Secondary Questions Research Articles

Influence of extreme weather conditions on the deployment volume of emergency medical services

Due to global warming aworldwide increase in the frequency and intensity of heat waves have been forecast. In the context of the overall increasing number of emergency service calls, weather-induced effects on the number of calls are highly relevant. We evaluated the influence of extreme temperatures on emergency medical services. The study was conducted in Bochum, Germany. The authors examined the data from 16,767emergency calls. In addition, the daily updated temperature data were collected for each emergency doctor call. Data were collected from 01January2014 until 31December2015. The primary question was the influence of extremes of the perceived temperature (PT; on the day of the call and the three previous days) on the diagnosis group of cardiovascular diseases. A secondary question was the influence of extremes of the temperature parameters (air temperature, PT, physiological equivalent temperature [PET]) on the day of call and the three previous days. Atotal of 16,767 calls were assessed. The threshold values (upper and lower 5%) were -8.7 and 32.5 °C for PT and -0.7 and 26.7 °C for air temperature. Examination of the PT indicated asignificantly increased rate of calls for cold spells on the day of the call (RR = 1.14; p = 0.033) as well as alag effect of 3days (RR = 1.1; p = 0.049). The present study shows that during cold spells there is an increased rate of calls for cardiovascular diseases. This effect is not only observable on the extreme day itself but also 3days later.

Evaluation of an International Classification of Functioning, Disability and Health-based rehabilitation for thermal burn injuries: a prospective non-randomized design

BackgroundSevere burn injuries result in relevant restrictions of physical capacity as well as psychological and social integrity and require a specialized rehabilitation. There is a common agreement, among national as well as international burn associations, that burn rehabilitation is a complex, dynamic process which needs an interdisciplinary and specialized treatment team. There is wide agreement that more research is needed in this field.Methods/designThe aim of the study is to examine the effectiveness and efficiency of our new ICF (International Classification of Functioning, Disability and Health)-based rehabilitation for thermal injuries. Because of ethical reasons, we have chosen a prospective non-randomized design, which takes place at two different rehabilitation centers. At center A, a newly developed ICF-based rehabilitation program was established; at rehabilitation center B, a well-established rehabilitation program has existed for 20 years and is used as reference. The primary research question addresses the “Pre-post comparison of the physical and psychological outcome measurements,” secondary question I looks at the “Examination of the non-inferiority of the new treatment concept with the established concept,” and secondary question II is the “Analysis of the rehabilitation process based on the rehabilitation cycle.”Only patients of the two burn rehabilitation centers who are insured by workers’ compensation will be asked to participate in this study to avoid outcome bias by insurance status. A physical examination (physical working capacity testing, grip strength, range of motion, and scar evaluation by Cutometer and Vancouver Scar Scale) and a standardized questionnaire battery (Burn Specific Health Scale-Brief , Short Form 36, Impact of Event Scale-Revised, the German version of the Symptom Checklist, the Freiburg Social Support Questionnaire, Patient/Client Satisfaction Questionnaire, Disabilities of the Arm, Shoulder and Hand, and Lower Extremity Functional Scale ) measure physical and psychological conditions. Data will be taken on admission, during stay, and on discharge of the rehabilitation program and at follow-up 3 and 12 months after discharge. A minimum of 162 participants will be enrolled in this clinical longitudinal, prospective, observational study.DiscussionThe proof of the effectiveness of the ICF-based rehabilitation program for thermal injuries will give evidence in a comprehensive way for the first time in this field. As result, a standardized rehabilitation concept will be introduced, which can be provided to other rehabilitation institutions treating thermal injuries.Trial registrationGerman Clinical Trials Register, DRKS00017702. Registered on 2 September 2019.

