Search Hits Research Articles

Identifying influential nodes in complex networks based on global and local structure

Identifying influential nodes in complex networks is still an open issue. A number of measures have been proposed to improve the validity and accuracy of the influential nodes in complex networks. In this paper, we propose a new method, called GLS, to identify influential nodes. This method aims to determine the influence of the nodes themselves, while combining the structural characteristics of the network. This method considers not only the local structure of the network but also its global structure. The influence of the global structure is measured by its closeness to all other nodes in the network, but the influence of local structures only considers the influence contribution of the nearest neighbor nodes. To evaluate the performance of GLS, we use the Susceptible-Infected-Recovered (SIR) model to examine the spreading efficiency of each node, and compare GLS with PageRank, Hyperlink Induced Topic Search (Hits), K-shell, H-index, eigenvector centrality (EC), closeness centrality (CC), ProfitLeader, betweenness centrality (BC) and Weighted Formal Concept Analysis (WFCA) on 8 real-world networks. The experimental results show that GLS can rank the spreading ability of nodes more accurately and more efficiently than other methods.

Patient-Centered Outcomes From Multiparametric MRI and MRI-Guided Biopsy for Prostate Cancer: A Systematic Review.

ObjectiveTo identify and characterize patient-centered outcomes (PCOs) relating to multiparametric MRI (mpMRI) and MRI-guided biopsy as diagnostic tests for possible prostate cancer.MethodsMedline via OVID, EMBASE, PsycInfo, and the Cochrane Central register of Controlled Trials (CENTRAL) were searched for relevant articles. Hand searching of reference lists and snowballing techniques were performed. Studies of mpMRI and MRI-guided biopsy that measured any PCO were included. There were no restrictions placed on year of publication, language, or country for study inclusion. All database search hits were screened independently by two reviewers, and data were extracted using a standardized form.ResultsOverall, 2,762 database search hits were screened based on title and abstract. Of these, 222 full-text articles were assessed, and 10 studies met the inclusion criteria. There were 2,192 participants featured in the included studies, all of which were conducted in high-income countries. Nineteen different PCOs were measured, with a median of four PCOs per study (range 1-11). Urethral bleeding, pain, and urinary tract infection were the most common outcomes measured. In the four studies that compared mpMRI or MRI-guided biopsy to transrectal ultrasound biopsy, most adverse outcomes occurred less frequently in MRI-related tests. These four studies were assessed as having a low risk of bias.DiscussionPCOs measured in studies of mpMRI or MRI-guided biopsy thus far have mostly been physical outcomes, with some evidence that MRI tests are associated with less frequent adverse outcomes compared with transrectal ultrasound biopsy. There was very little evidence for the effect of mpMRI and MRI-guided biopsy on emotional, cognitive, social, or behavioral outcomes.

Maternal plasma levels of oxytocin during physiological childbirth \u2013 a systematic review with implications for uterine contractions and central actions of oxytocin

BackgroundOxytocin is a key hormone in childbirth, and synthetic oxytocin is widely administered to induce or speed labour. Due to lack of synthetized knowledge, we conducted a systematic review of maternal plasma levels of oxytocin during physiological childbirth, and in response to infusions of synthetic oxytocin, if reported in the included studies.MethodsAn a priori protocol was designed and a systematic search was conducted in PubMed, CINAHL, and PsycINFO in October 2015. Search hits were screened on title and abstract after duplicates were removed (n = 4039), 69 articles were examined in full-text and 20 papers met inclusion criteria. As the articles differed in design and methodology used for analysis of oxytocin levels, a narrative synthesis was created and the material was categorised according to effects.ResultsBasal levels of oxytocin increased 3–4-fold during pregnancy. Pulses of oxytocin occurred with increasing frequency, duration, and amplitude, from late pregnancy through labour, reaching a maximum of 3 pulses/10 min towards the end of labour. There was a maximal 3- to 4-fold rise in oxytocin at birth. Oxytocin pulses also occurred in the third stage of labour associated with placental expulsion. Oxytocin peaks during labour did not correlate in time with individual uterine contractions, suggesting additional mechanisms in the control of contractions. Oxytocin levels were also raised in the cerebrospinal fluid during labour, indicating that oxytocin is released into the brain, as well as into the circulation. Oxytocin released into the brain induces beneficial adaptive effects during birth and postpartum.Oxytocin levels following infusion of synthetic oxytocin up to 10 mU/min were similar to oxytocin levels in physiological labour. Oxytocin levels doubled in response to doubling of the rate of infusion of synthetic oxytocin.ConclusionsPlasma oxytocin levels increase gradually during pregnancy, and during the first and second stages of labour, with increasing size and frequency of pulses of oxytocin. A large pulse of oxytocin occurs with birth. Oxytocin in the circulation stimulates uterine contractions and oxytocin released within the brain influences maternal physiology and behaviour during birth. Oxytocin given as an infusion does not cross into the mother’s brain because of the blood brain barrier and does not influence brain function in the same way as oxytocin during normal labour does.

