bluuebunny/crossref_metadata_2025 huggingface dataset:
Gut microbiome a promising target for management of respiratory diseases
Authors: Trivedi Riddhi , Barve Kalyani
Published: July 2020

The intestinal microbial flora has risen to be one of the important etiological factors in the development of diseases like colorectal cancer, obesity, diabetes, inflammatory bowel disease, anxiety and Parkinson's. The emergence of the association between bacterial flora and lungs led to the discovery of the gut–lung axis. Dysbiosis of several species of colonic bacteria such as Firmicutes and Bacteroidetes and transfer of these bacteria from gut to lungs via lymphatic and systemic circulation are associated with several respiratory diseases such as lung cancer, asthma, tuberculosis, cystic fibrosis, etc. Current therapies for dysbiosis include use of probiotics, prebiotics and synbiotics to restore the balance between various species of beneficial bacteria. Various approaches like nanotechnology and microencapsulation have been explored to increase the permeability and viability of probiotics in the body. The need of the day is comprehensive study of mechanisms behind dysbiosis, translocation of microbiota from gut to lung through various channels and new technology for evaluating treatment to correct this dysbiosis which in turn can be used to manage various respiratory diseases. Microfluidics and organ on chip model are emerging technologies that can satisfy these needs. This review gives an overview of colonic commensals in lung pathology and novel systems that help in alleviating symptoms of lung diseases. We have also hypothesized new models to help in understanding bacterial pathways involved in the gut–lung axis as well as act as a futuristic approach in finding treatment of respiratory diseases caused by dysbiosis.
Blood routine test in mild and common 2019 coronavirus (COVID-19) patients
Authors: Djakpo Dodji Kossi , Wang Zhiquan , Zhang Rong , Chen Xin , Chen Peng , Antoine Malyn Martha Lilac Ketisha
Published: July 2020

The new 2019 coronavirus disease (COVID-19), according to the World Health Organization (WHO), has been characterized as a pandemic. As more is being discovered about this virus, we aim to report findings of the complete blood count (CBC) of COVID-19 patients. This would serve in providing physicians with important knowledge on the changes that can be expected from the CBC of mild and normal COVID-19 patients. A total of 208 mild and common patients were admitted at the Dongnan Hospital located in the city of Xiaogan, Hubei, China. The CBCs of these patients, following a confirmed diagnosis of COVID-19, were retrospectively analyzed and a significant P<0.05 was found after a full statistical analysis was conducted using the Statistical Package for the Social Sciences (IBM SPSS). CBC analysis revealed changes in the levels of red blood cells (RBCs), hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), and C-reactive protein (CRP). Clinicians should expect similar findings when dealing with the new COVID-19.
DNA copy number and structural variation (CNV) contributions to adult and childhood obesity
Authors: Phillips Megan , Babu Jeganathan Ramesh , Wang Xu , Geetha Thangiah
Published: July 2020

In recent years, obesity has reached epidemic proportions globally and has become a major public health concern. The development of obesity is likely caused by several behavioral, environmental, and genetic factors. Genomic variability among individuals is largely due to copy number variations (CNVs). Recent genome-wide association studies (GWAS) have successfully identified many loci containing CNV related to obesity. These obesity-related CNVs are informative to the diagnosis and treatment of genomic diseases. A more comprehensive classification of CNVs may provide the basis for determining how genomic diversity impacts the mechanisms of expression for obesity in children and adults of a variety of genders and ethnicities. In this review, we summarize current knowledge on the relationship between obesity and the CNV of several genomic regions, with an emphasis on genes at the following loci: 11q11, 1p21.1, 10q11.22, 10q26.3, 16q12.2, 16p12.3, and 4q25.
Structural insight into FANCI–FANCD2 monoubiquitination
Authors: Li Landing , Tan Winnie , Deans Andrew J.
Published: July 2020

The Fanconi anemia (FA) pathway coordinates a faithful repair mechanism for DNA damage that blocks DNA replication, such as interstrand cross-links. A key step in the FA pathway is the conjugation of ubiquitin on to FANCD2 and FANCI, which is facilitated by a large E3 ubiquitin ligase complex called the FA core complex. Mutations in FANCD2, FANCI or FA core complex components cause the FA bone marrow failure syndrome. Despite the importance of these proteins to DNA repair and human disease, our molecular understanding of the FA pathway has been limited due to a deficit in structural studies. With the recent development in cryo-electron microscopy (EM), significant advances have been made in structural characterization of these proteins in the last 6 months. These structures, combined with new biochemical studies, now provide a more detailed understanding of how FANCD2 and FANCI are monoubiquitinated and how DNA repair may occur. In this review, we summarize these recent advances in the structural and molecular understanding of these key components in the FA pathway, compare the activation steps of FANCD2 and FANCI monoubiquitination and suggest molecular steps that are likely to be involved in regulating its activity.
Effects of Monaural Asymmetry and Target–Masker Similarity on Binaural Advantage in Children and Adults With Normal Hearing
Authors: Liu Ji-Sheng , Yu Ya-Feng , Tao Duo-Duo , Li Yi , Ye Fei , Galvin John J. , Gopen Quinton , Fu Qian-Jie
Published: July 2020

Purpose

For colocated targets and maskers, binaural listening typically offers a small but significant advantage over monaural listening. This study investigated how monaural asymmetry and target–masker similarity may limit binaural advantage in adults and children.

