bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protocol of the SOMNIA project: an observational study to create a neurophysiological database for advanced clinical sleep monitoring
Authors: van Gilst Merel M , van Dijk Johannes P , Krijn Roy , Hoondert Bertram , Fonseca Pedro , van Sloun Ruud J G , Arsenali Bruno , Vandenbussche Nele , Pillen Sigrid , Maass Henning , van den Heuvel Leonie , Haakma Reinder , Leufkens Tim R , Lauwerijssen Coen , Bergmans Jan W M , Pevernagie Dirk , Overeem Sebastiaan 
Published: November 2019

IntroductionPolysomnography (PSG) is the primary tool for sleep monitoring and the diagnosis of sleep disorders. Recent advances in signal analysis make it possible to reveal more information from this rich data source. Furthermore, many innovative sleep monitoring techniques are being developed that are less obtrusive, easier to use over long time periods and in the home situation. Here, we describe the methods of the Sleep and Obstructive Sleep Apnoea Monitoring with Non-Invasive Applications (SOMNIA) project, yielding a database combining clinical PSG with advanced unobtrusive sleep monitoring modalities in a large cohort of patients with various sleep disorders. The SOMNIA database will facilitate the validation and assessment of the diagnostic value of the new techniques, as well as the development of additional indices and biomarkers derived from new and/or traditional sleep monitoring methods.Methods and analysisWe aim to include at least 2100 subjects (both adults and children) with a variety of sleep disorders who undergo a PSG as part of standard clinical care in a dedicated sleep centre. Full-video PSG will be performed according to the standards of the American Academy of Sleep Medicine. Each recording will be supplemented with one or more new monitoring systems, including wrist-worn photoplethysmography and actigraphy, pressure sensing mattresses, multimicrophone recording of respiratory sounds including snoring, suprasternal pressure monitoring and multielectrode electromyography of the diaphragm.Ethics and disseminationThe study was reviewed by the medical ethical committee of the Maxima Medical Center (Eindhoven, the Netherlands, File no: N16.074). All subjects provide informed consent before participation.The SOMNIA database is built to facilitate future research in sleep medicine. Data from the completed SOMNIA database will be made available for collaboration with researchers outside the institute.
Association of employment status and income with self-rated health among waged workers with disabilities in South Korea: population-based panel study
Authors: Choi Jae Woo , Kim Juyeong , Han Euna , Kim Tae Hyun 
Published: November 2019

ObjectiveThis study aimed to examine the association of employment status and income with self-rated health among waged workers with disabilities in South Korea.MethodsThis study used the Panel Survey of Employment for the Disabled from 2011 to 2015. A total of 951 waged workers with disabilities were selected as baseline subjects in 2011 and were followed up for 5 years. This study used a generalised linear mixed model after adjusting for covariates.ResultsAmong 951 waged workers with disabilities, the results showed that 39.3% of workers with disabilities reported poor self-rated health. Workers with disabilities with a precarious employment status and lower income were 1.22 (95% CI 1.21 to 1.23) and 1.81 (95% CI 1.80 to 1.83) times more likely to have poor self-rated health than those with permanent employment and higher income, respectively. A subgroup analysis found that precarious workers with disabilities in lower income households had higher possibilities of poor self-rated health.ConclusionThis study suggests that precarious employment and lower income of waged workers with disabilities are significantly associated with poor self-rated health compared with those with permanent jobs or higher income.
Validity of increasing the number of motor control tests within a test battery for discrimination of low back pain conditions in people attending a physiotherapy clinic: a case–control study
Authors: Biele Christoph , Möller Dirk , von Piekartz Harry , Hall Toby , Ballenberger Nikolaus 
Published: November 2019

