Background:Problematic scarring remains a challenging aspect to address in the treatment of burns and can significantly affect the quality of life of the burn survivor.At present,there are few treatments available in ...Background:Problematic scarring remains a challenging aspect to address in the treatment of burns and can significantly affect the quality of life of the burn survivor.At present,there are few treatments available in the clinic to control adverse scarring,but experimental pharmacological anti-scarring strategies are now beginning to emerge.Their comparative success must be based on objective measurements of scarring,yet currently the clinical assessment of scars is not carried out systematically and is mostly based on subjective review of patients.However,several techniques and devices are being introduced that allow objective analysis of the burn scar.The aim of this article is to evaluate various objective measurement tools currently available and recommend a useful panel that is suitable for use in clinical trials of anti-scarring therapies.Methods:A systematic literature search was done using the Web of Science,PubMed and Cochrane databases.The identified devices were then classified and grouped according to the parameters they measured.The tools were then compared and assessed in terms of inter-and intra-rater reproducibility,ease of use and cost.Results:After duplicates were removed,5062 articles were obtained in the search.After further screening,157 articles which utilised objective burn scar measurement systems or tools were obtained.The scar measurement devices can be broadly classified into those measuring colour,metric variables,texture,biomechanical properties and pathophysiological disturbances.Conclusions:Objective scar measurement tools allow the accurate and reproducible evaluation of scars,which is important for both clinical and scientific use.However,studies to evaluate their relative performance and merits of these tools are scarce,and there remain factors,such as itch and pain,which cannot be measured objectively.On reviewing the available evidence,a panel of devices for objective scar measurement is recommended consisting of the 3D cameras(Eykona/Lifeviz/Vectra H1)for surface area and volum展开更多
Virtual reality simulation is becoming the standard when beginning endoscopic training. It offers various benefits including learning in a low-stakes environment, improvement of patient safety and optimization of valu...Virtual reality simulation is becoming the standard when beginning endoscopic training. It offers various benefits including learning in a low-stakes environment, improvement of patient safety and optimization of valuable endoscopy time. This is a review of the evidence surrounding virtual reality simulation and its efficacy in teaching endoscopic techniques. There have been 21 randomized controlled trials(RCTs) that have investigated virtual reality simulation as a teaching tool in endoscopy. 10 RCTs studied virtual reality in colonoscopy, 3 in flexible sigmoidoscopy, 5 in esophagogastroduodenoscopy, and 3 in endoscopic retrograde cholangiopancreatography. RCTs reported many outcomes including distance advanced in colonoscopy, comprehensive assessment of technical and non-technical skills, and patient comfort. Generally, these RCTs reveal that trainees with virtual reality simulation based learning improve in all of these areas in the beginning of the learning process. Virtual reality simulation was not effective as a replacement of conventional teaching methods. Additionally, feedback was shown to be an essential part of the learning process. Overall, virtual reality endoscopic simulation is emerging as a necessary augment to conventional learning given the ever increasing importance of patient safety and increasingly valuable endoscopy time; although work is still needed to study the nuances surrounding its integration into curriculum.展开更多
Schizophrenia is a severe mental illness which is associated with significant consequences for both the patients and their relatives. Due to chronicity of the illness, the relatives of patients of schizophrenia have t...Schizophrenia is a severe mental illness which is associated with significant consequences for both the patients and their relatives. Due to chronicity of the illness, the relatives of patients of schizophrenia have to bear the main brunt of the illness. Studies across the world have evaluated various aspects of caregiving and caregivers such as burden, coping, quality of life, social support, expressed emotions, and psychological morbidity. In general the research has looked at caregiving as a negative phenomenon, however, now it is increasingly recognised that caregiving is not only associated with negative consequences only, also experience subjective gains and satisfaction. This review focus on the conceptual issues, instruments available to assess the positive aspects of caregiving and the various correlates of positive aspects of caregiving reported in relation to schizophrenia. The positive aspect of caregiving has been variously measured as positive caregiving experience, caregiving satisfaction, caregiving gains and finding meaning through caregiving scale and positive aspects of caregiving experience. Studies suggests that caregivers of patients with schizophrenia and psychotic disorders experience caregiving gains(in the form of becoming more sensitive to persons with disabilities, clarity about their priorities in life and a greater sense of inner strength), experience good aspects of relationship with the patient, do have personal positive experiences. Some of the studies suggest that those who experience greater negative caregiving experience also do experience positive caregiving experience.展开更多
Over the years many scales have been designed for screening, diagnosis and assessing the severity of delirium. In this paper we review the various instruments available to screen the patients for delirium, instruments...Over the years many scales have been designed for screening, diagnosis and assessing the severity of delirium. In this paper we review the various instruments available to screen the patients for delirium, instruments available to diagnose delirium, assess the severity, cognitive functions, motoric subtypes, etiology and associated distress. Among the various screening instruments, NEECHAM confusion scale and delirium observation scale appear to be most suitable screening instrument for patients' in general medical and surgical wards, depending on the type of rater(physician or nurse). In general, the instruments which are used for diagnosis [i.e., confusion assessment method(CAM), CAM for intensive care unit(CAM-ICU), Delirium Rating Scale-revised version(DRS-R-98), memorial selirium assessment scale, etc. ] are based on various Diagnostic and Statistical Manual criteria and have good to excellent reliability and fair to good validity. Among the various diagnostic instruments, CAM is considered to be most useful instrument because of its accuracy, brevity, and ease of use by clinicians and lay interviewers. In contrast, DRS-R-98 appears to be a comprehensive instrument useful for diagnosis, severity rating and is sensitive to change and hence can be used for monitoring patients over a period. In the ICU setting, evidence suggests that CAM-ICU and Nursing Delirium Screening Scale had comparable sensitivities, but CAM-ICU has higher specificity. With regard to assessment of delirium in pediatric age group, certain instruments like Pediatric Anesthesia Emergence Delirium scale and pediatric CAM-ICU has been designed and have been found to be useful.展开更多
Cover crops are the plants which are grown to improve soil fertility, prevent soil erosion, enrichment and protection of soil, and enhance nutrient and water availability, and quality of soil. Cover crops provide seve...Cover crops are the plants which are grown to improve soil fertility, prevent soil erosion, enrichment and protection of soil, and enhance nutrient and water availability, and quality of soil. Cover crops provide several benefits to soils used for agriculture production. Cover crops are helpful in increasing and sustaining microbial biodiversity in soils. We summarized the effect of several cover crops in soil properties such as soil moisture content, soil microbial activities, soil carbon sequestration, nitrate leaching, soil water, and soil health. Selection of cover crops usually depends on the primary benefits which are provided by cover crops. Other factors may also include weather conditions, time of sowing, either legume or non-legume and timing and method of killing of a cover crop. In recent times, cover crops are also used for mitigating climate change, suppressing weeds in crops and increasing exchangeable nutrients such as Mg2+ and K+. Cover crops are also found to be economical in long-term experiment studies. Although some limitations always come with several benefits. Cover crops have some problems including the method of killing, host for pathogens, regeneration, and not immediate benefits of using them. Despite the few limitations, cover crops improve the overall health of the soil and provide a sustainable environment for the main crops.展开更多
AIM: To investigate the efficacy of lubiprostone compared to Senna on bowel symptoms and constipation in post-operative orthopedic patients treated with opioids.
