bluuebunny/crossref_metadata_2025 huggingface dataset:
Peningkatan Performa Naive Bayes Dengan Seleksi Atribut Menggunakan Chi Square Untuk Klasifikasi Loyalitas Pelanggan GRAB
Authors: Kisworini Rianti Yunita
Published: September 2020

Transportasi menjadi salah satu dari beberapa area yang dipengaruhi oleh kemajuan perkembangan teknologi informasi. Dimana transportasi merupakan sarana yang diperlukan untuk mendukung aktivitas manusia dan mobilitas setiap saat, oleh karena itu transportasi harus dipersiapkan dengan baik dan aman. Layanan Grab online menjadi salah satu alat transportasi yang banyak digunakan oleh masyarakat Indonesia. Naive Bayes adalah salah satu algoritma classifying data yang biasa digunakan untuk mengklasifikasikan data. Tetapi kinerja yang baik dari Naiv Bayes sangat dipengaruhi oleh penggunaan atribut pada dataset. Untuk mengatasi ini, penelitian ini mengusulkan peningkatan kinerja Naiv Bayes dengan pemilihan atribut menggunakan Chi Square. Pada tahap pra pengolahan dilakukan pembersihan data untuk menghapus data yang kosong. Dari percobaan yang dilakukan, menunjukkan hasil pengujian dengan nilai akurasi yang diperoleh Bayes naif + chi Square sebesar 99,51%., Tetapi standar baye naif sebesar 92,73%.

Kata kunci: Penambangan data, klasifikasi, Naiv Bayes, pra pemrosesan, pemilihan atribut, Chi Square, klasifikasi loyalitas pelanggan Grab
Study of Biaxial Mechanical Properties of the Passive Pig Heart: Material Characterisation and Categorisation of Regional Differences
Authors: Nemavhola Fulufhelo
Published: September 2020

Regional mechanics of the heart is vital in the development of accurate computational models for the pursuit of relevant therapies. Challenges related to heart dysfunctioning are the most important sources of mortality in the world. For example, myocardial infarction (MI) is the foremost killer in sub-Saharan African countries. Mechanical characterisation plays an important role in achieving accurate material behaviour. Material behaviour and constitutive modelling are essential for accurate development of computational models. In most cases previously, the mechanical properties of the heart myocardium were assumed to be homogeneous. The main objective of this paper is to determine the mechanical material properties of healthy porcine myocardium in three regions, namely left ventricle (LV), mid-wall/interventricular septum (MDW) and right ventricle (RV). The biomechanical properties of the pig heart RV, LV and MDW were characterised using biaxial testing. The biaxial tests show the pig heart myocardium behaves non-linearly, heterogeneously and anisotropically. In this study, it was shown that RV, LV and MDW may exhibit slightly different mechanical properties. Data presented here may be helpful in regional tissue mechanics, especially for the understanding of various heart diseases and development of new therapies.
Quantum Calcium-Ion Affective Influences Measured by EEG
Authors: Ingber Lester
Published: September 2020

Background: Since circa 1980, a model of neocortical interactions, Statistical Mechanics of Neocortical Interactions (SMNI) has been successful in calculating many experimental phenomena, including fits to electroencephalographic (EEG) data in attention tasks, using an importance-sampling code Adaptive Simulated Annealing (ASA). The SMNI model is developed in the context of classical path-integrals, which affords intuitive insights as well as direct numerical benefits, e.g., using the effective Action as a a cost/objective function for parameter fits to data. Objective: Previous authors have fit affective EEG data to neural-network models. This project seeks to use models based on physics and biology to fit this same data. Previous work showed improvements in fits to EEG for attention states; this project extends these methods to affective states. Method: Path integrals are used in both classical and quantum contexts. Classical path integrals are used to define a cost/objective function to fit data, and quantum path integrals are used to derive a closed-form analytic expression for Ca-ion waves in the presence of a magnetic vector potential which is generated by highly synchronous neuronal firings which give rise to EEG. ASA is used to fit EEG data. Results: The mathematical-physics and computer parts of the study are successful, in that cost/objective functions used to fit EEG data using these models are consistent with previous work published by other authors. However, since the SMNI model includes these quantum effects, this is another reason to continue examining these issues. The results here are consistent, not better, than previous work using neural-network models, albeit only one parameter was used here, instead of multiple filters and kernels used previously on such data. Conclusion: Although these quantum effects are highly speculative, explicit calculations have shown them to be consistent with experimental data, at least to date. The current supercomputer project extends this model to affective/emotion data. Results from several authors using neural-network approaches at individual electrode sites show some predictive capabilities; the results given here are consistent with these other results. However, since the SMNI model includes these quantum effects, this is another reason to continue examining these issues.
Measuring Co-Axial Hole Size of Finite-Size Metallic Disk Based on a Dual-Constraint Integration Feature Using Multi-Frequency Eddy Current Testing
Authors: Huang Ruochen , Lu Mingyang , He Xiaohong , Peyton Anthony , Yin Wuliang
Published: September 2020

