bluuebunny/crossref_metadata_2025 huggingface dataset:
Differences in medical specialist utilization among older people in need of long-term care – results from German health claims data
Authors: Schulz Maike , Czwikla Jonas , Tsiasioti Chrysanthi , Schwinger Antje , Gand Daniel , Schmiemann Guido , Schmidt Annika , Wolf-Ostermann Karin , Kloep Stephan , Heinze Franziska , Rothgang Heinz
Published: February 2020

Background

Elderly in need of long-term care tend to have worse health and have higher need of medical care than elderly without need for long-term care. Yet, characteristics associated with long-term care need can impede health care access: Higher levels of long-term care need come with physical and cognitive decline such as frailty and memory loss. Yet, it has not been investigated whether level of long-term care need is related to medical care utilization.

Methods

We investigated the association between the level of long-term care and medical specialist utilization among nursing home residents and home care recipients. We applied zero-inflated Poisson regression with robust standard errors based on a sample of statutory health insurance members. The sample consisted of 100.000 elderly over age 60. We controlled for age, gender, morbidity and mortality, residential density, and general practitioner utilization.

Results

We found a strong gradient effect of the level of long-term care for 9 out of 12 medical specialties: A higher level of long-term care need was associated with a lower probability of having a medical specialist visit. Yet, we did not find clear effects of the level of long-term care need on the intensity of medical specialist care. These findings were similar for both the nursing home and home care setting.

Conclusion

The findings indicate that inequalities in medical specialist utilization exist between elderly with differing levels of long-term care need because differences in morbidity were controlled for. Elderly with higher need of long-term care might face more access barriers to specialist medical care.
Psychometric properties of the Malay version of the Diabetes Empowerment Scale among Hospital Serdang type 2 diabetes mellitus patients using exploratory factor analysis
Authors: Ching Siew Mooi , Yee Anne , Lee Ping Yein , Ramachandran Vasudevan , Shum Khai Mun , Ismael Nur Fati’Izzati , Wan Sulaiman Wan Aliaa , Hoo Fan Kee , Foo Yoke Loong , Lee Kai Wei , Danaee Mahmoud , Tan Kit-Aun
Published: February 2020

Background

This study was initiated to examine the psychometric components of the Diabetes Empowerment Scale (DES) by translating and validating the scale into the Malay language (DES-M) which is the main language spoken in Malaysia. This study can determine the level of empowerment among diabetic patients towards diabetes management. In addition, the reliability and validity of the DES-M was also demonstrated.

Methods

A total of 151 patients with type 2 diabetes mellitus were recruited (between June 2016 and October 2016) to complete sets of questionnaires, which were DES-M, the Malay versions of the Diabetes Quality of Life (DQOL) for Adults and Summary of Diabetes Self Care Activities Questionnaire (SDSCA). Confirmatory and Exploratory factor analysis (CFA and EFA) were carried out to determine the factor structures of the DES-M.

Results

There were 100 males and 51 females with ages ranging from 19 to 81 years old (55 ± 13) included in this study. The instrument displayed good internal consistency (Cronbach’s α =0.920) and the respective coefficients ranged from 0.65–0.84. Discriminant validity showed adequate correlations ranged from 0.257–0.744. Concurrent validity with SDSCA (Pearson’s correlation = 0.313, p = 0.012). Predictive validity with DQOL (B = 0.27, p = 0.016). CFA indicated that four factor model of the DES-M has good fit to the data.

Conclusion

This study indicates that the DES-M has a good internal consistency and validity. Therefore, it is a valid and reliable instrument for assessing empowerment score among patients with diabetes in Malaysia.

Trial registration

NMRR-16-805-30503 (IIR).
Comparison between covert sound-production task (sound-imagery) vs. motor-imagery for onset detection in real-life online self-paced BCIs
Authors: Song Youngjae , Sepulveda Francisco
Published: February 2020

Background

Even though the BCI field has quickly grown in the last few years, it is still mainly investigated as a research area. Increased practicality and usability are required to move BCIs to the real-world. Self-paced (SP) systems would reduce the problem but there is still the big challenge of what is known as the ‘onset detection problem’.

Methods

Our previous studies showed how a new sound-imagery (SI) task, high-tone covert sound production, is very effective for onset detection scenarios and we expect there are several advantages over most common asynchronous approaches used thus far, i.e., motor-imagery (MI): 1) Intuitiveness; 2) benefits to people with motor disabilities and, especially, those with lesions on cortical motor areas; and 3) no significant overlap with other common, spontaneous cognitive states, making it easier to use in daily-life situations. The approach was compared with MI tasks in online real-life scenarios, i.e., during activities such as watching videos and reading text. In our scenario, when a new message prompt from a messenger program appeared on the screen, participants watching a video (or reading text, browsing images) were asked to open the message by executing the SI or MI tasks, respectively, for each experimental condition.

Results

The results showed the SI task performed statistically significantly better than the MI approach: 84.04% (SI) vs 66.79 (MI) True-False positive rate for the sliding image scenario, 80.84% vs 61.07% for watching video. The classification performance difference between SI and MI was found not to be significant in the text-reading scenario. Furthermore, the onset response speed showed SI (4.08 s) being significantly faster than MI (5.46 s). In terms of basic usability, 75% of subjects found SI easier to use.

