bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Scaffold Derived from GGTA1 and CMAH Gene Knockout Pigs Generated by Gene Editing Provoked Little Inflammatory Responses in a Humanized Pig Model
Authors: yen chon-ho , Tai Hao-Chih , Peng Su-Hei , Yang Tien-Shuh , Tu Ching-Fu 
Published: February 2020

Abstract
BackgroundThe porcine small intestinal submucosa ECM (SIS-ECM) has been used as a supportive scaffold for healing in a variety of tissues. However, the outcomes of its application are far from satisfactory.ResultsThe possibility of generating a porcine small intestinal submucosa extracellular matrix (SIS-ECM) that is fully biocompatible was investigated. Samples of SIS-ECM were prepared from either domestic wild-type (WT) or double-gene knockout (dKO) pigs without antigenic responses to α-Gal and N-glycolylneuraminic acid (Neu5Gc). The scaffolds, which were sutured into cuts made in the longissimus muscle of the dKO pigs, were expected to exhibit xeno-reactions through natural antibodies as in a human response. A process was established to manufacture ameliorating acellular porcine SIS-ECM implants with consistent quality characteristics, which were assured by analyzing the level of residual DNA, the glycosaminoglycan content, and histochemical stains. Once implanted, the acellular SIS-ECM from the WT pigs caused a significant increase in serum IL-6 levels in the dKO recipient pigs, indicating a host defense through immune reactions. The levels remained unchanged when preparations from the dKO pigs were used. The pathological score of the multinuclear giant cells of the dKO (WT) group (2.3±0.5) was significantly greater than that of the dKO (dKO) group (0.7±0.3).ConclusionThe IL-6 levels and pathological evidences suggested that dKO pigs without α-Gal or Neu5Gc antigenic causing lower inflammatory response can serve as biocompatible SIS-ECM donors or as animal models for testing anthropomorphic immune responses to biomedical devices.
Improved cycling stability of LiCoO2 at 4.5 V via surface modification of cathode plates with conductive LLTO
Authors: Song Shipai , Peng Xiang , Huang Kai , Zhang Hao , Wu Fang , Xiang Yong , Zhang Xiaokun 
Published: February 2020

Abstract
The stability issue of LiCoO 2 cycled at high voltages is one of the burning questions for the development of lithium ion batteries with high energy density and long cycling life. Although it is effective to improve the cycling performance of LiCoO 2 via coating individual LiCoO 2 particles with another metal oxides or fluorides, the rate capacity is generally compromised because the typical coating materials are poor conductors. Herein, amorphous Li 0.33 La 0.56 TiO 3 , one of the most successful solid electrolytes, was directly deposited on the surface of made-up LiCoO 2 cathode plates through magnetron sputtering. Not only the inherent conductive network in the made-up LiCoO 2 cathode plates was retained, but also the Li + transport in bulk and across the cathode-electrolyte interface was enhanced. In addition, the surface chemical analysis of the cycled LiCoO 2 cathode plates suggests that most of the stability issues can be addressed via the deposition of amorphous Li 0.33 La 0.56 TiO 3 . With an optimized deposition time, the LiCoO 2 cathode plates modified by Li 0.33 La 0.56 TiO 3 performed a steady reversible capacity of 150 mAh/g at 0.2 C with the cut-off voltage from 2.75 to 4.5 V vs. Li + /Li, and an 84.6% capacity gain at 5 C comparing with the pristine one.
Simulated patient and role play methodologies for communication skills and empathy training of undergraduate medical students
Authors: Bagacean Cristina , Cousin Ianis , Ubertini Anne-Helene , Idrissi Mohamed El Yacoubi El , Bordron Anne , Mercadie Lolita , Garcia Leonor Canales , Ianotto Jean-Christophe , De Vries Philine , Berthou Christian 
Published: February 2020

Abstract
Background

Verbal and non-verbal communication, as well as empathy are central to patient-doctor interactions and have been associated with patients’ satisfaction. Non-verbal communication tends to override verbal messages. The aim of this study was to analyze how medical students use verbal and non-verbal communication using two different educational approaches, student role play (SRP) and actor simulated patient (ASP), and whether the non-verbal behaviour is different in the two different poses.

