bluuebunny/crossref_metadata_2025 huggingface dataset:
The influence of expectation modification in knee arthroplasty on satisfaction of patients: a randomized controlled trial
Authors: Tolk Jaap J. , Janssen Rob P. A. , Haanstra Tsjitske M. , van der Steen M. C. , Bierma-Zeinstra Sita M. A. , Reijman Max
Published: April 2021

Aims

Meeting preoperative expectations is known to be of major influence on postoperative satisfaction after total knee arthroplasty (TKA). Improved management of expectation, resulting in more realistic expectations can potentially lead to higher postoperative satisfaction. The objective of this study was to assess the effect of an additional preoperative education module, addressing realistic expectations for long-term functional recovery, on postoperative satisfaction and expectation fulfilment.

Methods

In total, 204 primary TKA patients with osteoarthritis were enrolled in this randomized controlled trial (RCT). Patients were allocated to either usual preoperative education (control group) or usual education plus an additional module on realistic expectations (intervention group). Primary outcome was being very satisfied (numerical rating scale for satisfaction ≥ 8) with the treatment result at 12 months' follow-up. Other outcomes were change in preoperative expectations and postoperative expectation fulfilment.

Results

A total of 187 patients (91.7%) were available for analysis at follow-up. In the intention-to-treat analysis, 58.5% (55/94) of patients were very satisfied with the treatment result in the control group, and 69.9% (65/93) of patients in the intervention group (adjusted odds ratio (AOR) 1.72, 95% confidence interval (CI) 0.90 to 3.29). A per-protocol analysis for patients who attended the education session (92.0%, n = 172) showed that 56.9% (49/86) of patients were very satisfied in the control group and 74.4% (61/86) in the intervention group (AOR 2.44, 95% CI 1.21 to 4.91). After preoperative education, the expectation scores in the intervention group were significantly lower (mean difference -6.9 (95% CI -10.2 to -3.6)) and did not alter in the control group (mean difference 0.5 (95% CI -2.9 to 3.9)). Overall, fulfilment of expectations at 12 months was significantly higher in the intervention group (mean difference 11.4% (95% CI 2.3 to 20.5)).

Conclusion

Improved preoperative patient education can modify patient expectations, resulting in higher postoperative fulfilment of expectation and higher satisfaction in the group that attended the preoperative education. This is the first RCT to confirm the potential of improved expectation management on satisfaction after TKA. Cite this article: Bone Joint J 2021;103-B(4):619–626.
Management of low periprosthetic distal femoral fractures
Authors: Ross Lauren A. , Keenan Oisin J. F. , Magill Matthew , Brennan Caitlin M. , Clement Nick D. , Moran Matt , Patton James T. , Scott Chloe E. H.
Published: April 2021

Aims

Debate continues regarding the optimum management of periprosthetic distal femoral fractures (PDFFs). This study aims to determine which operative treatment is associated with the lowest perioperative morbidity and mortality when treating low (Su type II and III) PDFFs comparing lateral locking plate fixation (LLP-ORIF) or distal femoral arthroplasty (DFA).

Methods

This was a retrospective cohort study of 60 consecutive unilateral (PDFFs) of Su types II (40/60) and III (20/60) in patients aged ≥ 60 years: 33 underwent LLP-ORIF (mean age 81.3 years (SD 10.5), BMI 26.7 (SD 5.5); 29/33 female); and 27 underwent DFA (mean age 78.8 years (SD 8.3); BMI 26.7 (SD 6.6); 19/27 female). The primary outcome measure was reoperation. Secondary outcomes included perioperative complications, calculated blood loss, transfusion requirements, functional mobility status, length of acute hospital stay, discharge destination and mortality. Kaplan-Meier survival analysis was performed. Cox multivariate regression analysis was performed to identify risk factors for reoperation after LLP-ORIF.

Results

Follow-up was at mean 3.8 years (1.0 to 10.4). One-year mortality was 13% (8/60). Reoperation was more common following LLP-ORIF: 7/33 versus 0/27 (p = 0.008). Five-year survival for reoperation was significantly better following DFA; 100% compared to 70.8% (95% confidence interval (CI) 51.8% to 89.8%, p = 0.006). There was no difference for the endpoint mechanical failure (including radiological loosening); ORIF 74.5% (56.3 to 92.7), and DFA 78.2% (52.3 to 100, p = 0.182). Reoperation following LLP-ORIF was independently associated with medial comminution; hazard ratio (HR) 10.7 (1.45 to 79.5, p = 0.020). Anatomical reduction was protective against reoperation; HR 0.11 (0.013 to 0.96, p = 0.046). When inadequately fixed fractures were excluded, there was no difference in five-year survival for either reoperation (p = 0.156) or mechanical failure (p = 0.453).

Conclusion

Absolute reoperation rates are higher following LLP fixation of low PDFFs compared to DFA. Where LLP-ORIF was well performed with augmentation of medial comminution, there was no difference in survival compared to DFA. Though necessary in very low fractures, DFA should be used with caution in patients with greater life expectancies due to the risk of longer term aseptic loosening. Cite this article: Bone Joint J 2021;103-B(4):635–643.
The use of low intensity pulsed ultrasound in the foot and ankle
Authors: Rashid Mustafa S. , Tourné Yves , Teoh Kar H.
Published: April 2021

Low intensity pulsed ultrasound (LIPUS) therapy has demonstrated clinical effectiveness in achieving union in a variety of fracture situations. Few studies have investigated the effectiveness of LIPUS therapy in foot and ankle surgery. The overall rate of union in all published studies relating to the use of LIPUS in a variety of foot and ankle fracture and fusion situations is 95%. Some studies suggest lower healing rates (~ 67%) when LIPUS therapy is used to treat hindfoot fusion nonunion. A well-powered, high-quality, randomized controlled trial is needed to demonstrate the clinical and cost effectiveness of LIPUS therapy in foot and ankle surgery.

