bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deep Neural Network for Differentiation of Brain Tumor Tissue Displayed by Confocal Laser Endomicroscopy
Authors: Ziebart Andreas , Stadniczuk Denis , Roos Veronika , Ratliff Miriam , von Deimling Andreas , Hänggi Daniel , Enders Frederik 
Published: May 2021

BackgroundReliable on site classification of resected tumor specimens remains a challenge. Implementation of high-resolution confocal laser endoscopic techniques (CLEs) during fluorescence-guided brain tumor surgery is a new tool for intraoperative tumor tissue visualization. To overcome observer dependent errors, we aimed to predict tumor type by applying a deep learning model to image data obtained by CLE.MethodsHuman brain tumor specimens from 25 patients with brain metastasis, glioblastoma, and meningioma were evaluated within this study. In addition to routine histopathological analysis, tissue samples were stained with fluorescein ex vivo and analyzed with CLE. We trained two convolutional neural networks and built a predictive level for the outputs.ResultsMultiple CLE images were obtained from each specimen with a total number of 13,972 fluorescein based images. Test accuracy of 90.9% was achieved after applying a two-class prediction for glioblastomas and brain metastases with an area under the curve (AUC) value of 0.92. For three class predictions, our model achieved a ratio of correct predicted label of 85.8% in the test set, which was confirmed with five-fold cross validation, without definition of confidence. Applying a confidence rate of 0.999 increased the prediction accuracy to 98.6% when images with substantial artifacts were excluded before the analysis. 36.3% of total images met the output criteria.ConclusionsWe trained a residual network model that allows automated, on site analysis of resected tumor specimens based on CLE image datasets. Further in vivo studies are required to assess the clinical benefit CLE can have.
Adverse Events and Unsuccessful Intubation Attempts Are Frequent During Neonatal Nasotracheal Intubations
Authors: Tippmann Susanne , Haan Martin , Winter Julia , Mühler Ann-Kathrin , Schmitz Katharina , Schönfeld Mascha , Brado Luise , Mahmoudpour Seyed Hamidreza , Mildenberger Eva , Kidszun André 
Published: May 2021

Background: Intubation of neonates is difficult and hazardous. Factors associated with procedure-related adverse events and unsuccessful intubation attempts are insufficiently evaluated, especially during neonatal nasotracheal intubations.Objective: Aim of this study was to determine the frequency of tracheal intubation–associated events (TIAEs) during neonatal nasotracheal intubations and to identify factors associated with TIAEs and unsuccessful intubation attempts in our neonatal unit.Methods: This was a prospective, single-site, observational study from May 2017 to November 2019, performed at a tertiary care neonatal intensive care unit in a German academic teaching hospital. All endotracheal intubation encounters performed by the neonatal team were recorded.Results: Two hundred and fifty-eight consecutive intubation encounters in 197 patients were analyzed. One hundred and forty-eight (57.4%) intubation encounters were associated with at least one TIAE. Intubation inexperience (&lt;10 intubation encounters) (OR = 2.15; 95% CI, 1.257–3.685) and equipment problems (OR = 3.43; 95% CI, 1.12–10.52) were predictive of TIAEs. Intubation at first attempt (OR = 0.10; 95% CI, 0.06–0.19) and videolaryngoscopy (OR = 0.47; 96% CI, 0.25–0.860) were predictive of intubation encounters without TIAEs. The first intubation attempt was commonly done by pediatric residents (67.8%). A median of two attempts were performed until successful intubation. Restricted laryngoscopic view (OR = 3.07; 95% CI, 2.08–4.53; Cormack-Lehane grade 2 vs. grade 1), intubation by pediatric residents when compared to neonatologists (OR = 1.74; 95% CI, 1.265–2.41) and support by less experienced neonatal nurses (OR = 1.60; 95% CI, 1.04–2.46) were associated with unsuccessful intubation attempts.Conclusions: In our unit, TIAEs and unsuccessful intubation attempts occurred frequently during neonatal nasotracheal intubations. To improve success rates, quality improvement und further research should target interprofessional education and training, equipment problems and videolaryngoscopy.
Synergistic Effect of Cefazolin Plus Fosfomycin Against Staphylococcus aureus in vitro and in vivo in an Experimental Galleria mellonella Model
Authors: Kussmann Manuel , Obermueller Markus , Karer Matthias , Kriz Richard , Chen Rui-Yang , Hohl Lena , Schneider Lisa , Burgmann Heinz , Traby Ludwig , Vossen Matthias G. 
Published: May 2021

