bluuebunny/crossref_metadata_2025 huggingface dataset:
Why Do Healthcare Professionals Fail to Escalate as Per the Early Warning System (EWS) Protocol? A Qualitative Evidence Synthesis of the Barriers and Facilitators of Escalation
Authors: Neill Sinead M O , Clyne Barbara , Bell Miriam , Casey Avilene , Leen Brendan , Smith Susan M , Ryan Mairin , O’Neill Michelle
Published: September 2020

Background: Early warning systems (EWSs) are used to assist clinical judgment in the detection of acute deterioration to avoid or reduce adverse events including unanticipated cardiopulmonary arrest, admission to the intensive care unit and death. Sometimes healthcare professionals (HCPs) do not trigger the alarm and escalate for help according to the EWS protocol and it is unclear why this is the case. The aim of this qualitative evidence synthesis was to answer the question ‘why do HCPs fail to escalate care according to EWS protocols?’ The findings will inform the update of the National Clinical Effectiveness Committee (NCEC) National Clinical Guideline No. 1 Irish National Early Warning System (INEWS). Methods: A systematic search of the published and grey literature was conducted (until February 2018). Data extraction and quality appraisal were conducted by two reviewers independently using standardised data extraction forms and quality appraisal tools. A thematic synthesis was conducted by two reviewers of the qualitative studies included and categorized into the barriers and facilitators of escalation. GRADE CERQual was used to assess the certainty of the evidence.Results: Eighteen studies incorporating a variety of HCPs across seven countries were included. The barriers and facilitators to the escalation of care according to EWS protocols were developed into five overarching themes: Governance, Rapid Response Team (RRT) Response, Professional Boundaries, Clinical Experience, and EWS parameters. Barriers to escalation included: Lack of Standardisation, Resources, Lack of accountability, RRT behaviours, Fear, Hierarchy, Increased Conflict, Over confidence, Lack of confidence, and Patient variability. Facilitators included: Accountability, Standardisation, Resources, RRT behaviours, Expertise, Additional support, License to escalate, Bridge across boundaries, Clinical confidence, Empowerement, Clinical judgment, and a tool for detecting deterioration. These are all individual yet inter-related barriers and facilitators to escalation.Conclusions: The findings of this qualitative evidence synthesis provide insight into the real world experience of HCPs when using EWSs. This in turn has the potential to inform policy-makers and HCPs as well as hospital management about emergency response system-related issues in practice and the changes needed to address barriers and facilitators and improve patient safety and quality of care.
Growth in ataxia telangiectasia
Authors: Natale Valerie , Cole Tim J , Rothblum-Oviatt Cynthia , Wright Jennifer , Crawford Thomas , Lefton-Greif Maureen , McGrath-Morrow Sharon , Schlechter Haley , Lederman Howard M.
Published: September 2020

Background
Ataxia telangiectasia (A-T) is a DNA repair disorder that affects multiple body systems. Neurological problems and immunodeficiency are two important features of this syndrome. At this time, two main severity groups are defined in A-T: classic (the more severe form) and mild. Poor growth is a common problem in classic A-T. An objective of this study was to develop growth references for classic A-T. Another objective was to compare growth patterns in classic A-T and mild A-T with each other and with the general population, using the CDC growth references. A final objective was to examine the effects of chronic infection on height.
Results
We found that classic A-T patients were smaller overall, and suffered from height and weight faltering that continued throughout childhood and adolescence. When compared to the CDC growth references, the median heights and weights for both male and female patients eventually fell to or below the 3rd centile on the CDC charts. Height faltering was more pronounced in females. Birthweight was lower in the classic A-T group compared to mild A-T and the general population, whereas birth length was not. Finally, we investigated height and BMI faltering in relation to number of infections and found no association.
Conclusions
Classic A-T appears to affect growth in utero. Although children appear to grow well in very early life, faltering begins early and is unrelenting.
Prognostic Factors for Persistent Symptoms in Adults With Mild Traumatic Brain Injury: Protocol for an Overview of Systematic Reviews
Authors: Déry Julien , De Guise Élaine , Lamontagne Marie-Eve
Published: September 2020

Background: Mild traumatic brain injury (mTBI) is an increasing public health problem, and persistent symptoms following mTBI have several functional consequences. Understanding the prognosis of a condition is an important component of clinical decision-making and can help to guide prevention of long-term disabilities and to intervene with mTBI patients. Prognosis of chronic symptoms in mTBI has stimulated several empirical primary research papers and many systematic reviews. We aim to integrate these heterogenous factors into a model in order to have a better understanding of such prognostic factors on the development of chronic symptoms.Methods: We will conduct an overview of systematic reviews following steps described in the Cochrane Handbook. We will search for systematic reviews in databases using a search strategy to include articles that review evidence about prognosis of persistent symptoms after an mTBI in the adult population. Two reviewers will independently screen all references and then select eligible reviews based on eligibility criteria. Any disagreements will be discussed by the two reviewers and if consensus is not reached, we will consult a third reviewer. A data extraction grid will be used to extract relevant information. The risk of bias included will be rated using ROBIS tool. Data will be synthesized into a comprehensive conceptual map in order to have a better understanding of the predictor factors that could impact the recovery after mTBI.Discussion: Results will help multiple stakeholders, such as clinicians and rehabilitation program managers, to understand the prognosis of long-term consequences following an mTBI. It could guide stakeholders to recognize predisposing, precipitating, and perpetuating factors of their patients and to invest their time and resources on patients needing the most.Systematic review registration: PROSPERO CRD42020176676
The Modification and Optimization of Retroperitoneal Laparoscopic Radical Nephrectomy for the Treatment of Localized Renal Cell Carcinoma
Authors: Zhang Yimu , Zhou Zhengyu , Bai Jiyan , Tian Pei , Yang Dong , Zhao Pengcheng , Li Jing , He Chaohong
Published: September 2020

