bluuebunny/crossref_metadata_2025_split huggingface dataset:
Resuscitation refresher training in the wake of the COVID-19 pandemic – instructor-led training outperforms self-directed learning.
Authors: O’Donnell Alice , Pawar Aniela , Hardy Emma , Percival Harriet , Coffin Nicholas , Hulme Jonathan , Owen Andrew , Alderman Joseph 
Published: October 2020

Abstract
Background: survival following out-of-hospital cardiac arrest is worse in the United Kingdom than in many other developed countries, possibly due to below average delivery of early bystander cardiopulmonary resuscitation (CPR). Training laypeople how to perform CPR is vital, but skill decays quickly. Most methods of training require face-to-face contact which is challenging during the Covid-19 pandemic. The optimal method of delivering CPR refresher training is not yet known. Our aim was to understand how basic life support (BLS) performance decays over time, and how best to deliver refresher training in terms of timeframe and training method – are methods with limited instructor / student contact effective? Methods: this quasi-randomised trial allocated participants to receive refresher training one, two, or three years after their initial BLS training. Participants’ baseline BLS performance was assessed by a trained instructor, and then they were randomly allocated to receive refresher training via one of three methods: one-to-one instructor led training, video assisted learning with self-directed practice, or a written information guide alone. BLS performance was assessed again following refresher training. Results: 42 participants were recruited - all completed all study stages. Baseline BLS performance was poor – only 21% of participants passed a formative assessment. Students who had received BLS training most recently showed better BLS performance than those where greater time had elapsed. one-to-one training was the most effective refresher training modality, and video assisted training did not lead to significant improvement in BLS performance. Conclusion: one-to-one BLS refresher training outperforms self-directed methods with more limited instructor contact, though it requires greater resource and planning. It may be impractical to deliver instructor-led BLS refresher training during the Covid-19 pandemic. The video we chose to use for our training was not interactive, though such tools exist. Alternative video-led approaches (with or without instructor guidance) should be explored to investigate if they are more effective than the tool we used in this study.
A Conceptual Design for Deflection Device in VTDP System
Authors: Gao Yongwei , Zhang Jianming , Wang Long , Chen Bingzhen , Wei Binbin 
Published: October 2020

Abstract
The effectiveness of the Vectored Thrust Ducted Propeller (VTDP) system is not high currently, especially the lateral force is not large enough. Thus, a conceptual design for a deflection device of a VTDP system was proposed to achieve effective hovering control. The magnitude of the lateral force that was applied to maintain balance while hovering was examined. A comparison between the experimental and numerical results for the 16H-1 was made to verify the numerical simulation approach. The deflection devices of the X-49 and the proposed design were analyzed using numerical simulations. The results indicated that a larger lateral force and lower power consumption were presented in the proposed design. The results of this article provide a new idea for the design of the VTDP system.
Total Spine Magnetic Resonance Imaging for Detection of Multifocal Infection in Pyogenic Spondylodiscitis: a retrospective observational Study
Authors: Henkelmann Jeanette , Denecke Timm , Pieroh Philipp , Einhorn Stephanie , Hoeh Nicolas H. von der , Heyde Christoph-Eckhard , Voelker Anna 
Published: October 2020

Abstract
Background

Due to the unspecific symptoms of spondylodiscitis (SpD), an early radiological examination is necessary. However, controversially discussed is the need for an magnetic resonance imaging of the entire spine to exclude multisegmental infections and to determine the required surgical interventions. The aims of this study were to assess the incidence of multilevel non-contiguous pyogenic SpD and compare comorbidities, pain symptoms, and subsequent surgical strategies between unifocal (uSpD) and multifocal (mSpD) SpD.

Methods

We retrospectively evaluated the data of patients with confirmed, surgically treated, pyogenic SpD who had received a total spine MRI in a single spine center between 2016 and 2018. MRI findings were classified according to Pola-classification and demographics, duration of clinical symptoms (pain and neurology) and Charlson Comorbidity-Index (CCI) results were compared between uSpD und mSpD groups. Surgical therapy was evaluated in patients with mSpD.

