bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of oral sarolaner againstLynxacarus radovskyiin naturally infested cats
Authors: Campos Diefrey R. , Chaves Jéssica K. O. , Assis Rayane C. P. , Fernandes Júlio I. , Scott Fabio B.
Published: June 2020

Background

Lynxacarus radovskyiis a fur mite of cats. Several classes of ectoparasiticides have shown success for treatment, including an isoxazoline.

Objectives

To evaluate the efficacy of a single oral dose of sarolaner for the treatment ofL. radovskyimites in naturally infested cats.

Animals

Fourteen adult cats (six males and eight females), naturally infested withL. radovskyi.

Methods and materials

Animals were randomized according to sex and average pretreatment mite count. The cats were assigned to two groups of seven cats each. The treated group received one 10 mg sarolaner tablet,corresponding to a dose of 2–4 mg/kg body weight, and the control group received no treatment. From each cat, three trichograms consisting of approximately 50 hairs each were collected from the dorsal neck, lateral thigh and perineum/tail region (total of nine samples per cat). The severity of infestation was scored on a scale of 0 (no parasites) to 4 (>50 mites) at baseline and days 7, 15, 30, 45 and 60 post‐treatment. Efficacy was compared between the treatment and control groups using the arithmetic mean reduction of the mite score; results were analysed using the Kruskal–Wallis test followed by the Student–Newtman–Keuls test, with significance set atP < 5%.

Results

The efficacy of oral sarolaner was >95% at Day 30 post‐treatment. Statistical differences were first observed between the means of the control and treated groups 15 days post‐treatment.

Conclusion

A single oral dose of sarolaner effectively eliminatedL. radovskyiin most cats.
Dynamics of malaria-dengue fever and its optimal control
Authors: Shah Nita H. , Suthar Ankush H. , Jayswal Ekta N.
Published: June 2020

The mosquito-borne infectious diseases like malaria and dengue are putative as important tropical infections and cause high morbidity and mortality around the world. In some cases, simultaneous coexistence of both the infections in one individual is seen which is very hard to distinguish as both diseases have almost similar symptoms. In this proposed article, dynamical system of non-linear differential equations is constructed with the help of mathematical modeling, which describe dynamics of the spread of these infectious diseases separately and concurrently. Basic reproduction number is evaluated to understand dynamical behaviour of the model. Local and global stability criteria have been deliberated rigorously. Control parameters are used to perceive effect of medication on these prevalent tropical diseases. Numerical simulations are used to observe effect of control parameters graphically.
Return to Preinjury Function Following Knee Injury
Authors: Sciascia Aaron D. , Nitz Arthur J. , McKeon Patrick O. , Havens Jennifer , Uhl Timothy L.
Published: June 2020

Athletic preinjury function is typically determined via patient recall, however obtaining preinjury function before injury occurs should be attempted. The purpose of this study was to obtain preinjury physical function baseline values using the Knee Injury and Osteoarthritis Outcome Score (KOOS), single-leg hop for distance (SLH), and Star Excursion Balance Test (SEBT) anterior reach to determine if athletes return to those baseline values following knee injury. Out of 27 qualifying injuries, KOOS scores were significantly reduced at initial injury compared to baseline and all follow-up points (p ≤ .02). In most instances, baseline KOOS scores were not met at the discharge time point. SLH and SEBT recovered to baseline values by discharge. Injury severity and previous injury created variations in KOOS scores across multiple time points. Subjective and objective preinjury function can be re-established following knee injury but recovery may not occur at discharge from rehabilitation.
“Not Everybody’s an Athlete, But They Certainly Can Move”: Facilitators of Physical Activity Maintenance in Older Adults in a Northern and Rural Setting
Authors: Ward Kirsten , Pousette Anne , Pelletier Chelsea A.
Published: June 2020

Although the benefits of maintaining a physical activity regime for older adults are well known, it is unclear how programs and facilities can best support long-term participation. The purpose of this study is to determine the facilitating factors of physical activity maintenance in older adults at individual, program, and community levels. Nine semistructured interviews were conducted with individuals aged 60 years and older and long-term participants (>6 months) in community-based group exercise at a clinical wellness facility in northern British Columbia, Canada. Interviews were audio recorded, transcribed, and analyzed via inductive thematic analysis. Themes identified as facilitators of physical activity included (a) social connections, (b) individual contextual factors, and (c) healthy aging. Older adults are more likely to maintain physical activity when environments foster healthy aging and provide opportunity for social engagement.
The Coach–Parent Relationship and Athlete Development in Elite Youth Hockey: Lessons Learned for Conflict Management
Authors: Preston Cassidy , Allan Veronica , Wolman Lauren , Fraser-Thomas Jessica
Published: June 2020

Extensive research highlights the important roles of coaches and parents in fostering positive youth development (PYD). However, little research has examined the complex coach–parent relationship in the bidirectional interactions of the coach-parent-athlete triad. This research is particularly pertinent in elite youth sport, wherein the performance-oriented environment may impede the pursuit of PYD. As such, this study aimed to deepen understandings of the coach–parent relationship in relation to athletes’ PYD. Specifically, the first author critically analyzed and reflected on his experiences as an elite youth ice hockey coach, thus offering a unique portrayal of reflective practice in the context of sport coaching. Two interconnected themes emerged: understanding conflict in the coach-parent-athlete relationship and fostering collaboration through enhanced coach–parent communication. Findings and reflections are discussed in relation to the dual-concern model of conflict resolution, and strategies to help practitioners foster cooperative coach–parent relationships are presented.
Europe bets R&D spending will bring jobs to battered economy
Authors: Wallace Nicholas
Published: June 2020

