Explore the vast range of titles available.

The vascular location of an enzyme accounts for the cardiovascular hazards associated with its inhibition. Nonsteroidal anti-inflammatory drugs (NSAIDs) are used by millions of people worldwide to reduce pain and inflammation. They exert their pharmacologic effect by inhibiting the cyclooxygenase-1 (COX-1) and COX-2 enzymes, thereby blocking conversion of arachidonic acid to prostaglandin E 2 (PGE 2 ) and PGI 2 (prostacyclin), which mediate pain (see the figure). However, because COX enzymes exist throughout the body, NSAIDs have many physiological effects, including complications, such as development of gastric ulcers and gastrointestinal bleeding. In 2004, the blockbuster drug rofecoxib (sold commercially as Vioxx) was withdrawn from the U.S. market when a study linked a selective COX-2 inhibitor with a higher rate of heart attack and stroke. However, studies on COX inhibitors have shown varying risk profiles, fueling a debate about their association with cardiovascular risk. A recent study by Yu et al. ( 1 ) now provides a biochemical explanation for the increased cardiovascular risk associated with COX-2 inhibitors, closing this part of the long-standing discussion.

Background: Systematic reviews are increasingly appearing in doctoral theses and being supported by librarians. There is, however, evidence that students struggle to undertake systematic reviews. Case Presentation: We sought to understand the perspectives of, and confidence utilising systematic review search methods following an online escape room teaching intervention as part of our in-person orientation session for Doctorate in Clinical Psychology trainees. Following the session, trainees were invited to participate in an online survey to which we received a 90% response rate (n=35). The escape room was enjoyed by most trainees with many using the words “fun” and “engaging” to describe the intervention, this despite more participants finding the escape room difficult. The average scores for confidence in utilising search syntax were positive, but there was a wide range of scores. Many of the comments that trainees made centred on time pressure to escape. We believe that allowing the trainees more time would increase their enjoyment of the game and aid their learning. Conclusion: Our systematic review escape room demonstrates that key methodological concepts and search skills can be taught in an active, fun, and engaging way that helps introduce and scaffold learning for latter in-depth teaching.

Background A common challenge for randomised controlled trials (RCTs) is recruiting enough participants to be adequately powered to answer the research question. Recruitment has been set as a priority research area in trials to improve recruitment and thereby reduce wasted resources in conducted trials that fail to recruit sufficiently. Methods We conducted a systematic mixed studies review to identify the factors associated with recruitment to RCTs in general practice. On September 8, 2020, English language studies were identified from MEDLINE, EMBASE, Cochrane Database of Systematic Reviews and CENTRAL databases for published studies. NTIS and OpenGrey were searched for grey literature, and BMC Trials was hand searched. A narrative synthesis was conducted for qualitative studies and a thematic synthesis for qualitative studies. Results Thirty-seven studies met the inclusion criteria. These were of different study types (10 cross-sectional, 5 non-randomised studies of interventions, 2 RCTs, 10 qualitative and 10 mixed methods). The highest proportion was conducted in the UK (48%). The study quality was generally poor with 24 (65%) studies having major concerns. A complex combination of patient, practitioner or practice factors, and patient, practitioner or practice recruitment were assessed to determine the possible associations. There were more studies of patients than of practices or practitioners. Conclusions For practitioners and patients alike, a trial that is clinically relevant is critical in influencing participation. Competing demands are given as an important reason for declining participation. There are concerns about randomisation relating to its impact on shared decision-making and not knowing which treatment will be assigned. Patients make decisions about whether they are a candidate for the trial even when they objectively fulfil the eligibility criteria. General practice processes, such as difficulties arranging appointments, can hinder recruitment, and a strong pre-existing doctor-patient relationship can improve recruitment. For clinicians, the wish to contribute to the research enterprise itself is seldom an important reason for participating, though clinicians reported being motivated to participate when the research could improve their clinical practice. One of the few experimental findings was that opportunistic recruitment resulted in significantly faster recruitment compared to systematic recruitment. These factors have clear implications for trial design. Methodologically, recruitment research of practices and practitioners should have increased priority. Higher quality studies of recruitment are required to find out what actually works rather than what might work. Trial registration PROSPERO CRD42018100695. Registered on 03 July 2018.

