, we aimed to compare the efficacy and clinical outcomes of shock wave lithotripsy (SWL) for patients with renal stones using pure fluoroscopy (FS) or ultrasound-assisted (USa) localization with two lithotripters.

Methods

We retrospectively identified 425 patients with renal calculi who underwent SWL with either a LiteMed LM-9200 ELMA lithotripter (209 cases), which combined ultrasound and fluoroscopic stone targeting or a Medispec EM-1000 lithotripter machine (216 cases), which used fluoroscopy for stone localization and tracking. The patient demographic data, stone-free rates, stone disintegration rates, retreatment rates and complication rates were analyzed.

Results

The USa group had a significantly higher overall stone-free rate (43.6 vs. 28.2%, p < 0.001) and stone disintegration rate (85.6 vs. 64.3%, p < 0.001), as well as a significantly lower retreatment rate (14.8 vs. 35.6%, p < 0.001) and complication rate (1.9 vs. 5.5%, p = 0.031) compared with the FS group. This superiority remained significant in the stone size < 1 cm stratified group. In the stone size > 1 cm group, the stone-free rate (32.4 vs. 17.8%, p = 0.028), disintegration rate (89.2 vs. 54.8%, p = 0.031) and retreatment rate (21.6 vs. 53.4%, p < 0.001) were still significantly better in the USa group, however there was no significant difference in the complication rate. The most common complication was post-SWL-related flank pain.

Conclusion

SWL is a safe and non-invasive way of treating renal stones. This study compared two electromagnetic shock wave machines with different stone tracking systems. LiteMed LM-9200 ELMA lithotripter, which combined ultrasound and fluoroscopic stone targeting outperformed Medispec EM-1000 lithotripter, which used fluoroscopy for stone localization and tracking, with better stone-free rates and disintegration rates, as well as lower retreatment rates and complications with possible reduced radiation exposure.
Multivariate analysis of factors for failed continuous bladder irrigation in hemorrhagic cystitis patients after hematopoietic stem cell transplantation
Authors: Yang Wenbo , Du Yiqing , Qu Zhan , Bai Wenjun , Yu Luping , Zhang Xiaopeng , Wang Qi , Zhang Xiaowei , Li Qing , Xu Tao
Published: November 2020

Background

Continuous bladder irrigation (CBI) and proper adjustment of saline irrigation speed are important to avoid CBI failure in hemorrhagic cystitis (HC) patients after allogeneic hematopoietic stem cell transplantation (HSCT). Nevertheless, too fast irrigation speed could take away the patient's much heat, contribute to blood coagulopathy, and increase the nursing workload. Evaluation of risk for CBI failure remains an unmet clinical need.

Methods

The general information, clinical characteristics, and consultation records of HC patients in 1380 patients with hematopoietic stem cell transplantation in our center from 2017 to 2019 were analyzed retrospectively. The receiver operating characteristic (ROC) curve was used to calculate the cutoff point of the continuous variable, and multivariate logistic regression was used to analyze the risk factors affecting CBI failure in HC patients.

Results

The incidence of HC after HSCT was 23%. A total of 227 patients with HC above grade 2 were included. Univariate analysis showed that CRP, age, platelet counts, onset time after transplantation, albumin, and hemoglobin were associated with CBI failure in the short-term (P < 0.05). ROC curve and multivariate logistic regression analysis showed that CRP > 8.89 ng/ml (RR = 7.828, 95% CI 2.885–21.244), age < 14.5 years (RR = 9.940, 95% CI 3.219–30.697), and onset time of HC > 37d after transplantation (RR = 7.021, 95% CI 2.204–22.364), were independent risk factors for failure of CBI (P < 0.05).

Conclusions

The study identified CRP > 8.89 ng/ml, age < 14.5 years, and onset time of HC after HSCT > 37d are independent factors for failure of CBI, which could be combined to allow stratification of HC after HSCT patients into low-, intermediate- and high-risk subgroups of CBI failure.
Capitalising on the transformational opportunities of early clinical academic career training for nurses, midwives and allied health professionals
Authors: Cowley Alison , Diver Claire , Edgley Alison , Cooper Joanne
Published: November 2020

Background

A highly skilled workforce is required to deliver high quality evidence-based care. Clinical academic career training programmes have been developed to build capacity and capabilities of nurses, midwives and allied health professionals (NMAHPs) but it remains unclear how these skills and roles are operationalised in the healthcare context. The aim of this study was to explore the experiences of early career clinical academic NMAHPs who have undertaken, or are undertaking, clinical academic master’s and doctoral studies in the United Kingdom.

