bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of stylet angulation at the holding position during tracheal intubation with a videolaryngoscope: a randomized controlled trial
Authors: Wakabayashi Ryo , Shiko Yuki , Kodaira Tomofumi , Shiroshita Yuko , Otsuka Hitomi , Baba Kosuke , Hishinuma Norimasa 
Published: October 2021

AbstractThe aim of this randomized controlled trial was to determine the efficacy of stylet angulation at the holding position during tracheal intubation with a McGRATH MAC videolaryngoscope. Patients were randomized to a group for intubation without stylet angulation at the holding position (non-angulation group) and to a group for intubation with stylet angulation at the holding position (angulation group). The primary outcome was the time for placement of the tracheal tube. Sixty patients were analyzed. The mean (standard deviation) times for tube placement were 21.3 (5.6) s in the non-angulation group and 16.9 (3.8) s in the angulation group (P < 0.001). The scores of operator's perception of difficulty in tube delivery, number of attempts for tube delivery, and degrees of extension, abduction, internal rotation of the right upper arm and extension of the right wrist during tube placement in the angulation group were significantly smaller than those in the non-angulation group (P < 0.001, P = 0.002, P < 0.001, P < 0.001, P < 0.001, P < 0.001, respectively). Our results suggest that stylet angulation at the holding position improves maneuverability of the tracheal tube and enables easy, smooth, and swift tube placement during tracheal intubation with a McGRATH MAC videolaryngoscope.
SARS-CoV-2 transmission during an indoor professional sporting event
Authors: Pauser Johannes , Schwarz Chantal , Morgan James , Jantsch Jonathan , Brem Matthias 
Published: October 2021

AbstractSporting events with spectators can present a risk during the COVID-19 pandemic of becoming potential superspreader events that can result in mass-infection amongst participants—both sportspeople and spectators alike. In order to prevent disease transmission, many professional sporting bodies have implemented detailed hygiene regulations. This report analyzes SARS-CoV-2 transmission during a professional sports event (2nd division professional basketball in Germany). Whilst social distancing in this context is not always possible, the rate of infection was significantly reduced by wearing face masks that cover the mouth and nose. There was no infection amongst individuals who continuously wore medical particle filter masks (Category KN95/FFP2 or higher) during this sporting event.
Osteoprotegerin regulates vascular function through syndecan-1 and NADPH oxidase-derived reactive oxygen species
Authors: Alves-Lopes Rhéure , Neves Karla Bianca , Strembitska Anastasiya , Harvey Adam P. , Harvey Katie Y. , Yusuf Hiba , Haniford Susan , Hepburn Ross T. , Dyet Jennifer , Beattie Wendy , Haddow Laura , McAbney John , Graham Delyth , Montezano Augusto C. 
Published: October 2021

Abstract
Osteogenic factors, such as osteoprotegerin (OPG), are protective against vascular calcification. However, OPG is also positively associated with cardiovascular damage, particularly in pulmonary hypertension, possibly through processes beyond effects on calcification. In the present study, we focused on calcification-independent vascular effects of OPG through activation of syndecan-1 and NADPH oxidases (Noxs) 1 and 4. Isolated resistance arteries from Wistar–Kyoto (WKY) rats, exposed to exogenous OPG, studied by myography exhibited endothelial and smooth muscle dysfunction. OPG decreased nitric oxide (NO) production, eNOS activation and increased reactive oxygen species (ROS) production in endothelial cells. In VSMCs, OPG increased ROS production, H2O2/peroxynitrite levels and activation of Rho kinase and myosin light chain. OPG vascular and redox effects were also inhibited by the syndecan-1 inhibitor synstatin (SSNT). Additionally, heparinase and chondroitinase abolished OPG effects on VSMCs-ROS production, confirming syndecan-1 as OPG molecular partner and suggesting that OPG binds to heparan/chondroitin sulphate chains of syndecan-1. OPG-induced ROS production was abrogated by NoxA1ds (Nox1 inhibitor) and GKT137831 (dual Nox1/Nox4 inhibitor). Tempol (SOD mimetic) inhibited vascular dysfunction induced by OPG. In addition, we studied arteries from Nox1 and Nox4 knockout (KO) mice. Nox1 and Nox4 KO abrogated OPG-induced vascular dysfunction. Vascular dysfunction elicited by OPG is mediated by a complex signalling cascade involving syndecan-1, Nox1 and Nox4. Our data identify novel molecular mechanisms beyond calcification for OPG, which may underlie vascular injurious effects of osteogenic factors in conditions such as hypertension and/or diabetes.
An In-Depth Case Description of Gaze Patterns of an Individual With Cortical Visual Impairment to Stimuli of Varying Complexity: Implications for Augmentative and Alternative Communication Design
Authors: Wilkinson Krista M. , Wolf Sophie J. 
Published: October 2021

