bluuebunny/crossref_metadata_2025 huggingface dataset:
CIDACS-RL: a novel indexing search and scoring-based record linkage system for huge datasets with high accuracy and scalability
Authors: Barbosa George C. G. , Ali M. Sanni , Araujo Bruno , Reis Sandra , Sena Samila , Ichihara Maria Y. T. , Pescarini Julia , Fiaccone Rosemeire L. , Amorim Leila D. , Pita Robespierre , Barreto Marcos E. , Smeeth Liam , Barreto Mauricio L.
Published: November 2020

Background

Record linkage is the process of identifying and combining records about the same individual from two or more different datasets. While there are many open source and commercial data linkage tools, the volume and complexity of currently available datasets for linkage pose a huge challenge; hence, designing an efficient linkage tool with reasonable accuracy and scalability is required.

Methods

We developed CIDACS-RL (Centre for Data and Knowledge Integration for Health – Record Linkage), a novel iterative deterministic record linkage algorithm based on a combination of indexing search and scoring algorithms (provided by Apache Lucene). We described how the algorithm works and compared its performance with four open source linkage tools (AtyImo, Febrl, FRIL and RecLink) in terms of sensitivity and positive predictive value using gold standard dataset. We also evaluated its accuracy and scalability using a case-study and its scalability and execution time using a simulated cohort in serial (single core) and multi-core (eight core) computation settings.

Results

Overall, CIDACS-RL algorithm had a superior performance: positive predictive value (99.93% versus AtyImo 99.30%, RecLink 99.5%, Febrl 98.86%, and FRIL 96.17%) and sensitivity (99.87% versus AtyImo 98.91%, RecLink 73.75%, Febrl 90.58%, and FRIL 74.66%). In the case study, using a ROC curve to choose the most appropriate cut-off value (0.896), the obtained metrics were: sensitivity = 92.5% (95% CI 92.07–92.99), specificity = 93.5% (95% CI 93.08–93.8) and area under the curve (AUC) = 97% (95% CI 96.97–97.35). The multi-core computation was about four times faster (150 seconds) than the serial setting (550 seconds) when using a dataset of 20 million records.

Conclusion

CIDACS-RL algorithm is an innovative linkage tool for huge datasets, with higher accuracy, improved scalability, and substantially shorter execution time compared to other existing linkage tools. In addition, CIDACS-RL can be deployed on standard computers without the need for high-speed processors and distributed infrastructures.
The relationship of nursing home price and quality of life
Authors: Raes Sarah , Vandepitte Sophie , De Smedt Delphine , Wynendaele Herlinde , DeJonghe Yannai , Trybou Jeroen
Published: November 2020

Background

Knowledge about the relationship between the residents’ Quality of Life (QOL) and the nursing home price is currently lacking. Therefore, this study investigates the relationship between 11 dimensions of QOL and nursing homes price in Flemish nursing homes.

Methods

The data used in this cross-sectional study were collected by the Flemish government from years 2014 to 2017 and originates from 659 Flemish nursing homes. From 2014 to 2016, data on the QOL of 21,756 residents was assessed with the InterRAI instrument. This instrument contains 11 QOL dimensions. Multiple linear regression analyses were conducted to examine the research question.

Results

The multiple linear regressions indicated that a 10 euro increase in the daily nursing home price is associated with a significant decrease (P <  0.001) of 0.1 in 5 dimensions of QOL (access to services, comfort and environment, food and meals, respect, and safety and security). Hence, our results indicate that the association between price and QOL is very small. When conducting a subgroup analysis based on ownership type, the earlier found results remained only statistically significant for private nursing homes.

Conclusion

Our findings show that nursing home price is of limited importance with respect to resident QOL. Contrary to popular belief, our study demonstrates a limited negative effect of price on QOL. Further research that includes other indicators of QOL is needed to allow policymakers and nursing home managers to improve nursing home residents’ QOL.
Sodium-glucose cotransporter 2 inhibitor versus metformin as first-line therapy in patients with type 2 diabetes mellitus: a multi-institution database study
Authors: Chen Tien-Hsing , Li Yan-Rong , Chen Shao-Wei , Lin Yu-Sheng , Sun Chi-Chin , Chen Dong-Yi , Mao Chun-Tai , Wu Michael , Chang Chih-Hsiang , Chu Pao-Hsien , Wu Victor Chien-Chia
Published: November 2020

Background

Sodium-glucose co-transporter 2 inhibitors (SGLT2i) has shown evidence of cardiovascular benefit in patients with type 2 diabetes mellitus (T2DM). Currently metformin is the guideline-recommended first-line treatment. We aimed to investigate the benefit of SGLT2i vs metformin as first-line therapy.

Methods

Electronic medical records from Chang Gung Research Database during 2016–2019 were retrieved for patients with T2DM. Patients aged < 20, not receiving anti-diabetic medication, first-line treatment neither metformin nor SGLT2i were excluded. Primary outcomes were heart failure hospitalization, acute coronary syndrome, ischemic stroke, and all-cause mortality. Patients were followed up for events or December 31, 2019, whichever comes first.

