Effectiveness of Personal Protective Equipment for Healthcare Workers Caring for Patients with Filovirus Disease: A Rapid Review

BACKGROUND: A rapid review, guided by a protocol, was conducted to inform development of the World Health Organization’s guideline on personal protective equipment in the context of the ongoing (2013-present) Western African filovirus disease outbreak, with a focus on health care workers directly caring for patients with Ebola or Marburg virus diseases. METHODS: Electronic databases and grey literature sources were searched. Eligibility criteria initially included comparative studies on Ebola and Marburg virus diseases reported in English or French, but criteria were expanded to studies on other viral hemorrhagic fevers and non-comparative designs due to the paucity of studies. After title and abstract screening (two people to exclude), full-text reports of potentially relevant articles were assessed in duplicate. Fifty-seven percent of extraction information was verified. The Grading of Recommendations Assessment, Development and Evaluation framework was used to inform the quality of evidence assessments. RESULTS: Thirty non-comparative studies (8 related to Ebola virus disease) were located, and 27 provided data on viral transmission. Reporting of personal protective equipment components and infection prevention and control protocols was generally poor. CONCLUSIONS: Insufficient evidence exists to draw conclusions regarding the comparative effectiveness of various types of personal protective equipment. Additional research is urgently needed to determine optimal PPE for health care workers caring for patients with filovirus

Checking whether there is an increased risk of post-transplant lymphoproliferative disorder and other cancers with specific modern immunosuppression regimens in renal transplantation: Protocol for a network meta-analysis of randomized and observational studies

BACKGROUND: Patients undergoing renal transplant procedures require multi-agent immunosuppressive regimens both short term (induction phase) and long term (maintenance phase) to minimize the risk of organ rejection. There are several drug classes and agents for immunosuppression. Use of these agents may increase the risk of different harms including not only infections, but also malignancies including post-transplant lymphoproliferative disorder. There is a need to identify which regimens minimize the risk of such outcomes. The objective of this systematic review and network meta-analysis of randomized and observational studies is to explore whether certain modern regimens of immunosuppression used to prevent organ rejection in renal transplant patients are associated with an increased risk of post-transplant lymphoproliferative disorder and other malignancies. METHODS/DESIGN: ‘Modern’ regimens were defined to be those evaluated in controlled studies beginning in 1990 or later. An electronic literature search of Medline, Embase and the Cochrane Central Register of Controlled Trials has been designed by an experienced information specialist and peer reviewed by a second information specialist. Study selection and data collection will be performed by two reviewers. The outcomes of interest will include post-transplant lymphoproliferative disorder and other incident forms of malignancy occurring in adult renal transplant patients. Network meta-analyses of data from randomized and observational studies will be performed where judged appropriate based on a review of the clinical and methodological features of included studies. A sequential approach to meta-analysis will be used to combine data from different designs. DISCUSSION: Our systematic review will include both single-agent and multi-agent modern pharmacotherapy regimens in patients undergoing renal transplantation. It will synthesize malignancy outcomes. Our work will also add to the development of methods for network meta-analysis across study designs to assess treatment safety. TRIAL REGISTRATION: PROSPERO Registration Number: CRD4201300695

Assessing the format and content of journal published and non-journal published rapid review reports : A comparative study

BACKGROUND: As production of rapid reviews (RRs) increases in healthcare, knowing how to efficiently convey RR evidence to various end-users is important given they are often intended to directly inform decision-making. Little is known about how often RRs are produced in the published or unpublished domains, and what and how information is structured. OBJECTIVES: To compare and contrast report format and content features of journal-published (JP) and non-journal published (NJP) RRs. METHODS: JP RRs were identified from key databases, and NJP RRs were identified from a grey literature search of 148 RR producing organizations and were sampled proportionate to cluster size by organization and product type to match the JP RR group. We extracted and formally compared 'how' (i.e., visual arrangement) and 'what' information was presented. RESULTS: We identified 103 RRs (52 JP and 51 NJP) from 2016. A higher percentage of certain features were observed in JP RRs compared to NJP RRs (e.g., reporting authors; use of a traditional journal article structure; section headers including abstract, methods, discussion, conclusions, acknowledgments, conflict of interests, and author contributions; and use of figures (e.g., Study Flow Diagram) in the main document). For NJP RRs, a higher percentage of features were observed (e.g., use non-traditional report structures; bannering of executive summary sections and appendices; use of typographic cues; and including outcome tables). NJP RRs were more than double in length versus JP RRs. Including key messages was uncommon in both groups. CONCLUSIONS: This comparative study highlights differences between JP and NJP RRs. Both groups may benefit from better use of plain language, and more clear and concise design. Alternative innovative formats and end-user preferences for content and layout should be studied further with thought given to other considerations to ensure better packaging of RR results to facilitate uptake into policy and practice. STUDY REGISTRATION: The full protocol is available at: https://osf.io/29xvk/

