bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deciphering the “Art” in Modeling and Simulation of the Knee Joint: Variations in Model Development
Authors: Rooks Nynke B. , Schneider Marco T. Y. , Erdemir Ahmet , Halloran Jason P. , Laz Peter J. , Shelburne Kevin B. , Hume Donald R. , Imhauser Carl W. , Zaylor William , Elmasry Shady , Schwartz Ariel , Chokhandre Snehal K. , Abdollahi Nohouji Neda , Besier Thor F. 
Published: February 2021

Abstract
The use of computational modeling to investigate knee joint biomechanics has increased exponentially over the last few decades. Developing computational models is a creative process where decisions have to be made, subject to the modelers' knowledge and previous experiences, resulting in the “art” of modeling. The long-term goal of the KneeHub project is to understand the influence of subjective decisions on the final outcomes and the reproducibility of computational knee joint models. In this paper, we report on the model development phase of this project, investigating model development decisions and deviations from initial modeling plans. Five teams developed computational knee joint models from the same dataset, and we compared each teams' initial uncalibrated models and their model development workflows. Variations in the software tools and modeling approaches were found, resulting in differences such as the representation of the anatomical knee joint structures in the model. The teams consistently defined the boundary conditions and used the same anatomical coordinate system convention. However, deviations in the anatomical landmarks used to define the coordinate systems were present, resulting in a large spread in the kinematic outputs of the uncalibrated models. The reported differences and similarities in model development and simulation presented here illustrate the importance of the “art” of modeling and how subjective decision-making can lead to variation in model outputs. All teams deviated from their initial modeling plans, indicating that model development is a flexible process and difficult to plan in advance, even for experienced teams.
Design of a Quadratic, Antagonistic, Cable-Driven, Variable Stiffness Actuator
Authors: Moore Ryan , Schimmels Joseph M. 
Published: February 2021

Abstract
Antagonistically actuated variable stiffness actuators (VSAs) take inspiration from biological muscle structures to control both the stiffness and positioning of a joint. This paper presents the design of an elastic mechanism that utilizes a cable running through a set of three pulleys to displace a linear spring, yielding quadratic spring behavior in each actuator. A joint antagonistically actuated by two such mechanisms yields a linear relationship between force and deflection from a selectable equilibrium position. A quasi-static model is used to optimize the mechanism. Testing of the fabricated prototype yielded a good match to the desired elastic behavior.
Unknown Parameter Excitation and Estimation for Complex Systems With Dynamic Performances
Authors: Chen Yi-Ping , Chan Kuei-Yuan 
Published: February 2021

Abstract
Simulation models play crucial roles in efficient product development cycles, therefore many studies aim to improve the confidence of a model during the validation stage. In this research, we proposed a dynamic model validation to provide accurate parameter settings for minimal output errors between simulation models and real model experiments. The optimal operations for setting parameters are developed to maximize the effects by specific model parameters while minimizing interactions. To manage the excessive costs associated with simulations of complex systems, we propose a procedure with three main features: the optimal excitation based on global sensitivity analysis (GSA) is done via metamodel techniques, for estimating parameters with the polynomial chaos-based Kalman filter, and validating the updated model based on hypothesis testing. An illustrative mathematical model was used to demonstrate the detail processes in our proposed method. We also apply our method on a vehicle dynamic case with a composite maneuver for exciting unknown model parameters such as inertial and coefficients of the tire model; the unknown model parameters were successfully estimated within a 95% credible interval. The contributions of this research are also underscored through multiple cases.
An Experimental Study on Dynamic Properties of Rubber Specimens for a Crankshaft Torsional Vibration Damper of Automobiles
Authors: Honda Yasuhiro , Wakabayashi Katsuhiko , Kodama Tomoaki , Okamura Hiroshi 
Published: February 2021