Conclusions

Our novel SI task outperforms typical MI for SP onset detection BCIs, therefore it would be more easily used in daily-life situations. This could be a significant step forward for the BCI field which has so far been mainly restricted to research-oriented indoor laboratory settings.
Classical galactosemia: neuropsychological and psychosocial functioning beyond intellectual abilities
Authors: Welsink-Karssies Mendy M. , Oostrom Kim J. , Hermans Merel E. , Hollak Carla E. M. , Janssen Mirian C. H. , Langendonk Janneke G. , Oussoren Esmee , Rubio Gozalbo M. Estela , de Vries Maaike , Geurtsen Gert J. , Bosch Annet M.
Published: February 2020

Background

Despite early diagnosis and treatment, Classical Galactosemia (CG) patients frequently develop long-term complications, such as cognitive impairment. Available literature primarily reports on general intellectual abilities and shows a substantially lower Full Scale Intelligence Quotient (FSIQ) in CG patients than in the general population. Both problems in social functioning as well as internalizing problems are often reported in CG patients. The combination of intelligence, cognitive functioning, behavior and social functioning has not been studied systematically in CG patients.

Methods

To determine if CG patients demonstrate a specific neuropsychological and psychosocial profile, we investigated intelligence, functioning on multiple cognitive domains, behavior and social functioning with a comprehensive neuropsychological test battery and questionnaires (self- and proxy-reported).

Results

The data of 48 patients, aged 4–47 years are reported. FSIQ ranged from 45 to 103 (mean 77 ± 14). A negative correlation between age and FSIQ was demonstrated (p = 0.037) which resulted directly from the inclusion of four young ‘milder’ patients detected by newborn screening (NBS) with an expected better clinical outcome. Compared to normative data, patients had significantly lower but highly variable scores on all cognitive domains, especially on tests requiring mental speed. In the context of the FSIQ, 43% of the cognitive test results exceeded IQ based expectations. Overall, the patients’ scores on social functioning were in the normal range but internalizing problems were frequently reported. In our cohort, an early initiation of dietary treatment due to NBS or family screening did not result in a more favorable neuropsychological outcome.

Conclusions

In this study, we demonstrated that as a cohort, CG patients have a below average intelligence and impaired cognitive functioning without a distinctive neuropsychological profile. The effect of age on neurocognitive functioning should be assessed in longitudinal studies. Social functioning was not impaired, but patients may be at risk for internalizing problems. Considering the large variability in cognitive, behavioral and social functioning and the finding that cognitive outcomes may exceed IQ based expectations, an individual evaluation and follow-up is warranted in all CG patients to ensure timely support if needed.
Eleven grand challenges in single-cell data science
Authors: Lähnemann David , Köster Johannes , Szczurek Ewa , McCarthy Davis J. , Hicks Stephanie C. , Robinson Mark D. , Vallejos Catalina A. , Campbell Kieran R. , Beerenwinkel Niko , Mahfouz Ahmed , Pinello Luca , Skums Pavel , Stamatakis Alexandros , Attolini Camille Stephan-Otto , Aparicio Samuel , Baaijens Jasmijn , Balvert Marleen , Barbanson Buys de , Cappuccio Antonio , Corleone Giacomo , Dutilh Bas E. , Florescu Maria , Guryev Victor , Holmer Rens , Jahn Katharina , Lobo Thamar Jessurun , Keizer Emma M. , Khatri Indu , Kielbasa Szymon M. , Korbel Jan O. , Kozlov Alexey M. , Kuo Tzu-Hao , Lelieveldt Boudewijn P.F. , Mandoiu Ion I. , Marioni John C. , Marschall Tobias , Mölder Felix , Niknejad Amir , Rączkowska Alicja , Reinders Marcel , Ridder Jeroen de , Saliba Antoine-Emmanuel , Somarakis Antonios , Stegle Oliver , Theis Fabian J. , Yang Huan , Zelikovsky Alex , McHardy Alice C. , Raphael Benjamin J. , Shah Sohrab P. , Schönhuth Alexander
Published: February 2020

The recent boom in microfluidics and combinatorial indexing strategies, combined with low sequencing costs, has empowered single-cell sequencing technology. Thousands—or even millions—of cells analyzed in a single experiment amount to a data revolution in single-cell biology and pose unique data science problems. Here, we outline eleven challenges that will be central to bringing this emerging field of single-cell data science forward. For each challenge, we highlight motivating research questions, review prior work, and formulate open problems. This compendium is for established researchers, newcomers, and students alike, highlighting interesting and rewarding problems for the coming years.
Opportunities and challenges in long-read sequencing data analysis
Authors: Amarasinghe Shanika L. , Su Shian , Dong Xueyi , Zappia Luke , Ritchie Matthew E. , Gouil Quentin
Published: February 2020

Long-read technologies are overcoming early limitations in accuracy and throughput, broadening their application domains in genomics. Dedicated analysis tools that take into account the characteristics of long-read data are thus required, but the fast pace of development of such tools can be overwhelming. To assist in the design and analysis of long-read sequencing projects, we review the current landscape of available tools and present an online interactive database, long-read-tools.org, to facilitate their browsing. We further focus on the principles of error correction, base modification detection, and long-read transcriptomics analysis and highlight the challenges that remain.
The mixed model for repeated measures for cluster randomized trials: a simulation study investigating bias and type I error with missing continuous data
Authors: Bell Melanie L. , Rabe Brooke A.
Published: February 2020

Background

Cluster randomized trials (CRTs) are a design used to test interventions where individual randomization is not appropriate. The mixed model for repeated measures (MMRM) is a popular choice for individually randomized trials with longitudinal continuous outcomes. This model’s appeal is due to avoidance of model misspecification and its unbiasedness for data missing completely at random or at random.