This paper presents a new approach of eddy current methods for determining the size of the co-axial hole in the metallic circular disk. In recent decades, for the air-cored sensor probe, the impedance change due to the presence of an infinite metal plate can be calculated by the Dodd-Deeds model. However, in practical measurements, the sample cannot match with the condition required - ‘infinite’, thus the Dodd-Deeds model could not be applied to the disk with finite size and certainly not a co-axial hole in the center. In this paper, a dual-constraint analytical method is proposed. That is, the upper and lower limits of the integration are substituted with specific values instead of the original 0 and . Besides, it is found that, once the outer radius of the disk is fixed (i.e. the lower limit of integration is fixed), the upper limit reduces linearly as the size of the coaxial hole increases. Both the FEM simulation and experiments have been carried out to validate this method. The radius of the hole can be estimated based on the dual-constraint integration feature.
Theoretical Analysis of Three-Dimensional Seepage through the Fracture with Surrounding Rock Deformation
Authors: Ma Haichun , Wang Jingping , Qian Jiazhong , Tan Xiaohui , Ma Lei , Lu Zhitang , Deng Yaping
Published: September 2020

The formation of rock fractures in nature has a certain relationship with water seepage. In order to analyze the shape of rock fracture, we propose a rock deformation theoretical model in three-dimensional space considering with the condition of seepage water pressure, and establish the mass conservation equation, seepage equation, surrounding rock displacement equation, so as to deduce the rock deformation control equation under seepage pressure action. The numerical analysis of the nonlinear quadratic partial differential equation obtains the fracture deformation distribution in the example, and verifies with the calculated fracture morphology. And we further use this principle to analyze the fracture morphology in nature and prove the rationality of the theory.
Russia’s Eurasian Union Dream: A Way Forward Towards Multi Polar World Order
Authors: Abbas Shahzada Rahim
Published: September 2020

Since the disintegration of USSR Eurasia has gained a new geopolitical and strategic significance. Fifteen Countries emerged as result of disintegration, among which only Russian Federation was the successor state. The post-soviet era especially the era of 1990s was a political and economic trauma for the Russian federation and the post-soviet space. But Eurasianists were well aware about the American unilateralism and American ‘Grand Chessboard strategy” that was solely aimed at encircling Russian geography. With these concerns, the Eurasianists advised the Russian political and military elites to initiate the Eurasian Union Project. This paper briefly sketches Russian historical Eurasian dream, which deeply rooted in Russian imperial history and discusses about the importance of Eurasian philosophy for the political and economic stability of Russia-Eurasia. The paper also illustrates about the challenges and opportunities for the Eurasian integration and for the establishment of multipolar world order. Moreover, the paper also briefly outlines the geopolitical rationale behind the Eurasian project as key objective of the contemporary Russian foreign policy and geopolitics.
Parámetros genéticos en la varianza residual de variables de comportamiento en toros de lidia
Authors: Domínguez-Viveros J.
Published: September 2020

Los objetivos fueron analizar la presencia de varianza genética en la varianza residual de notas de comportamiento en Toros de Lidia. De una ganadería de lidia se analizó los residuales condicionales (RCON; ê = y - Ε[y|a] = y - Xβ - Za) y marginales (RMAR; ξ = y - Ε[y] = y - Xβ), de las notas de tienta al caballo (n, 2369), tienta al torero (n, 1432), lidia al caballo (n, 792) y lidia al torero (n, 820); en dos bases de datos: BD1, transformación logarítmica; BD2, transformación logarítmica eliminando datos extremos (x̄ ±2σ). Con el software MTDFREML se realizó un análisis multivariado (cuatro notas) dentro de tipo de residual y para cada base de datos; se calcularon las heredabilidades (h2) y las correlaciones genéticas (rg) a través de variables. Las h² oscilaron entre 0.14 y 0.96, con un valor promedio de 0.58; las h2 de RMAR en la BD2 presentaron sobre estimaciones (> 0.78). Estos resultados muestran variabilidad genética en la varianza residual y presentan la posibilidad de respuesta a la selección (canalización ambiental) para reducir la varianza ambiental. La selección para varianza residual puede mejorar la respuesta ante los conceptos de resiliencia, plasticidad, robustez y rusticidad. Las rg fueron positivas, en el intervalo de 0.01 a 0.99 y un valor promedio de 0.79; con estas rg puede haber una respuesta correlacionada en los residuales de las cuatro notas.
Evaluación de PCR en tiempo real en el diagnóstico de leucosis enzoótica bovina en una raza local de Panamá
Authors: Villalobos-Cortés A.I. , Gonzalez R. , Castillo H. , Jaén M.
Published: September 2020

El objetivo de este trabajo fue evaluar la prueba de RT-PCR, para detectar el virus de leucosis enzoótica bovina y compararlas con las pruebas de nPCR y AGID en 42 animales de la raza Guaymí de 5 regiones de Panamá. La prueba de AGID identificó el menor número de animales positivos (52%) comparada con la nPCR (71%) y PCR en tiempo real, RT-PCR (76%). Cuatro animales positivos a la prueba de AGID fueron negativos a la prueba de nPCR y dos animales positivos a esta misma prueba fueron negativos a la RT-PCR. 11 de los 20 animales negativos por AGID dieron positivo a nPCR y 12 de los 20 animales negativos a AGID fueron positivos a RT-PCR. Respecto a las pruebas moleculares, de los 12 animales que resultaron negativos a la prueba de nPCR, cinco resultaron positivos a la RT-PCR y de los 10 animales negativos a RT-PCR, 3 resultaron positivos a nPCR. La sensibilidad del nPCR respecto a AGID fue de 82% mientras que la especificidad fue de 40%. La prueba de concordancia entre pruebas fue de k= 0.316, considerada débil mientras que la sensibilidad del RT-PCR respecto a la AGID fue de 91% con una especificidad de 40%; la prueba de concordancia entre ambas pruebas fue de k=0.222 considerada también débil. La técnica de RT-PCR se presenta como una alternativa viable dentro del grupo de técnicas para el diagnóstico del virus de la leucosis enzoótica bovina, particularmente en un eventual programa de control y su erradicación en centros de conservación de razas criollas donde se requiere mantener un estricto control de la salud animal.
An analysis of the effect of the technique of the repair and postoperative rehabilitation protocol on the treatment outcomes of flexor tendon injuries: a review
Authors: Żyluk Andrzej , Piotuch Bernard
Published: September 2020

