bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictive Factors of Successful Return to Work Following Discectomy
Authors: Andersen Mikkel Ø. , Ernst Carsten , Rasmussen Jesper , Ankjær Thomas , Carreon Leah Y.
Published: September 2020

Study Design:

Retrospective analysis of prospectively collected data.

Objective:

To identify modifiable factors associated with successful return to work 12 weeks following discectomy. Lumbar disc herniation is a common cause of sciatica and sick leave. This presents an economic burden to the individual and the society.

Methods:

Data from DaneSpine on a consecutive cohort of patients operated due to lumbar disc herniation during a 3-year period was identified and merged with data from the Ministry of Employment’s register on public welfare payments. Data on welfare payments 2 years prior to the date of operation and 1 year postoperative was included. Patients were considered to be on sick leave if they received welfare payments for the week. Patients are considered to have returned to work if they did not receive public welfare payments for a 4-week period.

Results:

Of 1134 patients meeting inclusion criteria, 98.5% had complete preoperative surgical data available. Postoperatively, 79.1% of the patients returned to the work within 12 weeks. Physically demanding jobs, low preoperative EQ5D score, and long duration of sick leave prior to surgery were associated negatively with return to work at 12 weeks.

Conclusion:

The results of this study indicate that patients who have a longer duration of sick leave have a physically demanding job and are in a poor health are more likely not to return to work by 12 weeks after surgery for lumbar disc herniation. Future studies are needed to determine if earlier referral to a surgeon leads to an earlier return to work.
High Altitude and Its Effects on Oral Health: A Review of Literature
Authors: Ashour Amal Adnan
Published: September 2020

Health deterioration at high altitudes is related to many pathophysiological processes. The literature contains much evidence describing the multiple factors responsible for this deterioration, including hypoxia, decreased oxygen saturation, and decreased barometric pressure. An increase in the levels of oxidative stress at high altitudes can lead to many serious health events, although the human body may be able to adapt to such changes in the case of people who are accustomed to living at a high altitude. The pathophysiological processes at high altitudes also have adverse effects on oral tissue health. The aim of this review is to summarize the major published findings about oral health deterioration of living in and travelling to high-altitude areas.

Most studies have noted the adverse effects of prolonged exposure to hypoxia at high altitudes on oral tissues, including the salivary gland, periodontal tissue, gingival crevicular fluids, and jawbone. These changes include increases in the levels of inflammatory mediators and periodontal inflammation parameters. In addition, the incidence and severity of dental fluorosis is higher in residents of high-altitude areas. Abrupt changes in barometric pressure in people who travel to high altitudes may cause dental barotrauma and appear to increase sensitivity to pain (barodontalgia). In conclusion, it is important to consider that travelling to and living in high-altitude areas is a possible risk factor for multiple oral diseases.
Free-Text Documentation of Dementia Symptoms in Home Healthcare: A Natural Language Processing Study
Authors: Topaz Maxim , Adams Victoria , Wilson Paula , Woo Kyungmi , Ryvicker Miriam
Published: September 2020

Background:

Little is known about symptom documentation related to Alzheimer’s disease and related dementias (ADRD) by home healthcare (HHC) clinicians.

Objective:

This study: (1) developed a natural language processing (NLP) algorithm that identifies common neuropsychiatric symptoms of ADRD in HHC free-text clinical notes; (2) described symptom clusters and hospitalization or emergency department (ED) visit rates for patients with and without these symptoms.

Method:

We examined a corpus of −2.6 million free-text notes for 112,237 HHC episodes among 89,459 patients admitted to a non-profit HHC agency for post-acute care with any diagnosis. We used NLP software (NimbleMiner) to construct indicators of six neuropsychiatric symptoms. Structured HHC assessment data were used to identify known ADRD diagnoses and construct measures of hospitalization/ED use during HHC.

Results:

Neuropsychiatric symptoms were documented for 40% of episodes. Common clusters included impaired memory, anxiety and/or depressed mood. One in three episodes without an ADRD diagnosis had documented symptoms. Hospitalization/ED rates increased with one or more symptoms present.

Conclusion:

HHC providers should examine episodes with neuropsychiatric symptoms but no ADRD diagnoses to determine whether ADRD diagnosis was missed or to recommend ADRD evaluation. NLP-generated symptom indicators can help to identify high-risk patients for targeted interventions.
An assessment of annual procedure volumes and therapy adoption of transcatheter closure of patent foramen ovale in four European countries
Authors: Pietzsch Jan B , Geisler Benjamin P , Daniels Matthew J , Busca Rachele M , Tarantini Giuseppe , Søndergaard Lars , Kasner Scott E
Published: September 2020

Introduction

Patent foramen ovale closure reduces recurrence of cryptogenic ischaemic stroke compared to anti-platelet therapy. Our goal was to determine procedure volumes and closure utilisation as a proportion of candidates in four large European countries.

