bluuebunny/crossref_metadata_2025 huggingface dataset:
Four-Skill Assessment of Turkish Language: Results from a Pilot Project
Authors: EROĞLU Emine , SUNA Eren , TANBERKAN Hande , CANIDEMİR Amine , ALTUN Umare , ÖZER Mahmut
Published: April 2020

This study analyses the results of the ‘Four-Skill Test in Turkish Language’ (FSTTL) project conducted by the Ministry of National Education to assess the language skills of students as a pilot project and investigates the effects of various variables on language skills. Relationships between language scores and school type, gender, preschool participation, parents’ level of education, and course grades are investigated in this descriptive study. The sample is consisted of 1932 students in seventh grade who participated in the pilot study. Test battery, consisted of reading, listening, writing, and speaking subtests, is used to assess the language skills of students within the scope of the FSTTL. Findings show that students in imam-hatip middle schools and middle schools performed at a similar level in all subtests. Female students performed significantly higher than male students in all subtests. Students participated in pre-school education performed significantly higher than those who did not participate in reading, writing, and listening subtests. Findings also show that the increase in parents’ level of education leads to an increase in students’ subtest scores. The effect of parents’ level of education on subtest scores is comparatively higher than the effects of other factors in focus. Significant correlations have been obtained between the four-skill scores and student’s Turkish course, social sciences, mathematics, and science course grades. It is suggested that FSTTL must be developed based on the experiences of the pilot project as a standardized test in accordance with the international standards and actively used to improve educational processes.
A Sequential-Quadratic-Programming-Filter Algorithm with a Modified Stochastic Gradient for Robust Life-Cycle Optimization Problems with Nonlinear State Constraints
Authors: Liu Zhe , Reynolds Albert C.
Published: April 2020

Solving a large-scale optimization problem with nonlinear state constraints is challenging when adjoint gradients are not available for computing the derivatives needed in the basic optimization algorithm used. Here, we present a methodology for the solution of an optimization problem with nonlinear and linear constraints, where the true gradients that cannot be computed analytically are approximated by ensemble-based stochastic gradients using an improved stochastic simplex approximate gradient (StoSAG). Our discussion is focused on the application of our procedure to waterflooding optimization where the optimization variables are the well controls and the cost function is the life-cycle net present value (NPV) of production. The optimization algorithm used for solving the constrained-optimization problem is sequential quadratic programming (SQP) with constraints enforced using the filter method. We introduce modifications to StoSAG that improve its fidelity [i.e., the improvements give a more accurate approximation to the true gradient (assumed here to equal the gradient computed with the adjoint method) than the approximation obtained using the original StoSAG algorithm]. The modifications to StoSAG vastly improve the performance of the optimization algorithm; in fact, we show that if the basic StoSAG is applied without the improvements, then the SQP might yield a highly suboptimal result for optimization problems with nonlinear state constraints. For robust optimization, each constraint should be satisfied for every reservoir model, which is highly computationally intensive. However, the computationally viable alternative of letting the reservoir simulation enforce the nonlinear state constraints using its internal heuristics yields significantly inferior results. Thus, we develop an alternative procedure for handling nonlinear state constraints, which avoids explicit enforcement of nonlinear constraints for each reservoir model yet yields results where any constraint violation for any model is extremely small.
Predictors of intra-hospital mortality in patients with diabetic foot ulcers in Nigeria: data from the MEDFUN Study.
Authors: Adeleye Olufunmilayo O , Ugwu Ejiofor T , Gezawa Ibrahim D , Okpe Innocent , Ezeani Ignatius , Enamino Marcelina
Published: April 2020

Background/Objective: Diabetic foot ulcers (DFU) are associated with high morbidity and mortality globally. Mortality in patients hospitalized for DFU in Nigeria is unacceptably high. This study is to document contributory factors that predict mortality in patients hospitalized for DFU in Nigeria. Methods: Multi-centre Evaluation of Diabetic Foot Ulcer in Nigeria (MEDFUN), an observational study conducted in six tertiary healthcare institutions across the 6 geopolitical zones of Nigeria. Consecutive type 1 or 2 diabetic patients hospitalized for DFU who consented. Co-morbid complications were documented. Results: Mean age 55.9 +/- 12.5 years. 96.1% had type 2 diabetes (DM), the mean duration of DM was 8.5 ± 5.7 years. The duration of ulcers was 39 days with a range of 28 to 54 days. 79.2% presented with at least grade 3 DFU. About one-fifth of the patients died (20.5%). Highest mortality among subjects with Wagner grade 5. Middle-aged subjects (45-64 years) had significantly high mortality- odds ratio (OR) 5.107, Confidence interval (CI) of 1.429-18.252.Variables significantly associated with mortality with the respective p- values are DM duration more than 120 months (0.008), ulcer duration > one month (0.013), ulcer severity of Wagner grade 3 and above (0.001), peripheral arterial disease (0.002), foot gangrene (< 0.001). Laboratory variables associated with mortality; proteinuria (<0.001), positive blood cultures (<0.001), severe vascular stenosis (0.001), moderate vascular stenosis (< 0.001), Low HDL (< 0.001). Co-morbid complications significantly associated with mortality; shock at presentation (<0.001), anaemia (0.034), cardiac failure (0.020), renal impairment (<0.001). Sepsis was the strongest predictor of mortality (OR 5.128; 95% CI 2.614 – 10.060) followed by renal impairment (OR 2.831; 95% CI 1.346 – 5.953). Conclusions: Mortality among Nigerian diabetic patients admitted for DFU is high. The majority who died during hospitalization for DFU belong to the working-age population. Predictors of mortality were older age, higher Wagner grade (≥ 3) ulcer, longer duration of DM, longer duration of ulcer, peripheral arterial disease, foot gangrene, renal impairment, low HDL- cholesterol, anaemia, shock, and cardiac failure. Renal impairment and positive blood culture were independent determinants of mortality.
Occurrences of septuple and elevated Pfdhfr-Pfdhps quintuple mutations in general population threatens the use of sulfadoxine‑pyrimethamine for malaria prevention during pregnancy in Eastern-coast of Tanzania
Authors: Bwire George M. , Mikomangwa Wigilya P. , Kilonzi Manase
Published: April 2020