Methods

Three raters evaluated 20 students playing the doctor role, 10 in the SRP group and 10 in the ASP group. The videos were analyzed with the Calgary-Cambridge Referenced Observation Guide (CCG) and, for a more accurate evaluation of non-verbal communication, we also evaluated signs of nervousness, and posture. Empathy was rated with the CARE questionnaire. Independent Mann Whitney U tests and Qhi square tests were performed for statistical analysis.

Results

From the 6 main tasks of the CCG score, we obtained higher scores in the ASP group for the task ‘Gathering information’ (p=0.0008). Concerning the 17 descriptors of the CCG, the ASP group obtained significantly better scores for ‘Exploration of the patients’ problems to discover the biomedical perspective’ (p=0.007), ‘Exploration of the patients’ problems to discover background information and context’ (p=0.0004) and for ‘Closing the session – Forward planning’ (p=0.02). With respect to non-verbal behaviour items, nervousness was significantly higher in the ASP group compared to the SRP group (p<0.0001). Concerning empathy, no differences were found between the SRP and ASP groups.

Conclusions

Medical students displayed differentiated verbal and non-verbal communication behaviour during the two communication skills training methodologies. These results show that both methodologies have certain advantages and that more explicit non-verbal communication training might be necessary in order to raise students’ awareness for this type of communication and increase doctor-patient interaction effectiveness.
Prognostic death factors in SHLH children with MODS receiving CRRT: a multicenter prospective nested case-control study
Authors: Cui Yun , Shi Jingyi , Shan Yijun , Wang Chunxia , Ren Yuqian , Lu Guoping , Yan Gangfeng , Zhu Xiaodong , Zhu Yueniu , Wang Ying , Ren Hong , Zhang Yucai 
Published: February 2020

Abstract
Background: Multiple organ dysfunction syndrome (MODS) with secondary hemophagocytic lymphohistiocytosis (SHLH) causes significant mortality, while continuous renal replacement therapy (CRRT) is commonly conducted. The objective is to identify the predictor factors associated with poor outcomes in pediatric patients with SHLH -associated MODS who received CRRT. Methods: A multicenter prospective nested case-control study in four PICUs of tertiary university children’s hospital in Shanghai from September 2013 to August 2018.We prospectively studied 52 SHLH-associated MODS pediatric patients receiving CRRT. Results: Overall PICU mortality rate was 46.15%(24/52). Less respiratory (28.6% vs. 87.5%, P <0.001) or cardiovascular dysfunction (25% vs. 83.3%, P <0.001) caused in survivors at CRRT initiation, as well as reduced demands of mechanical ventilation and vasoactive agents (28.6% vs. 87.5%,17.9 % vs. 66.7 %, both P <0.001). Non-survivors had higher levels of serum lactate dehydrogenase (1404.5 (713.25, 2793) vs. 982.7 (692, 1461) (U/L), P = 0.037), lactic acid (1.9 (1.3, 4.53) (mmol/L) vs. 1.65 (0.8, 2.45) , P=0.034), triglyceride (2.88 (1.94, 5.08) (mmol/L) vs. 2.41 (1.63, 3.32), P=0.032) and IL-6 (28.66 (17.77, 113.63) (pg/ml) vs.0.98 (0.1, 4.63) P=0.000). More than 3 organ dysfunction (Odd ratio [ OR ] : 3.464; 95% confidence interval [ CI ] [1.018-11.788], P = 0.047), and the serum IL-6 level higher than 13.12 pg/mL ( OR :1.388; 95% CI [1.058-1.821], P = 0.018 ) were two independent risk factors for mortality. Conclusions: The number of organ dysfunction and IL-6 levels at CRRT initiation are the independent risk factors for mortality in SHLH-associated MODS patients.
Recommendations for fluid management of adults with sepsis in sub-Saharan Africa: A systematic review of guidelines
Authors: Silberberg Benjamin Peter , Aston Stephen , Boztepe Selda , Rylance Jamie 
Published: February 2020

