bluuebunny/crossref_metadata_2025_split huggingface dataset:
Source apportionment of polycyclic aromatic hydrocarbons in New York/New Jersey Harbour sediment
Authors: Al Hello Mohson , Burris David R. , Chitsaz Mahdi , Rodenburg Lisa A. 
Published: March 2023

AbstractData on polycyclic aromatic hydrocarbons (PAHs) measured in surface sediment and cores in the New York/New Jersey Harbour under the Contamination Assessment and Reduction Project (CARP) was examined via Positive Matrix Factorization (PMF), which revealed six sources. Two represented the higher and lower molecular weight (MW) fractions of coal tar and/or creosote (pyrogenic) sources and explained 49% of PAH mass in the sediment samples. Two sources were related to uncombusted petroleum (petrogenic) sources, such as heavy fuel oil and crude oil, and explained 30% of PAH mass. The final two sources were related to combustion (pyrogenic) sources such as gasoline‐ and diesel‐fuelled vehicles and explained 21% of the PAH mass. Sediment cores revealed that Σ22PAH increased from the pre‐industrial period until about 1980 and then decreased because of efforts to control water pollution via mechanisms such as the Clean Water Act.
Can local vibration alter the contribution of persistent inward currents to human motoneuron firing?
Authors: Lapole T. , Mesquita R. N. O. , Baudry S. , Souron R. , Brownstein C. G. , Rozand V. 
Published: March 2023

AbstractThe response of spinal motoneurons to synaptic input greatly depends on the activation of persistent inward currents (PICs), which in turn are enhanced by the neuromodulators serotonin and noradrenaline. Local vibration (LV) induces excitatory Ia input onto motoneurons and may alter neuromodulatory inputs. Therefore, we investigated whether LV influences the contribution of PICs to motoneuron firing. This was assessed in voluntary contractions with concurrent, ongoing LV, as well as after a bout of prolonged LV. High‐density surface electromyograms (HD‐EMG) of the tibialis anterior were recorded with a 64‐electrode matrix. Twenty males performed isometric, triangular, dorsiflexion contractions to 20% and 50% of maximal torque at baseline, during LV of the tibialis anterior muscle, and after 30‐min of LV. HD‐EMG signals were decomposed, and motor units tracked across time points to estimate PICs through a paired motor unit analysis, which quantifies motor unit recruitment–derecruitment hysteresis (ΔF). During ongoing LV, ΔF was lower for both 20% and 50% ramps. Although significant changes in ΔF were not observed after prolonged LV, a differential effect across the motoneuron pool was observed. This study demonstrates that PICs can be non‐pharmacologically modulated by LV. Given that LV leads to reflexive motor unit activation, it is postulated that lower PIC contribution to motoneuron firing during ongoing LV results from decreased neuromodulatory inputs associated with lower descending corticospinal drive. A differential effect in motoneurons of different recruitment thresholds after prolonged LV is provocative, challenging the interpretation of previous observations and motivating future investigations.
imageKey points
Neuromodulatory inputs from the brainstem influence motoneuron intrinsic excitability through activation of persistent inward currents (PICs). PICs make motoneurons more responsive to excitatory input.
We demonstrate that vibration applied on the muscle modulates the contribution of PICs to motoneuron firing, as observed through analysis of the firing of single motor units.
The effects of PICs on motoneuron firing were lower when vibration was concurrently applied during voluntary ramp contractions, likely due to lower levels of neuromodulation. Additionally, prolonged exposure to vibration led to differential effects of lower‐ vs. higher‐threshold motor units on PICs, with lower‐threshold motor units tending to present an increased and higher‐threshold motor units a decreased contribution of PICs to motoneuron firing.
These results demonstrate that muscle vibration has the potential to influence the effects of neuromodulation on motoneuron firing. The potential of using vibration as a non‐pharmacological neuromodulatory intervention should be further investigated.
The Value of Incorporating Inclusive Sports in Schools: An Exploration of Unified Sport Experiences
Authors: O’Rourke Roxy Helliker , Orr Krystn , Renwick Rebecca , Wright F. Virginia , Noronha James , Bobbie Kirsten , Arbour-Nicitopoulos Kelly P. 
Published: March 2023

