bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between musculoskeletal function deterioration and locomotive syndrome in the general elderly population: A Japanese cohort survey randomly sampled from a basic resident registry
Authors: Tokida Ryosuke , Ikegami Shota , Takahashi Jun , Ido Yoshikazu , Sato Ayaka , Sakai Noriko , Horiuchi Hiroshi , Kato Hiroyuki 
Published: June 2020

Abstract
Background: Locomotive syndrome (LoS) is defined as the loss of mobility due to age-related impairment of motor organs. The purpose of this study was to evaluate the prevalence and severity of LoS, muscular strength and balancing ability, and prevalence of sarcopenia in relation to the presence of LoS according to sex and age groups ranging between 50-89 years.Methods: Male and female participants between the ages of 50-89 were randomly selected in the resident registry of a cooperating town. Calls for participation continued until approximately 50 consenting participants were successfully recruited for each age group and sex. A total of 413 participants (203 male and 210 female) were enrolled for undergoing a LoS risk test and measuring their physical function. Physical function was compared to participants with or without LoS.Results: A total of 312 patients (75.5%) were diagnosed as LoS, of which 144 (46.2%) were male and 168 (53.8%) were female. The severity of LoS for the 312 patients were 210 (67.3%) for stage 1 and 102 (32.7%) for stage 2. The prevalence of LoS in males were 37%, 59%, 91%, and 100% in the 50s, 60s, 70s, and 80s age strata, respectively. The prevalence of LoS in females were 71%, 62%, 89%, and 98% in the 50s, 60s, 70s, and 80s age strata, respectively. The prevalence of sarcopenia was significantly higher as the age strata in males grew higher. Knee extension strength was significantly lower for participants in their 50s and females in addition to females in their 60s with LoS. The 31 patients diagnosed as sarcopenia included 29 (93.5%) with LoS, 11 (35.4%) classified as LoS stage 1, and 18 (58.1%) classified as stage 2.Conclusions: The prevalence of LoS was high in participants over 70 years of age. In males, the prevalence of sarcopenia was higher as the age strata grew higher. Patients with LoS exhibited lower knee extension strength. We believe that some measures to prevent or improve LoS may require exercise to increase the muscle strength of the lower limbs.
Regional education on endoscopic surgery using a teleconference system with high-quality video via the internet: Saga surgical videoconferences
Authors: Manabe Tatsuya , Takasaki Mitsuhiro , Ide Takao , Kitahara Kenji , Sato Seiji , Yunotani Seiji , Hirohashi Yoshimi , Iyama Akihiro , Taniguchi Masahiko , Ogata Toshiro , Shimizu Shuji , Noshiro Hirokazu 
Published: June 2020

Abstract
Background: Effective education about endoscopic surgery (ES) is greatly needed for unskilled surgeons, especially at low-volume institutions, to maintain the safety of patients. We have tried to establish the remote educational system using videoconference system through the internet for education about ES to surgeons belonging to affiliate institutions. The aim of this manuscript was to report the potential to establish a comfortable remote educational system and to debate its advantages. Methods: We established a local remote educational conference system by combining the use of a general web conferencing system and a synchronized remote video playback system with annotation function through a high-speed internet. Results: During 2014 – 2019, we conducted 14 videoconferences to review and improve surgeons’ skills in performing ES at affiliated institutions. At these conferences, while an uncut video of ES that had been performed at one of the affiliated institutions was shown, the surgical procedure was discussed frankly, and expert surgeons advised improvements. The annotation system is useful for easy, prompt recognition among the audience regarding anatomical structures and procedures that are difficult to explain verbally. Conclusions: This system is of low initial cost and offers easy participation and high-quality videos. It would therefore be a useful tool for regional ES education.
Barriers to Childhood Immunization in Sub-Saharan Africa: A Systematic Review
Authors: Bangura Joseph Benjamin , Xiao Shui-yuan , Qiu Dan , Ouyang Feiyun , Chen Lei 
Published: June 2020

