bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigating the natural history and prognostic factors of ASD in children: the multicEntric Longitudinal study of childrEN with ASD - the ELENA study protocol
Authors: Baghdadli Amaria , Miot Stéphanie , Rattaz Cécile , Akbaraly Tasnime , Geoffray Marie-Maude , Michelon Cécile , Loubersac Julie , Traver Sabine , Mortamais Marion , Sonié Sandrine , Pottelette Julien , Robel Laurence , Speranza Mario , Vesperini Stéphanie , Maffre Thierry , Falissard Bruno , Picot Marie-Christine 
Published: June 2019

IntroductionThere is global concern about the increasing prevalence of autism spectrum disorders (ASDs), which are early-onset and long-lasting disorders. Although ASDs are considered to comprise a unique syndrome, their clinical presentation and outcome vary widely. Large-scale and long-term cohort studies of well-phenotyped samples are needed to better understand the course of ASDs and their determinants. The primary objective of the multicEntric Longitudinal study of childrEN with ASD (ELENA) study is to understand the natural history of ASD in children and identify the risk and prognostic factors that affect their health and development.Methods and analysisThis is a multicentric, longitudinal, prospective, observational cohort in which 1000 children with ASD diagnosed between 2 and 16 years of age will be recruited by 2020 and followed over 6 years. The baseline follow-up starts with the clinical examination to establish the ASD diagnosis. A battery of clinical tools consisting of the Autism Diagnostic Observation Schedule, the revised version of the Autism Diagnostic Interview, measures of intellectual functioning, as well as large-scale behavioural and developmental measurements will allow us to study the heterogeneity of the clinical presentation of ASD subtypes. Subsequent follow-up at 18 months and at 3, 4.5 and 6 years after the baseline examination will allow us to explore the developmental trajectories and variables associated with the severity of ASD. In addition to the children’s clinical and developmental examinations, parents are invited to complete self-reported questionnaires concerning perinatal and early postnatal history, congenital anomalies, genetic factors, lifestyle factors, medical and psychiatric comorbidities, and the socioeconomic environment. As of 1 November 2018, a total of 766 participants have been included.Ethics and disseminationEthical approval was obtained through the Marseille Mediterranean Ethics Committee (ID RCB: 2014-A01423-44), France. We aim to disseminate the findings through national and international conferences, international peer-reviewed journals, and social media.Trial registration numberNCT02625116; Pre-results.
Different potencies of topical corticosteroids for a better treatment strategy in children with atopic dermatitis (the Rotterdam Eczema study): protocol for an observational cohort study with an embedded randomised open-label controlled trial
Authors: van Halewijn Karlijn F , Bohnen Arthur M , van den Berg Pieter J , Pasmans Suzanne G M A , Bindels Patrick J E , Elshout Gijs 
Published: June 2019

IntroductionTopical corticosteroids (TCS) of different potencies are the main treatment to control atopic dermatitis (AD). The Dutch guideline on AD for general practitioners (GPs) recommends a stepwise approach in which treatment steps are tailored to the severity of the disease, starting with the lowest possible potency of TCS. However, it remains unclear whether the recommended stepwise approach is most efficient. This randomised open-label controlled trial aims to determine whether a potent TCS is more effective than a low-potency TCS in the initial treatment of children with a moderate flare-up of AD in primary care. In the observational cohort, the overall aim is to determine the frequency, burden and determinants of flare-ups of AD during follow-up.Methods and analysisThe study is an observational cohort study with an embedded pragmatic randomised controlled, open-label trial. Eligible are patients diagnosed with AD (aged 12 weeks to 18 years) who visited the GP for AD or received repeated prescriptions for AD in the previous 12 months; follow-up of the cohort is 1 year. Children are enrolled in the trial if they have a flare-up of AD during follow-up in the cohort. Eligible children are randomised to the intervention group (with a potent TCS once daily) or to the GP guideline group (with a low potency TCS once daily). Primary outcome is the difference in average subjective disease severity over 24 weeks follow-up in the trial, measured with the patient-oriented eczema measure. As secondary outcome, the Eczema Area and Severity Index is measured.Ethics and disseminationThis study tests the hypothesis that immediate treatment with a potent TCS during a flare-up of AD leads to faster and more efficacious results as compared with starting with a TCS with low potency with less overall use of TCS. The study protocol is approved by the Medical Ethics Committee (MEC) of the Erasmus Medical Center Rotterdam, the Netherlands (MEC-2017–328). The results of the study will be published in international peer-reviewed journals and presented at national and international conferences.Trial registration numberNTR: 6679; Pre-results.
Novel insights of overtraining syndrome discovered from the EROS study
Authors: Cadegiani Flavio A , Kater Claudio Elias 
Published: June 2019

