bluuebunny/crossref_metadata_2025_split huggingface dataset:
Detecting non-alcoholic fatty liver disease and risk factors in health databases: accuracy and limitations of the ICD-10-AM
Authors: Hayward Kelly Lee , Johnson Amy L , Horsfall Leigh U , Moser Chris , Valery Patricia C , Powell Elizabeth E 
Published: February 2021

ObjectiveThe prevalence of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) cirrhosis is often underestimated in healthcare and administrative databases that define disease burden using International Classification of Diseases (ICD) codes. This retrospective audit was conducted to explore the accuracy and limitations of the ICD, Tenth Revision, Australian Modification (ICD-10-AM) to detect NAFLD, metabolic risk factors (obesity and diabetes) and other aetiologies of chronic liver disease.Design/MethodICD-10-AM codes in 308 admitted patient encounters at two major Australian tertiary hospitals were compared with data abstracted from patients’ electronic medical records. Accuracy of individual codes and grouped combinations was determined by calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and Cohen’s kappa coefficient (κ).ResultsThe presence of an ICD-10-AM code accurately predicted the presence of NAFLD/NASH (PPV 91.2%) and obesity (PPV 91.6%) in most instances. However, codes underestimated the prevalence of NAFLD/NASH and obesity by 42.9% and 45.3%, respectively. Overall concordance between clinical documentation and ‘grouped alcohol’ codes (κ 0.75) and hepatitis C codes (κ 0.88) was high. Hepatitis B codes detected false-positive cases in patients with previous exposure (PPV 55.6%). Accuracy of codes to detect diabetes was excellent (sensitivity 95.8%; specificity 97.6%; PPV 94.9%; NPV 98.1%) with almost perfect concordance between codes and documentation in medical records (κ 0.93).ConclusionRecognition of the utility and limitations of ICD-10-AM codes to study the burden of NAFLD/NASH cirrhosis is imperative to inform public health strategies and appropriate investment of resources to manage this burgeoning chronic disease.
Predicting mortality in adults with suspected infection in a Rwandan hospital: an evaluation of the adapted MEWS, qSOFA and UVA scores
Authors: Klinger Amanda , Mueller Ariel , Sutherland Tori , Mpirimbanyi Christophe , Nziyomaze Elie , Niyomugabo Jean-Paul , Niyonsenga Zack , Rickard Jennifer , Talmor Daniel S , Riviello Elisabeth 
Published: February 2021

RationaleMortality prediction scores are increasingly being evaluated in low and middle income countries (LMICs) for research comparisons, quality improvement and clinical decision-making. The modified early warning score (MEWS), quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA), and Universal Vital Assessment (UVA) score use variables that are feasible to obtain, and have demonstrated potential to predict mortality in LMIC cohorts.ObjectiveTo determine the predictive capacity of adapted MEWS, qSOFA and UVA in a Rwandan hospital.Design, setting, participants and outcome measuresWe prospectively collected data on all adult patients admitted to a tertiary hospital in Rwanda with suspected infection over 7 months. We calculated an adapted MEWS, qSOFA and UVA score for each participant. The predictive capacity of each score was assessed including sensitivity, specificity, positive and negative predictive value, OR, area under the receiver operating curve (AUROC) and performance by underlying risk quartile.ResultsWe screened 19 178 patient days, and enrolled 647 unique patients. Median age was 35 years, and in-hospital mortality was 18.1%. The proportion of data missing for each variable ranged from 0% to 11.7%. The sensitivities and specificities of the scores were: adapted MEWS >4, 50.4% and 74.9%, respectively; qSOFA >2, 24.8% and 90.4%, respectively; and UVA >4, 28.2% and 91.1%, respectively. The scores as continuous variables demonstrated the following AUROCs: adapted MEWS 0.69 (95% CI 0.64 to 0.74), qSOFA 0.65 (95% CI 0.60 to 0.70), and UVA 0.71 (95% CI 0.66 to 0.76); there was no statistically significant difference between the discriminative capacities of the scores.ConclusionThree scores demonstrated a modest ability to predict mortality in a prospective study of inpatients with suspected infection at a Rwandan tertiary hospital. Careful consideration must be given to their adequacy before using them in research comparisons, quality improvement or clinical decision-making.
Who will benefit from bariatric surgery for diabetes? A protocol for an observational cohort study
Authors: Kenkre Julia S , Ahmed Ahmed R , Purkayastha Sanjay , Malallah Khalefah , Bloom Stephen , Blakemore Alexandra I , Prevost A Toby , Tan Tricia 
Published: February 2021

