bluuebunny/crossref_metadata_2025 huggingface dataset:
On optimal life extension for degrading systems
Authors: Cha Ji Hwan , Finkelstein Maxim
Published: February 2020

We consider life extension models for critical, complex systems with relatively long lifecycles. In contrast to traditional optimal preventive maintenance that usually minimizes the corresponding long run cost rate, a finite number of preventive maintenances are performed to increase the expected lifetime of these systems in an optimal way. The cases of periodic and aperiodic preventive maintenance actions are discussed. The proposed novel approach to life extension allows for simple sensitivity analysis with respect to parameters of the model. The obtained optimal solutions can result in a noticeable increase in the useful life of complex systems. Our findings are illustrated by numerical examples.
Reliability and barrier assessment of series–parallel systems subject to cascading failures
Authors: Xie Lin , Lundteigen Mary Ann , Liu Yiliu
Published: February 2020

Cascading failures can occur in many technical systems where the components are organized as in series–parallel structures. The failures in these systems may propagate from one component to the other, not only within the same parallel sub-structure but also between different sub-structures. This article presents a recursive aggregation method based on the extended models of reliability block diagram, for analyzing the impacts of cascading failures on the reliability of series–parallel systems. Based on the reliability analysis, the effects of safety barriers on preventing cascading failures are studied, and the importance of safety barriers at different locations is evaluated. One simple example of three components and one practical case from an oil production system are presented. The findings in these case studies illustrate how system designers and safety managers can identify the effective and reasonable ways of installing safety barriers by using the proposed approaches, for the mitigation of cascading failures in series–parallel technical systems.
Comment: Measuring Guilty and Grateful Behaviors in Children and Adults
Authors: Tsang Jo-Ann
Published: February 2020

This comment explores the use of behavioral measures in the developmental study of guilt and gratitude reviewed by Vaish and Hepach (2020). Although the use of behavioral measures in developmental emotion research might be seen as a limitation in that researchers cannot be sure that young children are actually experiencing guilt or gratitude, behavioral measures have several advantages over self-report measures, including the ability to reduce self-presentation bias and to assess emotions and motivations that may be implicit. Other fields that study guilt and gratitude might follow in developmental psychology’s lead and incorporate more behavioral measures of guilt, gratitude, and prosociality.
Strategic Framing and Social Media Engagement: Analyzing Memes Posted by the German Identitarian Movement on Facebook
Authors: Guenther Lars , Ruhrmann Georg , Bischoff Jenny , Penzel Tessa , Weber Antonia
Published: February 2020

While officially classified as a right-wing movement, the German Identitarian Movement (GIM) claims to be neither left nor right wing but rather identitarian. The social movement stands for what they call “ethno-pluralism,” communicated online without intermediate gatekeepers, in supposedly socially acceptable messages. Without a clear classification to a political wing, some Internet users encountering information created by the GIM could have difficulties assessing what this movement really stands for and what identitarian means. That is why this study examined strategic frames in a full sample of memes ( N = 511) posted by the movement on their Facebook page, because memes (here: image macros) have been the GIM’s main form of communication on Facebook. This study identified six strategic frames that represent a plurality of different social issues; some of them call for immediate action. Hence, the movement’s strategic framing goes far beyond emphasizing “ethno-pluralism.” The findings elucidate the overall communication strategies of the movement and show that the frames represent characteristics and semantics of the New Right. These frames also triggered different levels of social media engagement.
Public trust in state governments in India: Who are more confident and what makes them confident about the government?
Authors: Kumar Deepak , Pratap Bhanu , Aggarwal Archana
Published: February 2020

Public trust in government is crucial for good governance, encompassing economic and social development of the region in a representative democratic setup. This study uses India Human Development Survey (2004–2005 and 2011–2012) data to examine the changing pattern of household confidence in state governments in India. Using a logit model analysis, we examine how the level of household confidence in the state government changes with households’ socioeconomic status, personal experiences, and benefits received from government programs and direct social benefit schemes. We find that households with a low socioeconomic status (such as Scheduled Castes/Scheduled Tribes, and low-income and less educated households) are more likely to trust the state government. In addition, households that have had a positive experience or have received benefits from a government program and/or social scheme are more likely to exhibit high levels of trust in the state government. We also find that residents of less developed states are more likely to have high levels of trust in their state government than residents of highly developed states.
Preoperative Rotator Muscle Strength Ratio Predicts Shoulder Function in Patients After Rotator Cuff Repair
Authors: Lee Sang Min , Seo Yong Gon , Park Won Hah , Yoo Jae Chul
Published: February 2020

Background:

Shoulder function after rotator cuff repair is associated with patient satisfaction after surgery. Several studies have demonstrated that the muscle strength ratio (external rotators/internal rotators) is an important factor to evaluate shoulder function, but little is known about the relationship between the preoperative muscle strength ratio and postoperative shoulder function.

Purpose:

To evaluate the effect of the preoperative muscle strength ratio of the shoulder rotators on function after rotator cuff repair.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

The study participants were patients with small- to medium-sized rotator cuff tears diagnosed by magnetic resonance imaging; 77 patients were included in the analysis. Preoperative muscle strength was assessed through use of isokinetic equipment. Patients were classified into 2 groups (normal and abnormal) according to a normal strength ratio range of 55% to 75%, with “abnormal” meaning a deviation of more than 15% from the normal range. The American Shoulder and Elbow Surgeons (ASES) score and the Constant score were used to evaluate shoulder function preoperatively and postoperatively at 6 months, 1 year, and 2 years.

