bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gamification versus Face-to-Face Learning Approach in Point-of-Care Ultrasound Training: A Randomized Controlled Trial
Authors: Chew Keng Sheng , Lai Aaron Kuo Huo , Azhar Abdul Muhaimin Noor , Bustam Aidawati , Tiong Xun Ting , Chan Hiang Chuan , Ahmad Rashidi 
Published: March 2020

Abstract
Background: Although gamification increases user engagement, its effectiveness in point-of-care ultrasound training may yet to be fully established. This study was conducted with the primary outcome of evaluating its effectiveness in point-of-care ultrasound training workshop as compared to conventional face-to-face learning. Methods: Participants (who were junior doctors between 2 – 4 years of clinical experience) were randomized into either the (1) gamification or the (2) face-to-face learning arms. Similar educational intervention was implemented to participants in both arms but the in-gamification arm, the theory assessment was administered in the form of live quizzes with real time leaderboards, and the practical assessment was administered in the form of 3 games, i.e., ultrasound minefield, ultrasound pong and ultrasound game. Pre-test, post-test and 2 months post-training theory and practical assessments were conducted. Results: A total 32 junior doctors participated in this study (16 participants in each arm). For theory assessment, paired student’s t-test showed significant improvement in both face-to-face learning (pre-test score: 12.38 vs post-test score: 19.88; 95% CI [5.35, 9.65] p < 0.001) and gamification arms (pre-test score: 13.38 vs post-test score: 20.81; 95% CI [5.93, 8.94] p < 0.001). For the practical assessment, paired student’s t-test showed significant improvement in gamification arm (pre-test score: 12.56 vs post-test score: 18.13; 95% CI [2.44, 8.69] p<0.001) but not the in the face-to-face learning arm (pre-test score: 16.00 vs post-test score: 18.38; 95% CI [-0.17, 4.92] p<0.065). When re-tested 2 months post-training, both face-to-face learning and gamification arms showed significant improvement for both theory and practical assessment. Conclusions: Gamification approach could be an effective alternative or more effective than face-to-face learning in point-of-care ultrasound training.
Reverse fracture displacement direction closed reduction technique (RCRT) for the treatment of valgus impacted femoral neck fracture
Authors: Zhu QiuLiang , Yan Maohua , Xu Bin , Ma Jun 
Published: March 2020

Abstract
Background Impacting locked in fracture site of valgus impacted femoral neck fracture may be the difficulty to achieve anatomical reduction. The aim of this article is to introduce a novel technique to successful complete anatomical reduction. Methods After identify the fracture classification and displace direction. Two 2.0 mm diameter kirschners wire were inserted crossing the femoral head and fixed into acetabular bone. under the continuous image guiding and monitoring, reversing fracture displacement direction with internal rotation and abduction of the hip to complete the closed reduction. results anatomical reduction was achieved in X-ray and CT data postoperative. conclusions This technique provides anatomical reduction, simple procedure, and few interference of internal environment of hip and fracture site in valgus impacted femoral neck fracture.
Effect of Intraoperative Goal-directed Balanced Crystalloid versus Colloid Administration on Postoperative Cardiac Outcome
Authors: Reiterer Christian , Kabon Barbara , Taschner Alexander , Zotti Oliver , Kurz Andrea , Fleischmann Edith 
Published: March 2020