ObjectivesTo develop a time-efficient motor control (MC) test battery while maximising diagnostic accuracy of both a two-level and three-level classification system for patients with non-specific low back pain (LBP).DesignCase–control study.SettingFour private physiotherapy practices in northern Germany.ParticipantsConsecutive males and females presenting to a physiotherapy clinic with non-specific LBP (n=65) were compared with 66 healthy-matched controls.Primary outcome measuresAccuracy (sensitivity, specificity, Youden index, positive/negative likelihood ratio, area under the curve (AUC)) of a clinically driven consensus-based test battery including the ideal number of test items as well as threshold values and most accurate items.ResultsFor both the two and three-level categorisation system, the ideal number of test items was 10. With increasing number of failed tests, the probability of having LBP increases. The overall discrimination potential for the two-level categorisation system of the test is good (AUC=0.85) with an optimal cut-off of three failed tests. The overall discrimination potential of the three-level categorisation system is fair (volume under the surface=0.52). The optimal cut-off for the 10-item test battery for categorisation into none, mild/moderate and severe MC impairment is three and six failed tests, respectively.ConclusionA 10-item test battery is recommended for both the two-level (impairment or not) and three-level (none, mild, moderate/severe) categorisation of patients with non-specific LBP.
Medication errors during simulated paediatric resuscitations: a prospective, observational human reliability analysis
Authors: Appelbaum Nicholas , Clarke Jonathan , Feather Calandra , Franklin Bryony , Sinha Ruchi , Pratt Phillip , Maconochie Ian , Darzi Ara 
Published: November 2019

IntroductionMedication errors during paediatric resuscitation are thought to be common. However, there is little evidence about the individual process steps that contribute to such medication errors in this context.ObjectivesTo describe the incidence, nature and severity of medication errors in simulated paediatric resuscitations, and to employ human reliability analysis to understand the contribution of discrepancies in individual process steps to the occurrence of these errors.MethodsWe conducted a prospective observational study of simulated resuscitations subjected to video microanalysis, identification of medication errors, severity assessment and human reliability analysis in a large English teaching hospital. Fifteen resuscitation teams of two doctors and two nurses each conducted one of two simulated paediatric resuscitation scenarios.ResultsAt least one medication error was observed in every simulated case, and a large magnitude (>25% discrepant) or clinically significant error in 11 of 15 cases. Medication errors were observed in 29% of 180 simulated medication administrations, 40% of which considered to be moderate or severe. These errors were the result of 884 observed discrepancies at a number of steps in the drug ordering, preparation and administration stages of medication use, 8% of which made a major contribution to a resultant medication error. Most errors were introduced by discrepancies during drug preparation and administration.ConclusionsMedication errors were common with a considerable proportion likely to result in patient harm. There is an urgent need to optimise existing systems and to commission research into new approaches to increase the reliability of human interactions during administration of medication in the paediatric emergency setting.
Facial injury management undertaken at US and UK medical treatment facilities during the Iraq and Afghanistan conflicts: a retrospective cohort study
Authors: Breeze John , Bowley Douglas M , Combes James G , Baden James , Rickard Rory F , DuBose Joseph , Powers David B 
Published: November 2019

ObjectivesTo perform the first direct comparison of the facial injuries sustained and treatment performed at USA and UK deployed medical treatment facilities (MTFs) in support of the military campaigns in Iraq and Afghanistan.SettingThe US and UK Joint Theatre Trauma Registries were scrutinised for all patients with facial injuries presenting alive to a UK or US deployed MTF between 1 March 2003 and 31 October 2011.ParticipantsUS and UK military personnel, local police, local military and civilians.Primary and secondary outcome measuresAn adjusted multiple logistic regression model was performed using tracheostomy as the primary dependent outcome variable and treatment in a US MTF, US or UK military, mandible fracture and treatment of mandible fracture as independent secondary variables.ResultsFacial injuries were identified in 16 944 casualties, with the most common being those to skin/muscle (64%), bone fractures (36%), inner/middle ear (28%) and intraoral damage (11%). Facial injuries were equally likely to undergo surgery in US MTF as UK MTF (OR: 1.06, 95% CI 0.4603 to 1.142, p=0.6656); however, variations were seen in injury type treated. In US MTF, 692/1452 (48%) of mandible fractures were treated by either open or closed reduction compared with 0/167 (0%) in UK MTF (χ2: 113.6; p≤0.0001). US military casualties who had treatment of their mandible fracture (open reduction and internal fixation or mandibulo-maxillary fixation) were less likely to have had a tracheostomy than those who did not undergo stabilisation of the fractured mandible (OR: 0.61, 95% CI 0.44 to 0.86; p=0.0066).ConclusionsThe capability to surgically treat mandible fractures by open or closed reduction should be considered as an integral component of deployed coalition surgical care in the future.
Reliability and validity of the Japanese version of the Ocular Surface Disease Index for dry eye disease
Authors: Midorikawa-Inomata Akie , Inomata Takenori , Nojiri Shuko , Nakamura Masahiro , Iwagami Masao , Fujimoto Keiichi , Okumura Yuichi , Iwata Nanami , Eguchi Atsuko , Hasegawa Hitomi , Kinouchi Hikaru , Murakami Akira , Kobayashi Hiroyuki 
Published: November 2019

