bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Machine Learning Algorithms for the Automated Detection of Functional Brain Networks in fMRI (Preprint)
Authors: Lem�e Jean-Michel , Bernard Florian , Labriffe Matthieu , Menei Philippe , Ter Minassian Aram
Published: October 2018

BACKGROUND

The functional MRI (fMRI) is an essential tool for the presurgical planning of brain tumor removal, allowing the identification of functional brain networks in order to preserve the patient’s neurological functions. One fMRI technique used to identify the functional brain network is the resting-state-fMRI (rsfMRI). However, this technique is not routinely used because of the necessity to have a expert reviewer to identify manually each functional networks.

OBJECTIVE

We aimed to automatize the detection of brain functional networks in rsfMRI data using machine learning algorithms.

METHODS

We used the rsfMRI data of 30 healthy patients to test the diagnostic performance of 10 machine learning algorithms compared to the reference functional networks identified manually by 2 expert reviewers. Then we selected the most fitted algorithm that we trained and tuned to optimize the diagnostic performance.

RESULTS

The comparison of the diagnostic performance of the machine learning algorithms identified the artificial neuron network using a scale conjugate gradient backpropagation as the most fitted algorithm. After training and fine tuning of the hyperparameters, the selected machine learning algorithm was able to identify correctly the different functional networks with an accuracy between 89 and 100%.

CONCLUSIONS

The artificial neural network using a scaled conjugate gradient backpropagation was the most performant machine learning algorithm. The use of this machine learning to automatize the functional networks detection in rsfMRI may allow to broaden the use of the rsfMRI, allowing the presurgical identification of these networks and thus help to preserve the patient’s neurological status.
Exploring the Transition to Fatherhood: Feasibility Study Using Social Media and Machine Learning (Preprint)
Authors: Teague Samantha J , Shatte Adrian BR
Published: October 2018

BACKGROUND

Fathers’ experiences across the transition to parenthood are underreported in the literature. Social media offers the potential to capture fathers’ experiences in real time and at scale while also removing the barriers that fathers typically face in participating in research and clinical care.

OBJECTIVE

This study aimed to assess the feasibility of using social media data to map the discussion topics of fathers across the fatherhood transition.

METHODS

Discussion threads from two Web-based parenting communities, r/Daddit and r/PreDaddit from the social media platform Reddit, were collected over a 2-week period, resulting in 1980 discussion threads contributed to by 5853 unique users. An unsupervised machine learning algorithm was then implemented to group discussion threads into topics within each community and across a combined collection of all discussion threads.

RESULTS

Results demonstrated that men use Web-based communities to share the joys and challenges of the fatherhood experience. Minimal overlap in discussions was found between the 2 communities, indicating that distinct conversations are held on each forum. A range of social support techniques was demonstrated, with conversations characterized by encouragement, humor, and experience-based advice.

CONCLUSIONS

This study demonstrates that rich data on fathers’ experiences can be sourced from social media and analyzed rapidly using automated techniques, providing an additional tool for researchers exploring fatherhood.
(Preprint)
Authors: Abd-Alrazaq Alaa Ali , Bewick Bridgette , Farragher Tracey , Gardner Peter
Published: October 2018

BACKGROUND

Electronic Personal Health Records (ePHRs) are secure web-based tools that enable individuals to access, manage, and share their medical records. England recently introduced a nationwide ePHR called Patient Online. As with ePHRs in other countries, adoption rates of Patient Online remain low. Understanding factors affecting patients’ use of ePHRs is important to increase adoption rates and improve the implementation success of ePHRs.

OBJECTIVE

This study aims to examine factors associated with patients’ use of ePHRs in England.

METHODS

The Unified Theory of Acceptance and Use of Technology (UTAUT) was adapted to the use of ePHRs. To empirically examine the adapted model, a cross-sectional survey of a convenience sample was carried out in four general practices in West Yorkshire, England. Factors associated with use of ePHRs were explored using Structural Equation Modelling (SEM).

RESULTS

Of 800 eligible patients invited to take part in the survey, 624 (78%) participants returned a valid questionnaire. Behavioural intention was significantly influenced by performance expectancy (β=0.57, P<0.001), effort expectancy (β=0.16, P<0.001), and perceived privacy and security (β=0.24, P<0.001). The path from social influence to behavioural intention was not significant (β=0.03, P=0.183). Facilitating conditions and behavioural intention significantly influenced use behaviour (β=0.25, P<0.001; β=0.53, P<0.001, respectively). Performance expectancy significantly mediated the effect of effort expectancy and perceived privacy and security on behavioural intention (β=0.19, P<0.001; β=0.28, P=0.001, respectively). Age significantly moderated three paths; PEBI, EEBI, and FCUB. Sex significantly moderated only the relationship between performance expectancy and behavioural intention. Two paths were significantly moderated by education and internet access: EEBI and FCUB. Income moderated the relationship between facilitating conditions and use behaviour. The adapted model accounted for 51% of the variance in performance expectancy, 76% of the variance in behavioural intention, and 48% of the variance in use behaviour.

