bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does psychological distress influence postoperative satisfaction and outcomes in patients undergoing total knee arthroplasty? A prospective cohort study
Authors: Bian Tao , Shao Hongyi , Zhou Yixin , Huang Yong , Song Yang 
Published: July 2021

Abstract
Background
Preoperative psychological distress may be related to dissatisfaction and poorer outcomes after total knee arthroplasty (TKA). However, the kind of psychological distress that could influence postoperative satisfaction and outcomes remains controversial. Few studies have examined these issues in Chinese cohorts. Thus, this study aimed to examine (1) the prevalence of preoperative psychological distress in patients undergoing TKA and (2) whether preoperative psychological distress influences patient satisfaction, early postoperative outcomes, and improvement of knee function after TKA.

Methods
We prospectively included 210 patients undergoing unilateral primary TKA between March 2017 and September 2017 at our institution. Preoperatively, patients completed the Depression Anxiety and Stress Scales and new Knee Society Scores (KSS) questionnaires. At 3 months and 1 year postoperatively, patients’ KSS and overall satisfaction were assessed. Stepwise multivariate linear regression models were used to assess the variables that influenced changes in each KSS item.

Results
Preoperatively, 89 (42.4%) patients experienced psychological distress. The satisfaction rate and postoperative KSS were not significantly different between patients with or without psychological distress; a higher preoperative score was shown to predict less KSS improvement. Patients with depression had fewer symptom score changes.

Conclusions
The prevalence of preoperative psychological distress was relatively high; thus, surgeons should consider the patient’s psychological state. Patients’ satisfaction was not influenced by psychological factors. Patients with depression and higher preoperative scores had lower symptom scores and KSS improvement, respectively.
The aiming device for cervical distractor pin insertion: a proof-of-concept, feasibility study
Authors: Bunmaprasert Torphong , Luangkittikong Sittichai , Tosinthiti Menghong , Nivescharoenpisan Supachoke , Raphitphan Raphi , Sugandhavesa Nantawit , Liawrungrueang Wongthawat , Riew K. Daniel 
Published: July 2021

Abstract
Background
Restoration of cervical lordosis after anterior discectomy and fusion is a desirable goal. Proper insertion of the vertebral distraction or Caspar pin can assist lordotic restoration by either putting the tips divergently or parallel to the index vertebral endplates. With inexperienced surgeons, the traditional free-hand technique for Caspar pin insertion may require multiple insertion attempts that may compromise the vertebral body and increase radiation exposure during pin localization. Our purpose is to perform a proof-of-concept, feasibility study to evaluate the effectiveness of a pin insertion aiming device for vertebral distraction pin insertion.

Methods
A Smith-Robinson approach and anterior cervical discectomy were performed from C3 to C7 in 10 human cadaveric specimens. Caspar pins were inserted using a novel pin insertion aiming device at C3-4, C4-5, C5-6, and C6-7. The angles between the cervical endplate slope and Caspar pin alignment were measured with lateral cervical imaging.

Results
The average Superior Endplate-to-Caspar Pin angle (SE-CP) and the average Inferior Endplate-to-Caspar Pin angle (IE-CP) were 6.2 ± 2.0° and 6.3 ± 2.2° respectively. For the proximal pins, the SE-CP and the IE-CP were 4.0 ± 1.1°and 5.2 ± 2.4° respectively. For the distal pins, the SE-CP and the IE-CP were 7.7 ± 1.4° and 6.2 ± 2.0° respectively. No cervical endplate violations occurred.

Conclusion
The novel Caspar pin insertion aiming device can control the pin entry points and pin direction with the average SE-CP and average IE-CP of 6.2 ± 2.0° and 6.3 ± 2.2°, respectively. The study shows that the average different angles between the Caspar pin and cervical endplate are less than 7°.
Implications of gender-based variabilities in bone mineral density and hemoglobin levels
Authors: Zhou Yumei , Liu Shengjun , Wang Ximei , Fu Yuhan , Su Fan , Cao Lei , Zha Xiaojuan , Wen Yufeng 
Published: July 2021

Abstract
Background
Studies reported that there is a relationship between volumetric bone mineral density (vBMD) and hemoglobin (HGB) in sickle cell anemia, chronic obstructive pulmonary disease, inflammatory bowel disease, and chronic kidney disease, it is not clear whether this association exists in normal populations or different genders. In order to further clarify the relationship between vBMD and HGB, and provide the basis for the diagnosis of related diseases, this study was conducted in the physical examination population.

Methods
A cross-sectional study was conducted on a health check-up population from Wannan area of China from January to December 2018. The study involved 1238 individuals aged 23 to 85 years. Linear regression analysis and smooth curve were applied to determine the relationship of HGB and vBMD.

