bluuebunny/crossref_metadata_2025 huggingface dataset:
The possible effect of different types of ventilation on reducing operation theatre infections: a meta-analysis
Authors: Lv Q , Lu Y , Wang H , Li X , Zhang W , Abdelrahim MEA , Wang L
Published: March 2021

It has been brought to our attention that this article is very similar to a publication in the journal, Infection Control & Hospital Epidemiology. Due to the timing of publication and difference in authorship between papers, we have decided to not retract this publication in this case, but would like to highlight the nature of this duplicate publication.

Introduction

The relation between type of ventilation used in the operating theatre and surgical site infection has drawn considerable attention. It has been reported that there is a possible relationship between the type of ventilation used in the operation theatre and surgical site infection. This meta-analysis was performed to evaluate this relationship.

Methods

Through a systematic literature search up to May 2020, 14 studies describing 590,121 operations, 328,183 were performed under laminar airflow ventilation and 2,611,938 were performed under conventional ventilation. Studies were identified that reported relationships between type of ventilation with its different categories and surgical site infection (10 studies were related to surgical site infection in total hip replacement, 7 in total knee arthroplasties and 3 in different abdominal and open vascular surgery). Odds ratios with 95% confidence intervals were calculated comparing surgical site infection prevalence and type of theatre ventilation using the dichotomous method with a random or fixed-effect model.

Findings

No significant difference was found between surgery performed under laminar airflow ventilation and conventional ventilation in total hip replacement (OR 1.23; 95% CI 0.97–1.56, p = 0.09), total knee arthroplasties (OR 1.14; 95% CI 0.62–2.09, p = 0.67) or different abdominal and open vascular surgery (OR 0.75; 95% CI 0.43–1.33, p = 0.33). The impact of the type of theatre ventilation may have no influence on surgical site infection as a tool for decreasing its occurrence.

Conclusions

Based on this meta-analysis, operating under laminar airflow or conventional ventilation may have no independent relationship with the risk of surgical site infection. This relationship forces us not to recommend the use of laminar airflow ventilation since it has a much higher cost compared with conventional ventilation.
A single centre evaluation of risk prediction models and imaging modalities in acute appendicitis
Authors: Ashcroft J , Singh AA , Rooney S , Bennett J , Davies RJ
Published: March 2021

Introduction

Patients with suspected appendicitis remain a diagnostic challenge. The aim of this study was to validate risk prediction models, and to investigate diagnostic accuracy of ultrasonography and computed tomography (CT) in adults undergoing appendicectomy.

Methods

A retrospective case review was performed of patients aged 16–45 years having an appendicectomy between January 2019 and January 2020 at a tertiary referral centre. Primary outcomes were the accuracy of a high risk appendicitis risk score and ultrasonography and CT imaging modalities compared with histological reports following appendicectomy.

Results

A total of 206 patients (52% female) were included in the study. Removal of a histologically normal appendix was equally likely in men and women (13.1% vs 11.2% respectively, relative risk: 1.17, 95% confidence interval: 0.56–2.44, p=0.674). A high risk appendicitis score correctly identified 84.0% (79/94) of cases in men and 85.9% (67/78) of cases in women. Ultrasonography was reported as equivocal in 85.7% (18/21) of low risk women and 59.0% (23/39) of high risk women. CT correctly detected or excluded appendicitis in 75.0% (6/8) of low risk women and 88.5% (23/26) of high risk women.

Conclusions

This study suggests that risk prediction models may be useful in both women and men to identify appendicitis. Ultrasonography gave high rates of equivocal results and should not be relied on for the diagnosis of appendicitis. CT is a highly accurate diagnostic tool and could be considered in those at low risk where clinical suspicion remains to reduce negative appendicectomy rates.
Penile fracture associated with complete urethra and bilateral corpora cavernosa transection
Authors: Mathew J , Parmar K , Chandna A , Kumar S
Published: March 2021

Penile fracture is a rare urological emergency caused by blunt trauma to the erect penis. It occurs due to the forcible bending of the turgid erect penis against resistance leading to tunica albuginea tear. The rupture of tunica albuginea surrounding the corpora cavernosa leads to hematoma formation and classical ‘aubergine’ deformity. Timely intervention is essential to improve sexual function. Urethral injury may occur concomitantly in case of severe trauma. Blood at the meatus, inability to void and haematuria are distinctive features. We describe a case of 36-year-old man who presented to the emergency department with penile fracture during sexual intercourse associated with blood at the meatus and voiding difficulty. On surgical exploration, complete bilateral corpora cavernosa tear and penile urethral transection was noted. The patient was successfully managed with timely repair. This case highlights the need for suspicion of an associated urethral injury in patients of penile fracture with blood at the meatus.
Locally advanced tongue squamous cell carcinoma in epidermolysis simplex bullosa patient: a therapeutic conundrum
Authors: Al Shareef W , Sayed S , Kamel S , Alkaf H , Bahaj A , Amin R , Al Herabi A
Published: March 2021

