bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of elastic ankle exoskeleton stiffness on neuromechanics and energetics of human walking across multiple speeds
Authors: Nuckols Richard W. , Sawicki Gregory S. 
Published: April 2020

Abstract
Background: Elastic ankle exoskeletons with springs of intermediate stiffness in parallel with the human plantarflexors can reduce the metabolic cost of walking by ~7% at 1.25 m s -1 . In a move toward ‘real-world’ application, we examined whether the unpowered approach has metabolic benefit across a range of walking speeds, and if so, whether the optimal exoskeleton stiffness was speed dependent. We hypothesized that, for any walking speed, there would be an optimal ankle exoskeleton stiffness - not too compliant and not too stiff - that minimizes the user’s metabolic rate. In addition, we expected the optimal exoskeleton stiffness to increase with walking speed. Methods: Eleven participants walked on a level treadmill at 1.25, 1.50, and 1.75 m s -1 while we used a state-of-the-art exoskeleton emulator system to apply bilateral ankle exoskeleton assistance at five controlled rotational stiffnesses (k exo = 0, 50, 100, 150, 250 Nm rad -1 ). We measured metabolic cost, lower limb joint mechanics, and EMG of muscles crossing the ankle, knee, and hip. Results: We measured significant reductions in metabolic cost at the lowest exoskeleton stiffness (50 Nm rad -1 ) for assisted walking at both 1.25 (4.2%; p = 0.032) and 1.75 m s -1 (4.7%; p = 0.009). At these speeds, the metabolically optimal ankle exoskeleton stiffness provided peak assistive torques of ~0.20 Nm kg -1 that resulted in reduced biological ankle moment of ~12% and reduced soleus muscle activity of ~10%. We found no spring stiffness that could reduce the metabolic cost of walking at 1.5 m s -1 . Across all speeds, the non-weighted sum of soleus and tibialis anterior activation rate explained the change metabolic rate due to exoskeleton assistance ( p < .05; R 2 > 0.56)). Conclusions: Elastic ankle exoskeletons with low rotational stiffness reduce users’ metabolic cost of walking at slow and fast walking speeds but not at intermediate walking speed. The relationship between the non-weighted sum of soleus and tibialis activation rate and metabolic cost (R 2 > 0.56) indicates that muscle activation may drive metabolic demand. Future work using computer simulations and ultrasound imaging will get ‘under the skin’ and examine the interaction between exoskeleton stiffness and plantarflexor muscle dynamics to better inform stiffness selection in human-machine systems.
Optimal Partner Wavelength Combination Method Applied to NIR Spectroscopic Analysis of Human Serum Globulin
Authors: Han Yun , Zhong Yun , Zhou Huihui , Kuang Xuesong 
Published: April 2020

Abstract
Human serum globulin (GLB), which contains various antibodies in healthy human serum, is of great significance for clinical trials and disease diagnosis. In this study, the GLB in human serum was rapidly analyzed by near infrared (NIR) spectroscopy without chemical reagents. Optimal partner wavelength combination (OPWC) method was employed for selecting discrete information wavelength. For the OPWC, the redundant wavelengths were removed by repeated projection iteration based on binary linear regression, and the result converged to stable number of wavelengths. By the way, the convergence of algorithm was proved theoretically. Moving window partial least squares (MW-PLS) and Monte Carlo uninformative variable elimination PLS (MC-UVE-PLS) methods, which are two well-performed wavelength selection methods, were also performed for comparison. The optimal models were obtained by the three methods, and the corresponding root-mean-square error of cross validation and correlation coefficient of prediction (SECV, RP,CV) were 0.813 g·L-1 and 0.978 with OPWC combined with PLS (OPWC-PLS), and 0.804 g L-1 and 0.979 with MW-PLS, and 1.153 g L-1 and 0.948 with MC-UVE-PLS, respectively. The OPWC-PLS and MW-PLS methods achieved almost the same good results. However, the OPWC only contained 28 wavelengths, so it had obvious lower model complexity. Thus it can be seen that the OPWC-PLS has great prediction performance for GLB and its algorithm is convergent and rapid. The results provide important technical support for the rapid detection of serum.
Comparison of 99mTc-MIBI scintigraphy, ultrasound, and mammography for the diagnosis of BI-RADS 4 category lesions
Authors: Liu Hongbiao , Zhan Hongwei , Sun Da 
Published: April 2020