BackgroundExcessive training and inadequate recovery could cause ‘overtraining syndrome’ (OTS), which is characterised by underperformance and fatigue. The pathophysiology of OTS is unclear. We aimed to describe novel mechanisms and risk factors associated with OTS, and thereby facilitate its early identification and prevention, from a comprehensive joint qualitative analysis of the findings from all the four arms of the Endocrine and Metabolic Responses on Overtraining Syndrome (EROS) study.MethodsWe compared the types and proportions of behavioural patterns of 67 evaluated parameters of OTS from 51 participants—athletes with OTS (OTS, n=14), healthy athletes (n=25) and healthy non-physically active controls (n=12). We performed overall and pairwise comparisons for statistically significant differences between the three groups (p<0.05).ResultsA total of 44 (65.7%) markers exhibited significant differences between the three groups: 32 (72.7%) showed a loss of the conditioning effect of exercise (‘deconditioning’), 7 (15.9%) showed changes exclusive to OTS, 3 (6.8%) maintained the exercise-induced conditioning effects and 2 (4.5%) revealed an exacerbation of the adaptive changes to exercises.ConclusionOur findings suggest that OTS is likely triggered by multiple factors, not restricted to excessive training, resulted from a chronic energy deprivation, leading to multiple losses in the conditioning processes typically observed in healthy athletes, as a combination of ‘paradoxical deconditioning’ processes, which explains the gradual and marked loss of physical conditioning found in OTS. We, therefore, suggest that the term ‘paradoxical deconditioning syndrome’ better represents the features of this syndrome.
Cataract surgery for falls prevention and improving vision: modelling the health gain, health system costs and cost-effectiveness in a high-income country
Authors: Boyd Matt , Kvizhinadze Giorgi , Kho Adeline , Wilson Graham , Wilson Nick 
Published: June 2019

AimTo estimate the health gain, health system costs and cost-effectiveness of cataract surgery when expedited as a falls prevention strategy (reducing the waiting time for surgery by 12 months) and as a routine procedure.MethodsAn established injurious falls model designed for the New Zealand (NZ) population (aged 65+ years) was adapted. Key parameters relating to cataracts were sourced from the literature and the NZ Ministry of Health. A health system perspective with discounting at 3% was used.ResultsExpedited cataract surgery for 1 year of incident cases was found to generate a total 240 quality-adjusted life years (QALYs) (95% uncertainty interval (UI) 161 to 360) at net health system costs of NZ$2.43 million (95% UI 2.02 to 2.82 million) over the remaining lifetimes of the surgery group. This intervention was cost-effective by widely accepted standards with an incremental cost-effectiveness ratio (ICER) of NZ$10 600 (US$7540) (95% UI NZ$6030 to NZ$15 700) per QALY gained. The level of cost-effectiveness did not vary greatly by sex, ethnicity and previous fall history, but was higher for the 65–69 age group compared with the oldest age group of 85–89 years (NZ$7000 vs NZ$14 200 per QALY gained). Comparing cataract surgery with no surgery, the ICER was even more favourable at NZ$4380 (95% UI 2410 to 7210) per QALY. Considering only the benefits for vision improvement and excluding the benefits of falls prevention, it was still favourable at NZ$9870 per QALY.ConclusionsExpedited cataract surgery appears very cost-effective. Routine cataract surgery is itself very cost-effective, and its value appears largely driven by the falls prevention benefits.
Mystery or Mycobacterium? Lessons learned from a challenging incision site infection
Authors: Weisent Jennifer , May Elizabeth 
Published: June 2019

