bluuebunny/crossref_metadata_2025 huggingface dataset:
Paracetamol versus other analgesia in adult patients with minor musculoskeletal injuries: a systematic review
Authors: Ridderikhof Milan L , Saanen Joppe , Goddijn Helma , Van Dieren Susan , Van Etten-Jamaludin Faridi , Lirk Philipp , Goslings J Carel , Hollmann Markus W
Published: June 2019

Objectives

Pain treatment in acute musculoskeletal injuries usually consists of paracetamol, non-steroidal antiinflammatory drugs (NSAIDs) or opioids. It would be beneficial to determine whether paracetamol is as effective as other analgesics. The objective of this study was to evaluate available evidence regarding efficacy of paracetamol in these patients.

Methods

Embase, MEDLINE, Cochrane and relevant trial registers were searched from inception to 14 February 2018 by two independent reviewers to detect all randomised studies with adult patients with acute minor musculoskeletal injuries treated with paracetamol as compared with other analgesics. There were no language or date restrictions. Two independent reviewers evaluated risk of bias and quality of evidence. Primary outcome was decrease in pain scores during the first 24 hours, and secondary outcomes included pain decrease beyond 24 hours, need for additional analgesia and occurrence of adverse events.

Results

Seven trials were included, evaluating 2100 patients who were treated with paracetamol or NSAIDs or the combination of both as comparisons, of which only four studies addressed the primary outcome. No studies were found comparing paracetamol with opioids. There were no differences in analgesic effectiveness within and beyond 24 hours, nor in need for additional analgesia and occurrence of adverse events. Overall, quality of evidence was low. Because of methodological inconsistencies, a meta-analysis was not possible.

Conclusions

Based on available evidence, paracetamol is as effective as NSAIDs or the combination of both in treating pain in adult patients with minor musculoskeletal injuries in the acute setting. The quality of evidence is low.
Prevention of recurrent idiopathic gastroduodenal ulcer bleeding: a double-blind, randomised trial
Authors: Wong Grace L H , Lau Louis H S , Ching Jessica Y L , Tse Yee-Kit , Ling Rachel H Y , Wong Vincent W S , Chiu Philip W Y , Lau James Y W , Chan Francis K L
Published: June 2019

Objective

Patients with a history ofHelicobacter pylori-negative idiopathic bleeding ulcers have a considerable risk of recurrent ulcer complications. We hypothesised that a proton pump inhibitor (lansoprazole) is superior to a histamine 2 receptor antagonist (famotidine) for the prevention of recurrent ulcer bleeding in such patients.

Design

In this industry-independent, double-blind, randomised trial, we recruited patients with a history of idiopathic bleeding ulcers. After ulcer healing, we randomly assigned (1:1) patients to receive oral lansoprazole 30 mg or famotidine 40 mg daily for 24 months. The primary endpoint was recurrent upper GI bleeding within 24 months, analysed in the intention-to-treat population as determined by an independent adjudication committee.

Results

Between 2010 and 2018, we enrolled 228 patients (114 patients in each study group). Recurrent upper GI bleeding occurred in one patient receiving lansoprazole (duodenal ulcer) and three receiving famotidine (two gastric ulcers and one duodenal ulcer). The cumulative incidence of recurrent upper GI bleeding in 24 months was 0.88% (95% CI 0.08% to 4.37%) in the lansoprazole arm and 2.63% (95% CI 0.71% to 6.91%) in the famotidine arm (p=0.313; crude HR 0.33, 95% CI 0.03 to 3.16, p=0.336). None of the patients who rebled used aspirin, non-steroidal anti-inflammatory drugs or other antithrombotic drugs.

Conclusion

This 2-year, double-blind randomised trial showed that among patients with a history ofH. pylori-negative idiopathic ulcer bleeding, recurrent bleeding rates were comparable between users of lansoprazole and famotidine, although a small difference in efficacy cannot be excluded.

Trial registration number

NCT01180179; Results.
The influence of frailty under direct oral anticoagulant use in patients with atrial fibrillation
Authors: Yamamoto Takashi , Yamashita Kentaro , Miyamae Kiichi , Koyama Yuichiro , Izumimoto Masataka , Kamimura Yoshihiro , Hayakawa Satoko , Mori Kazutaka , Yamada Takaaki , Tomita Yasushi , Murohara Toyoaki
Published: June 2019

Background

Frailty is a prognostic factor in patients with atrial fibrillation (AF). However, there is no report on the associations between frailty and clinical adverse events in patients with AF taking direct oral anticoagulants (DOAC). The factors related to the occurrence of clinical adverse events are still under discussion. Therefore, we examined the associations between frailty and clinical adverse events in patients with AF taking DOAC in daily clinical practice.

Methods

We retrospectively evaluated 240 consecutive patients with AF who had been newly prescribed DOAC in our hospital from April 2016 through May 2017. Data collected included Clinical Frailty Scale (CFS) scores, laboratory results and basic demographic information.