Background: Plasmodium falciparum dihydrofolate reductase (Pfdhfr) and dihydropteroate synthetase (Pfdhps) mutations compromise the effectiveness of sulfadoxine-pyrimethamine (SP) for treatment of uncomplicated malaria, and are likely to impair the efficiency of intermittent preventive treatment during pregnancy (IPTp). This study was conducted to determine the level of Pfdhfr-Pfdhps mutations, more than one decade since SP was limited for IPTp use in pregnant women in Tanzania. Methods: Parasite genomic DNA was extracted from dried blood spots prepared by finger prick. Extracted DNA were sequenced using a single MiSeq lane combining all PCR products. Genotyping of Pfdhfr and Pfdhps mutations were done using bcftools as well as custom scripts to filter and translate genotypes into drug resistance haplotypes. Results: The Pfdhfr was analyzed from 445 samples, the wild type (WT) Pfdhfr haplotype NCSI was detected in 6 (1.3%) samples. Triple Pfdhfr IRNI (mutations are bolded and underlined) haplotype was dominant, contributing to 84% (number [n]=374) of haplotypes while 446 samples were studied for Pfdhps, WT for Pfdhps (SAKAA) was found in 6.7% (n=30) in samples. Double Pfdhps haplotype (SGEAA) accounted for 83% of all mutations at Pfdhps gene. Of 447 Pfdhfr-Pfdhps combined genotypes, only 0.9% (n=4) samples contained WT gene (SAKAA-NCSI). Quintuple (five) mutations, SGEAA-IRNI accounted for 71.4% (n=319) whereas 0.2% (n=1) had septuple (seven) mutations (AGKGS-IRNI). The overall prevalence of Pfdhfr K540E was 90.4% (n=396) while Pfdhps A581G was 1.1% (n=5).Conclusions: This study found high prevalence of Pfdhfr–Pfdhps quintuple and presence of septuple mutations. However, mutations at Pfdhfr K540E and Pfdhps A581G, major predictors for IPTp-SP failure were within the recommended WHO range. Stopping IPTp-SP is recommended in areas where the Pfdhfr K540E prevalence is >95 % and Pfdhps A581G is >10 % as SP is likely to be ineffective. Nonetheless, saturation in Pfdhfr and Pfdhps haplotypes is alarming, a search for alternative antimalarial drug for IPTp in the study area is recommended.
Broadening Risk Profile in Familial Colorectal Cancer Type X; increased risk for five cancer types in the national Danish cohort
Authors: Therkildsen Christina , Rasmussen Maria , Smith-Hansen Lars , Kallemose Thomas , Lindberg Lars Joachim , Nilbert Mef
Published: April 2020

BackgroundFamilial colorectal cancer type X (FCCTX) is a phenotypically defined subset of hereditary colorectal cancer with unknown and potentially heterogeneous genetic aetiology. FCCTX has been characterized as a colorectal cancer-specific syndrome, which we herein challenge by estimating the risk for extra-colorectal cancer in the Danish FCCTX cohort. MethodsThrough the national hereditary non-polyposis colorectal cancer (HNPCC) register, 213 families fulfilling the Amsterdam I criteria and showing retained mismatch repair (MMR) function were identified. In here, sex and age-specific incidence rate ratios (IRR) were calculated for 30 extra-colorectal cancer types in comparison with the general Danish population. ResultsIn total, 494 extra-colorectal cancers developed with significantly increased risks for cancers of the urinary tract, breast, stomach, pancreas, and eye tumours. The age groups at increased risks were 30-49 years for gastric cancer, 30-69 years for female breast cancer, 50-69 years for ocular melanoma and above age 70 for pancreatic cancer and urothelial cancer. ConclusionsDanish FCCTX families show an increased risk of several extra-colorectal cancer types. This observation may indicate unidentified disease-predisposing genetic variants in this phenotypically defined subset of hereditary colorectal cancer and calls for awareness during genetic counselling and follow-up.
Chromosomal instability in untreated primary prostate cancer as an indicator of metastatic potential
Authors: Miller Eric T , You Sungyong , Cadaneanu Radu M , Kim Minhyung , Yoon Junhee , Liu Sandy T , Li Xinmin , Kwan Lorna , Hodge Jennelle , Quist Michael J , Grasso Catherine S , Lewis Michael S. , Knudsen Beatrice S , Freeman Michael R , Garraway Isla P
Published: April 2020