This study covers updated information on the methods of the repair of flexor tendon injuries, postoperative rehabilitation protocols and their effect on treatment outcomes. Contemporary techniques of flexor tendon repair are based on combinations of various types of core sutures and circumferential epitenon sutures. Literature shows a tendency of replacing earlier 2-strand core tendon sutures with novel multistrand core sutures, however the results of meta-analyses do not confirm any definitive superiority over traditional techniques. Likewise, literature does not provide conclusive evidence that early active postoperative mobilization results in better outcomes than active-passive and controlled passive mobilization techniques. The choice of the method of flexor tendon repair and postoperative rehabilitation protocol depends only in part on scientific evidence, but more on individual or institutional preference of the surgeon.
Ada-WHIPS: Explaining AdaBoost Classification with Applications in the Health Sciences
Authors: Hatwell Julian , Gaber Mohamed Medhat , Azad R.M. Atif
Published: September 2020

Background Computer Aided Diagnostics (CAD) can support medical practitioners to make critical decisions about their patients' disease conditions. Practitioners require access to the chain of reasoning behind CAD to build trust in the CAD advice and to supplement their own expertise. Yet, CAD systems might be based on black box machine learning (ML) models and high dimensional data sources (electronic health records, MRI scans, cardiotocograms, etc). These foundations make interpretation and explanation of the CAD advice very challenging. This challenge is recognised throughout the machine learning research community. eXplainable Artificial Intelligence (XAI) is emerging as one of the most important research areas of recent years because it addresses the interpretability and trust concerns of critical decision makers, including those in clinical and medical practice. Methods In this work, we focus on AdaBoost, a black box ML model that has been widely adopted in the CAD literature. We address the challenge -- to explain AdaBoost classification -- with a novel algorithm that extracts simple, logical rules from AdaBoost models. Our algorithm, Adaptive-Weighted High Importance Path Snippets (Ada-WHIPS), makes use of AdaBoost's adaptive classifier weights. Using a novel formulation, Ada-WHIPS uniquely redistributes the weights among individual decision nodes of the internal decision trees (DT) of the AdaBoost model. Then, a simple heuristic search of the weighted nodes finds a single rule that dominated the model's decision. We compare the explanations generated by our novel approach with the state of the art in an experimental study. We evaluate the derived explanations with simple statistical tests of well-known quality measures, precision and coverage, and a novel measure stability that is better suited to the XAI setting.Results Experiments on 9 CAD-related data sets showed that Ada-WHIPS explanations consistently generalise better (mean coverage 15%-68%) than the state of the art while remaining competitive for speciﬁcity (mean precision 80%-99%). A very small trade-oﬀ in speciﬁcity is shown to guard againstover-ﬁtting which is a known problem in the state of the art methods.Conclusions The experimental results demonstrate the beneﬁts of using our novel algorithm for explaining CAD AdaBoost classiﬁers widely found in the literature. Our tightly coupled, AdaBoost-speciﬁc approach outperforms model-agnostic explanation methods and should be considered by practitioners looking for an XAI solution for this class of models.
Can virtual reality improve traditional anatomy educational programmes?A mixed-methods study on the use of a 3D skull model
Authors: Chen Shi , Zhu Jiawei , Cheng Cheng , Pan Zhouxian , Liu Lingshan , Du Jianhua , Shen Xinhua , Shen Zhen , Zhu Huijuan , Liu Jihai , Yang Hua , Ma Chao , Pan Hui
Published: September 2020

Background: Realistic, portable, and scalable lectures, cadaveric models, 2D atlases and computer simulations are being combined more frequently for teaching anatomy, which result in major increases in user satisfaction. However, although digital simulations may be more portable, interesting, or motivating than traditional teaching tools, whether they are superior in terms of student learning remain unclear. This paper presents a study in which the educational effectiveness of a virtual reality (VR) skull model is compared with that of cadaveric skulls and atlases. The aim of this study was to compare the results of teaching with VR to results of teaching with traditional teaching methods by administering objective questionnaires and perception surveys. Methods: A mixed-methods study with 73 medical students was conducted with three different groups, namely, the VR group (N=25), cadaver group (N=25) and atlas group (N=23). Anatomical structures were taught through an introductory lecture and model-based learning. All students completed the pre- and post-intervention tests, which comprised a theory test and an identification test. The theory test consisted of 18 multiple-choice questions, and the identification test consisted of 25 fill-in-the-blank questions.Results: The participants in all three groups had significantly higher total scores on the post-intervention test than on the pre-intervention test; the post-intervention test score in the VR group was not statistically significantly higher than the post-intervention test score of the other groups (VR: 30 [IQR: 22-33.5], cadaver: 26 [IQR: 20-31.5], atlas: 28[IQR: 20-33]; p>0.05). The participants in the VR and cadaver groups provided more positive feedback on their learning models than the atlas group (VR: 26 [IQR: 19-30], cadaver: 25 [IQR: 19.5-29.5], atlas: 12 [IQR: 9-20]; p<0.001).Conclusions: The skull virtual learning resource (VLR) was equally efficient as the cadaver skull and atlas in teaching anatomy structures. Such a model can aid individuals in understanding complex anatomical structures with a higher level of motivation and tolerable adverse effects.
Patterns and patient factors associated with loss to follow-up in the Muhimbili Sickle Cell Cohort, Tanzania
Authors: Masamu Upendo , Sangeda Raphael Zozimus , Kandoga Daniel , Ondego Jesca , Ndobho Florah , Mmbando Bruno , Nkya Siana , Msami Khadija , Makani Julie
Published: September 2020

