bluuebunny/crossref_metadata_2025_split huggingface dataset:
Flipping the Classroom to Optimize Clinical Decision-Making in the Didactic Setting
Authors: Arca-Contreras Karen Marie 
Published: January 2021

BackgroundDeliberate inclusion of clinical decision-making nursing skills in the didactic setting will assist students in potentially making better patient care decisions. This can be optimized through use of the flipped learning andragogy. Flipped learning promotes an interactive classroom environment. It fosters teamwork and collaboration. Direct content instruction is the responsibility of students.ObjectiveThis cohort pilot study investigated how the flipped and nonflipped approach to teaching impacted clinical decision-making and student participation.MethodsThe Clinical Decision-Making in Nursing Scale (CDMNS) was administered to the students in the flipped classroom and the nonflipped classroom on week 1 and week 6. A student participation checklist was used to observe class activities at three separate intervals (baseline, mid-semester, and end-semester). A repeated measures analysis of covariance was conducted with Instruction Group as the between subjects factor (Flipped and Nonflipped) and Time (preinstruction and postinstruction) as the within subjects factor, and covarying age. The Time by the Instruction group was significant. The Flipped group showed an increase in Clinical decision-making scores (p < .001) after instruction while the Nonflipped group did not (p = .40).ResultsThe Flipped group (n = 24) showed an increase in Clinical decision-making scores (p < .001) after instruction while the Nonflipped group (n = 23) did not (p = .40). The Flipped classroom showed 100% participation at baseline, mid-semester, and end of semester. The Nonflipped classroom showed overall lower levels of participation, with 42%, 33%, and 39% at each point respectively.Conclusion/Implications for NursingStudents who were taught using the flipped instruction were able to apply what they learned in relevant case studies, virtual simulations, and practice National Council Licensure Examination RN (NCLEX-RN) type questions. Through teamwork and collaboration, students had time to practice clinical decision-making skills. This was evident in the increased CDMNS scores and increased levels of participation over time in the flipped group when compared to the nonflipped group.
KAJIAN PARAMETER MARSHALL DENGAN MENGGUNAKAN LIMBAH KARET BAN-DALAM KENDARAAN SEBAGAI BAHAN TAMBAH PADA CAMPURAN LAPIS AUS PERMUKAAN ASPAL BETON (AC-WC)
Authors: Akhbar Herry Takbir , Hadi Winoto , Daryati Daryati 
Published: January 2021

This research was using the waste of inner-tube rubber as an additive on asphalt concrete wearing course mixture (AC-WC). The purpose is to know is there a difference between aspal beton that used the waste of inner tube rubber on marshall parameter value. This reseach used experiment method that examine the marshall parameter in 5 extra content variations of the waste of inner-tube rubber, that is 1%, 2%, 3%, 4% and 5%, by 5 sample test items for each variant. Result of this reseach show that the best extra levels of inner-tube rubber was be obtained in 1% level with stability value 804.556 kg, melted value (flow) 3,0 mm, Marshall Quentient (MQ) value 271.333 kg/mm, Voin in Mineral Aggregates (VMA) value 19.131%, Void Filled with Asphalt (VFA) value 73.826% and Void in the Mix (VIM) 4.463%. based on the result of this research, it can be concluded that the inner-tube rubber can be used as an additive on asphalt concrete wearing course mixture (AC-WC).
Introduction of a video assignment: advantages and disadvantages from the studentsâ€™ perspective
Authors: Cornock Claire , Crombie Alex 
Published: January 2021

Â We present a case study on the introduction of video assignments into Level 4 (year 1) and 6 (year 3) modules within a BSc Mathematics degree. The students were required to provide verbal explanations within a video about some written steps in their argument. We present the details of the assignments and assessment criteria. The introduction of the video assignments was evaluated through focus groups. We present a number of advantages and disadvantages from the studentsâ€™ perspective when they compared the methods of providing answers through videos, presentations and written work. In particular, we present information on confidence levels, the ability to spot mistakes, skills development and the usefulness for job applications. We provide some practical suggestions for anyone thinking about introducing their own video assignment. Â Â
Technological Explorations in the Move to Online Mathematics Support
Authors: Heraty Calum , Mac an Bhaird CiarÃ¡n , McGlinchey Aisling , Mulligan Peter , O'Hanrahan PÃ¡dhraic , O'Malley James , O'Neill Rachel , Vivash Tara 
Published: January 2021

