bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extracellular Volume Quantification using Synthetic Haematocrit Assessed from Native and Post-contrast Longitudinal Relaxation T1 Times of a Blood Pool
Authors: Opatril Lukas , Panovsky Roman , Machal Jan , Holecek Tomas , Masarova Lucia , Feitova Vera , Kincl Vladimir , Hodejovsky Marek , Spinarova Lenka 
Published: March 2021

Abstract
Background: In terms of cardiovascular magnetic resonance are haematocrit values required for calculation of extracellular volume fraction (ECV). Previously published studies have hypothesized that haematocrit could be calculated from T1 blood pool relaxation time, however only native T1 relaxation time values have been used and the resulting formulae had been both in reciprocal and linear proportion. The aim of the study was to generate a synthetic haematocrit formula from only native relaxation time values first, calculate whether linear or reciprocal model is more precise in haematocrit estimation and then determine whether adding post-contrast values further improve its precision.Methods: One hundred thirty-nine subjects underwent CMR examination. Haematocrit was measured using standard laboratory methods. Afterwards T1 relaxation times before and after the application of a contrast agent were measured and a statistical relationship between these values was calculated.Results: Different linear and reciprocal models were created to estimate the value of synthetic haematocrit and ECV. The highest coefficient of determination was observed in the combined reciprocal model “-0.047 + (779/ blood native) – (11.36/ blood post-contrast)”.Conclusions: This study provides more evidence that assessing synthetic haematocrit and synthetic ECV is feasible and statistically most accurate model to use is reciprocal. Adding post-contrast values to the calculation was proved to improve the precision of the formula statistically significantly.
Moving Forward from the “Boot Camp Method” To Learning-Curve Development in Simulation-Based Paracentesis Training For Undergraduate Medical Students
Authors: Inzunza Martin , Tejos Rodrigo , Villagrán Ignacio , Fuentes Eduardo , Contreras Caterina , Vela Javier , Pizarro Margarita , Alseidi Adnan , Varas Julian , Riquelme Arnoldo 
Published: March 2021

Abstract
Background: Abdominal paracentesis is an essential competence for physicians. Simulation-based mastery learning (SBML) programs lead to developing these skills for medical students. Most programs are structured as short boot-camps, without assessing skills' retention mid and long-term or learning curves.Aim: To assess the learning curve of paracentesis through an SBML program for medical students and compare this learning curve-based program with the boot-camp method.Methods: A prospective quasi-experimental study was conducted. A cohort of medical students participated in an SBML program with successive sessions until proficiency criteria were met while their learning curve was assessed (LC group). A control group received an SBML boot-camp intervention (BC group). As a proficient group, gastroenterology fellows (GF group) performed a paracentesis on the simulated model. The skills of the three groups were compared using technical/proficiency scores. Learning curves and cost analysis were performed.Results: 100% of the LC group achieved proficiency in the fourth session, with a flattening learning curve between third-fourth sessions. Comparing the initial and final sessions of LC group showed a significant improvement in their scores. When comparing the three groups, statistical differences were found in the skill scores, with the BC group having the lowest. The overall cost per participant was highest for the LC group.Conclusion: This study identifies a learning curve for paracentesis with an SBML program. The LC group significantly improved their skills, comparable with the GF group’s performance. SBML focused on a learning curve ensured better skills acquisition than the “boot-camp method.”
The Safety of Non-Transport Decisions Made by Ambulance Personnel: A Retrospective Study of Subsequent Hospital Admission and 30-Day Mortality
Authors: Amundsen Kjersti , Elden Marie Svanes , Myrmel Lars , Assmus Jörg , Lange Audun , Brattebø Guttorm 
Published: March 2021