CONCLUSIONS

This study identified the main factors that affect patients’ use of ePHRs in England, which should be taken into account for the successful implementation of these systems. For example, developers of ePHRs should involve patients in the process of designing the system to consider functions and features that fit patients’ preferences and skills, thereby, create a useful and easy to use system. The proposed model accounted for 48% of the variance in use behaviour, indicating the existence of other, as yet unidentified, factors that influence adoption of ePHRs. Future studies should confirm the effect of the factors included in the current model and to identify additional factors.
Web-Based Prescription Opioid Abuse Prevention for Adolescents: Program Development and Formative Evaluation (Preprint)
Authors: Moore Sarah K , Grabinski Michael , Bessen Sarah , Borodovsky Jacob T , Marsch Lisa A
Published: October 2018

BACKGROUND

The unprecedented number of youths engaged in nonmedical use of prescription opioids (POs), as well as the myriad negative consequences of such misuse, emphasizes the importance of prevention efforts targeting this public health crisis. Although there are several science-based, interactive drug abuse prevention programs focused on preventing the use of nonprescription drugs in youths, to our knowledge, there are no science-based interactive programs that focus on the prevention of PO abuse among adolescents.

OBJECTIVE

The aim of this study was to develop and conduct a formative evaluation of a science-based interactive Web-based program focused on the prevention of PO abuse among adolescents aged 12 to 17 years (Pop4Teens). This study was conducted to prepare for a randomized controlled trial designed to evaluate the effectiveness of Pop4Teens compared with an active control website, JustThinkTwice.com (Drug Enforcement Administration), in impacting knowledge and attitudes about POs and perceptions of risk associated with the abuse of POs, as well as intentions to use and actual use of POs.

METHODS

We conducted 6 focus groups with 30 youths (a mean of 5 per group: the eligibility being aged 12-19 years) along a continuum of exposure to POs (in treatment for opioid use disorder, in general treatment for other substance use disorder, prescribed an opioid, and opioid-naïve) and writing sessions with 30 youths in treatment for opioid use disorder (12-19 years) to inform the development of the Web-based prevention tool. Feasibility and acceptability of a prototype of the Web-based intervention were then assessed through individual feedback sessions with 57 youths (drawn from the same populations as the focus groups).

RESULTS

We successfully completed the development of a Web-based PO abuse prevention program (Pop4Teens). Analyses of focus group transcripts informed the development of the program (eg, quiz content/format, script writing, and story editing). Selected writing session narratives anchored the planned scientific content by lending credibility and informing the development of compelling storylines intended to motivate the youth to engage with the program. Feedback session data indicated that the Web-based tool could be potentially useful and acceptable. In addition, feedback session participants demonstrated significant increases in their knowledge of key topics related to the prevention of PO abuse after the exposure to sections of the Web-based program.

CONCLUSIONS

The opioid crisis is predicted to get worse before it gets better. An effective response will likely require a multipronged strategy inclusive of effective evidence-based prevention programs acceptable to, and accessible by, a majority of youths.
(Preprint)
Authors: Bandi Varun Kumar , Makkena Vamsikrishna , Mamidi Varun , Shekar Manikantan , Elumalai Ramprasad , Matcha Jayakumar
Published: October 2018

UNSTRUCTURED

Introduction: Cardiovascular disease is a major cause of morbidity and is now the leading cause of death in patients with renal transplants. We report a case of acute myocardial infarction three weeks post renal transplant. Case Report: A 45 year old male renal transplant renal transplant recipient presented three weeks post-transplant with acute chest pain, hypotension and atrial fibrillation. He was found to have Infero-posterior wall myocardial infarction. He was thrombolysed with Tenectaplase, and developed a perinephric hematoma six hours later. He underwent transfusions and pigtail drainage of the hematoma. The hematoma resolved, and he was started on dual anti-platelets with stable renal function. Conclusion: Thrombolysis in the early post-transplant period is considered a very high risk procedure. Our case illustrates the use of the thrombolytic therapy in the early post transplant period and successful management of the attendant complications.
Use of an Atrial Fibrillation Medication Decision Aid Improves Knowledge and Process for Decision Making (Preprint)
Authors: Beinfeld Molly , Brodney Suzanne , Barry Michael , Poole Erika , Kunin Adam
Published: October 2018

BACKGROUND

A rural community-based Cardiology practice implemented shared decision making supported by an evidence-based decision aid booklet to improve the quality of anticoagulant therapy decisions in patients with atrial fibrillation.

OBJECTIVE

To develop a practical workflow for implementation of an anticoagulant therapy decision aid and to assess the impact on patients’ knowledge and process for anticoagulant medication decision making.

METHODS

The organization surveyed all patients with atrial fibrillation being seen at Copley Hospital to establish a baseline level of knowledge, certainty about the decision and process for decision making. The intervention surveys included the same knowledge, certainty, process and demographic questions as the baseline surveys, but also included questions asking for feedback on the decision aid booklet. Stroke risk scores (CHA2DS2-VASc score) were calculated by Copley staff for both groups using EMR data.

