bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rationale for using the velocity–time integral and the minute distance for assessing the stroke volume and cardiac output in point-of-care settings
Authors: Blanco Pablo 
Published: April 2020

Abstract
Background
Stroke volume (SV) and cardiac output (CO) are basic hemodynamic parameters which aid in targeting organ perfusion and oxygen delivery in critically ill patients with hemodynamic instability. While there are several methods for obtaining this data, the use of transthoracic echocardiography (TTE) is gaining acceptance among intensivists and emergency physicians. With TTE, there are several points that practitioners should consider to make estimations of the SV/CO as simplest as possible and avoid confounders.

Main body
With TTE, the SV is usually obtained as the product of the left ventricular outflow tract (LVOT) cross-sectional area (CSA) by the LVOT velocity–time integral (LVOT VTI); the CO results as the product of the SV and the heart rate (HR). However, there are important drawbacks, especially when obtaining the LVOT CSA and thus the impaction in the calculated SV and CO. Given that the LVOT CSA is constant, any change in the SV and CO is highly dependent on variations in the LVOT VTI; the HR contributes to CO as well. Therefore, the LVOT VTI aids in monitoring the SV without the need to calculate the LVOT CSA; the minute distance (i.e., SV × HR) aids in monitoring the CO. This approach is useful for ongoing assessment of the CO status and the patient’s response to interventions, such as fluid challenges or inotropic stimulation. When the LVOT VTI is not accurate or cannot be obtained, the mitral valve or right ventricular outflow tract VTI can also be used in the same fashion as LVOT VTI. Besides its pivotal role in hemodynamic monitoring, the LVOT VTI has been shown to predict outcomes in selected populations, such as in patients with acute decompensated HF and pulmonary embolism, where a low LVOT VTI is associated with a worse prognosis.

Conclusion
The VTI and minute distance are simple, feasible and reproducible measurements to serially track the SV and CO and thus their high value in the hemodynamic monitoring of critically ill patients in point-of-care settings. In addition, the LVOT VTI is able to predict outcomes in selected populations.
Sonographic signs and patterns of COVID-19 pneumonia
Authors: Volpicelli Giovanni , Gargani Luna 
Published: April 2020

AbstractThe pandemic of COVID-19 is seriously challenging the medical organization in many parts of the world. This novel corona virus SARS-CoV-2 has a specific tropism for the low respiratory airways, but causes severe pneumonia in a low percentage of patients. However, the rapid spread of the infection during this pandemic is causing the need to hospitalize a high number of patients. Pneumonia in COVID-19 has peculiar features and can be studied by lung ultrasound in the early approach to suspected patients. The sonographic signs are non-specific when considered alone, but observation of some aspects of vertical artifacts can enhance the diagnostic power of the ultrasound examination. Also, the combination of sonographic signs in patterns and their correlation with blood exams in different phenotypes of the disease may allow for a reliable characterization and be of help in triaging and admitting patients.
The impact of propranolol on nitric oxide and total antioxidant capacity in patients with resistant hypertension—evidence from the APPROPRIATE trial
Authors: Ranasinghe H. N. , Fernando N. , Handunnetti S. , Weeratunga P. N. , Katulanda P. , Rajapakse S. , Galappatthy P. , Constantine G. R. 
Published: April 2020

Abstract
Objectives
The objective was to assess the effect of propranolol on oxidative stress and anti-oxidant potential in patients with resistant hypertension as a secondary analysis of the APPROPRIATE trial. This randomized double blinded clinical trial recruited patients with resistant hypertension and allocated forty patients to propranolol and placebo in 1:1 ratio. The pro-oxidant state (nitrate and nitrite) was assessed using modified Griess assay. The total anti-oxidant capacity was measured using ABTS assay.

