bluuebunny/crossref_metadata_2025_split huggingface dataset:
From LMS to adaptive training systems
Authors: Popova Y. B. 
Published: August 2019

The use of information technology and, in particular, learning management systems, increases the ability of both the teacher and the learner to achieve their goals in the educational process. Such systems provide educational content, help organize and monitor training, collect progress statistics, and can also take into account the individual characteristics of each user of the system. The purpose of this study is to determine the direction of development of modern learning systems and technologies for their implementation. The evolution of learning management systems, the transition to intelligent learning systems, the main stages of such systems were reviewed, the types of learning sequences were analyzed, the transformationinto adaptive learning systems was identified, and the scheme of the system and its mathematical model were presented. Expertise systems, the theory of fuzzy sets and fuzzy logic, cluster analysis, as well as genetic algorithms and artificial neural networks are defined as the mechanisms for implementing the learning systems. An artificial neural network in an adaptive learning system will allow you to create a unique training program that will build on existing knowledge and the level of perception of educational material by students. By formalizing the intellectual processes that both the teacher and the student carry out, it is possible to automate a certain part of the teacher’s functions, reduce the cost of manual labor, which will make it easier to monitor the learning process and also make the learning process more efficient.
Efficacy and safety of prophylactic use of ketamine for prevention of postanesthetic shivering: A system review and meta analysis
Authors: Zhou Yang , Mannan Abdul , Han Yuan , Liu He , Guan Hui-Lian , Gao Xing , Dai Ming-Sheng , Cao Junli 
Published: August 2019

Abstract
Background Post-anaesthetic shivering is a common complication of anaesthesia which accounts for much discomfort in postoperative patients. The main purpose of this meta analysis is to analyze and evaluate the efficacy and safety of prophylactic use of ketamine for preventing postanesthetic shivering. Methods We searched the following databases: Medline, EMBASE and the Cochrane Central Register of Controlled Trails for randomized controlled trials. The primary outcome being observed was the incidence rate of postanesthetic shivering. The secondary outcome was the sedation score and incidence of the side effects caused by drugs utilized in the study. Results In this meta analysis, we analyzed a total of 16 trials including 1485 patients. Ketamine did reduced the incidence rate of postanesthetic shivering compared with placebo(odds ratio [OR]: 0.13, 95% confidence interval [CI]: 0.06 to 0.26, P＜0.00001). The observation related to the side effects showed no evident variability regarding the incidence rate of nausea and vomiting. Usage of ketamine was associated with a lower rate of hypotension and bradycardia when compared with placebo. Hallucination was more frequently observed in patients receiving ketamine of higher doses. No significant difference was found in the incidence of postanesthetic shivering for all comparisons between ketamine and other pharmacological interventions. The occurrence of side effects caused by ketamine or other study drugs was similar with an exception of the comparison between ketamine and ondansetron where ketamine lowered the incidence of hypotension but with a relatively higher incidence of postoperative nausea and vomiting. Conclusions Ketamine has a preventive effect on postanesthetic shivering without causing any severe side effects. However, ketamine shows no advantage over other antishivering drugs.
Effect of Daesiho-tang on obesity with non-alcoholic fatty liver disease: A study protocol for a randomised, double-blind, placebo-controlled pilot trial
Authors: Han Kyungsun , Kwon Ojin , Park Hyo-ju , Jung So-Young , Yang Changsop , Son Chang-Gue 
Published: August 2019

Abstract
Background

The high prevalence of obesity and non-alcoholic fatty acid disease has become an important public health problem. Daesiho-tang (DST) is an herbal medicine widely used to treat obesity, metabolic syndrome and liver diseases. This pilot study will assess the feasibility of using DST in obese patients with a non-alcoholic fatty liver disease (NAFLD) prior to undertaking a full-scale clinical trial.