The Systematic Review Data Repository (SRDR): descriptive characteristics of publicly available data and opportunities for research

BackgroundConducting systematic reviews (“reviews”) requires a great deal of effort and resources. Making data extracted during reviews available publicly could offer many benefits, including reducing unnecessary duplication of effort, standardizing data, supporting analyses to address secondary research questions, and facilitating methodologic research. Funded by the US Agency for Healthcare Research and Quality (AHRQ), the Systematic Review Data Repository (SRDR) is a free, web-based, open-source, data management and archival platform for reviews. Our specific objectives in this paper are to describe (1) the current extent of usage of SRDR and (2) the characteristics of all projects with publicly available data on the SRDR website.MethodsWe examined all projects with data made publicly available through SRDR as of November 12, 2019. We extracted information about the characteristics of these projects. Two investigators extracted and verified the data.ResultsSRDR has had 2552 individual user accounts belonging to users from 80 countries. Since SRDR’s launch in 2012, data have been made available publicly for 152 of the 735 projects in SRDR (21%), at a rate of 24.5 projects per year, on average. Most projects are in clinical fields (144/152 projects; 95%); most have evaluated interventions (therapeutic or preventive) (109/152; 72%). The most frequent health areas addressed are mental and behavioral disorders (31/152; 20%) and diseases of the eye and ocular adnexa (23/152; 15%). Two-thirds of the projects (104/152; 67%) were funded by AHRQ, and one-sixth (23/152; 15%) are Cochrane reviews. The 152 projects each address a median of 3 research questions (IQR 1–5) and include a median of 70 studies (IQR 20–130).ConclusionsUntil we arrive at a future in which the systematic review and broader research communities are comfortable with the accuracy of automated data extraction, re-use of data extracted by humans has the potential to help reduce redundancy and costs. The 152 projects with publicly available data through SRDR, and the more than 15,000 studies therein, are freely available to researchers and the general public who might be working on similar reviews or updates of reviews or who want access to the data for decision-making, meta-research, or other purposes.

Regulation and adaptation of endocrine axes at high altitude.

As a model of extreme conditions, eight healthy women, part of a 40-member Nepal mountain-climbing expedition, were monitored for dynamic endocrine adaptations. Endocrine measurements were made at frequent intervals over a 6-10-h period at four altitudes: 450 m, 4,800 m (base camp), 6,050 m, and again at 4,800 m (on descent) after an acclimatization (A) period (4,800 mA). Quantified hormones were growth hormone (GH), prolactin (PROL), cortisol (Cort), thyroid-stimulating hormone (TSH), and free thyroxine. These hormones are important to the anabolic/catabolic balance of the body, and are vital to growth, homeostasis, hypothalamic inhibition, regulation of stress, and metabolism. A key secondary question was the degree to which acclimatization can stabilize hormonal disruption. On the basis of statistical false discovery rates, the present analyses unveil marked adaptive changes in the thyroid axis at the level of pulsatile secretion of the pituitary hormone TSH and its downstream product, free thyroxine; strong effects on the mass of GH, TSH, Cort, and PROL secretion per burst; and prominent pulsatile frequency disruption and recovery for PROL and Cort. Because pulsatility changes reflect de facto perturbations in hypothalamo-pituitary control mechanisms, the present data introduce the concept of both frequency- and amplitude-dependent adaptive control of brain-pituitary neuroendocrine signals under conditions of extreme altitude exertion and exposure.

How are nature based solutions contributing to priority societal challenges surrounding human well-being in the United Kingdom: a systematic map protocol

BackgroundThe concept of Nature-based Solutions (NBS) has evolved as an umbrella concept embracing concepts such as Green/Blue/Nature Infrastructure, Ecosystem Approach, Ecosystem Services, but at their core, they cluster into the general theme of learning from and using nature to create sustainable socio-ecological systems, which enhance human well-being (HWB). NBS address societal challenges across a broad range of spatial scales—local, regional and global—and temporal scales—medium to long-term. While there are many reviews and a clear evidence base linking certain NBS to various elements of HWB, particularly urban greenspace and human health, no comprehensive mapping exists of the links between NBS interventions and the associated multiple positive and negative HWB outcomes across a range of habitats. The initial research phase used a participatory co-design process to select four priority societal challenges facing the United Kingdom: three related to management issues i.e. NBS cost-efficacy, governance in planning, environmental justice, and the fourth threats to the acoustic environment. These challenges collectively address priority management issues which stakeholders requested be investigated widely i.e. across landscapes, cityscapes, seascapes and soundscapes. Results of the study are intended to identify and define potential future environmental evidence challenges for UK science.MethodsThis protocol describes the methodology for approaching the research question: What evidence is there for nature based solutions and their impacts on human wellbeing for societal challenges related to cost-efficacy, governance in planning, environmental justice, and the acoustic environment? Using systematic mapping, this study will search for and identify studies that seek to assess nature-based solutions on human well-being with regard to these four societal challenges. Systematic searches across a number of academic/online databases are tested against a number of test articles. Search results are refined using eligibility criteria through a three stage process: title, abstract, full text. Data from screened studies are extracted using a predefined coding strategy. Key trends in data will be synthesized according to a range of secondary questions and be presented in a graphical matrix illustrating the knowledge gaps and clusters for research into nature-based solutions and human well-being for each societal challenge.

