bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Activity Recognition Framework for Monitoring Non-Steady-State Locomotion of Individuals with Parkinson’s Disease
Authors: Kazemimoghadam Mahdieh , Fey Nicholas 
Published: January 2021

Abstract
Background: Fundamental knowledge in activity recognition of individuals with motor disorders such as Parkinson’s disease (PD) has been primarily limited to detection of steady-state/static tasks (e.g., sitting, standing, walking), and identification of non-steady-state locomotion on uneven terrains (stairs, ramps) has not received much attention. Furthermore, previous research has mainly relied on data from a large number of locations which could adversely affect user convenience and system performance. Methods: Here, individuals with mild stages of PD and healthy subjects performed non-steady-state circuit trials comprising stairs, ramp, and changes of direction. An offline analysis using a linear discriminant analysis (LDA) classifier and a Long-Short Term Memory (LSTM) neural network was performed for task recognition. The performance of accelerographic and gyroscopic information from varied lower/upper-body segments were tested across a set of user-independent and user-dependent training paradigms. Results: Comparing the F1 score of a given segment across classifiers showed improved performance using LSTM compared to LDA. Using LSTM, even a subset of information (e.g., feet data) in subject-independent paradigms appeared to provide F1 score > 0.8. However, employing LDA was shown to be at the expense of being limited to using a subject-dependent paradigm and/or biomechanical data from multiple body locations. Conclusion: The findings could inform a number of applications in the field of healthcare monitoring and developing advanced lower-limb assistive devices by providing insights into classification schemes capable of handling non-steady-state and unstructured locomotion in individuals with mild Parkinson’s disease.
Rigorous Method of Weights Calculation in Adjustment of Measurement Data with Different Qualities
Authors: Xiaoming Ye , Shijun Ding 
Published: January 2021

Abstract
In the traditional measurement theory, precision is defined as the dispersion of measured value, and is used as the basis of weights calculation in the adjustment of measurement data with different qualities, which leads to the trouble that trueness is completely ignored in the weight allocation. In this paper, following the concepts of pure probability theory, the measured value (observed value) is regarded as a constant, the error as a random variable, and the variance is interpreted as the dispersion of all possible values of the error. Thus, a rigorous formula for weights calculation and variance propagation is derived, which solves the theoretical problem of determining the weight values in the adjustment of multi-channel observation data with different qualities.
A Novel External Fixator to Facilitate Accurate and Efficient Fracture Treatment
Authors: Shen Mingkui , Wang Lulu , Ai Zizheng , Li Jingna , Liang Huaping , Dong Xieping 
Published: January 2021

Abstract
Background: The rapid popularization and application of bone external fixation technology has led to external fixators emerging as remarkable methods to treat various complex fractures. Because of their instability, assembly complexity and poor controllability, however, new external fixators are challenging to design in terms of facilitating accurate and efficient fracture treatment.Methods: We designed a novel external fixator that could feasibly treat clinical complex fractures. A prospective study was conducted on patients with various complex fractures from September 2017 to September 2019. During this period, we treated 24 patients with a universal joint external fixator and then evaluated its therapeutic effects. In this study, adult cadaver femur fracture fixations were modelled by using universal joint (UJ) and AO external fixators, and the mechanical stability was assessed by applying a biomechanical testing device.Results: The designed device not only fits the repair site but could also be conveniently installed and implanted. All patients achieved good fixation and fracture healing with the universal joint fracture external fixators. In in vitro biomechanical testing, constructs were loaded under axial compression, lateral compression and torsion. Overall axial stiffness showed no significant differences between the two groups. The lateral stiffness was 1.554 ± 0.017 mm for the UJ group and 1.342 ± 0.020 mm for the AO group (p<0.001) under a 600 N load, while the torsional stiffness was 15.727 ± 0.141° for the UJ group and 14.472 ± 0.292° for the AO group under a 40 Nm load.Conclusion: In this small and preliminary study, the universal joint external fixator, which achieved a stable mechanical structure, was capable of intensive and efficient treatment for comprehensive fractures. If these findings can be confirmed in a larger study, this external fixator may be widely used in certain situations where traditional external fixators are not a convenient option.
Postoperative Bisphosphonate Do Not Significantly Alter The Fusion Rate After Lumbar Spinal Fusion: A Meta-Analysis
Authors: Mei Jun , Song Xiaoxu , Guan Xiaoming , Wu Dou , Wang Junjie , Liu Qiang 
Published: January 2021

