bluuebunny/crossref_metadata_2025 huggingface dataset:
Yield components detection and image-based indicators for non-invasive grapevine yield prediction at different phenological phases
Authors: Victorino Gonçalo Filipe , Braga Ricardo , Santos-Victor José , Lopes Carlos M.
Published: October 2020

Forecasting vineyard yield with accuracy is one of the most important trends of research in viticulture today. Conventional methods for yield forecasting are manual, require a lot of labour and resources and are often destructive. Recently, image-analysis approaches have been explored to address this issue. Many of these approaches encompass cameras deployed on ground platforms that collect images in proximal range, on-the-go. As the platform moves, yield components and other image-based indicators are detected and counted to perform yield estimations. However, in most situations, when image acquisition is done in non-disturbed canopies, a high fraction of yield components is occluded. The present work’s goal is twofold. Firstly, to evaluate yield components’ visibility in natural conditions throughout the grapevine’s phenological stages. Secondly, to explore single bunch images taken in lab conditions to obtain the best visible bunch attributes to use as yield indicators.In three vineyard plots of red (Syrah) and white varieties (Arinto and Encruzado), several canopy 1 m segments were imaged using the robotic platform Vinbot. Images were collected from winter bud stage until harvest and yield components were counted in the images as well as in the field. At pea-sized berries, veraison and full maturation stages, a bunch sample was collected and brought to lab conditions for detailed assessments at a bunch scale.At early stages, all varieties showed good visibility of spurs and shoots, however, the number of shoots was only highly and significantly correlated with the yield for the variety Syrah. Inflorescence and bunch occlusion reached high percentages, above 50 %. In lab conditions, among the several bunch attributes studied, bunch volume and bunch projected area showed the highest correlation coefficients with yield. In field conditions, using non-defoliated vines, the bunch projected area of visible bunches presented high and significant correlation coefficients with yield, regardless of the fruit’s occlusion.Our results show that counting yield components with image analysis in non-defoliated vines may be insufficient for accurate yield estimation. On the other hand, using bunch projected area as a predictor can be the best option to achieve that goal, even with high levels of occlusion.
Phase Transitions in Virology
Authors: Sole Ricard , Sardanyes Josep , Elena Santiago F.
Published: October 2020

Viruses have established symbiotic relationships with almost every other living organism on Earth and at all levels of biological organisation, from other viruses up to entire ecosystems. In most cases, peacefully coexisting with their hosts, but in most relevant cases, parasitising them and inducing diseases. Viruses are playing an essential role in shaping the eco-evolutionary dynamics of their hosts, and have been also involved in some of the major evolutionary innovations either by working as vectors of genetic information or by being themselves coopted by the host into their genomes. Viruses can be studied at different levels of biological organisation, from the molecular mechanisms of genome replication, gene expression and encapsidation, to global pandemics. All these levels are different and yet connected through the presence of threshold conditions allowing for the formation of a capsid, the loss of genetic information or epidemic spreading. These thresholds, as it occurs with temperatures separating phases in a liquid, define sharp qualitative types of behaviour. These {\em phase transitions} are very well known in Physics. They have been studied by means of simple, but powerful models able to capture their essential properties, allowing to understand them. Can the physics of phase transitions be an inspiration for our understanding of viral dynamics at different scales? Here we review well-known examples of transition phenomena in virology and their simplest mathematical modelling approaches. We suggest that the advantages of abstract, simplified pictures used in Physics are also the key to properly understand the origins and evolution of complexity in viruses. By means of several examples, we explore this multilevel landscape and how minimal models provide deep insights into a diverse array of problems. The relevance of these transitions in connecting dynamical patterns across levels and their evolutionary and clinical implications are outlined.
Exploring the Modulation of Immune Response and Oxidative Stress of Intracellular Pathogens Using Nanoparticles Encapsulating Drugs
Authors: Pandey Ramendra Pati , Priyadarshini Anjali , Gupta Archana , Vibhuti Arpana , Leal Elcio , Sengupta Utpal , Katoch Vishwa Mohan , Sharma Pawan , Moore Catrin E , Raj V. Samuel
Published: October 2020

The immune system is a dynamic network of cells and cytokines are the major mediators of immune responses which combat pathogens. Based on the cytokine production, effector T cells differentiate into subsets known as Th1, Th2, Th17 or Treg (T regulatory). This system serves as a barrier to intracellular pathogens, bacterial infections and stimulates the production of reactive oxygen species (ROS), reactive nitrogen intermediates (RNI) and nitric oxide (NO), which diffuses across membranes and engulfs intracellular pathogens. Oxidative stress occurs when ROS, reactive nitrogen species (RNS) production and antioxidant defences become imbalanced. Oxidative stress generated by infected cells produces a substantial amount of free radicals which enables killing of intracellular pathogens. Intracellular pathogens are exposed to endogenous ROS as part of normal aerobic respiration, also aexogenous ROS and RNS are generated by the host immune system in response to infection. Nanoparticles which are designed for drug delivery are capable of trapping the desired drug in the particles which protects the drug from enzymatic degradation in a biological system. The small (subcellular) size of nanoparticles enables higher intracellular uptake of the drug which results in the reduction of the concentration of free drugs reducing their toxic effect. Research on the modulation of immune response and oxidative stress using nanoparticles used to encapsulate drugs has yet to be explored fully. In this review we illustrate the immune activation and generation of oxidative stress properties which are mediated by nanoparticle encapsulated drug delivery systems which can make the therapy more effective in case of diseases caused by intracellular pathogens.
Endothelial Dysfunction and Extra-Articular Neurological Manifestations in Rheumatoid Arthritis
Authors: Maiuolo Jessica , Muscoli Carolina , Gliozzi Micaela , Musolino Vincenzo , Carresi Cristina , Scicchitano Miriam , Bosco Francesca , Macrì Roberta , Scarano Federica , Ruga Stefano , Paone Sara , Zito Maria Caterina , Nucera Saverio , Ilari Sara , Mollace Rocco , Palma Ernesto , Mollace Vincenzo
Published: October 2020