Methods

This is a study protocol for a randomised, double-blind, parallel-group, stratified, placebo-controlled pilot trial. We will recruit a total of 60 participants with body mass index ≥ 25 kg/m2 and will have NAFLD. They will take either DST or placebo (3 g, three times daily) for 12 weeks with a 4-week follow-up period. The effects of DST will be evaluated by the mean change in body weight as the primary measurement and other secondary parameters (body composition, anthropometric measurements, blood tests, hepatic fat quantification through transient elastography and a physical symptoms questionnaire). Faecal samples will be collected before and after the intervention for a gut microbial analysis.

Discussion

This study will evaluate the efficacy and safety of DST on weight loss and obesity-related markers, along with NAFLD-related clinical parameters in obese patients with NAFLD. Furthermore, it will provide insight into the DST pharmacological mechanism of action through a gut microbiome analysis
Prevalence and Factors Associated with Late Antenatal Care Visit in Ethiopia: A population-based study using the 2016 Ethiopia Demographic and Health Survey
Authors: Abebe Eskeziaw Kassahun , Dessie Amanuel Addisu , Zeleke Liknaw Bewket 
Published: August 2019

Abstract
Objectives

Maternal health care services are important for the survival and wellbeing of both mother and infant. In 2015, an estimated 303,000 women died from pregnancy-related complications. The Ethiopian government has implemented strategies to enhance maternal health service utilization, and reduce maternal morbidity and mortality. However, only 20.4% of women initiated the first antenatal care visit before 16 weeks of gestation. Therefore, this study assessed factors associated with late antenatal care visit in Ethiopia. A community based cross-sectional study design was used to examine 4,740 women from the 2016 Ethiopia Demographic and Health Survey data. Odds ratios with corresponding 95% confidence intervals (CI) were computed to examine the strength of an association. In the multivariable analysis, variables with p-value <0.05 were considered as statistically significant.

Result

The prevalence of late initiation of first antenatal care visit in Ethiopia was 67.3% (65.0%,69.6%). Living in rural areas (AOR= 95% CI:1.19,2.56) and fifth or above birth order (AOR=1.5;95% CI:1.10,2.00) were significantly associated with late antenatal care visit. Consequently, increasing the access and utilization of family planning, and raise an awareness on the benefit of early initiation of first antenatal care visit is recommended.
Informing patients with progressive neurological disease of their health status, and their adaptation to the disease
Authors: Bužgová Radka , Kozáková Radka 
Published: August 2019

Abstract
Background

Progressive neurological diseases, such as multiple sclerosis, Parkinson's disease, Huntington's disease, significantly interfere with patients' lives, and those of their families. The aim of the research was to establish whether the extent of the information on patients' health conditions, and the way patients learn this information from doctors affect their adaptation to chronic and progressive diseases.

Methods

Qualitative methodology was used for a total of 52 participants (patients with progressive neurological diseases, their family members, and health and social workers). Data were collected using individual, in-depth interviews and focus groups. Analysis of data for interpretation, conceptualization, and re-integration was performed by open, axial, and selective coding.

Results

It was determined that adequate information about patients’ health status, and the use of coping strategies are related to their adaptation to their disease, and consequently, to their quality of life. The participants often considered the extent of the information provided, and the way they were informed to be inadequate. Receiving the diagnosis, the progression of the disease, and the end of life were found to be the most burdensome.

Conclusion

Our results show that Czech neurologist should develop better communication skills, particularly for informing patients with progressive neurological diseases. Open communication, emotional support, and support in selecting effective coping strategies can help patients adapt more readily to their disease, and improve their quality of life.
Superiority of mucosal incision-assisted biopsy over ultrasound-guided fine needle aspiration biopsy to diagnose small gastric subepithelial lesions:A propencity score matching analysis
Authors: Minoda Yosuke , Chinen Takatoshi , Osoegawa Takashi , Itaba Soichi , Haraguchi Kazuhiro , Akiho Hirotada , Aso Akira , Sumida Yorinobu , Komori Keishi , Ogino Haruei , Ihara Eikichi , Ogawa Yoshihiro 
Published: August 2019

Abstract
Background/ Aims

Gastric subepithelial lesions (SELs), including gastrointestinal stromal tumors (GISTs), which have malignant potential, are often found during routine gastroscopy. Although careful histological evaluation is necessary to diagnose gastric SELs, biopsies of such lesions are not as easily performed as for epithelial lesions. While endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) is the gold standard to diagnose gastric SELs, an open biopsy technique (mucosal incision-assisted biopsy (MIAB)), has been reported useful. The aim of this study was to evaluate the efficacy of MIAB for gastric SELs compared with EUS-FNAB.