Horizon Europe gets €13.5 billion to spend fast, spur growth.
MTOR signaling orchestrates stress-induced mutagenesis, facilitating adaptive evolution in cancer
Authors: Cipponi Arcadi , Goode David L. , Bedo Justin , McCabe Mark J. , Pajic Marina , Croucher David R. , Rajal Alvaro Gonzalez , Junankar Simon R. , Saunders Darren N. , Lobachevsky Pavel , Papenfuss Anthony T. , Nessem Danielle , Nobis Max , Warren Sean C. , Timpson Paul , Cowley Mark , Vargas Ana C. , Qiu Min R. , Generali Daniele G. , Keerthikumar Shivakumar , Nguyen Uyen , Corcoran Niall M. , Long Georgina V. , Blay Jean-Yves , Thomas David M.
Published: June 2020

How cancer cells adapt to stress

Bacteria adapt to harsh conditions such as antibiotic exposure by acquiring new mutations, a process called stress-induced mutagenesis. Cipponi
et al.
investigated whether similar programs of mutagenesis play a role in the response of cancer cells to targeted therapies. Using in vitro models of intense drug selection and genome-wide functional screens, the authors found evidence for an analogous process in cancer and showed that it is regulated by the mammalian target of rapamycin (mTOR) signaling pathway. This pathway appears to mediate a stress-related switch to error-prone DNA repair, resulting in the generation of mutations that facilitate the emergence of drug resistance.

Science
, this issue p.
1127
Time-resolved observation of spin-charge deconfinement in fermionic Hubbard chains
Authors: Vijayan Jayadev , Sompet Pimonpan , Salomon Guillaume , Koepsell Joannis , Hirthe Sarah , Bohrdt Annabelle , Grusdt Fabian , Bloch Immanuel , Gross Christian
Published: June 2020

Spin and charge go their separate ways

Strongly interacting chains of fermions are predicted to exhibit two types of collective excitations: spinons, which carry only spin, and holons, which carry only charge. These excitations move at different velocities. Signatures of this so-called spin-charge separation have been observed in solid-state systems, but obtaining direct dynamical evidence is tricky. With this goal in mind, Vijayan
et al.
perturbed a chain of ultracold interacting fermions housed in a one-dimensional optical lattice by removing one of the atoms. This gave rise to two independent excitations, which the researchers identified as spinons and holons using a quantum gas microscope.

Science
, this issue p.
186
Photoelectron spectra of alkali metal–ammonia microjets: From blue electrolyte to bronze metal
Authors: Buttersack Tillmann , Mason Philip E. , McMullen Ryan S. , Schewe H. Christian , Martinek Tomas , Brezina Krystof , Crhan Martin , Gomez Axel , Hein Dennis , Wartner Garlef , Seidel Robert , Ali Hebatallah , Thürmer Stephan , Marsalek Ondrej , Winter Bernd , Bradforth Stephen E. , Jungwirth Pavel
Published: June 2020

Watching electrons swarm ammonia

Liquid ammonia is unusual in its capacity to host electrons in stable solution, with vivid blue and bronze colors signifying the low- and high-concentration regimes, respectively. Buttersack
et al.
used photoelectron spectroscopy and accompanying theoretical simulations to track the precise energetic changes that ensued as steadily rising quantities of electrons were introduced by dissolved lithium, sodium, or potassium (see the Perspective by Isborn). The results point to a gradual transition from the dilute electrolyte solution of paired dielectrons to the more delocalized metallic structure at the highest concentrations.

Science
, this issue p.
1086
; see also p.
1056
The structure of human CST reveals a decameric assembly bound to telomeric DNA
Authors: Lim Ci Ji , Barbour Alexandra T. , Zaug Arthur J. , Goodrich Karen J. , McKay Allison E. , Wuttke Deborah S. , Cech Thomas R.
Published: June 2020

Architecture of DNA-organizing complex

The highly conserved mammalian CTC1-STN1-TEN1 (CST) complex is critical for genome stability and telomere maintenance. Lim
et al.
solved the structure of the human CST complex using cryo–electron microscopy. CST forms an unprecedented and substantial decameric supercomplex triggered by telomeric single-stranded binding. This decameric form with single-stranded DNA–binding capacity of up to 10 telomeric repeats, suggested the possibility of CST organizing telomere overhangs into compact and restrictive structures in a manner similar to the nucleosome's organization of double-stranded DNA. This work provides a platform for understanding the mechanisms of various CST functions.

