bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of inter- and intra-fraction 6D motion for stereotactic body radiation therapy of spinal metastases: influence of treatment time
Authors: Hadj Henni Ahmed , Gensanne David , Roge Maximilien , Hanzen Chantal , Bulot Guillaume , Colard Elyse , Thureau Sebastien 
Published: August 2021

Abstract
Background
The objective of this study was to analyze the amplitude of translational and rotational movements occurring during stereotactic body radiotherapy (SBRT) of spinal metastases in two different positioning devices. The relevance of intra-fractional imaging and the influence of treatment time were evaluated.

Methods
Twenty patients were treated in the supine position either (1) on a body vacuum cushion with arms raised and resting on a clegecel or (2) on an integrated SBRT solution consisting of a SBRT table top, an Orfit™ AIO system, and a vacuum cushion. Alignments between the cone beam computed tomography (CBCT) and the planning computed tomography allowed corrections of inter- and intra-fraction positional shifts using a 6D table. The absolute values of the translational and rotational setup errors obtained for 329 CBCT were recorded. The translational 3D vector, the maximum angle, and the characteristic times of the treatment fractions were calculated.

Results
An improvement in the mean (SD) inter-fraction 3D vector (mm) from 7.8 (5.9) to 5.9 (3.8) was obtained by changing the fixation devices from (1) to (2) (p < 0.038). The maximum angles were less than 2° for a total of 87% for (1) and 96% for (2). The mean (SD) of the intra-fraction 3D vectors (mm) was lower for the new 1.1 (0.8) positioning fixation (2) compared to the old one (1) 1.7 (1.7) (p = 0.004). The angular corrections applied in the intra-fraction were on average very low (0.4°) and similar between the two systems. A strong correlation was found between the 3D displacement vector and the fraction time for (1) and (2) with regression coefficients of 0.408 (0.262–0.555, 95% CI) and 0.069 (0.010–0.128, 95% CI), respectively. An accuracy of 1 mm would require intra-fraction imaging every 5 min for both systems. If the expected accuracy was 2 mm, then only system (2) could avoid intra-fractional imaging.

Conclusions
This study allowed us to evaluate setup errors of two immobilization devices for spine SBRT. The association of inter- and intra-fraction imaging with 6D repositioning of a patient is inevitable. The correlation between treatment time and corrections to be applied encourages us to move toward imaging modalities which allow a reduction in fraction time.
Lung transplant after long-term veno-venous extracorporeal membrane oxygenation: a case report
Authors: Yoshiyasu Nobuyuki , Sato Masaaki , Anraku Masaki , Ichiba Shingo , Nakajima Jun 
Published: August 2021

Abstract
Background
Although the number of patients who undergo extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation is increasing worldwide, there are few reports on lung transplantation after long-term ECMO (more than 1 month). We report a rare case of successful bilateral lung transplantation in a Japanese patient after 5 months of veno-venous (VV)-ECMO support.

Case presentation
A 27-year-old man who underwent bone marrow transplantation (BMTx) with fully matched human leukocyte antigen typing was diagnosed with bronchiolitis obliterans caused by chronic graft-versus-host disease 3 years after the BMTx. One year later, his respiratory condition had exacerbated, with carbon dioxide retention that required conventional mechanical ventilation. He was then deemed a suitable candidate for lung transplantation by a multidisciplinary transplantation selection committee. While waiting for donor lungs, his hypercapnia and acidosis became barely manageable under care with mechanical ventilation and ultimately he was switched to VV-ECMO. He remained on VV-ECMO for the next 5 months, during which period the circuit was switched nine times. In addition, sophisticated intensive care was required to manage multiple episodes of sepsis and coagulopathy. A suitable donor was identified 5 months later, and bilateral lung transplantation was initiated with continuous VV-ECMO. The procedure itself was extremely challenging owing to severe adhesions resulting from previous thoracotomy, inflammation, infection, and intrapulmonary hemorrhage. The operative time for the transplantation was about 19 h. Currently, at 2 years 8 months postoperatively, the patient is alive and well.

