bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence-based Classification in Track Athletics for Athletes with a Vision Impairment: A Delphi Study
Authors: Allen Peter M. , Dolan Rebecca , Croxall Helen , Ravensbergen Rianne H. J. C. , Brooks Ashley , Zenk Franziska , Mann David L. 
Published: October 2020

SIGNIFICANCEThe Delphi analysis presented here highlights the need for a sport-specific evidence-based classification system for track athletics for athletes with a vision impairment (VI). This system may differ for different race distances. Further research is required to develop a useful test battery of vision tests for classification. The issue of intentional misrepresentation during classification needs particular attention.PURPOSEAt present, athletes with VI are placed into competition classes developed on the basis of legal definitions of VI. The International Paralympic Committee Athlete Classification Code states that all sports should have their own classification system designed to reflect the (visual) demands of that individual sport. This project gathered expert opinion on the specific requirements for an evidence-based sport-specific classification system for VI track athletics and to identify any particular issues within track athletics that require further research into their impact on sport performance.METHODSA three-round Delphi review was conducted with a panel of 17 people with expertise in VI track athletics.RESULTSThe panel agreed that the current classification system in VI track athletics does not completely minimize the impact of impairment on competition outcome, highlighting the need for improvements. There was clear agreement that the existing measures of vision may fail to adequately reflect the type of vision loss that would impact running performance, with additional measures required. Intentional misrepresentation, where athletes “cheat” on classification tests, remains a serious concern.CONCLUSIONSThe panel has identified measures of vision and performance that will inform the development of an evidence-based classification system by better understanding the relationship between VI and performance in track athletics. Issues such as the use of guides and whether the current class system was equitable gave rise to differing opinions within the panel, with these varying across the different running distances.
The Effect of Temporal Information on Placebo Analgesia and Nocebo Hyperalgesia
Authors: Camerone Eleonora Maria , Piedimonte Alessandro , Testa Marco , Wiech Katja , Vase Lene , Zamfira Denisa Adina , Benedetti Fabrizio , Carlino Elisa 
Published: October 2020

ABSTRACT

Objective
Expectations are known to be key determinants of placebo and nocebo phenomena. In previous studies, verbal suggestions to induce such expectations have mainly focused on the direction and magnitude of the effect, whereas little is known about the influence of temporal information.

Methods
Using an experimental placebo and nocebo design, we investigated whether information about the expected onset of a treatment effect modulates the start and time course of analgesic and hyperalgesic responses. Healthy volunteers (n = 166) in three placebo and three nocebo groups were informed that the application of an (inert) cream would reduce (placebo groups) or amplify pain (nocebo groups) after 5, 15, or 30 minutes. Two control groups were also included (natural history and no expectations). Participants’ pain intensity rating of electrical stimuli administered before and 10, 20, and 35 minutes after cream application was obtained.

Results
Mixed-method analysis of variance showed a significant interaction between group and time (F(12,262) = 18.172, p < .001, pη2 = 0.454), suggesting that pain variations differed across time points and between groups. Post hoc comparisons revealed that the placebo and nocebo groups began to show a significantly larger change in perceived pain intensity than the no-expectancy control group at the expected time point (p < .05) but not earlier (p > .05). Once triggered, the analgesic effect remained constant over the course of the experiment, whereas the hyperalgesic effect increased over time.

Conclusions
Our results indicate that temporal suggestions can shape expectancy-related treatment effects, which, if used systematically, could open up new ways to optimize treatment outcome.
Incremental Diagnostic Value of Virtual Noncalcium Dual-Energy Computed Tomography for the Depiction of Cervical Disk Herniation Compared With Standard Gray-Scale Computed Tomography
Authors: Booz Christian , Yel Ibrahim , Martin Simon S. , Lenga Lukas , Eichler Katrin , Wichmann Julian L. , Vogl Thomas J. , Albrecht Moritz H. 
Published: October 2020

Objectives
The aim of this study was to investigative the diagnostic accuracy of colored dual-energy computed tomography (CT) virtual noncalcium (VNCa) series for analyzing cervical disk herniation compared with standard gray-scale CT images, with magnetic resonance imaging (MRI) serving as standard of reference.