This paper addresses the development of a random forest classifier for the muki-class fault diagnosis in spur gearboxes. The vibration signal＇s condition parameters are first extracted by applying the wavelet packet ...This paper addresses the development of a random forest classifier for the muki-class fault diagnosis in spur gearboxes. The vibration signal＇s condition parameters are first extracted by applying the wavelet packet decomposition with multiple mother wavelets, and the coefficients＇ energy content for terminal nodes is used as the input feature for the classification problem. Then, a study through the parameters＇ space to find the best values for the number of trees and the number of random features is performed. In this way, the best set of mother wavelets for the application is identified and the best features are selected through the internal ranking of the random forest classifier. The results show that the proposed method reached 98.68% in classification accuracy, and high efficiency and robustness in the models.展开更多
All over the world women are the predominant providers of informal care for family members with chronic medical conditions or disabilities, including the elderly and adults with mental illnesses. It has been suggested...All over the world women are the predominant providers of informal care for family members with chronic medical conditions or disabilities, including the elderly and adults with mental illnesses. It has been suggested that there are several societal and cultural demands on women to adopt the role of a family-caregiver. Stress-coping theories propose that women are more likely to be exposed to caregiving stressors, and are likely to perceive, report and cope with these stressors differently from men. Many studies, which have examined gender differences among family-caregivers of people with mental illnesses, have concluded that women spend more time in providing care and carry out personal-care tasks more often than men. These studies have also found that women experience greater mental and physical strain, greater caregiver-burden, and higher levels of psychological distress while providing care. However, almost an equal number of studies have not found any differences between men and women on these aspects. This has led to the view that though there may be certain differences between male and female caregivers, most of these are small in magnitude and of doubtful clinical significance. Accordingly, caregivergender is thought to explain only a minor proportion of the variance in negative caregiving outcomes. A similar inconsistency characterizes the explanations provided for gender differences in caregiving such as role expectations, differences in stress, coping and social support, and response biases in reporting distress. Apart from the equivocal and inconsistent evidence, there are other problems in the literature on gender differences in caregiving. Most of the evidence has been derived from studies on caregivers of elderly people who either suffer from dementia or other physical conditions. Similar research on other mental illnesses such as schizophrenia or mood disorders is relatively scarce. With changing demographics and social norms men are increasingly assuming roles as caregivers. However, the experie展开更多
As healthcare professionals continue to combat the coronavirus disease 2019(COVID-19)infection worldwide,there is an increasing interest in the role of imaging and the relevance of various modalities.Since imaging not...As healthcare professionals continue to combat the coronavirus disease 2019(COVID-19)infection worldwide,there is an increasing interest in the role of imaging and the relevance of various modalities.Since imaging not only helps assess the disease at the time of diagnosis but also aids evaluation of response to management,it is critical to examine the role of different modalities currently in use,such as baseline X-rays and computed tomography scans carefully.In this article,we will draw attention to the critical findings for the radiologist.Further,we will look at point of care ultrasound,an increasingly a popular tool in diagnostic medicine,as a component of COVID-19 management.展开更多
Detection and quantification of transgenes are important in analyzing genetically modified organisms (GMOs). Quantitative polymerase chain reaction (qPCR) is commonly utilized for such purposes. However, qPCR has cert...Detection and quantification of transgenes are important in analyzing genetically modified organisms (GMOs). Quantitative polymerase chain reaction (qPCR) is commonly utilized for such purposes. However, qPCR has certain limitations in detecting and quantifying transgenes in GMOs, such as the need of certified reference materials, a standard curve, and possible affection by inhibitors. Therefore, alternative and possibly better methods are needed. Recent advances in digital PCR technologies have promised to allow accurate quantification of nucleic acids and therefore provided another useful technique to analyze GMOs. Thermo Fisher Scientific<sup>TM</sup> has recently commercialized the Applied Biosystems<sup>TM</sup> QuantStudio<sup>TM</sup> 3D digital PCR system that can be used for a wide range of applications involving nucleic acids. It will be beneficial to the scientific community to show the applicability of this digital PCR system in detecting and quantifying transgenes in GMOs. In the present study, the transgenes present in the Roundup Ready Soybean (RR1, event 40-3-2) and Roundup Ready Soybean 2 (RR2, event MON89788) developed by Monsanto Corporation were analyzed by using this digital PCR system. The qPCR analysis results were included for comparison. Using specifically designed TaqMan assays, as low as 1% of the RR1 or RR2 soybean material was reliably detected and quantified on the dPCR platform. Therefore, digital PCR is a sensitive and reliable method to analyze the RR transgenic soybeans, and should be another useful tool for analyzing other transgenic plants.展开更多
A comparison between deep learning and standalone models in predicting the compaction parameters of soil is presented in this research.One hundred and ninety and fifty-three soil samples were randomly picked up from t...A comparison between deep learning and standalone models in predicting the compaction parameters of soil is presented in this research.One hundred and ninety and fifty-three soil samples were randomly picked up from two hundred and forty-three soil samples to create training and validation datasets,respectively.The performance and accuracy of the models were measured by root mean square error(RMSE),coefficient of determination(R2),Pearson product-moment correlation coefficient(r),mean absolute error(MAE),variance accounted for(VAF),mean absolute percentage error(MAPE),weighted mean absolute percentage error(WMAPE),a20-index,index of scatter(IOS),and index of agreement(IOA).Comparisons between standalone models demonstrate that the model MD 29 in Gaussian process regression(GPR)and model MD 101 in support vector machine(SVM)can achieve over 96%of accuracy in predicting the optimum moisture content(OMC)and maximum dry density(MDD)of soil,and outperformed other standalone models.The comparison between deep learning models shows that the models MD 46 and MD 146 in long short-term memory(LSTM)predict OMC and MDD with higher accuracy than ANN models.However,the LSTM models outperformed the GPR models in predicting the compaction parameters.The sensitivity analysis illustrates that fine content(FC),specific gravity(SG),and liquid limit(LL)highly influence the prediction of compaction parameters.展开更多