Methods

We extended the MMRM to cluster randomized trials by adding a random intercept for the cluster and undertook a simulation experiment to investigate statistical properties when data are missing at random. We simulated cluster randomized trial data where the outcome was continuous and measured at baseline and three post-intervention time points. We varied the number of clusters, the cluster size, the intra-cluster correlation, missingness and the data-generation models. We demonstrate the MMRM-CRT with an example of a cluster randomized trial on cardiovascular disease prevention among diabetics.

Results

When simulating a treatment effect at the final time point we found that estimates were unbiased when data were complete and when data were missing at random. Variance components were also largely unbiased. When simulating under the null, we found that type I error was largely nominal, although for a few specific cases it was as high as 0.081.

Conclusions

Although there have been assertions that this model is inappropriate when there are more than two repeated measures on subjects, we found evidence to the contrary. We conclude that the MMRM for CRTs is a good analytic choice for cluster randomized trials with a continuous outcome measured longitudinally.

Trial registration

ClinicalTrials.gov, ID: NCT02804698.
A sharp upper bound on the spectral radius of a nonnegative k-uniform tensor and its applications to (directed) hypergraphs
Authors: Lv Chuang , You Lihua , Zhang Xiao-Dong
Published: February 2020

In this paper, we obtain a sharp upper bound on the spectral radius of a nonnegative k-uniform tensor and characterize when this bound is achieved. Furthermore, this result deduces the main result in [X. Duan and B. Zhou, Sharp bounds on the spectral radius of a nonnegative matrix, Linear Algebra Appl. 439:2961–2970, 2013] for nonnegative matrices; improves the adjacency spectral radius and signless Laplacian spectral radius of a uniform hypergraph for some known results in [D.M. Chen, Z.B. Chen and X.D. Zhang, Spectral radius of uniform hypergraphs and degree sequences, Front. Math. China 6:1279–1288, 2017]; and presents some new sharp upper bounds for the adjacency spectral radius and signless Laplacian spectral radius of a uniform directed hypergraph. Moreover, a characterization of a strongly connected k-uniform directed hypergraph is obtained.
Gene manipulation to test links between genome, brain and behavior in developing songbirds: a test case
Authors: London Sarah E.
Published: February 2020

Songbird research has made many seminal contributions to the fields of ethology, endocrinology, physiology, ecology, evolution and neurobiology. Genome manipulation is thus a promising new methodological strategy to enhance the existing strengths of the songbird system to advance and expand fundamental knowledge of how genetic sequences and regulation of genomic function support complex natural learned behaviors. In zebra finches (Taeniopygia guttata) in particular, a rich set of questions about the complex process of developmental song learning in juvenile males has been defined. This Review uses one area of zebra finch song learning to demonstrate how genome editing can advance causal investigations into known genome–brain–behavior relationships. Given the number and diversity of songbird species, comparative work leveraging genome manipulation would expand the influence of these birds in additional fields of ecology and evolution for song learning and other behaviors.
Progress towards engineering gene drives for population control
Authors: Raban Robyn R. , Marshall John M. , Akbari Omar S.
Published: February 2020

Vector-borne diseases, such as dengue, Zika and malaria, are a major cause of morbidity and mortality worldwide. These diseases have proven difficult to control and currently available management tools are insufficient to eliminate them in many regions. Gene drives have the potential to revolutionize vector-borne disease control. This suite of technologies has advanced rapidly in recent years as a result of the availability of new, more efficient gene editing technologies. Gene drives can favorably bias the inheritance of a linked disease-refractory gene, which could possibly be exploited (i) to generate a vector population incapable of transmitting disease or (ii) to disrupt an essential gene for viability or fertility, which could eventually eliminate a population. Importantly, gene drives vary in characteristics such as their transmission efficiency, confinability and reversibility, and their potential to develop resistance to the drive mechanism. Here, we discuss recent advancements in the gene drive field, and contrast the benefits and limitations of a variety of technologies, as well as approaches to overcome these limitations. We also discuss the current state of each gene drive technology and the technical considerations that need to be addressed on the pathway to field implementation. While there are still many obstacles to overcome, recent progress has brought us closer than ever before to genetic-based vector modification as a tool to support vector-borne disease elimination efforts worldwide.
The coding loci of evolution and domestication: current knowledge and implications for bio-inspired genome editing
Authors: Courtier-Orgogozo Virginie , Martin Arnaud
Published: February 2020