Abstract
Background Immunization to prevent infectious diseases is a core strategy to improve childhood health as well as survival. It remains a challenge for some African countries to attain the required childhood immunization coverage. We aim at identifying individual barriers confronting parents/caretakers, providers, and health systems that hinder childhood immunization coverage in Sub-Saharan Africa. Method This systematic review searched PubMed/MEDLINE, Web of Science and EMBASE. We restricted to published articles in English that focused on childhood immunization barriers in Sub-Saharan Africa from January 1988 to February 2019. We excluded studies if: focused on barriers to immunization for children in other regions of the world, studied adult immunization barriers; studies not available on the university library, they were editorial, reports, reviews, supplement, and bulletins. Study designs included were cross-sectional, second-hand data analysis; and case control. Results Of the 2,538 items identified, 40 met inclusion criteria. Parents/caretakers were the most common subjects. Eight articles were of moderate and 32 were of high methodological quality. Seven studies analyzed secondary data; 30 used cross-sectional designs and three employed case control method. Twenty-five studies reported national immunization coverage of key vaccines for children under one, fifteen did not. When reported, national immunization coverages of childhood vaccines were reported to be low. Parents/caretaker’s barriers included lack of knowledge of immunization, distance to access point, financial deprivation, lack of partners support, and distrust in vaccines and immunization programs. Other associated factors for low vaccine rates included the number of off-springs, life style, migration and occupation. Barriers at health system level cited by healthcare providers included limited human resources and inadequate infrastructures to maintain the cold chain and adequate supply of vaccines. Conclusion In this review we identified more thoroughly the parents/caretakers’ barriers than those of providers and health systems. Factors that influenced decisions to get children vaccinated were mainly their gender, beliefs, socio-economic and socio-culture factors in the communities in which they live. Thus it is vital that immunization programs consider these barriers and address the people and societies in their communities across Sub-Saharan Africa.
An in vivo multimodal feasibility study in a rat brain tumour model using flexible multinuclear MR and PET systems
Authors: Choi Chang-Hoon , Stegmayr Carina , Shymanskaya Aliaksandra , Worthoff Wieland A. , Silva Nuno A da , Felder Jörg , Langen Karl-Josef , Shah Nadim Jon 
Published: June 2020

Abstract
Background: In addition to the structural information afforded by 1H MRI, the use of X-nuclei, such as sodium-23 (23Na) or phosphorus-31 (31P), offers important complementary information concerning physiological and biochemical parameters. By then combining this technique with PET, which provides valuable insight into a wide range of metabolic and molecular processes by using of a variety of radioactive tracers, the scope of medical imaging and diagnostics can be significantly increased. While the use of multimodal imaging is undoubtedly advantageous, identifying the optimal combination of these parameters to diagnose a specific dysfunction is very important and is advanced by the use of sophisticated imaging techniques in specific animal models. Methods: In this pilot study, rats with intracerebral 9L gliosarcomas were used to explore a combination of sequential multinuclear MRI using a sophisticated switchable coil set in a small animal 9.4 T MRI scanner and, subsequently, a small animal PET with the tumour tracer O-(2-[18F]-fluoroethyl)-L-tyrosine ([18F]FET). This made it possible for in vivo multinuclear MR-PET experiments to be conducted without compromising the performance of either multinuclear MR or PET. Results: High-quality in vivo images and spectra including high-resolution 1H imaging, 23Na-weighted imaging, detection of 31P metabolites and [18F]FET uptake were obtained, allowing the characterisation of tumour tissues in comparison to a healthy brain. It has been reported in the literature that these parameters are useful in the identification of the genetic profile of gliomas, particularly concerning the mutation of the isocitrate hydrogenase gene, which is highly relevant for treatment strategy.Conclusions: The combination of multinuclear MR and PET in, for example, brain tumour models with specific genetic mutations will enable the physiological background of signal alterations to be explored and the identification of the optimal combination of imaging parameters for the non-invasive characterisation of the molecular profile of tumours.
Artificial Immune Network Clustering Based on a Cultural Algorithm
Authors: Deng Liyuan , Yang Ping , Liu Weidong 
Published: June 2020