Conclusion
Transplant surgery in this patient was extremely challenging because of the presence of severe pleural adhesions and stiff native lungs secondary to hemorrhagic complications due to the prolonged ECMO support. Surgeons must recognize that lung transplantation after long-term ECMO bridging can be technically more complicated and challenging than shorter-term ECMO.
Patients with neuromyelitis optica spectrum disorder (NMOSD) are associated with adverse outcome after total hip arthroplasty: a matched case–control study
Authors: Chen Xi , Qian Wenwei , Qiu Guixing , Weng Xisheng , Lin Jin , Jin Jin , Zhu Shibai , Wang Yiou , Li Shanni 
Published: August 2021

Abstract
Background
Neuromyelitis Optica Spectrum Disorders (NMOSD) are rare inflammatory diseases of the central nervous system that cause transverse myelitis and optic neuritis. Steroids are commonly administered in NMOSD patients. The use of steroids may lead to osteonecrosis, which makes some of the NMOSD patients candidate for total hip arthroplasty (THA). To date, the clinical outcome of THA in NMOSD patients have not been investigated.

Aim
Investigate the patient reported outcome measures (PROM), radiographic outcome and complication in NMOSD patients after THA, compared with that of non-NMOSD patients.

Methods
Patients from Jan. 2016 to October. 2020 were identified in our database. 12 NMOSD cases which met the inclusion criteria were matched to non-NMOSD cases in a ratio of 1:2 based on age, sex, Charlson Comorbidity Index (CCI) and surgical date. Relevant outcome were analyzed and compared between the two groups.

Results
There was a significantly increased risk of dislocation in NMOSD patients. Post-operative HOOS score was similar between the two groups even though the pre-operative HOOS score is significantly higher in the non-NMOSD group. NMOSD patients had poor performance in EQ-5D and EQ-VAS. The cups were placed more anteverted in NMOSD cases (P = 0.01).

Conclusion
There is a significantly increased risk of dislocation after THA in NMOSD patients. However, satisfactory improvement in functional outcome of the hip was achieved. Due to the natural process of NMOSD, rehabilitation and hip precaution should be patient-specific and time-specific.
The validity of using one force platform to quantify whole-body forces, velocities, and power during a plyometric push-up
Authors: Sha Zhanxin , Dai Boyi 
Published: August 2021

Abstract
Background
Previous studies have typically measured velocity and power parameters during the push-up, either using one or two force platforms. The purpose of the study was to compare the force, velocity, and power parameters between the one-force-platform method and the two-force-platform method during plyometric push-ups.

Methods
Thirty-four physically active young adults participated in the study to perform the plyometric push-up. For the two-force-platform calculation method, the forces applied to the feet and hands were both measured. For the one-force-platform calculation method, the forces applied to the feet were assumed to be constant, while the forces applied to hands were measured by one force platform. Whole-body linear velocities were calculated based on the impulse and momentum theorem. Whole-body power was calculated as the product of the whole-body forces and velocities.

Results
The one-force-platform method overestimated the whole-body velocities and power compared with the two-force-platform method (1.39 ± 0.37 m/s vs. 0.90 ± 0.23 m/s, Cohen’s d = 1.59, p < 0.05; 1.63 ± 0.47 W/body weight vs. 1.03 ± 0.29 W/body weight, Cohen’s d = 1.49, p < 0.05). These differences were caused by the decreased forces applied to the feet compared to the initial value throughout most of the push-up phase. Large to perfect correlations (r = 0.55 – 0.99) were found for most variables between the two-force-platform and one-force-platform methods. Previous findings of push-up velocities and power using the two-force-platform and one-force-platform methods should be compared with caution. While the two-force-platform method is recommended, linear regression equations may be used to predict velocities and power parameters obtained from one force platform.

Conclusions
For those professionals who need to accurately quantify kinetic variables during the plyometric push-up, the two-force-platform method should be considered.
Challenges of dengue and coronavirus disease 2019 coinfection: two case reports
Authors: Agudelo Rojas Olga Lucia , Tello-Cajiao María Elena , Rosso Fernando 
Published: August 2021

Abstract
Background
Dengue fever and coronavirus disease 2019 have now begun to overlap within tropical and subtropical regions. This is due to the high prevalence of dengue fever in these regions and the current severe acute respiratory syndrome coronavirus 2 pandemic situation. The similarity of symptoms between the two diseases can confuse diagnoses, but coinfection can also occur.