School sports programs intentionally created for students with and without disabilities may increase social participation of students with intellectual disabilities (IDs). Special Olympics Unified Sports is one program where students with and without ID participate on one team. Guided by a critical realist paradigm, this study explored the perceptions of students with and without ID and coaches of in-school Unified Sports. Interviews were conducted with 21 youths (12 with ID) and 14 coaches. Thematic analysis resulted in four developed themes (identified is outdated language): Inclusion—Is it a “we” or a “they?” Roles and Responsibilities, Educational Context for Inclusion, and Buy-In. Findings suggest students with and without ID and coaches value the inclusive nature of Unified Sports. Future research should explore training for coaches on inclusive practices (e.g., language), and optimal methods for consistent training (e.g., use of training manuals) to foster the philosophy of inclusion within school sports.
Social Support for Physical Activity Over 9 Years in Adults Aged 60–65 Years at Baseline
Authors: Smith Genevieve S.E. , Ware Robert S. , Moyle Wendy , Burton Nicola W. 
Published: March 2023

Physical activity is a leading determinant of health and well-being in older adults; however, participation is low. Social support can significantly influence physical activity uptake and maintenance; however, most research is cross-sectional and does not differentiate among types of support. The current study assessed four types of social support for physical activity reported over 9 years by adults aged 60–65 at baseline (n = 1,984). Data were collected using a mail survey at four time points. Data were analyzed using linear mixed models. The most common type of support was emotional, with 25% of participants reporting this often/very often. Total support for activity declined by 16% across the 9 years (p < .001). Companionship had the greatest decline among types (17%–18%, p < .001). More work is needed to understand the factors contributing to the decline in support and how to enable access to support for physical activity in older adults.
Motor-Evoked Potentials for Early Individual Elements of an Action Sequence During Planning Reflect Parallel Activation Processes
Authors: Behmer Lawrence P. , Crump Mathew J.C. , Jantzen Kelly J. 
Published: March 2023

Several computational models make predictions about the activation states of individual elements of an action sequence during planning and execution; however, the neural mechanisms of action planning are still poorly understood. Simple chaining models predict that only the first response in an action sequence should be active during planning. Conversely, some parallel activation models suggest that during planning, a serial inhibition process places the individual elements of the action into a serial order across a winner-takes-all competitive choice gradient in which earlier responses are more active, and hence likely to be selected for execution compared with later responses. We triggered transcranial magnetic stimulation pulses at 200 or 400 ms after the onset of a five-letter word, in which all but one response was planned and typed with the left hand, except for a single letter which required a right index finger response exclusively at one of five serial positions. We measured the resulting motor-evoked potentials at the right index finger as a marker for the activation state of that planned response. We observed no difference in motor-evoked potential amplitude across any serial position when a right index finger response was planned at 200 ms after the onset of the word; however, we observed a graded pattern of activation at 400 ms, with earlier positions that required a right index finger response showing greater motor-evoked potentials amplitude compared with later positions. These findings provide empirical support for competitive queuing computational models of action planning.
High Dose Inhalation with Gaseous Nitric Oxide in COVID-19 Treatment
Authors: Pechyonkin E. V. , Kovrizhkin A. V. , Pekshev A. V. , Vagapov A. B. , Sharapov N. A. , Vanin A. F. 
Published: March 2023

Abstract
A method of treatment of a new coronavirus infection COVID-19 in patients undergoing high flow oxygenation is proposed and technically implemented; the method is based on high-dose inhalation of gaseous nitric oxide (NO) with the patient’s spontaneous breathing. The results of the treatment of this disease demonstrating the high efficiency of the new method are presented. A possible mechanism of the blocking effect of high doses of inhaled nitric oxide on the replication of the SARS-CoV-2 virus is discussed; it is based on the formation of dinitrosyl iron complexes in the respiratory tract and lungs of COVID-19 patients with thiol-containing ligands acting as donors of NO and nitrosonium NO+ cations in a living organism that have a cytotoxic effect on the SARS CoV-2 virus.
Modeling of the Tricuspid Valve and Right Ventricle in Hypoplastic Left Heart Syndrome With a Fontan Circulation
Authors: Nam Hannah H. , Flynn Maura , Lasso Andras , Herz Christian , Sabin Patricia , Wang Yan , Cianciulli Alana , Vigil Chad , Huang Jing , Vicory Jared , Paniagua Beatriz , Allemang David , Goldberg David J. , Nuri Mohammed , Cohen Meryl S. , Fichtinger Gabor , Jolley Matthew A. 
Published: March 2023