Abstract
BackgroundAmbulance missions do not always result in the patient being transported to a doctor or hospital after evaluation at the scene by ambulance personnel. Sometimes a patient is discharged at the scene but should have been transported for further examination and treatment. In this study, we aimed to identify and describe this group, and to investigate subsequent hospital admission within 72 hours and 30-day mortality, which may indicate the safety of leaving a patient at the scene after examination. MethodThis retrospective study was carried out in the Bergen health trust in western Norway and included ambulance missions from 2018. For each mission, we recorded the patient’s demographic information (age, gender, time of day), initial reason for contacting the emergency medical service (EMS), hospital admissions after non-transport, and time of death if within 30 days, in addition to some other variables. ResultsAmong 33,183 included acute and urgent ambulance missions, 7.3% of the patients were discharged at the scene after evaluation by ambulance personnel. The median age in this group was 47 years (IQR 28–70 years), compared to 64 years (IQR 39–80 years) for all included missions. Following a non-transport decision, 4.8% of the patients were admitted to a public hospital within 72 hours (median age, 59 years; IQR 35–76 years), with mental and behavioral disorders (ICD-10 chapter V) being the most common reason for admission (24.8%). The 30-day mortality rate following non-transport mission was 2.4%. In this group, the median age was 83 years (IQR 73–90 years), and the most common reasons for contacting EMS were breathing difficulties or lung diseases (25.4%), and injuries or fractures (18.6%). ConclusionOur present analysis revealed low rates of hospital admission within 72 hours, and 30-day mortality, among patients left at the scene following evaluation by ambulance personnel. These findings do not suggest an unsafe rate of non-transport in the Bergen EMS. There remains a need for further evaluation of the factors involved in the decision not to transport a patient, and the safety of these decisions.
Ongoing Epidemiological Changes in Hand, Foot, and Mouth Disease Following the Introduction of Enterovirus 71 Vaccines in Yunnan Province, China, 2008-2019
Authors: Jiang Li , Jiang Hongchao , Tian Xin , Xia Xueshan , Huang Tian 
Published: March 2021

Abstract
Background:Since 2016, enterovirus 71 (EV71) vaccines have been approved for market entry, and litter is known about how the epidemiology of hand, foot, and mouth disease (HFMD) has been affected by the introduction of the vaccines in Yunnan Province. The study describes the ongoing epidemiological changes in HFMD following the introduction of EV71 vaccination in Yunnan.Methods:Surveillance data collected between 2008 and 2019 were analyzed to produce EV71 vaccination coverage, epidemiological distribution on cases, and etiologic composition as well as to compare these characteristics before and after EV71 vaccination.Results:A total of 1,653,533 people received EV71 vaccines from 2016 through 2019 in Yunnan. The cumulative EV71 vaccination coverage rate was 68.14%. After the introduction of EV71 vaccines, the overall incidence of HFMD increased and reached over 200 cases per 100,000 population-years in 2018 and 2019. However, the case severity and case fatality rate decreased and remained lower than 1% and 0.005% after 2016, respectively. EV71-associated mild, severe and fatal cases sharply decreased. The predominant viral serotype changed to non-EV71/non-CV-A16 enteroviruses which were detected across the whole province.Conclusions: EV71 vaccination helped to reduce severe HFMD. However, other enteroviruses became the predominant strain and let to a higher incidence. Expanding EV71 vaccination and strengthening laboratory-based surveillance could further decrease the burden of severe HFMD and reveal the existence of emerging enteroviruses.
A continuous conversion technology from top coal caving into multi-slice mining for thick bifurcated coal seams
Authors: Deng Xuejie , Liu Hao , Feng Jianye , Li Yu , de Wit Benjamin 
Published: March 2021