KEGIATAN TES URINE SEBAGAI UPAYA P4GN DI INSTANSI PEMERINTAH OLEH BNNP JAWA TIMUR

Togetherness in realizing healthy Indonesia free of narcotics is a global action carried out to improve public health. Narcotics stands for Narcotics, Psychotropic and Other Addictive Materials. Other terms are drugs (narcotics, psychotoprics, and addictive substances). Drug abuse if not handled seriously from an early age, is feared to damage the future of the nation's next generation. This has invited the attention of the Indonesian government by making the implementing regulation of the Law of the Republic of Indonesia Number 35 of 2009 concerning Narcotics, namely the restructuring of the National Narcotics Agency institutions in the Prevention and Eradication of Drug Abuse and Illicit Circulation (P4GN). Preventive measures in drug abuse can be done by detecting the content of drugs in the body. Urine is one of the samples most often used to examine the types of drug substances because it is considered the most accurate with the target, namely students, employees and the general public so that many urine test activities that use rapid tests. This research is a kind of qualitative descriptive and observational research. The study was conducted by collecting secondary data, observation, question and answer and participation. Based on the results of the analysis and discussion, it can be concluded that the report on the results of the activities of the section on prevention and community empowerment of the BNN East Java Province in 2017 shows the total activities carried out, namely times. In 2018, until August 2018 it is known that 220 activities have been carried out 220 times. The P2M field has implemented a full health promotion strategy, namely by using advocacy methods, fostering atmosphere and empowerment. Based on the results of observations and interviews conducted in urine testing activities at the Customs Office in Surabaya the urine test examination stage is in accordance with the technical guidelines in the field of community participation.

Deficits in Auditory Rhythm Perception in Children With Auditory Processing Disorder Are Unrelated to Attention.

Auditory processing disorder (APD) is defined as a specific deficit in the processing of auditory information along the central auditory nervous system, including bottom-up and top-down neural connectivity. Even though music comprises a big part of audition, testing music perception in APD population has not yet gained wide attention in research. This work tests the hypothesis that deficits in rhythm perception occur in a group of subjects with APD. The primary focus of this study is to measure perception of a simple auditory rhythm, i.e., short isochronous sequences of beats, in APD children and to compare their performance to age-matched normal controls. The secondary question is to study the relationship between cognition and auditory processing of rhythm perception. We tested 39 APD children and 25 control children aged between 6 and 12 years via (a) clinical APD tests, including a monaural speech in noise test, (b) isochrony task, a test measuring the detection of small deviations from perfect isochrony in a isochronous beats sequence, and (c) two cognitive tests (auditory memory and auditory attention). APD children scored worse in isochrony task compared to the age-matched control group. In the APD group, neither measure of cognition (attention nor memory) correlated with performance in isochrony task. Left (but not right) speech in noise performance correlated with performance in isochrony task. In the control group a large correlation (r = −0.701, p = 0.001) was observed between isochrony task and attention, but not with memory. The results demonstrate a deficit in the perception of regularly timed sequences in APD that is relevant to the perception of speech in noise, a ubiquitous complaint in this condition. Our results suggest (a) the existence of a non-attention related rhythm perception deficit in APD children and (b) differential effects of attention on task performance in normal vs. APD children. The potential beneficial use of music/rhythm training for rehabilitation purposes in APD children would need to be explored.

Unplanned Operations and Adverse Events after Surgery for Diaphyseal Fracture of the Clavicle.

