bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examination of Intramuscular and Skin Temperature Decreases Produced by the PowerPlay Intermittent Compression Cryotherapy
Authors: Ostrowski Jennifer , Purchio Angelina , Beck Maria , Leisinger JoLynn , Tucker Mackenzie , Hurst Sarah 
Published: April 2017

Context: Previous research has found ice bags are more effective at lowering intramuscular temperature than gel packs. Recent studies have evaluated intramuscular temperature cooling decreases with ice bag versus Game Ready and with the PowerPlay system wetted ice bag inserts; however, intramuscular temperature decreases elicited by PowerPlay with the standard frozen gel pack inserts have not been examined. Objective: Evaluate the rate and magnitude of cooling using PowerPlay with frozen gel pack (PP-gel) option, PowerPlay with wetted ice bag (PP-ice) option, and control (no treatment) on skin and intramuscular temperature (2 cm subadipose). Design: Repeated-measures counterbalanced study. Setting: University research laboratory. Patients or Other Participants: Twelve healthy college-aged participants (4 men and 8 women; age = 23.08 (1.93) y, height = 171.66 (9.47) cm, mass = 73.67 (13.46) kg, and subcutaneous thickness = 0.90 (0.35) cm). Intervention(s): PowerPlay (70 mm Hg) with either wetted ice bag or frozen gel pack was applied to posterior aspect of nondominant calf for 30 minutes; control lay prone for 30 minutes. Participants underwent each treatment in counterbalanced order (minimum 4 d, maximum 10 d between). Main Outcome Measure(s): Muscle temperature was measured via 21-gauge catheter thermocouple (IT-21; Physitemp Instruments, Inc). Skin temperature was measured via surface thermocouple (SST-1; Physitemp Instruments, Inc). Results: Significant treatment-by-time interaction for muscle cooling (F10,80 = 11.262, P = .01, , observed β = 0.905) was observed. PP-ice cooled faster than both PP-gel and control from minutes 12 to 30 (all Ps < .05); PP-gel cooled faster than control from minutes 18 to 30 (all Ps < .05). Mean decreases from baseline: PP-ice = 4.8°C (2.8°C), PP-gel = 2.3°C (0.8°C), and control = 1.1°C (0.4°C). Significant treatment-by-time interaction for skin cooling (F10,80 = 23.920, P = .001, , observed β = 0.998) was observed. PP-ice cooled faster than both PP-gel and control from minutes 6 to 30 (all Ps < .05); PP-gel cooled faster than control from minutes 12 to 30 (all Ps < .05). Mean decreases from baseline: PP-ice = 14.6°C (4.8°C), PP-gel = 4.0°C (0.9°C), and control = 1.0°C (1.0°C). Conclusions: PP-ice produces clinically and statistically greater muscle and skin cooling compared with PP-gel and control.
Effects of economic downturns on child mortality: a global economic analysis, 1981–2010
Authors: Maruthappu Mahiben , Watson Robert A , Watkins Johnathan , Zeltner Thomas , Raine Rosalind , Atun Rifat 
Published: April 2017

ObjectivesTo analyse how economic downturns affect child mortality both globally and among subgroups of countries of variable income levels.DesignRetrospective observational study using economic data from the World Bank's Development Indicators and Global Development Finance (2013 edition). Child mortality data were sourced from the Institute for Health Metrics and Evaluation.SettingGlobal.Participants204 countries between 1981 and 2010.Main outcome measuresChild mortality, controlling for country-specific differences in political, healthcare, cultural, structural, educational and economic factors.Results197 countries experienced at least 1 economic downturn between 1981 and 2010, with a mean of 7.97 downturns per country (range 0–21; SD 0.45). At the global level, downturns were associated with significant (p<0.0001) deteriorations in each child mortality measure, in comparison with non-downturn years: neonatal (coefficient: 1.11, 95% CI 0.855 to 1.37), postneonatal (2.00, 95% CI 1.61 to 2.38), child (2.93, 95% CI 2.26 to 3.60) and under 5 years of age (5.44, 95% CI 4.31 to 6.58) mortality rates. Stronger (larger falls in the growth rate of gross domestic product/capita) and longer (lasting 2 years rather than 1) downturns were associated with larger significant deteriorations (p<0.001). During economic downturns, countries in the poorest quartile experienced ∼1½ times greater deterioration in neonatal mortality, compared with their own baseline; a 3-fold deterioration in postneonatal mortality; a 9-fold deterioration in child mortality and a 3-fold deterioration in under-5 mortality, than countries in the wealthiest quartile (p<0.0005). For 1–5 years after downturns ended, each mortality measure continued to display significant deteriorations (p<0.0001).ConclusionsEconomic downturns occur frequently and are associated with significant deteriorations in child mortality, with worse declines in lower income countries.
Person-centred transition programme to empower adolescents with congenital heart disease in the transition to adulthood: a study protocol for a hybrid randomised controlled trial (STEPSTONES project)
Authors: Acuña Mora Mariela , Sparud-Lundin Carina , Bratt Ewa-Lena , Moons Philip 
Published: April 2017