Abstract
Torsional vibration occurs at a crankshaft system of operating multi-cylinder reciprocating engine in mechanism. A torsional vibration rubber damper is generally used to control or reduce the torsional vibration appearing at the crankshaft system of small diesel engine for automobile. Since automotive diesel engines have recently become engine weight lightening and higher performance output, both the amplitudes and the frequencies of the torsional vibrations generate increasingly more than before. Therefore, the torsional rubber damper should be required as one of the most important engine vibration reduction devices. The torsional vibration rubber damper must be precisely designed to match with a crankshaft system of engine with which it is mounted in order to reduce sufficiently. However, the prediction difficulty of its dynamic characteristics gives damper designers the design of a torsional rubber damper with variable experiments. While this design method requires too much time for examination of the vibration reduction effects obtained from some torsional oscillation tests, it is doubt whether the designed torsional damper will be able to sufficiently reduce the torsional vibration in variable engine operations. This paper refers to influences of rubber shape and forced frequency on properties of test rubber specimens designed for contribution to damper design.
Furthermore, some important subjects on properties of rubber are described for design of shear-type torsional rubber dampers by using a rheological model. The rubber properties can be obtained from exciting vibration tests of rubber specimens with the changes of exciting frequency, amplitude and temperature. It is confirmed that the shape factor should be reduced to suppress the influence on rubber dynamic properties of external factors such as amplitude and frequency.
Improved quality of reporting safety data of medication in paediatric randomised controlled trials
Authors: Prins Taco Jan , Rollema Corine , van Roon Eric , Vries Tjalling de 
Published: February 2021

ObjectiveEvaluating the reporting of safety data of medication in paediatric randomised controlled trials (RCTs) in 2017–2018 compared with our earlier study.DesignLiterature search with a systemic appraisal of adverse drug event reporting.Main outcome measuresQuality of reporting of safety data using Consolidated Standards of Reporting Trials (CONSORT) and Ioannidis scores in paediatric drug RCTs. The CONSORT score consists of nine recommendations of the CONSORT Group issued to improve the quality of reporting adverse events. The Ioannidis score is based on these advices. We considered a CONSORT score of at least 6 and an Ioannidis score of at least 3 as sufficient.ResultsWe reviewed 100 RCTs published in 2017 and 2018. Ninety-four (94%) articles mentioned adverse events compared with 78% in the earlier study. Fifty-seven per cent used a standardised method for reporting adverse events compared with 34% in our earlier study. In 26 of the articles, the expected adverse events were defined, and 27 articles had a preset standardised scale for adverse events. Of these, 62 articles (62%) had a CONSORT score of 6 or higher compared with 18% in 2010. In the present study, 67% had an Ioannidis score of 3 or higher, whereas in the earlier study this was 29%. Both differences are statistically significant (p<0.05).ConclusionsReporting safety data in paediatric RCTs has improved over the past 10 years. However, there is still room for improvement and for further improvement. Authors and editors should give more attention to methods for collecting, reporting and presenting safety data of RCTs in studies and manuscripts.
Improvement of transitional care from hospital to home for older patients, the TIGER study: protocol of a randomised controlled trial
Authors: Rimmele Martina , Wirth Jenny , Britting Sabine , Gehr Thomas , Hermann Margit , van den Heuvel Dirk , Kestler Andreas , Koch Thomas , Schoeffski Oliver , Volkert Dorothee , Wingenfeld Klaus , Wurm Susanne , Freiberger Ellen , Sieber Cornel 
Published: February 2021

IntroductionIn Germany, an efficient and feasible transition from hospital to home for older patients, ensuring continuous care across healthcare settings, has not yet been applied and evaluated. Based on the transitional care model (TCM), this study aims to reduce preventable readmissions of patients ≥75 years of age with a transitional care intervention performed by geriatric-experienced care professionals. The study investigates whether the intervention ensures continuous care during transition and stabilises the care situation of patients at home.Methods and analysesRandomised controlled clinical trial, recruiting between 25 April 2018 and 31 December 2019 in one German hospital in the city of Regensburg. The intervention group is supported by care professionals in the transition process from hospital to home for up to 12 months. Based on TCM, the intervention includes an individual care plan according to a patient’s symptoms, risks, needs and values. The plan is advanced in the domestic situation via personal visits and telephone contacts. All necessary care actions regarding, for example, mobility, residence adjustments, or nutrition, are initiated to be executed by ambulant care services, and are monitored, evaluated and adapted if necessary. In supervising the care plan, the care professionals do not administer active care services themselves but coordinate them. Patients and their caregivers are actively engaged in the care planning and execution. In contrast, the control group receives only usual discharge planning in the hospital and usual ambulatory care.The primary outcome is the all-cause readmission rate assessed using health insurance data within a follow-up of up to 12 months after hospital discharge. Secondary outcomes include care quality, mobility, nutritional and wound situation, and health-related quality of life. They are assessed at baseline, after 1 month, 3 months, 6 months, and at the end of study visit. Additionally, the economic efficiency of the intervention will be evaluated.Ethics and disseminationEthics approval for the trial was obtained from the Ethics Committee of the Friedrich-Alexander-Universität Erlangen-Nürnberg. Results will be published in peer-reviewed, open-access scientific journals and disseminated at national and international research conferences and through public presentations in the geriatric and healthcare community.Trial registrationClinicalTrials.gov identifier:NCT03513159.
Implementation of the Moyo fetal heart rate monitor in district hospitals in Bihar, India: a feasibility study
Authors: Oommen Hanna , Ranjan Kunal , Murugesan Sudha , Gore Aboli , Sonthalia Sunil , Ninan Pradeep , Bernitz Stine , Sorbye Ingvil , Lukasse Mirjam 
Published: February 2021

