bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving the Assisting Efficiency of Ankle Robot through Energy Harvesting of Achilles Tendon
Authors: Huang Guowei , Wang Zhihou , Liu Biao , Zhou Zikang , Xian Xiaoming , Xie Longhan 
Published: June 2020

Abstract
Background The construction of lightweight robots poses one of the major challenges in the field of active robots since bearing the weight of an active robot significantly increases metabolic cost. However, few studies have achieved a substantial reduction in the robot weight. The primary reason is that the weight of the actuator, which comprises the main weight of the robot, is limited by the specific power, power requirements and assisting efficiency. Methods In this paper, we propose a new method that is utilizing the energy harvesting function of the Achilles tendon to improve the assistance efficiency of ankle robots to reduce the weight of the actuator and we design a novel ankle robot to test the validity of the method. The robot works with the ankle plantar flexor at 43%-60% of the gait cycle and has no other effects on the joints or the tendon of the lower limb. Healthy subjects were recruited to test the prototype in three conditions: free walking, power-on walking, and power-off walking. Data on the robot assisting power, metabolic cost and kinematics in different conditions were collected and analyzed. Result The results showed that the ankle robot can deliver forces at the controlled assistance timing. The average assisting power of 0.0650±0.0054 W/kg per leg resulted in an 8.7±8.1% and 19.0±6.4% net reduction in metabolic cost in power-on walking compared to free-walking and power-off walking, respectively. Conclusion Compared with the results of some of the best research, our initial result supports the validity of the method. This method can help to reduce the weight of active robots and the technical innovative method to determine the assistance timing more accurately and the novel design of the ankle robot can provide a reference for future research. To the best of our knowledge, this method is the first to use the human physiological structure to optimize the design of active robots.
Sensitivity and specificity of the URAM scale for Dupuytren contracture: A systematic review and meta-analysis
Authors: Gomez-Herrero Diego , Sanjuan-Cervero Rafael , Vazquez-Ferreiro Pedro , Carrera-Hueso Francisco Javier , Poquet-Jornet Jaime Eduardo , Garcia-Jimenez Emilio 
Published: June 2020

Abstract
Background

The URAM (Unité Rhumatologique des Affections de la Main) scale is a patient-reported functional outcome measurement tool validated for exclusive use in Dupuytren contracture (DC) a condition in which one or more fingers become permanently bent in a flexed position. The current study´s purposes were to evaluate: How sensitive and specific is the URAM scale for defining quality of life in patients with in DC and how sensitive to change is the URAM scale after treatment.
Methods

We performed a meta-analysis of all relevant articles published in PubMed, Embase, Cochrane, Google Scholar, LILACS and in various gray literature databases that describe the use of the URAM. We built three models: a hierarchical summary receiver operating characteristic (HSROC) model to determine the optimal threshold for defining DC, a difference in means models to assess the magnitude of the effect of different treatment modalities, and a meta-regression model to determine the effect on patient quality of life questionnaires according to variations in Tubiana scores after treatment (URAM).
Results

The HSROC and bivariate models showed a sensitivity of 80.23% (95%CI: 75.66 to 84.14) and an overall specificity of 2.61% (95%CI: 1.11–6.05). The second model showed an overall difference in means of 1.95 (95%CI: -2.86 to -1.04). The coefficient obtained in the meta-regression model was − 1.666 (95%CI: -4.183 to 0.851).
Conclusion

The URAM scale is highly sensitive to changes in DC but has low specificity. It also showed a strong correlation with worsening of finger contracture.
Reintubation Rate and Mortality After Emergent Airway Management Outside the Operating Room
Authors: Yoon Uzung , Mojica Jeffrey , Wiltshire Matthew , Torjman Marc , Wolo Elizabeth 
Published: June 2020

