bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk disclosure and informed consent: Practice caveats in the post Montgomery era
Authors: Lee Danny W. H. , Lai Paul B. S. 
Published: April 2020

AbstractThe UK Supreme Court decision in Montgomery v Lanarkshire Health Board has overturned the use of the “accepted practice test” (Bolam) in deciding breach of duty cases related to risk disclosure and informed consent. Following Montgomery, a doctor is under a legal duty to take reasonable care to ensure his patient is aware of any material risks involved in the recommended treatment, and of any reasonable alternative or variant treatments. Based on Montgomery and a number of relevant published cases, this article highlights some practice caveats for surgeons to take note of when they participate in the consent process with the following headings: the objective and subjective elements of the legal test of materiality of risks; postoperative risks, follow‐up and management; timing and adequacy of risk disclosure; withholding information and therapeutic exception; and the incorporation of Montgomery into local professional code and case law. In order to minimize legal risks, surgeons are also encouraged to keep abreast of the medico‐legal development in this area, to reflect on their own practices, and to take proactive steps to enhance their interactions with patients.
Evaluation of the anterior inferior tibiofibular and anterior talofibular ligaments using 2D oblique coronal imaging and 3D isotropic resolution T2‐weighted fast spin‐echo sequences at 3.0 T: Is there additional diagnostic value?
Authors: Khil Eun Kyung , Cha Jang Gyu , Lee Young Koo , Kim Hyun‐Joo 
Published: April 2020

AbstractIntroductionTo compare diagnostic performance of additional two‐dimensional (2D) oblique coronal view and three‐dimensional (3D) T2‐weighted fast spin‐echo(FSE) images for diagnosing injury of the anterior inferior tibiofibular (AiTFL) and anterior talofibular ligaments (ATFL).MethodsThis study included 48 patients with ankle sprain who had undergone MRI using standard protocol and two additional sequences with 2D oblique coronal and 3D isotropic images, followed by arthroscopic surgery. Ligament injuries was subdivided by intact tendon, partial or complete tear. Retrospectively, two musculoskeletal radiologists respectively reviewed three image sets of MR including 2D axial image only (set 1), 2D axial and oblique coronal images (set 2), and 2D axial with 3D‐isotropic images (set 3). Using arthroscopic findings as reference standard, diagnostic performances of both methods were analysed by the area under the curve (AUC).ResultsArthroscopy confirmed 13 AiTFL and 41 ATFL injuries. For AiTFL, when set 1 and set 3 were compared, AUC value was significantly higher for set 3 (P < 0.05). However, there was no significant difference between AUC values for set 2 and set 3 sequences by either reader for either type of tear (P > 0.05). For ATFL, both readers found there was no significant difference in AUC values between set 1 and set 3 and between set 2 and set 3.ConclusionAdditional oblique coronal sequence demonstrated better diagnostic performance for AiTFL injury than conventional and isotropic imaging did. This sequence showed as much diagnostic accuracy as isotropic sequence for evaluation of ATFL injury.
Hospital admission and associated factors among individuals presenting to healthcare facilities for low back pain in Ethiopia
Authors: Beyera Getahun Kebede , O'Brien Jane , Campbell Steven 
Published: April 2020