Hepatocellular carcinoma (HCC) is the commonest primary malignancy of the liver. It usually occurs in the setting of chronic liver disease and has a poor prognosis if untreated. Orthotopic liver transplantation (OLT) ...Hepatocellular carcinoma (HCC) is the commonest primary malignancy of the liver. It usually occurs in the setting of chronic liver disease and has a poor prognosis if untreated. Orthotopic liver transplantation (OLT) is a suitable therapeutic option for early,unresectable HCC particularly in the setting of chronic liver disease. Following on from disappointing initial results,the seminal study by Mazzaferro et al in 1996 established OLT as a viable treatment for HCC. In this study,the "Milan criteria" were applied achieving a 4-year survival rate similar to OLT for benign disease. Since then various groups have attempted to expand these criteria whilst maintaining long term survival rates. The technique of living donor liver transplantation has evolved over the past decade,particularly in Asia,and published outcome data is comparable to that of OLT. This article will review the evidence,indications,and the future direction of liver transplantation for liver cancer.展开更多
The accurate prediction of bearing capacity is crucial in ensuring the structural integrity and safety of pile foundations.This research compares the Deep Neural Networks(DNN),Convolutional Neural Networks(CNN),Recurr...The accurate prediction of bearing capacity is crucial in ensuring the structural integrity and safety of pile foundations.This research compares the Deep Neural Networks(DNN),Convolutional Neural Networks(CNN),Recurrent Neural Networks(RNN),Long Short-Term Memory(LSTM),and Bidirectional LSTM(BiLSTM)algorithms utilizing a data set of 257 dynamic pile load tests for the first time.Also,this research illustrates the multicollinearity effect on DNN,CNN,RNN,LSTM,and BiLSTM models’performance and accuracy for the first time.A comprehensive comparative analysis is conducted,employing various statistical performance parameters,rank analysis,and error matrix to evaluate the performance of these models.The performance is further validated using external validation,and visual interpretation is provided using the regression error characteristics(REC)curve and Taylor diagram.Results from the comparative analysis reveal that the DNN(Coefficient of determination(R^(2))_(training(TR))=0.97,root mean squared error(RMSE)_(TR)=0.0413;R^(2)_(testing(TS))=0.9,RMSE_(TS)=0.08)followed by BiLSTM(R^(2)_(TR)=0.91,RMSE_(TR)=0.782;R^(2)_(TS)=0.89,RMSE_(TS)=0.0862)model demonstrates the highest performance accuracy.It is noted that the BiLSTM model is better than LSTM because the BiLSTM model,which increases the amount of information for the network,is a sequence processing model made up of two LSTMs,one of which takes the input in a forward manner,and the other in a backward direction.The prediction of pile-bearing capacity is strongly influenced by ram weight(having a considerable multicollinearity level),and the effect of the considerable multicollinearity level has been determined for the model based on the recurrent neural network approach.In this study,the recurrent neural network model has the least performance and accuracy in predicting the pile-bearing capacity.展开更多
Guar is a drought and salt tolerant summer annual legume, which could be a potential alternative crop in the semi-arid Southern High Plains. Increased use of guar gum in oil industries has increased the demand of guar...Guar is a drought and salt tolerant summer annual legume, which could be a potential alternative crop in the semi-arid Southern High Plains. Increased use of guar gum in oil industries has increased the demand of guar globally. Planting date effects on stand establishment, physiological parameters, and yield formation of guar genotypes were investigated at the New Mexico State University’s Agricultural Science Center at Clovis, NM for two seasons (2014 and 2015). Four guar genotypes (HES 1123, Kinman, Lewis, and Matador) were tested under three planting dates (June 18, July 7, and July 22 in 2014;and June 18, July 6, and July 20 in 2015). Higher temperature and rainfall were recorded under mid-June planting than early-July and late-July plantings. Guar planted under mid-June had better stand establishment as shown by the higher number of plants m<sup>-2</sup>, better physiology as revealed by higher photosynthetic rate (P<sub>n</sub>), transpiration rate (T<sub>r</sub>), leaf area index (LAI), and SPAD values than early-July and late-July plantings. Guar planted under mid-June resulted in taller plants, and therefore, produced higher plant biomass than both of the July plantings. Yield attributing characteristics including clusters plant<sup>-1</sup>, pods plant<sup>-1</sup>, seeds plant<sup>-1</sup>, seed spod<sup>-1</sup>, 1000 seed weight, and harvest index (HI) were highest under mid-June planting followed by the early-July and late-July plantings, respectively. The mid-June planting increased seed yield by 26% and 55% over early-July and late-July (1399 vs. 1111 and 903 kg·ha<sup>-1</sup>) plantings, respectively in 2014;while the same increase in 2015 was 51% and 243% (1308 vs. 868 and 381 kg·ha<sup>-1</sup>), respectively. These results indicate that delaying planting beyond mid-June is detrimental to guar productivity. However, genotypes did not show any significant variation in their performance. Overall, warmer growing conditions and more precipitation under mid-June planting caused bett展开更多
