bluuebunny/crossref_metadata_2025 huggingface dataset:
Segmentation of Tourists That Participate in a Cultural Event: The Fiesta of the Patios in Córdoba (Spain)
Authors: Roldán Nogueras Jaime Daniel , Gomez-Casero Gema , Pérez Gálvez Jesús Claudio , González Santa Cruz Francisco
Published: February 2021

United Nations Educational, Scientific and Cultural Organization (UNESCO) recognizes various historical sites as world heritage sites (WHSs). A historical heritage represents the cultural tradition of people, to whom it grants the essence of their diversity. In 2003, UNESCO expanded the area of cultural protection to include other heritage assets known as “intangible cultural heritage” (ICH). The Fiesta of the Patios celebrated in the city of Córdoba (Spain) was recognized as an ICH by UNESCO in 2012. The problem this research analyzes is studying and understanding whether the tourists who participate in an event registered as an ICH have the same motivations as the tourists who visit a specific WHS have. This research is thus to find out the segmentation of tourists who wish to discover ICHs using two models: Poria et al. and McKercher. On the basis of this segmentation, four groups of tourists of WHS were identified: alternative, cultural, emotional, and heritage. In addition, in this research, three motivational dimensions were detected when visitors decide to attend the Fiesta of the Patios: hedonic, cultural, and convenience.
Disrupted Salience and Cingulo-Opercular Network Connectivity During Impaired Rapid Instructed Task Learning in Schizophrenia
Authors: Sheffield Julia M. , Mohr Holger , Ruge Hannes , Barch Deanna M.
Published: February 2021

Rapid instructed task learning (RITL) is the uniquely human ability to transform task information into goal-directed behavior without relying on trial-and-error learning. RITL is a core cognitive process supported by functional brain networks. In patients with schizophrenia, RITL ability is impaired, but the role of functional network connectivity in these RITL deficits is unknown. We investigated task-based connectivity of eight a priori network pairs in participants with schizophrenia ( n = 29) and control participants ( n = 31) during the performance of an RITL task. Multivariate pattern analysis was used to determine which network connectivity patterns predicted diagnostic group. Of all network pairs, only the connectivity between the cingulo-opercular network (CON) and salience network (SAN) during learning classified patients and control participants with significant accuracy (80%). CON-SAN connectivity during learning was significantly associated with task performance in participants with schizophrenia. These findings suggest that impaired interactions between identification of salient stimuli and maintenance of task goals contributes to RITL deficits in participants with schizophrenia.
Drug-Induced Bruxism: a Comprehensive Literature Review
Authors: George Sosa , Joy Rini , Roy Anitha
Published: February 2021

Bruxism is a parafunctional teeth grinding activity that is attributed to be of multifactorial origin. The aim of this article is to provide a brief overview on drug-induced bruxism, commonly associated drugs, and its possible pathogenic mechanisms. Around 43 relevant publications were selected after a comprehensive search in PubMed, Cochrane library, Science Direct, and Google Scholar with appropriate keywords to collect data and compile this review. Disturbances in the neurotransmitters and their receptors in the central nervous system may play a significant role, particularly in sleep bruxism. Drugs that interfere normal secretion and function of neurotransmitters are documented to be capable of inducing bruxism. Such psychotropic drugs are being used in clinical practice chiefly for the management of mood disorders, anxiety, and depression. Although bruxism is a well-recognized side effect of certain medications, the extent of awareness about the same is still inadequate among dental professionals.
Successful turnarounds in bankrupt firms? Assessing retrenchment in the most severe form of crisis
Authors: Rico Manuel , Puig Francisco
Published: February 2021

During economic downturns, firms file for bankruptcy in an effort to attempt a “turnaround.” The objective of this study is to assess the effectiveness of retrenchment strategies in the context of bankruptcy, as the most severe form of crisis. We conducted a longitudinal analysis of a sample of 868 bankrupt Spanish firms during the period 2004–2017. The empirical results show that stakeholder support and deep cost retrenchment increase the likelihood of survival and performance recovery, while aggressive layoffs are detrimental for turning bankrupt firms around. Surprisingly, intense asset retrenchment had no significant effects on firm survival and also pushed performance downward. The findings suggest that retrenchment should not be regarded as a general remedy for firms suffering the most severe of crisis. Bankrupt firms should focus on restoring stakeholder relationships and reducing superfluous expenses, while making employees redundant or selling assets should be evaluated carefully when attempting a turnaround.

JEL CLASSIFICATION M10; G33
U.S. Children “Learning Online” during COVID-19 without the Internet or a Computer: Visualizing the Gradient by Race/Ethnicity and Parental Educational Attainment
Authors: Friedman Joseph , York Hunter , Mokdad Ali H. , Gakidou Emmanuela
Published: February 2021

The coronavirus disease 2019 pandemic has caused unprecedented disruptions to education in the United States, with a large proportion of schooling moving to online formats, which has the potential to exacerbate existing racial/ethnic and socioeconomic disparities in learning. The authors visualize access to online learning technologies using data from the Household Pulse Survey from the early fall 2020 school period (August 19 to October 26). The authors find that 10.1 percent of children participating in online learning nationally did not have adequate access to the Internet and a computer. Rates of inadequate access varied nearly 20-fold across the gradient of parental race/ethnicity and education, from 1.9 percent for children of Asian parents with graduate degrees to 35.5 percent among children of Black parents with less than a high school education. These findings indicate alarming gaps in potential learning among U.S. children. Renewed investments in equitable access to distance-learning resources will be necessary to prevent widening racial/ethnic and class learning disparities.
Beta-binomial models for meta-analysis with binary outcomes: Variations, extensions, and additional insights from econometrics
Authors: Mathes Tim , Kuss Oliver
Published: February 2021

Background

Meta-analysis of systematically reviewed studies on interventions is the cornerstone of evidence based medicine. In the following, we will introduce the common-beta beta-binomial (BB) model for meta-analysis with binary outcomes and elucidate its equivalence to panel count data models.

