Social capital and health: a review of prospective multilevel studies.

PubMed

Murayama, Hiroshi; Fujiwara, Yoshinori; Kawachi, Ichiro

2012-01-01

This article presents an overview of the concept of social capital, reviews prospective multilevel analytic studies of the association between social capital and health, and discusses intervention strategies that enhance social capital. We conducted a systematic search of published peer-reviewed literature on the PubMed database and categorized studies according to health outcome. We identified 13 articles that satisfied the inclusion criteria for the review. In general, both individual social capital and area/workplace social capital had positive effects on health outcomes, regardless of study design, setting, follow-up period, or type of health outcome. Prospective studies that used a multilevel approach were mainly conducted in Western countries. Although we identified some cross-sectional multilevel studies that were conducted in Asian countries, including Japan, no prospective studies have been conducted in Asia. Prospective evidence from multilevel analytic studies of the effect of social capital on health is very limited at present. If epidemiologic findings on the association between social capital and health are to be put to practical use, we must gather additional evidence and explore the feasibility of interventions that build social capital as a means of promoting health.

Prognostic factors for chronic headache

PubMed Central

Bowers, Hannah; Caldwell, Fiona; Mistry, Dipesh; Underwood, Martin; Matharu, Manjit; Pincus, Tamar

2017-01-01

Objective: To identify predictors of prognosis and trial outcomes in prospective studies of people with chronic headache. Methods: This was a systematic review of published literature in peer-reviewed journals. We included (1) randomized controlled trials (RCTs) of interventions for chronic headache that reported subgroup analyses and (2) prospective cohort studies, published in English, since 1980. Participants included adults with chronic headache (including chronic headache, chronic migraine, and chronic tension-type headache with or without medication overuse headache). We searched key databases using free text and MeSH terms. Two reviewers independently extracted data and assessed the methodologic quality of studies and overall quality of evidence identified using appropriate published checklists. Results: We identified 16,556 titles, removed 663 duplicates, and reviewed 199 articles, of which 27 were included in the review—17 prospective cohorts and 10 RCTs with subgroup analyses reported. There was moderate-quality evidence indicating that depression, anxiety, poor sleep and stress, medication overuse, and poor self-efficacy for managing headaches are potential prognostic factors for poor prognosis and unfavorable outcomes from preventive treatment in chronic headache. There was inconclusive evidence about treatment expectations, age, age at onset, body mass index, employment, and several headache features. Conclusions: This review identified several potential predictors of poor prognosis and worse outcome postinterventions in people with chronic headache. The majority of these are modifiable. The findings also highlight the need for more longitudinal high-quality research of prognostic factors in chronic headache. PMID:28615422

Improving transparency and reproducibility through registration: The status of intervention trials published in clinical psychology journals.

PubMed

Cybulski, Lukasz; Mayo-Wilson, Evan; Grant, Sean

2016-09-01

Prospective registration increases the validity of randomized controlled trials (RCTs). In the United States, registration is a legal requirement for drugs and devices regulated by the Food and Drug Administration (FDA), and many biomedical journals refuse to publish trials that are not registered. Trials in clinical psychology have not been subject to these requirements; it is unknown to what extent they are registered. We searched the 25 highest-impact clinical psychology journals that published at least 1 RCT of a health-related psychological intervention in 2013. For included trials, we evaluated their registration status (prospective, retrospective, not registered) and the completeness of their outcome definitions. We identified 163 articles that reported 165 RCTs; 73 (44%) RCTs were registered, of which only 25 (15%) were registered prospectively. Of registered RCTs, only 42 (58%) indicated their registration status in the publication. Only 2 (1% of all trials) were registered prospectively and defined their primary outcomes completely. For the primary outcome(s), 72 (99%) of all registrations defined the domain, 67 (92%) the time frame, and 48 (66%) the specific measurements. Only 19 (26%) and 5 (7%) defined the specific metric and method of aggregation, respectively, for all primary outcomes. Very few reports of RCTs published in clinical psychology journals were registered prospectively and completely. Clinical psychology journals could improve transparency and reproducibility, as well as reduce bias, by requiring complete prospective trial registration for publication and by including trial registration numbers in all reports of RCTs. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Evidence from prospective cohort studies did not support the introduction of dietary fat guidelines in 1977 and 1983: a systematic review.

PubMed

Harcombe, Zoë; Baker, Julien S; Davies, Bruce

2017-12-01

National dietary guidelines were introduced in 1977 and 1983, by the USA and UK governments to reduce coronary heart disease (CHD) mortality by reducing dietary fat intake. Our 2015 systematic review examined randomised controlled trial (RCT) evidence available to the dietary committees at the time; we found no support for the recommendations to restrict dietary fat. What epidemiological evidence was available to the dietary guideline committees in 1983? A systematic review of prospective cohort studies, published prior to 1983, which examined the relationship between dietary fat, serum cholesterol and the development of CHD. Across 6 studies, involving 31 445 participants, there were 1521 deaths from all-causes and 360 deaths from CHD during the mean follow-up of 7.5±6.2 years. The death rates were 4.8% and 1.1% from all-causes and CHD respectively. One study included men with previous heart disease. The death rate from CHD for those with, and without previous myocardial infarction was 20.9% and 1.0% respectively. None of the six studies found a significant relationship between CHD deaths and total dietary fat intake. One of the six studies found a correlation between CHD deaths and saturated dietary fat intake across countries; none found a relationship between CHD deaths and saturated dietary fat in the same population. 1983 dietary recommendations for 220 million US and 56 million UK citizens lacked supporting evidence from RCT or prospective cohort studies. The extant research had been undertaken exclusively on males, so lacked generalisability for population-wide guidelines. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Prospective content in the friendship conversations of young adults.

PubMed

Young, Richard A; Marshall, Sheila K; Murray, John

2017-01-01

Prospection is cognitive processes that involve constructing, encoding, and remembering the future. Less is known about the how these processes are evident in the prospective content of conversations. This study sought to identify and describe evidence of the prospective content in the conversations of friends as they transition to adulthood. The present secondary content analysis of the videotaped conversations of 15 young adult friendship dyads (n = 30, 16 females, 14 males, mean age = 21.3 years) in Canada examined these conversations based the following characteristics of prospection: simulation, reasoning about counterfactuals, constructing multiple possible futures, and episodic memory of the past. Four categories of prospective content were evident in these conversations, these processes were used sparingly in all but one conversation, and relatively few of them were collaborative in that dyad partners did not appear to serve to augment, clarify, or disconfirm prospective content. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Prospective associations between loneliness and emotional intelligence.

PubMed

Wols, A; Scholte, R H J; Qualter, P

2015-02-01

Loneliness has been linked cross-sectionally to emotional skill deficits (e.g., Zysberg, 2012), but missing from the literature is a longitudinal examination of these relationships. The present study fills that gap by examining the prospective relationships between loneliness and emotional functioning in young adolescents in England. One hundred and ninety-six adolescents aged 11-13 years (90 females) took part in the study and completed the youth version of the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT-YV) and the peer-related subscale of the Loneliness and Aloneness Scale for Children and Adolescents (LACA) at two time points, which were 10 months apart. Prospective associations were obtained for male and female adolescents separately using cross-lagged statistical techniques. Our results showed prospective links between understanding and managing emotions and loneliness for both females and males. Perceiving and using emotions were prospectively linked to loneliness in males only. Possible explanations and directions for future research are discussed. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Retrospective Validation of a Surveillance System for Unexplained Illness and Death: New Haven County, Connecticut

PubMed Central

Kluger, Michael D.; Sofair, Andre N.; Heye, Constance J.; Meek, James I.; Sodhi, Rajesh K.; Hadler, James L.

2001-01-01

Objectives. This study investigated retrospective validation of a prospective surveillance system for unexplained illness and death due to possibly infectious causes. Methods. A computerized search of hospital discharge data identified patients with potential unexplained illness and death due to possibly infectious causes. Medical records for such patients were reviewed for satisfaction of study criteria. Cases identified retrospectively were combined with prospectively identified cases to form a reference population against which sensitivity could be measured. Results. Retrospective validation was 41% sensitive, whereas prospective surveillance was 73% sensitive. The annual incidence of unexplained illness and death due to possibly infectious causes during 1995 and 1996 in the study county was conservatively estimated to range from 2.7 to 6.2 per 100 000 residents aged 1 to 49 years. Conclusions. Active prospective surveillance for unexplained illness and death due to possibly infectious causes is more sensitive than retrospective surveillance conducted through a published list of indicator codes. However, retrospective surveillance can be a feasible and much less labor-intensive alternative to active prospective surveillance when the latter is not possible or desired. PMID:11499106

Predictors of not pursuing infertility treatment after an infertility diagnosis: examination of a prospective U.S. cohort.

PubMed

Eisenberg, Michael L; Smith, James F; Millstein, Susan G; Nachtigall, Robert D; Adler, Nancy E; Pasch, Lauri A; Katz, Patricia P

2010-11-01

We studied a prospective cohort of 434 couples in Northern California and found that 13% did not pursue any form of infertility treatment after their initial consultation. Although age, education, and financial concerns remain important for patients in choosing whether to pursue infertility treatment, depressive symptoms may also be a barrier to achieving reproductive goals. Copyright © 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Use of Platelet-Rich Plasma in Intra-Articular Knee Injections for Osteoarthritis: A Systematic Review.

PubMed

Lai, Lawrence P; Stitik, Todd P; Foye, Patrick M; Georgy, John S; Patibanda, Varun; Chen, Boqing

2015-06-01

To systematically analyze the literature on the use of platelet-rich plasma (PRP) for intra-articular injections of the knee and its efficacy in the treatment of knee osteoarthritis (OA). Systematic literature reviews were conducted in PubMed, Embase, and CINAHL (ie, Cumulative Index to Nursing and Allied Health Literature) on October 30, 2013, using the keywords "platelet-rich plasma" and "knee" and "osteoarthritis." Inclusion criteria included (1) studies with human subjects, (2) prospective clinical studies (including either clinical trials or observational studies), and (3) full-text articles published in English. Exclusion criteria were: (1) animal studies; (2) retrospective studies; (3) patients with previous surgical intervention with total knee arthroplasty or reconstruction of the anterior cruciate ligaments; and (4) articles not published in English A total of 319 abstracts and titles were reviewed (60 from PubMed, 250 from Embase, and 9 from CINAHL). A total of 8 relevant journal articles were identified, all of which were published between 2010 and 2013. One-half of the studies were prospective observational studies that included only PRP treatment; the rest were prospective comparative studies including both PRP and controls-2 were randomized controlled trials. Of the 4 comparative studies, 3 compared PRP with hyaluronic acid, which was considered as a commonly used effective treatment for knee OA; the other one used saline injection (ie, placebo) as the control. Although most of the analyses suffered from small sample size and was thus inconclusive, the findings consistently indicated that PRP might have better outcomes in patients with a lesser degree of degeneration and in younger patients. PRP intra-articular injections of the knee may be an effective alternative treatment for knee OA. However, current studies are at best inconclusive regarding the efficacy of the PRP treatment. A large, multicenter randomized trial study is needed to further assess the efficacy of PRP treatment for patients with knee OA. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Modelling duodenum radiotherapy toxicity using cohort dose-volume-histogram data.

PubMed

Holyoake, Daniel L P; Aznar, Marianne; Mukherjee, Somnath; Partridge, Mike; Hawkins, Maria A

2017-06-01

Gastro-intestinal toxicity is dose-limiting in abdominal radiotherapy and correlated with duodenum dose-volume parameters. We aimed to derive updated NTCP model parameters using published data and prospective radiotherapy quality-assured cohort data. A systematic search identified publications providing duodenum dose-volume histogram (DVH) statistics for clinical studies of conventionally-fractionated radiotherapy. Values for the Lyman-Kutcher-Burman (LKB) NTCP model were derived through sum-squared-error minimisation and using leave-one-out cross-validation. Data were corrected for fraction size and weighted according to patient numbers, and the model refined using individual patient DVH data for two further cohorts from prospective clinical trials. Six studies with published DVH data were utilised, and with individual patient data included outcomes for 531 patients in total (median follow-up 16months). Observed gastro-intestinal toxicity rates ranged from 0% to 14% (median 8%). LKB parameter values for unconstrained fit to published data were: n=0.070, m=0.46, TD 50(1) [Gy]=183.8, while the values for the model incorporating the individual patient data were n=0.193, m=0.51, TD 50(1) [Gy]=299.1. LKB parameters derived using published data are shown to be consistent to those previously obtained using individual patient data, supporting a small volume-effect and dependence on exposure to high threshold dose. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

A review of temporomandibular joint-related papers published between 2014-2015.

PubMed

Singh, Vaibhav; Sudhakar, K N V; Mallela, Kiran Kumar; Mohanty, Rajat

2017-12-01

We conducted a retrospective study and reviewed the temporomandibular joint (TMJ)-related papers published in a leading international journal, Journal of Oral and Maxillofacial Surgery , between January 2014 and December 2015. The study was conducted to ascertain and compare the trends of articles being published in the years 2014 and 2015. A total of 28 articles were reviewed, of which most of the full-length articles were on clinical management and outcomes and the role of radiology. The bulk of the studies were prospective, and less interest was shown in experimental research. A thorough review and analysis thus gives the impression that there is a great need for well-designed clinical studies on TMJ.

Is Mandatory Prospective Trial Registration Working to Prevent Publication of Unregistered Trials and Selective Outcome Reporting? An Observational Study of Five Psychiatry Journals That Mandate Prospective Clinical Trial Registration.

PubMed

Scott, Amelia; Rucklidge, Julia J; Mulder, Roger T

2015-01-01

To address the bias occurring in the medical literature associated with selective outcome reporting, in 2005, the International Committee of Medical Journal Editors (ICMJE) introduced mandatory trial registration guidelines and member journals required prospective registration of trials prior to patient enrolment as a condition of publication. No research has examined whether these guidelines are impacting psychiatry publications. Our objectives were to determine the extent to which articles published in psychiatry journals adhering to ICMJE guidelines were correctly prospectively registered, whether there was evidence of selective outcome reporting and changes to participant numbers, and whether there was a relationship between registration status and source of funding. Any clinical trial (as defined by ICMJE) published between 1 January 2009 and 31 July 2013 in the top five psychiatry journals adhering to ICMJE guidelines (The American Journal of Psychiatry, Archives of General Psychiatry/JAMA Psychiatry, Biological Psychiatry, Journal of the American Academy of Child and Adolescent Psychiatry, and The Journal of Clinical Psychiatry) and conducted after July 2005 (or 2007 for two journals) was included. For each identified trial, where possible we extracted trial registration information, changes to POMs between publication and registry to assess selective outcome reporting, changes to participant numbers, and funding type. Out of 3305 articles, 181 studies were identified as clinical trials requiring registration: 21 (11.6%) were deemed unregistered, 61 (33.7%) were retrospectively registered, 37 (20.4%) had unclear POMs either in the article or the registry and 2 (1.1%) were registered in an inaccessible trial registry. Only 60 (33.1%) studies were prospectively registered with clearly defined POMs; 17 of these 60 (28.3%) showed evidence of selective outcome reporting and 16 (26.7%) demonstrated a change in participant numbers of 20% or more; only 26 (14.4%) of the 181 the trials were prospectively registered and did not alter their POMs or the time frames at which they were measured. Prospective registration with no changes in POMs occurred more frequently with pharmaceutical funding. Although standards are in place to improve prospective registration and transparency in clinical trials, less than 15% of psychiatry trials were prospectively registered with no changes in POMs. Most trials were either not prospectively registered, changed POMs or the timeframes at some point after registration or changed participant numbers. Authors, journal editors and reviewers need to further efforts to highlight the value of prospective trial registration.

Parenting styles and body mass index: a systematic review of prospective studies among children.

PubMed

Sokol, R L; Qin, B; Poti, J M

2017-03-01

Parenting style may be an important determinant of an individual's future weight status. However, reviews that evaluate the relationship between parenting style and weight-related outcomes have not focused on prospective studies. We systematically searched PubMed, Embase and PsychInfo for studies published between 1995 and 2016 that evaluated the prospective relationship between parenting style experienced in childhood and subsequent weight outcomes. We identified 11 prospective cohort studies. Among the eight studies that categorized parenting style into distinct groups (i.e. authoritative, authoritarian, permissive and neglectful), five provided evidence that authoritative parenting was associated with lower body mass index gains. Among the six highest quality studies, four suggested a protective role of authoritative parenting style against adverse weight-related outcomes. However, only one study controlled for a comprehensive set of confounders, and the small number of studies conducted within certain age groups precluded our ability to ascertain critical periods when parenting style is most strongly related to child weight. The present literature supports the idea that authoritative parenting may be protective against later overweight and obesity, although findings are mixed. More prospective cohort studies of longer durations, with more sophisticated methods that examine age-varying relationships, and that control for a comprehensive set of confounders, are needed. © 2017 World Obesity Federation.

Parenting styles and body mass index: A systematic review of prospective studies among children

PubMed Central

Sokol, Rebeccah L; Qin, Bo; Poti, Jennifer M

2017-01-01

Background Parenting style may be an important determinant of an individual's future weight status. However, reviews that evaluate the relationship between parenting style and weight-related outcomes have not focused on prospective studies. Methods We systematically searched PubMed, Embase, and PsychInfo for studies published between 1995-2016 that evaluated the prospective relationship between parenting style experienced in childhood and subsequent weight outcomes. Results We identified eleven prospective cohort studies. Among the eight studies that categorized parenting style into distinct groups (i.e. authoritative, authoritarian, permissive, and neglectful), five provided evidence that authoritative parenting was associated with lower body mass index gains. Among the six highest quality studies, four suggested a protective role of authoritative parenting style against adverse weight-related outcomes. However, only one study controlled for a comprehensive set of confounders, and the small number of studies conducted within certain age groups precluded our ability to ascertain critical periods when parenting style is most strongly related to child weight. Conclusions The present literature supports the idea that authoritative parenting may be protective against later overweight and obesity, although findings are mixed. More prospective cohort studies of longer durations, with more sophisticated methods that examine age-varying relationships, and that control for a comprehensive set of confounders, are needed. PMID:28086262

Sugar-sweetened beverage intake before 6 years of age and weight or BMI status among older children; systematic review of prospective studies.

PubMed

Pérez-Morales, Eugenia; Bacardí-Gascón, Montserrat; Jiménez-Cruz, Arturo

2013-01-01

The purpose of this study was to conduct a systematic review of prospective studies that examined the association between sugar-sweetened beverage intake before 6y of age and later weight or BMI status among older children. An electronic literature search was conducted in the MEDLINE/PubMed, SciELO, and EBSCO databases of prospective studies published from 2001 to 2011. Seven studies were analyzed. The study population was from 72 to 10,904 children. Three studies showed a consistent association between SSB intake before 6 y of age and increased weight, BMI, or waist circumference later in childhood, one study showed a positive trend of consumption of SSB and childhood obesity and the OR for incidence of overweight by baseline beverage intake was 1.04, another study it was observed that an increase in total sugar intake and sugar from sweets and beverages in children 1-2 y of age and 7-9 y of age have a tendency to increase BMI, and two studies showed no association. In conclusion, although the trend of the reviews studies, indicate an association between sugar-sweetened beverage intake before 6 y of age and increased weight, BMI or waist circumference later in childhood, to date, the results are inconsistent, and the two studies with the higher number of children showed a positive association. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

Blood concentrations of carotenoids and retinol and lung cancer risk: an update of the WCRF-AICR systematic review of published prospective studies.

PubMed

Abar, Leila; Vieira, Ana Rita; Aune, Dagfinn; Stevens, Christophe; Vingeliene, Snieguole; Navarro Rosenblatt, Deborah A; Chan, Doris; Greenwood, Darren C; Norat, Teresa

2016-08-01

Carotenoids and retinol are considered biomarkers of fruits and vegetables intake, and are of much interest because of their anti-inflammatory and antioxidant properties; however, there is inconsistent evidence regarding their protective effects against lung cancer. We conducted a meta-analysis of prospective studies of blood concentrations of carotenoids and retinol, and lung cancer risk. We identified relevant prospective studies published up to December 2014 by searching the PubMed and several other databases. We calculated summary estimates of lung cancer risk for the highest compared with lowest carotenoid and retinol concentrations and dose-response meta-analyses using random effects models. We used fractional polynomial models to assess potential nonlinear relationships. Seventeen prospective studies (18 publications) including 3603 cases and 458,434 participants were included in the meta-analysis. Blood concentrations of α-carotene, β-carotene, total carotenoids, and retinol were significantly inversely associated with lung cancer risk or mortality. The summary relative risk were 0.66 (95% confidence interval [CI]: 0.55-0.80) per 5 μg/100 mL of α-carotene (studies [n] = 5), 0.84 (95% CI: 0.76-0.94) per 20 μg/100 mL of β-carotene (n = 9), 0.66 (95% CI: 0.54-0.81) per 100 μg/100 mL of total carotenoids (n = 4), and 0.81 (95% CI: 0.73-0.90) per 70 μg/100 mL of retinol (n = 8). In stratified analysis by sex, the significant inverse associations for β-carotene and retinol were observed only in men and not in women. Nonlinear associations were observed for β-carotene, β-cryptoxanthin, and lycopene, with stronger associations observed at lower concentrations. There were not enough data to conduct stratified analyses by smoking. In conclusion, higher blood concentrations of several carotenoids and retinol are associated with reduced lung cancer risk. Further studies in never and former smokers are needed to rule out confounding by smoking. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

A strange program for LHCb

NASA Astrophysics Data System (ADS)

Martínez Santos, Diego

2018-05-01

The LHCb experiment is expanding its physics program towards studies of rare decays of strange particles. In this talk, we reviewed the published results by LHCb in Ks0→μ+μ-and Σ+→pμ+μ- decays, as well as sensitivity studies and prospects for other strangeness decays.

Performance characteristics of optical coherence tomography in assessment of Barrett's esophagus and esophageal cancer: systematic review.

PubMed

Kohli, D R; Schubert, M L; Zfass, A M; Shah, T U

2017-11-01

Optical coherence tomography (OCT) can generate high-resolution images of the esophagus that allows cross-sectional visualization of esophageal wall layers. We conducted a systematic review to assess the utility of OCT for diagnosing of esophageal intestinal metaplasia (IM; Barrett's esophagus BE)), dysplasia, cancer and staging of early esophageal cancer. English language human observational studies and clinical trials published in PubMed and Embase were included if they assessed any of the following: (i) in-vivo features and accuracy of OCT at diagnosing esophageal IM, sub-squamous intestinal metaplasia (SSIM), dysplasia, or cancer, and (ii) accuracy of OCT in staging esophageal cancer. Twenty-one of the 2,068 retrieved citations met inclusion criteria. In the two prospective studies that assessed accuracy of OCT at identifying IM, sensitivity was 81%-97%, and specificity was 57%-92%. In the two prospective studies that assessed accuracy of OCT at identifying dysplasia and early cancer, sensitivity was 68%-83%, and specificity was 75%-82%. Observational studies described significant variability in the ability of OCT to accurately identify SSIM. Two prospective studies that compared the accuracy of OCT at staging early squamous cell carcinoma to histologic resection specimens reported accuracy of >90%. Risk of bias and applicability concerns was rated as low among the prospective studies using the QUADAS-2 questionnaire. OCT may identify intestinal metaplasia and dysplasia, but its accuracy may not meet recommended thresholds to replace 4-quadrant biopsies in clinical practice. OCT may be more accurate than EUS at staging early esophageal cancer, but randomized trials and cost-effective analyses are lacking. © The Authors 2017. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Health effects of employment: a systematic review of prospective studies.

PubMed

van der Noordt, Maaike; IJzelenberg, Helma; Droomers, Mariël; Proper, Karin I

2014-10-01

The purpose of this review was to systematically summarise the literature on the health effects of employment. A search for prospective studies investigating the effect of employment on health was executed in several electronic databases, and references of selected publications were checked. Subsequently, the methodological quality of each study was assessed by predefined criteria. To draw conclusions about the health effect of employment, a best evidence synthesis was used, and if possible, data were pooled. 33 prospective studies were included, of which 23 were of high quality. Strong evidence was found for a protective effect of employment on depression and general mental health. Pooled effect sizes showed favourable effects on depression (OR=0.52; 95% CI 0.33 to 0.83) and psychological distress (OR=0.79; 95% CI 0.72 to 0.86). Insufficient evidence was found for general health, physical health and mortality due to lack of studies or inconsistent findings. This systematic review indicates that employment is beneficial for health, particularly for depression and general mental health. There is a need for more research on the effects of employment on specific physical health effects and mortality to fill the knowledge gaps. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Nonsuicidal self-injury in community adolescents: A systematic review of prospective predictors, mediators and moderators.

PubMed

Valencia-Agudo, Fatima; Burcher, Georgina Corbet; Ezpeleta, Lourdes; Kramer, Tami

2018-06-01

Nonsuicidal self-injury (NSSI) usually starts during adolescence and is associated with an array of psychological and psychiatric symptoms and future suicide attempts. The aim of this study is to determine prospective predictors, mediators and moderators of NSSI in adolescent community samples in order to target prevention and treatment strategies. Two team members searched online databases independently. Thirty-nine studies were included in the review. Several variables were seen to prospectively predict NSSI: female gender, family-related variables, peer victimisation, depression, previous NSSI and self-concept. Few studies analysed mediators and moderators. Low self-concept was highlighted as a relevant moderator in the relationship between intra/interpersonal variables and NSSI. Implications of these findings are discussed. The considerable heterogeneity between studies posed a limitation to determine robust predictors of NSSI. Further prospective studies using standardised measures of predictors and outcomes are needed to ascertain the most at risk individuals and develop prevention strategies. Copyright © 2018 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Trade Publishing: A Report from the Front.

ERIC Educational Resources Information Center

Fister, Barbara

2001-01-01

Reports on the current condition of trade publishing and its future prospects based on interviews with editors, publishers, agents, and others. Discusses academic libraries and the future of trade publishing, including questions relating to electronic books, intellectual property, and social and economic benefits of sharing information…

Ocular complications of oral contraceptives.

PubMed

Wood, J R

1977-01-01

The systemic side effects of oral contraceptives are mentioned, and the incidence and variety of ocular complications are discussed. Experimental studies on the ocular effects of oral contraceptives in laboratory animals have shown only increased permeability of the lens and possibly vascular dilatation. Numerous case reports, however, have been published which describe neuroophthalamic, vascular, retinal and macular, aqueous humor dynamic, cornea and contact lense, lens, color vision, and other miscellaneous effects. These reports are reviewed as are the 6 reported prospective studies. These prospective studies reveal only changes in kerotometry readings. Thus the large number of case reports may represent a low overall incidence or may be normal findings in the population as a whole or may be caused by other systemic factors. Until multicenter prospective studies provide definitive guidelines, the risk associated with oral contraceptive use must be kept in its proper perpsective and ocular histories should contain information on oral contraceptive use.

Weight change and all-cause mortality in older adults: A meta-analysis

USDA-ARS?s Scientific Manuscript database

This meta-analysis of observational cohort studies examined the association between weight change (weight loss, weight gain, and weight fluctuation) and all-cause mortality among older adults. We used PubMed (MEDLINE), Web of Science, and Cochrane Library to identify prospective studies published in...

A prospective international Aspergillus terreus survey: an EFISG, ISHAM and ECMM joint study.

PubMed

Risslegger, B; Zoran, T; Lackner, M; Aigner, M; Sánchez-Reus, F; Rezusta, A; Chowdhary, A; Taj-Aldeen, S J; Arendrup, M C; Oliveri, S; Kontoyiannis, D P; Alastruey-Izquierdo, A; Lagrou, K; Lo Cascio, G; Meis, J F; Buzina, W; Farina, C; Drogari-Apiranthitou, M; Grancini, A; Tortorano, A M; Willinger, B; Hamprecht, A; Johnson, E; Klingspor, L; Arsic-Arsenijevic, V; Cornely, O A; Meletiadis, J; Prammer, W; Tullio, V; Vehreschild, J-J; Trovato, L; Lewis, R E; Segal, E; Rath, P-M; Hamal, P; Rodriguez-Iglesias, M; Roilides, E; Arikan-Akdagli, S; Chakrabarti, A; Colombo, A L; Fernández, M S; Martin-Gomez, M T; Badali, H; Petrikkos, G; Klimko, N; Heimann, S M; Houbraken, J; Uzun, O; Edlinger, M; Fuente, S de la; Lass-Flörl, C

2017-10-01

A prospective international multicentre surveillance study was conducted to investigate the prevalence and amphotericin B susceptibility of Aspergillus terreus species complex infections. A total of 370 cases from 21 countries were evaluated. The overall prevalence of A. terreus species complex among the investigated patients with mould-positive cultures was 5.2% (370/7116). Amphotericin B MICs ranged from 0.125 to 32 mg/L, (median 8 mg/L). Aspergillus terreus species complex infections cause a wide spectrum of aspergillosis and the majority of cryptic species display high amphotericin B MICs. Copyright © 2017. Published by Elsevier Ltd.

Comparison of whole body magnetic resonance imaging (WBMRI) to whole body computed tomography (WBCT) or 18F-fluorodeoxyglucose positron emission tomography/CT (18F-FDG PET/CT) in patients with myeloma: Systematic review of diagnostic performance.

PubMed

Gariani, Joanna; Westerland, Olwen; Natas, Sarah; Verma, Hema; Cook, Gary; Goh, Vicky

2018-04-01

To undertake a systematic review to determine the diagnostic performance of whole body MRI (WBMRI) including diffusion weighted sequences (DWI) compared to whole body computed tomography (WBCT) or 18 F-fluorodeoxyglucose positron emission tomography/CT ( 18 F-FDG PET/CT) in patients with myeloma. Two researchers searched the primary literature independently for WBMRI studies of myeloma. Data were extracted focusing on the diagnostic ability of WBMRI versus WBCT and 18 F-FDG PET/CT. Meta-analysis was intended. 6 of 2857 articles were eligible that included 147 patients, published from 2008 to 2016. Studies were heterogeneous including both newly diagnosed & relapsed patients. All were single centre studies. Four of the six studies (66.7%) accrued prospectively and 5/6 (83.3%, 3 prospective) included WBMRI and 18 F-FDG PET/CT. Three of seven (42.9%) included DWI. The lack of an independent reference standard for individual lesions was noted in 5/6 (83.3%) studies. Studies reported that WBMRI detected more lesions than 18 F-FDG PET/CT (sensitivity 68-100% versus 47-100%) but was less specific (specificity 37-83% versus 62-85.7%). No paper assessed impact on management. Studies were heterogeneous, the majority lacking an independent reference standard. Future prospective trials should address these limitations and assess the impact of WBMRI on management. Copyright © 2018. Published by Elsevier B.V.

Prospective patients rate practice factors: development of a questionnaire.

PubMed

St Louis, Brian Lingg; Firestone, Allen R; Johnston, William; Shanker, Shiva; Vig, Katherine W L

2011-02-01

The importance that prospective patients place on practice characteristics when choosing an orthodontic practice has not been extensively reported. The objective of this research was to develop a valid and reliable questionnaire to address the relative importance of orthodontic office and doctor characteristics for prospective patients or parents of child patients during the initial orthodontic office consultation. An initial questionnaire, based on published literature, was field-tested on 16 subjects to assess its validity. Based on the field test, the questionnaire was modified and tested for reliability by using a test-retest method. The questionnaire covered the following areas: doctor, office, staff, and finances. The reliability study included 2 groups of subjects: 12 consecutive prospective adult patients and 41 consecutive parents of prospective child patients. The questionnaires consisted of 43 and 50 questions for the adult patients and the parents of patients, respectively. The subjects rated the importance of practice characteristics in their selection of an orthodontic practice using a 100-mm visual analog scale anchored at "not important at all" and "most important." Reliability was analyzed by using the intraclass correlation coefficient (ICC). Summary scores of all 53 subjects showed excellent reliability (ICC, 0.88; range, 0.61-1.0). Summary scores of all 50 questions showed acceptable reliability (ICC, 0.70; range, 0.45-0.88). Twenty-one questions had excellent reliability (ICC, >.75), and 29 questions had fair-to-good reliability (ICC, 0.41-0.75). No questions showed poor reliability (ICC, <0.4). The pilot study data indicated that the overall reliability of the questionnaire is acceptable. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Protocol for a multicentre, prospective, population-based cohort study of variation in practice of cholecystectomy and surgical outcomes (The CholeS study).

PubMed

Vohra, Ravinder S; Spreadborough, Philip; Johnstone, Marianne; Marriott, Paul; Bhangu, Aneel; Alderson, Derek; Morton, Dion G; Griffiths, Ewen A

2015-01-12

Cholecystectomy is one of the most common general surgical operations performed. Despite level one evidence supporting the role of cholecystectomy in the management of specific gallbladder diseases, practice varies between surgeons and hospitals. It is unknown whether these variations account for the differences in surgical outcomes seen in population-level retrospective data sets. This study aims to investigate surgical outcomes following acute, elective and delayed cholecystectomies in a multicentre, contemporary, prospective, population-based cohort. UK and Irish hospitals performing cholecystectomies will be recruited utilising trainee-led research collaboratives. Two months of consecutive, adult patient data will be included. The primary outcome measure of all-cause 30-day readmission rate will be used in this study. Thirty-day complication rates, bile leak rate, common bile duct injury, conversion to open surgery, duration of surgery and length of stay will be measured as secondary outcomes. Prospective data on over 8000 procedures is anticipated. Individual hospitals will be surveyed to determine local policies and service provision. Variations in outcomes will be investigated using regression modelling to adjust for confounders. Research ethics approval is not required for this study and has been confirmed by the online National Research Ethics Service (NRES) decision tool. This novel study will investigate how hospital-level surgical provision can affect patient outcomes, using a cross-sectional methodology. The results are essential to inform commissioning groups and implement changes within the National Health Service (NHS). Dissemination of the study protocol is primarily through the trainee-led research collaboratives and the Association of Upper Gastrointestinal Surgeons (AUGIS). Individual centres will have access to their own results and the collective results of the study will be published in peer-reviewed journals and presented at relevant surgical conferences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Assessment of published models and prognostic variables in epithelial ovarian cancer at Mayo Clinic

PubMed Central

Hendrickson, Andrea Wahner; Hawthorne, Kieran M.; Goode, Ellen L.; Kalli, Kimberly R.; Goergen, Krista M.; Bakkum-Gamez, Jamie N.; Cliby, William A.; Keeney, Gary L.; Visscher, Dan W.; Tarabishy, Yaman; Oberg, Ann L.; Hartmann, Lynn C.; Maurer, Matthew J.

2015-01-01

Objectives Epithelial ovarian cancer (EOC) is an aggressive disease in which first line therapy consists of a surgical staging/debulking procedure and platinum based chemotherapy. There is significant interest in clinically applicable, easy to use prognostic tools to estimate risk of recurrence and overall survival. In this study we used a large prospectively collected cohort of women with EOC to validate currently published models and assess prognostic variables. Methods Women with invasive ovarian, peritoneal, or fallopian tube cancer diagnosed between 2000-2011 and prospectively enrolled into the Mayo Clinic Ovarian Cancer registry were identified. Demographics and known prognostic markers as well as epidemiologic exposure variables were abstracted from the medical record and collected via questionnaire. Six previously published models of overall and recurrence-free survival were assessed for external validity. In addition, predictors of outcome were assessed in our dataset. Results Previously published models validated with a range of c-statistics (0.587-0.827), though application of models containing variables not part of routine practice were somewhat limited by missing data; utilization of all applicable models and comparison of results is suggested. Examination of prognostic variables identified only the presence of ascites and ASA score to be independent predictors of prognosis in our dataset, albeit with marginal gain in prognostic information, after accounting for stage and debulking. Conclusions Existing prognostic models for newly diagnosed EOC showed acceptable calibration in our cohort for clinical application. However, modeling of prospective variables in our dataset reiterates that stage and debulking remain the most important predictors of prognosis in this setting. PMID:25620544

Coffee consumption and mortality from all causes, cardiovascular disease, and cancer: a dose-response meta-analysis.

PubMed

Crippa, Alessio; Discacciati, Andrea; Larsson, Susanna C; Wolk, Alicja; Orsini, Nicola

2014-10-15

Several studies have analyzed the relationship between coffee consumption and mortality, but the shape of the association remains unclear. We conducted a dose-response meta-analysis of prospective studies to examine the dose-response associations between coffee consumption and mortality from all causes, cardiovascular disease (CVD), and all cancers. Pertinent studies, published between 1966 and 2013, were identified by searching PubMed and by reviewing the reference lists of the selected articles. Prospective studies in which investigators reported relative risks of mortality from all causes, CVD, and all cancers for 3 or more categories of coffee consumption were eligible. Results from individual studies were pooled using a random-effects model. Twenty-one prospective studies, with 121,915 deaths and 997,464 participants, met the inclusion criteria. There was strong evidence of nonlinear associations between coffee consumption and mortality for all causes and CVD (P for nonlinearity < 0.001). The largest risk reductions were observed for 4 cups/day for all-cause mortality (16%, 95% confidence interval: 13, 18) and 3 cups/day for CVD mortality (21%, 95% confidence interval: 16, 26). Coffee consumption was not associated with cancer mortality. Findings from this meta-analysis indicate that coffee consumption is inversely associated with all-cause and CVD mortality. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Fructose intake and risk of gout and hyperuricemia: a systematic review and meta-analysis of prospective cohort studies.

PubMed

Jamnik, Joseph; Rehman, Sara; Blanco Mejia, Sonia; de Souza, Russell J; Khan, Tauseef A; Leiter, Lawrence A; Wolever, Thomas M S; Kendall, Cyril W C; Jenkins, David J A; Sievenpiper, John L

2016-10-03

The prevalence of hyperuricemia and gout has increased in recent decades. The role of dietary fructose in the development of these conditions remains unclear. To conduct a systematic review and meta-analysis of prospective cohort studies investigating the association fructose consumption with incident gout and hyperuricemia. MEDLINE, EMBASE and the Cochrane Library were searched (through September 2015). We included prospective cohort studies that assessed fructose consumption and incident gout or hyperuricemia. 2 independent reviewers extracted relevant data and assessed study quality using the Newcastle-Ottawa Scale. We pooled natural-log transformed risk ratios (RRs) using the generic inverse variance method. Interstudy heterogeneity was assessed (Cochran Q statistic) and quantified (I 2 statistic). The overall quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. 2 studies involving 125 299 participants and 1533 cases of incident gout assessed the association between fructose consumption and incident gout over an average of 17 years of follow-up. No eligible studies assessed incident hyperuricemia as an outcome. Fructose consumption was associated with an increase in the risk of gout (RR=1.62, 95% CI 1.28 to 2.03, p<0.0001) with no evidence of interstudy heterogeneity (I 2 =0%, p=0.33) when comparing the highest (>11.8% to >11.9% total energy) and lowest (<6.9% to <7.5% total energy) quantiles of consumption. Despite a dose-response gradient, the overall quality of evidence as assessed by GRADE was low, due to indirectness. There were only two prospective cohort studies involving predominantly white health professionals that assessed incident gout, and none assessed hyperuricemia. Fructose consumption was associated with an increased risk of developing gout in predominantly white health professionals. More prospective studies are necessary to understand better the role of fructose and its food sources in the development of gout and hyperuricemia. NCT01608620. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Editorial Commentary: Got Evidence? What We Really Need Is an Algorithm for Treating Symptomatic Bipartite Patella.

PubMed

Fithian, Donald C

2018-05-01

Bipartite patella is an uncommon but potentially troublesome problem for young athletes. Numerous uncontrolled retrospective studies have reported good results after various treatments. What is needed are studies that will guide workup and support treatment decisions based on the condition of the cartilage surfaces of the fragment, presence of pseudoarthrosis, and size and location of the fragment. To support decisions, we need prospective comparative studies, either randomized or, at least, prospective cohort studies that identify patients at the time of presentation, document key decision points, and follow patients to successful resolution of symptoms. Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Everolimus as first line therapy for pancreatic neuroendocrine tumours: current knowledge and future perspectives.

PubMed

Gallo, Marco; Malandrino, Pasqualino; Fanciulli, Giuseppe; Rota, Francesca; Faggiano, Antongiulio; Colao, Annamaria

2017-07-01

Everolimus has been shown to be effective for advanced pancreatic neuroendocrine tumours (pNETs), but its positioning in the therapeutic algorithm for pNETs is matter of debate. With the aim to shed light on this point, we performed an up-to-date critical review taking into account the results of both retrospective and prospective published studies, and the recommendations of international guidelines. In addition, we performed an extensive search on the Clinical Trial Registries databases worldwide, to gather information on the ongoing clinical trials related to this specific topic. We identified eight retrospective published studies, two prospective published studies, and five registered clinical trials. Moreover, we analyzed the content of four widespread international guidelines. Our critical review confirms the lack of high-quality data to recommend everolimus as the first line therapy for pNETs. The ongoing clinical trials reported in this review will hopefully help clinicians, in the near future, to better evaluate the role of everolimus as the first line therapy for pNETs. However, at the moment, there is already enough evidence to recommend everolimus as the first line therapy for patients with symptomatic malignant unresectable insulin-secreting pNETs, to control the endocrine syndrome regardless of tumour growth.

Understanding the Potential Interethnic Difference in Rosuvastatin Pharmacokinetics.

PubMed

Benet, Leslie Z; Wu, Hsin-Fang

2017-09-01

Here we address the potential difference in rosuvastatin pharmacokinetics in Asians vs. whites. Our prospective study, reported in this issue, shows no ethnic difference when all subjects are wild-type for OATP1B1 and BCRP. We argue that although our study may be under powered to prove no ethnic difference, and that further confirmatory study is required, the virtual clinical study analysis, also reported in this issue, does not contradict the results of our prospective clinical study and that previous retrospective analysis of clinical studies does not include enough relevant subjects to conclude that wild-type OATP1B1 and BCRP do still demonstrate ethnic differences. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

The benefits of digital thoracic drainage system for outpatients undergoing pulmonary resection surgery.

PubMed

Mier, J M; Fibla, J J; Molins, L

2011-01-01

Since digital thoracic drainage system (DTDS) came onto the market, a number of its advantages have become clear, for example that of eliminating the differences between observers. The withdrawal of thoracic drainage has been found to be comfortable, safe and well tolerated by patients; it helps to reduce or eliminate the cost of hospital stay, because, according to the different series published in recent months, it is possible to withdraw drainage sooner and thus discharge patients earlier. Prospective studies are underway, but as yet nothing has been written about the possible benefits in outpatient surgery programmes. In this report we present our findings of 3 cases of patients undergoing pulmonary resection who were treated with continuous intra-domiciliary DTDS. Pending the results of a prospective study now underway our observation is that with properly selected patients this is a safe method. Copyright © 2010 Sociedade Portuguesa de Pneumologia. Published by Elsevier España. All rights reserved.

PROSPECT: a practical method for formulating evidence-based expert recommendations for the management of postoperative pain.

PubMed

Neugebauer, E A M; Wilkinson, R C; Kehlet, H; Schug, S A

2007-07-01

Many patients still suffer severe acute pain in the postoperative period. Although guidelines for treating acute pain are widely published and promoted, most do not consider procedure-specific differences in pain experienced or in techniques that may be most effective and appropriate for different surgical settings. The procedure-specific postoperative pain management (PROSPECT) Working Group provides procedure-specific recommendations for postoperative pain management together with supporting evidence from systematic literature reviews and related procedures at http://www.postoppain.org The methodology for PROSPECT reviews was developed and refined by discussion of the Working Group, and it adapts existing methods for formulation of consensus recommendations to the specific requirements of PROSPECT. To formulate PROSPECT recommendations, we use a methodology that takes into account study quality and source and level of evidence, and we use recognized methods for achieving group consensus, thus reducing potential bias. The new methodology is first applied in full for the 2006 update of the PROSPECT review of postoperative pain management for laparoscopic cholecystectomy. Transparency in PROSPECT processes allows the users to be fully aware of any limitations of the evidence and recommendations, thereby allowing for appropriate decisions in their own practice setting.

Human oral microbiome and prospective risk for pancreatic cancer: a population-based nested case-control study.

PubMed

Fan, Xiaozhou; Alekseyenko, Alexander V; Wu, Jing; Peters, Brandilyn A; Jacobs, Eric J; Gapstur, Susan M; Purdue, Mark P; Abnet, Christian C; Stolzenberg-Solomon, Rachael; Miller, George; Ravel, Jacques; Hayes, Richard B; Ahn, Jiyoung

2018-01-01

A history of periodontal disease and the presence of circulating antibodies to selected oral pathogens have been associated with increased risk of pancreatic cancer; however, direct relationships of oral microbes with pancreatic cancer have not been evaluated in prospective studies. We examine the relationship of oral microbiota with subsequent risk of pancreatic cancer in a large nested case-control study. We selected 361 incident adenocarcinoma of pancreas and 371 matched controls from two prospective cohort studies, the American Cancer Society Cancer Prevention Study II and the National Cancer Institute Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. From pre-diagnostic oral wash samples, we characterised the composition of the oral microbiota using bacterial 16S ribosomal RNA (16S rRNA) gene sequencing. The associations between oral microbiota and risk of pancreatic cancer, controlling for the random effect of cohorts and other covariates, were examined using traditional and L1-penalised least absolute shrinkage and selection operator logistic regression. Carriage of oral pathogens, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans , were associated with higher risk of pancreatic cancer (adjusted OR for presence vs absence=1.60 and 95% CI 1.15 to 2.22; OR=2.20 and 95% CI 1.16 to 4.18, respectively). Phylum Fusobacteria and its genus Leptotrichia were associated with decreased pancreatic cancer risk (OR per per cent increase of relative abundance=0.94 and 95% CI 0.89 to 0.99; OR=0.87 and 95% CI 0.79 to 0.95, respectively). Risks related to these phylotypes remained after exclusion of cases that developed within 2 years of sample collection, reducing the likelihood of reverse causation in this prospective study. This study provides supportive evidence that oral microbiota may play a role in the aetiology of pancreatic cancer. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Aeromagnetic maps of the Mazatzal Wilderness and contiguous roadless areas, Gila, Maricopa, and Yavapai counties, Arizona

USGS Publications Warehouse

Moss, C.K.; Abrams, G.A.

1985-01-01

Studies of the geology, geochemistry (Marsh and others, 1983a, b, Erickson, 1984), mines and prospects (Ellis, 1982), and mineral resource potential (Wrucke and others, 1983) of the Mazatzal Wilderness and contiguous roadless areas have been published elsewhere.

The Publication Rate of Abstracts Presented at the 2003 Urological Brazilian Meeting

PubMed Central

Oliveira, Leonardo Resende Sousa; Figueiredo, André Avarese; Choi, Mauro; Ferrarez, Carlos Eduardo Prata Fernandes; Bastos, Andre Netto; Netto, Jose Murillo Bastos

2009-01-01

OBJECTIVE: To determine the publication rate of orally-presented abstracts from the 2003 Urological Brazilian Meeting, as well as the factors determining this publication rate. MATERIALS AND METHODS: The publication rate of the 313 orally-presented abstracts at the 2003 Urological Brazilian Meeting was evaluated by scanning the Lilacs, Scielo and Medline databases. The time between presentation and publication, the state and country of the abstract, the research methodology (cross-sectional, case-control, retrospective case series, prospective case series or clinical trial), whether drugs were utilized and the topic of the study were all characterized. RESULTS: Thirty-nine percent of the abstracts were published after a median time of 14 months (range: 1 to 51 months). There were high publication rates for cross-sectional abstracts (75%), drug utilization studies (51.3%), clinical trials (50%) and prospective case series’ (48.1%). However, there was only a moderate statistical trend towards a higher publication rate in the prospective case series (p=0.07), while the retrospective case series’ showed statistically lower publication rates than the other groups (33.7%, p=0.04). Abstracts on laparoscopic surgery had the highest publication rate (61.9%, p=0.03) compared to others topics. In 57% of the unpublished abstracts, there was no interest in or attempt to publish, and rejection was responsible for the lack of publication of only 4% of the abstracts. CONCLUSION: The publication rate of the orally-presented abstracts from the 2003 Urological Brazilian Meeting was comparable to that of international congresses. The subsequent publication of presented abstracts and the selection of prospective studies with stronger evidence should be encouraged and may improve the scientific quality of the meeting. PMID:19488593

Quality of life improvement in patients with Hashimoto thyroiditis and other goiters after surgery: A prospective cohort study.

PubMed

Zivaljevic, Vladan R; Bukvic Bacotic, Branka R; Sipetic, Sandra B; Stanisavljevic, Dejana M; Maksimovic, Jadranka M; Diklic, Aleksandar D; Paunovic, Ivan R

2015-09-01

Hashimoto thyroiditis (HT) and other benign goiters (BG) might influence patients' quality of life (QoL). The objective of this study was to analyze influence of surgery on these patients' QoL. A prospective cohort study was conducted. The ThyPRO questionnaire was used in the QoL assessment. The HT patients experienced significantly worse hypothyroid symptoms and sex life than the BG patients. The improvement in QoL in the BG patients was significant after surgery in all ThyPRO domains. In the HT patients, the improvement was significant in all but two domains, eye symptoms and cognitive impairment. The best improvement in both groups was in overall QoL. None of the patients developed permanent consequences. The QoL of HT and BG patients is impaired and improves significantly after surgical treatment. Thyroidectomy should be considered as a treatment option in the HT patients more often as in the BG patients. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

A Decade of War: Prospective Trajectories of Posttraumatic Stress Disorder Symptoms Among Deployed US Military Personnel and the Influence of Combat Exposure (Publisher’s Version)

DTIC Science & Technology

2017-09-27

physical health (5) of service mem- bers. In addition, previous research indicates that exposure to combat may increase the likelihood of negative health ... physical , and behavioral health , studies have shown few negative effects of deployment with respect to posttraumatic stress disorder (PTSD) (10...American Journal of Epidemiology Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This

Dietary flavonoid intake and the risk of stroke: a dose-response meta-analysis of prospective cohort studies

PubMed Central

Tang, Zhenyu; Li, Min; Zhang, Xiaowei; Hou, Wenshang

2016-01-01

Objective To clarify and quantify the potential association between intake of flavonoids and risk of stroke. Design Meta-analysis of prospective cohort studies. Data source Studies published before January 2016 identified through electronic searches using PubMed, Embase and the Cochrane Library. Eligibility criteria for selecting studies Prospective cohort studies with relative risks and 95% CIs for stroke according to intake of flavonoids (assessed as dietary intake). Results The meta-analysis yielded 11 prospective cohort studies involving 356 627 participants and more than 5154 stroke cases. The pooled estimate of the multivariate relative risk of stroke for the highest compared with the lowest dietary flavonoid intake was 0.89 (95% CI 0.82 to 0.97; p=0.006). Dose-response analysis indicated that the summary relative risk of stroke for an increase of 100 mg flavonoids consumed per day was 0.91 (95% CI 0.77 to 1.08) without heterogeneity among studies (I2=0%). Stratifying by follow-up duration, the relative risk of stroke for flavonoid intake was 0.89 (95% CI 0.81 to 0.99) in studies with more than 10 years of follow-up. Conclusions Results from this meta-analysis suggest that higher dietary flavonoid intake may moderately lower the risk of stroke. PMID:27279473

Review and Analysis of Publication Trends over Three Decades in Three High Impact Medicine Journals.

PubMed

Ivanov, Alexander; Kaczkowska, Beata A; Khan, Saadat A; Ho, Jean; Tavakol, Morteza; Prasad, Ashok; Bhumireddy, Geetha; Beall, Allan F; Klem, Igor; Mehta, Parag; Briggs, William M; Sacchi, Terrence J; Heitner, John F

2017-01-01

Over the past three decades, industry sponsored research expanded in the United States. Financial incentives can lead to potential conflicts of interest (COI) resulting in underreporting of negative study results. We hypothesized that over the three decades, there would be an increase in: a) reporting of conflict of interest and source of funding; b) percentage of randomized control trials c) number of patients per study and d) industry funding. Original articles published in three calendar years (1988, 1998, and 2008) in The Lancet, New England Journal of Medicine and Journal of American Medical Association were collected. Studies were reviewed and investigational design categorized as prospective and retrospective clinical trials. Prospective trials were categorized into randomized or non-randomized and single-center or multi-center trials. Retrospective trials were categorized as registries, meta-analyses and other studies, mostly comprising of case reports or series. Study outcomes were categorized as positive or negative depending on whether the pre-specified hypothesis was met. Financial disclosures were researched for financial relationships and profit status, and accordingly categorized as government, non-profit or industry sponsored. Studies were assessed for reporting COI. 1,671 original articles were included in this analysis. Total number of published studies decreased by 17% from 1988 to 2008. Over 20 year period, the proportion of prospective randomized trials increased from 22 to 46% (p < 0.0001); whereas the proportion of prospective non-randomized trials decreased from 59% to 27% (p < 0.001). There was an increase in the percentage of prospective randomized multi-center trials from 11% to 41% (p < 0.001). Conversely, there was a reduction in non-randomized single-center trials from 47% to 10% (p < 0.001). Proportion of government funded studies remained constant, whereas industry funded studies more than doubled (17% to 40%; p < 0.0001). The number of studies with negative results more than doubled (10% to 22%; p<0.0001). While lack of funding disclosure decreased from 35% to 7%, COI reporting increased from 2% to 84% (p < 0.0001). Improved reporting of COI, clarity in financial sponsorship, increased publication of negative results in the setting of larger and better designed clinical trials represents a positive step forward in the scientific publications, despite the higher percentage of industry funded studies.

Diagnostic performance of reproducible chest wall tenderness to rule out acute coronary syndrome in acute chest pain: a prospective diagnostic study.

PubMed

Gräni, Christoph; Senn, Oliver; Bischof, Manuel; Cippà, Pietro E; Hauffe, Till; Zimmerli, Lukas; Battegay, Edouard; Franzen, Daniel

2015-01-28

Acute chest pain (ACP) is a leading cause of hospital emergency unit consultation. As there are various underlying conditions, ranging from musculoskeletal disorders to acute coronary syndrome (ACS), thorough clinical diagnostics are warranted. The aim of this prospective study was to assess whether reproducible chest wall tenderness (CWT) on palpation in patients with ACP can help to rule out ACS. In this prospective, double-blinded diagnostic study, all consecutive patients assessed in the emergency unit at the University Hospital Zurich because of ACP between July 2012 and December 2013 were included when a member of the study team was present. Reproducible CWT on palpation was the initial step and was recorded before further examinations were initiated. The final diagnosis was adjudicated by a study-independent physician. 121 patients (60.3% male, median age 47 years, IQR 34-66.5 years) were included. The prevalence of ACS was 11.6%. Non-reproducible CWT had a high sensitivity of 92.9% (95% CI 66.1% to 98.8%) for ACS and the presence of reproducible CWT ruled out ACS (p=0.003) with a high negative predictive value (98.1%, 95% CI 89.9% to 99.7%). Conversely non-reproducible CWT ruled in ACS with low specificity (48.6%, 95% CI 38.8% to 58.5%) and low positive predictive value (19.1%, 95% CI 10.6% to 30.5%). This prospective diagnostic study supports the concept that reproducible CWT helps to rule out ACS in patients with ACP in an early stage of the evaluation process. However, ACS and other diagnoses should be considered in patients with a negative CWT test. ClinicalTrial.gov: NCT01724996. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Dietary fiber intake and total mortality: a meta-analysis of prospective cohort studies.

PubMed

Kim, Youngyo; Je, Youjin

2014-09-15

Greater intake of dietary fiber has been associated with lower risk of several chronic diseases. Some observational studies have examined the association between dietary fiber intake and total mortality, but the results were inconclusive. We conducted a meta-analysis of data from prospective cohort studies to quantitatively assess the association. Eligible studies were identified by searching the PubMed and Embase databases for all articles published through November 30, 2013, and by reviewing the reference lists of retrieved articles. Study-specific estimates adjusting for potential confounders were combined to calculate a pooled relative risk and 95% confidence interval using a random-effects model. Seven prospective cohort studies of dietary fiber intake and total mortality, including 62,314 deaths among 908,135 participants, were identified. The pooled adjusted relative risk of total mortality for the highest category of dietary fiber intake versus the lowest was 0.77 (95% confidence interval: 0.74, 0.80). In a dose-response meta-analysis, the pooled adjusted relative risk for a 10-g/day increment of dietary fiber intake was 0.89 (95% confidence interval: 0.85, 0 92). By source of fiber, cereal and, to a lesser extent, vegetable fiber were significantly associated with lower total mortality, while fruit fiber showed no association. In conclusion, high dietary fiber intake may reduce the risk of total mortality. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Socioeconomic research in agroforestry: progress, prospects, priorities

Treesearch

D. Evan Mercer; R.P. Miller

1998-01-01

Fourteen years after the birth of the journal Agroforestry Systems, biophysical studies continue to dominate agroforestry research while other important areas have not received the attention they deserve. This paper reviews the progress in one of these under-researched areas, socioeconomics. A quantitative and qualitative analysis of published socioeconomic research...

An Exploratory Approach to ATEE Output: Some Results and Some Prospects.

ERIC Educational Resources Information Center

Linne, Agneta; Tarrou, Anne-Lise Hostmark

2001-01-01

Reviews research on teacher education published by the Association for Teacher Education in Europe, examining type of content, purpose, focus of study, and (when appropriate) authors' perspectives and the educational theory perspective chosen. The inquiry underscores the importance of relating teacher education research to general social and…

Associations of pet ownership with biomarkers of ageing: population based cohort study.

PubMed

Batty, G David; Zaninotto, Paola; Watt, Richard G; Bell, Steven

2017-12-13

To examine the prospective relation between animal companionship and biomarkers of ageing in older people. Analyses of data from the English Longitudinal Study of Ageing, an ongoing, open, prospective cohort study initiated in 2002-03. Nationally representative study from England. 8785 adults (55% women) with a mean age of 67 years (SD 9) at pet ownership assessment in 2010-11 (wave 5). Established biomarkers of ageing in the domains of physical, immunological, and psychological function, as assessed in 2012-13 (wave 6). One third of study members reported pet ownership: 1619 (18%) owned a dog, 1077 (12%) a cat, and 274 (3%) another animal. After adjustment for a range of covariates, there was no evidence of a clear association of any type of pet ownership with walking speed, lung function, chair rise time, grip strength, leg raises, balance, three markers of systemic inflammation, memory, or depressive symptoms. In this population of older adults, the companionship of creatures great and small seems to essentially confer no relation with standard ageing phenotypes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Pediatric regional anesthesia: what is the current safety record?

PubMed

Polaner, David M; Drescher, Jessica

2011-07-01

The use of regional anesthetics, whether as adjuncts, primary anesthetics or postoperative analgesia, is increasingly common in pediatric practice. Data on safety remain limited because of the paucity of very large-scale prospective studies that are necessary to detect low incidence events, although several studies either have been published or have reported preliminary results. This paper will review the data on complications and risk in pediatric regional anesthesia. Information currently available suggests that regional blockade, when performed properly, carries a very low risk of morbidity and mortality in appropriately selected infants and children. © 2010 Blackwell Publishing Ltd.

Is diabetes mellitus a risk factor for venous thromboembolism? A systematic review and meta-analysis of case-control and cohort studies.

PubMed

Gariani, Karim; Mavrakanas, Thomas; Combescure, Christophe; Perrier, Arnaud; Marti, Christophe

2016-03-01

Diabetes mellitus is a well-established risk factor for atherosclerotic disease, but its role in the occurrence of venous thromboembolism (VTE) has not been elucidated. We conducted a meta-analysis of published cohort and case-control studies to assess whether diabetes mellitus is a risk factor for VTE. We systematically searched MEDLINE and EMBASE for case-control and prospective cohort studies assessing association between the risk of venous thromboembolism and diabetes. Odds ratios (OR) from case-control studies were combined while for prospective studies hazard ratios (HR) were combined. Models with random effects were used. Meta-analyses were conducted separately for raw and adjusted measures of association. 24 studies were identified including 10 cohort studies (274,501 patients) and 14 case-control studies (1,157,086 patients). Meta-analysis of the prospective cohort studies demonstrated a significant association between diabetes and VTE (HR 1.60; 95% CI 1.35 to 1.89). This association was no longer present after analysis of multi-adjusted HRs (HR 1.10; 95% CI 0.77 to 1.56). Meta-analysis of case-control studies showed a significant association between diabetes and VTE (OR 1.57; 95%CI 1.17 to 2.12), but this association was no longer present when adjusted ORs were used (OR 1.18; 95%CI 0.89 to 1.56). The increased risk of VTE associated with diabetes mainly results from confounders rather than an intrinsic effect of diabetes on venous thrombotic risk. Therefore, no specific recommendations should apply for the management of diabetic patients at risk for VTE. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Study to Improve Cardiovascular Outcomes in high-risk older patieNts (ICON1) with acute coronary syndrome: study design and protocol of a prospective observational study.

PubMed

Kunadian, Vijay; Neely, R Dermot G; Sinclair, Hannah; Batty, Jonathan A; Veerasamy, Murugapathy; Ford, Gary A; Qiu, Weiliang

2016-08-23

The ICON1 study (a study to Improve Cardiovascular Outcomes in high-risk older patieNts with acute coronary syndrome) is a prospective observational study of older patients (≥75 years old) with non-ST-elevation acute coronary syndrome managed by contemporary treatment (pharmacological and invasive). The aim of the study was to determine the predictors of poor cardiovascular outcomes in this age group and to generate a risk prediction tool. Participants are recruited from 2 tertiary hospitals in the UK. Baseline evaluation includes frailty, comorbidity, cognition and quality-of-life measures, inflammatory status assessed by a biomarker panel, including microRNAs, senescence assessed by telomere length and telomerase activity, cardiovascular status assessed by arterial stiffness, endothelial function, carotid intima media thickness and left ventricular systolic and diastolic function, and coronary plaque assessed by virtual histology intravascular ultrasound and optical coherence tomography. The patients are followed-up at 30 days and at 1 year for primary outcome measures of death, myocardial infarction, stroke, unplanned revascularisation, bleeding and rehospitalisation. The study has been approved by the regional ethics committee (REC 12/NE/016). Findings of the study will be presented in scientific sessions and will be published in peer-reviewed journals. NCT01933581: Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

100th anniversary of the birth of B M Pontecorvo (Scientific session of the Physical Sciences Division of the Russian Academy of Sciences, 2 September 2013)

NASA Astrophysics Data System (ADS)

2014-05-01

A scientific session "Prospects of Studies in Neutrino Particle Physics and Astrophysics," of the Physical Sciences Division of the Russian Academy of Sciences (DPS RAS), devoted to the centenary of B M Pontecorvo, was held on 2-3 September 2014 at the JINR international conference hall (Dubna, Moscow region).The following reports were put on the session agenda as posted on the website http://www.gpad.ac.ru of the RAS Physical Sciences Division: (1) Kudenko Yu G (Institute for Nuclear Research, RAS, Moscow; Moscow Institute of Physics and Technology, Dolgoprudnyi, Moscow region; National Research Nuclear University MEPhI, Moscow) "Long-baseline neutrino accelerator experiments: results and prospects";(2) Spiering Ch (Deutsches Elektronen-Synchrotron (DESY), Germany) "Results obtained by ICECUBE and prospects of neutrino astronomy";(3) Barabash A S (Alikhanov Institute for Theoretical and Experimental Physics, Moscow) "Double beta decay experiments: current status and prospects";(4) Bilenky S M (Joint Institute for Nuclear Research, Dubna, Moscow region; Technische Universitat M'unchen, Garching, Germany) "Bruno Pontecorvo and the neutrino";(5) Olshevskiy A G (Joint Institute for Nuclear Research, Dubna, Moscow region) "Reactor neutrino experiments: results and prospects";(6) Gavrin V N (Institute for Nuclear Research, RAS, Moscow) "Low-energy neutrino research at the Baksan Neutrino Laboratory";(7) Gorbunov D S (Institute for Nuclear Research, RAS, Moscow): "Sterile neutrinos and their role in particle physics and cosmology";(8) Derbin A V (Konstantinov Petersburg Nuclear Physics Institute, Gatchina, Leningrad region) "Solar neutrino experiments";(9) Rubakov V A (Institute for Nuclear Research, RAS, Moscow) "Prospects of studies in the field of neutrino particle physics and astrophysics." An article by V N Gavrin, close in essence to talk 6, was published in Usp. Fiz. Nauk 181 (9), 975 (2011) [Phys. Usp. 54 (9) 941 (2011)]. Articles by V A Rubakov, close in essence to talk 9, were published in Usp. Fiz. Nauk 182 (10) 1017 (2012); 181 (6) 655 (2011) [Phys. Usp. 55 (10) 949 (2012); 54 (6) 633 (2011)]. Articles based on talks 1-5, 7, and 8 are published below. • Long-baseline neutrino accelerator experiments: results and prospects, Yu G Kudenko Physics-Uspekhi, 2014, Volume 57, Number 5, Pages 462-469 • High-energy neutrino astronomy: a glimpse of the promised land, Ch Spiering Physics-Uspekhi, 2014, Volume 57, Number 5, Pages 470-481 • Double beta decay experiments: current status and prospects, A S Barabash Physics-Uspekhi, 2014, Volume 57, Number 5, Pages 482-488 • Bruno Pontecorvo and the neutrino, S M Bilenky Physics-Uspekhi, 2014, Volume 57, Number 5, Pages 489-496 • Reactor neutrino experiments: results and prospects, A G Olshevskiy Physics-Uspekhi, 2014, Volume 57, Number 5, Pages 497-502 • Sterile neutrinos and their role in particle physics and cosmology, D S Gorbunov Physics-Uspekhi, 2014, Volume 57, Number 5, Pages 503-511 • Solar neutrino experiments, A V Derbin Physics-Uspekhi, 2014, Volume 57, Number 5, Pages 512-524

Intrathecal Drug Delivery and Spinal Cord Stimulation for the Treatment of Cancer Pain.

PubMed

Xing, Fangfang; Yong, R Jason; Kaye, Alan David; Urman, Richard D

2018-02-05

The purpose of the present investigation is to summarize the body and quality of evidence including the most recent studies in support of intrathecal drug delivery systems and spinal cord stimulation for the treatment of cancer-related pain. In the past 3 years, a number of prospective studies have been published supporting intrathecal drug delivery systems for cancer pain. Additional investigation with adjuvants to morphine-based analgesia including dexmedetomidine and ziconotide support drug-induced benefits of patient-controlled intrathecal analgesia. A study has also been recently published regarding cost-savings for intrathecal drug delivery system compared to pharmacologic management, but an analysis in the Ontario, Canada healthcare system projects additional financial costs. Finally, the Polyanalgesic Consensus Committee has updated its recommendations regarding clinical guidelines for intrathecal drug delivery systems to include new information on dosing, trialing, safety, and systemic opioid reduction. There is still a paucity of clinical evidence for spinal cord stimulation in the treatment of cancer pain. There are new intrathecal drugs under investigation including various conopeptides and AYX1. Large, prospective, modern, randomized controlled studies are still needed to support the use of both intrathecal drug delivery systems as well as spinal cord stimulation for cancer pain populations. There are multiple prospective and small randomized controlled studies that highlight a potential promising future for these interventional modalities. Related to the challenge and urgency of cancer pain, the pain practitioner community is moving toward a multimodal approach that includes discussions regarding the role of intrathecal therapies and spinal cord stimulation to the individualized treatment of patients.

Potato intake and incidence of hypertension: results from three prospective US cohort studies.

PubMed

Borgi, Lea; Rimm, Eric B; Willett, Walter C; Forman, John P

2016-05-17

To determine whether higher intake of baked or boiled potatoes, French fries, or potato chips is associated with incidence of hypertension. Prospective longitudinal cohort studies. Healthcare providers in the United States. 62 175 women in Nurses' Health Study, 88 475 women in Nurses' Health Study II, and 36 803 men in Health Professionals Follow-up Study who were non-hypertensive at baseline. Incident cases of hypertension (self reported diagnosis by healthcare provider). Compared with consumption of less than one serving a month, the random effects pooled hazard ratios for four or more servings a week were 1.11 (95% confidence interval 0.96 to 1.28; P for trend=0.05) for baked, boiled, or mashed potatoes, 1.17 (1.07 to 1.27; P for trend=0.001) for French fries, and 0.97 (0.87 to 1.08; P for trend=0.98) for potato chips. In substitution analyses, replacing one serving a day of baked, boiled, or mashed potatoes with one serving a day of non-starchy vegetables was associated with decreased risk of hypertension (hazard ratio 0.93, 0.89 to 0.96). Higher intake of baked, boiled, or mashed potatoes and French fries was independently and prospectively associated with an increased risk of developing hypertension in three large cohorts of adult men and women. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Eating disorder psychopathology, brain structure, neuropsychological correlates and risk mechanisms in very preterm young adults.

PubMed

Micali, Nadia; Kothari, Radha; Nam, Kie Woo; Gioroukou, Elena; Walshe, Muriel; Allin, Matthew; Rifkin, Larry; Murray, Robin M; Nosarti, Chiara

2015-03-01

This study investigates the prevalence of eating disorder (ED) psychopathology, neuropsychological function, structural brain correlates and risk mechanisms in a prospective cohort of very preterm (VPT) young adults. We assessed ED psychopathology and neuropsychological correlates in 143 cohort individuals born at <33 weeks of gestation. Structural brain correlates and risk factors at birth, in childhood and adolescence, were investigated using prospectively collected data throughout childhood/adolescence. VPT-born individuals had high levels of ED psychopathology at age 21 years. Executive function did not correlate with ED symptomatology. VPT adults presenting with ED psychopathology had smaller grey matter volume at age 14/15 years in the left posterior cerebellum and smaller white matter volume in the fusiform gyrus bilaterally, compared with VPT adults with no ED psychopathology. Caesarean delivery predicted engaging in compensatory behaviours, and severe eating difficulty at age 14 years predicted ED symptomatology in young adulthood. VPT individuals are at risk for ED symptomatology, with evidence of associated structural alterations in posterior brain regions. Further prospective studies are needed to clarify the pathways that lead from perinatal/obstetric complications to ED and relevant neurobiological mechanisms. © 2015 The Authors. European Eating Disorders Review published by John Wiley &Sons, Ltd. © 2015 The Authors. European Eating Disorders Review published by John Wiley & Sons, Ltd.

Night Shift Work and Breast Cancer Incidence: Three Prospective Studies and Meta-analysis of Published Studies

PubMed Central

Balkwill, Angela; Fensom, Georgina K.; Appleby, Paul N.; Reeves, Gillian K.; Wang, Xiao-Si; Roddam, Andrew W.; Gathani, Toral; Peto, Richard; Green, Jane; Key, Timothy J.; Beral, Valerie

2016-01-01

Background: It has been proposed that night shift work could increase breast cancer incidence. A 2007 World Health Organization review concluded, mainly from animal evidence, that shift work involving circadian disruption is probably carcinogenic to humans. We therefore aimed to generate prospective epidemiological evidence on night shift work and breast cancer incidence. Methods: Overall, 522 246 Million Women Study, 22 559 EPIC-Oxford, and 251 045 UK Biobank participants answered questions on shift work and were followed for incident cancer. Cox regression yielded multivariable-adjusted breast cancer incidence rate ratios (RRs) and 95% confidence intervals (CIs) for night shift work vs no night shift work, and likelihood ratio tests for interaction were used to assess heterogeneity. Our meta-analyses combined these and relative risks from the seven previously published prospective studies (1.4 million women in total), using inverse-variance weighted averages of the study-specific log RRs. Results: In the Million Women Study, EPIC-Oxford, and UK Biobank, respectively, 673, 28, and 67 women who reported night shift work developed breast cancer, and the RRs for any vs no night shift work were 1.00 (95% CI = 0.92 to 1.08), 1.07 (95% CI = 0.71 to 1.62), and 0.78 (95% CI = 0.61 to 1.00). In the Million Women Study, the RR for 20 or more years of night shift work was 1.00 (95% CI = 0.81 to 1.23), with no statistically significant heterogeneity by sleep patterns or breast cancer risk factors. Our meta-analysis of all 10 prospective studies included 4660 breast cancers in women reporting night shift work; compared with other women, the combined relative risks were 0.99 (95% CI = 0.95 to 1.03) for any night shift work, 1.01 (95% CI = 0.93 to 1.10) for 20 or more years of night shift work, and 1.00 (95% CI = 0.87 to 1.14) for 30 or more years. Conclusions: The totality of the prospective evidence shows that night shift work, including long-term shift work, has little or no effect on breast cancer incidence. PMID:27758828

Nonlinear reduction in risk for colorectal cancer by fruit and vegetable intake based on meta-analysis of prospective studies.

PubMed

Aune, Dagfinn; Lau, Rosa; Chan, Doris S M; Vieira, Rui; Greenwood, Darren C; Kampman, Ellen; Norat, Teresa

2011-07-01

The association between fruit and vegetable intake and colorectal cancer risk has been investigated by many studies but is controversial because of inconsistent results and weak observed associations. We summarized the evidence from cohort studies in categorical, linear, and nonlinear, dose-response meta-analyses. We searched PubMed for studies of fruit and vegetable intake and colorectal cancer risk that were published until the end of May 2010. We included 19 prospective studies that reported relative risk estimates and 95% confidence intervals (CIs) of colorectal cancer-associated with fruit and vegetable intake. Random effects models were used to estimate summary relative risks. The summary relative risk for the highest vs the lowest intake was 0.92 (95% CI: 0.86-0.99) for fruit and vegetables combined, 0.90 (95% CI: 0.83-0.98) for fruit, and 0.91 (95% CI: 0.86-0.96) for vegetables (P for heterogeneity=.24, .05, and .54, respectively). The inverse associations appeared to be restricted to colon cancer. In linear dose-response analysis, only intake of vegetables was significantly associated with colorectal cancer risk (summary relative risk=0.98; 95% CI: 0.97-0.99), per 100 g/d. However, significant inverse associations emerged in nonlinear models for fruits (Pnonlinearity<.001) and vegetables (Pnonlinearity=.001). The greatest risk reduction was observed when intake increased from very low levels of intake. There was generally little evidence of heterogeneity in the analyses and there was no evidence of small-study bias. Based on meta-analysis of prospective studies, there is a weak but statistically significant nonlinear inverse association between fruit and vegetable intake and colorectal cancer risk. Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.

Flavonoid intake and mortality from cardiovascular disease and all causes: A meta-analysis of prospective cohort studies.

PubMed

Kim, Youngyo; Je, Youjin

2017-08-01

Accumulating studies have suggested that flavonoid intake is associated with a decreased risk of coronary heart disease and cardiovascular disease (CVD). There are many epidemiological studies on flavonoid intake and mortality, but no comprehensive investigation has yet been conducted. To quantitatively assess the association between flavonoid intake and mortality from CVD and all-causes, we performed a meta-analysis of prospective cohort studies. Eligible studies were identified by searching PubMed and Web of Science databases for all articles published up to May 2016 and via hand searching. Study-specific estimates adjusting for potential confounders were combined to calculate a pooled relative risk (RR) with 95% confidence interval (CI) using a random-effects model. A total of 15 prospective cohort studies that examined the association between flavonoid intake and mortality from CVD and all-causes were identified. The pooled RR of CVD mortality for the highest versus lowest category of flavonoid intake was 0.86 (95% CI: 0.75, 0.98). By subclass of flavonoids, all classes, except flavonols and isoflavones, showed significant inverse associations. A nonlinear association was found between flavonoid intake and CVD mortality in the dose-response analysis. For total mortality, a high intake of flavonoids was associated with lower total mortality (pooled RR = 0.86, 95% CI: 0.73, 1.00). Our findings indicate that a high intake of flavonoids is associated with reduced risk of mortality from CVD and all causes in men and women. These results support current recommendations of high fruit and vegetables intake as a part of a healthy diet. Copyright © 2017 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Energetic particle-driven compressional Alfvén eigenmodes and prospects for ion cyclotron emission studies in fusion plasmas

NASA Astrophysics Data System (ADS)

Gorelenkov, N. N.

2016-10-01

As a fundamental plasma oscillation the compressional Alfvén waves (CAWs) are interesting for plasma scientists both academically and in applications for fusion plasmas. They are believed to be responsible for the ion cyclotron emission (ICE) observed in many tokamaks. The theory of CAW and ICE was significantly advanced at the end of 20th century in particular motivated by first DT experiments on TFTR and subsequent JET DT experimental studies. More recently, ICE theory was advanced by ST (or spherical torus) experiments with the detailed theoretical and experimental studies of the properties of each instability signal. There the instability responsible for ICE signals previously indistinguishable in high aspect ratio tokamaks became the subjects of experimental studies. We discuss further the prospects of ICE theory and its applications for future burning plasma experiments such as the ITER tokamak-reactor prototype being build in France where neutrons and gamma rays escaping the plasma create extremely challenging conditions for fusion alpha particle diagnostics. This manuscript has been authored by Princeton University under Contract Number DE-AC02-09CH11466 with the US Department of Energy. The United States Government retains and the publisher, by accepting the article for publication, acknowledges that the United States Government retains a non-exclusive, paid-up, irrevocable, world-wide license to publish or reproduce the published form of this manuscript, or allow others to do so, for United States Government purposes.

Correction to: Incidence of severe sepsis and septic shock in German intensive care units: the prospective, multicentre INSEP study.

PubMed

Marx, Gernot

2018-01-01

The members of the SepNet Critical Care Trials Group were provided in such a way that they could not be indexed as collaborators on PubMed. The publisher apologizes for this error and is pleased to list the members of the group here.

Prospects for Religious Studies in Turkey

ERIC Educational Resources Information Center

Wiseman, Wendy A.; Kesgin, Burak

2015-01-01

This essay is part of a collection of short essays solicited from authors around the globe who teach religion courses at the college level (not for professional religious training). They are published together with an introduction in "Teaching Theology and Religion" 18:3 (July 2015). The authors were asked to provide a brief overview of…

Examining Values, Use, and Role in Evaluation: Prospects for a Broadened View

ERIC Educational Resources Information Center

Boulay, David A.; Han, Heeyoung

2008-01-01

This article reviews evaluation studies published in the HRD (human resource development) field. The authors further discuss general evaluation theories in terms of value, use, and evaluator role. The comparison of this literature suggests that evaluation in HRD has been limited by narrow perspectives. The authors attribute this narrow notion of…

Childhood meningitis in the conjugate vaccine era: a prospective cohort study.

PubMed

Sadarangani, Manish; Willis, Louise; Kadambari, Seilesh; Gormley, Stuart; Young, Zoe; Beckley, Rebecca; Gantlett, Katherine; Orf, Katharine; Blakey, Sarah; Martin, Natalie G; Kelly, Dominic F; Heath, Paul T; Nadel, Simon; Pollard, Andrew J

2015-03-01

Bacterial conjugate vaccines have dramatically changed the epidemiology of childhood meningitis; viral causes are increasingly predominant, but the current UK epidemiology is unknown. This prospective study recruited children under 16 years of age admitted to 3 UK hospitals with suspected meningitis. 70/388 children had meningitis-13 bacterial, 26 viral and 29 with no pathogen identified. Group B Streptococcus was the most common bacterial pathogen. Infants under 3 months of age with bacterial meningitis were more likely to have a reduced Glasgow Coma Score and respiratory distress than those with viral meningitis or other infections. There were no discriminatory clinical features in older children. Cerebrospinal fluid (CSF) white blood cell count and plasma C-reactive protein at all ages, and CSF protein in infants <3 months of age, distinguished between bacterial meningitis and viral meningitis or other infections. Improved diagnosis of non-bacterial meningitis is urgently needed to reduce antibiotic use and hospital stay. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The nature of the association between childhood ADHD and the development of bipolar disorder: a review of prospective high-risk studies.

PubMed

Duffy, Anne

2012-12-01

The author reviewed prospective longitudinal studies of the offspring of parents with bipolar disorder to inform our understanding of the nature of the association between childhood ADHD and the risk of developing bipolar disorder in adolescence and young adulthood. A literature review of published prospective cohort studies of the offspring of bipolar parents since 1985 was undertaken using a comprehensive search strategy in several electronic databases. The author provides a qualitative synthesis of results focusing on ADHD and the association with bipolar disorder in prospectively assessed high-risk offspring. These results are discussed in light of findings from other prospective epidemiological and clinical cohort studies. From the reviewed high-risk studies, evidence suggests that the clinical diagnosis of childhood ADHD is not a reliable predictor of the development of bipolar disorder. However, the author found evidence that symptoms of inattention may be part of a mixed clinical presentation during the early stages of evolving bipolar disorder in high-risk offspring, appearing alongside anxiety and depressive symptoms. The author also found preliminary evidence that childhood ADHD may form part of a neurodevelopmental phenotype in offspring at risk for developing a subtype of bipolar disorder unresponsive to lithium stabilization. While childhood ADHD does not appear to be part of the typical developmental illness trajectory of bipolar disorder, subjective problems with attention can form part of the early course, while neurodevelopmental abnormalities may be antecedents in a subgroup of high-risk children.

Prospective study of polydimethylsiloxane vs dextranomer/hyaluronic acid injection for treatment of vesicoureteral reflux.

PubMed

Moore, Katherine; Bolduc, Stéphane

2014-12-01

Endoscopic injection of a bulking agent is becoming a first-line treatment for low grade vesicoureteral reflux. We prospectively compared the efficacy of 2 such products commercially available in Canada. A total of 275 patients with documented grade I to V vesicoureteral reflux were prospectively enrolled in a comparative study between April 2005 and February 2011 to be randomly treated endoscopically with either polydimethylsiloxane (Macroplastique®) or dextranomer/hyaluronic acid copolymer (Deflux®). Of the ureters 202 were treated with polydimethylsiloxane and 197 with dextranomer/hyaluronic acid copolymer. Patients were followed with voiding cystourethrography at 3 months and renal ultrasonography at 3 months and at 1 year. Median followup was 4.3 years. The primary outcome was surgical success (resolution vs nonresolution), and secondary outcomes included occurrence of adverse events. Vesicoureteral reflux was fully corrected in 182 of 202 ureters (90%) treated with polydimethylsiloxane, compared to 159 of 197 (81%) treated with dextranomer/hyaluronic acid copolymer (p <0.05). Obstruction was found in 5 ureters. Univariate and multivariate analyses did not allow identification of any characteristics that could explain the significant difference in the success rates except for the type of product used. We present the largest known prospective evaluation comparing 2 bulking agents for the treatment of vesicoureteral reflux. Endoscopic injection of polydimethylsiloxane resulted in a better success rate than dextranomer/hyaluronic acid copolymer. The rate of resolution obtained with the latter is lower than those previously published due to the inclusion of high grade reflux. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Current practices of commercial cryobanks in screening prospective donors for genetic disease and reproductive risk.

PubMed

Conrad, E A; Fine, B; Hecht, B R; Pergament, E

1996-01-01

To determine how the screening practices of commercial semen banks vary from published guidelines, which factors influence cryobanks to exclude prospective semen donors for genetic reasons, and the current role of clinical geneticists/genetic counselors in evaluating prospective semen donors. The genetic screening of prospective donors by commercial semen banks was evaluated using written questionnaires completed by bank directors. Responses were analyzed to determine exclusion criteria, adherence to published guidelines, and contribution of genetic professionals. Semen banks were selected on the basis of membership in the American Association of Tissue Banks and commercial use of semen for artificial insemination by donor. Semen bank practices as reported by commercial semen bank directors. Of 37 eligible banks, 16 responded. All screen prospective donors by medical/family history and physical examination, 94% have upper age limits; 63% examine for minor physical defects; 56% routinely karyotype; 81% screen men of ethnic groups at risk for Tay Sachs disease, sickle cell disease and thalassemia; 19% screen all donors; 25% screen all donors for cystic fibrosis and 50% only screen if family history positive. Donor rejection was based on three criteria: mode of inheritance of familial disorder, severity of disease, and availability of carrier/confirmatory testing of donor genotype. Ten of 16 banks have no genetic professional on staff. Commercial semen banks primarily rely on family history as the major exclusion criterion in genetic screening of donors. Considerable differences exist among semen bank practices in accordance with guidelines published by national agencies. Genetic professionals have a minimal effect overall on evaluation of semen donors.

QUIT EMR trial: a prospective, observational, multicentre study to evaluate quality and 24 hours post-transport morbidity of interhospital transportation of critically ill patients: study protocol.