Feasibility and Cost Optimization Study of Osmotic Assisted Reverse Osmosis Process for Brine Management

Due to the excessive demand to desalinate seawater to satisfy the domestic need in Qatar. This targeted the need to develop safe and cost effective desalination processes with the consideration of stringent regulation for water quality production and wastewater/brine discharge quality. The direct disposal of brines to the environment raised potential negative impact to the aquatic system and therefore the best practice is to minimize the volume of brine production and reuse it for beneficiary application. Several brine-dewatering techniques include both evaporative and non-evaporative approach are capable to dewater high salinity brines with 50-350 g/L of total dissolved solids (TDS). The commonly adopted technology for dewatering brine is mechanical vapor compression , that is known for its significant energy consumption up to 25 kWh/m3 of produced water for 50% of water recovery1. Non-evaporative membrane base technologies are a promising approach to dewater brines with minimum energy usage. Osmotically assisted reverse osmosis (OARO) is an advance membrane based technology for energy efficient and high recovery desalination of saline brine. OARO differ from reverse osmosis (RO) by adding saline sweep on permeate side to reduce osmotic pressure difference across the membrane to generate more water flux. The ongoing research work are based on mathematical/numerical approach that focuses on finding the optimum OARO configuration, inlet hydraulic pressure to avoid membrane burst and cost analysis. However, most of these studies conducted by considering ideal conditions. In this study, an algorithm for simulating OARO process based on MATLAB and Aspen Plus to model membrane calculation and to design process configuration considering the effect of concentration polarization (CP) and reverse solute flux (RSF). The objective is to study the effect of inlet feed concentration and flowrate, sweep concentration and flowrate, inlet hydraulic pressure, number of stages, membrane size and characteristic and module configuration flow. In addition, technical economic analysis to evaluate the economic feasibility of OARO process. The stopping criteria of this model is the quality of water permeate at the feasible operating conditions and the cost. This model demonstrated high potential simulating OARO process to be used as a palate form for the user to predict the behavior of the process by varying operating conditions to desired outcomes

Effective Models of Provider Care in Long-term Care: A Rapid Scoping Review

Final repor

Guidance for using artificial intelligence for title and abstract screening while conducting knowledge syntheses

Abstract Background Systematic reviews are the cornerstone of evidence-based medicine. However, systematic reviews are time consuming and there is growing demand to produce evidence more quickly, while maintaining robust methods. In recent years, artificial intelligence and active-machine learning (AML) have been implemented into several SR software applications. As some of the barriers to adoption of new technologies are the challenges in set-up and how best to use these technologies, we have provided different situations and considerations for knowledge synthesis teams to consider when using artificial intelligence and AML for title and abstract screening. Methods We retrospectively evaluated the implementation and performance of AML across a set of ten historically completed systematic reviews. Based upon the findings from this work and in consideration of the barriers we have encountered and navigated during the past 24 months in using these tools prospectively in our research, we discussed and developed a series of practical recommendations for research teams to consider in seeking to implement AML tools for citation screening into their workflow. Results We developed a seven-step framework and provide guidance for when and how to integrate artificial intelligence and AML into the title and abstract screening process. Steps include: (1) Consulting with Knowledge user/Expert Panel; (2) Developing the search strategy; (3) Preparing your review team; (4) Preparing your database; (5) Building the initial training set; (6) Ongoing screening; and (7) Truncating screening. During Step 6 and/or 7, you may also choose to optimize your team, by shifting some members to other review stages (e.g., full-text screening, data extraction). Conclusion Artificial intelligence and, more specifically, AML are well-developed tools for title and abstract screening and can be integrated into the screening process in several ways. Regardless of the method chosen, transparent reporting of these methods is critical for future studies evaluating artificial intelligence and AML

Assessing how information is packaged in rapid reviews for policymakers and other stakeholders: a cross-sectional study

This study explores the extent to which rapid reviews are a useful information-packaging mechanism based on criteria for communicating clearly to support healthcare policymaking

Synthesis and performance evaluation of nanostructured NaFexCr1-X(SO4)2 cathode materials in sodium ion batteries (SIBs)