An eight‐month‐old female domestic short hair cat underwent routine ovariohysterectomy and was adopted from a shelter nine days later. A refractory infection associated with the abdominal incision site proved unresponsive to surgical debridement and multiple courses of oral antibiotic treatment over 10 weeks, resulting in relinquishment of the cat. Initial diagnostic test samples submitted by the shelter veterinarian failed to identify a causative agent for a deep pyogranulomatous dermatitis and panniculitis. The lesions resolved following treatment with oral pradofloxacin, and the cat was adopted but subsequently lost to follow‐up. This case highlights the importance of generating a differential diagnoses list and outlines difficulties obtaining appropriate and timely diagnostic testing and treatment, especially in cases involving multiple practitioners and financial constraints. The report also emphasises how a challenging and potentially zoonotic infection might be overlooked and under‐reported, specifically in low‐income and shelter settings.
Simulating switchgrass aboveground biomass and production costs in eastern Canada with the Integrated Farm System Model
Authors: Duchemin Marc , Jégo Guillaume , Morissette René 
Published: June 2019

Switchgrass (Panicum virgatum L.) is a herbaceous perennial grass that can be used as bedding for livestock, planted in buffer strips, and used as biofuel, but it is still not widely grown in eastern Canada. The objectives of this study were to verify the performance of the Integrated Farm System Model (IFSM) in simulating switchgrass growth and to estimate its yield potential and production costs in eastern Canada. The performance of IFSM was assessed with dry matter (DM) yield of switchgrass (‘Cave-in-Rock’) measured over three growing seasons (2015–2017) in southern Quebec, Canada. The model performed reasonably well, with normalized root mean square errors of 19.5% for calibration and 27.9% for validation. Simulation results of potential yield and economic management over the long term (1986–2015) for five switchgrass production sites in eastern Canada indicated that average DM yields in Quebec City and Fredericton (9.6 and 9.7 t ha−1, respectively) were significantly lower than average DM yields in Saint-Hubert, Ottawa, and London (10.8, 10.4, and 11.0 t ha−1, respectively). Average annual production costs per tonne of DM for the spring harvest were higher at low-yield sites (CAD$66.67 and $64.50 for Fredericton and Quebec City, respectively) than at high-yield sites ($60.10, $62.82, and $60.08 for Saint-Hubert, Ottawa, and London, respectively). The IFSM-estimated production costs were within the range of the calculated values reported in other agro-economic analyses conducted in Ontario and Quebec.
Automated Detection of Brain Stroke in MRI with Hybrid Fuzzy C-Means Clustering and Random Forest Classifier
Authors: Subudhi Asit , Jena Subhransu S. , Sabut Sukanta 
Published: June 2019

Neuroimaging investigation is an essential parameter to detect infarct lesion in stroke patients. Precise detection of brain lesions is an important task related to impaired behavior. In this paper, we aimed to develop an automatic method to segment and classify infarct lesion in diffusion-weighted imaging (DWI) of brain MRI. The method includes hybrid fuzzy [Formula: see text]-means (HFCM) clustering in which the structure of [Formula: see text]-means clustering is modified with rough sets and fuzzy sets to improve the segmentation performance with self-adjusted intensity thresholds. Quantitative evaluation was carried out on 128 MRI slices of brain image collected from ischemic stroke patients at the Department of Radiology, IMS and SUM Hospital, Bhubaneswar. The informative statistical features have been extracted using gray-level co-occurrence matrix (GLCM) and used to classify the types of stroke infarct according to the Oxfordshire Community Stroke Project (OCSP) classification. The parameters such as accuracy, Dice similarity index (DSI) and Jaccard index (JI) were utilized to evaluate the effectiveness of the proposed method in detecting the stroke lesions. The segmentation method achieved the average accuracy, DSI and JI of 96.8%, 95.8% and 92.2%, respectively, in support vector machine (SVM) classifier. The obtained results are higher in terms of random forest (RF) classification. With a high Dice coefficient of 0.958 and other evaluated parameters, the proposed method outperforms earlier published results.
Balancing Prediction Errors for Robust Sentiment Classification
Authors: Iqbal Mohsin , Karim Asim , Kamiran Faisal 
Published: June 2019

