bluuebunny/crossref_metadata_2025_split huggingface dataset:
EMG-driven control in lower limb prostheses: a topic-based systematic review
Authors: Cimolato Andrea , Driessen Josephus J. M. , Mattos Leonardo S. , De Momi Elena , Laffranchi Matteo , De Michieli Lorenzo 
Published: May 2022

AbstractBackgroundThe inability of users to directly and intuitively control their state-of-the-art commercial prosthesis contributes to a low device acceptance rate. Since Electromyography (EMG)-based control has the potential to address those inabilities, research has flourished on investigating its incorporation in microprocessor-controlled lower limb prostheses (MLLPs). However, despite the proposed benefits of doing so, there is no clear explanation regarding the absence of a commercial product, in contrast to their upper limb counterparts.Objective and methodologiesThis manuscript aims to provide a comparative overview of EMG-driven control methods for MLLPs, to identify their prospects and limitations, and to formulate suggestions on future research and development. This is done by systematically reviewing academical studies on EMG MLLPs. In particular, this review is structured by considering four major topics: (1) type of neuro-control, which discusses methods that allow the nervous system to control prosthetic devices through the muscles; (2) type of EMG-driven controllers, which defines the different classes of EMG controllers proposed in the literature; (3) type of neural input and processing, which describes how EMG-driven controllers are implemented; (4) type of performance assessment, which reports the performance of the current state of the art controllers.Results and conclusionsThe obtained results show that the lack of quantitative and standardized measures hinders the possibility to analytically compare the performances of different EMG-driven controllers. In relation to this issue, the real efficacy of EMG-driven controllers for MLLPs have yet to be validated. Nevertheless, in anticipation of the development of a standardized approach for validating EMG MLLPs, the literature suggests that combining multiple neuro-controller types has the potential to develop a more seamless and reliable EMG-driven control. This solution has the promise to retain the high performance of the currently employed non-EMG-driven controllers for rhythmic activities such as walking, whilst improving the performance of volitional activities such as task switching or non-repetitive movements. Although EMG-driven controllers suffer from many drawbacks, such as high sensitivity to noise, recent progress in invasive neural interfaces for prosthetic control (bionics) will allow to build a more reliable connection between the user and the MLLPs. Therefore, advancements in powered MLLPs with integrated EMG-driven control have the potential to strongly reduce the effects of psychosomatic conditions and musculoskeletal degenerative pathologies that are currently affecting lower limb amputees.
Quantifying intra- and interlimb use during unimanual and bimanual tasks in persons with hemiparesis post-stroke
Authors: Duff Susan V. , Miller Aaron , Quinn Lori , Youdan Gregory , Bishop Lauri , Ruthrauff Heather , Wade Eric 
Published: May 2022

AbstractBackgroundIndividuals with hemiparesis post-stroke often have difficulty with tasks requiring upper extremity (UE) intra- and interlimb use, yet methods to quantify both are limited.ObjectiveTo develop a quantitative yet sensitive method to identify distinct features of UE intra- and interlimb use during task performance.MethodsTwenty adults post-stroke and 20 controls wore five inertial sensors (wrists, upper arms, sternum) during 12 seated UE tasks. Three sensor modalities (acceleration, angular rate of change, orientation) were examined for three metrics (peak to peak amplitude, time, and frequency). To allow for comparison between sensor data, the resultant values were combined into one motion parameter, per sensor pair, using a novel algorithm. This motion parameter was compared in a group-by-task analysis of variance as a similarity score (0–1) between key sensor pairs: sternum to wrist, wrist to wrist, and wrist to upper arm. A use ratio (paretic/non-paretic arm) was calculated in persons post-stroke from wrist sensor data for each modality and compared to scores from the Adult Assisting Hand Assessment (Ad-AHA Stroke) and UE Fugl-Meyer (UEFM).ResultsA significant group × task interaction in the similarity score was found for all key sensor pairs. Post-hoc tests between task type revealed significant differences in similarity for sensor pairs in 8/9 comparisons for controls and 3/9 comparisons for persons post stroke. The use ratio was significantly predictive of the Ad-AHA Stroke and UEFM scores for each modality.ConclusionsOur algorithm and sensor data analyses distinguished task type within and between groups and were predictive of clinical scores. Future work will assess reliability and validity of this novel metric to allow development of an easy-to-use app for clinicians.
Extracellular water to total body water ratio predicts survival in cancer patients with sarcopenia: a multi-center cohort study
Authors: Ge Yi-Zhong , Ruan Guo-Tian , Zhang Qi , Dong Wen-Jun , Zhang Xi , Song Meng-Meng , Zhang Xiao-Wei , Li Xiang-Rui , Zhang Kang-Ping , Tang Meng , Li Wei , Shen Xian , Shi Han-Ping ,   Investigation on the Nutrition Status and Clinical Outcome of Common Cancers (INSCOC) Group
Published: May 2022

