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UFGI publications round-up week 1/16/2017

Naturalistic study of guideline implementation tool use via evaluation of website access and physician survey

Author information: Melissa J. Armstrong,1,2 Gary S. Gronseth,3 Richard Dubinsky,3 Sonja Potrebic,4 Rebecca Penfold Murray,5Thomas S. D. Getchius,5 Carol Rheaume,5 and  Anna R Gagliardi6 

1Department of Neurology, University of Florida College of Medicine, Gainesville, FL USA
2University of Maryland School of Medicine, Baltimore, MD USA
3Department of Neurology, University of Kansas Medical Center, Kansas City, KS USA
4Department of Neurology, Kaiser Permanente – Los Angeles Medical Center, Los Angeles, CA USA
5American Academy of Neurology, Minneapolis, MN USA
6Toronto General Research Institute, University Health Network, Toronto, Canada
Journal: BMC Medical Informatics and Decision Making

Date of e-pub: January 2017

Abstract: Clinical guidelines support decision-making at the point-of-care but the onus is often on individual users such as physicians to implement them. Research shows that the inclusion of implementation tools in or with guidelines (GItools) is associated with guideline use. However, there is little research on which GItools best support implementation by individual physicians. The purpose of this study was to investigate naturalistic access and use of GItools produced by the American Academy of Neurology (AAN) to inform future tool development.

Website accesses over six months were summarized for eight AAN guidelines and associated GItools published between July 2012 and August 2013. Academy members were surveyed about use of tools accompanying the sport concussion guideline. Data were analyzed using summary statistics and the Chi-square test.

The clinician summary was accessed more frequently (29.0%, p < 0.001) compared with the slide presentation (26.8%), patient summary (23.2%) or case study (20.9%), although this varied by guideline topic. For the sport concussion guideline, which was accompanied by a greater variety of GItools, the mobile phone quick reference check application was most frequently accessed, followed by the clinician summary, patient summary, and slide presentation. For the sports concussion guideline survey, most respondents (response rate 21.8%, 168/797) were aware of the guideline (88.1%) and had read the guideline (78.6%). For GItool use, respondents indicated reading the reference card (51.2%), clinician summary (45.2%), patient summary (28.0%), mobile phone application (26.2%), and coach/athletic trainer summary (20.2%). Patterns of sports concussion GItool use were similar between respondents who said they had and had not yet implemented the guideline.

Developers faced with resource limitations may wish to prioritize the development of printable or mobile application clinician summaries, which were accessed significantly more than other types of GItools. Further research is needed to understand how to optimize the design of such GItools.

Determinants of quality of shared sanitation facilities in informal settlements: case study of Kisumu, Kenya

Author information: Sheillah Simiyu,1,4 Mark Swilling,1 Sandy Cairncross,2 and  Richard Rheingans3,5

1School of Public Leadership, Stellenbosch University, Private Bag, X1, Matieland, 7602 Stellenbosch South Africa
2Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
3Department of Environmental and Global Health, University of Florida, Gainesville, FL 32611 USA
4Great Lakes University of Kisumu (GLUK), Box 2224-40100, Kisumu, Kenya
5Sustainable Development Department, Appalachian State University, 287 Rivers St, Boone, NC USA
Journal: BMC Public Health

Date of e-pub: January 2017

Abstract: Shared facilities are not recognised as improved sanitation due to challenges of maintenance as they easily can be avenues for the spread of diseases. Thus there is need to evaluate the quality of shared facilities, especially in informal settlements, where they are commonly used. A shared facility can be equated to a common good whose management depends on the users. If users do not work collectively towards keeping the facility clean, it is likely that the quality may depreciate due to lack of maintenance. This study examined the quality of shared sanitation facilities and used the common pool resource (CPR) management principles to examine the determinants of shared sanitation quality in the informal settlements of Kisumu, Kenya.

Using a multiple case study design, the study employed both quantitative and qualitative methods. In both phases, users of shared sanitation facilities were interviewed, while shared sanitation facilities were inspected. Shared sanitation quality was a score which was the dependent variable in a regression analysis. Interviews during the qualitative stage were aimed at understanding management practices of shared sanitation users. Qualitative data was analysed thematically by following the CPR principles.

Shared facilities, most of which were dirty, were shared by an average of eight households, and their quality decreased with an increase in the number of households sharing. The effect of numbers on quality is explained by behaviour reflected in the CPR principles, as it was easier to define boundaries of shared facilities when there were fewer users who cooperated towards improving their shared sanitation facility. Other factors, such as defined management systems, cooperation, collective decision making, and social norms, also played a role in influencing the behaviour of users towards keeping shared facilities clean and functional.

