bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multidisciplinary Team Meetings for Patients with Complex Extremity Defects – A Retrospective Analysis of Treatment Recommendations and Prognostic Factors for Non-Implementation.
Authors: Kotsougiani-Fischer Dimitra , Fischer Sebastian , Warszawski Jan , Gruetzner Paul , Reiter Gregor , Hirche Christoph , Kneser Ulrich 
Published: December 2020

Abstract
BACKGROUNDThis study aimed to assess a multidisciplinary team (MDT) meeting approach for the management of patients with complex extremity defects, analyze treatment recommendations, and evaluate factors influencing non-implementation.METHODSAll patients introduced to an MDT meeting for complex extremity defects from 2015 to 2017 were included. Patients’ characteristics and defect causes were evaluated. Treatment recommendations of MDT meetings and subsequent implementation were reviewed, and factors associated with non-adherence to recommendations were statistically analyzed using logistic regression.RESULTSFifty-one patients (41 male) with a mean age of 54 years were presented in 27 MDT meetings. Most of the patients (70%) suffered from reconstructive challenging or combined bone- and soft tissue defects, primarily located at the lower extremity (88%). Large skeletal defects, chronic osteomyelitis, and multi-fragmented fractures were present in 65% of cases. Forty-five percent of the patients suffered from peripheral vascular disease, necessitating surgical optimization. Of the 51 MDT decisions, 40 were implemented (78%; (32/40) limb salvage versus 22%; (8/40) limb amputation). Limb salvage was successfully achieved in 91% (29/32) of the cases. Failed limb salvages were due to flap failure (33%; 1/3), recurring periprosthetic joint infections (66%; 2/3) and concomitant reconstructive failure. Patients who underwent limb amputation, as recommended, showed proper stump healing and regained mobility with a prosthesis. Overall the MDT treatment plan was effective in 92.5% (37/40) of the patients, who adhered to the MDT treatment recommendation. In eleven patients (22%; 11/51), the MDT treatment was not implemented. MDT decisions were less likely to be implemented, if amputation was recommended (p = 0.029.CONCLUSIONSMDT meetings represent a valid tool to formulate individualized treatment plans, avoiding limb amputation in most patients with severe extremity defects. Recommendation for limb amputation is less likely to be implemented than plans for limb salvage.TRIAL REGISTRATION:Retrospectively registered
Hidden Patterns: The Voronoi Theory of the Normal Liver Lobular Architecture and its Applicability in Hepatic Zonation.
Authors: Lau Chun , Kalantari Bahman , Batts Kenneth , Ferrell Linda , Nyberg Scott , Graham Rondell , Moreira Roger 
Published: December 2020

Abstract
The precise characterization of the lobular architecture of the liver has been subject of investigation since the earliest historical publications, but an accurate model to describe the hepatic lobular microanatomy is yet to be proposed. Our aim was to evaluate whether Voronoi diagrams can be used to describe the classic liver lobular architecture. We examined the histology of normal porcine and human livers and analyzed the geometric relationships of various microanatomic structures utilizing digital tools. The Voronoi diagram model described the organization of the hepatic classic lobules with overall accuracy nearly 90% based on known histologic landmarks. We have also designed a Voronoi-based algorithm of hepatic zonation, which also showed an overall zonal accuracy of nearly 90%. Therefore, we have presented evidence that Voronoi diagrams represent the basis of the two-dimensional organization of the normal liver and that this concept may have wide applicability in liver pathology and research.
Usability Assessment of Neurostim System: A sEMG Activated Neuroprosthesis Remotely Monitorable and Configurable
Authors: Argentim Lucas Malassise , Terranova Thais Tavares , Battistella Linamara Rizzo , Castro Maria Claudia Ferrari 
Published: December 2020

