bluuebunny/crossref_metadata_2025 huggingface dataset:
Do the Means Matter? Defense Attorneys’ Perceptions of Procedural Transgressions by Police and Their Implication on Police Legitimacy
Authors: Liu Siyu , Nir Esther
Published: April 2020

Through interviews ( n = 40) and surveys ( n = 140) with separate samples of U.S. defense attorneys practicing criminal law in a Northeastern state, we utilize a mixed-methods approach to explore police procedural transgressions (e.g., pretextual stops, overreaching searches) during stops, searches, and seizures. With a structural equation path model, we examine whether and how procedural justice (an assessment of “the means” to control crime) and police effectiveness (an assessment of police performance or “the ends”) affect each other and influence perceptions of police legitimacy. Our findings indicate that procedural justice enhances perceptions of police legitimacy, whereas police effectiveness does not have an effect. Policy implications for developing mechanisms that discourage procedural transgressions by police are discussed.
Intellectual Capital and Profitability: Evidence from Indian Pharmaceutical Sector
Authors: Gupta Kanishka , Goel Sweta , Bhatia Prakash
Published: April 2020

Intellectual capital (IC) has gained recognition in enhancing the firms’ value and gain competitive advantage in the developed world. Thus, it is imperative for all stakeholders to have an understanding of its impact on firms’ profitability. The present study aims to analyse the impact of intellectual capital on firms’ profitability of Indian pharmaceutical companies listed in National Stock Exchange (NSE-500) for the time period of 10 years (i.e. 2009–2018). The paper has used modified version of Pulic’s Value Added Intellectual Coefficient, i.e., M-VAIC as a proxy to measure intellectual capital and firms’ profitability as represented by ROA, ROE and EBITDA. In line to analyse the effectiveness, a balanced panel data regression technique has been used. The results of the paper indicate a significant relationship between intellectual capital and firms’ profitability. Also, it is found that human capital, relational capital and physical capital have a significant role in increasing the profitability of the firm. The analysis would help the administration and management of pharmaceutical companies in the composition and organization of intellectual capital, stakeholders in the decisions related to investment and financial specialist for enhancing intellectual capital efficiency and value creation for the firm. Human capital is found to be having a positively significant impact on firms’ profitability; their inclusion and management are suggested for the companies.
Precision and Sample Size Requirements for Regression-Based Norming Methods for Change Scores
Authors: Gu Zhengguo , Emons Wilco H. M. , Sijtsma Klaas
Published: April 2020

To interpret a person’s change score, one typically transforms the change score into, for example, a percentile, so that one knows a person’s location in a distribution of change scores. Transformed scores are referred to as norms and the construction of norms is referred to as norming. Two often-used norming methods for change scores are the regression-based change approach and the T Scores for Change method. In this article, we discuss the similarities and differences between these norming methods, and use a simulation study to systematically examine the precision of the two methods and to establish the minimum sample size requirements for satisfactory precision.
Predictive Properties of the Violence Risk Scale–Sexual Offense Version as a Function of Age
Authors: Olver Mark E. , Beggs Christofferson Sarah M. , Nicholaichuk Terry P. , Wong Stephen C. P.
Published: April 2020

The present study examined the discrimination and calibration properties of Violence Risk Scale–Sexual Offense version (VRS-SO) risk and change scores for sexual and violent recidivism as a function of age at release, on a combined sample of 1,287 men who had attended sexual offense-specific treatment services. The key aim was to examine to what extent VRS-SO scores can accurately discriminate recidivists from nonrecidivists among older cohorts, and if the existing age-related adjustments in the instrument adequately correct for increasing age. VRS-SO risk and change scores showed consistent properties of discrimination for sexual recidivism across the age cohorts, via area under the curve and Cox regression survival analysis, as demonstrated through fixed effects meta-analysis. Calibration analyses, employing logistic regression, demonstrated that age at release was consistently incrementally predictive of violent, but not sexual, recidivism after controlling for individual differences on static and dynamic risk factors. E/O index analyses demonstrated that predicted rates of sexual recidivism from VRS-SO scores, particularly when employed with Static-99R, were not significantly different from those observed among age cohorts; however, calibration was weaker for general violence. Implications for use of the VRS-SO in sexual recidivism risk assessment with older offenders are discussed.
A Double-Blind, Randomized Study of Extended-Release Molindone for Impulsive Aggression in ADHD
Authors: Ceresoli-Borroni Gianpiera , Nasser Azmi , Adewole Toyin , Liranso Tesfaye , Xu Jiahong , Schwabe Stefan , Findling Robert L.
Published: April 2020