Results:

There were 30 patients in the normal group and 47 in the abnormal group, with a preoperative muscle strength ratio of 63.5% ± 5.5% and 42.6% ± 6.1%, respectively. The ASES score was 88.6 ± 9.1 in the normal group and 77.5 ± 13.6 in the abnormal group at 2 years postoperatively, and the Constant score was 82.7 ± 8.4 in the normal group and 69.5 ± 13.4 in the abnormal group at 2 years postoperatively. A significant difference was found in postoperative shoulder function between the normal and abnormal groups.

Conclusion:

This study demonstrated that the preoperative muscle strength ratio was associated with postoperative shoulder function. The preoperative muscle strength ratio should be considered an important predictor of shoulder function after rotator cuff repair.
Pediatric Patient and Family Advisory Councils: A Guide to Their Development and Ongoing Implementation
Authors: Richard Julie , Azar Rima , Doucet Shelley , Luke Alison
Published: February 2020

Background:

Patient and family engagement is increasingly recognized in the care of children with complex health conditions. Through the implementation of Patient and Family Advisory Councils (PFACs), health-care institutions are working to improve patient care by nurturing partnerships among patients/families, managers, and clinicians. Despite the potential for PFACs, empirical research about their implementation remains scarce.

Objective:

To address this gap, this study explored the recruitment, retention, and implementation strategies used by Canadian PFACs.

Design:

We used a qualitative descriptive design.

Participants:

We interviewed 10 spokespersons from Canadian PFACs.

Results:

We found themes within 2 stages of implementation. The first stage, getting PFACs started, included 4 themes: (1) using evolving recruitment methods, (2) preparing for effective participation, (3) ensuring diversity within PFACs, and (4) preparing terms of reference. The second stage involved strategies to support ongoing PFACs implementation and included 1 overall theme: facilitating optimal PFACs participation. The underlying link between themes was that establishing/maintaining PFACs is an ongoing learning curve.

Conclusion:

Our findings have the potential to inform new and existing PFACs.
Dalit Leadership, Collective Pride and Struggle for Social Change Among Educated Dalits: Contesting the Legitimacy of Social Class Mobility Approach
Authors: Sinha Chetan
Published: February 2020

Dalit leaders have played a significant role in the lives of lower caste people. They have created a meaningful political identity for Dalits (oppressed) and inspired them in the collective movement for social change. This article critically explores three major theoretically interlinked and contested components, which are Dalit leadership, collective pride and social class mobility, and discusses the emergent categories. Participants in the present work are highly educated Dalits who take inspiration and pride from Ambedkar’s leadership and believe in the role of collective movement for social change.
Electric Shock Retinopathy: Case Report of a Late Retinal Manifestation
Authors: Valera-Cornejo Diego Alejandro , García-Roa Marlon , Ramírez-Neria Paulina , Romero-Morales Verónica , Villalpando-Gómez Yolanda , García-Franco Renata
Published: February 2020

Purpose:

This is a case report of a male patient who suffered a high-voltage electrical burn and presented with bilateral pigmentary retinopathy.

Methods:

A 40-year-old man presented with bilateral vision loss following a high-voltage electrical injury sustained 10 years earlier. Family history, ocular history, and anterior segment evaluation were unremarkable.

Results:

Fundus examination revealed bilateral optic disc pallor, widespread areas of chorioretinal atrophy, and pigmentary changes surrounding the optic disc that partially involved the macula with some spared areas located on the superior retina.

Conclusions:

Retinal manifestations following a high-voltage electrical injury can resemble other hereditary and inflammatory diseases with similar clinical patterns, therefore, a meticulous family, medical, and clinical evaluation is essential.
The genetic correlation between feed conversion ratio and growth rate affects the design of a breeding program for more sustainable fish production
Authors: Besson Mathieu , Komen Hans , Rose Gus , Vandeputte Marc
Published: February 2020

Background

Most fish breeding programs aim at improving growth rate and include feed conversion ratio (FCR) neither in the breeding goal nor in the selection index, although decreasing FCR is known to increase farm profit and decrease environmental impacts. This is because FCR is difficult to measure in fish that live in groups and FCR is assumed to have a favourable (negative) genetic correlation with growth, although the magnitude of this correlation is unknown. We investigated the effect of the genetic correlation between growth and FCR on the economic and environmental responses of a two-trait breeding goal (growth and FCR), compared to a single-trait breeding goal (growth only). Next, we evaluated the weights to assign to growth and FCR in a two-trait breeding goal to maximize sustainability of fish production.

Methods

We used pseudo-best linear unbiased prediction (BLUP) index calculations to simulate a breeding program for sea bass. For the single-trait breeding goal, the trait in the breeding goal and in the index was thermal growth coefficient (TGC) and for the two-trait breeding goal, the traits in the breeding goal were TGC and FCR and the traits in the index were TGC and percentage of fat in the dorsal muscle (an indirect measure of FCR). We simulated responses to selection for genetic and phenotypic correlations between TGC and FCR ranging from 0 to − 0.8. Then, in the two-trait breeding goal, we calculated the economic return and the change in eutrophication when using economic values (EV) or environmental values (ENV).

