Barriers to and facilitators of interventions to counter publication bias: thematic analysis of scholarly articles and stakeholder interviews.

BACKGROUND: When the nature and direction of research results affect their chances of publication, a distortion of the evidence base - termed publication bias - results. Despite considerable recent efforts to implement measures to reduce the non-publication of trials, publication bias is still a major problem in medical research. The objective of our study was to identify barriers to and facilitators of interventions to prevent or reduce publication bias. METHODS: We systematically reviewed the scholarly literature and extracted data from articles. Further, we performed semi-structured interviews with stakeholders. We performed an inductive thematic analysis to identify barriers to and facilitators of interventions to counter publication bias. RESULTS: The systematic review identified 39 articles. Thirty-four of 89 invited interview partners agreed to be interviewed. We clustered interventions into four categories: prospective trial registration, incentives for reporting in peer-reviewed journals or research reports, public availability of individual patient-level data, and peer-review/editorial processes. Barriers we identified included economic and personal interests, lack of financial resources for a global comprehensive trial registry, and different legal systems. Facilitators identified included: raising awareness of the effects of publication bias, providing incentives to make data publically available, and implementing laws to enforce prospective registration and reporting of clinical trial results. CONCLUSIONS: Publication bias is a complex problem that reflects the complex system in which it occurs. The cooperation amongst stakeholders to increase public awareness of the problem, better tailoring of incentives to publish, and ultimately legislative regulations have the greatest potential for reducing publication bias.

Implementation of automated reporting of estimated glomerular filtration rate among Veterans Affairs laboratories: a retrospective study.

BACKGROUND: Automated reporting of estimated glomerular filtration rate (eGFR) is a recent advance in laboratory information technology (IT) that generates a measure of kidney function with chemistry laboratory results to aid early detection of chronic kidney disease (CKD). Because accurate diagnosis of CKD is critical to optimal medical decision-making, several clinical practice guidelines have recommended the use of automated eGFR reporting. Since its introduction, automated eGFR reporting has not been uniformly implemented by U. S. laboratories despite the growing prevalence of CKD. CKD is highly prevalent within the Veterans Health Administration (VHA), and implementation of automated eGFR reporting within this integrated healthcare system has the potential to improve care. In July 2004, the VHA adopted automated eGFR reporting through a system-wide mandate for software implementation by individual VHA laboratories. This study examines the timing of software implementation by individual VHA laboratories and factors associated with implementation. METHODS: We performed a retrospective observational study of laboratories in VHA facilities from July 2004 to September 2009. Using laboratory data, we identified the status of implementation of automated eGFR reporting for each facility and the time to actual implementation from the date the VHA adopted its policy for automated eGFR reporting. Using survey and administrative data, we assessed facility organizational characteristics associated with implementation of automated eGFR reporting via bivariate analyses. RESULTS: Of 104 VHA laboratories, 88% implemented automated eGFR reporting in existing laboratory IT systems by the end of the study period. Time to initial implementation ranged from 0.2 to 4.0 years with a median of 1.8 years. All VHA facilities with on-site dialysis units implemented the eGFR software (52%, p<0.001). Other organizational characteristics were not statistically significant. CONCLUSIONS: The VHA did not have uniform implementation of automated eGFR reporting across its facilities. Facility-level organizational characteristics were not associated with implementation, and this suggests that decisions for implementation of this software are not related to facility-level quality improvement measures. Additional studies on implementation of laboratory IT, such as automated eGFR reporting, could identify factors that are related to more timely implementation and lead to better healthcare delivery.

BEYOND THE LIBRETTO: HOW THE COMPOSER GUIDES THE CREATION OF CHARACTER THREE CASE STUDIES

When performing in opera, a singer portrays a character. A libretto is used as the principal resource for the research. Music can also reveal insights into the composer’s ideas regarding characterization. This performance dissertation examines how musical devices such as genre, texture, meter, melody, instrumentation and form can be used to inform choices of characterization. Three roles from diverse operas were examined and performed. The first role, Estelle Oglethorpe in Later the Same Evening (2007) by John Musto (b 1954) was performed November 15, 16, 17, 18 2007. The second role, Dorabella in Così fan tutte (1789) by Wolfgang Amadeus Mozart (1756-1791) was performed April 20, 25, 27, 2008. The third role, Olga in Eugene Onegin (1878) by Pyotr Ilyich Tchaikovsky (1840-1893) was performed on April 19, 2009. All operas were presented by the University of Maryland Opera Studio at the Ina and Jack Kay Theater in the Clarice Smith Performing Arts Center, University of Maryland College Park. DVD recordings of all performances can be found in the University of Maryland library system.