RESULTS

We received 46 completed surveys in the baseline group (64% response rate) and 50 surveys in the intervention group (72% response rate). The intervention group had higher knowledge score than the baseline group (3.6 out of 4 correct answers vs 3.1, p=0.036) and Decision Process Score (2.89 out of 4 vs 2.09, p=0.0023) but similar scores on the SURE scale (3.12 out of 4 vs 3.17, p=0.79). Knowledge and Process score differences were sustained even after adjusting for co-variates in stepwise linear regression analyses. Patients with high school or lower education appeared to benefit the most from shared decision making, as demonstrated by their knowledge scores.

CONCLUSIONS

It is feasible and practical to implement shared decision making supported by decision aids in a community-based Cardiology practice. Shared decision making can improve knowledge and process for decision making for patients with atrial fibrillation.

CLINICALTRIAL

None
A Self-Regulation–Based eHealth and mHealth Intervention for an Active Lifestyle in Adults With Type 2 Diabetes: Protocol for a Randomized Controlled Trial (Preprint)
Authors: Poppe Louise , De Bourdeaudhuij Ilse , Verloigne Maïté , Degroote Laurent , Shadid Samyah , Crombez Geert
Published: October 2018

BACKGROUND

Adoption of an active lifestyle plays an important role in the management of type 2 diabetes. Online interventions targeting lifestyle changes in adults with type 2 diabetes have provided mixed results. Previous research highlights the importance of creating theory-based interventions adapted to the population’s specific needs. The online intervention “MyPlan 2.0” targets physical activity and sedentary behavior in adults with type 2 diabetes. This intervention is grounded in the self-regulation framework and, by incorporating the feedback of users with type 2 diabetes, iteratively adapted to its target population.

OBJECTIVE

The aim of this paper is to thoroughly describe “MyPlan 2.0” and the study protocol that will be used to test the effectiveness of this intervention to alter patients’ levels of physical activity and sedentary behavior.

METHODS

A two-arm superiority randomized controlled trial will be performed. Physical activity and sedentary behavior will be measured using accelerometers and questionnaires. Furthermore, using questionnaires and diaries, patients’ stressors and personal determinants for change will be explored in depth. To evaluate the primary outcomes of the intervention, multilevel analyses will be conducted.

RESULTS

The randomized controlled trial started in January 2018. As participants can start at different moments, we aim to finish all testing by July 2019.

CONCLUSIONS

This study will increase our understanding about whether and how a theory-based online intervention can help adults with type 2 diabetes increase their level of physical activity and decrease their sedentary time.

INTERNATIONAL REGISTERED REPOR

DERR1-10.2196/12413
Design Choices and Trade-Offs in Health Care Blockchain Implementations: Systematic Review (Preprint)
Authors: O'Donoghue Odhran , Vazirani Anuraag A , Brindley David , Meinert Edward
Published: October 2018

BACKGROUND

A blockchain is a list of records that uses cryptography to make stored data immutable; their use has recently been proposed for electronic medical record (EMR) systems. This paper details a systematic review of trade-offs in blockchain technologies that are relevant to EMRs. Trade-offs are defined as “a compromise between two desirable but incompatible features.”

OBJECTIVE

This review’s primary research question was: “What are the trade-offs involved in different blockchain designs that are relevant to the creation of blockchain-based electronic medical records systems?”

METHODS

Seven databases were systematically searched for relevant articles using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Papers published from January 1, 2017 to June 15, 2018 were selected. Quality assessments of papers were performed using the Risk Of Bias In Non-randomized Studies—of Interventions (ROBINS-I) tool and the Critical Assessment Skills Programme (CASP) tool. Database searches identified 2885 articles, of which 15 were ultimately included for analysis.

RESULTS

A total of 17 trade-offs were identified impacting the design, development, and implementation of blockchain systems; these trade-offs are organized into themes, including business, application, data, and technology architecture.

CONCLUSIONS

The key findings concluded the following: (1) multiple trade-offs can be managed adaptively to improve EMR utility; (2) multiple trade-offs involve improving the security of blockchain systems at the cost of other features, meaning EMR efficacy highly depends on data protection standards; and (3) multiple trade-offs result in improved blockchain scalability. Consideration of these trade-offs will be important to the specific environment in which electronic medical records are being developed. This review also uses its findings to suggest useful design choices for a hypothetical National Health Service blockchain.

INTERNATIONAL REGISTERED REPOR

RR2-10.2196/10994
Decision Support Tools for Regenerative Medicine: Systematic Review (Preprint)
Authors: Lam Ching , Meinert Edward , Alturkistani Abrar , Carter Alison R. , Karp Jeffrey , Yang Aidong , Brindley David , Cui Zhanfeng
Published: October 2018

BACKGROUND

Decisional tools have demonstrated their importance in informing manufacturing and commercial decisions in the monoclonal antibody domain. Recent approved therapies in regenerative medicine have shown great clinical benefits to patients.

OBJECTIVE

The objective of this review was to investigate what decisional tools are available and what issues and gaps have been raised for their use in regenerative medicine.

METHODS

We systematically searched MEDLINE to identify articles on decision support tools relevant to tissue engineering, and cell and gene therapy, with the aim of identifying gaps for future decisional tool development. We included published studies in English including a description of decisional tools in regenerative medicines. We extracted data using a predesigned Excel table and assessed the data both quantitatively and qualitatively.

