bluuebunny/crossref_metadata_2025 huggingface dataset:
A comparative user study of visualization techniques for cluster analysis of multidimensional data sets
Authors: Ventocilla Elio , Riveiro Maria
Published: July 2020

This article presents an empirical user study that compares eight multidimensional projection techniques for supporting the estimation of the number of clusters, [Formula: see text], embedded in six multidimensional data sets. The selection of the techniques was based on their intended design, or use, for visually encoding data structures, that is, neighborhood relations between data points or groups of data points in a data set. Concretely, we study: the difference between the estimates of [Formula: see text] as given by participants when using different multidimensional projections; the accuracy of user estimations with respect to the number of labels in the data sets; the perceived usability of each multidimensional projection; whether user estimates disagree with [Formula: see text] values given by a set of cluster quality measures; and whether there is a difference between experienced and novice users in terms of estimates and perceived usability. The results show that: dendrograms (from Ward’s hierarchical clustering) are likely to lead to estimates of [Formula: see text] that are different from those given with other multidimensional projections, while Star Coordinates and Radial Visualizations are likely to lead to similar estimates; t-Stochastic Neighbor Embedding is likely to lead to estimates which are closer to the number of labels in a data set; cluster quality measures are likely to produce estimates which are different from those given by users using Ward and t-Stochastic Neighbor Embedding; U-Matrices and reachability plots will likely have a low perceived usability; and there is no statistically significant difference between the answers of experienced and novice users. Moreover, as data dimensionality increases, cluster quality measures are likely to produce estimates which are different from those perceived by users using any of the assessed multidimensional projections. It is also apparent that the inherent complexity of a data set, as well as the capability of each visual technique to disclose such complexity, has an influence on the perceived usability.
Group sparsity-aware convolutional neural network for continuous missing data recovery of structural health monitoring
Authors: Tang Zhiyi , Bao Yuequan , Li Hui
Published: July 2020

In structural health monitoring, data quality is crucial to the performance of data-driven methods for structural damage identification, condition assessment, and safety warning. However, structural health monitoring systems often suffer from data imperfection, resulting in some entries being unusable in a data matrix. Discrete missing points are relatively easy to recover based on known adjacent points, whereas segments of continuous missing data are more common and also more challenging to recover in a practical scenario. Formulating the data recovery task as an optimization problem for matrix completion, we present a convolutional neural network to achieve simultaneous recovery for multi-channel data with the awareness of group sparsity. The data recovery process based on compressive sensing is formulated as a regression problem and achieved in the neural network. The basis matrix is utilized as the input and the incomplete data matrix as the output to provide partial information for approximation. Basis coefficient optimization is performed via convolutional operation. Group sparsity regularization is applied while updating the kernel of the convolutional layer. The recovery can be readily obtained after optimization (training) without further validation and testing. The proposed method does not need intact data prepared in advance for training; also, it can handle sporadic data loss and make the most of interrupted information. Recovery ability evaluations on synthetic data, field-test data, and monitoring data of seismic response indicate that the proposed method achieves a good recovery result with high loss ratio and continuous data loss. The code is available at https://github.com/dawnnao/Group-sparsity-aware-CNN .
Technological Developments and Transitions in Israel’s Preschool Television Industry
Authors: Grossaug Ranit
Published: July 2020

This article documents two ethnographic explorations (2012, 2015) held at Hop! group based in Israel, when it was in transition from being a preschool television company into a preschool content group. Three core challenges presented by new technologies were revealed: the need to be present on every screen; understanding the affordances of each technology; and finding successful collaborations. The article discusses the ways in which Hop! addressed those challenges, focusing on the transition from a dedicated television set into a multiplicity of screens; the negotiation of the new platforms’ affordances; and the development of a workforce suitable for platform content production. These challenges reveal that despite the feeling of revolution within the company caused by the great extent and rapid pace of technological innovation, what we see is a potentially endless transition period since, like the mythological hydra, after the affordances of new technologies become clear another technology springs up.
Growth Mindset for Human Resource Development: A Scoping Review of the Literature with Recommended Interventions
Authors: Han Soo Jeoung , Stieha Vicki
Published: July 2020

Although the concept of mindsets is relatively ubiquitous in the common press and well-studied in the education literature, the idea of a growth mindset, rooted in implicit theories is less represented in human resource development (HRD) scholarly literature. Given that absence, the purpose of this paper is to investigate the effects of a growth mindset on HRD outcomes. To achieve this purpose, we conducted a scoping literature review including research conducted globally and in a wide variety of organizations. Based on the empirical findings, we discuss three categories of HRD outcomes of mindsets: (a) individual-level outcomes (e.g., work engagement, creativity, task performance, job satisfaction), (b) dyadic-level outcomes (e.g., supervisor-employee relationship and conflict resolution), and (c) organizational-level outcomes (e.g., organizational citizenship behaviors and organizational growth mindset). We synthesize several suggestions for growth mindset interventions emphasizing career development, training and development, and organizational development for HRD practitioners. Research implications and future research suggestions for HRD scholars are presented.
Effect of Standing on a Standardized Measure of Upper Extremity Function
Authors: Stewart Jill Campbell , Saba Ashley , Baird Jessica F. , Kolar Melissa B. , O’Donnell Michael , Schaefer Sydney Y.
Published: July 2020

