bluuebunny/crossref_metadata_2025_split huggingface dataset:
Autonomic nervous system response to remote ischemic conditioning: heart rate variability assessment
Authors: Noronha Osório Daniel , Viana-Soares Ricardo , Marto João Pedro , Mendonça Marcelo D. , Silva Hugo P. , Quaresma Cláudia , Viana-Baptista Miguel , Gamboa Hugo , Vieira Helena L. A. 
Published: September 2019

Abstract

Background
Remote ischemic conditioning (RIC) is a procedure applied in a limb for triggering endogenous protective pathways in distant organs, namely brain or heart. The underlying mechanisms of RIC are still not fully understood, and it is hypothesized they are mediated either by humoral factors, immune cells and/or the autonomic nervous system. Herein, heart rate variability (HRV) was used to evaluate the electrophysiological processes occurring in the heart during RIC and, in turn to assess the role of autonomic nervous system.

Methods
Healthy subjects were submitted to RIC protocol and electrocardiography (ECG) was used to evaluate HRV, by assessing the variability of time intervals between two consecutive heart beats. This is a pilot study based on the analysis of 18 ECG from healthy subjects submitted to RIC. HRV was characterized in three domains (time, frequency and non-linear features) that can be correlated with the autonomic nervous system function.

Results
RIC procedure increased significantly the non-linear parameter SD2, which is associated with long term HRV. This effect was observed in all subjects and in the senior (> 60 years-old) subset analysis. SD2 increase suggests an activation of both parasympathetic and sympathetic nervous system, namely via fast vagal response (parasympathetic) and the slow sympathetic response to the baroreceptors stimulation.

Conclusions
RIC procedure modulates both parasympathetic and sympathetic autonomic nervous system. Furthermore, this modulation is more pronounced in the senior subset of subjects. Therefore, the autonomic nervous system regulation could be one of the mechanisms for RIC therapeutic effectiveness.
Determinants of trends in neonatal, post-neonatal, infant, child and under-five mortalities in Tanzania from 2004 to 2016
Authors: Ogbo Felix Akpojene , Ezeh Osita Kingsley , Awosemo Akorede O. , Ifegwu Ifegwu K. , Tan Lawrence , Jessa Emmanuel , Charwe Deborah , Agho Kingsley Emwinyore 
Published: September 2019

Abstract

Background
Under-five mortality is still a major health issue in many developing countries like Tanzania. To achieve the Sustainable Development Goal target of ending preventable child deaths in Tanzania, a detailed understanding of the risk factors for under-five deaths is essential to guide targeted interventions. This study aimed to investigate trends and determinants of neonatal, post-neonatal, infant, child and under-five mortalities in Tanzania from 2004 to 2016.

Methods
The study used combined data from the 2004–2005, 2010 and 2015–2016 Tanzania Demographic and Health Surveys, with a sample of 25,951 singletons live births and 1585 under-five deaths. We calculated age-specific mortality rates, followed by an assessment of trends and determinants (community, socioeconomic, individual and health service) of neonatal, postneonatal, infant, child and under-five mortalities in Cox regression models. The models adjusted for potential confounders, clustering and sampling weights.

Results
Between 2004 and 2016, we found that neonatal mortality rate remained unchanged, while postneonatal mortality and child mortality rates have halved in Tanzania. Infant mortality and under-five mortality rates have also declined. Mothers who gave births through caesarean section, younger mothers (< 20 years), mothers who perceived their babies to be small or very small and those with fourth or higher birth rank and a short preceding birth interval (≤2 years) reported higher risk of neonatal, postneonatal and infant mortalities.

Conclusion
Our study suggests that there was increased survival of children under-5 years in Tanzania driven by significant improvements in postneonatal, infant and child survival rates. However, there remains unfinished work in ending preventable child deaths in Tanzania.
Effective implementation of primary school-based healthy lifestyle programmes: a qualitative study of views of school staff
Authors: Day Rhiannon Eleanor , Sahota Pinki , Christian Meaghan Sarah 
Published: September 2019

Abstract

Background
Primary schools are valuable settings to implement healthy lifestyle (healthy eating and physical activity) interventions, aimed at targeting childhood obesity. This study explored school staff perceptions of factors that hinder and enable successful implementation and sustainability of healthy lifestyle interventions in primary schools. Qualitative data was pooled and analysed from two evaluations carried out in primary schools in North England: a feasibility study of a nutrition and physical activity educational programme (PhunkyFoods Feasibility Study), and an evaluation of a healthy eating programme (The Food Dudes Evaluation).