Results:
uSpD was detected by MRI in 69 of 79 patients (87%). Of these, mSpD was detected in 10 patients (13%) with 21 infected segments (cervical and/ or thoracic and/ or lumbar region). Age and CCI were similar between uSpD and mSpD and 24 of all SpD regions were clinically unapparent. All patients with uSpD were treated operatively. In seven patients with mSpD, all infected levels of the spine were treated surgically in a one-stage procedure; one patient had a two-stage procedure and one patient had surgery at the lumbar spine, and an additional infected segment of the upper thoracic spine was treated conservatively. One patient died before a planned two-stage procedure was performed.

Conclusions

Due to mSpD being found in approximately 13% of SpD cases, and considering the risk of overlooking an mSpD case, MRI imaging of the total spine is recommended. The detection of multiple infection levels can have an impact on the therapeutic strategy chosen.
Metabolic syndrome among children and adolescents in Low and Middle Income Countries: A systematic review and meta-analysis
Authors: Bitew Zebenay Workneh , Alemu Ayinalem , Ayele Ermias Getaneh , Tenaw Zelalem , Alebel Anmut , Worku Teshager 
Published: October 2020

Abstract
Background: Metabolic syndrome (MetS) is a clustering of cardiovascular risk factors, which is rising in the low and middle income countries (LMICs). There are various studies with inconsistent findings that are inconclusive for policy makers and program planners. Thus, this systematic review and meta-analysis aimed at estimating the pooled prevalence of MetS and its components in LMICs.Methods: Electronic searches were conducted in international databases including PubMed, Web of Science, EMBASE (Elsevier), Scopus, CINAHL (EBSCOhost), Science direct (Elsevier), Food Science and Technology Abstracts (FSTA), Global Health and Medline, and other sources (World Cat, Google Scholar, and Google). The pooled estimates were computed in the random effect model. The pooled prevalence was computed using the three diagnostic methods (IDF, ATP III and de Ferranti). Publication bias was verified using funnel plot and Egger’s regression test. Subgroup and sensitivity analysis were performed to identify the possible sources of heterogeneity among the included studies. Result: In this study, 142,142 children and adolescents from 76 eligible articles were included to compute the pooled prevalence of MetS and its components in LMCIs. MeTs among overweight and obese population was computed from 20 articles with the pooled prevalence of 24.09%, 36.5%, and 56.32% in IDF, ATP III and de Ferranti criteria, respectively. Similarly, a total of 56 articles were eligible to compute the pooled prevalence of MetS in the general population of children and adolescents. Hence, Mets was found in 3.98% (IDF), 6.71% (ATP III) and 8.91% (de Ferranti) of study subjects. Regarding the components of MetS, abdominal obesity was the major component in overweight and obese population and low HDL-C was the most common component in the general population. This study also revealed that males were highly affected by MetS than females.Conclusion: This study illustrates that MetS among children and adolescents is an emerging public health challenge in LMICs, where the prevalence of obesity is on the move. Preventive strategies such as community and school based intervention need to be designed. Promoting physical activities and healthy eating behaviors could avert this problem.
LINC01123 Promotes the Proliferation and Migration of Vascular Smooth Muscle Cells and Alleviates Carotid Atherosclerosis by Modulating miR-1277-5p/KLF5
Authors: Weng Guohu , Gu Minhua , Zhang Yifan , Zhao Guangfeng , Gu Yong 
Published: October 2020

Abstract
Background: The pathophysiological mechanism of carotid atherosclerosis (CAS) involves endothelial cell dysfunction, vascular smooth muscle cells (VSMCs) and macrophage activation, which ultimately leads to fibrosis of the vessel wall. lncRNA works weightily in the formation of CAS, but the function and mechanism of lncRNA LINC01123 in CAS are still equivocal.Methods: We collected blood samples from 35 CAS patients as well as 33 healthy volunteers. VSMCs treated with oxidized low-density lipoprotein (ox-LDL) were utilized as the CAS cell model. We applied qRT-PCR for detecting LINC01123, miR-1277-5p and KLF5 mRNA expression, CCK-8 method and BrdU test for determining cell proliferation, Transwell test for measuring cell migration, as well as Western blot for assaying KLF5 protein expression. Dual-luciferase reporter experiment was adopted for assessing the interaction between LINC01123 and miR-1277-5p, as well as KLF5 and miR-1277-5p.Results: LINC01123 and KLF5 expression was dramatically up-regulated, while miR-1277-5p expression was down-regulated in CAS patients and ox-LDL-induced CAS cell models. Overexpressed LINC01123 notedly promoted VSMC migration and proliferation. LINC01123 knockdown repressed cell proliferation and migration. Also, LINC01123 targeted miR-1277-5p and down-regulated its expression, while miR-1277-5p could negatively regulate KLF5 expression.Conclusion: LINC01123 is highly expressed in CAS patients and is capable of being utilized as a latent target for treating CAS.
Diabetes impairs the protective effects of sevoflurane postconditioning in myocardium subjected to ischemia/reperfusion injury in rats: important role of Drp1
Authors: Yu Jing , He Jiandong , Yang Wenqu , Wang Xiang , Shi Gaoxiang , Duan Yinglei , Wang Hui , Han Chongfang 
Published: October 2020

