bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing survival time of heart failure patients: using Bayesian approach
Authors: Ashine Tafese , Muleta Geremew , Tadesse Kenenisa
Published: December 2021

Heart failure is a failure of the heart to pump blood with normal efficiency and a globally growing public health issue with a high death rate all over the world, including Ethiopia. The goal of this study was to identify factors affecting the survival time of heart failure patients. To achieve the aim, 409 heart failure patients were included in the study based on data taken from medical records of patients enrolled from January 2016 to January 2019 at Jimma University Medical Center, Jimma, Ethiopia. The Kaplan Meier plots and log-rank test were used for comparison of survival functions; the Cox-PH model and the Bayesian parametric survival models were used to analyze the survival time of heart failure patients using R-software. Integrated nested Laplace approximation methods have been applied. Out of the total heart failure patients in the study, 40.1% died, and 59.9% were censored. The estimated median survival time of patients was 31 months. Using model selection criteria, the Bayesian log-normal accelerated failure time model was found to be appropriate. The results of this model show that age, chronic kidney disease, diabetes mellitus, etiology of heart failure, hypertension, anemia, smoking cigarettes, and stages of heart failure all have a significant impact on the survival time of heart failure patients. The Bayesian log-normal accelerated failure time model described the survival time of heart failure patient's data-set well. The findings of this study suggested that the age group (49 to 65 years, and greater than or equal to 65 years); etiology of heart failure (rheumatic valvular heart disease, hypertensive heart disease, and other diseases); the presence of hypertension; the presence of anemia; the presence of chronic kidney disease; smokers; diabetes mellitus (type I, and type II); and stages of heart failure (II, III, and IV) shortened their survival time of heart failure patients.
Blood purification could tackle COVID-19?
Authors: Yamada Hiroyuki , Ohtsuru Shigeru
Published: December 2021

Coronavirus disease 2019 (COVID-19) threatened human lives worldwide since first reported. The current challenge for global intensivists is to establish an effective treatment for severe COVID-19. Blood purification has been applied to the treatment of various critical illnesses. Theoretically, its technique also has an enormous possibility of treating severe COVID-19 in managing inflammatory cytokines and coagulopathy. Recent clinical studies have revealed the positive clinical effect of therapeutic plasma exchange. Other studies have also indicated the considerable potential of other blood purification techniques, such as Cytosorb, AN69 surface-treated membrane, and polymyxin b hemoperfusion. Further research is needed to elucidate the actual effects of these applications.
Comparison of the rate of delayed/nonunion in fifth metatarsal fractures receiving anti-inflammatory medications
Authors: Barnds Brandon , Heenan Matt , Ayres Jack , Tarakemeh Armin , Schroeppel J. Paul , Mullen Scott , Vopat Bryan G.
Published: December 2021

Purpose

Controversy exists regarding the acute effect of non-steroidal anti-inflammatory drugs (NSAIDs) on early fracture healing. The purpose of this study was to analyze the rate of nonunion or delayed union in patients with fifth metatarsal (5th MT) fractures. We hypothesize that the use of NSAIDs would increase the rate of nonunion/delayed union in 5th MT fractures.

Methods

Using PearlDiver, a national insurance database was analyzed. ICD codes were used to identify patients diagnosed with 5th MT fracture from 2007-2018. Patients were grouped by initial management (nonoperative vs. open reduction and internal fixation (ORIF) or non/malunion repair within 60 days) and sub-grouped by whether they had been prescribed at least one pre-defined NSAID. Subsequent ORIF or nonunion/malunion repair operative intervention was used as a surrogate for fracture nonunion/delayed union.

Results

Of the 10,991 subjects with a diagnosis of 5th MT, 10,626 (96.7%) underwent initial nonoperative treatment, 1,409 of which (13.3%) received prescription NSAIDS within 60 days of diagnosis. 16/1,409 (1.14%) subjects who received anti-inflammatory prescriptions underwent ORIF or repair of non/malunion at least 60 days after diagnosis while 46/9,217 (0.50%; P=0.003483) subjects who did not receive anti-inflammatory prescriptions underwent ORIF or repair of non/malunion at least 60 days after diagnosis. In the 365 subjects who underwent early repair/ORIF (within 60 days), there was no significant difference in the rate of nonunion/delayed union.

Conclusion

The rate of nonunion/delayed union of 5th MT fractures was significantly higher in subjects receiving NSAIDs within 60 days of initial diagnosis in patients managed non-operatively.

