bluuebunny/crossref_metadata_2025 huggingface dataset:
PP106 Regional Guidance On Aids For Ostomy
Authors: Redomi Anna , Torbol Marika , Cavazzana Anna , Mottola Rita , Andretta Margherita , Scroccaro Giovanna
Published: January 2018

INTRODUCTION:

The Veneto Region established a Technical Panel for Continence (TPC) with the purpose of producing guidance for aids based on a Health Technology Assessment (HTA) approach. TPC is a multidisciplinary experts group that involves local clinicians, pharmacists, health economist and patients associations. Among its tasks, TPC can issue recommendations in the field of appropriate use, purchasing and distribution for aids. Currently the TPC is investigating aids for ostomy patients in order to provide the first regional guidance on appropriateness and disease management for ostomy.

METHODS:

The Regional Health Technology Assessment Unit (CRUF) conducted a literature review of the evidence on aids for ostomy. Grey literature, and National and Regional laws and regulations were also included in the analysis. TPC discussed the collected evidence by consensus. Final recommendations have been sent to the Regional Technical Committee on Medical Devices (CTRDM) for eventual remarks, before final approval.

RESULTS:

The literature review did not retrieve any relevant international studies on the topic, except for the Canadian clinical guidelines on ostomy. The upcoming regional guidance will suggest recommendations on: (i) appropriate patient disease management based on a multidisciplinary team evaluation; (ii) characteristics and selection criteria for ostomy aids and related accessories; (iii) prescribing medical specialists, authorization and distribution features; and (iv) specific indicators for appropriateness monitoring.

CONCLUSIONS:

The regional guidance on aids and accessories for ostomy aim at ensuring the appropriateness throughout the Regional Health Service. The strict monitoring of agreed indicators is essential for appropriateness compliance and consequently the sustainability of regional medical devices expenditure.
PP129 Methodological Issues With Assessing Newborn Screening Tests
Authors: Guo Bing
Published: January 2018

INTRODUCTION:

To outline the methodological issues associated with the assessment of newborn screening for severe combined immunodeficiency, which was conducted to address the policy question of whether this test should be added to an existing newborn screening panel.

METHODS:

We conducted a systematic review of published primary studies and critically appraised the methodological quality of selected studies (1).

RESULTS:

Fifteen studies were included; six focused on screening test performance, and seven on treatment effectiveness, and two on the effectiveness of a newborn screening program. The methodological issues identified included: (i) Overall poor methodological quality ratings of included studies using the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies-2). This tool was originally developed for assessing diagnostic accuracy studies where subjects usually receive both index test and reference standard so a 2×2 table can be constructed; however it is almost impossible to apply this cross-sectional approach to studies of a screening test for a rare disease like severe combined immunodeficiency. (ii) Case control design using healthy controls could inflate estimates of test accuracy compared to studies using a cohort of consecutive patients, possibly due to spectrum effects and limited-challenge bias. This type of study is useful in the early phase of test development, but estimates of test accuracy based on this type of study should be interpreted with caution. (iii) Some screening programs reported no false negatives, indicating a sensitivity of 100 percent. However, lack of a systematic search for “missed cases” created uncertainty in arriving at a true value for the sensitivity. (iv) Variations in inclusion of pre-term infants, races/ethnicities, and screening protocols made it difficult to compare screening test performance across different studies.

CONCLUSIONS:

Although severe combined immunodeficiency screening was the first addition to the US Recommended Uniform Screening Panel following an evidence-based review process, caution needs to be exercised when interpreting research findings due to important methodological issues.
VP29 Organizational Aspects In Health Technology Assessment: A New Approach For Future Assessments
Authors: Specchia Maria Lucia , Cacciatore Pasquale , Mazzotta Francesco , Ricciardi Walter , Damiani Gianfranco
Published: January 2018

INTRODUCTION:

Organizational aspects influence the behavior of healthcare professionals and managers, and may help to overcome the barriers in the implementation of new health technologies. However, the organizational domain is often under-represented or absent when Health Technology Assessment (HTA) reports are built. The objective of this study was to to explore the organizational assessment in HTA and build a new framework for applicative experience after the comparison with the European Network for HTA (EUnetHTA's) CoreModel 3.0.

METHODS:

A literature review was performed by extracting full HTA reports through INAHTA (International Network of Agencies for Health Technology Assessment) members websites, HTA agencies and snowball search, and the aspects relating to the organizational assessment were analyzed. A quantitative and qualitative analysis was performed on the retrieved reports and the results were compared with a framework of five domains and fifteen subdomains from EUnetHTA's CoreModel 3.0. A Multiple Correspondence Analysis was carried out in order to evaluate the power of CoreModel and identify new common domains to guide the organizational assessments in HTA reports.

RESULTS:

The assessments of organizational issues in the reports were significantly heterogeneous and less common than inclusion of other classic assessments. When included, domains and subdomains of the CoreModel were not covered homogeneously by the organizational assessments (representation level varied from 19 percent to 62 percent). The statistical analysis performed on the current data and the subsequent clustering of items offered the possibility to develop a new methodology based on three new composite indicators.