Methods

We conducted 17 in-depth semi-structured interviews with early career clinical academics which included; nurses, midwives and allied health professionals. The data were analysed using thematic analysis.

Results

Two themes emerged from the data; identity transformation and operationalising transformation. Both these highlighted the challenges and opportunities that early clinical academic training provided to the individual and organisation in which they practiced. This required the reconceptualization of this training from the pure acquisition of skills to one of personal and professional transformation. The findings suggest that individuals, funders, and organisations may need to relinquish the notion that training is purely or largely a transactional exchange in order to establish collaborative initiatives.

Conclusion

Stakeholders need to recognise that a cultural shift about the purposes of research training from a transactional to transformative approaches is required to facilitate the development of NMAHPS clinical academics, to enable them to contribute to innovative health and patient care.
Web-based online resources about adverse interactions or side effects associated with complementary and alternative medicine: a systematic review, summarization and quality assessment
Authors: Ng Jeremy Y. , Munford Vanessa , Thakar Harmy
Published: November 2020

Background

Given an increased global prevalence of complementary and alternative medicine (CAM) use, healthcare providers commonly seek CAM-related health information online. Numerous online resources containing CAM-specific information exist, many of which are readily available/accessible, containing information shareable with their patients. To the authors’ knowledge, no study has summarized nor assessed the quality of content contained within these online resources for at least a decade, specifically pertaining to information about adverse effects or interactions.

Methods

This study provides summaries of web-based online resources that provide safety information on potential interactions or adverse effects of CAM. Specifically, clinicians are the intended users of these online resources containing patient information which they can then disseminate to their patients. All online resources were assessed for content quality using the validated rating tool, DISCERN.

Results

Of 21 articles identified in our previously published scoping review, 23 online resources were eligible. DISCERN assessments suggests that online resources containing CAM-specific information vary in quality. Summed DISCERN scores had a mean of 56.13 (SD = 10.25) out of 75. Online resources with the highest total DISCERN scores across all questions included Micromedex (68.50), Merck Manual (67.50) and Drugs.com (66.50). Online resources with the lowest total scores included Drug Information (33.00), Caremark Drug Interactions (42.50) and HIV Drug Interactions (43.00). The DISCERN questions that received the highest mean score across all online resources referred to whether the risks were described for each treatment (4.66), whether the aims were clear (4.58), whether the source achieved those aims (4.58), and whether the website referred to areas of uncertainty (4.58). The DISCERN questions that received the lowest mean score across all online resources assessed whether there was discussion about no treatment being used (1.29) and how treatment choices would affect quality of life (2.00).

Conclusion

This study provides a comprehensive list of online resources containing CAM-specific information. Informed by the appraisal of these resources, this study provides a summarized list of high quality, evidence-based, online resources about CAM and CAM-related adverse effects. This list of recommended resources can thereby serve as a useful reference for clinicians, researchers, and patients.
Study protocol: Whole genome sequencing Implementation in standard Diagnostics for Every cancer patient (WIDE)
Authors: Samsom Kris G. , Bosch Linda J. W. , Schipper Luuk J. , Roepman Paul , de Bruijn Ewart , Hoes Louisa R. , Riethorst Immy , Schoenmaker Lieke , van der Kolk Lizet E. , Retèl Valesca P. , Frederix Geert W. J. , Buffart Tineke E. , van der Hoeven Jacobus J. M. , Voest Emile E. , Cuppen Edwin , Monkhorst Kim , Meijer Gerrit A.
Published: November 2020

Background

‘Precision oncology’ can ensure the best suitable treatment at the right time by tailoring treatment towards individual patient and comprehensive tumour characteristics. In current molecular pathology, diagnostic tests which are part of the standard of care (SOC) only cover a limited part of the spectrum of genomic changes, and often are performed in an iterative way. This occurs at the expense of valuable patient time, available tissue sample, and interferes with ‘first time right’ treatment decisions. Whole Genome Sequencing (WGS) captures a near complete view of genomic characteristics of a tumour in a single test. Moreover, WGS facilitates faster implementation of new treatment relevant biomarkers. At present, WGS mainly has been applied in study settings, but its performance in a routine diagnostic setting remains to be evaluated. The WIDE study aims to investigate the feasibility and validity of WGS-based diagnostics in clinical practice.