Results

When the genetic correlation between TGC and FCR was lower than − 0.45, we found major differences in economic returns and in eutrophication between single and two-trait breeding programs. At a correlation of − 0.25, the two-trait breeding goal based on EV increased economic return by 25% compared to the single-trait breeding goal, while using ENV decreased eutrophication by 1.34% per ton of fish produced after one generation of selection.

Conclusions

The genetic correlation between TGC and FCR affects the magnitude of economic losses due to omitting FCR in the breeding program. In addition, the genetic correlation affects the importance of choosing EV or ENV to reduce eutrophication and increase profit.
T lymphocyte subpopulations and intestinal helminthes profile among tuberculosis patients co-infected with HIV before and after anti tubercular treatment at University of Gondar Hospital, Northwest Ethiopia
Authors: Wondmagegn Tadelo , Damtie Debasu , Genetu Meaza , Biadgo Belete , Lemma Mulualem , Negash Markos
Published: February 2020

Background

Tuberculosis continues to be a health problem of both developed and developing countries, and its incidence has currently increased due to HIV induced immune suppression. HIV-co-infection decreases the total number of CD4+ T cells since the virus preferentially replicates with in activated CD4+ T cells and macrophages, resulting in the disruption of granuloma to contain M. tuberculosis. In this study, we investigated the change in T lymphocyte subpopulations before and after anti-tubercular treatment and the effect of intestinal parasites on the cell populations of tuberculosis patients before the initiation of anti TB treatment.

Method

A prospective cohort study was conducted in the outpatient TB Clinic, University of Gondar hospital between January 2014 and August 2015. Blood samples were collected from 80 newly diagnosed TB patients with and without HIV co-infection. The mean CD4+ and CD8+ T lymphocyte counts of the patients were assessed before and after the course of anti-TB treatment. The mean values of T lymphocytes of TB, TB/HIV co-infected patients and of the control groups were compared. Data was analyzed by SPSS version 16 and the graph pad prism software.

Results

A total of 80 tuberculosis patients 40 of whom were co-infected with HIV participated in our study. The mean CD4 + T lymphocytes counts of the TB/HIV cohort were 354.45 ± 138cell/μl, and the mean CD8+ cell counts were 926.82 ± 384cell/μl. There were significant changes in the mean CD4+ and CD8+ T cell counts after the course of anti-TB treatment in both groups of patients(p < 0.05). However, no statistically significant differences were observed in the mean CD4 + and CD8+ T cell counts of helminthes infected and non-infected patients (P > 0.05).

Conclusion

We found significantly lower CD4+ T cell counts among TB infected HIV negative patients compared with controls who showed that TB was the cause of non–HIV-associated declination of circulating CD4 counts, and the reduction was reversible with anti-tubercular treatment in both HIV-negative and ART naïve TB-HIV co-infected patients.
Diagnostic accuracy of sFlt1/PlGF ratio as a marker for preeclampsia
Authors: Nikuei Pooneh , Rajaei Minoo , Roozbeh Nasibeh , Mohseni Fatemeh , Poordarvishi Fatemeh , Azad Mohsen , Haidari Solmaz
Published: February 2020

Background

Preeclampsia (PE) is a serious complication of pregnancy and one of the main causes of maternal and neonatal mortality and morbidity in the world. Finding a biomarker with high sensitivity and specificity could lead to prediction and early diagnosis of the disease and reduces its complications. In this study, we evaluated diagnostic accuracy of Soluble fms-like tyrosine kinase-1 (sFlt-1) to Placental growth factor (PlGF) ratio for diagnosis of PE.

Methods

The cases included 23 mild, 15 severe preeclamptic patients, and 20 normal term pregnant women as control referred to GYN ward of the Persian Gulf Hospital in Bandar Abbas from 2014 to 2016. Levels of sFlt-1 and PlGF were measured. Receiver Operating Characteristic (ROC) curve analysis was applied to calculate diagnostic accuracy of sFlt-1/PlGF ratio.

Results

The mean Level of sFlt-1/PlGF in PE patients (91.33 ng/ml) was significantly higher than control women (17.62) (P<0.001). ROC curve analysis showed sFlt-1/PlGF ratio diagnostic accuracy in preeclamptic patients with Area Under Curve (AUC) of 0.90, the best cut-off value of 24.96, sensitivity and specificity of 84.2 and 85.0%, respectively.

Conclusions

Our data showed sFlt-1/PlGF ratio has higher accuracy for differentiating PE patients from non-PEs in comparison with its power for differentiating severe or early onset forms of the disease.
Induction of labour in nulliparous women- quick or slow: a cohort study comparing slow-release vaginal insert with low-dose misoprostol oral tablets
Authors: Eriksson Axelina , Jeppesen Sarah , Krebs Lone
Published: February 2020

Background

This study was undertaken with the objective of comparing efficacy and safety for two different regimens using misoprostol for induction of labour.

Methods

The study was set in two different hospitals in the region of Zeeland, Denmark, and designed as a prospective cohort study. Nulliparous women with unripe cervix, eligible for vaginal delivery and medical induction of labour were included. Exclusion criteria were a previous uterine scar, suspicion of growth restriction of the fetus and prelabour rupture of membranes.

One department used 25 mcg oral misoprostol tablets and the other department used 200 mcg slow-release misoprostol vaginal insert, for induction of labour.

Primary outcomes were predefined as frequency of cesarean section, tachysystole and delivery within 24 h. Secondary outcomes were: time from induction to delivery, use of additional methods for induction, postpartum hemorrhage, anal sphincter rupture, epidural, pyrexia (rectal temperature >  38.5 °C), prolonged rupture of membranes, and use of tocolysis.