IntroductionType 2 diabetes mellitus (T2DM) and obesity are pandemic diseases that lead to a great deal of morbidity and mortality. The most effective treatment for obesity and T2DM is bariatric or metabolic surgery; it can lead to long-term diabetes remission with 4 in 10 of those undergoing surgery having normal blood glucose on no medication 1 year postoperatively. However, surgery carries risks and, additionally, due to resource limitations, there is a restricted number of patients who can access this treatment. Moreover, not all those who undertake surgery respond equally well metabolically. The objective of the current research is to prospectively investigate predictors of T2DM response following metabolic surgery, including those directly involved in its aetiopathogenesis such as fat distribution and genetic variants. This will inform development of a clinically applicable model to help prioritise this therapy to those predicted to have remission.Methods and analysisA prospective multicentre observational cohort study of adult patients with T2DM and obesity undergoing Roux-en-Y gastric bypass surgery. Patients will be comprehensively assessed before surgery to determine their clinical, metabolic, psychological, genetic and fat distribution profiles. A multivariate logistic regression model will be used to assess the value of the factors derived from the preoperative assessment in terms of prediction of diabetes remission.Ethics and disseminationFormal ethics review was undertaken with a favourable opinion (UK HRA RES reference number 18/LO/0931). The dissemination plan is to present the results at conferences, in peer-reviewed journals as well as to lay media and to patient organisations.Trial registration detailsClinicalTrials.gov, Identifier:NCT03842475.
Diurnal variations in the expression of core-clock genes correlate with resting muscle properties and predict fluctuations in exercise performance across the day
Authors: Basti Alireza , Yalçin Müge , Herms David , Hesse Janina , Aboumanify Ouda , Li Yin , Aretz Zita , Garmshausen Josefin , El-Athman Rukeia , Hastermann Maria , Blottner Dieter , Relógio Angela 
Published: February 2021

ObjectivesIn this study, we investigated daily fluctuations in molecular (gene expression) and physiological (biomechanical muscle properties) features in human peripheral cells and their correlation with exercise performance.Methods21 healthy participants (13 men and 8 women) took part in three test series: for the molecular analysis, 15 participants provided hair, blood or saliva time-course sampling for the rhythmicity analysis of core-clock gene expression via RT-PCR. For the exercise tests, 16 participants conducted strength and endurance exercises at different times of the day (9h, 12h, 15h and 18h). Myotonometry was carried out using a digital palpation device (MyotonPRO), five muscles were measured in 11 participants. A computational analysis was performed to relate core-clock gene expression, resting muscle tone and exercise performance.ResultsCore-clock genes show daily fluctuations in expression in all biological samples tested for all participants. Exercise performance peaks in the late afternoon (15–18 hours for both men and women) and shows variations in performance, depending on the type of exercise (eg, strength vs endurance). Muscle tone varies across the day and higher muscle tone correlates with better performance. Molecular daily profiles correlate with daily variation in exercise performance.ConclusionTraining programmes can profit from these findings to increase efficiency and fine-tune timing of training sessions based on the individual molecular data. Our results can benefit both professional athletes, where a fraction of seconds may allow for a gold medal, and rehabilitation in clinical settings to increase therapy efficacy and reduce recovery times.
Role of health simulation centres in the COVID-19 pandemic response in Italy: a national study
Authors: Ingrassia Pier Luigi , Ferrari Mattia , Paganini Matteo , Mormando Giulia 
Published: February 2021

