bluuebunny/crossref_metadata_2025_split huggingface dataset:
Equivalent performance of single-use and reusable duodenoscopes in a randomised trial
Authors: Bang Ji Young , Hawes Robert , Varadarajulu Shyam 
Published: September 2020

ObjectiveSingle-use duodenoscopes have been recently developed to eliminate risk of infection transmission from contaminated reusable duodenoscopes. We compared performances of single-use and reusable duodenoscopes in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP).DesignPatients with native papilla requiring ERCP were randomised to single-use or reusable duodenoscope. Primary outcome was comparing number of attempts to achieve successful cannulation of desired duct. Secondary outcomes were technical performance that measured duodenoscope manoeuvrability, mechanical-imaging characteristics and ability to perform therapeutic interventions, need for advanced cannulation techniques or cross-over to alternate duodenoscope group to achieve ductal access and adverse events.Results98 patients were treated using single-use (n=48) or reusable (n=50) duodenoscopes with >80% graded as low-complexity procedures. While median number of attempts to achieve successful cannulation was significantly lower for single-use cohort (2 vs 5, p=0.013), ease of passage into stomach (p=0.047), image quality (p<0.001), image stability (p<0.001) and air–water button functionality (p<0.001) were significantly worse. There was no significant difference in rate of cannulation, adverse events including mortality (one patient in each group), need to cross-over or need for advanced cannulation techniques to achieve ductal access, between cohorts. On multivariate logistic regression analysis, only duodenoscope type (single-use) was associated with less than six attempts to achieve selective cannulation (p=0.012), when adjusted for patient demographics, procedural complexity and type of intervention.ConclusionGiven the overall safety profile and similar technical performance, single-use duodenoscopes represent an alternative to reusable duodenoscopes for performing low-complexity ERCP procedures in experienced hands.Trial registration numberClinicaltrials.gov number:NCT04143698
WASh multicentre randomised controlled trial: water-assisted sigmoidoscopy in English NHS bowel scope screening
Authors: Rutter Matthew D , Evans Rachel , Hoare Zoe , Von Wagner Christian , Deane Jill , Esmaily Shiran , Larkin Tony , Edwards Rhiannon , Yeo Seow Tien , Spencer Llinos Haf , Holmes Emily , Saunders Brian P , Rees Colin J , Tsiamoulos Zacharias P , Beintaris Iosif 
Published: September 2020

ObjectivesThe English Bowel Cancer Screening Programme invites 55 year olds for a sigmoidoscopy (Bowel Scope Screening (BSS)), aiming to resect premalignant polyps, thus reducing cancer incidence. A national patient survey indicated higher procedural pain than anticipated, potentially impacting on screening compliance and effectiveness. We aimed to assess whether water-assisted sigmoidoscopy (WAS), as opposed to standard CO2technique, improved procedural pain and detection of adenomatous polyps.DesignThe WASh (Water-Assisted Sigmoidoscopy) trial was a multicentre, single-blind, randomised control trial for people undergoing BSS. Participants were randomised to either receive WAS or CO2from five sites across England. The primary outcome measure was patient-reported moderate/severe pain, as assessed by patients on a standard Likert scale post procedure prior to discharge. The key secondary outcome was adenoma detection rate (ADR). The costs of each technique were also measured.Results1123 participants (50% women, mean age 55) were randomised (561 WAS, 562 CO2). We found no difference in patient-reported moderate/severe pain between WAS and CO2(14% in WAS, 15% in CO2; p=0.47). ADR was 15% in the CO2arm and 11% in the WAS arm (p=0.03); however, it remained above the minimum national performance standard in both arms. There was no statistical difference in mean number of adenomas nor overall polyp detection rate. There was negligible cost difference between the two techniques.ConclusionIn the context of enema-prepared unsedated screening sigmoidoscopies performed by screening-accredited endoscopists, no difference in patient-reported pain was seen when using either a CO2or WAS intubation technique.Trial registration numberISRCTN81466870.
Impact of video games on ultrasound-guided regional anesthesia skills
Authors: Shafqat Atif , Mukarram Shumaila , Bedforth Nigel M , Hardman Jonathan G , McCahon Robert A 
Published: September 2020

