bluuebunny/crossref_metadata_2025_split huggingface dataset:
Viability and thresholds for treatment of extremely preterm infants: survey of UK neonatal professionals
Authors: Di Stefano Lydia Mietta , Wood Katherine , Mactier Helen , Bates Sarah Elizabeth , Wilkinson Dominic 
Published: April 2021

BackgroundDecisions about treatments for extremely preterm infants (EPIs) born in the ‘grey zone’ of viability can be ethically complex. This 2020 survey aimed to determine views of UK neonatal staff about thresholds for treatment of EPIs given a recently revised national Framework for Practice from the British Association of Perinatal Medicine.MethodsThe online survey requested participants indicate the lowest gestation at which they would be willing to offer active treatment and the highest gestation at which they would withhold active treatment of an EPI at parental request (their lower and upper thresholds). Relative risks were used to compare respondents’ views based on profession and neonatal unit designation. Further questions explored respondents’ conceptual understanding of viability.Results336 respondents included 167 consultants, 127 registrars/fellows and 42 advanced neonatal nurse practitioners (ANNPs). Respondents reported a median grey zone for neonatal resuscitation between 22+1 and 24+0 weeks’ gestation. Registrars/fellows were more likely to select a lower threshold at 22+0 weeks compared with consultants (Relative Risk (RR)=1.37 (95% CI 1.07 to 1.74)) and ANNPs (RR=2.68 (95% CI 1.42 to 5.06)). Those working in neonatal intensive care units compared with other units were also more likely to offer active treatment at 22+0 weeks (RR=1.86 (95% CI 1.18 to 2.94)). Most participants understood a fetus/newborn to be ‘viable’ if it was possible to survive, regardless of disability, with medical interventions accessible to the treating team.ConclusionCompared with previous studies, we found a shift in the reported lower threshold for resuscitation in the UK, with greater acceptance of active treatment for infants <23 weeks’ gestation.
‘The nurse did not even greet me’: how informed versus non-informed
patients evaluate health systems responsiveness in South Africa
Authors: Hompashe Dumisani MacDonald , Gerdtham Ulf-G , Christian Carmen S , Smith Anja , Burger Ronelle 
Published: April 2021

Introduction
Universal Health Coverage is not only about access to health
services but also about access to high-quality care, since poor
experiences may deter patients from accessing care. Evidence shows that
quality of care drives health outcomes, yet little is known about
non-clinical dimensions of care, and patients’ experience thereof
relative to satisfaction with visits. This paper investigates the role
of non-clinical dimensions of care in patient satisfaction.

Methods
Our study describes the interactions of informed and non-informed
patients with primary healthcare workers at 39 public healthcare
facilities in two metropolitan centres in two South African provinces.
Our analysis included 1357 interactions using standardised patients (for
informed patients) and patients’ exit interviews (for non-informed
patients). The data were combined for three types of visits:
contraception, hypertension and tuberculosis. We describe how
satisfaction with care was related to patients’ experiences of
non-clinical dimensions.

Results
We show that when real patients (RPs) reported being satisfied (vs
dissatisfied) with a visit, it was associated with a 30% increase in the
probability that a patient is greeted at the facilities. Likewise, when
the RPs reported being satisfied (vs dissatisfied) with the visit, it
was correlated with a 15% increase in the prospect that patients are
pleased with healthcare workers’ explanations of health
conditions.

Conclusion
Informed patients are better equipped to assess health-systems
responsiveness in healthcare provision. Insights into responsiveness
could guide broader efforts aimed at targeted education and empowerment
of primary healthcare users to strengthen health systems and shape
expectations for appropriate care and conduct.
High-flow nasal cannula oxygen therapy for outpatients undergoing flexible bronchoscopy: a randomised controlled trial
Authors: Longhini Federico , Pelaia Corrado , Garofalo Eugenio , Bruni Andrea , Placida Roberta , Iaquinta Caterina , Arrighi Eugenio , Perri Graziella , Procopio Giada , Cancelliere Anna , Rovida Serena , Marrazzo Giuseppina , Pelaia Girolamo , Navalesi Paolo 
Published: April 2021