Patients and methods

National statistics were obtained for Germany, England, France, and Italy for the last available five years (2014–2018). Eligibility was aligned to the enrolment criteria of pivotal trials and current consensus documents. Stroke and transient ischaemic attack incidences were obtained from epidemiological registries and claims data. The eligible candidate pool for analysis included current year candidates plus untreated patients from the prior two years. Absolute strokes avoided assumed the hazard ratio for ischaemic stroke recurrence from a recent meta-analysis.

Results

In 2018, closure incidence rates were 5.64, 0.53, 2.94 and 5.26 per 100,000 in Germany, England, France and Italy, respectively. This reflects five-year increases of 128% in Germany, 462% in France and 36% in Italy ( p < 0.05 for all), and a decline of 37% in England. The proportions of treated patients versus candidates for the combined stroke and transient ischaemic attack pool were 55%, 30%, 80%, and 6%, respectively.

Discussion

Patent foramen ovale closure volumes increased after the 2017 announcement of positive trial results but still differ substantially across large European countries. If all closure candidates in 2018 with prior ischaemic stroke were treated, the resulting absolute reduction of recurrent ischaemic strokes, compared to anti-platelet therapy alone, would be between 782 and 2295 across the four countries over five years.

Conclusion

Many eligible patients at risk for a recurrent cryptogenic event might remain untreated due to regional practice variations.
A Spatial Livability Index for dense urban centers
Authors: Benita Francisco , Kalashnikov Vyacheslav , Tunçer Bige
Published: September 2020

This article introduces a Spatial Livability Index based on geographically weighted principal component analysis. We study the case of 203 subzones in Singapore which are dense geographic boundaries in terms of population and built-up area. These regions share spatial correlations of objective measures of livability such as open spaces or community facilities. The proposed objective indicator captures the “hidden” patterns of livability provided by neighboring locations. Moreover, the results allow to identify atypical areas, that is geographical units that score very good/bad under the spatial approach but very bad/good under the non-spatial framework of livability.
Using event reports in real-time to identify and mitigate patient safety concerns during the COVID-19 pandemic
Authors: Kasda Eileen , Robson Christine , Saunders Jamia , Adadey Asa , Ford Brenna , Sinha Nisha , Teter Jonathan , Warner Nicole , Paine Lori
Published: September 2020

In the midst of a crisis, monitoring patient safety and quality concerns is of utmost importance, particularly if attention paid to monitoring is diverted by other operational needs. The emergence of novel COVID-19 virus emerged new patient safety concerns. In an effort to help organizations respond rapidly to safety concerns, we describe a close to real-time process used to monitor, escalate, and resolve concerns submitted to the patient safety event reporting system of an academic health system.
Trends in worldwide asthma prevalence
Authors: Asher M. Innes , García-Marcos Luis , Pearce Neil E. , Strachan David P.
Published: September 2020

This review of trends in worldwide asthma prevalence starts with defining how asthma prevalence is measured in populations and how it is analysed. Four population studies of asthma across at least two regions are described: European Community Respiratory Health Survey (ECRHS), the International Study of Wheezing in Infants (EISL), the International Study of Asthma and Allergies in Childhood (ISAAC) and the World Health Survey (WHS). Two of these (ISAAC and WHS) covered all the regions of the world; each using its own standardised questionnaire-based methodology with cross-sectional study design, suitable for large populations. EISL (2005 and 2012) and ISAAC (1996–1997 and 2002–2003) have undertaken a second cross-sectional population survey from which trends are available: EISL in three centres in two countries; ISAAC 106 centres in 56 countries (13–14 year olds) and 66 centres in 37 countries (6–7 year olds). Key results from these studies are presented. Unfortunately, there is no new worldwide data outside of EISL since 2003. Global Burden of Disease estimates of asthma prevalence have varied greatly. Recent reliable worldwide data on asthma prevalence and trends is needed; the Global Asthma Network Phase I will provide this in 2021.
Parasexual recombination enablesAspergillus fumigatusto persist in cystic fibrosis
Authors: Engel Tobias , Verweij Paul E. , van den Heuvel Joost , Wangmo Dechen , Zhang Jianhua , Debets Alfons J.M. , Snelders Eveline
Published: September 2020

Aspergillus fumigatusis a saprobic fungus that causes a range of pulmonary diseases, some of which are characterised by fungal persistence such as is observed in cystic fibrosis (CF) patients. Creation of genetic variation is critical forA. fumigatusto adapt to the lung environment, but biofilm formation, especially in CF patients, may preclude mutational supply inA. fumigatusdue to its confinement to the hyphal morphotype. We tested our hypothesis that genetic variation is created through parasexual recombination in chronic biofilms by phenotypic and genetic analysis ofA. fumigatusisolates cultured from different origins.

As diploids are the hallmark of parasex, we screened 799A. fumigatusisolates obtained from patients with CF, chronic pulmonary lung disease and acute invasive aspergillosis, and from the environment for spore size. Benomyl sensitivity, nuclear content measurements through fluorescence-activated cell sorting and scanning electron microscopy were used to confirm the diploid state of large size spores. Whole genome sequencing was used to characterise diploid-associated genetic variation.

We identified 11 diploids in isolates recovered from six of 11 (55%) CF patients and from one of 24 (4%) chronic aspergillosis patients, but not in 368 isolates from patients with acuteAspergillusinfection and the environment. Diploid formation was associated with accumulation of mutations and variable haploid offspring including a voriconazole-resistant isolate.