Background: Monitoring patient's clinical attendance is a crucial means of improving retention in care and treatment programmes. Sickle cell patients' outcomes are improved by participation in comprehensive care programmes, but these benefits cannot be achieved when patients are lost from clinical care. In this study, patients are defined as loss to follow-up when they did not attend clinic for more than nine months. Precise information on the retention rate and characteristics of those who are not following their clinic appointments is needed to enable the implementation of interventions that will be effective in increasing the retention to care. Method: This was a retrospective study involving sickle cell patients registered in the Muhimbili Sickle Cohort in Tanzania. Descriptive and survival analysis techniques both non-parametric methods (Kaplan-Meier estimator and Log-rank test) and semi-parametric method (Cox’s proportional hazard model), were used. A p-value of 0.05 was considered significant to make an inference from the analysis.Results: A total of 5476 patients were registered in the cohort from 2004 to 2016. Of these, 3350 (58.13%) were actively participating in clinics, while 2126 (41.87%) were inactive, of which 1927 (35.19%) were loss to follow-up. We used data from 2004-2014 because between 2015-2016, patients were referred to other government hospitals. From the survival analysis results, pediatric (HR: 14.29,95% CI: 11.0071-18.5768, p <0.001) and children between 5-17 years [HR:2.61,95% CI:2.2324 - 3.0705, p< 0.001] patients were more likely to be loss to follow-up than the adult (18 and above years) patients. It was found that patients with above averages for hematocrit (HR: 2.38, 95% CI: 1.0076 - 1.0404, p=0.0039) or mean cell volume (HR: 4.28, (95% CI: 1.0260 - 1.0598, p<0.001) were more likely to be loss to follow-up than their counterparts. Conclusion: Loss to follow-up is evident in the cohort of patients in long term comprehensive care. It is, therefore, necessary to design interventions that improve patients’ retention. Suggested solutions include refresher training for health care workers and those responsible for patient follow-up on techniques for retaining patients and comprehensive transition programs to prepare patients who are moving from pediatric to adult clinics
Differential susceptibility of Onchocerca volvulus microfilaria to ivermectin in two areas of contrasting history of mass drug administration in Cameroon: Relevance of microscopy and molecular techniques for the monitoring of skin microfilarial repopulation within six months of direct observed treatment
Authors: Abong Raphael Awah , Amambo Glory Ngongeh , Ndongmo Patrick Chounna , Njouendou Abdel Jelil , Manuel Ritter , Beng Amuam Andrew , Esum Mathias Eyong , Deribe Kebede , Cho Jerome Fru , Fombad Fanny Fri , Nji Theobald Mue , Enyong Peter Ivo , Poole Catherine , Pfarr Kenneth , Hoerauf Achim , Carlow Clotilde , Wanji Samuel
Published: September 2020

Background. Ivermectin is an excellent microfilaricide against Onchocerca volvulus. However, in some regions, long term use of ivermectin has resulted in sub-optimal responses to the treatment. More data to properly document the phenomenon in various contexts of ivermectin mass drug administration (IVM-MDA) is needed. Also, there is a need to accurately monitor a possible repopulation of skin by microfilariae following treatment. Skin snip microscopy is known to have a low sensitivity in individuals with light infections, which can be the case following treatment. This study was designed with two complementary objectives: (i) to assess the susceptibility of O. volvulus microfilariae to ivermectin in two areas undergoing IVM-MDA for different lengths of time, and (ii) to document the repopulation of skin by the O. volvulus microfilariae following treatment, using 3 independent diagnostic techniques.Method. Identified microfilaridermic individuals were treated with ivermectin and re-examined after 1, 3, and 6 months using microscopy, actin real-time PCR (actin-qPCR) and O-150 LAMP assays. Susceptibility to ivermectin and trends in detecting reappearance of skin microfilariae were determined using three techniques. Microscopy was used as an imperfect gold standard to determine the performance of actin-qPCR and LAMP.Results. In Bafia with over 20 years of IVM-MDA, 11/51 (21.6%) direct observe treated microfilaridemic participants were still positive for skin microfilariae after 1 month. In Melong, with 10 years of IVM-MDA, 2/29 (6.9%) treated participants were still positive. The microfilarial density reduction per skin biopsy within one month following treatment was significantly lower in participants from Bafia.In both study sites, the molecular techniques detected higher proportions of infected individuals than microscopy at all monitoring time points. LAMP demonstrated the highest levels of sensitivity and real-time PCR was found to have the highest specificity.Conclusion. Patterns in skin mirofilariae clearance and repopulation were established. O. volvulus worms from Bafia with higher number of annual MDA displayed a lower clearance and higher repopulation rate after treatment with ivermectin. Molecular assays displayed higher sensitivity in monitoring O. volvulus microfilaridemia within six months following treatment.
Incidence of Idiopathic Cardiomyopathy in Patients with Type 2 Diabetes in Taiwan: Age, Sex, and Urbanization Status-stratified Analysis
Authors: Chen Hua-Fen Chen , Chang Ya-Hui , Lo Hsien-Jung Lo , Isfandiari Atoillah , Martini Santi , Hou Wen-Hsuan , Li Chung-Yi
Published: September 2020