RESULTS

We identified 9 articles addressing key decisions in manufacturing and product development challenges in cell therapies. The decision objectives, parameters, assumptions, and solution methods were analyzed in detail. We found that all decisional tools focused on cell therapies, and 6 of the 9 reviews focused on allogeneic cell therapy products. We identified no available tools on tissue-engineering and gene therapy products. These studies addressed key decisions in manufacturing and product development challenges in cell therapies, such as choice of technology, through modeling.

CONCLUSIONS

Our review identified a limited number of decisional tools. While the monoclonal antibodies and biologics decisional tool domain has been well developed and has shown great importance in driving more cost-effective manufacturing processes and better investment decisions, there is a lot to be learned in the regenerative medicine domain. There is ample space for expansion, especially with regard to autologous cell therapies, tissue engineering, and gene therapies. To consider the problem more comprehensively, the full needle-to-needle process should be modeled and evaluated.
Improving the Quality of Consumer Health Information on Wikipedia: Case Series (Preprint)
Authors: Weiner Shira Schecter , Horbacewicz Jill , Rasberry Lane , Bensinger-Brody Yocheved
Published: October 2018

BACKGROUND

Wikipedia is one of the most consulted health resources in the world. Since the public is using health information from Wikipedia to make health care decisions, improving the quality of that health information is in the public interest. The open editable content design of Wikipedia and quality control processes in place provide an opportunity to add high-value, evidence-based information and take an active role in improving the health care information infrastructure.

OBJECTIVE

The aim of this project was to enhance Wikipedia health pages using high-quality, current research findings and track the persistence of those edits and number of page views after the changes to assess the reach of this initiative.

METHODS

We conducted Wikipedia Editathons with 3 different cohorts of Physical Therapy (PT) students to add high-quality health information to existing Wikipedia pages. Students synthesized best evidence information and updated and/or corrected existing Wikipedia entries on specific health pages. To evaluate the impact of these contributions, we examined two factors: (1) response to our contributions from the Wikipedia editing community, including number and type of subsequent edits as well as persistence of the student contributions and (2) number of page views by the public from the time of the page edits.

RESULTS

A total of 98 PT students in 3 different cohorts engaged in Editathons, editing 24 health pages. Of the 24 edits, 22 persisted at the end of the observation period (from time of entry to May 31, 2018) and received nearly 8 million page views. Each health page had an average of 354,724 page views.

CONCLUSIONS

The Wikipedia Editathon is an effective way to continuously enhance the quality of health information available on Wikipedia. It is also an excellent way of bridging health technology with best-evidence medical facts and disseminating accurate, useful information to the public.
Sharing health-data among general practitioners: the Italian experience (Preprint)
Authors: Frontoni Emanuele , Mancini Adriano , Baldi Marco , Moccia Sara , Migliorelli Lucia , Paolanti Marina , Zingaretti Primo , Misericordia Paolo
Published: October 2018

BACKGROUND

Sharing General-Practitioners' (GPs) health data has been widely pointed out to be crucial in improving care delivery and achieving a more efficient use of National Health Service (NHS) resources.

OBJECTIVE

The aim of this paper is to present a Service Oriented Architecture (SOA), called Nu.Sa., that fosters the digitalization, storage and sharing GPs' health data. The Nu.Sa. SOA also allows the integration of clinical decision support systems based on GPs' health-data processing. The Nu.Sa. SOA is currently available to Italian GPs through a website application.

METHODS

The Nu.Sa. architecture is fully interoperable and able to automatically collect standardized data from 16 different Italian GPs' softwares (accounting for the 98% of the Italian GPs' softwares). The data are stored on a dataset on cloud and GPs have full and continuous access to them. Data standards are implemented with a strong focus on data protection and cybersecurity. All data standards are publicly available and under continuous improvement. To test the Nu.Sa. architecture, both qualitative and quantitative analyses were performed.

RESULTS

The Nu.Sa. database average traffic per hour in 2017 was 432 (received) and 791 (sent) MByte/hour, with average and failed connections equal to 178/hour and 0.2/hour, respectively. From preliminary usability tests on 20 GPs and 10 patients, more than the 85% reported very good feeling with the Nu.Sa. website application. A survey on more than 650 Italian GPs revealed that Nu.Sa. action priorities are information sharing, e-prescription de-materialization and interaction with local pharmacies. The most critical perceived barrier to the Nu.Sa. wide spread at a national level was the reduced availability of economic resources. A learning-based Clinical Decision Support System (CDSS) for diabetes diagnosis was also implemented from data relative to more than 2000 patients collected from the Nu.Sa. database, achieving a sensitivity of 75%. Currently, the Nu.Sa. system manages more than 5000 GPs with about 5500000 patients in total, with 4700000 pharmacological and 1700000 laboratory-exam e-prescriptions, respectively per month.