Cite this article: EFORT Open Rev 2021;6:217-224. DOI: 10.1302/2058-5241.6.200045
Next generation sequencing for pathogen detection in periprosthetic joint infections
Authors: Indelli Pier F. , Ghirardelli Stefano , Violante Bruno , Amanatullah Derek F.
Published: April 2021

Periprosthetic joint infections (PJI) represent one of the most catastrophic complications following total joint arthroplasty (TJA). The lack of standardized diagnostic tests and protocols for PJI is a challenge for arthroplasty surgeons. Next generation sequencing (NGS) is an innovative diagnostic tool that can sequence microbial deoxyribonucleic acids (DNA) from a synovial fluid sample: all DNA present in a specimen is sequenced in parallel, generating millions of reads. It has been shown to be extremely useful in a culture-negative PJI setting. Metagenomic NGS (mNGS) allows for universal pathogen detection, regardless of microbe type, in a 24–48-hour timeframe: in its nanopore-base variation, mNGS also allows for antimicrobial resistance characterization. Cell-free DNA (cfDNA) NGS, characterized by lack of the cell lysis step, has a fast run-time (hours) and, together with a high sensitivity and specificity in microorganism isolation, may provide information on the presence of antimicrobial resistance genes. Metagenomics and cfDNA testing have reduced the time needed to detect infecting bacteria and represent very promising technologies for fast PJI diagnosis. NGS technologies are revolutionary methods that could disrupt the diagnostic paradigm of PJI, but a comprehensive collection of clinical evidence is still needed before they become widely used diagnostic tools.

Cite this article: EFORT Open Rev 2021;6:236-244. DOI: 10.1302/2058-5241.6.200099
Spatial light interference microscopy: principle and applications to biomedicine
Authors: Chen Xi , Kandel Mikhail E. , Popescu Gabriel
Published: April 2021

In this paper, we review spatial light interference microscopy (SLIM), a common-path, phase-shifting interferometer, built onto a phase-contrast microscope, with white-light illumination. As one of the most sensitive quantitative phase imaging (QPI) methods, SLIM allows for speckle-free phase reconstruction with sub-nanometer path-length stability. We first review image formation in QPI, scattering, and full-field methods. Then, we outline SLIM imaging from theory and instrumentation to diffraction tomography. Zernike’s phase-contrast microscopy, phase retrieval in SLIM, and halo removal algorithms are discussed. Next, we discuss the requirements for operation, with a focus on software developed in-house for SLIM that enables high-throughput acquisition, whole slide scanning, mosaic tile registration, and imaging with a color camera. We introduce two methods for solving the inverse problem using SLIM, white-light tomography, and Wolf phase tomography. Lastly, we review the applications of SLIM in basic science and clinical studies. SLIM can study cell dynamics, cell growth and proliferation, cell migration, mass transport, etc. In clinical settings, SLIM can assist with cancer studies, reproductive technology, blood testing, etc. Finally, we review an emerging trend, where SLIM imaging in conjunction with artificial intelligence brings computational specificity and, in turn, offers new solutions to outstanding challenges in cell biology and pathology.
Individual differences in the perception of probability
Authors: Khaw Mel W. , Stevens Luminita , Woodford Michael
Published: April 2021

In recent studies of humans estimating non-stationary probabilities, estimates appear to be unbiased on average, across the full range of probability values to be estimated. This finding is surprising given that experiments measuring probability estimation in other contexts have often identified conservatism: individuals tend to overestimate low probability events and underestimate high probability events. In other contexts, repulsive biases have also been documented, with individuals producing judgments that tend toward extreme values instead. Using extensive data from a probability estimation task that produces unbiased performance on average, we find substantial biases at the individual level; we document the coexistence of both conservative and repulsive biases in the same experimental context. Individual biases persist despite extensive experience with the task, and are also correlated with other behavioral differences, such as individual variation in response speed and adjustment rates. We conclude that the rich computational demands of our task give rise to a variety of behavioral patterns, and that the apparent unbiasedness of the pooled data is an artifact of the aggregation of heterogeneous biases.
Identification of common predisposing loci to hematopoietic cancers in four dog breeds
Authors: Hédan Benoît , Cadieu Édouard , Rimbault Maud , Vaysse Amaury , Dufaure de Citres Caroline , Devauchelle Patrick , Botherel Nadine , Abadie Jérôme , Quignon Pascale , Derrien Thomas , André Catherine
Published: April 2021