Abstract
Background
Sevoflurane postconditioning (SevP) is an effective way in relieving myocardial ischemia/reperfusion (IR) injury, which doesn’t work well in diabetic myocardium unfortunately. Prior studies have noted the importance of increasing oxidative stress in diabetic tissues. Noteworthily, mitochondrial fission mediated by dynamin-related protein 1 (Drp1) is an upstream pathway of reactive oxygen production. Whether Drp1 dependent mitochondrial fission is associated with the ineffectiveness of SevP in diabetic myocardium remains unknown. The aim of this study was to explore the important role of Drp1 in diabetic myocardium and investigate whether Drp1 inhibition could restore the cardioprotective effect of SevP.
Methods
In the first part, adult male Sprague-Dawley(SD) rats were divided into 6 groups. Rats in diabetic groups were fed with high-fat and high-sugar for 8 weeks, and then received a injection of streptozotocin (35 mg/kg) intraperitoneally. Myocardial IR was induced by 30 min occlusion of left anterior descending branch of coronary artery followed by 120 min reperfusion༎SevP was applied by continuous inhalation of 2.5% sevoflurane 1 min before reperfusion, which lasted for 10 min. In the second part, mdivi-1 was used to investigate whether Drp1 inhibition could restore the cardioprotective effects of SevP in diabetic myocardium against I/R injury. The myocardial infarct size, pathology, mitochondrial ultrastructure, cardiomyocyte apoptosis, total SOD activity, MDA content, and Drp1 expression were detected.
Results
The diabetic myocardium displayed severer injury with greater infarct size and apoptosis. Up-regulated Drp1 expression concomitant with increased mitochondrial fission and oxidative stress were observed in diabetic myocardium subjected to I/R. The deteriorated changes were alleviated in normal but not in diabetic rats. Importantly, mdivi-1 administration significantly suppressed mitochondrial fission and oxidative stress, and the beneficial effects of SevP were restored by mdivi-1.
Conclusions
The present study indicates a crucial role of Drp1 dependent mitochondrial fission in diabetic myocardium subjected to IR. Drp1 inhibition may be effective in restoring the effect of SevP in reducing diabetic myocardial IR injury.
The Distribution Pattern of Periprostatic Neurovascular Bundles Examined with Successive Celloidin Slices
Authors: Li Xuemei , Wu Jianhui , Cai Qiliang , Pan Janming , Meng Qingguo , Zhang Ping , Xu Yong , Zhai Lidong 
Published: October 2020

Abstract
Background: Although several distribution patterns of periprostatic neurovascular bundles have been proposed, variant dissection technique based on these patterns still confused surgeons.The aim of this study was to describe the periprostatic neurovascular bundles and their relationship with the fascicles around prostate and provide the accurate morphologic knowledge of periprostatic tissue for prostate operation.Methods: The pelvic viscera were obtained from 26 adult male cadavers. They were embedded in celloidin and cut into successive slices. The slices were explored with anatomic microscopy. 3-Dimensional reconstruction was achieved with celloidin sections and series software.Results: The prostatic capsule which surrounded the dorsal, bilateral aspect of the prostate was attached ventrally to anterior fibrous muscular stroma (AFMS). The lower part of the striated sphincter completely embraced the urethral; the upper part of this muscle covered the lower ventral surface of prostate. The upper ventral surface of prostate is covered by the circular muscle of detrusor. The levator fascia and the capsule adhered on the most convex region of the lateral prostate, but separated on the other region. The pelvic neurovascular bundles (PNVB) divided into the anterior and posterior divisions. The anterior division continued as dorsal vascular complex (DVC). The distal part of DVC entered into penile hilum. The posterior division continued as neurovascular bundles NVB, and then as the cavernous supply (CS). The distal part of CS joined into pudendal neurovascular bundles. Conclusions: The capsule and AFMS formed a pocket like complex. There were anterior and posterior neurovascular approaches from PNVB to penile hilum.
Development and Evaluation of A New Measure of Children’s Play: The Children’s Play Scale (CPS)
Authors: Dodd Helen , Nesbit Rachel J. , Maratchi Laura 
Published: October 2020