Results
Analysis was performed for 18 patients from the propranolol group and 15 from the placebo group. A decline in end point ambulatory blood pressure (p = 0.031) and greater mean reduction in office SBP (29.7 ± 13.0 mmHg, p = 0.021) was noted in the propranolol arm. Nitrate and nitrite levels were lower at the end of a 90 day follow up period in both arms, with a greater mean reduction with propranolol. A significant increase in the AOC was noted in both arms with higher incremental value with Propranolol. The findings of this study do not demonstrate a statistically significant effect of propranolol on the oxidative stress/antioxidant balance in patients with resistant hypertension. The observed trends merit further evaluation.
The relationship between physical activity, apolipoprotein E ε4 carriage, and brain health
Authors: de Frutos-Lucas Jaisalmer , Cuesta Pablo , López-Sanz David , Peral-Suárez África , Cuadrado-Soto Esther , Ramírez-Toraño Federico , Brown Belinda M. , Serrano Juan M. , Laws Simon M. , Rodríguez-Rojo Inmaculada C. , Verdejo-Román Juan , Bruña Ricardo , Delgado-Losada Maria L. , Barabash Ana , López-Sobaler Ana M. , López-Higes Ramón , Marcos Alberto , Maestú Fernando 
Published: April 2020

AbstractBackgroundNeuronal hyperexcitability and hypersynchrony have been described as key features of neurophysiological dysfunctions in the Alzheimer’s disease (AD) continuum. Conversely, physical activity (PA) has been associated with improved brain health and reduced AD risk. However, there is controversy regarding whether AD genetic risk (in terms ofAPOEε4 carriage) modulates these relationships. The utilization of multiple outcome measures within one sample may strengthen our understanding of this complex phenomenon.MethodThe relationship between PA and functional connectivity (FC) was examined in a sample of 107 healthy older adults using magnetoencephalography. Additionally, we explored whether ε4 carriage modulates this association. The correlation between FC and brain structural integrity, cognition, and mood was also investigated.ResultsA relationship between higher PA and decreased FC (hyposynchrony) in the left temporal lobe was observed among all individuals (across the whole sample, in ε4 carriers, and in ε4 non-carriers), but its effects manifest differently according to genetic risk. In ε4 carriers, we report an association between this region-specific FC profile and preserved brain structure (greater gray matter volumes and higher integrity of white matter tracts). In this group, decreased FC also correlated with reduced anxiety levels. In ε4 non-carriers, this profile is associated with improved cognition (working and episodic memory).ConclusionsPA could mitigate the increase in FC (hypersynchronization) that characterizes preclinical AD, being beneficial for all individuals, especially ε4 carriers.
The validation of published utility mapping algorithms: an example of EORTC QLQ-C30 and EQ-5D in non-small cell lung cancer
Authors: Gregory Joanne , Dyer Matthew , Hoyle Christopher , Mann Helen , Hatswell Anthony J. 
Published: April 2020

AbstractBackgroundMapping algorithms can be used to generate health state utilities when a preference-based instrument is not included in a clinical study. Our aim was to investigate the external validity of published mapping algorithms in non-small cell lung cancer (NSCLC) between the EORTC QLQ-C30 and EQ-5D instruments and to propose methodology for validating any mapping algorithms.MethodsWe conducted a targeted literature review to identify published mappings, then applied these to data from the osimertinib clinical trial programme. Performance of the algorithms was evaluated using the mean absolute error, root mean squared error, and graphical techniques for the observed versus predicted EQ-5D utilities. These statistics were also calculated across the range of utility values (as well as ordinary least squares and quantile regression), to investigate how the mappings fitted across all values, not simply around the mean utility.ResultsThree algorithms developed in NSCLC were identified. The algorithm based on response mapping (Young et al., 2015) fitted the validation dataset across the range of observed values with similar fit statistics to the original publication (overall MAE of 0.087 vs 0.134). The two algorithms based on beta-binomial models presented a poor fit to both the mean and distribution of utility values (MAE 0.176, 0.178).ConclusionsThe validation of mapping algorithms is key to demonstrating their generalisability beyond the original dataset, particularly across the range of plausible utility values (not just the mean) – perceived patient similarity being insufficient. The identified algorithm from Young et al. performed well across the range of EORTC scores observed, and thus appears most suitable for use in other studies of NSCLC patients.
Preference-based measures of health-related quality of life in congenital mobility impairment: a systematic review of validity and responsiveness
Authors: Bray Nathan , Spencer Llinos Haf , Edwards Rhiannon Tudor 
Published: April 2020