One promising application of CRISPR/Cas9 is to create targeted mutations to introduce traits of interest into domesticated organisms. However, a major current limitation for crop and livestock improvement is to identify the precise genes and genetic changes that must be engineered to obtain traits of interest. Here, we discuss the advantages of bio-inspired genome editing, i.e. the engineered introduction of natural mutations that have already been associated with traits of interest in other lineages (breeds, populations or species). To obtain a landscape view of potential targets for genome editing, we used Gephebase (www.gephebase.org), a manually curated database compiling published data about the genes responsible for evolutionary and domesticated changes across eukaryotes, and examined the >1200 mutations that have been identified in the coding regions of more than 700 genes in animals, plants and yeasts. We observe that our genetic knowledge is relatively important for certain traits, such as xenobiotic resistance, and poor for others. We also note that protein-null alleles, often owing to nonsense and frameshift mutations, represent a large fraction of the known loci of domestication (42% of identified coding mutations), compared with intraspecific (27%) and interspecific evolution (11%). Although this trend may be subject to detection, publication and curation biases, it is consistent with the idea that breeders have selected large-effect mutations underlying adaptive traits in specific settings, but that these mutations and associated phenotypes would not survive the vagaries of changing external and internal environments. Our compilation of the loci of evolution and domestication uncovers interesting options for bio-inspired and transgene-free genome editing.
Molecular evolution of gland cell types and chemical interactions in animals
Authors: Brückner Adrian , Parker Joseph
Published: February 2020

Across the Metazoa, the emergence of new ecological interactions has been enabled by the repeated evolution of exocrine glands. Specialized glands have arisen recurrently and with great frequency, even in single genera or species, transforming how animals interact with their environment through trophic resource exploitation, pheromonal communication, chemical defense and parental care. The widespread convergent evolution of animal glands implies that exocrine secretory cells are a hotspot of metazoan cell type innovation. Each evolutionary origin of a novel gland involves a process of ‘gland cell type assembly’: the stitching together of unique biosynthesis pathways; coordinated changes in secretory systems to enable efficient chemical release; and transcriptional deployment of these machineries into cells constituting the gland. This molecular evolutionary process influences what types of compound a given species is capable of secreting, and, consequently, the kinds of ecological interactions that species can display. Here, we discuss what is known about the evolutionary assembly of gland cell types and propose a framework for how it may happen. We posit the existence of ‘terminal selector’ transcription factors that program gland function via regulatory recruitment of biosynthetic enzymes and secretory proteins. We suggest ancestral enzymes are initially co-opted into the novel gland, fostering pleiotropic conflict that drives enzyme duplication. This process has yielded the observed pattern of modular, gland-specific biosynthesis pathways optimized for manufacturing specific secretions. We anticipate that single-cell technologies and gene editing methods applicable in diverse species will transform the study of animal chemical interactions, revealing how gland cell types are assembled and functionally configured at a molecular level.
Two new species of Odontotrypes (Coleoptera: Geotrupidae) from Ningxia and Sichuan, China

Authors: KRÁL DAVID , LU YUANYUAN , BAI MING
Published: February 2020

The following two new species from China are described: Odontotrypes (Odontotrypes) anthracinus Král & Lu, sp. nov. (Sichuan) and Odontotrypes (Odontotrypes) liupan Král & Lu, sp. nov. (Ningxia). New species are compared with similar and probably related species. Relevant diagnostic characters of the new species including external male genitalia are illustrated. Key words: Taxonomy, new species, Coleoptera, Scarabaeoidea, Geotrupidae, Geotrupinae, Geotrupini, Odontotrypes, Palaearctic region
Advanced Imaging Techniques for the Detection of Breast Cancer
Authors: Jochelson Maxine
Published: February 2020

Overview:

Mammography is the only breast imaging examination that has been shown to reduce breast cancer mortality. Population-based sensitivity is 75% to 80%, but sensitivity in high-risk women with dense breasts is only in the range of 50%. Breast ultrasound and contrast-enhanced breast magnetic resonance imaging (MRI) have become additional standard modalities used in the diagnosis of breast cancer. In high-risk women, ultrasound is known to detect approximately four additional cancers per 1,000 women. MRI is exquisitely sensitive for the detection of breast cancer. In high-risk women, it finds an additional four to five cancers per 100 women. However, both ultrasound and MRI are also known to lead to a large number of additional benign biopsies and short-term follow-up examinations. Many new breast imaging tools have improved and are being developed to improve on our current ability to diagnose early-stage breast cancer. These can be divided into two groups. The first group is those that are advances in current techniques, which include digital breast tomosynthesis and contrast-enhanced mammography and ultrasound with elastography or microbubbles. The other group includes new breast imaging platforms such as breast computed tomography (CT) scanning and radionuclide breast imaging. These are exciting advances. However, in this era of cost and radiation containment, it is imperative to look at all of them objectively to see which will provide clinically relevant additional information.
Research and Standard of Care: Lung Cancer in Romania
Authors: Ciuleanu Tudor E.
Published: February 2020

Overview:

In Romania, lung cancer is the most frequent cancer in men and fourth most frequent in women, and its incidence and mortality continue to rise. Recently, firm antitobacco policies were implemented, in agreement with the MPOWER strategies recommended by the World Health Organization (WHO). As of January 2012, the recognized “official” standard of care in lung cancer is still represented by the 2009 edition of the European Society for Medical Oncology (ESMO) guidelines. Cancer treatment is free, as the National Program of Oncology covers the budget for all cytotoxic agents and targeted therapy. However, reimbursement for several expensive drugs such as pemetrexed, erlotinib, and bevacizumab is individually approved by a centralized commission. All new drugs registered in Europe by the European Medicines Agency are concomitantly registered in Romania. However, no new drugs (such as gefitinib) or new indications (such as first-line tyrosine-kinase inhibitors or maintenance treatment) have been accepted for reimbursement since 2008. Clinical research is rapidly growing, and Romanian centers demonstrate a high recruitment rate in pivotal trials, despite initial delays because of a slow approval of the studies by authorities.
Parody and Garden Path
Authors: Hou Guojin , Feng Mei
Published: February 2020

This is a study of Chinese rhetorical constructions, parody and garden path (GP), from the perspective of lexico-constructional pragmatics (LCP). LCP adopts a holographic view of lexicon and construction so that they can be analyzed alike. We take parody and GP examples from Chinese advertisements for analysis. The LCP analysis highlights the pragmaticity and rhetoricality of each case: for a particular effect. When difficulty arises, pragmatic means may be used to “pragma-coerce” the right, clever, or erroneous use of a rhetorical construction for delivery of a retrievable intended effect, an Aha-effect. We conduct a mini-questionnaire with two cases, the former dealing with parody and the latter with GP. The study indicates the humor competence of ordinary Chinese participants (around the level of BA) as far as parody and GP are concerned and the participants’ potential for cognition of the pragma-rhetorical values of parody and GP or their potential for generation of such utterances. It is suggested that rhetorical constructions outwit the less rhetorical or grammatical constructionsiffthey are available and accessible, and that LCP can offer us a feasible interpretation of such tropes as parody and GP.
Spectral property of the planar self-affine measures with three-element digit sets
Authors: Chen Ming-Liang , Liu Jing-Cheng , Su Juan
Published: February 2020

Let the self-affine measure

μ

M
,
D

{\mu_{M,D}}

be generated by an expanding real matrix

M
=

diag
⁡

(

ρ
1

-
1

,

ρ
2

-
1

)

{M=\operatorname{diag}(\rho_{1}^{-1},\rho_{2}^{-1})}

and an integer digit set

D
=

{

(
0
,
0
)

t

,

(

α
1

,

α
2

)

t

,

(

β
1

,

β
2

)

t

}

{D=\{(0,0)^{t},(\alpha_{1},\alpha_{2})^{t},(\beta_{1},\beta_{2})^{t}\}}

with

α
1

⁢

β
2

-

α
2

⁢

β
1

≠
0

{\alpha_{1}\beta_{2}-\alpha_{2}\beta_{1}\neq 0}

. In this paper, the sufficient and necessary conditions for

L
2

⁢

(

μ

M
,
D

)

{L^{2}(\mu_{M,D})}

to contain an infinite orthogonal set of exponential functions are given.
Cross-talk of Signaling Pathways in the Pathogenesis of Allergic Asthma and Cataract
Authors: Zhao Yang , Liu Sumei , Li Xiangsheng , Xu Zhenzhen , Hao Lifang , Cui Zhe , Bi Kewei , Zhang Yanfen , Liu Zhongcheng
Published: February 2020

:

Allergic asthma is a chronic inflammatory disease, which involves many cellular and
cellular components. Cataract is a condition that affects the transparency of the lens, which the
opacity of the lens caused by any innate or acquired factor degrades its transparency or changes in
color. Both of them belong to diseases induced by immune disorders or inflammation. We want to
confirm the signaling pathways involved in the regulation of asthma and cataract simultaneously,
and provide reference for the later related experiments. So we conducted a scoping review of many
databases and searched for studies (Academic research published in Wiley, Springer and Bentham
from 2000 to 2019) about the possible relationship between asthma and cataract. It was found that
during the onset of asthma and cataract, Rho/Rock signaling pathway, Notch signaling pathway,
Wnt/β-catenin signaling pathway, PI3K/AKT signaling pathway, JAK/STAT signaling pathway,
MAPK signaling pathway, TGF-β1/Smad signaling pathway and NF-κB signaling pathway are all
active, so they may have a certain correlation in pathogenesis. Asthma may be associated with
cataract through the eight signaling pathways, causing inflammation or immune imbalance based
on allergy that can lead to cataract. According to these studies, we speculated that the three most
likely signaling pathways are PI3K/AKT, MAPK and NF-κB signaling pathway.
Ensemble Learning Models Based on Noninvasive Features for Type 2 Diabetes Screening: Model Development and Validation
Authors: Yang Tianzhou , Zhang Li , Yi Liwei , Feng Huawei , Li Shimeng , Chen Haoyu , Zhu Junfeng , Zhao Jian , Zeng Yingyue , Liu Hongsheng
Published: February 2020

Background

Early diabetes screening can effectively reduce the burden of disease. However, natural population–based screening projects require a large number of resources. With the emergence and development of machine learning, researchers have started to pursue more flexible and efficient methods to screen or predict type 2 diabetes.

Objective

The aim of this study was to build prediction models based on the ensemble learning method for diabetes screening to further improve the health status of the population in a noninvasive and inexpensive manner.