Objective: To evaluate efficacy and safety of SPN-810 (extended-release molindone) in a Phase-2b, randomized, double-blind, placebo-controlled, dose-ranging study of children (6–12 years) with ADHD and persistent impulsive aggression (IA). Method: After lead-in, children were randomized to (a) placebo ( N = 31); (b) low-dose ( N = 29, 12/18 mg/day); (c) medium-dose ( N = 30, 24/36 mg/day); and (4) high-dose ( N = 31, 36/54 mg/day) groups. Treatment included ~2.5-week titration, 3-week maintenance, and 1-week tapering/conversion, alongside existing monotherapy (stimulants/nonstimulants) and behavioral therapy. The primary endpoint was change in Retrospective-Modified Overt Aggression Scale (R-MOAS) score at end of study, with safety monitored. Results: A total of 95 (78.5%) children completed the study. Aggression (R-MOAS) improved with low and medium doses (low dose: p = .031; medium dose: p = .024; high dose: p = .740). The most common adverse events were headache (10.0%), sedation (8.9%), and increased appetite (7.8%). Conclusion: These results suggest SPN-810 may be effective in reducing residual IA behaviors in children with ADHD. Research is still needed to support the benefit–risk profile of SPN-810 in pediatric populations.
Parental Prenatal Symptoms of Depression and Offspring Symptoms of ADHD: A Genetically Informed Intergenerational Study
Authors: Eilertsen Espen Moen , Hannigan Laurie J. , McAdams Tom A. , Rijsdijk Fruhling V. , Czajkowski Nikolai , Reichborn-Kjennerud Ted , Ystrom Eivind , Gjerde Line C.
Published: April 2020

Objective: The primary aim of the present study was to separate the direct effect of maternal prenatal depression on offspring ADHD from the passive transmission of genetic liability. Method: A children-of-twins and siblings design including 17,070 extended-family units participating in the Norwegian Mother and Child Cohort Study was used. Self-ratings were obtained from parents using the Symptom Checklist during pregnancy. Maternal ratings using Conner’s Parent Rating Scale were obtained when the children were 5 years of age. Results: Genetic influences were important for explaining similarity between parents and offspring. There was also evidence for a maternal effect after accounting for genetic transmission ( m = 0.06, 95% confidence interval [CI] = [0.02, 0.09]). Conclusion: Our results were consistent with hypotheses suggesting that maternal prenatal depression influences symptoms of ADHD in offspring. However, the effect was weak and a substantial portion of the association could be accounted for by shared genetic influences.
Pathways From ADHD Symptoms to Suicidal Ideation During College Years: A Longitudinal Study on the i-Share Cohort
Authors: Arsandaux Julie , Orri Massimiliano , Tournier Marie , Gbessemehlan Antoine , Coté Sylvana , Salamon Réda , Tzourio Christophe , Galéra Cédric
Published: April 2020

Objective: To estimate the association between ADHD symptoms and suicidal ideation in college students, and to test mediation by depressive symptoms or self-esteem. Method: Based on the i-Share cohort (prospective cohort of 2,331 college students in France). Self-reported measures included ADHD symptoms at baseline, self-esteem and depressive symptoms at 3 months, and suicidal ideation at 1-year follow-up. We conducted path analysis to estimate total, direct, and indirect effect. Results: Participants with high ADHD symptoms were more likely to report suicidal ideation 1 year later ( p < .0001). Indirect effects through depressive symptoms ( p < .0001) and self-esteem ( p < .0001) explained 44% and 25% of this association, respectively. An indirect pathway via a combination of self-esteem, then depressive symptoms, was also identified ( p < .0001), explaining 19% of the total effect. The direct effect was not significant ( p = .524). Conclusion: ADHD symptoms seem to have no direct but indirect effect through both self-esteem and depressive symptoms on suicidal ideation.
Exploring the Efficacy of a Mindfulness Program for Boys With Attention-Deficit Hyperactivity Disorder and Oppositional Defiant Disorder
Authors: Muratori Pietro , Conversano Ciro , Levantini Valentina , Masi Gabriele , Milone Annarita , Villani Silvia , Bögels Susan , Gemignani Angelo
Published: April 2020

Objective: This study was the first attempt to explore the efficacy of a mindfulness protocol for children with attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD), and their parents. Method: Fifty male children with ADHD and ODD diagnosis, aged 8 to 12, were randomly assigned to the mindfulness intervention ( n = 25) or the wait-list ( n = 25) group. Outcome measures included children, parents’, and teachers’ reports and objective measures of attention. Results: Children from the intervention group had a greater reduction in hyperactive behaviors in the school context (effect size [ES] = 0.59) and a greater improvement in visual sustained attention (ES = 0.77) and in Avoidance and Fusion Questionnaire scores (ES = 0.43) than those in the wait-list control group. No significant effect of the intervention on aggressive behaviors was revealed. Conclusion: A mindfulness intervention for children and their parents showed partial beneficial effects in children with ADHD + ODD.
Medication Use for ADHD and the Risk of Driving Citations and Crashes Among Teenage Drivers: A Population-Based Cohort Study
Authors: Winterstein Almut G. , Li Yan , Gerhard Tobias , Linden Stephan , Shuster Jonathan J.
Published: April 2020

