bluuebunny/crossref_metadata_2025 huggingface dataset:
Injury of Corticospinal tract and Corticoreticular pathway caused by high-voltage electrical shock: a case report
Authors: Boudier-Revéret Mathieu , Hsiao Ming-Yen , Shyu Shaw-Gang , Chang Min Cheol
Published: April 2020

Background

We imaged the corticospinal tract (CST) and corticoreticular pathway (CRP) using diffusion tensor tractography (DTT) to evaluate the cause of muscle weakness in a patient who was exposed to high-voltage electricity.

Case presentation

A 39-year-old man presented with quadriparesis after high-voltage electrical shock from power lines while working about 5.8 years ago. The electrical current entered through the left hand and exited through the occipital area of the head. The degree of weakness on bilateral upper and lower extremities was 3–4 on the Medical Research Council strength scale. Diffusion tensor imaging (DTI) was performed 5.8 years after onset. The CST and CRP were depicted by placing two regions of interest for each neural tract on the two-dimensional fractional anisotropy color map. DTT of the DTI scan showed that the bilateral CST and CRP were thinned compared to those of the healthy control subject. On the nerve conduction test, abnormal findings suggesting peripheral nerve lesion were not observed. Therefore, injury of bilateral CST and CRP seems to have contributed to our patient’s weakness after the electrical shock.

Conclusion

Depiction of neural tracts in the brain using DTT can assist in the accurate and detailed evaluation of the cause of neural deficit after electrical injury.
The prevalence of Restless Legs Syndrome/Willis-ekbom disease (RLS/WED) in the third trimester of pregnancy: a systematic review
Authors: Darvishi Niloofar , Daneshkhah Alireza , Khaledi-Paveh Behnam , Vaisi-Raygani Aliakbar , Mohammadi Masoud , Salari Nader , Darvishi Fateme , Abdi Alireza , Jalali Rostam
Published: April 2020

Background

RLS is known as one of the most common movement disorders during pregnancy, which is most aggravated in the third trimester of pregnancy and can affect up to one-third of pregnant women. This study intends to determine the total prevalence of RLS in the third trimester of pregnancy through a systematic review.

Methods

The present study was conducted via meta-analysis method up to 2019. The papers related to the subject of interest were obtained through searching in SID, MagIran, IranDoc, Scopus, Embase, Web of Science (ISI), PubMed, Science Direct, and Google Scholar databases. Heterogeneity of the studies was examined via I2 index, and the data were analyzed in Comprehensive meta-analysis software.

Results

In investigating 10 papers capturing 2431 subjects within the age range of 25–39 years, the total prevalence of RLS in the third trimester of pregnancy based on meta-analysis was obtained as 22.9% (95% CI: 14.7–33.8%). Further, as the sample size increased, the RLS prevalence diminished, while with increase in years, this prevalence increased, where this difference was statistically significant (P < 0.05).

Conclusion

Prevalence of RLS in the third trimester of pregnancy is high, healthcare policymakers should organize educational classes to improve the life dimensions among this group of pregnant women.
The effect of sleeping position on heart rate variability in newborns
Authors: Fister Petja , Nolimal Manca , Lenasi Helena , Klemenc Matjaž
Published: April 2020

Background

Lower heart rate variability (HRV) in a newborn might represent a risk factor for unfavourable outcome, a longer recovery after illness, and a sudden infant death. Our aim was to determine whether the newborn’s sleeping position is associated with HRV.

Methods

We performed a prospective clinical study in 46 hospitalized cardiorespiratory stable term newborns. During sleeping, we measured the parameters of HRV in four body positions (supine, supine with tilt, prone, prone with tilt).

Results

The TP (total power spectral density) was significantly higher when lying supine in comparison to prone (p = 0,048) and to prone with tilt (p = 0,046). The HF (high frequency of power spectral density) in the supine position without tilt tended to be higher compared to prone without tilt (p > 0,05). The LF (low frequency power) was significantly higher when lying supine compared to prone, both without tilt (p = 0,018). TP and HF showed a positive correlation with gestational but not postmenstrual age (p = 0.044 and p = 0.036, respectively).

Conclusions

In term newborns, sleeping position is associated with HRV. Higher TP and HF were found in the supine position, which might reflect better ANS stability. Gestational age positively correlated with TP and HF power, but only in supine position.

Trial registration

ISRCTN11702082, date of registration: March, 13th, 2020; retrospectively registered.
Point-of-care ultrasound may be useful for detecting pediatric intussusception at an early stage
Authors: Lee Jeong-Yong , Kim Jung Heon , Choi Seung Jun , Lee Jong Seung , Ryu Jeong-Min
Published: April 2020

Background

This study aimed to verify the usefulness of point-of-care ultrasound (POCUS) performed by pediatric emergency physicians for detecting intussusception at an early stage.

Methods

This retrospective study included 1-month- to 6-year-old children with clinically suspected intussusception, who underwent POCUS in the pediatric emergency department between December 2016 and February 2018. The criteria for performing POCUS were set to broader standards: presenting any one of intermittent abdominal pain/irritability or bloody stool, or ≥ 2 symptoms among nonspecific abdominal pain/irritability, abdominal mass/distension, vomiting, or lethargy. POCUS results were interpreted and categorized as “negative” or “suspicious,” and a radiologist performed confirmatory ultrasound in “suspicious” cases.

