bluuebunny/crossref_metadata_2025 huggingface dataset:
Generic Drug Policy and Suboxone to Treat Opioid Use Disorder
Authors: Haffajee Rebecca L. , Frank Richard G.
Published: January 2020

Despite some improvements in access to evidence-based medications for opioid use disorder, treatment rates remain low at under a quarter of those with need. High costs for brand name products in these medication markets have limited the volume of drugs purchased, particularly through public health insurance and grant programs. Brand firm anti-competitive practices around the leading buprenorphine product Suboxone — including product hops, citizen petitions and Risk Evaluation and Mitigation Strategy abuses — helped to maintain high prices by extending brand exclusivity periods and hindering generic drug entry. Remedies to address costly anti-competitive activities include adoption of the proposed CREATES Act and modernization of the Hatch-Waxman Act by the Congress, and implementation of substantive modifications to the Food and Drug Administration citizen petition filing procedures. Given the persistence of these abuses, prescriptive changes are favorable to the procedural and clarifying steps thus far favored by the federal government. Extrapolating from the 37% price declines attributable to generic entry for buprenorphine tablets in 2011, our calculations suggest that implementing these remedies to facilitate generic competition with Suboxone film would have resulted in savings of approximately $703 million overall and $203 million to Medicaid in 2017.
Health Reform and Higher Ed: Campuses as Harbingers of Medicaid Universality and Medicare Commonality
Authors: Sanford Sallie Thieme
Published: January 2020

Between 2010 and 2016, the percentage of uninsured higher education students dropped by more than half. All the Affordable Care Act's key access provisions contributed, but the most important factor appears to be the Medicaid expansion. This article is the first to highlight this phenomenon and ground it in data. It explores the reasons for this dramatic expansion of coverage, links it to theoretical frameworks, and considers its implications for the future of health reform. Drawing on Medicaid universality scholarship, I discuss potential consequences of including the educationally privileged in this historically stigmatized program. Extending this scholarship, I argue that the student experience and its reverberating effects portend support for emerging proposals to make Medicare a more common option. Woven into both analyses is the role of the Trump-era retrenchment, notably the administration's promotion of Medicaid “work or community engagement” requirements and of cheap, skimpy plans. Higher education students were an afterthought in the ACA's debates, and yet the law has profoundly impacted their coverage options. Students are now much more likely to have health insurance, and for it to be comprehensive. Looking to the next decade, the student experience harbingers support for both Medicaid universality and Medicare commonality.
Early Reading Instruction With Embedded Behavioral Supports for Children With Emotional and Behavioral Disorders
Authors: Garwood Justin D. , McKenna John W. , Ciullo Stephen
Published: January 2020

Professional development in research-based early reading intervention and curriculum materials is not consistently available to special educators working with students with emotional and behavioral disorders (EBD). This article provides practitioners serving elementary school students with and at risk for EBD with a variety of options for delivering reading instruction with embedded behavioral supports.
Climate Change and South Africa: A Critical Analysis of the Earthlife Africa Johannesburg and Another v Minister of Energy and Others 65662/16 (2017) Case and the Drive for Concrete Climate Practices
Authors: van der Bank Marjoné , Karsten Jaco
Published: January 2020

The findings and recommendations of this article will redound to the benefit of society considering that climate change regulation plays an important role in the promotion of a sustainable environment. The greater demand for a clean and healthy environment justifies the need for more effective regulation of climate change, and this can be achieved through climate change impact assessments. In the High Court case of EarthLife Africa Johannesburg v Minister of Environmental Affairs and Others, the court considered what the impact of the Thabametsi Power Project on the global climate and the changing climate will be if it is operated to the expected year of 2060. This judgement highlights the significance, place, and principles of climate change impact assessments in South Africa’s environmental law that has its founding principles in the Constitution of the Republic of South Africa, 1996. The Thabametsi-case contributed to environmental litigation in the manner as to how equality and the rule of law have been addressed in the court. This paper will examine the advances for climate change regulation in a jurisdiction where the Environmental Impact Assessment (EIA) Regulations currently refer to climate change explicitly.
Pre-service teachers articulating their learning about meaningful physical education
Authors: Fletcher Tim , Chróinín Déirdre Ní , O’Sullivan Mary , Beni Stephanie
Published: January 2020

The purpose of this research was to examine pre-service teachers’ articulation of their learning through the development of a shared professional language of teaching practice focused on meaningful physical education. Qualitative data gathered from 90 pre-service teachers over four years in Canada and Ireland were analysed. Framed by a didactical research framework, pre-service teachers used elements of the shared language to articulate why they would promote meaningful experiences in physical education, what the features of meaningful experiences tend to consist of, and how they would use particular strategies to promote meaningful experiences. This research demonstrates how a shared language that reflects a coherent approach in physical education teacher education can support pre-service teachers to access, interpret, and articulate their learning about teaching in ways that support meaningful experiences for pupils.
A kinetic and mechanistic study of the osmium(VIII)-catalysed oxidation of crotyl alcohol by hexacyanoferrate(III) in aqueous Alkaline medium
Authors: Sharma Priyamvada , Sailani Riya , Meena Anita , Khandelwal Chandra Lata
Published: January 2020