CONCLUSIONS

Results showed the applicability of the Nu.Sa. system at a national level for data storage and sharing. Further achievements dealt with implementation of GPs' self-audit and integration of a learning-based CDSS for data analysis and diagnosis support. Such results are surely a promising step towards improving patients' management and optimizing NHS resources.
A Mobile Smoking Cessation Intervention for Mexico (Vive sin Tabaco... ¡Decídete!): Single-Arm Pilot Study (Preprint)
Authors: Cupertino Ana Paula , Cartujano-Barrera Francisco , Ramírez Mariana , Rodríguez-Bolaños Rosibel , Thrasher James F , Pérez-Rubio Gloria , Falfán-Valencia Ramcés , Ellerbeck Edward F , Reynales-Shigematsu Luz Myriam
Published: October 2018

BACKGROUND

Of the 14.3 million Mexicans who smoke, only a minority take advantage of evidence-based approaches to smoking cessation. Mobile health interventions have the potential to increase the reach of effective cessation interventions in Mexico.

OBJECTIVE

This study aimed to assess the feasibility and acceptability of an innovative, personalized, and interactive smoking cessation mobile intervention developed for Mexican smokers.

METHODS

We recruited 40 Mexican smokers to participate in Vive sin Tabaco... ¡Decídete!, a smoking cessation program that uses a tablet-based decision support software to drive a 12-week text messaging smoking cessation program and pharmacotherapy support. Outcome measures included participant text messaging interactivity with the program, participant satisfaction, and 12-week verified abstinence using urinary cotinine testing or exhaled carbon monoxide.

RESULTS

Average age of the participants was 36 years (SD 10.7), and they were primarily male (65%, 26/40) with at least an undergraduate degree (62%, 25/40). Most participants (95%, 38/40) smoked daily and were interested in quitting in the next 7 days. As an indicator of participant interactivity, participants sent an average of 21 text messages during the 12-week intervention (SD 17.62). Of the 843 messages that participants sent to the program, only 96 messages (11.3%, 96/843) used keywords. At 12 weeks, 40% (16/40) of participants were biochemically verified (87%, 35/40, follow-up rate). The majority of participants (85%, 30/35) reported being very satisfied or extremely satisfied with the program.

CONCLUSIONS

The Vive sin Tabaco... ¡Decídete! smoking cessation mobile intervention was accepted by participants, generated high satisfaction and high text messaging interactivity, and resulted in a noteworthy cessation rate at the end of treatment. This intervention is a promising strategy for smoking cessation in Mexico. Additional testing as a formal randomized clinical trial appears warranted.
An mHealth Assistive System “MyLung” to Empower Patients with Chronic Obstructive Pulmonary Disease: Design Science Research (Preprint)
Authors: Alharbey Riad , Chatterjee Samir
Published: October 2018

BACKGROUND

Chronic obstructive pulmonary disease (COPD) comprises a group of progressive diseases that deteriorate lung functions. When patients cannot breathe, nothing else in their lives matter. Breathlessness has negative implications on patients’ lives, which leads to physical and psychological limitations. Moreover, the lack of relevant and updated information about the causes and consequences of the disease can exacerbate the problems of health literacy, information accessibility, and medical adherence.

OBJECTIVE

The objective of this study is to design an innovative mobile health (mHealth) app system called “MyLung” that provides complete solutions in order to increase self-awareness and promote better self-care management. This system, an information technology artifact, includes three novel integrative modules: education, risk reduction, and monitoring.

METHODS

The utility and effectiveness of the assistive mobile-based technology were evaluated using a mixed-methods approach. The study combined quantitative and qualitative research methods to thoroughly understand how the assistive mobile-based technology can influence patients’ behavioral intention to change their lifestyle. Thirty patients were categorized into two groups (intervention group and control group).

RESULTS

The results from the quantitative analysis led to four follow-up interviews in the qualitative study. The results of the quantitative study provided significant evidence to show that the design of MyLung leads to a change in the awareness level, self-efficacy, and behavioral intention for patients with COPD. The t tests revealed a significant difference before and after using the mobile-based app with regard to the awareness level (mean 3.28 vs 4.56; t10=6.062; P<.001), self-efficacy (mean 3.11 vs 5.56; t10=2.96; P=.01), and behavioral intention (mean 2.91 vs 4.55; t10=3.212; P=.009). Independent sample t tests revealed significant differences between the intervention group and the control group in terms of the awareness level (mean 4.56 vs 3.31; t19=4.80; P<.001) and self-efficacy (mean 5.56 vs 3.66; t19=2.8; P<.01). Integration of findings from quantitative and qualitative studies reveled the impact of the design in a comprehensive manner. These inferences are referred to as “meta-inferences” in this study.

CONCLUSIONS

We designed an innovative assistive mobile-based technology to empower patients with COPD, which helped increase awareness and engage patients in self-care management activities. The assistive technology aims to inform patients about the risk factors of COPD and to improve access to relevant information. Meta-inferences that emerge from the research outputs contribute to research into chronic management information systems by helping us gain a more complete understanding of the potential impacts of this proposed mobile-based design on patients with chronic disease.
The Implementation of Interactive Comprehensible Written Input-Output Instruction in Teaching Writing of English
Authors: Sutarsyah Cucu , Yufrizal Hery
Published: October 2018

