bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of Tocilizumab in Cytokine Storm and Improving Outcomes in COVID-19
Authors: Ali Afroze , Kamjani Milad H. , Kesselman Marc M. 
Published: September 2020

:
To date, severe acute respiratory syndrome coronavirus 2 (SARSCoV-
2) has infected millions of individuals worldwide. This virus causes coronavirus
disease 2019 (COVID-19) and has led to numerous deaths worldwide. A
large percentage of infected patients present asymptomatically, augmenting the
spread of the virus. Symptomatic COVID-19 commonly causes mild to severe
respiratory disease and fever, but some individuals experience serious complications
resulting in death. Immune compromised, high risk, and elderly individuals
are at an increased risk of more severe consequences of the illness such as respiratory
failure, organ dysfunction, and shock. Cytokine storm (also known as cytokine
release syndrome (CRS)), a systemic inflammatory response that can be
triggered by an infection, has been associated with the symptom progression of
COVID-19. This review evaluates several published studies that have implemented
tocilizumab (TCZ), an IL-6 receptor antibody (US20120253016A1), in
COVID-19 treatment. Outcomes and biomarkers of patients treated with TCZ are
compared to patients treated with standard of care regimens. Interleukin-6 (IL-6),
a prominent inflammatory cytokine involved in CRS in various inflammatory
conditions, may have a vital role in the underlying mechanism involved in debilitating
SARS-CoV-2 infections and could serve as a viable treatment target.
Studies suggest that TCZ may aid in the recovery of patients with COVID-19
and reduce mortality.
Challenges and Issues in the Design of Micro-machined Antennas - A Review
Authors: Kumar Ashish , Pharwaha Amar P.S. 
Published: September 2020

Background:
Patch antennas are composed of the substrate material with patch and
ground plane on both sides of the substrate. The dimensions and performance characteristics of the
antenna are highly influenced by choice of the appropriate substrate depending upon the value of
their dielectric constant. Generally, low index substrate materials are used to design the patch antenna,
but there are also some of the applications, which require the implementation of patch antenna
design on high index substrates like silicon and gallium arsenide.

Objective:
The objective of this article was to review the design of antennas developed on high index
substrate and the problems associated with the use of these materials as a substrate. Also, main
challenges and solutions have been discussed to improve the performance characteristics while using
the high index substrates.

Methods:
This review article is divided into various sections, including the solution of the problems
associated with the high index substrates in the form of the micro-machining process. Along with
this, types of micro-machining and its applications have been discussed in detail.

Results:
This review article investigates the various patch antennas designed with micro-machining
technology and also discusses the impact of the micro-machining process on the performance parameters
of the patch antennas designed on high index substrates.

Conclusion:
By using the micro-machining process, the performance of the patch antenna improves
drastically, but fabrication and tolerances at such minute structures are very tedious task for the antenna
designers.
Research on Improved Gamma Transform Face Image Preprocessing Fusion Algorithm Under Complex Lighting Conditions
Authors: Tang Xiaolin , Wang Xiaogang , Hou Jin , Wu Huafeng , He Ping 
Published: September 2020

Introduction:
Under complex illumination conditions, such as poor light sources and light
changes rapidly, there are two disadvantages of current gamma transform in pre-processing face
image: one is that the parameters of transformation need to be set based on experience; the other is
that the details of the transformed image are not obvious enough.

Objective:
To improve the current gamma transform.

Methods:
This study proposes a weighted fusion algorithm of adaptive gamma transform and edge
feature extraction. First, this paper proposes an adaptive gamma transform algorithm for face image
pre-processing, that is, the parameter of transformation generated by calculation according to the
specific gray value of the input face image. Secondly, this paper uses a Sobel edge detection operator
to extract the edge information of the transformed image to get the edge detection image. Finally,
this paper uses the adaptively transformed image and the edge detection image to obtain the final
processing results through a weighted fusion algorithm.

Results:
The contrast of the face image after pre-processing is appropriate, and the details of the
image are obvious.

