bluuebunny/crossref_metadata_2025_split huggingface dataset:
Compensating for Soft-Tissue Artifact Using the Orientation of Distal Limb Segments During Electromagnetic Motion Capture of the Upper Limb
Authors: Bons Zachary , Dickinson Taylor , Clark Ryan , Beardsley Kari , Charles Steven K. 
Published: December 2021

AbstractMost motion capture measurements suffer from soft-tissue artifacts (STA). Especially affected are rotations about the long axis of a limb segment, such as humeral internal-external rotation (HIER) and forearm pronation-supination (FPS). Unfortunately, most existing methods to compensate for STA were designed for optoelectronic motion capture systems. We present and evaluate an STA compensation method that (1) compensates for STA in HIER and/or FPS, (2) is developed specifically for electromagnetic motion capture systems, and (3) does not require additional calibration or data. To compensate for STA, calculation of HIER angles relies on forearm orientation, and calculation of FPS angles rely on hand orientation. To test this approach, we recorded whole-arm movement data from eight subjects and compared their joint angle trajectories calculated according to progressive levels of STA compensation. Compensated HIER and FPS angles were significantly larger than uncompensated angles. Although the effect of STA compensation on other joint angles (besides HIER and FPS) was usually modest, significant effects were seen in certain degrees-of-freedom under some conditions. Overall, the method functioned as intended during most of the range of motion of the upper limb, but it becomes unstable in extreme elbow extension and extreme wrist flexion–extension. Specifically, this method is not recommended for movements within 20 deg of full elbow extension, full wrist flexion, or full wrist extension. Since this method does not require additional calibration of data, it can be applied retroactively to data collected without the intent to compensate for STA.
A Family of Novel Compliant Linear-Motion Mechanisms Based on Compliant Rolling-Contact Element Pivot
Authors: Huo Tonglong , Yu Jingjun , Zhao Hongzhe , Wei Xian 
Published: December 2021

Abstract
Compliant linear-motion mechanisms are of great use in precision machines due to their excellent performances such as infinite resolution and low cost. The accuracy of the mechanisms is an important consideration for mechanical design in applications, especially in the case of large working load. Considering that COmpliant Rolling-contact Element (CORE) pivot is characterized with high bearing capacity, the paper adopts it as a building block to design a family of compliant linear-motion mechanisms for applications of heavy load. These mechanisms are achieved by replacing four rigid pivots in a parallel four-bar mechanism with CORE pivots, and the motion accuracy is improved by means of contacting surfaces design of four CORE pivots. First, structures of CORE pivot are introduced and five extended arrangements for bearing heavy load are presented. Meanwhile, motion for the CORE pivot is analyzed and preconditions for achieving a pure roll are discussed. Then, configuration of the compliant linear-motion mechanisms constructed by CORE pivots is obtained, and kinematics of the mechanisms is analyzed and parametric design condition for rectilinear motion is modeled. Based on the condition, detailed topological structures of the mechanisms are designed. Finally, motion simulations and experiment tests are implemented to verify accuracy of the proposed mechanisms. The results demonstrate that the mechanisms proposed in this paper are capable of offering a high-precision linear motion and providing a promising application prospect in precision machines.
A Contra-Rotating Open Rotor Noise Reduction Methodology by Using Anhedral Blade Tip
Authors: Yang Tianxiao , Yu Wenjun , Liang Dong , He Xiang , Zhao Zhenguo 
Published: December 2021

Abstract
In this article, a novel contra-rotating open rotor (CROR) noise reduction methodology based on the anhedral blade tip applied to the front blade is developed. Results indicate that anhedral blade tip can provide noise reduction over 60 deg. polar angle range in both upstream and downstream areas at takeoff condition. The noise reduction becomes more significant as the lean angle of anhedral blade tip increases, and the maximum noise reduction is over 4 dB. Further analysis shows that anhedral blade tip decreases the strength and size of blade tip vortex shed from the front blade and reduces its interaction with the rear rotor, which decreases the fluctuation of loading acting on the rear rotor and its loading noise. Furthermore, the anhedral blade tip does not have a significant effect on the aerodynamic performance of CROR at cruise.
New insights into organic matter accumulation from high-resolution geochemical analysis of a black shale: Middle and Upper Devonian Horn River Group, Canada
Authors: Zhou Haolin , Harris Nicholas B. , Dong Tian , Ayranci Korhan , Feng Jilu , Rivard Benoit , Hackley Paul , Hatcherian Javin 
Published: December 2021