Methods
Sixty-five qualitative semi-structured interviews were conducted with head teachers, teachers, catering managers, designated school-based programme coordinators and programme staff supporting schools with programme delivery, at 14 schools involved in both evaluations. Thematic analysis was undertaken and emergent themes categorised using a framework for successful implementation by Durlak and Dupre (2008).

Results
Overall, all schools were delivering a range of healthy lifestyle programmes, often with overlapping content. Perceived challenges to implementation of individual programmes included: limited time, timing of implementation, limited training and support, insufficient resources, capacity and facilities, staff perceptions of intervention and perceived skill-proficiency (for cooking and physical activities). Short-term funding, lack of external and internal support were perceived to hinder sustainability. Staff recommendations for successful implementation of future programmes included: extended training and planning time, sufficient capacity, external support for delivery, good resources (interactive, practical and adaptable), and facilities for cooking, healthy eating, gardening and physical activities. Head teachers need to prioritise delivery of a few key healthy lifestyle programmes, in an overcrowded curriculum. Schools need to employ strategies to engage participation of staff, pupils and parents long term.

Conclusions
Effective implementation of school-based healthy lifestyle programmes was thought to be aided by flexible and adaptable programmes, enabling good contextual fit, well-resourced programmes and effective leadership at multiple levels, pupil (pupils support delivery) and parent involvement. To facilitate sustainability, it was perceived that programmes need to be integrated within the curriculum and school policies long term, with sustained support from head teachers and staff. These findings are relevant to programme developers, policy makers and those involved in delivering interventions.
Duodenal perforation nine months after accidental foreign body ingestion, a case report
Authors: Li Chi , Yong Chee-Chien , Encarnacion Domelle Dave 
Published: September 2019

Abstract

Background
Foreign body ingestion is a scenario occasionally encountered in the emergency room. Pediatric and psychiatric patients are the two most common populations suffering from accidental or in some cases intentional ingestion of foreign bodies. Commonly, majority of cases require no specific treatment and the swallowed objects pass through the digestive tract spontaneously without causing any significant complications. Less than 1% of the cases complicates with gastrointestinal tract perforation, which are often caused by sharp objects, which warrants surgical intervention. The average time from foreign body ingestion to development of perforation was noted at 10.4 days in previous reports. These cases often present in rapidly progressing peritonitis and are subsequently managed by emergent laparotomy. In this case report, we describe an accidental chopstick ingestion of a patient who initially was misdiagnosed and remained asymptomatic for nine months, then presented with acute abdomen.

Case presentation
A 27-year-old man accidentally ingested a wooden chopstick and sought consult at a clinic. Negative abdominal plain film misled the physician to believe ingested chopstick was digested into fragments and passed out unnoticed. The patient presented acute abdomen caused by duodenal perforation nine months later and was subsequently treated with emergency laparotomy with primary duodenorrhaphy.

Conclusions
Negative plain films are not sufficient to conclude a conservative treatment in foreign body ingestion. Computed tomography scan or endoscopic examinations should be done to rule out retained foreign body within gastrointestinal tract.
The impact of uncertainty in society on the use of traditional, complementary and alternative medicine: a comparative study on visits to alternative/traditional/folk health care practitioners
Authors: Misawa Jimpei , Ichikawa Rie , Shibuya Akiko , Maeda Yukihiro , Arai Ichiro , Hishiki Teruyoshi , Kondo Yoshiaki 
Published: September 2019

Abstract

Background
While traditional, complementary and alternative medicine (TCAM) is gaining increased interest worldwide, the structural factors associated with the usage of TCAM at the social level have not been sufficiently explored. We aim to understand the social structure of uncertainty in society that affects the TCAM usage for men and women.

Methods
We studied 32 countries using data from the International Social Survey Programme and the World Bank. In this study, we defined TCAM usage as visits to an alternative/traditional/folk health care practitioner during the past 12 months. We performed a correlation analysis and used a generalized linear model .

