ResearchPad - research-methods https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Density waves in shear-thickening suspensions]]> https://www.researchpad.co/article/elastic_article_15378 Shear thickening corresponds to an increase of the viscosity as a function of the shear rate. It is observed in many concentrated suspensions in nature and industry: water or oil saturated sediments, crystal-bearing magma, fresh concrete, silica suspensions, and cornstarch mixtures. Here, we reveal how shear-thickening suspensions flow, shedding light onto as yet non-understood complex dynamics reported in the literature. When shear thickening is important, we show the existence of density fluctuations that appear as periodic waves moving in the direction of flow and breaking azimuthal symmetry. They come with strong normal stress fluctuations of the same periodicity. The flow includes small areas of normal stresses of the order of tens of kilopascals and areas of normal stresses of the order of hundreds of pascals. These stress inhomogeneities could play an important role in the damage caused by thickening fluids in the industry.

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<![CDATA[Adherence to the Standards for Reporting of Diagnostic Accuracy (STARD) 2015 Guidelines in Acute Point-of-Care Ultrasound Research]]> https://www.researchpad.co/article/Nee6a5caa-fab9-467b-8d9f-86f377e063b5 Incomplete reporting of diagnostic accuracy research impairs assessment of risk of bias and limits generalizability. Point-of-care ultrasound has become an important diagnostic tool for acute care physicians, but studies assessing its use are of varying methodological quality.ObjectiveTo assess adherence to the Standards for Reporting of Diagnostic Accuracy (STARD) 2015 guidelines in the literature on acute care point-of-care ultrasound.Evidence ReviewMEDLINE was searched to identify diagnostic accuracy studies assessing point-of-care ultrasound published in critical care, emergency medicine, or anesthesia journals from 2016 to 2019. Studies were evaluated for adherence to the STARD 2015 guidelines, with the following variables analyzed: journal, country, STARD citation, STARD-adopting journal, impact factor, patient population, use of supplemental material, and body region. Data analysis was performed in November 2019.FindingsSeventy-four studies were included in this systematic review for assessment. Overall adherence to STARD was moderate, with 66% (mean [SD], 19.7 [2.9] of 30 items) of STARD items reported. Items pertaining to imaging specifications, patient population, and readers of the index test were frequently reported (>66% of studies). Items pertaining to blinding of readers to clinical data and to the index or reference standard, analysis of heterogeneity, indeterminate and missing data, and time intervals between index and reference test were either moderately (33%-66%) or infrequently (<33%) reported. Studies in STARD-adopting journals (mean [SD], 20.5 [2.9] items in adopting journals vs 18.6 [2.3] items in nonadopting journals; P = .002) and studies citing STARD (mean [SD], 21.3 [0.9] items in citing studies vs 19.5 [2.9] items in nonciting studies; P = .01) reported more items. Variation by country and journal of publication were identified. No differences in STARD adherence were identified by body region imaged (mean [SD], abdominal, 20.0 [2.5] items; head and neck, 17.8 [1.6] items; musculoskeletal, 19.2 [3.1] items; thoracic, 20.2 [2.8] items; and other or procedural, 19.8 [2.7] items; P = .29), study design (mean [SD], prospective, 19.7 [2.9] items; retrospective, 19.7 [1.8] items; P > .99), patient population (mean [SD], pediatric, 20.0 [3.1] items; adult, 20.2 [2.7] items; mixed, 17.9 [1.9] items; P = .09), use of supplementary materials (mean [SD], yes, 19.2 [3.0] items; no, 19.7 [2.8] items; P = .91), or journal impact factor (mean [SD], higher impact factor, 20.3 [3.1] items; lower impact factor, 19.1 [2.4] items; P = .08).Conclusions and RelevanceOverall, the literature on acute care point-of-care ultrasound showed moderate adherence to the STARD 2015 guidelines, with more complete reporting found in studies citing STARD and those published in STARD-adopting journals. This study has established a current baseline for reporting; however, future studies are required to understand barriers to complete reporting and to develop strategies to mitigate them. ]]> <![CDATA[FEASIBILITY AND ACCEPTABILITY OF DETECTING COGNITIVE IMPAIRMENT AND DEMENTIA IN PRIMARY CARE PRACTICES]]> https://www.researchpad.co/article/Nd3705a81-4c76-4aed-873e-143b9060a401

