bluuebunny/crossref_metadata_2025 huggingface dataset:
Short-term findings of a custom-made 3D-printed titanium partial scaphoid prosthesis and scapholunate interosseous ligament reconstruction
Authors: Rossello Mario Igor
Published: July 2021

Following wrist trauma due to a karate accident, an 18-year-old male patient developed non-union of the scaphoid with proximal pole necrosis and significant scapholunate gap from an evident scapholunate interosseous ligament (SLIL) injury. A custom-made 3D-printed titanium implant was used for scaphoid replacement and SLIL reconstruction. Good clinical and radiographic outcomes were observed at his 2-year follow-up. Custom-made 3D-printed titanium implants are thought to provide a surgical solution for patients requiring site-specific scaphoid replacement while allowing the reconstruction of the scapholunate ligament.
Acute proptosis secondary to bilateral pansinus mucopyocele with orbital compartment syndrome: a rare presentation, its management and outcome
Authors: Chauhan Khushboo , Sharma Tanya , Sharma Bhavana , Karkhur Samendra
Published: July 2021

A 37-year-old Indian female presented with forward protrusion of left eye for one week, associated with progressive diminution of vision. The patient had undergone sinus surgery for nasal polyposis a year ago. On examination, there was severe proptosis and limitation of extraocular movements in all gazes. CT-scan revealed a heterogeneous expansile mass, arising from left fronto-ethmoidal sinus, infiltrating left orbit. MRI showed T2-hyperintense, peripherally enhancing areas in bilateral nasal cavity (right >left), bilateral ethmoidal sinuses and frontal, sphenoidal and maxillary sinuses. Otorhinolaryngology consultation was sought and in view of vision threatening proptosis — with likely orbital compartment syndrome — emergent endoscopic guided exploration and orbital decompression was undertaken. Rapid relief of signs and symptoms was achieved, with normal vision, extraocular movements and resolution of proptosis. Cytology and microbiology ruled out infectious or malignant aetiology and helped in resolving a diagnostic dilemma. Histopathology confirmed the diagnosis of mucopyocele and follow-up period was uneventful.
Deep learning algorithms for automatic detection of pterygium using anterior segment photographs from slit-lamp and hand-held cameras
Authors: Fang Xiaoling , Deshmukh Mihir , Chee Miao Li , Soh Zhi-Da , Teo Zhen Ling , Thakur Sahil , Goh Jocelyn Hui Lin , Liu Yu-Chi , Husain Rahat , Mehta Jodhbir S , Wong Tien Yin , Cheng Ching-Yu , Rim Tyler Hyungtaek , Tham Yih-Chung
Published: July 2021

Background/aims

To evaluate the performances of deep learning (DL) algorithms for detection of presence and extent pterygium, based on colour anterior segment photographs (ASPs) taken from slit-lamp and hand-held cameras.

Methods

Referable pterygium was defined as having extension towards the cornea from the limbus of >2.50 mm or base width at the limbus of >5.00 mm. 2503 images from the Singapore Epidemiology of Eye Diseases (SEED) study were used as the development set. Algorithms were validated on an internal set from the SEED cohort (629 images (55.3% pterygium, 8.4% referable pterygium)), and tested on two external clinic-based sets (set 1 with 2610 images (2.8% pterygium, 0.7% referable pterygium, from slit-lamp ASP); and set 2 with 3701 images, 2.5% pterygium, 0.9% referable pterygium, from hand-held ASP).

Results

The algorithm’s area under the receiver operating characteristic curve (AUROC) for detection of any pterygium was 99.5%(sensitivity=98.6%; specificity=99.0%) in internal test set, 99.1% (sensitivity=95.9%, specificity=98.5%) in external test set 1 and 99.7% (sensitivity=100.0%; specificity=88.3%) in external test set 2. For referable pterygium, the algorithm’s AUROC was 98.5% (sensitivity=94.0%; specificity=95.3%) in internal test set, 99.7% (sensitivity=87.2%; specificity=99.4%) in external set 1 and 99.0% (sensitivity=94.3%; specificity=98.0%) in external set 2.

Conclusion

DL algorithms based on ASPs can detect presence of and referable-level pterygium with optimal sensitivity and specificity. These algorithms, particularly if used with a handheld camera, may potentially be used as a simple screening tool for detection of referable pterygium. Further validation in community setting is warranted.

Synopsis/precis

DL algorithms based on ASPs can detect presence of and referable-level pterygium optimally, and may be used as a simple screening tool for the detection of referable pterygium in community screenings.
Measuring physician practice, preparedness and preferences for genomic medicine: a national survey
Authors: Nisselle Amy , King Emily A , McClaren Belinda , Janinski Monika , Metcalfe Sylvia , Gaff Clara
Published: July 2021

Objective

Even as genomic medicine is implemented globally, there remains a lack of rigorous, national assessments of physicians’ current genomic practice and continuing genomics education needs. The aim of this study was to address this gap.

Design

A cross-sectional survey, informed by qualitative data and behaviour change theory, to assess the current landscape of Australian physicians’ genomic medicine practice, perceptions of proximity and individual preparedness, and preferred models of practice and continuing education. The survey was advertised nationally through 10 medical colleges, 24 societies, 62 hospitals, social media, professional networks and snowballing.