Abstract
Background Sepsis guidelines are widely used in High Income Countries and intravenous fluids are an important supportive treatment modality. However, fluids have been harmful in intervention trials in Low-Income Countries, most notably in sub-Saharan Africa. We assessed the relevance, quality and applicability of available guidelines for the fluid management of adult patients with sepsis in this region. Methods We identified sepsis guidelines by systematic review with broad search terms, duplicate screening and data extraction. We included peer-reviewed publications with explicit relevance to sepsis and fluid therapy. We excluded those designed for specific medical conditions, for limited geographic locations, or for non-adult populations. We used the AGREE II tool to assess the quality of guideline development, performed a narrative synthesis and using theoretical case scenarios to assess practical applicability to everyday clinical practice in resource-constrained settings. Results Published sepsis guidelines are heterogeneous in sepsis definition and in quality: 8/10 guidelines had significant deficits in applicability, particularly with reference to resource considerations in low-income settings. Indications for intravenous fluid were: hypotension (8/10); clinical markers of hypoperfusion (6/10); lactataemia (3/10). Crystalloids were overwhelmingly recommended (9/10). Suggested volumes varied; 5/10 explicitly recommended “fluid challenges” with reassessment, totalling between 1L and 4L during initial resuscitation. Fluid balance, including later de-escalation of therapy was not specifically described in any. Norepinephrine was the preferred initial vasopressor (5/10), specifically targeted to MAP >65mmHg (3/10), with higher values suggested in pre-existing hypertension (1/10). Recommendations for guidelines were almost universally derived from evidence in High Income Countries. None of the guidelines suggested any refinement for patients with malnutrition. Conclusions Widely used international guidelines contain disparate recommendations on intravenous fluid use, lack specificity and are largely unattainable in Low-Income Countries given available resources. A relative lack of high-quality evidence from sub-Saharan Africa increases reliance on recommendations which may not be relevant or implementable.
Enhanced Biometric Recognition for Secure Authentication using Iris Preprocessing and Hyper Elliptic Curve Cryptography
Authors: Rajasekar Vani , J Premalatha , K Sathya 
Published: February 2020

Abstract
Biometrics combined with cryptography can be employed to solve the conceptual and factual identity frauds in digital authentication. Biometric traits are proven to provide enhanced security for detecting crimes because of its interesting features such as accuracy, stability and uniqueness. Although diverse techniques have been raised to address this objective, limitations such as higher computational time, minimal accuracy and maximum recognition time remain. To overcome these challenges an enhanced iris recognition approach has been proposed based on Hyper Elliptic Curve Cryptography (HECC). The proposed study uses 2D Gabor filter approach for perfect feature extraction in iris preprocessing. Light weight cryptographic scheme called HECC was employed to encrypt the iris template to avoid intentional attack by the intruders. The benchmark CASIA Iris V-4 and IITD Iris datasets were used in the proposed approach for experimental analysis. The result analysis witnessed that the prime objective of the research such as lesser false acceptance rate, lesser false rejection rate, maximum accuracy of 99.74%, maximum true acceptance rate of 100%, and minimal recognition time of 3 seconds has been achieved. Also it has been identified that the proposed study outperforms other existing well known techniques.
Similar outcomes for intramedullary nail versus locking plate in treating proximal humerus fractures: a retrospective study
Authors: FENG GAO , wang xiu-hui , xia sheng-li , zhou xiao-xiao , fu bei-gang , yi cun-guo , wang ming-hui 
Published: February 2020

Abstract
Objective The aim of this study was to compare the clinical and radiographic outcomes and complications following locking plate versus intramedullary nail fixation of 2- and 3-part proximal humerus fractures. Methods A total of 97 patients (47, nail group; 50, plate group) were included in this retrospective study. The patients were treated either with an intramedullary nail or a locking plate. The length of the surgical incision, operative time, healing time, Constant-Murley score, and postoperative complications were compared between groups. Results The average length of the incision, operative time of intramedullary nail group were significantly less than locking plate group (P<0.05). There were no significant differences in the average fracture union time, Constant-Murley functional score, postoperative neck-shaft angle and neck-shaft angle a year after surgery (P>0.05). Postoperative complications in the plate group included delayed union (n=2), screw cutout (n=1), varus malunion (n=3), displacement of the greater tubercle (n=1), and subacromial impingement syndrome (n=1). Complications in the nail group included delayed union (n=1), screw cutout (n=3), displacement of the greater tubercle (n=4), and subacromial impingement syndrome (n=3); varus malunion was not observed. Conclusion Both the nail and locking plate were effective and had similar outcomes in patients with 2- or 3-part proximal humerus fractures. For valgus-type fractures, the plate had an advantage over the nail; for varus-type, the nail was a better option.
Does the current Scope of nutrition labelling provided in the Saudi markets cope with the increasing trend of chronic disease?
Authors: Jr Hoda , AlMughthem Amal , Bawazir Amen A 
Published: February 2020