Rheumatoid arthritis (RA) is a chronic systemic inflammatory autoimmune disease that affects about 1% of the global population, with a female-male ratio of 3:1. To date, genetic predisposition, the involvement of a deficient immune system and lifestyle are known to be the major responsible for the onset of the disease. RA preferably affects the joints, with consequent joint swelling and deformities followed by ankylosis. Patients suffering from rheumatoid arthritis can also develop extra-articular manifestations, which mainly affect the cardiovascular system, the nervous system, the skin, the eye, the respiratory system, the kidney and the gastrointestinal system. It has been shown that about 20% of RA patients can develop neuropathies, multiple mononeuritis, distal sensory neuropathies and sense motor neuropathies. Neurological involvement occurs as a consequence of vasculitis of the nerve vessels leading to vascular ischaemia, axonal degeneration and neuronal demyelination. In RA, the risk of developing cardiovascular disease is very high and depends, most probably, on vascular damage resulting from endothelial dysfunction. Hence, it is reasonable to assume that the integrity of the endothelium is also involved in the neurological disorders resulting from RA. This review aims to highlight the main characteristics of the extra-articular manifestations at the nervous level resulting from rheumatoid arthritis. To this end, the literature main results on these pathological manifestations have been collected with particular focus on the involvement of endothelial dysfunction. In fact, the endothelium could be considered a valuable target for minimizing the incidence of extra-articular neurological manifestations in RA.
The Effects of Inertial Forces on the Dynamics of Disk Galaxies
Authors: Zimmerman Tomer , Gomel Roy
Published: October 2020

When dealing with galactic dynamics, or more specifically, with galactic rotation curves, one basic assumption is always taken: the frame of reference relative to which the rotational velocities are given is assumed to be inertial. In other words, fictitious forces are assumed to vanish relative to the observational frame of a given galaxy. It might be interesting, however, to explore the outcomes of dropping that assumption; that is, to search for signatures of non-inertial behavior in the observed data. In this work, we show that the very discrepancy in galaxy rotation curves could be attributed to non-inertial effects. We derive a model for spiral galaxies that takes into account the possible influence of fictitious forces and find that the additional terms in the new model, due to fictitious forces, closely resemble dark halo profiles. Following this result, we apply the new model to a wide sample of galaxies, spanning a large range of luminosities and radii. It turns out that the new model accurately reproduces the structures of the rotation curves and provides very good fittings to the data.
Media and Misinformation in Times of COVID-19 How People Informed Themselves in the Days Following the Portuguese Declaration of the State of Emergency
Authors: Ferreira Gil Baptista , Borges Susana
Published: October 2020

This study takes as a starting point the importance and dependence of the media (Ball-Rokeach & DeFleur, 1976) to obtain information about the pandemic. The dependency theory of the media system was developed in the 1970s when mass media were the dominant source of information. Today, at a time when media choices have become abundant, studies are needed to understand the phenomenon of media dependence in light of new dimensions made important by the transformations that have taken place in the social and media fields - where the coexistence of mass media with social media platforms stands out. As large-scale crises rarely occur and the media environment changes rapidly, it is important to analyze how media dependence relates to choose and trust in different media (traditional media vs. social media) in times of crisis. Several questions arise. What is the trust attributed by individuals to social media as sources of information about the COVID-19? How well informed are the individuals who choose these sources as the main sources of information? From a questionnaire administered to 240 individuals in Portugal, during the first week of the state of emergency (March 2020), this research seeks to identify how people gained access to information about the COVID-19, how they acted critically towards the various sources and how they assess the reliability of different media. Finally, it analyzes the association between the type of medium chosen and adherence to misinformation content about the virus. The results reveal the existence of a phenomenon of dependence on the media, with a strong exposure (both active and accidental) to informative content, with conventional media being privileged as the main source, and positively distinguished in terms of confidence. Finally, a statistically significant association of a positive sign was identified between the use of social media as the main source and the acceptance of misinformation.
Natural Hydrogen System in Western Australia?
Authors: Rezaee Reza
Published: October 2020