BackgroundThere is an association between video game practice and laparoscopic expertize in trainee surgeons. Ultrasound-guided regional anesthesia has many parallels with laparoscopic surgery. The aim of this study was to explore whether video game experience is associated with enhanced performance in a simulated ultrasound-guided task in novice operators.MethodsIn this prospective observational study, 60 medical student volunteers were recruited. Following characterization of video game experience, they underwent an assessment of visuospatial abilities. Following standardized teaching, the recruits’ technical performance of an ultrasound-guided needle task was assessed for overall quality by global rating scale (GRS).ResultsOut of a total possible GRS score of 35, gamers compared with non-gamers demonstrated 5.2 (95% CI 1.9 to 8.4) units of better performance. Gamers also performed better in mental rotation test scores (difference 4.1, 95% CI 1.2 to 7.0) .ConclusionVideo game practice is associated with increased mental rotation ability and enhanced technical performance in a simulated ultrasound-guided task.
Long-term survival following initiation of home non-invasive ventilation: a European study
Authors: Patout Maxime , Lhuillier Elodie , Kaltsakas Georgios , Benattia Amira , Dupuis Johan , Arbane Gill , Declercq Pierre-Louis , Ramsay Michelle , Marino Philip , Molano Luis-Carlos , Artaud-Macari Elise , Viacroze Catherine , Steier Joerg , Douiri Abdel , Muir Jean-Francois , Cuvelier Antoine , Murphy Patrick Brian , Hart Nicholas 
Published: September 2020

IntroductionAlthough home non-invasive ventilation (NIV) is increasingly used to manage patients with chronic ventilatory failure, there are limited data on the long-term outcome of these patients. Our aim was to report on home NIV populations and the long-term outcome from two European centres.MethodsCohort analysis including all patients established on home NIV from two European centres between 2008 and 2014.ResultsHome NIV was initiated in 1746 patients to treat chronic ventilatory failure caused by (1) obesity hypoventilation syndrome±obstructive sleep apnoea (OHS±OSA) (29.5%); (2) neuromuscular disease (NMD) (22.7%); and (3) obstructive airway diseases (OAD) (19.1%). Overall cohort median survival following NIV initiation was 6.6 years. Median survival varied by underlying aetiology of respiratory failure: rapidly progressive NMD 1.1 years, OAD 2.7 years, OHS±OSA >7 years and slowly progressive NMD >7 years. Multivariate analysis demonstrated higher mortality in patients with rapidly progressive NMD (HR 4.78, 95% CI 3.38 to 6.75), COPD (HR 2.25, 95% CI 1.64 to 3.10), age >60 years at initiation of home NIV (HR 2.41, 95% CI 1.92 to 3.02) and NIV initiation following an acute admission (HR 1.38, 95% CI 1.13 to 1.68). Factors associated with lower mortality were NIV adherence >4 hours per day (HR 0.64, 95% CI 0.51 to 0.79), OSA (HR 0.51, 95% CI 0.31 to 0.84) and female gender (HR 0.79, 95% CI 0.65 to 0.96).ConclusionThe mortality rate following initiation of home NIV is high but varies significantly according to underlying aetiology of respiratory failure. In patients with chronic respiratory failure, initiation of home NIV following an acute admission and low levels of NIV adherence are poor prognostic features and may be amenable to intervention.
$$\mathbf {O}(D,D)$$ completion of the Friedmann equations
Authors: Angus Stephen , Cho Kyoungho , Franzmann Guilherme , Mukohyama Shinji , Park Jeong-Hyuck 
Published: September 2020

AbstractIn string theory the closed-string massless NS-NS sector forms a multiplet of $$\mathbf {O}(D,D)$$

O
(
D
,
D
)

symmetry. This suggests a specific modification to General Relativity in which the entire NS-NS sector is promoted to stringy graviton fields. Imposing off-shell $$\mathbf {O}(D,D)$$

O
(
D
,
D
)

symmetry fixes the correct couplings to other matter fields and the Einstein field equations are enriched to comprise $$D^{2}+1$$

D
2

+
1

components, dubbed recently as the Einstein Double Field Equations. Here we explore the cosmological implications of this framework. We derive the most general homogeneous and isotropic ansatzes for both stringy graviton fields and the $$\mathbf {O}(D,D)$$

O
(
D
,
D
)

-covariant energy-momentum tensor. Crucially, the former admits space-filling magnetic H-flux. Substituting them into the Einstein Double Field Equations, we obtain the $$\mathbf {O}(D,D)$$

