bluuebunny/crossref_metadata_2025 huggingface dataset:
High CXCR2 expression predicts poor prognosis in adult patients with acute myeloid leukemia
Authors: Tang Wei , Li Zunyan , Li Xian , Huo Zhonghua
Published: September 2020

Aims:

This study aimed to assess the associations between clinical parameters, long-term outcomes, and expression of chemokine receptor CXCR2 in patients with acute myeloid leukemia (AML).

Methods:

From May 2013 to May 2017, 83 adult patients newly diagnosed with AML in the Affiliated Hospital of BeiHua University and Jilin Chemical Hospital, were enrolled in this study. The expression of CXCR2 in bone marrow mononuclear cells was determined by quantitative real-time polymerase chain reaction (qRT-PCR). Clinical information and RNA-sequencing datasets of The Cancer Genome Atlas (TCGA) ( n = 136) were obtained. The associations between clinical parameters, prognosis, and CXCR2 expression were analyzed.

Results:

From both cohorts, patients with AML with M4 and M5 subtypes showed higher CXCR2 expression levels than those with other French-American-British (FAB) subtypes. Patients with extramedullary leukemia infiltration had higher CXCR2 levels than those without. In our cohort, patients with high CXCR2 levels (⩾2.099) had lower relapse-free survival (RFS) ( p < 0.000001) and overall survival (OS) ( p = 0.000107) than those with low levels (<2.099). High CXCR2 levels (⩾2.082) also indicated a poor OS in the TCGA cohort but only in patients younger than 65 years (5-year OS: 7.7% versus 29.9% in those with CXCR2 levels < 2.082). High CXCR2 levels independently predicted poor prognosis in AML patients, as determined by Cox proportional hazards models.

Conclusion:

Our results suggest that high CXCR2 expression associates with the monocytic lineage of AML and is an independent risk factor for poor patient prognosis.
Efficacy and safety of human intravenous immunoglobulin 5% (Ig VENA) in pediatric patients affected by primary immunodeficiency
Authors: Ricci Silvia , Lippi Francesca , Canessa Clementina , Guarnieri Chiara , Macchia Roberta , Azzari Chiara
Published: September 2020

Patients affected by primary immunodeficiencies are characterized for high susceptibility for severe infections. Our data demonstrate Kedrion 5% intravenous immunoglobulin G (IVIg) treatment effective and safe as replacement therapy for children and adolescents affected by primary immunodeficiency. The particularities of our study are the selection of a long period of follow-up (71 patient-years of follow-up), and to the best of our knowledge, our study is one of few that assesses the safety and efficacy of intravenous immunoglobulin treatment of primary immunodeficiency specifically in a pediatric population.
Analysis of Glucose Levels in Patients Hospitalized With COVID-19 During the First Phase of This Pandemic in West Texas
Authors: Rao Sanjana , Ali Kiran , Dennis Jeff , Berdine Gilbert , Test Victor , Nugent Kenneth
Published: September 2020

Background:

Patients with hyperglycemia during hospitalization, especially during ICU hospitalizations, often have worse outcomes, even if they do not have a premorbid diagnosis of diabetes. High glucose levels can provide insight into the underlying pathogenesis of a disease and can contribute to tissue injury. Some patients with COVID-19 have hyperglycemia during hospitalizations.

Methods:

The Infectious Disease and Control office at University Medical Center in Lubbock, Texas, provided a list of patients with a COVID-19 infection hospitalized between March 1 and May 15, 2020. The medical records were reviewed to collect information on age, gender, history of diabetes, and glucose levels on admission and through the first 7 days of hospitalization.

Results:

This study included 63 patients with a mean age of 62.1 ± 14.1 years. Thirty-five patients (55.6%) were males. The in-hospital mortality rate was 30.2%. The mean admission glucose level was 129.4 ± 57.1 mg/dL in patients who survived (N = 47) and 189.6 ± 112.2 mg/dL in patients who died during hospitalization (N = 16, P = .007). An admission glucose greater than 180 mg/dL predicted mortality in a model adjusted for a diabetes, age, and male gender. The mean differences between the maximum and minimum glucose levels calculated over the first 7 days of hospitalization were 112.93 ± 115.4 (N = 47) in patients who survived and were 240.5 ± 97.7 (N = 15) in patients who died during hospitalization ( P = .0003). A difference between the maximum and minimum glucose level greater than 105 mg/dL was associated with increased mortality.