Science
, this issue p.
1081
Barcoded microbial system for high-resolution object provenance
Authors: Qian Jason , Lu Zhi-xiang , Mancuso Christopher P. , Jhuang Han-Ying , del Carmen Barajas-Ornelas Rocío , Boswell Sarah A. , Ramírez-Guadiana Fernando H. , Jones Victoria , Sonti Akhila , Sedlack Kole , Artzi Lior , Jung Giyoung , Arammash Mohammad , Pettit Mary E. , Melfi Michael , Lyon Lorena , Owen Siân V. , Baym Michael , Khalil Ahmad S. , Silver Pamela A. , Rudner David Z. , Springer Michael
Published: June 2020

DNA barcodes in small packages

Under adverse environmental conditions, some microorganisms form spores that provide robust protection for genetic material. Qian
et al.
developed a system in which DNA barcodes are encapsulated inside nongerminating microbial spores and can be dispersed on objects or in the environment (see the Perspective by Nivala). These barcoded spores provide a durable, specific marker that can be read out quickly with simple equipment. When applied to soil, the spores can be transferred to and from objects around them, enabling tracking at meter-scale resolution. On plant leaves, the spores are not readily transferred, and the authors demonstrate a potential use for tracking agricultural products.

Science
, this issue p.
1135
; see also p.
1058
A fractional corner anomaly reveals higher-order topology
Authors: Peterson Christopher W. , Li Tianhe , Benalcazar Wladimir A. , Hughes Taylor L. , Bahl Gaurav
Published: June 2020

Topological insulators in the spotlight

In addition to having an insulating interior while at the same time supporting conducting surface states, topological insulators have many other interesting properties. Higher-order topological insulating states, where regions of interest are along edges and at corners, have been difficult to identify unambiguously. Peterson
et al.
developed a theoretical framework to help identify and characterize these exotic states, including a new topological marker—the fractional charge density—that can be used to detect topological states of matter when the spectroscopic probe of gapless surface states is not accessible. The agreement between experimental work and theory is encouraging for applicability to other topological platforms.

Science
, this issue p.
1114
Comment on “RNA-guided DNA insertion with CRISPR-associated transposases”
Authors: Rice Phoebe A. , Craig Nancy L. , Dyda Fred
Published: June 2020

Strecker
et al
. (Research Articles, 5 July 2019, p. 48) described a system for exploiting a Tn7-type transposon-encoded CRISPR-Cas system to make RNA-guided, programmable insertions. Although this system has great promise, we note that the well-established biochemistry of Tn7 suggests that the particular system used may insert not only the transposon but also the entire donor plasmid.
Iridium-catalyzed acid-assisted asymmetric hydrogenation of oximes to hydroxylamines
Authors: Mas-Roselló Josep , Smejkal Tomas , Cramer Nicolai
Published: June 2020

Hydrogenations that tolerate N–O bonds

Catalysts that add hydrogen to carbon-carbon, carbon-nitrogen, and carbon-oxygen double bonds are among the most widely used in synthetic chemistry. They are particularly adept at delivering just one of two mirror-image products. However, they may also target adjacent bonds in the compound that would be better left intact. Mas-Roselló
et al.
report that an iridium catalyst paired with a strong acid can hydrogenate C=N bonds without disturbing a weak N–O bond on the same nitrogen center. The reactions proceed at room temperature with high enantioselectivity.

Science
, this issue p.
1098
In Vitro
Activities of Eravacycline and Other Antimicrobial Agents against Human Mycoplasmas and Ureaplasmas
Authors: Waites Ken B. , Crabb Donna M. , Xiao Li , Duffy Lynn B. , Leal Sixto M.
Published: June 2020

We performed
in vitro
susceptibility testing for eravacycline in comparison to 4 other antimicrobials against 10
Mycoplasma genitalium
, 40
Mycoplasma hominis
, 44
Mycoplasma pneumoniae
, 20
Ureaplasma parvum
, and 20
Ureaplasma urealyticum
isolates. All eravacycline MICs were ≤0.25 μg/ml, except that for one isolate of
M. genitalium
, for which the MIC was 2 μg/ml.
Genetic Redundancy in Iron and Manganese Transport in the Metabolically Versatile Bacterium Rhodopseudomonas palustris TIE-1
Authors: Singh Rajesh , Ranaivoarisoa Tahina Onina , Gupta Dinesh , Bai Wei , Bose Arpita
Published: June 2020

Rhodopseudomonas palustris
TIE-1 is a metabolically versatile bacterium that can use various electron donors, including Fe(II) and poised electrodes, for photoautotrophic growth. TIE-1 can produce useful biomolecules, such as biofuels and bioplastics, under various growth conditions. Production of such reduced biomolecules is controlled by intracellular electron availability, which, in turn, is mediated by various iron-containing proteins in the cell. Several putative Fe transporters exist in TIE-1’s genome. Some of these transporters can also transport Mn, part of several important cellular enzymes. Therefore, understanding the ability to transport and respond to various levels of Fe and Mn under different conditions is important to improve TIE-1’s ability to produce useful biomolecules. Our data suggest that by overexpressing Fe transporter genes via plasmid-based expression, we can increase the import of Fe and Mn in TIE-1. Future work will leverage these data to improve TIE-1 as an attractive microbial chassis and future biotechnological workhorse.
Supplemental Material: Direct coupling between carbon release and weathering during the Toarcian oceanic anoxic event
Authors: Kemp David , al. et
Published: June 2020

Description of methods, Table S1, and Figures S1 and S2.
Supplemental Material: Aridity-driven decoupling of δ13C between pedogenic carbonate and soil organic matter
Authors: Da Jiawei , Ji Junfeng , al. et
Published: June 2020

Descriptions of chronology and analytical methods, Figures S1–S5, and Tables S1–S3.
Supplemental Material: Field evidence for coal combustion links the 252 Ma Siberian Traps with global carbon disruption
Authors: Elkins-Tanton Linda , al. et
Published: June 2020