Results
The average level of vBMD in the population was 130.11 ± 79.51 mg/cm3, after adjusting for age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triglycerides (TG), glucose (GLU), high-density lipoprotein (HDL) and low-density lipoprotein (LDL). A U-shape relationship was established between vBMD and HGB, the cut off value of HGB was 130 g/L. After gender stratification, the results showed a U-shaped curve relationship between vBMD and HGB in male group, and a linear relationship between vBMD and HGB in female group. The vBMD decreased with HGB when HGB < 120 g/L, and increased when HGB ≥ 120 g/L in male group.

Conclusion
The relationship between vBMD and HGB in the male physical examination population presents a U-shaped curve.
Research on epileptic EEG recognition based on improved residual networks of 1-D CNN and indRNN
Authors: Ma Mengnan , Cheng Yinlin , Wei Xiaoyan , Chen Ziyi , Zhou Yi 
Published: July 2021

Abstract
Background
Epilepsy is one of the diseases of the nervous system, which has a large population in the world. Traditional diagnosis methods mostly depended on the professional neurologists’ reading of the electroencephalogram (EEG), which was time-consuming, inefficient, and subjective. In recent years, automatic epilepsy diagnosis of EEG by deep learning had attracted more and more attention. But the potential of deep neural networks in seizure detection had not been fully developed.

Methods
In this article, we used a one-dimensional convolutional neural network (1-D CNN) to replace the residual network architecture’s traditional convolutional neural network (CNN). Moreover, we combined the Independent recurrent neural network (indRNN) and CNN to form a new residual network architecture-independent convolutional recurrent neural network (RCNN). Our model can achieve an automatic diagnosis of epilepsy EEG. Firstly, the important features of EEG were learned by using the residual network architecture of 1-D CNN. Then the relationship between the sequences were learned by using the recurrent neural network. Finally, the model outputted the classification results.

Results
On the small sample data sets of Bonn University, our method was superior to the baseline methods and achieved 100% classification accuracy, 100% classification specificity. For the noisy real-world data, our method also exhibited powerful performance.

Conclusion
The model we proposed can quickly and accurately identify the different periods of EEG in an ideal condition and the real-world condition. The model can provide automatic detection capabilities for clinical epilepsy EEG detection. We hoped to provide a positive significance for the prediction of epileptic seizures EEG.
Spatiotemporal evolution of epileptic seizure based on mutual information and dynamic brain network
Authors: Ma Mengnan , Wei Xiaoyan , Cheng Yinlin , Chen Ziyi , Zhou Yi 
Published: July 2021

Abstract
Background
Epilepsy was defined as an abnormal brain network model disease in the latest definition. From a microscopic perspective, it is also particularly important to observe the Mutual Information (MI) of the whole brain network based on different lead positions.

Methods
In this study, we selected EEG data from representative temporal lobe and frontal lobe epilepsy patients. Based on Phase Space Reconstruction and the calculation of MI indicator, we used Complex Network technology to construct a dynamic brain network function model of epilepsy seizure. At the same time, about the analysis of our network, we described the index changes and propagation paths of epilepsy discharge in different periods, and spatially monitors the seizure change process based on the analysis of the parameter characteristics of the complex network.

Results
Our model portrayed the functional synergy between the various regions of the brain and the state transition during the seizure process. We also characterized the EEG synchronous propagation path and core nodes during seizures. The results shown the full node change path and the distribution of important indicators during the seizure process, which makes the state change of the seizure process more clearly.

Conclusion
In this study, we have demonstrated that synchronization-based brain networks change with time and space. The EEG synchronous propagation path and core nodes during epileptic seizures can provide a reference for finding the focus area.
Risk-adjusted zero-inflated Poisson CUSUM charts for monitoring influenza surveillance data
Authors: Tan Yueying , Lai Xin , Wang Jiayin , Zhang Xuanping , Zhu Xiaoyan , Chong Ka-chun , Chan Paul K. S. , Tang Jing 
Published: July 2021

Abstract
Background
The influenza surveillance has been received much attention in public health area. For the cases with excessive zeroes, the zero-inflated Poisson process is widely used. However, the traditional control charts based on zero-inflated Poisson model, ignore the association between influenza cases and risk factors, and thus may lead to unexpected mistakes when implementing monitoring charts.

Method
In this paper, we proposed risk-adjusted zero-inflated Poisson cumulative sum control charts, in which the risk factors were put to adjust the risk of influenza and the adjustment was made by zero-inflated Poisson regression. We respectively proposed the control chart monitoring the parameters individually and simultaneously.

Results
The performance of our proposed risk-adjusted zero-inflated Poisson cumulative sum control chart was evaluated and compared with the unadjusted standard cumulative sum control charts in simulation studies. The results show that for different distribution of impact factors and different coefficients, the risk-adjusted cumulative sum charts can generate much less false alarm than the standard ones. Finally, the influenza surveillance data from Hong Kong is used to illustrate the application of the proposed chart.