PubMed

Strauch, Ulrich; Bergmans, Dennis C J J; Habers, Joachim; Jansen, Jochen; Winkens, Bjorn; Veldman, Dirk J; Roekaerts, Paul M H J; Beckers, Stefan K

2017-03-10

It is widely accepted that transportation of critically ill patients is high risk. Unfortunately, however, there are currently no evidence-based criteria with which to determine the quality of various interhospital transport systems and their impact on the outcomes for patients. We aim to rectify this by assessing 2 scores which were developed in our hospital in a prospective, observational study. Primarily, we will be examining the Quality of interhospital critical care transportation in the Euregion Meuse-Rhine (QUIT EMR) score, which focuses on the quality of the transport system, and secondarily the SEMROS (Simplified EMR outcome score) which detects changes in the patient's clinical condition in the 24 hours following their transportation. A web-based application will be used to document around 150 pretransport, intratransport and post-transport items of each patient case.To be included, patients must be at least 18-years of age and should have been supervised by a physician during an interhospital transport which was started in the study region.The quality of the QUIT EMR score will be assessed by comparing 3 predefined levels of transport facilities: the high, medium and low standards. Subsequently, SEMROS will be used to determine the effect of transport quality on the morbidity 24 hours after transportation.It is estimated that there will be roughly 3000 appropriate cases suitable for inclusion in this study per year. Cases shall be collected from 1 April 2015 until 31 December 2017. This trial was approved by the Ethics committees of the university hospitals of Maastricht (Netherlands) and Aachen (Germany). The study results will be published in a peer reviewed journal. Results of this study will determine if a prospective randomised trial involving patients of various categories being randomly assigned to different levels of transportation system shall be conducted. NTR4937. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Dietary Flavonoid and Lignan Intake and Mortality in Prospective Cohort Studies: Systematic Review and Dose-Response Meta-Analysis.

PubMed

Grosso, Giuseppe; Micek, Agnieszka; Godos, Justyna; Pajak, Andrzej; Sciacca, Salvatore; Galvano, Fabio; Giovannucci, Edward L

2017-06-15

Recent evidence has suggested that flavonoid and lignan intake may be associated with decreased risk of chronic and degenerative diseases. The aim of this meta-analysis was to assess the association between dietary flavonoid and lignan intake and all-cause and cardiovascular disease (CVD) mortality in prospective cohort studies. A systematic search was conducted in electronic databases to identify studies published from January 1996 to December 2015 that satisfied inclusion/exclusion criteria. Risk ratios and 95% confidence intervals were extracted and analyzed using a random-effects model. Nonlinear dose-response analysis was modeled by using restricted cubic splines. The inclusion criteria were met by 22 prospective studies exploring various flavonoid and lignan classes. Compared with lower intake, high consumption of total flavonoids was associated with decreased risk of all-cause mortality (risk ratio = 0.74, 95% confidence intervals: 0.55, 0.99), while a 100-mg/day increment in intake led to a (linear) decreased risk of 6% and 4% of all-cause and CVD mortality, respectively. Among flavonoid classes, significant results were obtained for intakes of flavonols, flavones, flavanones, anthocyanidins, and proanthocyanidins. Only limited evidence was available on flavonoid classes and lignans and all-cause mortality. Findings from this meta-analysis indicated that dietary flavonoids are associated with decreased risk of all-cause and CVD mortality. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

External validation of prognostic models to predict risk of gestational diabetes mellitus in one Dutch cohort: prospective multicentre cohort study.

PubMed

Lamain-de Ruiter, Marije; Kwee, Anneke; Naaktgeboren, Christiana A; de Groot, Inge; Evers, Inge M; Groenendaal, Floris; Hering, Yolanda R; Huisjes, Anjoke J M; Kirpestein, Cornel; Monincx, Wilma M; Siljee, Jacqueline E; Van 't Zelfde, Annewil; van Oirschot, Charlotte M; Vankan-Buitelaar, Simone A; Vonk, Mariska A A W; Wiegers, Therese A; Zwart, Joost J; Franx, Arie; Moons, Karel G M; Koster, Maria P H

2016-08-30

 To perform an external validation and direct comparison of published prognostic models for early prediction of the risk of gestational diabetes mellitus, including predictors applicable in the first trimester of pregnancy.  External validation of all published prognostic models in large scale, prospective, multicentre cohort study.  31 independent midwifery practices and six hospitals in the Netherlands.  Women recruited in their first trimester (<14 weeks) of pregnancy between December 2012 and January 2014, at their initial prenatal visit. Women with pre-existing diabetes mellitus of any type were excluded.  Discrimination of the prognostic models was assessed by the C statistic, and calibration assessed by calibration plots.  3723 women were included for analysis, of whom 181 (4.9%) developed gestational diabetes mellitus in pregnancy. 12 prognostic models for the disorder could be validated in the cohort. C statistics ranged from 0.67 to 0.78. Calibration plots showed that eight of the 12 models were well calibrated. The four models with the highest C statistics included almost all of the following predictors: maternal age, maternal body mass index, history of gestational diabetes mellitus, ethnicity, and family history of diabetes. Prognostic models had a similar performance in a subgroup of nulliparous women only. Decision curve analysis showed that the use of these four models always had a positive net benefit.  In this external validation study, most of the published prognostic models for gestational diabetes mellitus show acceptable discrimination and calibration. The four models with the highest discriminative abilities in this study cohort, which also perform well in a subgroup of nulliparous women, are easy models to apply in clinical practice and therefore deserve further evaluation regarding their clinical impact. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Does culture medium influence offspring birth weight?

PubMed

Carrasco, Beatriz; Boada, Montserrat; Rodríguez, Ignacio; Coroleu, Buenaventura; Barri, Pedro N; Veiga, Anna

2013-11-01

To determine whether the type of medium used to culture human embryos in vitro influences neonatal birth weight after IVF/intracytoplasmic sperm injection (ICSI). A prospective study and a retrospective study. Private assisted reproduction center. The prospective study included 449 IVF/ICSI cycles from August to December 2008. The retrospective analysis was performed for 2,518 IVF/ICSI cycles from October 2006 to December 2010. In the prospective study, patients were randomized for embryo culture in Cook or Vitrolife medium. The retrospective study was performed with three different culture media (MediCult, Cook, and Vitrolife). Mean birth weight, adjusted for gestational age and gender (z score) of newborns. In the prospective study, the average z score was -0.19 ± 0.85 in Cook and 0.08 ± 1.40 in Vitrolife. In the retrospective study, the z scores obtained in each group were as follows: Cook, -0.14 ± 0.96; MediCult, 0.06 ± 1.13; and Vitrolife, 0.03 ± 1.05. No significant differences were observed regarding the birth weight of children born in the different groups in both studies. The results do not show any relationship between the medium used for in vitro culture and mean birth weight adjusted for gestational age and gender of singletons born after IVF/ICSI. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

An international prospective cohort study of mobile phone users and health (Cosmos): design considerations and enrolment.

PubMed

Schüz, Joachim; Elliott, Paul; Auvinen, Anssi; Kromhout, Hans; Poulsen, Aslak Harbo; Johansen, Christoffer; Olsen, Jørgen H; Hillert, Lena; Feychting, Maria; Fremling, Karin; Toledano, Mireille; Heinävaara, Sirpa; Slottje, Pauline; Vermeulen, Roel; Ahlbom, Anders

2011-02-01

There is continuing public and scientific interest in the possibility that exposure to radiofrequency (RF) electromagnetic fields (EMF) from mobile telephones or other wireless devices and applications might increase the risk of certain cancers or other diseases. The interest is amplified by the rapid world-wide penetration of such technologies. The evidence from epidemiological studies published to date have not been consistent and, in particular, further studies are required to identify whether longer term (well beyond 10 years) RF exposure might pose some health risk. The "Cosmos" study described here is a large prospective cohort study of mobile telephone users (ongoing recruitment of 250,000 men and women aged 18+ years in five European countries - Denmark, Finland, Sweden, The Netherlands, UK) who will be followed up for 25+ years. Information on mobile telephone use is collected prospectively through questionnaires and objective traffic data from network operators. Associations with disease risks will be studied by linking cohort members to existing disease registries, while changes in symptoms such as headache and sleep quality and of general well-being are assessed by baseline and follow-up questionnaires. A prospective cohort study conducted with appropriate diligence and a sufficient sample size, overcomes many of the shortcomings of previous studies. Its major advantages are exposure assessment prior to the diagnosis of disease, the prospective collection of objective exposure information, long-term follow-up of multiple health outcomes, and the flexibility to investigate future changes in technologies or new research questions. Copyright © 2010 Elsevier Ltd. All rights reserved.

Longitudinal changes in the antecedent and early manifest course of bipolar disorder-A narrative review of prospective studies.

PubMed

Pfennig, Andrea; Leopold, Karolina; Ritter, Philipp; Böhme, Anne; Severus, Emanuel; Bauer, Michael

2017-05-01

Prospective study designs ideally allow patients to be followed from the first manifestations of the illness or even from an at-risk stage. It can thus provide data on the predictive value of changes in clinical symptomatology, cognition or further biological markers to broaden our understanding of the etiopathology and symptomatic trajectory of bipolar disorders. The scope of this narrative review is to summarize evidence from prospectively collected data on psychopathological and other clinical and biological changes in the early developmental course of bipolar disorders. The narrative review was based on a literature search conducted in February 2016 within the PubMed library for prospective study data of persons in antecedent and early manifest stages of manifest bipolar disorder published within the last 15 years. A total of 19 prospective studies were included. Regarding psychopathological features; personality, temperament and character traits as well as changes in sleep and circadian rhythm, the evidence suggests that risk factors for the development of bipolar disorder can already be described and should be studied further to understand their interaction, mediation with other factors and timing in the developmental process of bipolar disorder. Apart from the positive family history, childhood anxiety, sleep problems, subthreshold (hypo)manic symptoms and certain character traits/emotionality should be identified and monitored already in clinical practice as their presence likely increases risk of bipolar disorder. Up to date no substantiated evidence was found from prospective studies addressing cognitive features, life events, immunological parameters and morphological central nervous system changes as potential risk factors for bipolar disorder. For an improved understanding of episodic disorders, longitudinal data collection is essential. Since the etiology of bipolar disorders is complex, a number of potential risk factors have been proposed. Prospective studies addressing this spectrum and resilience factors are critical and will be best conducted within multi-site research networks or initiatives.

Injury in China: a systematic review of injury surveillance studies conducted in Chinese hospital emergency departments

PubMed Central

2011-01-01

Background Injuries represent a significant and growing public health concern in China. This Review was conducted to document the characteristics of injured patients presenting to the emergency department of Chinese hospitals and to assess of the nature of information collected and reported in published surveillance studies. Methods A systematic search of MEDLINE and China Academic Journals supplemented with a hand search of journals was performed. Studies published in the period 1997 to 2007 were included and research published in Chinese was the focus. Search terms included emergency, injury, medical care. Results Of the 268 studies identified, 13 were injury surveillance studies set in the emergency department. Nine were collaborative studies of which eight were prospective studies. Of the five single centre studies only one was of a prospective design. Transport, falls and industrial injuries were common mechanisms of injury. Study strengths were large patient sample sizes and for the collaborative studies a large number of participating hospitals. There was however limited use of internationally recognised injury classification and severity coding indices. Conclusion Despite the limited number of studies identified, the scope of each highlights the willingness and the capacity to conduct surveillance studies in the emergency department. This Review highlights the need for the adoption of standardized injury coding indices in the collection and reporting of patient health data. While high level injury surveillance systems focus on population-based priority setting, this Review demonstrates the need to establish an internationally comparable trauma registry that would permit monitoring of the trauma system and would by extension facilitate the optimal care of the injured patient through the development of informed quality assurance programs and the implementation of evidence-based health policy. PMID:22029774

Perceived job insecurity as a risk factor for incident coronary heart disease: systematic review and meta-analysis.

PubMed

Virtanen, Marianna; Nyberg, Solja T; Batty, G David; Jokela, Markus; Heikkilä, Katriina; Fransson, Eleonor I; Alfredsson, Lars; Bjorner, Jakob B; Borritz, Marianne; Burr, Hermann; Casini, Annalisa; Clays, Els; De Bacquer, Dirk; Dragano, Nico; Elovainio, Marko; Erbel, Raimund; Ferrie, Jane E; Hamer, Mark; Jöckel, Karl-Heinz; Kittel, France; Knutsson, Anders; Koskenvuo, Markku; Koskinen, Aki; Lunau, Thorsten; Madsen, Ida E H; Nielsen, Martin L; Nordin, Maria; Oksanen, Tuula; Pahkin, Krista; Pejtersen, Jan H; Pentti, Jaana; Rugulies, Reiner; Salo, Paula; Shipley, Martin J; Siegrist, Johannes; Steptoe, Andrew; Suominen, Sakari B; Theorell, Töres; Toppinen-Tanner, Salla; Väänänen, Ari; Vahtera, Jussi; Westerholm, Peter J M; Westerlund, Hugo; Slopen, Natalie; Kawachi, Ichiro; Singh-Manoux, Archana; Kivimäki, Mika

2013-08-08

To determine the association between self reported job insecurity and incident coronary heart disease. A meta-analysis combining individual level data from a collaborative consortium and published studies identified by a systematic review. We obtained individual level data from 13 cohort studies participating in the Individual-Participant-Data Meta-analysis in Working Populations Consortium. Four published prospective cohort studies were identified by searches of Medline (to August 2012) and Embase databases (to October 2012), supplemented by manual searches. Prospective cohort studies that reported risk estimates for clinically verified incident coronary heart disease by the level of self reported job insecurity. Two independent reviewers extracted published data. Summary estimates of association were obtained using random effects models. The literature search yielded four cohort studies. Together with 13 cohort studies with individual participant data, the meta-analysis comprised up to 174,438 participants with a mean follow-up of 9.7 years and 1892 incident cases of coronary heart disease. Age adjusted relative risk of high versus low job insecurity was 1.32 (95% confidence interval 1.09 to 1.59). The relative risk of job insecurity adjusted for sociodemographic and risk factors was 1.19 (1.00 to 1.42). There was no evidence of significant differences in this association by sex, age (<50 v ≥ 50 years), national unemployment rate, welfare regime, or job insecurity measure. The modest association between perceived job insecurity and incident coronary heart disease is partly attributable to poorer socioeconomic circumstances and less favourable risk factor profiles among people with job insecurity.

Pulmonary toxoplasmosis in immunocompromised patients with interstitial pneumonia: a single-centre prospective study assessing PCR-based diagnosis.

PubMed

Desoubeaux, Guillaume; Cabanne, Églantine; Franck-Martel, Claire; Gombert, Martin; Gyan, Emmanuel; Lissandre, Séverine; Renaud, Marc; Monjanel, Hélène; Dartigeas, Caroline; Bailly, Éric; Van Langendonck, Nathalie; Chandenier, Jacques

2016-08-01

Pulmonary toxoplasmosis has become a very rare parasitic infection since the advent of highly active antiretroviral therapies. It is generally diagnosed by the direct microscopic observation of Toxoplasma gondii tachyzoites in bronchoalveolar lavage fluid (BALF). The aim of this study was to assess possible improvements in diagnostic performance associated with the use of real-time PCR. This prospective study was carried out on BALFs obtained from immunocompromised patients over a 2-year period. We systematically compared the results of conventional staining with those of molecular detection. Two cases of pulmonary toxoplasmosis were diagnosed for a total of 336 samples. PCR did not detect any additional cases and was more time-consuming than conventional staining. Conventional staining is a reliable technique and is probably the most appropriate method for experienced microbiology laboratories, whereas T. gondii-specific PCR may be useful for laboratories with less experience in parasitology. 2015_030, May 27th 2015. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Plant extracts: sense or nonsense?

PubMed

Madersbacher, Stephan; Berger, Ingrid; Ponholzer, Anton; Marszalek, Martin

2008-01-01

To assess the current role of plant extracts in the medical management of lower urinary tract symptoms due to benign prostatic enlargement/benign prostatic obstruction. In 2006, two clinical trials meeting the WHO benign prostatic hyperplasia consensus conference criteria (randomized against placebo/standard therapy, study duration 12 months) were published. One trial compared a saw palmetto extract with placebo. This industry-independent trial published in the New England Journal of Medicine was negative, that is, this saw palmetto extract had no effect on symptoms, Qmax and postvoid residual volume. In another trial, a saw palmetto/urtica combination was compared with tamsulosin. After 12 months, the improvement of symptoms was identical in both study arms. No detailed data were presented, however, on Qmax, postvoid residual or prostate volume. The biological mechanisms of plant extracts in vivo are still unknown and the numerous metaanalyses cannot supplement high-quality prospective trials. Further prospective studies according to WHO benign prostatic hyperplasia standards are required to reliably determine the role of plant extracts in contemporary lower urinary tract symptoms management and to be able to answer the question in the title: 'plant extracts: sense or nonsense?' Plant extracts are currently not recommended by the American and European Association of Urology benign prostatic hyperplasia guidelines.

Knowledge Integration in Cancer: Current Landscape and Future Prospects

PubMed Central

Ioannidis, John P.A.; Schully, Sheri D.; Lam, Tram Kim; Khoury, Muin J.

2015-01-01

Knowledge integration includes knowledge management, synthesis, and translation processes. It aims to maximize the use of collected scientific information and accelerate translation of discoveries into individual and population health benefits. Accumulated evidence in cancer epidemiology constitutes a large share of the 2.7 million articles on cancer in PubMed. We examine the landscape of knowledge integration in cancer epidemiology. Past approaches have mostly used retrospective efforts of knowledge management and traditional systematic reviews and meta-analyses. Systematic searches identify 2,332 meta-analyses, about half of which are on genetics and epigenetics. Meta-analyses represent 1:89-1:1162 of published articles in various cancer subfields. Recently, there are more collaborative meta-analyses with individual-level data, including those with prospective collection of measurements [e.g., genotypes in genome-wide association studies (GWAS)]; this may help increase the reliability of inferences in the field. However, most meta-analyses are still done retrospectively with published information. There is also a flurry of candidate gene meta-analyses with spuriously prevalent "positive" results. Prospective design of large research agendas, registration of datasets, and public availability of data and analyses may improve our ability to identify knowledge gaps, maximize and accelerate translational progress or—at a minimum—recognize dead ends in a more timely fashion. PMID:23093546

Knowledge integration in cancer: current landscape and future prospects.

PubMed

Ioannidis, John P A; Schully, Sheri D; Lam, Tram Kim; Khoury, Muin J

2013-01-01

Knowledge integration includes knowledge management, synthesis, and translation processes. It aims to maximize the use of collected scientific information and accelerate translation of discoveries into individual and population health benefits. Accumulated evidence in cancer epidemiology constitutes a large share of the 2.7 million articles on cancer in PubMed. We examine the landscape of knowledge integration in cancer epidemiology. Past approaches have mostly used retrospective efforts of knowledge management and traditional systematic reviews and meta-analyses. Systematic searches identify 2,332 meta-analyses, about half of which are on genetics and epigenetics. Meta-analyses represent 1:89-1:1162 of published articles in various cancer subfields. Recently, there are more collaborative meta-analyses with individual-level data, including those with prospective collection of measurements [e.g., genotypes in genome-wide association studies (GWAS)]; this may help increase the reliability of inferences in the field. However, most meta-analyses are still done retrospectively with published information. There is also a flurry of candidate gene meta-analyses with spuriously prevalent "positive" results. Prospective design of large research agendas, registration of datasets, and public availability of data and analyses may improve our ability to identify knowledge gaps, maximize and accelerate translational progress or-at a minimum-recognize dead ends in a more timely fashion.

Measuring childhood maltreatment to predict early-adult psychopathology: Comparison of prospective informant-reports and retrospective self-reports.

PubMed

Newbury, Joanne B; Arseneault, Louise; Moffitt, Terrie E; Caspi, Avshalom; Danese, Andrea; Baldwin, Jessie R; Fisher, Helen L

2018-01-01

Both prospective informant-reports and retrospective self-reports may be used to measure childhood maltreatment, though both methods entail potential limitations such as underestimation and memory biases. The validity and utility of standard measures of childhood maltreatment requires clarification in order to inform the design of future studies investigating the mental health consequences of maltreatment. The present study assessed agreement between prospective informant-reports and retrospective self-reports of childhood maltreatment, as well as the comparative utility of both reports for predicting a range of psychiatric problems at age 18. Data were obtained from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally-representative birth cohort of 2232 children followed to 18 years of age (with 93% retention). Childhood maltreatment was assessed in two ways: (i) prospective informant-reports from caregivers, researchers, and clinicians when children were aged 5, 7, 10 and 12; and (ii) retrospective self-reports of maltreatment experiences occurring up to age 12, obtained at age 18 using the Childhood Trauma Questionnaire. Participants were privately interviewed at age 18 concerning several psychiatric problems including depression, anxiety, self-injury, alcohol/cannabis dependence, and conduct disorder. There was only slight to fair agreement between prospective and retrospective reports of childhood maltreatment (all Kappa's ≤ 0.31). Both prospective and retrospective reports of maltreatment were associated with age-18 psychiatric problems, though the strongest associations were found when maltreatment was retrospectively self-reported. These findings indicate that prospective and retrospective reports of childhood maltreatment capture largely non-overlapping groups of individuals. Young adults who recall being maltreated have a particularly elevated risk for psychopathology. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Full length articles published in BJOMS during 2010-11--an analysis by sub-specialty and study type.

PubMed

Arakeri, Gururaj; Colbert, Serryth; Rosenbaum, Gavin; Brennan, Peter A

2012-12-01

Full length articles such as prospective and retrospective studies, case series, laboratory-based research and reviews form the majority of papers published in the British Journal of Oral and Maxillofacial Surgery (BJOMS). We were interested to evaluate the breakdown of these types of articles both by sub-specialty and the type of study as well as the proportion that are written by UK colleagues compared to overseas authors over a 2 year period (2010-11). A total of 191 full length articles across all sub-specialties of our discipline were published, with 107 papers (56%) coming from UK authors. There were proportionately more oncology papers arising from the UK than overseas (60 and 30% of total respectively) while the opposite was found for cleft/deformity studies (10% and 22%). There was only one laboratory-based study published from the UK compared with 27 papers from overseas. The number of quality papers being submitted to the Journal continues to increase, and the type of article being published between UK and overseas probably reflects different practices and case-loads amongst colleagues. The relatively few UK laboratory based studies published in BJOMS compared to overseas authors are most likely due to authors seeking the most prestigious journals possible for their work. Copyright © 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

The Alaska Mineral Resource Assessment Program; guide to information about the geology and mineral resources of the Ketchikan and Prince Rupert quadrangles, southeastern Alaska

USGS Publications Warehouse

Berg, Henry C.

1982-01-01

The Ketchikan and Prince Rupert 1-degree by 2-degree quadrangles, which encompass about 16,000 km2 at the south tip of southeastern Alaska, have been investigated by integrated field and laboratory studies in the disciplines of geology, geochemistry, geophysics, and Landsat data interpretation to determine their mineral-resource potential. Mineral deposits in the study area have been mined or prospected intermittently since about 1900, and production of small tonnages of ores containing gold, silver, copper, lead, zinc, and tungsten has been recorded. Extensive exploration and development currently (1981) is underway at a molybdenum prospect about 65 km east of Ketchikan. Our mineral-resource assessment indicates that the area contains potentially significant amounts of those metallic commodities, as well as of molybdenum, iron, antimony, and barite. The results of these studies have been published in a folio of maps accompanied by descriptive texts, diagrams, tables, and pertinent references. The present report serves as a guide to these investigations, provides relevant background information, and integrates the component maps and reports. It also describes revisions to the geology based on studies completed since the folio was published and includes a list of specific and general references on the geology and mineral deposits of the study area.

The SWENOTECA group: A good example of continuous binational and multidisciplinary collaboration for patients with testicular cancer in Sweden and Norway.

PubMed

Tandstad, Torgrim; Ståhl, Olof; Håkansson, Ulf; Wahlqvist, Rolf; Klepp, Olbjørn; Cavallin-Ståhl, Eva; Cohn-Cedermark, Gabriella

2016-01-01

The aim of this article is to present the Swedish and Norwegian Testicular Cancer Group (SWENOTECA), with an emphasis on the history of SWENOTECA, organization, results and current status. SWENOTECA was founded in 1981 as a binational organization open to hospitals in Sweden and Norway treating testicular cancer. It has since published treatment protocols for testicular cancer and prospectively registered patients with testicular cancer. Today, all hospitals in Norway and Sweden involved in the care of testicular cancer participate in SWENOTECA, and all patients with testicular cancer are prospectively registered in a population-based database. Nine protocols with standardized guidelines on the diagnosis, treatment and follow-up of testicular cancer have been published. In addition to the guidelines, several studies have been performed or initiated within the scope of SWENOTECA. The details are presented in this article. SWENOTECA has been a very fruitful binational collaboration and has thoughtfully evolved over time. The group's continuous work and dedication have provided an example for other national and international cancer networks. The binational implementation of standardized guidelines has resulted in excellent patient outcomes, regardless of place of residence. Although testicular cancer is a relatively rare disease, the population-based binational organization of SWENOTECA has made it possible to publish some of the largest studies in the field of testicular cancer.

Dietary cholesterol, fats and risk of Parkinson's disease in the Singapore Chinese Health Study.

PubMed

Tan, Louis C; Methawasin, Kulthida; Tan, Eng-King; Tan, June H; Au, Wing-Lok; Yuan, Jian-Min; Koh, Woon-Puay

2016-01-01

Prospective studies on lipids and risk of Parkinson's disease (PD) in Asian populations are sparse. This study prospectively examined the associations between dietary cholesterol and major fatty acids, and risk of PD among the Chinese in Singapore. This study used data from the Singapore Chinese Health Study, a population-based prospective cohort of 63 257 men and women aged 45-74 years in Singapore enrolled in 1993-1998. Dietary intakes of cholesterol and fatty acids were derived from a validated semiquantitative food frequency questionnaire and the Singapore Food Composition Table. Incident PD cases were identified either through follow-up interviews or record linkage analysis with hospital discharge and PD outpatient registries. After an average of 14.6 years, 218 men and 193 women in the cohort developed PD. Dietary cholesterol was associated with statistically significantly lower risk of PD in a dose-dependent manner among men after adjustment for established risk factors for PD and intakes of major fatty acids. Compared to the lowest quartile, HR (95% CI) for the highest quartile was 0.53 (95% CI 0.33 to 0.84) (P for trend=0.006). Among women, dietary monounsaturated fatty acid was inversely associated with PD risk (P for trend=0.033). Compared to the lowest quartile, HR for the highest quartile was 0.44 (95% CI 0.22 to 0.88). There was no statistically significant association between dietary saturated, n-3 and n-6 fatty acids and PD risk. Higher intakes of cholesterol and monounsaturated fatty acids may reduce risk of PD in men and women, respectively. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Brain function and structure and risk for incident diabetes: The Atherosclerosis Risk in Communities Study.

PubMed

Bancks, Michael P; Alonso, Alvaro; Gottesman, Rebecca F; Mosley, Thomas H; Selvin, Elizabeth; Pankow, James S

2017-12-01

Diabetes is prospectively associated with cognitive decline. Whether lower cognitive function and worse brain structure are prospectively associated with incident diabetes is unclear. We analyzed data for 10,133 individuals with cognitive function testing (1990-1992) and 1212 individuals with brain magnetic resonance imaging (1993-1994) from the Atherosclerosis Risk in Communities cohort. We estimated hazard ratios for incident diabetes through 2014 after adjustment for traditional diabetes risk factors and cohort attrition. Higher level of baseline cognitive function was associated with lower risk for diabetes (per 1 standard deviation, hazard ratio = 0.94; 95% confidence interval = 0.90, 0.98). This association did not persist after accounting for baseline glucose level, case ascertainment methods, and cohort attrition. No association was observed between any brain magnetic resonance imaging measure and incident diabetes. This is one of the first studies to prospectively evaluate the association between both cognitive function and brain structure and the incidence of diabetes. Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Like, Love, Delete: Social Media's Influence on College Choice

ERIC Educational Resources Information Center

Turner, Marcia Layton

2017-01-01

Ten years ago, NACAC published a report showing that 61 percent of college admission offices were using social media to recruit prospective students. The authors--and many people in college admission--could see the writing on the wall: Social media was becoming indispensable. One of the study's authors, Nora Ganim Barnes, recently observed,…

Prospects and Problems for Religious Education in England, 1967-1970: Curriculum Reform in Political Context

ERIC Educational Resources Information Center

Freathy, R. J. K.; Parker, S. G.

2015-01-01

This article provides an historical case study of an abortive attempt to revise policy and legislation relating to Religious Education (RE) in English schools in the late 1960s and early 1970s. Drawing upon published sources, including parliamentary debates, as well as previously unutilised national archival sources from the Department of…

Alcohol Consumption, Genetic Variants in Alcohol Deydrogenases, and Risk of Cardiovascular Diseases: A Prospective Study and Meta-Analysis

PubMed Central

Drogan, Dagmar; Sheldrick, Abigail J.; Schütze, Madlen; Knüppel, Sven; Andersohn, Frank; di Giuseppe, Romina; Herrmann, Bianca; Willich, Stefan N.; Garbe, Edeltraut; Bergmann, Manuela M.; Boeing, Heiner; Weikert, Cornelia

2012-01-01

Objective First, to investigate and compare associations between alcohol consumption and variants in alcohol dehydrogenase (ADH) genes with incidence of cardiovascular diseases (CVD) in a large German cohort. Second, to quantitatively summarize available evidence of prospective studies on polymorphisms in ADH1B and ADH1C and CVD-risk. Methods We conducted a case-cohort study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort including a randomly drawn subcohort (n = 2175) and incident cases of myocardial infarction (MI; n = 230) or stroke (n = 208). Mean follow-up time was 8.2±2.2 years. The association between alcohol consumption, ADH1B or ADH1C genotypes, and CVD-risk was assessed using Cox proportional hazards regression. Additionally, we report results on associations of variants in ADH1B and ADH1C with ischemic heart disease and stroke in the context of a meta-analysis of previously published prospective studies published up to November 2011. Results Compared to individuals who drank >0 to 6 g alcohol/d, we observed a reduced risk of MI among females consuming >12 g alcohol/d (HR = 0.31; 95% CI: 0.10–0.97) and among males consuming >24 to 60 g/d (HR = 0.57; 95% CI: 0.33–0.98) or >60 g alcohol/d (HR = 0.30; 95% CI: 0.12–0.78). Stroke risk was not significantly related to alcohol consumption >6 g/d, but we observed an increased risk of stroke in men reporting no alcohol consumption. Individuals with the slow-coding ADH1B*1/1 genotype reported higher median alcohol consumption. Yet, polymorphisms in ADH1B or ADH1C were not significantly associated with risk of CVD in our data and after pooling results of eligible prospective studies [ADH1B*1/1: RR = 1.35 (95% CI: 0.98–1.88; p for heterogeneity: 0.364); ADH1C*2/2: RR = 1.07 (95% CI: 0.90–1.27; p for heterogeneity: 0.098)]. Conclusion The well described association between alcohol consumption and CVD-risk is not reflected by ADH polymorphisms, which modify the rate of ethanol oxidation. PMID:22363810

Explanation of fields used in the Alaska Resource Data File of mines, prospects, and mineral occurrences in Alaska

USGS Publications Warehouse

,

1996-01-01

Descriptions of mines, prospects, and mineral occurrences in the Alaska Resource Data File (ARDF) are published for individual U.S. Geological Survey 1:250,000 scale quadrangles in Alaska (see accompanying map) and are available for downloading from USGS World Wide Web site: http://www-rnrs-ak.wr.usgs.gov/ardf.These descriptions are divided into a number of fields which describe features of each mine, prospect, or mineral occurrence. These descriptions were complied from published literature and from unpublished reports and data from industry, the U.S. Bureau of Mines, and the U.S. Geological Survey and other sources. Compilation of this database is an ongoing process and each report is essentially a progress report. The authors of the individual quadrangle reports would appreciate any corrections or additional information that users may be able to contribute.

Travel style is a major risk factor for diarrhoea in India: a prospective cohort study.

PubMed

Schindler, V M; Jaeger, V K; Held, L; Hatz, C; Bühler, S

2015-07-01

Although some studies suggested specific foods/beverages as risk factors for travellers' diarrhoea (TD), details of transmission remain unclear. We assessed the influence of travel style (luxury/middle-class versus backpacking) on TD risk. TD attack rates were compared in a prospective study among travellers to India at the University of Zurich's Travel Clinic. Information on consumption of foods/beverages was collected. Seventy-one luxury/middle-class travellers and 21 backpackers completed the study; overall 37% suffered from TD (62% backpackers, 30% luxury/middle-class travellers, OR 4.43, p 0.022). Travel style rather than the consumption of specific foods/beverages appears to be a risk factor for TD development. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Examining the pathways for young people with drug and alcohol dependence: a mixed-method design to examine the role of a treatment programme.

PubMed

Nathan, Sally; Rawstorne, Patrick; Hayen, Andrew; Bryant, Joanne; Baldry, Eileen; Ferry, Mark; Williams, Megan; Shanahan, Marian; Jayasinha, Ranmalie

2016-05-25

Young people with drug and alcohol problems are likely to have poorer health and other psychosocial outcomes than other young people. Residential treatment programmes have been shown to lead to improved health and related outcomes for young people in the short term. There is very little robust research showing longer term outcomes or benefits of such programmes. This paper describes an innovative protocol to examine the longer term outcomes and experiences of young people referred to a residential life management and treatment programme in Australia designed to address alcohol and drug issues in a holistic manner. This is a mixed-methods study that will retrospectively and prospectively examine young people's pathways into and out of a residential life management programme. The study involves 3 components: (1) retrospective data linkage of programme data to health and criminal justice administrative data sets, (2) prospective cohort (using existing programme baseline data and a follow-up survey) and (3) qualitative in-depth interviews with a subsample of the prospective cohort. The study will compare findings among young people who are referred and (a) stay 30 days or more in the programme (including those who go on to continuing care and those who do not); (b) start, but stay fewer than 30 days in the programme; (c) are assessed, but do not start the programme. Ethics approval has been sought from several ethics committees including a university ethics committee, state health departments and an Aboriginal-specific ethics committee. The results of the study will be published in peer-reviewed journals, presented at research conferences, disseminated via a report for the general public and through Facebook communications. The study will inform the field more broadly about the value of different methods in evaluating programmes and examining the pathways and trajectories of vulnerable young people. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Farm environment during infancy and lung function at the age of 31: a prospective birth cohort study in Finland.

PubMed

Lampi, Jussi; Koskela, Heikki; Hartikainen, Anna-Liisa; Ramasamy, Adaikalavan; Couto Alves, Alexessander; Järvelin, Marjo-Riitta; Pekkanen, Juha

2015-07-22

Farming as an occupation is considered a risk factor for asthma and reduced lung function. By contrast, living on a farm during infancy has been reported to be associated with lower risk of asthma in adulthood. However, little is known about the association between farming environment during infancy and lung function in adulthood. We aimed to study the prospective longitudinal association between farming environment during infancy and lung function in adulthood. A prospective birth cohort study. Northern Finland. 5666 participants born in 1966 were followed up at the age of 31 years. Spirometry at the age of 31 years. To be born into a farmer's family was associated with higher forced expiratory volume in 1 s (FEV1) (36 mL; 95% CI 6 to 67 mL) and forced vital capacity (FVC) (40 mL; 95% CI 5 to 75 mL) at the age of 31 years. Contact with farm animals during infancy was associated with higher FEV1. No associations were seen with FEV1/FVC (FEV1/FVC ratio). Having dogs in childhood revealed similar associations. There was a suggestive dose-dependent association with the number of animal species during childhood and higher FEV1 and FVC at adulthood, especially among women. Farming environment in early life may have a positive impact on lung function in adulthood. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Does Study Design Affect Redislocation Rates After Primary Shoulder Dislocations? A Systematic Review Comparing Prospective and Retrospective Studies.

PubMed

Gohal, Chetan; Rofaiel, James; Abouali, Jihad; Ayeni, Olufemi R; Pinsker, Ellie; Whelan, Daniel

2017-10-01

To compare recurrence rates between prospectively collected and retrospectively collected data on primary anterior shoulder dislocations, as this could influence the timing of surgical decision making. A comprehensive literature search of Medline, Embase, CINAHL, and hand searches was performed. Recurrence rates of anterior shoulder dislocations were collected from relevant articles, along with follow-up length, age, and gender. An independent sample t test was conducted to evaluate our hypothesis. A multiple linear regression model was used to examine the variance in recurrence rates while controlling for covariates. A total of 1,379 articles were identified, of which 25 were relevant to our study-16 prospective and 9 retrospective. The average rate of recurrence of anterior shoulder dislocations in retrospective studies (mean [M] = 45.2, standard deviation [SD] = 31.67) was not significantly different from that in prospective studies (M = 56.7, SD = 22.55). The 95% confidence interval for the difference of the means ranged from -34.05 to 10.91. After controlling for covariates with the multiple linear regression, only 1.9% of the variance in recurrence rates was due to study type and was not significant (P = .42). The t test performed to evaluate our hypothesis was also not significant t(23) = -1.07, P = .298. When comparing prospective and retrospective studies, there was no significant difference in recurrence rates of primary anterior shoulder dislocations treated nonoperatively. The average redislocation rate was 56.7% in prospective studies and 45.2% in retrospective studies. Furthermore, the majority of this difference was accounted for by varying rates between age groups. Further research is needed to determine the risk of redislocation in specific age groups, to guide treatment decisions based on varying risk. Systematic review of Level II and III studies. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Measuring change in quality of life: bias in prospective and retrospective evaluation.

PubMed

Blome, Christine; Augustin, Matthias

2015-01-01

Treatment effects on health-related quality of life (QOL) often differ depending on whether they are measured prospectively (before and after treatment) or retrospectively (after treatment only). These two approaches can be subject to different sorts of bias: Prospective evaluations may be biased by scale recalibration (a changed understanding of the response scale), and retrospective evaluations may be biased by recall bias (a wrong assessment of former QOL). On the basis of an analysis of the literature, we present an overview on possible biases in prospective and retrospective measurement of QOL and how these biases are named and defined in the literature. The definitions of different biases are inconsistent. Many authors do not clearly distinguish measurement bias from true change. Furthermore, some consider only scale recalibration or only recall bias. Much of the current discussion on bias in prospective and retrospective QOL measurement suffers from unclear definitions, especially of "response shift" and "recall bias," or from neglecting one of the possible biases. We suggest more elaborate definitions for different types of bias and recommend taking both kinds of bias into consideration when measuring change in QOL. The relevance of the different biases depends on the type of study, and so either prospective or retrospective assessment may be more appropriate. Copyright © 2015. Published by Elsevier Inc.

Near-death experiences in non-life-threatening events and coma of different etiologies

PubMed Central

Charland-Verville, Vanessa; Jourdan, Jean-Pierre; Thonnard, Marie; Ledoux, Didier; Donneau, Anne-Francoise; Quertemont, Etienne; Laureys, Steven

2014-01-01

Background: Near death experiences (NDEs) are increasingly being reported as a clearly identifiable physiological and psychological reality of clinical significance. However, the definition and causes of the phenomenon as well as the identification of NDE experiencers is still a matter of debate. To date, the most widely used standardized tool to identify and characterize NDEs in research is the Greyson NDE scale. Using this scale, retrospective and prospective studies have been trying to estimate their incidence in various populations but few studies have attempted to associate the experiences' intensity and content to etiology. Methods: This retrospective investigation assessed the intensity and the most frequently recounted features of self-reported NDEs after a non-life-threatening event (i.e., “NDE-like” experience) or after a pathological coma (i.e., “real NDE”) and according to the etiology of the acute brain insult. We also compared our retrospectively acquired data in anoxic coma with historical data from the published literature on prospective post-anoxic studies using the Greyson NDE scale. Results: From our 190 reports who met the criteria for NDE (i.e., Greyson NDE scale total score >7/32), intensity (i.e., Greyson NDE scale total score) and content (i.e., Greyson NDE scale features) did not differ between “NDE-like” (n = 50) and “real NDE” (n = 140) groups, nor within the “real NDE” group depending on the cause of coma (anoxic/traumatic/other). The most frequently reported feature was peacefulness (89–93%). Only 2 patients (1%) recounted a negative experience. The overall NDE core features' frequencies were higher in our retrospective anoxic cohort when compared to historical published prospective data. Conclusions: It appears that “real NDEs” after coma of different etiologies are similar to “NDE-like” experiences occurring after non-life threatening events. Subjects reporting NDEs retrospectively tend to have experienced a different content compared to the prospective experiencers. PMID:24904345

Near-death experiences in non-life-threatening events and coma of different etiologies.

PubMed

Charland-Verville, Vanessa; Jourdan, Jean-Pierre; Thonnard, Marie; Ledoux, Didier; Donneau, Anne-Francoise; Quertemont, Etienne; Laureys, Steven

2014-01-01

Near death experiences (NDEs) are increasingly being reported as a clearly identifiable physiological and psychological reality of clinical significance. However, the definition and causes of the phenomenon as well as the identification of NDE experiencers is still a matter of debate. To date, the most widely used standardized tool to identify and characterize NDEs in research is the Greyson NDE scale. Using this scale, retrospective and prospective studies have been trying to estimate their incidence in various populations but few studies have attempted to associate the experiences' intensity and content to etiology. This retrospective investigation assessed the intensity and the most frequently recounted features of self-reported NDEs after a non-life-threatening event (i.e., "NDE-like" experience) or after a pathological coma (i.e., "real NDE") and according to the etiology of the acute brain insult. We also compared our retrospectively acquired data in anoxic coma with historical data from the published literature on prospective post-anoxic studies using the Greyson NDE scale. From our 190 reports who met the criteria for NDE (i.e., Greyson NDE scale total score >7/32), intensity (i.e., Greyson NDE scale total score) and content (i.e., Greyson NDE scale features) did not differ between "NDE-like" (n = 50) and "real NDE" (n = 140) groups, nor within the "real NDE" group depending on the cause of coma (anoxic/traumatic/other). The most frequently reported feature was peacefulness (89-93%). Only 2 patients (1%) recounted a negative experience. The overall NDE core features' frequencies were higher in our retrospective anoxic cohort when compared to historical published prospective data. It appears that "real NDEs" after coma of different etiologies are similar to "NDE-like" experiences occurring after non-life threatening events. Subjects reporting NDEs retrospectively tend to have experienced a different content compared to the prospective experiencers.

The china patient-centered evaluative assessment of cardiac events (PEACE) prospective study of percutaneous coronary intervention: Study design.

PubMed

Du, Xue; Pi, Yi; Dreyer, Rachel P; Li, Jing; Li, Xi; Downing, Nicholas S; Li, Li; Feng, Fang; Zhan, Lijuan; Zhang, Haibo; Guan, Wenchi; Xu, Xiao; Li, Shu-Xia; Lin, Zhenqiu; Masoudi, Frederick A; Spertus, John A; Krumholz, Harlan M; Jiang, Lixin

2016-12-01

The number of percutaneous coronary interventions (PCI) in China has increased more than 20-fold over the last decade. Consequently, there is a need for national-level information to characterize PCI indications and long-term patient outcomes, including health status, to understand and improve evolving practice patterns. This nationwide prospective study of patients receiving PCI is to: (1) measure long-term clinical outcomes (including death, acute myocardial infarction [AMI], and/or revascularization), patient-reported outcomes (PROs), cardiovascular risk factor control and adherence to medications for secondary prevention; (2) determine patient- and hospital-level factors associated with care process and outcomes; and (3) assess the appropriateness of PCI procedures. The China Patient-centered Evaluative Assessment of Cardiac Events (PEACE) Prospective Study of PCI has enrolled 5,000 consecutive patients during 2012-2014 from 34 diverse hospitals across China undergoing PCI for any indication. We abstracted details of patient's medical history, treatments, and in-hospital outcomes from medical charts, and conducted baseline, 1-, 6-, and 12-month interviews to characterize patient demographics, risk factors, clinical presentation, healthcare utilization, and health status using validated PRO measures. The primary outcome, a composite measure of death, AMI and/or revascularization, as well as PROs, medication adherence and cardiovascular risk factor control, was assessed throughout the 12-month follow-up. Blood and urine samples were collected at baseline and 12 months and stored for future analyses. To validate reports of coronary anatomy, 2,000 angiograms are randomly selected and read by two independent core laboratories. Hospital characteristics regarding their facilities, processes and organizational characteristics are assessed by site surveys. China PEACE Prospective Study of PCI will be the first study to generate novel, high-quality, comprehensive national data on patients' socio-demographic, clinical, treatment, and metabolic/genetic factors, and importantly, their long-term outcomes following PCI, including health status. This will build the foundation for PCI performance improvement efforts in China. © 2016 The Authors. Catheterization and Cardiovascular Interventions. Published by Wiley Periodicals, Inc. © 2016 The Authors. Catheterization and Cardiovascular Interventions. Published by Wiley Periodicals, Inc.

Longitudinal Associations Between PTSD Symptoms and Dyadic Conflict Communication Following a Severe Motor Vehicle Accident.

PubMed

Fredman, Steffany J; Beck, J Gayle; Shnaider, Philippe; Le, Yunying; Pukay-Martin, Nicole D; Pentel, Kimberly Z; Monson, Candice M; Simon, Naomi M; Marques, Luana

2017-03-01

There are well-documented associations between posttraumatic stress disorder (PTSD) symptoms and intimate relationship impairments, including dysfunctional communication at times of relationship conflict. To date, the extant research on the associations between PTSD symptom severity and conflict communication has been cross-sectional and focused on military and veteran couples. No published work has evaluated the extent to which PTSD symptom severity and communication at times of relationship conflict influence each other over time or in civilian samples. The current study examined the prospective bidirectional associations between PTSD symptom severity and dyadic conflict communication in a sample of 114 severe motor vehicle accident (MVA) survivors in a committed intimate relationship at the time of the accident. PTSD symptom severity and dyadic conflict communication were assessed at 4 and 16weeks post-MVA, and prospective associations were examined using path analysis. Total PTSD symptom severity at 4weeks prospectively predicted greater dysfunctional communication at 16weeks post-MVA but not vice versa. Examination at the level of PTSD symptom clusters revealed that effortful avoidance at 4weeks prospectively predicted greater dysfunctional communication at 16weeks, whereas dysfunctional communication 4weeks after the MVA predicted more severe emotional numbing at 16weeks. Findings highlight the role of PTSD symptoms in contributing to dysfunctional communication and the importance of considering PTSD symptom clusters separately when investigating the dynamic interplay between PTSD symptoms and relationship functioning over time, particularly during the early posttrauma period. Clinical implications for the prevention of chronic PTSD and associated relationship problems are discussed. Copyright © 2016. Published by Elsevier Ltd.

Estimating reliable paediatric reference intervals in clinical chemistry and haematology.

PubMed

Ridefelt, Peter; Hellberg, Dan; Aldrimer, Mattias; Gustafsson, Jan

2014-01-01

Very few high-quality studies on paediatric reference intervals for general clinical chemistry and haematology analytes have been performed. Three recent prospective community-based projects utilising blood samples from healthy children in Sweden, Denmark and Canada have substantially improved the situation. The present review summarises current reference interval studies for common clinical chemistry and haematology analyses. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Intracranial Pressure and Its Relationship to Glaucoma: Current Understanding and Future Directions

PubMed Central

ROY CHOWDHURY, Uttio; FAUTSCH, Michael P.

2015-01-01

Retrospective and prospective studies looking at the role of cerebrospinal fluid pressure (CSFP)/intracranial pressure (ICP) have stimulated new theories and hypotheses regarding the underlying causal events for glaucoma. Most recently, studies supporting a low CSFP/ICP as a risk factor for glaucoma have been published. This review summarizes the current understanding of CSFP/ICP and its potential role in the pathogenicity of the disease. PMID:27350948

Higher risk of incident hepatitis C virus among young women who inject drugs compared with young men in association with sexual relationships: a prospective analysis from the UFO Study cohort.

PubMed

Tracy, Daniel; Hahn, Judith A; Fuller Lewis, Crystal; Evans, Jennifer; Briceño, Alya; Morris, Meghan D; Lum, Paula J; Page, Kimberly

2014-05-29

Female injection drug users (IDUs) may report differences in injection behaviours that put them at greater risk for hepatitis C virus (HCV). Few studies have examined these in association with HCV incidence. Longitudinal data from a cohort of 417 HCV-uninfected IDU aged 30 or younger were analysed. Cox proportional hazards was used to model female sex as a predictor of new HCV infection. General estimating equation (GEE) analysis was used to model female sex as a predictor of HCV-associated risk behaviour prospectively. Women were significantly more likely than men to become infected with HCV during study follow-up (HR 1.4, p<0.05), and were also more likely than men to report high-risk injecting behaviours, especially in the context of sexual and injecting relationships. Sex differences in injecting behaviours appeared to explain the relationship between sex and HCV infection. Young women's riskier injection practices lead to their higher rates of HCV infection. Further study on the impact of intimate partnership on women's risk behaviour is warranted. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Screening of gestational diabetes mellitus in early pregnancy by oral glucose tolerance test and glycosylated fibronectin: study protocol for an international, prospective, multicentre cohort trial.

PubMed

Huhn, E A; Fischer, T; Göbl, C S; Todesco Bernasconi, M; Kreft, M; Kunze, M; Schoetzau, A; Dölzlmüller, E; Eppel, W; Husslein, P; Ochsenbein-Koelble, N; Zimmermann, R; Bäz, E; Prömpeler, H; Bruder, E; Hahn, S; Hoesli, I

2016-10-12

As the accurate diagnosis and treatment of gestational diabetes mellitus (GDM) is of increasing importance; new diagnostic approaches for the assessment of GDM in early pregnancy were recently suggested. We evaluate the diagnostic power of an 'early' oral glucose tolerance test (OGTT) 75 g and glycosylated fibronectin (glyFn) for GDM screening in a normal cohort. In a prospective cohort study, 748 singleton pregnancies are recruited in 6 centres in Switzerland, Austria and Germany. Women are screened for pre-existing diabetes mellitus and GDM by an 'early' OGTT 75 g and/or the new biomarker, glyFn, at 12-15 weeks of gestation. Different screening strategies are compared to evaluate the impact on detection of GDM by an OGTT 75 g at 24-28 weeks of gestation as recommended by the International Association of Diabetes and Pregnancy Study Groups (IADPSG). A new screening algorithm is created by using multivariable risk estimation based on 'early' OGTT 75 g and/or glyFn results, incorporating maternal risk factors. Recruitment began in May 2014. This study received ethical approval from the ethics committees in Basel, Zurich, Vienna, Salzburg and Freiburg. It was registered under http://www.ClinicalTrials.gov (NCT02035059) on 12 January 2014. Data will be presented at international conferences and published in peer-reviewed journals. NCT02035059. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Organisation and function of the primary motor cortex in chronic pain: protocol for a systematic review and meta-analysis.

PubMed

Chang, Wei-Ju; O'Connell, Neil E; Burns, Emma; Chipchase, Lucy S; Liston, Matthew B; Schabrun, Siobhan M

2015-11-30

Primary motor cortical (M1) adaptation in the form of altered organisation and function is hypothesised to underpin motor dysfunction observed in chronic pain. The aim of this review is to assess the evidence for altered M1 organisation and function in chronic pain. Systematic review and meta-analysis. We will search electronic databases with predetermined search terms to identify relevant studies and evaluate the studies for inclusion and risks of bias. Two independent reviewers will extract data. Any disagreement will be resolved through a third reviewer. Cross-sectional or prospective studies published in English before May 2015 that investigate M1 organisation and function in chronic pain will be included if they meet the eligibility criteria. Primary outcomes will include M1 cortical excitability, spatial cortical representation, the function of inhibitory and facilitatory intracortical networks, cortical reactivity and cortical glucose metabolism. Clinical measures such as pain and disability will be included where the correlation with the primary outcomes of M1 organisation and function were investigated in the included studies. This systematic review does not require ethical approval. The results of this review will be submitted for peer-reviewed publication regardless of outcome and will be presented at relevant conferences. Our systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO; registration number CRD42015014823). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Feasibility of conducting prospective observational research on critically ill, dying patients in the intensive care unit.

PubMed

van Beinum, Amanda; Hornby, Laura; Dhanani, Sonny; Ward, Roxanne; Chambers-Evans, Jane; Menon, Kusum

2017-01-01

Studying patients during the end of life is important, as it has the potential to lead to improvements in care for the dying. For patients who die after a controlled withdrawal of life-sustaining therapies in the intensive care unit, information about the natural history of death and the process of removing life support has additionally led to advances in practice for deceased organ donation. However, this unique population of severely critically ill and imminently dying patients has been difficult to study, largely due to assumptions made by research teams and ethics boards alike about the logistical difficulties of obtaining consent and completing research procedures before or during the process of withdrawal of life-sustaining therapies. In this paper, we describe the ethics substudy of the first prospective observational research study in Canada to obtain consent and collect clinical data on patients during the process of withdrawal of life-sustaining therapies in the intensive care unit. We describe in detail the process of protocol development, review by five institutional research ethics boards and bedside staff satisfaction with the study. We conclude that prospective research on a critically ill and imminently dying population is feasible and can be conducted in an ethical manner. Further information is needed about the experiences and motivations of families and substitute decision makers who provide consent for research on critically ill intensive care unit patients at the end of life. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Has industry funding biased studies of the protective effects of alcohol on cardiovascular disease? A preliminary investigation of prospective cohort studies.

PubMed

McCambridge, Jim; Hartwell, Greg

2015-01-01

There have been no previous quantitative analyses of the possible effects of industry funding on alcohol and health research. This study examines whether findings of alcohol's protective effects on cardiovascular disease may be biased by industry funding. Findings from a recent systematic review of prospective cohort studies were combined with public domain data on alcohol industry funding. The six outcomes evaluated were alcohol's effects on cardiovascular disease mortality, incident coronary heart disease, coronary heart disease mortality, incident stroke, stroke mortality and mortality from all causes. We find no evidence of possible funding effects for outcomes other than stroke. Whether studies find alcohol to be a risk factor or protective against incident stroke depends on whether or not there is possible industry funding [risk ratio (RR) 1.07 (0.97-1.17) for those without concern about industry funding compared with RR 0.88 (0.81-0.94)]. For stroke mortality, a similar difference is not statistically significant, most likely because there are too few studies. Dedicated high-quality studies of possible alcohol industry funding effects should be undertaken, and these should be broad in scope. They also need to investigate specific areas of concern, such as stroke, in greater depth. © 2014 The Authors. Drug and Alcohol Review published by Wiley Publishing Asia Pty Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs .

Low power and type II errors in recent ophthalmology research.

PubMed

Khan, Zainab; Milko, Jordan; Iqbal, Munir; Masri, Moness; Almeida, David R P

2016-10-01

To investigate the power of unpaired t tests in prospective, randomized controlled trials when these tests failed to detect a statistically significant difference and to determine the frequency of type II errors. Systematic review and meta-analysis. We examined all prospective, randomized controlled trials published between 2010 and 2012 in 4 major ophthalmology journals (Archives of Ophthalmology, British Journal of Ophthalmology, Ophthalmology, and American Journal of Ophthalmology). Studies that used unpaired t tests were included. Power was calculated using the number of subjects in each group, standard deviations, and α = 0.05. The difference between control and experimental means was set to be (1) 20% and (2) 50% of the absolute value of the control's initial conditions. Power and Precision version 4.0 software was used to carry out calculations. Finally, the proportion of articles with type II errors was calculated. β = 0.3 was set as the largest acceptable value for the probability of type II errors. In total, 280 articles were screened. Final analysis included 50 prospective, randomized controlled trials using unpaired t tests. The median power of tests to detect a 50% difference between means was 0.9 and was the same for all 4 journals regardless of the statistical significance of the test. The median power of tests to detect a 20% difference between means ranged from 0.26 to 0.9 for the 4 journals. The median power of these tests to detect a 50% and 20% difference between means was 0.9 and 0.5 for tests that did not achieve statistical significance. A total of 14% and 57% of articles with negative unpaired t tests contained results with β > 0.3 when power was calculated for differences between means of 50% and 20%, respectively. A large portion of studies demonstrate high probabilities of type II errors when detecting small differences between means. The power to detect small difference between means varies across journals. It is, therefore, worthwhile for authors to mention the minimum clinically important difference for individual studies. Journals can consider publishing statistical guidelines for authors to use. Day-to-day clinical decisions rely heavily on the evidence base formed by the plethora of studies available to clinicians. Prospective, randomized controlled clinical trials are highly regarded as a robust study and are used to make important clinical decisions that directly affect patient care. The quality of study designs and statistical methods in major clinical journals is improving overtime, 1 and researchers and journals are being more attentive to statistical methodologies incorporated by studies. The results of well-designed ophthalmic studies with robust methodologies, therefore, have the ability to modify the ways in which diseases are managed. Copyright © 2016 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Perceived job insecurity as a risk factor for incident coronary heart disease: systematic review and meta-analysis

PubMed Central

Nyberg, Solja T; Batty, G David; Jokela, Markus; Heikkilä, Katriina; Fransson, Eleonor I; Alfredsson, Lars; Bjorner, Jakob B; Borritz, Marianne; Burr, Hermann; Casini, Annalisa; Clays, Els; De Bacquer, Dirk; Dragano, Nico; Elovainio, Marko; Erbel, Raimund; Ferrie, Jane E; Hamer, Mark; Jöckel, Karl-Heinz; Kittel, France; Knutsson, Anders; Koskenvuo, Markku; Koskinen, Aki; Lunau, Thorsten; Madsen, Ida E H; Nielsen, Martin L; Nordin, Maria; Oksanen, Tuula; Pahkin, Krista; Pejtersen, Jan H; Pentti, Jaana; Rugulies, Reiner; Salo, Paula; Shipley, Martin J; Siegrist, Johannes; Steptoe, Andrew; Suominen, Sakari B; Theorell, Töres; Toppinen-Tanner, Salla; Väänänen, Ari; Vahtera, Jussi; Westerholm, Peter J M; Westerlund, Hugo; Slopen, Natalie; Kawachi, Ichiro; Singh-Manoux, Archana; Kivimäki, Mika

2013-01-01

Objective To determine the association between self reported job insecurity and incident coronary heart disease. Design A meta-analysis combining individual level data from a collaborative consortium and published studies identified by a systematic review. Data sources We obtained individual level data from 13 cohort studies participating in the Individual-Participant-Data Meta-analysis in Working Populations Consortium. Four published prospective cohort studies were identified by searches of Medline (to August 2012) and Embase databases (to October 2012), supplemented by manual searches. Review methods Prospective cohort studies that reported risk estimates for clinically verified incident coronary heart disease by the level of self reported job insecurity. Two independent reviewers extracted published data. Summary estimates of association were obtained using random effects models. Results The literature search yielded four cohort studies. Together with 13 cohort studies with individual participant data, the meta-analysis comprised up to 174 438 participants with a mean follow-up of 9.7 years and 1892 incident cases of coronary heart disease. Age adjusted relative risk of high versus low job insecurity was 1.32 (95% confidence interval 1.09 to 1.59). The relative risk of job insecurity adjusted for sociodemographic and risk factors was 1.19 (1.00 to 1.42). There was no evidence of significant differences in this association by sex, age (<50 v ≥50 years), national unemployment rate, welfare regime, or job insecurity measure. Conclusions The modest association between perceived job insecurity and incident coronary heart disease is partly attributable to poorer socioeconomic circumstances and less favourable risk factor profiles among people with job insecurity. PMID:23929894

Mortality from respiratory diseases associated with opium use: a population-based cohort study.

PubMed

Rahmati, Atieh; Shakeri, Ramin; Khademi, Hooman; Poutschi, Hossein; Pourshams, Akram; Etemadi, Arash; Khoshnia, Masoud; Sohrabpour, Amir Ali; Aliasgari, Ali; Jafari, Elham; Islami, Farhad; Semnani, Shahryar; Gharravi, Abdolsamad; Abnet, Christian C; Pharoah, Paul D P; Brennan, Paul; Boffetta, Paolo; Dawsey, Sanford M; Malekzadeh, Reza; Kamangar, Farin

2017-11-01

Recent studies have suggested that opium use may increase mortality from cancer and cardiovascular diseases. However, no comprehensive study of opium use and mortality from respiratory diseases has been published. We aimed to study the association between opium use and mortality from respiratory disease using prospectively collected data. We used data from the Golestan Cohort Study, a prospective cohort study in northeastern Iran, with detailed, validated data on opium use and several other exposures. A total of 50 045 adults were enrolled from 2004 to 2008, and followed annually until June 2015, with a follow-up success rate of 99%. We used Cox proportional hazard regression models to evaluate the association between opium use and outcomes of interest. During the follow-up period, 331 deaths from respiratory disease were reported (85 due to respiratory malignancies and 246 due to non-malignant aetiologies). Opium use was associated with an increased risk of death from any respiratory disease (adjusted HR 95% CI 3.13 (2.42 to 4.04)). The association was dose-dependent with a HR of 3.84 (2.61 to 5.67) for the highest quintile of cumulative opium use versus never use (P trend <0.001). The HRs (95% CI) for the associations between opium use and malignant and non-malignant causes of respiratory mortality were 1.96 (1.18 to 3.25) and 3.71 (2.76 to 4.96), respectively. Long-term opium use is associated with increased mortality from both malignant and non-malignant respiratory diseases. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Consumption of garlic and risk of colorectal cancer: An updated meta-analysis of prospective studies

PubMed Central

Hu, Ji-Yi; Hu, Yi-Wang; Zhou, Jiao-Jiao; Zhang, Meng-Wen; Li, Dan; Zheng, Shu

2014-01-01

AIM: To conduct an updated meta-analysis of prospective studies addressing the association between garlic consumption and colorectal cancer. METHODS: Eligible cohort studies were identified by searching MEDLINE (PubMed) and screening the references of related articles published up to October 2013. Meta-analyses were conducted for colorectal cancer in relation to consumption of raw and cooked (RC) garlic and garlic supplements, separately. The summary relative risks (RR) with 95%CI were calculated using fixed-effects or random-effects model depending on the heterogeneity among studies. RESULTS: A total of 5 prospective cohort studies were identified. In contrast to the previous meta-analysis, no significant associations were found between consumption of RC garlic (RR: 1.06; 95%CI: 0.95-1.19) or garlic supplements (RR: 1.12; 95%CI: 0.96-1.31) and risk of colorectal cancer. A non-significant protective effect of garlic supplement intake against colorectal cancer was observed in females (RR: 0.84; 95%CI: 0.64-1.11), but the opposite was the case in males (RR: 1.24; 95%CI: 0.96-1.59). CONCLUSION: Consumption of RC garlic or garlic supplements is not significantly associated with reduced colorectal cancer risk. PMID:25386091

Consumption of garlic and risk of colorectal cancer: an updated meta-analysis of prospective studies.

PubMed

Hu, Ji-Yi; Hu, Yi-Wang; Zhou, Jiao-Jiao; Zhang, Meng-Wen; Li, Dan; Zheng, Shu

2014-11-07

To conduct an updated meta-analysis of prospective studies addressing the association between garlic consumption and colorectal cancer. Eligible cohort studies were identified by searching MEDLINE (PubMed) and screening the references of related articles published up to October 2013. Meta-analyses were conducted for colorectal cancer in relation to consumption of raw and cooked (RC) garlic and garlic supplements, separately. The summary relative risks (RR) with 95%CI were calculated using fixed-effects or random-effects model depending on the heterogeneity among studies. A total of 5 prospective cohort studies were identified. In contrast to the previous meta-analysis, no significant associations were found between consumption of RC garlic (RR: 1.06; 95%CI: 0.95-1.19) or garlic supplements (RR: 1.12; 95%CI: 0.96-1.31) and risk of colorectal cancer. A non-significant protective effect of garlic supplement intake against colorectal cancer was observed in females (RR: 0.84; 95%CI: 0.64-1.11), but the opposite was the case in males (RR: 1.24; 95%CI: 0.96-1.59). Consumption of RC garlic or garlic supplements is not significantly associated with reduced colorectal cancer risk.

National German Guideline (S2k): Guideline for the Diagnosis and Treatment of Endometriosis*

PubMed Central

Ulrich, U.; Buchweitz, O.; Greb, R.; Keckstein, J.; von Leffern, I.; Oppelt, P.; Renner, S. P.; Sillem, M.; Stummvoll, W.; De Wilde, R.-L.; Schweppe, K.-W.

2014-01-01

In this guideline, recommendations and standards for optimum diagnosis and treatment of endometriosis are presented. They are based on the analysis of the available scientific evidence as published in prospective randomized and retrospective studies as well as in systematic reviews. The guideline working group consisted of experts from Austria, Germany, Switzerland, and the Czech Republic. PMID:26157194

What was your question again? Types of medical studies.

PubMed

Jupiter, Daniel C

2014-01-01

Medical literature comes in all shapes and sizes, from animal studies to prospective clinical trials to retrospective chart reviews. In all of these cases, it is worth asking: What are the intellectual goals of the study: description, hypothesis testing, or hypothesis generating? This differentiation can help shape our view of the success or failure of the scientific effort. Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Rank-based testing of equal survivorship based on cross-sectional survival data with or without prospective follow-up.

PubMed

Chan, Kwun Chuen Gary; Qin, Jing

2015-10-01

Existing linear rank statistics cannot be applied to cross-sectional survival data without follow-up since all subjects are essentially censored. However, partial survival information are available from backward recurrence times and are frequently collected from health surveys without prospective follow-up. Under length-biased sampling, a class of linear rank statistics is proposed based only on backward recurrence times without any prospective follow-up. When follow-up data are available, the proposed rank statistic and a conventional rank statistic that utilizes follow-up information from the same sample are shown to be asymptotically independent. We discuss four ways to combine these two statistics when follow-up is present. Simulations show that all combined statistics have substantially improved power compared with conventional rank statistics, and a Mantel-Haenszel test performed the best among the proposal statistics. The method is applied to a cross-sectional health survey without follow-up and a study of Alzheimer's disease with prospective follow-up. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

25-hydroxyvitamin D levels and risk of stroke: A prospective study and meta-analysis

PubMed Central

Sun, Qi; Pan, An; Hu, Frank B.; Manson, JoAnn E.; Rexrode, Kathryn M.

2012-01-01

Background and Purpose Despite evidence suggesting that vitamin D deficiency may lead to elevated cardiovascular disease risk, results regarding the association of 25(OH)D levels with stroke risk are inconclusive. We aimed to examine this association in a prospective study in women and to summarize all existing data in a meta-analysis. Methods We measured 25(OH)D levels among 464 women who developed ischemic stroke and an equal number of controls who were free of stroke through 2006 in the Nurses’ Health Study (NHS). We searched MEDLINE and EMBASE for articles published through March 2011 that prospectively evaluated 25(OH)D levels in relation to stroke. Results After multivariable adjustment for lifestyle and dietary covariates, lower 25(OH)D levels were associated with an elevated risk of ischemic stroke in the NHS: the odds ratio (95% CI) comparing women in the lowest vs. highest tertiles was 1.49 (1.01, 2.18; Ptrend=0.04). We found 6 other prospective studies that examined 25(OH)D in relation to stroke outcomes. After pooling our results with these prospective studies that included 1,214 stroke cases in total, low 25(OH)D levels were associated with increased risk of developing stroke outcomes in comparison to high levels: the pooled relative risk (95% CI) was 1.52 (1.20, 1.85; I2 = 0.0%, Pheterogeneity=0.63). In two studies that explicitly examined ischemic stroke, this association was 1.59 (1.07, 2.12; I2 = 0.0%, Pheterogeneity=0.80). Conclusions These data provide evidence that low vitamin D levels are modestly associated with risk of stroke. Maintaining adequate vitamin D status may lower risk of stroke in women. PMID:22442173

Flares in childhood eczema.

PubMed

Langan, S M

2009-01-01

Eczema is a major public health problem affecting children worldwide. Few studies have directly assessed triggers for disease flares. This paper presents evidence from a published systematic review and a prospective cohort study looking at flare factors in eczema. This systematic review suggested that foodstuffs in selected groups, dust exposure, unfamiliar pets, seasonal variation, stress, and irritants may be important in eczema flares. We performed a prospective cohort study that focused on environmental factors and identified associations between exposure to nylon clothing, dust, unfamiliar pets, sweating, shampoo, and eczema flares. Results from this study also demonstrated some new key findings. First, the effect of shampoo was found to increase in cold weather, and second, combinations of environmental factors were associated with disease exacerbation, supporting a multiple component disease model. This information is likely to be useful to families and may lead to the ability to reduce disease flares in the future.

Use of Biomarkers to Guide Decisions on Adjuvant Systemic Therapy for Women With Early-Stage Invasive Breast Cancer: American Society of Clinical Oncology Clinical Practice Guideline.

PubMed

Harris, Lyndsay N; Ismaila, Nofisat; McShane, Lisa M; Andre, Fabrice; Collyar, Deborah E; Gonzalez-Angulo, Ana M; Hammond, Elizabeth H; Kuderer, Nicole M; Liu, Minetta C; Mennel, Robert G; Van Poznak, Catherine; Bast, Robert C; Hayes, Daniel F

2016-04-01

To provide recommendations on appropriate use of breast tumor biomarker assay results to guide decisions on adjuvant systemic therapy for women with early-stage invasive breast cancer. A literature search and prospectively defined study selection sought systematic reviews, meta-analyses, randomized controlled trials, prospective-retrospective studies, and prospective comparative observational studies published from 2006 through 2014. Outcomes of interest included overall survival and disease-free or recurrence-free survival. Expert panel members used informal consensus to develop evidence-based guideline recommendations. The literature search identified 50 relevant studies. One randomized clinical trial and 18 prospective-retrospective studies were found to have evaluated the clinical utility, as defined by the guideline, of specific biomarkers for guiding decisions on the need for adjuvant systemic therapy. No studies that met guideline criteria for clinical utility were found to guide choice of specific treatments or regimens. In addition to estrogen and progesterone receptors and human epidermal growth factor receptor 2, the panel found sufficient evidence of clinical utility for the biomarker assays Oncotype DX, EndoPredict, PAM50, Breast Cancer Index, and urokinase plasminogen activator and plasminogen activator inhibitor type 1 in specific subgroups of breast cancer. No biomarker except for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 was found to guide choices of specific treatment regimens. Treatment decisions should also consider disease stage, comorbidities, and patient preferences. © 2016 by American Society of Clinical Oncology.

Use of Biomarkers to Guide Decisions on Adjuvant Systemic Therapy for Women With Early-Stage Invasive Breast Cancer: American Society of Clinical Oncology Clinical Practice Guideline

PubMed Central

Harris, Lyndsay N.; McShane, Lisa M.; Andre, Fabrice; Collyar, Deborah E.; Gonzalez-Angulo, Ana M.; Hammond, Elizabeth H.; Kuderer, Nicole M.; Liu, Minetta C.; Mennel, Robert G.; Van Poznak, Catherine; Bast, Robert C.; Hayes, Daniel F.

2016-01-01

Purpose To provide recommendations on appropriate use of breast tumor biomarker assay results to guide decisions on adjuvant systemic therapy for women with early-stage invasive breast cancer. Methods A literature search and prospectively defined study selection sought systematic reviews, meta-analyses, randomized controlled trials, prospective-retrospective studies, and prospective comparative observational studies published from 2006 through 2014. Outcomes of interest included overall survival and disease-free or recurrence-free survival. Expert panel members used informal consensus to develop evidence-based guideline recommendations. Results The literature search identified 50 relevant studies. One randomized clinical trial and 18 prospective-retrospective studies were found to have evaluated the clinical utility, as defined by the guideline, of specific biomarkers for guiding decisions on the need for adjuvant systemic therapy. No studies that met guideline criteria for clinical utility were found to guide choice of specific treatments or regimens. Recommendations In addition to estrogen and progesterone receptors and human epidermal growth factor receptor 2, the panel found sufficient evidence of clinical utility for the biomarker assays Oncotype DX, EndoPredict, PAM50, Breast Cancer Index, and urokinase plasminogen activator and plasminogen activator inhibitor type 1 in specific subgroups of breast cancer. No biomarker except for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 was found to guide choices of specific treatment regimens. Treatment decisions should also consider disease stage, comorbidities, and patient preferences. PMID:26858339

Superior outcomes for military ankylosing spondylitis patients treated with anti-TNF.

PubMed

Rees, Jonathan D; Bennett, A N; Harris, D; Jones, T

2014-12-01

The British military has a cohort of patients with ankylosing spondylitis (AS) characterised by young age and short disease duration. Many of the most severely affected AS patients have been treated since 2005 at Headley Court with anti-tumour necrosis factor (anti-TNF) therapy in accordance with National Institute of Health and Care Excellence guidance. We wanted to prospectively determine both the safety and efficacy of this new treatment in our British military population and compare this with relevant civilian study outcome data. All AS patients commenced on anti-TNF therapy at Headley Court were prospectively monitored for treatment efficacy and side effects. Outcome measures used included the Bath Ankylosing Spondylitis Disease Activity Index. Our results were compared with a civilian comparison group (NHS) and relevant landmark clinical trial data. Our patients were younger (mean age 34.7 years) and had a shorter duration (mean disease duration 6.9 years) than the civilian (NHS) comparison group. Our safety data were extremely benign with only two patients suffering minor side effects (local injection site reaction). Furthermore, our outcome data were superior to both NHS routine care and to landmark clinical studies. Prior to this study, there were no data on military AS populations receiving anti-TNF therapy. The study confirms British military patients tolerate this therapy extremely well and receive greater benefit from this treatment than that seen in any published study to date. We believe that this confirms that young age and short disease duration are good prognostic factors in the treatment of AS with anti-TNF therapy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Walking Distance as a Predictor of Falls in People With Multiple Sclerosis.

PubMed

Nilsagård, Ylva; Westerdahl, Elisabeth; Wittrin, Anna; Gunnarsson, Martin

2016-06-01

People with multiple sclerosis (PwMS) experience falls, usually when walking and transferring. The aim was to investigate if walking distance and patient overestimate of walking distance are predictors of falls in PwMS. A prospective study was conducted, with a single test occasion followed by prospective registration of falls for 3 months. All PwMS in Region Örebro County with a previously registered Expanded Disability Status Scale score between 3.0 and 7.0 in the Swedish MS Registry were invited to participate (n = 149). Altogether, data from 49 PwMS being relapse free for at least 3 months and with a confirmed Expanded Disability Status Scale between 1.5 and 7.0 upon study entry were analysed. Twenty-two PwMS (45%) fell during the study period, providing information of 66 falls. Walking distance or overestimate of one's walking distance, as compared with test results, did not predict falls in this MS sample. Walking and standing activities are associated with numerous falls in PwMS. Our data do not clearly support routine measurements of walking distance in assessing individual fall risk. © 2015 The Authors. Physiotherapy Research International published by John Wiley & Sons, Ltd. © 2015 The Authors. Physiotherapy Research International published by John Wiley & Sons, Ltd.

Safety of 8-aminoquinolines given to people with G6PD deficiency: protocol for systematic review of prospective studies.

PubMed

Uthman, Olalekan A; Saunders, Rachel; Sinclair, David; Graves, Patricia; Gelband, Hellen; Clarke, Aileen; Garner, Paul

2014-05-14

A single dose or short course of primaquine given to people infected with malaria may reduce transmission of Plasmodium falciparum through its effects on gametocytes. Primaquine is also known to cause haemolysis in people with variants of glucose-6-phosphate dehydrogenase (G6PD) deficiency. The objective of this systematic review was to assess the risk of adverse effects in people with G6PD deficiency given primaquine or other 8-aminoquinoline (8AQ) as a single dose or short course (less than 7 days). We will search the following databases: Cochrane Infectious Diseases Group Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and LILACS. Prospective cohort studies, randomised and quasi-randomised trials that evaluated 8AQs for whatever reason in adults or children with a known G6PD deficiency will be included. Two authors will independently assess each study for eligibility, risk of bias and extract data. This systematic review will be published in a peer-reviewed journal. Brief reports of the review findings will be disseminated directly to the appropriate audiences and the WHO Technical Expert Group in Malaria Chemotherapy. As no primary data collection will be undertaken, no additional formal ethical assessment and informed consent are required. The protocol is registered with PROSPERO, registration number CRD42013006518. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Long-term risks of kidney living donation: review and position paper by the ERA-EDTA DESCARTES working group.

PubMed

Maggiore, Umberto; Budde, Klemens; Heemann, Uwe; Hilbrands, Luuk; Oberbauer, Rainer; Oniscu, Gabriel C; Pascual, Julio; Schwartz Sorensen, Soren; Viklicky, Ondrej; Abramowicz, Daniel

2017-02-01

Two recent matched cohort studies from the USA and Norway published in 2014 have raised some concerns related to the long-term safety of kidney living donation. Further studies on the long-term risks of living donation have since been published. In this position paper, Developing Education Science and Care for Renal Transplantation in European States (DESCARTES) board members critically review the literature in an effort to summarize the current knowledge concerning long-term risks of kidney living donation to help physicians for decision-making purposes and for providing information to the prospective live donors. Long-term risk of end-stage renal disease (ESRD) can be partially foreseen by trying to identify donors at risk of developing ‘de novo’ kidney diseases during life post-donation and by predicting lifetime ESRD risk. However, lifetime risk may be difficult to assess in young donors, especially in those having first-degree relatives with ESRD. The study from Norway also found an increased risk of death after living donor nephrectomy, which became visible only after >15 years of post-donation follow-up. However, these findings are likely to be largely the result of an overestimation due to the confounding effect related to a family history of renal disease. DESCARTES board members emphasize the importance of optimal risk–benefit assessment and proper information to the prospective donor, which should also include recommendations on health-promoting behaviour post-donation. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Working hours and the onset of depressive disorder: a systematic review and meta-analysis.

PubMed

Watanabe, Kazuhiro; Imamura, Kotaro; Kawakami, Norito

2016-12-01

: This systematic review and meta-analysis aimed to examine whether working beyond the standard working hours was associated with a greater risk of depressive disorder among workers included in published prospective studies. This manuscript was prepared according to the PRISMA guideline checklist. A database search was conducted using MEDLINE (PubMed), PsycINFO, and PsycARTICLES using a relevant set of keywords. The eligibility criteria were as follows: (1) participants were adult workers; (2) exposure was defined as overtime work; (3) outcome were depressive disorders clinically diagnosed or assessed by a structured interview and (4) the study design was prospective or cohort. 7 studies were identified in the systematic review and meta-analysis. Overtime work was associated with a small, non-significant, elevated risk of depressive disorder (pooled relative risk=1.075; 95% CI 0.834 to 1.387; p=0.575) in a random effects model. The association tended to be greater for women. The risk of working 50 or more hours per week was slightly but not significantly increased (pooled relative risk=1.241; 95% CI 0.880 to 1.750; p=0.218). The effect of overtime work on depressive disorder remains inconclusive and may be small if not negligible. Sex differences and the effect of longer working hours on depressive disorder should be addressed in the future. Prospero CRD42015020003; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

An Analysis of Factors Predicting Successful Transition From Pancreatology Abstracts to Full Publications.

PubMed

Grunwald, Douglas; Feuerstein, Joseph D; Maier, Irena Maria; Sheth, Sunil G

2017-01-01

Historically, less than half of peer-reviewed abstracts are published. We set out to determine how many pancreas-related abstracts are published within 5 years of presentation at gastroenterology conferences and to determine a model that predicts successful transition from abstract to journal publication. We collected data on study design from all pancreas-related abstracts at the 2010 Digestive Disease Week (DDW), American College of Gastroenterology, and American Pancreatic Association conferences. We then determined whether an abstract was published by October 2015 using a standardized search algorithm. Of 412 abstracts, 39.8% were published. Studies that were of basic science or translational design (P = 0.02, 0.01, respectively); had more listed authors (P = 0.05); employed randomized, prospective, and multicenter methodology (P = 0.02); and were accepted to DDW (P = 0.02) were more likely to be published. After regression, basic/translational studies (P = 0.002, 0.02, respectively) and DDW-accepted abstracts (P = 0.004) continued to predict successful publication. It is not clear why only 40% of the pancreas abstracts from 2010 were published 5 years later. Some abstracts may go unpublished because of methodological flaws that escape detection during abstract peer review. Therefore, physicians should use caution when applying abstract data to their clinical decision making.

Divided attention interferes with fulfilling activity-based intentions.

PubMed

Brewer, Gene A; Ball, B Hunter; Knight, Justin B; Dewitt, Michael R; Marsh, Richard L

2011-09-01

Two experiments were conducted to examine the effects of divided attention on activity-based prospective memory. After establishing a goal to fulfill an intention upon completion of an ongoing activity, successful completion of the intention generally suffered when attention was being devoted to an additional task (Experiment 1). Forming an implementation intention at encoding ameliorated the negative effects of divided attention (Experiment 2). The results from the present experiments demonstrate that activity-based prospective memory is susceptible to distraction and that implementing encoding strategies that enhance prospective memory performance can reduce this interference. The current work raises interesting questions about the similarities and differences between event- and activity-based prospective memories. Published by Elsevier B.V.

Periodontal systemic associations: review of the evidence.

PubMed

Linden, Gerard J; Lyons, Amy; Scannapieco, Frank A

2013-04-01

To critically appraise recent research into associations between periodontal disease and systemic diseases and conditions specifically respiratory disease, chronic kidney disease, rheumatoid arthritis, cognitive impairment, obesity, metabolic syndrome and cancer. A MEDLINE literature search of papers published between 2002 and April 2012 was conducted. Studies that included periodontitis as an exposure were identified. Cross-sectional epidemiological investigations on large samples, prospective studies and systematic reviews formed the basis of the narrative review. A threshold set for the identification of periodontitis was used to identify those studies that contributed to the conclusions of the review. Many of the investigations were cross-sectional secondary analyses of existing data sets in particular the NHANES studies. There were a small number of systematic reviews and prospective studies. There was substantial variability in the definitions of exposure to periodontitis. A small number of studies met the threshold set for periodontitis and supported associations; however, in some of the chronic diseases there were no such studies. There was strong evidence from randomized controlled trials that interventions, which improve oral hygiene have positive effects on the prevention of nosocomial pneumonias. There was substantial heterogeneity in the definitions used to identify periodontitis and very few studies met a stringent threshold for periodontitis. Published evidence supports modest associations between periodontitis and some, although not all, of the diseases and conditions reviewed. There is a need to reach a consensus on what constitutes periodontitis for future studies of putative associations with systemic diseases.

Periodontal systemic associations: review of the evidence.

PubMed

Linden, Gerard J; Lyons, Amy; Scannapieco, Frank A

2013-04-01

To critically appraise recent research into associations between periodontal disease and systemic diseases and conditions specifically respiratory disease, chronic kidney disease, rheumatoid arthritis, cognitive impairment, obesity, metabolic syndrome and cancer. A MEDLINE literature search of papers published between 2002 and April 2012 was conducted. Studies that included periodontitis as an exposure were identified. Cross-sectional epidemiological investigations on large samples, prospective studies and systematic reviews formed the basis of the narrative review. A threshold set for the identification of periodontitis was used to identify those studies that contributed to the conclusions of the review. Many of the investigations were cross-sectional secondary analyses of existing data sets in particular the NHANES studies. There were a small number of systematic reviews and prospective studies. There was substantial variability in the definitions of exposure to periodontitis. A small number of studies met the threshold set for periodontitis and supported associations; however, in some of the chronic diseases there were no such studies. There was strong evidence from randomized controlled trials that interventions, which improve oral hygiene have positive effects on the prevention of nosocomial pneumonias. There was substantial heterogeneity in the definitions used to identify periodontitis and very few studies met a stringent threshold for periodontitis. Published evidence supports modest associations between periodontitis and some, although not all, of the diseases and conditions reviewed. There is a need to reach a consensus on what constitutes periodontitis for future studies of putative associations with systemic diseases. © 2013 European Federation of Periodontology and American Academy of Periodontology.

HAL-RAR (Doppler guided haemorrhoid artery ligation with recto-anal repair) is a safe and effective procedure for haemorrhoids. Results of a prospective study after two-years follow-up.

PubMed

Hoyuela, Carlos; Carvajal, Fernando; Juvany, Montserrat; Troyano, Daniel; Trias, Miquel; Martrat, Antoni; Ardid, Jordi; Obiols, Joan

2016-04-01

To analyse prospectively results of HAL-RAR technique by evaluating pain, perioperative complications and clinical outcome after two years followup. A prospective study design including 30 consecutive patients with haemorrhoids grade III-IV treated from June 2012. After discharge, patients received a specific questionnaire to record postoperative pain, delayed complications, evolution/disappearance of the symptoms that led to the surgical intervention (bleeding, prolapse, itching, pain and soiling). A visual analog scale (VAS) was used to measure pain. Outpatient follow-up was carried out at 7 days, and 1, 6 and 12 months and annually thereafter. Pre, intra and postoperative data (including physical examination) had been recorded prospectively. The median operating time (range) was 40 (26-60) minutes. Average hospital stay (range) was 11 (3-25) hours. No postoperative complications were observed in 29 cases (96.6%). Median follow-up was 26 (12-36) months. All the patients attended the follow-up. Mean postoperative pain was VAS = 1.7 on the seventh day and it was practically non-existent (VAS = 0.7) 1 month after the procedure. 87.5% of patients confirmed complete relief of symptoms after 30 days and 93% of patients feel free of symptoms 6 months after the procedure. No patient has experienced late complications as dyschezia, urgency, soiling or faecal incontinence. After 24 months follow-up, recurrence of bleeding and prolapse was observed in only 1 patient; 93% of patients have considered results of HAL-RAR as very good or excellent. HAL-RAR is safe and almost painless technique and it has very good results in the control of haemorrhoidal symptoms. This procedure should be considered as an effective first treatment option for haemorrhoids. Copyright © 2016 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Prospective multi-center study of an automatic online seizure detection system for epilepsy monitoring units.