Abstract
BACKGROUND: To evaluate the effect of postoperative BP treatment on improving the fusion rate after lumbar spinal fusion surgery by performing a meta-analysis of randomized controlled trials (RCTs) and other comparative cohort studies.METHODS: A comprehensive search of PubMed, EMBASE, the Web of Science and the Cochrane Central Register of Controlled Trials was performed for RCTs and other comparative cohort studies on the effect of BP treatment on improving the fusion rate after lumbar spinal fusion surgery. The primary outcome measures were the number of patients with bone formation grades A, B, and C at 12 months of follow-up, fusion rates at 12 and 24 months of follow-up, vertebral compression fracture (VCF) at 12 and 24 months of follow-up, pedicle screw loosening at 24 months follow-up, cage subsidence, the Oswestry Disability Index (ODI) and the visual analogue score (VAS) at 12 months of follow-up. The final search was performed in July 2020.RESULTS: Seven studies with 401 patients were included. Compared with the placebo, BP treatment did not significantly alter the number of patients with bone formation grades A, B and C, or the VAS at the 12-month follow-up or the fusion rates at the 12- and 24-month follow-ups. In addition, compared with the placebo, BPs significantly reduced the risks of VCF at the 12- and 24-month follow-ups, pedicle screw loosening at the 24-month follow-up, and cage subsidence and the ODI at the 12-month follow-up.CONCLUSIONS: Postoperative BPs do not clearly improve bone formation and the fusion rate, but they reduce VCF, cage subsidence and loosening of pedicle screws after lumbar fusion surgery compared with the control treatment.
Comparison of SDSG and CARDS Classifications for L5/S1 Lumbar Degenerative Spondylolisthesis: an Independent Inter- and Intra-observer Agreement Study
Authors: Sun Zhengwang , Xu Chongqing , Yin Mengchen , Yan Wangjun 
Published: January 2021

Abstract
Background: Lumbar degenerative spondylolisthesis (DS) has been a common disease that make increasing patients suffer from different degrees of low back pain and radicular symptoms. SDSG and CARDS systems are commonly used to classify the disease, and help to make a more detailed treatment plan. The objective of this study is to evaluate the reliability and reproducibility of SDSG and CARDS classifications, and to explore their clinical application value.Methods/Design: All 117 patients with L5/S1 lumbar DS were enrolled. 5 spine surgeons who have certain clinical experience were selected. They determined the classification according to S SDSG and CARDS systems, we used kappa (K) value to check the coefficient consistency for multi-factor and assess the inter- and intra-observer agreement. After 12 weeks, we repeated the analysis.Results: The inter-observer reliability and intra-observer reproducibility of SDSG system were substantial with K values of 0.704 and 0.861, while those of CARDS system were substantial with values of 0.620 and 0.878.Conclusion: SDSG system has better inter-observer reliability in comparison with CARDS system, and though CARDS system is more intuitive and simpler, it is more likely to produce deviations when using it. Since both SDSG and CARDS systems show substantial agreement and have great significance in surgical strategy of L5/S1 lumbar DS, they can be widely used in clinical practice.
Particularities of the Evolution of SARS-CoV-2 Infection in Children
Authors: MARIA TOTAN , Grigore Camelia , ANTONESCU ELISABETA , Gligor Felicia , Duica Lavinia , Silisteanu Sinziana , Maniu Ionela , Cristea Stefan , Grigore Nicolae 
Published: January 2021