The risk of cytomegalovirus infection in daycare workers: a systematic review and meta-analysis.

The primary aim of this review was to summarize the evidence on the relationship between being a daycare worker working with children and the possible increased risk of cytomegalovirus infection. We searched the Medline and Embase databases using search strings defined according to the population, exposure, comparison, and outcomes (PECO) applicable to our research questions in order to find studies published since 2000. Two independent reviewers evaluated the search hits using predefined inclusion and exclusion criteria. A manual search was performed to identify additional relevant literature. We extracted the resulting studies and assessed them in eight domains of bias. The pooled CMV seroprevalence for daycare workers compared to the general population was calculated. After evaluating the 6879 records, six methodologically adequate studies were identified: five cross-sectional studies and one cohort study. The pooled seroprevalence of daycare workers was 59.3% (95% CI 47.6-70.9). The four studies investigating risk of infection indicated an increased seroprevalence for daycare workers compared to a reference population (prevalence ratio, PR = 1.54, 95% CI 1.33-1.77). No study evaluated CMV seroconversions for daycare workers. Our findings suggest a higher CMV seroprevalence for daycare workers compared to the general population. Notwithstanding the need for longitudinal and intervention studies, preventative efforts are needed. A pooled PR of 1.54 is compatible with a doubled seroconversion risk corresponding to a vocational probability of 50% if the substantial underestimation of the actual occupational seroconversion risk by prevalence-based estimators is considered.

Are Daycare Workers at a Higher Risk of Parvovirus B19 Infection? A Systematic Review and Meta-Analysis.

Objective: In this systematic review, we aimed to summarize the evidence on the association between being a daycare educator working with children and the possible increased risk of parvovirus B19 infection compared to the general population. Methods: The Medline and Embase databases were searched using a defined search to find studies published since 2000. Two reviewers evaluated the search hits using predefined inclusion and exclusion criteria. The resulting studies were extracted and were assessed in eight domains of bias. A pooled relative risk (RR) of parvovirus infection for daycare workers compared to the general population was calculated. Results: After evaluating the 7781 search hits and manual search, four methodologically-adequate studies were identified: three cross-sectional studies and one retrospective cohort study. Of the three studies investigating the risk of infection, one evaluated parvovirus B19 seroconversion rates for daycare workers. There was an indication for an increased risk for daycare workers compared to the unexposed population (RR = 1.12, 95% CI 0.98–1.27) using prevalence estimators. Furthermore, daycare workers had a higher seroconversion rate compared to the unexposed population (RR = 2.63, 95% CI 1.27–5.45) in the low risk of bias study. Conclusions: Our findings suggest a higher risk of parvovirus B19 infection for daycare workers compared to an unexposed comparison population, which necessitate preventative efforts. Considering the underestimation of the occupational seroconversion risk by prevalence-based estimators, parvovirus B19 infections among daycare workers might mostly be occupationally acquired.

Frailty Assessment Scales for the Elderly and their Application in Primary Care: A Systematic Literature Review.