Histiocytic sarcoma (HS) is a rare but aggressive cancer in both humans and dogs. The spontaneous canine model, which has clinical, epidemiological, and histological similarities with human HS and specific breed predispositions, provides a unique opportunity to unravel the genetic basis of this cancer. In this study, we aimed to identify germline risk factors associated with the development of HS in canine-predisposed breeds. We used a methodology that combined several genome-wide association studies in a multi-breed and multi-cancer approach as well as targeted next-generation sequencing, and imputation We combined several dog breeds (Bernese mountain dogs, Rottweilers, flat-coated retrievers, and golden retrievers), and three hematopoietic cancers (HS, lymphoma, and mast cell tumor). Results showed that we not only refined the previously identified HS risk CDKN2A locus, but also identified new loci on canine chromosomes 2, 5, 14, and 20. Capture and targeted sequencing of specific loci suggested the existence of regulatory variants in non-coding regions and methylation mechanisms linked to risk haplotypes, which lead to strong cancer predisposition in specific dog breeds. We also showed that these canine cancer predisposing loci appeared to be due to the additive effect of several risk haplotypes involved in other hematopoietic cancers such as lymphoma or mast cell tumors as well. This illustrates the pleiotropic nature of these canine cancer loci as observed in human oncology, thereby reinforcing the interest of predisposed dog breeds to study cancer initiation and progression.
Emergence of co-expression in gene regulatory networks
Authors: Yin Wencheng , Mendoza Luis , Monzon-Sandoval Jimena , Urrutia Araxi O. , Gutierrez Humberto
Published: April 2021

Transcriptomes are known to organize themselves into gene co-expression clusters or modules where groups of genes display distinct patterns of coordinated or synchronous expression across independent biological samples. The functional significance of these co-expression clusters is suggested by the fact that highly coexpressed groups of genes tend to be enriched in genes involved in common functions and biological processes. While gene co-expression is widely assumed to reflect close regulatory proximity, the validity of this assumption remains unclear. Here we use a simple synthetic gene regulatory network (GRN) model and contrast the resulting co-expression structure produced by these networks with their known regulatory architecture and with the co-expression structure measured in available human expression data. Using randomization tests, we found that the levels of co-expression observed in simulated expression data were, just as with empirical data, significantly higher than expected by chance. When examining the source of correlated expression, we found that individual regulators, both in simulated and experimental data, fail, on average, to display correlated expression with their immediate targets. However, highly correlated gene pairs tend to share at least one common regulator, while most gene pairs sharing common regulators do not necessarily display correlated expression. Our results demonstrate that widespread co-expression naturally emerges in regulatory networks, and that it is a reliable and direct indicator of active co-regulation in a given cellular context.
The efficacy of Personalized Normative Feedback interventions across addictions: A systematic review and meta-analysis
Authors: Saxton Jenny , Rodda Simone N. , Booth Natalia , Merkouris Stephanie S. , Dowling Nicki A.
Published: April 2021

Personalized Normative Feedback (PNF) may help address addictive disorders. PNF highlights discrepancies between perceived and actual peer norms, juxtaposed against self-reported behavior. PNF can be self-directed and cost-efficient. Our study estimates the efficacy of PNF alone, and in combination with other self-directed interventions, to address frequency and symptom severity of hazardous alcohol use, problem gambling, illicit drug and tobacco use. We searched electronic databases, grey literature, and reference lists of included articles, for randomized controlled trials published in English (January 2000-August 2019). We assessed study quality using the Cochrane Risk of Bias tool. Thirty-four studies met inclusion criteria (k = 28 alcohol, k = 3 gambling, k = 3 cannabis, k = 0 tobacco). Thirty studies provided suitable data for meta-analyses. PNF alone, and with additional interventions, reduced short-term alcohol frequency and symptom severity. PNF with additional interventions reduced short-term gambling symptom severity. Effect sizes were small. PNF did not alter illicit drug use. Findings highlight the efficacy of PNF to address alcohol frequency and symptom severity. The limited number of studies suggest further research is needed to ascertain the efficacy of PNF for gambling and illicit drug use. Cost-effectiveness analyses are required to determine the scale of PNF needed to justify its use in various settings.
Baseline cardiometabolic profiles and SARS-CoV-2 infection in the UK Biobank
Authors: Scalsky Ryan J. , Chen Yi-Ju , Desai Karan , O’Connell Jeffery R. , Perry James A. , Hong Charles C.
Published: April 2021

Background

SARS-CoV-2 is a rapidly spreading coronavirus responsible for the Covid-19 pandemic, which is characterized by severe respiratory infection. Many factors have been identified as risk factors for SARS-CoV-2, with much early attention being paid to body mass index (BMI), which is a well-known cardiometabolic risk factor.

Objective

This study seeks to examine the impact of additional baseline cardiometabolic risk factors including high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), Apolipoprotein A-I (ApoA-I), Apolipoprotein B (ApoB), triglycerides, hemoglobin A1c (HbA1c) and diabetes on the odds of testing positive for SARS-CoV-2 in UK Biobank (UKB) study participants.

Methods

We examined the effect of BMI, lipid profiles, diabetes and alcohol intake on the odds of testing positive for SARS-Cov-2 among 9,005 UKB participants tested for SARS-CoV-2 from March 16 through July 14, 2020. Odds ratios and 95% confidence intervals were computed using logistic regression adjusted for age, sex and ancestry.

Results

Higher BMI, Type II diabetes and HbA1c were associated with increased SARS-CoV-2 odds (p < 0.05) while HDL-C and ApoA-I were associated with decreased odds (p < 0.001). Though the effect of BMI, Type II diabetes and HbA1c were eliminated when HDL-C was controlled, the effect of HDL-C remained significant when BMI was controlled for. LDL-C, ApoB and triglyceride levels were not found to be significantly associated with increased odds.

