bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinically oriented contour evaluation using geometric and dosimetric indices based on geometric transformation
Authors: Xian Lixun , Li Guangjun , Xiao Qing , Li Zhibin , Zhang Xiangbin , Chen Li , Hu Zhenyao , Bai Sen 
Published: March 2020

Abstract
Background : In radiotherapy, geometric indices are often used to evaluate the accuracy of contouring; However, the ability of geometric indices to identify the error of contouring results is limited, and there is lack of clinical background. Based on the reference contouring, we systematically introduced geometric errors to study the relationship between geometric and dosimetric indices and evaluated the clinical feasibility of assessing the accuracy of contouring based on geometric indices alone. Materials and Methods: A C-shaped target, organ at risk (Core), and intensity-modulated radiotherapy (IMRT) plan outlined in the American Association of Physicists in Medicine (AAPM) TG-119 report (The report of Task Group 119 of the AAPM) were used as references. Translation, scaling, rotation (except for the Core), and sine function transformation were performed to simulate the contouring results. The corresponding dosimetric indices were obtained from the original dose distribution of the radiotherapy plan, and correlations (R²) between geometric indices and dosimetric indices were quantified through linear regression. The clinical applicability of the threshold for geometric indices was analyzed by combining the geometric indices and dose difference diagram. Results: The correlations between the geometric and dosimetric indices were different and inconsistent for the contouring of the target and Core after the geometric transformation simulation. Except for the sine function transformation (R²: 0.04–0.023, p > 0.05), the other three geometric indices of the planning target volume (PTV) had strong correlations with the dosimetric indices D98% and D mean (R²: 0.689–0.988), 80% of which were strongly correlated with a p < 0.001. The correlation results for the other geometric transformations in the Core were similar to those in the PTV except for the down shift transformation. Conclusions: The dosimetric indices are heavily influenced by the contour differences, thus highlighting their importance in the evaluation process. Clinically, an assessment of the contour accuracy of the region of interest is not feasible based on geometric indices alone, and should be combined with dosimetric indices. Keywords: Contour evaluation, Geometric indices, Dosimetric indices, Geometric transformation simulation
Prevalence and mechanisms of carbapenem resistance among Klebsiella aerogenes in a tertiary hospital in China
Authors: Liu Luxiang , Quan Jingjing , Zhao Dongdong , Liao Weichao , Lv Jiaojian , Zhuge Huang , Zhao Feng , Yu Yunsong , Zhou Zhihui 
Published: March 2020

Abstract
Background: Klebsiella aerogenes has emerged as one of the most important nosocomial pathogens for patients in intensive care units (ICU) in recent years. This study aims to evaluated the prevalence and molecular characteristics of clinical carbapenem-resistant K. aerogenes (CRKA) isolates in a tertiary hospital in China.Results: Twenty CRKA were identified among all the isolates, with the rate of 5.5% (20/364). Six CRKA isolates produced KPC-2 and 1 CRKA isolate produced NDM-1. PFGE and MLST indicated that the 20 CRKA strains were clonal diversity. All the bla KPC-2 gene and bla NDM-1 gene were located on plasmids and all the plasmids with bla KPC-2 and bla NDM-1 genes could successfully transferred to EC600 or J53. Twelve of 13 CRKA strains without any carbapenemase genes were positive for efflux pump inhibition test.Conclusion: Overall, the prevalence of CRKA in the tertiary hospital in Zhejiang Province of China is 5.5%. Only 35% of CRKA produce carbapenemase and efflux pumps might play an important role in the carbapenem resistance of K. aerogenes. It is necessary to strengthen the surveillance of carbapenem resistance in the hospital to prevent the horizontal and clonal spread of CRKA.
GPs perspective on the usability of the Dutch Primary Care Practice Report: a qualitative interpretative approach
Authors: Bekker Piet De , Vink Maarten , Donker Marianne , Sterkenburg Paul , Hijden Eric van der 
Published: March 2020