BackgroundThe increase in the elderly population is causing changes and challenges that demand a comprehensive public health response. A specific characteristic of the elderly is their frailty. Today’s problems with identifying levels of frailty are being resolved by numerous tools in the form of frailty assessment scales. This systematic review establishes which frailty assessment scales for the elderly are being used and what their applicability in primary care is like in Slovenia and around the world.MethodsDocuments published after 2010 were searched for in the PubMed database using keywords and other specific criteria.ResultsA total of 177 search hits were obtained based on various search strings. The final analysis included 28 articles, of which three were systematic literature reviews. These three covered quantitative studies, mainly consisting of observational cross-sectional surveys or cohort studies. Three other studies featured non-systematic literature reviews. Quantitative studies (mainly cross-sectional surveys or cohort studies) prevailed among the remaining 22 articles. One study had a qualitative design (Delphi method). The main outcome measures observed by all studies were frailty assessment scales for the elderly, the majority of which were evaluated on a sample of the elderly.ConclusionsNone of the assessment scales examined are used as the gold standard for primary care. A variety of tools are being used in clinical practice to assess frailty in elderly patients, highlighting the need for standardization and guidelines. This requires evaluating the current assessment scales in terms of validity and reliability, and suitably improving them.

The Effects of Publicized Suicide Deaths on Subsequent Suicide Counts in Israel

This study investigated associations between indiscriminate media reporting of suicides and later inflated suicide counts among Israel's general population between the years 2008 and 2012. Self-inflicted deaths that received post-suicide media exposure (referred to as “publicized suicides”) were selected via Google news search-hit appraisals. Distributions of suicides were inspected and risk ratios (RRs) estimated by comparing population suicide rates 4 weeks before and 4 weeks after each publicized suicide (“reference” vs. “affected” periods, respectively). Poisson time series regression was employed to account also for secular trends and seasonality. A total of 2,119 people died by suicide, 13 of whom received noticeable media attention throughout the study. No meaningful impact following the 13 deaths on subsequent suicide counts during the observation window (affected vs. reference phase) was found. Poisson regression confirmed that suicide counts following publicized suicides were independent of media coverage. Given the pronounced search hits following the publicized suicides developing regulation practices that constrain indiscreet media reporting should officially be included as part of suicide prevention practices. Future research should focus on imitation suicide effects as a function of post-suicide media exposure, while including both risk and protective factors.

Development and implementation of a national quality improvement skills curriculum for urology residents in the United Kingdom: A prospective multi-method, multi-center study

BackgroundSurgical quality improvement (QI) is a global priority. We report the design and proof-of concept testing of a QI skills curriculum for urology residents. Methods‘Umbrella review’ of QI curricula (Phase-1); development of draft QI curriculum (Phase-2); curriculum review by Steering Committee of urologists (Attendings & Residents), QI and medical education experts and patients (Phase-3); proof-of-concept testing (Phase-4). ResultsPhase-1: Six systematic reviews were identified of 4332 search hits. Most curricula are developed/evaluated in the USA; use mixed teaching methods (incl. didactic, QI exercises & self-reflection); and introduce core QI techniques (e.g., Plan-Do-Study-Act). Phase-2: curriculum drafted. Phase-3: the curriculum was judged to represent state-of-the-art, relevant QI training. Stronger patient involvement element was incorporated. Phase-4: the curriculum was delivered to 43 urology residents. The delivery was feasible; the curriculum implementable; and a knowledge-skills-attitudes evaluation approach successful. ConclusionWe have developed a practical QI curriculum, for further evaluation and national implementation.