IntroductionThe COVID-19 pandemic has dramatically affected the Italian health systems and drastically impacted healthcare workers’ daily routine and training. Simulation is an efficient tool to provide medical education, especially in the case of incoming public health emergencies. This study investigated the role and activities of Italian simulation centres (SCs) during the acute phase of the COVID-19 pandemic.MethodsThe population was identified through a web search. The directors of Italian SCs were contacted via email and then enrolled. A structured interview was created, internally validated and administrated by phone to participants.ResultsFollowing the government’s ordinance, 37 (88.37%) SCs had to be closed to the public. Twenty (46.51%) SCs organised in situ simulation while 7 (16.28%) of them organised simulation inside the centre. Twenty-three (53.49%) SCs resorted to telematic modalities to provide training about COVID-19 and 21 (48.84%) of them for other training. Up to date, 13 SCs are still closed to the public.ConclusionsItaly has been severely hit by COVID-19, with differences between the regions. Almost all the SCs were closed, with only a few delivering training. The SCs took advantage of emergent technologies to create new ways to train people safely. Unfortunately, nearly one-fourth of Italian SCs have not reopened yet. The evolution of the COVID-19 epidemic calls for reconsideration about training activities including adequate safety measures implemented for all individuals involved.
Success and failure of additional immune modulators in steroid-refractory/resistant pneumonitis related to immune checkpoint blockade
Authors: Beattie Jason , Rizvi Hira , Fuentes Paige , Luo Jia , Schoenfeld Adam , Lin I-Hsin , Postow Michael , Callahan Margaret , Voss Martin H , Shah Neil J , Betof Warner Allison , Chawla Mohit , Hellmann Matthew D 
Published: February 2021

BackgroundPneumonitis related to immune checkpoint blockade is uncommon but can be severe, fatal or chronic. Steroids are first-line treatment, however, some patients are refractory or become resistant to steroids. Like many immune-related adverse events, little is known regarding the outcomes and optimal management of patients in whom steroids are ineffective.MethodsWe performed a single-center retrospective cohort study at a high-volume tertiary cancer center to evaluate the clinical course, management strategies and outcomes of patients treated for immune checkpoint pneumonitis with immune modulatory medications in addition to systemic steroids. Pharmacy records were queried for patients treated with both immune checkpoint blockade and receipt of additional immune modulators. Records were then manually reviewed to identify patients who received the additional immune modulators for immune checkpoint pneumonitis.ResultsFrom 2013 to 2020, we identified 26 patients treated for immune checkpoint pneumonitis with additional immune modulators in addition to steroids. Twelve patients (46%) were steroid-refractory and 14 (54%) were steroid-resistant. Pneumonitis severity included grade 2 (42%) or grade 3–4 (58%). Additional immune modulation consisted of tumor necrosis factor-alpha inhibitor (77%) and/or mycophenolate (23%). Durable improvement in pneumonitis following initiation of additional immune modulators occurred in 10 patients (38%), including three patients (12%) in whom pneumonitis resolved and all immunosuppressants ceased. The rate of 90-day all-cause mortality/hospice referral was 50%. At last follow-up, mortality attributable to pneumonitis was 23%. In addition to mortality from pneumonitis and cancer, 3 patients (12%) died due to infections possibly associated with immunosuppression.ConclusionsSteroid-refractory or -resistant immune checkpoint pneumonitis is uncommon but associated with significant morbidity and mortality. Additional immunomodulators can yield durable improvement, attained in over one third of patients. An improved understanding of the underlying biology of immune-related pneumonitis will be crucial to guide more precise and effective treatment strategies in the future.
Evidence of morphological adaptation to life underwater: sternal keel affects swimming speed in giant water scavenger beetles (Coleoptera: Hydrophilidae: Hydrophilini)
Authors: Matsushima Ryosuke 
Published: February 2021

Fundamentally, insects evolved on land and secondarily inhabited aquatic environments multiple times. To live underwater, aquatic insects have acquired enormously variable morphological, developmental, physiological, and ecological traits, such as gas exchange systems and swimming-related characteristics. Giant water scavenger beetles of the tribe Hydrophilini (Coleoptera: Hydrophilidae) are characterized by the presence of a sternal keel, which often extends posteriorly. Despite being a conspicuous morphological trait, its function remains unclear. Here, I verified two hypotheses: keel affects (1) submergence time following air replacement and (2) speed and oscillatory movement during forward swimming in Hydrophilus acuminatus Motschulsky, 1854. Submergence time was affected by body mass rather than keel removal; in other words, larger individuals replaced their gas gills more frequently. Keel removal reduced swimming speed by 12.5%. These observations support the second hypothesis, and are also consistent with previous speculations that the sternal keel is a key adaptation for swimming, but the results showed that the degree of oscillation was closely related to body mass but not to keel removal. Further studies are warranted to elucidate precise factors through which the presence of the keel increases swimming speed. Such studies would provide clues into understanding the associations among body size, swimming methods, and morphological traits.
First observation of ion beam channeling in bent crystals at multi-TeV energies
Authors: Redaelli S. , Butcher M. , Barreto C. , Losito R. , Masi A. , Mirarchi D. , Montesano S. , Rossi R. , Scandale W. , Serrano Galvez P. , Valentino G. , Galluccio F. 
Published: February 2021