Abstract
Background : N-terminal pro brain natriuretic peptide (NT-proBNP) and troponin T are released during myocardial wall stress and/or ischemia and are strong predictors for postoperative cardiovascular complications. However, the effect of goal-directed crystalloid versus colloid administration on NT-proBNP and troponin T, especially in relatively healthy patients undergoing moderate- to high risk abdominal surgery, still remains unclear. Thus, we evaluated in this subanalysis the effect of a goal-directed crystalloid versus a goal-directed colloid fluid regimen on postoperative cardiac outcome. Methods: 30 patients were randomly assigned to receive additional fluid boluses of 6% hydroxyethyl starch 130/0.4 and 30 patients to receive lactated Ringer´s solution. Intraoperative fluid management was guided by oesophageal Doppler according to a previously published algorithm. The primary outcome were differences of maximum NT-proBNP (maxNT-proBNP) and maximum troponin T (maxTnT) concentrations during the first two postoperative days between both study groups. We defined maxNT-proBNP and maxTnT as maximum values measured 2 hours after surgery and on the first and second postoperative day. Results: In total 56 patients were analysed. There was no significant difference in postoperative maximum NT-proBNP between the colloid group (258.7 ng/L (IQR 199.4 to 782.1)) and the crystalloid group (440.3 ng/L (IQR 177.9 to 691.2)) during the first 2 postoperative days ( P = 0.29). 5 patients in the colloid group and 7 patients in the crystalloid group developed MINS ( P = 0.75). Conclusions: Postoperative cardiac outcome as defined by cardiac biomarkers was not significantly affected by goal-directed colloid administration; however, there was a tendency of lower maximum NT-proBNP concentrations in patients receiving colloids. Trial registration: ClinicalTrials.gov (NCT01195883)
De novo transcriptome assembly and hepatic gene expression analyses in overfed and ad libitum fed Muscovy and Pekin ducks and their reciprocal inter-specific Mule and Hinny hybrids
Authors: Liu Xi , Hérault Frédéric , Diot Christian , Corre Erwan 
Published: March 2020

Abstract
Background Common Pekin and Muscovy ducks and their intergeneric hinny and mule hybrids have different abilities for fatty liver production. RNA-Seq analyses from the liver of these different genetic types fed ad libitum or overfed would help to identify genes with different response to overfeeding between them. However RNA-seq analyses from different species and comparison is challenging. The goal of this study was develop a relevant strategy for transcriptome analysis and comparison between different species. Results Transcriptomes were first assembled with a reference-based approach. Important mapping biases were observed when heterologous mapping were conducted on common duck reference genome, suggesting that this reference-based strategy was not suited to compare the four different genetic types. De novo transcriptome assemblies were then performed using Trinity and Oases. Assemblies of transcriptomes were not relevant when more than a single genetic type was considered. Finally, single genetic type transcriptomes were assembled with DRAP in a mega-transcriptome. No bias was observed when reads from the different genetic types were mapped on this mega-transcriptome and differences in gene expression between the four genetic types could be identified. Conclusions Analyses using both reference-based and de novo transcriptome assemblies point out a good performance of the de novo approach for the analysis of gene expression in different species. It also allowed the identification of differences in responses to overfeeding between Pekin and Muscovy ducks and hinny and mule hybrids.
Expression and prognosis of microliposome maintenance proteins family in liver cancer
Authors: Cui Xiao-Han , Zhu Bei , Fu Li , Lao Yuan-Xiang , Zhu Chun-Fu , Qin Xihu 
Published: March 2020

Abstract
Cancer is the leading cause of death worldwide, despite advances in the treatment of cancer, mortality of liver cancer remains high. The Microliposome maintenance (MCM) family has been reported to be involved in a variety of diseases. However, little is known about its expression and prognostic value in liver cancer. In this study, we analyzed the expression of the MCM family in liver cancer tissues and normal liver tissues. Oncomine and GEPIA were used to analyze the mRNA expression level of MCM family in liver cancer and other cancers. We observed that the mRNA expression levels of MCM1-8 and MCM10 are higher than normal tissues in most cancers. In addition, the expression levels of MCM1-10 were highly expressed in liver cancer cell lines, analyzed by Cancer Cell Line Encyclopedia (CCLE) and European Bioinformatics Institute (EMBL-EBI) databases. Furthermore, LinkedOmics and GEPIA databases were used to evaluate correlation between MCM1-10 and overall survival of patients. In the LinkedOmics-based survival analysis, high expressions of MCM2-8 and MCM10 were associated with worse patient prognosis (OS). The results showed that there was no correlation between the expression levels of MCM1 and MCM9 and prognosis of patients’ prognosis. The GEPIA dataset was also used for overall survival analysis, and the results also support the results of LinkedOmics.In conclusion, the MCM family has the potential to become a biomarker, especially MCM2-8 and MCM10 are probably the most promising biomarkers for liver cancer prognosis.
Optimal Length of R-R Interval Segment Window for Lorenz Plot Detection of Paroxysmal Atrial Fibrillation by Machine Learning
Authors: Kisohara Masaya , Masuda Yuto , Yuda Emi , Ueda Norihiro , Hayano Junichiro 
Published: March 2020