Results

During the mean follow-up period of 13.4 months, 20 patients died (7.6 per 100 person-years), stroke or systemic embolism occurred in seven patients (2.6 per 100 person-years) and major bleeding occurred in 11 patients (4.2 per 100 person-years). We defined these adverse events as composite end points, and we estimated adjusted HRs and 95% CIs for risk factors using the Cox proportional hazard regression model. Frailty (defined as a CFS score of 5 or more; HR: 3.71; 95% CI: 1.59 to 8.65), female sex (HR: 3.49; 95% CI: 1.73 to 7.07), serum albumin level (HR: 0.47; 95% CI: 0.28 to 0.79) and malignancy (HR: 4.02; 95% CI: 1.83 to 8.84) were independent predictors of the composite end points.

Conclusions

Frailty, female sex, hypoalbuminaemia and malignancy were associated with clinical adverse events in patients with AF who were prescribed DOAC.
Hospital safety net burden is associated with increased inpatient mortality and postoperative morbidity after total hip arthroplasty: a retrospective multistate review, 2007–2014
Authors: La Melvin , Tangel Virginia , Gupta Soham , Tedore Tiffany , White Robert S
Published: June 2019

Background

Total hip arthroplasty (THA) is one of the most widely performed surgical procedures in the USA. Safety net hospitals, defined as hospitals with a high proportion of cases billed to Medicaid or without insurance, deliver a significant portion of their care to vulnerable populations, but little is known about the effects of a hospital’s safety net burden and its role in healthcare disparities and outcomes following THA. We quantified safety net burden and examined its impact on in-hospital mortality, complications and length of stay (LOS) in patients who underwent THA.

Methods

We analyzed 500 189 patient discharge records for inpatient primary THA using data from the Healthcare Cost and Utilization Project’s State Inpatient Databases for California, Florida, New York, Maryland and Kentucky from 2007 to 2014. We compared patient demographics, present-on-admission comorbidities and hospital characteristics by hospital safety net burden status. We estimated mixed-effect generalized linear models to assess hospital safety burden status’ effect on in-hospital mortality, patient complications and LOS.

Results

Patients undergoing THA at a hospital with a high or medium safety net burden were 38% and 30% more likely, respectively, to die in-hospital compared with those in a low safety net burden hospital (high adjusted OR: 1.38, 95% CI 1.10 to 1.73; medium adjusted OR: 1.30, 95% CI 1.07 to 1.57). Compared with patients treated in hospitals with a low safety net burden, patients treated in high safety net hospitals were more likely to develop a postoperative complication (adjusted OR: 1.11, 95% CI 1.00 to 1.24) and require a longer LOS (adjusted IRR: 1.06, 95% CI 1.05, 1.07).

Conclusions

Our study supports our hypothesis that patients who underwent THA at hospitals with higher safety net burden have poorer outcomes than patients at hospitals with lower safety net burden.
Public Service Motivation, Personality, and the Hiring Decisions of Public Managers: An Experimental Study
Authors: Bromberg Daniel E. , Charbonneau Étienne
Published: June 2019

One of the main practical recommendations from the copious public service motivation literature is that human resources (HR) professionals should use public service motivation (PSM) to assist in selecting candidates for public service jobs. To test if PSM is indeed attractive to HR professionals in selecting applicants to work in the public sector, 238 HR managers recruited from the International Public Management Association for Human Resources rated three cover letters and then rated themselves about PSM and the Big 5 personality traits. The cover letters were randomized on most likely combinations of PSM and Big 5, revealed in earlier research. Our results are that real HR professionals did not rate cover letters more highly when they displayed aspects of PSM.
Low Health Literacy Is Associated With Risk of Developing Type 2 Diabetes in a Nonclinical Population
Authors: O’Meara Lydia , Williams Susan L. , Ames Kate , Lawson Celeste , Saluja Sonia , Vandelanotte Corneel
Published: June 2019

Purpose

The purpose of this study was to examine associations among risk of type 2 diabetes (T2D), health literacy levels, and sociodemographic characteristics in a nonclinical adult population to assist in the development of effective T2D prevention programs.

Methods

The Health Literacy Questionnaire and Australian Type 2 Diabetes Risk Assessment Tool were included in an online survey. Participants were a random sample of adults residing in each Australian state and territory. Data were analyzed with descriptive statistics and multinomial logistic regression.

Results

A total of 1279 Australian adults participated (52% female; mean ± SD age, 61 ± 12 years). Most were at medium (42.4%) or high (46.9%) risk of developing T2D. The lowest health literacy scores were found for the domains “critical appraisal of health information” and “navigating the health care system.” After controlling for covariates, participants at the highest risk of developing T2D were significantly more likely to be unemployed, have ≥1 chronic conditions, or have a mental health condition. Furthermore, they were significantly more likely to develop T2D if they scored low in 1 of the following health literacy domains: critical appraisal of health information, navigating the health care system, actively managing health, social support, and health care provider support.

