bluuebunny/crossref_metadata_2025 huggingface dataset:
TÜRKİYE’DEKİ DENİZCİLİK EĞİTİM KURUMLARININ GEMİADAMLARI EĞİTİM VE SINAV YÖNERGESİ KAPSAMINDAKİ DENETİM SONUÇLARININ ANALİZİ
Authors: GÜZEL Esat , BOLAT Pelin
Published: May 2020

Dünyada eğitim kurumlarının eğitim kalitesinin değerlendirilmesi ve sıralanması için bazı metodolojiler geliştirilmiş ve bu hususta yayımlanmış “en iyi” sıralamaları mevcut olsa da, denizcilik eğitim kurumlarının eğitim kalitesini ve sıralamasını bilimsel ve sistematik bir yaklaşımla ele alan bir çalışma bulunmamaktadır. Yapılan çalışmalarda ağırlıklı olarak, denizcilik eğitiminde karşılaşılan sorunlar, eğitim kurumlarındaki eğitimci profilleri, gemiadamlarının eğitimine yönelik diğer tespitler ve öneriler yer almaktadır. Yine bu çalışmalarda, denizcilik eğitim kurumlarında yapılan iç denetim, dış denetim veya idari denetim gibi nesnel bir izleme ve değerlendirme mekanizması sonucu elde edilen veriler ışığında yapılmış bir araştırmaya rastlanılmamış, ağırlıklı olarak eğitimci sayısı, öğrenci sayısı, akademik çalışma sayısı, altyapı olanakları gibi temel bilgiler irdelenmiştir.

Türk denizcilik eğitim kurumlarının Gemiadamları ve Kılavuz Kaptanlar Eğitim ve Sınav Yönergesi çerçevesinde yapılan izleme ve değerlendirme faaliyetleri kapsamındaki denetlemelerde elde edilen uygunsuzluklar, Ulaştırma ve Altyapı Bakanlığı’nın Gemiadamları Eğitim Bilgi Sistemi(GAEBS) bünyesinde kaydedilmektedir. Bu çalışmada, 2011-2017 yılları arasında 117 denizcilik eğitim kurumu denetlemesinde elde edilen uygunsuzlukların entropi tabanlı gri ilişki analiziyle irdelenerek Türk denizcilik eğitim kurumlarının eksik ve zayıf olduğu alanlar ve hususlar tespit edilmeye çalışılmış, bunların giderilmesi için düzeltici faaliyetler ve önleyici tedbirler önerilmiştir.
Development and Validation of a Multidimensional Instrument: Assessing Barriers to Dietary Practices
Authors: Zigbuo-Wenzler Enia , Magwood Gayenell S. , Mueller Martina , Fraser Angela
Published: May 2020

Background and Purpose

Poor dietary practices are linked to many chronic diseases. The purpose of this validation study was to develop a psychometrically sound instrument that can be administered by health practitioners to measure dietary barriers.

Methods

The Dietary Health Status (DHS) instrument, designed to measure dietary barriers is comprised of items in the National Health and Nutrition Examination Survey-What We Eat in America datasets. Content validity was established for DHS using an expert review process. Principal component analysis (PCA) was then used to assess validity and reliability as determined by Cronbach's alpha values.

Results

The PCA supported a 10-component solution, explaining 61% of the total variance. Cronbach's alpha was .67 for the entire instrument, ranging from .55 to .87 for the 10 subscales.

Conclusion

Results suggest the instrument had sufficient construct and internal validity. This exploratory study is an important first step in validating the DHS instrument.
COMPLIANCE: A BUSCA DA EFICIÊNCIA EM COMPLEXA EQUAÇÃO NO ÂMBITO DA ADMINISTRAÇÃO PÚBLICA
Authors: Tremel Rosangela , Lopes Rosa Virginia
Published: May 2020

O presente artigo trata de princípios constitucionais e de regras que deles derivam, assinalando que existem bons diplomas legais para fortalecerem a efetivação da técnica de compliance no setor público. Paralelamente, o estudo reforça a urgência crescente com que tais dispositivos devem ser usados de maneira avassaladoramente preventiva pelos gestores da coisa pública.
RECURSO ORDINÁRIO E SUAS PECULIARIDADES NO CPC/2015
Authors: Silva Lemos Vinicius
Published: May 2020

O presente trabalho tem o escopo de analisar o recurso ordinário no CPC/2015, desde a sua conceituação até o procedimento, com um objeto de estudo em tratar as peculiaridades e desdobramentos desta espécie recursal, como o objeto recursal, impugnações, diretrizes, trâmites, procedimentos e relação com o duplo grau de jurisdição e o recurso de apelação.
A Study of the Impact of Innovation on Industrial Upgrading in China: A Spatial Econometric Analysis Based on China’s Provincial Panel Data
Authors: Jiang Jiao , Zhao Xindong ,   School of Economics and Finance, Huaqiao University No.269 Chenghua North Road, Fengze District, Quanzhou, Fujian 362021, China,   Institute of Quantitative Economics, Huaqiao University No.668 Jimei Avenue, Jimei District, Xiamen, Fujian 361021, China
Published: May 2020