Level of evidence

Level III
Nonclinical study and applicability of the absorbed dose conversion method with a single biodistribution measurement for targeted alpha-nuclide therapy
Authors: Sakashita Tetsuya , Matsumoto Shojiro , Watanabe Shigeki , Hanaoka Hirofumi , Ohshima Yasuhiro , Ikoma Yoko , Ukon Naoyuki , Sasaki Ichiro , Higashi Tatsuya , Higuchi Tetsuya , Tsushima Yoshito , Ishioka Noriko S.
Published: December 2021

Background

We recently reported a new absorbed dose conversion method, RAP (RAtio of Pharmacokinetics), for 211At-meta-astatobenzylguanidine (211At-MABG) using a single biodistribution measurement, the percent injected dose/g. However, there were some mathematical ambiguities in determining the optimal timing of a single measurement of the percent injected dose/g. Thus, we aimed to mathematically reconstruct the RAP method and to examine the optimal timing of a single measurement.

Methods

We derived a new formalism of the RAP dose conversion method at time t. In addition, we acquired a formula to determine the optimal timing of a single measurement of the percent injected dose/g, assuming the one-compartment model for biological clearance.

Results

We investigated the new formalism’s performance using a representative RAP coefficient with radioactive decay weighting. Dose conversions by representative RAP coefficients predicted the true [211At]MABG absorbed doses with an error of 10% or less. The inverses of the representative RAP coefficients plotted at 4 h post-injection, which was the optimal timing reported in the previous work, were very close to the new inverses of the RAP coefficients 4 h post-injection. Next, the behavior of the optimal timing was analyzed by radiolabeled compounds with physical half-lives of 7.2 h and 10 d on various biological clearance half-lives. Behavior maps of optimal timing showed a tendency to converge to a constant value as the biological clearance half-life of a target increased. The areas of optimal timing for both compounds within a 5% or 10% prediction error were distributed around the optimal timing when the biological clearance half-life of a target was equal to that of the reference. Finally, an example of RAP dose conversion was demonstrated for [211At]MABG.

Conclusions

The RAP dose conversion method renovated by the new formalism was able to estimate the [211At]MABG absorbed dose using a similar pharmacokinetics, such as [131I]MIBG. The present formalism revealed optimizing imaging time points on absorbed dose conversion between two radiopharmaceuticals. Further analysis and clinical data will be needed to elucidate the validity of a behavior map of the optimal timing of a single measurement for targeted alpha-nuclide therapy.
Artificial intelligence with deep learning in nuclear medicine and radiology
Authors: Decuyper Milan , Maebe Jens , Van Holen Roel , Vandenberghe Stefaan
Published: December 2021

The use of deep learning in medical imaging has increased rapidly over the past few years, finding applications throughout the entire radiology pipeline, from improved scanner performance to automatic disease detection and diagnosis. These advancements have resulted in a wide variety of deep learning approaches being developed, solving unique challenges for various imaging modalities. This paper provides a review on these developments from a technical point of view, categorizing the different methodologies and summarizing their implementation. We provide an introduction to the design of neural networks and their training procedure, after which we take an extended look at their uses in medical imaging. We cover the different sections of the radiology pipeline, highlighting some influential works and discussing the merits and limitations of deep learning approaches compared to other traditional methods. As such, this review is intended to provide a broad yet concise overview for the interested reader, facilitating adoption and interdisciplinary research of deep learning in the field of medical imaging.
The ANHEQ Evaluation Criteria: Introducing Reliable Rating Scales for Assessing Nordic Hamstring Exercise Quality
Authors: Alt Tobias , Schmidt Marcus
Published: December 2021

Background

The Nordic Hamstring Exercise (NHE) is very popular for selective eccentric hamstring strengthening. However, NHE-related research is hindered by insufficient details about implementation and reporting. Available tools to assess study quality (e.g., PEDro or TESTEX scale) are too unspecific to account for the specific demands of NHE. Therefore, this study aimed to introduce two rating scales for Assessing Nordic Hamstring Exercise Quality (ANHEQ) of assessment and intervention studies.

Methods

Eighteen graduated sports scientists, sports physiotherapists and elite coaches with scientific experience independently evaluated the quality of published NHE studies via ANHEQ scales, each comprising eight items and a maximal 13-point score. Inter-rater agreement was analyzed by using criterion-based reference values, while Krippendorff´s alpha determined inter-rater reliability. Systematic differences of the summated ANHEQ scores were determined using Friedman tests.