PIANIST-COMPOSERS WHOSE WORKS INCLUDE PIANISTIC INNOVATIONS

Throughout the piano’s history, certain composers have created innovations in the areas of virtuosity and sonority. These innovations came not only from the composers’ imagination, but also from the development of instruments and changes in musical style from one period to another. To investigate what kinds of innovations these pianist composers made, I divided them into technique and sound from Mozart to Cowell. I chose two-piano music (Sonata in D major, K.448 by Mozart and Rachmaninoff’s Second Suite) to demonstrate their experiments with varieties of textures and sonorities, using different registers of the two pianos orchestrally. En Blanc et noir by Debussy shows this composer’s deep interest and originality in piano sonorities. For solo piano music, Beethoven’s Piano Sonata Op.53 shows extensive technical invention. His use of long pedal effects shows a pianistic possibility not explored by Mozart. Hummel’s Piano Sonata in D major represents orchestral devices as well as pianistic techniques showing recent developments in the instrument. Chopin’s Ballade No.3 and Scherzo No.3 show virtuosic moments and also the expanded range of the keyboard. His Nocturne Op.27, no.2, with its sonorities resulting from the combination of pedal, and widespread accompaniments derived from Alberti bass figures, is a perfect example of Chopin’s characteristic sound-world. “Vallée d’Obermann” by Liszt uses many virtuosic techniques as well as the extreme wide ranges of keyboard in both hands to create dramatic contrasts of texture. Debussy’s etude, “Pour les Sonorités opposés” is probably the first etude designed for sonority rather than for keyboard virtuosity. Albeniz’s “Evocación” and “Triana” show Spanish atmosphere. Prokofiev’s Sonata no.3 shows frequent motoric driving elements that demand percussive virtuosity. Cowell’s piano music is some of the earliest to explore the sonorities of tone clusters and playing on the strings. This performance dissertation consists of three recitals performed in the Orchestra Room, Leah Smith Hall, and Gildenhorn Recital Hall at the University of Maryland, College Park. These recitals are documented on compact disc recordings that are housed within the University of Maryland Library System.

OPERA IN AMERICA: MUSIC OF, BY, AND FOR THE PEOPLE­: A PERFORMANCE DISSERTATION

Opera in America: Music of, by, and for the people is a study of the relationship between American popular culture and opera in the United States. Four performance projects demonstrate the on-going exchange between the operatic community-including its composer, singers, and patrons-and the country's popular entertainment industry with its broad audience base. Numerous examples of artistic cross pollination between lowbrow and highbrow music will illustrate the artistic and social consequences created by this artistic amalgamation. Program #1, By George! By Ira! By Gershwin!, is a retrospective of Gershwin's vocal music representing a blending of popular and serious music in both style and form. The concert includes selections from Porgy and Bess, a work considered by many musicologists as the first American opera. Program #2, Shadowboxer, is a premiere performance of an opera by Frank Proto and John Chenault. For this newly commissioned work, I serve as Assistant Director to Leon Major. Shadowboxer provides a clear example of opera utilizing popular culture both musically and dramatically to tell the true story of American hero and legendary boxer, Joe Louis. Program #3, Just a Song at Twilight, is an original theatrical music piece featuring music, letters, diaries, and journals of the Gilded Age, an era when opera was synonymous with popular entertainment. Special attention is focused on tum-of­ the-century singers who performed in both opera and vaudeville. Program #4 is a presentation of Dominick Argento's Miss Manners on Music and illustrates the strong relationship that can exist between opera and American popular entertainment. Originally conceived as a song cycle, I have staged the work as a one-act opera sung and acted by soprano Carmen Balthrop. This piece is based on the writings of pop icon and newspaper columnist Judith Martin, otherwise known as Miss Manners. All four performances are recorded in audio and video formats.

Scholarly research productivity is not related to higher three-year licensure pass rates for physical therapy academic programs.