Although many daily activities that require the upper extremity are performed in standing, arm motor function is generally measured in sitting. The purpose of this study was to examine the effect of standing on a measure of upper extremity function, the Jebsen Hand Function Test (JHFT). Twelve nondisabled adults (26.3 ± 3.1 years) completed the JHFT with the right and left arms under two conditions: sitting and standing. Total time to complete the JHFT increased when performed in standing compared with sitting in both arms ( p = .005); mean increase was 4.4% and 5.6% for the right and left arms, respectively. Checker stacking was the only subtest that showed a significant increase in completion time in standing for both arms ( p = .001); card turning showed an increase for the left arm only ( p = .002). Measurement of upper extremity function in standing may provide insight into arm motor capacity within the context of standing postural control demands.
Detention Experiences of Commercial Sexual Exploitation Survivors
Authors: Trejbalová Tereza , Monaghan Heather , Kennedy M. Alexis , Decker Michele R. , Cimino Andrea N.
Published: July 2020

Commercial sexual exploitation of children (CSEC) harms youth around the globe. In the United States, most states manage CSEC victims through the juvenile justice system. Once the youth enter the system, little is known about how being detained for prostitution and solicitation charges impacts them. This study explores how CSEC survivors in Nevada experience detention through a qualitative content analysis of 36 interviews with formerly detained young women. This article offers pivotal findings revealing patterns of stigmatization, turning points, obstacles, and relational breakthroughs while in detention. Treatment suggestions, proposed by the interviewees themselves, are also provided.
Perceptions of Victim Advocates and Predictors of Service Referral Among Law Enforcement Personnel
Authors: Goodson Amanda , Garza Alondra D. , Franklin Cortney A. , Updegrove Alexander H. , Bouffard Leana Allen
Published: July 2020

Limited research exists on police officers’ service provision for sexual and domestic violence survivors after they formally report. This study used surveys from 452 commissioned officers at an urban police department in one of the five largest and most diverse U.S. cities to examine police perceptions of victim advocates, self-reported frequency of referral, and predictors of service referral among police. Findings revealed officers were relatively likely to provide referrals and held somewhat favorable attitudes of advocates. Knowledge of services and positive perceptions of advocates increased the frequency of service referral to victims. Implications and future research directions are discussed.
Older Men With Living Spouses Versus Men Without Spouses: An Example From the Arab World—Kuwait
Authors: Al-Kandari Yagoub Yousif
Published: July 2020

This research is concentrated on elderly Kuwait men and the effect that losing wife, a major determinant of social support, has on their general health. A sample of 472 older male adults aged 60 years and older have been included in this study. A questionnaire was the major tool of the study. The questionnaire included sociocultural information and social support scales (Degree of Religiosity, Social Support Scale, Frequency of Contact, and Strength of Relation scales). Health measurements also were used: two, one-item self-reported health scales in the current year and last year and a Somatic Symptoms Inventory (SSI) were used. Systolic and diastolic blood pressure and glucose levels were taken. Statistical Package for Social Sciences (SPSS, version 21) was used for data entry and analysis. t-test and regression were the major statistical procedures. Data show that there are differences between elderly men with a living wife compared to those without a living wife. Having a living wife was positively associated with better social support and health in Kuwaiti elderly men. Data show that a living wife is an important factor of men’s health and well-being in general and that a wife is one of the major social support elements of elderly men.
A hierarchical tree-based decision-making approach for assessing the relative trustworthiness of risk assessment models
Authors: Bani-Mustafa Tasneem , Pedroni Nicola , Zio Enrico , Vasseur Dominique , Beaudouin Francois
Published: July 2020

Risk assessment provides information to support decision-making. Then, the confidence that can be put in its outcomes is fundamental, and this depends on the accuracy, representativeness and completeness of the models used in the risk assessment. A quantitative measure is needed to assess the credibility and trustworthiness of the outcomes obtained from such models, for decision-making purposes. This article proposes a four-level, top-down, hierarchical tree to identify the main attributes and criteria that affect the level of trustworthiness of models used in risk assessment. The level of trustworthiness (Level 1) is broken down into two attributes (Level 2), three sub-attributes and one “leaf” attribute (Level 3), and seven basic “leaf” sub-attributes (Level 4). Based on this hierarchical decomposition, a bottom-up, quantitative approach is employed for the assessment of model trustworthiness, using tangible information and data available for the basic “leaf” sub-attributes (Level 4). Analytical hierarchical process is adopted for evaluating and aggregating the sub-attributes, and Dempster–Shafer theory is adopted to consider the uncertainty and the inconsistency in the experts’ judgments. The approach is applied to a case study concerning the modeling of the residual heat removal system of a nuclear power plant, to compute its failure probability. The relative trustworthiness of two mathematical models of different complexity is evaluated: a fault tree and a multi-states physics-based model. The trustworthiness of the multi-states physics-based model is found to outweigh that of the fault tree model, which can be explained by the fact that multi-states physics-based model takes into account the components failure dependency relations and degradation effects. The feasibility and reasonableness of the approach are, thus, demonstrated, paving the way for its potential applicability to inform decision-making on safety-critical systems.
An analysis of 1386 periurethral bulking procedures with comparison to 18,763 retropubic tapes
Authors: Bach Fiona , Toozs-Hobson Philip
Published: July 2020

Objective

To use British Society of Urogynaecology surgical database to evaluate periurethral bulking agents and retropubic tapes.