Abstract
Background There is increasing recognition of the importance of children’s play from a public health perspective given the links between play and children’s physical and mental health. The present research aimed to develop and evaluate a new parent-report questionnaire that measures the time children spend playing and how adventurously children play, across a range of places.Method The questionnaire was developed with input from a diverse group of parents and experts in children’s play. It was designed to yield a range of metrics including time spent playing per year, time spent playing outside, time spent playing in nature and level of adventurous play. The reliability of the questionnaire was then evaluated with 245 parents (149 mothers, 96 fathers) of 154 children aged 5 to 11 years. All participants completed the measure at time 1. At time 2, an average of 20 days later, 184 parents (111 mothers and 73 fathers) of 99 children completed the measure again. Results Cross-informant agreement, evaluated using Concordance Correlation Coefficients (CCCs), ranged from 0.36 to 0.51. These fall in the poor to moderate range and are largely comparable to cross-informant agreement on other measures. Test-retest reliability for mothers was good (range 0.67 - 0.76) for time spent playing metrics. For fathers, test-retest reliability was lower (range 0.39 - 0.63). For both parents the average level of adventurous play variable had relatively poor test retest reliability (mothers = 0.49, fathers = 0.42). This variable also showed a significant increase from time 1 to time 2. This instability over time may be due to the timing of the research in relation to the Covid-19 lockdown and associated shifts in risk perception.Conclusions The measure will be of value in future research focusing on the public health benefits and correlates of children’s play as well as researchers interested in children’s outdoor play and play in nature specifically. The development of the measure in collaboration with parents and experts in children’s play is a significant strength. It will be of value for future research to further validate the measure against play diaries or activity monitors.
The Effects of Pre-Response Before COVID-19 Outbreak on Strategic Decision Making
Authors: Jung Jae Hun , Kim Daewook , Jung Il Hyo 
Published: October 2020

Abstract
Background: In the case of COVID-19, many countries have introduced their own policies for prevention. In Sweden, herd immunity policy was implemented and it was difficult to reduce the number of fatalities. In South Korea, the number of fatalities was not high because the public had earlier received a risk warning from the government and followed the policy well. In order to prevent the spread of infectious diseases, the government’s policy is important, but it is also important for people to agree and follow the policy. As such, an individual’s behavior such as preventive measures and pre-responses may be linked to the prevention of the spread of COVID-19. Methods: To evaluate the effect of strategy selection between individuals and groups when pre-response action, we incorporate a compartmental epidemic model into a game-theoretical framework and use this to fit the cumulative confirmed data of Sweden (Feb. 27 - Mar. 12) and South Korea (Feb. 4 - Mar. 3). Results: The transmission rate (β) is estimated from the fitted model, and the reproduction numbers (R0) of two countries, Sweden and South Korea are estimated by 6.93 and 3.71, respectively. The probability of infection (φ p) of Sweden is about 12% higher than that of South Korea. As the probability of attack that an epidemic occurs (θ) increases, the individual’s equilibrium gradually increased than group optimum. Conclusions: When comparing the prevention policies of Sweden and South Korea, it was confirmed that pre-response can be an appropriate preventive strategy against the transmission of infection. The selection of a strategy between individuals and groups can lead to the collapse of altruism that tends to select an action strategy for personal benefit, as the probability of the epidemic attack increases.
Motor Variances in Arm Cranking as a Function of the Resistance
Authors: Mravcsik Mariann , Botzheim Lilla , Zentai Norbert , Piovesan Davide , Laczko Jozsef 
Published: October 2020