IntroductionHigh-flow nasal cannula (HFNC) provides benefits to patients undergoing flexible bronchoscopy (FOB). We compared the effects of HFNC versus standard therapy (ST) on gas exchange, lung volume and diaphragm function in patients undergoing FOB for bronchoalveolar lavage (BAL).Methods36 outpatients were randomised to ST or HFNC. Arterial blood gases, episodes of severe desaturation, changes of end-expiratory lung impedance (ΔEELI), diaphragm ultrasound were recorded. Measurements were done at baseline (T0), after bronchoscope insertion (T1), at the end of the procedure (T2) and 10 min afterwards (T3).ResultsArterial partial oxygen pressure (PaO2) was not different between T0 (10.8 (95% CI 8.7 to 12.0) kPa and T2 (11.1 (95% CI 10.4 to 12.0) kPa) with HFNC, while decreased from 11.1 (95% CI 10.5 to 12.1) to 9.1 (95% CI 8.4 to 9.8) kPa with ST. At T2, PaO2 was significantly higher with HFNC than with ST (p<0.001). Also, with HFNC, compared with ST, fewer desaturations occurred (11% vs 56%; p<0.01). ΔEELI was no different at the different time points with HFNC, while with ST there was a significant decrease at T1 (−170 (95% CI −382 to −32) mL, p=0.003), T2 (−211 (95% CI −425 to −148) mL, p<0.001) and T3 (−213 (95% CI −398 to −81) mL, p<0.001), as opposed to T0. EELI was lower with ST than HFNC at T1 (p=0.006), T2 (p=0.001) and T3 (p=0.002). Diaphragm displacement was no different between groups (p=0.748), while the thickening fraction significantly increased at T1 and T2 with ST only (p<0.01).ConclusionsDuring FOB for BAL, HFNC improves gas exchange, avoiding loss of end-expiratory lung volume and preventing increase of diaphragm activation.Trial registration numberNCT04016480.
Vitexin regulates Epac and NLRP3 and ameliorates chronic cerebral hypoperfusion injury
Authors: Zhang Qilong , Fan Zhijia , Xue Wei , Sun Fanfan , Zhu Huaqing , Huang Dake , Wang Zhicheng , Dong Liuyi 
Published: April 2021

Chronic cerebral hypoperfusion (CCH), as a critical factor of chronic cerebrovascular diseases, has greatly influenced the health of patients with vascular dementia. Vitexin, a flavone C-glycoside (apigenin-8-C-β-D-glucopyranoside) that belongs to the flavone subclass of flavonoids, has been shown to possess antioxidant and anti-ischemic properties; however, the putative protective effects of vitexin on the CCH need further investigation. In the current study, the role of vitexin and its underlying mechanism were investigated with permanent bilateral common carotid artery occlusion (2VO) in rats as well as mouse hippocampal neuronal (HT22) cells with oxygen and glucose deprivation/reoxygenation (OGD/R) injury model. The results demonstrated that vitexin improved cognitive dysfunction as well as alleviated pathological neuronal damage in hematoxylin plus eosin (HE) and TUNEL results. The decreased levels of exchange protein directly activated by cAMP 1 (Epac1), Epac2, Ras-associated protein 1 (Rap1), and phospho-extracellular signal-regulated kinase (p-ERK) were reversed by vitexin in rats with CCH. Furthermore, this study indicated that vitexin alleviated CCH-induced inflammation injuries by reducing the expression of NOD-like receptor 3 (NLRP3), caspase-1, interleukin 1β (IL-1β), IL-6, and cleaved caspase-3. In vitro, vitexin increased the expression of Epac1 and Epac2, decreased the activation of the NLRP3-mediated inflammation, and improved cell viability. Taken together, our findings suggest that vitexin can reduce the degree of the progressing pathological damage in the cortex and hippocampus and inhibit further deterioration of cognitive function in rats with CCH. Epac and NLRP3 can be regulated by vitexin in vivo and in vitro, which provides enlightenment for the protection of CCH injury.
Diagnostic Value of High-Sensitivity Troponin T for Subclinical Left Ventricular Systolic Dysfunction in Patients with Sepsis
Authors: Hai Pham Dang , Binh Nguyen Thanh , Tot Nguyen Hong , Hung Ha Manh , Hoa Le Thi Viet , Hien Nguyen Viet Quang , Son Pham Nguyen 
Published: April 2021

