bluuebunny/crossref_metadata_2025_split huggingface dataset:
O.6.1-11 Children’s play and physical activity levels in a natural playground: an observational case study from the Netherlands
Authors: Bliekendaal Sander , Ekkel Dinand 
Published: September 2023

Abstract

Purpose
Natural playgrounds stimulate active play in children and, as such, support their healthy development. Therefore, the municipality of Almere (The Netherlands), aims to develop more natural playgrounds within its neighbourhoods and parks. However, insight into how children play in these playgrounds is lacking, which is needed for optimal playgrounds design and policy development. Therefore, this study aimed to map the usage of a typical natural playground in Almere.

Methods
In this observational case study, direct observations (4 days, 4 times a day) of visitors (number, gender, age category, physical activity level, activity) were conducted using the SOPARC method at the natural playground in the Cascade park in Almere (approx. 218.000 inhabitants). This playground (size: 1.5ha) is located at the centre of a neighbourhood and has a natural surface (i.e. grass, sand) and various amenities (e.g. swings, zip-line, slides, climber, hills, sand play area, tiny forest). Descriptive analysis was used to summarize the data. A chi-square test was used to analyze the difference in physical activity levels (sedentary, moderate to vigorous physical activity) between boys and girls.

Results
A total of 287 people were observed at the playgrounds, with an average of 18 people (SD = 15, range: 3-50) per measurement. Most visitors were children (56%), followed by adults (29%), teenagers (14%), and seniors (1%). More girls (56%) were observed and more than half of the children (58%) were playing actively. Physical activity levels of boys and girls were similar (p=.81). The children’s main activities were walking (33%), standing (15%), running (14%), sitting (11%), climbing or sliding (9%), and chasing games (7%).

Conclusions
The playground was mainly used by children, slightly favouring girls. More than half of the children were involved in physically active play, which mostly was a locomotor type of activity. Boys and girls had similar physical activity levels.

Funding Source
This study was supported by a SIA fund (HBOPD.2018.05.57).
O.6.3-2 Implementation of a systems approach for co-creating actions to promote vocational students’ physical activity and wellbeing
Authors: Heinze Clara , Sidenius Anne , Bjerregaard Anne-Louise , Krølner Rikke Fredenlund , Klinker Charlotte Demant 
Published: September 2023

Abstract

Purpose
Participatory systems approaches are suggested to address the complexity of health promotion in communities but has not been tested and adapted to school settings.
The Data-driven Health Promotion at Vocational schools (Data Health) study aims to test and evaluate a systems approach to create collective actions to promote health among students. Three Group Model Building (GMB1-3) sessions were applied at eight vocational schools, with involvement from the local community, to develop a causal loop diagram (CLD), prioritise evidence-informed actions, and develop implementation strategies. This process evaluation aimed to determine if the GMB sessions were implemented as intended across intervention sites.

Methods
According to the Medical Research Council guidelines, six components were assessed: recruitment, reach, fidelity, dose delivered and received and context.
Data included registration and observation notes from the workshops (n = 24) and recorded and transcribed qualitative interviews with the school programme-coordinators (n = 8). All data were analysed thematically.

Results
At all intervention sites GMB sessions were completed in 2022, with representation of students, school staff and managers, the municipal staff and local community actors. Based on local data, four intervention sites chose to target physical activity and four sites chose wellbeing. At most intervention sites, attendance (reach) from all participant groups fell below expectation. Especially recruitment of school staff (average no. of participants n = 1.75; range 0-3) and managers (average no. of participants n = 0.63; range 0-2) was challenging, with lack of time as the main reason for non-attendance. The expected 'dose' of the GMB sessions was delivered to participants, whereas fidelity, conceptualised as consistency in delivery, was mixed due to contextual circumstances e.g. school size.
The school programme coordinators were generally positive about the GMB sessions but indicated mixed opinions about the value of CLDs to guide the discussion in this setting.

Conclusions
The Data Health study is the first to apply a systems approach to health promotion among vocational students and adapt GMB methodologies to school settings. Understanding the implementation of a systems approach in a school setting provides vital knowledge for researchers and practitioners regarding enablers and barriers of this approach.