Methods

The dataset for building and evaluating the diabetes prediction model was extracted from the National Health and Nutrition Examination Survey from 2011-2016. After data cleaning and feature selection, the dataset was split into a training set (80%, 2011-2014), test set (20%, 2011-2014) and validation set (2015-2016). Three simple machine learning methods (linear discriminant analysis, support vector machine, and random forest) and easy ensemble methods were used to build diabetes prediction models. The performance of the models was evaluated through 5-fold cross-validation and external validation. The Delong test (2-sided) was used to test the performance differences between the models.

Results

We selected 8057 observations and 12 attributes from the database. In the 5-fold cross-validation, the three simple methods yielded highly predictive performance models with areas under the curve (AUCs) over 0.800, wherein the ensemble methods significantly outperformed the simple methods. When we evaluated the models in the test set and validation set, the same trends were observed. The ensemble model of linear discriminant analysis yielded the best performance, with an AUC of 0.849, an accuracy of 0.730, a sensitivity of 0.819, and a specificity of 0.709 in the validation set.

Conclusions

This study indicates that efficient screening using machine learning methods with noninvasive tests can be applied to a large population and achieve the objective of secondary prevention.
The Longitudinal Influence of Social Determinants of Health on Glycemic Control in Elderly Adults With Diabetes
Authors: Walker Rebekah J. , Garacci Emma , Palatnik Anna , Ozieh Mukoso N. , Egede Leonard E.
Published: February 2020

OBJECTIVE

This study aimed to understand the longitudinal relationship between financial, psychosocial, and neighborhood social determinants and glycemic control (HbA1c) in older adults with diabetes.

RESEARCH DESIGN AND METHODS

Data from 2,662 individuals with self-reported diabetes who participated in the Health and Retirement Study (HRS) were used. Participants were followed from 2006 through 2014. Financial hardship, psychosocial, and neighborhood-level social determinant factors were based on validated surveys from the biennial core interview and RAND data sets. All social determinant factors and measurements of HbA1c from the time period were used and treated as time varying in analyses. SAS PROC GLIMMIX was used to fit a series of hierarchical linear mixed models. Models controlled for nonindependence among the repeated observations using a random intercept and treating each individual participant as a random factor. Survey methods were used to apply HRS weighting.

RESULTS

Before adjustment for demographics, difficulty paying bills (β = 0.18 [95% CI 0.02, 0.24]) and medication cost nonadherence (0.15 [0.01, 0.29]) were independently associated with increasing HbA1c over time, and social cohesion (−0.05 [−0.10, −0.001]) was independently associated with decreasing HbA1c over time. After adjusting for both demographics and comorbidity count, difficulty paying bills (0.13 [0.03, 0.24]) and religiosity (0.04 [0.001, 0.08]) were independently associated with increasing HbA1c over time.

CONCLUSIONS

Using a longitudinal cohort of older adults with diabetes, this study found that financial hardship factors, such as difficulty paying bills, were more consistently associated with worsening glycemic control over time than psychosocial and neighborhood factors.
Die Praxis der bedingten Entlassung aus dem Strafvollzug
Authors: Urwyler Christoph
Published: February 2020

The decision on conditional release from prison (Art. 86 89 SCC) is one ofthe most important decisions in the Swiss criminal justice system. At stakeare both the freedom of the convicted person, who is to be given a chance ofreintegration by the conditional release, and the security of the general public, which must be protected against the commission of further criminal offences.Despite its significance forconvicted persons and the society as a whole, thepractice of conditional release is scarcely discussed in Swiss literature: Whatis the procedure for conditional release? How do the opinions of the parties involved in the procedure influence its outcome? How do the persons responsible for conditional release exercise the discretion left to them by the law? The clarification of these issues seems all the more important giventhat in recent decades the number of conditional release decisions has decreased and there are considerable cantonal differences.The focus of the work is on the process of decision-making by the responsible authorities in Switzerland, in particular the implementation of theright to be heard, as well as the criteria which influence the decision on theconditional release of offenders. The research is based on a representativesample of 943 criminal files from the cantons of Berne, Fribourg, Lucerneand Vaud, which are evaluated using statistical methods (logisticregression).The results of the investigation show that the responsible authorities selectonly a few aspects from a large number of case characteristics that largelydetermine their decision-making process. The decision is strongly influenced by the residency status of the convicted person, his criminal record and theopinion of the prison authorities. The legal prognosis is therefore primarilybased on static factors from the past, whereas dynamic factors which theconvicted person or the involved actors could influence are more secondary.In addition, it emerges that the temporal and cantonal differences in the release rates do not relate to a differing prison population, as it most often assumed, but to a different way of implementing the law and appreciating theprofile of prisoners following a more restrictive or liberal understandingand practice of the release decision depending on time and canton.The study shows as well that there is no uniform practice for the procedure:the use of risk assessment tools, the opinions of the prison management or the organisation of the right to be heard are extremely disparate and therefore the right of the sentenced person to an equal and fair trial is not guaranteed to the same extent everywhere.The work concludes with a legal classification of the findings as well as withcriminal policy considerations and proposals for a more precise reformulation of Art. 86 SCC. These should contribute to a more harmonious and broader application across cantonal borders and therefore strengthen conditional release as an efficient instrument of crime prevention.
Penerapan Metode Taguchi untuk Meningkatkan Kualitas Bata Ringan pada UD. XY Malang
Authors: Halimah Putri , Ekawati Yurida
Published: February 2020

