bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acupuncture or auricular electro-acupuncture as adjuncts to lifestyle interventions for weight management in PCOS: protocol for a randomised controlled feasibility study
Authors: Ee Carolyn , Smith Caroline A. , Costello Michael , Moran Lisa , Steiner Genevieve Z. , Stepto Nigel , Cave Adele , Albrehee Atekah , Teede Helena 
Published: April 2020

Abstract
Background
Polycystic ovary syndrome (PCOS) is a prevalent women’s health condition with reproductive, metabolic, and psychological manifestations. Weight loss can improve these symptoms and is a key goal; however, many women find this difficult to achieve. Acupuncture is a Chinese medical treatment that involves insertion of very fine metal needles into specific areas of the body and has been shown to be efficacious for weight loss in non-PCOS populations. However, few studies have been conducted in women with PCOS. A variant of acupuncture, auricular electro-acupuncture (AEA), may have beneficial effects on sympathetic tone, which is associated with insulin resistance, obesity and PCOS.

Methods
This prospective three-arm open label parallel randomised controlled trial will assess feasibility and acceptability of acupuncture and/or AEA for weight loss in women with PCOS. We will enrol 39 women from the community aged between 18 and 45 years, with physician diagnosis of PCOS according to the Rotterdam criteria: body mass index (BMI) between 25 and 40 kg/m2. Women will be randomly allocated to receive one of three treatments for 12 weeks duration: body electro-acupuncture + lifestyle interventions, AEA + lifestyle interventions, or lifestyle interventions alone. The lifestyle intervention in this study is telephone-based health coaching (between 4 and 13 phone calls, depending on individual need), provided by the Get Healthy Service. Primary outcomes of the study are feasibility and acceptability of trial methods as determined by recruitment and retention rates, adherence, acceptability, credibility, and safety. Secondary outcomes include anthropometric (body weight, BMI, waist and hip circumference), metabolic (glucose tolerance and insulin sensitivity obtained from a 2-h 75 g oral glucose tolerance test with area under the curve insulin calculated using the trapezoid rule), reproductive (androgen levels, menstrual cyclicity, clinical hyperandrogenism using the Ferriman-Gallwey scoring system), autonomic (heart rate variability, blood pressure), lifestyle (physical activity levels, diet quality, weight self-efficacy), quality of life, and psychological (depression and anxiety symptoms, internal health locus of control).

Discussion
This study addresses the feasibility and acceptability of novel interventions to treat overweight/obesity in PCOS. Study findings have the potential to generate a new understanding of the role of acupuncture and auricular acupuncture in weight management.

Trial registration
Australian New Zealand Clinical Trial Registry, 8/6/18 ACTRN12618000975291
A single-arm feasibility cohort study of rivaroxaban in antiphospholipid syndrome
Authors: Legault Kimberly , Blostein Mark , Carrier Marc , Kahn Susan , Schulman Sam , Shivakumar Sudeep , Wu Cynthia , Crowther Mark A. 
Published: April 2020

Abstract
Background
There is uncertainty regarding the safety and effectiveness of direct oral anticoagulant agents in patients with antiphospholipid syndrome (APS). We performed a multicenter feasibility study to examine our ability to identify and obtain consent from eligible APS patients and to obtain 95% adherence with daily rivaroxaban administration, in order to inform and power a larger study. Clinical outcomes of bleeding and thrombosis were also collected.

Methods
APS patients with prior venous thromboembolism (VTE) were recruited over 2 years (Oct 2014–Sept 2016) and followed for ≥ 1 year. Patients were assessed clinically every 3 months and had pill counts performed every 6 months. Numbers of patients fulfilling study criteria, as well as those consenting to participate, were tracked, and percentage adherence based on pill counts was recorded. These data were compared against the feasibility endpoints. Rates of thrombosis and bleeding were calculated. Criterion for feasibility was obtaining consent from 135 of 150 identified APS patients over 2 years.