The kinetics and mechanism of the osmium(VIII)-catalysed oxidation of crotyl alcohol by hexacyanoferrate(III) in aqueous alkaline medium is studied. The role of the osmium(VIII) catalyst is delineated to account for the experimental observations. A plausible reaction mechanism is suggested. Activation parameters such as the energy and entropy of activation are evaluated by employing the Eyring equation and are found to be 36.833 kJ mol−1 and −141.518 J K−1 mol−1, respectively.
Methodological Challenges in Retrospective Evaluation of Mental Health Court Effectiveness
Authors: Prince Kort C. , Jaggers Jeremiah W. , Walker Allyn , Shade Jess , Worwood Erin B.
Published: January 2020

Mental Health Courts (MHCs) are problem-solving courts that have been implemented throughout the United States. One critical component of MHCs is determining their effectiveness and limitations. However, unique challenges are encountered when evaluating MHCs. One major challenge, and the focus of this paper, is identifying an adequate control group. The ideal approach to determining efficacy is using a controlled group design whereby participants are randomized to treatment or control conditions. However, this approach is not possible when conducting retrospective evaluation of court data. In addition, a specific set of ethical and logistical issues arise. Propensity score matching (PSM) provides an alternative approach for comparing groups when randomization is not possible. PSM works by first identifying the characteristics that make a person likely to be in treatment. We describe our attempts to use PSM in a MHC evaluation. Specific challenges with PSM are discussed and recommendations are made for use of PSM with MHCs.
Comparison of optical coherence tomography measurements between high hyperopic and low hyperopic children
Authors: Dikkaya Funda , Karaman Erdur Sevil
Published: January 2020

Purpose:

To identify the peripapillary retinal nerve fiber layer, total macular, ganglion cell layer, and inner plexiform layer thicknesses in children with high hyperopia using spectral domain optical coherence tomography.

Methods:

Twenty-one children with high hyperopia and 20 controls were enrolled in this study. Subjects with spherical equivalent +5.0 D or higher were evaluated in the study group and subject with spherical equivalent between +0.25 and +2.0 D in the control group. The retinal nerve fiber layer thickness, macular thickness, macular ganglion cell layer and inner plexiform layer thicknesses were measured using a spectral domain optical coherence tomography, and results were compared between groups.

Results:

The nasal and inferior quadrant and the global retinal nerve fiber layer thickness were significantly thicker in the study group. The mean thickness of inferior quadrant of the inner macula was significantly thicker in the study group than those in the control group. The mean thickness of the ganglion cell layer in nasal, temporal and inferior quadrant of outer macula was significantly thinner in the study group than the control group. The mean thickness of the inner plexiform layer in the inferior quadrant of the inner macula and nasal and inferior quadrant of the outer macula were significantly higher in study group than those in control group.

Conclusion:

High hyperopic children had thicker retinal nerve fiber layer when compared to the controls. This difference should be taken into account when evaluating children with glaucoma or other optic disc disorders.
Improving management of comorbidity in patients with colorectal cancer using comprehensive medical assessment: a pilot study
Authors: Signal Virginia , Jackson Christopher , Signal Louise , Hardie Claire , Holst Kirsten , McLaughlin Marie , Steele Courtney , Sarfati Diana
Published: January 2020

Background

Screening for and active management of comorbidity soon after cancer diagnosis shows promise in altering cancer treatment and outcomes for comorbid patients. Prior to a large multi-centre study, piloting of the intervention (comprehensive medical assessment) was undertaken to investigate the feasibility of the comorbidity screening tools and proposed outcome measures, and the feasibility, acceptability and potential effect of the intervention.

Methods

In this pilot intervention study, 72 patients of all ages (36 observation/36 intervention) with newly diagnosed or recently relapsed colorectal adenocarcinoma were enrolled and underwent comorbidity screening and risk stratification. Intervention patients meeting pre-specified comorbidity criteria were referred for intervention, a comprehensive medical assessment carried out by geriatricians. Each intervention was individually tailored but included assessment and management of comorbidity, polypharmacy, mental health particularly depression, functional status and psychosocial issues. Recruitment and referral to intervention were tracked, verbal and written feedback were gathered from staff, and semi-structured telephone interviews were conducted with 13 patients to assess screening tool and intervention feasibility and acceptability. Interviews were transcribed and analysed thematically. Patients were followed for 6–12 months after recruitment to assess feasibility of proposed outcome measures (chemotherapy uptake and completion rates, grade 3–5 treatment toxicity, attendance at hospital emergency clinic, and unplanned hospitalisations) and descriptive data on outcomes collated.

Results

Of the 29 intervention patients eligible for the intervention, 21 received it with feedback indicating that the intervention was acceptable. Those in the intervention group were less likely to be on 3+ medications, to have been admitted to hospital in previous 12 months, or to have limitations in daily activities. Collection of data to measure proposed outcomes was feasible with 55% (6/11) of intervention patients completing chemotherapy as planned compared to none (of 14) of the control group. No differences were seen in other outcome measures. Overall the study was feasible with modification, but the intervention was difficult to integrate into clinical pathways.

Conclusions

This study generated valuable results that will be used to guide modification of the study and its approaches prior to progressing to a larger-scale study.