Background: The epidemiology of diabetes and idiopathic cardiomyopathy have limited data. We investigated the overall and the age-, sex-, and urbanization-specific incidence and relative hazard of idiopathic cardiomyopathy in association with type 2 diabetes and various anti-diabetic medications used in Taiwan.Methods: A total of 474,268 patients with type 2 diabetes were identified from ambulatory care and inpatient claims in 2007-2009 from Taiwan’s National Health Insurance (NHI) database. We randomly selected 474,266 age-, sex-, and diagnosis date-matched controls from the registry of NHI beneficiaries. All study subjects were linked to ambulatory care and inpatient claims (up to the end of 2016) to identify the possible diagnosis of idiopathic cardiomyopathy. The person-year approach with Poisson assumption was used to estimate the incidence, and Cox proportional hazard regression model with Fine and Gray’s method was used to estimate the relative hazards of idiopathic cardiomyopathy in relation to type 2 diabetes.Results: The overall incidence of idiopathic cardiomyopathy for men and women patients, respectively, was 3.83 and 2.94 per 10,000 person-years, which were higher than the corresponding men and women controls (2.00 and 1.34 per 10,000 person-years). Compared with the control group, patients with type 2 diabetes were significantly associated with an increased hazard of idiopathic cardiomyopathy (adjusted hazard ratio [aHR]: 1.60, 95% confidence interval [CI]: 1.45-1.77] in all age and sex stratifications except in those men aged >64 years. Patients with type 2 diabetes aged <45 years confronted the greatest increase in the hazard of idiopathic cardiomyopathy, with an aHR of 3.35 (95% CI: 2.21-5.06) and 3.48 (95% CI: 1.60-7.56) for men and women, respectively. The usage of some anti-diabetic medications revealed lower risks of idiopathic cardiomyopathy.Conclusions: In Taiwan, diabetes increased the risk of idiopathic cardiomyopathy in both sexes and in all age groups, except in men aged >64 years. Younger patients were vulnerable to have higher HRs of idiopathic cardiomyopathy. Some anti-diabetic medications may reduce the risks of cardiomyopathy.
125 I seeds irradiation inhibits tumor growth and induces apoptosis by Ki-67, P21, Survivin，Livin and Caspase-9 expression in lung carcinoma xenografts
Authors: Jin Qing , Lin Cunzhi , Zhu Xinhong , Cao Yiwei , Guo Caihong , Wang Lijun
Published: September 2020

Background: Lung cancer is a fatal disease and a serious health problem worldwide. Patients are usually diagnosed at an advanced stage, and the effectiveness of chemotherapy for such patients is very limited. Iodine 125 seed(125I) irradiation can be used as an important adjuvant treatment for lung carcinoma. The purpose of this study was to examine the role of irradiation by 125I seeds in human lung cancer xenograft model and to determine the underlying mechanisms involved, with a focus on apoptosis. Methods: 40 mice with A549 lung adenocarcinoma xenografts were randomly divided into 4 groups: control group (n=10), sham seed (0 mCi) implant group (n=10), 125I seed (0.6 mCi) implant group (n=10) and 125I seed (0.8 mCi) implant group (n=10), respectively. The body weight and tumor volume, were recorded every four days until the end of the study. Apoptotic cells were checked by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay and activities of caspase-3 and caspase-8 enzyme were tested. Expression of P21, survivin, livin, caspase-9 and proliferating cell nuclear antigen (Ki-67) was detected with immunohistochemical staining. Results: The results of TUNEL staining assays showed that 125I seed irradiation suppresses the growth of lung cancer xenografts in nude mice and induced apoptosis. The activity of caspase-3 and caspase-8 was significantly higher. The expression levels Ki67, survivin and livin were substantially downregulated, while P21 and caspase-9 protein expression were significantly increased following 125I seed irradiation. This study revealed that 125I seed irradiation could significantly change apoptosis-related protein in human lung cancer xenografts. Conclusions: Overall, our study demonstrates that radiation exposure by 125I seedscould be a new treatment option for lung cancer.
Slow radiological improvement and persistent low-grade inflammation after chemotherapy in tuberculosis patients with type 2 diabetes
Authors: Mily Akhirunnesa , Sarker Protim , Taznin Inin , Hossain Md. Delwar , Haq Md. Ahsanul , Kamal SM. Mostofa , Agerberth Birgitta , Brighenti Susanna , Raqib Rubhana
Published: September 2020

