BACKGROUND & AIMS: BACKGROUND:It is essential that dental clinicians, including dental students, have sufficient knowledge of and adhere to relevant prophylactic guidelines for the prevention of infective endocarditis. Because the overprescription of antibiotics contributes to the development of drug resistance, antibiotic stewardship should be at the forefront of patient care. The aim of this review is to determine the level of knowledge and compliance of dentists and dental students to relevant guidelines regarding antibiotic prophylaxis for the prevention of infective endocarditis. In addition, we aim to identify the factors that influence the level of knowledge and compliance. MATERIALS AND METHODS:The following electronic databases were searched: MEDLINE (OvidSP), Scopus, Web of Science, CINAHL (EBSCOhost), and Informit Health Database. Inclusion criteria were (1) published quantitative studies that assessed dentists' and dental students' knowledge of and compliance with relevant guidelines for prescribing antibiotic prophylaxis for the prevention of infective endocarditis; (2) studies in English; and (3) studies published on any date. The National Institutes of Health, National Heart, Lung and Blood Institute Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to appraise each of the included studies. The required data were collected and formatted to provide a narrative synthesis. RESULTS:A total of 3427 articles were identified, 167 full-text articles were reviewed, and 43 articles from 37 studies were included. Overall knowledge of guidelines ranged from as low as 1.9% to as high as 100% depending on the detail being examined. No statistically significant difference was found between dental students' and qualified dentists' knowledge. Overall compliance with guidelines ranged from 40% to 81%. Respondents' age and postgraduate training were the variables most associated with dentists' knowledge of guidelines for infective endocarditis. A limitation of this review is that only quantitative studies in English were assessed. CONCLUSION:Knowledge levels of guidelines for antibiotic prophylaxis varied greatly depending on the study design, respondent characteristics, and time period factors. There is a lack of research published on compliance rates for dentists and dental students with respect to guidelines for the prevention of infective endocarditis.

背景与目标： 背景：至关重要的是，包括牙科学生在内的牙科临床医生必须具有足够的知识并遵守相关的预防性指南，以预防感染性心内膜炎。由于抗生素的过量处方会导致耐药性的发展，因此抗生素管理应成为患者护理的重中之重。这篇综述的目的是确定牙医和牙科学生对预防感染性心内膜炎的抗生素预防相关指南的了解程度和依从性。此外，我们旨在确定影响知识水平和合规性的因素。
材料和方法：搜索以下电子数据库：MEDLINE（OvidSP），Scopus，Web of Science，CINAHL（EBSCOhost）和Informit Health数据库。纳入标准是：（1）已发表的定量研究评估了牙医和牙科学生对预防感染性心内膜炎的抗生素预防处方的了解和遵守情况； （2）英语学习； （3）在任何日期发表的研究。美国国立卫生研究院，国家心脏，肺和血液研究所用于观察性队列研究和跨学科研究的质量评估工具用于评估每个纳入的研究。收集所需数据并格式化以提供叙述性综合。
结果：共鉴定了3427篇文章，审查了167篇全文文章，并纳入了来自37个研究的43篇文章。根据所检查的细节，指南的总体知识范围从低至1.9％到高至100％。牙科学生的知识和合格的牙医的知识之间没有发现统计学上的显着差异。总体上符合准则的范围从40％到81％。受访者的年龄和研究生培训是与牙医了解感染性心内膜炎指南最相关的变量。该评论的局限性在于仅评估了英语的定量研究。
结论：根据研究设计，应答者特征和时间因素，抗生素预防指南的知识水平差异很大。关于预防感染性心内膜炎的指南，目前还缺乏关于牙医和牙科学生的依从率的研究。