Results

We analyzed 575 POCUS scans from 549 patients (mean age, 25.5 months). Among the 92 “suspicious” cases (16.0%), 70 (12.2%) were confirmed to have intussusception. POCUS showed 100% sensitivity, 95.6% specificity, and 97.8% accuracy. Patients with confirmed intussusception were mainly diagnosed in the early stages, with a mean symptom duration of 11.7 h, and most patients (97.1%) were treated successfully via air enema reduction. Compared to the non-intussusception group, the intussusception group had more intermittent abdominal pain (P < 0.001), but less vomiting (P = 0.001); the other clinical features showed no intergroup differences.

Conclusion

POCUS performed using the criteria set to broader standards by pediatric emergency physicians may be useful for detecting intussusception at an early stage, which may present with obscure clinical symptoms.
Exacerbations and Pseudomonas aeruginosa colonization are associated with altered lung structure and function in primary ciliary dyskinesia
Authors: Piatti G. , De Santi M. M. , Farolfi A. , Zuccotti G. V. , D’Auria E. , Patria M. F. , Torretta S. , Consonni D. , Ambrosetti U.
Published: April 2020

Background

Recurrent bacterial infections of the respiratory tract are one of the major clinical features of the primary ciliary dyskinesia (PCD), a rare genetic disease due to malfunctioning of motile cilia. Chronic infections and persistent inflammation of the respiratory system result in progressive lung disease.

Aim of the study was to highlight the main factors associated with clinical, functional and anatomical deterioration in PCD patients.

Methods

We retrospectively analyzed data from 58 patients with PCD, 37 adults and 21 children. The demographic and clinical data, forced expiratory volume at 1 s (FEV1) and forced vital capacity (FVC), sputum microbiology and imaging results (chest CT scores-modified Bhalla) were recorded. Patients were stratified according to the number of exacerbations (< 2/year vs ≥ 2/year) and chronic Pseudomonas aeruginosa (PA) colonization. The possible correlations between lung function and chest CT scores were assessed; we also evaluated the correlation between these parameters and the severity scores for bronchiectasis (BSI, FACED and e-FACED).

Results

Chest CT scores showed a significant correlation with FEV1 (p = 0.0002), age (p <  0.0001), BMI (p = 0.0002) and number of lung lobes involved (p <  0.0001). PA colonization had an overall prevalence of 32.6%: no significant difference in FEV1 between PA colonized and non-colonized patients was found (p = 0.70), while chest CT score was significantly worse in chronic PA colonized patients (p = 0.009). Patients with a high number of exacerbation (≥ 2/year) were older (p = 0.01), had lower FEV1 (p = 0.03), greater number of lobes involved (p < 0.001) and worse CT score than patients with low number of exacerbations (p = 0.001); they also had higher prevalence of PA chronic bronchial infection (33.3% versus 13.6%, p = 0.10). Multivariable linear regression analyses adjusted for gender, age and BMI showed positive associations between PA colonization and number of exacerbations with severity of disease (number of lobes involved, CT score, BSI, FACED, and e-FACED).

Conclusions

In our PCD population the number of exacerbations (≥ 2/year) and PA colonization were the two most relevant factors associated with severity of disease.
Musculoskeletal pain in other body sites is associated with new-onset low back pain: a longitudinal study among survivors of the great East Japan earthquake
Authors: Yabe Yutaka , Hagiwara Yoshihiro , Sekiguchi Takuya , Sugawara Yumi , Tsuchiya Masahiro , Yoshida Shinichirou , Sogi Yasuhito , Yano Toshihisa , Onoki Takahiro , Takahashi Tadahisa , Iwatsu Jun , Tsuji Ichiro , Itoi Eiji
Published: April 2020

Background

Low back pain (LBP) is a common health problem experienced after natural disasters. LBP is often concurrent with other musculoskeletal pain; however, the effects of preexisting musculoskeletal pain on the development of LBP are not clear. The purpose of this study was to elucidate the association of musculoskeletal pain in other body sites with new-onset LBP among survivors of the Great East Japan Earthquake (GEJE).

Methods

A longitudinal study was conducted with survivors of the GEJE. The survivors who did not have LBP at the 3 year time period after the GEJE were followed up 1 year later (n = 1782). Musculoskeletal pain, such as low back, hand and/or foot, knee, shoulder, and neck pain, were assessed with self-reported questionnaires. The outcome of interest was new-onset LBP, which was defined as LBP absent at 3 years but present at 4 years after the disaster. The main predictor was musculoskeletal pain in other body sites 3 years after the GEJE, which was categorized according to the number of pain sites (0, 1, ≥ 2). Multiple regression analyses were performed to calculate the odds ratio (OR) and 95% confidence interval (CI) for new-onset LBP due to musculoskeletal pain in other body sites.

Results

The incidence of new-onset LBP was 14.1% (251/1782). Musculoskeletal pain in other body sites was significantly associated with new-onset LBP. Including people without other musculoskeletal pain as a reference, the adjusted OR and 95% CI for new-onset LBP were 1.73 (1.16–2.57) for people with one musculoskeletal pain site and 3.20 (2.01–5.09) for people with ≥ 2 sites (p <  0.001).