Abstract
Background

Machine learning of R-R interval Lorenz plot (LP) images is a promising method for the detection of atrial fibrillation (AF) in long-term ECG monitoring, but the optimal length of R-R interval segment window for the LP images is unknown. We examined the performance of LP AF detection by differing the segment length using convolutional neural network (CNN). LP images with a 32 x 32-pixel resolution of non-overlapping R-R interval segments with lengths of 10, 20, 50, 100, 200, and 500 beats were created from 24-h ECG data in 52 patients with chronic AF and 58 non-AF controls as training data and in 53 patients with paroxysmal AF and 52 non-AF controls as test data. For each segment length, classification models were made by 5-fold cross-validation subsets of the training data and its classification performance was examined with the test data.

Results

In machine learning with the training data, the averages of cross-validation scores were 0.995 and 0.999 for 10 and 20-beat LP images, respectively, and >0.999 for 50 to 500-beat images. The classification of test data showed good performance for all segment lengths with an accuracy from 0.970 to 0.988. Positive likelihood ratio for detecting AF segments, however, showed a convex parabolic curve linear relationship to log segment length with a peak ratio of 111 at 100 beats, while negative likelihood ratio showed monotonous increase with increasing segment length.

Conclusions

This study suggests that the optimal R-R interval segment window length that maximizes the positive likelihood ratio for detecting paroxysmal AF with 32 x 32-pixel LP image is about 100 beats.
Transcriptomic and proteomic responses to herbivory in cultivated, Bt-transgenic and wild rice
Authors: Liu Yongbo , Wang Weiqing , Li Yonghua , Liu Fang , Han Weijuan , Li Junsheng 
Published: March 2020

Abstract
Background: Strategies are still employed to decrease insect damage in crop production, including conventional breeding with wild germplasm resources and transgenic technology with the insertion of foreign genes, while the insect-resistant mechanism of these strategies remains unclear. Results: Under the feeding of brown planthopper (Nilaparvata lugens), cultivated rice (WT) showed less DEGs (568) and DAPs (4) than transgenic rice (2098 and 11) and wild rice CL (1990 and 39) and DX (1932 and 25). Hierarchical cluster of DEGs showed gene expression of CL and DX were similar, slightly distinct to GT, and clearly different from WT. DEGs assigned to the GO terms were less in WT rice than GT, CL and DX, and “Metabolic process”, “cellular process”, “response to stimulus” were dominant. Wild rice CL significantly enriched in KEGG pathways of “Metabolic pathways”, “biosynthesis of secondary metabolites”, “plant-pathogen interaction” and “plant hormone signal transduction”. The iTRAQ analysis confirmed the results of RNA-seq, which showing the least GO terms and KEGG pathways responding to herbivory in the cultivated rice. Synthesize conclusions: This study demonstrated that similarity in the transcriptomic and proteomic response to herbivory for the wild rice and Bt-transgenic rice, while cultivated rice lack of enough pathways in response to herbivory. Our results highlighted the importance of conservation of crop wild species.
Risk of stroke after unilateral or bilateral TKA in 327,438 matched patients using data from the National Health Insurance Claims
Authors: Han Seung-Beom , Yoon Jung-Ro , Lee Sang-Soo , Shin Young-Soo 
Published: March 2020