We used a database of patients treated at three hospitals to study the primary null hypothesis that there are no factors associated with unplanned reoperations or adverse events after surgical repair for diaphyseal clavicle fracture. Additionally we addressed the following secondary study questions: 1. What is the prevalence of unplanned reoperations or adverse events after surgical repair for diaphyseal clavicle fracture? 2. Is early implant loosening or breakage after surgical repair for diaphyseal clavicle fracture related to fixation type? 3. Is the type of fixation associated with the prevalence of brachial plexus palsy after surgical repair of a diaphyseal clavicle fracture? We retrospectively analyzed 249 adult patients who had surgery for a diaphyseal clavicle fracture to determine factors associated with unplanned reoperations or adverse events. Thirty-two patients (13%) had at least one unplanned reoperation or adverse event. Four of 249 patients (1.6%) developed early implant loosening or breakage. Patients that had local implant irritation, planned implant removal, or sensory symptoms thought to be due to nerve irritation were not included in the reported unplanned reoperations or adverse event rate. Only female sex was associated with unplanned reoperations or adverse events after surgery for diaphyseal clavicle fracture. No other patient, technical, or injury related factors tested in this study were associated with unplanned reoperations or adverse events. Patients that have surgery for diaphyseal clavicle fracture have an approximately 13% risk of an unplanned second surgery or an adverse event. Women can be counseled that they are three times as likely as men to have an unplanned reoperations or adverse event.

Thrombotic thrombocytopenic purpura patients' attitudes toward depression management: A qualitative study.

Background and aimsThrombotic thrombocytopenic purpura (TTP) is a rare disorder characterized by acute episodes of systemic microvascular thrombosis; TTP is more common in adults, women, and African‐Americans (Blacks). Our Oklahoma TTP Registry documented that survivors have an increased prevalence of depression compared with the general population; however, many patients' depression remains untreated. Moreover, studies identifying attitudes toward depression management are lacking. The objective of this study was to identify TTP patients' attitudes towards pharmacotherapy. As a secondary question, we explored attitudes towards counseling.MethodsWe interviewed TTP patients with major depression who had experience with different management strategies (previous/current pharmacotherapy treatment versus no pharmacotherapy treatment). Eligibility criteria included (a) age > 18 years, (b) ADAMTS13‐deficient TTP, (c) enrolled in the Oklahoma Registry, and (d) moderate/major depression on either the Beck Depression Inventory II or Patient Health Questionnaire from 2004 to 2012. Qualitative purposive sampling was used to interview patients with a range of experiences with TTP and depression symptom management. Our study was based on the theoretical framework of the Theory of Reasoned Action. Patients were asked about their views on depression (attitudes), their family and friends' views (social norms), and ways they cope with depression.ResultsSemi‐structured interviews were conducted between June and October 2013. Data saturation was achieved after interviewing 16 patients (nine, pharmacotherapy and seven, no pharmacotherapy). The majority (88%) were women; 56% were Black, and the median age was 49 years. Patients in both groups believed TTP was life altering and traumatic and that counseling improved depressive symptoms. However, the pharmacologic group believed medication improved one's quality of life, whereas the no pharmacotherapy group was not sure pharmacotherapy was effective and expressed fears related to potential addiction and side effects. When asked about cultural views to depression management, many Black patients stated that in the Black community, a person is taught to deal with his/her emotional issues instead of asking strangers for help.ConclusionEnsuring effective depression management is a critical part of TTP care. Understanding attitudes toward management will assist in tailoring patient discussions.

Drug–drug interactions with cannabidiol (CBD) appear to have no effect on treatment response in an open-label Expanded Access Program

ObjectiveWe have previously shown that cannabidiol (CBD; Epidiolex®) significantly affects levels of clobazam/N-desmethylclobazam, rufinamide, topiramate, zonisamide, and eslicarbazepine. In the present study, we tested whether the presence of concomitant clobazam affected seizure frequency and severity (treatment response) 12 weeks after initiation of therapy with CBD in patients with treatment-resistant epilepsy (TRE). The secondary questions were whether the presence of any of the other antiepileptic drugs (AEDs) had an effect on seizure frequency or severity at 12, 24, or 48 weeks after therapy initiation. MethodsOne hundred and thirty-two adults and children with TRE receiving CBD were studied prospectively. Participants were separated into two groups — either taking (CBD + clobazam) or not taking concomitant clobazam (CBD − clobazam). In the secondary analyses, participants were divided into groups depending on whether they were taking at least 1/4 of the other AEDs shown to interact with CBD (iAED). Seizure counts and Chalfont Seizure Severity Scale (CSSS) were obtained at baseline, 12, 24, and 48 weeks. Groups were compared at each respective time point in the study using generalized estimating equations (GEE) analyses. ResultsAll groups demonstrated statistically significant reductions in seizure frequency and severity from baseline (all P < 0.05). When participants on CBD + clobazam were compared with CBD − clobazam, there were no significant differences in seizure frequency and severity reduction between the groups at 12 weeks (both P > 0.05). When comparing groups with iAEDs vs. group without iAEDs, independent of coadministration of clobazam, no differences in treatment response were observed (all P > 0.05). Longitudinal analyses up to 48 weeks after therapy initiation did not reveal any differences in treatment response between groups. ConclusionThese analyses suggest that concomitant to CBD, AEDs may not have an effect on reducing seizure frequency and severity in patients with TRE.