Background The internet is an integral part of everyone’s life.College going adolescents are highly vulnerable to the misuse of the internet.Aims To estimate the pooled prevalence of internet addiction(IA)among colle...Background The internet is an integral part of everyone’s life.College going adolescents are highly vulnerable to the misuse of the internet.Aims To estimate the pooled prevalence of internet addiction(IA)among college students in India.Methods Literature databases(PubMed,Web of Science,Scopus,EMBASE,PsycINFO and Google Scholar)were searched for studies assessing IA using the Young Internet Addiction Test(Y-IAT)among adolescents from India,published in the English language up to December 2020.We included studies from 2010 to 2020 as this is the marked era of momentum in wireless internet connectivity in India.The methodological quality of each study was scored,and data were extracted from the published reports.Pooled prevalence was estimated using the fixed-effects model.Publication bias was evaluated using Egger’s test and visual inspection of the symmetry in funnel plots.Results Fifty studies conducted in 19 states of India estimated the prevalence of IA and the overall prevalence of IA as 19.9%(95%CI:19.3%to 20.5%)and 40.7%(95%CI:38.7%to 42.8%)based on the Y-IAT cut-off scores of 50 and 40,respectively.The estimated prevalence of severe IA was significantly higher in the Y-IAT cut-off points of 70 than 80(12.7%(95%CI:11.2%to 14.3%)vs 4.6%(95%CI:4.1%to 5.2%)).The sampling method and quality of included studies had a significant effect on the estimation of prevalence in which studies using non-probability sampling and low risk of bias(total quality score≥7)reported lower prevalence.The overall quality of evidence was rated as‘moderate’based on the Grading of Recommendations Assessment,Development and Evaluation criteria.Conclusions Our nationally representative data suggest that about 20%to 40%of college students in India are at risk for IA.There is a need for further research in the reconsideration of Y-IAT cut-off points among Indian college students.展开更多
AIM： To evaluate the differential inhibitory effects of bevacizumab on cell proliferation of vascular endothelial growth factor （VEGF）-stimulated choroidal vascular endothelial cells （CVECs） and retinal vascular ...AIM： To evaluate the differential inhibitory effects of bevacizumab on cell proliferation of vascular endothelial growth factor （VEGF）-stimulated choroidal vascular endothelial cells （CVECs） and retinal vascular endothelial cells （RVECs） in vitro.METHODS： VEGF （400 ng/mL） enriched CVECs and RVECs were treated with escalating doses of bevacizumab （0.1, 0.5, 1, 1.5 and 2 mg/mL）. Cell proliferation changes were analyzed with WST-1 assay and trypan blue exclusion assay at 48, 72h and 1wk. Morphological changes were recorded with bright field microscopy.RESULTS： VEGF enriched RVECs showed significantly more decline of cell viability than CVECs after bevacizumab treatment. One week after treatment, RVEC cell proliferation decreased by 29.7%, 37.5%, 52.8%, 35.9% and 45.6% at 0.1, 0.5, 1.0, 1.5 and 2 mg/mL bevacizumab respectively compared to CVEC proliferation decrease of 4.1%, 7.7%, 2.4%, 4.1% and 17.7% （P〈0.05） by WST-1 assay. Trypan blue exclusion assay also revealed similar decrease in RVEC proliferation of 20%, 60%, 73.3%, 80% and 93.3% compared to CVEC proliferation decrease of 4%, 12%, 22.9%, 16.7% and 22.2% respectively （P〈0.05）. The maximum differential effect between the two cell types was observed at bevacizumab doses of 1.0 and 1.5 mg/mL at all time points. RVECs were 22 fold more sensitive （P〈0.01） compared to CVECs （52.8% vs 2.4%） at concentration of 1.0 mg/mL, and 8.7 fold more at 1.5 mg/mL （35.9% vs 4.1%） 1wk after treatment （P〈0.05 respectively）.CONCLUSION： VEGF-enriched RVECs are more susceptible to bevacizumab inhibition than CVECs at clinically used dosage of 1.25 mg and this differential sensitivity between two cell types should be taken into consideration in dosage selection.展开更多
Over the last three decades burgeoning research has shown that anxiety disorder comorbidity is not only highly prevalent in bipolar disorder(BD),but it also adversely impacts the course,outcome,and treatment of BD.The...Over the last three decades burgeoning research has shown that anxiety disorder comorbidity is not only highly prevalent in bipolar disorder(BD),but it also adversely impacts the course,outcome,and treatment of BD.The present review provides an overview of the current trends in research on comorbid anxiety and BDs based on prior reviews and meta-analyses(n=103),epidemiological surveys,and large-scale clinical studies.The results reiterated the fact that at least half of those with BD are likely to develop an anxiety disorder in their lifetimes and a third of them will manifest an anxiety disorder at any point of time.All types of anxiety disorders were equally common in BD.However,there was a wide variation in rates across different sources,with most of this discrepancy being accounted for by methodological differences between reports.Comorbid anxiety disorders negatively impacted the presentation and course of BD.This unfavourable clinical profile led to poorer outcome and functioning and impeded treatment of BD.Despite the extensive body of research there was paucity of data on aetiology and treatment of anxiety disorder comorbidity in BD.Nevertheless,the substantial burden and unique characteristics of this comorbidity has important clinical and research implications.展开更多
Situs inversus with dextrocardia is a rare congenital anomaly.There are limited published case reports of successful percutaneous coronary intervention(PCI) in these patients who have atherosclerotic coronary artery d...Situs inversus with dextrocardia is a rare congenital anomaly.There are limited published case reports of successful percutaneous coronary intervention(PCI) in these patients who have atherosclerotic coronary artery disease,especially when presenting with acute myocardial infarction.PCI is technically difficult be-cause of mirror image dextrocardia.We hereby de-scribe a 48-yr-old female,who had acute inferior wall myocardial infarction and underwent successful emer-gency primary coronary angioplasty and stenting of a proximally occluded right coronary artery.Technical details about PCI are discussed.展开更多
Heart failure continues to be one of the leading causes of morbidity and mortality worldwide.Myocardial infarction is the primary causative agent of chronic heart failure resulting in cardiomyocyte necrosis and the su...Heart failure continues to be one of the leading causes of morbidity and mortality worldwide.Myocardial infarction is the primary causative agent of chronic heart failure resulting in cardiomyocyte necrosis and the subsequent formation of fibrotic scar tissue.Current pharmacological and non-pharmacological therapies focus on managing symptoms of heart failure yet remain unable to reverse the underlying pathology.Heart transplantation usually cannot be relied on,as there is a major discrepancy between the availability of donors and recipients.As a result,heart failure carries a poor prognosis and high mortality rate.As the heart lacks significant endogenous regeneration potential,novel therapeutic approaches have incorporated the use of stem cells as a vehicle to treat heart failure as they possess the ability to self-renew and differentiate into multiple cell lineages and tissues.This review will discuss past,present,and future clinical trials,factors that influence stem cell therapy outcomes as well as ethical and safety considerations.Preclinical and clinical studies have shown a wide spectrum of outcomes when applying stem cells to improve cardiac function.This may reflect the infancy of clinical trials and the limited knowledge on the optimal cell type,dosing,route of administration,patient parameters and other important variables that contribute to successful stem cell therapy.Nonetheless,the field of stem cell therapeutics continues to advance at an unprecedented pace.We remain cautiously optimistic that stem cells will play a role in heart failure management in years to come.展开更多