The long term goal of this research is to prove the effect of input and output means in the theory of Second Language Acquisition. The input-output means has been proven to be able to influence the process of second language acquisition (Izumi et al., 1999). A comprehensible approach called Interactive Input-Output Instruction Written designed and developed to maximize input obtained through reading materials that were then used to produce meaningful paper or essay. Assuming that there was a problem with the ability of students to use the language, especially in terms of ability to write, which is important for every students of English, type of learning in a group can be used to benefit the students to get input from the reading process to influence their writing skills. In groups, the students were given a writing assignment that must be completed. This writing task brings a bias problem solved by recourse through the reading process. Therefore, the reading was done with a purpose and contribution of each member in the group is very helpful in completing the task of writing. The study involved 36 students who attend Mathematics English courses in the first semester of academic year 2016/2017. The students were given the opportunity to process narrative and anecdotal text, made text reconstruction, paragraph predicting continued, wrote prediction, give and receive feedback and make revisions. The results show there significant difference between students’ ability to write comprehensible Written before implementation Interactive Input-Output Instruction and after implementation comprehensible Written Interactive Input-Output Instruction. Of the five aspects of writing, the students obtained an increase in value in terms of content and organization. The predictive ability of students is quite high as evidenced by the nine groups that made predictions, five groups could do exactly.
Relationship of serum netrin-1 levels with breast masses
Authors: SOLAK İbrahim , YİLDİRİM Duygu İlke , SOLAK Mustafa , CETİNKAYA Cigdem Damla , BOYACİ Ayse , ERYİLMAZ Mehmet Ali
Published: October 2018

Introduction: Netrin-1
has been shown to induce angiogenesis and is considered to function as a
proto-oncogene. We aimed to evaluate the relationship of serum netrin-1 level
with the presence of breast mass and the nature of mass.Methods: A total of
84 patients, including 27 patients with benign mass, 31 patients with malignant
mass and 26 healthy controls, were enrolled in the study. Results: In our
study, the mean serum netrin-1 level was 479±325 pg/ml in the patients with
malignant mass, 336.9±178.2 pg/ml in the patients with benign mass and
264.7±112.4 pg/ml in the healthy controls, respectively. There was a
statistically significant difference in mean serum netrin-1 level between these
three groups (p=0.007). When the patients participating in the study were
divided in to two groups as those with (the benign and malign groups) and
without (the control group) mass, the mean serum netrin-1 level was 264.7±112.4
pg/ml in those without mass and 412.8±274.2 pg/ml in those with mass,
respectively. It was seen that the mean serum netrin-1 level of those with mass
was statistically significantly higher than that of those without mass
(p=0.016).

Conclusion: The mean
serum netrin-1 level was found to be significantly higher in the patients with
breast mass, especially those with malignant mass.
ATUAÇÃO DE UMA EQUIPE MULTIPROFISSIONAL NA ASSISTÊNCIA PRÉ-NATAL E PUERPERAL: UM RELATO DE EXPERIÊNCIA
Authors: Cristina Alves Renata , Vertuan Rufino Jessica , Da Silva Capello Thais , Luisa Gobbo Catharino Anna , Fontana Medeiros Fabiana
Published: October 2018

O Programa de Residência Multiprofissional em Saúde da Mulher (RMSM) foi criado como estratégia para melhoria da assistência integral à saúde da mulher, sendo a gestação e puerpério uma das fases de maior enfoque. Tendo em vista a construção de uma visão transdisciplinar da assistência à saúde da mulher, o presente trabalho tem como objetivo relatar a experiência de uma equipe multiprofissional na assistência ao pré-natal e puerpério compartilhados. A metodologia empregada consiste na realização de consultas de pré-natal e visitas puerperais pela equipe em uma Unidade Básica de Saúde no município de Londrina-PR. Essa experiência traz aos profissionais um enriquecimento pelo fato de haver troca de informações e consequentemente, crescimento profissional.
Asymptotically almost periodic solutions of fractional relaxation inclusions with Caputo derivatives
Authors: Kostic Marko
Published: October 2018

We analyze asymptotically almost periodic solutions for a class of
(semilinear) fractional relaxation inclusions with Stepanov almost periodic
coefficients. As auxiliary tools, we use subordination principles, fixed
point theorems and the well known results on the generation of infinitely
differentiable degenerate semigroups with removable singularities at zero.
Our results are well illustrated and seem to be not considered elsewhere
even for fractional relaxation equations with almost sectorial operators.
Pancreatic Panniculitis Associated with Acinar Cell Pancreatic Carcinoma
Authors: Poelman Susan M. , Nguyen Khue
Published: October 2018

Background:

Pancreatic panniculitis is a rare entity, occurring in less than 2% of patients with pancreatic disorders. Skin manifestations may precede the diagnosis of a pancreatic disease by many months. When treatable, correction of the underlying pancreatic disorder may lead to prompt resolution of the panniculitis.

Objective:

We present the case of a 74-year-old-man with a history of chronic pancreatitis who presented with an acute onset of tender, nonulcerating nodules. The clinical and histologic features of pancreatic panniculitis are discussed, with a brief review of the differential diagnosis and clinical approach to panniculitis.

