bluuebunny/crossref_metadata_2025_split huggingface dataset:
Advances in transcatheter mitral and tricuspid therapies
Authors: Overtchouk Pavel , Piazza Nicolo , Granada Juan , Soliman Osama , Prendergast Bernard , Modine Thomas 
Published: January 2020

AbstractBackgroundWhile rheumatic mitral stenosis has been effectively treated percutaneously for more than 20 years, mitral and tricuspid regurgitation treatment appear as a contemporary unmet need. The advent of transcatheter therapies offer new treatment options to often elderly and frail patients at high risk for open surgery. We aimed at providing an updated review of fast-growing domain of transcatheter mitral and tricuspid technology.Main bodyWe reviewed the existing literature on mitral and tricuspid transcatheter therapies. Mitraclip is becoming an established therapy for secondary mitral regurgitation in selected patients with disproportionately severe regurgitation associated with moderate left ventricle dysfunction. Evidence is less convincing for primary mitral regurgitation. Transcatheter mitral valve replacement is a promising emerging alternative to transcatheter repair, for secondary as well as primary mitral regurgitation. But further development is needed to improve delivery. Transcatheter tricuspid intervention arrives late after similar technologies have been developed for aortic and mitral valves and is currently at its infancy. This is likely due in part to previously under-recognized impact of tricuspid regurgitation on patient outcomes. Edge-to-edge repair is the most advanced transcatheter solution in development. Data on tricuspid annuloplasty and replacement is limited, and more research is warranted.ConclusionThe future appears bright for transcatheter mitral therapies, albeit their place in clinical practice is yet to be clearly defined. Tricuspid transcatheter therapies might address the unmet need of tricuspid regurgitation treatment.
Emergency medical dispatch services across Pan-Asian countries: a web-based survey
Authors:   For the PAROS Clinical Research Network, Lee Shawn Chieh Loong , Mao Desmond Renhao , Ng Yih Yng , Leong Benjamin Sieu-Hon , Supasaovapak Jirapong , Gaerlan Faith Joan , Son Do Ngoc , Chia Boon Yang , Do Shin Sang , Lin Chih-Hao , Rao G. V. Ramana , Hara Takahiro , Ong Marcus Eng Hock 
Published: January 2020

Abstract
Background
Dispatch services (DS’s) form an integral part of emergency medical service (EMS) systems. The role of a dispatcher has also evolved into a crucial link in patient care delivery, particularly in dispatcher assisted cardio-pulmonary resuscitation (DACPR) during out-of-hospital cardiac arrest (OHCA). Yet, there has been a paucity of research into the emerging area of dispatch science in Asia. This paper compares the characteristics of DS’s, and state of implementation of DACPR within the Pan-Asian Resuscitation Outcomes (PAROS) network.

Methods
A cross-sectional descriptive survey addressing population characteristics, DS structures and levels of service, state of DACPR implementation (including protocols and quality improvement programs) among PAROS DS’s.

Results
9 DS’s responded, representing a total of 23 dispatch centres from 9 countries that serve over 80 million people. Most PAROS DS’s operate a tiered dispatch response, have implemented medical oversight, and tend to be staffed by dispatchers with a predominantly medical background. Almost all PAROS DS’s have begun tracking key EMS indicators. 77.8% (n = 7) of PAROS DS’s have introduced DACPR. Of the DS’s that have rolled out DACPR, 71.4% (n = 5) provided instructions in over one language. All DS’s that implemented DACPR and provided feedback to dispatchers offered feedback on missed OHCA recognition. The majority of DS’s (83.3%; n = 5) that offered DACPR and provided feedback to dispatchers also implemented corrective feedback, while 66.7% (n = 4) offered positive feedback. Compression-only CPR was the standard instruction for PAROS DS’s. OHCA recognition sensitivity varied widely in PAROS DS’s, ranging from 32.6% (95% CI: 29.9–35.5%) to 79.2% (95% CI: 72.9–84.4%). Median time to first compression ranged from 120 s to 220 s.