Conclusion

Elevated HDL-C and ApoA-I levels were associated with reduced odds of testing positive for SARS-CoV-2, while higher BMI, type II diabetes and HbA1c were associated with increased odds. The effects of BMI, type II diabetes and HbA1c levels were no longer significant after controlling for HDL-C, suggesting that these effects may be mediated in part through regulation of HDL-C levels. In summary, our study suggests that baseline HDL-C level may be useful for stratifying SARS-CoV-2 infection risk and corroborates the emerging picture that HDL-C may confer protection against sepsis in general and SARS-CoV-2 in particular.
Artificial intelligence for the classification of fractures around the knee in adults according to the 2018 AO/OTA classification system
Authors: Lind Anna , Akbarian Ehsan , Olsson Simon , Nåsell Hans , Sköldenberg Olof , Razavian Ali Sharif , Gordon Max
Published: April 2021

Background

Fractures around the knee joint are inherently complex in terms of treatment; complication rates are high, and they are difficult to diagnose on a plain radiograph. An automated way of classifying radiographic images could improve diagnostic accuracy and would enable production of uniformly classified records of fractures to be used in researching treatment strategies for different fracture types. Recently deep learning, a form of artificial intelligence (AI), has shown promising results for interpreting radiographs. In this study, we aim to evaluate how well an AI can classify knee fractures according to the detailed 2018 AO-OTA fracture classification system.

Methods

We selected 6003 radiograph exams taken at Danderyd University Hospital between the years 2002–2016, and manually categorized them according to the AO/OTA classification system and by custom classifiers. We then trained a ResNet-based neural network on this data. We evaluated the performance against a test set of 600 exams. Two senior orthopedic surgeons had reviewed these exams independently where we settled exams with disagreement through a consensus session.

Results

We captured a total of 49 nested fracture classes. Weighted mean AUC was 0.87 for proximal tibia fractures, 0.89 for patella fractures and 0.89 for distal femur fractures. Almost ¾ of AUC estimates were above 0.8, out of which more than half reached an AUC of 0.9 or above indicating excellent performance.

Conclusion

Our study shows that neural networks can be used not only for fracture identification but also for more detailed classification of fractures around the knee joint.
Prevalence and risk factors of hypertension among adults: A community based study in Addis Ababa, Ethiopia
Authors: Asemu Meseret Molla , Yalew Alemayehu Worku , Kabeta Negussie Deyessa , Mekonnen Desalew
Published: April 2021

Background

In all areas of the World Health Organization, the prevalence of hypertension was highest in Africa. High blood pressure is a significant risk factor for coronary and ischemic diseases, as well as hemorrhagic stroke. However, there were scarce data concerning the magnitude and risk factors of hypertension. Thus, this study aimed to identify the prevalence and associated factors of hypertension among adults in Addis Ababa city.

Method

A community-based cross-sectional study was conducted from June to October 2018 in Addis Ababa city. Participants aged 18 years and older recruited using a multi-stage random sampling technique. Data were collected by face-to-face interview technique. All three WHO STEPS instruments were applied. Additionally, participants’ weight, height, waist, hip, and blood pressure (BP) were measured according to standard procedures.

Multiple logistic regressions were used and Odds ratios with 95% confidence intervals were also calculated to identify associated factors.

Results

In this study, a total of 3560 participants were included.The median age was 32 years (IQR 25, 45). More than half (57.3%) of the respondents were females. Almost all (96.2%) of participants consumed vegetables and or fruits less than five times per day. Eight hundred and sixty-five (24.3%) of respondents were overweight, while 287 (8.1%) were obese. One thousand forty-one 29.24% (95% CI: 27.75–30.74) were hypertensive, of whom two-thirds (61.95%) did not know that they had hypertension.

Factors significantly associated with hypertension were age 30–49 and ≥50 years (AOR = 2.79, 95% CI: 1.39–5.56) and (AOR = 8.23, 95% CI: 4.09–16.55) respectively, being male (AOR = 1.88, 95% CI: 1.18–2.99), consumed vegetables less than or equal to 3 days per week (AOR = 2.44, 95% CI: 1.21–4.93), obesity (AOR = 2.05, 95%CI: 1.13–3.71), abdominal obesity (AOR = 1.70, 95% CI: 1.10–2.64) and high triglyceride level (AOR = 2.06, 95% CI: 1.38–3.07).

Conclusion

In Addis Ababa, around one in three adults are hypertensive. With a large proportion, unaware of their condition. We recommend integrating regular community-based screening programs as integral parts of the health promotion and disease prevention strategies. Lifestyle interventions shall target the modifiable risk factors associated with hypertension, such as weight loss and increased vegetable consumption.
Illumina sequencing of 16S rRNA genes reveals a unique microbial community in three anaerobic sludge digesters of Dubai
Authors: Khan Munawwar Ali , Khan Shams Tabrez , Sequeira Milred Cedric , Faheem Sultan Mohammad , Rais Naushad
Published: April 2021