Abstract
Background: The scientiﬁc community widely explores rehabilitation techniques for individuals with motor disabilities resulting from a stroke since this condition is observed in millions of individuals worldwide.Results: This work presents the usability assessment of Neurostim, a neuromuscular electrical stimulation system triggered by a myoelectrical surface signal, with patients with hemiplegia caused by stroke. The device has a Bluetooth connection with a smartphone application so that conﬁguration parameters can be sent. Usage statistics can be captured and monitored remotely by healthcare professionals, which is the innovation of the presented device following the strong tendency to expand the clinical environment to the patient’s home. The internet can provide healthcare professionals information to perform a detailed follow-up and interact with their patients remotely. Two control platforms were developed for diﬀerent user proﬁles: neuroprosthesis users (Smartphone Application) and health professionals (Web Interface).Conclusions: Neurostim showed to be a robust system application, despite the need for some improvements. It met all the proposal’s expectations, where users were successfully able to operate it, either from a patient or health professional perspective.
Robust Visual Digital Data Authentication using Hybrid Transform with Human Visual System Characteristics
Authors: P Satyanarayana Murty. , Addanki Purna Ramesh 
Published: December 2020

Abstract
Robust watermarking proposals supported on human visual characteristics with a series of hybrid transform of type discrete wavelet transform (DWT) followed by singular value decomposition (SVD) is wished-for. By analyzing the matrices U or V through SVD, it is bringing into being that there stay alive a well-built relationship amid the internal column elements of U or internal row elements of V. Hence, this work will make the most of these chattels for image watermarking. At the outset, visual digital data is segregated into 8 × 8 non-overlapping pixel blocks and each block is processed for brinks by using the algorithm of detection for a canny brink. An appropriate block is decided to pick in such a way that the number of brinks in each block is only about or equal to a threshold. A threshold is defined by finding the mean of the brinks in each block of the host visual digital data. Using these appropriate blocks, we will form an image of reference. This reference image is processed by a series of operations DWT-SVD. Then, the watermark is implanted by adapting the nth column of the U matrix of the host image with the nth column of the U matrix of the watermark image. The same operation is applied on the V matrix instead of a column vector, use a row vector. The adapted relation is wont to retrieve a watermark. The experimental findings demonstrate that the ideal watermarking algorithm will guarantee that the typical image processing operations and geometric attacks are invisible and more stable. The efficiency of this proposed method is out of shape than other proposed methods examined in this research.
Analysis of Peripheral Inflammatory T Cell Subsets and Their Effector Function in Patients With Birdshot Retinochoroiditis
Authors: Trombke Janine , Loyal Lucie , Julian Braun , Uwe Pleyer , Andreas Thiel , Dominika Pohlmann 
Published: December 2020

Abstract
Purpose: Birdshot Retinochoroiditis (BSRC) is a progressive non-infectious intraocular inflammation that affects choroid and retina. Inflammatory processes have adverse effects on vision by affecting photoreceptor-bearing cells that do not regenerate. Methods: This study aimed at characterizing inflammatory CD4+ and CD8+ T cell subsets in the peripheral blood of BSRCs. Furthermore, we correlated phenotypical and functional immunological analyses with clinical data. Results: We observed a slight increase of terminally differentiated effector memory CD8+ T cells expressing CD45RA (TEMRA) in blood of inactive, compared to active BSRCs. Moreover, we identified a trend for a decreased population of TH2 cells and increased TH1 frequencies in active BSRCs, a typical sign of ongoing autoimmune processes. Functional assays demonstrated severe and overall impairment of effector function of both, CD4+ and CD8+ inflammatory T cells, which might reflect T cell exhaustion. Conclusion: Although the eye is the main site of inflammation in BSRC, we observed altered T cell subset compositions in the peripheral blood, dependent on the disease status. Our results indicate that T cells may play a major role in BSRC pathology, although our cohort size is too limited for definitve conclusions. Future studies with larger and well-defined cohorts of BSRCs have to be performed.
Factors Influencing Choice of Delivery Place among Mothers in Rukungiri and Kanungu Districts, South Western Uganda: A Cross Sectional Study
Authors: Mugambe Richard , Yakubu Habib , Wafula Solomon , Ssekamatte Tonny , Kasasa Simon , Isunju John , Halage Abdullah , Osuret Jimmy , Bwire Constance , Ssempebwa John , Wang Yuke , McGriff Joanne , Moe Christine 
Published: December 2020