Conclusions:

Pancreatic panniculitis is a recognizable clinical entity with characteristic histologic features that may resolve with treatment of the underlying pancreatic disorder. The algorithm-based clinical approach to panniculitis presented in this study is a practical tool designed to guide clinicians in ordering investigations and determining the appropriate management for patients presenting with subcutaneous nodules.
Nevus Lipomatosus Superficialis Unseen or Unrecognized: A Report of Eight Cases
Authors: Kumaran Muthu Sendhil , Narang Tarun , Dogra Sunil , Saikia Uma Nahar , Kanwar Amarinder Jit
Published: October 2018

Background:

Nevus lipomatosus superficialis (NLS) is a unique developmental anomaly or nevoid form of lipoma characterized by the ectopic presence of mature adipocytes in reticular dermis. The condition is rare; apart frrom isolated case reports, there are no large case series dealing with the clinicoepidemiologic characteristics and posttreatment long-term follow-up in patients with NLS and little published information on treatment outcome.

Objective:

To study the clinicoepidemiologic characteristics and long-term posttreatment follow-up in patients with NLS.

Methods:

This was an 11-year retrospective study analyzing disease characteristics and treatment outcome in eight patients with NLS.

Results:

There were eight (six males, two females) patients with NLS, of whom three were children. The classic variant of NLS was the predominant presentation. One patient demonstrated a combination of both classic and solitary variants. Most patients, especially those with solitary variants, were commonly misdiagnosed before presenting to us. Four patients, including two with the solitary variant, one each with the classic and the combined type, underwent surgical resection without any recurrence over 8 years of follow-up.

Conclusions:

The rare nature of the disorder, which is commonly misdiagnosed, and the absence of long-term follow-up data prompted us to share our experience about NLS to increase its awareness among health care providers.
An Update on Chronic Wounds and The Role of Biofilms
Authors: Scali Christina , Kunimoto Brian
Published: October 2018

Background:

Chronic wounds cause significant morbidity and mortality and cost our health care system millions of dollars each year. A major impediment to wound healing is the formation of bacterial biofilms. Biofilms are communities of bacteria associated with chronic infections.

Objective:

This article reviews the literature on chronic wounds and biofilms. The role of biofilms in chronic wounds is not widely known. The purpose is to increase awareness of their role and to discuss research into novel therapeutic options.

Methods:

PubMed searches were performed to identify publications on chronic wounds and biofilms.

Results:

Biofilms contribute to chronic wound nonhealing. There is an abundance of research into novel antibiofilm strategies for chronic wounds.

Conclusion:

Current research is being targeted at antibiofilm strategies needed to restore an optimal wound-healing environment. A combined treatment approach involving aggressive débridement and the addition of antibiofilm agents is needed.
Dermabrasion and Staged Excision of Facial Lesions in a Neurofibromatosis Case for Improvement of Facial Appearance
Authors: Karabekmez Furkan Erol , Duymaz Ahmet , Karacor Zeynep
Published: October 2018

Background:

Neurofibromatosis may present with different skin lesions. Disfiguring lesions on the face might be challenging for the surgeon or clinician to correct and may have adverse effects on patients' social lives, especially in young women.

Objective:

To present the dermabrasion technique combined with serial excisions of a deeper accompanying lesion to treat superficial facial lesions in a young neurofibromatosis patient.

Methods:

Dermabrasion was applied to superficial lesions on the face, and staged excision was applied to the deeper lesion located on the forehead.

Results:

We obtained high patient satisfaction with the result. The deep lesion was excised totally, and superficial lesions were decreased with dermabrasion.

Conclusion:

Dermabrasion may become a good alternative in cases of neurofibromatosis with superficial facial lesions.
Favre-Racouchot Syndrome in a 39-Year Old Female following Radiation Therapy
Authors: Sutherland Ashley E. , Green Peter J.
Published: October 2018

Background:

Favre-Racouchot syndrome is a cutaneous disease characterized by nodules, cysts, and comedones that typically develops on sun-exposed areas of the face. This syndrome most commonly affects white males between the ages of 40 and 60 years and is frequently associated with chronic sun exposure and, more recently, chronic cigarette smoking.

Objective:

We report a case of Favre-Racouchot syndrome in a 39-year-old female who received 6 weeks of radiation therapy to treat a grade 3 oligodendroglioma.

Results and Conclusion:

Although there have been previously reported cases of Favre-Racouchot syndrome following radiation therapy, this case is unique given the young age of the patient and extent of involvement.
Scalp Trauma
Authors: Montpellier Renee-Anne , Donovan Jeff C.
Published: October 2018

Background:

Lichen planopilaris is a type of primary scarring alopecia that is characterized by perifollicular lymphocytic inflammation and fibrosis. The cause remains poorly understood, although recent research has begun to unravel some of the molecular mechanisms implicated in the pathogenesis.

Objective:

To present a case of biopsy-proven lichen planopilaris in a patient who had previously suffered serious head injury. Lichen planopilaris developed only in the areas of trauma.

Conclusion:

Our findings highlight the possible association between scalp trauma and the development of lichen planopilaris. Further research is needed to understand the role of scalp trauma in the pathogenesis of scarring alopecia.
Eosinophilic Fasciitis Occurring under Treatment with Natalizumab for Multiple Sclerosis
Authors: Bujold Janie , Boivin Catherine , Amin Mohamed , Bouchard Jean-Pierre , Soucy Jacques
Published: October 2018

Background:

Eosinophilic fasciitis is a rare sclerosing syndrome with a poorly understood etiology.