Results

After exclusion criteria, a total of 41,020 patients with T2DM were eligible for analysis. There were 1100 patients with SGLT2i as first-line and 39,920 patients with metformin as first-line treatment. IPTW was used for propensity score matching. During one year follow-up, the hazard ratio (HR) of patients on SGLT2i as first-line treatment to patients on metformin as first-line treatment were HR 0.47 (95% CI 0.41–0.54, p < 0.0001) in heart failure hospitalization, HR 0.50 (95% CI 0.41–0.61, p < 0.0001) in acute coronary syndrome, HR 1.21 (95% CI 1.10–1.32, p < 0.0001) in ischemic stroke, and HR 0.49 (95% CI 0.44–0.55, p < 0.0001) in all-cause mortality.

Conclusions

In patients with T2DM, SGLT2i as first-line treatment may be associated with decreased events of heart failure hospitalization, acute coronary syndrome, and all-cause mortality, compared with metformin as first-line treatment. However, there may be an increased events of ischemic stroke using SGLT2i compared to metformin.
Molecular targets of Yangyin Fuzheng Jiedu Prescription in the treatment of hepatocellular carcinoma based on network pharmacology analysis
Authors: Yan Fengna , Feng Miaomiao , Wang Xinhui , Wang Peng , Xie Yuqing , Liu Xiaoli , Li Weihong , Yang Zhiyun
Published: November 2020

Background

Yangyin Fuzheng Jiedu Prescription (YFJP) is a traditional Chinese medicine (TCM) indicated for the treatment of hepatocellular carcinoma (HCC). Its potential targets and molecular mechanisms are not clear. Therefore, this study intends to explore the molecular mechanism of YFJP based on network pharmacology analysis and in vitro validation.

Methods and results

Through univariate and multivariate analyses and survival analysis in HCC patients with or without YFJP treatment we found that drinking alcohol, alfafeto protein ≥ 400 ng/l, baseline portal vein tumor thrombus and total bilirubin level ≥ 18.8 μM) were independent risk factors for poor prognosis, while red blood cell count ≥ 4 × 109/l and TCM treatment were independent protective factors. Besides, YFJP prolonged the cumulative survival of HCC patients. Using online pharmacological methods, we obtained 58 relevant compounds and molecular 53 targets. By using scratch test, Transwell assay, EdU assay, and TUNEL staining, we found that YFJP-containing serum repressed the migration, invasion and proliferation of HCC cells in vitro, and induced cell apoptosis. Moreover, YFJP diminished the gene expression of TP53, CCND1, p-EGFR, EGF, VEGFA, JUN, IL6, COX-2, AKT1, and MAPK1 in HCC cells, but elevated the expression of ESR1 and CASP3.

Conclusions

Taken together, results showed that YFJP attenuated HCC progression through mediating effects on HCC-related genes.
Socio-economic and demographic factors associated with reproductive and child health preventive care in Mozambique: a cross-sectional study
Authors: Daca Chanvo , Sebastian Miguel San , Arnaldo Carlos , Schumann Barbara
Published: November 2020

Background

Reproductive and child health interventions are essential to improving population health in Africa. In Mozambique, although some progress on reproductive and child health has been made, knowledge of social inequalities in health and health care is lacking.

Objective

To investigate socio-economic and demographic inequalities in reproductive and child preventive health care as a way to monitor progress towards universal health coverage.

Methods

A cross-sectional study was conducted, using data collected from the 2015 Immunization, AIDS and Malaria Indicators Survey (IMASIDA) in Mozambique. The sample included 6946 women aged 15 to 49 years. Outcomes variables were the use of insecticide treated nets (ITN) for children under 5 years, full child immunization and modern contraception use, while independent variables included age, marital status, place of residence, region, education, occupation, and household wealth index. Prevalence ratios (PR) with 95% confidence intervals (95% CI) were calculated by log binomial regression to assess the relationship between the socio-economic and demographic characteristics and the three outcomes of interest.

Results

The percentage of mothers with at least one child under 5 years that did not use ITN was 51.01, 46.25% of women had children aged 1 to 4 years who were not fully immunized, and 74.28% of women were not using modern contraceptives. Non-educated mothers (PR = 1.33; 95% CI: 1.16–1.51) and those living in the Southern region (PR = 1.36; 95% CI: 1.17–1.59) had higher risk of not using ITN, while the poorest quintile (PR = 1.34; 95% CI: 1.04–1.71) was more likely to have children who were not fully immunized. Similarly, non-educated women (PR = 1.17; 95% CI: 1.10–1.25), non-working women (PR = 1.09; 95% CI: 1.04–1.16), and those in the poorest quintile (PR = 1.13; 95% CI: 1.04–1.24) had a higher risk of not using modern contraceptives.

Conclusion

Our study showed a low rate of ITN utilization, immunization coverage of children, and modern contraceptive use among women of reproductive age. Several socio-economic and demographics factors (region, education, occupation, and wealth) were associated with these preventive measures. We recommend an equity-oriented resource allocation across regions, knowledge dissemination on the importance of ITN and contraceptives use, and an expansion of immunization services to reach socio-economically disadvantaged families in order to achieve universal health coverage in Mozambique.
Comparing the reliability and validity of the SF-36 and SF-12 in measuring quality of life among adolescents in China: a large sample cross-sectional study
Authors: Lin Yanwei , Yu Yulan , Zeng Jiayong , Zhao Xudong , Wan Chonghua
Published: November 2020

Objective

We compare the reliability and validity of the Short Form 36 (version 1, SF-36) and the Short Form 12 (version 1, SF-12) in adolescence, the period of life when a child develops into an adult, i.e., the period from puberty to maturity terminating legally at the age of majority (10–19 years), thus supplying evidence for the selection of instruments measuring the quality of life (QOL) and decision-making processes of adolescents in China.