Background: Diabetes mellitus type 2 (DM) may impede immune responses in tuberculosis (TB) and thus contribute to enhanced disease severity. In this study, we aimed to evaluate DM-mediated alterations in clinical, radiological and immunological outcomes in TB disease.Methods: Newly diagnosed pulmonary TB patients with or without DM (TB n=40; TB-DM n=40) were recruited in Dhaka, Bangladesh. Clinical symptoms, sputum smear and culture conversion as well as chest radiography were assessed. Peripheral blood and sputum samples were collected at the time of diagnosis (baseline) and after 1, 2 and 6 months of standard anti-TB treatment. Blood samples were also obtained from healthy controls (n=20). mRNA expression of inflammatory markers in blood and sputum samples were quantified using real-time PCR.Results: The majority of TB-DM patients had poor glycemic control (HbA1c>8%) and displayed elevated pulmonary pathology (P=0.039) particularly in the middle (P<0.004) and lower lung zones (P<0.02) throughout the treatment period. However, reduction of clinical symptoms and time to sputum smear and culture conversion did not differ between the groups. Transcripts levels of the pro-inflammatory cytokines IL-1β (P=0.003 at month-1 and P=0.045 at month-2) and TNF-α (P=0.005 at month-1) and the anti-inflammatory cytokine IL-10 (P=0.005 at month-2) were higher in peripheral blood after anti-TB treatment in TB-DM compared to TB patients. Conversely in sputum, TB-DM patients had reduced CD4 (P<0.009 at month-1) and IL-10 (P=0.005 at month-1 and P=0.006 at month-2) transcripts, whereas CD8 was elevated (P=0.016 at month-2). At 1- and 2-months post-treatment, sputum IL-10 transcripts were inversely correlated with fasting blood glucose and HbA1C levels in all patients. Conclusion: Insufficient up-regulation of IL-10 in the lung may fuel persistent local inflammation thereby promoting lung pathology in TB-DM patients with poorly controlled DM.
Barriers and Facilitators to Colorectal Cancer Diagnosis in New Zealand: A Qualitative Study
Authors: Blackmore Tania , Norman Kimberley , Kidd Jacquie , Cassim Shemana , Chepulis Lynne , Keenan Rawiri , Firth Melissa , Jackson Christopher , Stokes Tim , Weller David , Emery Jon , Lawrenson Ross
Published: September 2020

Background: New Zealand (NZ) has high rates of colorectal cancer but low rates of early diagnosis. Due to a lack of understanding of the pre-diagnostic experience from the patient’s perspective, it is necessary to investigate potential patient and health system factors that contribute to longer diagnostic intervals. Previous qualitative studies have discussed delays using The Model of Pathways to Treatment, but this has not been explored in the NZ context. This study aimed to understand the patient experience and perception of their general practitioner (GP) through the diagnostic process in the Waikato region of NZ. In particular, we sought to investigate potential barriers and facilitators that contribute to longer diagnostic intervals. Methods: Ethical approval for this study was granted by the New Zealand Health and Disability Ethics Committee. Twenty-eight participants, diagnosed with colorectal cancer, were interviewed about their experience. Semi-structured interviews were audio recorded, transcribed verbatim and analysed thematically using The Model of Pathways to Treatment framework (intervals: appraisal, help-seeking, diagnostic). Results: Participant appraisal of symptoms was a barrier to prompt diagnosis, particularly if symptoms were normalised, intermittent, or isolated in occurrence. Successful self-management techniques also resulted in delayed help-seeking. However if symptoms worsened, disruption to work and daily routines were important facilitators to seeking a GP consultation. Participants positively appraised GPs if they showed good technical competence and were proactive in investigating symptoms. Negative GP appraisals were associated with a lack of physical examinations and misdiagnosis, and left participants feeling dehumanised during the diagnostic process. However high levels of GP interpersonal competence could override poor technical competence, resulting in an overall positive experience, even if the cancer was diagnosed at an advanced stage. Māori participants often appraised symptoms inclusive of their sociocultural environment and considered the impact of their symptoms in relation to family. Conclusions: The findings of this study highlight the importance of tailored colorectal cancer symptom communication in health campaigns, and indicate the significance of the interpersonal competence aspect of GP-patient interactions. These findings suggest that interpersonal competence be overtly displayed in all GP interactions to ensure a higher likelihood of a positive experience for the patient.
Predicting Target Profiles with Confidence as a Service using Docking Scores
Authors: Ahmed Laeeq , Alogheli Hiba , Arvidsson Staffan , Alvarsson Jonathan , Berg Arvid , Larsson Anders , Schaal Wesley , Laure Erwin , Spjuth Ola
Published: September 2020

Background: Identifying and assessing ligand-target binding is a core component in early drug discovery asone or more unwanted interactions may be associated with safety issues.Contributions: We present an open-source, extendable web service for predicting target profiles withconfidence using machine learning for a panel of 7 targets, where models are trained on molecular dockingscores from a large virtual library. The method uses conformal prediction to produce valid measures ofprediction efficiency for a particular confidence level. The service also offers the possibility to dock chemicalstructures to the panel of targets with QuickVina on individual compound basis.Results: The docking procedure and resulting models were validated by docking well-known inhibitors for eachof the 7 targets using QuickVina. The model predictions showed comparable performance to molecular dockingscores against an external validation set. The implementation as publicly available microservices on Kubernetesensures resilience, scalability, and extensibility
Malaria Risks Related to Poor Practices in the Use of Mosquito Bite Control Tools During The Cold and Hot Seasons
Authors: Sominahouin André , Dagnon Fortuné , Padonou Gil , Aikpon Rock , N'tcha Ludovic , Akinro Bruno , Salako Albert , Agossa Fiacre , Gbenou Dina , Odjo Esdras , Houssou Christophe , Akogbeto Martin
Published: September 2020

