bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of weight trajectory after bariatric surgery on co-morbidity evolution and burden
Authors: Davis Jason , Saunders Rhodri 
Published: January 2020

Abstract
Background
Bariatric surgery, such as Roux-en-Y gastric bypass [RYGB] has been shown to be an effective intervention for weight management in select patients. After surgery, different patients respond differently even to the same surgery and have differing weight-change trajectories . The present analysis explores how improving a patient’s post-surgical weight change could impact co‑morbidity prevalence, treatment and associated costs in the Canadian setting.
Methods
Published data were used to derive statistical models to predict weight loss and co‑morbidity evolution after RYGB. Burden in the form of patient-years of co-morbidity treatment and associated costs was estimated for a 100-patient cohort on one of 6 weight trajectories, and for real-world simulations of mixed patient cohorts where patients experience multiple weight loss outcomes over a 10-year time horizon after RYGB surgery. Costs (2018 Canadian dollars) were considered from the Canadian public payer perspective for diabetes, hypertension and dyslipidaemia. Robustness of results was assessed using probabilistic sensitivity analyses using the R language.
Results
Models fitted to patient data for total weight loss and co-morbidity evolution (resolution and new onset) demonstrated good fitting. Improvement of 100 patients from the worst to the best weight loss trajectory was associated with a 50% reduction in 10-year co-morbidity treatment costs, decreasing to a 27% reduction for an intermediate improvement. Results applied to mixed trajectory cohorts revealed that broad improvements by one trajectory group for all patients were associated with 602, 1,710 and 966 patient-years of treatment of type 2 diabetes, hypertension and dyslipidaemia respectively in Ontario, the province of highest RYGB volume, corresponding to a cost difference of $3.9 million.
Conclusions
Post-surgical weight trajectory, even for patients receiving the same surgery, can have a considerable impact on subsequent co-morbidity burden. Given the potential for alleviated burden associated with improving patient trajectory after RYGB, health care systems may wish to consider investments based on local needs and available resources to ensure that more patients achieve a good long-term weight trajectory.
Eosinopenia as a diagnostic marker of bloodstream infection in a general internal medicine setting: A cohort study
Authors: Hirosawa Takanobu , Harada Yukinori , Morinaga Kohei , Takase Hiroshi , Nin Michihiro , Shimizu Taro 
Published: January 2020

Abstract
Background Little is known about the potential use of the eosinophil count as a predictive marker of bloodstream infection. In this study, we aimed to assess the reliability of eosinopenia as a predictive marker of bloodstream infection. Methods This study was a retrospective cohort study. The outpatient department and general internal medicine department of a tertiary university hospital in Japan. A total of 189 adult patients with at least 2 sets of blood cultures obtained during January 1–December 31, 2018, after excluding those with the use of antibiotic therapy within 2 weeks prior to blood culture, steroid therapy, a history of haematological cancer, or eosinophilia. The diagnostic accuracies of each univariate variable and the multivariable logistic regression models were assessed by calculating the areas under the receiver operating characteristic curves (AUROCs). The primary outcome was a positive blood culture indicating bloodstream infection. Results Severe eosinopenia (<10 cells/mm3) alone yielded little overall predictive ability (AUROC: 0.606, 95% confidence interval (CI): 0.502–0.710, P=0.035), and only moderate sensitivity (50%, 95%CI: 29–70%) and specificity (71%, 95%CI: 63–78%). The model comprising baseline variables (age, sex) and the C-reactive protein level yielded an AUROC of 0.7384, and the further addition of eosinopenia yielded a slight improvement, with an AUROC of 0.7547 (P=0.4297) and a statistically significant net reclassification improvement (NRI) (P=0.03). However, the integrated discrimination index (IDI) (P=0.282) remained non-significant. Conclusions Severe eosinopenia can be considered an inexpensive marker of bloodstream infection in a general internal medicine setting.
Transcriptomic study of pedicels from GA3-treated table grape genotypes with different susceptibility to berry drop reveals responses elicited in cell wall yield, primary growth and phenylpropanoids synthesis.
Authors: Meneses Marco , García-Rojas Miguel , Muñoz-Espinoza Claudia , Carrasco-Valenzuela Tomás , Defilippi Bruno , González-Agüero Mauricio , Meneses Claudio , Infante Rodrigo , Hinrichsen Patricio 
Published: January 2020