Study design

Permission was granted to analyse 1386 periurethral bulking agents and 18,763 retropubic tapes. The primary outcome measure was patient reported global impression of improvement for incontinence with secondary outcomes of change in symptoms of stress incontinence, overactive bladder and complications.

Results

Patients undergoing periurethral bulking agents were older than retropubic tapes (mean 59.4 vs. 52.3 years). Urodynamic stress incontinence was the commonest urodynamic diagnosis (periurethral bulking agents 67%, retropubic tapes 77%) but there was a higher proportion of complex diagnoses in the periurethral bulking agents group. 59.2% patients reported ‘very much/much better’ on patient reported global impression of improvement for incontinence for periurethral bulking agents compared to 91% for retropubic tapes; 28% patients felt their symptoms of stress incontinence were cured following periurethral bulking agents compared to 77.6% for retropubic tapes and 0.8% developed de novo overactive bladder following periurethral bulking agents compared to 4% with retropubic tapes. There was no difference in outcomes when using periurethral bulking agents as a primary or secondary procedure. There were no intraoperative complications with periurethral bulking agents and fewer post-operative complications compared to retropubic tapes (3.6%).

Conclusion

Patient reported success of periurethral bulking agents is lower than retropubic tapes but this is offset by minimal complications despite being an older, more complex patient group. Periurethral bulking agents do appear equally efficacious as a secondary procedure. Information derived from databases can be used during counselling to allow clinicians to demonstrate their own success and complication rates to ensure patients make an informed choice. Patient choice is paramount so all options should be included in full counselling.
Symptoms, attitudes and treatment perceptions of vulvo-vaginal atrophy in UK postmenopausal women: Results from the REVIVE-EU study
Authors: Domoney Claudine , Short Hannah , Particco Martire , Panay Nick
Published: July 2020

Objectives

To describe the attitudes and perceptions of postmenopausal women from the United Kingdom regarding menopause, vulvo-vaginal atrophy and its therapeutic management.

Study design

Post hoc analysis of the United Kingdom population from the REVIVE-EU Study.

Main outcome measures

The survey contained questions about women’s knowledge of menopause and vulvo-vaginal atrophy symptoms, impact on their life and sexual activities, communication with healthcare professionals and treatments.

Results

The most frequent symptom of menopause was hot flushes (75%). Vulvo-vaginal atrophy symptoms had a significant impact on participants’ ability to enjoy sexual intercourse (66%), spontaneity (62%) and ability to be intimate (61%); however, only 68% of women had been to their healthcare professional for advice. Half of the sample expected that doctors would initiate a discussion of menopausal symptoms and sexual health, but was in fact rare (5%). Only 27% were under current treatment without a clear therapy pattern, of which 43% used vaginal over-the-counter treatments, 28% prescription (Rx), and 13% both. Efficacy was the main limitation for over-the-counter treatments, while for Rx products were side effects and safety. Women highlighted the restoring of the natural condition of the vagina as the main goal for a treatment (35%). Many United Kingdom women did not feel the need to see any healthcare professional for their gynaecological symptoms. Overall satisfaction with treatment was only 44%.

Conclusions

Vulvo-vaginal atrophy remains underdiagnosed and undertreated in United Kingdom. There is a lack of coherent discussion about vulvo-vaginal atrophy symptoms with clinicians. Many United Kingdom healthcare professionals could improve proactive communication with patients about vulvo-vaginal atrophy.
Management of urinary incontinence
Authors: Nightingale Gemma
Published: July 2020

Urinary incontinence is a common problem affecting 25–45% women. Effective management can have a huge impact on a patient’s quality of life and many treatments are available. Management should be dictated by the degree of bother the symptoms are having, and vary depending on the type on incontinence. Conservative measures should always be initiated, including optimisation of body mass index and smoking cessation. Overactive bladder and urge urinary incontinence can be improved with bladder retraining and avoidance of bladder stimulants. Medical treatment then includes anticholinergic medications or Mirabegron. More invasive options include Botulinum Toxin A (Botox®) injections, sacral nerve stimulation or urological surgery. Stress urinary incontinence should be managed initially with pelvic floor exercises, and input from a specialist nurse or physiotherapist is beneficial. The surgical options for managing stress incontinence have changed considerably over the years, but include bladder neck injections, mid-urethral slings, colposuspension or autologous fascial slings. Mixed urinary incontinence is more challenging to manage, but all conservative measures should be started. Further treatment is directed towards the predominant symptom, but overactivity should be controlled before surgical measures for stress urinary incontinence are performed.
Assessment of the urogynaecology patient in primary care and when to refer
Authors: Basu Maya
Published: July 2020

