bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving Workers’ Musculoskeletal Health During Human-Robot Collaboration Through Reinforcement Learning
Authors: Xie Ziyang , Lu Lu , Wang Hanwen , Su Bingyi , Liu Yunan , Xu Xu 
Published: May 2023

Objective This study aims to improve workers’ postures and thus reduce the risk of musculoskeletal disorders in human-robot collaboration by developing a novel model-free reinforcement learning method. Background Human-robot collaboration has been a flourishing work configuration in recent years. Yet, it could lead to work-related musculoskeletal disorders if the collaborative tasks result in awkward postures for workers. Methods The proposed approach follows two steps: first, a 3D human skeleton reconstruction method was adopted to calculate workers’ continuous awkward posture (CAP) score; second, an online gradient-based reinforcement learning algorithm was designed to dynamically improve workers’ CAP score by adjusting the positions and orientations of the robot end effector. Results In an empirical experiment, the proposed approach can significantly improve the CAP scores of the participants during a human-robot collaboration task when compared with the scenarios where robot and participants worked together at a fixed position or at the individual elbow height. The questionnaire outcomes also showed that the working posture resulted from the proposed approach was preferred by the participants. Conclusion The proposed model-free reinforcement learning method can learn the optimal worker postures without the need for specific biomechanical models. The data-driven nature of this method can make it adaptive to provide personalized optimal work posture. Application The proposed method can be applied to improve the occupational safety in robot-implemented factories. Specifically, the personalized robot working positions and orientations can proactively reduce exposure to awkward postures that increase the risk of musculoskeletal disorders. The algorithm can also reactively protect workers by reducing the workload in specific joints.
Diagnostic value of high-frequency ultrasound for Poland syndrome
Authors: Cui Liyuan , Wang Tiezheng , Liu Lihua , Teng Jianbo , Qi Hengtao 
Published: May 2023

Background The imaging diagnosis of Poland syndrome is mostly computed tomography (CT) or magnetic resonance imaging (MRI), whereas high-frequency ultrasound for the diagnosis of Poland syndrome is relatively rare. Purpose To investigate the diagnostic value of high-frequency ultrasound for Poland syndrome. Material and Methods A retrospective analysis of 15 patients diagnosed with Poland syndrome was performed, and the characteristics of ultrasound images were summarized. Results High-frequency ultrasound clearly depict the anatomical structures of each layer of the chest wall in patients with Poland syndrome. Ultrasonography mainly showed partial or total absence of the pectoralis major muscle on the affected side, and some of which were combined with the absence of the pectoralis minor muscle. The difference was statistically significant in the thickness of the affected chest wall compared with the healthy side ( P < 0.01). Out of 15 cases with Poland syndrome, 11 were associated with ipsilateral brachydactyly or syndactyly, and high-frequency ultrasonography showed that the bifurcation position of the common palmar digital artery on the affected finger was lower than that on the healthy side. Conclusion High-frequency ultrasound is an effective imaging method for the diagnosis of Poland syndrome.
Prognostic analysis and clinical characteristics of osteosarcoma and Ewing sarcoma of the rib, sternum, and clavicle: a SEER-based study
Authors: He Fangming , Wang Zhan , Chen Genlian , Lu Huanxin 
Published: May 2023

Objective Osteosarcoma and Ewing sarcoma of the rib, sternum, and clavicle are rare tumor entities, and their clinical features and treatment outcomes have been rarely reported. The present study was performed to evaluate their survival and confirm independent survival predictors. Methods Data on patients with osteosarcoma or Ewing sarcoma of the rib, sternum, and clavicle from 1973 to 2016 were retrospectively extracted from the database. Univariate and multivariate Cox regression analyses were used to determine the independent risk factors. Kaplan–Meier survival curves were applied to examine the prognostic difference between the groups. Results In total, 475 patients with osteosarcoma or Ewing sarcoma of the rib, sternum, and clavicle were eligible for this study, including 173 (36.4%) with osteosarcoma and 302 (63.6%) with Ewing sarcoma. The 5-year overall survival and cancer-specific survival rates of all patients were 53.6% and 60.8%, respectively. Six independent variables were identified, including age at diagnosis, sex, histological grade, metastatic status, tumor type, and surgery. Conclusions Surgical resection is a reliable treatment for osteosarcoma and Ewing sarcoma of the rib, sternum, and clavicle. Further research is needed to reconfirm the role of chemotherapy and radiotherapy in survival of these patients.
Chronic Ankle Instability and Associated Self-Reported Function in South African Professional Ballet Dancers
Authors: Stander Cherezane , van der Merwe Anke , Nel Mariette 
Published: May 2023

