bluuebunny/crossref_metadata_2025 huggingface dataset:
Laser fluorescence as an alternative for digital radiography in detecting caries lesions
Authors: Moreira Lucila Massu Yoshizaki Akinaga , Amarante Bruna Cordeiro , Marotta Bruno Munhoz , Iida Christyan Hiroshi , Nishimura Danielle Ayumi , Schumiski Suelen , Costa Claudio
Published: September 2020

Diagnosis of caries lesions consists of visual/tactile methods following the International Caries Detection and Assessment System (ICDAS) and radiographic methods (BW), however these methods have limitations for detecting caries at different depths and locations and is usually influenced by the examiner’s experience. New technologies have emerged to improve caries diagnosis methods, among these are methods that use optical principles to quantify differences between healthy and demineralized tissues, for example: quantitative light- -induced fluorescence (QLF), the “DIAGNOdent” caries detection pen, and VistaProof (fluorescence camera). This literature review aims to provide up-to-date information on the applicability of fluorescence-based methods in the diagnosis of caries. The results show that DIAGNOdent pen was the most effective method for diagnosing caries, wherein some authors indicate that it can be used as the only diagnostic method, but most recommend using it as a complementary method to ICDAS and BW. LFpen must be used in association with ICDAS and 2 articles indicate near-infrared light transillumination (NILT) as a substitute for BW, however there is still a need for further studies to reach a concrete decision. In conclusion, digital methods for the diagnosis of caries are efficient, but they do not replace visual/tactile methods and bitewing radiographs. Therefore, they should be used as a complementary diagnostic method to those already known and widely used and studied.
Soft Liner with antimicrobial activity
Authors: Kreve Simone , Vidal Carla Larissa , Alves Oswaldo Luiz , Reis Andréa Cândido dos
Published: September 2020

Objective: To develop a material for denture relining and assess the microbiological and mechanical properties. The proposed liner was obtained through the incorporation of nanostructured silver vanadate (AgVO3) at 0, 1, 2.5, 5, and 10% polyethyl methacrylate (PEMA) containing plasticizer. Methods: Antimicrobial efficacy was evaluated by the Kirby Bauer agar method against Enterococcus faecalis, Pseudomonas aeruginosa, Candida albicans and Staphyloccocus aureus (n = 5); and mechanical properties were also assessed through roughness, such as Shore A hardness and tensile test. The results were analyzed by ANOVA and Tukey’s Multiple Comparison test (α = 0.05). Results: The material with AgVO3 at concentrations of 1% and 2.5% showed antimicrobial activity for E. faecalis, and 5% and 10% groups were effective for E. faecalis, P. aeruginosa and C. albicans. In the 5% group, hardness remained unchanged (p < 0.001). None of the tested concentrations significantly changed the roughness and the tensile strength (P > 0.05). Conclusion: Obtaining the material with antimicrobial potential promoted efficacy against E. faecalis, P. aeruginosa and C. albicans, kept the roughness property unchanged, did not change the adhesion property of the material to polymethyl methacrylate, and it maintained the hardness values compatible with resilient denture liners.
Psicanálise e literatura - Imre Kertész e o desterro humano
Authors: Spiry Zsuzsanna
Published: September 2020

No dia 23 de outubro de 2015, coincidindo com a celebração do 59º aniversáriodo levante húngaro contra o regime stalinista ocorrido em 1956, o Instituto dePsicologia da USP, através de seu Departamento de Psicologia Clínica, promoveuo lançamento do livro, em formato e-book, organizado por José Alberto Cottae Gilberto Safra: Psicanálise e Literatura – Imre Kertész e o desterro humano.Entre diversos convidados, deram seus depoimentos a professora Sarolta Kóbori,responsável por ministrar o curso de língua e cultura húngara na FFLCH/USP, ePaulo Schiller, psicanalista e tradutor, entre outros, de Imre Kertész.
Entrevista com Giorgio De Marchis e Gian Luigi De Rosa: tradução al di là dell’oceano
Authors: Cricelli Francesca
Published: September 2020

Nós, da Cadernos de Literatura em Tradução, decidimos apresentar uma entrevista que passa pelo caminho inverso, ou no contrafluxo do caminho ‘de/ para’ comumente tomado nas entrevistas feitas com tradutores. Nesta edição, convidamos os professores e tradutores italianos Giorgio De Marchis e Gian Luigi De Rosa para conversarem conosco sobre sua experiência na tradução do português para o italiano. Colhemos o momento do lançamento do livro de ensaios de Haroldo de Campos Traduzione, Transcreazione Saggi pela editora Oèdipus, na Itália, volume organizado por Andrea Lombardi e traduzido por ele junto a Gaetano D’Itria, para conversar com nossos entrevistados também sobre o legado de Haroldo al di là dell’oceano. Para De Marchis, a obra de Haroldo é um autêntico desafio hermenêutico ao qual se deve retornar periodicamente. Já De Rosa nos lembra que através de Haroldo percebe-se que a tradução não é somente a “transposição” de signos verbais, mas também a passagem de uma língua-cultura para outra.
Diagnosis of Transient Ischemic Attack
Authors: Gocan Sophia , Fitzpatrick Tess , Wang Chu Qi , Taljaard Monica , Cheng Wei , Bourgoin Aline , Dowlatshahi Dar , Stotts Grant , Shamy Michel
Published: September 2020

Background and Purpose:

Research suggests that women and men may present with different transient ischemic attack (TIA) and stroke symptoms. We aimed to explore symptoms and features associated with a definite TIA/stroke diagnosis and whether those associations differed by sex.