Urogynaecological symptoms are commonly encountered problems in women of post-reproductive age, which have a major impact on quality of life in affected women. This review summarises a standardised approach to common urogynaecological problems in primary care, which focuses on making the correct diagnosis, assessing impact, evaluating for other relevant lifestyle and medical factors and indications for referral into secondary care.
Interstitial cystitis/bladder pain syndrome and recurrent urinary tract infection and the potential role of the urinary microbiome
Authors: Bhide Alka , Tailor Visha , Khullar Vik
Published: July 2020

Interstitial cystitis/bladder pain syndrome and recurrent urinary tract infections carry significant burden for those affected. As women enter the menopause, other factors may influence how these conditions manifest. The urinary microbiome has shown that the urine contains extensive numbers of bacteria. There is some evidence to suggest that it is altered depending on the menopausal state of the individual. It is possible that this alteration may go on to influence how the disease course of interstitial cystitis/bladder pain syndrome and recurrent urinary tract infections runs in the post-menopausal group. The review will explore these two conditions and the potential role of the urinary microbiome.
Stone Prevalence in Autosomal Dominant Polycystic Kidney Disease: A Systematic Review and Meta-Analysis
Authors: Kalatharan Vinusha , Grewal Gary , Nash Danielle M , Welk Blayne , Sarma Sisira , Pei York , Garg Amit X.
Published: July 2020

Background:

It is uncertain how often patients with autosomal dominant polycystic kidney disease (ADPKD) develop kidney stones.

Objective:

To review English-language studies reporting the incidence and prevalence of stones and stone interventions in adults with ADPKD.

Design:

Systematic review and meta-analysis.

Setting:

Any country of origin.

Patients:

Adult patients with ADPKD.

Measurements:

Incidence or prevalence of kidney stones and stone interventions.

Methods:

We reviewed 1812 citations from bibliographic databases, abstracted data from 49 eligible studies, and assessed methodological quality in duplicate. In some studies, the proportion of adults with ADPKD with the outcome were compared to adults without ADPKD; for these studies, prevalence risk ratios were calculated and pooled using a random effects model.

Results:

We identified 49 articles that met our review criteria. The methodological quality of many studies was limited (scores ranging from 2 to 14 out of 22, with a higher score indicating higher quality). No study clearly reported stone incidence, and in the cross-sectional studies, the definition of stones was often unclear. The prevalence of stones ranged from 3% to 59%, and a prevalence of stone interventions ranged from 1% to 8%; the average patient age at the time of assessment ranged from 26 to 61 years across the studies. Two studies reported a nonstatistically significant higher stone prevalence in patients with ADPKD compared to unaffected family members. Compared to unaffected family members, patients with ADPKD had a higher prevalence of kidney stones (6 cross-sectional studies; unadjusted prevalence ratio: 1.8; 95% confidence interval: 1.3 to 2.6; P = .0007; test for heterogeneity: I2 = 0%, P = .8).

Limitations:

Studies were limited to articles published in English.

Conclusions:

The prevalence of kidney stones and stone interventions in adults with ADPKD remains uncertain. Future studies of higher methodological quality are needed to better characterize the incidence and prevalence of kidney stones in patients with ADPKD.

Trial registration:

We did not register the protocol for this systematic review.
Stressed to the Punishing Point: Economic Insecurity and State Imprisonment Rates
Authors: Malone Chad A. , King Ryan D.
Published: July 2020

This research examines the association between economic insecurity and imprisonment rates in the United States. Building on Garland’s thesis about punishment and late modernity, it is hypothesized that rising economic insecurity in a population is associated with an increase in the imprisonment rate. This hypothesis is tested with state-level data for the years 1986–2013. Results indicate a robust association between changes in economic insecurity, measured as the percentage of households in a state losing a quarter or more of their income in a single year, and changes in imprisonment rates. This finding suggests that economic insecurity is not only relevant for explaining large-scale shifts in penal philosophy and practice, as prior sociological theory has argued. It also explains some of the year-to-year variation in imprisonment rates and points to another way in which inequality is associated with punishment.
Screening of vitamin D and calcium concentrations in neonates of mothers at high risk of vitamin D deficiency
Authors: Kozgar Sheikh Arif M. , Chay Paul , Munns Craig F.
Published: July 2020

Objective

The aim of this study was to determine, retrospectively, the serum 25OHD and calcium concentrations of screened neonates of mothers at high risk of 25OHD deficiency and examine whether their measurement contributes to the management of these neonates.

Methods

Serum 25OHD and calcium concentrations from 600 samples of umbilical cord blood or venous blood collected from neonates over a 12-month period were analysed.

Results

There was a high prevalence of vitamin D insufficiency (27.6%, 30–50 nmol/L) and deficiency (21.3%, < 30 nmol/L) in neonates from high-risk maternal groups. There was a statistically positive but weak correlation (ρ = 0.22,P < 0.0001) between 25OHD and serum calcium. Only 7 neonates out of 569 (1.2%) had calcium concentrations in the hypocalcaemic range; however, a significant number (47.6%) were reported to be in the hypercalcaemic range. Nearly all of these were venous samples collected in first 24 h after birth.