Conclusions:

Patients who died during hospitalization for COVID-19 had higher admission glucose levels than patients who survived. Larger differences between maximum and minimum glucose levels during the first 7 days of hospitalization were associated with increased mortality. These results suggest that high glucose levels identify patients at increased risk for mortality and warrant more study.
The Effect of Youth Entrepreneurship Education Programs: Two Large-Scale Experimental Studies
Authors: Kim Gayoung , Kim Dohyeon , Lee Woo Jin , Joung Sunyoung
Published: September 2020

Recent years have witnessed the worldwide growth of entrepreneurship education (EE) as entrepreneurship is regarded as the key driver of innovation and economic growth. Most extant studies on EE have focused on its impact on entrepreneurial intentions. However, the application of the same EE measurements for both adults and adolescents has long been criticized; the indices developed for potential adult entrepreneurs may not be suitable for young entrepreneurs, considering the large time gap before they enter the workforce. This study aims to develop appropriate indicators for the assessment of youth EE in Korea and to examine the effectiveness of youth EE. Two large-scale quasi-experimental studies were conducted with pre- and posttest matched-comparison groups for verification. This study suggests six common variables for measuring the impact of youth EE: opportunity discovery, opportunity exploitation, entrepreneurship, creativity capacity, social problem solving, and entrepreneurial intention. The analyses showed that all these indicators positively influenced youth EE. We also proposed practical suggestions for the development of EE programs.
Comparison of Genetic Variants and Manifestations of OTUD6B-Related Disorder: The First Mexican Case
Authors: Romero-Ibarguengoitia Maria Elena , Cantú-Reyna Consuelo , Gutierrez-González Dalia , Cruz-Camino Héctor , González-Cantú Arnulfo , Sanz Sánchez Miguel Angel
Published: September 2020

The intellectual disability syndrome characterized by seizures and dysmorphic features was initially described in 2017 and was associated with genetic variants in the OTUD6B gene, identified by exome sequencing (ES) in a large cohort. This multisystem disorder primarily affects the central nervous system, the gastrointestinal, and the skeletal systems. In this article, we describe the first Mexican patient diagnosed by ES. The homozygous c.433C>T (p.Arg145*) variant of the OTUD6B gene confirmed this intellectual disability syndrome. In addition to seizures and other more frequently reported manifestations of this condition, this is the third patient with associated hypothyroidism and hypogammaglobulinemia, underscoring the value of screening for these conditions in other patients. The current challenge with this patient is to ensure medical management of his seizures and provide him with a better quality of life. The possibilities of additional therapeutic approaches may increase by understanding the physiopathology of the involved pathways.
Individual Aided Speech-Recognition Performance and Predictions of Benefit for Listeners With Impaired Hearing Employing FADE
Authors: Schädler Marc R. , Hülsmeier David , Warzybok Anna , Kollmeier Birger
Published: September 2020

The benefit in speech-recognition performance due to the compensation of a hearing loss can vary between listeners, even if unaided performance and hearing thresholds are similar. To accurately predict the individual performance benefit due to a specific hearing device, a prediction model is proposed which takes into account hearing thresholds and a frequency-dependent suprathreshold component of impaired hearing. To test the model, the German matrix sentence test was performed in unaided and individually aided conditions in quiet and in noise by 18 listeners with different degrees of hearing loss. The outcomes were predicted by an individualized automatic speech-recognition system where the individualization parameter for the suprathreshold component of hearing loss was inferred from tone-in-noise detection thresholds. The suprathreshold component was implemented as a frequency-dependent multiplicative noise (mimicking level uncertainty) in the feature-extraction stage of the automatic speech-recognition system. Its inclusion improved the root-mean-square prediction error of individual speech-recognition thresholds (SRTs) from 6.3 dB to 4.2 dB and of individual benefits in SRT due to common compensation strategies from 5.1 dB to 3.4 dB. The outcome predictions are highly correlated with both the corresponding observed SRTs ( R2 = .94) and the benefits in SRT ( R2 = .89) and hence might help to better understand—and eventually mitigate—the perceptual consequences of as yet unexplained hearing problems, also discussed in the context of hidden hearing loss.
Immunotherapy use in kidney transplant recipients: Immune checkpoint inhibitors and CAR-T cell therapy
Authors: Bassil Claude , Khimani Farhad
Published: September 2020

Cancer immunotherapy including the use of immune checkpoint inhibitors (ICI) and chimeric antigen receptor T cell therapy (CAR-T) are showing a promising role as part of cancer therapy and slowly replacing conventional chemotherapy. However, the use of ICI and CAR-T in organ transplant recipients with malignancies could be complicated with acute rejection and graft loss. Many proposed immunosuppressive (IS) regimens showed a probable role in preventing acute rejection related to ICI, including the use of a single ICI rather than double ICI, concomitant use of glucocorticoids (GC), converting tacrolimus to mTor inhibitors (m-TorI) and avoid close sequencing of ICI agents. Furthermore, low dose prednisone (LDP) before CAR-T infusion in patients with stable allograft kidney function could favor the regulatory T cells (T-regs), actively regulating alloimmune responses, and maintaining self-tolerance of the renal transplant. Further prospective trials will be needed to examine the long-term effect of these regimens in renal transplant recipients undergoing CAR-T or receiving ICI as curative therapies for their refractory cancers.
ORP1L, ORP1S, and ORP2: Lipid Sensors and Transporters
Authors: Aw Yvette C. , Brown Andrew J. , Wu Jia-Wei , Yang Hongyuan
Published: September 2020