Methods

1200 consecutive patients in a single comprehensive cancer centre with (suspicion of) a metastasized solid tumour will be enrolled with the intention to analyse tumour tissue with WGS, in parallel to SOC diagnostics. Primary endpoints are (1) feasibility of implementation of WGS-based diagnostics into routine clinical care and (2) clinical validation of WGS by comparing identification of treatment-relevant variants between WGS and SOC molecular diagnostics. Secondary endpoints entail (1) added clinical value in terms of additional treatment options and (2) cost-effectiveness of WGS compared to SOC diagnostics through a Health Technology Assessment (HTA) analysis. Furthermore, the (3) perceived impact of WGS-based diagnostics on clinical decision making will be evaluated through questionnaires. The number of patients included in (experimental) therapies initiated based on SOC or WGS diagnostics will be reported with at least 3 months follow-up. The clinical efficacy is beyond the scope of WIDE. Key performance indicators will be evaluated after every 200 patients enrolled, and procedures optimized accordingly, to continuously improve the diagnostic performance of WGS in a routine clinical setting.

Discussion

WIDE will yield the optimal conditions under which WGS can be implemented in a routine molecular diagnostics setting and establish the position of WGS compared to SOC diagnostics in routine clinical care.
Comparative assessments of indel annotations in healthy and cancer genomes with next-generation sequencing data
Authors: Chen Jing , Guo Jun-tao
Published: November 2020

Background

Insertion and deletion (indel) is one of the major variation types in human genomes. Accurate annotation of indels is of paramount importance in genetic variation analysis and investigation of their roles in human diseases. Previous studies revealed a high number of false positives from existing indel calling methods, which limits downstream analyses of the effects of indels on both healthy and disease genomes. In this study, we evaluated seven commonly used general indel calling programs for germline indels and four somatic indel calling programs through comparative analysis to investigate their common features and differences and to explore ways to improve indel annotation accuracy.

Methods

In our comparative analysis, we adopted a more stringent evaluation approach by considering both the indel positions and the indel types (insertion or deletion sequences) between the samples and the reference set. In addition, we applied an efficient way to use a benchmark for improved performance comparisons for the general indel calling programs

Results

We found that germline indels in healthy genomes derived by combining several indel calling tools could help remove a large number of false positive indels from individual programs without compromising the number of true positives. The performance comparisons of somatic indel calling programs are more complicated due to the lack of a reliable and comprehensive benchmark. Nevertheless our results revealed large variations among the programs and among cancer types.

Conclusions

While more accurate indel calling programs are needed, we found that the performance for germline indel annotations can be improved by combining the results from several programs. In addition, well-designed benchmarks for both germline and somatic indels are key in program development and evaluations.
Prevalence and factors associated with carriage of Pfmdr1 polymorphisms among pregnant women receiving intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) and artemether-lumefantrine for malaria treatment in Burkina Faso
Authors: Natama Hamtandi Magloire , Toussaint Rouamba , Bazié Djamina Line Cerine , Samadoulougou Sékou , Coulibaly-Traoré Maminata , Tinto Halidou , Kirakoya-Samadoulougou Fati
Published: November 2020

Background

Single nucleotide polymorphisms occurring in the Plasmodium falciparum multidrug resistant gene 1 (pfmdr1) are known to be associated with aminoquinoline resistance and, therefore, represent key P. falciparum markers for monitoring resistance both in susceptible groups (children under 5 years old and pregnant women) and in the general population. This study aimed to determine prevalence and factors associated with the carriage of pfmdr1 N86Y, Y184F and D1246Y polymorphisms among pregnant women in a setting of high malaria transmission in Burkina Faso.