CONCLUSIONS:

This ongoing study analyzed the relevance of organizational assessments in current literature and the challenges of promoting an international approach to the matter. In this sense, according to the current state of the research, we proposed a new methodology to cover the most relevant aspects of organizational appraisal according to new, more homogeneous domains and a less context-oriented approach to encourage health professionals to perform organizational analysis and better fulfill the needs of future HTA research.
VP44 Rapid Health Technology Assessment – High-Intensity Focused Ultrasound For Breast Fibroadenomas And Benign Thyroid Nodules
Authors: Pwee Keng Ho
Published: January 2018

INTRODUCTION:

High-intensity focused ultrasound (HIFU) is a non-invasive ablative technique to treat breast fibroadenomas and benign thyroid nodules. A rapid Health Technology Assessment (HTA) was commissioned to inform the Changi General Hospital's decision on procuring a HIFU system.

METHODS:

A systematic literature search was conducted for systematic reviews, HTA reports and clinical practice guidelines on the clinical effectiveness of HIFU systems with the following PICO elements:

Patients = patients with benign breast fibroadenomas or thyroid nodules

Intervention = HIFU

Comparator = conventional treatment

Outcomes = clinical outcomes

Retrieved studies were summarized in a narrative synthesis.

RESULTS:

A few small case series showed reduction in volume of fibroadenomas/nodules in the short term and side effects were minor. Additionally, in HIFU for benign thyroid nodules, conference abstracts described a small open-label, randomized controlled trial where patients receiving HIFU had nodule volume reduction of over 30 percent compared to no reduction in the observation group, at 6 months; and a small non-randomized controlled study where volume reduction was about 70 percent in patients receiving HIFU compared to active observation.

Recent clinical guidelines do not mention HIFU as a therapeutic option for fibroadenomas/nodules.

Major United States health insurers do not cover HIFU and consider it experimental, investigational or unproven. In Germany, HIFU for breast fibroadenomas and benign thyroid nodules are covered by some insurers under special integrated care contracts.

CONCLUSIONS:

HIFU for fibroadenomas/nodules is a technology still developing its evidence base. The peer-reviewed literature comprises a few small case series and two controlled trials showing fibroadenoma/nodule reduction in the short term (up to 12 months) but no long term outcomes. Professional opinion from current guidelines does not mention HIFU as an option.

It may be prudent to await stronger evidence on long-term patient-important outcomes before offering the treatment as a hospital service. HIFU may be suitable for further clinical research.
VP69 Mapping Brazilian Nuclear Medicine Installed Capacity And Perspectives
Authors: Pozzo Lorena , Trindade Evelinda
Published: January 2018

INTRODUCTION:

Guidelines compliance, with a priori non-invasive and earlier tests and interventions, depends on access. This study investigates the Brazilian Unified Health System (SUS) outpatient access to nuclear medicine procedures through SUS data comparison with those from the National Commission of Nuclear Energy (CNEN: Comissão Nacional de Energia Nuclear).

METHODS:

Data provided by the SUS outpatient database (SIA-DATASUS) regarding procedures performed from 2013 to 2016 was compared with data from institutions (Nuclear Medicine Services and Cyclotron Facilities) and radioprotection supervisors with numbers certified by CNEN.

RESULTS:

CNEN has authorized 420 nuclear medicine institutions (.20 per million inhabitants) and certified 294 radioprotection supervisors (.14 per million inhabitants), and 1.4 services per supervisor. There are 457 graduated professionals qualified for radioactive sources preparation, use and handling for diagnostic and therapeutic radiopharmaceuticals (.9 professionals / installation). During the last four years, 08 new nuclear medicine facilities were authorized by CNEN. The number of nuclear medicine procedures performed slightly increased in the South, but remained constant in other regions. Annual SUS reimbursements increased by 21.2 percent on average for the 03 PET/CT (Positron emission tomography–computed tomography) adopted procedures: regional analysis showed the Central-West as the highest growth area (70.8 percent), compared to the South (53.4 percent), North-East region (30.8 percent), and the South-East (5 percent). Currently, thirteen Cyclotron Facilities operate in Brazil: South-East (six), South (three), North-East (three) and Central-West (one). Some nuclear medicine procedures largely outnumber the average increase: for example, reticuloendothelial system scintigraphy (513.9 percent), gastric transit scintigraphy (112.8 percent), and thyroid screening with suppression/stimulation test (100.6 percent). However, myocardial scintigraphy (stress and rest) and bone scintigraphy with or without blood flow still correspond to 82 percent of total nuclear medicine in vivo procedures.

CONCLUSIONS:

Regional disparity is quantitatively depicted in Brazil and reflects access to SUS nuclear medicine procedures. This denotes a potential for improvements related to nuclear medicine areas, for example developments concerning new PET/CT coverage, new radiopharmaceuticals research, and national and international training.
VP102 The Determinants Of Diffusion Of New Technologies Across Life Cycle
Authors: Callea Giuditta , Gautier Lara , Armeni Patrizio , Tarricone Rosanna
Published: January 2018

INTRODUCTION:

The proliferation and uneven diffusion of new medical technologies in recent years has been raising concerns on affordability and equity of care, and inspiring the publication of scientific articles on the determinants of their uptake and adoption (1). Indeed, the knowledge of the determinants spurring the adoption and diffusion of innovative medical technologies is relevant for policymakers because it helps them implementing evidence-based health policies aimed at influencing the use of new technologies, thus reducing inequities in uptake rates across areas and populations.

The aims of this study were (i) to identify the empirical literature investigating the determinants of adoption and diffusion of innovative non-pharmaceutical health technologies, and (ii) to discuss the existence of consensus on the direction and significance of the factors that influence their adoption in each phase of technologies life cycle (that is, early adoption, adoption, diffusion).