Background: Metastatic prostate cancer (PC) is highly lethal. The ability to identify primary tumors capable of dissemination is an unmet need in the quest to understand lethal biology and improve patient outcomes. Previous studies have linked chromosomal instability (CIN), which generates aneuploidy following chromosomal missegregation during mitosis, to PC progression. Evidence of CIN includes broad copy number alterations (CNAs) spanning >300 base pairs of DNA, which may also be measured via RNA expression signatures associated with CNA frequency. Signatures of CIN in metastatic PC, however, have not been interrogated or well defined. We examined a published 70-gene CIN signature (CIN70) in untreated and castration-resistant prostate cancer (CRPC) cohorts from The Cancer Genome Atlas (TCGA) and previously published reports. We also performed transcriptome and CNA analysis in a unique cohort of untreated primary tumors collected from diagnostic prostate needle biopsies (PNBX) of localized (M0) and metastatic (M1) cases to determine if CIN was linked to clinical stage and outcome.
Methods: PNBX were collected from 99 patients treated in the VA Greater Los Angeles (GLA-VA) Healthcare System between 2000-2016. Total RNA was extracted from high-grade cancer areas in PNBX cores, followed by RNA sequencing and/or copy number analysis using OncoScan. Multivariate logistic regression analyses permitted calculation of odds ratios for CIN status (high versus low) in an expanded GLA-VA PNBX cohort (n = 121).
Results: The CIN70 signature was significantly enriched in primary tumors and CRPC metastases from M1 PC cases. An intersection of gene signatures comprised of differentially expressed genes (DEGs) generated through comparison of M1 versus M0 PNBX and primary CRPC tumors versus metastases revealed a 157-gene "metastasis" signature that was further distilled to 7-genes (PC-CIN) regulating centrosomes, chromosomal segregation, and mitotic spindle assembly. High PC-CIN scores correlated with CRPC, PC-death and all-cause mortality in the expanded GLA-VA PNBX cohort. Interestingly, approximately 1/3 of M1 PNBX cases exhibited low CIN, illuminating differential pathways of lethal PC progression.
Conclusions: Measuring CIN in PNBX by transcriptome profiling is feasible, and the PC-CIN signature may identify patients with a high risk of lethal progression at the time of diagnosis.
Glucose transporter GLUT1 influences Plasmodium berghei infection in Anopheles stephensi
Authors: Wang Mengfei , Wang Jingwen
Published: April 2020

Background: Sugar feeding provides energy for mosquitoes. Facilitated glucose transporters (GLUTs) are responsible for the uptake of glucose in animals. However, the knowledge of GLUTs function in Anopheles mosquito is limited. Methods: Phylogenetic analysis of GLUTs in Anopheles stephensi (Asteglut) was performed by the maximum likelihood and Bayesian method. The spatial and temporal expression patterns of the four Astegluts were analyzed by qPCR. The function of Asteglut1 was examined using a dsRNA-mediated RNA interference method. Transcriptome analysis was used to investigate the global influence of Asteglut1 on mosquito physiology. Results: We identified 4 glut genes, Asteglut1 , Asteglutx , Asteglut3 and Asteglut4 in An. stephensi . Asteglut1, Asteglut3 and Asteglut4 were mainly expressed in the midgut. Plasmodium berghei infection differentially regulated the expression of Astegluts with significant downregulation of Asteglut1 and Asteglut4 , while upregulation of Asteglutx . Only knocking down Asteglut1 facilitated Plasmodium berghei infection in An. stephensi . This might be due to the accumulation of glucose prior to blood feeding in dsAsteglut1-treated mosquitoes. Our transcriptome analysis revealed that knockdown of Asteglut1 differentially regulated expression of genes associated with multiple functional clusters, especially those related to detoxification and immunity. The dysregulation of multiple pathways might contribute to the increased P. berghei infection. Conclusions: Our study shows that Asteglut1 participates in defense against P. berghei in An. stephensi . The regulation of Asteglut1 on vector competence might through modulating multiple biological processes, such as detoxification and immunity.
Assessing the youth-friendliness of youth clinics in northern Sweden: a survey analyzing the perspective of the youth
Authors: Waenerlund Anna-Karin , Sebastian Miguel San , Hurtig Anna-Karin , Wiklund Maria , Christianson Monica , Goicolea Isabel
Published: April 2020

Background: Sweden has nearly 300 youth clinics that have been offering services since the 1970s. However, no evaluation has been done to assess their youth-friendliness. This study aims to assess: i) to what extent youth clinics are perceived as youth-friendly by the young people using them; and ii) if the level of youth friendliness is equally perceived across different sociodemographic groups of users. Methods: The four northernmost counties of Sweden were included in the study. Of the total identified 22 youth clinics, 20 participated by giving out questionnaires to the youth after their visits to the respective youth clinics. In total 1,110 youth participated in the study and answered questions according to the World Health Organization’s criteria of accessibility, equity, respect, privacy and confidentiality, no judgement, and quality. Means and frequencies were calculated, and t-test and ANOVA were used to compare means by sociodemographic variables. Results: Participants perceived the youth clinics as very youth friendly across the measured domains, with scores as high as 4.8 and 4.9 (of a maximum of 5).Youth clinics were perceived in a similar way regardless of gender, but other sociodemographic factors influenced some of the domains, especially ethnic background. Conclusions: The perception of youth friendliness in youth clinics was very high. Nonetheless, younger users; users who did not categorize themselves as either heterosexual, homosexual, or bisexual; users with trans-experiences; and users with non-Swedish backgrounds gave youth clinics lower scores for certain domains.
Influence of marital status on overall survival in adult patients with chordoma: A SEER-based study
Authors: Tang Chao , Wang Ruiliang , Lu Qingguo , Wang Shantao , Jia Gen , Cao Pengfei , Nie Xinfa , Zhang Hailong
Published: April 2020