Methods

Stratified cluster random sampling was adopted according to geographical location, and the SF-36 was administered to assess QOL. The Pearson correlation coefficient was used to show correlation. Cronbach’s alpha and construct reliability (CR) were used to evaluate the reliability of SF-36 and SF-12, while criterion validity and average variance extracted (AVE, convergence validity) were used to evaluate validity. Confirmatory factor analysis was used to calculate the load factors for the items of the SF-36 and SF-12, then to obtain the CR and AVE. The Semejima grade response model (logistic two-parameter module) in item response theory was used to estimate item discrimination, item difficulty, and item average information for the items of the SF-36 and SF-12.

Results

19,428 samples were included in the study. The mean age of respondents was 14.78 years (SD = 1.77). Reliability of each domain of the SF-36 was better than for the corresponding domain of the SF-12. The domains of PF, RP, BP, and GH in SF-36 had good construct reliability (CR > 0.6). The criterion validities of some domains of the SF-36 were a little higher in some corresponding dimensions of the SF-12, except for PCS. The convergence validities of the SF-12 were higher than the SF-36 in PF, RP, BP, and PCS. The items of BP, SF, RP, and VT in the SF-12 had acceptable discrimination of items that were higher than in the SF-36. The items’ average amounts of information on BP, VT, SF, RE, and MH in the SF-36 and SF-12 were poor.

Conclusion

Two component (PCS and MCS) measurements of the SF-12 appeared to perform at least as well as the SF-36 in cross-sectional settings in adolescence, but the reliability and validity of the 8 domains of the SF-36 were better than those of the SF-12. Some domains, for instance SF and BP, were not suitable for adolescents or need to be studied further.
Evaluation of treatment of previous cesarean scar pregnancy with methotrexate: a systematic review and meta-analysis
Authors: Salari Nader , Kazeminia Mohsen , Shohaimi Shamarina , Nankali Anis al-Dawlah , Mohammadi Masoud
Published: November 2020

Background

Previous caesarean scar pregnancy is one type of ectopic pregnancy in myometrium and fibrous tissue of previous caesarean scar. One of the therapeutic methods of this type of ectopic pregnancy is treatment with methotrexate. Given various findings on the treatment of caesarean scar pregnancy with methotrexate and lack of global report in this regard, we aimed to achieve a global report on the treatment of CSP with methotrexate through related literature review and analysis of the results of the studies, to enable more precise planning to reduce complications of CSP.

Method

This review study extracted information through searching national and international databases of SID،, Embase, ScienceDirect, ، Scopus, ، PubMed, Web of Science (ISI) between 2003 and January 2020. To perform the meta-analysis, random-effects model and heterogeneity of the studies with I2 index were investigated. Data were sanalysed using Comprehensive Meta-Analysis version 2.

Results

In total, 26 articles with a sample size of 600 individuals were enrolled in the meta-analysis. According to the results of the study, the mean level of β-hCG was 28,744.98 ± 4425.1 mIU/ml before the intervention and was 23,836.78 ± 4533.1 mIU/ml after the intervention. The mean intraoperative blood loss (ml) was 4.8 ± 3.76 ml, mean hospital stay (days) was 11.7 ± 1.2 days, mean time for serum-hCG normalization (days) was 41.6 ± 3.2 days, success was 90.7% (95% CI: 86.7–93.5%), and complication was 9% (95% CI: 6.3–12.8%).

Conclusion

The results of the current study show methotrexate significantly reduces β-hCG levels and can be effective in treating caesarean scar pregnancy and its complications.
SARS-CoV-2 and mitochondrial health: implications of lifestyle and ageing
Authors: Nunn Alistair V. W. , Guy Geoffrey W. , Brysch Wolfgang , Botchway Stanley W. , Frasch Wayne , Calabrese Edward J. , Bell Jimmy D.
Published: November 2020

Infection with SARs-COV-2 displays increasing fatality with age and underlying co-morbidity, in particular, with markers of the metabolic syndrome and diabetes, which seems to be associated with a “cytokine storm” and an altered immune response. This suggests that a key contributory factor could be immunosenescence that is both age-related and lifestyle-induced. As the immune system itself is heavily reliant on mitochondrial function, then maintaining a healthy mitochondrial system may play a key role in resisting the virus, both directly, and indirectly by ensuring a good vaccine response. Furthermore, as viruses in general, and quite possibly this new virus, have also evolved to modulate immunometabolism and thus mitochondrial function to ensure their replication, this could further stress cellular bioenergetics. Unlike most sedentary modern humans, one of the natural hosts for the virus, the bat, has to “exercise” regularly to find food, which continually provides a powerful adaptive stimulus to maintain functional muscle and mitochondria. In effect the bat is exposed to regular hormetic stimuli, which could provide clues on how to resist this virus. In this paper we review the data that might support the idea that mitochondrial health, induced by a healthy lifestyle, could be a key factor in resisting the virus, and for those people who are perhaps not in optimal health, treatments that could support mitochondrial function might be pivotal to their long-term recovery.
Author Correction: In vitro virucidal activity of Echinaforce®, an Echinacea purpurea preparation, against coronaviruses, including common cold coronavirus 229E and SARS-CoV-2
Authors: Signer Johanna , Jonsdottir Hulda R. , Albrich Werner C. , Strasser Marc , Züst Roland , Ryter Sarah , Ackermann-Gäumann Rahel , Lenz Nicole , Siegrist Denise , Suter Andreas , Schoop Roland , Engler Olivier B.
Published: November 2020