Conclusions
Our results suggest that the adjusted cumulative sum control chart we proposed is more accurate and credible than the unadjusted standard control charts because of the lower false alarm rate of the adjusted ones. Even the unadjusted control charts may signal a little faster than the adjusted ones, the alarm they raise may have low credibility since they also raise alarm frequently even the processes are in control. Thus we suggest using the risk-adjusted cumulative sum control charts to monitor the influenza surveillance data to alert accurately, credibly and relatively quickly.
Selection strategy for sedation depth in critically ill patients on mechanical ventilation
Authors: Su Longxiang , Liu Chun , Chang Fengxiang , Tang Bo , Han Lin , Jiang Huizhen , Zhu Weiguo , Hong Na , Zhou Xiang , Long Yun 
Published: July 2021

Abstract
Background
Analgesia and sedation therapy are commonly used for critically ill patients, especially mechanically ventilated patients. From the initial nonsedation programs to deep sedation and then to on-demand sedation, the understanding of sedation therapy continues to deepen. However, according to different patient’s condition, understanding the individual patient’s depth of sedation needs remains unclear.

Methods
The public open source critical illness database Medical Information Mart for Intensive Care III was used in this study. Latent profile analysis was used as a clustering method to classify mechanically ventilated patients based on 36 variables. Principal component analysis dimensionality reduction was used to select the most influential variables. The ROC curve was used to evaluate the classification accuracy of the model.

Results
Based on 36 characteristic variables, we divided patients undergoing mechanical ventilation and sedation and analgesia into two categories with different mortality rates, then further reduced the dimensionality of the data and obtained the 9 variables that had the greatest impact on classification, most of which were ventilator parameters. According to the Richmond-ASS scores, the two phenotypes of patients had different degrees of sedation and analgesia, and the corresponding ventilator parameters were also significantly different. We divided the validation cohort into three different levels of sedation, revealing that patients with high ventilator conditions needed a deeper level of sedation, while patients with low ventilator conditions required reduction in the depth of sedation as soon as possible to promote recovery and avoid reinjury.

Conclusion
Through latent profile analysis and dimensionality reduction, we divided patients treated with mechanical ventilation and sedation and analgesia into two categories with different mortalities and obtained 9 variables that had the greatest impact on classification, which revealed that the depth of sedation was limited by the condition of the respiratory system.
Five regions, five retinopathy screening programmes: a systematic review of how Portugal addresses the challenge
Authors: Pereira Andreia Marisa Penso , da Silva Laureano Raul Manuel , de Lima Neto Fernando Buarque 
Published: July 2021

Abstract
Background
The implementation of a population-based screening programme for diabetic retinopathy involves several challenges, often leading to postponements and setbacks at high human and material costs. Thus, it is of the utmost importance to promote the sharing of experiences, successes, and difficulties. However, factors such as the existence of regional programmes, specificities of each country’s health systems, organisational and even linguistic barriers, make it difficult to create a solid framework that can be used as a basis for future projects.

Methods
Web of Science and PubMed platforms were searched using appropriate key words. The review process resulted in 423 articles adherent to the search criteria, 28 of which were accepted and analysed. Web sites of all Portuguese governmental and non-governmental organisations, with a relevant role on the research topic, were inspected and 75 official documents were retrieved and analysed.

Results
Since 2001, five regional screening programmes were gradually implemented under the guidelines of Portuguese General Health Department. However, complete population coverage was still not achieved. Among the main difficulties reported are the complex articulation between different levels of care providers, the low number of orthoptic technician in the national health system, the high burden that images grading, and treatment of positive cases represents for hospitals ophthalmology services, and low adherence rates. Yet, the comparison between strategies adopted in the different regions allowed the identification of potential solutions: hire orthoptic technician for primary health care units, eliminating the dependence of hospital professionals; use artificial intelligence algorithms for automatic retinographies grading, avoiding ophthalmologists overload; adoption of proximity strategies, as the use of portable retinographers, to promote adherence to screening.

Conclusion
Access to diabetic retinopathy screening remains remarkably variable in Portugal and needs urgent attention. However, several characteristics of effective screening programmes were found in Portuguese screening programmes, what seems to point toward promising outcomes, especially if each other highlights are considered. The findings of this research could be very useful for the other countries with similar socio-political characteristics.