Abstract

As the age of the US population increases, so does cognitive impairment (CI); therefore early detection of CI is critical for ensuring its appropriate management. As part of a NINDS Consortium to detect CI and dementia in primary care (DetectCID), we are implementing and evaluating a brief 2-step CI detection paradigm (MyCog), that can be delivered in clinics with diverse populations via the electronic health record (step 1) and iPad (step 2). We conducted focus groups with 25 clinicians and administrative leaders from academic and community primary care practices to 1) understand how CI is being assessed, and 2) evaluate the feasibility of implementing the MyCog paradigm into existing primary care workflows. Several key themes emerged from the discussions. No proactive detection strategy for CI was regularly used outside of the Medicare Annual Wellness Visits (AWV); variable assessments including the Minicog, MoCA, or MMSE were used to fulfill the AWV requirement. Regarding the feasibility of our MyCog Paradigm, our 2-step process was positively received, with the brief case-finding step 1 satisfying AWV requirements and replacing the longer assessments currently being used. Clinicians preferred that step 2 be self-administered due to limited clinician time for wellness visits, and highlighted logistical challenges such as room availability and storage and maintenance of the iPad. Overall, clinicians felt that the identification of CI was valuable and supported standardization, but indicated regular case finding was unlikely without clear guidance on clinical decision-making.

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<![CDATA[Perceptions of health providers towards the use of standardised trauma form in managing trauma patients: a qualitative study from Tanzania]]> https://www.researchpad.co/article/N56ab2cae-a6e7-4c96-9fe5-57097fedafc0

Background

Trauma registries (TRs) are essential to informing the quality of trauma care within health systems. Lack of standardised trauma documentation is a major cause of inconsistent and poor availability of trauma data in most low- and middle-income countries (LMICs), hindering the development of TRs in these regions. We explored health providers’ perceptions on the use of a standardised trauma form to record trauma patient information in Tanzania.

Methods

An exploratory qualitative research using a semi-structured interview guide was carried out to purposefully selected key informants comprising of healthcare providers working in Emergency Units and surgical disciplines in five regional hospitals in Tanzania. Data were analysed using a thematic analysis approach to identify key themes surrounding potential implementation of the standardised trauma form.

Results

Thirty-three healthcare providers participated, the majority of whom had no experience in the use of standardised charting. Only five respondents had prior experience with trauma forms. Responses fell into three themes: perspectives on the concept of a standardised trauma form, potential benefits of a trauma form, and concerns regarding successful and sustainable implementation.

Conclusion

Findings of this study revealed wide healthcare provider acceptance of moving towards standardised clinical documentation for trauma patients. Successful implementation likely depends on the perceived benefits of using a trauma form as a tool to guide clinical management, standardise care and standardise data reporting; however, it will be important moving forward to factor concerns brought up in this study. Potential barriers to successful and sustainable implementation of the form, including the need for training and tailoring of form to match existing resources and knowledge of providers, must be considered.

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<![CDATA[Constructing treatment episodes from concomitant medication logs: a prospective observational study]]> https://www.researchpad.co/article/N2c898704-41ff-4ef9-8ca9-1d7015a262db

Objectives

To describe an approach using concomitant medication log records for the construction of treatment episodes. Concomitant medication log records are routinely collected in clinical studies. Unlike prescription and dispensing records, concomitant medication logs collect utilisation data. Logs can provide information about drug safety and drug repurposing.

Design

A prospective multicentre, multicohort observational study.

Setting

Twenty-one clinical sites in the USA, Europe, Israel and Australia.

Participants

415 subjects from the de novo cohort of the Parkinson’s Progression Markers Initiative.

Methods

We construct treatment episodes of concomitant medication use. The proposed approach treats temporal gaps as a stoppage of medication and temporal overlaps as simultaneous use or changes in dose. Log records with no temporal gaps were combined into a single treatment episode.

