bluuebunny/crossref_metadata_2025 huggingface dataset:
An Approach for the Evaluation and Correction of Manually Designed Video Game Levels Using Deep Neural Networks
Authors: Davoodi Omid , Ashtiani Mehrdad , Rajabi Morteza
Published: June 2020

In the current state of the video game productions, most of the video game levels are created by the human operators working as level designers. This manual process is not only time-consuming and resource-intensive but also hard to guarantee uniform quality in the contents created by the level designers. One way to address this issue is to use computer-assisted level design techniques. In this paper, we have proposed a novel framework for computer-assisted video game level design that leverages neural networks, particularly generative adversarial networks (GANs) and autoencoders. The general idea is to learn over a dataset of high-quality levels and subsequently improve the ones created by the level designers. The proposed method is independent of the graphical dimensionality of the game and will work for 2D and 3D games in general. The autoencoder is used to create an intermediate representation of the level that is itself changed using the backpropagation technique according to the feedback obtained by feeding the output of the autoencoder to the discriminator component of the GAN. After performing a series of evaluations on the proposed framework and by automatically improving a series of purposefully corrupted game levels, the results demonstrate a noticeable improvement compared with the usage of simple autoencoders used to improve the video game levels in the previous researches.
Long-term outcome of patients with Marfan syndrome with previous aortic surgery but native aortic roots
Authors: Mosbahi Selim , Yildiz Murat , Heinisch Paul-Philipp , Langhammer Bettina , Jungi Silvan , Carrel Thierry P , Schoenhoff Florian S
Published: June 2020

OBJECTIVES

The goal of this study was to report the long-term outcomes of patients with Marfan syndrome who had aortic surgery on any aortic segment except for the replacement of the aortic root itself.

METHODS

An observational retrospective single-centre study was conducted with 115 Marfan syndrome patients who underwent 189 major aortic interventions from 1995 until 2018. Patients without aortic root replacement were identified and aortic root growth was analysed over time.

RESULTS

Eleven of 115 patients (9.5%) did not have aortic root replacement during a follow-up of 10.5 [standard deviation (SD) 5.7] years and a mean age at last follow-up of 53.9 (SD 13.4) years. Patients without root replacement did not suffer less frequently from any type of acute aortic dissection (type A 27% vs 25%, P = 0.999; type B 36% vs 25%, P = 0.474). Patients with native aortic roots did not undergo fewer aortic interventions than those with aortic root replacement [12/11, mean 1.09 (SD 0.54) operations/patient vs 177/104, mean 1.7 (SD 1.3); P = 0.128]. Progression of the aortic root dimension was 0.5 (SD 0.3) mm/year in the group of patients with native aortic roots.

CONCLUSIONS

Current data suggest that 10% of patients with Marfan syndrome with previous aortic surgery will be free from aortic root replacement until the sixth decade of life.
Insufficient Advance Care Planning? Correlates of Planning Without Personal Conversations
Authors: Boerner Kathrin , Moorman Sara M , Carr Deborah , Ornstein Katherine A
Published: June 2020

Objectives

Advance care planning (ACP) typically comprises formal preparations (i.e., living will and/or durable power of attorney for health care) and informal discussions with family members and health care providers. However, some people complete formal documents without discussing them with others. If they become incapacitated, their appointed decision makers may lack guidance on how to interpret or enact their formal wishes. We document the prevalence and correlates of this partial approach to ACP.

Method

Using multinomial logistic regression models and data from a U.S. sample of 4,836 older adults in the 2018 wave of the National Health and Aging Trends Study (NHATS), this brief report evaluated associations between social integration indicators and the odds of completing (a) both discussions and formal plans (two-pronged ACP), (b) discussions only, (c) no ACP, and (d) formal ACP only (reference category). We adjust for demographic and health characteristics established as correlates of ACP.

Results

A minority (15%) of NHATS participants reported formal plans without having discussed them. Indicators of social isolation (e.g., smaller social networks and fewer social activities) increased the odds of engaging in formal planning only compared to two-pronged ACP. Socioeconomic disadvantage and probable dementia reduced the odds of having end-of-life conversations, whether as one’s only preparation or in tandem with formal preparations.

Discussion

Socially isolated persons are especially likely to do formal planning only, which is considered less effective than two-pronged ACP. Health care professionals should recognize that older adults with few kin may require additional support and guidance when doing ACP.
Bycatches of the red king crab in the bottom fish fishery in the Russian waters of the Barents Sea: assessment and regulations
Authors: Stesko Aleksei V , Bakanev Sergey V
Published: June 2020

An analysis of red king crab bycatch in bottom-trawl fisheries in the Russian exclusive economic zone (EEZ) in the Barents Sea based on data collected from 2010 to 2019 shows an annual range of 2.2–9.8 thousand tonnes of crab bycatch from 2010 to 2018, which is 0.7–2.9% of the total biomass of red king crab in the EEZ. It was found that the catch of commercially valuable male crabs in the bottom-trawl fishery ranged from 1.4 to 6.5 thousand tonnes, which is ∼0.7–3.3% of the total commercial stock. A protected area created in 2006 is estimated to prevent the catch of 1.1–4.8 thousand tonnes of crab; however, protective measures do not take into account the peculiarities of the current distribution of crab populations and the geography of the fishing area. This work offers suggestions for improving the regulatory measures to protect the king crab stock in Russian waters of the Barents Sea.
Higher Order Polars of Quasi-Ordinary Singularities
Authors: García Barroso Evelia R , Gwoździewicz Janusz
Published: June 2020