Epidermolysis bullosa simplex (EBS) is a debilitating condition affecting the skin and mucous membranes that is characterised by frequent ulceration and blistering on trivial trauma. In EBS, oral cavity mucosal injuries lead to a high propensity for developing squamous cell carcinomas. Locally advanced tongue carcinoma arising in this background presents a challenging therapeutic conundrum. To our knowledge, this is the first case of aggressive locally advanced tongue carcinoma that has developed sporadically in a patient with EBS and no family history. Routine screening of oral mucosal lesions will lead to early detection and timely management of this debilitating condition.
A huge abdominal mass revealing a depressive syndrome
Authors: Tarchouli M , Ait Idir B , Bouhabba N , El Jaouhari SD , Salaheddine T , Hnach Y , Zentar A
Published: March 2021

Trichobezoar is a rare condition that occurs mostly in young women with psychiatric disorders such as trichotillomania and trichophagia. We report the case of a giant gastric trichobezoar in a 21-year-old woman who presented with chronic abdominal pain, vomiting and weight loss. Abdominal examination revealed a large epigastric mass. Endoscopic and imaging findings were highly suggestive of a gastric trichobezoar. Surgical extraction of the huge hair mass was successfully performed through an open gastrotomy. Postoperatively, history of a neglected chronic depression with suicidal ideation was diagnosed. Consequently, the patient was referred to the psychiatric department for mental healthcare, to prevent trichobezoar recurrences.
Out-of-programme experience in UK neurosurgery trainees: optimising the transition back into clinical practice
Authors: Lam J , Evans G , deSouza RM , Amarouche M , Cheserem J , Tolias CM
Published: March 2021

INTRODUCTION

Out of programme (OOP) experience from training increases the skill pool of the neurosurgical workforce and drives innovation in the specialty. OOP approval criteria are well defined but transition back to clinical work can be challenging with a paucity of data published on trainee perspectives. Our study aimed to investigate factors influencing transition from OOP back to clinical work among neurosurgical trainees in the UK.

METHODS

An online survey was sent to all members of the Society of British Neurological Surgeons. Questions pertained to details of OOP and factors influencing transition back to clinical work.

RESULTS

Among the 73 respondents, 7 were currently on OOP and 27 had completed OOP in the past. Research was the most common reason for OOP (28/34, 82%) and this was generally motivated by the aspiration of an academic neurosurgery career (17/34, 50%). Although the majority (27/34, 79%) continued clinical work during OOP, 37% of this group (10/27) reported a reduction in their surgical skills. Fewer than half (15/34, 44%) had a return to work plan, of which only half (8/34, 24%) were formal plans. The majority of respondents who had completed OOP in the past (22/27, 81%) felt that they were able to apply the skills gained during OOP to their clinical work on return.

CONCLUSIONS

Skills learnt during OOP are relevant and transferable to the clinical environment but mainly limited to research with OOP for management and education underrepresented. Deterioration of surgical skills is a concern. However, recognition of this problem has prompted new methods and schemes to address challenges faced on return to work.
848 ppi high-brightness active-matrix micro-LED micro-display using GaN-on-Si epi-wafers towards mass production
Authors: Qi Longheng , Zhang Xu , Chong Wing Cheung , Li Peian , Lau Kei May
Published: March 2021

In this paper, fabrication processes of a 0.55-inch 400 × 240 high-brightness active-matrix micro-light-emitting diode (LED) display using GaN-on-Si epi-wafers are described. The micro-LED array, featuring a pixel size of 20 µm × 20 µm and a pixel density of 848 pixels per inch (ppi), was fabricated and integrated with a custom-designed CMOS driver through Au-Sn flip-chip bonding. Si growth substrate was removed using a crack-free wet etching method. Four-bit grayscale images and videos are clearly rendered. Optical crosstalk is discussed and can be mitigated through micro-LED array design and process modification. This high-performance, high-resolution micro-LED display demonstration provides a promising and cost-effective solution towards mass production of micro-displays for VR/AR applications.
Weak measurements of the waist of an arbitrarily polarized beam via in-plane spin splitting
Authors: Li Sixian , Chen Zhihao , Xie Linguo , Liao Qiyong , Zhou Xinxing , Chen Yu , Lin Xiao
Published: March 2021

As an important parameter to determine the transmission characteristics of a Gaussian beam, the beam waist holds a huge impact in laser technology and imaging systems. Although it is necessary to clearly measure the specific value of the beam waist, the traditional measurement steps are complex and easily introduce error in the measurement process. In this work, we propose an effective method using the in-plane spin splitting (IPSS) generated by the photonic spin Hall effect (PSHE) to precisely estimate the beam waist. We establish a highly sensitive propagation model to describe the relationship between the IPSS shifts and the beam waist of an arbitrary linearly polarized light and then combine with the quantum weak measurement system to amplify the IPSS shifts. We reveal that the IPSS shifts are sensitive to the variation of beam waists when the beam is reflected near the Brewster angle. With the huge amplified IPSS shifts (maximum of 1500 microns), the variation of beam waist can be accurately detected, even by propagation amplification alone. Prospectively, our scheme may provide an effective method for accurately determining the Gaussian beam waist of arbitrary polarization.
Boosting transparent electromagnetic interference shielding by multi-cavity resonances
Authors: Yuan Changwei , Huang Jinhua , Dong Yuxuan , Lu Yuehui , Li Jia , Liu Wenqing , Tang Genchu , Zhong Shuomin , Song Weijie
Published: March 2021

We propose a multi-cavity resonant architecture that is established by employing two opposing ultrathin silver-based films to form a Fabry–Pérot (F–P) cavity and inserting one or two metallic mesh layers in between. Compared with the single F–P cavity, the multi-cavity architecture with one metallic mesh layer experimentally exhibits a