Methods:

We completed a retrospective cohort study of patients referred to The Ottawa Hospital Stroke Prevention Clinic in 2015. Exploratory multinomial logistic regression was used to evaluate candidate variables associated with diagnosis and patient sex. Backwards elimination of the interaction terms with a significance level for staying in the model of 0.25 was used to arrive at a more parsimonious model.

Results:

Based on 1770 complete patient records, sex-specific differences were noted in TIA/stroke diagnosis based on features such as duration of event, suddenness of symptom onset, unilateral sensory loss, and pain.

Conclusions:

This preliminary work identified sex-specific differences in the final diagnosis of TIA/stroke based on common presenting symptoms/features. More research is needed to understand if there are biases or sex-based differences in TIA/stroke manifestations and diagnosis.
Nested Named Entity Recognition via Second-best Sequence Learning and Decoding
Authors: Shibuya Takashi , Hovy Eduard
Published: September 2020

When an entity name contains other names within it, the identification of all combinations of names can become difficult and expensive. We propose a new method to recognize not only outermost named entities but also inner nested ones. We design an objective function for training a neural model that treats the tag sequence for nested entities as the second best path within the span of their parent entity. In addition, we provide the decoding method for inference that extracts entities iteratively from outermost ones to inner ones in an outside-to-inside way. Our method has no additional hyperparameters to the conditional random field based model widely used for flat named entity recognition tasks. Experiments demonstrate that our method performs better than or at least as well as existing methods capable of handling nested entities, achieving F1-scores of 85.82%, 84.34%, and 77.36% on ACE-2004, ACE-2005, and GENIA datasets, respectively.
George Graham and the Orrery
Authors: McEvoy Rory
Published: September 2020

In his 1734 discourse on the planetarium, John Theophilus Desaguliers was careful to point out that the invention of the orrery had been incorrectly attributed to John Rowley and that it was George Graham who had made the first truthful working model of the Earth and Moon’s motion around the Sun. Two such models by Graham survive in Museum collections: one at the Adler Planetarium in Chicago and the other at the History of Science Museum in Oxford, UK. This paper assesses the differences between the two instruments and the physical evidence contained within to test out the unfounded assertion made by Henry C. King that the Adler instrument is the prototype and the Oxford orrery a developed commercial product.
Francesco Bianchini (1662–1729) and the Origins of Planetary Globes
Authors: Tirapicos Luís , Horst Thomas
Published: September 2020

The Veronese astronomer Francesco Bianchini (1662–1729) was a prominent figure at the papal court in the pontificates of Clement XI (pp. 1700–1721), Innocent XII (pp. 1721–1724), and Benedict XIII (pp. 1724–1730). In his influential treatise Hesperi et Phosphori Nova Phaenomena sive Observationes circa Planetam Veneris, published in Rome in 1728, he presents the first cartographical depiction of Venus, containing the gores for a globe. Bianchini also produced at least four Venus globes of which two still exist as original models in Paris (BNF) and Bologna (Museo della Specola). With this set of globes, Bianchini provided the first identified three-dimensional model of a planet (if we exclude earlier cartographical examples of the Earth and the Moon). In this article we address the conceptual and technological changes permitting the emergence of planetary globes.
Geometry and the Making of Utopian Knowledge in Early Modern Europe
Authors: Chen-Morris Raz
Published: September 2020

In his Della Pittura, Leon Battista Alberti initiated what I call a “utopian moment,” a philosophical and practical disposition fusing human ingenuity, geometry, and political harmony. This paper follows these notions as they evolved over the course of the sixteenth century and were embraced by the new science of Johannes Kepler and René Descartes, who reshaped these utopian dispositions with their new geometrical analyses of sight and light. In his Dioptrice, Kepler suggests a new science of refractions produced and manipulated artificially through lenses, their physical properties analyzed geometrically; in analyzing the rainbow, Descartes artificially reproduces it, initially through a glass flask filled with water, and then through a prism, thus giving a geometrical causal account of its colors. In both cases these analyses are entwined with subtle political metaphors, transforming the technical scientific issues into key features of a “utopian moment.”
The Iran Nuclear Crisis, the Lessons of Westphalia and the Value of Biased Mediation
Authors: Wolf Albert
Published: September 2020

In this paper, I examine one component of the Peace of Westphalia: the use of biased or non-neutral mediators. Biased mediators made a significant, but not the only, contribution to the Peace of Westphalia. Contrary to the received wisdom, biased mediators can be effective in forging peace because they have a vested interest in the success or failure of a settlement, whereas neutral mediators do not have the same stakes at play. I examine the role biased mediators may play in the ongoing nuclear crisis between the U.S. and Iran.
Three new species of Protosticta Selys, 1885 (Odonata: Zygoptera: Platystictidae) from the Western Ghats, India, with taxonomic notes on P. mortoni Fraser, 1922 and rediscovery of P. rufostigma Kimmins, 1958
Authors: JOSHI SHANTANU , SUBRAMANIAN K.A. , BABU R. , SAWANT DATTAPRASAD , KUNTE KRUSHNAMEGH
Published: September 2020