Kolokasi Bahasa Inggris Dalam Tugas Akhir Mahasiswa: Analisis Berbasis Frekuensi Dengan Google Sebagai Korpus

This study aims to analyze the search results’ frequency of collocations used by students of English Program, Vocational College UGM in their graduating papers (Tugas Akhir) and to show how Google can be used as a practical online corpus for collocations query. Collocations are words that co-occur together in any text and have fixed association. The use of collocations is part of linguistic awareness which determines how language is used in its natural state. Through corpus-based analyses, 1000 collocations are randomly chosen from 10 graduating papers (100 collocations per graduating paper). Using Google search engine, each collocation is entered as key words to find out the frequency of its search hits. The frequency is subsequently categorized into high frequency, medium frequency, and low frequency. From the 1000 collocations, 802 (80.2%) collocations belong to high-frequency collocations, 120 (12%) collocations are in the category of medium frequency, and 78 (7.8%) collocations are categorized as low-frequency collocations. The results indicate that students have shown good level of accuracy in using collocations in their academic writing.

Structure-based virtual screening and ADME/T-based prediction analysis for the discovery of novel antifungal CYP51 inhibitors.

With the increasing incidence of pathogenic fungi and drug-resistant fungi in clinic, it has become very important to develop the novel rate-limiting enzyme 14α-demethylase (CYP51) as an antifungal inhibitor. In this study, a method involving structure-based virtual screening was employed. First, a publicly available database was obtained from the Dow Chemical Company, and the database was screened by the designed pharmacophore model of CYP51 inhibitors. Then, the pharmacophore search hits were docked into the CYP51 crystal structure. Finally, sixteen compounds were selected for in vitro antifungal inhibition assay, and most of the compounds showed a certain degree of antifungal activity. In particular, compounds 3, 4, and 9 exhibited significant antifungal and anti-drug resistance activities by blocking the synthesis of ergosterol. The molecular docking and ADME/T properties of the compounds 3, 4, and 9 were further predicted, and the results indicated that they can form hydrophobic and coordination interactions with the active sites of CYP51. At the same time, compounds 4 and 9 showed promising drug-like properties. This study reveals that the compounds can be further optimized and developed as lead compounds.

Google Scholar como una fuente de evaluación científica: una revisión bibliográfica sobre errores de la base de datos

Google Scholar es un motor de búsqueda académico y herramienta de descubrimiento lanzada por Google (ahora Alphabet) en noviembre de 2004. El hecho de que para cada registro bibliográfico se proporcione información acerca del número de citas recibidas por dicho registro desde el resto de registros indizados en el sistema (independientemente de su fuente) ha propiciado su utilización en análisis bibliométricos y en procesos de evaluación de la actividad académica, especialmente en Ciencias Sociales y Humanidades. No obstante, la existencia de errores, en ocasiones de gran magnitud, ha provocado su rechazo y crítica por una parte de la comunidad científica. Este trabajo pretende precisamente realizar una revisión bibliográfica exhaustiva de todos los estudios que de forma monográfica o colateral proporcionan alguna evidencia empírica sobre cuáles son los errores cometidos por Google Scholar (y productos derivados, como Google Scholar Metrics y Google Scholar Citations). Los resultados indican que el corpus bibliográfico dedicado a los errores en Google Scholar es todavía escaso (n= 49), excesivamente fragmentado, disperso, con resultados obtenidos sin metodologías sistemáticas y en unidades no comparables entre sí, por lo que su cuantificación y su efecto real no pueden ser caracterizados con precisión. Ciertas limitaciones del propio buscador (tiempo requerido de limpieza de datos, límite de citas por registro y resultados por consulta) podrían ser la causa de esta ausencia de trabajos empíricos.

Trends in biological control: public interest, international networking and research direction

We investigated trends in biological control to both capture its evolution and explore future opportunities. We examined recent changes in public interest, international networking and peer-reviewed research. A Google Trends analysis revealed that the popularity of biological control is decreasing in terms of search hits on the internet. This trend is potentially worrying for the biological control community, given that public interest tends to drive political decisions regarding regulatory processes and governmental funding of research. To examine patterns of international collaboration, we established the list of authors who published their work in the three main biological control journals from the early 1990s to 2016. International co-authorship has intensified and the biological control sector is increasingly characterized by multilateral collaboration. We surveyed papers published in BioControl and Biological Control over the last 25 years to identify research trends with respect to target pests, commodities, biological control agents and biological control approaches. Finally, we report that articles on biological control are published in the broad-based scientific journals Science and Nature on a regular basis. This reflects contributions that biological control research makes to scientific discussions in general. Our analyses revealed a thriving scientific discipline with several major research trends in arthropod, plant pathogen and weed biological control.