Results
The prevalence of TCAM usage in terms of visits to practitioners was 26.1% globally, while usage varied across the 32 countries. Generalized linear models showed that unemployment rate was associated with the prevalence of TCAM usage in terms of visits to practitioners.

Conclusions
At the social-structural level TCAM usage involving visits to practitioners was related to job insecurity. Job insecurity led to a decrease in TCAM usage regarding visits to practitioners. These findings suggest that it is necessary to consider the social-structural factors of uncertainty in society when designing health policies related to TCAM.
Diagnosis and surgical repair of congenital double aortic arch in infants
Authors: Yang Yiting , Jin Xin , Pan Zhengxia , Li Yonggang , Wu Chun 
Published: September 2019

Abstract

Objectives
Double aortic arch (DAA) is a rare congenital vascular malformation. This study aims to summarize the experience of diagnosis and surgical treatment for congenital double aortic arch.

Methods
The clinical data of 24 cases with double aortic arch (DAA) from January 2008 to January 2018 in our hospital was reviewed retrospectively.

Results
A total of 24 cases, including 12 patients with isolated DAA and 12 patients with DAA and associated intracardiac defects were identified. There were 14 males and 10 females, with an average age of 11 months. The associated intracardiac malformations included ventricular septal defect (VSD), atrial septal defect (ASD), patent ductus arteriosus (PDA), tetralogy of Fallot (TOF), transposition of the great arteries (TGA), pulmonary stenosis (PS), and patent foramen ovale (PFO). Of the 12 patients with DAA and intracardiac malformations, 7 patients underwent intracardiac repair simultaneously, however, 3 patients underwent isolated double aortic arch correction. One patient with DAA and TGA underwent surgical correction of congenital vascular ring at the first stage, and the arterial switch operation was performed at the second stage. The clinical outcomes of 23 patients were promising, however, in one patient, parents decided not to do the surgery due to personal reasons. The average follow-up time was 35 months.

Conclusions
Tracheal and esophageal compression are commonly seen in patients with DAA, however could be relieved significantly after surgery. In particular cases, the simultaneous intracardiac defects repair could be performed. Misdiagnosis was easily established with isolated echocardiography. Fortunately, the correct diagnosis of DAA and associated intracardiac defects could be established with the use of combined chest computed tomography.
Multi-sensor fusion based on multiple classifier systems for human activity identification
Authors: Nweke Henry Friday , Teh Ying Wah , Mujtaba Ghulam , Alo Uzoma Rita , Al-garadi Mohammed Ali 
Published: September 2019

Abstract
Multimodal sensors in healthcare applications have been increasingly researched because it facilitates automatic and comprehensive monitoring of human behaviors, high-intensity sports management, energy expenditure estimation, and postural detection. Recent studies have shown the importance of multi-sensor fusion to achieve robustness, high-performance generalization, provide diversity and tackle challenging issue that maybe difficult with single sensor values. The aim of this study is to propose an innovative multi-sensor fusion framework to improve human activity detection performances and reduce misrecognition rate. The study proposes a multi-view ensemble algorithm to integrate predicted values of different motion sensors. To this end, computationally efficient classification algorithms such as decision tree, logistic regression and k-Nearest Neighbors were used to implement diverse, flexible and dynamic human activity detection systems. To provide compact feature vector representation, we studied hybrid bio-inspired evolutionary search algorithm and correlation-based feature selection method and evaluate their impact on extracted feature vectors from individual sensor modality. Furthermore, we utilized Synthetic Over-sampling minority Techniques (SMOTE) algorithm to reduce the impact of class imbalance and improve performance results. With the above methods, this paper provides unified framework to resolve major challenges in human activity identification. The performance results obtained using two publicly available datasets showed significant improvement over baseline methods in the detection of specific activity details and reduced error rate. The performance results of our evaluation showed 3% to 24% improvement in accuracy, recall, precision, F-measure and detection ability (AUC) compared to single sensors and feature-level fusion. The benefit of the proposed multi-sensor fusion is the ability to utilize distinct feature characteristics of individual sensor and multiple classifier systems to improve recognition accuracy. In addition, the study suggests a promising potential of hybrid feature selection approach, diversity-based multiple classifier systems to improve mobile and wearable sensor-based human activity detection and health monitoring system.
A five-year retrospective study on patterns of casuistry and insights on the current status of wildlife rescue and rehabilitation centers in Chile
Authors: Romero Francisca , Espinoza Angelo , Sallaberry-Pincheira Nicole , Napolitano Constanza 
Published: September 2019