IntroductionWhen a young person grows up, they evolve from an independent child to an empowered adult. If an individual has a chronic condition, this additional burden may hamper adequate development and independence. Transition programmes for young persons with chronic disorders aim to provide the necessary skills for self-management and participation in care. However, strong evidence on the effects of these interventions is lacking. Therefore, as part of the STEPSTONES project (Swedish Transition Effects Project Supporting Teenagers with chrONic mEdical conditionS), we propose a trial to assess the effectiveness of a structured, person-centred transition programme to empower adolescents with congenital heart disease in the transition to adulthood.Methods/designSTEPSTONES will use a hybrid experimental design in which a randomised controlled trial is embedded in a longitudinal, observational study. It will be conducted in 4 paediatric cardiology centres in Sweden. 2 centres will be allocated to the randomised controlled trial group, assigning patients randomly to the intervention group (n=63) or the comparison group (n=63). The other 2 centres will form the intervention-naïve control group (n=63). The primary outcome is the level of patient empowerment, as measured by the Gothenburg Young Persons Empowerment Scale (GYPES).Ethics and disseminationThe study has been approved by the Regional Ethical Board of Gothenburg, Sweden. Findings will be reported following the CONSORT statement and disseminated at international conferences and as published papers in peer-reviewed journals.Trial registration numberNCT02675361; pre-results.
Optimal body fat percentage cut-off values for identifying cardiovascular risk factors in Mongolian and Han adults: a population-based cross-sectional study in Inner Mongolia, China
Authors: Li Yanlong , Wang Hailing , Wang Ke , Wang Wenrui , Dong Fen , Qian Yonggang , Gong Haiying , Xu Guodong , Li Guoju , Pan Li , Zhu Guangjin , Shan Guangliang 
Published: April 2017

ObjectiveThe present study was designed to determine the optimal cut-off values of body fat percentage (BF%) for the detection of cardiovascular disease (CVD) risk factors in Mongolian and Han adults.MethodThis cross-sectional study involving 3221 Chinese adults (2308 Han and 913 Mongolian) aged 20–80 years was conducted in Inner Mongolia Autonomous Region, China, in 2014. Data from a standardised questionnaire, physical examination and blood sample were obtained. The BF% was estimated using bioelectrical impedance analysis. Optimal BF% cut-offs were analysed by receiver operating characteristic curves to predict the risk of diabetes, hypertension and dyslipidaemia. Binary logistic regression analysis was performed to evaluate the OR of each CVD risk factor according to obesity defined by BF%.ResultsMean BF% levels were lower in men than in women (22.54±5.77 vs 32.95±6.18 in Han, 23.86±5.72 vs 33.98±6.40 in Mongolian population, respectively; p<0.001). In Han population, the area under curve (AUC) values for BF% ranged from 0.589 to 0.699 for men and from 0.711 to 0.763 for women. Compared with men, AUCs for diabetes and clustering of ≥2 risk factors in women were significantly higher (p<0.05). The AUCs for BF% in women (0.685–0.783) were similar with those in men (0.686–0.736) for CVD risk factors in Mongolian population. In Han adults, the optimal BF% cut-off values to detect CVD risk factors varied from 18.7% to 24.2% in men and 32.7% to 35.4% in women. In Mongolian population, the optimal cut-off values of BF% for men and women ranged from 21.0% to 24.6% and from 35.7% to 40.0%, respectively. Subjects with high BF% (≥24% in men, ≥34% in women) had higher risk of CVD risk factors in Han (age-adjusted ORs from 1.479 to 3.680, 2.660 to 4.016, respectively). In Mongolia, adults with high BF% (≥25% in men, ≥35% in women) had higher risk of CVD risk factors (age-adjusted ORs from 2.587 to 3.772, 2.061 to 4.882, respectively).ConclusionsThe optimal BF% cut-offs for obesity for the prediction of CVD risk factors in Chinese men and women were approximately 24% and 34% for Han adults and 25% and 35% for Mongolian population of Inner Mongolia, China, respectively.
The UK Cardiac and Vascular Surgery Interventional Anaemia Response (CAVIAR) Study: protocol for an observational cohort study to determine the impact and effect of preoperative anaemia management in cardiac and vascular surgical patients
Authors: Chau Marisa , Richards Toby , Evans Caroline , Butcher Anna , Collier Timothy , Klein Andrew 
Published: April 2017