Abstract
Background : We sought to determine the diagnostic efficacy of Breast-specific gamma imaging (BSGI) in Chinese women with BI-RADS 4 category lesions and to compare this efficacy to that of ultrasound/mammography. Methods : We retrospectively assessed 177 women who had undergone BSGI of BI-RADS 4 category lesions detected via ultrasound and/or mammography. Results: Of the 177 cases, 117 (66.1%) were malignant lesions and 60 (33.9%) were benign. The sensitivity, specificity, positive, and negative predictive values of BSGI were 94.9% (111/117), 78.3% (47/60), 89.5% (111/124), and 88.7% (47/53), respectively. For mammography, the specificity and positive predictive values were 48.3% (29/60) and 77.5% (107/138), while for ultrasound they were 53.3% (32/60) and 79.6% (109/137). The sensitivity and specificity of BSGI for the detection lesions ≤1 cm were 90.9% (10/11) and 88.0% (22/25), while these values for breast lesions ＞1cm were 94.3% (100/106) and 71.4% (25/35), and these values for dense breast tissue were 94.0% (79/84) and 78.0% (39/50), as opposed to non-dense breast values of 97.0% (32/33) and 80.0% (8/10). The sensitivity of BSGI for invasive ductal carcinomas (IDC) and ductal carcinomas in situ (DCIS) were 98.9% (95/96) and 75.0% (9/12).The tumor to normal tissue ratio of BSGI for malignant lesions was significantly higher than that of benign lesions (2.18±1.17 vs 1.66±0.40, t =7.56, P ＜0.05). Conclusions : These results reveal that BSGI is highly sensitive, with good positive/negative predictive values. BSGI for IDC proved to be superior to DCIS for diagnosis of BI-RADS 4 category lesions as compared with ultrasound or mammography. BSGI showed perfect results in dense breasts and lesions ≤ 1 cm in size.
Compbdt: an R program to compare two binary diagnostic tests subject to a paired design
Authors: Roldán-Nofuentes Jose Antonio 
Published: April 2020

Abstract
Background: The comparison of the effectiveness of two binary diagnostic tests is an important topic in Clinical Medicine. The most frequent type of sample design to compare two binary diagnostic tests is the paired design. This design consists of applying the two binary diagnostic tests to all of the individuals in a random sample, where the disease status of each individual is known through the application of a gold standard . This article presents an R program to compare parameters of two binary tests subject to a paired design.
Results: The “compbdt” program estimates the sensitivity and the specificity, the likelihood ratios and the predictive values of each diagnostic test applying the confidence intervals with the best asymptotic performance. The program compares the sensitivities and specificities of the two diagnostic tests simultaneously, as well as the likelihood ratios and the predictive values, applying the global hypothesis tests with the best performance in terms of Type I error and power. When the global hypothesis test is significant, the causes of the significance are investigated solving the individual hypothesis tests and applying the multiple comparison method of Holm. The most optimal confidence intervals are also calculated for the difference or ratio between the respective parameters. Based on the data observed in the sample, the program also estimates the probability of making a Type II error if the null hypothesis is not rejected, or estimates the power if the if the alternative hypothesis is accepted. The “compbdt” program provides all the necessary results so that the researcher can easily interpret them. The estimation of the probability of making a Type II error allows the researcher to decide about the reliability of the null hypothesis when this hypothesis is not rejected. The “compbdt” program has been applied to a real example on the diagnosis of coronary artery disease.
Conclusions: The “compbdt” program is one which is easy to use and allows the researcher to compare the most important parameters of two binary tests subject to a paired design. The “compbdt” program is available as supplementary material.
Efficacy and safety of IL-17 inhibitors for the treatment of ankylosing spondylitis: a systematic review and meta-analysis
Authors: Yin Yufeng , Wang Mingjun , Liu Mengru , Zhou Erye , Ren Tian , Chang Xin , He Michun , Zeng Keqin , Guo Yufan , Wu Jian 
Published: April 2020