Conclusion

Vitamin D deficiency is prevalent in neonates of high-risk mothers but the risk of hypocalcaemia due to vitamin D deficiency at birth is low. Screening neonates entails blood testing which can cause distress to neonates and their parents, substantial imposition on staff and financial burden on the health care system. Vitamin D supplementation of these neonates from birth without routine screening appears more reasonable. Also, the data from this study suggest that the paediatric reference range for corrected calcium concentrations in neonates should be re-evaluated.
Exercise for people with a fragility fracture of the pelvis or lower limb: a systematic review of interventions evaluated in clinical trials and reporting quality
Authors: Keene David J. , Forde Colin , Sugavanam Thavapriya , Williams Mark A. , Lamb Sarah E.
Published: July 2020

Background

To aid design of exercise trials for people with pelvic and lower limb fragility fractures a systematic review was conducted to identify what types of exercise interventions and mobility outcomes have been assessed, investigate intervention reporting quality, and evaluate risk of bias in published trials.

Methods

Systematic searches of electronic databases (CENTRAL, MEDLINE, EMBASE, PEDro) 1996–2019 were conducted to identify randomised controlled trials of exercise for pelvic or lower limb fragility fractures. Two reviewers independently screened titles and abstracts. One reviewer extracted data, a second verified. Two reviewers independently assessed risk of bias. Intervention reporting quality was based on TIDieR, assessed by one reviewer and verified by a second. Narrative synthesis was undertaken. Registration: PROSPERO CRD42017060905.

Results

Searches identified 37 trials including 3564 participants, median sample size 81 (IQR 48–124), participants aged 81 years (IQR 79–82) and 76% (2536/3356) female. All trials focussed on people with hip fracture except one on ankle fracture. Exercise types focussed on resistance exercise in 14 trials, weight bearing exercise in 5 trials, 13 varied dose of sessions with health professionals, and 2 trials each focussed on treadmill gait training, timing of weight bearing or aerobic exercise. 30/37 (81%) of trials reported adequate sequence generation, 25/37 (68%) sufficient allocation concealment. 10/37 (27%) trials lacked outcome assessor blinding. Of 65 exercise interventions, reporting was clear for 33 (51%) in terms of when started, 61 (94%) for where delivered, 49 (75%) for who delivered, 47 (72%) for group or individual, 29 (45%) for duration, 46 (71%) for session frequency, 8 (12%) for full prescription details to enable the exercises to be reproduced, 32 (49%) clearly reported tailoring or modification, and 23 (35%) reported exercise adherence. Subjectively assessed mobility was assessed in 22/37 (59%) studies and 29/37 (78%) used an objective measure.

Conclusions

All trials focussed on hip fracture, apart from one ankle fracture trial. Research into pelvic and other lower limb fragility fractures is indicated. A range of exercise types were investigated but to date deficiencies in intervention reporting hamper reproducibility. Adoption of TIDieR and CERT guidelines should improve intervention reporting as use increases. Trials would be improved by consistent blinded outcome assessor use and with consensus on which mobility outcomes should be assessed.
Quality of life outcomes in patients undergoing knee replacement surgery: longitudinal findings from the QPro-Gin study
Authors: Siviero Paola , Marseglia Anna , Biz Carlo , Rovini Augusto , Ruggieri Pietro , Nardacchione Roberto , Maggi Stefania
Published: July 2020

Background

Many patients report postoperative pain, limited improvement in physical function and poor quality of life (QOL) after knee replacement surgery. Our study uses baseline predictors of change to investigate the QOL of patients with knee osteoarthritis 3-months after knee replacement surgery.

Methods

A prospective observational study was designed to evaluate patients (n = 132) scheduled for uni-compartmental or total knee replacement surgery who were assessed at baseline (preoperatively) and 3-months after. Physical and mental endpoints based on the component scores of the SF-12 and on the Western Ontario and McMaster Universities Arthritis (WOMAC) index were used to investigate patients’ QOL. Generalised estimating equation methodology was used to assess patients’ baseline characteristics (age, sex, education, body mass index (BMI), comorbidity, depressive symptoms, cognitive impairment, smoking/alcohol and type of surgery), the study endpoints and their changes over a 3-month post-surgery period. Stratified analyses by rehabilitation status after discharge were performed.

Results

Longitudinal data analysis showed that the baseline factors associated with improvement in general QOL at the 3-month post-surgery assessment were higher BMI, a high comorbidity, total (as opposed to unicompartmental) knee replacement and low education level. Data analysis of the patients who underwent rehabilitation after discharge revealed that the current smokers’ physical QOL worsened over time. The general QOL was unchanged over time in the presence of depressive symptomatology.

Conclusions

These findings underline the importance of using comprehensive assessment methods to identify factors affecting functionality and QOL, and developing interventions to improve the health/wellbeing of patients after knee replacement.
Augmented glycaemic gap is a marker for an increased risk of post-infarct left ventricular systolic dysfunction
Authors: Zhu Yong , Liu Kesen , Meng Shuai , Jia Ruofei , Lei Xuan , Chen Maolin , Zou Kaiyuan , Zhu Huagang , Jin Zening
Published: July 2020

Background

Left ventricular systolic dysfunction (LVSD) occurs frequently after acute ST-segment elevation myocardial infarction (STEMI). The predisposing factors and underlying mechanism of post-infarct LVSD are not fully understood. The present study mainly investigated the correlation between glycaemic gap, a novel index of stress-induced hyperglycaemia (SIH), and post-infarct LVSD.