Introduction: Ankle sprains are the most common acute injury among dancers and may result in the development of chronic ankle instability (CAI). Chronic ankle instability is characterized by recurrent ankle sprains, incidents of the ankle “giving way,” and sensations of instability and has been reported to negatively impact functioning and psychosocial status. The large number of ankle sprains in addition to contextual factors relating to professional dancing, suggests that CAI may be a significant problem in professional ballet dancers. This study aimed to determine the prevalence of CAI and describe the ankle injury history and level of self-reported function in South African ballet dancers. Methods: This descriptive, cross-sectional study included all professional ballet dancers employed by three professional South African ballet companies (n = 65). The Identification of Functional Ankle Instability Questionnaire (IdFAI), Foot and Ankle Ability Measure (FAAM), Dance Functional Outcome Survey (DFOS), and a researcher-developed injury history questionnaire were completed by consenting participants. Descriptive statistics were calculated. Results: A CAI prevalence of 73.3% CI [55.6%, 85.8%] was calculated among 30 participants. Twenty-five (83.3%) participants reported sustaining at least one significant ankle sprain with 88% (n = 22) indicating dance related activities as the cause. Dancers with CAI demonstrated a tendency to have less control over their ankles giving way and tended to take longer to recover from their ankles giving way than those dancers not affected. Eight participants (36.4%) with CAI were identified as having a significant level of disability on the FAAM activities of daily living (ADL) subscale and six participants (27.3%) on the sport subscale. Participants with CAI had a median total score of 83.5; IQR [80 - 90] on the DFOS. Conclusion: The self-reported function of South African professional ballet dancers is not severely affected, however, the high prevalence of CAI and reported symptoms is concerning. Education on CAI symptoms, prevention, and evidence-based management is recommended.
Prevalence of Urinary Incontinence and Other Pelvic Floor-Related Symptoms in Female Professional Dancers
Authors: Winder Brooke , Lindegren Kari , Blackmon Amanda 
Published: May 2023

Introduction: Urinary incontinence (UI) is a common issue in female athletes and is known to negatively impact quality of life and sport performance. However, the prevalence of UI in dancers has not been widely investigated. The purpose of this study was to assess the prevalence of UI as well as other symptoms of pelvic floor dysfunction in female professional dancers. Methods: An anonymous online survey that included the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) was developed and distributed via e-mail and social media. Two hundred and eight female professional dancers between the ages of 18 and 41 years (mean: 25.4 ± 5.2 years) who had a typical dance training and performance schedule of 25 hours or more per week completed the survey. Results: A total of 34.6% of participants reported experiencing UI, with 31.9% of the dancers who reported UI reporting symptoms consistent with urge UI, 52.8% reporting UI with coughing or sneezing, and 54.2% reporting UI with physical activity or exercise. For those reporting UI, the mean ICIQ-UI SF score was 5.4 ± 2.5 points and the mean score for impact on everyday life was 2.9 ± 1.9. A report of pain with sexual activity and intercourse was significantly associated with presence of UI (p = 0.024), but the effect size was not notable (phi = 0.159). Conclusion: The prevalence of UI in female professional dancers is similar to that found in other high-level female athletes. Based on the notable prevalence of UI, health care professionals working with professional dancers should consider regularly screening for UI and other symptoms of pelvic floor dysfunction.
The Efficacy of Pretreatment 18F-FDG PET-CT-Based Deep Learning Network Structure to Predict Survival in Nasopharyngeal Carcinoma
Authors: Long Zi-chan , Ding Xing-chen , Zhang Xian-bin , Shui-Yu  , Zheng-Fu  , sun Peng-peng , Hao Fu-rong , Li Zi-rong , Hu Man 
Published: May 2023