AbstractPlanar channeling in bent crystals has been observed in LHC with multi-TeV proton beam in 2015. Two crystals, mounted on novel high-accuracy goniometers (one in the horizontal and one in the vertical plane), are integrated in the LHC collimation system, for studying the feasibility of the crystal-based collimation scheme. Using this experimental setup, tests with fully-stripped lead ion beams at both 450 Z and 6500 Z GeV were carried during dedicated LHC beam time. Planar channeling was observed for the first time with lead ions at these unprecedented energies surpassing by more than 1 order of magnitude the previous state-of-the-art for lead heavy ions and providing an important experimental basis for future applications of bent crystals in beam manipulations. The set of measurements performed to confirm this observation, as the local loss reduction in presence of channeling and the evidence of a deflected beam downstream of the crystal, are presented.
PP2A-activating Drugs Enhance FLT3 Inhibitor Efficacy through AKT Inhibition–Dependent GSK-3β–Mediated c-Myc and Pim-1 Proteasomal Degradation
Authors: Scarpa Mario , Singh Prerna , Bailey Christopher M. , Lee Jonelle K. , Kapoor Shivani , Lapidus Rena G. , Niyongere Sandrine , Sangodkar Jaya , Wang Yin , Perrotti Danilo , Narla Goutham , Baer Maria R. 
Published: February 2021

Abstract
Fms-like tyrosine-like kinase 3 internal tandem duplication (FLT3-ITD) is present in acute myeloid leukemia (AML) in 30% of patients and is associated with short disease-free survival. FLT3 inhibitor efficacy is limited and transient but may be enhanced by multitargeting of FLT3-ITD signaling pathways. FLT3-ITD drives both STAT5-dependent transcription of oncogenic Pim-1 kinase and inactivation of the tumor-suppressor protein phosphatase 2A (PP2A), and FLT3-ITD, Pim-1, and PP2A all regulate the c-Myc oncogene. We studied mechanisms of action of cotreatment of FLT3-ITD–expressing cells with FLT3 inhibitors and PP2A-activating drugs (PADs), which are in development. PADs, including FTY720 and DT-061, enhanced FLT3 inhibitor growth suppression and apoptosis induction in FLT3-ITD–expressing cell lines and primary AML cells in vitro and MV4-11 growth suppression in vivo. PAD and FLT3 inhibitor cotreatment independently downregulated c-Myc and Pim-1 protein through enhanced proteasomal degradation. c-Myc and Pim-1 downregulation was preceded by AKT inactivation, did not occur in cells expressing myristoylated (constitutively active) AKT1, and could be induced by AKT inhibition. AKT inactivation resulted in activation of GSK-3β, and GSK-3β inhibition blocked downregulation of both c-Myc and Pim-1 by PAD and FLT3 inhibitor cotreatment. GSK-3β activation increased c-Myc proteasomal degradation through c-Myc phosphorylation on T58; infection with c-Myc with T58A substitution, preventing phosphorylation, blocked downregulation of c-Myc by PAD and FLT3 inhibitor cotreatment. GSK-3β also phosphorylated Pim-1L/Pim-1S on S95/S4. Thus, PADs enhance efficacy of FLT3 inhibitors in FLT3-ITD–expressing cells through a novel mechanism involving AKT inhibition–dependent GSK-3β–mediated increased c-Myc and Pim-1 proteasomal degradation.
Trajectory Planning and Walking Pattern Generation of Humanoid Robot Motion
Authors: Abdolshah Saeed , Abdolshah Majid , Tang Sai Hong 
Published: February 2021

Walking trajectory generation for a humanoid robot is a challenging control issue. In this paper, a walking cycle has been recognized considering human motion, and nine simple steps were distinguished in a full step of walking which form motion trajectory, and generates a simplified ZMP motion formulation. This system was used in humanoid robot simulation motion and is achievable easily in walking steps of robot. A minimum DOFs humanoid robot has been considered and geometrical relationships between the robot links were presented by the Denavit-Hartenberg method. The inverse kinematics equations have been solved regarding to extracted ZMP trajectory formula, and constraints in different steps. As a result; angular velocity, acceleration and power of motors were obtained using the relationships and Jacobin. At each step, extracted data were applied on simulated robot in Matlab, and Visual Nastran software. Zero moment point trajectory was evaluated in simulation environment.
Manuscript shapes generated by novel bi-axis control algorithm based on a mathematical handwriting model
Authors: Mahmoud Imene , Chihi Ines , Abedlkrim Afef , Benrejeb Mohamed 
Published: February 2021