Objectives: To evaluate the real-world effectiveness of ADHD medications on adverse driving outcomes in teenage drivers with ADHD. Method: We retrospectively followed 15- to 20-year-old ADHD patients with valid driver’s license to compare the risk for crashes and citations between periods with and without ADHD medication use, using Florida Medicaid records linked to Department of Motor Vehicles data from 1999 to 2004. Patient-level demographic, clinical, and driver licensing characteristics as well as county-level crash and traffic statistics were adjusted in Cox models. Results: A total of 2,049 patients had 67 crashes and 319 citations. Adjusted hazard ratios comparing ADHD medication use versus no use were 1.22 (95% confidence interval [CI] = [0.66, 1.90]) and 0.89 (95% CI = [0.69, 1.13]) for crashes and citations, respectively. Conclusion: Our study showed no evidence that ADHD medication use was associated with a reduced risk of adverse driving outcomes among teenage drivers enrolled in Medicaid programs. Limitations in interpreting this finding are presented.
Racial Capitalism: A Fundamental Cause of Novel Coronavirus (COVID-19) Pandemic Inequities in the United States
Authors: Laster Pirtle Whitney N.
Published: April 2020

Racial capitalism is a fundamental cause of the racial and socioeconomic inequities within the novel coronavirus pandemic (COVID-19) in the United States. The overrepresentation of Black death reported in Detroit, Michigan is a case study for this argument. Racism and capitalism mutually construct harmful social conditions that fundamentally shape COVID-19 disease inequities because they (a) shape multiple diseases that interact with COVID-19 to influence poor health outcomes; (b) affect disease outcomes through increasing multiple risk factors for poor, people of color, including racial residential segregation, homelessness, and medical bias; (c) shape access to flexible resources, such as medical knowledge and freedom, which can be used to minimize both risks and the consequences of disease; and (d) replicate historical patterns of inequities within pandemics, despite newer intervening mechanisms thought to ameliorate health consequences. Interventions should address social inequality to achieve health equity across pandemics.
Understanding Body-Worn Camera Diffusion in U.S. Policing
Authors: Nix Justin , Todak Natalie , Tregle Brandon
Published: April 2020

By 2016, approximately one half of American police agencies had adopted body-worn cameras (BWCs). Although a growing body of research has examined the impact of BWCs on outcomes such as use of force, complaints, and perceptions of police, few have considered how and why some agencies adopted BWCs, while others have not. With guidance from the diffusion of innovations paradigm, this study explores variation in BWC adoption by police agencies. Drawing on a survey administered to a national probability sample of 665 municipal police executives in the spring of 2018, we found agency size, region, and the demographic composition of municipalities were associated with BWC usage. We then examined executives’ support for (or opposition to) legislation that would require BWC footage to be released publicly. Results suggest (a) a variety of environmental factors were associated with support and (b) the correlates of support varied across agencies of different sizes.
Factors Influencing Speech-Language Pathologists’ Application of Terminology for Describing Pediatric Language Assessments
Authors: Denman Deborah , Wilson Nathan J. , Munro Natalie , Kim Jae-Hyun , Speyer Renée , Cordier Reinie
Published: April 2020

This study investigated speech-language pathologists’ (SLPs) perceptions of factors that influence application of a new taxonomy with terminology for describing child language assessment and identified strategies that may facilitate use of taxonomy terminology to collect data on SLP assessment practice. Semi-structured interviews were conducted with 13 SLPs and data were analyzed using thematic analysis. Three main themes were identified in relation to factors that may influence application including applying the taxonomy is arduous, contextual factors may influence application, and SLP experience and knowledge may influence application. Participants identified a number of strategies to facilitate use of taxonomy by SLPs. Findings from this study give insight into the factors that influence SLPs’ application of a taxonomy of assessment terms. These findings are important for all SLPs in the child language field to consider if the profession is to be effective in establishing greater consistency in use of professional terminology.
Taking a Moment for Life: Remembering Black Queer Lives Through Performance
Authors: Callier Durell M.
Published: April 2020

This essay foregrounds Black and queer youth stories of encountering and surviving violence, as reenacted through Tell It!: A Contemporary Chorale for Black Youth Voices. A performance ethnography, Tell It! draws from narratives on the bullying experienced inside and outside K-12 schooling contexts, and narratives of anti-Black and anti-queer violence. Throughout the essay, I argue for the reframing of anti-Black and anti-queer violence as mutually constitutive, coalescing within and through educative spaces and practices. Reflecting on the staged performance of Tell It!, I demonstrate how and why performances of Black and queer youth narratives enable the valuing of these lives and experiences. Rooted in the lives of Black and queer youth, this essay expands educational theory and practice by exploring how the coupling of queer pedagogy, race, and performance creates possibilities for new and different (queer) futures.
Breast Cancer: A Lifestyle Medicine Approach
Authors: Orman Amber , Johnson Dianne L. , Comander Amy , Brockton Nigel
Published: April 2020

Breast cancer is the most common female cancer diagnosis in the United States (excluding skin cancers), and the second leading cause of female cancer death. This article highlights the role that lifestyle plays in primary breast cancer prevention, breast cancer treatment, and tertiary breast cancer prevention. Current data regarding the benefits of a predominantly plant-based diet in combination with physical activity and maintenance of a healthy body weight will be reviewed. The evidenced-based patient-focused recommendations developed by the World Cancer Research Fund/American Institute for Cancer Research will be discussed in the context of an overall lifestyle strategy. It is our hope that this publication empowers clinicians to provide patients with personalized cancer-protective lifestyle prescriptions.
Produce Prescriptions, Food Pharmacies, and the Potential Effect on Food Choice
Authors: White Nicole D.
Published: April 2020