Purpose:
Many individuals with cortical visual impairment (CVI) are unable to meet their daily communication needs through natural speech. Augmentative and alternative communication (AAC) provides supports for individuals with complex communication needs, including those with CVI. However, many forms of AAC involve access via a visual modality. This presents specific challenges for assessment and intervention of individuals with CVI using AAC.

Method:
This study used an automated eye tracking technology to analyze the gaze patterns of one individual with CVI to stimuli of varying complexity. The automated eye tracking technology captured the point of gaze of the participant every 16 ms (60 Hz), allowing for a detailed evaluation of what captured the participant's attention.

Results:
Variations in stimulus complexity resulted in changes in visual attention. Overall, the participant engaged significantly faster to and longer with simpler images both when presented one at a time and also during a preferential looking task when two stimuli were presented. Additionally, one stimulus displayed a teddy bear, with an animated face. The participant gazed at the face for the majority of her looking time to that stimulus, rather than the colorful foot pads.

Conclusions:
The participant demonstrated clear patterns of quicker response times and longer gaze times when the stimuli were simpler in design. This has implications for AAC interventions and choice of symbols. Additionally, the participant's ability to engage with the face of the teddy bear image suggests her visual processing was consistent with the score she received on the CVI Range, an assessment tool that describes functional vision in individuals with CVI.
A new automated tool for the spectral classification of OB stars
Authors: Kyritsis E. , Maravelias G. , Zezas A. , Bonfini P. , Kovlakas K. , Reig P. 
Published: October 2021

Context.As an increasing number of spectroscopic surveys become available, an automated approach to spectral classification becomes necessary. Due to the significance of the massive stars, it is of great importance to identify the phenomenological parameters of these stars (e.g., the spectral type), which can be used as proxies to their physical parameters (e.g., mass and temperature).Aims.In this work, we aim to use the random forest (RF) algorithm to develop a tool for the automated spectral classification of OB-type stars according to their sub-types.Methods.We used the regular RF algorithm, the probabilistic RF, which is an extension of RF that incorporates uncertainties, and we introduced the KDE – RF method which is a combination of the kernel-density estimation and the RF algorithm. We trained the algorithms on the equivalent width (EW) of characteristic absorption lines measured in high-quality spectra (signal-to-noise (S/N)≳50) from large Galactic (LAMOST, GOSSS) and extragalactic surveys (2dF, VFTS) with available spectral types and luminosity classes. By following an adaptive binning approach, we grouped the labels of these data in 11 spectral classes within the O2-B9 range. We examined which of the characteristic spectral lines (features) are more important for the classification based on a number of feature selection methods, and we searched for the optimal hyperparameters of the classifiers to achieve the best performance.Results.From the feature-screening process, we find that the full set of 17 spectral lines is needed to reach the maximum performance per spectral class. We find that the overall accuracy score is ∼70%, with similar results across all approaches. We apply our model in other observational data sets providing examples of the potential application of our classifier to real science cases. We find that it performs well for both single massive stars and for the companion massive stars in Be X-ray binaries, especially for data of similar quality to the training sample. In addition, we propose a reduced ten-features scheme that can be applied to large data sets with lowerS/N ∼ 20 − 50.Conclusions.The similarity in the performances of our models indicates the robustness and the reliability of the RF algorithm when it is used for the spectral classification of early-type stars. The score of ∼70% is high if we consider (a) the complexity of such multiclass classification problems (i.e., 11 classes), (b) the intrinsic scatter of the EW distributions within the examined spectral classes, and (c) the diversity of the training set since we use data obtained from different surveys with different observing strategies. In addition, the approach presented in this work is applicable to products from different surveys in terms of quality (e.g., different resolution) and different formats (e.g., absolute or normalized flux), while our classifier is agnostic to the luminosity class of a star, and, as much as possible, it is metallicity independent.
Planetary climate under extremely high vertical diffusivity
Authors: Si Yidongfang , Yang Jun , Liu Yonggang 
Published: October 2021