Methods

We present a variation of the standard “common-rho” BB (BBST model) for meta-analysis, namely a “common-beta” BB model. This model has an interesting connection to fixed-effect negative binomial regression models (FE-NegBin) for panel count data. Using this equivalence, it is possible to estimate an extension of the FE-NegBin with an additional multiplicative overdispersion term (RE-NegBin), while preserving a closed form likelihood. An advantage due to the connection to econometric models is, that the models can be easily implemented because “standard” statistical software for panel count data can be used. We illustrate the methods with two real-world example datasets. Furthermore, we show the results of a small-scale simulation study that compares the new models to the BBST. The input parameters of the simulation were informed by actually performed meta-analysis.

Results

In both example data sets, the NegBin, in particular the RE-NegBin showed a smaller effect and had narrower 95%-confidence intervals. In our simulation study, median bias was negligible for all methods, but the upper quartile for median bias suggested that BBST is most affected by positive bias. Regarding coverage probability, BBST and the RE-NegBin model outperformed the FE-NegBin model.

Conclusion

For meta-analyses with binary outcomes, the considered common-beta BB models may be valuable extensions to the family of BB models.
Asthma-COPD overlap: current understanding and the utility of experimental models
Authors: Tu Xiaofan , Donovan Chantal , Kim Richard Y. , Wark Peter A.B. , Horvat Jay C. , Hansbro Philip M.
Published: February 2021

Pathological features of both asthma and COPD coexist in some patients and this is termed asthma-COPD overlap (ACO). ACO is heterogeneous and patients exhibit various combinations of asthma and COPD features, making it difficult to characterise the underlying pathogenic mechanisms. There are no controlled studies that define effective therapies for ACO, which arises from the lack of international consensus on the definition and diagnostic criteria for ACO, as well as scantin vitroandin vivodata. There remain unmet needs for experimental models of ACO that accurately recapitulate the hallmark features of ACO in patients. The development and interrogation of such models will identify underlying disease-causing mechanisms, as well as enabling the identification of novel therapeutic targets and providing a platform for assessing new ACO therapies. Here, we review the current understanding of the clinical features of ACO and highlight the approaches that are best suited for developing representative experimental models of ACO.
Similar Vertices and Isomorphism Detection for Planar Kinematic Chains Based on Ameliorated Multi-Order Adjacent Vertex Assignment Sequence
Authors: Sun Liang , Ye Zhizheng , Lu Fuwei , Cui Rongjiang , Wu Chuanyu
Published: February 2021

Isomorphism detection is fundamental to the synthesis and innovative design of kinematic chains (KCs). The detection can be performed accurately by using the similarity of KCs. However, there are very few works on isomorphism detection based on the properties of similar vertices. In this paper, an ameliorated multi-order adjacent vertex assignment sequence (AMAVS) method is proposed to seek out similar vertices and identify the isomorphism of the planar KCs. First, the specific definition of AMAVS is described. Through the calculation of the AMAVS, the adjacent vertex value sequence reflecting the uniqueness of the topology features is established. Based on the value sequence, all possible similar vertices, corresponding relations, and isomorphism discrimination can be realized. By checking the topological graph of KCs with a different number of links, the effectiveness and efficiency of the proposed method are verified. Finally, the method is employed to implement the similar vertices and isomorphism detection of all the 9-link 2-DOF(degree of freedom) planar KCs.
Macrofaunal assemblages associated with two common seagrass‐dwelling demosponges (Amorphinopsis atlantica and Haliclona implexiformis) in a tropical estuarine system of the southern Gulf of Mexico
Authors: Briceño-Vera Antony E. , Ávila Enrique , Rodríguez-Santiago María A. , Ruiz-Marín Alejandro
Published: February 2021

Among the ecological roles that sponges play in marine ecosystems, one of the highlights is their ability to host a wide diversity and abundance of epibenthic organisms. However, of the different marine environments, this role has been less investigated in seagrass-dwelling sponges. In this study, the main objective was to determine whether the structure of the associated faunal assemblages in two common sympatric species of seagrass-dwelling sponges (Amorphinopsis atlantica and Haliclona implexiformis) vary depending on the volume and morphology of the host sponge as well as the environment to which both sponges are exposed. Even though the collection sites had the same habitat type (seagrass meadows composed by Thalassia testudinum and Halodule wrightii) and depth, there were substantial differences in faunal composition (ANOSIM test, R = 0.86) between both sponge species. The value of the data on species richness, diversity, and abundance of associated organisms was significantly higher in the individuals of A. atlantica than in those of H. implexiformis. These differences in the community structure of associated fauna could be influenced by the differential growth form of the hosts (e.g. growth form and oscula diameter) as well as their distinct environmental preferences (sites with different degrees of exposure to wind-generated waves and levels of human disturbance). This study contributes to the knowledge on the functional role that sponges play in seagrass meadows, one of the world’s most endangered ecosystems. Furthermore, it underlines the importance of examining both, the sponge morphology and the local environmental conditions, to explain spatial variations in the macrofaunal assemblages associated with sponges.
Differentiation of two human neuroblastoma cell lines alters SV2 expression patterns
Authors: Lekholm Emilia , Ceder Mikaela M. , Forsberg Erica C. , Schiöth Helgi B. , Fredriksson Robert
Published: February 2021

