bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of transcranial direct current stimulation on sports performance for two profiles of athletes (power and endurance) (COMPETE): a protocol for a randomised controlled trial.
Authors: Grandperrin Yohan , Grosprêtre Sidney , Nicolier Magali , Gimenez Philippe , Vidal Chrystelle , Haffen Emmanuel , Bennabi Djamila 
Published: April 2020

Abstract
Background Transcranial direct current stimulation (tDCS) is promising for improving motor and cognitive performance. Nevertheless, its mechanisms of action are unclear and need to be better characterised according to the stimulated brain area and the type of exercise performed. Methods/design This is a double-blind cross-over study, organised into two parts: the first is to assess the effects of tDCS on explosive performance (jump task) and the second is to assess the effects on endurance performance (cycling time trial task). Participants, who are recreationally active or athletes (cyclists, parkour practitioners), will receive two active tDCS sessions (over the left dorsolateral prefrontal cortex and right motor cortex) and one sham tDCS session (part A) or two daily tDCS sessions (one active sequence and one sham) over five days (part B). Motor and cognitive performance will be compared before and after the tDCS sessions (part A) and before and after the first session, after the last session and at day 12 and day 30 of each tDCS sequence (part B). Discussion This study investigates the acute and long-term effects of tDCS on the motor and cognitive performance in healthy subjects. It will try to evaluate if tDCS could be considered as a neuroenhancement technology according to the physical task investigated (endurance versus explosive).
Relation between quantity and quality of peri-coronary epicardial adipose tissue and its underlying hemodynamically significant coronary stenosis
Authors: Du Yu , Yang Lin , Liu Yan , Yang Bangguo , Lv Sai , Hu Chenping , Zhu Yong , Zhang Hongkai , Ma Qian , Wang Zhijian , Liu Yuyang , Shi Dongmei , Zhao Yingxin , Xu Lei , Zhou Yujie 
Published: April 2020

Abstract
Background: We aimed to investigate the association of lesion-specific epicardial adipose tissue (EAT) volume and density with the presence of lesion ischemia.Methods: We enrolled 45 patients (55 lesions) with known or suspected coronary artery disease who underwent coronary computed tomography angiography (CTA) followed by invasive fractional flow reserve (FFR) assessment within 30 days. EAT volume (index) and density in patient-, vessel- and lesion-level were measured on CTA images. Lesion-specific ischemia was defined as a lesion with stenosis diameter >90% or FFR ≤0.80. Multivariate analysis determined the independent association of EAT parameters with lesion ischemia. Results: Mean age of the patients was 60 years, and 75% were male. Overall, 55.6% of patients had ischemic lesions and a mean FFR baseline value of 0.82±0.10. Total EAT volume index was significantly higher in patients with functionally or anatomically significant stenosis. Specifically, peri-lesion EAT volume index, not the density, was positively correlated with lesion-specific ischemia independent of luminal stenosis and plaque characteristics (hazard ratio 1.56, 95% confidence interval 1.04–2.33, P=0.032; per 0.1 ml/m2 increase). Moreover, peri-lesion EAT volume was negatively correlated with lesion FFR values, whereas total EAT volume was positively correlated with fat accumulation and glucose metabolism. In addition, there was no association of EAT volume or density with lesion ischemia in vessel-level analysis.Conclusions: Lesion-specific EAT volume index, but not density, seems positively and independently associated with lesion ischemia, while its incremental diagnostic value of lesion ischemia should be further investigated.
Comparison of three dimensional reconstruction and conventional computer tomography angiography in patients undergoing zero-ischemia laparoscopic partial nephrectomy
Authors: Wu Xiaorong , Jiang Chen , Wu Guangyu , Shen Chao , Fu Qibo , Chen Yonghui , Liu Dongming , Xue Wei 
Published: April 2020