This study provides an in-depth analysis of the impact of innovation on industrial upgrading from theoretical and practical perspectives. In terms of theory, based on the endogenous growth theory model, a multi-sectoral growth model is constructed to portray the inherent logical connection between innovation and industrial structure upgrading. The results show that innovation has an important impact on industrial structure upgrading. Industrial structure upgrading depends on differences in innovation level among industries and the substitution relationship of finished products in the industry. From an empirical perspective, based on the panel data of 31 provinces in China from 2005 to 2017, the spatial effect of innovation on industrial upgrading was analyzed using the spatial Durbin model. The results show that innovation and industrial structure upgrading has significant spatial correlation effects, and regional innovation can drive China’s industrial upgrading. Meanwhile, the space spillover effect is an important factor that cannot be ignored in industrial upgrading.
Forecasting Realized Volatility Based on Sentiment Index and GRU Model
Authors: Gu Wentao ,   School of Statistics and Mathematics, Zhejiang Gongshang University 18 Xuezheng Street, Xiasha Education Park, Hangzhou, Zhejiang 310018, China, Zheng Suhao , Wang Ru , Dong Cui
Published: May 2020

Numerous studies have proven that news media sentiment has an impact on stock market volatility, making topics such as how to quantify news media sentiment and use it to predict stock market volatility increasingly relevant. In this paper, a Chinese financial sentiment lexicon was constructed to quantify the emotions in the news media as a sentiment index to be added to the model and establish new prediction models HAR-RV-AI and GRU-AI. To compare the prediction ability of the models, we consider the loss function and model confidence set (MCS) test as the evaluation criterion and employ the rolling window strategy for out-of-sample forecasting. The prediction results of the GRU model are found to be better than the HAR-RV model, and the prediction effect of the model improved after the addition of the news media sentiment index.
Comparison of Nutrient Digestibility of Bligon and Kejobong Goats Fed by King Grass and Peanut Straw
Authors: Hanim Chusnul , Yusiati Lies Mira , Budisatria I Gede Suparta , Rachman Fandi Widya
Published: May 2020

This experiment aimed to determine the nutrient digestibility of Bligon and Kejobong goats fed by king grass and peanut straw. The sample used was 6 to 8 months of five male Bligon goats, and five male Kejobong goats with the initial body weight of 15 to 20 kg and placed in separated metabolism cages. The diet and water were supplied ad libitum. This experiment was done in 14 days of adaptation period and seven days of the collection period. In the collection period, samples of feed, refusal feed, and feces were collected to get the chemical content includes dry matter (DM), organic matter (OM), ether extract (EE), crude fiber (CF), crude protein (CP), nitrogen-free extract (NFE), and total digestible nutrient (TDN). The data obtained were subjected to a T-test analysis. Results showed that nutrients intake, digested nutrient as well as nutrient digestibility of Bligon and Kejobong goats were not significantly different. However, Kejobong goats had EE and CP intake of 15.42% and 14.02%, digested DM, OM, and NFE of 16.29%, 15.71%, and 13.93% respectively, as well as NFE digestibility 4.37% higher than those Bligon goats (P< 0.05). Therefore, there was no difference in nutrient intake, digested, and digestibility of nutrients in Bligon and Kejobong goats fed by king grass and peanut straw. However, Kejobong goats appeared to have higher EE and CP intake, as well as digested and digestibility of DM, OM, and NFE than Bligon goats.
Lactation Characteristic of Etawah Crossed Breed Goats Under Intensive Management
Authors: Suranindyah Yuni , Widyobroto Budi Prasetyo , Astuti Sulvia Dwi , Murti Tridjoko Wisnu , Adiarto Adiarto
Published: May 2020

The study aimed to describe lactation characteristic of Etawah Crossed Breed goats raised under intensive management. The study located in BBPTU HPT Baturraden, Purwokerto, used 27 female pregnant goats, at 24 to 27 months old. The goats were managed followed standard operating procedure of the research institute. The data consisted of body size and body weight, colostrum and milk yield, lactation period and reproductive performance. The results showed the average of daily milk yield, lactation period, total milk and colostrum production in first lactation were 960±340 mL/day, 157±41 days, 114,720±68,900 mL and 415±240 mL/day. The proportion of monthly milk production from initial lactation to dry off were 21.27, 22.17, 20.18, 17.29, 12.52, 9.13, and 5.65% of total lactation yield, respectively. Peak production ranged from first to second months of lactation, the highest was in the week 4th, averaged of 1080 mL/day. Production persistency was 66.39%. The rate of increase toward peak was 5.60%/week and rate of decline from peak was -3.92% of milk yield in the previous week. Trend equation of lactation curve was Y = 8412.7 –233.65 x. Means period of postpartum mating, service per conception and body condition score were 88.7±39.2 days, 1.2 and 3.45, respectively. There was no correlation between postpartum mating, body condition score and milk production. The study concluded that Etawah Crossed Breed goat under intensive management had short lactation period, early peak production, low persistency. The dry period was estimated 3 months and pregnancy occurred after peak production.
La salud de los pueblos indígenas: retos y perspectivas
Authors: Pelcastre-Villafuerte Blanca Estela , Meneses-Navarro Sergio , Reyes-Morales Hortensia , Rivera-Dommarco Juan Ángel
Published: May 2020

No disponible
Real-Time Analysis of Formation-Face Pressures in Acid-Fracturing Treatments
Authors: Pandey Vibhas J. , Burton Robert C. , Capps Kay
Published: May 2020