Three new species of Protosticta Selys, 1885 (Odonata: Zygoptera: Platystictidae) from the Western Ghats biodiversity hotspot in India: P. cyanofemora sp. nov. (wet evergreen forests in Shendurney Wildlife Sanctuary, Kollam, Kerala and Kalakkad Mundanthurai Tiger Reserve, Tirunelveli, Tamil Nadu), P. myristicaensis sp. nov. (Myristica swamp at Kathalekan, Shivamogga, Karnataka) and P. sholai sp. nov. (montane sholas of Upper Manalar, Meghamalai Wildlife Sanctuary, Theni, Tamil Nadu) are described and illustrated. We compare these three new species with other Protosticta spp. from the Western Ghats based on new material and provide comprehensive differential diagnoses with determination key for males of all species occurring in the Western Ghats. The taxonomic validity of P. mortoni Fraser, 1922 is established with fresh specimens from Hassan, Karnataka, and rediscovery of P. rufostigma Kimmins, 1958 is reported from Kanyakumari Wildlife Sanctuary, Tamil Nadu.
Five new species of the Neotropical genus Venezolanoconnus Franz (Coleoptera, Staphylinidae, Scydmaeninae)
Authors: JAŁOSZYŃSKI PAWEŁ
Published: September 2020

Five hitherto known species of Venezolanoconnus Franz are distributed in Colombia, Costa Rica, and Venezuela. This number is doubled by describing V. meridanus sp. n. (Venezuela), V. minimus sp. n. (Venezuela), V. bejumanus sp. n. (Venezuela), V. colombianus sp. n. (Colombia), and V. ecuadoranus sp. n. (Ecuador). All nominal species occur within the American Cordillera, mainly in the northern Andes.
The impact of reduced sleep on school related outcomes for typically developing children aged 11–19: A systematic review
Authors: Hayes Ben , Bainton Josie
Published: September 2020

This systematic literature review examines the relationship between restricted and reduced sleep and school performance, learning and cognitive functioning in typically developing adolescents. Correlational and experimental data were evaluated from 17 studies which included participants ranging from 11 to 19 years in studies from seven countries around the world. The review found that there is evidence that restricted and reduced sleep is negatively associated with school performance and cognitive outcomes, although the findings were mixed. Implications for psychologists working with schools are discussed. More research and evaluation is needed to establish how these factors relate to each other conclusively.
Development and Validation of the Nurse Prescribing Self-Efficacy Scale
Authors: Galiana-Camacho Teresa , Ruiz-Fernandez María Dolores , Dobarrio-Sanz Iria , Granero-Molina José , Fernandez-Sola Cayetano , Hernandez-Padilla José Manuel
Published: September 2020

Low self-efficacy is a barrier to effective nurse prescribing. Therefore, nurses’ self-efficacy should be assessed using validated tools. We aimed to develop and psychometrically test the Nurse Prescribing Self-Efficacy Scale (NP-SES). We conducted an observational cross-sectional study with 290 nurses between January and June 2019. We studied the NP-SES’ reliability (i.e., internal consistency and temporal stability), validity (i.e., content, criterion, and construct) and legibility. The NP-SES showed good internal consistency (Cronbach’s alpha=0.958) and temporal stability (intraclass correlation coefficient=0.783). The NP-SES also showed good content validity (scale’s content validity index=0.98) and criterion validity ( r=0.75; p<0.001). Construct validity analysis revealed the NP-SES’ three-dimensional structure and showed its ability to detect significant differences between nurses with different levels of experience. Our psychometric analysis suggests that the NP-SES is a reliable and valid instrument that could be used to assess nurses’ self-efficacy in nurse prescribing.
Illicit drug use and sexually transmitted infections among young adults in the US: evidence from a nationally representative survey
Authors: Haider Mohammad Rifat , Kingori Caroline , Brown Monique J , Battle-Fisher Michele , Chertok Ilana Azulay
Published: September 2020

Young people aged 15–24 years account for half of all new sexually transmitted infections (STIs) in the United States. The aim of this study was to examine the cross-sectional associations of factors linked to STIs among US young adults (18–25 years). This study used the 2015–2018 pooled National Survey on Drug Use and Health data on 55,690 young adults. Almost 3.4% of the respondents reported having an STI in the past year. Among the participants, 38.4% used illicit drugs and 3.7% reported a history of delinquency in the past year. In the survey-weighted logistic regression model, odds for contracting STIs in the preceding year was higher among adults aged 22–25 versus 18–21 years (OR:1.26, 95%CI:1.12–1.42); male versus female (OR:2.44, 95%CI:2.11–2.82); non-Hispanic African American versus non-Hispanic White (OR:1.77, 95%CI:1.55–2.02); widowed/separated/divorced (OR:1.93, 95%CI:1.36–2.75) and never married (OR:1.29, 95%CI:1.07–1.55) versus married; full-time/part-time employed (aOR:1.17, 95% CI:1.04–1.31) compared to unemployed/other; history of delinquency (OR:2.31, 95%CI:1.89–2.83); and use of illicit drugs in the last year (OR:3.10, 95%CI:2.77–3.47). High incidence of illicit drug use by the young adults and its strong association with STI incidence in recent years warrant special attention. Tailored preventive measures should be focused on key predictors.
Transient characteristics of internal flow fields of mixed-flow pump with different tip clearances under stall condition
Authors: Ji Leilei , Li Wei , Shi Weidong , Agarwal Ramesh
Published: September 2020