Abstract
Data mining technology has been applied in many fields. Prototype-based cluster analysis is an important data mining method, but its ability to discover knowledge is limited because of the need to know the number of target data categories and cluster prototypes in advance. Artificial immune evolutionary network clustering is a clustering method based on network structure. Compared with prototype-based cluster analysis, it has the advantage of realizing unsupervised learning and clustering without any prior knowledge of data. However, artificial immune evolutionary network clustering also has problems such as a lack of guidance in the clustering process, fuzzy boundary sensitivity, and difficulty in determining parameters. To solve these problems, an artificial immune network clustering algorithm based on a cultural algorithm is proposed. First, three kinds of knowledge are constructed: normative knowledge is used to regulate the spatial range of population initialization to avoid blindness; state knowledge is used to distinguish the type of antigen, and immune defense measures are taken to prevent the network structure caused by noise and boundaries from being unclear; topology knowledge is used to guide the antigen for optimal antibody search. Second, topology knowledge in the cultural algorithm is used to characterize the distribution of antigens and antibodies in space, and elite learning is used to improve the traditional clone mutation operator. Based on the shadow set theory, a method for adaptively determining the compression threshold is proposed. Finally, the results of simulation experiments show that the proposed algorithm can effectively overcome the above problems, and the clustering performances on a synthetic dataset and an actual dataset are satisfactory.
Risk factors and clinical features of deterioration in COVID-19 patients in Zhejiang, China: a single- centre, retrospective study
Authors: Yi Ping , Yang Xiang , Ding Cheng , Chen Yanfei , Xu Kaijin , Ni Qing , Zhao Hong , Li Yongtao , Zhang Xuan , Liu Jun , Sheng Jifang , Li Lanjuan 
Published: June 2020

Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection swept through Wuhan and spread across China and overseas beginning in December 2019. To identify predictors associated with disease progression, we evaluated clinical risk factors for exacerbation of SARS-CoV-2 infection. Methods A retrospective analysis was used for PCR-confirmed COVID-19 (coronavirus disease 2019)-diagnosed hospitalized cases between January 19, 2020, and February 19, 2020, in Zhejiang, China. We systematically analysed the clinical characteristics of the patients and predictors of clinical deterioration.Results One hundred patients with COVID-19, with a median age of 54 years, were included. Among them, 49 patients (49%) had severe and critical disease. Age ([36-58] vs [51-70], P=0.0001); sex (49% vs 77.6%, P=0.0031); BMI ([21.53-25.51] vs [23.28-27.01], P=0.0339); hypertension (17.6% vs 57.1%, P<0.0001); IL-6 ([6.42-30.46] vs [16.2-81.71], P=0.0001); IL-10 ([2.16-5.82] vs [4.35-9.63], P<0.0001); T lymphocyte count ([305- 1178] vs [167.5-440], P=0.0001); B lymphocyte count ([91-213] vs [54.5-163.5], P=0.0001); white blood cell count ([3.9-7.6] vs [5.5-13.6], P=0.0002); D2 dimer ([172-836] vs [408-953], P=0.005), PCT ([0.03-0.07] vs [0.04-0.15], P=0.0039); CRP ([3.8-27.9] vs [17.3-58.9], P<0.0001); AST ([16, 29] vs [18, 42], P=0.0484); artificial liver therapy (2% vs 16.3%, P=0.0148); and glucocorticoid therapy (64.7% vs 98%, P<0.0001) were associated with the severity of the disease. Age and weight were independent risk factors for disease severity. Conclusion Deterioration among COVID-19-infected patients occurred rapidly after hospital admission. In our cohort, we found that multiple factors were associated with the severity of COVID19. Early detection and monitoring of these indicators may reduce the progression of the disease. Removing these factors may halt the progression of the disease. In addition, early treatment with low doses of glucocorticoids and liver therapy, when necessary, may help reduce mortality in critically ill patients.
The potential of CBC-derived ratios (Monocyte-to-lymphocyte, neutrophil-to-lymphocyte, and platelet-to-lymphocyte) to predict or diagnose incident TB infection in Tanzanian adolescents
Authors: Rees Christiaan , PINEROS Dwan , AMOUR Maryam , MUNSERI Patricia , SAID Jamila , MAGOHE Albert , MATEE Mecky , PALLANGYO Kisali , VON REYN C Fordham 
Published: June 2020