The Challenge of Teaching Essential Immunology Laboratory Skills to Undergraduates in One Month-Experience of an Osteoimmunology Course on TLR Activation.

Acquiring immunology laboratory skills during undergraduate studies is often a prerequisite for admission to Masters’ programs. Many broad liberal arts and sciences honors degree colleges struggle in teaching these essentials since only limited time is usually reserved for this. Here, we describe a new 1-month-course developed to train a small group of honors students in 6 techniques that are useful for immunology research. In essence, 15 students were divided into 3 groups of 5 students where each student became involved in current osteoimmunology research. Osteoimmunology is a relatively new branch of the immunology tree, where the effects of inflammation and the immune system on bone formation and bone degradation is studied. A broad, 3 weeks experiment on the chronic effects of molecules that specifically activate toll-like receptors TLR2 and TLR4 on bone formation or osteoclast differentiation was performed just before the start of the course. Control samples and samples treated with TLR2 (group A), TLR4 (group B), or TLR2+TLR4 (group C) agonists were harvested and analyzed using quantitative PCR, ELISA, biochemistry, microscopy of enzyme-histochemically stained osteoclasts, scanning electron microscopy, and confocal microscopy. Each technique was taught for 2 days by a specialized instructor, who was present at all laboratory activities. The primary research question for each group was: how does the experimental condition affect bone formation or osteoclast formation? The secondary research question specified per technique was: how does this technique answer part of the primary research question? Pedagogically, students were encouraged to collaborate within the group to analyze the obtained data. Secondly, at the end of the course, a representative of each group collaborated to summarize the TLR activation modalities of a technique of choice. Thirdly, each group wrote a report, where introduction and discussion were graded as a group; each technique part was graded individually. The summary of the results from the 3 treatment modalities was presented orally. The student evaluation of the course was high, students remarked that the course had a curriculum overarching function, since it created an awareness and appreciation for both the joy and the blood-sweat-and-tears aspects of pipetting, and writing research articles, making interpretation of those easier.

Evaluation the Educational Quality Performance of Islamic Azad University, Karaj Branch, Based on Kirkpatrick’s Model

There are various models to evaluate educational quality performance of high educational systems in which the Kirkpatrick’s model has been described as comprehensive, simple, and practical model form many educational situations and has been known as a criterion in this field by many specialists. The objective of this research is evaluating educational quality performance in Islamic Azad University, Karaj branch based on Kirkpatrick’s model. Methodology: The methodology of this research is surveying-descriptive and statistical population includes all managers and students of Islamic Azad University, Karaj branch with 34,100 members. Sampling method was stratified random sampling method and 384 members were selected according to population volume based on table randomly. The used instrument was the researcher-made questionnaires, which was designed according to input, output, process, and content sub-scales, then face and content validity was determined by specialized professors, and research reliability was determined 0.75 by Cronbach alpha coefficient. Results: Single-sample statistical t-test to test research hypotheses. In order to test the main question of research based on education quality performance in Islamic Azad University, Karaj branch, it was observed according to the obtained scores from questionnaire and results of t-test that education quality performance situation in Islamic Azad University, Karaj branch, is higher than average (good) level. Conclusion: According to investigate and test the secondary questions, it was observed that education quality performance in Islamic Azad University, Karaj branch has average (good) level. In addition, the input dimension of education quality performance in Islamic Azad University, Karaj branch has average level. The education performance in process and output dimensions was observed in good level.