Sentiment classification is a popular text mining task in which textual content (e.g., a message) is assigned a polarity label (typically positive or negative) reflecting the sentiment expressed in it. Sentiment classification is used widely in applications like customer feedback analysis where robustness and correctness of results are critical. In this article, we highlight that prediction accuracy alone is not sufficient for assessing the performance of a sentiment classifier; it is also important that the classifier is not biased toward positive or negative polarity, thus distorting the distribution of positive and negative messages in the predictions. We propose a measure, called Polarity Bias Rate, for quantifying this bias in a sentiment classifier. Second, we present two methods for removing this bias in the predictions of unsupervised and supervised sentiment classifiers. Our first method, called Bias-Aware Thresholding (BAT), shifts the decision boundary to control the bias in the predictions. Motivated from cost-sensitive learning, BAT is easily applicable to both lexicon-based unsupervised and supervised classifiers. Our second method, called Balanced Logistic Regression (BLR) introduces a bias-remover constraint into the standard logistic regression model. BLR is an automatic bias-free supervised sentiment classifier.
We evaluate our methods extensively on seven real-world datasets. The experiments involve two lexicon-based and two supervised sentiment classifiers and include evaluation on multiple train-test data sizes. The results show that bias is controlled effectively in predictions. Furthermore, prediction accuracy is also increased in many cases, thus enhancing the robustness of sentiment classification.
A Distributed Algorithm to Calculate Max-Min Fair Rates Without Per-Flow State
Authors: Jose Lavanya , Ibanez Stephen , Alizadeh Mohammad , McKeown Nick 
Published: June 2019

Most congestion control algorithms, like TCP, rely on a reactive control system that detects congestion, then marches carefully towards a desired operating point (e.g. by modifying the window size or adjusting a rate). In an effort to balance stability and convergence speed, they often take hundreds of RTTs to converge; an increasing problem as networks get faster, with less time to react.
This paper is about an alternative class of congestion control algorithms based on proactive-scheduling: switches and NICs "pro-actively" exchange control messages to run a \em distributed algorithm to pick "explicit rates for each flow. We call these Proactive Explicit Rate Control (PERC) algorithms. They take as input the routing matrix and link speeds, but not a congestion signal. By exploiting information such as the number of flows at a link, they can converge an order of magnitude faster than reactive algorithms.
Our main contributions are (1) s-PERC ("stateless" PERC), a new practical distributed PERC algorithm without per-flow state at the switches, and (2) a proof that s-PERC computes exact max-min fair rates in a known bounded time, the first such algorithm to do so without per-flow state. To analyze s-PERC, we introduce a parallel variant of standard waterfilling, 2-Waterfilling. We prove that s-PERC converges to max-min fair in 6N rounds, where N is the number of iterations 2-Waterfilling takes for the same routing matrix.
We describe how to make s-PERC practical and robust to deploy in real networks. We confirm using realistic simulations and an FPGA hardware testbed that s-PERC converges 10-100x faster than reactive algorithms like TCP, DCTCP and RCP in data-center networks and 1.3--6x faster in wide-area networks (WANs). Long flows complete in close to the ideal time, while short-lived flows are prioritized, making it appropriate for data-centers and WANs.
Separate and combined influences of heat and hypobaric hypoxia on self-paced aerobic exercise performance
Authors: Bradbury Karleigh E. , Coffman Kirsten E. , Mitchell Katherine M. , Luippold Adam J. , Fulco Charles S. , Kenefick Robert W. 
Published: June 2019