METHODS:

We performed a systematic literature review of quantitative empirical literature.

RESULTS:

We identified a total of thirty-three studies, published between 1977 and 2014. We concluded that early adoption of innovative technologies is positively affected by physician characteristics (for example, experience with new technology by the practitioner or by other physicians in the same hospital) and by the fee-for-service reimbursement scheme. The probability of adoption is mainly driven by provider characteristics (for example, size, importance of being perceived as technology leaders, previous adoption of similar or substitute technologies, strong medical staff involvement in decisions of acquisition), by physician experience with the technology and by the new technology expected impact on hospitals and physicians revenues. Socio-economic determinants (for example, health expenditure), hospitals and physicians reimbursement schemes, market structure (for example, number of providers, number of substitute procedures), provider features (for example, size, quality of care, reputation), and physician characteristics (for example, experience with technology, innovator status of the team) significantly increased the extent of diffusion.

CONCLUSIONS:

Our results can be used as a guide by policymakers who wish to make evidence-based decisions.
VP113 Reframing “Disinvestment”: Appropriateness And Real-Time Data Capture
Authors: Ronquillo Charlene , Roome Chris , Stein Ken
Published: January 2018

INTRODUCTION:

Disinvestment – stopping the use of health technologies with little or no clinical benefits – can reduce health system costs and change practice towards effective innovations. In England, efforts to support disinvestment have included the National Institute of Health and Care Excellence (NICE's) list of 900+ “Do Not Do (DND) technologies”. However, recent studies show ongoing, varying rates of DND technology, suggesting limited influence. In response, we propose a shift in perspective and reframing of the concept of ‘disinvestment’ to focus on ‘appropriateness’.

METHODS:

We have developed a two-pronged approach to ‘appropriateness’. The first develops local clinician agreements on specific, appropriate indications for a technology. The "RAND/UCLA Appropriateness Method” is being extended in this stage. This knowledge management process enables incorporation of local knowledge and practice via consensus development amongst local experts alongside scientific evidence. The second, and more novel, element is to specify and routinely collect data on technology use associated with these agreed indications. Shifting from cross-sectional clinical audits to real-time monitoring will highlight variation from the agreed indications, which can inform reimbursement policy and decisions. Evaluating the feasibility and sustainability of this approach will provide important lessons for scaling up.

RESULTS:

For clinicians, the reframing from disinvestment to appropriateness has important implications. The approach recognizes that there are very few technologies with absolutely no benefit. Framing the management of technology diffusion in terms of appropriateness emphasises benefits and maximises value for public health. Furthermore, combining local agreements on indications with real-time data capture facilitates intelligent, flexible commissioning and informs real-life evaluation.

CONCLUSIONS:

Shifting the perspective from disinvestment to appropriateness overcomes negative associations of stopping healthcare technologies. Linking clinically driven decisions on technology indications with routine data capture on use can transform clinical audit and healthcare commissioning. The combination of these approaches is, we believe, a novel approach on which more reflection and research will be valuable.
VP126 The Effectiveness And Safety Of Barbed Sutures In Bariatric Surgery
Authors: Lin Yifei , Huang Jin , Du Liang , Zhang Yonggang , Liao Ga
Published: January 2018

INTRODUCTION:

Knotless barbed sutures can eliminate knot tying during the bariatric surgery (BS) (1). Since effects reported by patients and surgeons are ambiguous, the aim of this study was to establish the safety and efficacy of barbed sutures for intestinal sutures to close the gastrojejunal anastomosis in obese patients undergoing BS.

METHODS:

PubMed, EMBASE, Cochrane Register of Clinical Studies, and ClinicalTrials.gov were searched for randomized controlled trials (RCTs) and cohort studies comparing barbed sutures with conventional sutures in BS (until 30 June 2016). Quality assessment was conducted using to Cochrane recommendations. Review Manager was applied to analyze the data, and we sequentially omitted each study to perform sensitivity analyses.

RESULTS:

A total of five cohort studies (low to moderate risk of bias) (n = 859), and no RCTs provided eligible patients. BS includes laparoscopic Roux-en-Y gastric bypass and Laparoscopic sleeve gastrectomy. Comparing to conventional sutures, pooling data showed that suture time (Mean Difference, MD = -5.73, 95 percent Confidence Interval, CI -6.25 to -5.21, P < .01) and operative time (MD = - 7.67, 95 percent CI -10.49 to -4.85, P < .01) decreased significantly in the barbed group. Although the postoperative complications did not suggest significant changes (Odds Ratio, OR = 1.56, 95 percent CI .79 to 3.07, P = .2), the pooling results of hospital stay suggested that a significantly longer duration happened in the barbed groups, despite the fact that there may be only 0.18 day longer. (MD =0.18, 95 percent CI .06 to .29, P = .003).

CONCLUSIONS:

The barbed suture is an effective and safe surgical technique in BS. More evidence with randomized design, larger sample sizes and longer follow up need to compel validations of this state-of-the-art product in the future (2,3).
VP130 Burden Of Illness For Urothelial Bladder Cancer (UBC) In Italy
Authors: Recchia Alessandra , Gerace Claudio , Era Sara , Doria Simona , Di Ponzio Giuseppe , Teruzzi Cristina
Published: January 2018

INTRODUCTION:

Urothelial Bladder Cancer (UBC) is the ninth worldwide most common cancer. In Italy the prevalence of the disease is about 10 percent, representing the third most prevalent cancer with 180,775 cases in men and 42,757 cases in women. The increase in the incidence requires continuous surveillance and care, resulting in a significant burden on Italian Healthcare System, making any improvement to the strategy for diagnosing and treating this disease important to the medical and scientific community. The aim of this study was to evaluate the burden of UBC in the Italian context, collecting and measuring the total costs of the disease.