Understanding the microbial communities in anaerobic digesters, especially bacteria and archaea, is key to its better operation and regulation. Microbial communities in the anaerobic digesters of the Gulf region where climatic conditions and other factors may impact the incoming feed are not documented. Therefore, Archaeal and Bacterial communities of three full-scale anaerobic digesters, namely AD1, AD3, and AD5 of the Jebel Ali Sewage water Treatment Plant (JASTP) were analyzed by Illumina sequencing of 16S rRNA genes. Among bacteria, the most abundant genus was fermentative bacteriaAcetobacteroides(Blvii28). Other predominant bacterial genera in the digesters included thermophilic bacteria (FervidobacteriumandCoprothermobacter) and halophilic bacteria likeHaloterrigenaandSediminibacter. This can be correlated with the climatic condition in Dubai, where the bacteria in the incoming feed may be thermophilic or halophilic as much of the water used in the country is desalinated seawater. The predominant Archaea include mainly the members of the phyla Euryarchaeota and Crenarchaeota belonging to the genusMethanocorpusculum,Metallosphaera,Methanocella, andMethanococcus. The highest population ofMethanocorpusculum(more than 50% of total Archaea), and other hydrogenotrophic archaea, is in agreement with the high population of bacterial generaAcetobacteroides(Blvii28) andFervidobacterium, capable of fermenting organic substrates into acetate and H2.Coprothermobacter, which is known to improve protein degradation by establishing syntrophy with hydrogenotrophic archaea, is also one of the digesters’ dominant genera. The results suggest that the microbial community in three full-scale anaerobic digesters is different. To best of our knowledge this is the first detailed report from the UAE.
Public willingness to participate in personalized health research and biobanking: A large-scale Swiss survey
Authors: Brall Caroline , Berlin Claudia , Zwahlen Marcel , Ormond Kelly E. , Egger Matthias , Vayena Effy
Published: April 2021

This paper reports survey findings on the Swiss public’s willingness, attitudes, and concerns regarding personalized health research participation by providing health information and biological material. The survey reached a sample of 15,106 Swiss residents, from which we received 5,156 responses (34.1% response rate). The majority of respondents were aware of research using human biological samples (71.0%) and held a positive opinion towards this type of research (62.4%). Of all respondents, 53.6% indicated that they would be willing to participate in a personalized health research project. Willingness to participate was higher in younger, higher educated, non-religious respondents with a background in the health sector. Respondents were more willing to provide ‘traditional’ types of health data, such as health questionnaires, blood or biological samples, as opposed to social media or app-related data. All respondents valued the return of individual research results, including risk for diseases for which no treatment is available. Our findings highlight that alongside general positive attitudes towards personalized health research using data and samples, respondents have concerns about data privacy and re-use. Concerns included potential discrimination, confidentiality breaches, and misuse of data for commercial or marketing purposes. The findings of this large-scale survey can inform Swiss research institutions and assist policymakers with adjusting practices and developing policies to better meet the needs and preferences of the public. Efforts in this direction could focus on research initiatives engaging in transparent communication, education, and engagement activities, to increase public understanding and insight into data sharing activities, and ultimately strengthen personalized health research efforts.
Comparison of analgesic activities of aconitine in different mice pain models
Authors: Deng Jianhua , Han Jiada , Chen Jiahao , Zhang Yanmin , Huang Qiuju , Wang Ying , Qi Xiaoxiao , Liu Zhongqiu , Leung Elaine Lai-Han , Wang Dawei , Feng Qian , Lu Linlin
Published: April 2021

Aconitine (AC) is the primary bioactive and secondary metabolite alkaloidin of Aconitum species which is accounted for more than 60% of the total diester-diterpenoid alkaloids in Aconite. To evaluate the analgesic effects of AC, 4 different pain models including hot plate assay, acetic acid writhing assay, formalin and CFA induced pain models were adopted in this study. In hot plate experiment, AC treatment at concentration of 0.3 mg/kg and 0.9 mg/kg improved the pain thresholds of mice similar to the positive drug aspirin at the concentration of 200 mg/kg (17.12% and 20.27% VS 19.21%). In acetic acid writhing experiment, AC significantly reduced the number of mice writhing events caused by acetic acid, and the inhibition rates were 68% and 76%. These results demonstrated that AC treatment revealed significant analgesic effects in both acute thermal stimulus pain model and chemically-induced visceral pain model. The biphasic nociceptive responses induced by formalin were significantly inhibited after AC treatment for 1h or 2h. The inhibition rates were 33.23% and 20.25% of AC treatment for 1h at 0.3 mg/kg and 0.9 mg/kg in phase I. In phase II, the inhibition rates of AC and aspirin were 36.08%, 32.48% and 48.82% respectively, which means AC showed similar analgesic effect to non-steroidal anti-inflammatory compounds. In the chronic CFA-induced nociception model, AC treatment also improved mice pain threshold to 131.33% at 0.3 mg/kg, which was similar to aspirin group (152.03%). Above all, our results verified that AC had obviously analgesic effects in different mice pain models.
Machine learning methods to predict mechanical ventilation and mortality in patients with COVID-19
Authors: Yu Limin , Halalau Alexandra , Dalal Bhavinkumar , Abbas Amr E. , Ivascu Felicia , Amin Mitual , Nair Girish B.
Published: April 2021

Background

The Coronavirus disease 2019 (COVID-19) pandemic has affected millions of people across the globe. It is associated with a high mortality rate and has created a global crisis by straining medical resources worldwide.

Objectives

To develop and validate machine-learning models for prediction of mechanical ventilation (MV) for patients presenting to emergency room and for prediction of in-hospital mortality once a patient is admitted.

Methods

Two cohorts were used for the two different aims. 1980 COVID-19 patients were enrolled for the aim of prediction ofMV. 1036 patients’ data, including demographics, past smoking and drinking history, past medical history and vital signs at emergency room (ER), laboratory values, and treatments were collected for training and 674 patients were enrolled for validation using XGBoost algorithm. For the second aim to predict in-hospital mortality, 3491 hospitalized patients via ER were enrolled. CatBoost, a new gradient-boosting algorithm was applied for training and validation of the cohort.

