bluuebunny/crossref_metadata_2025_split huggingface dataset:
Computer-based patient education is non-inferior to nurse counselling prior to colonoscopy: a multicenter randomized controlled trial
Authors: Veldhuijzen Govert , Klemt-Kropp Michael , Terhaar sive Droste Jochim S. , van Balkom Bas , van Esch Aura A. J. , Drenth Joost P. H. 
Published: July 2020

Abstract
Background Optimal patient education prior to colonoscopy improves adherence to instructions for bowel preparation and leads to cleaner colons. We developed computer-based education (CBE) supported by video and 3 D animations. We hypothesized that CBE could replace nurse counselling without loss of bowel preparation quality during colonoscopy.
Methods We conducted a prospective, multicenter, endoscopist-blinded, non-inferiority randomized controlled trial. The primary outcome was adequate bowel preparation, evaluated using the Boston Bowel Preparation Scale (BBPS). Secondary outcome measures were: sickness absence for outpatient clinic visits; patient anxiety/satisfaction scores; and information recall. We included patients in four endoscopy units (rural, urban, and tertiary).
Results We screened 1035 eligible patients and randomized 845. After evaluation, 684 were included in the intention-to-treat (ITT) group. Subsequently, 497 patients were included in the per-protocol analysis, 217 in the nurse counselling and 280 in the CBE group. Baseline characteristics were similarly distributed among the groups. On per-protocol analysis, adequate bowel cleansing was achieved in 93.2 % (261/280) of CBE patients, which was non-inferior to nurse-counselled patients (94.0 %; 204/217), with a difference of −0.8 % (95 % confidence interval [CI] −5.1 % to 3.5 %). Non-inferiority was confirmed in the ITT population. Sickness absence was significantly more frequent in nurse-counselled patients (28.0 % vs. 4.8 %). In CBE patients, 21.5 % needed additional information, with 3.0 % needing an extra outpatient visit.
Conclusion CBE is non-inferior to nurse counselling in terms of bowel preparation during colonoscopy, with lower patient sickness leave. CBE may serve as an efficient educational tool to inform patients before colonoscopy in routine clinical practice.
Pneumonic versus Nonpneumonic Exacerbations of Chronic Obstructive Pulmonary Disease
Authors: Crisafulli Ernesto , Manco Alessandra , Ferrer Miquel , Huerta Arturo , Micheletto Claudio , Girelli Domenico , Clini Enrico , Torres Antoni 
Published: July 2020

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

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

Abstract
Background The nosodes are well-known preparations in homeopathy that are sourced from organisms and diseased materials. More than 40 known nosodes have been used in homeopathic practice for over a century. Having identified the need for scientifically developed new nosodes sourced from organisms that are currently prevalent, the preparation of Escherichia coli nosodes from different strains of the bacterium is presented in this article.
Materials and Methods Escherichia coli strains (E. coli ATCC 11775E, ATCC 25922, and ATCC 8739) were identified, cultured, and tested for purity, and 20 billion cells were processed following the nosode preparation method given in the Homoeopathic Pharmacopoeia of India, group N1. Serial dilution and potentization for liquid potency were done up to 30c potency. Nosodes were prepared by two methods: from cell-free extract (endotoxin) and from entire-cell extract.
Result Six nosodes were developed in total. Three univalent nosodes were prepared using individual endotoxins, one from each of the three E. coli strains; those three univalent nosodes were also combined as “Trivalent nosode-I”. “Trivalent nosode-II” was prepared by mixing entire cells of the three E. coli strains. A mix of both Trivalent nosode-I and Trivalent nosode-II was labeled “EC-Polynosode”. The safety profile of the potentized nosodes was documented by the non-detectability of traces of source material (absence of contamination, live organisms, or DNA material) through a culture test, sterility test, and molecular testing (polymerase chain reaction).
Conclusion Different variants of E. coli nosodes were systematically and scientifically prepared and standardized using the cultures. Homeopathic pathogenetic trials, in-vitro efficacy studies, and clinical evaluation of E. coli nosodes (single, trivalent, or polyvalent nosodes) will be required in future.
Epidemiological Analysis of Avulsion Fractures in Dogs
Authors: Matos Cruz Alyssa M. , Kayano Mitsunori , Tomihari Mizuki , Chou Po-Yen , Kim Sun Young , Kapatkin Amy S. , Hayashi Kei 
Published: July 2020

Abstract
Objective This study aimed to analyse the epidemiological data of canine appendicular avulsion fractures from three academic veterinary hospitals in the United States.
Study Design A total of 114 avulsion fractures that presented to three study centres (teaching hospitals in New York, California, and Michigan) between 2008 and 2018 were analysed for avulsion type, breed, sex, body weight, age and affected side.
Results The mean age for avulsion fractures was 1.6 years (±2.3 standard deviation), and side and sex were comparable (53% females and 54% left sided, only 2% bilateral). Tibial tuberosity fracture was the most common type, comprising 54% of all avulsion fractures, significantly more prevalent in younger and lighter dogs (p < 0.001). There was no significant difference in avulsion type, breed, sex, weight, age and affected side among three study centres (p = 0.66).
Conclusion The most common avulsion fractures were tibial tuberosity fractures, which tend to occur in young, small dogs. There is no sex or side predilection for avulsion fractures noted in this study, although the effect of neuter could not be determined. There were no differences in fracture characteristics among the three different geographical locations in the United States.
Generating a Novel Bispecific Nanobody to Enhance Antitumor Activity
Authors: Ge Qiuhan , Sun Tianyuan , Bian Yanlin , Xiao Xiaodong , Zhu Jianwei 
Published: July 2020