Conclusions

Health literacy was associated with increased risk for developing T2D and should therefore be part of diabetes prevention initiatives. Specifically, new health promotion initiatives need to help people develop skills required to critically appraise health information and navigate the health care system. Health practitioners and educators should ensure that health information developed for consumers is uncomplicated and easily understood.
Using a Nonverbal Cognitive Abilities Screening Test in Identifying Gifted and Talented Young Children in Jordan: A Focus Group Discussion of Teachers
Authors: Alodat Ali M. , Zumberg Marshall F.
Published: June 2019

This qualitative study aimed to discover teachers’ perceptions about the effectiveness of using the nonverbal Cognitive Abilities Screening Test (CogAT) in identifying gifted and talented children. The study’s sample of six teachers participated in standardizing the Jordanian version of the CogAT. Teachers attended a focus group discussion, and they were asked to discuss four open-ended questions. The focus group discussion results indicated strong agreement by teachers of the effectiveness of using the Arabic Jordanian version of CogAT. Specifically, teachers expressed their satisfaction about the test items and guidelines. Moreover, they unanimously agreed that the test is appropriate to use in Jordan. Also, teachers provided many positive comments and feedback about the ability of this test to identify young gifted children. Finally, teachers described the reality of gifted education services in Jordan.
How Do Older Adults Consider Age, Life Expectancy, Quality of Life, and Physician Recommendations When Making Cancer Screening Decisions? Results from a National Survey Using a Discrete Choice Experiment
Authors: Janssen Ellen M. , Pollack Craig E. , Boyd Cynthia , Bridges John F. P. , Xue Qian-Li , Wolff Antonio C. , Schoenborn Nancy L.
Published: June 2019

Background. Older adults with limited life expectancy frequently receive cancer screening, although on average, harms outweigh benefits. We examined the influence of life expectancy on older adults’ cancer screening decisions relative to three other factors. Methods. Adults aged 65+ years ( N = 1272) were recruited from a national online survey panel. Using a discrete choice experiment, we systematically varied a hypothetical patient’s life expectancy, age, quality of life, and physician’s recommendation and asked whether the participant would choose screening. Participants were randomized to questions about colonoscopy or prostate-specific antigen/mammography screenings. Logistic regression produced preference weights that quantified the relative influence of the 4 factors on screening decisions. Results. 879 older adults completed the survey, 660 of whom varied their screening choices in response to the 4 factors we tested. The age of the hypothetical patient had the largest influence on choosing screening: the effect of age being 65 versus 85 years had a preference weight of 2.44 (95% confidence interval [CI]: 2.22, 2.65). Life expectancy (10 versus 1 year) had the second largest influence (preference weight: 1.64, CI: 1.41, 1.87). Physician recommendation (screen versus do not screen) and quality of life (good versus poor) were less influential, with preference weights of 0.90 (CI: 0.72, 1.08) and 0.68 (CI: 0.52, 0.83), respectively. Conclusions. While clinical practice guidelines increasingly use life expectancy in addition to age to guide screening decisions, we find that age is the most influential factor, independent of life expectancy, quality of life, and physician recommendation, in older adults’ cancer screening choices. Strategies to reduce overscreening should consider the importance patients give to continuing screening at younger ages, even when life expectancy is limited.
Estimate Sentiment of Crowds from Social Media during City Events
Authors: Gong Vincent X. , Daamen Winnie , Bozzon Alessandro , Hoogendoorn Serge P.
Published: June 2019

City events are being organized more frequently, and with larger crowds, in urban areas. There is an increased need for novel methods and tools that can provide information on the sentiments of crowds as an input for crowd management. Previous work has explored sentiment analysis and a large number of methods have been proposed relating to various contexts. None of them, however, aimed at deriving the sentiments of crowds using social media in city events, and no existing event-based dataset is available for such studies. This paper investigates how social media can be used to estimate the sentiments of crowds in city events. First, some lexicon-based and machine learning-based methods were selected to perform sentiment analyses, then an event-based sentiment annotated dataset was constructed. The performance of the selected methods was trained and tested in an experiment using common and event-based datasets. Results show that the machine learning method LinearSVC achieves the lowest estimation error for sentiment analysis on social media in city events. The proposed event-based dataset is essential for training methods to reduce estimation error in such contexts.
Co-continuous hollow glass microspheres/epoxy resin syntactic foam prepared by vacuum resin transfer molding
Authors: Ding Junjie , Ye Feng , Liu Qiang , Yang Chunping , Gao Ye , Zhang Biao
Published: June 2019

It is generally accepted that matrix pores in the hollow glass microspheres (HGMs)/resin-based composites prepared using stir-casting method (SCM) seriously affect its performance. In this paper, HGMs preforms were prepared using sintering method, and co-continuous HGMs/epoxy resin syntactic foams were prepared using vacuum resin transfer molding (VARTM) method. In order to compare how preparation method affects properties of the composites, the same volume fraction of HGMs filled epoxy resin composites was prepared by SCM. The effects of preparation methods on microstructure, density, compression properties and water absorption of composites were investigated. Compression deformation mechanism of the composites prepared by two methods is discussed. Syntactic foam with the same HGMs volume fraction contained different porosity depending on the preparation method. Porosity of the matrix in the composite prepared using SCM was ∼10 vol.%, while the densities of composites prepared by VARTM were close to the theoretical density, indicating no matrix pores. Co-continuous HGMs/epoxy resin syntactic foams prepared using VARTM showed properties superior to syntactic foams prepared by SCM: compressive strength increase by 45.31%, compressive modulus increase by 37.63%, and water absorption decrease by 69.91%. All these properties improved mainly because of the elimination of the matrix pores.
Chicanas/Latinas Advance Intersectional Thought and Practice
Authors: Baca Zinn Maxine , Zambrana Ruth Enid
Published: June 2019