PubMed

Fürbass, F; Ossenblok, P; Hartmann, M; Perko, H; Skupch, A M; Lindinger, G; Elezi, L; Pataraia, E; Colon, A J; Baumgartner, C; Kluge, T

2015-06-01

A method for automatic detection of epileptic seizures in long-term scalp-EEG recordings called EpiScan will be presented. EpiScan is used as alarm device to notify medical staff of epilepsy monitoring units (EMUs) in case of a seizure. A prospective multi-center study was performed in three EMUs including 205 patients. A comparison between EpiScan and the Persyst seizure detector on the prospective data will be presented. In addition, the detection results of EpiScan on retrospective EEG data of 310 patients and the public available CHB-MIT dataset will be shown. A detection sensitivity of 81% was reached for unequivocal electrographic seizures with false alarm rate of only 7 per day. No statistical significant differences in the detection sensitivities could be found between the centers. The comparison to the Persyst seizure detector showed a lower false alarm rate of EpiScan but the difference was not of statistical significance. The automatic seizure detection method EpiScan showed high sensitivity and low false alarm rate in a prospective multi-center study on a large number of patients. The application as seizure alarm device in EMUs becomes feasible and will raise the efficiency of video-EEG monitoring and the safety levels of patients. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

A prospective cohort and extended comprehensive-cohort design provided insights about the generalizability of a pragmatic trial: the ProtecT prostate cancer trial.

PubMed

Donovan, Jenny L; Young, Grace J; Walsh, Eleanor I; Metcalfe, Chris; Lane, J Athene; Martin, Richard M; Tazewell, Marta K; Davis, Michael; Peters, Tim J; Turner, Emma L; Mills, Nicola; Khazragui, Hanan; Khera, Tarnjit K; Neal, David E; Hamdy, Freddie C

2018-04-01

Randomized controlled trials (RCTs) deliver robust internally valid evidence but generalizability is often neglected. Design features built into the Prostate testing for cancer and Treatment (ProtecT) RCT of treatments for localized prostate cancer (PCa) provided insights into its generalizability. Population-based cluster randomization created a prospective study of prostate-specific antigen (PSA) testing and a comprehensive-cohort study including groups choosing treatment or excluded from the RCT, as well as those randomized. Baseline information assessed selection and response during RCT conduct. The prospective study (82,430 PSA-tested men) represented healthy men likely to respond to a screening invitation. The extended comprehensive cohort comprised 1,643 randomized, 997 choosing treatment, and 557 excluded with advanced cancer/comorbidities. Men choosing treatment were very similar to randomized men except for having more professional/managerial occupations. Excluded men were similar to the randomized socio-demographically but different clinically, representing less healthy men with more advanced PCa. The design features of the ProtecT RCT provided data to assess the representativeness of the prospective cohort and generalizability of the findings of the RCT. Greater attention to collecting data at the design stage of pragmatic trials would better support later judgments by clinicians/policy-makers about the generalizability of RCT findings in clinical practice. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Focal Therapy for Prostate Cancer: An "À la Carte" Approach.

PubMed

Sivaraman, Arjun; Barret, Eric

2016-06-01

Personalizing focal ablation energy for prostate cancer on the basis of cancer location is a novel concept. We propose the use of high-intensity focused ultrasound, cryotherapy, and brachytherapy for posterior, anterior, and apical tumors, respectively, to improve the overall outcome. This concept needs to be verified in prospective studies. Copyright © 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Provisional Tic Disorder: What to tell parents when their child first starts ticcing.

PubMed

Black, Kevin J; Black, Elizabeth Rose; Greene, Deanna J; Schlaggar, Bradley L

2016-01-01

The child with recent onset of tics is a common patient in a pediatrics or child neurology practice. If the child's first tic was less than a year in the past, the diagnosis is usually Provisional Tic Disorder (PTD). Published reviews by experts reveal substantial consensus on prognosis in this situation: the tics will almost always disappear in a few months, having remained mild while they lasted. Surprisingly, however, the sparse existing data may not support these opinions. PTD may have just as much importance for science as for clinical care. It provides an opportunity to prospectively observe the spontaneous remission of tics. Such prospective studies may aid identification of genes or biomarkers specifically associated with remission rather than onset of tics. A better understanding of tic remission may also suggest novel treatment strategies for Tourette syndrome, or may lead to secondary prevention of tic disorders. This review summarizes the limited existing data on the epidemiology, phenomenology, and outcome of PTD, highlights areas in which prospective study is sorely needed, and proposes that tic disorders may completely remit much less often than is generally believed.

Prospective observational studies to assess comparative effectiveness: the ISPOR good research practices task force report.

PubMed

Berger, Marc L; Dreyer, Nancy; Anderson, Fred; Towse, Adrian; Sedrakyan, Art; Normand, Sharon-Lise

2012-01-01

In both the United States and Europe there has been an increased interest in using comparative effectiveness research of interventions to inform health policy decisions. Prospective observational studies will undoubtedly be conducted with increased frequency to assess the comparative effectiveness of different treatments, including as a tool for "coverage with evidence development," "risk-sharing contracting," or key element in a "learning health-care system." The principle alternatives for comparative effectiveness research include retrospective observational studies, prospective observational studies, randomized clinical trials, and naturalistic ("pragmatic") randomized clinical trials. This report details the recommendations of a Good Research Practice Task Force on Prospective Observational Studies for comparative effectiveness research. Key issues discussed include how to decide when to do a prospective observational study in light of its advantages and disadvantages with respect to alternatives, and the report summarizes the challenges and approaches to the appropriate design, analysis, and execution of prospective observational studies to make them most valuable and relevant to health-care decision makers. The task force emphasizes the need for precision and clarity in specifying the key policy questions to be addressed and that studies should be designed with a goal of drawing causal inferences whenever possible. If a study is being performed to support a policy decision, then it should be designed as hypothesis testing-this requires drafting a protocol as if subjects were to be randomized and that investigators clearly state the purpose or main hypotheses, define the treatment groups and outcomes, identify all measured and unmeasured confounders, and specify the primary analyses and required sample size. Separate from analytic and statistical approaches, study design choices may strengthen the ability to address potential biases and confounding in prospective observational studies. The use of inception cohorts, new user designs, multiple comparator groups, matching designs, and assessment of outcomes thought not to be impacted by the therapies being compared are several strategies that should be given strong consideration recognizing that there may be feasibility constraints. The reasoning behind all study design and analytic choices should be transparent and explained in study protocol. Execution of prospective observational studies is as important as their design and analysis in ensuring that results are valuable and relevant, especially capturing the target population of interest, having reasonably complete and nondifferential follow-up. Similar to the concept of the importance of declaring a prespecified hypothesis, we believe that the credibility of many prospective observational studies would be enhanced by their registration on appropriate publicly accessible sites (e.g., clinicaltrials.gov and encepp.eu) in advance of their execution. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

The Horsens-Aarhus Femoro Acetabular Impingement (HAFAI) cohort: outcome of arthroscopic treatment for femoroacetabular impingement. Protocol for a prospective cohort study.

PubMed

Kierkegaard, Signe; Lund, Bent; Dalgas, Ulrik; Sørensen, Henrik; Søballe, Kjeld; Mechlenburg, Inger

2015-09-07

During the past decade, it has become increasingly more common to offer hip arthroscopic surgery when treating people with femoroacetabular impingement (FAI). Nevertheless, the latest reviews conclude that it still remains to be properly investigated how surgery affects the patients. Specifically, detailed information on the functional, muscular and mechanical impact of surgery in larger groups is lacking. Furthermore, the long-term outcome of the surgery is still to be investigated. In this prospective cohort study, a total of 60 patients with FAI scheduled for arthroscopic surgery will be followed and tested preoperatively, and again after 3, 6, 9 and 12 months. Assessment includes isokinetic dynamometry evaluating hip flexion and extension; evaluation of functional capacity in a three-dimensional motion laboratory; pain assessment; self-reported function, quality of life, expectation and satisfaction with the surgery; recording of previous and present sporting activities and accelerometry. In addition, data on surgical procedure, rehabilitation progress, adverse events and failure will be recorded. Patients will be compared with an age-matched and gender-matched reference group of 30 persons with no hip, knee, ankle or back problems. Long-term follow-up of this cohort may evaluate possible reoperations and development of hip osteoarthritis. Furthermore, analysis on how subgroups respond to the treatment could be performed together with identification of possible "non-responders". The study is approved by the Central Denmark Region Committee on Biomedical Research Ethics (Journal No 1-10-72-239-14). The results from this study will be presented at national and international congresses and published in peer-reviewed journals. NCT02306525. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Pain sensitisation and the risk of poor outcome following physiotherapy for patients with moderate to severe knee osteoarthritis: protocol for a prospective cohort study.

PubMed

O'Leary, Helen; Smart, Keith M; Moloney, Niamh A; Blake, Catherine; Doody, Catherine M

2015-06-09

Pain is the dominant symptom of knee osteoarthritis (OA), and recent evidence suggests factors outside of local joint pathology, such as pain sensitisation, can contribute significantly to the pain experience. It is unknown how pain sensitisation influences outcomes from commonly employed interventions such as physiotherapy. The aims of this study are, first, to provide a comprehensive description of the somatosensory characteristics of people with pain associated with knee OA. Second, we will investigate if indicators of pain sensitisation in patients with knee osteoarthritis are predictive of non-response to physiotherapy. This is a multicentre prospective cohort study with 140 participants. Eligible patients with moderate to severe symptomatic knee osteoarthritis will be identified at outpatient orthopaedic and rheumatology clinics. A baseline assessment will provide a comprehensive description of the somatosensory characteristics of each participant by means of clinical examination, quantitative sensory testing, and validated questionnaires measuring pain and functional capacity. Participants will then undergo physiotherapy treatment. The primary outcome will be non-response to physiotherapy on completion of the physiotherapy treatment programme as defined by the Osteoarthritis Research Society International treatment responder criteria. A principal component analysis will identify measures related to pain sensitisation to include in the predictive model. Regression analyses will explore the relationship between responder status and pain sensitisation while accounting for confounders. This study has been approved by St James' Hospital/AMNCH Research Ethics Committee and by the St Vincent's Healthcare Group Ethics and Medical Research Committee. The results will be presented at international conferences and published in a peer review journal. NCT02310945. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Extracorporeal shock waves in the treatment of nonunions.

PubMed

Biedermann, Rainer; Martin, Arho; Handle, Gerhart; Auckenthaler, Thomas; Bach, Christian; Krismer, Martin

2003-05-01

Nonunion remains a major complication after skeletal trauma. In the last decade, extracorporeal shock wave therapy has become a common tool for the treatment of nonunions. To date, no prospective, randomized trial has been conducted to show the efficacy of this form of treatment. This study was performed to determine the value of extracorporeal shock wave therapy for nonunions. Previous published results in the literature and our own clinical results were analyzed and related to the natural history of bony union. No study has proven that extracorporeal shock wave therapy improves bone healing. Clinical studies reporting the acceleration of union after application of shock waves instead seem to misinterpret the natural history of bony union. No evidence supports the treatment of pseudarthroses with extracorporeal shock waves. A randomized, prospective, clinical trial with a control group has to be performed before a final decision can be made regarding this indication for extracorporeal shock wave therapy.

A multicenter prospective study to assess the effect of early cleavage on embryo quality, implantation, and live-birth rate.

PubMed

de los Santos, Maria José; Arroyo, Gemma; Busquet, Ana; Calderón, Gloria; Cuadros, Jorge; Hurtado de Mendoza, Maria Victoria; Moragas, Marta; Herrer, Raquel; Ortiz, Agueda; Pons, Carme; Ten, Jorge; Vilches, Miguel Angel; Figueroa, Maria José

2014-04-01

To investigate the impact of early cleavage (EC) on embryo quality, implantation, and live-birth rates. Prospective cross-sectional study. Multicenter study. Seven hundred embryo transfers and 1,028 early-stage human embryos. None. Implantation according to the presence of EC and embryo quality. The presence of EC is associated with embryo quality, especially in cycles with autologous oocytes. However, the use of EC as an additional criterion for selecting an embryo for transfer does not appear to significantly improve likelihood of implantation. Furthermore, embryos that presented EC had live-birth rates per implanted embryo similar to those that did not show any sign of cleavage. At least for conventional embryo culture and morphologic evaluations, the additional evaluation of EC in embryos may not be valuable to improve embryo implantation. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

High dose vitamin D therapy for chronic pain in children and adolescents with sickle cell disease: results of a randomized double blind pilot study.

PubMed

Osunkwo, Ifeyinwa; Ziegler, Thomas R; Alvarez, Jessica; McCracken, Courtney; Cherry, Korin; Osunkwo, Chinyere E; Ofori-Acquah, Solomon F; Ghosh, Samit; Ogunbobode, Adeolu; Rhodes, Jim; Eckman, James R; Dampier, Carlton; Tangpricha, Vin

2012-10-01

We report results of a pilot study of high-dose vitamin D in sickle cell disease (SCD). Subjects were given a 6-week course of oral high-dose cholecalciferol (4000-100 000 IU per week) or placebo and monitored prospectively for a period of six months. Vitamin D insufficiency and deficiency was present at baseline in 82·5% and 52·5% of subjects, respectively. Subjects who received high-dose vitamin D achieved higher serum 25-hydroxyvitamin D, experienced fewer pain days per week, and had higher physical activity quality-of-life scores. These findings suggest a potential benefit of vitamin D in reducing the number of pain days in SCD. Larger prospective studies with longer duration are needed to confirm these effects. © 2012 Blackwell Publishing Ltd.

Electronic Cigarettes for Smoking Cessation.

PubMed

Orellana-Barrios, Menfil A; Payne, Drew; Medrano-Juarez, Rita M; Yang, Shengping; Nugent, Kenneth

2016-10-01

The use of electronic cigarettes (e-cigarettes) is increasing, but their use as a smoking-cessation aid is controversial. The reporting of e-cigarette studies on cessation is variable and inconsistent. To date, only 1 randomized clinical trial has included an arm with other cessation methods (nicotine patches). The cessation rates for available clinical trials are difficult to compare given differing follow-up periods and broad ranges (4% at 12 months with non-nicotine e-cigarettes to 68% at 4 weeks with concomitant nicotine e-cigarettes and other cessation methods). The average combined abstinence rate for included prospective studies was 29.1% (combination of 6-18 months׳ rates). There are few comparable clinical trials and prospective studies related to e-cigarettes use for smoking cessation, despite an increasing number of citations. Larger randomized clinical trials are essential to determine whether e-cigarettes are effective smoking-cessation devices. Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

Prospective cross-sectional study of tuberculosis screening in United Arab Emirates.

PubMed

Almarzooqi, Farida; Alkhemeiri, Aysha; Aljaberi, Ahmed; Hashmey, Rayhan; Zoubeidi, Taoufik; Souid, Abdul-Kader

2018-05-01

Intense migrations from tuberculosis endemic areas to Gulf countries create special risks for people in the region. The purpose of this study was to provide data that could justify implementing universal, regular TB screening in UAE. This prospective, cross-sectional study used interferon-γ release assay (IGRA) to screen for TB among Emirati citizens between August-2016 and May-2017; expatriates were not included in this study. Participants were recruited from Emiratis attending Tawam Hospital Polyclinics for problems unrelated to TB risk assessment. IGRA was requested for all enrolled participants. A risk-assessment questionnaire was completed by all participants. In addition, a retrospective review of IGRA results (January-2011 to April-2016) was conducted to compare prevalence of positive IGRA in the 'prospective sample' with that in 'patients screened in the past'. Four hundred fifty-five participants (69% females) were enrolled in this study. Participants' age (mean±SD) was 42±16y. The majority of participants had traveled to or had helpers from TB-endemic areas. Two hundred forty (53%) participants had IGRA test. Forty-five (18.8%) participants had positive IGRA, similar to the retrospective results of 12.4% to 23.5%. The prevalence of positive-IGRA in this study is high. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Risk Factors for Repetition of Self-Harm: A Systematic Review of Prospective Hospital-Based Studies

PubMed Central

Larkin, Celine; Di Blasi, Zelda; Arensman, Ella

2014-01-01

Background Self-harm entails high costs to individuals and society in terms of suicide risk, morbidity and healthcare expenditure. Repetition of self-harm confers yet higher risk of suicide and risk assessment of self-harm patients forms a key component of the health care management of self-harm patients. To date, there has been no systematic review published which synthesises the extensive evidence on risk factors for repetition. Objective This review is intended to identify risk factors for prospective repetition of self-harm after an index self-harm presentation, irrespective of suicidal intent. Data sources PubMed, PsychInfo and Scirus were used to search for relevant publications. We included cohort studies which examining factors associated with prospective repetition among those presenting with self-harm to emergency departments. Journal articles, abstracts, letters and theses in any language published up to June 2012 were considered. Studies were quality-assessed and synthesised in narrative form. Results A total of 129 studies, including 329,001 participants, met our inclusion criteria. Some factors were studied extensively and were found to have a consistent association with repetition. These included previous self-harm, personality disorder, hopelessness, history of psychiatric treatment, schizophrenia, alcohol abuse/dependence, drug abuse/dependence, and living alone. However, the sensitivity values of these measures varied greatly across studies. Psychological risk factors and protective factors have been relatively under-researched but show emerging associations with repetition. Composite risk scales tended to have high sensitivity but poor specificity. Conclusions Many risk factors for repetition of self-harm match risk factors for initiation of self-harm, but the most consistent evidence for increased risk of repetition comes from long-standing psychosocial vulnerabilities, rather than characteristics of an index episode. The current review will enhance prediction of self-harm and assist in the efficient allocation of intervention resources. PMID:24465400

Ambulance smartphone tool for field triage of ruptured aortic aneurysms (FILTR): study protocol for a prospective observational validation of diagnostic accuracy.

PubMed

Lewis, Thomas L; Fothergill, Rachael T; Karthikesalingam, Alan

2016-10-24

Rupture of an abdominal aortic aneurysm (rAAA) carries a considerable mortality rate and is often fatal. rAAA can be treated through open or endovascular surgical intervention and it is possible that more rapid access to definitive intervention might be a key aspect of improving mortality for rAAA. Diagnosis is not always straightforward with up to 42% of rAAA initially misdiagnosed, introducing potentially harmful delay. There is a need for an effective clinical decision support tool for accurate prehospital diagnosis and triage to enable transfer to an appropriate centre. Prospective multicentre observational study assessing the diagnostic accuracy of a prehospital smartphone triage tool for detection of rAAA. The study will be conducted across London in conjunction with London Ambulance Service (LAS). A logistic score predicting the risk of rAAA by assessing ten key parameters was developed and retrospectively validated through logistic regression analysis of ambulance records and Hospital Episode Statistics data for 2200 patients from 2005 to 2010. The triage tool is integrated into a secure mobile app for major smartphone platforms. Key parameters collected from the app will be retrospectively matched with final hospital discharge diagnosis for each patient encounter. The primary outcome is to assess the sensitivity, specificity and positive predictive value of the rAAA triage tool logistic score in prospective use as a mob app for prehospital ambulance clinicians. Data collection started in November 2014 and the study will recruit a minimum of 1150 non-consecutive patients over a time period of 2 years. Full ethical approval has been gained for this study. The results of this study will be disseminated in peer-reviewed publications, and international/national presentations. CPMS 16459; pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Epidemiology of invasive fungal diseases among patients with haematological disorders in the Asia-Pacific: a prospective observational study.

PubMed

Hsu, L Y; Lee, D G; Yeh, S P; Bhurani, D; Khanh, B Q; Low, C Y; Norasetthada, L; Chan, T; Kwong, Y L; Vaid, A K; Alejandria, I; Mendoza, M; Chen, C Y; Johnson, A; Tan, T Y

2015-06-01

We conducted a 2-year multicentre prospective observational study to determine the epidemiology of and mortality associated with invasive fungal diseases (IFDs) among patients with haematological disorders in Asia. Eleven institutions from 8 countries/regions participated, with 412 subjects (28.2% possible, 38.3% probable and 33.5% proven IFDs) recruited. The epidemiology of IFDs in participating institutions was similar to Western centres, with Aspergillus spp. (65.9%) or Candida spp. (26.7%) causing the majority of probable and proven IFDs. The overall 30-day mortality was 22.1%. Progressive haematological disorder (odds ratio [OR] 5.192), invasive candidiasis (OR 3.679), and chronic renal disease (OR 6.677) were independently associated with mortality. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Chronic exposure of grandparents to poverty and body mass index trajectories of grandchildren: a prospective intergenerational study.

PubMed

Li, Miao

2015-02-01

In this study, I used the growth curve model to examine the association between grandparents' (first generation (G1)) life-course exposure to chronic poverty and grandchildren's (third generation (G3)) body mass index (BMI; weight (kg)/height (m)(2)) growth trajectories. This association was estimated separately for male and female grandchildren. Analyses were based on prospective data from a US longitudinal survey, the Panel Study of Income Dynamics (1968-2011), and 2 of its supplemental studies: the Child Development Supplement (1997-2011) and the Transition into Adulthood Study (1997-2011). A prospectively enrolled nationally representative cohort of 2,613 G3 youth (1,323 male, 1,290 female) sampled in the 2 supplemental studies was linked to 1,719 grandparents from the Panel Study of Income Dynamics core sample. Chronic exposure to poverty among grandparents was prospectively ascertained annually over a 30-year period prior to the collection of data on grandchildren. Findings suggested that grandparents' chronic poverty exposure was positively associated with the slope of the BMI trajectory among granddaughters (β = 0.10, 95% confidence interval: 0.03, 0.17) but not among grandsons (β = 0.02, 95% confidence interval: -0.04, 0.08). The association between grandparents' chronic poverty exposure and granddaughters' BMI growth slope remained even after controlling for parental (second generation (G2)) socioeconomic status and BMI. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Chinese herbal medicine for the treatment of Henoch-Schönlein purpura nephritis in children: A prospective cohort study protocol.

PubMed

Zhang, Jun; Lv, Jing; Pang, Shuang; Bai, Xiaohong; Yuan, Fang; Wu, Yubin; Jiang, Hong; Yang, Guanqi; Zhang, Shaoqing

2018-06-01

Henoch-Schönlein purpura nephritis (HSPN) involves the renal impairment of Henoch-Schönlein purpura and can easily relapse into life-threatening late nephropathy in severe cases. Although there is a lack of validated evidence for its effectiveness, Chinese herbal medicine (CHM) is one of the most commonly used methods in China to treat HSPN. It is thus need to report the protocol of a prospective cohort trial using CHM to investigate the effectiveness, safety and advantages for children with HSPN. This large, prospective, multicenter cohort study started in May 2015 in Shenyang. Six hundred children diagnosed with HSPN were recruited from 3 institutions and are followed-up every 2 to 4 weeks till May 2020. Detailed information of participants includes general information, history of treatment, physical examination, and symptoms of TCM is taken face-to-face at baseline. This study has received ethical approval from the ethics committee of institutional review board of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine (No.2016CS(KT)-002-01). Articles summarizing the primary results and ancillary analyses will be published in peer-reviewed journals. Clinical Trials Registration: NCT02878018.

Greater physician involvement improves coding outcomes in endobronchial ultrasound-guided transbronchial needle aspiration procedures.

PubMed

Pillai, Anilkumar; Medford, Andrew R L

2013-01-01

Correct coding is essential for accurate reimbursement for clinical activity. Published data confirm that significant aberrations in coding occur, leading to considerable financial inaccuracies especially in interventional procedures such as endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Previous data reported a 15% coding error for EBUS-TBNA in a U.K. service. We hypothesised that greater physician involvement with coders would reduce EBUS-TBNA coding errors and financial disparity. The study was done as a prospective cohort study in the tertiary EBUS-TBNA service in Bristol. 165 consecutive patients between October 2009 and March 2012 underwent EBUS-TBNA for evaluation of unexplained mediastinal adenopathy on computed tomography. The chief coder was prospectively electronically informed of all procedures and cross-checked on a prospective database and by Trust Informatics. Cost and coding analysis was performed using the 2010-2011 tariffs. All 165 procedures (100%) were coded correctly as verified by Trust Informatics. This compares favourably with the 14.4% coding inaccuracy rate for EBUS-TBNA in a previous U.K. prospective cohort study [odds ratio 201.1 (1.1-357.5), p = 0.006]. Projected income loss was GBP 40,000 per year in the previous study, compared to a GBP 492,195 income here with no coding-attributable loss in revenue. Greater physician engagement with coders prevents coding errors and financial losses which can be significant especially in interventional specialties. The intervention can be as cheap, quick and simple as a prospective email to the coding team with cross-checks by Trust Informatics and against a procedural database. We suggest that all specialties should engage more with their coders using such a simple intervention to prevent revenue losses. Copyright © 2013 S. Karger AG, Basel.

Quality of research and level of evidence in foot and ankle publications.

PubMed

Barske, Heather L; Baumhauer, Judith

2012-01-01

The quality of research and evidence to support medical treatments is under scrutiny from the medical profession and the public. This study examined the current quality of research and level of evidence (LOE) of foot and ankle surgery papers published in orthopedic and podiatric medical journals. Two independent evaluators performed a blinded assessment of all foot and ankle clinical research articles (January 2010 to June 2010) from seven North American orthopedic and podiatric journals. JBJS-A grading system was used for LOE. Articles were assessed for indicators of study quality. The data was stratified by journal and medical credentials. A total of 245 articles were published, 128 were excluded based on study design, leaving 117 clinical research articles. Seven (6%) were Level I, 14 (12%) Level II, 18 (15%) Level III, and 78 (67%) Level IV. The orthopedic journals published 78 studies on foot and ankle topics. Of the podiatric journals, the Journal of the American Podiatric Medical Association (JAPMA) published 12 clinical studies and the Journal of Foot and Ankle Surgery (JFAS) published 27, 21 (78%) of which were Level IV studies. When the quality of research was examined, few therapeutic studies used validated outcome measures and only 38 of 96 (40%) gathered data prospectively. Thirty (31%) studies used a comparison group. Eighty-seven articles (74%) were authored by a MD and 22 (19%) by a DPM. Foot & Ankle International (FAI) published higher quality studies with a higher LOE as compared to podiatry journals. Regardless of the journal, MDs produced the majority of published clinical foot and ankle research. Although improvements have been made in the quality of some clinical research, this study highlights the need for continued improvement in methodology within foot and ankle literature.

Past and Present ARDS Mortality Rates: A Systematic Review.

PubMed

Máca, Jan; Jor, Ondřej; Holub, Michal; Sklienka, Peter; Burša, Filip; Burda, Michal; Janout, Vladimír; Ševčík, Pavel

2017-01-01

ARDS is severe form of respiratory failure with significant impact on the morbidity and mortality of critical care patients. Epidemiological data are crucial for evaluating the efficacy of therapeutic interventions, designing studies, and optimizing resource distribution. The goal of this review is to present general aspects of mortality data published over the past decades. A systematic search of the MEDLINE/PubMed was performed. The articles were divided according to their methodology, type of reported mortality, and time. The main outcome was mortality. Extracted data included study duration, number of patients, and number of centers. The mortality trends and current mortality were calculated for subgroups consisting of in-hospital, ICU, 28/30-d, and 60-d mortality over 3 time periods (A, before 1995; B, 1995-2000; C, after 2000). The retrospectivity and prospectivity were also taken into account. Moreover, we present the most recent mortality rates since 2010. One hundred seventy-seven articles were included in the final analysis. General mortality rates ranged from 11 to 87% in studies including subjects with ARDS of all etiologies (mixed group). Linear regression revealed that the study design (28/30-d or 60-d) significantly influenced the mortality rate. Reported mortality rates were higher in prospective studies, such as randomized controlled trials and prospective observational studies compared with retrospective observational studies. Mortality rates exhibited a linear decrease in relation to time period (P < .001). The number of centers showed a significant negative correlation with mortality rates. The prospective observational studies did not have consistently higher mortality rates compared with randomized controlled trials. The mortality trends over 3 time periods (before 1995, 1995-2000, and after 2000) yielded variable results in general ARDS populations. However, a mortality decrease was present mostly in prospective studies. Since 2010, the overall rates of in-hospital, ICU, and 28/30-d and 60-d mortality were 45, 38, 30, and 32%, respectively. Copyright © 2017 by Daedalus Enterprises.

Diabetes, plasma glucose and incidence of pancreatic cancer: A prospective study of 0.5 million Chinese adults and a meta-analysis of 22 cohort studies.

PubMed

Pang, Yuanjie; Kartsonaki, Christiana; Guo, Yu; Bragg, Fiona; Yang, Ling; Bian, Zheng; Chen, Yiping; Iona, Andri; Millwood, Iona Y; Lv, Jun; Yu, Canqing; Chen, Junshi; Li, Liming; Holmes, Michael V; Chen, Zhengming

2017-04-15

Diabetes is associated with an increased risk of pancreatic cancer (PC) in Western populations. Uncertainty remains, however, about the relevance of plasma glucose for PC among people without diabetes and about the associations of diabetes and high blood glucose with PC in China where the increase in diabetes prevalence has been very recent. The prospective China Kadoorie Biobank (CKB) study recruited 512,000 adults aged 30-79 years from 10 diverse areas of China during 2004-2008, recording 595 PC cases during 8 years of follow-up. Cox regression yielded adjusted hazard ratios (HRs) for PC associated with diabetes (previously diagnosed or screen-detected) and, among those without previously diagnosed diabetes, with levels of random plasma glucose (RPG). These were further meta-analysed with 22 published prospective studies. Overall 5.8% of CKB participants had diabetes at baseline. Diabetes was associated with almost twofold increased risk of PC (adjusted HR = 1.87, 95% CI 1.48-2.37), with excess risk higher in those with longer duration since diagnosis (p for trend = 0.01). Among those without previously diagnosed diabetes, each 1 mmol/L higher usual RPG was associated with a HR of 1.12 (1.04-1.21). In meta-analysis of CKB and 22 other studies, previously diagnosed diabetes was associated with a 52% excess risk (1.52, 1.43-1.63). Among those without diabetes, each 1 mmol/L higher blood glucose was associated with a 15% (1.15, 1.09-1.21) excess risk. In Chinese and non-Chinese populations, diabetes and higher blood glucose levels among those without diabetes are associated with an increased risk of PC. © 2017 The Authors International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.

Reciprocal relations between body satisfaction and self-esteem: A large 13-year prospective study of adolescents.

PubMed

Wichstrøm, Lars; von Soest, Tilmann

2016-02-01

Previous research has demonstrated that body satisfaction and self-esteem are highly correlated in adolescence, but reasons are poorly understood. We tested three explanations: (i) the two constructs are actually one; (ii) the correlation is explained by a third factor; (iii) there are prospective relationships between body satisfaction and self-esteem. A population based sample of Norwegian adolescents (n = 3251) was examined four times over a 13-year period. Confirmatory factor analysis showed that body satisfaction and self-esteem were separate constructs and the correlation between them was not attenuated when adjusting for 3rd variables. Autoregressive cross-lagged analysis showed reciprocal relations between body satisfaction and self-esteem. The prospective relationship between body satisfaction during adolescence and self-esteem in late adolescence and emerging adulthood was stronger than at later stages. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Evolution of target organ damage and haemodynamic parameters over 4 years in patients with increased insulin resistance: the LOD-DIABETES prospective observational study.

PubMed

Gómez-Marcos, Manuel Ángel; Recio-Rodríguez, José Ignacio; Patino-Alonso, María Carmen; Agudo-Conde, Cristina; Rodríguez-Sanchez, Emiliano; Maderuelo-Fernandez, Jose Angel; Gómez-Sánchez, Leticia; Gomez-Sanchez, Marta; García-Ortiz, Luís

2016-06-01

We prospectively examined the impact of type 2 diabetes compared with metabolic syndrome (MetS) on the development of vascular disease over 4 years as determined by anatomic and functional markers of vascular disease. By comparing the vascular outcomes of the 2 disorders, we seek to determine the independent effect of elevated glucose levels on vascular disease. 2 primary care centres in Salamanca, Spain. We performed a prospective observational study involving 112 patients (68 with type 2 diabetes and 44 with MetS) who were followed for 4 years. Measurements included blood pressure, blood glucose, lipids, smoking, body mass index, waist circumference, Homeostasis Model Assessment Insulin Resistance (HOMA-IR), hs-c-reactive protein and fibrinogen levels. We also evaluated vascular, carotid intima media thickness (IMT), pulse wave velocity (PWV) and ankle/brachial index, heart and renal target organ damage (TOD). The haemodynamic parameters were central (CAIx) and peripheral (PAIx) augmentation indices. In year 4, participants with type 2 diabetes had increased IMT thickness. These patients had more plaques and an IMT>0.90 mm. In participants with MetS, we only found an increase in the number of plaques. We found no changes in PWV, CAIx and PAIx. The patients with diabetes had a greater frequency of vascular TOD. There were no differences neither in renal nor cardiac percentage of TOD in the patients with MetS or diabetes mellitus type 2. This prospective study showed that the evolution of vascular TOD is different in participants with type 2 diabetes compared with those with MetS. While IMT and PWV increased in type 2 diabetes, these were not modified in MetS. The renal and cardiac TOD evolution, as well as the PAIx and CAIx, did not change in either group. NCT01065155; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

"Democratic and Humanistic/Humane Paideia in the Euro-Cypriot Polity--Prospects for Reconstruction and Modernization": A Biographical Sociological Analysis of A Reform Initiative in a (De-)Globalizing World

ERIC Educational Resources Information Center

Klerides, Eleftherios

2018-01-01

In 2004, a reform report entitled "Democratic and Humanistic/ Humane Paideia in the Euro-Cypriot Polity: Prospects for Reconstruction and Modernization" was published by the Ministry of Education and Culture in the Republic of Cyprus. Professor Andreas M. Kazamias is held to have been the driving force behind this initiative, shaping…

Medical care and organisation at the 2012 Roskilde Music Festival: a prospective observational study.

PubMed

Stagelund, S; Jans, Ø; Nielsen, K; Jans, H; Wildgaard, K

2014-10-01

Music festivals, with a mix of music, alcohol and camping at the festival site combined with low hygiene, have become an integral part of society and attracts large numbers of guests. Our study was performed in order to increase the very limited knowledge on health-care issues and organisation of major music festivals. Pre-defined illness and injury categories were constructed based on categories previously reported from music festivals. We prospectively recorded patient presentations to the Medical Health Care Organisation (MHCO) at the 2012 Roskilde Festival. During 10 days, more than 130,000 guests and volunteers attended the 2012 Roskilde Festival. Ten thousand six hundred thirty patient presentations were registered between the 30th of June and 9th of July 2012 by the MHCO. The majority of patient presentations, 6919, could be handled by first-aid volunteers with different levels of training. The remaining 3473 patient presentations were assessed to require further health-care competencies or additional resources such as prescriptions, medication or suturing. Two hundred thirty-eight patient presentations were triaged to a designated observation area. Two hundred sixty patients were referred to a local hospital, a general practitioner or a dentist. The overall patient presentation rate was 72/1000 attendees, and the transport-to-hospital rate was 1.8/1000 attendees. Our study demonstrates that illnesses and injuries are frequent, although mostly minor, in this normally low-risk population consisting of primarily young and healthy guests. However, comparison with other recent events was difficult as only limited data have been published from other music festivals. Future festivals should publish similar data. © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Streptococcal upper respiratory tract infections and exacerbations of tic and obsessive-compulsive symptoms: a prospective longitudinal study.

PubMed

Leckman, James F; King, Robert A; Gilbert, Donald L; Coffey, Barbara J; Singer, Harvey S; Dure, Leon S; Grantz, Heidi; Katsovich, Liliya; Lin, Haiqun; Lombroso, Paul J; Kawikova, Ivana; Johnson, Dwight R; Kurlan, Roger M; Kaplan, Edward L

2011-02-01

The objective of this blinded, prospective, longitudinal study was to determine whether new group A β hemolytic streptococcal (GABHS) infections are temporally associated with exacerbations of tic or obsessive-compulsive (OC) symptoms in children who met published criteria for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS). A group of children with Tourette syndrome and/or OC disorder without a PANDAS history served as the comparison (non-PANDAS) group. Consecutive clinical ratings of tic and OC symptom severity were obtained for 31 PANDAS subjects and 53 non-PANDAS subjects. Clinical symptoms and laboratory values (throat cultures and streptococcal antibody titers) were evaluated at regular intervals during a 25-month period. Additional testing occurred at the time of any tic or OC symptom exacerbation. New GABHS infections were established by throat swab cultures and/or recent significant rise in streptococcal antibodies. Laboratory personnel were blinded to case or control status, clinical (exacerbation or not) condition, and clinical evaluators were blinded to the laboratory results. No group differences were observed in the number of clinical exacerbations or the number of newly diagnosed GABHS infections. On only six occasions of a total of 51 (12%), a newly diagnosed GABHS infection was followed, within 2 months, by an exacerbation of tic and/or OC symptoms. In every instance, this association occurred in the non-PANDAS group. This study provides no evidence for a temporal association between GABHS infections and tic/OC symptom exacerbations in children who meet the published PANDAS diagnostic criteria. Copyright © 2011 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Psychosocial work environment and stress-related disorders, a systematic review.

PubMed

Nieuwenhuijsen, K; Bruinvels, D; Frings-Dresen, M

2010-06-01

Knowledge on the impact of the psychosocial work environment on the occurrence of stress-related disorders (SRDs) can assist occupational physicians in the assessment of the work-relatedness of these disorders. To systematically review the contribution of work-related psychosocial risk factors to SRDs. A systematic review of the literature was carried out by searching Medline, PsycINFO and Embase for studies published up until October 2008. Studies eligible for inclusion were prospective cohort studies or patient-control studies of workers at risk for SRDs. Studies were included in the review when data on the association between exposure to psychosocial work factors and the occurrence of SRDs were presented. Where possible, meta-analysis was conducted to obtain summary odds ratios of the association. The strength of the evidence was assessed using four levels of evidence. From the 2426 studies identified, seven prospective studies were included in this review. Strong evidence was found that high job demands, low job control, low co-worker support, low supervisor support, low procedural justice, low relational justice and a high effort-reward imbalance predicted the incidence of SRDs. This systematic review points to the potential of preventing SRDs by improving the psychosocial work environment. However, more prospective studies are needed on the remaining factors, exposure assessment and the relative contributions of single factors, in order to enable consistent assessment of the work-relatedness of SRDs by occupational physicians.

Validation of risk stratification for children with febrile neutropenia in a pediatric oncology unit in India.

PubMed

Das, Anirban; Trehan, Amita; Oberoi, Sapna; Bansal, Deepak

2017-06-01

The study aims to validate a score predicting risk of complications in pediatric patients with chemotherapy-related febrile neutropenia (FN) and evaluate the performance of previously published models for risk stratification. Children diagnosed with cancer and presenting with FN were evaluated in a prospective single-center study. A score predicting the risk of complications, previously derived in the unit, was validated on a prospective cohort. Performance of six predictive models published from geographically distinct settings was assessed on the same cohort. Complications were observed in 109 (26.3%) of 414 episodes of FN over 15 months. A risk score based on undernutrition (two points), time from last chemotherapy (<7 days = two points), presence of a nonupper respiratory focus of infection (two points), C-reactive protein (>60 mg/l = five points), and absolute neutrophil count (<100 per μl = two points) was used to stratify patients into "low risk" (score <7, n = 208) and assessed using the following parameters: overall performance (Nagelkerke R 2 = 34.4%), calibration (calibration slope = 0.39; P = 0.25 in Hosmer-Lemeshow test), discrimination (c-statistic = 0.81), overall sensitivity (86%), negative predictive value (93%), and clinical net benefit (0.43). Six previously published rules demonstrated inferior performance in this cohort. An indigenous decision rule using five simple predefined variables was successful in identifying children at risk for complications. Prediction models derived in developed nations may not be appropriate for low-middle-income settings and need to be validated before use. © 2016 Wiley Periodicals, Inc.

Efficacy of standard (SLA) and modified sandblasted and acid-etched (SLActive) dental implants in promoting immediate and/or early occlusal loading protocols: a systematic review of prospective studies.

PubMed

Chambrone, Leandro; Shibli, Jamil Awad; Mercúrio, Carlos Eduardo; Cardoso, Bruna; Preshaw, Philip M

2015-04-01

To assess the survival percentage, clinical and radiographic outcomes of sandblasted and acid-etched (SLA) dental implants and its modified surface (SLActive) in protocols involving immediate and early occlusal loading. MEDLINE, EMBASE and the Cochrane Oral Health Group's Trials Register CENTRAL were searched in duplicate up to, and including, June 2013 to include randomised controlled trials (RCTs) and prospective observational studies of at least 6-month duration published in all languages. Studies limited to patients treated with SLA and/or SLActive implants involving a treatment protocol describing immediate and early loading of these implants were eligible for inclusion. Data on clinical and/or radiographic outcomes following implant placement were considered for inclusion. Of the 447 potentially eligible publications identified by the search strategy, seven RCTs comprising a total of 853 implants (8% titanium plasma-sprayed, 41.5% SLA and 50.5% SLActive) and 12 prospective observational studies including 1394 SLA and 145 SLActive implants were included in this review. According to the Cochrane Collaboration's tool for assessing risk of bias, one of the studies was considered to be at a low risk of bias, whereas the remaining studies were considered to be at an unclear risk. Regarding the observational studies, all of them presented a medium methodological quality based on the Modified Newcastle-Ottawa scale. There were no significant differences reported in the studies in relation to implant loss or clinical parameters between the immediate/early loading and delayed loading protocols. Overall, 95% of SLA and 97% of SLActive implants still survive at the end of follow-up. Despite of the positive findings achieved by the included studies, few RCTs were available for analysis for SLActive implants. Study heterogeneity, scarcity of data and the lack of pooled estimates represent a limitation between studies' comparisons and should be considered when interpreting the present findings. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Mixture effects of 30 environmental contaminants on incident metabolic syndrome-A prospective study.

PubMed

Lind, Lars; Salihovic, Samira; Lampa, Erik; Lind, P Monica

2017-10-01

Several cross-sectional studies have linked different environmental contaminants to the metabolic syndrome (MetS). However, mixture effects have not been investigated and no prospective studies exist regarding environmental contaminants and the MetS. To study mixture effects of contaminants on the risk of incident MetS in a prospective fashion. Our sample consisted of 452 subjects from the Prospective Study of the Vasculature in Uppsala Seniors (PIVUS) study (50% women, all aged 70years) free from the MetS at baseline, being followed for 10years. At baseline, 30 different environmental contaminants were measured; 6 polychlorinated biphenyls (PCBs), 3 organochlorine (OC) pesticides, one dioxin, one polybrominated diphenyl ether (all in plasma), 8 perfluoroalkyl substances (in plasma) and 11 metals (in whole blood). The MetS was defined by the ATPIII/NCEP criteria. Gradient boosted Classification and Regression Trees (CARTs) was used to evaluate potential synergistic and additive mixture effects on incident MetS. During 10-year follow-up, 92 incident cases of the MetS occurred. PCB126, PCB170, hexachlorobenzene (HCB) and PCB118 levels were all associated with incident MetS in an additive fashion (OR 1.73 for a change from 10th to 90th percentile (95%CI 1.24-3.04) for PCB126, OR 0.63 (0.42-0.78) for PCB170, OR 1.44 (1.09-2.20) for HCB and OR 1.46 (1.13-2.43) for PCB118). No synergistic effects were found. A mixture of environmental contaminants, with PCB126, PCB170, HCB and PCB118 being the most important, showed associations with future development of the MetS in an additive fashion in this prospective study. Thus, mixture effects of environmental contaminants could contribute to the development of cardio-metabolic derangements. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Prospective comparison of running injuries between shod and barefoot runners.

PubMed

Altman, Allison R; Davis, Irene S

2016-04-01

Advocates of barefoot running suggest that it is more natural and may be a way to minimise injury risk. In contrast, opponents believe shoes are needed to adequately cushion and support the foot. However, to date, there have been no prospective studies of injury patterns in barefoot and shod runners. The purpose of this study was to compare the incidence and rate of injuries between shod and barefoot runners. A prospective survey was conducted over the course of a year among 201 (107 barefoot and 94 shod) adult runners. Information regarding injuries and mileage was logged monthly using a custom, web-based database program. The number of injured runners, number of injuries per runner and injury rates were compared between habitual barefoot and habitual shod runners. Both musculoskeletal and plantar surface injuries were assessed. Statistically fewer overall, diagnosed, musculoskeletal injuries/runner were noted in the barefoot group. However, injury rates were not statistically different between groups due to significantly less mileage run in the barefoot group. As expected, barefoot runners sustained a statistically greater number of injuries to the plantar surface of the foot. The descriptive analysis suggests a greater number of calf injuries, but lower number of knee and hip injuries in the barefoot group. Additionally barefoot runners reported less plantar fasciitis than the shod group. Barefoot running is associated with fewer overall musculoskeletal injuries/runner, but similar injury rates. A larger scale cohort is needed to more accurately assess differences in individual injuries between these two groups. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Systematic review of pathways for the delivery of allergy services.

PubMed

Diwakar, Lavanya; Cummins, Carole; Lilford, Richard; Roberts, Tracy

2017-02-07

The incidence and prevalence of allergies worldwide has been increasing and allergy services globally are unable to keep up with this increase in demand. This systematic review aims to understand the delivery of allergy services worldwide, challenges faced and future directions for service delivery. A systematic scoping review of Ovid, EMBASE, HMIC, CINAHL, Cochrane, DARE, NHS EED and INAHTA databases was carried out using predefined inclusion and exclusion criteria. Data on the geographical region, study design and treatment pathways described were collected, and the findings were narratively reported. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. 205 publications were screened and 27 selected for review. Only 3 were prospective studies, and none included a control group. There were no eligible publications identified from North America, Africa, Australia and most parts of Asia. Most publications relate to allergy services in the UK. In general, allergy services globally appear not to have kept pace with increasing demand. The review suggests that primary care practitioners are not being adequately trained in allergy and that there is a paucity of appropriately trained specialists, especially in paediatric allergy. There appear to be considerable barriers to service improvement, including lack of political will and reluctance to allocate funds from local budgets. Demand for allergy services appears to have significantly outpaced supply. Primary and secondary care pathways in allergy seem inadequate leading to poor referral practices, delays in patient management and consequently poor outcomes. Improvement of services requires strong public and political engagement. There is a need for well-planned, prospective studies in this area and a few are currently underway. There is no evidence to suggest that any given pathway of service provision is better than another although data from a few long-term, prospective studies look very promising. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Inferior Vena Cava Filters to Prevent Pulmonary Embolism: Systematic Review and Meta-Analysis.

PubMed

Bikdeli, Behnood; Chatterjee, Saurav; Desai, Nihar R; Kirtane, Ajay J; Desai, Mayur M; Bracken, Michael B; Spencer, Frederick A; Monreal, Manuel; Goldhaber, Samuel Z; Krumholz, Harlan M

2017-09-26

Inferior vena cava (IVC) filters are widely used for prevention of pulmonary embolism (PE). However, uncertainty persists about their efficacy and safety. The authors conducted a systematic review and meta-analysis of the published reports on the efficacy and safety of IVC filters. The authors searched PubMed, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov through October 3, 2016, for randomized controlled trials (RCTs) or prospective controlled observational studies of IVC filters versus none in patients at risk of PE. Inverse variance fixed-effects models with odds ratio (OR) as the effect measure were used for primary analyses. Main outcomes included subsequent PE, PE-related mortality, all-cause mortality, and subsequent deep vein thrombosis (DVT). The authors' search retrieved 1,986 studies, of which 11 met criteria for inclusion (6 RCTs and 5 prospective observational studies). Quality of evidence for RCTs was low to moderate. Overall, patients receiving IVC filters had lower risk for subsequent PE (OR: 0.50; 95% confidence interval [CI]: 0.33 to 0.75); increased risk for DVT (OR: 1.70; 95% CI: 1.17 to 2.48); nonsignificantly lower PE-related mortality (OR: 0.51; 95% CI: 0.25 to 1.05); and no change in all-cause mortality (OR: 0.91; 95% CI: 0.70 to 1.19). Limiting the results to RCTs showed similar results. Findings were substantively similar across a wide range of sensitivity analyses. Very few prospective controlled studies, with limited quality of evidence, exist regarding the efficacy and safety of IVC filters. Overall, filters appear to reduce the risk of subsequent PE, increase the risk for DVT, and have no significant effect on overall mortality. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Workplace social capital and the onset of major depressive episode among workers in Japan: a 3-year prospective cohort study.

PubMed

Sakuraya, Asuka; Imamura, Kotaro; Inoue, Akiomi; Tsutsumi, Akizumi; Shimazu, Akihito; Takahashi, Masaya; Totsuzaki, Takafumi; Kawakami, Norito

2017-06-01

This study examined the prospective association of workplace social capital (WSC) with major depressive episode (MDE) among Japanese employees. A 3-year prospective cohort study was conducted among 1058 employees from a private think-tank company who participated in a baseline survey; after excluding those with MDE in the past 12 months, 929 were followed up. WSC at baseline was measured using a 3-item scale. MDE was assessed at baseline and at follow-up every year, by using a web-based, self-administered version of the WHO Composite International Diagnostic Interview (WHO-CIDI) 3.0 depression section, based on the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition: Text Revision (DSM-IV-TR)/DSM-5 criteria. Cox discrete-time hazards analyses were used to estimate HRs and 95% CIs, adjusting for covariates. A group with middle-level WSC scores had the lowest risk of MDE after being fully adjusted (HR 0.34, 95% CI 0.14 to 0.84, p=0.02). The relationship between WSC and MDE was U-shaped, although a non-linear model fit better than a linear model, with only marginally statistical significance (p=0.06). Dichotomised and continuous variables of WSC scores were significantly and negatively associated with MDE (p=0.03 and p<0.01, respectively). The current study replicated a previous finding from Finland that WSC was a protective factor of the onset of MDE in Japan. The slightly U-shaped relationship, that is, the group with high WSC having a small elevated risk of MDE, may reflect a dark side of WSC in a country with collectivity-oriented and hierarchy-oriented culture, such as Japan. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Real-Time Peer Review: An Innovative Feature to an Evidence-Based Practice Conference

PubMed Central

Eldredge, Jonathan D.; Phillips, Holly E.; Kroth, Philip J.

2013-01-01

Many health sciences librarians as well as other professionals attend conferences on a regular basis. This study sought to link an innovative peer review process of presented research papers to long-term conference outcomes in the peer-reviewed professional journal literature. An evidence-based conference included a proof-of-concept study to gauge the long-term outcomes from research papers presented during the program. Real-time peer review recommendations from the conference were linked to final versions of articles published in the peer-reviewed literature. The real-time peer review feedback served as the basis for further mentoring to guide prospective authors toward publishing their research results. These efforts resulted in the publication of two of the four research papers in the peer-viewed literature. A third presented paper appeared in a blog because the authors wanted to disseminate their findings more quickly than through the journal literature. The presenters of the fourth paper never published their study. Real-time peer review from this study can be adapted to other professional conferences that include presented research papers. PMID:24180649

Ion cyclotron emission studies: Retrospects and prospects

DOE PAGES

Gorelenkov, N. N.

2016-06-05

Ion cyclotron emission (ICE) studies emerged in part from the papers by A.B. Mikhailovskii published in the 1970s. Among the discussed subjects were electromagnetic compressional Alfv,nic cyclotron instabilities with the linear growth rate similar ~ √(n α/n e) driven by fusion products, -particles which draw a lot of attention to energetic particle physics. The theory of ICE excited by energetic particles was significantly advanced at the end of the 20th century motivated by first DT experiments on TFTR and subsequent JET experimental studies which we highlight. Recently ICE theory was advanced by detailed theoretical and experimental studies on spherical torusmore » (ST) fusion devices where the instability signals previously indistinguishable in high aspect ratio tokamaks due to high toroidal magnetic field became the subjects of experiments. Finally, we discuss prospects of ICE theory applications for future burning plasma (BP) experiments such as those to be conducted in ITER device in France, where neutron and gamma rays escaping the plasma create extremely challenging conditions fusion alpha particle diagnostics.« less

Ion cyclotron emission studies: Retrospects and prospects

NASA Astrophysics Data System (ADS)

Gorelenkov, N. N.

2016-05-01

Ion cyclotron emission (ICE) studies emerged in part from the papers by A.B. Mikhailovskii published in the 1970s. Among the discussed subjects were electromagnetic compressional Alfvénic cyclotron instabilities with the linear growth rate √ {n_α /n_e } driven by fusion products, -particles which draw a lot of attention to energetic particle physics. The theory of ICE excited by energetic particles was significantly advanced at the end of the 20th century motivated by first DT experiments on TFTR and subsequent JET experimental studies which we highlight. More recently ICE theory was advanced by detailed theoretical and experimental studies on spherical torus (ST) fusion devices where the instability signals previously indistinguishable in high aspect ratio tokamaks due to high toroidal magnetic field became the subjects of experiments. We discuss further prospects of ICE theory applications for future burning plasma (BP) experiments such as those to be conducted in ITER device in France, where neutron and gamma rays escaping the plasma create extremely challenging conditions fusion alpha particle diagnostics.

Prospective Incidence of Paediatric Inflammatory Bowel Disease in New Zealand in 2015: Results From the Paediatric Inflammatory Bowel Disease in New Zealand (PINZ) Study.

PubMed

Lopez, Robert N; Evans, Helen M; Appleton, Laura; Bishop, Jonathan; Chin, Simon; Mouat, Stephen; Gearry, Richard B; Day, Andrew S

2018-05-01

The global incidence of paediatric inflammatory bowel disease (IBD) is increasing. Much of the evidence attesting to this has arisen from North America and Europe. There is a relative paucity of information on the epidemiology of paediatric IBD in the Southern Hemisphere. The present study aimed to document the prospectively collected incidence of paediatric IBD in New Zealand in 2015. All patients younger than 16 years of age and diagnosed with IBD in New Zealand between 1 January 2015 and 31 December 2015 were identified. Demographic and disease phenotypic details were collected and entered into a secure database. Age-specific population data for New Zealand were obtained and national incidence rates for IBD and its subtypes were calculated. The prospectively calculated incidence of paediatric IBD, Crohn disease, ulcerative colitis (UC), and IBD unclassified in New Zealand in 2015 were 5.2 (95% confidence interval 3.9-6.8), 3.5 (2.4-4.8), 1.0 (0.5-1.8), and 0.7 (0.3-1.4) per 100,000 children, respectively. Incidence rates of paediatric IBD in New Zealand are comparable to the highest rates published in the literature from Western Europe and North America. Ongoing prospective ascertainment of the incidence of paediatric IBD is required to better understand the environmental factors, which are accounting for this increase in disease burden.

Western Trauma Association Critical Decisions in Trauma: Management of rib fractures.

PubMed

Brasel, Karen J; Moore, Ernest E; Albrecht, Roxie A; deMoya, Marc; Schreiber, Martin; Karmy-Jones, Riyad; Rowell, Susan; Namias, Nicholas; Cohen, Mitchell; Shatz, David V; Biffl, Walter L

2017-01-01

This is a recommended management algorithm from the Western Trauma Association addressing the management of adult patients with rib fractures. Because there is a paucity of published prospective randomized clinical trials that have generated Class I data, these recommendations are based primarily on published observational studies and expert opinion of Western Trauma Association members. The algorithm and accompanying comments represent a safe and sensible approach that can be followed at most trauma centers. We recognize that there will be patient, personnel, institutional, and situational factors that may warrant or require deviation from the recommended algorithm. We encourage institutions to use this as a guideline to develop their own local protocols.

Compilation of field methods used in geochemical prospecting by the U.S. Geological Survey

USGS Publications Warehouse

Lakin, Hubert William; Ward, Frederick Norville; Almond, Hy

1952-01-01

The field methods described in this report are those currently used in geochemical prospecting by the U. S. Geological Survey. Some have been published, others are being processed for publication, while others are still being investigated. The purpose in compiling these methods is to make them readily available in convenient form. The methods have not been thoroughly tested and none is wholly satisfactory. Research is being continued.

Functional neuroimaging studies of prospective memory: what have we learnt so far?

PubMed

Burgess, Paul W; Gonen-Yaacovi, Gil; Volle, Emmanuelle

2011-07-01

The complexity of the behaviour described by the term "prospective memory" meant that it was not at all clear, when the earliest studies were conducted, that this would prove a fruitful area for neuroimaging study. However, a consistent relation rapidly emerged between activation in rostral prefrontal cortex (approximating Brodmann Area 10) and performance of prospective memory paradigms. This consistency has greatly increased the accumulation of findings, since each study has offered perspectives on the previous ones. Considerable help too has come from broad agreement between functional neuroimaging findings and those from other methods (e.g. human lesion studies, electrophysiology). The result has been a quite startling degree of advance given the relatively few studies that have been conducted. These findings are summarised, along with those from other brain regions, and new directions suggested. Key points are that there is a medial-lateral dissociation within rostral PFC. Some (but not all) regions of medial rostral PFC are typically more active during performance of the ongoing task only, and lateral aspects are relatively more active during conditions involving delayed intentions. Some of these rostral PFC activations seem remarkably insensitive to the form of stimulus material presented, the nature of the ongoing task, the specifics of the intention, how easy or hard the PM cue is to detect, or the intended action is to recall. However there are other regions within rostral PFC where haemodynamic changes vary with alterations in these, and other, aspects of prospective memory paradigms. It is concluded that rostral PFC most likely plays a super-ordinate role during many stages of creating, maintaining and enacting delayed intentions, which in some cases may be linked to recent evidence showing that this brain region is involved in the control of stimulus-oriented vs. stimulus-independent attending. Other key brain regions activated during prospective memory paradigms appear to be the parietal lobe, especially Brodmann Area (BA) 40 and precuneus (BA 7), and the anterior cingulate (BA 32). These regions are often co-activated with lateral rostral PFC across a wide range of tasks, not just those involving prospective memory. Copyright © 2011. Published by Elsevier Ltd.

Dose profiles for lung and breast regions at prospective and retrospective CT coronary angiography using optically stimulated luminescence dosimeters on a 64-detector CT scanner.

PubMed

Funama, Yoshinori; Taguchi, Katsuyuki; Utsunomiya, Daisuke; Oda, Seitaro; Murasaki, Hiroo; Yamashita, Yasuyuki; Awai, Kazuo

2012-01-01

The purpose of our study was to acquire dose profiles at critical organs of lung and breast regions using optically stimulated luminescence (OSL) dosimeters; assess the actual radiation dose delivered at retrospective and prospective computed tomography coronary angiography (CTCA). Using a chest CT phantom we applied a prospectively-gated step-and-shoot- and a retrospectively-gated helical mode on a 64-detector row CT scanner. Retrospective scan mode was used with and without electrocardiogram (ECG) based tube current modulation. OSL dosimeters were used to measure dose profiles. In the both scan modes we acquired dose profiles and determined the mean and maximum dose in left lung and in left breast regions. In prospective mode, the mean dose was 21.53 mGy in left lung- and 23.59 mGy in left breast region. With respect to the retrospective mode, the mean dose with tube current modulation was 38.63 mGy for left lung- and 46.02 mGy for left breast region, i.e. 0.56 and 0.55 times lower than the mean dose without modulation. The OSL dosimeter is useful for measurement of the actual radiation dose along z-axis at lung and breast regions in the prospective and the retrospective CTCA. Copyright © 2011 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Awareness of “Predatory” Open-Access Journals among Prospective Veterinary and Medical Authors Attending Scientific Writing Workshops

PubMed Central

Christopher, Mary M.; Young, Karen M.

2015-01-01

Authors face many choices when selecting a journal for publication. Prospective authors, especially trainees, may be unaware of “predatory” online journals or how to differentiate them from legitimate journals. In this study, we assessed awareness of open-access and predatory journals among prospective authors attending scientific writing workshops; our long-term goal was to inform educational goals for the workshops. We surveyed participants of writing workshops at veterinary and medical schools and an international conference over a 1-year period. The survey included 14 statements for respondents to indicate agreement level on a Likert-like scale and four questions on awareness of resources about predatory journals; respondents also defined “predatory journal.” A total of 145 participants completed the survey: 106 (73.1%) from veterinary schools and 86 (59.3%) graduate students or residents. Fewer faculty (vs trainees) agreed that open access was an important factor in deciding where to publish; faculty and postdoctoral researchers were more likely to expect to pay more to publish in an open-access journal. Most respondents (120/145, 82.7%) agreed/strongly agreed that the decision to accept a manuscript should not be influenced by publication charges, but 50% (56/112) indicated that they “didn’t know” how publishing costs were supported. Of the 142 respondents who answered, 33 (23.0%) indicated awareness of the term “predatory journal”; 34 (23.9%) were aware of the Directory of Open Access Journals; 24 (16.9%) were aware of the Science “sting” article about predatory journals; and 7 (4.8%) were aware of Beall’s list. Most (93/144, 64.5%) definitions of predatory journals described poor but not predatory journal practices, and some respondents misunderstood the term completely. Mentors should help novice authors to be aware of predatory journals and to distinguish between legitimate and illegitimate open-access journals, thus selecting the best journal for their work. PMID:26664951

Provisional Tic Disorder: What to tell parents when their child first starts ticcing

PubMed Central

Black, Kevin J; Black, Elizabeth Rose; Greene, Deanna J.; Schlaggar, Bradley L.

2016-01-01

The child with recent onset of tics is a common patient in a pediatrics or child neurology practice. If the child’s first tic was less than a year in the past, the diagnosis is usually Provisional Tic Disorder (PTD). Published reviews by experts reveal substantial consensus on prognosis in this situation: the tics will almost always disappear in a few months, having remained mild while they lasted. Surprisingly, however, the sparse existing data may not support these opinions. PTD may have just as much importance for science as for clinical care. It provides an opportunity to prospectively observe the spontaneous remission of tics. Such prospective studies may aid identification of genes or biomarkers specifically associated with remission rather than onset of tics. A better understanding of tic remission may also suggest novel treatment strategies for Tourette syndrome, or may lead to secondary prevention of tic disorders. This review summarizes the limited existing data on the epidemiology, phenomenology, and outcome of PTD, highlights areas in which prospective study is sorely needed, and proposes that tic disorders may completely remit much less often than is generally believed. PMID:27158458

Deficits in cue detection underlie event-based prospective memory impairment in major depression: an eye tracking study.

PubMed

Chen, Siyi; Zhou, Renlai; Cui, Hong; Chen, Xinyin

2013-10-30

This study examined the cue detection in the non-focal event-based prospective memory (PM) of individuals with and without a major depressive disorder using behavioural and eye tracking assessments. The participants were instructed to search on each trial for a different target stimulus that could be present or absent and to make prospective responses to the cue object. PM tasks included cue only and target plus cue, whereas ongoing tasks included target only and distracter only. The results showed that a) participants with depression performed more poorly than those without depression in PM; b) participants with depression showed more fixations and longer total and average fixation durations in both ongoing and PM conditions; c) participants with depression had lower scores on accuracy in target-plus-cue trials than in cue-only trials and had a higher gaze rate of targets on hits and misses in target-plus-cue trials than did those without depression. The results indicate that the state of depression may impair top-down cognitive control function, which in turn results in particular deficits in the engagement of monitoring for PM cues. Copyright © 2013. Published by Elsevier Ireland Ltd.

Evidence for efficacy and effectiveness of changes in eating frequency for body weight management.

PubMed

Kant, Ashima K

2014-11-01

In self-reported diets of free living individuals, frequent eating is associated with higher energy intake, yet beliefs about the possible beneficial effect of higher eating frequency for managing body weight persist. Prospective cohort studies and controlled trials of manipulation of eating frequency published by 31 December 2012 were reviewed to assess whether variation in eating frequency may be an adjunct to weight management. Four prospective cohort studies were identified; 2 of these included adults followed for 10 y and 2 followed pre-adolescent/adolescent girls for 6 or 10 y. Within each age category, the findings of the 2 studies were contradictory. Six controlled trials with adult subjects serving as their own controls found no significant changes in body weight due to manipulation of eating frequency interventions lasting 6-8 wk. In 6 additional intervention trials of 8-52 wk duration, free-living adults were counseled to change the eating frequency of self-selected food intake with no significant differences in weight loss attributable to eating frequency. Overall, the consistency of the null findings from controlled trials of manipulation of eating frequency for promoting weight loss suggests that beliefs about the role of higher eating frequency in adult weight management are not supported by evidence. Interpretation of the evidence from published observational studies is complicated by differences in definition of eating frequency and limited knowledge of systematic and random errors in measurement of eating frequency. © 2014 American Society for Nutrition.

Ear for recovery: protocol for a prospective study on parent-child communication and psychological recovery after paediatric injury.

PubMed

Alisic, Eva; Barrett, Anna; Bowles, Peter; Babl, Franz E; Conroy, Rowena; McClure, Roderick J; Anderson, Vicki; Mehl, Matthias R

2015-02-04

One in six children who have been admitted to hospital with an injury develop persistent stress symptoms that put their development at risk. Parents play a crucial role in children's psychological recovery, however, it is unknown how specific parenting behaviours can help or hinder. We aim to describe the nature and quantity of parent-child communication after a child has been injured, and to examine how these interactions are related to children's psychological recovery. We are conducting a prospective observational study among children aged 3-16 years, who have been admitted to a tertiary children's hospital with a serious injury. Data collection involves a naturalistic observation of spontaneous, everyday parent-child communication at home, shortly after discharge, and an assessment of children's psychological recovery at 6 weeks and 3 months post-injury. Main analyses comprise descriptive statistics, cluster analysis and analyses of variance. This study has been approved by the Human Research Ethics Committee of the Royal Children's Hospital Melbourne (33103) and Monash University Human Research Ethics Committee (CF13/2515-2013001322). We aim to disseminate the findings through international peer-reviewed journals, international conferences and social media. Participants will be sent a summary of the overall study findings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Clinical, Ergonomic, and Economic Outcomes With Multichamber Bags Compared With (Hospital) Pharmacy Compounded Bags and Multibottle Systems: A Systematic Literature Review.

PubMed

Alfonso, Jorge Emilio; Berlana, David; Ukleja, Andrew; Boullata, Joseph

2017-09-01

Multichamber bags (MCBs) may offer potential clinical, ergonomic, and economic advantages compared with (hospital) pharmacy compounded bags (COBs) and multibottle systems (MBSs). A systematic literature review was performed to identify and assess the available evidence regarding advantages of MCBs compared with COBs and MBSs. Medline, Embase, the Cochrane Databases, and EconLit were searched for articles reporting clinical, ergonomic, and economic outcomes for MCBs compared with COBs or MBSs. The search was limited to studies conducted in hospitalized patients >2 years of age that were published in English between January 1990 and November 2014. The Population Intervention Comparison Outcomes Study Design (PICOS) framework was used for the analysis. From 1307 unique citations, 74 potentially relevant publications were identified; review of references identified 2 additional publications. Among the 76 publications, 18 published studies met the inclusion criteria. Most were retrospective in design. Ten studies reported clinical outcomes, including 1 prospective randomized trial and multiple retrospective analyses that reported a lower risk of bloodstream infection for MCBs compared with other delivery systems. Sixteen studies reported ergonomic and/or economic outcomes; most reported a potential cost benefit for MCBs, with consistent reports of reduced time and labor compared with other systems. The largest cost benefit was observed in studies evaluating total hospitalization costs. The systematic literature review identified evidence of potential clinical, ergonomic, and economic benefits for MCBs compared with COBs and MBSs; however, methodological factors limited evidence quality. More prospective studies are required to corroborate existing evidence.

Social Media and Peer-Reviewed Medical Journal Readership: A Randomized Prospective Controlled Trial.

PubMed

Hawkins, C Matthew; Hunter, Makeba; Kolenic, Giselle E; Carlos, Ruth C

2017-05-01

To prospectively evaluate the impact of increasing levels of social media engagement on page visits and web-link clicks for content published in the Journal of the American College of Radiology. A three-arm prospective trial was designed using a control group, a basic Twitter intervention group (using only the Journal's @JACRJournal Twitter account), and an enhanced Twitter intervention group (using the personal Twitter accounts of editorial board members and trainees). Overall, 428 articles published between June 2013 and July 2015 were randomly assigned to the three groups. Article-specific tweets for both intervention arms were sent between September 14, 2015, and October 28, 2015. Primary end points included article-specific weekly and monthly page visits on the journal's Elsevier website (Amsterdam, Netherlands). For the two intervention groups, additional end points included 7-day and 30-day Twitter link clicks. Weekly page visits for the enhanced Twitter arm (mean 18.2; 95% confidence interval [CI] 15.6-20.7) were significantly higher when compared with the weekly page visits for the control arm (mean 7.6; 95% CI 1.7-13.6). However, there was no demonstrable increase in weekly page visits (mean 9.4; 95% CI 7.4-11.5) for the basic Twitter arm compared with the control arm. No intervention effects over control, regardless of Twitter arm assignment, were demonstrated for monthly page visits. The enhanced Twitter intervention resulted in a statistically significant increase in both 7-day and 30-day Twitter link clicks compared with the basic Twitter intervention group. An organized social media strategy, with focused social media activity from editorial board members, increased engagement with content published in a peer-reviewed radiology journal. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Consumption of citrus and cruciferous vegetables with incident type 2 diabetes mellitus based on a meta-analysis of prospective study.

PubMed

Jia, Xiujuan; Zhong, Lina; Song, Yan; Hu, Yi; Wang, Guimei; Sun, Shuqin

2016-08-01

Observational studies and meta-analyses suggested that increased total fruits and vegetables consumption have a protective role in incidence of type 2 diabetes mellitus (T2DM). However, we still don't know whether the subtypes, such as citrus fruits and cruciferous vegetables (CV), have a preventive role. We systematically searched the MEDLINE and EMBASE databases up to December 31, 2014. Summary relative risks (SRRs) and 95% confidence intervals (CIs) were calculated using random-effects models. Seven distinct prospective cohort studies (five articles) were identified for this study. A total of 16,544 incident cases of type 2 diabetes were ascertained among 306,723 participants with follow-up periods ranging from 4.6 to 24 years. Based on four prospective cohort studies, we found that overall, consumption of CV had a protective role in the T2DM incidence (highest vs. lowest analysis: SRR=0.84, 95% CI: 0.73 to 0.96), with evidence of significant heterogeneity (P=0.09, I(2)=54.4%). This association was independent of the main risk factors for cardiovascular disease: smoking, alcohol use, BMI, and physical activity etc. Consumption of citrus fruits did not have a protective role in the T2DM development (highest vs. lowest analysis: SRR=1.02, 95% CI: 0.96 to 1.08), with no evidence of significant heterogeneity (P=0.49, I(2)=0). Higher consumption of CV, but not citrus fruits, is associated with a significantly decreased risk of type 2 diabetes. Further large prospective studies are needed to elucidate both relationships. Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

Does antibiotic exposure during infancy lead to development of asthma?: a systematic review and metaanalysis.

PubMed

Marra, Fawziah; Lynd, Larry; Coombes, Megan; Richardson, Kathryn; Legal, Michael; Fitzgerald, J Mark; Marra, Carlo A

2006-03-01

To determine the association between antibiotic exposure in the first year of life and the development of childhood asthma. Metaanalysis of observational studies retrieved through systematic search of all available electronic data sources. Studies included in the metaanalyses were those with populations exposed to one or more courses of antibiotics during the first year of life, and asthma diagnosis was defined as diagnosis by a physician between the age of 1 to 18 years. Retrospective and prospective studies published in the English-language literature from 1966 to present. Eight studies (four prospective and four retrospective) examined the association between exposure to at least one course of antibiotics and development of childhood asthma. The total number of subjects for the analysis comparing exposure to at least one antibiotic to no exposure in the first year of life was 12,082 children and 1,817 asthma cases. In the dose-response analysis, we included data from a total of 27,167 children and 3,392 asthma cases. The pooled odds ratio (OR) for the eight studies was 2.05 (95% confidence interval [CI], 1.41 to 2.99). The association was significantly stronger in the retrospective studies (OR, 2.82; 95% CI, 2.07 to 3.85) than the prospective studies (OR, 1.12; 95% CI, 0.88 to 1.42). Five of the eight studies examined whether the association was related to the number of courses of antibiotics taken in the first year of life. The overall OR for the dose-response analysis was 1.16 (95% CI, 1.05 to 1.28) for each additional course of antibiotics; however, this association was not significantly stronger in the retrospective studies (OR, 1.37; 95% CI, 1.18 to 1.60) relative to the prospective studies (OR, 1.07; 95% CI, 0.95 to 1.20). Exposure to at least one course of antibiotics in the first year of life appears to be a risk factor for the development of childhood asthma. Because of the limitations of the studies conducted to date, additional large-scale, prospective studies are needed to confirm this potential association.

The Use of Published Clinical Study Reports to Support U.S. Food and Drug Administration Approval of Imaging Agents.

PubMed

Rieves, Dwaine; Jacobs, Paula

2016-12-01

Pharmaceutical companies typically perform prospective, multicenter phase 3 clinical studies to support approval of a new imaging agent by the U.S. Food and Drug Administration (FDA). In uncommon situations, the FDA has approved imaging agents based solely, or in large part, on the clinical study experience described in published reports, including reports of exploratory (i.e., phase 1 or 2) studies performed at a single clinical site. We performed a survey of published reports to assess the potential of the reported information to support FDA approval of a commonly cited investigational imaging agent. Our survey revealed critical data limitations in most publications, all of which reported exploratory clinical studies. Here we summarize the precedent for FDA approval of imaging agents using effectiveness data from publications, FDA guidance, and our experience in reviewing publications. We also present a key-data checklist for investigators to consider in the design, conduct, and reporting of exploratory clinical studies for publication. We encourage editors and peer reviewers to consider requiring these key data when reviewing these reports for publication. © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

Dietary acrylamide intake and risk of breast cancer: The Japan Public Health Center-based Prospective Study.

PubMed

Kotemori, Ayaka; Ishihara, Junko; Zha, Ling; Liu, Rong; Sawada, Norie; Iwasaki, Motoki; Sobue, Tomotaka; Tsugane, Shoichiro

2018-03-01

Acrylamide forms during cooking and is classified as a probable carcinogen in humans, mandating the need for epidemiological studies of dietary acrylamide and cancers. However, the risk of dietary acrylamide exposure to breast cancer in Japanese women has not been assessed. We investigated the association between dietary acrylamide intake and risk of breast cancer in the Japan Public Health Center-based Prospective Study. The present study included 48 910 women aged 45-74 years who responded to a 5-year follow-up survey questionnaire. Dietary acrylamide intake was assessed using a validated food frequency questionnaire. Cox proportional hazards regression models were used to estimate hazard ratios and 95% confidence intervals. During an average of 15.4 years of follow up, 792 breast cancers were diagnosed. Energy-adjusted dietary acrylamide intake was not associated with the risk of breast cancer (adjusted hazard ratio for highest versus lowest tertile = .95, 95% confidence intervals: 0.79-1.14, P-trend = .58). Further, no significant associations were observed when stratified analyses were conducted by smoking status, coffee consumption, alcohol consumption, body mass index, menopausal status, estrogen receptor status, and progesterone receptor status. In conclusion, dietary acrylamide intake was not associated with the risk of breast cancer in this population-based prospective cohort study of Japanese women. © 2017 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

A systematic review of hypofractionation for primary management of prostate cancer.

PubMed

Koontz, Bridget F; Bossi, Alberto; Cozzarini, Cesare; Wiegel, Thomas; D'Amico, Anthony

2015-10-01

Technological advances in radiation therapy delivery have permitted the use of high-dose-per-fraction radiation therapy (RT) for early-stage prostate cancer (PCa). Level 1 evidence supporting the safety and efficacy of hypofractionated RT is evolving as this modality becomes more widely utilized and refined. To perform a systematic review of the current evidence on the safety and efficacy of hypofractionated RT for early-stage PCa and to provide in-context recommendations for current application of this technology. Embase, PubMed, and Scopus electronic databases were queried for English-language articles from January 1990 through June 2014. Prospective studies with a minimum of 50 patients were included. Separate consideration was made for studies involving moderate hypofractionation (doses of 2.5-4Gy per fraction) and extreme hypofractionation (5-10Gy in 4-7 fractions). Six relatively small superiority designed randomized trials of standard fractionation versus moderate hypofractionation in predominantly low- and intermediate-risk PCa have been published with follow-up ranging from 4 to 8 yr, noting similar biochemical control (5-yr freedom from biochemical failure in modern studies is >80% for low-risk and intermediate-risk patients) and late grade ≥2 genitourinary and gastrointestinal toxicities (between 2% and 20%). Noninferiority studies are pending. In prospective phase 2 studies, extreme hypofractionation has promising 2- to 5-yr biochemical control rates of >90% for low-risk patients. Results from a randomized trial are expected in 2015. Moderate hypofractionation has 5-yr data to date establishing safety compared with standard fractionation, but 10-yr outcomes and longer follow-up are needed to establish noninferiority for clinical effectiveness. Extreme hypofractionation is promising but as yet requires reporting of randomized data prior to application outside of a clinical protocol. Hypofractionation for prostate cancer delivers relatively high doses of radiation per treatment. Prospective studies support the safety of moderate hypofractionation, while extreme fractionation may have greater toxicity. Both show promising cancer control but long-term results of noninferiority studies of both methods are required before use in routine treatment outside of clinical protocols. Copyright © 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Acute uncomplicated appendicitis study: rationale and protocol for a multicentre, prospective randomised controlled non-inferiority study to evaluate the safety and effectiveness of non-operative management in children with acute uncomplicated appendicitis.

PubMed

Xu, Jane; Liu, Yingrui Cyril; Adams, Susan; Karpelowsky, Jonathan

2016-12-21

This article presents an overview of a prospective randomised controlled non-inferiority study designed to evaluate the safety and effectiveness of non-operative management (NOM) with operative management in children with acute uncomplicated appendicitis (AUA). Here, we present the study protocol for this APRES study, a multicentre Australian study. The rationale and details of future analysis, in particular, non-inferiority calculations, cost-effectiveness, feasibility and acceptability of each intervention. A multicentre, prospective randomised controlled clinical trial, conducted in 2 Australian tertiary paediatric hospitals. Children who meet the inclusion criteria of an age between 5 and 15 years and a clinical diagnosis of AUA will be invited to participate, and after consent will be randomised via a computer-based program into treatment groups. The study started in June 2016, and the target recruitment is 220 patients. Children in the control group will be treated with prophylactic antibiotics and appendicectomy, and those in the intervention group will be treated with antibiotic therapy alone. Primary outcome measures include unplanned or unnecessary operation and complications at 30 days. Secondary outcomes include longer term complications within 1 year, length of stay, time off work and school analgesic requirements and cost. Data analyses will be on the intention-to-treat principle using non-inferiority analysis. Analysis will include the Pearson χ 2 test for categorical variables and independent sample t-test or Mann-Whitney test for continuous variables. Non-inferiority for NOM will be tested using 1-sided Wald tests with an α level of 0.05. The research has been approved by the Human Research Ethics Committee of the Sydney Children's Hospital Network. In addition, results will be reported through academic journals, seminars and conference presentations. NCT02795793; ACTRN12616000788471. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Transcranial electric stimulation (tES) and NeuroImaging: the state-of-the-art, new insights and prospects in basic and clinical neuroscience.

PubMed

Soekadar, Surjo R; Herring, Jim Don; McGonigle, David

2016-10-15

Transcranial electric stimulation (tES) of the brain has attracted an increased interest in recent years. Yet, despite remarkable research efforts to date, the underlying neurobiological mechanisms of tES' effects are still incompletely understood. This Special Issue aims to provide a comprehensive and up-to-date overview of the state-of-the-art in studies combining tES and neuroimaging, while introducing most recent insights and outlining future prospects related to this new and rapidly growing field. The findings reported here combine methodological advancements with insights into the underlying mechanisms of tES itself. At the same time, they also point to the many caveats and specific challenges associated with such studies, which can arise from both technical and biological sources. Besides promising to advance basic neuroscience, combined tES and neuroimaging studies may also substantially change previous conceptions about the methods of action of electric or magnetic stimulation on the brain. Copyright © 2016. Published by Elsevier Inc.

Trauma airway management in emergency departments: a multicentre, prospective, observational study in Japan.

PubMed

Nakao, Shunichiro; Kimura, Akio; Hagiwara, Yusuke; Hasegawa, Kohei

2015-02-04

Although successful airway management is essential for emergency trauma care, comprehensive studies are limited. We sought to characterise current trauma care practice of airway management in the emergency departments (EDs) in Japan. Analysis of data from a prospective, observational, multicentre registry-the Japanese Emergency Airway Network (JEAN) registry. 13 academic and community EDs from different geographic regions across Japan. 723 trauma patients who underwent emergency intubation from March 2010 through August 2012. ED characteristics, patient and operator demographics, methods of airway management, intubation success or failure at each attempt and adverse events. A total of 723 trauma patients who underwent emergency intubation were eligible for the analysis. Traumatic cardiac arrest comprised 32.6% (95% CI 29.3% to 36.1%) of patients. Rapid sequence intubation (RSI) was the initial method chosen in 23.9% (95% CI 21.0% to 27.2%) of all trauma patients and in 35.5% (95% CI 31.4% to 39.9%) of patients without cardiac arrest. Overall, intubation was successful in ≤3 attempts in 96% of patients (95% CI 94.3% to 97.2%). There was a wide variation in the initial methods of intubation; RSI as the initial method was performed in 0-50.9% of all trauma patients among 12 EDs. Similarly, there was a wide variation in success rates and adverse event rates across the EDs. Success rates varied between 35.5% and 90.5% at the first attempt, and 85.1% and 100% within three attempts across the 12 EDs. In this multicentre prospective study in Japan, we observed a high overall success rate in airway management during trauma care. However, the methods of intubation and success rates were highly variable among hospitals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Mental health problems among young doctors: an updated review of prospective studies.

PubMed

Tyssen, Reidar; Vaglum, Per

2002-01-01

Previous studies have shown the medical community to exhibit a relatively high level of certain mental health problems, particularly depression, which may lead to drug abuse and suicide. We reviewed prospective studies published over the past 20 years to investigate the prevalence and predictors of mental health problems in doctors during their first postgraduate years. We selected clinically relevant mental health problems as the outcome measure. We found nine cohort studies that met our selection criteria. Each of them had limitations, notably low response rate at follow-up, small sample size, and/or short observation period. Most studies showed that symptoms of mental health problems, particularly of depression, were highest during the first postgraduate year. They found that individual factors, such as family background, personality traits (neuroticism and self-criticism), and coping by wishful thinking, as well as contextual factors including perceived medical-school stress, perceived overwork, emotional pressure, working in an intensive-care setting, and stress outside of work, were often predictive of mental health problems. The studies revealed somewhat discrepant findings with respect to gender. The implications of these findings are discussed.

Database documentation of marine mammal stranding and mortality: current status review and future prospects.

PubMed

Chan, Derek K P; Tsui, Henry C L; Kot, Brian C W

2017-11-21

Databases are systematic tools to archive and manage information related to marine mammal stranding and mortality events. Stranding response networks, governmental authorities and non-governmental organizations have established regional or national stranding networks and have developed unique standard stranding response and necropsy protocols to document and track stranded marine mammal demographics, signalment and health data. The objectives of this study were to (1) describe and review the current status of marine mammal stranding and mortality databases worldwide, including the year established, types of database and their goals; and (2) summarize the geographic range included in the database, the number of cases recorded, accessibility, filter and display methods. Peer-reviewed literature was searched, focussing on published databases of live and dead marine mammal strandings and mortality and information released from stranding response organizations (i.e. online updates, journal articles and annual stranding reports). Databases that were not published in the primary literature or recognized by government agencies were excluded. Based on these criteria, 10 marine mammal stranding and mortality databases were identified, and strandings and necropsy data found in these databases were evaluated. We discuss the results, limitations and future prospects of database development. Future prospects include the development and application of virtopsy, a new necropsy investigation tool. A centralized web-accessed database of all available postmortem multimedia from stranded marine mammals may eventually support marine conservation and policy decisions, which will allow the use of marine animals as sentinels of ecosystem health, working towards a 'One Ocean-One Health' ideal.

Depression and the risk of coronary heart disease: a meta-analysis of prospective cohort studies.