Background

The synaptic vesicle glycoprotein 2 (SV2) family is essential to the synaptic machinery involved in neurotransmission and vesicle recycling. The isoforms SV2A, SV2B and SV2C are implicated in neurological diseases such as epilepsy, Alzheimer’s and Parkinson’s disease. Suitable cell systems for studying regulation of these proteins are essential. Here we present gene expression data of SV2A, SV2B and SV2C in two human neuroblastoma cell lines after differentiation.

Methods

Human neuroblastoma cell lines SiMa and IMR-32 were treated for seven days with growth supplements (B-27 and N-2), all-trans-retinoic acid (ATRA) or vasoactive intestinal peptide (VIP) and gene expression levels of SV2 and neuronal targets were analyzed.

Results

The two cell lines reacted differently to the treatments, and only one of the three SV2 isoforms was affected at a time. SV2B and choline O-acetyltransferase (CHAT) expression was changed in concert after growth supplement treatment, decreasing in SiMa cells while increasing in IMR-32. ATRA treatment resulted in no detected changes in SV2 expression in either cell line while VIP increased both SV2C and dopamine transporter (DAT) in IMR-32 cells.

Conclusion

The synergistic expression patterns between SV2B and CHAT as well as between SV2C and DAT mirror the connectivity between these targets found in disease models and knock-out animals, although here no genetic alteration was made. These cell lines and differentiation treatments could possibly be used to study SV2 regulation and function.
In vitro mass reduction of calcium oxalate urinary calculi by some medicinal plants
Authors: El Habbani R. , Lahrichi A. , Sqalli Houssaini T. , Kachkoul R. , Mohim M. , Chouhani B. A. , Chaqroune A.
Published: February 2021

Background

Calcium oxalate is the most frequent urinary stone component; it exists in three different crystalline forms. In this case, the most common is the calcium oxalate monohydrate (whewellite). However, Morocco is one of the countries that has used the traditional medicine based on natural plants to treat many diseases including urolithiasis. In this respect, the most medicinal plants used for this purpose are Herniaria hirsuta L., Opuntia ficus-indica flowers, Zea mays styles and Ammi visnaga L. seeds. The purpose of this work is to study experimentally the effectiveness of each plant on the dissolution of whewellite stones.

Methods

In 1 L boiled saline solution (9 g/L of NaCl), 5 g of plant extract powder has been introduced. Thereafter, the mixture was left soaked for 15 min and then filtered. Further, a specific installation that resembles the urinary circuit has been conducted in the laboratory. As a starting step, three whewellite stones are placed in contact with extract solutions for 8 weeks. Two other solutions have been used to correct the loss mass: the first one is a solution of potassium citrate of 3 mmol/L served as a positive control, and the second one is a solution of NaCl of 9 g/L without extract used as a reference point.

Results

After 8 weeks, the loss mass is about 54.88 ± 1.32% with Z. mays styles, 49.86 ± 1.69% with H. hirsuta L., 47.10 ± 1019% with A. visnaga L. and 44.97 ± 1.76% with flowers O. ficus-indica, while the loss of mass in the presence of witnesses solutions is 21.95 ± 0.76% for potassium citrate (C Pot) and 21.05 ± 1.07% in the case of saline solutions.

Conclusion

Our experiments show the effectiveness of the extracts of four plants specially for Z. mays styles. These extracts can be effective remedies in the oxalocalcic stones’ dissolution.
MQF and buffered MQF: quotient filters for efficient storage of k-mers with their counts and metadata
Authors: Shokrof Moustafa , Brown C. Titus , Mansour Tamer A.
Published: February 2021

Background

Specialized data structures are required for online algorithms to efficiently handle large sequencing datasets. The counting quotient filter (CQF), a compact hashtable, can efficiently store k-mers with a skewed distribution.

Result

Here, we present the mixed-counters quotient filter (MQF) as a new variant of the CQF with novel counting and labeling systems. The new counting system adapts to a wider range of data distributions for increased space efficiency and is faster than the CQF for insertions and queries in most of the tested scenarios. A buffered version of the MQF can offload storage to disk, trading speed of insertions and queries for a significant memory reduction. The labeling system provides a flexible framework for assigning labels to member items while maintaining good data locality and a concise memory representation. These labels serve as a minimal perfect hash function but are ~ tenfold faster than BBhash, with no need to re-analyze the original data for further insertions or deletions.

