3,625 research outputs found
Evidence-based urology in practice : heterogeneity in a systematic review meta-analysis
The definitive version is available at www3.interscience.wiley.com.Peer reviewedPreprin
Data extraction methods for systematic review (semi)automation: A living systematic review [version 1; peer review: awaiting peer review]
Background: The reliable and usable (semi)automation of data
extraction can support the field of systematic review by reducing the
workload required to gather information about the conduct and
results of the included studies. This living systematic review examines
published approaches for data extraction from reports of clinical
studies.
Methods: We systematically and continually search MEDLINE,
Institute of Electrical and Electronics Engineers (IEEE), arXiv, and the
dblp computer science bibliography databases. Full text screening and
data extraction are conducted within an open-source living systematic
review application created for the purpose of this review. This
iteration of the living review includes publications up to a cut-off date
of 22 April 2020.
Results: In total, 53 publications are included in this version of our
review. Of these, 41 (77%) of the publications addressed extraction of
data from abstracts, while 14 (26%) used full texts. A total of 48 (90%)
publications developed and evaluated classifiers that used
randomised controlled trials as the main target texts. Over 30 entities
were extracted, with PICOs (population, intervention, comparator,
outcome) being the most frequently extracted. A description of their
datasets was provided by 49 publications (94%), but only seven (13%)
made the data publicly available. Code was made available by 10 (19%)
publications, and five (9%) implemented publicly available tools.
Conclusions: This living systematic review presents an overview of
(semi)automated data-extraction literature of interest to different
types of systematic review. We identified a broad evidence base of
publications describing data extraction for interventional reviews and
a small number of publications extracting epidemiological or diagnostic accuracy data. The lack of publicly available gold-standard
data for evaluation, and lack of application thereof, makes it difficult
to draw conclusions on which is the best-performing system for each
data extraction target. With this living review we aim to review the
literature continually
Commentary: Unravelling the mechanisms linking climate change, agriculture and avian population declines
Exploring the behavioural drivers of veterinary surgeon antibiotic prescribing: a qualitative study of companion animal veterinary surgeons in the UK
Background:
Multi-drug resistant bacteria are an increasing concern in both human and veterinary medicine. Inappropriate prescribing and use of antibiotics within veterinary medicine may be a contributory factor to antimicrobial resistance (AMR). The âOne Healthâ Initiative aims to work across species and environments to reduce AMR, however; little is currently known about the factors which influence antibiotic prescribing among veterinary surgeons in companion animal practice.
This paper reports on qualitative data analysis of interviews with veterinary surgeons whose practice partially or wholly focuses on companion animals (N =â16). The objective of the research was to explore the drivers of companion animal veterinary surgeonsâ antibiotic prescribing behaviours. The veterinary surgeons interviewed were all practising within the UK (England (n =â4), Scotland (n =â11), Northern Ireland (n =â1)). A behavioural thematic analysis of the data was undertaken, which identified barriers and facilitators to specific prescribing-related behaviours.
Results:
Five components of prescribing behaviours were identified: 1) confirming clinical need for antibiotics; 2) responding to clients; 3) confirming diagnosis; 4) determining dose, duration and type of antibiotic; and 5) preventing infection around surgery (with attendant appropriate and inappropriate antibiotic prescribing behaviours). Barriers to appropriate prescribing identified include: business, diagnostic, fear, habitual practice and pharmaceutical factors. Facilitators include: AMR awareness, infection prevention, professional learning and regulation and government factors.
Conclusion:
This paper uses a behavioural lens to examine drivers which are an influence on veterinary surgeonsâ prescribing behaviours. The paper contributes new understandings about factors which influence antibiotic prescribing behaviours among companion animal veterinary surgeons. This analysis provides evidence to inform future interventions, which are focused on changing prescribing behaviours, in order to address the pressing public health concern of AMR
Cigarette smoking and gastric cancer in the stomach cancer pooling (StoP) project
Tobacco smoking is a known cause of gastric cancer, but
several aspects of the association remain imprecisely
quantified. We examined the relation between cigarette
smoking and the risk of gastric cancer using a uniquely large
dataset of 23 epidemiological studies within the âStomach
cancer Pooling (StoP) Projectâ, including 10 290 cases and
26 145 controls. We estimated summary odds ratios (ORs)
and the corresponding 95% confidence intervals (CIs) by
pooling study-specific ORs using random-effects models.
Compared with never smokers, the ORs were 1.20 (95% CI:
1.09â1.32) for ever, 1.12 (95% CI: 0.99â1.27) for former, and
1.25 (95% CI: 1.11â1.40) for current cigarette smokers. Among
current smokers, the risk increased with number of cigarettes
per day to reach an OR of 1.32 (95% CI: 1.10â1.58) for
smokers of more than 20 cigarettes per day. The risk
increased with duration of smoking, to reach an OR of 1.33
(95% CI: 1.14â1.54) for more than 40 years of smoking and
decreased with increasing time since stopping cigarette
smoking (P for trend<0.01) and became similar to that of
never smokers 10 years after stopping. Risks were somewhat
higher for cardia than noncardia gastric cancer. Risks were
similar when considering only studies with information on
Helicobacter pylori infection and comparing all cases to
H. pylori+ controls only. This study provides the most precise
estimate of the detrimental effect of cigarette smoking on the
risk of gastric cancer on the basis of individual data, including
the relationship with dose and duration, and the decrease in
risk following stopping smoking
Agitation near the end of life with dementia: An ethnographic study of care
Background and objectives
Agitation is common in people living with dementia especially at the end of life. We examined how staff interpreted agitation behavior in people with dementia nearing end of life, how this may influence their responses and its impact on the quality of care.