Conclusion:
The method proposed in this paper can enhance the face image while retaining more
face details, without human-computer interaction, and has a lower computational complexity degree.
Automated Cluster Detection of Health Care–Associated Infection Based on the Multisource Surveillance of Process Data in the Area Network: Retrospective Study of Algorithm Development and Validation
Authors: Fan Yunzhou , Wu Yanyan , Cao Xiongjing , Zou Junning , Zhu Ming , Dai Di , Lu Lin , Yin Xiaoxv , Xiong Lijuan 
Published: September 2020

Background
The cluster detection of health care–associated infections (HAIs) is crucial for identifying HAI outbreaks in the early stages.

Objective
We aimed to verify whether multisource surveillance based on the process data in an area network can be effective in detecting HAI clusters.

Methods
We retrospectively analyzed the incidence of HAIs and 3 indicators of process data relative to infection, namely, antibiotic utilization rate in combination, inspection rate of bacterial specimens, and positive rate of bacterial specimens, from 4 independent high-risk units in a tertiary hospital in China. We utilized the Shewhart warning model to detect the peaks of the time-series data. Subsequently, we designed 5 surveillance strategies based on the process data for the HAI cluster detection: (1) antibiotic utilization rate in combination only, (2) inspection rate of bacterial specimens only, (3) positive rate of bacterial specimens only, (4) antibiotic utilization rate in combination + inspection rate of bacterial specimens + positive rate of bacterial specimens in parallel, and (5) antibiotic utilization rate in combination + inspection rate of bacterial specimens + positive rate of bacterial specimens in series. We used the receiver operating characteristic (ROC) curve and Youden index to evaluate the warning performance of these surveillance strategies for the detection of HAI clusters.

Results
The ROC curves of the 5 surveillance strategies were located above the standard line, and the area under the curve of the ROC was larger in the parallel strategy than in the series strategy and the single-indicator strategies. The optimal Youden indexes were 0.48 (95% CI 0.29-0.67) at a threshold of 1.5 in the antibiotic utilization rate in combination–only strategy, 0.49 (95% CI 0.45-0.53) at a threshold of 0.5 in the inspection rate of bacterial specimens–only strategy, 0.50 (95% CI 0.28-0.71) at a threshold of 1.1 in the positive rate of bacterial specimens–only strategy, 0.63 (95% CI 0.49-0.77) at a threshold of 2.6 in the parallel strategy, and 0.32 (95% CI 0.00-0.65) at a threshold of 0.0 in the series strategy. The warning performance of the parallel strategy was greater than that of the single-indicator strategies when the threshold exceeded 1.5.

Conclusions
The multisource surveillance of process data in the area network is an effective method for the early detection of HAI clusters. The combination of multisource data and the threshold of the warning model are 2 important factors that influence the performance of the model.
Exploring Participants’ Experiences of a Web-Based Program for Bulimia and Binge Eating Disorder: Qualitative Study
Authors: Yim See Heng , Bailey Emma , Gordon Gemma , Grant Nina , Musiat Peter , Schmidt Ulrike 
Published: September 2020

Background
Guided cognitive behavioral self-help is a recommended first-line treatment for eating disorders (EDs) such as bulimia nervosa (BN) or binge eating disorder (BED). Online versions of such self-help programs are increasingly being studied in randomized controlled trials (RCTs), with some evidence that they can reduce ED symptoms, although intervention dropout is variable across interventions. However, in-depth research into participants’ experiences and views on the acceptability of web-based interventions is limited.

Objective
This is a qualitative process study of participants’ experiences of everyBody Plus, a web-based cognitive behavioral intervention, integrated into a large RCT to aid the interpretation of the main trial’s results. To our knowledge, this is the first such study in digital intervention for EDs research to include real-time feedback into the qualitative analysis. This study aims to build upon the emerging literature by qualitatively exploring participants’ experiences of a web-based intervention for BN and BED.

Methods
Participants were those who took part in the UK arm of a larger RCT investigating the efficacy of the everyBody Plus intervention. Reflexive thematic analysis was completed on 2 sources of data from the online platform: real-time feedback quotes provided at the end of completing a module on the platform (N=104) and semistructured telephone interview transcripts (n=12).