This paper investigates the influence of different tip clearances on the transient characteristics of mixed-flow pump under stall condition. The instantaneous internal flow fields of mixed-flow pump with four tip clearances (0.2 mm, 0.5 mm, 0.8 mm and 1.1 mm) are explored by conducting unsteady time accurate simulations. Reynolds-averaged Navier-Stokes (RANS) equations are employed in the simulations and the results of computations are compared with experimental data. The results show that the pump head decreases by 22.1% and the pump efficiency drops by 13.9% at design flow condition when the impeller tip clearance increases from 0.2 mm to 1.1 mm. The swirling flow occurs in the inlet pipe of the mixed-flow pump with different tip clearances under stall condition, and the initial starting point of the swirling flow gets further away from the impeller inlet with increase in tip clearance because of increase in circumferential velocity and change in momentum of the tip leakage flow (TLF). The high turbulent eddy dissipation (TED) regions in the flow are attributed to the TLF, swirling flow, back flow and stall vortex, and their intensity are affected by the change in tip clearance. The oscillating trend of time domain distribution of TED enhances first and then decreases with increase in tip clearance and it exhibits a propagation feature under the effect of stall vortex, while most of the energy in the frequency domain remains concentrated in the low frequency part under stall condition.
Quality of Life Using General Population Validated Questionnaires in Children With Cleft Lip and/or Palate in New Zealand
Authors: Thompson John M. D. , Ayrey S. Louise , Slykerman Rebecca F. , Stone Peter R. , Fowler Peter V.
Published: September 2020

Objective:

To determine the level of quality of life (QoL) in children with cleft lip and/or palate (CL/P) and whether this differs by cleft phenotype.

Design:

A cohort of children with CL/P born in New Zealand.

Setting:

A nationwide study of children born with CL/P and having primary surgery in New Zealand.

Participants:

Children with CL/P and their families (n = 397) who attended a cleft clinic between October 1, 2014, and September 30, 2017, and agreed to complete questionnaires on QoL.

Main Outcomes:

Primary outcomes were QoL from the PedsQL 4.0 core generic questionnaires and the PedsQL 2.0 Family impact scale.

Results:

Children with CL/P in New Zealand generally have a high QoL as assessed by the PedsQL. The impact of cleft phenotype had limited effects on the child, however there were significant impacts on parents and families. We found that the family impact scale differed by cleft phenotype with those with CL having the highest QoL and those with cleft palate the lowest, and this was consistent across QoL subscales. Quality of life improved as a whole by age, particularly in physical and cognitive functioning, as well as in the ability to undertake family activities.

Conclusions:

Children with CL/P have generally good levels of QoL in New Zealand, however cleft phenotype impacts on the level, with the lowest levels in those with cleft palate. Psychological support of children with cleft and their families should be an integral part of cleft care.
Early risk stratification of acute myocardial infarction using a simple physiological prognostic scoring system: insights from the REACP study
Authors: Li Dongze , Cheng Yisong , Yu Jing , Jia Yu , Li Fanghui , Zhang Qin , Chen Xiaoli , Gao Yongli , Wu Jiang , Ye Lei , Wan Zhi , Cao Yu , Zeng Rui
Published: September 2020

Background

A more accurate and simpler scoring systems for early risk stratification of acute myocardial infarction at admission can accelerate and improve decision-making.

Aim

To develop and validate a simple physiological prognostic scoring system for early risk stratification in patients with acute myocardial infarction.

Methods

Easily accessible physiological vital signs and demographic characteristics of patients with acute myocardial infarction at the time of presentation in the multicentre Retrospective Evaluation of Acute Chest Pain study were used to develop a multivariate logistic regression model predicting 12 and 24-month mortality. The study population consisted of 2619 patients from seven hospitals and was divided into a 70% sample for model derivation and a 30% sample for model validation. A nomogram was created to enable prospective risk stratification for clinical care.

Results

The simple physiological prognostic scoring system consisted of age, heart rate, body mass index and Killip class. The area under the receiver operating characteristic curve of the simple physiological prognostic scoring system was superior to that of several risk scoring systems in clinical use. Net reclassification improvement, integrated discrimination improvement and decision curve analysis of the derivation set also revealed superior performance to the Global Registry of Acute Coronary Events score, and the Hosmer–Lemeshow test indicated good calibration for predicting mortality in patient with acute myocardial infarction in the validation set (P = 0.612).

Conclusion

This simple physiological prognostic scoring system may be a useful risk stratification tool for early assessment of patients with acute myocardial infarction.
Performance and emission characteristics of a diesel engine employing straight vegetable oils from Vanuatu as fuels
Authors: Sisi Misel J , Ahmed M Rafiuddin , Rohindra David
Published: September 2020

The performance characteristics of the engine and the emission levels with Copra Oil (CPO), Virgin Coconut (cocos nucifera) Oil (VCO), Tamanu (calaphyllum inopyllum) Oil (TMO), and Nangae (canarium indicum) Oil (NGO) are presented. The oils, obtained from naturally grown trees in Vanuatu, were tested as straight vegetable oils (SVOs) in a Diesel engine and the results are compared with those of neat diesel. The oils were converted to their fatty-acid-methyl-esters (FAMEs) using gas chromatography to determine their fatty acid compositions. The brake thermal efficiency with SVOs was found to be comparable to diesel. The structure of the alkyl chain and the carbon-to-hydrogen ratio were also studied. All the oils have Palmitic acid, Capric acid, Caprylic acid, and Oleic acid as the major fatty acids. The CPO and VCO have higher amounts of Oleic acid, which acts as an additive and breaks up the interaction between the major fatty acids at higher temperatures, reducing the viscosity. Emissions of CO2 were lower while those of CO, NOx, and SO2 were higher with SVOs compared to diesel. The results indicate that the local SVOs are good and inexpensive substitute fuels for Vanuatu that can help the country meet the UN’s sustainable development goals.
Leveraging TCGA gene expression data to build predictive models for cancer drug response
Authors: Clayton Evan A. , Pujol Toyya A. , McDonald John F. , Qiu Peng
Published: September 2020

Background

Machine learning has been utilized to predict cancer drug response from multi-omics data generated from sensitivities of cancer cell lines to different therapeutic compounds. Here, we build machine learning models using gene expression data from patients’ primary tumor tissues to predict whether a patient will respond positively or negatively to two chemotherapeutics: 5-Fluorouracil and Gemcitabine.