When it comes to health and longevity, what we eat may be the most important choice we make on a daily basis. This choice is influenced by a variety of determinants, including cost and accessibility of healthy foods as well as knowledge, attitudes and beliefs about how food impacts health. Produce prescriptions and food pharmacies are innovative care models directed at promoting intake of healthy foods. These programs as well as their potential effect on food choice is described.
Nitinol, Stainless Steel, and Titanium Kirschner Wire Durability
Authors: Jastifer James R. , Gustafson Peter A. , Silva Luis F. , Noffsinger Sarah , Coughlin Michael J.
Published: April 2020

Kirschner wires (K wires) are a common fixation device in foot and ankle surgery, particularly in lesser-toe fixation. Fatigue failure is a known complication of this fixation. The material properties of the K wire are a factor in the strength and durability of the wire. The purpose of this study is to compare the durability of K wires made of stainless steel, titanium, and Nitinol. Ten samples each of stainless steel, titanium. and Nitinol underwent cyclic durability testing using a rotating beam approach, and S-N curves (applied stress vs the number of cycles to failure) were generated. The results demonstrate that, generally, Nitinol K wires have a shorter life for the same applied stress than the stainless steel or titanium wires. Titanium had a longer life at low stresses compared with stainless steel, and stainless steel had a longer life at higher stresses. This study provides comparative durability data for K wires made of different metals, which have not been previously reported. Although there was a statistically significant difference in durability for wires used in K wire fixation, all 3 metal types are reasonable choices for temporary K wire fixation.

Levels of Evidence: Level 5: Mechanical study
Brain morphologic abnormalities in migraine patients: an observational study
Authors: Bonanno Lilla , Lo Buono Viviana , De Salvo Simona , Ruvolo Claudio , Torre Viviana , Bramanti Placido , Marino Silvia , Corallo Francesco
Published: April 2020

Background

Migraine is a common neurological disorder characterized by a complex physiopathology. We assessed brain morphologic differences in migraine and the possible pathogenetic mechanism underlying this disease.

Methods

We analyzed brain morphologic images of migraine patients, 14 with aura (MwA) [the mean (SD) age was 42.36 (2.95) years (range, 37–47)] and 14 without aura (MwoA) [the mean (SD) age was 43.5 (3.25) years (range, 39–50)] during episodic attack compared with health subjects balanced (HS) [the mean (SD) age was 42.5 (5.17) years (range, 34–51)]. All subjects underwent a Magnetic Resonance Imaging (MRI) examination with a scanner operating at 3.0 T and voxel based morphometry (VBM) approach was used to examine the gray matter volume (GMV). The statistical analysis to compare clinicl characteristics was performed using unpaired t-test an one-way Anova. Results: Total cerebral GMV showed a significant difference between MwA and HS (p = 0.02), and between MwoA and HS (p = 0.003). In addition, not significative differences were found between MwA and MwoA groups (p = 0.17). We found three clusters of regions which showed significant GMV reduction in MwA compared with MwoA. MwA subjects showed a less of GMV in 4 clusters if compared with HS, and MwoA subjects showed a less of GMV in 3 clusters if compared with HS. We observed that MwA and MwoA patients had a significant reduction of GMV in the frontal and temporal lobe and the cerebellum, if compared to HS. The bilateral fusiform gyrus and the cingulate gyrus were increase in MwoA patients compared with HS.

Conclusion

Our findings could provide a approach to understand possible differences in the pathogenesis of two type of migraine.
Preparation and Evaluation of Novel Emodin-loaded Stearic Acid-g-chitosan Oligosaccharide Nanomicelles
Authors: Jiang Xiaohong , Ma Mingxing , Li Mingjuan , Shao Shihong , Yuan Hong , Hu Fuqiang , Liu Jianwen , Huang Xuan
Published: April 2020

The purpose of this study was to prepare and characterize emodin-loaded stearic acid-g-chitosan oligosaccharide (CSO-SA/EMO) and to evaluate its antitumor activity in vitro. In this study, stearic acid-g-chitosan oligosaccharide was used as a carrier and its physicochemical properties were determined by different methods. Cell uptake behavior was examined using FITC-labeled stearic acid-g-chitosan oligosaccharide. CSO-SA/EMO was prepared using ultrasonication and dialysis. Particle size, surface potential, entrapment efficiency, and drug release behavior were studied in vitro. The effects of CSO-SA/EMO on gastric cancer cells were investigated using MTT assay and flow cytometry. Results showed CSO-SA/EMO particle size was larger and potential was smaller than that of stearic acid-g-chitosan oligosaccharide. The 12 h micellar uptake by MGC803 and BGC823 cells was sufficient, and the micelles were able to abundantly accumulate at lesion sites in mice thus achieving good passive EPR targeting. MTT and cell cycle arrest assays showed CSO-SA/EMO-enhanced antitumor activity significantly towards MGC803 and BGC823 cells compared with that of free emodine. Tumor volume, hematoxylin and eosin staining, and terminal deoxynucleotide transferase dUTP nick-end labeling assay proved CSO-SA/EMO had a significant antitumor effect on tumor tissues in vivo. In conclusion, the ultrasonication-dialysis method provided a simple and effective method for preparing CSO-SA/EMO. The delivery of emodine using a micelle system improved its antitumor effects effectively.
A review of ocular adverse events of biological anti-TNF drugs
Authors: Nicolela Susanna Fernanda , Pavesio Carlos
Published: April 2020

The recent introduction of biological agents has revolutionized the treatment of chronic immune-inflammatory diseases; however, this new therapy did not come without significant side effects.