Objectives: This study investigated the synergistic in vitro and in vivo activity of cefazolin plus fosfomycin against methicillin-susceptible and methicillin-resistant S. aureus (MSSA and MRSA) to provide the basis for a potential treatment alternative.Methods: Antimicrobial susceptibility and in vitro synergy tests were performed with five MSSA and five MRSA isolates using the broth microdilution and chequerboard assays, respectively. The in vivo efficacy of cefazolin plus fosfomycin for the treatment of MRSA infections was assessed using the Galleria mellonella survival assay.Results: Using fractional inhibitory concentration index (FICI), the evaluated combination of cefazolin plus fosfomycin showed synergistic in vitro activity against all MSSA and MRSA isolates tested. In addition, cefazolin susceptibility was recovered in all MRSA isolates except one fosfomycin-resistant strain when combined with fosfomycin at readily achievable concentrations. The G. mellonella survival assay demonstrated highly synergistic in vivo activity of cefazolin plus fosfomycin, resulting in a 44–52% reduction in mortality when compared to cefazolin-alone and fosfomycin-alone, respectively.Conclusion: If susceptibility to fosfomycin is either confirmed or can be assumed based on local resistance patterns, combination therapy with cefazolin plus fosfomycin could be a valuable treatment option for empirical as well as targeted therapy of S. aureus and MRSA infections. Future studies proving the clinical significance of this combination therapy are therefore warranted.
Risk Factors for Delirium Are Different in the Very Old: A Comparative One-Year Prospective Cohort Study of 5,831 Patients
Authors: Marquetand Justus , Bode Leonie , Fuchs Simon , Hildenbrand Florian , Ernst Jutta , von Känel Roland , Boettger Soenke 
Published: May 2021

Background: In an ever-aging society, health care systems will be confronted with an increasing number of patients over 80 years (“the very old”). Currently, knowledge about and recommendations for delirium management are often based on studies in patients aged 60 to 65 years. It is not clear whether these findings apply to patients ≥80 years.Aim: Comparison of younger and older patients with delirium, especially regarding risk factors.Methods: In this prospective cohort study, within 1-year, 5,831 patients (18–80 years: n = 4,730; ≥80: n = 1,101) with delirium were enrolled. The diagnosis of delirium was based on the Delirium Observation screening scale (DOS), Intensive Care Delirium Screening Checklist (ICDSC) and a DSM (Diagnostic and Statistical Manual)-5 construct of nursing instrument. Sociodemographic trajectories, as well as the relevant predisposing and precipitating factors for delirium, were assessed via a multiple regression analysis.Results: The very old were more commonly admitted as emergencies (OR 1.42), had a greater mortality risk (OR 1.56) and displayed fewer precipitating risk factors for the development of a delirium, although the number of diagnoses were not different (p = 0.325). Predisposing factors were sufficient almost alone for the development of delirium in patients ≥ 80 years of age; in 18–80 years of age, additional precipitating factors had to occur to make a delirium possible.Conclusion: When relevant predisposing factors for delirium are apparent, patients over 80 years of age require comparatively few or no precipitating factors to develop delirium. This finding should be taken into account at hospitalization and may allow better treatment of delirium in the future.
Excited Catatonia in Autism Spectrum Disorder: A Case Series
Authors: Burns Nora Kathleen , Grissett Kathleen , Macaluso Marc , Raza Mohsin , Gracious Barbara 
Published: May 2021