IntroductionPreoperative anaemia is linked to poor postsurgical outcome, longer hospital stays, greater risk of complications and mortality. Currently in the UK, some sites have developed anaemia clinics or pathways that use intravenous iron to correct iron deficiency anaemia prior to surgery as their standard of care. Although intravenous iron has been observed to be effective in a variety of patient settings, there is insufficient evidence in its use in cardiac and vascular patients. The aim of this study is to observe the impact and effect of anaemia and its management in patients undergoing cardiac and vascular surgery. In addition, the UK Cardiac and Vascular Surgery Interventional Anaemia Response (CAVIAR) Study is also a feasibility study with the aim to establish anaemia management pathways in the preoperative setting to inform the design of future randomised controlled trials.Methods and analysisThe UK CAVIAR Study is a multicentre, stepped, observational study, in patients awaiting major cardiac or vascular surgery. We will be examining different haematological variables (especially hepcidin), functional capacity and patient outcome. Patients will be compared based on their anaemia status, whether they received intravenous iron in accordance to their hospital’s preoperative pathway, and their disease group. The primary outcomes are the change in haemoglobin levels from baseline (before treatment) to before surgery; and the number of successful patients recruited and consented (feasibility). The secondary outcomes will include changes in biomarkers of iron deficiency, length of stay, quality of life and postoperative recovery.Ethics and disseminationThe study protocol was approved by the London-Westminster Research Ethics Committee (15/LO/1569, 27 November 2015). NHS approval was also obtained with each hospital trust. The findings of the study will be published in peer-reviewed journals.Trial registration numberClinical Trials registry (NCT02637102) and the ISRCTN registry (ISRCTN55032357).
Can a partnership between general practitioners and ambulance services reduce conveyance to emergency care?
Authors: Villarreal Manuel , Leach Jonathan , Ngianga-Bakwin Kandala , Dale Jeremy 
Published: April 2017

BackgroundEmergency services are facing increasing workload pressures, and new models of care are needed. We evaluate the impact of a service development involving a partnership between emergency ambulance crews and general practitioners (GPs) on reducing conveyance rates to the Hospital Emergency Department(ED) .MethodsThe service model was implemented in the West Midlands of England. Call handlers identified patients with needs that could be addressed by a GP using locally agreed criteria. GPs supported the assessment of such patients either at scene or by telephone. Routine data were collected from October 2012 to November 2013, from the ambulance service computer-aided dispatch system. Logistic regression models were used to determine the likelihood for patients being transported to ED.ResultsOf 23 395 emergency contacts during the evaluation period, 1903 (8.1 %) patients were triaged to GP supported assessment. Mean age (SD) was 61.8 (27.9) years; 42.9 % were aged 75 years and over. 1221 (64.2%) had face-to-face GP assessment and 682 (35.8%) via telephone. 1500 (78%) of those who received GP support were not transported to hospital. After controlling for confounders, those aged greater than 75 years (OR 0.67; 95% CI 0.52 to 0.86), and females (OR 0.64; 95% CI 0.51 to 0.82) were less likely to be transported, while those who received GP telephone input rather than face-to-face assessment were more likely to be transferred to an ED (OR 2.14; 95% CI 1.69 to 2.72).ConclusionSupport of the paramedic service by GPs enabled patients to avoid transfer to an ED, potentially avoiding subsequent hospital admission, reducing costs and improving quality of care for patients that are not in need of hospital services. However, use of services in the days following the call was not assessed, and hence the overall impact and safety requires further evaluation.
‘The year of first aid’: effectiveness of a 3-day first aid programme for 7-14-year-old primary school children
Authors: Banfai Balint , Pek Emese , Pandur Attila , Csonka Henrietta , Betlehem Jozsef 
Published: April 2017