Results

5723 concomitant medication log records were used to construct 3655 treatment episodes for 65 medications. There were 405 temporal gaps representing a stoppage of medication; 985 temporal overlaps representing simultaneous regimens of the same medication and 2696 temporal overlaps representing a change in dose regimen. The median episode duration was 37 months (IQ interval: 11–73 months).

Conclusions

The proposed approach for constructing treatment episodes offers a method of estimating duration and dose of treatment from concomitant medication log records. The accompanying recommendations guide log data collection to improve their quality for drug safety and drug repurposing.

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<![CDATA[Does mobile phone instructional video demonstrating sputum expectoration improve the sputum sample quality and quantity in presumptive pulmonary TB cases? Protocol for a prospective pragmatic non-randomised controlled trial in Karnataka state, India]]> https://www.researchpad.co/article/Nc7830a14-2978-4ea1-9c0e-d38619ce92c9

Introduction

Sputum smear microscopy is the cornerstone of tuberculosis (TB) diagnosis under the Revised National Tuberculosis Control Programme (RNTCP) in India. Instructions on how to produce a good sputum sample are a part of RNTCP training manuals, but its assessment is not emphasised. Healthcare provider’s instruction to expectorate a good sputum sample has limitations. Presumptive TB patients often submit inadequate (in quantity and/or quality) sputum samples, which may result in false-negative results. Objectives of the study are, among the selected RNTCP designated microscopy centres in Dakshina Kannada district, Karnataka, India, (a) to assess the effectiveness of mobile phone instructional video demonstrating sputum expectoration on sputum quality and quantity and (b) to explore the mobile phone video implementation challenges as perceived by the healthcare providers.

Methods and analysis

This is a pragmatic, prospective, non-randomised controlled trial in two pairs of RNTCP Designated Microscopy Centres (located at secondary and primary healthcare facilities) of Dakshina Kannada district, India. Presumptive pulmonary TB patients aged ≥18 years will be included. We will exclude who are severely ill, blind, hearing impaired, patients who have already brought their sputum for examination, and transported sputum. In the intervention group, participants will watch a mobile phone instructional video demonstrating submission of an adequate sputum sample. The control group will follow the usual ongoing procedure for sputum submission. This study would require 406 participants for each group to achieve a power of 90% for detecting a difference of 15% between the two groups. The participant enrolment started in December 2019.

Ethics and dissemination

Yenepoya University Ethics Committee, Mangaluru, India, has approved the study protocol (YEC-1/158/2019). It complies with the Declaration of Helsinki, local laws, and the International Council for Harmonization-good clinical practices. Investigators will present the results in scientific forums, publish in a scientific journal, and share with RNTCP officers.

Trial registration number

Clinical Trial Registry of India (CTRI/2019/06/019887).

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<![CDATA[Picosecond-resolution phase-sensitive imaging of transparent objects in a single shot]]> https://www.researchpad.co/article/N18907721-50d4-417e-aea3-7575e4e301d4

Integration of dark-field microscopy into compressed ultrafast photography enables 1 THz real-time imaging of transparent objects.

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<![CDATA[Semblance: An empirical similarity kernel on probability spaces]]> https://www.researchpad.co/article/N5f89a685-fd97-4dcd-b1ce-0c4277feb5d6

Semblance uses empirical data distributions to improve the sensitivity and robustness in downstream machine learning algorithms.

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<![CDATA[Application of volumetric absorptive microsampling (VAMS) to measure multidimensional anti-influenza IgG antibodies by the mPlex-Flu assay]]> https://www.researchpad.co/article/N3af4a83e-47d1-4d61-a5cd-7cf5dfbad201