Abstract
Background: Ratios of different immune cell populations (i.e., monocyte-to-lymphocyte, neutrophil-to-lymphocyte, and platelet-to-lymphocyte ratios) have been studied as a means of predicting future tuberculosis (TB) disease risk or to assist in the diagnosis of incident TB disease. No studies to-date, however, have evaluated the potential of these ratios to predict or assist in the diagnosis of incident TB infection - the first step in the natural history of TB disease. Methods: In this prospective study, we evaluated the complete blood count (CBC)-derived metrics of monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) as predictors of future TB infection risk or aids in the diagnosis of TB infection among 145 Tanzanian adolescents enrolled in the DAR-901 vaccine trial, using paired CBCs and interferon-gamma release assays (IGRAs) obtained at 0, 60 and 720 days after study enrollment.Results: At baseline, there were no significant differences between study participants who remained persistently IGRA negative throughout the study period and those who subsequently converted to IGRA positive with respect to MLR (0.18 vs 0.17, p=0.10), NLR (0.88 vs 1.02, p=0.08), or PLR (115 vs 120, p=0.28). Similarly, no significant differences were noted with respect to MLR, NLR, and PLR between IGRA converters and time-matched negative controls at the time of IGRA conversion. With respect to other blood cell measures, however, there were modest but significant differences between IGRA negatives and IGRA converters with respect to red blood cell count (4.8 vs 4.6 × 106 cells/mcL, p=0.008), hemoglobin (12.6 vs 12.3 g/dL, p=0.01), and hematocrit (38.8 vs 37.8 %, p=0.005).Conclusions: In contrast to prior studies that have suggested that the ratios of different immune cell populations are associated with development of TB disease, our present findings do not demonstrate an association between these ratios and the development of TB infection. However, decreased red blood cell measures were associated with the subsequent development of TB infection, suggesting either that dysregulation of iron metabolism may play a role in TB pathogenesis or that following TB infection, iron dysregulation may precede IGRA positivity. Trial Registration: Data presented are from clinical trial NCT02712424.
Similar outcomes with first-line observation versus metastasectomy for bone giant cell tumor lung metastases
Authors: Tsukamoto Shinji , Ciani Giovanni , Mavrogenis Andreas F. , Ferrari Cristina , Akahane Manabu , Tanaka Yasuhito , Rocca Michele , Longhi Alessandra , Donati Davide Maria , Errani Costantino 
Published: June 2020

Abstract
Background: The outcome of lung metastases in patients with giant cell tumor of bone (GCTB) varies from spontaneous regression to uncontrolled growth. To investigate whether observation is an appropriate first-line management for patients with lung metastases from GCTB, we compared the outcomes of patients initially treated with observation with those treated with metastasectomy.Methods: We retrospectively reviewed the data of 29 patients with lung metastases from histologically confirmed GCTB. The median follow-up period was 114 months. We evaluated progression-free survival, which was defined as the time from the date of occurrence of lung metastases to the date of disease progression in the observation or incomplete metastasectomy group, disease recurrence in the complete metastasectomy group, or the last follow-up.Results: Disease progression or recurrence occurred in 14 patients (48.3%). Progression-free survival did not vary significantly between the observation and metastasectomy groups (p=0.373). The total number of metastasectomies was significantly higher in the initial metastasectomy group than in the observation group (p=0.017).Conclusions: The number of patients included in this study is small, however the data suggests that observation can be used safely as first-line management for patients with lung metastases from GCTB with an outcome similar to that of metastasectomy. It is necessary to confirm our result in multi-institutional study with sufficient number of patients.
Developing a Sensor-Based Mobile Application for In-Home Frailty Assessment: A Qualitative Study
Authors: Blinka Marcela D. , Buta Brian , Bader Kevin D , Hanley Casey , Schoenborn Nancy , McNabney Matthew , Xue Qian-Li 
Published: June 2020