Lipid transfer proteins are crucial for intracellular cholesterol trafficking at sites of membrane contact. In the OSBP/ORPs (oxysterol binding protein and OSBP-related proteins) family of lipid transfer proteins, ORP1L, ORP1S and ORP2 play important roles in cholesterol transport. ORP1L is an endosome/lysosome-anchored cholesterol sensor which may also move cholesterol bidirectionally at the interface between the endoplasmic reticulum and the endosome/lysosome. ORP2 delivers cholesterol to the plasma membrane, driven by PI(4,5)P2hydrolysis. ORP1S may also transport cholesterol to the plasma membrane, although it is unclear if phosphoinositides are involved. The source of cholesterol delivered to the plasma membrane by ORP1S and ORP2 remains unclear. This review summarises the roles of these proteins in maintaining cellular cholesterol homeostasis and in human disease.
Lives saved: Correctional officers’ experiences in the prevention of prisoner death by suicide
Authors: Ricciardelli Rosemary , Idzikowski Maia , Pratt Keltie
Published: September 2020

Few researchers have empirically examined completed or attempted death by suicide in prison and, of the available research, most has been conducted in the United Kingdom. Our purpose in this article is to increase awareness and knowledge about “lives saved” in custody drawing on the voices of Canadian provincial and territorial correctional officers (COs; n = 43). We investigate their experiences with attempted and completed death by suicide to shed light on the commonality of such experiences, and their impact on officers over time. Based on an analysis of semi-structured interview transcripts, we explore the effects of exposure to these potentially psychologically traumatic events on COs, specifically their emotional responses, as well as the supports available, both informal and formal, as they navigate their work. We found that the roles of officers, which frequently overlap with the domains of mental health support and first response in a crisis situation, are often under-recognized and underappreciated. Ultimately, we highlight the need for increased dialogue surrounding workplace trauma and mental health in prison and explore the institutional barriers that arise when facilitating discussion about mental health. We show that although some lives are lost in prison, due to natural and nonnatural causes, many lives are saved by prison staff.
Mutational analysis of hematologic neoplasms in 164 paired peripheral blood and bone marrow samples by next-generation sequencing
Authors: Lucas Fabienne , Michaels Phillip D. , Wang Dahai , Kim Annette S.
Published: September 2020

Key Points

Findings support use of PB samples for chronic myeloid neoplasms and for acute leukemias with sufficient circulating disease. In acute leukemias, BM appears to be superior to PB for monitoring measurable residual disease, even in the absence of BM excess blasts.
Airway–artery quantitative assessment on chest computed tomography in paediatric primary ciliary dyskinesia
Authors: Ferraro Valentina , Andrinopoulou Eleni-Rosalina , Sijbring Anna Marthe Margaretha , Haarman Eric G. , Tiddens Harm A.W.M. , Pijnenburg Marielle W.H.
Published: September 2020

Chest computed tomography (CT) is the gold standard for detecting structural abnormalities in patients with primary ciliary dyskinesia (PCD) such as bronchiectasis, bronchial wall thickening and mucus plugging. There are no studies on quantitative assessment of airway and artery abnormalities in children with PCD. The objectives of the present study were to quantify airway and artery dimensions on chest CT in a cohort of children with PCD and compare these with control children to analyse the influence of covariates on airway and artery dimensions.

Chest CTs of 13 children with PCD (14 CT scans) and 12 control children were collected retrospectively. The bronchial tree was segmented semi-automatically and reconstructed in a three-dimensional view. All visible airway–artery (AA) pairs were measured perpendicular to the airway centre line, annotating per branch inner and outer airway and adjacent artery diameter and computing inner airway diameter/artery ratio (AinA ratio), outer airway diameter/artery ratio (AoutA ratio), wall thickness (WT), WT/outer airway diameter ratio (Awt ratio) and WT/artery ratio.

In the children with PCD (38.5% male, mean age 13.5 years, range 9.8–15.3) 1526 AA pairs were measuredversus1516 in controls (58.3% male, mean age 13.5 years, range 8–14.8). AinA ratio and AoutA ratio were significantly higher in children with PCD than in control children (both p<0.001). Awt ratio was significantly higher in control children than in children with PCD (p<0.001).

Our study showed that in children with PCD airways are more dilated than in controls and do not show airway wall thickening.
Clinical manifestations and epidemiology of adolescent tuberculosis in Ukraine
Authors: Chiang Silvia S. , Dolynska Maria , Rybak Natasha R. , Cruz Andrea T. , Aibana Omowunmi , Sheremeta Yana , Petrenko Vasyl , Mamotenko Andrii , Terleieva Iana , Horsburgh C. Robert , Jenkins Helen E.
Published: September 2020

Background

During adolescence, childhood and adult forms of tuberculosis (TB) overlap, resulting in diverse disease manifestations. Knowing which patient characteristics are associated with which manifestations may facilitate diagnosis and enhance understanding of TB pathophysiology.

Methods

In this cross-sectional study, we included 10–19-year-olds in Ukraine's national TB registry who started TB treatment between 2015 and 2018. Using multivariable regression, we estimated associations between patient characteristics and four presentations of TB: pleural, extrathoracic, cavitary and rifampicin-resistant (RR). We also described the epidemiology of adolescent TB in Ukraine.