Abstract
Objectives: To systematically assess the efficacy and safety of IL-17 inhibitors in patients with active ankylosing spondylitis. Methods: A systematic review of the literature was performed for randomized controlled trials (RCTs) concerning IL-17 inhibitors in patients with ankylosing spondylitis. Meta-analyses were used to determine the efficacy and safety of the IL-17 inhibitors in the treatment of these patients. The primary end point was predefined as the proportion of patients with at least 20% improvement in the Assessment of Spondyloarthritis International Society (ASAS20) response criteria at week 16, and the secondary end point was defined as ASAS40 at week 16. Results: Six phase III randomized, double-blind, placebo-controlled trials including 1733 patients (1153 patients received IL-17 inhibitors, including secukinumab or ixekizumab, whereas 580 patients received a placebo as comparators) were included. At week 16, the IL-17 inhibitor regimen produced a significant increase in the ASAS20 response rate (RR=1.63, 95% CI 1.45 to 1.84, p=0.00) and the secondary endpoint ASAS40 response rate (RR=2.12, 95% CI 1.75 to 2.56, p=0.00) versus those for the placebo. With respect to the safety profile, more treatment-emergent adverse events (RR=1.11, 95% CI 1.01 to 1.22, p=0.03) and non-severe infections (RR=1.82, 95% CI 1.40 to 2.37, p<0.001) were described after treatment with IL-17 inhibitors than after treatment with placebo, while no increased risk of other adverse events was indicated after IL-17 inhibitor therapy, including death, discontinuation due to adverse events, or serious adverse events. Conclusions: IL-17 inhibitors produced favourable response rates but an increased risk of non-severe infections in the treatment of active ankylosing spondylitis.
Comparison of Personal and Shared Frameshift Neoantigen Vaccines in a Mouse Mammary Cancer Model.
Authors: Peterson Milene , Murphy Sierra Nicole , Lainson John , Zhang Jian , Shen Luhui , Diehnelt Chris W , Johnston Stephen Albert 
Published: April 2020

Abstract
Background: It is widely hoped that personal cancer vaccines will extend the number of patients benefiting from checkpoint and other immunotherapies. However, it is clear creating such vaccines will be challenging. It requires obtaining and sequencing tumor DNA/RNA, predicting potentially immunogenic neoepitopes and manufacturing a one-use vaccine. This process takes time and considerable cost. Importantly, most mutations will not produce an immunogenic peptide and many patient’s tumors do not contain enough DNA mutations to make a vaccine. We have discovered that frameshift peptides (FSP) created from errors in the production of RNA rather than from DNA mutations are potentially a rich source of neoantigens for cancer vaccines. These errors are predictable, enabling the production of a FSP microarray. Previously we found that these microarrays can identify both personal and shared neoantigens. Here, we compared the performance of personal cancer vaccines (PCVs) with that of a shared antigen vaccine, termed Frameshift Antigen Shared Therapeutic (FAST) vaccine , using the 4T1 breast cancer model. Sera from 4T1-tumor bearing mice were assayed on the peptide microarray containing 200 Fs neoantigens, for the PCV, the top 10 candidates were select and personal vaccines constructed and administrated to the respective mice. For the FAST, we selected the top 10 candidates with higher prevalence among all the mice challenged. Seven to 12 days challenged mice were immunized, combined or not with immune checkpoint inhibitor (ICI) (αPD-L1 and αCTLA-4). Primary and secondary tumor clearance and growth were evaluated as well as cellular and humoral immune response against the vaccine targets by IFN-γ ELISPOT and ELISA. Lastly, we analyzed the immune response of the FAST-vaccinated mice by flow cytometry in comparison to the control group. Results: We found that PCVs and FAST vaccines both reduced primary tumor incidence and growth as well as lung metastases when delivered as monotherapies or in combination with ICI. Additionally, the FAST vaccine induces a robust and effective T-cell response. Conclusions: These results suggest that FSPs produced from RNA-based errors are potent neoantigens that could enable production of off-the-shelf shared antigen vaccines for solid tumors with efficacy comparable to that of PCVs.
Does the addition of concurrent visual feedback increase adherence to a home exercise program in people with stroke: a single-case series?
Authors: Levy Tamina , Crotty Maria , Laver Kate , Lannin Natasha , Killington Maggie 
Published: April 2020

Abstract
Objective

Evidence is accumulating for the benefits of technology use in stroke rehabilitation. Few studies have examined ways in which technology can be used to increase adherence to programs after discharge from rehabilitation. The aim of this study was to determine if the addition of concurrent visual feedback, via a tablet computer, increased adherence to an exercise program following stroke.