Abstract
Background: Limited data is available regarding the incidence rate and risk factors for stroke associated with unilateral total knee arthroplasty (TKA) and bilateral TKA. This study aims to investigate the incidence rate and risk factors of stroke in patients treated with bilateral TKA compared with patients with unilateral TKA.Methods: In this retrospective nationwide cohort study, we compared patients undergoing unilateral TKA or bilateral TKA using data from the Korean National Health Insurance claims database between January 1, 2009 and August 31, 2017 and included patients older than 40 years of age who underwent primary TKA by the index date as documented primary diagnosis and first additional diagnosis without a history of stroke during the preceding 1 year. We used matched Cox regression models to compare the incidence rate and risk factors of newly acquired stroke among patients treated with unilateral TKA or bilateral TKA after propensity score (PS) matching.Results: In the present study, 163,719 patients who received unilateral TKA were matched to163,719 patients with bilateral TKA based on PS. The risk of stroke during the study period was lower in patients treated with bilateral TKA than in patients with unilateral TKA (adjusted hazard ratio [HR] 0.79). Patients who received bilateral TKA were at decreased risk of stroke when the following variables were present: advanced age (70-79 years, HR 0.76), female sex (HR 0.75), rural area (HR 0.77), small- or medium-sized hospital (HR 0.75), health insurance (HR 0.77), history of hypertension drug use (HR 0.75), congestive heart failure (HR 0.70), connective tissue disease (HR 0.71), diabetes (HR 0.77), and diabetes with complication (HR 0.76).Conclusions: The risk of stroke was lower in patients treated with bilateral TKA than in patients with unilateral TKA. Patients treated with bilateral TKA were at decreased risk of stroke when the following variables were present: age (70-79 years), female sex, health insurance, history of hypertension drug use, and comorbidities, such as congestive heart failure, connective tissue disease, and diabetes. More importantly, we do state that those with simultaneous bilateral TKA and staged bilateral TKA without discharge could have been healthier. Therefore, those who underwent 2 unilateral TKAs could have been at more risk of stroke, especially in the 2nd unilateral TKA.
Experimental research on flow field of a high head model pump turbine based on PIV test
Authors: Liu Demin , Zhao Yongzhi , Xu Weilin 
Published: March 2020

Abstract
Pump turbine operating conditions are complex, mainly including turbine mode and pump mode. Pump turbines have various instability problems during operation, such as S-shaped, pump hump, pressure pulsation and cavitation. PIV (Particle Image Velocimetry) is a very effective test technique for the internal flow field observation of pump turbines. In this paper, the internal flow field of pump hump, cavitation, pressure pulsation and four quadrants of the pump turbine are tested by PIV technology. The experimental observations show that the internal flow on those unstable working conditions of the pump turbine is extremely complicated. Those conditions which the vortex separation is serious and the flow angle is changed is far away the best efficiency working condition. Since the operating condition deviates from the optimal operating condition, the inflow Angle is changed and the inflow Angle is far away from the optimal inflow Angle.And the vortex induces and develops strongly by PIV test. The flow phenomenon are demonstrated at each operating points by PIV test.
Real-time surveillance of surgical margins via ICG-based near-infrared fluorescence imaging in patients with OSCC
Authors: Pan Jiongru , Deng Han , Hu Shiqi , Xia Chengwan , Chen Yongfeng , Wang Jianquan , Wang Yuxin 
Published: March 2020

Abstract
Background

Local recurrence is the main cause of death among patients with oral squamous cell carcinoma (OSCC). This study assessed near-infrared fluorescence (NIF) imaging and spectroscopy to monitor surgical margins intraoperative for OSCC.

Methods

Cytological and animal experiments were first performed to confirm the feasibility of monitoring surgical margins with NIF imaging and spectroscopy. Then, 20 patients with OSCC were included in the clinical trials. At 6–8 hours after 0.75 mg/kg indocyanine green (ICG) injection, all patients underwent surgery with NIF imaging. During the surgery, both NIF images and quantified fluorescence intensity were acquired to monitor the surgical margins.

Results

In cytological and animal experiments, the results showed it is feasible to monitor surgical margins with NIF imaging and spectroscopy. Fluorescence was detected in primary tumors in all patients. The fluorescence intensities of the tumor, peritumoral, and normal tissues were 398.863±151.47, 278.52±84.89, and 274.5±100.93 arbitrary units (AUs), respectively (P<0.05). The SBR of tumor to peritumoral tissue and normal tissues was computed to be 1.45±0.36 and 1.56±0.41 respectively. After primary tumor excision, the wounds showed abnormal fluorescence in four patients (4/20), and residual cancer cells were confirmed by pathological examination in two patients (2/20).