Knowledge of fracture-entry pressures or formation-face pressures (FFPs) during acid-fracturing treatments in real-time mode can help in evaluating the effectiveness of the treatment and improve the decision-making process during execution. In this paper, methods and tools used to generate FFPs in real-time mode with the help of bottomhole-pressure (BHP) data are discussed in detail. The horizontal wells selected for the study were drilled and completed in the North Sea with permanent BHP gauges that enabled constant monitoring of downhole pressures. The tool in discussion uses the combination of treatment data such as surface pressure, fluid density, injection rates, fluid type, wellbore details, and wellbore deviation, along with bottomhole-gauge pressures, to calculate fracture-inlet pressures just outside the casing at active perforation(s) depth. The tool performs the calculations in “live” mode during treatment execution and simultaneously generates a dynamic array of data that assists in “on-the-fly” evaluation and the decision-making process. Several acid-fracture treatments were analyzed using the tool and led to important conclusions related to fracture-propagation modes, acid-exposure times, and the effectiveness of given acid types. The results had a direct influence on the modification of treatment designs and pump schedules to optimize treatment outcomes.
Simulating the Behavior of Reservoirs with Convolutional and Recurrent Neural Networks
Authors: Alakeely Abdullah , Horne Roland N.
Published: May 2020

Recent experience in applying recurrent neural networks (RNNs) to interpreting permanent downhole gauge records has highlighted the potential utility of machine learning algorithms to learn reservoir behavior from data. The power of the RNN resides in its ability to retain information in a form of memory of previous patterns and information contained in the previous behavior of phenomena being modeled. This memory plays a role of informing the decision at the present time by using what happened in the past. This property suggests the RNN as a suitable choice to model sequences of reservoir information, even when the reservoir modeler is faced with incomplete knowledge of the underlying physical system.

Convolutional neural networks (CNNs) are another variant of the machine learning algorithm that have shown promise in sequence modeling domains, such as audio synthesis and machine translation. In this study, RNNs and CNNs were applied to tasks that traditionally would be modeled by a reservoir simulator. This was achieved by formulating the relationship between physical quantities of interest from subsurface reservoirs as a sequence mapping problem. In addition, the performance of a CNN layer as compared with an RNN was evaluated systematically to investigate their capabilities in a variety of tasks of interest to the reservoir engineer.

Preliminary results suggest that CNNs, with specific design modifications, are as capable as RNNs in modeling sequences of information, and as reliable when making inferences to cases that have not been seen by the algorithm during training. Design details and reasons pertaining to the way these two seemingly different architectures process information and handle memory are also discussed.
In-hospital Mortality and Failure to Rescue Following Hepatobiliary Surgery in Germany - A Nationwide Analysis.
Authors: Krautz Christian , Gall Christine , Gefeller Olaf , Nimptsch Ulrike , Mansky Thomas , Brunner Maximilian , Weber Georg F. , Grützmann Robert , Kersting Stephan
Published: May 2020

Background: Recent observational studies on volume-outcome associations in hepatobiliary surgery were not designed to account for the varying extent of hepatobiliary resections and the consequential risk of perioperative morbidity and mortality. Therefore, this study aimed to determine the risk-adjusted in-hospital mortality for minor and major hepatobiliary resections at the national level in Germany and to examine the effect of hospital volume on in-hospital mortality, and failure to rescue. Methods: All inpatient cases of hepatobiliary surgery (n = 31,114) in Germany from 2009 to 2015 were studied using national hospital discharge data. After ranking hospitals according to increasing hospital volumes, five volume categories were established based on all hepatobiliary resections. The association between hospital volume and in-hospital mortality following minor and major hepatobiliary resections was evaluated by multivariable regression methods. Results: Minor hepatobiliary resections were associated with an overall mortality rate of 3.9% and showed no significant volume-outcome associations. In contrast, overall mortality rate of major hepatobiliary resections was 10.3%. In this cohort, risk-adjusted in-hospital mortality following major resections varied widely across hospital volume categories, from 11.4% (95% CI 10.4–12.5) in very low volume hospitals to 7.4% (95% CI 6.6–8.2) in very high volume hospitals (risk-adjusted OR 0.59, 95% CI 0.41–0.54). Moreover, rates of failure to rescue decreased from 29.38% (95% CI 26.7-32.2) in very low volume hospitals to 21.38% (95% CI 19.2-23.8) in very high volume hospitals. Conclusions: In Germany, patients who are undergoing major hepatobiliary resections have improved outcomes, if they are admitted to higher volume hospitals. However, such associations are not evident following minor hepatobiliary resections. Following major hepatobiliary resections, 70-80% of the excess mortality of the very low volume hospitals was estimated to be attributable to failure to rescue.
Antibiotics stewardship in Ghana: a cross-sectional study of public knowledge, attitudes, and practices among communities.
Authors: Jimah Tamara , Fenny Ama P. , Ogunseitan Oladele
Published: May 2020