Results

409 medical specialists across Australia responded, representing 30 specialties (majority paediatricians, 20%), from mainly public hospitals (70%) in metropolitan areas (75%). Half (53%) had contacted their local genetics services and half (54%) had ordered or referred for a gene panel or exome/genome sequencing test in the last year. Two-thirds (67%) think genomics will soon impact their practice, with a significant preference for models that involved genetics services (p<0.0001). Currently, respondents mainly perform tasks associated with pretest family history taking and counselling, but more respondents expect to perform tasks at all stages of testing in the future, including tasks related to the test itself, and reporting results. While one-third (34%) recently completed education in genomics, only a quarter (25%) felt prepared to practise. Specialists would like (more) education, particularly on genomic technologies and clinical utility, and prefer this to be through varied educational strategies.

Conclusions

This survey provides data from a breadth of physician specialties that can inform models of genetic service delivery and genomics education. The findings support education providers designing and delivering education that best meet learner needs to build a competent, genomic-literate workforce. Further analyses are underway to characterise early adopters of genomic medicine to inform strategies to increase engagement.
Effect of the oXiris membrane on microcirculation after cardiac surgery under cardiopulmonary bypass: study protocol for a randomised controlled trial (OXICARD Study)
Authors: Abou-Arab Osama , Huette Pierre , Haye Guillaume , Guilbart Mathieu , Touati Gilles , Diouf Momar , Beyls Christophe , Dupont Herve , Mahjoub Yazine
Published: July 2021

Introduction

Cytokine storm and endotoxin release during cardiac surgery with cardiopulmonary bypass (CPB) have been related to vasoplegic shock and organ dysfunction. We hypothesised that early (during CPB) cytokine adsorption with oXiris membrane for patients at high risk of inflammatory syndrome following cardiac surgery may improve microcirculation, endothelial function and outcomes.

Methods and analysis

The Oxicard trial is a prospective, monocentric trial, randomising 70 patients scheduled for cardiac surgery. The inclusion criterion is patients aged more than 18 years old undergoing elective cardiac surgery under CPB with an expected CPB time >90 min (double valve replacement or valve replacement plus coronary arterial bypass graft). Patients will be allocated to the intervention group (n=35) or the control group (n=35). In the intervention group, oXiris membrane will be used on the Prismaflex device (Baxter) at blood pump flow of 450 mL/min during cardiac surgery under CPB. In the control group, cardiac surgery under CPB will be conducted as usual without oXiris membrane. An intention-to-treat analysis will be performed. The primary endpoint will be the microcirculatory flow index measured by sublingual microcirculation device at day 1 following cardiac surgery. The secondary endpoints will be other microcirculation variables at CPB end, 6 hours after CPB, at day 1 and at day 2. We also aim to evaluate the occurrence of major cardiovascular and cerebral events (eg, myocardial infarction, stroke, ischaemic mesenteric, resuscitated cardiac arrest, acute kidney injury) within the first 30 days. Cumulative catecholamine use, intensive care unit length of stay, endothelium glycocalyx shedding parameters (syndecan-1, heparan-sulfate and hyaluronic acid), inflammatory cytokines (tumour necrosis factor (TNF) alpha, interleukin 1 (IL1) beta, IL 10, IL 6, lipopolysaccharide, endothelin) and endothelial permeability biomarkers (angiopoietin 1, angiopoietin 2, Tie2 soluble receptor and Vascular Endothelial Growth Factor (VEGF) will also be evaluated.

Ethics and dissemination

Ethical approval has been obtained from the Institutional Review Board of the University Hospital of Amiens (registration number ID RDB: 2019-A02437-50 in February 2020). Results of the study will be disseminated via peer-reviewed publications and presentations at national and international conferences.

Trial registration number

NCT04201119.
Initial implementation of PrEP in Zambia: health policy development and service delivery scale-up
Authors: Claassen Cassidy W. , Mumba Daliso , Njelesani Mwansa , Nyimbili Derrick , Mwango Linah K , Mwitumwa Mundia , Mubanga Ellen , Mulenga Lloyd B. , Chisenga Tina , Nichols Brooke E. , Hendrickson Cheryl , Chitembo Lastone , Okuku Jackson , O'Bra Heidi
Published: July 2021

Introduction

Daily pre-exposure prophylaxis (PrEP) for HIV prevention is highly effective, but not yet widely deployed in sub-Saharan Africa. We describe how Zambia developed PrEP health policy and then successfully implemented national PrEP service delivery.

Policy development

Zambia introduced PrEP as a key strategy for HIV prevention in 2016, and established a National PrEP Task Force to lead policy advocacy and development. The Task Force was composed of government representatives, regulatory agencies, international donors, implementation partners and civil society organisations. Following an implementation pilot, PrEP was rolled out nationally using risk-based criteria alongside a national HIV prevention campaign.

National Scale-up

In the first year of implementation, ending September 2018, 3626 persons initiated PrEP. By September 2019, the number of people starting PrEP increased by over sixfold to 23 327 persons at 728 sites across all ten Zambian provinces. In the first 2 years, 26 953 clients initiated PrEP in Zambia, of whom 31% were from key and priority populations. Continuation remains low at 25% and 11% at 6 and 12 months, respectively.

