bluuebunny/crossref_metadata_2025_split huggingface dataset:
BivRec: an R package for the nonparametric and semiparametric analysis of bivariate alternating recurrent events
Authors: Castro-Pearson Sandra , Sur Aparajita , Lee Chi Hyun , Huang Chiung-Yu , Luo Xianghua 
Published: April 2022

Abstract
Background
Bivariate alternating recurrent event data can arise in longitudinal studies where patients with chronic diseases go through two states that occur repeatedly, e.g., care periods and break periods. However, there was no statistical software that provided tools for the analysis of such data. To meet this software need, we developed , a package for R that contains a set of tools for exploratory, nonparametric and semiparametric regression analysis of bivariate alternating recurrent events.

Results
The package provides functions for nonparametric estimations for the joint distribution of bivariate gap times () and semiparametric regression methods for evaluating covariate effects on the two types of gap times under the accelerated failure time model framework (). The package also provides exploratory data analysis tools such as a visualization of the gap times by groups. We utilize a subset of the South Verona Psychiatric Case Register (PCR) data to illustrate the use of the package for the reviewed methods.

Conclusions
We demonstrate ’s capability for data visualization, nonparametric and regression based analysis, as well as data simulation. The package has default methods with satisfactory performance despite the complexity of calculations and fills a gap in software for statistical analysis of bivariate alternating recurrent events. is accessible under the GPL-3 General Public License through CRAN, facilitating its installation.
Identification of tools used to assess the external validity of randomized controlled trials in reviews: a systematic review of measurement properties
Authors: Jung Andres , Balzer Julia , Braun Tobias , Luedtke Kerstin 
Published: April 2022

Abstract
Background
Internal and external validity are the most relevant components when critically appraising randomized controlled trials (RCTs) for systematic reviews. However, there is no gold standard to assess external validity. This might be related to the heterogeneity of the terminology as well as to unclear evidence of the measurement properties of available tools. The aim of this review was to identify tools to assess the external validity of RCTs. It was further, to evaluate the quality of identified tools and to recommend the use of individual tools to assess the external validity of RCTs in future systematic reviews.

Methods
A two-phase systematic literature search was performed in four databases: PubMed, Scopus, PsycINFO via OVID, and CINAHL via EBSCO. First, tools to assess the external validity of RCTs were identified. Second, studies investigating the measurement properties of these tools were selected. The measurement properties of each included tool were appraised using an adapted version of the COnsensus based Standards for the selection of health Measurement INstruments (COSMIN) guidelines.

Results
38 publications reporting on the development or validation of 28 included tools were included. For 61% (17/28) of the included tools, there was no evidence for measurement properties. For the remaining tools, reliability was the most frequently assessed property. Reliability was judged as “sufficient” for three tools (very low certainty of evidence). Content validity was rated as “sufficient” for one tool (moderate certainty of evidence).

Conclusions
Based on these results, no available tool can be fully recommended to assess the external validity of RCTs in systematic reviews. Several steps are required to overcome the identified difficulties to either adapt and validate available tools or to develop a better suitable tool.

Trial registration
Prospective registration at Open Science Framework (OSF): 10.17605/OSF.IO/PTG4D.
Design of a new Z-test for the uncertainty of Covid-19 events under Neutrosophic statistics
Authors: Aslam Muhammad 
Published: April 2022

Abstract
Background
The existing Z-test for uncertainty events does not give information about the measure of indeterminacy/uncertainty associated with the test.

Methods
This paper introduces the Z-test for uncertainty events under neutrosophic statistics. The test statistic of the existing test is modified under the philosophy of the Neutrosophy. The testing process is introduced and applied to the Covid-19 data.