Trial registration

Retrospective, 26 August 2019, ACTRN12619001192178.
The role of perceived stress and cognitive function on the relationship between neuroticism and depression among the elderly: a structural equation model approach
Authors: Banjongrewadee Mukda , Wongpakaran Nahathai , Wongpakaran Tinakon , Pipanmekaporn Tanyong , Punjasawadwong Yodying , Mueankwan Sirirat
Published: January 2020

Background

Depression comprises common psychological problems, and has been strongly related to neuroticism and perceived stress. While neuroticism has been shown to have a direct effect on depression, it also has an indirect effect via perceived stress. Among the elderly, cognitive function produces influences that should not be overlooked when investigating depression. This study aimed to determine the role of mediating effects of perceived stress as well as cognitive function on neuroticism and depression among elderly patients.

Methods

This research constituted a secondary analysis, with data collected during the pre-operative period of 429 elderly individuals undergoing elective, noncardiac surgery. The evaluation included the Perceived Stress Scale, the Neuroticism Inventory, the Montreal Cognitive Assessment, and the Geriatric Depression Scale. Structural equation modeling was used to investigate the hypothesized model.

Results

Neuroticism exhibited a significant indirect effect on perceived stress via depression and cognition (β = 0.162, 95% CI 0.026, 0.322, p = .002). Neuroticism initially had a direct effect on depression (β = 0.766, 95% CI 0.675, 0.843 p = 0.003); thereafter, it was reduced after covariates were added (β = 0.557, 95% CI 0.432, 0.668 p = 0.002). Based on this model, the total variance explained by this model was 67%, and the model showed an acceptable fit with the data.

Conclusions

Both perceived stress and cognitive function partially mediated the effect of neuroticism on depression, with perceived stress exhibiting a greater effect.

Trial registration

The study protocol has been registered at Clinicaltrials.gov under registered number: NCT02131181.
The impact of COPD on polyneuropathy: results from the German COPD cohort COSYCONET
Authors: Kahnert K. , Föhrenbach M. , Lucke T. , Alter P. , Trudzinski F. T. , Bals R. , Lutter J. I. , Timmermann H. , Söhler S. , Förderreuther S. , Nowak D. , Watz H. , Waschki B. , Behr J. , Welte T. , Vogelmeier C. F. , Jörres R. A.
Published: January 2020

Background

Peripheral neuropathy is a common comorbidity in COPD. We aimed to investigate associations between alterations commonly found in COPD and peripheral neuropathy, with particular emphasize on the distinction between direct and indirect effects.

Methods

We used visit 4 data of the COPD cohort COSYCONET, which included indicators of polyneuropathy (repeated tuning fork and monofilament testing), excluding patients with diabetes a/o increased HbA1c. These indicators were analysed for the association with COPD characteristics, including lung function, blood gases, 6-min walk distance (6-MWD), timed-up-and-go-test (TUG), exacerbation risk according to GOLD, C-reactive protein (CRP), and ankle-brachial index (ABI). Based on the results of conventional regression analyses adjusted for age, BMI, packyears and gender, we utilized structural equation modelling (SEM) to quantify the network of direct and indirect relationships between parameters.

Results

606 patients were eligible for analysis. The indices of polyneuropathy were highly correlated with each other and related to base excess (BE), ABI and TUG. ABI was linked to neuropathy and 6-MWD, exacerbations depended on FEV1, 6-MWD and CRP. The associations could be summarized into a SEM comprising polyneuropathy as a latent variable (PNP) with three measured indicator variables. Importantly, PNP was directly dependent on ABI and particularly on BE. When also including patients with diabetes and/or elevated values of HbA1c (n = 742) the SEM remained virtually the same.

Conclusion

We identified BE and ABI as major determinants of peripheral neuropathy in patients with COPD. All other associations, particularly those with lung function and physical capacity, were indirect. These findings underline the importance of alterations of the micromilieu in COPD, in particular the degree of metabolic compensation and vascular status.
Effects of cyclic adenosine monophosphate modulators on maturation and quality of vitrified-warmed germinal vesicle stage mouse oocytes
Authors: Lee Dayong , Lee Hyang Heun , Lee Jung Ryeol , Suh Chang Suk , Kim Seok Hyun , Kim S. Samuel
Published: January 2020

Background

It is still one of the unresolved issues if germinal vesicle stage (GV) oocytes can be successfully cryopreserved for fertility preservation and matured in vitro without damage after warming. Several studies have reported that the addition of cyclic adenosine monophosphate (cAMP) modulators to in vitro maturation (IVM) media improved the developmental potency of mature oocytes though vitrification itself provokes cAMP depletion. We evaluated whether the addition of cAMP modulators after GV oocytes retrieval before vitrification enhances maturation and developmental capability after warming of GV oocytes.

Methods

Retrieved GV oocytes of mice were divided into cumulus-oocyte complexes (COCs) and denuded oocytes (DOs). Then, GV oocytes were cultured with or without dibutyryl-cAMP (dbcAMP, cAMP analog) and 3-isobutyl-l-methylxanthine (phosphodiesterase inhibitor) during the pre-vitrification period for 30 min.

Results

One hour after warming, the ratio of oocytes that stayed in the intact GV stage was significantly higher in groups treated with cAMP modulators. After 18 h of IVM, the percentage of maturation was significantly higher in the COC group treated with dbcAMP. The expression of F-actin, which is involved in meiotic spindle migration and chromosomal translocation, is likewise increased in this group. However, there was no difference in chromosome and spindle organization integrity or developmental competence between the MII oocytes of all groups.