PubMed

Gan, Yong; Gong, Yanhong; Tong, Xinyue; Sun, Huilian; Cong, Yingjie; Dong, Xiaoxin; Wang, Yunxia; Xu, Xing; Yin, Xiaoxu; Deng, Jian; Li, Liqing; Cao, Shiyi; Lu, Zuxun

2014-12-24

Several systematic reviews and meta-analyses demonstrated the association between depression and the risk of coronary heart disease (CHD), but the previous reviews had some limitations. Moreover, a number of additional studies have been published since the publication of these reviews. We conducted an updated meta-analysis of prospective studies to assess the association between depression and the risk of CHD. Relevant prospective studies investigating the association between depression and CHD were retrieved from the PubMed, Embase, Web of Science search (up to April 2014) and from reviewing reference lists of obtained articles. Either a random-effects model or fixed-effects model was used to compute the pooled risk estimates when appropriate. Thirty prospective cohort studies with 40 independent reports met the inclusion criteria. These groups included 893,850 participants (59,062 CHD cases) during a follow-up duration ranging from 2 to 37 years. The pooled relative risks (RRs) were 1.30 (95% CI, 1.22-1.40) for CHD and 1.30 (95% CI, 1.18-1.44) for myocardial infarction (MI). In the subgroup analysis by follow-up duration, the RR of CHD was 1.36 (95% CI, 1.24-1.49) for less than 15 years follow-up, and 1.09 (95% CI, 0.96-1.23) for equal to or more than 15 years follow-up. Potential publication bias may exist, but correction for this bias using trim-and-fill method did not alter the combined risk estimate substantially. The results of our meta-analysis suggest that depression is independently associated with a significantly increased risk of CHD and MI, which may have implications for CHD etiological research and psychological medicine.

Are pushing and pulling work-related risk factors for upper extremity symptoms? A systematic review of observational studies.

PubMed

Hoozemans, M J M; Knelange, E B; Frings-Dresen, M H W; Veeger, H E J; Kuijer, P P F M

2014-11-01

Systematically review observational studies concerning the question whether workers that perform pushing/pulling activities have an increased risk for upper extremity symptoms as compared to workers that perform no pushing/pulling activities. A search in MEDLINE via PubMed and EMBASE was performed with work-related search terms combined with push/pushing/pull/pulling. Studies had to examine exposure to pushing/pulling in relation to upper extremity symptoms. Two authors performed the literature selection and assessment of the risk of bias in the studies independently. A best evidence synthesis was used to draw conclusions in terms of strong, moderate or conflicting/insufficient evidence. The search resulted in 4764 studies. Seven studies were included, with three of them of low risk of bias, in total including 8279 participants. A positive significant relationship with upper extremity symptoms was observed in all four prospective cohort studies with effect sizes varying between 1.5 and 4.9. Two out of the three remaining studies also reported a positive association with upper extremity symptoms. In addition, significant positive associations with neck/shoulder symptoms were found in two prospective cohort studies with effect sizes of 1.5 and 1.6, and with shoulder symptoms in one of two cross-sectional studies with an effect size of 2.1. There is strong evidence that pushing/pulling is related to upper extremity symptoms, specifically for shoulder symptoms. There is insufficient or conflicting evidence that pushing/pulling is related to (combinations of) upper arm, elbow, forearm, wrist or hand symptoms. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Tracing a Path to the Past: Exploring the Use of Commercial Credit Reporting Data to Construct Residential Histories for Epidemiologic Studies of Environmental Exposures.

PubMed

Hurley, Susan; Hertz, Andrew; Nelson, David O; Layefsky, Michael; Von Behren, Julie; Bernstein, Leslie; Deapen, Dennis; Reynolds, Peggy

2017-02-01

Large-scale environmental epidemiologic studies often rely on exposure estimates based on linkage to residential addresses. This approach, however, is limited by the lack of residential histories typically available for study participants. Our objective was to evaluate the feasibility of using address data from LexisNexis (a division of RELX, Inc., Dayton, Ohio), a commercially available credit reporting company, to construct residential histories for participants in the California Teachers Study (CTS), a prospective cohort study initiated in 1995-1996 to study breast cancer (n = 133,479). We evaluated the degree to which LexisNexis could provide retrospective addresses prior to study enrollment, as well as the concordance with existing prospective CTS addresses ascertained at the time of the completion of 4 self-administered questionnaires. For approximately 80% of CTS participants, LexisNexis provided at least 1 retrospective address, including nearly 25,000 addresses completely encompassed by time periods prior to enrollment. This approach more than doubled the proportion of the study population for whom we had an address of residence during the childbearing years-an important window of susceptibility for breast cancer risk. While overall concordance between the prospective addresses contained in these 2 data sources was good (85%), it was diminished among black women and women under the age of 40 years. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

Psychological Predictors of Outcomes with Lumbar Spinal Fusion: A Systematic Literature Review.

PubMed

Wilhelm, Mark; Reiman, Michael; Goode, Adam; Richardson, William; Brown, Christopher; Vaughn, Daniel; Cook, Chad

2017-04-01

To review the predictive/risk psychological factors at baseline that are associated with a favourable (or non-favourable) outcome following lumbar spinal fusion (LSF). A computer-assisted literature search of PubMed, CINAHL complete and EMBASE for studies published between January 1, 1990 and October 1, 2014 with controlled vocabulary and key words related to LSF, degenerative lumbar spine diagnoses and appropriate terms for predictive variables. Each study was required to be a retrospective or prospective design that involved LSF (all forms). Quality assessment was conducted with the Quality In Prognosis Studies tool. A study protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO# CRD42014008728). The majority of the eight accepted studies were observational, prospective cohorts (n = 6). High levels of baseline depression and lower SF-36 Mental Component Scores (MCS) lower quality of life were associated with non-favourable outcomes. Two studies were rated as high quality, five were moderate and one study had low quality. At present, there are a number of psychological variables that are associated with a poorer outcome with LSF. Higher levels of depression and lower scores on the SF-36 MCS are the most commonly implicated. However, based on the results of the studies using single arm designs there is not enough evidence to determine which psychological variables are influential in predicting outcomes for LSF. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Editorial Commentary: Hip Labral Revision Reconstruction in a Fellowship Training Center: A Report From the Mountains.

PubMed

Martin, Hal David

2018-04-01

Hip labral reconstruction has proven to be a successful technique in restoring normal labrum function. However, sometimes revision surgery is required. A recent, well-designed prospective study provides significant support for revision labral reconstruction, showing how it leads to improved hip mechanics and reduction in pain. The success of the study design and this report is a testament to an educational institution dedicated to fellowship training. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Barriers to the universal adoption of bilateral internal mammary artery grafting.

PubMed

Umakanthan, Jeremiah; Jeyakumar, Panch; Umakanthan, Branavan; Jeyakumar, Nikeshan; Senthilkumar, Nadarajah; Saraswathy, Mathioli R; Umakanthan, Padminidevi; Umakanthan, Janani; Sial, Tamoor; Abrina, Sofia; Buendia, Frances M; Pan, Irene; Kamath, Ramadas K; Pathmarajah, Canagaratnam; Sivalingam, Kanagaratnam; Nathan, Shan A; Sunder, Shun K; Mahendra, Tom; Umakanthan, Ramanan

2015-04-01

The left internal mammary artery (LIMA) graft is considered the "gold standard" of coronary artery bypass grafting (CABG). This conduit provides increased survival, symptomatic relief, increased freedom from myocardial infarction, and increased freedom from re-intervention when compared to saphenous venous grafting. It has a remarkable long term patency rate with clinical and angiographic outcomes that are unmatched by other conduits. Given the fact that patients often require more than one graft during a coronary revascularization procedure, the prospect of bilateral internal mammary artery (BIMA) grafting has been very appealing to some surgeons. BIMA grafting has been extensively studied via multiple retrospective and prospective cohort studies and findings have indicated that BIMA grafting can have an increased survival benefit when compared to LIMA grafting alone. As a result, this technique has accrued increasing popularity over the course of the last decade. Yet, questions still remain on whether BIMA grafting is the optimal treatment modality for patients in terms of long-term prognosis. There is limited data at the present time from randomized controlled trials and only 4-12% of CABGs performed today utilize BIMA grafting. Concerns regarding perioperative complications, which patient subsets are at higher risks for complications from the technique, and the technical challenges involved in utilizing and teaching the technique have limited its widespread use. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Achilles tendinopathy: A prospective study on the effect of active rehabilitation and steroid injections in a clinical setting.

PubMed

Wetke, E; Johannsen, F; Langberg, H

2015-08-01

In published efficacy studies on Achilles tendinopathy (AT) exercise alone results in improvement in 60-90% of the cases. However, this high success rate cannot be expected in usual clinical practice. We prospectively investigated the effectiveness of a treatment regimen consisting of home-based exercises (concentric, eccentric, and stretching) and optional glucocorticosteroid (GCS) injections in patients with (AT) in a usual clinical setting. Patients unable to commence or progress in exercise were offered GCS, hypothesizing that the GCS would facilitate exercise. Ninety-three consecutive patients with AT referred to two outpatient rheumatology clinics were registered, and seen at five visits over a 6-month period. Exercises seemed to have a slow, but long-lasting effect with GCS having a dramatic short-term effect on symptoms. Twenty-six percent of the patients could proceed with training alone, the remainder received one to three supplementary GCS. There were significant improvements on all outcome variables over time (P ≤ 0.001). At follow-up, 42 had no more symptoms, 29 good result, 16 slightly improved, 4 unchanged, and 2 slightly worse. Overall, 94% of the patients had improved, and we thus recommend the use of GCS injections in AT patients if training alone does not lead to improvement. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A simple web-based risk calculator (www.anastomoticleak.com) is superior to the surgeon's estimate of anastomotic leak after colon cancer resection.

PubMed

Sammour, T; Lewis, M; Thomas, M L; Lawrence, M J; Hunter, A; Moore, J W

2017-01-01

Anastomotic leak can be a devastating complication, and early prediction is difficult. The aim of this study is to prospectively validate a simple anastomotic leak risk calculator and compare its predictive value with the estimate of the primary operating surgeon. Consecutive patients undergoing elective or emergency colon cancer surgery with a primary anastomosis over a 1-year period were prospectively included. A recently published anastomotic leak risk nomogram was converted to an online calculator ( www.anastomoticleak.com ). The calculator-derived risk of anastomotic leak and the risk estimated by the primary operating surgeon were recorded at the completion of surgery. The primary outcome was anastomotic leak within 90 days as defined by previously published criteria. Area under receiver operating characteristic curve analysis (AUROC) was performed for both risk estimates. A total of 105 patients were screened for inclusion during the study period, of whom 83 met the inclusion criteria. The overall anastomotic leak rate was 9.6%. The anastomotic leak calculator was highly predictive of anastomotic leak (AUROC 0.84, P = 0.002), whereas the surgeon estimate was not predictive (AUROC 0.40, P = 0.243). A simple anastomotic leak risk calculator is significantly better at predicting anastomotic leak than the estimate of the primary surgeon. Further external validation on a larger data set is required.

The relationship between sweetened beverage consumption and risk of heart failure in men.

PubMed

Rahman, Iffat; Wolk, Alicja; Larsson, Susanna C

2015-12-01

To investigate whether sweetened beverage consumption is associated with risk of heart failure (HF) in a large prospective population-based study of men. A population-based cohort comprising 42,400 men, 45-79 years of age, was followed from 1998 through 2010. Sweetened beverage consumption was assessed by utilising a food frequency questionnaire. Incident events of HF were identified through linkage to the Swedish National Patient Register and the Cause of Death Register. Cox regression analyses were implemented to investigate the association between sweetened beverage consumption and HF. During a mean follow-up time of 11.7 years, a total of 4113 HF events were identified. We observed a positive association between sweetened beverage consumption and risk of HF after adjustment for other risk factors (p for trend <0.001). Men who consumed two or more servings of sweetened beverages per day had a statistically significant higher risk of developing HF (23%, 95% CI 1.12 to 1.35) compared to men who were non-consumers. Our finding that sweetened beverage consumption is associated with higher risk of HF could have implications for HF prevention strategies. Additional prospective studies investigating the link between sweetened beverage consumption and HF are therefore needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

EUropean prospective cohort study on Enterobacteriaceae showing REsistance to CArbapenems (EURECA): a protocol of a European multicentre observational study.

PubMed

Gutiérrez-Gutiérrez, Belén; Sojo-Dorado, Jesús; Bravo-Ferrer, José; Cuperus, Nienke; de Kraker, Marlieke; Kostyanev, Tomislav; Raka, Lul; Daikos, George; Feifel, Jan; Folgori, Laura; Pascual, Alvaro; Goossens, Herman; O'Brien, Seamus; Bonten, Marc J M; Rodríguez-Baño, Jesús

2017-04-03

The rapid worldwide spread of carbapenem-resistant Enterobacteriaceae (CRE) constitutes a major challenge. The aim of the EUropean prospective cohort study on Enterobacteriaceae showing REsistance to CArbapenems (EURECA), which is part of the Innovative Medicines Initiative Joint Undertaking (IMI JU) funded COMBACTE-CARE project, is to investigate risk factors for and outcome determinants of CRE infections to inform randomised clinical trial designs and to provide a historical cohort that could eventually be used for future comparisons with new drugs targeting CRE. A multicentre (50 sites), multinational (11 European countries), analytical observational project was designed, comprising 3 studies. The aims of study 1 (a prospective cohort study) include characterising the features, clinical management and outcomes of hospitalised patients with intra-abdominal infection, pneumonia, complicated urinary tract infections and bloodstream infections caused by CRE (202 patients in each group). The main outcomes will be 30-day all-cause mortality and clinical response. Study 2 (a nested case-control study) will identify the risk factors for target infections caused by CRE; 248 selected patients from study 1 will be matched with patients with carbapenem-susceptible Enterobacteriaceae (1:1) and with hospitalised patients (1:3) and will provide a historical cohort of patients with CRE infections. Study 3 (a matched cohort study) will follow patients in study 2 in order to assess mortality, length of stay and hospital costs associated with CRE. All patients will be followed for 30 days. Different, up-to-date statistical methods will be applied to come to unbiased estimates for all 3 studies. Before-study sites will be initiated, approval will be sought from appropriate regulatory agencies and local Ethics Committees of Research or Institutional Review Boards (IRBs) to conduct the study in accordance with regulatory requirements. This is an observational study and therefore no intervention in the diagnosis, management or treatment of the patients will be required on behalf of the investigation. Any formal presentation or publication of data collected from this study will be considered as a joint publication by the participating physician(s) and will follow the recommendations of the International Committee of Medical Journal Editors (ICMJE) for authorship. NCT02709408. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Plasma 25-hydroxyvitamin D concentration and subsequent risk of total and site specific cancers in Japanese population: large case-cohort study within Japan Public Health Center-based Prospective Study cohort.

PubMed

Budhathoki, Sanjeev; Hidaka, Akihisa; Yamaji, Taiki; Sawada, Norie; Tanaka-Mizuno, Sachiko; Kuchiba, Aya; Charvat, Hadrien; Goto, Atsushi; Kojima, Satoshi; Sudo, Natsuki; Shimazu, Taichi; Sasazuki, Shizuka; Inoue, Manami; Tsugane, Shoichiro; Iwasaki, Motoki

2018-03-07

To evaluate the association between pre-diagnostic circulating vitamin D concentration and the subsequent risk of overall and site specific cancer in a large cohort study. Nested case-cohort study within the Japan Public Health Center-based Prospective Study cohort. Nine public health centre areas across Japan. 3301 incident cases of cancer and 4044 randomly selected subcohort participants. Plasma concentration of 25-hydroxyvitamin D measured by enzyme immunoassay. Participants were divided into quarters based on the sex and season specific distribution of 25-hydroxyvitamin D among subcohorts. Weighted Cox proportional hazard models were used to calculate the multivariable adjusted hazard ratios for overall and site specific cancer across categories of 25-hydroxyvitamin D concentration, with the lowest quarter as the reference. Incidence of overall or site specific cancer. Plasma 25-hydroxyvitamin D concentration was inversely associated with the risk of total cancer, with multivariable adjusted hazard ratios for the second to fourth quarters compared with the lowest quarter of 0.81 (95% confidence interval 0.70 to 0.94), 0.75 (0.65 to 0.87), and 0.78 (0.67 to 0.91), respectively (P for trend=0.001). Among the findings for cancers at specific sites, an inverse association was found for liver cancer, with corresponding hazard ratios of 0.70 (0.44 to 1.13), 0.65 (0.40 to 1.06), and 0.45 (0.26 to 0.79) (P for trend=0.006). A sensitivity analysis showed that alternately removing cases of cancer at one specific site from total cancer cases did not substantially change the overall hazard ratios. In this large prospective study, higher vitamin D concentration was associated with lower risk of total cancer. These findings support the hypothesis that vitamin D has protective effects against cancers at many sites. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Map showing locations of mines, prospects, and patented mining claims, and classification of mineral deposits in the Silver City 7 1/2-minute Quadrangle, Black Hills, South Dakota

USGS Publications Warehouse

DeWitt, Ed; Buscher, David; Wilson, A.B.; Johnson, Thomas

1988-01-01

This map is one in a set of 26 maps (see index map) at 1:24,000 scale of the Black Hills region of South Dakota and Wyoming om which are shown a geologic classification of mines, a bibliography of mineral deposits, and locations of active and inactive mines, prospects, and patented mining claims. Some of these maps are published as U. S. Geological Survey Miscellaneous Field Studies Maps (MF series) and some as U.S. Geological Survey Open-File Reports (QF series); see index map. An earlier unpublished version of this set of maps was the data base from which plate 4 (scale 1:250,000) of DeWitt and others (1986) was compiled. Subsequent to that publication, the set has been revised and updated, and prospects and patented claims have been added. These revised and more detailed 1:24,000-scale maps should be used for the equivalent areas of plate 4 of DeWitt and others (1986).

Seeing light at the end of the tunnel: Positive prospective mental imagery and optimism in depression.

PubMed

Ji, Julie L; Holmes, Emily A; Blackwell, Simon E

2017-01-01

Optimism is associated with positive outcomes across many health domains, from cardiovascular disease to depression. However, we know little about cognitive processes underlying optimism in psychopathology. The present study tested whether the ability to vividly imagine positive events in one's future was associated with dispositional optimism in a sample of depressed adults. Cross-sectional and longitudinal analyses were conducted, using baseline (all participants, N=150) and follow-up data (participants in the control condition only, N=63) from a clinical trial (Blackwell et al., 2015). Vividness of positive prospective imagery, assessed on a laboratory-administered task at baseline, was significantly associated with both current optimism levels at baseline and future (seven months later) optimism levels, including when controlling for potential confounds. Even when depressed, those individuals able to envision a brighter future were more optimistic, and regained optimism more quickly over time, than those less able to do so at baseline. Strategies to increase the vividness of positive prospective imagery may aid development of mental health interventions to boost optimism. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Imaging for uterine myomas and adenomyosis.

PubMed

Shwayder, James; Sakhel, Khaled

2014-01-01

Uterine myomas and adenomyosis are common findings, in particular in patients with symptoms of abdominal enlargement, pelvic pressure, abnormal uterine bleeding, dysmenorrhea, and dyspareunia. Diagnosis and differentiation between the 2 entities are critical in establishing treatment options and the operative approach for surgical management. Herein are reviewed diagnostic options, their relative accuracy, and the effect of accurate diagnosis on treatment. A review was performed using PubMed, MdConsult, OVID, and reviews including cross-referenced articles and prospective and retrospective studies published from 1980 to 2013. Also reviewed are use of ultrasound with its various methods, magnetic resonance imaging, computed tomography, and positron emission tomography in the diagnosis, pretreatment evaluation, and differentiation of myomas and adenomyosis. Copyright © 2014 AAGL. Published by Elsevier Inc. All rights reserved.

A meta-analysis of prospective studies of coffee consumption and mortality for all causes, cancers and cardiovascular diseases.

PubMed

Malerba, Stefano; Turati, Federica; Galeone, Carlotta; Pelucchi, Claudio; Verga, Federica; La Vecchia, Carlo; Tavani, Alessandra

2013-07-01

Several prospective studies considered the relation between coffee consumption and mortality. Most studies, however, were underpowered to detect an association, since they included relatively few deaths. To obtain quantitative overall estimates, we combined all published data from prospective studies on the relation of coffee with mortality for all causes, all cancers, cardiovascular disease (CVD), coronary/ischemic heart disease (CHD/IHD) and stroke. A bibliography search, updated to January 2013, was carried out in PubMed and Embase to identify prospective observational studies providing quantitative estimates on mortality from all causes, cancer, CVD, CHD/IHD or stroke in relation to coffee consumption. A systematic review and meta-analysis was conducted to estimate overall relative risks (RR) and 95 % confidence intervals (CI) using random-effects models. The pooled RRs of all cause mortality for the study-specific highest versus low (≤1 cup/day) coffee drinking categories were 0.88 (95 % CI 0.84-0.93) based on all the 23 studies, and 0.87 (95 % CI 0.82-0.93) for the 19 smoking adjusting studies. The combined RRs for CVD mortality were 0.89 (95 % CI 0.77-1.02, 17 smoking adjusting studies) for the highest versus low drinking and 0.98 (95 % CI 0.95-1.00, 16 studies) for the increment of 1 cup/day. Compared with low drinking, the RRs for the highest consumption of coffee were 0.95 (95 % CI 0.78-1.15, 12 smoking adjusting studies) for CHD/IHD, 0.95 (95 % CI 0.70-1.29, 6 studies) for stroke, and 1.03 (95 % CI 0.97-1.10, 10 studies) for all cancers. This meta-analysis provides quantitative evidence that coffee intake is inversely related to all cause and, probably, CVD mortality.

Genetic, clinical and pharmacological determinants of out-of-hospital cardiac arrest: rationale and outline of the AmsteRdam Resuscitation Studies (ARREST) registry.

PubMed

Blom, M T; van Hoeijen, D A; Bardai, A; Berdowski, J; Souverein, P C; De Bruin, M L; Koster, R W; de Boer, A; Tan, H L

2014-01-01

Out-of-hospital cardiac arrest (OHCA) is a major public health problem. Recognising the complexity of the underlying causes of OHCA in the community, we aimed to establish the clinical, pharmacological, environmental and genetic factors and their interactions that may cause OHCA. We set up a large-scale prospective community-based registry (AmsteRdam Resuscitation Studies, ARREST) in which we prospectively include all resuscitation attempts from OHCA in a large study region in the Netherlands in collaboration with Emergency Medical Services. Of all OHCA victims since June 2005, we prospectively collect medical history (through hospital and general practitioner), and current and previous medication use (through community pharmacy). In addition, we include DNA samples from OHCA victims with documented ventricular tachycardia/fibrillation during the resuscitation attempt since July 2007. Various study designs are employed to analyse the data of the ARREST registry, including case-control, cohort, case only and case-cross over designs. We describe the rationale, outline and potential results of the ARREST registry. The design allows for a stable and reliable collection of multiple determinants of OHCA, while assuring that the patient, lay-caregiver or medical professional is not hindered in any way. Such comprehensive data collection is required to unravel the complex basis of OHCA. Results will be published in peer-reviewed journals and presented at relevant scientific symposia.

Predictors of postherpetic neuralgia in patients with herpes zoster: a pooled analysis of prospective cohort studies from North and Latin America and Asia.

PubMed

Kawai, Kosuke; Rampakakis, Emmanouil; Tsai, Tsen-Fang; Cheong, Hee Jin; Dhitavat, Jittima; Covarrubias, Alejandro Ortiz; Yang, Lin; Cashat-Cruz, Miguel; Monsanto, Homero; Johnson, Kelly; Sampalis, John S; Acosta, Camilo J

2015-05-01

The most common complication of herpes zoster (HZ) is postherpetic neuralgia (PHN), a persistent pain that can substantially affect quality of life (QoL). This analysis aimed to evaluate predictors of PHN in HZ patients. A pooled analysis of prospective cohort studies of HZ patients aged ≥ 50 years from North America (Canada), Latin America (Brazil, Mexico, and Argentina), and Asia (Taiwan, South Korea, and Thailand) was performed. Patients within 14 days of rash onset were included. The incidence of PHN was defined as a worst pain score of ≥ 3, persisting/appearing at >90 days after rash onset. Socio-demographics, HZ disease characteristics, treatment, pain-related interference with activities of daily living, and health-related QoL were assessed. Of 702 patients with HZ, 148 (21.1%) developed PHN. Similar risks of PHN were observed across geographic regions. On multivariate analysis, older age, greater severity of pain at rash onset, employment status, walking problems at enrollment, and pain interference affecting social relationships were significantly associated with the development of PHN. In addition to older age and severe acute pain, this study suggests that impaired physical and social functioning from acute zoster pain may play a role in the development of PHN in this prospective cohort study of HZ patients from North and Latin America and Asia. Copyright © 2015. Published by Elsevier Ltd.

Nonoperative management in children with early acute appendicitis: A systematic review.

PubMed

Xu, Jane; Adams, Susan; Liu, Yingrui Cyril; Karpelowsky, Jonathan

2017-09-01

Appendectomy has remained the gold standard treatment of acute appendicitis for more than 100years. Nonoperative management (NOM) has been shown to be a valid treatment alternative for acute uncomplicated appendicitis in adults. A systematic review of available evidence comparing operative management (OM) and NOM in children with acute uncomplicated appendicitis was performed. Systematic searches of MedLine, Embase, and a clinical trial register (https://clinicaltrials.gov/) were performed in March 2016. Only articles that studied NOM for uncomplicated appendicitis in children were included. Data generation was performed independently by two authors, and quality was assessed using the rating schema by the Oxford Centre for Evidence-Based Medicine. 15 articles were selected: four retrospective analyses, four prospective cohort studies, four prospective nonrandomized comparative trials and one randomized controlled trial (RCT). Initial success of the NOM groups (a cure within two weeks of intervention) ranged from 58 to 100%, with 0.1-31.8% recurrence at one year. Although present literature is scarce, publications support the feasibility of further studies investigating NOM of acute uncomplicated appendicitis in children. Higher quality prospective RCTs with larger sample sizes and robust randomization methods, studying the noninferiority of NOM with antibiotics compared with OM are required to establish its utility. This manuscript is a systematic review and thus assigned the lowest evidence used from the manuscripts analyzed which is a Level IV. Copyright © 2017. Published by Elsevier Inc.

A prospective study of the severity of early respiratory distress in late preterms compared to term infants.

PubMed

Kitsommart, Ratchada; Phatihattakorn, Chayawat; Pornladnun, Pornpat; Paes, Bosco

2016-01-01

To compare the severity of early respiratory distress in late preterm (LPT) versus term infants. A prospective cohort study was conducted in a tertiary care neonatal unit in Thailand. Levels of respiratory support, duration of intubation, and short term morbidities were compared between LPT and term infants. Two-hundred nineteen LPT and 564 term infants were included over a period of 2 years (2009-2011). 106 (48.4%) LPTs versus 58 (10.3%) term infants received non-invasive ventilation or intubation [p < 0.001; OR (95% CI) 8.2 (5.6, 12.0)]. The intubation rate was 24.7% in LPTs versus 7.3% in term infants [p < 0.001; OR (95% CI) 4.18 (2.7, 6.5)]. The duration of intubation was longer in LPT infants (median 5.0 versus 2.0 days. p = 0.03). There was a non-significant trend towards a higher mortality rate in the LPT group [p = 0.14; OR (95% CI) 3.9 (0.7, 23.5)]. This is one of three published prospective studies on the topic. The study design lends more robust credence to the results previously identified only in retrospective and systematic reviews. LPT infants are more likely to require positive-pressure ventilation support and incur a longer duration of intubation. A trend towards greater mortality is prevalent compared to term infants.

Predicting urinary incontinence in women in later life: A systematic review.

PubMed

Troko, Joy; Bach, Fiona; Toozs-Hobson, Philip

2016-12-01

Urinary incontinence (UI) affects 10-40% of the population and treatment costs in the UK are estimated to be £233 million per annum. A systematic review of online medical databases between July 1974 and 2016 was conducted to identify studies that had investigated risk and prediction strategies of UI in later life. Eighteen prospective longitudinal studies fulfilled the search criteria. These were analysed systematically (as per the PRISMA checklist) and bias risk through study design was minimised where possible upon data analysis. One paper proposed a predictive assessment tool called the 'continence index'. It was derived following secondary analysis of a cohort study and its predictive threshold had suboptimal sensitivity (79%) and specificity (65%) rates. Seventeen studies identified multiple strong risk factors for UI but despite a large selection of papers on the topic, no robust risk assessment tool prospectively identified patients at risk of UI in later life. Thus more research in this field is required. Clinicians should be aware particularly of modifiable UI risk factors to help reduce the clinical burden of UI in the long term. Copyright © 2016. Published by Elsevier Ireland Ltd.

Sexual functioning in women after mastectomy versus breast conserving therapy for early-stage breast cancer: a prospective controlled study.

PubMed

Aerts, L; Christiaens, M R; Enzlin, P; Neven, P; Amant, F

2014-10-01

Breast cancer (BC) and/or its treatments may affect sexual functioning based on physiological and psychosocial mechanisms. The aim of this study was to prospectively investigate sexual adjustment of BC patients during a follow-up period of one year after mastectomy (ME) or breast conserving therapy (BCT). In this prospective controlled study, women with BC and an age-matched control group of healthy women completed the Beck Depression Inventory Scale, World Health Organization 5 Well-being scale, Body Image Scale, EORTC QLQ questionnaire, Dyadic Adjustment Scale, Short Sexual Functioning Scale and Specific Sexual Problems Questionnaire to assess various aspects of sexual and psychosocial functioning before surgery, six months and one year after surgical treatment. In total, 149 women with BC and 149 age-matched healthy controls completed the survey. Compared to the situation before surgery, significantly more BCT women reported problems with sexual arousal six months after surgery and significantly more women of the ME group reported problems with sexual desire, arousal and the ability to achieve an orgasm six months and one year after surgery. While in comparison with healthy controls, no significant differences in sexual functioning were found after BCT surgery, significantly more women who underwent ME reported problems with sexual desire, arousal, the ability to achieve an orgasm and intensity of the orgasm. Although little differences were seen in sexual functioning in the BCT group during prospective analyses and in comparison with healthy controls, analyses revealed that women who underwent a ME were at risk for post-operative sexual dysfunctions. Copyright © 2014. Published by Elsevier Ltd.

Factors and motivations associated with use of e-cigarette among primary care patients in a prospective cohort study: e-TAC study protocol.

PubMed

Kinouani, Shérazade; Castéra, Philippe; Laporte, Catherine; Pétrègne, François; Gay, Bernard

2016-06-15

While the relationship between electronic cigarette use and smoking has often been studied, the association between electronic cigarette use and socioeconomic factors has received less attention. This is a study protocol aiming to describe the relationship between the consumption of psychoactive products (in particular: smoking) or some socioeconomic factors and the evolution of the use of electronic cigarette in primary healthcare over 1 year. Electronic cigarette, Tobacco, Alcohol and Cannabis (e-TAC) is a prospective multisite cohort study, including 473 patients at baseline and carrying out in general practices in the Aquitaine area (France). The volunteer patients participated in the study regardless of their initial reason for consultation. They filled out a self-administered questionnaire at baseline and will also do so after 12 months by phone, email or letter. The study will focus on the factors that explain the experimentation with or the current use of the electronic cigarette, as well as factors associated with their evolutions over time using multivariate logistic regression modelling or Cox regression modelling. This study received ethical approval from the University of Bordeaux Committee for the protection of persons. It was also approved by the National Commission for Data Processing and Freedoms. Findings will be submitted for publication in peer-reviewed journals and we will disseminate them by presentations at national or international conferences. RCB: 2015-A00778-41; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Could Fractional Exhaled Nitric Oxide Test be Useful in Predicting Inhaled Corticosteroid Responsiveness in Chronic Cough? A Systematic Review.

PubMed

Song, Woo-Jung; Won, Ha-Kyeong; Moon, Sung-Do; Chung, Soo-Jie; Kang, Sung-Yoon; Sohn, Kyoung-Hee; Kim, Ju-Young; Kim, Byung-Keun; Lim, Kyung-Hwan; Kim, Mi-Yeong; Yang, Min-Suk; Park, Heung-Woo; Chang, Yoon-Seok; Lee, Byung-Jae; Morice, Alyn H; Cho, Sang-Heon

Fractional exhaled nitric oxide (Feno) is a safe and convenient test for assessing T H 2 airway inflammation, which is potentially useful in the management of patients with chronic cough. To summarize the current evidence on the diagnostic usefulness of Feno for predicting inhaled corticosteroid (ICS) responsiveness in patients with chronic cough. A systematic literature review was conducted to identify articles published in peer-reviewed journals up to February 2015, without language restriction. We included studies that reported the usefulness of Feno (index test) for predicting ICS responsiveness (reference standard) in patients with chronic cough (target condition). The data were extracted to construct a 2 × 2 accuracy table. Study quality was assessed with Quality Assessment of Diagnostic Accuracy Studies 2. We identified 5 original studies (2 prospective and 3 retrospective studies). We identified considerable heterogeneities in study design and outcome definitions, and thus were unable to perform a meta-analysis. The proportion of ICS responders ranged from 44% to 59%. Sensitivity and specificity ranged from 53% to 90%, and from 63% to 97%, respectively. The reported area under the curve ranged from about 0.60 to 0.87; however, studies with a prospective design and a lower prevalence of asthma had lower area under the curve values. None measured placebo effects or objective cough frequency. We did not find strong evidence to support the use of Feno tests for predicting ICS responsiveness in chronic cough. Further studies need to have a randomized, placebo-controlled design, and should use validated measurement tools for cough. Standardization would facilitate the development of clinical evidence. Copyright © 2016. Published by Elsevier Inc.

Is a specific eyelid patch test series useful? Results of a French prospective study.

PubMed

Assier, Haudrey; Tetart, Florence; Avenel-Audran, Martine; Barbaud, Annick; Ferrier-le Bouëdec, Marie-Christine; Giordano-Labadie, Françoise; Milpied, Brigitte; Amsler, Emmanuelle; Collet, Evelyne; Girardin, Pascal; Soria, Angèle; Waton, Julie; Truchetet, François; Bourrain, Jean-Luc; Gener, Gwendeline; Bernier, Claire; Raison-Peyron, Nadia

2018-06-08

Eyelids are frequent sites of contact dermatitis. No prospective study focused on eyelid allergic contact dermatitis (EACD) has yet been published, and this topic has never been studied in French patients. To prospectively evaluate the usefulness of an eyelid series in French patients patch tested because of EACD, and to describe these patients. We prospectively analysed standardized data for all patients referred to our departments between September 2014 and August 2016 for patch testing for suspected EACD as the main reason. All patients were patch tested with an eyelid series, the European baseline series (EBS), the French additional series, and their personal products. Patch testing with additional series and repeated open application tests (ROATs) or open tests were performed if necessary. A standardized assessment of the relevance was used, and the analysis of the results was focused on patients having positive test results with a current certain relevance. Two-hundred and sixty-four patients (238 women and 26 men) were included. Three-hundred and twenty-two tests gave positive results in 167 patients, 84 of whom had currently relevant reactions: 56 had currently relevant positive test reactions to the EBS, 16 had currently relevant positive test reactions to their personal products, 8 had currently relevant positive test reactions to the French additional series, and 4 had currently relevant positive test reactions to the eyelid series. Sixty-seven per cent of all relevant cases were related to cosmetic products. The most frequent allergens with current relevance were methylisothiazolinone (10.2%), fragrance mix I (3%), nickel (2.7%), hydroxyperoxides of linalool (2.7%) and limonene (2.3%), and Myroxylon pereirae (2.3%). Current atopic dermatitis was found in 9.5% of patients. The duration of dermatitis was shorter (23.2 vs 34.2 months; P = .035) in patients with currently relevant test reactions. The percentage of currently relevant tests remained the same when atopic patients or dermatitis localized only on the eyelids were taken into account. In French patients, testing for EACD with the extended baseline series and personal products, also including ROATs and use tests, appears to be adequate, considering the currently relevant positive test reactions. The regular addition of an eyelid series does not seem to be necessary. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The renaissance of life near the boiling point - at last, genetics and metabolic engineering.

PubMed

Adams, Michael W W; Kelly, Robert M

2017-01-01

We discuss here the prospects for biotechnology of extreme thermophilic microorganisms. © 2016 The Authors. Microbial Biotechnology published by John Wiley & Sons Ltd and Society for Applied Microbiology.

A prospective gating method to acquire a diverse set of free-breathing CT images for model-based 4DCT

NASA Astrophysics Data System (ADS)

O'Connell, D.; Ruan, D.; Thomas, D. H.; Dou, T. H.; Lewis, J. H.; Santhanam, A.; Lee, P.; Low, D. A.

2018-02-01

Breathing motion modeling requires observation of tissues at sufficiently distinct respiratory states for proper 4D characterization. This work proposes a method to improve sampling of the breathing cycle with limited imaging dose. We designed and tested a prospective free-breathing acquisition protocol with a simulation using datasets from five patients imaged with a model-based 4DCT technique. Each dataset contained 25 free-breathing fast helical CT scans with simultaneous breathing surrogate measurements. Tissue displacements were measured using deformable image registration. A correspondence model related tissue displacement to the surrogate. Model residual was computed by comparing predicted displacements to image registration results. To determine a stopping criteria for the prospective protocol, i.e. when the breathing cycle had been sufficiently sampled, subsets of N scans where 5  ⩽  N  ⩽  9 were used to fit reduced models for each patient. A previously published metric was employed to describe the phase coverage, or ‘spread’, of the respiratory trajectories of each subset. Minimum phase coverage necessary to achieve mean model residual within 0.5 mm of the full 25-scan model was determined and used as the stopping criteria. Using the patient breathing traces, a prospective acquisition protocol was simulated. In all patients, phase coverage greater than the threshold necessary for model accuracy within 0.5 mm of the 25 scan model was achieved in six or fewer scans. The prospectively selected respiratory trajectories ranked in the (97.5  ±  4.2)th percentile among subsets of the originally sampled scans on average. Simulation results suggest that the proposed prospective method provides an effective means to sample the breathing cycle with limited free-breathing scans. One application of the method is to reduce the imaging dose of a previously published model-based 4DCT protocol to 25% of its original value while achieving mean model residual within 0.5 mm.

The China Patient-Centred Evaluative Assessment of Cardiac Events (China PEACE)-Prospective Study of 3-Vessel Disease: rationale and design.

PubMed

Rao, Chenfei; Bongiovanni, Tasce; Li, Xi; Gao, Huawei; Zhang, Heng; Li, Jing; Zhao, Yan; Yuan, Xin; Hua, Kun; Hu, Shengshou; Krumholz, Harlan M; Jiang, Lixin; Zheng, Zhe

2016-02-15

Complex coronary artery disease (left main and three-vessel disease) carries high risks of adverse events and cost burden. However, in China, little is known about which patients are directed toward which treatment strategies and what outcomes are being achieved. Using the China PEACE (Patient-centered Evaluative Assessment of Cardiac Events) research network, this prospective study of three-Vessel Disease, the China PEACE-3VD study, has a plan to consecutively register over 4000 patients with a diagnosis of 3VD and/or left-main disease by elective coronary angiography at 24 large cardiovascular centres in China. We centrally conducted medical record abstraction and SYNTAX Score calculation for all registered patients. The sites invited patients to the prospective cohort, and conducted 1-year follow-up on major events, including cardiac events, symptoms, secondary prevention and quality of life. The estimated entire sample size of eligible patients of 4000 was determined based on both feasibility and consideration of adequate statistical precision for describing the treatment decisions, guidelines adherence and appropriateness of treatment for patients with complex coronary artery diseases. The study is designed to investigate patient, clinician and hospital factors associated with each treatment strategy (percutaneous coronary intervention, coronary artery bypass grafting or medical therapy) as well as appropriateness of treatment choice, current guideline compliance and patient-reported outcomes for patients with complex coronary artery disease in large cardiovascular centres in China, as a foundation for enhanced knowledge in the field and to assist quality improvement initiatives. The study protocol was approved by the ethics committee at the China National Center for Cardiovascular Diseases. Findings will be shared with participating hospitals, policymakers and the academic community, to promote quality monitoring, quality improvement and the efficient allocation, and use of coronary revascularisation procedures in China. NCT01625312; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Distraction to treat knee osteoarthritis.

PubMed

Flouzat-Lachaniette, Charles-Henri; Roubineau, François; Heyberger, Clémence; Bouthors, Charlie

2017-03-01

The objective of this article is to review data on joint distraction used to treat knee osteoarthritis. Joint distraction is a surgical procedure in which the two bony ends of the joint are gradually pulled apart then kept separated for 2 months in an external fixation frame. Weight bearing is continued to ensure variations in hydrostatic pressure within the joint. In published studies, joint distraction provided substantial clinical and structural improvements in patients with knee osteoarthritis, delaying joint replacement surgery for at least 2 years. Animal studies showed that joint distraction was associated with decrease in the secondary inflammatory response, cartilage breakdown, and subchondral bone remodeling. In vitro, the intermittent application of hydrostatic pressure stimulated the production of extracellular matrix, particularly in joints with osteoarthritis. Nevertheless, several considerations invite caution when considering the more widespread use of joint distraction. Published studies have short follow-ups and small sample sizes. In addition, the high frequency of pin tract infection is of concern, since most patients eventually require knee replacement surgery. These two considerations indicate a need for longer-term prospective studies of patient cohorts. Copyright © 2016 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Increased postural sway during quiet stance as a risk factor for prospective falls in community-dwelling elderly individuals.

PubMed

Johansson, Jonas; Nordström, Anna; Gustafson, Yngve; Westling, Göran; Nordström, Peter

2017-11-01

fall-related injuries constitute major health risks in older individuals, and these risks are projected to increase in parallel with increasing human longevity. Impaired postural stability is a potential risk factor related to falls, although the evidence is inconclusive, partly due to the lack of prospective studies. This study aimed to investigate how objective measures of postural sway predict incident falls. this prospectively observational study included 1,877 community-dwelling individuals aged 70 years who participated in the Healthy Ageing Initiative between June 2012 and December 2015. postural sway was measured during eyes-open (EO) and eyes-closed (EC) trials using the Wii Balance Board. Functional mobility, muscle strength, objective physical activity and cognitive performance were also measured. Participants reported incident falls 6 and 12 months after the examination. during follow-up, 255 (14%) prospective fallers were identified. Division of centre of pressure (COP) sway lengths into quintiles revealed a nonlinear distribution of falls for EO trial data, but not EC trial data. After adjustment for multiple confounders, fall risk was increased by 75% for participants with COP sway lengths ≥400 mm during the EO trial (odds ratio [OR] 1.75, 95% confidence interval [CI] 1.09-2.79), and approximately doubled for sway lengths ≥920 mm during the EC trial (OR 1.90, 95% CI 1.12-3.22). objective measures of postural sway independently predict incident falls in older community-dwelling men and women. Further studies are needed to evaluate whether postural sway length is of interest for the prediction of incident falls in clinical settings. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com

Association between Adult Height and Risk of Colorectal, Lung, and Prostate Cancer: Results from Meta-analyses of Prospective Studies and Mendelian Randomization Analyses.

PubMed

Khankari, Nikhil K; Shu, Xiao-Ou; Wen, Wanqing; Kraft, Peter; Lindström, Sara; Peters, Ulrike; Schildkraut, Joellen; Schumacher, Fredrick; Bofetta, Paolo; Risch, Angela; Bickeböller, Heike; Amos, Christopher I; Easton, Douglas; Eeles, Rosalind A; Gruber, Stephen B; Haiman, Christopher A; Hunter, David J; Chanock, Stephen J; Pierce, Brandon L; Zheng, Wei

2016-09-01

Observational studies examining associations between adult height and risk of colorectal, prostate, and lung cancers have generated mixed results. We conducted meta-analyses using data from prospective cohort studies and further carried out Mendelian randomization analyses, using height-associated genetic variants identified in a genome-wide association study (GWAS), to evaluate the association of adult height with these cancers. A systematic review of prospective studies was conducted using the PubMed, Embase, and Web of Science databases. Using meta-analyses, results obtained from 62 studies were summarized for the association of a 10-cm increase in height with cancer risk. Mendelian randomization analyses were conducted using summary statistics obtained for 423 genetic variants identified from a recent GWAS of adult height and from a cancer genetics consortium study of multiple cancers that included 47,800 cases and 81,353 controls. For a 10-cm increase in height, the summary relative risks derived from the meta-analyses of prospective studies were 1.12 (95% CI 1.10, 1.15), 1.07 (95% CI 1.05, 1.10), and 1.06 (95% CI 1.02, 1.11) for colorectal, prostate, and lung cancers, respectively. Mendelian randomization analyses showed increased risks of colorectal (odds ratio [OR] = 1.58, 95% CI 1.14, 2.18) and lung cancer (OR = 1.10, 95% CI 1.00, 1.22) associated with each 10-cm increase in genetically predicted height. No association was observed for prostate cancer (OR = 1.03, 95% CI 0.92, 1.15). Our meta-analysis was limited to published studies. The sample size for the Mendelian randomization analysis of colorectal cancer was relatively small, thus affecting the precision of the point estimate. Our study provides evidence for a potential causal association of adult height with the risk of colorectal and lung cancers and suggests that certain genetic factors and biological pathways affecting adult height may also affect the risk of these cancers.

Risk factors for gastric cancer in Latin-America: a meta-analysis

PubMed Central

Bonequi, Patricia; Meneses-González, Fernando; Correa, Pelayo; Rabkin, Charles S.; Camargo, M. Constanza

2013-01-01

Background Latin America has among the highest gastric cancer incidence rates in the world, for reasons that are still unknown. In order to identify region-specific risk factors for gastric cancer, we conducted a meta-analysis summarizing published literature. Methods Searches of PubMed and regional databases for relevant studies published up to December 2011 yielded a total of 29 independent case-control studies. We calculated summary odds ratios (OR) for risk factors reported in at least five studies, including socioeconomic status (education), lifestyle habits (smoking and alcohol use), dietary factors (consumption of fruits, total vegetables, green vegetables, chili pepper, total meat, processed meat, red meat, fish and salt) and host genetic variants (IL1B-511T, IL1B-31C, IL1RN*2, TNFA-308A, TP53 codon 72 Arg and GSTM1 null). Study-specific ORs were extracted and summarized using random-effects models. Results Chili pepper was the only region-specific factor reported in at least five studies. Consistent with multifactorial pathogenesis, smoking, alcohol use, high consumption of red meat or processed meat, excessive salt intake and carriage of IL1RN*2 were each associated with a moderate increase in gastric cancer risk. Conversely, higher levels of education, fruit consumption, and total vegetable consumption were each associated with a moderately decreased risk. The other exposures were not significantly associated. No prospective study data were identified. Conclusion Risk factor associations for gastric cancer in Latin America are based on case-control comparisons that have uncertain reliability, particularly with regard to diet; the specific factors identified and their magnitudes of association are largely similar to those globally recognized. Future studies should emphasize prospective data collection and focus on region-specific exposures that may explain high gastric cancer risk. PMID:23224270

A systematic review of interventions to improve knowledge and self-management skills concerning contraception, pregnancy and breastfeeding in people with rheumatoid arthritis.

PubMed

Ackerman, Ilana N; Ngian, Gene-Siew; Van Doornum, Sharon; Briggs, Andrew M

2016-01-01

This systematic review aimed to determine the effectiveness of interventions for improving knowledge and/or self-management skills concerning contraception, pregnancy and breastfeeding in people with rheumatoid arthritis (RA). We searched four databases (MEDLINE, CINAHL, Cochrane Trials, PsycINFO) using a comprehensive search strategy. Studies were eligible if they were prospective, published in English from 2004 to 2015, included participants with RA and tested an intervention designed to improve knowledge and/or self-management skills relating to family planning, pregnancy or breastfeeding. As no studies met the latter criterion, the search strategy was expanded to include all prospective studies evaluating RA educational and/or self-management interventions. Data on study characteristics, participant characteristics and programme content were extracted to summarise the evidence base for interventions to support people with RA during their reproductive years. Expanded literature searches identified 2290 papers, of which 68 were eligible. Of these, nine papers (13%) specifically excluded pregnant women/breastfeeding mothers or recruited only older people. Only one study (1%) explicitly evaluated pregnancy-focused education via a motherhood decision aid, while eight studies (12%) incorporated relevant (albeit minor) components within broader RA educational or self-management interventions. Of these, three studies provided methotrexate education in relation to conception/pregnancy/breastfeeding; three incorporated discussions on RA and relationships, impact of RA on the family or sexual advice; one provided information regarding contraception and fertility; and one issued a warning regarding use of biologic therapy in pregnancy/breastfeeding. In conclusion, information regarding family planning, pregnancy or breastfeeding represents a negligible part of published RA educational interventions, with scope to develop targeted resources.

Impact of positive and negative lesion site remodeling on clinical outcomes: insights from PROSPECT.

PubMed

Inaba, Shinji; Mintz, Gary S; Farhat, Naim Z; Fajadet, Jean; Dudek, Dariusz; Marzocchi, Antonio; Templin, Barry; Weisz, Giora; Xu, Ke; de Bruyne, Bernard; Serruys, Patrick W; Stone, Gregg W; Maehara, Akiko

2014-01-01

This study investigated coronary artery remodeling patterns associated with clinical outcomes. In the prospective, multicenter PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree: An Imaging Study in Patients With Unstable Atherosclerotic Lesions) study, reported predictors of nonculprit lesion (NCL) major adverse cardiac events (MACE) were an intravascular ultrasound (IVUS) minimal lumen area (MLA) ≤4 mm(2), a plaque burden ≥70%, and a IVUS-virtual histology (VH) thin-cap fibroatheroma (TCFA), but not lesion site remodeling. Overall, 697 consecutive patients with an acute coronary syndrome were enrolled and underwent 3-vessel gray-scale and IVUS-VH; 3,223 NCLs were identified by IVUS. The remodeling index (RI) was calculated as the external elastic membrane area at the MLA site divided by the average of the proximal and distal reference external elastic membrane areas. First, one third of the patients were randomly selected to determine RI cutoffs related to NCL MACE (development cohort). Receiver-operating characteristic analysis showed that there were 2 separate cut points that predicted NCL MACE: RI = 0.8789 and RI = 1.0046 (area under the curve = 0.663). These cut points were used to define negative remodeling as an RI <0.88, intermediate remodeling as an RI of 0.88 to 1.00, and positive remodeling as an RI >1.00. Second, we used the remaining two-thirds of patients to validate these cut points with respect to lesion morphology and clinical outcomes (validation cohort). Kaplan-Meier curve analysis in the validation cohort showed that NCL MACE occurred more frequent (and equally) in negative and positive remodeling lesions compared with intermediate remodeling lesions. In this cohort, negative remodeling lesions had the smallest MLA, positive remodeling lesions had the largest plaque burden, and VH TCFA, especially VH TCFA with multiple necrotic cores, was most common in negatively remodeling lesions. The present study showed the novel concept that positive and negative lesion site remodeling was associated with unanticipated NCL MACE in the PROSPECT study. ( An Imaging Study in Patients With Unstable Atherosclerotic Lesions [PROSPECT]; NCT00180466). Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Daytime Napping and the Risk of Cardiovascular Disease and All-Cause Mortality: A Prospective Study and Dose-Response Meta-Analysis

PubMed Central

Yamada, Tomohide; Hara, Kazuo; Shojima, Nobuhiro; Yamauchi, Toshimasa; Kadowaki, Takashi

2015-01-01

Study Objectives: To summarize evidence about the association between daytime napping and the risk of cardiovascular disease and all-cause mortality, and to quantify the potential dose-response relation. Design: Meta-analysis of prospective cohort studies. Methods and Results: Electronic databases were searched for articles published up to December 2014 using the terms nap, cardiovascular disease, and all-cause mortality. We selected well-adjusted prospective cohort studies reporting risk estimates for cardiovascular disease and all-cause mortality related to napping. Eleven prospective cohort studies were identified with 151,588 participants (1,625,012 person-years) and a mean follow-up period of 11 years (60% women, 5,276 cardiovascular events, and 18,966 all-cause deaths). Pooled analysis showed that a long daytime nap (≥ 60 min/day) was associated with a higher risk of cardiovascular disease (rate ratio [RR]: 1.82 [1.22–2.71], P = 0.003, I2 = 37%) compared with not napping. All-cause mortality was associated with napping for ≥ 60 min/day (RR: 1.27 [1.11–1.45], P < 0.001, I2 = 0%) compared with not napping. In contrast, napping for < 60 min/day was not associated with cardiovascular disease (P = 0.98) or all-cause mortality (P = 0.08). Meta-analysis demonstrated a significant J-curve dose-response relation between nap time and cardiovascular disease (P for nonlinearity = 0.01). The RR initially decreased from 0 to 30 min/day. Then it increased slightly until about 45 min/day, followed by a sharp increase at longer nap times. There was also a positive linear relation between nap time and all-cause mortality (P for non-linearity = 0.97). Conclusions: Nap time and cardiovascular disease may be associated via a J-curve relation. Further studies are needed to confirm the efficacy of a short nap. Citation: Yamada T, Hara K, Shojima N, Yamauchi T, Kadowaki T. Daytime napping and the risk of cardiovascular disease and all-cause mortality: a prospective study and dose-response meta-analysis. SLEEP 2015;38(12):1945–1953. PMID:26158892

A multicentre prospective study of Guillain-Barré syndrome in Japan: a focus on the incidence of subtypes.

PubMed

Mitsui, Yoshiyuki; Kusunoki, Susumu; Arimura, Kimiyoshi; Kaji, Ryuji; Kanda, Takashi; Kuwabara, Satoshi; Sonoo, Masahiro; Takada, Kazuo

2015-01-01

Guillain-Barré Syndrome (GBS) is classified into the two major subtypes; acute inflammatory demyelinating polyneuropathy (AIDP) and acute motor axonal neuropathy (AMAN). Previous studies have suggested that AIDP is predominant and AMAN is rare in Western countries, whereas AMAN is not always uncommon in East Asia. We aimed to clarify the incidence of the subtypes of GBS in Japan. We performed a prospective multicentre survey over 3 years (2007-2010). Clinical and electrophysiological findings were collected from 184 patients with GBS in 23 tertiary neurology institutes. Anti-ganglioside antibodies were measured by ELISA. We also surveyed the incidence of Fisher syndrome (FS). By electrodiagnostic criteria of Ho et al, patients were classified as having AIDP (40%), or AMAN (22%), or unclassified (38%). Anti-GM1 IgG antibodies were found for 47% of AMAN patients, and 18% of AIDP patients (p<0.001). There were no specific regional trends of the electrodiagnosis and anti-GM1 positivity. During the same study period, 79 patients with FS were identified; the percentage of FS cases out of all cases (FS/(GBS+FS)) was 26%. The frequency of GBS patients with the electrodiagnosis of AMAN by single nerve conduction studies is approximately 20% in Japan, and the AMAN pattern is closely associated with anti-GM1 antibodies. The incidence of FS appears to be much higher in Japan than in Western countries. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Adolescent brain cognitive development (ABCD) study: Overview of substance use assessment methods.

PubMed

Lisdahl, Krista M; Sher, Kenneth J; Conway, Kevin P; Gonzalez, Raul; Feldstein Ewing, Sarah W; Nixon, Sara Jo; Tapert, Susan; Bartsch, Hauke; Goldstein, Rita Z; Heitzeg, Mary

2018-08-01

One of the objectives of the Adolescent Brain Cognitive Development (ABCD) Study (https://abcdstudy.org/) is to establish a national longitudinal cohort of 9 and 10 year olds that will be followed for 10 years in order to prospectively study the risk and protective factors influencing substance use and its consequences, examine the impact of substance use on neurocognitive, health and psychosocial outcomes, and to understand the relationship between substance use and psychopathology. This article provides an overview of the ABCD Study Substance Use Workgroup, provides the goals for the workgroup, rationale for the substance use battery, and includes details on the substance use module methods and measurement tools used during baseline, 6-month and 1-year follow-up assessment time-points. Prospective, longitudinal assessment of these substance use domains over a period of ten years in a nationwide sample of youth presents an unprecedented opportunity to further understand the timing and interactive relationships between substance use and neurocognitive, health, and psychopathology outcomes in youth living in the United States. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Leucocyte-rich and platelet-rich fibrin for the treatment of bisphosphonate-related osteonecrosis of the jaw: a prospective feasibility study.

PubMed

Kim, Jin-Woo; Kim, Sun-Jong; Kim, Myung-Rae

2014-11-01

Our aim was to assess the feasibility of using leucocyte-rich and platelet-rich fibrin (L-PRF) for the treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ) in a single group study. After treatment with L-PRF, the response of each patient was recorded 1 month and 4 months postoperatively. Further assessments were made of the site, stage, concentration of c-terminal crosslinked telopepide of type 1 collagen, and actinomycosis. Among the total of 34 patients, 26 (77%) showed complete resolution, 6 (18%) had delayed resolution, and 2 (6%) showed no resolution. There was a significant association between the response to treatment and the stage of BRONJ (p=0.002) but no other significant associations were detected. This study has shown that it is feasible to use L-PRF for the treatment of BRONJ, but the effectiveness cannot be judged with this study design. Randomised prospective trials are needed to confirm this. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Evidence-based medicine in the treatment of peritoneal carcinomatosis: Past, present, and future.

PubMed

Nissan, Aviram; Stojadinovic, Alexander; Garofalo, Alfredo; Esquivel, Jesus; Piso, Pompiliu

2009-09-15

The current treatment of peritoneal surface malignancies (PSMs) is moving from a nihilistic approach, into a combined modality approach offering selected patients long-term survival. As primary PSM are rare, extrapolation of data from clinical trials of related disease is necessary to develop treatment guidelines. Secondary PSM are more common, and therefore, treatment guidelines should be developed based on prospective clinical trials. We reviewed the published and ongoing clinical trials studying the treatment of PSM. (c) 2009 Wiley-Liss, Inc.

Pediatric trauma research in the Gulf Cooperation Council countries.

PubMed

Hefny, Ashraf F; Grivna, Michal; Abbas, Alaa K; Branicki, Frank J; Abu-Zidan, Fikri M

2012-04-01

To review published pediatric trauma research from the Gulf Cooperation Council (GCC) countries so as to identify research fields that need to be enhanced. A MEDLINE search for articles on pediatric trauma from GCC countries during the period 1960 to 2010 was performed. The content of articles was analyzed, classified and summarized. Fifty-three articles were found and retrieved of which 18 (34%) were published in the last 5 years, 42 (79.2%) were original articles. The first author was affiliated to a university in 29 reports (54.7%), to a community hospital in 13 (24.5%) and to a military hospital in 10 (18.9%). All articles were observational studies that included 18 (34%) case-control studies, 18 (34%) case reports/case series studies, 8 (15.1%) prospective studies, and 7 (13.2%) cross sectional studies. The median (range) impact factor of the journals was 1.3 (0.5-3.72). No meta-analysis studies were found. A strategic plan is required to support pediatric trauma research in GCC countries so as to address unmet needs. Areas of deficiency include pre-hospital care, post-traumatic psychological effects and post-traumatic rehabilitation, interventional studies focused on a safe child environment and attitude changes, and the socioeconomic impact of pediatric trauma. Copyright © 2012. Published by Elsevier B.V.

High Impact = High Statistical Standards? Not Necessarily So

PubMed Central

Tressoldi, Patrizio E.; Giofré, David; Sella, Francesco; Cumming, Geoff

2013-01-01

What are the statistical practices of articles published in journals with a high impact factor? Are there differences compared with articles published in journals with a somewhat lower impact factor that have adopted editorial policies to reduce the impact of limitations of Null Hypothesis Significance Testing? To investigate these questions, the current study analyzed all articles related to psychological, neuropsychological and medical issues, published in 2011 in four journals with high impact factors: Science, Nature, The New England Journal of Medicine and The Lancet, and three journals with relatively lower impact factors: Neuropsychology, Journal of Experimental Psychology-Applied and the American Journal of Public Health. Results show that Null Hypothesis Significance Testing without any use of confidence intervals, effect size, prospective power and model estimation, is the prevalent statistical practice used in articles published in Nature, 89%, followed by articles published in Science, 42%. By contrast, in all other journals, both with high and lower impact factors, most articles report confidence intervals and/or effect size measures. We interpreted these differences as consequences of the editorial policies adopted by the journal editors, which are probably the most effective means to improve the statistical practices in journals with high or low impact factors. PMID:23418533

High impact  =  high statistical standards? Not necessarily so.

PubMed

Tressoldi, Patrizio E; Giofré, David; Sella, Francesco; Cumming, Geoff

2013-01-01

What are the statistical practices of articles published in journals with a high impact factor? Are there differences compared with articles published in journals with a somewhat lower impact factor that have adopted editorial policies to reduce the impact of limitations of Null Hypothesis Significance Testing? To investigate these questions, the current study analyzed all articles related to psychological, neuropsychological and medical issues, published in 2011 in four journals with high impact factors: Science, Nature, The New England Journal of Medicine and The Lancet, and three journals with relatively lower impact factors: Neuropsychology, Journal of Experimental Psychology-Applied and the American Journal of Public Health. Results show that Null Hypothesis Significance Testing without any use of confidence intervals, effect size, prospective power and model estimation, is the prevalent statistical practice used in articles published in Nature, 89%, followed by articles published in Science, 42%. By contrast, in all other journals, both with high and lower impact factors, most articles report confidence intervals and/or effect size measures. We interpreted these differences as consequences of the editorial policies adopted by the journal editors, which are probably the most effective means to improve the statistical practices in journals with high or low impact factors.

Congenital portosystemic shunts: imaging findings and clinical presentations in 11 patients.

PubMed

Konstas, Angelos A; Digumarthy, Subba R; Avery, Laura L; Wallace, Karen L; Lisovsky, Mikhail; Misdraji, Joseph; Hahn, Peter F

2011-11-01

To evaluate the clinical anatomy and presentations of congenital portosystemic shunts, and determine features that promote recognition on imaging. Institutional review board approval was obtained for this HIPAA-compliant study. The requirement for written informed consent was waived. Radiology reports were retrospectively reviewed from non-cirrhotic patients who underwent imaging studies from January 1999 through February 2009. Clinical sources reviewed included electronic medical records, archived images and histopathological material. Eleven patients with congenital portosystemic shunts were identified (six male and five female; age range 20 days to 84 years). Seven patients had extrahepatic and four patients had intrahepatic shunts. All 11 patients had absent or hypoplastic intrahepatic portal veins, a feature detected by CT and MRI, but not by US. Seven patients presented with shunt complications and four with presentations unrelated to shunt pathophysiology. Three adult patients had four splenic artery aneurysms. Prospective radiological evaluation of five adult patients with cross-sectional imaging had failed prospectively to recognize the presence of congenital portosystemic shunts on one or more imaging examinations. Congenital portosystemic shunts are associated with splenic artery aneurysms, a previously unrecognized association. Portosystemic shunts were undetected during prospective radiologic evaluation in the majority of adult patients, highlighting the need to alert radiologists to this congenital anomaly. Copyright © 2010. Published by Elsevier Ireland Ltd.

Diagnosis and management of subclinical hypothyroidism in pregnancy.

PubMed

Negro, Roberto; Stagnaro-Green, Alex

2014-10-06

In prospective studies, the prevalence of undiagnosed subclinical hypothyroidism in pregnant women ranges from 3% to 15%. Subclinical hypothyroidism is associated with multiple adverse outcomes in the mother and fetus, including spontaneous abortion, pre-eclampsia, gestational hypertension, gestational diabetes, preterm delivery, and decreased IQ in the offspring. Only two prospective studies have evaluated the impact of levothyroxine therapy in pregnant women with subclinical hypothyroidism, and the results were mixed. Subclinical hypothyroidism is defined as raised thyrotropin combined with a normal serum free thyroxine level. The normal range of thyrotropin varies according to geographic region and ethnic background. In the absence of local normative data, the recommended upper limit of thyrotropin in the first trimester of pregnancy is 2.5 mIU/L, and 3.0 mIU/L in the second and third trimester. The thyroid gland needs to produce 50% more thyroid hormone during pregnancy to maintain a euthyroid state. Consequently, most women on levothyroxine therapy before pregnancy require an increase in dose when pregnant to maintain euthyroidism. Ongoing prospective trials that are evaluating the impact of levothyroxine therapy on adverse outcomes in the mother and fetus in women with subclinical hypothyroidism will provide crucial data on the role of thyroid hormone replacement in pregnancy. © BMJ Publishing Group Ltd 2014.

Advances in surgical management of lumbar degenerative disease.

PubMed

Silber, Jeff S; Anderson, D Greg; Hayes, Victor M; Vaccaro, Alexander R

2002-07-01

The past several years have seen many advances in spine technology. Some of these advances have improved the quality of life of patients suffering from disabling low back pain from degenerative disk disease. Traditional fusion procedures are trending toward less invasive approaches with less iatrogenic soft-tissue morbidity. The diversity of bone graft substitutes is increasing with the potential for significant improvements in fusion success with the future introduction of several well tested bone morphogenic proteins to the spinal market. Biologic solutions to modify the natural history of disk degeneration are being investigated. Recently, electrothermal modulation of the posterior annulus fibrosis has been published as a semi-invasive technique to relieve low back pain generated by fissures in the outer annulus and ingrowing nociceptors (intradiskal electrothermal therapy, and intradiskal electrothermal annuloplasty). Initial results are promising, however, prospective randomized studies comparing this technique with conservative therapy are still lacking. The same is true for artificial nucleus pulposus replacement using hydrogel cushions implanted in the intervertebral space after removal of the nucleus pulposus posterior or through an anterior approach. Intervertebral disk prostheses are presently being studied in small prospective patient cohorts. As with all new developments, careful prospective, long-term trials are needed to fully define the role of these technologies in the management of symptomatic lumbar degenerative disk disease.

Bacterial meningitis in alcoholic patients: A population-based prospective study.

PubMed

van Veen, Kiril E B; Brouwer, Matthijs C; van der Ende, Arie; van de Beek, Diederik

2017-04-01

To study clinical features and outcome of community-acquired bacterial meningitis in alcoholic patients. Patients with a history of alcoholism were selected from our nationwide, prospective cohort on community-acquired bacterial meningitis performed from March 2006 to October 2014. Data on patient history, symptoms and signs on admission, treatment, and outcome were prospectively collected. Of 1359 included episodes, 88 episodes (6%) occurred in 88 alcoholic patients. Seizures as presenting symptom were present in 18% alcoholic patients, and 23% presented with co-existing pneumonia. Causative organisms were Streptococcus pneumoniae in 76%, Listeria monocytogenes in 8%, and Neisseria meningitidis in 6% of patients. A high rate of systemic complications occurred with respiratory failure in 40% and endocarditis in 9% of patients. Outcome was unfavorable in 58% of alcoholic patients, and 25% died. Alcoholism was associated with unfavorable outcome in a multivariate analysis (OR 1.96; 95% CI 1.12-3.46; P = 0.019), but not with death (OR 0.76; 95% CI 0.35-1.68; P = 0.762). Alcoholic bacterial meningitis patients often have an unfavorable outcome, which appears to result from a high rate of systemic complications, mainly respiratory failure. Seizures are common in alcoholic patients and warrant caution of development of an alcohol withdrawal syndrome. Copyright © 2017. Published by Elsevier Ltd.

Coronary CT angiography with single-source and dual-source CT: comparison of image quality and radiation dose between prospective ECG-triggered and retrospective ECG-gated protocols.

PubMed

Sabarudin, Akmal; Sun, Zhonghua; Yusof, Ahmad Khairuddin Md

2013-09-30

This study is conducted to investigate and compare image quality and radiation dose between prospective ECG-triggered and retrospective ECG-gated coronary CT angiography (CCTA) with the use of single-source CT (SSCT) and dual-source CT (DSCT). A total of 209 patients who underwent CCTA with suspected coronary artery disease scanned with SSCT (n=95) and DSCT (n=114) scanners using prospective ECG-triggered and retrospective ECG-gated protocols were recruited from two institutions. The image was assessed by two experienced observers, while quantitative assessment was performed by measuring the image noise, the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR). Effective dose was calculated using the latest published conversion coefficient factor. A total of 2087 out of 2880 coronary artery segments were assessable, with 98.0% classified as of sufficient and 2.0% as of insufficient image quality for clinical diagnosis. There was no significant difference in overall image quality between prospective ECG-triggered and retrospective gated protocols, whether it was performed with DSCT or SSCT scanners. Prospective ECG-triggered protocol was compared in terms of radiation dose calculation between DSCT (6.5 ± 2.9 mSv) and SSCT (6.2 ± 1.0 mSv) scanners and no significant difference was noted (p=0.99). However, the effective dose was significantly lower with DSCT (18.2 ± 8.3 mSv) than with SSCT (28.3 ± 7.0 mSv) in the retrospective gated protocol. Prospective ECG-triggered CCTA reduces radiation dose significantly compared to retrospective ECG-gated CCTA, while maintaining good image quality. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

[Valorisation of brachytherapy and medico-economic considerations].

PubMed

Pommier, P; Morelle, M; Millet-Lagarde, F; Peiffert, D; Gomez, F; Perrier, L

2013-04-01

Economic data in the literature for brachytherapy are still sparse and heterogeneous, with few controlled prospective studies and a perspective most often limited to those of the provider (health insurances). Moreover, these observation and conclusions are difficult to generalize in France. The prospective health economic studies performed in France in the framework of a national program to sustain innovative and costly therapies (STIC program) launched by the French cancer national institute are therefore of most importance. With the exception of prostate brachytherapy with permanent seeds, the valorisation of the brachytherapy activity by the French national health insurance does not take into account the degree of complexity and the real costs supported by health institutions (i.e. no specific valorisation for 3D image-based treatment planning and dose optimization and for the use of pulsed dose rate brachytherapy). Copyright © 2013 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

Predicting aggression in late adolescent romantic relationships: A short-term longitudinal study.

PubMed

Caiozzo, Christina N; Houston, Jessica; Grych, John

2016-12-01

This study sought to prospectively predict aggression in the romantic relationships of 1180 college students from the United States (807 females; 373 males) over the course of two months with a set of intrapersonal risk and protective factors, including personality characteristics that rarely have been examined in this population. After accounting for prior dating aggression, perpetration of verbal aggression was predicted uniquely by aggressive attitudes, emotion regulation, and for females, narcissism. Perpetration of physical aggression was predicted by aggressive attitudes, but only at low levels of emotion regulation, and the interaction of callous-unemotional traits, emotion regulation, and gender: males with low levels of callous-unemotional traits perpetrated less physical aggression when they reported greater emotion regulation. These findings are among the first to show that personality traits and emotion regulation prospectively predict partner aggression in late adolescence and suggest mechanisms for continuity in interpersonal aggression from early adolescence to adulthood. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

School lunch, policy, and environment are determinants for preventing childhood obesity: Evidence from a two-year nationwide prospective study.

PubMed

Liou, Yiing Mei; Yang, Ya-Lan; Wang, Ting-Yao; Huang, Chiu-Mieh

2015-01-01

To explore the effects of the school lunches related factors on student obesity rates. In this 2-year prospective census, we collected data on the obesity rate in 2007 and 2008 and school lunch data for 2007 from the Student Health Examination and School Health Profile Database. We used geographic information system software to collect spatial environmental data. Hierarchical regression was used to analysis data. A total of 2208 elementary and junior high schools, excluding offshore islands in Taiwan were collected. The highest obesity rate (13.5%) was observed at a school in which one school meal cost less than US$ 0.83 in 2008. The obesity rates in schools that employed dietitians were lower than in schools that did not (p<0.001 in 2007, 2008). School lunches and childhood obesity exert a greater effect on boys than on girls. Copyright © 2015 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Prospective memory impairment in multiple sclerosis: a review.

PubMed

Rouleau, Isabelle; Dagenais, Emmanuelle; Tremblay, Alexandra; Demers, Mélanie; Roger, Élaine; Jobin, Céline; Duquette, Pierre

2017-08-04

Multiple sclerosis (MS) is a progressive disease of the central nervous system affecting information processing speed, episodic memory, attention, and executive functions. MS patients also often report prospective memory (PM) failures that directly impact their functional autonomy, including professional and social life. The purpose of this paper was to review the literature concerning the assessment and remediation of PM deficits in MS. The literature pertaining to PM impairment in MS was carefully reviewed using PubMed, PsyINFO, and Google Scholar, as well as cross-references from the articles published on this topic. Since PM rehabilitation in MS patients is still in its infancy, this review mainly focuses on studies that have directly assessed PM through various measures including questionnaires, standardized clinical tests, and experimental procedures. This literature review confirms the presence of PM deficits in MS patients, even in the early stages of the disease. A further need for controlled studies on PM assessment and PM interventions in patients with MS is stressed.

Effectiveness of hyaluronic acid in post-tonsillectomy pain relief and wound healing: a prospective, double-blind, controlled clinical study.

PubMed

Hancı, Deniz; Altun, Huseyin

2015-09-01

To find the effectiveness of hyaluronic acid in post-tonsillectomy pain relief and wound healing. Fifty patients were included in this prospective, double-blind, controlled clinical study (20 males, 30 females mean age of 13.56 years). Hyaluronic acid was applied to one side and the other side was used as a control during tonsillectomy. Therefore, the same patient evaluated and scored the post-tonsillectomy pain, excluding individual bias. Results indicated that patients had significantly lower pain scores for hyaluronic acid treated side (p<0.001). At the end of two weeks follow-up period, the wound in the hyaluronic acid side was almost completely healed, indicating that the healing was faster with hyaluronic acid compared to control side (p<0.001). Hyaluronic acid could be recommended as an effective treatment for the management of post-tonsillectomy pain and wound healing. Copyright © 2015. Published by Elsevier Ireland Ltd.

Dietary habits among the JPHC study participants at baseline survey. Japan Public Health Center-based Prospective Study on Cancer and Cardiovascular Diseases.

PubMed

Tsugane, S; Sasaki, S; Kobayashi, M; Tsubono, Y; Sobue, T

2001-10-01

Dietary habit is closely associated with development of cancer and cardiovascular diseases, however little prospective evidence has been published for Japanese, whose dietary habit is substantially different from Western countries. Therefore, frequencies of food consumption, food preference, cooking method and acceptance of dietary advice were investigated at the baseline by two kinds of self-administered food frequency questionnaires. Dietary habits between urban and rural (Tokyo and Osaka vs. others), or between Okinawa and non-Okinawa revealed recognizable differences. The so-called westernized foods such as bread, beef and coffee were more consumed in the urban areas such as Tokyo and Osaka and also in Okinawa. The frequencies of salted food intake such as pickled vegetables and salted seafoods were remarkably low in Okinawa. Cooking methods for meats, seafoods and vegetables were also unique in Okinawa. No distinct geographical difference was shown in food preference and modification of dietary habit by dietary advice.

African Breast Cancer-Disparities in Outcomes (ABC-DO): protocol of a multicountry mobile health prospective study of breast cancer survival in sub-Saharan Africa.

PubMed

McKenzie, Fiona; Zietsman, Annelle; Galukande, Moses; Anele, Angelica; Adisa, Charles; Cubasch, Herbert; Parham, Groesbeck; Anderson, Benjamin O; Abedi-Ardekani, Behnoush; Schuz, Joachim; Dos Santos Silva, Isabel; McCormack, Valerie

2016-08-23

Sub-Saharan African (SSA) women with breast cancer (BC) have low survival rates from this potentially treatable disease. An understanding of context-specific societal, health-systems and woman-level barriers to BC early detection, diagnosis and treatment are needed. The African Breast Cancer-Disparities in Outcomes (ABC-DO) is a prospective hospital-based study of overall survival, impact on quality of life (QOL) and delays along the journey to diagnosis and treatment of BC in SSA. ABC-DO is currently recruiting in Namibia, Nigeria, South Africa, Uganda and Zambia. Women aged 18 years or older who present at participating secondary and tertiary hospitals with a new clinical or histocytological diagnosis of primary BC are invited to participate. For consented women, tumour characteristics, specimen and treatment data are obtained. Over a 2-year enrolment period, we aim to recruit 2000 women who, in the first instance, will be followed for between 1 and 3 years. A face-to-face baseline interview obtains information on socioeconomic, cultural and demographic factors, QOL, health and BC attitudes/knowledge, and timing of all prediagnostic contacts with caregivers in orthodox health, traditional and spiritual systems. Responses are immediately captured on mobile devices that are fed into a tailored mobile health (mHealth) study management system. This system implements the study protocol, by prompting study researchers to phone women on her mobile phone every 3 months and, failing to reach her, prompts contact with her next-of-kin. At follow-up calls, women provide updated information on QOL, care received and disease impacts on family and working life; date of death is asked of her next-of-kin when relevant. The study was approved by ethics committees of all involved institutions. All participants provide written informed consent. The findings from the study will be published in peer-reviewed scientific journals, presented to funders and relevant local organisations and at scientific conferences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Protocol of the PLeural Effusion And Symptom Evaluation (PLEASE) study on the pathophysiology of breathlessness in patients with symptomatic pleural effusions.

PubMed

Thomas, Rajesh; Azzopardi, Maree; Muruganandan, Sanjeevan; Read, Catherine; Murray, Kevin; Eastwood, Peter; Jenkins, Sue; Singh, Bhajan; Lee, Y C Gary

2016-08-03

Pleural effusion is a common clinical problem that can complicate many medical conditions. Breathlessness is the most common symptom of pleural effusion of any cause and the most common reason for pleural drainage. However, improvement in breathlessness following drainage of an effusion is variable; some patients experience either no benefit or a worsening of their breathlessness. The physiological mechanisms underlying breathlessness in patients with a pleural effusion are unclear and likely to be multifactorial with patient-related and effusion-related factors contributing. A comprehensive study of the physiological and symptom responses to drainage of pleural effusions may provide a clearer understanding of these mechanisms, and may identify predictors of benefit from drainage. The ability to identify those patients whose breathlessness will (or will not) improve after pleural fluid drainage can help avoid unnecessary pleural drainage procedures, their associated morbidities and costs. The PLeural Effusion And Symptom Evaluation (PLEASE) study is a prospective study to comprehensively evaluate factors contributing to pleural effusion-related breathlessness. The PLEASE study is a single-centre prospective study of 150 patients with symptomatic pleural effusions that require therapeutic drainage. The study aims to identify key factors that underlie breathlessness in patients with pleural effusions and develop predictors of improvement in breathlessness following effusion drainage. Participants will undergo evaluation pre-effusion and post-effusion drainage to assess their level of breathlessness at rest and during exercise, respiratory and other physiological responses as well as respiratory muscle mechanics. Pre-drainage and post-drainage parameters will be collected and compared to identify the key factors and mechanisms that correlate with improvement in breathlessness. Approved by the Sir Charles Gairdner Group Human Research Ethics Committee (HREC number 2014-079). Registered with the Australian New Zealand Clinical Trials Registry (ACTRN12616000820404). Results will be published in peer-reviewed journals and presented at scientific meetings. ACTRN12616000820404; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Child-rearing ability and the provision of fertility services: an Ethics Committee opinion.

PubMed

2017-12-01

Fertility programs may withhold services from prospective patients on the basis of well-grounded reasons that those patients will be unable to provide minimally adequate or safe care for offspring. This document was reviewed and updated; this version replaces the previous version of this document, last published July 2013 (Fertil Steril 2013;100:50-53). Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

75 FR 30917 - Medicare Program; Supplemental Proposed Changes to the Hospital Inpatient Prospective Payment...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-02

...This proposed rule is a supplement to the fiscal year (FY) 2011 hospital inpatient prospective payment systems (IPPS) and long- term care prospective payment system (LTCH PPS) proposed rule published in the May 4, 2010 Federal Register. This supplemental proposed rule would implement certain statutory provisions relating to Medicare payments to hospitals for inpatient services that are contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act). It would also specify statutorily required changes to the amounts and factors used to determine the rates for Medicare acute care hospital inpatient services for operating costs and capital-related costs, and for long-term care hospital costs.

Factors Influencing Functional Outcomes and Return-to-Work After Amputation: A Review of the Literature.

PubMed

Darter, Benjamin J; Hawley, Carolyn E; Armstrong, Amy J; Avellone, Lauren; Wehman, Paul

2018-02-03

Purpose Amputation is a life changing event that can significantly impact an individual's physical and mental well-being. Our objective was to review literature exploring the impact of amputation upon a person's functioning and inclusion in the workplace. Methods Medline, CINAHL, and PsycINFO were searched using keywords related to amputation, employment and community reintegration. Eligible studies were published since 2000 and one of the following study designs: randomized controlled trial, non-randomized controlled trial, retrospective study, prospective study, concurrent cohort study, or cross sectional study. Studies for civilians with amputation as well as service members and Veterans with amputation were considered for inclusion. Results The search identified 995 articles, 25 of which met inclusion/exclusion criteria and were included in the review. While strong evidence for correlations and predictors of outcomes after amputation were limited, multiple factors were identified as contributing to physical functioning and employment after amputation. Conclusions Outcomes after amputation can vary widely with many potentially inter-related factors contributing. The factors identified may also serve to inform the development of interventions aiming to improve functional performance and reintegration after amputation. Furthermore, the review highlights the need for more high quality prospective studies.

Shift work, job strain and changes in the body mass index among women: a prospective study.

PubMed

Fujishiro, Kaori; Lividoti Hibert, Eileen; Schernhammer, Eva; Rich-Edwards, Janet W

2017-06-01

The effects of job strain and shift work on weight gain have not been studied jointly. Cross-sectional and longitudinal studies on shift work and weight gain have reported different results. This study examines potential effect modification by job strain on the link between shift work and weight gain, and concurrent and delayed effects of shift work on weight gain. Data came from 52 622 women who participated in the Nurses' Health Study II, a prospective cohort study. Using linear regression, we modelled change in body mass index (BMI) over 4 years as a function of change in job strain, cumulative exposure to rotating night shift previously and during the 4 years (ie, previous and concurrent exposures) and the interaction between job strain and concurrent shift work exposure. Age, race/ethnicity, pregnancy history, baseline BMI, job types and health behaviours at baseline were controlled for. Job strain and rotating shift work, concurrent and previous, all had independent associations with BMI change during the 4-year period. There was no evidence for effect modification by job strain. Concurrent and previous exposures to rotating night shift had different associations with BMI change: an inverted U-shape for concurrent exposure (ranging from 0.01 to 0.14 kg/m 2 increase), a dose-response for previous exposure (-0.02 to 0.09 kg/m 2 ). Job strain and rotating night shift work have independent contributions to weight gain. Reducing job strain and supporting night shift workers are both important intervention goals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Cohort profile: cerebral palsy in the Norwegian and Danish birth cohorts (MOBAND-CP).

PubMed

Tollånes, Mette C; Strandberg-Larsen, Katrine; Forthun, Ingeborg; Petersen, Tanja Gram; Moster, Dag; Andersen, Anne-Marie Nybo; Stoltenberg, Camilla; Olsen, Jørn; Wilcox, Allen J

2016-09-02

The purpose of MOthers and BAbies in Norway and Denmark cerebral palsy (MOBAND-CP) was to study CP aetiology in a prospective design. MOBAND-CP is a cohort of more than 210 000 children, created as a collaboration between the world's two largest pregnancy cohorts-the Norwegian Mother and Child Cohort study (MoBa) and the Danish National Birth Cohort. MOBAND-CP includes maternal interview/questionnaire data collected during pregnancy and follow-up, plus linked information from national health registries. Initial harmonisation of data from the 2 cohorts has created 140 variables for children and their mothers. In the MOBAND-CP cohort, 438 children with CP have been identified through record linkage with validated national registries, providing by far the largest such sample with prospectively collected detailed pregnancy data. Several studies investigating various hypotheses regarding CP aetiology are currently on-going. Additional data can be harmonised as necessary to meet requirements of new projects. Biological specimens collected during pregnancy and at delivery are potentially available for assay, as are results from assays conducted on these specimens for other projects. The study size allows consideration of CP subtypes, which is rare in aetiological studies of CP. In addition, MOBAND-CP provides a platform within the context of a merged birth cohort of exceptional size that could, after appropriate permissions have been sought, be used for cohort and case-cohort studies of other relatively rare health conditions of infants and children. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Cryotherapy for primary treatment of prostate cancer: intermediate term results of a prospective study from a single institution.