Parasexual recombination allowsA. fumigatusto adapt and persist in CF patients, and plays a role in azole resistance development. Our findings are highly significant for understanding the genetics and biology ofA. fumigatusin the human lung.
Comparison of histological and computed tomographic measurements of pig lung bronchi
Authors: Schmitt Volker H. , Schmitt Christine , Hollemann David , Mamilos Andreas , Wagner Willi , Weinheimer Oliver , Brochhausen Christoph
Published: September 2020

Aim

Light microscopy is used as template in the evaluation and further development of medical imaging methods. Tissue shrinkage caused by histological processing is known to influence lung tissue dimensions. In diagnosis of COPD, computed tomography (CT) is widely used for automated airway measurement. The aim of this study was to compare histological and computed tomographic measurements of pig lung bronchi.

Methods

Airway measurements of pig lungs were performed after freezing under controlled inflation pressure in a liquid nitrogen bath. The wall thickness of seven bronchi was measuredviaMicro-CT and CT using the integral-based method (IBM) and the full-width-at-half-maximum method (FWHM) automatically and histologically on frozen and paraffin sections. Statistical analysis was performed using the Wilcoxon test, Pearson's correlation coefficient with a significance level at p<0.05, scatter plots and Bland–Altman plots.

Results

Bronchial wall thickness was smallest in frozen sections (median 0.71 mm) followed by paraffin sections (median 0.75 mm), Micro-CT (median 0.84 mm), and CT measurements using IBM (median 0.68 mm) and FWHM (median 1.69 mm). Statistically significant differences were found among all tested groups (p<0.05) except for CT IBM and paraffin and frozen sections and Micro-CT. There was high correlation between all parameters with statistical significance (p<0.05).

Conclusions

Significant differences in airway measurement were found among the different methods. The absolute measurements with CT IBM were closest to the histological results followed by Micro-CT, whereas CT FWHM demonstrated a distinct divergence from the other groups.
RICE CENTRORADIALIS 1, a TFL1-like Gene, Responses to Drought Stress and Regulates Rice Flowering Transition
Authors: Wang Yan , Lu Yuyang , Guo Ziyu , Ding Yanfeng , Ding Chengqiang
Published: September 2020

Background

The initiation of flowering transition in rice (Oryza sativa) is a complex process regulated by genes and environment. In particular, drought can interfere with flowering; therefore, many plants hasten this process to shorten their life cycle under water scarcity, and this is known as drought-escape response. However, rice has other strategies; for example, drought stress can delay flowering instead of accelerating it. RICE CENTRORADIALIS 1 (RCN1) is a TERMINAL FLOWER-like gene that influences rice flowering transition and spike differentiation. It interacts with 14–3-3 proteins and transcription factor OsFD1 to form a florigen repression complex that suppresses flowering transition in rice.

Results

In this study, we explored the role of RCN1 in the molecular pathway of drought-regulated flowering transition. The rcn1 mutant plants displayed early heading under both normal water and drought stress conditions, and they were more insensitive to drought stress than the wild-type plants. Abscisic acid (ABA) signaling-mediated drought-induced RCN1 is involved in this process.

Conclusions

Thus, RCN1 plays an important role in the process of drought stress inhibiting flowering transition. It may worked by suppressing the protein function rather than transcription of HEADING DATE 3a.
Beyond clinical outcomes: the social and healthcare system implications of hepatitis C treatment
Authors: Torrens Marta , Soyemi Tokunbo , Bowman Darcy , Schatz Eberhard
Published: September 2020

Background

Hepatitis C virus (HCV) infections in people who inject drugs (PWID) can now be treated and cured. However, the impact that HCV treatment has on drug-user health, practices and wellbeing is not known. The aim of this research was to understand the non-clinical impact that HCV treatment has in PWID and their reasons for accessing and completing treatment.

Methods

Participants aged 25–67 years who had injected opioids or stimulants (currently or in the past) and had completed direct-acting antiviral treatment were recruited from seven European countries. Participants completed a 30-min online survey administered face-to-face between September 2018 and April 2019. The questionnaire responses were used to assess the mental and physical impact of having completed treatment.

Results

Of the 124 participants who completed the survey questionnaire, 75% were male, 69% were over 45 years old and 65% were using opioids and/or stimulants at the start of HCV treatment. Participants reported improvements in the following areas after completing HCV treatment: outlook for the future (79%); self-esteem (73%); ability to plan for the future (69%); belief in their abilities (68%); confidence (67%); empowerment (62%); energy levels (59%); and ability to look after themselves (58%). The most common reasons for starting HCV treatment were: becoming aware of treatments that were well tolerated (77%) and effective (75%); and understanding the potentially severe consequences of HCV (75%).