There is a marked momentum towards the use of clean hydrogen energy as an alternative for fossil fuels. Renewable energies such as solar and wind are being used to generate hydrogen from the water hydrolysis process. Indeed, this approach stores renewable energies in the form of combustible hydrogen for other energy uses. The other alternative that could be economically more cost-effective at the current technology stage is to explore the natural “Hydrogen System” where the natural hydrogen is generated and accumulated within the earth system, the same that stands for a “Petroleum System”. The Discovery of a large accumulation of relatively pure natural hydrogen (H2) in Mali has triggered the opportunity of searching for natural hydrogen accumulations in other countries. The generation of hydrogen from a circular depression in Mali and some other countries is linked to the presence of geologically very old iron-rich basement rocks. Solid-liquid redox reactions between iron-rich minerals and groundwater that split water are a possible source of H2 in deep basement rocks. It is believed that the hydrogen degassing may be detected by surface topographic circular to sub-circular shallow depressions. Chemical processes such as dissolution by hydrogen are considered to play the main role in the formation of the circular depressions through preferential vertical hydrogen migration channel. Archean iron-rich Yilgarn Craton that covers a vast area of Western Australia (WA) contains abundant iron-rich mafic-ultramafic rocks. The craton reveals many surficial circular depressions visible through satellite images. The area has abundant fault systems and is blanketed with Eocene sedimentary rocks containing high-quality reservoir rocks. All these characteristics seem to provide most of the required elements, such as hydrogen source, migration pathway, and reservoir rock for a “Hydrogen System” in this area.
Environmental and Nutritional “Stressors” and Oligodendrocyte Dysfunction: Role of Mitochondrial and Endoplasmatic Reticulum Impairment
Authors: Maiuolo Jessica , Gliozzi Micaela , Musolino Vincenzo , Carresi Cristina , Nucera Saverio , Scicchitano Miriam , Scarano Federica , Bosco Francesca , Oppedisano Francesca , Macrì Roberta , Ruga Stefano , Zito Maria Caterina , Palma Ernesto , Mollace Vincenzo
Published: October 2020

Oligodendrocytes are myelinating cells of the central nervous system, which are generated by progenitor oligodendrocytes as a result of maturation processes. The main function of mature oligodendrocytes is to produce myelin, a lipid-rich multi-lamellar membrane that wraps tightly around neuronal axons, isolating them and facilitating nerve conduction through saltatory propagation. The myelination process requires the consumption of a lot of energy and a high metabolic turnover. Mitochondria are essential organelles which regulate many cellular functions including the energy production through oxidative phosphorylation. Any mitochondrial dysfunction impacts cellular metabolism and negatively affects the health of the organism. If the functioning of the mitochondria is unbalanced the myelination process is impaired. At the end of myelination, oligodendrocytes synthesize about 40% of the total lipids present in the brain. Since lipid synthesis occurs in the cellular endoplasmic reticulum, the alteration of this organelle can lead to partial or deficient myelination, triggering numerous neurodegenerative diseases. In this review the main dysfunctions of oligodendrocytes caused by exogenous or endogenous stimuli will be investigated. Furthermore, the oligodendrocyte reactions to excessive mitochondrial oxidative stress and an altered regulation of the functioning of the endoplasmic reticulum will be discussed.
Unidirectional Pedestrian Circulation: Physical Distancing in Informal Settlements
Authors: Fernandez Gonzalez Juan , Gongal Ankit
Published: October 2020

The COVID-19 pandemic has resulted in a wide range of spatial interventions to slow down the spread of the virus. The spatial limitations of narrow public circulation spaces within informal settlements, which house over one billion people around the world, make it impossible for pedestrians to practice physical distancing (or social distancing). In this paper, we propose a flexible mathematical method, named the Cluster Lane Method, for turning a planar circulation network of any size or complexity into a network of unidirectional lanes, making physical distancing possible in narrow circulation spaces by limiting face-to-face interactions. New notions and theorems about oriented graphs in graph theory are introduced. The paper ends with a discussion of the potential implementation of this cost-efficient, low-tech, sustainable solution, and with the introduction of a novel unidirectional tactile paving for the visually impaired.
The Complete Mitochondrial Genome of the New Zealand Parasitic Blowfly Lucilia sericata (Insecta: Diptera: Calliphoridae)
Authors: Palevich Nikola
Published: October 2020

In the present study, the complete mitochondrial genome of the New Zealand parasitic blowfly Lucilia sericata (green bottle blowfly) field strain NZ_LucSer_NP was generated using next-generation sequencing technology. The length of complete the mitochondrial genome is 15,938 bp, with 39.4% A, 13.0% C, 9.3% G, and 38.2% T nucleotide distribution. The complete mitochondrial genome consists of 13 protein-coding genes, two ribosomal RNAs, 22 transfer RNAs, and a and a 1,124 bp non-coding region, similar to most metazoan mitochondrial genomes. Phylogenetic analysis showed that L. sericata NZ_LucSer_NP forms a monophyletic cluster with the remaining six Lucilia species and the Calliphoridae are polyphyletic. This study provides the first complete mitochondrial genome sequence for a L. sericata blowfly species derived from New Zealand to facilitate species identification and phylogenetic analysis.
People-Centeredness, Chronic Conditions and Diversity Sensitive eHealth: Exploring Emancipation of the ‘Health Care System’ and the ‘Patient’ in Health Informatics
Authors: Botin Lars , Bertelsen Pernille S. , Nøhr Christian
Published: October 2020