Abstract
Background Little is known about reintubations that are performed outside of the operating room (outside-OR). Reintubation in general does not occur without risk and is associated with prolonged mechanical ventilation, higher incidence of nosocomial pneumonia, increased morbidity, mortality, and care of cost. The objective of this study was to evaluate the reintubation rate and mortality after emergent airway management outside-OR, including ICU and non-ICU settings. Methods A retrospectives cohort study design was used to review all emergent airway management outside-OR. The primary outcome measures were reintubation rate and mortality. Secondary outcome measures were demographics, location of intubation, indication for intubation, time until reintubation, total intubated days, ICU-stay, hospital stay, 30-day in-hospital mortality, and overall in-hospital mortality. Results A total of 336 outside-OR intubations were performed in 275 patients. Of those 275 patients, 51 (18.5%) were reintubated during the same hospital admission. Of the 336 performed intubations, 61 (18.1%) were reintubations. There was no statistical difference in admission demographics and comorbidities among reintubated and non-reintubated patients. Reintubations occurred after up to 30-days after extubation, including within 24-hours (8.2%, n=5), 24-72 hours (27.9%, n=17), 3-7 days, (23%, n=14), and 7-30 days after extubation (32.8%, n=20). Most of the reintubated patients were reintubated just once (56.9%; n=29), but some were reintubated two times (29.4%; n=15) or three times or more (13.7%; n=7). Reintubated patients had significant longer total ICU-stay (24±3 days vs. 12±1 day, p <0.001), hospital stay (37±3 vs.18±1, p<0.001), and total intubation days (8±1 vs. 7±0.6, p<0.02) than non-reintubated patients. The 30-day in-hospital mortality in reintubated patients was 13.7% (n=7) compared to non-reintubated patients 35.9% (n=80; p=0.002). Conclusion The reintubation rate was high, reaching 18%, in intubations performed outside-OR and is associated with a significant increase in hospital and ICU-stay. Almost half of the reintubation occurred in a non-ICU setting and more than 72-hours after extubation. The higher mortality rate among non-reintubated patients may indicate survival bias, in that severely sick patients did not survive long enough to attempt extubation. Further research is needed to identify the causes for increased reintubation outside-OR and the difference in mortality between the two groups.
Identification of dysregulated long noncoding RNA and associated mechanism in gastric cancer
Authors: Shao Liang , Ming Yanan , Zhou Zhaoming 
Published: June 2020

Abstract
Gastric cancer (GC) is one of the most malignant epithelial tumors. The incidence of GC varies worldwide, and nearly half of the cases occur in Asian countries, especially in Japan and China. GC is the second leading cause of cancer-related deaths in the world, and current prognosis of advanced GC remains dismal despite improvements in diagnosis and therapy. Our current study aimed to identify significant long noncoding RNAs (lncRNAs) that could be used for prognosis and for the elucidation of associated molecular mechanisms. This study identified a substantial variety of reports using high-throughput lncRNA detection to investigate the expression of lncRNAs in GC development. However, the reported potentially diagnostic lncRNAs were unsuitable for meta-analysis, so we verified the expression of diagnostic lncRNAs and selected eight of them using Gene Expression Profiling Interactive Analysis (GEPIA). Next, we explored interactions of selected lncRNAs using Qiagen’s IPA system. We also identified differentially expressed genes (DEGs) of GC using the GEO2R online tool and datasets GSE52149, GSE19826, and GSE79973. To reveal genes that could be regulated by the selected lncRNA in GC, we used a Venn diagram and selected IGF2BP3 and FOLR1 as potential downstream targets of lncRNAs H19 and PVT1, respectively. Expression of IGF2BP3 and FOLR1 in GC validated by GEPIA was related to the worse prognosis for GC patients as shown by Kaplan Meier plots. Considering that IGF2BP3 promotes the expression of H19 and PEG10, down-regulation of their expression may improve the prognosis for GC patients, although at this time there is no evidence for direct involvement of IGF2BP3 in the regulation of these lncRNAs. The second DEG, FOLR1, is a crucial component of cell metabolism and DNA synthesis/repair required for cancer cell division. However, the role of FOLR1 in the etiology and progression of GC requires further study. In conclusion, using an integrated bioinformatic approach we identified eight significantly altered lncRNAs with diagnostic potential in GC patients. We also identified two axes - H19-IGF2BP3 and PVT1-FOLR1 – that may be related to the prognosis of GC and provide new insights into the etiology of GC and management of GC patients.
Efficacy of Retreats on Resident Physician Well-being as Measured by Maslach Burnout Index Analysis: a Cross-sectional Study
Authors: McLeod Kristyn N , Hopp Shelby L , Woods Emily J , Lohse Christine M , Bellolio Fernanda , Battaglioli Nicole J , Colletti James E 
Published: June 2020