Methods

Plasmodium falciparum isolates were collected at the first antenatal care visit (ANC-1) as well as at delivery from pregnant women participating in the COSMIC trial (NTC01941264), which assessed malaria preventive interventions during pregnancy in the Nanoro Health District. Here, pregnant women received intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) and malaria infections and/or diseases were treated using artemether-lumefantrine (AL) during the trial. Parasite DNA was extracted from dried blood spots and the presence of pfmdr1 mutations at positions 86, 184 and 1246 was determined using nested PCR, followed by restriction fragment length polymorphism (RFLP) analysis.

Results

A prevalence of 13.2% (20/151) and 12.1% (14/116) of the pfmdr1 86Y mutant allele was found at ANC-1 and at delivery, respectively, while no mutant allele was observed for Y184F and D1246Y codons at both ANC-1 and at delivery. There were no significant factors associated with pfmdr1 86Y mutant allele carriage at ANC-1. However, malaria infections at delivery with a parasite density above the median (2237.2 (IQR: 613.5–11,425.7) parasites/µl) was associated with an increase risk of pfmdr1 86Y mutant allele carriage (AOR = 5.5 (95% CI  1.07–28.0); P = 0.04). In contrast, both three or more IPTp-SP doses (AOR = 0.25 (95% CI 0.07–0.92); P = 0.04) and one or more AL treatment (AOR = 0.25 (95% CI 0.07–0.89); P = 0.03) during pregnancy were associated with a significant reduce risk of pfmdr1 86Y mutant allele carriage at delivery.

Conclusion

These findings suggest that both high coverage of IPTp-SP and the use of AL for the treatment of malaria infection/disease during pregnancy select for pfmdr1 N86 wild-type allele at delivery.
Efficacy evaluation of Veeralin LN, a PBO-incorporated alpha-cypermethrin long-lasting insecticidal net against Anopheles culicifacies in experimental huts in Odisha State
Authors: Kasinathan Gunasekaran , Sahu Sudhansu Sekhar , Krishnamoorthy Nallan , Baig Mohammed Mustafa , Thankachy Sonia , Dash Smrutidhara , Subramanian Swaminathan , Jambulingam Purushothaman
Published: November 2020

Background

The success of malaria control using long-lasting insecticidal nets (LLINs) is threatened by pyrethroid resistance developed by the malaria vectors, worldwide. To combat the resistance, synergist piperonyl butoxide (PBO) incorporated LLINs is one of the available options. In the current phase II hut trial, the efficacy of Veeralin®LN (an alpha-cypermethrin and PBO-incorporated net) was evaluated against Anopheles culicifacies, a pyrethroid resistant malaria vector.

Methods

The performance of Veeralin®LN was compared with MAGNet®LN and untreated net in reducing the entry, induced exit, mortality and blood feeding inhibition of target vector species.

Results

The performance of Veeralin was equal to MAGNet in terms of reducing hut entry, inhibiting blood feeding and inducing exophily, and with regard to causing mortality Veeralin was better than MAGNet. When compared to untreated net, a significant reduction in hut entry and blood feeding and an increase in exophily and mortality were observed with Veeralin. In cone bioassays, unwashed Veeralin caused > 80% mortality of An. culicifacies.

Conclusions

Veeralin performed equal to (entry, exit, feeding) or better than (mortality in huts and cone bioassays) MAGNet and could be an effective tool against pyrethroid resistant malaria vectors.
Acceptability, motivation and the prospect of cure for people living with HIV and their healthcare providers in HIV cure-focused treatment interruption studies
Authors: Lau Jillian S. Y. , Smith Miranda Z. , Allan Brent , Martinez Cipriano , Power Jennifer , Lewin Sharon R. , McMahon James H.
Published: November 2020

Background

Analytical treatment interruptions (ATI) are commonly used clinical endpoints to assess interventions aimed at curing HIV or achieving antiretroviral therapy (ART)-free HIV remission. Understanding the acceptability of ATI amongst people living with HIV (PLHIV) and their HIV healthcare providers (HHP) is limited.