METHODS:

An economic analysis in the National Health Service perspective was carried out, evaluating in six centers direct costs in terms of outpatient, inpatient and emergency care, pharmaceuticals and follow up procedures and indirect costs in terms of productivity losses. Data were collected through aggregated form reports, focusing on patients with an existing diagnosis of UBC who were taken in charge in the last year. Statistical analysis was conducted in order to explore variations between centers.

RESULTS:

Mean total annual cost per patients was EUR11,310, increasing for disease severity from EUR6,954 for superficial disease to EUR24,896 for metastatic stage. The analysis confirmed a proportional relation between disease severity and disability grade. The total burden of the disease considering all patients, including prevalence and incidence data coming from AIOM guidelines 2015, was EUR2,833,655,822, of which 15 percent is represented by estimated productivity losses.

CONCLUSIONS:

Our analysis represents the first economic burden study of UBC in the Italian context as well as the first real life evidence of the current therapeutic algorithm. This study opens the possibility for further analysis on the indirect costs components that represent a great burden for the society, especially for the stages of the disease with high disability grade.
VP144 Health Technology Assessment In Hospitals: Determinants Of Performance
Authors: Ferrario Lucrezia , Foglia Emanuela , Pagani Roberta , Lettieri Emanuele , Garagiola Elisabetta , Porazzi Emanuele , Croce Davide
Published: January 2018

INTRODUCTION:

While “how to perform” a rigorous Health Technology Assessment (HTA) at the institutional level is well established (1), very little has been experienced for empirically approaching an HTA in hospitals: no scientific evidence is available concerning the correct organizational model, to maximise and to improve the functioning, the performance and the effectiveness of the HTA units (2).

This study aims at crystallizing those design options that may positively contribute to the HTA units’ effectiveness (quality) and/or to the efficiency (timely) (3).

METHODS:

After the collection of qualitative data from ninety-five healthcare professionals by means of ad hoc questionnaires and interviews, a hierarchical sequential linear regression model was conducted to verify the existence of HTA units determinants. Size, multidisciplinary, trust among members, HTA previous skills and organizational support were the variables investigated, determining team performance.

RESULTS:

A greater size and the presence of different specialities within the working unit positively influenced effectiveness, even if they spent more time to complete the assessment. Trust, previous HTA skills and organizational support played a key role in team performance. Size and previous HTA skills most explained the variance of team effectiveness (R2 = .317; Adjusted R2 = .249). The five investigated variables presented a higher explanatory nature regarding team efficiency (R2 = .246; Adjusted R2 = .165).

CONCLUSIONS:

The study suggested the creation of multi-dimensional and multi-disciplinary HTA units to increase their effectiveness. HTA units should be monitored by the hospital management board, because an excessive increase in multi-disciplinary and size could determine inefficiency. Trust within members and the attendance of HTA training course improve performance. According to these results, the study gave solutions both to the scholars of HTA and to hospitals strategic management boards, paving the way to the determination of a more efficient and effective HTA units composition.
VP167 Comparison Of Methodology In Mixed Treatment Comparisons Of Treatments For Multiple Sclerosis
Authors: Sormani Maria , Giovannoni Gavin , Wolff Robert , Duffy Steve , Kinter Elizabeth , Wakeford Craig , Hyde Robert , Kleijnen Joseph , Birnie Richard
Published: January 2018

INTRODUCTION:

The expanding range of disease modifying therapies (DMT) for relapsing-remitting multiple sclerosis (RRMS) has led to increased interest in the relative effects of different DMTs. Previous mixed treatment comparisons (MTCs) have used different methods to address similar questions highlighting the need for a consistent approach to the assessment of treatments in RRMS.

METHODS:

We compared the methodology of six published MTCs of DMTs for RRMS identified by a systematic search of the literature. We assessed sources of evidence, DMTs included, outcomes reported and methods of data synthesis.

RESULTS:

All six MTCs were based on systematic reviews that included randomized controlled trials (RCTs). MS relapse was reported as the rate ratio based on annualised relapse rates (four MTCs) and as odds ratios or relative risk (one MTC each) based on the proportion with relapse. The analysis of relapse included between sixteen and twenty-seven RCTs and seven to twenty DMTs in different MTCs. One MTC reported both disability progression confirmed after three months (CDP3M) and disability progression confirmed after six months (CDP6M) as hazard ratios. One MTC combined CDP3M and CDP6M as a single outcome. One MTC reported only CDP3M based on hazard ratios. Two MTCs reported only CDP6M as either odds ratios or risk ratios (one MTC each). In one MTC the definition of disability progression was not reported. The analysis of disability included between seven and twenty-six RCTs and between six and nineteen DMTs in different MTCs. All six MTCs fitted a random effects MTC model using either Bayesian (four MTCs) or frequentist (two MTCs) methods.