Results

No significant differences in women achieving vaginal delivery was found. However, a significantly increased risk of tachysystole for the vaginal administration route was observed; 28.4% compared with 2.3%. There were no events of serious neonatal asphyxia. Half of the women induced with vaginal insert delivered within 24 h, compared with 16.8% of the women induced with oral misoprostol.

Conclusions

Induction with vaginal slow-release misoprostol leads to quicker delivery with an increased risk of tachysystole but with similar perinatal outcomes and rates of cesarean sections. Low-dose oral misoprostol appears to be safe, however it leads to an increased use of secondary methods and a tendency of more intrapartum pyrexia.

Trial registration

Clinicaltrials.gov ID: NCT02693587 on February 262,016.

EudraCT number 2020–000366-42 on 23 January 2020, retrospectively registered.
Prediction of cesarean hysterectomy in placenta previa complicated with prior cesarean: a retrospective study
Authors: Liu Bin , Deng Songqing , Lin Meifang , Chen Yimin , Cai Jian , Yang Jianbo , Zhang Jinxin , Cui Jianjian , Shen Lixia , Xie Hongning , Wang Zilian
Published: February 2020

Background

The prevalence of both placenta previa and cesarean are on the rise. Multiple adverse outcomes are critically increased when placenta previa is subsequent to prior cesarean. The purpose of the present study is to develop a pre-surgical method for predicting adverse outcomes in pregnancy complicated with both placenta previa and prior cesarean.

Methods

Clinical data was obtained from the medical history system at the First Affiliated Hospital of Sun Yat-sen University from February 2003 to December 2016. All cases with a final diagnosis of “placenta previa/low lying placenta (ICD:O44.001-105)” and “scarred uterus complicated with pregnancy (ICD: O34.200-202)” were collected and reviewed. Hysterectomy was taken as the primary outcome; and blood loss was taken as the secondary outcome.

Results

Of 219 pregnant women in the final analysis, 25 received a hysterectomy following delivery, and 48 had blood loss exceeding 1000 ml. Pre-surgical risk factors for hysterectomy are ultrasonic signs of vascular lacunae, central placenta previa, and loss of normal hypoechoic retroplacental zone. A pre-surgical predictive equation referred to as “Hysterectomy Index in Placenta Previa with Prior cesarean (HIPs)” was generated and each risk factor was weighted to create an 8-point scale. This index yielded an area under the curve of 0.972 for the prediction of hysterectomy.

Conclusions

Application of the HIPs score may provide an effective pre-surgical prediction of cesarean hysterectomy in pregnant women complicated with both placenta previa and prior cesarean.
Individual-, home- and preschool-level correlates of preschool children’s sedentary time
Authors: Määttä Suvi , Konttinen Hanna , de Oliveira Figueiredo Rejane Augusta , Haukkala Ari , Sajaniemi Nina , Erkkola Maijaliisa , Roos Eva
Published: February 2020

Background

Prechoolers’ significant portions of sedentary time (ST) is a public-health concern due to its high prevalence and negative health consequences. However, few studies have explored correlates of preschoolers’ ST covering individual-, home- and preschool- factors within one study. The aim of this study was to identify the associations between multiple individual-, home- and preschool-level factors and preschoolers’ ST. In addition, it was studied how much individual-, home- and preschool-level factors explained the variance in children’s ST.

Methods

A total of 864 children aged three to six, their parents and 66 preschools participated in the cross-sectional DAGIS study, which occurred between 2015 and 2016. The children wore an accelerometer for 1 week. Guardians, principals and early educators completed questionnaires covering the potential correlates of children’s ST, for example, temperament, practices, self-efficacy and regulations. Multilevel regression analyses were conducted in multiple steps; calculation of marginal and conditional R2values occurred in the final phase.

Results

Of the 29 studied correlates, the following factors remained significant in the final models. Being a boy (p < 0.001) and having high levels of surgency temperament (p < 0.001) were associated with lower ST. Regarding the home setting, frequent co-visits in physical activity (PA) places (p = 0.014) were associated with lower ST. Higher parental perceived barriers related to children’s outside PA (p = 0.032) was associated with higher ST. None of the preschool setting factors remained significant in the final model. Approximately 11% of the variance in children’s ST was attributed to factors related to the individual level whereas 5% was attributed to home-level factors; and 2% to preschool-level factors.

Conclusions

This study identified a set of correlates of preschool children’s ST. Interventions aimed at reducing children’s ST should develop strategies targeting established correlates of preschoolers’ ST covering individual-, home- and preschool-level factors. The preschool-level factors included in this study explained little the variance in children’s ST. However, the included measures may not have captured the essential preschool-level factors that specifically influence children’s ST. Therefore, more studies are needed regarding potential preschool-level factors.
One-stage posterior debridement, bone grafting fusion, and mono-segment vs. short-segment fixation for single-segment lumbar spinal tuberculosis: minimum 5-year follow-up outcomes
Authors: Liu Zheng , Li Weiwei , Xu Zhengchao , Wang Xiyang , Zeng Hao
Published: February 2020

Background

To compare the clinical and radiological outcomes between posterior mono-segment and short-segment fixation combined with one-stage posterior debridement and bone grafting fusion in treating single-segment lumbar spinal tuberculosis (LSTB).