Results

Inter-rater agreement was 87 ± 5% for NHE assessments and 88 ± 6% for interventions with single items ranging from 71 to 100%. Alpha values for inter-rater reliability ranged from fair (.250) to perfect (1.00) depending on the item. Total ANHEQ scores revealed coefficients of .829 (almost perfect) and .772 (substantial) without significant inter-rater differences (p = .292).

Conclusions

The ANHEQ scales are suitable tools to rate NHE execution quality and data presentation. They facilitate a comprehensive review of NHE-related evidence and potentially improve the design and reporting of future NHE studies.
Validating a Japanese Version of the Athlete Psychological Strain Questionnaire
Authors: Ojio Yasutaka , Matsunaga Asami , Kawamura Shin , Horiguchi Masanori , Yoshitani Goro , Hatakeyama Kensuke , Amemiya Rei , Kanie Ayako , Purcell Rosemary , Rice Simon M. , Fujii Chiyo
Published: December 2021

Background

There is increasing international interest in clinical practice and research related to mental health in the international sports society. The athlete-specific psychological distress assessment tool that addresses potential mental health needs can help promote early detection and recovery of mental illness, as well as physical illnesses. Currently, little is known about the applicability of the useful assessment tool for Japanese elite athletes. The Athlete Psychological Strain Questionnaire (APSQ) is a brief, effective and reliable screening tool to identify early signs of athlete-specific distress and potential mental health symptoms. We examined the applicability and reliability of a Japanese version of the APSQ (APSQ-J) in a Japanese elite athlete context. Further, we examined the construct validity of the APSQ-J.

Methods

We collected web-based anonymous self-report data from 219 currently competing Japanese professional male rugby players. A two-stage process was conducted to validate the factor structure of the APSQ-J using exploratory factor analysis (EFA) in a randomly partitioned calibration sample and confirmatory factor analysis (CFA) in a separate validation sample. Cronbach’s alpha is used to assess internal consistency. Pearson product-moment correlation coefficients were calculated to determine if the APSQ-J was significantly associated with measures of psychological distress and well-being using Kessler-6 (K6) and the WHO-5 Well-Being Index, respectively.

Results

We identified a one-factor structure for the APSQ-J. Confirmatory factor analysis supports this one-factor model, revealing good model fit indices. The standardized path coefficients for each of the items were β = 0.41–0.83 (p < 0.001). A Cronbach’s alpha of 0.84 was obtained for the APSQ-J. The APSQ-J demonstrated significant correlations with the K-6 (r = 0.80, p < 0.001) and WHO-5 (r = −0.58, p < 0.001).

Conclusion

The APSQ-J can be an appropriate and psychometrically robust measure for identifying athlete-specific distress in elite athletes in Japan. Widely disseminating and utilizing this scale in Japanese sports society may support athletes' mental health via early detection of symptoms of psychological distress.
The Relationship Between Psychological Stress and Anxiety with Gastrointestinal Symptoms Before and During a 56 km Ultramarathon Running Race
Authors: Urwin Charles S. , Main Luana C. , Mikocka-Walus Antonina , Skvarc David R. , Roberts Spencer S. H. , Condo Dominique , Carr Amelia J. , Convit Lilia , Jardine William , Rahman Shant S. , Snipe Rhiannon M. J.
Published: December 2021

Background

This study assessed relationships and sex differences between psychological state (recovery, stress, anxiety, and self-confidence) and gastrointestinal symptoms (GIS) prior to and during a 56 km ultramarathon running race and identified predictive factors of race GIS. Forty-four (26 males, 18 females) ultramarathon competitors completed anxiety, recovery, stress and GIS questionnaires for three days prior to the race and immediately pre-race. Race GIS were assessed immediately post-race. Spearman’s rank order, Mann–WhitneyUtests and regression analyses were used to determine correlations and identify sex differences between psychological state and GIS and determine predictors of race GIS.