Results
Ninety-six eligible patients were identified, and 14 declined participation. Eighty-two patients were followed for a mean of 19 months, representing 129.8 patient-years. Average rivaroxaban adherence was 95.0%. During follow-up, there were 4 thromboembolic events (2 cerebrovascular and 2 VTE). There were no episodes of major bleeding.

Conclusions
Adequately powered comparative trials using patient-important outcomes in APS are unlikely to be successful due to inability to recruit sufficient numbers of study subjects. This study does not reveal a higher than expected risk of recurrent thromboembolic disease compared to historical cohorts; however, this is an uncontrolled study in relatively low-risk APS patients.

Trial registration
The study was registered with clinicaltrials.gov, identifier NCT02116036, April 16, 2014.
Fractures of implant fixtures: a retrospective clinical study
Authors: Yu Han-Chang , Kim Young-Kyun 
Published: April 2020

Abstract
Background
The aim of this study was to evaluate the factors that may affect implant fixture fractures.

Methods
Patients who experienced implant fixture removal at Seoul National University Bundang Hospital from 2007 to 2015 due to implant fixture fracture were included. Implant/crown ratio, time of implant fracture, clinical symptoms before implant fracture, treatment of fractured implants, and the success and survival rate of the replaced implants were evaluated retrospectively.

Results
Thirteen implants were fractured in 12 patients. Patient mean age at the time of fracture was 59.3 years. Of the 13 implants, 7 implants were placed at our hospital, and 6 were placed at a local clinic. The mean crown/implant ratio was 0.83:1. The clinical symptoms before fracture were screw loosening in five implants, marginal bone loss in five implants, and the presence of peri-implant diseases in five implants. All the fractured implants were removed, and 12 out of the 13 sites were re-implanted. Parafunctions were observed in two patients: one with bruxism and one with attrition due to a strong chewing habit.

Conclusions
Several clinical symptoms before the fracture of an implant can predict implant fixture failure. Therefore, if these clinical symptoms are observed, appropriate treatments can be taken before more serious complications result.
Compositional characteristics and oxidative stability of chia seed oil (Salvia hispanica L)
Authors: Abad Abrehem , Shahidi Fereidoon 
Published: April 2020

Abstract
Fatty acid composition and triacylglycerols (TAG) profile of chia seed oil were determined. The main fatty acids present in the tested oil were α-linolenic acid (Ln, 61.1%) > linoleic acid (L, 16.6%) > palmitic acid (P, 6.7%) > oleic acid (O, 6.0%) > stearic acid (S, 3.2%). Five major triacylglycerols in chia oil were LnLnLn, LnLLn, LnLnP, LnOLn, and LLLn and these contributed more than 76% to the total. The oxidative stability under autoxidative and photooxidative conditions before and after the removal of their minor components was also determined. In addition, tocols, chlorophylls and carotenoids were measured in the oil. Oil samples were stripped of their minor components by using a facile silicic acid and charcoal in one pot rather than in a column. Storage under Schaal oven condition and photooxidation were also monitored for both crude oil (non-stripped) and stripped oil using stationary phase material. Total tocopherol contents were in the order of β−/γ- 282.68, δ- 47.44, and α-tocopherols 10.94 mg/kg of oil. Stripping removed all the minor components including tocopherols, chlorophylls and carotenoids. Oxidative stability of the tested seed oil was primarily affected by its composition of fatty acids, triacylglycerols, minor components, and storage conditions.

Graphical abstract
Role of Endocannabinoids in Energy-Balance Regulation in Participants in the Postobese State—a PREVIEW Study
Authors: Drummen Mathijs , Tischmann Lea , Gatta-Cherifi Blandine , Cota Daniela , Matias Isabelle , Raben Anne , Adam Tanja , Westerterp-Plantenga Margriet 
Published: April 2020

Abstract

Context
Endocannabinoids are suggested to play a role in energy balance regulation.

Objective
We aimed to investigate associations of endocannabinoid concentrations during the day with energy balance and adiposity and interactions with 2 diets differing in protein content in participants in the postobese phase with prediabetes.