∼

37

%

improvement in the average shielding effectiveness and maintains a transmittance over 80% at 550 nm. A more significant improvement of

∼

108

%

in shielding effectiveness (SE) can be achieved by inserting two metallic mesh layers. The proposed multi-cavity architecture provides a strategy for removal of the hindrance to transparent electromagnetic interference shielding.
Is Nothing Better Than Something?
Authors: Hecht Jeff
Published: March 2021

The idea of guiding light through hollow pipes dates to the 19th century, but solid-core fibers made much better optical waveguides. Now the emerging technology of hollow-core fibers has resurrected an old idea.
Impact of Preanalytical Factors on the Measurement of Tumor Tissue Biomarkers Using Immunohistochemistry
Authors: Bagchi Aditi , Madaj Zachary , Engel Kelly B. , Guan Ping , Rohrer Daniel C. , Valley Dana R. , Wolfrum Emily , Feenstra Kristin , Roche Nancy , Hostetter Galen , Moore Helen M. , Jewell Scott D.
Published: March 2021

Analysis of formalin-fixed paraffin-embedded (FFPE) tissue by immunohistochemistry (IHC) is commonplace in clinical and research laboratories. However, reports suggest that IHC results can be compromised by biospecimen preanalytical factors. The National Cancer Institute’s Biospecimen Preanalytical Variables Program conducted a systematic study to examine the potential effects of delay to fixation (DTF) and time in fixative (TIF) on IHC using 24 cancer biomarkers. Differences in IHC staining, relative to controls with a DTF of 1 hr, were observed in FFPE kidney tumor specimens after a DTF of ≥2 hr. Reductions in H-score and/or staining intensity were observed for c-MET, p53, PAX2, PAX8, pAKT, and survivin, whereas increases were observed for RCC1, EGFR, and CD10. Prolonged TIF of 72 hr resulted in significantly reduced H-scores of CD44 and c-Met in kidney tumor specimens, compared with controls with 12-hr TIF. An elevated probability of altered staining intensity due to DTF was observed for nine antigens, whereas for prolonged TIF an elevated probability was observed for one antigen. Results reported here and elsewhere across tumor types and antigens support limiting DTF to ≤1 hr when possible and fixing tissues in formalin for 12–24 hr to avoid confounding effects of these preanalytical factors on IHC.
Assessment of transparency indicators across the biomedical literature: How open is open?
Authors: Serghiou Stylianos , Contopoulos-Ioannidis Despina G. , Boyack Kevin W. , Riedel Nico , Wallach Joshua D. , Ioannidis John P. A.
Published: March 2021

Recent concerns about the reproducibility of science have led to several calls for more open and transparent research practices and for the monitoring of potential improvements over time. However, with tens of thousands of new biomedical articles published per week, manually mapping and monitoring changes in transparency is unrealistic. We present an open-source, automated approach to identify 5 indicators of transparency (data sharing, code sharing, conflicts of interest disclosures, funding disclosures, and protocol registration) and apply it across the entire open access biomedical literature of 2.75 million articles on PubMed Central (PMC). Our results indicate remarkable improvements in some (e.g., conflict of interest [COI] disclosures and funding disclosures), but not other (e.g., protocol registration and code sharing) areas of transparency over time, and map transparency across fields of science, countries, journals, and publishers. This work has enabled the creation of a large, integrated, and openly available database to expedite further efforts to monitor, understand, and promote transparency and reproducibility in science.
Public Baseline and shared response structures support the theory of antibody repertoire functional commonality
Authors: Raybould Matthew I. J. , Marks Claire , Kovaltsuk Aleksandr , Lewis Alan P. , Shi Jiye , Deane Charlotte M.
Published: March 2021

The naïve antibody/B-cell receptor (BCR) repertoires of different individuals ought to exhibit significant functional commonality, given that most pathogens trigger an effective antibody response to immunodominant epitopes. Sequence-based repertoire analysis has so far offered little evidence for this phenomenon. For example, a recent study estimated the number of shared (‘public’) antibody clonotypes in circulating baseline repertoires to be around 0.02% across ten unrelated individuals. However, to engage the same epitope, antibodies only require a similar binding site structure and the presence of key paratope interactions, which can occur even when their sequences are dissimilar. Here, we search for evidence of geometric similarity/convergence across human antibody repertoires. We first structurally profile naïve (‘baseline’) antibody diversity using snapshots from 41 unrelated individuals, predicting all modellable distinct structures within each repertoire. This analysis uncovers a high (much greater than random) degree of structural commonality. For instance, around 3% of distinct structures are common to the ten most diverse individual samples (‘Public Baseline’ structures). Our approach is the first computational method to find levels of BCR commonality commensurate with epitope immunodominance and could therefore be harnessed to find more genetically distant antibodies with same-epitope complementarity. We then apply the same structural profiling approach to repertoire snapshots from three individuals before and after flu vaccination, detecting a convergent structural drift indicative of recognising similar epitopes (‘Public Response’ structures). We show that Antibody Model Libraries derived from Public Baseline and Public Response structures represent a powerful geometric basis set of low-immunogenicity candidates exploitable for general or target-focused therapeutic antibody screening.
Co-circulation and misdiagnosis led to underestimation of the 2015–2017 Zika epidemic in the Americas
Authors: Oidtman Rachel J. , España Guido , Perkins T. Alex
Published: March 2021