Aim of the studyBystanders can play an important role in the event of sudden injury or illness. Our aim was to evaluate the effects of a 3-day first aid course for all primary school age groups (7–14 years old).Methods582 school children were involved in the study. Training consisted of three sessions with transfer of theoretical knowledge and practical skills about first aid. The following most urgent situations were addressed in our study: adult basic life support (BLS), using an automated external defibrillator (AED), handling an unconscious patient, managing bleeding and calling the ambulance. Data collection was made with a questionnaire developed for the study and observation. Students were tested before, immediately after and 4 months after training. Results were considered significant in case of p<0.05.ResultsPrior to training there was a low level of knowledge and skills on BLS, management of the unconscious patient, use of an AED and management of bleeding. Knowledge and skills improved significantly in all of these categories (p<0.01) and remained significantly higher than the pre-test level at 4 months after training (p<0.01). Younger children overall performed less well than older children, but significantly improved over the pre-test level both immediately and 4 months after training (p<0.01). Prior first aid training was associated with knowledge of the correct ambulance number (p=0.015) and management of bleeding (p=0.041). Prior to training, age was associated with pre-test knowledge and skills of all topics (p<0.01); after training, it was only associated with AED use (p<0.001). There was a significant correlation between the depth of chest compression and children’s age, weight, height and body mass index (p<0.001). Ventilation depended on the same factors (p<0.001).ConclusionChildren aged 7–14 years are able to perform basic life-saving skills. Knowledge retention after 4 months is good for skills, but thinking in algorithms is difficult for these children.
Bandgaps characteristics of the periodical slit metal tubes with backstraps
Authors: Bao Kai , Chen Tianning , Wang Xiaopeng , Song Ailing , Wan Lele 
Published: April 2017

In this paper, a new two-dimensional (2D) phononic crystal structure composed of periodic slit metal tubes, in which the unit cell consists of straight or curved backstraps, is proposed, and the propagation characteristics of acoustic waves in this structure are theoretically investigated. Using the finite-element method, we calculate the dispersion relations and transmission coefficients of this structure. The results show that, in contrast to the only slit metal tubes, the periodic slit metal tubes with straight or curved backstraps are proved to display band gaps (BGs) at much lower frequency range. Meanwhile, the effect of the slit width of the backstraps on the BGs is investigated. The results show that the positions and widths of the BGs can be effectively modulated by the backstraps without changing the mass density or lattice constant of the material. The lowest frequency falls by about 200 Hz. Moreover, we investigated how the BGs are affected by the location parameter of the backstraps, finding that the acoustic BGs are sensitive to the location parameter of the backstraps. Numerical results show that BGs are significantly dependent upon the slit width and location parameters of the backstraps. The BGs are optimized because, the effect of the Helmholtz resonators of the slit tube is strengthened and changed when the location and slit width of the backstraps change. These results provide a good reference for optimizing BGs, generating filters and designing devices.
Discrete and Continuous Consecutive 2-Out-of-n:F System Reliability with Correlated Components
Authors: Jafary Bentolhoda , Fiondella Lance , Xing Liudong 
Published: April 2017