Case presentation
We present two cases of patients with dengue and severe acute respiratory syndrome coronavirus 2 coinfection. The first case is that of a 24-year-old Hispanic woman with acute fever, odynophagia, and diarrhea, without respiratory symptoms and with positive molecular tests for both dengue and severe acute respiratory syndrome coronavirus 2. The second case is that of a 59-year-old Hispanic male patient with fever and respiratory symptoms of 2 weeks duration, negative molecular tests, and positive serological tests for both viruses. The clinical and epidemiological characteristics of both viral infections can help elucidate diagnoses and prognoses.

Conclusions
Severe dengue infection is common in young adults, while coronavirus disease 2019 is generally asymptomatic. In older people, the severity of dengue fever will depend on their comorbidities or the infectious serotype, but coronavirus disease 2019 is consistently more severe in this group. The accurate diagnosis of both infections can better guide clinical management, as well as public health actions in transmission control, now especially important during the coronavirus disease 2019 pandemic.
Some new oscillation criteria of fourth-order quasi-linear differential equations with neutral term
Authors: Althubiti Saeed , Alsharari Fahad , Bazighifan Omar , Chatzarakis George E. 
Published: August 2021

AbstractIn this article, we are interested in studying the asymptotic behavior of fourth-order neutral differential equations. Despite the growing interest in studying the oscillatory behavior of delay differential equations of second-order, fourth-order equations have received less attention. We get more than one criterion to check the oscillation by the generalized Riccati method and the integral average technique. Our results are an extension and complement to some results published in the literature. Examples are given to prove the significance of new theorems.
Structural decomposition analysis with disaggregate factors within the Leontief inverse
Authors: Muradov Kirill 
Published: August 2021

AbstractA trivial case in input–output structural decomposition analysis is a decomposition of a product of variables, or factors, where one factor is an inverse—typically, Leontief inverse—of a sum of other factors. There may be dozens and hundreds of such factors that describe the changes in subsets of technical coefficients. The existing literature offers ambiguous guidance in this case. The solution that is consistent with the index number theory may be virtually infeasible. The simplified ad hoc solutions require the researcher to make arbitrary choices, lead to biased estimates and do not ensure the consistency-in-aggregation of factors. This paper reviews the ad hoc solutions to the said problem and describes a numerical test to identify the best-performing solution. It is found that calculating the average of the two polar decomposition forms for each factor is superior to other approximations in terms of minimising the errors.
Five risk factors and their interactions of probability for a sow in breeding herds having a piglet death during days 0–1, 2–8 and 9–28 days of lactation
Authors: Koketsu Yuzo , Iida Ryosuke , Piñeiro Carlos 
Published: August 2021

AbstractBackgroundIncreasing preweaning piglet mortality is a concern for veterinarians and producers in relation to sow performance and piglet welfare. Our objectives were (1) to characterize pre-weaning piglet mortality risk for sows (PWM) during early (0–1 days), mid- (2–8 days) and late (9–28 days) lactation and (2) to quantify the following five factors and their interactions, parity, number of piglets born alive (PBA), number of stillborn piglets (SB), gestation length (GL) and season for PWM during the three lactation phases.MethodsData obtained from 264,333 parity records of 55,635 sows farrowed in 2015 and 2016 from 74 Spanish herds. Three multi-level mixed-effects logistic regression models were separately applied for PWM during three lactation phases, which was analyzed as whether or not a sow had a piglet death (i.e. probability of a sow having a piglet death) in each phase.ResultsPWM during early, mid- and late lactation were 36.9, 27.0 and 15.4%, respectively. As PBA increased from 11 or less to 16 or more pigs, PWM during early and mid-lactation increased by 15.8 and 6.0%, respectively, but there was no increase during late lactation. Also, as GL decreased from 117–120 to 110–113 days, PWM during early, mid- and late lactation increased by 7.5, 6.8 and 1.5%, respectively. Additionally, PWM during the respective lactation phases increased by 8.3, 5.2 and 1.0%, as SB increased from 0 to 3 or more pigs. During early lactation, parity 1 sows had 2.1% lower PWM than parity 5 or higher sows, but during mid- and late lactation they had 4.2% higher PWM (P < 0.05). However, there was no difference between summer and winter for PWM during early lactation (P = 0.26).ConclusionManagement practices to reduce PWM need to take account of these factors, and be modified for different phases. For example, during early lactation special care should be given to piglets born to parity 5 or higher sows farrowing 16 or more PBA, having 3 or more SB or GL 110–113 days, whereas during mid- and late lactation more care should be given to piglets born to parity 1 sows with the same PBA, GL and SB conditions.
Simultaneous quantification of empagliflozin, linagliptin and metformin hydrochloride in bulk and synthetic mixture by RP–LC method
Authors: Patel Ishita M. , Chhalotiya Usmangani K. , Jani Harsha D. , Kansara Devansh , Kachhiya Hetaben M. , Shah Dimal A. 
Published: August 2021