Results
Four main themes were identified. The first theme identified positive and negative user experiences, with a desire for a more customized and personalized intervention. Another theme positively reflected on how flexible and easy the intervention was to embed into daily life, compared with the silo of face-to-face therapy. The third theme identified how the intervention had a holistic impact cognitively, emotionally, interpersonally, and behaviorally. The final theme was related to how the intervention was not a one size fits all and how the perceived usefulness and relevance were often dependent on participants’ demographic and clinical characteristics.

Conclusions
Overall, participants reported positive experiences with the use of the everyBody Plus web-based intervention, including flexibility of use and the potential to holistically impact people’s lives. The participants also provided valuable suggestions for how similar future web-based interventions could be improved and, in the context of EDs, how programs can be designed to be more inclusive of people by encompassing different demographic and clinical characteristics.
New Checklist for the Heuristic Evaluation of mHealth Apps (HE4EH): Development and Usability Study
Authors: Khowaja Kamran , Al-Thani Dena 
Published: September 2020

Background
Diabetes is one of the leading causes of death in developing countries. Existing mobile health (mHealth) app design guidelines lack a description of the support of continuous self-monitoring of health status, behavior change to improve and adopt a healthy lifestyle, and communication with health educators and health care professionals in case of any need.

Objective
This paper presents the development of a specialized set of heuristics called heuristic evaluation for mHealth apps (HE4EH) as an all-in-one tool and its applicability by performing a heuristic evaluation of an mHealth app.

Methods
An extensive review of heuristics and checklists was used to develop the HE4EH. The HE4EH was evaluated by domain experts for heuristics, checklist items, severity ratings, and overall satisfaction. The OneTouch app, which helps individuals with diabetes manage their blood glucose levels, was evaluated using HE4EH to identify usability problems that need to be fixed in the app.

Results
The expert evaluation of HE4EH revealed that the heuristics were important, relevant, and clear. The checklist items across the heuristics were clear, relevant, and acceptably grouped. In terms of evaluating the OneTouch app using the HE4EH, the most frequently violated heuristics included Content, Visibility, Match, and Self-monitoring. Most of the usability problems found were minor. The system usability scale score indicated that the OneTouch app is marginally acceptable.

Conclusions
This heuristic evaluation using the OneTouch app shows that the HE4EH can play a vital role for designers, researchers, and practitioners to use HE4EH heuristics and checklist items as a tool to design a new or evaluate and improve an existing mHealth app.
Trends in Use and In-Hospital Outcomes of Subcutaneous Implantable Cardioverter Defibrillators in Patients Undergoing Long-Term Dialysis
Authors: Pun Patrick H. , Parzynski Craig S. , Friedman Daniel J. , Sanders Gillian , Curtis Jeptha P. , Al-Khatib Sana M. 
Published: September 2020

Background and objectives
Patients on dialysis are at high risk of complications related to implantable cardioverter defibrillator (ICD) implantation; use of subcutaneous ICDs may be preferred over transvenous devices due to lower risk of bloodstream infection and interference with vascular access sites. We evaluated trends in use and in-hospital outcomes of subcutaneous compared with transvenous ICDs among patients on dialysis in the United States.

Design, setting, participants, & measurements
Retrospective analysis of ICD implants from 2012 to 2018 among patients on dialysis reported to the National Cardiovascular Data Registry ICD Registry, a nationally representative US ICD Registry. We examined overall trends in subcutaneous ICD adoption as a proportion of all eligible ICD implants among patients on dialysis and then compared in-hospital outcomes between eligible subcutaneous ICD and transvenous ICD recipients using inverse probability of treatment weighting.

Results
Of the 23,136 total ICD implants in patients on dialysis during the study period, 3195 (14%) were subcutaneous ICDs. Among eligible first-time ICD recipients on dialysis, the proportion of subcutaneous ICDs used increased yearly from 10% in 2012 to 69% in 2018. In propensity score–weighted analysis of 3327 patients, compared with transvenous ICDs, patients on dialysis receiving subcutaneous ICDs had a higher rate of in-hospital cardiac arrest (2% versus 0.4%, P=0.002), but there was no significant difference in total in-hospital complications (2% versus 1%, P=0.08), all-cause death, or length of hospital stay.