Funding Sources
The Danish Regions, Tværspuljen, Helsefonden.
O.6.3-5 A national audit into the different levels of typical school provision of physical education, physical activity and sports in the Republic of Ireland
Authors: Rocliffe Padraic , O'Keeffe Brendan , Sherwin Ian , Mannix-McNamara Patricia , MacDonncha Ciaran 
Published: September 2023

Abstract
International guidelines recommend sixty-minutes of moderate-to-vigorous-intensity physical activity (PA) daily for adolescents (WHO, 2020). Prevalence of physical inactivity is high and is regarded as a leading risk factor for death worldwide, contributing to the onset of non-communicable diseases with just 20% of adolescents meeting the recommended PA guidelines (Guthold et al., 2020). Physical inactivity cost $67.5 billion worldwide in 2013 and is estimated to reach over €110 billion in 2030 (WHO, 2022). Despite the worldwide adoption of school PE, PA and sport policies to promote PA and health, paralleled with significant investment, a gap in the literature exists that audits the different levels of typical school provision of PE, PA and sports.
Participating schools (n = 112) completed the validated PE, PA and sports provision evaluation index. A One-way ANOVA with Tukey Kramer's Post-Hoc test was performed to examine variation in the demographic profile relative to the indicators of provision. A proposed grade for each indicator of provision was established using a standardized, international grading system.
Half of schools had no outdoor all-weather surface (54.5%). Two thirds had no facilities to accommodate active transport (66.1%). One in five felt the percentage of the budget given towards PE, PA and sports was inadequate (19.6%). Regarding indicators of provision, partnerships received the lowest grade (C-) while facilities and equipment received the highest grade (B-). Provision scores for personnel were significantly higher for mixed schools (girls/boys) in comparison to girls schools. Provision scores for budget and partnerships were significantly higher for larger schools (&gt;800) then small schools (&lt;300).
The evidence suggests that while there has been a significant shift in focus both in policy development and the availability of financial resources to enhance typical school provision of PE, PA and sports for adolescent health, considerable modification of existing provision is required to potentiate positive impact.
O.6.3-9 Intervention adaption protocol for the holistic school-based intervention, Youth-Physical Activity Towards Health, within a Danish context
Authors: Amholt Thea Toft , Kurtzhals Mette , Melby Paulina , Elsborg Peter , Nielsen Glen , Bentsen Peter 
Published: September 2023

Abstract

Introduction
In recent years, the concept of physical literacy (PL) has gained interest worldwide. Yet, only a few interventions targeting PL exist on a global scale. A promising theory-based and nationally tested intervention, Youth-Physical Activity Towards Health (Y-PATH), has proven to be effective in improving children's and adolescents’ physical activity levels and motor skills in Ireland. Using this protocol, we aim to context-adapt the Irish Y-PATH into an intervention that works through the schools in Denmark and targets PL among pupils in 4th and 5th grades.

Methods and analysis
We apply a stepwise approach to intervention adaptation, inspired by the Medical Research Council’s guidance for developing complex interventions as well as the ‘consensus informed guidance for adapting interventions to achieve a good fit between the intervention and context’ (ADAPT) process model and its principles and actions. First, we combine evidence synthesis with stakeholders' and researchers’ engagement to identify relevant and tentative adaptations and to understand barriers and enablers of the promotion of physical literacy in school-based interventions. Next, we adjust and improve our intervention adaptation ideas by collecting detailed data through interviews with purposively sampled stakeholders and pre-pilot tests of selected prototypes of materials in a ‘real-world’ setting. Finally, we clarify the intervention adaptations – its components, materials, and content – in a discussion with purposively sampled stakeholders, and finally, we test the study design.

Expected results and outcomes
A Danish version of the Y-PATH intervention, ready for feasibility testing within a Danish context, and a TIDieR intervention description checklist suitable for testing and further refinement in a feasibility study. The process will further increase our knowledge and understanding of the Danish school context as well as the teacher and pupils’ needs for an intervention promoting PL. In this presentation, we will present the preliminary results from the adaptation process, including the intervention components, materials, and content.