Lessons learnt

Risk-based criteria for PrEP ensures access to those most in need of HIV prevention. Healthcare worker training in PrEP service delivery and health needs of key and priority populations is crucial. PrEP expansion into primary healthcare clinics and community education is required to reach full potential. Additional work is needed to understand and address low PrEP continuation. Finally, a task force of key stakeholders can rapidly develop and implement health policy, which may serve as a model for countries seeking to implement PrEP.
Health-related quality of life in patients with implantable cardioverter defibrillators in Sweden: a cross-sectional observational trial
Authors: Magnusson Peter , Mattsson Gustav , Wallhagen Marita , Karlsson Jan
Published: July 2021

Objectives

Decisions regarding implantable cardioverter defibrillators (ICDs) must consider information about presumed health-related quality of life (HRQL). The purpose of the study was to assess HRQL in patients with ICD and compare it to a Swedish age-matched and sex-matched population.

Design

Cross-sectional observational trial.

Setting

Swedish ICD cohort.

Interventions

Short form 36 (SF-36) questionnaires from ICD recipients implanted 2007–2017 (response rate 77.2%) were analysed using Mann-Whitney U test and effect size (ES).

Results

In total, 223 patients (mean age 71.1±9.7 years, 82.1% men) were included. In most SF-36 domains (physical functioning (PF), role physical, general health (GH), vitality, social functioning and mental health), the score for patients with ICD was significantly lower (ES range 0.23–0.41, ie, small difference) than norms, except for bodily pain and role emotional. Both the physical component summary (PCS) and the mental component summary (MCS) scores had ES=0.31. Men and women had similar scores. Primary and secondary prevention patients scored similarly, except for worse GH in primary prevention (p=0.016, ES=0.35). Atrial fibrillation was associated with worse PF (ES=0.41) and PCS (ES=0.38). Appropriate therapy, inappropriate shock or complications requiring surgery were not associated with lower scores in any domain. In primary prevention due to ischaemic versus non-ischaemic cardiomyopathy, no domain was significantly different. PCS decreased with higher age strata (p=0.002) in contrast to MCS (p=0.986).

Conclusions

Patients with ICDs have lower physical and mental HRQL than age-matched and sex-matched norms; however, the ESs are small. HRQL is similar regardless of sex, primary/secondary prevention indication, appropriate therapy, inappropriate shock or complications, but decreases with advancing age.
Mixed-methods approach to develop an agreed concept on patient relevance: study protocol for the ‘PRO patients study’
Authors: Kersting Christine , Barzel Anne , Mortsiefer Achim
Published: July 2021

Introduction

With respect to patient-centred care and shared decision-making, measuring care effects based on outcomes relevant to patients is becoming increasingly important. Recently, a scoping review of the international literature revealed a wide range of supposedly patient-relevant outcomes and found that there is neither a sound definition of patient relevance nor a consistent set of outcomes relevant to patients. To close this gap, this study aims to develop an agreed concept on patient relevance including a set of outcomes relevant to patients irrespective of diseases, which grades outcomes according to their importance.

Methods and analysis

This prospective mixed-methods study will integrate the perspectives of patients across diseases, healthcare professionals and researchers. The consensus process will consist of four phases. Based on the results of the recent scoping review, a patient survey will be conducted first, followed by a multiprofessional group discussion. Finally, a two-round online Delphi approach based on data from the previous phases will be applied to agree on a concept.

Ethics and dissemination

Ethics approval for the study was granted on 26 August 2020 by the Ethics Commission of Witten/Herdecke University (reference number: 156/2020). In the long run, the implementation of an agreed concept on patient relevance will help improve the comparability of study results regarding the patient benefit and thereby strengthen the role of patients in the decision-making process. Also, the experiences regarding grading outcomes according to importance will help to develop a method on how to individualise clinical trial outcomes according to each patient’s individual specifics and priorities in order to more adequately represent the patient perspective in clinical research.

Trial registration number

Core Outcome Measures in Effectiveness Trials Initiative (registration number: 1685).
Mixed methods study protocol to explore acculturation, lifestyles and health of immigrants from the Community of Portuguese-Speaking Countries in two Iberian contexts: how to face uncertainties amidst the COVID-19 pandemic
Authors: Alves Daniela , Craveiro Isabel , Basabe Nekane , Gonçalves Luzia
Published: July 2021

Introduction

Studies which focus on the process of acculturation in the lifestyles, nutritional status and health of immigrants from the Community of Portuguese-Speaking Countries (CPLP) in the Iberian Peninsula are still scarce. This study aims to explore the influence of the acculturation process and dietary acculturation on the lifestyle and nutritional and health status of CPLP immigrants in Portugal and Spain, focusing on two Iberian contexts: Lisbon Metropolitan Area and the Basque Country.