Results
Based on the information, the proposed test is interpreted as the probability that there is no reduction in uncertainty of Covid-19 is accepted with a probability of 0.95, committing a type-I error is 0.05 with the measure of an indeterminacy 0.10. Based on the analysis, it is concluded that the proposed test is informative than the existing test. The proposed test is also better than the Z-test for uncertainty under fuzzy-logic as the test using fuzz-logic gives the value of the statistic from 2.20 to 2.42 without any information about the measure of indeterminacy. The test under interval statistic only considers the values within the interval rather than the crisp value.

Conclusions
From the Covid-19 data analysis, it is found that the proposed Z-test for uncertainty events under the neutrosophic statistics is efficient than the existing tests under classical statistics, fuzzy approach, and interval statistics in terms of information, flexibility, power of the test, and adequacy.
Measuring demand and supply of community care services for older people healthy ageing in rural Zhejiang Province
Authors: Zhou Wusi , Jiang Biya , Yu Liujun , Dai Weidong 
Published: April 2022

AbstractBackgroundA consequence of demographic trends and economic prosperous is the increasing diversity in needs for care services. However, the traditional family support for older people has been largely supplanted by the wider provision of community care services. This study aims to investigate the current status of demand and supply in community care services across different villages of Zhejiang province and assess service effectiveness for healthy ageing.MethodsA questionnaire survey was carried out towards 207 rural villages across 9 cities in Zhejiang province. One hundred eighty-six valid responses were received, representing a response rate of around 89.9%. Descriptive statistics were employed to identify older villagers’ care needs and available community services. Comparative analysis examined the balance between the demand and supply of community care services. Correlation analysis were applied to determine key factors that impacted the supply of social services in rural communities.ResultsThe research found that rural older residents normally lived with their children or spouse with limited literacy and income. On average the categories of community care services is substantially small in comparison with the increasingly diverse demands of older people in rural areas. There was an obvious mismatch between service demand and service supply in rural communities, which often caused the waste of public resources. Moving forward, the uppermost priority is given to infrastructure construction service and daily life service, while little attention is paid to mental health service and specialized nursing service.ConclusionThere needs to be an improvement in the socio-economic capacity of rural communities and in the diversity of social care services. Policies and strategies are also needed to encourage private sectors’ involvement in providing care services for rural older people. Local government should have a clear vision of the potential demands for community care services, practical guidelines will be useful in guaranteeing better service quality.
Prediction of gestational diabetes mellitus by different obesity indices
Authors: Song Zhimin , Cheng Yan , Li Tingting , Fan Yongfang , Zhang Qingying , Cheng Haidong 
Published: April 2022

Abstract
Background
The incidence rates of obesity and gestational diabetes mellitus (GDM) are increasing in parallel. This study aimed to evaluate the relationship between different obesity indices, including prepregnancy body mass index (preBMI), the first-trimester abdominal circumference (AC), and first-trimester abdominal circumference/height ratio (ACHtR), and GDM, and the efficacy of these three indices in predicting GDM was assessed.

Methods
A total of 15,472 pregnant women gave birth to a singleton at the Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China. Prepregnancy weight was self-reported by study participants, body height and AC were measured by nurses at the first prenatal visit during weeks 11 to 13+6 of pregnancy. GDM was diagnosed through a 75-g oral glucose tolerance test at 24–28 gestational weeks. Using receiver operator characteristic (ROC) curve analysis, we evaluated the association between obesity indices and GDM.

Results
A total of 1912 women (12.4%) were diagnosed with GDM. Logistic regression analysis showed that AC, ACHtR, and preBMI (P < 0.001) were all independent risk factors for the development of GDM. In the normal BMI population, the higher the AC or ACHtR was, the more likely the pregnant woman was to develop GDM. The area under the ROC curve (AUC) was 0.63 (95% CI: 0.62–0.64) for the AC, 0.64 (95% CI: 0.62–0.65) for the ACHtR and 0.63 (95% CI: 0.62–0.64) for the preBMI. An AC ≥ 80.3 cm (sensitivity: 61.6%; specificity: 57.9%), an ACHtR of ≥ 0.49 (sensitivity: 67.3%; specificity: 54.0%), and a preBMI ≥ 22.7 (sensitivity: 48.4%; specificity: 71.8%) were determined to be the best cut-off levels for identifying subjects with GDM.