Through large controlled studies indicating decrease in the number of uveitis flares, the role of TNF inhibitors therapy for non-infectious uveitis gained more ground. Paradoxically to its therapeutic effect, there are reports associating these drugs with the onset or recurrence of inflammatory eye disease.

A number of studies have suggested possible roles for anti-TNF-α agents in precipitating or worsening an underlying inflammatory process, including the hypothesis of a disequilibrium in cytokine balance, but to date the mechanisms responsible for these adverse events are not fully understood.

A PubMed literature search was performed using the following terms: ophthalmic complication, uveitis, inflammatory eye disease, optic neuritis, neuropathy, adverse events, anti-TNF, TNF alpha inhibitor, infliximab, etanercept, adalimumab, golimumab, certolizumab, and biologics. The data presented in this study was mainly derived from the use of TNF inhibitors in rheumatology, essentially because these drugs have been used for a longer period in this medical field.

Many of the ocular adverse events reported on this review may be considered a paradoxical effect of anti-TNF therapy. We found a variety of data associating new onset of uveitis with anti-TNF therapy for rheumatic conditions, predominantly under etanercept.

In conclusion, although there is increasing data on ocular adverse events, it remains to be seen whether the suggested link between TNF inhibitors and the onset of ocular inflammation is substantiated by more quality data. Nevertheless, the awareness of potential treatment side effects with anti-TNF should be highlighted.
Pattern and timing of diversification in the African freshwater fish genus Distichodus (Characiformes: Distichodontidae)
Authors: Arroyave Jairo , Denton John S. S. , Stiassny Melanie L. J.
Published: April 2020

Background

Distichodusis a clade of tropical freshwater fishes currently comprising 25 named species distributed continent-wide throughout the Nilo-Sudan and most Sub-Saharan drainages. This study investigates the phylogenetic relationships, timing of diversification, and biogeographic history of the genus from a taxonomically comprehensive mutilocus dataset analyzed using Maximum Likelihood and Bayesian methods of phylogenetic inference, coalescence-based species-tree estimation, divergence time estimation, and inference of geographic range evolution.

Results

Analyses of comparative DNA sequence data in a phylogenetic context reveal the existence of two major clades of similar species-level diversity and provide support for the monophyletic status of most sampled species. Biogeographic reconstruction on a time-scaled phylogeny suggest that the origins of the genus date back to the late Oligocene and that current geographic distributions are the result of a Congo Basin origin followed by dispersal and range expansion into adjacent ichthyofaunal provinces at different times during the evolutionary history of the group.

Conclusions

We present the most comprehensive phylogenetic, chronological, and biogeographic treatment yet conducted for the genus. The few instances of species paraphyly (D. teugelsi, D. fasciolatus) revealed by the resulting phylogenies are likely a consequence of post-divergence introgressive hybridization and/or incomplete lineage sorting due to recent speciation. Historical biogeographic findings are both in agreement and conflict with previous studies of other continent-wide African freshwater fish genera, suggesting a complex scenario for the assemblage of Africa’s continental ichthyofaunal communities.
How are systematic reviews of prevalence conducted? A methodological study
Authors:   on behalf of the Prevalence Estimates Reviews – Systematic Review Methodology Group (PERSyst), Borges Migliavaca Celina , Stein Cinara , Colpani Verônica , Barker Timothy Hugh , Munn Zachary , Falavigna Maicon
Published: April 2020

Background

There is a notable lack of methodological and reporting guidance for systematic reviews of prevalence data. This information void has the potential to result in reviews that are inconsistent and inadequate to inform healthcare policy and decision making. The aim of this meta-epidemiological study is to describe the methodology of recently published prevalence systematic reviews.

Methods

We searched MEDLINE (via PubMed) from February 2017 to February 2018 for systematic reviews of prevalence studies. We included systematic reviews assessing the prevalence of any clinical condition using patients as the unit of measurement and we summarized data related to reporting and methodology of the reviews.