AbstractAimThe aim of this paper is to analyze hospital admission and associated factors following presentation to healthcare facilities for low back pain (LBP) in Ethiopia.MethodsA population‐based cross‐sectional study was conducted between June and November 2018 in South‐west Shewa zone of Oromia regional state. Data were collected by face‐to‐face interviews of adults (≥18 years) with self‐reported LBP using a newly developed and validated instrument. All the statistical analyses of (n = 543) individuals with a 1‐year history of presentation to healthcare facilities for LBP were performed using R version 3.5.1. The log‐binomial regression model was fitted and prevalence ratios with 95% confidence intervals (CIs) were calculated to identify factors associated with hospitalization and the significance level was considered at the P value of ≤ .05.ResultsThe proportion of hospital admissions following presentation to healthcare facilities for LBP was 14.4%, 95% CI 11.4‐17.3, with an average length of stay (LOS) 7.4 days, 95% CI 6.4‐8.8. The admission rate was 18.5%, 95% CI 13.4‐23.3 in females and 11.4%, 95% CI 8.0‐15.1 in males. Multiple factors, such as gender, age, living conditions, residential environment, alcohol consumption status, intensity of pain, and presence of additional spinal pain, were found to be independently associated with hospitalization for LBP.ConclusionsThe burden on the individuals and the Ethiopian healthcare system as a result of LBP is evident by the rate of hospital admissions. Further evidence on LBP case referral procedures is needed to allow health policy makers to develop appropriate management strategies capable of dealing with the increasing epidemiology of LBP.
Estimation of genomic breed composition of individual animals in composite beef cattle
Authors: Li Z. , Wu X.‐L. , Guo W. , He J. , Li H. , Rosa G. J. M. , Gianola D. , Tait R. G. , Parham J. , Genho J. , Schultz T. , Bauck S. 
Published: April 2020

SummaryThree statistical models (an admixture model, linear regression, and ridge‐regression BLUP) and two strategies for selecting SNP panels (uniformly spaced vs. maximum Euclidean distance of SNP allele frequencies between ancestral breeds) were compared for estimating genomic‐estimated breed composition (GBC) in Brangus and Santa Gertrudis cattle, respectively. Animals were genotyped with a GeneSeek Genomic Profiler bovine low‐density version 4 SNP chip. The estimated GBC was consistent among the uniformly spaced SNP panels, and values were similar between the three models. However, estimated GBC varied considerably between the three methods when using fewer than 10 000 SNPs that maximized the Euclidean distance of allele frequencies between the ancestral breeds. The admixture model performed most consistently across various SNP panel sizes. For the other two models, stabilized estimates were obtained with an SNP panel size of 20 000 SNPs or more. Based on the uniformly spaced 20K SNP panel, the estimated GBC was 69.8–70.5% Angus and 29.5–30.2% Brahman for Brangus, and 63.9–65.3% Shorthorn and 34.7–36.1% Brahman in Santa Gertrudis. The estimated GBC of ancestries for Santa Gertrudis roughly agreed with the pedigree‐expected values. However, the estimated GBC in Brangus showed a considerably larger Angus composition than the pedigree‐expected value (62.5%). The elevated Angus composition in the Brangus could be due to the mixture of some 1/2 Ultrablack animals (Brangus × Angus). Another reason could be the consequences of selection in Brangus cattle for phenotypes where the Angus breed has advantages.
Effects of blood pump orientation on performance: In vitro assessment of universal advanced ventricular assist device
Authors: Miyamoto Takuma , Kado Yuichiro , Polakowski Anthony R. , Horvath David J. , Kuban Barry D. , Fukamachi Kiyotaka , Karimov Jamshid H. 
Published: April 2020

AbstractAn advanced ventricular assist device (VAD), which is under development in our institution, has specific features that allow changes in the axial rotor position and pump performance by intrapump pressure difference. However, performance could be influenced by the pump orientation because of the effect of gravity on the rotor position. The purpose of this study was to evaluate the effects of pump orientation on the pump performance, including pulse pressure and regurgitant flow through the pump when the pump was stopped. Bench testing of the VAD was performed on a static or pulsatile mock loop with a pneumatic device to simulate the native ventricle. The pump performance, including pressure–flow curve, pulsatility, and regurgitant flow, was evaluated at several angles, ranging from −90° (inlet pointed upward) to +90° (inlet pointed downward) at pump speeds of 2000, 2500, 3000, and 3500 rpm. The pump performance was slightly lower at +90° at all rotational speeds, compared with −90°. The pulse pressure on the pulsatile mock loop (80 bpm) was 50 mm Hg without pump support, remained at 50 mm Hg during pump support, and was not changed by orientation (−90°, 0°, and +90°). When the pump was stopped, the regurgitant flow was near 0 L/min at all angles. Pump orientation had a minor effect on pump performance, with no effect on pulse pressure or regurgitant flow when the pump was stopped. This indicates that the effect of gravity on the rotor assembly is insignificant.
Salivary pepsin A detection related to gastro‐oesophageal reflux episodes in children undergoing impedance probe monitoring
Authors: Haddad Hadeel Alatrash , He Zhaoping , Shaffer Stephen E. , Molle‐Rios Zarela L. 
Published: April 2020