A quasi-ordinary polynomial is a monic polynomial with coefficients in the power series ring such that its discriminant equals a monomial up to unit. In this paper, we study higher derivatives of quasi-ordinary polynomials, also called higher order polars. We find factorizations of these polars. Our research in this paper goes in two directions. We generalize the results of Casas–Alvero and our previous results on higher order polars in the plane to irreducible quasi-ordinary polynomials. We also generalize the factorization of the first polar of a quasi-ordinary polynomial (not necessarily irreducible) given by the first-named author and González-Pérez to higher order polars. This is a new result even in the plane case. Our results remain true when we replace quasi-ordinary polynomials by quasi-ordinary power series.
A Theorem About Maximal Cohen–Macaulay Modules
Authors: Polstra Thomas
Published: June 2020

It is shown that for any local strongly $F$-regular ring there exists natural number $e_0$ so that if $M$ is any finitely generated maximal Cohen–Macaulay module, then the pushforward of $M$ under the $e_0$th iterate of the Frobenius endomorphism contains a free summand. Consequently, the torsion subgroup of the divisor class group of a local strongly $F$-regular ring is finite.
On the role of reduced wind mass-loss rate in enabling exoplanets to shape planetary nebulae
Authors: Hegazi Ahlam , Bear Ealeal , Soker Noam
Published: June 2020

We use the stellar evolution code MESA–binary and follow the evolution of three exoplanets and two brown dwarfs (BDs) to determine their potential role in the future evolution of their parent star on the red giant branch (RGB) and on the asymptotic giant branch (AGB). We limit this study to exoplanets and BDs with orbits that have semimajor axis of $1 {~\rm au}\lesssim a_0 \lesssim 20 {~\rm au}$, a high eccentricity, $e_0 \gtrsim 0.25$, and having a parent star of mass M*,0 ≥ 1 M⊙. We find that the star HIP 75 458 will engulf its planet HIP 75 458b during its RGB phase. The planet will remove the envelope and terminate the RGB evolution, leaving a bare helium core of mass 0.4 M⊙ that will evolve to form a helium white dwarf. Only in one system out of five, the planet beta Pic c will enter the envelope of its parent star during the AGB phase. For that to occur, we have to reduce the wind mass-loss rate by a factor of about four from its commonly used value. This strengthens an early conclusion, which was based on exoplanets with circular orbits, which states that to have a non-negligible fraction of AGB stars that engulf planets we should consider lower wind mass-loss rates of isolated AGB stars (before they are spun-up by a companion). Such an engulfed planet might lead to the shaping of the AGB mass-loss geometry to form an elliptical planetary nebula.
The role of dust destruction and dust growth in the evolution of the interstellar medium
Authors: Osman Omima , Bekki Kenji , Cortese Luca
Published: June 2020

We use Milky Way-like chemodynamical simulations with a new treatment for dust destruction and growth to investigate how these two processes affect the properties of the interstellar medium in galaxies. We focus on the role of two specific parameters, namely fdes (a new parameter that determines the fraction of dust destroyed in a single gas particle vicinity of a supernova) and Cs (the probability that a metal atom or ion sticks to the dust grain after colliding, i.e. the sticking coefficient), in regulating the amount and distribution of dust, cold gas and metals in galaxies. We find that simulated galaxies with low fdes and/or high Cs values not only produce more dust, but they also have a shallower correlation between the dust surface density and the total gas surface density, and a steeper correlation between the dust-to-gas ratio and the metallicity. Only for values of fdes between 0.01 and 0.02, and of Cs between 0.5 and 1 do our simulations produce an average slope of the dust-to-gas ratio versus metallicity relationship that is consistent with observations. fdes values correspond to a total fraction of dust destroyed by a single supernova ranging between 0.42 and 0.44. Finally, we compare predictions of several simulations (with different star formation recipes, gas fractions, central metallicities, and metallicity gradients) with the spatially resolved M101 galaxy, and conclude that metallicity is the primary driver of the spatial distribution of dust, while the dust-to-gas ratio controls the cold gas distribution, as it regulates the atomc-to-molecular hydrogen conversion rate.
Wavefront prediction using artificial neural networks for open-loop adaptive optics
Authors: Liu Xuewen , Morris Tim , Saunter Chris , de Cos Juez Francisco Javier , González-Gutiérrez Carlos , Bardou Lisa
Published: June 2020

Latency in the control loop of adaptive optics (AO) systems can severely limit performance. Under the frozen flow hypothesis linear predictive control techniques can overcome this; however, identification and tracking of relevant turbulent parameters (such as wind speeds) is required for such parametric techniques. This can complicate practical implementations and introduce stability issues when encountering variable conditions. Here, we present a non-linear wavefront predictor using a long short-term memory (LSTM) artificial neural network (ANN) that assumes no prior knowledge of the atmosphere and thus requires no user input. The ANN is designed to predict the open-loop wavefront slope measurements of a Shack–Hartmann wavefront sensor (SH-WFS) one frame in advance to compensate for a single-frame delay in a simulated 7 × 7 single-conjugate adaptive optics system operating at 150 Hz. We describe how the training regime of the LSTM ANN affects prediction performance and show how the performance of the predictor varies under various guide star magnitudes. We show that the prediction remains stable when both wind speed and direction are varying. We then extend our approach to a more realistic two-frame latency system. AO system performance when using the LSTM predictor is enhanced for all simulated conditions with prediction errors within 19.9–40.0 nm RMS of a latency-free system operating under the same conditions compared to a bandwidth error of 78.3 ± 4.4 nm RMS.
Suppression of luminosity and mass–radius relation of highly magnetized white dwarfs
Authors: Gupta Abhay , Mukhopadhyay Banibrata , Tout Christopher A
Published: June 2020