Methods and analysis

A mixed methods sequential explanatory design, combining cross-sectional studies and semistructured interviews. Official data will also be analysed. Primary data will be collected through a questionnaire and assessment of nutritional status and body composition. The estimated samples sizes are 1061 adults (≥18 years old) in the Lisbon Metropolitan Area and 573 in the Basque Country. Time-location sampling will be used for the quantitative component and non-probabilistic sampling for the qualitative component. If safety conditions are not guaranteed due to the COVID-19 pandemic, online studies will be conducted. The semistructured interviews will complement the questionnaire data and extend knowledge about the process of acculturation of CPLP immigrants and their relationship with eating habits and physical activity. Thematic analysis will be used for qualitative data. Triangulation of data derived from different methods will be carried out. An integrative approach will be used to address potential discrepancies in findings and limitations inherent to the study design. As inter-method discrepancies may occur, triangulation protocol will be used, elaborating a ‘convergence coding matrix’ to display findings emerging from each component of the study.

Ethics and dissemination

Ethical approval was obtained through the IHMT Ethics Council (Doc No 20/2020), Portugal, and it was submitted to the Ethics Committee of the UPV/EHU (Doc No under revision), Spain.
Impact of duration of antibiotic prophylaxis on rates of surgical site infection (SSI) in patients undergoing mastectomy without immediate reconstruction, comparing a single prophylactic dose versus continued antibiotic prophylaxis postoperatively: a multicentre, double-blinded randomised control trial protocol
Authors: Sattar Abida K , Zahid Nida , Shahzad Hania , Soomro Rufina , Saleem Omema , Mahmood Syed Faisal
Published: July 2021

Introduction

In breast surgeries, prophylactic antibiotics given before the surgical incision as per Joint Commission Surgical Care Improvement Project guidelines have been shown to decrease the rate of postoperative infections. There is, however, no clear consensus on postoperative antibiotic prophylaxis in patients undergoing mastectomy with indwelling drains. This trial protocol proposes to study the difference in rates of surgical site infection (SSI) with or without continuation of postoperative antibiotics in patients undergoing mastectomy without immediate reconstruction and with indwelling drains.

Methods and analysis

In this multicentre, double-blinded clinical trial, all patients undergoing mastectomy (without immediate reconstruction) will receive a single prophylactic dose of preoperative antibiotics at induction of anaesthesia and will then get randomised to either continue antibiotic prophylaxis or a placebo postoperatively, for the duration of indwelling drains. The primary and secondary outcomes will be development of an SSI and antibiotic-associated adverse effects, respectively. Data will be collected through a standard questionnaire by wound assessors. Intention-to-treat analysis will be carried out using STATA V.12. For categorical variables, frequencies and percentages will be assessed by χ2test/Fisher’s exact test as appropriate. The quantitative variables will be computed by their mean±SD or median (IQR) and will be assessed by independent t-test/Mann-Whitney test as appropriate. Unadjusted and adjusted relative risk with their 95% CI will be reported using Cox proportional regression. A p value of <0.05 will be considered statistically significant.

Ethics and dissemination

Ethical approval has been obtained from each site’s Ethical Review Board. The study background and procedure will be explained to the study participants and informed consent will be obtained. Participation in the study is voluntary. All data will be deidentified and kept confidential. The study findings will be published in scientific media and authorship guidelines of International Committee of Medical Journal Editors will be followed.

Trial registration number

NCT04577846. (patient recruitment)
Ethnicity and COVID-19 outcomes among healthcare workers in the UK: UK-REACH ethico-legal research, qualitative research on healthcare workers’ experiences and stakeholder engagement protocol
Authors: Gogoi Mayuri , Reed-Berendt Ruby , Al-Oraibi Amani , Hassan Osama , Wobi Fatimah , Gupta Amit , Abubakar Ibrahim , Dove Edward , Nellums Laura B , Pareek Manish
Published: July 2021

Introduction

As the world continues to grapple with the COVID-19 pandemic, emerging evidence suggests that individuals from ethnic minority backgrounds may be disproportionately affected. The United Kingdom Research study into Ethnicity And COVID-19 outcomes in Healthcare workers (UK-REACH) project has been initiated to generate rapid evidence on whether and why ethnicity affects COVID-19 diagnosis and clinical outcomes in healthcare workers (HCWs) in the UK, through five interlinked work packages/work streams, three of which form the basis of this protocol. The ethico-legal work (Work Package 3) aims to understand and address legal, ethical and acceptability issues around big data research; the HCWs" experiences study (Work Package 4) explores their work and personal experiences, perceptions of risk, support and coping mechanisms; the stakeholder engagement work (Work Package 5) aims to provide feedback and support with the formulation and dissemination of the project recommendations.

Methods and analysis

Work Package 3 has two different research strands: (A) desk-based doctrinal research; and (B) empirical qualitative research with key opinion leaders. For the empirical research, in-depth interviews will be conducted digitally and recorded with participants’ permission. Recordings will be transcribed, coded and analysed using thematic analysis. In Work Package 4, online in-depth interviews and focus groups will be conducted with approximately 150 HCWs, from across the UK, and these will be recorded with participants’ consent. The recordings will be transcribed and coded and data will be analysed using thematic analysis. Work Package 5 will achieve its objectives through regular group meetings and in-group discussions.