Background. As a rare primary bone tumour, no studies have reported the relationship between prognosis and marital status in patients with chordoma.Methods. We classified patients with chordoma identified from the Surveillance, Epidemiology, and End Results (SEER) database from 1975 to 2016 into four groups: married, divorced/separated, widowed and single groups. Kaplan-Meier curves with log-rank test and Cox regression were used to analyse the effect of marital status on overall survival (OS).Results. A total of 1,080 patients were included in the study: 700 (64.8%) were married, 88 (8.1%) were divorced/separated, 78 (7.2%) were widowed, and 214 (19.8%) were single. Among the four groups, the 5-year OS (45.2%), 10-year OS (12.5%) and median OS (56.0 months) were the lowest in the widowed group. After including age, sex, primary site, marital status, disease stage, tumor size, histological type, and treatment pattern, multivariate analysis showed that marital status was still an independent risk factor for patients with chordoma, and widowed patients had the lowest OS (hazard ratio [HR]: 1.71; 95% confidence interval [CI]: 1.25–2.33, p<0.001) compared with married patients. Similar results were observed after stratifying the primary site and disease stage.Conclusion. Marital status was an independent prognostic indicator for adult patients with chordoma, and marital status was conducive to patient survival. Compared with married patients, widowed patients have a higher risk of death.
A Novel COMP Mutation in a Chinese Family with Multiple Epiphyseal Dysplasia
Authors: Shao Jiashen , Zhao Sen , Yan Zihui , Wang Lianlei , Zhang Yuanqiang , Lin Mao , Yu Chenxi , Wang Shengru , Niu Yuchen , Li Xiaoxin , Qiu Guixing , Zhang Jianguo , Wu Zhihong , Wu Nan
Published: April 2020

Background: Multiple epiphyseal dysplasia (MED) is a skeletal disorder characterized by delayed and irregular ossification of the epiphyses and early-onset osteoarthritis. At least 66% of the reported autosomal dominant MED (AD-MED) cases are caused by COMP mutations. Methods: We recruited a four-generation Chinese family with early-onset hip osteoarthritis, flatfoot, brachydactyly, and mild short stature. The assessment of family history, detailed physical examinations, and radiographic evaluations were performed on the proband and other family members, followed by the performance of whole-exome sequencing (WES). The pathogenicity of the candidate mutation was also analyzed. Results: We recruited an AD-MED family with 10 affected members and 17 unaffected members. The main radiographic findings were symmetrical changes in the dysplastic acetabulum and femoral heads, irregular contours of the epiphyses, a shortened femoral neck, and flatfoot. Lower bone density was also observed in the ankle joints, wrist joints, and knees, as well as irregular vertebral end plates. In the proband, we identified the missense mutation c.1153G>T (p. Asp385Tyr), located in exon 11 of the COMP gene. This mutation was assessed as “pathogenic” because of its low allele frequency and its high likelihood of co-segregation with disease in the reported family. Sanger sequencing identified the novel heterozygous mutation c.1153G>T (p. Asp385Tyr) in exon 11 of COMP in all affected individuals in the family. Conclusions: Our result underlined a key role of the Asp385 amino acid in the protein function of COMP, and confirmed the pathogenicity of the COMP (c.1153G>T; p. Asp385Tyr) mutation in AD-MED disease. We have therefore expanded the known mutational spectrum of COMP and revealed new phenotypic information for AD-MED.
Feasibility of Multi-Parametric Magnetic Resonance Imaging Combined with Machine Learning in the Assessment of Necrosis of Osteosarcoma after Neoadjuvant Chemotherapy: A Preliminary Study
Authors: Huang Bingsheng , Wang Jifei , Sun Meili , Chen Xin , Xu Danyang , Li Zi-Ping , Ma Jinting , Feng Shi-Ting , Gao Zhenhua
Published: April 2020

Background Response evaluation of neoadjuvant chemotherapy (NACT) in patients with osteosarcoma is significant for the termination of ineffective treatment, the development of postoperative chemotherapy regimens, and the prediction of prognosis. However, histological response and tumour necrosis rate can currently be evaluated only in resected specimens after NACT. A preoperatively accurate, noninvasive, and reproducible method of response assessment to NACT is required. In this study, the value of multi-parametric magnetic resonance imaging (MRI) combined with machine learning for assessment of tumour necrosis after NACT for osteosarcoma was investigated.Methods Twelve patients with primary osteosarcoma of limbs underwent NACT and received MRI examination before surgery. Postoperative tumour specimens were made corresponding to the transverse image of MRI. One hundred and two tissue samples were obtained and pathologically divided into tumour survival areas (non-cartilaginous and cartilaginous tumour viable areas) and tumour-nonviable areas (non-cartilaginous tumour necrosis areas, post-necrotic tumour collagen areas, and tumour necrotic cystic/haemorrhagic and secondary aneurismal bone cyst areas). The MRI parameters, including standardised apparent diffusion coefficient (ADC) values, signal intensity values of T2-weighted imaging (T2WI) and subtract-enhanced T1-weighted imaging (ST1WI) were used to train machine learning models based on the random forest algorithm. Three classification tasks of distinguishing tumour survival, non-cartilaginous tumour survival, and cartilaginous tumour survival from tumour nonviable were evaluated by five-fold cross-validation.Results For distinguishing non-cartilaginous tumour survival from tumour nonviable, the classifier constructed with ADC achieved an AUC of 0.93, while the classifier with multi-parametric MRI improved to 0.97 (P=0.0933). For distinguishing tumour survival from tumour nonviable, the classifier with ADC achieved an AUC of 0.83, while the classifier with multi-parametric MRI improved to 0.90 (P<0.05). For distinguishing cartilaginous tumour survival from tumour nonviable, the classifier with ADC achieved an AUC of 0.61, while the classifier with multi-parametric MRI parameters improved to 0.81(P<0.05).ConclusionsThe combination of multi-parametric MRI and machine learning significantly improved the discriminating ability of viable cartilaginous tumour components. Our study suggests that this method may provide an objective and accurate basis for NACT response evaluation in osteosarcoma.
CT Differential Diagnosis of COVID-19 and Non-COVID-19 in Symptomatic Suspects: A Practical Scoring Method
Authors: Luo Lin , Luo Zhendong , Jia Yizhen , Zhou Cuiping , He Jianlong , Lyu Jianxun , Shen Xinping
Published: April 2020