During the 2015–2017 Zika epidemic, dengue and chikungunya–two other viral diseases with the same vector as Zika–were also in circulation. Clinical presentation of these diseases can vary from person to person in terms of symptoms and severity, making it difficult to differentially diagnose them. Under these circumstances, it is possible that numerous cases of Zika could have been misdiagnosed as dengue or chikungunya, or vice versa. Given the importance of surveillance data for informing epidemiological analyses, our aim was to quantify the potential extent of misdiagnosis during this epidemic. Using basic principles of probability and empirical estimates of diagnostic sensitivity and specificity, we generated revised estimates of reported cases of Zika that accounted for the accuracy of diagnoses made on the basis of clinical presentation with or without laboratory confirmation. Applying this method to weekly reported case data from 43 countries throughout Latin America and the Caribbean, we estimated that 944,700 (95% CrI: 884,900–996,400) Zika cases occurred when assuming all confirmed cases were diagnosed using molecular methods versus 608,400 (95% CrI: 442,000–821,800) Zika cases that occurred when assuming all confirmed cases were diagnosed using serological methods. Our results imply that misdiagnosis was more common in countries with proportionally higher reported cases of dengue and chikungunya, such as Brazil. Given that Zika, dengue, and chikungunya appear likely to co-circulate in the Americas and elsewhere for years to come, our methodology has the potential to enhance the interpretation of passive surveillance data for these diseases going forward. Likewise, our methodology could also be used to help resolve transmission dynamics of other co-circulating diseases with similarities in symptomatology and potential for misdiagnosis.
Subjective caregiver burden and anxiety in informal caregivers: A systematic review and meta-analysis
Authors: del-Pino-Casado Rafael , Priego-Cubero Emilia , López-Martínez Catalina , Orgeta Vasiliki
Published: March 2021

There is increasing evidence that subjective caregiver burden is an important determinant of clinically significant anxiety in family carers. This meta-analysis aims to synthesise this evidence and investigate the relationship between subjective caregiver burden and anxiety symptoms in informal caregivers. We searched PubMed, CINAHL and PsycINFO up to January 2020. Combined estimates were obtained using a random-effects model. After screening of 4,312 articles, 74 studies (with 75 independent samples) were included. There was a large, positive association between subjective caregiver burden and anxiety symptoms (r = 0.51; 95% CI = 0.47, 0.54; I2 = 0.0%). No differences were found in subgroup analyses by type of study design (cross-sectional vs. longitudinal), sampling, control of confounders or care-recipient characteristics. Subjective caregiver burden is an important risk factor for anxiety in informal caregivers. Targeting subjective caregiver burden could be beneficial in preventing clinically significant anxiety for the increasing number of family carers worldwide.
Personalized prediction of early childhood asthma persistence: A machine learning approach
Authors: Bose Saurav , Kenyon Chén C. , Masino Aaron J.
Published: March 2021

Early childhood asthma diagnosis is common; however, many children diagnosed before age 5 experience symptom resolution and it remains difficult to identify individuals whose symptoms will persist. Our objective was to develop machine learning models to identify which individuals diagnosed with asthma before age 5 continue to experience asthma-related visits. We curated a retrospective dataset for 9,934 children derived from electronic health record (EHR) data. We trained five machine learning models to differentiate individuals without subsequent asthma-related visits (transient diagnosis) from those with asthma-related visits between ages 5 and 10 (persistent diagnosis) given clinical information up to age 5 years. Based on average NPV-Specificity area (ANSA), all models performed significantly better than random chance, with XGBoost obtaining the best performance (0.43 mean ANSA). Feature importance analysis indicated age of last asthma diagnosis under 5 years, total number of asthma related visits, self-identified black race, allergic rhinitis, and eczema as important features. Although our models appear to perform well, a lack of prior models utilizing a large number of features to predict individual persistence makes direct comparison infeasible. However, feature importance analysis indicates our models are consistent with prior research indicating diagnosis age and prior health service utilization as important predictors of persistent asthma. We therefore find that machine learning models can predict which individuals will experience persistent asthma with good performance and may be useful to guide clinician and parental decisions regarding asthma counselling in early childhood.
Facial expression in humans as a measure of empathy towards farm animals in pain
Authors: Ly Lexis H. , Weary Daniel M.
Published: March 2021

People often express concern for the welfare of farm animals, but research on this topic has relied upon self-report. Facial expressions provide a quantifiable measure of emotional response that may be less susceptible to social desirability bias and other issues associated with self-report. Viewing other humans in pain elicits facial expressions indicative of empathy. Here we provide the first evidence that this measure can also be used to assess human empathetic responses towards farm animals, showing that facial expressions respond reliably when participants view videos of farm animals undergoing painful procedures. Participants (n= 30) were asked to watch publicly sourced video clips of cows and pigs undergoing common management procedures (e.g. disbudding, castration, tail docking) and control videos (e.g. being lightly restrained, standing). Participants provided their subjective rating of the intensity of 5 negative emotions (pain, sadness, anger, fear, disgust) on an 11-point Likert scale. Videos of the participants (watching the animals) were scored for intensity of unpleasantness of the participants’ facial expression (also on an 11-point Likert scale) by a trained observer who was blind to treatment. Participants showed more intense facial expressions while viewing painful procedures versus control procedures (mean ± SE Likert; 2.4 ± 0.08 versus 0.6 ± 0.17). Participants who reported more intense negative responses also showed stronger facial expressions (slope ± SE = 0.4 ± 0.04). Both the self-reported and facial measures varied with species and procedure witnessed. These results indicate that facial expressions can be used to assess human-animal empathy.
A 4D continuous representation of myocardial velocity fields from tissue phase mapping magnetic resonance imaging
Authors: Bendiksen Bård A. , McGinley Gary , Sjaastad Ivar , Zhang Lili , Espe Emil K. S.
Published: March 2021