Funding
The intervention adaptation forms part of an overarching feasibility study that is financed by the Foundation TrygFonden (Grant ID #153181).
Reliability of Gordon Lateral Rotation Percentage and Prabhakar Percentage of Metaphyseal Overhang for Pediatric Supracondylar Humerus Fracture; Is it Clinically Reliable for John Hopkins Classification Coronal Fracture Subtypes?
Authors: Şahbat Yavuz , Bekiroğlu Gülnaz Nural , Çat Görkem , Gündoğdu Mert , Ağirdil Yücel , Çayir Hüseyin , Onay Tolga , Akgülle Ahmet Hamdi 
Published: September 2023

Background:
Rotational malalignment is a common problem in pediatric supracondylar humerus fractures (SCHF). Several techniques have been described to evaluate the true rotation value. Although the Prabhakar and Gordon techniques are used frequently, their superiority to each other in terms of measurement quality is unknown.

Questions/Purposes:
The aim of this study was to investigate the clinical compatibility of the 2 techniques and to evaluate whether they are suitable for all subtypes.

Methods:
This cross-sectional study included 40 patients with SCHF (including subtypes; Typical, Medial Oblique, Lateral Oblique, and High fracture pattern). The Gordon lateral rotation percentage and Prabhakar percentage of metaphyseal overhang were measured twice by 4 experienced Orthopedics and Traumatology surgeons at 8-week intervals. The interobserver and intraobserver reliability were examined using the intraclass correlation coefficient.

Results:
The interobserver reliability for Gordon and Prabhakar technique was 0.816 and 0.762 for the first measurement and 0.811 and 0.811 for the second measurement, respectively.
The medial oblique fracture pattern was determined to have the best interobserver agreement among the subtypes. The result was excellent for the medial and lateral oblique subtypes, good for the typical fracture pattern, and fair for the high fracture pattern. The intraobserver reliability for Gordon and Prabhakar technique was excellent, 0.924 and 0.922, respectively.

Conclusion:
The main finding of this study was that the Gordon and Prabhakar techniques have similar interobserver and intraobserver reliability. Although the Gordon technique tends to have higher interobserver reliability, the difference was clinically insignificant. These measurements should not be relied upon in cases of SCHF with a high fracture pattern because of the different anatomic features of that region.

Level of Evidence:
Level III.
A multi-device robotic-assisted PCI system: a proof-of concept study for left main bifurcation stenting with culotte technique in a porcine model
Authors: Han Wenzheng , Wang Ming , Guan Shaofeng , Gan Qian , Fang Weiyi , Xia Kun , Qu Xinkai 
Published: September 2023

Background and purpose:
Robotic-assisted percutaneous coronary intervention (PCI) has been increasingly used for simple lesion. For complex lesions, extensive manual intervention is still required. This study aims to verify the stability and safety of this robot system in complex lesion under fifth-generation (5G) network before clinical trial.

Methods:
We developed a robotic system that allows simultaneous remote control of multiple devices using a 5G wireless network. The key feature of the system is a bionic thumb along with two-bionic forefingers. The system was tested in eight pigs (six over 18.3 km and two over 1,100 km). Two stents were placed in the left main bifurcation using the culotte technique. All procedures, barring device loading onto the robot system, including manipulation of the guiding catheter, wire adjustments, stent or balloon positioning, and notably the final kissing step, were conducted remotely.

Results:
The rate of procedure success was 100%, with no device-related complications. In comparison to short-distance remote control, the delay with long-distance remote control was minimal (90.9 ± 1.5 vs. 81.5 ± 2.7 ms for command data transmission; 163.2 ± 1.3 vs. 161.0 ± 1.4 ms for image transmission). The procedure time was shorter when using two pairs versus a single pair of bionic fingers (104.3 ± 10.2 vs. 126.0 ± 3.9 min), primarily due to less time needed for device loading and exchange (33.1 ± 4.2 vs. 56.1 ± 4.0 min).