We explore the luminosity L of magnetized white dwarfs and its effect on the mass–radius relation. We self-consistently obtain the interface between the electron degenerate-gas dominated inner core and the outer ideal gas surface layer or envelope by incorporating both the components of gas throughout the model white dwarf. This is obtained by solving the set of magnetostatic equilibrium, photon diffusion, and mass conservation equations in the Newtonian framework, for different sets of luminosity and magnetic field. We appropriately use magnetic opacity, instead of Kramer’s opacity, wherever required. We show that the Chandrasekhar limit is retained, even at high luminosity up to about $10^{-2}\, L_\odot$ but without magnetic field, if the temperature is set constant inside the interface. However, there is an increased mass for large-radius white dwarfs, an effect of photon diffusion. Nevertheless, in the presence of strong magnetic fields, with central strength of about 1014 G, super-Chandrasekhar white dwarfs, with masses of about $1.9\, {\rm M}_{\odot }$, are obtained even when the temperature inside the interface is kept constant. Most interestingly, small-radius magnetic white dwarfs remain super-Chandrasekhar even if their luminosity decreases to as low as about $10^{-20}\, L_{\odot }$. However, their large-radius counterparts in the same mass–radius relation merge with Chandrasekhar’s result at low L. Hence, we argue for the possibility of highly magnetized, low luminous super-Chandrasekhar mass white dwarfs that, owing to their faintness, can be practically hidden.
Short-term Peginterferon-Induced High Functional Cure Rate in Inactive Chronic Hepatitis B Virus Carriers With Low Surface Antigen Levels
Authors: Zeng Qing-Lei , Yu Zu-Jiang , Shang Jia , Xu Guang-Hua , Sun Chang-Yu , Liu Na , Li Chun-Xia , Lv Jun , Liu Yan-Min , Liang Hong-Xia , Li Zhi-Qin , Pan Ya-Jie , Hu Qiu-Yue , Li Wei , Zhang Da-Wei , Wang Fu-Sheng
Published: June 2020

Background

None of the current guidelines recommend antiviral therapy for inactive hepatitis B virus (HBV) carriers (IHCs).

Methods

In this real-world, multicenter, nonrandomized study, 32 participants meeting the inclusion criteria were enrolled 1:1 for treatment with peginterferon α-2b or monitoring without treatment based on participant preference. The expected treatment duration was 48 weeks. The primary end point was hepatitis B surface antigen (HBsAg) loss. The HBV vaccine could be injected after HBsAg loss.

Results

All patients had HBsAg levels of <20 IU/mL. The mean baseline HBsAg levels were 6.6 IU/mL and 5.8 IU/mL in the treated and untreated groups, respectively. Fifteen (93.8%) participants achieved HBsAg loss, 5 obtained HBsAg seroconversion after undergoing a mean of 19.7 weeks of therapy in the treated group, and no one in the follow-up group achieved HBsAg loss during a mean follow-up time of 12.6 months (P < .0001). Generally, the therapy was well tolerated. Nine of 11 individuals who exhibited HBsAg loss benefited from receiving the HBV vaccine.

Conclusions

This study provides justification for further studies of short-course peginterferon α-2b for the functional cure of IHCs with low HBsAg levels. Additionally, HBV vaccine injection is beneficial after interferon-induced HBsAg loss.
Association of delayed time in the emergency department with the clinical outcomes for critically ill patients
Authors: Lin S , Ge S , He W , Zeng M
Published: June 2020

Background

Previous studies have shown the association of waiting time in the emergency department with the prognosis of critically ill patients, but these studies linking the waiting time to clinical outcomes have been inconsistent and limited by small sample size.

Aim

To determine the relationship between the waiting time in the emergency department and the clinical outcomes for critically ill patients in a large sample population.

Design

A retrospective cohort study of 13 634 patients.

Methods

We used the Medical Information Mart for Intensive Care III database. Multivariable logistic regression was used to determine the independent relationships of the in-hospital mortality rate with the delayed time and different groups. Interaction and stratified analysis were conducted to test whether the effect of delayed time differed across various subgroups.

Results

After adjustments, the in-hospital mortality in the ≥6 h group increased by 38.1% (OR 1.381, 95% CI 1.221–1.562). Moreover, each delayed hour was associated independently with a 1.0% increase in the risk of in-hospital mortality (OR 1.010, 95% CI 1.008–1.010). In the stratified analysis, intensive care unit (ICU) types, length of hospital stay, length of ICU stay, simplified acute physiology score II and diagnostic category were found to have interactions with ≥6 h group in in-hospital mortality.