Background: We report our modified surgical technique of retroperitoneal laparoscopic radical nephrectomy (RLRN) and assess its perioperative outcomes and postoperative complications, with a focus on operative time (OT). Methods: We retrospectively analyzed a single-center, single-surgeon cohort of 130 consecutive patients who underwent RLRN between January 2015 and March 2019. A study group of 65 patients who received modified RLRN was compared with a control group of 65 patients who received classical RLRN. OT, estimated blood loss ( EBL ), perioperative complications, postoperative first exhaust time (PFET), pathological stage, and postoperative hospital stay (PHS) were compared between the two groups. Results: All demographic, clinical, and pathological variables were comparable between the groups. No differences were observed in perioperative complications (p=0.648), peritoneal injuries (p=0.843), PFET (p=0.448), pathological stage (p=0.767), and PHS (p=0.304). The modified RLRN group resulted in a significantly reduced overall OT (53.8±8.4 min vs. 60.5±10.6 min, p=0.000), peritoneal injury intervention subgroup OT (56.3±9.8 min vs. 75.2±12.4 min, p=0.000), and EBL (55.7±10.1 mL vs. 62.3±11.6 mL, p=0.001) compared with the classical RLRN group. We observed a significant reduction in OT and EBL but no increase in postoperative complications, PFET, or PHS with modified versus traditional RLRN for localized renal carcinoma.Conclusions: Findings from this study present a modified RLRN surgical technique that is standardized, more precise, and has better practicability.
Does Respiratory Co-Infection Facilitate Dispersal of SARS-CoV-2? Investigation of a Super-Spreading Event in an Open-Space Office
Authors: Weissberg Dana , Böni Jürg , Rampini Silvana , Kufner Verena , Zaheri Maryam , Schreiber Peter W. , Abela Irene A. , Huber Michael , Sax Hugo , Wolfensberger Aline
Published: September 2020

Background: Super-spreaders are individuals infecting disproportionately large numbers of contacts. They probably play a crucial role in the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We describe a super-spreading event within a team working in an open-space office and investigate factors potentially having facilitated SARS-CoV-2 transmission.Methods: In this retrospective cohort study, semi-structured telephone interviews with all team members were carried out to identify symptoms, contacts, and adherence to basic hygiene measures. During site visits, we gathered information about workplace and seating arrangements. The secondary attack rate in office and households was calculated. Potential respiratory viral co-infections were assessed by multiplex PCR. SARS-CoV-2 whole-genome sequencing was performed using a tiled-amplicon sequencing approach.Results: Of 13 team members, 11 fell ill with Coronavirus disease 2019 (COVID-19). Due to the sequence of events and full genome sequence data, one person was considered the index case for this outbreak, directly infecting 67% to 83% of the teammates. All team members reported repetitive close contacts among themselves during joint computer work, team meetings and a “Happy Birthday” serenade. Two individuals shared nuts and dates. The arrangement of the office and meeting rooms precluded sufficient adherence to physical distancing. The index case and a further individual were diagnosed with an adenovirus serotype 4 co-infection, but secondary household attack rate was not higher for co-infected individuals. Conclusion: We identified several environmental and behavioral factors that probably have facilitated the transmission of SARS-CoV-2. The relevance of the adenovirus co-infection remains unclear and merits further investigation.
Litterfall, Decomposition and Nutrient Release in Sacred Forests of Western Odisha, India.
Authors: Pradhan Antaryami , Behera Niranjan
Published: September 2020

Background Recognizing that litterfall and decomposition are key ecosystem functions for ecosystem stability in a terrestrial ecosystem, litterfall and decomposition in four sacred forests were studied from western part of Odisha. The present study focuses on the detailed aspects of litter dynamics, decomposition and consequent release of nutrients to the forest floor. The results obtained in this study will be beneficial in understanding the ecosystem functioning associated with nutrient cycling, which helps in determining possible management strategies for optimization of ecosystem functioning and productivity of these sacred forests. Results Litterfall and standing litter showed a seasonal pattern with most of the litter accumulated during the dry seasons and lowest in the rainy season. However, no significant difference was observed between the litterfall patterns of the sacred forests. The annual turnover rate (KL) was found to be in the range of 3.59/yr to 4.22/yr in studied sacred forests. The litter decomposition study was performed by litter bag technique and almost 95% of mass loss was observed within a period of 6 months. Such fast decomposition leads to faster rate of nutrient release across the sites. The studied elements can be set in the following order as regards to their return to the topsoil during decomposition in the order of K (Potassium) > N (Nitrogen) > P (Phosphorus). The approximate amount of nutrient released to the forest soil is quantified in the range of 184.76 to 33.61kg/ha of NPK (Nitrogen, Phosphorus and Potassium) in different sacred forests.Conclusion Such nutrient release and dynamics in sacred forests, may contribute an effective nutrient flow to the topsoil as well as to the surrounding agricultural landscapes boosting agricultural productivity and sustainability. This signifies the role of sacred forests in rendering an important ecological service in terms of nutrient cycling.
The impact of technology use on agricultural production in Rwanda (2016 season A, B, C)
Authors: UBARIJORO Jules Maurice , NDIKUBWIMANA Jean Bosco , DUKUNDE Angelique , MUZUNGU Eric Shyaka
Published: September 2020