Conclusion

These findings confirmed the complementary value of NIF imaging during radical tumor resection of OSCC.
Evaluation of different treatment strategies between right-sided and left-sided pneumonectomy for stage I-IIIA non-small cell lung cancer patients
Authors: Jia Bo , Zheng Qiwen , Li Jianjie , Zhao Jun , Wu Meina , An Tongtong , Wang Yuyan , Zhuo Minglei , Yang Xue , Zhong Jia , Chen Hanxiao , Chi Yujia , Wang Jingjing , Zhai Xiaoyu , wang ziping 
Published: March 2020

Abstract
Background This study aimed to assess the different survival outcome of stage I-IIIA NSCLC patients who received right-sided and left-sided pneumonectomy, and to further develop the most appropriate treatment strategies. Methods We accessed data from the Surveillance, Epidemiology, and End Results database in the United States for the present study. An innovative propensity score matching analysis was used to minimize the variance between groups. Results For 2,683 patients who received pneumonectomy, cancer-specific survival (HR=0.863, 95%CI: 0.771 to 0.965, P=0.010) and overall survival (OS) (HR=0.875, 95%CI: 0.793 to 0.967, P=0.008) were significantly superior of left-sided pneumonectomy compared with right-sided pneumonectomy. Cancer-specific survival (HR=0.847, 95%CI: 0.745 to 0.963, P=0.011) and OS (HR=0.858, 95%CI: 0.768 to 0.959, P=0.007) were also significantly longer with left-sided over opposite-sided pneumonectomy after matching analysis for 2,050 patients. Adjuvant therapy could significantly prolong cancer-specific survival (67 versus 51 months, HR=1.314, 95%CI: 1.093 to 1.579, P=0.004) and OS (46 versus 30 months, HR=1.458, 95%CI: 1.239 to 1.715, P<0.001) among left-sided pneumonectomy patients after matching procedure. While adjuvant therapy did not increase cancer-specific survival for right-sided pneumonectomy patients (46 versus 42 months, HR=1.112, 95%CI: 0.933 to 1.325, P=0.236). Subgroup analysis showed that adjuvant chemotherapy could significantly improve cancer-specific survival and OS for all pneumonectomy patients. But radiotherapy was associated with worse survival for patients with right-sided pneumonectomy. Conclusions Pneumonectomy side could be deemed as an important factor when physicians choosing the most optimal treatment strategies. The abstract was presented at the 2018 American Society of Clinical Oncology Annual Meeting (Abstract #8524)
Primiparous Women’s Experiences of Normal Vaginal Delivery in Iran: A Qualitative Study
Authors: Khamehchian Marzieh , Adib-Hajbaghery Mohsen , Khayat Nastaran Heydari , Sabery Mahdieh , New Mahboubeh Rezaei 
Published: March 2020

Abstract
Primiparous Women’s Experiences of Normal Vaginal delivery in Iran: A qualitative study Abstract Background: Childbirth is considered as the most challenging psychological event in women's life. It has a powerful effect on women’s lives with long-term positive or negative impacts. Cultural, religious, and socioeconomic differences can affect women’s perception about normal vaginal delivery (NVD) experience, it is necessary to explore the primiparous women's perception about it. Methods: This qualitative study with a descriptive content analysis approach was conducted in Kashan, a city in the center of Iran. Purposive sampling was used to recruit the participants of the current study. Data was gathered by semi-structured interviews during 24 hours after normal vaginal birth among primiparous women. The Sampling started from June to October in 2016. Interviews continued till data saturation. Data saturation was achieved in the 14th interview but for assurance, it continued until the 17th one. Results: The following three main themes were extracted "immersion in stress", "pain, the essence of NVD" and "strategies for situation management". Also, seven sub themes were obtained including 'loss threat’, ‘stressful context', temporary impairment in physiologic harmony, paradoxical emotions, self-management, emotional support, and spiritual support. Conclusions: This study showed that stress and pain were two highlighted issues in NVD process. Increasing women's awareness about NVD process and what they experience during this process, familiarizing the primiparous women with the simulated delivery room, accompanying these women for emotional support, and providing spiritual support can be effective in situation management to make the child delivery a pleasant and satisfying experience.