Abstract
This paper presents a mining technology that enables the continuous conversion from top coal caving (TCC) to multi-slice mining (MSM). The technology helps operations overcome challenges with mining thick bifurcated coal seams, particularly the challenge of rock-parting seams affecting the caving of TCC mining methods. Findings show that the relationship between the rock-parting thickness and the caveability of top coal can be divided into 3 phases, including a complete caving phase, a transition phase, and a stable phase. This continuous conversion technology was applied in the Zhongwei Coal Mine in which TCC was used to extract the initial 260 m of the study area where the rock-parting seam was relatively thin before a transition to MSM was made due to the rock-parting seam becoming significantly thicker. The continuous conversion to MSM involved the working face advancing upward at an angle of 10 degrees until the rock-parting seam could serve as the immediate floor for the upper slice of the coal seam. The rock-parting seam floor also acted as the immediate roof for the working face of the subsequently mined lower slice. The application of this continuous conversion mining technology obtained good application results.
Exogenous Application of Silicon Can Help Augment Drought Tolerance in Wheat (Triticum aestivum L.) by Enhancing Morpho-physiological and Antioxidant Potential
Authors: Aurangzaib Muhammad , Ahmad Zahoor , Jalil Muhammad Imran , Nawaz Muhammad Faheem , Shaheen Muhammad Rashid , Ahmad Maqshoof , Hussain Azhar , Ejaz Muhammad Kashif , Tabassum Muhammad Adnan 
Published: March 2021

Abstract
Drought stress is considered one of the most severe stresses, which can result in devastating yield reduction in agriculture crops. There are many approaches recommended by the researchers and adopted by the farmers to minimize the devastating effect of drought. However, exogenous application of growth regulators in combination to plant nutrients is the innovative attitude to ameliorate the shocking effects of drought stress. So we planned a study to investigate the ameliorative effect of exogenously applied potassium silicate wheat (Triticum aestivum L.) crop under water deficit conditions. The current study was conducted at the Agronomic Research Farm area, Faculty of Agriculture and Environment, The Islamia University of Bahawalpur. RCBD-Split plot design with four repeats was used. The treatments consist on “T0” (Control), “T1” (exogenous application of potassium silicate @ 1% solution), “T2” (exogenous application of potassium silicate @ 2% solution), “T3” (exogenous application of potassium silicate @ 3% solution). The results of our study revealed that drought stress can significantly affect crop yield as a result of the reduction in chlorophyll-a (1.07), chlorophyll-b (0.49), total chlorophyll contents (1.62), flag leaf area (38.33 cm2), plant height (100.17cm), number of nodes per plant (3.91), tiller height (92.42), number of tillers m− 2 (191.17), spike length (7.58 cm), number of spikes per plant (10.25), number of grains per spike (25.08), 1000-grain weight (36.66g), total dry weight per plant (309.75g), biomass yield (23424kg/ha) and grain yield (4564.2 kg/ha). On the other hand, the exogenous application of potassium silicate at 2% solution showed promising results in terms of ameliorating the drought effect by significantly enhancing chlorophyll-a (1.21), chlorophyll-b (0.64), total chlorophyll contents (1.92), flag leaf area(45.25 cm2), plant height (123.50cm), number of nodes per plant (5.25), tiller height (99.42), number of tillers m− 2 (276.26), spike length (12.92cm), number of spikes per plant (14.25), number of grains per spike (38.33), 1000-grain weight (44.33g), total dry weight per plant (385.00g), biomass yield (24000 kg/ha) and grain yield (5074.8kg/ha). These findings led us to conclude that the exogenous application of potassium silicate has a great ability to compensate for the detrimental effects of drought in wheat crops.
Incidence and Challenges of Helicopter Emergency Medical Service (HEMS) Rescue Missions with Helicopter Hoist Operations: Analysis of 12,000 Daytime and Nighttime Missions in Switzerland
Authors: Pietsch Urs , Knapp Jürgen , Mann Michael , Meuli Lorenz , Lischke Volker , Tissi Mario , Sollid Stephen J.M. , Rauch Simon , Wenzel Volker , Becker Stefan , Albrecht Roland 
Published: March 2021