Background Antibiotic resistance is a major contributing factor to global morbidity and mortality and is associated with inappropriate medication use. However, the level of antibiotic consumption and knowledge about antibiotic resistance in Ghana is inadequately quantified. Our study identifies strategies for improved stewardship of antibiotics to prevent the proliferation of resistant pathogens by assessing the level of antibiotic knowledge, attitudes, and consumption behaviors by region, gender, age, and education in rural and urban Ghana. Methods A cross-sectional study was conducted in 12 communities in the urban Greater Accra and rural Upper West regions of Ghana. A questionnaire survey was administered to 400 individuals aged 18 years and older in selected locations during September-October 2018 to collect data on individual knowledge, attitudes, and practices concerning antibiotics and antibiotic resistance. Multivariate analysis was used to investigate the association between demographic characteristics and knowledge, attitudes, and related behaviors. Results Over 30% (125/400) had not received a doctor’s prescription during their last illness. Seventy percent (278/400) had taken at least one antibiotic in the year prior to the survey. The top five frequently used antibiotics were Amoxicillin, Amoxicillin-clavulanic acid, Ampicillin, Ciprofloxacin, and Metronidazole. Women and older adults had higher knowledge compared to their respective counterparts (p<0.01). Furthermore, prudent antibiotic use was significantly more prevalent in women than men (p<0.05). Although no regional differences were found in overall knowledge, compared to urban residents, individuals residing in rural settings exhibited higher knowledge about the ineffectiveness of antibiotics for viruses like the cold and HIV/AIDS (p<0.001). Two hundred and fifty-two (63%) respondents were unaware of antibiotic resistance. There was generally a low level of self-efficacy among participants regarding their role in preserving the effectiveness of antibiotics. Conclusion Antibiotic knowledge, attitudes, and use varied significantly across demographics, suggesting a context-specific approach to developing effective community interventions.
Factors associated with sexual and reproductive health behaviour of street-involved young people: findings from a baseline survey in southwest Nigeria
Authors: Olaleye Atinuke O , Obiyan Mary O. , Folayan Morenike O.
Published: May 2020

Background: To achieve the Sustainable Development Goal 3, which is to ensure healthy lives and promote well-being for all persons of all ages, street-involved young people (SIYP) must be assured of universal access to sexual and reproductive healthcare. This study aims to determine the factors associated with age- and sex-specific differences in the sexual and reproductive health (SRH) behaviour of SIYP in southwest Nigeria.Methods: This was a cross-sectional study that recruited 1505 SIYP aged 10-24 years by use of respondent-driven and time-location sampling. Data were collected through interviewer-administered questionnaires on socioeconomic characteristics; access to SRH information; contraceptive knowledge and use; sexual behavior; and sexual practice. The outcome variables were inconsistent condom use, multiple sexual partners, and transactional sex. Binomial regression analysis models were developed to determine risk indicators for outcome variables. Results: Although 968 (64.3%) participants were sexually active and 1089 (72.4%) knew about modern contraception, only 300 (31.0%) sexually active respondents used modern contraceptives. Knowledge of modern contraception (AOR: 0.11; 95% C.I: 0.01-0.82, p=0.03) and being employed (AOR: 0.38; 95% C.I: 0.15-0.95, p=0.04) reduced the odds for inconsistent condom use among male SIYPs. For female SIYPs, knowledge of modern contraception reduced the odds for inconsistent condom use (AOR: 0.26; 95% C.I: 0.08-0.90, p=0.03), whereas access to SRH information significantly increased the odds for inconsistent condom use (AOR: 5.06; 95% C.I: 1.67-15.37, p=0.004). Conclusion: Age- and sex- related factors associated with risky sexual behaviors vary among SIYP. Addressing these differences in the delivery of targeted interventions to reduce sexual health risk of SIYP may be required.
Direct oligonucleotide sequencing with nanopores
Authors: Chalapati Sachin , Crosbie Conor , Limbachiya Dixita , Pinnamaneni Nimesh Chandra
Published: May 2020

Third-generation DNA sequencing has enabled users to sequence long, unamplified DNA fragments with minimal sample and library preparation steps. Sequencing single-stranded nucleic acids directly without amplification or by ligating a spacer strand are challenging, as the single-strand species are poor templates to add the sequencing adapters. Sequencing ssDNA or RNA directly gives valuable insights like base-level modifications and degradation levels along with saving valuable time and resources. Biological nanopores used by Oxford Nanopore Technologies process the target strands at a single-strand level, although the typical samples sequenced are double-stranded or converted into double-strand. We have identified that the MinION platform from Oxford Nanopore can perform sequencing of short, single-strand oligonucleotides directly without amplification or second-strand synthesis by performing an annealing step before library preparation. Short 5’ phosphorylated oligos when annealed to an adapter sequence can be directly sequenced in the 5' to 3' direction via nanopores, the adapters were designed to bind to the 5’ end of the oligos and leave a 3’ adenosine overhang after binding to their target. The 3’ adenosine overhang of the adapter and the terminal phosphate makes the 5’ end of the oligo to be analogous to an end-prepared dsDNA, rendering it compatible with ligation-based library preparation for sequencing. An oligo-pool containing 42,000 orthogonal sequences of 120 bp length were sequenced using the method and 37,265 of the total sequences were recovered with high accuracy. While analyzing the raw data, we had interesting observations. In our raw data, we have identified that empty signals can be wrongly identified as a valid read by the MinION platform and sometimes multiple signals containing several strands can be fused into a single read by the platforms segmentation faults. We believe that this method could enable novel applications of nanopore sequencing in DNA data-storage systems where short oligonucleotides function as the primary information carriers.
Normative Values For Circulating Intestinal Fatty Acid Binding Protein And Calprotectin Across Gestational Ages
Authors: Shores Darla , Fundora Jennifer , Go Mitzi , Shakeel Fauzia , Brooks Sandra , Alaish Samuel M. , Yang Jun , Sodhi Chhinder P. , Hackam David J. , Everett Allen
Published: May 2020