Conclusions

Preexisting musculoskeletal pain in other body sites was associated with new-onset LBP among survivors in the recovery period after the GEJE.
Self-reported physical activity in people with limb-girdle muscular dystrophy and Charcot-Marie-Tooth disease in Norway
Authors: Andries Aristomo , van Walsem Marleen R. , Frich Jan C.
Published: April 2020

Background

Physical activity is associated with positive health effects, but individuals with neuromuscular disease (NMD) may experience constraints being physically active. There is a gap in the literature on the activity level of people with NMDs, and therefore we did a study to determine the physical activity level in people with Limb-Girdle muscular dystrophy (LGMD) and Charcot-Marie-Tooth disease (CMT).

Methods

This study used a cross-sectional design to obtain self-reported physical activity and sitting time among individuals with LGMD and CMT who were recruited from the Norwegian registry for hereditary and congenital neuromuscular diseases.

Results

A total of 127 respondents who filled out questionnaires about either physical activity or sitting time were included in the analysis. Seventy (55.1%) had a diagnosis of CMT and 57 (44.9%) had a diagnosis of LGMD. Seventy-three (57.5%) respondents were female and 54 (42.5%) were male. Among the 108 respondents with available physical activity data, 44.4% reported being physically inactive. Among the 109 respondents with available sitting time data, the average sitting time was 8.6 h. Longer sitting time was associated with higher physical inactivity.

Conclusion

Among people with LGMD and CMT in our study, 55.6% reported being physically active. Respondents with LGMD and CMT reported longer sitting time and less physical activity compared with healthy respondents in other studies. Further research should explore variables and measures that can promote physical activity among people with neuromuscular conditions.
Atypical osteochondroma of the hamate that presented clinically as carpal tunnel syndrome: report of an extremely rare case and literature review
Authors: Motomiya Makoto , Sakazaki Taiki , Iwasaki Norimasa
Published: April 2020

Background

Osteochondroma is a benign tumor that occurs mainly at the metaphysis of long bones and seldom arises from carpal bones. We describe an extremely rare case of osteochondroma of the hamate without a typical cartilaginous cap and with a spiky bony protrusion in an elderly patient.

Case presentation

A 78-year-old right-handed female housekeeper had a multilobed osteochondroma of the hamate, which caused carpal tunnel syndrome and irritation of the flexor tendons. Radiological examinations showed a morphological abnormality of the hamate comprising a spiky bony protrusion into the carpal tunnel and a free body proximal to the pisiform. Open carpal tunnel release and resection of the spiky bony protrusion on the hook of the hamate were performed. The flexor digitorum profundus tendons of the ring and little fingers displayed synovitis and partial laceration in the carpal tunnel. Histological examination also showed atypical findings: only a few regions of cartilaginous tissue were seen in the spiky bony protrusion, whereas the free body proximal to the pisiform contained thick cartilaginous tissue such as a cartilaginous cap typical of osteochondroma. We speculated that the bony protrusion to the carpal tunnel had been eroded by mechanical irritation caused by gliding of the flexor tendon and had resulted in the protruding spiky shape with less cartilaginous tissue. The fractured cartilaginous cap had moved into the cavity within the carpal tunnel proximal to the pisiform and had become a large free body.

Conclusions

Osteochondroma of the carpal bone may take various shapes because the carpal bone is surrounded by neighboring bones and tight ligaments, which can restrict tumor growth. This type of tumor is likely to present with various symptoms because of the close proximity of important structures including nerves, tendons, and joints. The diagnosis of osteochondroma of the carpal bone may be difficult because of its rarity and atypical radiological and histological findings, such as the lack of a round cartilaginous cap. We suggest that surgeons should have a detailed understanding of this condition and should make a definitive diagnosis based on the overall findings.
Cross-cultural adaptation and validation of the Slovenian version of the Core outcome measures index for low back pain
Authors: Topolovec Matevž , Vozlič David , Plohl Nejc , Vengust Rok , Vodičar Miha , Mannion Anne Frances
Published: April 2020

Background

To conduct a cross-cultural adaptation and validation of the Core Outcome Measures Index (COMI) in the Slovenian language, for use in patients with low back pain.

Methods

The English version of COMI was translated into Slovene following established guidelines. Three hundred fifty-three patients with chronic low back pain were recruited from the Orthopedic clinic department of a tertiary care teaching institution. Data quality, construct validity, responsiveness, and test-retest reliability of the COMI were assessed.

Results

The questionnaire was generally well accepted with no missing values. The majority of items exhibited only mild ceiling effects (below 20.0%) and somewhat more prominent floor effects, which were similar to previous studies (4.5–78.8%). Correlations with Oswestry Disability Index (ODI) were high (ρ = 0.76 between overall COMI and ODI scores), suggesting that the Slovene version of COMI had high construct validity. Additionally, the Slovene version of COMI successfully captured surgical patients’ improvement in their low back problem after surgery (overall COMI score change: Z = − 9.34, p < .001, r = − 0.53) and showed acceptable test-retest reliability (ICC = 0.86).