Aims. Planets with large moon(s) or those in the habitable zone of low-mass stars may experience much stronger tidal force and tide-induced ocean mixing than that on Earth. Thus, the vertical diffusivity (or, more precisely, diapycnal diffusivity) on such planets, which represents the strength of vertical mixing in the ocean, would be greater than that on Earth. In this study, we explore the effects of extremely high diffusivity on the ocean circulation and surface climate of Earth-like planets in one asynchronous rotation orbit.
Methods. The response of planetary climate to 10 and 100 times greater vertical diffusivity than that found on Earth is investigated using a fully coupled atmosphere–ocean general circulation model. In order to perform a clear comparison with the climate of modern Earth, Earth’s orbit, land–sea configuration, and present levels of greenhouse gases are included in the simulations.
Results. We find that a larger vertical diffusivity intensifies the meridional overturning circulation (MOC) in the ocean, which transports more heat to polar regions and melts sea ice there. Feedback associated with sea ice, clouds, and water vapor act to further amplify surface warming. When the vertical diffusivity is 10 (100) times the present-day value, the magnitude of MOC increases by ≈3 (18) times, and the global-mean surface temperature increases by ≈4 °C (10 °C). This study quantifies the climatic effect of an extremely strong vertical diffusivity and confirms an indirect link between planetary orbit, tidal mixing, ocean circulation, and surface climate. Our results suggest a moderate effect of varying vertical ocean mixing on planetary climate.
Präferenzen von Patienten, pflegenden Angehörigen,
Leistungserbringern, Kostenträgern und politischen
Entscheidungsträgern bei der integrierten Versorgung in Deutschland: Ein
Discrete Choice Experiment
Authors: Struckmann Verena , Vogt Verena , Köppen Julia , Meier Theresa , Hoedemakers Maaike , Leijten Fenna , Looman Willemijn , Karimi Milad , Busse Reinhard , Rutten-van Mölken Maureen 
Published: October 2021

Zusammenfassung
Ziel Ziel dieser Studie ist Präferenzen zu erheben, die
multimorbide Patienten, pflegende Angehörige, Leistungserbringer,
Kostenträger oder politische Entscheidungsträger verschiedenen
Endpunkten von integrierten Versorgungsprogrammen (IV-Programmen) in Deutschland
beimessen und diese zu vergleichen.
Methodik Mit Hilfe eines Discrete Choice Experiments (DCE) wurden die
Präferenzen der Befragten für die Endpunkte von zwei
IV-Programmen ermittelt. Jedes IV-Programm wurde anhand von Attributen,
bzw.Endpunkten präsentiert, die das „Triple Aim“
abbilden. Sie waren in die Endpunkte Wohlbefinden, Erfahrung mit Versorgung und
Kosten unterteilt, mit insgesamt acht Attributen und jeweils drei
Ausprägungen.
Ergebnisse Die Ergebnisse von 676 Fragebögen zeigen, dass die
Attribute „Lebensfreude“ und „Kontinuität der
Versorgung“ interessengruppenübergreifend die höchsten
Bewertungen erhalten. Am geringsten blieben die relativen Bewertungen
für alle Interessengruppen bei dem Attribut „Kosten“.
Die Präferenzen der Leistungserbringer und pflegenden
Angehörigen unterschieden sich am deutlichsten von denen der Patienten.
Diese Unterschiede betrafen meist die „körperliche
Funktionsfähigkeit“, die von Patienten am höchsten
bewertet wurde, die „Personenzentrierung“ und
„Kontinuität der Versorgung“, die die höchsten
Bewertungen von den Leistungserbringern erhielten.
Schlussfolgerung Die identifizierten
Präferenzheterogenitäten in Bezug auf die Endpunkte von
IV-Programmen zwischen den Interessengruppen verdeutlichen, wie wichtig es
für eine optimale Ausgestaltung von IV-Programmen ist, Vertreter der
Praxis und politische Entscheidungsträger über die
unterschiedlichen Perspektiven zu informieren. Die Ergebnisse unterstreichen
zudem die Relevanz von gemeinsamen Entscheidungsfindungs- und
Abstimmungsprozessen zwischen Leistungserbringern, pflegenden
Angehörigen und Patienten.
Der Effekt von hochintensivem Kräftigungstraining auf Knieschmerzen und im Kniegelenk auftretende Kräfte bei Erwachsenen mit Kniearthrose
Authors: Scheer Janik 
Published: October 2021