Abbreviation of kampo formulations and basic terminology in kampo medicine

ABSTRACTInternational standards regarding traditional medicine – particularly the International Organization for Standardization/Technical Committee (ISO/TC) 249 – are currently being debated. Kampo extract formulations of standardized quality are one area in which Japanese kampo medicines have a global advantage. While there is increasing medical evidence regarding the efficacy of kampo extract formulations such as daikenchuto and yokukansan, one issue in documenting this evidence is how to describe kampo formulations using English notation. Researchers currently use abbreviations for kampo formulations, which has led to some confusion. There is also a need for a system of English notation to facilitate searches on PubMed and other search engines by researchers in countries that do not use Chinese characters. We have therefore developed a system of abbreviated English notation for kampo formulations in order to aid the global expansion of kampo medicine. Our proposed system targets the 298 kampo formulations, including over‐the‐counter kampo extract formulations, which appear in the 2013 New Guidebook on Nonprescription Kampo Formulas. When developing the abbreviations, we investigated the notation used to express kampo formulas in academic articles on kampo identified using the PubMed search engine. Various notations were used in the literature for daikenchuto, which is a typical kampo extract formulation, and the number of articles located differed according to the search term, thus demonstrating the need to create a system of abbreviations. We used the following four guidelines in creating the abbreviations: (i) abbreviations are generally selected by choosing three letters contained in the romanized name/notation of the kampo formulation; (ii) when multiple kampo formulations have the same abbreviation, priority is given to the formulation with the most search hits on PubMed; (iii) when multiple kampo formulations have the same abbreviation, we select the one already in use; and (iv) for kampo formulations containing herbal additives, the basic structure of the name is maintained and the name of the additive is abbreviated and added to the end. Based on these four guidelines, we submitted the proposed system of abbreviations for joint discussion by the Medical and Pharmaceutical Society for Wakan‐Yaku and the Japan Society for Oriental Medicine (JSOM) in August 2014. We then sought public comment on the proposed system in October 2014 and, after receiving various suggestions for revision and corrections, the system of abbreviations for these 298 kampo formulations was established. The Committee for Vocabulary in JSOM has been overseeing Japanese terminology in kampo medicine since 1969. Approximately 300 basic terms were selected for English translation in 2014–2015. These terms are based on the terms in International Classification of Disease (ICD)‐11. These terms have been translated into English and await future publication (planned for 2018).

Side effects of radiotherapy in breast cancer patients : The Internet as an information source.

Breast cancer is the most common cancer type among women necessitating adjuvant radiotherapy. As the Internet has become amajor source of information for cancer patients, this study aimed to evaluate the quality of websites giving information on side effects of radiotherapy for breast cancer patients. Apatients' search for the English terms "breast cancer - radiotherapy - side effects" and the corresponding German terms "Brustkrebs - Strahlentherapie - Nebenwirkungen" was carried out twice (5months apart) using the search engine Google. The first 30search results each were evaluated using the validated 16-question DISCERN Plus instrument, the Health on the Net Code of Conduct (HONcode) certification and the Journal of the American Medical Association (JAMA) benchmark criteria. The overall quality (DISCERN score) of the retrieved websites was further compared to queries via Bing and Yahoo search engines. The DISCERN score showed agreat range, with the majority of websites ranking fair to poor. Significantly superior results were found for English websites, particularly for webpages run by hospitals/universities and nongovernmental organizations (NGO), when compared to the respective German categories. In general, only aminority of websites met all JAMA benchmarks and was HONcode certified (both languages). We did not determine a relevant temporal change in website ranking among the top ten search hits, while significant variation occurred thereafter. Mean overall DISCERN score was similar between the various search engines. The Internet can give breast cancer patients seeking information on side effects of radiotherapy an overview. However, based on the currently low overall quality of websites and the lack of transparency for the average layperson, we emphasize the value of personal contact with the treating radio-oncologist in order to integrate and interpret the information found online.

