Methods and quality of disease models incorporating more than two sexually transmitted infections: a protocol for a systematic review of the evidence

INTRODUCTION: Disease models can be useful tools for policy makers to inform their decisions. They can help to estimate the costs and benefits of interventions without conducting clinical trials and help to extrapolate the findings of clinical trials to a population level.Sexually transmitted infections (STIs) do not operate in isolation. Risk-taking behaviours and biological interactions can increase the likelihood of an individual being coinfected with more than one STI.Currently, few STI models consider coinfection or the interaction between STIs. We aim to identify and summarise STI models for two or more STIs and describe their modelling approaches. METHODS AND ANALYSIS: Six databases (Cochrane, Embase, PLOS, ProQuest, Medline and Web of Science) were searched on 27 November 2018 to identify studies that focus on the reporting of the methodology and quality of models for at least two different STIs. The quality of all eligible studies will be accessed using a percentage scale published by Kopec et al. We will summarise all used approaches to model two or more STIs in one model. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework will be used to report all outcomes. ETHICS AND DISSEMINATION: Ethical approval is not required for this systematic review. The results of this review will be published in a peer-reviewed journal and presented at a suitable conference. The findings from this review will be used to inform the development of a new multi-STI model. PROSPERO REGISTRATION NUMBER: CRD42017076837

Electronic transient spectroscopy from the deep UV to the NIR: unambiguous disentanglement of complex processes

Complex multi-stage relaxation and reaction pathways after the optical excitation of molecules makes the disentanglement of the underlying mechanisms challenging. We present four examples that a new transient spectrometer with excitation fully tunable from the deep UV to the IR and 225 to 1700 nm probing allows for an analysis with greatly reduced ambiguity. The temporal resolution of about 50 fs allows us to resolve all relevant processes. For each example there is a new twist in the sequence of relaxation steps that had previously been overlooked. In malachite green it appears that the importance of the phenyl twisting has been overemphasized and rather a charge transfer state should be considered. In TINUVIN-P the predicted twisting as the driving motion for the ultrafast IC is confirmed and leads to a resolution of the earlier puzzle that the sub-5 ps regime shows kinetics deviating from a pure cooling process despite the sub-ps proton transfer cycle. For the bond cleavage of Ph2CH-Cl and Ph2CH-Br the degree of electron transfer within the radical pair can now be determined quantitatively and leads to a profound understanding of the long term cation yield. For the first time coherent wavepacket motion in the photoproducts is reported. Last but not least the measurement of the GSB recovery in the deep UV allows for the surprising result, that even after S-2 excitation of cyclopentenones the triplet states are reached with near unity probability within a few picoseconds

The effect of coaching on the simulated malingering of memory impairment

<p>Abstract</p> <p>Background</p> <p>Detecting malingering or exaggeration of impairments in brain function after traumatic brain injury is of increasing importance in neuropsychological assessment. Lawyers involved in brain injury litigation cases routinely coach their clients how to approach neuropsychological testing to their advantage. Thus, it is important to know how robust assessment methods are with respect to symptom malingering or exaggeration.</p> <p>Methods</p> <p>The influence of different coaching methods on the simulated malingering of memory impairments is investigated in neurologically healthy participants using the Short-Term-Memory Test from the Bremer Symptom-Validierung (STM-BSV). Cut-offs were derived from patients with mild to severe traumatic brain injury. For comparison purposes, the German adaptation of the Rey Auditory Verbal Learning Test (AVLT), and the Rey 15 Items Test (FIT) were additionally administered. Four groups of neurologically healthy subjects were instructed to (1) perform as best as they can, (2) simulate brain injury, (3) simulate brain injury and received additional information about the sequelae of head trauma, (4) simulate brain injury and received additional information on how to avoid detection. Furthermore, a group of patients with mild to severe closed head injury performed the tests with best effort.</p> <p>Results</p> <p>The naïve simulator and the symptom coached groups were the easiest to detect, whereas the symptom plus test coached group was the hardest to detect. The AVLT and the FIT were not suited to detect simulators (sensitivities from 0% to 50.8% at 75% specificity) whereas the STM-BSV detected simulators with 67% – 88% sensitivity at a specificity of 73%. However, the STM-BSV was not robust to coaching.</p> <p>Conclusion</p> <p>The present investigation shows that symptom validity testing as implemented in the BSV-STM is one clinically useful element in the detection of memory malingering. However, clinicians have to be aware that coaching influences performance in the test.</p

Music-supported training is more efficient than functional motor training for recovery of fine motor skills in stroke patients

MOTOR IMPAIRMENTS ARE COMMON AFTER STROKE but efficacious therapies for these dysfunctions are scarce. Extending an earlier study on the effects of music-supported training (MST), behavioral indices of motor function were obtained before and after a series of training sessions to assess whether this new treatment leads to improved motor functions. Furthermore, music-supported training was contrasted to functional motor training according to the principles of constraint-induced therapy (CIT). In addition to conventional physiotherapy, 32 stroke patients with moderately impaired motor function and no previous musical experience received 15 sessions of MST over a period of three weeks, using a manualized, step-bystep approach. A control group consisting of 15 patients received 15 sessions of CIT in addition to conventional physiotherapy. A third group of 30 patients received exclusively conventional physiotherapy and served as a control group for the other three groups. Fine as well as gross motor skills were trained by using either a MIDI-piano or electronic drum pads programmed to emit piano tones. Motor functions were assessed by an extensive test battery. MST yielded significant improvement in fine as well as gross motor skills with respect to speed, precision, and smoothness of movements. These improvements were greater than after CIT or conventional physiotherapy. In conclusion, with equal treatment intensity, MST leads to more pronounced improvements of motor functions after stroke than CIT