OriginalpublikationMessier SP, Mihalko SL, Beavers DP et al. Effect of High-Intensity Strength Training on Knee Pain and Knee Joint Compressive Forces Among Adults With Knee Osteoarthritis. The START Randomized Clinical Trial 2021; 325: 646–657
Hypoxietraining als alternative oder ergänzende Bewegungstherapieform bei Diabetes Typ 2 – eine narrative Übersicht
Authors: Schwarzer Janina , Schröder Jan 
Published: October 2021

ZusammenfassungDass körperliche Aktivität bei Diabetes Typ 2 ein wichtiger Therapiebaustein ist, ist gut belegt. Das Hypoxietraining als Trainingsform findet derzeit jedoch noch eher wenig Anwendung in der Trainingstherapie. Ziel dieses narrativen Reviews war es zu untersuchen, inwiefern das Hypoxietraining als alternative Therapieform in der Trainingstherapie bei Diabetes-Typ-2-Patienten angewendet werden kann und ob es einen Vorteil zur konventionellen Trainingstherapie bietet.Für die Literaturrecherche wurden Studien im Zeitraum zwischen 2010 und 2020 identifiziert und auf Relevanz für die Fragestellung hin geprüft. In die Analyse wurden n=8 Studien miteinbezogen. Diese Studien untersuchten besonders den Einfluss des Hypoxietrainings auf kardiovaskuläre Gesundheit, Insulinsensitivität und Glukosestoffwechsel. Die Untersuchungen fanden hauptsächlich in künstlicher Höhe statt. Insgesamt ergaben die Studien durchaus positive Effekte durch Hypoxietraining, sowohl auf die kardiovaskuläre Gesundheit als auch auf die Insulinsensitivität und den Glukosestoffwechsel bei Diabetes-Typ-2-Patienten. So zeigte sich, dass besonders ein kontinuierliches und längeres Training in Hypoxie (60 Minuten) am effektivsten war, um die Insulinsensitivität und den Glukosestoffwechsel kurzfristig (bis zu 48 Stunden) positiv zu beeinflussen. Dennoch fehlen Studien, die die langfristige Wirkung des Hypoxietrainings an Diabetes-Typ-2-Patienten untersuchen. Zudem sollte die Trainingsintensität in der Betrachtung von Studien mehr Bedeutung finden, da sie einen wichtigen Aspekt in der Vergleichbarkeit ausmacht. So können möglicherweise stärkere Effekte des Hypoxietrainings, im Vergleich zum Training in Normoxie, auf eine höhere Belastungsintensität zurückgeführt werden. Es sind somit weitere Untersuchungen nötig, um einen möglichen Vorteil des Hypoxietrainings in der Trainingstherapie für Diabetes-Typ-2-Patienten auszumachen.Hypoxietraining könnte somit in der Trainingstherapie bei Diabetes Typ 2 als ergänzende Maßnahme zum Einsatz kommen, wenn mögliche Risiken noch besser bekannt sind.
Chancen und Barrieren digitaler Gesundheitsförderung
Authors: Kellner Mona 
Published: October 2021

ZusammenfassungDie Covid-19-Pandemie und die damit einhergehenden Einschränkungen des gewohnten Alltagslebens zwingen auch die Gesundheitsförderung dazu, vermehrt digitalisierte Programme zu entwickeln und anzubieten. Eine Analyse des bisherigen Forschungsstandes zeigt, dass in diesem Forschungsfeld Entwicklungsbedarf besteht. Speziell in Zeiten, in denen sich persönlicher Kontakt negativ auswirken kann, sollte die Digitalisierung rasch vorangetrieben werden. Die aktuelle Corona-Pandemie hat die Nebenwirkung, dass freizeitliches sowie formelles Sporttreiben und auch die Aktivität im gewöhnlichen Alltag voraussichtlich reduziert werden.Auch Studierende sind in der aktuellen Ausnahmesituation speziellen Anforderungen ausgesetzt. Fehlende Planungssicherheit für die Zukunft, Studieren und Lernen im Homeoffice und mangelnde Sozialkontakte machen dieser Statusgruppe an Hochschulen stark zu schaffen. Auch das Bewegungsverhalten ist durch die Distanz zu Freunden und dem Sportverein ausgesetzt respektive deutlich vermindert: eine dringende Handlungsaufforderung für Gesundheitsförderer im Setting Hochschule!
Ultrasound as a Sole Modality for Prenatal Diagnosis of Placenta Accreta Spectrum: Potentialities and Pitfalls
Authors: Gulati Anshika , Anand Rama , Aggarwal Kiran , Agarwal Shilpi , Tomer Shaili 
Published: October 2021

