Prehospital randomised assessment of a mechanical compression device in cardiac arrest (PaRAMeDIC) trial protocol

Background Survival after out-of-hospital cardiac arrest is closely linked to the quality of CPR, but in real life, resuscitation during pre-hospital care and ambulance transport is often suboptimal. Mechanical chest compression devices deliver consistent chest compressions, are not prone to fatigue and could potentially overcome some of the limitations of manual chest compression. However, there is no high-quality evidence that they improve clinical outcomes, or that they are cost effective. The Pre-hospital Randomised Assessment of a Mechanical Compression Device In Cardiac Arrest (PARAMEDIC) trial is a pragmatic cluster randomised study of the LUCAS-2 device in adult patients with non-traumatic out-of-hospital cardiac arrest. Methods The primary objective of this trial is to evaluate the effect of chest compression using LUCAS-2 on mortality at 30 days post out-of-hospital cardiac arrest, compared with manual chest compression. Secondary objectives of the study are to evaluate the effects of LUCAS-2 on survival to 12 months, cognitive and quality of life outcomes and cost-effectiveness. Methods: Ambulance service vehicles will be randomised to either manual compression (control) or LUCAS arms. Adult patients in out-of-hospital cardiac arrest, attended by a trial vehicle will be eligible for inclusion. Patients with traumatic cardiac arrest or who are pregnant will be excluded. The trial will recruit approximately 4000 patients from England, Wales and Scotland. A waiver of initial consent has been approved by the Research Ethics Committees. Consent will be sought from survivors for participation in the follow-up phase. Conclusion The trial will assess the clinical and cost effectiveness of the LUCAS-2 mechanical chest compression device. Trial Registration: The trial is registered on the International Standard Randomised Controlled Trial Number Registry (ISRCTN08233942)

Parental sensitivity and child behavioral problems: A meta-analytic review

Meta-analytic associations between observed parental sensitivity and child behavioral problems were examined (children aged 0-17 years). Studies (k = 108, N = 28,114) contained sociodemographically diverse samples, primarily from North America and Europe, reporting on parent-child dyads (95% mothers; 54% boys). Sensitivity significantly related to internalizing (k = 69 studies; N = 14,729; r = -.08, 95% CI [-.12, -.05]) and externalizing (k = 94; N = 25,418; r = -.14, 95% CI [-.17, -.11]) problems, with stronger associations found for externalizing. For internalizing problems, associations were significantly stronger among samples with low socioeconomic status (SES) versus mid-high SES, in peer-reviewed versus unpublished dissertations, and in studies using composite versus single scale sensitivity measures. No other moderators emerged as significant

Molecular Genetic Influences on Normative and Problematic Alcohol Use in a Population-Based Sample of College Students

Background: Genetic factors impact alcohol use behaviors and these factors may become increasingly evident during emerging adulthood. Examination of the effects of individual variants as well as aggregate genetic variation can clarify mechanisms underlying risk. Methods: We conducted genome-wide association studies (GWAS) in an ethnically diverse sample of college students for three quantitative outcomes including typical monthly alcohol consumption, alcohol problems, and maximum number of drinks in 24 h. Heritability based on common genetic variants (h2SNP) was assessed. We also evaluated whether risk variants in aggregate were associated with alcohol use outcomes in an independent sample of young adults. Results: Two genome-wide significant markers were observed: rs11201929 in GRID1 for maximum drinks in 24 h, with supportive evidence across all ancestry groups; and rs73317305 in SAMD12 (alcohol problems), tested only in the African ancestry group. The h2SNP estimate was 0.19 (SE = 0.11) for consumption, and was non-significant for other outcomes. Genome-wide polygenic scores were significantly associated with alcohol outcomes in an independent sample. Conclusions: These results robustly identify genetic risk for alcohol use outcomes at the variant level and in aggregate. We confirm prior evidence that genetic variation in GRID1impacts alcohol use, and identify novel loci of interest for multiple alcohol outcomes in emerging adults. These findings indicate that genetic variation influencing normative and problematic alcohol use is, to some extent, convergent across ancestry groups. Studying college populations represents a promising avenue by which to obtain large, diverse samples for gene identification