Results

Older age, higher temperature, increased respiratory rate (RR) and a lower oxygen saturation (SpO2) from the first set of vital signs were associated with an increased risk of MV amongst the 1980 patients in the ER. The model had a high accuracy of 86.2% and a negative predictive value (NPV) of 87.8%. While, patients who required MV, had a higher RR, Body mass index (BMI) and longer length of stay in the hospital were the major features associated with in-hospital mortality. The second model had a high accuracy of 80% with NPV of 81.6%.

Conclusion

Machine learning models using XGBoost and catBoost algorithms can predict need for mechanical ventilation and mortality with a very high accuracy in COVID-19 patients.
Comparative assessment of immune evasion mechanisms in human whole-blood infection assays by a systems biology approach
Authors: Lehnert Teresa , Prauße Maria T. E. , Hünniger Kerstin , Praetorius Jan-Philipp , Kurzai Oliver , Figge Marc Thilo
Published: April 2021

Computer simulations of mathematical models open up the possibility of assessing hypotheses generated by experiments on pathogen immune evasion in human whole-blood infection assays. We apply an interdisciplinary systems biology approach in which virtual infection models implemented for the dissection of specific immune mechanisms are combined with experimental studies to validate or falsify the respective hypotheses. Focusing on the assessment of mechanisms that enable pathogens to evade the immune response in the early time course of a whole-blood infection, the least-square error (LSE) as a measure for the quantitative agreement between the theoretical and experimental kinetics is combined with the Akaike information criterion (AIC) as a measure for the model quality depending on its complexity. In particular, we compare mathematical models with three different types of pathogen immune evasion as well as all their combinations: (i) spontaneous immune evasion, (ii) evasion mediated by immune cells, and (iii) pre-existence of an immune-evasive pathogen subpopulation. For example, by testing theoretical predictions in subsequent imaging experiments, we demonstrate that the simple hypothesis of having a subpopulation of pre-existing immune-evasive pathogens can be ruled out. Furthermore, in this study we extend our previous whole-blood infection assays for the two fungal pathogens Candida albicans and C. glabrata by the bacterial pathogen Staphylococcus aureus and calibrated the model predictions to the time-resolved experimental data for each pathogen. Our quantitative assessment generally reveals that models with a lower number of parameters are not only scored with better AIC values, but also exhibit lower values for the LSE. Furthermore, we describe in detail model-specific and pathogen-specific patterns in the kinetics of cell populations that may be measured in future experiments to distinguish and pinpoint the underlying immune mechanisms.
Real-time recognition of spraying area for UAV sprayers using a deep learning approach
Authors: Khan Shahbaz , Tufail Muhammad , Khan Muhammad Tahir , Khan Zubair Ahmad , Iqbal Javaid , Wasim Arsalan
Published: April 2021

Agricultural production is vital for the stability of the country’s economy. Controlling weed infestation through agrochemicals is necessary for increasing crop productivity. However, its excessive use has severe repercussions on the environment (damaging the ecosystem) and the human operators exposed to it. The use of Unmanned Aerial Vehicles (UAVs) has been proposed by several authors in the literature for performing the desired spraying and is considered safer and more precise than the conventional methods. Therefore, the study’s objective was to develop an accurate real-time recognition system of spraying areas for UAVs, which is of utmost importance for UAV-based sprayers. A two-step target recognition system was developed by using deep learning for the images collected from a UAV. Agriculture cropland of coriander was considered for building a classifier for recognizing spraying areas. The developed deep learning system achieved an average F1 score of 0.955, while the classifier recognition average computation time was 3.68 ms. The developed deep learning system can be deployed in real-time to UAV-based sprayers for accurate spraying.
A laboratory-based study to explore the use of honey-impregnated cards to detect chikungunya virus in mosquito saliva
Authors: Fourniol Lisa , Madec Yoann , Mousson Laurence , Vazeille Marie , Failloux Anna-Bella
Published: April 2021

Mosquito control is implemented when arboviruses are detected in patients or in field-collected mosquitoes. However, mass screening of mosquitoes is usually laborious and expensive, requiring specialized expertise and equipment. Detection of virus in mosquito saliva using honey-impregnated filter papers seems to be a promising method as it is non-destructive and allows monitoring the viral excretion dynamics over time from the same mosquito. Here we test the use of filter papers to detect chikungunya virus in mosquito saliva in laboratory conditions, before proposing this method in large-scale mosquito surveillance programs. We found that 0.9 cm2 cards impregnated with a 50% honey solution could replace the forced salivation technique as they offered a viral RNA detection until 7 days after oral infection of Aedes aegypti and Aedes albopictus mosquitoes with CHIKV.
Reducing unnecessary antibiotic prescription through implementation of a clinical guideline on self-limiting respiratory tract infections
Authors: Sánchez Xavier , Orrico María , Morillo Toa , Manzano Andrea , Jimbo Ruth , Armijos Luciana
Published: April 2021

Background

Clinical guidelines (CG) are used to reduce variability in practice when the scientific evidence is sparse or when multiple therapies are available. The development and implementation of evidence-based CG is intended to organize and provide the best available evidence to support clinical decision making in order to improve quality of care. Upper respiratory tract infections (URTI) are the leading cause of misuse of antibiotics and a CG may reduce the unnecessary antibiotic prescription.