Introduction: Recently, volumetric absorptive microsampling (VAMS) has been used for accurate sampling of a fixed peripheral blood volume (10 µL) on a volumetric swab, and long-term sample storage. The mPlex-Flu assay is a novel, high-throughput assay that simultaneously measures the concentration of antibodies against the hemagglutinin (HA) proteins from multiple influenza virus strains with ≤5 µL of serum. Here we describe combining these two methods to measure multidimensional anti-influenza IgG activity in whole blood samples collected by a finger stick and VAMS, with correction for serum volume based on simultaneous hemoglobin measurement. Methods: We compared capillary blood samples obtained from a finger stick using a VAMS device with serum samples collected by traditional phlebotomy from 20 subjects, with the influenza antibody profiles measured by the mPlex-Flu assay. Results: We found that results with the two sampling methods were highly correlated within subjects and across all influenza strains (mean R2 = 0.9470). Adjustment for serum volume, based on hemaglobin measurement, was used to estimate serum volume of samples and improved the accuracy. IgG measurements were stable over 3 weeks when VAMS samples were stored at room temperature or transported using a variety of shipping methods. Additionally, when volunteers performed finger-stick VAMS at-home by themselves, the comparison results of anti-HA antibody concentrations were highly consistent with sampling performed by study personnel on-site (R2 = 0.9496). Conclusions: This novel approach can provide a simple, accurate, and low-cost means for monitoring the IgG anti-influenza HA antibody responses in large population studies and clinical trials.

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<![CDATA[No-touch measurements of vital signs in small conscious animals]]> https://www.researchpad.co/article/5c8014cad5eed0c484a9e38c

Vital signs of small conscious animals are acquired in a civilized way without touching or interfering.

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<![CDATA[Assessment of Time-Series Machine Learning Methods for Forecasting Hospital Discharge Volume]]> https://www.researchpad.co/article/5c50f637d5eed0c48462c07e

Key Points

Question

What is the performance of a new time-series machine learning method for predicting hospital discharge volume?

Findings

In this cohort study of daily hospital discharge volumes at 2 academic medical centers (101 867 patient discharges), predictors of discharge volume were well calibrated. These findings were achieved even with shorter training sets and infrequent retraining.

Meaning

These results appear to demonstrate the feasibility of deploying simple time-series methods to more precisely estimate hospital discharge volumes based on historical data, and may facilitate better matching of resources with clinical volume.

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<![CDATA[Assessment of Long-term Follow-up of Randomized Trial Participants by Linkage to Routinely Collected Data]]> https://www.researchpad.co/article/5c50f52ed5eed0c48462aa33

Key Points

Question

Does follow-up of clinical trial participants by linkage to routinely collected data sources provide important insights into the long-term benefits and harms of treatment?

Findings

This scoping review of the published literature found only 113 trials that had been extended by record linkage. Analysis showed that some benefits of treatment extend beyond the trial, and some harms of treatment only become apparent after the trial is complete.

Meaning

The fate of patients after participation in clinical trials is a neglected topic, and the authors recommend that researchers routinely request permission from trial participants to study long-term treatment effects using linkage to routinely collected data.

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<![CDATA[Viral vectors as a novel tool for clinical and neuropsychiatric research applications]]> https://www.researchpad.co/article/5c26add7d5eed0c48474e5da

Background

A viral vector is a genetically modified vector produced by genetic engineering. As pathogenic genes in the virus are completely or largely eliminated, it is safe to be widely used in multidisciplinary research fields for expressing genes, such as neuroscience, metabolism, oncology and so on. Neuroscience and psychiatry are the most closely related disciplines in either basic research or clinical research, but the application of viral vectors in neuropsychiatry has not received much attention or not been widely accepted.

Objective

This article will focus on the application of viral vectors in basic and clinical neuropsychiatric research.

Methods

By using viral vectors, scientists can perform neurological labelling, gene expression regulation and physiological manipulation for investigating phenomenon from molecular mechanisms to behaviours. At the same time, to treat mental or neurological disorders, viral vectors can be designed for gene therapy, which alter gene expression levels or repair mutated genes in the brains of patients.

Perspective

Viral vectors play an important role in basic research and clinical applications. To further understand brain function and prevent mental and neurological diseases, we hypothesize that viral vectors could be used along with various advanced technologies, such as sequencing and high-throughput expression analysis in the neuroscience research field.

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<![CDATA[Challenges in studying statewide pedestrian injuries and drug involvement]]> https://www.researchpad.co/article/5c26b076d5eed0c4847579e4

Background

Increasing U.S. rates of pedestrian injuries could be attributable in part to changing policies and attitudes towards drugs and associated increases in use, yet drug use has not been investigated widely as a risk factor for pedestrian injury. This study details challenges to investigating drug-involved pedestrian crashes using existing surveillance systems.