Abstract
IntroductionSARS-CoV-2 virus infection was first reported in China in late 2019 and has spread rapidly around the world. There is little information about the peculiarities of COVID-19 infection in children because the number of infected children was small, around 2% of all diseases.MethodsIn this retrospective study, we recruited 143 children infected with SARS-CoV-2 between March and October 2020, in Sibiu, Romania. RT-PCR tests, serum SARS-CoV-2 IgG/ IgM antibodies, lung radiography, biochemical and hematological tests were performed during the hospitalization.ResultsOf the 143 children selected in the study, 47.0% were male and 53% were female. At admission, all children tested positive for SARS-CoV-2, collecting nasopharyngeal exudate.Clinical manifestations included: cough in 75.52% of cases, fever in 55.94% of cases, nasal obstruction in 50.34% of cases, rhinorrhea in 38.46% of cases, muscle pain in 26.57% of cases, fatigue in 17.48% of cases, diarrhea and headache in 14.68% of cases. In 21 children (14,68%), the number of leukocytes was increased. In 38 cases (26,57%), the lung radiograph showed changes similar to bronchopneumonia, and the other cases did not have pulmonary changes. The persistence of the virus in the body of infected children is above the average reported in studies performed in adults, the virus being identified in the respiratory tract between 16 and 34 days. IgG class antibodies in patients' serum appeared between the 4th day of hospitalization and up to a maximum of 25 days, with a mean of 16.5 days.ConclusionThe persistence of the virus in the body of infected children is above the average reported in studies performed in adults, the virus being identified in the respiratory tract between 16 and 34 days. IgG class antibodies in patients' serum appeared within a mean of 16.5 days. All children were treated with symptomatic support without complications.
The Long-term Outcomes of Hepatic Resection Between Single Tumor and Multiple Tumors of HCC Meeting UCSF Criteria
Authors: Zheng Jinli , Xie Wei , Huang Yang , Pu Xingyu , Jiang Li 
Published: January 2021

Abstract
Object: Searching the hepatectomy of hepatocellular carcinoma (HCC) within UCSF is limited. The study aims to compare the long-term surgical outcomes between single and multiple tumors to find an effective and safe treatment for the patients within UCSF criteria.Methods: We have enrolled 1006 patients meeting UCSF criteria, including 744 patients with single tumor and 262 patients with multiple tumors undergoing hepatic resection (HR). We divided the patients into two groups: single tumor group and multiple tumor group. By comparing the long-term outcomes between these two groups and analyzing the risk factors by the log-rank test and cox proportional hazards model in two groups.Results: The 1-, 3-, and 5-year OS rates in the single tumor group were significantly higher than the multiple tumors group (96.2%, 65.3% and 40.1% versus 93.1%, 47.6% and 22.5%, respectively, p<0.001). The 1-, 3- and 5-year RFS rates were 91.4%, 46.2%, and 24.6% in the single group and 90.8%, 31.1% and 13.0%, respectively (p<0.001). And the anatomic resection and MVI were the independent risk factors for single tumor, but it didn’t work for multiple tumors. The independent risk factors of multiple tumors are the diameter more than 2cm of the maximum tumor and the tumors located in different segments.Conclusion: The surgical resection will obtain a better outcomes for the HCC with single tumor meeting UCSF criteria than the multiple tumors. And the anatomic resection should be applied for the patients with single tumor, if possible.
Recurrent Colorectal Liver Metastasis Patients Would Benefit to Repeat Hepatic Resection
Authors: Liu Wei , Liu Jia-Ming , Wang Kun , Wang Hong-Wei , Xing Bao-Cai 
Published: January 2021

Abstract
Background
Local treatment remains the best option for recurrent colorectal liver metastasis. The current study aims to investigate predictive factors of survival outcomes and select candidates of local treatment for CRLM at first recurrence.
Methods
Data were collected retrospectively on CRLM patients who underwent hepatic resection and developed first recurrence between 2000 and 2019 at our institution. A nomogram to predict overall survival was established based on a multivariable Cox model of clinicopathologic factors. The predictive accuracy and discriminative ability of the nomogram were determined by concordance index and calibration curve.
Results
Among 867 patients who underwent curative hepatic resection, 549 patients developed recurrence. Three hundred patients were evaluated to be resectable and liver-limited disease. Among of them, repeat liver resection and percutaneous radiofrequency ablation were performed in 88 and 85 patients, respectively. The other 127 patients only received systemic chemotherapy. Multivariable analysis identified node-positive primary, tumor size > 3 cm, early recurrence, RAS gene mutation and no local treatment were independent risk factors for survival outcome. Integrating these five variables, the nomogram showed good concordance statistics of 0.707. Compared with patients who only received systemic chemotherapy, radical local treatment did not improve survival outcome significantly (median OS: 21 vs. 15 months, p = 0.126) in high risk group (total score above 13).
Conclusion
Radical local treatment is crucial to prolong the survival of recurrent CRLM patients. The proposed model facilitates personalized assessment of prognosis for patients who developed first recurrence in liver.
Development of a Web Tool to Calculate the Cumulative Dose of Glucocorticoids
Authors: Montero-Pastor Nuria , Sánchez-Costa Jesús , Guerra-Rodríguez Mercedes , Moriano Clara , Loricera Javier , Díaz-González Federico 
Published: January 2021