Methods and detailed location maps for samples.
Supplemental Material: Intrabasinal sediment recycling from detrital strontium isotope stratigraphy
Authors: Auchter Neal , al. et
Published: June 2020

Sample screening, trace element analysis, strontium isotope measurements, histogram, and kernel density estimate.
Supplemental Material: The western Hayfork terrane: Remnants of the Middle Jurassic arc in the Klamath Mountain province, California and Oregon
Authors: Barnes C.G. , Barnes M.A.
Published: June 2020

Table S1: Locations and lithology of analyzed samples. Table S2: Calculated temperatures and pressures of augite and amphibole crystallization. Table S3: Major-element compositions of clinopyroxene. Table S4: Major-element compositions of amphibole. Table S5: Trace-element compositions of clinopyroxene and amphibole. Table S6: Bulk-rock compositions of the Forks of Salmon pluton.
Female genital mutilation (FGM) in UK children: a review of a dedicated paediatric service for FGM
Authors: Ali Sakaria , Patel Roshnee , Armitage Alice Jane , Learner Hazel Isabella , Creighton Sarah M , Hodes Deborah
Published: June 2020

Objective

To describe the presentation and management of children with suspected or confirmed female genital mutilation (FGM) referred to a specialist paediatric clinic.

Methods

Data collected included referral source, age, ethnicity, circumstances of FGM and clinical findings in accordance with the WHO FGM classification.

Results

Between September 2014 and January 2019, 148 children attended the clinic of whom 55 (37.2%) had confirmed FGM. Police or social care referred 112 (76%) children. The proportion of looked-after children (LAC) was significantly higher in the group with confirmed FGM (17/55, 31%) compared with children where FGM was not confirmed (5/93, 5%). In almost all children where FGM was confirmed, FGM was initially disclosed by the child or family (53/55, 96%) and of these 48/55 (87%) underwent FGM prior to UK entry. The remaining seven cases were British children, potentially meeting legal criteria under the FGM Act, and one resulted in a successful prosecution.

Conclusions

The number of children with FGM was significantly lower than expected based on UK prevalence estimates. Most children had undergone FGM prior to UK entry, and the majority of cases were initially disclosed by the child or family themselves. These results reflect the lack of large-scale proof of the practice of FGM in the UK and are consistent with growing evidence of the abandonment of FGM among communities after migration.
Competitive flow diversion of multiple P1 aneurysms: proposed classification
Authors: MacLean Mark Alexander , Huynh Thien J , Schmidt Matthias Helge , Pereira Vitor M , Weeks Adrienne
Published: June 2020

We report the case of a patient with subarachnoid hemorrhage and three aneurysms arising from the posterior communicating artery (Pcomm)-P1 complex, treated with endovascular coiling and competitive flow diversion. The largest and likely ruptured Pcomm aneurysm was treated with traditional coiling. Two smaller potentially ruptured aneurysms arose from the distal right posterior cerebral artery (PCA) P1 segment. After a failed attempt to treat with conventional flow diversion across the PCA-P1 segment, the P1 aneurysms were successfully treated with competitive flow diversion distal to the PCA-P1 segment from Pcomm to the P2 segment. Over 12 months, competitive flow diversion redirected flow to the right PCA territory via the internal carotid artery-Pcomm-P2, reducing the size of the PCA-P1 segment and obliterating the P1 aneurysms. Competitive flow diversion treatment should be considered for aneurysms occurring at the circle of Willis when traditional methods are not feasible. Herein, we introduce a novel classification for competitive flow diversion treatment.
Protocol for a systematic review of reviews evaluating effectiveness of mass media interventions for prevention and control of non-communicable diseases
Authors: Jeet Gursimer , Thakur J S , Prinja Shankar , Singh Meenu , Nangia Ria , Sharma Deepti , Dhadwal Priya
Published: June 2020

Introduction

Timely interventions are required in order to change unhealthy lifestyles because if continued for a prolonged period of time, these become risk factors for non-communicable diseases (NCDs). Education through mass media is an important factor in bringing out the behavioural change which may get missed in community-based interventions due to their limited reach. Many countries engage in mass media interventions, however, the nature of interventions and their effectiveness differs. We, therefore, describe the protocol of a systematic review to evaluate the effectiveness of the mass media interventions to reduce the risk of NCDs in the general population and compare the differences in effectiveness estimates across low/middle-income countries and developed countries.

Methods and analysis

We will search The Cochrane Library, Database of Abstracts of Reviews of Effectiveness, PubMed, Excerpta Medica Database limited to publications since 2000 to October 2019. Specific terms for the search strategy will be piloted as database-controlled vocabulary in the databases searched. The searches will include variations of the following terms: mass media, mass communication, campaign, publicity and terms for types of media, that is, print media, mobile, digital media, social media and broadcast. Study designs to be included will be systematic reviews followed by grey literature and other good quality reviews identified. The primary outcome of effectiveness will be the percentage change in population having different behavioural risk factors. In addition, mean overall change in levels of several physical or biochemical parameters will be studied as secondary outcomes.

Ethics and dissemination

The review is being done under the doctoral research which has been approved by the Institute Ethics Committee of the Post Graduate Institute of Medical Education and Research Dissemination will be done by submitting scientific articles to academic peer-reviewed journals. We will present the results at relevant conferences and meetings.