Due toÂ Covid-19,Â mathematics support at Maynooth University transitionedÂ from in-person to online over a very short periodÂ in March 2020. This paper provides a brief description of the technologies used by six tutors to facilitate this move. WeÂ outline whyÂ the tutorsÂ pickedÂ these technologiesÂ and how they used them. WeÂ alsoÂ considerÂ the issues tutorsÂ wanted to resolve andÂ reflect on the outcomes of their experiences.
Novel Combination&nbsp;of HuanglianJiedu Decoction in Behavioral and Psychological Symptoms of Dementia in Alzheimer's Disease
Authors: Ma Su-Ya , Wang Xu , Shi Jing 
Published: January 2021

Abstract
Alzheimer's disease (AD) is characterized by progressive cognitive decline. Besides cognitive deficit, AD is also characterized by behavioral and psychological symptoms in dementia (BPSD). However, therapeutic management of BPSD remains challenging. HuanglianJiedu decoction (HLJDD), a traditional Chinese prescription, consisting of four herbs, is applied to treat AD, especially AD with BPSD. Though HLJDD, has the traditional combination with the principal herb Coptidis rhizoma (Huang-lian), it might, however, not be suitable for treating BPSD. Elucidating the mechanism underlying each herb is critical to the disease-matched combination of HLJDD. In this study, network pharmacology was used to determine the targets and biological processes regulated by HLJDD in the treatment of BPSD. Moreover, molecular docking was utilized to evaluate the binding activity between the herbs' main active ingredients and neurotransmitter receptors. The results showed that Scutellariae radix (Huang-qin) and Phellodendri chinrnsis cortex (Huang-bai) exhibited better anti-BPSD effects when compared to Coptidis rhizoma and Gardeniae fructus (Zhi-zi). Scutellariae radix exhibited superior anti-neuroinflammation functions, with better blood vessel regulation effects. Phellodendri chinrnsis cortex showed a higher binding affinity to the dopamine D2 receptor (DRD2) and 5-hydroxytryptamine receptor 2A (HTR2A). Coptidis rhizoma and Gardeniae fructus were better in neuronal signaling. In conclusion, for treating BPSD, Scutellariae radix and Phellodendri chinrnsis cortex are the principal herbs while Coptidis rhizoma and Gardeniae fructus are the ancillary herbs.
Optimal Number of Systematic Biopsy Cores used for Magnetic Resonance Imaging/Transrectal Ultrasound Fusion Targeted Biopsy
Authors: Teraoka Shogo , Honda Masashi , Shimizu Ryutaro , Nishikawa Ryoma , Kimura Yusuke , Yumioka Tetsuya , Iwamoto Hideto , Morizane Shuichi , Hikita Katsuya , Takenaka Atsushi 
Published: January 2021

Abstract
Background: In recent years, the effectiveness of magnetic resonance imaging (MRI)–ultrasound fusion targeted biopsy (MRF–TB) has been widely reported. In this study, we assessed the effect of reduction of the number of systematic biopsy (SB) cores on the cancer detection rate (CDR).Methods: MRI was performed for patients with high prostate-specific antigen (PSA) levels, and the PI–RADSTM (Prostate Imaging-Reporting and Data System version 2) was used to rate the lesions. Patient selection criteria were to satisfy both of the following conditions: ①PSA level between 4.0 ng/ml and 30.0 ng/ml ②Patients having one or more MRI lesions with a PI–RADS score of 3 or more. A total of 104 Japanese met this selection criterion. We have traditionally performed 14-core SB following the MRF–TB. In this study, the CDRs of 10-core SB methods, excluding biopsy results at the center of the base and mid-level on both sides, were compared with those of the conventional biopsy method.Results: We compared CDRs of 14-core and 10-core SBs used in combination. The overall CDR was 55.8% for the former and 55.8% for the latter, indicating no significant difference (p = 1.00). In addition, the CDRs of csPCa were 51.9% for the former and 51.1% for the latter, indicating no significant difference (p = 0.317).Conclusion: Even a 10-core SB used in combination with MRF-TB yields a good CDR. Reducing the number of biopsy cores leads to lower patient burden and lower testing costs.
Practices and Behaviors During the COVID-19 Pandemic in Patients With Rheumatoid Arthritis Who Attended Previously to An Educational Program. A Cross-Sectional Study
Authors: Santos-Moreno Pedro , Buitrago-Garcia Diana , Rodriguez-Florido Fernando , Sánchez-Vanegas Guillermo 
Published: January 2021

