bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dexmedetomidine as an adjunct to local anesthetics in nerve block relieved pain more effectively after TKA: a meta-analysis of randomized controlled trials
Authors: Pan Liping , Wu Hao , Liu Heng , Yang Xin , Meng Zhichao , Cao Yongping 
Published: December 2020

Abstract
Background
Dexmedetomidine has shown potential in pain control in patients undergoing total knee arthroplasty (TKA). However, the combination of nerve block and dexmedetomidine may be a preferred alternative for postoperative analgesia after TKA. The aim of this study was to perform a meta-analysis on existing randomized controlled trials (RCTs) to determine the efficacy and safety of dexmedetomidine as an adjunct to local anesthetics in nerve block after TKA.

Methods
A literature survey was conducted in the databases of PubMed, Embase, Cochrane Library, Web of science, and ScienceDirect for the RCTs completed before February 1st, 2020 that met pre-specified inclusion criteria. The primary outcomes included the pain scores, duration of analgesia, opioid consumption within 24 h postoperatively, and the level of patient satisfaction. The secondary outcomes included the motor strength, degree of sedation, postoperative nausea and vomiting, and other related complications. The methodological quality was assessed by the Cochrane risk of bias tool.

Results
The initial literature search yielded 143 studies, out of which seven studies met the inclusion criteria. The pooled data indicated that dexmedetomidine combined with local anesthetics in nerve block in TKA decreased the postoperative pain scores at rest as well as at motion (SMD = − 1.01 [95% CI − 1.29 to − 0.72], p < 0.01; SMD = − 1.01 [− 1.25 to − 0.77], p < 0.01) respectively, decreased the total opioid consumption within 24 h (SMD = − 0.63 [− 0.86 to − 0.40], p < 0.01), prolonged the duration of analgesia (SMD = 0.90 [0.64 to 1.17], p < 0.01), improved motor strength (SMD = 0.23 [0.01 to 0.45], p = 0.04), improved the degree of sedation (SMD = 0.94 [0.70 to 1.18], p < 0.01), and increased the level of patient satisfaction (SMD = 0.88 [0.60 to 1.17], p < 0.01) without increasing nausea and vomiting (RD = − 0.05 [− 0.11 to 0.01], p = 0.14), as well as other complications (RD = − 0.01 [− 0.08 to 0.07], p = 0.89), compared with local anesthetics alone.

Conclusions
It is effective and safe for dexmedetomidine as an adjunct to local anesthetics in nerve block in TKA to relieve postoperative pain, decrease total opioid consumption, prolong analgesic duration, and increase patient satisfaction without increasing related complications. Based on the quality of evidence, this meta-analysis recommends that dexmedetomidine can be used in a regular treatment regimen and as an adjunct addition to local anesthetics in nerve block for patients undergoing TKA.

Registration
This meta-analysis was prospectively registered on PROSPERO (International prospective register of systematic reviews) and the registering number was CRD42020169171.
Challenges and strategies in conducting sexual and reproductive health research among Rohingya refugees in Cox’s Bazar, Bangladesh
Authors: Ahmed Rushdia , Aktar Bachera , Farnaz Nadia , Ray Pushpita , Awal Abdul , Hassan Raafat , Shafique Sharid Bin , Hasan Md Tanvir , Quayyum Zahidul , Jafarovna Mohira Babaeva , Kobeissi Loulou Hassan , El Tahir Khalid , Chawla Balwinder Singh , Rashid Sabina Faiz 
Published: December 2020

Abstract
Background
Rohingya diaspora or Forcibly Displaced Myanmar Nationals (FDMNs), took shelter in the refugee camps of Cox’s Bazar, Bangladesh due to armed conflict in the Rakhine state of Myanmar. In such humanitarian crises, delivering sexual and reproductive health (SRH) services is critical for better health outcomes of this most-at-risk population where more than half are adolescent girls and women. This is a reflective paper on challenges and related mitigation strategies to conduct SRH research among FDMNs. The research on which this paper is based employed a concurrent mixed-method design combining a cross-sectional survey and qualitative interviews and group discussions with FDMNs to understand their SRH needs and demand-side barriers. Assessment of health facilities and qualitative interviews with healthcare providers and key stakeholders were carried out to assess facility readiness and supply-side barriers.

Challenges and strategies
The researchers faced different challenges while conducting this study due to the unique characteristics of the FDMN population and the location of the refugee camps. The three key challenges researchers encountered include: sensitivity regarding SRH in the FDMNs, identifying appropriate sampling strategies, and community trust issues. The key approaches to overcome these challenges involved: actively engaging community members and gatekeepers in the data collection process to access respondents, identifying sensitive SRH issues through survey and exploring in-depth during qualitative interviews; and contextually modifying the sampling strategy.