This study deals with the impact of technology use on agricultural productivity in Rwanda with purpose of assessing the impact of technology adoption in agriculture to its productivity in season A, B, and C in 2016 .The researchers used data from Rwanda seasonal agricultural survey (RSAS) to successfully complete the analysis. Chi-square, cross tabulation analysis and multiple linear regression analysis were used to identify the impact of technology use on agricultural production. From bivariate analysis find that there are some existing technologies that are not influencing production just because of low level of their utilization and multiple linear regressions was found that some of the technologies such as use of improved seed, use organic fertilizers, area and use irrigation were showed that are statistically significant on agricultural production with p-values of 0.0455, 0.0313, 0.000, and 0.0457 respectively which means that, these technologies increased agricultural production for few farmers who used technologies in 2016. Researchers conclude that, technologies were inefficiently used by farmers due to the accessibility of these technologies and then recommend the Government policy makers, farmers policy makers, researchers and farmers to consolidate their efforts towards technology adoption in agriculture sector to ensure food security and sustainable agriculture and also further researches that will emphasis on adding certain variables which reduce the farmers’ vulnerability to loss the income are highly encouraged.
Microstructural Evolution of H-BN Matrix Composite Ceramics With Amorphous La2O3-Al2O3-SiO2 Glass Phase During Hot Pressing
Authors: Qiu Baofu , Duan Xiaoming , Zhang Zhuo , Zhao Chen , Niu Bo , He Peigang , Cai Delong , Chen Lei , Yang Zhihua , Wang Yujin , Jia Dechang , Zhou Yu
Published: September 2020

BN-La2O3-Al2O3-SiO2 composite ceramics were fabricated by hot press sintering using h-BN, La2O3, Al2O3 and amorphous SiO2 as the raw materials. The effects of sintering temperature on the microstructural evolution, bulk density, apparent porosity, and mechanical properties of h-BN composite ceramics were investigated. The results indicated that ternary La2O3-Al2O3-SiO2 liquid phase was formed during sintering process, which provided an environment for the growth of h-BN grains. With increasing sintering temperature, the cristobalite phase precipitation and h-BN grain growth occurred at the same time, which had the significant influence on the densification and mechanical properties of h-BN composite ceramics. The best mechanical properties of BN-La2O3-Al2O3-SiO2 composite ceramics were obtained under sintering temperature of 1700 °C, and the elastic modulus, flexural strength, and fracture toughness were 80.5 GPa, 266.4 MPa and 3.25 MPa·m1/2, respectively.
Integration of RNA-seq and Ribosome Profiling to Characterize Transcriptional and Translational Estrogen Responses of Genes in Human Breast Cancer
Authors: Choo Siew Woh , Zhong Yu , Sendler Edward , Goustin Anton Scott , Cai Juan , Ju Donghong , Brown James Bentley , Kosir Mary Ann , Lipovich Leonard
Published: September 2020

BackgroundEstrogen is a hormone that is frequently essential in breast cancer to drive key transcriptional programs by interacting with the estrogen receptor alpha that upregulates proliferative and oncogenic genes and represses apoptotic and tumor suppressor genes. Protein-coding targets of estrogen regulation in breast cancer are well-defined. However, long non-coding RNA (lncRNA) genes account for the majority of human gene catalogs. The coding status of these genes – their accidental, or regulated, translation by ribosomes, under the influence of estrogen – remains a controversial topic. MethodsHere, we performed comprehensive transcriptome analysis using RNA-Seq, as well as ribosome profiling using Ribo-Seq, on the same samples: biological replicates of human estrogen receptor alpha (ERa) positive MCF7 breast cancer cells before and after estrogen treatment. We correlated these two datasets, globally highlighting protein-coding and lncRNA differentially expressed genes and transcripts that were positively as well as negatively responsive to estrogen, separately at the transcriptional level and the translational (as approximated by ribosome binding) level.ResultsOur data showed that some transcripts were more robustly detected in RNA-Seq than in the ribosome-profiling data, and vice versa, suggesting distinct gene-specific estrogen responses at the transcriptional and the translational level, respectively. Certain differentially expressed transcripts may point to the regulation of alternative splicing by estrogen. Several pseudogenes were co- and anti-regulated with their cancer-functional parental genes. Gene ontology analysis highlighted cancer-relevant pathways enriched after estrogen treatment in cells.ConclusionsOur study represents a significant advance in the estrogen receptor biology, because we demonstrated global effects of estrogen on splicing and translation that are distinct from, and not always correlated with, its effects on transcription, and that differ globally for protein-coding and lncRNA genes. We have also highlighted for the first time the transcriptional and translational response of expressed pseudogenes to estrogen, pointing to new perspectives for biomarker and drug-target development for breast cancer in future.
Evaluation of the Relationship Between Cytochrome P450 Polymorphisms and T2DM Risk
Authors: Zhao QingBin , Wei Huiyi , Li Zhiying , Wei Haoyang
Published: September 2020