Methods

Using California police reports from 2004 to 2016, we performed simple linear regression with the proportion of data that was missing by year for drug and alcohol use as the outcome of interest. We also explored differences in the relative proportion of missing data across sex, race, and age groups through simple logistic regression. Finally, we compared missing data for alcohol and drug use indicators for pedestrians and drivers.

Results

From 2004 to 2016, 182,278 pedestrians were involved in crashes across California. Only 1.22% (n = 2219) of records indicated drug use, and 98% had missing data for drug use; the proportion of missing data did not change over time (b = − 0.040, p = 0.145, 95% CI = (− 0.095, 0.016)). The proportion of missing values for alcohol use increased each year (b = 0.49, 95% CI = (0.26, 0.72), p = 0.001). Driver drug and alcohol use indictors showed similar data missingness, and missing data did not show significant variation over time. Hispanics were more likely to have missing data for drug use compared to Whites (OR = 0.61, p < 0.001, 95% CI = (0.56, 0.67)), and Blacks were more likely to have missing data for alcohol use compared to Whites (OR = 0.87, p < 0.0001, 95% CI = (0.84, 0.91)).

Conclusions

Drug use may be a key contributing factor to pedestrian injury, but drug use remains consistently and largely unmeasured in existing surveillance systems. Without better collection of drug and alcohol data, monitoring trends in drug-involved pedestrian injury will not be feasible.

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<![CDATA[Computer-assisted Patient-specific Prototype Template for Thoracolumbar Cortical Bone Trajectory Screw Placement: A Cadaveric Study]]> https://www.researchpad.co/article/5c1844eed5eed0c4847f9ef9

The cortical bone trajectory (CBT) screw technique yields effective mechanical and clinical results, improving the holding screw strength with a less invasive exposure. Accurate and safe screw placement is crucial. A patient-specific drill template with a preplanned trajectory was considered a promising solution; however, it is critical to assess the efficacy and safety of this technique. This study aims to evaluate the accuracy of patient-specific computed tomography (CT)-based rapid prototype drill guide templates for the CBT technique. CT scanning was performed in 7 cadaveric thoracolumbar spines, and a 3-dimensional reconstruction model was generated. By using computer software, we constructed drill templates that fit onto the posterior surface of thoracolumbar vertebrae with drill guides to match the CBT. In total, 80 guide templates from T11 to L5 were created from the computer models by using rapid prototyping. The drill templates were used to guide the drilling of CBT screws without any fluoroscopic control, and CT images were obtained after fixation. The entry point and direction of the planned and inserted screws were measured and compared. In total, 80 screws were inserted from T11 to L5. No misplacement or bony perforation was observed on postoperative CT scan. The patient-specific prototype template system showed the advantage of safe and accurate cortical screw placement in the thoracolumbar spine. This method showed its ability to customize the patient-specific trajectory of the spine, based on the unique morphology of the spine. The potential use of drill templates to place CBT screws is promising.

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<![CDATA[Training and Experience of Peer Reviewers: Authors' Reply]]> https://www.researchpad.co/article/5989db18ab0ee8fa60bcd89d ]]> <![CDATA[Could an Open-Source Clinical Trial Data-Management System Be What We Have All Been Looking For?]]> https://www.researchpad.co/article/5989dac7ab0ee8fa60bb2ee3

The authors argue that research organizations and funders should combine efforts to produce an open-source solution for trial data management.

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<![CDATA[How Can We Draw the Line between Clinical Care and Medical Research?]]> https://www.researchpad.co/article/5989db00ab0ee8fa60bc66a1

What can editors do to help resolve misinterpretation of the boundary between clinical care and medical research?

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<![CDATA[Enrolling Adolescents in Research on HIV and Other Sensitive Issues: Lessons from South Africa]]> https://www.researchpad.co/article/5989dab6ab0ee8fa60bace15

Jerome Singh and colleagues present the ethical and legal challenges surrounding the enrollment of adolescents in HIV observational studies and other types of sensitive research.

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<![CDATA[Undertaking Research in Other Countries: Further Considerations]]> https://www.researchpad.co/article/5989db49ab0ee8fa60bd9854 ]]>