bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Relationship between Learner Engagement and Teaching Effectiveness: A Novel Assessment of Engagement in Continuing Medical Education
Authors: Stephenson Christopher R. , Bonnes Sara L. , Sawatsky Adam P. , Richards Lukas W. , Schleck Cathy D. , Mandrekar Jayawant N. , Beckman Thomas J , Wittich Christopher M. 
Published: June 2020

Abstract
Background
Continuing medical education (CME) often uses passive educational models including lectures. However, numerous studies have questioned the effectiveness of these less engaging educational strategies. Studies outside of CME suggest that engaged learning is associated with improved educational outcomes. However, measuring participants’ engagement can be challenging. We developed and determined the validity evidence for a novel instrument to assess learner engagement in CME.
Methods
We conducted a cross-sectional validation study at a large, didactic-style CME conference. Content validity evidence was established through review of literature and previously published engagement scales and conceptual frameworks on engagement, along with an iterative process involving experts in the field, to develop an eight-item Learner Engagement Instrument (LEI). Response process validity was established by vetting LEI items on item clarity and perceived meaning prior to implementation, as well as using a well-developed online platform with clear instructions. All item responses were double-coded for statistical analysis, using a dedicated survey research center. Internal structure validity evidence was based on factor analysis and calculating internal consistency reliability. Relations to other variables validity evidence was determined by examining associations between LEI and previously validated CME Teaching Effectiveness (CMETE) instrument scores. Following each presentation, all participants were invited to complete the LEI and the CMETE.
Results
A total of 2486 LEI and CMETE surveys were submitted during the 5-day course. Correlations between the LEI and the CMETE overall scores were strong (r = 0.80). Internal consistency reliability for the LEI was excellent (Cronbach’s alpha = 0.96). To support validity to internal structure, a factor analysis was performed and revealed a two dimensional instrument consisting of internal and external engagement domains. The internal consistency reliabilities were 0.96 for the internal engagement domain and 0.95 for the external engagement domain.
Conclusion
Engagement, as measured by the LEI, is strongly related to teaching effectiveness. The LEI is supported by robust validity evidence including content, response process, internal structure, and relations to other variables. Given the relationship between learner engagement and teaching effectiveness, identifying more engaging and interactive methods for teaching in CME is recommended.
Key Technology of Computer Network Vulnerability Assessment Based on Neural Network
Authors: Wang Shaoqiang 
Published: June 2020

Abstract
With the wide application of computer network, network security has attracted more and more attention. The main reason why all kinds of attacks on the network can pose a great threat to the network security is the vulnerability of the computer network system itself. Introducing neural network technology into computer network vulnerability assessment can give full play to the advantages of neural network in network vulnerability assessment. The purpose of this article is by organizing feature map neural network and the combination of multilayer feedforward neural network, the training samples using SOM neural network clustering, the result of clustering are added to the original training samples and set a certain weight, based on the weighted iterative update ceaselessly, in order to improve the convergence speed of BP neural network. On the BP neural network algorithm for LM algorithm was improved, the large matrix inversion in the LM algorithm using the parallel algorithm method is improved for solving system of linear equations, and use of computer network vulnerability assessment as the computer simulation and analysis on the actual example, design a set of computer network vulnerability assessment scheme, finally the vulnerability is lower than 0.75, which is beneficial to research on related theory and application to provide the reference and help.
Reproductive tract microbiota of women in childbearing age shifts upon type of gynecological infections and phase in physiological cycle
Authors: Gao Yan , Liu Hongyan , Cheng Lijuan , Xia Qing , Xie Xiuzhen , Wang Hui , Shang Heying , Liu Yurong , Diao Yutao 
Published: June 2020