Conclusions:
With the 5G network, long distance was not a significant barrier for robotic-assisted PCI for chronic total occlusion. A design of the independent bionic finger module enabled final kissing balloon inflation with reduced requirement for manual intervention. Whether the system could be used beyond left main bifurcation lesions requires further investigation.
Impact of octreotide on sodium level in cirrhotic inpatients with hyponatremia: a retrospective study
Authors: Ismail Bahaaeldeen , Charnigo Richard , Ali Syed Mohammad , Alkhairi Baker , Benrajab Karim , Singh Harjinder , Castro Fernando J. 
Published: September 2023

Objective
Octreotide could increase serum sodium in cirrhotics with hyponatremia by counteracting splanchnic vasodilation. Current supporting data is limited to case reports and series. The aim of the study is to assess the effect of octreotide on serum sodium in cirrhotic inpatients with hyponatremia compared with controls.

Methods
This is a retrospective study including adult inpatients with cirrhosis, admitted for ≥5 days with Na <133 at baseline. We excluded those receiving other vasoconstrictor infusions, hypertonic saline, tolvaptan or dialysis. Controls represented an equal number of inpatients with cirrhosis not receiving octreotide. Sodium changes on days 5, 7 and 10 were evaluated with multivariable adjustment.

Results
Each group consisted of 156 patients. The octreotide subjects had more cirrhosis complications. Baseline sodium was lower in the octreotide group, and their change in sodium at day 5 was higher (6.6 ± 5.6 vs. 3.5 ± 5.3; P < 0.001). Significant differences were also noted on days 7 and 10 (7.84 ± 6.76 vs. 4.33 ± 6.2 and 7.99 ± 6.72 vs. 5.2 ± 6.56, respectively). The impact of octreotide was lessened but remained significant (P = 0.019) in a mixed model adjusting for baseline sodium, creatinine, requirement of paracentesis, midodrine, albumin and fresh frozen plasma. More octreotide patients achieved hyponatremia resolution (55.1% vs. 42.3%; P = 0.031), but significance was not preserved in multivariate logistic regression.

Conclusion
Octreotide administration is associated with an increase in serum sodium among inpatient cirrhotics with hyponatremia, even after accounting for confounders. Prospective randomized controlled trials are warranted.
Post-COVID pneumatocele, a rare entity managed surgically: a case series
Authors: Wahab Rida , Sohail Abdul A. , Khalid Rifsha , Sundardas Rita , Fatimi Saulat H. 
Published: September 2023

Introduction:
A pulmonary pneumatocele is a thin air filled cavitatory lesion that develops within the lung parenchyma. It is a unique, rarely occurring complication of COVID-19 pneumonia, most commonly detected by chest radiographs and computed tomography scans.

Case presentation:
The authors present a case series of four separate cases, all of which had suffered from COVID pneumonia, and now developed symptomatic pneumatocele. Two patients out of the four had also developed pneumothorax for which a tube thoracostomy was done, which is an infrequent complication of pneumatocele. One had an accompanying fungal infected loculated effusion. In all of these patients surgical management was approached as a treatment modality with three patients requiring bullectomy and one requiring lobectomy since image-guided drainage technique is not widely available in our resource-limited setting.

Discussion:
A pneumatocele, also called a pseudocyst, due to the absence of epithelial lining, is a thin-walled cystic cavity, filled with air that develops in the pulmonary interstitium. The most common cause is iatrogenic injury, due to prolonged mechanical ventilation. Pneumatoceles are usually asymptomatic and resolve spontaneously; however, image-guided drainage and surgical management can be opted for, in the presence of the complications.