An amendment to this paper has been published and can be accessed via the original article. The conclusions of this paper have been corroborated by additional data.
Improvements needed to support people living and working with a rare disease in Northern Ireland: current rare disease support perceived as inadequate
Authors: McMullan Julie , Crowe Ashleen L. , Bailie Caitlin , Moore Kerry , McMullan Lauren S. , Shamandi Nahid , McAneney Helen , McKnight Amy Jayne
Published: November 2020

Background

Many people living and working with rare diseases describe consistent difficulties accessing appropriate information and support. In this study an evaluation of the awareness of rare diseases, alongside related information and educational resources available for patients, their families and healthcare professionals, was conducted in 2018–2019 using an online survey and semi-structured interviews with rare disease collaborative groups (charities, voluntary and community groups) active across Northern Ireland (NI).

Methods

This study had 2 stages. Stage 1 was an online survey and stage 2 involved semi-structured interviews both with rare disease collaborative groups in Northern Ireland. The surveys and interviews were used to locate existing resources as well as identify gaps where the development of further resources would be appropriate.

Results

Ninety-nine rare disease collaborative groups engaged with the survey with 31 providing detailed answers. Resources such as information, communication, ‘registries’, online services, training and improvements to support services were queried. Excellent communication is an important factor in delivering good rare disease support. Training for health professionals was also highlighted as an essential element of improving support for those with a rare disease to ensure they approach people with these unique and challenging diseases in an appropriate way. Carers were mentioned several times throughout the study; it is often felt they are overlooked in rare disease research and more support should be in place for them. Current care/support for those with a rare disease was highlighted as inadequate. Nine semi-structured interviews were conducted with rare disease collaborative groups. Reoccurring themes included a need for more effective information and communication, training for health professionals, online presence, support for carers, and involvement in research.

Conclusions

All rare disease collaborative groups agreed that current services for people living and working with a rare disease are not adequate. An important finding to consider in future research within the rare disease field is the inclusion of carers perceptions and experiences in studies. This research provides insight into the support available for rare diseases across Northern Ireland, highlights unmet needs, and suggests approaches to improve rare disease support.
Prevalence of mental health problems in Chinese schoolchildren: The influence of measuring impact score and combining information from multiple informants
Authors: Liu Li , Li Shuang , Pan Wen , Wang Lijuan , Zheng Yang , An Xiaoxia , Zhou Yan , Li Yanxia , Na Jun , Zhang Rui , Mu Huijuan , Dong Wen , Gao Yuan , Sun Wei , Pan Guowei , Yan Lingjun
Published: November 2020

Background

To measure the effects of using different combinations of multiple informants and the impact score on the estimated prevalence of mental health problems in Chinese schoolchildren.

Methods

Complete information on the Strengths and Difficulties Questionnaire (SDQ) were obtained from students (S), parents (P), and teachers (T) for 4986 schoolchildren (11–17 years-old). We used 3 criteria to determine the prevalence of mental health problems: SDQ cut-off value (previously established in the United Kingdom), SDQ cut-off value plus an impact score of 1 or more, or plus an impact score of 2 or more. A student was defined as having a mental health problem if any informant (S, P, or T) classified the child as ‘abnormal’. We compared the prevalence of mental health problems determined from 1 informant, 2 informants, and 3 informants.

Results

The prevalence of overall mental health problems increased with rising number of informants, but decreased with increasing impact score. When the impact score was not considered, the prevalence was 8.2% to 14.2% when rated by 1 informant, 18.8% to 24.7% when rated by 2 informants, and 28.3% when rated by all 3 informants. Failure to measure the impact score led to a two to threefold greater estimate of the prevalence of mental health problems.

Conclusions

The types, number, and combinations of multiple informants and use of the impact score must be considered when comparing the results of different studies. It is preferable to use multiple informants and have the impact score taken the impact into account to reflect the real burden of mental health burden in children and adolescent.
A biomedical Engineering Laboratory module for exploring involuntary muscle reflexes using Electromyography
Authors: Franz Karly S. , Patel Kramay , Kilkenny Dawn M.
Published: November 2020

Background

Undergraduate biomedical engineering (BME) students interested in pursuing a career in research and development of medical or physiological monitoring devices require a strong foundation in biosignal analysis as well as physiological theory. Applied learning approaches are reported to be effective for reinforcing physiological coursework; therefore, we propose a new laboratory protocol for BME undergraduate physiology courses that integrates both neural engineering and physiological concepts to explore involuntary skeletal muscle reflexes. The protocol consists of two sections: the first focuses on recruiting soleus motor units through transcutaneous electrical nerve stimulation (TENS), while the second focuses on exploring the natural stretch reflex with and without the Jendrassik maneuver. In this case study, third-year biomedical engineering students collected electromyographic (EMG) activity of skeletal muscle contractions in response to peripheral nerve stimulation using a BioRadio Wireless Physiology Monitor system and analyzed the corresponding signal parameters (latency and amplitude) using the MATLAB platform.

