Progress and challenges of network meta-analysis.

In the past years, network meta-analysis (NMA) has been widely used among clinicians, guideline makers, and health technology assessment agencies and has played an important role in clinical decision-making and guideline development. To inform further development of NMAs, we conducted a bibliometric analysis to assess the current status of published NMA methodological studies, summarized the methodological progress of seven types of NMAs, and discussed the current challenges of NMAs.

Surface dual redox cycles of Mn(III)/Mn(IV) and Cu(I)/Cu(II) for heterogeneous peroxymonosulfate activation to degrade diclofenac: Performance, mechanism and toxicity assessment.

Advanced oxidation processes (AOPs) based on heterogeneous catalytic activated peroxymonosulfate (PMS) have been becoming alternatives to conventional wastewater treatment technologies to directly degrade chemical contaminants. To build dual/multi redox cycles of different metal ions may be an effective means for better PMS activation. Herein, this study designed Mn3O4/CuBi2O4 with dual redox cycles of Mn(III)/Mn(IV) and Cu(I)/Cu(II) to activate PMS for efficiently decomposing and mineralizing diclofenac sodium (DCF). Under optimal reaction conditions, DCF (50 mg/L) was degraded totally within 10 min, and TOC removal rate reached up to 74.3%. The possible mechanism of PMS activation by Mn3O4/CuBi2O4 was proposed, wherein dual redox cycles of Mn(III)/Mn(IV) and Cu(I)/Cu(II) on Mn3O4/CuBi2O4 effectively facilitated PMS activation to generate ·O2-, 1O2, SO4·- and ·OH, which was responsible for DCF degradation. Moreover, combined with degraded products detected by high resolution liquid chromatography coupled to mass spectrometry and corresponding toxic assessment results, the possible degradation pathways of DCF were proposed and the relative toxicity of degraded products was evaluated. This work may be useful for developing stronger heterogeneous activators of PMS to construct more efficient AOPs for purifying wastewater.

Diffusion Tensor Imaging for Quantitative Assessment of Anterior Cruciate Ligament Injury Grades and Graft.

BACKGROUND: As the need for quantitative assessment of anterior cruciate ligament (ACL) injuries and ACL graft increases, diffusion tensor imaging (DTI) becomes a more valuable measuring tool. However, DTI changes in differing injury grades of ACL and longitudinal graft remain unclear. PURPOSE: To investigate the diagnostic performance of DTI in quantitatively assessing ACL injury severity and the development of ACL grafts within 6 months of surgery. STUDY TYPE: A cohort study. SUBJECTS: Thirty-five patients diagnosed with grades I-IV ACL injuries and 20 volunteers as controls were recruited. FIELD STRENGTH/SEQUENCE: T1 -weighted, T2 -weighted, proton density (PD)-weighted, and DTI at 3.0T MRI. ASSESSMENT: ACL injury grades in arthroscopic images and DTI quantitative data were evaluated from July 2016 to July 2018. STATISTICAL TESTS: Chi-square test, analysis of variance, Spearman correlation analysis, and receiver operator characteristic (ROC) curves. RESULTS: Both fractional anisotropy (FA) (r = -0.898, P < 0.05) and apparent diffusion coefficient (ADC) (r = 0.851, P < 0.05) were significantly correlated with the severity of ACL injuries. The area under the curve (AUC) values for differentiation between low- and high-grade ACL injuries with FA and ADC were 0.973 and 0.963, respectively. Although there were no significant differences in FA (P > 0.05) and ADC (P > 0.05) between grades I and II ACL injuries or in ADC (P > 0.05) between grades III and IV, there were significant differences in FA and ADC between two grades (P < 0.05). There were significant differences in FA (P < 0.05) and ADC (P < 0.05) between normal ACL and 3-month graft postoperation, as well as in ADC values between 3-month and 6-month graft postoperation (P < 0.05). DATA CONCLUSION: DTI could be used to quantitatively evaluate the ACL injury grades and the development of ACL grafts. The diagnostic efficiency of FA values was higher than that of ADC values. LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY: Stage 3.

Customers as Co-Creators: Antecedents of Customer Participation in Online Virtual Communities.