Does Interactivity increase map user’s reasoning? A study with environmental map users

Abstract. Concomitant to massive use of interactive maps the actual research agenda in cartography use and user’s issues address the need of evaluating interactivity for specific map uses and users (ROTH et al. 2017). There is established scientific discussion concerning spatial tools and cartographic representations effects on learning and on increasing user’s spatial capabilities and thematic knowledge which lead science of maps to develop methods for evaluating map user and use. This in order to better comprehend and quantify relationships around the extensive universe of map interactivity and contributing to advance a comprehensive theory in how to design interactions when dealing with spatial-temporal representations. As an area of growing interest for the last decade, this research field is being susceptible to technologic advances such as ubiquitous mapping, and map usage became a state-of-the-art study case for nearly all new interactive devices and systems.There are several dimensions to comprehend interaction. This work presents a study case based on the concepts of map interface complexity model (Mendonça, Schmidt &amp;amp; Delazari, In Press) focusing on the interaction operators (Roth, 2013) and its effects on map reasoning (Olson, 1976; MacEachren and Ganter, 1990; Roth, 2012) and on cognitive workload (Hart &amp;amp; Staveland,1988) and SUS (System Usability Scale – Brooke, 1986), the later related to self-perception of usability, with both associated indicating better user experiences in the interaction with devices and interfaces (Longo and Dondio 2015; Borsci, Federici and Lauriola, 2009). Preliminary tests carried out with URUT usability remote evaluations showed more than 80% of usability issues can be assessed from workload and SUS forms (Mendonça, 2017)The experience of the 1st author working with public sector and spatial analysis upon conservation of environment in the Amazonas state can be used to estimate that thousands of maps are produced every year to depict present and past situations of the subject, and these are being used by at least three main user groups: environmental professionals, which includes geographers, geologists, environment, forest, agronomic and fishing engineers, both in the public and private – including NGO – sectors; education professionals and students, including high school, technical, graduation and post-graduation levels; society in general, considering the appeal of preserving natural ecosystem in one of the most diverse tropical forests in the world. These groups are used to define the study users sample.Since this study is focused in map use and user’s interaction, it carried out series of tests to measure and evaluate the role of interactivity in different levels of map tools interactions. Performance on better decision making and better understanding of environmental reality was stated and related to user interactions in order to answer if the variable level of interactivity can be related to better results on pointing out solutions to common maps ultimate goals: to support local and state policies on small scale issues like solid waste residuals disposal in small cities or analyze deforestation patterns together with forest fire focus against conservation units and the mosaic of protected areas. The study is part of a larger project which seeks to make better use of interactive technologies and to increase map use by different actors involved in the subject of monitoring Amazonas State environmental issues. This implies in identifying potential insights on environmental map use at local levels.The research main goal was to answer if levels of interactivity will play direct role on increasing understanding upon environmental issues depicted in interactive maps. Secondary research questions include: 1) If environmental professionals consider using interactive mapping techniques when presenting results or studies related to the thematic, and if this can be perceived by means of their strategies of using their own maps or thematic interactive maps built for them. 2) What are current usability and acceptability gaps of proposed interactive map model considering the three evaluated user groups? 3) Will other continuum like the type of input device, user’s personal characteristic plays a more decisive role in the user’s performance? 4) Workload and Usability are related to task performance success when using interactive maps?

What is the available evidence for the range of applications of genome-editing as a new tool for plant trait modification and the potential occurrence of associated off-target effects: a systematic map