PubMed

Rodríguez, S Alvarez; Arias Fúnez, F; Bueno Bravo, C; Rodríguez-Patrón Rodríguez, R; Sanz Mayayo, E; Palacios, V Hevia; Burgos Revilla, F J

2014-01-01

Purpose. Published data about cryotherapy for prostate cancer (PC) treatment are based on case series with a lack of clinical trials and the inexistence of a validated definition of biochemical failure. A prospective study with standardized followup protocol was conducted in our institution. Material and Methods. Prospective study of a series of cases including 108 patients diagnosed with localized PC at clinical stage T1c-T2c treated by primary cryoablation and median followup of 61 months. Criteria of biochemical recurrence were unified according to the American Society for Therapeutic Radiology and Oncology (ASTRO). End points were biochemical progression-free survival (BPFS), cancer-specific survival, and overall survival. Rate of complications was reported. Results. The BPFS for low-, medium-, and high-risk patients was 96.4%, 91.2%, and 62.2%, respectively. Cancer-specific survival was 98.1%. Overall survival reached 94.4%. Complications included incontinence in 5.6%, urinary tract obstruction in 1.9%, urethral sloughing in 5.6%, haematuria in 1.9%, perineal pain in 11.1%, and prostatorectal fistula in 0.9%. Erectile disfunction was found in 98.1%. Conclusions. Cryotherapy is an effective and minimally invasive treatment for primary PC in well-selected cases, with low surgical risk and good results in terms of BPFS, cancer-specific survival, and overall survival.

Cryotherapy for Primary Treatment of Prostate Cancer: Intermediate Term Results of a Prospective Study from a Single Institution

PubMed Central

Rodríguez, S. Alvarez; Arias Fúnez, F.; Bueno Bravo, C.; Rodríguez-Patrón Rodríguez, R.; Sanz Mayayo, E.; Palacios, V. Hevia; Burgos Revilla, F. J.

2014-01-01

Purpose. Published data about cryotherapy for prostate cancer (PC) treatment are based on case series with a lack of clinical trials and the inexistence of a validated definition of biochemical failure. A prospective study with standardized followup protocol was conducted in our institution. Material and Methods. Prospective study of a series of cases including 108 patients diagnosed with localized PC at clinical stage T1c-T2c treated by primary cryoablation and median followup of 61 months. Criteria of biochemical recurrence were unified according to the American Society for Therapeutic Radiology and Oncology (ASTRO). End points were biochemical progression-free survival (BPFS), cancer-specific survival, and overall survival. Rate of complications was reported. Results. The BPFS for low-, medium-, and high-risk patients was 96.4%, 91.2%, and 62.2%, respectively. Cancer-specific survival was 98.1%. Overall survival reached 94.4%. Complications included incontinence in 5.6%, urinary tract obstruction in 1.9%, urethral sloughing in 5.6%, haematuria in 1.9%, perineal pain in 11.1%, and prostatorectal fistula in 0.9%. Erectile disfunction was found in 98.1%. Conclusions. Cryotherapy is an effective and minimally invasive treatment for primary PC in well-selected cases, with low surgical risk and good results in terms of BPFS, cancer-specific survival, and overall survival. PMID:24693437

A low-fluence 1064-nm Q-switched neodymium-doped yttrium aluminium garnet laser for the treatment of café-au-lait macules.

PubMed

Kim, Hyeong-Rae; Ha, Jeong-Min; Park, Min-Soo; Lee, Young; Seo, Young-Joon; Kim, Chang-Deok; Lee, Jeung-Hoon; Im, Myung

2015-09-01

Café-au-lait macules (CALMs) are a common pigmentary disorder. Although a variety of laser modalities have been used to treat CALMs, their efficacies vary and dyspigmentation may develop. We evaluated the clinical efficacy and safety of a low-fluence 1064-nm Q-switched neodymium-doped yttrium aluminium garnet (Nd:YAG) laser for the treatment of CALMs. In a preliminary investigation, 6 patients underwent a split-lesion comparative study with 532- and 1064-nm Q-switched Nd:YAG laser treatment. In total, 32 patients with 39 CALMs were enrolled in a subsequent prospective trial to evaluate the treatment with a low-fluence 1064-nm Q-switched Nd:YAG laser. In the preliminary study, the 1064-nm treatment group had a more favorable response and a shorter recovery time. In a subsequent prospective trial of a 1064-nm laser, 74.4% of the lesions showed a clinical response with clearance of ≥50.0%. The treatment regimen was well tolerated; 15.4% of patients experienced adverse events. The study participants were followed for 6 months, and there were no relevant treatment controls in the prospective trial group. Low-fluence 1064-nm Q-switched Nd:YAG laser therapy afforded good clinical improvement for treating CALMs. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Bacterial meningitis in patients with HIV: A population-based prospective study.

PubMed

van Veen, Kiril E B; Brouwer, Matthijs C; van der Ende, Arie; van de Beek, Diederik

2016-03-01

We studied occurrence, disease course, and prognosis of community-acquired bacterial meningitis in HIV-infected adults in the Netherlands. We performed a nationwide, prospective cohort study. Patients over 16 years old with bacterial meningitis were included. Data on patient history, symptoms and signs on admission, laboratory findings, radiologic examination, treatment, and outcome were collected prospectively. For HIV-positive patients additional information was collected retrospectively. From March 2006 to December 2013, 1354 episodes of community-acquired meningitis were included in the cohort. Thirteen patients were HIV-infected (1.0%). The annual incidence of bacterial meningitis was 8.3-fold higher (95%CI 4.6-15.1, P < 0.001) among HIV-infected patients as compared to the general population (10.79 [95%CI 5.97-19.48] vs 1.29 [95%CI 1.22-1.37] per 100.000 patients per year). Predisposing factors (other than HIV), clinical symptoms and signs, ancillary investigations, causative organisms and outcome were comparable between HIV-infected and patients without HIV infection. HIV-infected patients in the Netherlands have a 8.3-fold higher risk for bacterial meningitis as compared to the general population despite cART therapy. Clinical presentation and outcome of patients with acute bacterial meningitis with and without HIV are similar. Copyright © 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Rotavirus genotypes in Malaysia and Universal rotavirus vaccination

PubMed Central

Lee, Way Seah; Lim, Benjamin Tze Ying; Chai, Pei Fan; Kirkwood, Carl D.; Lee, Jimmy Kok Foo

2012-01-01

Group A rotavirus (RV-A) genotypes isolated in Malaysia was studied to estimate the effectiveness of a universal RV-A vaccination in Malaysia. A simple mathematical model was used, with input from a two-year, two-center, prospective study on hospitalization of RV-A gastroenteritis (RVGE) in young children, published data on RV-A hospitalizations and genotypes, mortality on childhood GE and published genotype-specific efficacy data on two RV-A vaccines. Assuming a 95% vaccine coverage, the overall projected effectiveness was 75.7 to 88.1% for Rotateq® and 78.7 to 90.6% for Rotarix® against RVGE-related hospitalizations. The projected annual reduction in RVGE-related deaths was 27 to 32 deaths (from 34 deaths) for Rotateq® and 28 to 32 deaths annually forRotarix®. A universal RV-A vaccine is efficacious in reducing RVGE-related hospitalizations and mortality in Malaysia. PMID:23022710

Current issues in the economics of vaccination against dengue.

PubMed

Tozan, Yesim

2016-01-01

Dengue is a major public health concern in tropical and subtropical areas of the world. The prospects for dengue prevention have recently improved with the results of efficacy trials of a tetravalent dengue vaccine. Although partially effective, once licensed, its introduction can be a public health priority in heavily affected countries because of the perceived public health importance of dengue. This review explores the most immediate economic considerations of introducing a new dengue vaccine and evaluates the published economic analyses of dengue vaccination. Findings indicate that the current economic evidence base is of limited utility to support country-level decisions on dengue vaccine introduction. There are a handful of published cost-effectiveness studies and no country-specific costing studies to project the full resource requirements of dengue vaccine introduction. Country-level analytical expertise in economic analyses, another gap identified, needs to be strengthened to facilitate evidence-based decision-making on dengue vaccine introduction in endemic countries.

Red and Processed Meat and Colorectal Cancer Incidence: Meta-Analysis of Prospective Studies

PubMed Central

Chan, Doris S. M.; Lau, Rosa; Aune, Dagfinn; Vieira, Rui; Greenwood, Darren C.; Kampman, Ellen; Norat, Teresa

2011-01-01

Background The evidence that red and processed meat influences colorectal carcinogenesis was judged convincing in the 2007 World Cancer Research Fund/American Institute of Cancer Research report. Since then, ten prospective studies have published new results. Here we update the evidence from prospective studies and explore whether there is a non-linear association of red and processed meats with colorectal cancer risk. Methods and Findings Relevant prospective studies were identified in PubMed until March 2011. For each study, relative risks and 95% confidence intervals (CI) were extracted and pooled with a random-effects model, weighting for the inverse of the variance, in highest versus lowest intake comparison, and dose-response meta-analyses. Red and processed meats intake was associated with increased colorectal cancer risk. The summary relative risk (RR) of colorectal cancer for the highest versus the lowest intake was 1.22 (95% CI  = 1.11−1.34) and the RR for every 100 g/day increase was 1.14 (95% CI  = 1.04−1.24). Non-linear dose-response meta-analyses revealed that colorectal cancer risk increases approximately linearly with increasing intake of red and processed meats up to approximately 140 g/day, where the curve approaches its plateau. The associations were similar for colon and rectal cancer risk. When analyzed separately, colorectal cancer risk was related to intake of fresh red meat (RR for 100 g/day increase  = 1.17, 95% CI  = 1.05−1.31) and processed meat (RR for 50 g/day increase  = 1.18, 95% CI  = 1.10−1.28). Similar results were observed for colon cancer, but for rectal cancer, no significant associations were observed. Conclusions High intake of red and processed meat is associated with significant increased risk of colorectal, colon and rectal cancers. The overall evidence of prospective studies supports limiting red and processed meat consumption as one of the dietary recommendations for the prevention of colorectal cancer. PMID:21674008

Associations between fruit, vegetable and legume intakes and prostate cancer risk: results from the prospective Supplémentation en Vitamines et Minéraux Antioxydants (SU.VI.MAX) cohort.

PubMed

Diallo, Abou; Deschasaux, Mélanie; Galan, Pilar; Hercberg, Serge; Zelek, Laurent; Latino-Martel, Paule; Touvier, Mathilde

2016-05-01

Although experimental studies suggest that fruits, vegetables and legumes may exert protective effects against prostate carcinogenesis through various bioactive compounds such as dietary fibre and antioxidants, epidemiological evidence is lacking. Notably, very few prospective studies have investigated the relationship between legume intake and prostate cancer risk. Our objective was to prospectively investigate the association between fruit, vegetable, tomato products, potatoes and legume intakes and prostate cancer risk. This study included 3313 male participants to the SUpplémentation en VItamines et Minéraux AntioXydants cohort (follow-up: 1994-2007) who completed at least three 24-h dietary records during the first 2 years of follow-up. Associations between tertiles of intake and prostate cancer risk were assessed by multivariate Cox proportional hazards models. After a median follow-up of 12·6 years, 139 incident prostate cancers were diagnosed. An inverse association was observed between prostate cancer risk and tertiles of legume intake (hazard ratio (HR)T3v.T1=0·53; 95 % CI 0·34, 0·85; P trend=0·009). This association was maintained after excluding soya and soya products from the legume group (HRT3 v.T1=0·56; 95 % CI 0·35, 0·89; P trend=0·02). No association was observed between prostate cancer risk and tertiles of intakes of fruits (P trend=0·25), vegetables (P trend=0·91), potatoes (P trend=0·77) and tomato products (P trend=0·09). This prospective study confirms the null association between fruit and non-starchy vegetable intakes and prostate cancer risk observed in most previous cohorts. In contrast, although very few prospective studies have been published on the topic, our results suggest an inverse association between legume intake and prostate cancer risk, supported by mechanistic plausibility. These results should be confirmed by large-scale observational and intervention studies.

Cost-effectiveness of alternative strategies for interferon-γ release assays and tuberculin skin test in tuberculous uveitis.

PubMed

Ang, Marcus; Nguyen, Hai V; Kiew, Sieh Yean; Chen, Shu; Chee, Soon-Phaik; Finkelstein, Eric

2015-07-01

Although tuberculous uveitis remains a major cause of ocular morbidity in the developing world, there is no consensus on which diagnostic test or testing strategy is the most cost effective. In this study we carried out a cost-effectiveness analysis to determine the most cost-effective diagnostic test strategy. In this prospective study, we recruited 102 patients from Singapore National Eye Centre with signs suggestive of tuberculous uveitis. Using prospective data from this cohort and from published meta-analyses, we modelled the incremental cost effectiveness of the following strategies: tuberculin skin test (TST) only; interferon-γ release assay (IGRA) only; IGRA following a positive TST result; and dual-test strategy, conducting TST and IGRA at presentation. Incremental cost-effectiveness ratios (ICERs) were calculated for each strategy and analysed using a willingness-to-pay threshold of $50,000 per quality-adjusted life year (QALY) gained. In our population, the least cost effective was the IGRA-only strategy. The dual-test strategy was the most cost effective, with an improvement of 0.017 QALY at an incremental cost of $190 relative to the TST-only strategy (ICER $11,500); while the TST-only strategy was more cost effective than the third strategy, using IGRA following a positive TST result (ICER $3610). This remained consistent while varying the costs of IGRA and TST, the incidence of tuberculosis and tuberculous uveitis, as well as the diagnostic accuracy of IGRA and TST found in previous studies in various populations. The dual-test strategy (performing TST and IGRA at presentation) was the most cost effective strategy for the diagnosis of tuberculous uveitis in our population. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Study protocol for a framework analysis using video review to identify latent safety threats: trauma resuscitation using in situ simulation team training (TRUST).

PubMed

Fan, Mark; Petrosoniak, Andrew; Pinkney, Sonia; Hicks, Christopher; White, Kari; Almeida, Ana Paula Siquiera Silva; Campbell, Douglas; McGowan, Melissa; Gray, Alice; Trbovich, Patricia

2016-11-07

Errors in trauma resuscitation are common and have been attributed to breakdowns in the coordination of system elements (eg, tools/technology, physical environment and layout, individual skills/knowledge, team interaction). These breakdowns are triggered by unique circumstances and may go unrecognised by trauma team members or hospital administrators; they can be described as latent safety threats (LSTs). Retrospective approaches to identifying LSTs (ie, after they occur) are likely to be incomplete and prone to bias. To date, prospective studies have not used video review as the primary mechanism to identify any and all LSTs in trauma resuscitation. A series of 12 unannounced in situ simulations (ISS) will be conducted to prospectively identify LSTs at a level 1 Canadian trauma centre (over 800 dedicated trauma team activations annually). 4 scenarios have already been designed as part of this protocol based on 5 recurring themes found in the hospital's mortality and morbidity process. The actual trauma team will be activated to participate in the study. Each simulation will be audio/video recorded from 4 different camera angles and transcribed to conduct a framework analysis. Video reviewers will code the videos deductively based on a priori themes of LSTs identified from the literature, and/or inductively based on the events occurring in the simulation. LSTs will be prioritised to target interventions in future work. Institutional research ethics approval has been acquired (SMH REB #15-046). Results will be published in peer-reviewed journals and presented at relevant conferences. Findings will also be presented to key institutional stakeholders to inform mitigation strategies for improved patient safety. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Psychological aptitude evaluation of the special forces candidate.

PubMed

Genoni, Luca; Jelmini, F; Lang, M; Muggli, F

2017-02-01

Changes in recruitment procedures reduced early dismissal rates from Swiss military basic recruitment schools; however, such improvements were not reflected in premature discharge rates from the special forces (SF) (Grenadier) recruitment school. A six-item questionnaire designed to identify recruits likely to be subject to premature dismissal on psychological or psychiatric grounds was developed and prospectively validated. The questionnaire was based on an analysis of medical and psychiatric/psychological records of 26 recruits dismissed from a SF recruitment school. Six items were identified that appeared to have prognostic value for early discharge. These six questions were submitted to the remaining applicants in the recruitment school by a suitably qualified psychologist or psychiatrist and effectively identified candidates who would be discharged early. Based on these results a 0-6 scale was developed and applied prospectively to subsequent Grenadier recruitment courses. Statistical analysis showed that 75% of candidates with the lowest scores would eventually complete the course and that no candidates with highest scores would subsequently complete the recruitment course. Prospective studies in subsequent recruitment courses candidates with high scores were classified as not qualified to enter the course, and those with intermediate scores were subject to additional in-depth interviews with a psychologist or psychiatrist to determine their suitability. In the following courses a correlation was established between the questionnaire score and week of discharge for those discharged. Application of this method during subsequent recruitment courses has reduced early dismissal from Swiss SF recruitment schools. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Prospective relationships between body weight and physical activity: an observational analysis from the NAVIGATOR study.

PubMed

Preiss, David; Thomas, Laine E; Wojdyla, Daniel M; Haffner, Steven M; Gill, Jason M R; Yates, Thomas; Davies, Melanie J; Holman, Rury R; McMurray, John J; Califf, Robert M; Kraus, William E

2015-08-14

While bidirectional relationships exist between body weight and physical activity, direction of causality remains uncertain and previous studies have been limited by self-reported activity or weight and small sample size. We investigated the prospective relationships between weight and physical activity. Observational analysis of data from the Nateglinide And Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) study, a double-blinded randomised clinical trial of nateglinide and valsartan, respectively. Multinational study of 9306 participants. Participants with biochemically confirmed impaired glucose tolerance had annual measurements of both weight and step count using research grade pedometers, worn for 7 days consecutively. Along with randomisation to valsartan or placebo plus nateglinide or placebo, participants took part in a lifestyle modification programme. Longitudinal regression using weight as response value and physical activity as predictor value was conducted, adjusted for baseline covariates. Analysis was then repeated with physical activity as response value and weight as predictor value. Only participants with a response value preceded by at least three annual response values were included. Adequate data were available for 2811 (30%) of NAVIGATOR participants. Previous weight (χ(2)=16.8; p<0.0001), but not change in weight (χ(2)=0.1; p=0.71) was inversely associated with subsequent step count, indicating lower subsequent levels of physical activity in heavier individuals. Change in step count (χ(2)=5.9; p=0.02) but not previous step count (χ(2)=0.9; p=0.34) was inversely associated with subsequent weight. However, in the context of trajectories already established for weight (χ(2) for previous weight measurements 747.3; p<0.0001) and physical activity (χ(2) for previous step count 432.6; p<0.0001), these effects were of limited clinical importance. While a prospective bidirectional relationship was observed between weight and physical activity, the magnitude of any effect was very small in the context of natural trajectories already established for these variables. NCT00097786. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Five-year follow-up of a prospective non-randomised study comparing duodenum-preserving pancreatic head resection with classic Whipple procedure in the treatment of chronic pancreatitis.

PubMed

Möbius, C; Max, D; Uhlmann, D; Gumpp, K; Behrbohm, J; Horvath, K; Hauss, J; Witzigmann, H

2007-05-01

Three prospective randomised studies were conducted to compare pancreatoduodenectomy (PD) with duodenum-preserving pancreatic head resection (DPPHR) in patients suffering from chronic pancreatitis (cP). In these three series, the superiority of the duodenum-preserving technique with regard to quality of life (QOL) and pain relief has been demonstrated. Long-term follow-up investigations have not been published so far. The present paper reports on a 5-year follow-up study of a prospective, non-randomised trial comparing classic Whipple procedure (PD) with Beger DPPHR. Seventy patients were initially enrolled in this study. Fifty-one patients were left for the present long-term outcome analysis (PD, n = 24; DPPHR, n = 27). The follow-up included the following parameters: QOL, pain intensity, endocrine and exocrine function, and body mass index (BMI). The median follow-up was 63.5 (range 56-67) months. Two patients in the DPPHR group and none in the PD group underwent a re-operation. The QOL scores of the relevant symptom scales (nausea, pain, diarrhoea) and functional parameters (physical status, working ability, global QOL) were significantly better in the DPPHR group than in the PD group. Pain intensity as self-assessed by the patients was less pronounced in the DPPHR group (P < 0.001), whereas the frequency of acute episodes and analgesic medication did not differ between the two groups. No difference was observed between the two groups with regard to endocrine and exocrine function. The values of the median body mass index (BMI) in the PD group [23.4 (range 18.5-25.0) kg/m(2)] and in the DPPHR group [24.2 (range 17.9-27.8) kg/m(2)] were comparable. The 5-year outcome remained stable compared to the early post-operative data published elsewhere. This 5-year long-term outcome analysis documents the superiority of the Beger duodenum-preserving technique over the classic Whipple procedure in terms of QOL and pain intensity as self-assessed by the patients.

Refining Ovarian Cancer Test accuracy Scores (ROCkeTS): protocol for a prospective longitudinal test accuracy study to validate new risk scores in women with symptoms of suspected ovarian cancer.

PubMed

Sundar, Sudha; Rick, Caroline; Dowling, Francis; Au, Pui; Snell, Kym; Rai, Nirmala; Champaneria, Rita; Stobart, Hilary; Neal, Richard; Davenport, Clare; Mallett, Susan; Sutton, Andrew; Kehoe, Sean; Timmerman, Dirk; Bourne, Tom; Van Calster, Ben; Gentry-Maharaj, Aleksandra; Menon, Usha; Deeks, Jon

2016-08-09

Ovarian cancer (OC) is associated with non-specific symptoms such as bloating, making accurate diagnosis challenging: only 1 in 3 women with OC presents through primary care referral. National Institute for Health and Care Excellence guidelines recommends sequential testing with CA125 and routine ultrasound in primary care. However, these diagnostic tests have limited sensitivity or specificity. Improving accurate triage in women with vague symptoms is likely to improve mortality by streamlining referral and care pathways. The Refining Ovarian Cancer Test Accuracy Scores (ROCkeTS; HTA 13/13/01) project will derive and validate new tests/risk prediction models that estimate the probability of having OC in women with symptoms. This protocol refers to the prospective study only (phase III). ROCkeTS comprises four parallel phases. The full ROCkeTS protocol can be found at http://www.birmingham.ac.uk/ROCKETS. Phase III is a prospective test accuracy study. The study will recruit 2450 patients from 15 UK sites. Recruited patients complete symptom and anxiety questionnaires, donate a serum sample and undergo ultrasound scored as per International Ovarian Tumour Analysis (IOTA) criteria. Recruitment is at rapid access clinics, emergency departments and elective clinics. Models to be evaluated include those based on ultrasound derived by the IOTA group and novel models derived from analysis of existing data sets. Estimates of sensitivity, specificity, c-statistic (area under receiver operating curve), positive predictive value and negative predictive value of diagnostic tests are evaluated and a calibration plot for models will be presented. ROCkeTS has received ethical approval from the NHS West Midlands REC (14/WM/1241) and is registered on the controlled trials website (ISRCTN17160843) and the National Institute of Health Research Cancer and Reproductive Health portfolios. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Novel imaging detailing the origins of a pneumothorax.

PubMed

Nakanishi, Kozo; Goto, Hidenori; Ito, Tomokazu; Nagata, Yasuhito; Hayashi, Shinichi; Ishihara, Toshihiro

2018-01-01

This is a prospective clinical study aimed at introducing a method to visualise the location of an air leak and to identify the bulla responsible on three-dimensional (3-D) cine CT. In 10 patients with spontaneous pneumothorax, dynamic 320-detector row CT was performed with injection of 0.9% saline into the affected pleural cavity via a preplaced chest tube. In eight cases, 3-D cine CT thoracography revealed the location of the air leak and the bulla responsible (7 cases: air stream sign; 1 case: repeated collapse and expansion of a bulla with the patient's breathing). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

ART and uterine pathology: how relevant is the maternal side for implantation?

PubMed

Galliano, Daniela; Bellver, José; Díaz-García, César; Simón, Carlos; Pellicer, Antonio

2015-01-01

Assisted reproduction technology (ART) has become a standard treatment for infertile couples. Increased success rates obtained over the years have resulted primarily from improved embryo quality, but implantation rates still remain lower than expected. The uterus, an important player in implantation, has been frequently neglected. While a number of uterine pathologies have been associated with decreased natural fertility, less information exists regarding the impact of these pathologies in ART. This report reviews the evidence to help clinicians advise ART patients. An electronic search of PubMed and EMBASE was performed to identify articles in the English, French or Spanish language published until May 2014 which addressed uterine pathology and ART. Data from natural conception were used only in the absence of data from ART. Studies were classified in decreasing categories: RCTs, prospective controlled trials, prospective non-controlled trials, retrospective studies and experimental studies. Studies included in lower categories were only used if insufficient evidence was available. Pooled data were obtained from systematic reviews with meta-analyses when available. The summary of the evidence for the different outcomes and the degree of the recommendation for interventions were based on the GRADE (Grading of Recommendations Assessment, Development and Evaluation) statement recommendations. There is strong evidence that surrogacy is effective for uterine agenesia. For the remaining pathologies, however, there is very little evidence that the established treatments improve outcomes, or that these pathologies have a negative effect on ART. In the presence of an apparently normal uterus, assessing endometrial receptivity (ER) is the goal; however diagnostic tests are still under development. The real effect of different uterine/endometrial integrity pathologies on ART is not known. Moreover, currently proposed treatments are not based on solid evidence, and little can be done to assess ER in normal or abnormal conditions. No strong recommendations can be given based on the published experience, bringing an urgent need for well-designed studies. In this context, we propose algorithms to study the uterus in ART. © The Author 2014. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The accuracy of the general practitioner's sense of alarm when confronted with dyspnoea and/or thoracic pain: protocol for a prospective observational study.

PubMed

Barais, Marie; Barraine, Pierre; Scouarnec, Florie; Mauduit, Anne Sophie; Le Floc'h, Bernard; Van Royen, Paul; Liétard, Claire; Stolper, Erik

2015-03-10

Dyspnoea and chest pain are signs shared with multiple pathologies ranging from the benign to life-threatening diseases. Gut feelings such as the sense of alarm and the sense of reassurance are known to play a substantial role in the diagnostic reasoning of general practitioners (GPs). A Gut Feelings Questionnaire (GFQ) has been validated to measure the GP's sense of alarm. A French version of the GFQ is available following a linguistic validation procedure. The aim of the study is to calculate the diagnostic test accuracy of a GP's sense of alarm when confronted with dyspnoea and chest pain. Prospective observational study. Patients aged between 18 and 80 years, consulting their GP for dyspnoea and/or thoracic pain will be considered for enrolment in the study. These GPs will have to complete the questionnaire immediately after the consultation for dyspnoea and/or thoracic pain. The follow-up and the final diagnosis will be collected 4 weeks later by phone contact with the GP or with the patient if their GP has no information. Life-threatening and non-life-threatening diseases have previously been defined according to the pathologies or symptoms in the (ICPC2) International Collegiate Programming Contest classification. Members of the research team, blinded to the actual outcomes shown on the index questionnaire, will judge each case in turn and will, by consensus, classify the expected outcomes as either life-threatening or non-life-threatening diseases. The sensitivity, the specificity, the positive and negative likelihood ratio of the sense of alarm will be calculated from the constructed contingency table. This study was approved by the ethical committee of the University de Bretagne Occidentale. A written informed consent form will be signed and dated by GPs and patients at the beginning of the study. The results will be published in due course. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Medicare's prospective payment system: A critical appraisal

PubMed Central

Coulam, Robert F.; Gaumer, Gary L.

1992-01-01

Implementation of the Medicare prospective payment system (PPS) for hospital payment has produced major changes in the hospital industry and in the way hospital services are used by physicians and their patients. The substantial published literature that examines these changes is reviewed in this article. This literature suggests that most of the intended effects of PPS on costs and intensity of care have been realized. But the literature fails to answer fundamental questions about the effectiveness and equity of administered pricing as a policy tool for cost containment. The literature offers some hope that the worst fears about the effects of PPS on quality of care and the health of the hospital industry have not materialized. But because of data lags, the studies done to date seem to tell us more about the effects of the early, more generous period of PPS than about the opportunity costs of reducing hospital cost inflation. PMID:25372306

Running away from stress: How regulatory modes prospectively affect athletes' stress through passion.

PubMed

Lucidi, F; Pica, G; Mallia, L; Castrucci, E; Manganelli, S; Bélanger, J J; Pierro, A

2016-06-01

A prospective field study conducted with runners training for an upcoming marathon (Marathon of Rome 2013) examined the relation between regulatory modes, locomotion and assessment, and stress. Integrating regulatory mode theory and the dualistic model of passion, we hypothesized that the relation between regulatory modes (evaluated 3 months before the race) and the experience of stress approaching the marathon, is mediated by the type of passion (harmonious vs obsessive) athletes experience with regard to marathoning. Results revealed that (a) locomotion positively predicted harmonious passion, which in turn reduced athletes' experience of stress; and (b) assessment positively predicted obsessive passion, which in turn enhanced athletes' experience of stress. Overall, the present results suggest that proximal psychological mechanisms such as basic regulatory mode orientations can predict distal outcomes such as stress indirectly through their relation with motivational phenomena such as passion. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Three-dimensional vascular imaging of proliferative diabetic retinopathy by Doppler optical coherence tomography.

PubMed

Miura, Masahiro; Hong, Young-Joo; Yasuno, Yoshiaki; Muramatsu, Daisuke; Iwasaki, Takuya; Goto, Hiroshi

2015-03-01

To evaluate the 3-dimensional architecture of neovascularization in proliferative diabetic retinopathy using Doppler optical coherence tomography (OCT). Prospective, nonrandomized clinical trial. Seventeen eyes of 14 patients with proliferative diabetic retinopathy were prospectively studied. Prototype Doppler OCT was used to evaluate the 3-dimensional vascular architecture at vitreoretinal adhesions. Proliferative membranes were detected in all eyes with proliferative diabetic retinopathy by standard OCT images. Doppler OCT images detected blood flow by neovascularization of the disc in 12 eyes and neovascularization elsewhere in 11 eyes. Doppler OCT images showed the 3-dimensional extent of new vessels at various stages of neovascularization, and the extent of new vessels could be clearly confirmed at vitreoretinal adhesions. Doppler OCT is useful for the detection and evaluation of the 3-dimensional vascular structure of neovascularization, and can assist in the noninvasive assessment of proliferative diabetic retinopathy. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Quality of reporting in oncology studies: A systematic analysis of literature reviews and prospects.

PubMed

Rivoirard, Romain; Bourmaud, Aurélie; Oriol, Mathieu; Tinquaut, Fabien; Méry, Benoîte; Langrand-Escure, Julien; Vallard, Alexis; Fournel, Pierre; Magné, Nicolas; Chauvin, Franck

2017-04-01

The present review gives an overview of systematic reviews published in peer reviewed Journals analysing quality of reporting in oncology studies. PUBMED and Cochrane library were searched to identify systematic reviews assessing quality of reporting for randomized controlled trials (RCTs) and observational studies (OBS). Recommendations and primary endpoints used to assess the quality of reporting were described. Intrinsic quality of reporting was analyzed using an Overall Quality Score for literature Reviews (OQSR). Main evaluation themes were overall quality of reporting (20/58) and reporting of Health-Related Quality Of Life (HRQOL) in RCTs (7/58). Reporting recommendations used were not detailed in 56.9% of reviews. Insufficient reporting for the methodological description (randomization, blinding details, and allocation concealment) and the rationale for using specific measure of HRQOL were highlighted. OQSR was significantly higher for reviews published between 2010 and 2014 (after the PRISMA Publication), as compared to those published between 1996-2009 (median OQSR 10 (10-11) versus median OQSR 9 (6-10) respectively, p=0.0053). Intrinsic quality of reporting is satisfactory and has been improved in the last years. Copyright © 2017 Elsevier B.V. All rights reserved.

Association between Work-Related Stress and Risk for Type 2 Diabetes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies.

PubMed

Sui, Hua; Sun, Nijing; Zhan, Libin; Lu, Xiaoguang; Chen, Tuo; Mao, Xinyong

2016-01-01

The prevalence of type 2 diabetes is increasing rapidly around the world. Work-related stress is thought to be a major risk factor for type 2 diabetes; however, this association has not been widely studied, and the findings that have been reported are inconsistent. Therefore, we conducted a meta-analysis of prospective cohort studies to explore the association between work-related stress and risk for type 2 diabetes. A systematic literature search and manual search limited to articles published in English were performed to select the prospective cohort studies evaluated the association between work-related stress and risk for type 2 diabetes up to September 2014 from four electronic databases including PubMed, EMBASE, the Cochrane Library and Web of Science. A random-effects model was used to estimate the overall risk. No significant association was found between work-related stress and risk for type 2 diabetes based on meta-analysis of seven prospective cohort studies involving 214,086 participants and 5,511 cases (job demands: relative risk 0.94 [95% confidence interval 0.72-1.23]; decision latitude: relative risk 1.16 [0.85-1.58]; job strain: relative risk 1.12 [.0.95-1.32]). However, an association between work-related stress and risk for type 2 diabetes was observed in women (job strain: relative risk 1.22 [1.01-1.46]) (P = 0.04). A sensitivity analysis conducted by excluding one study in each turn yielded similar results. No publication bias was detected with a funnel plot despite the limited number of studies included in the analysis. The results of this meta-analysis did not confirm a direct association between work-related stress and risk for type 2 diabetes. In subgroup analyses we found job strain was a risk factor for type 2 diabetes in women.

Statistics of Petroleum Exploration in the World Outside the United States and Canada Through 2001

USGS Publications Warehouse

Attanasi, E.D.; Freeman, P.A.; Glovier, Jennifer A.

2007-01-01

Future oil and gas supplies depend, in part, on the reserves that are expected to be added through exploration and new discoveries. This Circular presents a summary of the statistics and an analysis of petroleum exploration in the world outside the United States and Canada (the study area) through 2001. It updates U.S. Geological Survey Circular 1096 (by E.D. Attanasi and D.H. Root, 1993) and expands coverage of the statistics to areas where drilling and discovery data have recently become available. These new areas include China, the formerly Communist countries of Eastern Europe, and the countries that once were part of the former Soviet Union in Europe and Asia. Data are presented by country but are organized by petroleum provinces delineated by the U.S. Geological Survey World Energy Assessment Team (USGS Digital Data Series DDS?60, published in 2000). The data and analysis are presented in maps and graphs, providing a visual summary of the exploration maturity of an area. The maps show the delineated prospective areas and explored areas through 2001; explored areas have a drilling density that would rule out the occurrence of undetected large petroleum accumulations. Graphs summarize the exploration yields in terms of cumulative recoverable discovered oil and gas by delineated prospective area. From 1992 through 2001 in areas outside the United States and Canada, the delineated prospective area expanded at a rate of about 50,000 square miles per year while the explored area grew at the rate of about 11,000 square miles per year. The delineated prospective area established by 1970 contains about 75 percent of the oil discovered to date in the study area. This area is slightly less than 40 percent of the delineated prospective area established through 2001. Maps and graphs show the extension of the delineated prospective area to deepwater areas offshore of Brazil and West Africa. From 1991 through 2000, offshore discoveries accounted for 59 percent of the oil and 77 percent of the gas discovered in the study area. The petroleum industry's decision to incur the greater costs of moving offshore and into deeper waters appears to be a response to the absence of onshore prospects of comparable quality. Where natural gas can be commercially developed and marketed, data show an expansion of exploration to target gas-prone areas.

[Prognostic scores for pulmonary embolism].

PubMed

Junod, Alain

2016-03-23

Nine prognostic scores for pulmonary embolism (PE), based on retrospective and prospective studies, published between 2000 and 2014, have been analyzed and compared. Most of them aim at identifying PE cases with a low risk to validate their ambulatory care. Important differences in the considered outcomes: global mortality, PE-specific mortality, other complications, sizes of low risk groups, exist between these scores. The most popular score appears to be the PESI and its simplified version. Few good quality studies have tested the applicability of these scores to PE outpatient care, although this approach tends to already generalize in the medical practice.

Sport and scholastic factors in relation to smoking and smoking initiation in older adolescents: a prospective cohort study in Bosnia and Herzegovina.

PubMed

Sekulic, Damir; Sisic, Nedim; Terzic, Admir; Jasarevic, Indira; Ostojic, Ljerka; Pojskic, Haris; Zenic, Natasa

2017-03-22

Sport and scholastic factors are known to be associated with cigarette smoking in adolescence, but little is known about the causality of this association. The aim of this study was to prospectively explore the relationships of different sport and scholastic factors with smoking prevalence initiation in older adolescents from Bosnia and Herzegovina. In this 2-year prospective cohort study, there were 872 adolescent participants (16 years at baseline; 46% females). The study consisted of baseline tests at the beginning of the third year (September 2013) and follow-up at the end of the fourth year of high school (late May to early June 2015). The independent variables were scholastic and sport-related factors. The dependent variables were (1) smoking at baseline, (2) smoking at follow-up and (3) smoking initiation over the course of the study. Logistic regressions controlling for age, gender and socioeconomic status were applied to define the relationships between independent and dependent variables. School absence at the baseline study was a significant predictor of smoking initiation during the course of the study (OR 1.4, 95% CI 1.1 to 1.8). Those who reported quitting sports at baseline showed an increased risk of smoking at the end of the study (OR 1.4, 95% CI 1.1 to 2.0) and of smoking initiation (OR 1.8, 95% CI 1.3 to 2.0). Adolescents who reported lower competitive achievements in sport were at a higher risk of (1) smoking at baseline (OR 1.5, 95% CI 1.1 to 2.1), (2) smoking at follow-up (OR 1.5, 95% CI 1.1 to 2.1) and (3) smoking initiation (OR 1.6, 95% CI 1.1 to 2.6). In developing accurate antismoking public health policies for older adolescents, the most vulnerable groups should be targeted. The results showed that most participants initiated smoking before 16 years of age. Therefore, further investigations should evaluate the predictors of smoking in younger ages. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Healthcare-associated infections in pediatric cancer patients: results of a prospective surveillance study from university hospitals in Germany and Switzerland.

PubMed

Simon, Arne; Ammann, Roland A; Bode, Udo; Fleischhack, Gudrun; Wenchel, Hans-Martin; Schwamborn, Dorothee; Gravou, Chara; Schlegel, Paul-Gerhardt; Rutkowski, Stefan; Dannenberg, Claudia; Körholz, Dieter; Laws, Hans Jürgen; Kramer, Michael H

2008-05-23

Pediatric cancer patients face an increased risk of healthcare-associated infection (HAI). To date, no prospective multicenter studies have been published on this topic. Prospective multicenter surveillance for HAI and nosocomial fever of unknown origin (nFUO) with specific case definitions and standardized surveillance methods. 7 pediatric oncology centers (university facilities) participated from April 01, 2001 to August 31, 2005. During 54,824 days of inpatient surveillance, 727 HAIs and nFUOs were registered in 411 patients. Of these, 263 (36%) were HAIs in 181 patients, for an incidence density (ID) (number of events per 1,000 inpatient days) of 4.8 (95% CI 4.2 to 5.4; range 2.4 to 11.7; P < 0.001), and 464 (64%) were nFUO in 230 patients. Neutropenia at diagnosis correlated significantly with clinical severity of HAI. Of the 263 HAIs, 153 (58%) were bloodstream infections (BSI). Of the 138 laboratory-confirmed BSIs, 123 (89%) were associated with use of a long-term central venous catheter (CVAD), resulting in an overall ID of 2.8 per 1,000 utilization days (95% CI 2.3 to 3.3). The ID was significantly lower in Port-type than in Hickman-type CVADs. The death of 8 children was related to HAI, including six cases of aspergillosis. The attributable mortality was 3.0% without a significant association to neutropenia at time of NI diagnosis. Our study confirmed that pediatric cancer patients are at an increased risk for specific HAIs. The prospective surveillance of HAI and comparison with cumulative multicenter results are indispensable for targeted prevention of these adverse events of anticancer treatment.

Low Risk of Injuries in Young Adolescents Participating in Top-Level Karate Competition.

PubMed

Arriaza, Rafael; Inman, David; Arriaza, Alvaro; Saavedra, Miguel A

2016-02-01

Prospective studies on injuries in martial arts competition are scarce, especially those involving young practitioners, but the upsurge of children and adolescents taking part in organized training and competition in these sports requires clarification of the injury risk that they represent for youths. Top-level karate competition for young adolescents (cadets, or 14- to 15-year-olds) has a low injury rate and can be safely promoted. Descriptive epidemiological study. Prospective recording of the injuries resulting from all bouts in 3 consecutive World Karate Championships (2009, 2011, and 2013) for cadets was performed. Data were collected prospectively in situ with checklists that described competitor sex, bout category, and weight as well as injured area, diagnosis, mechanism of injury, severity, and treatment. A total of 1020 bouts were reviewed, 671 in the male category and 349 in the female category. A total of 61 injuries were recorded. Of those, only 3 were time-loss injuries. During the 2009 and 2011 championships, there was 1 injury per 25.6 fights, while during the 2013 championship the number of injuries increased, with 1 injury per 10 fights (P = .003). There was no statistical difference in the total injury rate between the male and female categories (P = .71), with an odds ratio of 1.16 (95% CI, 0.52-2.55). The injury rate for cadet top-level karate competition found in this prospective study is much lower than the rates previously published for karate or other martial arts competitions, but there seems to be a marked increase as more championships are held, which is a matter of concern. © 2015 The Author(s).

Partial breast radiation for early-stage breast cancer.

PubMed

McCormick, Beryl

2012-02-01

This review is to provide an update on the current status of partial breast irradiation (PBI) for women presenting with early-stage breast cancer, as an alternate radiation technique to fractionated, whole breast radiation, following conservation surgery. As more women are asking for and receiving this treatment, both on and off protocols, understanding recent additions to the literature is important to physicians caring for this patient population. Newly published retrospective studies, with follow-up times out to 10 years and the status of both recently completed and still open large prospective phase III trials will be covered, with emphasis on unexpected side effects reported, and some hypothesis-generating radiobiology observations. A recent consensus treatment guideline for PBI use is also discussed. Selected retrospective studies continue to report outcomes matching those achieved with whole breast radiation; however, results from large prospective randomized trials comparing PBI to whole breast radiation have been reported only with short follow-up times, or in two studies, are still pending. A recent consensus guideline is useful at present in selecting patients for discussion of this treatment.

The effect of visiting surgical patients in the postanesthesia care unit on family members' anxiety: a prospective quasi-experimental study.

PubMed

Patelarou, Athina; Melidoniotis, Evangelos; Sgouraki, Maria; Karatzi, Maria; Souvatzis, Xenia

2014-06-01

Surgical procedures pose stressful events for patients and their family members. The main purpose of this study was to determine if visiting patients in the postanesthesia care unit (PACU) would reduce the anxiety levels of Greek patients' family members. A prospective study with a one-group quasi-experimental pretest/post-test design was used. Situational anxiety of surgical patients' relatives was assessed using the state subscale of the State-Trait Anxiety Inventory (STAI; Greek validation) at the beginning of the surgical procedure and again after their visitation of patients in the PACU. STAI scores were significantly higher preoperatively (57 [23-80]) than postoperatively (51 [21-77]; P=.000008). Clinically significant levels of anxiety were present in 76% and 58% of the participants, pre- and postoperatively, respectively. Although postoperative STAI scores were reduced, family visitation in the PACU did not sufficiently reduce the anxiety of Greek family members to clinically acceptable levels. Copyright © 2014 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

Tube shunt complications and their prevention.

PubMed

Sarkisian, Steven R

2009-03-01

Glaucoma drainage devices (GDDs) have been generally accepted as a treatment of refractory glaucoma. GDDs have their own unique set of complications that are important to evaluate to prevent them. Tube shunts are typically used in eyes with refractory glaucoma. There is increased interest in studying the efficacy of GDDs. Most of the attention has been focused on comparing trabeculectomy with the Baerveldt implant (Advanced Medical Optics, Inc., Santa Anna, California, USA). The other leading implant is the Ahmed Glaucoma Valve. There are several retrospective studies comparing these two devices and a prospective study is ongoing. There is great interest in the complication rate of tube shunts and these have been published both retrospectively and prospectively. Complications such as hypotony, diplopia, strabismus, proptosis, tube erosion, failure, corneal decompensation, endophthalmitis, and visual loss are all important and some have recently been reviewed in the literature. Moreover, the use of glaucoma drainage implants in the pediatric population has been evaluated. Glaucoma drainage implants have been a powerful tool in our surgical fight to prevent blindness; however, they are not without complications or controversy.

Improving scar quality: a prospective clinical study.

PubMed

Atiyeh, Bishara S; Ioannovich, John; Al-Amm, Christian A; El-Musa, Kusai A; Dham, Ruwayda

2002-01-01

Following traumatic or surgical injury to the skin, wounds do not heal by tissue regeneration but rather by scar formation. Though healing is definitely a welcomed event, the resultant scar, very often, is not aesthetically pleasing, and not infrequently, may be pathologic causing serious deformities and contractures. Management of problematic scars continues to be a frustrating endeavor with less than optimal results. Prophylactic methods of wound management to minimize serious scarring are being developed. In a previously published study, we have demonstrated improved healing of split thickness skin graft donor sites following treatment with Moist Exposed Burn Ointment (MEBO, Julphar Gulf Pharmaceutical Industries, Ras Al-Khaimah, UAE). At present, we are reporting the results of a comparative clinical prospective study evaluating scar quality following primary healing of elective surgical and traumatic facial wounds with prophylactic MEBO application, topical antibiotic ointment application, and no topical therapy at all. Scars were evaluated according to the Visual Analogue Scale for scar assessment. Statistical analysis of scar assessment scores demonstrated marked prevention of unfavorable scars with improved cosmetic results following MEBO prophylactic therapy.

Evidence-Based Management of Pain After Excisional Haemorrhoidectomy Surgery: A PROSPECT Review Update.

PubMed

Sammour, Tarik; Barazanchi, Ahmed W H; Hill, Andrew G

2017-02-01

The aim of this systematic review was to update previous PROSPECT ( http://www.postoppain.org ) review recommendations for the management of pain after excisional haemorrhoidectomy. Randomized studies and reviews published in the English language from July 2006 (end date of last review) to March 2016, assessing analgesic, anaesthetic, and operative interventions pertaining to excisional haemorrhoidectomy in adults, and reporting pain scores, were retrieved from the EMBASE and MEDLINE databases. An additional 464 studies were identified of which 74 met the inclusion criteria. There were 48 randomized controlled trials and 26 reviews. Quantitative analyses were not performed, as there were limited numbers of trials with a sufficiently homogeneous design. Pudendal nerve block, with or without general anaesthesia, is recommended for all patients undergoing haemorrhoidal surgery. Either closed haemorrhoidectomy, or open haemorrhoidectomy with electrocoagulation of the pedicle is recommended as the primary procedure. Combinations of analgesics (paracetamol, non-steroidal anti-inflammatory drugs, and opioids), topical lignocaine and glyceryl trinitrate, laxatives, and oral metronidazole are recommended post-operatively. The recommendations are largely based on single intervention, not multimodal intervention, studies.

Prospective Clinical Study of Precision Oncology in Solid Tumors.

PubMed

Sohal, Davendra P S; Rini, Brian I; Khorana, Alok A; Dreicer, Robert; Abraham, Jame; Procop, Gary W; Saunthararajah, Yogen; Pennell, Nathan A; Stevenson, James P; Pelley, Robert; Estfan, Bassam; Shepard, Dale; Funchain, Pauline; Elson, Paul; Adelstein, David J; Bolwell, Brian J

2015-11-09

Systematic studies evaluating clinical benefit of tumor genomic profiling are lacking. We conducted a prospective study in 250 patients with select solid tumors at the Cleveland Clinic. Eligibility required histopathologic diagnosis, age of 18 years or older, Eastern Cooperative Oncology Group performance status 0-2, and written informed consent. Tumors were sequenced using FoundationOne (Cambridge, MA). Results were reviewed at the Cleveland Clinic Genomics Tumor Board. Outcomes included feasibility and clinical impact. Colorectal (25%), breast (18%), lung (13%), and pancreatobiliary (13%) cancers were the most common diagnoses. Median time from consent to result was 25 days (range = 3-140). Of 223 evaluable samples, 49% (n = 109) of patients were recommended a specific therapy, but only 11% (n = 24) received such therapy: 12 on clinical trials, nine off-label, three on-label. Lack of clinical trial access (n = 49) and clinical deterioration (n = 29) were the most common reasons for nonrecommendation/nonreceipt of genomics-driven therapy. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Delirium in adult patients receiving palliative care: a systematic review of the literature.

PubMed

Sánchez-Román, Sofía; Beltrán Zavala, Cristina; Lara Solares, Argelia; Chiquete, Erwin

2014-01-01

Delirium in palliative care patients is common and its diagnosis and treatment is a major challenge. Our objective was to perform a literature analysis in two phases on the recent scientific evidence (2007-2012) on the diagnosis and treatment of delirium in adults receiving palliative care. In phase 1 (descriptive studies and narrative reviews) 133 relevant articles were identified: 73 addressed the issue of delirium secondarily, and 60 articles as the main topic. However, only 4 prospective observational studies in which delirium was central were identified. Of 135 articles analysed in phase 2 (clinical trials or descriptive studies on treatment of delirium in palliative care patients), only 3 were about prevention or treatment: 2 retrospective studies and one clinical trial on multicomponent prevention in cancer patients. Much of the recent literature is related to reviews on studies conducted more than a decade ago and on patients different to those receiving palliative care. In conclusion, recent scientific evidence on delirium in palliative care is limited and suboptimal. Prospective studies are urgently needed that focus specifically on this highly vulnerable population. Copyright © 2013 SEP y SEPB. Published by Elsevier España. All rights reserved.

Publishing SNP genotypes of human embryonic stem cell lines: policy statement of the International Stem Cell Forum Ethics Working Party.

PubMed

Knoppers, Bartha M; Isasi, Rosario; Benvenisty, Nissim; Kim, Ock-Joo; Lomax, Geoffrey; Morris, Clive; Murray, Thomas H; Lee, Eng Hin; Perry, Margery; Richardson, Genevra; Sipp, Douglas; Tanner, Klaus; Wahlström, Jan; de Wert, Guido; Zeng, Fanyi

2011-09-01

Novel methods and associated tools permitting individual identification in publicly accessible SNP databases have become a debatable issue. There is growing concern that current technical and ethical safeguards to protect the identities of donors could be insufficient. In the context of human embryonic stem cell research, there are no studies focusing on the probability that an hESC line donor could be identified by analyzing published SNP profiles and associated genotypic and phenotypic information. We present the International Stem Cell Forum (ISCF) Ethics Working Party's Policy Statement on "Publishing SNP Genotypes of Human Embryonic Stem Cell Lines (hESC)". The Statement prospectively addresses issues surrounding the publication of genotypic data and associated annotations of hESC lines in open access databases. It proposes a balanced approach between the goals of open science and data sharing with the respect for fundamental bioethical principles (autonomy, privacy, beneficence, justice and research merit and integrity).

Genetic, clinical and pharmacological determinants of out-of-hospital cardiac arrest: rationale and outline of the AmsteRdam Resuscitation Studies (ARREST) registry

PubMed Central

Blom, M T; van Hoeijen, D A; Bardai, A; Berdowski, J; Souverein, P C; De Bruin, M L; Koster, R W; de Boer, A; Tan, H L

2014-01-01

Introduction Out-of-hospital cardiac arrest (OHCA) is a major public health problem. Recognising the complexity of the underlying causes of OHCA in the community, we aimed to establish the clinical, pharmacological, environmental and genetic factors and their interactions that may cause OHCA. Methods and analysis We set up a large-scale prospective community-based registry (AmsteRdam Resuscitation Studies, ARREST) in which we prospectively include all resuscitation attempts from OHCA in a large study region in the Netherlands in collaboration with Emergency Medical Services. Of all OHCA victims since June 2005, we prospectively collect medical history (through hospital and general practitioner), and current and previous medication use (through community pharmacy). In addition, we include DNA samples from OHCA victims with documented ventricular tachycardia/fibrillation during the resuscitation attempt since July 2007. Various study designs are employed to analyse the data of the ARREST registry, including case–control, cohort, case only and case-cross over designs. Ethics and dissemination We describe the rationale, outline and potential results of the ARREST registry. The design allows for a stable and reliable collection of multiple determinants of OHCA, while assuring that the patient, lay-caregiver or medical professional is not hindered in any way. Such comprehensive data collection is required to unravel the complex basis of OHCA. Results will be published in peer-reviewed journals and presented at relevant scientific symposia. PMID:25332818

A prospective, multicenter, post marketing surveillance study to evaluate the safety and effectiveness of the Superia-Sirolimus Eluting Coronary Stent System (SSECSS) implanted during routine clinical practice in India.

PubMed

Chandra, Praveen; Kumar, Tarun

2014-01-01

A prospective, multicenter, post marketing surveillance study to evaluate the safety and effectiveness of the Superia-Sirolimus Eluting Coronary Stent System (SSECSS) implanted during routine clinical practice in India. 1. To study the MACE and in stent and In-segment Loss at Six Months (in a pre selected group of 50 patients). 1. Clinical and procedural success. This is a prospective, open label, single-arm, multicenter (16 sites), post marketing observational study enrolling patients implanted with Superia-Sirolimus Eluting Coronary Stent (SSECS) in routine clinical practice in India. A total of 200 Patients of coronary Artery Disease (CAD) implanted with Superia-Sirolimus Eluting Coronary Stent (SSECS) were enrolled. Clinical assessments were done at 30 days, 180 days and at 1, 2 years either telephonically or office visit. A cohort of 50 pre-selected patients were followed up for angiographic evaluation at 180 days. MACE at 12 month of follow up was 1.71%.Late lumen loss, in segment was 0.14 and in stent was 0.10 mm at 6 month of follow-up. TLR was required only in 2 patients. Superia stent is as safe as other biodegradable polymer stent in the market and time has come for biodegradable polymer stent with thin struts. Copyright © 2014 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

Health and economic burden of running-related injuries in runners training for an event: A prospective cohort study.

PubMed

Hespanhol Junior, L C; van Mechelen, W; Postuma, E; Verhagen, E

2016-09-01

Prospective running-related injury (RRI) data from runners training for an event are scarce, especially with regard to RRI-associated costs. Therefore, the aim of this study was to investigate the prevalence and economic burden of RRIs in runners participating in an organized training program preparing them for an event. This was a prospective cohort study with 18 weeks of follow-up. Individuals aged 18 or older and registered to participate in an organized running program were eligible. Follow-up surveys were sent every 2 weeks to collect data about running exposure, RRIs, and costs. Of the 161 potential participants, 53 (32.9%) were included in this study. A total of 32 participants reported 41 RRIs. The mean prevalence during follow-up was 30.8% [95% confidence interval (CI) 25.6-36.0%]. Overuse was the main mechanism of RRI (85.4%, n = 35). An RRI was estimated to have an economic burden of €57.97 (95% CI €26.17-94.00) due to healthcare utilization (direct costs) and €115.75 (95% CI €10.37-253.73) due to absenteeism from paid work (indirect costs). These results indicate that the health and economic burden of RRIs may be considered significant for public health. Therefore, prevention programs are needed for runners participating in organized training programs. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Seven deadly sins in trauma outcomes research: an epidemiologic post mortem for major causes of bias.

PubMed

del Junco, Deborah J; Fox, Erin E; Camp, Elizabeth A; Rahbar, Mohammad H; Holcomb, John B

2013-07-01

Because randomized clinical trials in trauma outcomes research are expensive and complex, they have rarely been the basis for the clinical care of trauma patients. Most published findings are derived from retrospective and occasionally prospective observational studies that may be particularly susceptible to bias. The sources of bias include some common to other clinical domains, such as heterogeneous patient populations with competing and interdependent short- and long-term outcomes. Other sources of bias are unique to trauma, such as rapidly changing multisystem responses to injury that necessitate highly dynamic treatment regimens such as blood product transfusion. The standard research design and analysis strategies applied in published observational studies are often inadequate to address these biases. Drawing on recent experience in the design, data collection, monitoring, and analysis of the 10-site observational PRospective Observational Multicenter Major Trauma Transfusion (PROMMTT) study, 7 common and sometimes overlapping biases are described through examples and resolution strategies. Sources of bias in trauma research include ignoring (1) variation in patients' indications for treatment (indication bias), (2) the dependency of intervention delivery on patient survival (survival bias), (3) time-varying treatment, (4) time-dependent confounding, (5) nonuniform intervention effects over time, (6) nonrandom missing data mechanisms, and (7) imperfectly defined variables. This list is not exhaustive. The mitigation strategies to overcome these threats to validity require epidemiologic and statistical vigilance. Minimizing the highlighted types of bias in trauma research will facilitate clinical translation of more accurate and reproducible findings and improve the evidence-base that clinicians apply in their care of injured patients.

Dual-task testing to predict falls in community-dwelling older adults: a systematic review.

PubMed

Muir-Hunter, S W; Wittwer, J E

2016-03-01

Cognitive impairment increases fall risk in older adults. Dual-task testing is an accepted way to assess the interaction between cognition and mobility; however, there is a lack of evidence-based recommendations for dual-task testing to evaluate fall risk in clinical practice. To evaluate the association between dual-task testing protocols and future fall risk, and to identify the specific dual-task test protocols associated with elevated risk. MEDLINE, Pubmed and EMBASE electronic databases were searched from January 1988 to September 2013. Two independent raters identified prospective cohort studies (duration of at least 1 year) of dual-task assessment in community-dwelling participants aged ≥60 years, with 'falls' as the primary outcome. Methodological quality was scored independently by two raters using a published checklist of criteria for evaluating threats to the validity of observational studies. Deterioration in gait during dual-task testing compared with single-task performance was associated with increased fall risk. Shortcomings within the literature significantly limit knowledge translation of dual-task gait protocols into clinical practice. There is a paucity of prospective studies on the association of dual-task gait assessment with fall risk. Changes in gait under dual-task testing are associated with future fall risk, and this association is stronger than that for single-task conditions. Limitations in the available literature preclude development of detailed recommendations for dual-task gait testing procedures in clinical practice to identify and stratify fall risk in older adults. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

A Norwegian prospective study of preterm mother-infant interactions at 6 and 18 months and the impact of maternal mental health problems, pregnancy and birth complications.

PubMed

Misund, Aud R; Bråten, Stein; Nerdrum, Per; Pripp, Are Hugo; Diseth, Trond H

2016-05-04

Pregnancy, birth and health complications, maternal mental health problems following preterm birth and their possible impact on early mother-infant interaction at 6 and 18 months corrected age (CA) were explored. Predictors of mother-infant interaction at 18 months CA were identified. This prospective longitudinal and observational study included 33 preterm mother-infant (<33 gestational age (GA)) interactions at 6 and 18 months CA from a socioeconomic low-risk, middle-class sample. The Parent-Child Early Relational Assessment (PCERA) scale was used to assess the mother-infant interaction. 'Bleeding in pregnancy' predicted lower quality in preterm mother-infant interaction in 6 PCERA scales, while high 'maternal trait anxiety' predicted higher interactional quality in 2 PCERA scales and 'family size' predicted lower interactional quality in 1 PCERA scale at 18 months CA. Mothers with symptoms of post-traumatic stress reactions, general psychological distress and anxiety at 2 weeks postpartum (PP) showed significantly better outcome than mothers without symptoms in 6 PCERA subscales at 6 months CA and 2 PCERA subscales at 18 months CA. Our study detected a correspondence between early pregnancy complications and lower quality of preterm mother-infant interaction, and an association between high levels of maternal mental health problems and better quality in preterm mother-infant interaction. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Higher body mass index is associated with plantar fasciopathy/'plantar fasciitis': systematic review and meta-analysis of various clinical and imaging risk factors.

PubMed

van Leeuwen, K D B; Rogers, J; Winzenberg, T; van Middelkoop, M

2016-08-01

What (risk) factors are associated with plantar fasciopathy (PF)? Systematic review with meta-analyses. Patients with PF. All factors described in prospective, case-control or cross-sectional observational studies. 51 included studies (1 prospective, 46 case-control and 4 cross-sectional studies) evaluated a total of 104 variables. Pooling was possible for 12 variables. Higher body mass index (BMI) (BMI>27, OR 3.7 (95% CI 2.93 to 5.62)) in patients with PF was the only significant clinical association, and its effect was the strongest in the non-athletic subgroup. In people with PF compared to controls, pooled imaging data demonstrated a significantly thicker, hypoechogenic plantar fascia with increased vascular signal and perifascial fluid collection. In addition, people with PF were more likely to have a thicker loaded and unloaded heel fat pat, and bone findings, including a subcalcaneal spur and increased Tc-99 uptake. No significant difference was found in the extension of the first metatarsophalangeal joint. We found a consistent clinical association between higher BMI and plantar fasciopathy. This association may differ between athletic and non-athletic subgroups. While consistent evidence supports a range of bone and soft tissue abnormalities, there is lack of evidence for the dogma of clinical and mechanical measures of foot and ankle function. Clinicians can use this information in shared decision-making. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Streptococcal upper respiratory tract infections and exacerbations of tic and obsessive-compulsive symptoms: A prospective longitudinal study

PubMed Central

Leckman, James F.; King, Robert A.; Gilbert, Donald L.; Coffey, Barbara J.; Singer, Harvey S.; Dure, Leon S.; Grantz, Heidi; Katsovich, Liliya; Lin, Haiqun; Lombroso, Paul J.; Kawikova, Ivana; Johnson, Dwight R.; Kurlan, Roger M.; Kaplan, Edward L.

2010-01-01

Objective The objective of this blinded, prospective longitudinal study was to determine whether new group A beta hemolytic streptococcal (GABHS) infections are temporally associated with exacerbations of tic or obsessive-compulsive (OC) symptoms in children who met published criteria for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS). A group of children with Tourette syndrome and/or obsessive-compulsive disorder without a PANDAS history served as the (non-PANDAS) comparison group. Method Consecutive clinical ratings of tic and OC symptom severity were obtained for 31 PANDAS subjects and 53 non-PANDAS subjects. Clinical symptoms and laboratory values (throat cultures and streptococcal antibody titers) were evaluated at regular intervals during a 25 month period. Additional testing occurred at the time of any tic or OC symptom exacerbation. New GABHS infections were established by throat swab cultures and/or recent significant rise in streptococcal antibodies. Laboratory personnel were blinded to case or control status, clinical (exacerbation or not) condition, and clinical evaluators were blinded to the laboratory results. Results No group differences were observed in either the number of clinical exacerbations or the number of newly diagnosed GABHS infections. On only six occasions out of a total of 51 (12%) a newly diagnosed GABHS infection was followed, within two months, by an exacerbation of tic and/or OC symptoms. In every instance, this association occurred in the non-PANDAS group. Conclusions This study provides no evidence for a temporal association between GABHS infections and tic/OC symptom exacerbations in children who meet the published PANDAS diagnostic criteria. PMID:21241948

Direct and indirect health economic impact of hypoglycaemia in a global population of patients with insulin-treated diabetes.

PubMed

Aronson, Ronnie; Galstyan, Gagik; Goldfracht, Margalit; Al Sifri, Saud; Elliott, Lisa; Khunti, Kamlesh

2018-04-01

The Hypoglycaemia Assessment Tool (HAT) study investigated the health economic impact of hypoglycaemic events in 24 countries, including countries without previously published data on hypoglycaemia. Self-assessment questionnaires and patient diaries (4-week prospective period) were completed by adults with type 1 (T1D) or type 2 diabetes (T2D) treated with insulin for more than 12 months (N = 27,585). Direct economic impacts of hypoglycaemia during the 4-week prospective period, included increased blood glucose monitoring (reported by 69.7% [T1D] and 60.9% [T2D] of patients), hospitalisation (T1D 2.1%; T2D 3.4% of patients) and medical contact (clinic or telephone; T1D 3.8%; T2D 6.8% of patients). Regional variation in medical contact and hospitalisation was found, with the highest usage in Russia (T1D 17.1%; T2D 17.3%), and Latin America (T1D 5.2%; T2D 6.8%) respectively. Indirect economic impacts following hypoglycaemia included loss of productivity due to absence from work or study; 3.9% (T1D) and 6.2% (T2D) of patients. Regional differences in work productivity were noted among patients with T2D, with a low prevalence in Northern Europe and Canada (0.9%) and high in Southeast Asia (14.6%). This study shows that hypoglycaemia has a significant but variable impact on the economics of diabetes healthcare globally. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

Registration status and outcome reporting of trials published in core headache medicine journals.

PubMed

Rayhill, Melissa L; Sharon, Roni; Burch, Rebecca; Loder, Elizabeth

2015-11-17

To evaluate randomized controlled trial (RCT) registration and outcome reporting compliance in core headache medicine journals. We identified RCTs published in core journals (Headache, Cephalalgia, and the Journal of Headache and Pain) from 2005 through 2014. We searched articles for trial registration numbers, which were verified in the corresponding trial registry. We categorized trial funding sources as industry, academic, government, or mixed. We contacted corresponding authors to assess reasons for nonregistration. We evaluated whether primary outcomes in trial registries matched those in corresponding publications. The journals published 225 RCTs over the study period. Fifty-eight of 225 (26%) reported a trial registration number in the article that could be linked to a corresponding registry entry. Trial registration rates increased over the 9 years of the study. Forty-six of 118 (39%) of industry-funded studies were registered compared with 27% of academic and 0% of government-funded studies. Only 5% of RCTs were prospectively registered, reported primary outcomes identical to those in the trial registry, and did not report unacknowledged post hoc outcomes. The most common reason for nonregistration was lack of awareness. Only about a quarter of the articles published in the core headache medicine journals are compliant with trial registration, but compliance has increased over time. Selective reporting of outcomes remains a problem, and very few trials met all 3 reporting standards assessed in this study. Efforts to improve the quality of trial reporting in the headache literature should continue. © 2015 American Academy of Neurology.

Applications of compact accelerator-driven neutron sources: An updated assessment from the perspective of materials research in Italy

DOE PAGES

Andreani, C.; Anderson, I. S.; Carpenter, J. M.; ...

2014-12-24

In 2005 the International Atomic Energy Agency (IAEA) in Vienna published a report [1] on ‘Development Opportunities of Small and Medium Scale Accelerator Driven Neutron Sources’ which summarized the prospect of smaller sources in supporting the large spallation neutron sources for materials characterization and instrumentation, a theme advocated by Bauer, Clausen, Mank, and Mulhauser in previous publications [2-4]. In 2010 the Union for Compact Accelerator-driven Neutron Sources (UCANS) was established [5], galvanizing cross-disciplinary collaborations on new source and neutronics development and expanded applications based on both slow-neutron scattering and other neutron-matter interactions of neutron energies ranging from 10⁻⁶ to 10²more » MeV [6]. Here, we first cover the recent development of ongoing and prospective projects of compact accelerator-driven neutron sources (CANS) but concentrate on prospective accelerators currently proposed in Italy. Two active R&D topics, irradiation effects on electronics and cultural heritage studies, are chosen to illustrate the impact of state-of-the-art CANS on these programs with respect to the characteristics and complementarity of the accelerator and neutronics systems as well as instrumentation development.« less

Occupational dreams, choices and aspirations: adolescents' entrepreneurial prospects and orientations.

PubMed

Schmitt-Rodermund, Eva; Vondracek, Fred W

2002-02-01

The present study examined possible early antecedents of entrepreneurship of 14-17-year-old 10th grade students (n=320). We hypothesized that Entrepreneurial Orientation (interest and self-efficacy), together with Willingness to Expend Effort, would be an important predictor of an adolescent's Entrepreneurial Prospects, i.e. prospects of becoming self-employed in the future. Furthermore, personality and the model of self-employed family were expected to predict the level of Entrepreneurial Orientation. The same relationships were investigated separately for students who were more or less willing to expend effort. Among students more willing to expend effort, levels of Entrepreneurial Orientation were higher for those who were conscientious, self-efficient, open to new experiences, and low in agreeableness. Among students less willing to expend effort, a high need for social recognition predicted higher levels of Entrepreneurial Orientation. In addition, parents' model for them was connected with lower levels of Entrepreneurial Orientation. A moderating effect of Willingness to Expend Effort was supported by the results for parents' model and need for social recognition. Copyright 2002 Published by Elsevier Science Ltd on behalf of The Association for Professionals in Services for Adolescents.

Methodology of AA CRASH: a prospective observational study evaluating the incidence and pathogenesis of adverse post-traumatic sequelae in African-Americans experiencing motor vehicle collision.

PubMed

Linnstaedt, Sarah D; Hu, JunMei; Liu, Andrea Y; Soward, April C; Bollen, Kenneth A; Wang, Henry E; Hendry, Phyllis L; Zimny, Erin; Lewandowski, Christopher; Velilla, Marc-Anthony; Damiron, Kathia; Pearson, Claire; Domeier, Robert; Kaushik, Sangeeta; Feldman, James; Rosenberg, Mark; Jones, Jeffrey; Swor, Robert; Rathlev, Niels; McLean, Samuel A

2016-09-06

A motor vehicle collision (MVC) is one of the most common life-threatening events experienced by individuals living in the USA. While most individuals recover following MVC, a significant proportion of individuals develop adverse post-traumatic sequelae such as post-traumatic stress disorder or persistent musculoskeletal pain. Adverse post-traumatic sequelae are common, morbid and costly public health problems in the USA and other industrialised countries. The pathogenesis of these disorders following MVC remains poorly understood. In the USA, available data suggest that African-Americans experience an increased burden of adverse post-traumatic sequelae after MVC compared to European Americans, but to date no studies examining the pathogenesis of these disorders among African-Americans experiencing MVC have been performed. The African-American CRASH (AA CRASH) study is an NIH-funded, multicentre, prospective study that enrols African-Americans (n=900) who present to the emergency department (ED) within 24 hours of MVC. Participants are enrolled at 13 ED sites in the USA. Individuals who are admitted to the hospital or who report a fracture or tissue injury are excluded. Participants complete a detailed ED interview that includes an assessment of crash history, current post-traumatic symptoms and health status prior to the MVC. Blood samples are also collected in the ED using PAXgene DNA and PAXgene RNA tubes. Serial mixed-mode assessments 6 weeks, 6 months and 1 year after MVC include an assessment of adverse sequelae, general health status and health service utilisation. The results from this study will provide insights into the incidence and pathogenesis of persistent pain and other post-traumatic sequelae in African-Americans experiencing MVC. AA CRASH has ethics approval in the USA, and the results will be published in a peer-reviewed journal. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Do women fare worse? A metaanalysis of gender differences in outcome after traumatic brain injury.

PubMed

Farace, E; Alves, W M

2000-01-01

The purpose of this metaanalysis was to investigate possible gender differences in TBI sequelae. The case fatality rates in patients after TBI have previously been shown to be significantly higher in women as compared with men. A quantitative review of published studies of TBI outcome revealed eight studies (20 outcome variables) of TBI in which outcome was reported separately for men and women. Outcome was worse in women than in men for 85% of the measured variables, with an average effect size of -0.15. Although clinical opinion is often that women tend to experience better outcomes than do men after TBI, the opposite pattern was suggested in the results of this metaanalysis. However, this conclusion is limited by the fact that in only a small percentage of the total published reports on TBI outcome was outcome described separately for each sex. A careful, prospective study of sex differences in TBI outcome is clearly needed.

Stress and multiple sclerosis: A systematic review considering potential moderating and mediating factors and methods of assessing stress.

PubMed

Briones-Buixassa, Laia; Milà, Raimon; Mª Aragonès, Josep; Bufill, Enric; Olaya, Beatriz; Arrufat, Francesc Xavier

2015-07-01

Research about the effects of stress on multiple sclerosis has yielded contradictory results. This study aims to systematically review the evidence focusing on two possible causes: the role of stress assessment and potential moderating and mediating factors. The Web of Knowledge (MEDLINE and Web of Science), Scopus, and PsycINFO databases were searched for relevant articles published from 1900 through December 2014 using the terms "stress*" AND "multiple sclerosis." Twenty-three articles were included. Studies focused on the effect of stress on multiple sclerosis onset ( n  = 9) were mostly retrospective, and semi-structured interviews and scales yielded the most consistent associations. Studies focused on multiple sclerosis progression ( n  = 14) were mostly prospective, and self-reported diaries yielded the most consistent results. The most important modifying factors were stressor duration, severity, and frequency; cardiovascular reactivity and heart rate; and social support and escitalopram intake. Future studies should consider the use of prospective design with self-reported evaluations and the study of moderators and mediators related to amount of stress and autonomic nervous system reactivity to determine the effects of stress on multiple sclerosis.

Stress and multiple sclerosis: A systematic review considering potential moderating and mediating factors and methods of assessing stress

PubMed Central

Briones-Buixassa, Laia; Milà, Raimon; Mª Aragonès, Josep; Bufill, Enric; Olaya, Beatriz; Arrufat, Francesc Xavier

2015-01-01

Research about the effects of stress on multiple sclerosis has yielded contradictory results. This study aims to systematically review the evidence focusing on two possible causes: the role of stress assessment and potential moderating and mediating factors. The Web of Knowledge (MEDLINE and Web of Science), Scopus, and PsycINFO databases were searched for relevant articles published from 1900 through December 2014 using the terms “stress*” AND “multiple sclerosis.” Twenty-three articles were included. Studies focused on the effect of stress on multiple sclerosis onset (n = 9) were mostly retrospective, and semi-structured interviews and scales yielded the most consistent associations. Studies focused on multiple sclerosis progression (n = 14) were mostly prospective, and self-reported diaries yielded the most consistent results. The most important modifying factors were stressor duration, severity, and frequency; cardiovascular reactivity and heart rate; and social support and escitalopram intake. Future studies should consider the use of prospective design with self-reported evaluations and the study of moderators and mediators related to amount of stress and autonomic nervous system reactivity to determine the effects of stress on multiple sclerosis. PMID:28070374

[Effect of gestational diabetes on adiposity indicators during the first 18 years of life; systematic review].

PubMed

Jiménez Cruz, Arturo; Ortega Cisneros, Armando; Bacardí Gascón, Montserrat

2014-02-01

Gestational diabetes has been associated with obesity later in life. However, reported results have not been consistent and the methods used have shown weakness. To analize prospective and retrospective cohort studies that assess the gestational diabetes effects on adiposity indicators in the offspring during their first 18 years. A search was made for prospective or retrospective cohort studies registered in Medline/ Pubmed database, from January 2011 to September 2013 that evaluated the gestational diabetes effects on adiposity indicators at birth or after birth. Eleven studies met the inclusion criteria. A total of 472,959 pairs of mother and child were studied. Children age at the moment of evaluation ranged from birth to 18 years. In nine out of eleven articles an association between gestational diabetes and adiposity indicators was observed. In seven studies adjustments for potential confounders (pre gestational BMI, maternal age) were made. In five of those an association between gestational diabetes and adiposity was found. The results of this review indicate that the evidence showing that gestational diabetes increase adiposity indicators later in life is moderate. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

The Medical Treatment of New-Onset Peripartum Cardiomyopathy: A Systematic Review of Prospective Studies.

PubMed

Desplantie, Olivier; Tremblay-Gravel, Maxime; Avram, Robert; Marquis-Gravel, Guillaume; Ducharme, Anique; Jolicoeur, E Marc

2015-12-01

Peripartum cardiomyopathy (PPCM) is a rare disorder with potentially fatal consequences, which occurs mainly in previously healthy women. The aetiology of PPCM remains unknown and various pathologic mechanisms have been proposed, including immune-mediated injuries and impaired response to oxidative stress and inflammatory cytokines. Several therapies have been studied, but few have been validated in a well-designed randomized controlled trial. In the present study we sought to review the medical treatment intended for acute PPCM. To this end, we performed a systematic review of the literature of randomized and nonrandomized prospective clinical studies. We identified 2 randomized controlled trials that evaluated the dopamine agonist bromocriptine and the inotrope levosimendan, respectively, and 1 nonrandomized study that evaluated the nonselective phosphodiesterase inhibitor pentoxifylline. We reviewed the pathophysiological, pharmacological, and clinical properties for each treatment option identified. Bromocriptine and pentoxifylline both improved left ventricular systolic function and patient-oriented clinical end points and levosimendan did not improve mortality or echocardiographic findings of PPCM. In this review we identified bromocriptine and pentoxifylline, but not levosimendan, as potentially useful agents to improve left ventricle function and outcomes in PPCM. Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Consumption of fruit and vegetables reduces risk of pancreatic cancer: evidence from epidemiological studies.

PubMed

Wu, Qi-Jun; Wu, Lang; Zheng, Li-Qiang; Xu, Xin; Ji, Chao; Gong, Ting-Ting

2016-05-01

Observational studies have reported inconsistent results on the association between fruit and vegetable intake and the risk of pancreatic cancer. We carried out a meta-analysis of epidemiological studies to summarize available evidence. We searched PubMed, Scopus, and ISI Web of Science databases for relevant studies published until the end of January 2015. Fixed-effects and random-effects models were used to estimate the summary relative risks (RRs) and 95% confidence intervals (CIs) for the associations between fruit and vegetable intake and the risk of pancreatic cancer. A total of 15 case-control studies, eight prospective studies, and one pooled analysis fulfilled the inclusion criteria. The summary RR for the highest versus the lowest intake was 0.73 (95% CI=0.53-1.00) for fruit and vegetables, 0.73 (95% CI=0.63-0.84) for fruit, and 0.76 (95% CI=0.69-0.83) for vegetables, with significant heterogeneities (I=70.5, 55.7, and 43.0%, respectively). Inverse associations were observed in the stratified analysis by study design, although the results of prospective studies showed borderline significance, with corresponding RR=0.90 (95% CI=0.77-1.05) for fruit and vegetable intake, 0.93 (95% CI=0.83-1.03) for fruit intake, and 0.89 (95% CI=0.80-1.00) for vegetable intake. Besides, significant inverse associations were observed in the majority of other subgroup analyses by study quality, geographic location, exposure assessment method, and adjustment for potential confounders. Findings from the present meta-analysis support that fruit and vegetable intake is associated inversely with the risk of pancreatic cancer. However, study design may play a key role in the observed magnitude of the aforementioned association. Future well-designed prospective studies are warranted to confirm these findings.

Why prudence is needed when interpreting articles reporting clinical trial results in mental health.

PubMed

Dal-Ré, Rafael; Bobes, Julio; Cuijpers, Pim

2017-03-28

Clinical trial results' reliability is impacted by reporting bias. This is primarily manifested as publication bias and outcome reporting bias. Mental health trials are prone to two methodological deficiencies: (1) using small numbers of participants that facilitates false positive findings and exaggerated size effects, and (2) the obligatory use of psychometric scales that require subjective assessments. These two deficiencies contribute to the publication of unreliable results. Considerable reporting bias has been found in safety and efficacy findings in psychotherapy and pharmacotherapy trials. Reporting bias can be carried forward to meta-analyses, a key source for clinical practice guidelines. The final result is the frequent overestimation of treatment effects that could impact patients and clinician-informed decisions. Prospective registration of trials and publication of results are the two major methods to reduce reporting bias. Prospective trial registration will allow checking whether they are published (so it will help to prevent publication bias) and, if published, whether those outcomes and analyses that were deemed as appropriate before trial commencement are actually published (hence helping to find out selective reporting of outcomes). Unfortunately, the rate of registered trials in mental health interventions is low and, frequently, of poor quality. Clinicians should be prudent when interpreting the results of published trials and some meta-analyses - such as those conducted by scientists working for the sponsor company or those that only include published trials. Prescribers, however, should be confident when prescribing drugs following the summary of product characteristics, since regulatory agencies have access to all clinical trial results.

Risk factors for age-related maculopathy.

PubMed

Connell, Paul P; Keane, Pearse A; O'Neill, Evelyn C; Altaie, Rasha W; Loane, Edward; Neelam, Kumari; Nolan, John M; Beatty, Stephen

2009-01-01

Age-related maculopathy (ARM) is the leading cause of blindness in the elderly. Although beneficial therapeutic strategies have recently begun to emerge, much remains unclear regarding the etiopathogenesis of this disorder. Epidemiologic studies have enhanced our understanding of ARM, but the data, often conflicting, has led to difficulties with drawing firm conclusions with respect to risk for this condition. As a consequence, we saw a need to assimilate the published findings with respect to risk factors for ARM, through a review of the literature appraising results from published cross-sectional studies, prospective cohort studies, case series, and case control studies investigating risk for this condition. Our review shows that, to date, and across a spectrum of epidemiologic study designs, only age, cigarette smoking, and family history of ARM have been consistently demonstrated to represent risk for this condition. In addition, genetic studies have recently implicated many genes in the pathogenesis of age-related maculopathy, including Complement Factor H, PLEKHA 1, and LOC387715/HTRA1, demonstrating that environmental and genetic factors are important for the development of ARM suggesting that gene-environment interaction plays an important role in the pathogenesis of this condition.

The effects of platelet apheresis on blood saving and coagulation in bilateral total hip replacement: A prospective study on 60 patients.

PubMed

Qu, Zhijun; Wang, Geng; Xu, Chengshi; Zhang, Dazhi; Qu, Xiangdong; Zhou, Haibin; Ma, Jun

2016-10-01

Preoperative platelet rich plasma (PRP) harvest has been used in cardiopulmonary surgery for more than 10 years. There is no previous study dealing with PRP in bilateral total hip replacement. This study was to investigate the effects of PRP on blood saving and blood coagulation function in patients with bilateral total hip replacement. A prospective, randomized, clinical trial was conducted. Sixty patients were enrolled, including 30 patients undergoing PRP in the PRP group and 30 controls. The surgery time, total transfusion volume, blood loss, allogenic blood transfusion, autologous blood transfusion, urine volume, drainage volume, some blood parameters (including Fibrinogen, D-dimer, Prothrombin time, international normalizedratio, activated partial thromboplastin time, Platelet, Haemoglobin B), thrombelastogram (TEG) and blood-gas parameters were studied in the perioperative stage. The measurement data were analyzed statistically. There was no statistical difference between the two groups in baseline characteristics, surgery time, total transfusion volume, blood loss, autologous blood transfusion, etc. Allogenic blood transfusion in the PRP group was less than the control group with statistical difference (p = 0.024). Fibrinogen in the PRP group was higher than the control group (p = 0.008). Among the TEG indicators, activated clotting time and coagulation time K in the PRP group were less than the control group. Clotting rate and maximum amplitude in the PRP group were higher. The blood-gas parameters presented no statistical difference. The results suggested that PRP probably played a positive role in blood coagulation function as well as blood saving in patients with bilateral total hip replacement. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Can psychosocial work conditions protect against age-related cognitive decline? Results from a systematic review.

PubMed

Nexø, Mette Andersen; Meng, Annette; Borg, Vilhelm

2016-07-01

According to the use it or lose it hypothesis, intellectually stimulating activities postpone age-related cognitive decline. A previous systematic review concluded that a high level of mental work demands and job control protected against cognitive decline. However, it did not distinguish between outcomes that were measured as cognitive function at one point in time or as cognitive decline. Our study aimed to systematically review which psychosocial working conditions were prospectively associated with high levels of cognitive function and/or changes in cognitive function over time. Articles were identified by a systematic literature search (MEDLINE, Web of Science (WOS), PsycNET, Occupational Safety and Health (OSH)). We included only studies with longitudinal designs examining the impact of psychosocial work conditions on outcomes defined as cognitive function or changes in cognitive function. Two independent reviewers compared title-abstract screenings, full-text screenings and quality assessment ratings. Eleven studies were included in the final synthesis and showed that high levels of mental work demands, occupational complexity or job control at one point in time were prospectively associated with higher levels of cognitive function in midlife or late life. However, the evidence to clarify whether these psychosocial factors also affected cognitive decline was insufficient, conflicting or weak. It remains speculative whether job control, job demands or occupational complexity can protect against cognitive decline. Future studies using methodological advancements can reveal whether workers gain more cognitive reserve in midlife and late life than the available evidence currently suggests. The public health implications of a previous review should thereby be redefined accordingly. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Clinical trial registration in physical therapy journals: a cross-sectional study.

PubMed

Babu, Abraham Samuel; Veluswamy, Sundar Kumar; Rao, Pratiksha Tilak; Maiya, Arun G

2014-01-01

Clinical trial registration has become an important part of editorial policies of various biomedical journals, including a few physical therapy journals. However, the extent to which editorial boards enforce the need for trial registration varies across journals. The purpose of this study was to identify editorial policies and reporting of trial registration details in MEDLINE-indexed English-language physical therapy journals. This study was carried out using a cross-sectional design. Editorial policies on trial registration of MEDLINE-indexed member journals of the International Society of Physiotherapy Journal Editors (ISPJE) (Journal of Geriatric Physical Therapy, Journal of Hand Therapy, Journal of Neurologic Physical Therapy, Journal of Orthopaedic and Sports Physical Therapy, Journal of Physiotherapy [formerly Australian Journal of Physiotherapy], Journal of Science and Medicine in Sport, Manual Therapy, Physical Therapy, Physical Therapy in Sport, Physiotherapy, Physiotherapy Research International, Physiotherapy Theory and Practice, and Revista Brasileira de Fisioterapia) were reviewed in April 2013. Full texts of reports of clinical trials published in these journals between January 1, 2008, and December 31, 2012, were independently assessed for information on trial registration. Among the 13 journals, 8 recommended trial registration, and 6 emphasized prospective trial registration. As of April 2013, 4,618 articles were published between January 2008 and December 2012, of which 9% (417) were clinical trials and 29% (121/417) of these reported trial registration details. A positive trend in reporting of trial registration was observed from 2008 to 2012. The study was limited to MEDLINE-indexed ISPJE member journals. Editorial policies on trial registration of physical therapy journals and a rising trend toward reporting of trial registration details indicate a positive momentum toward trial registration. Physical therapy journal editors need to show greater commitment to prospective trial registration to make it a rule rather than an option.