ObjectivesGlobally, half of all stillbirths occur during birth. Detection of fetal distress with fetal heart rate monitoring (FHRM), followed by appropriate and timely management, might reduce fresh stillbirths and neonatal morbidity. This study aimed to investigate the barriers and facilitators for the implementation of Moyo FHRM use in Bihar state, and secondarily, the feasibility of collecting reliable obstetrical and neonatal outcome data to assess the effect of implementation.SettingCARE Bihar and the hospital management at four district hospitals (DHs) in Bihar state, each with 6500 to 15 000 deliveries a year, agreed to testing the implementation of Moyo FHRM through a process of meetings, training sessions and collecting data. At each hospital, a clinical training expert was trained to train others, while a clinical assessment facilitator collected data.MethodologyObservational notes were taken at all training sessions and meetings. Individual interviews (n=4) were conducted with clinical training experts (CTEs) on training experiences and barriers and facilitators for Moyo FHRM implementation. The CTEs recoded field notes in diaries. Descriptive analyses performed on pre-implementation and post-implementation data (n=521) assessed quality and completeness.ResultsMain barriers to implementation of Moyo FHRM were health system and cultural challenges involving (1) existing practices, (2) insufficient human resources, (3) action delays and (4) cultural and local challenges. Another barrier was insufficient involvement of doctors. Facilitators for implementation were easy use of the Moyo FHRM device and adequate training for staff.Electronic collection of obstetrical data worked well but had substantial missing data.ConclusionHealth system and cultural challenges are a major constraint to Moyo FHRM implementation in low-resource settings. Improvements at all levels of infrastructure, practices and skills will be critical in busy DHs in Bihar. Full-scale implementation needs doctor-led leadership and ownership. Obstetrical data collection for the purpose of scientific analysis needs to be improved.
Piloting gender-oriented colorectal cancer screening with a faecal immunochemical test: population-based registry study from Finland
Authors: Sarkeala Tytti , Färkkilä Martti , Anttila Ahti , Hyöty Marja , Kairaluoma Matti , Rautio Tero , Voutilainen Markku , Helander Sanni , Jäntti Maija , Lehtinen Milla , Patrikka Lotta , Malila Nea , Heinävaara Sirpa 
Published: February 2021