Introduction: Autistic catatonia is an under-recognized debilitating syndrome with long-lasting negative effects for families, healthcare workers, and high-cost to the healthcare system. In this report, we describe two cases of excited catatonia in young men diagnosed with autism. Both endured a delay to diagnosis and difficulty to obtain appropriate treatment.Main concern: Each patient had a change in behavior from their baseline but with differences in severity and onset. The diagnosis in the first patient was made after only 3 months as the change was dramatic and sudden. Yet, despite a confirmed diagnosis, it was difficult to treat as the importance of M-ECT was not recognized by the clinicians. The second patient had been suffering for more than 5 years with a slow progression of worsening aggressive symptoms. The aggression was so uncontrollable that the patient required sedation, intubation and daily ECT. Both suffered from agitation, unprovoked aggression, urinary incontinence, stereotypic, and OCD behaviors and compulsive masturbation.Primary Diagnosis, intervention/outcomes: Both patients were diagnosed with autism, one high-functioning, attending high school and working a part-time job, the second low-functioning, nearly non-verbal, isolated to home and ABA school. The first patient's diagnosis of catatonia was only suspected after five psychiatric admissions and more than 20 medication trials. Lorazepam challenge was effective, he was treated with a short series of ECT but each time the treatments were tapered, the aggression returned. Ultimately, stabilized on weekly ECT. The second patient's behavior was escalating over a 5 month period, to the point, the aggression was uncontrollable. He presented to the ED under involuntary hold and the behavior could not be stabilized to the point that emergent ECT was initiated.Conclusion: Two cases of autistic catatonia diagnosed and treated within a year time span at a small community hospital indicates that this diagnosis is more common than previously recognized. We propose screening all patients with neurodevelopmental disorders with the Bush-Francis and Kanner scales to diagnose and treat them appropriately.
The implementation of the Student Response System (SRS) Kahoot! in EFL classes and its effects on reading comprehension
Authors: Narváez Paguay Joe Adrián , Santillán Juan José 
Published: May 2021

Improvement of teacher-student class interaction has been obtaining greater progresses thanks to technological development with the addition of practical resources and modern facilities in educational institutions. The use of game-based response systems for enhancing language skills inside an EFL classroom has reported benefits mainly for certain particular skills like grammar and sentence structuring. In this study, the online gaming platform Kahoot! was used specifically for enhancing the reading comprehension skill through a period of nearly three months on students of A2 level from Universidad de Cuenca in Ecuador. The intervention of the Kahoot! website focused on the comprehension and remembering of specific details by means of quizzes. The research design of this study used a mixed-method based on the Hypothetico-Deductive approach to research and data collection instruments, as well as their further analysis and interpretation. Pre and posttests were used in order to compare the results before and after the methodology. The outcomes revealed a statistical improvement with favorable effects regarding the pre and posttests and also a general learner acceptance towards the stated methodology. Further research is suggested on the use of Kahoot! for reading comprehension improvement purposes and its continuous use as a supporting tool for remembering specific details of texts, together with other subskills which could possibly be benefitted from this methodology in the field of EFL instruction.
Obstetric and Perinatal Outcomes after Very Early Preterm Premature Rupture of Membranes (PPROM)-A Retrospective Analysis over the Period 2000–2020
Authors: González-Mesa Ernesto , Blasco-Alonso Marta , Benítez María José , Gómez-Muñoz Cristina , Sabonet-Morente Lorena , Gómez-Castellanos Manuel , Ulloa Osmayda , González-Cazorla Ernesto , Puertas-Prieto Alberto , Mozas-Moreno Juan , Jiménez-López Jesús , Lubián-López Daniel 
Published: May 2021

Background and Objectives: Pre-term premature rupture of membranes (PPROM) responds for one third of preterm births, and it is associated with other complications that increase the risk of maternal or fetal poor outcome. To reduce uncertainty and provide accurate information to patients, the analysis of the large series is of great importance. In order to learn about the evolution over the time of the obstetric and perinatal outcomes in cases of PPROM at, or before, 28 weeks (very early PPROM) managed with an expectant/conservative protocol, we have designed the present study. Materials and Methods: We retrospectively studied all cases of very early PPROM attended in Malaga University Regional Hospital from 2000 to 2020. Results: Among 119,888 deliveries assisted, 592 cases of PPROM occurred in pregnancies at or before 28 weeks (0.49% of all deliveries, 3.9% of all preterm births and 12.9% of all cases of PPROM). The mean duration of the latency period between PPROM and delivery was 13.5 days (range 0 to 88 days), enlarging over the years. The mean gestational age at delivery was 27 weeks (SD 2.9; range 17–34). The proportion of cesarean deliveries was 52.5%. The overall perinatal mortality rate was 26.5%, decreasing over the period with a significant correlation Pearson’s coefficient −0.128 (p < 0.05). Conclusions: In the period 2000–2020, there was an improvement in the outcomes of very early PPROM cases and perinatal mortality showed a clear trend to decrease.
Structural Changes of Nitrogen Ferrite After Aging in Temperature Interval up to 100 °С
Authors: MECHKAROVA Tatyana , ARGIROV Yaroslav , SPASOVA Daniela , STOYANOVA Aneliya 
Published: May 2021