Abstract
Background
Body water measured by bioelectrical impedance analysis (BIA) predicts the outcomes of many diseases. This study aimed to evaluate the relationship between body water and the prognosis of cancer patients with sarcopenia.

Methods
This study employed 287 cancer patients with sarcopenia underwent BIA from a prospective multicenter study of patients with cancer in China from 2013 to 2020. The primary outcome of interest was all-cause mortality presented as the longest time to follow-up available. Eight indicators of body water [total body water, extracellular water, intracellular water, free fat mass, active cell mass, extracellular water/intracellular water, extracellular water/total body water (ECW/TBW), and intracellular water/total body water] were included in the research. Neutrophil–lymphocyte ratio (NLR) = neutrophil (× 109)/lymphocyte (× 109). The discriminatory ability and prediction accuracy of each factor were assessed using the C-index. The hazard ratios (HR) and 95% confidence intervals (CI) were calculated using the Cox proportional hazard model.

Results
The median age was 65 years old, and 138 (48%) patients were men. During a mean follow-up of 46 months, 140 deaths were recorded, resulting in a rate of 204.6 events per 1000 patient-years. ECW/TBW showed the best predictive accuracy (C-index = 0.619) compared to the other indicators [p = 0.004, adjusted HR (95% CI) 1.70 (1.18,2.44)]. In the middle tertile (0.385–0.405), ECW/TBW had a strong independent negative association with patient survival [adjusted HR (95% CI) 2.88 (1.39–5.97), p = 0.004]. Patients who had a high ECW/TBW (ECW/TBW ≥ 0.395) combined with a high NLR had 3.84-fold risk of mortality (p < 0.001, 95% CI 1.99,7.38).

Conclusions
ECW/TBW was better than other indicators in predicting survival of cancer patients with sarcopenia. High ECW/TBW combined with high NLR would further increase the risk of mortality.
Trial registration: The Investigation on Nutrition Status and Clinical Outcome of Common Cancers (INSCOC) (Chinese Clinical Trial Registry: ChiCTR1800020329, URL of registration: http://www.chictr.org.cn/showprojen.aspx?proj=31813).
The application of existing genotoxicity methodologies for grouping of nanomaterials: towards an integrated approach to testing and assessment
Authors: Verdon Rachel , Stone Vicki , Murphy Fiona , Christopher Emily , Johnston Helinor , Doak Shareen , Vogel Ulla , Haase Andrea , Kermanizadeh Ali 
Published: May 2022

AbstractThe incorporation of nanomaterials (NMs) in consumer products has proven to be highly valuable in many sectors. Unfortunately, however, the same nano specific physicochemical properties, which make these material attractive, might also contribute to hazards for people exposed to these materials. The physicochemical properties of NMs will impact their interaction with biological surroundings and influence their fate and their potential adverse effects such as genotoxicity. Due to the large and expanding number of NMs produced, their availability in different nanoforms (NFs) and their utilization in various formats, it is impossible for risk assessment to be conducted on an individual NF basis. Alternative methods, such as grouping are needed for streamlining hazard assessment. The GRACIOUS Framework provides a logical and science evidenced approach to group similar NFs, allowing read-across of hazard information from source NFs (or non-NFs) with adequate hazard data to target NFs that lack such data. Here, we propose a simple three-tiered testing strategy to gather evidence to determine whether different NFs are sufficiently similar with respect to their potential to induce genotoxicity, in order to be grouped. The tiered testing strategy includes simple in vitro models as well as a number of alternative more complex multi-cellular in vitro models to allow for a better understanding of secondary NM-induced DNA damage, something that has been more appropriate in vivo until recently.
Becoming our young people’s case managers: caregivers’ experiences, needs, and ideas for improving opioid use treatments for young people using opioids
Authors: Marchand Kirsten , Turuba Roxanne , Katan Christina , Brasset Chantal , Fogarty Oonagh , Tallon Corinne , Fairbank Jill , Mathias Steve , Barbic Skye 
Published: May 2022