Abstract

Glucocorticoids are associated with many serious side effects, most of which are related to dosing and time of use. Correct assessment of cumulative dose, especially in patients undergoing long-term treatment, is essential to determine the risk of undesirable glucocorticoid-related events. Unfortunately, there is no standard method currently available for determining exposure to glucocorticoids in daily clinical practice. The aim of this work was to create an easy-to-use free-access web application to help clinicians and researchers calculate, in a systematic way, the cumulative dose of corticosteroids in their patients. The total cumulative dose is calculated as the sum of all periods of treatment with different doses of oral or intravenous corticosteroids, and is expressed as the equivalent dose of prednisone in mg. The doses of glucocorticoids during the periods without information are estimated by first determining the average doses between the previous and subsequent periods for which such information is available, and then multiplying that average dose by the number of days of the period. If the day on which glucocorticoids were discontinued is unknown, it is assumed to be the day before the start of the next known treatment period. For unknown start dates, the day after the end of the known prior period is used. In conclusion, this tool simplifies and, through the systematic application of assumptions when information is incomplete, standardizes the glucocorticoids cumulative dose calculation, minimizing bias in the assessment of glucocorticoid-related side effects in the context of daily clinical practice.
The iDEM trial (intervention for Dengue Epidemiology in Malaysia) to measure the effectiveness of integrated vector management with targeted outdoor residual spraying and autodissemination devices on the incidence of dengue in urban Malaysia: Study protocol for a cluster randomized controlled trial
Authors: SAADATIAN-ELAHI Mitra , Alexander Neal , Möhlmann Tim , Langlois-Jacques Carole , Suer Remco , Ahmad Nazni Wasi , Mudin Rose Nani , Ariffin Farah Diana , Baur Frederic , Schmitt Frederic , Richardson Jason H , Rabilloud Muriel , Hamid Nurulhusna Ab 
Published: January 2021

Abstract
Background: In common with many South East Asian countries, Malaysia is endemic for dengue. Dengue control in Malaysia is currently based on reactive vector management within 24 hours of a dengue case being reported. Preventive rather than reactive vector control approaches, with combined interventions, are expected to improve the cost-effectiveness of dengue control programs. The principal objective of this cluster randomized controlled trial is to quantify the effectiveness of a preventive integrated vector management (IVM) strategy on the incidence of dengue as compared to routine vector control efforts. Methods: The trial is conducted in randomly allocated low and medium cost clusters located in the Federal Territory of Kuala Lumpur and Putrajaya. The IVM approach combines: targeted outdoor residual spraying with K-Othrine Polyzone, deployment of mosquito traps as auto-dissemination devices, and community engagement activities. The trial includes 280 clusters randomly allocated in a 1:1 ratio. The clusters receive either the preventive IVM in addition to the routine vector control activities, or the routine vector control activities only. Epidemiological data from monthly confirmed dengue cases during the study period will be obtained from the Vector Borne Disease Sector, Malaysian Ministry of Health e-Dengue surveillance system. Entomological surveillance data will be collected in 12 clusters randomly selected from each arm. To measure the effectiveness of the IVM approach on dengue incidence, a negative binomial regression model will be used to compare the incidence between control and intervention clusters. To quantify the effect of the interventions on the main entomological outcome, ovitrap index, a modified ordinary least squares regression model using a robust standard error estimator will be used. Discussion: Considering the ongoing expansion of dengue burden in Malaysia, setting up proactive control strategies is critical. Despite some limitations of the trial such as the use of passive surveillance to identify cases the results will be informative for a better understanding of effectiveness of proactive IVM approach in the control of dengue. Evidence from this trial may help justify investment in preventive IVM approaches as preferred to reactive case management strategies. Trial registration: ISRCTN, ISRCTN81915073, retrospectively registered on 17 April 2020 (https://doi.org/10.1186/ISRCTN81915073)
The Challenges of Recruitment to a Randomised Trial Registry – What Information Matters to the Patient?
Authors: Murphy Ellen , Shea Niamh O , O'Keeffe Aoife , Long Eva , Eustace Joseph , Shiely Frances 
Published: January 2021