Coordination of health-service provision in humanitarian crises: a systematic review of suggested models

BackgroundNational and international humanitarian relief organizsations play an important part in humanitarian crises. There is evidence of lack of coordination between organisations providing health services in public health emergencies. Our objective was to identify published models of coordination between organisations funding or delivering health services in situations of humanitarian crisis worldwide. MethodsWe followed standard systematic review methodology. We searched Medline (1946 to week 1 of March, 2014), PubMed, EMBASE (1980 to week 10 of 2014), the Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and the WHO Global Health Library. We only included papers published in English. We used search terms such as “refugee”, “disaster”, “conflict”, “coordination”, “cooperation”, “international organization” and “non profit organization”. Two teams of two reviewers screened titles and abstracts in duplicate and independently for potential eligibility, retrieved full texts of citations judged as potentially eligible by at least one reviewer, screened full texts in duplicate and independently for eligibility, and resolved disagreement by discussion. When disagreement was not resolved, a third reviewer made the final decision. We also searched websites of relevant organisations. One reviewer reviewed titles of search hits. We then obtained full texts of articles identified as potentially eligible, and two reviewers screened them in duplicate and independently, compared their results, and resolved any disagreement by discussion. We included reports describing models of coordination in sufficient detail to allow reproducibility. We also included reports describing implementation of identified models as case studies. FindingsOur search captured 14 309 citations. The screening process identified five models of coordination of delivering health services: the health cluster approach (with 15 case studies), the “who is where, when, doing what” mapping tool (4Ws; four case studies), the sphere project model (two case studies), the 5×5 model (one case study), and the model of information coordination (one case study). The 4Ws and 5x5 models focused on coordination of services for mental health, while the remaining models did not focus on a specific health topic. The health cluster approach appeared to be the most widely used. One case study used a mixed implementation of the health cluster approach and the sphere model. We did not identify any model of coordination related to funding of health services. InterpretationThis systematic review identified three proposed coordination models that have been implemented by organisations funding or delivering health services in situations of humanitarian crisis. There is a need to compare the effectiveness and efficiency of these different models. FundingAlliance for Health Policy and Systems Research, National Council for Scientific Research.

Issues of aquatic experimentation in research on marine finfish larval production in Europe and North America

AbstractThe aim of this review was to examine practices in academic research focusing on production of larvae of European marine fish species. The literature spanned peer‐reviewed articles over the years 1977–2014 for the main commercially produced marine species: Atlantic cod, halibut, sea bream, sea bass and turbot. Search hits were categorized into the main themes basic biology, natural habitat studies and aquaculture, and the latter theme further subdivided into nutrition, health, reproduction and production factor studies. In total, 74 of the production factor studies were thoroughly examined in terms of overall research structure, study designs, methods, analyses and reporting practices. A picture of a fragmented whole with many isolated contributors and limited cooperation appeared, and despite the multivariate nature and high complexity of the area, isolated and low replicated studies focusing on one variable at the time dominated. Randomization and blinding procedures were rarely accounted for, and a need to standardize practical conduct of research in terms of physical infrastructure, biological material used, control of tank environment, sampling, tank tending and response measurements appeared. Issues of statistical analysis were also apparent, spanning the choice of main techniques and follow‐up contrast procedures and Pseudoreplication. Additionally, the reporting of designs, analyses and results was often incomplete. Consequences of the different issues are discussed, and possible remedies proposed. The findings are in accordance with conclusions from contemporary studies addressing scientific quality and methodological issues at other areas of research.