Conclusions

The benefits of HCV treatment go beyond clinical outcomes and are linked to improved drug-user health and wellbeing. Sharing information about well-tolerated and effective HCV treatments, and raising awareness about the potentially severe consequences of untreated HCV are likely to increase the number of PWID who are motivated to access and complete HCV treatment in future.
Correction to: A matched case-control study
of risk factors associated with multiple sclerosis in Kuwait
Authors: El-Muzaini Hadeel , Akhtar Saeed , Alroughani Raed
Published: September 2020

An amendment to this paper has been published and can be accessed via the original
article.
A comparison, for older people with diabetes, of health and health care utilisation in two different health systems on the island of Ireland
Authors: Pierse Tom , Barry Luke , Glynn Liam , Murphy Andrew W. , Cruise Sharon , O’Neill Ciaran
Published: September 2020

Background

There are social and economic differences between Northern Ireland (NI) and the Republic of Ireland (ROI). There are also differences in the health care systems in the two jurisdictions. The aims of this study are to compare health (prevalence of diabetes and related complications) and health care utilisation (general practitioner, outpatient or accident and emergency utilisation) among older people with diabetes in the NI and ROI.

Methods

Large scale comparable surveys of people over 50 years of age in Northern Ireland (NICOLA, wave 1) and the Republic of Ireland (TILDA, wave 1) are used to compare people with diabetes (type I and type II) in the two jurisdictions. The combined data set comprises 1536 people with diabetes. A coarsened exact matching approach is used to compare health care utilisation among people with diabetes in NI and ROI with equivalent demographic, lifestyle and illness characteristics (age, gender, education, smoking status and self-related health, number of other chronic diseases and number of diabetic complications).

Results

The overall prevalence of diabetes in the 50 to 84 years old age group is 3.4 percentage points higher in NI (11.1% in NI, 7.7% ROI, p-value < 0.01). The diabetic population in NI appear sicker – with more diabetic complications and more chronic illnesses. Comparing people with diabetes in the two jurisdictions with similar levels of illness we find that there are no statistically significant differences in GP, outpatient or A&E utilisation.

Conclusion

Despite the proximity of NI and ROI there are substantial differences in the prevalence of diabetes and its related complications. Despite differences in the health services in the two jurisdictions the differences in health care utilisation for an equivalent cohort are small.
Factors associated with zinc utilization for the management of diarrhea in under-five children in Ethiopia
Authors: Teshale Achamyeleh Birhanu , Liyew Alemneh Mekuriaw , Tesema Getayeneh Antehunegn
Published: September 2020

Background

Zinc has a tremendous advantage to save the life of children. It reduces the mean duration of diarrhea and mortality due to diarrhea. Besides, it reduces the severity of the initial episode, and also it prevents future diarrhea episodes. But there is low utilization of zinc for the management of diarrhea in under-five children in Ethiopia and there is a paucity of literature regarding the factors associated with the utilization.

Method

The 2016 Ethiopian demographic and health survey data were used as a data source. A total weighted sample of 1228 under-five children with diarrhea within 2 weeks preceding the survey were used. A mixed-effects logistic regression analysis was done to account for the complex sample design of the data. Variables with p-value < 0.20 in the bivariable analysis were eligible for multivariable analysis and those variables with p value< 0.05 in the multivariable analysis were declared to be determinants of zinc utilization for the management of diarrhea in under-five children.

Result

In this study, we found multiple determinants of zinc utilization. Mothers with formal education (adjusted odds ratio (AOR) = 1.83;95% CI; 1.30–2.58) and media exposure (AOR = 1.46;95% CI; 1.04–2.04) had higher odds of zinc utilization. But mothers from five and above household size (AOR = 0.57;95% CI; 0.39–0.82) had lower odds of zinc utilization for the management of diarrhea in under-five children.

Conclusion

In our study maternal education, media exposure, and household size were determinants of zinc utilization for the management of diarrhea in under-five children. Being having a formal education and being exposed to all or either of the three media (radio, TV, and newspaper) increases the likelihood of zinc utilization while being mothers from large household size decreases the likelihood of zinc utilization. Therefore, giving special attention to those mothers with no formal education, and mothers from high family size could increase the utilization of zinc for the management of diarrhea in under-five children. Also, media campaigns regarding diarrhea management could be scaled up to potentially achieve the desired impact.
Misconceptions of pathophysiology of happy hypoxemia and implications for management of COVID-19
Authors: Tobin Martin J. , Jubran Amal , Laghi Franco
Published: September 2020

In the article “The pathophysiology of ‘happy’ hypoxemia in COVID-19,” Dhont et al. (Respir Res 21:198, 2020) discuss pathophysiological mechanisms that may be responsible for the absence of dyspnea in patients with COVID-19 who exhibit severe hypoxemia. The authors review well-known mechanisms that contribute to development of hypoxemia in patients with pneumonia, but are less clear as to why patients should be free of respiratory discomfort despite arterial oxygen levels commonly regarded as life threatening. The authors propose a number of therapeutic measures for patients with COVID-19 and happy hypoxemia; we believe readers should be alerted to problems with the authors’ interpretations and recommendations.
A comparison of the four healthy days measures (HRQOL-4) with a single measure of self-rated general health in a population-based health survey in New York City
Authors: Dumas Sarah E. , Dongchung Tenzin Yangchen , Sanderson Michael L. , Bartley Katherine , Levanon Seligson Amber
Published: September 2020

Background

Data on health-related quality of life (HRQOL) can be used to track health disparities, assess the impact of chronic diseases, and predict mortality. The Centers for Disease Control and Prevention’s “Healthy Days Measures” (HRQOL-4) assesses four key domains: self-rated general health, physical health, mental health, and activity limitations. The domains are not easily combined to summarize overall HRQOL, and some evidence suggests that self-rated general health may be an adequate proxy indicator for overall HRQOL. This study compares self-rated general health as a solitary measure of HRQOL with two summary indices of the HRQOL-4 as a predictor of adverse health conditions in a representative sample of adult New York City residents.