Conclusions

The MQF is a flexible and efficient data structure that extends our ability to work with high throughput sequencing data.
Evolutionary pattern of Macaca fascicularis in Southeast Asia inferred using Y-chromosomal gene
Authors: Rovie-Ryan Jeffrine J. , Khan Faisal Ali Anwarali , Abdullah Mohd Tajuddin
Published: February 2021

Background

We analyzed a combined segment (2032-bp) of the sex-determining region and the testis-specific protein of the Y-chromosome (Y-DNA) gene to clarify the gene flow and phylogenetic relationships of the long-tailed macaques (Macaca fascicularis) in Southeast Asia. Phylogenetic relationships were constructed using the maximum likelihood, Bayesian inference, and the median-joining network from a total of 164 adult maleM. fascicularisfrom 62 localities in Malaysia, including sequences from the other regions from previous studies.

Results

Based on Y-DNA, we confirm the presence of two lineages ofM. fascicularis: the Indochinese and Sundaic lineages. The Indochinese lineage is represented byM. fascicularislocated northwards of the Surat Thani-Krabi depression region and is introgressed by theMacaca mulattaY-DNA. The Sundaic lineage is free from such hybridization event, thus defined as the original carrier of theM. fascicularisY-DNA. We further revealed that the Sundaic lineage differentiated into two forms: the insular and the continental forms. The insular form, which represents the ancestral form ofM. fascicularis, consists of two haplotypes: a single homogenous haplotype occupying the island of Borneo, Philippines, and southern Sumatra; and the Javan haplotype.The more diverse continental form consists of 17 haplotypes in which a dominant haplotype was shared by individuals from southern Thai Peninsular (south of Surat Thani-Krabi depression), Peninsular Malaysia, and Sumatra. Uniquely, Sumatra contains both the continental and insular Y-DNA which can be explained by a secondary contact hypothesis.

Conclusions

Overall, the findings in this study are important: (1) to help authority particularly in Malaysia on the population management activities including translocation and culling of conflictM. fascicularis, (2) to identify the unknown origin of captiveM. fascicularisused in biomedical research, and; (3) the separation between the continental and insular forms warrants for the treatment as separate management units.
Protecting the patches from the footprints: examining the land use factors associated with forest patches in Atewa range forest reserve
Authors: Agyemang-Duah Williams , Oduro Appiah Joseph , Adei Dina
Published: February 2021

Background

Land use practices are noted to contribute to changes in forest landscape composition. However, whereas studies have reported the intermix of land uses and forest patches and measured the direct impacts of land uses on forest patches, little is known regarding the spatially-explicit association between the most recent forest patches and land use footprints in protected areas. In this study, we use methods from GIS, remote sensing, and statistics to model the spatial relationship between footprints of land uses and patches of forest cover by drawing on geospatial data from the Atewa range forest reserve (ARFR).

Results

The study finds that forest patches that are within 1 km from agricultural land use footprints (AOR = 86.625, C.I. 18.057–415.563, P = 0.000), logging sites (AOR = 55.909, C.I. 12.032–259.804, P = 0.000), mine sites (53.571, C.I. 11.287–254.255, P = 0.000), access roads (AOR = 24.169, C.I. 5.544–105.357, P = 0.000), and human settlement footprints (AOR = 7.172, C.I. 1.969–26.128, P = 0.003) are significantly more likely to be less than the mean patch area (375,431.87 m2 = 37.54 ha) of forest cover. A ROC statistic of 0.995 achieved in this study suggests a high predictive power of the proposed model.

Conclusion

The study findings suggest that to ensure sustainable land uses and ecological integrity, there is a need for land use policies and land management strategies that ensure responsible livelihood activities as well as further restrictions on logging and mining in the globally significant biodiversity area.
Nectar-dwelling microbes of common tansy are attractive to its mosquito pollinator, Culex pipiens L.
Authors: Peach D. A. H. , Carroll C. , Meraj S. , Gomes S. , Galloway E. , Balcita A. , Coatsworth H. , Young N. , Uriel Y. , Gries R. , Lowenberger C. , Moore M. , Gries G.
Published: February 2021

Background

There is widespread interkingdom signalling between insects and microbes. For example, microbes found in floral nectar may modify its nutritional composition and produce odorants that alter the floral odor bouquet which may attract insect pollinators. Mosquitoes consume nectar and can pollinate flowers. We identified microbes isolated from nectar of common tansy,Tanacetum vulgare, elucidated the microbial odorants, and tested their ability to attract the common house mosquito,Culex pipiens.

Results

We collected 19 microbial isolates fromT. vulgarenectar, representing at least 12 different taxa which we identified with 16S or 26S rDNA sequencing as well as by biochemical and physiological tests. Three microorganisms (Lachancea thermotolerans, Micrococcus lactis,Micrococcus luteus) were grown on culture medium and tested in bioassays. Only the yeastL. thermotoleransgrown on nectar, malt extract agar, or in synthetic nectar broth significantly attractedCx. pipiensfemales. The odorant profile produced byL. thermotoleransvaried with the nutritional composition of the culture medium. All three microbes grown separately, but presented concurrently, attracted fewerCx. pipiensfemales thanL. thermotoleransby itself.