Myocardial velocities carry important diagnostic information in a range of cardiac diseases, and play an important role in diagnosing and grading left ventricular diastolic dysfunction. Tissue Phase Mapping (TPM) Magnetic Resonance Imaging (MRI) enables discrete sampling of the myocardium’s underlying smooth and continuous velocity field. This paper presents a post-processing framework for constructing a spatially and temporally smooth and continuous representation of the myocardium’s velocity field from TPM data. In the proposed scheme, the velocity field is represented through either linear or cubic B-spline basis functions. The framework facilitates both interpolation and noise reducing approximation. As a proof-of-concept, the framework was evaluated using artificially noisy (i.e., synthetic) velocity fields created by adding different levels of noise to an original TPM data. The framework’s ability to restore the original velocity field was investigated using Bland-Altman statistics. Moreover, we calculated myocardial material point trajectories through temporal integration of the original and synthetic fields. The effect of noise reduction on the calculated trajectories was investigated by assessing the distance between the start and end position of material points after one complete cardiac cycle (end point error). We found that the Bland-Altman limits of agreement between the original and the synthetic velocity fields were reduced after application of the framework. Furthermore, the integrated trajectories exhibited consistently lower end point error. These results suggest that the proposed method generates a realistic continuous representation of myocardial velocity fields from noisy and discrete TPM data. Linear B-splines resulted in narrower limits of agreement between the original and synthetic fields, compared to Cubic B-splines. The end point errors were also consistently lower for Linear B-splines than for cubic. Linear B-splines therefore appear to be more suitable for TPM data.
SNX25 regulates proinflammatory cytokine expression via the NF-κB signal in macrophages
Authors: Nishimura Kazuya , Tanaka Tatsuhide , Takemura Shoko , Tatsumi Kouko , Wanaka Akio
Published: March 2021

Innate immunity is the first line of defense against bacterial infection and is initiated by macrophages. Sorting nexin 25 (SNX25) is an SNX family member and is reported to negatively regulate TGF-β signaling by enhancing TGF receptor degradation. However, few studies have focused on the relationship between SNX25 and the immune system. We knocked down SNX25 expression in macrophages and examined inflammatory cytokine expression, a hallmark of innate immunity, after lipopolysaccharide stimulation. SNX25 knockdown increased proinflammatory cytokine expression in RAW 264.7 cells. In addition, SNX25 knockdown activated the NF-κB signal by promoting ubiquitination of IκBα. These results suggest that SNX25 inhibits the NF-κB signal and thereby regulates proinflammatory cytokine expression in macrophages.
The impact of public coverage of newer hepatitis C medications on utilization, adherence, and costs in British Columbia
Authors: Ho Harriet , Janjua Naveed Z. , McGrail Kimberlyn M. , Harrison Mark ,   The BC Hepatitis Testers Cohort Team, Law Michael R.
Published: March 2021

Background

Sofosbuvir and ledipasvir-sofosbuvir are both newer direct-acting antiviral agents for the treatment of hepatitis C. The high list prices for both drugs have led to concern about the budget impact for public drug coverage programs. Therefore, we studied the impact of public prescription drug coverage for both drugs on utilization, adherence, and public and private expenditure in British Columbia, Canada.

Methods

We used provincial administrative claims data from January 2014 to June 2017 for all individuals historically tested for either hepatitis C and/or human immunodeficiency virus. Using interrupted time series analysis, we examined the impact of public insurance coverage on treatment uptake, adherence (proportion of days covered), and public and private expenditures.

Results

Over our study period, 4,462 treatment initiations were eligible for analysis (1,131 sofosbuvir and 3,331 ledipasvir-sofosbuvir, which include 19 patients initiated on both treatments). We found the start of public coverage for sofosbuvir and ledipasvir-sofosbuvir increased treatment uptake by 154%. Adherence rates were consistently high and did not change with public coverage. Finally, public expenditure increased after the policy change, and crowded out some private expenditure.

Conclusion

Public coverage for high-cost drugs for hepatitis C dramatically increased use of these drugs, but did not reduce adherence. From a health policy perspective, public payers should be prepared for increased treatment uptake following the availability of public coverage. However, they should not be concerned that populations without private insurance coverage will be less adherent and not finish their treatment course.
EGFR mutation-guided use of afatinib, erlotinib and gefitinib for advanced non-small-cell lung cancer in Hong Kong – A cost-effectiveness analysis
Authors: You Joyce H. S. , Cho William C. S. , Ming Wai-kit , Li Yu-chung , Kwan Chung-kong , Au Kwok-hung , Au Joseph Siu-kie
Published: March 2021

Introduction

Tyrosine kinase inhibitors (TKIs) therapy targets at epidermal growth factor receptor (EGFR) gene mutations in non-small-cell lung cancer (NSCLC). We aimed to compare the EGFR mutation-guided target therapy versus empirical chemotherapy for first-line treatment of advanced NSCLC in the public healthcare setting of Hong Kong.