Apart from hardware factors, quality of shared sanitation is largely due to group behaviour of users. The CPR principles form a crucial lens through which the dynamics of shared sanitation facilities in informal settlements can be understood. Development and policy efforts should incorporate group behaviour as they determine the quality of shared sanitation facilities.

A Methodology for Cancer Therapeutics by Systems Pharmacology-Based Analysis: A Case Study on Breast Cancer-Related Traditional Chinese Medicines

Author information: Yan Li,1,2 Jinghui Wang,1,2 Feng Lin,2  Yinfeng Yang,2 and  Su-Shing Chen1

1Systems Biology Laboratory, Department of Computer Information Science and Engineering, University of Florida, Gainesville, Florida, United States of America
2Key Laboratory of Industrial Ecology and Environmental Engineering (MOE), Faculty of Chemical, Environmental and Biological Science and Technology, Dalian University of Technology, Dalian, Liaoning, P R China
Southern Illinois University School of Medicine, UNITED STATES
Journal: PLoS One

Date of e-pub: January 2017

Abstract: Breast cancer is the most common carcinoma in women. Comprehensive therapy on breast cancer including surgical operation, chemotherapy, radiotherapy, endocrinotherapy, etc. could help, but still has serious side effect and resistance against anticancer drugs. Complementary and alternative medicine (CAM) may avoid these problems, in which traditional Chinese medicine (TCM) has been highlighted. In this section, to analyze the mechanism through which TCM act on breast cancer, we have built a virtual model consisting of the construction of database, oral bioavailability prediction, drug-likeness evaluation, target prediction, network construction. The 20 commonly employed herbs for the treatment of breast cancer were used as a database to carry out research. As a result, 150 ingredient compounds were screened out as active molecules for the herbs, with 33 target proteins predicted. Our analysis indicates that these herbs 1) takes a ‘Jun-Chen-Zuo-Shi” as rule of prescription, 2) which function mainly through perturbing three pathways involving the epidermal growth factor receptor, estrogen receptor, and inflammatory pathways, to 3) display the breast cancer-related anti-estrogen, anti-inflammatory, regulation of cell metabolism and proliferation activities. To sum it up, by providing a novel in silico strategy for investigation of the botanical drugs, this work may be of some help for understanding the action mechanisms of herbal medicines and for discovery of new drugs from plants.

Management of Dentin Hypersensitivity by National Dental Practice-Based Research Network practitioners: results from a questionnaire administered prior to initiation of a clinical study on this topic

Author information: Dorota T. Kopycka-Kedzierawski,1 Cyril Meyerowitz,1 Mark S. Litaker,2 Sidney Chonowski,3 Marc W. Heft,4 Valeria V. Gordan,4 Robin L. Yardic,5 Theresa E. Madden,6 Stephanie C. Reyes,7 Gregg H. Gilbert,2 and National Dental PBRN Collaborative Group

1Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Ave, Rochester, NY 14620 USA
2University of Alabama at Birmingham, Birmingham, AL USA
3Private practice of general dentistry, Morristown, NJ USA
4University of Florida, Gainesville, FL USA
5Health Partners, Minneapolis, MN USA
6Private practice of periodontics, Olympia, WA USA
7University of Texas Health Science Center at San Antonio, San Antonio, TX USA
Journal: BMC Oral Health

Date of e-pub: January 2017

Abstract: Dentin hypersensitivity (DH) is a common problem encountered in clinical practice. The purpose of this study was to identify the management approaches for DH among United States dentists.

One hundred eighty five National Dental Practice-Based Research Network clinicians completed a questionnaire regarding their preferred methods to diagnose and manage DH in the practice setting, and their beliefs about DH predisposing factors.

Almost all dentists (99%) reported using more than one method to diagnose DH. Most frequently, they reported using spontaneous patient reports coupled with excluding other causes of oral pain by direct clinical examination (48%); followed by applying an air blast (26%), applying cold water (12%), and obtaining patient reports after dentist’s query (6%). In managing DH, the most frequent first choice was desensitizing, over-the-counter (OTC), potassium nitrate toothpaste (48%), followed by fluorides (38%), and glutaraldehyde/HEMA (3%). A total of 86% of respondents reported using a combination of products when treating DH, most frequently using fluoride varnish and desensitizing OTC potassium nitrate toothpaste (70%). The most frequent predisposing factor leading to DH, as reported by the practitioners, was recessed gingiva (66%), followed by abrasion, erosion, abfraction/attrition lesions (59%) and bruxism (32%).

The majority of network practitioners use multiple methods to diagnose and manage DH. Desensitizing OTC potassium nitrate toothpaste and fluoride formulations are the most widely used products to manage DH in dental practice setting.