Abstract
Background: Advances in three dimensional (3D) reconstruction and printing technology have fueled a rapidly growing interest in its applications in the field of urology. To our knowledge, the experience on the use of 3D reconstruction to facilitate zero-ischemia partial nephrectomy (PN) remains sparse and the role of 3D reconstruction is still needed to be defined. This study aimed to assess the role of 3D reconstruction and conventional computer tomography angiography (CTA) in zero-ischemia laparoscopic partial nephrectomy (LPN).Methods: A total of 60 consecutive patients undergoing zero-ischemia LPN between October 2017 and March 2018 who underwent CTA (CTA group including 30 patients) and 3D reconstruction (3D group including the remaining 30 patients) preoperatively were included. 3D reconstruction and CTA images were prepared which were used to demonstrate the number and spatial interrelationships of the location of renal tumors and tumor feeding arteries. These radiological findings were directly correlated with intraoperative surgical findings at laparoscopy. Baseline, perioperative variables and the rate of accurate tumor feeding artery orientation were compared between groups.Results: All the procedures were performed successfully without conversion to main renal artery clamping. Preoperative 3D reconstruction identified that 15 patients had only one tumor feeding artery, 12 had two, and another 3 had three, while the conventional CTA revealed that 22 patients had one tumor feeding artery, 8 had two (P>0.05). The mean operation time was shorter and estimated blood loss was less in the 3D group (P<0.05). 3D reconstruction group resulted in more accurate dissection of tumor artery (91.7%) as compared to conventional CTA (84.2%). There were no statistical differences in the baseline characteristics and renal function outcomes between two groups. Conclusions: 3D reconstruction can provide comprehensive information for the preoperative evaluation and intraoperative orientation that may facilitate tumor resection during zero-ischemia LPN for renal tumors.
Validation of RESP and PRESERVE score for ARDS patients with pumpless Extracorporeal Lung Assist (pECLA)
Authors: Petran Jan , Muelly Thorsten , Dembinski Rolf , Steuer Niklas , Arens Jutta , Marx Gernot , Kopp Ruedger 
Published: April 2020

Abstract
Background RESP score and PRESERVE score have been validated for veno-venous Extracorporeal Membrane Oxygenation in severe ARDS to assume individual mortality risk. ARDS patients with low-flow Extracorporeal Carbon Dioxide Removal, especially pumpless Extracorporeal Lung Assist, have also a high mortality rate, but there are no validated specific or general outcome scores. This retrospective study tested whether these established specific risk scores can be validated for pumpless Extracorporeal Lung Assist in ARDS patients in comparison to a general organ dysfunction score, the SOFA score.Methods In a retrospective single center cohort study we calculated and evaluated RESP, PRESERVE, and SOFA score for 73 ARDS patients with pumpless Extracorporeal Lung Assist treated between 2002 and 2016 using the XENIOS iLA Membrane Ventilator. 6 patients had a mild, 40 a moderate and 27 a severe ARDS according to the Berlin criteria. Demographic data and hospital mortality as well as ventilator settings, hemodynamic parameters, and blood gas measurement before and during extracorporeal therapy were recorded.Results Pumpless Extracorporeal Lung Assist of mechanical ventilated ARDS patients resulted in an optimized lung protective ventilation, significant reduction of PaCO2, and compensation of acidosis. Scoring showed a mean score of alive versus deceased patients of 3 ± 1 versus -1 ± 1 for RESP (p < 0.01), 3 ± 0 versus 6 ± 0 for PRESERVE (p < 0.05) and 8 ± 1 versus 10 ± 1 for SOFA (p < 0.05). Using receiver operating characteristic curves, area under the curve (AUC) was 0.78 (95 % confidence interval (CI) 0.67 – 0.89, p < 0.01) for RESP score, 0.80 (95 % CI 0.70 – 0.90, p < 0.0001) for PRESERVE score and 0.66 (95 % CI 0.53 – 0.79, p < 0.05) for SOFA score. Conclusions RESP and PRESERVE scores were superior to SOFA, as non-specific critical care score. Although scores were developed for veno-venous ECMO, we could validate RESP and PRESERVE score for pumpless Extracorporeal Lung Assist. In conclusion, RESP and PRESERVE score are suitable to estimate mortality risk of ARDS patients with an arterio-venous pumpless Extracorporeal Carbon Dioxide Removal.
Effectiveness of a health education intervention on the use of long-lasting insecticidal nets for the prevention of malaria in pregnant women of Pakistan: A Quasi-experimental study
Authors: Kumar Ramesh , Farzeen Midhat , Hafeez Assad , Achakzai Baseer Khan , Vankwani Muskan , Lal Manohar , Iqbal Rabia , Somrongthong Ratana 
Published: April 2020

Abstract
Background: About one quarter pregnant women population were using long lasting insecticides treated bed nets in Pakistan for prevention of malaria.. Past research has reported that adequate information and education could act as mediator to change the behavior among patients for prevention of malaria infection. Hence, the effective use of LLINs could contribute in reduction of disease burden caused by malaria. Aim of this study was to determine the effectiveness of health education on adoption of LLINs among pregnant women living in a remote district Tharparkar Sindh Pakistan. Methods: A Quasi-experimental study design with control and intervention group was conducted with 200 pregnant women (100in each group). Women in intervention group were provided with health education sessions on malaria for 12 weeks while those in control group obtained routine information by lady health workers (LHWs). Pre and post intervention assessment was done for knowledge about malaria and use of LLINs; and was statistically analyzed using descriptive statistics and difference in difference (DID) multivariable regression analysis to test the effectiveness of intervention. Results: Baseline was conducted with 200 pregnant women. Demographic characteristics were similar in both groups with slight differences in age, education, income, type of latrine and source of drinking water. There were no significant differences between the mean knowledge and use of LLINs scores between groups at baseline. However, the estimated difference-in-difference value after the intervention was 4.170 (p <0.01) represents an increase in scores of knowledge in the intervention group as compared to control. Similarly difference-in-difference value of 3.360 (p <0.05) showed an increase in use of LLINs score after the intervention which was significant therefore showing that the intervention had a positive effect. Conclusions: Results proved that health education could be an effective intervention for improving knowledge and usage of LLINs among pregnant women for prevention of malaria. Therefore, such educational interventions have a positive potential to be implemented at larger scale by incorporating them into routine health sessions provided by health workers.
Photosynthetic performance and growth responses of Liriope muscari (Decne.) L.H. Bailey (Asparagaceae) planted within poplar forests having different canopy densities
Authors: zhang jiaojiao , Zhu Ling , Zhang Xu , Zhou Jian 
Published: April 2020