The development of internet technology and the popularity of smartphones has been gradually affecting people's daily lives, thus causing subtle changes to their health. Manufacturing companies are increasingly establishing virtual communities to motivate customers to participate in new product development. However, the reasons that customers participate in the innovation process and the timing of participation remain under-researched. Hence, using data on 517 customers of 14 manufacturing enterprises, we investigate the reasons behind such participation and the moderating role of perceived ease of use and perceived control based on the social exchange theory. Results show that learning benefits, integrative benefits, and hedonic benefits have positive effects on participation. Perceived ease of use strengthens the positive relationship between integrative benefits and customer participation. Perceived control strengthens the positive relationship between hedonic benefits and customer participation. Theoretical implications and managerial practices are also discussed.

SHG/TPEF-based image technology improves liver fibrosis assessment of minimally sized needle biopsies.

BACKGROUND AND AIMS: Sampling size variability of liver biopsy remains a major limitation in the assessment of liver fibrosis. We aimed to evaluate the diagnostic value of a fully quantitative method (second harmonic generation/two-photon excitation fluorescence, SHG/TPEF based) in "short" liver biopsy samples. METHODS: Liver biopsy samples from chronic hepatitis B (CHB) patients were constructed into "virtual" biopsies with different lengths. The original and "virtual" samples were measured by SHG/TPEF-based technology to obtain qFibrosis score, respectively. Here, ΔqFibrosis was defined as difference of qFibrosis between original biopsy and "virtual" biopsy. Equivalence test was used to compare ΔqFibrosis with the clinically acceptable error (deviation of 0.50) in each group. RESULTS: In real-world practice, qFibrosis score increased significantly with fibrosis progression in ≥ 1.5-cm-, 1.0-1.5-cm-, and 0.5-1.0-cm-long specimens (p < 0.05), compared with ≤ 0.5-cm-long specimens (p > 0.05). In virtual biopsy samples with specified length, the equivalence was confirmed in 0.5-1.0-cm- and 1.0-1.5-cm-long specimens (0.27 vs. 0.22, p < 0.001), whereas not in ≤ 0.5-cm-long specimens (0.53, p > 0.05). The number of cross-linked collagen fibers, the total and aggregated collagen proportionate area, and the collagen strings in number, length, width and perimeter showed excellent consistency with original biopsy samples in 0.5-1.0-cm- and 1.0-1.5-cm-long specimens (ICC > 0.90). CONCLUSIONS: The use of SHG/TPEF-based image technology may give useful suggestive information in evaluation of CHB-related liver fibrosis for the short sample (biopsy length > 0.5 cm).

Estimating Green Net National Product for Puerto Rico: An Economic Measure of Sustainability.

This paper presents the data sources and methodology used to estimate Green Net National Product (GNNP), an economic metric of sustainability, for Puerto Rico. Using the change in GNNP as a one-sided test of weak sustainability (i.e., positive growth in GNNP is not enough to show the economy is sustainable), we measure the movement away from sustainability by examining the change in GNNP from 1993 to 2009. In order to calculate GNNP, we require both economic and natural capital data, but limited data for Puerto Rico require a number of simplifying assumptions. Based on the environmental challenges faced by Puerto Rico, we include damages from air emissions and solid waste, the storm protection value of mangroves and the value of extracting crushed stone as components in the depreciation of natural capital. Our estimate of GNNP also includes the value of time, which captures the effects of technological progress. The results show that GNNP had an increasing trend over the 17 years studied with two periods of negative growth (2004-2006 and 2007-2008). Our additional analysis suggests that the negative growth in 2004-2006 was possibly due to a temporary economic downturn. However, the negative growth in 2007-2008 was likely from the decline in the value of time, suggesting the island of Puerto Rico was moving away from sustainability during this time.

The neural dynamic mechanisms of asymmetric switch costs in a combined Stroop-task-switching paradigm.

Switch costs have been constantly found asymmetrical when switching between two tasks of unequal dominance. We used a combined Stroop-task-switching paradigm and recorded electroencephalographic (EEG) signals to explore the neural mechanism underlying the phenomenon of asymmetrical switch costs. The results revealed that a fronto-central N2 component demonstrated greater negativity in word switch (cW) trials relative to word repeat (wW) trials, and both First P3 and P3b components over the parieto-central region exhibited greater positivity in color switch (wC) trials relative to color repeat (cC) trials, whereas a contrasting switch-related fronto-central SP effect was found to have an opposite pattern for each task. Moreover, the time-frequency analysis showed a right-frontal lower alpha band (9-11 Hz) modulation in the word task, whereas a fronto-central upper alpha band (11-13 Hz) modulation was exclusively found in the color task. These results provide evidence for dissociable neural processes, which are related to inhibitory control and endogenous control, contributing to the generation of asymmetrical switch costs.

The quality of clinical practice guidelines in China: a systematic assessment.