BackgroundAlthough typical and atypical CT image findings are reported in current studys, overlapping CT image features with viral pneumonia and other respiratory diseases also make difficulties on exclusion diagnosis. To explore a CT practical scoring system to differentia suspected COVID-19 in general hospital.MethodsThirty confirmed cases of COVID-19 and fourty-three cases of other etiology or clinical confirmed non-COVID-19 in a general hospital were included. The clinical data including age, sex, exposure history and laboratory parameters of all patients were collected. Seven positive signs (posterior part/ lower lobe predilection, bilateral involvement, rounded GGO, subpleural bandlike GGO, crazy-paving pattern, peripheral distribution, GGO +/- consolidation) from significant COVID-19 CT image features and four negative signs (only one lobe involvement, only central distribution, tree-in-bud sign, bronchial wall thickening) from other pneumonia significant image features were set. Scoring analysis of CT features were compared between the two groups (COVID-19 and non-COVID-19).ResultsOlder age, symptoms of diarrhea, exposure history of Wuhan, lower level of white blood cell and lymphocyte count were significantly suggestive of COVID-19 rather than Non- COVID-19 (p<0.05). The receiver operating characteristic (ROC) curve of combined CT image features analysis revealed area under the curves (AUC) of the scoring system was 0.854. These cut-off values yielded a sensitivity of 56.67% and a specificity of 95.35% for Score>4, a sensitivity of 100% and a specificity of 23.26% for Score>0, and a sensitivity of 86.67% and a specificity of 67.44% for score>2.ConclusionsWith a simple and practical scoring system based on the CT image features, we can make a hierarchical diagnosis on COVID-19 and non-COVID-19 with different management suggestion.
Coronavirus (COVID-19) in Italy: knowledge, management of patients and clinical experience of Italian dentists during the spread of contagion
Authors: Putrino Alessandra , Raso Mario , Magazzino Cosimo , Galluccio Gabriella
Published: April 2020

Background: The coronavirus infection that emerged in China in the last few months of 2019 has now spread globally. Italy registered its first case in the second half of February, and in a short time period, it became the top country in Europe in terms of the number of infected people and the first in the world in terms of deaths. The medical and scientific community has been called upon to manage the emergency and to take measures. Dentists also need to take new precautions during their clinical activity to protect themselves, coworkers and patients from the risks of contagion and to avoid further spread of infection. Methods: Following the data published in the international literature as well as the guidelines and directives constantly updated by the WHO and by the national health authorities, a questionnaire to be completed anonymously was submitted online to Italian dentists using social tools and online professional platforms. The collected data were processed statistically, providing descriptive data and analysis of correlations of the most significant parameters using the Pearson’s χ2, the Likelihood-Ratio χ2, Cramér’s V, Fisher’s exact test, Goodman and Kruskal’s γ, and Kendall’s τb (p<0.05). Results: A total of 535 dentists from Italy participated in the survey. A good level of scientific knowledge about coronavirus and the extra precautionary measures needed to limit the spread was related to the age of respondents and their sex. Coming from areas with higher concentrations of cases affected knowledge, level of attention and perception of risk related to dental activity. Conclusions: At the moment, there are no therapies or vaccines to contain the infection with the new coronavirus that is causing many infections, many of which are fatal, worldwide. Dentists are one of the categories at highest risk of encountering diseases and infections because they work in close proximity with patients, and in their procedures, there is always contact with aerosols with high bacterial and viral potential. Therefore, during this COVID-19 emergency, it is important that dentists are properly informed and take the appropriate precautionary measures.
Effectiveness of a Psycho-Education Intervention by Midwives (BILIEF protocol) on childbirth fear and childbirth self-efficacy in fearful first time pregnant women: a randomized controlled trial
Authors: Firouzan Laya , Kharaghani Roghieh , Zenoozian Saeedeh , Moloodi Reza , Jafari Elham
Published: April 2020

Background

The present study investigated the effectiveness of a Psycho-Education Intervention by Midwives (BILIEF protocol) in decreasing childbirth fear and childbirth self-efficacy among fearful first pregnant women in Iran.

Methods

From among 171 pregnant women screened to participate in the study, 80 women who got score ≥ 66 on the Wijma Delivery Expectancy/Experience Questionnaire were recruited. They were randomly assigned into two groups: intervention (n = 40) and control group (n = 40). The intervention group received two face-to-face counseling sessions in the 24th week and 34th week of pregnancy. Between this two counseling sessions, intervention group had 8 weekly telephone counseling sessions. The control group only received the prenatal routine care. The outcome measures were childbirth fear, childbirth self-efficacy, and childbirth preference.