Conclusions

Increasing the intracellular cAMP level before vitrification of the GV oocytes maintained the cell cycle arrest, and this process may facilitate oocyte maturation after IVM by preventing cryodamage and synchronizing maturation between nuclear and cytoplasmic components. The role of cumulus cells seems to be essential for this mechanism.
A scoping review of the uses and institutionalisation of knowledge for health policy in low- and middle-income countries
Authors: Koon Adam D. , Windmeyer Lauren , Bigdeli Maryam , Charles Jodi , El Jardali Fadi , Uneke Jesse , Bennett Sara
Published: January 2020

There is growing interest in how different forms of knowledge can strengthen policy-making in low- and middle-income country (LMIC) health systems. Additionally, health policy and systems researchers are increasingly aware of the need to design effective institutions for supporting knowledge utilisation in LMICs. To address these interwoven agendas, this scoping review uses the Arskey and O’Malley framework to review the literature on knowledge utilisation in LMIC health systems, using eight public health and social science databases. Articles that described the process for how knowledge was used in policy-making, specified the type of knowledge used, identified actors involved (individual, organisation or professional), and were set in specific LMICs were included. A total of 53 articles, from 1999 to 2016 and representing 56 countries, were identified. The majority of articles in this review presented knowledge utilisation as utilisation of research findings, and to a lesser extent routine health system data, survey data and technical advice. Most of the articles centered on domestic public sector employees and their interactions with civil society representatives, international stakeholders or academics in utilising epistemic knowledge for policy-making in LMICs. Furthermore, nearly all of the articles identified normative dimensions of institutionalisation. While there is some evidence of how different uses and institutionalisation of knowledge can strengthen health systems, the evidence on how these processes can ultimately improve health outcomes remains unclear. Further research on the ways in which knowledge can be effectively utilised and institutionalised is needed to advance the collective understanding of health systems strengthening and enhance evidence-informed policy formulation.
Whole genome sequencing and genetic variations in several dengue virus type 1 strains from unusual dengue epidemic of 2017 in Vietnam
Authors: Dang Thuy Thi , Pham My Ha , Bui Huy Vu , Van Le Duyet
Published: January 2020

Background

Dengue hemorrhagic fever is an acute viral infection transmitted by mosquitoes. In the 2017, a dengue epidemic occurred in Hanoi in a short time interval and many cases were serious with associated mortality. This was the largest and unusual dengue fever outbreak in the North of Vietnam over the past 20 years. The objective of the present study was to understand the genetic characteristics of the DENV-1 strain in the 2017 epidemic and its relationship with previous viruses in Vietnam and the rest of the world.

Methods

Complete genomes of 72 DENV-1 from patients in the 2017 epidemic were sequenced using NGS. The full genome sequences were then analyzed to find out the genetic variants in the groups of 72 strains, followed by their comparison with other strains that caused disease in Vietnam previously and several other regions of the world, revealing a genetic relationship between them.

Results

The complete genome sequence of 72 DENV-1 strains comprised 10,697 nucleotides with an open reading frame coding for 3392 amino acids. The genomic analysis revealed different amino acid substitutions in all genes, especially varying at position S75 (Capsid), M125 (PrM), D54 (E), T147, V180 (NS1), G45, Y126, I154 (NS2A), A94 (NS2B), M298 (NS3), K47, V68 (NS4A), I29 (NS4B), and R166, E536, G614, T821 (NS5). The genetic analysis suggested that the viruses were most closely related to the causative virus of the dengue outbreak in Vietnam and Cambodia from 2006 to 2008. These results indicated that DENV-1 from the dengue epidemic 2017 in Northern Vietnam originated from the virus that caused the dengue outbreak during the 2007 to 2008 period in Vietnam.

Conclusion

The present study is the first of its kind to describe complete genome sequence as well as genetic variants and phylogenetic analysis of DENV-1 associated with the unusual dengue epidemic of 2017 in northern Vietnam. These results provide detailed evidence to elucidate the origin, circulation, and genetic evolution of DENV in Vietnam.
Mechanisms of lung toxicity induced by biomass burning aerosols
Authors: Pardo Michal , Li Chunlin , He Quanfu , Levin-Zaidman Smadar , Tsoory Michael , Yu Qingqing , Wang Xinming , Rudich Yinon
Published: January 2020

Background

Carbonaceous aerosols emitted from indoor and outdoor biomass burning are major risk factors contributing to the global burden of disease. Wood tar aerosols, namely, tar ball particles, compose a substantial fraction of carbonaceous emissions, especially from biomass smoldering. However, their health-related impacts and toxicity are still not well known. This study investigated the toxicity of the water-soluble fraction of pyrolyzed wood tar aerosols in exposed mice and lung epithelial cells.

Results

Mice exposed to water-soluble wood tar aerosols showed increased inflammatory and oxidative stress responses. Bronchial epithelial cells exposed to the same water-soluble wood tar aerosols showed increased cell death with apoptotic characteristics. Alterations in oxidative status, including changes in reactive oxygen species (ROS) levels and reductions in the expression of antioxidant genes related to the transcription factor Nrf2, were observed and were confirmed by increased levels of MDA, a lipid peroxidation adduct. Damage to mitochondria was observed as an early event responsible for the aforementioned changes.