A prospective clinical study to evaluate the performance of zirconium dioxide dental implants in single-tooth gaps.

PubMed

Gahlert, Michael; Kniha, Heinz; Weingart, Dieter; Schild, Sabine; Gellrich, Nils-Claudius; Bormann, Kai-Hendrik

2016-12-01

Dental implants have traditionally been made from titanium or its alloys, but recently full-ceramic implants have been developed with comparable osseointegration properties and functional strength properties to titanium. These ceramic implants may have advantages in certain patients and situations, for example, where esthetic outcomes are particularly important. The objective of this investigation was to evaluate the performance of a newly developed full-ceramic ZrO 2 monotype implant design (PURE Ceramic Implant; Institut Straumann AG, Basel, Switzerland) in single-tooth gaps in the maxilla and mandible. This was a prospective, open-label, single-arm study in patients requiring implant rehabilitation in single-tooth gaps. Full-ceramic implants were placed, with provisional and final prostheses inserted after 3 and 6 months, respectively. Crestal bone level was measured at implant placement and after 6 and 12 months. Implant survival and success were evaluated after 6 and 12 months. Further evaluations are planned after 24 and 36 months. Forty-six patients were screened for potential study participation, of whom 44 (17 men and 27 women, mean age 48 ± 14 years) were recruited into the study. The majority of implants (90.9%) were placed in the maxilla. The implant survival and implant success rate after 12 months were 97.6%. A minor change of the mean bone level occurred between implant loading (final prosthesis insertion after 6 months) and 12 months (-0.14 mm) after initial bone remodeling was observed between implant placement and loading (-0.88 mm). The results indicated that monotype ceramic implants can achieve clinical outcomes comparable to published outcomes of equivalent titanium implants. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Assessing global risk factors for non-fatal injuries from road traffic accidents and falls in adults aged 35-70 years in 17 countries: a cross-sectional analysis of the Prospective Urban Rural Epidemiological (PURE) study.

PubMed

Raina, Parminder; Sohel, Nazmul; Oremus, Mark; Shannon, Harry; Mony, Prem; Kumar, Rajesh; Li, Wei; Wang, Yang; Wang, Xingyu; Yusoff, Khalid; Yusuf, Rita; Iqbal, Romaina; Szuba, Andrzej; Oguz, Aytekin; Rosengren, Annika; Kruger, Annamarie; Chifamba, Jephat; Mohammadifard, Noushin; Darwish, Ebtihal Ahmad; Dagenais, Gilles; Diaz, Rafael; Avezum, Alvaro; Lopez-Jaramillo, Patricio; Seron, Pamela; Rangarajan, Sumathy; Teo, Koon; Yusuf, Salim

2016-04-01

To assess risk factors associated with non-fatal injuries (NFIs) from road traffic accidents (RTAs) or falls. Our study included 151 609 participants from the Prospective Urban Rural Epidemiological study. Participants reported whether they experienced injuries within the past 12 months that limited normal activities. Additional questions elicited data on risk factors. We employed multivariable logistic regression to analyse data. Overall, 5979 participants (3.9% of 151 609) reported at least one NFI. Total number of NFIs was 6300: 1428 were caused by RTAs (22.7%), 1948 by falls (30.9%) and 2924 by other causes (46.4%). Married/common law status was associated with fewer falls, but not with RTA. Age 65-70 years was associated with fewer RTAs, but more falls; age 55-64 years was associated with more falls. Male versus female was associated with more RTAs and fewer falls. In lower-middle-income countries, rural residence was associated with more RTAs and falls; in low-income countries, rural residence was associated with fewer RTAs. Previous alcohol use was associated with more RTAs and falls; current alcohol use was associated with more falls. Education was not associated with either NFI type. This study of persons aged 35-70 years found that some risk factors for NFI differ according to whether the injury is related to RTA or falls. Policymakers may use these differences to guide the design of prevention policies for RTA-related or fall-related NFI. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Factors influencing successful peer-reviewed publication of original research presentations from the American Society of Pediatric Otolaryngology (ASPO).

PubMed

MacKinney, Erin C; Chun, Robert H; Cassidy, Laura D; Link, T Roxanne; Sulman, Cecille G; Kerschner, Joseph E

2015-03-01

To analyze factors associated with progression of an original scientific presentation at the American Society of Pediatric Otolaryngology (ASPO) Annual Meeting to publication in a peer-reviewed journal. A dataset of presenters was created to enable prospective follow-up to assess early impressions regarding publication success with longer-term publication outcomes. Prior to the Annual ASPO meeting in 2013, a survey consisting of 10 questions was e-mailed to all 59 presenters. Questions were designed to assess presenter expectations on publication, barriers to publishing, and experience in presenting, publishing and clinical practice. A second survey was sent 12 months later to those respondents of the first survey who were amenable to follow-up. Overall, 46 of 59 (78%) presenters responded to the initial survey prior to their ASPO 2013 presentation. Of these, 34 agreed to participate in a longer-term follow-up of their presentation to publication experience. Of these 34, there were 17 who participated in the follow-up survey 1 year later. Just under half of the original respondents were residents (46%). All presenters (100%) planned to re-submit a revised manuscript if initially rejected. However, 35% of follow-up respondents did not make initial submission to a peer-reviewed journal. Results of a descriptive analysis suggest that more experienced researchers expect their submitted manuscript to be accepted for publication within a shorter time frame than those that have published fewer papers. Time was ranked as the greatest barrier to publication (60%) of those surveyed both in the initial prospective survey and for those who did not publish a paper in the follow-up survey (83%). This study suggests a strong desire and expectation of publishing ASPO presentations. Despite this expectation, past research and this data set suggest this expectation often does not materialize. "Time constraints" were the most commonly identified barrier to publication. To enhance dissemination of new findings from ASPO meetings, institutions and individuals should examine methods that facilitate and incentivize publication of findings in peer-reviewed publications. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Implementing Program Integrity from an HBCU Perspective: Progress, Problems, and Prospects. An Analysis of Part H, Program Integrity - TRIAD of the Higher Education Act and the Final Rules and Related Interim Final Regulations Published in the "Federal Register" on April 29, 1994.

ERIC Educational Resources Information Center

Blakely, William A.

This paper examines the impact and implications for the nation's 104 historically black colleges and universities (HBCUs) of the final regulations published in the April 29, 1994 "Federal Register" and traces both the legislative and regulatory history of Part H of the Higher Education Act provisions. The analysis addresses specific…

Daytime Napping and the Risk of Cardiovascular Disease and All-Cause Mortality: A Prospective Study and Dose-Response Meta-Analysis.

PubMed

Yamada, Tomohide; Hara, Kazuo; Shojima, Nobuhiro; Yamauchi, Toshimasa; Kadowaki, Takashi

2015-12-01

To summarize evidence about the association between daytime napping and the risk of cardiovascular disease and all-cause mortality, and to quantify the potential dose-response relation. Meta-analysis of prospective cohort studies. Electronic databases were searched for articles published up to December 2014 using the terms nap, cardiovascular disease, and all-cause mortality. We selected well-adjusted prospective cohort studies reporting risk estimates for cardiovascular disease and all-cause mortality related to napping. Eleven prospective cohort studies were identified with 151,588 participants (1,625,012 person-years) and a mean follow-up period of 11 years (60% women, 5,276 cardiovascular events, and 18,966 all-cause deaths). Pooled analysis showed that a long daytime nap (≥ 60 min/day) was associated with a higher risk of cardiovascular disease (rate ratio [RR]: 1.82 [1.22-2.71], P = 0.003, I(2) = 37%) compared with not napping. All-cause mortality was associated with napping for ≥ 60 min/day (RR: 1.27 [1.11-1.45], P < 0.001, I(2) = 0%) compared with not napping. In contrast, napping for < 60 min/day was not associated with cardiovascular disease (P = 0.98) or all-cause mortality (P = 0.08). Meta-analysis demonstrated a significant J-curve dose-response relation between nap time and cardiovascular disease (P for nonlinearity = 0.01). The RR initially decreased from 0 to 30 min/day. Then it increased slightly until about 45 min/day, followed by a sharp increase at longer nap times. There was also a positive linear relation between nap time and all-cause mortality (P for non-linearity = 0.97). Nap time and cardiovascular disease may be associated via a J-curve relation. Further studies are needed to confirm the efficacy of a short nap. © 2015 Associated Professional Sleep Societies, LLC.

Publication Rate of Abstracts Presented at the Annual Congress of the European Society for Surgical Research during 2008-2011.

PubMed

Meral, Ulvi Mehmet; Alakus, Umit; Urkan, Murat; Ureyen, Orhan; Oren, Nisa Cem; Ozturk Meral, Aylin; Çağıltay, Eylem; Can, Mehmet Fatih

2016-01-01

The presentation of scientific studies at major meetings serves to rapidly share study results with the scientific community. On the other hand, full-text publication of abstracts in peer-reviewed journals ensures the dissemination of science. This study examines the publication rate (PR) of meeting abstracts presented at the European Society for Surgical Research (ESSR) congresses and determines/compares the factors affecting the PRs. All presentations at the ESSR congresses held during 2008-2011 were retrospectively assessed. Manuscripts indexed in PubMed were included. The meeting year, journal impact factor (IF) in the publication year, study type, presentation type, time to publication and geographic origin of studies were assessed. Among a total of 1,368 oral and poster abstracts, 48.7% (n = 391) of the oral presentations (OPs) and 29.7% (n = 168) of the poster presentations (PPs) were published in medical journals indexed in PubMed. The mean IF of the journals was 2.696 (0.17-14.95). The journals that published OPs had a higher IF than the journals in which PPs were published (2.944 vs. 2.118; p < 0.001). The PR was also higher in the OP group than in the PP group of journals (p < 0.001). The time to publication was 17.5 months (-166 to 82) and was shorter for PPs than for OPs (14.02 vs. 19.09 months; p = 0.01). According to the study type, experimental studies had a significantly higher PR (53.7%; p < 0.001); however, there was no significant difference in PR in terms of the prospective or retrospective nature of clinical studies. The clinical studies were also compared according to the IF values of the journals in terms of the prospective or retrospective nature of the study, and no significant difference was found (p = 0.62). The ESSR congress is an efficient meeting for researchers from varied surgical disciplines and has a PR equivalent to that of similar scientific meetings. The congress has achieved a PR of 40.9% over 4 years with an average IF of 2.696 and a mean time to publication of 17.5 months, which is equivalent to that of similar scientific meetings. OPs have a higher PR in journals with greater IF values as compared with PPs. © 2016 S. Karger AG, Basel.

A prospective study of central venous catheters placed in a tertiary care Emergency Department: indications for use, infectious complications, and natural history.

PubMed

Diaz, Katrina; Kelly, Sean G; Smith, Barbara; Malani, Preeti N; Younger, John G

2012-02-01

Despite successful efforts to improve overall central line-associated bloodstream infections (CLABSI) rates, little is known about CLABSI rates or even central venous catheter insertion practices in the Emergency Department. We sought to determine the baseline CLABSI rate for Emergency Department-inserted central venous catheters and to describe indications for placement, duration of use, and the natural history of these devices. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

["SOS SEIN 84" accelerated breast disease management: Patients satisfaction survey].

PubMed

Arnaud, Antoine; Dumuids, Magali; Mège, Alice; de Rauglaudre, Gaëtan; Regis Arnaud, Anne; Martin, Nicole; Dupuy Meurat, Françoise; Dolle, Sabine; Gallon, Elise; Serin, Daniel

2016-05-01

In case of a new breast symptom or an abnormal result of breast imaging, some women have a problem finding a quick answer to allay their anxiety. The Institut Sainte-Catherine in Avignon has set up a new form of accelerated disease management through the opening of a new dedicated consultation called SOS SEIN 84. We present the result of a prospective quality study of our first new patients. Copyright © 2016 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Fruits, vegetables, and bladder cancer risk: a systematic review and meta-analysis.

PubMed

Vieira, Ana R; Vingeliene, Snieguole; Chan, Doris S M; Aune, Dagfinn; Abar, Leila; Navarro Rosenblatt, Deborah; Greenwood, Darren C; Norat, Teresa

2015-01-01

Smoking is estimated to cause about half of all bladder cancer cases. Case-control studies have provided evidence of an inverse association between fruit and vegetable intake and bladder cancer risk. As part of the World Cancer Research/American Institute for Cancer Research Continuous Update Project, we conducted a systematic review and meta-analysis of prospective studies to assess the dose-response relationship between fruit and vegetables and incidence and mortality of bladder cancer. We searched PubMed up to December 2013 for relevant prospective studies. We conducted highest compared with lowest meta-analyses and dose-response meta-analyses using random effects models to estimate summary relative risks (RRs) and 95% confidence intervals (CIs), and used restricted cubic splines to examine possible nonlinear associations. Fifteen prospective studies were included in the review. The summary RR for an increase of 1 serving/day (80 g) were 0.97 (95% CI: 0.95-0.99) I(2)  = 0%, eight studies for fruits and vegetables, 0.97 (95% CI: 0.94-1.00, I(2)  = 10%, 10 studies) for vegetables and 0.98 (95% CI: 0.96-1.00, I(2)  = 0%, 12 studies) for fruits. Results were similar in men and women and in current, former and nonsmokers. Amongst fruits and vegetables subgroups, for citrus fruits the summary RR for the highest compared with the lowest intake was 0.87 (95% CI: 0.76-0.99, I(2)  = 0%, eight studies) and for cruciferous vegetables there was evidence of a nonlinear relationship (P = 0.001). The current evidence from cohort studies is not consistent with a role for fruits and vegetables in preventing bladder cancer. © 2014 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Influence of an apical negative pressure irrigation system on bacterial elimination during endodontic therapy: a prospective randomized clinical study.

PubMed

Pawar, Rekha; Alqaied, Abdullah; Safavi, Kamran; Boyko, Jennifer; Kaufman, Blythe

2012-09-01

Recent in vitro studies that use an apical negative pressure irrigation system, EndoVac, have demonstrated promising results in the production of debris-free root canals, while also preventing potential extrusion of irrigants into the periapical region. We conducted a randomized, controlled, prospective clinical study to determine whether the use of EndoVac irrigation (EndoVac group) was more efficient compared with standard needle irrigation (control group) in obtaining canals from which microbes could not be cultivated. Routine endodontic therapy was performed in 48 patients with necrotic, single-rooted, single-canal teeth. The patients were randomly assigned to either the EndoVac group (n = 25) or control group (n = 23). Irrigation with either method was carried out with 0.5% sodium hypochlorite. After surface disinfection, before instrumentation and on completion of chemomechanical preparation, intracanal microbial samples were obtained and cultured under anaerobic conditions. The frequency of microbial cultivability by using either irrigation system was analyzed. The frequency of obtaining culture-negative root canals was 90.9% and 82.6% for the control group and EndoVac group, respectively. There was no significant difference in the antimicrobial efficacy of either control group or EndoVac group (Fisher exact test, P = .665). Furthermore, no significant association between study variables and the irrigation systems' antimicrobial efficacy was found (P > .05). The results of this prospective in vivo study demonstrate that the antimicrobial efficacy of EndoVac irrigation is comparable to that of standard irrigation. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

The efficacy and adverse effects of in vitro fertilization and embryo transfer.

PubMed

Corabian, P; Hailey, D

1999-01-01

This paper examines the current status of in vitro fertilization and embryo transfer (IVF-ET) as a treatment for various types of infertility. We reviewed studies on the efficacy and safety of IVF-ET and intracytoplasmic sperm injection (ICSI) plus IVF-ET, compared with conventional treatment or no treatment for various infertility diagnoses. Material retrieved included English language publications between 1992 and January 1997 that reported the results of prospective controlled clinical trials, cohort studies, and retrospective comparative studies with large series, and reviews presenting risks, complications, and longer-term health consequences associated with IVF-ET and ICSI. No adequate prospective comparative studies of sufficient power on the use of IVF-ET for specific infertility diagnoses have been reported to date. Most of the published reports concerning results with IVF-ET as a treatment of infertility have been based upon small, uncontrolled studies, with various methodological weaknesses. Reported results are not directly comparable. There are few follow-up data on outcomes after pregnancy is established or on long-term health consequences of the use of IVF-ET on mothers and their babies. IVF-ET has diffused widely without comprehensive assessment of its efficacy and safety. The available evidence supports its use only for severe bilateral tubal occlusion. For other diagnoses of infertility the evidence is limited and does not establish whether IVF-ET is effective. Long-term, well-designed, prospective clinical trials are required to determine when and for what indications IVF-ET is effective and what its health effects are on both mothers and their babies.

Evaluation of prevalence and risk factors of gestational diabetes in a tertiary care hospital in Kerala.

PubMed

Mohan, Manju A; Chandrakumar, Abin

2016-01-01

The prospective study was conducted with the aim to evaluate the prevalence and risk factors of gestational diabetes mellitus in a tertiary care referral hospital in Kerala. A prospective observational study was conducted with the aim to study the prevalence, risk factors, complications, treatment pattern and cost analysis of GDM. The study was carried out in the Obstetrics & Gynecology dDepartment of Al Shifa hHospital located in northern Kerala. Over an eight-month period, 201 patients who met the inclusion criteria were enrolled for study from which prevalence of GDM was estimated at 15.9%. The study revealed higher prevalence of risk factors and complications such as age >25 years, BMI >26kg/m(2), family history of DM, past history GDM, history of big baby, gestational hypertension, vaginal candidiasis, premature rupture of membranes and hyperbilirubinemia in GDM group as compared to non-GDM group. The study also demonstrated that modern life-style was a major influencing factor for development of diabetes in the study population. The study reveals the necessity of proper screening diagnosis and management of GDM in pregnant women by the clinicians so as to prevent the future burden of type 2 diabetes. Copyright © 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Imagining a brighter future: the effect of positive imagery training on mood, prospective mental imagery and emotional bias in older adults.

PubMed

Murphy, Susannah E; Clare O'Donoghue, M; Drazich, Erin H S; Blackwell, Simon E; Christina Nobre, Anna; Holmes, Emily A

2015-11-30

Positive affect and optimism play an important role in healthy ageing and are associated with improved physical and cognitive health outcomes. This study investigated whether it is possible to boost positive affect and associated positive biases in this age group using cognitive training. The effect of computerised imagery-based cognitive bias modification on positive affect, vividness of positive prospective imagery and interpretation biases in older adults was measured. 77 older adults received 4 weeks (12 sessions) of imagery cognitive bias modification or a control condition. They were assessed at baseline, post-training and at a one-month follow-up. Both groups reported decreased negative affect and trait anxiety, and increased optimism across the three assessments. Imagery cognitive bias modification significantly increased the vividness of positive prospective imagery post-training, compared with the control training. Contrary to our hypothesis, there was no difference between the training groups in negative interpretation bias. This is a useful demonstration that it is possible to successfully engage older adults in computer-based cognitive training and to enhance the vividness of positive imagery about the future in this group. Future studies are needed to assess the longer-term consequences of such training and the impact on affect and wellbeing in more vulnerable groups. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Implant-supported single-tooth restorations. A 12-year prospective study.

PubMed

Donati, Mauro; Ekestubbe, Annika; Lindhe, Jan; Wennström, Jan L

2016-10-01

The aim of this study was to evaluate prospectively the 12-year outcome of implant-supported single-tooth restorations. Originally 45 self-tapping Astra Tech TiOblast ® ST-implants were installed by a two-stage protocol in 40 subjects requiring single-tooth prosthetic replacement for a missing tooth. Clinical and radiologic examinations were performed at completion of the prosthetic treatment 4-7 months after implant installation surgery and after 5 and 12 years in function. At 12 years 31 patients and 35 implants were available for evaluation. The overall failure rate after 12 years was 10.3% on the subject level and 9.1% on the implant level. The mean bone loss amounted to 0.67 mm (SD 2.20) on a subject level and 0.47 mm (1.72) on an implant level. Three subjects (10%) and three implants (8.6%) were diagnosed with peri-implantitis. Five subjects had experienced technical complications; three incidences of loosening of the abutment retention screw during the first 5 years and two minor porcelain fracture of the crown (two patients) between 5- and 12-years of follow-up. The findings reported in this 12-year prospective case series suggest that the use of the Astra Tech dental implants may be a valid treatment alternative for single-tooth replacement prostheses. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Prospective study of cost of care at multidisciplinary ALS centers adhering to American Academy of Neurology (AAN) ALS practice parameters.

PubMed

Boylan, Kevin; Levine, Todd; Lomen-Hoerth, Catherine; Lyon, Mary; Maginnis, Kimberly; Callas, Peter; Gaspari, Celeste; Tandan, Rup

2015-01-01

Multidisciplinary care in ALS is associated with longer survival, improved quality of life, and reduced hospital admissions, but there are no published data on institutional costs associated with multidisciplinary ALS care at U.S. centers. We prospectively examined institutional costs, adherence to AAN Practice Parameters and patient satisfaction in multidisciplinary ALS clinics at 18 U.S. ALS centers. Centers reported patient volumes; direct costs for staff salary/benefits, supplies and equipment; and institutional non-salary and overhead costs over a three-month period. In 1117 patients seen during this period, mean age was 61.5 years (range 25-91 years), 56% were male, and mean ALSFRS-R score was 29. Mean total salary/benefit cost per clinic day for all providers was $2964 (range $1692-$5236 across centers). Mean salary/benefit cost per patient per clinic was $507 (range $258-$806 across centers). Differences among centers in reporting non-salary costs prevented meaningful analysis. Practice parameter adherence and patient satisfaction were high. This prospective collaborative study demonstrates the direct financial burden of evidence-based multidisciplinary ALS care in the U.S.; more refined non-salary and overhead cost data are needed to evaluate the full cost impact of care. These data may be useful in supporting evidence-based models of patient centered care for ALS.

Prospective Investigation of the Contrast Avoidance Model of Generalized Anxiety and Worry.

PubMed

Crouch, Tara A; Lewis, Jamie A; Erickson, Thane M; Newman, Michelle G

2017-07-01

The factors that maintain generalized anxiety disorder (GAD) symptoms and worry over time are not entirely clear. The Contrast Avoidance Model (CAM) postulates that individuals at risk for pathological worry and GAD symptoms uniquely fear emotional shifts from neutral or positive emotions into negative emotional states, and consequently use worry to maintain negative emotion in order to avoid shifts or blunt the effect of negative contrasts. This model has received support in laboratory experiments, but has not been investigated prospectively in the naturalistic context of daily life. The present study tested the CAM in a longitudinal experience sampling study with a subclinical sample. Participants selected to represent a broad range of symptoms (N = 92) completed baseline measures of GAD and depression symptoms, and eight weekly assessments of worry, experiences of negative emotional contrasts during their worst event of the week, and situation-specific negative emotion. Consistent with the CAM, GAD symptoms prospectively predicted higher endorsement of negative contrast experiences as worst events, independent of depression symptoms. Unsurprisingly, higher negative contrasts predicted higher negative emotion. However, both higher baseline GAD symptoms and weekly worry uniquely moderated (reduced) this relationship, providing consistent support for the idea that worry may blunt the emotional effects of contrasts. Depression symptoms did not have the same moderating effect. These findings support the CAM in an ecologically valid context. Copyright © 2016. Published by Elsevier Ltd.

Diagnostic and prognostic stratification in the emergency department using urinary biomarkers of nephron damage: a multicenter prospective cohort study.

PubMed

Nickolas, Thomas L; Schmidt-Ott, Kai M; Canetta, Pietro; Forster, Catherine; Singer, Eugenia; Sise, Meghan; Elger, Antje; Maarouf, Omar; Sola-Del Valle, David Antonio; O'Rourke, Matthew; Sherman, Evan; Lee, Peter; Geara, Abdallah; Imus, Philip; Guddati, Achuta; Polland, Allison; Rahman, Wasiq; Elitok, Saban; Malik, Nasir; Giglio, James; El-Sayegh, Suzanne; Devarajan, Prasad; Hebbar, Sudarshan; Saggi, Subodh J; Hahn, Barry; Kettritz, Ralph; Luft, Friedrich C; Barasch, Jonathan

2012-01-17

This study aimed to determine the diagnostic and prognostic value of urinary biomarkers of intrinsic acute kidney injury (AKI) when patients were triaged in the emergency department. Intrinsic AKI is associated with nephron injury and results in poor clinical outcomes. Several urinary biomarkers have been proposed to detect and measure intrinsic AKI. In a multicenter prospective cohort study, 5 urinary biomarkers (urinary neutrophil gelatinase-associated lipocalin, kidney injury molecule-1, urinary liver-type fatty acid binding protein, urinary interleukin-18, and cystatin C) were measured in 1,635 unselected emergency department patients at the time of hospital admission. We determined whether the biomarkers diagnosed intrinsic AKI and predicted adverse outcomes during hospitalization. All biomarkers were elevated in intrinsic AKI, but urinary neutrophil gelatinase-associated lipocalin was most useful (81% specificity, 68% sensitivity at a 104-ng/ml cutoff) and predictive of the severity and duration of AKI. Intrinsic AKI was strongly associated with adverse in-hospital outcomes. Urinary neutrophil gelatinase-associated lipocalin and urinary kidney injury molecule 1 predicted a composite outcome of dialysis initiation or death during hospitalization, and both improved the net risk classification compared with conventional assessments. These biomarkers also identified a substantial subpopulation with low serum creatinine at hospital admission, but who were at risk of adverse events. Urinary biomarkers of nephron damage enable prospective diagnostic and prognostic stratification in the emergency department. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Prospective performance evaluation of selected common virtual screening tools. Case study: Cyclooxygenase (COX) 1 and 2.

PubMed

Kaserer, Teresa; Temml, Veronika; Kutil, Zsofia; Vanek, Tomas; Landa, Premysl; Schuster, Daniela

2015-01-01

Computational methods can be applied in drug development for the identification of novel lead candidates, but also for the prediction of pharmacokinetic properties and potential adverse effects, thereby aiding to prioritize and identify the most promising compounds. In principle, several techniques are available for this purpose, however, which one is the most suitable for a specific research objective still requires further investigation. Within this study, the performance of several programs, representing common virtual screening methods, was compared in a prospective manner. First, we selected top-ranked virtual screening hits from the three methods pharmacophore modeling, shape-based modeling, and docking. For comparison, these hits were then additionally predicted by external pharmacophore- and 2D similarity-based bioactivity profiling tools. Subsequently, the biological activities of the selected hits were assessed in vitro, which allowed for evaluating and comparing the prospective performance of the applied tools. Although all methods performed well, considerable differences were observed concerning hit rates, true positive and true negative hits, and hitlist composition. Our results suggest that a rational selection of the applied method represents a powerful strategy to maximize the success of a research project, tightly linked to its aims. We employed cyclooxygenase as application example, however, the focus of this study lied on highlighting the differences in the virtual screening tool performances and not in the identification of novel COX-inhibitors. Copyright © 2015 The Authors. Published by Elsevier Masson SAS.. All rights reserved.

Reaching out for patients: public relations and events with real results.

PubMed

Kuechel, Marie Czenko

2010-02-01

In today's market, the aesthetic physician needs to connect with patients using methods that are personal, educational, and that will glean the interest of prospective patients whose attention and dollars are sought by countless facial plastic surgery competitors near and far. Public relations, or reaching your prospective patient without a direct solicitation (advertising) for services, are traditional means that include media relations and charitable and social events. With the added component of social media, today the opportunities to reach out for new patients and garner real results are more varied and more affordable than ever before. Thieme Medical Publishers.

Registration status and methodological reporting of randomized controlled trials in obesity research: A review.

PubMed

Byrne, Jillian L S; Yee, Tamara; O'Connor, Kathleen; Dyson, Michele P; Ball, Geoff D C

2017-04-01

To assess registration and reporting details of randomized controlled trials (RCTs) published from 2011 to 2016 across four obesity journals. All issues from four leading obesity journals were searched systematically for RCTs from January 2011 to June 2016. Data on registration status were extracted from manuscripts, online trial registries, and a trial database; corresponding authors were contacted for registration details, when necessary. The methodological reporting of RCTs was assessed on specific criteria from the Consolidated Standards of Reporting Trials. A total of 223 RCTs were reviewed. Three-quarters (n = 170) were registered publicly; 94 (55.3%) reported registration details in the manuscript, and 82 (48.2%) were registered prospectively. Newer RCTs were more likely to be registered prospectively than older RCTs (2014-2016: 57.3% vs. 2011-2013: 39.2%; c 2  = 5.5, P = 0.02). Assessment on the Consolidated Standards of Reporting Trials demonstrated that less than half of all studies reported data collection dates (n = 108; 48.4%) or included "randomized trial" in the title (n = 89; 39.9%). The methodological reporting of RCTs published in obesity journals is suboptimal, despite current guidelines and policies. To complement existing standards, editorial boards should incorporate mandatory fields within the online manuscript submission process to enhance the quality, transparency, and comprehensiveness of reporting RCTs in obesity journals. © 2017 The Obesity Society.

Physical and cultural determinants of postpartum pelvic floor support and symptoms following vaginal delivery: a protocol for a mixed-methods prospective cohort study.

PubMed

Nygaard, Ingrid E; Clark, Erin; Clark, Lauren; Egger, Marlene J; Hitchcock, Robert; Hsu, Yvonne; Norton, Peggy; Sanchez-Birkhead, Ana; Shaw, Janet; Sheng, Xiaoming; Varner, Michael

2017-01-10

Pelvic floor disorders (PFDs), including pelvic organ prolapse (POP), stress and urgency urinary incontinence, and faecal incontinence, are common and arise from loss of pelvic support. Although severe disease often does not occur until women become older, pregnancy and childbirth are major risk factors for PFDs, especially POP. We understand little about modifiable factors that impact pelvic floor function recovery after vaginal birth. This National Institutes of Health (NIH)-funded Program Project, 'Bridging physical and cultural determinants of postpartum pelvic floor support and symptoms following vaginal delivery', uses mixed-methods research to study the influences of intra-abdominal pressure, physical activity, body habitus and muscle fitness on pelvic floor support and symptoms as well as the cultural context in which women experience those changes. Using quantitative methods, we will evaluate whether pelvic floor support and symptoms 1 year after the first vaginal delivery are affected by biologically plausible factors that may impact muscle, nerve and connective tissue healing during recovery (first 8 weeks postpartum) and strengthening (remainder of the first postpartum year). Using qualitative methods, we will examine cultural aspects of perceptions, explanations of changes in pelvic floor support, and actions taken by Mexican-American and Euro-American primipara, emphasising early changes after childbirth. We will summarise project results in a resource toolkit that will enhance opportunities for dialogue between women, their families and providers, and across lay and medical discourses. We anticipate enrolling up to 1530 nulliparous women into the prospective cohort study during the third trimester, following those who deliver vaginally 1 year postpartum. Participants will be drawn from this cohort to meet the project's aims. The University of Utah and Intermountain Healthcare Institutional Review Boards approved this study. Data are stored in a secure password-protected database. Papers summarising the primary results and ancillary analyses will be published in peer-reviewed journals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Methods of a large prospective, randomised, open-label, blinded end-point study comparing morning versus evening dosing in hypertensive patients: the Treatment In Morning versus Evening (TIME) study.

PubMed

Rorie, David A; Rogers, Amy; Mackenzie, Isla S; Ford, Ian; Webb, David J; Willams, Bryan; Brown, Morris; Poulter, Neil; Findlay, Evelyn; Saywood, Wendy; MacDonald, Thomas M

2016-02-09

Nocturnal blood pressure (BP) appears to be a better predictor of cardiovascular outcome than daytime BP. The BP lowering effects of most antihypertensive therapies are often greater in the first 12 h compared to the next 12 h. The Treatment In Morning versus Evening (TIME) study aims to establish whether evening dosing is more cardioprotective than morning dosing. The TIME study uses the prospective, randomised, open-label, blinded end-point (PROBE) design. TIME recruits participants by advertising in the community, from primary and secondary care, and from databases of consented patients in the UK. Participants must be aged over 18 years, prescribed at least one antihypertensive drug taken once a day, and have a valid email address. After the participants have self-enrolled and consented on the secure TIME website (http://www.timestudy.co.uk) they are randomised to take their antihypertensive medication in the morning or the evening. Participant follow-ups are conducted after 1 month and then every 3 months by automated email. The trial is expected to run for 5 years, randomising 10,269 participants, with average participant follow-up being 4 years. The primary end point is hospitalisation for the composite end point of non-fatal myocardial infarction (MI), non-fatal stroke (cerebrovascular accident; CVA) or any vascular death determined by record-linkage. Secondary end points are: each component of the primary end point, hospitalisation for non-fatal stroke, hospitalisation for non-fatal MI, cardiovascular death, all-cause mortality, hospitalisation or death from congestive heart failure. The primary outcome will be a comparison of time to first event comparing morning versus evening dosing using an intention-to-treat analysis. The sample size is calculated for a two-sided test to detect 20% superiority at 80% power. TIME has ethical approval in the UK, and results will be published in a peer-reviewed journal. UKCRN17071; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Towards a standardised informed consent procedure for live donor nephrectomy: the PRINCE (Process of Informed Consent Evaluation) project-study protocol for a nationwide prospective cohort study.

PubMed

Kortram, Kirsten; Spoon, Emerentia Q W; Ismail, Sohal Y; d'Ancona, Frank C H; Christiaans, Maarten H L; van Heurn, L W Ernest; Hofker, H Sijbrand; Hoksbergen, Arjan W J; Homan van der Heide, Jaap J; Idu, Mirza M; Looman, Caspar W N; Nurmohamed, S Azam; Ringers, Jan; Toorop, Raechel J; van de Wetering, Jacqueline; Ijzermans, Jan N M; Dor, Frank J M F

2016-04-01

Informed consent is mandatory for all (surgical) procedures, but it is even more important when it comes to living kidney donors undergoing surgery for the benefit of others. Donor education, leading to informed consent, needs to be carried out according to certain standards. Informed consent procedures for live donor nephrectomy vary per centre, and even per individual healthcare professional. The basis for a standardised, uniform surgical informed consent procedure for live donor nephrectomy can be created by assessing what information donors need to hear to prepare them for the operation and convalescence. The PRINCE (Process of Informed Consent Evaluation) project is a prospective, multicentre cohort study, to be carried out in all eight Dutch kidney transplant centres. Donor knowledge of the procedure and postoperative course will be evaluated by means of pop quizzes. A baseline cohort (prior to receiving any information from a member of the transplant team in one of the transplant centres) will be compared with a control group, the members of which receive the pop quiz on the day of admission for donor nephrectomy. Donor satisfaction will be evaluated for all donors who completed the admission pop-quiz. The primary end point is donor knowledge. In addition, those elements that have to be included in the standardised format informed consent procedure will be identified. Secondary end points are donor satisfaction, current informed consent practices in the different centres (eg, how many visits, which personnel, what kind of information is disclosed, in which format, etc) and correlation of donor knowledge with surgeons' estimation thereof. Approval for this study was obtained from the medical ethical committee of the Erasmus MC, University Medical Center, Rotterdam, on 18 February 2015. Secondary approval has been obtained from the local ethics committees in six participating centres. Approval in the last centre has been sought. Outcome will be published in a scientific journal. NTR5374; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Fruit and vegetable intake and risk of type 2 diabetes mellitus: meta-analysis of prospective cohort studies

PubMed Central

Li, Min; Fan, Yingli; Zhang, Xiaowei; Hou, Wenshang; Tang, Zhenyu

2014-01-01

Objective To clarify and quantify the potential dose–response association between the intake of fruit and vegetables and risk of type 2 diabetes. Design Meta-analysis and systematic review of prospective cohort studies. Data source Studies published before February 2014 identified through electronic searches using PubMed and Embase. Eligibility criteria for selecting studies Prospective cohort studies with relative risks and 95% CIs for type 2 diabetes according to the intake of fruit, vegetables, or fruit and vegetables. Results A total of 10 articles including 13 comparisons with 24 013 cases of type 2 diabetes and 434 342 participants were included in the meta-analysis. Evidence of curve linear associations was seen between fruit and green leafy vegetables consumption and risk of type 2 diabetes (p=0.059 and p=0.036 for non-linearity, respectively). The summary relative risk of type 2 diabetes for an increase of 1 serving fruit consumed/day was 0.93 (95% CI 0.88 to 0.99) without heterogeneity among studies (p=0.477, I2=0%). For vegetables, the combined relative risk of type 2 diabetes for an increase of 1 serving consumed/day was 0.90 (95% CI 0.80 to 1.01) with moderate heterogeneity among studies (p=0.002, I2=66.5%). For green leafy vegetables, the summary relative risk of type 2 diabetes for an increase of 0.2 serving consumed/day was 0.87 (95% CI 0.81 to 0.93) without heterogeneity among studies (p=0.496, I2=0%). The combined estimates showed no significant benefits of increasing the consumption of fruit and vegetables combined. Conclusions Higher fruit or green leafy vegetables intake is associated with a significantly reduced risk of type 2 diabetes. PMID:25377009

Long working hours and depressive symptoms: systematic review and meta-analysis of published studies and unpublished individual participant data.

PubMed

Virtanen, Marianna; Jokela, Markus; Madsen, Ida Eh; Magnusson Hanson, Linda L; Lallukka, Tea; Nyberg, Solja T; Alfredsson, Lars; Batty, G David; Bjorner, Jakob B; Borritz, Marianne; Burr, Hermann; Dragano, Nico; Erbel, Raimund; Ferrie, Jane E; Heikkilä, Katriina; Knutsson, Anders; Koskenvuo, Markku; Lahelma, Eero; Nielsen, Martin L; Oksanen, Tuula; Pejtersen, Jan H; Pentti, Jaana; Rahkonen, Ossi; Rugulies, Reiner; Salo, Paula; Schupp, Jürgen; Shipley, Martin J; Siegrist, Johannes; Singh-Manoux, Archana; Suominen, Sakari B; Theorell, Töres; Vahtera, Jussi; Wagner, Gert G; Wang, Jian Li; Yiengprugsawan, Vasoontara; Westerlund, Hugo; Kivimäki, Mika

2018-05-01

Objectives This systematic review and meta-analysis combined published study-level data and unpublished individual-participant data with the aim of quantifying the relation between long working hours and the onset of depressive symptoms. Methods We searched PubMed and Embase for published prospective cohort studies and included available cohorts with unpublished individual-participant data. We used a random-effects meta-analysis to calculate summary estimates across studies. Results We identified ten published cohort studies and included unpublished individual-participant data from 18 studies. In the majority of cohorts, long working hours was defined as working ≥55 hours per week. In multivariable-adjusted meta-analyses of 189 729 participants from 35 countries [96 275 men, 93 454 women, follow-up ranging from 1-5 years, 21 747 new-onset cases), there was an overall association of 1.14 (95% confidence interval (CI) 1.03-1.25] between long working hours and the onset of depressive symptoms, with significant evidence of heterogeneity (I 2 =45.1%, P=0.004). A moderate association between working hours and depressive symptoms was found in Asian countries (1.50, 95% CI 1.13-2.01), a weaker association in Europe (1.11, 95% CI 1.00-1.22), and no association in North America (0.97, 95% CI 0.70-1.34) or Australia (0.95, 95% CI 0.70-1.29). Differences by other characteristics were small. Conclusions This observational evidence suggests a moderate association between long working hours and onset of depressive symptoms in Asia and a small association in Europe.

Systematic review of renal carcinoma prognostic factors.

PubMed

Lorente, D; Trilla, E; Meseguer, A; Planas, J; Placer, J; Celma, A; Salvador, C; Regis, L; Morote, J

2017-05-01

The natural history of renal cell carcinoma is heterogeneous. Some scenarios can be found in terms of clinical presentation, clinical evolution or type of recurrence (local/metastatic). The aim of this publication is to analyze the most important prognostic factors published in the literature. A literature review ob published papers was performed using the Pubmed, from first Motzer's classification published in 1999 to 2015, according to PRISMA declaration. Search was done using the following keywords: kidney neoplasm, kidney cancer, renal cell carcinoma, prognostic factors, mortality, survival and disease progression. Papers were classified according to level of evidence, the number of patients included and the type of study performed. The evolution in the knowledge of molecular pathways related to renal oncogenesis and the new targeted therapies has left to remain obsolete the old prognostic models. It's necessary to perform a continuous review to actualize nomograms and to adapt them to the new scenarios. Is necessary to perform a proper external validation of existing prognostic factors using prospective and multicentric studies to add them into the daily urologist clinical practice. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Association between Adult Height and Risk of Colorectal, Lung, and Prostate Cancer: Results from Meta-analyses of Prospective Studies and Mendelian Randomization Analyses

PubMed Central

Khankari, Nikhil K.; Shu, Xiao-Ou; Wen, Wanqing; Kraft, Peter; Lindström, Sara; Peters, Ulrike; Schildkraut, Joellen; Schumacher, Fredrick; Bofetta, Paolo; Risch, Angela; Bickeböller, Heike; Amos, Christopher I.; Easton, Douglas; Gruber, Stephen B.; Haiman, Christopher A.; Hunter, David J.; Chanock, Stephen J.; Pierce, Brandon L.; Zheng, Wei

2016-01-01

Background Observational studies examining associations between adult height and risk of colorectal, prostate, and lung cancers have generated mixed results. We conducted meta-analyses using data from prospective cohort studies and further carried out Mendelian randomization analyses, using height-associated genetic variants identified in a genome-wide association study (GWAS), to evaluate the association of adult height with these cancers. Methods and Findings A systematic review of prospective studies was conducted using the PubMed, Embase, and Web of Science databases. Using meta-analyses, results obtained from 62 studies were summarized for the association of a 10-cm increase in height with cancer risk. Mendelian randomization analyses were conducted using summary statistics obtained for 423 genetic variants identified from a recent GWAS of adult height and from a cancer genetics consortium study of multiple cancers that included 47,800 cases and 81,353 controls. For a 10-cm increase in height, the summary relative risks derived from the meta-analyses of prospective studies were 1.12 (95% CI 1.10, 1.15), 1.07 (95% CI 1.05, 1.10), and 1.06 (95% CI 1.02, 1.11) for colorectal, prostate, and lung cancers, respectively. Mendelian randomization analyses showed increased risks of colorectal (odds ratio [OR] = 1.58, 95% CI 1.14, 2.18) and lung cancer (OR = 1.10, 95% CI 1.00, 1.22) associated with each 10-cm increase in genetically predicted height. No association was observed for prostate cancer (OR = 1.03, 95% CI 0.92, 1.15). Our meta-analysis was limited to published studies. The sample size for the Mendelian randomization analysis of colorectal cancer was relatively small, thus affecting the precision of the point estimate. Conclusions Our study provides evidence for a potential causal association of adult height with the risk of colorectal and lung cancers and suggests that certain genetic factors and biological pathways affecting adult height may also affect the risk of these cancers. PMID:27598322

Self-reported breast feeding practices and the Baby Friendly Hospital Initiative in Riyadh, Saudi Arabia: prospective cohort study.

PubMed

Mosher, Cynthia; Sarkar, Abdullah; Hashem, Alaa AbouBakr; Hamadah, Reem E; Alhoulan, Asma; AlMakadma, Yosra A; Khan, Tehreem A; Al-Hamdani, Abdurahman K; Senok, Abiola

2016-12-16

The Baby Friendly Hospital Initiative (BFHI) is a practice guideline for healthcare providers to promote breastfeeding and increase breastfeeding rates. This study aimed to examine reported experiences and views on breastfeeding of women using prenatal and postnatal services, and opinions of staff, in the context of the BFHI programme in Riyadh, Saudi Arabia. Prospective cohort study. This prospective, longitudinal study was conducted from December 2013 to September 2015 at two healthcare facilities (BFHI and non-BFHI) in Riyadh Saudi Arabia. Women 36-40 weeks gestation receiving antenatal care at the hospitals were enrolled. Questionnaires were administered prenatally, at 1, 3 and 6 months postnatal and to the administrator and maternity staff. We recruited 277 women with an estimated 80% response rate. 156 (BFHI=78/139, non-BFHI=78/138, 56%) participants completed all questionnaires. Most BFHI-hospital participants (77.9%, n=8 for this question) acknowledged seeing the breast feeding policy compared to 23.5% (n=23) at the non-BFHI-hospital (p<0.01). Breast feeding education and encouragement was higher at the BFHI-hospital (93.3%) compared to the non-BFHI-hospital (48.2%; p<0.01). At postpartum discharge, 51% (n=53) of mothers in the BFHI-hospital were breast feeding exclusively versus 29.6% (n=29) at the non-BFHI-hospital. Where formula feed was introduced, women in the BFHI-hospital more often practiced mixed feeding rather than exclusive formula feeding with some switching from mixed feeding to exclusive breast feeding between 3 and 6 months postpartum. Exclusive breast feeding rates declined in both hospitals at 3 and 6 months postpartum with lack of community services for lactation being a major reason. Although BFHI-hospital staff (n=9) were more conversant with BFHI principles, defects in adherence to the BFHI 10 Steps were identified. This is the first study assessing the effectiveness of BFHI implementation in Saudi Arabia. Although women reported increased breast feeding rates, we identified important weaknesses that could be improved through strict compliance with BFHI practices. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Oral rehabilitation with tilted dental implants: A metaanalysis

PubMed Central

Peñarrocha-Oltra, David; Candel-Marti, Eugenia; Peñarrocha-Diago, Maria

2012-01-01

Objective: To compare the course of patients treated with tilted implants versus those treated conventionally with axial implants, analyzing the success rate and marginal bone loss. Material and Methods: A PubMed search was made using the key words “tilted implants”, “angled implants”, “angulated implants”, “inclined implants” and “maxillary atrophy.” A review was made of the articles published between 1999-2010. The inclusion criteria were the use of tilted implants, clinical series involving at least 10 patients, and a minimum follow-up of 12 months after prosthetic loading. The exclusion criteria were isolated clinical cases, studies with missing data, and publications in languages other than English or Spanish. The metaanalysis finally included 13 articles: 7 retrospective studies and 6 prospective studies. Results: On analyzing the success rate in the retrospective studies, two reported a higher success rate with tilted implants; one a higher success rate with axial implants; and two reported similar success rates with both implants. On analyzing the success rate in the prospective studies, two reported a higher success rate with tilted implants; two a higher success rate with axial implants; and two reported similar success rates with both implants. On examining marginal bone loss, three studies reported greater bone loss with axial implants and one with tilted implants. Conclusions: There was no evidence of differences in success rate between tilted and axial implants in either the prospective or retrospective studies subjected to review. The marginal bone loss observed with the tilted and axial implants likewise proved very similar. It thus can be deduced that tilted implants exhibit the same evolutive behavior as axial implants. Key words:Axial implants, tilted implants, maxillary atrophy, tilted implants. PMID:22322494

Comparison of prospective risk estimates for postoperative complications: human vs computer model.

PubMed

Glasgow, Robert E; Hawn, Mary T; Hosokawa, Patrick W; Henderson, William G; Min, Sung-Joon; Richman, Joshua S; Tomeh, Majed G; Campbell, Darrell; Neumayer, Leigh A

2014-02-01

Surgical quality improvement tools such as NSQIP are limited in their ability to prospectively affect individual patient care by the retrospective audit and feedback nature of their design. We hypothesized that statistical models using patient preoperative characteristics could prospectively provide risk estimates of postoperative adverse events comparable to risk estimates provided by experienced surgeons, and could be useful for stratifying preoperative assessment of patient risk. This was a prospective observational cohort. Using previously developed models for 30-day postoperative mortality, overall morbidity, cardiac, thromboembolic, pulmonary, renal, and surgical site infection (SSI) complications, model and surgeon estimates of risk were compared with each other and with actual 30-day outcomes. The study cohort included 1,791 general surgery patients operated on between June 2010 and January 2012. Observed outcomes were mortality (0.2%), overall morbidity (8.2%), and pulmonary (1.3%), cardiac (0.3%), thromboembolism (0.2%), renal (0.4%), and SSI (3.8%) complications. Model and surgeon risk estimates showed significant correlation (p < 0.0001) for each outcome category. When surgeons perceived patient risk for overall morbidity to be low, the model-predicted risk and observed morbidity rates were 2.8% and 4.1%, respectively, compared with 10% and 18% in perceived high risk patients. Patients in the highest quartile of model-predicted risk accounted for 75% of observed mortality and 52% of morbidity. Across a broad range of general surgical operations, we confirmed that the model risk estimates are in fairly good agreement with risk estimates of experienced surgeons. Using these models prospectively can identify patients at high risk for morbidity and mortality, who could then be targeted for intervention to reduce postoperative complications. Published by Elsevier Inc.

Texting on mobile phones and musculoskeletal disorders in young adults: A five-year cohort study.

PubMed

Gustafsson, Ewa; Thomée, Sara; Grimby-Ekman, Anna; Hagberg, Mats

2017-01-01

The aim was to examine whether texting on a mobile phone is a risk factor for musculoskeletal disorders in the neck and upper extremities in a population of young adults. In a longitudinal population-based cohort study with Swedish young adults (aged 20-24 years) data were collected via a web-based questionnaire at baseline (n = 7092) and after one and five years. Cross-sectional associations were found between text messaging and reported ongoing symptoms in neck and upper extremities (odds ratios, ORs 1.3-2.0). Among symptom-free at baseline prospective associations were only found between text messaging and new cases of reported symptoms in the hand/fingers (OR 2.0) at one year follow up. Among those with symptoms at baseline prospective associations were found between text messaging and maintained pain in neck/upper back (OR 1.6). The results imply mostly short-term effects, and to a lesser extent, long-term effects on musculoskeletal disorders in neck and upper extremities. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Contamination in the Prospective Study of Child Maltreatment and Female Adolescent Health.

PubMed

Shenk, Chad E; Noll, Jennie G; Peugh, James L; Griffin, Amanda M; Bensman, Heather E

2016-01-01

To evaluate the impact of contamination, or the presence of child maltreatment in a comparison condition, when estimating the broad, longitudinal effects of child maltreatment on female health at the transition to adulthood. The Female Adolescent Development Study (N = 514; age range: 14-19 years) used a prospective cohort design to examine the effects of substantiated child maltreatment on teenage births, obesity, major depression, and past-month cigarette use. Contamination was controlled via a multimethod strategy that used both adolescent self-report and Child Protective Services records to remove cases of child maltreatment from the comparison condition. Substantiated child maltreatment significantly predicted each outcome, relative risks = 1.47-2.95, 95% confidence intervals: 1.03-7.06, with increases in corresponding effect size magnitudes, only when contamination was controlled using the multimethod strategy. Contamination truncates risk estimates of child maltreatment and controlling it can strengthen overall conclusions about the effects of child maltreatment on female health. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A 3-year prospective study of parent-child communication in early adolescents with type 1 diabetes: relationship to adherence and glycemic control.

PubMed

Iskander, Jeannette M; Rohan, Jennifer M; Pendley, Jennifer Shroff; Delamater, Alan; Drotar, Dennis

2015-01-01

To examine changes in parent-child communication patterns and their relation to glycemic control and treatment adherence using observational data in a 3-year prospective multisite study of youth with type 1 diabetes aged 9-11 years at baseline and their families (n = 217). Adolescents and caregivers participated in a diabetes problem-solving discussion. Families were rated on negative and positive communication and interactions using the Interaction Behavior Code. Maternal and paternal negative communication decreased over time, whereas adolescent and maternal positive communication and positive reciprocity increased. Baseline preadolescent youth and maternal positive communication predicted adherence 3 years later. Changes in family communication did not predict changes in glycemic control or adherence. During the transition to adolescence, family communication changed in unexpected and positive ways. Additionally, the relationship of baseline family communication to subsequent adherence suggests the need to assess family communication concerning diabetes-related management during preadolescence. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Gymnema sylvestre for Diabetes: From Traditional Herb to Future's Therapeutic.

PubMed

Tiwari, Pragya; Ahmad, Khurshid; Baig, Mohammad Hassan

2017-01-01

Diabetes has increased at an unprecedented rate and is fast emerging as a global threat worldwide. The focus on pharmacological studies pertaining to diabetes has seen a remarkable shift from conventional medicines to therapeutics employing bioactive phytomolecules from natural sources. The prospective effectiveness of natural products together with their low cost and minimal side effects has revolutionized the entire concept of drug discovery and management programs. One such beneficial herb is Gymnema sylvestre, possessing remarkable hypoglycemic properties and forms the platform of diabetes therapeutics in the traditional system of medication. The present article discusses the significance of G. sylvestre in diabetes management, the herbal-formulations from the herb together with its standardization and clinical trials on animal models, and why Peroxisome Proliferator Activated Receptor gamma (PPARγ) may serve as a prospective molecular target for Gymnemic acid analogs. Such studies would define the molecular basis of bioactive molecules which would aid in the development of natural product based therapeutics in the treatment of diabetes. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Measuring Medication Adherence in Pediatric Cancer: An Approach to Validation.

PubMed

Rohan, Jennifer M; Fukuda, Tsuyoshi; Alderfer, Melissa A; Wetherington Donewar, Crista; Ewing, Linda; Katz, Ernest R; Muriel, Anna C; Vinks, Alexander A; Drotar, Dennis

2017-03-01

This study described the prospective relationship between pharmacological and behavioral measures of 6-mercaptopurine (6MP) medication adherence in a multisite cohort of pediatric patients diagnosed with cancer ( N  = 139). Pharmacological measures (i.e., metabolite concentrations) assessed 6MP intake. Behavioral measures (e.g., electronic monitoring) described adherence patterns over time. Three metabolite profiles were identified across 15 months: one group demonstrated low levels of both metabolites (40.8%) consistent with nonadherence and/or suboptimal therapy; two other groups demonstrated metabolite clusters indicative of adequate adherence (59.2%). Those patients whose metabolite profile demonstrated low levels of both metabolites had consistently lower behavioral adherence rates. To our knowledge, this was the first study to prospectively validate a pharmacological measure of medication adherence with a behavioral adherence measure in a relatively large sample of pediatric patients with cancer. Using multiple methods of adherence measurement could inform clinical care and target patients in need of intervention. © The Author 2016. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Asthma and lung cancer, after accounting for co-occurring respiratory diseases and allergic conditions: a systematic review protocol.

PubMed

Denholm, Rachel; Crellin, Elizabeth; Arvind, Ashwini; Quint, Jennifer

2017-01-16

Asthma is one of the most frequently diagnosed respiratory diseases in the UK, and commonly co-occurs with other respiratory and allergic diseases, such as chronic obstructive pulmonary disease (COPD) and atopic dermatitis. Previous studies have shown an increased risk of lung cancer related to asthma, but the evidence is mixed when accounting for co-occurring respiratory diseases and allergic conditions. A systematic review of published data that investigate the relationship between asthma and lung cancer, accounting for co-occurring respiratory and allergic diseases, will be conducted to investigate the independent association of asthma with lung cancer. A systematic review will be conducted, and include original reports of cohort, cross-sectional and case-control studies of the association of asthma with lung cancer after accounting for co-occurring respiratory diseases. Articles published up to June 2016 will be included, and their selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A standardised data extraction form will be developed and pretested, and descriptive analyses will be used to summarise the available literature. If appropriate, pooled effect estimates of the association between asthma and lung cancer, given adjustment for a specific co-occurring condition will be estimated using random effects models. Potential sources of heterogeneity and between study heterogeneity will also be investigated. The study will be a review of published data and does not require ethical approval. Results will be disseminated through a peer-reviewed publication. International Prospective Register for Systematic Reviews (PROSPERO) number CRD42016043341. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Resilience research in schizophrenia: a review of recent developments.

PubMed

Mizuno, Yuya; Wartelsteiner, Fabienne; Frajo-Apor, Beatrice

2016-05-01

The concept of resilience is expected to be relevant in understanding the heterogeneous outcomes associated with schizophrenia. We reviewed recent developments in clinical studies focusing on the biological and psychological aspects of resilience in this population. We aimed to clarify current concepts of resilience in the field, elucidate gaps in the literature, and provide recommendations for future research. A total of 20 articles published between 2014 and 2015 were included. Six studies were neuroimaging studies, while the remaining studies used various psychological assessments. Most studies were cross-sectional except for three studies with naturalistic follow-up, one single-blind randomized controlled trial, and two published protocols of prospective studies. The following patterns of research were evident among the highly heterogeneous literature: studies focusing on protective factors and others emphasizing dynamic processes, studies investigating 'at-risk but resilient' groups (e.g. nonpsychotic siblings of patients with schizophrenia), and studies using psychological scales to measure resilience. The heterogeneity in how reports conceptualize, assess, and interpret resilience likely reflects the multidimensional nature of the concept itself and the lack of a 'gold standard' in assessing resilience in schizophrenia. Further research is needed to make recommendations on how to facilitate resilience in clinical care.

Is there a causal link between knee loading and knee osteoarthritis progression? A systematic review and meta-analysis of cohort studies and randomised trials.

PubMed

Henriksen, Marius; Creaby, Mark W; Lund, Hans; Juhl, Carsten; Christensen, Robin

2014-07-15

We performed a systematic review, meta-analysis and assessed the evidence supporting a causal link between knee joint loading during walking and structural knee osteoarthritis (OA) progression. Systematic review, meta-analysis and application of Bradford Hill's considerations on causation. We searched MEDLINE, Scopus, AMED, CINAHL and SportsDiscus for prospective cohort studies and randomised controlled trials (RCTs) from 1950 through October 2013. We selected cohort studies and RCTs in which estimates of knee joint loading during walking were used to predict structural knee OA progression assessed by X-ray or MRI. Meta-analysis was performed to estimate the combined OR for structural disease progression with higher baseline loading. The likelihood of a causal link between knee joint loading and OA progression was assessed from cohort studies using the Bradford Hill guidelines to derive a 0-4 causation score based on four criteria and examined for confirmation in RCTs. Of the 1078 potentially eligible articles, 5 prospective cohort studies were included. The studies included a total of 452 patients relating joint loading to disease progression over 12-72 months. There were very serious limitations associated with the methodological quality of the included studies. The combined OR for disease progression was 1.90 (95% CI 0.85 to 4.25; I(2)=77%) for each one-unit increment in baseline knee loading. The combined causation score was 0, indicating no causal association between knee loading and knee OA progression. No RCTs were found to confirm or refute the findings from the cohort studies. There is very limited and low-quality evidence to support for a causal link between knee joint loading during walking and structural progression of knee OA. CRD42012003253. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Lacosamide for uncontrolled primary generalized tonic-clonic seizures: An open-label pilot study with 59-week extension.

PubMed

Wechsler, Robert T; Yates, Stephen L; Messenheimer, John; Leroy, Robert; Beller, Cynthia; Doty, Pamela

2017-02-01

Assess the safety of adjunctive lacosamide for the treatment of uncontrolled primary generalized tonic-clonic seizures in patients (16-65 years) with primary generalized (genetic) epilepsy (PGE). An open-label pilot safety study (SP0961; NCT01118949), comprising 12 weeks' historical baseline, 4 weeks' prospective baseline, 3 weeks' titration (target: 400mg/day adjunctive lacosamide) and 6 weeks' maintenance. Patients who continued to the extension study (SP0962; NCT01118962) then received ≤59 weeks of flexible treatment (100-800mg/day lacosamide with flexible dosing of concomitant antiepileptic drugs). The primary outcomes for SP0961 were the mean change (±standard deviation) in absence seizure or myoclonic seizure days per 28days from prospective baseline to maintenance; for SP0962, the incidence of treatment-emergent adverse events (TEAEs) and withdrawals because of TEAEs. Of the 49 patients who enrolled, 40 (82%) completed the pilot study and 9 discontinued (5 because of adverse events). Of the 39 patients who continued to the extension study, 10 discontinued (2 owing to TEAEs) and 29 (74%) completed the study. During the pilot study, patients reported a reduction in mean (±standard deviation) absence and myoclonic seizure days per 28days (-0.37±4.80, -2.19±5.80). Reductions were also observed during the extension study (-2.38±5.54, -2.78±6.43). Five patients in SP0961 and 2 patients in SP0962 experienced TEAEs of new or increased frequency of absence seizures or myoclonic seizures. The most common TEAEs during SP0961 were dizziness (39%) and nausea (27%), and during SP0962 were dizziness (26%) and upper respiratory tract infection (26%). The safety profile of adjunctive lacosamide was similar to that previously published. Adjunctive lacosamide did not systematically worsen absence or myoclonic seizures, and appears to be well tolerated in patients with PGE. Copyright © 2016. Published by Elsevier B.V.

Multicentre, prospective, randomised, open-label, blinded end point trial of the efficacy of allopurinol therapy in improving cardiovascular outcomes in patients with ischaemic heart disease: protocol of the ALL-HEART study.

PubMed

Mackenzie, Isla S; Ford, Ian; Walker, Andrew; Hawkey, Chris; Begg, Alan; Avery, Anthony; Taggar, Jaspal; Wei, Li; Struthers, Allan D; MacDonald, Thomas M

2016-09-08

Ischaemic heart disease (IHD) is one of the most common causes of death in the UK and treatment of patients with IHD costs the National Health System (NHS) billions of pounds each year. Allopurinol is a xanthine oxidase inhibitor used to prevent gout that also has several positive effects on the cardiovascular system. The ALL-HEART study aims to determine whether allopurinol improves cardiovascular outcomes in patients with IHD. The ALL-HEART study is a multicentre, controlled, prospective, randomised, open-label blinded end point (PROBE) trial of allopurinol (up to 600 mg daily) versus no treatment in a 1:1 ratio, added to usual care, in 5215 patients aged 60 years and over with IHD. Patients are followed up by electronic record linkage and annual questionnaires for an average of 4 years. The primary outcome is the composite of non-fatal myocardial infarction, non-fatal stroke or cardiovascular death. Secondary outcomes include all-cause mortality, quality of life and cost-effectiveness of allopurinol. The study will end when 631 adjudicated primary outcomes have occurred. The study is powered at 80% to detect a 20% reduction in the primary end point for the intervention. Patient recruitment to the ALL-HEART study started in February 2014. The study received ethical approval from the East of Scotland Research Ethics Service (EoSRES) REC 2 (13/ES/0104). The study is event-driven and results are expected after 2019. Results will be reported in peer-reviewed journals and at scientific meetings. Results will also be disseminated to guideline committees, NHS organisations and patient groups. 32017426, pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Risk profiles for aortic dissection and ruptured or surgically treated aneurysms: a prospective cohort study.

PubMed

Landenhed, Maya; Engström, Gunnar; Gottsäter, Anders; Caulfield, Michael P; Hedblad, Bo; Newton-Cheh, Christopher; Melander, Olle; Smith, J Gustav

2015-01-21

Community screening to guide preventive interventions for acute aortic disease has been recommended in high-risk individuals. We sought to prospectively assess risk factors in the general population for aortic dissection (AD) and severe aneurysmal disease in the thoracic and abdominal aorta. We studied the incidence of AD and ruptured or surgically treated aneurysms in the abdominal (AAA) or thoracic aorta (TAA) in 30 412 individuals without diagnosis of aortic disease at baseline from a contemporary, prospective cohort of middle-aged individuals, the Malmö Diet and Cancer study. During up to 20 years of follow-up (median 16 years), the incidence rate per 100 000 patient-years at risk was 15 (95% CI 11.7 to 18.9) for AD, 27 (95% CI 22.5 to 32.1) for AAA, and 9 (95% CI 6.8 to 12.6) for TAA. The acute and in-hospital mortality was 39% for AD, 34% for ruptured AAA, and 41% for ruptured TAA. Hypertension was present in 86% of individuals who subsequently developed AD, was strongly associated with incident AD (hazard ratio [HR] 2.64, 95% CI 1.33 to 5.25), and conferred a population-attributable risk of 54%. Hypertension was also a risk factor for AAA with a smaller effect. Smoking (HR 5.07, 95% CI 3.52 to 7.29) and high apolipoprotein B/A1 ratio (HR 2.48, 95% CI 1.73 to 3.54) were strongly associated with AAA and conferred a population-attributable risk of 47% and 25%, respectively. Smoking was also a risk factor for AD and TAA with smaller effects. This large prospective study identified distinct risk factor profiles for different aortic diseases in the general population. Hypertension accounted for more than half of the population risk for AD, and smoking for half of the population risk of AAA. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Fruit and vegetable intake and prostate cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC).

PubMed

Perez-Cornago, Aurora; Travis, Ruth C; Appleby, Paul N; Tsilidis, Konstantinos K; Tjønneland, Anne; Olsen, Anja; Overvad, Kim; Katzke, Verena; Kühn, Tilman; Trichopoulou, Antonia; Peppa, Eleni; Kritikou, Maria; Sieri, Sabina; Palli, Domenico; Sacerdote, Carlotta; Tumino, Rosario; Bueno-de-Mesquita, H B As; Agudo, Antonio; Larrañaga, Nerea; Molina-Portillo, Elena; Ardanaz, Eva; Chirlaque, Maria-Dolores; Lasheras, Cristina; Stattin, Pär; Wennberg, Maria; Drake, Isabel; Malm, Johan; Schmidt, Julie A; Khaw, Kay-Tee; Gunter, Marc; Freisling, Heinz; Huybrechts, Inge; Aune, Dagfinn; Cross, Amanda J; Riboli, Elio; Key, Timothy J

2017-07-15

Several dietary factors have been studied in relation to prostate cancer; however, most studies have not reported on subtypes of fruit and vegetables or tumor characteristics, and results obtained so far are inconclusive. This study aimed to examine the prospective association of total and subtypes of fruit and vegetable intake with the incidence of prostate cancer overall, by grade and stage of disease, and prostate cancer death. Lifestyle information for 142,239 men participating in the European Prospective Investigation into Cancer and Nutrition from 8 European countries was collected at baseline. Multivariable Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). After an average follow-up time of 13.9 years, 7,036 prostate cancer cases were identified. Compared with the lowest fifth, those in the highest fifth of total fruit intake had a significantly reduced prostate cancer risk (HR = 0.91; 95% CI = 0.83-0.99; p-trend = 0.01). No associations between fruit subtypes and prostate cancer risk were observed, except for citrus fruits, where a significant trend was found (HR = 0.94; 95% CI = 0.86-1.02; p-trend = 0.01). No associations between total and subtypes of vegetables and prostate cancer risk were observed. We found no evidence of heterogeneity in these associations by tumor grade and stage, with the exception of significant heterogeneity by tumor grade (p heterogeneity <0.001) for leafy vegetables. No significant associations with prostate cancer death were observed. The main finding of this prospective study was that a higher fruit intake was associated with a small reduction in prostate cancer risk. Whether this association is causal remains unclear. © 2017 The Authors International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.

A Meta-Analysis of Randomized Controlled Trials and Prospective Cohort Studies of Eicosapentaenoic and Docosahexaenoic Long-Chain Omega-3 Fatty Acids and Coronary Heart Disease Risk.

PubMed

Alexander, Dominik D; Miller, Paige E; Van Elswyk, Mary E; Kuratko, Connye N; Bylsma, Lauren C

2017-01-01

To conduct meta-analyses of randomized controlled trials (RCTs) to estimate the effect of eicosapentaenoic and docosahexaenoic acid (EPA+DHA) on coronary heart disease (CHD), and to conduct meta-analyses of prospective cohort studies to estimate the association between EPA+DHA intake and CHD risk. A systematic literature search of Ovid/Medline, PubMed, Embase, and the Cochrane Library from January 1, 1947, to November 2, 2015, was conducted; 18 RCTs and 16 prospective cohort studies examining EPA+DHA from foods or supplements and CHD, including myocardial infarction, sudden cardiac death, coronary death, and angina, were identified. Random-effects meta-analysis models were used to generate summary relative risk estimates (SRREs) and 95% CIs. Heterogeneity was examined in subgroup and sensitivity analyses and by meta-regression. Dose-response was evaluated in stratified dose or intake analyses. Publication bias assessments were performed. Among RCTs, there was a nonstatistically significant reduction in CHD risk with EPA+DHA provision (SRRE=0.94; 95% CI, 0.85-1.05). Subgroup analyses of data from RCTs indicated a statistically significant CHD risk reduction with EPA+DHA provision among higher-risk populations, including participants with elevated triglyceride levels (SRRE=0.84; 95% CI, 0.72-0.98) and elevated low-density lipoprotein cholesterol (SRRE=0.86; 95% CI, 0.76-0.98). Meta-analysis of data from prospective cohort studies resulted in a statistically significant SRRE of 0.82 (95% CI, 0.74-0.92) for higher intakes of EPA+DHA and risk of any CHD event. Results indicate that EPA+DHA may be associated with reducing CHD risk, with a greater benefit observed among higher-risk populations in RCTs. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Systematic review and meta-analysis of homicide recidivism and Schizophrenia

PubMed Central

2014-01-01

Background The aim of this study was to estimate the proportion of homicide recidivists among population studies of homicide offenders with schizophrenia. Methods Systematic review and meta-analysis of published studies of homicide associated with schizophrenia conducted in defined populations and indexed in Medline, PsychINFO, or Embase between January 1960 and November 2013. Published data was supplemented with unpublished data about recidivism obtained by personal communication from the authors of published studies of homicide and schizophrenia. Random effects meta-analysis was used to calculate a pooled estimate of the proportion of homicide recidivists. Results Three studies reported that 4.3%, 4.5%, and 10.7% of homicide offenders with schizophrenia had committed an earlier homicide. Unpublished data were obtained from the authors of 11 studies of homicide in schizophrenia published in English between 1980 and 2013. The authors of 2 studies reported a single case of homicide recidivism and the authors of 9 studies reported no cases. The rates of homicide recidivism between studies were highly heterogeneous (I-square = 79). The pooled estimate of the proportion of homicide offenders with schizophrenia who had committed an earlier homicide was 2.3% (95% CI (Confidence Interval) 0.07% to 7.2%), a figure that was not reported in any individual study. The pooled proportion of homicide recidivists from published reports was more than ten times greater (8.6%, 95% CI 5.7%-12.9%) than the pooled proportion of homicide recidivists estimated from data provided by personal communication (0.06%, 95% CI 0.02% to 1.8%). Conclusions In most jurisdictions, homicide recidivism by people with schizophrenia is less common than published reports have suggested. The reasons for the variation in the rates of homicide recidivism between studies are unclear, although in most jurisdictions long-term secure treatment and supervision after release appears to be effective in preventing homicide recidivism. A prospective study conducted in a large population or in multiple jurisdictions over a long period of time might result in a more accurate estimate the risk of a second homicide by a person with schizophrenia. PMID:24548381

Systematic review and meta-analysis of homicide recidivism and schizophrenia.

PubMed

Golenkov, Andrei; Nielssen, Olav; Large, Matthew

2014-02-18

The aim of this study was to estimate the proportion of homicide recidivists among population studies of homicide offenders with schizophrenia. Systematic review and meta-analysis of published studies of homicide associated with schizophrenia conducted in defined populations and indexed in Medline, PsychINFO, or Embase between January 1960 and November 2013. Published data was supplemented with unpublished data about recidivism obtained by personal communication from the authors of published studies of homicide and schizophrenia. Random effects meta-analysis was used to calculate a pooled estimate of the proportion of homicide recidivists. Three studies reported that 4.3%, 4.5%, and 10.7% of homicide offenders with schizophrenia had committed an earlier homicide. Unpublished data were obtained from the authors of 11 studies of homicide in schizophrenia published in English between 1980 and 2013. The authors of 2 studies reported a single case of homicide recidivism and the authors of 9 studies reported no cases. The rates of homicide recidivism between studies were highly heterogeneous (I-square = 79). The pooled estimate of the proportion of homicide offenders with schizophrenia who had committed an earlier homicide was 2.3% (95% CI (Confidence Interval) 0.07% to 7.2%), a figure that was not reported in any individual study. The pooled proportion of homicide recidivists from published reports was more than ten times greater (8.6%, 95% CI 5.7%-12.9%) than the pooled proportion of homicide recidivists estimated from data provided by personal communication (0.06%, 95% CI 0.02% to 1.8%). In most jurisdictions, homicide recidivism by people with schizophrenia is less common than published reports have suggested. The reasons for the variation in the rates of homicide recidivism between studies are unclear, although in most jurisdictions long-term secure treatment and supervision after release appears to be effective in preventing homicide recidivism. A prospective study conducted in a large population or in multiple jurisdictions over a long period of time might result in a more accurate estimate the risk of a second homicide by a person with schizophrenia.

Update on the pathogenesis and treatment of childhood-onset systemic lupus erythematosus.

PubMed

Couture, Julie; Silverman, Earl D

2016-09-01

This article will provide an update of studies published in the last year regarding epidemiology, pathogenesis, major disease manifestations and outcomes, and therapies in childhood-onset systemic lupus erythematosus (cSLE). Recent studies on cSLE epidemiology supported previous findings that cSLE patients have more severe disease and tend to accumulate damage rapidly. Lupus nephritis remains frequent and is still a significant cause of morbidity and mortality. In the past year unfortunately there were no new reproducible, biomarker studies to help direct therapy of renal disease. However, some progress was made in neuropsychiatric disease assessment, with a new and promising automated test to screen for cognitive dysfunction reported. There were no prospective interventional treatment trials designed for patients with cSLE published in the last year, but some studies involving children are currently active and might improve the therapeutic options for patients with cSLE. There is a need to get a better understanding of pathogenesis and identify new biomarkers in cSLE to more accurately predict outcomes. New insights into characterization of different clinical manifestations may enable to optimize individual interventions and influence the prognosis.

Clinical studies of fiber posts: a literature review.

PubMed

Cagidiaco, Maria C; Goracci, Cecilia; Garcia-Godoy, Franklin; Ferrari, Marco

2008-01-01

This literature review aimed to find answers to relevant questions regarding the clinical outcome of endontically treated teeth restored with fiber posts. All clinical studies published since 1990 in journals indexed in MEDLINE were retrieved by searching PubMed with the query terms "fiber posts and clinical studies." The reference list of the collected articles was also screened for further relevant citations. The strength of the evidence provided by the reviewed papers was assessed according to the criteria of evidence-based dentistry. Five randomized controlled trials (RCTs) on fiber posts have been published in peer-reviewed journals. A meta-analysis is not applicable to these studies since they do not address the same specific clinical question. Retrospective and prospective trials without controls are also available. Two RCTs indicate that fiber-reinforced composite posts outperform metal posts in the restoration of endontically treated teeth. However, this evidence cannot be considered as conclusive. Longer-term RCTs would be desirable. The placement of a fiber-reinforced composite post protects against failure, especially under conditions of extensive coronal destruction. The most common type of failure with fiber-reinforced composite posts is debonding.

Venous thromboembolism and coffee: critical review and meta-analysis.

PubMed

Lippi, Giuseppe; Mattiuzzi, Camilla; Franchini, Massimo

2015-07-01

Among the various risk factors of venous thromboembolism (VTE), nutrients seem to play a significant role in the pathogenesis of this condition. This study aimed to clarify the relationship between coffee intake and venous thrombosis, and we performed a critical review of clinical studies that have been published so far. An electronic search was carried out in Medline, Scopus and ISI Web of Science with the keywords "coffee" AND "venous thromboembolism" OR "deep vein thrombosis" OR "pulmonary embolism" in "Title/Abstract/Keywords", with no language and date restriction. According to our criteria, three studies (two prospective and one case-control) were finally selected (inter-study heterogeneity: 78%; P<0.001). Cumulative data suggests that a modest intake of coffee (i.e., 1-4 cups/day) may be associated with an 11% increased risk of VTE compared to abstainers, whereas a larger intake (i.e., ≥5 coffee/day) may be associated with a 25% decreased risk. Our analysis of published data seemingly confirm the existence of a U-shape relationship between coffee intake and VTE, thus exhibiting a trend that overlaps with that previously reported for cardiovascular disease (CVD).

Erythrocyte superoxide dismutase, glutathione peroxidase, and catalase activities and risk of coronary heart disease in generally healthy women: a prospective study.

PubMed

Yang, Shuman; Jensen, Majken K; Rimm, Eric B; Willett, Walter; Wu, Tianying

2014-11-01

Erythrocyte antioxidant enzymes are major circulating antioxidant enzymes in the oxidative stress defense system. Few prospective studies have assessed the association between these enzymes and the risk of coronary heart disease (CHD) in generally healthy adults. We conducted a prospective nested case-control study of CHD among 32,826 women at baseline with 15 years of follow-up from 1989 to 2004 in the Nurses' Health Study. We investigated the association of baseline erythrocyte superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase (CAT) activities with the risk of CHD. A total of 365 cases and 728 controls were included in the analysis. Overall, the relative risks of CHD associated with 1-standard deviation higher SOD, GPx, and CAT activities were 1.07 (95% confidence interval (CI): 0.94, 1.22), 1.04 (95% CI: 0.91, 1.18), and 1.04 (95% CI: 0.92, 1.17), respectively. Multivariable adjustments did not change the associations appreciably. Fasting status did not modify the associations, with the exception that SOD activity was positively associated with the risk of CHD among participants who provided blood samples within 12 hours of fasting. Overall, activities of SOD, GPx, and CAT were not associated with CHD among women who were generally healthy at the time of blood collection. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Transarterial Onyx Embolization of Intracranial Dural Fistulas: A Prospective Cohort, Systematic Review, and Meta-Analysis.

PubMed

Sadeh-Gonike, Udi; Magand, Nicolas; Armoiry, Xavier; Riva, Roberto; Labeyrie, Paul Emile; Lamy, Bernadette; Lukaszewicz, Anne-Claire; Lehot, Jean-Jacques; Turjman, Francis; Gory, Benjamin

2018-06-01

Onyx is important embolic material in the endovascular treatment of intracranial dural arteriovenous fistula (DAVF). However, its impact on DAVF occlusion rates, morbidity, mortality, and complication rates is not fully examined. To improve understanding of safety and effectiveness profiles associated with transarterial endovascular treatment using Onyx for intracranial DAVF. We analyzed data from our prospective clinical registry and conducted a systematic review of all previous transarterial embolization studies using Onyx published between January 2005 and December 2015 in MEDLINE and EMBASE. In the prospective study, 41 transarterial procedures were performed in 33 consecutive patients harboring 36 DAVFs. Complete initial exclusion was obtained in 32 of 36 (88.9%) fistulas; 31 fistulas were followed up showing 4 (12.9%) recurrences. Procedure-related morbidity and mortality were 3% and 0%, respectively. The literature review identified 19 studies involving a total of 425 patients with 463 DAVFs. Meta-analysis, including our registry data, showed an initial complete occlusion rate of 82% (95% confidence interval [CI]: 74%, 88%; I2, 70.6%), and recurrence rate at midterm of 2% (95% CI: 0%, 5%; I2, 21.5%). Pooled postoperative neurological deficit, procedure-related morbidity, and mortality rates were 4% (95% CI: 2%, 6%; I2, 0%), 3% (95% CI: 1%, 5%; I2, 0%), and 0%, respectively. This meta-analysis suggests that transarterial embolization with Onyx is a safe treatment modality for DAVFs. Although Onyx showed a low recurrence rate at midterm, the long-term risk is poorly addressed in our study and should warrant a longer follow-up.

Heterogeneous relationships of squamous and basal cell carcinomas of the skin with smoking: the UK Million Women Study and meta-analysis of prospective studies.

PubMed

Pirie, Kirstin; Beral, Valerie; Heath, Alicia K; Green, Jane; Reeves, Gillian K; Peto, Richard; McBride, Penelope; Olsen, Catherine M; Green, Adèle C

2018-06-14

Published findings on the associations between smoking and the incidence of cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) are inconsistent. We aimed to generate prospective evidence on these relationships overall and by anatomical site. We followed 1,223,626 women without prior cancer by electronic linkage to national cancer registration data. Questionnaire information about smoking and other factors was recorded at recruitment (1996-2001) and every 3-5 years subsequently. Cox regression yielded adjusted relative risks (RRs) comparing smokers versus never-smokers. After 14 (SD4) years follow-up per woman, 6699 had a first registered cutaneous SCC and 48,666 a first BCC. In current versus never-smokers, SCC incidence was increased (RR = 1.22, 95% CI 1.15-1.31) but BCC incidence was decreased (RR = 0.80, 0.78-0.82). RRs varied substantially by anatomical site; for the limbs, current smoking was associated with an increased incidence of SCC (1.55, 1.41-1.71) and a decreased incidence of BCC (0.72, 0.66-0.79), but for facial lesions there was little association of current smoking with either SCC (0.93, 0.82-1.06) or BCC (0.92, 0.88-0.96). Findings in meta-analyses of results from this and seven other prospective studies were largely dominated by the findings in this study. Smoking-associated risks for cutaneous SCC and BCC are in the opposite direction to each other and appear to vary by anatomical site.

Association of vegetable and fruit intake with gastric cancer risk among Japanese: a pooled analysis of four cohort studies.

PubMed

Shimazu, T; Wakai, K; Tamakoshi, A; Tsuji, I; Tanaka, K; Matsuo, K; Nagata, C; Mizoue, T; Inoue, M; Tsugane, S; Sasazuki, S

2014-06-01

Prospective evidence is inconsistent regarding the association between vegetable/fruit intake and the risk of gastric cancer. In an analysis of original data from four population-based prospective cohort studies encompassing 191 232 participants, we used Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of gastric cancer incidence according to vegetable and fruit intake and conducted a meta-analysis of HRs derived from each study. During 2 094 428 person-years of follow-up, 2995 gastric cancer cases were identified. After adjustment for potential confounders, we found a marginally significant decrease in gastric cancer risk in relation to total vegetable intake but not total fruit intake: the multivariate-adjusted HR (95% CI; P for trend) for the highest versus the lowest quintile of total vegetable intake was 0.89 (0.77-1.03; P for trend = 0.13) among men and 0.83 (0.67-1.03; P for trend = 0.40) among women. For distal gastric cancer, the multivariate HR for the highest quintile of total vegetable intake was 0.78 (0.63-0.97; P for trend = 0.02) among men. This pooled analysis of data from large prospective studies in Japan suggests that vegetable intake reduces gastric cancer risk, especially the risk of distal gastric cancer among men. © The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Intravenous levetiracetam vs phenytoin for status epilepticus and cluster seizures: A prospective, randomized study.

PubMed

Gujjar, Arunodaya R; Nandhagopal, Ramachandiran; Jacob, Poovathoor C; Al-Hashim, Abdulhakeem; Al-Amrani, Khalfan; Ganguly, Shyam S; Al-Asmi, Abdullah

2017-07-01

Status Epilepticus (SE) is a common medical emergency carrying a high morbidity and mortality. Levetiracetam (LEV) is a novel anticonvulsant effective against varied seizures. Few prospective studies have addressed its use in SE. We aimed to examine the efficacy of intravenous LEV in controlling SE and cluster attacks of seizures (CS), in comparison with IV phenytoin (DPH), using a prospective, randomized study design. Adult patients with SE or CS, following an initial dose of IV benzodiazepine to control ongoing seizure, were randomized to receive either medication. Rates of seizure control over 24h, adverse effects and outcomes were compared. A logistic regression model was used to identify outcome predictors. 52 patients with SE and 63 with CS received either LEV or DPH. In the SE group, LEV was effective in18/22(82%) and DPH in 22/30(73.3%) patients in controlling seizures. Among patients with CS, LEV was effective in 31/38(81.6%) and DPH in 20/25(80%). With the use of LEV, DPH or both, SE and CS were controlled among 92% and 96% of patients respectively. Adverse events included hypotension (in 2 on DPH) and transient agitation (2 on LEV). IV Levetiracetam controls status epilepticus or cluster seizures with an efficacy comparable to that of phenytoin. Use of these two agents consecutively may control >90% of all such conditions without resort to anaesthetic agents. Further studies should explore its efficacy in larger cohorts of epileptic emergencies. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

An evidence-update on the prospective relationship between childhood sedentary behaviour and biomedical health indicators: a systematic review and meta-analysis.

PubMed

van Ekris, E; Altenburg, T M; Singh, A S; Proper, K I; Heymans, M W; Chinapaw, M J M

2016-09-01

Evidence for adverse health effects of excessive sedentary behaviour in children is predominantly based on cross-sectional studies, measuring TV viewing as proxy for sedentary behaviour. This systematic review and meta-analysis summarizes the evidence on the prospective relationship between childhood sedentary behaviour and biomedical health indicators, overall and stratified by type of sedentary behaviour (TV viewing, computer use/games, screen time and objective sedentary time). PubMed, EMBASE, PsycINFO and Cochrane were systematically searched till January 2015. Methodological quality of all included studies was scored, and a best evidence synthesis was applied. We included 109 studies of which 19 were of high quality. We found moderate-to-strong evidence for a relationship of overall sedentary time with some anthropometrics (overweight/obesity, weight-for-height), one cardiometabolic biomarker (HDL-cholesterol) and some fitness indicators (fitness, being unfit). For other health indicators, we found no convincing evidence because of inconsistent or non-significant findings. The evidence varied by type of sedentary behaviour. The meta-analysis indicated that each additional baseline hour of TV viewing (β = 0.01, 95%CI = [-0.002; 0.02]) or computer use (β = 0.00, 95%CI = [-0.004; 0.01]) per day was not significantly related with BMI at follow-up. We conclude that the evidence for a prospective relationship between childhood sedentary behaviour and biomedical health is in general unconvincing. © 2016 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of International Association for the Study of Obesity (IASO).