O
(
D
,
D
)

completion of the Friedmann equations along with a generalized continuity equation. We discuss how solutions in this framework may be characterized by two equation-of-state parameters, w and $$\lambda $$
λ
, where the latter characterizes the relative intensities of scalar and tensor forces. When $$\lambda +3w=1$$

λ
+
3
w
=
1

, the dilaton remains constant throughout the cosmological evolution, and one recovers the standard Friedmann equations for generic matter content (i.e. for any w). We further point out that, in contrast to General Relativity, neither an $$\mathbf {O}(D,D)$$

O
(
D
,
D
)

-symmetric cosmological constant nor a scalar field with positive energy density gives rise to a de Sitter solution.
Preconditioning the EFIE on screens
Authors: Hiptmair Ralf , Urzúa-Torres Carolina 
Published: September 2020

We consider the electric field integral equation (EFIE) modeling the scattering of time-harmonic electromagnetic waves at a perfectly conducting screen. When discretizing the EFIE by means of low-order Galerkin boundary methods (BEM), one obtains linear systems that are ill-conditioned on fine meshes and for low wave numbers [Formula: see text]. This makes iterative solvers perform poorly and entails the use of preconditioning. In order to construct optimal preconditioners for the EFIE on screens, the authors recently derived compact equivalent inverses of the EFIE operator on simple Lipschitz screens in [R. Hiptmair and C. Urzúa-Torres, Compact equivalent inverse of the electric field integral operator on screens, Integral Equations Operator Theory 92 (2020) 9]. This paper elaborates how to use this result to build an optimal operator preconditioner for the EFIE on screens that can be discretized in a stable fashion. Furthermore, the stability of the preconditioner relies only on the stability of the discrete [Formula: see text] duality pairing for scalar functions, instead of the vectorial one. Therefore, this novel approach not only offers [Formula: see text]-independent and [Formula: see text]-robust condition numbers, but it is also easier to implement and accommodates non-uniform meshes without additional computational effort.
Large deviation for two-time-scale stochastic burgers equation
Authors: Sun Xiaobin , Wang Ran , Xu Lihu , Yang Xue 
Published: September 2020

A Freidlin–Wentzell type large deviation principle is established for stochastic partial differential equations with slow and fast time-scales, where the slow component is a one-dimensional stochastic Burgers equation with small noise and the fast component is a stochastic reaction-diffusion equation. Our approach is via the weak convergence criterion developed in [A. Budhiraja and P. Dupuis, A variational representation for positive functionals of infinite dimensional Brownian motion, Probab. Math. Statist. 20 (2000) 39–61].
Changes in Tinnitus by Cochlear Implantation: A Parametric Study of the Effect of Single-Electrode Stimulation
Authors: Kloostra Francka J.J. , de Kleine Emile , Free Rolien H. , Hofman Rutger , Van Dijk Pim 
Published: September 2020

<b><i>Introduction:</i></b> While cochlear implantation may have a positive effect on tinnitus, it is not effective in reducing tinnitus in all patients. This may be due to different patients requiring different strategies of electrical stimulation in order to obtain a positive effect on tinnitus. It is, therefore, important to identify the most effective stimulation strategies to reduce tinnitus. The simplest possible strategy is stimulation by only one electrode. In this study, we investigated tinnitus suppression by electrical stimulation via a single electrode of the cochlear implant. <b><i>Methods:</i></b> We performed a listening experiment in 19 adult participants, who had received a unilateral cochlear implant (CI) because of severe bilateral hearing loss. All of these patients had indicated that they suffered from tinnitus. During a 300-s interval, patients listened to blocks of single-electrode stimulation and rated the loudness of the stimulus and any effects on their tinnitus. The 300-s interval included a block of single-electrode stimulation (duration 120 s). In consecutive intervals, the stimulus differed in its cochlear location (basal or apical), its pulse rate (720 or 725 Hz, 1,200 Hz, and 2,400 or 2,320 Hz), and amplitude (just above threshold or equivalent to moderate loudness). Thus, 2 × 3 × 2 = 12 stimulus conditions were tested in each participant, and each condition was presented only once. During the experiment, the participants promptly rated the loudness of the stimuli and the loudness of their tinnitus on a Visual Analogue Scale (10-point VAS). <b><i>Results:</i></b> Significantly more tinnitus reduction was observed with stimuli at a moderate intensity level (30%) compared to stimuli at near-threshold level (18%) (χ<sup>2</sup> [1, <i>N</i> = 222] = 14.115, <i>p</i> &#x3c; 0.01). No significant differences in tinnitus levels resulted from the different pulse rates and stimulation sites. Eight participants reported an increase of tinnitus loudness under at least one stimulus condition. Changes in tinnitus loudness were generally minor, and never exceeded 3 points on the VAS. The overall effect of cochlear implantation on tinnitus, that is, the effect with full-array stimulation, was not correlated with the effectiveness of the single-electrode stimulation on tinnitus. <b><i>Conclusion:</i></b> In conclusion, the effect of single-electrode stimulation on tinnitus is relatively insignificant in comparison to the effect of full-array stimulation. However, in some individual cases, sustained single-electrode stimulation may be beneficial for tinnitus management.
Comparison of the Functional Success of Fat Myringoplasty and Perifascial Areolar Tympanoplasty in Transcanal Endoscopic Ear Surgery
Authors: Ko Chien-An , Yang Chao-Hui , Wu Ching-Nung , Huang Pingche , Hwang Chung-Feng 
Published: September 2020