Background: Necrotizing enterocolitis (NEC) is associated with significant morbidity and mortality. Serum biomarkers to aid diagnosis, such as intestinal fatty acid binding protein (IFABP) and calprotectin, are actively being investigated; however, the normative values of these markers among healthy premature and term infants remains unknown.Aims: We sought to identify normative values for the serum concentrations of IFABP and calprotectin across gestational (GA) and post-menstrual age.Methods: We collected serum from infants (24-40 weeks GA) in the first week of life and at multiple time points in a sub-cohort of premature infants (24-29 weeks GA), excluding sepsis or known intestinal disease. IFABP and calprotectin were measured using ELISA. Groups were compared with descriptive statistics and mixed effects linear regression.Results: 112 infants had specimens in the first week of life, and 19 premature infants had longitudinal specimens. IFABP concentration in the first week of life was low and did not differ across gestational ages. Longitudinally, IFABP increased 4% per day (P<0.001). Calprotectin concentration in the first week of life was more variable. An inverse relationship between day of life and calprotectin level was found in the longitudinal cohort (P <0.001).Conclusions: Serum IFABP and calprotectin fluctuate over time. Infants had low levels of IFABP during the first week of life, independent of gestational age, and levels increased longitudinally in premature infants. Calprotectin levels generally declined over time. Normative data for infants is necessary to establish meaningful cut-off levels for clinical use.
Use of static and dynamic 18F-FDopa PET parameters for detecting patients with glioma recurrence or progression
Authors: Zaragori Timothée , Ginet Merwan , Marie Pierre-Yves , Roch Veronique , Grignon Rachel , Gauchotte Guillaume , Rech Fabien , Blonski Marie , Lamiral Zohra , Taillandier Luc , Imbert Laetitia , Verger Antoine
Published: May 2020

Background: Static 18 F-FDopa PET images are currently used for identifying patients with glioma recurrence/progression after treatment, although the additional diagnostic value of dynamic parameters remains unknown in this setting. The aim of this study was to evaluate the performances of static and dynamic 18 F-FDopa PET parameters for detecting patients with glioma recurrence/progression as well as assess further relationships with patient outcome. Methods: Fifty-one consecutive patients who underwent an 18 F-FDopa PET for a suspected glioma recurrence/progression at post-resection MRI, were retrospectively included. Static parameters, including mean and maximum tumor-to-normal-brain (TBR) ratios, tumor-to-striatum (TSR) ratios and metabolic tumor volume (MTV), as well as dynamic parameters with time-to-peak (TTP) values and curve slope, were tested for predicting: 1) glioma recurrence/progression at 6-months after the PET exam and 2) survival on longer follow-up. Results: All static parameters were significant predictors of glioma recurrence/progression (accuracy≥94%) with all parameters also associated with mean progression-free survival (PFS) in the overall population (all p<0.001, 29.7 vs. 0.4 months for TBR max , TSR max and MTV). The curve slope was the sole dynamic PET predictor of glioma recurrence/progression (accuracy=76.5%) and was also associated with mean PFS (p<0.001, 18.0 vs. 0.4 months). However, no additional information was provided relative to static parameters in multivariate analysis. Conclusion: Although patients with glioma recurrence/progression can be detected by both static and dynamic 18 F-FDopa PET parameters, most of this diagnostic information can be achieved by conventional static parameters. Further studies are warranted to investigate the relevance of such 18 F-FDopa kinetics in populations involving only high-grade gliomas.
Pioglitazone for primary stroke prevention in Asian patients with type 2 diabetes and cardiovascular risk factors: A retrospective study
Authors: Hung Yi-Chih , Chiu Lu-Ting , Huang Hung-Yu , Bau Da-Tian
Published: May 2020

Background: Studies assessing the efficacy of pioglitazone solely for primary stroke prevention in Asian patients with type 2 diabetes mellitus (DM) and present multiple cardiovascular (CV) risk factors are rare. Thus, we aimed to assess the effect of pioglitazone on primary stroke prevention in Asian patients with type 2 DM without established CV diseases but with risk factors for CV diseases. Methods: Between 2000 and 2012, we enrolled patients aged ≥18 years, who were newly diagnosed with type 2 diabetes and had at least one of the following CV risk factors: hypertension and hyperlipidemia. Patients with a history of stroke and those using insulin or glucagon-like peptide-1 agonist for more than 3 months were excluded. Patients were divided into the pioglitazone and non-pioglitazone groups based on their receipt of pioglitazone during the follow-up period. Propensity-score matching (1:1) was used to balance the distribution of the baseline characteristics and medications. Follow-up was terminated upon ischemic stroke development, withdrawal from the insurance system, or on December 31, 2013, whichever occurred first. The overall incidence of new-onset ischemic stroke in the two groups was subsequently compared. The subgroup analyses of ischemic stroke were conducted using different baseline features. Additionally, the effect of pioglitazone exposure dose on the occurrence of ischemic stroke was evaluated. Chi-square test, Student’s t-test, competing risk regression models, Kaplan–Meier method, and log-rank test were some of the statistical tests conducted.Results: A total of 13 078 patients were included in the pioglitazone and non-pioglitazone groups. Compared with patients who did not receive pioglitazone, those administered pioglitazone had a lower risk of developing ischemic stroke (adjusted hazard ratio: 0.78; 95% confidence interval: 0.62–0.95). The subgroup analyses defined by different baseline features did not reveal significant alterations in the observed effect of pioglitazone. Moreover, a significant decreasing trend in ischemic stroke risk with an increase in pioglitazone dose (p-value for trend = 0.04) was observed.Conclusion: Pioglitazone use decreased the risk of new-onset ischemic stroke in Asian patients with type 2 DM and CV risk factors.Trial registration number: CMUH104-REC2-115-CR4
Detection of Gastrointestinal Parasitism at Recreational Canine Sites in the United States (the DOGPARCS study)
Authors: Stafford Kristina , Kollasch Todd M , Duncan Kathryn T , Horr Stephanie , Goddu Troy , Heinz-Loomer Christine , Rumschlag Anthony J , Ryan William G , Sweet Sarah , Little Susan E
Published: May 2020