BACKGROUND & AIMS: OBJECTIVES:To evaluate the limits of stability (LOS) in persons with transtibial amputation (TTA), and to determine the effects of prosthetic alignment alterations on motor control strategies. DESIGN:Before-and-after trial. SETTING:A kinesiology laboratory at a university hospital. PARTICIPANTS:Male patients with TTA (n=10) and controls (n=17). INTERVENTIONS:Prosthetic alignment. MAIN OUTCOME MEASURES:For the LOS test, the maximum excursion, endpoint excursion, direction control, movement velocity, and reaction time with inclination in the forward direction, toward the amputated leg/right leg, and in the backward direction, and toward the nonamputated leg/left leg. Measurements were performed using the following 5 prosthetic alignments: the optimal alignment, with the prosthesis shorter by 1cm, with the prosthesis longer by 1cm, and with the prosthetic foot in 5° of extra plantar flexion and 5° of extra dorsiflexion. RESULTS:Compared with the control group, maximum excursion and direction control were lower (P<.05) in patients with TTA with backward body inclination for all tested prosthetic alignments. Direction control in backward inclination was reduced (P<.05) compared with other tested directions for all assessed prosthetic alignments. Differences between the tested alignments were not significant in any of the tested directions. CONCLUSIONS:Patients with TTA have decreased voluntary body inclination backward within the LOS for all tested prosthetic alignments. Compared with controls, changes in prosthetic foot settings by means of rotation in the sagittal plane had a larger impact on movement strategy in patients with TTA than did changes to the length of the prosthesis.

背景与目标： 目的：评估胫骨截肢（TTA）患者的稳定性（LOS）极限，并确定假体排列改变对运动控制策略的影响。
设计：试用前后。
地点：大学医院的运动机能实验室。
参与者：男性TTA患者（n = 10）和对照组（n = 17）。
干预：假体对齐。
主要观察指标：对于LOS测试，最大偏移，端点偏移，方向控制，运动速度和反应时间，向前，向截肢/右腿，向后截肢，向后，向非截肢倾斜腿/左腿。使用以下5种假体对齐方式进行测量：最佳对齐方式，假体短1cm，假体长1cm，假脚足底弯曲5°，背背弯曲5°。
结果：与对照组相比，对于所有测试的假体排列，TTA身体向后倾斜的患者的最大偏移和方向控制均较低（P <.05）。对于所有评估的假体排列，与其他测试方向相比，向后倾斜的方向控制减少了（P <.05）。在任何测试方向上，测试对齐之间的差异均不显着。
结论：对于所有测试的假体排列，患有TTA的患者在LOS内向后减少了自愿的身体倾斜。与对照组相比，在TTA患者中，通过矢状面旋转引起的假脚设置改变对假肢长度的影响更大。

BACKGROUND & AIMS: :T11 target structure (T11TS), a membrane glycoprotein has been documented with antineoplastic activity in animal model in our lab. Previously, in animal study we have documented T11TS induced cytotoxic abrogation of tumor cells. Encouraged by these established findings by our group and as prerequisite for clinical trial, this study has been designed to assess the cytotoxic potential of the patient's lymphocytes in in vitro study of autologous human glioma as modulated by T11TS. Meningioma samples were chosen as disease control group. The data produced indicates T11TS induced up regulation of cytotoxicity of T lymphocytes in grade I and II glioma. Significant enhancement of cytotoxic protein, perforin and granzyme suggest cytotoxic death of T11TS induced target tumor. Also, T11TS downregulates the TGF-β secretion in grade I and II tumor cells. These preliminary findings may help in pushing this molecule into pharmaceutical domain.