Critically the paper argues that a truly people-centered technology supported chronic care system can only be designed by understanding and responding to the needs, attributes and capabilities of the most vulnerable in society. The paper suggests innovative ways of supporting interactions with these ‘end-users’ and highlights how reflection on these approaches can contribute to emancipating both the health system to move towards more socially inclusive e-health solutions.
Analisis Faktor Penyebab Kesulitan Belajar Matematika di Kelas IV Sekolah Dasar Negeri 004 Bangkinang Kota (Materi Pecahan)
Authors: Natasya Nordiana
Published: October 2020

Kesulitan belajar adalah ketidakmampuan siswa dalam menguasai fakta, konsep, prinsip dan keterampilan. Penelitian ini bertujuan untuk mengetahui faktor penyebab kesulitan belajar yang dialami oleh siswa kelas IV SD Negeri 004 Bangkinang Kota dalam mempelajari matematika. Dalam penelitian ini teknik sampling yang digunakan adalah sampling jenuh yaitu seluruh siswa kelas IV yang berjumlah 14 orang menjadi subjek dalam penelitian ini. Siswa kelas IV terpilih sebagai subjek berdasarkan hasil observasi peneliti selama masa PPL (Program Praktek Lapangan). Kemudian data diperkuat dengan pengakuan guru mata pelajaran matematika tentang adanya kesulitan belajar matematika di kelas IV tahun ajaran 2018/2019. Teknik yang digunakan untuk mengumpulkan data adalah observasi, wawancara, kuesioner, catatan lapangan, dokumentasi dan checklist. Kuesioner siswa digunakan untuk mengetahui faktor kesulitan belajar matematika siswa, sedangkan wawancara guru, kuesioner orang tua dan catatan lapangan untuk mengakuratkan hasil kuesioner siswa. Dokumentasi dan checklist berfungsi sebagai penunjang dalam penelitian ini. Hasil penelitian ini menunjukkan bahwa faktor penyebab kesulitan belajar matematika siswa kelas IV adalah siswa tidak pernah kecewa saat mendapatkan nilai rendah (85,7%), siswa mengalami kesulitan dalam memahami materi menyederhanakan pecahan (85,7%) dan guru tidak pernah membawa alat peraga untuk menunjang pemahaman siswa dalam materi menyederhanakan pecahan (85,7%). Sehingga diambil kesimpulan bahwa faktor penyebab kesulitan belajar matematika di kelas IV SD Negeri 004 Bangkinang Kota adalah faktor intern dan faktor ekstern. Faktor intern meliputi sikap negative dalam belajar matematika dan motivasi belajar masih rendah. Sedangkan faktor ekstern meliputi kurangnya variasi mengajar guru dan penggunaan media/alat peraga pembelajaran yang belum maksimal.
Improved Detection of Scaphoid Fractures with High-Resolution Peripheral Quantitative CT Compared with Conventional CT
Authors: Daniels A.M. , Bevers M.S.A.M. , Sassen S. , Wyers C.E. , van Rietbergen B. , Geusens P.P.M.M. , Kaarsemaker S. , Hannemann P.F.W. , Poeze M. , van den Bergh J.P. , Janzing H.M.J.
Published: October 2020

Background:

Computed tomography (CT), magnetic resonance imaging, and bone scintigraphy are second-line imaging techniques that are frequently used for the evaluation of patients with a clinically suspected scaphoid fracture. However, as a result of varying diagnostic performance results, no true reference standard exists for scaphoid fracture diagnosis. We hypothesized that the use of high-resolution peripheral quantitative CT (HR-pQCT) in patients with a clinically suspected scaphoid fracture could improve scaphoid fracture detection compared with conventional CT in the clinical setting.

Methods:

The present study included 91 consecutive patients (≥18 years of age) who presented to the emergency department with a clinically suspected scaphoid fracture between December 2017 and October 2018. All patients were clinically reassessed within 14 days after first presentation, followed by CT and HR-pQCT. If a scaphoid fracture was present, the fracture type was determined according to the Herbert classification system and correlation between CT and HR-pQCT was estimated with use of the Kendall W statistic or coefficient of concordance (W) (the closer to 1, the higher the correlation).

Results:

The cohort included 45 men and 46 women with a median age of 52 years (interquartile range, 29 to 67 years). HR-pQCT revealed a scaphoid fracture in 24 patients (26%), whereas CT revealed a scaphoid fracture in 15 patients (16%). Patients with a scaphoid fracture were younger and more often male. The correlation between CT and HR-pQCT was high for scaphoid fracture type according to the Herbert classification system (W = 0.793; 95% confidence interval [CI], 0.57 to 0.91; p < 0.001) and very high for scaphoid fracture location (W = 0.955; 95%, CI 0.90 to 0.98; p < 0.001).

Conclusions:

In the present study, the number of patients diagnosed with a scaphoid fracture was 60% higher when using HR-pQCT as compared with CT. These findings imply that a substantial proportion of fractures—in this study, more than one-third—will be missed by the current application of CT scanning in patients with a clinically suspected scaphoid fracture.