Results/protocol validation

Electrical tibial nerve stimulation successfully recruited M-waves in all 8 student participants and F-waves in three student participants. The students used this data to learn about orthodromic and antidromic motor fiber activation as well as estimate the neural response latency and amplitude. With the stretch reflex, students were able to collect distinct signals corresponding to the tendon strike and motor response. From this, they were able to estimate the sensorimotor conduction velocity. Additionally, a significant increase in the stretch reflex EMG amplitude response was observed when using the Jendrassik maneuver during the knee-jerk response. A student exit survey on the laboratory experience reported that the class found the module engaging and helpful for reinforcing physiological course concepts.

Conclusion

This newly developed protocol not only allows BME students to explore physiological responses using natural and electrically-induced involuntary reflexes, but demonstrates that budget-friendly commercially available devices are capable of eliciting and measuring involuntary reflexes in an engaging manner. Despite some limitations caused by the equipment and students’ lack of signal processing experience, this new laboratory protocol provides a robust framework for integrating engineering and physiology in an applied approach for BME students to learn about involuntary reflexes, neurophysiology, and neural engineering.
LncRNA MYLK-AS1 facilitates tumor progression and angiogenesis by targeting miR-424-5p/E2F7 axis and activating VEGFR-2 signaling pathway in hepatocellular carcinoma
Authors: Teng Fei , Zhang Ju-Xiang , Chang Qi-Meng , Wu Xu-Bo , Tang Wei-Guo , Wang Jian-Fa , Feng Jin-Feng , Zhang Zi-Ping , Hu Zhi-Qiu
Published: November 2020

Background

Long non-coding RNAs (lncRNAs) are crucial in the invasion, angiogenesis, progression, and metastasis of hepatocellular carcinoma (HCC). The lncRNA MYLK-AS1 promotes the growth and invasion of HCC through the EGFR/HER2-ERK1/2 signaling pathway. However, the clinical significance of MYLK-AS1 in HCC still needs to be further determined.

Methods

Bioinformatic analysis was performed to determine the potential relationship among MYLK-AS1, miRNAs and mRNAs. A total of 156 samples of normal liver and paired HCC tissues from HCC patients were used to evaluate MYLK-AS1 expression by qRT-PCR. Human HCC cell lines were used to evaluate the colony formation, cell proliferation, migration, invasion, cell cycle and apoptosis after transfection of lentiviral short-hairpin RNAs (shRNAs) targeting MYLK-AS1 or MYLK-AS1 vectors. The competitive endogenous RNA (ceRNA) mechanism was clarified using fluorescence in situ hybridization (FISH), Western blotting, qPCR, RNA binding protein immunoprecipitation (RIP), and dual luciferase reporter analysis.

Results

MYLK-AS1 up-regulation was detected in the HCC tumor tissues and cell lines associated with the enhancement of the angiogenesis and tumor progression. The down-regulation of MYLK-AS1 reversed the effects on angiogenesis, proliferation, invasion and metastasis in the HCC cells and in vivo. MYLK-AS1 acted as ceRNA, capable of regulating the angiogenesis in HCC, while the microRNA miR-424-5p was the direct target of MYLK-AS1. Promoting the angiogenesis and the tumor proliferation, the complex MYLK-AS1/miR-424-5p activated the VEGFR-2 signaling through E2F7, whereas the specific targeting of E2F transcription factor 7 (E2F7) by miR-424-5p, was indicated by the mechanism studies.

Conclusions

MYLK-AS1 and E2F7 are closely related to some malignant clinicopathological features and prognosis of HCC, thus the MYLK-AS1/ miR-424-5p/E2F7 signaling pathway might represent a promising treatment strategy to combat HCC.
Analysis of multicenter clinical trials with very low event rates
Authors: Kim Jiyu , Troxel Andrea B. , Halpern Scott D. , Volpp Kevin G. , Kahan Brennan C. , Morris Tim P. , Harhay Michael O.
Published: November 2020

Introduction

In a five-arm randomized clinical trial (RCT) with stratified randomization across 54 sites, we encountered low primary outcome event proportions, resulting in multiple sites with zero events either overall or in one or more study arms. In this paper, we systematically evaluated different statistical methods of accounting for center in settings with low outcome event proportions.

Methods

We conducted a simulation study and a reanalysis of a completed RCT to compare five popular methods of estimating an odds ratio for multicenter trials with stratified randomization by center: (i) no center adjustment, (ii) random intercept model, (iii) Mantel–Haenszel model, (iv) generalized estimating equation (GEE) with an exchangeable correlation structure, and (v) GEE with small sample correction (GEE-small sample correction). We varied the number of total participants (200, 500, 1000, 5000), number of centers (5, 50, 100), control group outcome percentage (2%, 5%, 10%), true odds ratio (1, > 1), intra-class correlation coefficient (ICC) (0.025, 0.075), and distribution of participants across the centers (balanced, skewed).

