Plos One
-
Confounding by disease severity is an issue in pharmacoepidemiology studies of rheumatoid arthritis (RA), due to channeling of sicker patients to certain therapies. To address the issue of limited clinical data for confounder adjustment, a patient-level prediction model to differentiate between patients prescribed and not prescribed advanced therapies was developed as a surrogate for disease severity, using all available data from a US claims database. ⋯ A prediction model demonstrated good discrimination across multiple claims databases to identify RA patients with a prescription claim for advanced therapies during different time-at-risk periods as proxy for current and future moderate-to-severe disease. This work provides a robust model-derived risk score that can be used as a potential covariate and proxy measure to adjust for confounding by severity in multivariable models in the RA population. An R package to develop the prediction model and risk score are available in an open source platform for researchers.
-
Oxidative stresses intensify the progression of diabetes-related behavioural changes and testicular injuries. Graviola (Annona muricata), a small tree of the Annonaceae family, has been investigated for its protective effects against diabetic complications, oxidative stress, and neuropathies. This study was planned to investigate the effects of graviola on behavioural alterations and testicular oxidative status of streptozotocin (STZ; 65 mg/kg)-induced diabetic rats. ⋯ In addition, Graviola significantly decreased the expression of apoptotic (Bax) and inflammatory (interleukin-1β) testicular genes. In conclusion, these data propose that both the hypoglycemic and antioxidative potential of graviola are possible mechanisms that improve behavioural alterations and protect testis in diabetic animals. Concomitantly, further clinical studies in human are required to validate the current study.
-
Injury accounts for more than 5.8 million deaths globally with an increasing burden in the developing world. In Kenya, trauma is one of the top 10 leading causes of death. However, no formal continuous injury surveillance systems are in place to inform injury prevention, pre-hospital care or emergency department management. The aim of this study was to implement a hospital-based trauma registry to characterize high acuity injuries presenting to a private tertiary, teaching and referral hospital in Kenya. ⋯ Injured patients in Kenya showed concordance with prior studies looking at injury prevalence in the developing world when looking at demographics and place of injury. However, differences were found when looking at the mechanism of injury, with falls surpassing road traffic incidents. A delayed presentation to the hospital was also noted in this patient population. Given the rate of traumatic injuries in Kenya and their contribution to morbidity, mortality and overall healthcare costs, there is a need to implement formal trauma registries in all major hospitals in Kenya to generate more data that can be used to improve injury prevention, the overall trauma system and enhance training and preparedness.
-
Mild systemic hypothermia increases gastric mucosal oxygenation (μHbO2) during hemorrhagic shock in dogs. In the context of critical blood loss hypothermia might be fatal due to adverse side effects. Selective regional hypothermia might overcome these limitations. ⋯ Selective local hypothermia improves gastric μHbO2 during hemorrhagic shock without relevant side effects. In contrast to systemic hypothermia, regional mucosal hypothermia did not affect perfusion and oxygen supply during hemorrhage. Thus, the increased μHbO2 during local hypothermia rather indicates reduced mucosal oxygen demand.
-
Journals are trying to make their papers more accessible by creating a variety of research summaries including graphical abstracts, video abstracts, and plain language summaries. It is unknown if individuals with science, science-related, or non-science careers prefer different summaries, which approach is most effective, or even what criteria should be used for judging which approach is most effective. A survey was created to address this gap in our knowledge. Two papers from Nature on similar research topics were chosen, and different kinds of research summaries were created for each one. Questions to measure comprehension of the research, as well as self-evaluation of enjoyment of the summary, perceived understanding after viewing the summary, and the desire for more updates of that summary type were asked to determine the relative merits of each of the summaries. ⋯ Participants (n = 538) were randomly assigned to one of the summary types. The response of adults with science, science-related, and non-science careers were slightly different, but they show similar trends. All groups performed well on a post-summary test, but participants reported higher perceived understanding when presented with a video or plain language summary (p<0.0025). All groups enjoyed video abstracts the most followed by plain language summaries, and then graphical abstracts and published abstracts. The reported preference for different summary types was generally not correlated to the comprehension of the summaries. Here we show that original abstracts and graphical abstracts are not as successful as video abstracts and plain language summaries at producing comprehension, a feeling of understanding, and enjoyment. Our results indicate the value of relaxing the word counts in the abstract to allow for more plain language or including a plain language summary section along with the abstract.