bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rewarming With Closed Thoracic Lavage Following 3-h CPR at 27°C Failed to Reestablish a Perfusing Rhythm
Authors: Nivfors Joar O. , Mohyuddin Rizwan , Schanche Torstein , Nilsen Jan Harald , Valkov Sergei , Kondratiev Timofei V. , Sieck Gary C. , Tveita Torkjel 
Published: September 2021

Introduction: Previously, we showed that the cardiopulmonary resuscitation (CPR) for hypothermic cardiac arrest (HCA) maintained cardiac output (CO) and mean arterial pressure (MAP) to the same reduced level during normothermia (38°C) vs. hypothermia (27°C). In addition, at 27°C, the CPR for 3-h provided global O2 delivery (DO2) to support aerobic metabolism. The present study investigated if rewarming with closed thoracic lavage induces a perfusing rhythm after 3-h continuous CPR at 27°C.Materials and Methods: Eight male pigs were anesthetized, and immersion-cooled. At 27°C, HCA was electrically induced, CPR was started and continued for a 3-h period. Thereafter, the animals were rewarmed by combining closed thoracic lavage and continued CPR. Organ blood flow was measured using microspheres.Results: After cooling with spontaneous circulation to 27°C, MAP and CO were initially reduced by 37 and 58% from baseline, respectively. By 15 min after the onset of CPR, MAP, and CO were further reduced by 58 and 77% from baseline, respectively, which remained unchanged throughout the rest of the 3-h period of CPR. During CPR at 27°C, DO2 and O2 extraction rate (VO2) fell to critically low levels, but the simultaneous small increase in lactate and a modest reduction in pH, indicated the presence of maintained aerobic metabolism. During rewarming with closed thoracic lavage, all animals displayed ventricular fibrillation, but only one animal could be electro-converted to restore a short-lived perfusing rhythm. Rewarming ended in circulatory collapse in all the animals at 38°C.Conclusion: The CPR for 3-h at 27°C managed to sustain lower levels of CO and MAP sufficient to support global DO2. Rewarming accidental hypothermia patients following prolonged CPR for HCA with closed thoracic lavage is not an alternative to rewarming by extra-corporeal life support as these patients are often in need of massive cardio-pulmonary support during as well as after rewarming.
Cultural Competence and Cultural Sensitivity Education in University Nursing Courses. A Scoping Review
Authors: Gradellini Cinzia , Gómez-Cantarino Sagrario , Dominguez-Isabel Patricia , Molina-Gallego Brigida , Mecugni Daniela , Ugarte-Gurrutxaga María Idoia 
Published: September 2021

When assessing the fragility that characterizes the health of an immigrant person, a culturally competent transformation of the nurse–patient teaching-learning process is necessary. Therefore, it is considered essential to incorporate cultural competence and intercultural communication in higher nursing education.ObjectiveTo determine the content and knowledge of cultural competence and intercultural communication offered in higher education in nursing courses.DesignThe Campinha-Bacote model of cultural competence was used as the primary reference.MethodA scoping review was conducted about studies published in the period 2003 and 2020. The research was conducted between May and October 2020. More than a hundred documents (books, chapters, articles, conference proceedings) have been consulted.ResultsUndergraduate nursing courses and postgraduate education move toward promoting cultural competence and sensitivity through teaching strategies.ConclusionsTeaching projects that combine multiple competencies are more effective, including teacher training. A predominant element is a need for continuous and transversal projects. University nursing education must adapt culturally competent curricula.
Parent-Infant Interactions Among Infants With High Risk of Cerebral Palsy: A Protocol for an Observational Study of Infant and Parental Factors for Dyadic Reciprocity
Authors: Røhder Katrine , Willerslev-Olsen Maria , Nielsen Jens Bo , Greisen Gorm , Harder Susanne 
Published: September 2021