Methods

Sixty-two patients with single-segment LSTB treated by a posterior-only approach were divided into two groups: short-segment fixation (Group A, n = 32) and mono-segment fixation (Group B, n = 30). The clinical and radiographic outcomes were analyzed and compared between the two groups.

Results

The intraoperative bleeding volume, operation time, and hospitalization duration were lower in Group B than in Group A. All patients achieved the bony fusion criteria. The visual analog scale score, Japanese Orthopedic Association score, and Oswestry Disability Index were substantially improved 3 months postoperatively and at the last visit in both groups, with no significant difference between the two groups (P > 0.05). Kirkaldy–Willis functional evaluation at the final follow-up demonstrated that all patients in both groups achieved excellent or good results. The difference in the angle correction rate and correction loss between Groups A and B was not significant (P > 0.05).

Conclusions

One-stage posterior debridement, bone grafting fusion, and mono-segment or short-segment fixation can provide satisfactory clinical and radiological outcomes. Mono-segment fixation is more suitable for the treatment of single-segment LSTB because the lumbar segments with normal motion can be preserved with less trauma, a shorter operation time, shorter hospitalization, and lower costs.
Heparin-induced thrombocytopenia and acute colonic pseudo-obstruction after therapeutic anticoagulation in a very elderly patient with hip fracture: a case report
Authors: Liu Yijun , Lu Hao , Xu Hailin , Fu Zhongguo , Zhang Dianying , Jiang Baoguo
Published: February 2020

Background

Hip fractures have become a severe public health problem, especially in very elderly patients. Most of them are treated with low molecular weight heparin as prophylaxis or treatment of venous thromboembolism. Heparin-induced thrombocytopenia is one of the complications induced by low molecular weight heparin, which may cause poor prognosis. However, there is not enough awareness for heparin-induced thrombocytopenia in very elderly trauma patients.

Case presentation

We report a case of hip fracture with heparin-induced thrombocytopenia in a very elderly patient. The patient developed heparin-induced thrombocytopenia, digestive hemorrhage and acute colonic pseudo-obstruction after the use of low molecular weight heparin, which eventually led to death.

Conclusions

This is the first case report of digestive hemorrhage and acute colonic pseudo-obstruction in heparin-induced thrombocytopenia patients with major trauma. This case highlights the severity of HIT in very elderly patients with hip fractures using low molecular weight heparin, and the need for platelet monitoring in these patients. We indicate that there may be a correlation of pathogenesis between digestive hemorrhage and acute colonic pseudo-obstruction in heparin-induced thrombocytopenia patients.
Associations between the menstrual cycle, lifestyle factors and clinical assessment of the ocular surface: a prospective observational study
Authors: Colorado Luisa H. , Edwards Katie , Dinh Lynne , Ha Sarah , Liu Danica , Luu Annie , Trang Shona , Yu-Ting Tina H. , Schmid Katrina L.
Published: February 2020

Background

Little is known about the ocular surface changes over the menstrual cycle in young women and the interactions with lifestyle factors. Therefore, the purpose of this study was to explore the associations between modifiable lifestyle factors and menstrual cycle phases on the ocular signs and symptoms of dry eye in young healthy women.

Methods

This was a prospective 1-month observational study. Thirty young healthy women with regular, 24 to 32-day menstrual cycles were recruited. Participants attended three visits at day 7, 14, and 21 (± 1) of their menstrual cycle. At baseline, general health questionnaire was conducted. At each visit, symptomology was quantified using Ocular Surface Disease Index (OSDI) and overall ocular comfort (OOC, visual analogue scale). Ocular signs were assessed using Efron scales, tear break-up time (TBUT) and phenol red thread (PRT). Pearson’s correlation was used to determine associations between variables at each visit.

Results

A total of 26 participants (mean age = 22.3 ± 3.7 years) with an average menstrual cycle of 28.3 ± 1.3 days completed the 3 visits. The interaction between signs/symptoms and lifestyle factors changed over the cycle. At the follicular phase (day 7), lifestyle factors such diet and levels of stress were correlated with PRT and OSDI, (r = − 0.4, p = 0.022; r = 0.4, p = 0.045 respectively). At the ovulation phase (day 14), the general health score was correlated with OOC scores (r = 0.4, p = 0.047). At day 14, exercise frequency correlated with PRT (r = − 0.4, p = 0.028) and caffeine intake was positively correlate with both; TBUT (r = 0.5, p = 0.020) and PRT (r = 0.5, p = 0.014). At the luteal phase (day 21), we found no correlations between lifestyle factors and dry eye signs or symptoms.

Conclusions

The associations between lifestyle factors and objective and subjective ocular surface assessment appeared to be more pronounced during the ovulation phase of the menstrual cycle compared to the follicular and luteal phases. Misalignment of these factors with the ocular health during the luteal phase could be attributed to central sensitization and changes in levels of luteinising hormone. Natural hormonal changes during menstrual cycle should be considered for diagnosis and treatment of dry eye in young healthy women.
Retrieving 3D medical data along fitted curved slices and their display
Authors: Paluszny Marco , Ríos Dany
Published: February 2020

Background

Computeros tomography and magnetic resonance imaging are usually offered to the clinician in the form of sequences of axial, sagittal and coronal planar cuts. Frequently this does not allow for the full inspection of the morphology of the area of interest, because it is limited by the planarity. Efforts have been made to extract information along curved slices but their planar display is prone to metric deformation.