Abstract
Background

Awareness of burnout has led residency programs to seek interventions to promote well-being, resiliency, camaraderie and social network development. Limited evidence exists on the efficacy of specific interventions. This study evaluated the efficacy of an emergency medicine residency program’s semi-annual retreat using serial administration of the Maslach burnout index and resident well-being survey.
Methods

Surveys were administered to all emergency medicine residents (n = 25) in July 2018 and before and after fall 2018 and winter 2019 retreats. Retreats included a meal, team building, and social networking opportunities (bowling, softball, snow tubing, and sledding). Comparisons of responses between baseline, pre-retreat, and post-retreat were evaluated using two-sample t, Wilcoxon rank sum, and Fisher exact tests.
Results

Sixteen emergency medicine residents (64%) responded at baseline. Response rates on subsequent surveys ranged from 14 (56%) to 21 (84%). Nineteen percent of residents exhibited burnout at baseline. This peaked at 36% pre-winter retreat. Burnout decreased after each retreat (fall: 29–6%, winter: 36–13%). Mean Maslach burnout index subscores for emotional exhaustion (13 to 9) and depersonalization (7 to 5) decreased from baseline to post-fall retreat, but neither changed significantly over the entire study period (emotional exhaustion: 13 to 12, depersonalization: 7 to 6). Resident well-being survey pre- and post-retreat responses were similar on all items.
Conclusion

Meaningful, but not statistically significant differences were detected on the Maslach burnout index and resident well-being survey in association with a retreat. Mean emotional exhaustion, depersonalization and burnout decreased after retreats. Larger studies would provide further insight into the significance of these trends.
Opportunities and Challenges of Implementing Service Agreement between the Government and Faith Based Organizations in Ilala Municipality, Dar Es Salaam, Tanzania
Authors: luoga pankras wilbard , Gasto Frumence 
Published: June 2020

Abstract
Background

Access to essential health services is an important aspect of development. Due to the population increase and technological advancement, governments could no longer cater for the services needed. One of the solutions was to involve private sector through Public Private Partnerships (PPPs) in provision of the services. In 2007 Tanzania made a generic Service Agreement (SA) to govern PPPs in health sector. However, since its establishment, less is known on opportunities and challenges of implementing SA in the provision of health services in Tanzania. Therefore, the focus of this study was to assess the opportunities and challenges of implementing SA in Tanzania using a case of SA between the Cardinal Rugambwa Mission Hospital (CRMH) and the Ilala Municipality in Dar es Salaam.
Methods

The study employed a case study design using qualitative method of data collection. Data were collected by using in depth interview guide. Purposive sampling was used to select participants. The sample size was based on the principle of saturation level of the information collected. Data were analyzed using a thematic analysis approach.
Results

The opportunities of implementing SA in CRMH, Ilala Municipality include: the existence of guidelines and policies, Patients receive some health Services free of charges, availability of some services at reduced prices, presence of SA review meetings, good coordination, availability of supervision, training and mentorship opportunities, presence of political support, trust of the hospital by suppliers and trust between government and the hospital. The identified challenges in implementing SA include: - partial fulfillment of financial commitment, inadequacy deployment of HRH to CRMH by government, lack of transport for supervision and donor dependence.
Conclusion