Methods

A total of 274 first STEMI patients were enrolled in this cross-sectional study. Transthoracic echocardiography was performed within 48 h after admission and at 6 months after discharge to obtain left ventricular ejection fraction (LVEF). The change in LVEF was calculated as LVEF at 6 months after discharge minus baseline LVEF. Additionally, post-infarct LVSD was defined as LVEF ≤ 50%. Most importantly, glycaemic gap was calculated as admission blood glucose (ABG) minus the estimated average glucose over the previous 3 months.

Results

In patients without diabetes mellitus (DM), multivariate linear regression analysis revealed that both glycaemic gap (Beta = − 1.214, 95% CI − 1.886 to − 0.541, p < 0.001) and ABG (Beta = − 1.124, 95% CI − 1.795 to − 0.453, p = 0.001) were associated with change in LVEF. In DM patients, only glycaemic gap was still associated with change in LVEF, although this association was not observed in univariate linear regression analysis. Regarding the association between SIH and post-infarct LVSD, multivariate logistic regression analysis revealed that both glycaemic gap (OR = 1.490, 95% CI 1.043 to 2.129, p = 0.028) and ABG (OR = 1.600, 95% CI 1.148 to 2.229, p = 0.005) were associated with an increased risk of having post-infarct LVSD in non-DM patients. However, after multivariate adjustment in DM patients, only glycaemic gap (OR = 1.399, 95% CI 1.021 to 1.919, p = 0.037) remained associated with an increased risk of having post-infarct LVSD. Furthermore, the predictive value of glycaemic gap for post-infarct LVSD was not inferior to ABG in non-DM patients (p = 0.499), and only glycaemic gap, instead of ABG, could significantly predict post-infarct LVSD in DM patients (AUC = 0.688, 95% CI 0.591 to 0.774, p = 0.002).

Conclusions

Glycaemic gap was strongly associated with a change in LVEF and an increased risk of having post-infarct LVSD in patients following STEMI. In STEMI patients with DM, glycaemic gap could provide more valuable information than ABG in identifying patients at high risk of developing post-infarct LVSD.
Long-term outcomes of medical therapy versus successful recanalisation for coronary chronic total occlusions in patients with and without type 2 diabetes mellitus
Authors: Guo Lei , Wang Junjie , Ding Huaiyu , Meng Shaoke , Zhang Xiaoyan , Lv Haichen , Zhong Lei , Wu Jian , Xu Jiaying , Zhou Xuchen , Huang Rongchong
Published: July 2020

Background

In this study, we compared the outcomes of medical therapy (MT) with successful percutaneous coronary intervention (PCI) in chronic total occlusions (CTO) patients with and without type 2 diabetes mellitus.

Methods

A total of 2015 patients with CTOs were stratified. Diabetic patients (n = 755, 37.5%) and non-diabetic patients (n = 1260, 62.5%) were subjected to medical therapy or successful CTO-PCI. We performed a propensity score matching (PSM) to balance the baseline characteristics. A comparison of the major adverse cardiac events (MACE) was done to evaluate long-term outcomes.

Results

The median follow-up duration was 2.6 years. Through multivariate analysis, the incidence of MACE was significantly higher among diabetic patients compared to the non-diabetic patients (adjusted hazard ratio [HR] 1.32, 95% confidence interval [CI] 1.09–1.61, p = 0.005). Among the diabetic group, the rate of MACE (adjusted HR 0.61, 95% CI 0.42–0.87, p = 0.006) was significantly lower in the successful CTO-PCI group than in the MT group. Besides, in the non-diabetic group, the prevalence of MACE (adjusted HR 0.85, 95% CI 0.64–1.15, p = 0.294) and cardiac death (adjusted HR 0.94, 95% CI 0.51–1.70, p = 0.825) were comparable between the two groups. Similar results as with the early detection were obtained in propensity-matched diabetic and non-diabetic patients. Notably, there was a significant interaction between diabetic or non-diabetic with the therapeutic strategy on MACE (p for interaction = 0.036).

Conclusions

For treatment of CTO, successful CTO-PCI highly reduces the risk of MACE in diabetic patients when compared with medical therapy. However, this does not apply to non-diabetic patients.
Importance of lipid ratios for predicting intracranial atherosclerotic stenosis
Authors: Yang Wen-Song , Li Rui , Shen Yi-Qing , Wang Xing-Chen , Liu Qing-Jun , Wang Hai-Yang , Li Qi , Yao Guo-En , Xie Peng
Published: July 2020

Background

This study aims to investigate the association of lipid ratios with intracranial atherosclerotic stenosis (ICAS) in a Chinese population.