Ten participants were provided with a self-administered exercise program and were asked to perform 60 minutes of exercise daily. After a baseline phase (one week), participants were given a tablet computer (two weeks) and were asked to video record each exercise session. The tablet computer was removed during the fourth week of the program.

Results

Exercise duration, measured via wrist-worn accelerometry, was investigated over the four weeks using the two-standard deviation (2 SD) band method. A statistically significant effect was observed in four out of ten cases, demonstrated by two successive data points occurring outside the 2 SD band during the intervention phase, suggesting that adherence was increased in response to the tablet computer use. This preliminary study indicates that the use of visual feedback, via a tablet computer, may increase adherence to an exercise program in people with stroke.
Cessation of nucleos(t)ide analogues therapy in chronic hepatitis B: a systematic review and meta-analysis
Authors: Xie Yandi , Jin Rui , Song Guangjun , Ma Hui , Feng Bo 
Published: April 2020

Abstract
Backgroud: To address the possibility of safe cessation of nucleos(t)ide analogues (NAs) therapy in chronic hepatitis B (CHB) and to identify factors associated with off-NAs virological relapse (VR).
Methods: A published work search was performed to identify all published studies including patients who ceased NAs and were followed for ≥12 months. A meta-analysis was performed.
Results: Twenty-six studies involving 2573 patients who discontinued NAs were included. The pooled rate of off-NAs VR was 0.63, being lower in initially hepatitis B e antigen (HBeAg)-positive than HBeAg-negative patients (0.57 versus 0.62, P = 0.732). The pooled rates of VR were 0.47, 0.55, 0.61, 0.51, 0.73 and 0.64 at 6, 12, 24, 36, 48 and 60 months after NAs cessation, respectively, being relatively lower in initially HBeAg-positive (0.31, 0.45, 0.55, 0.44, 0.48, 0.52) than HBeAg-negative patients (0.50, 0.55, 0.69, 0.57, 0.53, 0.68) ( P = 0.405). The pooled rate of biochemical relapse was 0.44, being lower in initially HBeAg-positive than HBeAg-negative patients (0.43 versus 0.48, P = 0.554). The pooled rates of hepatitis B surface antigen (HBsAg) loss and seroconversion was 0.09 and 0.06, respectively. The pooled rates of VR at 12 months after NAs cessation were significantly different between duration of on-NAs virological response ≤24 months and >24 months in all patients (0.55 versus 0.41, P = 0.011), initially HBeAg-positive patients (0.59 versus 0.41, P = 0.031), and initially HBeAg-negative patients (0.53 versus 0.37, P = 0.025).
Conclusions: Safe cessation of NAs therapy seems to be feasible in a substantial proportion of CHB patients. On-NAs virological response >24 months reduces the risk of off-NAs VR. Stopping NAs treatment may have an impact on long-term HBsAg decline and HBsAg clearance.
Psychiatric inpatient beds for youths in China: data from a nation-wide survey
Authors: Geng Feng , Jiang Feng , Rakofsky Jeffrey , Liu Tingfang , Liu Yuanli , Liu Huanzhong , Tang Yi-lang 
Published: April 2020

Abstract
Background The development of child psychiatric services in China has been slow and very limited resources have been allocated to support its growth. This study set out to investigate the child and adolescent inpatient psychiatric resources currently available in top-tier psychiatric hospitals in China and the characteristics of youth patients hospitalized on an adult unit. Method As part of a official national survey, 29 most representative provincial tertiary psychiatric hospitals in China were selected. Data of 1975 inpatients discharged from these hospitals from March 19 to 31, 2019 were retrieved and analyzed. Results The mean number of youth psychiatric beds was 27.7±22.9 in these hospitals and 6/29 hospitals had zero youth beds. There were significantly more youth beds in developed regions than in less developed regions (P<0.05). Most of discharged youth patients were teenagers with severe mental illnesses, including schizophrenia, depressive disorder and bipolar disorder. 7.5% (149) of 1975 discharged patients were youth while youth beds only accounted for 3.2% (804/25136) of all psychiatric beds. 45.6% (68) of youth patients were discharged from adult psychiatric units. Conclusion Our findings highlight the lack of adequate youth psychiatric inpatient services for children and adolescents living in China, especially in less developed regions. There is an urgent need to build more child and adolescent psychiatric units in provinces where there are none, and to increase the number of beds within the units that exist presently.
Research on the establishment and application of protein fingerprint spectrum database of Burkholderia pseudomallei in Hainan Province China
Authors: Wang Xu-Ming , Liu Ling-Li , Wu Hua , Huang Mei-Hui 
Published: April 2020