Ethics and dissemination

Ethical approval has been received from the London-Brighton & Sussex Research Ethics Committee of the Health Research Authority (Ref No 20/HRA/4718). Results of the study will be published in open-access journals, and disseminated through conference presentations, project website, stakeholder organisations, media and scientific advisory groups.

Trial registration number

ISRCTN11811602.
Mechanical bowel preparation and oral antibiotics versus mechanical bowel preparation only prior rectal surgery (MOBILE2): a multicentre, double-blinded, randomised controlled trial—study protocol
Authors: Koskenvuo Laura , Lunkka Pipsa , Varpe Pirita , Hyöty Marja , Satokari Reetta , Haapamäki Carola , Lepistö Anna , Sallinen Ville
Published: July 2021

Introduction

Mechanical bowel preparation (MBP) prior to rectal surgery is widely used. Based on retrospective data many guidelines recommend mechanical and oral antibiotic bowel preparation (MOABP) to reduce postoperative complications and specifically surgical site infections (SSIs). The primary aim of this study is to examine whether MOABP reduces complications of rectal surgery.

Methods and analysis

The MOBILE2 (Mechanical Bowel Preparation and Oral Antibiotics vs Mechanical Bowel Preparation Only Prior Rectal Surgery) trial is a multicentre, double-blinded, parallel group, superiority, randomised controlled trial comparing MOABP to MBP among patients scheduled for rectal surgery with colorectal or coloanal anastomosis. The patients randomised to the MOABP group receive 1 g neomycin and 1 g metronidazole two times on a day prior to surgery and patients randomised to the MBP group receive identical placebo. Based on power calculations, 604 patients will be enrolled in the study. The primary outcome is Comprehensive Complication Index within 30 days after surgery. Secondary outcomes are SSIs within 30 days after surgery, the number and classification of anastomosis dehiscences, the length of hospital stay, mortality within 90 days after surgery and the number of patients who received adjuvant treatment if needed. Tertiary outcomes are overall survival, disease-specific survival, recurrence-free survival and difference in quality-of-life before and 1 year after surgery. In addition, the microbiota differences in colon mucosa are analysed.

Ethics and dissemination

The Ethics Committee of Helsinki University Hospital approved the study. The findings will be disseminated in peer-reviewed academic journals.

Trial registration number

NCT04281667.
How do children and adolescents experience healthcare professionals? Scoping review and interpretive synthesis
Authors: Davison Gail , Kelly Martina Ann , Conn Richard , Thompson Andrew , Dornan Tim
Published: July 2021

Objective

Explore children’s and adolescents’ (CADs’) lived experiences of healthcare professionals (HCPs).

Design

Scoping review methodology provided a six-step framework to, first, identify and organise existing evidence. Interpretive phenomenology provided methodological principles for, second, an interpretive synthesis of the life worlds of CADs receiving healthcare, as represented by verbatim accounts of their experiences.

Data sources

Five key databases (Ovid Medline, Embase, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus, and Web of Science), from inception through to January 2019, reference lists, and opportunistically identified publications.

Eligibility criteria

Research articles containing direct first-person quotations by CADs (aged 0–18 years inclusive) describing how they experienced HCPs.

Data extraction and synthesis

Tabulation of study characteristics, contextual information, and verbatim extraction of all ‘relevant’ (as defined above) direct quotations. Analysis of basic scope of the evidence base. The research team worked reflexively and collaboratively to interpret the qualitative data and construct a synthesis of children’s experiences. To consolidate and elaborate the interpretation, we held two focus groups with inpatient CADs in a children’s hospital.

Results

669 quotations from 99 studies described CADs’ experiences of HCPs. Favourable experiences were of forming trusting relationships and being involved in healthcare discussions and decisions; less favourable experiences were of not relating to or being unable to trust HCPs and/or being excluded from conversations about them. HCPs fostered trusting relationships by being personable, wise, sincere and relatable. HCPs made CADs feel involved by including them in conversations, explaining medical information, and listening to CADs’ wider needs and preferences.

Conclusion

These findings strengthen the case for making CADs partners in healthcare despite their youth. We propose that a criterion for high-quality child-centred healthcare should be that HCPs communicate in ways that engender trust and involvement.
Scoping review of balanced scorecards for use in healthcare settings: development and implementation
Authors: Bohm Victoria , Lacaille Diane , Spencer Nicole , Barber Claire EH
Published: July 2021

Objective

Balanced scorecards (BSCs) were developed in the early 1990s in corporate settings as a strategic performance management tool that emphasised measurement from multiple perspectives. Since their introduction, BSCs have been adapted for a variety of industries, including to healthcare settings. The aim of this scoping review was to describe the application of BSCs in healthcare.

Methods

Medline, Embase and CINHAL databases were searched using keywords and medical subject headings for ‘balanced scorecard’ and related terms from 1992 to 17/04/2020. Title and abstract screening and full text review were conducted in duplicate by two reviewers. Studies describing the development and/or implementation of a BSC in a healthcare setting were included. Data were abstracted using pilot-tested forms and reviewed for key themes and findings.