Level of Evidence:

Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.
Influence of Femoral Component Design on Proximal Femoral Bone Mass After Total Hip Replacement
Authors: Slullitel Pablo A. , Mahatma Mohit M. , Farzi Mohsen , Grammatopoulos George , Wilkinson J. Mark , Beaulé Paul E.
Published: October 2020

Background:

In this randomized controlled trial (RCT), we compared bone remodeling and bone turnover between 2 total hip arthroplasty implants—the short, proximally porous-coated Tri-Lock Bone-Preservation Stem and a conventional, fully-coated Corail prosthesis—over a 2-year postoperative period.

Methods:

Forty-six participants received the Tri-Lock prosthesis and 40 received the Corail prosthesis. At baseline, the 2 groups had similar demographics, proximal femoral bone mineral density (BMD), bone turnover markers, radiographic canal flare index, and patient-reported outcome measure (PROM) scores. Outcomes were measured at weeks 26, 52, and 104.

Results:

Loss of periprosthetic bone, measured by high-sensitivity dual x-ray absorptiometry region-free analysis (DXA-RFA), was identified at the calcar and proximal-lateral aspect of the femur in both prosthesis groups (p < 0.05). However, the conventional prosthesis was associated with a smaller reduction in BMD compared with the bone-preservation prosthesis (p < 0.001). This effect was most prominent in the region of the femoral calcar and greater trochanter. A small gain in BMD was also identified in some areas, and this gain was greater with the conventional than the bone-preservation prosthesis (p < 0.001). The 2 groups had similar changes in bone turnover markers and improvement in PROM scores over the study period (p > 0.05). The adverse-event rate was also similar between the groups (p > 0.05).

Conclusions:

This RCT shows that prostheses intended to preserve proximal femoral bone do not necessarily perform better in this regard than conventional cementless designs. DXA-RFA is a sensitive tool for detecting spatially complex patterns of periprosthetic bone remodeling.

Level of Evidence:

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Characterization of Gut Microbiota Associated with Clinical Parameters in Intrahepatic Cholestasis of Pregnancy
Authors: Li Rong , chen xuehai , Liu Zhongzhen , Chen Yan , Liu Chuan , Ye Lingfei , Xiao Liang , Yang Zhenjun , He Jian , Wang Wen-Jing , Qi Hongbo
Published: October 2020

BackgroundIntrahepatic cholestasis of pregnancy (ICP) is a liver disorder that specifically occurs in pregnancy. Elevated levels of liver transaminases aspartate aminotransferase, alanine aminotransferase and serum bilirubin levels are common biochemical characteristics in ICP. The disorder is associated with an increased risk of premature delivery and stillbirth. The characterization of the potential microbiota in ICP could go a long way in the prevention and treatment of this pregnancy disease.MethodsA total of 58 patients were recruited for our study: 27 ICP patients and 31 healthy pregnant subjects with no ICP. The V3 and V4 regions of the 16S rDNA collected from fecal samples of both diseased and control groups were amplified. 16S rRNA gene amplicon sequencing was then performed on gut microbiota. Sequencing data were analyzed and the correlation between components of microbiota and patient ICP status was found. Related metabolic pathways, relative abundance and significantly different OTUs (Operational Taxonomic Units) between ICP and controls were also identified.ResultsElevated levels of total bile acid, ALT, AST, Dbil and Tbil were recorded or observed in ICP subjects as compared to the control. Gut microbiota in pregnant women was dominated by four major phyla and 27 core genera. PCoA analysis results indicated that there was no significant clustering in Bray-Curtis distance matrices. Our results showed that there was a correlation between specific OTUs and measured clinical parameters of pregnant women. Comparison at the different taxonomy levels revealed high levels of abundance of Blautia and Citrobacter in ICP patients. At the family level, Enterobacteriaceae and Leuconostocaceae were higher in ICP patients. 638 KEGG Orthologs and 138 pathways significantly differed in the two groups. PLS-DA model with VIP plots indicated a total of eight genera and seven species were key taxa in ICP and control groups.ConclusionsOur research indicated that although there was no significant clustering by PCoA analysis, patients with ICP have increased rare bacteria at different phylogenetic levels. Our results also illustrated that all 638 KEGG Orthologs and 136 in 138 KEGG pathways were less abundant in ICP patients compared to the controls.
Routinely collected patient data in neurology research: A systematic mapping review
Authors: Biggin Frances , Emsley Hedley , Knight Jo
Published: October 2020