AbstractAimGastro‐oesophageal reflux is routinely diagnosed with invasive intraluminal impedance pH probe monitoring. This study aimed to determine whether gastric pepsin A detected in saliva of children correlates with gastro‐oesophageal reflux.MethodsPatients undergoing probe monitoring were prospectively recruited between 2014 and 2016 at a paediatric hospital. Standard impedance and demographic data were obtained from electronic medical records. Salivary samples were collected during impedance and measured for gastric pepsin A with an enzyme‐linked immunosorbent assay. Impedance probe and pepsin data were analysed and compared for correlation.ResultsFrom 52 enrolled subjects, 28 males and 24 females with mean age 8.0 ± 5.9 and range 0.58‐18.0 years, 417 salivary samples were collected. Positive pepsin was found in 14% of samples and 48% patients. The sensitivity of pepsin A in predicting an abnormal impedance was 43% and specificity, 50%. Among pepsin A positive samples, 72% corresponded with a gastro‐oesophageal reflux episode. Pepsin peak levels significantly correlated with acidic reflux.ConclusionPepsin A was presented in saliva of children undergoing gastro‐oesophageal reflux disease investigation. Positive pepsin A was associated with a gastro‐oesophageal reflux episode, and its peak value correlated with acidic reflux. Salivary pepsin as a marker for gastro‐oesophageal reflux needs further investigation.
Towards learning analytics adoption: A mixed methods study of data‐related practices and policies in Latin American universities
Authors: Hilliger Isabel , Ortiz‐Rojas Margarita , Pesántez‐Cabrera Paola , Scheihing Eliana , Tsai Yi‐Shan , Muñoz‐Merino Pedro J. , Broos Tom , Whitelock‐Wainwright Alexander , Gašević Dragan , Pérez‐Sanagustín Mar 
Published: April 2020

AbstractIn Latin American universities, Learning Analytics (LA) has been perceived as a promising opportunity to leverage data to meet the needs of a diverse student cohort. Although universities have been collecting educational data for years, the adoption of LA in this region is still limited due to the lack of expertise and policies for processing and using educational data. In order to get a better picture of how existing data‐related practices and policies might affect the incorporation of LA in Latin American institutions, we conducted a mixed methods study in four Latin American universities (two Chilean and two Ecuadorian). In this paper, the qualitative data were based on 37 interviews with managers and 16 focus groups with 51 teaching staff and 45 students; the quantitative data were collected through two surveys answered by 1884 students and 368 teachers, respectively. The findings reveal opportunities to incorporate LA services into existing data practices in the four case studies. However, the lack of reliable information systems and policies to regulate the use of data imposes challenges that need to be overcome for future LA adoption.
B cell rich meningeal inflammation associates with increased spinal cord pathology in multiple sclerosis
Authors: Reali Camilla , Magliozzi Roberta , Roncaroli Federico , Nicholas Richard , Howell Owain W. , Reynolds Richard 
Published: April 2020