Methods

Two online surveys for PLHIV and HHP assessed awareness and acceptability of ATI, and understanding of the prospect for HIV cure in the future. Responses were collected from July 2017–January 2018. A descriptive analysis was performed and similar questions across the two surveys were compared using χ squared test.

Results

442 PLHIV and 144 HHP completed the survey. 105/400 (26%) PLHIV had ever interrupted ART, 8% of which were in a clinical trial. Altruistic motivations were drivers of participation of PLHIV in cure related research. 81/135 (60%) HHP would support their patients wishing to enrol in an HIV cure-focused trial, but fewer would promote and allow such participation (25% and 31% respectively). Compared to HHP, PLHIV were more likely to believe that an HIV cure would be achievable within 10 years (55% vs. 19%, p < 0.001), had less awareness of ATI (46% vs. 62%, p < 0.001) and were less likely to have had experience of either participation or enrolment in an ATI study (5% vs. 18%, p < 0.001)

Conclusion

PLHIV were more optimistic about the potential for HIV cure. HHP had more direct experience with HIV cure-focused studies. Educational strategies are required for both groups to increase understanding around ATIs in HIV cure research but should be tailored specifically to each group.
Nondestructive estimation of potato yield using relative variables derived from multi-period LAI and hyperspectral data based on weighted growth stage
Authors: Luo Shanjun , He Yingbin , Li Qian , Jiao Weihua , Zhu Yaqiu , Zhao Xihai
Published: November 2020

Background

The accurate estimation of potato yield at regional scales is crucial for food security, precision agriculture, and agricultural sustainable development.

Methods

In this study, we developed a new method using multi-period relative vegetation indices (rVIs) and relative leaf area index (rLAI) data to improve the accuracy of potato yield estimation based on the weighted growth stage. Two experiments of field and greenhouse (water and nitrogen fertilizer experiments) in 2018 were performed to obtain the spectra and LAI data of the whole growth stage of potato. Then the weighted growth stage was determined by three weighting methods (improved analytic hierarchy process method, IAHP; entropy weight method, EW; and optimal combination weighting method, OCW) and the Slogistic model. A comparison of the estimation performance of rVI-based and rLAI-based models with a single and weighted stage was completed.

Results

The results showed that among the six test rVIs, the relative red edge chlorophyll index (rCIred edge) was the optimal index of the single-stage estimation models with the correlation with potato yield. The most suitable single stage for potato yield estimation was the tuber expansion stage. For weighted growth stage models, the OCW-LAI model was determined as the best one to accurately predict the potato yield with an adjusted R2 value of 0.8333, and the estimation error about 8%.

Conclusion

This study emphasizes the importance of inconsistent contributions of multi-period or different types of data to the results when they are used together, and the weights need to be considered.
Developing and validating an integrated gross tumor volume (GTV)-TNM stratification system for supplementing unresectable locally advanced non-small cell lung cancer treated with concurrent chemoradiotherapy
Authors: Chen Nai-Bin , Li Qi-Wen , Zhu Zheng-Fei , Wang Yi-Ming , Cheng Zhangkai J. , Hui Zhou-Guang , Guo Su-Ping , He Hao-Qiang , Wang Bin , Huang Xiao-Yan , Li Ji-Bin , Guo Jin-Yu , Hu Nan , Ai Xin-Lei , Zhou Yin , Wang Da-Quan , Liu Fang-Jie , Xie Chuan-Miao , Qiu Bo , Liu Hui
Published: November 2020

Purpose

The gross tumor volume (GTV) could be an independent prognostic factor for unresectable locally advanced non-small cell lung cancer (LANSCLC). We aimed to develop and validate a novel integrated GTV-TNM stratification system to supplement LANSCLC sub-staging in patients treated with concurrent chemoradiotherapy (CCRT).

Methods

We performed a retrospective review of 340 patients with unresectable LANSCLC receiving definitive CCRT. All included patients were divided into two randomized cohorts. Then the Kaplan–Meier method and Cox regression were calculated to access the prognostic value of the integrated GTV-TNM stratification system, which was further validated by the area under the receiver operating characteristic curve (AUC) score and F1-score.