Abstract
Background: To describe the practices and behaviors of patients with rheumatoid arthritis (RA) who attend to a face-to-face education program, during the quarantine of the COVID-19 pandemic. Methods: Patients who attended previously a face-to-face education program, responded to a telephonic survey in July 2020. The survey included questions about their practices related to the COVID-19 pandemic, SARS-Cov-2 symptoms, adherence to rheumatoid arthritis treatment, virtual rheumatology consultancy compliance and, the influence of news on their adherence. Results: A total of 260 patients participated in a survey. In July 2020 88% of patients had accessed a telemedicine-based and 12% a face-to-face rheumatology consultation. 3.5% of patients reported having been less adherent to pharmacological therapy due to information received through media or social networks. In general patients had been compliant with COVID-19 prevention recommendations. Only one patient was positive for SARS-CoV-2 and reported only flu symptoms without any complications. Patients highlighted the necessity to have information and education about the relationship between rheumatoid arthritis, its treatment, and COVID-19. Conclusions: An educational program is a helpful tool to maintain high adherence rates to the RA treatment despite of the new challenges associated to the pandemic; Patient-centered education programs should continue to address the patient's concerns and beliefs about their disease and COVID-19.
Stroke and Major Bleeding when Switching from Warfarin to Apixaban in Patients with Advanced Chronic Kidney Disease and Prevalent Atrial Fibrillation
Authors: Garlo Katherine , Mavrakanas Thomas , Wang Wei , Burdick Elisabeth , Charytan David 
Published: January 2021

Abstract
Background Apixaban is the most widely used direct oral anticoagulant in patients with chronic kidney disease (CKD). Data on the incidence of stroke and major bleeding after switching from warfarin to apixaban in patients with prevalent atrial fibrillation (AF) and CKD are limited.Methods Warfarin users with stage 4-5 CKD not on dialysis and non-valvular AF prior to Jan 1,2012 were identified from the United States Data Renal System CKD dataset and individuals switching to apixaban from Jan 1,2012 -Dec 31, 2015 were identified. The incidence of stroke (ischemic or hemorrhagic), transient ischemic attack, or systemic thromboembolism and major bleeding events were estimated. Outcomes were compared between individuals switching to apixaban and those continuing warfarin using survival analyses with inverse probability treatment weighting. Individuals were censored at the time of anticoagulation discontinuation, loss of Medicare part D coverage, dialysis, kidney transplant, a 2nd switch in anticoagulant class, or death. Results 1762 individuals with advanced CKD and AF were initially on warfarin; 71 (4.0%) switched to apixaban (57.8% male, mean age 78.2 years (SD ±6.6), 78.9% white, mean CHA2DS2-VASc 5.0 (SD ±1.5), mean HAS-BLED 2.2 (SD ±0.5) and 1691 (96.0%) continued warfarin (47.6% male, mean age 80.1 years (SD ±8.7), 87.9% white, mean CHA2DS2-VASc 5.5 (SD ±1.6), mean HAS-BLED 2.5 (SD ±0.8). The incidence of stroke in the apixaban switch and warfarin continuation groups were 0.02/patient-year (95%CI 0.002-0.12) and 0.06/patient-year (95%CI 0.05-0.07) (p=0.21). Incidence of major bleeding were 0.02/patient-year (95% CI 0.002-0.13) and 0.06 (95% CI 0.03-0.04) (p =0.44) in the switch and warfarin groups, respectively. In adjusted models, the risk of stroke (HR 0.27 (95% CI 0.04-1.99)) and major bleeding (HR 0.41 (95% CI 0.06-3.02)) trended lower in the apixaban switch compared to the warfarin continuation group.Conclusions The incidence and risk of stroke and major bleeding trended lower in individuals with stage 4-5 CKD and prevalent AF who switched from warfarin to apixaban than individuals continuing warfarin. Our findings support a strategy of switching prevalent AF patients with late stage CKD from warfarin to apixaban. Additional studies including a larger number of events with a longer-duration of follow-up are needed to refine effect estimates.
Climate change and Forest disturbances in Europe: an economic analysis of the losses
Authors: Da-Rocha Jose-Maria , Garcia-Cutrin Javier , Sempere Jaume , Gutierrez Maria-Jose , Chas-Amil Maria-Luisa , Sanchez-Llamas Eduardo 
Published: January 2021