This paper aims to determine the extent of aging of nitrogen ferrite at temperatures below 100 °C and the structural and strength changes that occur in the process. The tests are carried out on samples of technically pure iron (Armco). The specimens are pre-deformed by tension and re-crystallisation heating to achieve a large-grain ferrite structure. A large-grained structure has been chosen to more accurately track the change in micro-hardness of the individual grains during the aging process. Nitric ferrite results from gas carbonitriding and subsequent hardening. Upon hardening, the samples are stored in a refrigerator, and then the surface layer formed is removed through electrochemical corrosion. Afterwards, aging heat treatment at temperatures below 100 °C is undertaken. After the aging process, micro-hardness of the individual grains is examined and X-ray structural analysis is performed.
Green Synthesis of Metallic Nanoparticles, Phytochemical Compounds and Antioxidant Activity Using Two Types of Algae Plants
Authors: SUICA-BUNGHEZ Ioana Raluca , COVALIU Ileana Cristina , SORESCU Ana Alexandra , ION Rodica Mariana 
Published: May 2021

Scientific studies have demonstrated that the vegetable material extracts act as potential precursors for the synthesis of nanomaterial using eco-friendly ways. Because the plant extracts contain various secondary metabolites, they act as reducing and stabilizing agents for the bioreduction reaction for synthesis of novel metallic nanoparticles.Herein, we describe the characteristics of different algae types, from different locations (Belgium and South Correa). Algae have important components, like chlorophyll and other plant pigments, omega-3 fatty acids and essential elements. Also, it has been demonstrated that algae provide a rich source of natural bioactive compounds with antibacterial and antioxidant properties. Another important aspect is the fact that algae represent a good wastewater treatment. In addition to the economic aspect, algae biomass is a source of biodiesel and offers an efficient way for nutrient consumption and provides aerobic bacteria with oxygen through photosynthesis. It is a low-cost technique for the removal of phosphorus, nitrogen and pathogens. We first characterized and compared quantitatively (polyphenols, flavonoids) and qualitatively (carbohydrates, alkaloids) the properties of two algae types extracts (green algae - Enteromorpha spp. and brown ones - Hizikia fusiforme). We then obtained and characterized the gold nanoparticles, formed using HAuCl4 (10-3 M) and algae sample extracts. The algae extracts, the green method for obtaining metallic nanoparticles (AuNP) and the nanoparticles investigated by UV-Vis spectroscopy, optical microscopy and SEM technique are shown in this research.
Manufacturing Technology of Some Impact Resistant Materials
Authors: PĂDURARU Iulian , BRIA Vasile , CÎRCIUMARU Adrian 
Published: May 2021

In this paper impact resistance is a key parameter for composite materials. Composite structures can experience impact loads either accidentally in the designed life or in an anticipated hostile service environment. That is why the manufacturing technology is very important. For materials manufacture were established: the type of polymer matrix, the types of fabrics and additives which will be used to improve impact resistance and also analysis of mechanical properties of formed composite materials (bending and tensile tests). Knowledge of the mechanical properties of polymeric materials is necessary in all areas of their applicability. Thus, rigidity and mechanical strength are key properties for most applications in which polymeric matrix composites are used.
EVALUASI NILAI GIZI TEPUNG PISANG GOROHO (Musa acuminate, sp) TERMODIFIKASI
Authors: Sangkilen Lisa , Djarkasi Gregoria Sri Suhartati , Mandey Lucia Cecilia 
Published: May 2021