Design and Participants
Participants (n = 38) were individually fed in energy balance with a medium protein (MP: 15:55:30% of energy from protein:carbohydrate:fat) or high-protein diet (HP: 25:45:30% energy from P:C:F) for 48 hours in a respiration chamber.

Main Outcome Measures
Associations between energy balance, energy expenditure, respiratory quotient, and endocannabinoid concentrations during the day were assessed.

Results
Plasma-concentrations of anandamide (AEA), oleoylethanolamide (OEA), palmitoyethanolamide (PEA), and pregnenolone (PREG) significantly decreased during the day. This decrease was inversely related to body mass index (AEA) or body fat (%) (PEA; OEA). The lowest RQ value, before lunch, was inversely associated with concentrations of AEA and PEA before lunch. Area under the curve (AUC) of concentrations of AEA, 2-AG, PEA, and OEA were positively related to body fat% (P &lt; .05).
The HP and MP groups showed no differences in concentrations of AEA, OEA, PEA, and PREG, but the AUC of 2-arachidonoylglycerol (2-AG) was significantly higher in the HP vs the MP group.

Conclusions
In energy balance, only the endocannabinoid 2-AG changed in relation to protein level of the diet, whereas the endocannabinoid AEA and endocannabinoid-related compounds OEA and PEA reflected the gradual energy intake matching energy expenditure during the day.
Hypocalcemia After Thyroidectomy and Parathyroidectomy in a Pregnant Woman
Authors: Lebrun Benjamin , De Block Christophe , Jacquemyn Yves 
Published: April 2020

AbstractHypoparathyroidism during pregnancy is a very rare endocrine disorder. The majority of cases are postsurgical (75%). Managing pregnant or nursing women with hypoparathyroidism is challenging due to complications arising from either under- or overtreatment, including premature delivery or fetal death, abortion, stillbirth, perinatal death, and neonatal tetany. Specific adaptations are needed within each time period to meet the fetal, neonatal, and maternal calcium requirements. A systematic search was performed on PubMed using the search terms “pregnancy” and “hypoparathyroidism.” Included were articles published in English between January 1, 1966, and January 1, 2018. We provide an overview of all published cases (n = 43) of hypoparathyroidism in pregnancy, including a case report of a 29-year-old pregnant woman who underwent a total thyroidectomy before her current pregnancy because of a therapy-resistantant Graves’ disease. The procedure was complicated by postsurgical hypoparathyroidism. She carried out the pregnancy to term with minor complaints of paresthesia and muscle cramps. Furthermore, we discuss treatment, complications, and follow-up of hypoparathyroidism in pregnancy. Treatment of hypoparathyroidism in pregnancy should still be individualized, depending on the patient’s complaints and serum levels of calcium, which should be maintained in the lower normal range of 2.15 to 2.55 mmol/l, according to the literature. We recommend monitoring calcium levels every 3 to 4 weeks throughout the pregnancy, within 1 week postpartum, and monthly during lactation to ensure normocalcemia.
Outcome of upper respiratory tract infections in healthy children: Antibiotic stewardship in treatment of acute upper respiratory tract infections
Authors: Khan Ejaz Ahmed , Raja Mazhar Hussain , Chaudhry Shehla , Zahra Tehreem , Naeem Salman , Anwar Masuma 
Published: April 2020