AbstractBackground Gibberellins (GA3) are the most sprayed growth regulator for table grape production worldwide, increasing berry size of seedless varieties through pericarp cell expansion. However, these treatments also exacerbate berry drop, which has a detrimental effect on the postharvest quality of commercialized clusters. Several studies have suggested that pedicel stiffening caused by GA3 would have a role in this disorder. Nevertheless, transcriptional and phenotypic information regarding pedicel responses to GA3 is minimal. Results Characterization of responses to GA3 treatments using the lines L23 and Thompson Seedless showed that the former was up to six times more susceptible to berry drop than the latter. GA3 also increased the diameter and dry matter percentage of the pedicel on both genotypes. Induction of lignin biosynthesis-related genes by GA3 has been reported, so the quantity of this polymer was measured. The acetyl bromide method detected a decreased concentration of lignin seven days after GA3 treatment, due to a higher cell wall yield of the isolated fractions of GA3-treated pedicel samples which caused a dilution effect. Thus, an initial enrichment of primary cell wall components in response to GA3 was suggested, particularly in the L23 background. A transcriptomic profiling was performed to identify which genes were associated with these phenotypic changes. This analysis identified 1,281 and 1,787 genes differentially upregulated by GA3 in L23 and cv. Thompson Seedless, respectively. Concomitantly, 1,202 and 1,317 downregulated genes were detected in L23 and cv. Thompson Seedless (FDR≤0.05). Gene ontology analysis of upregulated genes showed enrichment in pathways including phenylpropanoids, cell wall metabolism, xylem development, photosynthesis and the cell cycle at seven days post GA3 application. Twelve genes were characterized by qPCR and striking differences were observed between genotypes, mainly in genes related to cell wall synthesis. Conclusions High levels of berry drop are related to an early strong response of primary cell wall synthesis in the pedicel promoted by GA3 treatment. Genetic backgrounds can produce similar phenotypic responses to GA3, although there is considerable variation in the regulation of genes in terms of which are expressed, and the extent of transcript levels achieved within the same time frame.
Brain Natriuretic Peptide to Predict Successful Liberation from Mechanical Ventilation in Critically Ill Patients: a Systematic Review and Meta-Analysis
Authors: Deschamps Jean , Andersen Sarah K. , Webber Jordan , Featherstone Robin , Sebastianski Meghan , Vandermeer Ben , Senaratne Janek , Bagshaw Sean M. 
Published: January 2020

Abstract
Background: Predicting successful liberation from mechanical ventilation (MV) in critically ill patients is challenging. Brain natriuretic peptide (BNP) has been proposed to help guide decision-making for readiness to liberate from MV following a spontaneous breathing trial (SBT). Methods : We performed a systematic review and meta-analysis of randomized and prospective observational studies that measured BNP levels at the time of SBT in patients receiving MV. The primary endpoint was successful liberation from MV (absence of re-intubation or non-invasive ventilation at 48h). Statistical analyses included bi-variate and Moses-Littenberg models, and DerSimonian-Laird pooling of areas under ROC curve (AUROC). Results: A total of 731 articles were screened. Eighteen adult and 2 pediatric studies were fulfilled pre-specified eligibility. The measure of the relative variation of BNP during SBT (DBNP%) after exclusion of SBT failure by clinical criteria in adults yielded a sensitivity and specificity of 0.889 [0.831-0.929] and 0.828 [0.730-0.896] for successful liberation from MV respectively, with a pooled AUROC of 0.92 [0.88-0.97]. The pooled AUROC for any method of analysis for absolute variation of BNP (DBNP), pre-SBT BNP and post-SBT BNP were 0.89 [0.83-0.95], 0.77 [0.63-0.91], and 0.85 [0.80-0.90], respectively.Conclusion: The relative change in BNP during a SBT has potential value as an incremental tool after successful SBT to predict successful liberation from MV in adults. There is insufficient data to support the use of BNP in children or as an alternate test to clinical indices of SBT or the use of DBNP, BNP-pre and BNP-post as an alternate or incremental test.Trial registration number: PROSPERO CRD42018087474 (2018-02-06)
A Longitudinal Implementation Evaluation of a Physical Activity Program for Cancer Survivors: LIVESTRONG® at the Y.
Authors: Faro Jamie M , Arem Hannah , Heston Ann-Hilary , Hohman Katherine , Hodge Heather , Wang Bo , Lemon Stephenie C , Houston Thomas K , Sadasivam Rajani S 
Published: January 2020