Methods

A Markov model was designed to simulate outcomes of a hypothetical cohort of advanced (stage IIIB/IV) NSCLC adult patients with un-tested EGFR-sensitizing mutation status. Four treatment strategies were evaluated: Empirical first-line chemotherapy with cisplatin-pemetrexed (empirical chemotherapy group), and EGFR mutation-guided use of a TKI (afatinib, erlotinib, and gefitinib). Model outcome measures were direct medical cost, progression-free survival, overall survival, and quality-adjusted life-years (QALYs). Incremental cost per QALY gained (ICER) was estimated. Sensitivity analyses were performed to examine robustness of model results.

Results

Empirical chemotherapy and EGFR mutation-guided gefitinib gained lower QALYs at higher costs than the erlotinib group. Comparing with EGFR mutation-guided erlotinib, the afatinib strategy gained additional QALYs with ICER (540,633 USD/QALY). In 10,000 Monte Carlo simulations for probabilistic sensitivity analysis, EGFR mutation-guided afatinib, erlotinib, gefitinib and empirical chemotherapy were preferred strategy in 0%, 98%, 0% and 2% of time at willingness-to-pay (WTP) 47,812 USD/QALY (1x gross domestic product (GDP) per capita), and in 30%, 68%, 2% and 0% of time at WTP 143,436 USD/QALY (3x GDP per capita), respectively.

Conclusions

EGFR mutation-guided erlotinib appears to be the cost-effective strategy from the perspective of Hong Kong public healthcare provider over a broad range of WTP.
Genomic characterization of 99 viruses from the bunyavirus families Nairoviridae, Peribunyaviridae, and Phenuiviridae, including 35 previously unsequenced viruses
Authors: Kapuscinski Marylee L. , Bergren Nicholas A. , Russell Brandy J. , Lee Justin S. , Borland Erin M. , Hartman Daniel A. , King David C. , Hughes Holly R. , Burkhalter Kristen L. , Kading Rebekah C. , Stenglein Mark D.
Published: March 2021

Bunyaviruses (Negarnaviricota:Bunyavirales) are a large and diverse group of viruses that include important human, veterinary, and plant pathogens. The rapid characterization of known and new emerging pathogens depends on the availability of comprehensive reference sequence databases that can be used to match unknowns, infer evolutionary relationships and pathogenic potential, and make response decisions in an evidence-based manner. In this study, we determined the coding-complete genome sequences of 99 bunyaviruses in the Centers for Disease Control and Prevention’s Arbovirus Reference Collection, focusing on orthonairoviruses (familyNairoviridae), orthobunyaviruses (Peribunyaviridae), and phleboviruses (Phenuiviridae) that either completely or partially lacked genome sequences. These viruses had been collected over 66 years from 27 countries from vertebrates and arthropods representing 37 genera. Many of the viruses had been characterized serologically and through experimental infection of animals but were isolated in the pre-sequencing era. We took advantage of our unusually large sample size to systematically evaluate genomic characteristics of these viruses, including reassortment, and co-infection. We corroborated our findings using several independent molecular and virologic approaches, including Sanger sequencing of 197 genome segments, and plaque isolation of viruses from putative co-infected virus stocks. This study contributes to the described genetic diversity of bunyaviruses and will enhance the capacity to characterize emerging human pathogenic bunyaviruses.
Shaping physical, social and imaginary spaces in healthcare design labs
Authors: Romm Jonathan , Agudelo Natalia , Freitas Thiago
Published: March 2021

The use of service design to support healthcare innovation has increased over the past decade. Recently, a growing number of design labs have been established to facilitate service design processes inside healthcare organizations. There is a growing need to gain a deeper understanding of how to set up and work within these spaces so that they live up to their promise of healthcare innovation and do not become a hype that fades out over time. Despite a growing body of literature on design labs, little attention has been given to the role of the lab space and how space may be ‘made use of’ to support healthcare service design. To examine the practice of making use of space, action research was conducted by embedding a design lab inside a hospital. Through empirical observations, we unpack three spatial dimensions that are made use of inside healthcare service design labs: (1) physical spaces supporting sensemaking and promoting innovation as culture; (2) social spaces facilitating and encouraging interactions among stakeholders; and (3) imaginary spaces challenging mental models and shaping propositions collaboratively. This extended understanding of lab space challenges existing research priorities, suggesting practical implications for using space more purposefully within design labs.
Antologia Grega. Epigramas de Banquete e Burlescos: (Livro XI)
Authors: Jesus Carlos A. Martins de
Published: March 2021