Results

We focused on 5-Fluorouracil and Gemcitabine because based on our exclusion criteria, they provide the largest numbers of patients within TCGA. Normalized gene expression data were clustered and used as the input features for the study. We used matching clinical trial data to ascertain the response of these patients via multiple classification methods. Multiple clustering and classification methods were compared for prediction accuracy of drug response. Clara and random forest were found to be the best clustering and classification methods, respectively. The results show our models predict with up to 86% accuracy; despite the study’s limitation of sample size. We also found the genes most informative for predicting drug response were enriched in well-known cancer signaling pathways and highlighted their potential significance in chemotherapy prognosis.

Conclusions

Primary tumor gene expression is a good predictor of cancer drug response. Investment in larger datasets containing both patient gene expression and drug response is needed to support future work of machine learning models. Ultimately, such predictive models may aid oncologists with making critical treatment decisions.
Genetic diversity, evolution and selection in the major histocompatibility complex DRB and DQB loci in the family Equidae
Authors: Klumplerova Marie , Splichalova Petra , Oppelt Jan , Futas Jan , Kohutova Aneta , Musilova Petra , Kubickova Svatava , Vodicka Roman , Orlando Ludovic , Horin Petr
Published: September 2020

Background

The mammalian Major Histocompatibility Complex (MHC) is a genetic region containing highly polymorphic genes with immunological functions. MHC class I and class II genes encode antigen-presenting molecules expressed on the cell surface. The MHC class II sub-region contains genes expressed in antigen presenting cells. The antigen binding site is encoded by the second exon of genes encoding antigen presenting molecules. The exon 2 sequences of these MHC genes have evolved under the selective pressure of pathogens. Interspecific differences can be observed in the class II sub-region. The familyEquidaeincludes a variety of domesticated, and free-ranging species inhabiting a range of habitats exposed to different pathogens and represents a model for studying this important part of the immunogenome. While equine MHC class IIDRAandDQAloci have received attention, the genetic diversity and effects of selection onDRBandDQBloci have been largely overlooked. This study aimed to provide the first in-depth analysis of the MHC class IIDRBandDQBloci in theEquidaefamily.

Results

ThreeDRBand twoDQBgenes were identified in the genomes of all equids. The genesDRB2,DRB3andDQB3showed high sequence conservation, while polymorphisms were more frequent atDRB1andDQB1across all species analyzed.DQB2was not found in the genome of the Asiatic assesEquus hemionus kulanandE. h. onager. The bioinformatic analysis of non-zero-coverage-bases ofDRBandDQBgenes in 14 equine individual genomes revealed differences among individual genes. Evidence for recombination was found forDRB1,DRB2, DQB1andDQB2genes. Trans-species allele sharing was identified in all genes exceptDRB1. Site-specific selection analysis predicted genes evolving under positive selection both atDRBandDQBloci. No selected amino acid sites were identified inDQB3.

Conclusions

The organization of the MHC class II sub-region of equids is similar across all species of the family. Genomic sequences, along with phylogenetic trees suggesting effects of selection as well as trans-species polymorphism support the contention that pathogen-driven positive selection has shaped the MHC class IIDRB/DQBsub-regions in theEquidae.
Effects of electroencephalography and regional cerebral oxygen saturation monitoring on perioperative neurocognitive disorders: a systematic review and meta-analysis
Authors: Ding Lin , Chen Dong Xu , Li Qian
Published: September 2020

Background

Perioperative neurocognitive disorders (PND) is a common postoperative complication including postoperative delirium (POD), postoperative cognitive decline (POCD) or delayed neurocognitive recovery. It is still controversial whether the use of intraoperative cerebral function monitoring can decrease the incidence of PND. The purpose of this study was to evaluate the effects of different cerebral function monitoring (electroencephalography (EEG) and regional cerebral oxygen saturation (rSO2) monitoring) on PND based on the data from randomized controlled trials (RCTs).

Methods

The electronic databases of Ovid MEDLINE, PubMed, EMBASE, Cochrane Library database were systematically searched using the indicated keywords from their inception to April 2020. The odds ratio (OR) or mean difference (MD) with 95% confidence interval (CI) were employed to analyze the data. Heterogeneity across analyzed studies was assessed with chi-square test and I2 test.

Results

Twenty two RCTs with 6356 patients were included in the final analysis. Data from 12 studies including 4976 patients were analyzed to assess the association between the EEG-guided anesthesia and PND. The results showed that EEG-guided anesthesia could reduce the incidence of POD in patients undergoing non-cardiac surgery (OR: 0.73; 95% CI: 0.57–0.95; P = 0.02), but had no effect on patients undergoing cardiac surgery (OR: 0.44; 95% CI: 0.05–3.54; P = 0.44). The use of intraoperative EEG monitoring reduced the incidence of POCD up to 3 months after the surgery (OR: 0.69; 95% CI: 0.49–0.96; P = 0.03), but the incidence of early POCD remained unaffected (OR: 0.61; 95% CI: 0.35–1.07; P = 0.09). The remaining 10 studies compared the effect of rSO2 monitoring to routine care in a total of 1380 participants on the incidence of PND. The results indicated that intraoperative monitoring of rSO2 could reduce the incidence of POCD (OR 0.53, 95% CI 0.39–0.73; P < 0.0001), whereas no significant difference was found regarding the incidence of POD (OR: 0.74; 95% CI: 0.48–1.14; P = 0.17).