Research design
Ethnographic study. Structured and semi-structured non-participant observations (referred to subsequently in this paper as âstructured observationsâ) of people living with dementia nearing the end of life in hospital and care homes (south-east England) and in-depth interviews with staff, conducted August 2015-March 2017.
Methods
Three data sources: 1) detailed field notes, 2) observations using a structured tool and checklist for behaviors classed as agitation and staff and institutional responses, 3) staff semi-structured qualitative interviews. We calculated the time participants were agitated and described staff responses. Data sources were analyzed separately, developed continuously and relationally during the study and synthesized where appropriate.
Results
We identified two main âideal typesâ of staff explanatory models for agitation: In the first, staff attribute agitated behaviors to the personâs âmoral judgementâ, making them prone to rejecting or punitive responses. In the second staff adopt a more âneeds-basedâ approach in which agitation behaviors are regarded as meaningful and managed with proactive and investigative approaches. These different approaches appear to have significant consequences for the timing, frequency and quality of staff response. While these models may overlap they tend to reflect distinct organizational resources and values.
Conclusions
Care worker knowledge about agitation is not enough, and staff need organizational support to care better for people living with dementia towards end of life. Positional theory may help to explain much of the cultural-structural context that produces staff disengagement from people with dementia, offering insights on how agitation behavior is reframed by some staff as dangerous. Such behavior may be associated with low-resource institutions with minimal staff training where the personhood of staff may be neglected
Agitation near the end of life with dementia: An ethnographic study of care
Background and objectivesAgitation is common in people living with dementia especially at the end of life. We examined how staff interpreted agitation behavior in people with dementia nearing end of life, how this may influence their responses and its impact on the quality of care.Research designEthnographic study. Structured and semi-structured non-participant observations (referred to subsequently in this paper as "structured observations") of people living with dementia nearing the end of life in hospital and care homes (south-east England) and in-depth interviews with staff, conducted August 2015-March 2017.MethodsThree data sources: 1) detailed field notes, 2) observations using a structured tool and checklist for behaviors classed as agitation and staff and institutional responses, 3) staff semi-structured qualitative interviews. We calculated the time participants were agitated and described staff responses. Data sources were analyzed separately, developed continuously and relationally during the study and synthesized where appropriate.ResultsWe identified two main 'ideal types' of staff explanatory models for agitation: In the first, staff attribute agitated behaviors to the person's "moral judgement", making them prone to rejecting or punitive responses. In the second staff adopt a more "needs-based" approach in which agitation behaviors are regarded as meaningful and managed with proactive and investigative approaches. These different approaches appear to have significant consequences for the timing, frequency and quality of staff response. While these models may overlap they tend to reflect distinct organizational resources and values.ConclusionsCare worker knowledge about agitation is not enough, and staff need organizational support to care better for people living with dementia towards end of life. Positional theory may help to explain much of the cultural-structural context that produces staff disengagement from people with dementia, offering insights on how agitation behavior is reframed by some staff as dangerous. Such behavior may be associated with low-resource institutions with minimal staff training where the personhood of staff may be neglected
Is psychotherapy for depression equally effective in younger and older adults? A meta-regression analysis.
Background: It is well established that psychotherapy is effective in the treatment of depression in younger as well as in older adults. Whether these psychotherapies are equally effective in younger and older age groups has not been examined in meta-analytic research. Methods: We conducted a systematic literature search and included 112 studies with 170 comparisons between a psychotherapy and a control group (with a total of 7,845 participants). Twenty studies with 26 comparisons were aimed at older adults. Results: We found no indication that psychotherapies were more or less effective for older adults compared to younger adults. The effect sizes of both groups of comparisons did not differ significantly from each other (older adults: d = 0.74; 95% CI: 0.49~0.99; younger adults: d = 0.67; 95% CI: 0.58~0.76). In a multivariate meta-regression analysis, in which we controlled for major characteristics of the participants, the interventions and the study designs, no indication of a difference between psychotherapy in younger and older adults was found. Conclusions: There appears to be no significant difference between psychotherapy in younger and older adults, although it is not clear whether this is also true for clinical samples, patients with more severe depression, and the older old
Pirin, an Nrf2-regulated protein, is overexpressed in human colorectal tumors
The evolutionary conserved non-heme Fe-containing protein pirin has been implicated as an important factor in cell proliferation, migration, invasion, and tumour progression of melanoma, breast, lung, cervical, prostate, and oral cancers. Here we found that pirin is overexpressed in human colorectal cancer in comparison with matched normal tissue. The overexpression of pirin correlates with activation of transcription factor nuclear factor erythroid 2 p45-related factor 2 (Nrf2) and increased expression of the classical Nrf2 target NAD(P)H:quinone oxidoreductase 1 (NQO1), but interestingly and unexpectedly, not with expression of the aldo-keto reductase (AKR) family members AKR1B10 and AKR1C1, which are considered to be the most overexpressed genes in response to Nrf2 activation in humans. Using pharmacologic and genetic approaches to either downregulate or upregulate Nrf2, we show that pirin is regulated by Nrf2 in human and mouse cells and in the mouse colon in vivo. The small molecule pirin inhibitor TPhA decreased the viability of human colorectal cancer (DLD1) cells, but this decrease was independent of the levels of pirin. Our study demonstrates the Nrf2-dependent regulation of pirin and encourages the pursuit for specific pirin inhibitors
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