Background This review focuses on neurology research which uses routinely collected data. The number of such studies is growing alongside the expansion of data collection. We aim to gain a broad picture of the scope of how routine healthcare data have been utilised. Methods This study follows a systematic mapping review approach which does not make a judgement on the quality of the papers included in the review, thereby enabling a complete overview of the field. Results Of 4481 publications retrieved, 386 met the eligibility criteria for this study. These publications covered a wide range of conditions, but the majority were based on one or only a small number of neurological conditions. In particular, publications concerned with three discrete areas of neurological practice - multiple sclerosis (MS), epilepsy/seizure and Parkinson’s disease - accounted for 60% of the total. MS was the focus of the highest proportion of eligible studies (35%), yet in the recent Global Burden of Neurological Disease study it ranks only 14th out of 15 neurological disorders for DALY rates. In contrast, migraine is the neurological disorder with the highest ranking of DALYs globally (after stroke) and yet it was represented by only 4% of eligible studies. Conclusion This review shows that there is a disproportionately large body of literature pertaining to relatively rare disorders, and a correspondingly small body of literature describing more common conditions. Therefore, there is potential for future research to redress this balance.
Prevalence of anemia and iron deficiency anemia in Chinese pregnant women (IRON WOMEN): a national cross-sectional survey
Authors: Tan Jing , He Guolin , Qi Yana , Yang Hongmei , Xiong Yiquan , Liu Chunrong , Wang Wen , Zou Kang , Lee Andy H. , Sun Xin , Liu Xinghui
Published: October 2020

Background: The current evidence about anemia and iron deficiency anemia (IDA) during pregnancy remains elusive in China. The purpose of this study is to investigate the prevalence of anemia and IDA and their risk factors in Chinese pregnant women.Methods: A nationwide cross-sectional survey of pregnant women was conducted during their antenatal visits. Using a multi-stage sampling method, 24 hospitals from 16 provinces across China were selected. Structured questionnaires were administered to collect information from participants and to extract clinical data from electronic medical records. Mixed-effects logistic regression models were performed to determine the risk factors associated with anemia and IDA.Results: In total, 12,403 pregnant women were enrolled, including 1,018 (8.2%) at the first trimester, 3,487 (28.1%) at the second, and 7,898 (63.7%) at the third. Overall, 19.8% of women were diagnosed with anemia and 13.9% were diagnosed with IDA. The prevalence of anemia and IDA varied among regions and increased by gestational month, peaking at the eighth gestational month (24.0% for anemia and 17.8% for IDA). Pregnant women at advanced stage of gestation, non-local residents, multiple gestations, multiparity, pre-pregnancy underweight, and those experiencing severe nausea or vomiting during pregnancy, were associated with higher risks of anemia and IDA.Conclusions: The prevalence of anemia and IDA during pregnancy are similar to those from developed countries and vary across regions in China.
Regional Registration of Whole Slide Image Stacks Containing Major Histological Artifacts
Authors: Paknezhad Mahsa , Loh Sheng Yang Michael , Choudhury Yukti , Koh Valerie Koh Cui , Yong Timothy Tay Kwang , Tan Hui Shan , Kanesvaran Ravindran , Tan Puay Hoon , Peng John Yuen Shyi , Yu Weimiao , Tan Yongcheng Benjamin , Loy Yong Zhen , Tan Min Han , Lee Hwee Kuan
Published: October 2020

Background: High resolution 2D whole slide imaging provides rich information about the tissue structure. This information can be a lot richer if these 2D images can be stacked into a 3D tissue volume. A 3D analysis, however, requires accurate reconstruction of the tissue volume from the 2D image stack. This task is not trivial due to the distortions such as tissue tearing, folding and missing at each slide. Performing registration for the whole tissue slices may be adversely affected by distorted tissue regions. Consequently, regional registration is found to be more effective. In this paper, we propose a new approach to an accurate and robust registration of regions of interest for whole slide images. We introduce the idea of multi-scale attention for registration. Results: Using mean similarity index as the metric, the proposed algorithm (mean +- std: 0.84 +- 0.11) followed by a fine registration algorithm (0.86 +- 0.08) outperformed the state-of-the-art linear whole tissue registration algorithm (0.74 +- 0.19) and the regional version of this algorithm (0.81 +- 0.15). The proposed algorithm also outperforms the state-of-the-art nonlinear registration algorithm (original: 0.82 +- 0.12, regional: 0.77 +- 0.22) for whole slide images and a recently proposed patch-based registration algorithm (patch size 256: 0.79 +- 0.16 , patch size 512: 0.77 +- 0.16) for medical images. Conclusion: Using multi-scale attention mechanism leads to a more robust and accurate solution to the problem of regional registration of whole slide images corrupted in some parts by major histological artifacts in the imaged tissue.
The effectiveness and cost effectiveness of a hospital avoidance program in a residential aged care facility: a prospective cohort study and modelled decision analysis
Authors: Carter Hannah , Lee Xing J. , Dwyer Trudy , O’Neill Barbara , Jeffrey Dee , Doran Chris , Parkinson Lynne , Osborne Sonya , Reid-Searl Kerry , Graves Nicholas
Published: October 2020