Conclusions

The toxicity and health effect-related mechanisms of water-soluble wood tar were investigated for the first time in the context of biomass burning. Wood tar particles may account for major responses such as cell death, oxidative stress, supression of protection mechnaisms and mitochondrial damaged cause by expsoure to biomass burning aerosols.
Government policy and agricultural production: a scoping review to inform research and policy on healthy agricultural commodities
Authors: Lencucha Raphael , Pal Nicole E. , Appau Adriana , Thow Anne-Marie , Drope Jeffrey
Published: January 2020

Unhealthy foods and tobacco remain the leading causes of non-communicable disease (NCDs). These are key agricultural commodities for many countries, and NCD prevention policy needs to consider how to influence production towards healthier options. There has been little scholarship to bridge the agriculture with the public health literature that seeks to address the supply of healthy commodities. This scoping review synthesizes the literature on government agricultural policy and production in order to 1) present a typology of policies used to influence agricultural production, 2) to provide a preliminary overview of the ways that impact is assessed in this literature, and 3) to bring this literature into conversation with the literature on food and tobacco supply.

This review analyzes the literature on government agricultural policy and production. Articles written in English and published between January 1997 and April 2018 (20-year range) were included. Only quantitative evaluations were included. Studies that collected qualitative data to supplement the quantitative analysis were also included. One hundred and three articles were included for data extraction. The following information was extracted: article details (e.g., author, title, journal), policy details (e.g., policy tools, goals, context), methods used to evaluate the policy (e.g., outcomes evaluated, sample size, limitations), and study findings. Fifty four studies examined the impact of policy on agricultural production. The remaining articles assessed land allocation (n = 25) (e.g., crop diversification, acreage expansion), efficiency (n = 23), rates of employment including on- and off-farm employment (n = 18), and farm income (n = 17) among others. Input supports, output supports and technical support had an impact on production, income and other outcomes. Although there were important exceptions, largely attributed to farm level allocation of labour or resources. Financial supports were most commonly evaluated including cash subsidies, credit, and tax benefits. This type of support resulted in an equal number of studies reporting increased production as those with no effects.

This review provides initial extrapolative insights from the general literature on the impact of government policies on agricultural production. This review can inform dialogue between the health and agricultural sector and evaluative research on policy for alternatives to tobacco production and unhealthy food supply.
Appalachian disparities in tobacco cessation treatment utilization in Medicaid
Authors: Goodin Amie , Talbert Jeffery , Freeman Patricia R. , Hahn Ellen J. , Fallin-Bennett Amanda
Published: January 2020

Background

Kentucky Medicaid enrollees, particularly those in the rural Appalachian region, face disproportionate smoking rates and tobacco-related disease burden relative to the rest of the United States (US). The Affordable Care Act (ACA) mandated tobacco cessation treatment coverage by the US public health insurance program Medicaid. Medicaid coverage was also expanded in Kentucky, in 2013, with laxer income eligibility requirements. This short report describes tobacco use incidence and tobacco cessation treatment utilization, comparing by Appalachian status before and after ACA-mandated cessation treatment coverage.

Methods

The study design was a retrospective cross-sectional analysis from 2013 to 2015. Subjects were Medicaid enrollees with 1) diagnosis of any tobacco use (2013 n = 541,349; 2014 n = 864,183; 2015 n = 1,090,274); and/or (2) procedure claim for tobacco cessation counseling, and/or (3) pharmaceutical claim for varenicline or any nicotine replacement product. Primary measures included tobacco use incidence and proportion of users receiving cessation treatment. Analysis was via chi square testing of change by year.

Results

Overall, the proportion of tobacco users utilizing cessation treatment decreased (4.75% tobacco users in 2013; 3.15% in 2015). Tobacco users receiving counseling decreased from 2.06% pre-ACA (2013) to 1.06% post-ACA (2015, p < 0.001), as did the proportion receiving nicotine replacement products post-ACA (2.69% in 2013 to 1.55% by 2015; p < 0.001). More Appalachians received cessation treatment than non-Appalachians in 2013 (2.72% vs. 2.03%), but by 2015 non-Appalachians received more treatment overall (1.50% vs. 1.65%; p < 0.001). Appalachians received more counseling and NRT, but less varenicline, than non-Appalachians.

Conclusions

Utilization of all forms of tobacco cessation treatment throughout Kentucky, and particularly in rural Appalachia, remained limited despite Medicaid enrollment as well as coverage expansions. These findings suggest that barriers persist in access to tobacco cessation treatment for individuals in Medicaid.
Ipsilateral femoral neck and shaft fractures fixation with proximal femoral nail antirotation II (PFNA II): technical note and cases series
Authors: Wu Kuen-Ting , Lin Shih-Jie , Chou Ying-Chao , Cheng Hsiang-Hen , Wen Po-Chong , Lin Che-Han , Yeh Wen-Ling
Published: January 2020

Background

Combined ipsilateral femoral neck and shaft fractures are an uncommon type of fractures. A number of different implant options are available for the management of this injury. Two-device procedures were suggested because of the higher rate of malunion by single-device treatment. However, surgical treatment using a cephalomedullary nail is still an alternative option that provides better mechanical advantage and minimal invasion. This study details the technique of treating these pattern fractures with proximal femoral nail anti-rotation II (PFNA-II) to achieve an acceptable reduction in both fracture sites.