How experimental biology and ecology can support evidence-based decision-making in conservation: avoiding pitfalls and enabling application

Policy development and management decisions should be based upon the best available evidence. In recent years, approaches to evidence synthesis, originating in the medical realm (such as systematic reviews), have been applied to conservation to promote evidence-based conservation and environmental management. Systematic reviews involve a critical appraisal of evidence, but studies that lack the necessary rigour (e.g. experimental, technical and analytical aspects) to justify their conclusions are typically excluded from systematic reviews or down-weighted in terms of their influence. One of the strengths of conservation physiology is the reliance on experimental approaches that help to more clearly establish cause-and-effect relationships. Indeed, experimental biology and ecology have much to offer in terms of building the evidence base that is needed to inform policy and management options related to pressing issues such as enacting endangered species recovery plans or evaluating the effectiveness of conservation interventions. Here, we identify a number of pitfalls that can prevent experimental findings from being relevant to conservation or would lead to their exclusion or down-weighting during critical appraisal in a systematic review. We conclude that conservation physiology is well positioned to support evidence-based conservation, provided that experimental designs are robust and that conservation physiologists understand the nuances associated with informing decision-making processes so that they can be more relevant

The first 20,000 strange situation procedures: A meta-analytic review

The Strange Situation Procedure (SSP) was developed five decades ago to assess infant–parent attachment relationships. Although the procedure itself has remained relatively constant in over 285 studies (20,720 dyads) conducted to date, there have been vast sociological changes during this time, and research foci shifts to studying diverse populations. Since its inception, the SSP has also been adopted in over 20 countries. In this meta-analysis, we collate this large body of work, with the objectives of producing reliable estimates of the distribution of the four SSP attachment classifications, assessing temporal trends and geographical differences, and determining if and when distributions are different across various populations. Results revealed that the global distribution of SSP attachment was 51.6% secure, 14.7% avoidant, 10.2% resistant, and 23.5% disorganized. There were no differences in the distribution among mothers and fathers, and no child age or sex differences. We found a temporal trend in which there was less avoidant attachment over time and there were attachment distribution differences between samples from North America versus other regions of the world, particularly Asia, Middle East/Israel and South America. We found higher rates of avoidant and disorganized attachment in populations with sociodemographic risks and higher rates of disorganized attachment in samples where parents had psychopathology and when the child experienced maltreatment or was adopted from foster or institutional care. The implications of these findings for future research and practice are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved

What are the impacts of flow regime changes on fish productivity in temperate regions? A systematic map protocol

Background: Ecosystem changes from altered flows can have multiple impacts on fish, including changes to physical habitat, habitat access, food supplies, behaviour, community composition, energy expenditure, and population dynamics. There is growing evidence of the potential negative consequences of altered flow regimes on fluvial ecosystems and the fisheries they support. As such, the scientific and policy communities have acknowledged the need for maintaining or restoring natural flow variability in order to sustain ecological health of fluvial ecosystems. However, for resource managers, making decisions on the potential effects of flow alterations on fish productivity has been problematic because there are still uncertainties regarding flow-fish productivity relationships. Therefore, to ensure the maintenance of healthy and productive aquatic ecosystems and the sustainability of riverine fisheries, a better understanding of the impacts of flow alteration on fish productivity is needed. Due to the wide scope of this review, and the diversity of fish productivity outcomes used to evaluate flow alteration impacts, the set of studies will be quite heterogeneous. Therefore, prior to undertaking a comprehensive and quantitative synthesis, we propose to begin with a systematic map to provide an overview of the available evidence on the impacts of flow regime changes on fish productivity. We will also use this systematic map to identify subtopics that are sufficiently covered by existing studies to allow full systematic reviewing. Methods: This systematic map will compile evidence on the impacts of flow regime changes on fish productivity. All studies that evaluate the effects of flow regime change on direct outcomes of fish productivity, will be included in the review. We will use a broad definition of fish productivity to include any measurement related to: biomass, abundance, density, yield, diversity, growth, survival, individual performance, migration, reproduction, recruitment, or surrogate thereof. Relevant causes of a change in/modification to flow regime can include: (1) anthropogenic causes: dams, reservoirs (impoundments), hydroelectric facilities, locks, levees, water withdrawal (abstraction), water diversion, land-use changes, and road culverts; or (2) natural causes: climate change (possible indirect anthropogenic cause as well), floods, droughts, seasonal changes. Any freshwater or estuarine fish species or species groups in temperate regions will be considered. The review will include a wide range of sources including primary and grey literature and use public databases, search engines and specialist websites. A searchable database containing extracted meta-data from relevant included studies will be developed and provided as a supplementary file to the map report. The final narrative will describe the quantity and key characteristics of the available evidence, identify knowledge gaps for future research and identify subtopics that are sufficiently covered by existing studies to allow full systematic reviewing