Background: Recent studies have identified some genetic polymorphisms of CYP2C8 and CYP2D6 related to disease susceptibility. However, it has not been reported whether polymorphisms in CYP2C8 and CYP2D6 are associated with the risk of type 2 diabetes mellitus (T2DM). We designed a case-control study to evaluate the relationship between those CYP polymorphisms and T2DM risk. Methods: Four single nucleotide polymorphisms (SNPs) of CYP2C8 and CYP2D6 were genotyped from 512 patients and 515 healthy controls using Agena MassARRAY. The chi-square test was used to compare the differences in allele and genotype frequencies between the two groups. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by logistic regression analysis to evaluate the relationship between polymorphism and T2DM risk. Results: The results found that the rs1065852 in CYP2D6 was correlated with the T2DM risk in overall (A vs. G: OR = 1.22, 95% CI: 1.03–1.45, P = 0.024; AA vs.GG: OR = 1.46, 95% CI: 1.04–2.06, P = 0.031; AA-AG vs. GG: OR = 1.36, 95% CI: 1.04–1.79, P = 0.026; additive: OR = 1.21, 95% CI: 1.02–1.44, P = 0.027). Gender stratification analysis results demonstrated that the rs1065852 in CYP2D6 was related with an increased the risk of T2DM in male and age < 59 years old. However, no statistical significance relation was found between CYP2C8 SNPs and T2DM risk. Conclusions: This study revealed that CYP2D6 (rs1065852) could be potential genetic markers of susceptibility to T2DM. Further studies are required to confirm our findings.
Socio-demographic, clinical and health facility-related predictors of delayed HIV diagnosis among patients newly diagnosed with HIV in Northwest Ethiopia: a multilevel analysis
Authors: Moges Nurilign Abebe , Berhane Yemane , AKINYEMI Joshua Odunayo , Okunlola Micheal A. , Adesina Olubukola Adeponle
Published: September 2020

Background

Ethiopia recently implemented the ‘test and treat’ strategy for all HIV-infected individuals receiving a diagnosis at the health facility level. However, the impact of this policy in terms of timely HIV diagnosis and factors associated with it were not evaluated. Therefore, this study aimed to determine the magnitude and predictors of delayed HIV diagnosis among newly diagnosed people living with HIV in the northwest, Ethiopia.
Methods

In this cross-sectional study, a total of 759 newly diagnosed patients were recruited consecutively. The multistage sampling technique was employed to select health facilities and all newly diagnosed patients were included. Delayed HIV diagnosis was defined when there is an established AIDS-defining clinical condition (WHO clinical stage III or IV), irrespective of CD4 count. Data were entered into Epi-Data version 3.5 and exported to STATA version 14 for further analysis. Taking into account the nested structure of the data, multilevel logistic regression analysis has been employed. Four models containing variables of interest were fitted. Multivariate multilevel logistic regression analysis was performed to estimate the adjusted odds ratios (AOR) at a 95% confidence interval (CI).
Results

A one-fourth of newly diagnosed HIV patients diagnosed at advanced disease stage. After controlling for other individual and health facility level factors, factors associated with delayed HIV diagnosis were: Patients who had completed secondary school or higher (AOR = 2.08, 95% CI = 1.06, 4.08), patients who presented to health facilities with HIV symptoms (AOR = 5.87, 95% CI = 3.57, 9.62), being non-working functional status (AOR = 4.80, 95% CI = 2.58, 8.92) and HIV diagnosis at hospitals (AOR = 2.16, 95% CI = 1.08, 4.31).
Conclusion

The magnitude of delayed HIV diagnosis was improved. In addition to individual-level factors, it is important to address health facility-related factors to improve earlier HIV diagnosis. Here, we recommend using both clinical and laboratory characteristics of a patient particularly, baseline CD4 count and viral load to identify patients diagnosed with advanced disease stage. Moreover, public health interventions are important targeted on factors associated with delayed HIV diagnosis.
Factors Associated With Self-efficacy Toward Healthy Eating and Physical Activity Among Kuwaiti Adolescent Girls 
Authors: AlGhanim Latifa , Alkazemi Dalal Usamah Zaid
Published: September 2020