Methods

The 2017 NYC Social Determinants of Health survey implemented by the New York City Department of Health and Mental Hygiene collected data from a representative sample of New Yorkers (n = 2335) via phone, mail, and web. We compared the information criteria and predictive power of self-rated general health with two alternative summary indices of the HRQOL-4 in predicting self-reported health conditions (hypertension, diabetes, obesity, non-specific psychological distress, and a summary indicator for at least one those four morbidities).

Results

Overall, 19.1% (95% CI: 16.9, 21.5) of respondents reported that they had fair or poor general health. Self-rated general health was significantly associated with days of poor physical health, poor mental health, and activity limitations (p < 0.001 for each). While the Akaike and Bayesian information criteria suggested that the summary indices of the HRQOL-4 produced marginally better models for predicting adverse health conditions, self-rated general health had slightly higher predictive power than did the summary indices in all models of physical health outcomes as measured by Tjur’s pseudo-R2and the area under the curve.

Conclusion

We found very small differences between self-rated general health and the summary indices of the HRQOL-4 in predicting health conditions, suggesting self-rated general health is an appropriate proxy measure of overall HRQOL. Because it can be measured with a single question rather than four, it might be the most simple, efficient, and cost-effective method of summarizing HRQOL in large population-based surveys.
Exercise and colorectal cancer: a systematic review and meta-analysis of exercise safety, feasibility and effectiveness
Authors: Singh Benjamin , Hayes Sandra C. , Spence Rosalind R. , Steele Megan L. , Millet Guillaume Y. , Gergele Laurent
Published: September 2020

Background

This meta-analysis evaluated the safety, feasibility and effect of exercise among individuals with colorectal cancer.

Methods

A database search (CINAHL, Ebscohost, MEDLINE, Pubmed, ProQuest Health and Medical Complete, ProQuest Nursing, Science Direct) for randomised, controlled, exercise trials involving individuals with colorectal cancer, published before January 1, 2020 was undertaken. Safety (adverse events), feasibility (withdrawal and adherence rates) and effect data (health outcomes including quality of life, QoL) were abstracted. Risk difference (RD) and standardised mean differences (SMD) were calculated to compare safety and effects between exercise and usual care (UC). Subgroup analyses were conducted to assess whether outcomes differed by exercise mode, duration, supervision and treatment. Risk of bias was assessed using the Physiotherapy Evidence Database tool.

Results

For the 19 trials included, there was no difference in adverse event risk between exercise and UC (RD = 0.00; 95% CI:–0.01, 0.01, p = 0.92). Median withdrawal rate was 12% (0–22%) and adherence was 86% (42–91%). Significant effects of exercise compared to UC were observed for QoL, fatigue, aerobic fitness, upper-body strength, depression, sleep and reduced body fat (SMD = 0.21–0.66, p < 0.05). Subgroup analyses suggested larger benefits (p < 0.05) for QoL and fatigue for supervised interventions; for QoL, aerobic fitness and reduced body fat for ≥12-week interventions; and for aerobic fitness when interventions were during chemotherapy.

Conclusion

Although reporting of safety and compliance data was lacking in most trials, findings support that exercise is safe and feasible in colorectal cancer. Further, participation in mixed-mode exercise, including unsupervised exercise, leads to improvements in various health-related outcomes.
Fibrin-associated diffuse large B-cell lymphoma with plasmacytic differentiation: case report and literature review
Authors: Moreno Esther Moreno , Ferrer-Gómez Ana , Arias Héctor Pian , García Irene García , García-Cosío Mónica
Published: September 2020

Background

Primary cardiac lymphomas are extremely rare entities (< 2% of cardiac tumours) and the most frequent histologic type is diffuse large B-cell lymphoma (DLBCL). Fibrin-associated DLBCL (FA-DLBCL) is a very unusual form of DLBCL associated with chronic inflammation, and only case reports and small series have been described. In the heart, it usually occurs in the context of a cardiac myxoma or cardiac prostheses and it is not bulk forming. These lymphomas frequently present with non-germinal center phenotype and are associated with Epstein-Barr virus (EBV) type III latency.

Case presentation

We describe a case of FA-DLBCL arising in a cardiac myxoma, with plasmacytic differentiation and type I EBV latency.