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

Abstract
Background The radial forearm free flap (RFFF) is a staple of microsurgical reconstruction. Significant attention has been paid to donor-site morbidity, particularly vascular and aesthetic consequences. Relatively few authors have discussed peripheral nerve morbidity such as persistent hypoesthesia, hyperesthesia, or allodynia in the hand and wrist or neuroma formation in the wrist and forearm. Here, we present a diagnostic and therapeutic algorithm for painful neurologic complications of the RFFF donor site.
Materials and Methods The peripheral nerves that can be involved with the RFFF are reviewed with respect to the manner in which they may be involved in postoperative pain manifestations. A method for prevention and for treatment of each of these possibilities is also presented.
Results Nerves from the forearm that can be harvested with the RFFF will have the most likelihood for injury and these include the lateral antebrachial cutaneous nerve, the radial sensory nerve, and the medial antebrachial cutaneous nerve. A nerve that may be injured at the distal juncture of the skin graft to the forearm is the palmar cutaneous branch of the median nerve. The “prevention” portion of the algorithm suggests that each nerve divided to become a recipient nerve should have its proximal end implanted into a muscle to prevent painful neuroma. The “treatment” portion of the algorithm suggests that if a neuroma does form, it should be resected, not neurolysed, and the proximal portion should be implanted into an adjacent muscle. The diagnostic role of nerve block is emphasized.
Conclusion Neurological complications following RFFF can be prevented by an appropriate algorithm as described by devoting attention to the proximal end of recipient nerves. Neurological complications, once present, can be difficult to diagnose accurately. Nerve blocks are critical in this regard and are employed in the treatment algorithm presented.
Common Genetic Variants in ABO and CLEC4M Modulate the Pharmacokinetics of Recombinant FVIII in Severe Hemophilia A Patients
Authors: Garcia-Martínez Iris , Borràs Nina , Martorell Marta , Parra Rafael , Altisent Carme , Ramírez Lorena , Álvarez-Román Maria Teresa , Nuñez Ramiro , Megias-Vericat Juan Eduardo , Corrales Irene , Alonso Sofia , Vidal Francisco 
Published: July 2020

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

Abstract
Introduction The aim of our study is to compare the surgical complications of the transcanal and posterior tympanotomy approach and to evaluate the advantages and disadvantages of both techniques.
Materials and Methods It is a prospective study involving 252 pediatric cochlear implant patients operated in the Department of ENT, GMERS Medical College and General Hospital, Gandhinagar, Gujarat, India. Out of these, 126 patients were operated by transcanal approach (group A) and 126 patients were operated by posterior tympanotomy approach (group B).
Results No significant difference in the mean duration of surgery (p > 0.064) was observed in both the groups. Major complications occurred in 60.2% of group A and 3.1% of group B and minor complications occurred in 65% of group A and 3.1% in group B, which is highly significant (p < 0.0134). The categories of auditory perception, speech intelligibility rating scales, meaningful auditory integration scale, and meaningful use of speech scale were assessed in both groups.
Conclusion Complication rate in the transcanal approach is higher as compared with posterior tympanotomy approach. A complete alignment and introduction of electrode array into the basal turn of cochlea is more favorable in the posterior tympanotomy approach. Transcanal technique even as an alternative may not be useful. Outcomes may be affected depending upon the technique chosen.
Flow structure and turbulent kinetic energy of velocity fluctuations in a cylinder near wake at Re = 3900
Authors: Molochnikov V M , Mikheev N I , Mikheev A N , Saushin I I 
Published: July 2020

Abstract
SIV measurements of instantaneous vector fields of velocity have been performed in the near wake behind a circular cylinder in a cross flow at Re = 3900. Patterns of velocity profile evolution with the distance from the cylinder have been refined. Distributions of components of the turbulent production term of the turbulent kinetic energy transport equation have been estimated. Their main patterns and correlation with the formation and motion of large-scale vortices (Karman vortices) have been revealed.
Modeling of characteristics of heat exchangers of heat supply systems in variable operating modes
Authors: Rafalskaya T A , Rudyak V Ya 
Published: July 2020