ObjectivesThe Ocular Surface Disease Index (OSDI) questionnaire is widely used to evaluate subjective symptoms of dry eye disease (DED) as a primary diagnostic criterion. This study aimed to develop a Japanese version of the OSDI (J-OSDI) and assess its reliability and validity.Design and settingHospital-based cross-sectional observational study.ParticipantsA total of 209 patients recruited from the Department of Ophthalmology at Juntendo University Hospital.MethodsWe translated and culturally adapted the OSDI into Japanese. The J-OSDI was then assessed for internal consistency, reliability and validity. We also evaluated the optimal cut-off value to suspect DED using an area under the receiver operating characteristic curve (AUC) analysis.Primary outcome measuresInternal consistency, test–retest reliability and discriminant validity of the J-OSDI as well as the optimal cut-off value to suspect DED.ResultsOf the participants, 152 had DED and 57 did not. The J-OSDI total score showed good internal consistency (Cronbach's alpha=0.884), test–retest reliability (interclass correlation coefficient=0.910) and discriminant validity by known-group comparisons (non-DED, 19.4±16.0; DED, 37.7±22.2; p<0.001). Factor validity was used to confirm three subscales within the J-OSDI according to the original version of the questionnaire. Concurrent validity was assessed by Pearson correlation analysis, and the J-OSDI total score showed a strong positive correlation with the Dry Eye-Related Quality-of-Life Score (γ=0.829). The optimal cut-off value of the J-OSDI total score was 36.3 (AUC=0.744).ConclusionsThe J-OSDI was developed and validated in terms of reliability and validity as an effective tool for DED assessment and monitoring in the Japanese population.
Impact of high spinal anesthesia technique on fast-track strategy in cardiac surgery: retrospective study
Authors: Hanada Satoshi , Kurosawa Atsushi , Randall Benjamin , Van Der Horst Theodore , Ueda Kenichi 
Published: November 2019

Background and objectivesAlthough high spinal anesthesia (HSA) has been used in cardiac surgery, the technique has not yet been widely accepted. This retrospective study was designed to investigate the impact of HSA technique on fast-track strategy in cardiac surgery.MethodsElective cardiac surgery cases (n=1025) were divided into two groups: cases with HSA combined with general anesthesia (GA) (HSA group, n=188) and cases with GA only (GA group, n=837). In the HSA group, bupivacaine and morphine were intrathecally administered immediately before GA was induced. Outcomes included fast-track extubation (less than 6 hours), extubation in the operating room, fast-track discharge from the intensive care unit (ICU) (less than 48 hours) and hospital (less than 7 days).ResultsIn the HSA group, 60.1% were extubated in less than 6 hours after ICU admission, as compared with 39.9% in the GA group (p<0.001). In the HSA group, 33.0% were extubated in the operating room, as compared with 4.4% in the GA group (p<0.001). LOS in the ICU was less than 48 hours in 67.6% in the HSA group, as compared with 57.2% of those in the GA group (p=0.033). LOS in the hospital was less than 7 days in 63.3% in the HSA group, as compared with 53.5% in the GA group (p=0.084).ConclusionsHSA technique combined with GA in cardiac surgery increased the rate of fast-track extubation (less than 6 hours) when compared with GA only.
Comparison of diagnostic methods for uterine health in dairy cattle on different days postpartum
Authors: Kusaka Hiromi , Hasegawa Ryo , Nishimoto Namiko , Kawahata Masatoshi , Miura Hiroshi , Kikuchi Motohiro , Sakaguchi Minoru 
Published: November 2019