Results

A total of 235 systematic reviews of prevalence were analyzed. The median number of authors was 5 (interquartile range [IQR] 4–7), the median number of databases searched was 4 (3–6) and the median number of studies included in each review was 24 (IQR 15–41.5). Search strategies were presented for 68% of reviews. Forty five percent of reviews received external funding, and 24% did not provide funding information. Twenty three percent of included reviews had published or registered the systematic review protocol. Reporting guidelines were used in 72% of reviews. The quality of included studies was assessed in 80% of reviews. Nine reviews assessed the overall quality of evidence (4 using GRADE). Meta-analysis was conducted in 65% of reviews; 1% used Bayesian methods. Random effect meta-analysis was used in 94% of reviews; among them, 75% did not report the variance estimator used. Among the reviews with meta-analysis, 70% did not report how data was transformed; 59% percent conducted subgroup analysis, 38% conducted meta-regression and 2% estimated prediction interval; I2 was estimated in 95% of analysis. Publication bias was examined in 48%. The most common software used was STATA (55%).

Conclusions

Our results indicate that there are significant inconsistencies regarding how these reviews are conducted. Many of these differences arose in the assessment of methodological quality and the formal synthesis of comparable data. This variability indicates the need for clearer reporting standards and consensus on methodological guidance for systematic reviews of prevalence data.
Bayesian joint modelling of longitudinal and time to event data: a methodological review
Authors: Alsefri Maha , Sudell Maria , García-Fiñana Marta , Kolamunnage-Dona Ruwanthi
Published: April 2020

Background

In clinical research, there is an increasing interest in joint modelling of longitudinal and time-to-event data, since it reduces bias in parameter estimation and increases the efficiency of statistical inference. Inference and prediction from frequentist approaches of joint models have been extensively reviewed, and due to the recent popularity of data-driven Bayesian approaches, a review on current Bayesian estimation of joint model is useful to draw recommendations for future researches.

Methods

We have undertaken a comprehensive review on Bayesian univariate and multivariate joint models. We focused on type of outcomes, model assumptions, association structure, estimation algorithm, dynamic prediction and software implementation.

Results

A total of 89 articles have been identified, consisting of 75 methodological and 14 applied articles. The most common approach to model the longitudinal and time-to-event outcomes jointly included linear mixed effect models with proportional hazards. A random effect association structure was generally used for linking the two sub-models. Markov Chain Monte Carlo (MCMC) algorithms were commonly used (93% articles) to estimate the model parameters. Only six articles were primarily focused on dynamic predictions for longitudinal or event-time outcomes.

Conclusion

Methodologies for a wide variety of data types have been proposed; however the research is limited if the association between the two outcomes changes over time, and there is also lack of methods to determine the association structure in the absence of clinical background knowledge. Joint modelling has been proved to be beneficial in producing more accurate dynamic prediction; however, there is a lack of sufficient tools to validate the prediction.
Study design factors influencing patients’ willingness to participate in clinical research: a randomised vignette-based study
Authors: Gayet-Ageron Angèle , Rudaz Sandrine , Perneger Thomas
Published: April 2020

Background

High patient participation in clinical research reduces selection bias and ensures the generalizability of study findings. We explored study-related factors that may influence patients’ willingness to participate in research.

Methods

We submitted by mail two vignettes that described clinical research studies – a drug trial and a diagnostic study – to patients recently discharged from hospital and assessed their willingness to participate. We used a factorial design to randomly allocate three study attributes per vignette: in the drug trial, presumed superiority of new drug versus equipoise, public versus industry funding, and random versus non-random treatment allocation; in the diagnostic study, common versus rare disease, genetic versus protein analysis, and automatic reporting of results versus reporting on request.

Results

Of 2600 patients contacted, 1140 (44%) participated. Globally, willingness to participate in a drug trial was lower than in a diagnostic study (44.8% vs. 76.2%; P < 0.001). In the drug trial, participation was significantly higher when the new drug was presented as presumably better than the old (vs. equipoise) and when the study was funded by public sources (vs. industry), but was not affected by the allocation method. None of the factors tested in the diagnostic study was associated with participation.

Conclusions

Patients were more likely to participate in a hypothetical observational diagnostic study than in a hypothetical drug trial. Participation in the trial was lower when clinical equipoise was expressed and when the trial was funded by industry. These results suggest that some features of study design can influence participation.
Ordinal logistic regression model describing factors associated with extent of nodal involvement in oral cancer patients and its prospective validation
Authors: Singh Vishwajeet , Dwivedi Sada Nand , Deo S. V. S.
Published: April 2020

Background

Oral cancer is the most common cancer among Indian men, and has strong tendency of metastatic spread to neck lymph node which strongly influences prognosis especially 5 year survival-rate and also guides the related managements more effectively. Therefore, a reliable and accurate means of preoperative evaluation of extent of nodal involvement becomes crucial. However, earlier researchers have preferred to address mainly its dichotomous form (involved/not-involved) instead of ordinal form while dealing with epidemiology of nodal involvement. As a matter of fact, consideration of ordinal form appropriately may increase not only the efficiency of the developed model but also accuracy in the results and related implications. Hence, to develop a model describing factors associated with ordinal form of nodal involvement was major focus of this study.

Methods

The data for model building were taken from the Department of Surgical Oncology, Dr.BRA-IRCH, AIIMS, New Delhi, India. All the OSCC patients (duly operated including neck dissection) and confirmed histopathologically from 1995 to 2013 were included. Further, another data of 204 patients collected prospectively from 2014 to 2015 was considered for the validation of the developed model. To assess the factors associated with extent of nodal involvement, as a first attempt in the field of OSCC, stepwise multivariable regression procedure was used and results are presented as odds-ratio and corresponding 95% confidence interval (CI). For appropriate accounting of ordinal form, the ordinal models were assessed and compared. Also, performance of the developed model was validated on a prospectively collected another data.

