bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ultrasound versus manipulation to determine an intercostal space for single-port thoracoscopy surgery: a diagnostic accuracy study
Authors: Li Chenxi , Wang Jianjun , Ma Zeheng , Li Bing , Kang Kang , Wei Li , Zhang Wei 
Published: May 2020

Abstract
Background
Malposition of the intercostal space used for single-port thoracoscopy surgery can lead to problems. This study was to assess the accuracy of point-of-care ultrasound in verifying the position of intercostal space.

Methods
A total of 200 patients, ASA (American Society of Anesthesiologists) physical status I or II, who underwent single-port thoracoscopic lobectomy, were enrolled. After the induction of anesthesia, a thoracic team confirmed the incision position. Firstly, the intercostal space was located by a young resident thoracic surgeon by ultrasound. Secondly, the intercostal space was located by an experienced thoracic surgeon by manipulation. Finally, the investigator verified the location of the intercostal space under direct vision through thoracoscopy, which was recognized as standard method. The time required by ultrasound and manipulation were recorded.

Results
The inter-relationships between ultrasound and the standard method and between manipulation and the standard method were consistent. Manipulation positioning showed a sensitivity of 90.6% and specificity of 30% while ultrasound positioning showed a sensitivity of 87.1% and specificity of 60%. The specificity of ultrasound positioning was higher than that of manipulation position. The time required by ultrasound was shorter than that required by manipulation.

Conclusions
Compared with the manipulation method, the ultrasound-guided method could accurately locate the intercostal space. Ultrasound requires less time than manipulation.

Trial registration
ISRCTN10722758. Registered 04 June 2019
Context-aware seeds for read mapping
Authors: Xin Hongyi , Shao Mingfu , Kingsford Carl 
Published: May 2020

Abstract
Motivation
Most modern seed-and-extend NGS read mappers employ a seeding scheme that requires extracting t non-overlapping seeds in each read in order to find all valid mappings under an edit distance threshold of t. As t grows, this seeding scheme forces mappers to use more and shorter seeds, which increases the seed hits (seed frequencies) and therefore reduces the efficiency of mappers.

Results
We propose a novel seeding framework, context-aware seeds (CAS). CAS guarantees finding all valid mappings but uses fewer (and longer) seeds, which reduces seed frequencies and increases efficiency of mappers. CAS achieves this improvement by attaching a confidence radius to each seed in the reference. We prove that all valid mappings can be found if the sum of confidence radii of seeds are greater than t. CAS generalizes the existing pigeonhole-principle-based seeding scheme in which this confidence radius is implicitly always 1. Moreover, we design an efficient algorithm that constructs the confidence radius database in linear time. We experiment CAS with E. coli genome and show that CAS significantly reduces seed frequencies when compared with the state-of-the-art pigeonhole-principle-based seeding algorithm, the Optimal Seed Solver.

Availability
https://github.com/Kingsford-Group/CAS_code
Nice guideline on thyroid disease: where does it take us with liothyronine?
Authors: Leese Graham P. 
Published: May 2020

AbstractThe new NICE guidelines on thyroid disease and its management do not recommend the routine use of liothyronine, but do not completely rule it out either. Guidelines from the British and European Thyroid Associations are open to a “trial of liothyronine” on an individual basis.Some patients do not feel well on L-thyroxine despite a serum TSH in the reference range. Key issues to consider in such patients include establishing whether the patient had established hypothyroidism initially, and whether the L-thyroxine has been titrated carefully enough, possibly using small increments, to achieve a careful balance between symptoms and serum TSH concentrations. Patients should also be considered for other causes of the symptoms which may be wide-ranging.Meta-analyses of several, but small, randomised control trials show no advantage, or disadvantage of liothyronine over L-thyroxine. However, detailed sub-analysis identifies some tantalising results eg on preferential weight loss, patient preference, and possibly genetic markers. Although linked with plausible theoretical explanations, these results may be over-interpreted. The key questions are whether a short-term trial treatment is worthwhile and safe, and whether in the future sub-groups of patients can be identified who may benefit from liothyronine. These questions remain divisive but require additional focussed research.It could be argued that inflated costs of liothyronine in some countries have either distracted from or helped focus on the science. Costs need to be addressed. However better biomarkers of tissue level thyroid action, and a better understanding of the impact of genetic polymorphisms will help to make progress when choosing if there is a place for liothyronine in the future.(words: 262)
Design and rationale of the Danish trial of beta-blocker treatment after myocardial infarction without reduced ejection fraction: study protocol for a randomized controlled trial
Authors: Kristensen Anna Meta Dyrvig , Bovin Ann , Zwisler Ann Dorthe , Cerquira Charlotte , Torp-Pedersen Christian , Bøtker Hans Erik , Gustafsson Ida , Veien Karsten Tange , Thomsen Kristian Korsgaard , Olsen Michael Hecht , Larsen Mogens Lytken , Nielsen Olav Wendelboe , Hildebrandt Per , Foghmar Sussie , Jensen Svend Eggert , Lange Theis , Sehested Thomas , Jernberg Tomas , Atar Dan , Ibanez Borja , Prescott Eva 
Published: May 2020