Results

Among 2491 adolescent TB cases, 88.4% were microbiologically confirmed. RR-TB was confirmed in 16.9% of new and 29.7% of recurrent cases. Of 88 HIV-infected adolescents, 59.1% were not on antiretroviral therapy at TB diagnosis. Among 10–14-year-olds, boys had more pleural disease (adjusted OR (aOR) 2.12, 95% CI: 1.08–4.37). Extrathoracic TB was associated with age 15–19 years (aOR 0.26, 95% CI: 0.18–0.37) and HIV (aOR 3.25, 95% CI: 1.55–6.61 in 10–14-year-olds; aOR 8.18, 95% CI: 3.58–17.31 in 15–19-year-olds). Cavitary TB was more common in migrants (aOR 3.53, 95% CI: 1.66–7.61) and 15–19-year-olds (aOR 4.10, 95% CI: 3.00–5.73); among 15–19-year-olds, it was inversely associated with HIV (aOR 0.32, 95% CI: 0.13–0.70). RR-TB was associated with recurrent disease (aOR 1.87, 95% CI: 1.08–3.13), urban residence (aOR 1.27, 95% CI: 1.01–1.62) and cavitation (aOR 2.98, 95% CI: 2.35–3.78).

Conclusions

Age, sex, HIV and social factors impact the presentation of adolescent TB. Preventive, diagnostic and treatment activities should take these factors into consideration.
On the dynamical aspects of local translation at the activated synapse
Authors: Khlebodarova Tamara M. , Kogai Vladislav V. , Likhoshvai Vitaly A.
Published: September 2020

Background

The key role in the dynamic regulation of synaptic protein turnover belongs to the Fragile X Mental Retardation Protein, which regulates the efficiency of dendritic mRNA translation in response to stimulation of metabotropic glutamate receptors at excitatory synapses of the hippocampal pyramidal cells. Its activity is regulated via positive and negative regulatory loops that function in different time ranges, which is an absolute factor for the formation of chaotic regimes that lead to disrupted proteome stability. The indicated condition may cause a number of neuropsychiatric diseases, including autism and epilepsy. The present study is devoted to a theoretical analysis of the local translation system dynamic properties and identification of parameters affecting the chaotic potential of the system.

Results

A mathematical model that describes the maintenance of a specific pool of active receptors on the postsynaptic membrane via two mechanisms – de novo synthesis of receptor proteins and restoration of protein function during the recycling process – has been developed. Analysis of the model revealed that an increase in the values of the parameters describing the impact of protein recycling on the maintenance of a pool of active receptors in the membrane, duration of the signal transduction via the mammalian target of rapamycin pathway, influence of receptors on the translation activation, as well as reduction of the rate of synthesis and integration of de novo synthesized proteins into the postsynaptic membrane – contribute to the reduced complexity of the local translation system dynamic state. Formation of these patterns significantly depends on the complexity and non-linearity of the mechanisms of exposure of de novo synthesized receptors to the postsynaptic membrane, the correct evaluation of which is currently problematic.

Conclusions

The model predicts that an increase of “receptor recycling” and reduction of the rate of synthesis and integration of de novo synthesized proteins into the postsynaptic membrane contribute to the reduced complexity of the local translation system dynamic state. Herewith, stable stationary states occur much less frequently than cyclic states. It is possible that cyclical nature of functioning of the local translation system is its “normal” dynamic state.
Accurate determination of node and arc multiplicities in de bruijn graphs using conditional random fields
Authors: Steyaert Aranka , Audenaert Pieter , Fostier Jan
Published: September 2020

Background

De Bruijn graphs are key data structures for the analysis of next-generation sequencing data. They efficiently represent the overlap between reads and hence, also the underlying genome sequence. However, sequencing errors and repeated subsequences render the identification of the true underlying sequence difficult. A key step in this process is the inference of the multiplicities of nodes and arcs in the graph. These multiplicities correspond to the number of times eachk-mer (resp.k+1-mer) implied by a node (resp. arc) is present in the genomic sequence. Determining multiplicities thus reveals the repeat structure and presence of sequencing errors. Multiplicities of nodes/arcs in the de Bruijn graph are reflected in their coverage, however, coverage variability and coverage biases render their determination ambiguous. Current methods to determine node/arc multiplicities base their decisions solely on the information in nodes and arcs individually, under-utilising the information present in the sequencing data.

Results

To improve the accuracy with which node and arc multiplicities in a de Bruijn graph are inferred, we developed a conditional random field (CRF) model to efficiently combine the coverage information within each node/arc individually with the information of surrounding nodes and arcs. Multiplicities are thus collectively assigned in a more consistent manner.