Abstract
Purpose: Increased physical activity (PA) levels in cancer survivors are associated with decreased risk of recurrence and mortality as well as additional positive health outcomes. PA interventions have shown to be efficacious, though many lack translation to and sustainability in community settings. We used dimensions of the RE-AIM framework to evaluate LIVE STRONG® at the YMCA, a nation-wide community-based PA program for cancer survivors delivered at Ys. Methods: LIVE STRONG at the Y national data compiled by YMCA of the USA and Y Association Program Managers between the years of 2010-2018 was examined. We assessed reach (number of participants), adoption (Associations offering the program), implementation (conducting 3 fidelity checks), setting-level maintenance (Associations recently offering program) and participant-level maintenance (membership conversion rate). We also examined relationships between organizational characteristics (years of program existence and Association area household income), and program implementation factors with member conversion. Results: As of 2018, LIVE STRONG at the Y has reached 62,044 survivors and 245 of the 840 (29.2%) of Y Associations have adopted the program. Among the adopters, 91% were aware of fidelity checks; implementation of Observational (62.3%), Goal-setting (49.9%), and Functional (64.6%) checklists varied. Most (95.1%) adopters reported offering ≥1 LIVE STRONG session per year (setting-level maintenance) and a facility-level mean membership conversion percentage of 46.9±31.2% (participant-level maintenance). Fewer years implementing the program and higher Association area household income were significantly associated with a greater membership conversion rate vs their comparison (all t-test p’s <0.05). In a multiple regression model controlling for organizational characteristics, conducting the fidelity checks (Observational, β=8.41; Goal-setting, β=9.70; and Functional, β=9.61; all p’s <0.01) was positively associated with higher membership conversion rates. Conclusions: LIVE STRONG at the Y, in its early years, has shown promise for high reach, while adoption at more Associations could be facilitated. Implementing fidelity checks along with organizational characteristics were associated with higher participant-level maintenance. Identification of Association-level strategies to increase reach, adoption, implementation and maintenance may increase the impact of this community-based PA program.
Hearing and vision care provided to older people residing in care homes: a cross-sectional survey of care home staff
Authors: Andrusjak Wendy , Barbosa Ana , Mountain Gail 
Published: January 2020

Abstract
Background: Hearing and vision loss in older people has proven to affect physical and mental health and increase the speed of cognitive decline. Studies have proven certain practices and aspects of staff knowledge increase the effective care of residents’ ears and eyes, yet it is not known which of these are being implemented in care homes. This study aims to identify the gaps in staff knowledge and underused practices evident in long term care homes when identifying and managing hearing and vision difficulties in older residents. Methods: This study used a cross-sectional survey design. Survey questions were informed by the existing literature and were focused on practices, staff knowledge, and other aspects that have shown to affect residents’ hearing and vision care. The survey was sent to care homes across England between November 2018 and February 2019 both via Email and in paper format for care home staff to complete. Descriptive statistics and Chi-Square analysis was used to assess the factors particularly influencing the current care being provided to care home residents. Results: A total of 400 care home staff responded from 74 care homes. The results revealed that screening tools are rarely used by staff to identify hearing and vision impairments, care homes have limited access to other assistive devices, and audiology services do not regularly assess care home residents. A majority of staff were also not entirely confident in their knowledge of ear and eye care. Responses were also affected by the respondents’ job role, length of time working in care homes and also the care home type and care home capacity revealing a lack of standardised practice and shared communication. Conclusion: This study identifies which practices known to facilitate ear and eye care are currently under used in care homes across England and what particularly staff are not knowledgeable on when it comes to ear and eye care. This can now inform future research of the areas requiring improvement to as effectively address to acknowledged slow identification and poor management of hearing and vision loss in older people residing in care homes.
Hybrid Simulation of pediatric gynecologic examination: a mix-methods study of learners’ attitudes and factors affecting learning.
Authors: Torres Anna , Horodeńska Magdalena , Witkowski Grzegorz , Torres Kamil 
Published: January 2020

Abstract
Background: Children and adolescents with reproductive health issues may require immediate or emergency care, however in many countries availability of the pediatric and adolescent gynecology (PAG) service is low. That being said, teaching PAG examination to OBGYN, pediatrics and emergency medicine residents seems reasonable and cannot be underestimated. In order to provide residents with opportunity to learn PAG examination a high-fidelity hybrid simulation (HFHS) workshop was implemented in our institution.Methods: The study aimed to investigate learners’ attitudes towards the hybrid model as compared with pelvic trainer in the HFS environment and the factors connected to learners’ attitudes towards the hybrid model that could influence learning in HFS. The concept of attitude was used as the theoretical framework and the mixed method approach to study design was utilized with simultaneous collection of quantitative (original questionnaires) and qualitative data (semi-structured interviews). Results: Residents valued the hybrid model higher over task trainer-SP-voice model in regards to all three attitude components: cognitive (95%), affective (87.5%) and behavioral (83.7%). Analysis of qualitative data revealed six themes important to learners and informing learning of PAG examination in HFS and allowed to develop a conceptual model.Conclusions: Participants of our study appreciated the learning experience with hybrid model more based on attitude questionnaire. Moreover, findings revealed that multiple, various factors connected to attitude may influence learning of PAG examination in HFS with hybrid model, and we propose a conceptual model illustrating relationships between those factors.
WITHDRAWN: Exploring the Effectiveness of Convolutional Neural Network with Ensemble Technique
Authors: Ghosh Monalisha , Sanyal Goutam 
Published: January 2020