AbstractIncreased inflammation in the cerebral meninges is associated with extensive subpial cortical grey matter pathology in the forebrain and a more severe disease course in a substantial proportion of secondary progressive multiple sclerosis (SPMS) cases. It is not known whether this relationship extends to spinal cord pathology. We assessed the contribution of meningeal and parenchymal immune infiltrates to spinal cord pathology in SPMS cases characterized in the presence (F+) or absence (F−) of lymphoid‐like structures in the forebrain meninges. Transverse cryosections of cervical, thoracic and lumbar cord of 22 SPMS and five control cases were analyzed for CD20+ B cells, CD4+ and CD8+ T cells, microglia/macrophages (IBA‐1+), demyelination (myelin oligodendrocyte glycoprotein+) and axon density (neurofilament‐H+). Lymphoid‐like structures containing follicular dendritic cell networks and dividing B cells were seen in the spinal meninges of 3 out of 11 F+ SPMS cases. CD4+ and CD20+ cell counts were increased in F+ SPMS compared to F− SPMS and controls, whilst axon loss was greatest in motor and sensory tracts of the F+ SPMS cases (P < 0.01). The density of CD20+ B cells of the spinal leptomeninges correlated with CD4+ T cells and total B and T cells of the meninges; with the density of white matter perivascular CD20+ and CD4+ lymphocytes (P < 0.05); with white matter lesion area (P < 0.05); and the extent of axon loss (P < 0.05) in F+ SPMS cases only. We show that the presence of lymphoid‐like structures in the forebrain is associated with a profound spinal cord pathology and local B cell rich meningeal inflammation associates with the extent of cord pathology. Our work supports a principal role for B cells in sustaining inflammation and tissue injury throughout the CNS in the progressive disease stage.
Towards an approach using grammars for automatic classification of masses in mammograms
Authors: Dias Pedro Ricardo Wandré , Machado‐Lima Ariane , Nunes Fátima L. S. 
Published: April 2020

AbstractApproximately 15% of all cancer deaths among women worldwide is due to breast cancer. Mammography is one of the most useful methods for the early detection of this disease. Over the last decade, several papers were published reporting the usage of different computer‐aided diagnosis systems using pattern recognition techniques as a second opinion to obtain a more accurate diagnosis. However, the theory of formal languages has not been explored in this field. In this context, the main contribution of this study is to present the usage of a new syntactic approach that is able to classify breast masses found in mammograms as benign or malignant. The experimental tests were performed using a dataset that contains 111 images from different sources. The grammar‐based classifiers achieved accuracy values ranging from 89% to 100% depending on the features and the model employed. Furthermore, to achieve a feature dimension reduction, a feature selection technique based on the Gini importance of each feature was employed. Additionally, we compared the obtained results with the grammar‐based classifiers to the more traditional classifiers used in this research area, such as artificial neural networks, support vector machines, k‐nearest neighbors, and random forest. The best result achieved by the grammar‐based classifiers was approximately 10% higher, in terms of accuracy, than the best results produced by the traditional classifiers, showing the strength of this grammatical approach.
Regional right ventricular longitudinal systolic strain for detection of severely impaired right ventricular performance in pulmonary hypertension
Authors: Zhai Ya‐Nan , Li Ai‐Li , Tao Xin‐Cao , Xie Wan‐Mu , Wan Jun , Zhang Yu , Zhai Zhen‐Guo , Liu Min 
Published: April 2020

AbstractObjectivesRight ventricular (RV) function is identified as a key determinant of the outcome in patients with pulmonary hypertension (PH). Several studies have assessed the role of peak global longitudinal RV strain in PH patients; however, less emphasis was given to the RV regional longitudinal strain. The aim of this study was to evaluate the regional RV systolic strain in PH patients and investigate the relationship of these parameters with the severity of PH.MethodsRV regional longitudinal peak systolic strain (LPSS) and strain rate (LPSSR) were measured using speckle tracking echocardiography on 100 patients with PH who underwent right heart catheterization, and 29 control subjects. Severe PH was identified by a decreased cardiac index (CI) (<2.0 L/min/m2).ResultsLPSS and LPSSR of the RV free wall were significantly lower in PH patients than control subjects, especially when comparing the basal and mid regions (P < .001). When comparing severe PH and nonsevere PH, basal and mid LPSS and LPSSR were significantly lower (P < .001). RV free wall mid LPSSR correlated with CI (r = −.703, P < .001). In the multiple logistic regression analysis, mid LPSSR was identified as an independent predictor of severe PH (odds ratio 1.82; 95% confidential interval 1.39–2.40; P < .001). In the receiver operating characteristics curve analysis, a cutoff value of mid LPSSR of −0.92 s−1 predicted severe PH, with a sensitivity and specificity of 75.0% and 93.7%, respectively (AUC = 0.889, P < .001).ConclusionsRV free wall mid longitudinal peak systolic strain rate may be useful for the detection of severely impaired RV performance in PH.
Multimodality approach to the diagnosis and management of constrictive pericarditis
Authors: Ansari‐Gilani Kianoush , Gilkeson Robert C. , Kikano Elias G. , Hoit Brian D. 
Published: April 2020