Results

Mantel–Haenszel methods generally performed poorly in terms of power and bias and led to the exclusion of participants from the analysis because some centers had no events. Failure to account for center in the analysis generally led to lower power and type I error rates than other methods, particularly with ICC = 0.075. GEE had an inflated type I error rate except in some settings with a large number of centers. GEE-small sample correction maintained the type I error rate at the nominal level but suffered from reduced power and convergence issues in some settings when the number of centers was small. Random intercept models generally performed well in most scenarios, except with a low event rate (i.e., 2% scenario) and small total sample size (n ≤ 500), when all methods had issues.

Discussion

Random intercept models generally performed best across most scenarios. GEE-small sample correction performed well when the number of centers was large. We do not recommend the use of Mantel–Haenszel, GEE, or models that do not account for center. When the expected event rate is low, we suggest that the statistical analysis plan specify an alternative method in the case of non-convergence of the primary method.
Negative pressure wound therapy (NPWT) on closed incisions to prevent surgical site infection in high-risk patients in hepatopancreatobiliary surgery: study protocol for a randomized controlled trial—the NP-SSI trial
Authors: Brennfleck Frank W. , Linsenmeier Lena , Junger Henrik H.G. , Schmidt Katharina M. , Werner Jens M. , Woehl Daniel , Zeman Florian , Mutzbauer Ingrid , Hutchinson James A. , Geissler Edward K. , Schlitt Hans J. , Brunner Stefan M.
Published: November 2020

Background

Incisional surgical site infections (iSSI) in hepatopancreatobiliary (HPB) surgery usually lead to prolonged hospital stays, consume valuable resources, and impact on patients’ outcome. Prophylactic closed incision negative pressure wound therapy (ciNPWT) to decrease wound complications has become available. Owing to an increasing number of studies, evidence for superiority in many indication areas has accumulated; however, in general surgery, there are a few data and those have shown contradictory results.

Methods

In this monocentric, prospective, randomized, controlled, two-armed study, the influence of ciNPWT on incisional surgical site infection rates after HPB operations will be investigated. A total of 222 patients will be randomized 1:1 to an interventional group (7-day treatment with ciNPWT) or a control group (treated with gauze dressing). The primary parameter to evaluate efficacy is the rate of incisional SSIs within 30 days after surgery. Additionally, several clinically relevant secondary outcomes will be assessed.

Discussion

A reduction in the rate of incisional SSIs would not only lead to a significant cost reduction and shorter postoperative length of stay, but may also improve postoperative quality of life for patients. While earlier publications have shown advantages for ciNPWT, recent studies did not confirm a positive effect regarding iSSI rate. Even if iSSI rate is not reduced, findings obtained from the secondary endpoints may be of clinical relevance, such as reduction of wound complication rates.

Trial registration

This trial has been registered in the German Clinical Trials Register, DRKS 00015136. Registered on 19 February 2019 and has been approved by the local ethics committee of the University of Regensburg: 18-1225-101.
Evolutionary engineering of E. coli MG1655 for tolerance against isoprenol
Authors: Babel Heiko , Krömer Jens O.
Published: November 2020

Background

Isoprenol is the basis for industrial flavor and vitamin synthesis and also a promising biofuel. Biotechnological production of isoprenol withE. coliis currently limited by the high toxicity of the final product. Adaptive laboratory evolution (ALE) is a promising method to address complex biological problems such as toxicity.

Results

Here we applied this method successfully to evolveE. colitowards higher tolerance against isoprenol, increasing growth at the half-maximal inhibitory concentration by 47%. Whole-genome re-sequencing of strains isolated from three replicate evolutions at seven time-points identified four major target genes for isoprenol tolerance:fabF, marC, yghB,androb. We could show that knock-out ofmarCand expression of mutated Rob H(48) → frameshiftincreased tolerance against isoprenol and butanol. RNA-sequencing showed that the deletion identified upstream ofyghBcorrelated with a strong overexpression of the gene. The knock-out ofyghBdemonstrated that it was essential for isoprenol tolerance. The mutated Rob protein andyghBdeletion also lead to increased vanillin tolerance.

Conclusion

Through ALE, novel targets for strain optimization in isoprenol production and also the production of other fuels, such as butanol, could be obtained. Their effectiveness could be shown through re-engineering. This paves the way for further optimization ofE. colifor biofuel production.
Prediction of Alzheimer’s disease biomarker status defined by the ‘ATN framework’ among cognitively healthy individuals: results from the EPAD longitudinal cohort study
Authors:   The European Prevention of Alzheimer’s Dementia (EPAD) Consortium, Calvin Catherine M. , de Boer Casper , Raymont Vanessa , Gallacher John , Koychev Ivan
Published: November 2020

Background

The Amyloid/Tau/Neurodegeneration (ATN) framework has been proposed as a means of evidencing the biological state of Alzheimer’s disease (AD). Predicting ATN status in pre-dementia individuals therefore provides an important opportunity for targeted recruitment into AD interventional studies. We investigated the extent to which ATN-defined biomarker status can be predicted by known AD risk factors as well as vascular-related composite risk scores.

Methods

One thousand ten cognitively healthy older adults were allocated to one of five ATN-defined biomarker categories. Multinomial logistic regression tested risk factors including age, sex, education, APOE4, family history of dementia, cognitive function, vascular risk indices (high systolic blood pressure, body mass index (BMI), high cholesterol, physical inactivity, ever smoked, blood pressure medication, diabetes, prior cardiovascular disease, atrial fibrillation and white matter lesion (WML) volume), and three vascular-related composite scores, to predict five ATN subgroups; ROC curve models estimated their added value in predicting pathology.