Conclusions
We found notable variations in characteristics and state of DACPR implementation between PAROS DS’s. These findings will lay the groundwork for future DS and DACPR studies in the PAROS network.
Comparison of Bayesian and frequentist group-sequential clinical trial designs
Authors: Stallard Nigel , Todd Susan , Ryan Elizabeth G. , Gates Simon 
Published: January 2020

Abstract
Background
There is a growing interest in the use of Bayesian adaptive designs in late-phase clinical trials. This includes the use of stopping rules based on Bayesian analyses in which the frequentist type I error rate is controlled as in frequentist group-sequential designs.

Methods
This paper presents a practical comparison of Bayesian and frequentist group-sequential tests. Focussing on the setting in which data can be summarised by normally distributed test statistics, we evaluate and compare boundary values and operating characteristics.

Results
Although Bayesian and frequentist group-sequential approaches are based on fundamentally different paradigms, in a single arm trial or two-arm comparative trial with a prior distribution specified for the treatment difference, Bayesian and frequentist group-sequential tests can have identical stopping rules if particular critical values with which the posterior probability is compared or particular spending function values are chosen. If the Bayesian critical values at different looks are restricted to be equal, O’Brien and Fleming’s design corresponds to a Bayesian design with an exceptionally informative negative prior, Pocock’s design to a Bayesian design with a non-informative prior and frequentist designs with a linear alpha spending function are very similar to Bayesian designs with slightly informative priors.This contrasts with the setting of a comparative trial with independent prior distributions specified for treatment effects in different groups. In this case Bayesian and frequentist group-sequential tests cannot have the same stopping rule as the Bayesian stopping rule depends on the observed means in the two groups and not just on their difference. In this setting the Bayesian test can only be guaranteed to control the type I error for a specified range of values of the control group treatment effect.

Conclusions
Comparison of frequentist and Bayesian designs can encourage careful thought about design parameters and help to ensure appropriate design choices are made.
Value of pyrazinamide for composition of new treatment regimens for multidrug-resistant Mycobacterium tuberculosis in China
Authors: Xia Hui , van den Hof Susan , Cobelens Frank , Zhou Yang , Zhao Bing , Wang Shengfen , Zhao Yanlin 
Published: January 2020

Abstract
Background
Pyrazinamide still may be a useful drug for treatment of rifampin-resistant (RR-TB) or multidrug-resistant tuberculosis (MDR-TB) in China while awaiting scale up of new drugs and regimens including bedaquiline and linezolid. The level of pyrazinamide resistance among MDR-TB patients in China is not well established. Therefore, we assessed pyrazinamide resistance in a representative sample and explored determinants and patterns of pncA mutations.

Methods
MDR-TB isolates from the 2007 national drug resistance survey of China were sub-cultured and examined for pyrazinamide susceptibility by BACTEC MGIT 960 method. pncA mutations were identified by sequencing. Characteristics associated with pyrazinamide resistance were analyzed using univariable and multivariable log-binominal regression.

Results
Of 401 MDR-TB isolates, 324 were successfully sub-cultured and underwent drug susceptibility testing. Pyrazinamide resistance was prevalent in 40.7% of samples, similarly among new and previously treated MDR-TB patients. Pyrazinamide resistance in MDR-TB patients was associated with lower age (adjusted OR 0.54; 95% CI, 0.34–0.87 for those aged ≧60 years compared to < 40 years). Pyrazinamide resistance was not associated with gender, residential area, previous treatment history and Beijing genotype. Of 132 patients with pyrazinamide resistant MDR-TB, 97 (73.5%) had a mutation in the pncA gene; with 61 different point mutations causing amino acid change, and 11 frameshifts in the pncA gene. The mutations were scattered throughout the whole pncA gene and no hot spot region was identified.