AbstractBackgroundTreatment with beta-blockers is currently recommended after myocardial infarction (MI). The evidence relies on trials conducted decades ago before implementation of revascularization and contemporary medical therapy or in trials enrolling patients with heart failure or reduced left ventricular ejection fraction (LVEF ≤ 40%). Accordingly, the impact of beta-blockers on mortality and morbidity following acute MI in patients without reduced LVEF or heart failure is unclear.Methods/designThe Danish trial of beta-blocker treatment after myocardial infarction without reduced ejection fraction (DANBLOCK) is a prospective, randomized, controlled, open-label, non-blinded endpoint clinical trial designed to evaluate the efficacy of beta-blocker treatment in post-MI patients in the absence of reduced LVEF or heart failure. We will randomize 3570 patients will be randomized within 14 days of index MI to beta-blocker or control for a minimum of 2 years. The primary endpoint is a composite of all-cause mortality, recurrent MI, acute decompensated heart failure, unstable angina pectoris, or stroke. The primary composite endpoint will be assessed through locally reported and adjudicated endpoints supplemented by linkage to the Danish national registers. A number of secondary endpoints will be investigated including patient reported outcomes and cardiovascular mortality. Data from similar ongoing trials in Norway and Sweden will be pooled to perform an individual patient data meta-analysis.DiscussionDANBLOCK is a randomized clinical trial investigating the effect of long-term beta-blocker therapy after myocardial infarction in patients without heart failure and reduced LVEF. Results from the trial will add important scientific evidence to inform future clinical guidelines.Trial registrationClinicaltrials.gov,NCT03778554. Registered on 19 December 2018.European Clinical Trials Database,2018-002699-42, registered on 28 September 2018.
A digital decision support system (selfBACK) for improved self-management of low back pain: a pilot study with 6-week follow-up
Authors: Sandal Louise Fleng , Øverås Cecilie K. , Nordstoga Anne Lovise , Wood Karen , Bach Kerstin , Hartvigsen Jan , Søgaard Karen , Mork Paul Jarle 
Published: May 2020

Abstract
Background
Very few of the publicly available apps directed towards self-management of low back pain (LBP) have been rigorously tested and their theoretical underpinnings seldom described. The selfBACK app was developed in collaboration with end-users and clinicians and its content is supported by best evidence on self-management of LBP. The objectives of this pilot study were to investigate the basis for recruitment and screening procedures for the subsequent randomized controlled trial (RCT), to test the inclusion process in relation to questionnaires and app installation, and finally to investigate the change in primary outcome over time.

Methods
This single-armed pilot study enrolled 51 participants who had sought help for LBP of any duration from primary care (physiotherapy, chiropractic, or general practice) within the past 8 weeks. Participants were screened for eligibility using the PROMIS-Physical-Function-4a questionnaire. Participants were asked to use the selfBACK app for 6 weeks. The app provided weekly tailored self-management plans targeting physical activity, strength and flexibility exercises, and education. The construction of the self-management plans was achieved using case-based reasoning (CBR) methodology to capture and reuse information from previous successful cases. Participants completed the primary outcome pain-related disability (Roland-Morris Disability Questionnaire [RMDQ]) at baseline and 6-week follow-up along with a range of secondary outcomes. Metrics of app use were collected throughout the intervention period.

Results
Follow-up data at 6 weeks was obtained for 43 participants. The recruitment procedures were feasible, and the number needed to screen was acceptable (i.e., 1.6:1). The screening questionnaire was altered during the pilot study. The inclusion process, answering questionnaires and app installation, were feasible. The primary outcome (RMDQ) improved from 8.6 (SD 5.1) at baseline to 5.9 (SD 4.0) at 6-week follow-up (change score 1.8, 95% CI 0.7 to 2.9). Participants spent on average 134 min (range 0–889 min) using the app during the 6-week period.