Objective:

We report a case of eosinophilic fasciitis in a 40-year-old man undergoing treatment with natalizumab for multiple sclerosis. Natalizumab is a selective adhesion molecule inhibitor that prevents interaction of leukocytes with endothelial cells. Peripheral blood eosinophilia has been described under treatment with natalizumab, but we herein report the first case to our knowledge of eosinophilic fasciitis as a possible complication of this medication.
Eruptive Melanocytic Nevi Induced by Interferon for Nodal Metastatic Melanoma: Case Report and Review of the Literature
Authors: Salopek Thomas G. , Mahmood Muhammad N.
Published: October 2018

Background:

The rapid appearance of multiple new melanocytic nevi is known as eruptive nevi and has been well documented to occur with certain medications, in particular chemotherapeutic agents.

Methods:

We report a case of a woman with melanoma complicated by nodal metastasis who developed multiple melanocytic nevi while on high-dose interferon.

Results:

Serial photographs confirmed that the pigmented lesions were of new onset, whereas histology documented that the lesions were dysplastic nevi. A survey of the literature documented numerous causes of eruptive nevi, which we review. To date, interferon has not been linked to eruptive nevi.

Conclusions:

The phenomenon of eruptive nevi has been attributed to medications, bullous dermatoses, immunosuppression, and systemic conditions and is possibly a paraneoplastic disorder. Interferon appears to be another possible cause of this disorder.
External Tissue Expander for Closing Large Defects of the Extremities and Trunk
Authors: Kirschke Julia , Georgas Dimitrios , Sand Michael , Bechara Falk G.
Published: October 2018

Background:

Direct closure is the reconstruction of choice for surface soft tissue defects; however, it may not be suitable for larger defects due to extensive tension. A variety of techniques are available for achieving tension free closure, including skin grafts, skin flaps, and internal or external tissue expansion.

Materials and Methods:

The external skin expander developed by Blomqvist and Steenfos consists of single tissue expander units that contain an atraumatic needle and two friction stoppers connected via a silicone string. Each device of the expander is inserted under local anaesthesia on each side of the defect at a distance of about 2 cm from each other. Postoperative the silicone strings have to be tightened at least once a day. After about 5 to 10 days a sufficient expansion is achieved and the defect can be closed directly after expander removal.

Results:

The external tissue expander developed by Blomqvist and Steenfos is an efficient, time-effective, easy-to-handle device that can be inserted under local anesthesia, providing a good functional and satisfactory cosmetic outcome. Due to the comparatively low complication rate, even outpatient treatment is possible. The major drawback of this technique is the possibility of developing uncommon secondary scars under the plastic stoppers.
Cutaneous T-Cell Lymphoma–Like Drug Eruption in an HIV-Positive Patient Taking Vancomycin and Rifampin
Authors: MacIsaac Jennifer L. , Ward Chloé E. , Pratt Melanie
Published: October 2018

Background:

Cutaneous T-cell pseudolymphoma (CTPL) is a benign reactive T-cell lymphoproliferative subtype of pseudolymphoma. Some variants of CTPL can resemble the plaques of mycosis fungoides (MF). The vast majority of drug-induced cases have been associated with anticonvulsants. There is only one report in the literature documenting a case of vancomycin-induced CTPL.

Methods:

We report a cutaneous T-cell lymphoma–like eruption in a human immunodeficiency virus (HIV)-positive patient recently started on vancomycin and rifampin.

Results:

A skin biopsy showed several histologic features of MF with immunohistochemical and T-cell receptor gene rearrangement studies suggestive of CTPL. This atypical T-cell reaction mimicking MF completely resolved on cessation of rifampin followed by vancomycin.

Conclusion:

Considering drug-induced causes of MF-like histologic changes is crucial to prevent unnecessary treatment for MF.
Spectrum of Dermoscopic Patterns in Lichen Planus: A Case Series from China
Authors: Tan Cheng , Min Zhong-Sheng , Xue Yanning , Zhu Wen-Yuan
Published: October 2018

Background:

Dermoscopy has been shown to be a promising method to facilitate the diagnosis of lichen planus (LP) outside of China.

Objective:

To investigate the spectrum of dermoscopic patterns in Chinese LP patients.

Methods:

The clinical data and dermoscopic patterns of nine LP cases with a total of 43 lesions were evaluated.

Results:

To the naked eye, 20.97% of the lesions exhibited graying Wickham striae (WS); however, 37.5% presented with white streaks of annular, reticular, or leaf venation patterns under dermoscopy. Blue-white veils were occasionally observed in the center. Pigment patterns varied from dots, globules, and peppered pigment to pigmented lines, which were unrelated to the pigment network of the skin. At the periphery of the WS, red fine lines ran parallel to the delicate white streaming lines.

Conclusions:

WS exhibits five morphological patterns (leaf venation, reticular, white dots, circular and radial streaming) and three color patterns (homogeneous crystalline white, blue-white veil and yellowish-white). The pigment patterns consisted of dots/globules, peppered pigments and pigment. streaming lines.