Background: An early diagnosis of chronic disability, such as risk of Cerebral Palsy (CP), is likely to affect the quality of parent-infant interactions by affecting both infant and parental factors. Due to adverse perinatal events, infants at high risk of CP may exhibit less engagement in interactions, while parents may experience increased mental health problems and disrupted parental representations that can have a negative effect on parental sensitivity. Recent clinical guidelines on early intervention among families with infants at risk of CP recommends supporting parental sensitivity and mutual enjoyable interactions more research is needed to inform such interventions. This includes understanding how infant and parental risk as well as resilience factors impact parent-infant interactions and how existing parenting programs developed among typical developing infants should be adapted to families with infants at risk of CP. In addition, as majority of research on infant neurohabilitation focus on improving motor and cognitive outcomes research on infant emotional development is needed. The study aim is to assess the quality of early parent-infant interactions in families with high-risk infants, compared to families with low-risk infants, and to explore how interaction quality is affected by infant and parental factors. Three potential mediating factors explaining the association between CP risk and less optimal parent-infant interactions will be explored: infant interactional capacities, parental mental health and well-being, and parents' representations of their child.Methods: The prospective, longitudinal design will follow infants at high risk for CP and their parents and a control group at three time points from 15 weeks to 15 months corrected infant age (CA). Measures comprise infant developmental assessments, questionnaires and interviews with both parents, and global ratings of video-recorded parent-infant interactions.Discussion: Study results will enhance our understanding of how parent-infant interactions may be affected by perinatal neurological risk and identify potential important mechanisms for observed associations. This knowledge could assist in planning future early screening and intervention programs and identifying families who should be offered targeted psychological interventions in addition to neurohabilitation programs.
A Clinical Study Investigating Whether the Tongue-Out Position Improves the Quality of the Anatomical Appearance of the Pharynx on CT Imaging
Authors: Wu Jin-Long , Ge Rui-Gang , Tang Guang-Jian 
Published: September 2021

Objective: To evaluate the effect of using the tongue-out position on the quality of the anatomical appearance of the pharynx on computed tomography (CT) images.Methods: The data from enhanced CT thin-section images of the head and neck in 119 cases scanned were retrospectively analyzed. The cases were divided into two groups based on the position of the tip of the tongue on the images: the tongue-out group (63 cases) and non-tongue-out group (56 cases). Two observers separately evaluated the anatomy of the soft palate, uvula, palatine tonsils, epiglottis, epiglottic fossa, pyriform fossa, arytenoid folds, and tongue on all images. The Kappa test was applied to assess the consistency of scores between the two observers. In the case of data that satisfied the normal distribution, the significance of the difference in the average scores between the two groups was tested using an independent samples t-test with a value of p &gt; 0.05. In the case of data that did not satisfy the normal distribution, the Mann–Whitney U test was adopted to test the significance of the difference in the average scores between the two groups using a value of p &lt; 0.05. The number of cases with swallowing artifacts on the CT images in both groups was statistically analyzed and the chi-square test was used to determine whether the difference in the incidence of artifacts between the two groups was significant.Results: The Kappa test showed good consistency between the two observers scoring of the soft palate, uvula, epiglottis, epiglottic fossa, pyriform fossa, aryepiglottic folds, and tongue. The image scores of the soft palate, uvula, epiglottis, epiglottic fossa, and tongue in the tongue-out group vs. the non-tongue-out group did not satisfy the normal distribution. The Mann–Whitney U test showed that the differences in the image scores between the two groups were statistically significant in all cases (p &lt; 0.05). The incidence of swallowing artifacts in the tongue-out group and the non-tongue-out group was 15 and 32%, respectively. The result of the chi-square test showed that the difference in the incidence of swallowing artifacts between the two groups was statistically significant (p = 0.037).Conclusion: The tongue-out position facilitated an improvement in the CT appearance of pharyngeal anatomy and was associated with a reduction in the incidence of swallowing artifacts.
In Silico Assessment of Safety and Efficacy of Screw Placement for Pediatric Image-Guided Otologic Surgery
Authors: Hermann Jan , Mueller Fabian , Weber Stefan , Caversaccio Marco , O'Toole Bom Braga Gabriela 
Published: September 2021