Abstract
ObjectiveWe aimed to investigate the medical characteristics of helicopter hoist operations (HHO) in HEMS missions.MethodsWe designed a retrospective study evaluating all HHO and other human external cargo (HEC) missions performed by Swiss Air-Rescue (Rega) from 1 January 2010 to 31 December 2019.ResultsDuring the study period, 9,963 (88.7%) HEMS missions with HHO and HEC were conducted during the day, and 1,265 (11.3%) at night. Of the victims with time-critical injuries (NACA ≥4), 21.1% (n=400) reached the hospital within 60 min during the day, and 9.1% (n=18) at night. Nighttime missions, a trauma diagnosis, intubation on-site, and NACA Score ≥4were independently and highly significantly associated with longer mission times (p<0.001). The greatest proportion of patients, who needed hoist or HEC operations in the course of the HEMS mission during daytime, sustained moderate injuries (NACA 3, n=3,731, 37.5%) while practicing recreational activities (n=5,492, 55.1%). In daytime HHO missions, the most common medical interventions performed were an insertion of a peripheral intravenous access (n=3,857, 38.7%) and administration of analgesia (n=3,121, 31.3%). ConclusionsNearly 20% of patients, who needed to be evacuated by a hoist, were severely injured, and complex and lifesaving medical interventions were necessary before the HHO procedure. Therefore, only adequately trained and experienced medical crew members should accompany HHO missions.
Cloning and Identification of a New Repressor of 3,17β-Hydroxysteroid Dehydrogenase of Comamonas Testosteroni
Authors: Xie Weiqi , Xia Qin , Chen Ling , Xiong Guangming , Gao Yuwei , Yu Yuanhua , He Xiuxia 
Published: March 2021

Abstract
3,17β-hydroxysteroid dehydrogenase (3,17β-HSD) is a key enzyme that can degrade steroid compounds in Comamonas testosteroni. Tetracycline repressor (TetR) family, repressors existing in most microorganisms, may play key roles in regulating the expression of 3,17β-HSD. Previous reports showed that three TetR genes were located in the contig58 of C. testosteroni ATCC 11996 (GenBank: AHIL01000049.1), among which the first TetR gene encoded a potential repressor of 3,17β-HSD by sensing environmental signals. However, whether the other proposed TetR genes acts as repressors of 3,17β-HSD is still unknown. In the present study, we cloned the second TetR gene and analyzed the regulation mechanism of the protein on 3,17β-HSD using electrophoretic mobility shift assay (EMSA), gold nanoparticles (AuNPs)-based assay, and loss-of-function analysis. The results showed that the second TetR gene was 660-bp, encoding a 26 kD protein, which could regulate the expression of 3,17β-HSD gene via binding to the conserved consensus sequences located 1100-bp upstream of the 3,17β-HSD gene. Furthermore, the mutant strain of C. testosteroni with the second TetR gene knockout has good biological genetic stability, and the expression of 3,17β-HSD in the mutant strain is slightly higher than that in the wild type under testosterone induction, suggesting the mutant can efficiently degrade steroids as carbon sources. The mutant generated in this study can be used to treat environmental pollution caused by steroid hormones.
"The Alarm Was Grass Fire": Emergency Services' Perceptions of Chemical Incident Mobilization in Sweden - a Focus Group Study
Authors: Westman Anton , Saveman Britt-Inger , Björnstig Ulf , Hylander Johan , Gyllencreutz Lina 
Published: March 2021