Methods

The aim of this quasi-experimental, before-after study was to analyze the short- and long-term effects of the implementation of a CG to decrease the rate of antibiotic prescription in URTI cases in the emergency department of a third level private hospital in Quito, Ecuador. The study included 444 patients with a main diagnosis of URTI. They were distributed in three groups: a baseline cohort 2011 (n = 114), a first post-implementation cohort 2011 (n = 114), and a later post-implementation cohort 2018 (n = 216). The implementation strategy consisted of five key steps: acceptance of the need for implementation of the CG, dissemination of the CG, an educational campaign, constant feedback, and sustainability of the strategy through continuous training.

Results

The results of this study show a 42.90% of antibiotic prescription rate before the CG implementation. After the implementation of the CG, the prescription rate of antibiotics was significantly reduced by 24.5% (42.9% vs 18.4%, p<0.0001) and the appropriate antibiotic prescription rate was significantly increased by 44.2% (22.4% vs 66.6%, p<0.0001) in the first post-implementation cohort 2011. There was not a significant difference in antibiotic prescription rate and appropriate antibiotic prescription rate between two post-implementation cohorts: 18.4% vs 25.9% (p = 0.125) and 66.6% vs 50% (p = 0.191), respectively.

Conclusions

The implementation of CGs decreases the rate of antibiotic prescription in URTI cases. The results are remarkable after early implementation, but the effect persists over time. The emphasis must shift from guideline development to strategy implementation.
Comparison between magnetic resonance and ultrasound-derived indicators of hepatic steatosis in a pooled NAFLD cohort
Authors: Beyer Cayden , Hutton Chloe , Andersson Anneli , Imajo Kento , Nakajima Atsushi , Kiker Dustin , Banerjee Rajarshi , Dennis Andrea
Published: April 2021

Background & aims

MRI-based proton density fat fraction (PDFF) and the ultrasound-derived controlled attenuation parameter (CAP) are non-invasive techniques for quantifying liver fat, which can be used to assess steatosis in patients with non-alcoholic fatty liver disease (NAFLD). This study compared both of these techniques to histopathological graded steatosis for the assessment of fat levels in a large pooled NAFLD cohort.

Methods

This retrospective study pooled N = 581 participants from two suspected NAFLD cohorts (mean age (SD) 56 (12.7), 60% females). Steatosis was graded according to NASH-CRN criteria. Liver fat was measured non-invasively using PDFF (with Liver MultiScan’s Iterative Decomposition of water and fat with Echo Asymmetry and Least-squares estimation method, LMS-IDEAL, Perspectum, Oxford) and CAP (FibroScan, Echosens, France), and their diagnostic performances were compared.

Results

LMS-IDEAL and CAP detected steatosis grade ≥ 1 with AUROCs of 1.00 (95% CI, 0.99–1.0) and 0.95 (95% CI, 0.91–0.99), respectively. LMS-IDEAL was superior to CAP for detecting steatosis grade ≥ 2 with AUROCs of 0.77 (95% CI, 0.73–0.82] and 0.60 (95% CI, 0.55–0.65), respectively. Similarly, LMS-IDEAL outperformed CAP for detecting steatosis grade ≥ 3 with AUROCs of 0.81 (95% CI, 0.76–0.87) and 0.63 (95% CI, 0.56–0.70), respectively.

Conclusion

LMS-IDEAL was able to diagnose individuals accurately across the spectrum of histological steatosis grades. CAP performed well in identifying individuals with lower levels of fat (steatosis grade ≥1); however, its diagnostic performance was inferior to LMS-IDEAL for higher levels of fat (steatosis grades ≥2 and ≥3).

Trial registration

ClinicalTrials.gov (NCT03551522); https://clinicaltrials.gov/ct2/show/NCT03551522. UMIN Clinical Trials Registry (UMIN000026145); https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000026145.
A IMPORTÂNCIA DA EDUCAÇÃO PARA OS PORTADORES DE NECESSIDADES ESPECIAIS
Authors: Nogueira Mário Lúcio de Lima
Published: April 2021

Este trabalho pretende trazer Ã  reflexão o sentido que a Educação

tem para os portadores de necessidades especiais tendo como foco

principal a formação do caráter destes indivíduos, bem como a

formação de atitudes e a compreensão de mundo e de sua inserção nele. Estas reflexões nos levam a entender a Educação Especial como sendo a busca de práticas pedagógicas que respondam à diversidade do alunado no contexto da escola para todos, oferecendo respostas educacionais centradas no processo de construção da cidadania de todos os alunos, especiais ou não.
SABERES E PODERES: PROPOSIÇÕES E PROVOCAÇÕES A PARTIR DA INFÂNCIA, DA ESCOLA E DA FORM AÇÃO DOCENTE
Authors: Leite César Donizetti Pereira
Published: April 2021

O tema Â“Infância, Escola e Formação DocenteÂ”, sugere uma

infinidade de percursos, caminhos e sendas pelos quais podemos

circular. Este texto indicará a possibilidade de andar nos

descaminhos das tramas e dos enredos que constituem as idéias

de Educação e de Escola, bem como de Infância e de Formação

Docente. Para tanto, partiremos de uma concepção etimológica

de Â‘disciplinaÂ’, procurando pensar este conceito naquilo que o

define enquanto um campo de Â‘saberÂ’ e de Â‘poderÂ’, para então

apontar uma reflexão sobre as possibilidades de um saber a respeito

da Educação. Buscaremos no cinema, na literatura e nas artes

plásticas possibilidades que indiquem estas tramas de sentidos no

campo das práticas educativas.
UN TENTATIVO DI ESPLORAZIONE DEI MOLTEPLICI NESSI DELLE NOZIONI ARISTOTELICHE DI GIUSTIZIA E INGIUSTIZIA, VIZIO E VIRTÃ™, TRA PIANO ETICO E PIANO GIURIDICO
Authors: Fermani Arianna
Published: April 2021