BACKGROUND: Clinical guidelines are an important tool for improving service quality, the benefits of guidelines depend on their quality. In China, there has been a great increase in production of guidelines. However, little is known about their quality. METHOD: We identified Chinese guidelines published between 2006 and 2010 by searching three Chinese full-text databases, major Chinese guidelines websites and Google. Three appraisers independently evaluated each guideline by using the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument. Subgroup analyses were performed according to source, title, version, aspect of care and developer of guidelines. RESULTS: A total of 327 guidelines were eligible and 57 were excluded for their lacking of any account of the guideline development methodology. Of the 270 guidelines, 77 (28.5%) can be recommended, 6 (2.2%) were evidence-based guidelines. Sixteen (5.9%) guidelines described the methods used to search for evidence, 61 (22.6%) appraised the quality of evidence and 53 (19.6%) graded the strength of recommendations. Two guidelines declared the involvement of methodological experts and none reported considering patients' values. 29 (10.7%) guidelines received drug company sponsorship but only two declared the views of the funding bodies did not influence the recommendations, 259 (95.9%) didn't declare the interest conflicts of guideline developers. Guidelines downloaded from Internet and with updated versions yielded higher quality than the rest. CONCLUSIONS: Although numerous guidelines were produced in China, the quality was generally low. Focusing on improving the quality of Chinese guidelines, rather than continuing to produce them in great quantity, is urgently needed.

[The assessment of reliability and validity of musculoskeletal questionnaire].

OBJECTIVE: To evaluate the reliability and validity of musculoskeletal questionnaire. METHODS: A self-administered modified musculoskeletal questionnaire was used to investigate 12 098 workers from eight occupations, i.e. coal mining, petroleum, metallurgical, mechanical manufacturing, chemical, garment and railroad transportation industries and education. The Cronbach's α coefficient, analysis of covariance and multiple logistic regression were used to assess the reliability and validity of musculoskeletal questionnaire. RESULTS: The consistent test between total items of Musculoskeletal Questionnaire and each factor showed that the range of Cronbach's α was 0.52 ∼ 0.92, except from vibration factor, other Cronbach's α was more than 0.7. All 55 items of Musculoskeletal Questionnaire were subjected to factor analysis, and ten latent factors were identified, which explained 55.17% of the total variance. The potentially hazardous working conditions could be categorized into seven dimensions (force, dynamic load, static load, repetitive load, climate factors, vibration exposure and environmental ergonomic factor), which consisted with the theory model. The results of covariance analysis indicated that there were significant difference among 7 dimension indices in different jobs (P < 0.01). CONCLUSION: The modified Musculoskeletal Questionnaire is a valid and reliable tool for measuring musculoskeletal workload.

Green Net Regional Product for the San Luis Basin, Colorado: an economic measure of regional sustainability.

This paper presents the data sources and methodology used to estimate Green Net Regional Product (GNRP), a green accounting approach, for the San Luis Basin (SLB). We measured the movement away from sustainability by examining the change in GNRP over time. Any attempt at green accounting requires both economic and natural capital data. However, limited data for the Basin requires a number of simplifying assumptions and requires transforming economic data at the national, state, and county levels to the level of the SLB. Given the contribution of agribusiness to the SLB, we included the depletion of both groundwater and soil as components in the depreciation of natural capital. We also captured the effect of the consumption of energy on climate change for future generations through carbon dioxide (CO(2)) emissions. In order to estimate the depreciation of natural capital, the shadow price of water for agriculture, the economic damages from soil erosion due to wind, and the social cost of carbon emissions were obtained from the literature and applied to the SLB using benefit transfer. We used Colorado's total factor productivity for agriculture to estimate the value of time (i.e., to include the effects of exogenous technological progress). We aggregated the economic data and the depreciation of natural capital for the SLB from 1980 to 2005. The results suggest that GNRP had a slight upward trend through most of this time period, despite temporary negative trends, the longest of which occurred during the period 1985-86 to 1987-88. However, given the upward trend in GNRP and the possibility of business cycles causing the temporary declines, there is no definitive evidence of moving away from sustainability.

Synthesis of isoxazolo[5,4-b]pyridines by microwave-assisted multi-component reactions in water.

A series of new polycyclic-fused isoxazolo[5,4-b]pyridines were obtained by a one-pot tandem reaction under microwave irradiation in water. Without any use of additional reagent or catalyst, the synthetic protocol represents a green one and makes this methodology suitable for library synthesis in drug discovery efforts.