Conclusions
Pyrazinamide resistance among MDR-TB patients in China is common, although less so in elderly patients. Therefore, pyrazinamide should only be used for treatment of RR/MDR-TB in China if susceptibility is confirmed. Molecular testing for detection of pyrazinamide resistance only based on pncA mutations has certain value for the rapid detection of pyrazinamide resistance in MDR-TB strains but other gene mutations conferring to pyrazinamide resistance still need to be explored to increase its predictive ability .
Intensity of perinatal care for extremely preterm babies and outcomes at a higher gestational age: evidence from the EPIPAGE-2 cohort study
Authors: Morgan Andrei Scott , Khoshnood Babak , Diguisto Caroline , Foix L’Helias Laurence , Marchand-Martin Laetitia , Kaminski Monique , Zeitlin Jennifer , Bréart Gérard , Goffinet François , Ancel Pierre-Yves 
Published: January 2020

Abstract
Background
Perinatal decision-making affects outcomes for extremely preterm babies (22–26 weeks’ gestational age (GA)): more active units have improved survival without increased morbidity. We hypothesised such units may gain skills and expertise meaning babies at higher gestational ages have better outcomes than if they were born elsewhere. We examined mortality and morbidity outcomes at age two for babies born at 27–28 weeks’ GA in relation to the intensity of perinatal care provided to extremely preterm babies.

Methods
Fetuses from the 2011 French national prospective EPIPAGE-2 cohort, alive at maternal admission to a level 3 hospital and delivered at 27–28 weeks’ GA, were included. Morbidity-free survival (survival without sensorimotor (blindness, deafness or cerebral palsy) disability) and overall survival at age two were examined. Sensorimotor disability and Ages and Stages Questionnaire (ASQ) result below threshold among survivors were secondary outcomes. Perinatal care intensity level was based on birth hospital, grouped using the ratio of 24–25 weeks’ GA babies admitted to neonatal intensive care to fetuses of the same gestation alive at maternal admission. Sensitivity analyses used ratios based upon antenatal steroids, Caesarean section, and newborn resuscitation. Multiple imputation was used for missing data; hierarchical logistic regression accounted for births nested within centres.

Results
633 of 747 fetuses (84.7%) born at 27–28 weeks’ GA survived to age two. There were no differences in survival or morbidity-free survival: respectively, fully adjusted odds ratios were 0.96 (95% CI: 0.54 to 1.71) and 1.09 (95% CI: 0.59 to 2.01) in medium and 1.12 (95% CI: 0.63 to 2.00) and 1.16 (95% CI: 0.62 to 2.16) in high compared to low-intensity hospitals. Among survivors, there were no differences in sensorimotor disability or ASQ below threshold. Sensitivity analyses were consistent with the main results.

Conclusions
No difference was seen in survival or morbidity-free survival at two years of age among fetuses alive at maternal hospital admission born at 27–28 weeks’ GA, or in sensorimotor disability or presence of an ASQ below threshold among survivors. There is no evidence for an impact of intensity of perinatal care for extremely preterm babies on births at a higher gestational age.
Improving the psychometric properties of the dissociative experiences scale (DES-II): a Rasch validation study
Authors: Saggino Aristide , Molinengo Giorgia , Rogier Guyonne , Garofalo Carlo , Loera Barbara , Tommasi Marco , Velotti Patrizia 
Published: January 2020

Abstract
Background
The Dissociative Experiences Scale-II (DES-II) is a self-report questionnaire that measures dissociative experiences such as derealization, depersonalization, absorption and amnesia. The DES-II has been prevalently used as a screening tool in patients suffering from psychotic disorders or schizophrenia. However, dissociative experiences can also be part of normal psychological life. Despite its popularity, the most problematic aspect of the DES-II is the inconsistency in its factor structure, which is probably due to the tendency to treat ordinal responses as responses on an interval scale, as it is assumed in the Classical Test Theory approach. In order to address issues related to the inconsistency of previous results, the aim of the present study was to collect new psychometric evidence to improve the properties of the DES-II using Rasch analysis, i.e. analyzing the functioning of the response scale.

Methods
Data were obtained on a sample composed by 320 Italian participants (122 inmates and 198 community-dwelling individuals) and were analyzed with the Rasch model. This model allows the estimation of participants’ level of dissociation, the degree of misfit of each item, the reliability of each item, and their measurement invariance. Moreover, Rasch estimation allows to determine the best response scale, in terms of response modalities number and their discriminant power.

Results
Three items of the scale had strong misfit. After their deletion, the resulting scale was composed by 25 items, which had low levels of misfit and high reliability, and showed measurement invariance. Participants tended to select more often lower categories of the response scale.