Title: Progression-Free Survival 2 in Hematological Cancer Treatment Choices: Challenges to Routine Use

Background: In 2012, the European Medicines Agency (EMA) recommended the use of progression-free survival (PFS) 2 as a secondary endpoint in trials evaluating maintenance treatment in hematology oncology trials. PFS2 is defined by the EMA as time from randomization to objective tumor progression on next-line treatment or death from any cause. Potential benefits of PFS2 may be found in cases where experimental treatments appear to improve PFS but not overall survival (OS), particularly in situations with improved survival but where measurement of OS is confounded, for example when drugs are trialed in early lines of therapy and subsequently coupled with improved salvage treatments. However, in practice the utility of this endpoint may seem unclear in cases where tumor cells undergo molecular or microenvironment changes without obvious clinical progression. Currently, the US Food and Drug Administration (FDA) does not recognize this end point and in our experience, healthcare providers are unsure of its definition or value.Objective: To understand the current definitions and limitations of PFS2 from a review of the literature and registered clinical trials in the context of PFS.Methods: We undertook a pragmatic literature review relating to PFS and PFS2. Sources investigated included peer-reviewed literature, clinicaltrials.gov, horizon scanning and health technology appraisal (HTA) activities, and 'grey literature' sources. After review of the search hits, information was grouped according to the therapy area and type of information and the main themes and questions identified.Results: We identified a range of specific challenges and issues regarding each endpoint. For PFS, we noted ongoing debates across disease areas. These principally related to the interpretation of clinical trial evidence: expert clinical opinion routinely highlighted concerns about statistical issues and bias arising from censoring, missing data, subjectivity and assessment time. Two other common issues were the need for adequate sample size to detect differences in OS and a lack of evidence relating prolonged PFS to better health-related quality of life (HRQoL).For PFS2, more basic challenges and needs were identified than for PFS. Only the EMA provides a clear definition; the US Food and Drug Administration (FDA) and other regulatory agencies do not appear to have a definition or policy regarding PFS2 at this time. On the other hand, PFS2 is increasingly incorporated into oncology trials as a secondary endpoint in both hematologic and solid tumors. As of 1 August 2016, there were 41 oncology trials registered on clinicaltrials.gov where PFS2 is included. Of these, 20 trials have been registered or updated since January 2015. The implications of routinely generating and using PFS2 data for regulatory and market access purposes therefore are currently unclear. Most of the current information is related to PFS2 data in trials of lenalidomide in multiple myeloma.Based on commentaries and discussions in the literature, there is an ongoing need to understand the clinical and economic rationales for using PFS2 data to support benefit-risk assessments (e.g. relating effect sizes to clinical outcomes) and to determine how best to communicate these potential benefits meaningfully. There is also a need to understand how PFS2 may relate to patient-centered benefits, such as HRQoL, which may help to identify patient preferences in the context of treatment choice.This information has been used to develop a physician questionnaire that would help identify insights and opinions about PFS2 in the following areas: (1) use of surrogate endpoints, (2) treatment choice in relapsing cancers, (3) implications of PFS2 for clinical practice and (4) future needs for PFS2. Results from this primary research will be presented subsequently.Conclusions: PFS2 is increasingly included as a secondary endpoint in oncology trials assessing the benefits of maintenance or sequential treatments. However, there is limited guidance from regulatory bodies on using and interpreting PFS2 data even though there are post-approval implications regarding potential positioning of drugs within treatment pathways. To date, the EMA is the only regulatory agency that has considered the relevance of PFS2 as a clinical endpoint. The clinical importance of PFS2 needs greater understanding to help physicians apply the data in patient management. DisclosuresSolaman:Celgene: Consultancy. Walker:Celgene: Consultancy, Honoraria; Janssen: Consultancy, Honoraria; Takeda: Consultancy, Honoraria; Amgen: Consultancy, Honoraria. Davies:Janssen: Consultancy, Honoraria; Takeda: Consultancy, Honoraria; Celgene: Consultancy, Honoraria.

Effects of clinical pathways for chronic obstructive pulmonary disease (COPD) on patient, professional and systems outcomes: protocol for a systematic review.