Abstract
Background: The aim of this study was to establish a SuperSpectrum of Burkholderia pseudomallei(B. pseudomallei) in Hainan and evaluate its application value in the rapid identification of clinical isolates of B. pseudomallei.Methods: Using a collection of 167 isolates of B. pseudomallei from June 2010 to May 2019 in different regions of Hainan province, multilocus sequence typing (MLST) was performed, and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was applied for spectrum acquisition. A SuperSpectrum was created based on the selection of 80 representative average spectra. In a second step, we validated the SuperSpectra with 137 strains of B. pseudomallei, 8 strains of Burkholderia thailandensis(B. thailandensis), 2 strains of Burkholderia cepacia(B. cepacia), 1 strain of Burkholderia cenocepacia(B. cenocepacia) and 1 strain of Burkholderia multivorans(B. multivorans), as well as 1 strain of Burkholderia gladioli(B. gladioli) identified by MLST typing and 16S rRNA gene sequencing.Results: The results showed that there was 100% agreement between the validation strains analyzed by MALDI-TOF MS and those evaluated by MLST typing and 16S rRNA gene-sequencing analysis methods. Protein fingerprints spectra showed that specific peaks occurred in B. pseudomallei from the Hainan region. The result of clustering typing indicated that B. pseudomallei and its closely related species could be well classified by MALDI-TOF MS at the protein level.Conclusions: MALDI-TOF MS is a promising, rapid, and economical method to monitor the outbreaks and spread of B. pseudomallei isolates.The establishment of an accurate and objective SuperSpectrum database can provide a new platform for the clinical rapid diagnosis of melioidosis.
Triglyceride glucose index for the detection of asymptomatic coronary artery stenosis in patients with type 2 diabetes
Authors: Thai Pham Viet , Tien Hoang Anh , Minh Huynh Van , Valensi Paul 
Published: April 2020

Abstract
Background Triglyceride Glucose index (TyG) was associated with an increased risk of cardiovascular events. Silent coronary disease is common in patients with type 2 diabetes. In Vietnam, a low-middle income country, the burden of cardiovascular disease is growing in parallel to the epidemiologic transition. The aim was in patients with type 2 diabetes and no history or symptom of cardiovascular disease, to assess the prevalence of coronary stenoses (CS) and investigate the association between TyG and cardiovascular risk factors and the presence and severity of CS. Methods We recruited 166 patients at Ninh Thuan General Hospital, Vietnam. TyG and HOMA-IR were calculated, and a coronary computed tomography angiography (CCTA) was performed. Results The population was separated according to tertiles of TyG. Patients with highest TyG had higher BMI, waist circumference, total cholesterol, LDL-cholesterol, triglycerides, plasma glucose and HbA1c levels, lower HDL-cholesterol; more of them had a metabolic syndrome and less practiced physical activity (p<0.05 to <0.001). TyG correlated with HOMA-IR (p<0.001). CS ≥50% were present in 60 patients, with a coronary artery narrowing ≥70% in 32 of them. The patients with CS had higher TyG (p<0.05). The association of TyG with CS remained significant in a multivariate analysis including confounding risk factors. The number of narrowed vessels and the degree of stenosis were associated with higher TyG levels (p=0.04 and <0.005). TyG was significant in identifying patients with CS with an area under the ROC curve of 0.678 (95%CI: 0.582-0.775, p=0.002), a cut-off point of 9.63 offering 75% sensitivity and 44% specificity. In subgroup analysis the association TyG-CS was stronger in patients ≥60 yrs, with HbA1c≥7%, on statin or anti-platelet therapy. The AROC was higher with the triple criterion age-HbA1c-TyG than with age or HbA1c alone (p<0.001 for both comparisons). Conclusion More than one third of asymptomatic patients with type 2 diabetes had CS on CCTA. TyG may be considered as a marker of insulin resistance and allows to identify patients with high risk of coronary stenoses, particularly in those ≥ 60 yrs with poor glycemic control, and is associated with the number and the severity of narrowed branches.