Abstract
Background: Liriope muscari (Decne.) L.H. Bailey is a valuable horticultural and medicinal plant that grows under a range of light intensities, from high to low, in the understories of shrubs. To understand how this species adapts to these various environments, we selected two groups of lilyturf growing under poplar trees at two different spacings. Each group was divided into three types, open field, forest edge and shaded forest with high, medium and low irradiance levels, respectively, and then we examined their photosynthetic characteristics, physiology and biomasses. Results: Light saturation point, light compensation point and in situ net photosynthetic rate (PN) were highest in lilyturf growing under high light. In contrast, lilyturf growing under low light had a higher apparent quantum yield and Chl a and b contents, indicating that they adapted to low light. Although the leaves of lilyturf growing under low light were small, their root tubers were heavier. Conclusions: The research demonstrates the eco-physiological basis of lilyturf’s shade adaptation mechanism as indicated by photosynthetic activity, chlorophyll fluorescence, Chl a, Chl b and Car contents when grown under different irradiances. We believe that lilyturf is a shade-tolerant plant suitable for planting in undergrowth, but attention should be paid to the canopy density of the forest when interplanting. The findings presented here advance our understanding of the photosynthetic characteristics of understory plants and may assist in the optimization of irradiances in the future.
Distinctions between sex and time in patterns of DNA methylation across puberty
Authors: Moore Sarah R , Humphreys Kathryn L , Colich Natalie L , Davis Elena Goetz , Lin David T S , MacIsaac Julia L , Kobor Michael S , Gotlib Ian H 
Published: April 2020

Abstract
Background: There are significant sex differences in human physiology and disease; the genomic sources of these differences, however, are not well understood. During puberty, a drastic neuroendocrine shift signals physical changes resulting in robust sex differences in human physiology. Here, we explore how shifting patterns of DNA methylation may inform these pathways of biological plasticity during the pubertal transition. Methods: In this study we analyzed DNA methylation (DNAm) in saliva at two time points across the pubertal transition within the same individuals. We targeted two domains of DNAm patterns that may inform processes of sexual differentiation 1) sex related sites, which demonstrated differences between males from females and 2) time related sites in which DNAm shifted significantly between timepoints. We further explored the correlated network structure sex and time related DNAm networks and linked these patterns to pubertal stage, assays of salivary testosterone, a reliable diagnostic of free, unbound hormone that is available to act on target tissues, and overlap with androgen response elements.Results: Sites that differed by biological sex were largely independent of sites that underwent change across puberty. Time-related DNAm sites, but not sex-related sites, formed correlated networks that were associated with pubertal stage. Both time and sex DNAm networks reflected salivary testosterone levels that were enriched for androgen response elements, with sex-related DNAm networks being informative of testosterone levels above and beyond biological sex later in the pubertal transition. Conclusions: These results inform our understanding of the distinction between sex- and time-related differences in DNAm during the critical period of puberty and highlight a novel linkage between correlated patterns of sex-related DNAm and levels of salivary testosterone.
Factors influencing cognitive reactivity among young adults at high risk for depression in China: a cross-sectional study
Authors: huang fei fei , Wen Zhi Peng , li qi , chen bin , Weng Wen Jie 
Published: April 2020