Abstract
Background: In chemical incidents, infrequent but potentially disastrous, the World Health Organization calls for inter-organizational coordination of actors involved. Multi-organizational studies of chemical response capacities are scarce and testable hypotheses are largely lacking. We aimed to describe chemical incident experiences and perceptions of Swedish fire and rescue services, emergency medical services, police services, and emergency dispatch services personnel.Methods: Eight emergency service organizations in two distinct and dissimilar regions in Sweden participated in one organization-specific focus group interview each. The total number of respondents was 25 (7 females and 18 males). A qualitative inductive content analysis was performed.Results: Three types of information processing were derived as emerging during acute-phase chemical incident mobilization: Unspecified (a caller communicating with an emergency medical dispatcher), specified (each emergency service obtaining organization-specific expert information), and aligned (continually updated information from the scene condensed and disseminated back to all parties at the scene). Improvable shortcomings were identified, e.g. randomness (unspecified information processing), inter-organizational reticence (specified information processing), and downprioritizing central information transmission while saving lives (aligned information processing).Conclusions: It is inferred that sensitivity, specificity and time-effectiveness in the flow of information may be improved by automation, public education, revised dispatcher education, and use of technical resources in the field. It is further inferred that inter-organizational coordination may be improved by inter-organizational training and revised standard operating procedures. We propose systematic assessments of chemical incident probabilities in Sweden.
The Mesoscale Crystallinity of Nacreous Pearls
Authors: Gim Jiseok , Koch Alden , Otter Laura , Savitzky Benjamin , Erland Sveinung , Estroff Lara , Jacob Dorrit , Hovden Robert 
Published: March 2021

Abstract
A pearl’s distinguished beauty and toughness is attributable to the periodic stacking of aragonite tablets known as nacre. Nacre is a naturally occurring mesocrystal that remarkably arises in the absence of translational symmetry. Gleaning the inspiring biomineral design of a pearl requires quantifying its structural coherence and understanding the stochastic processes that govern formation. By characterizing the entire structure of pearls (~3 mm) in cross-section at high resolution, we show nacre is a medium-range mesocrystal formed through nanoparticle assembly processes. Self-correcting growth mechanisms actively remedy disorder and topological defects of the tablets and act as a countervailing force to paracrystallinity (i.e. long-range disorder). Nacre has a correlation length of roughly 16 tablets (~5.5 µm) despite persistent fluctuations and topological defects. For longer distances (> 25 tablets, ~8.5 µm), the frequency spectrum of nacre tablets follows f-1.5 behavior suggesting growth is coupled to external stochastic processes—a universality found across disparate natural phenomena which now includes pearls.
How Many Trials Are Needed in Kinematic Analysis of a Reach-to-Grasp Task? - a Study in Persons With Stroke and Non-Disabled Controls
Authors: Frykberg Gunilla Elmgren , Grip Helena , Alt-Murphy Margit 
Published: March 2021

Abstract
Background Kinematic analysis of the 3D reach-to-grasp drinking task is recommended in stroke rehabilitation research. The number of trials required to reach performance stability, as an important aspect of reliability, has not been investigated. Thus, the aims of this study were to determine the number of trials needed to reach within-session performance stability and to investigate trends in performance over a set of trials in non-disabled people and in a sample of individuals with chronic stroke. In addition, the between-sessions test-retest reliability in persons with stroke was established. MethodsThe drinking task was performed at least 10 times, following a standardized protocol, in 44 non-disabled and 8 post-stroke individuals. A marker-based motion capture system registered arm and trunk movements during 5 pre-defined phases of the drinking task. Intra class correlation statistics were used to determine the number of trials needed to reach performance stability as well as to establish test-retest reliability. Systematic within-session trends over multiple trials were analyzed with a paired t-test. Results For most of the kinematic variables 2 to 3 trials were needed to reach good performance stability in both investigated groups. More trials were needed for movement times in reaching and returning phase, movement smoothness, time to peak velocity and inter-joint-coordination. A small but significant trend of improvement in movement time over multiple trials was demonstrated in the non-disabled group, but not in the stroke group. A mean of 3 trials was sufficient to reach good to excellent test-retest reliability for most of the kinematic variables in the stroke sample. Conclusions This is the first study that determines the number of trials needed for good performance stability (non-disabled and stroke) and test-retest reliability (stroke) for temporal, endpoint and angular metrics of the drinking task. For most kinematic variables, 3 trials are sufficient to reach good reliability. This knowledge can be used to guide future kinematic studies.