PROSPERO registration number

CRD42016048013
Prevalence of hepatitis B virus infection and associated risk factors among pregnant women attending antenatal clinic in Mulago Hospital, Uganda: a cross-sectional study
Authors: Kayondo Simon Peter , Byamugisha Josaphat K , Ntuyo Peter
Published: June 2020

Aim

To determine the prevalence and factors associated with hepatitis B virus infection among pregnant women attending antenatal clinic in Mulago Hospital.

Design

Cross-sectional observational study.

Setting

Mulago National Referral Hospital, Uganda, antenatal clinic.

Participants

We randomly selected 340 pregnant women attending their first antenatal visit at Mulago Hospital antenatal clinic.

Primary outcome

Hepatitis B surface antigen positivity.

Results

We recruited 340 participants, with a mean age of 27±5.7 years, and a median gravidity of 3. The prevalence of hepatitis B virus infection among pregnant women attending the antenatal clinic in Mulago Hospital, in our study, was 2.9% (95% CI 1.58% to 5.40%, n=10). Factors positively associated with hepatitis B virus infection were: marital status (adjusted OR (aOR)=11.37, p=0.002), having a hepatitis B positive family member (aOR=49.52, p<0.001) and having had a blood or body fluid splash to mucous membranes from a hepatitis B positive patient (aOR=61.69, p=0.015). Other factors such as age, socioeconomic status, number of sexual partners, HIV serostatus, piercing of ears and history of blood transfusion were not significantly associated with hepatitis B virus infection in this study.

Conclusion

The prevalence of hepatitis B virus infection among pregnant women attending antenatal clinic in Mulago Hospital was of intermediate endemicity. We found that marital status, having a hepatitis B positive family member at home and having had a blood or body fluid splash to mucous membranes from a hepatitis B positive patient were independently associated with hepatitis B infection. Factors such as age, HIV status, history of blood transfusion, piercing of ears and social status were not associated with hepatitis B status in this study.
Monitoring patients with acute dyspnoea with a serial focused ultrasound of the heart and the lungs (MODUS): a protocol for a multicentre, randomised, open-label, pragmatic and controlled trial
Authors: Arvig Michael D , Lassen Annmarie T , Gæde Peter H , Laursen Christian B
Published: June 2020

Introduction

Among patients admitted to an emergency department, dyspnoea is one of the most common symptoms. Patients with dyspnoea have high mortality and morbidity. Therefore, novel methods to monitor the patients are warranted. The aim is to investigate whether therapy guided by monitoring patients with acute dyspnoea with serial ultrasound examinations of the heart and the lungs together with standard care can change the severity of dyspnoea compared with treatment guided by standard monitoring alone.

Methods and analysis

The study will be conducted as a multicentre, randomised, pragmatic, open-label and controlled trial where patients admitted with acute dyspnoea to an emergency ward will be randomised into a standard care group and a serial ultrasound group with 103 patients in each. All patients will be examined with an ultrasound of the heart and the lungs upfront. In addition, the patients in the serial ultrasound group will be examined with an ultrasound of the heart and lungs two more times to guide further therapy during the admittance. The primary outcome is a change in dyspnoea on a verbal scale. After discharge, the patients are followed for 1 year to assess the number of readmissions, death and length of hospital stay.

Ethics and dissemination

The trial is conducted in accordance with the Declaration of Helsinki and approved by The Regional Committee on Health Research Ethics for Region Zealand, Denmark (identifier SJ-744). Data handling agreement with participating centres has been made (identifier REG-056–2019). The General Data Protection Regulation and the Danish Data Protection Act will be respected. The results of the trial will be reported in peer-reviewed scientific journals regardless of the outcomes.

Trial registration number

NCT04091334
Risk and protective factors of dementia among adults with post-traumatic stress disorder: a systematic review protocol
Authors: Lawrence Karen A , Pachner Theresia M , Long Molly M , Henderson Stephanie , Schuman Donna L , Plassman Brenda L
Published: June 2020

Introduction

Post-traumatic stress disorder (PTSD) is associated with an increased risk of dementia. Individual epidemiological studies have controlled for several confounders of the relationship between PTSD and increased dementia risk, yet particular risk factors underlying this relationship have not been determined. This systematic review protocol aims to identify risk and protective factors of dementia among adults with PTSD.

Methods and analysis

We will conduct an electronic search of the databases: PubMed, CINAHL, PsychINFO, The Cochrane Library, Scopus and ProQuest Dissertation and Theses Global. After screening the studies, quantitative synthesis will be performed, if possible. Otherwise, a narrative synthesis will be performed. We will include randomised controlled trials and other types of research evidence including longitudinal cohort studies. Strength of evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluations method. Examples of variables that will be extracted are: year of PTSD diagnosis, comorbid conditions, health behaviours, pharmacological treatments and year of mild cognitive impairment or dementia diagnosis. We developed this systematic review protocol according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 statement.

Ethics and dissemination

The proposed study will not collect individual-level data and, therefore, does not require ethical approval. Results of this study will provide current evidence on risk and protective factors of dementia in adults with PTSD. Findings will be disseminated in peer-reviewed publications and conference presentations.