Methods

We propose a new visualization alternative of 3D medical volumes using curved slices adapted to areas of interest. We use surfaces fitted to specific organs as visualization canvasses. We describe the differential geometry techniques used to build the surfaces that may be isometrically flattened. These are referred to as develpable surfaces.

Results

We show concrete examples deemed useful for the development of clinical and educational tools. Our examples are centered in magnetic resonance data of the rotator cuff muscle complex and computed tomography data of maxillofacial and dental studies. We also look at the extraction and display of information from volumes of aortic aneurysms along transversal surfaces.

Discussion

We look at extensions of the technique and propose further possible clinical use of texturized surfaces in the context of volume navigation.

Conclusions

We presented a technique to extract information from computer tomography and magnetic resonance volumes, using two different texturization techniques. In the cases that the fitting surfaces are chosen to be developable, they may be flattened without distortion. We also discuss how tu use the technique in other visualization tasks such as volume navigation and detection of volumetric features.
Left lung cancer in a patient with congenital unilateral absence of the left pulmonary artery: a case report and literature review
Authors: Wang Jing , Lu Xiaoqian , Ding Xiaobo , Cao Dian-bo
Published: February 2020

Background

Unilateral absence of pulmonary artery (UAPA) is a rare congenital disease of pulmonary circulation, which is often accompanied by other cardiovascular anomalies. Infrequently, it may remain undiagnosed until adulthood. More rarely, it is to be found with lung cancer in the ipsilateral or contralateral lung simultaneously.

Case presentation

A 56-year-old man with complaints of intermittent left chest pain for 2 months was referred to our hospital. Chest computed tomography(CT) revealed a cavitary lesion measuring 5.5 cm × 5.7 cm in the superior segment of the left lower lobe. Absence of left pulmonary artery and right-sided aortic arch were found on chest computed tomography angiography (CTA). The tumor was successfully removed via left pneumonectomy, and postoperative histopathology showed that the tumor was a squamous cell carcinoma (T2bN1). At a postoperative 24-month follow-up, the patient was free of disease and no evidence of recurrence or metastasis. Based on literature review, this is the ninth case of lung cancer in UAPA patients.

Conclusions

Lung cancer and UAPA occurred ipsilaterally in 66.7% of these cases (6/9), including the present case. For those patients who occurred contralaterally, surgical treatment may be more challenging. CT and CTA could provide an accurate diagnosis for this disease entity. Identification and recognition of this rare and special disease entity may facilitate timely diagnosis and appropriate treatment.
Luteal phase stimulation versus follicular phase stimulation in poor ovarian responders: results of a randomized controlled trial
Authors: Llácer Joaquín , Moliner Belén , Luque Lydia , Bernabéu Andrea , Lledó Belén , Castillo Juan Carlos , Guerrero Jaime , Ten Jorge , Bernabéu Rafael
Published: February 2020

Background

In young women with poor ovarian response, luteal-phase ovarian stimulation (LPOS) is a potential method for collecting competent oocytes. The aim of this study was to assess the efficacy of LPOS compared with follicular phase ovarian stimulation (FPOS) in young women with poor ovarian response (POR).

Methods

This single-center, prospective, randomized pilot study compared LPOS and FPOS in women with POR fulfilling Bologna criteria who underwent in vitro fertilization at the Instituto Bernabeu. The primary outcome was the number of metaphase II (MII) oocytes obtained by follicular puncture.

Results

Sixty women were included in the study, with 27 women completing LPOS and 30 undergoing FPOS. There was no statistically significant difference in the number of MII oocytes obtained between the LPOS group and the FPOS group (2.1 ± 2.0 vs. 2.6 ± 2.2, p = 0.31). Length of stimulation was also similar in both groups (8.35 ± 2.8 vs. 8.15 ± 4.1 days, p = 0.69). Similarly, there was no significant difference in the follicle-stimulating hormone total dose, number of cumulus-oocyte complexes, survival rate, fertilization rate, or cancellation rate between groups. A significantly higher Ovarian Sensitivity Index was observed in the LPOS group versus the FPOS group (0.96 vs. 0.57, p = 0.037).

Conclusion

LPOS was comparable with FPOS in terms of efficacy and may improve ovarian responsiveness in young women with POR.

Trial registration

ClinicalTrials.gov identifier: NCT02625532; EudraCT identifier: 2015–003856-31.
Correction to: Systematic review and meta-analysis of public hospital efficiency studies in Gulf region and selected countries in similar settings
Authors: Alatawi Ahmed D. , Ahmed Sayem , Niessen Louis , Khan Jahangir
Published: February 2020

Please note that following publication of the original article [1], two errors have been flagged by the authors. Firstly, the article has been processed with the wrong article type: it is not a ‘Review’, but rather a ‘Research article’.
Infants’ and toddlers’ physical activity and sedentary time as measured by accelerometry: a systematic review and meta-analysis
Authors: Bruijns Brianne A. , Truelove Stephanie , Johnson Andrew M. , Gilliland Jason , Tucker Patricia
Published: February 2020

Background

Early experiences in physical activity (PA) are important to shape healthy movement behaviours long-term; as such, it is critical that PA is promoted from infancy, and that detrimental behaviours (e.g., prolonged sedentary time [ST]) are minimized. The purpose of this systematic review and meta-analysis was to examine infants’ and toddlers’ movement behaviours across daytime hours.