Abstract
Background: The association of the normal physiological cycle to the structural pattern of microbiota in reproductive tract of women at reproductive age has not been extensively explored. This study was undertaken to determine whether the vaginal microbes of women at childbearing age is different among groups defined by urogenital tract infections, childbearing history and menstrual cycle, respectively.Results: This was a multiple case-control study of women at childbearing age who were assigned to case or control groups according to their states of urogenital tract infections. The participants were also grouped by childbearing history and menstrual cycle. Samples of vaginal swabs were collected and stored at -70℃ until assayed. The V3-V4 regions of 16S rRNA genes were amplified using PCR and sequenced on the Illumina MiSeq platform. We tested the hypothesis of whether the relative abundance of microbial species in vaginal microbiota was different between women with different urogenital tract infections, childbearing history and menstrual cycle. We showed that the vaginal microbial richness(Alpha diversity measured by PD_whole tree) was decreased in normal women(without reproductive tract infections) than in those with bacterial vaginosis (BV), and decreased in pregnant women than in other groups of non-pregnancy. Similarly, women from groups of normal and in pregnancy had lower beta diversity on measure of unweighted_unifrac distance in comparison to those of uninfected and non-pregnant. The top 10 genus relative abundance, especially that Lactobacillus was the most dominant genus with the relative abundance of 71.55% among all samples, did not differ significantly between groups of childbearing history and menstrual cycle analyzed by ANOVA and nonparametric kruskal_wallis.Lactobacillus iners and Lactobacillus helveticus have the most abundance, totally account for 97.92% relative abundance of genus Lactobacillus. It is proposed that a higher L.helveticus/L.iners ratio is more likely to present in normal women than in the infected and in pregnant than in non-pregnant, although this comparison lacks statistical significance.Conclusions: The relative abundance of dominant bacterial taxa in vaginal microbial communities of women at childbearing age, characterized with 16S rRNA gene sequence and QIIME based analysis, were not different among groups of childbearing history and menstrual cycle. Women from groups of in pregnancy and without reproductive tract infections had lower alpha and beta diversity. The compositional ratio of the main lactobacillus species may shift depending on the normal physiological cycle and reproductive tract infections.
Microglial Deletion and Inhibition Alleviate Behavior of Post-Traumatic Stress Disorder in Mice
Authors: Li Shuoshuo , Liao Yajin , Dong Yuan , Li Xiaoheng , Li Jun , Cheng Yong , Cheng Jinbo , Yuan Zengqiang 
Published: June 2020

Abstract
Background: Alteration of immune status in the central nervous system (CNS) has been implicated in the development of Post-Traumatic Stress Disorder (PTSD). However, the nature of overall changes in brain immunocyte landscape in PTSD condition remains unclear. Methods: We constructed a mouse PTSD model by electric foot-shocks followed by contextual reminders and verified the PTSD-related symptoms by behavior test (including contextual freezing test, open filed test and elevated plus maze test). We examined the immunocyte panorama in the brains of the naïve or PTSD mice by using single cell mass cytometry. Microglia number and morphological changes in hippocampus, prefrontal cortex and amygdala were analyzed by histopathological methods. The gene expression changes of those microglia were detected by quantitative real-time PCR. Genetic/pharmacological depletion of microglia or minocycline treatment before foot-shock exposure were performed to study the role of microglia in the PTSD development and progress. Results: We found microglia are the major brain immune cells respond to PTSD. The number of microglia and ratio of microglia to immunocytes was significantly increased on the fifth day of foot-shock exposure. Furthermore, morphological analysis and gene expression profiling revealed temporal patterns of microglial activation in the hippocampus of PTSD brains. Importantly, we found that genetic/pharmacological depletion of microglia or minocycline treatment before foot-shock exposure alleviated PTSD-associated anxiety and contextual fear. Conclusion: Our results demonstrated a critical role for microglial activation in PTSD development and a potential therapeutic strategy for the clinical treatment of PTSD in the form of microglial inhibition.
Evaluation of the District Health Information System 2 Supported Malaria Reporting System in Solomon Islands
Authors: Wangdi Kinley , Sarma Haribondu , Leaburi John , McBryde Emma , Clements Archie CA 
Published: June 2020