Background:
In hypoplastic left heart syndrome, tricuspid regurgitation (TR) is associated with circulatory failure and death. We hypothesized that the tricuspid valve (TV) structure of patients with hypoplastic left heart syndrome with a Fontan circulation and moderate or greater TR differs from those with mild or less TR, and that right ventricle volume is associated with TV structure and dysfunction.

Methods:
TV of 100 patients with hypoplastic left heart syndrome and a Fontan circulation were modeled using transthoracic 3-dimensional echocardiograms and custom software in SlicerHeart. Associations of TV structure to TR grade and right ventricle function and volume were investigated. Shape parameterization and analysis was used to calculate the mean shape of the TV leaflets, their principal modes of variation, and to characterize associations of TV leaflet shape to TR.

Results:

In univariate modeling, patients with moderate or greater TR had larger TV annular diameters and area, greater annular distance between the anteroseptal commissure and anteroposterior commissure, greater leaflet billow volume, and more laterally directed anterior papillary muscle angles compared to valves with mild or less TR (all
P
<0.001). In multivariate modeling greater total billow volume, lower anterior papillary muscle angle, and greater distance between the anteroposterior commissure and anteroseptal commissure were associated with moderate or greater TR (
P
<0.001, C statistic=0.85). Larger right ventricle volumes were associated with moderate or greater TR (
P
<0.001). TV shape analysis revealed structural features associated with TR, but also highly heterogeneous TV leaflet structure.

Conclusions:
Moderate or greater TR in patients with hypoplastic left heart syndrome with a Fontan circulation is associated with greater leaflet billow volume, a more laterally directed anterior papillary muscle angle, and greater annular distance between the anteroseptal commissure and anteroposterior commissure. However, there is significant heterogeneity of structure in the TV leaflets in regurgitant valves. Given this variability, an image-informed patient-specific approach to surgical planning may be needed to achieve optimal outcomes in this vulnerable and challenging population.
Long-Term Prognosis of Patients With Coexisting Obesity and Malnutrition After Acute Myocardial Infarction: A Cohort Study
Authors: Kong Gwyneth , Zhang Audrey , Chong Bryan , Lim Jieyu , Kannan Shankar , Han Chin Yip , Ng Cheng Han , Lin Chaoxing , Khoo Chin Meng , Muthiah Mark , Dalakoti Mayank , Kristanto William , Wang Yibin , Kong William , Poh Kian Keong , Chai Ping , Foo Roger , Chan Mark Yan-Yee , Loh Poay-Huan , Chew Nicholas W.S. 
Published: March 2023

Background:
The double burden of malnutrition, described as the coexistence of malnutrition and obesity, is a growing global health issue. This study examines the combined effects of obesity and malnutrition on patients with acute myocardial infarction (AMI).

Methods:

Patients presenting with AMI to a percutaneous coronary intervention-capable hospital in Singapore between January 2014 and March 2021 were retrospectively studied. Patients were stratified into the following: (1) nourished nonobese, (2) malnourished nonobese, (3) nourished obese, and (4) malnourished obese. Obesity and malnutrition were defined according to the World Health Organization definition (body mass index ≥27.5 kg/m
2
) and Controlling Nutritional Status score, respectively. The primary outcome was all-cause mortality. The association between combined obesity and nutritional status with mortality was examined using Cox regression, adjusted for age, sex, AMI type, previous AMI, ejection fraction, and chronic kidney disease. Kaplan-Meier curves for all-cause mortality were constructed.