Conclusions
Results provided new knowledge on the DES-II structure and its psychometric properties, contributing to the understanding and measurement of the dissociation construct.
Advocating an attack against severe malaria: a cost-effectiveness analysis
Authors: Greenhalgh Scott , Chandwani Veda 
Published: January 2020

Abstract
Background
A recent study found that the gut microbiota, Lactobacillus and Bifidobacterium, have the ability to modulate the severity of malaria. The modulation of the severity of malaria is not however, the typical focal point of most widespread interventions. Thus, an essential element of information required before serious consideration of any intervention that targets reducing severe malaria incidence is a prediction of the health benefits and costs required to be cost-effective.

Methods
Here, we developed a mathematical model of malaria transmission to evaluate an intervention that targets reducing severe malaria incidence. We consider intervention scenarios of a 2-, 7-, and 14-fold reduction in severe malaria incidence, based on the potential reduction in severe malaria incidence caused by gut microbiota, under entomological inoculation rates occurring in 41 countries in sub-Saharan Africa. For each intervention scenario, disability-adjusted life years averted and incremental cost-effectiveness ratios were estimated using country specific data, including the reported proportions of severe malaria incidence in healthcare settings.

Results
Our results show that an intervention that targets reducing severe malaria incidence with annual costs between $23.65 to $30.26 USD per person and causes a 14-fold reduction in severe malaria incidence would be cost-effective in 15–19 countries and very cost-effective in 9–14 countries respectively. Furthermore, if model predictions are based on the distribution of gut microbiota through a freeze-dried yogurt that cost $0.20 per serving, a 2- to 14-fold reduction in severe malaria incidence would be cost-effective in 29 countries and very cost-effective in 25 countries.

Conclusion
Our findings indicate interventions that target severe malaria can be cost-effective, in conjunction with standard interventions, for reducing the health burden and costs attributed to malaria. While our results illustrate a stronger cost-effectiveness for greater reductions, they consistently show that even a limited reduction in severe malaria provides substantial health benefits, and could be economically viable. Therefore, we suggest that interventions that target severe malaria are worthy of consideration, and merit further empirical and clinical investigation.
Screening of cellulolytic bacteria from rotten wood of Qinling (China) for biomass degradation and cloning of cellulases from Bacillus methylotrophicus
Authors: Ma Lingling , Lu Yingying , Yan Hong , Wang Xin , Yi Yanglei , Shan Yuanyuan , Liu Bianfang , Zhou Yuan , Lü Xin 
Published: January 2020

AbstractBackgroundCellulosic biomass degradation still needs to be paid more attentions as bioenergy is the most likely to replace fossil energy in the future, and more evaluable cellulolytic bacteria isolation will lay a foundation for this filed. Qinling Mountains have unique biodiversity, acting as promising source of cellulose-degrading bacteria exhibiting noteworthy properties. Therefore, the aim of this work was to find potential cellulolytic bacteria and verify the possibility of the cloning of cellulases from the selected powerful bacteria.ResultsIn present study, 55 potential cellulolytic bacteria were screened and identified from the rotten wood of Qinling Mountains. Based on the investigation of cellulase activities and degradation effect on different cellulose substrates,Bacillus methylotrophicus1EJ7,Bacillus subtilis1AJ3 andBacillus subtilis3BJ4 were further applied to hydrolyze wheat straw, corn stover and switchgrass, and the results suggested thatB. methylotrophicus1EJ7 was the most preponderant bacterium, and which also indicated thatBacilluswas the main cellulolytic bacteria in rotten wood. Furthermore, scanning electron microscopy (SEM) and X-ray diffraction analysis of micromorphology and crystallinity of wheat straw also verified the significant hydrolyzation. With ascertaining the target sequence of cellulase β-glucosidase (243 aa) and endoglucanase (499 aa) were successfully heterogeneously cloned and expressed fromB. methylotrophicus1EJ7, and which performed a good effect on cellulose degradation with enzyme activity of 1670.15 ± 18.94 U/mL and 0.130 ± 0.002 U/mL, respectively. In addition, based on analysis of amino acid sequence, it found that β-glucosidase were belonged to GH16 family, and endoglucanase was composed of GH5 family catalytic domain and a carbohydrate-binding module of CBM3 family.ConclusionsBased on the screening, identification and cellulose degradation effect evaluation of cellulolytic bacteria from rotten wood of Qinling Mountains, it found thatBacilluswere the predominant species among the isolated strains, andB. methylotrophicus1EJ7 performed best on cellulose degradation. Meanwhile, the β-glucosidase and endoglucanase were successfully cloned and expressed fromB. methylotrophicusfor the first time, which provided new materials of both strain and the recombinant enzymes for the study of cellulose degradation and its application in industry.
Validation of a competence-based assessment of medical students’ performance in the physician’s role
Authors: Prediger Sarah , Schick Kristina , Fincke Fabian , Fürstenberg Sophie , Oubaid Viktor , Kadmon Martina , Berberat Pascal O. , Harendza Sigrid 
Published: January 2020