Os 442 epigramas que constituem o livro XI da Antologia Grega constituem uma a melhor mostra do género do epigrama satírico da antiguidade grega, da época clássica à bizantina. Ainda assim, o anónimo escriba do Palatinus estabeleceu uma subdivisão interna, entre poemas ditos “de banquete” (sympotika, núms. 1-64) e “burlescos” (skoptika, núms. 65-442). Reveladoras são as suas palavras sobre estes componentes: “Amplo uso se fez, ao longo da vida, dos epigramas burlescos, dado que o homem tanto gosta de burlar-se dos outros como de ouvir os outros a burlar-se do próximo, algo que, estou em crer, sempre aconteceu entre os antigos, como se mostrará com os epigramas seguintes”
Trust and Normative Control in Multi-Agent Systems
Authors: Urbano Joana , Cardoso Henrique Lopes , Rocha Ana Paula , Oliveira Eugénio
Published: March 2021

Despite relevant insights from socio-economics, little research in multi-agent systems has addressed the interconnections between trust and normative notions such as contracts and sanctions. Focusing our attention on scenarios of betrayal, in this paper we combine the use of trust and sanctions in a negotiation process. We describe a scenario of dyadic relationships between truster agents, which make use of trust and/or sanctions, and trustee agents, characterized by their ability and integrity, which may influence their attitude toward betrayal. Both agent behavior models are inspired in socio-economics literature. Through simulation, we show the virtues and shortcomings of using trust, sanctions, and a combination of both in processes of selection of partners.
Real-Time Activity Recognition and Assistance in Smart Classrooms
Authors: Efthymiou Vasileios , Koutraki Maria , Antoniou Grigoris
Published: March 2021

In this paper, we propose Bees Algorithm (BA) to enhance the performance in estimating the parameters for metabolic pathway data to simulate fermentation pathway for Saccharomyces cerevisiae. However, the parameter estimation of biological processes has always been a challenging task due to the complexity and nonlinear equations. Therefore, we present this algorithm as a new approach for parameter estimation for biological interactions to obtain more accurate parameter values. The result shows that BA outperforms other estimation algorithms as it produces the most accurate kinetic parameters, which contributes to the precision of simulated kinetic model.
Detecting DoS Attack in Web Services by Using an Adaptive Multiagent Solution
Authors: Beliz Nicholas , Rangel José Carlos , Hong Chi Shun
Published: March 2021

One of the most frequent techniques of a DoS attack is to exhaust available resources (memory, CPU cycles, and bandwidth) on the host server. A SOAP message can be affected by a DoS attack if the incoming message has been either created or modified maliciously. Resources available in the server (memory and CPU cycles) of the provider can be drastically reduced or exhausted while a malicious SOAP message is being parsed. This article presents a solution based on an adaptive solution for dealing with DoS attacks in Web service environments. The solution proposes a multi-agent hierarchical architecture that implements a classification mechanism in two phases. Each phase incorporates a special type of CBR-BDI agent that functions as a classifier. In the first phase, a case-based reasoning (CBR) engine utilizes a decision tree to carry out an initial filter, and in the second phase, a CBR engine incorporates a neural network to complete the classification mechanism. A prototype of the architecture was developed and the results obtained are presented in this study.
User-independent accelerometer-based gesture recognition for mobile devices
Authors: Wang Xian , Tarrío Paula , Bernardos Ana María , Metola Eduardo , Casar José Ramón
Published: March 2021

Many mobile devices embed nowadays inertial sensors. This enables new forms of human-computer interaction through the use of gestures (movements performed with the mobile device) as a way of communication. This paper presents an accelerometer-based gesture recognition system for mobile devices which is able to recognize a collection of 10 different hand gestures. The system was conceived to be light and to operate in a user-independent manner in real time. The recognition system was implemented in a smart phone and evaluated through a collection of user tests, which showed a recognition accuracy similar to other state-of-the art techniques and a lower computational complexity. The system was also used to build a human-robot interface that enables controlling a wheeled robot with the gestures made with the mobile phone
Firearm Classification using Neural Networks on Ring of Firing Pin Impression Images
Authors: Kamaruddin SAADI Bin Ahmad , Ghanib Nor AZURA MD , Liong Choong-Yeun , Jemain Abdul AZIZ
Published: March 2021

This paper implements two layer neural networks with different feedforward backpropagation algorithms for better performance of firearm classification us-ing numerical features from the ring image. A total of 747 ring images which are extracted from centre of the firing pin impression have been captured from five different pistols of the Parabellum Vector SPI 9mm model. Then, based on finding from the previous studies, the six best geometric moments numerical fea-tures were extracted from those ring images. The elements of the dataset were further randomly divided into the training set (523 elements), testing set (112 el-ements) and validation set (112 elements) in accordance with the requirement of the supervised learning nature of the backpropagation neural network (BPNN). Empirical results show that a two layer BPNN with a 6-7-5 configura-tion and tansig/tansig transfer functions with ‘trainscg’ training algorithm has produced the best classification result of 98%. The classification result is an improvement compared to the previous studies as well as confirming that the ring image region contains useful information for firearm classification.
Design Smart Games with requirements, generate them with a Click, and revise them with a GUIs
Authors: Cofini Vincenza , De La Prieta Fernando , Di Mascio Tania , Gennari Rosella , Vittorini Pierpaolo
Published: March 2021