Abstract

Background
Human activities are permanently threatening wildlife. Wildlife Rescue and Rehabilitation Centers (WRRC) have served for the rescue, rehabilitation and reinsertion of affected and recovered animals.

Methods
We reviewed the casuistry of five wildlife rescue and rehabilitation centers in Chile over 5 years, and described the main causes of admission, most affected taxonomic groups and final outcomes of the admitted individuals, shedding light into general patterns and relevant factors currently affecting wildlife in Chile. To understand the current work and status of WRRC system in Chile, we also conducted a qualitative survey to WRRC personnel and Agricultural and Livestock Service (SAG) regional offices regarding their operation.

Results
A total of 3418 cases of animals admitted to WRRC were obtained; 95.3% corresponded to native species. Of native animal cases, 86.0% corresponded to birds, 12.3% were mammals and 1.7% reptiles. Trauma was the most frequently observed cause of admission in all three native fauna groups (35.8% in birds, 23.2% in mammals, 27.8% in reptiles).

Conclusions
WRRC are a tool for conservation and education of wild animal species in Chile, however WRRC and SAG regional office personnel highlighted several deficiencies in the current system and suggested opportunities for improvement. The current WRRC system needs modernization and financial support from the Chilean state to fulfil their relevant mission.
Short-term eplerenone for treatment of chronic central serous chorioretinopathy; a prospective study
Authors: Moein Hamid-Reza , Bierman Lauren W. , Novais Eduardo A. , Moreira-Neto Carlos , Baumal Caroline R. , Rogers Adam , Duker Jay S. , Witkin André J. 
Published: September 2019

Abstract
Background
Increased mineralocorticoid activity is one of the plausible causes of chronic central serous chorioretinopathy (CSCR) and mineralocorticoid inhibitors such as eplerenone have been investigated as its potential therapy. This study investigates the short-term safety and efficacy of oral eplerenone in patients with chronic CSCR.

Patients and methods
Prospective study of 13 eyes of 13 patients with the diagnosis of chronic CSCR. All patients received eplerenone 50 mg/day for 4 weeks. Enhanced depth imaging optical coherence tomography (OCT) was obtained. Best corrected visual acuity (BCVA), and OCT parameters including sub retinal fluid (SRF), choroidal thickness (CT) and central macular thickness (CMT), were measured manually.

Results
The mean SRF height decreased slightly at 1-month follow-up as compared to baseline, but the change was not statistically significant (94.18 ± 17.53 vs. 113.15 ± 18.69; p = 0.08). Subfoveal CT and CMT was significantly reduced as compared to baseline (6.6% [p = 0.002] and 7.05% [p = 0.04], respectively). The BCVA did not change significantly (20/28 vs. 20/30 [p = 0.16]).

Conclusion
This study suggests that oral eplerenone may be used as a safe and potentially effective treatment in chronic CSCR, however there are minimal short-term effects on subretinal fluid or visual acuity therefore therapeutic trials longer than one month are necessary to test its benefits.
Trial registration Clinicaltrials.gov identification number: NCT01822561. Registered 3/25/13, https://clinicaltrials.gov/ct2/show/study/NCT01822561
Obtaining consensus regarding patient-centred professionalism in community pharmacy: nominal group work activity with professionals, stakeholders and members of the public
Authors: Hutchings Hayley A , Rapport Frances L , Wright Sarah , Doel Marcus A , Wainwright Paul 
Published: September 2019

Abstract

Objectives
The aim of this study was to develop a ranked thematic list encompassing the positive and negative exemplars of patient-centred professionalism in community pharmacy.

Methods
An adapted Nominal Group Work (NGW) method was used in six individual consultation workshops (two with established pharmacists, one with newly qualified pharmacists, one with pharmacy staff, one with stakeholders and one with members of the public) followed by a mixed-group forum event.