Objectives: We compared the functional outcomes of fat myringoplasty and areolar tympanoplasty through a small postauricular incision in patients who underwent transcanal endoscopic ear surgery (TEES). Methods: The study included patients who underwent myringoplasty or type I tympanoplasty using TEES in our Department of Otolaryngology between April 2016 and May 2019. The patients were divided into 2 groups according to the type of graft material used, which was selected based on the available amount of subcutaneous fat and the surgeon’s experience. Results: In total, 63 patients received fat tissue grafts (group A) and 77 received areolar tissue grafts (group B). The median operative time was significantly longer in group B (132 minutes) than in group A (65 minutes); perforations were significantly larger in group B than in group A (61.0% vs 29.7% of the eardrum surface). The postoperative air conduction threshold, air–bone gap, and speech reception threshold values were significantly lower than the preoperative values in both groups. The graft success rate did not significantly differ between groups A (96.8%, 61/63) and B (96.1%, 74/77). In group A, the perforation was > 35% of the eardrum surface in 27.0% (17/63) of the patients; the graft success rate was 100% (17/17). In the remaining 46 patients (perforation > 35%), the graft success rate was 95.7% (44/46); this difference was not statistically significant. Conclusions: Transcanal endoscopic ear surgery increases the usefulness of fat myringoplasty for the repair of perforations > 35% of the eardrum surface. Postauricular fatty and areolar tissues are suitable for this simple and rapid technique, which yields excellent outcomes.
Features of a mobile health intervention to manage chronic obstructive pulmonary disease: a qualitative study
Authors: Alwashmi Meshari F. , Fitzpatrick Beverly , Davis Erin , Farrell Jamie , Gamble John-Michael , Hawboldt John 
Published: September 2020

Background: The use of mobile health (mHealth) interventions has the potential to enhance chronic obstructive pulmonary disease (COPD) treatment outcomes. Further research is needed to determine which mHealth features are required to potentially enhance COPD self-management. Aim: The aim of this study was to explore the potential features of an mHealth intervention for COPD management with healthcare providers (HCPs) and patients with COPD. It could inform the development and successful implementation of mHealth interventions for COPD management. Methods: This was a qualitative study. We conducted semi-structured individual interviews with HCPs, including nurses, pharmacists and physicians who work directly with patients with COPD. Interviews were also conducted with a diverse sample of patients with COPD. Interview topics included demographics, mHealth usage, the potential use of medical devices and recommendations for features that would enhance an mHealth intervention for COPD management. Results: A total of 40 people, including nurses, physicians and pharmacists, participated. The main recommendations for the proposed mHealth intervention were categorised into two categories: patient interface and HCP interface. The prevalent features suggested for the patient interface include educating patients, collecting baseline data, collecting subjective data, collecting objective data via compatible medical devices, providing a digital action plan, allowing patients to track their progress, enabling family members to access the mHealth intervention, tailoring the features based on the patient’s unique needs, reminding patients about critical management tasks and rewarding patients for their positive behaviours. The most common features of the HCP interface include allowing HCPs to track their patients’ progress, allowing HCPs to communicate with their patients, educating HCPs and rewarding HCPs. Conclusion: This study identifies important potential features so that the most effective, efficient and feasible mHealth intervention can be developed to improve the management of COPD. The reviews of this paper are available via the supplemental material section.
Impact assessment of rural PPP MaaS pilots
Authors: Eckhardt Jenni , Lauhkonen Arttu , Aapaoja Aki 
Published: September 2020