Este artigo objetiva descobrir a multiplicidade de conexões entre

justiça e virtude e entre injustiça e vício, bem como demonstrar

como apenas o aceite da polivalência destas noções e a extrema

adaptabilidade da relação entre elas permitem a co-existência nãocontradit

ória da diferença e mesmo afirmações contrárias no

interior do texto de Aristóteles. Por exemplo, é apenas usando todos

os sentidos da noção de justiça que podemos entender como a

afirmação segunda a qual o mesmo ato injusto, sob uma certa

perspectiva, é vício, enquanto sob outra não é vício, é possível. Um

complexo cenário, sublinhado pelo Estagirita, extremamante rico

de articulações internas (que devem ser respeitadas contra cada

tentativa de redução), que se torna ainda mais complicado pelo

contínuo jogo de transposições e de comparações entre ética e

legitimidade legal estabelecidas pelo Filósofo.
Analysis of Pay Later Payment System on Online Shopping in Indonesia
Authors: Pratika Yeyen , Salahudin Salahudin , Riyanto Dicky Wisnu Usdek , Ambarwati Titiek
Published: April 2021

Due to the technology development, the digital payment is becoming more attractive to consumers. This type of payments provides an easy way for consumers to meet their needs. Pay later is currently one of the most attractive digital payments in Indonesia. This system, which is similar to credit card, allows consumers to buy products or services with the possibility to pay them later. This study aims to examine the pay later system and the consequences of applying it in Indonesian market. This study used a qualitative approach using online news content analysis to understand the issue of pay later. The software used in this study is Nvivo plus 12 by utilizing the word similarity, cluster analysis and matrix coding functions. The results show that pay later has a correlation with credit due to the system allows consumers to pay in installments. In addition, this pay later provides a possibility of impulsive buying for consumers. However, this study is limited to analysis based on online news data. It suggests that future studies combine online news with interviews or observation or many others documents to get a more comprehensive result.
Seasonality of coronaviruses and other respiratory viruses in Canada: Implications for COVID-19
Authors: Lagacé-Wiens Philippe , Bullard Jared , Cole Roy , Van Caeseele Paul
Published: April 2021

Background: Like endemic coronaviruses, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is believed to have emerged in humans from a zoonotic source and may ultimately develop a seasonal pattern. A seasonal pattern, particularly if combined with other seasonal outbreaks of respiratory virus infections, may have significant impacts on the healthcare system. We evaluated the seasonal pattern of existing endemic coronaviruses and several other common respiratory viruses to determine the potential impacts of added burden of respiratory disease should SARS-CoV-2 establish seasonality. Methods: National surveillance data for laboratory confirmations of endemic coronaviruses, influenza A and B viruses, rhinovirus/enterovirus, human metapneumovirus, respiratory syncytial virus and parainfluenza virus for the past 10 years were obtained from the Government of Canada Open Data and FluWatch. Epidemic curves were generated from total case numbers and percent of samples testing positive for each respiratory virus by epidemiological week. Results: In Canada, endemic coronaviruses and other common respiratory viruses cause annual seasonal outbreaks in the winter months. Should SARS-CoV-2 develop a seasonal pattern similar to endemic coronaviruses and respiratory viruses, co-circulation would be expected to peak between January and March. Peak endemic coronavirus activity occurs during the nadir of rhinovirus/enterovirus and parainfluenza activity. Conclusion: Healthcare settings, assisted-living and long-term care homes, schools and essential services employers should anticipate and have contingencies for seasonal outbreaks of SARS-CoV-2 and co-circulating respiratory viruses during peak seasons. Given the likelihood of co-circulation, diagnostic multiplex testing targeting co-circulating pathogens may be more efficient than single target assays for symptomatic individuals if a seasonal pattern to coronavirus disease 2019 (COVID-19) is established.
A hybrid multi-criteria decision-making approach to order natural gas consuming countries
Authors: Girão Ester Figueiredo , Gomes Luiz Flavio Autran Monteiro
Published: April 2021

Societies worldwide are committed to moving towards a low carbon economy, and natural gas is considered a transition fuel between fossil (such as gasoline and diesel) and renewable fuels. Based on the relevance of natural gas in this economic transition, this paper demonstrates the application of a hybrid multi-criteria decision-making approach to order the natural gas consuming countries. The aim is to support decision-making in the natural gas market, offering elements to prioritize the trade worldwide. The study observed three criteria: consumption variation for years 2014 to 2016; the volume of production in the same period; and proven natural gas reserves in 2016. The data to demonstrate the countries’ performance was obtained from a yearly statistic publication of the Brazilian National Agency of Petroleum, Natural Gas, and Biofuels (ANP), released in 2017. Finally, the decision-making methods adopted to assess the criteria were, first, the WINGS method, applied to generate the weights of each criterion. Second, the study adopted the TOPSIS method to pre-select the countries closest to becoming a global consumer of natural gas. After applying the TOPSIS method, a pre-analysis of dominance among alternatives (pre-selected countries) was conducted, excluding the dominated ones from the list obtained. Third, the PROMÉTHÉE II method was applied to establish the order of the natural gas-consuming countries.