Conclusion
Contextual adaptation of research methods and involving community and local key stakeholders in data collection are the key lessons learnt from this study. Another important lesson was researchers’ identity and positionality as a member of the host country may create distrust and suspicion among the refugees. The multi-level complexities of humanitarian settings may introduce unforeseen challenges and interrupt research plans at different stages of research which require timely and contextual adaptations.
Amplification-free long-read sequencing reveals unforeseen CRISPR-Cas9 off-target activity
Authors: Höijer Ida , Johansson Josefin , Gudmundsson Sanna , Chin Chen-Shan , Bunikis Ignas , Häggqvist Susana , Emmanouilidou Anastasia , Wilbe Maria , den Hoed Marcel , Bondeson Marie-Louise , Feuk Lars , Gyllensten Ulf , Ameur Adam 
Published: December 2020

AbstractBackgroundOne ongoing concern about CRISPR-Cas9 genome editing is that unspecific guide RNA (gRNA) binding may induce off-target mutations. However, accurate prediction of CRISPR-Cas9 off-target activity is challenging. Here, we present SMRT-OTS and Nano-OTS, two novel, amplification-free, long-read sequencing protocols for detection of gRNA-driven digestion of genomic DNA by Cas9 in vitro.ResultsThe methods are assessed using the human cell line HEK293, re-sequenced at 18x coverage using highly accurate HiFi SMRT reads. SMRT-OTS and Nano-OTS are first applied to three different gRNAs targeting HEK293 genomic DNA, resulting in a set of 55 high-confidence gRNA cleavage sites identified by both methods. Twenty-five of these sites are not reported by off-target prediction software, either because they contain four or more single nucleotide mismatches or insertion/deletion mismatches, as compared with the human reference. Additional experiments reveal that 85% of Cas9 cleavage sites are also found by other in vitro-based methods and that on- and off-target sites are detectable in gene bodies where short-reads fail to uniquely align. Even though SMRT-OTS and Nano-OTS identify several sites with previously validated off-target editing activity in cells, our own CRISPR-Cas9 editing experiments in human fibroblasts do not give rise to detectable off-target mutations at the in vitro-predicted sites. However, indel and structural variation events are enriched at the on-target sites.ConclusionsAmplification-free long-read sequencing reveals Cas9 cleavage sites in vitro that would have been difficult to predict using computational tools, including in dark genomic regions inaccessible by short-read sequencing.
Stability analysis of a neural field self-organizing map
Authors: Detorakis Georgios , Chaillet Antoine , Rougier Nicolas P. 
Published: December 2020

AbstractWe provide theoretical conditions guaranteeing that a self-organizing map efficiently develops representations of the input space. The study relies on a neural field model of spatiotemporal activity in area 3b of the primary somatosensory cortex. We rely on Lyapunov’s theory for neural fields to derive theoretical conditions for stability. We verify the theoretical conditions by numerical experiments. The analysis highlights the key role played by the balance between excitation and inhibition of lateral synaptic coupling and the strength of synaptic gains in the formation and maintenance of self-organizing maps.
Computation offloading through mobile vehicles in IoT-edge-cloud network
Authors: Long Jun , Luo Yueyi , Zhu Xiaoyu , Luo Entao , Huang Mingfeng 
Published: December 2020

AbstractWith the developing of Internet of Things (IoT) and mobile edge computing (MEC), more and more sensing devices are widely deployed in the smart city. These sensing devices generate various kinds of tasks, which need to be sent to cloud to process. Usually, the sensing devices do not equip with wireless modules, because it is neither economical nor energy saving. Thus, it is a challenging problem to find a way to offload tasks for sensing devices. However, many vehicles are moving around the city, which can communicate with sensing devices in an effective and low-cost way. In this paper, we propose a computation offloading scheme through mobile vehicles in IoT-edge-cloud network. The sensing devices generate tasks and transmit the tasks to vehicles, then the vehicles decide to compute the tasks in the local vehicle, MEC server or cloud center. The computation offloading decision is made based on the utility function of the energy consumption and transmission delay, and the deep reinforcement learning technique is adopted to make decisions. Our proposed method can make full use of the existing infrastructures to implement the task offloading of sensing devices, the experimental results show that our proposed solution can achieve the maximum reward and decrease delay.
A hierarchical game-based power allocation algorithm in 5G heterogeneous integrated networks
Authors: Chen Geng , Ma Luyao , Zeng Qingtian , Zhang Jinjin 
Published: December 2020