Conclusions

We demonstrate that the CRF model yields significant improvements in accuracy and a more robust expectation-maximisation parameter estimation. Truek-mers can be distinguished from erroneousk-mers with a higher F1score than existing methods. A C++11 implementation is available athttps://github.com/biointec/detoxunder the GNU AGPL v3.0 license.
Retraction Note: Prognostic value of heart failure in hemodialysis-dependent end-stage renal disease patients with myocardial fibrosis quantification by extracellular volume on cardiac magnetic resonance imaging
Authors: Xu Hua-yan , Yang Zhi-gang , Zhang Yi , Peng Wan-lin , Xia Chun-chao , Li Zhen-lin , He Yong , Xu Rong , Rao Li , Peng Ying , Li Yu-ming , Gao Hong-ling , Guo Ying-kun
Published: September 2020

This article has been retracted. Please see the retraction notice for more detail: https://doi.org/10.1186/s12872-020-01688-7.
Recruitment of adolescents with suicidal ideation in the emergency department: lessons from a randomized controlled pilot trial of a youth suicide prevention intervention
Authors: Tracey Matthew , Finkelstein Yaron , Schachter Reva , Cleverley Kristin , Monga Suneeta , Barwick Melanie , Szatmari Peter , Moretti Myla E. , Willan Andrew , Henderson Joanna , Korczak Daphne J.
Published: September 2020

Background

Emergency Departments (EDs) are a first point-of-contact for many youth with mental health and suicidality concerns and can serve as an effective recruitment source for randomized controlled trials (RCTs) of mental health interventions. However, recruitment in acute care settings is impeded by several challenges. This pilot RCT of a youth suicide prevention intervention recruited adolescents aged 12 to 17 years presenting to a pediatric hospital ED with suicide related behaviors.

Methods

Recruitment barriers were identified during the initial study recruitment period and included: the time of day of ED presentations, challenges inherent to study presentation, engagement and participation during an acute presentation, challenges approaching and enrolling acutely suicidal patients and families, ED environmental factors, and youth and parental concerns regarding the study. We calculated the average recruitment productivity for published trials of adolescent suicide prevention strategies which included the ED as a recruitment site in order to compare our recruitment productivity.

Results

In response to identified barriers, an enhanced ED-centered recruitment strategy was developed to address low recruitment rate, specifically (i) engaging a wider network of ED and outpatient psychiatry staff (ii) dissemination of study pamphlets across multiple areas of the ED and relevant outpatient clinics. Following implementation of the enhanced recruitment strategy, the pre-post recruitment productivity, a ratio of patients screened to patients randomized, was computed. A total of 120 patients were approached for participation, 89 (74.2%) were screened and 45 (37.5%) were consented for the study from March 2018 to April 2019. The screening to randomization ratio for the study period prior to the introduction of the enhanced recruitment strategies was 3:1, which decreased to 1.8:1 following the implementation of enhanced recruitment strategies. The ratio for the total recruitment period was 2.1:1. This was lower than the average ratio of 3.2:1 for published trials.

Conclusions

EDs are feasible sites for participant recruitment in RCTs examining new interventions for acute mental health problems, including suicidality. Engaging multi-disciplinary ED staff to support recruitment for such studies, proactively addressing anticipated concerns, and creating a robust recruitment pathway that includes approach at outpatient appointments can optimize recruitment.

Trial registration

ClinicalTrials.gov:NCT03488602, retrospectively registered April 4, 2018.
Lutetium-177-PSMA-I&T as metastases directed therapy in oligometastatic hormone sensitive prostate cancer, a randomized controlled trial
Authors: Privé Bastiaan M. , Janssen Marcel J. R. , van Oort Inge M. , Muselaers Constantijn H. J. , Jonker Marianne A. , de Groot Michel , Mehra Niven , Verzijlbergen J. Fred , Scheenen Tom W. J. , Zámecnik Patrik , Barentsz Jelle O. , Gotthardt Martin , Noordzij Walter , Vogel Wouter V. , Bergman Andries M. , van der Poel Henk G. , Vis André N. , Oprea-Lager Daniela E. , Gerritsen Winald R. , Witjes J. Alfred , Nagarajah James
Published: September 2020

Background

In recent years, there is increasing evidence showing a beneficial outcome (e.g. progression free survival; PFS) after metastases-directed therapy (MDT) with external beam radiotherapy (EBRT) or targeted surgery for oligometastatic hormone sensitive prostate cancer (oHSPC). However, many patients do not qualify for these treatments due to prior interventions or tumor location. Such oligometastatic patients could benefit from radioligand therapy (RLT) with 177Lu-PSMA; a novel tumor targeting therapy for end-stage metastatic castration-resistant prostate cancer (mCRPC). Especially because RLT could be more effective in low volume disease, such as the oligometastatic status, due to high uptake of radioligands in smaller lesions. To test the hypothesis that 177Lu-PSMA is an effective treatment in oHSPC to prolong PFS and postpone the need for androgen deprivation therapy (ADT), we initiated a multicenter randomized clinical trial. This is globally, the first prospective study using 177Lu-PSMA-I&T in a randomized multicenter setting.

Methods & design

This study compares 177Lu-PSMA-I&T MDT to the current standard of care (SOC); deferred ADT. Fifty-eight patients with oHSPC (≤5 metastases on PSMA PET) and high PSMA uptake (SUVmax > 15, partial volume corrected) on 18F-PSMA PET after prior surgery and/or EBRT and a PSA doubling time of < 6 months, will be randomized in a 1:1 ratio. The patients randomized to the interventional arm will be eligible for two cycles of 7.4GBq 177Lu-PSMA-I&T at a 6-week interval. After both cycles, patients are monitored every 3 weeks (including adverse events, QoL- and xerostomia questionnaires and laboratory testing) at the outpatient clinic. Twenty-four weeks after cycle two an end of study evaluation is planned together with another 18F-PSMA PET and (whole body) MRI. Patients in the SOC arm are eligible to receive 177Lu-PSMA-I&T after meeting the primary study objective, which is the fraction of patients who show disease progression during the study follow up. A second primary objective is the time to disease progression. Disease progression is defined as a 100% increase in PSA from baseline or clinical progression.