Despite the considerable body of scholarship and practice on interconnected systems of dominance and its effects on women in different social locations, Chicanas remain “outside the frame” of mainstream academic feminist dialogues. This article provides an overview of the contributions of Chicana intersectional thought, research, and activism. We highlight four major scholarly areas of contribution: borders, identities, institutional inequalities, and praxis. Although not a full mapping of the Chicana/Latina presence in intersectionality, it proffers the distinctive features and themes defining the intersectional terrain of Chicana feminism.
Electricity conservation opportunities within private university campuses in Bangladesh
Authors: Murshed Muntasir
Published: June 2019

The mushroom growth of universities in the developing economies, in particular, is believed to be a key contributor to the relentless aggravation in the overall demand for electricity. Moreover, the large university campuses are often compared to cities whereby the associated electricity-consumption within these campuses are also referred to account for a bulk of the total urban electricity consumption. Thus, conservation of electricity within the campus has become a core agenda of universities in quest of ensuring respective campus sustainability. Against this backdrop, this paper aims to highlight and recommend the cost-effective and best-practiced techniques applied to conserve electricity within the private universities in Bangladesh. As part of the methodology, a cost–benefit analysis of electricity conservation is put forward in the context of a case study of the North South University, the largest private university in Bangladesh. The results from the analyses imply that proper implementation of the electricity conservation and efficiency enhancement techniques within the campus can effectively cut down the total electricity bills by almost one-third and simultaneously account for a 5% reduction in the total electricity demand within the campus.
Giovanni Rajberti (1805–1861): An uncompromising physician and poet
Authors: Petria Iulia , Cesana Giancarlo , Riva Michele A
Published: June 2019

The aim of this paper is to describe the figure of the Italian uncompromising physician and poet Giovanni Rajberti (1805–1861), who was a strenuous opponent of non-scientific medical practices in Italy, including Animal Magnetism, Homeopathy and Hydropathy. In particular, he demonstrated the inconsistency of mesmerist practices in an exemplary yet less-known episode that involved the famous French writer Honoré de Balzac (1799–1850). Although his ideas hindered his career, Rajberti continued to criticize alternative practices, sustaining the value of true medicine and science against charlatans.
Sodium-Glucose Cotransporters as Potential Therapeutic Targets in Patients With Type 1 Diabetes Mellitus: An Update on Phase 3 Clinical Trial Data
Authors: Patel Kajal , Carbone Antonia
Published: June 2019

Objective: To review phase 3 trials of sodium-glucose cotransporter (SGLT) inhibitors in type 1 diabetes mellitus (T1DM) patients. Data Sources: A literature search of Ovid MEDLINE databases (1946 through May 17, 2019) limited to English-language human clinical trials was conducted using the following terms: sodium-glucose transporter 2 inhibitors, canagliflozin, dapagliflozin, empagliflozin, sotagliflozin, ertugliflozin, ipragliflozin, or remogliflozin combined with type 1 diabetes mellitus. Results were verified via Google Scholar and clinicaltrials.gov. Study Selection and Data Extraction: Articles were included if they were phase 3 trials in adults with T1DM. Data Synthesis: Phase 3 trials are available for dapagliflozin, empagliflozin, and sotagliflozin. All 3 drugs demonstrated statistically significant reductions in hemoglobin A1C, weight, and total daily insulin dose without an increased risk of hypoglycemia in up to 52 weeks of therapy. The incidence of diabetic ketoacidosis (DKA) was higher in patients on a SGLT inhibitor at all doses, with the exception of empagliflozin 2.5 mg (0.8% vs 1.2% with placebo). Relevance to Patient Care and Clinical Practice: SGLT inhibitors are potential adjuncts to insulin in T1DM patients, providing clinically meaningful benefits. Regulatory bodies have either approved or are reviewing these agents for use in T1DM. Clinicians should be familiar with the DKA risk associated with SGLT inhibitors and utilize DKA risk-mitigation strategies. Empagliflozin 2.5 mg warrants additional investigation given its efficacy without an increased incidence of DKA. Conclusions: Phase 3 trial data of SGLT inhibitors provide evidence for sustained efficacy in T1DM patients. Appropriate patient selection for therapy and routine monitoring are essential to minimize associated risks.
Association of Hospital Characteristics With Early SEP-1 Performance
Authors: Liao Jeff , Aaronson Emily , Kim Jungyeon , Liu Xiu , Snydeman Colleen , Goldfarb Ilona , Black Lauren , Filbin Michael , Phillips Michael T. , Mort Elizabeth , Lee Jarone
Published: June 2019

A variety of hospital characteristics, including teaching status, ownership, location, and size, have been shown to be associated with quality measure performance. The association of hospital characteristics, including teaching intensity, with performance on the Centers for Medicare & Medicaid Services (CMS) SEP-1 sepsis measure has not been well studied. Utilizing a statewide, all-payer database and the CMS Hospital Compare database, this study investigated the association of various hospital characteristics with early SEP-1 performance in 48 acute hospitals in Massachusetts. Hospital teaching intensity and Magnet designation did not have a statistically significant association with SEP-1 performance in multivariable linear modeling. However, SEP-1 performance was higher in smaller, for-profit hospitals with higher case mix index. This finding suggests that emergency department activity, hospital ownership, and patient complexity should be studied further across a larger geographic spectrum and longitudinally as hospitals implement efforts to reduce morbidity associated with sepsis.
Mathematical and experimental analysis of the thermal effectiveness of an oscillating jet with side-to-side swing louvers in a cassette split type air conditioner
Authors: Fan Yunqing
Published: June 2019