Background: The factors that may influence adolescents’ health-related behaviors in Kuwait are unclear. We hypothesized that girls’ self-efficacy would be negatively associated with their weight statuses and positively associated with healthy eating-related behaviors. This study aimed to measure healthy eating-related parameters, including self-efficacy, dietary habits, dietary beliefs, nutrition knowledge, and physical activity, in a sample of Kuwaiti adolescent girls and assess the correlates of self-efficacy, including weight status and dietary and health behaviors. Methods: In this cross-sectional, self-administered survey at the school level, we evaluated students of three schools in different governorate locations in Kuwait. The participants were adolescent girls (n=301; mean age, 16.6±1.2 years) who attended secondary schools. The main outcome measures were self-efficacy, dietary habits, dietary beliefs, nutrition knowledge, physical activity, and weight status per body mass index (BMI) categories. Pearson’s correlation analysis was performed to determine the associations among the healthy behavior related parameter scores. The independent samples t-test was used to examine the differences in scores between participants’ characteristics and self-efficacy scores (SES). Multivariate regression analysis was used to determine the final independent correlates of SES.Results: Only 19.9% of the participants had high self-efficacy toward healthy eating behaviors, 20.9% had “satisfactory eating habits,” 11.3% had a good comprehension of the meanings of healthy and unhealthy dietary habits and food, 16.3% had good nutrition knowledge, and 29.2% had an active lifestyle. SES was negatively correlated with BMI (r=-0.074, P=0.03) and positively correlated with all domains of healthy eating and physical activity. However, SES was not associated with nutritional knowledge. The independent correlates of SES in the multivariate regression analysis were governorate, eating beliefs, healthy eating score, and physical activity (R2=38.3%).Conclusions: Adolescent girls in Kuwait demonstrated a high level of self-efficacy toward healthy eating and behaviors and had firm nutritional beliefs; however, they failed to translate their beliefs into good nutritional habits. It is necessary to develop interventional nutrition programs at the school level that aim at improving healthy behaviors among adolescents.
Systematic Review and Meta-analysis of the Safety of Chloroquine and Hydroxychloroquine From Randomized Controlled Trials on Malarial and Non-malarial Conditions
Authors: Botelho Mayra Souza , Bolfi Fernanda , Leite Renata Giacomini Occhiuto Ferreira , Leite Mauro Salles Ferreira , Banzato Luisa Rocco , Soares Luiza Teixeira , Olivatti Thaina Oliveira Felicio , Mangolim Amanda Sampaio , Oliveira Flávia Ramos Kazan , Abbade Luciana Patrícia Fernandes , Abbade Joelcio Francisco , Almeida Ricardo Augusto Monteiro de Barros , Galendi Julia Simões Correa , Thabane Lehana , Nogueira Vania dos Santos Nunes
Published: September 2020

Background: Despite the expectations regarding the effectiveness of chloroquine (CQ) and hydroxychloroquine (HCQ) for coronavirus disease (COVID-19) management, concerns about their adverse events have remained. Objectives: The objective of this systematic review was to evaluate the safety of CQ and HCQ from malarial and non-malarial randomized clinical trials (RCTs). Methods: The primary outcomes were the frequencies of serious adverse events (SAEs), retinopathy, and cardiac complications. Search strategies were applied to MEDLINE, EMBASE, LILACS, CENTRAL, Scopus, and Trip databases. We used random-effects model to pool results across studies and Peto one-step odds ratio (OR) for event rates below 1 %. Both-armed zero-event studies were excluded from the meta-analyses. We used the Grading of Recommendations Assessment, Development, and Evaluation system to evaluate the certainty of evidence.Results: Ninety-two RCTs were included. We found no significant difference between CQ/HCQ and control (placebo or non-CQ/HCQ) in the frequency of SAEs (OR: 0.98, 95 % confidence interval [CI]: 0.71–1.36, 25 trials, 11,605 participants, moderate certainty of evidence). No clear relationship was observed between CQ/HCQ and retinopathy (OR: 1,63, 95 % CI: -0.4–6.57, 5 trials, 344 participants, very low certainty of evidence). There was a low certainty of evidence of the effect of CQ/HCQ versus control on cardiac complications (Relative risk: 1.48, 95 % CI: 1.1–1.98, 8 trials, 5,970 participants).Conclusions: CQ and HCQ might be safe, with low frequency of SAEs on malarial and non-malarial conditions. No clear effect of their use on the incidence of retinopathy and cardiac complications was observed.The protocol for this systematic review was registered with PROSPERO (registration number: CRD42020177818)
The How, Why, and for Whom Mindfulness-based Programs and Practices Produce Change in the General Population: A Scoping Review Protocol
Authors: Maloney Shannon , Montero-Marin Jesus , Kuyken Willem
Published: September 2020