Conclusions

The Slovene version of COMI showed good psychometric properties, comparable to those of previously tested language versions. It represents a valuable instrument for the use in future domestic and multicenter clinical studies.
Patient and public involvement in research: from tokenistic box ticking to valued team members
Authors: Jackson Tracy , Pinnock Hilary , Liew Su May , Horne Elsie , Ehrlich Elisabeth , Fulton Olivia , Worth Allison , Sheikh Aziz , De Simoni Anna
Published: April 2020

Background

Patient and public involvement (PPI) in research envisages a relationship built throughout the lifespan of a research project between academics, clinicians and PPI colleagues in order to inform, plan, execute and, in due course, disseminate and translate research. To be meaningful, all stakeholders need to actively engage in this exchange of expertise. However, despite some funders requiring PPI plans to be included in grant applications, there remains a gap between what is expected and what is delivered.

Main body

As an exemplar, we reflect on how, in the Asthma UK Centre for Applied Research (AUKCAR), we set out to create a supportive, organised environment with the overarching value of ‘keeping patients at the heart of everything we do’. The key has been in planning and creating a suitably funded organisational infrastructure with dedicated PPI researchers along with the development of and expectation to abide by an agreed set of norms and values. Specifically, expecting AUKCAR PhD students and early career researchers to engage with PPI has established a working mode that we hope will last. Regular interactions and proactive Patient Leads increase PPI network cohesion.

Conclusion

With adaptation, the AUKCAR PPI model can be translated to international contexts.
Improving production of Streptomyces griseus trypsin for enzymatic processing of insulin precursor
Authors: Zhang Yunfeng , Liang Qixing , Zhang Chuanzhi , Zhang Juan , Du Guocheng , Kang Zhen
Published: April 2020

Background

Trypsin has many applications in food and pharmaceutical manufacturing. Although commercial trypsin is usually extracted from porcine pancreas, this source carries the risks of infectivity and immunogenicity. Microbial Streptomyces griseus trypsin (SGT) is a prime alternative because it possesses efficient hydrolysis activity without such risks. However, the remarkable hydrolysis efficiency of SGT causes autolysis, and five autolysis sites, R21, R32, K122, R153, and R201, were identified from its autolysate.

Results

The tbcf (K101A, R201V) mutant was screened by a directed selection approach for improved activity in flask culture (60.85 ± 3.42 U mL−1, increased 1.5-fold). From the molecular dynamics simulation, in the K101A/R201V mutant the distance between the catalytical residues D102 and H57 was shortened to 6.5 Å vs 7.0 Å in the wild type, which afforded the improved specific activity of 1527.96 ± 62.81 U mg−1. Furthermore, the production of trypsin was increased by 302.8% (689.47 ± 6.78 U mL−1) in a 3-L bioreactor, with co-overexpression of chaperones SSO2 and UBC1 in Pichia pastoris.

Conclusions

SGT protein could be a good source of trypsin for insulin production. As a result of the hydrolysates analysis and direct selection, the activity of the tbcf (K101A, R201V) mutant increased 1.5-fold. Furthermore, the production of trypsin was improved threefold by overexpressing chaperone protein in Pichia pastoris. Future studies should investigate the application of SGT to insulin and pharmaceutical manufacturing.
Optimising remote site airway management kit dump using the SCRAM bag—a randomised controlled trial
Authors: Schyma Barry M. , Wood Andrew E. , Sothisrihari Saranga , Swinton Paul
Published: April 2020

Background

Emergency airway management may be required at any hospital location. Remote site management is associated with increased airway morbidity and mortality. Poor planning and interrupted workflow are significant contributors. Equipment may be unfamiliar, difficult to locate or inadequate.

The SCRAM (Structured CRitical Airway Management) bag aims to provide a portable, structured and reproducible approach to airway management preparation. We hypothesised that SCRAM bag use reduces equipment preparation time, the rate of error and operator cognitive load.

Methods

Fifty experienced anaesthetists were randomised into two groups and asked to prepare (kit dump) for and manage a simulated remote site difficult airway scenario. The control group (n = 25) used a standard resuscitation trolley while the experimental group used the SCRAM bag (n = 25). The primary outcome was time taken to kit dump completion (seconds). Secondary outcomes were the number of errors and self-reported difficulty (100 mm visual analogue scale).

Results

Using the SCRAM bag, a 29% reduction in kit dump time (111.7 ± 29.5 vs 156.7 ± 45.1, p = 0.0001) was noted. Participants using the SCRAM bag reported it to be less challenging to use (18.36 ± 16.4 mm vs 50.64 ± 22.9 mm, p < 0.001), and significantly fewer errors were noted (1 (IQR 1–3) vs 8 (IQR 5–9), p = 0.03) (87.5% reduction in the total number of errors).