CONCLUSIONS:

There is substantial heterogeneity between published MTCs in RRMS with regard to inclusion criteria, outcome definitions, effect measures and statistical methods. There is a clear requirement for a consistent approach to health technology assessment of DMTs for RRMS.
VP191 Peripheral Nerve Field Stimulation For Chronic Low Back Pain
Authors: Rhainds Marc , Larocque Brigitte , Bussières Sylvain , Nourrisat Alice , Coulombe Martin , Cantin Léo , Canuel Jean-Francois , Prudhomme Michel
Published: January 2018

INTRODUCTION:

Despite numerous medical, pharmacological and surgical approaches for chronic low back pain (LBP), many patients continue to complain of severe disabling pain. Peripheral nerve field stimulation (PNfS), alone or combined with spinal cord stimulation, is a neuromodulation procedure that have been recently developed and implemented in our hospital. We conducted a Health Technology Assessment (HTA) to determine if PNfS may be considered as a standard of practice in the management of intractable LBP and failed back surgery syndrome (FBSS).

METHODS:

An interdisciplinary group of experts was involved in the project. A systematic review (SR) was performed in several databases and grey literature to identify clinical practice guidelines, SR and observational studies published through September 2016. A survey was conducted among other chronic pain centers in Canada to document PNfS use in LBP and FBSS treatment.

RESULTS:

Data on effectiveness and safety of PNfS in chronic LBP treatment were scarce. Short-term results (3-12 months) from small sample and low quality studies suggest that PNfS, alone or combined with spinal cord stimulation, is associated with pain intensity and opioid use reductions. Effects on functional status and quality of life remain undetermined. Most frequent adverse events reported with PNfS devices are lead migrations, discomfort or pain and surgical site infections. No other Canadian pain centers were found to use PNfS in chronic LBP or FBSS.

CONCLUSIONS:

PNfS is potentially a beneficial treatment option for patients with chronic low back pain or FBSS. However, the value of this innovative treatment remains unknown. Among factors to be clarified are target population (any chronic low back pain or FBSS), use of PNfS alone or combined with spinal cord stimulation, long-term effects, and comparison with conventional medical management. PNfS use in chronic LBP has to be assessed through a rigorous framework before its introduction as a standard medical practice.
VP209 Two-Way Short Message Service (SMS) For Better Engagement And Quality Bio-Surveillance System
Authors: Dang Linh , Wong Jordan , Le Thuy , Phan Ngoc , James Spencer , Katona Peter , Vu Nguyen , Vu Thiem , Katona Lindsay , Rosen Joseph , Nguyen Cuong
Published: January 2018

INTRODUCTION:

Along with the exponential growth of technology, the use of mobile devices in health, or mHealth, has been quickly becoming a viable practice to strengthen health systems, especially in low-resource settings. Nevertheless, the majority of mHealth interventions are pilot efforts which mostly lack robust design and evidence about the use of mHealth in public health. This study assessed the use of a bi-directional Short Message Service (SMS) in disease surveillance in Vietnam and aimed to bring evidence in improving engagement of health staff as well as the quality of reporting.

METHODS:

Eighty health staff from fourty communes of Hoa Binh and Hung Yen provinces were trained and participated in two 6-month pilots: one with one-way, and one with a bi-directional SMS system for assisting in error screening, and reminder and feedback provision to report two diseases: influenza and diarrhea using cell phones. After each examination and checking-in onto the paper logbook, participants reported the case by texting an SMS to a designated number and made notes of successfully reported cases. A central data repository server was set up to collect SMS reports, and aggregate reported patient data. Engagement of health staff and quality of the reporting work were assessed by the evaluation of the qualitative questionnaires, and the comparison of the texted SMS reports to the patient logbooks.

RESULTS:

With the use of a two-way versus one-way SMS system, participants were 4.6 times more likely (95 percent Confidence Interval, CI 3.93-5.44, p< .001) to send correctly formatted text reports, and 3.4 times more likely (95 percent CI 2.72-4.33, p< .001) to have precise information in their texted messages. Results also revealed that while their position, age, or gender of participants did not statistically influence the results, ethnicity and management roles did.

CONCLUSIONS:

The study showed that the use of a bi-directional SMS-based reporting system both significantly improved participants engagement in the reporting protocol, and greatly enhanced their reporting quality. The study demonstrated that robust evidence of a practical utilization of SMS in a disease reporting system to replace the traditional paper-based one has great potential for a scale-up and national-wide implementation.
Platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, and platelet indices in patients with acute deep vein thrombosis
Authors: Ming Liang , Jiang Zhiyun , Ma Junfen , Wang Qian , Wu Fan , Ping Jiedan
Published: January 2018

Abstract. Background: Inflammation is associated with an increased risk of thrombotic events and complete blood count (CBC) is an easily measured test. The purpose of this study was to evaluate the value of CBC relative parameters including mean platelet volume (MPV), platelet-to-lymphocyte ratio (PLR), mean platelet volume-to-lymphocyte ratio (MPVLR), and neutrophil-to-lymphocyte ratio (NLR) for patients with acute deep vein thrombosis (DVT). Patients and methods: A total of 115 patients with unprovoked DVT of the lower extremities and 105 controls were recruited in this study. Blood samples were drawn from all participants to obtain the concentrations of CBCs and D-dimers. Results: MPVs (P = 0.044), PLRs (P = 0.005), MPVLRs (P = 0.001), and NLRs (P < 0.0001) were significantly higher in acute DVT patients compared to controls. The MPV was inversely correlated with platelet count (P < 0.0001) and the NLR was positively associated with D-dimers (P = 0.002) and the PLR (P < 0.0001). Notably, on multivariate logistic regression analysis, NLRs and D-dimers were independent risk factors of acute DVT (OR: 1.889, P = 0.024; OR: 1.009, P < 0.0001, respectively). Conclusions: MPV, PLR, MPVLR, and NLR have potential diagnostic values for patients with unprovoked DVT. NLR is an independent risk factor related to DVT.
Resonant plasma excitation by single-cycle THz pulses
Authors: Curcio A. , Marocchino A. , Dolci V. , Lupi S. , Petrarca M.
Published: January 2018