文摘Background:Problematic scarring remains a challenging aspect to address in the treatment of burns and can significantly affect the quality of life of the burn survivor.At present,there are few treatments available in the clinic to control adverse scarring,but experimental pharmacological anti-scarring strategies are now beginning to emerge.Their comparative success must be based on objective measurements of scarring,yet currently the clinical assessment of scars is not carried out systematically and is mostly based on subjective review of patients.However,several techniques and devices are being introduced that allow objective analysis of the burn scar.The aim of this article is to evaluate various objective measurement tools currently available and recommend a useful panel that is suitable for use in clinical trials of anti-scarring therapies.Methods:A systematic literature search was done using the Web of Science,PubMed and Cochrane databases.The identified devices were then classified and grouped according to the parameters they measured.The tools were then compared and assessed in terms of inter-and intra-rater reproducibility,ease of use and cost.Results:After duplicates were removed,5062 articles were obtained in the search.After further screening,157 articles which utilised objective burn scar measurement systems or tools were obtained.The scar measurement devices can be broadly classified into those measuring colour,metric variables,texture,biomechanical properties and pathophysiological disturbances.Conclusions:Objective scar measurement tools allow the accurate and reproducible evaluation of scars,which is important for both clinical and scientific use.However,studies to evaluate their relative performance and merits of these tools are scarce,and there remain factors,such as itch and pain,which cannot be measured objectively.On reviewing the available evidence,a panel of devices for objective scar measurement is recommended consisting of the 3D cameras(Eykona/Lifeviz/Vectra H1)for surface area and volum
文摘Virtual reality simulation is becoming the standard when beginning endoscopic training. It offers various benefits including learning in a low-stakes environment, improvement of patient safety and optimization of valuable endoscopy time. This is a review of the evidence surrounding virtual reality simulation and its efficacy in teaching endoscopic techniques. There have been 21 randomized controlled trials(RCTs) that have investigated virtual reality simulation as a teaching tool in endoscopy. 10 RCTs studied virtual reality in colonoscopy, 3 in flexible sigmoidoscopy, 5 in esophagogastroduodenoscopy, and 3 in endoscopic retrograde cholangiopancreatography. RCTs reported many outcomes including distance advanced in colonoscopy, comprehensive assessment of technical and non-technical skills, and patient comfort. Generally, these RCTs reveal that trainees with virtual reality simulation based learning improve in all of these areas in the beginning of the learning process. Virtual reality simulation was not effective as a replacement of conventional teaching methods. Additionally, feedback was shown to be an essential part of the learning process. Overall, virtual reality endoscopic simulation is emerging as a necessary augment to conventional learning given the ever increasing importance of patient safety and increasingly valuable endoscopy time; although work is still needed to study the nuances surrounding its integration into curriculum.
文摘Schizophrenia is a severe mental illness which is associated with significant consequences for both the patients and their relatives. Due to chronicity of the illness, the relatives of patients of schizophrenia have to bear the main brunt of the illness. Studies across the world have evaluated various aspects of caregiving and caregivers such as burden, coping, quality of life, social support, expressed emotions, and psychological morbidity. In general the research has looked at caregiving as a negative phenomenon, however, now it is increasingly recognised that caregiving is not only associated with negative consequences only, also experience subjective gains and satisfaction. This review focus on the conceptual issues, instruments available to assess the positive aspects of caregiving and the various correlates of positive aspects of caregiving reported in relation to schizophrenia. The positive aspect of caregiving has been variously measured as positive caregiving experience, caregiving satisfaction, caregiving gains and finding meaning through caregiving scale and positive aspects of caregiving experience. Studies suggests that caregivers of patients with schizophrenia and psychotic disorders experience caregiving gains(in the form of becoming more sensitive to persons with disabilities, clarity about their priorities in life and a greater sense of inner strength), experience good aspects of relationship with the patient, do have personal positive experiences. Some of the studies suggest that those who experience greater negative caregiving experience also do experience positive caregiving experience.
文摘Over the years many scales have been designed for screening, diagnosis and assessing the severity of delirium. In this paper we review the various instruments available to screen the patients for delirium, instruments available to diagnose delirium, assess the severity, cognitive functions, motoric subtypes, etiology and associated distress. Among the various screening instruments, NEECHAM confusion scale and delirium observation scale appear to be most suitable screening instrument for patients' in general medical and surgical wards, depending on the type of rater(physician or nurse). In general, the instruments which are used for diagnosis [i.e., confusion assessment method(CAM), CAM for intensive care unit(CAM-ICU), Delirium Rating Scale-revised version(DRS-R-98), memorial selirium assessment scale, etc. ] are based on various Diagnostic and Statistical Manual criteria and have good to excellent reliability and fair to good validity. Among the various diagnostic instruments, CAM is considered to be most useful instrument because of its accuracy, brevity, and ease of use by clinicians and lay interviewers. In contrast, DRS-R-98 appears to be a comprehensive instrument useful for diagnosis, severity rating and is sensitive to change and hence can be used for monitoring patients over a period. In the ICU setting, evidence suggests that CAM-ICU and Nursing Delirium Screening Scale had comparable sensitivities, but CAM-ICU has higher specificity. With regard to assessment of delirium in pediatric age group, certain instruments like Pediatric Anesthesia Emergence Delirium scale and pediatric CAM-ICU has been designed and have been found to be useful.
