Full Manuscripts Research Articles

CT densitometry in emphysema: a systematic review of its clinical utility.

BackgroundThe aim of the study was to assess the relationship between computed tomography (CT) densitometry and routine clinical markers in patients with chronic obstructive pulmonary disease (COPD) and alpha-1 anti-trypsin deficiency (AATD).MethodsMultiple databases were searched using a combination of pertinent terms and those articles relating quantitatively measured CT densitometry to clinical outcomes. Studies that used visual scoring only were excluded, as were those measured in expiration only. A thorough review of abstracts and full manuscripts was conducted by 2 reviewers; data extraction and assessment of bias was conducted by 1 reviewer and the 4 reviewers independently assessed for quality. Pooled correlation coefficients were calculated, and heterogeneity was explored.ResultsA total of 112 studies were identified, 82 being suitable for meta-analysis. The most commonly used density threshold was −950 HU, and a significant association between CT density and all included clinical parameters was demonstrated. There was marked heterogeneity between studies secondary to large variety of disease severity within commonly included cohorts and differences in CT acquisition parameters.ConclusionCT density shows a good relationship to clinically relevant parameters; however, study heterogeneity and lack of longitudinal data mean that it is difficult to compare studies or derive a minimal clinically important difference. We recommend that international consensus is reached to standardize CT conduct and analysis in future COPD and AATD studies.

The Society of Thoracic Surgeons, The Society of Cardiovascular Anesthesiologists, and The American Society of ExtraCorporeal Technology: Clinical Practice Guidelines-Anticoagulation During Cardiopulmonary Bypass.

Despite more than a half century of "safe" cardiopulmonary bypass (CPB), the evidence base surrounding the conduct of anticoagulation therapy for CPB has not been organized into a succinct guideline. For this and other reasons, there is enormous practice variability relating to the use and dosing of heparin, monitoring heparin anticoagulation, reversal of anticoagulation, and the use of alternative anticoagulants. To address this and other gaps, The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiologists, and the American Society of Extracorporeal Technology developed an Evidence Based Workgroup. This was a group of interdisciplinary professionals gathered to summarize the evidence and create practice recommendations for various aspects of CPB. To date, anticoagulation practices in CPB have not been standardized in accordance with the evidence base. This clinical practice guideline was written with the intent to fill the evidence gap and to establish best practices in anticoagulation therapy for CPB using the available evidence. To identify relevant evidence, a systematic review was outlined and literature searches were conducted in PubMed using standardized medical subject heading (MeSH) terms from the National Library of Medicine list of search terms. Search dates were inclusive of January 2000 to December 2015. The search yielded 833 abstracts, which were reviewed by two independent reviewers. Once accepted into the full manuscript review stage, two members of the writing group evaluated each of 286 full papers for inclusion eligibility into the guideline document. Ninety-six manuscripts were included in the final review. In addition, 17 manuscripts published before 2000 were included to provide method, context, or additional supporting evidence for the recommendations as these papers were considered sentinel publications. Members of the writing group wrote and developed recommendations based on review of the articles obtained and achieved more than two thirds agreement on each recommendation. The quality of information for a given recommendation allowed assessment of the level of evidence as recommended by the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Recommendations were written in the three following areas: (1) heparin dosing and monitoring for initiation and maintenance of CPB; (2) heparin contraindications and heparin alternatives; and (3) reversal of anticoagulation during cardiac operations. It is hoped that this guideline will serve as a resource and will stimulate investigators to conduct more research and to expand on the evidence base on the topic of anticoagulation therapy for CPB.

Review article: the physiological effects and safety of peppermint oil and its efficacy in irritable bowel syndrome and other functional disorders.

Peppermint oil has been used for centuries as a treatment for gastrointestinal ailments. It has been shown to have several effects on gastrointestinal physiology relevant to clinical care and management. To review the literature on peppermint oil regarding its metabolism, effects on gastrointestinal physiology, clinical use and efficacy, and safety. We performed a PubMed literature search using the following terms individually or in combination: peppermint, peppermint oil, pharmacokinetics, menthol, oesophagus, stomach, small intestine, gallbladder, colon, transit, dyspepsia, nausea, abdominal pain, and irritable bowel syndrome. Full manuscripts evaluating peppermint oil that were published through 15 July 2017 were reviewed. When evaluating therapeutic indications, only randomised clinical trials were included. References from selected manuscripts were used if relevant. It appears that peppermint oil may have several mechanisms of action including: smooth muscle relaxation (via calcium channel blockade or direct enteric nervous system effects); visceral sensitivity modulation (via transient receptor potential cation channels); anti-microbial effects; anti-inflammatory activity; modulation of psychosocial distress. Peppermint oil has been found to affect oesophageal, gastric, small bowel, gall-bladder, and colonic physiology. It has been used to facilitate completion of colonoscopy and endoscopic retrograde cholangiopancreatography. Placebo controlled studies support its use in irritable bowel syndrome, functional dyspepsia, childhood functional abdominal pain, and post-operative nausea. Few adverse effects have been reported in peppermint oil trials. Peppermint oil is a natural product which affects physiology throughout the gastrointestinal tract, has been used successfully for several clinical disorders, and appears to have a good safety profile.