Abstract
Background Audit and feedback informs healthcare providers and may affect professional practice and patient outcomes. The Primary Care Practice Report (PCPR) is a web based personalized feedback instrument for general practitioners (GPs) in the Netherlands, based on claims data. Its yearly uptake is limited. In order to improve the use and usability of the report this study aims to identify key criteria that GPs deem important for audit and feedback.Methods A qualitative interpretative approach was used. We interviewed 12 GPs about their use of the practice report. These interviews followed the Three-Step Test-Interview method. Thematic content analysis was used to investigate the perception of the GP on the report and their perspective on the usability. The interviews resulted in critical items for audit and feedback, on which all tables and graphs in the report were systematically assessed.Results From the interviews with GPs recurring criteria emerged that were identified as decisive for the effectiveness of performance feedback: content, reliability, validity and usability. The 34 tables and graphs of the PCPR were assessed using factual characteristics. Content analysis shows that the PCPR has a strong focus on costs. Assessment on validity indicates that casemix correction is always performed if relevant, but explanatory notes hardly clarify which (sub)population is measured (3/34), therefore GP’s in general have difficulty interpreting the results. Assessment on usability shows that, although benchmark figures are almost always presented based on national references, the formulation of goals or any specific attention for an action perspective is lacking because the perceived comparability with the patient group of the GP is limited.Conclusions The current PCPR does not meet key criteria for effective audit and feedback, as defined by GPs. It has a strong focus on costs instead of clinical behavior and is poorly understood when it comes to the specific population the data reflect. The results are in line with theoretical perspectives on learning and improvement of professionals. Improvement of the PCPR requires information on aspects of clinical behavior that are recognizable for GPs and they actually can influence. First steps are made to improve the method of case-mix correction in the benchmarking.
Adapting the Sudden Landslide Identification Product (SLIP) and Detecting Real-Time Increased Precipitation (DRIP) algorithms to map and predict rainfall-triggered landslides in the West-Cameroons’ highlands (Central-Africa)
Authors: MFONDOUM ALFRED HOMERE NGANDAM , Nguet Pauline Wokwenmendam , Mfondoum Jean Valery Mefire , Tchindjang Mesmin , Hakdaoui Sofia , Cooper Ryan , Gbetkom Paul Gérard , Penaye Joseph , Bekoa Ateba , Moudioh Cyriel 
Published: March 2020

Abstract
Background – The SLIP and DRIP algorithms recently developed correlate Landsat 8 images and local daily precipitation records to map and time rainfall-triggered landslides. In many areas recently affected by that geohazard in west-Cameroon’s highlands, only the dry season images are available, while rainfall data are recorded on a monthly scale.
Methods – The SLIP algorithm is modified, integrating the inverse NDVI to assess the soil exposure, the Modified Normalized Multi-band Drought Index (MNMDI) combined with the hydrothermal index to assess soil moisture, and the slopes in degrees. They are converted into binned layers and overlaid to map the recent landslide. The DRIP algorithm is also modified, using the monthly rainfall rescaled to a daily window and the days of rainfall per month. Their probability density function (PDF) curves are superimposed and their intersection are used to propose set dichotomous variables before and after the 28 October 2019 landslide event, for a prediction model.
Results – The Landslide Hazard Zonation (LHZ) map of latest landslides is effective at 100% , while the overall accuracy is 77.8% when integrating the control point around the disaster area. Moreover, for 1948-2018 individual thresholds of , and 2019 threshold of between June and October, the risk of rainfall-triggered landslide is 95% , while the 'no-landslide' probabilities are between 98.95% and 99.99% .
Conclusions – Based on the SLIP and DRIP algorithms, the proposed methodology offers a new alternative in case of voids and gaps between data. Improvements and comparisons with others models are in perspective.
Keywords – SLIP, DRIP, Landsat 8, geohazard, West-Cameroons’ Highlands, rainfall-triggered Landslides, LHZ, prediction model.
Factors Associated with Physical Activity in Elderly Nursing Home Residents: A Path Analysis
Authors: Huang Jingxin , Zou Youqing , Huang Wentao , Zhou Ye , Lin Shanshan , Chen Jiaojiao , Lan Yutao 
Published: March 2020