Results

At the post-test, the intervention group showed significantly higher reduction in childbirth fear and higher increase in childbirth self-efficacy compared to the control group. Also, at posttest more women in the intervention group reported that they preferred to give birth via normal vaginal birth than women in the control group.

Conclusions

The BILIEF protocol could be effective approach to improve childbirth fear and childbirth self-efficacy in fearful first pregnant women.

Trial registration number

IRCT20101219005417N3, Date of Registration: 12-19-2018.
Evaluation of the eighth AJCC TNM stage for lung cancer (NSCLC): a meta-analysis of 8 validation studies
Authors: Wankhede Durgesh
Published: April 2020

Introduction

The AJCC eighth edition TNM classification for lung cancer was released in 2017 and included major newer modifications. External validation studies have evaluated the efficacy of the new system and obtained paradoxical results.

Methods

A meta-analysis was performed of these studies to evaluate the new classification. Eight eligible studies with 654,185 patients were included in the analysis. Hazard ratios (HRs) and associated 95% confidence intervals were extracted from identified studies. The primary outcomes were survival discrimination and prognostic value of the new staging system with respect to the 7 th edition.

Results

The HRs for the eighth edition staging system were found to increase steadily showing linear progression with 1.52 in IB, 1.82 in IIA, 1.97 in IIB, 2.19 in IIIA, 5.03 in IIIB, and 7.15 in IIIC compared with IA. The prognostic values of both systems were almost the same.

Conclusion

This study indicated that the survival discrimination of the eighth edition of the TNM classification is valid but its prognostic ability needs further evaluation.
Perceived barriers & facilitators for bedtime routines in families with young children living in economically deprived areas
Authors: Kitsaras George , Goodwin Michaela , Allan Julia , Kelly Michael P , Pretty Iain A
Published: April 2020

Background: Bedtime routines are a highly recurrent family activity with important health, social and behavioural consequences. Despite their importance, information regarding formation, establishment and maintenance of bedtime routines remains limited. This study examined perceived barriers to, and facilitators of, formulating, establishing and maintaining optimal bedtime routines in families with young children from deprived socio-economic areas.Methods: A total of 12 parents participated in the study. Most participants (N=11) were females, had between 1 and 2 children (N=10), were white (N=9) and stay at home parents (N=6). They completed a semi-structured interview based on the Theoretical Domains Framework (TDF). Analysis followed a deductive, theory-informed mapping approach.Results: Key barriers included lack of appropriate knowledge and sources of information, problematic skills development, social influences, cognitive overload, lack of self-monitoring, lack of motivation and negative emotions. Facilitators included social role/identity, environment/access to resources, positive intentions, beliefs about consequences and reinforcement. In particular, optimal bedtime routines were less likely to be enacted when parents were tired/fatigued and there was a strong effect of habit, with suboptimal routines maintained over time due to past experiences and a lack of awareness about the contents and importance of a good bedtime routine. Conclusions: Several theory-based, and potentially modifiable, determinants of optimal bedtime routines were identified in this study, providing important information for future interventions. Several of the key determinants identified were transient (tiredness) and/or non-conscious (habit), suggesting that future interventions may need to be deployed in real time, and should extend beyond conventional techniques.
Risk Factors for Sub–therapeutic Serum Concentrations of Magnesium Sulfate in Severe Preeclampsia of Chinese Patients
Authors: Li Jingjing , Tang Lian , Tang Ruiheng , Peng Lan , Chai Liqiang , Zhu Liping , Yu Yanxia
Published: April 2020

Background: Magnesium sulfate (MgSO4) is the ideal drug for eclampsia prophylaxis and treatment. In China, the effective therapeutic serum magnesium level is 1.8–3.0 mmol/L. Although there have been individual reports on the use of MgSO4 in pregnant women with severe preeclampsia, there is little information on how to achieve and maintain effective therapeutic concentrations in China. This study aimed to investigate risk factors for sub-therapeutic serum concentrations of MgSO4 in patients with severe preeclampsia.Methods: Patients with severe preeclampsia who received MgSO4 intravenous (IV) infusion were retrospectively reviewed. The maternal demographic characteristics, regimens for the administration of MgSO4, and lab test results of patients were collected. Multivariate logistic regression analysis and receiver operating characteristic (ROC) curve analysis were conducted for the risk factors influencing the serum magnesium concentration.Results: A total of 93 patients with severe preeclampsia were included in the study. There were 41 (44.09%) patients attained therapeutic serum magnesium levels and 52 (55.91%) patients did not. A multivariate logistic regression analysis identified creatinine clearance (Ccr), whether the loading dose was given, and measurement time of serum magnesium concentration (referring to the time interval from measurement of blood magnesium concentration to the beginning of maintenance dose administration) as independent risk factors for sub-therapeutic serum magnesium concentration (P < 0.05). ROC curve analysis indicated that the continuous variable Ccr had a significant predictive value for the serum magnesium concentration, which resulted in the area under ROC curve of 0.715 and a cutoff point of 132.82 mL/min, while measurement time had limited predictive value, with the area under ROC curve of 0.650 and cutoff point of 2.375 h.Conclusions: Ccr, whether the loading dose was given, and measurement time were independent risk factors for sub-therapeutic serum magnesium concentration. A loading dose of MgSO4 everytime before the maintenance dose, as well as an infusion time of more than 2.375 hours for MgSO4 maintenance dose are recommended for all the patients with severe PE. Routine evaluation of serum magnesium levels is a recommended practice for women with severe PE and whose Ccr is ≥ 132.82 mL/min.
Does internal limiting membrane peeling during epiretinal membrane surgery induce microscotomas on microperimetry? Study protocol for PEELING, a randomized controlled clinical trial
Authors: Ducloyer Jean-Baptiste , Ivan Juliette , Poinas Alexandra , Lebreton Olivier , Bonissent Alexandre , Fossum Paul , Volteau Christelle , Tadayoni Ramin , creuzot-garcher Catherine , Mer Yannick Le , Perol Julien , Fortin June , Chiffoleau Anne , Billaud Fanny , Ivan Catherine , Weber Michel
Published: April 2020