A linear consecutive [Formula: see text]-out-of-[Formula: see text]:failed system, henceforth written consecutive [Formula: see text]-out-of-[Formula: see text]:F, is an [Formula: see text]-component system that fails if [Formula: see text] or more consecutive components in positions [Formula: see text] fail, where [Formula: see text]. The consecutive [Formula: see text]-out-of-[Formula: see text]:F system model is particularly valuable for characterizing critical infrastructures such as telecommunications that provide essential services to society. However, events that impact critical infrastructures such as natural disasters often produce geospatially correlated failures, necessitating reliability models that can accommodate these scenarios where component failures may be correlated. This paper presents a method to explicitly model the correlation between component failures of a consecutive [Formula: see text]-out-of-[Formula: see text]:F system. The approach produces analytical expressions for the reliability of discrete and continuous systems in terms of component reliabilities and correlation between the component failures. The explicit correlation parameter simplifies sensitivity analysis for a variety of measures of interest, including reliability, density function, hazard rate, mean time to failure (MTTF), availability, and mean residual life (MRL). It is illustrated through examples where correlated failures can negatively influence system reliability. Thus, the approach can quantify improvements to system reliability that could be achieved by lowering the correlation between failures of system components.
Determination of Overhead Power Line Cables Configuration by FEM and Meshless FDM
Authors: Cecot W. , Milewski S. , Orkisz J. 
Published: April 2017

The paper addresses numerical modeling of overhead power line cables subjected to static loads. Cable extensibility, their large 3D displacements as well as an interaction with strings of insulators and elastic towers are considered. A 2D exact closed solution available for certain type of loading was generalized by us to a 3D displacement case and applied as one of the benchmarks, that were used in convergence, efficiency and accuracy studies of numerical methods to select the most reliable one. Various formulations of the problem (strong and weak in both the Bubnov and local Petrov–Galerkin MLPG-5 versions) as well as various solution approximation approaches were examined, namely the finite element method (FEM) with the higher order shape functions as well as for the first time the meshless finite difference method (MFDM). Validation done by comparison of the numerical results with in situ measurements confirmed that the assumed models are reliable.
Monitoring Daily Dynamics of Early Tumor Response to Targeted Therapy by Detecting Circulating Tumor DNA in Urine
Authors: Husain Hatim , Melnikova Vladislava O. , Kosco Karena , Woodward Brian , More Soham , Pingle Sandeep C. , Weihe Elizabeth , Park Ben Ho , Tewari Muneesh , Erlander Mark G. , Cohen Ezra , Lippman Scott M. , Kurzrock Razelle 
Published: April 2017

Abstract
Purpose: Noninvasive drug biomarkers for the early assessment of tumor response can enable adaptive therapeutic decision-making and proof-of-concept studies for investigational drugs. Circulating tumor DNA (ctDNA) is released into the circulation by tumor cell turnover and has been shown to be detectable in urine.
Experimental Design: We tested the hypothesis that dynamic changes in EGFR activating (exon 19del and L858R) and resistance (T790M) mutation levels detected in urine could inform tumor response within days of therapy for advanced non–small cell lung cancer (NSCLC) patients receiving osimertinib, a second-line third-generation anti-EGFR tyrosine kinase inhibitor.
Results: Eight of nine evaluable NSCLC patients had detectable T790M-mutant DNA fragments in pretreatment baseline samples. Daily monitoring of mutations in urine indicated a pattern of intermittent spikes throughout week 1, suggesting apoptosis with an overall decrease in fragment numbers from baselines to day 7 preceding radiographic response assessed at 6 to 12 weeks.
Conclusions: These findings suggest drug-induced tumor apoptosis within days of initial dosing. Daily sampling of ctDNA may enable early assessment of patient response and proof-of-concept studies for drug development. The modeling of tumor lysis through the day-to-day kinetics of ctDNA released into the blood and then into the urine is demonstrated in this proof-of-concept study in lung cancer patients receiving anti-EGFR tyrosine kinase inhibitors. This strategy may determine the specific clonal populations of cells which undergo apoptosis within the first week of therapy. This has important implications for developing combinational strategies to address inter- and intralesional heterogeneity and characterizing residual disease after initial drug exposure. Clin Cancer Res; 23(16); 4716–23. ©2017 AACR.