PurposeInjection of botulinum neurotoxin A (BoNTA) to the lacrimal gland (LG) offers a simple and effective treatment in the management of epiphora. However, there is little data on current practice trends or uptake as an alternative to surgery. This study assesses current practice trends of such treatment amongst BOPSS (British Oculoplastic Surgery Society) members.MethodsAll consultant BOPSS members were invited to participate in a web-based survey which consisted of 5 questions, with a reminder invitation to participate. The role, dose, potential side effects, use as an alternative to surgical intervention, and impact on service delivery were assessed.ResultsFifty-one BOPSS consultants (43% uptake) completed the survey. Ninety percent of respondents were regularly using LG BoNTA in their management of epiphora. The main indicators for considering BoNTA use were medical comorbidities and elderly patients. The mean first treatment dose of Botox® was 3.6 units (SD 1.5). Diplopia and ptosis complications were always discussed in the consent for treatment in addition to dry eye. Twenty-five percent of surgeons reported doing less conjunctivo-dacryocystorhinostomies (cDCR) due to the availability of LG BoNTA. No respondents felt that the requirement for repeated BoNTA treatments was impacting on their service delivery.ConclusionUptake of LG BoNTA in the management of epiphora is at a similar rate to all other available treatments. As a result, respondents are performing less surgical procedures, particularly cDCR in patients at higher surgical morbidity.

In advancing to one name for fungi, this paper treats generic names competing for use in the order Diaporthales ( Ascomycota, Sordariomycetes ) and makes a recommendation for the use or protection of one generic name among synonymous names that may be either sexually or asexually typified. A table is presented that summarizes these recommendations. Among the genera most commonly encountered in this order, Cytospora is recommended over Valsa and Diaporthe over Phomopsis . New combinations are introduced for the oldest epithet of important species in the recommended genus. These include Amphiporthe tiliae, Coryneum lanciforme, Cytospora brevispora, C. ceratosperma, C. cinereostroma, C. eugeniae, C. fallax, C. myrtagena, Diaporthe amaranthophila, D. annonacearum, D. bougainvilleicola, D. caricae-papayae, D. cocoina, D. cucurbitae, D. juniperivora, D. leptostromiformis, D. pterophila, D. theae, D. vitimegaspora, Mastigosporella georgiana, Pilidiella angustispora, P. calamicola, P. pseudogranati, P. stromatica , and P. terminaliae .

Space-based low-frequency synthetic aperture radar (SAR) is affected by the ionosphere, which induces both phase and amplitude fluctuations, known as scintillation, into the radar signal. This paper describes the effect of amplitude scintillation on SAR imagery. The two-way amplitude and intensity probability density functions (pdf) for both monostatic and bistatic SAR are derived from the one-way Nakagami-m distribution. The moments are then used to determine the SAR radiometric calibration error and image contrast from the one-way S4 index. It is also shown that monostatic SAR experiences an S4-dependent radar cross-section (RCS) enhancement that is not experienced by bistatic SAR. The anisotropy of the ionospheric irregularities strongly affects the degree to which amplitude scintillation will be visible in SAR imagery. The description of anisotropic effects is reviewed and extended to cover SAR. The variation over the Earth is illustrated, showing that a sun-synchronous satellite will experience the strongest effect near Brazil. Two PALSAR images of the same area of Brazilian rainforest are compared, one of which shows azimuthal streaking, corresponding to an amplitude modulation of ± 1 dB. The one-way S4 index is determined from this imagery using both the RCS enhancement and image contrast measures of S4, which produce similar results.