Joel Berson: 1936–2017

Joel Berson: 1936–2017

Peer review in scientific journal

Peer review is the critical assessment of manuscripts submitted to scientific journals to facilitate ‘a fair hearing’ by experts in the field, to help authors and editors to improve the quality of reporting. It plays important role to ensure the integrity of research and publication, help maintain trust and ethical conduct of researcher and journal. By and large it is a quality control measure.
 Peer review starts with internal review for the suitability of manuscript to the journal, whether author have followed the guidelines. Normally two experts are sent the manuscript for review to see for the originality of work, study design, methodology, and relevance of the research. When both reviewers advise to accept, or reject the work, the decision is easier for the editor. When there are controversies, the editor may send for 3rd review. The final decision is solely that of the editor.
 Peer review is the basis of good science. Reviewing is a skill that requires to be developed. The reviewers are contacted by journal office, requesting their availability to complete the review within a certain time frame, usually 1-2 weeks. First abstract is sent to and if the reviewer agrees, the full manuscript is made available, either by email or by providing link to the online peer review system. The reviewers are required to declare any conflicts of interest to maintain ethics, keep the information confidential and do not publicly disclose or uses the information for personal gain. All comments regarding the review are communicated to the journal and not to the authors directly. The reviewers are requested for ‘constructive, concise and polite’ comments.

Interrupted versus continuous suturing for vesicourethral anastomosis during radical prostatectomy: protocol for a systematic review and meta-analysis

IntroductionRadical prostatectomy is the mainstay of treatment for prostate cancer. The vesicourethral anastomosis is a critical step, which most likely impacts urinary continence and urethral stenosis. To date, it still...

A Plea for MERSQI: The Medical Education Research Study Quality Instrument.

To describe the quality of educational scholarship presented at a large national conference of obstetrics and gynecology educators. We reviewed Council on Resident Education in Obstetrics and Gynecology-Association of Professors of Gynecology and Obstetrics annual meeting abstracts from 2015 and 2016, published as supplements to Obstetrics & Gynecology. For this uncontrolled observational study, abstracts were reviewed and scored using the Medical Education Research Study Quality Instrument (MERSQI). Comparisons between types of submissions (oral presentations or posters), origin of the report (academic or community), setting (undergraduate, graduate, postgraduate), and focus of the study (tool development or evaluation) were made. Abstracts from award-winning presentations and full manuscripts were compared with the remaining abstracts. One- and two-tailed Student t tests with a two-sample unequal variance (heteroscedastic) test were performed with a significance threshold of P≤.05. One hundred eighty-six abstracts and articles were available, with 101 posters and 77 oral presentations that could be scored in all six of the MERSQI domains. The average MERSQI score was 9.05 (±1.90) with scores ranging from 5 to 13.5 (median 9). Abstracts from full-text articles scored more than 1 point higher than other abstracts (10.2 compared with 9.0, P<.001, Cohen's d=0.72). Statistically significant smaller magnitude differences were found comparing tool development with evaluation, academic with community studies, and for award with nonaward winners. No differences were found comparing oral and poster presentations. The quality of educational scholarship presented at a national meeting of obstetrics and gynecology educators falls within the published range for other specialties. The MERSQI scoring system is a useful method for tracking and benchmarking the quality of medical education scholarship in obstetrics and gynecology.