Method

Ten Mandarin-speaking Chinese adults (aged 22–27 years) and 12 children (aged 7–14 years) with normal hearing participated in the study. Monaural and binaural speech recognition thresholds (SRTs) were adaptively measured for colocated competing speech. The target–masker sex was the same or different. Performance was measured using headphones for three listening conditions: left ear, right ear, and both ears. Binaural advantage was calculated relative to the poorer or better ear.

Results

Mean SRTs were significantly lower for adults than children. When the target–masker sex was the same, SRTs were significantly lower with the better ear than with the poorer ear or both ears (p< .05). When the target–masker sex was different, SRTs were significantly lower with the better ear or both ears than with the poorer ear (p< .05). Children and adults similarly benefitted from target–masker sex differences. Substantial monaural asymmetry was observed, but the effects of asymmetry on binaural advantage were similar between adults and children. Monaural asymmetry was significantly correlated with binaural advantage relative to the poorer ear (p= .004), but not to the better ear (p= .056).

Conclusions

Binaural listening may offer little advantage (or even a disadvantage) over monaural listening with the better ear, especially when competing talkers have similar vocal characteristics. Monaural asymmetry appears to limit binaural advantage in listeners with normal hearing, similar to observations in listeners with hearing impairment. While language development may limit perception of competing speech, it does not appear to limit the effects of monaural asymmetry or target–masker sex on binaural advantage.
Do Children With Developmental Language Disorder (DLD) Have Difficulties With Interference Control, Visuospatial Working Memory, and Selective Attention? Developmental Patterns and the Role of Severity and Persistence of DLD
Authors: Blom Elma , Boerma Tessel
Published: July 2020

Purpose

Many children with developmental language disorder (DLD) have weaknesses in executive functioning (EF), specifically in tasks testing interference control and working memory. It is unknown how EF develops in children with DLD, if EF abilities are related to DLD severity and persistence, and if EF weaknesses expand to selective attention. This study aimed to address these gaps.

Method

Data from 78 children with DLD and 39 typically developing (TD) children were collected at three times with 1-year intervals. At Time 1, the children were 5 or 6 years old. Flanker, Dot Matrix, and Sky Search tasks tested interference control, visuospatial working memory, and selective attention, respectively. DLD severity was based on children's language ability. DLD persistence was based on stability of the DLD diagnosis.

Results

Performance on all tasks improved in both groups. TD children outperformed children with DLD on interference control. No differences were found for visuospatial working memory and selective attention. An interference control gap between the DLD and TD groups emerged between Time 1 and Time 2. Severity and persistence of DLD were related to interference control and working memory; the impact on working memory was stronger. Selective attention was unrelated to DLD severity and persistence.

Conclusions

Age and DLD severity and persistence determine whether or not children with DLD show EF weaknesses. Interference control is most clearly impaired in children with DLD who are 6 years and older. Visuospatial working memory is impaired in children with severe and persistent DLD. Selective attention is spared.
New fossil assemblage with amber, plants and vertebrates from the lower Cenomanian near Châtellerault (Vienne, western France)
Authors: Valentin Xavier , Garcia Géraldine , Gomez Bernard , Daviero Gomez Véronique , Boiteau Jean-Marie , Saint Martin Simona , Saint Martin Jean-Paul
Published: July 2020

A large number of fossil-rich beds have been located from over 30 km along the Tours-Poitiers High Speed Line (LGV) during earthworks prior to its construction, and in particular amber was collected from Scorbé-Clairvaux (locality of La Bergeonneau) to the north of Poitiers. The paper describes also amber pieces from Châtellerault (locality of La Désirée) discovered during the development of sewage treatment plant along the Vienne river. Lower Cenomanian shelly sandstones and siltstones of Scorbé-Clairvaux contain rare amber pieces associated with seed plants (Frenelopsissp.,Nehvizdyasp., and angiosperm seeds) and a diversified fauna, composed of micro-remains of 27 taxa, comprising elasmobranchs (Haimirichia amonensisCappetta and Case, 1975,Protolamasp. andSqualicoraxsp.), actinopterygians (Enchodussp. and Pycnodontidae), reptiles including vertebrae the marine snakeSimoliophis rochebruneiSauvage, 1880, some rare helochelydrid plates (cf.Plastremys), teeth of three crocodilian families (Atoposauridae, Goniopholididae and Bernissartiidae) and an undetermined dinosaurian long bone fragment.
Electronic Stability Control of Vehicles
Authors: Gupta Suryakant , Hiremath Nidhi , Raut Samiksha , Datkhile Gaurav , Trivedi Prasiddh
Published: July 2020

The paper presents the Electronic Control Unit of vehicles with the main focus on Anti-lock braking system. ABS is used in traction control and to maintain vehicle stability. The paper describes the detail study of CarSim model and it gives us the most accurate and efficient method to simulate the performance of vehicle and how ABS can be used in different scenarios. The result of vehicular model without and with ABS for different test cases is presented in the paper. The vehicular model is implemented on MATLAB Simulink environment and the corresponding results are presented.
Diabetic Retinopathy Severity Detection using Convolutional Neural Network
Authors: Shete Mayank , Sabnis Saahil , Rai Srijan , Birajdar Gajanan
Published: July 2020