Abstract
Background Frailty syndrome disproportionately affects older people, including 15% of non-nursing home population, and is known to be a strong predictor of poor health outcomes. There is a growing interest in incorporating frailty assessment into research and clinical practice, which may provide an opportunity to improve in home frailty assessment and improve doctor patient communication.Methods We conducted focus groups discussions to solicit input from older adult care recipients (non-frail, pre-frail, and frail), their informal caregivers, and medical providers about their preferences to tailor a mobile app to measure frailty in the home using sensor based technologies. Focus groups were recorded, transcribed, and analyzed thematically.Results We identified three major themes: 1) perspectives of frailty; 2) perceptions of home based sensors; and 3) data management concerns. These relate to the participants’ insight, attitudes and concerns about having sensor-based technology to measure frailty in the home. Our qualitative findings indicate that knowing frailty status is important and useful and would allow older adults to remain independent longer. Participants also noted concerns with data management and the hope that this technology would not replace in-person visits with their healthcare provider.Conclusions This study found that study participants of each frailty status expressed high interest and acceptance of sensor-based technologies. Based on the qualitative findings of this study, sensor-based technologies show promise for frailty assessment of older adults with care needs. The main concerns identified related to the volume of data collected and strategies for responsible and secure transfer, reporting, and distillation of data into useful and timely care information. Sensor-based technologies should be piloted for feasibility and utility. This will inform the larger goal of helping older adults to maintain independence while tracking potential health declines, especially among the most vulnerable, for early detection and intervention. Keywords: Frailty, wearable, health services
Clinical Risk Factors for Long-term Hospital Stay in Common Patients with coronavirus disease 2019(COVID-19)
Authors: Lu Wei , Fang Junjie , Chen Bin , Wu Dan , Yu Chunyao , Piao Sirong , Zhang Shun , Jin Yinhua 
Published: June 2020

Abstract
Background

This study aimed to investigate the potential risk factors associated with hospital stay in mild patients with COVID-19.
Methods

A total of 109 laboratory-confirmed COVID patients with initial common subtype diseased by real-time RT-PCR that meet discharge standards were retrospectively included from January 16 to March 15 of 2020. Baseline demographic, clinical, laboratory examination was extracted from electronic medical records at the first day of admission and compared between short-term hospital stay and long-term hospital stay. Univariable and multivariable logistic regression methods were used to explore the risk factors associated with hospital stay.
Results

Of 109 COVID-19 patients, 61 patients were short-term stay (≤ 10 days) and 48 patients were long-term stay (> 10 days). The average age of patients in short-term stay were younger than those long-term stay(P = 0.01). Hypertension was the most common comorbidity (34%, 21/61), followed by diabetes (15%,9/61) and Cardiopathy (8%, 5/61). Fever and cough were the typical clinical manifestation in two group. Decreased WBC, Hemoglobin and increased Monocyte, MLR (Monocyte Lymphocyte ratio) and Hypersensitive CRP showed a long-term stay (all P < 0.05). The treatment of Resochin and Human immunoglobulin had a shorter hospital stay. Multivariable regression showed that MLR and CRP on admission were risk factors for predicting the hospital stay, with the HR (hazard ratio 2.03, 1.02–5.39; P = 0.022) and (1.32,1.05–3.24, P = 0.045) respectively.
Conclusions

The potential risk factors of MLR and CRP may help clinicians to predict the hospital stay of COVID-19 patients.