Abstract
Background: Physical activity (PA) is low among elderly residents in nursing homes in China. We aimed to determine the factors that influence PA among elderly nursing home residents and their direct or indirect effects on PA levels.Methods: The PA levels of the participants were measured using the International Physical Activity Questionnaire, and their health beliefs were assessed using a self-developed 18-item questionnaire titled the ‘Health Beliefs of Nursing Home Residents Regarding Physical Activity,’ in accordance with Health Belief Model (HBM) constructs. The correlations between HBM constructs and PA levels were analyzed and a regression-based path analysis was conducted to examine the relationships between HBM constructs and PA levels.Results: A total of 180 residents with a mean age of 82.5 years (standard deviation = 5.76) were recruited. Linear regression analysis revealed that self-efficacy (p<0.001), perceived severity (p<0.01), and cues to action (p<0.01) were associated with the level of PA among nursing home residents. In the conceptual path model, self-efficacy, perceived severity, and cues to action had positive direct effects on PA level, while perceived benefits and perceived barriers had indirect effects on the PA level.Conclusion: The residents’ self-efficacy, perceived severity, and cues to action were found to be important factors that can affect the design and implementation of educational programs for PA. A better understanding of such associations may help healthcare providers design informed educational interventions to increase PA levels among nursing home residents.
Can judgments according to case fatality rate be correct all the time during epidemics? Some lessons from Coronavirus 2019-nCoV case fatality rate index in Iran
Authors: Piroozi Bakhtiar , Moradi Ghobad , Mohamadi-Bolbanabad Amjad , Safari Hossein 
Published: March 2020

Abstract
Background: Coronavirus 2019-nCoV was first identified in China in 2019. One of the most important indices noticed by experts, policymakers and managers which is daily evaluated in epidemics and a lot of judgments are made based on it, is case fatality rate (CFR) index of the disease. CFR can change during epidemics. This study aims to calculate CFR index for nCov-2019 in Iran and answer the following question: Is it right to base judgment on CFR all the time during epidemics and is it right to judge based on that since the outbreak of an epidemic?Methods: This research is a descriptive study. Its required data was obtained from the website of The Ministry of Health and Medical Education of Iran from February 20th 2020 until March 14th 2020. CFR index was calculated when the death toll of a disease is divided by the total number of people infected by that disease. Excel 2013 software was used to a1nalyze the data.Results: According to the findings of this study, In Iran, until March 14th 2020, 11364 people have been infected by Coronavirus 2019-nCoV and 514 people died of it. CFR index had a descending trend and it was 100%, 18.6%, 8.8%, 3.1%, 3.3%, 4.5% on the first, fifth, tenth, fifteenth, twentieth and twenty fifth day, respectively. Conclusion: In emerging epidemics, an index must not be based to judge a health system’s performance until that epidemics condition has not been clarified. It would be suggested that in the outbreak of an epidemic, specifically emerging diseases, CFR must not be the base of judgment. Making judgments, specifically, in the outbreak of emerging epidemics based on fatality rate can lead to an information bias.
Single tree crown shape and volume models for Pinus nigra planted forests in Italy to support forest management strategies in artificial stands
Authors: Salvatore Umberto Di , Marchi Maurizio , Cantiani Paolo 
Published: March 2020

Abstract
Background Tree crown can be considered the engine of trees whose size is a key variable to understand the most important ecological and physiological processes that occur in forest ecosystem. The shape and dimension of single-tree crown are affected by a combination of multiple factors such as lateral competition, fertility as well as forest management practices. Anyway, few models are provided in literature to derive their shape and volume from sampled data except the light transmittance or light measurements under canopy closure (Photosynthetic Active Radiation or Leaf Area Index). The main goal of the study is to present a simple and effective method to predict crown shape and crown volume in artificial black pine plantations in Italy from simple field data. Two key parameters involved in crown volume calculation in literature were here modelled. Such parameters were the distance from the top where the crown expresses its the maximum radius (L 0 ) and the radius at crown base height (r cb ). The analysis of crown profile and volume is based on available knowledge we found in literature (Pretzsch 2009) and where the considered species was not included. Results The nonlinear equation results the most adequate for the fitting and able to characterise the ecological processes more properly. Even if just slightly different, the mean absolute error was lower and statistically significant and around 84 cm for L 0 and 36 cm for r cb . Then the use of a modelling procedure also allowed the calculation of confidence intervals and was more powerful than a single multiplier, which is the most common method available in literature. Once compared with field data collected during thinning harvesting, the calculated volumes were correlated with thinning intensities and able to characterise the number of trees removed in each treatment and the increased amount of PAR on the ground. Conclusions The proposed model results useful to evaluate the spatial structure of forest stand without sophisticated and time-consuming surveys and could be an additional tool to support the practical management of artificial black pine stands.
Characteristics of Symptomatic and Asymptomatic Bacteriuria in Patients with Neurogenic Bladder under Neurorehabilitation
Authors: Lopes Fauster O. B. , Bomfim Maria Rosa Q. , Monteiro Sílvio G. , Silva Marcello T. da , Pinho Virginia Maria L. S. de , Aires Raimundo José D. , Carvalho Roberto M. L. de , Monteiro-Neto Valerio 
Published: March 2020