Methods

We retrospectively analyzed data from the medical records of 177 consecutive patients with gastric SELs who underwent either MIAB or EUS-FNAB at five hospitals in Japan between January 2010 and January 2018. Diagnostic yield, procedural time, and adverse event rates for the two procedures were evaluated before and after propensity-score matching.

Results

No major procedure-related adverse events were observed in either group. Both procedures yielded highly-accurate diagnoses once large enough samples were obtained; however, such successful sampling was more often accomplished by MIAB than by EUS-FNAB, especially for small SELs. As a result, MIAB provided better diagnostic yields for SELs smaller than 20-mm diameter. The diagnostic yields of both procedures were comparable for SELs larger than 20-mm diameter; however, MIAB required significantly longer procedural time (approximately 13 minutes) compared with EUS-FNAB.

Conclusions

Although MIAB required longer procedural time, it outperformed EUS-FNAB when diagnosing gastric SELs smaller than 20-mm diameter.
Prevalence unmet need for family planning and its associated factors in Ethiopia 2019: sytematic review and meta analysis
Authors: Getaneh Temesgen , Negesse Ayenew , Moltot Tebabere 
Published: August 2019

Abstract
Background

unmet need for family planning is a common cuase of uninteded pregnancy which mostly end up with abortion. Many fragmented studies were conducted on unmet need in Ethiopia but no single evidence was present. So this meta analysis was established to estimate the pooled prevalence of unmet need for family planning in Ethiopia.

Methods

articles were retrived through search engines: PubMed/MEDLINE, EMBASE, CINAHL, Google Scholar, HINARI portal, and Cochrane Library using the preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA) checklist guidelines. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was applied for critical appraisal of included articles. Random effect model meta analysis was done to estimate the pooled prevalence of unmet need for family planning with their respective Odds Ratio (OR) and 95% confidence interval (CI). Cochran’s Q statistic, Egger’s and Begg’s test and meta regression were carried out to assess heterogeneity, publication bias and to identify associated factors respectively.

Results

15 articles and 17, 585 reproductive age women were included to estimate the polled prevalence of unmet need for family planning in Ethiopia. The pooled prevalence of unmet need for family planning in Ethiopia was 31.45% (95%CI: 26.52, 36.39). Age at first marriage <18yrs with OR=2.3 (95% CI: 1.08, 4.87), being illiterate women with OR= 0.9 (95%CI: 1.19, 3.04), illiterate partner with OR=1.78 (95%CI: 1.18, 2.68) and absence of discussion with their partner with OR=3.52 (95%CI: 2.56, 4.87) were the associated factors.

Conclusion

This meta analysis revealed the prevalence of unmet need for family planning in Ethiopia was high. Early marriage, illiteracy and absence of open discussion were factors affecting the prevalence of unmet ned for family planning. Therefore, the responsible body inlcuding family health guiadance should strength women empowerment interms of education (equal accessible eduaction for all), avoid early marriage (before 18yrs) and facilitate open partners discussion within house hold.
The Key Candidate Genes in Tubulointerstitial Injury of Chronic Kidney Diseases (CKD) Patients as Determined by Bioinformatic Analysis
Authors: Wang Wanpeng , Shen Jianxiao , Pan Yan , Qi Chaojun , Liang Senlin , Kuai Qiaolin , Zuo Zhi 
Published: August 2019