Background: Residential aged care facility residents experience high rates of hospital admissions which are stressful, costly and often preventable. The EDDIE program is a hospital avoidance initiative designed to enable nursing and care staff to detect, refer and quickly respond to early signals of a deteriorating resident. The program was implemented in a 96-bed residential aged care facility in regional Australia.Methods: A prospective pre-post cohort study design was used to collect data on costs of program delivery, hospital admission rates and length of stay for the 12 months prior to, and following, the intervention. A Markov decision model was developed to synthesize study data with published literature in order to estimate the cost-effectiveness of the program. Quality adjusted life years (QALYs) were adopted as the measure of effectiveness.Results: The EDDIE program was associated with a 19% reduction in annual hospital admissions and a 31% reduction in the average length of stay. The cost-effectiveness analysis found the program to be both more effective and less costly than usual care, with 0.06 QALYs gained and $249,000 health system costs saved in a modelled cohort of 96 residents. A probabilistic sensitivity analysis estimated that there was an 86% probability that the program was cost-effective after taking the uncertainty of the model inputs into account. Conclusions: This study provides promising evidence for the effectiveness and cost-effectiveness of a nurse led, early intervention program in preventing unnecessary hospital admissions within a residential aged care facility. Further research in multi-site randomised studies is needed to confirm the generalisability of these results.
A patients’ view of OA: the Global Osteoarthritis Patient Perception Survey (GOAPPS), a pilot study
Authors: Vitaloni Marianna , Bemden Angie Botto-van , Sciortino Rosa , Carné Xavier , Quintero Maritza , Santos-Moreno Pedro , Espinosa Rolando , Rillo Oscar , Monfort Jordi , de Abajo Francisco , Oswald Elisabeth , Matucci Marco , du Souich Patrick , Möller Ingrid , Baures Monserrat Romera , Vinci Arlene , Scotton Deborah , Bibas Marco , Eakin Guy , Verges Josep
Published: October 2020

Background: Globally, osteoarthritis (OA) is the third condition associated with disability. There is still poor treatment in OA but science holds the key to finding better treatments and a cure. It is essential to learn what’s important to patients from them to implement the most effective OA management. The OA Patients Task Force, conducted the Global OA Patient Perception Survey (GOAPPS)-the first global survey made by patients to analize the quality of life (QoL) & patient perceptions of care across countries. The goal was to collect data on OA patients' perception of OA to understand patients’ needs and expectations to improve OA management.Methods: Observational, cross-sectional study by online survey data collection from six countries, translated into three languages. The survey was comprised of 3 sections: patient demographics and clinical symptomology characteristics; relationship with physicians: perception of attention, treatment, and information provided; and OA impact on daily activity and QoL. The results of the survey were evaluated using the Limited Data Set. The survey results were analyzed using descriptive statistics to characterize the patients' answers. Additionally, Cronbach's alpha was calculated to determine internal consistency validity.Results. A total of 1512 surveys were completed in 6 countries. 84.2% of respondents reported pain/tenderness and 91.1% experienced limitations to physical activities. 42.3% of patients were not satisfied with their current OA treatment. 86% had comorbidities, especially hypertension, and obesity. 51.3% and 78% would like access to additional drug or additional non-drug/non-surgical treatments respectively. 48.2% of patients perceived their QoL to be affected by OA. The Cronbach's alpha was 0.61.Conclusions: OA has a significant impact on patients’ daily activities and their desire to play an active role in managing this disease. Patients are seeking additional treatments, especially no pharmacological/no surgical treatments stressing the need for investing in clinical research, implementing OA preventive measures, and managing interventions to improve the healthcare value chain in OA.
Nurses’ Knowledge, Attitude, and Fall Prevention Practices at South Korean Hospitals: A Cross-Sectional Survey
Authors: Cho Mi-young , Jang Sun Joo
Published: October 2020

Background: Fall-prevention activities are nursing interventions which are designed to improve patient safety. The introduction of evaluations of medical institutions and an increase in medical litigation has led institutions to emphasize the importance of fall-prevention activities. The current situation regarding falls among patients in small and medium-sized hospitals is poorly understood. This study assessed knowledge and attitudes regarding falls, and fall-prevention activities of nurses working in small- and medium-sized hospitals. Methods: Participants were 162 nurses from seven small- and medium-sized hospitals. Data on participants’ characteristics, education regarding patient falls, knowledge of stretcher cart use, attitudes regarding patient falls, and fall-prevention activities were collected from August 1 to September 1, 2016. Results: Nurses’ knowledge of patient falls was positively correlated with their experience with inpatient falls. Furthermore, nurses’ attitudes regarding falls were influenced by their nursing experience and fall prevention education. Attitudes positively correlated with fall-prevention activities, but knowledge did not. Nurses’ attitudes regarding patient falls were correlated with fall-prevention activities. Conclusion: Hospitals should develop incentive programs to improve nurses’ attitudes which are based on their subjective norms and tailored to each hospital’s specific circumstances to ensure engagement in fall prevention activities. In short, we recommend that consistent, repeated, and custom fall-prevention education should be implemented in small- and medium-sized hospitals to promote engagement in fall-prevention activities. Patient safety activities in small- and medium-sized hospitals can be enhanced by creating an environment that encourages active and self-directed participation in developing fall-prevention strategies using motivation and rewards.
Transanal Proctocolectomy And Ileal Pouch-Anal Anastomosis (TaIPAA) For Ulcerative Colitis: Medium Term Functional Outcomes In A Single Centre.
Authors: Capolupo Gabriella Teresa , Carannante Filippo , Mascianà Gianluca , Lauricella Sara , Mazzotta Erica , Caricato Marco
Published: October 2020