Abstract
Background
Evidence continues to show that young people, ages 15-24, remain at significant risk of harms from non-medical opioid use and opioid use disorder (OUD), with experts calling for widespread implementation of developmentally-appropriate interventions. These recommendations include the involvement of caregivers in the prevention, early intervention, and treatment of young people using opioids. However, little research has investigated caregivers’ experiences supporting young people, leaving critical gaps in understanding this role. The aim of this study is to explore caregivers’ experiences accessing opioid use treatments with young people and their needs and ideas for improving such treatments.

Methods
This study reports qualitative findings from Phase 1 of the Improving Treatment Together project, a multi-phase, multi-site community-based participatory study broadly aimed at co-designing opioid use treatments to improve the experiences and outcomes of young people using non-medical opioids. During Phase 1, a total of 27 caregivers (parents, guardians) participated in full-day workshops that were conducted in three communities in British Columbia, Canada. Following human-centred co-design methods, caregivers engaged in small and large group discussions of their experiences, needs, and ideas for improving opioid use treatments for young people. Discussions were audio-recorded, transcribed verbatim, and thematically analysed.

Results
Across communities, caregivers’ main experiences were defined as ‘becoming our young people’s case managers’ and ‘enduring a never-ending rollercoaster’. To improve these experiences, two needs themes were identified – expanding organizational and system-level capacity and wider-spread understanding of opioid use as a health issue. Caregivers brainstormed a total of 378 individual ideas to meet these needs, several of which spanned multiple needs themes.

Conclusions
Caregivers’ experiences, needs, and ideas reveal critical opportunities for improving the quality of interventions for opioid use among young people. This study represents a substantial contribution to the design and implementation of developmentally-appropriate and family-centred interventions for young people using opioids.
Developing an accurate model of spot-scanning treatment delivery time and sequence for a compact superconducting synchrocyclotron proton therapy system
Authors: Zhao Lewei , Liu Gang , Chen Shupeng , Shen Jiajian , Zheng Weili , Qin An , Yan Di , Li Xiaoqiang , Ding Xuanfeng 
Published: May 2022

Abstract
Background
A new compact superconducting synchrocyclotron single-room proton solution delivers pulsed proton beams to each spot through several irradiation bursts calculated by an iterative layer delivery algorithm. Such a mechanism results in a new beam parameter, burst switching time (BST) in the total beam delivery time (BDT) which has never been studied before. In this study, we propose an experimental approach to build an accurate BDT and sequence prediction model for this new proton solution.

Methods
Test fields and clinical treatment plans were used to investigate each beam delivery parameter that impacted BDT. The machine delivery log files were retrospectively analyzed to quantitatively model energy layer switching time (ELST), spot switching time (SSWT), spot spill time (SSPT), and BST. A total of 102 clinical IMPT treatment fields’ log files were processed to validate the accuracy of the BDT prediction model in comparison with the result from the current commercial system. Interplay effect is also investigated as a clinical application by comparing this new delivery system model with a conventional cyclotron accelerator model.

Results
The study finds that BST depends on the amount of data to be transmitted between two sequential radiation bursts, including a machine irradiation log file of the previous burst and a command file to instruct the proton system to deliver the next burst. The 102 clinical treatment fields showed that the accuracy of each component of the BDT matches well between machine log files and BDT prediction model. More specifically, the difference of ELST, SSWT, SSPT, and BST were (− 3.1 ± 5.7)%, (5.9 ± 3.9)%, (2.6 ± 8.7)%, and (− 2.3 ± 5.3)%, respectively. The average total BDT was about (2.1 ± 3.0)% difference compared to the treatment log files, which was significantly improved from the current commercial proton system prediction (58 ± 15)%. Compared to the conventional cyclotron system, the burst technique from synchrocyclotron effectively reduced the interplay effect in mobile tumor treatment.