Abstract
Background: Tubulointerstitial injury (TIL) is common in chronic kidney disease (CKD), which in turn, leads to loss of renal function. The aims of present study were to screen critical genes with tubulointerstitial lesion in CKD by weighted gene correlation network analysis (WGCNA).
Methods: GSE104954 gene expression data downloaded from GEO database were used for analysis for differential expression genes(DEGs); Meanwhile, 90 expression data of tubulointerstitial samples in GSE47185 combined with clinic information were applied to WGCNA. According to the enrichment analysis and relationship with estimated glomerular filtration rate (eGFR), the eGFR-associated modules were defined, and the hub gene is selected according to the average intramodular connectivity (Kwithin); Clinical data from Nephroseq were obtained to further validate the relationship between CKD and hub genes.
Results: Totally 294 DEGs were screened. Using the WGCNA, we identified 15 co-expressed modules, the blue, brown and yellow modules exhibited strongly association with eGFR, and were significantly enriched in several signaling pathways that have been reported involved in pathogenesis of CKD. Furthermore, it was found that the 4 genes (PLG, ITGB2, CTSS and CCL5) was one of the DEGs which also be identified as hub genes according to Kwithin. Finally, the Nephroseq online tool showed that the tubulointerstitial expression levels of PLG significantly positively correlated with the eGFR, while ITGB2, CTSS and CCL5 connected negatively to the eGFR.
Conclusion: WGCNA is an efficient approach to system biology. By this procedure, the present study improved the understanding of the transcriptome status of renal tubulointerstitial injury in CKD.
Comparison of the JOURNEY II Bi-Cruciate Stabilised and GENESIS II Total Knee Arthroplasty in Performance and functional Ability. A Randomised Controlled Trial (CAPAbility). The study protocol.
Authors: Clarke Celia , Pomeroy Valerie , Clark Allan , Creelman Graham , Hancock Nicola , Horton Simon , Killett Anne , Mann Charles , Payerne Estelle , Toms Andoni , Roberts Gareth , Smith Toby , Swart Ann Marie , McNamara Iain 
Published: August 2019

Abstract
Background: Osteoarthritis of the knee is a common condition that is expected to rise in the next two decades leading to an associated increase in total knee replacement (TKR) surgery. Although there is little debate regarding the safety and efficacy of modern TKR, up to 20% (Baker et al 2007) of patients report poor functional outcomes following surgery. This study will look at the functional outcome of two TKR; the JOURNEY II Bi Cruciate Stabilised knee, a newer prosthesis designed to provide guided motion and improve knee kinematics by more closely approximating a normal knee and the GENESIS II, a proven existing design. Aim: The aim of the CAPAbility study is to compare the change in patient reported outcome scores, of the JOURNEY II BCS and the GENESIS II from pre-operation to six months post-operation. Methods: CAPAbility is a pragmatic, blinded, two-arm parallel, randomised controlled trial recruiting patients with primary osteoarthritis due to have unilateral knee replacement surgery across two UK hospitals. Eligible participants (n = 80) will be randomly allocated to receive either the JOURNEY II or the GENESIS II BCS knee prosthesis. Baseline measures will be taken prior to surgery, with patients followed at one week, six to eight weeks and six months post-operatively. The primary outcome is the Oxford Knee Score (OKS) at six months post-operatively. Secondary outcomes include: other patient-reported outcome measures (PROMs), biomechanical, radiological (computer tomography, (CT)), clinical efficacy and safety outcomes. An embedded qualitative study will also investigate patients’ perspectives via interview pre and post-surgery on variables known to affect the outcome of knee replacement surgery. A sub-sample (n=30) will have additional in-depth interviews to explore themes identified. The surgeons’ perspectives on the operation will be investigated by a group interview after all participants have had surgery. Discussion: This trial will evaluate two generations of TKR by PROMS and kinematic analysis with additional CT measurements and qualitative outcomes from the patient perspective. Trial registration. ISRCTN32315753, 12 December 2017. http://www.isrctn.com/ISRCTN32315753 Keywords: Total Knee Arthroplasty; knee replacement; functional ability; knee prosthesis; kinematics; primary 0steoarthritis.
Pivarubicin is more effective than doxorubicin against triple-negative breast cancer in vivo
Authors: Lothstein Leonard , Soberman Judith Ellen , Parke Deanna , Gandhi Jatin , Sweatman Trevor , Seagroves Tiffany 
Published: August 2019