Abstract
Background: Child birth in health facilities is generally associated with lower risk of maternal and neonatal mortality. However, in Uganda, little is known about factors that influence use of health facilities for delivery especially in rural areas. In this study, we examined the determinants of mothers’ decision of the choice of child delivery place in Western Uganda.Methods: Cross-sectional data was collected from 894 randomly-sampled mothers within the catchment of two private hospitals in Rukungiri and Kanungu districts. Data was collected on the place of delivery for the most recent child, mothers’ sociodemographic characteristics, health facility water, sanitation and hygiene (WASH) status. Modified Poisson regression was used to estimate prevalence ratios (PRs) for the determinants of mothers’ choice of delivery place as well as determinants for the choice of private versus public facility for delivery at 95% confidence intervals. Results: Majority of mothers (90.2%) delivered in health facilities. Non-facility deliveries were attributed to fast progression of labour (77.3%), lack of transport (31.8%) and high cost of hospital delivery (12.5%). Being engaged in business as an occupation [APR = 1.06, 95% CI (1.01 – 1.11)] and belonging to the highest wealth quintile [APR = 1.09, 95% CI (1.02 – 1.17)] favoured facility delivery while higher parity of 3 – 4 [APR = 0.93, 95% CI (0.88 – 0.99)] was inversely associated with facility delivery as compared to parity of 1-2. Choice of private facility over public facility was influenced by how mothers valued factors such as high skilled health workers [APR = 1.15, 95% CI (1.05 – 1.26)], higher quality of WASH services [APR = 1.11, 95% CI (1.04 – 1.17)], cost of the delivery [APR = 0.85, 95% CI (0.78 – 0.92)] and availability of caesarean services [APR = 1.13, 95% CI (1.08 – 1.19)].Conclusion: Utilization of health facility child delivery services was high. Health facility delivery service utilization was influenced by engaging in business, belonging to wealthiest quintile and being multiparous. Choice of private versus public health facility for child delivery was influenced by health facility WASH status, cost of services, and availability of skilled workforce and caesarean services.
Seroprevalence of Bovine Viral Diarrhea Virus (BVDV) and Its Associated Risk Factors in Dairy Cattle in and Around Assela Town, South East Ethiopia
Authors: Asnake Pawlos , Lemma Abdissa , Tesfaye Asamnew , Gizaw Daneil , Guta Sintayehu , Dima Chala , Tadesse Fanos 
Published: December 2020

Abstract
Background: Bovine viral diarrhea (BVD) is one of the most economically important diseases of cattle population worldwide and caused by Bovine viral diarrhea virus (BVDV). A cross-sectional study was conducted from October, 2019 to April, 2020 to investigate the sero-prevalence and associated risk factors for Bovine Viral Diarrhea Virus (BVDV) infection. in and around Asella town, Ethiopia. Semi structured questionnaire survey was designed to assess the different variables related to herd managements through personal interview of the farmers. Serum samples were collected from a total of 45 non-vaccinated cattle herds (225 individual cattle) during the study period. Samples were examined for detection of bovine viral diarrhea virus (BVDV) antibodies using indirect enzyme-linked immunosorbent assay (iELISA) kit (ID Screen® BVD p80 Antibody) following the manufacturers protocol. Chi-square analysis and multivariable logistic regression model were used to identify risk factors for BVDV seropositivity. Results: In the present study, 8.4% (95% CI: 5.2-12.9) and 22.2% (95% CI: 11.2-37.1) seroprevalence of BVDV antibody was observed at individual and herds level, respectively. Among the animal and management risk factors observed in multiple logistic regression analysis, higher seroprevalence of was observed in cows with history of abortion 53.8% (95% CI: 25.1-80.8%), cattle reared in semi intensive farming system 28.3% (95% CI: 16.0-43.5) (P<0.05). In this study, abortion (adjusted OR: 30.5, P<0.05), repeated breeder (adjusted OR: 6.95, P<0.05) and intensive farming systems (adjusted OR: 0.13, P<0.05) were identified as potential variables for the seroprevalence of BVDV. Conclusion: The study revealed immense exposure of cattle in and around Asella town to BVDV infection that varied with reproductive problem and farming system of the animals. Further studies will be required to elucidate the molecular epidemiology of BVDV infection in cattle and other livestock species in the study area.
Lack of Association of Baseline 25-Hydroxyvitamin D Levels and Cholecalciferol Treatment With Disease Severity and Mortality in Indian Patients Hospitalized for Covid-19
Authors: Jevalikar Ganesh , Mithal Ambrish , Singh Anshu , Sharma Rutuja , Farooqui Khalid , Mahendru Shama , Dewan Arun , Budhiraja Sandeep 
Published: December 2020