Background The rapid growth in off-leash dog parks provides opportunity for canine socialization activities but carries risk of exposure to intestinal parasites. This study assessed the prevalence of these infections in dogs visiting off-leash dog parks.Methods Fresh defecations were collected from dogs visiting parks in 30 metropolitan areas across the United States. Samples were analyzed by coproantigen immunoassay (CAI) (FecalDx ® and Giardia Test, IDEXX Laboratories, Inc) and zinc sulfate centrifugal flotation (CF). Owners responded to a questionnaire on their dog’s signalment and use of heartworm/intestinal parasite control medications (HWCM).Results Samples were examined from 3,006 dogs, 87.9% aged at least 12 months, visiting 288 parks. At least one intestinal parasite was detected in 622 (20.7%) samples, nematodes in 263 (8.8%), with hookworm, whipworm, and ascarids in 7.1, 1.9, and 0.6% of samples, respectively. A sample positive for one or more intestinal parasites was found in 245 (85.1%) parks, with nematodes found in 143 (49.7%). Combined, CAI and CF detected 78.4% more intestinal nematode infections than CF alone. Hookworm and whipworm were detected in all age groups, but ascarids were only detected in dogs less than 4 years. Approximately 42% of dogs aged less than 1 year were positive for nematodes or Giardia . Based on owner reports, HWCM was current for 68.8% of dogs, dogs previously diagnosed with intestinal parasitism were more likely to be receiving a HWCM than those without such history, and a significantly lower ( P = 0.0003) proportion of dogs receiving a HWCM were positive for intestinal nematodes compared with those not on such medication.Conclusion Intestinal parasites, the most common of which were Giardia , Ancylostoma caninum and Trichuris vulpis , were found in 20% of dogs and 85% of dog parks across the United States. Enhanced detection of canine intestinal parasitism was achieved by combining CF and CAI. Canine intestinal parasites are common across the United States, and dog health can be improved by regular testing of fecal samples and routine administration of medications effective against the most common infections.
The efficacy of different treatment approaches for pediatric OSAHS patients with mandibular rethognathia: a study protocol for a multicenter randomized controlled trial
Authors: Li Yuanyuan , Wu Jiali , Guo Jinghan , Yu Liming , Wang Jing , Li Xiaoyan , Xu Shuhua , Zhu Min , Feng Jinqiu , Liu Yuehua
Published: May 2020

Background: Pediatric obstructive sleep apnea/hypopnea syndrome (OSAHS) is a multifactorial syndrome caused by many risk factors, such as craniofacial anomalies, adenotonsillar hypertrophy, obesity and airway inﬂammation. Although new treatment patterns have recently been proposed, treatment methods for children remain particularly challenging and controversial. This randomized controlled trial was designed to investigate the efficacy of adenotonsillectomy and/or orthodontic treatment for mild OSAHS children with mandibular rethognathia.Methods: A sample of 352 children with mild OSAHS and mandibular rethognathia, aged between 7 and 10 years, will be enrolled in the study. They will be randomized into four groups – the drug treatment group, the surgical treatment group,the orthodontic treatment group, or the surgery and postoperative orthodontic group. After randomization they will receive treatments within 4 weeks. Outcome assessment will take place at the following points: (1)baseline, (2) 7 months after the treatment starting point, (3) 12 months after the treatment starting point, and (3) 24 months after the treatment starting point. The primary endpoint of the trial is the mean change of obstructive apnea/hypopnea index. Other endpoints will consist of the lowest oxygen saturation, apnea index, and hypopnea index assessed by polysomnogram, subjective symptoms (assessed by the OSA-20 questionnaire), cephalometric measurements and morphologic analysis of the upper airway.Discussion: The results of this study will provide valuable evidence for the merits and long-term efficacy of different treatment approaches and contribute to facilitating the multidisciplinary treatment of pediatric OSAHS.Trial registration: Clinicaltrials.gov, ID: NCT03451318. Registered on 2 March 2018 (last update posted 19 April 2018).
Real-time surveillance of surgical margins via ICG-based near-infrared fluorescence imaging in patients with OSCC
Authors: Pan Jiongru , Deng Han , Hu Shiqi , Xia Chengwan , Chen Yongfeng , Wang Jianquan , Wang Yuxin
Published: May 2020