ABSTRACTThe purpose of this research is to identify the chemical properties of goroho plantain flour produced through the process of modification of cold-boiled, cold-steamed and cold-roasted. The method used in this study is the experimental method. The parameters measured were starch content, amylose content, resistant starch content and in vitro digestibility of starch on modified goroho plantain flour. The results obtained in this study were an increase in starch content in cold-boiled treatment 79.29%, cold-steamed 76.83%, cold-roasted 72.86%, amylose content in cold-boiled treatment 25.54%, cold-boiled 24.37%, cold-roasted 21.40 %, resistant starch content of cold-boiled treatment 28.87%, cold-steamed 28.18%, cold-roasted 27.21%, and in vitro digestibility cold-boiled treatment 46.17%, cold-boiled 55.66%, cold-roasted 66.12%. The modification of goroho plantain flour with boiled, steamed and roasted treatments can increase the levels of resistant starch in goroho plantain flour. Keywords: goroho banana flour, resistant starch, goroho banana
REKAYASA MESIN PENGUPAS KULIT BUAH KOPI JENIS ROBUSTA MODEL TEP-JLL 2015 DI KABUPATEN TANA TORAJA
Authors: Langi Jois Limbong , Ludong Daniel P. M. , Lengkey Lady C. Ch. E. 
Published: May 2021

ABSTRACT The objective of this research was to design a pulper machine model TEP-JLL 2015 for fresh coffee robusta used in rural areas of Tana Toraja district. The machine was designed based on the analysis of physical characteristics of Robusta Tana Toraja coffee and literature study. The analysis result of physical characteristics showed the average length, thickness width was 12.494 mm, 12.802 mm, 10.687 mm, respectively, and the bulk density was 1,115 kg/m3. The theoretical hopper capacity of this machine was 3.7687 kg. Assuming the cylinder speed was 111.594 rpm with an effective distance setting system or flawed setting of 1.2 cm, the theoretical capacity of this pulper machine was 380.62 kg/hour. Keywords: fresh Robusta coffee fruit, pulper machine
Analisis Sekuens DNA Penyandi 18S rRNA pada Tumbuhan Cocor Bebek (Kalanchoe x laetivirens)
Authors: Andariyusti Felly , Roslim Dewi Indriyani 
Published: May 2021

(Article History: Received January 16, 2021; Revised April 6, 2021; Accepted April 13, 2021) ABSTRAKStudi mengenai stress pada tumbuhan semakin banyak didasarkan pada ekspresi gen. Gen penyandi 18S rRNA merupakan salah satu anggota dari gen housekeeping yang umum digunakan sebagai kontrol internal. Penelitian ini bertujuan untuk menganalisis sekuens DNA penyandi 18S rRNA pada tumbuhan cocor bebek (K. x laetivirens). Metode penelitian meliputi ekstraksi DNA total dari daun segar menggunakan Mini Kit Genomic DNA Mini Kit Plant (Geneaid). Data sekuen DNA diolah menggunakan program BioEdit, BLASTn dan MEGA 6. Sekuen DNA parsial dari gen penyandi 18S rRNA K. x laetivirens telah diperoleh dengan ukuran 419pb. Sekuen tersebut memiliki kemiripan sebesar 99,28% dengan K. daigremontiana. Kalanchoe x laetivirens membentuk satu kelompok dengan sesama anggota dari famili Crassulaceae dan terpisah dari famili lainnya yang diteliti. Primer 18S rRNA spesifik terhadap cocor bebek telah dirancang, yaitu forward 5’- CAA ATT ACC CAA TCC TGA CA -3’ dan reverse 5’- CCA ACG TAA ATA GGA TCG AA -3’. Sekuen yang diperoleh pada penelitian ini berpotensi sebagai gen referensi setelah dilakukan validasi.Kata kunci: 18S rRNA; gen housekeeping; Kalanchoe x laetivirens; kontrol internal; PCR ABSTRACTPlant stress studies are based on gene expressions. This study aims to analyze the DNA sequence of 18S rRNA in cocor bebek (K. x laetivirens). Methods being out are total DNA isolation using Mini Kit Genomic DNA Mini Kit Plant (Geneaid). The DNA sequence was analyzed utilizing BioEdit, BLASTn and Mega 6 programs. Partial DNA sequence of 18S rRNA in K. x laetivirens has been obtained with 419 bp length. The DNA sequence has 99.28% similarity to K. daigremontiana. Kalanchoe x laetivirens formed one group with another species from the same family, Crassulaceae, based on the DNA sequence of 18S rRNA. A primer pair specific to K. x laetivirens for amplifying 18S rRNA has been designed such as forward 5’- CAA ATT ACC CAA TCC TGA CA -3’ and reverse 5’- CCA ACG TAA ATA GGA TCG AA -3’. This DNA sequence is potentially being employed as an internal control once the validation process completed.Keywords: 18S rRNA; housekeeping gene; internal control; Kalanchoe x laetivirens; PCR