Conclusions

Floral nectar ofT. vulgarecontains various microbes whose odorants contribute to the odor profile of inflorescences. In addition,L. thermotoleransproduced odorants that attractCx. pipiensfemales. As the odor profile ofL. thermotoleransvaried with the composition of the culture medium, we hypothesize that microbe odorants inform nectar-foraging mosquitoes about the availability of certain macro-nutrients which, in turn, affect foraging decisions by mosquitoes.
GCA: an R package for genetic connectedness analysis using pedigree and genomic data
Authors: Yu Haipeng , Morota Gota
Published: February 2021

Background

Genetic connectedness is a critical component of genetic evaluation as it assesses the comparability of predicted genetic values across units. Genetic connectedness also plays an essential role in quantifying the linkage between reference and validation sets in whole-genome prediction. Despite its importance, there is no user-friendly software tool available to calculate connectedness statistics.

Results

We developed the GCA R package to perform genetic connectedness analysis for pedigree and genomic data. The software implements a large collection of various connectedness statistics as a function of prediction error variance or variance of unit effect estimates. The GCA R package is available at GitHub and the source code is provided as open source.

Conclusions

The GCA R package allows users to easily assess the connectedness of their data. It is also useful to determine the potential risk of comparing predicted genetic values of individuals across units or measure the connectedness level between training and testing sets in genomic prediction.
Age-related changes of microbiota in midlife associated with reduced saccharolytic potential: an in vitro study
Authors: Chen Junkui , Pi Xionge , Liu Wei , Ding Qunfang , Wang Xin , Jia Weiguo , Zhu Liying
Published: February 2021

Background

Gut microbiota is critical in maintaining human health, of which diversity and abundance are subject to significantly reduce in seniors. Gut microbiota is reported to be stable across the long adulthood in general, but lack of careful examination, especially for the midlife people.

Results

To characterize the gut microbiota in midlife, we investigated the faecal microbiota between two groups of healthy people, young, 20–39 years old, n = 15; and midlife, 40–60 years old, n = 15. Metabolic responses of the microbiota were studied through in vitro batch fermentation model. Although no difference was observed in the diversity indices between the two age groups, a wide range taxonomic changes were found in the faecal microbiota. Furthermore, substantial Bifidobacterium reduction was also found in both faecal and fermented samples. The faecal SCFAs are similar in both groups, as well as starch fermentation broth. However, after inulin fermentation, the acetate concentration and inulin degradation rate decreased while the gas production increased in midlife group, suggesting a deficiency of saccharolytic potential in midlife, especially for non-digestible carbohydrate.

Conclusions

Our data demonstrate that gut microbiota begins to change as early as in midlife. The reduction in Bifidobacterium dominates the change of the microbiota composition in midlife resulting in attenuated saccharolytic capacity of inulin, possibly leading to insufficient acetate production which might be associated with healthy problems in this transition period from young to elderly.
Comparison of BCYEα+AB agar and MWY agar for detection and enumeration of Legionella spp. in hospital water samples
Authors: Ditommaso Savina , Giacomuzzi Monica , Memoli Gabriele , Garlasco Jacopo , Zotti Carla M.
Published: February 2021

Background

This study illustrates for the first time the performance (sensitivity and selectivity) of the selective medium BCYEα +AB suggested by the new edition of ISO 11731 for legionella isolation and enumeration. We compared the efficacy of the selective BCYEα +AB medium with that of the highly selective MWY medium.

Results

Legionellaspp.was detected in 48.2 and 47.1% of the samples by BCYEα +AB and MWY agar, respectively. For optimal detection ofLegionellaspp., most protocols recommend using selective media to reduce the number of non-Legionellabacteria. Agreement between the two media was 86.7%.

Conclusions

According to the results, both media have a very similar performance and they both have advantages and disadvantages over each other. In AB medium there is the risk of being less selective so more interfering microbiota may grow but in MWY medium there is the risk of being too selective. The low selectivity of the AB medium could be resolved if other treatments are applied after filtration, e.g. acid and/or heat treatment, but it must be taken into account that these treatments still reduce the number of viableLegionella. In conclusion, we recommend using MWY as a selective medium for the detection ofLegionellaspp. as it is easier discern suspected colonies and facilitate the finalLegionellaspp. count.
The visually estimated blood volume in scaled canisters based on a simulation study
Authors: Gerdessen Lara , Neef Vanessa , Raimann Florian J. , Zacharowski Kai , Piekarski Florian
Published: February 2021

Background

The most common technique used worldwide to quantify blood loss during an operation is the visual assessment by the attending intervention team. In every operating room you will find scaled suction canisters that collect fluids from the surgical field. This scaling is commonly used by clinicians for visual assessment of intraoperative blood loss. While many studies have been conducted to quantify and improve the inaccuracy of the visual estimation method, research has focused on the estimation of blood volume in surgical drapes. The question whether and how scaling of canisters correlates with actual blood loss and how accurately clinicians estimate blood loss in scaled canisters has not been the focus of research to date.

Methods

A simulation study with four “bleeding” scenarios was conducted using expired whole blood donations. After diluting the blood donations with full electrolyte solution, the sample blood loss volume (SBL) was transferred into suction canisters. The study participants then had to estimate the blood loss in all four scenarios. The difference to the reference blood loss (RBL) per scenario was analyzed.