Results

Age, APOE4, family history, BMI, MMSE and white matter lesions (WML) volume differed between ATN biomarker groups. Prediction of Alzheimer’s disease pathology (versus normal AD biomarkers) improved by 7% after adding family history, BMI, MMSE and WML to a ROC curve that included age, sex and APOE4. Risk composite scores did not add value.

Conclusions

ATN-defined Alzheimer’s disease biomarker status prediction among cognitively healthy individuals is possible through a combination of constitutional and cardiovascular risk factors but established dementia composite risk scores do not appear to add value in this context.
An itchy erythematous papular skin rash as a possible early sign of COVID-19: a case report
Authors: Serafini Alice , Kurotschka Peter Konstantin , Bertolani Mariabeatrice , Riccomi Silvia
Published: November 2020

Background

Several recent studies suggest the possibility of a skin rash being a clinical presentation of coronavirus disease 2019 (COVID-19). The purpose of this case report is to bring attention to skin manifestations in the early stage of COVID-19 in order to support frontline physicians in their crucial activity of case identification.

Case presentation

The patient is an Italian 32-year-old female nurse who had several close contacts with multiple patients with COVID-19 as part of her professional workload. On March 13, 2020, the patient developed an itchy, erythematous papular rash (sparing only her face, scalp, and abdomen), which lasted for 10 days. The rash was accompanied by a feeling of general fatigue that gradually worsened over the following days and has continued for 5 months (until the end of July 2020). During the first week of remote assessment carried out by her general practitioner, the patient gradually developed a dry cough, intermittent fever, and diarrhoea and then had a positive test result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Her skin manifestations disappeared completely 48 days after the onset of the disease, followed by the disappearance of the dry cough.

Conclusions

In light of recent studies, this case report suggests that skin manifestations, when taken into account with other situational factors (such as profession and patient history) should be taken into proper consideration by frontline physicians as possibly being caused by SARS-CoV-2. Early identification of COVID-19 is a key part of the strategy of case detection and case isolation. To enhance this activity, further research is needed to establish frequency, symptoms, signs, and pathogenesis of skin manifestations in patients with COVID-19.
A fair credit-based incentive mechanism for routing in DTN-based sensor network with nodes’ selfishness
Authors: Mao Yuxin , Zhou Chenqian , Qi Ji , Zhu Xudong
Published: November 2020

Due to the unguaranteed connectivity, wireless sensor networks based on delay tolerant network (DTN) are typically characterized by the opportunistic forwarding mechanism in transmission. Such a mechanism requires nodes to participate in forwarding messages actively. However, when the mechanism is used in the real world, selfish nodes will exhibit some non-cooperation behaviors. Therefore, some incentive mechanism may be designed to encourage selfish nodes. In order to solve the selfishness problem, we propose a fair credit-based incentive mechanism for routing in DTN-based sensor networks. In this mechanism, when a source node sends messages to its destination, each relay node will be rewarded with some credits. The accumulated credits are then used to evaluate the level of cooperation in the network. The selfish nodes with few credits are not able to get enough service from other nodes. With the fair incentive, all participating relays will get equal rewards by the trusted third party. In order to evaluate the proposed mechanism, we also perform some simulation, and the results demonstrate that the method can be used to support efficient routing for DTN-based sensor networks.
Common fixed points of monotone ρ-nonexpansive semigroup in modular spaces
Authors: El Harmouchi Noureddine , Chaira Karim , Marhrani El Miloudi
Published: November 2020

In this paper, we consider the class of monotone ρ-nonexpansive semigroups and give existence and convergence results for common fixed points. First, we prove that the set of common fixed points is nonempty in uniformly convex modular spaces and modular spaces. Then we introduce an iteration algorithm to approximate a common fixed point for the same class of semigroups.
Prevalence of and factors associated with self-reported noncompliance with mandatory seatbelt-use law while driving among adults in Kuwait
Authors: Ridha Hashem , Bouzaber Fahed , Al-Sallal Maryam , Almutairi Aisha , Al-dhubaiei Reem , Akhtar Saeed
Published: November 2020

Objectives

This cross-sectional study assessed the prevalence of self-reported noncompliance with mandatory seatbelt-use law and examined the factors associated with noncompliance with seatbelt-use while driving in adult working population in Kuwait.

Methods

During October 2017, 822 adults aged 21–60 years from 11 government ministries and departments were enrolled in this study. Data were collected using a pre-tested, structured, and self-administered questionnaire. We computed the prevalence of self-reported noncompliance with mandatory seatbelt-use law while driving and evaluated the factors associated with noncompliance with seatbelt-use law while driving using a multivariable log-binomial regression model. The adjusted prevalence ratios (PR) and corresponding 95% confidence intervals (CI) were computed using model’s parameters’ estimates.