TERENCE is an FP7 ICT European project that is developing an adaptive learning system for supporting poor comprehenders and their educators. Its learning material are books of stories and games. The games are specialised into smart games, which stimulate inference-making for story comprehension, and relaxing games, which stimulate visual perception and not story comprehension. The paper focuses on smart games. It first describes the TERENCE system architecture, thus delves into the design of smart games starting from the requirements and their automated generation, by highlighting the role of the reasoning module therein. Finally, it outlines the manual revision of the generated smart games, and ends with short conclusions about the planned improvements on the automated generation process.
A Distributed and Collaborative Intelligent System for Medical Diagnosis
Authors: Khayati Naoufel , Lejouad-Chaari Wided
Published: March 2021

In this paper, we present a distributed collaborative system assisting physicians in diagnosis when processing medical images. This is a Web-based solution since the different participants and resources are on various sites. It is collaborative because these participants (physicians, radiologists, knowledgebasesdesigners, program developers for medical image processing, etc.) can work collaboratively to enhance the quality of programs and then the quality of the diagnosis results. It is intelligent since it is a knowledge-based system including, but not only, a knowledge base, an inference engine said supervision engine and ontologies. The current work deals with the osteoporosis detection in bone radiographies. We rely on program supervision techniques that aim to automatically plan and control complex software usage. Our main contribution is to allow physicians, who are not experts in computing, to benefit from technological advances made by experts in image processing, and then to efficiently use various osteoporosis detection programs in a distributed environment.
Designing a Web Spam Classifier Based on Feature Fusion in the Layered Multi-Population Genetic Programming Framework
Authors: Keyhanipour Amir Hosein , Moshiri Behzad
Published: March 2021

Nowadays, Web spam pages are a critical challenge for Web retrieval systems which have drastic influence on the performance of such systems. Although these systems try to combat the impact of spam pages on their final results list, spammers increasingly use more sophisticated techniques to increase the number of views for their intended pages in order to have more commercial success. This paper employs the recently proposed Layered Multi-population Genetic Programming model for Web spam detection task as well application of correlation coefficient analysis for feature space reduction. Based on our tentative results, the designed classifier, which is based on a combination of easy to compute features, has a very reasonable performance in comparison with similar methods.
Prevalência de infecção do trato urinário entre pacientes atendidos na Unidade de Pronto Atendimento (UPA) no município de Passos – MG / Prevalence of Urinary Tract Infection Among Patients Attended at the Emergency Care Unit (ECU) at the Municipality of Passos – MG
Authors: Arroyo José Carlos Laurenti , Moraes Renata De Oliveira , Silva Eliane Freitas e , Sá Odila Rigolin de , França Norival
Published: March 2021

As infecções do trato urinário (ITU) estão entre as infecções bacterianas mais comuns que acometem a população durante toda a vida, de qualquer idade e gênero, podem comprometer o trato urinário inferior e/ou superior. A ocorrência de ITU é um problema crescente sendo que o diagnóstico e o tratamento realizado de forma inadequada podem agravar o quadro do paciente, não somente por aumentar a resistência bacteriana devido ao uso incorreto de antibióticos, como também, levar a doenças mais graves. Portanto, objetivou-se, com este estudo identificar a prevalência em pacientes suspeitos de infecção urinária, atendidos na Unidade de Pronto Atendimento (UPA) no Município de Passos - MG. Esta pesquisa configura-se como um estudo de delineamento transversal, descritiva, retrospectivo, com abordagem quantitativa. Através do sistema unificado da UPA (VIVVER - Sistema de Gestão Em Saúde) foram coletados 5445 dados de urina tipo I, realizado no período de julho a dezembro de 2016, dos quais 69% eram do sexo feminino e 31% do sexo masculino. Desses dados coletados 37% dos pacientes tiveram resultado positivo e com a possível suspeita de ITU. Evidenciou-se uma maior prevalência no sexo feminino, com 81% dos casos positivos, enquanto no sexo masculino a prevalência foi de 19%. Observou-se na faixa etária entre 14 aos 19 anos com 151 casos e picos de maior acometimento de infecção urinária entre 20 a 29 anos com 445 casos sugestivos de ITU. Concluiu-se que a maior ocorrência de ITU foi em pacientes do sexo feminino na faixa etária de 21 a 30 anos, há associação significativa (p 0,02) entre o número de prevalência de ITU e a faixa etária e a associação muito significativa (p0,0001) entre a prevalência de ITU e o sexo do paciente. Verifica-se uma necessidade de se implantar programas de rastreamento.
Perfil psicosocial, factores de riesgo y reinserción en reclusas adultas: una revisión sistemática
Authors:   Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), Universidad de Granada, España, Romero-Lara Patricia Rocío , Guillén-Riquelme Alejandro ,   Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), Universidad de Granada, España, Quevedo-Blasco Raúl ,   Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), Universidad de Granada, España
Published: March 2021

El objetivo de este trabajo fue analizar los efectos psicológicos asociados con la estancia en prisión en mujeres reclusas, así como su perfil psicosocial. Para esto se llevó a cabo una búsqueda de la literatura en las siguientes bases de datos: Web of Science, Scopus, Psicodoc, PsycInfo, Pubmed y DOAJ. En la búsqueda se localizó un total de 1403 trabajos (1350 artículos y 53 revisiones), de los cuales se seleccionaron, finalmente, 106 estudios. Se observan importantes diferencias entre hombres y mujeres en cuanto al ajuste a prisión, además de que las mujeres reclusas tienen unas necesidades específicas. Como conclusión cabe señalar la necesidad de más estudios que complementen la información sobre los efectos psicológicos de las mujeres en países menos desarrollados.