Background The epiretinal membrane (ERM) is a degenerative condition associated with age, which can cause loss of vision and/or metamorphopsia. The treatment of symptomatic ERM involves surgical removal including a vitrectomy followed by peeling of the ERM using a microforceps. As the internal limiting membrane (ILM) is adherent to the ERM, it is sometimes removed with it (spontaneous peeling). If ILM remains in place, it can be removed to reduce ERM recurrence. However, it is important to clarify the safety of ILM peeling while it increases surgical risks and cause histological disorganization of the retina that can lead to microscotomas maybe responsible for definitive visual discomfort.Methods PEELING is a prospective, randomized, controlled, single-blind and multi-centered trial with two parallel arms. This study investigates the benefit/risk ratio of active ILM peeling among subjects undergoing ERM surgery without spontaneous ILM peeling. Randomization is done in the operating room after ERM removal if ILM remains in place. After randomization, the two groups “active peeling of the ILM” and “no peeling of the ILM” are compared during a total of three follow-up visits scheduled at M1, M6 and M12. Primary endpoint is the difference in microscotomas before surgery and 6 months after surgery. Patients with spontaneous peeling are not randomized and are included in the ancillary study with the same follow-up visits and the same examinations as the principal study. Relevant inclusion criteria involve subjects over 18 years living with idiopathic symptomatic ERM, including pseudophakic patients with transparent posterior capsule or open capsule or lensed patients with age-related cataracts. The calculated sample size corresponds to 53 randomized eyes (1eye/patient) per arm that means 106 randomized eyes (106 randomized patients) in total and a maximum of 222 included patients (116 spontaneous peeling).Discussion ILM peeling is often practiced in ERM surgery to reduce ERM recurrence. It does not impair post-operative visual acuity but it increases the surgical risks and causes anatomical damages. If active ILM peeling is significantly associated with more microscotomas, it may contraindicate the ILM peeling during primitive idiopathic ERM surgery.Trial Registration ClinicalTrials.gov NCT02146144. Registered May 22, 2014. Recruitment is still ongoing
Nowcast Deep Learning Models For Constraining Zero-Day Pathogen Attacks – Application on Chest Radiographs to Covid-19
Authors: Kuo Michael D. , Chiu Wan Hang Keith , Vardhanabhuti Varut , Poplavskiy Dymtro , Yu Philip LH , Du Richard , Yap Alistair Yun Hee , Zhang Sailong , Fong Ambrose Ho-Tung , Chin Thomas Wing-Yan , Lee Jonan Chun Yin , Leung Siu Ting , Lo Christine Shing Yen , Lui Macy Mei-Sze , Fang Benjamin Xin Hao , Ng Ming-Yen
Published: April 2020

Outbreaks due to emergent pathogens like Covid-19 are difficult to contain as the time to gather sufficient information to develop a detection system is outpaced by the speed of transmission. Here we develop a general pneumonia (PNA) CXR Deep Learning (DL) model (MAIL1.0) follow by a second-generation DL model (MAIL2.0) for detection of Covid-19 on chest radiographs (CXR). We validate the models on two prospective cohorts of high-risks patients screened for Covid-19 reverse transcriptase-polymerase chain reaction (RT-PCR). MAIL1.0 has an Area Under the Receiver Operating Characteristics (AUC) of 0.93, sensitivity and specificity of 90.5% and 76.7% in detection of visible pneumonia and MAIL2.0 has an AUC of 0.81, sensitivity and specificity of 84.7% and 71.6%, significantly outperforming radiologists, especially amongst asymptomatic and patients presenting with early symptoms. Nowcast DL models may be an effective tool in helping to constrain the outbreak, particularly in resource-stretched healthcare systems.
Compact Single-Family Housing Generated by Parametric Design – Search for Optimal, Sustainable or Smart Densities
Authors: BRADECKI Tomasz , KĄTNY Dawid
Published: April 2020

Single-family housing – the form of residential buildings expected by the society is often inconsistent with the theoretical optimum form of housing that is recommended in urban theories and ideas. Research indicates that most Poles want single-family housing, while its density is low in comparison with multi-family housing which provides a more compact city. The paper identifies the thesis to what degree it is possible to develop a compact city with single-family housing. The authors verify how parametric design may be useful in urban design and spatial planning. The purpose of the article is to discuss the possibility to generate single-family housing estates’ projects using the parametric tool of the Grasshopper program. The authors demonstrate how parameter tool-supported designing may be useful for better effectiveness of using space. The research used a script by Dawid Kątny, developed for the purposes of his diploma thesis, in which he attempted parametric variants and optimization. The paper describes the issue of “density vs quality of life” in quantitative terms. Quantitative density variants can be used in analysis for future smart and intelligent cities’ development.
Method of Developing Conservation Guidelines for Revitalisation of the Historical Urban Ensembles Cultural Landscape
Authors: LUDWIG Bogna , WRÓBLEWSKI Sebastian , LISOWSKA Agnieszka , BALIŃSKA-CIĘŻKI Dorota , BALIŃSKA Grażyna
Published: April 2020