Diabetic Retinopathy is one of the most prominent eye diseases and is the leading cause of blindness amongst adults. Automatic detection of Diabetic Retinopathy is important to prevent irreversible damage to the eye-sight. Existing feature learning methods have a lesser accuracy rate in computer aided diagnostics; this paper proposes a method to further increase the accuracy. Machine learning can be used effectively for the diagnosis of this disease. CNN and transfer learning are used for the severity classification and have achieved an accuracy of 73.9 percent. The use of XGBoost classifier yielded an accuracy of 76.5 percent.
A Novel Communication System For Deaf And Dumb People using gesture
Authors: Ambavane Pritesh , Karjavkar Rahul , Pathare Hemant , Relekar Shubham , Alte Bhavana , Sharma Neeraj Kumar
Published: July 2020

Human Beings know each other and contact with themselves through thoughts and ideas.The best way to present our idea is through speech. Some people don’t have the power of speech; the only way they communicate with others is through sign language. Now a days technology has reduced the gap through systems which can be used to change the sign language used by these people to speech. Sign language recognition (SLR) and gesture-based control are two major applications used for hand gesture recognition technologies. On the other side the controller converts the sign language in to the text and speech which gets converted with the help of text to speech conversion and analog to digital conversion. A Dumb person throughout the world uses sign language for the communication.The best way to present our idea is through speech. Some people don’t have the power of speech; the only way they communicate with others is through sign language. Now a days technology has reduced the gap through systems which can be used to change the sign language used by these people to speech. Sign language recognition (SLR) and gesture-based control are two major applications used for hand gesture recognition technologies. On the other side the controller converts the sign language in to the text and speech which gets converted with the help of text to speech conversion and analog to digital conversion. A Dumb person throughout the world uses sign language for the communication.
Detection of Keratoconus Disease
Authors: Sonar Hitesh , Kadam Ankit , Bhoir Prasad , Joshi Bharti
Published: July 2020

It has described that the development of an application which is used to detect Kera-toconus disease is based on the photographs of the eyes. At the heart of the application is an algorithm that acquires the features of an eye, then classify the affected and healthy eye. Firstly, It has proposed a basic identification of keratoconus disease using supervised learning. Described method obtains better results in comparison with other existing methods with the same dataset. The algorithm which used in this method is trained against several samples of healthy and affected eyes and then used to classify unknown sample of eyes. This algorithm analyzes the eye’s corneal curvature and topography using a convolutional neural network (CNN), capable of extracting and understanding an eye’s features. This algorithm is very successful in properly classifying images contained in the training library. The aim of this study is to characterize another arrangement technique to recognize keratoconus based on statistical analysis, and to understand the forecast with insightful systems of these organized facts. The purpose of this study is to define another grouping strategy to differentiate keratoconus based on statistical analysis and to understand the expectations.
Classifying Informatory Tweets during Disaster Using Deep Learning
Authors: Bhere Pradip , Upadhyay Anand , Chaudhari Ketan , Ghorpade Tushar
Published: July 2020

Micro blogging platforms like Twitter generate a wealth of information during a disaster. Data can be in the form of sound, image, text, video etc. by way of tweets. Tweets produced during a disaster are not always educational. Information tweets can provide useful information about affected people, infrastructure damage, civilized organizations etc. Studies show that when it comes to sharing emergency information during a natural disaster, time is everything. Research on Twitter use during hurricanes, floods and floods provide potentially life-saving data on how information is disseminated in emergencies. The proposed system outlines how to distinguish sensitive and non-useful tweets during a disaster. The proposed method is based on the use of Word2Vec and the Convolutional Neural Network (CNN). Word2vec provides a feature vector and CNN is used to classify tweets.
Product Recommendation System based on User Trustworthiness & Sentiment Analysis
Authors: Soor Gunjeet Kaur , Morje Amey , Dalal Rohit , Vora Deepali
Published: July 2020

The current online product recommendation system based on reviews has many limitations due to randomness in the review patterns. The data which is used are the reviews and ratings from the e-commerce websites. This data might contain fake reviews that make the data uncertain. Due to this, the currently existing systems produce ambiguous results on this present data. Instead of this, the new system uses only genuine reviews, considering the trustworthiness of the user and generates the results in a more significant manner. The proposed system scrapes reviews from different online websites and performs opinion mining and sentiment analysis on it. Other factors like star ratings, the buyer’s profile and previous purchases and whether the review has been given after purchasing or not are included. Based on these factors & user trustworthiness, the website from which the user should buy the product will be recommended.
Collaborative Recommendation System For Agriculture Sector
Authors: Jaiswal Sapna , Kharade Tejaswi , Kotambe Nikita , Shinde Shilpa
Published: July 2020

Agriculture is one of the most important sector in India and the farmers are one of the most essential members of society. The major economy of the country comes from the agricultural sector. Though there is no end to the woes of Indian Farmers. One of the major causes for the continuing Indian farmer distress is lack of knowledge and benefits of the agricultural programs and schemes proposed by the Government of India.The Collaborative Recommendation System For Agriculture Sector is one such way to solve this problem. There are various workshops conducted to create awareness about the government schemes to the farmers but still the results are not seen as expected. Even if they are aware they are not solved and hence many NGOs and and Institutes have come up with various measures to solve this problem. Our research system focuses on helping the farmers by answering their agricultural queries by generating a profile of basic requirements through a web application and recommends the proposed government schemes developed to help farmers.The recommendation system also periodically update farmers with the recent trends in agricultural field, new Government schemes and programs. Keywords - agriculture, government schemes, web application, recommendation, knn algorithm, cosine similarity, CRSAS- Collaborative Recommendation System For Agriculture Sector
EEG Based Brain Computer Interfacing for Hand Assistant System Using Wavelet Transform
Authors: Dhongade Dayanand , Patil Mukesh
Published: July 2020