Background. Left ventricular systolic dysfunction (LVSD) is common in sepsis. Speckle-tracking echocardiography (STE) is a useful emerging tool for evaluating the intrinsic left ventricular systolic function. High-sensitivity cardiac troponin T (hs-cTnT) is the most sensitive biomarker of myocardial injury. However, there are limited data regarding the association between hs-cTnT level and left ventricular systolic dysfunction based on STE in septic patients. We performed this prospective study to evaluate the diagnostic value of hs-cTnT level for subclinical left ventricular systolic dysfunction measured by STE in septic patients according to the sepsis-3 definition. Methods. Patients with sepsis based on sepsis-3 definition admitted to the intensive care unit were prospectively performed STE and hs-cTnT level within 24 hours after the onset of sepsis. Baseline clinical and echocardiographic variables were collected. Left ventricular systolic dysfunction was defined as a global longitudinal strain of   ≥−15%. Results. During a 19-month period, 116 patients were enrolled in the study. The elevated hs-cTnT level was seen in 86.2% of septic patients, and 43.1% of patients had LVSD on STE. The median hs-cTnT level and the proportion of elevated hs-cTnT level (>14 ng/L) were significantly higher in patients with LVSD than in patients without LVSD. The area under the ROC curves of hs-cTnT to detect LVSD was 0.73 (

P

< 0.001). In the multivariate analysis, hs-cTnT (HR, 1.002; 95% CI, 1.000 to 1.004;

P

= 0.025) and septic shock (HR, 7.6; 95% CI, 2.25 to 25.76;

P

= 0.001) were independent predictors of LVSD. Conclusion. Our study indicated that the serum hs-cTnT level might be a useful biomarker for detecting LVSD in septic patients.
Important Role of Concomitant Lymphangiogenesis for Reparative Angiogenesis in Hindlimb Ischemia
Authors: Pu Zhongyue , Shimizu Yuuki , Tsuzuki Kazuhito , Suzuki Junya , Hayashida Ryo , Kondo Kazuhisa , Fujikawa Yusuke , Unno Kazumasa , Ohashi Koji , Takefuji Mikito , Bando Yasuko K. , Ouchi Noriyuki , Calvert John W. , Shibata Rei , Murohara Toyoaki 
Published: April 2021

Objective:
Lymphatic vessels are distributed throughout the body and tightly collaborate with blood vessels to maintain tissue homeostasis. However, the functional roles of lymphangiogenesis in the process of reparative angiogenesis in ischemic tissues are largely unknown. Accordingly, we investigated potential roles of lymphangiogenesis using a mouse model of ischemia-induced angiogenesis.

Approach and Results:
Male C57BL/6J mice were subjected to unilateral hindlimb ischemia, in which not only angiogenesis but also lymphangiogenesis was induced. Next, the excessive and prolonged tissue edema model significantly deteriorated reparative angiogenesis and blood perfusion recovery in ischemic limbs. Finally, implantation of adipose-derived regenerative cells augmented ischemia-induced lymphangiogenesis, which was accompanied by reduced tissue edema and inflammation, resulting in improving reparative angiogenesis and blood perfusion recovery. In addition, inhibition of lymphangiogenesis by MAZ51, a specific VEGFR3 (vascular endothelial cell growth factor receptor 3) inhibitor, resulted in enhanced inflammatory cell infiltration, gene expression of TNF (tumor necrosis factor)-α, IL (interleukin)-1β, IL-6, TGF (transforming growth factor)-β, angiostatin, vasohibin, and endostatin, and tissue edema, resulting in reduced angiogenesis.