Abstract
Climate warming is expected to increase the frequency and magnitude of extreme events in the mid to long term. Here, we combine a model of forest management with inter-country input-output tables to estimate the economic effect on the EU-28 and USA economies of changes in the output of the forestry and logging sectors due to extreme forest disturbance events. Given our model results, we estimate that the impact on the EU-28 economy will be equivalent to the value of wood damaged multiplied 3.32 fold [3.00-3.44]. We find that the economic cost of a global pan-European extreme event (a pulse of 450 M m3) could be 120.4 billion Euros in the EU-28 and and 1.7 billion in the USA (i.e. 0.926 and 0.015% of their respective GDPs). Finally, we explore how to design incentives to increase the economic resilience of the response of forestry and logging companies to expected future climate change. Using a heterogeneous companies model, we show that payments to landowners to conserve forest increase economic resilience.
Application of Convolutional Neural Networks Towards Nuclei Segmentation in Localization-based Super-Resolution Fluorescence Microscopy Images
Authors: Mela Christopher , Liu Yang 
Published: January 2021

Abstract
Background Automated segmentation of nuclei in microscopic images has been conducted to enhance throughput in pathological diagnostics and biological research. Segmentation accuracy and speed has been significantly enhanced with the advent of convolutional neural networks. A barrier in the broad application of neural networks to nuclei segmentation is the necessity to train the network using a set of application specific images and image labels. Previous works have attempted to create broadly trained networks for universal nuclei segmentation; however, such networks do not work on all imaging modalities, and best results are still commonly found when the network is retrained on user specific data. Stochastic optical reconstruction microscopy (STORM) based super-resolution fluorescence microscopy has opened a new avenue to image nuclear architecture at nanoscale resolutions. Due to the large size and discontinuous features typical of super-resolution images, automatic nuclei segmentation can be difficult. In this study, we apply commonly used networks (Mask R-CNN and UNet architectures) towards the task of segmenting super-resolution images of nuclei. First, we assess whether networks broadly trained on conventional fluorescence microscopy datasets can accurately segment super-resolution images. Then, we compare the resultant segmentations with results obtained using networks trained directly on our super-resolution data. We next attempt to optimize and compare segmentation accuracy using three different neural network architectures. Results Results indicate that super-resolution images are not broadly compatible with neural networks trained on conventional bright-field or fluorescence microscopy images. When the networks were trained on super-resolution data, however, we attained nuclei segmentation accuracies (F1-Score) in excess of 0.8, comparable to past results found when conducting nuclei segmentation on conventional fluorescence microscopy images. Overall, we achieved the best results utilizing the Mask R-CNN architecture. Conclusions We found that convolutional neural networks are powerful tools capable of accurately and quickly segmenting localization-based super-resolution microscopy images of nuclei. While broadly trained and widely applicable segmentation algorithms are desirable for quick use with minimal input, optimal results are still found when the network is both trained and tested on visually similar images. We provide a set of Colab notebooks to disseminate the software into the broad scientific community (https://github.com/YangLiuLab/Super-Resolution-Nuclei-Segmentation).
Expressions and Prognostic Values of LPARs in Human Breast Cancer
Authors: Wang Tao , Sun Kai , Luo Zhanxiong , Chen Rixin , Li Jingzhang 
Published: January 2021