Abstract
Background: Triple-negative breast cancer (TNBC) is unresponsive to anti-estrogen and anti-HER2 therapies, requiring the use of cytotoxic drug combinations of anthracyclines, taxanes, cyclophosphamide and platinum compounds. Multidrug therapies achieve pathological cure rates of only 20-40%, a consequence of drug resistance and cumulative dose limitations necessitated by the irreversible cardiotoxic effects of anthracyclines and other cytotoxic agents. Safer and more effective treatments for TNBC are required to achieve durable therapeutic responses. This study describes the mechanism of action and in vivo efficacy of pivarubicin, a structurally and functionally novel anthracycline, to determine whether pivarubicin is potentially more effective and safer than doxorubicin against human primary TNBC.

Methods: Hydrolytic stability, mechanism and ability of pivarubicin to circumvent mechanisms of resistance are tested in multiple tumor lines through modulation of PKC-delta activity and assessment of drug cytotoxicity. Comparative in vivo efficacy is tested in an orthotopic NSG mouse model implanted with MDA-MB-231 human TNBC cells and treated with the maximum tolerated doses of pivarubicin and doxorubicin, followed by monitoring of tumor growth by digital caliper measurements and determination of endpoint tumor weight and volume. Endpoint cardiotoxicity is assessed histologically by identifying microvacuolization in ventricular cardiomyocytes.

Results: The trimethylester moiety of pivarubicin confers hydrolytic stability relative to the closely related congener, AD 198, but retains the ability of other N -alkylbenzyladriamycin compounds to directly activate PKC-delta and trigger rapid mitochondrial-dependent apoptosis. The structure and function of pivarubicin permits circumvention of resistance conferred by overexpression of P-glycoprotein, Bcl-2, Bcl-X L and Bcr-Abl. Primary tumors treated with the multiple rounds of the maximum tolerated dose (MTD) of doxorubicin failed to inhibit tumor growth compared with vehicle-treated tumors. However, administration of a single MTD of pivarubicin produced significant inhibition of tumor growth and tumor regression relative to tumor volume prior to initiation of treatment. Histological analysis of hearts excised from drug- and vehicle-treated mice revealed that pivarubicin produced no evidence of myocardial damage at this therapeutic dose.

Conclusion: These results support the development of pivarubicin as a safer and more effective replacement for doxorubicin against TNBC as well as other malignancies for which doxorubicin therapy is indicated.
Determinants of health-related quality of life in colon cancer patients include stoma and smoking habits, but not type of surgery
Authors: Tiselius Catarina , Rosenblad Andreas , Strand Eva , Smedh Kennet 
Published: August 2019

Abstract
Background: Health-related quality of life (HRQoL) has gained increased attention in cancer care. Studies have shown that poor QoL might worsen the cancer related prognosis. The aim of this study was to investigate HRQoL in patients with colon cancer and to compare data with reference values from the general population in Sweden at diagnosis (baseline) and at six months of follow-up.

Methods : This was a prospective population-based study of colon cancer patients from Västmanland County, Sweden, included between March 2012 and September 2016. HRQoL was measured using the cancer-specific EORTC QLQ-C30 questionnaire. Data on HRQoL was compared with Swedish population reference values. Multiple linear regression analysis adjusted for age, sex, body mass index (BMI), American Society of Anaesthesiology (ASA) physical status classification, emergency/elective surgery, and resection with/without a stoma and tumour stage (TNM), was used.

Results : A total of 67% (376/561) of all incident colon cancer patients (196 [52.1%] females) were included. Mean (range) age was 73 (30-96) years. The univariate analysis showed that patients with colon cancer had worse QoL (8/15 parameters) compared with a Swedish reference population both at baseline and at 6 months follow-up. Furthermore, linear regression analysis showed that patients with more comorbidity (ASA 3 and 4), smokers and patients planned to be operated on with a stoma, were at higher risks for poor QoL than the other included patients.

Conclusions : The reported determinants of HRQoL may be used to identify risk groups and enable individualized care for patients that need more support from health care.