Abstract
Vitamin D deficiency (VDD) owing to its immunomodulatory effects is believed to influence outcomes in COVID-19. We conducted a prospective, observational study of patients, hospitalized with COVID-19. Serum 25-OHD level < 20 ng/mL was considered VDD. Patients were classified as having mild and severe disease on basis of the WHO ordinal scale for clinical improvement (OSCI). Of the 410 patients recruited, patients with VDD (197,48∙2%) were significantly younger and had lesser comorbidities. The proportion of severe cases (13∙2% vs.14∙6%), mortality (2% vs. 5∙2%), oxygen requirement (34∙5% vs.43∙4%), ICU admission (14∙7% vs.19∙8%) was not significantly different between patients with or without VDD. There was no significant correlation between serum 25-OHD levels and inflammatory markers studied. Serum parathormone levels correlated with D-dimer (r 0∙117, p- 0∙019), ferritin (r 0∙132, p-0∙010), and LDH (r 0∙124, p-0∙018). Amongst VDD patients, 128(64.9%) were treated with oral cholecalciferol (median dose of 60000 IU). The proportion of severe cases, oxygen, or ICU admission was not significantly different in the treated vs. untreated group. In conclusion, serum 25-OHD levels at admission did not correlate with inflammatory markers, clinical outcomes, or mortality in hospitalized COVID-19 patients. Treatment of VDD with cholecalciferol did not make any difference to the outcomes.
Cardio-Respiratory Events and Food Autonomy Responses to Early Uni-Modal Orofacial Stimulation in Very Premature Babies : A Randomized, Controlled Study
Authors: Meziane Sahra , Brévaut-Malaty Véronique , Garbi Aurélie , Busuttil Muriel , Sorin Gaelle , Tosello Barthélémy , Gire Catherine 
Published: December 2020

Abstract
BackgroundThe Uni-modal OroFacial Stimulation (OFS) for preventing very preterm infants’ oral disorders is highly controversial. Our study sought to demonstrate that OFS reduced cardio-respiratory events and improved food autonomy in a population of very preterm infants.MethodsRandomized, controlled, prospective, and unicentric study. Preterm included were born between 26-29 week‘s gestational age (GA) and with a corrected postnatal age <33 week’s GA. They were randomized in two groups: experimental group underwent an OFS according to a protocol established over 10 consecutive days, and the control group underwent no OFS. The primary outcome were the number of cardiorespiratory events: apnea-bradycardia (with or without desaturations) or number of isolated desaturations which were evaluated at four separate times. The measurement occurred during a first, four and eight independent feedings. Results17 patients in the experimental group and 18 in the control group were included. The number of cardiorespiratory events for all independent- feedings time was significantly reduced in the OFS group (p = 0.003) in the univariate analysis but not in multivariable analysis. There were no signs of poor tolerance noted in the protocol. The quantity of milk ingested during the first autonomous feeding was higher in the experimental group. The acquisition of food autonomy and the duration of the hospitalization stay were similar in the two groups.ConclusionsWhile our study does not affirm that an early unimodal OFS improves the premature infants’ cardiorespiratory evolution and/or the acquisition of food autonomy, it does indicate an improved food efficiency during their first autonomous feedings.The ClinicalTrials.gov identifier is NCT01116765, on May 2010.
Expression Patterns of Major Genes in Fatty Acid Synthesis, Inflammation and Oxidative Stress Related Pathways and Quality Parameters During the Transition From Colostrum to Milk in Dairy Goats
Authors: YAKAN Akın , OZKAN Huseyin , ÇAMDEVİREN Baran , KAYA Ufuk , KARAASLAN İrem , DALKIRAN Sevda 
Published: December 2020