Abstract
Background
Extensive literature review revealed that no RP–LC method has been developed for simultaneous estimation of EMPA, LINA and MET in combined dosage form. This is a newer combination approved by USFDA on 4th June 2019 and it is launch in the United State Market on 27th January 2020.

Result
A simple, sensitive, specific, precise and accurate reverse phase—high performance liquid chromatography (RP- HPLC) method has been developed for simultaneous estimation of Empagliflozin, Linagliptin and Metformin HCl in bulk and synthetic mixture. Phenomenex C18 column (250 mm × 4.6 mm, 5 µm) was used as stationary phase for chromatographic separation through isocratic elution using Acetonitrile: Methanol: Water in a ratio (27: 20: 53, v/v/v) pH 4 adjusted with 1% Ortho-phosphoric acid as mobile phase at flow rate 1 ml/min. PDA detector was used for simultaneous analysis of all three drugs at common wavelength 223 nm and the each injection volume was 20 µl. The linearity range for Empagliflozin, Linagliptin and Metformin HCl was found to be 0.5–5 µg/ml, 0.25–2.5 µg/ml, and 50–500 µg/ml, respectively. The retention time for Empagliflozin, Linagliptin and Metformin HCl was found to be 14.5 min, 3.4 min and 2.01 min, respectively. The percentage (%) recovery was found to be 99.98–100.81% for Empagliflozin, 99.33–100.57% for Linagliptin and 100.65–101.35% for Metformin HCl respectively.

Conclusion
As per the international Conference on Harmonisation (ICH) Q2 (R1) guideline, proposed RP–LC method validation has been carried out. The proposed RP–LC method was repeatable and selective as per statistical analysis and it can be use for simultaneous estimation of Empagliflozin, Linagliptin and Metformin HCl in bulk and synthetic mixture. The proposed method might be applied for simultaneous estimation of all three drugs in pharmaceutical formulation.
The Autonomy of Art and the Legitimization of Biofiction: An Aesthetic Turning Point in Twentieth-Century Literature
Authors: Lackey Michael 
Published: August 2021

Abstract
Biofiction is literature that names its protagonist after a historical figure, and since the 1990s it has become one of the most dominant literary forms. This is surprising because many prominent scholars, critics, and writers have criticized and even condemned it. This essay hypothesizes that postmodern theories of truth and concomitant transformations in reader sensibilities partly account for the legitimization and now dominance of biofiction. The essay analyzes a 1968 literary debate among Ralph Ellison, William Styron, and Robert Penn Warren, which on the surface concerned the uses of history in literature. But because it happened just one year after the publication of Styron’s controversial novel about Nat Turner, the debate ended up focusing primarily on the nature and value of biofiction. By analyzing the discussion in relation to contemporary formulations about and theorizations of biofiction, this essay illustrates why the forum represents a turning point in literary history, resulting in the decline of a traditional type of literary symbol and the rise of a more anchored and empirical symbol—that is, the type of symbol found in biofiction.
A High-Fidelity Model to Predict Length of Stay in the Neonatal Intensive Care Unit
Authors: Wang Kanix , Hussain Walid , Birge John R. , Schreiber Michael D. , Adelman Daniel 
Published: August 2021