文摘Cover crops are the plants which are grown to improve soil fertility, prevent soil erosion, enrichment and protection of soil, and enhance nutrient and water availability, and quality of soil. Cover crops provide several benefits to soils used for agriculture production. Cover crops are helpful in increasing and sustaining microbial biodiversity in soils. We summarized the effect of several cover crops in soil properties such as soil moisture content, soil microbial activities, soil carbon sequestration, nitrate leaching, soil water, and soil health. Selection of cover crops usually depends on the primary benefits which are provided by cover crops. Other factors may also include weather conditions, time of sowing, either legume or non-legume and timing and method of killing of a cover crop. In recent times, cover crops are also used for mitigating climate change, suppressing weeds in crops and increasing exchangeable nutrients such as Mg2+ and K+. Cover crops are also found to be economical in long-term experiment studies. Although some limitations always come with several benefits. Cover crops have some problems including the method of killing, host for pathogens, regeneration, and not immediate benefits of using them. Despite the few limitations, cover crops improve the overall health of the soil and provide a sustainable environment for the main crops.
基金Supported by A grant from Takeda Pharmaceuticals North America,Inc
文摘AIM: To investigate the efficacy of lubiprostone compared to Senna on bowel symptoms and constipation in post-operative orthopedic patients treated with opioids.
文摘This paper addresses the development of a random forest classifier for the muki-class fault diagnosis in spur gearboxes. The vibration signal＇s condition parameters are first extracted by applying the wavelet packet decomposition with multiple mother wavelets, and the coefficients＇ energy content for terminal nodes is used as the input feature for the classification problem. Then, a study through the parameters＇ space to find the best values for the number of trees and the number of random features is performed. In this way, the best set of mother wavelets for the application is identified and the best features are selected through the internal ranking of the random forest classifier. The results show that the proposed method reached 98.68% in classification accuracy, and high efficiency and robustness in the models.
文摘All over the world women are the predominant providers of informal care for family members with chronic medical conditions or disabilities, including the elderly and adults with mental illnesses. It has been suggested that there are several societal and cultural demands on women to adopt the role of a family-caregiver. Stress-coping theories propose that women are more likely to be exposed to caregiving stressors, and are likely to perceive, report and cope with these stressors differently from men. Many studies, which have examined gender differences among family-caregivers of people with mental illnesses, have concluded that women spend more time in providing care and carry out personal-care tasks more often than men. These studies have also found that women experience greater mental and physical strain, greater caregiver-burden, and higher levels of psychological distress while providing care. However, almost an equal number of studies have not found any differences between men and women on these aspects. This has led to the view that though there may be certain differences between male and female caregivers, most of these are small in magnitude and of doubtful clinical significance. Accordingly, caregivergender is thought to explain only a minor proportion of the variance in negative caregiving outcomes. A similar inconsistency characterizes the explanations provided for gender differences in caregiving such as role expectations, differences in stress, coping and social support, and response biases in reporting distress. Apart from the equivocal and inconsistent evidence, there are other problems in the literature on gender differences in caregiving. Most of the evidence has been derived from studies on caregivers of elderly people who either suffer from dementia or other physical conditions. Similar research on other mental illnesses such as schizophrenia or mood disorders is relatively scarce. With changing demographics and social norms men are increasingly assuming roles as caregivers. However, the experie
文摘As healthcare professionals continue to combat the coronavirus disease 2019(COVID-19)infection worldwide,there is an increasing interest in the role of imaging and the relevance of various modalities.Since imaging not only helps assess the disease at the time of diagnosis but also aids evaluation of response to management,it is critical to examine the role of different modalities currently in use,such as baseline X-rays and computed tomography scans carefully.In this article,we will draw attention to the critical findings for the radiologist.Further,we will look at point of care ultrasound,an increasingly a popular tool in diagnostic medicine,as a component of COVID-19 management.
文摘Detection and quantification of transgenes are important in analyzing genetically modified organisms (GMOs). Quantitative polymerase chain reaction (qPCR) is commonly utilized for such purposes. However, qPCR has certain limitations in detecting and quantifying transgenes in GMOs, such as the need of certified reference materials, a standard curve, and possible affection by inhibitors. Therefore, alternative and possibly better methods are needed. Recent advances in digital PCR technologies have promised to allow accurate quantification of nucleic acids and therefore provided another useful technique to analyze GMOs. Thermo Fisher Scientific<sup>TM</sup> has recently commercialized the Applied Biosystems<sup>TM</sup> QuantStudio<sup>TM</sup> 3D digital PCR system that can be used for a wide range of applications involving nucleic acids. It will be beneficial to the scientific community to show the applicability of this digital PCR system in detecting and quantifying transgenes in GMOs. In the present study, the transgenes present in the Roundup Ready Soybean (RR1, event 40-3-2) and Roundup Ready Soybean 2 (RR2, event MON89788) developed by Monsanto Corporation were analyzed by using this digital PCR system. The qPCR analysis results were included for comparison. Using specifically designed TaqMan assays, as low as 1% of the RR1 or RR2 soybean material was reliably detected and quantified on the dPCR platform. Therefore, digital PCR is a sensitive and reliable method to analyze the RR transgenic soybeans, and should be another useful tool for analyzing other transgenic plants.