Results

8129 records were identified and 841 underwent a full text review. 87 articles were included. Over 26 countries were represented and the majority of BSCs were applied at a local level (54%) in hospital settings (41%). While almost all discussed Kaplan and Norton’s original BSC (97%), only 69% described alignment with a strategic plan. Patients/family members were rarely involved in development teams (3%) which typically were comprised of senior healthcare leaders/administrators. Only 21% of BSCs included perspectives using identical formatting to the original BSC description. Lessons learnt during development addressed three main themes: scorecard design, stakeholder engagement and feasibility.

Conclusions

BSC frameworks have been used in various healthcare settings but frequently undergo adaptation from the original description in order to suit a specific healthcare context. Future BSCs should aim to include patients/families to promote patient-centred healthcare systems. Considering the heterogeneity evident in development approaches, methodological guidance in this area is warranted.
Quantum fluctuation of stress tensor in a higher-derivative scalar field theory around a cosmic string
Authors: Kan Nahomi , Kuniyasu Masashi , Shiraishi Kiyoshi
Published: July 2021

In this paper, we calculate the vacuum fluctuation of the stress tensor of a higher-derivative theory around a thin cosmic string. To this end, we adopt the method to obtain the stress tensor from the effective action developed by Gibbons et al. By their method, the quantum stress tensor of higher-derivative scalar theories without self-interaction is expressed as a simple sum of quantum stress tensors of free massive scalar fields. Unlike the vacuum expectation value of the scalar field squared obtained in the similar model, there appears no reduction of the values near the conical singularity.
Hypergraphs and Rough Sets with Their Applications in Decision-Making Problems
Authors: Praba B. , Gomathi G.
Published: July 2021

In this work, authors introduce a novel rough set called hypergraph rough set using the minimal soft description. A relation [Formula: see text] on the set of all hypergraph rough sets T is defined and theoretically proved that [Formula: see text] is a lattice. The uniqueness of this study is highlighted by combining the hypergraphs and rough set theory. The developed concepts are illustrated through a real-life example which aims at finding the satisfaction level of employees in an organization. A comparative analysis authenticates the accuracy of the newly framed concept over the existing rough set theory.
Soft Measure Theory
Authors: Goldar Sujay , Ray Subhasis
Published: July 2021

In this paper, the notion of soft σ-algebra on the soft sets has been introduced. A correspondence relationship between the soft σ-algebra and the σ-algebra has been established. Consequently, soft measure is defined over the soft σ-algebra and the relationship between the soft measure and the corresponding measure has been drawn. Finally, the soft outer measure on the soft power set is coined and also the correspondence between the soft outer measure and the measure has been depicted.
Unprecedented reorganization of development history of traditional medicine: Part I
Authors: Liu Wenxian , Le Jingjing , Dong Jingcheng
Published: July 2021

According to the period development and the typical characteristics of medical stages, traditional medicine can be divided into six aspects: legendary traditional medicine, instinctive traditional medicine, witchcraft traditional medicine, empirical traditional medicine, theoretical traditional medicine and integrated traditional medicine. Among them, instinctive traditional medicine and legendary traditional medicine belong to the stage of ignorance according to the level of human cognition (“not knowing reason and result”, “only knowing result” and “knowing reason and result”). It belongs to the immature and hazy development period of human traditional medicine before it became “medicine” from the perspective of the development of traditional medicine, which can be summarized as the pre-medical period. Scientific understanding of traditional medicine and instinctive traditional medicine is helpful for people to understand and grasp the development of traditional medicine and even the whole medicine.
Evaluation of Pregnancy Outcomes of Vitrified-Warmed Blastocyst Transfer before and after Endometrial Receptivity Analysis in Identical Patients with Recurrent Implantation Failure
Authors: Kasahara Yuta , Hashimoto Tomoko , Yokomizo Ryo , Takeshige Yuya , Yoshinaga Koki , Toya Mayumi , Igarashi Hideki , Kishi Hiroshi , Kyono Koichi
Published: July 2021

Background: The clinical value of personalized embryo transfer (pET) guided by the endometrial receptivity analysis (ERA) tests for recurrent implantation failure (RIF) cases is still unclear. The aim of this study is to clarify the efficacy of ERA leading to personalization of the day of embryo transfer (ET) in RIF patients.

Methods: A retrospective study was performed for 94 patients with RIF who underwent ERA between July 2015 and December 2019. Pregnancy outcomes in a previous vitrified-warmed blastocyst transfer (previous VBT) and a personalized vitrified-warmed blastocyst transfer (pVBT) in identical patients were compared. The details of each pVBT were further analyzed between patients in a non-displaced group, which indicated “receptive” cases in ERA results and those who were in the displaced group, which indicated “non-receptive” cases.

Results: When the pregnancy rate, both per patient and per transfer cycle, of previous VBT and pVBT were compared, a significant increase in pVBT was observed between the two methods (5.3% vs. 62.8%, 4.4% vs. 47.9%, respectively). The pregnancy rates, implantation rates, and clinical pregnancy rates of the first pVBT were significantly higher in the displaced group than the non-displaced group. The cumulative ongoing pregnancy rate of the displaced group tended to be higher compared to that of the non-displaced group in the first pVBT, although the difference was not statistically significant (51.0% vs. 31.1%, [Formula: see text]).