Abstract
Background: LPA and its receptors play a major role in adjusting malignant behaviors in breast cancer (BC). Abnormal expression of certain LPA receptors in BC indicate that LPA receptors could be novel potential biomarkers in predicting prognosis and progression of BC. Further studies would focus on molecular mechanisms of LPA receptors in BC.Results: In this study, we examined the transcription and survival data of BC patient LPARs from ONCOMINE, Kaplan-Meier plotter, GEPIA, bcGenEx-Miner and cBioPortal database. We revealed that LPAR2/3/5 expression levels in BC tissue were higher than that in normal breast tissue, whereas the expression levels of LPAR1/4/6 in BC tissue were lower than normal breast tissue. The expression levels of LPAR1/4/6 were associated with advanced-stage tumor. Survival analysis using the K-M plotter database showed that in all BC patients, high mRNA expression of LPAR1/4/5/6 and the low mRNA expression of LPAR2/3 were correlated with the improved outcomes of BC patients. Subgroup analyses based on clinicopathological factors further revealed relationship between the expression levels of LPARs and the prognosis of BC patients with different types.Conclusions: This study shows that LPAR2/3/5 are potential targets for precision treatment of BC patients, and six LPARs are new biomarkers for the prognosis of BC patients.
The Accuracy of Virtual Fractional Flow Reserve From Invasive Angiography: Importance of the Method of Reconstructing Three-dimensional Coronary Artery Anatomy
Authors: Solanki Roshni , Gosling Rebecca , Rammohan Vignesh , Pederzani Giulia , Garg Pankaj , Heppenstall James , Hose D , Lawford Patricia , Narracott Andrew , Fenner John , Gunn Julian , Morris Paul 
Published: January 2021

Abstract
Background Three dimensional (3D) coronary anatomy, reconstructed from coronary angiography (CA), is now being used as the basis to compute ‘virtual’ fractional flow reserve (vFFR), and thereby guide treatment decisions in patients with coronary artery disease (CAD). Reconstruction accuracy is therefore important. Yet these methods remain poorly validated. Furthermore, the magnitude of vFFR error arising from reconstruction is unkown. We aimed to validate a new method for 3D CA reconstruction and determine the effect this had upon the accuracy of vFFR.Methods Clinically realistic coronary phantom models were created (seven standard stenoses in aluminium and 15 patient-based 3D-printed) and imaged with CA, three times, according to clinical protocols, yielding 66 datasets. Each was reconstructed using epipolar line projection and intersection. All reconstructions were compared against the phantom models in terms of minimal lumen diameter, centreline and surface similarity. 3D-printed reconstructions (n=45) and the reference files from which they were printed underwent vFFR computation, and the results were compared. Results The average error in reconstructing minimum lumen diameter (MLD) was 0.05 (±0.03 mm) which was <1% (95%CI 0.13-1.61%) compared with caliper measurement. Overall surface similarity was excellent (Hausdorff distance 0.65 mm). Errors in 3D CA reconstruction accounted for an error in vFFR of ±0.06 (95% limits of agreement).Conclusions Errors arising from the epipolar line projection method used to reconstruct 3D coronary anatomy from CA are small but result in clinically relevant errors in vFFR simulation, amounting to approximately 40% of the total error associated with vFFR.
Impact of Conduction Disturbances on Left Ventricular Mass Regression and Remodeling Following Transcatheter Aortic Valve Replacement
Authors: Ko Tsung-Yu , Kao Hsien-Li , Liu Ying-Ju , Yeh Chih-Fan , Huang Ching-Chang , Chen Ying-Hsien , Hung Chi-Sheng , Chan Chih-Yang , Lin Lung-Chun , Chen Yih-Sharng , Lin Mao-Shin 
Published: January 2021

Abstract
Our study aimed to compare the difference of LV mass regression and remodeling in regard of conduction disturbances (CD) following transcatheter aortic valve replacement (TAVR). A prospective analysis of 152 consecutive TAVR patients was performed. 53 patients (34.9%) had CD following TAVR, including 30 (19.7%) permanent pacemaker implantation and 23 (15.2%) new left bundle branch block. In 123 patients with 1-year follow-up, significant improvement of LV ejection fraction (LVEF) (baseline vs 12-month: 65.1±13.2 vs 68.7±9.1, P=0.017) and reduced LV end-systolic volume (LVESV) (39.8±25.8 vs 34.3±17.1, P=0.011) was found in non-CD group (N=85), but not in CD group (N=38). Both groups had significant decrease in LV mass index (baseline vs 12-month: 148.6±36.9 vs. 136.4±34.7 in CD group, p=0.023; 153.0±50.5 vs. 125.6±35.1 in non-CD group, p<0.0001). In 46 patients with 3-year follow-up, only non-CD patients (N=28) had statistically significant decrease in LV mass index (Baseline vs 36-month: 180.8±58.8 vs 129.8±39.1, p=0.0001). Our study showed the improvement of LV systolic function, LV reverse remodeling and mass regression at 1 year could be observed in patients without CD after TAVR. Sustained LV mass regression within 3-year was found only in patients without CD.