Abstract
Background: With increased demand for prepackaged food, the nutrient content of those products has increased especially fat, sugar, and sodium. We aimed to assess the compliance of nutritional labeling and to analyze the stated nutritional components as presented on prepackaged food products in Saudi market. Methods: A total of 1153 foods were randomly sampled from fourteen stores. Nutritional information was taken from nutrient declarations present on food labels and assessed through a comparison of mean levels and assess compliance with Saudi Food and Drug Authority regulations. Results: Overall, of the total number of products surveyed, 88% displayed nutritional facts, while 12% did not. Of the total products that had nutritional facts, only 38% met SFDA requirements while 97% disclosed the four key nutritional elements (energy, carbohydrate, protein and fat). In total, almost one third of the products had a high fat content, 40% were high in sugar and 20% were high in Sodium. We found also, 20% listed hydrogenated fat in their ingredient information, 90% of which was fully hydrogenated, while 10% was partially hydrogenated. Conclusion: There was a high percentage of products that displayed nutritional facts, but only a small percentage complied with SFDA's recent regulations. Food reformulation could have an extraordinary potential to overcome the increase in nutrition-related chronic disease in Saudi Arabia, and the information acquired from this paper provides an overview of thinking about the food supply as a major source needed for a national intervention.
Risk Factors for Prolonged Hospital Stay and In-Hospital Mortality in Hip Fracture Patients Aged Over 65 Years: A Composite Endpoint Analysis
Authors: Marín Jorge Salvador , Martínez Francisco Javier Ferrández , Ripoll Jose Miguel Seguí , Rico José Antoio Quesada , Beltrán Domingo Orozco , Munuera María Concepción Carratalá , López José Fernando Martínez , Campos Juan Carlos Marzo 
Published: February 2020

Abstract
Objectives : This study aimed to determine the risk factors that increase the risk of in-hospital mortality and/or prolonged hospital stay in hip fracture patients aged over 65 years. Methods : We conducted a retrospective study of patients aged over 65 years who underwent hip fracture surgery in the period from January 2015 to December 2017. Our analysis included 54 variables related to medical, psychological, functional and laboratory comorbidities present at admission; treatment, complications and laboratory follow-up during the hospital stay; and functional status and destination on discharge. We performed a bivariate analysis and a multivariate analysis with a composite endpoint combining in-hospital mortality and hospital stay lasting more than 10 days. Results : We included 360 patients with an average age of 84 years. Women accounted for 75% of the sample, and 53.5% of all patients had a pertrochanteric fracture. The mean number of comorbidities per patient was 2.72, and the most common comorbidities were high blood pressure, dementia and diabetes. The rate of in-hospital mortality was 3.6% (n 13) and the mean length of hospital stay was 8.48 days, with 16.4% of patients staying in hospital for more than 10 days. Medical complications, lower hemoglobin on admission, high blood pressure, obesity and Parkinson’s disease were significantly associated with our endpoint in the multivariate analysis Conclusions : Patients who suffer medical complications during hospitalization, and those with lower hemoglobin on admission, high blood pressure, obesity or Parkinson’s disease, have an increased risk of in-hospital mortality or prolonged hospital stay
High Pain Catastrophizing Scale predicts lower patient-reported outcome measures in the foot and ankle patient
Authors: Veljkovic Andrea , Gagne Oliver , Abuhantash Monther , Younger Alastair , Symes Michael , Abbas Kaniza Zahra , Penner Murray J. , Wing Kevin J. , Syed Khaled A. , Lau Johnny 
Published: February 2020