Abstract
BackgroundDistrict Health Information Systems 2 (DHIS2) is used for supporting health information management in 67 countries, including Solomon Islands. However, there have been few published evaluations of the performance of DHIS2-enhanced disease reporting systems, in particular for managing infectious diseases such as malaria. The aim of this study was to evaluate DHIS2 supported malaria reporting in Solomon Islands and to develop recommendations for improving the system.MethodsThe evaluation was conducted in three administrative areas of Solomon Islands: Honoria City Council, and Malaita and Gundacanal Provinces. Records of nine malaria indicators from 1st January to 31st December 2016 were extracted from the DHIS2 database. The indicators permitted assessment in four core areas: availability, completeness, timeliness and reliability. To obtain more detailed information on performance of the malaria case reporting system, focus group discussions (FGD) were conducted with health centre nurses, whilst in-depth interviews (IDI) were conducted with stakeholder representatives from government (province and national) staff and WHO officials who were users of DHIS2. ResultsData were extracted from nine health centres in Honoria City Council and 64 health centres in Malaita Province. Overall, completeness of all nine indicators was 28.2% and 5.1% of health centres submitted reports on time. The most reliable indicator in DHIS2 was ‘clinical malaria’ (i.e. numbers of clinically diagnosed malaria cases) with 62.4% reliability. Challenges to completeness were a lack of supervision, limited feedback, high workload, and a lack of training and refresher courses. Health centres located in geographically remote areas, a lack of regular transport, high workload and too many variables in the reporting forms led to delays in timely reporting. Reliability of reports was impacted by a lack of technical professionals such as statisticians and unavailability of tally sheets and reporting forms. ConclusionThe availability, completeness, timeliness and reliability of nine malaria indicators collected in DHIS2 were variable within the study area, but generally low. Continued onsite support, supervision, feedback and additional enhancements such as electronic reporting will be required to further improve the malaria reporting system.
Prevalence and Risk factors of Hypoglycaemia in Neonates at St. Paul’s Hospital Millennium Medical College Neonatal Intensive Care Unit, Ethiopia: A Cross Sectional Study
Authors: Fantahun Bereket Yismaw , Nurussen Ikram 
Published: June 2020

Abstract
Background

Hypoglycaemia is a common metabolic abnormality seen in neonates that can cause preventable death. Its overall incidence has been estimated to be 1 to 5 per 1,000 live births, with higher incidence in at-risk populations. There is limited data regarding its prevalence and risk factors in developing countries like Ethiopia. Therefore, this study was aimed to determine the prevalence and risk factors of neonatal hypoglycaemia in neonatal intensive care unit (NICU) at Saint Paul’s Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia.

Methodology

A cross sectional study was conducted from June 17 to August 3, 2018 at SPHMMC, NICU. Neonates whose age was less than 48hrs and admitted to NICU were enrolled. Sociodemographic, maternal and neonatal factors were collected using structured questionnaire. Blood glucose was measured using glucometer with a test strip. Random blood glucose level < 47mg/dl was taken as a cut-off point to define hypoglycaemia. The data was entered and analysed using SPSS version 20.

Results

Neonatal hypoglycaemia was detected in 25% (49/196) of the neonates. Birth weight, duration of labor, maternal age, time of feeding initiation, hypothermia and respiratory distress syndrome were associated with hypoglycaemia. From these factors, maternal age, birth weight and hypothermia were found to be independent predictors of the outcome.

Conclusion

Hypoglycaemia was prevalent in neonates admitted to the NICU of SPHMMC and was associated with low birth weight and hypothermia. These findings calls for early detection of hypoglycaemia, prevention of hypothermia and early initiation of feeding to prevent neonatal morbidity and mortality.
Immune Landscape of Periodontitis Unveils Alterations of Infiltrating Immunocytes and Molecular Networks-Aggregating into an Interactive Web-Tool for Periodontitis Related Immune Analysis and Visualization
Authors: Zhang Xiaoqi , Wang Qingxuan , Yan Xinyu , Shan Yue , Xing Lu , Li Minqi , Long Hu , Lai Wenli 
Published: June 2020