The impact of air supply control strategies (louvers movement) on indoor thermal environment were evaluated in this study. The temperature uniformity was evaluated by: (i) the air distribution performance index (ADPI) to determine the air diffusion performance in heating mode; (ii) the air draught rate (DR%) on the face to determine the local discomfort due to cold draught; (iii) the mathematically determined vertical temperature stratification in a room with Beta distributions. A comparison of the conventional type with three different oscillating type airflows (louvers swing angle ±20°, ±40° and ±60°) were experimentally analysed to determine appropriate air supply control strategies. The results indicated that Beta distributions could capture the overall trend of the oscillating airflow, to establish the acceptable thermal uniformity and higher thermal effectiveness. The oscillating airflow as generated by the side-to-side swing type delivery louvers mounted inside a cassette split type air conditioner could shorten heating time by 20% to attain room temperature from 9°C. The data reveal that oscillating airflow can provide a better thermal sensation to feeling warm in the heating mode at both ankle and neck level. The ADPI is approximately 85% in the occupied zone. The actual draught rates on the face ranged 0–35%.
Multizone modelling of a hybrid ventilated high-rise building based on full-scale measurements for predictive control
Authors: Qi Dahai , Cheng Jun , Katal Ali , Wang Liangzhu (Leon) , Athienitis Andreas
Published: June 2019

Hybrid ventilation is an effective approach to reduce cooling energy consumption by combining natural and mechanical ventilation. Previous studies of full-scale whole-building measurements of high-rise hybrid ventilation are quite limited due to the complexities of buildings and variable ambient conditions. As a result, validated and accurate whole-building simulations of hybrid ventilation often cannot be found in the literature. This paper reports a series of full-scale measurements of hybrid ventilation in a 17-storey high-rise building and associated whole-building simulations by 15-zone detailed and a 5-zone simplified multizone models. The paper is one of the first studies of using multizone models and real-world full-scale data and sharing key operational and performance experience and case studies of high-rise hybrid ventilation. Both the test data and the validated simulation models can be used for the comparison and validation of simulation models. The 5-zone simplified model developed from this study was able to model such a complex high-rise building by only a few zones, making possible the on-line model predictive control of a high-rise building. This was illustrated in this paper by an example of optimizing the uniformity of the hybrid ventilation on different floors by modifying inlet areas.
Contribution of videothoracoscopy in the management of thoracic wounds with diaphragmatic lesions: A single African center experience
Authors: Rabiou Sani , Harmouchi Hicham , Lakranbi Marouane , Rachid Sani , Ouadnouni Yassine , Smahi Mohamed
Published: June 2019

Background and aims

The management of thoracic wounds induced by sharp objects outside an extreme emergency remains controversial. The means vary from exploratory thoracotomy to simple monitoring. Between these two extremes, videothoracoscopy as a means of exploration plays an important role and helps to avoid unnecessary thoracotomies, thus making it possible to make early diagnosis of diaphragmatic lesions. The aim of this study was to report our experience in videothoracoscopic management of thoracic wounds by penetrating objects.

Material and methods

From January 2010 to December 2015, 58 patients with an average age 22.5 years with a thoracic stab wound with a stable hemodynamic condition underwent videothoracoscopy.

Results

Thoracoscopy revealed a diaphragmatic injury in 17 patients, cardiac or pericardial wounds in four and a haemorrhagic pulmonary injury in 1; all were treated at video-assisted mini-thoracotomy. In the other 36 patients, videothoracoscopic exploration did not demonstrate any intra-thoracic lesion and the procedure consisted of aspiration of a residual hemothorax with the installation of a good view-controlled thoracic drainage. Hospital stay was between 48 and 72 h.

Conclusion

Videothoracoscopy is a safe and effective way to explore the thoracic cavity in patients with chest wounds with suspected diaphragmatic lesions. It avoids thoracotomy especially in hemodynamically stable patients.
Investigation into attitudes towards older people with dementia in acute hospital using the Approaches to Dementia Questionnaire
Authors: de Vries Kay , Drury-Ruddlesden Jenny , McGill George
Published: June 2019

Background

Health care professionals have poor recognition of cognitive impairment among older patients and often have difficulties in providing care for people with dementia in acute hospitals. There are also reported high levels of stigma and negative staff attitudes towards people with dementia.

Methodology

A one-time survey of staff working on acute medical and orthopaedic wards of five District Health Boards in New Zealand using the ‘Approaches to Dementia Questionnaire’; a 19-item Questionnaire that aims to capture two attitudinal domains (Hope and Person-Centredness), towards people with dementia. A total of 563 questionnaires were distributed. Data were analysed using R.

Results

Three hundred and four (53.99%) respondents completed the survey. Ninety-four of the respondents (31.1%) were aged 51 years or older, and nearly all (88.4%) were women. One hundred and sixty-four of the respondents (53.9%) were registered nurses, 10 were student nurses (3.3%), 24 (7.9%) were healthcare assistants, 70 (23.0%) were allied health professionals, 27 (8.9%) were doctors and 9 (3%) were pharmacists. The mean total score of 72.7 reflected positive attitudes overall on the part of the respondents. Allied health professionals, student nurses and pharmacists had high scores on both scales whilst healthcare assistants scored lowest on both scales.