Background: Previous studies have shown that the 5-year survival rates of patients with nasopharyngeal carcinoma (NPC) were still not ideal despite great improvement in NPC treatments. To achieve individualized treatment of NPC, we have been looking for novel models to predict the prognosis of patients with NPC. The objective of this study was to use a novel deep learning network structural model to predict the prognosis of patients with NPC and to compare it with the traditional PET-CT model combining metabolic parameters and clinical factors. Methods: A total of 173 patients were admitted to 2 institutions between July 2014 and April 2020 for the retrospective study; each received a PET-CT scan before treatment. The least absolute shrinkage and selection operator (LASSO) was employed to select some features, including SUVpeak-P, T3, age, stage II, MTV-P, N1, stage III and pathological type, which were associated with overall survival (OS) of patients. We constructed 2 survival prediction models: an improved optimized adaptive multimodal task (a 3D Coordinate Attention Convolutional Autoencoder and an uncertainty-based jointly Optimizing Cox Model, CACA-UOCM for short) and a clinical model. The predictive power of these models was assessed using the Harrell Consistency Index (C index). Overall survival of patients with NPC was compared by Kaplan–Meier and Log-rank tests. Results: The results showed that CACA-UOCM model could estimate OS (C index, 0.779 for training, 0.774 for validation, and 0.819 for testing) and divide patients into low and high mortality risk groups, which were significantly associated with OS ( P < .001). However, the C-index of the model based only on clinical variables was only 0.42. Conclusions: The deep learning network model based on 18F-FDG PET/CT can serve as a reliable and powerful predictive tool for NPC and provide therapeutic strategies for individual treatment.
L2 activation during L1 processing is increased by exposure but decreased by proficiency
Authors: Berghoff Robyn , Bylund Emanuel 
Published: May 2023

Aims: The study investigates the effects of L2 proficiency and L2 exposure on L2-to-L1 cross-language activation (CLA) in L1-dominant bilinguals. In so doing, it tests the predictions made by prominent models of the bilingual lexicon regarding how language experience modulates CLA. Design: The participants (27 L1-dominant L1 English–L2 Afrikaans speakers) completed a visual world eye-tracking task, conducted entirely in English, in which they saw four objects on a screen: a target object, which they were instructed to click on; a competitor object, whose Afrikaans label overlapped phonetically at onset with the English target object label; and two unrelated distractors. Language background data were collected using the Language History Questionnaire 3.0. Analysis: A growth curve analysis was performed to investigate the extent to which the background variables modulated looks to the Afrikaans competitor item versus to the two unrelated distractor items. Findings: Increased L2 exposure was associated with greater CLA, which is consistent with models suggesting that exposure modulates the likelihood and speed with which a linguistic item becomes activated. Moreover, CLA was reduced at higher levels of L2 proficiency, which aligns with accounts of the bilingual lexicon positing that parasitism of the L2 on the L1 is reduced at higher proficiency levels, leading to reduced CLA. Originality: L2 activation during L1 processing and the variables that modulate it are not well documented, particularly among L1 speakers with limited proficiency in and exposure to the L2. Significance: The findings contribute to the evaluation of competing accounts of bilingual lexical organization.
Predictors of poor clinical outcomes including in-hospital death and low ability to perform activities of daily living at discharge in hospitalized patients with chronic obstructive pulmonary disease exacerbation
Authors: Murakami Yurina , Yasui Hideki , Sato Jun , Uto Tomohiro , Inui Naoki , Suda Takafumi , Imokawa Shiro 
Published: May 2023

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of mortality and morbidity worldwide. Many patients with COPD experience exacerbations that require hospitalization, which is associated with an increased risk of in-hospital death and impaired ability to perform activities of daily living (ADL). Declining ability to perform ADL is a critical issue for these patients. Objectives: To identify predictors of poor clinical outcomes, including in-hospital death and low ability to perform ADL at discharge, in patients who are hospitalized with exacerbation of COPD. Design: This retrospective study involved a cohort of patients with exacerbation of COPD who were admitted to Iwata City Hospital in Japan between July 2015 and October 2019. Methods: We collected clinical data, measured the cross-sectional area of the erector spinae muscles (ESMCSA) on computed tomography (CT) scans at admission, and investigated the associations of poor clinical outcomes (in-hospital death and severe dependence when performing ADL, defined as a Barthel Index (BI) of ⩽40 at discharge) with clinical parameters. Results: Overall, 207 patients were hospitalized for exacerbation of COPD during the study period. The incidence of poor clinical outcomes was 21.3%, and the in-hospital mortality rate was 6.3%. Multivariate logistic regression analyses showed that older age, long-term oxygen therapy, an elevated D-dimer concentration, and a reduced ESMCSA on chest CT at admission were significantly associated with poor clinical outcomes (in-hospital death and a BI of ⩽40). Conclusion: Hospitalization for exacerbation of COPD was associated with high rates of in-hospital mortality and a BI of ⩽40 at discharge, which may be predicted by assessment of ESMCSA.
Development of phonologically-balanced and perceptually equivalent Singapore Mandarin word lists for word recognition test
Authors: Soh Kimberly Wanxian , Loo Jenny Hooi Yin 
Published: May 2023