BackgroundUterine health status is a key factor for dairy management.MethodsThe uteri of 28 Holstein cows were assessed weekly by three different methods: ultrasonography (UT), Metricheck device (MT) and cytobrush (CYT), during two weeks to seven weeks postpartum.ResultsThe percentage of cows with an MT‐positive, UT‐positive and CYT‐positive result decreased dramatically at three weeks, four weeks and five weeks postpartum, respectively. The agreement of the results was poor or weak within six weeks postpartum (κ=0.09–0.35), and only at seven weeks moderate or good agreement was achieved (κ=0.60–0.70). When comparing the results obtained by UT and MT, 30 per cent or more of the total cows had conflicting results from postpartum three weeks to six weeks. The uterine health of cows was re‐evaluated by the combined usage of UT and MT referring to CYT. The highest sensitivity was achieved when positive individuals were identified as either MT‐positive or UT‐positive, whereas the highest specificity occurred when results were positive by both MT‐ and UT‐ methods.ConclusionThe accuracy of early postpartum uterine health status by three methods depended heavily on the time postpartum. The combined use of UT and MT is a practical candidate for cow‐side monitoring method of uterine health.
A high current focused electron ring-beam column design
Authors: Balamuniappan Pranesh , Ang Wei Kean , Khursheed Anjam 
Published: November 2019

There are many applications in electron microscopy, electron spectroscopy, as well as accelerator physics that require the combination of minimizing a focused electron beam’s probe size while maximizing its beam current. This paper describes how this can be done through the use of annular focused electron beam column designs, where an electron beam is propagated and focused in the form of a ring beam. For probe semi-angles of [Formula: see text] radians, a column consisting of two identical electric sectors and two identical focusing lenses functioning with odd symmetry will be presented, together with a wide-angle cold field emission gun design. The column is designed to cancel energy dispersion while limiting geometric aberrations to the third order at the point of final focus. This design is predicted to have over two orders of magnitude higher beam current than the corresponding conventional on-axis focused electron beam columns for the same final probe size. For a 1.2 keV annular electron beam, simulation results predict a spot radius of 4.8 nm at a working distance of 3.4 mm, final beam angle of [Formula: see text] mrad, and energy spread of [Formula: see text] eV.
Beam optics of a superconducting proton-therapy gantry with a large momentum acceptance
Authors: Nesteruk Konrad P. , Calzolaio Ciro , Seidel Mike , Schippers Jacobus M. 
Published: November 2019

In proton therapy, the last part of the beam transport system is installed on a rotatable gantry, so that the beam can be aimed at the tumor from different angles. Since such a gantry system consists of many dipole and quadrupole magnets, it is typically a 100–200 tons device of more than 10 m in diameter. The use of superconducting (SC) magnets for proton therapy allows gantries to be significantly lighter and potentially smaller, which is attractive for this medical application. In addition to that, SC combined function magnets enable beam optics with a very large momentum acceptance. The latter can be advantageous for patient treatment, since the irradiation time can then be significantly reduced by avoiding magnet current changes. To design such an achromatic system, we performed precise high-order calculations. To reach the required accuracy and to check consistency of the obtained results, we have used different simulation tools in our iterative design approach. Here, we will describe our beam optics calculations in the code COSY Infinity and particle tracking using OPAL (open source software from PSI) in 3D field maps obtained from detailed magnet calculations performed in Opera. Our method has shown to be advantageous in a complicated beam optics study and it reduces the risk of systematic errors in a design.
Gain-of-Function RHOA Mutations Promote Focal Adhesion Kinase Activation and Dependency in Diffuse Gastric Cancer
Authors: Zhang Haisheng , Schaefer Antje , Wang Yichen , Hodge Richard G. , Blake Devon R. , Diehl J. Nathaniel , Papageorge Alex G. , Stachler Matthew D. , Liao Jennifer , Zhou Jin , Wu Zhong , Akarca Fahire G. , de Klerk Leonie K. , Derks Sarah , Pierobon Mariaelena , Hoadley Katherine A. , Wang Timothy C. , Church George , Wong Kwok-Kin , Petricoin Emanuel F. , Cox Adrienne D. , Lowy Douglas R. , Der Channing J. , Bass Adam J. 
Published: November 2019