Conclusion

Overall, the Approaches to Dementia Questionnaire is a useful measure, but it can be difficult to differentiate between genuine attitudinal differences and confounding influences such as level of knowledge and education amongst such a diverse group of participants. Differences between staff may be considered as a reflection of the high level of direct care that is expected of some staff and not of others. Further, the Approaches to Dementia Questionnaire may not be the most appropriate measure to accurately understand attitudes to dementia care in acute environments; and that it more usefully reveals knowledge about dementia rather than attitudes related to real-time practice.
The autonomy of the political and the challenge of social sciences
Authors: Tsarapatsanis Dimitrios
Published: June 2019

In 2010, Martin Loughlin published his opus magnum Foundations of Public Law, the culmination of years of intensive research on the topics of public law and constitutional theory. In Questioning the Foundations of Public Law, Michael Wilkinson and Michael Dowdle put together a rich collection of papers that probe deeply into various facets of Loughlin’s work. In this review article, I critically examine an aspect of this probing, articulated by Wilkinson, to do with the autonomy of the political as the basis of political jurisprudence. I argue that both the probing and Loughlin’s response articulate horns of a dilemma that points to a deeper issue: the epistemological repercussions of the rise of the social sciences as forms of distinctively modern inquiry into the causes of social phenomena, where these include phenomena such as the autonomy of political power in modern states.
Navigating Terminology and Promoting Evidence-Based Practice for Child Language Disorders: Challenges and Solutions for Educators
Authors: Victorino Kristen R. , Magaldi Nicole M.
Published: June 2019

Diagnostic labels for children with primary, or otherwise unexplained, language disorders range across settings and within the scientific literature. Among other problems, this lack of agreement creates difficulty with the successful employment of evidence-based practice. This article reviews the evolving terminology and addresses issues of inconsistency with a particular focus on instructional opportunities for students in Communication Sciences and Disorders (CSD). The pedagogical approach of problem-based learning (PBL) is well suited to this challenge; a structured model for instruction is reviewed and specific guidelines for educators are suggested.
Micro/nano microfiber synthetic leather base with different nanofiber diameters
Authors: Duo Yongchao , Qian Xiaoming , Zhao Baobao , Qian Yao , Xu Ping , Qi Jingjing
Published: June 2019

The microfiber synthetic leather base (MSLB) was prepared by mixing hollow segmented pie microfibers and polyacrylonitrile electrospun nanofibers. Micro/nano hybrid leather base was prepared to simulate the three-dimensional (3D) structure of natural leather. The diameter of the polyacrylonitrile nanofibers was 950 nm, 450 nm and 200 nm, respectively. The effects of nanofibers of different diameters on the performances of MSLB were investigated. The results indicated that polyacrylonitrile nanofibers were randomly dispersed in MSLB. Differential scanning calorimetry further demonstrated the presence of polyacrylonitrile nanofibers in MSLB, and thermogravimetric analysis showed that the addition of polyacrylonitrile nanofibers had a little influence on the thermal stability of MSLB. There was no significant change in the water contact angle of the MSLB surface before and after the addition of nanofibers. As the diameter of the nanofibers decreased from 950 nm to 200 nm, the static water vapor transmission rate was increased by 28.2%, the softness was increased by 39.74%, and air permeability was decreased by 17.16%. When the nanofiber diameter is 950 nm, the moisture absorption performance of MSLB was better, which was 768.99%. Moreover, the tear strength was also significantly enhanced by 105.76%.
The role of spectrin in cell adhesion and cell–cell contact
Authors: Machnicka Beata , Grochowalska Renata , Bogusławska Dżamila M , Sikorski Aleksander F
Published: June 2019

Spectrins are proteins that are responsible for many aspects of cell function and adaptation to changing environments. Primarily the spectrin-based membrane skeleton maintains cell membrane integrity and its mechanical properties, together with the cytoskeletal network a support cell shape. The occurrence of a variety of spectrin isoforms in diverse cellular environments indicates that it is a multifunctional protein involved in numerous physiological pathways. Participation of spectrin in cell–cell and cell–extracellular matrix adhesion and formation of dynamic plasma membrane protrusions and associated signaling events is a subject of interest for researchers in the fields of cell biology and molecular medicine. In this mini-review, we focus on data concerning the role of spectrins in cell surface activities such as adhesion, cell–cell contact, and invadosome formation. We discuss data on different adhesion proteins that directly or indirectly interact with spectrin repeats. New findings support the involvement of spectrin in cell adhesion and spreading, formation of lamellipodia, and also the participation in morphogenetic processes, such as eye development, oogenesis, and angiogenesis. Here, we review the role of spectrin in cell adhesion and cell–cell contact.