ObjectiveTo assess the feasibility and evaluate the performance of a relaunched colorectal cancer (CRC) screening programme with different cut-offs for men and women.DesignPopulation-based registry study.SettingNine municipalities in Finland which started CRC screening with faecal immunochemical test (FIT) in April 2019 with cut-off levels 70 µg Hg/g faeces for men and 25 µg Hg/g faeces for women.ParticipantsMen (n=13 059) and women (n=14 669) aged 60–66 years invited to screening during the first programme year.Outcome measuresParticipation rates, positivity rates, detection rates of CRC and advanced adenoma (AA), and positive predictive values (PPV) of FIT for CRC and AA.ResultsAltogether 21 993 invitees returned stool samples. The participation rate of women (83.4%; 95% CI 82.8 to 84.0) was significantly higher than that of men (74.7%; 95% CI 73.9 to 75.4). The positivity rates were 2.4% (2.2 to 2.7) and 2.8% (2.5 to 3.1), respectively. In total, 37 CRCs and 116 AAs were detected. The detection rates of CRC and AA per 1000 participants were 1.8 (1.1 to 2.9) and 7.2 (5.6 to 9.1) for men and 1.6 (0.9 to 2.4) and 3.8 (2.8 to 5.0) for women. The PPVs per 100 positive tests were 6.6 (4.0 to 10.3) and 25.7 (20.6 to 31.4) for men and 6.4 (3.9 to 9.8) and 15.5 (11.6 to 20.2) for women.ConclusionsThe chosen FIT strategy narrowed the gap in the diagnostic performance between men and women especially in the detection of CRC. The participation rates were excellent. The levels of positivity and detection rates were moderate and need further action. The results indicate that gender-specific protocols can be introduced to organised CRC screening. It is yet to be seen whether they are more effective than a uniform screening protocol.
Involvement of community paediatricians in the care of children and young people with mental health difficulties in the UK: implications for case ascertainment by child and adolescent psychiatric, and paediatric surveillance systems
Authors: Ayyash Hani F , Ogundele Michael Oladipo , Lynn Richard M , Schumm Tanja-Sabine , Ani Cornelius 
Published: February 2021

ObjectiveTo ascertain the extent to which community paediatricians are involved in the care of children with mental health conditions in order to determine which difficulties are appropriate for single or joint surveillance by the British Paediatric Surveillance Unit (BPSU) and Child and Adolescent Psychiatry Surveillance System (CAPSS).DesignAn online survey of the 1120 members of the British Association of Community Child Health (BACCH) working in 169 Community Child Health (CCH) services in the UK.ResultsA total of 245 community paediatricians responded to the survey. This represents 22% of members of BACCH but likely to have covered many of the 169 CCH units because participants could respond on behalf of other members in their unit. The survey showed that children and young people (CYP) with neurodevelopmental conditions presented more frequently to paediatrics than to Child and Adolescent Mental Health Services (CAMHS). In addition, a sizeable proportion of CYP with emotional difficulties presented to paediatricians (eg, 29.5% for anxiety/obsessive compulsive disorder (OCD), and 12.8% for depression)—mainly due to difficulty with accessing CAMHS. More than half of the community paediatricians are involved in the care of CYP with anxiety and OCD, while 32.3% are involved in the care of those with depression.ConclusionThere is significant involvement of community paediatricians in the care of CYP with mental health conditions. Involvement is highest for neurodevelopmental conditions, but also significant for CYP with emotional difficulties. The implication of the findings for surveillance case ascertainment is that joint BPSU and CAPSS is recommended for surveillance studies of neurodevelopmental conditions. However, for emotional disorders, single or joint surveillance should be made based on the specific research question and the relative trade-offs between case ascertainment, and the additional cost and reporting burden of joint surveillance. Single CAPSS studies remain appropriate for psychosis and bipolar disorder.
Prostaglandin E2 receptor PTGER4-expressing macrophages promote intestinal epithelial barrier regeneration upon inflammation
Authors: Na Yi Rang , Jung Daun , Stakenborg Michelle , Jang Hyeri , Gu Gyo Jeong , Jeong Mi Reu , Suh Soo Youn , Kim Hak Jae , Kwon Yoon Hey , Sung Tae Sik , Ryoo Seung Bum , Park Kyu Joo , Im Jong Pil , Park Ji Yong , Lee Yun Sang , Han Heonjong , Park Boyoun , Lee Sungwook , Kim Daesik , Lee Ho Su , Cleynen Isabelle , Matteoli Gianluca , Seok Seung Hyeok 
Published: February 2021