Conclusions
The utilization of subcutaneous ICDs among US patients on dialysis has been steadily increasing. The overall risk of short-term complications is low and comparable with transvenous ICDs, but higher risks of in-hospital cardiac arrest merits closer monitoring and further investigation.

Podcast
This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2020_09_23_CJN07920520.mp3
Características clínicas y epidemiológicas de los pacientes VIH/SIDA diagnosticados con tuberculosis en el Servicio de Atención Integral del Hospital Infantil Dr. Robert Reid Cabral durante el periodo 2010-2016
Authors: Elías Melgen Ricardo , Abreu Rosa , García Milandres 
Published: September 2020

Introducción: el diagnóstico de TB puede ser particularmente difícil en niños infectados con VIH porque es común la superposición clínica con otra enfermedad relacionada con el VIH, lo que dificulta y retrasa un correcto diagnóstico.
Objetivo: conocer las características clínicas y epidemiológicas de los pacientes VIH/SIDA diagnosticados con tuberculosis en el Hospital Infantil Dr. Robert Reid Cabral durante el periodo 2010- 2016.
Métodos: se realizó un estudio descriptivo, la información se obtuvo de los expedientes de los pacientes VIH/SIDA diagnosticados con tuberculosis en el Hospital Infantil Dr. Robert Reid Cabral durante el periodo 2010-2016. Las variables de estudio se recolectaron en un instrumento diseñado para estos fines. Los datos se procesaron mediante el paquete estadístico SPSS 2007 y en el análisis se usó estadística descriptiva.
Resultados: el 13.2 % de los pacientes con VIH desarrollaron TB, 72.3 % presentaba una inmunosupresión grave al momento del diagnóstico de TB, 45 % refería el antecedente de contacto TB y el 90.5 % era intradomiciliario. 53 % no estaba recibiendo TARV antes de establecer el diagnóstico TB. Tos (65.9 %), fiebre (61.7 %) y pérdida o mal progreso de peso (40.4 %), fueron las principales manifestaciones clínicas. 76.6 % completó 6 meses de tratamiento, 17 % se perdió durante el seguimiento y 4.3 % falleció durante el tratamiento.
Conclusión: 13.2 % de los pacientes con VIH desarrollaron tuberculosis, con un importante deterioro de su inmunidad al momento de hacer este diagnóstico, más de la mitad no recibía terapia antiretroviral; un alto porcentaje de estos pacientes tenían antecedente de contacto intradomiciliario con un caso TB, 17 % abandono tratamiento antituberculosis luego de iniciado.
Comparison of the transfer accuracy of two digital indirect bonding trays for labial bracket bonding
Authors: Niu Ye , Zeng Yunting , Zhang Zeyu , Xu Wanghan , Xiao Liwei 
Published: September 2020

ABSTRACT

Objectives
To compare the transfer accuracy of two digital transfer trays, the three-dimensional printed (3D printed) tray and the vacuum-formed tray, in the indirect bonding of labial brackets.

Materials and Methods
Ten digital dental models were constructed by oral scans using an optical scanning system. 3D printed trays and vacuum-formed trays were obtained through the 3Shape indirect bonding system and rapid prototyping technology (10 in each group). Then labial brackets were transferred to 3D printed models, and the models with final bracket positioning were scanned. Linear (mesiodistal, vertical, buccolingual) and angular (angulation, torque, rotation) transfer errors were measured using GOM Inspect software. The mean transfer errors and prevalence of clinically acceptable errors (linear errors of ≤0.5 mm and angular errors of ≤2°) of two digital trays were compared using the Mann-Whitney U-test and the Chi-square test, respectively.

Results
The 3D printed tray had a lower mean mesiodistal transfer error (P &lt; .01) and a higher prevalence of rotation error within the limit of 2° (P = .03) than did the vacuum-formed tray. Linear errors within 0.5 mm were higher than 90% for both groups, while torque errors within 2° were lowest at 50.9% and 52.9% for the 3D printed tray and vacuum-formed tray, respectively. Both groups had a directional bias toward the occlusal, mesial, and buccal.