This research work focuses on the synthesis and performance evaluation of NaFexCr1-X(SO4)2 (X = 0, 0.8 and 1.0) cathode materials in sodium ion batteries (SIBs). The novel materials having a primary particle size of around 100-200 nm were synthesized through a sol-gel process by reacting stoichiometric amounts of the precursor materials. The structural analysis confirms the formation of crystalline, phase pure materials that adopt a monoclinic crystal structure. Thermal analysis indicates the superior thermal stability of NaFe0.8Cr0.2(SO4)2 when compared to NaFe(SO4)2 and NaCr(SO4)2. Galvanostatic charge/discharge analysis indicates that the intercalation/de-intercalation of a sodium ion (Na+) into/from NaFe(SO4)2 ensues at about 3.2 V due to the Fe2+/Fe3+ active redox couple. Moreover, ex situ XRD analysis confirms that the insertion/de-insertion of sodium into/from the host structure during charging/discharging is accompanied by a reversible single-phase reaction rather than a biphasic reaction. A similar sodium intercalation/de-intercalation mechanism has been noticed in NaFe0.8Cr0.2(SO4)2which has not been reported earlier. The galvanostatic measurements and X-ray photoelectron spectroscopy (XPS) analysis confirm that the Cr2+/Cr3+ redox couple is inactive in NaFexCr1-X(SO4)2 (X = 0, 0.8) and thus does not contribute to capacity augmentation. However, suitable carbon coating may lead to activation of the Cr2+/Cr3+ redox couple in these inactive materials.bDepartment of Chemical Engineering, College of Engineering, Qatar University, P. O. Box 2713, Doha, Qatar cQatar Environment and Energy Research Institute, Hamad Bin Khalifa University, Qatar Foundation, 5825, Doha, Qatar dDepartment of Chemistry & Earth Sciences, College of Arts and Science, Qatar University, P. O. Box 2713, Doha, Qatar eGas Processing Center (GPC), Qatar University, P. O. Box 2713, Doha, QatarScopu

Incidence, causes, and consequences of preventable adverse drug reactions occurring in inpatients: A systematic review of systematic reviews.

BACKGROUND:Preventable adverse drug reactions (PADRs) in inpatients are associated with harm, including increased length of stay and potential loss of life, and result in elevated costs of care. We conducted an overview of reviews (i.e., a systematic review of systematic reviews) to determine the incidence of PADRs experienced by inpatients. Secondary review objectives were related to assessment of the effects of patient age, setting, and clinical specialty on PADR incidence. METHODS:The protocol was registered in PROSPERO (CRD42016043220). We performed a search of Medline, Embase, and the Cochrane Library, limiting languages of publication to English and French. We included published systematic reviews that reported quantitative data on the incidence of PADRs in patients receiving acute or ambulatory care in a hospital setting. The full texts of all primary studies for which PADR data were reported in the included reviews were obtained and data relevant to review objectives were extracted. Quality of the included reviews was assessed using the AMSTAR-2 tool. Both narrative summaries of findings and meta-analyses of primary study data were undertaken. RESULTS:Thirteen systematic reviews encompassing 37 unique primary studies were included. Across primary studies, the PADR incidence was highly varied, ranging from 0.006 to 13.3 PADRs per 100 patients, with a pooled incidence estimate of 0.59 PADRs per 100 patients. Substantial heterogeneity was present across both reviews and primary studies with respect to review/study objectives, patient age, hospital setting, medical discipline, definitions and assessment tools used, event detection methods, endpoints of interest, and units of measure. Thirteen primary studies used prospective event detection methods and had a pooled PADR incidence of 3.13 (2.87-3.38) PADRs per 100 patients; however, extreme statistical heterogeneity (I2 = 97%) indicated this finding should be considered with caution. Subgroup meta-analyses demonstrated that PADR incidence varied significantly with event detection method (prospective > retrospective > voluntary reporting methods), hospital setting (ICU > wards), and medical discipline (medical > surgical). High statistical heterogeneity (I2 > 80%) was present across all analyses, indicating results should be interpreted with caution. Effects of patient age could not be assessed due to poor reporting of age groups used in primary studies. DISCUSSION:The method of event detection appeared to significantly influence PADR incidence, with prospective methods having the highest reported PADR rate. This finding is in agreement with the background literature. High methodological and statistical heterogeneity across primary studies evaluating adverse drug events reduces the validity of the overall PADR incidence derived from the meta-analyses of the pooled data. Data pooled from studies using only prospective methods of event detection should provide an overall estimate closest to the true PADR incidence; however, our estimate should be considered with caution due to the statistical heterogeneity found in this group of studies. Future studies should employ prospective methods of detection. This review demonstrates that the true overall incidence of PADRs is likely much greater than the overall pooled incidence estimate of 0.59 PADRs per 100 patients obtained when event detection method was not taken into consideration