Abstract

Diffuse gastric cancer (DGC) is a lethal malignancy lacking effective systemic therapy. Among the most provocative recent results in DGC has been that of highly recurrent missense mutations in the GTPase RHOA. The function of these mutations has remained unresolved. We demonstrate that RHOAY42C, the most common RHOA mutation in DGC, is a gain-of-function oncogenic mutant, and that expression of RHOAY42C with inactivation of the canonical tumor suppressor Cdh1 induces metastatic DGC in a mouse model. Biochemically, RHOAY42C exhibits impaired GTP hydrolysis and enhances interaction with its effector ROCK. RHOAY42C mutation and Cdh1 loss induce actin/cytoskeletal rearrangements and activity of focal adhesion kinase (FAK), which activates YAP–TAZ, PI3K–AKT, and β-catenin. RHOAY42C murine models were sensitive to FAK inhibition and to combined YAP and PI3K pathway blockade. These results, coupled with sensitivity to FAK inhibition in patient-derived DGC cell lines, nominate FAK as a novel target for these cancers.

Significance:
The functional significance of recurrent RHOA mutations in DGC has remained unresolved. Through biochemical studies and mouse modeling of the hotspot RHOAY42C mutation, we establish that these mutations are activating, detail their effects upon cell signaling, and define how RHOA-mediated FAK activation imparts sensitivity to pharmacologic FAK inhibitors.
See related commentary by Benton and Chernoff, p. 182.
This article is highlighted in the In This Issue feature, p. 161
Butterfly diversity throughout Midnapore urban area in West Bengal, India
Authors: Biswas Surjyo Jyoti , Patra Debarun , Roy Soumyajit , Giri Santosh Kumar , Pal Suman , Hossain Asif 
Published: November 2019

Butterflies have always attracted attention due to their unique colourations. As most butterflies are highly specific in their niche utilisation, abundance of the species in a locality may advocate status of ecosystem functioning and environmental health. In recent times, different anthropogenic activities and unscientific management of nature have resulted in a decline of butterfly communities at a rapid rate. The objective of the present study is to study butterfly diversity in and around Midnapore Town, West Bengal, India. A total of 82 butterfly species belonging to six families were recorded during the two years of the study period. Of the six families Nymphalidae is the most abundant family comprising 42.54% of the total population followed by Lycaenidae (22.5%), Pieridae (19.03%), Papilionidae (8.58%), Hesperiidae (7.24%), and Riodinidae (0.11%). Different diversity indices, Lorenz curve, Whittaker plot, and Gini index show high diversity in the butterfly community structure. As Midnapore Town is the connecting area between the plains of Bengal and Chota Nagpur Plateau, the present study may be the baseline for further ecological, environmental, and conservation studies.
New distribution records in the orchid flora of Tripura, India
Authors: Adit Arjun , Koul Monika , Tandon Rajesh 
Published: November 2019

Ten species of orchids belonging to eight genera are recorded for the first time from Tripura State of India. The taxa include Bulbophyllum affine Wall. ex Lindl., Bulbophyllum lobbii Lindl., Coelogyne suaveolens (Lindl.) Hook.f., Dendrobium tortile Lindl., Micropera pallida Lindl., Mycaranthes floribunda (D.Don) S.C.Chen & J.J.Wood, Pinalia acervata (Lindl.) Kuntze, Pinalia globulifera (Seidenf.) A.N.Rao, Thelasis khasiana Hook.f. and Trichoglottis ramosa (Lindl.) Senghas. Geographical distribution along with detailed descriptions and photographs of the recorded species are provided.
Bone fractures in roadkill Northern Tamandua Tamandua mexicana (Mammalia: Pilosa: Myrmecophagidae) in Costa Rica
Authors: Arguedas Randall , López Elisa C. , Ovares Lizbeth 
Published: November 2019

Northern Tamandua Tamandua mexicana is one of the most common roadkill species encountered on Costa Rican highways. Ten roadkill Northern Tamanduas were collected along different roads in Costa Rica and moved to a veterinary facility where appendicular radiologic studies were undertaken. The number of fractures present in each individual varied from zero to five (mean=2.6), with only one animal sustaining no fractures at all. Most fractures were present in the humerus (31%), followed by the ulna and ilium (both 19%), whilst the cranial portion of the body represented the highest number of fractures (61%). These data can contribute, not only to establishing causes of animal-road-mortalities, but also to the future understanding and decision-making of clinical actions for animals injured on the roads.