AbstractDespite advances in cardiovascular imaging, the diagnosis of constrictive pericarditis remains challenging. A multimodality approach to the diagnosis of CP is essential to (a) fully assess the extent of pericardial thickening and calcification, (b) detect the functional and hemodynamic consequences of the constricting pericardium, and (c) implement the optimal management strategy in these often complex cases. This case‐based review highlights the role and diagnostic ambiguities of multimodality imaging.
Effect of augmented reality simulation on administration of local anaesthesia in paediatric patients
Authors: Mladenovic Rasa , Dakovic Dragana , Pereira Leandro , Matvijenko Vladimir , Mladenovic Kristina 
Published: April 2020

AbstractBackgroundAugmented reality (AR) is a simulation of a three‐dimensional environment created using hardware and software that provides the user with realistic experiences and ability to interact. The aim of the study was to evaluate the impact of AR simulator on the perception of learning and acute stress level in students administering local anaesthesia to paediatric patients relative to standard teaching methods.Material and methodsThe prospective study included 21 fourth‐ and fifth‐year students enrolled in 5‐year dental programme. In addition to conventional training, the students of the study group used the augmented reality simulator in a dental office 2 hours weekly in 2 weeks. The level of salivary cortisol was measured before and after the anaesthetic procedure as one of the indicators of acute stress.ResultsA statistically significant shorter time to perform infiltrative anaesthesia technique for the anterior superior alveolar nerve was observed in students using the AR technique (28.91 ± 9.06 seconds in the study group and 39.80 ± 9.29 seconds in the control group). The level of cortisol before and after anaesthesia was statistically significant in all subjects (cortisol concentration was 0.53 μg/dL before anaesthesia and 2.44 μg/dL after the procedure); however, there was no statistically significant difference between the groups.ConclusionThe AR concept may influence better manipulation and control of the syringe in students administering their first anaesthetic injection to paediatric patients, but may not reduce acute stress.
Scintigraphic evaluation of salivary gland function in thyroid cancer patients after radioiodine remnant ablation
Authors: Krčálová Eva , Horáček Jiří , Gabalec Filip , Žák Pavel , Doležal Jiří 
Published: April 2020

Radioiodine (131I, RAI) has traditionally been used in thyroid cancer treatment but its benefit should be balanced against possible risks. Among them, salivary gland dysfunction has often been discussed, although the reported data have been inconsistent. The aim of our prospective study was to evaluate salivary gland function in 31 thyroidectomised patients (6 men, 25 women; median age 52 yr) before and 4–6 months after RAI remnant ablation (RRA), using activity of 3.7 GBq 131I‐NaI. Salivary gland uptake and excretion fractions were quantitatively assessed with 99mTc – pertechnetate salivary gland scintigraphy. Pre‐ and post‐treatment values were compared using Wilcoxon signed rank test. No statistically significant difference in the pre‐ and post‐treatment values was observed in parotid or submandibular glands uptake, or in the parotid or submandibular excretion fractions. The calculated power for minimum relevant difference of 25% with the sample size of 31 ranged between 86% and 96% for the individual variables, making our negative results reasonably reliable. The results suggest that RRA with the most commonly used activity of 3.7 GBq has no important impact on salivary gland function. Therefore, the concerns about putative salivary gland functional deterioration following RRA are probably unjustified.
Neutrosophic structured element
Authors: Edalatpanah Seyyed Ahmad 
Published: April 2020

AbstractThis paper presents a new concept in neutrosophic sets (NS) called neutrosophic structured element (NSE). Based on this concept, we define the operational laws, score function, and some aggregation operators of NS. Finally, as an application of this concept, we propose a decision‐making method for a multi‐attribute decision making (MADM) problem under NSE information. The results indicate that this concept is a useful tool for dealing with neutrosophic decision problems.