Conclusions
An increase in ACHtR may be an independent risk factor for GDM in the first trimester of pregnancy. Even in the normal BMI population, the higher the AC and ACHtR are, the more likely a pregnant woman is to develop GDM. AC, ACHtR in the first trimester and preBMI might be anthropometric indices for predicting GDM, but a single obesity index had limited predictive value for GDM.
A cross-sectional international study shows confidence in public health scientists predicts use of COVID-19 non-pharmaceutical interventions
Authors: Goldfinch Shaun , Taplin Ross 
Published: April 2022

Abstract
Background
We examine the antecedents of COVID-19 phone tracking applications use, social distancing, and mask use, in the United States, Hong Kong and Japan.

Methods
We draw on online panel surveys of over 1000 respondents each in the USA, Hong Kong and Japan, using broadly representative quota sample selections. Results are tested by ordinal logistic regression for the two ordinal dependent variables and logistic regression for phone app use.

Results
Confidence in public health scientists predicts use of phone tracking applications, social distancing, and mask use, albeit statistically insignificant for tracer phone application use in Hong Kong. Trust in government predicts the use of a phone tracking application. Counterintuitively, trust in government is negatively and significantly associated with mask use and social distancing in Hong Kong and Japan. Women are more likely to wear masks and practice social distancing. Government employees are more likely to use a phone tracking application, but less likely to mask and social distance. Voting and civic participation are positively associated with trust in government and confidence in public health scientists, in all three countries. There are interesting variations across all three countries on other antecedents and controls.

Conclusions
Building and maintaining confidence in public health scientists provides a key tool to manage pandemics. Credible, effectively communicative – and independent – medical and scientific leaders may be central to pandemic control success. For digital measures, trust in government and privacy protection is central. Political and social factors are important to understand successful public health policy implementation.
Accuracy and safety of robot-assisted cortical bone trajectory screw placement: a comparison of robot-assisted technique with fluoroscopy-assisted approach
Authors: Li Yue , Chen Long , Liu Yuzeng , Ding Hongtao , Lu Hongyi , Pan Aixing , Zhang Xinuo , Hai Yong , Guan Li 
Published: April 2022

Abstract
Objective
To compare the safety and accuracy of cortical bone trajectory screw placement between the robot-assisted and fluoroscopy-assisted approaches.

Methods
This retrospective study was conducted between November 2018 and June 2020, including 81 patients who underwent cortical bone trajectory (CBT) surgery for degenerative lumbar spine disease. CBT was performed by the same team of experienced surgeons. The patients were randomly divided into two groups—the fluoroscopy-assisted group (FA, 44 patients) and the robot-assisted group (RA, 37 patients). Robots for orthopedic surgery were used in the robot-assisted group, whereas conventional fluoroscopy-guided screw placement was used in the fluoroscopy-assisted group. The accuracy of screw placement and rate of superior facet joint violation were assessed using postoperative computed tomography (CT). The time of single screw placement, intraoperative blood loss, and radiation exposure to the surgical team were also recorded. The χ2 test and Student’s t-test were used to analyze the significance of the variables (P < 0.05).

Results
A total of 376 screws were inserted in 81 patients, including 172 screws in the robot-assisted group and 204 pedicle screws in the fluoroscopy-assisted group. Screw placement accuracy was higher in the RA group (160, 93%) than in the FA group (169, 83%) (P = 0.003). The RA group had a lower violation of the superior facet joint than the FA group. The number of screws reaching grade 0 in the RA group (58, 78%) was more than that in the FA group (56, 64%) (P = 0.041). Screw placement time was longer in the FA group (7.25 ± 0.84 min) than in the RA group (5.58 ± 1.22 min, P < 0.001). The FA group had more intraoperative bleeding (273.41 ± 118.20 ml) than the RA group (248.65 ± 97.53 ml, P = 0.313). The radiation time of the FA group (0.43 ± 0.07 min) was longer than the RA group (0.37 ± 0.10 min, P = 0.001). Furthermore, the overall learning curve tended to decrease.