Abstract
Background: Arm cycling on an ergometer is common in sports training and rehabilitation protocols, but has not been widely studied from an aspect of neural control. The hand movement is constrained along a circular path, and the user is working against a resistance, maintaining a cadence. Even if the desired hand trajectory is given, there is the flexibility to choose patterns of joint coordination and muscle activation, given the kinematic redundancy of the upper limb. With changing external load, motor noise and changing joint stiffness may affect the pose of the arm even though the endpoint trajectory is unchanged, unless a control mechanism maintains the same arm configuration in corresponding time points of the cycles. However, the effect of crank resistance on the variances of arm configuration and muscle activation has not been investigated, yet. Methods: Fifteen healthy participants performed arm cranking on an arm-cycle ergometer both unimanually and bimanually with a cadence of 60 rpm against three crank resistances. We investigated arm configuration variances and muscle activation variances. Arm configuration was given by inter-segmental joint angles, while muscle activation by surface EMGs of arm muscles. Applying multifactorial ANOVA we evaluated the effects of resistance conditions. Results: Arm configuration variance in the course of arm cranking was not affected by crank resistance, while muscle activation variance was proportional to the square of electromyographic muscle activity. Furthermore, the shape of the variance time profiles for both arm configuration and muscle activation was not affected by crank resistance independently on cranking being performed unimanually or bimanually. Conclusions: Contrary to the prevailing assumption that an increased motor noise would affect the variance of auxiliary movements, the influence of noise doesn’t appear at the arm configuration level even when the system is redundant. Our results suggest that neural control stabilizes arm configurations against altered external force in arm cranking. This may reflect the separation of kinematic- and force-control, via mechanisms that are compensating for dynamic non-linearities. Arm cranking may be suitable when the aim is to perform training under different load conditions, preserving stable and secure control of joint movements and muscle activations.
Application of [68Ga]Ga-citrate PET/CT for Differentiating Prosthetic Joint Infection from Aseptic Loosening After Joint Replacement Surgery
Authors: Xu Tingting , Zeng Yalan , Yang Hongbin , Cai Liang , Ding Haoyuan , Liu Nan , Zhang Li , Lei Lei , Qi Chi , Zhang Yan , Liu Lin , Zhang Xiaoling , Wang Junzheng , Fan Dongmei , Liu Guangfu , Du Tao , Xiang Ke , Wang Peng , Jiang Fei , Chen Yue 
Published: October 2020

Abstract
Purpose

Preoperative differentiation of prosthetic joint infection (PJI) and aseptic loosening (AL) is challenging. We aimed to evaluate the utility of visual analysis and semi-quantitative parameters of [68Ga]Ga-citrate positron emission tomography/computed tomography (PET/CT) in the differentiation of PJI and AL.
Methods

Sixteen patients with suspected PJI or AL underwent [68Ga]Ga-citrate PET/CT imaging. Results were evaluated by three nuclear medicine doctors based on (1) visual analysis of the attenuation correction (AC) and non-attenuation correction (NAC) based on tracer uptake intensity and range; (2) maximum standard uptake value (SUVmax) of lesions and the SUVmax of the target area/SUVmax of the non-target area (bone and muscle; T/NT [bone] and T/NT [muscle]). The final diagnosis was based on the Musculoskeletal Infection Society criteria, intraoperative findings, and histopathological and microbiological examinations.
Results

Overall, 10 (62.5%) and 6 (37.5%) patients were diagnosed with PJI and AL, respectively. Receiver operating characteristic analysis revealed that the areas under the curve for SUVmax, T/NT (bone), and T/NT (muscle) were 0.617 (cut-off = 2.243, P = 0.4312), 0.850 (cut-off = 2.844, P = 0.0052), and 0.850 (cut-off = 5.983, P = 0.0003), respectively. AC, NAC, and T/NT (bone) exhibited high differential diagnostic values (sensitivity, specificity, and accuracy of 90.0%, 83.3%, and 87.5%, respectively). The diagnostic efficacy of T/NT (muscle) was the second highest (sensitivity, specificity, and accuracy of 60.0%, 100%, and 75.0%, respectively). SUVmax demonstrated the poorest diagnostic efficacy (sensitivity, specificity, and accuracy of 70.0%, 66.7%, and 68.8%, respectively).
Conclusion

Our results suggest that [68Ga]Ga-citrate may differentiate PJI and AL.