Conclusions: Our study demonstrates that pVBT guided by ERA tests may improve pregnancy outcomes in RIF patients whose window of implantation (WOI) is displaced, and its effect may be more pronounced at the first pVBT. The displacement of WOI may be considered to be one of the causes of RIF, and its adjustment may contribute to the improvement of pregnancy outcomes in RIF patients.
A Survey of Unsupervised Generative Models for Exploratory Data Analysis and Representation Learning
Authors: Abukmeil Mohanad , Ferrari Stefano , Genovese Angelo , Piuri Vincenzo , Scotti Fabio
Published: July 2021

For more than a century, the methods for data representation and the exploration of the intrinsic structures of data have developed remarkably and consist of supervised and unsupervised methods. However, recent years have witnessed the flourishing of big data, where typical dataset dimensions are high and the data can come in messy, incomplete, unlabeled, or corrupted forms. Consequently, discovering the hidden structure buried inside such data becomes highly challenging. From this perspective, exploratory data analysis plays a substantial role in learning the hidden structures that encompass the significant features of the data in an ordered manner by extracting patterns and testing hypotheses to identify anomalies. Unsupervised generative learning models are a class of machine learning models characterized by their potential to reduce the dimensionality, discover the exploratory factors, and learn representations without any predefined labels; moreover, such models can generate the data from the reduced factors’ domain. The beginner researchers can find in this survey the recent unsupervised generative learning models for the purpose of data exploration and learning representations; specifically, this article covers three families of methods based on their usage in the era of big data: blind source separation, manifold learning, and neural networks, from shallow to deep architectures.
Rethinking the Landscape: Emerging Approaches to Archaeological Remote Sensing
Authors: Casana Jesse
Published: July 2021

An emerging arena of archaeological research is beginning to deploy remote sensing technologies—including aerial and satellite imagery, digital topographic data, and drone-acquired and terrestrial geophysical data—not only in support of conventional fieldwork but also as an independent means of exploring the archaeological landscape. This article provides a critical review of recent research that relies on an ever-growing arsenal of imagery and instruments to undertake innovative investigations: mapping regional-scale settlement histories, documenting ancient land use practices, revealing the complexity of settled spaces, building nuanced pictures of environmental contexts, and monitoring at-risk cultural heritage. At the same time, the disruptive nature of these technologies is generating complex new challenges and controversies surrounding data access and preservation, approaches to a deluge of information, and issues of ethical remote sensing. As we navigate these challenges, remote sensing technologies nonetheless offer revolutionary ways of interrogating the archaeological record and transformative insights into the human past.
The Genomics and Cell Biology of Host-Beneficial Intracellular Infections
Authors: McCutcheon John P.
Published: July 2021

Microbes gain access to eukaryotic cells as food for bacteria-grazing protists, for host protection by microbe-killing immune cells, or for microbial benefit when pathogens enter host cells to replicate. But microbes can also gain access to a host cell and become an important—often required—beneficial partner. The oldest beneficial microbial infections are the ancient eukaryotic organelles now called the mitochondrion and plastid. But numerous other host-beneficial intracellular infections occur throughout eukaryotes. Here I review the genomics and cell biology of these interactions with a focus on intracellular bacteria. The genomes of host-beneficial intracellular bacteria have features that span a previously unfilled gap between pathogens and organelles. Host cell adaptations to allow the intracellular persistence of beneficial bacteria are found along with evidence for the microbial manipulation of host cells, but the cellular mechanisms of beneficial bacterial infections are not well understood.
Analysis on Forestry Economic Growth Index Based on Internet Big Data
Authors: Duan Qingru , Kan Lianbao , Tsai Sang-Bing
Published: July 2021

The development of economic forestry industry is an important support in the process of rural revitalization strategy and precise poverty alleviation, as well as enrichment of the people. As the market of economic forestry products is close to a perfectly competitive market, brand effect is crucial under homogeneous competition, and economic forestry product enterprises and other business entities need to win and maintain sustainable competitive advantages through brand management. Currently, in the field of economic forest, products such as Chinese wolfberry, jujube, blueberry, fungus, walnut, tephrosia, hazelnut, and chestnut and forest foods and product brands with certain market recognition have emerged, but for most small- and medium-sized economic forest product enterprises, forest product brand cultivation and construction are still in the initial stage. Under the rapid development of the Internet, different types of Internet platforms, which provide new tools and possibilities for branding, the way of corporate brand marketing, and customer management services, have also undergone significant changes. In the market with serious homogenization and increasingly fierce competition, how to establish brand-consumer connection through the Internet platform, strengthen the intensity of consumer participation and connection to the brand, give play to the brand effect, and enhance the brand value in the long term, so as to obtain a new way to win a sustainable competitive advantage, has become an important proposition for all kinds of enterprises, including economic forest product enterprises. Combining the competitive characteristics of economic forestry products and the development of the Internet, the model of brand value enhancement of economic forestry products based on virtual brand communities is constructed. The model takes the experience value obtained by consumers in the virtual brand community as the antecedent and studies the path relationship from experience value, community identity, brand fit, and consumer brand value creation to brand value in four dimensions, utilitarian experience value, emotional experience value, social experience value, and learning experience value, and takes community integration and community support feeling as the moderating variables.
Stock Price Forecast Based on CNN-BiLSTM-ECA Model
Authors: Chen Yu , Fang Ruixin , Liang Ting , Sha Zongyu , Li Shicheng , Yi Yugen , Zhou Wei , Song Huilin
Published: July 2021