Methods

Ten cases of ipsilateral femoral neck and shaft fractures under reduction by PFNA II were included and reviewed. A saw-bone model was also utilized to perform the detailed technique of reduction and fixation of PFNA II.

Results

Under the special technique by using the PFNA II, all ten cases achieved optimal reduction and alignment of both fracture sites in intra-operative fluoroscopy. There was no intra-operative complication noted. After 6 months of follow-up, radiography revealed proper alignment and well union of the fractures.

Conclusions

Fixation of ipsilateral femoral neck and shaft fractures with a single construct provides advantages of good biomechanical function, minimal invasion, reduced blood loss, and less operation time when comparing to two-device fixation. Thus, if acceptable reduction could be achieved, fixation by one PFNA II was a good alternative choice for this injury pattern.
Comparison of efficacy and safety between oral and intravenous administration of tranexamic acid for primary total knee/hip replacement: a meta-analysis of randomized controlled trial
Authors: Ye Wei , Liu Yafang , Liu Wei Feng , Li Xiao Long , Fei Yanqiang , Gao Xing
Published: January 2020

Background

Tranexamic acid (TXA) has been demonstrated to reduce blood loss following primary total knee and hip arthroplasty. This study aimed to compare the efficacy and safety of oral and intravenous tranexamic acid for primary total knee and hip arthroplasty.

Methods

The PubMed, Embase, and Cochrane Library databases were searched for relevant studies published before June 20, 2019. Studies clearly reporting a comparison of oral and intravenous TXA were selected, and total blood loss (TBL), the decline in hemoglobin (DHB), deep vein thrombosis (DVT), intramuscular venous thrombosis (IVT), the length of hospital stay, and the transfusion rate were evaluated. The weighted mean differences and relative risks were calculated using a fixed-effects or random-effects model.

Results

Ten studies involving 1140 (oral 557; intravenous 583) patients were included in this meta-analysis. There was no significant difference in terms of total blood loss, the decline in hemoglobin, the length of hospital stay, the incidence of DVT or IVT, or the transfusion rate between the oral and intravenous groups, and five studies reported that oral TXA was associated with a lower cost.

Conclusion

Our research suggests that compared with intravenous use of TXA, the oral approach has similar clinical outcomes and is less expensive for total joint replacement patients.
The status of and trends in the pharmacology of berberine: a bibliometric review [1985–2018]
Authors: Gao Yu , Wang Fengxue , Song Yanjun , Liu Haibo
Published: January 2020

Berberine has significant antibacterial and antipyretic effects and is a commonly used drug for treating infectious diarrhoea. The current research data show that the pharmacological effects of berberine are numerous and complex, and researchers have been enthusiastic about this field. To allow researchers to quickly understand the field and to provide references for the direction of research, using bibliometrics, we analysed 1426 articles, dating from 1985 to 2018, in the field of berberine pharmacology. The research articles we found came from 69 countries/regions, 1381 institutions, 5675 authors, and 325 journals; they contained 3794 key words; they were written in 7 languages; and they were of 2 article types. This study summarizes and discusses the evolution of the historical themes of berberine pharmacology as well as the status quo and the future development directions from a holistic perspective.
Asymptomatic intracranial aneurysms in beta-thalassemia: a three-year follow-up report
Authors: Manara Renzo , Caiazza Martina , Di Concilio Rosanna , Ciancio Angela , De Michele Elisa , Maietta Caterina , Capalbo Daniela , Russo Camilla , Roberti Domenico , Casale Maddalena , Elefante Andrea , Esposito Fabrizio , Ponticorvo Sara , Russo Andrea Gerardo , Canna Antonietta , Cirillo Mario , Perrotta Silverio , Tartaglione Immacolata
Published: January 2020

Background

No information is currently available regarding the natural history of asymptomatic intracranial aneurysms in beta-thalassemia, raising several concerns about their proper management.

Methods

We performed a prospective longitudinal three-year-long MR-angiography study on nine beta-thalassemia patients (mean-age 40.3 ± 7.5, six females, 8 transfusion dependent) harboring ten asymptomatic intracranial aneurysms. In addition, we analyzed the clinical files of all adult beta-thalassemia patients (160 patients including those followed with MR-angiography, 121 transfusion dependent) referring to our Centers between 2014 and 2019 searching for history of subarachnoid hemorrhage or history of symptomatic intracranial aneurysms.

Results

At the end of the three-year-long follow-up, no patient showed any change in the size and shape of the aneurysms, none presented new intracranial aneurysms or artery stenoses, none showed new brain vascular-like parenchymal lesions or enlargement of the preexisting ones. Besides, in our database of all adult beta-thalassemia patients, no one had history of subarachnoid hemorrhage or history of symptomatic intracranial aneurysms.