An experimental validation of genomic selection in octoploid strawberry

Author information: Salvador A Gezan,1 Luis F Osorio,2 Sujeet Verma,2 and  Vance M Whitaker,2

1School of Forest Resources and Conservation, University of Florida, 363 Newins-Ziegler Hall, PO Box 110410, Gainesville, FL 32611-0410, USA
2Gulf Coast Research and Education Center, University of Florida, 14625 CR 672, Wimauma, FL 33598, USA
Journal: Horticulture Research

Date of e-pub: January 2017

Abstract: The primary goal of genomic selection is to increase genetic gains for complex traits by predicting performance of individuals for which phenotypic data are not available. The objective of this study was to experimentally evaluate the potential of genomic selection in strawberry breeding and to define a strategy for its implementation. Four clonally replicated field trials, two in each of 2 years comprised of a total of 1628 individuals, were established in 2013–2014 and 2014–2015. Five complex yield and fruit quality traits with moderate to low heritability were assessed in each trial. High-density genotyping was performed with the Affymetrix Axiom IStraw90 single-nucleotide polymorphism array, and 17 479 polymorphic markers were chosen for analysis. Several methods were compared, including Genomic BLUP, Bayes B, Bayes C, Bayesian LASSO Regression, Bayesian Ridge Regression and Reproducing Kernel Hilbert Spaces. Cross-validation within training populations resulted in higher values than for true validations across trials. For true validations, Bayes B gave the highest predictive abilities on average and also the highest selection efficiencies, particularly for yield traits that were the lowest heritability traits. Selection efficiencies using Bayes B for parent selection ranged from 74% for average fruit weight to 34% for early marketable yield. A breeding strategy is proposed in which advanced selection trials are utilized as training populations and in which genomic selection can reduce the breeding cycle from 3 to 2 years for a subset of untested parents based on their predicted genomic breeding values.

FGF19/FGFR4 signaling contributes to the resistance of hepatocellular carcinoma to sorafenib

Author information: Lixia Gao,1 Xuli Wang,2,3 Yaoliang Tang,4 Shuang Huang,5 Chien-An Andy Hu,6 and  Yong Teng1,7

1Department of Oral Biology, Dental College of Georgia, Augusta University, 1120 15th Street, Augusta, GA 30912 USA
2Department of Radiology and Imaging Sciences, School of Medicine, University of Utah, Salt Lake City, UT USA
3Experimental Therapeutics Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT USA
4Vascular Biology Center, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA USA
5Department of Anatomy and Cell Biology, University of Florida College of Medicine, Gainesville, FL USA
6Department of Biochemistry and Molecular Biology, University of New Mexico School of Medicine, Albuquerque, NM USA
7Department of Biochemistry and Molecular Biology, Medical College of Georgia, Augusta University, 1120 15th Street, Augusta, GA USA
Journal: Journal of Experimental & Clinical Cancer Research: CR

Date of e-pub: January 2017

Abstract: Sorafenib, a multi-kinase inhibitor, is used as a standard therapy for advanced hepatocellular carcinoma (HCC). However, complete remission has not been achieved and the molecular basis of HCC resistance to sorafenib remains largely unknown. Previous studies have shown that fibroblast growth factor 19 (FGF19) expression correlates with tumor progression and poor prognosis of HCC. Here, we demonstrate the novel role of FGF19 in HCC resistance to sorafenib therapy.

FGF19 Knockdown cells were achieved by lentiviral-mediated interference, and FGFR4 knockout cells were achieved by CRISPR-Cas9. Protein levels of FGF19, FGFR4 and c-PARP in various HCC cell lines were measured by Western blotting analysis. Cell viability was determined by MTS assay, apoptosis was determined by DAPI nuclear staining and Western blot of c-PRAP, and ROS generation was determined by DCFH-DA staining and electrochemical biosensor.

We showed that FGF19, when overexpressed, inhibited the effect of sorafenib on ROS generation and apoptosis in HCC. In contrast, loss of FGF19 or its receptor FGFR4 led to a remarkable increase in sorafenib-induced ROS generation and apoptosis. In addition, knockdown of FGF19 in sorafenib-resistant HCC cells significantly enhanced the sensitivity to sorafenib. Importantly, targeting FGF19/FGFR4 axis by ponatinib, a third-generation inhibitor of chronic myeloid leukemia, overcomes HCC resistance of sorafenib by enhancing ROS-associated apoptosis in sorafenib-treated HCC.

Our results provide the first evidence that inhibition of FGF19/FGFR4 signaling significantly overcomes sorafenib resistance in HCC. Co-treatment of ponatinib and sorafinib may represent an effective therapeutic approach for eradicating HCC.

NOTE: These abstracts were retrieved from the U.S. National Library of Medicine website managed in collaboration with the U.S. National Library of Medicine

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