Materials and Methods
Data from 57 patients who underwent noncontrast dual-source CT and 3.0-Tesla (T) MRI within 2 weeks between January 2017 and December 2018 were retrospectively analyzed. Five radiologists analyzed standard gray-scale dual-energy CT scans for the presence and degree of cervical disk herniation and spinal nerve root impingement. Readers reassessed scans after 8 weeks using colored VNCa series. Two experienced radiologists set the reference standard in consensus MRI reading sessions. Primary indices of diagnostic accuracy for both CT approaches were sensitivity and specificity, which were compared by application of the McNemar test.

Results
A total of 57 patients (mean age, 64 ± 11 years; 30 women) were evaluated (337 intervertebral disks). Magnetic resonance imaging indicated a total of 103 cervical disk herniations. The VNCa reconstructions had higher overall sensitivity compared with gray-scale CT (487/515 [95%; 95% confidence interval (CI), 91%–98%] vs 392/515 [76%; 95% CI, 70%–83%]), as well as higher specificity (1107/1170 [95%; 95% CI, 90%–99%] vs 906/1170 [77%; 95% CI, 72%–82%]) for assessing cervical disk herniation (all P < 0.001). The VNCa reconstructions had higher diagnostic accuracy for analyzing spinal nerve root impingement in comparison with gray-scale CT (sensitivity, 195/230 [85%; 95% CI, 79%–90%] vs 115/230 [50%; 95% CI, 40%–59%]; specificity, 1430/1455 [98%; 95% CI, 94%–100%] vs 1325/1455 [91%; 95% CI, 88%–98%]; accuracy, 1625/1685 [96%; 95% CI, 93%–99%] vs 1440/1685 [86%; 95% CI, 82%–90%]; all P < 0.001).

Conclusions
Color-coded VNCa series improved the diagnostic accuracy for assessing cervical disk herniation and spinal nerve root impingement compared with standard gray-scale CT.
Deep Learning on Conventional Magnetic Resonance Imaging Improves the Diagnosis of Multiple Sclerosis Mimics
Authors: Rocca Maria A. , Anzalone Nicoletta , Storelli Loredana , Del Poggio Anna , Cacciaguerra Laura , Manfredi Angelo A. , Meani Alessandro , Filippi Massimo 
Published: October 2020

Objectives
The aims of this study were to present a deep learning approach for the automated classification of multiple sclerosis and its mimics and compare model performance with that of 2 expert neuroradiologists.

Materials and Methods
A total of 268 T2-weighted and T1-weighted brain magnetic resonance imagin scans were retrospectively collected from patients with migraine (n = 56), multiple sclerosis (n = 70), neuromyelitis optica spectrum disorders (n = 91), and central nervous system vasculitis (n = 51). The neural network architecture, trained on 178 scans, was based on a cascade of 4 three-dimensional convolutional layers, followed by a fully dense layer after feature extraction. The ability of the final algorithm to correctly classify the diseases in an independent test set of 90 scans was compared with that of the neuroradiologists.

Results
The interrater agreement was 84.9% (Cohen κ = 0.78, P < 0.001). In the test set, deep learning and expert raters reached the highest diagnostic accuracy in multiple sclerosis (98.8% vs 72.8%, P < 0.001, for rater 1; and 81.8%, P < 0.001, for rater 2) and the lowest in neuromyelitis optica spectrum disorders (88.6% vs 4.4%, P < 0.001, for both raters), whereas they achieved intermediate values for migraine (92.2% vs 53%, P = 0.03, for rater 1; and 64.8%, P = 0.01, for rater 2) and vasculitis (92.1% vs 54.6%, P = 0.3, for rater 1; and 45.5%, P = 0.2, for rater 2). The overall performance of the automated method exceeded that of expert raters, with the worst misdiagnosis when discriminating between neuromyelitis optica spectrum disorders and vasculitis or migraine.

Conclusions
A neural network performed better than expert raters in terms of accuracy in classifying white matter disorders from magnetic resonance imaging and may help in their diagnostic work-up.
What Does Your Pelvic Floor Do for You? Knowledge of the Pelvic Floor in Female University Students: A Cross-sectional Study
Authors: Falvey Leah , Salameh Fadi , O’Sullivan Orfhlaith E. , O’Reilly Barry A. 
Published: October 2020

Objectives
To assess the knowledge of the pelvic floor in female university students, including knowledge of pelvic floor structure, function, pelvic floor dysfunction, and pelvic floor muscle exercises (PFMEs).