Results

The optimal outcome-based GTV cut-off values (70 and 180 cm3) of the modeling cohort were used to determine each patient’s integrated GTV-TNM stratum in the whole cohort. Our results indicated that a lower integrated GTV-TNM stratum could had better overall survival and progression-free survival (allP < 0.001), which was recognized as an independent prognostic factor. Also, its prognostic value was robust in both the modeling and validation cohorts. Furthermore, the prognostic validity of the integrated GTV-TNM stratification system was validated by significantly improved AUC score (0.636 vs. 0.570,P = 0.027) and F1-score (0.655 vs. 0.615,P < 0.001), compared with TNM stage.

Conclusions

We proposed a novel integrated GTV-TNM stratification system to supplement unresectable LANSCLC sub-staging due to its prognostic value independent of TNM stage and other clinical characteristics, suggesting that it could be considered in individual treatment decision-making process.
Pre-operative clinical predictors for cardiology referral prior to total joint arthroplasty: the ‘asymptomatic’ patient
Authors: Elsiwy Yassin , Symonds Tristan , Doma Kenji , Hazratwala Kaushik , Wilkinson Matthew , Letson Hayley
Published: November 2020

Background

No validated pre-operative cardiac risk stratification tool exists that is specific for total hip and total knee arthroplasty (THA and TKA, respectively). To reduce the risk of post-operative cardiac complication, surgeons need clear guidance on which patients are likely to benefit from pre-operative cardiac optimisation. This is particularly important for asymptomatic patients, where the need is harder to determine.

Methods

Primary THA and TKA performed between January 1, 2010, and December 31, 2017, were identified from a single orthopaedic practice. Over 25 risk factors were evaluated as predictors for patients requiring additional cardiac investigation beyond an ECG and echocardiogram, and for cardiac abnormality detected upon additional investigation. A multivariate logistic regression was conducted using significant predictor variables identified from inferential statistics. A series of predictive scores were constructed and weighted to identify the influence of each variable on the ability to predict the detection of cardiac abnormality pre-operatively.

Results

Three hundred seventy-four patients were eligible for inclusion. Increasing age (p< 0.001), history of cerebrovascular accident (p= 0.018), family history of cardiovascular disease (FHx of CVD) (p< 0.001) and decreased ejection fraction (EF) (p< 0.001) were significant predictors of additional cardiac investigation being required. Increasing age (p= 0.003), male gender (p= 0.042), FHx of CVD (p= 0.001) and a reduced EF (p< 0.001) were significantly predictive for the detection of cardiac abnormality upon additional cardiac investigation.

Conclusions

Increasing age, male gender, FHx of CVD and decreased ejection fraction are important risk factors to consider for pre-operative cardiac optimisation in THA and TKA patients. These findings can be applied towards future predictive models, to determine which asymptomatic patients are likely to benefit from pre-operative cardiac referral.
Correlation between osteoarthritis and monocyte chemotactic protein-1 expression: a meta-analysis
Authors: Ni Feifei , Zhang Yanchao , Peng Xiaoxiao , Li Jianjun
Published: November 2020

Objective

We evaluated the association between monocyte chemotactic protein-1 (MCP-1) and osteoarthritis.

Methods

We searched PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), VIP (Chinese database), and Wan Fang (Chinese database) (before May 10, 2020), with no language limitations. STATA version 12.0 and Revman version 5.3 were used for data analysis. The standard mean difference (SMD) and corresponding 95% confidence intervals (95% CIs) were calculated. Nine clinical studies, including 376 patients with osteoarthritis and 306 healthy controls, were evaluated.

Results

The combined SMDs of MCP-1 expression levels suggested that MCP-1 expression was significantly higher in patients with osteoarthritis than healthy controls (SMD = 1.97, 95% CI = 0.66–3.28,p= 0.003). Moreover, subgroup analysis implied that osteoarthritis patients from both Asians and mixed populations had higher MCP-1 expression levels than controls, whereas Caucasians did not (p> 0.05). Serum MCP-1 levels (SMD = 2.83, 95% CI = 1.07–4.6,p< 0.00001) were significantly higher in patients with osteoarthritis than in controls; however, this difference was not significant in synovial fluid and cartilage tissue. Subgroup analysis for ethnicity showed that MCP-1 levels were significantly higher in Chinese, Dutch, and Brazilian patients with osteoarthritis than in control groups, although significant differences were not observed for American and Italian subgroups.