Abstract
Colostrum is quietly different from mature milk. The molecular regulation of milk secretion and quality in the transition period from colostrum to milk in goats is largely unknown. The present study, mammary gland secretion of goats was collected in 0th, 4th, 7th, 14th and 28th days after parturition. In addition to composition and fatty acid profile of colostrum or milk, FASN, SCD, ACACA, COX-2, NRF2, TLR2, NF-kB, LTF and PTX3 genes expression patterns were determined from milk somatic cells. While somatic cell count (SCC), malondialdehyde (MDA), fat, fat-free dry matter (FFDM), protein and lactose were highest as expression levels of the oxidative and inflammatory genes (P<0.05), freezing point and electrical conductivity were lowest in colostrum. With the continuation of lactation, most of the fatty acids, n3 ratio, and odour index had increased, on the other hand, C14:0 and C16:0 had decreased. In addition, FASN was upregulated almost 3 folds in 14th day (P<0.05). While SCD was similar, ACACA was upregulated more than 5 folds in 7th and 14th days (P<0.05). Furthermore, significant correlations were determined between studied genes. Although colostrum is important for offspring health in terms of inflammation and oxidative stress related pathways, further studies are needed on complex molecular pathways including fatty acid synthesis on goat mammary gland.
Study on Surface Enhanced Raman Scattering of Au and Au@Al2O3 Spherical Dimers Based on 3D Finite Element Method
Authors: Yan Baoxin , Zhu Yanying , Wei Yong , Pei Huan 
Published: December 2020

Abstract
In this paper, the surface enhanced Raman scattering (SERS) characteristics of Au and Au@Al2O3 nanoparticle dimers were calculated and analyzed by using finite element method (3D-FEM). Firstly, the electric field enhancement factors of Au nanoparticles at the dimer gap were optimized from three aspects: the incident angle of the incident light, the radius of nanoparticle and the distance of the dimer. Then, aluminum oxide is wrapped on the Au dimer. What is different from the previous simulation is that Al2O3 shell and Au core are regarded as a whole and the total radius of Au@Al2O3 dimer is controlled to remain unchanged. By comparing the distance of Au nucleus between Au and Au@Al2O3 dimer, it is found that the electric field enhancement factor of Au@Al2O3 dimer is much greater than that of Au dimer with the increase of Al2O3 thickness. The peak electric field of Au@Al2O3 dimer moves towards the middle of the resonance peak of the two materials, but the peak electric field of Au dimer is more concentrated than that of Au dimer, so that the excitation wavelength has less influence on Raman enhancement. The maximum electric field enhancement factor 583 is reached at the shell thickness of 1 nm. Our results provide a theoretical reference for the design of SERS substrate and the extension of the research scope.
Burnout Syndrome in Spanish Medical Students
Authors: Gil-Calderón Javier , Alonso-Molero Jéssica , Dierssen-Sotos Trinidad , Gómez-Acebo Inés , Llorca Javier 
Published: December 2020

Abstract
Background: Burnout syndrome is an increasingly frequent pathology that is related to people that suffer a deterioration in their daily activities due to highly demandant psychological requirements in their workplaces. Within last decades, burnout syndrome has been studied across medical professionals, concluding that physicians suffer stress levels high enough to make them develop it. Recently, attention has also been paid to medical students, although with small samples. Given that this phenomenon may produce a huge impact in medical students´ development, the aim of this study is to analyze the influential factors that may contribute to its occurrence. Methods: The necessary information was gathered through a web-based questionnaire, divided in two parts. The first part of the survey included questions related to personal aspects of the students. Burnout related questions (second part) were divided in three subscales to evaluate exhaustion, cynicism, and academic efficacy levels. Results: Family support for studying medicine is associated with lower burnout levels in all three scales of the Maslach Burnout Inventory. The number of years spent in the degree show the opposite trend: the more years in the degree, the higher score in all burnout scales. High percentage of Spanish medical students score high in one or more subscales composing burnout syndrome.Conclusions: Burnout syndrome is a problem among medical students in Spain that increases with the number of years studying medicine. It should be also noticed that family support and vocational studies are independent factors related to lower levels of burnout.