The economic origins of the postwar southern elite

The U.S. Civil War destroyed a substantial fraction of southern wealth and emancipation transferred human capital to the formerly enslaved. The prevailing view of most economic historians is that the southern planter elite was able to retain its relative status despite these shocks. Previous studies have been hampered, however, by limits on the ability to link individuals between census years, and scholars have been forced to focus on persistence within one or a few counties. Recent advances in electronic access to the Federal Census manuscripts now make it possible to link individuals without these constraints. In this paper, we exploit the ability to search the full manuscript census to construct a sample that links top wealth holders in 1870 to their 1860 census records. Although there was an entrenched southern planter elite that retained their economic status, we find evidence that the turmoil of the 1860s opened greater opportunities for mobility in the South than was the case in the North, resulting in much greater turnover among wealthy southerners than among comparably wealthy northerners.

Audiatur et Altera Pars: The Polish Record of the Działyński Embassy of 1597

The mission of Ambassador Paweł Działyński to Queen Elizabeth in the summer of 1597, conducted on behalf of Sigismund III, King of Poland, and the City of Gdańsk, is usually presented by scholars relying exclusively on English records as an embarrassment to Poland-Lithuania. However, the Polish point of view, expounded at length in the Ambassador’s account of the embassy, gives an entirely different picture and interpretation of the events, far more consistent with the practical outcome for relations between the two states in the following years. The full original manuscript of Mercurius Sarmaticus survives in a major Polish library, and copies are extant elsewhere in Europe. Of particular interest are Działyński’s observations on Elizabeth and the religious situation in her realm. Mercurius Sarmaticus also throws light on the Isle of Dogs incident in the history of the Elizabethan theatre and may be regarded as a Shakespeare source. This article will provide an introduction to the manuscript source, a synopsis of its content, and English translations of selected passages.

Sex Differences and Bone Metastases of Breast, Lung, and Prostate Cancers: Do Bone Homing Cancers Favor Feminized Bone Marrow?

Sex-associated differences in bone metastasis formation from breast, lung, and prostate cancer exist in clinical studies, but have not been systematically reviewed. Differences in the bone marrow niche can be attributed to sexual dimorphism, to genetic variations that affect sex hormone levels, or to the direct effects of sex hormones, natural or exogenously delivered. This review describes the present understanding of sex-associated and sex hormone level differences in the marrow niche and in formation of bone metastasis during the transition of these three cancers from treatable disease to an often untreatable, lethal metastatic one. Our purpose is to provide insight into some underlying molecular mechanisms for hormonal influence in bone metastasis formation, and to the potential influence of sexual dimorphism, genetic differences affecting sex assignment, and sex hormone level differences on the bone niche and its favorability for metastasis formation. We reviewed publications in PubMed and EMBASE, including full length manuscripts, case reports, and clinical studies of relevance to our topic. We focused on bone metastasis formation in breast, lung, and prostate cancer because all three commonly present with bone metastases. Several clear observations emerged. For breast cancer bone metastasis formation, estrogen receptor (ER) signaling pathways indicate a role for ER beta (ERβ). Estrogen influences the bone microenvironment, creating and conditioning a favorable niche for colonization and breast cancer progression. For lung cancer, studies support the hypothesis that females have a more favorable bone microenvironment for metastasis formation. For prostate cancer, a decrease in the relative androgen to estrogen balance or a “feminization” of bone marrow favors bone metastasis formation, with a potentially important role for ERβ that may be similar to that in breast cancer. Long-term estrogen administration or androgen blockade in males may feminize the bone marrow niche to one more favorable for bone metastases in prostate cancer. Administration of androgens in females, especially combined with mastectomy, may reduce risk of developing bone metastatic breast cancer. We conclude that it should be considered that females, those with female-leaning genetic variations, or hormonal states that feminize the bone marrow, may offer favorable sites for bone metastases.

257 - American Heart Association Abstracts to Manuscripts—Barriers to Publication