Conclusions
Robot-assisted screw placement improves screw placement accuracy, shortens screw placement time, effectively improves surgical safety and efficiency, and reduces radiation exposure to the surgical team. In addition, the learning curve of robot-assisted screw placement is smooth and easy to operate.
In Vivo three-dimensional kinematics of normal knees during sitting sideways on the floor
Authors: Kono Kenichi , Yamazaki Takaharu , Konda Shoji , Inui Hiroshi , Tanaka Sakae , Sugamoto Kazuomi , Tomita Tetsuya 
Published: April 2022

Abstract
Background
The normal knee kinematics during asymmetrical kneeling such as the sitting sideways remains unknown. This study aimed to clarify in vivo kinematics during sitting sideways of normal knees.

Methods
Twelve knees from six volunteers were examined. Under fluoroscopy, each volunteer performed a sitting sideways. A two-dimensional/three-dimensional registration technique was used. The rotation angle, varus-valgus angle, anteroposterior translation of the medial and lateral sides of the femur relative to the tibia, and kinematic pathway in each flexion angle was evaluated.

Results
Bilateral knees during sitting sideways showed a femoral external rotation relative to the tibia with flexion (ipsilateral: 13.7 ± 3.5°, contralateral: 5.8 ± 6.8°). Whereas the ipsilateral knees showed valgus movement of 4.6 ± 2.5° from 130° to 150° of flexion, and the contralateral knees showed varus movement of -3.1 ± 4.4° from 110° to 150° of flexion. The medial side of the contralateral knees was more posteriorly located than that of the ipsilateral knees beyond 110° of flexion. The lateral side of the contralateral knees was more anteriorly located than that of the ipsilateral knees from 120° to 150° of flexion. In the ipsilateral knees, a medial pivot pattern followed by a bicondylar rollback was observed. In the contralateral knees, no significant movement followed by a bicondylar rollback was observed.

Conclusion
Even though the asymmetrical kneeling such as sitting sideways, the knees did not display asymmetrical movement.
First report of a gallbladder hemangioma coexisting with gallstones: a case report and literature review of a rare finding
Authors: Trucco Giulia , Chiusa Luigi , Tandoi Francesco , Bertero Luca 
Published: April 2022

Abstract
Background
Gallbladder hemangioma is an exceptionally rare entity, with only ten cases reported in literature hitherto. The here described case is the first report of a gallbladder hemangioma coexisting with gallstones.

Case presentation
A 76-year-old male was hospitalized following repeated episodes of epigastric pain. Patient’s medical history included primary hypertension, type 2 diabetes mellitus, dyslipidemia, obesity and hyperuricemia. Physical examination revealed marked pain in the right hypochondriac region, and laboratory workup was notable for mildly elevated glycemia (125 mg/dL) and pancreatic amylase (60 IU/L). Abdominal ultrasound showed multiple gallstones, a thickened gallbladder wall and mild edema of the perivisceral adipose tissue as well as a hepatic angioma. During surgery, an incidental subserosal nodule of about 1 cm was detected within the gallbladder fundus. After surgery, the clinical course was uneventful and the patient was discharged. Histopathological examination of the subserosal nodule showed multiple dilated vascular channels within a sclerosing matrix, a finding consistent with a cavernous hemangioma. Diffuse chronic cholecystitis was also present.