Results

Fifty-three anesthetists participated in the study. The median estimated blood loss was 500 ml (IQR 300/1150) compared to the RBL median of 281.5 ml (IQR 210.0/1022.0). Overestimations up to 1233 ml were detected. Underestimations were also observed in the range of 138 ml. The visual estimate for canisters correlated moderately with RBL (Spearman’s rho: 0.818; p < 0.001). Results from univariate nonparametric confirmation statistics regarding visual estimation of canisters show that the deviation of the visual estimate of blood loss is significant (z = − 10.95, p < 0.001, n = 220). Participants’ experience level had no significant influence on VEBL (p = 0.402).

Conclusion

The discrepancies between the visual estimate of canisters and the actual blood loss are enormous despite the given scales. Therefore, we do not recommend estimating the blood loss visually in scaled suction canisters. Colorimetric blood loss estimation could be a more accurate option.
The impact of vildagliptin on the daily glucose profile and coronary plaque stability in impaired glucose tolerance patients with coronary artery disease: VOGUE—A multicenter randomized controlled trial
Authors: Yamamoto Hiroyuki , Konishi Akihide , Shinke Toshiro , Otake Hiromasa , Kuroda Masaru , Osue Tsuyoshi , Sawada Takahiro , Takaya Tomofumi , Kawai Hiroya , Hashimoto Naoko , Ohara Takeshi , Hirota Yushi , Sakaguchi Kazuhiko , Omori Takashi , Ogawa Wataru , Hirata Ken-ichi
Published: February 2021

Background

The impact of reduction in glycemic excursion on coronary plaques remains unknown. This study aimed to elucidate whether a dipeptidyl peptidase 4 inhibitor could reduce the glycemic excursion and stabilize the coronary plaques compared with conventional management in coronary artery disease (CAD) patients with impaired glucose tolerance (IGT).

Methods

This was a multicenter, randomized controlled trial including CAD patients with IGT under lipid-lowering therapy receiving either vildagliptin (50 mg once a day) or no medication (control group) regarding glycemic treatment. The primary endpoint was changes in the minimum fibrous cap thickness and lipid arc in non-significant native coronary plaques detected by optical coherence tomography at 6 months after intervention. Glycemic variability expressed as the mean amplitude of glycemic excursion (MAGE) measured with a continuous glucose monitoring system was evaluated before and 6 months after intervention.

Results

A total of 20 participants with 47 lesions were allocated to either the vildagliptin group (10 participants, 22 lesions) or the control group (10 participants, 25 lesions). The adjusted difference of mean changes between the groups was − 18.8 mg/dl (95% confidence interval, − 30.8 to − 6.8) (p = 0.0064) for the MAGE (vildagliptin, − 20.1 ± 18.0 mg/dl vs. control, 2.6 ± 12.7 mg/dl), − 22.8° (− 40.6° to − 5.1°) (p = 0.0012) for the mean lipid arc (vildagliptin, − 9.0° ± 25.5° vs. control, 15.8° ± 16.8°), and 42.7 μm (15.3 to 70.1 μm) (p = 0.0022) for the minimum fibrous cap thickness (vildagliptin, 35.7 ± 50.8 μm vs. control, − 15.1 ± 25.2 μm).

Conclusions

Vildagliptin could reduce the MAGE at 6 months and may be associated with the decreased lipid arc and increased minimum FCT of the coronary plaques in CAD patients with IGT as compared with the control group. These findings may represent its potential stabilization effect on coronary plaques, which are characteristic in this patient subset.

Trial registration Registered in the UMIN clinical trial registry (UMIN000008620), Name of the registry: VOGUE trial, Date of registration: Aug 6, 2012, URL: https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000010058
Assessment of the ability of the CHA2DS2-VASc scoring system to grade left atrial function by 2D speckle-tracking echocardiography
Authors: Hadadi Marjan , Mohseni-Badalabadi Reza , Hosseinsabet Ali
Published: February 2021

Background

The CHA2DS2-VASc scoring system is correlated with left atrial (LA) reservoir function in patients with atrial fibrillation (AF) rhythm or paroxysmal AF. We assessed the ability of CHA2DS2-VASc to grade LA function in patients with sinus rhythm who were candidates for coronary artery bypass grafting (CABG).

Methods

This cross-sectional study recruited 340 consecutive candidates for CABG and categorized them according to their CHA2DS2-VASc scores as mild-, moderate-, and high-risk score groups with 34 (10%), 83 (24%), and 223 (66%) patients, respectively. LA function was evaluated via 2D speckle-tracking echocardiography in terms of global longitudinal strain and strain rate during the reservoir, conduit, and contraction phases. In-hospital mortality, postoperative AF, prolonged intensive care unit (ICU) stay, and prolonged mechanical ventilation were assessed.

Results

LA strain and strain rate during the reservoir phase was statistically significantly lower in the high-risk score group than the low- and moderate-risk score groups (27.8 ± 6.9% vs 31.0 ± 5.0% vs 29.8 ± 6.1%, respectively;P = 0.004 and 2.6 ± 0.7 s−1vs 2.9 ± 0.6 s−1vs 2.9 ± 0.6 s−1, correspondingly;P = 0.009) and regarding LA strain and strain rate during the conduit phase (9.7 [7.1–12.5]% vs 12.9 [9.4–15.1]% vs 11.5 [9.1–13.8]%, correspondingly;P < 0.001 and 2.1 [1.6–2.7] s−1vs 2.8 [2.4–3.6] s−1vs 2.6 [2.2–3.0] s−1, respectively;P < 0.001). In addition, LA strain rate during the conduit phase was lower in the moderate-risk score group than the low-risk score group. After adjustments for possible confounders, these differences remained statistically significant. The risk of postoperative AF and prolonged ICU stay was highest in the high-risk score group (relative risk = 9.67 (1.31–71.43) and 8.05 (1.08–60.16), respectively;P = 0.026 andP = 0.042, respectively).