Abstract
Organic matter (OM) accumulation in organic matter-rich mudstones, or black shales, is generally recognized to be controlled by combinations of bioproductivity, preservation, and dilution. However, specific triggers of OM deposition in these formations are commonly difficult to identify with geochemical proxies, in part because of feedbacks that cause geochemical proxies for these controls to vary synchronously. This apparent synchronicity is partly a function of sample spacing, commonly at decimeter to meter intervals, which may represent longer periods of time than is required for the development of feedbacks. Higher resolution data sets may be required to fully interpret OM accumulation.
This study applies a novel combination of technologies to develop a high-resolution geochemical data set, integrating energy-dispersive X-ray fluorescence (EDXRF) and infrared imagery analyses, to record proxies for redox conditions, bioproductivity, and clastic and carbonate dilution in millimeter-resolution profiles of 133 core slabs from the Middle and Upper Devonian Horn River shale in the Western Canada Sedimentary Basin, which provides decadal-scale temporal resolution. A comparison to a more coarsely sampled data set from the same core results in substantially different interpretations of variations in bioproductivity, redox, and dilution proxies. Stratigraphic distributions of organic matter accumulation patterns (bioproductivity-control, siliciclastic/carbonate-dilution, and redox conditions-control) show that organic enrichment events were highly varied during deposition of the shale and were closely related to second- and third-order sea-level changes. High-resolution profiles indicate that bioproductivity was the predominant trigger for organic matter accumulation in a second-order highstand, particularly during deposition of third-order transgressive systems tracts. Organic matter accumulation was largely controlled by dilution from either carbonate or clastic sediments in a second-order lowstand. Bioproductivity-redox feedbacks developed on timescales of decades to centuries.
Risk of a post-colonoscopy colorectal cancer in patients with type 2 diabetes: a Danish population-based cohort study
Authors: Troelsen Frederikke Schønfeldt , Sørensen Henrik Toft , Pedersen Lars , Erichsen Rune 
Published: December 2021

ObjectivePrevalent type 2 diabetes (T2D) is associated with an increased risk of colorectal cancer and could impair the quality of bowel preparation for colonoscopy. This may in turn increase the risk of overlooked precancerous polyps and subsequent risk of post-colonoscopy colorectal cancer (PCCRC). We investigated whether patients with T2D are at increased risk of PCCRC compared with patients without T2D.DesignWe conducted a population-based cohort study of patients with T2D and without T2D undergoing colonoscopy in Denmark (1995–2015). We investigated the risk of PCCRC by calculating >6 to 36 months cumulative incidence proportions (CIPs) treating death and colectomy as competing risks. Using Cox proportional-hazards regression analyses, we also computed HRs of PCCRC, comparing patients with T2D and non-T2D. According to the World Endoscopy Organization guidelines, we calculated PCCRC 3-year rates to estimate the proportions of T2D and non-T2D CRC patients experiencing PCCRC.ResultsWe identified 29 031 patients with T2D and 333 232 patients without T2D undergoing colonoscopy. We observed 250 PCCRCs among patients with T2D and 1658 PCCRCs among patients without T2D. The >6 to 36 months CIP after a first-time colonoscopy was 0.64% (95% CI 0.55% to 0.74%) for T2D and 0.36% (95% CI 0.34% to 0.38%) for patients without T2D. The HRs of PCCRC were 1.43 (95% CI 1.21 to 1.72) after a first-time colonoscopy and 1.18 (95% CI 0.75 to 1.85) after a second-time colonoscopy. The PCCRC 3-year rate was 7.9% for patients with T2D and 7.4% for patients without T2D.ConclusionT2D may be associated with an increased HR of PCCRC.
Improving equity in the distribution and financing of health services in Mauritius, a small island state with deeply rooted welfare state standards
Authors: Nundoochan Ajoy 
Published: December 2021