背景与目标： ：T11靶结构（T11TS），一种膜糖蛋白已在我们实验室的动物模型中被证明具有抗肿瘤活性。以前，在动物研究中，我们已经记录了T11TS诱导的肿瘤细胞细胞毒素消除。受我们小组这些既定发现的鼓舞，并作为临床试验的前提，本研究旨在评估在体外研究受T11TS调节的自体人类神经胶质瘤患者淋巴细胞的细胞毒性潜力。选择脑膜瘤样品作为疾病对照组。产生的数据表明，T11TS诱导了I级和II级神经胶质瘤中T淋巴细胞的细胞毒性上调。细胞毒性蛋白，穿孔素和颗粒酶的显着增强表明T11TS诱导的靶肿瘤的细胞毒性死亡。同样，T11TS下调I级和II级肿瘤细胞中TGF-β的分泌。这些初步发现可能有助于将该分子推入药物领域。

BACKGROUND & AIMS: Background:Competent and skilled birth attendants are critical in the reduction of maternal and infant morbidity and mortality at delivery. This study aimed to determine the association between knowledge and self-rated confidence in facility birth attendants affiliated with maternal and neonatal health (MNH) interventions. Methods:A descriptive cross-sectional study was conducted in 24 primary healthcare facilities in Osun state, Nigeria among 128 consenting facility birth attendants who were selected via a multi-stage sampling technique. Each attendant received a semi-structured interviewer-administered questionnaire. The dependent variables included the respondent's level of knowledge in MNH interventions and their self-rated confidence in MNH skills such as the provision of antenatal care service, normal labour, use of a partograph and the management of obstetric complications and post-partum haemorrhage. Bivariate analysis of factors associated with knowledge and self-rated confidence in MNH skills was performed with statistical significance set at p<0.05. Results:Only 48 (37.5%) of the respondents had good knowledge of all of the assessed interventions; worse performances were reported with regards to the respondent's knowledge of normal labour and partograph use. However, 96 (75%) of respondents were confident in performing 75% of the skills assessed. Our analysis identified two factors that were significantly associated with a good knowledge of MNH skills: the cadre of the birth attendants (p<0.001) and training in life-saving skills (p=0.001). The knowledge of our respondents relating to most of the MNH interventions assessed was not significantly associated with their self-rated confidence in the required skills. Conclusion:The confidence of facility birth attendants in MNH skills was not knowledge-based and could frustrate national efforts to reduce maternal and perinatal deaths. We recommend effective and evidence-based training of all cadres of facility birth attendants to ensure that the skills being practiced clinically are based on adequate knowledge.

背景与目标： 背景：合格和熟练的接生员对于降低产妇和婴儿的发病率和死亡率至关重要。这项研究旨在确定与产妇和新生儿健康（MNH）干预相关的设施接生员的知识与自评信心之间的关联。
方法：描述性横断面研究在尼日利亚奥森州的24家主要医疗机构中进行，该研究采用多阶段抽样技术从128名同意的机构接生员中选出。每位服务员都收到了由访谈员管理的半结构化问卷。因变量包括受访者对MNH干预的知识水平，以及他们对MNH技能的自评信心，例如提供产前护理服务，正常分娩，使用分形仪以及管理产科并发症和产后出血。对与MNH技能的知识和自我评估的自信心相关的因素进行双变量分析，统计学显着性设为p <0.05。
结果：只有48（37.5％）位被调查者对所有评估的干预措施都有很好的了解；据报告，关于受访者的正常劳动和零件使用情况，表现较差。但是，有96名（75％）的受访者对完成所评估技能的75％有信心。我们的分析确定了与MNH技能的良好知识显着相关的两个因素：接生人员的干部（p <0.001）和救生技能的培训（p = 0.001）。我们的受访者对大多数MNH干预措施的了解与他们对所需技能的自我评价信心没有显着相关。
结论：设施接生员对MNH技能的信心不是基于知识的，可能会挫伤国家减少孕产妇和围产儿死亡的努力。我们建议对设施接生的所有干部进行有效且循证的培训，以确保临床实践的技能是基于足够的知识。