Robots have been of great use to mankind for several years. In situation where human body fails to operate as per the need robot’s functions in those situations quite efficiently. Electroencephalogram (EEG) controlled hand assistant makes use of EEG signals and Brain Computer Interface (BCI). EEG signals are obtained from the brain using Emotiv Insight headset, after which processing and features extraction of the signals is performed and then conditioning of signals is done as it is a low amplitude signal with additive noise. Signals processing is done on the analog signal by using wavelet transform. Wavelet transform will help to extract information from the analog signal. Then the signals are assigned with the signatures to perform the dedicated task Filtered signal is given to analog pins of Arduino Uno. With the help of inbuilt ADC available on Arduino Uno, Digital Data is also made available on the digital pins. Then through MATLAB access Arduino board. In near future if it gets similar kind of input it will understand exactly what operation to perform. Further the Robotic hand assistant can be operated as we want.
A scene perception system for visually impaired based on object detection and classification using CNN
Authors: Moharkar Lalita , Varun Sudhanshu , Patil Apurva , Pal Abhishek
Published: July 2020

In this paper we have developed a system for visually impaired people using OCR and machine learning. Optical Character Recognition is an automated data entry tool. To convert handwritten, typed or printed text into data that can be edited on a computer, OCR software is used. The paper documents are scanned on simple systems with an image scanner. Then, the OCR program looks at the image and compares letter shapes to stored letter images. OCR in English has evolved over the course of half a century to a point that we have established application that can seamlessly recognize English text. This may not be the case for Indian languages, as they are much more complex in structure and computation compared to English. Therefore, creating an OCR that can execute Indian languages as suitably as it does for English becomes a must. Devanagari is one of the Indian languages spoken by more than 70% of people in Maharashtra, so some attention should be given to studying ancient scripts and literature. The main goal is to develop a Devanagari character recognition system that can be implemented in the Devanagari script to recognize different characters, as well as some words.
Image Super-Resolution for MRI Images using 3D Faster Super-Resolution Convolutional Neural Network architecture
Authors: Mane Vanita , Jadhav Suchit , Lal Praneya
Published: July 2020

Single image super-resolution using deep learning techniques has shown very high reconstruction performance over the last few years. We propose a novel three-dimensional convolutional neural network called 3D FSRCNN based on FSRCNN, which reinstates the high-resolution quality of structural MRI. The 3D neural network generates output brain images of high-resolution (HR) from a low-resolution (LR) input image. A simple design ensures less time complexity and high reconstruction quality. The network is trained using T1-weighted structural MRI images from the human connectome project dataset which is a large publicly available brain MRI database.
Implementation of Airy function using Graphics Processing Unit (GPU)
Authors: Keluskar Yugesh C. , Navada Megha M. , Jage Chaitanya S. , Singhaniya Navin G.
Published: July 2020

Special mathematical functions are an integral part of Fractional Calculus, one of them is the Airy function. But it’s a gruelling task for the processor as well as system that is constructed around the function when it comes to evaluating the special mathematical functions on an ordinary Central Processing Unit (CPU). The Parallel processing capabilities of a Graphics processing Unit (GPU) hence is used. In this paper GPU is used to get a speedup in time required, with respect to CPU time for evaluating the Airy function on its real domain. The objective of this paper is to provide a platform for computing the special functions which will accelerate the time required for obtaining the result and thus comparing the performance of numerical solution of Airy function using CPU and GPU.
L’acier à la rose
Critère de qualité ou défaut de fabrication ?
Authors: Le Coze Jean
Published: July 2020

L’acier à la rose a été considéré comme le meilleur en Europe depuis, au moins le 17e siècle et jusqu’au 19e siècle. La « rose » était une tache colorée observée sur les cassures de certaines barres d’acier d’Allemagne. La formation de ces taches ne fut comprise qu’au début du 19e siècle. Cet article décrit le mécanisme d’apparition de la rose selon nos connaissances actuelles et analyse les interprétations du phénomène aux 17–18e siècles. Les relations de la rose avec la qualité de l’acier et les conditions de livraison des barres sont discutées pour répondre à la question : critère de qualité ou défaut de fabrication ? La réponse est équivoque : c’est un défaut de fabrication délibéré mettant en valeur la qualité intrinsèque de l’acier considéré.
Regularisierte regressionsanalytische Verfahren für hochdimensionale Daten: ein neuer Ansatz in der Krankheitskostenrechnung des Statistischen Bundesamts zu ärztlichen Leistungen und Arzneiverordnungen﻿
Authors: Heuer J. , Rosenbusch M.-L. , Steiger E. , Erhart M.
Published: July 2020

Hintergrund und Zielsetzung Im Rahmen seiner Krankheitskostenrechnung hat das Statistische Bundesamt (Destatis) vom Zentralinstitut für die kassenärztliche Versorgung (Zi) berechnete Kosten in Arztpraxen erhalten. Das Zi hat hierfür einen neuen statistischen Ansatz entwickelt, dessen Ergebnisse in dieser Arbeit mit den Befunden der bisherigen Methode verglichen werden.