Conclusions:
The lymphatic system may have a clearance role of tissue edema and inflammation, which contribute to functional reparative angiogenesis in response to tissue ischemia. Modulation of lymphangiogenesis would become a novel therapeutic strategy for severe ischemic disease in addition to ordinary vascular intervention and therapeutic angiogenesis.
Speech Perception under the Tent: A Domain-general Predictive Role for the Cerebellum
Authors: Skipper Jeremy I. , Lametti Daniel R. 
Published: April 2021

AbstractThe role of the cerebellum in speech perception remains a mystery. Given its uniform architecture, we tested the hypothesis that it implements a domain-general predictive mechanism whose role in speech is determined by connectivity. We collated all neuroimaging studies reporting cerebellar activity in the Neurosynth database (n = 8206). From this set, we found all studies involving passive speech and sound perception (n = 72, 64% speech, 12.5% sounds, 12.5% music, and 11% tones) and speech production and articulation (n = 175). Standard and coactivation neuroimaging meta-analyses were used to compare cerebellar and associated cortical activations between passive perception and production. We found distinct regions of perception- and production-related activity in the cerebellum and regions of perception–production overlap. Each of these regions had distinct patterns of cortico-cerebellar connectivity. To test for domain-generality versus specificity, we identified all psychological and task-related terms in the Neurosynth database that predicted activity in cerebellar regions associated with passive perception and production. Regions in the cerebellum activated by speech perception were associated with domain-general terms related to prediction. One hallmark of predictive processing is metabolic savings (i.e., decreases in neural activity when events are predicted). To test the hypothesis that the cerebellum plays a predictive role in speech perception, we examined cortical activation between studies reporting cerebellar activation and those without cerebellar activation during speech perception. When the cerebellum was active during speech perception, there was far less cortical activation than when it was inactive. The results suggest that the cerebellum implements a domain-general mechanism related to prediction during speech perception.
How Globalization Shifts the Global Economic and Political Balance
Authors: Grinin Leonid 
Published: April 2021

Abstract
One of the main accusations directed toward globalization is that it deepens the gap between the developed and developing countries dooming them to eternal backwardness. The article demonstrates that the actual situation is very different. It is shown that this is due to globalization that the developing countries are generally growing much faster than the developed states. The World System core starts weakening while its periphery gains strength. At the same time there is a continuing divergence between the main bulk of developing countries and the group of the poorest developing states. The article also explains why globalization was bound to lead to an explosive rise of many developing countries and relative weakening of the developed economies. In the forthcoming decades this trend is likely to continue (though, of course, not without certain interruptions). It is also demonstrated that this convergence constitutes a necessary condition for the ongoing and forthcoming change of political and power balance in the World System. We also show how and why it manifests itself in the US current and possible future policy.
Recovering Joy for Young People in the Afterburn of Violence
Authors: Baker Dori Grinenko , Reyes Patrick B. 
Published: April 2021

Abstract
This article addresses a systemic culture of violence as an inhibitor of joy for young people in North America today. We offer a possibility that the church can use its remaining influence in North American society to address joy in the afterburn of violence in a way that is patterned after the life, death and resurrection of Jesus. We define joy and flourishing through a liberatory theological lens and offer a framework for faith communities to use in helping create cultures in which more young people can reclaim joy in the afterburn of violence. This framework mirrors the way of Jesus by: naming violence as a primary inhibitor to adolescent joy; connecting isolated individuals and organizations who are addressing this issue through liberative pedagogies; building communities of practice which strengthen one another and share contextually adaptable resources, and finally; illuminating practices that lead to new systems of influence and cultural change.
Adapting Passive Microwave-Based Precipitation Algorithms to Variable Microwave Land Surface Emissivity to Improve Precipitation Estimation from the GPM Constellation
Authors: Turk F. Joseph , Ringerud Sarah E. , You Yalei , Camplani Andrea , Casella Daniele , Panegrossi Giulia , Sanò Paolo , Ebtehaj Ardeshir , Guilloteau Clement , Utsumi Nobuyuki , Prigent Catherine , Peters-Lidard Christa 
Published: April 2021