Conclusions

In this large retrospective cohort study, every delayed hour was associated with an increase in mortality. Furthermore, clinicians should be cautious of patients diagnosed with sepsis, liver/renal/metabolic diseases, internal hemorrhage and cardiovascular disease, and if conditions permit, they should give priority to transferring to the corresponding ICUs.
Revisiting 35 and 94 GHZ Millimeter Wave Exposure to the Non-Human Primate Eye
Authors: Parker James E. , Beason Charles W. , Sturgeon Stephen P. , Voorhees William B. , Johnson Samuel S. , Nelson Kaitlin S. , Johnson Leland R. , Whitmore Jeffrey N.
Published: June 2020

A previous study reported thermal effects resulting from millimeter wave exposures at 35 and 94 GHz on non-human primates, specifically rhesus monkeys’ (Macaca mulatta) corneas, but the data exhibited large variations in the observed temperatures and uncertainties in the millimeter wave dosimetry. By incorporating improvements in models and dosimetry, a non-human primate experiment was conducted involving corneal exposures that agreed well with a three-layer, one-dimensional, thermodynamic model to predict the expected surface temperature rise. The new data indicated that the originally reported safety margins for eye exposures were underestimated by 41 ± 20% over the power densities explored. As a result, the expected minimal visible lesion thresholds should be raised to 10.6 ± 1.5 and 7.1 ± 1.0 J cm−2 at 35 and 94 GHz, respectively, provided that the power density is less than 6 W cm−2 for subjects that are unable to blink. If the blink reflex was active, a power density threshold of 20 W cm−2 could be used to protect the eye, although the eyelid could be burned if the exposure was long enough.
Acupuncture therapy on postoperative nausea and vomiting in abdominal operation
Authors: Fu Chengwei , Wu Tong , Shu Qing , Song Aiqun , Jiao Yang
Published: June 2020

Background:

Postoperative nausea and vomiting (PONV) is a common complication after surgery. However, drugs cannot prevent it completely, and acupuncture therapy shows the potential in preventing PONV, yet the best choice hasn’t been demonstrated.

Objective:

This network meta analysis aimed to evaluate the effectiveness of different acupuncture therapies used for preventing PONV in abdominal operation.

Methods:

Authors searched articles from PubMed/Medline, Cochrane library, Web of Science, Ebsco and Ovid/Embase, and established database from setup time to June 2019. Quality evaluation of included studies was performed with Cochrane risk-of-bias tool (ROB 2.0). Pairwise and network meta analysis were conducted by RevMan and Addis respectively.

Results:

Twenty studies with 2862 patients were included in this research. Pairwise meta analysis shows that compared with placebo, transcutaneous electric nerve stimulation had lower risk of postoperative nausea (PON) (odds ratio (OR) = 0.42, 95%confidence interval (CI): 0.30–0.60), postoperative vomiting (POV) (OR = 0.53, 95%CI: 0.36–0.78), PONVs (OR = 0.46, 95%CI: 0.31–0.68), and postoperative rescue (POR) (OR = 0.61, 95%CI: 0.41–0.90), Capsicum had lower risk of PON (OR = 0.16, 95%CI: 0.09–0.28), PONVs (OR = 0.23, 95%CI: 0.12–0.45), Acupressure had lower risk of POV (OR = 0.42, 95%CI: 0.25–0.70), POR (OR = 0.42, 95%CI: 0.27–0.64). In network meta analysis, compared with usual care, the probability rank suggested that Acupoint Injection showed lowest risk of PON (OR = 0.02, 95%CI: 0.00–0.11), POV (OR = 0.06, 95%CI: 0.01–0.49), Usual care for PONVs (OR = 0.31, 95%CI: 0.13–0.75), and Capsicum for POR (OR = 0.39, 95%CI: 0.07–2.33). Further study should be carried out to verify this result.

Conclusion:

Both pairwise and network meta analysis showed acupuncture therapy was superior to placebo and usual care. Different acupuncture therapy regimens may have advantages in different aspects. And compared with POV, PON seems easier to control. Research results may provide guidance for the prevention of PONV.

Systematic review registration: PROSPERO CRD42019147556.
Effect of vagus nerve stimulation for the treatment of drug-resistant epilepsy
Authors: Chen Peng , Hao Mei-mei , Zhu Jiang , Yang Zeng-ye
Published: June 2020

Background:

Drug-resistant epilepsy (DRE) is a very tricky disorder, which greatly affects quality of life in such patients. Relevant studies suggested that vagus nerve stimulation (VNS) has potential benefits for DRE. However, there are inconsistent conclusions. The purpose of this study is to investigate whether VNS is effective and safety for DRE.

Methods:

To collect comprehensive randomized controlled trials (RCTs), the following electronic databases will be retrieved: MEDLINE, EMBASE, Cochrane Library, Web of Science, PsycINFO, CINAHL, AMED, and China National Knowledge Infrastructure from the commencement of each electronic database up to the present with no language restrictions. Two authors will independently carry out all procedures of literature selection, information collection, and risk of bias assessment. Any objections will be worked out by a third author through consultation. The risk of bias for each included trial will be identified using Cochrane risk of bias tool, and statistical analysis will be performed utilizing RevMan 5.3 software.

Results:

This study will synthesize the data from the present eligible high quality RCTs to assess whether VNS is effective and safety for DRE.

Conclusion:

This study will provide systematic evidence of VNS for the treatment of patients with DRE.

Systematic review registration:

INPLASY202040086.
Effect of advanced nursing care on psychological condition in patients with chronic heart failure
Authors: Lin Yang , Su Zhi-qiang , Yu Shan-shan
Published: June 2020

Background:

This study will appraise the effect and safety of advanced nursing care (ANC) on psychological condition (PC) in patients with chronic heart failure (CHF).