In this paper, an alternative perspective for the generation of millimetric high-gradient resonant plasma waves is discussed. This method is based on the plasma-wave excitation by energetic single-cycle THz pulses whose temporal length is comparable to the plasma wavelength. The excitation regime discussed in this paper is the quasi-nonlinear regime that can be achieved when the normalized vector potential of the driving THz pulse is on the order of unity. To investigate this regime and determine the strength of the excited electric fields, a Particle-In-Cell (PIC) code has been used. It has been found that by exploiting THz pulses with characteristics currently available in laboratory, longitudinal electron plasma waves with electric gradients up to hundreds MV/m can be obtained. The mm-size nature of the resonant plasma wave can be of great utility for an acceleration scheme in which high-brightness electron bunches are injected into the wave to undergo a strong acceleration. The long-size nature of the acceleration bucket with respect to the short length of the electron bunches can be handled in a more robust manner in comparison with the case when micrometric waves are employed.
Publisher Correction: Marked bias towards spontaneous synaptic inhibition distinguishes non-adapting from adapting layer 5 pyramidal neurons in the barrel cortex
Authors: Popescu Ion R. , Le Kathy Q. , Palenzuela Rocío , Voglewede Rebecca , Mostany Ricardo
Published: January 2018

A correction to this article has been published and is linked from the HTML version of this paper. The error has been fixed in the paper.
Epigallocatechin gallate (EGCG) reduces the intensity of pancreatic amyloid fibrils in human islet amyloid polypeptide (hIAPP) transgenic mice
Authors: Franko Andras , Rodriguez Camargo Diana C. , Böddrich Annett , Garg Divita , Rodriguez Camargo Andres , Rathkolb Birgit , Janik Dirk , Aichler Michaela , Feuchtinger Annette , Neff Frauke , Fuchs Helmut , Wanker Erich E. , Reif Bernd , Häring Hans-Ulrich , Peter Andreas , Hrabě de Angelis Martin
Published: January 2018

The formation of amyloid fibrils by human islet amyloid polypeptide protein (hIAPP) has been implicated in pancreas dysfunction and diabetes. However, efficient treatment options to reduce amyloid fibrils in vivo are still lacking. Therefore, we tested the effect of epigallocatechin gallate (EGCG) on fibril formation in vitro and in vivo. To determine the binding of hIAPP and EGCG, in vitro interaction studies were performed. To inhibit amyloid plaque formation in vivo, homozygous (tg/tg), hemizygous (wt/tg), and control mice (wt/wt) were treated with EGCG. EGCG bound to hIAPP in vitro and induced formation of amorphous aggregates instead of amyloid fibrils. Amyloid fibrils were detected in the pancreatic islets of tg/tg mice, which was associated with disrupted islet structure and diabetes. Although pancreatic amyloid fibrils could be detected in wt/tg mice, these animals were non-diabetic. EGCG application decreased amyloid fibril intensity in wt/tg mice, however it was ineffective in tg/tg animals. Our data indicate that EGCG inhibits amyloid fibril formation in vitro and reduces fibril intensity in non-diabetic wt/tg mice. These results demonstrate a possible in vivo effectiveness of EGCG on amyloid formation and suggest an early therapeutical application.
Prime-boost vaccination with recombinant protein and adenovirus-vector expressing Plasmodium vivax circumsporozoite protein (CSP) partially protects mice against Pb/Pv sporozoite challenge
Authors: de Camargo Tarsila Mendes , de Freitas Elisângela Oliveira , Gimenez Alba Marina , Lima Luciana Chagas , de Almeida Caramico Karina , Françoso Kátia Sanches , Bruna-Romero Oscar , Andolina Chiara , Nosten François , Rénia Laurent , Ertl Hildegund C. J. , Nussenzweig Ruth S. , Nussenzweig Victor , Rodrigues Mauricio M. , Reyes-Sandoval Arturo , Soares Irene S.
Published: January 2018

Vaccine development against Plasmodium vivax malaria lags behind that for Plasmodium falciparum. To narrow this gap, we administered recombinant antigens based on P. vivax circumsporozoite protein (CSP) to mice. We expressed in Pichia pastoris two chimeric proteins by merging the three central repeat regions of different CSP alleles (VK210, VK247, and P. vivax-like). The first construct (yPvCSP-AllFL) contained the fused repeat regions flanked by N- and C-terminal regions. The second construct (yPvCSP-AllCT) contained the fused repeat regions and the C-terminal domain, plus RI region. Mice were vaccinated with three doses of yPvCSP in adjuvants Poly (I:C) or Montanide ISA720. We also used replication-defective adenovirus vectors expressing CSP of human serotype 5 (AdHu5) and chimpanzee serotype 68 (AdC68) for priming mice which were subsequently boosted twice with yPvCSP proteins in Poly (I:C) adjuvant. Regardless of the regime used, immunized mice generated high IgG titres specific to all CSP alleles. After challenge with P. berghei ANKA transgenic parasites expressing Pb/PvVK210 or Pb/PvVK247 sporozoites, significant time delays for parasitemia were observed in all vaccinated mice. These vaccine formulations should be clinically tried for their potential as protective universal vaccine against P. vivax malaria.
Surround inhibition can instantly be modulated by changing the attentional focus
Authors: Kuhn Yves-Alain , Keller Martin , Lauber Benedikt , Taube Wolfgang
Published: January 2018