AbstractA fully global satellite-based precipitation estimate that can transition across changing Earth surface and complex land/water conditions is an important capability for many hydrological applications, and for independent evaluation of the precipitation derived from weather and climate models. This capability is inherently challenging owing to the complexity of the surface geophysical properties upon which the satellite-based instruments view. To date, these satellite observations originate primarily from a variety of wide-swath passive microwave (MW) imagers and sounders. In contrast to open ocean and large water bodies, the surface emissivity contribution to passive MW measurements is much more variable for land surfaces, with varying sensitivities to near-surface precipitation. The NASA/JAXA Global Precipitation Measurement (GPM) spacecraft (2014-current) is equipped with a dual-frequency precipitation radar and a multichannel passive MW imaging radiometer specifically designed for precipitation measurement, covering substantially more land area than its predecessor Tropical Rainfall Measuring Mission (TRMM). The synergy between GPM’s instruments has guided a number of new frameworks for passive MW precipitation retrieval algorithms, whereby the information carried by the single narrow-swath precipitation radar is exploited to recover precipitation from a disparate constellation of passive MW imagers and sounders. With over six years of increased land surface coverage provided by GPM, new insight has been gained into the nature of the microwave surface emissivity over land and ice/snow covered surfaces, leading to improvements in a number of physical and semi-physical based precipitation retrieval techniques that adapt to variable Earth surface conditions. In this manuscript, the workings and capabilities of several of these approaches are highlighted.
Robust video content analysis schemes for human action recognition
Authors: Aly Cherry A. , Abas Fazly S. , Ann Goh H. 
Published: April 2021

Introduction: Action recognition is a challenging time series classification task that has received much attention in the recent past due to its importance in critical applications, such as surveillance, visual behavior study, topic discovery, security, and content retrieval. Objectives: The main objective of the research is to develop a robust and high-performance human action recognition techniques. A combination of local and holistic feature extraction methods used through analyzing the most effective features to extract to reach the objective, followed by using simple and high-performance machine learning algorithms. Methods: This paper presents three robust action recognition techniques based on a series of image analysis methods to detect activities in different scenes. The general scheme architecture consists of shot boundary detection, shot frame rate re-sampling, and compact feature vector extraction. This process is achieved by emphasizing variations and extracting strong patterns in feature vectors before classification. Results: The proposed schemes are tested on datasets with cluttered backgrounds, low- or high-resolution videos, different viewpoints, and different camera motion conditions, namely, the Hollywood-2, KTH, UCF11 (YouTube actions), and Weizmann datasets. The proposed schemes resulted in highly accurate video analysis results compared to those of other works based on four widely used datasets. The First, Second, and Third Schemes provides recognition accuracies of 57.8%, 73.6%, and 52.0% on Hollywood2, 94.5%, 97.0%, and 59.3% on KTH, 94.5%, 95.6%, and 94.2% on UCF11, and 98.9%, 97.8% and 100% on Weizmann. Conclusion: Each of the proposed schemes provides high recognition accuracy compared to other state-of-art methods. Especially, the Second Scheme as it gives excellent comparable results to other benchmarked approaches.
Perception of wellbeing in educational spaces
Authors: Agg Chloe , Khimji Samana 
Published: April 2021

Wellbeing and mental health are important pillars of sustainability, as recognised by the WELL Building Standards. With higher education facing a mental health crisis, which has been exacerbated by the pandemic, all potential solutions must be investigated. Applying WELL to educational spaces could help to improve student and staff wellbeing. However, the constant change in occupancy of teaching spaces within higher education alters how design factors influence wellbeing outcomes as compared to standard office or domestic occupancy. This study collects student and staff responses on their experience of wellbeing in educational spaces, together with indoor environment quality data for validation. It found that whilst the perception of the quality of spaces did not necessarily align with the measured quality, it was the perceived quality that impacted wellbeing. Design for wellbeing is a growing market and a costly investment, it is important therefore that this investment is having the impact anticipated. This research demonstrates the importance of designing a space taking into account user perception rather than focusing solely on space performance, and perceived space quality impacts on occupant wellbeing.