Methods:

The following databases will be sought from the beginning up to the February 29, 2020: MEDLINE, EMBASE, Cochrane Library, Web of Science, Scopus, the Cumulative Index to Nursing and Allied Health Literature, the Allied and Complementary Medicine Database, the Chinese Scientific Journal Database, and China National Knowledge Infrastructure. There are not language and publication status limitations related to any electronic databases. In addition, we will also identify conference proceedings, reference lists of included studies, and websites of clinical trials registry. Two reviewers will separately carry out study selection, data extraction, and study quality evaluation. Any inconsistencies will be solved by a third reviewer through discussion. RevMan 5.3 software will be utilized to carry out statistical analysis.

Results:

This study will comprehensively summarize all potential evidence to systematically address the effects and safety of ANC on PC in patients with CHF.

Conclusion:

The findings of the present study will help to determine whether ANC is effective or not on PC in patients with CHF.

Study registration number:

INPLASY202040077.
Effect of Tai Chi on psychological disorder in college students
Authors: Jiang Li-Li , Meng Yang , Zhang Qian , Pan Wei
Published: June 2020

Background:

This study will explore the effect of Tai Chi on psychological disorder (PD) in college students (CS).

Methods:

A comprehensive literature search of relevant randomized controlled trials will be carried out in electronic databases from inception to the February 29, 2020: PUBMED, EMBASE, Cochrane Library, Web of Science, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. There are not limitations related to the language and publication time. Study quality will be assessed by Cochrane risk of bias tool, and evidence quality will be appraised by the grading of recommendations assessment, development, and evaluation approach. RevMan 5.3 software will be exploited to perform statistical analysis.

Results:

The protocol of this proposed study will investigate the effect of Tai Chi on PD in CS.

Conclusion:

The findings of this study will provide helpful evidence for clinical practice, and health related policy maker to develop a better intervention plan for PD in CS.

Study registration number:

INPLASY202040140.
Effect of cinnamaldehyde on Cav-1 and Survivin expression in epilepsy
Authors: Yu Jia-Nan , Yue Cai-Fang , Wang Ke-Jian , Chi Nan-Nan , Li Xin
Published: June 2020

Background:

This systematic review aims to assess the effect of cinnamaldehyde on Cav-1 and Survivin expression in epilepsy.

Methods:

We will search Cochrane Library, PUBMED, EMBASE, CINAHL, Web of Science, Google Scholar, PsycINFO, WANGFANG, VIP, CBM, and CNKI from their inceptions to the March 31, 2020, without language restrictions. Two authors will independently carry out searching literature records, scanning titles and abstracts, full texts, collecting data, and assessing risk of bias. RevMan 5.3 software will be used for statistical analysis.

Results:

This systematic review will investigate whether cinnamaldehyde is effective on Cav-1 and Survivin expression in epilepsy.

Conclusion:

Its findings will provide helpful evidence for the effect of cinnamaldehyde on Cav-1 and Survivin expression in epilepsy.

Systematic review registration: INPLASY202040152.
Acute compartment syndrome in children; beware of “silent” compartment syndrome
Authors: Frei Benjamin , Sommer-Joergensen Vivienne , Holland-Cunz Stefan , Mayr Johannes
Published: June 2020

Rationale:

Acute compartment syndrome (ACS) is a feared complication following traumatic injuries. We describe the occurrence of silent ACS of the hand in a 2-year old patient with atypical symptoms.

Patient concerns:

Our patient experienced massive swelling but minimal pain of the hand after a heavy bistro table with a stone tabletop had fallen on the right hand.

Diagnosis:

After monitoring the development of ACS for 1 night, we noted increased firmness of the swelling and impaired perfusion of the skin covering the palm and dorsum of the hand. Notably, the patient held the hand in an intrinsic minus position but did not complain of pain after administration of only a single (weight-matched) dose of ibuprofen. Our suspicion of ACS was confirmed intraoperatively because of the elevated intramuscular pressure (up to 60 mm Hg) in several hand compartments.

Interventions:

We performed surgical fasciotomy of all hand compartments, followed by temporary coverage of the wounds with Epigard synthetic skin substitute. The wounds were closed stepwise after 2 and 7 days, and occupational therapy was initiated after 3 weeks.

Outcomes:

At the 1-year follow-up, we noted unrestricted wrist and finger functions of the patient. The parents reported that there was no difference in the use of the 2 hands during daily activities.

Lessons:

The possible development of ACS should be borne in mind even in the absence of marked pain. Although the 3 A's (i.e., anxiety, agitation, and increased analgesic requirements) in the diagnosis of ACS in children are well established, some patients may experience only minimal pain. This challenges the correct and timely diagnosis of ACS in children, particularly if they are very young.
The prognostic and diagnostic values of MicroRNA-10b in gastric cancer
Authors: Mei Lina , Lu Zhouxiang , Shen Zhangguo , Xu Sumei
Published: June 2020

We conducted a study to evaluate the prognostic and diagnostic values of microRNA-10b (miR-10b) in gastric cancer (GC) based on meta-analysis and TCGA database. Relevant studies were searched in English and Chinese database and meta-analysis was conducted on Stata 12.0. The expression value of miR-10b and clinical parameters of GC patients were downloaded from TCGA database, and relevant analyses were conducted on SPSS. High expression of miR-10b was linked with unfavorable overall survival (OS) in GC (HR = 1.572, 95% CI: 1.240–1.992, P < .001). However, the meta-analysis was significant for patients in early stage, but not for patients in advanced stage. The expression of miR-10b-3p was significantly lower in cancer tissue compared with adjacent tissue (P < .001). Meanwhile, the area under the ROC curve (AUC) value was 0.652 (0.562–0.742), P = .001. Disease-free survival analysis showed increasing miR-10b-5p was correlated with worse survival outcome (HR = 2.366, 95% CI: 1.414–3.959, P = .001). In conclusion, miR-10b acts as a tumor suppressor with prognostic and diagnostic values for GC.
Silver acupuncture for myofascitis
Authors: Zhang Guilong , Lin Yanming , Zhou Qun , Gao Liang , Zhang Leixiao , Yu Yang , Shen Yuquan , Huang Yong
Published: June 2020

Background:

This systematic review aims to evaluate the effectiveness and safety of silver acupuncture in treatment of myofascitis.