The effectiveness of spawning habitat creation or enhancement for substrate spawning temperate fish: a systematic review protocol

Background: Habitat is the foundation for healthy and productive fisheries. For substrate spawning fish, lack of appropriate spawning substrate is inherently limiting and a lack of access to suitable spawning habitat will lead to population collapse. When specific properties of a habitat (e.g., temperature, depth, vegetation composition) are matched to the species’ ecological niche, a spawning habitat can be created or enhanced as a means of mitigating or offsetting the harmful effects of human development. Given the acceleration of habitat degradation in aquatic systems as a result of human activity and resultant loss of biodiversity, it is becoming ever more important to consider the effectiveness of the techniques being used to enhance or create habitat, to ensure management resources are being allocated wisely. The primary aim of this systematic review will be to assess the effectiveness of techniques currently being used to create or enhance spawning habitat for substrate spawning fish in temperate climate regions. Methods: This review will examine studies on the effectiveness of habitat creation or enhancement for substrate spawning fish. We will consider studies in either the North or South temperate climate regions, and include freshwater, estuarine, coastal, or marine environments. Relevant outcomes will include a range of measures used by authors to define effectiveness, including but not limited to the presence of eggs, successful emergence, or improved recruitment. This review will obtain relevant studies from online publication databases, specialist websites, and grey literature using a range of search engines and networking tools. Additional searches will be conducted using the bibliographies of relevant review publications. Study data will be extracted and appraised for quality, including study design, confounding factors, and statistical analysis. A narrative synthesis will be compiled and a meta-analysis will be completed should the data availability and quality allow for it

A genome-wide association study for diabetic nephropathy genes in African Americans

A genome-wide association study was performed using the Affymetrix 6.0 chip to identify genes associated with diabetic nephropathy in African Americans. Association analysis was performed adjusting for admixture in 965 type 2 diabetic African American patients with end-stage renal disease (ESRD) and in 1029 African Americans without type 2 diabetes or kidney disease as controls. The top 724 single nucleotide polymorphisms (SNPs) with evidence of association to diabetic nephropathy were then genotyped in a replication sample of an additional 709 type 2 diabetes-ESRD patients and 690 controls. SNPs with evidence of association in both the original and replication studies were tested in additional African American cohorts consisting of 1246 patients with type 2 diabetes without kidney disease and 1216 with non-diabetic ESRD to differentiate candidate loci for type 2 diabetes-ESRD, type 2 diabetes, and/or all-cause ESRD. Twenty-five SNPs were significantly associated with type 2 diabetes-ESRD in the genome-wide association and initial replication. Although genome-wide significance with type 2 diabetes was not found for any of these 25 SNPs, several genes, including RPS12, LIMK2, and SFI1 are strong candidates for diabetic nephropathy. A combined analysis of all 2890 patients with ESRD showed significant association SNPs in LIMK2 and SFI1 suggesting that they also contribute to all-cause ESRD. Thus, our results suggest that multiple loci underlie susceptibility to kidney disease in African Americans with type 2 diabetes and some may also contribute to all-cause ESRD