Background Word recognition tests must be conducted in the native language of the listener to obtain valid word recognition scores. Existing Singapore Mandarin speech audiometry test materials that are disyllabic lack in sensitivity and are not phonologically balanced. Objective The purpose of this study was to address those limitations and develop a set of word lists for testing speakers of Singapore Mandarin. Methods The word lists were developed over three phases. (1) Frequently occurring words were chosen from a database consisting of subtitles from local Mandarin programmes, and subjected to familiarity rating by 50 native Singapore Mandarin speakers. (2) Phonologically balanced word lists were created and professionally recorded using words rated as familiar in phase 1. (3) Psychometric curves of words were obtained from 20 normal-hearing native speakers and word lists were analysed for perceptual equivalence. Results Sixteen phonologically balanced word lists consisting of 25 monosyllables each were created in phase 2. Eight of the 16 lists were found to be perceptually equivalent. Conclusion Word lists developed in this study addressed the limitations of existing Singapore Mandarin speech audiometry materials. The word lists need to be validated with normal-hearing and hearing-impaired Singapore Mandarin speakers before they can be used clinically.
Musculoskeletal disorders and incongruous postures in workers on ropes: A pilot study
Authors: Cirrincione Luigi , Martorana Daniela , Plescia Fulvio , Campagna Marcello , Lecca Luigi Isaia , Skerjanc Alenka , Fruscione Santo , Plescia Fabiana , Cannizzaro Emanuele 
Published: May 2023

Background: Occupational hazards believed to cause musculoskeletal disorders in rope workers are traditionally associated with maintaining incongruous postures for prolonged periods of time. Design and methods: A cross-sectional survey was conducted on 132 technical operators in the wind energy and acrobatic construction sectors, who work on ropes, analysing the ergonomic characteristics of the environments, the way in which tasks are carried out, the strain perceived by individual workers, and assessing the presence of any musculoskeletal disorders (MSDs) by means of an objective examination focused on the anatomical districts that were the object of our study. Results: Analysis of the data obtained showed that there were differences in the perception of the level of physical intensity and perceived exertion between the groups of workers. Statistical analysis also revealed a significant association between the frequency of MSDs analysed and perceived exertion. Discussion: The most significant finding to emerge from this study is the high prevalence of MSDs of the cervical spine (52.94%), the upper limbs (29.41%), and the dorso-lumbar spine (17.65%). These values differ from those classically found in those exposed to the risk of conventional manual handling of loads. Conclusions: The high prevalence of disorders of the cervical spine, the scapulo-humeral girdle and the upper limbs, indicates the need to consider the forced position to be assumed for a large part of the work activity, staticity, and the inability to move the lower limbs for long periods as the predominant risk in rope work.
Evaluating the Impact of Youth Early Sport Specialization on Injury: An Evolution in Measurement
Authors: Rockwood Todd , Edwards Nicholas M. , Nelson Bradley , Agel Julie 
Published: May 2023

Objective To track youth sports participation and injury occurrence accurately and longitudinally. Results An online survey tool that captures sports participation, frequency, level of competition, and tracks injury occurrence has been developed. The survey allows for longitudinal tracking of sports participation to evaluate the change from recreational to highly specialized sports participation. To maximize the utility of this research tool we identified swimmer plots which allow for clear visualization of the data as the best method for graphical representation. Implication Longitudinal measurement of sports participation to evaluate the impact of early sports specialization on injury is feasible with this tool and enhanced by the swimmer plots for visualization.
Barriers to Timely Administration of Hepatitis B Birth Dose Vaccine to Neonates of Mothers With Hepatitis B in Ghana: Midwives’ Perspectives
Authors: Adjei Charles Ampong , Suglo Damasus , Ahenkorah Alfred Yanful , MacDonald Shannon E. , Richter Solina 
Published: May 2023