Abstract
Background: The definitions of urinary tract infections (UTI) and asymptomatic bacteriuria (ABU) are problematic to apply in patients with neurogenic bladder (NB). Here, we carried out a comparative analysis of the main clinical and laboratory data of NB patients with UTI and ABU.Methods: One hundred ninety five patients with neurogenic bladder were evaluated in the Urology Sector at a neurorehabilitation hospital. Patients were divided into either ABU or UTI group based on clinical and laboratory data. The sociodemographic data, clinical history, and laboratory test results were collected and used in the comparative analysis.Results: Of the patients evaluated, 161 (82.6%) had ABU. Patients of different age groups were affected, predominantly young adults (20-39 years). The median time of bladder involvement was 8.9 years (0-35). Neurogenic bowel was observed in 97.5% of cases and renal lithiasis in 11.3%. The main underlying pathologies leading to urologic involvement were spinal cord injury, myelomeningocele, stroke, and neoplasms. Only 16.4% of patients were not on intermittent catheterization, in which the risk of recurrent infection was higher than in patients who were under for intermittent bladder catheterization (p = 0.016, OR 2.65). Infection rates were significantly different between patients with histories of recurrent urinary tract infections (asymptomatic bacteriuria 29.8% vs 52.9% infection, p = 0.016). Leukocyturia was frequent in both groups, however, our data suggested that only values ≤ 30 cells/high power field excluded infection.Conclusions: In summary, intermittent catheterization was observed to be essential in the prevention of recurrent UTI, as well as the need to adjust the reference values for leukocyturia in the definition of the infectious condition.
Individualized treatment for acute Achilles tendon rupture based on the Copenhagen Achilles Rupture Treatment Algorithm (CARTA): a study protocol for a multicenter randomized controlled trial
Authors: Hansen Maria Swennergren , Vestermark Marianne Toft , Hölmich Per , Kristensen Morten Tange , Barfod Kristoffer Weisskirchner 
Published: March 2020

Abstract
Background: An individualized treatment algorithm (Copenhagen Achilles Rupture Treatment Algorithm - CARTA) based on the ultrasonographic appearance of an acute Achilles tendon rupture has been developed aiming to select the correct patients for operative and non-operative treatment. The objective of this study is to investigate if this individualized treatment algorithm gives a better functional outcome than treating all patients either operatively or non-operatively per default. Methods: This study is conducted as a multicenter three-armed randomized controlled trial. Participants are included from four hospitals in Denmark and randomized 1:1:1 to one of three parallel groups: 1) Intervention group: Participants are treated according to an individualized treatment algorithm,2) Control group A: Participants are treated non-operative, 3) Control group B: Participants are treated operative. The individualized treatment algorithm for the intervention group is based on an ultrasonographic examination; tendon overlap and elongation below 7% is to be treated non-operative, while no tendon overlap and and/or elongation above 7% will be treated operative. 300 participants will be included over a period of 3 years. The primary outcome is the heel-rise work test at 12 months post-injury. Secondary outcomes are tendon elongation, the Achilles tendon Total Rupture Score (ATRS), the rate of re-ruptures and other complications. The primary analysis will be conducted as intention-to-treat analysis. Discussion: This trial will indicate if treatment of acute Achilles tendon rupture can be individualized based on the elongation and tendon overlap. It is hypothesized that different patients will benefit from different treatment instead of offering all the same treatment. Trial registration: ClinicalTrials.gov Identifier: NCT03525964. Registered 16 May 2018. Keywords: Achilles tendon, Achilles tendon rupture, individualized treatment, ultrasound.
Timing of antiretroviral therapy for HIV-infected patients with moderate-to-severe Pneumocystis pneumonia: study protocol for a multi-center prospective randomized controlled trial
Authors: Qin Yuanyuan , Lu Yanqiu , Zhou Yihong , Harypursat Vijay , Sun Feng , Yang Sen , Tang Shengquan , Li Yao , He Xiaoqing , Zeng Yanming , Chen Yaokai 
Published: March 2020