Interplay of fixed points in scalar models

We performed the renormalization group analysis of scalar models exhibiting spontaneous symmetry breaking. It is shown that an infrared fixed point appears in the broken symmetric phase of the models, which induces a dynamical scale, that can be identified with the correlation length. This enables one to identify the type of the phase transition which shows similarity to the one appearing in the crossover scale. The critical exponent $\nu$ of the correlation length also proved to be equal in the crossover and the infrared scaling regimes.Comment: 11 pages, 4 figure

Cemented vs screw-retained zirconia-based single implant reconstructions: A 3-year prospective randomized controlled clinical trial

OBJECTIVES The objective of the present randomized clinical trial was to test whether or not the use of screw-retained all ceramic implant-borne reconstructions results in clinical, technical, and biologic outcomes similar to those obtained with cemented all ceramic reconstructions. The hypothesis was that there is no difference in clinical, technical, and biological parameters between the two types of retention. MATERIALS AND METHODS Forty-four patients randomly received 20 cemented reconstruction (CR) and 24 screw-retained (SR) all ceramic single crowns on two-piece dental implants with nonmatching implant-abutment junctions. All patients were recalled after crown insertion, at 6 months, 1 year, as well as at 3 years. At these visits, biological and radiographic evaluations were performed. Technical outcomes were assessed using modified USPHS (United States Public Health Service) criteria. Data were statistically analyzed with Wilcoxon-Mann-Whitney, Wilcoxon and Fisher exact tests. RESULTS During 3 years of follow-up, eight patients (18.2%) lost the reconstruction due to technical (6 patients, 13.6%, 2 CR and 4 SR group) or biological complications (2 patients, 4.5%, only CR group). Thirty-two subjects with 18 SR and 14 CR reconstructions attended the FU-3Y, whereas four patients (9.1%, 2 SR, 2 CR) were not available (drop-outs). Biological, technical, and radiographic outcomes did not differ significantly between the groups (P > 0.05). One implant (2.3%) was lost in the CR group. One more cemented crown (2.3%) had to be removed because of peri-implant disease. Six patients (13.6%) lost the reconstructions due to a fracture of the zirconia abutment (4 SR, 2 CR). The mean marginal bone level at 3 years was -0.4 mm (-0.5; -0.3) in group SR and - 0.4 mm (-0.6; -0.3) group CR (P = 0.864). CONCLUSIONS At 3 years, CR and SR exhibited similar survival technical, biological and radiographic outcomes. The rate of technical complications was high in both groups

Development of a chlamydia infection model for evaluating costs and outcomes of health interventions

Introduction: Chlamydia is a very common bacterial sexual transmitted infection (STI) among young adults. High numbers of asymptomatic cases hamper a timely treatment start, whereas the treatment itself is efficient and cheap. Proactive screening can decrease this mismatch. There are many models which are able to evaluate and simulate different screening options. Most of them though are based on old or insufficient data, are not accessible for everybody, or are not designed in a user-friendly way. Aim: We want to determine the feasibility of developing an easy-to-use chlamydia infection model, which can be easily updated to reflect changes in medical knowledge. Methods: Starting with a literature review, we have set up a chlamydia infection model. This model was refined with the help of STI experts. The model was implemented by using the programming language Java (version 1.6). We validated the model using internal and external validation methods. Results: The implementation of the model allows users to edit all parameters. The model consists of two separate sub-models. One sub-model simulates health effects of chlamydia for individuals, including the different outcomes in males and females. The other sub-model tracks the spreading of chlamydia within the computed cohort and regards heterosexual as well as homosexual partnerships. Both sub-models are independent of each other and therefore easily exchangeable. The overall model can be kept up to date by either updating single parameters of the model or exchanging a sub-model. The model can be operated by graphical user interfaces to enable non-health economists and non-modelling experts to work with this disease model. Discussion: We showed the feasibility of implementing an easy-to-use chlamydia model. This study can be regarded as a step towards developing more user-friendly decision support tools in health economics to assist decision makers in medicine

Tracking serendipitous interactions: How individual cultures shape the office

In many work environments, serendipitous interactions between members of different groups may lead to enhanced productivity, collaboration and knowledge dissemination. Two factors that may have an influence on such interactions are cultural differences between individuals in highly multicultural workplaces, and the layout and physical spaces of the workplace itself. In this work, we investigate how these two factors may facilitate or hinder inter-group interactions in the workplace. We analyze traces collected using wearable electronic badges to capture face-to-face interactions and mobility patterns of employees in a research laboratory in the UK. We observe that those who interact with people of different roles tend to come from collectivist cultures that value relationships and where people tend to be comfortable with social hierarchies, and that some locations in particular are more likely to host serendipitous interactions, knowledge that could be used by organizations to enhance communication and productivity.This work was supported by the Google Europe Fellowship in Mobile Computing.This is the author accepted manuscript. The final version is published in the Proceedings of the ACM Conference on Computer Supported Cooperative Work and Social Computing and can be found in the ACM digital library here: http://dl.acm.org/citation.cfm?doid=2531602.2531641