Methods
The study design is a cross-sectional study via online questionnaire with convenience sampling of female students registered at University College Cork, Ireland for the academic year 2018 to 2019. An online questionnaire was distributed to students at their registered email addresses. Overall knowledge was assessed through 15 questions, looking at pelvic floor structure, function, pelvic floor dysfunction and PFMEs. A score of 1 was allocated to each correct question, with a maximum possible score of 15. Only respondents who answered all 15 questions were included in the analysis. Ethical approval was granted by the Clinical Research and Ethics Committee, Cork, Ireland, on January 4, 2019.

Results
Nine hundred thirty-eight responses were received. There were 72.6% (n = 640) students who had never received information on the pelvic floor. There were 83.9% (n = 691) students who reported that they thought it was important to exercise the pelvic floor. The mean overall knowledge score of 792 respondents was 9.57 (SD, ± 2.72). There was a statistically significant difference (P < 0.001) in the overall knowledge between the students in the school of medicine and health (n = 307, mean = 11.8, SD = 2.35) and the students of other schools (n = 529, mean = 9.39, SD = 2.88).

Conclusions
Knowledge of the pelvic floor in female university students is poor. Further interventions should aim to improve knowledge of the pelvic floor and encourage correct performance of PFMEs in college students.
Comparison of surgical versus medical termination of pregnancy between 13-20 weeks of gestation in Ethiopia: A quasi-experimental study
Authors: Tufa Tesfaye H. , Prager Sarah , Wondafrash Mekitie , Mohammed Shikur , Byl Nicole , Bell Jason 
Published: October 2020

AbstractBackgroundDilation and evacuation is a method of second trimester pregnancy termination introduced recently in Ethiopia. However, little is known about the safety and effectiveness of this method in an Ethiopian setting. Therefore, the study is intended to determine the safety and effectiveness of dilation and evacuation for surgical abortion as compared to medical abortion between 13-20 weeks’ gestational age.MethodsThis is a quasi-experimental study of women receiving second trimester termination of pregnancy between 13-20 weeks. Patients were allocated to either medical or surgical abortion based on their preference. A structured questionnaire was used to collect demographic information and clinical data upon admission. Procedure related information was collected after the procedure was completed and before the patient was discharged. Additionally, women were contacted 2 weeks after the procedure to evaluate for post-procedural complications. The primary outcome of the study was a composite complication rate. Data were collected using Open Data Kit and then analyzed using Stata version 14.2. Univariate analyses were performed using means (standard deviation), or medians (interquartile range) when the distribution was not normal. Multivariate logistic regression was also performed to control for confounders.ResultsTwo hundred nineteen women chose medical abortion and 60 chose surgical abortion. The composite complication rate is not significantly different among medical and surgical abortion patients (15% versus 10%; p=0.52). Nine patients (4.1%) in the medical arm required additional intervention to complete the abortion, while none of the surgical abortion patients required additional intervention. Median (IQR) hospital stay was significantly longer in the medical group at 24 (12-24) hours versus 6(4-6) hours in the surgical group p<0.001.ConclusionFrom the current study findings, we concluded that there is no difference in safety between surgical and medical methods of abortion. This study demonstrates that surgical abortion can be used as a safe and effective alternative to medical abortion and should be offered equivalently with medical abortion, per the patient’s preference.
DPP6 gene in European American Alzheimer’s Disease
Authors: Kirola Laxmi , Budde John P. , Wang Fengxian , Norton Joanne , Morris John C. ,   NIA-LOAD family study group, NCRAD, the ADSP project, Cruchaga Carlos , Fernández Maria Victoria 
Published: October 2020

AbstractDPP6 encodes a transmembrane protein that expresses highly in the hippocampal regions of the brain and regulates dendritic excitability. Recently, rare and loss of function variants were reported in DPP6 and further demonstrated to be associated with early onset Alzheimer Disease (AD) and frontotemporal dementia. We performed single variant and gene-based analyses in three non-Hispanic white cohorts: a familial late onset AD (cases=1212, controls=341), an unrelated early onset AD (cases=1385, controls=3864) and in the unrelated Alzheimer disease sequencing project (ADSP, cases=5679, controls=4601). Neither single variant or gene-based analysis revealed any significant statistical association of DPP6 variants with the risk for AD in the cohorts examined.
Rapid Development of a De Novo Convalescent Plasma Program in Response to a Global Pandemic: A Large Southeastern U.S. Blood Center’s Experience
Authors: Reik Rita , Gammon Richard R. , Carol Nancy , Smith Judith , Grable Martin , Forbes Susan , Wu Yanyun , Reed Lance , Rogers Michael , Prichard Alicia , Paul Scott , Scholl George 
Published: October 2020