The paper presents a method developed and improved over many years (since 1982) by a team of researchers of the Faculty of Architecture of Wrocław University of Science and Technology for elaborating on guidelines for the conservation of cultural landscape areas. Thanks to systematic research – studies of the past changes to the landscape and analyses of the current state of affairs – they enable a synthesis of the whole spectrum of conservation protection and revalorisation problems of the area under development. They provide an appropriate basis for the preparation of planning documents. The use of their content is facilitated by an unambiguous, precise and easy-to-read graphical presentation. Currently, the technique of preparing conservation guidelines in their entirety or in certain selected aspects is applied by all graduates of the Wrocław University of Science and Technology in works requiring analysis of fragments of the cultural landscape.
Compressive Strength of Selected Fine Grained Soils Treated with Cement Kiln Dust and Calcareous Fly Ash
Authors: KNAPIK-JAJKIEWICZ Karolina , GAJ Grzegorz , KOWALSKI Adrian , PRĘDKA Sandra
Published: April 2020

This paper presents the results of unconfined compressive strength tests carried out on samples of two different fine grained soils mixed with anthropogenic materials produced in Poland, showing binding properties – cement kiln dust and fly ash obtained from combustion of brown coal in a pulverized boiler. The tests were performed on cylindrical samples in a testing machine for compression tests after various curing time ranging from 1 to 8 weeks. The conducted work constitutes the first stage of research devoted to the recognition of the effects of calcareous fly ash and cement kiln dust addition into the fine grained soils.
Shaping of Axially Compressed Bipolarly Prestressed Closely Spaced Built-Up Members
Authors: SIEDLECKA Monika
Published: April 2020

The paper presents a method of shaping and describing the geometry of bipolarly prestressed closely spaced built-up member with symmetrical supports and a bisymmetrical cross-section. The following has been defined as a function dependant on the position along the length of the x section of the closely spaced built-up member with determined geometrical parameters: intial elastic y
0 (x) of the closely spaced built-up member chord in the prestressing zone, distance between the chords in the clear s

i
(x), moment of inertia J

i
(x) relative to main axes and eccentricity e

i
(x) of compressive force in a single chord. The length of the extreme section L
1 and the prestressing zone L
2, the maximum distance between chords s

max
in the clear and the geometric characteristics of a single chord section were assumed. A full and correct description of the geometry of bipolarly prestressed closely spaced built-up members is necessary to start the static and stress analysis. As a result of the introduction of a bipolar displacement prestressing into the closely spaced built-up member, the moment of inertia increases in the middle part with respect to the non-material axis z. It allows predicting the increase of the critical load bearing capacity of the closely spaced built-up member. The load bearing capacity of bipolarly prestressed closely spaced built-up members was estimated using the modified Engesser’s formula for two-chord closely spaced built-up member with rigid battens. For selected pair of channel sections, the analytical critical load estimation results were verified using FEM.
Best Available Technologies for Waste Co-Firing Applications
Authors: WYKA Krzysztof , SKOREK-OSIKOWSKA Anna
Published: April 2020

Thermal transformation of waste is one way in which the negative impact of human activities on the environment can be reduced. Thermal waste treatment is generally negatively associated by the public as hazardous and harmful to the environment. In this study the authors present the possibility of waste management in the process of co-firing with coal using BAT (Best Available Techniques) for both the combustion process and the exhaust gas purification process. Co-firing of coal with RDF (Refuse Derived Fuel) while ensuring stable production of electricity and heat supports the process of waste management which, if not burned, will end up in landfills, which, according to the authors, is the worst possible way to handle waste both from the point of view of environmental protection itself and from the point of view of energy efficiency.
Morphological and physiological responses to drought stress in a set of Brazilian traditional upland rice varieties in post-anthesis stage
Authors: Ferreira Leandro Martins , Tavares Orlando Carlos Huertas , Oliveira Cristiana Maia de , Souza Sonia Regina de , Fernandes Manlio Silvestre , Santos Leandro Azevedo
Published: April 2020

Among the abiotic stresses that can affect the growth and development of the crop, drought is considered one of the main factors that can reduce the global food production. The goal of this study was to analyze the effect of drought stress on several morphological and physiological parameters in ten traditional upland rice varieties. The experimental design set up in a factorial scheme 10 x 2 (varieties x treatments) with four replicates under greenhouse conditions. At the start of the reproductive stage, rice varieties were submitted to control and drought conditions during 30 days and evaluated for physiological and morphological parameters. Rice varieties were considered as tolerant and susceptible to drought stress based on the classification proposed by five different stress tolerance indices (SSI, TOL, SSSI, DYI and DTE). The results suggest that the adopted indices associated with multivariate analysis from the parameters analyzed are efficient to discriminate between tolerant and susceptible rice varieties to the drought stress. Catetão and Piauí were considered as the most tolerant, while Quebra Cacho and Mira were the most susceptible. The analysis of morphological and physiological parameters through multivariate analyses revealed as an important tool to assist breeders in the identification of tolerant and susceptible varieties and to characterize how the varieties alter their metabolism to withstand the drought stress.