PROSPERO registration number

CRD42019128553.
Impact of integrated care on trends in the rate of emergency department visits among older persons in Stockholm County: an interrupted time series analysis
Authors: Doheny Megan , Agerholm Janne , Orsini Nicola , Schön Pär , Burström Bo
Published: June 2020

Objective

To investigate the association between the implementation of an integrated care (IC) system in Norrtälje municipality and changes in trends of the rate of emergency department (ED) visits.

Design

Interrupted time series analysis from 2000 to 2015.

Setting

Stockholm County.

Participants

All inhabitants 65+ years in Stockholm County on 31 December of each study year.

Intervention

IC was established by combining the funding, administration and delivery of health and social care for older persons in Norrtälje municipality, within Stockholm County.

Outcome

Rates of hospital-based ED visits.

Results

IC was associated with a decrease in the rate of ED visits (incidence rate ratio: 0.997, 95% CI 0.995 to 0.998) among inhabitants 65+ years in Norrtälje. However, the rate of ED visits remained higher in Norrtälje than the rest of Stockholm in the preintervention and postintervention periods. Stratified analyses showed that IC was associated with a decline in the trend of the rate of ED visits among those 65–79 years, the lowest income group and born outside of Sweden. However, there was no significant decrease in the trend among those 80+ years.

Conclusion

The implementation of IC was associated with a modest change in the trend of ED visits in Norrtälje, though the rate of ED visits remained higher than in the rest of Stockholm. Changes in the composition of the population and contextual changes may have impacted our findings. Further research, using other outcome measures is needed to assess the impact of IC on healthcare utilisation.
‘Power plays plus push’: experts’ insights into the development and implementation of active tuberculosis case-finding policies globally, a qualitative study
Authors: Biermann Olivia , Atkins Salla , Lönnroth Knut , Caws Maxine , Viney Kerri
Published: June 2020

Objective

To explore experts’ views on factors influencing national and global active case-finding (ACF) policy development and implementation, and the use of evidence in these processes.

Design

This is an exploratory study based on semistructured expert interviews. Framework analysis was applied.

Participants

The study involved a purposive sample of 39 experts from international, non-governmental and non-profit organisations, funders, government institutions, international societies, think tanks, universities and research institutions worldwide.

Results

This study highlighted the perceived need among experts for different types of evidence for ACF policy development and implementation, and for stakeholder engagement including researchers and policymakers to foster evidence use. Interviewees stressed the influence of government, donor and non-governmental stakeholders in ACF policy development. Such key stakeholders also influence ACF policy implementation, in addition to available systems and processes in a given health system, and implementers’ motivation and incentives. According to the interviewees, the World Health Organization (WHO) guidelines for systematic screening face the innate challenge of providing guidance to countries across the broad area of ACF in terms of target groups, settings and screening algorithms. The guidelines could be improved by focusing on what should be done rather than what can be done in ACF, and by providing howto examples. Leadership, integration into health systems and long-term financing are key for ACF to be sustainable.

Conclusions

We provide new insights into ACF policy processes globally, particularly regarding facilitators for and barriers to ACF policy development, evidence need and use, and donor organisations’ influence. According to expert participants, national and global ACF policy development and implementation can be improved by broadening stakeholder engagement. Meanwhile, using diverse evidence to inform ACF policy development and implementation could mitigate the ‘power plays plus push’ that might otherwise disrupt and mislead these policy processes.
Identifying and de-implementing low-value care in primary care: the GP’s perspective—a cross-sectional survey
Authors: Kool Rudolf Bertijn , Verkerk Eva W , Winnemuller Lieke JA , Wiersma Tjerk , Westert Gert P , Burgers Jaco S , van Dulmen Simone A
Published: June 2020

Objective

General practitioners have an important role in reducing low-value care as gatekeepers of the health system. The aim of this study was to assess the experiences of Dutch general practitioners regarding low-value care and to identify their needs to decrease low-value primary care.

Design

We performed a cross-sectional study.

Participants

We sent a survey to 500 general practitioners.

Setting

Primary care in the Netherlands.

Primary and secondary outcomes

The survey contained questions about the provision of low-value care and on clinical cases about lumbosacral spine X-rays in patients with low back pain and vitamin B12laboratory tests without an evidence-based indication. We also asked general practitioners what they needed to reduce low-value care.

Results

A total of 182 general practitioners (37%) responded. 67% indicated that low-value care practices are regularly provided in general practice. 57% of the general practitioners have seen negative consequences of low-value care, in particular side effects of medication. The most provided low-value care practices are medication prescriptions such as antibiotics and laboratory tests such as vitamin B12tests. The most reported drivers are patient-related. General practitioners want to maintain a good relationship with their patients by offering their patients an intervention instead of watchful waiting. Lack of time also plays a major role. In order to reduce low-value care, general practitioners suggested that educating patients on the value of tests and treatments might help. Supporting general practitioners and other healthcare professionals with clear guidelines as well as having more time for consultation were also mentioned by general practitioners.

Conclusion

General practitioners are aware of providing unnecessary care despite their role as gatekeepers and have reasons for this. They need support in order to change their practice. This support might consist of better education of healthcare professionals and providing more time for consultation. Local and national media, such as websites and television, could be used to educate patients while guidelines could support professionals in reducing low-value care.
Twenty-five years after the introduction of Evidence-based Medicine: knowledge, use, attitudes and barriers among physiotherapists in Italy — a cross-sectional study
Authors: Castellini Greta , Corbetta Davide , Cecchetto Simone , Gianola Silvia
Published: June 2020

Objectives

To explore the knowledge, use, attitudes towards Evidence-based Medicine, also known as Evidence-based Practice (EBP), and perceived barriers to its dissemination among physiotherapists.