Results

Of 822 participants, 64.4% were females, 56.6% were 21 to 30 years old, 86.5% were Kuwaitis, and 70.3% had college and/or university level education. The prevalence of self-reported noncompliance with mandatory seatbelt-use law while driving was 55.5%, whereas the prevalence of noncompliance with self-reported mandatory use seatbelt as a passenger was 80.9%. Multivariable log-binomial regression model showed that after adjusting for the influence of other variables in the model, participants were more likely to be noncompliers with mandatory seatbelt law while driving, if they believed that seatbelt does not protect against injuries during road traffic crashes (RTC) (adjusted PR = 1.20; 95% CI: 1.06–1.37; p = 0.004) or if they were ever fined for not wearing seatbelt (adjusted PR = 1.34; 95% CI: 1.24–1.47; p <  0.001). Furthermore, participants were significantly more likely to be noncompliers with mandatory seatbelt law while driving, if they were unaware of implemented mandatory seatbelt law in Kuwait (adjusted PR = 1.11; 95% CI: 1.04–1.19; p = 0.003).

Conclusions

The prevalence of noncompliance with mandatory seatbelt-use law in the adult working population of Kuwait is considerably high. Being unaware of mandatory seatbelt use law, belief that seatbelt does not protect during RTC, and having ever been fined in the past for not having seatbelt on while driving were significant predictors of noncompliance with seatbelt-use law. These results warrant the focused mass education and rigorous enforcement of seatbelt-use law while driving. These strategies are likely to enhance the adherence to seatbelt-use law and minimize RTCs related injuries and mortality among adult drivers in this and other similar settings in the region. If implemented, future studies may look at the impact of such interventions on RTCs related frequency and severity of injuries in this and other similar settings.
Doing Post-Western sociology in Central and Eastern Europe before and after the Great Change: some epistemological questions
Authors: Koleva Svetla
Published: November 2020

Analyzing the sociology in Central and Eastern Europe before and after the Great Change in 1989, the article aims to present the main epistemological questions that Post-Western sociology raises for the discipline of sociology as a whole. The focus is put on a paradoxical feature in the development of sociology in the countries of Central and Eastern Europe: before 1989, under conditions of Marxist monoparadigmality, relative isolation of scientific cognition, and political and ideological pressure, sociological research in these countries was characterized by methodological rigor and conceptual innovativeness, while after 1989, in the context of institutionalized plurality of paradigms (polyparadigmality), and intensive scientific exchange, the dominant tendency is—for social scientists in the countries in question—to borrow methodologies, theories, and concepts from the Western sociological tradition, without analyzing the epistemic relevance of these loans with regard to the societies in which they are applied. This paradox is examined in terms of sociological production in two research fields: the general sociological theory of society and sociology of youth. Comparing studies and analyses carried out in these two fields in Central and Eastern Europe before and after the Great Change, the article demonstrates that Post-Western sociology is a validresearch posturefor a wide variety of sociological practices regardless of the concrete national, theoretical, or institutional frameworks in which researchers are working. Sensitivity to the context of research is what permits Post-Western sociology to eliminate cognitive hierarchies and inequalities and restores the epistemic autonomy of each cognitive practice, emphasizing the inevitable cultural variations in the interpretation of one and the same phenomenon and the impact of these variations on methodology. In this sense, Post-Western sociology raises important epistemological problems regarding the relationship between maintaining the disciplinary principles of sociological knowledge on the one hand, and the application of those principles in different epistemic contexts on the other hand. The main question could be formulated as follows: how does Post-Western sociology enrich the deontological and epistemological principles of the discipline and in what way does it contribute to developing its scientific project?
Laparoscopic right hemicolectomy for an ascending colon cancer patient with an implantable left ventricular assist device: a case report
Authors: Kajiwara Taiki , Naitoh Takeshi , Suzuki Yusuke , Kohyama Atsushi , Karasawa Hideaki , Suzuki Hideyuki , Akiyama Masatoshi , Saiki Yoshikatsu , Watanabe Kazuhiro , Ohnuma Shinobu , Kamei Takashi , Unno Michiaki
Published: November 2020

Background

Left ventricular assist devices (LVADs) currently play an important role in the treatment of patients with end-stage heart failure who require a bridge to heart transplantation or destination therapy. With the development and improvement of the LVADs, the morbidity and mortality rates are declining and life expectancies increasing, and the number of patients with LVADs requiring non-cardiac surgery is likely to increase. We present the case of a patient with implantable LVAD who underwent laparoscopic right hemicolectomy for ascending colon cancer.

Case description

The patient was a 66-year-old man who underwent LVAD implantation as a BTT 3 years prior. He suffered from severe anemia at follow-up, and a colonoscopy revealed ascending colon cancer. The LVAD pump was implanted in the epigastrium. The long C-shaped subfascial driveline tunnel was made, and driveline exit site was located on the left lateral abdominal wall. We assessed the positional relationship between the tumor and the driveline using X-ray and three-dimensional computed tomography (3D CT) images. 3D CT image allowed us to easily identify the location of the driveline, and we determined to perform laparoscopic right hemicolectomy. The port sites were decided upon carefully to avoid the driveline injury, and the driveline was marked on the skin before surgery. There were no adhesions in the abdominal cavity, and both the LVAD and the driveline were observable. The trocars were in nearly the same positions as in a standard laparoscopic right hemicolectomy. During the operation, the LVAD and the driveline did not interfere with the trocars. We successfully completed a standard laparoscopic right hemicolectomy despite hemorrhagic tendency. The patient was discharged without any bleeding complications during the postoperative course.

Conclusion

Laparoscopic surgery is feasible and safe for patients with LVADs with intensive preoperative simulation and perioperative prevention of infection.