Conclusions

Although they are very rare, FA-DLBCLs should be known for their diagnostic difficulty, due to its unspecified clinical manifestations, and for their more favourable prognosis, sometimes even without additional treatment after surgical resection.
Advances in the assessment of minimal residual disease in mantle cell lymphoma
Authors: Jung Dayoung , Jain Preetesh , Yao Yixin , Wang Michael
Published: September 2020

The clinical impact of minimal residual disease detection at early time points or during follow-ups has been shown to accurately predict relapses among patients with lymphomas, mainly in follicular and diffuse large B cell lymphoma. The field of minimal residual disease testing in mantle cell lymphoma is still evolving but has great impact in determining the prognosis. Flow cytometry and polymerase chain reaction-based testing are most commonly used methods in practice; however, these methods are not sensitive enough to detect the dynamic changes that underline lymphoma progression. Newer methods using next-generation sequencing, such as ClonoSeq, are being incorporated in clinical trials. Other techniques under evolution include CAPP-seq and anchored multiplex polymerase chain reaction-based methods. This review article aims to provide a comprehensive update on the status of minimal residual disease detection and its prognostic effect in mantle cell patients. The role of circulating tumor DNA-based minimal residual disease detection in lymphomas is also discussed.
Establishment of an extracorporeal cardio-pulmonary resuscitation program in Berlin – outcomes of 254 patients with refractory circulatory arrest
Authors: Nee Jens , Koerner Roland , Zickler Daniel , Schroeder Tim , Enghard Philipp , Nibbe Lutz , Hasper Dietrich , Buder Robert , Leithner Christoph , Ploner Christoph J. , Eckardt Kai-Uwe , Storm Christian , Kruse Jan M.
Published: September 2020

Objective

Optimal management of out of hospital circulatory arrest (OHCA) remains challenging, in particular in patients who do not develop rapid return of spontaneous circulation (ROSC). Extracorporeal cardiopulmonary resuscitation (eCPR) can be a life-saving bridging procedure. However its requirements and feasibility of implementation in patients with OHCA, appropriate inclusion criteria and achievable outcomes remain poorly defined.

Design

Prospective cohort study.

Setting

Tertiary referral university hospital center.

Patients

Here we report on characteristics, course and outcomes on the first consecutive 254 patients admitted between August 2014 and December 2017.

Intervention

eCPR program for OHCA.

Mesurements and main results

A structured clinical pathway was designed and implemented as 24/7 eCPR service at the Charité in Berlin. In total, 254 patients were transferred with ongoing CPR, including automated chest compression, of which 30 showed or developed ROSC after admission. Following hospital admission predefined in- and exclusion criteria for eCPR were checked; in the remaining 224, 126 were considered as eligible for eCPR.

State of the art postresuscitation therapy was applied and prognostication of neurological outcome was performed according to a standardized protocol.

Eighteen patients survived, with a good neurological outcome (cerebral performance category (CPC) 1 or 2) in 15 patients. Compared to non-survivors survivors had significantly shorter time between collaps and start of eCPR (58 min (IQR 12–85) vs. 90 min (IQR 74–114), p = 0.01), lower lactate levels on admission (95 mg/dL (IQR 44–130) vs. 143 mg/dL (IQR 111–178), p <  0.05), and less severe acidosis on admission (pH 7.2 (IQR 7.15–7.4) vs. 7.0 (IQR6.9–7.2), p <  0.05). Binary logistic regression analysis identified latency to eCPR and low pH as independent predictors for mortality.

Conclusion

An eCPR program can be life-saving for a subset of individuals with refractory circulatory arrest, with time to initiation of eCPR being a main determinant of survival.
Outdoor air pollution and terminal duct lobular involution of the normal breast
Authors: Niehoff Nicole M. , Keil Alexander P. , Jones Rena R. , Fan Shaoqi , Gierach Gretchen L. , White Alexandra J.
Published: September 2020

Background

Exposure to certain outdoor air pollutants may be associated with a higher risk of breast cancer, though potential underlying mechanisms are poorly understood. We examined whether outdoor air pollution was associated with involution of terminal duct lobular units (TDLUs), the histologic site where most cancers arise and an intermediate marker of breast cancer risk.

Methods

Pathologist-enumerated TDLUs were assessed in H&E (hematoxylin and eosin)-stained breast tissue sections from 1904 US women ages 18–75 who donated to the Susan G. Komen Tissue Bank (2009–2012). The 2009 annual fine particulate matter < 2.5 μm in diameter (PM2.5) total mass (μg/m3) at each woman’s residential address was estimated from the Environmental Protection Agency’s Downscaler Model combining Community Multiscale Air Quality (CMAQ) System modeling with air quality monitoring data. We secondarily considered CMAQ-modeled components of PM2.5 and gaseous pollutants. We used K-means clustering to identify groups of individuals with similar levels of PM2.5 components, selecting groups via cluster stability analysis. Relative rates (RRs) and 95% confidence intervals (95% CIs) for the association between air pollutants and TDLU counts were estimated from a zero-inflated negative binomial regression model adjusted for potential confounders.