Objective: The objective of the study was to assess the outcome of upper respiratory tract infections (URTI) in healthy children.
Methods: This descriptive study was conducted on 314 children aged 3-36 months in the paediatric outpatient clinic and emergency department with symptoms of URTI (fever, cough, rhinorrhoea) for ≤5 days. Patient’s demographics, clinical features, laboratory data and outcome were recorded. Follow up phone calls were made to parents on day 7 (response 93.6%) and day 14 (response 94.6%) to record outcome.
Results: A total of 314 children with URTIs were included. Majority (57.6%) were males and <1year of age (40%). Common manifestations of URTI were fever (89%), cough (79%), rhinorrhoea (62%), pharyngitis (79%) and conjunctivitis (46%). More than half (53%) had history of contact with URTI in a family member. Mean duration of symptoms was 2.7±1.3 days. Majority (93%) of children were given supportive treatment and only 6.7% received antibiotics initially. Most of children (76%) recovered within one week and 91.8% within two weeks with supportive care only. Only 4% children were hospitalized and 12% required follow up visit of which 16% needed oral antibiotics. Complications or deaths did not occur.
Conclusions: Majority of URTIs in healthy children resolved with supportive treatment and do not require antibiotics. Antibiotic stewardship in simple URTIs should be practiced using awareness and advocacy campaigns.
doi: https://doi.org/10.12669/pjms.36.4.1420
How to cite this:Khan EA, Raja MH, Chaudhry S, Zahra T, Naeem S, Anwar M. Outcome of upper respiratory tract infections in healthy children: Antibiotic stewardship in treatment of acute upper respiratory tract infections. Pak J Med Sci. 2020;36(4):642-646. doi: https://doi.org/10.12669/pjms.36.4.1420
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Personal and professional modeling of operational and service functioning of employees of operational divisions of internal affairs bodies
Authors: Vahnina Viktoriya , Naumova Svetlana 
Published: April 2020

The article discusses the problem of personal-professional modeling of the operational and official functioning of employees of operational units of the internal affairs bodies. A model of personal and professional suitability of employees of the units to ensure the safety of persons subject to state protection of the Ministry of Internal Affairs in the Republic of Sakha (Yakutia) is proposed, taking into account the specific characteristics of the activity and features of the region. Conceptual and theoretical modeling within the framework of personal-professional diagnostics and professional selection involves building a holistic concept of psychological diagnostics and its theoretical justification, which allows to improve the quality and efficiency of operational-service functioning. In the article, modeling is understood as a systematization of the psychological characteristics of the activities of police officers in certain typical professional situations, which allows you to create a generalized professiogram of the specialist’s activity, which is used in professional psychological selection, staff selection, and in the process of professional and psychological preparation. The object of the study is the operational and official functioning of employees of operational units. The subject of the research is the model of personal and professional suitability of employees of the operational investigative unit to ensure the safety of persons subject to state protection of the Ministry of Internal Affairs in the Republic of Sakha (Yakutia). The hypothesis of the study: the model of personal and professional suitability of an employee of the unit for ensuring the safety of persons subject to state protection of the Ministry of Internal Affairs in the Republic of Sakha (Yakutia), taking into account the specific characteristics of the activity, can improve the quality of their operational and official functioning.
The professiographic analysis made it possible to single out the basic structural elements of the personality-professional profile. The following groups of professionally important qualities are attributed to these elements: verbal thinking, emotional-volitional, communicative-organizational, moral and ethical, business qualities, as well as such a characteristic as physiological reserves of the body.
Transoral robotic surgery for the benefit of patients with head and neck cancer of unknown primary: our experience at St George’s University Hospital, London
Authors: Mistry R , Walker A , Kim D , Ofo E 
Published: April 2020

Introduction Head and neck carcinoma of unknown primary represents 1–5% of all head and neck cancers and presents a diagnostic and therapeutic dilemma. In approximately 40% of cases, a primary tumour location remains unknown despite investigation. With advancements in our understanding of the role of high-risk human papilloma virus in head and neck cancer, transoral robotic surgery presents an option for diagnosis and therapy. Materials and methods This is a retrospective case series from a single centre. Case notes were reviewed for 28 patients who had transoral robotic surgery for head and neck carcinoma of unknown primary between May 2015 and July 2019. Results Transoral robotic surgery identified an oropharyngeal primary tumour in 19 of 28 (67.8%) patients. All oropharyngeal primaries were p16 positive. The base of tongue identification rate was 63.2%. Median length of inpatient stay postoperatively was 1.0 day. Normal oral intake resumed within 48 hours in 96% (27/28) of patients. Three patients (10.3%) suffered minor postoperative bleeds that were all managed conservatively. Discussion The base of tongue primary identification rate (63.2%) in this series is consistent with that previously reported (43–63%; 95% confidence interval). Primary tumour identification rate if a patient is p16 positive is 86.3% (19/22), with 100% of these being oropharyngeal. We suggest future investigation into p16 status as a means of stratifying patients with head and neck carcinoma of unknown primary for transoral robotic surgery. Conclusion Transoral robotic base of tongue mucosectomy (or lingual tonsillectomy) is a promising technique that offers a high yield of positive identification for the primary tumour. It is well tolerated with minimal associated morbidity. Our findings are comparable with those in the current literature.
Compact multi-million Q resonators and 100  MHz passband filter bank in a thick-SOI photonics platform
Authors: Zhang Bohan , Al Qubaisi Kenaish , Cherchi Matteo , Harjanne Mikko , Ehrlichman Yossef , Khilo Anatol N. , Popović Miloš A. 
Published: April 2020