Abstract
Background: Understanding the factors influencing cognitive reactivity (CR) may help identify individuals at risk for first episode depression and relapse and facilitate routine access to preventative treatments. However, few studies have examined the relationship between CR and depression in Asian countries. This study was performed to assess the current status of CR among Chinese young adults and explore influencing factors.Methods: A national cross-sectional online study using convenience sampling was conducted among 1597 healthy young adults in China (response rate: 93.94%) with a mean age of 24.34 (SD=5.76) years. Results: The mean CR score was 51.36±18.97 (range 0-130). Binary logistic regression showed that a low level of CR was associated with the following factors: high self-compassion, high social support, high resilience, high monthly household income, and living in a rural area, with odds ratios (ORs) ranging from 0.14 to 0.70. Young adults in full-time employment, experiencing poor sleep, with high neuroticism, who reported frequent sad mood, and who had a high intensity of negative life events had increased CR to depression, with ORs ranging from 1.18 to 6.66. The prediction probability of these factors was 75.40%. Causal relationships among the influencing factors and CR could not be explored.Conclusions: The self-reported CR levels among Chinese young adults were moderate. Enhancing self-compassion, resilience, and social support for young adults and reducing negative life events, neuroticism, and poor sleep may help decrease CR. These findings may help healthcare providers or researchers determine how to cultivate and improve the CR of young adults by establishing documented policies and/or improving intervention efficacies.
Effect of Sulfadoxine-Pyrimethamine doses for prevention of malaria during pregnancy in hypoendemic area in Tanzania
Authors: Mikomangwa Wigilya Padili , Minzi Omary , Mutagonda Ritah , Baraka Vito , Mlugu Eulambius M. , Aklillu Eleni , Kamuhabwa Appolinary A.R. 
Published: April 2020

Abstract
Background Malaria in pregnancy increases the risk of deleterious maternal and birth outcomes. The use of ≥3 doses of sulfadoxine-pyrimethamine (SP) for intermittent preventive treatment of malaria (IPTp-SP) is recommended for preventing the consequences of malaria during pregnancy. This study assessed the effect of IPTp-SP for prevention of malaria during pregnancy in low transmission settings. Methods A cross-sectional study that involved consecutively selected 1,161 pregnant women was conducted at Mwananyamala regional referral hospital in Dar es Salaam. Assessment of the uptake of IPTp-SP was done by extracting information from antenatal clinic cards. Maternal venous blood, cord blood, placental blood and placental biopsy were collected for assessment of anaemia and malaria. High performance liquid chromatography with ultraviolet detection (HPLC-UV) was used to detect and quantify sulfadoxine (SDX). Dried blood spots (DBS) of placental blood were collected for determination of sub-microscopic malaria using polymerase chain reaction (PCR). Results In total, 397 (34.2%) pregnant women reported to have used sub-optimal doses (≤2) while 764(65.8%) used optimal doses (≥3) of IPTp-SP at the time of delivery. The prevalence of placental malaria as determined by histology was 3.6%. Submicroscopic placental malaria was detected in 1.4% of the study participants. Women with peripheral malaria had six times risk of maternal anaemia than those who were malaria negative (aOR, 5.83; 95% CI, 1.10-30.92; p = 0.04). The geometric mean plasma SDX concentration was 10.76± 2.51μg/mL. Sub-optimal IPTp-SP dose was not associated with placental malaria, premature delivery and fetal anaemia. The use of ≤2 doses of IPTp-SP increased the risk of maternal anaemia by 1.36 fold compared to ≥3 doses (aOR, 1.36; 95%CI, 1.04-1.79; p = 0.02). Conclusion The use of <2 doses of IPTp-SP increased the risk of maternal anaemia. However, sub-optimal doses (≤2 doses) were not associated with increased the risk of malaria parasitaemia, fetal anaemia and preterm delivery among pregnant women in low malaria transmission setting. The use of optimal doses (≥3doses) of IPTp-SP and complementary interventions should continue even in areas with low malaria transmission.
A framework for distributed health professions training: using participatory action research to build consensus
Authors: Schalkwyk Susan C Van , Couper Ian D , Blitz Julia , De Villiers Marietjie Rene 
Published: April 2020

Abstract
Background There is a global trend towards providing training for health professions students outside of tertiary academic complexes. In many countries, this shift places pressure on available sites and the resources at their disposal, specifically within the public health sector. Introducing an educational remit into a complex health system is challenging, requiring commitment from a range of stakeholders, including national authorities. To facilitate the effective implementation of distributed training, we developed a guiding framework through an extensive, national consultative process with a view to informing both practice and policy.Methods We adopted a participatory action research approach over a four year period across three phases, which included seven local, provincial and national consultative workshops, reflective work sessions by the research team, and expert reviews. Approximately 240 people participated in these activities. Engagement with the national department of health and health professions council further informed the development of the Framework. Results Each successive ‘feedback loop’ contributed to the development of the Framework which comprised a set of guiding principles, as well as the components essential to the effective implementation of distributed training. Analysis further pointed to the centrality of relationships, while emphasising the importance of involving all sectors relevant to the training of health professionals. A tool to facilitate the implementation of the Framework was also developed, incorporating a set of ‘Simple Rules for Effective distributed health professions training’. A national consensus statement was adopted.Conclusions In this project, we drew on the thinking and practices of key stakeholders to enable a synthesis between their embodied and inscribed knowledge, and the prevailing literature, this with a view to further enaction as the knowledge generators become knowledge users. The Framework and its subsequent implementation has not only assisted us to apply the evidence to our educational practice, but also to begin to influence policy at a national level.