BACKGROUND: In the domain of academia, the scholarship of research may include, but not limited to, peer-reviewed publications, presentations, or grant submissions. Programmatic research productivity is one of many measures of academic program reputation and ranking. Another measure or tool for quantifying learning success among physical therapists education programs in the USA is 100 % three year pass rates of graduates on the standardized National Physical Therapy Examination (NPTE). In this study, we endeavored to determine if there was an association between research productivity through artifacts and 100 % three year pass rates on the NPTE. METHODS: This observational study involved using pre-approved database exploration representing all accredited programs in the USA who graduated physical therapists during 2009, 2010 and 2011. Descriptive variables captured included raw research productivity artifacts such as peer reviewed publications and books, number of professional presentations, number of scholarly submissions, total grant dollars, and numbers of grants submitted. Descriptive statistics and comparisons (using chi square and t-tests) among program characteristics and research artifacts were calculated. Univariate logistic regression analyses, with appropriate control variables were used to determine associations between research artifacts and 100 % pass rates. RESULTS: Number of scholarly artifacts submitted, faculty with grants, and grant proposals submitted were significantly higher in programs with 100 % three year pass rates. However, after controlling for program characteristics such as grade point average, diversity percentage of cohort, public/private institution, and number of faculty, there were no significant associations between scholarly artifacts and 100 % three year pass rates. CONCLUSIONS: Factors outside of research artifacts are likely better predictors for passing the NPTE.

CANCIONES ARGENTINAS (SONGS OFARGENTINA): A RECORDING PROJECT

This Dissertation Project comprises recordings of Argentine art songs. The discs are approximately 40-60 minutes in length and consist of songs from the traditional art-song repertoire for voice and piano. This project is particularly appropriate because of the very limited number of recordings of Argentine songs, which are notable both not only for their high quality but for their accessibility of performance for voice teachers, students, and professional singers alike. Art songs in the Spanish language are a welcome resource, and the poetry included in this project is of an outstanding quality. Some of the poets set to music are Gabriela Mistral (a poet laureate of Chile and the first Latin American woman to win the Nobel Prize for Literature), Pablo Neruda (also a Nobel laureate), Luis Cernuda, and Leon Benar6s. The lyrics of some songs are based on traditional sources, and the melodies and rhythms of all are representative of South American-indigenous and European­ immigrant cultures. The composers represented here will be familiar to some listeners but more than likely unfamiliar to most. Yet Alberto Ginastera (1916-1983) is considered to be the greatest of all Argentine composers. Alberto Williams (1862-1952) is known as the father of the Nationalist School of composition in Argentina, and Carlos Lopez Buchardo (1881-1963) is a most influential composer and pedagogue after whom the national Conservatory of Music in Buenos Aries is named. Two composers who remain relatively unknown outside of South America, Abraham Jurafsky (1906- 1993) and Julio Perceval (1903-1963) are also represented in this project. A complete compact disc is devoted to the works of Carlos Guastavino. Known as the "Argentine Schubert", Guastavino has over 250 songs to his credit. Chiefly a composer for piano and voice, his recent death (October 2000) makes a recording of his works especially appropriate. This project also includes a written component, a supportive dissertation briefly describing the history of the Argentine art song and the lives and influences of the composers and poets represented in the studio recordings. The CD recordings are held in the Michelle Smith Performing Arts Library at the University of Maryland.

Accuracy of proactive case finding for mental disorders by community informants in Nepal.

BACKGROUND: Accurate detection of persons in need of mental healthcare is crucial to reduce the treatment gap between psychiatric burden and service use in low- and middle-income (LAMI) countries. AIMS: To evaluate the accuracy of a community-based proactive case-finding strategy (Community Informant Detection Tool, CIDT), involving pictorial vignettes, designed to initiate pathways for mental health treatment in primary care settings. METHOD: Community informants using the CIDT identified screen positive (n = 110) and negative persons (n = 85). Participants were then administered the Composite International Diagnostic Interview (CIDI). RESULTS: The CIDT has a positive predictive value of 0.64 (0.68 for adults only) and a negative predictive value of 0.93 (0.91 for adults only). CONCLUSIONS: The CIDT has promising detection properties for psychiatric caseness. Further research should investigate its potential to increase demand for, and access to, mental health services.

The accuracy and completeness for receipt of colorectal cancer care using Veterans Health Administration administrative data.

BACKGROUND: The National Comprehensive Cancer Network and the American Society of Clinical Oncology have established guidelines for the treatment and surveillance of colorectal cancer (CRC), respectively. Considering these guidelines, an accurate and efficient method is needed to measure receipt of care. METHODS: The accuracy and completeness of Veterans Health Administration (VA) administrative data were assessed by comparing them with data manually abstracted during the Colorectal Cancer Care Collaborative (C4) quality improvement initiative for 618 patients with stage I-III CRC. RESULTS: The VA administrative data contained gender, marital, and birth information for all patients but race information was missing for 62.1% of patients. The percent agreement for demographic variables ranged from 98.1-100%. The kappa statistic for receipt of treatments ranged from 0.21 to 0.60 and there was a 96.9% agreement for the date of surgical resection. The percentage of post-diagnosis surveillance events in C4 also in VA administrative data were 76.0% for colonoscopy, 84.6% for physician visit, and 26.3% for carcinoembryonic antigen (CEA) test. CONCLUSIONS: VA administrative data are accurate and complete for non-race demographic variables, receipt of CRC treatment, colonoscopy, and physician visits; but alternative data sources may be necessary to capture patient race and receipt of CEA tests.