Discussion

This is the first prospective randomized clinical study assessing the therapeutic efficacy and toxicity of 177Lu-PSMA-I&T for patients with oHSPC.

Trial registration

Clinicaltrials.gov identifier: NCT04443062.
COVID-19 related reduction in pediatric emergency healthcare utilization – a concerning trend
Authors: Dopfer Christian , Wetzke Martin , Zychlinsky Scharff Anna , Mueller Frank , Dressler Frank , Baumann Ulrich , Sasse Michael , Hansen Gesine , Jablonka Alexandra , Happle Christine
Published: September 2020

Background

The COVID-19 pandemic has disrupted healthcare systems worldwide. In addition to the direct impact of the virus on patient morbidity and mortality, the effect of lockdown strategies on health and healthcare utilization have become apparent. Little is known on the effect of the pandemic on pediatric and adolescent medicine. We examined the impact of the pandemic on pediatric emergency healthcare utilization.

Methods

We conducted a monocentric, retrospective analysis of n = 5,424 pediatric emergency department visits between January 1st and April 19th of 2019 and 2020, and compared healthcare utilization during the pandemic in 2020 to the same period in 2019.

Results

In the four weeks after lockdown in Germany began, we observed a massive drop of 63.8% in pediatric emergency healthcare utilization (mean daily visits 26.8 ± SEM 1.5 in 2019 vs. 9.7 ± SEM 1 in 2020, p < 0.005). This drop in cases occurred for both communicable and non-communicable diseases. A larger proportion of patients under one year old (daily mean of 16.6% ±SEM 1.4 in 2019 vs. 23.1% ±SEM 1.7 in 2020, p < 0.01) and of cases requiring hospitalisation (mean of 13.9% ±SEM 1.6 in 2019 vs. 26.6% ±SEM 3.3 in 2020, p < 0.001) occurred during the pandemic. During the analysed time periods, few intensive care admissions and no fatalities occurred.

Conclusions

Our data illustrate a significant decrease in pediatric emergency department visits during the COVID-19 pandemic. Public outreach is needed to encourage parents and guardians to seek medical attention for pediatric emergencies in spite of the pandemic.
What we know and don’t know about the immunization program of Ethiopia: a scoping review of the literature
Authors: Tilahun Binyam , Mekonnen Zeleke , Sharkey Alyssa , Shahabuddin Asm , Feletto Marta , Zelalem Meseret , Sheikh Kabir
Published: September 2020

Background

There has been significant recent prioritization and investment in the immunization program in Ethiopia. However, coverage rates have stagnated and remained low for many years, suggesting the presence of systemic barriers to implementation. Hence, there is a need to consolidate the existing knowledge, in order to address them and consequently improve program effectiveness.

Methods

A thorough literature review and Delphi method were used. In this review, we searched Pubmed/Medline, WHO library, Science direct, Cochrane library, Google scholar and Google using different combinations of search strategies. Studies that applied any study design, data collection and analysis methods related to immunization program were included. In the Delphi method, a panel of 28 national and international experts were participated to identify current evidence gaps and set research priorities under the immunization program.

Results

In this review, a total of 55 studies and national documents were included. The review showed that the vaccination coverage ranged from 20.6% in Afar to 91.7% in Amhara region with large inequities related to socio-economic, health service access and knowledge about vaccination across different settings. Only one study reported evidence on timeliness of immunization as 60%. The review revealed that 80% of health facilities provide immunization service nationally while service availability was only 2% in private health facilities. This review indicated that poor vaccine storage, vaccine shortage, service interruptions, poor defaulter tracing, low community engagement and poor documentation were the main barriers for the Expanded Program on Immunization with variations across different regions. Through expert panel of discussion using Delphi method, 10 priority research areas were identified across different domains of the immunization program at national level.

Conclusion

We found out that there is substantial knowledge on vaccination coverage, however, there is little evidence on timeliness of vaccination. The existing barriers that affect full immunization coverage also varied from context to context which indicates there is a need to design and implement evidence based locally tailored interventions. This review also indicated evidence gaps with more focus on health system related implementation barriers at lower level and identified further research priorities in the immunization program of Ethiopia.
Which interventions increase hearing protection behaviors during noisy recreational activities? A systematic review
Authors: Loughran Michael T. , Lyons Stephanie , Plack Christopher J. , Armitage Christopher J.
Published: September 2020

Background

Hearing loss and tinnitus are global concerns that can be reduced through hearing protection behaviors (e.g., earplug use). Little is known about the effectiveness of interventions to increase hearing protection use in recreational domains. For the first time we review systematically the effectiveness of such interventions.