Background The global health sector strategy on viral hepatitis aims to reduce new hepatitis B infections by 90% by 2030. Yet, hepatitis B birth dose (HepB-BD) vaccination, which is effective in preventing mother-to-child transmission of hepatitis B, remains low in sub-Saharan Africa. Given the essential role that midwives play in infants’ birth dose immunisation, we explore their perspectives on the reasons for delays and non-administration of HepB-BD to eligible neonates in Ghana. Methods We conducted interviews with 18 midwives, stratified by region (Greater Accra and Northern regions). Participants were selected purposively. The data were transcribed, coded, and analysed following the Braun and Clarke data analysis procedure. Results The participants conveyed a broad range of barriers to HepB-BD vaccination in Ghana. These include the mother's denial of hepatitis B seropositivity; the mother's ignorance of the impact of hepatitis B on their newborn; partners’ non-involvement in post-test counselling; and the high cost of hepatitis B immunoglobulin and hepatitis B monovalent vaccine. Other reasons included vaccine unavailability and midwives’ oversight and documentation lapses. Conclusion We recommend educating expectant mothers on the importance and effectiveness of HepB-BD vaccination during antenatal care (ANC) visits, as well as educating midwives on HepB-BD vaccination procedures. In addition, ensuring sufficient supplies and administering hepatitis B vaccines in the delivery ward should be done to guarantee that babies receive the vaccines on time. Importantly, Ghana needs policies that require HepB-BD vaccination as part of the Expanded Programme on Immunisation (EPI) to ensure the investments and funding it needs.
Cytotoxicity of the CD3×CD20 bispecific antibody epcoritamab in CLL is increased by concurrent BTK or BCL-2 targeting
Authors: Mhibik Maissa , Gaglione Erika M. , Eik David , Herrick John , Le Janet , Ahn Inhye E. , Chiu Christopher , Wielgos-Bonvallet Monica , Hiemstra Ida H. , Breij Esther C. W. , Chen Jenny , Reilly Edward B. , Epling-Burnette Pearlie K. , Szafer-Glusman Edith , Sun Clare , Wiestner Adrian 
Published: May 2023

Abstract
Chronic lymphocytic leukemia (CLL) is an immunosuppressive disease characterized by increased infectious morbidity and inferior antitumor activity of immunotherapies. Targeted therapy with Bruton's tyrosine kinase inhibitors (BTKis) or the Bcl-2 inhibitor venetoclax has profoundly improved treatment outcomes in CLL. To overcome or prevent drug resistance and extend the duration of response after a time-limited therapy, combination regimens are tested. Anti-CD20 antibodies that recruit cell- and complement-mediated effector functions are commonly used. Epcoritamab (GEN3013), an anti–CD3×CD20 bispecific antibody that recruits T-cell effector functions, has demonstrated potent clinical activity in patients with relapsed CD20+ B-cell non-Hodgkin lymphoma. Development of CLL therapy is ongoing. To characterize epcoritamab-mediated cytotoxicity against primary CLL cells, peripheral blood mononuclear cells from treatment-naive and BTKi-treated patients, including patients progressing on therapy, were cultured with epcoritamab alone or in combination with venetoclax. Ongoing treatment with BTKi and high effector-to-target ratios were associated with superior in vitro cytotoxicity. Cytotoxic activity was independent of CD20 expression on CLL cells and observed in samples from patients whose condition progressed while receiving BTKi. Epcoritamab induced significant T-cell expansion, activation, and differentiation into Th1 and effector memory cells in all patient samples. In patient-derived xenografts, epcoritamab reduced the blood and spleen disease burden compared with that in mice receiving a nontargeting control. In vitro, the combination of venetoclax with epcoritamab induced superior killing of CLL cells than either agent alone. These data support the investigation of epcoritamab in combination with BTKis or venetoclax to consolidate responses and target emergent drug-resistant subclones.