Abstract
Background: Pneumocystis pneumonia (PCP) is a common AIDS-related opportunistic infection. Recent reports estimate that more than 400,000 HIV patients develop PCP each year globally. However, the timing of antiretroviral therapy (ART) initiation for HIV infected patients with PCP is still controversial, and the benefits and risks of early initiation of ART are not completely clear. We thus designed this study in order to determine the optimal timing for ART initiation for HIV-positive patients with moderate to severe PCP.Methods: This study will be an open-labelled, multi-center, prospective, randomized controlled trial. A total of 200 subjects will be randomized to an early ART initiation group (≤14 days after PCP diagnosis), and a deferred ART initiation group (>14 days after PCP diagnosis) at a 1:1 ratio. All subjects will be followed up for 48 weeks after starting ART. The primary outcome is incidence of disease progression (including new opportunistic infections and all-cause mortality) at week 48. The secondary endpoints are the changes in CD4 counts from baseline at week 12, week 24 and week 48, the degree of virological suppression (HIV-RNA<50 copies/mL) at week 24 and week 48, the rate of development of PCP-associated immune reconstitution inflammatory syndrome (IRIS), and adverse events(AEs) at each visit.Discussion: We hope that the results of this study will reveal the optimal timing for initiation of ART in HIV-infected patients with moderate to severe PCP.Trial registration: This trial was registered as one of the twelve trials under the name of a general project at chictr.org.cn on February 1, 2019, and the registration number of the general project is ChiCTR1900021195.
High-flow nasal cannula versus standard oxygen therapy assisting sedation during endoscopic retrograde cholangiopancreatography in high risk cases (OTHER): study protocol of a randomised multicentric trial
Authors: Thiruvenkatarajan Venkatesan , Dharmalingam Ashok , Arenas Gilberto , Wahba Medhat , Steiner Reinhard , Kadam Vasanth Rao , Tran Andre , Currie John , Wijk Roelof Van , Quail Anthony , Ludbrook Guy 
Published: March 2020

Abstract
Background Endoscopic retrograde cholangiopancreatography (ERCP) is an increasingly common intervention in the treatment of pancreatico-biliary disorders. Patients are often elderly with complex co-morbidities. While monitored anaesthesia care with sedation is commonly used for most cases, few would require general anaesthesia with an endotracheal tube. Both low flow and high flow nasal cannulas (HFNC) are established ways of delivering supplemental oxygen, but it is unclear whether one technique is better than the other. HFNC seems a promising tool for advanced procedures but evidence to support its application in high-risk ERCP cases is limited. The rate of oxygen desaturation during endoscopy has been reported to be as high as 11-50%, and the method of oxygen delivery for ERCP merits further study.Methods/design This is a prospective, randomised, multi-centre trial comparing the efficacy of oxygen supplementation through high flow nasal cannula versus low flow nasal cannula during ERCP, in a cohort of patients at risk of adverse respiratory events. A total of 132 patients will be recruited across three sites and randomly assigned to either the low flow or the HFNC group. The primary outcome is the proportion of patients experiencing hypoxia, defined by any event of SpO2 <90%. The secondary outcomes include parameters centred on oxygenation, requirement of airway manoeuvres, successful completion of procedure, perioperative complications, patient satisfaction, and cost analysis of the consumables. An intention-to-treat principle will be applied while analysing.Discussion The demand for ERCPs is likely to increase in the future with the aging population. Our study results may lead to improved outcomes and reduce airway related complications in patients undergoing ERCPs. The results will be presented at national and international meetings and published in per-reviewed journals.Trial registration: www.ANZCTR.org.au CTRN12619000397112, Registered on on March 12, 2019.