Results:

The study included 1829 AMI patients, of which 75.7% were male and mean age was 66 years. Over 75% of patients were malnourished. Majority were malnourished nonobese (57.7%), followed by malnourished obese (18.8%), nourished nonobese (16.9%), and nourished obese (6.6%). Malnourished nonobese had highest all-cause mortality (38.6%), followed by the malnourished obese (35.8%), nourished nonobese (21.4%), and nourished obese (9.9%,
P
<0.001). Kaplan-Meier curves demonstrated least favorable survival in malnourished nonobese group, followed by malnourished obese, nourished nonobese, and nourished obese. With nourished nonobese group as the reference, malnourished nonobese had higher all-cause mortality (hazard ratio, 1.46 [95% CI, 1.10–1.96],
P
=0.010), but only a nonsignificant increase in mortality was observed in the malnourished obese (hazard ratio, 1.31 [95% CI, 0.94–1.83],
P
=0.112).

Conclusions:
Among AMI patients, malnutrition is prevalent even in the obese. Compared to nourished patients, malnourished AMI patients have a more unfavorable prognosis especially in those with severe malnutrition regardless of obesity status, but long-term survival is the most favorable among nourished obese patients.
Cost-Effectiveness of Smoking Cessation Interventions in Patients With Ischemic Stroke and Transient Ischemic Attack
Authors: Wechsler Paul M. , Liberman Ava L. , Restifo Daniel , Abramson Erika L. , Navi Babak B. , Kamel Hooman , Parikh Neal S. 
Published: March 2023

Background:
Smoking cessation rates after stroke and transient ischemic attack are suboptimal, and smoking cessation interventions are underutilized. We performed a cost-effectiveness analysis of smoking cessation interventions in this population.

Methods:
We constructed a decision tree and used Markov models that aimed to assess the cost-effectiveness of varenicline, any pharmacotherapy with intensive counseling, and monetary incentives, compared with brief counseling alone in the secondary stroke prevention setting. Payer and societal costs of interventions and outcomes were modeled. The outcomes were recurrent stroke, myocardial infarction, and death using a lifetime horizon. Estimates and variance for the base case (35% cessation), costs and effectiveness of interventions, and outcome rates were imputed from the stroke literature. We calculated incremental cost-effectiveness ratios and incremental net monetary benefits. An intervention was considered cost-effective if the incremental cost-effectiveness ratio was less than the willingness-to-pay threshold of $100 000 per quality-adjusted life-year (QALY) or when the incremental net monetary benefit was positive. Probabilistic Monte Carlo simulations modeled the impact of parameter uncertainty.

Results:
From the payer perspective, varenicline and pharmacotherapy with intensive counseling were associated with more QALYs (0.67 and 1.00, respectively) at less total lifetime costs compared with brief counseling alone. Monetary incentives were associated with 0.71 more QALYs at an additional cost of $120 compared with brief counseling alone, yielding an incremental cost-effectiveness ratio of $168/QALY. From the societal perspective, all 3 interventions provided more QALYs at less total costs compared with brief counseling alone. In 10 000 Monte Carlo simulations, all 3 smoking cessation interventions were cost-effective in >89% of runs.

Conclusions:
For secondary stroke prevention, it is cost-effective and potentially cost-saving to deliver smoking cessation therapy beyond brief counseling alone.
Use of modified ichip for the cultivation of thermo-tolerant microorganisms from the hot spring
Authors: Zhao Juntian , Shakir Yasmeen , Deng Yulin , Zhang Ying 
Published: March 2023

Abstract
Background
Thermostable microorganisms are extremophiles. They have a special genetic background and metabolic pathway and can produce a variety of enzymes and other active substances with special functions. Most thermo-tolerant microorganisms from environmental samples have resisted cultivation on artificial growth media. Therefore, it is of great significance to isolate more thermo-tolerant microorganisms and study their characteristics to explore the origin of life and exploit more thermo-tolerant enzymes. Tengchong hot spring in Yunnan contains a lot of thermo-tolerant microbial resources because of its perennial high temperature. The ichip method was developed by D. Nichols in 2010 and can be used to isolate so-called “uncultivable” microorganisms from different environments. Here, we describe the first application of modified ichip to isolate thermo-tolerant bacteria from hot springs.