Conclusions

The findings in the present study indicated that intraoperative use of EEG or/and rSO2 monitor could decrease the risk of PND.

Trial registration

PROSPREO registration number: CRD42019130512.
Grisel’s syndrome: a case report on this rare pediatric disease and its anesthetic challenges
Authors: Reddy Kavya N. , Baig Shabaaz M. , Batra Meenu , Colodner Kevin , Madubuko Uchenna , Korban Anna , Pandya Shah Shridevi
Published: September 2020

Background

Grisel’s syndrome is a non-traumatic atlantoaxial subluxation associated with inflammatory conditions of the head and neck, which occurs primarily in children. Increased flexibility of the ligaments during inflammation is implicated in the pathogenesis of the subluxation between the axis and atlas. The potential sequelae may be severe, and early diagnosis and treatment of Grisel’s syndrome can prevent tragic outcomes.

Case presentation

We present a case of torticollis in an 8-year-old child. She had a two-week history of a streptococcal throat infection. The patient was treated with several different methods of conservative care, including muscle relaxation, cervical halter traction, and Halo application. However, the torticollis persisted. The patient then required surgical correction involving cervical spine fusion. She had no complications and experienced no reoccurrence of the torticollis to date.

Conclusion

Grisel’s syndrome is a pathology for which conservative management is successful in most cases. Cases requiring surgical intervention are rarely documented in the literature. Our case is significant, as in spite of aggressive conservative management, the patient required surgical correction. Patients requiring surgical management of Grisel’s syndrome may require additional anesthetic exposure for diagnostic interventions like magnetic resonance imaging or neck manipulations for closed reduction. We discuss the features of Grisel’s syndrome and specific anesthetic management considerations for procedures such as magnetic resonance imaging, application of cervical traction, and surgical correction of torticollis.
Semantic and cognitive tools to aid statistical science: replace confidence and significance by compatibility and surprise
Authors: Rafi Zad , Greenland Sander
Published: September 2020

Background

Researchers often misinterpret and misrepresent statistical outputs. This abuse has led to a large literature on modification or replacement of testing thresholds and P-values with confidence intervals, Bayes factors, and other devices. Because the core problems appear cognitive rather than statistical, we review some simple methods to aid researchers in interpreting statistical outputs. These methods emphasize logical and information concepts over probability, and thus may be more robust to common misinterpretations than are traditional descriptions.

Methods

We use the Shannon transform of the P-value p, also known as the binary surprisal or S-value s = −log2(p), to provide a measure of the information supplied by the testing procedure, and to help calibrate intuitions against simple physical experiments like coin tossing. We also use tables or graphs of test statistics for alternative hypotheses, and interval estimates for different percentile levels, to thwart fallacies arising from arbitrary dichotomies. Finally, we reinterpret P-values and interval estimates in unconditional terms, which describe compatibility of data with the entire set of analysis assumptions. We illustrate these methods with a reanalysis of data from an existing record-based cohort study.

Conclusions

In line with other recent recommendations, we advise that teaching materials and research reports discuss P-values as measures of compatibility rather than significance, compute P-values for alternative hypotheses whenever they are computed for null hypotheses, and interpret interval estimates as showing values of high compatibility with data, rather than regions of confidence.

Our recommendations emphasize cognitive devices for displaying the compatibility of the observed data with various hypotheses of interest, rather than focusing on single hypothesis tests or interval estimates. We believe these simple reforms are well worth the minor effort they require.
The effect of family doctor policy practice on primary health-care workers’ health in Hongkou District of Shanghai, China: varied by occupational divisions?
Authors: Huang Jiaoling , Gong Xin , Gu Qing , Liu Rui , Shi Jianwei , Yu Wenya , Zu Ping , Ma Xiaojun , Lin Jie , Sun Jin , Yang Yonghua , Wang Zhaoxin
Published: September 2020

Background

A key component of the 2009 medical reform in China was the change to family doctor (FD) policy practice. However, this led to an increased workload for primary health-care workers (PHCWs) at community health service centres. Their increasing workload may play a significant role in affecting PHCWs’ health.

Methods

A questionnaire survey was conducted in Hongkou district of Shanghai amongst PHCWs including family doctors (FDs), family nurses (FNs), public health doctors (PHDs), and other PHCWs in early 2019. Ordered logistic regression models (Models 1 to 3) were performed to explore the differing health status amongst PHCWs, and their respective influential factors were also tested (Models 4 to 7).