Results

Race GIS were significantly correlated with recovery (rs =  − 0.381,p = 0.011), stress (rs = 0.500,p = 0.001) and anxiety (rs = 0.408,p = 0.006), calculated as the mean of the three days preceding the race and on race morning. The correlation between anxiety and GIS was strongest in the 24 h immediately prior to the race (allrs > 0.400, and allp < 0.05), but unclear patterns were identified for stress and recovery. Regression analyses showed 36% and 40% of variation in the severity and number of race GIS was accounted for by body mass and measures of stress, anxiety, and GIS over the three days preceding the race and on race morning (bothp < 0.001). There were no sex differences in the number and severity of GIS leading up to or during the race (allp > 0.05), however, females reported greater state anxiety (p = 0.018) and lower self-confidence than males (p = 0.006) over the three days preceding the race and on race morning.

Conclusion

Endurance athletes that experience GIS during competition should investigate elevated stress and/or anxiety as a potential contributor and identify if management strategies can reduce the occurrence and severity of GIS.
Design of protection and control scheme for hybrid nanogrid
Authors: Jolhe Sachin P. , Dhomane Gunwant A. , Karalkar Minal D.
Published: December 2021

Nanogrid is “The new ray of hope” for people living in remote isolated locations as well as where power supply reliability is poor. A nanogrid is a small power capacity distribution system with the ability to operate standalone or with a utility grid. It consists of local power production supplying local loads and energy storage systems. In this paper, an innovative inverter design is presented, which converts the power in a single stage. It is superior to the traditional two-stage inverter system and can supply hybrid loads (AC and DC loads) with a single input. System AC and DC bus voltages are regulated under both steady-state and dynamic load variation conditions in the nanogrid. Simulation results are presented which confirm the suitability of the inverter and its control strategy for a hybrid nanogrid system.
Association between schizophrenia and periodontal disease in relation to cortisol levels: an ELISA-based descriptive analysis
Authors: Albahli Bariah Fahad , Alrasheed Najd Mohammed , Alabdulrazaq Raghad Saleh , Alasmari Dhafer S. , Ahmed Muzammil Moin
Published: December 2021

Background

Schizophrenia is a chronic psychosis marked by multiple bioenvironmental and immunological dysregulation with its intricate role in etiopathogenesis of periodontal disease remaining unclear. Hence, the aim of this study is to determine the association between periodontal disease and schizophrenia in relation with cortisol levels.

Methods

The study is in descriptive design comprised of 40 subjects randomly selected (20 schizophrenic patients as Group A and 20 healthy volunteers as group B). All the study participants underwent complete periodontal examination including scoring of gingival index (GI), plaque index (PI), Probing depths (PD) and clinical attachment loss (CAL). Salivary cortisol levels are estimated using ELISA. Link between schizophrenia and periodontal disease is described in relation to cortisol levels with elimination of other shared risk factors, such as tobacco smoking and xerostomia.

Results

Significant higher values of periodontal parameters are observed in Group A with schizophrenic patients (GI 2.467 ± 0.528; PI 2.402 ± 0.526; PD 2.854 ± 0.865; CAL 1.726 ± 3.096) than Group B with healthy subjects (GI 0.355 ± 0.561; PI 0.475 ± 0.678; PD 1.493 ± 0.744; CAL 0.108 ± 0.254). However, cortisol levels are lower in schizophrenic group (0.190 ± 0.059) than non-schizophrenic group (0.590 ± 0.228) ruling out the possible role of cortisol in periodontal disease severity associated with schizophrenic patients.

Conclusion

Findings of this study, provides ground evidence for consideration of schizophrenia as a risk factor for periodontitis and demands greater emphasis on management of schizophrenic patients in dental setting similar to other comorbid disorders such as diabetes mellitus and also incorporating periodontal care measures in the clinical guidelines for schizophrenia management.
Erosive acute colitis associated with intestinal spirochetosis
Authors: de Paula Fabio Dantas , de Abreu Glicia Estevam , de Souza Maiara Ferreira , de Freitas Luiz Antonio Rodrigues , Athanazio Daniel Abensur
Published: December 2021

Background

Although usually believed to be harmless, intestinal spirochetosis may active erosive colitis associated with intestinal spirochetosis that may mimic idiopathic chronic inflammatory bowel disease. Case presentation. A 49-year-old homosexual male patient sought medical assistance due to asthenia, rectal bleeding, tenesmus, and diarrhea for one month. He had been using corticosteroids for nine months to treat sciatic nerve pain. Colonoscopy showed rectum and distal sigmoid with diffuse erythema with many surface erosions. Rectal biopsy showed inflammatory changes including chronic changes such as architectural distortion and basal plasmacytosis, and active inflammation including crypt microabscesses. In all large bowel sample, dense colonization of intestinal spirochetosis was observed. Patient also had a positive PCR testing for Chlamydia trachomatis. The patient was treated with metronidazole for 14 days, ciprofloxacin for 14 days and azithromycin (single dose). Symptoms improved and the patient is asymptomatic after two months of follow-up.