BackgroundEnsuring benefits of free healthcare services are accessible to those in need is essential to achieve universal health coverage (UHC). Mauritius has sustained a welfare state over four decades with free health services in all public facilities. However, paradoxically, the national UHC service coverage index stood at only 63 in 2017. An assessment of who benefits from health interventions is, therefore, vital to shape future health financing strategies.MethodsThe study applied benefit incidence analysis (BIA) to understand the distribution of healthcare utilisation and spending in comparison to income distribution. Also, a financial incidence analysis (FIA) was conducted to assess the progressivity of the health financing systems. Data from the national survey on household out-of-pocket (OOP) expenditure for health were used for the purpose of BIA and FIA. Concentration curves and concentration indices (CI) were nationally estimated and disaggregated to rural/urban levels. Kakwani index (KI) was calculated to assess the progressivity of private healthcare financing.ResultsThe CI for outpatient, inpatient and day care within the public health sector is estimated at −0.33, –0.14 and −0.14, respectively. Overall, CI in the public sector is −0.26. Benefit distribution in the private sector is pro-rich with CI of 0.27. Healthcare financing is regressive as demonstrated by a KI of −0.004, with the poorest population groups contributing a large share, in terms of taxes and OOP, to finance the health system.ConclusionThe BIA posits that government spending on public healthcare has resulted in significant pro-poor services distribution. This is largely offset by pro-rich distribution in the private sector. Thus, implying health financing strategies must be reviewed to promote financial protection against catastrophic health payments and bolster efforts to improve UHC service coverage index and achieve UHC Target 3.8 under Sustainable Development Goal 3.
Comparative efficacy and safety of anti-HGF/MET pathway agents plus chemotherapy versus chemotherapy alone as first-line treatment in advanced gastric cancer: a protocol for a systematic review and meta-analysis
Authors: Jiang Zhiyuan , Cai Zhaolun , Ma Qin , Shen Chaoyong , Yin Yuan , Yin Xiaonan , Liu Chunyu , Chang Chen , Zhao Zhou , Mu Mingchun , Zhang Bo 
Published: December 2021

IntroductionPhase I/II clinical trials suggested that the hepatocyte growth factor (HGF)/mesenchymal-epithelial transition (MET) pathway-targeted agents were active in suppression of gastric cancer (GC). Randomised controlled trials (RCTs) were undertaken assessing whether the addition of anti-HGF/MET agent (rilotumumab or onartuzumab) to chemotherapy improves survival outcomes of advanced GC, but conflict conclusions were reached. Therefore, we plan to perform this systematic review and meta-analysis to synthesise evidence concerning efficacy and safety of anti-HGF/MET agents combined with chemotherapy as the first-line treatment to advanced GC.Methods and analysisSystematic searches of the PubMed, Embase and the Cochrane Central Register of Controlled Trials will be performed with no language restriction from inception to 31 January 2022 to identify RCTs exploring the comparative efficacy and safety of anti-HGF/MET agents plus chemotherapy as first-line treatment in advanced GC. The primary outcome will be the time-to-event progression-free survival and overall survival, and the secondary outcomes will be disease control rate, overall adverse events rate and grade 3–5 adverse events rate. Statistical heterogeneity will be assessed by visual inspection of forest plots and measured using the I2statistics. A fixed-effect model will be used when heterogeneity is low otherwise, a random-effect model will be chosen. Publication bias will be assessed by funnel plots; subgroup analysis and sensitivity analysis will be performed in the right context. For each outcome, we will perform data synthesis using Rev Man V.5.3 software, and compile ‘summary of findings’ tables using GRADEpro software.Ethics and disseminationThere is no requirement for ethics approval because no individual data will be collected in this research. It is anticipated that the dissemination of results will take place at conferences and through publication in a peer-review journal, any adjustments from the protocol will be clearly documented and explained in its final report.PROSPERO registration numberCRD42020177404.
Detecting young people with mental disorders: a cluster-randomised trial of multidisciplinary health teams at the GP office
Authors: Haavet Ole Rikard , Šaltytė Benth Jūratė , Gjelstad Svein , Hanssen-Bauer Ketil , Dahli Mina Piiksi , Kates Nick , Ruud Torleif 
Published: December 2021