Methods

This cross-sectional study included 658 consecutive patients with ischemic stroke. Intracranial and extracranial arteries were evaluated for atherosclerotic stenosis using digital subtraction angiography or computed tomography angiography. Lipid ratios [total cholesterol (TC)/high-density lipoprotein-cholesterol (HDL-C), triglycerides (TG)/HDL-C, low-density lipoprotein-cholesterol (LDL-C)/HDL-C, non-high-density lipoprotein-cholesterol (non-HDL-C)/HDL-C, remnant cholesterol (RC)/HDL-C, apolipoprotein B (apo B)/apolipoprotein A-I (apo A-I), and apo B/HDL-C] were calculated.

Results

The TC/HDL-C, LDL-C/HDL-C, RC/HDL-C, non-HDL-C/HDL-C, apo B/HDL-C and apo B/apo A-I ratios (all P < 0.05) were significantly associated with ICAS but not with extracranial atherosclerotic stenosis after adjustment for confounding factors. Receiver operating characteristic (ROC) curves analysis revealed that the apo B/apo A-I ratio had the largest area under the ROC curve (AUC) among lipid levels alone and for lipid ratios (AUC = 0.588). Lipid ratios had higher AUC values than those for lipid levels alone for the identification of ICAS.

Conclusion

The TC/HDL-C, LDL-C/HDL-C, RC/HDL-C, non-HDL-C/HDL-C apo B/HDL-C, and apo B/apo A-I ratios were significantly related to ICAS risk. Compared with the other variables tested, the apo B/apo A-I ratio appeared to be a better discriminator for identifying ICAS risk in stroke patients.
A rare case of recurrent epidermoid anal cancer treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy—case report
Authors: Pravong Vera , Brind’Amour Alexandre , Sidéris Lucas , Dubé Pierre , Tremblay Jean-François
Published: July 2020

Background

Anal cancer is a rare cancer with chemoradiation being the mainstay of treatment for locoregional presentation. In North America, the most common subtype is anal squamous cell carcinoma (epidermoid). A surgical approach is considered for persistent or recurrent anal disease and systemic chemotherapy for metastatic disease. We are presenting a unique case of recurrent anal cancer with isolated peritoneal malignancy, an oligometastatic state which is rare in itself. It was treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. There are currently no clear guidelines for the aforementioned presentation. The discussion drew on the feasibility and safety of this approach.

Case presentation

A 68-year-old woman diagnosed with an epidermoid anal cancer (stage 3B) was initially treated with chemoradiation therapy (Standard Nigro Protocol) in 2014. At the 5-year mark post-treatment, she was diagnosed with a recurrent anal epidermoid cancer in the form of isolated peritoneal carcinomatosis proven by biopsy. After declining systemic chemotherapy, she underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy with Mitomycin-C©. Peritoneal carcinomatosis index was evaluated at 10, and intraoperative frozen sections were positive for carcinoma of epidermoid origin compatible with anal cancer. A completeness of cytoreduction score of 0 was achieved during the cytoreductive surgery, and her hospital course was unremarkable. She remains disease-free 12 months later.

Conclusions

To our knowledge, this is the first case reporting the disease presentation of anal cancer with oligometastatic dissemination to the peritoneum. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy were performed. Thus far, this approach seems to be a safe and feasible option for short-term control of the disease.
IS982 and kin: new insights into an old IS family
Authors: Fayad Nancy , Kallassy Awad Mireille , Mahillon Jacques
Published: July 2020

Insertion sequences (IS) are ubiquitous transposable elements with a very simple organization: two inverted repeats flanking a transposase coding gene. IS982 is one of 26 insertion sequence families known so far. With 70 registered members in the ISFinder database, this family remains somewhat unexplored, despite the association of many of its members with important features such as antibiotic resistance. IS982 has a fairly simple organization with a mean length of ca. 1 Kb, two inverted repeats with conserved 5′ AC 3′ ends flanking a transposase coding gene and direct repeats of variable lengths. Its transposase has a RNAse-H like chemistry with an atypical DDE motif.

In this study, we first highlight the current knowledge on the IS982 family by dissecting its registered members and their characteristics. Secondly, we bring new insights into this old, yet uncharted IS family, by exploring its registered elements, as well as the genomic and proteomic databases of bacterial and archaeal strains. This probing showed that the presence and distribution of this family goes far beyond the clear-cut registry of ISFinder database.
Relationships between design problem agglomerations and concerns having types and domains of software as transverse dimensions
Authors: da S. Carvalho Luis Paulo , Novais Renato L. , Mendonça Manoel
Published: July 2020

Context

Design problems have been recognized as one of the main causes behind the loss of software systems’ quality. Agglomerated design problems impact the quality even more. So, organizing and analyzing the relationship between design problems and concerns as agglomerations is a possible way to enhance the identification of defective source code artifacts.

Problem

As different systems evolve in varied manners, it is important to analyze if the evolution of agglomerated design problems can reveal cases of discrepancies and inconstancies through time. We call these cases non-uniformity of agglomerations, and they can prevent the use of agglomerations in approaches to mitigate design problems (e.g., prediction models). To the best of our knowledge, we consider that this problem has not been investigated yet.