Background: Despite growing evidence for the salutary effects of mindfulness-based programs (MBPs), there is limited understanding of the how, why, and for whom these programs work in the general population. To better understand these questions, one must implement design and data-analytic approaches that can elucidate potential mediators, mechanisms, and moderators. These variables explain the processes through which treatments, such as MBPs, produce change (mediators/mechanisms) and illuminate in which contexts these programs work best (moderators). The extant literature has investigated these variables predominately in pre-post analyses of MBPs. However, there are other ways to explore these processes or ‘pathways of change.’ One option is to implement dismantling trials and investigate the effects of core components of MBPs (e.g. mindfulness practice). Understanding how key elements operate in isolation will help specify ‘active ingredients’ and how the MBP framework works on the whole. The primary objective of the current scoping review will be to comprehensively evaluate studies that have explored pathways of change in MBPs and individual mindfulness practices to further our understanding of how to best adapt these programs and maximise benefits across the general population. Methods: Five electronic databases (PubMed, PsycINFO, Embase, Scopus, and the Cochrane Central) will be systematically searched for eligible studies. Studies will be included if they investigate a MBP or practice in the general population (adults aged 18 and over). Eligible studies must evaluate a proposed mediator, mechanism, or moderator of a MBP or practice. The following information will be extracted for charting: (a) Name of author(s), (b) year of publication (c) sample characteristics (d) sampling method (e) reported mediators, mechanisms, and moderators, (f) design approach, (g) data-analytic approach, (h) adherence to methodological requirements, (i) description of MBP or practice, (j) treatment dosage, (k) delivery mode, (l) effect sizes and outcomes. A qualitative narrative summary of the results will be described in accordance with the information extracted for charting.Discussion: The results from this review will help inform mindfulness teachers, researchers, and health-care professionals who intend to adapt MBPs or practices.Systematic review registration: Open Science Framework, DOI: 10.17605/OSF.IO/XJDSU
KRAS mutation effects on the 2-[18F]FDG PET uptake of colorectal adenocarcinoma metastases in the liver
Authors: Popovic Marko , Talarico Olga , Hoff Jörg van den , Kunin Henry , Zhang Zhigang , Lafontaine Daniel , Dogan Snjezana , Leung Johnny , Kaye Elena , Czmielewski Christian , Mayerhoefer Marius E. , Zanzonico Pat , Yaeger Rona , Schöder Heiko , Humm John L. , Solomon Stephen B. , Sofocleous Constantinos T. , Kirov Assen S.
Published: September 2020

Background: Deriving individual tumor genomic characteristics from patient imaging analysis is desirable. We explore the predictive value of 2-[18F]FDG uptake with regards to the KRAS mutational status of colorectal adenocarcinoma liver metastases (CLM). Methods : 2-[18F]FDG PET/CT images, surgical pathology and molecular diagnostic reports of 37 patients who underwent PET/CT-guided biopsy of CLM were reviewed under an IRB-approved retrospective research protocol. Sixty CLM in 39 interventional PET scans of the 37 patients were segmented using two different auto-segmentation tools implemented in different commercially available software packages. PET standard uptake values (SUV) were corrected for: 1) partial volume effect (PVE) using cold wall-corrected contrast recovery coefficients derived from phantom spheres with variable diameter; and 2) variability of arterial tracer supply and variability of uptake time after injection until start of PET scan derived from the tumor-to-blood standard uptake ratio (SUR) approach. The correlations between the KRAS mutational status and the mean, peak, and maximum SUV were investigated using Student ’ s t-test, Wilcoxon rank sum test with continuity correction, logistic regression and receiver operation characteristic (ROC) analysis. These correlation analyses were also performed for the ratios of the mean, peak and maximum tumor uptake to the mean blood activity concentration at the time of scan: SUR_mean, SUR_peak, and SUR_max , respectively. Results: Fifteen patients harbored KRAS missense mutations ( KRAS+ ) while another 3 harbored KRAS gene amplification. For 31 lesions the mutational status was derived from the PET/CT-guided biopsy. The Student ’ s-t p-values for separating KRAS mutant cases decreased after applying PVE correction to all uptake metrics of each lesion and when applying correction for uptake time variability to the SUR metrics. The observed correlations were strongest when both corrections were applied to SUR MAX and when the patients harboring gene amplification were grouped with the wild type: p ≤ 0.001; ROC area under the curve (AUC) = 0.77 and 0.75 for the two different segmentations respectively with a mean specificity of 0.69 and sensitivity of 0.85. Conclusions: The correlations observed after applying the described corrections show potential for assigning probabilities for the KRAS missense mutation status in CLM using 2-[18F]FDG PET images.
Integrable matrix models in discrete space-time
Authors: Krajnik Žiga , Ilievski Enej , Prosen Tomaz
Published: September 2020

We introduce a class of integrable dynamical systems of interacting
classical matrix-valued fields propagating on a discrete space-time
lattice, realized as many-body circuits built from elementary symplectic
two-body maps. The models provide an efficient integrable Trotterization
of non-relativistic \sigmaσ-models
with complex Grassmannian manifolds as target spaces, including, as
special cases, the higher-rank analogues of the Landau–Lifshitz field
theory on complex projective spaces. As an application, we study
transport of Noether charges in canonical local equilibrium states. We
find a clear signature of superdiffusive behavior in the
Kardar–Parisi–Zhang universality class, irrespectively of the chosen
underlying global unitary symmetry group and the quotient structure of
the compact phase space, providing a strong indication of superuniversal
physics.
Digital transformation and new business models as determinants of formation of the economy of nontypical employment
Authors: Kolot Anatoliy , Herasymenko Oksana
Published: September 2020