Conclusion

The SCRAM bag facilitates a quicker, less challenging kit dump with significantly fewer errors. We propose that this would reduce delay to airway management, reduce cognitive load and provide an improved capability to manage anticipated and unanticipated airway events.
Retraction Note to: Predictability and controlling factors of overpressure in the North Alpine Foreland Basin, SE Germany: an interdisciplinary post-drill analysis of the Geretsried GEN-1 deep geothermal well
Authors: Drews Michael C. , Hofstetter Peter , Zosseder Kai , Straubinger Robert , Gahr Andreas , Stollhofen Harald
Published: April 2020

The authors have retracted this article (Drews et al. 2019) because some data have been used without the appropriate permissions. Additionally, the funding statement is not complete and the authorship is incorrect.
Bitcoin pricing: impact of attractiveness variables
Authors: Hakim das Neves Rodrigo
Published: April 2020

The research seeks to contribute to Bitcoin pricing analysis based on the dynamics between variables of attractiveness and the value of the digital currency. Using the error correction model, the relationship between the price of the virtual currency, Bitcoin, and the number of Google searches that used the terms bitcoin, bitcoin crash and crisis between December 2012 and February 2018 is analyzed. The study also applied the same analysis to prices of Bitcoin denominated in different sovereign currencies traded during the same period. The Johansen (J Econ Dyn Control 12:231-254, 1988) test demonstrates that the price and number of searches on Google for the first two terms are cointegrated. This research indicates that there are strong short-term and long-term dynamics among attractiveness factors, suggesting that an increase in worldwide interest in Bitcoin is usually preceded by a price increase. In contrast, an increase in market mistrust over a collapse of the currency, as measured by the term bitcoin crash, is followed by a fall in price. Intense world economic crisis events appear to have a strong impact on interest in the virtual currency. This study demonstrates that during a worldwide crisis Bitcoin becomes an alternative investment, increasing its price. Based on it, bitcoin may be used as a safe haven by the financial market and its intrinsic characteristics might help the investors and governments to find new mechanisms to deal with monetary transactions.
Prevention of migraine with monoclonal antibodies against CGRP or the CGRP receptor
Authors: Diener Hans-Christoph , Förderreuther Stefanie , Gaul Charly , Giese Florian , Hamann Till , Holle-Lee Dagny , Jürgens Tim P. , Kamm Katharina , Kraya Torsten , Lampl Christian , May Arne , Reuter Uwe , Scheffler Armin , Tfelt-Hansen Peer
Published: April 2020

Monoclonal antibodies against the calcitonin gene-related peptide (CGRP) receptor (Erenumab) or against CGRP (Eptinezumab, Fremanezumab, Galcanezumab) are new substances for the preventive treatment of migraine. They represent an extension of the therapeutic options, which already exist in migraine prevention. In randomized, placebo-controlled studies, the efficacy and good tolerability of these specific substances have been demonstrated in patients with episodic and chronic migraine. The following treatment recommendation presents a summary of the pivotal studies. Recommendations are provided for the targeted selection of patients as well as for the evaluation of therapeutic success and the duration of treatment. Finally, possible restrictions on the use of this new substance group are discussed.

This guideline is an abridged and translated version of the guideline published by Diener H-C, May A et al., Prevention of migraine with monoclonal antibodies against CGRP or the CGRP receptor, Supplement to S1 Guideline Therapy of Migraine Attack and Prevention of Migraine, 2019, Deutsche Gesellschaft für Neurologie (eds.), Guidelines for Diagnostics and Therapy in Neurology. A complete version of this guideline can be found on the website of the Deutsche Gesellschaft für Neurologie (www.dgn.org/leitlinien) and the AWMF (Arbeitsgemeinschaft wissenschaftlicher Medizinischer Gesellschaften).

This guideline has been approved by the German Neurological Society (DGN) and the German Migraine and Headache Society (GMHS) and was reviewed by the two societies.
Open reduction and internal fixation with cables for the variant AGT Periprosthetic fracture: a case report and literature review
Authors: Fan Meng-Qiang , Chen Xiao-Lei , Huang Yong , Huang Jie-Feng
Published: April 2020

Background

Periprosthetic femoral fracture is identified as the third most frequent reason for revision total hip arthroplasty (THA). Treatment of periprosthetic fractures of the femur after THA remains a surgical challenge. In this report, we presented 2 patients with periprosthetic proximal femur fracture variant (a fracture of the greater trochanter with lateral cortical extension) and femoral stem destabilization.

Cases presentation

Two patients presented with chief complaints of pain in hip, restricted hip movements and gait changes. On the basis of clinicoradiological findings, the patients were diagnosed as pseudo AGTperiprosthetic fracture, since the stem was loosened. They underwent open reduction and internal fixation (ORIF) with cables. After 2 years of follow-up, the 2 patients had favorable clinical outcomes after operation. Both lower limbs of the 2 patients were of equal length. The Harris score of the two hips was 96 and 94, respectively.

Conclusion

CT scan worked better than X-ray examination in the diagnosis of prosthetic looseness with this type of fracture. Compared to longer-stem revision, ORIF with cables could also achieve good result with these fractures.
Disclosing mental illness: a doctor's dilemma
Authors: Lawrence Rebecca
Published: April 2020

There is increasing evidence that doctors have high levels of mental illness, and there are concerns that, for some, this may be exacerbated by their working environment. It can be difficult for doctors to disclose mental illness, either to senior or junior colleagues, and perhaps even harder to know what, if anything, to say to patients. Many doctors may be unsure of their position as regards disclosing to governing bodies; others may disclose widely on social media. I am a psychiatrist who also has a significant mental illness, and refer both to my personal experience and the literature to explore some of these issues.
To travel is to live: embracing the emerging field of travel psychiatry
Authors: Flaherty Gerard , Chai Shang Yuin , Hallahan Brian
Published: April 2020