Background: National conferences serve as an important platform to inform physicians of emerging research but the most effective method for researchers to disseminate their findings is through publications in a peer reviewed journal. Studies have shown that the proportion of abstracts presented at national conferences that eventually get published is low. Aim: We aimed to determine the number of heart failure abstracts presented at the American Heart Association (AHA) Scientific Sessions 2010 that were published by February 2017. In addition, we hoped to identify the determinants of successful publication in a peer-reviewed journal and analyze reasons for failure. Methods: In this pilot study, we collected data on study design, demographics of first and senior authors of the first 584 heart failure abstracts that were accepted to the AHA Scientific Sessions 2010 meeting. We determined the proportion of these abstracts published by February 2017, gender of first and senior authors, and whether studies that were published had different conclusions, results or number of study participants compared to the original abstracts. Results: Of the 584 abstracts reviewed, 266 (45.54%) were published as articles in peer reviewed journals within 7 years of presentation at the conference. In total, 10.68% of senior authors and 27.11% of first authors were female. However, 53.44% of female senior authors published manuscripts of their abstracts compared to 45.15% of male senior authors (P = .23). Similarly, 44.8% of female first authors converted abstracts to manuscripts in comparison to 45.83% of male first authors (P = .80). Among the 266 abstracts that were eventually published as full manuscripts, 60(22.55%) articles reported a different sample size, 178 (66.91%) articles reported different results, and 8(3%) articles published with different conclusions, when compared to their original abstracts. Conclusions: Less than 50% of abstracts presented at the AHA Scientific Sessions 2010 were published as full manuscripts, in over six years since the conference. There was no significant difference in the proportion of first and senior authors of both genders who published abstracts into articles, although in total, far more authors were males. With many studies reporting different sample sizes, results and conclusions compared to the original abstracts, data presented at the abstract stage are likely to be incomplete. It may be premature to use data from abstracts in systematic reviews or secondary analyses. Further analysis is needed to determine the more prevalent barriers so that supportive interventions can be performed to increase successful completion and dissemination of research.

Laryngeal Cysts in Adults: Simplifying Classification and Management.

Objective Laryngeal cysts may occur at any mucosa-lined location within the larynx and account for 5% to 10% of nonmalignant laryngeal lesions. A number of proposed classifications for laryngeal cysts exist; however, no previously published classification aims to guide management. This review analyzes contemporary laryngeal cyst management and proposes a framework for the terminology and management of cystic lesions in the larynx. Data Sources PubMed/Medline. Review Methods A primary literature search of the entire Medline database was performed for all titles of publications pertaining to laryngeal cysts and reviewed for relevance. Full manuscripts were reviewed per the relevance of their titles and abstracts, and selection into this review was according to their clinical and scientific relevance. Conclusion Laryngeal cysts have been associated with rapid-onset epiglottitis, dyspnea, stridor, and death; therefore, they should not be considered of little significance. Symptoms are varied and nonspecific. Laryngoscopy is the primary initial diagnostic tool. Cross-sectional imaging may be required, and future use of endolaryngeal ultrasound and optical coherence tomography may revolutionize practice. Where possible, cysts should be completely excised, and there is growing evidence that a transoral approach is superior to transcervical excision for nearly all cysts. Histology provides definitive diagnosis, and oncocytic cysts require close follow-up. Implications for Practice A new classification system is proposed that increases clarity in terminology, with the aim of better preparing surgeons and authors for future advances in the understanding and management of laryngeal cysts.

The Middle English Bible: A Reassessment

The Middle English Bible: A Reassessment

Job Safety Analysis (Human&amp; Equipment)

Risk assessment, the proactive and systematic assessment of risks, is a standard element of most offshore and maritime companies' safety management systems. Risk assessment is a powerful and flexible tool to identify and control potential undesirable events that can have safety, environmental, quality, or financial repercussions. The focus of these Guidance Notes (prolusion) is risk assessment applied to work tasks, commonly referred to as job safety analysis for human and equipment. This paper will discuss safety of seaman and equipment (JSAHA) before the start of any job. In this regard all safety and errors of any task will be checked and investigated. Moreover, the manner in which the equipment Functions is studied the instruction for the preparation of the full manuscript is detailed in this template file. The template is intended as a tool to assist you in the layout of your manuscript. It is encouraged that this template can be used for submission of manuscripts. Use of the template will save time during production and expedite publication.

Using Patient-Reported Measures in Dialysis Clinics.

Patient-reported outcome measures (PROMs), including patient-reported outcomes (PROs), are one of two primary sources of data about patients on dialysis ([1][1]); the other is biologically based patient data. The Food and Drug Administration definition of a PRO is “any report coming from patients

II Chemistry Conference of West Bahia

The II Chemistry Conference of West Bahia, also well-known as II JornaQui [1], it has become a traditional regional event in the state of Bahia. It was conceived with a proposal on behalf of the Nucleo de Ensino, Pesquisa e Extensao de Quimica (NEPEQ) of the Universidade Federal do Oeste da Bahia (UFOB) in order to improve the quality of the researches in chemistry of the west Bahia. This special issue brings a bit of works presented as poster along the II JornaQui, although henceforth, they were selected as full manuscripts for editorial evaluation. As can be seen, this special issue presents researches on theoretical chemistry with application of computational calculations for intermolecular systems, biological evaluations of nature compounds, determination of physical chemistry parameters of water used for agriculture, studies of inorganic compounds on rice husk produced in west region, as well as a full and brief overview of the pesticides used in this regard. Boaz Galdino de Oliveira (UFOB) Chairman [1] Conference website: http://jornaqui.ufob.edu.br/

Posttransplant Lymphoproliferative Disorder: Otolaryngological Manifestations and Management.