Methods:

Electronic databases of all silver acupuncture for myofascitis will be searched at PubMed, Cochrane Library, Springer, Embase, China National Knowledge Infrastructure, Wanfang, and Chinese Biological Medical disc from inception to March 31, 2020, with language restricted in Chinese and English. The primary outcome is visual analog scale, a short pain scale with sensitivity and comparability. Secondary outcomes included Clinical Assessment Scale for Cervical Spondylosis, Japanese Orthopaedic Association Scores, Oswestry dysfunction index, American Orthopaedic Foot and Ankle Society-Ankle Hindfoot scale, Foot and Ankle Ability Measure, The Cumberland ankle instability tool, Pittsburgh sleep quality index, self-rating anxiety scale, self-depression rating scale, and follow-up relapse rate. The systematic review and searches for randomized controlled trials of this therapy for myofascitis. The Cochrane RevMan V5.3 bias assessment tool is implemented to assess bias risk, data integration risk, meta-analysis risk, and subgroup analysis risk (if conditions are met). Mean difference, standard mean deviation, and binary data will be used to represent continuous results.

Results:

This study will provide a comprehensive review and evaluation of the available evidence for the treatment of myofascitis with this therapy.

Conclusion:

This study will provide new evidence to evaluate the effectiveness and side effects of silver acupuncture for myofascitis. Due to the data are not personalized, no formal ethical approval is required.

Ethics and dissemination:

There is no requirement of ethical approval and it will be in print or disseminated by electronic copies.

PROSPERO registration number:

CRD42020151476
The effect of massage on the quality of life in patients recovering from COVID-19
Authors: Wu Liu , Dong Yuting , Li Jin , Huang Ju , Wen Dengpeng , Peng Tao , Luo Jian
Published: June 2020

Background:

There is a worldwide outbreak of covid-19, and as the number of patients increases, more and more patients are recovering. Massage is used as an alternative therapy. Currently, there are no relevant articles for systematic review.

Methods:

We will search the randomized controlled trials related to acupuncture therapy and postoperative anorectal diseases from inception to January 2020. The following database is our focus area: the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Wan-Fang Database. All published randomized controlled trials in English or Chinese related to massage for COVID-19 will be included. Primary outcome asthe influence of massage on the quality of life of convalescent patients. Secondary outcomes were accompanying symptoms (such as myalgia, expectoration, stuffiness, runny nose, pharyngalgia, anhelation, chest distress, dyspnea, crackles, headache, nausea, vomiting, anorexia, diarrhea) disappear rate, negative COVID-19 results rate on 2 consecutive occasions (not on the same day), average hospitalization time, clinical curative effect, and improved quality of life.

Results:

The results will provide a high-quality synthesis of current evidence for researchers in this subject area.

Conclusion:

The conclusion of our study will provide evidence to judge whether massage is an effective intervention on the quality of life in patients recovering.

PROSPERO registration number:

CRD42020181398
Association of the interaction between the rs9619311 and rs402007 polymorphisms and smoking with essential hypertension in Chinese Han population
Authors: Chen Chao , Yang Ming , Dou Li-Ping , Ling Dong-Ming , Huang Shuwei
Published: June 2020

Background:

To assess the association of the interaction between the rs9619311 and rs402007 polymorphisms and smoking with essential hypertension (EH) in a Chinese Han population.

Method:

Peripheral blood samples were extracted from 422 EH patients and 280 normotensive (NT) patients in a Chinese Han population. A whole blood genomic DNA extraction kit was used to extract genomic DNA from the blood samples. Polymerase chain reaction restriction fragment length polymorphism was used to detect the rs402007 polymorphism of a disintegrin and metalloproteinase with thrombospondin type motifs 1 gene and the rs9619311 polymorphism of the tissue inhibitor of metalloproteinase-3 gene. The distributions of the genotypes and alleles between the 2 study groups (EH and NT) were compared. The main risk factors for EH were determined by using logistic regression analysis. The effects of gene-gene and gene-smoking interactions on EH were analyzed using multifactor dimensional reduction.

Results:

The frequencies of the rs402007 GC + CC genotype and the C allele were significantly different between the EH and NT groups (0.68 vs 0.57, χ
2 = 8.99a, P = .003, odds ratio [OR] = 1.19; 0.45 vs 0.32, χ
2 = 22.16a, P < .001, OR = 1.38). The frequencies of the rs9619311 TC + CC genotype and the C allele were also significantly different between the 2 groups (0.33 vs 0.25, χ
2 = 4.51a, P = .04, OR = 1.44; 0.18 vs 0.13, χ
2 = 7.03a, P = .01, OR = 1.50). Logistic regression analysis suggests that the rs402007 and rs9619311 polymorphisms are independent risk factors for EH (OR = 2.37, 1.86; P < .001, respectively). The multifactor dimensionality redundant analysis results showed that the interaction among rs402007, rs9619311, and smoking was statistically significant (P = .001).