For a person with mental illness, travelling abroad can be challenging but it can be easier when the traveller and healthcare practitioner have a clear understanding of the likely impact of travel on the illness and of the illness on the travel experience. Travel may also precipitate first presentations of mental illness or unmask previously undiagnosed mental disorders. We propose that mental health problems should receive greater recognition in travel medicine and that psychiatrists should collaborate more closely with travel medicine clinicians to ensure that their patients benefit from the opportunities afforded by international travel.
Reliable Analysis of Clinical Tumor-Only Whole-Exome Sequencing Data
Authors: Oh Sehyun , Geistlinger Ludwig , Ramos Marcel , Morgan Martin , Waldron Levi , Riester Markus
Published: April 2020

PURPOSE

Allele-specific copy number alteration (CNA) analysis is essential to study the functional impact of single-nucleotide variants (SNVs) and the process of tumorigenesis. However, controversy over whether it can be performed with sufficient accuracy in data without matched normal profiles and a lack of open-source implementations have limited its application in clinical research and diagnosis.

METHODS

We benchmark allele-specific CNA analysis performance of whole-exome sequencing (WES) data against gold standard whole-genome SNP6 microarray data and against WES data sets with matched normal samples. We provide a workflow based on the open-source PureCN R/Bioconductor package in conjunction with widely used variant-calling and copy number segmentation algorithms for allele-specific CNA analysis from WES without matched normals. This workflow further classifies SNVs by somatic status and then uses this information to infer somatic mutational signatures and tumor mutational burden (TMB).

RESULTS

Application of our workflow to tumor-only WES data produces tumor purity and ploidy estimates that are highly concordant with estimates from SNP6 microarray data and matched normal WES data. The presence of cancer type–specific somatic mutational signatures was inferred with high accuracy. We also demonstrate high concordance of TMB between our tumor-only workflow and matched normal pipelines.

CONCLUSION

The proposed workflow provides, to our knowledge, the only open-source option with demonstrated high accuracy for comprehensive allele-specific CNA analysis and SNV classification of tumor-only WES. An implementation of the workflow is available on the Terra Cloud platform of the Broad Institute (Cambridge, MA).
The Most Influential Publications in Obstetric Anesthesiology, 1998–2017: Utilizing the Delphi Method for Expert Consensus
Authors: Reale Sharon C. , Tsen Lawrence C. , Camann William R. , Bateman Brian T. , Farber Michaela K.
Published: April 2020

BACKGROUND:

There have been many advances in obstetric anesthesiology in the past 2 decades. We sought to create a list of highly influential publications in the field using the Delphi method among a group of obstetric anesthesiology experts to create an important educational, clinical, and research resource.

METHODS:

Experts in the field, defined as obstetric anesthesiologists selected to present the Gerard W. Ostheimer Lecture at the Society for Obstetric Anesthesia and Perinatology (SOAP) annual meeting within the past 20 years, were recruited to participate. The Delphi technique was used by administering 3 rounds of surveys. Participants were initially asked to identify the highly influential publications from the year they presented the Ostheimer lecture, in addition to the most influential publications from the time period overall. Highly influential publications were defined as those that changed traditional views, invoked meaningful practices, catalyzed additional research, and fostered ideas or practices that had durability over time. After each round of surveys, responses were collected and used as choices for subsequent surveys with the goal of obtaining group consensus.

RESULTS:

We determined expert consensus on 22 highly influential publications from 1998 to 2017. The focus of these publications ranged from disease entities, interventions, treatment methodologies, and complications.

CONCLUSIONS:

Key themes in the publications chosen included the reduction of maternal morbidity and mortality and refinements in the analgesic and anesthetic management of labor and delivery.
Thromboelastographic Assessment of Fibrinolytic Activity in Postpartum Hemorrhage: A Retrospective Single-Center Observational Study
Authors: Arnolds David E. , Scavone Barbara M.
Published: April 2020

BACKGROUND:

Postpartum hemorrhage is a leading cause of maternal mortality. Antifibrinolytic therapy has the potential to influence outcomes in postpartum hemorrhage, but the incidence of elevated fibrinolytic activity in postpartum hemorrhage is unknown.

METHODS:

We retrospectively reviewed thromboelastography (TEG) results obtained for postpartum hemorrhage from 118 deliveries at The University of Chicago. TEG results were obtained as part of our postpartum hemorrhage protocol when blood loss exceeded 500 mL after vaginal delivery or 1000 mL after cesarean delivery. Our primary outcome was the incidence of elevated fibrinolytic activity, which we predefined as clot lysis ≥3% at 30 minutes (Ly30) on kaolin TEG. Platelet-mediated clot retraction can also lead to an elevated Ly30 on kaolin TEG. Therefore, to distinguish between fibrinolysis and clot retraction, we evaluated clot lysis using functional fibrinogen TEG, which contains a platelet inhibitor. We considered a kaolin TEG Ly30 ≥3% in conjunction with a nonzero functional fibrinogen TEG Ly30 suggestive of elevated fibrinolytic activity. We also recorded quantitative blood loss, primary etiology of hemorrhage, standard laboratory measurements of coagulation, and demographic and obstetric characteristics of the study population.