Key findings
Each of the six workshops resulted in the production of approximately 10 positive and 10 negative exemplars of patient-centred professionalism. The thematization of these exemplars allowed the development of 11 broad themes. The mixed-group forum event then provided a mechanism for ranking the importance of these themes. Safety, professional characteristics and relationships with patients were ranked as the most important themes by our study participants.
Trust compliance with best practice tariff criteria for total hip and knee replacement
Authors: Vanhegan Ivor , Sankey Andrew , Radford Warwick , Ball Simon , Gibbons Charles 
Published: September 2019

Background: Satisfaction of the best practice tariff criteria for primary hip and knee replacement enables on average an additional £560 of reimbursement per case. The Getting it Right First Time report highlighted poor awareness of these criteria among orthopaedic departments. Methods: The authors investigated the reasons for non-compliance with the best practice tariff criteria at their trust and implemented a quality improvement approach to ensure successful adherence to the standards (a minimum National Joint Registry compliance rate of 85%, a National Joint Registry unknown consent rate below 15%, a patient-reported outcome measure participation rate of ≥50%, and an average health gain not significantly below the national average). This was investigated using quarterly online reports from the National Joint Registry and NHS Digital. Results: Initially, the trust had a 31% patient-reported outcome measures participation rate arising from a systematic error in the submission of preoperative patient-reported outcome measure scores. Re-audit following the resubmission of patient-reported outcome measure data under the trust's correct organization data service code confirmed an improvement in patient-reported outcome measure compliance to 90% and satisfaction of all criteria resulting in over £450 000 of additional reimbursement to the trust. Conclusions: The authors would urge others to review their compliance with these four best practice tariff criteria to ensure that they too are not missing out on this significant reimbursement sum.
Cuantificación de hormonas 17β - estradiol y progesterona en el caracol rosa Lobatus gigas (Mollusca, Gastropoda)
Authors: Chong Sánchez Fabiola , Enriquez Diaz Martha , Aldana Aranda Dalila 
Published: September 2019

Las hormonas sexuales son responsables del mantenimiento de los caracteres sexuales, maduración de gametos y del comportamiento sexual en vertebrados y algunos invertebrados. Lobatus gigas es un gasterópodo de importancia económica y ecológica del Caribe, para el cual pocos han sido los estudios de su reproducción en cautiverio y de la influencia de hormonas en el proceso. El objetivo de este trabajo fue determinar la presencia de estrógeno y progesterona en L. gigas y comparar las concentraciones de estas hormonas con la técnica de cromatografía liquida de alta resolución y la de Enzimoinmunoensayo. Ambas técnicas arrojaron resultados similares principalmente al medir estrógeno, sin embargo, las diferencias entre éstas no permite que sean utilizadas de manera indistinta. Junto con estos resultados, el análisis de sus costos, requerimientos de personal y de instrumentos, se concluye que la técnica de Enzimoinmunoensayo es la más viable para continuar con los estudios sobre hormonas en L. gigas. El conocimiento de la posible acción que llevan a cabo las hormonas estrógeno y progesterona en el proceso reproductivo de esta especie permitiría comprender y manejar aspectos reproductivos fundamentales para el mejoramiento del cualquier cultivo de reproductores del caracol rosa.
Augmenting Markov Decision Processes with Advising
Authors: Vanhée Loïs , Jeanpierre Laurent , Mouaddib Abdel-Illah 
Published: September 2019

This paper introduces Advice-MDPs, an expansion of Markov Decision Processes for generating policies that take into consideration advising on the desirability, undesirability, and prohibition of certain states and actions. AdviceMDPs enable the design of designing semi-autonomous systems (systems that require operator support for at least handling certain situations) that can efficiently handle unexpected complex environments. Operators, through advising, can augment the planning model for covering unexpected real-world irregularities. This advising can swiftly augment the degree of autonomy of the system, so it can work without subsequent human intervention.
This paper details the Advice-MDP formalism, a fast AdviceMDP resolution algorithm, and its applicability for real-world tasks, via the design of a professional-class semi-autonomous robot system ready to be deployed in a wide range of unexpected environments and capable of efficiently integrating operator advising.