Conclusion

In some high-risk groups, intestinal spirochetosis may cause colonic manifestations with overlapping features with intestinal bowel diseases. Awareness of this association is importance since proper antibiotic therapy against Brachyspira (metronidazole) is highly effective. Coinfection with other sexually transmitted infections is common and proper treatment is required.
Evaluation of the effects of sound exposure and low field electromagnetism on growth and antibiotics susceptibility of some microorganisms
Authors: Garuba Emmanuel Oluwaseun , Ajunwa Obinna Markraphael , Ibrahim-King Aishat Nana
Published: December 2021

Background

The emergence of antibiotic-resistant microorganisms has been largely associated with drug misuse, drug abuse, and indiscriminate disposal of drugs; however, the interactions between some environmental factors and antibiotic resistance by microorganisms have been understudied. In this study, the effects of sound and electromagnetic field on the growth and antibiotic susceptibility of selected microorganisms to antibiotics were investigated.

Results

Microorganisms used includeGluconobacter oxydansATCC 19,357,Rhodobacter sphaeroidesATCC 17,023,Citrobacter freundiiATCC 33,128,Yersina pestisATCC 11,953,Bacillus subtilis6633,Acetobacter acetiATCC 15,973,Escherichia coliATCC 25,922,Pseudomonas aeuriginosaATCC 9027,Streptococcus pyogenesATCC 19,613,Klebsiella pneumoniaATCC 25,955,Staphylococcus aureusATCC 25,923 andSerratia marcescensATCC 14,766. The antibiotics used were: Ciprofloxacin 5 μg, Imipenem 10 μg, Ampicillin 10 μg, Ceftazidime 30 μg and Tetracycline 30 μg for Gram-negative bacteria while Pefloxacin 10 μg, Gentamycin 10 μg, Amplicillin + Cloxacillin 30 μg, Cefuroxime 20 μg, Amoxacillin 30 μg, Ceftriaxone 25 μg, Ciprofloxacin 10 μg, Streptomycin 30 μg, Co-trimoxazole 30 μg, and Erythromycin 10 μg for Gram-positive bacteria, respectively. Acoustic treatment had varying effects on the antibiotics susceptibility profile of all test bacterial culture. Before exposure, P. aeruginosahad the highest zone of inhibition of 34 ± 3.4 mm, whileB. subtilis had least inhibition zone of 12 ± 2.8. After exposure to acoustic treatment at 5000 Hz/90 dB at 72 h, C. freundiihad highest zone of inhibition of 32 ± 0.7 mm and the least zone of 11 ± 1.4 mm observed inP. aeruginosa. At 1125 Hz/80 dB after 72 h,R. sphaeroideshad highest zone of 34 ± 0.7 mm while A. acetihad least zone of inhibition of 10 ± 0 mm. Effect of electromagnetic flux treatment of 15 min showedE. colito be the most inhibited having a growth rate of 0.08 log cfu/mL, antibiotics testing showedG. oxydansto have the highest zone of inhibition of 28 ± 3.5 mm and least zone was observed inB. subtilis having a zone of 13 ± 2.8 mm.

Conclusion

This study showed that environmental factor such as sound and electromagnetic flux (EMF) could interfere with the physiology of bacteria including resistance/susceptibility to antibiotics. However, further investigation will be needed to understand full mechanisms of action of sound and electromagnetic field on bacteria.
The protective role of vitamin C in the management of COVID-19: A Review
Authors: Uddin Mohammad Sarowar , Millat Md. Shalahuddin , Baral Prodip Kumar , Ferdous Mahmuda , Uddin Md. Giash , Sarwar Md. Shahid , Islam Mohammad Safiqul
Published: December 2021

Background

The outbreak of coronavirus infectious disease-2019 (COVID-19) is globally deemed a significant threat to human life. Researchers are searching for prevention strategies, mitigation interventions, and potential therapeutics that may reduce the infection’s severity. One such means that is highly being talked in online and in social media is vitamin C.