RESULTS:

The median kaolin TEG Ly30 was 0.2% (interquartile range: 0%–0.8%). Fifteen of 118 women (12.7%; 95% confidence interval, 7.9%–19.9%) had kaolin TEG Ly30 values ≥3%. Of 15 patients with elevated Ly30 values, functional fibrinogen TEG Ly30 was available for 13, of which none demonstrated detectable clot lysis.

CONCLUSIONS:

Our observation that none of the patients in our sample with kaolin TEG Ly30 values ≥3% had a nonzero functional fibrinogen TEG Ly30 value suggests that the observed elevations in kaolin TEG Ly30 may have been secondary to platelet-mediated clot retraction as opposed to fibrinolysis. Platelet-mediated clot retraction should be distinguished from fibrinolysis when assayed using viscoelastic techniques in postpartum hemorrhage. Further research is necessary to determine the optimal methods to assess fibrinolytic activity in postpartum hemorrhage.
Images of Linear Conditions on a Manhattan Plane
Authors: Yurkov V.
Published: April 2020

In this paper are considered planar point sets generated by linear conditions, which are realized in rectangular or Manhattan metric. Linear conditions are those expressed by the finite sum of the products of distances by numerical coefficients. Finite sets of points and lines are considered as figures defining linear conditions. It has been shown that linear conditions can be defined relative to other planar figures: lines, polygons, etc. The design solutions of the following general geometric problem are considered: for a finite set of figures (points, line segments, polygons...) specified on a plane with a rectangular metric, which are in a common position, it is necessary to construct sets that satisfy any linear condition. The problems in which the given sets are point and segment ones have been considered in detail, and linear conditions are represented as a sum or as relations of distances. It is proved that solution result can be isolated points, broken lines, and areas on the plane. Sets of broken lines satisfying the given conditions form families of isolines for the given condition. An algorithm for building isoline families is presented. The algorithm is based on the Hanan lattice construction and the isolines behavior in each node and each sub-region of the lattice. For isoline families defined by conditions for relation of distances, some of their properties allowing accelerate their construction process are proved. As an example for application of the described theory, the problem of plane partition into regions corresponding to a given set of points, lines and other figures is considered. The problem is generalized problem of Voronoi diagram construction, and considered in general formulation. It means the next: 1) the problem is considered in rectangular metric; 2) all given points may be integrated in various figures – separate points, line segments, triangles, quadrangles etc.; 3) the Voronoi diagram’s property of proximity is changed for property of proportionality. Have been represented examples for plane partition into regions, determined by two-point sets.
Computational Graphics in Solving of Non-Traditional Engineering Problems
Authors: Savel'ev Yu. , Cherkasova Elena
Published: April 2020

Based on the published data, the essence of computational graphics has been laid down. Have been reported examples of new results obtained only through accurate computer constructions and measurements. The work content is a presentation of new ways to achieve the goal by solving non-traditional engineering problems. The author's method of projection with time-stamps, which, in fact, is a computer descriptive geometry, allows solve multi-parameter (not to be confused with multi-dimensional) problems with 9 variables [1–3; 13]. The author’s method of two-axis equal-sized evolvement [11; 12; 17] allows quantitatively measurements of solid angles. The addition of trigonometric functions (sinuses, sinusoids, etc.) can also be considered as a novelty [10; 11; 14]. At the junction of analytic (AG) and descriptive geometries have been calculated parameters of dodecahedron and has been given its mathematical description. In the traditional AG task, the required parameters have been calculated graphically, including a point’s speed of movement. Has been presented the author’s method for determining the instantaneous center in theoretical mechanics. For the first time, the equality of the angles of rotation for points and the link as a whole has been established, and a continuous centroid has been built. By decomposition of vectors a new way for summing up theirs vertical projections has been demonstrated. The developed method of projections with time-stamps allows simultaneously consider such parameters as spatial coordinates of moving objects (two or more) in time, their speeds and even sizes, including the variable ones. Has been shown the possibility for graphical programming while solving systems of equations, as well as for graphical solution of algebraic and stereometric problems. This publication aims to disseminate computer methods for engineering problems solving.
Application of Information Technologies in Checking Procedure of Future Specialists’ Graphic Literacy
Authors: Turutina T. , Tret'yakov D.
Published: April 2020

Topical issues related to improving the quality of higher education and solving teaching-learning problems, aimed at providing a checking procedure of future specialists’ graphic literacy in the process of teaching graphic design are considered in this paper. Among the national tasks of providing specialists for various arears of professional activity, the improvement of higher education’s quality and practical training of competent staff capable for professional self-education is considered as one of priorities. Education is interpreted as a process and result of acquiring the system of knowledge and personality development. Sufficiently frequent updating of requirements to future specialists’ training because of practical implementation of information technology in all professional spheres makes actual the search for more efficient methodologies aimed at changing of professional competences. The development of graphic literacy as future specialists' professional competence is defined by the learning activity process signification. The specificity of graphic disciplines as result of the introduction of information technologies requires the development of an effective methodology to ensure the content of the educational process, changing the nature of expertise, knowledge and skills; forming competence as a special ability necessary to perform a particular action in the object-graphic area. In the modern process for learning of graphic courses the KOMPAS graphic program is widely used, along with Autocad, Archicad, Revit, and others. Further is interpreted the KOMPAS practical use in the process of preparation of future specialists for learning of graphic courses. The KOMPAS jumps out as the program allowing using information technologies in checking procedure of future specialists' graphic literacy. The features of generation in the KOMPAS graphic program are revealed, as well as the software application “Generator”, including an educational-methodical complex aimed at forming of the necessary competence, development of self-learning activities, checking of expertise, knowledge and skills on graphic courses.
Development of Students’ Creative Potential in the Framework of Academic Olympics on Engineering and Computer Graphics
Authors: Mishukovskaya Yu. , Usataya Tat'yana , Deryabina Lyubov'
Published: April 2020