Results

Five hundred sixty-two valid questionnaires were collected with a response rate of 96.4%. Other PHCWs’ (OR = 2.03; 95% CI: 1.163–3.560) and FNs’ (OR = 1.98; 95% CI: 1.136–3.452) self-rated health (SRH) were significantly better than that of FDs. In terms of FNs, the OR of SRH for those who strongly perceived the extra workload brought by FD-contracted services was only 12.0% (95% CI: 0.018–0.815) of that of the no-pressure group. Similarly, FNs with stronger work pressure had worse SRH, i.e., compared with “no” pressure, the SRH ORs for “neutral,” “strong,” and “very strong” evaluations of work pressure were 0.002 (95% CI: 0.000–0.055), 0.001 (95% CI: 0.000–0.033), and 0.000 (95% CI: 0.000–0.006), respectively. Information technology (IT) systems and performance incentives were suggested to improve SRH for FNs, while the former was found to be negatively correlated with other PHCWs. After one unit increase in the PHDs’ team/department support, their OR was 10.7 times (95% CI: 1.700–67.352) higher. In addition, policy support had a negative effect on SRH for PHDs. The OR of “good” assessments of cultural environments was 25.98 times (95% CI: 1.391–485.186) higher than that of “very poor” for Other PHCWs.

Conclusions

The influences of FD policy practice on FNs’ SRH were the most significant amongst PHCWs, rather than FDs’ as expected. The significant factors of SRH were varied over different occupational categories, that is team/department support and policy support (though negative) for PHDs, IT system and incentive for FNs, facility and equipment for FDs, and culture environment for other PHCWs respectively.
Quantifying the under-estimation of cervical Cancer in remote regions of Tanzania
Authors: Gesink Mariah P. , Chamberlain Robert M. , Mwaiselage Julius , Kahesa Crispin , Jackson Kahima , Mueller William , Meza Jane L. , Soliman Amr S.
Published: September 2020

Background

Cervical cancer is the most common cancer among women in Sub-Saharan countries, including Tanzania. While early detection and diagnosis are available in some parts of this large country, radiotherapy has been only available at the Ocean Road Cancer Institute (ORCI), in the capital city of Dar es Salaam and is just starting in a few regions.

Methods

The objective of this study was to compare the observed incidence of cervical cancer for the two remote regions of Mwanza in western Tanzania and Mbeya in southern Tanzania, based on their patients treated at the ORCI from 2011 to 2014. Results: The number patients referred and treated at ORCI were (120 from Mwanza, and 171 from Mbeya, representing 24.6 and 32.8% of the patients histopathologically confirmed in the two sites, respectively. The results showed significant underestimation of cervical cancer in the two regions. The vast majority of patients who were histopathologically-confirmed in their local regions (73.92% from Mwanza and 65.1% from Mbeya), but did not receive the needed radiotherapy treatment at the ORCI. The estimated incidence for the two regions based on the number of patients treated at the ORCI were underestimated by 53.9% for Mwanza and 68.9% for Mbeya.

Conclusions

Local establishment of radiotherapy treatment facilities in remote regions in Tanzania and similar other low-income countries is essential for providing effective treatment and improving survival of diagnosed cervical cancer patients. Linkage between the records of local remote hospitals and the main cancer treatment center in the capital city can also help support the emerging the population-based cancer registry at ORCI.
Korean clinical entity recognition from diagnosis text using BERT
Authors: Kim Young-Min , Lee Tae-Hoon
Published: September 2020

Background

While clinical entity recognition mostly aims at electronic health records (EHRs), there are also the demands of dealing with the other type of text data. Automatic medical diagnosis is an example of new applications using a different data source. In this work, we are interested in extracting Korean clinical entities from a new medical dataset, which is completely different from EHRs. The dataset is collected from an online QA site for medical diagnosis. Bidirectional Encoder Representations from Transformers (BERT), which is one of the best language representation models, is used to extract the entities.

Results

A slightly modified version of BERT labeling strategy replaces the original labeling to enhance the separation of postpositions in Korean. A new clinical entity recognition dataset that we construct, as well as a standard NER dataset, have been used for the experiments. A pre-trained multilingual BERT model is used for the initialization of the entity recognition model. BERT significantly outperforms a character-level bidirectional LSTM-CRF, a benchmark model, in terms of all metrics. The micro-averaged precision, recall, and f1 of BERT are 0.83, 0.85 and 0.84, whereas that of bi-LSTM-CRF are 0.82, 0.79 and 0.81 respectively. The recall values of BERT are especially better than that of the other model. It can be interpreted that the trained BERT model could detect out of vocabulary (OOV) words better than bi-LSTM-CRF.

Conclusions

The recently developed BERT and its WordPiece tokenization are effective for the Korean clinical entity recognition. The experiments using a new dataset constructed for the purpose and a standard NER dataset show the superiority of BERT compared to a state-of-the-art method. To the best of our knowledge, this work is one of the first studies dealing with clinical entity extraction from non-EHR data.
Implementation and evaluation of short peripheral intravenous catheter flushing guidelines: a stepped wedge cluster randomised trial
Authors: Keogh Samantha , Shelverton Caroline , Flynn Julie , Mihala Gabor , Mathew Saira , Davies Karen M. , Marsh Nicole , Rickard Claire M.
Published: September 2020

Background

Peripheral intravenous catheters (PIVCs) are ubiquitous medical devices, crucial to providing essential fluids and drugs. However, post-insertion PIVC failure occurs frequently, likely due to inconsistent maintenance practice such as flushing. The aim of this implementation study was to evaluate the impact a multifaceted intervention centred on short PIVC maintenance had on patient outcomes.