Methode Die Kosten werden erstmalig mit einem Regressionsmodell geschätzt. Aufgrund der hohen Anzahl teilweise kollinearer Prädiktoren wird die Ridge-Regression angewendet, die darüber hinaus die Varianz der Schätzung reduziert und zu den Verfahren des maschinellen statistischen Lernens gezählt werden kann.

Ergebnisse Die Verteilung der Kosten in Arztpraxen des Jahres 2008 und der Verordnungskosten in Apotheken des Jahres 2009 nach dem Ridge-Regressionsmodell folgt annähernd der Kostenverteilung gemäß den nach der bisherigen Methode berechneten und publizierten Ergebnissen, weicht jedoch für bestimmte Erkrankungsgruppen erkennbar ab. Die höchsten direkten Behandlungs- bzw. Verordnungskosten werden für Nierenversagen bzw. HIV-Erkrankungen ermittelt.

Schlussfolgerung Die durchgeführten Analysen resultieren in plausiblen Ergebnissen und zeigen die Möglichkeiten, regularisierte Regressionsverfahren für die Analyse hochdimensionaler Versorgungsdaten Gewinn bringend einzusetzen.
Use of Anticoagulants in Patients with Pulmonary Hypertension
Authors: Bertoletti Laurent , Mismetti Valentine , Giannakoulas George
Published: July 2020

Since the earliest works on the understanding of different forms of pulmonary hypertension, thrombosis has been involved in the pathophysiology of the disease, both in pulmonary arterial hypertension (PAH) and in chronic thromboembolic pulmonary hypertension (CTEPH). Autopsy and then pathophysiological data paved the way for the use of anticoagulants as a treatment for PAH and CTEPH. In PAH their role has diminished with the advent of specific targeted therapies, but they are still prescribed in more than half of PAH patients, because of concomitant venous thromboembolism or atrial fibrillation. In CTEPH long-term anticoagulant therapy is the cornerstone of the management. The recent development of direct oral anticoagulants (DOACs) raises the question of the best anticoagulation strategy, both in patients with PAH and in patients with CTEPH. In this review, we present an overview of the history of anticoagulants in the management of patients suffering from PAH or CTEPH, an update of the available data on the underlying rationale of their use in these subjects, an alert on the potential risks of using DOACs in these poorly explored situations, and the setting up of dedicated trials to evaluate the best anticoagulant treatment strategies in patients suffering from PAH or CTEPH.
Management of Anticoagulant Treatment and Anticoagulation-Related Complications in Nonagenarians
Authors: Giustozzi Michela , Castellucci Lana A. , Barnes Geoffrey D.
Published: July 2020

Given the aging population, the burden of age-dependent diseases is growing. Despite this, elderly patients are often underrepresented in clinical trials and little data are available on current anticoagulant management and outcomes in this unique population, especially those aged 90 years or older. There is uncertainty, and a fear of “doing harm,” that often leads to de-prescription of antithrombotic agents in nonagenarian patients. Decision-making concerning the use of anticoagulant treatment needs to balance the risk of thrombotic events against the risk of major bleeding, especially intracranial hemorrhage. In this perspective, the development of direct oral anticoagulants (DOACs), acting as direct and selective inhibitors of a specific step or enzyme of the coagulation cascade, has dramatically changed oral anticoagulant treatment. In fact, given the lower incidence of intracranial hemorrhage, the favorable overall efficacy and safety, and the lack of routine monitoring, DOACs are the currently recommended anticoagulant agents for the treatment of both atrial fibrillation and venous thromboembolism even in very elderly patients. However, given the limited data available on the management of anticoagulation in nonagenarians, a few unanswered questions remain. In this review, we focused on recent evidence for anticoagulant treatment in atrial fibrillation and venous thromboembolism along with management of anticoagulation-related bleeding in nonagenarians.
Computer-based patient education is non-inferior to nurse counselling prior to colonoscopy: a multicenter randomized controlled trial
Authors: Veldhuijzen Govert , Klemt-Kropp Michael , Terhaar sive Droste Jochim S. , van Balkom Bas , van Esch Aura A. J. , Drenth Joost P. H.
Published: July 2020

Background Optimal patient education prior to colonoscopy improves adherence to instructions for bowel preparation and leads to cleaner colons. We developed computer-based education (CBE) supported by video and 3 D animations. We hypothesized that CBE could replace nurse counselling without loss of bowel preparation quality during colonoscopy.

Methods We conducted a prospective, multicenter, endoscopist-blinded, non-inferiority randomized controlled trial. The primary outcome was adequate bowel preparation, evaluated using the Boston Bowel Preparation Scale (BBPS). Secondary outcome measures were: sickness absence for outpatient clinic visits; patient anxiety/satisfaction scores; and information recall. We included patients in four endoscopy units (rural, urban, and tertiary).