Main text

Vitamin C is a robust antioxidant that boosts the immune system of the human body. It helps in normal neutrophil function, scavenging of oxidative species, regeneration of vitamin E, modulation of signaling pathways, activation of pro-inflammatory transcription factors, activation of the signaling cascade, regulation of inflammatory mediators, and phagocytosis and increases neutrophil motility to the site of infection. All of these immunological functions are required for the prevention of COVID-19 infection.

Conclusion

Considering the role of vitamin C, it would be imperative to administrate vitamin C for the management of severe COVID-19. However, there is no specific clinical data available to confirm the use of vitamin C in the current pandemic.
Ergonomic risk factors and musculoskeletal disorders in bank staff: an interventional follow-up study in Iran
Authors: Motamedzadeh Majid , Jalali Mahdi , Golmohammadi Rostam , Faradmal Javad , Zakeri Hamid Reza , Nasiri Iman
Published: December 2021

Background

Long-term use of computer in a static mode may cause musculoskeletal disorders (MSDs) in bank staff. Considering the high number of bank employees in different countries, such as Iran, the risk factors of these disorders should be investigated in order to implement interventions required to reduce the risk factors. This study aimed to examine the risk factors of MSDs using the Rapid Office Strain Assessment (ROSA) method and to perform an ergonomic intervention program with banking staff in Iran.

Methods

This interventional study was conducted on 277 bank employees in Iran. Subjects were randomly divided into three groups, including a control group (without any intervention), an educational intervention (EI) group, and a group receiving both educational and physical intervention (EPI). Before and after the intervention, the ROSA method and Nordic questionnaire were used to assess the risk factors of MSDs in office jobs and to investigate the prevalence of MSDs. Data were collected 2 weeks before and 9 months following the intervention.

Results

Before the intervention, the mean score of ROSA at workstations of all groups was above five with high risk. Nine months after the start of the intervention, there was a significant decrease in the mean ROSA score and its components in the two groups that received the intervention, which was statistically significant (P < 0.001). The results of the study of the prevalence of MSDs in the employees—before the intervention—indicate that the highest prevalence of MSDs in the control group was in areas of the neck (67.1%), back (64.4%), and lower back (63%). In the EI group, the highest prevalence of MSDs was in the neck (65.2%), lower back (61.6%), and back (60.7%) areas. In the EPI group, the discomfort areas were the neck (68.5%), shoulders (66.3%), and lower back (60.9%). Nine months after the intervention, there was a significant decrease in the prevalence of MSDs in the neck, shoulders, and lumbar regions of staff who received the intervention (P < 0.05).

Conclusion

Nine months after performing the interventions, there was a relative improvement in workstations and prevalence of MSDs in various areas within the bodies of the bank staff. This study showed that using the ROSA method is appropriate for assessing the risk factors of office work and that it can identify deficiencies in workstations. These defects can be addressed by designing and implementing an EI program together with physical interventions according to the components of the ROSA method.
Good soldiers in implementation: validation of the Implementation Citizenship Behavior Scale and its relation to implementation leadership and intentions to use evidence-based practices
Authors: Borge Randi Hovden , Skar Ane-Marthe Solheim , Endsjø Mathilde , Egeland Karina M.
Published: December 2021

Background

Implementation citizenship behavior (ICB) describes extra-role behaviors performed by employees to support evidence-based practice (EBP) implementation. Such behaviors can be measured using the Implementation Citizenship Behavior Scale (ICBS), which divides ICB into two dimensions, namely helping others and keeping informed. The current study extends the use of the ICBS to a context outside the USA and adds to the literature by investigating how leader-perceived ICB relates to practitioner-perceived implementation leadership and practitioners’ intentions to use EBPs.

Methods

Participants were 42 leaders and 152 practitioners in Norwegian mental health services implementing EBPs for post-traumatic stress disorder. Leaders rated each practitioner on ICB, and each practitioner rated their leader on implementation leadership and reported on their own intentions to use EBPs. The psychometric properties of the ICBS were assessed using confirmatory factor analysis and internal consistency reliabilities. The relationships between ICB, implementation leadership and intentions to use EBPs, were investigated through a series of bivariate correlation analyses and a path analysis of the total scales.

Results

The ICBS showed excellent psychometric properties. The hypothesized two-factor model provided an excellent fit to the data, and both subscales and the total scale were internally reliable. Leader-perceived ICB was positively and significantly correlated with both practitioner-perceived implementation leadership and practitioners’ intentions to use EBPs. Correlations with intentions to use EBPs were stronger for the subscale of keeping informed than for the subscale of helping others.