Design

Cross-sectional study.

Setting and participants

Members of the Italian Association of Physiotherapists (n=2000) were invited to participate in an online survey about EBP knowledge and use.

Primary outcome measures

The survey questionnaire comprised four sections: (1) respondent characteristics; (2) knowledge of EBP principles; (3) attitude, use and perceived effectiveness of EBP; (4) perceived barriers to implementing EBP in clinical practice.

Results

Out of 2000 physiotherapists, 1289 participated in the survey (64.5% response rate). Overall, 90% perceived EBP as useful and necessary for their clinical practice. More than 85% stated that they were familiar with the principles of EBP, 75% reported that they were able to search online databases for relevant information and 60% reported that they were able to understand statistical analyses. However, 56% believed that patient preferences and 39% that clinical expertise are not part of the EBP model. Half stated that they understood and could explain the term ‘meta-analysis’ but only 17% knew what a forest plot is and just 20% correctly judged the finding of a given meta-analysis. Lack of time was reported as the main barrier to EBP.

Conclusion

The majority of Italian physiotherapists overrated their knowledge about EBP, demonstrating a gap between perceived and actual knowledge of EBP in this population.
Prevalence and stability of insomnia from preschool to early adolescence: a prospective cohort study in Norway
Authors: Falch-Madsen Jonas , Wichstrøm Lars , Pallesen Ståle , Steinsbekk Silje
Published: June 2020

Background

There is limited knowledge about the prevalence and stability of insomnia defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM). We therefore provide such estimates from preschool to early adolescence and explore potential sex differences.

Methods

We followed a representative community sample (n=1037) biennially from 4 to 14 years of age (2007–2017). Insomnia diagnoses and symptoms were captured by a semistructured clinical interview of parents and children (from age 8 years).

Results

At ages 4 and 6 years approximately 2.5% of children met the criteria for insomnia, whereas at ages 8, 10, 12 and 14 years the prevalence ranged from 7.5% to 12.3%. During the 10-year period examined nearly 1 in 5 children had insomnia at least once (18.7%). Sex differences were apparent with DSM-IV, but not DSM-5, criteria: boys (8.1%) had more insomnia than girls (4.5%) did at ages 4–10 years, whereas girls (11.4%) had more insomnia than boys (7.1%) did at ages 12 and 14 years. Insomnia proved stable, with 22.9%–40.1% of children retaining their diagnosis 2 years later. Having current insomnia produced medium to large ORs of between 5.1 (95% CI 2.6 to 9.8) and 15.3 (95% CI 4.4 to 52.9) for subsequent insomnia 2 years later compared with not having preceding insomnia.

Conclusions

Insomnia was less prevalent than previous research indicates, with nearly 1 in 5 participants having insomnia at least once between the ages of 4 and 14 years. Female preponderance emerged in early adolescence. Having insomnia at one time point was a considerable risk for subsequent insomnia, indicating that insomnia is persistent and warrants clinical attention.
Breast cancer nursing interventions and clinical effectiveness: a systematic review
Authors: Chan Raymond Javan , Teleni Laisa , McDonald Suzanne , Kelly Jaimon , Mahony Jane , Ernst Kerryn , Patford Kerry , Townsend James , Singh Manisha , Yates Patsy
Published: June 2020

Objectives

To examine the effects of nurse-led interventions on the health-related quality of life, symptom burden and self-management/behavioural outcomes in women with breast cancer.

Methods

Cochrane Controlled Register of Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline and Embase databases were searched (January 1999 to May 2019) to identify randomised controlled trials (RCTs) and controlled before-and-after studies of interventions delivered by nurses with oncology experience for women with breast cancer. Risk of bias was evaluated using therevised Cochrane risk-of-bias tool for randomised trials. Intervention effects were synthesised by cancer trajectory usingThe Omaha System Intervention Classification Scheme.

Results

Thirty-one RCTs (4651 participants) were included. All studies were at risk of bias mainly due to inherent limitations such as lack of blinding and self-report data. Most studies (71%; n=22) reported at least one superior intervention effect. There were no differences in all outcomes between those who receive nurse-ledsurveillancecare versus those who received physical led or usual discharge care. Compared with control interventions, there were superiorteaching, guidance and counselling(63%) andcase management(100%) intervention effects on symptom burden during treatment and survivorship. Effects of these interventions on health-related quality of life and symptom self-management/behavioural outcomes were inconsistent.

Discussion

There is consistent evidence from RCTs that nurse-ledsurveillanceinterventions are as safe and effective as physician-led care and strong evidence that nurse-ledteaching, guidance and counsellingandcase managementinterventions are effective for symptom management. Future studies should ensure the incorporation of health-related quality of life and self-management/behavioural outcomes and consider well-designed attentional placebo controls to blind participants for self-report outcomes.