Conclusion
The recruitment, screening, and inclusion procedures were feasible for the subsequent RCT with a small adjustment. The improvement on the RMDQ from baseline to follow-up was small. Time pattern of app usage varied considerably between the participants.

Trial registration
NCT03697759. Registered on August 10, 2018. https://clinicaltrials.gov/ct2/show/NCT03697759
An analysis of factors influencing pulmonary artery catheter passage through the tricuspid and pulmonary valves
Authors: Miyata Yuka , Takada Shoko , Fujimoto Tomoko , Iwasaki Mitsuo , Hayashi Yukio 
Published: May 2020

AbstractPurposeA pulmonary artery catheter (PAC) has to pass the tricuspid and pulmonary valves for its proper placement. Although several factors were reported to hinder the placement, there have been no reports to identify the factors that prolong the individual time for passing through each valve.MethodWe individually measured the time required for a PAC to pass through the tricuspid and pulmonary valves. We examined the effect of the following factors on those times: the patient’s age, sex, height, weight, cardiothoracic ratio, tricuspid regurgitation, left ventricular ejection fraction, and the diameters of the sinus of Valsalva and of the sinotubular junction divided by the body surface area which represent the diameter of the aorta. Data were analyzed by multiple linear regression analysis after univariate analysis.ResultsThe placement of a PAC was successful in all of 100 patients. The time required to pass through the pulmonary valve was significantly longer than that through the tricuspid valve (15 [10–28] s vs 9 [5–16] s, median [range],P< 0.01). The incidence of ventricular arrhythmias during passage through the pulmonary valve was significantly higher than that through the tricuspid valve (17% vs 0%,P< 0.01). Tricuspid regurgitation and the diameter of sinotubular junction had a significant positive association with the time required to advance a PAC through the pulmonary valve, although there was no significant factors that increased the time required to advance a PAC through the tricuspid valve.ConclusionThe time required to advance a PAC through the pulmonary valve is much longer than that to pass through the tricuspid valve. The diameter of aortic root and tricuspid regurgitation are significant factors that increased the time required to advance a PAC through the pulmonary valve.
Fatores de Risco no Contexto de Adolescentes Envolvidos no Tráfico de Drogas
Authors: Pessoa Alex Sandro Gomes , Coimbra Renata Maria 
Published: May 2020

O objetivo deste artigo foi verificar os fatores de risco presentes no contexto de adolescentes com histórico de envolvimento no tráfico de drogas. Trata-se de um estudo de natureza qualitativa, exploratório-descritivo e com recorte transversal. Foram realizadas entrevistas semiestruturadas com 8 adolescentes que apresentavam envolvimento intenso no tráfico de drogas. As questões foram estruturadas levando em considerações diferentes dimensões da vida dos adolescentes, incluindo fatores de risco, bem como sobre a trajetória de envolvimento no tráfico de drogas. Os dados obtidos na investigação sugerem que os fatores de risco na vida dos adolescentes possuem três dimensões temporais: antes, durante e após o envolvimento no tráfico de drogas. Os resultados apontaram que o envolvimento no tráfico de drogas consolida um conjunto de variáveis que se mostram prejudiciais ao desenvolvimento dos adolescentes. Além das repercussões sociais debatidas neste manuscrito, materializados a partir do estigma que recebem, passam a depender financeiramente (seja para atividades de lazer, consumo ou auxílio às famílias) e psicologicamente (para manter o status social adquirido e até mesmo consumir as substâncias psicoativas) do tráfico de drogas.
Bewertung der Einsatzpotenziale und Risiken von Robotic Process Automation
Authors: Brettschneider Jennifer 
Published: May 2020