AbstractBackgroundWith no vaccine or treatment for SARS-CoV-2 and its associated disease, COVID-19, convalescent plasma from recovered COVID-19 (CCP) patients offered a potential therapy. In March of 2020, the United States (US) Food and Drug Administration (FDA) authorized CCP under emergency Investigational New Drug (eIND) exemption and an IRB-approved Expanded Access Program (EAP) to treat severe COVID-19. Hospital demand grew rapidly in the Southeastern US, resulting in backlogs of CCP orders. We describe a large US blood center’s (BC) rapid implementation of a CCP program in response to community needs.Study Design and MethodsFrom April 2 to May 17, 2020 CCP was collected by whole blood or apheresis. Initial manual approaches to donor intake, collection and distribution were rapidly replaced with automated processes. All CCP donors and products underwent FDA-required screening and testing.Results619 CCP donors (299 females, 320 males) presented for CCP donation [161 (25.6%) whole blood, 466 (74.1%) plasmapheresis] resulting in 1219 CCP units. Production of CCP increased as processes were automated and streamlined, from a mean of 11 donors collected/day for the first month to a mean of 25 donors collected/day in the subsequent two weeks. Backlogged orders were cleared, and inventory began to accumulate 4 weeks after project initiation.ConclusionThe BC was able to implement an effective de novo CCP collection program within 6 weeks in response to a community need in a global pandemic. Documentation of the experience may inform preparedness for future pandemics.
Wearable Robotic Ankle Resistance Training Improves Neuromuscular Control and Walking Efficiency in Cerebral Palsy
Authors: Conner Benjamin C. , Schwartz Michael H. , Lerner Zachary F. 
Published: October 2020

AbstractCerebral palsy (CP) is characterized by deficits in motor function due to reduced neuromuscular control. We leveraged the guiding principles of motor learning theory to design a wearable robotic intervention intended to improve neuromuscular control of the ankle. The goal of this pilot clinical trial was to determine the response to four weeks of exoskeleton ankle resistance therapy (exo-therapy) in children with CP. Five children with CP (12 – 17 years, GMFCS I – II, four males and one female) were recruited for ten, 20-minute sessions of exo-therapy. Surface electromyography, three-dimensional kinematics, and metabolic data were collected at baseline and after training was complete. Changes in neural complexity (via muscle synergy analysis) and metabolic cost were compared to retrospective age- and GMFCS-matched controls who had undergone either single event multi-level orthopedic surgery (SEMLS) or selective dorsal rhizotomies (SDR). Participants displayed decreased co-contraction at the ankle (−29 ± 11%, p = 0.02) and a more typical plantar flexor activation profile (33 ± 13%, p = 0.01), and improvements in neuromuscular control led to a more mechanically-efficient gait pattern (58 ± 34%, p < 0.05) with a reduced metabolic cost of transport (−29 ± 15%, p = 0.02). There were significant increases in neural complexity (5 ± 3%, p = 0.03), where were significantly greater than those seen with SEMLS and SDR (p < 0.01 for both). Ankle exoskeleton resistance therapy shows promise for rapidly improving neuromuscular control for children with CP, and may serve as a meaningful rehabilitative complement to common surgical procedures.
Evaluation of filtration efficacy of various types of facemasks using ambient and PAO aerosols following with different sterilization methods
Authors: Kumar Amit , Bhattacharjee Basundhara , Sangeetha D.N , Subramanian V , Venkatraman B 
Published: October 2020

AbstractDue to the ongoing pandemic, various types of facemasks such as N-95, surgical mask and cloth masks are being used as an essential protective measure. The filtration efficiency of these masks were tested before and after sterilization by different methods for two flow rates conditions corresponding to normal breathe rate (20 lpm) and during sneezing (90 lpm). Sterilization techniques used here are autoclaving (30 and 60 minutes), dry oven heating (30 and 60 minutes), gamma irradiation (15 and 25 kGy), hot water washing with and without detergent and immersing in 10% concentration of liquid hydrogen peroxide for 30 minutes. As expected, the N-95 is the greatest filtering efficiency among all the other type face masks. The best method to sterilize N-95 masks without affecting its performance is by using dry heat with temperature ranging from 70-80°C. The cloth masks and surgical mask are performed more or less same for both flow conditions. As an affordable sterilization method hot water washing is highly recommended which does not deteriorate the efficiency of the masks and can be used for the general public. The use of double or triple layer cotton cloth masks in the general public serves fit for the purpose than surgical masks. The surgical mask can be sterilized only few times with the help of dry heat, hot water wash and/or autoclave.
SARS-CoV-2 seroprevalence in healthcare workers of dedicated-COVID hospitals and non–COVID hospitals of District Srinagar, Kashmir
Authors: Khan Muhammad Salim , Haq Inaamul , Qurieshi Mariya Amin , Majid Sabhiya , Bhat Arif Akbar , Obaid Muhammad , Qazi Tanzeela Bashir , Chowdri Iqra Nisar , Sabah Iram , Kawoosa Misbah Ferooz , Lone Abdul Aziz , Nabi Shahroz , Sumji Ishtiyaq Ahmad , Kousar Rafiya 
Published: October 2020