Results

PM2.5 total mass was associated with higher TDLU counts among all women (interquartile range (IQR) increase, RR = 1.06; 95% CI: 1.01–1.11). This association was evident among both premenopausal and postmenopausal women (premenopausal RR = 1.05, 95% CI: 1.00–1.11; postmenopausal RR = 1.11, 95% CI: 1.00–1.23). We identified 3 groups corresponding to clusters that varied geographically and roughly represented high, medium, and low levels of PM2.5 components relative to population mean levels. Compared to the cluster with low levels, the clusters with both high (RR = 1.74; 95% CI: 1.08–2.80) and medium (RR = 1.82; 95% CI: 1.13–2.93) levels were associated with higher TDLU counts; although not significantly different, the magnitude of the associations was stronger among postmenopausal women.

Conclusions

Higher PM2.5 levels were associated with reduced TDLU involution as measured by TDLU counts. Air pollution exposure may influence the histologic characteristics of normal tissue which could in turn affect breast cancer risk.
The effect of a mystery shopper scheme on prescribing behavior in primary care: Results from a field experiment
Authors: Cheo Roland , Ge Ge , Godager Geir , Liu Rugang , Wang Jian , Wang Qiqi
Published: September 2020

Background

Health care systems in many countries are characterized by limited availability of provider performance data that can be used to design and implement welfare improving reforms in the health sector. We question whether a simple mystery shopper scheme can be an effective measure to improve primary care quality in such settings.

Methods

Using a randomized treatment-control design, we conducted a field experiment in primary care clinics in a Chinese city. We investigate whether informing physicians of a forthcoming mystery shopper audit influences their prescribing behavior. The intervention effects are estimated using conditional fixed-effects logistic regression. The estimated coefficients are interpreted as marginal utilities in a choice model.

Results

Our findings suggest that the mystery shopper intervention reduced the probability of prescribing overall. Moreover, the intervention had heterogeneous effects on different types of drugs.

Conclusions

This study provides new evidence suggesting that announced performance auditing of primary care providers could directly affect physician behavior even when it is not combined with pay-for-performance, or measures such as reminders, feedback or educational interventions.
Existence theory and approximate solution to prey–predator coupled system involving nonsingular kernel type derivative
Authors: Alqudah Manar A. , Abdeljawad Thabet , Eiman  , Shah Kamal , Jarad Fahd , Al-Mdallal Qasem
Published: September 2020

This manuscript considers a nonlinear coupled system under nonsingular kernel type derivative. The considered problem is investigated from two aspects including existence theory and approximate analytical solution. For the concerned qualitative theory, some fixed point results are used. While for approximate solution, the Laplace transform coupled with Adomian method is applied. Finally, by a pertinent example of prey–predator system, we support our results. Some graphical presentations are given using Matlab.
A failure innovation strategy of acquisition during excess capacity: financial approach based on case study at the state-owned cement holding PT Semen Indonesia (Persero) Tbk
Authors: Subiyanto Effnu
Published: September 2020

This research aims to prove that wide gap between theories and practices in terms of acquisition that should be positive to drive performance of the acquirer but the distinctive things happened in Indonesia was not according to the preliminary design planned. The failure acquisition of Semen Indonesia (SMGR) over Holcim Indonesia (SMCB) in 2018 due to what had been done during excessive capacity should be priority to strengthen interns than acting to intervene outside. This study elaborates a case study, mixed-type research, and presents by explanatory design. It comes to find that acquisition during excess capacity is a failure step taken by PT Semen Indonesia (Persero) Tbk. Many corporate steps are taken to a polish performance of the SMCB-acquiree but so far failing and endangering the whole performance. To compensate and withhold the climb-down due to oversupply, the management engineering of market intervention had been done. Big portions of market’s regions previously belong to SMGR had been handed over to SMCB to help increase its performance. The forced switching to polishing SBI’s performance is hurting all of the holding’s members. SBI enjoys improving market but at the same time endangers the performance of the whole groups of holdings. This research contributes to updating the present development of recent corporate actions of popular merger and acquisition are both previously labeled as the best corporate strategy for decades.
Community pharmacist-administered seasonal influenza vaccination: a national customer survey
Authors: Stämpfli Dominik , la Torre Adrian Martinez-De , Du Pasquier Sophie , Stegmann Danielle , Brügger Andrea , Burden Andrea M.
Published: September 2020

Background

In Switzerland, the influenza vaccination is recommended for high-risk groups and people who have contact with high-risk groups. Since 2015, Swiss pharmacists are allowed to vaccinate healthy adults after acquiring a certificate of competence for vaccination and blood sampling techniques. We aimed to assess customers of the seasonal influenza vaccination in pharmacies in regard to their satisfaction, motivation, and reasons.

Methods

Swiss pharmacies collected survey data during a period of 12 weeks from mid-October 2019 to mid-January 2020. Each participating pharmacy was sent 20 questionnaires to be handed out to vaccinated customers. The questionnaire was available in German and French and subdivided into four sections: demographic information, satisfaction, reasons for getting the vaccination, and reasons for choosing a pharmacy as a place of vaccination. We tested for statistical differences in answer tendencies across strata on questionnaire language, age groups, and levels of education.