BackgroundChronic obstructive pulmonary disease (COPD) is a respiratory syndrome characterized by progressive, partially reversible airway obstruction and lung hyperinflation. COPD has a substantial burden which is seen in both patient quality of life and healthcare costs. One proposed method of minimizing this burden is the implementation of clinical pathways (CPWs). CPWs aim to guide evidence-based practice and improve the interaction between health services. They bring the best available evidence to a range of healthcare professionals by adapting evidence-based clinical guidelines to a local context and detailing the essential steps in the assessment and care of patients.MethodsThe aim of this systematic review is to synthesize existing literature on the effects of CPWs for the treatment or management of COPD. We will screen search hits from search strategies developed for a Cochrane Effective Practice and Organisation of Care (EPOC) systematic review on the use of CPWs in primary care and a Cochrane EPOC review on the use of CPWs in hospitals. These searches were run in a range of databases. Studies will be screened independently by two reviewers. All studies identified by our search strategy will be considered regardless of study design as long as they meet the operational definition for clinical pathways developed by Kinsman et al. (BMC Medicine 8, 2010) and focus on the treatment or management of COPD. All included studies will be evaluated for risk of bias utilizing methodologies set out by the Cochrane collaboration. Data regarding patient, professional and systems outcomes will be extracted from all included studies. Data will be presented in both narrative and tabular form.DiscussionThe systematic review outlined in this protocol aims to identify, assess and synthesise all available evidence on the effects of CPWs regarding the treatment and management of COPD. As a result, this review will provide an evidence base for decision makers regarding the practicality, cost effectiveness, patient benefit and best practices regarding the implementation of CPWs for the care of COPD.Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0311-8) contains supplementary material, which is available to authorized users.

The effectiveness of mental health courts in reducing recidivism and police contact: a systematic review protocol.

BackgroundMental health courts were created to help criminal defendants who have a mental illness that significantly contributes to their criminal offense. Despite the increasing number of mental health courts around the world, data about their effectiveness have only begun to emerge in the past decade. The purpose of this systematic literature review is to assess the current evidence on the effectiveness of mental health courts. Specifically, this review will address the question, “How effective are mental health courts in reducing recidivism and police contact?”Methods/designEight electronic databases will be searched, specifically PsycINFO, Medline, Medline In-Process, Embase, Web of Science, CINAHL, Social Work s, and Criminal Justice s. A multi-phase screening process will be used to identify relevant search hits. Articles that pass the three-stage screening process will then be assessed for risk of bias and have their reference lists hand searched. Full-text articles that are rated to have low to moderate risk of bias will be summarized into two tables, one containing a brief description of the study and the other reporting the results of relevant outcomes measured.DiscussionBy synthesizing the results of the studies, this systematic review will help illuminate gaps in the literature, direct future research, and inform policy makers.Systematic review registrationPROSPERO CRD42016036084

Low‐level laser therapy as a treatment for androgenetic alopecia

Androgenetic alopecia (AGA) affects 50% of males by age 50 and 50% of females by age 80. Recently, the use of low-level laser therapy (LLLT) has been proposed as a treatment for hair loss and to stimulate hair regrowth in AGA. This paper aims to review the existing research studies to determine whether LLLT is an effective therapy for AGA based on objective measurements and patient satisfaction. A systematic literature review was done to identify articles on Medline, Google Scholar, and Embase that were published between January 1960 and November 2015. All search hits were screened by two reviewers and examined for relevant abstracts and titles. Articles were divided based on study design and assessed for risk of bias. Eleven studies were evaluated, which investigated a total of 680 patients, consisting of 444 males and 236 females. Nine out of 11 studies assessing hair count/hair density found statistically significant improvements in both males and females following LLLT treatment. Additionally, hair thickness and tensile strength significantly improved in two out of four studies. Patient satisfaction was investigated in five studies, and was overall positive, though not as profound as the objective outcomes. The majority of studies covered in this review found an overall improvement in hair regrowth, thickness, and patient satisfaction following LLLT therapy. Although we should be cautious when interpreting these findings, LLLT therapy seems to be a promising monotherapy for AGA and may serve as an effective alternative for individuals unwilling to use medical therapy or undergo surgical options. Lasers Surg. Med. 49:27-39, 2017. © 2016 Wiley Periodicals, Inc.