BACKGROUND & AIMS: PURPOSE:To determine whether the combined magnetic resonance imaging (MRI) and magnetic resonance spectroscopy imaging (MRSI) before radiation therapy (RT) is valuable for RT target definition, and to evaluate the feasibility of replacing the current definition of uniform margins by custom-shaped margins based on the information from MRI and MRSI. METHODS AND MATERIALS:A total of 23 glioblastoma multiforme (GBM) patients underwent MRI and MRSI within 4 weeks after surgery but before the initiation of RT and at 2-month follow-up intervals thereafter. The MRSI data were quantified on the basis of a Choline-to-NAA Index (CNI) as a measure of spectroscopic abnormality. A combined anatomic and metabolic region of interest (MRI/S) consisting of T2-weighted hyperintensity, contrast enhancement (CE), resection cavity, and CNI2 (CNI >or= 2) based on the pre-RT imaging was compared to the extent of CNI2 and the RT dose distribution. The spatial relationship of the pre-RT MRI/S and the RT dose volume was compared with the extent of CE at each follow-up. RESULTS:Nine patients showed new or increased CE during follow-up, and 14 patients were either stable or had decreased CE. New or increased areas of CE occurred within CNI2 that was covered by 60 Gy in 6 patients and within the CNI2 that was not entirely covered by 60 Gy in 3 patients. New or increased CE resided within the pre-RT MRI/S lesion in 89% (8/9) of the patients with new or increased CE. CONCLUSION:These data indicate that the definition of RT target volumes according to the combined morphologic and metabolic abnormality may be sufficient for RT targeting.

背景与目标： 目的：确定放射治疗（RT）之前的磁共振成像（MRI）和磁共振波谱成像（MRSI）的组合对于RT目标定义是否有价值，并评估用定制的方法代替当前定义的均匀余量的可行性-根据MRI和MRSI的信息对边缘进行整形。
方法和材料：总共23例多形性胶质母细胞瘤（GBM）患者在手术后4周内，开始RT之前以及随后的2个月随访期间接受了MRI和MRSI。 MRSI数据基于胆碱到NAA指数（CNI）进行量化，以衡量光谱异常。比较基于T2加权的高强度，造影剂增强（CE），切除腔和CNI2（CNI>或= 2）组成的感兴趣的解剖和代谢组合区域（MRI / S），在一定程度上CNI2和RT剂量分布的关系。在每次随访时，将RT前MRI / S与RT剂量的空间关系与CE的程度进行比较。
结果：9例患者在随访期间显示出新的或增加的CE，14例病情稳定或CE降低。 6例患者的CNG2内出现新的或增加的CE区域，被60 Gy覆盖； 3例患者的CNI2内未完全被60 Gy覆盖。在新的或增加的CE患者中，有89％（8/9）的患者在RT之前的MRI / S病变中存在新的或增加的CE。
结论：这些数据表明，根据形态和代谢异常的结合来确定RT靶标的量可能足以作为RT靶标。

BACKGROUND & AIMS: :To overcome the two-class imbalanced problem existing in the diagnosis of breast cancer, a hybrid of K-means and Boosted C5.0 (K-Boosted C5.0) is proposed which is based on undersampling. K-means is utilized to select the informative samples near the boundary. During the training phase, the K-means algorithm clusters the majority and minority instances and selects a similar number of instances from each cluster. Boosted C5.0 is then used as the classifier. As there is one different instance selection factor via clustering that encourages the diversity of the training subspace in K-Boosted C5.0, it would be a great advantage to get better performance. To test the performance of the new hybrid classifier, it is implemented on 12 small-scale and 2 large-scale datasets, which are the often used datasets in class imbalanced learning. The extensive experimental results show that our proposed hybrid method outperforms most of the competitive algorithms in terms of Matthews' correlation coefficient (MCC) and accuracy indices. It can be a good alternative to the well-known machine learning methods.