Background Local recurrence is the main cause of death among patients with oral squamous cell carcinoma (OSCC). This study assessed near-infrared fluorescence (NIF) imaging and spectroscopy to monitor surgical margins intraoperatively for OSCC. Methods Cytological and animal experiments were first performed to confirm the feasibility of monitoring surgical margins with NIF imaging and spectroscopy. Then, 20 patients with OSCC were included in the clinical trials. At 6–8 hours after 0.75 mg/kg indocyanine green (ICG) injection, all patients underwent surgery with NIF imaging. During the surgery, both NIF images and quantified fluorescence intensity were acquired to monitor the surgical margins. Results In cytological and animal experiments, the results showed it was feasible to monitor surgical margins with NIF imaging and spectroscopy. Fluorescence was detected in primary tumors in all patients. The fluorescence intensities of the tumor, peritumoral, and normal tissues were 398.863±151.47, 278.52±84.89, and 274.5±100.93 arbitrary units (AUs), respectively (P<0.05). The SBR of tumor to peritumoral tissue and normal tissues was computed to be 1.45±0.36 and 1.56±0.41 respectively. After primary tumor excision, the wounds showed abnormal fluorescence in four patients (4/20), and residual cancer cells were confirmed by pathological examination in two patients (2/20). Conclusion These findings confirmed the complementary value of NIF imaging during radical tumor resection of OSCC. Before tumor resection, we could utilize the fluorescence margin produced by ICG NIF imaging to determine the surgical margin. Moreover, after tumor blocks were removed, the status of surgical margin could also be evaluated rapidly by ICG NIF imaging of tumor bed and in vitro specimens.
Is fibroid location associated with hemorrhage and complication rates following laparoscopic myomectomy?
Authors: Aslan Kiper , Orhan Adnan , Turkgeldi Engin , Suer Ebru , Duzok Nergis , Ozerkan Kemal , Ata Baris , Uncu Gurkan
Published: May 2020

Objective To determine whether hemorrhage and complication rates vary according to location of the dominant fibroid following laparoscopic myomectomy. Background Laparoscopic myomectomy is associated with less postoperative pain, analgesic requirement, shorter hospitalization period, and less febrile complications when compared to conventional laparotomy. Despite the advantages, complications like hemorrhage, blood transfusion, bowel and urinary tract injury and conversion to laparotomy may be seen in laparoscopic myomectomy. We don’t know whether fibroid location effect these complications. Materials & Methods Women, who underwent laparoscopic myomectomy at two different tertiary academic hospitals, were analyzed retrospectively. Only women with at least one intramural fibroid (Monroe type 3, 4 or 5) were included. Patients were categorized according to localization of the dominant fibroid, i.e. anterior uterine wall, posterior uterine wall, and fundus. Change in hemoglobin levels before and after surgery, and complication rates were compared across categories. Results 219 women with mean age of 35.7 +/-6 years were included. There were 81 women with fundal fibroid, 56 with anterior wall, and 72 with posterior wall fibroid. Other 10 women with intraligamentary and isthmic fibroid were excluded. The mean fibroid diameter was 6.7 ± 2.6, 6.6 ± 2.3, and 6.7 ± 2.3 cm in the fundal, anterior and posterior groups, respectively (p=0.9). The median (25 th – 75 th percentile) changes in hemoglobin levels were 1.5 (0.8 – 2.2), 1.3 (0.6 – 2.1), and 1.3 (0.9 – 2) g/dl in fundal, anterior and posterior wall groups, respectively (p = 0.55). There were 5 (6.2%), 5 (8.9%), and 2 (2.8%) complications in fundal, anterior, and posterior wall groups, respectively (p = 0.33). Conclusion Incidence of hemorrhage or complication does not seem to vary depending on fibroid location. However, the sample size was limited, the observed values suggest that fibroid location does not affect hemorrhage and complication rates.
Cepharanthine and Curcumin inhibited mitochondrial apoptosis induced by PCV2
Authors: Xu Yinlan , Zheng Jiangang , Sun Panpan , Guo Jianhua , Zheng Xiaozhong , Sun Yaogui , Fan Kuohai , Yin Wei , Li Hongquan , Sun Na
Published: May 2020

Background
Porcine circovirus type 2 (PCV2) is an immunosuppressive pathogen with high prevalence rate in pig farms. It has caused serious economic losses to the global pig industry. Due to the rapid variation of PCV2 strain, short vaccine protection period and poor cross-protection effect, etc. It is necessary to screen and develop effective new compounds and explore their anti-PCV2 mechanism. The 13 natural compounds were purchased, with a clear plant origin, chemical structure and content and specific biological activities.
Methods
The maximum no-cytotoxic concentration (MNTC) and 50% cytotoxic concentration (CC50) for 13 tested compounds were determined by the cytopathologic effect (CPE) assay and (3-(4,5-dimethyithiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) method in PK-15 cells, respectively, qPCR and Western blot were used to detect the anti-PCV2 effect of compounds. Western blot method, AnnexinV-FITC /PI, JC-1, and ROS Kits were respectively used to detect the anti-PCV2 induced apoptosis mechanism of Cepharanthine and Curcumin. In this study, Ribavirin was used as the positive control.
Results
MNTC and CC50 of 13 compounds were obtained. Compared with the PCV2 infected group, the expression of Cap treated with Paeonol (0.4 mg/mL and 0.2 mg/mL), Cepharanthine (0.003 mg/mL, 0.0015 mg/mL and 0.00075 mg/mL) and Curcumin (0.02 mg/mL, 0.001 mg/mL and 0.005 mg/mL) were significantly lower in a dose-dependent manner. The expression of Cleaved-caspase3 and Bax were up-regulated in the treated with Cepharanthine or Curcumin, while the expression of Bcl-2 was down-regulated, ROS value and MMP value were decreased to different degrees and the apoptosis rate was reduced.
Conclusion
Paeonol, Cepharanthine and Curcumin have significant antiviral effect. And the PCV2-induced Mitochondrial apoptosis was mainly remitted by Cepharanthine and Curcumin.
A novel SPAST gene mutation identified in a Chinese family with hereditary spastic paraplegia
Authors: Yu Weiwei , Jin Haiqiang , Deng Jianwen , Nan Ding , Huang Yining
Published: May 2020