Abstract
Introduction
Mobility impairment is the leading cause of disability in the UK. Individuals with congenital mobility impairments have unique experiences of health, quality of life and adaptation. Preference-based outcomes measures are often used to help inform decisions about healthcare funding and prioritisation, however the applicability and accuracy of these measures in the context of congenital mobility impairment is unclear. Inaccurate outcome measures could potentially affect the care provided to these patient groups. The aim of this systematic review was to examine the performance of preference-based outcome measures for the measurement of utility values in various forms of congenital mobility impairment.

Methods
Ten databases were searched, including Science Direct, CINAHL and PubMed. Screening of reference lists and hand-searching were also undertaken. Descriptive and narrative syntheses were conducted to combine and analyse the various findings. Results were grouped by condition. Outcome measure performance indicators were adapted from COSMIN guidance and were grouped into three broad categories: validity, responsiveness and reliability. Screening, data extraction and quality appraisal were carried out by two independent reviewers.

Results
A total of 31 studies were considered eligible for inclusion in the systematic review. The vast majority of studies related to either cerebral palsy, spina bifida or childhood hydrocephalus. Other relevant conditions included muscular dystrophy, spinal muscular atrophy and congenital clubfoot. The most commonly used preference-based outcome measure was the HUI3. Reporting of performance properties predominantly centred around construct validity, through known group analyses and assessment of convergent validity between comparable measures and different types of respondents. A small number of studies assessed responsiveness, but assessment of reliability was not reported. Increased clinical severity appears to be associated with decreased utility outcomes in congenital mobility impairment, particularly in terms of gross motor function in cerebral palsy and lesion level in spina bifida. However, preference-based measures exhibit limited correlation with various other condition-specific and clinically relevant outcome measures.

Conclusion
Preference-based measures exhibit important issues and discrepancies relating to validity and responsiveness in the context of congenital mobility impairment, thus care must be taken when utilising these measures in conditions associated with congenital mobility impairments.
A note on degenerate Genocchi and poly-Genocchi numbers and polynomials
Authors: Kim Taekyun , Kim Dae San , Kwon Jongkyum , Kim Han Young 
Published: April 2020

AbstractRecently, Dolgy–Jang introduced the poly-Genocchi polynomials and numbers arising from the modified polyexponential function. In this paper, we study the degenerate poly-Genocchi polynomials and numbers constructed from the modified degenerate polyexponential function. We derive explicit expressions for those polynomials and numbers. Also, we obtain identities involving those polynomials and numbers and some other special numbers and polynomials. In addition, we investigate the higher-order degenerate Genocchi polynomials and find identities involving those polynomials and the higher-order Changhee polynomials.
EFL Teachers’ Conceptions of Professional Development during the Practicum: Retrospective Perceptions and Prospective Insights
Authors: Aghabarari Mozhgan , Rahimi Mehrak 
Published: April 2020

AbstractThe current study probes into English as a Foreign Language (EFL) teachers’ conceptions of their professional development during practicum course. The study merits a mixed methods approach and has utilized both quantitative and qualitative data gathering and analysis. To gather quantitative data, 100 EFL teachers were asked to complete a questionnaire that measured their retrospective perceptions of the role of practicum in their professional development. To gather qualitative data, 20 student-teachers (STs) of Teaching English as Foreign Language (TEFL) were asked to write narrations while they were taking part in their practicum courses for two years. The results of quantitative data analysis revealed that the participants had roughly positive retrospective perceptions of the practicum course and its role in their professional development. It was also found that novice teachers (with 1-5 years of experience), those participants whose practicum course lasted longer (two semesters or longer), and those who had taken part in the practicum after teacher education curriculum change had more positive perceptions of the practicum course.The result of qualitative analysis revealed that STs were generally satisfied with the content, methodology and assessment of the practicum. They reported certain challenges they faced during the practicum including relation with cooperating teachers and their supervisors’ strictness. They also believed that the practicum helped them expand their pedagogical insights on EFL theories and practices, although they needed help on certain issues including assessment of students’ learning.
An efficient load flow solution for distribution system with addition of distributed generation using improved harmony search algorithms
Authors: Tyagi Arjun , Kumar Krishan , Ansari M. A. , Kumar Bhavnesh 
Published: April 2020