Conclusion:
From our case report, it can be concluded that the surgical approach is relatively safe and effective, with increased survival benefits, especially in those patients who develop complicated pneumatocele.
Mycobacterium tuberculosis-induced monocyte transcriptional responses associated with resistance to tuberculin skin test/interferon-γ release assay conversion in people with HIV
Authors: Hong Hyejeong , Dill-Mcfarland Kimberly A. , Benson Basilin , Simmons Jason D. , Peterson Glenna J. , Benchek Penelope , Stein Catherine M. , Boom W. Henry , Mayanja-Kizza Harriet , Hawn Thomas R. 
Published: September 2023

Objective:
To determine whether Mycobacterium tuberculosis (Mtb)-induced monocyte transcriptional responses differ in people with HIV (PWH) who do (RSTR) or do not (LTBI) resist tuberculin skin test/interferon-γ (IFN-γ) release assay (TST/IGRA) conversion after exposure.

Design:
We compared ex-vivo Mtb-induced monocyte transcriptional responses in a Ugandan tuberculosis (TB) household contact study of RSTR and LTBI individuals among PWH.

Methods:
Monocytes were isolated from peripheral blood mononuclear cells from 19 household contacts of pulmonary TB patients, and their transcriptional profiles were measured with RNA-Seq after a 6 h infection with Mtb (H37Rv) or media. Differentially expressed genes (DEGs) were identified by a linear mixed effects model and pathways by gene set enrichment analysis that compared RSTR and LTBI phenotypes with and without Mtb stimulation.

Results:
Among PWH, we identified 8341 DEGs that were dependent on Mtb stimulation [false discovery rate (FDR) <0.01]. Of these, 350 were not significant (FDR >0.2) in individuals without HIV. Additionally, we found 26 genes that were differentially expressed between RSTR and LTBI monocytes in PWH, including 20 which were Mtb-dependent (FDR <0.2). In unstimulated monocytes, several gene sets [TGF-β signaling, TNF-α signaling via NF-κB, NOTCH signaling, coagulation, and epithelial mesenchymal transition (EMT)] were enriched in RSTR relative to LTBI monocytes (FDR <0.1). These patterns were not observed in individuals without HIV.

Conclusion:
RSTR monocytes in PWH show different gene expressions in response to Mtb infection when compared with those with LTBI and RSTR without HIV. These differential expression patterns are enriched in inflammatory pathways.
Kidney Donation After Circulatory Death Using Thoracoabdominal Normothermic Regional Perfusion: The Largest Report of the United States Experience
Authors: Zhou Alice L. , Leng Albert , Ruck Jessica M. , Akbar Armaan F. , Desai Niraj M. , King Elizabeth A. 
Published: September 2023

Background.
Thoracoabdominal normothermic regional perfusion (TA-NRP) has been increasingly used for donation after circulatory death (DCD) procurements in the United States. We present the largest report of outcomes of kidney transplants performed using DCD donor grafts perfused with TA-NRP.

Methods.
Adult DCD kidney transplants between 2020 and 2022 in the United Network for Organ Sharing database were included. Donors with ≥50 min between asystole and aortic cross-clamp time in which the heart was also transplanted were considered TA-NRP donors. All other donors were considered direct recovery donors. Multivariable regressions were used to assess delayed graft function, as well as posttransplant survival and all-cause graft failure at 30, 90, and 180 d. A propensity-matched analysis of cohorts matched on donor Kidney Donor Profile Index was performed.

Results.
Of the 16 140 total DCD kidney transplants performed during the study period, 306 (1.9%) used TA-NRP. TA-NRP donors were younger (P < 0.001) and had lower Kidney Donor Profile Index (P < 0.001) compared with direct recovery donors. Recipients receiving grafts recovered using TA-NRP were younger (P < 0.001) and more likely to be blood group O (P < 0.001). Transplants using TA-NRP had lower likelihood of delayed graft function (adjusted odds ratio 0.22 [95% confidence interval, 0.15-0.31], P < 0.001) but similar 180-d survival (P = 0.8) and all-cause graft failure (P = 0.3) as transplants using direct recovery grafts. These inferences were unchanged on propensity-matched analysis.

Conclusions.
Our results demonstrate that kidney transplants using TA-NRP DCD allografts have positive short-term mortality and graft survival outcomes, with significantly decreased rates of delayed graft function compared with direct recovery DCD grafts.