Conclusions

Our meta-analysis demonstrated that MCP-1 expression levels were higher in patients with osteoarthritis than in healthy controls and that MCP-1 may play important roles in the progression of osteoarthritis. Serum MCP-1 levels may serve as a potential biomarker for the diagnosis of osteoarthritis.
Risk factors related to perioperative systemic complications and mortality in elderly patients with osteoporotic vertebral fractures—analysis of a large national inpatient database
Authors: Morishita Shingo , Yoshii Toshitaka , Okawa Atsushi , Inose Hiroyuki , Hirai Takashi , Yuasa Masato , Fushimi Kiyohide , Fujiwara Takeo
Published: November 2020

Background

The surgical treatment of osteoporotic vertebral fractures (OVF) is generally associated with a high risk of complications due to an aging population with osteoporosis; however, the detailed risk factors for systemic complications and mortality have not been clarified. We evaluated the risk factors for systemic complications and mortality in surgically treated OVF patients using a large national inpatient database.

Methods

Patients over 65 years old who were diagnosed with OVF and received either anterior fusion (AF) or posterior fusion (PF), from 2012 to 2016, were extracted from the diagnosis procedure combination (DPC) database. In each of the perioperative systemic complications (+) or (−) group, and the in-hospital death (+) or (−) group, we surveyed the various risk factors related to perioperative systemic complications and in-hospital death.

Results

The significant factors associated with systemic complications were older age (OR 1.38, 95% CI 1.09–1.74), a lower activity of daily living score upon admission (OR 1.52, 95%CI 1.19–1.94), atrial fibrillation (OR 2.14, 95%CI 1.25–3.65), renal failure (OR 2.29, 95%CI 1.25–4.20), and surgical procedure (AF, OR 1.73, 95%CI 1.35–2.22). The significant explanatory variables for in-hospital death were revealed to be male sex (OR 3.26, 95%CI 1.20–8.87), a lower body mass index (OR 3.97, 95%CI 1.23–12.86), unscheduled admission (OR 3.52, 95%CI 1.17–10.63), atrial fibrillation (OR 8.31, 95%CI 2.25–30.70), renal failure (OR 7.15, 95%CI 1.32-38.77), and schizophrenia (OR 8.23, 95%CI 1.66–42.02).

Conclusions

Atrial fibrillation and renal failure as preoperative comorbidities were common factors between perioperative systemic complications and mortality in elderly patients for OVF.
Wrist function recovery course in patients with scaphoid nonunion treated with combined volar bone grafting and a dorsal antegrade headless screw
Authors: Yeh Chen-Wei , Hsu Cheng-En , Wang Wei-Chih , Chiu Yung-Cheng
Published: November 2020

Background

Surgical treatment is necessary for scaphoid nonunion. Open surgery with a combined volar and dorsal approach is thought to have poor functional outcomes and a prolonged recovery course. However, the detailed recovery course for this approach is rarely reported. The aim of this study was to investigate the recovery course and radiographic outcome for patients with scaphoid nonunion who underwent a combined volar bone grafting and dorsal antegrade headless screw approach.

Material and methods

Eighteen patients with scaphoid nonunion who underwent combined volar bone grafting and dorsal antegrade headless screw fixation were enrolled in this retrospective study. Preoperative and serial postoperative wrist functional and radiographic outcomes were collected and analysed.

Results

All 18 patients achieved bone union at a mean time of 14.3 weeks. Compared to the preoperative status, the grip strength, wrist motion arc, and Mayo Wrist score were improved significantly 6 months after surgery, whilst the Disabilities of the Arm, Shoulder, and Hand (DASH) score did not recover until 12 months after surgery. Significant improvements were found in all scaphoid radiographic parameters.

Conclusion

The surgical outcomes for scaphoid nonunion treated with a combined volar bone grafting and dorsal antegrade headless screw achieved a high union rate, with great wrist functional and radiographic outcomes. The earliest recovered wrist functional parameters were grip strength, motion arc, Mayo Wrist score and finally the DASH score at postoperative 6 months and 12 months, respectively.