文摘A comparison between deep learning and standalone models in predicting the compaction parameters of soil is presented in this research.One hundred and ninety and fifty-three soil samples were randomly picked up from two hundred and forty-three soil samples to create training and validation datasets,respectively.The performance and accuracy of the models were measured by root mean square error(RMSE),coefficient of determination(R2),Pearson product-moment correlation coefficient(r),mean absolute error(MAE),variance accounted for(VAF),mean absolute percentage error(MAPE),weighted mean absolute percentage error(WMAPE),a20-index,index of scatter(IOS),and index of agreement(IOA).Comparisons between standalone models demonstrate that the model MD 29 in Gaussian process regression(GPR)and model MD 101 in support vector machine(SVM)can achieve over 96%of accuracy in predicting the optimum moisture content(OMC)and maximum dry density(MDD)of soil,and outperformed other standalone models.The comparison between deep learning models shows that the models MD 46 and MD 146 in long short-term memory(LSTM)predict OMC and MDD with higher accuracy than ANN models.However,the LSTM models outperformed the GPR models in predicting the compaction parameters.The sensitivity analysis illustrates that fine content(FC),specific gravity(SG),and liquid limit(LL)highly influence the prediction of compaction parameters.
基金Supported by NIHR Biomedical Research Centre funding scheme, Grants from the Higher Education Funding Council for Englandthe British Liver Trust and the Alan Morement Memorial Fund, Essex, United Kingdom the British Medical Association (Gunton Award)
文摘Hepatocellular carcinoma (HCC) is the commonest primary malignancy of the liver. It usually occurs in the setting of chronic liver disease and has a poor prognosis if untreated. Orthotopic liver transplantation (OLT) is a suitable therapeutic option for early,unresectable HCC particularly in the setting of chronic liver disease. Following on from disappointing initial results,the seminal study by Mazzaferro et al in 1996 established OLT as a viable treatment for HCC. In this study,the "Milan criteria" were applied achieving a 4-year survival rate similar to OLT for benign disease. Since then various groups have attempted to expand these criteria whilst maintaining long term survival rates. The technique of living donor liver transplantation has evolved over the past decade,particularly in Asia,and published outcome data is comparable to that of OLT. This article will review the evidence,indications,and the future direction of liver transplantation for liver cancer.
文摘The accurate prediction of bearing capacity is crucial in ensuring the structural integrity and safety of pile foundations.This research compares the Deep Neural Networks(DNN),Convolutional Neural Networks(CNN),Recurrent Neural Networks(RNN),Long Short-Term Memory(LSTM),and Bidirectional LSTM(BiLSTM)algorithms utilizing a data set of 257 dynamic pile load tests for the first time.Also,this research illustrates the multicollinearity effect on DNN,CNN,RNN,LSTM,and BiLSTM models’performance and accuracy for the first time.A comprehensive comparative analysis is conducted,employing various statistical performance parameters,rank analysis,and error matrix to evaluate the performance of these models.The performance is further validated using external validation,and visual interpretation is provided using the regression error characteristics(REC)curve and Taylor diagram.Results from the comparative analysis reveal that the DNN(Coefficient of determination(R^(2))_(training(TR))=0.97,root mean squared error(RMSE)_(TR)=0.0413;R^(2)_(testing(TS))=0.9,RMSE_(TS)=0.08)followed by BiLSTM(R^(2)_(TR)=0.91,RMSE_(TR)=0.782;R^(2)_(TS)=0.89,RMSE_(TS)=0.0862)model demonstrates the highest performance accuracy.It is noted that the BiLSTM model is better than LSTM because the BiLSTM model,which increases the amount of information for the network,is a sequence processing model made up of two LSTMs,one of which takes the input in a forward manner,and the other in a backward direction.The prediction of pile-bearing capacity is strongly influenced by ram weight(having a considerable multicollinearity level),and the effect of the considerable multicollinearity level has been determined for the model based on the recurrent neural network approach.In this study,the recurrent neural network model has the least performance and accuracy in predicting the pile-bearing capacity.
文摘Guar is a drought and salt tolerant summer annual legume, which could be a potential alternative crop in the semi-arid Southern High Plains. Increased use of guar gum in oil industries has increased the demand of guar globally. Planting date effects on stand establishment, physiological parameters, and yield formation of guar genotypes were investigated at the New Mexico State University’s Agricultural Science Center at Clovis, NM for two seasons (2014 and 2015). Four guar genotypes (HES 1123, Kinman, Lewis, and Matador) were tested under three planting dates (June 18, July 7, and July 22 in 2014;and June 18, July 6, and July 20 in 2015). Higher temperature and rainfall were recorded under mid-June planting than early-July and late-July plantings. Guar planted under mid-June had better stand establishment as shown by the higher number of plants m<sup>-2</sup>, better physiology as revealed by higher photosynthetic rate (P<sub>n</sub>), transpiration rate (T<sub>r</sub>), leaf area index (LAI), and SPAD values than early-July and late-July plantings. Guar planted under mid-June resulted in taller plants, and therefore, produced higher plant biomass than both of the July plantings. Yield attributing characteristics including clusters plant<sup>-1</sup>, pods plant<sup>-1</sup>, seeds plant<sup>-1</sup>, seed spod<sup>-1</sup>, 1000 seed weight, and harvest index (HI) were highest under mid-June planting followed by the early-July and late-July plantings, respectively. The mid-June planting increased seed yield by 26% and 55% over early-July and late-July (1399 vs. 1111 and 903 kg·ha<sup>-1</sup>) plantings, respectively in 2014;while the same increase in 2015 was 51% and 243% (1308 vs. 868 and 381 kg·ha<sup>-1</sup>), respectively. These results indicate that delaying planting beyond mid-June is detrimental to guar productivity. However, genotypes did not show any significant variation in their performance. Overall, warmer growing conditions and more precipitation under mid-June planting caused bett
文摘Background The internet is an integral part of everyone’s life.College going adolescents are highly vulnerable to the misuse of the internet.Aims To estimate the pooled prevalence of internet addiction(IA)among college students in India.Methods Literature databases(PubMed,Web of Science,Scopus,EMBASE,PsycINFO and Google Scholar)were searched for studies assessing IA using the Young Internet Addiction Test(Y-IAT)among adolescents from India,published in the English language up to December 2020.We included studies from 2010 to 2020 as this is the marked era of momentum in wireless internet connectivity in India.The methodological quality of each study was scored,and data were extracted from the published reports.Pooled prevalence was estimated using the fixed-effects model.Publication bias was evaluated using Egger’s test and visual inspection of the symmetry in funnel plots.Results Fifty studies conducted in 19 states of India estimated the prevalence of IA and the overall prevalence of IA as 19.9%(95%CI:19.3%to 20.5%)and 40.7%(95%CI:38.7%to 42.8%)based on the Y-IAT cut-off scores of 50 and 40,respectively.The estimated prevalence of severe IA was significantly higher in the Y-IAT cut-off points of 70 than 80(12.7%(95%CI:11.2%to 14.3%)vs 4.6%(95%CI:4.1%to 5.2%)).The sampling method and quality of included studies had a significant effect on the estimation of prevalence in which studies using non-probability sampling and low risk of bias(total quality score≥7)reported lower prevalence.The overall quality of evidence was rated as‘moderate’based on the Grading of Recommendations Assessment,Development and Evaluation criteria.Conclusions Our nationally representative data suggest that about 20%to 40%of college students in India are at risk for IA.There is a need for further research in the reconsideration of Y-IAT cut-off points among Indian college students.