Trial registration
PROSPERO registration ID CRD42020200115.
Age-related susceptibility to insulin resistance arises from a combination of CPT1B decline and lipid overload
Authors: Vieira-Lara Marcel A. , Dommerholt Marleen B. , Zhang Wenxuan , Blankestijn Maaike , Wolters Justina C. , Abegaz Fentaw , Gerding Albert , van der Veen Ydwine T. , Thomas Rachel , van Os Ronald P. , Reijngoud Dirk-Jan , Jonker Johan W. , Kruit Janine K. , Bakker Barbara M. 
Published: July 2021

Abstract
Background
The skeletal muscle plays a central role in glucose homeostasis through the uptake of glucose from the extracellular medium in response to insulin. A number of factors are known to disrupt the normal response to insulin leading to the emergence of insulin resistance (IR). Advanced age and a high-fat diet are factors that increase the susceptibility to IR, with lipid accumulation in the skeletal muscle being a key driver of this phenomenon. It is debated, however, whether lipid accumulation arises due to dietary lipid overload or from a decline of mitochondrial function. To gain insights into the interplay of diet and age in the flexibility of muscle lipid and glucose handling, we combined lipidomics, proteomics, mitochondrial function analysis and computational modelling to investigate young and aged mice on a low- or high-fat diet (HFD).

Results
As expected, aged mice were more susceptible to IR when given a HFD than young mice. The HFD induced intramuscular lipid accumulation specifically in aged mice, including C18:0-containing ceramides and diacylglycerols. This was reflected by the mitochondrial β-oxidation capacity, which was upregulated by the HFD in young, but not in old mice. Conspicuously, most β-oxidation proteins were upregulated by the HFD in both groups, but carnitine palmitoyltransferase 1B (CPT1B) declined in aged animals. Computational modelling traced the flux control mostly to CPT1B, suggesting a CPT1B-driven loss of flexibility to the HFD with age. Finally, in old animals, glycolytic protein levels were reduced and less flexible to the diet.

Conclusion
We conclude that intramuscular lipid accumulation and decreased insulin sensitivity are not due to age-related mitochondrial dysfunction or nutritional overload alone, but rather to their combined effects. Moreover, we identify CPT1B as a potential target to counteract age-dependent intramuscular lipid accumulation and thereby IR.
Assessing the antigenicity of different VP3 regions of infectious bursal disease virus in chickens from South Brazil
Authors: Palka Ana Paula Gori , Assunção de Matos Tatiana Reichert , de Souza Claudemir , Eugênio Danilo Santos , Krieger Marco Aurélio , Fragoso Stenio Perdigão , Pavoni Daniela Parada 
Published: July 2021

AbstractBackgroundInfectious bursal disease (IBD), also known as Gumboro disease, is a viral infection that causes mortality and immunosuppression in chickens (Gallus gallus). VP2 and VP3 are the major structural viral capsid components and are the most immunogenic proteins of IBD virus (IBDV). Reliable diagnostic tests using VP2 and VP3 produced in heterologous systems are important tools to control this infection. One advantage of an IBD diagnostic based on VP3, over those that use VP2, is that VP3 has linear epitopes, enabling its production in bacteria.ResultsWe tested the suitability of recombinant VP3 (rVP3) as a diagnostic reagent in an enzyme-linked immunosorbent assay (ELISA). Compared with a commercial test, rVP3 ELISA showed high sensitivity and specificity as a diagnostic tool for vaccinated animals. In addition, rVP3, but not the commercial ELISA, was able to detect antibodies in nonvaccinated chickens, probably developed against circulating IBDV strains. It was possible the assessment of VP3 regions antigenicity using chicken antisera.ConclusionsThe full-length recombinant VP3 can be used to assess post vaccination immunological status of chickens and its production is feasible and inexpensive. The evaluation of VP3 regions as candidates for general use in the diagnosis of IBD in chickens should be conducted with caution. Our work was the first to identify several regions of VP3 recognized by chicken antibodies.
Variation p.R1045H in MYH7 correlated with hypertrophic cardiomyopathy in a Chinese pedigree
Authors: Zhang Yan , Shang Yiyi , Liu Luo , Ding Xiaoxue , Wu Haiyan , Li Lijiang , Pang Mingjie 
Published: July 2021

Abstract
Background
Inherited hypertrophic cardiomyopathy (HCM) is a common heart muscle disease that damages heart function and may cause the heart to suddenly stop beating. Genetic factors play an important role in HCM. Pedigree analysis is a good way to identify the genetic defects that cause disease.

Methods
An HCM pedigree was determined in Yunnan, China. Whole-exome sequencing was performed to identify the genetic variants of HCM. Another 30 HCM patients and 200 healthy controls were also used to investigate the frequency of the variants by customized TaqMan genotyping assay.

Results
The variant NM_000257.4:c.3134G > A (NP_000248.2:p.Arg1045His, rs397516178, c.3134G > A in short) was found to cosegregate with the clinical phenotype of HCM. Moreover, the variant was not found in the 200 control subjects. After genotyping the variant in 30 HCM patients, there was one patient who carried the variant and had a family history.

Conclusions
Our findings suggest that this variant may be closely related to the occurrence of the disease. According the ACMG guidelines, the c.3134G > A variant should be classified as "Likely pathogenic".