Abstract
Background: Immunity and immunocyte reaction play an essential role in periodontitis progress and we aim to investigate the underlying regulatory network of periodontitis immune alterations. Methods: CIBERSORT was used to estimated immunocyte fractions in different clinical status. Logistic regression was used to assess the immunocyte weight to periodontitis. Immune-related periodontitis subtypes were identified by the NMF algorithm. GSEA and GSVA were conducted to analyze pathway activity. Immunocytes related gene modules were identified by WGCNA. Results: Altered immunocytes in healthy-vs-periodontitis, aggressive-vs-chronic, male-vs-female and age were identified. Contributing for periodontitis of immunocytes was calculated and their correlation was also done. Two distinct immune-related periodontitis subtypes were identified and one is characterized by B cell reaction and the other is IL-6 cytokine reactions. 463 statistically significant correlations between 22 immunocytes and pathways were revealed. Immunocytes and clinical phenotypes matched their gene modules, and their functions were annotated. Last, an easy-to-use and user-friendly interactive web-tool were developed for periodontitis related immune analysis and visualization (http://118.24.100.193:3838/tool-PIA/).Conclusions: This study systematically investigated periodontitis immune atlas and glimpse the underlying mechanism of periodontitis from gene-pathway-immunocyte networks, which can not only inspire researchers but also help them in periodontitis related immune researches.
Triple-knockout, synuclein-free mice display compromised lipid pattern
Authors: Guschina Irina , Ninkina Natalia , Roman Andrei Y. , Pokrovskiy Mikhail V. , Buchman Vladimir L. 
Published: June 2020

Abstract
Background: Recent studies have implicated synucleins in several reactions during the biosynthesis of lipids and fatty acids in addition to their recognised role in membrane lipid binding and synaptic functions. All members of the synuclein family interact robustly with lipid membranes, and appear to be important for the physiological functions of proteins while influencing the pathological aggregation of α-synuclein. Methods: The following tissues were used for lipid and fatty acid analysis: plasma, liver and two brain areas (cortex and midbrain). Lipid classes were separated using thin-layer chromatography. Fatty acids were analysed using gas chromatography. Results: We describe the importance of long-chain polyunsaturated fatty acids (LCPUFA) and palmitic acid in liver and plasma, reduced triacylglycerol (TAG) accumulation in liver and circulated plasma non-esterified fatty acids in synuclein free mice. In midbrain, observed changes in the relative concentrations of phosphatidylcholine (PC) and cerebrosides (CER) were counterbalanced. In midbrain, we recorded a notable reduction in ethanolamine plasmalogens in synuclein free mice and consider this an important finding considering the abnormal ether lipid metabolism usually associated with neurological disorders.Conclusions: In summary, our data demonstrate that synuclein deficiency can result in alterations of PUFA synthesis, storage lipid accumulation in liver, and reduction of plasmalogens and CER, those polar lipids which are principal compounds of lipid rafts in many tissues. An ablation of all three synuclein family members resulted in more pronounced lipid modifications then previously showed by us γ-synuclein deficiency. Possible mechanisms by which synuclein deficiency may govern the reported modifications of lipid metabolism in TKO mice are proposed and discussed.
Prevalence and Diagnosis of Latent Tuberculosis Infection Among Pediatric Household Contacts of Iranian Tuberculosis Cases
Authors: Ghanaie Roxana , Karimi Abdollah , Azimi Leila , James Seddon , Nasehi Mahshid , Mishkar Abolfazl Panahi , Sheikhi Mahnaz , Fallah Fatemeh , Tabatabaei Sedigheh Rafiei , Hoseini‐Alfatemi Seyedeh Mahsan 
Published: June 2020

Abstract
Background: Although the World Health Organization has recommended the diagnosis and prophylactic treatment of latent tuberculous infection (LTBI) in child household contacts of tuberculosis (TB) cases, the national programs in high-burden TB regions rarely implement adequate screening of this high-risk group, mainly because of resource limitations. We aimed to evaluate the prevalence of LTBI among pediatric household contacts of TB cases in two high-burden provinces in Iran.Methods: We conducted a cohort study in children who had been in household contact with a TB index. All subjects were assessed for active disease through evaluation of symptoms and if active disease was suspected were investigated by chest radiograph and bacilli detection in sputum or nasogastric lavage. For LTBI diagnosis, tuberculin skin test (TST) and QuantiFERON®-TB Gold Plus (QFT-Plus) were performed at the time of the index TB case diagnosis, as well as, 3, 12, and 18 months, if the first results were negative. In addition, interferon-γ-induced protein-10 (IP-10) concentrations were measured in QFT-Plus supernatants for all participants. Results: A total of 230 children were enrolled, who had contact with an index TB case. Three contacts were diagnosed with active TB. According to the TST/QFT-Plus results, 104 (45.2%) children were identified with LTBI during our study.Conclusion: This study alarmingly illustrates a high prevalence of LTBI among Iranian children exposed to TB cases. We, therefore, emphasize that the children living in close contact with an infectious TB case should be screened effectively and receive prophylactic therapy.
Impact of Daily Versus Weekly Service of Infectious Diseases Consultation on Hospital Antimicrobial Consumption: A Retrospective Study
Authors: Cona Andrea , Gazzola Lidia , Viganò Ottavia , Bini Teresa , Marchetti Giulia Carla , Monforte Antonella d'Arminio 
Published: June 2020