Conclusions
Gallbladder hemangiomas represent a rare, likely underdiagnosed condition which can be undetected during the preoperative workup.
Pursuing impact in research: towards an ethical approach
Authors: Bærøe Kristine , Kerasidou Angeliki , Dunn Michael , Teig Inger Lise 
Published: April 2022

Abstract
Background
Research proactively and deliberately aims to bring about specific changes to how societies function and individual lives fare. However, in the ever-expanding field of ethical regulations and guidance for researchers, one ethical consideration seems to have passed under the radar: How should researchers act when pursuing actual, societal changes based on their academic work?

Main text
When researchers engage in the process of bringing about societal impact to tackle local or global challenges important concerns arise: cultural, social and political values and institutions can be put at risk, transformed or even hampered if researchers lack awareness of how their ‘acting to impact’ influences the social world. With today’s strong focus on research impacts, addressing such ethical challenges has become urgent within in all fields of research involved in finding solutions to the challenges societies are facing. Due to the overall goal of doing something good that is often inherent in ethical approaches, boundaries to researchers’ impact of something good is neither obvious, nor easy to detect. We suggest that it is time for the field of bioethics to explore normative boundaries for researchers’ pursuit of impact and to consider, in detail, the ethical obligations that ought to shape this process, and we provide a four-step framework of fair conditions for such an approach. Our suggested approach within this field can be useful for other fields of research as well.

Conclusion
With this paper, we draw attention to how the transition from pursuing impact within the Academy to trying to initiate and achieve impact beyond the Academy ought to be configured, and the ethical challenges inherent in this transition. We suggest a stepwise strategy to identify, discuss and constitute consensus-based boundaries to this academic activity. This strategy calls for efforts from a multi-disciplinary team of researchers, advisors from the humanities and social sciences, as well as discussants from funding institutions, ethical committees, politics and the society in general. Such efforts should be able to offer new and useful assistance to researchers, as well as research funding agencies, in choosing ethically acceptable, impact-pursuing projects.
The use of electronic health records to inform cancer surveillance efforts: a scoping review and test of indicators for public health surveillance of cancer prevention and control
Authors: Conderino Sarah , Bendik Stefanie , Richards Thomas B. , Pulgarin Claudia , Chan Pui Ying , Townsend Julie , Lim Sungwoo , Roberts Timothy R. , Thorpe Lorna E. 
Published: April 2022

Abstract
Introduction
State cancer prevention and control programs rely on public health surveillance data to set objectives to improve cancer prevention and control, plan interventions, and evaluate state-level progress towards achieving those objectives. The goal of this project was to evaluate the validity of using electronic health records (EHRs) based on common data model variables to generate indicators for surveillance of cancer prevention and control for these public health programs.

Methods
Following the methodological guidance from the PRISMA Extension for Scoping Reviews, we conducted a literature scoping review to assess how EHRs are used to inform cancer surveillance. We then developed 26 indicators along the continuum of the cascade of care, including cancer risk factors, immunizations to prevent cancer, cancer screenings, quality of initial care after abnormal screening results, and cancer burden. Indicators were calculated within a sample of patients from the New York City (NYC) INSIGHT Clinical Research Network using common data model EHR data and were weighted to the NYC population using post-stratification. We used prevalence ratios to compare these estimates to estimates from the raw EHR of NYU Langone Health to assess quality of information within INSIGHT, and we compared estimates to results from existing surveillance sources to assess validity.

Results
Of the 401 identified articles, 15% had a study purpose related to surveillance. Our indicator comparisons found that INSIGHT EHR-based measures for risk factor indicators were similar to estimates from external sources. In contrast, cancer screening and vaccination indicators were substantially underestimated as compared to estimates from external sources. Cancer screenings and vaccinations were often recorded in sections of the EHR that were not captured by the common data model. INSIGHT estimates for many quality-of-care indicators were higher than those calculated using a raw EHR.

Conclusion
Common data model EHR data can provide rich information for certain indicators related to the cascade of care but may have substantial biases for others that limit their use in informing surveillance efforts for cancer prevention and control programs.