Background: Transanal dissection of the rectum has been recently introduced for ileal pouch-anal anastomosis (IPAA) in UC showing promising results. Thanks to the precise identification of the rectotomy site the risk of long rectal stump is avoided, and a single stapled anastomosis is performed easily.The aim of this study is to analyze our initial experience of transanal IPAA (Ta-IPAA), considering postoperative complications and medium-term functional outcomes.Methods: Our Center has experienced the transanal approach for proctectomy and IPAA since October 2018. All patients underwent Enhanced Recovery After Surgery (ERAS) protocol. Postoperative complications occurring within 30 days after surgery were taken into consideration. Fecal continence, genito-urinary activity and global quality of life at 1 and 6 months after ileostomy reversal have been assessed.Results: Until March 2019, 8 patients underwent Ta-IPAA. In all cases the laparoscopic approach was performed during the transabdominal phase; abdominal drainage was never used. At the time of the pouch construction a defunctioning loop ileostomy was created in all patients. Stoma closure was performed in all cases at a median time of 6 months after surgery. Postoperative complications occurred in only one patient, who showed rectal bleeding. There were no cases of anastomotic leakage.Medium-term functional outcomes were determined prospectively by a validated questionnaire (Cleveland Global Quality of Life). Fecal incontinence for liquid or solid stool, genitourinary and sexual functions were also investigated, showing comparable results with the literature data.Conclusions: In our experience, Ta-IPAA provided good short and medium-term functional results in UC.
Predictors and clinical features of methotrexate (MTX) therapy for ectopic pregnancy
Authors: Zhang Jing , Zhang Yu , Gan Lu , Liu Xiao-ying , Du Shan-ping
Published: October 2020

Background: Ectopic pregnancy is a major life- and fertility-threatening women’s health concern. As a result of advances in examination technology, an increasing number of ectopic pregnancies can be diagnosed early and treated with medical methods instead of surgery. The aim of this study was to summarize the clinical features and identify the predictors of success of methotrexate (MTX) treatment of ectopic pregnancy. Methods: This was a retrospective study of 238 ectopic pregnancies treated with MTX in the Department of Gynecology of Shaanxi Provincial People's Hospital from January 2017 to December 2017. Results: Patients were divided into two groups: the successful treatment group (n=166) and the failed treatment group (n=72). The overall success rate of MTX therapy for ectopic pregnancy was 69.75%. The mean initial beta-human chorionic gonadotropin (β-hCG) level was significantly lower in the successful treatment group than in the failed treatment group (2538.08 IU/L versus 3533.17 IU/L, P=0.000). The treatment success rate of the group with an initial β-hCG concentration less than 4000 IU/L was significantly higher than that of the group with an initial β-hCG concentration greater than 4000 IU/L. However, the success rate of the group with an initial β-hCG concentration greater than 4000 IU/L was still relatively high (54.55%). β-hCG levels were significantly increased on the 4th day in the failed treatment group (P=0.000). Compared to the initial β-hCG level, the day-4 β-hCG level increased by more than 8.21%, indicating that the treatment was effective. The diagnostic sensitivity was 88.6%, the specificity was 74.5%, and the area under the receiver operating characteristic (ROC) curve was 0.863 (95% confidence interval (CI): 0.805-0.920). Conclusions: MTX therapy as a treatment option is safe and effective for asymptomatic, hemodynamically stable patients with ectopic pregnancies who are interested in conservative treatment, regardless of the serum β-hCG level or adnexal mass size. The change in the β-hCG level between the initial day and the 4th day is an effective and early predictive tool for the success of MTX therapy for ectopic pregnancy.
Validation of the Arabic version of the Perinatal Anxiety Screening Scale (PASS) among antenatal and postnatal women
Authors: Jr Hoda , Alfarhan Thikrayat , Alsuraimi Anas
Published: October 2020

Background Anxiety among women in the perinatal period is common. Assessing the severity of perinatal anxiety will help monitor the progress of the patient through the stages of anxiety and facilitated the treatment. This study assesses the validity and reliability of the “Perinatal Anxiety Screening Scale” (PASS) in the Arabic language. Methods The PASS was translated into Arabic. 217 women in the antenatal and postnatal phase participated (92 antenatal and 125 postnatal) answered to PASS, GHQ12, EPDS-10, and DASS-21. Content validity, factor analysis, internal consistency, and test retest reliability were assessed. Results Content Validity Index (CVI) and Content Validity Ratio (CVR) were .88 and 0.79; respectively. The scale loaded on four components: acute anxiety, social anxiety, and dissociation; specific fears and trauma; general anxiety and adjustment; and perfectionism and control. Cronbach’s Alpha value for the scale was 0.78 and test retest correlation coefficient was 0.94. PASS significantly correlated with EPDS-10 (rho=0.46), GHQ-12(rho=0.58), the three components of DASS-21 (0.47, 0.50, and 0.43; respectively), and experiencing adverse life events. Conclusion The Arabic translated version of the PASS showed reasonably adequate validity and reliability and can be used to screen for anxiety disorder among women in the perinatal phase.