Methods

Seven online databases were searched for terms related to infants (< 12 months), toddlers (12–35.9 months), PA, ST, and accelerometry. Two independent reviewers examined 4873 articles for peer-reviewed original research, published in English, that assessed infants’ (counts/min) and/or toddlers’ PA or ST (min/day) using accelerometry across daytime hours. Infants’ mean PA level (counts/min) was averaged across studies, and ranges were produced. Estimates of toddlers’ movement behaviours were aggregated meta-analytically to produce average daily rates, and accelerometer placement, cut-point validity, device type, and epoch length were tested as a moderating variables.

Results

Twenty-four studies from 16 countries (published 2011–2019), representing 3699 participants, were included in the systematic review. Five studies reported on infants’ PA, which ranged from 78.2 to 2580.5 cpm. Across 20 studies, toddlers’ total PA, light PA, moderate-to vigorous-intensity PA, and ST ranged from 72.9 to 636.5, 48.5 to 582.4, 6.5 to 89.9, and 172.7 to 545.0 min/day, respectively. After taking into account accelerometer placement, cut-point validity, device type, and epoch length, we found that toddlers engaged in 246.19 min/day (SE = 28.50; 95% CI: 190.34, 302.04) of total PA, 194.10 min/day (SE = 28.76; 95% CI: 137.73, 250.47) of light PA, and 60.16 min/day (SE = 5.88; 95% CI: 48.64, 71.69) of moderate-to vigorous-intensity PA. Toddlers engaged in 337.04 min/day (SE = 32.67; 95% CI: 273.01, 401.07) of ST.

Conclusions

With limited studies conducted in infants (n = 5), PA estimates are inconclusive and largely heterogeneous. Overall, toddlers tend to exceed the total PA recommendation of 180 min/day; however, very little of this time is spent at higher movement intensities. Even with high PA rates, toddlers still engage in substantial ST. More consistent and valid measurement protocols are needed to improve comparability across studies.
Using a multi-stakeholder experience-based design process to co-develop the Creating Active Schools Framework
Authors: Daly-Smith Andy , Quarmby Thomas , Archbold Victoria S. J. , Corrigan Nicola , Wilson Dan , Resaland Geir K. , Bartholomew John B. , Singh Amika , Tjomsland Hege E. , Sherar Lauren B. , Chalkley Anna , Routen Ash C. , Shickle Darren , Bingham Daniel D. , Barber Sally E. , van Sluijs Esther , Fairclough Stuart J. , McKenna Jim
Published: February 2020

Background

UK and global policies recommend whole-school approaches to improve childrens’ inadequate physical activity (PA) levels. Yet, recent meta-analyses establish current interventions as ineffective due to suboptimal implementation rates and poor sustainability. To create effective interventions, which recognise schools as complex adaptive sub-systems, multi-stakeholder input is necessary. Further, to ensure ‘systems’ change, a framework is required that identifies all components of a whole-school PA approach. The study’s aim was to co-develop a whole-school PA framework using the double diamond design approach (DDDA).

Methodology

Fifty stakeholders engaged in a six-phase DDDA workshop undertaking tasks within same stakeholder (n= 9; UK researchers, public health specialists, active schools coordinators, headteachers, teachers, active partner schools specialists, national organisations, Sport England local delivery pilot representatives and international researchers) and mixed (n= 6) stakeholder groupings. Six draft frameworks were created before stakeholders voted for one ‘initial’ framework. Next, stakeholders reviewed the ‘initial’ framework, proposing modifications. Following the workshop, stakeholders voted on eight modifications using an online questionnaire.

Results

Following voting, the Creating Active Schools Framework (CAS) was designed. At the centre, ethos and practice drive school policy and vision, creating the physical and social environments in which five key stakeholder groups operate to deliver PA through seven opportunities both within and beyond school. At the top of the model, initial and in-service teacher training foster teachers’ capability, opportunity and motivation (COM-B) to deliver whole-school PA. National policy and organisations drive top-down initiatives that support or hinder whole-school PA.

To the authors’ knowledge, this is the first time practitioners, policymakers and researchers have co-designed a whole-school PA framework from initial conception. The novelty of CAS resides in identifying the multitude of interconnecting components of a whole-school adaptive sub-system; exposing the complexity required to create systems change. The framework can be used to shape future policy, research and practice to embed sustainable PA interventions within schools. To enact such change, CAS presents a potential paradigm shift, providing a map and method to guide future co-production by multiple experts of PA initiatives ‘with’ schools, while abandoning outdated traditional approaches of implementing interventions ‘on’ schools.
HIV-1 subtype C predicted co-receptor tropism in Africa: an individual sequence level meta-analysis
Authors: Matume Nontokozo D. , Tebit Denis M. , Bessong Pascal O.
Published: February 2020

Background

Entry inhibitors, such as Maraviroc, hold promise as components of HIV treatment and/or pre-exposure prophylaxis in Africa. Maraviroc inhibits the interaction between HIV Envelope gp120 V3-loop and CCR5 coreceptor. HIV-1 subtype C (HIV-1-C) is predominant in Southern Africa and preferably uses CCR5 co-receptor. Therefore, a significant proportion of HIV-1-C CXCR4 utilizing viruses (X4) may compromise the effectiveness of Maraviroc. This analysis examined coreceptor preferences in early and chronic HIV-1-C infections across Africa.