Light brick compressive strength produced by UD. XY has a very high variation because there is no standard composition of raw materials. This research is carried out to design an improvement or quality improvement for light brick products at UD. XY. Quality improvement is on increasing the compressive strength of light brick with optimal composition. Quality improvement is conducted using the experimental design of the Taguchi method to obtain an optimal composition combination. The orthogonal array notation used is L9(34) with material control factors in the form of water (A), cement (B), and sand (C). Data processing is done by calculating ANOVA on average values and SNR with larger better classification. The classification is chosen because of the greater the compressive strength of the light brick the higher the quality of the light brick. This ANOVA calculation is carried out to find out which factors significantly influence the light brick compressive strength. The test conducted to determine the quality of light brick is a concrete compressive strength test carried out using the Compression Machine. Based on the results of data processing, a comparison of the optimal composition of water: cement: sand is 1: 2.5: 4. The confirmation experiment proves that the compressive strength of the composition is robust.
Myths and Mythical Names in Euripides’Andromache
Authors: Férez Juan Antonio López
Published: February 2020

This article discusses the presentation of myths and mythical names in Euripides’ Andromache. Euripides knows and uses different sources, but he is always free, and sometimes an innovator in the treatment of mythical materials. The piece attacks some epic personages (Menelaus, above all), but rehabilitates Neoptolemus, for instance. We identify some possible innovations in Euripides’ use of myths and mythical figures, although we have only a few references about those predecessors who treated a similar mythical saga.
Gorging on Prodicus: Prodicus of Ceos, Cleon, and Aristophanes’Acharnians
Authors: Cooper Craig
Published: February 2020

Acharnians 4–6 alludes to an early diplomatic activity on the part of Prodicus that involved the islanders, Cleon, and accusations of bribe taking. The allusion is cleverly imbedded in a comedic parody of a verbal distinction known to have been made by Prodicus. The Sophist was famous for drawing fine distinctions between the meanings of near synonyms, a unique wisdom that he showcased in the many epideictic speeches that he delivered in Athens. As a well-known public intellectual, he was thus a favourite target of Aristophanes, whom we suggest Aristophanes is parodying here.
Effects of Perinatal Stress and Drug Abuse on Maternal Behavior and Sensorimotor Development of Affected Progeny
Authors: HOLUBOVÁ A. , ŠEVČÍKOVÁ M. , MACÚCHOVÁ E. , HREBÍČKOVÁ I. , POMETLOVÁ M. , ŠLAMBEROVÁ R.
Published: February 2020

Methamphetamine (MA) is an addictive psychostimulant with significant potential for abuse. Previous rat studies have demonstrated that MA use during pregnancy impairs maternal behavior and induced delayed development of affected pups. The offspring of drug-addictive mothers were often neglected and exposed to neonatal stressors. The present study therefore examines the effect of perinatal stressors combined with exposure to prenatal MA on the development of pups and maternal behavior. Dams were divided into three groups according to drug treatment during pregnancy: controls (C); saline (SA, s.c., 1 ml/kg); MA (s.c., 5 mg/ml/kg). Litters were divided into four groups according to postnatal stressors: controls (N); maternal separation (S); maternal cold-water stress (W); maternal separation plus cold-water stress (SW). The pup-retrieval test showed differences among postnatally stressed mothers and non-stressed controls. The righting reflex on a surface revealed delayed development of pups prenatally exposed to MA/SA and postnatal stress. Negative geotaxis and Rotarod results confirmed that the MA group was the most affected. Overall, our data suggests that a combination of perinatal stress and prenatal MA can have a detrimental effect on maternal behavior as well as on the sensorimotor development of pups. However, MA exposure during pregnancy seems to be the decisive factor for impairment.
VALIDACIÓN EMPÍRICA DE LA TEORÍA MULTICÉNTRICA DEL ORIGEN Y DIVERSIDAD DEL MAÍZ EN MÉXICO
Authors: Caballero-García Marco A. , Córdova-Téllez Leobigildo , López- Herrera Agustín de J.
Published: February 2020

Mesoamérica es considerada el centro de origen y diversidad del maíz (Zea mays L.). La teoría multicéntrica del origen y diversidad del maíz define cinco centros de origen-domesticación, a partir de los cuales se conformaron cuatro macro regiones o centros de diversificación primaria de este cereal, de donde fueron emergiendo las diversas razas y la concentración de su diversidad. Un centro de diversidad genética se define como aquella área geográfica donde existe diversidad morfológica, genética, o ambas, para una determinada especie, que se caracteriza por albergar poblaciones de los parientes silvestres y que constituye una reserva genética. El objetivo de este estudio fue validar de manera empírica las regiones geográficas de México que conforman con la definición de centro de diversidad genética para el caso del maíz. Se utilizó análisis espacial para examinar la diversidad y distribución de 24,126 colectas de maíz nativo y 1,106 registros de parientes silvestres (Teocintle: 692 y Tripsacum: 414) colectadas durante el periodo 1926-2014, disponibles en los bancos de germoplasma y herbarios de las instituciones de investigación y enseñanza agrícola nacionales e internacionales ubicados en México y, mediante el uso de sistemas de información geográfica y modelación. En apego a los criterios y definiciones considerados en la teoría multicéntrica de origen y diversidad del maíz, se definieron y validaron empíricamente 19 regiones geográficas que se consideran centros de diversidad genética del maíz nativo de México.
Pengetahuan, Persepsi dan Sikap Generasi Muda Tentang Perubahan Iklim dan Pengaruhnya Terhadap Niat Perilaku Pro-Lingkungan
Authors: Harmuningsih Dian , Saleky Saul Ronald Jacob
Published: February 2020