Conclusions
The 3D printed tray generally scored better in terms of transfer accuracy than did the vacuum-formed tray. Both types of trays had better linear control than angular control of brackets.
Effect of the presence of orthodontic brackets on intraoral scans
Authors: Kang Sung-Ja , Kee Youn-Ju , Lee Kyungmin Clara 
Published: September 2020

ABSTRACT

Objectives
The need for intraoral scanning in the presence of brackets has increased for monitoring tooth movement during orthodontic treatment. The purpose of this study was to evaluate the effect of orthodontic brackets bonded to tooth surfaces on intraoral scans.

Materials and Methods
Intraoral scans were performed in 30 patients using both iTero and Trios scanners before and after bonding of the brackets. The two sets of intraoral scans of each patient and intraoral scans with and without brackets were superimposed using a best-fit algorithm, and three-dimensional (3D) surface analysis was performed. In each superimposition, discrepancies in the 3D axes and arch-width measurements in the incisor and molar regions were compared. In addition, the range of distortion around the brackets was evaluated on the cross sections of each superimposition.

Results
The overall discrepancies between the intraoral scans with and without brackets were within 0.30 mm. The arch-width discrepancies in the molar region were greater than those in the incisor region, but the differences were not statistically significant (P = .972 for iTero; P = .960 for Trios). The cross sections of the superimposed intraoral scans with and without brackets showed that the deviations were within 0.40 mm in the horizontal section and within 0.35 mm in the vertical section around the brackets.

Conclusions
The results of this study indicate that the accuracy of intraoral scans, even in the presence of brackets, is clinically acceptable, and the regions beyond 0.50 mm around the brackets should be used for superimposition on images without brackets.
Metformin Use Is Associated With Slowed Cognitive Decline and Reduced Incident Dementia in Older Adults With Type 2 Diabetes: The Sydney Memory and Ageing Study
Authors: Samaras Katherine , Makkar Steve , Crawford John D. , Kochan Nicole A. , Wen Wei , Draper Brian , Trollor Julian N. , Brodaty Henry , Sachdev Perminder S. 
Published: September 2020

OBJECTIVEType 2 diabetes (diabetes) is characterized by accelerated cognitive decline and higher dementia risk. Controversy exists regarding the impact of metformin, which is associated with both increased and decreased dementia rates. The objective of this study was to determine the association of metformin use with incident dementia and cognitive decline over 6 years in participants with diabetes compared with those not receiving metformin and those without diabetes.RESEARCH DESIGN AND METHODSA prospective observational study was conducted of N = 1,037 community-dwelling older participants without dementia aged 70–90 years at baseline (the Sydney Memory and Ageing Study). Exclusion criteria were dementia, major neurological or psychiatric disease, or progressive malignancy. Neuropsychological testing measured cognitive function every 2 years; a battery of tests measured executive function, memory, attention/speed, language, and visuospatial function individually. These were used to determine the measure of global cognition. Incident dementia was ascertained by a multidisciplinary panel. Total brain, hippocampal, and parahippocampal volumes were measured by MRI at baseline and 2 years (n = 526). Data were analyzed by linear mixed modeling, including the covariates of age, sex, education, BMI, heart disease, hypertension, stroke, smoking, and apolipoprotein Eε4 carriage.RESULTSOf n = 1,037, 123 had diabetes; 67 received metformin (DM+MF) and were demographically similar to those who did not (DM-noMF) and participants without diabetes (no-DM). DM+MF had significantly slower global cognition and executive function decline compared with DM-noMF. Incident dementia was significantly higher in DM-noMF compared with DM+MF (odds ratio 5.29 [95% CI 1.17–23.88]; P = 0.05).CONCLUSIONSOlder people with diabetes receiving metformin have slower cognitive decline and lower dementia risk. Large randomized studies in people with and without diabetes will determine whether these associations can be attributed to metformin.