Methods

Systematic searches of nine databases, as well as grey literature and hand-searching, were conducted. Any study design was included if it assessed quantitatively a purposeful attempt to increase hearing protection in recreational settings. Studies were excluded if they assessed noise exposure from occupational sources and headphones/earphones, as these have been reviewed elsewhere. PROSPERO protocol: CRD42018098573.

Results

Eight studies were retrieved following the screening of 1908 articles. Two pretest-posttest studies detected a small to medium effect (d ≥ 0·3 ≤ 0·5), one a small effect (d ~ =0·2) and two no real effect. Three posttest experimental studies detected small to medium effects (d ≥ 0·3 ≤ 0·5). Studies were rated as “poor quality” and 17 out of a possible 93 behavior change techniques were coded, with the majority targeting the intervention function ‘education’.

Conclusions

Hearing loss and tinnitus due to recreational noise exposure are major public health concerns yet very few studies have examined preventive interventions. The present systematic review sets the agenda for the future development and testing of evidence-based interventions designed to prevent future hearing loss and tinnitus caused by noise in recreational settings, by recommending systematic approaches to intervention design, and implementation of intervention functions beyond education, such as incentivization, enablement and modeling.
Psychological correlates of COVID-19 pandemic in the Austrian population
Authors: Traunmüller Claudia , Stefitz Rene , Gaisbachgrabner Kerstin , Schwerdtfeger Andreas
Published: September 2020

Background

COVID-19 poses the greatest challenge for the entire world since the Second World War. Governments are forced to define strict measures to avoid the spreading of the virus, which may further impose psychological burden for the majority of the population. The aim of this study was to evaluate the psychological distress in Austria during the initial stage of the COVID-19 outbreak.

Methods

From 25 March to 3 April 2020, an anonymous online survey was conducted. Target group included all members of the Austrian population older than 16 years. The survey addressed the following areas (1) and sociodemographic data, (2) physical and mental health; (3) knowledge and concerns about COVID-19; (4) contact with infected people; (5) prevention efforts; (6) need for further information. The Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety and Stress Scale (DASS-21) were used to assess mental health. Analyses were based on 4126 individuals (74% female, age: M = 38.68, SD = 13.36).

Results

43.3% rated the psychological impact as moderate (5.6%) or severe (37.7%). 26.5% reported moderate (13.3%) to severe (13.2%) depression; 20.3% moderate (8.9%) to severe (11.4%) anxiety and 21.2% reported to suffer from moderate (10.5%) or severe stress (10.7%). Being female, higher age, lower levels of education, concern about family members, internet as main source of information, student or pupil status, poor self-rated health, and downplaying the seriousness of the problem were significantly associated with higher psychological burden. Protective factors were the possibility to work in home office, frequent (indirect) contact with family or friends, the availability of virus-specific information, confidence in the diagnosis capability, and physical activity during the crisis.

Conclusion

This study is among the first in Europe on the psychological correlates of the COVID-19 pandemic. 37.7% of the Austrian study population reported a severe psychological impact on the event and 1 in 10 is considered to suffer from severe depression, anxiety or stress. The present findings inform about the identification of protective factors, psychologically vulnerable groups and may guide the development of psychological interventions.
Social diversity and access to healthcare in Europe: how does European Union’s legislation prevent from discrimination in healthcare?
Authors: Orzechowski Marcin , Nowak Marianne , Bielińska Katarzyna , Chowaniec Anna , Doričić Robert , Ramšak Mojca , Łuków Paweł , Muzur Amir , Zupanič-Slavec Zvonka , Steger Florian
Published: September 2020

Background

Social diversity can affect healthcare outcomes in situations when access to healthcare is limited for specific groups. Although the principle of equality is one of the central topics on the agenda of the European Union (EU), its scope in the field of healthcare, however, is relatively unexplored. The aim of this study is to identify and systematically analyze primary and secondary legislation of the EU Institutions that concern the issue of access to healthcare for various minority groups. In our research, we have concentrated on three features of diversity: a) gender identity and sexual orientation, b) race and ethnicity, and c) religion or belief.

Method and materials

For the purpose of this analysis, we conducted a search of database Eur-Lex, the official website of European Union law and other public documents of the European Union, based on specific keywords accompanied by review of secondary literature. Relevant documents were examined with regard to the research topic. Our search covered documents that were in force between 13 December 2007 and 31 July 2019.

Results

Generally, the EU legal system prohibits discrimination on grounds of religion or belief, racial or ethnic origin, sex, and sexual orientation. However, with regard to the issue of non-discrimination in access to healthcare EU secondary law provides protection against discrimination only on the grounds of racial or ethnic origin and sex. The issue of discrimination in healthcare on the grounds of religion or belief, gender identity and sexual orientation is not specifically addressed under EU secondary law.

Discussion

The absence of regulations regarding non-discrimination in the EU secondary law in the area of healthcare may result from the division of competences between the European Union and the Member States. Reluctance of the Member States to adopt comprehensive antidiscrimination regulations leads to a situation, in which protection in access to healthcare primarily depends on national regulations.