AbstractThe distribution system analysis is very important to know the system condition at any given point of time. This distribution power flow plays an important role. Many power flow techniques have been proposed in the past for distribution power flow (DPF). The implicit Z-bus Gauss–Seidel (GS) method is good when dispersed generations are modelled as PQ nodes in the distribution system but, when dispersed generations are modelled as PV nodes, it leads to divergence problems. In a Newton-like method, a slight change in the execution of the bus-type switching logic leads to an unlike convergence characteristic. Though backward/forward (BW/FW) method is effective and efficient, it slows down under heavy-load condition. Now, with the addition of distributed generation (wind/solar, etc.) at the distribution level, the classical configuration of the distribution system is also changed. This poses a need for more robust and efficient technique. This paper investigates the application of a new algorithm known as improved harmony search (IHS) for DPF. The IHS can determine multiple power flow solutions which fix the limitations of other methods while determining a solution for the highly stressed condition. The results for a standard test system are taken with IHS, Newton–Raphson (NR) and BW/FW method without and with the impact of the wind energy system, to show the potential of the proposed algorithm.
Section 136: the ‘grey zone’ after the 24-h validity period lapses
Authors: Ramesh Yathooshan , Kripalani Mukesh 
Published: April 2020

SUMMARYIf a Mental Health Act section 136 lapses at 24 h because no in-patient bed is available, the legal grounds to continue holding an individual in the place of safety are dubious. Duty of candour and a senior clinical review are essential. The use of common law and the Mental Capacity Act have limitations, the latter also raising a question about whether deprivation of liberty safeguards would also apply. Clarity of this dilemma is needed through legislation.
A stable sub-complex between GCP4, GCP5 and GCP6 promotes the assembly of γ-tubulin ring complexes
Authors: Haren Laurence , Farache Dorian , Emorine Laurent , Merdes Andreas 
Published: April 2020

ABSTRACT
γ-Tubulin is the main protein involved in the nucleation of microtubules in all eukaryotes. It forms two different complexes with proteins of the GCP family (γ-tubulin complex proteins): γ-tubulin small complexes (γTuSCs) that contain γ-tubulin, and GCPs 2 and 3; and γ-tubulin ring complexes (γTuRCs) that contain multiple γTuSCs in addition to GCPs 4, 5 and 6. Whereas the structure and assembly properties of γTuSCs have been intensively studied, little is known about the assembly of γTuRCs and the specific roles of GCPs 4, 5 and 6. Here, we demonstrate that two copies of GCP4 and one copy each of GCP5 and GCP6 form a salt (KCl)-resistant sub-complex within the γTuRC that assembles independently of the presence of γTuSCs. Incubation of this sub-complex with cytoplasmic extracts containing γTuSCs leads to the reconstitution of γTuRCs that are competent to nucleate microtubules. In addition, we investigate sequence extensions and insertions that are specifically found at the N-terminus of GCP6, and between the GCP6 grip1 and grip2 motifs. We also demonstrate that these are involved in the assembly or stabilization of the γTuRC.
Essential Role of Heterocyclic Structure of N-Alkylated 2-Pyrrolidone Derivatives for Recycling Uranium from Spent Nuclear Fuels
Authors: Inoue Tsubasa , Kazama Hiroyuki , Tsushima Satoru , Takao Koichiro 
Published: April 2020