Results
In this study, 133 strains of bacteria belonging to 19 genera were obtained. 107 strains of bacteria in 17 genera were isolated by modified ichip, and 26 strains of bacteria in 6 genera were isolated by direct plating methods. 25 strains are previously uncultured, 20 of which can only be cultivated after being domesticated by ichip. Two strains of previously unculturable Lysobacter sp., which can withstand 85 °C, were isolated for the first time. Alkalihalobacillus, Lysobacter and Agromyces genera were first found to have 85 °C tolerance.

Conclusion
Our results indicate that the modified ichip approach can be successfully applied in a hot spring environment.
Can mixed reality technologies teach surgical skills better than traditional methods? A prospective randomised feasibility study
Authors: Guha Payal , Lawson Jason , Minty Iona , Kinross James , Martin Guy 
Published: March 2023

Abstract
Background
Basic surgical skills teaching is often delivered with didactic audio-visual content, and new digital technologies may allow more engaging and effective ways of teaching to be developed. The Microsoft HoloLens 2 (HL2) is a multi-functional mixed reality headset. This prospective feasibility study sought to assess the device as a tool for enhancing technical surgical skills training.

Methods
A prospective randomised feasibility study was conducted. 36 novice medical students were trained to perform a basic arteriotomy and closure using a synthetic model. Participants were randomised to receive a structured surgical skills tutorial via a bespoke mixed reality HL2 tutorial (n = 18), or via a standard video-based tutorial (n = 18). Proficiency scores were assessed by blinded examiners using a validated objective scoring system and participant feedback collected.

Results
The HL2 group showed significantly greater improvement in overall technical proficiency compared to the video group (10.1 vs. 6.89, p = 0.0076), and a greater consistency in skill progression with a significantly narrower range of scores (SD 2.48 vs. 4.03, p = 0.026). Participant feedback showed the HL2 technology to be more interactive and engaging with minimal device related problems experienced.

Conclusions
This study has demonstrated that mixed reality technology may provide a higher quality educational experience, improved skill progression and greater consistency in learning when compared to traditional teaching methodologies for basic surgical skills. Further work is required to refine, translate, and evaluate the scalability and applicability of the technology across a broad range of skills-based disciplines.
The determinants of expert opinion in the development of care pathways: insights from an exploratory cluster analysis
Authors: Ratti Matteo , Milicia Osvaldo , Rescinito Riccardo , Coeckelberghs Ellen , Seys Deborah , Vanhaecht Kris , Panella Massimiliano 
Published: March 2023

Abstract
Background
We performed a secondary exploratory cluster analysis on the data collected from the validation phase of the study leading to the development of the model care pathway (CP) for Myasthenia Gravis (MG), in which a panel of 85 international experts were asked some characteristics about themselves and their opinion about the model CP. Our aim was to identify which characteristics of the experts play a role in the genesis of their opinion.

Methods
We extracted the questions probing an opinion and those describing a characteristic of the expert from the original questionnaire. We performed a multiple correspondence analysis (MCA) and a subsequent hierarchical clustering on principal component (HCPC) on the opinion variables, integrating the characteristic variables as supplementary (predicted).

Results
After reducing the dimensionality of the questionnaire to three dimensions we noticed that the not-appropriateness judgement of the clinical activities may overlap with the completeness one. From the HCPC it seems that the working setting of the expert may play a crucial role in determining the opinion about the setting of the sub-processes of MG: shifting from a cluster where the experts do not work in sub-specialist settings to one where the experts are working in them, the opinion changes accordingly from a mono-disciplinary setting to a multi-disciplinary one. Another interesting result is that the experience in neuromuscular diseases (NMD) measured in years and the expert typology (whether general neurologist or NMD expert) seem not to contribute significantly to the opinions.

Conclusions
These findings might indicate a poor ability of the expert to discriminate what is not appropriate from what is not complete. Also, the opinion of the expert might be influenced by the working setting, but not by the experience in NMD (as measured in years).