Abstract
Background: To verify whether daily service of Infectious Diseases consultation (ID-cons) is more effective than weekly service in reducing antibiotic (ABT) consumption without worsening of clinical outcomes. Methods: Two-years observational analysis of all the ID-cons provided in a hospital in Milan. ID-cons resulted in: start-of-ABT; no-ABT; confirmation; modification-of-ABT. We evaluated the impact of weekly (09/2016-09/2017) versus daily (10/2017-10/2018) service of ID-cons on: time-from-admission-to-first-ID-cons, type of ABT-intervention and number-of-ID-cons per 100patientdays(pd). Primary outcomes: (i) reduction of overall hospital ABT consumption and (ii) reduction of ABT consumption by department and by ABT classes expressed as defined-daily-dose (DDD)/100pd (by wilcoxon test for paired data). Secondary outcome: no significant increment of overall and sepsis-related in-hospital mortality (as death/patient’s admissions) from 2017 to 2018.Results: Overall 2552 ID-cons in 1111 patients were performed (18.6% weekly vs 81.4% daily). No differences in patient’s characteristics were observed. In daily-service, compared to weekly, patients were seen by the ID-consultant earlier (time-from-admission-to-ID-cons: 6 days (IQR 2-13) vs 10 days (IQR 6-19), p<0.0001) and ABT was more often started by the ID-consultant (Start-of-ABT: 11.6% vs 8%, p=0.02). After switch to daily service, the number-of-ID-cons increased from 0.4/100pd to 1.5/100pd(p=0.01), with the greatest increase in the emergency department (1.5/100pd vs 6.7/100pd, p<0.0001). Total ABT consumption decreased from 62.1 to 59.3 DDD/100 pd, p=0.02. As for the number-of-cons, the consumption of ABT decreased mainly in the emergency area. According to ABT classes, glycopeptides’ consumption has been reduced from 3.1 to 2.1 DDD/100pd (p=0.02) while carbapenem use decreased from 3.7 to 3.1 DDD/100pd (p=0.07). No changes in overall-mortality (5.2% vs 5.2%) and sepsis-related mortality (19.3% vs 20.9%; p=0.7) were observed among the two time-period.Conclusions: Daily-ID-cons resulted in a more comprehensive take charge of the infected patient by the ID-consultant especially in the emergency area where we also observed the highest rate of reduction of ABT-usage. No change in mortality was observed.
Design of irrigation canals with minimum overall cost using particle swarm optimization – case study: El-Sheikh Gaber canal, north Sinai Peninsula, Egypt
Authors: El-Ghandour Hamdy A. , Elbeltagi Emad , Gabr Mohamed E. 
Published: June 2020

Abstract
Nowadays, the scarcity of freshwater sources, climate change and the deterioration of freshwater quality have a great impact on the lives of human beings. As such, improving the design of irrigation canals will reduce water losses through evaporation and seepage. In this paper, particle swarm optimization (PSO) is used to determine the optimum design of irrigation canals' cross-sections with the objective to minimize the overall costs. The overall costs include the costs of earthwork, lining, and water loss by both seepage and evaporation. The velocity constraints for sedimentation and erosion have been taken into consideration in the proposed design method. The proposed PSO is compared with both the Probabilistic Global Search Lausanne (PGSL) and classical optimization methods to verify its usefulness in optimal design of canals' cross-sections. The proposed PSO is then used to design El-Sheikh Gaber canal, north Sinai Peninsula, Egypt and the obtained dimensions are compared with the existing canal dimensions. To facilitate the use of the developed model, optimal design graphs are presented. The results show that the reduction of overall cost ranged from 28 to 41% and consequently, the proposed PSO algorithm can be reliably used for the design of irrigation open canals without going through the conventional and cumbersome trial and error methods.