Conclusions

Incidental asymptomatic intracranial aneurysms do not seem to be associated, in beta-thalassemia, with an increased risk of complications (enlargement or rupture) at least in the short term period, helping to optimize human and economic resources and patient compliance during their complex long-lasting management.
Reduced progression of bone erosion in cytomegalovirus seropositive rheumatoid arthritis patients
Authors: Rauwel B. , Degboé Y. , Nigon D. , Boyer J.-F. , Abravanel F. , Izopet J. , Combe B. , Ruyssen-Witrand A. , Constantin A. , Cantagrel A. , Davignon J.-L.
Published: January 2020

Background

Human cytomegalovirus (HCMV) seropositivity has been associated with higher inflammation during rheumatoid arthritis (RA). However, no data are available on the impact of HCMV seropositivity on bone erosion progression during RA.

Methods

We selected 487 individuals of ESPOIR cohort who fulfilled the 2010 ACR/EULAR criteria for RA. HCMV serology for these patients was determined using Architect CMV IgG assay. Baseline and 1-year central X-ray reading using modified Total Sharp Score (mTSS), Erosion Sharp Score, and joint space narrowing Sharp score were used to quantify structural damage progression. We performed univariate and multivariate analyses to investigate the association between HCMV status and bone erosion progression.

Results

We analyzed 273 HCMV seropositive (HCMV+) and 214 HCMV seronegative (HCMV−) RA patients. At inclusion, HCMV+ patients were less frequently ACPA+ (49.8% versus 58.9%, p < 0.0465) and had a higher DAS28-ESR (5.55 ± 1.24 versus 5.20 ± 1.14, p < 0.0013) in comparison with HCMV−. At 1 year, bone erosion progression (delta erosion Sharp score > 1 point) was lower in HCMV+ patients (16.1% versus 25.2%, p = 0.0128) in comparison with HCMV−. HCMV+ status remained independently associated with lower bone erosion progression in multivariate analysis.

Conclusions

Our findings suggest that, independently of other confounding factors, HCMV seropositivity is associated with a lower progression of bone erosion during RA.
Methylome and transcriptome analyses reveal insights into the epigenetic basis for the good survival of hypomethylated ER-positive breast cancer subtype
Authors: Chen Xiao-Qiong , Zhang Fan , Su Qi-Chen , Zeng Chi , Xiao Fu-Hui , Peng Yu
Published: January 2020

Background

Breast cancer (BRCA) is a heterogeneous disease, characterized by different histopathological and clinical features and responses to various therapeutic measures. Despite the research progress of DNA methylation in classification and diagnosis of BRCA and the close relationship between DNA methylation and hormone receptor status, especially estrogen receptor (ER), the epigenetic mechanisms in various BRCA subtypes and the biomarkers associated with diagnostic characteristics of patients under specific hormone receptor status remain elusive.

Results

In this study, we collected and analyzed methylation data from 785 invasive BRCA and 98 normal breast tissue samples from The Cancer Genome Atlas (TCGA) database. Consensus classification analysis revealed that ER-positive BRCA samples were constitutive of two distinct methylation subgroups; with the hypomethylated subgroup showing good survival probability. This finding was further supported by another cohort of ER-positive BRCA containing 30 subjects. Additionally, we identified 977 hypomethylated CpG loci showing significant associations with good survival probability in ER-positive BRCA. Genes with these loci were enriched in cancer-related pathways (e.g., Wnt signaling pathway). Among them, the upregulated 47 genes were also in line with good survival probability of ER-positive BRCA, while they showed significantly negative correlations between their expression and methylation level of certain hypomethylated loci. Functional assay in numerous literatures provided further evidences supporting that some of the loci have close links with the modulation of tumor-suppressive mechanisms via regulation gene transcription (e.g., SFRP1 and WIF1).

Conclusions

Our study identified a hypomethylated ER-positive BRCA subtype. Notably, this subgroup presented the best survival probability compared with the hypermethylated ER-positive and hypomethylated ER-negative BRCA subtypes. Specifically, we found that certain upregulated genes (e.g., SFRP1 and WIF1) have great potential to suppress the progression of ER-positive BRCA, concurrently exist negative correlations between their expression and methylation of corresponding hypomethylated CpG loci. Therefore, our study indicates that different epigenetic mechanisms likely exist in ER-positive BRCA and provides novel clinical biomarkers specific to ER-positive BRCA diagnosis and therapy.
On boundedness of unified integral operators for quasiconvex functions
Authors: Zhao Dongming , Farid Ghulam , Zeb Muhammad , Ahmad Sohail , Mahreen Kahkashan
Published: January 2020

This work deals with the bounds of a unified integral operator with which several fractional and conformable integral operators are directly associated. By using quasiconvex and monotone functions we establish bounds of these integral operators. We prove their boundedness and continuity. The results of this paper generalize already published results and have direct consequences for fractional and conformable integrals
Delay dynamic double integral inequalities on time scales with applications
Authors: Rafeeq Sobia , Kalsoom Humaira , Hussain Sabir , Rashid Saima , Chu Yu-Ming
Published: January 2020

In the article, we present the explicit bounds for three generalized delay dynamic Gronwall–Bellman type integral inequalities on time scales, which are the unification of continuous and discrete results. As applications, the boundedness for the solutions of delay dynamic integro-differential equations with initial conditions is discussed.
Variable retention harvesting in the Douglas-fir region
Authors: Franklin Jerry F. , Donato Daniel C.
Published: January 2020