BackgroundWithin the last decades, genome-editing techniques such as CRISPR/Cas, TALENs, Zinc-Finger Nucleases, Meganucleases, Oligonucleotide-Directed Mutagenesis and base editing have been developed enabling a precise modification of DNA sequences. Such techniques provide options for simple, time-saving and cost-effective applications compared to other breeding techniques and hence genome editing has already been promoted for a wide range of plant species. Although the application of genome-editing induces less unintended modifications (off-targets) in the genome compared to classical mutagenesis techniques, off-target effects are a prominent point of criticism as they are supposed to cause unintended effects, e.g. genomic instability or cell death. To address these aspects, this map aims to answer the following question: What is the available evidence for the range of applications of genome-editing as a new tool for plant trait modification and the potential occurrence of associated off-target effects? This primary question will be considered by two secondary questions: One aims to overview the market-oriented traits being modified by genome-editing in plants and the other explores the occurrence of off-target effects.MethodsA literature search in nine bibliographic databases, Google Scholar, and 47 web pages of companies and governmental agencies was conducted using predefined and tested search strings in English language. Articles were screened on title/abstract and full text level for relevance based on pre-defined inclusion criteria. The relevant information of included studies were mapped using a pre-defined data extraction strategy. Besides a descriptive summary of the relevant literature, a spreadsheet containing all extracted data is provided.ResultsAltogether, 555 relevant articles from journals, company web pages and web pages of governmental agencies were identified containing 1328 studies/applications of genome-editing in model plants and agricultural crops in the period January 1996 to May 2018. Most of the studies were conducted in China followed by the USA. Genome-editing was already applied in 68 different plants. Although most of the studies were basic research, 99 different market-oriented applications were identified in 28 different crops leading to plants with improved food and feed quality, agronomic value like growth characteristics or increased yield, tolerance to biotic and abiotic stress, herbicide tolerance or industrial benefits. 252 studies explored off-target effects. Most of the studies were conducted using CRISPR/Cas. Several studies firstly investigated whether sites in the genome show similarity to the target sequence and secondly analyzed these potential off-target sites by sequencing. In around 3% of the analyzed potential off-target sites, unintended mutations were detected. Only a few studies conducted off-target analyses using unbiased detection methods (e.g. whole genome sequencing). No off-target effects that could be correlated to the genome-editing process were identified in these studies.ConclusionsThe rapid adoption in plant breeding was demonstrated by a considerable number of market oriented applications (crops and traits) described in publications worldwide. Studies investigating off-target effects are very heterogeneous in their structure and design. Therefore, an in-depth assessment regarding their weight of evidence is mandatory.

“Let’s Make Your Clinic Visit a Little Simpler”—Development of a Question Prompt List for Adult Patients With Gastroesophageal Reflux Disease: a Modified Delphi Study

To develop a QPL specific to adults with GERD created by physician experts. The QPL content (110 questions) was derived through a modified Delphi method consisting of two rounds. In round one, experts in esophageal disease were invited to participate and were requested to provide five answers to the prompt “what you wish your patients would ask” and “what questions do patients often not ask, that I wish they would ask?” Eighteen esophageal experts were recruited. In round two, the panel received an emailed survey hosted on Qualtrics (Provo, Utah, USA). The survey included a comprehensive list of questions based on expert feedback. Panel members then rated each question on a five-point Likert scale, where 1= should not be included, 2=unimportant, 3=don’t know/depends, 4=important and 5=essential. Responses were then collected among all panelists and accepted questions were those rated as “essential” or “important”, determined by an a priori median value of ≥ 4.0. Twelve esophageal experts participated. A total of 168 questions, including 80 responses from “what you wish your patients would ask” and 88 responses from “what questions do patients often not ask, that I wish they would ask?” were obtained from round one. Of these, 110 (76.9%) were accepted for inclusion in the QPL, meeting a median value of ≥ 4.0. Median values ranged between 4.0 and 5.0 for both sets of questions, with the highest agreement median (5.0) including examples such as “What is the dosing and timing of a PPI, including body position” and “Does my Barrett’s need surveillance endoscopy?” (Figure 1 and 2). Additional questions covered key topics and were separated into six categories: “what does this illness mean”, “lifestyle modifications”, “general treatment”, “treatment with proton pump inhibitors (PPI)”, “what I should expect for my future”, and “Barrett’s esophagus”. On secondary analysis questions were stratified by categories with the largest number of questions fitting into lifestyle modifications (21.8%). The highest agreement median (5.0) within this category was “Do I actually have GERD?” The topic with the lowest number of questions was “Barrett’s esophagus” (n=6, 7.7%). To our knowledge, this is the first GERD-specific QPL to be developed by experts in esophageal disease through a modified Delphi method. Upon further validation and implementation, in addition to next steps of measuring patient perspectives, we hope that the implementation of this GERD-specific QPL will enable patients to ask essential questions during consultation – an additional step to make their clinic visit more expeditious, helpful and ultimately a little simpler.View Large Image Figure ViewerDownload Hi-res image Download (PPT)View Large Image Figure ViewerDownload Hi-res image Download (PPT)

THE SCD-WELL RANDOMIZED CONTROLLED TRIAL: EFFECTS OF A MINDFULNESS-BASED INTERVENTION VERSUS HEALTH EDUCATION ON MENTAL HEALTH AND COGNITION IN PATIENTS WITH SUBJECTIVE COGNITIVE DECLINE

Subjectively experienced cognitive decline in older adults is an indicator of increased risk for dementia and is also associated with increased levels of anxiety symptoms. As anxiety is itself emerging as a risk factor for cognitive decline and dementia, the primary question of the present study is whether an 8-week mindfulness-based intervention can significantly reduce anxiety symptoms in patients with subjective cognitive decline (SCD). The secondary questions pertain to whether such changes extend to other domains of psychological, social, and biological functioning (including cognition, self-regulation, lifestyle, well-being and quality of life, sleep, and selected blood-based biomarkers) associated with mental health, older age, and risk for dementia.