Low prevalence of vitamin D deficiency in Ugandian HIV-infected patients with and without tuberculosis.

info:eu-repo/semantics/published

LPS-binding protein and IL-6 Mark paradoxical tuberculosis immune reconstitution inflammatory syndrome in HIV patients

Background: Tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) remains a poorly understood complication in HIV-TB co-infected patients initiating antiretroviral therapy (ART). The role of the innate immune system in TB-IRIS is becoming increasingly apparent, however the potential involvement in TB-IRIS of a leaky gut and proteins that interfere with TLR stimulation by binding PAMPs has not been investigated before. Here we aimed to investigate the innate nature of the cytokine response in TB-IRIS and to identify novel potential biomarkers. Methods: From a large prospective cohort of HIV-TB co-infected patients receiving TB treatment, we compared 40 patients who developed TB-IRIS during the first month of ART with 40 patients matched for age, sex and baseline CD4 count who did not. We analyzed plasma levels of lipopolysaccharide (LPS)-binding protein (LBP), LPS, sCD14, endotoxin-core antibody, intestinal fatty acid-binding protein (I-FABP) and 18 pro-and anti-inflammatory cytokines before and during ART. Results: We observed lower baseline levels of IL-6 (p = 0.041), GCSF (p = 0.036) and LBP (p = 0.016) in TB-IRIS patients. At IRIS event, we detected higher levels of LBP, IL-1RA, IL-4, IL-6, IL-7, IL-8, G-CSF (p ≤ 0.032) and lower I-FABP levels (p = 0.013) compared to HIV-TB co-infected controls. Only IL-6 showed an independent effect in multivariate models containing significant cytokines from pre-ART (p = 0.039) and during TB-IRIS (p = 0.034). Conclusion: We report pre-ART IL-6 and LBP levels as well as IL-6, LBP and I-FABP levels during IRIS-event as potential biomarkers in TB-IRIS. Our results show no evidence of the possible contribution of a leaky gut to TB-IRIS and indicate that IL-6 holds a distinct role in the disturbed innate cytokine profile before and during TB-IRIS. Future clinical studies should investigate the importance and clinical relevance of these markers for the diagnosis and treatment of TB-IRIS. Copyright: © 2013 Goovaerts et al.

Clinical Spectrum, risk factors and outcome of immune reconstitution inflammatory syndrome in patients with tuberculosis-HIV coinfection.

info:eu-repo/semantics/published

El diseño del laboratorio de física como herramienta para la resignificación de conceptos matemáticos

La presente ponencia resume el inicio de la construcción de un laboratorio de física y matemáticas en el programa de la Licenciatura en Matemáticas y Tecnologías de la Información, de la Universidad La Gran Colombia. Se presenta la experiencia en el diseño de la primera actividad y de los constructos teóricos y prácticos que se tuvieron en cuenta. Esta experiencia de aula está avalada dentro de la conformación de un semillero de investigación de la facultad, y muestra cómo a partir de un sistema masaresorte se pueden construir algunos conceptos fundamentales como el período de funciones, el comportamiento de las mismas y destacar la importancia del modelado de datos para su respectivo análisis y obtener así una aproximación por medio de la matemática.

A volume of fluid numerical model for wave impacts at coastal structures

The first stages in the development of a new design tool, to be used by coastal engineers to improve the efficiency, analysis, design, management and operation of a wide range of coastal and harbour structures, are described. The tool is based on a two-dimensional numerical model, NEWMOTICS-2D, using the volume of fluid (VOF) method, which permits the rapid calculation of wave hydrodynamics at impermeable natural and man-made structures. The critical hydrodynamic flow processes and forces are identified together with the equations that describe these key processes. The different possible numerical approaches for the solution of these equations, and the types of numerical models currently available, are examined and assessed. Preliminary tests of the model, using comparisons with results from a series of hydraulic model test cases, are described. The results of these tests demonstrate that the VOF approach is particularly appropriate for the simulation of the dynamics of waves at coastal structures because of its flexibility in representing the complex free surfaces encountered during wave impact and breaking. The further programme of work, required to develop the existing model into a tool for use in routine engineering design, is outlined.