Variable retention harvesting evolved in the Douglas-fir region of the Pacific Northwest gradually in response to increasing dissatisfaction with the ecological consequences of clear-cutting, from the standpoint of wildlife habitat and other important forest functions. It is a harvesting technique that can provide for retention (continuity) of such structures as large and old live trees, snags, and logs. Variable retention is based on the natural model of the biological legacies that are typically left behind following natural disturbances, such as wildfire, wind, and flood. Variable retention is also an important technique for fulfilling the first silvicultural principle of ecological forestry, that of providing for continuity in structure, function, and composition between forest generations. The history and current application of variable retention approaches on forests in western Washington and Oregon states (USA), where many of the fundamental concepts were first developed and applied, is described in this article.
Crowdsourcing in health and medical research: a systematic review
Authors: Wang Cheng , Han Larry , Stein Gabriella , Day Suzanne , Bien-Gund Cedric , Mathews Allison , Ong Jason J. , Zhao Pei-Zhen , Wei Shu-Fang , Walker Jennifer , Chou Roger , Lee Amy , Chen Angela , Bayus Barry , Tucker Joseph D.
Published: January 2020

Background

Crowdsourcing is used increasingly in health and medical research. Crowdsourcing is the process of aggregating crowd wisdom to solve a problem. The purpose of this systematic review is to summarize quantitative evidence on crowdsourcing to improve health.

Methods

We followed Cochrane systematic review guidance and systematically searched seven databases up to September 4th 2019. Studies were included if they reported on crowdsourcing and related to health or medicine. Studies were excluded if recruitment was the only use of crowdsourcing. We determined the level of evidence associated with review findings using the GRADE approach.

Results

We screened 3508 citations, accessed 362 articles, and included 188 studies. Ninety-six studies examined effectiveness, 127 examined feasibility, and 37 examined cost. The most common purposes were to evaluate surgical skills (17 studies), to create sexual health messages (seven studies), and to provide layperson cardio-pulmonary resuscitation (CPR) out-of-hospital (six studies). Seventeen observational studies used crowdsourcing to evaluate surgical skills, finding that crowdsourcing evaluation was as effective as expert evaluation (low quality). Four studies used a challenge contest to solicit human immunodeficiency virus (HIV) testing promotion materials and increase HIV testing rates (moderate quality), and two of the four studies found this approach saved money. Three studies suggested that an interactive technology system increased rates of layperson initiated CPR out-of-hospital (moderate quality). However, studies analyzing crowdsourcing to evaluate surgical skills and layperson-initiated CPR were only from high-income countries. Five studies examined crowdsourcing to inform artificial intelligence projects, most often related to annotation of medical data. Crowdsourcing was evaluated using different outcomes, limiting the extent to which studies could be pooled.

Conclusions

Crowdsourcing has been used to improve health in many settings. Although crowdsourcing is effective at improving behavioral outcomes, more research is needed to understand effects on clinical outcomes and costs. More research is needed on crowdsourcing as a tool to develop artificial intelligence systems in medicine.

Trial registration

PROSPERO: CRD42017052835. December 27, 2016.
Re-prioritizing traffic stops to reduce motor vehicle crash outcomes and racial disparities
Authors: Fliss Mike Dolan , Baumgartner Frank , Delamater Paul , Marshall Steve , Poole Charles , Robinson Whitney
Published: January 2020

Background

Law enforcement traffic stops are one of the most common entryways to the US justice system. Conventional frameworks suggest traffic stops promote public safety by reducing dangerous driving practices and non-vehicular crime. Law enforcement agencies have wide latitude in enforcement, including prioritization of stop types: (1) safety (e.g. moving violation) stops, (2) investigatory stops, or (3) economic (regulatory and equipment) stops. In order to prevent traffic crash fatalities and reduce racial disparities, the police department of Fayetteville, North Carolina significantly re-prioritized safety stops.

Methods

Annual traffic stop, motor vehicle crash, and crime data from 2002 to 2016 were combined to examine intervention (2013–2016) effects. Fayetteville was compared against synthetic control agencies built from 8 similar North Carolina agencies by weighted matching on pre-intervention period trends and comparison against post-intervention trends.

Results

On average over the intervention period as compared to synthetic controls, Fayetteville increased both the number of safety stops + 121% (95% confidence interval + 17%, + 318%) and the relative proportion of safety stops (+ 47%). Traffic crash and injury outcomes were reduced, including traffic fatalities − 28% (− 64%, + 43%), injurious crashes − 23% (− 49%, + 16%), and total crashes − 13% (− 48%, + 21%). Disparity measures were reduced, including Black percent of traffic stops − 7% (− 9%, − 5%) and Black vs. White traffic stop rate ratio − 21% (− 29%, − 13%). In contrast to the Ferguson Effect hypothesis, the relative de-prioritization of investigatory stops was not associated with an increase in non-traffic crime outcomes, which were reduced or unchanged, including index crimes − 10% (− 25%, + 8%) and violent crimes − 2% (− 33%, + 43%). Confidence intervals were estimated using a different technique and, given small samples, may be asymmetrical.

Conclusions

The re-prioritization of traffic stop types by law enforcement agencies may have positive public health consequences both for motor vehicle injury and racial disparity outcomes while having little impact on non-traffic crime.