Conclusion
An accurate BDT and sequence prediction model was established for this new clinical compact superconducting synchrocyclotron single-room proton solution. Its application could help users of similar facilities better assess the interplay effect and estimate daily patient treatment throughput.
Scanning methodology for contact lens-type ocular in vivo dosimeter (CLOD) dosimetry applying a silicone material
Authors: Son Jaeman , Cho Jin Dong , Jung Seongmoon , Choi Chang Heon , Park Jong Min , Kim Jung-in 
Published: May 2022

Abstract
Purpose
Contact lens-type ocular in vivo dosimeters (CLODs) were recently developed as the first in vivo dosimeter that can be worn directly on the eye to measure the dose delivered to the lens during radiotherapy. However, it has an inherent uncertainty because of its curved shape. Newton’s ring effect inevitably occurs because the spacing between the glass window and the active layer is not constant. Furthermore, it involves a large uncertainty because the objective of the CLOD with such morphological characteristics is to measure the dose delivered to an out-of-field lens. In this study, we aimed to investigate the effects of various compensating materials on the sensitivity, accuracy, and uniformity of analysis using a curved CLOD. We developed a new scanning methodology that involves applying a compensating material to reduce the uncertainty caused by the air gap.

Methods
Four compensating materials—Dragon Skin™ 10 (DS), a transparent silicon material, SORTA-Clear™ 40 (SC), optical grease (OG), and air (no compensating material)—were used in this study. The CLOD was scanned in the reflective mode and transmission mode using each compensating material. We then examined the sensitivity, accuracy, and scan uniformity to evaluate the scanning methodology using compensating materials.

Results
The increase in sensitivity was the highest for OG compared to that for air in the reflective mode. On average, the sensitivity in the reflective mode was higher than that in the transmission mode by a factor of 2.5 for each dose. Among the four compensating materials, OG had the smallest uncertainty. Therefore, the best scan uniformity was achieved when OG was used.

Conclusions
Scanning methodology was proposed in which a compensating material is applied for a curved lens-type dosimeter. Our results show that OG is the most suitable compensating material to obtain the best accuracy of dose analysis. Following this methodology, the scan uncertainty of curved dosimeters significantly decreased.
Possibilities and limits of using gyroscopic sensors in the diagnosis of progression of osteoarthritis and femoroacetabular impingement syndrome
Authors: Holeka Pavel , Studnička Filip , Bušovský Damián , Štěpán Jan , Matyska Jan , Šlégr Jan 
Published: May 2022

AbstractOsteoarthritis is the most common type of degenerative joint disease and affects millions of people. In this paper, we propose a non-obtrusive and straightforward method to assess the progression of osteoarthritis. In standard medicine praxis, osteoarthritis is observed with X-rays. In this study, we use widely available wearable sensors with gyroscopes to make the observation. Two novel methods are proposed for gyroscope data processing. A small-scale study has shown that these methods can be used to monitor osteoarthritis’s progression, and to differentiate between healthy subjects and subjects with femoroacetabular impingement syndrome.
Accuracy of point-of-care coagulation testing during cardiopulmonary bypass in a patient post COVID-19 infection
Authors: Grewal Nimrat , Yousef David , Palmen Meindert , Klautz Robert , Eikenboom Jeroen , Wink Jeroen 
Published: May 2022