Having an interpretable, dynamic length-of-stay model can help hospital administrators and clinicians make better decisions and improve the quality of care. The widespread implementation of electronic medical record (EMR) systems has enabled hospitals to collect massive amounts of health data. However, how to integrate this deluge of data into healthcare operations remains unclear. We propose a framework grounded in established clinical knowledge to model patients’ lengths of stay. In particular, we impose expert knowledge when grouping raw clinical data into medically meaningful variables that summarize patients’ health trajectories. We use dynamic, predictive models to output patients’ remaining lengths of stay, future discharges, and census probability distributions based on their health trajectories up to the current stay. Evaluated with large-scale EMR data, the dynamic model significantly improves predictive power over the performance of any model in previous literature and remains medically interpretable. Summary of Contribution: The widespread implementation of electronic health systems has created opportunities and challenges to best utilize mounting clinical data for healthcare operations. In this study, we propose a new approach that integrates clinical analysis in generating variables and implementations of computational methods. This approach allows our model to remain interpretable to the medical professionals while being accurate. We believe our study has broader relevance to researchers and practitioners of healthcare operations.
O Território Econômico Alemão na Europa Central: análise dos investimentos estrangeiros recebidos pelo Grupo de Visegrado a partir de Hilferding | The German Economic Territory in Central Europe: analysis of foreign investments received by the Visegrado Group based on Hilferding
Authors: Ferreira Letícia Figueiredo 
Published: August 2021

Formado por Polônia, Hungria, República Tcheca e Eslováquia, o Grupo de Visegrado é uma área privilegiada de destino dos investimentos alemães, integrando com a indústria alemã a maior cadeia produtiva da Europa. Visando responder como se organizam as relações econômicas entre o grupo e a Alemanha, apresentamos a hipótese de que Berlim converteu os países da Europa Central em parte do seu território econômico através de exportações massivas de capital. O objetivo deste artigo é analisar as relações de produção entre Alemanha e Visegrado, de modo a lançar luz sobre a posição de dependência do último. Como referencial teórico, recorremos à obra de Hilferding (1910) e, como metodologia, empregamos uma análise quantitativa dos fluxos de capitais alemães para a região, além de uma análise qualitativa dos efeitos desse processo. Esperamos demonstrar que o grupo desempenha o papel de fábrica dos produtos alemães para o mercado europeu.Palavras-chave: Visegrad Group; Germany; economic territory.ABSTRACTFormed by Poland, Hungary, the Czech Republic and Slovakia, the Visegrad Group is a privileged area of destination for German investments, integrating with the German industry the lar-gest supply chain in Europe. Aiming to answer how the economic relations between the group and Germany are organized, we present the hypothesis that Berlin converted the countries of Central Europe into part of its economic territory through massive capital exports. This article’s purpose is to analyze the production relations between Germany and Visegrad, in order to shed light on the latter's dependent position. As our theoretical framework, we resort to the work of Hilferding (1910) and, as our methodology, we employ a quantitative analysis of German capital flows to the region, as well as a qualitative analysis of the effects of this process. We expect to demonstrate that the group plays the role of a factory for German products in the European market.Keywords: Visegrad Group; Germany; economic territory. Recebido em: 02 abr. 2021 | Aceito em: 08 jun. 2021.
Implementation of a cauda equina service in a medium-sized district general hospital in the UK
Authors: Graham Selina , Madhavan Pradeep ,   on behalf of the Cauda Equina Syndrome Study Group at Somerset Foundation Trust
Published: August 2021

Aim This project explored how the implementation of national guidance for investigation and management of patients with suspected cauda equina syndrome impacted on service provision. Methods Retrospective analysis of patients with suspected cauda equina syndrome during 12 months before the implementation of the national guidelines were compared with data from the 21 months following. Results Monthly mean numbers of referrals for suspected cauda equina syndrome increased from 10.1 to 18.9 (P<0.001). Statistically significant increases were also seen in the total number of magnetic resonance imaging scans for suspected cauda equina syndrome, and the number of magnetic resonance imaging scans performed out of hours. The mean time interval, from magnetic resonance imaging scan confirming cauda equina syndrome to starting emergency decompressive surgery, reduced from 14.87 hours to 9.57 hours. Conclusions Compliance with the national guidance for suspected cauda equina syndrome is imperative for patients to receive optimal treatment. However, this project has demonstrated challenges related to increased pressure on resources.