Results

Under multivariable proportional odds model, pain at the time of presentation, sub mucous fibrosis, palpable neck node, oral site and degree of differentiation were found to be significantly associated factors with extent of nodal involvement. In addition, tumor size also emerged to be significant under partial-proportional odds model.

Conclusions

The analytical results under the present study reveal that in case of ordinal form of the outcome, appropriate ordinal regression may be a preferred choice. Present data suggest that, pain, sub mucous fibrosis, palpable neck node, oral site, degree of differentiation and tumor size are the most probable associated factors with extent of nodal involvement.
Does early identification of high work related stress affect pharmacological treatment of primary care patients? - analysis of Swedish pharmacy dispensing data in a randomised control study
Authors: Bjerkeli Pernilla J. , Skoglund Ingmarie , Holmgren Kristina
Published: April 2020

Background

The study is part of a randomised controlled trial with the overall aim to evaluate if use of the Work Stress Questionnaire (WSQ), combined with feedback at consultation, can be used by healthcare professionals in primary health care to prevent sickness absence. The specific aim of the present study was to investigate whether there were differences in pharmacy dispensing of prescription medications between the intervention group and the control group.

Methods

The study was a randomized controlled trial. Non-sick-listed employed women and men, aged 18 to 64 years, seeking care at primary health care centres (PHCCs) were eligible participants. The intervention included early identification of work-related stress by the WSQ, general practitioner (GP) training and GP feedback at consultation. Pharmacy dispensing data from the Swedish Prescription Drug Register for a period of 12 months following the intervention was used. Primary outcomes were the number of different medications used, type of medication and number of prescribing clinics. Data was analysed using Mann Whitney U tests and chi-square tests.

Results

The study population included 271 individuals (132 in the intervention group and 139 in the control group). The number of different medications used per individual did not differ significantly between the control group (median 4.0) and the intervention group (median 4.0,p-value 0.076). The proportion of individuals who collected more than 10 different medications was higher in the control group than in the intervention group (15.8% versus 4.5%,p = 0.002). In addition, the proportion of individuals filling prescriptions issued from more than three different clinics was higher in the control group than in the intervention group (17.3% versus 6.8%,p = 0.007).

Conclusion

Systematic use of the WSQ combined with training of GPs and feedback at consultation may affect certain aspects of pharmacological treatment in primary health care patients. In this randomised control trial, analysis of pharmacy dispensing data show that patients in the intervention group had less polypharmacy and filled prescriptions issued from a smaller number of different clinics.

Trial registration

ClinicalTrials.gov. Identifier:NCT02480855. Registered 20 May 2015.
Impact of symptom severity in patients with diarrhoea-predominant irritable bowel syndrome (IBS-D): results from two separate surveys of HCPs and patients with IBS-D
Authors: Emmanuel Anton , Goosey Richard William , Wiseman Gwen , Baker Stephen , Törnblom Hans
Published: April 2020

Background

Management of diarrhoea-predominant irritable bowel syndrome (IBS-D) is generally based on patient-reported symptoms; however, limited information on symptom severity exists. The objective of the study was to assess the impact of IBS-D severity on patient burden and patient and healthcare professional attitudes towards IBS.

Methods

We conducted two web-based surveys of healthcare professionals and patients from Australia, Canada and Europe. We analysed patient characteristics and attitudes by IBS-D severity, which was assessed retrospectively using a composite of four variables: worst abdominal pain, IBS symptom frequency, Bristol Stool Form Scale and quality of life.

Results

Of 679 healthcare professional respondents, one-third routinely classified patients by severity. The patient survey was completed by 513 patients with mild (26%), moderate (33%) and severe (41%) IBS-D, classified using the composite scale. Age, sex and treatment satisfaction did not change with severity; however, 19% of patients classified with severe IBS-D agreed with the statement: ‘When my IBS is bad, I wish I was dead’ versus 4 and 7% of patients with mild and moderate IBS-D, respectively (p < 0.05). Significantly more patients classified with severe IBS-D reported medication use versus mild IBS-D.

Conclusion

Compared with milder symptoms, severe IBS-D was associated with increased medication use and a negative perspective of IBS-D. This highlights the need for a validated severity scale to inform treatment decisions.
Microbiology testing associated with antibiotic dispensing in older community-dwelling adults
Authors: Peng Zhuoxin , Hayen Andrew , Kirk Martyn D. , Pearson Sallie , Cheng Allen C. , Liu Bette
Published: April 2020

Background

It is commonly recommended that microbiological assessment should accompany the use of antibiotics prone to resistance. We sought to estimate the rate of microbiology testing and compare this to dispensing of the World Health Organization classified “watch” group antibiotics in primary care.