ObjectiveDysfunctional resolution of intestinal inflammation and altered mucosal healing are essential features in the pathogenesis of inflammatory bowel disease (IBD). Intestinal macrophages are vital in the process of inflammation resolution, but the mechanisms underlying their mucosal healing capacity remain elusive.DesignWe investigated the role of the prostaglandin E2 (PGE2) receptor PTGER4 on the differentiation of intestinal macrophages in patients with IBD and mouse models of intestinal inflammation. We studied mucosal healing and intestinal epithelial barrier regeneration in Csf1r-iCre Ptger4fl/fl mice during dextran sulfate sodium (DSS)-induced colitis. The effect of PTGER4+ macrophage secreted molecules was investigated on epithelial organoid differentiation.ResultsHere, we describe a subset of PTGER4-expressing intestinal macrophages with mucosal healing properties both in humans and mice. Csf1r-iCre Ptger4fl/fl mice showed defective mucosal healing and epithelial barrier regeneration in a model of DSS colitis. Mechanistically, an increased mucosal level of PGE2 triggers chemokine (C-X-C motif) ligand 1 (CXCL1) secretion in monocyte-derived PTGER4+ macrophages via mitogen-activated protein kinases (MAPKs). CXCL1 drives epithelial cell differentiation and proliferation from regenerating crypts during colitis. Specific therapeutic targeting of macrophages with liposomes loaded with an MAPK agonist augmented the production of CXCL1 in vivo in conditional macrophage PTGER4-deficient mice, restoring their defective epithelial regeneration and favouring mucosal healing.ConclusionPTGER4+ intestinal macrophages are essential for supporting the intestinal stem cell niche and regeneration of the injured epithelium. Our results pave the way for the development of a new class of therapeutic targets to promote macrophage healing functions and favour remission in patients with IBD.
Using synthetic control methodology to estimate effects of aCure Violenceintervention in Baltimore, Maryland
Authors: Buggs Shani A , Webster Daniel W , Crifasi Cassandra K 
Published: February 2021

ObjectiveTo estimate the long-term impact of Safe Streets Baltimore, which is based on theCure Violenceoutreach and violence interruption model, on firearm violence.MethodsWe used synthetic control methods to estimate programme effects on homicides and incidents of non-fatal penetrating firearm injury (non-fatal shootings) in neighbourhoods that had Safe Streets’ sites and model-generated counterfactuals. Synthetic control analyses were conducted for each firearm violence outcome in each of the seven areas where Safe Streets was implemented. The study also investigated variation in programme impact over time by generating effect estimates of varying durations for the longest-running programme sites.ResultsSynthetic control models reduced prediction error relative to regression analyses. Estimates of Safe Streets’ effects on firearm violence varied across intervention sites: some positive, some negative and no effect. Beneficial programme effects on firearm violence reported in prior research were found to have attenuated over time.ConclusionsFor highly targeted interventions, synthetic control methods may provide more valid estimates of programme impact than panel regression with data from all city neighbourhoods. This research offers new understanding about the effectiveness of theCure Violenceintervention over extended periods of time in seven neighbourhoods. Combined with existingCure Violenceevaluation literature, it also raises questions about contextual and implementation factors that might influence programme outcomes.
Neurofilament light chain predicts future dementia risk in cerebral small vessel disease
Authors: Egle Marco , Loubiere Laurence , Maceski Aleksandra , Kuhle Jens , Peters Nils , Markus Hugh S 
Published: February 2021

ObjectivesSerum neurofilament light chain (NfL) has been proposed as prognostic markers in neurogenerative disease. A cross-sectional study in cerebral small vessel disease (SVD) reported an association with cognition and disability. If NfL is to be used to predict outcome, studies are required to demonstrate baseline NfL predicts future dementia risk. Furthermore, if it is to be used as a surrogate marker in clinical trials, change in NfL over time periods typical of a clinical trial must be linked to clinical progression. In a longitudinal study of patients with lacunar stroke and confluent white matter hyperintensities, we determined whether both baseline, and change, in NfL levels were linked to changes in MRI markers, cognitive decline and dementia risk.MethodsPatients underwent MRI, cognitive testing and blood taking at baseline and annually for 3 years. Clinical and cognitive follow-up continued for 5 years.ResultsNfL data were available for 113 subjects for baseline analysis, and 90 patients for the longitudinal analysis. Baseline NfL predicted cognitive decline (global cognition β=−0.335, SE=0.094, p=0.001) and risk of converting to dementia (HR=1.676 (95% CI 1.183 to 2.373), p=0.004). In contrast to imaging, there was no change in NfL values over the follow-up period.ConclusionsBaseline NfL predicts changes in MRI markers, cognitive decline and dementia rate over a 5 years follow-up period in SVD, suggesting NfL may be a useful prognostic marker. However, change in NfL values was not detected, and therefore NfL may not be a useful surrogate marker in clinical trials in SVD.