Financial data as a kind of multimedia data contains rich information, which has been widely used for data analysis task. However, how to predict the stock price is still a hot research problem for investors and researchers in financial field. Forecasting stock prices becomes an extremely challenging task due to high noise, nonlinearity, and volatility of the stock price time series data. In order to provide better prediction results of stock price, a new stock price prediction model named as CNN-BiLSTM-ECA is proposed, which combines Convolutional Neural Network (CNN), Bidirectional Long Short-term Memory (BiLSTM) network, and Attention Mechanism (AM). More specifically, CNN is utilized to extract the deep features of stock data for reducing the influence of high noise and nonlinearity. Then, BiLSTM network is employed to predict the stock price based on the extracted deep features. Meanwhile, a novel Efficient Channel Attention (ECA) module is introduced into the network model to further improve the sensitivity of the network to the important features and key information. Finally, extensive experiments are conducted on the three stock datasets such as Shanghai Composite Index, China Unicom, and CSI 300. Compared with the existing methods, the experimental results verify the effectiveness and feasibility of the proposed CNN-BILSTM-ECA network model, which can provide an important reference for investors to make decisions.
Association between Lipid Profiles and Serum Urate: A Cross-Sectional Study in Southwestern China
Authors: Qi Jiying , Dai Xiaojuan , Zhou Binbin , Su Yang , Xie Zhen , Liu Dongmei
Published: July 2021

Objective. The relationship between lipid profiles and serum urate has not been fully investigated. This study aims to investigate the sex- and age-specific association between lipid profiles and serum urate. Methods. This was a cross-sectional study involving 122,351 participants aged 18–99 years from a check-up centre in Southwestern China. Generalized additive models and smooth curve fitting were conducted to explore the association between components of lipid profiles and serum urate. Furthermore, multivariate linear and logistic regression models were also performed. Results. In generalized additive models, the fitted smoothing curves showed that serum urate fluctuated in a small range with total cholesterol, LDL-C, or HDL-C raising. After adjusting for confounders, the differences in serum urate progressively increased with raising serum triglycerides quartiles. The likelihood (odds ratio, OR) for developing serum urate > 420 μmol/L significantly increased in the highest quartile of triglycerides than in the lowest quartile, in hypertriglyceridemia than in normal triglycerides, and with 1 mmol/L increment in triglycerides in all sex- and age-specific groups. Furthermore, the increased OR (95% confidence interval) was higher in females than in males compared with their respective controls. Conclusions. Serum urate and the likelihood for developing serum urate >420 μmol/L increased with triglycerides raising. Females were in a higher likelihood for developing serum urate >420 μmol/L than males with raising triglycerides. With changes in total cholesterol, LDL-C, or HDL-C, serum urate fluctuated in a small range.
UserRBPM: User Retweet Behavior Prediction with Graph Representation Learning
Authors: Guo Huihui , Yang Li , Liu Zeyu
Published: July 2021

Social and information networks such as Facebook, Twitter, and Weibo have become the main social platforms for the public to share and exchange information, where we can easily access friends’ activities and in turn be influenced by them. Consequently, the analysis and modeling of user retweet behavior prediction have an important application value, such as information dissemination, public opinion monitoring, and product recommendation. Most of the existing solutions for user retweeting behavior prediction are usually based on network topology maps of information dissemination or designing various handcrafted rules to extract user‐specific and network‐specific features. However, these methods are very complex or heavily dependent on the knowledge of domain experts. Inspired by the successful use of neural networks in representation learning, we design a framework, UserRBPM, to explore potential driving factors and predictable signals in user retweet behavior. We use the graph embedding technology to extract the structural attributes of the ego network, consider the drivers of social influence from the spatial and temporal levels, and use graph convolutional networks and the graph attention mechanism to learn its potential social representation and predictive signals. Experimental results show that our proposed UserRBPM framework can significantly improve prediction performance and express social influence better than traditional feature engineering‐based approaches.
Torsional Behavior of High Strength Concrete Members Strengthened by Mixed Steel Fibers
Authors: Mures Jawad Kadhim , Ahmed Mazin Abdul Imam , Chkheiwer Aqeel Hatem
Published: July 2021

Twelve mixing steel fibers-reinforced high strength concrete beams were experimentally tested under pure torsion to investigating the concrete member torsional behavior. The first cracking torque, ultimate torsional resistance, crack patterns, effect of steel fiber ratio, effects of shape and size of hollow cross-section, and effect of stirrups reinforcement were discussed. The ratio of mixing steel fiber, different shape and size of hollow cross-section, and ratio of stirrups reinforcement were considers as major parameters. The results are shown that the width of cracks decreases and the cracks number increases with mixing steel fibers ratio increased. The first cracking torque and ultimate torsion load increased with decrease in the hollow cross-section area of high strength concrete members strengthened by steel fibers.