SEARCHING COMMON EUROPEAN STANDARDS REGARDING BLASPHEMY? ANALYSIS OF ITALIAN, IRISH, AUSTRIAN REGULATION FROM THE LIGHT OF THE ECHR

The purpose of the presented article is to resolve the issue of the existence of the common European standard regarding the blasphemous speeches and examine its efficiency for possible mechanisms of resolving the collussion between freedom of expression and freedom of religion. The presented analysis will be commenced with reference to the judicial practice of the European Court of Human Rights regarding the tension between freedom of expression and freedom of religion with addition to blasphemy. Through the prism of such analysis the author formulates hypothesis of the wide diversity between the States of the Council of Europe towards granting priority for one of the aforesaid freedoms in case of blasphemy. Secondary question refers to the influence of such diversity for the efficiency of protection of both: freedom of expression and freedom of religion. Subsequently the author will analyse the domestic regulations of Italy, Ireland and Austria to illustrate the occurring differences as well as search for optimal model of protection. The author will also refer to the statement of selected representatives of human rights doctrine. The conclusion part will focus on formulating recommendations for amplifying the efficiency of the common European standard regarding the presented issue. The author will rely mainly on legal dogmatic methodology with reference to the literal resonance of the legal regulations as well as judicial practice of the European Court of Human Rights as well as comparative analysis to unveil similarities and differences within presented States legal systems.

An Assessment of the Evidence for Psychic Functioning

Research on psychic functioning, conducted over a two decade period, is examined to determine whether or not the phenomenon has been scientifically established. A secondary question is whether or not it is useful for government purposes. The primary work examined in this report was gov- ernment sponsored research conducted at Stanford Research Institute, later known as SRI International, and at Science Applications International Cor- poration, known as SAIC. Using the standards applied to any other area of science, it is concluded that psychic functioning has been well established. The statistical results of the studies examined are far beyond what is expected by chance. Arguments that these results could be due to methodological flaws in the experiments are soundly refuted. Effects of similar magnitude to those found in government- sponsored research at SRI and SAIC have been replicated at a number of lab- oratories across the world. Such consistency cannot be readily explained by claims of flaws or fraud. The magnitude of psychic functioning exhibited appears to be in the range between what social scientists call a small and medium effect. That means that it is reliable enough to be replicated in properly conducted experiments, with sufficient trials to achieve the long-run statistical results needed for replicability. A number of other patterns have been found, suggestive of how to conduct more productive experiments and applied psychic functioning. For instance, it doesn't appear that a sender is needed. Precognition, in which the answer is known to no one until a future time, appears to work quite well. Recent ex- periments suggest that if there is a psychic sense then it works much like our other five senses, by detecting change. Given that physicists are currently grappling with an understanding of time, it may be that a psychic sense exists that scans the future for major change, much as our eyes scan the environ- ment for visual change or our ears allow us to respond to sudden changes in sound.

Frustrations and roadblocks in data reference librarianship

As data skills are incorporated into academic curriculum and data becomes more widely available and used in everyday life, many librarians find themselves serving as 'accidental' data librarians in their subject areas. Due to this evolving landscape and growing data need, it is increasingly important for librarians to be familiar with data resources and able to answer secondary data reference questions. To learn more about this area of librarianship, this study uses survey responses from librarians who answer data questions to explore the challenges and frustrations that arise from data reference questions and interactions. Our key findings reveal that frustrations are ever present in data reference regardless of how much experience a librarian has, and many frustrations arise due to factors such as patron expectations, subject-specific and data-related jargon, and data formats and accessibility.

Can Postural Instability in Individuals with Distal Radius Fractures Be Alleviated by Concurrent Cognitive Tasks?

Can Postural Instability in Individuals with Distal Radius Fractures Be Alleviated by Concurrent Cognitive Tasks?