ZusammenfassungIn der heutigen Zeit nimmt die Bedeutung schlanker und effektiver Prozesse in Unternehmen vor dem Hintergrund des Wettbewerbs sowie Kostendrucks stetig zu. Um dieser Herausforderung entgegenzuwirken, fokussieren sich Unternehmen auf die Identifikation neuer innovativer Potenziale. Aufgrund der Tatsache, dass monotone und regelbasierte Prozesse durch Softwareroboter automatisiert werden können, ist das Interesse an Robotic Process Automation (RPA) in den letzten Jahren stetig gestiegen. Bevor sich Unternehmen allerdings für oder gegen den Einsatz von RPA entscheiden, ist es zunächst notwendig, dass die Entscheidungsträger ein Verständnis von RPA erlangen sowie die entsprechenden Einsatzpotenziale und Risiken einschätzen können. Dieser Artikel trägt diesem Bedürfnis Rechnung, indem es diese auf Basis einer Literaturrecherche ermittelt und bewertet. Im Ausblick wird das zukünftige Potenzial von RPA eingeschätzt.
Modular Organization ofCis-regulatory Control Information of Neurotransmitter Pathway Genes inCaenorhabditis elegans
Authors: Serrano-Saiz Esther , Gulez Burcu , Pereira Laura , Gendrel Marie , Kerk Sze Yen , Vidal Berta , Feng Weidong , Wang Chen , Kratsios Paschalis , Rand James B , Hobert Oliver 
Published: May 2020

AbstractHere, Serrano-Saiz et al. describe the cis-regulatory logic of how neurotransmitter identity is imposed onto individual, distinct neuron types...We explore here the cis-regulatory logic that dictates gene expression in specific cell types in the nervous system. We focus on a set of eight genes involved in the synthesis, transport, and breakdown of three neurotransmitter systems: acetylcholine (unc-17/VAChT, cha-1/ChAT, cho-1/ChT, and ace-2/AChE), glutamate (eat-4/VGluT), and γ-aminobutyric acid (unc-25/GAD, unc-46/LAMP, and unc-47/VGAT). These genes are specifically expressed in defined subsets of cells in the nervous system. Through transgenic reporter gene assays, we find that the cellular specificity of expression of all of these genes is controlled in a modular manner through distinct cis-regulatory elements, corroborating the previously inferred piecemeal nature of specification of neurotransmitter identity. This modularity provides the mechanistic basis for the phenomenon of “phenotypic convergence,” in which distinct regulatory pathways can generate similar phenotypic outcomes (i.e., the acquisition of a specific neurotransmitter identity) in different neuron classes. We also identify cases of enhancer pleiotropy, in which the same cis-regulatory element is utilized to control gene expression in distinct neuron types. We engineered a cis-regulatory allele of the vesicular acetylcholine transporter, unc-17/VAChT, to assess the functional contribution of a “shadowed” enhancer. We observed a selective loss of unc-17/VAChT expression in one cholinergic pharyngeal pacemaker motor neuron class and a behavioral phenotype that matches microsurgical removal of this neuron. Our analysis illustrates the value of understanding cis-regulatory information to manipulate gene expression and control animal behavior.
Evaluation of TOPS score as predictor for outcome in sick newborns
Authors: Sheth Nirali Maheshbhai , Pandya Nimisha 
Published: May 2020

Background: Multiple parameters have been developed to prognosticate the outcomes of critically ill newborns admitted in NICUs. The objective of this study is to predict the outcome of newborns admitted in NICU using a simple but efficient score, TOPS score, involving alteration of physiological parameters. Aim of this study was to evaluate role of TOPS score in predicting mortality in sick neonates.Methods: The variables assessed under TOPS score on arrival for all subjects were: Temperature, Oxygen Saturation, Perfusion and blood glucose reading <45 mg/dl. All affected neonates were given treatment as per NICU protocol and outcome was assessed in terms of mortality or discharge using TOPS score. It was prospective study conducted at NICU, Department of Pediatrics, GMERS medical college and general hospital, Gotri, Vadodara. Study population was all admitted neonates aged <28 days at NICU.Results: Mean age of presentation of all cases was 2.8±3.58 days. Hypothermia on admission was observed in 63.3% cases. 40.8% cases had hypoxia. 26.5% neonates recorded poor perfusion. Mortality observed in hypoxic group was 51.7% followed by hypothermic group (46.9%). Highest strength of association was found for poor perfusion, mortality (87.5%) and OR-33.406. TOPS score was observed to be statistically significant (X2 value is 63.27, p < 0.05) as predictor of mortality. Thus, mortality rate increased with increasing no. of altered TOPS parameters. Regression analysis showed three factors (hypothermia, hypoxia, prolonged CRT) which are consistently associated with p value ≤ 0.05 for each variable and can be used to predict mortality.Conclusions: All parameters in TOPS score are physiologically important and each parameter carries an independent risk associated with mortality. It is important to note that multiple parameters affected increases the risk. TOPS score is a simple, basic and effective tool to guide about the condition of new born at admission and outcome. of neonatal mortality.
West syndrome: clinic etiological profile, and response to treatment in Western India
Authors: Nawaz Shah , Gajre Mona P. , Adhikari Arpita , . Shagufta 
Published: May 2020