文摘AIM： To evaluate the differential inhibitory effects of bevacizumab on cell proliferation of vascular endothelial growth factor （VEGF）-stimulated choroidal vascular endothelial cells （CVECs） and retinal vascular endothelial cells （RVECs） in vitro.METHODS： VEGF （400 ng/mL） enriched CVECs and RVECs were treated with escalating doses of bevacizumab （0.1, 0.5, 1, 1.5 and 2 mg/mL）. Cell proliferation changes were analyzed with WST-1 assay and trypan blue exclusion assay at 48, 72h and 1wk. Morphological changes were recorded with bright field microscopy.RESULTS： VEGF enriched RVECs showed significantly more decline of cell viability than CVECs after bevacizumab treatment. One week after treatment, RVEC cell proliferation decreased by 29.7%, 37.5%, 52.8%, 35.9% and 45.6% at 0.1, 0.5, 1.0, 1.5 and 2 mg/mL bevacizumab respectively compared to CVEC proliferation decrease of 4.1%, 7.7%, 2.4%, 4.1% and 17.7% （P〈0.05） by WST-1 assay. Trypan blue exclusion assay also revealed similar decrease in RVEC proliferation of 20%, 60%, 73.3%, 80% and 93.3% compared to CVEC proliferation decrease of 4%, 12%, 22.9%, 16.7% and 22.2% respectively （P〈0.05）. The maximum differential effect between the two cell types was observed at bevacizumab doses of 1.0 and 1.5 mg/mL at all time points. RVECs were 22 fold more sensitive （P〈0.01） compared to CVECs （52.8% vs 2.4%） at concentration of 1.0 mg/mL, and 8.7 fold more at 1.5 mg/mL （35.9% vs 4.1%） 1wk after treatment （P〈0.05 respectively）.CONCLUSION： VEGF-enriched RVECs are more susceptible to bevacizumab inhibition than CVECs at clinically used dosage of 1.25 mg and this differential sensitivity between two cell types should be taken into consideration in dosage selection.
文摘Over the last three decades burgeoning research has shown that anxiety disorder comorbidity is not only highly prevalent in bipolar disorder(BD),but it also adversely impacts the course,outcome,and treatment of BD.The present review provides an overview of the current trends in research on comorbid anxiety and BDs based on prior reviews and meta-analyses(n=103),epidemiological surveys,and large-scale clinical studies.The results reiterated the fact that at least half of those with BD are likely to develop an anxiety disorder in their lifetimes and a third of them will manifest an anxiety disorder at any point of time.All types of anxiety disorders were equally common in BD.However,there was a wide variation in rates across different sources,with most of this discrepancy being accounted for by methodological differences between reports.Comorbid anxiety disorders negatively impacted the presentation and course of BD.This unfavourable clinical profile led to poorer outcome and functioning and impeded treatment of BD.Despite the extensive body of research there was paucity of data on aetiology and treatment of anxiety disorder comorbidity in BD.Nevertheless,the substantial burden and unique characteristics of this comorbidity has important clinical and research implications.
文摘Situs inversus with dextrocardia is a rare congenital anomaly.There are limited published case reports of successful percutaneous coronary intervention(PCI) in these patients who have atherosclerotic coronary artery disease,especially when presenting with acute myocardial infarction.PCI is technically difficult be-cause of mirror image dextrocardia.We hereby de-scribe a 48-yr-old female,who had acute inferior wall myocardial infarction and underwent successful emer-gency primary coronary angioplasty and stenting of a proximally occluded right coronary artery.Technical details about PCI are discussed.
文摘Heart failure continues to be one of the leading causes of morbidity and mortality worldwide.Myocardial infarction is the primary causative agent of chronic heart failure resulting in cardiomyocyte necrosis and the subsequent formation of fibrotic scar tissue.Current pharmacological and non-pharmacological therapies focus on managing symptoms of heart failure yet remain unable to reverse the underlying pathology.Heart transplantation usually cannot be relied on,as there is a major discrepancy between the availability of donors and recipients.As a result,heart failure carries a poor prognosis and high mortality rate.As the heart lacks significant endogenous regeneration potential,novel therapeutic approaches have incorporated the use of stem cells as a vehicle to treat heart failure as they possess the ability to self-renew and differentiate into multiple cell lineages and tissues.This review will discuss past,present,and future clinical trials,factors that influence stem cell therapy outcomes as well as ethical and safety considerations.Preclinical and clinical studies have shown a wide spectrum of outcomes when applying stem cells to improve cardiac function.This may reflect the infancy of clinical trials and the limited knowledge on the optimal cell type,dosing,route of administration,patient parameters and other important variables that contribute to successful stem cell therapy.Nonetheless,the field of stem cell therapeutics continues to advance at an unprecedented pace.We remain cautiously optimistic that stem cells will play a role in heart failure management in years to come.