With the development of the Fourth Industrial Revolution and the formation of a new technological basis – “Industry 4.0” - a dynamic multi-vector transformation of the leading institutes of economy and society takes place, social and labor relations in general and employment in particular acquire new format and content. The quintessence of the article is a scientific-applied substantiation of the construct of nontypical employment economy, scientific argumentation and further development of previous researches of authors regarding determinants of gig-economy formation under the influence of economic and social development “digitalization” and emergence of new business models. that radically change all components of the world of work. New facets of the complex world of work and employment have been revealed and the increase of the newest knowledge in this field has been received under systematic research of a chain of changes: introduction of “Industry 4.0” breakthrough technologies → “digitalization” as a dominant vector of technological innovations → formation of new business models → changes in social division of labor and the content of labor processes → the emergence and intensive development of employment forms immanent to the new (digital) economy. It is substantiated that the main root cause, a kind of “trig- ger” for the emergence and reproduction of the chain of researched changes is digital transformation of the economy and society. The essence of today’s phenomena, which determine the development of the “gig economy”, is revealed. The argumentation of the spread of platform business models and their impact on the world of work and employment is given. A new theoretical construction of a chain of changes, the “output” of which is new forms and, a new platform for social and labor developmen t in general, has been suggested. The research focuses on finding answers to a number of questions posed to every conscious person. Among them are the following ones: Why can’t the modern economy “get along” with traditional (standard) forms of employment? Why does atypicality become not the exception but the norm? How do specific mechanisms and tools for transforming standard forms of employment into new ones, which are immanent to modern conditions of economic and social progress, behave in practice?
The Sacred Freespace
Authors: Costanzo Francesco , Oliva Gaspare
Published: September 2020

Keeping in the background the search for geometric-mathematical exactness, that in different cultures oversees the construction of sacred building and starting from the need to isolate it in order to make its "true form" recognizable, this paper analyzes features and conditions of the spaces of the city where different isolated and formally defined religious buildings coexist, as happens, for example, in Italian squares characterized by opposition between Cathedral and Baptistery. The Campo dei Miracoli in Pisa is assumed as a paradigm of in-between consecrated space in which several isolated buildings determine a tensional space and define a unique and unrepeatable configuration individuated among the multiple possible combinations of positions and architectural figures that is, according to Leibniz, expression of the idea of infinity. This kind of space looks for exactness not through closed forms but through relationships, positions and alignments of standing buildings and its rarefaction is directly connected with the idea of open city dispersed in nature proposed by modern architecture.
Um olhar sobre Historiografia e Epistemologia no campo da Ciência da Informação
Authors: Freire Isa Maria , Silva Tiago José da
Published: September 2020

Investiga a produção científica na temática Epistemologia e Historiografia da Ciência da informação a partir dos Anais do Encontro Nacional de Pesquisa em Ciência da informação, de dados da Plataforma Lattes e da literatura indexada na Base de Dados da Ciência da informação. Identifica o coletivo de pesquisadores que dão continuidade e consistência ao trabalho epistemológico e historiográfico da área. Destaca, na temática abordada, um grupo que consegue produzir mais que a maioria dos demais pesquisadores. Pesquisadores com alunos na pós-graduação tendem a publicar mais artigos em colaboração do que os outros autores que se não encaixam nesse perfil. Os resultados permitiram a descrição de perfis de pesquisadores a partir de um recorte. Conclui que as pesquisas sobre a referida temática, alinhadas aos preceitos dos estudos métricos, podem permitir o desenvolvimento de teias conceituais e metodológicas da Ciência da Informação.
Pós-verdade, fake news e outras drogas
Authors: Wilke Valéria Cristina Lopes
Published: September 2020

O advento da sociedade em rede promoveu mudanças significativas na experiência-com-o-mundo. Observa-se nos últimos anos a crescente toxidade no ambiente informacional, marcado tanto pela vivência tóxica da informação que circula legalmente nas redes sociais como por informações que intoxicam os indivíduos e grupos. O objetivo é discutir, em tempos de pós-verdade e da sociedade non-stop, o aspecto tóxico da informação, que ao tornar o ambiente informacional tóxico, adoece indivíduos e também as sociedades democráticas, ao esmaecer a empatia para com os demais e de pôr em risco a própria ideia de democracia e de vida partilhada de modo democrático. A proposta é discutir a intoxicação pela informação não pelo excesso (infoxicação), mas pelo que nomeio informação tóxica, i.e., o aspecto tóxico da informação e de ambiente informacional tóxico tendo como referência os discursos de ódio. Para tanto serão consideradas a desconstrução de experiências de estados democráticos mediante o crescimento da circulação de discursos de ódio e de discursos de ódio fascistas; o crescimento da desinformação; o crescimento da circulação de notícias fraudulentas (Fake news) e de notícias falsas (por exemplo, as não endossadas pelos saberes científicos, como o terraplanismo, a ideia da supremacia branca); os robots e os algoritmos.
Protocol Development for HMU! (HIV Prevention for Methamphetamine Users), a Study of Peer Navigation and Text Messaging to Promote Pre-Exposure Prophylaxis Adherence and Persistence Among People Who Use Methamphetamine: Qualitative Focus Group and Interview Study
Authors: McMahan Vanessa M , Frank Noah , Buckler Smitty , Violette Lauren R , Baeten Jared M , Banta-Green Caleb J , Barnabas Ruanne V , Simoni Jane , Stekler Joanne D
Published: September 2020

Background

Cisgender men who have sex with men (MSM) and transgender people (TGP) who use methamphetamine are disproportionately impacted by HIV acquisition. Pre-exposure prophylaxis (PrEP) is highly effective at preventing HIV, and interventions that support PrEP persistence and adherence should be evaluated among MSM and TGP who use methamphetamine.