Climate change continues to occur and have an impact for the survival of mankind. Climate change is not only a natural phenomenon, but also includes contributions from the behavior of the human. Hence need for awareness and goodwill of all parties, especially the young generation, to reduce the impact of climate change. This study aimed to analyze the influence of factors of knowledge, perception and attitude towards pro-environmental behavior intention of the young generation. By using multiple regression analysis, the results of this study show that the factor of knowledge, perceptions and attitudes about climate change have a positive influence and significant to pro-environmental behavior intention of the young generation. Furthermore, of these factors, the perceptions of the climate change are factors that have a more dominant influence on the intention proenvironmental behavior of the young generation. Thus, in order to further grow and develop the intention of young people to behave in a pro-environment, for they need to be given opportunities and greater access to resources and information channels to increase their knowledge related to environmental strategic issues, especially climate change and its impacts, so with the knowledge that will shape their perceptions better on climate change and, in turn, will form a more empathetic attitude. For that, the one way can be used is to empower organizations where they are working as a means to increase knowledge, shape perceptions and attitudes and arouse their intentions to behave pro-environment, through the activity of an organized, planned and organized.
Pneumococcal Colonization and Pneumococcal Disease in Children with Influenza Clinical, laboratory and epidemiological features
Authors: Miron Victor Daniel , Draganescu Anca Cristina , Sandulescu Oana , Visan Constanta Angelica , Merisescu Maria Madalina , Cercel Anca Streinu , Pitigoi Daniela , Rafila Alexandru , Dorobat Olga Mihaela , Jugulete Gheorghita , Cercel Adrian Streinu , Stoicescu Silvia , Luminos Monica Luminita
Published: February 2020

We retrospectively studied clinical features of the 2015-2016 paediatric influenza season and the rate of pneumococcal colonization/disease in a reference Romanian infectious diseases institute. Peak influenza activity occurred between weeks 5-10/2016; A viruses initially predominated, switching to B viruses after week 12/2016. Patients� median age was 4.4 years. Patients with influenza A were significantly younger compared with influenza B (p[0.001), and required longer hospitalization (p[0.001). S. pneumoniae was identified in 5.4% of cases (only influenza A), accounting for 2.1% pneumococcal disease and 3.3% pneumococcal colonization. Patients with S. pneumoniae were younger compared to negative cases (p=0.164), presented to the hospital later (p=0.049), had higher erythrocyte sedimentation rate (ESR, p=0.008), and prolonged hospitalization (p=0.016), regardless of whether the strains caused disease or were colonizers. Commonly used inflammation markers may identify the presence of pneumococci (ESR, p=0.008) or differentiate between colonization and disease (neutrophil count, p=0.011) in children with influenza A.
MRI versus CT as Image Data Source for 3D Printing Bone
Authors: Plavitu Anca , Pogarasteanu Mark Edward , Moga Marius , Barbilian Raluca Costina , Stoica Ioan Cristian , Robu Georgiana Catalina , Oproiu Ana Maria , Jinga Mariana , Ifrim Chen Feng
Published: February 2020

In orthopedics, 3D printing is a novel way of visualizing dense human tissue and structures, for example bones and ligaments, but also the respective relations between them, thus providing the surgical team with taking the preoperative planning of an intervention one step further from 3D computer reconstructions. In order for a medical 3D print reconstruction to be possible, bidimensional imaging is necessary, in the form of DICOM files. These are then used by specific software in order to create an STL file, that can then be inputted into a 3D printer and a three-dimensional replica of the desired structure, usually on a 1:1 scale, can be generated. We aim to compare two methods of acquiring and processing of 2D images � MRI and CT scans � as sources of DICOM files, with the end purpose of 3D printing the image of human bone.
Coated copper Wire Calcium Selective Microelectrode for Applications in Dental Medicine
Authors: Totu Eugenia Eftimie , Isildak Ibrahim , Tavukcuoglu Ozlem , Agir Ismail , Yildirim Ridvan , Nigde Mustafa , Nechifor Aurelia Cristina , Cristache Corina Marilena
Published: February 2020

A coated wire calcium selective microelectrode for biological use was developed, comprising a PVC selective matrix containing calcium ionophore IV coated on copper wire, previously covered with a solid-state contact mixture. The obtained calcium microsensor presented a Nernstian answer in a concentration range of 10-1 to 10-6 mol/L. The selectivity coefficients over the main interfering ions of biological interest proved that the calcium microelectrode is highly selective. Also, the response time (6s) and repeatability have been determined. The pH variation did not significantly modify the calcium microelectrode answer, being stable over the pH range (6.7-7.3) of interest. The obtained calcium microelectrode is simple, inexpensive and able to give reliable electrochemical response, recommending itself as a solution for assessing the level of inorganic ions of the gingival crevicular fluid and saliva.