AbstractThe purpose of this paper is to present the impact assessment results of Mobility as a Service pilots based on public-private collaboration. In the pilots, companies and local and regional stakeholders joined their expertise to experiment with different ways of organizing mobility services in rural areas. The pilots included demand-responsive transport and integrated transport of different user groups and combining trips that include customers paying themselves and those being publicly subsidized. In addition to the call centre service, a smartphone application was introduced. The impact assessment of these pilots spans individual/user, business/organizational and societal levels. The main findings include improved accessibility of transport services in rural areas and resource efficiency in terms of improved occupancy rates of vehicles, reduced driven kilometres and emissions, and cost savings for the public sector.
MAPK cascade gene family in Camellia sinensis: In-silico identification, expression profiles and regulatory network analysis
Authors: Chatterjee Archita , Paul Abhirup , Unnati G. Meher , Rajput Ruchika , Biswas Trisha , Kar Tamalika , Basak Srijita , Mishra Neelam , Pandey Ashutosh , Srivastava Anurag Prakash 
Published: September 2020

Abstract
Background
Mitogen Activated Protein Kinase (MAPK) cascade is a fundamental pathway in organisms for signal transduction. Though it is well characterized in various plants, there is no systematic study of this cascade in tea.

Result
In this study, 5 genes of Mitogen Activated Protein Kinase Kinase (MKK) and 16 genes of Mitogen Activated Protein Kinase (MPK) in Camellia sinensis were found through a genome-wide search taking Arabidopsis thaliana as the reference genome. Also, phylogenetic relationships along with structural analysis which includes gene structure, location as well as protein conserved motifs and domains, were systematically examined and further, predictions were validated by the results. The plant species taken for comparative study clearly displayed segmental duplication, which was a significant candidate for MAPK cascade expansion. Also, functional interaction was carried out in C. sinensis based on the orthologous genes in Arabidopsis. The expression profiles linked to various stress treatments revealed wide involvement of MAPK and MAPKK genes from Tea in response to various abiotic factors. In addition, the expression of these genes was analysed in various tissues.

Conclusion
This study provides the targets for further comprehensive identification, functional study, and also contributed for a better understanding of the MAPK cascade regulatory network in C. sinensis.
Identification of loci controlling mineral element concentration in soybean seeds
Authors: Malle Sidiki , Morrison Malcolm , Belzile François 
Published: September 2020

AbstractBackgroundMineral nutrients play a crucial role in the biochemical and physiological functions of biological systems. The enhancement of seed mineral content via genetic improvement is considered as the most promising and cost-effective approach compared alternative means for meeting the dietary needs. The overall objective of this study was to perform a GWAS of mineral content (Ca, K, P and S) in seeds of a core set of 137 soybean lines that are representative of the diversity of early maturing soybeans cultivated in Canada (maturity groups 000-II).ResultsThis panel of 137 soybean lines was grown in five environments (in total) and the seed mineral content was measured using a portable x-ray fluorescence (XRF) spectrometer. The association analyses were carried out using three statistical models and a set of 2.2 million SNPs obtained from a combined dataset of genotyping-by-sequencing and whole-genome sequencing. Eight QTLs significantly associated with the Ca, K, P and S content were identified by at least two of the three statistical models used (in two environments) contributing each from 17 to 31% of the phenotypic variation. A strong reproducibility of the effect of seven out these eight QTLs was observed in three other environments. In total, three candidate genes were identified involved in transport and assimilation of these mineral elements.ConclusionsThere have been very few GWAS studies to identify QTLs associated with the mineral element content of soybean seeds. In addition to being new, the QTLs identified in this study and candidate genes will be useful for the genetic improvement of soybean nutritional quality through marker-assisted selection. Moreover, this study also provides details on the range of phenotypic variation encountered within the Canadian soybean germplasm.