Background: It is generally accepted that one of the reasons for the declining effectiveness of vector control tools (LLINs, IRS) is the misuse of these tools. Some people sleep outside while the walls of houses are treated with insecticide to protect people from mosquito bites.Methods:To check whether communities that misuse these tools are more exposed to malaria, we used the technique of direct and participatory observation of sleeping habits and we clocked every 30 min, the activities and positions of the communities from 7pm to 7am. The survey was conducted in 3 departments Northern Benin. These were mainly treatments related to variance analysis and descriptive statistics. Softwares used included SPSS 21, SAS 9.2 and Arcgis 10.4.Results: The study shows that 95% of the villages population included in the study stay in their rooms from 7:00 pm to 7:00 am, and only 5% of household members are outdoors during same time intervals during the harmattan season. On the other hand, during hot weather, there are more households outdoors (37%). Less than 20% of household members are outside their rooms during the harmattan season. This number decreases gradually until 10:00 pm when all of them are inside their rooms.Student Newman Keuls test shows that the household members being inside or outside their rooms does not depend on the urbanization situation of the village, but rather on the period.65% exposed to mosquito bites gave irritation as the main reason for their behavior and 15% because of heat and lack of space. Overall, because of household member mobility and malaria vector behaviors, human exposure to An. gambiae was higher outside than inside, despite all the observed food preferences in the vectors.Conclusion:To curtail residual malaria transmission, it must be prioritized to raise awareness in the best use of the tools and provide other complementary control tools for use outside the home.
Kinetic changes in virology, specific antibody response and imaging during the clinical course of COVID-19: A descriptive study
Authors: Wang Qiu-jing , Yao Yan-zhen , Song Jun-shuai , Wang Qiao , Xu Li-yun , Bao Zhou-jun , Mao Dai-wen , Zhou Ji-hang , Zhang Zhe-en , Wang Yan , Li Yi-wei , Wang He-ping , Li Lue , Pan Hai-yan , Zhang Guo-qiang , Li Shi-bo
Published: September 2020

Background: To explore the kinetic changes in virology, specific antibody response and imaging during the clinical course of COVID-19.Methods: This observational study enrolled 20 patients with COVID-19, who were hospitalized between January 20-April 6, 2020, in the two COVID-19 designated hospitals of Zhoushan, Zhejiang and Rushan, Shandong, China, The laboratory findings, imaging, serum response to viral infection, and viral RNA level in the throat and stool samples were assessed from onset to recovery phase in patients with COVID-19. Results: SARS-COV-2 RNA was positive as early as day four. It remained positive until day 55 post-onset in the sputum-throat swabs and became negative in most cases (55%) within 14 days after onset. Lymphocytopenia occurred in 40% (8/20) of patients during the peak infection period and returned to normal at week five. The most severe inflammation in the lungs appeared in week 2 or 3 after onset, and this was completely absorbed between week 6 and 8 in 85.7% of patients. All patients had detectable antibodies to the receptor binding domain (RBD), and 95% of these patients had IgG to viral N proteins. The antibody titer peaked at week four. Anti-S IgM was positive in 7 of 20 patients after week three. Conclusions: All COVID-19 patients in this cohort were self-limiting and recovered well though it may take as long as 6-8 weeks. Our findings on the kinetic changes in imaging, serum response to viral infection and viral RNA level may help understand pathogenesis and define clinical course of COVID-19.
Promoting Social Capital, Self-management and Health Literacy in Older Adults Through a Group-based Intervention Delivered in Low-income Urban Areas: Results of the Randomized Trial AEQUALIS
Authors: Blancafort Sergi , Nadal Rosa Monteserín , Moral Irene , Fígols Marta Roqué , Luque Xavier Rojano i , Coll-Planas Laura
Published: September 2020

BackgroundEvidence is scarce on how to promote health and decrease cumulative inequalities for disadvantaged older people. Downstream complex interventions focusing on intermediate factors (self-management, health literacy and social capital) may have the potential to mitigate the inequitable impacts of social determinants in health. The aim of the AEQUALIS study was to assess the effectiveness of a group-based intervention to improve self-perceived health as indicator of health inequality. MethodsPragmatic randomised clinical trial addressed to older adults (≥ 60 years) living in urban disadvantaged areas with low self-perceived health. The intervention was delivered in primary care settings and community assets between 2015-2017 and consisted in 12 weekly sessions. The primary outcome was self-perceived health assessed in two ways: with the first item of the SF-12 questionnaire, and with the EQ-5D visual analog scale. Secondary outcomes were health-related quality of life, social capital, self-management, mental health and use of health services. Outcomes were assessed at baseline, post intervention and follow-up at 9 months after the end of the intervention. Results390 people were allocated to the intervention group (IG) or the control group (CG) and 194 participants and 164 were included in the data analysis, respectively. Self perceived health as primary outcome assessed with SF-12-1 was not specifically affected by the intervention, but with the EQ-5D visual analog scale showed a significant increase at one-year follow-up only in the IG (MD=4.80, 95%CI [1.09, 8.52]). IG group improved health literacy in terms of a better understanding of medical information (-0.62 [-1.10, -0.13]). The mental component of SF-12 improved (3.77 [1.82, 5.73]), and depressive symptoms decreased at post-intervention (-1.26 [-1.90, -0.63]), and at follow-up (-0.95 [-1.62, -0.27]). The use of antidepressants increased in CG at the follow-up (1.59 [0.33, 2.86]), while it remained stable in the IG. ConclusionsThis study indicates that a group intervention with a strong social component, conducted in primary health care and community assets, shows promising effects on mental health and can be used as a strategy for health promotion among older adults in urban disadvantaged areas.Trial registration: ClinicalTrials.gov, NCT02733523. Registered 11 April 2016 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02733523
Repercussions of the COVID-19 Pandemic on the Well-being and Training of Medical Clerks: A Pan-Canadian Survey
Authors: Abbas Myriam , Dhane Malek , Beniey Michèle , Meloche-Dumas Léamarie , Eissa Mohamed , Guérard-Poirier Natasha , El-Raheb Myriam , Lebel-Guay Florence , Dubrowski Adam , Patocskai Erica
Published: September 2020