<span lang="EN-US">Handwriting movement is one of the most complex activities of human motions. It’s a blend of kinesthetic, cognitive, perceptual and motor components. The study of this biological process shows that bell-shaped velocity profiles are generally observed in the handwriting motion. In this paper, an identification technique, based on Recursive Least Square algorithm (RLS), is proposed to identify the pen-tip movement in human handwriting process, by using input and output data which present EMG signals and velocities according to x and y coordinates. Using the estimated coordinates that have resulted from the velocity model; we propose a novel algorithm to generate handwritten graphic traces, which is inspired from the idea of tracing circles by Bresenham bi-axis control algorithm. The effectiveness of this approach should be observed on predicting cursive Arabic letters and Arabic word written on (</span><em><span lang="EN-US">x,y</span></em><span lang="EN-US">) plane, these shapes constituting a recorded experimental basis.</span>
Review of Vision-Based Robot Navigation Method
Authors: Rahmani Budi , Putra Agfianto Eko , Harjoko Agus , Priyambodo Tri Kuntoro 
Published: February 2021

Vision-based robot navigation is a research theme that continues to be developed up to now by the researchers in the field of robotics. There are innumerable methods or algorithms are developed, and this paper described the reviews of the methods. The methods are distinguished whether the robot is equipped with the navigation map (map-based), the map is built incrementally as robot observes the environment (map-building), or the robot navigates using no map (mapless). In this paper will described navigation methods of map-based, map-building, and mapless category.
Design and Fabrication of Friction Stir Welding End-Effector for an ABB IRB1410 Robot
Authors: Vanama Santosh 
Published: February 2021

<p>The paper propose modelling and fabrication of friction stir welding end-effector for ABB IRB1410 robot. A dynamically developing version of pressure welding processes, join material without reaching the fusion temperature called friction stir welding. As friction stir welding occurs in solid state, no solidification structures are created thereby eliminating the brittle and eutectic phase’s common to fusion welding of high strength aluminium alloys. In this paper, Friction stir welding is applied to aluminum sheets of 2 mm thickness. A prototype setup is developed to monitor the evolution of main forces and tool temperature during the operation. Pressure of a gripper plays a major role for tool rotation and developing torque. Fabrication of the tool has done. Force calculations are done by placing the sensors on the outer surface of gripper. Methods of evaluating weld quality are surveyed as well.</p>
Concentration of Lp(a) (Lipoprotein[a]) in Aneurysm Sac Is Associated With Wall Enhancement of Unruptured Intracranial Aneurysm
Authors: Ishii Daizo , Zanaty Mario , Roa Jorge A. , Li Luyuan , Lu Yongjun , Sabotin Ryan , Allan Lauren , Samaniego Edgar A , Hasan David M. 
Published: February 2021

Background and Purpose:
Atherosclerotic remodeling of the aneurysm wall, which could be detected as aneurysm wall enhancement (AWE) by magnetic resonance–vessel wall imaging, is a part of degenerative change of unruptured intracranial aneurysms (UIAs). The purpose of this study was to determine whether the luminal concentrations of atherosclerotic proteins in the aneurysm sac were associated with increased wall enhancement of UIAs in vessel wall imaging.

Methods:
We performed a prospective study of subjects undergoing endovascular treatments for UIAs. All subjects underwent evaluation using 3T–magnetic resonance imaging, including pre/postcontrast vessel wall imaging of the UIAs. Blood samples were collected from the aneurysm sac and the parent artery during endovascular procedures. Presence/absence of AWE was correlated with the delta difference in concentration for each atherosclerotic protein between the lumen of UIA and in the parent artery.

Results:

A total of consecutive 17 patients with 19 UIAs were enrolled. The delta difference of lipoprotein(a) was significantly higher in UIAs with AWE compared with those without AWE (−6.9±16.0 versus −45.4±44.9 μg/mL,
P
=0.03).

Conclusions:
Higher luminal concentrations of lipoprotein(a) in the aneurysm sac were significantly associated with increased wall enhancement of UIAs. A larger study is needed to confirm these findings.