Introduction: Current high-accuracy image-guided systems for otologic surgery use fiducial screws for patient-to-image registration. Thus far, these systems have only been used in adults, and the safety and efficacy of the fiducial screw placement has not yet been investigated in the pediatric population.Materials and Methods: In a retrospective study, CT image data of the temporal region from 11 subjects meeting inclusion criteria (8–48 months at the time of surgery) were selected, resulting in n = 20 sides. These datasets were investigated with respect to screw stability efficacy in terms of the cortical layer thickness, and safety in terms of the distance of potential fiducial screws to the dura mater or venous sinuses. All of these results are presented as distributions, thickness color maps, and with descriptive statistics. Seven regions within the temporal bone were analyzed individually. In addition, four fiducial screws per case with 4 mm thread-length were placed in an additively manufactured model according to the guidelines for robotic cochlear implantation surgery. For all these screws, the minimal distance to the dura mater or venous sinuses was measured, or if applicable how much they penetrated these structures.Results: The cortical layer has been found to be mostly between 0.7–3.3 mm thick (from the 5th to the 95th percentile), while even thinner areas exist. The distance from the surface of the temporal bone to the dura mater or the venous sinuses varied considerably between the subjects and ranged mostly from 1.1–9.3 mm (from the 5th to the 95th percentile). From all 80 placed fiducial screws of 4 mm thread length in the pediatric subject younger than two years old, 22 touched or penetrated either the dura or the sigmoid sinus. The best regions for fiducial placement would be the mastoid area and along the petrous pyramid in terms of safety. In terms of efficacy, the parietal followed by the petrous pyramid, and retrosigmoid regions are most suited.Conclusion: The current fiducial screws and the screw placement guidelines for adults are insufficiently safe or effective for pediatric patients.
Investigating the Efficacy of a Canine Rabies Vaccine Following Storage Outside of the Cold-Chain in a Passive Cooling Device
Authors: Lugelo Ahmed , Hampson Katie , Czupryna Anna , Bigambo Machunde , McElhinney Lorraine M. , Marston Denise A. , Kazwala Rudovick , Lankester Felix 
Published: September 2021

Background: Thermostable vaccines greatly improved the reach and impact of large-scale programmes to eliminate infectious diseases such as smallpox, polio, and rinderpest. A study from 2015 demonstrated that the potency of the Nobivac® Rabies vaccine was not impacted following experimental storage at 30°C for 3 months. Whether the vaccine would remain efficacious following storage under more natural, fluctuating temperature conditions remains unknown. We carried out a randomised controlled non-inferiority trial to compare serological responses in dogs following vaccination with doses stored under cold chain conditions with those stored within a locally made Passive Cooling Device (“Zeepot”) under fluctuating temperature conditions.Materials and Methods: Nobivac® Rabies vaccine was stored under either cold-chain conditions or within the Zeepot for 2 months. Daily ambient temperatures and temperatures within the Zeepot were recorded every 3 h. Following storage, 412 domestic dogs were randomly assigned to receive either cold-chain or Zeepot stored Nobivac® Rabies vaccine. Baseline and day 28-post vaccination blood samples were collected. Serological analysis using the Fluorescent Antibody Virus Neutralisation assay was carried out with a threshold of 0.5 IU/ml to determine seroconversion. In addition, the impact of dog Body Condition Score, sex, and age on seroconversion was examined.Results: The serological response of dogs vaccinated using Nobivac® Rabies vaccine stored within the Zeepot was not inferior to the response of dogs vaccinated using cold-chain stored vaccine (z = 1.1, df = 313, p-value = 0.25). Indeed, the 28-day post-vaccination group geometric mean titre was 1.8 and 2.0 IU/ml for cold-chain vs. non-cold-chain storage, respectively. Moreover, the percentage of dogs that seroconverted in each arm was almost identical (85%). There was a positive linear trend between Body Condition Score (O.R. 2.2, 95% CI: 1.1–5.1) and seroconversion, suggesting dogs of poor condition may not respond as expected to vaccination.Conclusions: Our study demonstrated the potency of Nobivac® Rabies vaccine is not impacted following storage under elevated fluctuating temperatures within a Zeepot. These results have potentially exciting applications for scaling up mass dog vaccination programmes in low-and-middle income countries, particularly for hard-to-reach populations with limited access to power and cold-chain vaccine storage.
Comparison of Conventional Molecular and Whole-Genome Sequencing Methods for Differentiating Salmonella enterica Serovar Schwarzengrund Isolates Obtained from Food and Animal Sources
Authors: Li I-Chen , Wu Rayean , Hu Chung-Wen , Wu Keh-Ming , Chen Zeng-Weng , Chou Chung-Hsi 
Published: September 2021