Conclusions:

A disintegrin and metalloproteinase with thrombospondin type motifs 1 rs402007 and tissue inhibitor of metalloproteinase-3 rs9619311 polymorphisms are associated with EH in a Chinese Han population, and there was a positive interaction among rs402007, rs9619311, and smoking.
Metabolic syndrome, depression, and fibromyalgia syndrome prevalence in patients with irritable bowel syndrome
Authors: Bayrak Muharrem
Published: June 2020

Although both metabolic syndrome (MetS) and irritable bowel syndrome (IBS) have been linked with altered gut microbiota, only a few studies investigated the association between them. Hence, we aimed to evaluate the prevalence of MetS along with depression and fibromyalgia syndrome (FMS) in IBS patients.

This was a case-control study in which 3808 consecutive patients who attended outpatient clinics of Erzurum Regional Training and Research Hospital between May 2019 and August 2019 were evaluated in terms of IBS with Rome-IV criteria. Out of 486 patients who were diagnosed as IBS, 176 patients were excluded for various reasons. Control subjects were randomly selected from IBS-negative subjects. MetS was diagnosed based on International Diabetes Federation criteria. Depression, anxiety disorder, and FMS were assessed via Hamilton Depression Scale, Beck Anxiety Inventory, and American College of Rheumatology criteria, respectively. Blood samples were obtained to measure biochemical parameters.

Study group included 310 IBS patients, and control group included 304 subjects. The prevalence of the MetS was significantly higher among IBS patients compared with controls (36.8% vs 21.7%, respectively, P = .006). The rate of obesity was 18.1% among IBS subjects, and 10.2% in the controls. The prevalence of fibromyalgia (30% vs 3%, respectively, P < .001), anxiety-disorder (39.7% vs 10.2%, P < .001) and depression (8.1% vs 4.9%, P < .001) were significantly higher in IBS group than controls.

Metabolic syndrome and obesity were significantly more frequent in IBS patients compared with controls. FMS, anxiety disorder, and depression were also more common among IBS patients.
The epidemiological characteristics of 2019 novel coronavirus diseases (COVID-19) in Jingmen, Hubei, China
Authors: Gao Qijun , Hu Yingfu , Dai Zhiguo , Xiao Feng , Wang Jing , Wu Jing
Published: June 2020

There is currently a global outbreak of coronavirus disease 2019 (COVID-19), and its epidemic characteristics in the areas where the outbreak has been successfully controlled are rarely reported.

Describe the epidemic characteristics of COVID-19 in Jingmen, Hubei, introduce the local prevention and control experience, and observe the impact of various prevention and control measures on the number of new cases.

All the COVID-19 patients diagnosed in the municipal districts of Jingmen from January 12 to February 29, 2020 were enrolled in this study. We described epidemiological data and observed the impact of control measures on the epidemic.

Of the 219 cases (110 men and 109 women), 88 (40%) had exposure to Wuhan. The median age was 48 years (range, 2–88 years; IQR, 35–60). Thirty-three severe patients with a median age of 66 years (range, 33–82 years, IQR, 57–76) were treated in intensive care units; out of these patients, 66.7% (22) were men and 19 (57.5%) had chronic diseases, including hypertension, diabetes, heart failure, stroke, and renal insufficiency. Under the control measures, the number of new patients gradually decreased and nearly disappeared after 18 days. Wearing masks in all kinds of situations prevents most infections and is one of the most effective prevention and control measures.

In conclusion, all people are susceptible to COVID-19, and older males and those with comorbid conditions are more likely to become severe cases. Even though COVID-19 is highly contagious, control measures have proven to be very effective, particularly wearing masks, which could prevent most infections.
Characteristics and long-term outcomes of perineal endometriosis
Authors: Liu Yu , Pi Ruyu , Luo Hong , Wang Wei , Zhao Xia , Qi Xiaorong
Published: June 2020

To summarize the clinical features, diagnosis, and treatments of perineal endometriosis (PEM).

We retrospectively studied the clinical data of 35 patients with PEM between April 2012 and December 2018 in West China Second Hospital. Patients were divided into the gonadotropins releasing hormone (GnRH) agonist group and non-GnRH agonist group.

The main clinical symptom was vulvar painful swellings related to menstrual cycles. Thirty-three patients’ lesions (94.29%) were on the episiotomy scar while 1 case was at the opposite side of the scar. We even found 1 nullipara was diagnosed as PEM. Ten patients (28.57%) were found with anal sphincter involvement. All patients received complete excision of PEM. The recurrence rate of GnRH agonist group was 7.69% (1/13), while the rate of non-GnRH agonist group was 18.75% (3/16).

Most PEM was associated with episiotomy history, but PEM could also exist in nullipara. Complete excision of PEM was inevitable. The effect of GnRH agonist on recurrence of PEM needs further studies.
The effect of age distribution on the prognosis of retroperitoneal neuroblastoma
Authors: Liu Xiaoyan , Zhao Jichun , Zhang Lin , Huang Jing , Ma Yukui
Published: June 2020

Retroperitoneal neuroblastoma is a rare subtype of neuroblastoma and the role of age in its clinical prognosis is still unknown.

To describe the age distribution and investigate the association between age and survival outcomes in patients diagnosed with retroperitoneal neuroblastoma.