Objective Posttransplant lymphoproliferative disorder (PTLD) is a unifying term for a spectrum of lymphoid expansion entities brought about by immunosuppression and is strongly associated with Epstein-Barr virus (EBV). Otolaryngological findings tend to present early in the clinical course; therefore, disease awareness among otolaryngologists is of utmost importance. This review synthesizes the body of literature pertaining to PTLD involving the head and neck, summarizes contemporary management, and highlights areas for future research. Data Sources PubMed/Medline. Review Methods Primary literature search of the Medline database was performed for all titles published in the past 10 years pertaining to PTLD. The database search included PTLD combined with a collection of otolaryngological MeSH terms. Full manuscripts were reviewed based on relevance of their title and abstract. Selection into this review was according to clinical and scientific relevance. Conclusion Adenotonsillar focus is common in children in whom adenotonsillectomy may be diagnostic and prevents potentially morbid airway obstruction. Sinonasal PTLD may mimic fungal infection. Laryngotracheal involvement predominately presents in children with symptoms of airway obstruction. PTLD limited to the esophagus is rare. Oral PTLD is rare and phenotypically varied. Cutaneous presentation of PTLD is infrequent, yet one-third of cases affects the head and neck. PTLD may present as cervical lymphadenopathy. Implications for Practice PTLD consideration is vital when evaluating posttransplant patients. Children and EBV-seronegative patients should receive otolaryngological follow-up after transplant. PTLD treatment is multidisciplinary and typically led by lymphoma specialists. Formal partnerships between otolaryngologists and transplant centers may improve patient care and research quality.

Systematic reviews and meta-analyses in geriatric oncology.

e21517 Background: Cancer incidence for most malignancies increases with age with the majority diagnosed after age 65. Aging is also associated with an increasing number of major comorbidities and greater risk and consequences of treatment-related complications. Geriatric Oncology has emerged as a subdiscipline within oncology focused on clinical management and research related to the elderly. Methods: A comprehensive search of the English language literature between 1990-2016 was undertaken for systematic reviews or meta-analyses (SRMAs) related to geriatric oncology. Titles, abstracts and full text manuscripts when needed were reviewed. 1,088 potentially eligible records were identified including 703 not limited to elderly patients, 89 not cancer studies and 236 not SRMAs. Results:More than half of 61 eligible studies were published in the last five years including systematic reviews in 42 (69%), meta-analyses in 42 (69%) and both in 23 (40%). Studies came from Europe (30), US (14), Canada (9), Asia (7) and South America (1) with elderly age cutoffs ranging from &gt; 60 to &gt; 80. While 17 reviews included multiple cancer types, 44 were limited to lung cancer (9), colorectal cancer (8), breast cancer (7), multiple myeloma (5) and lymphoma (4). Research focus was survivorship or end-of-life (41), treatment (24), geriatric assessment (11) and supportive care (8). Studies were limited to randomized controlled trials (37), non-RCTs (9) and both (16). The primary outcome was overall survival (39), progression free or relapse-free survival (15), response or recurrence (11), treatment-related toxicity (21) and geriatric assessment or frailty (9). More than half of SRMAs included &lt; 10 studies while 20% included &gt; 30 with the number of subjects in included trials ranging from 153 to &gt; 15,000. Conclusions: The development of Geriatric Oncology has spanned nearly three decades. While a strong evidence base of published research including rigorous SRMAs in Geriatric Oncology has only emerged over the past decade, steady growth across a range of topics and outcomes relevant to cancer in the elderly is apparent.

Bringing International Perspectives to the Communication Curriculum in an Era of Globalization

Abstracts due: July 1, 2017Inivitations to submit full manuscripts: August 1, 2017Initial submissions due: November 1, 2017Acceptance/revision notices: January 1, 2018Revised submissions due: Febru...

Resuscitation in hip fractures: a systematic review

To evaluate the evidence for the resuscitation of patients with hip fracture in the preoperative or perioperative phase of their treatment and its impact on mortality.DesignWe searched MEDLINE, EMBASE, CENTRAL...