Abstract
Heat exchangers used in heating systems usually operate under conditions of variable flow rates and temperatures of heat carriers. However, the theory for calculating the variable modes of operation of such devices is based on the use of constant parameters of heat exchangers. At the same time it is clear that the parameter of the heat exchanger can be affected by all quantities that determine the change of the heat transfer coefficient. In addition, the groups of heat exchangers with a tied supply of heat, i.e. with redistribution of the heat flow in a variable mode of operation, are used. A new method for calculating the variable modes of operation of heat points with a tied heat supply has been developed. The method of mathematical modeling defines the dependencies that determine the change in the heat exchanger parameters in variable operating modes. The obtained expressions can be used to configure programmable regulators which will allow the correction of inefficient modes of operation of the heating system.
Experimental investigation of heat transfer during flow boiling with ozone-safe refrigerants in microchannels
Authors: Shamirzaev A S , Kuznetsov V V 
Published: July 2020

Abstract
The results of an experimental investigation of heat transfer during subcooled flow boiling with ozone-safe refrigerants R236fa and R141b in horizontal microchannels are presented. The experiments are performed in a closed loop that re-circulates the refrigerant. The working section is represented by two microchannels with a 2×0.36 mm cross-section separated by the wall with a thickness of 2 mm. The dependences of the heat flux and pressure drop on wall superheat are measured in the range of heat fluxes from 5 to 120 W/cm2 at reduced pressures of 0.2 and 0.044 for the case of R-236fa and R141b accordingly. It was obtained that the heat transfer deterioration arises for moderate reduced pressure when the transition to saturated flow boiling occurs.
Technologies for monitoring and cleaning the return manufacturing condensate in the energy-technological complex of heat power plant – petrochemical facility
Authors: Filimonova A A , Chichirova N D , Chichirov A A , Filimonov A G 
Published: July 2020

Abstract
Condensate reuse as feed water for boilers reduces the costs of the used natural resource, improving the environmental and economic efficiency of the facility. The return condensate during condensation of steam supplied from thermal power plants for the implementation of technological processes at many petrochemical facilities is an aqueous mixture of petroleum products and mechanical components with a small amount of inorganic components. The return condensate samples obtained from plants for the production of butyl rubber, synthetic rubber, styrene and polyester resins were used to determine the quantitative and qualitative composition of organic impurities. On the basis of obtained results, physical and chemical purification methods have been developed. According to the analysis results, it is recommended to bring the return condensate to the required standards by flotation with air bubbles of small diameter.
Physical and chemical methods of organic impurities control in the feed water of waste heat boilers of thermal power plants
Authors: Filimonova A A , Chichirova N D , Chichirov A A , Batalova A A 
Published: July 2020

Abstract
For the quantitative control of the organic impurities content in deeply purified waters, a simple, effective and inexpensive method with the carbon tetrachloride extraction was developed for waste heat boilers feeding. The presented methodology served to study the organic substances content in the nutrient water of the Kazan CHP-1 and Kazan CHP-3 waste heat boilers. According to the results of various physical and chemical methods, the samples extracted from feedwaters of waste-heat boilers have been were examined for their qualitative composition. The discovered organic substances belonged predominantly to the class of humic substances, which, due to their physicochemical properties, can penetrate into all types of deeply treated water. The proposed method for complex determination of organic impurities by extraction in the feedwaters of a waste-heat boiler may be used as an alternative to the total organic carbon analysis.
Multi-criteria decision making for a large heating system with heat loss
Authors: Korotkova T I , Kolesnik S A , Garibyan B A , Luneva S Yu , Kuzmina Ya V 
Published: July 2020

Abstract
A large heat supply system, which always has a multi-level hierarchical structure, is considered. There are levels of trunk and distribution heating networks with intermediate levels of regulation. Planning and selection of a mode that provides the required heat loads are associated in such a system with a large number of different factors that complicate the decision-making process. The present study investigates heat transfer in a flat anisotropic insulating plate with uniformly distributed internal heat sinks subjected to heat flows. An analytical solution is obtained that allowed us to study and build temperature distribution fields for various orientations of principal axes of thermal conductivity tensor in an insulating plate. The thermal field localization regime is shown to be possible in the presence of thermal energy sinks/sources inside the plate wherein heat propagation is bound with limiting isotherms.
Features of diffusion and convective mixing in mixtures containing hydrocarbons
Authors: Moldabekova M S , Asembaeva M K , Krasikov S A , Nurtay G F 
Published: July 2020

Abstract
Diffusion mixing in mixtures of C3H8 + CO2 - N2O, Ne + C3H8 - N2O + C3H8, N2O + He - C3H8 + CH4 at different pressures has been studied experimentally. It has been found that at a certain pressure in the mixture there are convective flows distorting the expected diffusion transfer. The transition parameters from diffusion to convective mixing type can be determined in terms of stability theory. The numerical results are compared with experimental data.
Heat transfer in turbulized gradient flows
Authors: Davletshin I A , Shakirov R R , Paereliy A A 
Published: July 2020

Abstract
Convective heat transfer in a plane channel with superimposed pressure gradient (converging and diverging channel) has been studied experimentally. The air flow was turbulized by different arrangements at the channel inlet. Distributions of heat transfer coefficients within the gradient part of the channel have been obtained in different regimes. Patterns of the effect of turbulence intensity on heat transfer have been described.