AbstractBackground Placenta accreta spectrum (PAS) is a significant cause of maternal and neonatal mortality and morbidity. Its prevalence has been rising considerably, primarily due to the increasing rate of primary and repeat cesarean sections. Accurate prenatal identification of PAS allows optimal management because the timing of delivery, availability of blood products, and recruitment of skilled anesthesia, and surgical team can be arranged in advance.Aims and Objectives This study aimed to (1) study the ultrasound and color Doppler features of PAS, (2) correlate imaging findings with clinical and per-operative/histopathological findings, and (3) evaluate the accuracy of ultrasound for the diagnosis of PAS in patients with previous cesarean section.Materials and Methods This prospective study was conducted in radiology department of a tertiary care hospital. After screening 1,200 pregnant patients, 50 patients of placenta previa with period of gestation ≥ 24 weeks and history of at least one prior cesarean section were included in the study. Following imaging features were evaluated: (1) gray scale covering intraplacental lacunae, disruption of uterovesical interface, myometrial thinning, loss of retroplacental clear space, and focal exophytic masses; and (2) color Doppler covering intraplacental lacunar flow, hypervascularity of uterine serosa–bladder wall interface, and perpendicular bridging vessels between placenta and myometrium.Study Design Present study is a prospective one in a tertiary care hospital.Results Of the 19 PAS cases, 18 were correctly diagnosed on ultrasonography (USG) and confirmed either by histopathological analysis of hysterectomy specimen or per-operatively due to difficulty in placental removal. PAS was correctly ruled out in 27 of 31 patients. The diagnostic accuracy of USG was 90%. The sensitivity, specificity, positive, and negative predictive values were 94.7, 87.1, 81.8, and 96.4%, respectively.Conclusion Ultrasound is indispensable for the evaluation of pregnant patients. It is an important tool for diagnosing PAS, thereby making the operating team more cautious and better equipped for difficult surgery and critical postoperative care. It can be relied upon as the sole modality to accurately rule out PAS in negative patients, thereby obviating unnecessary psychological stress among patients due to possible hysterectomy.
Comparison of PLANE Technique versus Standard Echocardiography Guidance for Pediatric Pericardiocentesis
Authors: Clark Stephen T. , Alten Jeffrey A. , Borasino Santiago , Hock Kristal M. , Law Mark A. 
Published: October 2021

AbstractPercutaneous pericardiocentesis remains a challenging and potentially dangerous procedure, particularly in small, critically ill patients. We present outcomes of the PLANE (pericardiocentesis using long-axis in-plane real-time echocardiography) technique for pediatric pericardiocentesis compared with a standard echocardiography (ECHO) guidance cohort. This was a retrospective chart review of all children undergoing percutaneous pericardiocentesis from March 2013 to February 2021 at a single center. A total of 78 procedures were performed, 52 utilizing PLANE technique and 26 utilizing standard ECHO-guidance technique. There was 100% technical success rate with only one minor complication for the entire cohort. Procedures were evenly split between the bedside intensive care unit and cardiac catheterization laboratory. PLANE technique was utilized in significantly younger (1.4 vs. 8.4 years, p = 0.008) and smaller (11.1 vs. 31.8 kg, p = 0.007) patients, as well as in most patients deemed high risk (postoperative < 7 days, extracorporeal membrane oxygenation (ECMO) support, and/or weight less than 5 kg; 19/22, p = 0.021). Other patient characteristics were similar between the two groups. There was a trend toward PLANE technique utilization by noncardiology trained operators. The PLANE technique for pediatric pericardiocentesis is safe and effective and can be effectively utilized in small and high-risk patient populations. The technical similarity to other long-axis ultrasound-guided procedures may facilitate adoption and mastery by critical care trained operators.