Background: Information on the profile of infants with West syndrome in developing countries is limited. This study was done to determine clinico-etiological profile and clinical response of infantile spasms to various medications in children with west syndrome in a developing country.Methods: It was a retrospective cohort study from January 2017-january 2020 done in a tertiary care hospital in western India. Records of 39 children with west syndrome who visited this pediatric neurology division during study period were analysed. 6 were excluded in view of incomplete data. Detailed history, examination, investigations and medications given were noted. Follow up records were assessed to look for long term control of spasms, relapse rates after cessation, or progression to other seizure types.Results: Mean age at onset of infantile spasms was found to be 8.12 months (1 - 36 months). Mean lag time to treatment was 5.35 months. Etiology was found in 69.7% children with perinatal causes being most common. With oral prednisolone, 54.5% had complete cessation of spasms, and with ACTH also 54.5% had complete spasm cessation. Favourable clinical response at 6 months follow up was found in 8 (47.05%) of the 17 children. Surprisingly, lag time (p=0.381) and symptomatic etiology (p=1.00) did not have any significant impact on outcome.Conclusions: This study highlights the developing country perspective of west syndrome. Increased lag time, different etiological profile and poor outcome are the challenges. High dose prednisolone is a good first line alternative treatment option in resource poor settings.
Effect of ART2 on the CD4 count and viral load during treatment of second line ART
Authors: Singh Narendra , Varma R. K. , Giri Richa , Varma Punit , Dwivedi Seema , Kumar Lalit 
Published: May 2020

Background: AIDS first recognized in US summer of 1981 by the U.S. CDC reported. In 1983 HIV was isolated from a patient of lymphadenopathy. This study was for monitoring the change in CD4 count and viral load of PL HIV before and after one year of second line ART in the period of 2016 to 2018.Methods: Study was single centre hospital based and clinical continuous longitudinal, prospective and retrospective, observational at ART plus Centre, Kanpur K.P.S. Institute of Medicine (G.S.V.M. medical college Kanpur) included the all patients on ART1 attending in centre were screened for treatment failure based on clinical, immunological and virological criteria’s as decided by SACEP from 2016 to 2018.Results: CD4 count at the time of initiation that of second line ART, there is low CD4 count the mean value is 181.44±85.02 in total subject 118 but 12 month of second line ART 2 treatment mean value of CD4 count 413.01±168.70. After Z test application the value is 13.316, p value 0.0001, MD 231.5, CI is 95%.Viral load value at time of start of second line ART mean value is 80683.85849±293449.2038, after 1 to 12 month of start of second line ART treatment mean value is 350.8559±128.1069, for this Z value is 2.972, p value 0.0033.Conclusions: Second line ART is most effective in treatment after failure with first line ART. CD 4 count increase and viral load decrease and clinical feature improve after treatment of ART 2.
Application of allergic rhinitis and its impact on asthma guidelines in terms of classification, risk factors, quality of life and co-morbidities in allergic rhinitis patients in Northern India
Authors: Agarwal Anmol Kumar , Sharma Rohit , Sharma Vinit 
Published: May 2020

<p class="abstract"><strong>Background:</strong> Despite the high prevalence of allergic rhinitis, there are only few studies on application of ARIA (allergic rhinitis and its impact on asthma) guidelines.</p><p class="abstract"><strong>Methods:</strong> It was a prospective study of 164 patients. Based on ARIA guidelines; patients were graded for severity, risk factors studied, co morbidities documented and quality of life assessed using rhinoconjunctivitis quality of life questionnaire (RQLQ). </p><p class="abstract"><strong>Results:</strong> A total of 164 cases were studied between the age group 10-72 years of which 56.1% were males. Most common trigger observed was dust (56.1%). Allergic conjunctivitis was most common co-morbidity associated. Using RQLQ it was observed that ARIA.</p><p class="abstract"><strong>Conclusions:</strong> ARIA guidelines appropriately classify allergic rhinitis, determines risk factors and associated co-morbidities. RQLQ can be used to determine quality of life in allergic rhinitis.</p>