BackgroundYoung people with mental health challenges present a major global challenge. More than half of adults with mental disorders experience their onset before age 14, but early detection and intervention may change this course. Shared care with mental health professionals in general practitioner (GP) offices has demonstrated its potential for improvement in these conditions.AimTo investigate whether shared care with mental health professionals in GP offices increases the detection of youth’s mental health disorders and is associated with a decrease in use of unspecified symptom diagnoses, as a whole and stratified by patient and physician gender and age, and type of consulting physician.Design and settingThis was a stratified cluster-randomised controlled trial with data extraction from electronic records. Two GP offices were recruited from each of three boroughs. Each borough had 3–8 GP offices. One GP office was randomised to the intervention group and the other to the control group.MethodWe used generalised linear mixed models to assess whether the intervention helped GPs identify more International Classification of Primary Care 2 diagnoses of depression, anxiety and unspecified symptoms in youth.ResultsOver a 18-month period between between 2015 and 2017, the intervention helped GPs identify more youth with anxiety (p=0.002 for interaction), but not depression. The increase was most significant among the patients’ regular GPs, less when patients met other GPs and least among external substitute physicians. The frequency of diagnoses with unspecified symptoms decreased in the intervention arm.ConclusionShared care with mental health professionals located in GP office contributed to increased detection of youth with anxiety symptoms. The increase was most prominent when the primary care physician was the patient’s regular GP. GPs need to pay greater attention to detecting anxiety in youth and embrace shared care models, thereby contributing to reduced mental health disorders in this age group.Trial registration numberNCT03624829; Results.
Randomised clinical trial research within Aboriginal and Torres Strait Islander primary health services: a qualitative study
Authors: Abbott Penelope , Askew Deborah , Watego Chelsea , Hu Wendy CY , Campbell Letitia , Tyson Claudette , Walsh Robyn , Hussey Sylvia , Doyle Kerrie , Gunasekera Hasantha , Leach Amanda Jane , Usherwood Tim , Armstrong-Kearns Jessica , Reath Jennifer 
Published: December 2021

ObjectiveTo better understand how to undertake valuable, ethical and sustainable randomised controlled clinical trial (RCT) research within Aboriginal and Torres Strait Islander primary health services.DesignIn a qualitative approach, we utilised data collected between 2013 and 2020 during the planning and implementation of two RCTs. The data comprised agreed records of research meetings, and semistructured interviews with clinical trial stakeholders. The stakeholders were parents/carers of child participants, and site-based research officers, healthcare providers and community advisory groups. Our thematic analysis was informed by constructivist grounded theory.SettingThe RCTs investigated the management of otitis media in Aboriginal and Torres Strait Islander children, with the first RCT commencing recruitment in 2014 and the second in 2017. They took place in Aboriginal Medical Services (AMSs), large primary health services for Aboriginal and Torres Strait Islander people, based in urban and regional communities across two Australian states and one territory.ResultsWe analysed data from 56 meetings and 67 interviews, generating themes on making research valuable and undertaking ethical and sustainable RCTs. Aboriginal and Torres Strait Islander leadership, and support of AMSs in their service delivery function were critical. The broad benefits of the trials were considered important to sustainability, including workforce development, enhanced ear healthcare and multidirectional research capacity building. Participants emphasised the long-term responsibility of research teams to deliver benefits to AMSs and communities regardless of RCT outcomes, and to focus on relationships, reciprocity and creating positive experiences of research.ConclusionWe identify principles and strategies to assist in undertaking ethical and sustainable RCTs within Aboriginal and Torres Strait Islander primary health services. Maintaining relationships with AMSs and focusing on mutual workforce development and capacity building creates opportunities for long-term benefits so that health research and RCTs work for Aboriginal and Torres Strait Islander peoples, services, communities and researchers.Trial registration numberACTRN12613001068752 (Pre-results); ACTRN12617001652369 (Pre-results).
Prospective comparative study of quantitative X-ray (QXR) versus dual energy X-ray absorptiometry to determine the performance of QXR as a predictor of bone health for adult patients in secondary care
Authors: Rangan Amar , Tuck Stephen P , Scott Paul D , Kottam Lucksy , Jafari Maya , Watson Terence , Lopez Ben , Crone Ben , Whitbread Tim , Ratcliffe Adam 
Published: December 2021