Over the last decade, Salmonella enterica serovar Schwarzengrund has become more prevalent in Asia, Europe, and the US with the simultaneous emergence of multidrug-resistant isolates. As these pathogens are responsible for many sporadic illnesses and chronic complications, as well as outbreaks over many countries, improved surveillance is urgently needed. For 20 years, pulsed-field gel electrophoresis (PFGE) has been the gold standard for determining bacterial relatedness by targeting genome-wide restriction enzyme polymorphisms. Despite its utility, recent studies have reported that PFGE results correlate poorly with that of closely related outbreak strains and clonally dominant endemic strains. Due to these concerns, alternative amplification-based molecular methods for bacterial strain typing have been developed, including clustered regular interspaced short palindromic repeats (CRISPR) and multilocus sequence typing (MLST). Furthermore, as the cost of sequencing continues to decrease, whole genome sequencing (WGS) is poised to replace other molecular strain typing methods. In this study, we assessed the discriminatory power of PFGE, CRISPR, MLST, and WGS methods to differentiate between 23 epidemiologically unrelated S. enterica serovar Schwarzengrund isolates collected over an 18-year period from distinct locations in Taiwan. The discriminatory index (DI) of each method for different isolates was calculated, resulting in values between 0 (not discriminatory) and 1 (highly discriminatory). Our results showed that WGS has the greatest resolution (DI = 0.982) compared to PFGE (DI = 0.938), CRISPR (DI = 0.906), and MLST (DI = 0.463) methods. In conclusion, the WGS typing approach was shown to be the most sensitive for S. enterica serovar Schwarzengrund fingerprinting.
Sharp Increase in Eating Disorders among University Students since the COVID-19 Pandemic
Authors: Tavolacci Marie-Pierre , Ladner Joel , Déchelotte Pierre 
Published: September 2021

The COVID-19 pandemic has caused stress as well as modified physical activity and eating habits among university students. The objectives were to identify the changes in body mass index (BMI) and eating disorders among university students between 2009 and 2021. Between 2009 and 2021, five repeated cross-sectional studies were conducted among university students who filled in an anonymous online self-questionnaire. Age, gender, and BMI were recorded, and the SCOFF questionnaire was used for ED screening which, in combination with BMI, allows to identify the four broad categories of ED with the Expali algorithm. With the five studies, 8981 university students were included in total. Obesity steadily increased between 2009 and 2021, for both men and women. The prevalence of ED was stable between 2009 and 2018 and significantly increased from 31.8% in 2018 to 51.8% in 2021 for women (p trend < 0.0001), and from 13.0% in 2009 to 31.3% in 2021 for men (p trend < 0.0001). All types of ED increased significantly between 2009 and 2021, except for restrictive ED among men. These results indicate for the first time a significant increase in ED prevalence among students since the COVID-19 pandemic. Initiatives to reinforce early screening of ED to implement targeted interventions in the student population are urgently needed.
preliminary study exploring the relation between visual prosody and the prosodic components in sign language
Authors: Renckens Maaten , De Raeve Leo , Nuyts Erik , Pérez Mena María , Beesemans Ann 
Published: September 2021