Conclusions

LA reservoir and conduit functions decreased in the high-risk score group, which was accompanied by an increased risk of postoperative AF and prolonged ICU stay.
Family satisfaction in the intensive care unit, a cross-sectional study from Norway
Authors: Haave Randi Olsson , Bakke Hilde Hammerud , Schröder Agneta
Published: February 2021

Background

Becoming critically ill represents not just a great upheaval for the patient in question, but also for the patient’s closest family. In recent years, there has been a change in how the quality of the public health service is measured. There is currently a focus on how patients and their families perceive the quality of treatment and care. It can be challenging for patients to evaluate their stay in an intensive care unit (ICU) due to illness and treatment. Earlier studies show that the perceptions of the family and the patient may concur. It is important, therefore, to ascertain the family’s level of satisfaction with the ICU stay.

The aim of the study was to describe how the family evaluate their satisfaction with the ICU stay. A further aim was to identify which demographic variables were associated with differences in family satisfaction.

Method

The study had a cross-sectional design. A sample of 57 family members in two ICUs in Norway completed the questionnaire: Family satisfaction in the intensive care unit 24 (FS-ICU 24). Statistical analysis was conducted using the Mann-Whitney U test (U), Kruskal Wallis, Spearman rho and a performance-importance plot.

Results

The results showed that families were very satisfied with a considerable portion of the ICU stay. Families were less satisfied with the information they received and the decision-making processes than with the nursing and care performed during the ICU stay. The results revealed that two demographic variables – relation to the patient and patient survival – significantly affected family satisfaction.

Conclusion

Although families were very satisfied with the ICU stay, several areas were identified as having potential for improvement. The results showed that some of the family demographic variables were significant for family satisfaction. The findings are clinically relevant since the results can strengthen intensive care nurses’ knowledge when meeting the family of the intensive care patient.
Regression models for interval censored data using parametric pseudo-observations
Authors: Johansen Martin Nygård , Lundbye-Christensen Søren , Larsen Jacob Moesgaard , Parner Erik Thorlund
Published: February 2021

Background

Time-to-event data that is subject to interval censoring is common in the practice of medical research and versatile statistical methods for estimating associations in such settings have been limited. For right censored data, non-parametric pseudo-observations have been proposed as a basis for regression modeling with the possibility to use different association measures. In this article, we propose a method for calculating pseudo-observations for interval censored data.

Methods

We develop an extension of a recently developed set of parametric pseudo-observations based on a spline-based flexible parametric estimator. The inherent competing risk issue with an interval censored event of interest necessitates the use of an illness-death model, and we formulate our method within this framework. To evaluate the empirical properties of the proposed method, we perform a simulation study and calculate pseudo-observations based on our method as well as alternative approaches. We also present an analysis of a real dataset on patients with implantable cardioverter-defibrillators who are monitored for the occurrence of a particular type of device failures by routine follow-up examinations. In this dataset, we have information on exact event times as well as the interval censored data, so we can compare analyses of pseudo-observations based on the interval censored data to those obtained using the non-parametric pseudo-observations for right censored data.

Results

Our simulations show that the proposed method for calculating pseudo-observations provides unbiased estimates of the cumulative incidence function as well as associations with exposure variables with appropriate coverage probabilities. The analysis of the real dataset also suggests that our method provides estimates which are in agreement with estimates obtained from the right censored data.

Conclusions

The proposed method for calculating pseudo-observations based on the flexible parametric approach provides a versatile solution to the specific challenges that arise with interval censored data. This solution allows regression modeling using a range of different association measures.
Changing phenotype, early clinical course and clinical predictors of inflammatory bowel disease in Sri Lanka: a retrospective, tertiary care-based, multi-centre study
Authors: Niriella M. A. , Liyanage I. K. , Kodisinghe S. K. , De Silva A. P. , Jayatissa A. V. G. A. M. , Navarathne N. M. M. , Peiris R. K. , Kalubovila U. P. , Kumarasena S. R. , Jayasekara R. W. , de Silva H. J.
Published: February 2021

Background

Inflammatory bowel disease (IBD) is increasing in the Asia-Pacific region, with changes in disease phenotype and course. We aimed to assess the changing phenotypes of IBD over ten years, describe the early clinical course (ECC) and identify the clinical predictors (CP) of poor outcomes among a large, multi-centre, cohort of Sri Lankan IBD patients.

Methods

We included patients [diagnosed between June/2003–December/2009-Group-1(G1), January/2010–June/2016-Group-2(G2)] with ulcerative colitis (UC) and Crohn disease (CD) from five national-referral centres. Changing phenotype from G1 to G2, ECC (disease duration < 3-years) and CP of poor outcomes (disease duration ≥ 1-year) was assessed. Poor outcomes were complicated-disease (CompD-stricturing/penetrating-CD, extensive-UC/pancolitis, perforation/bleeding/colectomy/malignancy) and treatment-refractory disease (TRD-frequently-relapsing, steroid-dependent/refractory and biologic use).