Impact statement

This article reviews properties of spectrins as a group of proteins involved in cell surface activities such as, adhesion and cell–cell contact, and their contribution to morphogenesis. We show a new area of research and discuss the involvement of spectrin in regulation of cell–cell contact leading to immunological synapse formation and in shaping synapse architecture during myoblast fusion. Data indicate involvement of spectrins in adhesion and cell–cell or cell–extracellular matrix interactions and therefore in signaling pathways. There is evidence of spectrin’s contribution to the processes of morphogenesis which are connected to its interactions with adhesion molecules, membrane proteins (and perhaps lipids), and actin. Our aim was to highlight the essential role of spectrin in cell–cell contact and cell adhesion.
Low-dose versus standard-dose alteplase in acute ischemic stroke in Asian stroke registries: an individual patient data pooling study
Authors: Wang Xia , Li Jingwei , Moullaali Tom J , Lee Keon-Joo , Kim Beom Joon , Bae Hee-Joon , Wang Anxin , Wang Yilong , Wang David Z , Wang Yongjun , Kumamoto Masaya , Toyoda Kazunori , Koga Masatoshi , Sato Shoichiro , Yoshimura Sohei , Sui Yi , Xu Bing , Xiao Ying , Lee Tsong-Hai , Liou Chia-Wei , Lee Jiann-Der , Peng Tsung-I , Huang Yen-Chu , Paliwal Prakash R , Sharma Manasi , Escabillas Cyrus , Navarro Jose C , Sun Mu-Chien , Dong Yi , Dong Qiang , Anderson Craig S , Sharma Vijay K
Published: June 2019

Objective

To investigate the comparative efficacy and safety of the low-dose versus standard-dose alteplase using real-world acute stroke registry data from Asian countries.

Methods

Individual participant data were obtained from nine acute stroke registries from China, Japan, Philippines, Singapore, South Korea, and Taiwan between 2005 and 2018. Inverse probability of treatment weight was used to remove baseline imbalances between those receiving low-dose versus standard-dose alteplase. The primary outcome was death or disability defined by modified Rankin Scale scores of 2 to 6 at 90 days. Secondary outcomes were symptomatic intracerebral hemorrhage and death. Generalized linear mixed models with the individual registry as a random intercept were performed to determine associations of treatment with low-dose alteplase and outcomes.

Results

Of the 6250 patients (mean age 66 years, 36% women) included in these analyses, 1610 (24%) were treated with low-dose intravenous alteplase. Clinical outcomes for low-dose alteplase were not significantly different to those for standard-dose alteplase, adjusted odds ratios for death or disability: 1.00 (0.85–1.19) and symptomatic intracerebral hemorrhage 0.87 (0.63–1.19), except for lower death with borderline significance, 0.77 (0.59–1.01).

Conclusions

The present analyses of real-world Asian acute stroke registry data suggest that low-dose intravenous alteplase has overall comparable efficacy for functional recovery and greater potential safety in terms of reduced mortality, to standard-dose alteplase for the treatment of acute ischemic stroke.
Dysphagia screening and risks of pneumonia and adverse outcomes after acute stroke: An international multicenter study
Authors: Ouyang Menglu , Boaden Elizabeth , Arima Hisatomi , Lavados Pablo M , Billot Laurent , Hackett Maree L , Olavarría Verónica V , Muñoz-Venturelli Paula , Song Lili , Rogers Kris , Middleton Sandy , Pontes-Neto Octavio M , Lee Tsong-Hai , Watkins Caroline , Robinson Thompson , Anderson Craig S ,   for the HeadPoST Investigators
Published: June 2019

Background

Dysphagia is associated with aspiration pneumonia after stroke. Data are limited on the influences of dysphagia screen and assessment in clinical practice.

Aims

To determine associations between a “brief” screen and “detailed” assessment of dysphagia on clinical outcomes in acute stroke patients.

Methods

A prospective cohort study analyzed retrospectively using data from a multicenter, cluster cross-over, randomized controlled trial (Head Positioning in Acute Stroke Trial [HeadPoST]) from 114 hospitals in nine countries. HeadPoST included 11,093 acute stroke patients randomized to lying-flat or sitting-up head positioning. Herein, we report predefined secondary analyses of the association of dysphagia screening and assessment and clinical outcomes of pneumonia and death or disability (modified Rankin scale 3–6) at 90 days.

Results

Overall, 8784 (79.2%) and 3917 (35.3%) patients were screened and assessed for dysphagia, respectively, but the frequency and timing for each varied widely across regions. Neither use of a screen nor an assessment for dysphagia was associated with the outcomes, but their results were compared to “screen-pass” patients, those who failed had higher risks of pneumonia (adjusted odds ratio [aOR] = 3.00, 95% confidence interval [CI] = 2.18–4.10) and death or disability (aOR = 1.66, 95% CI = 1.41–1.95). Similar results were evidence for the results of an assessment for dysphagia. Subsequent feeding restrictions were related to higher risk of pneumonia in patients failed dysphagia screen or assessment (aOR = 4.06, 95% CI = 1.72–9.54).