There are a number of available opportunities for partnering between the private sector and the government in the delivery of health services. However, for the PPP to achieve its desired objective of improving access to health services particularly to most vulnerable population such as women and children, there is a need for the two parties (private and public) to address the identified challenges such as partial fulfillment of financial commitment and inadequacy deployment of HRH from the government to the private health facilities as per SA.
A Modified Prone Position Using A Body-Shape Plaster Bed and Skull Traction for Posterior Cervical Spine Surgeries
Authors: Ding Zhiyu , Li Yuezhan , Wang Weiguo , Wang Jianlong , Cai Deyang , Zheng Ruping , Yu Haiyang , Chen Shijie , Miao Jinglei , Li Jinsong 
Published: June 2020

Abstract
Background

A modified prone cervical spine surgical position using a body-shape plaster bed with skull traction (BSPST) was compared with the traditional prone surgical position with horseshoe headrests.
Methods

Forty-seven patients undergoing posterior cervical spine surgery for cervical spine fracture were retrospectively classified into two groups, BSPST group (n = 24) and traditional group (n = 23) and underwent posterior instrumented fusion with or without decompression. Multiple indicators were used to evaluate the advantages of the BSPST compared with the traditional position.
Results

All the operations went smoothly. The mean recovery rate was 56.30% in the BSPST group and 48.55% in the traditional group, with no significant difference. Intraoperative blood loss and total incidence of complications were significantly less in the BSPST group than in the traditional group. In addition, the BSPST position provided greater comfort level for the operators and allowed convenient intraoperative radiography.
Conclusions

This is the first study to describe a combined body-shape plaster bed and skull traction as a modified cervical spine prone surgical position that is simple, safe and stable, adjustable during surgery, reproducible and economical for posterior cervical spine fracture surgery and potentially other cervical and upper dorsal spine surgeries in the prone position. Additionally, this position provides surgeons a comfortable surgical field and can be easily achieved in most orthopedic operation rooms.
Food Choice Decisions of Collegiate Division I Athletes: Qualitative Interviews
Authors: Eck Kaitlyn , Byrd-Bredbenner Carol 
Published: June 2020

Abstract
Background

Limited research has examined athletes’ food and health beliefs and decisions and the congruence of these decisions with recommendations from nutrition professionals. This study aimed to improve understanding of athletes’ food-related beliefs and practices to enable nutrition professionals to more effectively enhance performance while protecting athletes’ health.
Methods

Division I college athletes (n = 14, 64% female) from a variety of sports were recruited to participate in 20-minute semi-structured phone interviews about their food and nutrition-related behaviors and cognitions. Data were content analyzed to identify themes and trends.
Results

Prominent factors that influenced athletes’ food choices were potential benefits to health and performance, availability of foods, and recommendations from sports dietitians. Foods commonly consumed by athletes, including fruits, vegetables, and lean protein, were generally healthy and aligned with sports nutrition recommendations. Athletes reported avoiding energy-dense nutrient-poor foods, such as fast food and fried foods, with the goal of improving performance. Some athletes took supplements (i.e., multivitamin, iron, protein) on the premise that they would improve health and enhance performance or recovery.
Conclusions

While athletes’ nutrition behaviors are generally congruent with current recommendations, findings highlighted misconceptions held by athletes related to the benefits of some supplements, and the belief that packaged/processed foods were inherently less healthy than other options. Nutrition misconceptions held by athletes and incongruities between athletes’ nutrition knowledge and behaviors suggest that dietitians should aim to dispel nutrition misconceptions held by athletes and provide additional guidance and information to support athletes’ current healthful behaviors to ensure these behaviors extend beyond their college athletic career.
Standardized management of an outpatient service schedule in a large general hospital
Authors: Yao Yingchun , He Xiaoli , Gao Qin , Yang Ling 
Published: June 2020