Methods

African HIV-1-C Envelope gp120 V3-loop sequences sampled from 1988 to 2014 were retrieved from Los Alamos HIV Sequence Database. Sequences from early infections (< 186 days post infection) and chronic infections (> 186 days post infection) were analysed for predicted co-receptor preferences using Geno2Pheno [Coreceptor] 10% FPR, Phenoseq-C, and PSSMsinsi web tools. V3-loop diversity was determined, and viral subtype was confirmed by phylogenetic analysis. National treatment guidelines across Africa were reviewed for Maraviroc recommendation.

Results

Sequences from early (n = 6316) and chronic (n = 7338) HIV-1-C infected individuals from 10 and 15 African countries respectively were available for analyses. Overall, 518/6316 (8.2%; 95% CI 0.7–9.3) of early sequences were X4, with Ethiopia and Malawi having more than 10% each. For chronic infections, 8.3% (95% CI 2.4–16.2) sequences were X4 viruses, with Ethiopia, Tanzania, and Zimbabwe having more than 10% each. For sequences from early chronic infections (< 1 year post infection), the prevalence of X4 viruses was 8.5% (95% CI 2.6–11.2). In late chronic infections (≥ 5 years post infection), X4 viruses were observed in 36% (95% CI − 16.3 to 49.9), with two countries having relatively high X4 viruses: South Africa (43%) and Malawi (24%). The V3-loop amino acid sequence were more variable in X4 viruses in chronic infections compared to acute infections, with South Africa, Ethiopia and Zimbabwe showing the highest levels of V3-loop diversity. All sequences were phylogenetically confirmed as HIV-1-C and clustered according to their co-receptor tropism. In Africa, Maraviroc is registered only in South Africa and Uganda.

Conclusions

Our analyses illustrate that X4 viruses are present in significantly similar proportions in early and early chronic HIV-1 subtype C infected individuals across Africa. In contrast, in late chronic infections, X4 viruses increase 3–5 folds. We can draw two inferences from our observations: (1) to enhance the utility of Maraviroc in chronic HIV subtype C infections in Africa, prior virus co-receptor determination is needed; (2) on the flip side, research on the efficacy of CXCR4 antagonists for HIV-1-C infections is encouraged. Currently, the use of Maraviroc is very limited in Africa.
Development and validation of Attitude Toward Nutrition Counselling Questionnaire for use among Kuwaiti healthcare professionals
Authors: Al-Mughamis Nouf S. , Alayoub Abdullah A. , Meraj Hafsa , Waqas Ahmed
Published: February 2020

Objective

This study aims to report the developmental processes and validation of Attitude Toward Nutrition Questionnaire in Arabic language.

Results

A total of 173 (response rate = 86.93%) participants responded to the survey. There were a total of 92 (53.2%) nutritionists and 81(46.8%) doctors/surgeons. Principal component analyses revealed followed by visualization of Cattell’s scree plot, suggested a four-factor solution for the 36-item Attitude Toward Nutrition Counselling Questionnaire. It was found to have an acceptable validity. These four factors cumulatively explained 37.9% of the variance in the factor structure of the ATNQ. Cronbach’s alpha revealed an acceptable level of reliability for each subscale of the ATNQ. The first subscale named “Factual knowledge about nutrition” comprised of nine items. It yielded a Cronbach’s alpha value of 0.78. The second subscale “knowledge about nutrition in morbidities” comprised of seven items and yielded a Cronbach’s alpha value of 0.71. The third subscale “counselling of patients” comprised of 11 items and yielded a Cronbach’s alpha of 0.68. The fourth subscale comprising nine items yielded a Cronbach’s alpha value of 0.64 and was named, “Dietary programs and supplementation”.
Gonad shielding in pelvic radiography: modern optimised X-ray systems might allow its discontinuation
Authors: Jeukens Cécile R. L. P. N. , Kütterer Gerhard , Kicken Pierre J. , Frantzen Marij J. , van Engelshoven Jos M. A. , Wildberger Joachim E. , Kemerink Gerrit J.
Published: February 2020

Objective

As gonad shielding is currently under debate, this study evaluates the practice, from its introduction in about 1905 until today.

Methods

The literature was searched for developments in shielding and insights into the effects of ionising radiation on gonads. Based on own pre-1927 dose reconstructions, reported doses after 1927, a 2015-report from the European Union and recent own measurements, the effects of technological evolution and optimisation on radiation dose and hereditary risk were assessed.

Results

In the 1900s, gonad shielding was first applied to prevent male sterility, but was discontinued when instrumental developments led to reduced radiation doses. In the 1950s, concerns about hereditary risks intensified and gonad shielding was recommended again, becoming routine worldwide. Imaging-chain improvements over time were considerable: in 2018, the absorbed dose was 0.5% of its 1905 value for the testes and 2% for the ovaries, our optimised effective dose a factor five lower than the value corresponding to the current EU diagnostic reference level, and the reduction in detriment-adjusted risk by shielding less than 1 × 10−6 for women and 5 × 10−6 for men.

Conclusions

Assessment of pelvic doses revealed a large reduction in radiation risks facilitated by technological developments. Optimisation likewise contributed, but unfortunately, its potential was never adequately exploited. Today, using a modern and optimised X-ray system, gonad shielding can be safely discontinued for women. For men, there might be a marginal benefit, but potential negative side-effects may well dominate. Discontinuation of gonad shielding seems therefore justifiable.