Goal

This study aims to comprehend the degree to which the non-uniformity of agglomerations is either the most common or the most exceptional situation during the evolution of software projects. We perform this investigation by grouping software projects under two transverse dimensions: types and domains of software.

Method

To this end, we performed a two-phase investigation: in phase I, we analyzed the historical data obtained from fifteen software projects split as three groups of types of software (distributed, service-oriented, and mobile projects); in phase II, we analyzed the evolution of six projects grouped as two domains of software (graph and timeseries databases). For each phase, we (i) mined instances of a design problem (code complexity) and concerns from the source code of projects, (ii) agglomerated the instances of code complexity around the concerns and analyzed them according to the grouped projects, and (iii) examined the resulting dataset with the help of visualizations and a statistical analysis.

Results/Discussion

Types of software actually shows a tendency to reveal cases of non-uniformity. On the other hand, domains of software show a partial advantage regarding the production of more uniform agglomerations through evolution.
The general movements assessment in term and late-preterm infants diagnosed with neonatal encephalopathy, as a predictive tool of cerebral palsy by 2 years of age: a scoping review protocol
Authors: Seesahai Judy , Luther Maureen , Rhoden Carmen Cindy , Church Paige Terrien , Asztalos Elizabeth , Banihani Rudaina
Published: July 2020

Background

Prediction of long-term neurodevelopmental outcomes remains an elusive goal for neonatology. Clinical and socioeconomic markers have not proven to be adequately reliable. The limitation in prognostication includes those term and late-preterm infants born with neonatal encephalopathy. The General Movements Assessment tool by Prechtl has demonstrated reliability for identifying infants at risk for neuromotor impairment. This tool is non-invasive and cost-effective. The purpose of this study is to identify the published literature on how this tool applies to the prediction of cerebral palsy in term and late-preterm infants diagnosed with neonatal encephalopathy and so detect the research gaps.

Methods

We will conduct a systematic scoping review for data on sensitivity, specificity, positive, and negative predictive value and describe the strengths and limitations of the results. This review will consider studies that included infants more than or equal to 34 + 0 weeks gestational age, diagnosed with neonatal encephalopathy, with a General Movements Assessment done between birth to six months of life and an assessment for cerebral palsy by at least 2 years of age. Experimental and quasi-experimental study designs including randomized controlled trials, non-randomized controlled trials, before and after studies, interrupted time-series studies and systematic reviews will be considered. Case reports, case series, case control, and cross-sectional studies will be included. Text, opinion papers, and animal studies will not be considered for inclusion in this scoping review as this is a highly specific and medical topic. Studies in the English language only will be considered. Studies published from at least 1970 will be included as this is around the time when the General Movements Assessment was first introduced in neonatology as a potential predictor of neuromotor outcomes. We will search five databases (MEDLINE, Embase, PsychINFO, Scopus, and CINAHL). Two reviewers will conduct all screening and data extraction independently. The articles will be categorized according to key findings and a critical appraisal performed.

Discussion

The results of this review will guide future research to improve early identification and timely intervention in infants with neonatal encephalopathy at risk of neuromotor impairment.

Systematic review registration

Title registration with Joanna Briggs Institute https://joannabriggs.org/ebp/systematic_review_register.
Identifying potential patient-specific predictors for anterior cruciate ligament reconstruction outcome – a diagnostic in vitro tissue remodeling platform
Authors: van Vijven Marc , van Groningen Bart , Kimenai Joyce N. , van der Steen Maria C. , van Doeselaar Marina , Janssen Rob P. A. , Ito Keita , Foolen Jasper
Published: July 2020

Purpose

Upon anterior cruciate ligament (ACL) rupture, reconstruction is often required, with the hamstring tendon autograft as most widely used treatment. Post-operative autograft remodeling enhances graft rupture risk, which occurs in up to 10% of the patient population, increasing up to 30% of patients aged under 20 years. Therefore, this research aimed to identify potential biological predictors for graft rupture, derived from patient-specific tissue remodeling-related cell properties in an in vitro micro-tissue platform.

Methods

Hamstring tendon-derived cells were obtained from remnant autograft tissue after ACL reconstructions (36 patients, aged 12–55 years), and seeded in collagen I gels on a micro-tissue platform. Micro-tissue compaction over time – induced by altering the boundary constraints – was monitored. Pro-collagen I expression was assessed using ELISA, and protein expression of tenomodulin and α-smooth muscle actin were measured using Western blot. Expression and activity of matrix metalloproteinase 2 were determined using gelatin zymography.

Results

Only micro-tissues corresponding to younger patients occasionally released themselves from the constraining posts. Pro-collagen I expression was significantly higher in younger patients. Differences in α-smooth muscle actin and tenomodulin expression between patients were found, but these were age-independent. Active matrix metalloproteinase 2 expression was slightly more abundant in younger patients.

Conclusions

The presented micro-tissue platform exposed patient-specific remodeling-related differences between tendon-derived cells, with the micro-tissues that released from constraining posts and pro-collagen I expression best reflecting the clinical age-dependency of graft rupture. These properties can be the starting point in the quest for potential predictors for identifying individual patients at risk for graft rupture.