Abstract
Background: A patient’s healthcare experience can be modulated by their understanding of their pre-operative disability along with their overall coping strategy. It is hypothesized that patient’s catastrophization and expectation on what they deem to be a successful surgery can affect their outcome. Methods: This current study prospectively assessed a consecutive cohort of patients undergoing foot and ankle reconstruction to describe the relationship between Pain Catastrophizing Scale (PCS) and patient-reported outcomes: SF-12 & FAOS. The PCS has a total score and three subcategories which are rumination, helplessness and magnification. Results: Forty-six patients were found to be eligible in the study with an average age of 54.7±14.4 years-old, a majority female (65%), a minority employed at the pre-operative visit (41%) and with an average BMI of 26.2±5.56. Looking at the FAOS Pain domain, it correlated significantly with the PCS Rumination and Helplessness subcategories. The FAOS Activity of Daily Living domain showed significant correlation with the PCS Rumination and Helplessness subcategories. The FAOS Quality of life domain was also statistically significant for the PCS Rumination and Helplessness subcategories. We found that the mental domain of the SF-12 had a statistically significant effect when compared to the Rumination (p=0.01) and Helplessness (p=0.001) subcategories.Conclusion: This study showed a significant association between an increase preoperative PCS and a worse one-year outcome looking at the FAOS domains. As such, in elective foot and ankle surgery, catastrophization should be screened for and potentially modulated pre-operatively to improve patient operative outcomes.
Cost-Effectiveness Analysis of Advanced Radiotherapy Techniques for Post-Mastectomy Breast Cancer Patients
Authors: Xie Yibo , Guo Beibei , Zhang Rui 
Published: February 2020

Abstract
Background: Prior cost-effectiveness studies of post-mastectomy radiotherapy (PMRT) only compared conventional radiotherapy versus no radiotherapy and only considered tumor control. The goal of this study was to perform cost-effectiveness analyses of standard of care (SOC) and advanced PMRT techniques including intensity-modulated radiotherapy (IMRT), standard volumetric modulated arc therapy (STD-VMAT), non-coplanar VMAT (NC-VMAT), multiple arc VMAT (MA-VMAT), Tomotherapy (TOMO), mixed beam therapy (MIXED), and intensity-modulated proton therapy (IMPT).Methods: Using a Markov model, we estimated the cost-effectiveness of various techniques over 15 years. A cohort of women (55-year-old) was simulated in the model, and radiogenic side effects were considered. Transition probabilities, utilities, and costs for each health state were obtained from literature and Medicare data. Model outcomes include quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratio (ICER), and SOC was used as the reference.Results: For the patient cohort, IMRT is the most cost-effective technique with an ICER value of 27,310 $/QALY, and IMPT has the highest ICER of 74,564 $/QALY. One-way analysis shows that the probability of cardiac toxicity has the most significant impact on the model outcomes. The probability sensitivity analyses show that all advanced PMRT techniques are more cost-effective than SOC at a willingness-to-pay (WTP) threshold of 100,000 $/QALY, while almost none of the advanced techniques is more cost-effective than SOC at a WTP threshold of $50,000/QALY.Conclusion: Advanced PMRT techniques are more cost-effective for breast cancer patients at a WTP threshold of 100,000 $/QALY, and IMRT might be the most cost-effective option for PMRT patients.
Added value of SPECT-CT imaging in the diagnosis of unilateral active mandibular hypercondylia in adult: A Case Report.
Authors: FOKOUE Fabrice , Mselmi Sanae El , Abaouz Nadia , Ismaili Nadia Alaoui 
Published: February 2020

Abstract
Mandibular hypercondylia is a rare and autonomous bone disease due to the excessive growth of the condylar cartilage. The radiological assessment following the clinical examination remains essential to the diagnostic orientation. Planar bone scintigraphy has been frequently used to assess the active or inactive nature of this situation. We report here the case of a patient whose diagnosis of active mandibular hypercondylia was retained due to the complement with SPECT / CT imaging, the planar bone scintigraphy being negative.