•All RCTs on physical activity, fast-mimicking diet and psychological interventions with evaluated survival outcomes in all cancers were reviewed.•Long-term psychological therapies in primary and/or adjuvant treatment settings have demonstrated potential to improve survival.•The effects of fast-mimicking diet on cancer survival has not been evaluated to date.•Well-designed and sufficiently powered RCTs are needed to evaluate the survival benefits of physical activities and psychological and behavioural therapies in cancer. Health professionals are often asked if non-pharmacological interventions prolong life. This review aims to evaluate the effects of physical activity, fast-mimicking diet (FMD) and psychological interventions on survival in all cancers. A systematic review and meta-analysis of randomized controlled trials (RCTs). Only RCTs of physical activity, FMD and psychological interventions (including counselling, cognitive and other psychotherapies) in cancer patients that reported survival outcomes were included. CENTRAL, MEDLINE, Embase, CINAHL, APA PsycINFO, Web of Science, ICTRP and ClinicalTrials.gov from inception to January 2020 were searched without language restrictions. The protocol was prospectively registered at PROSPERO (CRD42019160944). Thirty-one RCTs (9 on physical activity and 22 on psychological interventions) were included in the final analysis after evaluation of 60,207 records from our initial search. No eligible RCT on FMD was reported. RCTs on group psychological interventions (41.9 %) and in patients with breast cancer (38.7 %) were the most common. Most evaluated short-term interventions and in primary or adjuvant settings. Only one of 9 (11 %) RCTs on physical activity and 8 of 22 (36 %) RCTs on psychological interventions were associated with improved overall survival. Only group psychological interventions in breast cancer had adequate number of RCTs to allow a meta-analysis to be performed. It demonstrated a trend towards improved overall survival (HR -0.20, 95 %CI -0.49 to 0.10), particularly in RCTs that evaluated long-term (>6 months) therapies (HR -0.29, 95 %CI -0.59 to 0.01). Longer term interventions starting early in the patients’ care journey in primary and adjuvant settings have shown the most promise for improving survival. Better designed RCTs including survival outcomes are particularly needed in non-breast cancers.

With the recent changes concerning pleomorphic fungi in the new International Code of Nomenclature for algae, fungi, and plants (ICN), it is necessary to propose the acceptance or protection of sexual morph-typified or asexual morph-typified generic names that do not have priority, or to propose the rejection or suppression 1 of competing names. In addition, sexual morph-typified generic names, where widely used, must be proposed for rejection or suppression in favour of asexual morph-typified names that have priority, or the latter must be proposed for conservation or protection. Some pragmatic criteria used for deciding the acceptance or rejection of generic names include: the number of name changes required when one generic name is used over another, the clarity of the generic concept, their relative frequencies of use in the scientific literature, and a vote of interested mycologists. Here, twelve widely used generic names in three families of Hypocreales are proposed for acceptance, either by conservation or protection, despite their lack of priority of publication, or because they are widely used asexual morph-typified names. Each pair of generic names is evaluated, with a recommendation as to the generic name to be used, and safeguarded, either through conservation or protection. Four generic names typified by a species with a sexual morph as type that are younger than competing generic names typified by a species with an asexual morph type, are proposed for use. Eight older generic names typified by species with an asexual morph as type are proposed for use over younger competing generic names typified by a species with a sexual morph as type. Within Bionectriaceae, Clonostachys is recommended over Bionectria; in Hypocreaceae, Hypomyces is recommended over Cladobotryum, Sphaerostilbella over Gliocladium , and Trichoderma over Hypocrea; and in Nectriaceae, Actinostilbe is recommended over Lanatonectria, Cylindrocladiella over Nectricladiella, Fusarium over Gibberella, Gliocephalotrichum over Leuconectria, Gliocladiopsis over Glionectria, Nalanthamala over Rubrinectria, Nectria over Tubercularia , and Neonectria over Cylindrocarpon.

IntroductionImproving oral health and reducing oral health inequalities is an important global health priority. ‘Upstream interventions’ are a vital part of the collective effort to reduce oral disease burdens, however it is a rather nebulous term. Furthermore, there is little evidence on the effectiveness, impact and sustainability of upstream interventions that have focused on oral health and wider public health measures that impact on oral health. The aim of this scoping review is to systematically map and synthesise evidence on the effectiveness, impact and sustainability of upstream interventions on population oral health and reducing socioeconomic oral health inequalities.Methods and analysisThis scoping review will be conducted in accordance with the Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist. A detailed search strategy will be used to conduct a comprehensive search of electronic databases: Scopus, Embase and MEDLINE, PsycINFO and CINAHL, ASSIA and Cochrane Database of Systematic Reviews. A search of grey literature will also be completed to identify relevant dissertations, governmental reports and evaluations of implemented policies. Identification and extraction of data will be performed by two pairs of reviewers. Oversight and feedback will be provided by an independent expert advisory group.Ethics and disseminationThis study will review published and available grey literature and does not require an ethics review. The scoping review protocol has been registered with the Open Science Framework. The final report will be circulated and disseminated through publication and feed into the work of the ongoing Lancet Commission on Oral Health. Due to the policy relevance of this work, discussions will take place with key stakeholders regarding the implications of the findings for future policy development.