Abstract
Background Randomised controlled trials (RCTs) are the gold standard for demonstrating efficacy of new therapies. Despite this, nephrology trials, especially of patients with end stage renal disease (ESRD) are much fewer in number than other specialties. Recruitment difficulties are cited as a particular challenge. Using registries to conduct RCTs is a reasonably new practice but is appealing as it combines the benefits of observational studies and clinical trials. There is limited literature on patient motivators, barriers, and consent to these registries. The purpose of our study is to establish this. MethodsWe conducted a cross-sectional questionnaire-based study. A questionnaire consisting of closed and open-ended questions was collected at a dialysis centre in Southwest Ireland representing a catchment patient population of approximately 430,000. Quantitative data were coded and analysed in SPSS (v16). Descriptive statistics were produced, and open-ended questions were analysed by thematic analysis. Results 87 patients completed the questionnaire. Motivators for participation included personal and altruistic benefits. Barriers/concerns include time requirements, risks (incl. data safety) and side effects along with impacts on current treatment. Though a total of 29.8% of patients ‘strongly agree/agree’ to having concerns regarding their data storage in a registry, 79.3% of patients were ‘very likely/likely’ to consent to participate in the registry. It was important to patients to have their GP (general practitioner) involved in the decision to participate, despite little day-to-day contact with their GP for renal dialysis management. ConclusionImproving patients understanding of clinical trials, emphasising personal and altruistic benefits, and addressing patient’s concerns regarding time and risks of involvement, may improve their likelihood to participate in a registry for RCTs and more broadly speaking, RCTs.
The COVID-19 Pandemic and New Clinical Trial Activations
Authors: Unger Joseph , Xiao Hong 
Published: January 2021

Abstract
Background The Covid-19 pandemic has caused severe disruptions in care for many patients. A key question is whether the landscape of clinical research has also changed. Methods In a retrospective cohort study, we examined the association of the COVID-19 outbreak with new clinical trial activations. Trial data for all interventional and observational oncology, cardiovascular, and mental health studies from January, 2015 through September, 2020 were obtained from clinicaltrials.gov. An interrupted time-series analysis with Poisson regression was used. Results We examined 62,252 trial activations. During the initial COVID-19 outbreak (February, 2020 through May, 2020), model-estimated monthly trial activations for U.S.-based studies were only 57% of the expected estimate had the pandemic not occurred (relative risk = 0.57, 95% CI, 0.52 to 0.61, p<.001). For non-U.S.-based studies, the impact of the pandemic was less dramatic (relative risk = 0.77, 95% CI, 0.73 to 0.82, p<.001), resulting in an overall 27% reduction in the relative risk of new trial activations for U.S.-based trials compared to non-U.S.-based trials (relative risk ratio = 0.73, 95% CI, 0.67 to 0.81, p<.001). Although a rebound occurred in the initial reopening phase (June, 2020 through September, 2020), the rebound was weaker for U.S.-based studies compared to non-U.S. based studies (relative risk ratio = 0.87, 95% CI, 0.80 to 0.95, p<.001). ConclusionsThese findings are consistent with the disproportionate burden of COVID-19 diagnoses and deaths during the initial phase of the pandemic in the U.S. Reduced activation of cancer clinical trials will likely slow the pace of clinical research and new drug discovery, with long-term negative consequences for cancer patients. An important question is whether the renewed outbreak period of winter 2020/2021 will have a similarly negative impact on the initiation of new clinical research studies for non-COVID-19 diseases.