We demonstrate ring and racetrack resonators with

Q

s of 3.8 to 7.5 million and 100 MHz bandwidth racetrack resonator filters, implemented in a thick silicon-on-insulator foundry platform that features a 3 µm thick device layer. We show that special racetrack resonators (with weakly guiding straight sections that transition to strongly confining bends) implemented in this platform can be preferable to rings for applications such as integrated microwave–photonic signal processing that require filters with sub-GHz bandwidth, tens of GHz of free spectral range (FSR), and a compact footprint for dense system-on-chip integration. We demonstrate ring resonators with

7.5
×

10
6

intrinsic

Q

, but limited FSR of 5.1 GHz and a taxing footprint of

21

m
m

2

due to a large 2.6 mm bend-loss-limited radius. In comparison, we demonstrate two racetrack resonator designs with intrinsic

Q

s of

3.8
×

10
6

and

4.3
×

10
6

, larger respective FSRs of 11.6 GHz and 7.9 GHz, and less than

1

/

20

t
h

the area of the ring resonator. Using racetrack resonators, we implemented a four-channel, 100 MHz wide passband filter bank with 4.2 to 5.4 dB insertion loss to drop ports.
Explainable Machine Learning Model for Predicting GI Bleed Mortality in the Intensive Care Unit
Authors: Deshmukh Farah , Merchant Shamel S. 
Published: April 2020

INTRODUCTION:
Acute gastrointestinal (GI) bleed is a common reason for hospitalization with 2%–10% risk of mortality. In this study, we developed a machine learning (ML) model to calculate the risk of mortality in intensive care unit patients admitted for GI bleed and compared it with APACHE IVa risk score. We used explainable ML methods to provide insight into the model's prediction and outcome.

METHODS:
We analyzed the patient data in the Electronic Intensive Care Unit Collaborative Research Database and extracted data for 5,691 patients (mean age = 67.4 years; 61% men) admitted with GI bleed. The data were used in training a ML model to identify patients who died in the intensive care unit. We compared the predictive performance of the ML model with the APACHE IVa risk score. Performance was measured by area under receiver operating characteristic curve (AUC) analysis. This study also used explainable ML methods to provide insights into the model's outcome or prediction using the SHAP (SHapley Additive exPlanations) method.

RESULTS:
The ML model performed better than the APACHE IVa risk score in correctly classifying the low-risk patients. The ML model had a specificity of 27% (95% confidence interval [CI]: 25–36) at a sensitivity of 100% compared with the APACHE IVa score, which had a specificity of 4% (95% CI: 3–31) at a sensitivity of 100%. The model identified patients who died with an AUC of 0.85 (95% CI: 0.80–0.90) in the internal validation set, whereas the APACHE IVa clinical scoring systems identified patients who died with AUC values of 0.80 (95% CI: 0.73–0.86) with P value <0.001.

DISCUSSION:
We developed a ML model that predicts the mortality in patients with GI bleed with a greater accuracy than the current scoring system. By making the ML model explainable, clinicians would be able to better understand the reasoning behind the outcome.