Conclusions

Failing a dysphagia screen is associated with increased risks of pneumonia and poor clinical outcome after acute stroke. Further studies concentrate on determining the effective subsequent feeding actions are needed to improve patient outcomes.
Changes in Muscle Morphology Following Gastrocnemius Recession for Achilles Tendinopathy: A Prospective Cohort Imaging Study
Authors: DiLiberto Frank E. , Nawoczenski Deborah A. , Tome Josh , Tan Raymond K. , DiGiovanni Benedict F.
Published: June 2019

Background. The purpose of this study was to evaluate changes in posterior compartment muscle volume and intramuscular fat content following gastrocnemius recession in people with Achilles tendinopathy (AT). Methods. Eight patients diagnosed with unilateral recalcitrant AT and an isolated gastrocnemius contracture participated in this prospective cohort study. Magnetic resonance imaging was performed on both limbs of each participant before and 6 months following an isolated gastrocnemius recession. Involved limb muscle volumes and fat fractions (FFs) of the medial gastrocnemius, lateral gastrocnemius, and soleus muscle were normalized to the uninvolved limb. Preoperative to postoperative comparisons were made with Wilcoxon signed-rank tests. Results. Soleus or lateral gastrocnemius muscle volumes or FFs were not significantly different between study time points. A significant difference was found in medial gastrocnemius muscle volume (decrease; P = .012) and FF (increase; P = .017). Conclusion. A major goal of the Strayer gastrocnemius recession, selective lengthening of the posterior compartment while preserving soleus muscle morphology, was supported. The observed changes isolated to the medial gastrocnemius muscle may reduce ankle plantarflexion torque capacity. Study findings may help inform selection of surgical candidates, refine anticipated outcomes, and better direct postoperative rehabilitation following gastrocnemius recession for AT.

Levels of Evidence: Level IV: Prospective cohort study
In vitro and in vivo Areca catechu crude aqueous extract as an anthelmintic against Ascaridia galli infection in chickens
Authors: Mubarokah Wida Wahidah , Nurcahyo Wisnu , Prastowo Joko , Kurniasih Kurniasih
Published: June 2019

Aim: Intestinal parasites cause severe diseases at poultry farms, especially in developing countries, including Indonesia. Infections cause significant decreases in productivity at poultry farms. Ascaridia galli is a common nematode found in chickens with a prevalence of up to 92%. This study evaluates the in vitro and in vivo effects of Areca catechu crude aqueous extract (AAE) as an anthelmintic against A. galli. Materials and Methods: In the in vitro study, already-infected slaughtered chickens were collected from local slaughterhouses in Yogyakarta. The chicken intestines were carefully examined and transported to the Parasitological Laboratory of Gadjah Mada University, Yogyakarta. A. galli was collected from the intestines and put into a Petri dish containing 0.62% saline solution. Sixty A. galli individuals were soaked in different concentrations of the AAE for 3-6 h. The number of deceased A. galli was recorded by ascertaining whether they had ceased movement using a stereo microscope. The morphological characteristics of the parasites were studied. The in vivo study used 40 female chickens that were 1.5 months old and infected with the eggs of A. galli. Approximately 3000 infective eggs were found in each chicken. There were four treatment groups; Group A served as the control and was treated with Aquadestilata, Group B was treated with 26 mg/ml of AAE, Group C was treated with 79 mg/ml of AAE, and Group D was treated with 50 mg/ml of pyrantel pamoate. The AAE was applied using a pipette for 14 days. The observed parameters include the effect of the treatments on hematology, body weight (BW), and the number of A. galli eggs within each gram of fecal matter. Results: The AAE damaged the morphology, including the anterior end, posterior end, and vulva, of A. galli in vitro. The tegument of the anterior and posterior ends was slightly rougher, wrinkled, and damaged. The vulva and spicule ducts were irregular and indistinct. The average eggs per gram (EPG) in the untreated control increased in vivo from 1450±355.90 to 1975±325.96. The average EPG decreased from 1485±386.62 to 0±0.00 during 14 days of treatment of 79 mg/ml of AAE. The mean BW gain in the treated chickens was significantly (p<0.5) higher than the control. The treatment with 79 mg/ml of AAE increased the total erythrocyte count, total leukocyte count, hemoglobin, and packed cell volume values in the chickens. Conclusion: AAE can cause morphological changes and subsequent death in adult A. galli in vitro and effectively decrease ascariasis severity in chickens, therefore increasing overall BW in vivo.
Canyons of Albania and geotourism development
Authors: Dollma Merita
Published: June 2019

Canyons are among the most interesting geosites created by the erosive activity of the rivers, processes of weathering and erosion or tectonic activity and are distinguished for the aesthetic beauty of the shapes, the labyrinths of the valleys, the steepness of the slopes, the greatness of vertical walls, waterfalls, caves, etc., bearing high scientific, educational and touristic values. Albania has a considerable number of canyons due to the presence of a rich river network flowing through the variety of geological formations and tectonic faults. Outstanding are the wellformed canyons in limestone rocks with almost vertical walls such as Gradec canyon in Çorovoda, Lëngarica canyon in Përmet, Grunas canyon in Theth, etc. The only canyons which are formed on magmatic rocks are the canyons of Devoll. For their values, the most interesting canyons are included in the list of nature monuments as geomonuments. The most magnificent and frequented canyons for tourism in Albania are the Osum canyons, Gradec canyon, Lëngarica canyon and Nivica canyon. These distant impressing landforms, once forgotten and unexplored, are now attracting the attention of many tourists either for admiring their natural scenery, hiking and rafting or for curative tourism. However, despite their values the canyons are not enough known due to lack of information or poor promotion. Filling this gap has served this study where the geotouristic potential of the canyons is evaluated according to four criteria of Knapik.at.al such as accessibility, state of preservation, scientific value and education value (Solarska and Jary, 2010). The database of the canyons is organized in an inventory card which contains general and specific data of each geosite. The final product of this project will be a website that will inform the public and promote the values of the canyons of Albania.