Abstract
­­­­­­­­­­­­­­­­­­­­­­­­­­­ Sentiment Analysis has recently been considered as the most active research field in the natural language processing (NLP) domain. Deep Learning is a subset of the large family of Machine Learning and becoming a growing trend due to its automatic learning capability with impressive consequences across different NLP tasks. Hence, a fusion-based Machine Learning framework has been attempted by merging the Traditional Machine Learning method with Deep Learning techniques to tackle the challenge of sentiment prediction for a massive amount of unstructured review dataset. The proposed architecture aims to utilize the Convolutional Neural Network (CNN) with a backpropagation algorithm to extract embedded feature vectors from the top hidden layer. Thereafter, these vectors augmented to an optimized feature set generated from binary particle swarm optimization (BPSO) method. Finally, a traditional SVM classifier is trained with these extended features set to determine the optimal hyper-plane for separating two classes of review datasets. The evaluation of this research work has been carried out on two benchmark movie review datasets IMDB, SST2. Experimental results with comparative studies based on performance accuracy and F-score value are reported to highlight the benefits of the developed frameworks.
Percutaneous vertebroplasty (PVP) to treat specialized type of endplate fractures around the Schmorl's node: a prospective study of 65 patients
Authors: Zhang Yaoshen , Yin Peng , Yang Jincai , Hai Yong 
Published: January 2020

Abstract
Background: The Schmorl's nodes (SNs) is defined as the herniation of the intervertebral disc into the vertebral body. Endplate fractures around the schmorl's node could result in severe back pain that is similar to vertebral compression fractures. The objective of this study was to prospectively analyze the surgical effectiveness and safety of percutaneous vertebroplasty (PVP) for endplate fractures around the SNs. Methods: Clinical data and medical records of 65 patients with the fresh endplate fracture aroud SNs who underwent single level (PVP) from October 2017 to February 2018 were enrolled in this study. The visual analog scale (VAS) and Oswestry disability index (ODI) scores of low back pain were evaluated in all patients preoperatively, postoperatively, and at 1 month, 6 months, and 1 year after primary surgery. Surgery related data including duration of the operation, injected cement volumes and surgical complications were recorded. Results: Sixty-five patients with fresh endplate fractures around the SNs were treated successfully via percutaneous vertebroplasty. Our study showed that the VAS scores and ODI scores of patients were obviously improved after operation. Cement leakage into the disc space occurred in 5 patients (7.7%), and adjacent segment refractures occurred in 2 patients (3.1%). No other surgical complications, including infections or nerve root injuries were encountered. Conclusions: Based on the results of this prospective study, PVP was an effective and safe procedure for endplate fractures around the SNs.
Staged surgical strategy of symptomatic lumbar adjacent-segment degeneration: full-endoscopic decompression versus extended posterior interbody fusion
Authors: Li Tong , Zhu Bin , Liu Xiaoguang 
Published: January 2020

Abstract
Background Symptomatic adjacent-segment degeneration (ASD) is a common complication after lumbar fusion surgery. We want to evaluate the clinical and imaging outcome of full-endoscopic lumbar decompression (FELD) in comparison with extended posterior lumbar interbody fusion (PLIF) for ASD after lumbar fusion surgeries and develop a staged revision strategy. Methods This retrospective study enrolled 65 patients with ASD who treated with FELD (n=31) or extended PLIF (n=34) between January 2014 and January 2018. Clinical outcome evaluations were performed preoperatively, at 3, 12, 24 months postoperatively, including Oswestry Disability Index (ODI) score and Japanese Orthopaedic Association (JOA) scores for function assessment, visual analog scale (VAS) scores for low-back pain and leg pain. Imaging outcome evaluations were performed preoperatively, immediately after surgery and at the last follow up, including disc height (DH) and lumbar lordosis (LL). Results The ratio of patients with adjacent segmental instability in the PLIF group was significantly higher than that in the FELD group (p<0.05). There was no significant difference in other baseline data for FELD and PLIF groups (p>0.05). Mean operative time, blood loss and length of hospital stay were significantly decreased for the FELD group (p<0.001). For patients with stable adjacent segments, there was no significant difference in preoperative and postoperative low-back pain, leg pain and function between 2 groups (p>0.05). The patients in PLIF group had restored DH after surgery, which was significantly higher than FELD group (p<0.05). For patients with unstable adjacent segments, the low-back and leg pain of PLIF group were significantly relieved than that in FELD group within 24 and 3 months after surgery (p<0.05). The function of PLIF group was significantly improved within 12 months after surgery (p<0.05). The DH was only significantly restored within 3 months after surgery (p<0.05). Recurrence was found in 2 (6.5%, p>0.05) patients in FELD group, while no patient in PLIF group had recurrence. Conclusions FELD could achieve satisfactory safety and efficacy for the treatment of stable ASD, which was not worse than PLIF. With less trauma and faster recovery, FELD may be an alternative surgical treatment for stable ASD.