Currently, they present design objects in the form of three-dimensional models and drawings. Accordingly, when training students at a technical university, it is necessary to pay attention to design and graphic disciplines. From the first course of study it is necessary show to students the relationship of the studied graphic disciplines with their future professional activities; stimulate their cognitive interest and motivation for learning and creativity with the help of Academic Olympics, that will help to achieve a high level of students' professional competence. So, one of the main tasks for higher education in the context of implementation of modern Federal State Educational Standards is the formation of the necessary professional competencies and improving the quality of students’ engineering training in technical high educational institutions [16; 25]. The use in the educational process of multilevel creative graphic tasks performed by means of three-dimensional computer graphics helps students to perfect themselves in further educational and professional activities. Creative tasks for Academic Olympics contribute to the development of students' creative potential through creative self-realization. Tasks for Academic Olympics are creative problems in engineering graphics with elements of project activities. For creative self-realization in graphic activities, it is important not only to be aware of graphic tasks, but also to find in them personally meaningful sense, which is manifested when a student implements his own ideas in situations that are significant for him and in a familiar, meaningful environment for him. For this, to students are offered Academic Olympics tasks of various types: propaedeutic (developing the students’ general readiness for graphic activity) and creative tasks with elements of project activity, i.e., creative project tasks. It is necessary also to develop Academic Olympics tasks taking into account the students' training program.
Game—The Transportation Game
Authors: Abasian Foroogh , Rönnqvist Mikael , Marier Philippe , Fjeld Dag
Published: April 2020

This paper presents an online educational game focusing on hierarchical procurement planning in a simulated forest supply chain with multiple companies. The purpose is to provide an understanding of the importance of individual decisions and their medium- to long-term impacts on the entire supply chain. The transportation game comprises three phases, each simulating hierarchical decision making when three competing companies (i.e., the game players) are making simultaneous decisions on the available resources. Each game phase also requires concurrent collaboration and competition. The phases represent different planning levels from long-term to short-term planning, considering the collaboration concept within the supply chain. The simulated supply chain objective is to minimize resource purchasing and transportation costs. The purchasing cost will be fixed after the first phase. The chance of decreasing transportation costs, however, is available until the end of the game. We develop three optimization models for each game phase. Once the game is finished, it compares the players’ results with optimal solutions prepared upfront. Finally, we present some comments about the game experience in various classrooms.
La vigilancia de la salud en España: ¿necesidades de mejora?
Authors: Terradillos García María Jesús
Published: April 2020

La Organización Internacional del Trabajo (OIT) define la vigilancia de la salud en el trabajo como la recopilación, el análisis, la interpretación y la difusión continuada y sistemática de datos a efectos de la prevención, y comprende tanto la vigilancia de la salud de los trabajadores (vigilancia de la salud individual) como la del medio ambiente de trabajo (vigilancia de la salud colectiva), siendo las actividades de vigilancia de la salud individual fundamentalmente de carácter diagnóstico-preventivo, orientadas a la detección precoz de posibles daños derivados del trabajo, mientras que las de nivel colectivo son de carácter epidemiológico.

Uno de los instrumentos de los que se vale la Medicina del Trabajo es precisamente esta vigilancia de la salud, que permite evaluar, controlar y realizar un  seguimiento de la repercusión de las condiciones de trabajo sobre la salud de la población trabajadora. Se trata, pues, de una técnica complementaria de las utilizadas por el resto de disciplinas de prevención de riesgos laborales ­­–Seguridad, Higiene y Ergonomía y Psicosociología– por lo que no tiene sentido su consideración como instrumento aislado de prevención: ha de integrarse en las políticas de prevención globales de la empresa…
Didactic Modes of Scientific Experiments in Moroccan High Schools: Photosynthesis as an Example
Authors: Bouzit Sophia , Alami Anouar , Selmaoui Sabah , Zaki Moncef , Agorram Boujemaa
Published: April 2020

This exploratory study aims to verify whether the current use of scientific experiments in the Moroccan high-school science curriculum meets students’ needs for experimental scientific learning. For that purpose, a sample chapter of the official science textbook was analysed in detail. The analysis was carried out using a didactic model of the French didactician Coquide, which categorizes teaching objectives into three modes: practical familiarisation, empirical investigation and conceptual construction. Analysis grids were built based on a selection of the three didactical modes’ attributes. These grids were used to identify the presence and the weight of these three didactical modes within the chosen sample chapter. Results reveal that experiments in the high-school scientific curriculum are not presented in a balanced way and rarely implemented according to a didactic logic. The study also shows that the experiments analysed are essentially focused on the conceptual construction mode while neglecting practical familiarisation and empirical investigation.