Heat and hypobaric hypoxia independently compromise exercise performance; however, their combined impact on exercise performance has yet to be quantified. This study examined the effects of heat, hypobaric hypoxia, and the combination of these environments on self-paced cycling time trial (TT) performance. Twelve subjects [2 female, 10 male; sea level (SL) peak oxygen consumption (V̇o2peak), 41.5 ± 4.4 mL·kg−1·min−1, mean ± SD] completed 30 min of steady-state cycling exercise (50% SL V̇o2peak), followed by a 15-min self-paced TT in four environmental conditions: SL thermoneutral [SLTN; 250 m, 20°C, 30–50% relative humidity (rh)], SL hot (SLH; 250 m, 35°C, 30% rh), hypobaric hypoxia thermoneutral (HTN; 3,000 m, 20°C, 30–50% rh), and hypobaric hypoxia hot (HH; 3,000 m, 35°C, 30% rh). Performance was assessed by the total work (kJ) completed. TT performance was lower ( P < 0.05) in SLH, HTN, and HH relative to SLTN (−15.4 ± 9.7, −24.1 ± 16.2, and −33.1 ± 13.4 kJ, respectively). Additionally, the total work completed in HTN and HH was lower ( P < 0.05) than that in SLH. In SLH, HTN, and HH, work rate was reduced versus SLTN ( P < 0.05) within the first 3 min of exercise and was consistent for the remainder of the bout. No differences ( P > 0.05) existed for heart rate or Ratings of Perceived Exertion at the end of exercise among conditions. The decrease in self-paced TT performance in the heat and/or hypobaric hypoxia conditions compared with SLTN conditions resulted from a nearly immediate reduction in work rate that may have been regulated by environmentally induced changes in physiological strain and perception of effort in response to TT exercise.NEW & NOTEWORTHY This is the first known study to examine the combined effects of heat and hypobaric hypoxia on short-duration self-paced cycling time trial performance. Regardless of environmental condition, subjects utilized an even work rate for the entire duration of the time trial. The presence of both environmental stressors led to a greater performance impairment than heat or hypobaric hypoxia alone, and the performance decrement stemmed from an early reduction of work rate.
Hopping with degressive spring stiffness in a full-leg exoskeleton lowers metabolic cost compared with progressive spring stiffness and hopping without assistance
Authors: Allen Stephen P. , Grabowski Alena M. 
Published: June 2019

When humans hop with a passive-elastic exoskeleton with springs in parallel with both legs, net metabolic power (Pmet) decreases compared with normal hopping (NH). Furthermore, humans retain near-constant total vertical stiffness ( ktot) when hopping with such an exoskeleton. To determine how spring stiffness profile affects Pmetand biomechanics, 10 subjects hopped on both legs normally and with three full-leg exoskeletons that each used a different spring stiffness profile at 2.4, 2.6, 2.8, and 3.0 Hz. Each subject hopped with an exoskeleton that had a degressive spring stiffness (DGexo), where stiffness, the slope of force vs. displacement, is initially high but decreases with greater displacement, linear spring stiffness (LNexo), where stiffness is constant, or progressive spring stiffness (PGexo), where stiffness is initially low but increases with greater displacement. Compared with NH, use of the DGexo, LNexo, and PGexonumerically resulted in 13–24% lower, 4–12% lower, and 0–8% higher Pmet, respectively, at 2.4–3.0 Hz. Hopping with the DGexoreduced Pmetcompared with NH at 2.4–2.6 Hz ( P ≤ 0.0457) and reduced Pmetcompared with the PGexoat 2.4–2.8 Hz ( P < 0.001). ktotwhile hopping with each exoskeleton was not different compared with NH, suggesting that humans adjust leg stiffness to maintain overall stiffness regardless of the spring stiffness profile in an exoskeleton. Furthermore, the DGexoprovided the greatest elastic energy return, followed by LNexoand PGexo( P ≤ 0.001). Future full-leg, passive-elastic exoskeleton designs for hopping, and presumably running, should use a DGexorather than an LNexoor a PGexoto minimize metabolic demand.NEW & NOTEWORTHY When humans hop at 2.4–3.0 Hz normally and with an exoskeleton with different spring stiffness profiles in parallel to the legs, net metabolic power is lowest when hopping with an exoskeleton with degressive spring stiffness. Total vertical stiffness is constant when using an exoskeleton with linear or nonlinear spring stiffness compared with normal hopping. In-parallel spring stiffness influences net metabolic power and biomechanics and should be considered when designing passive-elastic exoskeletons for hopping and running.