Abstract
In a simple and versatile reprocessing method for recycling U and Pu from spent nuclear fuels, cyclic amides like N-alkylated 2-pyrrolidone derivatives (NRPs) are exclusively employed. However, there has been no convincing rational to explain why such a heterocyclic structure is required. To answer this question, we employed N-cyclohexyl-2-pyrrolidone (NCP) and N-cyclohexylformamide (NCF) as cyclic and acyclic monodentate amides, and focused on the following 3 topics in this study; (1) structural chemistry of their uranyl dinitrato complexes, (2) precipitation behavior of UO22+ from HNO3(aq) by using these amides, and (3) their chemical stability in HNO3(aq) simulating the reprocessing conditions for spent nuclear fuels. Fundamental coordination chemistry of UO2(NO3)2(L)2 (L = NCP, NCF) was found to be common to both L, regardless of the presence or absence of the pyrrolidone ring. Furthermore, both L exhibit comparable capability in precipitation of UO22+ from HNO3(aq). The most critical difference between NCP and NCF was found in their chemical stability in HNO3(aq), where NCF was gradually decomposed through acid-catalyzed hydrolysis, while NCP remained intact for at least 4 h. In conclusion, the pyrrolidone ring of NRPs plays an important role to sterically protect the carbonyl C from nucleophilic hydrolysis which initiates the amide C(=O)–N bond cleavage.
Over-expression of Ki-67 as a predictor of lymph node metastasis in penile cancer patients
Authors: Warli Syah Mirsya , Siregar Ginanda Putra 
Published: April 2020

Introduction: Penile cancer is a moderately common malignancy in developing countries. Metastasis to regional lymph nodes is an essential factor in a patient’s prognosis, as its occurrence predicts poor patient prognosis. As micro-metastasis occurs in more than 25% of cases, the need for more accessible diagnostic tools is necessary. Ki-67 is commonly used as a marker of proliferation associated with tumor grade and lymph node metastasis. Methods: Samples were taken from penile cancer patients between 2013 to 2018, in the form of formalin-fixed paraffin-embedded (FFPE) blocks were analyzed. Patient demographic data, current and pre-cancer condition, cancer staging, outcomes, and other results of adjuncts and treatment modalities were obtained from medical records. Immunohistochemistry analysis was carried out on FFPE preparations. Under 20% of nuclei stained was considered as low-expression and more than 20% of nuclei stained was considered as Ki-67 over-expression. Data processing and analysis were carried out using SPSS software. Results: In total, 48 FFPE samples were analyzed, with a mean patient age of 50.79 (±9.51 SD). For all patients, the type of pathology was squamous cell carcinoma. Node metastasis was positive in 34 patients (70.8%) and negative in 14 patients (29.2%). Statistical analysis was carried out using the Chi-Square test, resulting in a significant correlation between the expression of Ki-67 and lymph node metastasis in penile squamous cell carcinoma (p=0.045). Conclusion: Over-expression of Ki-67 were found in penile cancer patients with lymph node metastasis. Therefore, Ki-67 might be useful in predicting lymph node metastasis in penile cancer patients.
Factors associated with burnout syndrome in surgeons: a systematic review
Authors: Galaiya R , Kinross J , Arulampalam T 
Published: April 2020

Introduction To date, studies have shown a high prevalence of burnout in surgeons. Various factors have been found to be associated with burnout, and it has significant consequences personally and systemically. Junior doctors are increasingly placing their own health and wellbeing as the most important factor in their decisions about training. Finding ways to reduce and prevent burnout is imperative to promote surgical specialties as attractive training pathways. Methods The MEDLINE, PsychInfo and EMBASE databases were searched using the subject headings related to surgery and burnout. All full text articles that reported data related to burnout were eligible for inclusion. Articles which did not use the Maslach Burnout Inventory or included non-surgical groups were excluded; 62 articles fulfilled the criteria for inclusion. Findings Younger age and female sex tended to be associated with higher levels of burnout. Those further in training had lower levels of burnout, while residents suffered more than their seniors. Burnout is associated with a lower personal quality of life, depression and alcohol misuse. Academic work and emotional intelligence may be protective of burnout. Certain personality types are less likely to be burnt out. Mentorship may reduce levels of burnout. Conclusions Workload and work environment are areas that could be looked at to reduce job demands that lead to burnout. Intervening in certain psychological factors such as emotional intelligence, resilience and mindfulness may help to reduce burnout. Promoting physical and mental health is important in alleviating burnout, and these factors likely have a complex interplay.