Trial Registration: Understanding and Preventing Reporting Bias in Social Work Research

ERIC Educational Resources Information Center

Harrison, Bronwyn A.; Mayo-Wilson, Evan

2014-01-01

Randomized controlled trials are considered the gold standard for evaluating social work interventions. However, published reports can systematically overestimate intervention effects when researchers selectively report large and significant findings. Publication bias and other types of reporting biases can be minimized through prospective trial…

Software Trends and Trendsetters: How They're Shaping an Industry.

ERIC Educational Resources Information Center

McGinty, Tony; And Others

1987-01-01

Discusses trends in educational software and the effects of new developments on publishers and on the computer industry. Marketing prospects for software are examined, and recent advances are highlighted, including integrated learning systems, skill-based software, software tied to textbooks, networking, and freeware. (LRW)

Application of computational toxicology to prospective and diagnostic ecological risk assessment

EPA Science Inventory

When the National Research Council published their Vision and Strategy for Toxicity Testing in the 21st Century, the sole focus was human health-related toxicity testing. However, ecotoxicity testing faces many of the same challenges and limitations relative to its traditional re...

Prenatal Care.

ERIC Educational Resources Information Center

Office of Child Development (DHEW), Washington, DC.

Initially published by the Children's Bureau in 1913, this pamphlet has been revised frequently. Its purpose is to point out the importance of medical care during pregnancy. Comfortable pregnancies, easy labor, and better care for their new infants are the usual concerns of prospective mothers. Consequently, this 1962 edition of "Prenatal Care"…

Deregulation of SYCP2 predicts early stage human papillomavirus-positive oropharyngeal carcinoma: A prospective whole transcriptome analysis.

PubMed

Masterson, Liam; Sorgeloos, Frederic; Winder, David; Lechner, Matt; Marker, Alison; Malhotra, Shalini; Sudhoff, Holger; Jani, Piyush; Goon, Peter; Sterling, Jane

2015-11-01

This study was designed to identify significant differences in gene expression profiles of human papillomavirus (HPV)-positive and HPV-negative oropharyngeal squamous cell carcinomas (OPSCC) and to better understand the functional and biological effects of HPV infection in the premalignant pathway. Twenty-four consecutive patients with locally advanced primary OPSCC were included in a prospective clinical trial. Fresh tissue samples (tumor vs. matched normal epithelium) were subjected to whole transcriptome analysis and the results validated on the same cohort with RT-quantitative real-time PCR. In a separate retrospective cohort of 27 OPSCC patients, laser capture microdissection of formalin-fixed, paraffin-embedded tissue allowed RNA extraction from adjacent regions of normal epithelium, carcinoma in situ (premalignant) and invasive SCC tissue. The majority of patients showed evidence of high-risk HPV16 positivity (80.4%). Predictable fold changes of RNA expression in HPV-associated disease included multiple transcripts within the p53 oncogenic pathway (e.g. CDKN2A/CCND1). Other candidate transcripts found to have altered levels of expression in this study have not previously been established (SFRP1, CRCT1, DLG2, SYCP2, and CRNN). Of these, SYCP2 showed the most consistent fold change from baseline in premalignant tissue; aberrant expression of this protein may contribute to genetic instability during HPV-associated cancer development. If further corroborated, this data may contribute to the development of a non-invasive screening tool. This study is registered with the UK Clinical Research Network (ref.: 11945). © 2015 The Authors. Cancer Science published by Wiley Publishing Asia Pty Ltd on behalf of Japanese Cancer Association.

Subtypes of mild cognitive impairment in patients with Parkinson's disease: evidence from the LANDSCAPE study.

PubMed

Kalbe, Elke; Rehberg, Sarah Petra; Heber, Ines; Kronenbuerger, Martin; Schulz, Jörg B; Storch, Alexander; Linse, Katharina; Schneider, Christine; Gräber, Susanne; Liepelt-Scarfone, Inga; Berg, Daniela; Dams, Judith; Balzer-Geldsetzer, Monika; Hilker, Rüdiger; Oberschmidt, Carola; Witt, Karsten; Schmidt, Nele; Mollenhauer, Brit; Trenkwalder, Claudia; Spottke, Annika; Roeske, Sandra; Wittchen, Hans-Ulrich; Riedel, Oliver; Dodel, Richard

2016-10-01

Inconsistent results exist regarding the cognitive profile in patients with Parkinson's disease with mild cognitive impairment (PD-MCI). We aimed at providing data on this topic from a large cohort of patients with PD-MCI. Sociodemographic, clinical and neuropsychological baseline data from patients with PD-MCI recruited in the multicentre, prospective, observational DEMPARK/LANDSCAPE study were analysed. 269 patients with PD-MCI (age 67.8±7.4, Unified Parkinson's Disease Rating Scale (UPDRS-III) scores 23.2±11.6) were included. PD-MCI subtypes were 39.4% non-amnestic single domain, 30.5% amnestic multiple domain, 23.4% non-amnestic multiple domain and 6.7% amnestic single domain. Executive functions were most frequently impaired. The most sensitive tests to detect cognitive dysfunctions were the Modified Card Sorting Test, digit span backwards and word list learning direct recall. Multiple stepwise regression analyses showed that global cognition, gender and age, but not education or disease-related parameters predicted PD-MCI subtypes. This study with the so far largest number of prospectively recruited patients with PD-MCI indicates that non-amnestic PD-MCI is more frequent than amnestic PD-MCI; executive dysfunctions are the most typical cognitive symptom in PD-MCI; and age, gender and global cognition predict the PD-MCI subtype. Longitudinal data are needed to test the hypothesis that patients with PD-MCI with specific cognitive profiles have different risks to develop dementia. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Stereotactic Radiosurgery in the Management of Limited (1-4) Brain Metasteses: Systematic Review and International Stereotactic Radiosurgery Society Practice Guideline.

PubMed

Chao, Samuel T; De Salles, Antonio; Hayashi, Motohiro; Levivier, Marc; Ma, Lijun; Martinez, Roberto; Paddick, Ian; Régis, Jean; Ryu, Samuel; Slotman, Ben J; Sahgal, Arjun

2017-11-03

Guidelines regarding stereotactic radiosurgery (SRS) for brain metastases are missing recently published evidence. To conduct a systematic review and provide an objective summary of publications regarding SRS in managing patients with 1 to 4 brain metastases. Using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, a systematic review was conducted using PubMed and Medline up to November 2016. A separate search was conducted for SRS for larger brain metastases. Twenty-seven prospective studies, critical reviews, meta-analyses, and published consensus guidelines were reviewed. Four key points came from these studies. First, there is no detriment to survival by withholding whole brain radiation (WBRT) in the upfront management of brain metastases with SRS. Second, while SRS on its own provides a high rate of local control (LC), WBRT may provide further increase in LC. Next, WBRT does provide distant brain control with less need for salvage therapy. Finally, the addition of WBRT does affect neurocognitive function and quality of life more than SRS alone. For larger brain metastases, surgical resection should be considered, especially when factoring lower LC with single-session radiosurgery. There is emerging data showing good LC and/or decreased toxicity with multisession radiosurgery. A number of well-conducted prospective and meta-analyses studies demonstrate good LC, without compromising survival, using SRS alone for patients with a limited number of brain metastases. Some also demonstrated less impact on neurocognitive function with SRS alone. Practice guidelines were developed using these data with International Stereotactic Radiosurgery Society consensus. Copyright © 2017 by the Congress of Neurological Surgeons

Evidence from prospective cohort studies does not support current dietary fat guidelines: a systematic review and meta-analysis.

PubMed

Harcombe, Zoë; Baker, Julien S; Davies, Bruce

2017-12-01

National dietary guidelines were introduced in 1977 and 1983, by the US and UK governments to reduce coronary heart disease (CHD) mortality by reducing dietary fat intake. Our 2016 systematic review examined the epidemiological evidence available to the dietary committees at the time; we found no support for the recommendations to restrict dietary fat. The present investigation extends our work by re-examining the totality of epidemiological evidence currently available relating to dietary fat guidelines. A systematic review and meta-analysis of prospective cohort studies currently available, which examined the relationship between dietary fat, serum cholesterol and the development of CHD, were undertaken. Across 7 studies, involving 89 801 participants (94% male), there were 2024 deaths from CHD during the mean follow-up of 11.9±5.6 years. The death rate from CHD was 2.25%. Eight data sets were suitable for inclusion in meta-analysis; all excluded participants with previous heart disease. Risk ratios (RRs) from meta-analysis were not statistically significant for CHD deaths and total or saturated fat consumption. The RR from meta-analysis for total fat intake and CHD deaths was 1.04 (95% CI 0.98 to 1.10). The RR from meta-analysis for saturated fat intake and CHD deaths was 1.08 (95% CI 0.94 to 1.25). Epidemiological evidence to date found no significant difference in CHD mortality and total fat or saturated fat intake and thus does not support the present dietary fat guidelines. The evidence per se lacks generalisability for population-wide guidelines. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Relative associations between depression and anxiety on adverse cardiovascular events: does a history of coronary artery disease matter? A prospective observational study.

PubMed

Pelletier, Roxanne; Bacon, Simon L; Arsenault, André; Dupuis, Jocelyn; Laurin, Catherine; Blais, Lucie; Lavoie, Kim L

2015-12-15

To assess whether depression and anxiety increase the risk of mortality and major adverse cardiovascular events (MACE), among patients with and without coronary artery disease (CAD). DECADE (Depression Effects on Coronary Artery Disease Events) is a prospective observational study of 2390 patients referred at the Montreal Heart Institute. Patients were followed for 8.8 years, between 1998 and 2009. Depression and anxiety were assessed using a psychiatric interview (Primary Care Evaluation of Mental Disorders, PRIME-MD). Outcomes data were obtained from Quebec provincial databases. All-cause mortality and MACE. After adjustment for covariates, patients with depression were at increased risks of all-cause mortality (relative risk (RR)=2.84; 95% CI 1.25 to 6.49) compared with patients without depression. Anxiety was not associated with increased mortality risks (RR=0.86; 95% CI 0.31 to 2.36). When patients were stratified according to CAD status, depression increased the risk of mortality among patients with no CAD (RR=4.39; 95% CI 1.12 to 17.21), but not among patients with CAD (RR=2.32; 95% CI 0.78 to 6.88). Neither depression nor anxiety was associated with MACE among patients with or without CAD. Depression, but not anxiety, was an independent risk factor for all-cause mortality in patients without CAD. The present study contributes to a better understanding of the relative and unique role of depression versus anxiety among patients with versus without CAD. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Does the duration of symptoms of anal fissure impact its response to conservative treatment? A prospective cohort study.

PubMed

Emile, Sameh Hany; Elgendy, Hesham; Elfeki, Hossam; Magdy, Alaa; Abdelmawla, Ahmed Aly; Abdelnaby, Mahmoud; Khafagy, Wael

2017-08-01

Conservative treatment is the first line of treatment for anal fissure. The current study aimed to evaluate the impact of symptom duration on the response of anal fissure to conservative treatment. This prospective study was conducted on sixty patients with acute or chronic anal fissure who were treated conservatively with bulking agents, Sitz baths, and topical glyceryl trinitrate (GTN) 0.2%. Pain and constipation were assessed prior to treatment and at 6 weeks after therapy using visual analogue scale (VAS) and Wexner constipation score. Adverse effects as headache and postural hypotension were also queried. The mean pre-treatment VAS for acute fissure was significantly higher than chronic fissure (8.8 ± 0.96 Vs 5.8 ± 1.12), also the post-treatment VAS for acute fissure was significantly lower at 6 weeks of treatment (0.47 ± 0.8 Vs 2.5 ± 1.3). The baseline Wexner constipation score was comparable in both groups; however, at six weeks of treatment it declined more significantly in patients with acute fissure. Patients with acute fissure achieved significantly better healing than chronic fissure (80% Vs 40%). Healing rates decreased from 100% in patients with symptoms < one month to 33.3% in patients with symptoms >6 months. Conservative treatment including topical GTN 0.2% significantly hastened healing and relieved pain and other symptoms of acute more than chronic anal fissure. Healing rates of anal fissure in response to conservative treatment showed remarkable decrease in proportion to the duration of complaint. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

A prospective multicenter study of microbiologically defined infections in pediatric cancer patients with fever and neutropenia: Swiss Pediatric Oncology Group 2003 fever and neutropenia study.

PubMed

Agyeman, Philipp; Kontny, Udo; Nadal, David; Leibundgut, Kurt; Niggli, Felix; Simon, Arne; Kronenberg, Andreas; Frei, Reno; Escobar, Hugo; Kühne, Thomas; Beck-Popovic, Maja; Bodmer, Nicole; Ammann, Roland A

2014-09-01

Fever and neutropenia (FN) often complicate anticancer treatment and can be caused by potentially fatal infections. Knowledge of pathogen distribution is paramount for optimal patient management. Microbiologically defined infections (MDI) in pediatric cancer patients presenting with FN by nonmyeloablative chemotherapy enrolled in a prospective multicenter study were analyzed. Effectiveness of empiric antibiotic therapy in FN episodes with bacteremia was assessed taking into consideration recently published treatment guidelines for pediatric patients with FN. MDI were identified in a minority (22%) of pediatric cancer patients with FN. In patients with, compared with patients without MDI, fever [median, 5 (interquartile range: 3-8) vs. 2 (interquartile range: 1-3) days, P < 0.001] and hospitalization [10 (6-14) vs. 5 (3-8) days, P < 0.001] lasted longer, transfer to the intensive care unit was more likely [13 of 95 (14%) vs. 7 of 346 (2.0%), P < 0.001], and antibiotics were given longer [10 (7-14) vs. 5 (4-7) days, P < 0.001]. Empiric antibiotic therapy in FN episodes with bacteremia was highly effective if not only intrinsic and reported antimicrobial susceptibilities were considered but also the purposeful omission of coverage for coagulase-negative staphylococci and enterococci was taken into account [81% (95% confidence interval: 68-90) vs. 96.6% (95% confidence interval: 87-99.4), P = 0.004]. MDI were identified in a minority of FN episodes but they significantly affected management and the clinical course of pediatric cancer patients. Compliance with published guidelines was associated with effectiveness of empiric antibiotic therapy in FN episodes with bacteremia.

Impact of an evidence-based guideline on the management of community-acquired bacterial meningitis: a prospective cohort study.

PubMed

Costerus, J M; Brouwer, M C; Bijlsma, M W; Tanck, M W; van der Ende, A; van de Beek, D

2016-11-01

To study the impact of an evidence-based guideline on the management of community-acquired bacterial meningitis. We performed an interrupted time series analysis in a prospective nationwide cohort study from 2006 to 2015. The guideline stresses the importance of cranial imaging before lumbar puncture (LP) in selected patients based on clinical criteria, and early treatment with amoxicillin and a third-generation cephalosporin for adults with suspected community-acquired bacterial meningitis. The guideline was published in April 2013. We included 1326 episodes before and 210 episodes after guideline introduction. Cranial imaging was performed before LP in 497 (84%) of 591 episodes with clinical criteria warranting computed tomography (CT). The guideline did not improve this (increase of 2%; 95% confidence interval (CI), -15 to 19). Without these criteria, imaging before LP occurred in 606 (67%) of 900 episodes, also without effect of the guideline (increase of 1%; 95% CI, -25 to 28). The estimate of effect of the guideline for treatment with the recommended antibiotic regimen was an increase of 19.5% (95% CI, 13.5 to 25.5), and there was a trend towards more frequent initiation of treatment before CT. There was no association between delay in antibiotic treatment due to imaging before LP and unfavourable outcome (odds ratio, 1.14; 95% CI 0.86 to 1.52). Cranial imaging is performed before LP in the majority of patients with bacterial meningitis, irrespective of guideline indications. The guideline introduction was associated with a trend towards early initiation of treatment before imaging and with increased adherence to antibiotic policy. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Can a barcode scanner for blood collection improve patient identification integrity in the emergency department? A prospective before-and-after study.

PubMed

Spain, David; Crilly, Julia; Pierce, John; Steele, Michael; Scuffham, Paul; Keijzers, Gerben

2015-02-01

To describe the effect of interventions designed to improve patient identification (PI) during pathology collection in the ED. A prospective before-and-after intervention study was conducted between June 2009 and June 2010 in a regional ED in Queensland, Australia. Interventions aimed to improve PI and specimen labelling, and consisted of: (i) education alone; and (ii) education plus an armband scanner that voice-prompted collector behaviour. Main outcomes measured included: frequency of correct key behaviours (KBs) during specimen collection, pathology integrity errors and cost of interventions. Data from 282 ED pathology collections were analysed (before: n = 115, after with education: n = 95, after with education plus armband scanner: n = 72). KBs for PI and labelling improved significantly following education plus armband scanner use. Application of armbands before sample collection increased (36% vs 90%, P < 0.001), as did asking the patient to state their name (25% vs 93%, P < 0.001) and date of birth (22% vs 93%, P < 0.001). These results were similar, albeit less pronounced, when the effect of education only was assessed. No primary patient misidentification was detected in this small study. The annual costs for a hospital to adopt the education programme with and without the armband scanner were $104,045 and $5330 respectively. ED staff had poor behaviours for identifying patients and labelling pathology specimens before intervention. These safety behaviours were considered an assumed skill. Education alone improved critical KBs markedly that was further augmented by the armband scanner. The cost to adopt education alone is relatively low compared to the addition of armband scanner technology. © 2015 The Authors. Emergency Medicine Australasia published by Wiley Publishing Asia Pty Ltd on behalf of Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Vaccine testing for emerging infections: the case for individual randomisation.

PubMed

Eyal, Nir; Lipsitch, Marc

2017-09-01

During the 2014-2015 Ebola outbreak in Guinea, Liberia and Sierra Leone, many opposed the use of individually randomised controlled trials to test candidate Ebola vaccines. For a raging fatal disease, they explained, it is unethical to relegate some study participants to control arms. In Zika and future emerging infections, similar opposition may hinder urgent vaccine research, so it is best to address these questions now. This article lays out the ethical case for individually randomised control in testing vaccines against many emerging infections, including lethal infections in low-income countries, even when at no point in the trial do the controls receive the countermeasures being tested. When individual randomisation is feasible-and it often will be-it tends to save more lives than alternative designs would. And for emerging infections, individual randomisation also tends as such to improve care, access to the experimental vaccine and prospects for all participants relative to their opportunities absent the trial, and no less than alternative designs would. That obtains even under placebo control and without equipoise-requiring which would undermine individual randomisation and the alternative designs that opponents proffered. Our arguments expound four often-neglected factors: benefits to non-participants, benefits to participants once a trial is over including post-trial access to the study intervention, participants' prospects before randomisation to arms and the near-inevitable disparity between arms in any randomised controlled trial. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Estimating the Minimal Important Difference for the Western Ontario Rotator Cuff Index (WORC) in adults with shoulder pain associated with partial-thickness rotator cuff tears.

PubMed

Braun, Cordula; Handoll, Helen H

2018-06-01

Knowledge about Minimal Important Differences (MIDs) is essential for the interpretation of continuous outcomes, especially patient-reported outcome measures (PROMS). The aim of this study was to estimate the MID for the Western Ontario Rotator Cuff Index (WORC: score 0 (best) to 2100 (worst disability)) in adults with shoulder pain associated with partial-thickness rotator cuff tears, 'symptomatic PTTs', undergoing conservative treatment with physiotherapy. A prospectively-designed anchor-based MID analysis using data from a prospective prognostic study with a three-month follow-up conducted within an outpatient care setting in Germany. The MID was estimated using data from 64 adults with atraumatic symptomatic PTTs who underwent three months of conservative treatment with physiotherapy. The anchor was a seven-point Global Perceived Change (GPC) scale. Based on a definition of the MID being the threshold of "being (at least slightly) improved" with a probability nearest to 0.90 (i.e. 9 of 10 patients achieving the MID), the MID for the WORC was estimated as -300 for 'improved' shoulder-related disability in 9 out of 10 patients (95% CI 8 out of 10 patients to everyone) undergoing three months of exercise-based physiotherapy for symptomatic PTTs. This is the first published MID estimate for the WORC in adults with symptomatic PTTs of the rotator cuff undergoing typical treatment comprising conservative treatment with physiotherapy. The conceptual framework for interpretation facilitates its use in similar clinical contexts. Copyright © 2018. Published by Elsevier Ltd.

External validation of a published nomogram for prediction of brain metastasis in patients with extra-cerebral metastatic breast cancer and risk regression analysis.

PubMed

Genre, Ludivine; Roché, Henri; Varela, Léonel; Kanoun, Dorra; Ouali, Monia; Filleron, Thomas; Dalenc, Florence

2017-02-01

Survival of patients with metastatic breast cancer (MBC) suffering from brain metastasis (BM) is limited and this event is usually fatal. In 2010, the Graesslin's nomogram was published in order to predict subsequent BM in patients with breast cancer (BC) with extra-cerebral metastatic disease. This model aims to select a patient population at high risk for BM and thus will facilitate the design of prevention strategies and/or the impact of early treatment of BM in prospective clinical studies. Nomogram external validation was retrospectively applied to patients with BC and later BM between January 2005 and December 2012, treated in our institution. Moreover, risk factors of BM appearance were studied by Fine and Gray's competing risk analysis. Among 492 patients with MBC, 116 developed subsequent BM. Seventy of them were included for the nomogram validation. The discrimination is good (area under curve = 0.695 [95% confidence interval, 0.61-0.77]). Risk factors of BM appearance are: human epidermal growth factor receptor 2 (HER2) overexpression/amplification, triple-negative BC and number of extra-cerebral metastatic sites (>1). With a competing risk model, we highlight the nomogram interest for HER2+ tumour subgroup exclusively. Graesslin's nomogram external validation demonstrates exportability and reproducibility. Importantly, the competing risk model analysis provides additional information for the design of prospective trials concerning the early diagnosis of BM and/or preventive treatment on high risk patients with extra-cerebral metastatic BC. Copyright © 2016 Elsevier Ltd. All rights reserved.

From source material to news story in New Zealand print media: a prospective study of the stigmatizing processes in depicting mental illness.

PubMed

Nairn, R; Coverdale, J; Claasen, D

2001-10-01

The aim of this study was to analyse how newspaper articles that depict mental illnesses are generated from source materials. From a prospectively collected national sample of print materials involving mental illness, 50 published items that related to the Privacy Commissioner's opinion about disclosure of a psychiatric patient's health information were identified. A copy of the Privacy Commissioner's original Case Note and three news stories about the Case Note distributed by the New Zealand Press Association constituted the database. These materials were subjected to discourse analysis. We identified themes and their transformation from the Case Note through the news stories and examined the impact of these transformations on the stigmatization of mental illness. Four themes were identified: human rights, vulnerability, risk of dangerousness and threat, and mental illness/psychiatric patient. The only potentially positive theme, human rights, was limited both by being fragmented in the source material, and by being utilized, in the published news stories to undermine the legitimacy of the patient's right to privacy. Use of the other themes was consistent with stereotypes about mental illness. Although there were no inaccuracies in the content of the news stories they were substantially more negative than the source material in their depiction of the identified patient. A potentially positive discourse (human rights) was not by itself sufficient to ensure a positive portrayal of mental illness. An understanding of the transformations is important for efforts to effectively combat the stigmatization of those with mental illness.

Point-of-care ultrasound leads to diagnostic shifts in patients with undifferentiated hypotension.

PubMed

Shokoohi, Hamid; Boniface, Keith S; Zaragoza, Michelle; Pourmand, Ali; Earls, James P

2017-12-01

To assess the impact of an ultrasound hypotension protocol in identifying life-threatening diagnoses that were missed in the initial evaluation of patients with hypotension and shock. A subset of cases from a previously published prospective study of hypotensive patients who presented at the Emergency Department in a single, academic tertiary care hospital is described. An ultrasound-trained emergency physician performed an ultrasound on each patient using a standardized hypotension protocol. In each case, the differential diagnosis and management plan was solicited from the treating physician immediately before and after the ultrasound. This is a case series of patients with missed diagnoses in whom ultrasound led to a dramatic shift in diagnosis and management by detecting life threatening pathologies. Following a published prospective study of the effect on an ultrasound protocol in 118 hypotensive patients, we identified a series of cases that ultrasound protocol unexpectedly determined serious life threatening diagnoses such as Takotsubo cardiomyopathy, pulmonary embolism, pericardial effusion with tamponade physiology, abdominal aortic aneurysm and perforated viscus resulting in proper diagnoses and management. These hypotensive patients had completely unsuspected but critical diagnoses explaining their hypotension, who in every case had their management altered to target the newly identified life-threatening condition. A hypotension protocol is an optimal use of ultrasound that exemplifies "right time, right place", and impacts decision-making at the bedside. In cases with undifferentiated hypotension, ultrasound is often the most readily available option to ensure that the most immediate life-threatening conditions are quickly identified and addressed in the order of their risk potential. Copyright © 2017 Elsevier Inc. All rights reserved.

Prospective aquatic risk assessment for chemical mixtures in agricultural landscapes.

PubMed

Holmes, Christopher M; Brown, Colin D; Hamer, Mick; Jones, Russell; Maltby, Lorraine; Posthuma, Leo; Silberhorn, Eric; Teeter, Jerold Scott; Warne, Michael St J; Weltje, Lennart

2018-03-01

Environmental risk assessment of chemical mixtures is challenging because of the multitude of possible combinations that may occur. Aquatic risk from chemical mixtures in an agricultural landscape was evaluated prospectively in 2 exposure scenario case studies: at field scale for a program of 13 plant-protection products applied annually for 20 yr and at a watershed scale for a mixed land-use scenario over 30 yr with 12 plant-protection products and 2 veterinary pharmaceuticals used for beef cattle. Risk quotients were calculated from regulatory exposure models with typical real-world use patterns and regulatory acceptable concentrations for individual chemicals. The results could differentiate situations when there was concern associated with single chemicals from those when concern was associated with a mixture (based on concentration addition) with no single chemical triggering concern. Potential mixture risk was identified on 0.02 to 7.07% of the total days modeled, depending on the scenario, the taxa, and whether considering acute or chronic risk. Taxa at risk were influenced by receiving water body characteristics along with chemical use profiles and associated properties. The present study demonstrates that a scenario-based approach can be used to determine whether mixtures of chemicals pose risks over and above any identified using existing approaches for single chemicals, how often and to what magnitude, and ultimately which mixtures (and dominant chemicals) cause greatest concern. Environ Toxicol Chem 2018;37:674-689. © 2017 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals, Inc. on behalf of SETAC. © 2017 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals, Inc. on behalf of SETAC.

The developmental neurotoxicity of arsenic: cognitive and behavioral consequences of early life exposure.

PubMed

Tolins, Molly; Ruchirawat, Mathuros; Landrigan, Philip

2014-01-01

More than 200 million people worldwide are chronically exposed to arsenic. Arsenic is a known human carcinogen, and its carcinogenic and systemic toxicity have been extensively studied. By contrast, the developmental neurotoxicity of arsenic has been less well described. The aim of this review was to provide a comprehensive review of the developmental neurotoxicity of arsenic. We reviewed the published epidemiological and toxicological literature on the developmental neurotoxicity of arsenic. Arsenic is able to gain access to the developing brain and cause neurotoxic effects. Animal models link prenatal and early postnatal exposure to reduction in brain weight, reductions in numbers of glia and neurons, and alterations in neurotransmitter systems. Animal and in vitro studies both suggest that oxidative stress may be a mechanism of arsenic neurotoxicity. Fifteen epidemiological studies indicate that early life exposure is associated with deficits in intelligence and memory. These effects may occur at levels of exposure below current safety guidelines, and some neurocognitive consequences may become manifest only later in life. Sex, concomitant exposures, and timing of exposure appear to modify the developmental neurotoxicity of arsenic. Four epidemiological studies failed to show behavioral outcomes of arsenic exposure. The published literature indicates that arsenic is a human developmental neurotoxicant. Ongoing and future prospective birth cohort studies will allow more precise definition of the developmental consequences of arsenic exposure in early life. Copyright © 2014. Published by Elsevier Inc.

Development of the teaching simulator based on animated film to strengthening pedagogical competencies of prospective teachers

NASA Astrophysics Data System (ADS)

Fatimah, Siti; Setiawan, Wawan; Kusnendar, Jajang; Rasim, Junaeti, Enjun; Anggraeni, Ria

2017-05-01

Debriefing of pedagogical competence through both theory and practice which became a requirement for prospective teachers were through micro teaching and teaching practice program. But, some reports from the partner schools stated that the participants of teaching practice program have not well prepared on implementing the learning in the classroom because of lacking the debriefing. In line with the development of information technology, it is very possible to develop a media briefing of pedagogical competencies for prospective teachers through an application so that they can use it anytime and anywhere. This study was one answer to the problem of unpreparedness participants of the teaching practice program. This study developed a teaching simulator, which was an application for learning simulation with the animated film to enhance the professional pedagogical competence prospective teachers. By the application of this teaching simulator, students as prospective teacher could test their own pedagogic competence through learning models with different varied characteristics of students. Teaching Simulator has been equipped with features that allow users to be able to explore the quality of teaching techniques that they employ for the teaching and learning activities in the classroom. These features included the election approaches, the student's character, learning materials, questioning techniques, discussion, and evaluation. Teaching simulator application provided the ease of prospective teachers or teachers in implementing the development of lessons for practice in the classroom. Applications that have been developed to apply simulation models allow users to freely manage a lesson. Development of teaching simulator application was passed through the stages which include needs assessment, design, coding, testing, revision, improvement, grading, and packaging. The application of teaching simulator was also enriched with some real instructional video as a comparison for the user. Based on the two experts, the media expert and education expert, stated that the application of teaching simulator is feasible to be used as an instrument for the debriefing of students as potential participants of the teaching practice program. The results of the use of the application to the students as potential participants of teaching practice program, showed significant increases in the pedagogic competence. This study was presented at an international seminar and in the process of publishing in international reputated journals. Applications teaching simulator was in the process of registration to obtain the copyright of the Ministry of Justice and Human Rights. Debriefing for prospective teachers to use teaching simulator application could improve the mastery of pedagogy, give clear feedback, and perform repetitions at anytime.

Crohn's disease of the vulva.

PubMed

Barret, Maximilien; de Parades, Vincent; Battistella, Maxime; Sokol, Harry; Lemarchand, Nicolas; Marteau, Philippe

2014-07-01

Crohn's disease (CD) of the vulva is a rare, yet under recognized condition. Fistulae arising from the digestive tract account for the greater part of genital lesions in CD. However, cutaneous so-called metastatic lesions of the vulva have been reported in the literature. They are clinically challenging for gastroenterologists as well as for gynecologists, with numerous differential diagnoses, especially among venereal diseases, and require a multidisciplinary approach. The most frequently observed features of the disease are labial swelling, vulvar ulcers, and hypertrophic lesions. Biopsy samples for histological study are mandatory, in order to establish the diagnosis of vulvar CD. Treatment options include oral prolonged courses of metronidazole and systemic immunosuppressive therapy such as corticosteroids and azathioprine, with promising data published on the efficacy of infliximab. Surgery remains restricted to medical treatment failures or resection of unsightly lesions. Prospective studies or case series with long follow-up data are still missing to guide the treatment of this condition. © 2013. Published by Elsevier B.V. All rights reserved.

Overview of different available chemotherapy regimens combined with radiotherapy for the neoadjuvant and definitive treatment of esophageal cancer.

PubMed

Tomasello, Gianluca; Ghidini, Michele; Barni, Sandro; Passalacqua, Rodolfo; Petrelli, Fausto

2017-06-01

Neoadjuvant chemoradiotherapy (CTRT) is the current standard of care for treatment of locally advanced cancer of the esophagus or gastroesophageal junction. Many efforts have been made over the last years to identify the best chemotherapy and radiotherapy combination regimen, but specific randomized trials addressing this issue are still lacking. Areas covered: A systematic review of the literature was performed searching in PubMed all published studies of combinations CTRT regimens for operable or unresectable esophageal cancer to describe activity and toxicity. Studies considered were prospective series or clinical phase II-III trials including at least 40 patients and published in English language. Expert commentary: Long-term results of CROSS trial have established RT combined with carboplatin plus paclitaxel chemotherapy as the preferred neoadjuvant treatment option for both squamous and adenocarcinoma of the esophagus. More effective multimodal treatment strategies integrating novel biological agents including immunotherapy and based on an extensive molecular tumor characterization are eagerly awaited.

Chemical Evolution and the Origin of Life: Bibliography 1975

NASA Technical Reports Server (NTRS)

West, Martha W. (Compiler); Koch, Rowena A. (Compiler); Chang, Sherwood (Compiler)

1977-01-01

This bibliography is the sixth annual supplement to the comprehensive bibliography on the same subject which was published in Space Life Sci.We would like to draw attention to a recently published cumulative bibliography on this same subject: Biochemical Origin of Life: Chemistry and Life. Soil and Water and Its Relationship to Origin of Life. MR - Studies of Prebiotic Polypeptides. Energy, Matter, and Life. Prospects for the Future Orientation of Scientific Research. Photochemical Formation of Self Sustaining Coacervates. Photochemical Formation of Self-Sustaining Coacervates. Comparative Study of Abiogenesis of Cysteine and Other Amino Acids Catalyzed by Various Metal Ions. Protein Structure and the Molecular Evolution of Biological Energy Conversion. Origin of Life. Clues from Relations Between Chemical Compositions of Living Organisms and Natural Environments. Shock Synthesis of Amino Acids II.', Origins of Life 6(1-2). Dynamics of the Chemical Evolution of Earth's Primitive Atmosphere. The Mechanisms of Amino Acids Synthesis by High Temperature Shock-Waves. Theory of Chemical Evolution. Physical Foundations of Probability of Biogenesis.

Laparoscopic repair of perforated peptic duodenal ulcer.

PubMed

Busić, Zeljko; Servis, Draien; Slisurić, Ferdinand; Kristek, Jozo; Kolovrat, Marijan; Cavka, Vlatka; Cavka, Mislav; Cupurdija, Kristijan; Patrlj, Leonardo; Kvesić, Ante

2010-03-01

Although prevalence of peptic ulcer is decreasing, the number of peptic ulcer perforations appears to be unchanged. This complication of peptic ulcer is traditionally surgically treated. In recent years, a number of papers have been published where the authors managed perforated duodenal peptic ulcer in selected patients using laparoscopic approach. Laparoscopic treatment of perforated duodenal ulcer has been described as safe and advantageous compared to open technique but advantages are still not clear due to small number of cases in published studies. Based on these recommendations we decided to establish our own protocol for laparoscopic treatment of perforated peptic duodenal ulcer. In this prospective study we evaluated the first 10 patients in whom we performed laparoscopic repair of perforated duodenal ulcer. There were no conversions to open procedure and no early postoperative complications. The patients were contacted by phone a year after the operation, and all were satisfied with the operation and the appearance of postoperative scars. We regard laparoscopic repair of selected patients with perforated duodenal ulcer as a safe and preferable treatment.

The impact of different definitions and reference groups on the prevalence of cognitive impairment: a study in postmenopausal breast cancer patients before the start of adjuvant systemic therapy.

PubMed

Schilder, Christina M; Seynaeve, Caroline; Linn, Sabine C; Boogerd, Willem; Gundy, Chad M; Beex, Louk V; van Dam, Frits S; Schagen, Sanne B

2010-04-01

Several prospective studies into the effects of adjuvant systemic therapy on cognitive functioning suggest that a proportion of breast cancer patients show cognitive deficits already before the start of systemic therapy. Owing to, among others, methodological inconsistency, studies report different rates of this pre-treatment cognitive impairment. We examined the impact of four different criteria of cognitive impairment and two types of reference groups (a study-specific healthy reference group versus published normative data) on the prevalence of cognitive impairment. Two hundred and five postmenopausal breast cancer patients underwent a battery of neuropsychological tests before the start of endocrine therapy, 124 healthy subjects underwent the same tests. Proportions of cognitive impaired patients were calculated for each of four criteria for cognitive impairment, using (1) study-specific healthy controls and (2) published norms of healthy controls as reference groups. The prevalence of cognitive impairment varied greatly with the strictness of the criterion, as expected, but also was dependent on the reference group used. Cognitive impairment, relative to published norms, ranged from 1% for the strictest to 36.6% for the less strict criterion, cognitive impairment relative to study-specific healthy controls, ranged from 13.7 to 45.4% for the same criteria. This study highlights contrasting proportions of cognitive impairment by using different criteria for cognitive impairment and different reference groups. (Dis)advantages of the methods using a criterion for cognitive impairment, and of the use of published norms versus a study-specific reference group are discussed. Copyright 2009 John Wiley & Sons, Ltd.

Receptor-Defined Subtypes of Breast Cancer in Indigenous Populations in Africa: A Systematic Review and Meta-Analysis

PubMed Central

Eng, Amanda; McCormack, Valerie; dos-Santos-Silva, Isabel

2014-01-01

Background Breast cancer is the most common female cancer in Africa. Receptor-defined subtypes are a major determinant of treatment options and disease outcomes but there is considerable uncertainty regarding the frequency of poor prognosis estrogen receptor (ER) negative subtypes in Africa. We systematically reviewed publications reporting on the frequency of breast cancer receptor-defined subtypes in indigenous populations in Africa. Methods and Findings Medline, Embase, and Global Health were searched for studies published between 1st January 1980 and 15th April 2014. Reported proportions of ER positive (ER+), progesterone receptor positive (PR+), and human epidermal growth factor receptor-2 positive (HER2+) disease were extracted and 95% CI calculated. Random effects meta-analyses were used to pool estimates. Fifty-four studies from North Africa (n = 12,284 women with breast cancer) and 26 from sub-Saharan Africa (n = 4,737) were eligible. There was marked between-study heterogeneity in the ER+ estimates in both regions (I2>90%), with the majority reporting proportions between 0.40 and 0.80 in North Africa and between 0.20 and 0.70 in sub-Saharan Africa. Similarly, large between-study heterogeneity was observed for PR+ and HER2+ estimates (I2>80%, in all instances). Meta-regression analyses showed that the proportion of ER+ disease was 10% (4%–17%) lower for studies based on archived tumor blocks rather than prospectively collected specimens, and 9% (2%–17%) lower for those with ≥40% versus those with <40% grade 3 tumors. For prospectively collected samples, the pooled proportions for ER+ and triple negative tumors were 0.59 (0.56–0.62) and 0.21 (0.17–0.25), respectively, regardless of region. Limitations of the study include the lack of standardized procedures across the various studies; the low methodological quality of many studies in terms of the representativeness of their case series and the quality of the procedures for collection, fixation, and receptor testing; and the possibility that women with breast cancer may have contributed to more than one study. Conclusions The published data from the more appropriate prospectively measured specimens are consistent with the majority of breast cancers in Africa being ER+. As no single subtype dominates in the continent availability of receptor testing should be a priority, especially for young women with early stage disease where appropriate receptor-specific treatment modalities offer the greatest potential for reducing years of life lost. Please see later in the article for the Editors' Summary PMID:25202974

Work characteristics, socioeconomic position and health: a systematic review of mediation and moderation effects in prospective studies

PubMed Central

Hoven, Hanno; Siegrist, Johannes

2013-01-01

Social inequalities in health persist in modern societies. The contribution of adverse work and employment conditions towards their explanation is analysed by two approaches, mediation and moderation. Yet the relative significance of each approach remains unclear in respective research. We set out to study this question by conducting a systematic literature review. We included all original papers based on prospective observational studies of employed cohorts that were published between January 1980 and October 2012 meeting our search criteria, by using major databases and by observing established quality criteria. 26 reports were included after quality assessment. 17 studies examined the mediation hypothesis and nine studies tested the moderation hypothesis. Moderate support was found for the mediation hypothesis where OR or HR of health according to socioeconomic position (SEP) were reduced in a majority of analyses after introducing work characteristics in multivariate models. Evidence in favour of the moderation hypothesis was found in some studies, demonstrating stronger effects of adverse work on health among people with low SEP. Despite some support in favour of the two hypotheses future research should aim at reducing the heterogeneity in defining and measuring core variables and at applying advanced statistical analyses. Policy recommendations would benefit from a higher degree of consistency of respective research evidence. PMID:23739492

Work characteristics, socioeconomic position and health: a systematic review of mediation and moderation effects in prospective studies.

PubMed

Hoven, Hanno; Siegrist, Johannes

2013-09-01

Social inequalities in health persist in modern societies. The contribution of adverse work and employment conditions towards their explanation is analysed by two approaches, mediation and moderation. Yet the relative significance of each approach remains unclear in respective research. We set out to study this question by conducting a systematic literature review. We included all original papers based on prospective observational studies of employed cohorts that were published between January 1980 and October 2012 meeting our search criteria, by using major databases and by observing established quality criteria. 26 reports were included after quality assessment. 17 studies examined the mediation hypothesis and nine studies tested the moderation hypothesis. Moderate support was found for the mediation hypothesis where OR or HR of health according to socioeconomic position (SEP) were reduced in a majority of analyses after introducing work characteristics in multivariate models. Evidence in favour of the moderation hypothesis was found in some studies, demonstrating stronger effects of adverse work on health among people with low SEP. Despite some support in favour of the two hypotheses future research should aim at reducing the heterogeneity in defining and measuring core variables and at applying advanced statistical analyses. Policy recommendations would benefit from a higher degree of consistency of respective research evidence.

A prospective cohort study of treatment decision-making for prostate cancer following participation in a multidisciplinary clinic.

PubMed

Hurwitz, Lauren M; Cullen, Jennifer; Elsamanoudi, Sally; Kim, Daniel J; Hudak, Jane; Colston, Maryellen; Travis, Judith; Kuo, Huai-Ching; Porter, Christopher R; Rosner, Inger L

2016-05-01

Patients diagnosed with prostate cancer (PCa) are presented with several treatment options of similar efficacy but varying side effects. Understanding how and why patients make their treatment decisions, as well as the effect of treatment choice on long-term outcomes, is critical to ensuring effective, patient-centered care. This study examined treatment decision-making in a racially diverse, equal-access, contemporary cohort of patients with PCa counseled on treatment options at a multidisciplinary clinic. A prospective cohort study was initiated at the Walter Reed National Military Medical Center (formerly Walter Reed Army Medical Center) in 2006. Newly diagnosed patients with PCa were enrolled before attending a multidisciplinary clinic. Patients completed surveys preclinic and postclinic to assess treatment preferences, reasons for treatment choice, and decisional regret. As of January 2014, 925 patients with PCa enrolled in this study. Surgery (54%), external radiation (20%), and active surveillance (12%) were the most common primary treatments for patients with low- and intermediate-risk PCa, whereas patients with high-risk PCa chose surgery (34%) or external radiation with neoadjuvant hormones (57%). Treatment choice differed by age at diagnosis, race, comorbidity status, and calendar year in both univariable and multivariable analyses. Patients preferred to play an active role in the decision-making process and cited doctors at the clinic as the most helpful source of treatment-related information. Almost all patients reported satisfaction with their decision. This is one of the first prospective cohort studies to examine treatment decision-making in an equal-access, multidisciplinary clinic setting. Studies of this cohort would aid in understanding and improving the PCa decision-making process. Published by Elsevier Inc.

No Evidence of Increased Risk of Stroke with Consumption of Refined Grains: A Meta-analysis of Prospective Cohort Studies.

PubMed

Wu, Demo; Guan, Yixiang; Lv, Shujun; Wang, Haibo; Li, Jun

2015-12-01

Results of the relationships between dietary consumption of refined grains and the risk of stroke are mixed. This study was based on a meta-analysis of prospective cohort studies. We systematically searched the MEDLINE (from January 1, 1966) and EMBASE (from January 1, 1974) databases up to November 30, 2014. Random-effects models were used to calculate summary relative risks (SRRs) and 95% confidence intervals (CIs). Between-study heterogeneity was assessed using Cochran's Q and I(2) statistics. Eight prospective studies (7 publications) with a total of 410,821 subjects and 8284 stroke events were included in the meta-analysis. Overall, a diet containing greater amounts of refined grains was not associated with risk of stroke, with no evidence of heterogeneity among studies (SRR = 1.02; 95% CI, .93-1.10; P(heterogeneity) = .970; I(2) = 0). In addition, no significant associations between consumption of refined grains and risk of stroke were found for both women and men, for both hemorrhagic and ischemic strokes, and for both incident and fatal strokes. These null results are consistent with those of linear dose-response meta-analyses (SRR = .98; 95% CI, .73-1.03 for per 3 servings/day). Consumption of white rice was not associated with risk of stroke (SRR = 1.01; 95% CI, .93-1.11; P(heterogeneity) = .966; I(2) = 0). The current meta-analysis provides some evidence for the hypothesis that consumption of refined grains was not associated with risk of stroke and its subtypes. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Perceived job insecurity, unemployment and depressive symptoms: a systematic review and meta-analysis of prospective observational studies.

PubMed

Kim, T J; von dem Knesebeck, O

2016-05-01

It was shown that both job insecurity and unemployment are strongly and consistently associated with depressive symptoms. It is, however, less clear whether perceived job insecurity and unemployment constitute a comparable risk for the onset of depressive symptoms. A meta-analysis was conducted to explore this issue. In December 2014, relevant records were identified through the databases MEDLINE, Embase and PsychINFO. Articles were included if they had been published in the last 10 years and contained a quantitative analysis on the prospective link between job insecurity and unemployment with depressive symptoms. In 20 cohort studies within 15 articles, job insecurity and unemployment were significantly related to a higher risk of depressive symptoms, with the odds ratio (OR) being modestly higher for job insecurity (1.29, 95% CI 1.06-1.57) than for unemployment (1.19, 95% CI 1.11-1.28). Sensitivity analyses revealed that the effects were strongest in studies that examined younger respondents (<40 years) and used an unadjusted statistical model. By considering the length of the observational period, it was shown that unemployment ORs were higher in shorter time lags (under 1 year), while ORs for job insecurity were increased in longer exposure-outcome intervals (3-4 years). Specifically for unemployment, ORs were highest in studies that did not control for potential health selection effects and that ascertained enduring unemployment. A statistically significant publication bias was found for studies on unemployment, but not for job insecurity. The analyses revealed that both perceived job insecurity and unemployment constitute significant risks of increased depressive symptoms in prospective observational studies. By comparing both stressors, job insecurity can pose a comparable (and even modestly increased) risk of subsequent depressive symptoms.

Emergence agitation during recovery from intracranial surgery under general anaesthesia: a protocol and statistical analysis plan for a prospective multicentre cohort study.

PubMed

Yan, Li-Mei; Chen, Han; Yu, Rong-Guo; Wang, Zhu-Heng; Zhou, Guan-Hua; Wang, Yong-Jin; Zhang, Xia; Xu, Ming; Chen, Lu; Zhou, Jian-Xin

2015-04-21

Emergence agitation after intracranial surgery is an important clinical issue during anaesthesia recovery. The aim of this multicentre cohort study is to investigate the incidence of emergence agitation, identify the risk factors and determine clinical outcomes in adult patients after intracranial surgery under general anaesthesia. Additionally, we will deliberately clarify the relationship between postoperative pneumocephalus and agitation. The present study is a prospective multicentre cohort study. Five intensive care units (ICUs) in China will participate in the study. Consecutive adult patients admitted to the ICUs after intracranial surgery will be enrolled. Sedation-Agitation Scale (SAS) or Richmond Agitation-Sedation Scale (RASS) will be used to evaluate the patients 12 h after the enrolment. Agitation is defined as an SAS score of 5-7, or an RASS score of +2 to +4. According to the maximal SAS and RASS score, patients will be divided into two cohorts: the agitation group and the non-agitation group. Factors potentially related to emergence agitation will be collected at study entry, during anaesthesia and operation, during postoperative care. Univariate analyses between the agitation and the non-agitation groups will be performed. The stepwise backward logistic regression will be carried out to identify the independent predictors of agitation. Patients will be followed up for 72 h after the operation. Accidental self-extubation of the endotracheal tube and removal of other catheters will be documented. The use of sedatives and analgesics will be collected. Ethics approval has been obtained from each of five participating hospitals. Study findings will be disseminated through peer-reviewed publications and conference presentations. NCT02318199. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Protocol for a 1-year prospective, longitudinal cohort study of patients undergoing Roux-en-Y gastric bypass and sleeve gastrectomy: the BARI-LIFESTYLE observational study

PubMed Central

Jassil, Friedrich C; Carnemolla, Alisia; Kingett, Helen; Paton, Bruce; O’Keeffe, Aidan G; Doyle, Jacqueline; Morris, Stephen; Lewis, Neville; Kirk, Amy; Pucci, Andrea; Chaiyasoot, Kusuma; Batterham, Rachel L

2018-01-01

Introduction Roux-en-Y gastric bypass and sleeve gastrectomy are the two most common bariatric surgery performed in the UK that result in comparable weight loss and remission of obesity-associated comorbidities. However, there is a paucity of studies examining the impact of these procedures on body composition, physical activity levels, sedentary behaviour, physical function and strength, dietary intake, health-related quality of life and costs. Methods and analysis The BARI-LIFESTYLE observational study is a 1-year prospective, longitudinal cohort study within a real-world routine clinical care setting aiming to recruit 100 patients with severe obesity undergoing either primary Roux-en-Y gastric bypass or sleeve gastrectomy from two bariatric centres in London, UK. Participants will be followed up four times during the study period; presurgery baseline (T0) and at 3 (T1), 6 (T2) and 12 months (T3) postsurgery. In addition to the standard follow-up investigations, assessments including dual-energy X-ray absorptiometry scan, bioelectric impedance analysis, 6 min walk test, sit-to-stand test and handgrip test will be undertaken together with completion of questionnaires. Physical activity levels and sedentary behaviour will be assessed using accelerometer, and dietary intake will be recorded using a 3-day food diary. Outcome measures will include body weight, body fat mass, lean muscle mass, bone mineral density, physical activity levels, sedentary behaviour, physical function and strength, dietary intake, health-related quality of life, remission of comorbidities, healthcare resource utilisation and costs. Ethics and dissemination This study has been reviewed and given a favourable ethical opinion by London-Dulwich Research Ethics Committee (17/LO/0950). The results will be presented to stakeholder groups locally, nationally and internationally and published in peer-reviewed medical journals. The lay-person summary of the findings will be published on the Centre for Obesity Research, University College London website (http://www.ucl.ac.uk/obesity). PMID:29549212

International standards for symphysis-fundal height based on serial measurements from the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project: prospective cohort study in eight countries.

PubMed

Papageorghiou, Aris T; Ohuma, Eric O; Gravett, Michael G; Hirst, Jane; da Silveira, Mariangela F; Lambert, Ann; Carvalho, Maria; Jaffer, Yasmin A; Altman, Douglas G; Noble, Julia A; Bertino, Enrico; Purwar, Manorama; Pang, Ruyan; Cheikh Ismail, Leila; Victora, Cesar; Bhutta, Zulfiqar A; Kennedy, Stephen H; Villar, José

2016-11-07

 To create international symphysis-fundal height standards derived from pregnancies of healthy women with good maternal and perinatal outcomes.  Prospective longitudinal observational study.  Eight geographically diverse urban regions in Brazil, China, India, Italy, Kenya, Oman, United Kingdom, and United States.  Healthy, well nourished pregnant women enrolled into the Fetal Growth Longitudinal Study component of the INTERGROWTH-21 st Project at 9-14 weeks' gestation, and followed up until birth.  Symphysis-fundal height was measured every five weeks from 14 weeks' gestation until birth using standardised methods and dedicated research staff who were blinded to the symphysis-fundal height measurements by turning the tape measure so that numbers were not visible during examination. The best fitting curve was selected using second degree fractional polynomials and further modelled in a multilevel framework to account for the longitudinal design of the study.  Of 13 108 women screened in the first trimester, 4607 (35.1%) met the study entry criteria. Of the eligible women, 4321 (93.8%) had pregnancies without major complications and delivered live singletons without congenital malformations. The median number of symphysis-fundal height measurements was 5.0 (range 1-7); 3976 (92.0%) women had four or more measurements. Symphysis-fundal height measurements increased almost linearly with gestational age; data were used to determine fitted 3rd, 50th, and 97th centile curves, which showed excellent agreement with observed values.  This study presents international standards to measure symphysis-fundal height as a first level screening tool for fetal growth disturbances. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Changes in leisure-time physical activity and physical and mental health functioning: a follow-up study.

PubMed

Holstila, A; Mänty, M; Rahkonen, O; Lahelma, E; Lahti, J

2017-12-01

Functioning will be an increasingly important issue in Finland over the coming decades as the proportion of the population aged 65 and older is growing significantly. However, the associations between changes in physical activity and subsequent health functioning are poorly understood. The aim of this study was to examine how changes in physical activity relate to concurrent and prospective levels of health functioning. Cohort data from the Helsinki Health Study were used. Phase 1 (n = 8960, response rate 67%, 80% women) was conducted among 40- to 60-year-old employees of the City of Helsinki in 2000-2002, phase 2 in 2007 (n = 7332, response rate 83%), and phase 3 in 2012 (n = 6814, response rate 79%). Linear mixed models were used as the main statistical method. Increasing physical activity was associated with higher concurrent and prospective levels of physical health functioning, whereas decreasing activity was associated with lower levels of physical health functioning. The associations were stronger with physical than with mental health functioning. Promoting physical activity among aging people may help to maintain their level of health functioning. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Helicobacter pylori infection amongst Arab Israeli women with hyperemesis gravidarum--a prospective, controlled study.

PubMed

Boltin, Doron; Perets, Tsachi Tsadok; Elheiga, Sami Abu; Sharony, Asher; Niv, Yaron; Shamaly, Hussein; Dickman, Ram

2014-12-01

Helicobacter pylori has been associated with hyperemesis gravidarum in some geographical regions. The prevalence of H. pylori in Arab Israeli women in the Upper Galilee and its association with hyperemesis gravidarum has not been studied previously. We aimed to examine if hyperemesis gravidarum is associated with H. pylori in this population. Subjects with hyperemesis gravidarum carrying a singleton fetus were recruited prospectively. Women with an uncomplicated pregnancy served as controls. All patients underwent (13)C-urea breath testing to assess for H. pylori infection. A total of 72 subjects, including 24 patients with hyperemesis gravidarum and 48 controls, aged 28.8±5.3 years, were included. H. pylori infection was identified in 75.0% (18/24) of cases and 60.4% (29/48) of controls (p=not significant). H. pylori infection did not correlate with age, fetal sex, or the number of previous pregnancies (p=not significant). H. pylori does not seem to increase the likelihood of hyperemesis gravidarum in Arab Israeli women. However, given the high background prevalence of H. pylori in this population, a larger study is required to corroborate these findings. (MOH20110066). Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Re-examining the prospects of aluminous cements based on alkali-earth and rare-earth oxides

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chatterjee, A.K., E-mail: anjan.k.chatterjee@gmail.co

2009-11-15

In the family of aluminous cements the potential of strontium aluminate, the strontium-barium aluminate and the barium aluminate cements have been sporadically and incoherently studied over several decades in various parts of the world and more particularly in the East European countries without much wide-spread commercial success. Attempts had also been made to extend the exploratory studies to the (Ca, Sr, Ba)O-Al{sub 2}O{sub 3}-ZrO{sub 2}-HfO{sub 2} system to synthesize super-refractory binders. In fact, the above compositions, prima facie, seem to have the potential of arriving at cementitious formulations that, apart from being super-refractory, may as well be highly resistant tomore » seawater, X-rays and gamma radiation. Looking at these potentials, quite a few experimental studies have been carried out under the guidance and supervision of the present author. The present paper is an endeavour to collate the data on some of these systems both from the published literature as well as from the author's findings. The prime motive has been to review and re-assess the prospects of manufacturing a range of new aluminous binders with superior properties.« less

Do the bullies survive? A five-year, three-wave prospective study of indicators of expulsion in working life among perpetrators of workplace bullying

PubMed Central

GLAMBEK, Mats; SKOGSTAD, Anders; EINARSEN, Ståle

2015-01-01

In recent series of studies, we have shown that targets of workplace bullying are at risk of expulsion in working life, both from current employment (e.g. in terms of changing employer) and from working life itself (e.g. becoming unemployed). The most recent of these, Take It or Leave: A Five-Year Prospective Study of Workplace Bullying and Indicators of Expulsion in Working Life was recently published in Industrial Health, and the present short communication aims to follow up that paper, investigating the possible job “survival” of the perpetrators. A nationally representative sample was employed (n=1,613), and responses were gathered at three time points with a two-year and a five-year time-lag. Outcomes were intention to leave and sickness absence at T1, and sickness absence, change of employer, disability benefit recipiency and unemployment at T2 and T3. The results of regression analyses clearly indicate that the perpetrators’ occupational status is largely unchanged, and remains so over time, as opposed to earlier findings regarding the targets of bullying. PMID:26320732

A prospective single-institute study of the impact of Daikenchuto on the early postoperative outcome after living donor liver transplantation.

PubMed

Takatsuki, Mitsuhisa; Hidaka, Masaaki; Soyama, Akihiko; Hara, Takanobu; Okada, Satomi; Ono, Shinichiro; Adachi, Tomohiko; Eguchi, Susumu

2018-01-20

The aim of this study was to investigate the impact of Daikenchuto (DKT) on early postoperative outcomes after living donor liver transplantation (LDLT), focusing on the prevention of abdominal distension and bacterial translocation. Adult LDLT recipients were prospectively divided into 2 groups, who were administered DKT (n = 20, group A) or not (n = 20, group B). The area of bowel gas defined as gas volume score (GVS) 7 days after LDLT was calculated. Postoperative liver function tests, the development of bacterial, viral, and fungal infections, and GVS after LDLT were reviewed. There were no significant differences in liver function tests and ammonia level after LDLT. Also, the rates of infection and the result of culture study were not different between groups. The median GVS 7 days after LDLT was not significantly different between groups A (0.26 (range, 0.12-0.58)) and B (0.23 (range, 0.15-0.42)). No positive impact was observed for 14-day DKT administration after LDLT, in terms of preventing infection or abdominal distension. Copyright © 2018. Published by Elsevier Taiwan.

Continuation and Maintenance Electroconvulsive Therapy for Mood Disorders: Review of the Literature

PubMed Central

Petrides, Georgios; Tobias, Kristen G.; Kellner, Charles H.; Rudorfer, Matthew V.

2011-01-01

Background Electroconvulsive therapy (ECT) is a highly effective treatment for mood disorders. Continuation ECT (C-ECT) and maintenance ECT (M-ECT) are required for many patients suffering from severe and recurrent forms of mood disorders. This is a review of the literature regarding C- and M-ECT. Methods We conducted a computerized search using the words continuation ECT, maintenance ECT, depression, mania, bipolar disorder and mood disorders. We report on all articles published in the English language from 1998 to 2009. Results We identified 32 reports. There were 24 case reports and retrospective reviews on 284 patients. Two of these reports included comparison groups, and 1 had a prospective follow-up in a subset of subjects. There were 6 prospective naturalistic studies and 2 randomized controlled trials. Conclusions C-ECT and M-ECT are valuable treatment modalities to prevent relapse and recurrence of mood disorders in patients who have responded to an index course of ECT. C-ECT and M-ECT are underused and insufficiently studied despite positive clinical experience of more than 70 years. Studies which are currently under way should allow more definitive recommendations regarding the choice, frequency and duration of C-ECT and M-ECT following acute ECT. PMID:21811083

Placental Volumetry by 2-D Sonography with a New Mathematical Formula: Prospective Study on the Shell of a Spherical Sector Model.

PubMed

Kozinszky, Zoltan; Surányi, Andrea; Péics, Hajnalka; Molnár, András; Pál, Attila

2015-08-01

The aim of this study was to determine the utility of a new mathematical model in volumetric assessment of the placenta using 2-D ultrasound. Placental volumetry was performed in a prospective cross-sectional survey by virtual organ computer-aided analysis (VOCAL) with the help of a shell-off method in 346 uncomplicated pregnancies according to STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. Furthermore, placental thickness, length and height were measured with the 2-D technique to estimate placental volume based on the mathematical formula for the volume of "the shell of the spherical sector." Fetal size was also assessed by 2-D sonography. The placental volumes measured by 2-D and 3-D techniques had a correlation of 0.86. In the first trimester, the correlation was 0.82, and later during pregnancy, it was 0.86. Placental volumetry using "the circle-shaped shell of the spherical sector" mathematical model with 2-D ultrasound technique may be introduced into everyday practice to screen for placental volume deviations associated with adverse pregnancy outcome. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Prospective cohort study of febrile neutropenia in breast cancer patients with neoadjuvant and adjuvant chemotherapy: CSPOR-BC FN study.

PubMed

Ishikawa, Takashi; Sakamaki, Kentaro; Narui, Kazutaka; Kaise, Hiroshi; Tsugawa, Koichiro; Ichikawa, Yasushi; Mukai, Hirofumi

2016-07-01

With the increasing use of adjuvant chemotherapy for treating early breast cancer, febrile neutropenia management has become crucial. Guidelines for febrile neutropenia management are mostly based on a Caucasian population survey although ethnic differences are reported in terms of adverse events. We survey the current status of febrile neutropenia and risk factors in Japanese female breast cancer patients receiving neoadjuvant and adjuvant chemotherapy regimens potential for febrile neutropenia. Subsequently, we plan to conduct a multicenter prospective cohort study involving 1000 patients with operable breast cancer. With the current state of oral antibiotics being routinely prescribed without hematology tests, we survey febrile neutropenia based on two different definitions, namely, true febrile neutropenia: ≥37.5°C and Grade 4 neutropenia, and surrogate febrile neutropenia: ≥37.5°C and oral antibiotic and antipyretic intake. The comparison of true febrile neutropenia and surrogate febrile neutropenia incidences is anticipated to provide information on the safety and feasibility of chemotherapy management without performing blood tests. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Condom use among female commercial sex workers in Nevada's legal brothels.

PubMed Central

Albert, A E; Warner, D L; Hatcher, R A; Trussell, J; Bennett, C

1995-01-01

OBJECTIVES. The purpose of this study was to evaluate condom use and the incidence of breakage and slippage during vaginal intercourse among female prostitutes in legal Nevada brothels, where use of condoms is required by law. METHODS. Forty-one licensed prostitutes in three brothels were enrolled in a prospective trial in August 1993. Used condoms were collected to verify reported breaks visually. Retrospective breakage and slippage rates were obtained in a standardized interview. RESULTS. Condoms were used for every act of vaginal intercourse with a brothel client during the study period, as well as in the previous year. In the prospective study phase, condoms were used in 353 acts of vaginal intercourse with clients. No condoms broke, and none fell off the penis during intercourse. Only twice (0.6%) did condoms completely fall off during withdrawal. Twelve times (3.4%) during intercourse and 15 times (4.3%) during withdrawal, condoms slipped down the penis but did not fall off. CONCLUSIONS. These findings, among the lowest breakage and slippage rates published, suggest that regular condom use may lead to condom mastery and the development of techniques to reduce the likelihood of breakage and slippage. PMID:7485663

46 CFR 531.3 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... directors or officers. (c) Amendment means any change to a filed NSA which has prospective effect and which is mutually agreed upon by all parties to the NSA. (d) Authorized person means an NVOCC or duly appointed agent who is authorized to file NSAs on behalf of the NVOCC and to publish the corresponding...

46 CFR 531.3 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... directors or officers. (c) Amendment means any change to a filed NSA which has prospective effect and which is mutually agreed upon by all parties to the NSA. (d) Authorized person means an NVOCC or duly appointed agent who is authorized to file NSAs on behalf of the NVOCC and to publish the corresponding...

46 CFR 531.3 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... directors or officers. (c) Amendment means any change to a filed NSA which has prospective effect and which is mutually agreed upon by all parties to the NSA. (d) Authorized person means an NVOCC or duly appointed agent who is authorized to file NSAs on behalf of the NVOCC and to publish the corresponding...

46 CFR 531.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... directors or officers. (c) Amendment means any change to a filed NSA which has prospective effect and which is mutually agreed upon by all parties to the NSA. (d) Authorized person means an NVOCC or duly appointed agent who is authorized to file NSAs on behalf of the NVOCC and to publish the corresponding...

46 CFR 531.3 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... directors or officers. (c) Amendment means any change to a filed NSA which has prospective effect and which is mutually agreed upon by all parties to the NSA. (d) Authorized person means an NVOCC or duly appointed agent who is authorized to file NSAs on behalf of the NVOCC and to publish the corresponding...

76 FR 4188 - Federal Acquisition Regulation; Public Access to the Federal Awardee Performance and Integrity...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-24

...: Mr. Edward Loeb, Procurement Analyst, at (202) 501-0650 for clarification of content. For information... business ethics and quality of prospective contractors competing for Federal contracts. That rulemaking... when the interim rule is published, the Department of Defense's Director of Defense Procurement and...

Reflections on a Feminist Psychology of Women: Paradoxes and Prospects.

ERIC Educational Resources Information Center

Fine, Michelle

1985-01-01

Reports an analysis of the methods and conclusions of articles published in Psychology of Women Quarterly from 1978 through 1981. Three paradoxes emerge from feminist psychology's commitent to contextual validity: the presumption of "progressive progress"; the implications of internal causes for social conditions; and the advancement of…

North American Security Cooperation: Prospects for Growth

DTIC Science & Technology

2006-11-01

to profane your ground with his step, think, oh beloved country, that heaven has given you a soldier in every son.” The remaining lyrics call for...Alistair Shepherd. Toward a European Army: A Military Power in The Making? Lynne Reinner Publishers, 2003. Singer, P.W.. Review Essay : “The War on

78 FR 33441 - Importer of Controlled Substances; Notice of Registration; Caraco Pharmaceutical Laboratories, LTD

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-04

... Registration; Caraco Pharmaceutical Laboratories, LTD By Notice dated February 8, 2013, and published in the Federal Register on February 21, 2013, 78 FR 12101, Caraco Pharmaceutical Laboratories, Ltd., 270 Prospect... 952(a), and determined that the registration of Caraco Pharmaceutical Laboratories, Ltd., to import...

Winning at the Publication Game

ERIC Educational Resources Information Center

McDaniel, Thomas R.; Childers, Pamela B.

2011-01-01

Prospective authors submitting articles to "The Clearing House" ("TCH") or other professional journals should realize that publishing success depends, in part, on game strategies. This article by the Executive Editors of "TCH" identifies 10 strategies, based on metaphors from competitive sports, that can help authors win at the publication game.…

Entrepreneurial Inclinations of Prospective Teachers

ERIC Educational Resources Information Center

Ali, Akhtar; Topping, Keith J.; Tariq, Riaz H.

2009-01-01

Background: Entrepreneurship has become an emerging field of research in America, Europe and Asia. It has contributed a lot in uplifting the socioeconomic status of the countries. Well reputed International Journals are widely publishing on a variety of entrepreneurial issues. A little research in the area has so far been reported from Pakistan.…

76 FR 41178 - Medicare Program; Proposed Changes to the Hospital Inpatient Prospective Payment Systems for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-13

... Insurance; and Program No. 93.774, Medicare-- Supplementary Medical Insurance Program) Dated: July 7, 2011...), HHS. ACTION: Correction of proposed rule. SUMMARY: This document corrects technical errors that... explanation of publishing such Tables on the Internet), reflect an error in the calculation of the...

Characterization of Mast Cell Activation Syndrome.

PubMed

Afrin, Lawrence B; Self, Sally; Menk, Jeremiah; Lazarchick, John

2017-03-01

Mast cell activation syndrome (MCAS), a recently recognized nonneoplastic mast cell disease driving chronic multisystem inflammation and allergy, appears prevalent and thus important. We report the first systematic characterization of a large MCAS population. Demographics, comorbidities, symptoms, family histories, physical examination and laboratory findings were reviewed in 298 retrospective and 115 prospective patients with MCAS. Blood samples from prospective subjects were examined by flow cytometry for clonal mast cell disease and tested for cytokines potentially driving the monocytosis frequent in MCAS. Demographically, white females dominated. Median ages at symptom onset and diagnosis were 9 and 49 years, respectively (range: 0-88 and 16-92, respectively) and median time from symptom onset to diagnosis was 30 years (range: 1-85). Median numbers of comorbidities, symptoms, and family medical issues were 11, 20, and 4, respectively (range: 1-66, 2-84, and 0-33, respectively). Gastroesophageal reflux, fatigue and dermatographism were the most common comorbidity, symptom and examination finding. Abnormalities in routine laboratories were common and diverse but typically modest. The most useful diagnostic markers were heparin, prostaglandin D 2 , histamine and chromogranin A. Flow cytometric and cytokine assessments were unhelpful. Our study highlights MCAS׳s morbidity burden and challenging heterogeneity. Recognition is important given good survival and treatment prospects. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

Prospective memory impairment and its implications for community living skills in bipolar disorder.

PubMed

Au, Raymond W C; Ungvari, Gabor S; Lee, Edwin; Man, David; Shum, David H K; Xiang, Yu-Tao; Tang, Wai-Kwong

2013-12-01

Prospective memory (PM) refers to the ability to undertake intended actions in the future. The functional significance of PM in bipolar disorder (BD) has not yet been investigated. This study examined PM impairment and its role in community living skills in clinically stable individuals with BD. Seventy-six individuals with BD and 44 healthy individuals were assessed with the Chinese version of the Cambridge Prospective Memory Test. Socio-demographic characteristics, retrospective memory (RM; the ability to recall or recognize past information), and intelligence were also measured in all participants. The clinical condition and community living skills of patients with BD were rated independently with standardized instruments. Patients with BD showed PM impairment and their PM total scores independently predicted the level of community living skills in regression analyses. In follow-up analyses, the contribution was found to be accounted for by the time-based PM scores. Given the expanding body of research on the utility of PM in predicting functioning, these findings further support the role of PM in community living skills in individuals with BD. The results suggest that PM training might be an integral part of clinical rehabilitation devised for individuals with BD. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Postoperative treatment of metacarpal fractures-Classical physical therapy compared with a home exercise program.

PubMed

Gülke, Joachim; Leopold, Barbara; Grözinger, Daniel; Drews, Björn; Paschke, Stephan; Wachter, Nikolaus J

Prospective cohort randomized controlled trial. Is either a home exercise (HE) program or traditional physical therapy (PT) more effective in the postoperative management of metacarpal fractures? Sixty patients suffering from nonthumb metacarpal fractures who received mobilization-stable open reduction and internal fixation were included. All patients were prospectively randomized into either the PT group or the HE group. Follow-up examinations at 2, 6 and 12 weeks postoperatively. After 2 weeks, the range of motion (ROM) in both groups was still severely reduced. Twelve weeks after surgery the ROM improved to 245° (PT) and 256° (HE). Grip strength after 6 weeks was 68% (PT) and 71% (HE) when compared to the non-injured hand, improving to 91% (PT) and 93% (HE) after 12 weeks. Study results show that both HE program and traditional PT are effective in the postoperative management of metacarpal fractures. II. Copyright © 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

De Novo Design of Bioactive Small Molecules by Artificial Intelligence.

PubMed

Merk, Daniel; Friedrich, Lukas; Grisoni, Francesca; Schneider, Gisbert

2018-01-01

Generative artificial intelligence offers a fresh view on molecular design. We present the first-time prospective application of a deep learning model for designing new druglike compounds with desired activities. For this purpose, we trained a recurrent neural network to capture the constitution of a large set of known bioactive compounds represented as SMILES strings. By transfer learning, this general model was fine-tuned on recognizing retinoid X and peroxisome proliferator-activated receptor agonists. We synthesized five top-ranking compounds designed by the generative model. Four of the compounds revealed nanomolar to low-micromolar receptor modulatory activity in cell-based assays. Apparently, the computational model intrinsically captured relevant chemical and biological knowledge without the need for explicit rules. The results of this study advocate generative artificial intelligence for prospective de novo molecular design, and demonstrate the potential of these methods for future medicinal chemistry. © 2018 The Authors. Published by Wiley-VCH Verlag GmbH & Co. KGaA.

Cyber victimization by peers: Prospective associations with adolescent social anxiety and depressive symptoms.

PubMed

Landoll, Ryan R; La Greca, Annette M; Lai, Betty S; Chan, Sherilynn F; Herge, Whitney M

2015-07-01

Peer victimization that occurs via electronic media, also termed cybervictimization, is a growing area of concern for adolescents. The current study evaluated the short-term prospective relationship between cybervictimization and adolescents' symptoms of social anxiety and depression over a six-week period. Participants were 839 high-school aged adolescents (14-18 years; 58% female; 73% Hispanic White), who completed measures of traditional peer victimization, cybervictimization, depression, and social anxiety at two time points. Findings supported the distinctiveness of cybervictimization as a unique form of peer victimization. Furthermore, only cybervictimization was associated with increased levels of depressive symptoms over time, and only relational victimization was associated with increased social anxiety over time, after controlling for the comorbidity of social anxiety and depression among youth. Cybervictimization appears to be a unique form of victimization that contributes to adolescents' depressive symptoms and may be important to target in clinical and preventive interventions for adolescent depression. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Medical Record Documentation Among Interns: A Prospective Quality Improvement Study.

PubMed

Owen, Jm; Conway, R; Silke, B; O'Riordan, D

2015-06-01

Comprehensive record keeping is a key aspect of medical practice. The National Hospitals Office (NHO) and Irish Medical Council (IMC) have published guidelines in this area. A prospective audit of 100 patients assessed by interns was performed to quantify adherence with these guidelines followed by an educational session and email reminders. Adherence was reassessed in an incidental manner. Compliance was recorded in a number of areas including the reason for review and documentation of a plan both 98 (98%). However less than half of interns recorded the patient's name, background history or their impression of the case. Only 31(31%) noted the patient's MRN and only 1(1%) the information they gave to the patient. Significant improvements following the intervention were found, however significant deficits remained in a number of areas including the noting of an impression of the case 62(62%) and information given to patients 18(18%). Suboptimal documentation can be improved through education and clinical auditing.

Proteomic prediction and Renin angiotensin aldosterone system Inhibition prevention Of early diabetic nephRopathy in TYpe 2 diabetic patients with normoalbuminuria (PRIORITY): essential study design and rationale of a randomised clinical multicentre trial.

PubMed

Lindhardt, Morten; Persson, Frederik; Currie, Gemma; Pontillo, Claudia; Beige, Joachim; Delles, Christian; von der Leyen, Heiko; Mischak, Harald; Navis, Gerjan; Noutsou, Marina; Ortiz, Alberto; Ruggenenti, Piero Luigi; Rychlik, Ivan; Spasovski, Goce; Rossing, Peter

2016-03-02

Diabetes mellitus affects 9% of the European population and accounts for 15% of healthcare expenditure, in particular, due to excess costs related to complications. Clinical trials aiming for earlier prevention of diabetic nephropathy by renin angiotensin system blocking treatment in normoalbumuric patients have given mixed results. This might reflect that the large fraction of normoalbuminuric patients are not at risk of progression, thereby reducing power in previous studies. A specific risk classifier based on urinary proteomics (chronic kidney disease (CKD)273) has been shown to identify normoalbuminuric diabetic patients who later progressed to overt kidney disease, and may hold the potential for selection of high-risk patients for early intervention. Combining the ability of CKD273 to identify patients at highest risk of progression with prescription of preventive aldosterone blockade only to this high-risk population will increase power. We aim to confirm performance of CKD273 in a prospective multicentre clinical trial and test the ability of spironolactone to delay progression of early diabetic nephropathy. Investigator-initiated, prospective multicentre clinical trial, with randomised double-masked placebo-controlled intervention and a prospective observational study. We aim to include 3280 type 2 diabetic participants with normoalbuminuria. The CKD273 classifier will be assessed in all participants. Participants with high-risk pattern are randomised to treatment with spironolactone 25 mg once daily, or placebo, whereas, those with low-risk pattern will be observed without intervention other than standard of care. Treatment or observational period is 3 years.The primary endpoint is development of confirmed microalbuminuria in 2 of 3 first morning voids urine samples. The study will be conducted under International Conference on Harmonisation - Good clinical practice (ICH-GCP) requirements, ethical principles of Declaration of Helsinki and national laws. This first new biomarker-directed intervention trial aiming at primary prevention of diabetic nephropathy may pave the way for personalised medicine approaches in treatment of diabetes complications. NCT02040441; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Rationale and design of three observational, prospective cohort studies including biobanking to evaluate and improve diagnostics, management strategies and risk stratification in venous thromboembolism: the VTEval Project.

PubMed

Frank, Bernd; Ariza, Liana; Lamparter, Heidrun; Grossmann, Vera; Prochaska, Jürgen H; Ullmann, Alexander; Kindler, Florentina; Weisser, Gerhard; Walter, Ulrich; Lackner, Karl J; Espinola-Klein, Christine; Münzel, Thomas; Konstantinides, Stavros V; Wild, Philipp S

2015-07-01

Venous thromboembolism (VTE) with its two manifestations deep vein thrombosis (DVT) and pulmonary embolism (PE) is a major public health problem. The VTEval Project aims to investigate numerous research questions on diagnosis, clinical management, treatment and prognosis of VTE, which have remained uncertain to date. The VTEval Project consists of three observational, prospective cohort studies on VTE comprising cohorts of individuals with a clinical suspicion of acute PE (with or without DVT), with a clinical suspicion of acute DVT (without symptomatic PE) and with an incidental diagnosis of VTE (PE or DVT). The VTEval Project expects to enrol a total of approximately 2000 individuals with subsequent active and passive follow-up investigations over a time period of 5 years per participant. Time points for active follow-up investigations are at months 3, 6, 12, 24 and 36 after diagnosis (depending on the disease cohort); passive follow-up investigations via registry offices and the cancer registry are performed 48 and 60 months after diagnosis for all participants. Primary short-term outcome is defined by overall mortality (PE-related death and all other causes of death), primary long-term outcome by symptomatic VTE (PE-related death, recurrence of non-fatal PE or DVT). The VTEval Project includes three 'all-comer' studies and involves the standardised acquisition of high-quality data, covering the systematic assessment of VTE including symptoms, risk profile, psychosocial, environmental and lifestyle factors as well as clinical and subclinical disease, and it builds up a large state-of-the-art biorepository containing various materials from serial blood samplings. The VTEval Project has been approved by the local data safety commissioner and the responsible ethics committee (reference no. 837.320.12 (8421-F)). Trial results will be published in peer-reviewed journals and presented at national and international scientific meetings. NCT02156401. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Students' satisfaction and perceived impact on knowledge, attitudes and skills after a 2-day course in scientific writing: a prospective longitudinal study in Spain.

PubMed

Fernández, Esteve; García, Ana M; Serés, Elisabet; Bosch, Fèlix

2018-01-27

This study aimed to determine students' satisfaction with a 2-day course on scientific writing in health sciences and to assess their perceptions of the long-term impact on their knowledge, attitudes and skills. 27 iterations of a 2-day course on writing and publishing scientific articles in health sciences. 741 students attending the 27 courses. Prospective longitudinal study. Immediately after each course, students completed a first questionnaire, rating their satisfaction with different aspects of the classroom sessions on a Likert scale (0-5). Approximately 2 years after the course, students completed a follow-up questionnaire, using a Likert scale (0-4) to rate their knowledge, skills and attitudes in relation to scientific writing before and after attending the course. 741 students (70% women) participated in the 27 iterations of the course; 568 (76.8%) completed the first questionnaire and 182 (24.6%) completed the follow-up questionnaire. The first questionnaire reflected high overall satisfaction (mean score, 4.6). In the second questionnaire, students reported that the course had improved their knowledge (mean improvement: 1.6; 95% CI 1.6 to 1.7), attitudes (mean improvement: 1.3; 95% CI 1.2 to 1.4) and skills (mean improvement: 1.4; 95% CI 1.3 to 1.4) related to writing and publishing scientific papers. Most respondents (n=145, 79.7%) had participated in drafting a scientific paper after the course; in this subgroup, all the specific writing skills assessed in the second questionnaire significantly improved. Students were satisfied with the format and the contents of the course, and those who responded to the follow-up survey considered that the course had improved their knowledge, attitudes and skills in relation to scientific writing and publishing. Courses are particularly important in countries without strong traditions in scientific publication. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Prospective Evaluation of Self-Reported Aggression in Transgender Persons.

PubMed

Defreyne, Justine; T'Sjoen, Guy; Bouman, Walter Pierre; Brewin, Nicola; Arcelus, Jon

2018-05-01

Although research on the relation between testosterone and aggression in humans is inconclusive, guidelines (including the World Professional Association for Transgender Health Standards of Care, edition 7) have warned for an increase in aggression in transgender men taking testosterone treatment. To investigate the association between levels of testosterone and aggression in treatment-seeking transgender people and explore the role of mental health psychopathology (anxiety and depressive symptoms) and social support in aggression in this population. Every transgender person invited for assessment at a national transgender health clinic in the United Kingdom during a 3-year period (2012-2015) completed self-report measures for interpersonal problems, including levels of aggression (Inventory of Interpersonal Problems [IIP-32]), symptoms of anxiety and depression (Hospital Anxiety and Depression Scale [HADS]), social support (Multidimensional Scale of Perceived Social Support), and experiences of transphobia before and 1 year after the initiation of gender-affirming hormonal therapy. Correlations between prospective scores for the IIP-32 factor "too aggressive" and prospective levels of sex steroids, prospective psychological (HADS), and baseline psychosocial measurements were tested. Prospective scores for the factor "too aggressive" were not correlated to prospective serum testosterone levels. Results of 140 people (56 transgender men, 84 transgender women) were analyzed. A prospective increase in scores for the factor "too aggressive" of the IIP-32 in transgender men 1 year after being treated with testosterone treatment or a decrease of the IIP-32 aggression scores in transgender women 1 year after gender-affirming hormonal therapy was not found. However, a positive correlation was found between increasing HADS anxiety scores and increasing scores for the IIP-32 "too aggressive" score in the entire study population and a positive correlation with lower support from friends in transgender women. Hormone-prescribing physicians can be reassured that the long-term administration of testosterone in transgender men does not increase aggressive behavior. This is the 1st prospective study to assess the effect of gender-affirming hormonal care on aggression. Limitations included the use of different laboratories, the use of a patient-reported outcome measure, and the lack of aggression subtypes. Testosterone therapy was not associated with an increase in levels of aggression in transgender men or a decrease in aggressive behavior in transgender women on antiandrogen and estrogen therapy, but other psychological and/or social factors, such as anxiety levels, appear to contribute to self-reported aggression in transgender people. Defreyne J, T'Sjoen G, Bouman WP, et al. Prospective Evaluation of Self-Reported Aggression in Transgender Persons. J Sex Med 2018;15:768-776. Copyright © 2018 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Use of the SONET score to evaluate Urgent Care Center overcrowding: a prospective pilot study.

PubMed

Wang, Hao; Robinson, Richard D; Cowden, Chad D; Gorman, Violet A; Cook, Christopher D; Gicheru, Eugene K; Schrader, Chet D; Jayswal, Rani D; Zenarosa, Nestor R

2015-04-14

To derive a tool to determine Urgent Care Center (UCC) crowding and investigate the association between different levels of UCC overcrowding and negative patient care outcomes. Prospective pilot study. Single centre study in the USA. 3565 patients who registered at UCC during the 21-day study period were included. Patients who had no overcrowding statuses estimated due to incomplete collection of operational variables at the time of registration were excluded in this study. 3139 patients were enrolled in the final data analysis. A crowding estimation tool (SONET: Severely overcrowded, Overcrowded and Not overcrowded Estimation Tool) was derived using the linear regression analysis. The average length of stay (LOS) in UCC patients and the number of left without being seen (LWBS) patients were calculated and compared under the three different levels of UCC crowding. Four independent operational variables could affect the UCC overcrowding score including the total number of patients, the number of results pending for patients, the number of patients in the waiting room and the longest time a patient was stationed in the waiting room. In addition, UCC overcrowding was associated with longer average LOS (not overcrowded: 133±76 min, overcrowded: 169±79 min, and severely overcrowded: 196±87 min, p<0.001) and an increased number of LWBS patients (not overcrowded: 0.28±0.69 patients, overcrowded: 0.64±0.98, and severely overcrowded: 1.00±0.97). The overcrowding estimation tool (SONET) derived in this study might be used to determine different levels of crowding in a high volume UCC setting. It also showed that UCC overcrowding might be associated with negative patient care outcomes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Cadmium exposure and risk of pancreatic cancer: A meta-analysis of prospective cohort studies and case-control studies among individuals without occupational exposure history

PubMed Central

Chen, Cheng; Xun, Pengcheng; Nishijo, Muneko; Sekikawa, Akira

2015-01-01

Pancreatic cancer is one of the most deadly types of cancer for both genders. Classified as a human carcinogen, cadmium has been related to diverse cancers. However, the association between cadmium exposure and the risk of pancreatic cancer is still unclear. We quantitatively reviewed the observational studies on the association of cadmium exposure with pancreatic cancer risk among individuals without occupational exposure history published through July 2014 in PubMed by using a fixed–effects model. Four prospective cohort studies (112,934 participants with 335 events) and two case-control studies (177 cases and 539 controls) were identified. The summarized relative risk (RR) with a 95% confidence interval (CI) was 2.05 (95% CI=1.58 – 2.66), comparing the highest to the lowest category of cadmium exposure. This positive association persisted in men (RR=1.78; 95% CI=1.04 – 3.05), but not in women (RR=1.02; 95% CI=0.63 – 1.65). Further research is needed to provide more solid evidence on the association of cadmium exposure with pancreatic cancer risk and to elucidate the underlying biological mechanism of the potential gender difference. PMID:26423282

Cadmium exposure and risk of pancreatic cancer: a meta-analysis of prospective cohort studies and case-control studies among individuals without occupational exposure history.