Results

375 (UC-227, CD-148) patients were recruited. Both G1/G2 had more UC than CD (77% vs 23%, 54.5 vs 45.5 respectively, p < 0.01). Increase of CD from G1-to-G2 was significant (23–45.4%, p < 0.001). In both groups, left-sided colitis (E2) and ileo-colonic (L3)/non-stricturing, non-penetrating disease behaviour (B1) CD predominated. Extensive-colitis (E3) (36.4% vs 22.7, p < 0.05) and stricturing-CD (B2) (26.1% vs 4.0%, p < 0.01) was commoner in G1. ECC was assessed in 173-patients (UC-94, CD-79). Aggressive disease behaviour and TRD were low among both UC and CD. Immunomodulator use was significantly higher among CD than UC (61.5% vs 29.0% respectively, p < 0.01). Anti-TNF use was low among both groups (UC-3.2%, CD-7.7%). Disease complications among UC [bleeding (2.1%), malignancy-(1.1%), surgery-(2.1%)] and CD [stricture-(3.9%), perforation-(1.3%), malignancy-(1.3%), surgery-(8.9%)] were generally low. CPs were assessed in 271-patients (UC-163, CD-108). Having a family history of IBD (for UC), extraintestinal manifestation (EIM), severe disease at presentation, being in younger age categories and severe disease at presentation, (for both UC and CD) predicted poor outcomes.

Conclusion

There was an increase in CD over time without change in disease phenotype for both UC and CD. A relatively benign ECC was observed. Family history (UC), EIMs (UC/CD), severe disease at presentation (UC/CD), younger age (CD/UC) CPs of poor outcomes.
Discriminant equation using mucosally expressed cytokines and transcription factor for making definite diagnosis of inflammatory bowel disease unclassified
Authors: Okuno Hiroaki , Ogino Haruei , Ihara Eikichi , Nishioka Kei , Tanaka Yoshimasa , Chinen Takatoshi , Kohjima Motoyuki , Oono Takamasa , Tanaka Masatake , Goya Takeshi , Fujimori Nao , Iboshi Yoichiro , Gotoda Takuji , Ogawa Yoshihiro
Published: February 2021

Background

The pathological conditions of UC and CD involved in inflammatory bowel disease-unclassified (IBD-U), UC with primary sclerosing cholangitis (PSC-UC), and UC with autoimmune pancreatitis type 2 (AIP-UC) remain unclear. Therefore, it is difficult to decide the appropriate treatments for these subtypes of UC. Our aim was to examine whether the discriminant equation using the mucosally expressed mediators designed as our previous study for IBD, could characterize IBD-U, PSC-UC, or AIP-UC.

Methods

A total of 56 patients including UC (n = 24), CD (n = 15), IBD-U (n = 10), PSC-UC (n = 4), and AIP-UC (n = 3), along with 9 control patients were enrolled in this study. Mucosally expressed inflammatory mediators related to Th1, Th2, Th17, and Treg were measured using quantitative PCR in endoscopic biopsies from the inflamed intestines of the patients. The IBD-U, PSC-UC or AIP-UC were characterized using discriminant analysis and principle component analysis.

Results

Through discriminant analyses, combinations of 3 to 7 inflammatory mediators were used to discriminate between UC and CD. Moreover, the identified 3 markers could diagnose patients with IBD-U as UC or CD with high accuracy. The distribution graph of inflammatory mediators using the principal component analysis revealed that PSC-UC and AIP-UC exhibited CD-like and UC-like features, respectively.

Conclusions

The discriminant equation using mucosally expressed mediators of IL-13, IL-21 and T-bet can be used as a universal diagnostic tool not only for IBD-U but also to assess pathological conditions in PSC-UC and AIP-UC.
Placing assistive technology and telecare in everyday practices of people with dementia and their caregivers: findings from an embedded ethnography of a national dementia trial
Authors: Lariviere Matthew , Poland Fiona , Woolham John , Newman Stanton , Fox Chris
Published: February 2021

Background

Policy makers and care providers see assistive technology and telecare as potential products to support people with dementia to live independently in their homes and communities. Previous research rarely examined how people with dementia and their caregivers actually use such technology. The study examined how and why people living with dementia and their caregivers used assistive technology and telecare in their own homes.

Methods

This study used an ethnographic design embedded within the NIHR-funded Assistive Technology and Telecare to maintain Independent Living At home for people with dementia (ATTILA) randomised controlled trial. We collected 208 h of observational data on situated practices of ten people with dementia and their ten caregivers. We used this data to construct extended cases to explain how technologies supported people with dementia in home and community settings.

Results

We identified three themes: placing technology in care, which illustrates how people with dementia and caregivers ‘fit’ technology into their homes and routines; replacing care with technology, which shows how caregivers replaced normal care practices with ones mediated through technologies; and technology displacing care and everyday life, which highlights how technologies disrupted the everyday lives of people with dementia.

Discussion

This study exemplifies unintended and unanticipated consequences for assistive technology and telecare uptake in ‘real world’ community-based dementia care. It underlines the need to identify and map the context of technological provision over time within the changing lives of people with dementia and their caregivers.