AbstractIn this paper, we proposed a novel power allocation algorithm based on hierarchical game in 5G heterogeneous integrated networks. The radio network controller is the first layer, the base stations are the second layer, and the base station users are the third layer. The stackelberg game model is used between the first and second layers, in which the radio network controller is the leader and the base stations are the followers. The radio network controller sets the interference prices for the base stations and the users in the third layer can update their transmission power by non-cooperative game based on the setting interference price. According to the proposed scheme, the users power allocation can reach the Nash equilibrium through by non-cooperative game and obtain the optimal transmission power. Moreover, it is proved that the equilibrium solution is composed of the optimal price and the optimal transmission power, and the convergence of this algorithm is also verified. The simulation results show that the proposed algorithm can decrease the interference and improve the system capacity.
Approximation by bivariate generalized Bernstein–Schurer operators and associated GBS operators
Authors: Mohiuddine S. A. 
Published: December 2020

AbstractWe construct the bivariate form of Bernstein–Schurer operators based on parameterα. We establish the Voronovskaja-type theorem and give an estimate of the order of approximation with the help of Peetre’sK-functional of our newly defined operators. Moreover, we define the associated generalized Boolean sum (shortly, GBS) operators and estimate the rate of convergence by means of mixed modulus of smoothness. Finally, the order of approximation for Bögel differentiable function of our GBS operators is presented.
Dynamical analysis and adaptive fuzzy control for the fractional-order financial risk chaotic system
Authors: Sukono  , Sambas Aceng , He Shaobo , Liu Heng , Vaidyanathan Sundarapandian , Hidayat Yuyun , Saputra Jumadil 
Published: December 2020

AbstractIn this paper, a fractional-order model of a financial risk dynamical system is proposed and the complex behavior of such a system is presented. The basic dynamical behavior of this financial risk dynamic system, such as chaotic attractor, Lyapunov exponents, and bifurcation analysis, is investigated. We find that numerical results display periodic behavior and chaotic behavior of the system. The results of theoretical models and numerical simulation are helpful for better understanding of other similar nonlinear financial risk dynamic systems. Furthermore, the adaptive fuzzy control for the fractional-order financial risk chaotic system is investigated on the fractional Lyapunov stability criterion. Finally, numerical simulation is given to confirm the effectiveness of the proposed method.
On approximate solutions for a fractional prey–predator model involving the Atangana–Baleanu derivative
Authors: Ghanbari Behzad 
Published: December 2020

AbstractMathematical modeling has always been one of the most potent tools in predicting the behavior of dynamic systems in biology. In this regard, we aim to study a three-species prey–predator model in the context of fractional operator. The model includes two competing species with logistic growing. It is considered that one of the competitors is being predated by the third group with Holling type II functional response. Moreover, one another competitor is in a commensal relationship with the third category acting as its host. In this model, the Atangana–Baleanu fractional derivative is used to describe the rate of evolution of functions in the model. Using a creative numerical trick, an iterative method for determining the numerical solution of fractional systems has been developed. This method provides an implicit form for determining solution approximations that can be solved by standard methods in solving nonlinear systems such as Newton’s method. Using this numerical technique, approximate answers for this system are provided, assuming several categories of possible choices for the model parameters. In the continuation of the simulations, the sensitivity analysis of the solutions to some parameters is examined. Some other theoretical features related to the model, such as expressing the necessary conditions on the stability of equilibrium points as well as the existence and uniqueness of solutions, are also examined in this article. It is found that utilizing the concept of fractional derivative order the flexibility of the model in justifying different situations for the system has increased. The use of fractional operators in the study of other models in computational biology is recommended.
Knowledge towards standard precautions among healthcare providers of hospitals in Amhara region, Ethiopia, 2017: a cross sectional study
Authors: Kasa Ayele Semachew , Temesgen Worku Animaw , Workineh Yinager , Tesfaye Tadesse Dagget , Kerie Sitotaw , Amsalu Eden , Awoke Solomon Emishaw 
Published: December 2020

