bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thermoregulatory Responses with Size-matched Simulated Torso or Limb Skin Grafts
Authors: CRAMER MATTHEW N. , HUANG MU , FISCHER MADS , MORALEZ GILBERT , CRANDALL CRAIG G. 
Published: May 2021

ABSTRACT
Skin grafting after a burn injury attenuates/abolishes sweat production within grafted areas. It is presently unknown whether the thermoregulatory consequences of skin grafting depend on anatomical location.

Purpose
This study aimed to test the hypothesis that a simulated burn injury on the torso will be no more or less detrimental to core temperature control than on the limbs during uncompensable exercise-heat stress.

Methods
Nine nonburned individuals (7 men, 2 women) completed the protocol. On separate occasions, burn injuries of identical surface area (0.45 ± 0.08 m2 or 24.4% ± 4.4% of total body surface area) were simulated on the torso or the arms/legs using an absorbent, vapor-impermeable material that impedes sweat evaporation in those regions. Participants performed 60 min of treadmill walking at 5.3 km·h−1 and a 4.1% ± 0.8% grade, targeting 6 W·kg−1 of metabolic heat production in 40.1°C ± 0.2°C and 19.6% ± 0.6% relative humidity conditions. Rectal temperature, heart rate, and perceptual responses were measured.

Results
Rectal temperature increased to a similar extent with simulated injuries on the torso and limbs (condition-by-time interaction, P = 0.86), with a final rectal temperature 0.9°C ± 0.3°C above baseline in both conditions. No differences in heart rate, perceived exertion, or thermal sensation were observed between conditions (condition-by-time interactions, P ≥ 0.50).

Conclusions
During uncompensable exercise-heat stress, sized-matched simulated burn injuries on the torso or limbs evoke comparable core temperature, heart rate, and perceptual responses, suggesting that the risk of exertional heat illness in such environmental conditions is independent of injury location.
СРАВНИТЕЛЬНЫЙ АНАЛИЗ ВЛИЯНИЯ ЭКЗАМЕНАЦИОННОГО СТРЕССА НА УРОВЕНЬ СИТУАТИВНОЙ И ЛИЧНОСТНОЙ ТРЕВОЖНОСТИ СТУДЕНТОВ
Authors: Rustamova Tukazban V. 
Published: May 2021

Цель. Изучение влияния экзаменационного процесса на изменения уровня ситуативной тревожности (УСТ) и уровня личностной тревожности (УЛТ) у студентов первого и пятого курсов в возрасте 17-21 года, относящихся к меланхолическому типу темперамента, в сравнении с сангвиниками, холериками и флегматиками.
Материалы и методы. Влияние эмоционального стресса на уровень ситуативной и личностной тревожности в трех различных ситуациях определялся экспресс версией тест-анкет по системе баллов: в обычные дни за два месяца до экзаменов (ОД), за 30 минут до экзамена (ДЭ) и через 30 минут после экзаменов (ПЭ).
Результаты и обсуждение. Установлено, что на всех этапах у студентов первого и пятого курсов уровень ситуативной и личностной тревожности между типами заметно отличается. У 17-летних студентов (I курс) меланхолического типа экзаменационный стресс перед экзаменом и после экзаменов повышает УСТ по сравнению с ОД. У этих студентов от влияния экзаменационного стресса по сравнению с ОД, в периоды ДЭ и ПЭ показатели УЛТ повышаются практически на одинаковом уровне. У 21- летних студентов меланхолического типа под воздействием экзаменационного стресса по сравнению с ОД в периоды ДЭ и ПЭ УСТ повышается. У этих студентов экзаменационный стресс в период ДЭ и ПЭ по сравнению с ОД повышает УЛТ еще более выраженно.
Выводы. У 21-летних студентов (V курс) меланхолического типа экзаменационный стресс повышает УСТ и УЛТ более выраженно по сравнению с 17-летними (I курс). В разном возрасте и в условиях эмоционального напряжения экзамена, с помощью психофизиологического тестирования студентов разных курсов рекомендуется определять тип темперамента и разных форм уровней тревожности.
Part 2: a qualitative description of participation in an eight-week infant skin integrity study
Authors: Phipps Fiona MacVane , Price Alan D , Ackers-Johnson James , Cook Penny A , Lythgoe Jeanne 
Published: May 2021