Background: The COVID-19 pandemic has been an unprecedented and potentially stressful event that inserted itself into the 2019-2020 Canadian medical curriculum. However, its impact on stress and subsequent professional pathways is not well understood. This study aims to assess the impact of the COVID-19 pandemic on the mental well-being, training, and career choices of Canadian medical clerks within the first three months of the pandemic. It also aims to assess their use of university support systems and their appreciation of potential solutions to common academic stressors.Methods: An electronic survey composed of four sections: demographics, stressors experienced during the pandemic, World Health Organization (WHO) well-being index, and stress management and resources was distributed to Canadian clerks. Results: Clerks from 10 of the 17 Canadian medical faculties participated in this study (n=627). Forty-five percent of clerks reported higher levels of stress than usual; 22% reconsidered their residency choice; and 19% reconsidered medicine as a career. The factors that were most stressful among clerks were: the means of return to rotations; decreased opportunities to be productive in view of residency match; and taking the national licensing exam after the beginning of residency. The mean WHO well-being index was 14.8/25 ± 4.5, indicating a poor level of well-being among a considerable proportion of students. Clerks who reconsidered their residency choice or medicine as a career had lower mean WHO well-being indices. Most clerks agreed with the following suggested solutions: training sessions on the clinical management of COVID-19 cases; being allowed to submit fewer reference letters when applying to residency; and having protected time to study for their licensing exam during residency. Overall, clerks were less concerned with being infected during their rotations than with the impact of the pandemic on their future career and residency match. Conclusion: The COVID-19 pandemic had a considerable impact on the medical curriculum and well-being of clerks. A number of student-identified solutions were proposed to reduce stress. The implementation of these solutions throughout the Canadian medical training system should be considered.
Clinical outcomes of acute pulmonary embolectomy as the first-line treatment for massive and submassive pulmonary embolism：a single-centre study in China
Authors: Qimin Wang , Liangwan Chen , Daozhong Chen , Hanfan Qiu , Zhongyao Huang , Xiaofu Dai , Xueshan Huang , Feng Lin , Huabin Chen
Published: September 2020

Background: Acute pulmonary embolism (PE) is one of the most critical cardiovascular diseases. PE treatment ranges from anticoagulation, and systemic thrombolysis to surgical embolectomy and catheter embolectomy. Surgical pulmonary embolectmy (SPE) indications and outcomes are still controversial. Although there have been more favourable SPE reports over the past decades, SPE has not yet been considered broadly as an initial PE therapy and is still considered as a reserve or rescue treatment for acute massive PE when systemic thrombolysis fails. This study aimed to evaluate the early and midterm outcomes of SPE, which was a first-line therapy for acute central major PE in one Chinese single centre. Methods: A retrospective review of patients who underwent SPE for acute PE was conducted .Patients with chronic thrombus or who underwent thromboendarterectomy were excluded. SPE risk factors for morbidity and mortality were reviewed, and echocardiographic examination were conducted for follow-up studies to access right ventricular functionResults: Overall, 41 patients were included; 17 (41.5%) had submassive PE, and 24 (58.5%) had massive PE. Mean cardiopulmonary bypass time was 103.2±48.9 min, and 10 patients (24.4%) underwent procedures without aortic cross-clamping . Ventilatory support time was 78 h (range, 40-336 h), intensive care unit stay was 7 days (range, 3-13 days), and hospital stay was 16 days (range, 12-23 days).Operative mortalities occurred in 3 massive PE patients, and no mortality occurred in submassive PE patients. The overall SPE mortality rate was 7.31% (3/41). If two systemic thrombolysis cases were excluded, SPE mortality was low (2.56%,1/39), evenlthough there were 2 cases of cardiac arrest preoperatively. Patients’ right ventricle function improved postoperatively in follow-ups .There were no deaths related to recurrent PE and chronic pulmonary hypertension in follow-ups, though 3 patients died of cerebral intracranial bleeding, gastric cancer,and brain cancer at 1 year, 3 years, and 8 years postoperatively, respectively. Conclusions: SPE presented with a low mortality rate when rendered as a first-line treatment in selected massive and submassive acute PE patients. Favorable outcomes of right ventricle function were also observed in the follow-ups . SPE should play the same role as ST in algorithmic acute PE treatment.