背景与目标： ：为克服乳腺癌诊断中存在的两类不平衡问题，基于欠采样，提出了K-均值和Boosted C5.0（K-Boosted C5.0）的混合体。利用K均值选择边界附近的信息量样本。在训练阶段，K-means算法将多数和少数实例聚类，并从每个聚类中选择相似数量的实例。然后将Boosted C5.0用作分类器。由于通过聚类存在一个不同的实例选择因子，可以鼓励K-Boosted C5.0中训练子空间的多样性，因此获得更好的性能将是一个巨大的优势。为了测试新混合分类器的性能，它在12个小型和2个大型数据集上实现，这是班级不平衡学习中经常使用的数据集。大量的实验结果表明，在Matthews的相关系数（MCC）和准确性指标方面，我们提出的混合方法优于大多数竞争算法。它可以替代众所周知的机器学习方法。

BACKGROUND & AIMS: BACKGROUND:The enzyme glyoxalase1 (GLO1) is the main opponent in the degradation of the reactive metabolite methylglyoxal (MG), which by glycation of macromolecules is involved in atherogenesis. Reduced GLO1-activity in atherosclerotic tissue is known to be associated with diabetes. It has been shown that treatment of patients with type 2 diabetes with metformin leads to increased GLO1-activity in peripheral-blood-cells. The aim of this study was to evaluate whether metformin treatment increases GLO1-activity in atherosclerotic lesions of patients with type 2 diabetes. PATIENTS AND METHODS:Patients with type 2 diabetes and carotid artery disease were included into the study prospectively. Type of diabetes-medication was documented upon admission along with demographic and clinical history. Using shock frozen endarterectomy-derived carotid artery plaques, GLO1-activity as well as protein expression was measured by a spectophotometric assay and western-blotting respectively. RESULTS:33 patients (76 % male, mean age 71 years) were included into the study and were divided according to treatment with metformin or not (15 vs. 18 patients). GLO1-activity was increased by the factor 1.36 when treated with metformin - however, not significantly (0.86 vs. 0.63 U/mg, p = 0.056). Normalisation of GLO1-activity onto GLO1-expression level lead to a significant increase by more than twofold (8.48 vs. 3.85, p = 0.044) while GLO1-protein levels did not differ significantly. GLO1-activity correlated positively with increasing HbA1c, especially under metformin treatment. CONCLUSIONS:Treatment with metformin in patients with type 2 diabetes is associated with enhanced GLO1-activity in atherosclerotic lesions. Regarding the macro- and microvascular complications in these patients further studies are needed to gain more insight into the effect of metformin on the GLO/MG system.

背景与目标： 背景：乙二醛酶1（GLO1）是反应性代谢产物甲基乙二醛（MG）降解的主要对手，后者通过大分子糖基化参与动脉粥样硬化的形成。已知动脉粥样硬化组织中GLO1活性降低与糖尿病有关。已经显示，用二甲双胍治疗2型糖尿病患者会导致外周血细胞中GLO1活性增加。这项研究的目的是评估二甲双胍治疗是否增加2型糖尿病患者的动脉粥样硬化病变中的GLO1活性。
患者与方法：前瞻性纳入了2型糖尿病和颈动脉疾病的患者。入院时记录了糖尿病用药的类型以及人口统计学和临床​​病史。使用激冷冷冻内膜切除术衍生的颈动脉斑块，分别通过分光光度法和蛋白质印迹法测量GLO1活性和蛋白质表达。
结果：33名患者（76％的男性，平均年龄71岁）被纳入研究，并根据是否接受二甲双胍治疗进行了划分（15例对18例）。用二甲双胍治疗时，GLO1活性增加了1.36倍-但没有显着提高（0.86比0.63 U / mg，p = 0.056）。 GLO1活性在GLO1表达水平上的标准化导致显着增加两倍以上（8.48对3.85，p = 0.044），而GLO1蛋白水平没有显着差异。 GLO1活性与HbA1c增加呈正相关，尤其是在二甲双胍治疗下。
结论：2型糖尿病患者用二甲双胍治疗与动脉粥样硬化病变中GLO1活性增强有关。关于这些患者的大血管和微血管并发症，需要进一步研究以进一步了解二甲双胍对GLO / MG系统的作用。