ObjectivesTo evaluate a method of quantitative X-ray (QXR) for obtaining bone health information from standard radiographs aimed at identifying early signs of osteoporosis to enable improved referral and treatment. This QXR measurement is performed by postexposure analysis of standard radiographs, meaning bone health data can be acquired opportunistically, alongside routine imaging.DesignThe relationship between QXR and dual energy X-ray absorptiometry (DEXA) was demonstrated with a phantom study. A prospective clinical study was conducted to establish areal bone mineral density (aBMD) prediction model and a risk prediction model of a non-normal DEXA outcome. This was then extrapolated to a larger patient group with DEXA referral data.SettingSecondary care National Health Service Hospital.Participants126 consenting adult patients from a DEXA clinic.InterventionsAll participants underwent a DEXA scan to determine BMD at the lumbar spine (L2–L4) and both hips. An additional Antero-Posterior pelvis X-ray on a Siemens Ysio, fixed digital radiograph system was performed for the study.OutcomePerformance of QXR as a risk predictor for non-normal (osteoporotic) BMD.ResultsInterim clinical study data from 78 patients confirmed a receiver operator curve (area under the ROC curve) of 0.893 (95% CI 0.843 to 0.942) for a risk prediction model of non-normal DEXA outcome. Extrapolation of these results to a larger patient group of 11 029 patients indicated a positive predictive value of 0.98 (sensitivity of 0.8) for a population of patients referred to DEXA under current clinical referral criteria.ConclusionsThis study confirms that the novel QXR method provides accurate prediction of a DEXA outcome.Trial registration numberISRCTN98160454; Pre-results.
Targeted Interventions in Tourette’s using Advanced Neuroimaging and Stimulation (TITANS): study protocol for a double-blind, randomised controlled trial of transcranial magnetic stimulation (TMS) to the supplementary motor area in children with Tourette’s syndrome
Authors: Kahl Cynthia K , Swansburg Rose , Kirton Adam , Pringsheim Tamara , Wilcox Gabrielle , Zewdie Ephrem , Harris Ashley , Croarkin Paul E , Nettel-Aguirre Alberto , Chenji Sneha , MacMaster Frank P 
Published: December 2021

IntroductionTourette’s syndrome (TS) affects approximately 1% of children. This study will determine the efficacy and safety of paired comprehensive behavioural intervention for tics (CBIT) plus repetitive transcranial magnetic stimulation (rTMS) treatment in children with Tourette’s syndrome. We hypothesise that CBIT and active rTMS to the supplementary motor area (SMA) will (1) decrease tic severity, and (2) be associated with changes indicative of enhanced neuroplasticity (eg, changes in in vivo metabolite concentrations and TMS neurophysiology measures).Methods and analysisThis study will recruit 50 youth with TS, aged 6–18 for a phase II, double-blind, block randomised, sham-controlled trial comparing active rTMS plus CBIT to sham rTMS plus CBIT in a 1:1 ratio. The CBIT protocol is eight sessions over 10 weeks, once a week for 6 weeks and then biweekly. The rTMS protocol is 20 sessions of functional MRI-guided, low-frequency (1 Hz) rTMS targeted to the bilateral SMA over 5 weeks (weeks 2–6). MRI, clinical and motor assessments and neurophysiological evaluations including motor mapping will be performed 1 week before CBIT start, 1 week after rTMS treatment and 1 week after CBIT completion. The primary outcome measure is Tourette’s symptom change from baseline to post-CBIT treatment, as measured by the Yale Global Tic Severity Scale. Secondary outcomes include changes in imaging, neurophysiological and behavioural markers.Ethics and disseminationEthical approval by the Conjoint Health Research Ethics Board (REB18-0220). The results of this study will be published in peer-reviewed scientific journals, on ClinicalTrials.gov and shared with the Tourette and OCD Alberta Network. The results will also be disseminated through the Alberta Addictions and Mental Health Research Hub.Trial registrationNCT03844919.