To further investigate the mechanism of surround inhibition (SI) and to determine whether adopting different attentional strategies might have an impact on the modulation of SI, the effects of adopting an external (EF) or internal focus of attention (IF) on SI and motor performance were investigated. While performing an index flexion with either an EF or IF, transcranial magnetic stimulation was applied at various time points in 14 healthy subjects. When adopting an EF compared to an IF, the results show an improved motor performance (+14.7% in MVC) and a reduced bEMG in the adjacent APB (−22.3%) during maximal index flexion. This was accompanied by an increased SI in the APB with an EF (+26.4%). Additionally, the decrease in bEMG correlated with the magnitude of SI in APB. The current results demonstrate an efficient way to modulate SI by changing the attentional focus in healthy subjects and might, at least in part, explain the better motor performance being associated with an EF. The present findings help to better understand the positive mechanisms of an EF on SI in the healthy motor system and may also points towards a treatment strategy in pathologies with disturbed SI such as focal hand dystonia.
Genome and secretome analysis of Pochonia chlamydosporia provide new insight into egg-parasitic mechanisms
Authors: Lin Runmao , Qin Feifei , Shen Baoming , Shi Qianqian , Liu Chichuan , Zhang Xi , Jiao Yang , Lu Jun , Gao Yaoyao , Suarez-Fernandez Marta , Lopez-Moya Federico , Lopez-Llorca Luis Vicente , Wang Gang , Mao Zhenchuan , Ling Jian , Yang Yuhong , Cheng Xinyue , Xie Bingyan
Published: January 2018

Pochonia chlamydosporia infects eggs and females of economically important plant-parasitic nematodes. The fungal isolates parasitizing different nematodes are genetically distinct. To understand their intraspecific genetic differentiation, parasitic mechanisms, and adaptive evolution, we assembled seven putative chromosomes of P. chlamydosporia strain 170 isolated from root-knot nematode eggs (~44 Mb, including 7.19% of transposable elements) and compared them with the genome of the strain 123 (~41 Mb) isolated from cereal cyst nematode. We focus on secretomes of the fungus, which play important roles in pathogenicity and fungus-host/environment interactions, and identified 1,750 secreted proteins, with a high proportion of carboxypeptidases, subtilisins, and chitinases. We analyzed the phylogenies of these genes and predicted new pathogenic molecules. By comparative transcriptome analysis, we found that secreted proteins involved in responses to nutrient stress are mainly comprised of proteases and glycoside hydrolases. Moreover, 32 secreted proteins undergoing positive selection and 71 duplicated gene pairs encoding secreted proteins are identified. Two duplicated pairs encoding secreted glycosyl hydrolases (GH30), which may be related to fungal endophytic process and lost in many insect-pathogenic fungi but exist in nematophagous fungi, are putatively acquired from bacteria by horizontal gene transfer. The results help understanding genetic origins and evolution of parasitism-related genes.
TPGLDA: Novel prediction of associations between lncRNAs and diseases via lncRNA-disease-gene tripartite graph
Authors: Ding Liang , Wang Minghui , Sun Dongdong , Li Ao
Published: January 2018

Accumulating evidences have indicated that lncRNAs play an important role in various human complex diseases. However, known disease-related lncRNAs are still comparatively small in number, and experimental identification is time-consuming and labor-intensive. Therefore, developing a useful computational method for inferring potential associations between lncRNAs and diseases has become a hot topic, which can significantly help people to explore complex human diseases at the molecular level and effectively advance the quality of disease diagnostics, therapy, prognosis and prevention. In this paper, we propose a novel prediction of lncRNA-disease associations via lncRNA-disease-gene tripartite graph (TPGLDA), which integrates gene-disease associations with lncRNA-disease associations. Compared to previous studies, TPGLDA can be used to better delineate the heterogeneity of coding-non-coding genes-disease association and can effectively identify potential lncRNA-disease associations. After implementing the leave-one-out cross validation, TPGLDA achieves an AUC value of 93.9% which demonstrates its good predictive performance. Moreover, the top 5 predicted rankings of lung cancer, hepatocellular carcinoma and ovarian cancer are manually confirmed by different relevant databases and literatures, affording convincing evidence of the good performance as well as potential value of TPGLDA in identifying potential lncRNA-disease associations. Matlab and R codes of TPGLDA can be found at following:https://github.com/USTC-HIlab/TPGLDA.
Synthesis of Luminescent Carbon Dots with Ultrahigh Quantum Yield and Inherent Folate Receptor-Positive Cancer Cell Targetability
Authors: Liu Haifang , Li Zhaohui , Sun Yuanqiang , Geng Xin , Hu Yalei , Meng Hongmin , Ge Jia , Qu Lingbo
Published: January 2018