We retrospectively analyzed patients registered for retroperitoneal neuroblastoma in the Surveillance, Epidemiology, and End Results (SEER) national database from 1973 to 2015. Age distribution was described and Cox proportional hazard regression was used to evaluate the measured effect of age on overall survival and disease-specific survival.

A total of 399 retroperitoneal neuroblastoma patients with a median follow-up of 53.0 (interquartile range 17.0–133.5) months were included. We found a unimodal distribution of age with a median age of diagnosis to be 1.0 (interquartile range 0.0–4.0) years. Univariate analysis suggested that transformed age was associated with an increased risk of total death and disease-specific death (OR = 4.2, 95% CI 3.0–5.9; OR = 4.7, 95% CI 3.2–6.8). Adjusted smoothed plots showed a nonlinear correlation between age and disease-specific death. The risk of disease-specific death did not increase sharply as the age increased until reaching the inflection point (age < 3 years, OR = 0.4, 95% CI 0.2–1.0; age ≥ 3 years, OR = 1.2, 95% CI 0.9–1.5). There was, however, a linear relationship between age and total deaths (OR = 1.0, 95% CI 0.7–1.2). Adjusted multivariate Cox regression analysis showed that ages ≥ 3 years were associated with a significant increased risks of disease-specific death and total death (OR = 2.5, 95% CI 1.7–3.8; OR = 2.3, 95% CI 1.6–3.3, respectively).

There was a unimodal age distribution of retroperitoneal neuroblastoma usually presented in infants or younger child. Older age was associated with a lower chance of overall survival and the risk of disease-specific death increased sharply after 3 years of age.
Effect of video-guided educational intervention on school engagement of adolescent students with hearing impairment
Authors: Asogwa Uche D. , Ofoegbu Theresa Onyema , Ogbonna Chimaobi Samuel , Eskay Michael , Obiyo Ngozi O. , Nji Godfrey C. , Ngwoke Oliver Rotachukwu , Eseadi Chiedu , Agboti Christian Iheanacho , Uwakwe Chinedozie , Eze Benedict C.
Published: June 2020

Background/objective:

Hearing impaired students still face stigmatization and marginalization especially in inclusive classrooms in developing regions. This negatively impacts their school engagement. The present study aimed at ascertaining the effect of video-guided educational intervention on school engagement of hearing impaired students.

Method:

Randomized controlled trial design was adopted for the present study. A total of 46 junior secondary school students with hearing impairment and low school engagement symptoms participated in this study. The students were randomly assigned to groups – intervention group and care-as-usual control group. A video-guided educational intervention package which consists of 13-minutes captioned video clips with school engagement themes served as the treatment intervention. Data were collected at 3 different times (pre-test, post-test and follow up) using School Engagement Scale created by Fredericks, Blumenfeld, Friedel and Paris (2005). Data were analyzed using independent sample t-test, paired sample t-test, Cohen d and Chi-square.

Results:

Results showed that the video-guided educational intervention significantly improved school engagement level among hearing impaired adolescent students in the intervention group in comparison with the students in the care-as-usual control group as measured by the Student Engagement Scale [Behavioral: t(24) = −9.305, P 
< .001; Emotional: t(24) = −7.772, P < .001; Cognitive: t(24) = −7.330 P 
< .001) as well as total student engagement (t(24) = 12.022, P < .001, Δ = 5.362). Also, the students who took part in the video-guided educational intervention maintained improved school engagement at follow-up.

Conclusion:

Video-guided educational intervention is an effective intervention for improving school engagement of hearing impaired adolescent students. Since acquiring relevant education is essential for leading a quality life especially among the special needs population, it was recommended that students with hearing impairment should be helped to acquire life skills through education by fostering their school engagement.
Loss of MHC Class I Expression in HPV-associated Cervical and Vulvar Neoplasia
Authors: Dibbern Megan E. , Bullock Timothy N. , Jenkins Taylor M. , Duska Linda R. , Stoler Mark H. , Mills Anne M.
Published: June 2020

Tumor cell expression of major histocompatibility complex (MHC) class I is required for antigen presentation and adaptive immune recognition. Absent or diminished MHC class I expression is thought to contribute to immunotherapeutic resistance in some epithelial tumors but has not been previously studied in cervical and vulvar carcinoma. Given that anti–programmed cell death 1 (PD-1) checkpoint inhibition is deployed for programmed cell death ligand 1 (PD-L1)-positive recurrent and metastatic cervical squamous carcinomas, identifying tumors with loss of MHC class I is of clinical interest to optimize the selection of immunotherapeutic candidates. Immunohistochemistry for PD-L1 and MHC class I combined A, B, and C heavy chains (MHC class I) was assessed in 58 human papillomavirus–associated cervical and vulvar lesions, including 27 squamous intraepithelial lesions (SILs) and 31 invasive squamous cell carcinoma (SCC). Although 84% of SCC and 22% of SIL were PD-L1-positive, 35.5% (11/31) of SCC and 18.5% (5/27) of SIL also showed clonal or complete loss of MHC class I. Loss of MHC class I expression was more common in PD-L1-positive (10/26, 38%) versus PD-L1-negative SCC (1/5, 20%). In summary, over one third of human papillomavirus–associated cervical and vulvar SCC show clonal or complete loss of MHC class I expression, including many PD-L1-positive cases. This suggests that the efficacy of checkpoint inhibitors targeting the PD-1/PD-L1 axis may be limited in a subset of cervical and vulvar squamous neoplasms due to an impaired ability to engage with the adaptive immune system related to loss of MHC class I expression.