PubMed

Chen, Cheng; Xun, Pengcheng; Nishijo, Muneko; Sekikawa, Akira; He, Ka

2015-11-01

Pancreatic cancer is one of the most deadly types of cancer for both genders. Classified as a human carcinogen, cadmium has been related to diverse cancers. However, the association between cadmium exposure and the risk of pancreatic cancer is still unclear. We quantitatively reviewed the observational studies on the association of cadmium exposure with pancreatic cancer risk among individuals without occupational exposure history published through July 2014 in PubMed by using a fixed-effect model. Four prospective cohort studies (112,934 participants with 335 events) and two case-control studies (177 cases and 539 controls) were identified. The summarized relative risk (RR) with a 95% confidence interval (CI) was 2.05 (95% CI = 1.58-2.66), comparing the highest to the lowest category of cadmium exposure. This positive association persisted in men (RR = 1.78, 95% CI = 1.04-3.05) but not in women (RR = 1.02, 95% CI = 0.63-1.65). Further research is needed to provide more solid evidence on the association of cadmium exposure with pancreatic cancer risk and to elucidate the underlying biological mechanism of the potential gender difference.

Risk factors for lower extremity injuries among half marathon and marathon runners of the Lage Landen Marathon Eindhoven 2012: A prospective cohort study in the Netherlands.

PubMed

van Poppel, D; de Koning, J; Verhagen, A P; Scholten-Peeters, G G M

2016-02-01

To determine risk factors for running injuries during the Lage Landen Marathon Eindhoven 2012. Prospective cohort study. Population-based study. This study included 943 runners. Running injuries after the Lage Landen Marathon. Sociodemographic and training-related factors as well as lifestyle factors were considered as potential risk factors and assessed in a questionnaire 1 month before the running event. The association between potential risk factors and injuries was determined, per running distance separately, using univariate and multivariate logistic regression analysis. In total, 154 respondents sustained a running injury. Among the marathon runners, in the univariate model, body mass index ≥ 26 kg/m(2), ≤ 5 years of running experience, and often performing interval training, were significantly associated with running injuries, whereas in the multivariate model only ≤ 5 years of running experience and not performing interval training on a regular basis were significantly associated with running injuries. Among marathon runners, no multivariate model could be created because of the low number of injuries and participants. This study indicates that interval training on a regular basis may be recommended to marathon runners to reduce the risk of injury. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Analysis of the time and workers needed to conduct systematic reviews of medical interventions using data from the PROSPERO registry.

PubMed

Borah, Rohit; Brown, Andrew W; Capers, Patrice L; Kaiser, Kathryn A

2017-02-27

To summarise logistical aspects of recently completed systematic reviews that were registered in the International Prospective Register of Systematic Reviews (PROSPERO) registry to quantify the time and resources required to complete such projects. Meta-analysis. All of the 195 registered and completed reviews (status from the PROSPERO registry) with associated publications at the time of our search (1 July 2014). All authors extracted data using registry entries and publication information related to the data sources used, the number of initially retrieved citations, the final number of included studies, the time between registration date to publication date and number of authors involved for completion of each publication. Information related to funding and geographical location was also recorded when reported. The mean estimated time to complete the project and publish the review was 67.3 weeks (IQR=42). The number of studies found in the literature searches ranged from 27 to 92 020; the mean yield rate of included studies was 2.94% (IQR=2.5); and the mean number of authors per review was 5, SD=3. Funded reviews took significantly longer to complete and publish (mean=42 vs 26 weeks) and involved more authors and team members (mean=6.8 vs 4.8 people) than those that did not report funding (both p<0.001). Systematic reviews presently take much time and require large amounts of human resources. In the light of the ever-increasing volume of published studies, application of existing computing and informatics technology should be applied to decrease this time and resource burden. We discuss recently published guidelines that provide a framework to make finding and accessing relevant literature less burdensome. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Prospects and perspectives for development of a vaccine against herpes simplex virus infections.

PubMed

McAllister, Shane C; Schleiss, Mark R

2014-11-01

Herpes simplex viruses 1 and 2 are human pathogens that lead to significant morbidity and mortality in certain clinical settings. The development of effective antiviral medications, however, has had little discernible impact on the epidemiology of these pathogens, largely because the majority of infections are clinically silent. Decades of work have gone into various candidate HSV vaccines, but to date none has demonstrated sufficient efficacy to warrant licensure. This review examines developments in HSV immunology and vaccine development published since 2010, and assesses the prospects for improved immunization strategies that may result in an effective, licensed vaccine in the near future.

Prospects and Perspectives for Development of a Vaccine Against Herpes Simplex Virus Infections

PubMed Central

McAllister, Shane C.; Schleiss, Mark R.

2014-01-01

Herpes simplex viruses 1 and -2 are human pathogens that lead to significant morbidity and mortality in certain clinical settings. The development of effective antiviral medications, however, has had little discernible impact on the epidemiology of these pathogens, largely because the majority of infections are clinically silent. Decades of work have gone into various candidate HSV vaccines, but to date none has demonstrated sufficient efficacy to warrant licensure. This review examines developments in HSV immunology and vaccine development published since 2010, and assesses the prospects for improved immunization strategies that may result in an effective, licensed vaccine in the near future. PMID:25077372

Implications of the method of capital cost payment on the weighted average cost of capital.

PubMed Central

Boles, K E

1986-01-01

The author develops a theoretical and mathematical model, based on published financial management literature, to describe the cost of capital structure for health care delivery entities. This model is then used to generate the implications of changing the capital cost reimbursement mechanism from a cost basis to a prospective basis. The implications are that the cost of capital is increased substantially, the use of debt must be restricted, interest rates for borrowed funds will increase, and, initially, firms utilizing debt efficiently under cost-basis reimbursement will be restricted to the generation of funds from equity only under a prospective system. PMID:3525468

Magnetic resonance neurography and diffusion tensor imaging: origins, history, and clinical impact of the first 50,000 cases with an assessment of efficacy and utility in a prospective 5000-patient study group.

PubMed

Filler, Aaron

2009-10-01

Methods were invented that made it possible to image peripheral nerves in the body and to image neural tracts in the brain. The history, physical basis, and dyadic tensor concept underlying the methods are reviewed. Over a 15-year period, these techniques-magnetic resonance neurography (MRN) and diffusion tensor imaging-were deployed in the clinical and research community in more than 2500 published research reports and applied to approximately 50,000 patients. Within this group, approximately 5000 patients having MRN were carefully tracked on a prospective basis. A uniform Neurography imaging methodology was applied in the study group, and all images were reviewed and registered by referral source, clinical indication, efficacy of imaging, and quality. Various classes of image findings were identified and subjected to a variety of small targeted prospective outcome studies. Those findings demonstrated to be clinically significant were then tracked in the larger clinical volume data set. MRN demonstrates mechanical distortion of nerves, hyperintensity consistent with nerve irritation, nerve swelling, discontinuity, relations of nerves to masses, and image features revealing distortion of nerves at entrapment points. These findings are often clinically relevant and warrant full consideration in the diagnostic process. They result in specific pathological diagnoses that are comparable to electrodiagnostic testing in clinical efficacy. A review of clinical outcome studies with diffusion tensor imaging also shows convincing utility. MRN and diffusion tensor imaging neural tract imaging have been validated as indispensable clinical diagnostic methods that provide reliable anatomic pathological information. There is no alternative diagnostic method in many situations. With the elapsing of 15 years, tens of thousands of imaging studies, and thousands of publications, these methods should no longer be considered experimental.

Prospective study of wound infections in Mohs micrographic surgery using clean surgical technique in the absence of prophylactic antibiotics.

PubMed

Rogers, Heather D; Desciak, Edward B; Marcus, Rebecca P; Wang, Shuang; MacKay-Wiggan, Julian; Eliezri, Yehuda D

2010-11-01

Mohs micrographic surgery (MMS) has a low rate of surgical site infection (SSI) without the use of prophylactic antibiotics. In the studies to date, there has been variation in the steps taken by each surgeon to prevent SSIs but in all cases sterile technique was used during wound reconstruction. We sought to evaluate the rate of SSIs among patients undergoing MMS with the use of clean surgical technique for all steps of MMS including wound reconstruction in the absence of prophylactic antibiotics. We prospectively evaluated 1000 patients undergoing MMS using clean surgical technique for SSIs. Clean surgical technique includes the use of clean surgical gloves and towels and a single pack of sterile instruments for all steps including wound reconstruction. There were 11 SSIs among 1000 patients with 1204 tumors, with an overall rate of infection of 0.91% (95% confidence interval 0.38%-1.45%). Three of the 11 infections were complications of hematomas. Four of the 11 infections occurred in flap closures, which had the highest rate of SSIs of 2.67% (4/150). The study was a prospective, single-institution uncontrolled study. To our knowledge, this is the first study to examine the rate of SSIs with the use of clean surgical technique, in the absence of antibiotic prophylaxis, for all steps of MMS including wound reconstruction. Our rate of SSIs of 0.91% is exceedingly low, underscoring the overall safety of MMS and its performance in the outpatient setting without the use of antibiotic prophylaxis or sterile technique. Copyright © 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Proximity to Liquor Stores and Adolescent Alcohol Intake: A Prospective Study.

PubMed

Trapp, Georgina S A; Knuiman, Matthew; Hooper, Paula; Foster, Sarah

2018-06-01

Cross-sectional studies have reported associations between liquor store availability and alcohol use among adolescents, but few prospective studies have confirmed this association. The aim of this study was to examine whether proximity to liquor stores at age 14 years was associated with alcohol intake at ages 14, 17, and 20 years. Participants of the Western Australian Pregnancy Cohort (Raine) Study (n=999) self-reported alcohol intake at age 14 years (early adolescence, 2003-2005); age 17 years (middle adolescence, 2006-2008); and age 20 years (late adolescence, 2009-2011). A GIS measured proximity to the closest liquor store from participants' home and school addresses at age 14 years. Regression analyses in 2017 assessed the relationship between distance to the closest liquor store around home, school, or both (≤800 m versus >800 m) and alcohol intake. In cross-sectional analyses (age 14 years), having a liquor store within 800 m of school was associated with ever having part of an alcoholic drink (OR=2.34, p=0.003). Also, having a liquor store within 800 m of home or school was associated with ever having part of an alcoholic drink (OR=1.49, p=0.029) and ever having engaged in heavy drinking (OR=1.79, p=0.023). In prospective analyses, liquor store proximity at age 14 years was a significant predictor of alcohol intake at age 17 years (OR=2.34, p=0.032) but not at age 20 years. Liquor store availability in early adolescence may be a risk factor for alcohol intake in early and middle, but not late, adolescence. Improved understanding of the longer-term impacts of liquor store exposure on sensitive populations could help inform future licensing regulations. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Omalizumab Effectiveness by Biomarker Status in Patients with Asthma: Evidence From PROSPERO, A Prospective Real-World Study.

PubMed

Casale, Thomas B; Luskin, Allan T; Busse, William; Zeiger, Robert S; Trzaskoma, Benjamin; Yang, Ming; Griffin, Noelle M; Chipps, Bradley E

2018-05-22

Omalizumab has demonstrated efficacy in clinical trials of patients with asthma, but real-world data are needed. To assess outcomes after omalizumab initiation in patients with asthma in a real-world setting. Patients aged 12 years and older with allergic asthma who were candidates for omalizumab on the basis of physician-assessed need were enrolled in a US-based, prospective, single-arm, 48-week multicenter study, the Prospective Observational Study to Evaluate Predictors of Clinical Effectiveness in Response to Omalizumab. Monthly assessments included exacerbations, health care utilization, asthma control test (ACT), and adverse events. At baseline, 6 months, and end of study, biomarkers (blood eosinophils and fractional exhaled nitric oxide) were collected and spirometry performed. Of 806 enrollees, 801 (99.4%) received omalizumab and 622 (77.2%) completed the study. The exacerbation rate significantly improved from a mean of 3.00 ± 3.28 in the 12 months before baseline to 0.78 ± 1.37 through month 12 (P < .001) and was similar in adults and adolescents; there was a reduction of 81.9% in the percentage of patients with 1 or more hospitalizations. Lung function remained generally unchanged. A mean improvement of 4.4 ± 4.9 in ACT scores was observed. Eighty-seven percent of patients were responders on the basis of clinical improvement in exacerbations, lung function, or ACT scores. Baseline biomarker status was associated with ACT scores and lung function improvement, but the magnitude of this improvement was not clinically relevant. No new safety signals emerged. Omalizumab initiation in patients with asthma resulted in improved exacerbation rates, reduced hospitalizations, and improved ACT scores compared with pretreatment values, regardless of biomarker status. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Evidence supporting contemporary post-operative radiation therapy (PORT) using linear accelerators in N2 lung cancer.

PubMed

Patel, Suchit H; Ma, Yan; Wernicke, A Gabriella; Nori, Dattatreyudu; Chao, K S C; Parashar, Bhupesh

2014-05-01

Post-operative radiotherapy (PORT) treatment for lung cancer declined since a meta-analysis failed to show benefit in patients with N2 disease. Because several included studies employed outmoded radiation planning and delivery techniques, we sought to determine whether PORT with modern technology benefits patients with N2 disease. We conducted searches of the published literature. For inclusion, studies must have included patients with stage III-N2 lung cancer treated with PORT using only linear accelerators, used a control group that did not receive PORT, and reported outcome data for overall survival (OS). Prospective and retrospective analyses were included. Exclusion criteria were the use of cobalt devices or orthovoltage radiation. Data were evaluated with random-effects models. Three prospective and eight retrospective studies were included. The PORT and no-PORT groups included 1368 and 1360 patients, respectively. The PORT group had significantly improved OS over the no-PORT group (hazard ratio [HR] = 0.77, 95% confidence interval [CI] 0.62-0.96, P = 0.020). Locoregional recurrence-free survival (LRFS) in 10 studies for which data was available was also improved in the PORT group (HR = 0.51, CI 0.41-0.65, P < 0.001). PORT was associated with significantly lower risk of death and locoregional recurrence in patients with N2 lung cancer. Our study was limited by lack of access to individual patient data, which would have enabled more detailed analyses. Regardless, data thus far suggest PORT may be associated with a survival benefit. Given a lack of large-scale prospective data, clinical trials evaluating PORT with modern technology are warranted. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Gastrointestinal manifestations of cow's milk allergy.

PubMed

Magazzù, Giuseppe; Scoglio, Riccardo

2002-12-01

To review and discuss the relationship between cow's milk allergy (CMA) and some gastrointestinal manifestations, such as gastroesophageal reflux, constipation, food protein-induced enterocolitis, and food-induced eosinophilic proctocolitis, with respect to diagnostic strategies that might eliminate the need for a double-blind, placebo-controlled oral food challenge (DBPCFC). A review of pertinent PubMed articles, published during the past 10 years, was performed. To obtain positive and negative predictive values known as posterior probabilities and to calculate the likelihood ratio, only those studies including both patients and control subjects were selected for analysis. With respect to gastroesophageal reflux, a typical 24-hour esophageal pH monitoring pattern might obviate the performance of a DBPCFC in patients with symptoms of reflux suspected of having CMA, provided this pH pattern is confirmed in other studies. A relationship between CMA and constipation has been reported in only one prospective controlled study; the clinical and laboratory variables of perianal lesions, histologic abnormalities, and signs of hypersensitivity had likelihood ratios of 2.2, 2.4, and 3.7, respectively, and posttest probabilities of 83, 84, and 88%, respectively. Therefore, a DBPCFC is warranted. In reference to food protein-induced enterocolitis, clinical and laboratory criteria suggested in the literature for defining a food challenge as positive have not been prospectively evaluated in the untreated state. Some simple stool tests, such as fecal tumor necrosis factor-alpha and alpha1-antitrypsin determination, might be candidates for diagnostic studies in patients with food protein-induced enterocolitis, if prospectively evaluated. In infants with food-induced eosinophilic proctocolitis, rectal biopsy invariably shows eosinophilic infiltration and thus makes performance of a DBPCFC unnecessary. Although the current diagnosis of gastrointestinal manifestations of CMA usually depends on a DBPCFC, investigators continue to study other options for confirming the diagnosis.

Prospective longitudinal study of testosterone and incident depression in older men: The Health In Men Study.

PubMed

Ford, Andrew H; Yeap, Bu B; Flicker, Leon; Hankey, Graeme J; Chubb, S A Paul; Handelsman, David J; Golledge, Jonathan; Almeida, Osvaldo P

2016-02-01

Depression in older men has been associated with low circulating testosterone concentration but data from prospective studies are limited. We conducted a prospective longitudinal study in a community representative cohort of 3179 older men free of clinically significant depressive symptoms at baseline. The main objective of this study was to determine if low serum testosterone, dihydrotestosterone and estradiol concentrations are associated with the development of depressive symptoms. Incident depression was assessed with the Patient Health Questionnaire and via an electronic health record database (The West Australian Data Linkage System). The main exposures of interest were serum testosterone, dihydrotestosterone and estradiol measured by liquid chromatography-mass spectrometry and calculated free testosterone in baseline blood samples (collected between 2001 and 2004). One hundred and thirty five men (4.2%) developed depression over a median follow up time of 9.4 years (range 8.4-10.9). Men with incident depression were older (median age 77.7 vs 76.1 years, z=-3.82, p=0<0.001) and were more likely to have cardiovascular disease (43.0% vs 32.6%, χ(2)=6.32, p=0.012) and diabetes (22.2% vs 13.2%, χ(2)=8.95, p=0.003). Low serum total testosterone (<6.4 nmol/L) was associated with incident depression (HR 2.07, 95%CI 1.17-3.68) and this remained significant after adjustment for relevant potential confounding factors (HR 1.86, 95%CI 1.05-3.31). Low serum dihydrotestosterone, estradiol and calculated free testosterone were not associated with risk of depression. Low serum total testosterone, but not calculated free testosterone, was associated with incident depression in this sample of older men. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Diabetes, plasma glucose and incidence of pancreatic cancer: A prospective study of 0.5 million Chinese adults and a meta‐analysis of 22 cohort studies

PubMed Central

Pang, Yuanjie; Guo, Yu; Bragg, Fiona; Yang, Ling; Bian, Zheng; Chen, Yiping; Iona, Andri; Millwood, Iona Y; Lv, Jun; Yu, Canqing; Chen, Junshi; Li, Liming; Holmes, Michael V; Chen, Zhengming

2017-01-01

Diabetes is associated with an increased risk of pancreatic cancer (PC) in Western populations. Uncertainty remains, however, about the relevance of plasma glucose for PC among people without diabetes and about the associations of diabetes and high blood glucose with PC in China where the increase in diabetes prevalence has been very recent. The prospective China Kadoorie Biobank (CKB) study recruited 512,000 adults aged 30‐79 years from 10 diverse areas of China during 2004‐2008, recording 595 PC cases during 8 years of follow‐up. Cox regression yielded adjusted hazard ratios (HRs) for PC associated with diabetes (previously diagnosed or screen‐detected) and, among those without previously diagnosed diabetes, with levels of random plasma glucose (RPG). These were further meta‐analysed with 22 published prospective studies. Overall 5.8% of CKB participants had diabetes at baseline. Diabetes was associated with almost twofold increased risk of PC (adjusted HR = 1.87, 95% CI 1.48‐2.37), with excess risk higher in those with longer duration since diagnosis (p for trend = 0.01). Among those without previously diagnosed diabetes, each 1 mmol/L higher usual RPG was associated with a HR of 1.12 (1.04‐1.21). In meta‐analysis of CKB and 22 other studies, previously diagnosed diabetes was associated with a 52% excess risk (1.52, 1.43‐1.63). Among those without diabetes, each 1 mmol/L higher blood glucose was associated with a 15% (1.15, 1.09‐1.21) excess risk. In Chinese and non‐Chinese populations, diabetes and higher blood glucose levels among those without diabetes are associated with an increased risk of PC. PMID:28063165

Green tea and liver cancer risk: A meta-analysis of prospective cohort studies in Asian populations.

PubMed

Huang, Ya-Qing; Lu, Xin; Min, Han; Wu, Qian-Qian; Shi, Xiao-Ting; Bian, Kang-Qi; Zou, Xiao-Ping

2016-01-01

The aim of this meta-analysis was to investigate whether an association existed between green tea consumption and the risk for liver cancer in prospective cohort studies in Asian populations. Relevant studies were identified by searching PubMed, EMBASE, ISI Web of Science, and the Chinese Bio-medicine Database published before April 2015. Study-specific risk estimates for the highest versus non- or lowest and increment of daily cup of green tea consumption levels were combined based on fixed- or random-effects models. STATA 11.0 (Stata Corporation, College Station, TX, USA) software was used for statistical analysis. Nine prospective cohort articles involving 465,274 participants and 3694 cases of liver cancer from China, Japan, and Singapore were included. The summary relative risk (RR) indicated a significant association between the highest green tea consumption and reduced risk for liver cancer (summary RR, 0.88; 95% confidence interval [CI], 0.81-0.97). However, no statistically significant association was observed when analyzing daily consumption of one cup (summary RR, 0.97; 95% CI, 0.95-1.00). When stratified by sex, the protective effect of green tea consumption on risk for liver cancer was observed only in the group of women (summary RR, 0.78; 95% CI, 0.64-0.96), but not in men (summary RR, 0.89; 95% CI, 0.79-1.00). The present analysis indicated the preventive effects of green tea intake on the risk for liver cancer in female Asian populations. However, additional studies are needed to make a convincing case for this association. Copyright © 2016 Elsevier Inc. All rights reserved.

The Misconception of Case-Control Studies in the Plastic Surgery Literature: A Literature Audit.

PubMed

Hatchell, Alexandra C; Farrokhyar, Forough; Choi, Matthew

2017-06-01

Case-control study designs are commonly used. However, many published case-control studies are not true case-controls and are in fact mislabeled. The purpose of this study was to identify all case-control studies published in the top three plastic surgery journals over the past 10 years, assess which were truly case-control studies, clarify the actual design of the articles, and address common misconceptions. MEDLINE, Embase, and Web of Science databases were searched for case-control studies in the three highest-impact factor plastic surgery journals (2005 to 2015). Two independent reviewers screened the resulting titles, abstracts, and methods, if applicable, to identify articles labeled as case-control studies. These articles were appraised and classified as true case-control studies or non-case-control studies. The authors found 28 articles labeled as case-control studies. However, only six of these articles (21 percent) were truly case-control designs. Of the 22 incorrectly labeled studies, one (5 percent) was a randomized controlled trial, three (14 percent) were nonrandomized trials, two (9 percent) were prospective comparative cohort designs, 14 (64 percent) were retrospective comparative cohort designs, and two (9 percent) were cross-sectional designs. The mislabeling was worse in recent years, despite increases in evidence-based medicine awareness. The majority of published case-control studies are not in fact case-control studies. This misunderstanding is worsening with time. Most of these studies are actually comparative cohort designs. However, some studies are truly clinical trials and thus a higher level of evidence than originally proposed.

Understanding development and stem cells using single cell-based analyses of gene expression.

PubMed

Kumar, Pavithra; Tan, Yuqi; Cahan, Patrick

2017-01-01

In recent years, genome-wide profiling approaches have begun to uncover the molecular programs that drive developmental processes. In particular, technical advances that enable genome-wide profiling of thousands of individual cells have provided the tantalizing prospect of cataloging cell type diversity and developmental dynamics in a quantitative and comprehensive manner. Here, we review how single-cell RNA sequencing has provided key insights into mammalian developmental and stem cell biology, emphasizing the analytical approaches that are specific to studying gene expression in single cells. © 2017. Published by The Company of Biologists Ltd.

Significant reduction of central line-associated bloodstream infection rates in a tertiary neonatal unit.

PubMed

Rallis, Dimitrios; Karagianni, Paraskevi; Papakotoula, Ifigeneia; Nikolaidis, Nikolaos; Tsakalidis, Christos

2016-04-01

To evaluate the effectiveness of a quality initiative in reducing central line-associated bloodstream infections (CLABSIs) in our neonatal intensive care unit, we designed a prospective study (January 2012-September 2013) estimating CLABSI incidence before and after our implementation. CLABSI rates were significantly decreased after our intervention, from 12 cases per 1,000 central vascular catheter (CVC) days during the preinterventional period to 3.4 cases per 1,000 CVC days during the postinterventional period (P = .004). Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Nurses' attitudes toward substance misusers. III. Emergency room nurses' attitudes, nurses' attitudes toward impaired nurses, and studies of attitudinal change.

PubMed

Howard, M O; Chung, S S

2000-08-01

Emergency room nurses generally regard alcohol and drug misusers as troublesome patients and dislike caring for them. Surveys of nurses' and nurse managers' attitudes toward impaired nurses, all published in recent years, suggest that they are generally supportive of impaired nurses and sanguine about their prospects for recovery; nonetheless, a substantial minority oppose the return to work of a formerly substance-misusing nurse colleague. Programs designed to change nurses' attitudes toward substance misusers are generally ineffective, although significant gains in substance-related knowledge are commonly reported.

Multivariate analysis of fatty acid and biochemical constitutes of seaweeds to characterize their potential as bioresource for biofuel and fine chemicals.

PubMed

Verma, Priyanka; Kumar, Manoj; Mishra, Girish; Sahoo, Dinabandhu

2017-02-01

In the present study bio prospecting of thirty seaweeds from Indian coasts was analyzed for their biochemical components including pigments, fatty acid and ash content. Multivariate analysis of biochemical components and fatty acids was done using Principal Component Analysis (PCA) and Agglomerative hierarchical clustering (AHC) to manifest chemotaxonomic relationship among various seaweeds. The overall analysis suggests that these seaweeds have multi-functional properties and can be utilized as promising bioresource for proteins, lipids, pigments and carbohydrates for the food/feed and biofuel industry. Copyright © 2016. Published by Elsevier Ltd.

Palliative Radiotherapy for Bone Metastases: An ASTRO Evidence-Based Guideline

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lutz, Stephen, E-mail: slutz@bvha.or; Berk, Lawrence; Chang, Eric

2011-03-15

Purpose: To present guidance for patients and physicians regarding the use of radiotherapy in the treatment of bone metastases according to current published evidence and complemented by expert opinion. Methods and Materials: A systematic search of the National Library of Medicine's PubMed database between 1998 and 2009 yielded 4,287 candidate original research articles potentially applicable to radiotherapy for bone metastases. A Task Force composed of all authors synthesized the published evidence and reached a consensus regarding the recommendations contained herein. Results: The Task Force concluded that external beam radiotherapy continues to be the mainstay for the treatment of pain and/ormore » prevention of the morbidity caused by bone metastases. Various fractionation schedules can provide significant palliation of symptoms and/or prevent the morbidity of bone metastases. The evidence for the safety and efficacy of repeat treatment to previously irradiated areas of peripheral bone metastases for pain was derived from both prospective studies and retrospective data, and it can be safe and effective. The use of stereotactic body radiotherapy holds theoretical promise in the treatment of new or recurrent spine lesions, although the Task Force recommended that its use be limited to highly selected patients and preferably within a prospective trial. Surgical decompression and postoperative radiotherapy is recommended for spinal cord compression or spinal instability in highly selected patients with sufficient performance status and life expectancy. The use of bisphosphonates, radionuclides, vertebroplasty, and kyphoplasty for the treatment or prevention of cancer-related symptoms does not obviate the need for external beam radiotherapy in appropriate patients. Conclusions: Radiotherapy is a successful and time efficient method by which to palliate pain and/or prevent the morbidity of bone metastases. This Guideline reviews the available data to define its proper use and provide consensus views concerning contemporary controversies or unanswered questions that warrant prospective trial evaluation.« less

Risk stratification after paracetamol overdose using mechanistic biomarkers: results from two prospective cohort studies.

PubMed

Dear, James W; Clarke, Joanna I; Francis, Ben; Allen, Lowri; Wraight, Jonathan; Shen, Jasmine; Dargan, Paul I; Wood, David; Cooper, Jamie; Thomas, Simon H L; Jorgensen, Andrea L; Pirmohamed, Munir; Park, B Kevin; Antoine, Daniel J

2018-02-01

Paracetamol overdose is common but patient stratification is suboptimal. We investigated the usefulness of new biomarkers that have either enhanced liver specificity (microRNA-122 [miR-122]) or provide mechanistic insights (keratin-18 [K18], high mobility group box-1 [HMGB1], and glutamate dehydrogenase [GLDH]). The use of these biomarkers could help stratify patients for their risk of liver injury at hospital presentation. Using data from two prospective cohort studies, we assessed the potential for biomarkers to stratify patients who overdose with paracetamol. We completed two independent prospective studies: a derivation study (MAPP) in eight UK hospitals and a validation study (BIOPAR) in ten UK hospitals. Patients in both cohorts were adults (≥18 years in England, ≥16 years in Scotland), were diagnosed with paracetamol overdose, and gave written informed consent. Patients who needed intravenous acetylcysteine treatment for paracetamol overdose had circulating biomarkers measured at hospital presentation. The primary endpoint was acute liver injury indicating need for continued acetylcysteine treatment beyond the standard course (alanine aminotransferase [ALT] activity >100 U/L). Receiver operating characteristic (ROC) curves, category-free net reclassification index (cfNRI), and integrated discrimination index (IDI) were applied to assess endpoint prediction. Between June 2, 2010, and May 29, 2014, 1187 patients who required acetylcysteine treatment for paracetamol overdose were recruited (985 in the MAPP cohort; 202 in the BIOPAR cohort). In the derivation and validation cohorts, acute liver injury was predicted at hospital presentation by miR-122 (derivation cohort ROC-area under the curve [AUC] 0·97 [95% CI 0·95-0·98]), HMGB1 (0·95 [0·93-0·98]), and full-length K18 (0·95 [0·92-0·97]). Results were similar in the validation cohort (miR-122 AUC 0·97 [95% CI 0·95-0·99], HMGB1 0·98 [0·96-0·99], and full-length K18 0·93 [0·86-0·99]). A combined model of miR-122, HMGB1, and K18 predicted acute liver injury better than ALT alone (cfNRI 1·95 [95% CI 1·87-2·03], p<0·0001 in the MAPP cohort; 1·54 [1·08-2·00], p<0·0001 in the BIOPAR cohort). Personalised treatment pathways could be developed by use of miR-122, HMGB1, and full-length K18 at hospital presentation for patient stratification. This prospective study supports their use for hepatic safety assessment of new medicines. Edinburgh and Lothians Health Foundation, UK Medical Research Council. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Risk and Protective Factors for Intimate Partner Violence Against Women: Systematic Review and Meta-analyses of Prospective-Longitudinal Studies.

PubMed

Yakubovich, Alexa R; Stöckl, Heidi; Murray, Joseph; Melendez-Torres, G J; Steinert, Janina I; Glavin, Calla E Y; Humphreys, David K

2018-07-01

The estimated lifetime prevalence of physical or sexual intimate partner violence (IPV) is 30% among women worldwide. Understanding risk and protective factors is essential for designing effective prevention strategies. To quantify the associations between prospective-longitudinal risk and protective factors and IPV and identify evidence gaps. We conducted systematic searches in 16 databases including MEDLINE and PsycINFO from inception to June 2016. The study protocol is registered with PROSPERO (CRD42016039213). We included published and unpublished studies available in English that prospectively analyzed any risk or protective factor(s) for self-reported IPV victimization among women and controlled for at least 1 other variable. Three reviewers were involved in study screening. One reviewer extracted estimates of association and study characteristics from each study and 2 reviewers independently checked a random subset of extractions. We assessed study quality with the Cambridge Quality Checklists. When studies investigated the same risk or protective factor using similar measures, we computed pooled odds ratios (ORs) by using random-effects meta-analyses. We summarized heterogeneity with I 2 and τ 2 . We synthesized all estimates of association, including those not meta-analyzed, by using harvest plots to illustrate evidence gaps and trends toward negative or positive associations. Of 18 608 studies identified, 60 were included and 35 meta-analyzed. Most studies were based in the United States. The strongest evidence for modifiable risk factors for IPV against women were unplanned pregnancy (OR = 1.66; 95% confidence interval [CI] = 1.20, 1.31) and having parents with less than a high-school education (OR = 1.55; 95% CI = 1.10, 2.17). Being older (OR = 0.96; 95% CI = 0.93, 0.98) or married (OR = 0.93; 95% CI = 0.87, 0.99) were protective. To our knowledge, this is the first systematic, meta-analytic review of all risk and protective factors for IPV against women without location, time, or publication restrictions. Unplanned pregnancy and having parents with less than a high-school education, which may indicate lower socioeconomic status, were shown to be risk factors, and being older or married were protective. However, no prospective-longitudinal study investigated the associations between IPV against women and any community or structural factor outside the United States, and more studies investigated risk factors related to women as opposed to their partners. Public health implications. This review highlights that prospective evidence for perpetrator- and context-related risk and protective factors for women's experiences of IPV outside of the United States is lacking and urgently needed to inform global policy recommendations. The current evidence base of prospective studies suggests that, at least in the United States, education and sexual health interventions may be effective targets for preventing IPV against women, with young, unmarried women at greatest risk.

Transcriptome profiles in sarcoidosis and their potential role in disease prediction.

PubMed

Schupp, Jonas C; Vukmirovic, Milica; Kaminski, Naftali; Prasse, Antje

2017-09-01

Sarcoidosis is a systemic disease defined by the presence of nonnecrotizing granuloma in the absence of any known cause. Although the heterogeneity of sarcoidosis is well characterized clinically, the transcriptome of sarcoidosis and underlying molecular mechanisms are not. The signal of all transcripts, small and long noncoding RNAs, can be detected using microarrays or RNA-Sequencing. Analyzing the transcriptome of tissues that are directly affected by granulomas is of great importance to understand biology of the disease and may be predictive of disease and treatment outcome. Multiple genome wide expression studies performed on sarcoidosis affected tissues were published in the last 11 years. Published studies focused on differences in gene expression between sarcoidosis vs. control tissues, stable vs. progressive sarcoidosis, as well as sarcoidosis vs. other diseases. Strikingly, all these transcriptomics data confirm the key role of TH1 immune response in sarcoidosis and particularly of interferon-γ (IFN-γ) and type I IFN-driven signaling pathways. The steps toward transcriptomics of sarcoidosis in precision medicine highlight the potentials of this approach. Large prospective follow-up studies are required to identify signatures predictive of disease progression and outcome.

A systematic review of microwave-based therapy for axillary hyperhidrosis.

PubMed

Hsu, Tzu-Herng; Chen, Yu-Tsung; Tu, Yu-Kang; Li, Chien-Nien

2017-10-01

To systematically analyse the literature on the use of the microwave-based device for subdermal thermolysis of the axilla and its efficacy for the treatment of axillary hyperhidrosis. A systematic review was conducted using PubMed, Embase, SCOPUS and Cochrane databases on 2 June 2016. The inclusion criteria including: (1) studies with human subjects, (2) full-text articles published in English, (3) a microwave-based device used to treat axillary hyperhidrosis and (4) trials that precisely evaluated axillary hyperhidrosis. Exclusion criteria were the following: (1) studies that did not fit the inclusion criteria mentioned above and (2) case reports and reviews. We reviewed five clinical trials and 189 patients, all of which were published between 2012 and 2016. There was one randomized controlled trial, one retrospective study and the remainder were prospective studies. Although all of the studies were conducted with a small sample size, the results indicated that microwave-based device treatment of axillary hyperhidrosis had long-term efficacy with mild adverse effects. In addition, most patients were satisfied with the outcomes in these studies. Microwave-based device treatment may be an effective alternative treatment for axillary hyperhidrosis. However, further investigation is necessary to determine its long-term efficacy and safety.

The relationship between nutrition and prostate cancer: is more always better?

PubMed

Masko, Elizabeth M; Allott, Emma H; Freedland, Stephen J

2013-05-01

Prostate cancer (PCa) remains one of the most diagnosed malignancies in the world, correlating with regions where men consume more of a so-called Western-style diet. As such, there is much interest in understanding the role of lifestyle and diet on the incidence and progression of PCa. To provide a summary of published literature with regard to dietary macro- and micronutrients and PCa incidence and progression. A literature search was completed using the PubMed database for all studies published on diet and PCa in June 2012 or earlier. Primary literature and meta-analyses were given preference over other review articles when possible. The literature was reviewed on seven dietary components: carbohydrates, protein, fat and cholesterol, vegetables, vitamins and minerals, and phytochemicals. Current literature linking these nutrients to PCa is limited at best, but trends in the published data suggest consumption of carbohydrates, saturated and ω-6 fats, and certain vitamin supplements may promote PCa risk and progression. Conversely, consumption of many plant phytochemicals and ω-3 fatty acids seem to slow the risk and progression of the disease. All other nutrients seem to have no effect or data are inconclusive. A brief summary about the clinical implications of dietary interventions with respect to PCa prevention, treatment, and survivorship is provided. Due to the number and heterogeneity of published studies investigating diet and PCa, it is difficult to determine what nutrients make up the perfect diet for the primary and secondary prevention of PCa. Because diets are made of multiple macro- and micronutrients, further prospective studies are warranted, particularly those investigating the relationship between whole foods instead of a single nutritional component. Copyright © 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Poor vitamin D status is prospectively associated with greater muscle mass loss in middle-aged and elderly Chinese individuals.

PubMed

Liu, Gang; Lu, Ling; Sun, Qi; Ye, Xingwang; Sun, Liang; Liu, Xin; Zong, Geng; Jin, Qianlu; Li, Huaixing; Lin, Xu

2014-10-01

Poor vitamin D status can increase age-related muscle mass loss. However, existing prospective evidence is limited and controversial. This study aimed to investigate the association of plasma 25-hydroxyvitamin D [25(OH)D] with muscle mass loss in middle-aged and elderly Chinese individuals over 6 years. We conducted a prospective cohort study. This community-based study included 568 men and women aged 50 to 70 years at baseline. Baseline plasma concentrations of 25(OH)D and biomarkers of liver and kidney functions and inflammation were measured. Body composition was assessed at baseline and 6-year follow-up by dual-energy x-ray absorptiometry. Appendicular skeletal muscle mass (ASMM) and trunk lean mass were calculated and total body lean mass was defined as an overall measure of total nonfat and nonbone tissues. Descriptive statistics and multiple linear regression were applied. The 6-year loss of ASMM was 1.14 kg (5.3%) in men and 0.47 kg (3.1%) in women (all P values <0.001). Compared with the highest 25(OH)D tertile, participants in the lowest tertile had significantly more absolute loss of ASMM (-1.21 vs -1.00 kg; P for trend=0.024) after multivariate adjustments for conventional confounders, as well as protein intake. The association persisted after additional adjustment of bone mineral density and inflammatory markers (P for trend=0.017). No significant associations were detected between 25(OH)D and absolute loss of trunk lean mass or total body lean mass. Lower 25(OH)D concentrations were prospectively associated with greater ASMM loss in middle-aged and elderly Chinese individuals independent of bone mineral density, inflammation, diet, and other risk factors. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Prospective evaluation of intra-operative quick parathyroid hormone assay as an early predictor of post thyroidectomy hypocalcaemia.

PubMed

Reddy, Ashwini C; Chand, Gyan; Sabaretnam, M; Mishra, Anjali; Agarwal, Gaurav; Agarwal, Amit; Verma, A K; Mishra, S K

2016-10-01

Hypocalcaemia following total thyroidectomy is a major contributing factor in delayed hospital discharge and dissuading surgeons from day care thyroidectomy. We prospectively evaluated the utility of Intra-operative serum quick parathyroid hormone level measurement twenty minutes after total thyroidectomy in predicting post-operative hypocalcemia. Prospective longitudinal study which included patients undergoing total thyroidectomy for benign or malignant thyroid disorders at SGPGIMS, Lucknow, India from November 2013 to February 2015. Patients who received calcium prophylaxis were excluded from the study. Intraoperative serum quick PTH level measurements were done twenty minutes after resection of thyroid. Serum calcium levels were estimated preoperatively and on three consecutive post operative days. Calcium supplementation was started in patients with symptomatic hypocalcemia. The study included 100 patients with a mean age of 41 years, range 17-72 years. 48 patients had Euthyroid multinodular goitre, 10 patients grave's disease and 42 patients had differentiated thyroid cancer. Total thyroidectomy was performed in 88 patients, total thyroidectomy with lymph node dissection in 12 patients. Post-operatively 23% patients experienced symptomatic hypocalcemia. The IOPTH level of 9 pmol/L, twenty minutes after total thyroidectomy, had the highest sensitivity and specificity of 92% and 83% respectively in predicting post-operative hypocalcemia. Parathyroid hormone assay twenty minutes after thyroidectomy is an accurate and reliable means of predicting clinically relevant hypocalcemia. Patients with PTH values greater than 9 pmol/L twenty minutes after thyroidectomy, can be safely discharged on the same postoperative day as the probability of life threatening hypocalcemia is unlikely. Copyright © 2016. Published by Elsevier Ltd.

Prospective associations between peer teasing in childhood and young men's obesity.

PubMed

Kerr, David C R; Gini, Gianluca

Being teased and otherwise victimised by peers during childhood increases risk for obesity. However, few prospective studies have considered whether risk extends to adulthood. We tested whether being teased in childhood predicted higher body mass index (BMI) and increased odds of obesity in early adulthood in a community sample of American males. Boys (n=206) were classified as victims of peer teasing or non-victims (n=55 and 151, respectively) based on mother, father, and teacher reports at ages 10-12 years. BMI was assessed at ages 24 or 32 years for 203 of the participants. Family income, parent and child depressive symptoms, child antisocial behaviour, and childhood BMI were assessed at ages 10-13 years and served as control variables. In unadjusted comparisons, childhood victims did not differ significantly from non-victims on BMI (mean [SD]=27.49 [4.53] and 26.97 [4.60], respectively) or rates of obesity (42% and 31%, respectively) in early adulthood. In adjusted models, no group differences emerged for BMI (β [95% confidence interval (CI)]=.02 [-.09 to .13], p=.77) or obesity (odds ratio [95% CI]=1.58 [.67-3.71], p=.30). Peer victimization has been associated with immediate and long-term maladjustment outcomes that are in some cases life threatening. However, our null results do not support that peer victimization significantly increases long-term risk for obesity, and findings are consistent with two other long-term prospective studies of this issue. Copyright © 2017 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Ovarian response to 150 µg corifollitropin alfa in a GnRH-antagonist multiple-dose protocol: a prospective cohort study.

PubMed

Lerman, Tamara; Depenbusch, Marion; Schultze-Mosgau, Askan; von Otte, Soeren; Scheinhardt, Markus; Koenig, Inke; Kamischke, Axel; Macek, Milan; Schwennicke, Arne; Segerer, Sabine; Griesinger, Georg

2017-05-01

The incidence of low (<6 oocytes) and high (>18 oocytes) ovarian response to 150 µg corifollitropin alfa in relation to anti-Müllerian hormone (AMH) and other biomarkers was studied in a multi-centre (n = 5), multi-national, prospective, investigator-initiated, observational cohort study. Infertile women (n = 212), body weight >60 kg, underwent controlled ovarian stimulation in a gonadotrophin-releasing hormone-antagonist multiple-dose protocol. Demographic, sonographic and endocrine parameters were prospectively assessed on cycle day 2 or 3 of a spontaneous menstruation before the administration of 150 µg corifollitropin alfa. Serum AMH showed the best correlation with the number of oocytes obtained among all predictor variables. In receiver-operating characteristic analysis, AMH at a threshold of 0.91 ng/ml showed a sensitivity of 82.4%, specificity of 82.4%, positive predictive value 52.9%and negative predictive value 95.1% for predicting low response (area under the curve [AUC], 95% CI; P-value: 0.853, 0.769-0.936; <0.0001). For predicting high response, the optimal threshold for AMH was 2.58 ng/ml, relating to a sensitivity of 80.0%, specificity 82.1%, positive predictive value 42.5% and negative predictive value 96.1% (AUC, 95% CI; P-value: 0.871, 0.787-0.955; <0.0001). In conclusion, patients with serum AMH concentrations between approximately 0.9 and 2.6 ng/ml were unlikely to show extremes of response. Copyright © 2017. Published by Elsevier Ltd.

Outcome Analysis of Day-3 Frozen Embryo Transfer v/s Fresh Embryo Transfer in Infertility: A Prospective Therapeutic Study in Indian Scenario.

PubMed

Chandel, Neha Palo; Bhat, Vidya V; Bhat, B S; Chandel, Sidharth S

2016-10-01

Advanced fertilization techniques like frozen embryo transfer (FET) and assisted reproductive technology have become popular and commonly used methods to treat patients suffering from infertility. Incidences of infertility are on a rise due to increased representation of females in the work place, delay in marriages, stress, and ignorance. We performed this prospective therapeutic study to compare FET and fresh embryo transfer in the treatment of infertility in terms of conception rate, patient acceptance, complications, and patient's compliance. A prospective screening therapeutic study on 108 patients, from September 2013 to September 2014 in Karnataka, India, randomized the patients into 2 groups (n = 54), Group-I treated with day-3 FET while Group-II was treated with fresh embryo transfer, after performing ICSI. In 108 patients, 45 % patients were within 35 years of age, 35 % were in the age group 35-39. Significantly, 22 (40.75 %) patients treated with FET conceived (P = 0.022), whereas 16 (29.63 %) patients treated with fresh embryo transfer conceived (P = 0.59). There is limited published literature from the subcontinent, comparing techniques like FET and embryo transfers in the treatment of infertility. Awareness and economic reforms must be formulated in India to facilitate individuals facing infertility problems to conceive. FET has better and significant conception rates compared to fresh embryo transfers. FET shares an advantage of providing good quality embryos for future and subsequent implantations in cases of failure. Patient counseling and motivation play a pivotal role in the success of therapeutic procedure.

Direct Costs of Very Old Persons with Subsyndromal Depression: A 5-Year Prospective Study.

PubMed

Ludvigsson, Mikael; Bernfort, Lars; Marcusson, Jan; Wressle, Ewa; Milberg, Anna

2018-03-15

This study aimed to compare, over a 5-year period, the prospective direct healthcare costs and service utilization of persons with subsyndromal depression (SSD) and non-depressive persons (ND), in a population of very old persons. A second aim was to develop a model that predicts direct healthcare costs in very old persons with SSD. A prospective population-based study was undertaken on 85-year-old persons in Sweden. Depressiveness was screened with the Geriatric Depression Scale at baseline and at 1-year follow-up, and the results were classified into ND, SSD, and syndromal depression. Data on individual healthcare costs and service use from a 5-year period were derived from national database registers. Direct costs were compared between categories using Mann-Whitney U tests, and a prediction model was identified with linear regression. For persons with SSD, the direct healthcare costs per month of survival exceeded those of persons with ND by a ratio 1.45 (€634 versus €436), a difference that was significant even after controlling for somatic multimorbidity. The final regression model consisted of five independent variables predicting direct healthcare costs: male sex, activities of daily living functions, loneliness, presence of SSD, and somatic multimorbidity. SSD among very old persons is associated with increased direct healthcare costs independently of somatic multimorbidity. The associations between SSD, somatic multimorbidity, and healthcare costs in the very old need to be analyzed further in order to better guide allocation of resources in health policy. Copyright © 2018 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Endovascular treatment of chronic cerebro spinal venous insufficiency in patients with multiple sclerosis modifies circulating markers of endothelial dysfunction and coagulation activation: a prospective study.

PubMed

Napolitano, Mariasanta; Bruno, Aldo; Mastrangelo, Diego; De Vizia, Marcella; Bernardo, Benedetto; Rosa, Buonagura; De Lucia, Domenico

2014-10-01

We performed a monocentric observational prospective study to evaluate coagulation activation and endothelial dysfunction parameters in patients with multiple sclerosis undergoing endovascular treatment for cerebro-spinal-venous insufficiency. Between February 2011 and July 2012, 144 endovascular procedures in 110 patients with multiple sclerosis and chronical cerebro-spinal venous insufficiency were performed and they were prospectively analyzed. Each patient was included in the study according to previously published criteria, assessed by the investigators before enrollment. Endothelial dysfunction and coagulation activation parameters were determined before the procedure and during follow-up at 1, 3, 6, 9, 12, 15 and 18 months after treatment, respectively. After the endovascular procedure, patients were treated with standard therapies, with the addition of mesoglycan. Fifty-five percent of patients experienced a favorable outcome of multiple sclerosis within 1 month after treatment, 25% regressed in the following 3 months, 24.9% did not experience any benefit. In only 0.1% patients, acute recurrence was observed and it was treated with high-dose immunosuppressive therapy. No major complications were observed. Coagulation activation and endothelial dysfunction parameters were shown to be reduced at 1 month and stable up to 12-month follow-up, and they were furthermore associated with a good clinical outcome. Endovascular procedures performed by a qualified staff are well tolerated; they can be associated with other currently adopted treatments. Correlations between inflammation, coagulation activation and neurodegenerative disorders are here supported by the observed variations in plasma levels of markers of coagulation activation and endothelial dysfunction.

[Occupational toxic exposure and the pregnant woman. 2: results of a prospective study of 100 pregnancies].

PubMed

Testud, F; Lambert-Chhum, R; Bellemin, B; Descotes, J

2001-12-01

Many women of childbearing age are occupationally exposed to chemicals and concerned with the ensuing risk when pregnant. To present the results of a prospective follow-up study of 100 pregnant women and to discuss them after a brief overview of the published data on this topic. Since January 1996 the Lyon Poison Center has been conducting a prospective follow-up of all request concerning pregnant women occupationally exposed to chemicals. A thorough evaluation of the hazards of the handled products and of the actual exposure at the workplace is done for each patient. A toxicological advice is given and the outcome of the pregnancy is followed-up. One hundred pregnant women were included between January 1996 and December 2000. Based on the nature of the handled products, two groups have been identified: the first included 73 women exposed to organic solvents and the second 27 women exposed to miscellaneous. When the exposure was considered potentially hazardous for the pregnancy, either withdrawal from the workstation (19 cases), avoidance of certain activities (9 cases) or improvement of individual protective measures (29 cases) was recommended. In 43% of the cases, the occupational exposure was not considered hazardous to the outcome of the pregnancy. No increase of adverse outcome was identified: 4 miscarriages and 96 living births were observed, with 2 major malformations and 1 minor malformation. Occupational exposure to chemicals was not found to affect adversely the outcome of these 100 pregnancies.

Fruit, vegetable, and fiber intake in relation to cancer risk: findings from the European Prospective Investigation into Cancer and Nutrition (EPIC).

PubMed

Bradbury, Kathryn E; Appleby, Paul N; Key, Timothy J

2014-07-01

Fruit, vegetables, and certain components of plant foods, such as fiber, have long been thought to protect against cancer. The European Prospective Investigation into Cancer and Nutrition (EPIC) is a prospective cohort that includes >500,000 participants from 10 European countries and has made a substantial contribution to knowledge in this research area. The purpose of this article is to summarize the findings published thus far from the EPIC study on the associations between fruit, vegetable, or fiber consumption and the risk of cancer at 14 different sites. The risk of cancers of the upper gastrointestinal tract was inversely associated with fruit intake but was not associated with vegetable intake. The risk of colorectal cancer was inversely associated with intakes of total fruit and vegetables and total fiber, and the risk of liver cancer was also inversely associated with the intake of total fiber. The risk of cancer of the lung was inversely associated with fruit intake but was not associated with vegetable intake; this association with fruit intake was restricted to smokers and might be influenced by residual confounding due to smoking. There was a borderline inverse association of fiber intake with breast cancer risk. For the other 9 cancer sites studied (stomach, biliary tract, pancreas, cervix, endometrium, prostate, kidney, bladder, and lymphoma) there were no reported significant associations of risk with intakes of total fruit, vegetables, or fiber. © 2014 American Society for Nutrition.

Prospective randomized trial: outcomes of SF₆ versus C₃F₈ in macular hole surgery.

PubMed

Briand, Sophie; Chalifoux, Emmanuelle; Tourville, Eric; Bourgault, Serge; Caissie, Mathieu; Tardif, Yvon; Giasson, Marcelle; Boivin, Jocelyne; Blanchette, Caty; Cinq-Mars, Benoit

2015-04-01

To compare macular hole (MH) closure and visual acuity improvement after vitrectomy using SF6 versus C3F8 gas tamponade. The secondary purposes were to report the cumulative incidence of cataract development at 1 year after MH surgery and the proportion of complications. Prospective, randomized study. Thirty-one patients were prospectively randomized to the SF6 group and 28 patients to the C3F8 group. Preoperative data included MH minimum diameter, Early Treatment Diabetic Retinopathy Study (ETDRS) best corrected visual acuity (BCVA), cataract staging, and intraocular pressure (IOP) measurement. Postoperative data included optical coherence tomography confirmation of the closure at 6 weeks and 1 year, and ETDRS BCVA and cataract development/extraction, both 1 year after the MH surgery. Primary MH closure was achieved in 93.3% in the SF6 group and 92.9% in the C3F8 group. Mean ETDRS BCVA improved by 17.7 letters in the SF6 and 16.9 letters in the C3F8 group. The difference in cumulative incidence of cataract development and extraction between both groups was not statistically significant. Regardless of the dye used, similar results were achieved. Finally, the proportion of adverse events was similar in both groups. MH surgery with SF6 gas achieves results similar to C3F8 in terms of visual acuity improvement, MH closure, cataract development/extraction, and adverse events. Copyright © 2015 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Lower extremity revascularization using directional atherectomy: 12-month prospective results of the DEFINITIVE LE study.

PubMed

McKinsey, James F; Zeller, Thomas; Rocha-Singh, Krishna J; Jaff, Michael R; Garcia, Lawrence A

2014-08-01

The aim of this study was to assess the safety and effectiveness of directional atherectomy (DA) for endovascular treatment of peripheral arterial disease (PAD) in infrainguinal arteries in patients with claudication or critical limb ischemia. To date, no prospective, multicenter, independently-adjudicated study has evaluated the effectiveness and durability of DA in the treatment of PAD. Previous DA studies have not been prospectively powered to evaluate any differences in outcomes in patients with and without diabetes. DEFINITIVE LE (Determination of EFfectiveness of the SilverHawk(®) PerIpheral Plaque ExcisioN System (SIlverHawk Device) for the Treatment of Infrainguinal VEssels / Lower Extremities) prospectively enrolled subjects at 47 multinational centers with an infrainguinal lesion length up to 20 cm. Primary endpoints were defined as primary patency at 12 months for claudicants and freedom from major unplanned amputation for critical limb ischemia (CLI) subjects. A pre-specified statistical hypothesis evaluated noninferiority of primary patency in diabetic versus nondiabetic claudicants. Independent angiographic and sonographic core laboratories assessed outcomes, and events were adjudicated by a clinical events committee. A total of 800 subjects were enrolled. The 12-month primary patency was 78% (95% confidence interval: 74.0% to 80.6%) in claudicants, with a 77% rate in the diabetic subgroup versus 78% in the nondiabetic subgroup (noninferior, p < 0.001). The rate of freedom from major unplanned amputation of the target limb at 12 months in CLI subjects was 95% (95% confidence interval: 90.7% to 97.4%). Periprocedural adverse events included embolization (3.8%), perforation (5.3%), and abrupt closure (2.0%). The bail-out stent rate was 3.2%. The DEFINITIVE LE study demonstrated that DA is a safe and effective treatment modality at 12 months for a diverse patient population with either claudication or CLI. Furthermore, DA was shown to be noninferior for treating PAD in patients with diabetes compared with those without diabetes. (Study of SilverHawk/TurboHawk in Lower Extremity Vessels [DEFINITIVE LE]; NCT00883246). Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

The china patient‐centered evaluative assessment of cardiac events (PEACE) prospective study of percutaneous coronary intervention: Study design

PubMed Central

Du, Xue; Pi, Yi; Dreyer, Rachel P.; Li, Jing; Li, Xi; Downing, Nicholas S.; Li, Li; Feng, Fang; Zhan, Lijuan; Zhang, Haibo; Guan, Wenchi; Xu, Xiao; Li, Shu‐Xia; Lin, Zhenqiu; Masoudi, Frederick A.; Spertus, John A.; Krumholz, Harlan M.

2016-01-01

Background The number of percutaneous coronary interventions (PCI) in China has increased more than 20‐fold over the last decade. Consequently, there is a need for national‐level information to characterize PCI indications and long‐term patient outcomes, including health status, to understand and improve evolving practice patterns. Objectives: This nationwide prospective study of patients receiving PCI is to: (1) measure long‐term clinical outcomes (including death, acute myocardial infarction [AMI], and/or revascularization), patient‐reported outcomes (PROs), cardiovascular risk factor control and adherence to medications for secondary prevention; (2) determine patient‐ and hospital‐level factors associated with care process and outcomes; and (3) assess the appropriateness of PCI procedures. Methods: The China Patient‐centered Evaluative Assessment of Cardiac Events (PEACE) Prospective Study of PCI has enrolled 5,000 consecutive patients during 2012–2014 from 34 diverse hospitals across China undergoing PCI for any indication. We abstracted details of patient's medical history, treatments, and in‐hospital outcomes from medical charts, and conducted baseline, 1‐, 6‐, and 12‐month interviews to characterize patient demographics, risk factors, clinical presentation, healthcare utilization, and health status using validated PRO measures. The primary outcome, a composite measure of death, AMI and/or revascularization, as well as PROs, medication adherence and cardiovascular risk factor control, was assessed throughout the 12‐month follow‐up. Blood and urine samples were collected at baseline and 12 months and stored for future analyses. To validate reports of coronary anatomy, 2,000 angiograms are randomly selected and read by two independent core laboratories. Hospital characteristics regarding their facilities, processes and organizational characteristics are assessed by site surveys. Conclusion: China PEACE Prospective Study of PCI will be the first study to generate novel, high‐quality, comprehensive national data on patients’ socio‐demographic, clinical, treatment, and metabolic/genetic factors, and importantly, their long‐term outcomes following PCI, including health status. This will build the foundation for PCI performance improvement efforts in China. © 2016 The Authors. Catheterization and Cardiovascular Interventions. Published by Wiley Periodicals, Inc. PMID:26945565

Association of High-Density Lipoprotein-Cholesterol Versus Apolipoprotein A-I With Risk of Coronary Heart Disease: The European Prospective Investigation Into Cancer-Norfolk Prospective Population Study, the Atherosclerosis Risk in Communities Study, and the Women's Health Study.

PubMed

van Capelleveen, Julian C; Bochem, Andrea E; Boekholdt, S Matthijs; Mora, Samia; Hoogeveen, Ron C; Ballantyne, Christie M; Ridker, Paul M; Sun, Wensheng; Barter, Philip J; Tall, Alan R; Zwinderman, Aeilko H; Kastelein, John J P; Wareham, Nick J; Khaw, Kay-Tee; Hovingh, G Kees

2017-08-03

The contribution of apolipoprotein A-I (apoA-I) to coronary heart disease (CHD) risk stratification over and above high-density lipoprotein cholesterol (HDL-C) is unclear. We studied the associations between plasma levels of HDL-C and apoA-I, either alone or combined, with risk of CHD events and cardiovascular risk factors among apparently healthy men and women. HDL-C and apoA-I levels were measured among 17 661 participants of the EPIC (European Prospective Investigation into Cancer)-Norfolk prospective population study. Hazard ratios for CHD events and distributions of risk factors were calculated by quartiles of HDL-C and apoA-I. Results were validated using data from the ARIC (Atherosclerosis Risk in Communities) and WHS (Women's Health Study) cohorts, comprising 15 494 and 27 552 individuals, respectively. In EPIC-Norfolk, both HDL-C and apoA-I quartiles were strongly and inversely associated with CHD risk. Within HDL-C quartiles, higher apoA-I levels were not associated with lower CHD risk; in fact, CHD risk was higher within some HDL-C quartiles. ApoA-I levels were associated with higher levels of CHD risk factors: higher body mass index, HbA1c, non-HDL-C, triglycerides, apolipoprotein B, systolic blood pressure, and C-reactive protein, within fixed HDL-C quartiles. In contrast, HDL-C levels were consistently inversely associated with overall CHD risk and CHD risk factors within apoA-I quartiles ( P <0.001). These findings were validated in the ARIC and WHS cohorts. Our findings demonstrate that apoA-I levels do not offer predictive information over and above HDL-C. In fact, within some HDL-C quartiles, higher apoA-I levels were associated with higher risk of CHD events, possibly because of the unexpected higher prevalence of cardiovascular risk factors in association with higher apoA-I levels. URL: https://www.clinicaltrials.gov. Unique identifier: NCT00000479. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

[Registration of observational studies: it is time to comply with the Declaration of Helsinki requirement].

PubMed

Dal-Ré, Rafael; Delgado, Miguel; Bolumar, Francisco

2015-01-01

Publication bias is a serious deficiency in the current system of disseminating the results of human research studies. Clinical investigators know that, from an ethical standpoint, they should prospectively register clinical trials in a public registry before starting them. In addition, it is believed that this approach will help to reduce publication bias. However, most studies conducted in humans are observational rather than experimental. It is estimated that less than 2% out of 2 million concluded or ongoing observational studies have been registered. The 2013 revision of the Declaration of Helsinki requires registration of any type of research study involving humans or identifiable samples or data. It is proposed that funding agencies, such as the Fondo de Investigaciones Sanitarias, as well as private companies, require preregistration of observational studies before providing funding. It is also proposed that Research Ethics Committees which, following Spanish regulation, have been using the Declaration as the framework for assessing the ethics of clinical trials with medicines since 1990, should follow the same provisions for the assessment of health-related observational studies: therefore, they should require prospective registration of studies before granting their final approval. This would allow observational study investigators to be educated in complying with an ethical requirement recently introduced in the most important ethical code for research involving humans. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

Opposing Shh and Fgf signals initiate nasotemporal patterning of the zebrafish retina.

PubMed

Hernández-Bejarano, María; Gestri, Gaia; Spawls, Lana; Nieto-López, Francisco; Picker, Alexander; Tada, Masazumi; Brand, Michael; Bovolenta, Paola; Wilson, Stephen W; Cavodeassi, Florencia

2015-11-15

The earliest known determinants of retinal nasotemporal identity are the transcriptional regulators Foxg1, which is expressed in the prospective nasal optic vesicle, and Foxd1, which is expressed in the prospective temporal optic vesicle. Previous work has shown that, in zebrafish, Fgf signals from the dorsal forebrain and olfactory primordia are required to specify nasal identity in the dorsal, prospective nasal, optic vesicle. Here, we show that Hh signalling from the ventral forebrain is required for specification of temporal identity in the ventral optic vesicle and is sufficient to induce temporal character when activated in the prospective nasal retina. Consequently, the evaginating optic vesicles become partitioned into prospective nasal and temporal domains by the opposing actions of Fgfs and Shh emanating from dorsal and ventral domains of the forebrain primordium. In absence of Fgf activity, foxd1 expression is established irrespective of levels of Hh signalling, indicating that the role of Shh in promoting foxd1 expression is only required in the presence of Fgf activity. Once the spatially complementary expression of foxd1 and foxg1 is established, the boundary between expression domains is maintained by mutual repression between Foxd1 and Foxg1. © 2015. Published by The Company of Biologists Ltd.

Leisure-time sport and overuse injuries of extremities in children age 6-13, a 2.5 years prospective cohort study: the CHAMPS-study DK.

PubMed

Chéron, Charlène; Leboeuf-Yde, Charlotte; Le Scanff, Christine; Jespersen, Eva; Rexen, Christina Trifonov; Franz, Claudia; Wedderkopp, Niels

2017-01-13

It is not known which sports are most likely to cause overuse injuries of the extremities in children. In this study, we report on the incidence of overuse injuries of the upper and lower extremities in children who participate in various leisure-time sports and relate this to the frequency of sport sessions. Natural experiment including a prospective cohort study. 10 state schools in 1 Danish municipality: Svendborg. 1270 children aged 6-13 years participating in the Childhood Health, Activity, and Motor Performance School Study Denmark. Over 2.5 years, parents answered weekly SMS-track messages (a) on type and frequency of leisure-time sports undertaken by their child, and (b) reporting if their child had experienced any musculoskeletal pain. Children with reported pain were examined by a clinician and diagnosed as having an overuse injury of an extremity or not. The incidence of diagnosed overuse injury was calculated for each of the 9 most common sports in relation to 5-week periods. Incidence by frequency of sessions was calculated, and multivariable analysis was performed taking into account age, sex and frequency of physical education classes at school. Incidence of overuse injuries of the lower extremity ranged from 0.2 to 3.3 for the 9 sports, but was near 0 for overuse injuries of the upper extremities. There was no obvious dose-response. The multivariate analysis showed soccer and handball to be the sports most likely to result in an overuse injury. Among a general population of schoolchildren, overuse injuries of the lower extremities were not common and overuse injuries of the upper extremities were rare. Organised leisure-time sport, as practised in Denmark, can be considered a safe activity for children. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Interactive Electronic Decision Trees for the Integrated Primary Care Management of Febrile Children in Low Resource Settings - Review of existing tools.

PubMed

Keitel, Kristina; D'Acremont, Valérie

2018-04-20

The lack of effective, integrated diagnostic tools pose a major challenge to the primary care management of febrile childhood illnesses. These limitations are especially evident in low-resource settings and are often inappropriately compensated by antimicrobial over-prescription. Interactive electronic decision trees (IEDTs) have the potential to close these gaps: guiding antibiotic use and better identifying serious disease. This narrative review summarizes existing IEDTs, to provide an overview of their degree of validation, as well as to identify gaps in current knowledge and prospects for future innovation. Structured literature review in PubMed and Embase complemented by google search and contact with developers. Six integrated IEDTs were identified: three (eIMCI, REC, and Bangladesh digital IMCI) based on Integrated Management of Childhood Illnesses (IMCI); four (SL eCCM, MEDSINC, e-iCCM, and D-Tree eCCM) on Integrated Community Case Management (iCCM); two (ALMANACH, MSFeCARE) with a modified IMCI content; and one (ePOCT) that integrates novel content with biomarker testing. The types of publications and evaluation studies varied greatly: the content and evidence-base was published for two (ALMANACH and ePOCT), ALMANACH and ePOCT were validated in efficacy studies. Other types of evaluations, such as compliance, acceptability were available for D-Tree eCCM, eIMCI, ALMANACH. Several evaluations are still ongoing. Future prospects include conducting effectiveness and impact studies using data gathered through larger studies to adapt the medical content to local epidemiology, improving the software and sensors, and Assessing factors that influence compliance and scale-up. IEDTs are valuable tools that have the potential to improve management of febrile children in primary care and increase the rational use of diagnostics and antimicrobials. Next steps in the evidence pathway should be larger effectiveness and impact studies (including cost analysis) and continuous integration of clinically useful diagnostic and treatment innovations. Copyright © 2018. Published by Elsevier Ltd.

HOspitals and patients WoRking in Unity (HOW R U?): protocol for a prospective feasibility study of telephone peer support to improve older patients' quality of life after emergency department discharge.

PubMed

Lowthian, Judy A; Lennox, Alyse; Curtis, Andrea; Dale, Jeremy; Browning, Colette; Smit, De Villiers; Wilson, Gillian; O'Brien, Debra; Rosewarne, Cate; Boyd, Lee; Garner, Cath; Cameron, Peter

2016-12-02

Older people presenting to an emergency department (ED) have a higher likelihood of social isolation, loneliness and depression; which are all associated with negative health outcomes and increased health service use, including higher rates of ED attendance. The HOW R U? study aims to ascertain the feasibility and acceptability of a postdischarge telephone support programme for older ED patients following discharge. The intervention, which aims to improve quality of life, will be delivered by hospital-based volunteers. A multicentre prospective uncontrolled feasibility study will enrol 50 community-dwelling patients aged ≥70 years with symptoms of loneliness or depression who are discharged home within 72 hours from the ED or acute medical ward. Participants will receive weekly supportive telephone calls over a 3-month period from a volunteer-peer. Feasibility will be assessed in terms of recruitment, acceptability of the intervention to participants and level of retention in the programme. Changes in level of loneliness (UCLA-3 item Loneliness Scale), mood (Geriatric Depression Scale-5 item) and health-related quality of life (EQ-5D-5L and EQ-VAS) will also be measured postintervention (3 months). Research ethics and governance committee approval has been granted for this study by each participating centre (reference: 432/15 and 12-09-11-15). Study findings will inform the design and conduct of a future multicentre randomised controlled trial of a postdischarge volunteer-peer telephone support programme to improve social isolation, loneliness or depressive symptoms in older patients. Results will be disseminated through peer-reviewed journal publication, and conference and seminar presentation. ACTRN12615000715572, Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Towards improving the efficiency of blowing through a permeable wall and prospects of its use for a flow control

NASA Astrophysics Data System (ADS)

Kornilov, V. I.; Boiko, A. V.

2016-10-01

Modern achievements, status, and prospects of studies on reducing the turbulent friction and aerodynamic drag with the help of the blowing through a permeable wall are discussed. The main focus is placed upon a physical modeling of the process of boundary layer blowing in the framework of the dimensional theory, a critical analysis of experimental and numerical results for different conditions of air blowing through a high-tech finely perforated wall including the case of external-pressure-flow air supply in wind tunnel, and elicitation of the physical mechanisms responsible for the reduction of turbulent friction at flow-exposed surfaces. It is shown that the use of air supply through the micro-perforated wall with low effective roughness, which is manufactured in compliance with the highest necessary requirements to quality and geometry of orifices, is quite a justified means for easy, affordable, and reliable control of near-wall turbulent flows in laboratory experiment and numerical simulation. This approach can provide a sustained reduction of local skin friction coefficient along flat plate, which in some cases reaches 90%. At the request of all authors of the paper and with the agreement of the Proceedings Editor, an updated version of this article was published on 26 October 2016. The original version supplied to AIP Publishing contained a misrepresentation in Figure 1. This has been corrected in the updated and republished article.

Tale of three prospects

USGS Publications Warehouse

Duffield, Wendell A.; ,

1992-01-01

Most high-temperature, hydrothermal-convection systems probably are heated by bodies of magma (and/or hot plutons), whose presence is suggested by geologically young, if not active volcanism. Study of a young volcanic area provides information about the general thermal status of the underlying heat source, and detailed information about the time-space-volume-composition (TSVC) characteristics for a volcanic area can help define temperature at least semi-quantitatively when interpreted within the framework of published magma-cooling models. Thus, TSVC study is a fairly powerful and cost effective tool in the pre-drilling phase of an exploration program in young volcanic terrane. Examples are described for Coso, California; Agua de Pau, Azores; and Tecuamburro, Guatemala.

The percentage of nosocomial-related out of total hospitalizations for rotavirus gastroenteritis and its association with hand hygiene compliance.

PubMed

Waisbourd-Zinman, Orith; Ben-Ziony, Shiri; Solter, Ester; Chodick, Gabriel; Ashkenazi, Shai; Livni, Gilat

2011-03-01

Because the absolute numbers of both community-acquired and nosocomial rotavirus gastroenteritis (RVGE) vary, we studied the percentage of hospitalizations for RVGE that were transmitted nosocomially as an indicator of in-hospital acquisition of the infection. In a 4-year prospective study, the percentage of nosocomial RVGE declined steadily, from 20.3% in 2003 to 12.7% in 2006 (P = .001). Concomitantly, the rate of compliance with hand hygiene increased from 33.7% to 49% (P = .012), with a significant (P < .0001) inverse association noted between the two trends. Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Cholesterol and Prostate Cancer

PubMed Central

Pelton, Kristine; Freeman, Michael R.; Solomon, Keith R.

2012-01-01

Summary Prostate cancer risk can be modified by environmental factors, however the molecular mechanisms affecting susceptibility to this disease are not well understood. As a result of a series of recently published studies, the steroidal lipid, cholesterol, has emerged as a clinically relevant therapeutic target in prostate cancer. This review summarizes the findings from human studies as well as animal and cell biology models which suggest that high circulating cholesterol increases risk of aggressive prostate cancer, while cholesterol lowering strategies may confer protective benefit. Relevant molecular processes that have been experimentally tested and might explain these associations are described. We suggest that these promising results now could be applied prospectively to attempt to lower risk of prostate cancer in select populations. PMID:22824430

Predicting response to physiotherapy treatment for musculoskeletal shoulder pain: a systematic review

PubMed Central

2013-01-01

Background People suffering from musculoskeletal shoulder pain are frequently referred to physiotherapy. Physiotherapy generally involves a multimodal approach to management that may include; exercise, manual therapy and techniques to reduce pain. At present it is not possible to predict which patients will respond positively to physiotherapy treatment. The purpose of this systematic review was to identify which prognostic factors are associated with the outcome of physiotherapy in the management of musculoskeletal shoulder pain. Methods A comprehensive search was undertaken of Ovid Medline, EMBASE, CINAHL and AMED (from inception to January 2013). Prospective studies of participants with shoulder pain receiving physiotherapy which investigated the association between baseline prognostic factors and change in pain and function over time were included. Study selection, data extraction and appraisal of study quality were undertaken by two independent assessors. Quality criteria were selected from previously published guidelines to form a checklist of 24 items. The study protocol was prospectively registered onto the International Prospective Register of Systematic Reviews. Results A total of 5023 titles were retrieved and screened for eligibility, 154 articles were assessed as full text and 16 met the inclusion criteria: 11 cohort studies, 3 randomised controlled trials and 2 controlled trials. Results were presented for the 9 studies meeting 13 or more of the 24 quality criteria. Clinical and statistical heterogeneity resulted in qualitative synthesis rather than meta-analysis. Three studies demonstrated that high functional disability at baseline was associated with poor functional outcome (p ≤ 0.05). Four studies demonstrated a significant association (p ≤ 0.05) between longer duration of shoulder pain and poorer outcome. Three studies, demonstrated a significant association (p ≤ 0.05) between increasing age and poorer function; three studies demonstrated no association (p > 0.05). Conclusion Associations between prognostic factors and outcome were often inconsistent between studies. This may be due to clinical heterogeneity or type II errors. Only two baseline prognostic factors demonstrated a consistent association with outcome in two or more studies; duration of shoulder pain and baseline function. Prior to developing a predictive model for the outcome of physiotherapy treatment for shoulder pain, a large adequately powered prospective cohort study is required in which a broad range of prognostic factors are incorporated. PMID:23834747

Higher dietary folate intake reduces the breast cancer risk: a systematic review and meta-analysis

PubMed Central

Chen, P; Li, C; Li, X; Li, J; Chu, R; Wang, H

2014-01-01

Background: Many epidemiological studies have investigated the association between folate intake, circulating folate level and risk of breast cancer; however, the findings were inconsistent between the studies. Methods: We searched the PubMed and MEDLINE databases updated to January, 2014 and performed the systematic review and meta-analysis of the published epidemiological studies to assess the associations between folate intake level, circulating folate level and the overall risk of breast cancer. Results: In all, 16 eligible prospective studies with a total of 744 068 participants and 26 205 breast cancer patients and 26 case–control studies with a total of 16 826 cases and 21 820 controls that have evaluated the association between folate intake and breast cancer risk were identified. Pooled analysis of the prospective studies and case–control studies suggested a potential nonlinearity relationship for dietary folate intake and breast cancer risk. Prospective studies indicated a U-shaped relationship for the dietary folate intake and breast cancer risk. Women with daily dietary folate intake between 153 and 400 μg showed a significant reduced breast cancer risk compared with those <153 μg, but not for those >400 μg. The case–control studies also suggested a significantly negative correlation between the dietary folate intake level and the breast cancer risk. Increased dietary folate intake reduced breast cancer risk for women with higher alcohol intake level, but not for those with lower alcohol intake. No significant association between circulating folate level and breast cancer risk was found when the results of 8 identified studies with 5924 participants were pooled. Conclusions: Our studies suggested that folate may have preventive effects against breast cancer risk, especially for those with higher alcohol consumption level; however, the dose and timing are critical and more studies are warranted to further elucidate the questions. PMID:24667649

Anatomy of the sural nerve: cadaver study and literature review.

PubMed

Riedl, Otto; Frey, Manfred

2013-04-01

The sural nerve is commonly used as donor for nerve grafting. Contrary to its constant retromalleolar position, formation and course of the proximal sural nerve show great variability. The coexistence of different and deceptive terminologies contributes to the complexity, and reviewing the international literature is confusing. Because detailed anatomical knowledge is essential for efficient and safe sural nerve harvesting, this study aims to bring clarity. Previous sural nerve reports listed in the PubMed database and established anatomical textbooks were reviewed. Different terminologies were compared and adjusted. Anatomical details and variations were noted. Subtle prospective anatomical dissections and comparison with actual data followed. Two hundred twenty-one relevant reports were identified and worked up going back to the nineteenth century. Fourteen established German and English language anatomical textbooks were reviewed. Thirty lower limbs were dissected. In total, this study pools the information of more than 2500 sural nerves. This study covers all information about the sural nerve anatomy published internationally. The coexistence of different and confusing terminologies is pinpointed and adjusted to allow comparison of previous reports and to gain a coordinated data pool of more than 2500 investigated sural nerves. Detailed features are clearly described and summarized, findings from the authors' own prospective dissections complete these data, and the prior existing anatomical confusion is resolved. Finally, clinical implications are described.

Swallowing outcomes following Intensity Modulated Radiation Therapy (IMRT) for head & neck cancer - a systematic review.

PubMed

Roe, Justin W G; Carding, Paul N; Dwivedi, Raghav C; Kazi, Rehan A; Rhys-Evans, Peter H; Harrington, Kevin J; Nutting, Christopher M

2010-10-01

A systematic review to establish what evidence is available for swallowing outcomes following IMRT for head and neck cancer. Online electronic databases were searched to identify papers published in English from January 1998 to December 2009. Papers were independently appraised by two reviewers for methodological quality, method of swallowing evaluation and categorized according to the World Health Organisation's International Classification of Health Functions. The impact of radiation dose to dysphagia aspiration risk structures (DARS) was also evaluated. Sixteen papers met the inclusion criteria. The literature suggests that limiting the radiation dose to certain structures may result in favourable swallowing outcomes. Methodological limitations included variable assessment methods and outcome measures and heterogeneity of patients. There are only limited prospective data, especially where pre-treatment measures have been taken and compared to serial post-treatment assessment. Few studies have investigated the impact of IMRT on swallow function and the impact on everyday life. Initial studies have reported potential benefits but are limited in terms of study design and outcome data. Further well designed, prospective, longitudinal swallowing studies including multidimensional evaluation methods are required to enable a more comprehensive understanding of dysphagia complications and inform pre-treatment counselling and rehabilitation planning. Copyright © 2010 Elsevier Ltd. All rights reserved.

Prospective observational study of emergent endotracheal intubation practice in the intensive care unit and emergency department of an Australian regional tertiary hospital.

PubMed

Phillips, Luke; Orford, Neil; Ragg, Michael

2014-08-01

The present study aimed to describe the characteristics and outcomes of intubation occurring in the ICU and ED of an Australian tertiary teaching hospital. This was a prospective observational study of intubation practice across the Geelong Hospital over a 6 month period from 1 August 2012 to 31 January 2013. Data were entered by the intubating team through an online data collection form. There were 119 patients intubated and 134 attempts at intubation in the ED and ICU over a 6 month period. The first-pass success rate was 104/119 (87.4%), and all but a single patient was intubated by the second attempt. Propofol, fentanyl, midazolam and suxamethonium were the most common drugs used in rapid sequence induction. AEs were reported in 44/134 (32.8%) of intubation attempts, with transient hypoxia and hypotension being the most common. A significant adverse outcome, namely aspiration pneumonitis, occurred in one patient. There were no peri-intubation deaths. The majority of airways are managed by ICU and ED consultants and trainees, with success rates and AE rates comparable with other published studies. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Cortical thickness in adolescent marijuana and alcohol users: A three-year prospective study from adolescence to young adulthood.

PubMed

Jacobus, Joanna; Squeglia, Lindsay M; Meruelo, Alejandro D; Castro, Norma; Brumback, Ty; Giedd, Jay N; Tapert, Susan F

2015-12-01

Studies suggest marijuana impacts gray and white matter neural tissue development, however few prospective studies have determined the relationship between cortical thickness and cannabis use spanning adolescence to young adulthood. This study aimed to understand how heavy marijuana use influences cortical thickness trajectories across adolescence. Subjects were adolescents with heavy marijuana use and concomitant alcohol use (MJ+ALC, n=30) and controls (CON, n=38) with limited substance use histories. Participants underwent magnetic resonance imaging and comprehensive substance use assessment at three independent time points. Repeated measures analysis of covariance was used to look at main effects of group, time, and Group × Time interactions on cortical thickness. MJ+ALC showed thicker cortical estimates across the brain (23 regions), particularly in frontal and parietal lobes (ps<.05). More cumulative marijuana use was associated with increased thickness estimates by 3-year follow-up (ps<.05). Heavy marijuana use during adolescence and into young adulthood may be associated with altered neural tissue development and interference with neuromaturation that can have neurobehavioral consequences. Continued follow-up of adolescent marijuana users will help understand ongoing neural changes that are associated with development of problematic use into adulthood, as well as potential for neural recovery with cessation of use. Published by Elsevier Ltd.

Associations between youth homelessness, sexual offenses, sexual victimization, and sexual risk behaviors: a systematic literature review.

PubMed

Heerde, Jessica A; Scholes-Balog, Kirsty E; Hemphill, Sheryl A

2015-01-01

Homeless youth commonly report engaging in sexual risk behaviors. These vulnerable young people also frequently report being sexually victimized. This systematic review collates, summarizes, and appraises published studies of youth investigating relationships between homelessness, perpetration of sexual offenses, experience of sexual victimization, and engagement in sexual risk behavior. A systematic search of seventeen psychology, health, and social science electronic databases was conducted. Search terms included "homeless*," "youth," "offend*," "victimization," "crime," "rape," "victim*," and "sex crimes." Thirty-eight studies were identified that met the inclusion criteria. Findings showed homeless youth commonly report being raped and sexually assaulted, fear being sexually victimized, and engage in street prostitution and survival sex. Rates of victimization and sexual risk behavior were generally higher for females. Given the paucity of longitudinal studies and limitations of current studies, it is unclear whether homelessness is prospectively associated with sexual victimization or engagement in sexual risk behavior, and whether such associations vary cross nationally and as a function of time and place. Future prospective research examining the influence of the situational context of homelessness is necessary to develop a better understanding of how homelessness influences the perpetration of sexual offenses, experience of sexual victimization, and engagement in sexual risk behavior among homeless youth.

Long-Term Coffee Consumption Is Associated with Decreased Incidence of New-Onset Hypertension: A Dose-Response Meta-Analysis.

PubMed

Grosso, Giuseppe; Micek, Agnieszka; Godos, Justyna; Pajak, Andrzej; Sciacca, Salvatore; Bes-Rastrollo, Maira; Galvano, Fabio; Martinez-Gonzalez, Miguel A

2017-08-17

To perform a dose-response meta-analysis of prospective cohort studies investigating the association between long-term coffee intake and risk of hypertension. An online systematic search of studies published up to November 2016 was performed. Linear and non-linear dose-response meta-analyses were conducted; potential evidence of heterogeneity, publication bias, and confounding effect of selected variables were investigated through sensitivity and meta-regression analyses. Seven cohorts including 205,349 individuals and 44,120 cases of hypertension were included. In the non-linear analysis, there was a 9% significant decreased risk of hypertension per seven cups of coffee a day, while, in the linear dose-response association, there was a 1% decreased risk of hypertension for each additional cup of coffee per day. Among subgroups, there were significant inverse associations for females, caffeinated coffee, and studies conducted in the US with longer follow-up. Analysis of potential confounders revealed that smoking-related variables weakened the strength of association between coffee consumption and risk of hypertension. Increased coffee consumption is associated with a modest decrease in risk of hypertension in prospective cohort studies. Smoking status is a potential effect modifier on the association between coffee consumption and risk of hypertension.