Carbon dots (CDs) have a wide range of applications in chemical, physical and biomedical research fields. We are particularly interested in the use of CDs as fluorescence nanomaterials for targeted tumor cell imaging. One of the important aspects of success is to enhance the fluorescence quantum yields (QY) of CDs as well as increase their targetability to tumor cells. However, most of the reported CDs are limited by relative low QY. In the current study, for the first time, one-step synthesis of highly luminescent CDs by using folic acid (FA) as single precursor was obtained in natural water through hydrothermal method. The as-prepared CDs exhibited QY as high as 94.5% in water, which is even higher than most of organic fluorescent dyes. The obtained CDs showed excellent photoluminescent activity, high photostability and favorable biocompatibility. The FA residuals in CDs led to extraordinary targetability to cancer cells and promoted folate receptor-mediated cellular uptake successfully, which holds a great potential in biological and bioimaging studies.
Association between plasma concentrations of branched-chain amino acids and adipokines in Japanese adults without diabetes
Authors: Katagiri Ryoko , Goto Atsushi , Budhathoki Sanjeev , Yamaji Taiki , Yamamoto Hiroshi , Kato Yumiko , Iwasaki Motoki , Tsugane Shoichiro
Published: January 2018

Previous studies have consistently reported an association between circulating levels of branched-chain amino acids (BCAAs) or adipokines and insulin resistance; however, the association between BCAA and adipokine levels remains to be clarified. In this cross-sectional study involving 678 participants (435 men) without diabetes, plasma BCAA (valine, leucine, and isoleucine), adipokine (total and high molecular weight [HMW] adiponectin, leptin, and tumor necrosis factor-α [TNF-α]) concentrations, and an updated homeostasis model assessment of insulin resistance (HOMA2-IR) were measured. The association between the concentrations of total BCAAs and adipokines was adjusted for confounding factors, including body mass index. For the lowest and highest BCAA quartiles, the adjusted geometric mean levels of HMW adiponectin were, respectively, 1.51 and 0.91 μg/mL, in men (P for trend < 0.0001); 3.61 and 2.29 μg/mL, in women (P = 0.0005). The corresponding geometric mean levels for leptin were 1681 and 2620 pg/mL, in men (P = 0.003), and 4270 and 6510 pg/mL, in women (P = 0.003). Those for HOMA2-IR were 0.89 and 1.11, in men (P < 0.0001), and 0.79 and 0.96, in women (P < 0.0001); no significant association was found with TNF-α. These results suggest significant associations between BCAA concentrations and those for adiponectin, leptin and HOMA2-IR in individuals without diabetes.
Effects of graphene intercalation on dielectric reliability of HfO2 and modulation of effective work function for Ni/Gr/c-HfO2 interfaces: first-principles study
Authors: Zhong Kehua , Yang Yanmin , Zhang Jian-Min , Xu Guigui , Huang Zhigao
Published: January 2018

We have investigated the effects of graphene intercalation on dielectric reliability of HfO2 for Ni/Gr/HfO2 interfaces, and the effects of graphene intercalation and interfacial atom vacancy on the effective work function (EWF) of Ni/Gr/HfO2 interfaces using first-principle calculation based on density functional theory. The calculated results indicate that graphene intercalation can improve dielectric reliability of HfO2 dielectric even for the interfaces having interfacial oxygen vacancy or a small amount carbon vacancy. Moreover, the calculated results indicate that, inserting graphene into Ni/HfO2 interface induces the EWF’s to decline, and controlling interfacial oxygen or carbon vacancy can effectively tune the EWF of Ni/Gr/HfO2 interface. Our work strongly suggests that the use of graphene synthesized into Ni/HfO2 interface is a very effective way to improve the interface quality, and controlling interfacial oxygen or carbon vacancy is also an attractive and promising way for modulating the EWF of Ni/Gr/HfO2 interfaces.
Motor signatures of emotional reactivity in frontotemporal dementia
Authors: Marshall Charles R. , Hardy Chris J. D. , Russell Lucy L. , Clark Camilla N. , Bond Rebecca L. , Dick Katrina M. , Brotherhood Emilie V. , Mummery Cath J. , Schott Jonathan M. , Rohrer Jonathan D. , Kilner James M. , Warren Jason D.
Published: January 2018

Automatic motor mimicry is essential to the normal processing of perceived emotion, and disrupted automatic imitation might underpin socio-emotional deficits in neurodegenerative diseases, particularly the frontotemporal dementias. However, the pathophysiology of emotional reactivity in these diseases has not been elucidated. We studied facial electromyographic responses during emotion identification on viewing videos of dynamic facial expressions in 37 patients representing canonical frontotemporal dementia syndromes versus 21 healthy older individuals. Neuroanatomical associations of emotional expression identification accuracy and facial muscle reactivity were assessed using voxel-based morphometry. Controls showed characteristic profiles of automatic imitation, and this response predicted correct emotion identification. Automatic imitation was reduced in the behavioural and right temporal variant groups, while the normal coupling between imitation and correct identification was lost in the right temporal and semantic variant groups. Grey matter correlates of emotion identification and imitation were delineated within a distributed network including primary visual and motor, prefrontal, insular, anterior temporal and temporo-occipital junctional areas, with common involvement of supplementary motor cortex across syndromes. Impaired emotional mimesis may be a core mechanism of disordered emotional signal understanding and reactivity in frontotemporal dementia, with implications for the development of novel physiological biomarkers of socio-emotional dysfunction in these diseases.