AbstractBackgroundLiteratures revealed that healthcare-associated infections are still a great concern in many developing countries including in Ethiopia. Despite the development of detailed guidelines for infection control, they remain as a critical challenge for the public health sectors and the knowledge of standard precautions among healthcare workers in many developing countries is low and not properly applied. Hence, the present study tried to determine the level of knowledge about standard precautions among healthcare workers of Amhara region, Ethiopia.MethodsInstitutional based cross-sectional study was conducted on a randomly selected public hospitals of Amhara region, Northwest Ethiopia from March 01–April 01/2017. A multistage sampling strategy was utilized to select 795 sampled healthcare workers. Data were collected using pretested self-administered questionnaire. The collected data entered using EpiData Version 3.1 statistical software and analyzed using SPSS version 20 statistical package. After using binary logistic regression, multivariable logistic regression analysis used to form the model. Variables which had statistically significant association with the outcome variable (P < 0.05) were identified as significant in the multivariable logistic regression analysis.ResultsAlmost half (49.2%) of the study participants were female healthcare workers. Three-fourth (74.3%) of the healthcare workers involved in the current study had good knowledge towards standard precautions. Good knowledge towards standard precautions refers to scoring correct responses to > 60% of knowledge items from the survey. Year of service (AOR: 0.27, 95% CI: 0.16 to 0.44), educational status (AOR: 1.7, 95% CI: 1.13 to 2.56) were among the predictor variables. In addition, physicians were 6.97 times more likely to be knowledgeable (AOR: 6.97, 95% CI 2.42 to 20.12) than laboratory technician/technology counterparts. Study participants working in medical, Gyn/obs, pediatrics wards, and OPD were about 2.23, 4.27, 2.81 and 2.52 times more likely to be knowledgeable than study participants working in surgical ward.ConclusionsOverall, the majority of healthcare workers had good knowledge of standard precautions. But variation in knowledge was detected across healthcare workers by hospital type and ward/units. This may help to design a solution by prioritizing the problem.
Why psychiatry is different - challenges and difficulties in managing a nosocomial outbreak of coronavirus disease (COVID-19) in hospital care
Authors: Rovers J. J. E. , van de Linde L. S. , Kenters N. , Bisseling E. M. , Nieuwenhuijse D. F. , Oude Munnink B. B. , Voss A. , Nabuurs-Franssen M. 
Published: December 2020

Abstract
Objective
Coronavirus disease (COVID-19) was officially declared a pandemic in March 2020. Many cases of COVID-19 are nosocomial, but to the best of our knowledge, no nosocomial outbreaks on psychiatric departments of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been reported in Europe. The different nature of psychiatry makes outbreak management more difficult. This study determines which psychiatry specific factors contributed to a nosocomial outbreak taking place in a psychiatric department. This will provide possible interventions in future outbreak management.

Method
A case series describing a nosocomial outbreak in a psychiatric department of an acute care hospital in the Netherlands between March 13, 2020 and April, 14 2020. The outbreak was analyzed by combining data from standardized interviews, polymerase chain reaction (PCR) tests and whole genome sequencing (WGS).

Results
The nosocomial outbreak in which 43% of staff of the psychiatric department and 19% of admitted patients were involved, was caused by healthcare worker (HCW)-to-HCW transmissions, as well as patient-to-HCW-to-patient transmission. We identified four aspects associated with the mental health care system which might have made our department more susceptible to an outbreak.

Conclusions
Infection control measures designed for hospitals are not directly applicable to psychiatric departments. Psychiatric patients should be considered a high-risk group for infectious diseases and customized measures should be designed and implemented. Extra attention for psychiatric departments is necessary during a pandemic as psychiatric HCWs are less familiar with outbreak management. Clear communication and governance is crucial in correctly implementing these measures.
Breeding schemes for intervertebral disc disease in dachshunds: Is disc calcification score preferable to genotyping of the FGF4 retrogene insertion on CFA12?
Authors: Bruun Camilla Sichlau , Bruun Charlotte , Marx Tine , Proschowsky Helle Friis , Fredholm Merete 
Published: December 2020

Abstract
Background
Approximately every fifth Dachshund is affected by disc herniation - a painful, hereditary condition which is typically preceded by disc calcification. Therefore, the selection of dogs suitable for breeding can be based on radiographic examination of calcification status.
Recently, an insertion of an FGF4 retrogene on CFA12 has been identified and associated with the risk of developing disc herniation in chondrodystrophic breeds and a DNA test is now offered.
In this study we investigate the incidence of disc herniation in the smooth-haired, long-haired and wire- haired Dachshund populations. We also evaluate and compare the accuracy of the two breeding schemes predicting the risk of disc herniation: the DNA test and the radiography based scheme.

Results
The overall incidence of disc herniation in Danish Dachshunds was 18% and no significant difference was found between the long-haired (17%), smooth-haired (22%) and wire-haired (16%) populations (p > 0.05). We found a significant association (p <  0.0001) between calcification status and the risk of disc herniation with a relative risk of 14.78. Using calcification status (≥ 5 or <  5 calcifications) as a risk indicator has a sensitivity of 0.79 and a specificity of 0.91.
A significant association between the FGF4 retrogene insertion and the disc calcification status was found in the wire-haired population (p <  0.0001) where the DNA test has a sensitivity of 1.0 and a specificity of 0.14. In the long- and smooth-haired populations no association was found (p > 0.05) and here the insertion allele was almost fixed.

Conclusion
Our results show that the FGF4 retrogene insertion on CFA12 is not a valid risk indicator on its own. Relying on the DNA test will have an irreversible effect on the Dachshund breed excluding almost all dogs from breeding. Thus, using calcification status remains the most reliable breeding scheme for disc herniation in Dachshunds.