Abstract
Background: An outpatient schedule should have attending physician names, number of consultations, consultation agenda, and information based on which patients book their appointments. Regulating physician discipline while ensuring improved service quality and high-quality physician–patient relationships have become critical issues in outpatient management. The purpose of this study is to identify the effects of an outpatient service schedule on patient satisfaction.Methods: This study is based on a mixed-methods approach and investigates the standardization of outpatient schedules’ formulation and operation processes. Following the implementation of standardized formulation, operation, and evaluation of outpatient service schedule, we analyzed the outpatient service data as well as third-party patient satisfaction between 2016 and 2018 about 2000 outpatients, and introduced interventions on the corresponding influencing factors. Results: The outpatient service-suspension rate fell from 2.5% in 2017 to 1.9% in 2018, while the service-substitution rate fell from 2.9% in 2017 to 2.5% in 2018. The service-suspension rates also decreased for attending physicians and professors; rates for senior doctors were higher than for junior doctors. Furthermore, the suspension and substitution rates were at their lowest in the first quarter and at their highest in the third quarter of each year. Patient loyalty, overall satisfaction, and registration convenience improved annually.Conclusions: The standardized management of outpatient-service schedules is a solemn commitment of public hospitals to honest and lawful practices; however, it also serves as a solid base for the consolidation and development of the medical-service reservation system.
CHD5 may be a promising novel bio-marker for the diagnosis of lung cancer patients
Authors: Yang Jun , Zhong Hua , Yang Qinghui , Yu Jian , Jin Cailing , Li Xiaorui 
Published: June 2020

Abstract
Background

Chromodomain helicase DNA binding protein 5 (CHD5) is a new tumor suppressor gene in various types of cancer. And it is still not clear about the role of CHD5 in lung cancer. In this study, we aim to assess diagnostic value of CHD5 in patients with lung cancer.
Methods

CHD5 expression in 108 lung cancer serum samples and 65 healthy controls were determined by quantitative Real-Time PCR (qRT-PCR). A receiver operating characteristic (ROC) curve was established to analyze the effect of CHD5 in the diagnosis of lung cancer.
Results

The expression of CHD5 was significantly decreased in lung cancer samples compared with the healthy controls (P < 0.0001). Advanced TNM stage (P = 0.020), gender (P = 0.001) and smoking history (P = 0.000) were associated with the decreased CHD5 expression. Besides, the results of ROC analysis showed that the area under ROC curve (AUC) was 0.855 with a sensitivity of 87.1% and a specificity of 81.3%.
Conclusions

In conclusion, this study suggested that CHD5 expression is down-regulated in lung cancer. Furthermore, CHD5 expression could be a potential diagnosis bio-marker in lung cancer patients.
Diagnosis of Tuberculosis Pleurisy with Three Endoscopic Features via Pleuroscopy
Authors: Lee Chung-Shu , Li Shih-Hong , Chang Chih-Hao , Chung Fu-Tsai , Chiu Li-Chung , Chou Chu-Liang , Wang Chih-Wei , Lin Shu-Min 
Published: June 2020

Abstract
Background: Tuberculosis (TB) is a constant threat even with worldwide active public health campaign. Diagnosis of TB pleurisy is challenging in case of pleural effusion of unknown origin after aspiration analysis. The study was designated to demonstrate a simple image interpretation technique to differentiate TB pleurisy from non-TB pleurisy using semi-rigid pleuroscopy. Methods: The study retrospectively enrolled 117 patients who underwent semi-rigid pleuroscopy from April 2016 to August 2018 in a tertiary hospital. We analyzed the possibility of TB pleurisy using three simple pleuroscopic images via semi-rigid pleuroscopy. Results: Among 117 patients, 28 patients (23.9%) were diagnosed with TB pleurisy. Sago-like nodules/micronodules, adhesion, and discrete distribution were noted in 20 (71.4%), 20 (71.4%), and 19 (67.9%) patients with TB pleurisy, respectively. Sago-like nodules/micronodules, adhesion, and discrete distribution were noted in 6 (6.7%), 37 (41.6%), and 0 (0.0%) patients with non-TB pleurisy, respectively. The positive and the negative predictive values of any two out of three pleuroscopic patterns for TB pleurisy were 100.0% and 93.7%, respectively. Conclusions: A high positive predictive value for TB pleurisy was demonstrated by the presence of any two out of the three characteristic features. Absence of all three features had an excellent negative predictive value for TB pleurisy. Our diagnostic criteria reconfirm that pleuroscopic images can be used as predictors for TB pleurisy.