Results We screened 1035 eligible patients and randomized 845. After evaluation, 684 were included in the intention-to-treat (ITT) group. Subsequently, 497 patients were included in the per-protocol analysis, 217 in the nurse counselling and 280 in the CBE group. Baseline characteristics were similarly distributed among the groups. On per-protocol analysis, adequate bowel cleansing was achieved in 93.2 % (261/280) of CBE patients, which was non-inferior to nurse-counselled patients (94.0 %; 204/217), with a difference of −0.8 % (95 % confidence interval [CI] −5.1 % to 3.5 %). Non-inferiority was confirmed in the ITT population. Sickness absence was significantly more frequent in nurse-counselled patients (28.0 % vs. 4.8 %). In CBE patients, 21.5 % needed additional information, with 3.0 % needing an extra outpatient visit.

Conclusion CBE is non-inferior to nurse counselling in terms of bowel preparation during colonoscopy, with lower patient sickness leave. CBE may serve as an efficient educational tool to inform patients before colonoscopy in routine clinical practice.
Pneumonic versus Nonpneumonic Exacerbations of Chronic Obstructive Pulmonary Disease
Authors: Crisafulli Ernesto , Manco Alessandra , Ferrer Miquel , Huerta Arturo , Micheletto Claudio , Girelli Domenico , Clini Enrico , Torres Antoni
Published: July 2020

Patients with chronic obstructive pulmonary disease (COPD) often suffer acute exacerbations (AECOPD) and community-acquired pneumonia (CAP), named nonpneumonic and pneumonic exacerbations of COPD, respectively. Abnormal host defense mechanisms may play a role in the specificity of the systemic inflammatory response. Given the association of this aspect to some biomarkers at admission (e.g., C-reactive protein), it can be used to help to discriminate AECOPD and CAP, especially in cases with doubtful infiltrates and advanced lung impairment. Fever, sputum purulence, chills, and pleuritic pain are typical clinical features of CAP in a patient with COPD, whereas isolated dyspnea at admission has been reported to predict AECOPD. Although CAP may have a worse outcome in terms of mortality (in hospital and short term), length of hospitalization, and early readmission rates, this has only been confirmed in a few prospective studies. There is a lack of methodologically sound research confirming the impact of severe AECOPD and COPD + CAP. Here, we review studies reporting head-to-head comparisons between AECOPD and CAP + COPD in hospitalized patients. We focus on the epidemiology, risk factors, systemic inflammatory response, clinical and microbiological characteristics, outcomes, and treatment approaches. Finally, we briefly discuss some proposals on how we should orient research in the future.
Pregnancy at the Cesarean Section Scar: Successful Management and Review of Current Literature
Authors: Singh Pratibha , Raikar Sunil , Yadav Garima , Gothwal Meenakshi , Ghuman Navdeep
Published: July 2020

When implantation of the early embryo occurs at the scar of previous cesarean, it is called cesarean scar pregnancy. Though in uterus, it behaves like an ectopic pregnancy with risk of rupture and hemoperitoneum. A 37-year-old woman came with missed period and vague abdominal discomfort; she had a positive pregnancy test. She had previous two cesarean sections. The last cesarean section was 12 years ago and the patient was not using any contraception. Her ultrasonography (USG) was inconclusive; β human chorionic gonadotropin was 2,980 mIU/mL. Her repeat USG showed a hypoechoic area at the cesarean scar site, behind the reflection of bladder, separated from bladder by a thin layer of myometrium. She was counseled regarding the management options and prognosis. She was managed with two doses of injection. Methotrexate on day 1 and day 4. β human chorionic gonadotropin was repeated until it was close to normal. USG was also repeated. Cesarean scar pregnancy can be managed by many ways; the one most suitable to the patient with least side effects should be adopted, after adequate counseling of the patient.
Preparation and Standardization of Escherichia coli Nosodes Sourced from Select E. coli Strains
Authors: Munshi Renuka , Talele Gitanjali , Shah Rajesh
Published: July 2020

Background The nosodes are well-known preparations in homeopathy that are sourced from organisms and diseased materials. More than 40 known nosodes have been used in homeopathic practice for over a century. Having identified the need for scientifically developed new nosodes sourced from organisms that are currently prevalent, the preparation of Escherichia coli nosodes from different strains of the bacterium is presented in this article.

Materials and Methods Escherichia coli strains (E. coli ATCC 11775E, ATCC 25922, and ATCC 8739) were identified, cultured, and tested for purity, and 20 billion cells were processed following the nosode preparation method given in the Homoeopathic Pharmacopoeia of India, group N1. Serial dilution and potentization for liquid potency were done up to 30c potency. Nosodes were prepared by two methods: from cell-free extract (endotoxin) and from entire-cell extract.

Result Six nosodes were developed in total. Three univalent nosodes were prepared using individual endotoxins, one from each of the three E. coli strains; those three univalent nosodes were also combined as “Trivalent nosode-I”. “Trivalent nosode-II” was prepared by mixing entire cells of the three E. coli strains. A mix of both Trivalent nosode-I and Trivalent nosode-II was labeled “EC-Polynosode”. The safety profile of the potentized nosodes was documented by the non-detectability of traces of source material (absence of contamination, live organisms, or DNA material) through a culture test, sterility test, and molecular testing (polymerase chain reaction).