Background This is the second paper in a two-part series; the first paper was published in volume 29, issue 4 of the British Journal of Midwifery. The qualitative phase of the Baby Skin Integrity Comparison Survey (BaSICS) study was designed to address a dearth of information about research recruitment and retention, and how mothers make decisions about neonatal skincare. Aims The aim of the qualitative phase of the BaSICS study was to explore participants’ experience of participating in the research and how this interrelated with the experience of newborn skincare. Methods Semi-structured, face-to-face or telephone interviews were used to collect data. Interviews were transcribed verbatim. Data analysis used both software and manual methods. Findings Motivation included both altruism and personal benefits. The bespoke smartphone application was a convenient and easy tool for data collection, and being afforded full responsibility for observing and recording infant skin condition increased mothers' awareness of skin changes. Family, friends and the internet were the most commonly used sources of information about baby skincare. Conclusion The qualitative interview component of the BaSICS study provided information that could not have been deduced from the daily survey and final questionnaire alone. This provides valuable guidance for future research in the field of infant skincare.
High sensitivity and large measurable range distributed acoustic sensing with Rayleigh-enhanced fiber
Authors: Xiong Ji , Wang Zinan , Jiang Jialin , Han Bing , Rao Yunjiang 
Published: May 2021

In this Letter, high sensitivity and large measurable range distributed acoustic sensing (DAS) based on sub-chirped-pulse extraction algorithm (SPEA) in time domain and dechirp operation is proposed; moreover, Rayleigh-enhanced fiber is used to further improve the quality of Rayleigh scattering (RS) signal. In the proof-of-concept experiment, the RS pattern with 60 µɛ strain range is generated during a single-shot measurement, while

80.7

p

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H
z

strain sensitivity and 28.4 cm spatial resolution are achieved on 920 m fiber.
Millimeter-wave radio-over-fiber system using optical phase modulation and photonic downconversion for uplink fronthaul transmission
Authors: Tien Dat Pham , Yamaguchi Yuya , Kanno Atsushi , Motoya Masayuki , Oikawa Satoshi , Ichikawa Junichiro , Yamamoto Naokatsu 
Published: May 2021

This Letter proposes a high-performance radio-over-fiber (RoF) system
for high-speed and high-fidelity analog waveform transmission of radio
signals in the millimeter-wave band in the uplink direction. At the
antenna site, the system utilizes a newly fabricated low half-wave
voltage broadband phase modulator to convert a millimeter-wave radio
signal into an optical signal. At the receiver, by using photonic
downconversion and optical filtering technology, a simple direct
detection and downconversion of the signal to the microwave band can
be achieved simultaneously. As a demonstration of proof of concept, we
successfully transmitted a 1024-quadrature amplitude modulation (QAM)
narrowband orthogonal frequency-division multiplexing signal at 38 GHz
and a 60 Gb/s 64-QAM single-carrier signal at 26.5 GHz over a 20 km
RoF system. The system is promising for facilitating the deployment of
ultra-dense small cells in high-frequency bands in 5G and
beyond networks.
Tranexamic acid and bleeding in patients treated with non-vitamin K oral anticoagulants undergoing dental extraction: The EXTRACT-NOAC randomized clinical trial
Authors: Ockerman Anna , Miclotte Isabel , Vanhaverbeke Maarten , Vanassche Thomas , Belmans Ann , Vanhove Jan , Meyns Joeri , Nadjmi Nasser , Van Hemelen Geert , Winderickx Patrick , Jacobs Reinhilde , Politis Constantinus , Verhamme Peter 
Published: May 2021

Background
Oral bleeding after dental extraction in patients on non-vitamin K oral anticoagulants (NOACs) is a frequent problem. We investigated whether 10% tranexamic acid (TXA) mouthwash decreases post-extraction bleeding in patients treated with NOACs.