AbstractIntroductionExtracorporeal circulation (ECC) in cardiac surgery is performed under systemic heparinization. Adequacy of heparin therapy and anticoagulation during ECC is assessed by activated clotting time (ACT), although there are concerns regarding the reliability of this measure. The ACT can be affected by factors other than heparin anticoagulation. A novel factor that should be considered is the influence of a COVID-19 infection. More than half of the hospitalized COVID-19 patients develop coagulation abnormalities with dysregulated coagulation test results. Patients recently recovered from COVID-19 may still demonstrate some forms of coagulation disorder affecting the ACT. This case describes an inaccurate point-of-care ACT testing in a patient with previous COVID-19 infection undergoing cardiac surgery with ECC and the alternative coagulation testing performed.Case presentationA 77-years-old Caucasian male presented with symptomatic severe mitral valve regurgitation for which he underwent surgery. Medical history revealed a COVID-19 infection one month before surgery. Pre-operative hematological lab results were normal and baseline ACT during surgery was 100 s. To achieve an adequate ACT of > 400 s, multiple doses of heparin were needed and after administration of a triple dose (75,000 IE heparin in total) this adequate ACT was achieved. In the meanwhile we measured anti-Xa level and APTT, which were at adequate levels when ACT was still < 400 s.DiscussionThis case emphasizes the need of alternative methods for monitoring heparin therapy in case ACT does not respond adequately. Another point to highlight in this case is the poorly correlated relation between ACT and APTT and anti-Xa in light of the recent COVID-19 infection. Although studies have shown that COVID-19 infection can cause coagulopathy and altered hemostatic parameters, ACT has never been investigated in COVID-19 patient. Understanding the correlation between ACT, APTT and anti-Xa in COVID-19 patients is mandatory.
Ascending aortic wall degeneration in patients with bicuspid versus tricuspid aortic valve
Authors: Mennander Ari , Kholova Ivana , Pelttari Saku , Paavonen Timo 
Published: May 2022

Abstract
Background
The magnitude of ascending aortic degeneration in patients with bicuspid aortic valves (BAV) is controversial.

Methods
The aim of this study was to investigate ascending aortic wall degeneration in patients with BAV as compared with tricuspid aortic valves (TAV). The ascending aortic wall of 67 consecutive patients was processed for histology and immunohistochemistry. The extent of surgery and wall degeneration were investigated. Unadjusted survival was evaluated by Kaplan–Meier analysis. Median follow-up for patients with BAV and TAV was 3.8 years (interquartile range [IQR] 3.5–4.1) and 3.7 years (IQR 3.4–3.9), respectively.

Results
There were 33 patients with BAV and 34 with TAV. Mid-ascending aorta diameter was 54 mm (IQR 50–60). Replacement of the aortic valve, together with an ascending aortic prosthesis, was more frequent in BAV vs TAV patients (24% vs. 3%, P = 0.013). However, medial fibrosis, elastic fiber thinning, incremental medial degeneration and smooth muscle cell nuclei loss were less prominent in BAV vs TAV patients (0.1 ± 0.4 vs. 0.8 ± 1.4, P = 0.016; 0.6 ± 1.4 vs. 1.6 ± 2.0, P = 0.027; 1.7 ± 0.7 vs. 2.2 ± 0.8, P = 0.045 and 2.3 ± 1.5 vs. 3.2 ± 1.3, P = 0.026, respectively).

Conclusions
Since degeneration of the ascending aortic wall was seldom prominent, histopathology alone may not support the need for surgery of the dilated ascending aorta in BAV patients as compared with TAV patients.
Mechanisms of hypoxia in the hippocampal CA3 region in postoperative cognitive dysfunction after cardiopulmonary bypass
Authors: Liu Ting , Deng Rui , Wang Xin , Liu Ping , Xiao Qiu-Xia , Liu Qing , Zhang Ying 
Published: May 2022

AbstractBackgroundPostoperative cognitive dysfunction (POCD) is a complication with high morbidity and mortality, commonly observed in the elderly who underwent anesthesia and surgery. The incidence is much higher in cardiac surgery. However, the reason and the mechanism of POCD remains unclear, but cerebral hypoxia is a common neurological complication after cardiac surgery. This study aims to investigate what role cerebral hypoxia plays in the pathogenesis of POCD.MethodsThe POCD model was established using cardiopulmonary bypass (CPB) surgery. Cognitive function was detected using Y maze and Morris water maze. The hypoxia in central nervous system was assessed using HE staining, western blot, and immunofluorescence. Inflammatory factors in hippocampus and plasma were detected by enzyme-linked immunosorbent assay. Evans blue was used to detect destruction of the blood brain barrier (BBB).ResultsCognitive impairment markedly occurred to rats underwent 2-h CPB operation. Cerebral thrombosis and hypoxia occurred in the hippocampal CA3 region of rats after surgery. In addition, microglia in hippocampal was activated and the expression of inflammatory factors such as IL-1β, IL-6 and TNF-α was upregulated. Moreover, the permeability of BBB increased in rats after CPB.ConclusionHypoxia in hippocampal CA3 region was involved in the occurrence and the mechanism may be associated with neuroinflammation and the damage of BBB.