Results

Of the 1600 surveys sent, 80 pharmacies sent back 656 completed questionnaires (return rate, 41%). Main age bracket was 65–74 years (26.2%), followed by 55–64 years (24.7%), with an equal distribution of reported sex (female, 49.5%). Of the respondents, 99% would have recommended the service and 88.5% felt very comfortable being vaccinated by a pharmacist. Satisfaction included injection technique, used facilities, preparatory discussions, and pricing of the service. Easy scheduling was a main motivation for choosing a pharmacy as the vaccination provider. We identified minor differences in answer tendencies across questionnaire language and age groups, but not across levels of education.

Conclusion

Customer satisfaction with community pharmacist-administered seasonal influenza vaccinations is high in Switzerland.
Comparison of the local pivotal method and systematic sampling for national forest inventories
Authors: Räty Minna , Kuronen Mikko , Myllymäki Mari , Kangas Annika , Mäkisara Kai , Heikkinen Juha
Published: September 2020

Background

The local pivotal method (LPM) utilizing auxiliary data in sample selection has recently been proposed as a sampling method for national forest inventories (NFIs). Its performance compared to simple random sampling (SRS) and LPM with geographical coordinates has produced promising results in simulation studies. In this simulation study we compared all these sampling methods to systematic sampling. The LPM samples were selected solely using the coordinates (LPMxy) or, in addition to that, auxiliary remote sensing-based forest variables (RS variables). We utilized field measurement data (NFI-field) and Multi-Source NFI (MS-NFI) maps as target data, and independent MS-NFI maps as auxiliary data. The designs were compared using relative efficiency (RE); a ratio of mean squared errors of the reference sampling design against the studied design. Applying a method in NFI also requires a proven estimator for the variance. Therefore, three different variance estimators were evaluated against the empirical variance of replications: 1) an estimator corresponding to SRS; 2) a Grafström-Schelin estimator repurposed for LPM; and 3) a Matérn estimator applied in the Finnish NFI for systematic sampling design.

Results

The LPMxy was nearly comparable with the systematic design for the most target variables. The REs of the LPM designs utilizing auxiliary data compared to the systematic design varied between 0.74–1.18, according to the studied target variable. The SRS estimator for variance was expectedly the most biased and conservative estimator. Similarly, the Grafström-Schelin estimator gave overestimates in the case of LPMxy. When the RS variables were utilized as auxiliary data, the Grafström-Schelin estimates tended to underestimate the empirical variance. In systematic sampling the Matérn and Grafström-Schelin estimators performed for practical purposes equally.

Conclusions

LPM optimized for a specific variable tended to be more efficient than systematic sampling, but all of the considered LPM designs were less efficient than the systematic sampling design for some target variables. The Grafström-Schelin estimator could be used as such with LPMxy or instead of the Matérn estimator in systematic sampling. Further studies of the variance estimators are needed if other auxiliary variables are to be used in LPM.
HALT (Hernia Active Living Trial): protocol for a feasibility study of a randomised controlled trial of a physical activity intervention to improve quality of life in people with bowel stoma with a bulge/parastomal hernia
Authors: Hubbard Gill , Beeken Rebecca J. , Taylor Claire , Oliphant Raymond , Watson Angus J. M. , Munro Julie , Russell Sarah , Goodman William
Published: September 2020

Background

Parastomal hernia (PSH) can be repaired surgically, but results to date have been disappointing, with reported recurrence rates of 30 to 76%. Other types of intervention are therefore needed to improve the quality of life of people with PSH. One potential intervention is physical activity. We hypothesise that the intervention will increase core activation and control across the abdominal wall at a site of potential weakness and thus reduce the risk of PSH progression. Increases in physical activity will improve body image and quality of life (QoL).

Methods

Subjects and sample

There were approximately 20 adults with a bowel stoma and PSH. People with previous PSH repair will be excluded as well as people who already do core training.

Study design

This is a feasibility study of a randomised controlled trial with 2 months follow-up, in 2 sites using mixed methods. Stage 1 involves intervention development and in stage 2, intervention and trial parameters will be assessed.

Intervention

A theoretically informed physical activity intervention was done, targeting people with PSH.

Main outcome of feasibility study

The main outcome is the decision by an independent Study Steering Committee whether to proceed to a full randomised controlled trial of the intervention.

Other outcomes

We will evaluate 4 intervention parameters—fidelity, adherence, acceptability and safety and 3 trial parameters (eligible patients’ consent rate, acceptability of study design and data availability rates for following endpoints):

Diagnosis and classification of PSH

Muscle activation

Body composition (BMI, waist circumference)

Patient reported outcomes: QoL, body image and physical functioning

Physical activity;

Psychological determinants of physical activity

Other data

Included are other data such as interviews with all participants about the intervention and trial procedures.

Data analysis and statistical power

As this is a feasibility study, the quantitative data will be analysed using descriptive statistics. Audio-recorded qualitative data from interviews will be transcribed verbatim and analysed thematically.

Discussion

The feasibility and acceptability of key intervention and trial parameters will be used to decide whether to proceed to a full trial of the intervention, which aims to improve body image, quality of life and PSH progression.

Trial registration

ISRCTN15207595