Methods

This single-centre, incomplete, stepped wedge, cluster randomised trial with an implementation period was undertaken at a quaternary hospital in Queensland, Australia. Eligible patients were from general medical and surgical wards, aged ≥ 18 years, and requiring a PIVC for > 24 h. Wards were the unit of randomisation and allocation was concealed until the time of crossover to the implementation phase. Patients, clinicians, and researchers were not masked but infections were adjudicated by a physician masked to allocation. Practice during the control period was standard care (variable practice with manually prepared flushes of 0.9% sodium chloride). The intervention group received education reinforcing practice guidelines (including administration with manufacturer-prepared pre-filled flush syringes). The primary outcome was all-cause PIVC failure (as a composite of occlusion, infiltration, dislodgement, phlebitis, and primary bloodstream or local infection). Analysis was by intention-to-treat.

Results

Between July 2016 and February 2017, 619 patients from 9 clusters (wards) were enrolled (control n = 306, intervention n = 313), with 617 patients comprising the intention-to-treat population. PIVC failure was 91 (30%) in the control and 69 (22%) in the intervention group (risk difference − 8%, 95% CI − 14 to − 1, p = 0.032). Total costs were lower in the intervention group. No serious adverse events related to study intervention occurred.

Conclusions

This study demonstrated the effectiveness of post-insertion PIVC flushing according to recommended guidelines. Evidence-based education, surveillance and products for post-insertion PIVC management are vital to improve patient outcomes.

Trial registration

Trial submitted for registration on 25 January 2016. Approved and retrospectively registered on 4 August 2016. Ref: ACTRN12616001035415.
Fibroblast growth factor-23 is associated with imaging markers of diabetic cardiomyopathy and anti-diabetic therapeutics
Authors: Sørensen Martin H. , Bojer Annemie S. , Jørgensen Niklas R. , Broadbent David A. , Plein Sven , Madsen Per L. , Gæde Peter
Published: September 2020

Background

The biomarker fibroblast growth factor-23 (FGF-23) has been associated with increased cardiovascular morbidity and mortality in both patients with and without type 2 diabetes. The aim of this study was to evaluate the relationship between FGF-23 and cardiac structure, function and perfusion in patients with type 2 diabetes and normal or mildly impaired kidney function. Furthermore, to investigate the association between FGF-23, anti-diabetes therapy and the classic complications and risk factors associated with type 2 diabetes.

Methods

In this cross-sectional study, 246 patients with type 2 diabetes underwent echocardiography and advanced cardiac magnetic resonance imaging to assess left ventricular (LV) structure and function. In addition, myocardial blood flow (MBF) during rest and pharmacological stress (adenosine 140 µg/kg/min) were evaluated in 183 of the patients. Patients with eGFR < 60 ml/min/1.73 m2 were excluded.

Results

Median (Q1–Q3) FGF-23 was 74 (58–91) ng/L. Patients with FGF-23 above the median had lower MBF during stress (2.3 ± 0.9 vs. 2.7 ± 0.9 ml/min/g, P = 0.001) and lower overall myocardial perfusion reserve (MPR) (2.7 ± 0.8 vs. 3.3 ± 1.1, P < 0.001). LV mass (143 ± 40 vs. 138 ± 36 g, P = 0.04) and E/e* (8.5 ± 3.2 vs. 7.6 ± 2.7, P = 0.04) were higher in patients with FGF-23 above the median. In a linear model adjusted for age, sex, eGFR and hypertension, increasing FGF-23 was associated with decreased MPR (P < 0.01, R2 = 0.11) and increased E/e* (P < 0.01, R2 = 0.07). FGF-23 was lower in patients receiving glucagon like peptide-1 (GLP-1) analogues (71 (57–86) vs. 80 (60–98) ng/L, P = 0.01) than in those who did not receive GLP-1 analogues.

Conclusions

In patients with type 2 diabetes and normal or mildly impaired kidney function, increased levels of FGF-23 are associated with impaired cardiac diastolic function and decreased MPR, caused by a decrease in maximal MBF during stress. Use of GLP-1 analogues is associated with decreased levels of FGF-23.

Clinical trial registrationhttps://www.clinicaltrials.gov. Unique identifier: NCT02684331. Date of registration: February 18, 2016
Long noncoding RNA LINC00261 suppresses prostate cancer tumorigenesis through upregulation of GATA6-mediated DKK3
Authors: Li Yang , Li Hai , Wei Xin
Published: September 2020

Background

Prostate cancer is one of the leading causes of cancer death in males. Recent studies have reported aberrant expression of lncRNAs in prostate cancer. This study explores the role of LINC00261 in prostate cancer progression.

Methods

The differentially expressed genes, transcription factors, and lncRNAs related to prostate cancer were predicted by bioinformatics analysis. Prostate cancer tissue samples and cell lines were collected for the determination of the expression of LINC00261 by reverse transcription quantitative polymerase chain reaction. The binding capacity of LINC00261 to the transcription factor GATA6 was detected by RIP, and GATA6 binding to the DKK3 promoter region was assessed by ChIP. In addition, luciferase reporter system was used to verify whether LINC00261 was present at the DKK3 promoter. After gain- and loss-of function approaches, the effect of LINC00261 on prostate cancer in vitro and in vivo was assessed by the determination of cell proliferation, invasion and migration as well as angiogenesis.

Results

LINC00261, GATA6, and DKK3 were poorly expressed in prostate cancer. LINC00261 could inhibit transcriptional expression of DKK3 by recruiting GATA6. Overexpression of LINC00261 inhibited prostate cancer cells proliferation, migration, and invasion as well as angiogenesis, which could be reversed by silencing DKK3. Furthermore, LINC00261 could also suppress the tumorigenicity of cancer cells in vivo.

Conclusions

Our study demonstrates the inhibitory role of LINC00261 in prostate cancer progression, providing a novel biomarker for early detection of prostate cancer.