Conclusion Different variants of E. coli nosodes were systematically and scientifically prepared and standardized using the cultures. Homeopathic pathogenetic trials, in-vitro efficacy studies, and clinical evaluation of E. coli nosodes (single, trivalent, or polyvalent nosodes) will be required in future.
Epidemiological Analysis of Avulsion Fractures in Dogs
Authors: Matos Cruz Alyssa M. , Kayano Mitsunori , Tomihari Mizuki , Chou Po-Yen , Kim Sun Young , Kapatkin Amy S. , Hayashi Kei
Published: July 2020

Objective This study aimed to analyse the epidemiological data of canine appendicular avulsion fractures from three academic veterinary hospitals in the United States.

Study Design A total of 114 avulsion fractures that presented to three study centres (teaching hospitals in New York, California, and Michigan) between 2008 and 2018 were analysed for avulsion type, breed, sex, body weight, age and affected side.

Results The mean age for avulsion fractures was 1.6 years (±2.3 standard deviation), and side and sex were comparable (53% females and 54% left sided, only 2% bilateral). Tibial tuberosity fracture was the most common type, comprising 54% of all avulsion fractures, significantly more prevalent in younger and lighter dogs (p < 0.001). There was no significant difference in avulsion type, breed, sex, weight, age and affected side among three study centres (p = 0.66).

Conclusion The most common avulsion fractures were tibial tuberosity fractures, which tend to occur in young, small dogs. There is no sex or side predilection for avulsion fractures noted in this study, although the effect of neuter could not be determined. There were no differences in fracture characteristics among the three different geographical locations in the United States.
Generating a Novel Bispecific Nanobody to Enhance Antitumor Activity
Authors: Ge Qiuhan , Sun Tianyuan , Bian Yanlin , Xiao Xiaodong , Zhu Jianwei
Published: July 2020

Tumor cells express high levels of human epidermal growth factor receptor 2 (HER2) and vascular endothelial growth factor receptor 2 (VEGFR2), which are closely related to their proliferation and survival. Cancer treatments that target a single signaling pathway may result in immune pathway escape or drug resistance. Based on the correlation between the HER2 and VEGFR2 signaling pathways, we speculated that targeting the two pathways simultaneously may produce a synergistic effect and avoid occurrence of drug resistance, resulting in improved efficacy. Anti-VEGFR2 nanobody 3VGR19–3 and anti-HER2 nanobody 2D3 were combined to construct a bispecific nanobody (Bi-Nb). They can recognize both HER2 and VEGFR2 (both highly expressed in HT-29 cells) to simultaneously block the two signaling pathways. We verified the affinity of the Bi-Nb to its targets using the surface plasmon resonance technology, and test its effects to inhibit tumor cell growth and promote cell apoptosis in vitro by the Cell Counting Kit-8 assay and apoptosis assay. In summary, we have successfully constructed a Bi-Nb, and verified its tumor-suppressing effects in vitro. Compared with a single monospecific nanobody, our Bi-Nb showed superior antitumor effect, which provides a new perspective for treatment of tumors with high HER2 and VEGFR2 expression.
An Algorithm for the Prevention and Treatment of Pain Complications of the Radial Forearm Free Flap Donor Site
Authors: Calotta Nicholas A. , Chandawarkar Akash , Desai Shaun C. , Dellon A. Lee
Published: July 2020

Background The radial forearm free flap (RFFF) is a staple of microsurgical reconstruction. Significant attention has been paid to donor-site morbidity, particularly vascular and aesthetic consequences. Relatively few authors have discussed peripheral nerve morbidity such as persistent hypoesthesia, hyperesthesia, or allodynia in the hand and wrist or neuroma formation in the wrist and forearm. Here, we present a diagnostic and therapeutic algorithm for painful neurologic complications of the RFFF donor site.

Materials and Methods The peripheral nerves that can be involved with the RFFF are reviewed with respect to the manner in which they may be involved in postoperative pain manifestations. A method for prevention and for treatment of each of these possibilities is also presented.

Results Nerves from the forearm that can be harvested with the RFFF will have the most likelihood for injury and these include the lateral antebrachial cutaneous nerve, the radial sensory nerve, and the medial antebrachial cutaneous nerve. A nerve that may be injured at the distal juncture of the skin graft to the forearm is the palmar cutaneous branch of the median nerve. The “prevention” portion of the algorithm suggests that each nerve divided to become a recipient nerve should have its proximal end implanted into a muscle to prevent painful neuroma. The “treatment” portion of the algorithm suggests that if a neuroma does form, it should be resected, not neurolysed, and the proximal portion should be implanted into an adjacent muscle. The diagnostic role of nerve block is emphasized.

Conclusion Neurological complications following RFFF can be prevented by an appropriate algorithm as described by devoting attention to the proximal end of recipient nerves. Neurological complications, once present, can be difficult to diagnose accurately. Nerve blocks are critical in this regard and are employed in the treatment algorithm presented.
Common Genetic Variants in ABO and CLEC4M Modulate the Pharmacokinetics of Recombinant FVIII in Severe Hemophilia A Patients
Authors: Garcia-Martínez Iris , Borràs Nina , Martorell Marta , Parra Rafael , Altisent Carme , Ramírez Lorena , Álvarez-Román Maria Teresa , Nuñez Ramiro , Megias-Vericat Juan Eduardo , Corrales Irene , Alonso Sofia , Vidal Francisco
Published: July 2020