Methods and findings
The EXTRACT-NOAC study is a randomized, double-blind, placebo-controlled, multicenter, clinical trial. Patients were randomly assigned to 10% TXA or placebo mouthwash and were instructed to use the mouthwash once prior to dental extraction, and thereafter for 3 times a day for 3 days. The primary outcome was the number of patients with any post-extraction oral bleeding up to day 7. Secondary outcomes included periprocedural, early, and delayed bleeding, and the safety outcomes included all thrombotic events. The first patient was randomized on February 9, 2018 and the last patient on March 12, 2020. Of 222 randomized patients, 218 patients were included in the full analysis set, of which 106 patients were assigned to TXA (74.8 (±8.8) years; 81 men) and 112 to placebo (72.7 (±10.7) years; 64 men). Post-extraction bleeding occurred in 28 (26.4%) patients in the TXA group and in 32 (28.6%) patients in the placebo group (relative risk, 0.92; 95% confidence interval [CI], 0.60 to 1.42; P = 0.72). There were 46 bleeds in the TXA group and 85 bleeds in the placebo group (rate ratio, 0.57; 95% CI, 0.31 to 1.05; P = 0.07). TXA did not reduce the rate of periprocedural bleeding (bleeding score 4 ± 1.78 versus 4 ± 1.82, P = 0.80) and early bleeding (rate ratio, 0.76; 95% CI, 0.42 to 1.37). Delayed bleeding (rate ratio, 0.32; 95% CI, 0.12 to 0.89) and bleeding after multiple extractions (rate ratio, 0.40; 95% CI, 0.20 to 0.78) were lower in the TXA group. One patient in the placebo group had a transient ischemic attack while interrupting the NOAC therapy in preparation for the dental extraction. Two of the study limitations were the premature interruption of the trial following a futility analysis and the assessment of the patients’ compliance that was based on self-reported information during follow-up.

Conclusions
In patients on NOACs undergoing dental extraction, TXA does not seem to reduce the rate of periprocedural or early postoperative oral bleeding compared to placebo. TXA appears to reduce delayed bleeds and postoperative oral bleeding if multiple teeth are extracted.

Trial registration
ClinicalTrials.gov NCT03413891
EudraCT; EudraCT number:2017-001426-17; EudraCT Public website: eudract.ema.europa.eu.
Effects of exogenous β-glucanase on ileal digesta soluble β-glucan molecular weight, digestive tract characteristics, and performance of coccidiosis vaccinated broiler chickens fed hulless barley-based diets with and without medication
Authors: Karunaratne Namalika D. , Newkirk Rex W. , Ames Nancy P. , Van Kessel Andrew G. , Bedford Michael R. , Classen Henry L. 
Published: May 2021

Introduction
Limited use of medication in poultry feed led to the investigation of exogenous enzymes as antibiotic alternatives for controlling enteric disease. The objective of this study was to evaluate the effects of diet β-glucanase (BGase) and medication on β-glucan depolymerization, digestive tract characteristics, and growth performance of broilers.

Materials and methods
Broilers were fed hulless barley (HB) based diets with BGase (Econase GT 200P from AB Vista; 0 and 0.1%) and medication (Bacitracin and Salinomycin Na; with and without) arranged as a 2 × 2 factorial. In Experiment 1, 160 broilers were housed in cages from d 0 to 28. Each treatment was assigned to 10 cages. In Experiment 2, broilers (2376) were housed in floor pens and vaccinated for coccidiosis on d 5. Each treatment was assigned to one floor pen in each of nine rooms.

Results
In Experiment 1, the soluble β-glucan weighted average molecular weight (Mw) in the ileal digesta was lower with medication in the 0% BGase treatments. Peak molecular weight (Mp) and Mw were lower with BGase regardless of medication. The maximum molecular weight for the smallest 10% β-glucan (MW-10%) was lower with BGase addition. In Experiment 2, Mp was lower with medication in 0% BGase treatments. Beta-glucanase resulted in lower Mp regardless of medication, and the degree of response was lower with medication. The MW-10% was lower with BGase despite antibiotic addition. Body weight gain and feed efficiency were higher with medication regardless of BGase use through-out the trial (except d 11–22 feed efficiency). Beta-glucanase resulted in higher body weight gain after d 11 and worsened and improved feed efficiency before and after d 11, respectively, in unmedicated treatments.

Conclusion
BGase and medication caused the depolymerization of soluble ileal β-glucan. Beta-glucanase acted as a partial replacement for diet medication by increasing growth performance in coccidiosis vaccinated broilers.
Attenuation parameter and liver stiffness measurement using FibroTouch vs Fibroscan in patients with chronic liver disease
Authors: Ng Ying Zhuang , Lai Lee Lee , Wong Sui Weng , Mohamad Siti Yatimah , Chuah Kee Huat , Chan Wah Kheong 
Published: May 2021

Background & aim
We studied FibroTouch (FT) and Fibroscan (FS) examination results and their repeatability when performed by healthcare personnel of different background.