Conclusions

Our study shows that EU antidiscriminatory law with regard to access to healthcare is fragmentary. Prohibition of discrimination of the level of European binding law does not fully encompass all aspects of social diversity.
Intrapulmonary mature cystic teratoma of the lung: case report of a rare entity
Authors: Mardani Parviz , Naseri Reyhaneh , Amirian Armin , Shahriarirad Reza , Anbardar Mohammad Hossein , Fouladi Damoun , Ranjbar Keivan
Published: September 2020

Background

Intrapulmonary teratoma (IPT) is a rare type of extra gonadal teratoma which often presents with non-specific symptoms and can be misdiagnosed as other diseases. Here we report a patient with IPT which was initially misdiagnosed as lung hydatid cyst versus abscess.

Case presentation

We report an intrapulmonary teratoma in a 27-year-old female presenting with persistent chest pain and dyspnea since a few years prior to her admission with associated symptoms of cough and fever. Chest x-ray only showed left side massive pleural effusion and computed tomography scan of the lungs was suggestive of hydatid cyst or a lung abscess. She underwent lobectomy and postoperative histopathological study revealed IPT as the final diagnosis.

Conclusion

Due to the non-specific symptoms and rarity, IPT can be easily misdiagnosed at first. It is essential that physicians take into account the possibility of IPT when approaching a new case of lung mass.
Women’s views about physical activity as a treatment for vasomotor menopausal symptoms: a qualitative study
Authors: Thomas Adèle , Daley Amanda J.
Published: September 2020

Background

Women commonly seek medical advice about menopausal symptoms. Although menopausal hormone therapy is the most effective treatment, many women prefer non-pharmacological treatments, such as physical activity. The effectiveness of physical activity has been inconclusive when assessed by randomised controlled trials, and it remains unclear how women feel about it as a possible treatment approach. The aim of the study was to explore symptomatic menopausal women’s views and experiences of physical activity as a treatment for vasomotor and other menopausal symptoms.

Methods

An in-depth qualitative study was embedded within a randomised controlled trial that assessed the effectiveness of physical activity as a treatment for vasomotor menopausal symptoms in previously inactive vasomotor symptomatic women. Participants were randomised to one of two physical activity interventions or a usual care group. Both physical activity interventions involved two one-to-one consultations, plus either supporting materials or access to physical activity support groups, over 6 months. Semi-structured interviews were conducted with 17 purposively selected participants from all three trial groups after they had completed trial follow-up. Interviews were audio recorded, transcribed verbatim, and analysed by constant comparison.

Results

All participants talked positively about physical activity as a treatment for their menopausal symptoms, with most reporting participation had improved their hot flushes and night sweats. They reported that they had experienced improved sleep, physical health and psychological well-being. Those who received the physical activity plus social-support intervention reported their ability to cope with their menopausal symptoms had improved. Many participants commented that they would prefer doctors to discuss physical activity as a possible treatment for their hot flushes and night sweats, before offering medication.

Conclusions

Based on the views and experiences of the women who participated in this study, healthcare professionals should continue discussing physical activity as a potential first treatment option with menopausal women. Furthermore, healthcare professionals should ensure they prepare, support, and encourage these women both physically and emotionally.

Trial registration

ISRCTN ISRCTN06495625 Registered 10/11/2010
Definitions, components and processes of data harmonisation in healthcare: a scoping review
Authors: Schmidt Bey-Marrié , Colvin Christopher J. , Hohlfeld Ameer , Leon Natalie
Published: September 2020

Background

Data harmonisation (DH) has emerged amongst health managers, information technology specialists and researchers as an important intervention for routine health information systems (RHISs). It is important to understand what DH is, how it is defined and conceptualised, and how it can lead to better health management decision-making. This scoping review identifies a range of definitions for DH, its characteristics (in terms of key components and processes), and common explanations of the relationship between DH and health management decision-making.

Methods

This scoping review identified relevant studies from 2000 onwards (date filter), written in English and published in PubMed, Web of Science and CINAHL. Two reviewers independently screened records for potential inclusion for the abstract and full-text screening stages. One reviewer did the data extraction, analysis and synthesis, with built-in reliability checks from the rest of the team. We developed a narrative synthesis of definitions and explanations of the relationship between DH and health management decision-making.

Results

We sampled 61 of 181 included to synthesis definitions and concepts of DH in detail. We identified six common terms for data harmonisation: record linkage, data linkage, data warehousing, data sharing, data interoperability and health information exchange. We also identified nine key components of data harmonisation: DH involves (a) a process of multiple steps; (b) integrating, harmonising and bringing together different databases (c) two or more databases; (d) electronic data; (e) pooling data using unique patient identifiers; and (f) different types of data; (g) data found within and across different departments and institutions at facility, district, regional and national levels; (h) different types of technical activities; (i) has a specific scope. The relationship between DH and health management decision-making is not well-described in the literature. Several studies mentioned health providers’ concerns about data completeness, data quality, terminology and coding of data elements as barriers to data utilisation for clinical decision-making.

Conclusion

To our knowledge, this scoping review was the first to synthesise definitions and concepts of DH and address the causal relationship between DH and health management decision-making. Future research is required to assess the effectiveness of data harmonisation on health management decision-making.