AbstractBackground and objectiveSARS-CoV-2 infection poses tremendous challenge to the healthcare system of nations across the globe. Serological testing for SARS-CoV-2 infection in healthcare workers, which form a high-risk group, helps in identifying the burden of hidden infection in an institutional setting.MethodsWe present the results of a cross-sectional serosurvey in healthcare workers from two different hospital settings based on their role in the management of SARS-CoV-2 patients in District Srinagar, Kashmir. In addition to testing for the presence of SARS-CoV-2 specific IgG, we collected information on influenza-like symptoms in the last four weeks and the status of RT-PCR testing. SARS-CoV-2 specific IgG antibodies were detected in serum samples using a sensitive and specific chemiluminescent microparticle immunoassay technology.Interpretation and ConclusionOf 2915 healthcare workers who participated in the study, we analysed data from 2905 healthcare workers. The overall prevalence of SARS-CoV-2 specific IgG antibodies was 2.5% (95% CI 2.0-3.1) in the healthcare workers of District Srinagar. Healthcare workers who had ever worked at a dedicated-COVID hospital had a substantially lower seroprevalence of 0.6% (95% CI: 0.2 - 1.9). Among healthcare workers who had tested positive for RT-PCR, seroprevalence was 27.6% (95% CI: 14.0 - 47.2).The seroprevalence of SARS-CoV-2 infection in healthcare workers of District Srinagar is low, reflecting that a high proportion of healthcare workers are still susceptible to the infection. It is crucial to lay thrust on infection prevention and control activities and standard hygiene practices by the healthcare staff to protect them from acquiring infection within the healthcare setting.
Abnormal liver tests in admitted patients with SARS-Cov-2 or other respiratory viruses- prognostic similarities and temporal disparities
Authors: Shafran Noa , Issachar Assaf , Shochat Tzippy , Shafran Inbal Haya , Bursztyn Michael , Shlomai Amir 
Published: October 2020

AbstractBackground and AimsAbnormal liver tests are common in patients with severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infection, but their association with short-term outcomes is controversial. We aimed to compare the pattern of abnormal liver tests in SARS-CoV-2 patients with those of patients infected with influenza or respiratory syncytial virus (RSV), two non-hepatotropic respiratory viruses, and their association with in-hospital mechanical ventilation or death.MethodsA retrospective cohort study of 1271 hospitalized patients (872 influenza, 218 RSV, and 181 SARS-Cov-2) in a tertiary medical center. We defined abnormal liver tests as GPT, GOT or GGT≥40IU/ML at any time-point during hospitalization.ResultsAbnormal liver tests were mild-moderate in the majority of patients regardless of infection type but the majority of patients with influenza or RSV had a transaminases peak earlier during hospitalization compared to patients with SARS-Cov-2. Abnormal liver tests correlated with markers of severe disease across all types of infections, and were associated with mechanical ventilation or death, occurring mainly in patients with severe liver tests abnormalities (>200IU/L) (27.2%, 39.4% and 55.6% of patients with influenza, RSV or SARS-Cov-2). In multivariate analysis, controlling for age, gender, lymphopenia and CRP, liver tests abnormalities remained significantly associated with mechanical ventilation or death for influenza (OR= 3.047, 95% CI 1.518-6.117) and RSV (OR= 3.402, 95% CI 1.032-11.220) but not for SARS-Cov-2 (OR= 0.995, 95% CI 0.198-4.989). These results were confirmed upon propensity score matching.ConclusionsAbnormal liver tests during hospitalization with different viral respiratory infections are common, may differ in their time-course and reflect disease severity. They are associated with worse outcomes, mainly in patients with severe liver test abnormalities, regardless of infection type.