Methods
FT and FS examinations were performed on patients with chronic liver disease by two operators, a doctor and a nurse, twice on each patient, at two different time points, independent of each other.

Results
The data for 163 patients with 1304 examinations was analyzed. There was strong correlation between FT and FS for attenuation parameter (Spearman’s rho 0.76, p<0.001) and liver stiffness measurement (LSM) (Spearman’s rho 0.70, p<0.001). However, FT produced higher value at lower attenuation parameter and LSM, and lower value at higher attenuation parameter and LSM. There was substantial agreement when using 15kPa LSM cut-off, but only moderate agreement when using 10kPa and 20kPa LSM cut-offs and 248dB/m, 268dB/m and 280dB/m attenuation parameter cut-offs. The IQR for attenuation parameter and IQR/median for LSM were significantly lower for FT compared with FS (4dB/m vs 27dB/m, p<0.001, and 10 vs 12, p<0.001, respectively). The intra- and inter-observer reliability of attenuation parameter and LSM using FT and FS were good to excellent with intraclass correlation coefficients 0.89–0.99. FT had shorter examination time (33s vs 47s, p<0.001) and less invalid measurements (0 vs 2, p<0.001).

Conclusion
Measurements obtained with FT and FS strongly correlated, but significant differences in their absolute values, consistency, examination time and number of invalid measurements were observed. Either device can be used by healthcare personnel of different backgrounds when sufficiently trained.
Postoperative abdominal sepsis induces selective and persistent changes in CTCF binding within the MHC-II region of human monocytes
Authors: Siegler Benedikt Hermann , Altvater Marc , Thon Jan Niklas , Neuhaus Christopher , Arens Christoph , Uhle Florian , Lichtenstern Christoph , Weigand Markus Alexander , Weiterer Sebastian 
Published: May 2021

Background
Postoperative abdominal infections belong to the most common triggers of sepsis and septic shock in intensive care units worldwide. While monocytes play a central role in mediating the initial host response to infections, sepsis-induced immune dysregulation is characterized by a defective antigen presentation to T-cells via loss of Major Histocompatibility Complex Class II DR (HLA-DR) surface expression. Here, we hypothesized a sepsis-induced differential occupancy of the CCCTC-Binding Factor (CTCF), an architectural protein and superordinate regulator of transcription, inside the Major Histocompatibility Complex Class II (MHC-II) region in patients with postoperative sepsis, contributing to an altered monocytic transcriptional response during critical illness.

Results
Compared to a matched surgical control cohort, postoperative sepsis was associated with selective and enduring increase in CTCF binding within the MHC-II. In detail, increased CTCF binding was detected at four sites adjacent to classical HLA class II genes coding for proteins expressed on monocyte surface. Gene expression analysis revealed a sepsis-associated decreased transcription of (i) the classical HLA genes HLA-DRA, HLA-DRB1, HLA-DPA1 and HLA-DPB1 and (ii) the gene of the MHC-II master regulator, CIITA (Class II Major Histocompatibility Complex Transactivator). Increased CTCF binding persisted in all sepsis patients, while transcriptional recovery CIITA was exclusively found in long-term survivors.

Conclusion
Our experiments demonstrate differential and persisting alterations of CTCF occupancy within the MHC-II, accompanied by selective changes in the expression of spatially related HLA class II genes, indicating an important role of CTCF in modulating the transcriptional response of immunocompromised human monocytes during critical illness.
The effect of intramuscular injection technique on injection associated pain; a systematic review and meta-analysis
Authors: Ayinde Oluseyi , Hayward Rachel S. , Ross Jonathan D. C. 
Published: May 2021

Aim
To review the effect of different intramuscular injection (IMI) techniques on injection associated pain, in adults.

Methods
The review protocol was registered on PROSPERO (CRD42019136097). MEDLINE, EMBASE, British Nursing Index and CINAHL were searched up to June 2020. Included studies were appraised and a meta-analysis, where appropriate, was conducted with a random effects model and test for heterogeneity. Standardised mean difference (SMD) with a 95% confidence interval in reported injection pain (intervention cf. control) was reported.