The pharmacokinetic (PK) response of severe hemophilia A (HA) patients to infused factor VIII (FVIII) shows substantial variability. Several environmental and genetic factors are associated with changes in FVIII plasma levels and infused FVIII PK. Based on the hypothesis that factors influencing endogenous FVIII can affect FVIII PK, the contribution of single-nucleotide variants (SNVs) in candidate genes was investigated in 51 severe HA patients. The effects of blood group, F8 variant type, von Willebrand factor antigen and activity levels, age, and weight were also explored. The myPKFiT device was used to estimate individual PK parameters, and SNVs and clinically reportable F8 variants were simultaneously analyzed in an Illumina MiSeq instrument, using the microfluidics-based Fluidigm Access Array system. The contribution of SNVs to FVIII half-life and clearance was addressed by robust regression modeling, taking into account other modulators. In line with previous studies, we provide robust evidence that age, body weight, and blood group, as well as SNVs in ABO and CLEC4M, participate in the variability of FVIII PK in HA patients. Main results: each copy of the rs7853989 (ABO) allele increases FVIII half-life by 1.4 hours (p = 0.0131) and decreases clearance by 0.5 mL/h/kg (p = 5.57E-03), whereas each additional rs868875 (CLEC4M) allele reduces FVIII half-life by 1.1 hours (p = 2.90E-05) and increases clearance by 0.3 mL/h/kg (p = 1.01E-03). These results contribute to advancing efforts to improve FVIII replacement therapies by adjusting to each patient's PK profile based on pharmacogenomic data. This personalized medicine will decrease the burden of treatment and maximize the benefits obtained.
Impact of the Surgical Approach: A Comparative Study between Transcanal and Posterior Tympanotomy Approach for Cochlear Implantation
Authors: Suri Neeraj , Sandilya Satya , Sayani Ruta , Anand Amit
Published: July 2020

Introduction The aim of our study is to compare the surgical complications of the transcanal and posterior tympanotomy approach and to evaluate the advantages and disadvantages of both techniques.

Materials and Methods It is a prospective study involving 252 pediatric cochlear implant patients operated in the Department of ENT, GMERS Medical College and General Hospital, Gandhinagar, Gujarat, India. Out of these, 126 patients were operated by transcanal approach (group A) and 126 patients were operated by posterior tympanotomy approach (group B).

Results No significant difference in the mean duration of surgery (p > 0.064) was observed in both the groups. Major complications occurred in 60.2% of group A and 3.1% of group B and minor complications occurred in 65% of group A and 3.1% in group B, which is highly significant (p < 0.0134). The categories of auditory perception, speech intelligibility rating scales, meaningful auditory integration scale, and meaningful use of speech scale were assessed in both groups.

Conclusion Complication rate in the transcanal approach is higher as compared with posterior tympanotomy approach. A complete alignment and introduction of electrode array into the basal turn of cochlea is more favorable in the posterior tympanotomy approach. Transcanal technique even as an alternative may not be useful. Outcomes may be affected depending upon the technique chosen.
Thermal kinetic inductance detectors for millimeter-wave detection
Authors: Wandui Albert , Bock James J. , Frez Clifford , Hollister M. , Minutolo Lorenzo , Nguyen Hien , Steinbach Bryan , Turner Anthony , Zmuidzinas Jonas , O’Brient Roger
Published: July 2020

Thermal Kinetic-Inductance Detectors (TKIDs) combine the excellent noise performance of traditional bolometers with a radio frequency multiplexing architecture that enables the large detector counts needed for the next generation of millimeter-wave instruments. In this paper, we first discuss the expected noise sources in TKIDs and derive the limits where the phonon noise contribution dominates over the other detector noise terms: generation–recombination, amplifier, and two-level system noise. Second, we characterize aluminum TKIDs in a dark environment. We present measurements of TKID resonators with quality factors of about 105 at 80 mK. We also discuss the bolometer thermal conductance, heat capacity, and time constants. These were measured by the use of a resistor on the thermal island to excite the bolometers. These dark aluminum TKIDs demonstrate a noise equivalent power, NEP = 2×10−17W/Hz, with a 1/f knee at 0.1 Hz, which provides background noise limited performance for ground-based telescopes observing at 150 GHz.
Study of the beam–wave interaction of a 220 GHz coaxial-cavity gyrotron with two electron beams
Authors: Hou Shenyong
Published: July 2020

In this paper, the mode selection, ohmic loss quality factor, mode competition, and beam–wave interaction of a 220 GHz coaxial-cavity gyrotron with two electron beams are studied by using the linear and nonlinear theories of a gyrotron. Research shows that a coaxial-cavity gyrotron with two electron beams has more advantages than a coaxial-cavity gyrotron with one electron beam in mode selection, suppressing mode competition and increasing output power, and the eigenvalue and the ohmic loss quality factor of modes have similar monotonicity in the direction of the gyrotron axis. Results find that (1) the current ratio K of the gyrotron has a greater influence on the beam–wave interaction efficiency of the two electron beams, (2) under B = 8.90 T, I = 136 A, α = 1.40, and K = 0.45, the coaxial-cavity gyrotron with two electron beams can operate steadily in the TE51,32− mode, which has an efficiency of 37.67% and an output power of 4.53 MW at f = 220.04 GHz, and (3) the total ohmic loss power of the gyrotron accounts for 1.3% of the output power.