Methods

Data from a cohort of older adults (mean age 69 years) were linked to Australian national health insurance (Pharmaceutical Benefits Scheme & Medicare Benefits Schedule) records of community-based antibiotic dispensing and microbiology testing in 2015. Participant characteristics associated with greater watch group antibiotic dispensing and microbiology testing were estimated using adjusted incidence rate ratios (aIRR) and 95% confidence intervals (CI) in multivariable zero-inflated negative binomial regression models.

Results

In 2015, among 244,299 participants, there were 63,306 watch group antibiotic prescriptions dispensed and 149,182 microbiology tests conducted; the incidence rate was 0.26 per person-year for watch group antibiotic dispensing and 0.62 for microbiology testing. Of those antibiotic prescriptions, only 19% were accompanied by microbiology testing within − 14 to + 7 days. After adjusting for socio-demographic factors and co-morbidities, individuals with chronic respiratory diseases were more likely to receive watch group antibiotics than those without, e.g. asthma (aIRR:1.59, 95%CI:1.52–1.66) and chronic obstructive pulmonary disease (COPD) (aIRR:2.71, 95%CI:2.48–2.95). However, the rate of microbiology testing was not comparably higher among them (with asthma aIRR:1.03, 95%CI:1.00–1.05; with COPD aIRR:1.00, 95%CI:0.94–1.06).

Conclusions

Priority antibiotics with high resistance risk are commonly dispensed among community-dwelling older adults. The discord between the rate of microbiology testing and antibiotic dispensing in adults with chronic respiratory diseases suggests the potential for excessive empirical prescribing.
Two distinct phenotypes, hemiplegic migraine and episodic Ataxia type 2, caused by a novel common CACNA1A variant
Authors: Nardello Rosaria , Plicato Giorgia , Mangano Giuseppe Donato , Gennaro Elena , Mangano Salvatore , Brighina Filippo , Raieli Vincenzo , Fontana Antonina
Published: April 2020

Background

To investigate the genetic and environmental factors responsible for phenotype variability in a family carrying a novel CACNA1A missense mutation. Mutations in the CACNA1A gene were identified as responsible for at least three autosomal dominant disorders: FHM1 (Familial Hemiplegic Migraine), EA2 (Episodic Ataxia type 2), and SCA6 (Spinocerebellar Ataxia type 6). Overlapping clinical features within individuals of some families sharing the same CACNA1A mutation are not infrequent. Conversely, reports with distinct phenotypes within the same family associated with a common CACNA1A mutation are very rare.

Case presentation

A clinical, molecular, neuroradiological, neuropsychological, and neurophysiological study was carried out in proband and his carrier mother. The new heterozygous missense variant c.4262G > A (p.Arg1421Gln) in the CACNA1A gene was detected in the two affected family members. The proband showed a complex clinical presentation characterized by developmental delay, poor motor coordination, hemiplegic migraine attacks, behavioral dysregulation, and EEG abnormalities. The mother showed typical episodic ataxia attacks during infancy with no other comorbidities and mild cerebellar signs at present neurological evaluation.

Conclusions

The proband and his mother exhibit two distinct clinical phenotypes. It can be hypothesized that other unknown modifying genes and/or environmental factors may cooperate to generate the wide intrafamilial variability.
Relationship of endoscopic lesions of the renal papilla with type of renal stone and 24 h urine analysis
Authors: Sabaté Arroyo X.A. , Grases Freixedas F. , Bauzà Quetglas J. L. , Guimerà Garcia J. , Pieras Ayala E.
Published: April 2020

Background

Our purpose was to study the relationship of the 3 different types of endoscopic calcifications of the renal papilla (Randall’s plaque, intratubular calcification, papillary crater) with the type of stone and urine analysis.

Methods

This prospective study examined 41 patients (age range: 18 to 80 years) who received retrograde intrarenal surgery (RIRS) for renal lithiasis (mean stone size: 15.3 ± 7.2 mm). The renal papilla injuries were endoscopically classified as Randall’s plaque, intratubular calcification, or papillary crater. Calculi were classified as uric acid, calcium oxalate monohydrate (COM; papillary and cavity), calcium oxalate dihydrate (COD), or calcium phosphate (CP). A 24 h urine analysis of calcium, oxalate, citrate, phosphate, and pH was performed in all patients. The relationship of each type of papillary injury with type of stone and urine chemistry was determined. Fisher’s exact test and Student’s t-test were used to determine the significance of relationships, and a p value below 0.05 was considered significant.

Results

The most common injury was tubular calcification (78%), followed by Randall’s plaque (58%), and papillary crater (39%). There was no significant relationship of Randall’s plaque with type of stone. However, endoscopic intratubular calcification (p = 0.025) and papillary crater (p = 0.041) were more common in patients with COD and CP stones. There were also significant relationships of papillary crater with hypercalciuria (p = 0.036) and hyperoxaluria (p = 0.024), and of Randall’s plaque with hypocitraturia (p = 0.005).

Conclusions

There are certain specific relationships between the different types of papillary calcifications that were endoscopically detected with stone chemistry and urine analysis. COD and CP stones were associated with endoscopic tubular calcifications and papillary craters. Hypercalciuria was associated with tubular calcification, and hypocitraturia was associated with Randall’s plaque.