Results
29 studies were included in the systematic review and 20 studies in the meta-analysis. 13 IMI techniques were identified. 10 studies applied local pressure to the injection site. Of these, applying manual pressure (4 studies, SMD = -0.85[-1.36,-0.33]) and Helfer (rhythmic) tapping (3 studies, SMD = -2.95[-5.51,-0.39]) to the injection site reduced injection pain, whereas the use of a plastic device to apply local pressure to the skin (ShotBlocker) did not significantly reduce pain (2 studies, SMD = -0.51[-1.58,0.56]). Acupressure techniques which mostly involved applying sustained pressure followed by intermittent pressure (tapping) to acupressure points local to the injection site reduced pain (4 studies: SMD = -1.62[-2.80,-0.44]), as did injections to the ventrogluteal site compared to the dorsogluteal site (2 studies, SMD = -0.43[-0.81,-0.06]). There was insufficient evidence on the benefits of the ‘Z track technique’ (2 studies, SMD = -0.20[-0.41,0.01]) and the cold needle technique (2 studies, SMD = -0.73[-1.83,0.37]) on injection pain. The effect of changing the needle after drawing up the injectate on injection pain was conflicting and warming the injectate did not reduce pain. Limitations included considerable heterogeneity, poor reporting of randomisation, and possible bias in outcome measures from unblinding of assessors or participants.

Conclusions
Manual pressure or rhythmic tapping over the injection site and applying local pressure around the injection site reduced IMI pain. However, there was very high unexplained heterogeneity between studies and risk of significant bias within small studies.
Communication of preclinical emergency teams in critical situations: A nationwide study
Authors: Zimmer Matthias , Czarniecki Daria Magdalena , Sahm Stephan 
Published: May 2021

Background
The emergency medical service as a high-risk workplace is a danger to patient safety. A main factor for patient safety, but also at the same time a main factor for patient harm, is team communication. Team communication is multidimensional and occurs before, during, and after the patient’s treatment.

Methods
In an online based, anonymous and single-blinded study, medical and non-medical employees in the emergency medical services were asked about team communication, and communication errors.

Results
Seven hundred and fourteen medical and non-medical rescue workers from all over Germany took part. Among them, 72.0% had harmed at least one patient during their work. With imprecise communication, 81.7% rarely asked for clarification. Also, 66.3% saw leadership behavior as the cause of poor communication; 46.0% could not talk to their superiors about errors. Of note, 96.3% would like joint training of medical and non-medical employees in communication.

Conclusion
Deficits in team communication occur frequently in the rescue service. There is a clear need for uniform training in team and communication skills in all professions.
Impact of diabetes mellitus on short-term prognosis, length of stay, and costs in patients with acute kidney injury: A nationwide survey in China
Authors: Tan Lishan , Chen Li , Jia Yan , Li Lingyan , Wang Jinwei , Huang Xiaoyan , Luo Qiong , Yang Li , Xiong Zuying ,   on behalf of ISN AKF 0 by 25 China Consortium
Published: May 2021

Background
International data suggest that people with diabetes mellitus (DM) are at increased risk for worse acute kidney injury (AKI) outcomes; however, the data in China are limited. Therefore, this study aimed to describe the association of DM with short-term prognosis, length of stay, and expenditure in patients with AKI.

Methods
This study was based on the 2013 nationwide survey in China. According to the 2012 Kidney Disease: Improving Global Outcomes (KDIGO) and expanded criteria of AKI, 7604 patients with AKI were identified, and 1404 and 6200 patients were with and without DM, respectively. Clinical characteristics, outcomes, length of stay, and costs of these patients were compared. Multivariate regression analyses were conducted to evaluate the association of DM with mortality, failed renal recovery, length of stay, and costs.

Results
Patients with AKI and DM were older, had higher male preponderance (61.9%), presented with more comorbidities, and had higher serum creatinine levels compared with those without DM. An apparent increase in all-cause in-hospital mortality, length of stay, and costs was found in patients with DM. DM was not independently associated with failed renal recovery (adjusted OR (95%CI): 1.08 (0.94–1.25)) and in-hospital mortality (adjusted OR (95%): 1.16 (0.95–1.41)) in multivariate models. However, the diabetic status was positively associated with the length of stay (β = 0.06, p<0.05) and hospital expenditure (β = 0.10, p<0.01) in hospital after adjusting for possible confounders.

Conclusion
In hospitalized AKI patients, DM (vs. no DM) is independently associated with longer length of stay and greater costs, but is not associated with an increased risk for failed renal recovery and in-hospital mortality.