Type enriched with visual prosody is a powerful tool to encourage expressive reading. Visual prosody adds cues to text to guide vocal variations in loud-ness, duration, and pitch. More vocal variations result in a less monotonous voice and thus more expression. A positive e!ect of visual prosody is known on the voice of normal hearing readers and of signed bilingual deaf readers who developed signed language and spoken language. These deaf readers rely on speech as well as sign language and both modalities can be used interchangeably to compensate each other.
This preliminary study explores visual prosody in text in relation to Flemish Sign Language to see if sign language can be used to explain prosody. We asked deaf readers between 7 and 18 to relate prosodic cues to videos presenting prosodic components of Flemish Sign Language. We found that those readers connect the prosodic cues with the components in Flemish Sign Language as intended. Larger word-spacing cor-relates with a pause between signs, a wider font with a sign with ‘longer du-ration’, a thicker font with more ‘displacement’ in the sign, a raised font with a ‘faster velocity’ in the sign. However, some confusion occurred as participants seemed to extract only two prosodic components in the sign language: both the ‘faster velocity’ and ‘longer duration’ were referred to in terms of 'speed' and were not perceived as separate prosodic components. Participants were confused about why there were three cues in the text. Therefore, it is advised to re-evaluate and to re-design visual prosody for sign language with only ‘displacement’ and ‘speed’ in mind.
Highly precise multi-cathode pulsed-DC sputtering employing digital processing–application to layer–by–layer synthesis of cubic (Er0.1Y0.9)2Zr2O7 thin film
Authors: Isshiki Hideo , Tanaka Yasuhito , Miyagi Kodai , Kasumi Tomoki , Nakamura Ghent , Saisho Shinichiro 
Published: September 2021

Abstract
A digitally processed DC reactive sputtering (DPDRS) system employing field-programmable gate-array has been developed. In this report, atomically precise pulsed-DC sputtering of a metal oxide compound, cubic (Er0.1Y0.9)2Zr2O7 (c-EYZO), is demonstrated by using DPDRS. An alternating process of pulsed metal sputtering and reactive gas pulsing was applied in order to realize layer-by-layer reactive sputtering. The pulsed metal sputtering separated from the oxidation process results in a stable and high deposition rate of c-EYZO at 1.9 μm h−1, which corresponds to 1.56 nm/cycle. By adjusting the deposition rate to the d-spacing of 0.26 nm corresponding to the (200) diffraction, layer-by-layer synthesis of a highly oriented c-EYZO thin film showing the d-spacing was achieved. X-ray diffraction and photoluminescence measurements indicate drastic improvement of the crystalline properties and the emission properties due to the layer-by-layer synthesis. It is expected that DPDRS enables arbitrarily designed atomically precise deposition of the metal oxide compound synthesis.
El ejercicio médico en el siglo XXI
Authors: Ruano Restrepo Mario Iván , Ramírez Zuluaga Liliana Patricia , Osorio Bermúdez Juan David , Díaz Vallejo Jhony Alejandro , Bastidas Achicanoy Eliana 
Published: September 2021

El método clínico, desde su creación en la Grecia antigua, no ha tenido mayores cambios en sus componentes y aplicación. Sin embargo, desde hace un tiempo se ha venido vulnerando debido al gran impacto que ha tenido la tecnología en las ciencias de la salud, y los nuevos paradigmas impuestos a la práctica clínica y la educación médica.
El presente artículo describe los datos históricos más relevantes del método clínico, sus componentes científicos y su aplicación en la medicina, se resalta su importancia en todos los aspectos médicos, y se plasma una reflexión acerca de las causas de esta crisis y cómo involucra al profesional de medicina general en Colombia.
Análisis crítico de la prueba material en delitos de portación ilegal de armas de fuego
Authors: Herrera González Julio Roberto 
Published: September 2021

Que significa prueba, su origen, de la pretensión de convencer al juez de darle credibilidad a la plataforma fáctica. Además de tomar en consideración aspectos relevantes sobre el estudio de la Prueba, es decir los diferentes sistemas que pueden utilizar los aplicadores de Justicia para valorar la prueba, se realizó un análisis, de aspectos importantes de dicha aplicación, cuestionando si son ignorados o desechados, por dichos jueces al momento de dictar sentencia, su justificación, de su idoneidad, de los aspectos tomados en cuenta de los diferentes sistemas de valoración de prueba. De las sentencias condenatorias emitidas, valorando la prueba material en nuestro caso el arma de fuego, por el delito de portación Ilegal de armas de fuego de uso civil y/o deportivas.