Abstract
Background
Assessing competence of advanced undergraduate medical students based on performance in the clinical context is the ultimate, yet challenging goal for medical educators to provide constructive alignment between undergraduate medical training and professional work of physicians. Therefore, we designed and validated a performance-based 360-degree assessment for competences of advanced undergraduate medical students.

Methods
This study was conducted in three steps: 1) Ten facets of competence considered to be most important for beginning residents were determined by a ranking study with 102 internists and 100 surgeons. 2) Based on these facets of competence we developed a 360-degree assessment simulating a first day of residency. Advanced undergraduate medical students (year 5 and 6) participated in the physician’s role. Additionally knowledge was assessed by a multiple-choice test. The assessment was performed twice (t1 and t2) and included three phases: a consultation hour, a patient management phase, and a patient handover. Sixty-seven (t1) and eighty-nine (t2) undergraduate medical students participated. 3) The participants completed the Group Assessment of Performance (GAP)-test for flight school applicants to assess medical students‘ facets of competence in a non-medical context for validation purposes. We aimed to provide a validity argument for our newly designed assessment based on Messick’s six aspects of validation: (1) content validity, (2) substantive/cognitive validity, (3) structural validity, (4) generalizability, (5) external validity, and (6) consequential validity.

Results
Our assessment proved to be well operationalised to enable undergraduate medical students to show their competences in performance on the higher levels of Bloom’s taxonomy. Its generalisability was underscored by its authenticity in respect of workplace reality and its underlying facets of competence relevant for beginning residents. The moderate concordance with facets of competence of the validated GAP-test provides arguments of convergent validity for our assessment. Since five aspects of Messick’s validation approach could be defended, our competence-based 360-degree assessment format shows good arguments for its validity.

Conclusion
According to these validation arguments, our assessment instrument seems to be a good option to assess competence in advanced undergraduate medical students in a summative or formative way. Developments towards assessment of postgraduate medical trainees should be explored.
Identification of biomarkers and drug repurposing candidates based on an immune-, inflammation- and membranous glomerulonephritis-associated triplets network for membranous glomerulonephritis
Authors: Zhang Chengwei , Leng Lei , Li Zhaozheng , Zhao Yao , Jiao Jundong 
Published: January 2020

Abstract
Background
Membranous glomerulonephritis (MGN) is a common kidney disease. Despite many evidences support that many immune and inflammation-related genes could serve as effective biomarkers and treatment targets for MGN patients, the potential associations among MGN-, immune- and inflammation-related genes have not been sufficiently understood.

Methods
Here, a global immune-, inflammation- and MGN-associated triplets (IIMATs) network is constructed and analyzed. An integrated and computational approach is developed to identify dysregulated IIMATs for MGN patients based on expression and interaction data.

Results
45 dysregulated IIMATs are identified in MGN by above method. Dysregulated patterns of these dysregulated IIMATs are complex and various. We identify four core clusters from dysregulated IIMATs network and some of these clusters could distinguish MGN and normal samples. Specially, some anti-cancer drugs including Tamoxifen, Bosutinib, Ponatinib and Nintedanib could become candidate drugs for MGN based on drug repurposing strategy follow IIMATs. Functional analysis shows these dysregulated IIMATs are associated with some key functions and chemokine signaling pathway.

Conclusions
The present study explored the associations among immune, inflammation and MGN. Some effective candidate drugs for MGN were identified based on immune and inflammation. Overall, these comprehensive results provide novel insights into the mechanisms and treatment of MGN.