Objective

We conducted formative work to inform the development of text messaging and peer navigation interventions to support PrEP persistence and adherence among MSM and TGP who use methamphetamine. In this paper, we describe how the findings from these focus groups and interviews were used to refine the study interventions and protocol for the Hit Me Up! study (HMU!; HIV Prevention in Methamphetamine Users).

Methods

Between October 2017 and March 2018, we conducted two focus groups and three in-depth interviews with MSM and TGP who use methamphetamine or who have worked with people who use methamphetamine. During these formative activities, we asked participants about their opinions on the proposed interventions, education and recruitment materials, and study design. We focused on how we could develop peer navigation and text messaging interventions that would be culturally appropriate and acceptable to MSM and TGP who use methamphetamine. Transcripts were reviewed by two authors who performed a retrospective content analysis to describe which specific opinions and recommendations influenced protocol development and the refinement of the interventions.

Results

Overall, participants thought that MSM and TGP would be interested in participating in the study, although they expected recruitment and retention to be challenging. Participants thought that the peer navigator should be someone who is nonjudgmental, has experience with people who use methamphetamine, and is patient and flexible. There was consensus that three text messages per day were appropriate, adherence reminders should be straightforward, all messages should be nonjudgmental, and participants should be able to tailor the timing and content of the text messages. These suggestions were incorporated into the study interventions via the hiring and training process and into the development of the text library, platform selection, and customizability of messages.

Conclusions

It is important to include the opinions and insights of populations most impacted by HIV to develop PrEP interventions with the greatest chance of success. Our formative work generated several recommendations that were incorporated into the interventions and protocol development for our ongoing study.

Trial Registration

ClinicalTrials.gov NCT03584282; https://clinicaltrials.gov/ct2/show/NCT03584282
Standalone Smartphone Cognitive Behavioral Therapy–Based Ecological Momentary Interventions to Increase Mental Health: Narrative Review
Authors: Marciniak Marta Anna , Shanahan Lilly , Rohde Judith , Schulz Ava , Wackerhagen Carolin , Kobylińska Dorota , Tuescher Oliver , Binder Harald , Walter Henrik , Kalisch Raffael , Kleim Birgit
Published: September 2020

Background

A growing number of psychological interventions are delivered via smartphones with the aim of increasing the efficacy and effectiveness of these treatments and providing scalable access to interventions for improving mental health. Most of the scientifically tested apps are based on cognitive behavioral therapy (CBT) principles, which are considered the gold standard for the treatment of most mental health problems.

Objective

This review investigates standalone smartphone-based ecological momentary interventions (EMIs) built on principles derived from CBT that aim to improve mental health.

Methods

We searched the MEDLINE, PsycINFO, EMBASE, and PubMed databases for peer-reviewed studies published between January 1, 2007, and January 15, 2020. We included studies focusing on standalone app-based approaches to improve mental health and their feasibility, efficacy, or effectiveness. Both within- and between-group designs and studies with both healthy and clinical samples were included. Blended interventions, for example, app-based treatments in combination with psychotherapy, were not included. Selected studies were evaluated in terms of their design, that is, choice of the control condition, sample characteristics, EMI content, EMI delivery characteristics, feasibility, efficacy, and effectiveness. The latter was defined in terms of improvement in the primary outcomes used in the studies.

Results

A total of 26 studies were selected. The results show that EMIs based on CBT principles can be successfully delivered, significantly increase well-being among users, and reduce mental health symptoms. Standalone EMIs were rated as helpful (mean 70.8%, SD 15.3; n=4 studies) and satisfying for users (mean 72.6%, SD 17.2; n=7 studies).

Conclusions

Study quality was heterogeneous, and feasibility was often not reported in the reviewed studies, thus limiting the conclusions that can be drawn from the existing data. Together, the studies show that EMIs may help increase mental health and thus support individuals in their daily lives. Such EMIs provide readily available, scalable, and evidence-based mental health support. These characteristics appear crucial in the context of a global crisis such as the COVID-19 pandemic but may also help reduce personal and economic costs of mental health impairment beyond this situation or in the context of potential future pandemics.
Cybersecurity in healthcare: Comparing cybersecurity maturity and experiences across global healthcare organizations (Preprint)
Authors: O'Brien Niki , Martin Guy , Grass Emilia , Durkin Mike , Darzi Ara , Ghafur Saira
Published: September 2020

BACKGROUND

Health systems around the world are increasingly reliant on digital technology. Such reliance requires that healthcare organizations consider effective cybersecurity and digital resilience as a fundamental component of patient safety, with recent cyberattacks highlighting the risks to patients and targeted organizations.

OBJECTIVE

The purpose of this study was to explore the current global cybersecurity landscape and maturity in healthcare.

METHODS

We developed and administered a survey to examine the current cybersecurity landscape and preparedness level across global healthcare organizations.

RESULTS

Cyber threats were a common concern for the 17 healthcare organizations who participated. The principal concerns highlighted were data security, including the manipulation or loss of electronic health records; loss of trust in the organization; and risks of service disruption. Cybersecurity maturity scoring showed that despite the majority of organizations having established cybersecurity practices, levels of awareness and education were universally poor.

CONCLUSIONS

Policymakers should consider raising awareness and improving education/training on cybersecurity as a fundamental tenet of patient safety.