Protocol registration

The International Prospective Register of Systematic Reviews (PROSPERO): CRD42020134914).
Performance of a tool to identify different types of self-reported sexual risk among women attending a contraception and sexual health clinic: results of a cross-sectional survey
Authors: Edelman Natalie , Whetham Jennifer , Cassell Jackie , de Visser Richard , Mercer Catherine , Jones Christopher , Gersten Abbey , Bremner Stephen
Published: June 2020

Introduction

A clinical prediction rule (CPR) using psychosocial questions was previously derived to target sexual healthcare in general practice by identifying women at risk of unintended pregnancy (UIP) and sexually transmitted infections (STIs). This psychosocial CPR may help target resources within contraception and sexual health (CASH) services. This study investigated how well it predicted recent self-reported risk of UIP and STI acquisition among women attending a CASH clinic.

Methods

Female patients aged 16–44 years attending a CASH clinic in South-East England were offered a questionnaire on arrival. This comprised psychosocial questions, and others addressing three sexual risks: (1) two or more male sexual partners in the last year (2+P), (2) risk of STI acquisition through most recent partner and (3) risk of UIP in the last 6 months. A CPR score was calculated for each participant and cross-tabulated against self-report of each sexual risk to estimate CPR sensitivity and specificity.

Results

The psychosocial questions predicting 2+P had sensitivity 83.2% (95% CI 79.3% to 86.5%) and specificity 56.1% (95% CI 51.3%−60.6%). Those predicting combined 2+P and/or risk of STI acquisition through most recent partner had a sensitivity of 89.1% (95% CI 85.7%−91.8%) and specificity of 43.7% (95% CI 39.0%−48.5%). Questions predicting risk of UIP in the last 6 months had a sensitivity of 82.5% (95% CI 78.6%−86.0%) and specificity of 48.3% (95% CI 43.4%−53.1%).

Conclusions

The CPR demonstrated good sensitivity but low specificity, so may be suited to triaging or stratifying which interventions to offer CASH patients and by which mode (eg, online vs face-to-face). Further investigation of causal links between psychosocial factors and sexual risk is warranted to support development of psychosocial interventions for this patient group.
HPV-related squamous cell carcinoma of oropharynx: a review
Authors: Rahimi Siavash
Published: June 2020

In early 1930, R. E. Shope paved the way for the recognition of human papillomavirus (HPV) as a causative agent of some types of cancers. In early 2000, the relationship between HPV and a subset of head and neck cancers, mostly located in the oropharynx, was discovered. In the last 20 years, we have made great progress in the recognition and treatment of HPV-positive head and neck cancers. However, there are still grey areas that leave room to subjective interpretation and need to be addressed. The majority of high risk (HR) HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) shows a ‘basaloid’ morphology, and despite the variegated morphological spectrum of this malignancy, highlighted by some very recent publications, there is a lack of consensus on a universal morphological classification of HPV-OPSCC. The advent of immunohistochemistry with p16ink4a(p16) protein made the diagnosis of HPV-related OPSCC more straightforward; currently patients with OPSCC are stratified in p16-positive and p16-negative. Although p16 is an excellent surrogate of HR HPV infection, it is not the direct demonstration of the presence of virus. At present, there is no univocal ‘gold-standard’ technique for the detection of oncogenic HPV infection. It is well known that HR HPV-related (OPSCC) bear significantly better survival outcome than HPV-negative cases. Consequently, the eighth edition of the American Joint Committee on Cancer and the Union for International Cancer Control now have separate staging systems for these two distinct malignancies. The present review discusses the salient features of HR HPV-driven OPSCC.
Nutrition interventions in populations with mental health conditions: a scoping review
Authors: Cherak Stephana J. , Fiest Kirsten M. , VanderSluis Laura , Basualdo-Hammond Carlota , Lorenzetti Diane L. , Buhler Sue , Stadnyk Janet , Driedger Lorna , Hards Lori , Gramlich Leah , Fenton Tanis R.
Published: June 2020

Nutrition is a modifiable factor for intervention in mental disorders. This scoping review characterized nutrition intervention research in mental disorders. A 3-category framework characterized nutrition interventions: Guide (e.g., counselling), Provide (e.g., food provisions), and Add (e.g., supplementation). Nutrition interventions were classified as single-component (e.g., Guide) or complex (e.g., Guide-Provide). Sixty-nine trials met inclusion criteria, 96% were randomized controlled trials. Most commonly diagnosed mental disorders were depressive disorder (i.e., persistent) or major depressive disorder (n = 39), schizophrenia (n = 17), and other psychotic disorders (n = 13). Few trials included patients with anxiety disorders (n = 2) or bipolar disorders (n = 3). Several trials (n = 15, 22%) assessed and implemented nutrition interventions to improve dietary patterns, of which 11 (73%) reported statistically significant and clinically important positive effects of nutrition interventions on mental disorders. The majority of the trials (n = 61, 90%) investigated supplementation, most commonly adding essential fatty acids, vitamins, or minerals. The majority (n = 48, 70%) reported either statistically significant or clinically important effect and 31 (51%) reported both. Though most interventions led to statistically significant improvements, trials were heterogeneous for targeted mental disorders, nutrition interventions, and outcomes assessed. Given considerable heterogeneity, further research from robust and clinically relevant trials is required to support high-quality health care with effective nutrition interventions.

Novelty Future research on whole-diet interventions powered to detect changes in mental health outcomes as primary objectives is needed. Dietitians may be an opportunity to improve feasibility and efficacy of nutrition interventions for mental disorder patients. Dietitians may be of value to educate mental health practitioners on the importance of nutrition.