Background: Hereditary spastic paraplegia is a heterogeneous group of clinically and genetically neurodegenerative diseases characterized by progressive gait disorder. Hereditary spastic paraplegia can be inherited in various ways, and all modes of inheritance are associated with multiple genes or loci. At present, more than 76 disease-causing loci have been identified in hereditary spastic paraplegia patients. Here, we report a novel mutation in SPAST gene associated with hereditary spastic paraplegia in a Chinese family, further enriching the hereditary spastic paraplegia spectrum. Methods: Whole genomic DNA was extracted from peripheral blood of the 15 subjects from a Chinese family using DNA Isolation Kit. The Whole Exome Sequencing of the proband was analyzed and the result was identified in the rest individuals. RaptorX prediction tool and Protein Variation Effect Analyzer were used to predict the effects of the mutation on protein tertiary structure and function.Results: Spastic paraplegia has been inherited across at least four generations in this family, during which only four HSP patients were alive. The results obtained by analyzing the Whole Exome Sequencing of the proband exhibited a novel disease-associated in-frame deletion in the SPAST gene, and the this mutation also existed in the rest three HSP patients in this family. This in-frame deletion consists of three nucleotides deletion (c.1710_1712delGAA) within the exon 16, resulting in lysine deficiency at the position 570 of the protein (p.K570del). This novel mutation was also predicted to result in the synthesis of misfolded SPAST protein and have the deleterious effect on the function of SPAST protein.Conclusion: In this case, we reported a novel mutation in the known SPAST gene that segregated with HSP disease, which can be inherited in each generation. Simultaneously, this novel discovery significantly enriches the mutation spectrum, which provides an opportunity for further investigation of genetic pathogenesis of HSP.
Smartband use during enhanced recovery after surgery facilitates inpatient recuperation following minimally invasive colorectal surgery
Authors: Yin Tzu-Chieh , Huang Ching-Wen , Tsai Hsiang-Lin , Su Wei-Chih , Ma Cheng-Jen , Chang Tsung-Kun , Wang Jaw Yuan
Published: May 2020

BackgroundEnhanced recovery after surgery (ERAS) is valuable in perioperative care for its ability to improve short-term surgical outcomes and facilitate patient recuperation after major surgery. Early postoperative mobilization is a vital component of the integrated care pathway and is a factor strongly associated with successful outcomes. However, early mobilization still has various definitions and lacks specific strategies.MethodsPatients who underwent minimally invasive surgery for colorectal cancer followed our perioperative ERAS program, including mobilization from the first postoperative day. After perioperative care skills were improved in our well-established program, compliance, inpatient surgical outcomes, and complications associated with adding smartband use were evaluated and compared with the outcomes for standard protocol. Quality of recovery was evaluated using patient-rated QoR-40 questionnaires the day before surgery, on postoperative day 1 and 3, and on the day of discharge.ResultsSmartband use after minimally invasive colorectal surgery failed to increase compliance with early mobilization or reduce the occurrence of postoperative complications significantly compared with standard ERAS protocol. However, when smartbands were utilized, quality of recovery was optimized and patients returned to their preoperative status earlier, at postoperative day 3. The duration of theoretical hospital stays and hospital stays of uncomplicated patients wearing smartbands was also reduced by 1.1 and 0.9 days, respectively (P = 0.0091 and 0.049).ConclusionsSmartbands enable enhanced communication between patients and surgical teams and strengthen self-management in patients undergoing minimally invasive colorectal resection surgery. Accelerated recovery to preoperative functional status can be facilitated by integrating smartbands into the process of early mobilization during ERAS.
Evaluation of Modified CC Stabilization Using LARS Artificial Ligament in Unstable Distal Clavicle Fracture
Authors: Li Yongchuan , Lu Nan , Shen Di , Zhang Fan , Lu Jiajia , Chen Aimin
Published: May 2020

Background: Unstable distal clavicle fracture is common, and there is no consensus regarding the gold standard treatment. The purpose of this study was to report a new surgical technique for the treatment of unstable distal clavicle fracture with modified coracoclavicular (CC) stabilization using a ligament augmentation and reconstruction system (LARS) artificial ligament, and to evaluate the clinical and radiographic outcomes.Patients and methods: We retrospectively reviewed 18 patients with acute unstable distal clavicle fractures (type Ⅱb) treated between January 2009 and June 2018 with modified CC stabilization using LARS artificial ligament. Indexes for evaluation included fracture healing, quality of reduction, and presence of complications (e.g., infections, nerve injuries, iatrogenic clavicle or coracoid fracture, the fixation loop failure, or loss of reduction). Shoulder function was evaluated using the Constant-Murley score.Results: Patients were assessed at a mean time of 31.8 months follow-up. All 18 patients experienced radiographic union. Follow-up radiographs showed anatomical reduction in 15 patients and slight loss of reduction in 3 patients. There were 2 cases of calcification of the CC ligament, 1 case of degenerative change around the acromioclavicular (AC) joint, and 1 case of clavicular osteolysis around screws noted during the follow-up. At the final follow-up, Constant scores were 91.2 ± 6.9.Conclusions: Treating unstable distal clavicle fractures (type Ⅱb) with modified CC stabilization using LARS artificial ligament resulted in a high union rate, satisfactory fracture reduction, a low complication rate, and excellent shoulder function. We consider this simple surgical technique that naturally restores stability to the distal clavicle fracture is an efficient method for treating the fracture.