Conclusions

Results indicated that practitioners who rated their leader higher on implementation leadership received higher ICB ratings from their leader and reported higher intentions to use EBPs. The results provide evidence of a reciprocal social exchange relationship between leaders and practitioners during EBP implementation and a link to an important proximal implementation outcome (i.e., intentions to use EBPs). Results also suggest cultural differences in how ICB is perceived and relates to other phenomena. Scientific and practical implications are discussed.

Trial registration

Retrospectively registered in ClinicalTrials with ID NCT03719651.
Implementation of evidence-based guidance for dementia palliative care using participatory action research: examining implementation through the Consolidated Framework for Implementation Research (CFIR)
Authors: Coffey Alice , Hartigan Irene , Timmons Suzanne , Buckley Catherine , Lehane Elaine , O’Loughlin Christina , O’Connell Selena , Cornally Nicola
Published: December 2021

Background

The importance of providing evidence-based palliative care for people with dementia is increasingly acknowledged as important for patient outcomes. In Ireland, evidence-based guidance has been developed in order to address key features of dementia palliative care, including the management of pain, medications and hydration and nutrition. The aim of this study was to identify and explore the factors affecting the implementation of evidence-based guidance on dementia palliative care.

Methods

The Consolidated Framework for Implementation (CFIR) guided a mixed-method pre-post study. One guidance document pertaining to the management of pain, medication or hydration and nutrition was implemented in three long-term care facilities. Participatory action research in the form of work-based learning groups was used to implement the guidance, drawing on a situational analysis (pre-implementation). Staff questionnaires and audits were conducted pre- and post-implementation while champion interviews were also conducted post-implementation.

Results

Features of the guidance, the inner setting components such as readiness to change, and the process of implementation were most frequently identified as impacting implementation. Components of the outer setting, such as external policy incentives and individual characteristics, featured less commonly. Data from qualitative interviews revealed that the guidance was perceived as advantageous or complimentary to previous care provided. Within the inner setting, leadership and support from other colleagues facilitated implementation. However, limited availability of other healthcare professionals to assist with carrying out guidance actions presented a barrier in some facilities. The external facilitators of the work-based learning groups (WBLGs) were perceived as experienced and encouraged active participation and reflection on practices. Despite the challenge of releasing staff to attend the WBLGs, quantitative data demonstrated reduced staff de-motivation amongst those who did attend was noted post-implementation (pre-Mdn = 19.50 versus post-Mdn = 22.00, U = 497.00, p = 0.07).

Conclusions

A situational analysis informed by the CFIR framework in conjunction with a participatory action research approach helped to advance the implementation of the guidance. The progress of implementation depended on the extent to which evidence-based care was previously being implemented at each site. Post-implementation analysis using CFIR identified challenges to address in future projects such as staff cover and timing of training to facilitate attendance for staff with different working hours. Facilitators included multidisciplinary engagement with the intervention and champions at each site to support the implementation process.
Angiopoietin-2 as a predictor of fibrosis regression in chronic hepatitis C virus patients after direct-acting antiviral drugs
Authors: Isaac Amira , El Sakaty Tarek Maged , Hussein Sarah Hamdan , Rasmy Hany Samir
Published: December 2021

Background

HCV infection is a major health concern. Disease progression to fibrosis, cirrhosis, and HCC is aided by the persistence of inflammatory reactions and cellular damage. Moreover, angiogenesis was found to have a substantial pathogenic role in disease progression. Serum Angiopoietin-2 appears to be correlated with liver stiffness in chronic HCV and its elevation is linked to disease progression from chronic hepatitis to cirrhosis. The aim of this study was to evaluate the role of serum Angiopoietin-2 in the prediction of regression of fibrosis in chronic HCV patients receiving direct-acting antiviral agents. Forty Egyptian chronic HCV patients for whom direct-acting antiviral agent (DAA) therapy was planned were included. All patients underwent assessment twice, at baseline and at SVR12, for standard laboratory tests, measurement of fibrosis using FibroScan, FIB-4 and APRI scores, and Angiopoietin-2 level.

Results

Statistically significantly higher levels of baseline Ang-2 were detected with the progression of fibrosis stages with a p-value of <0.001. The best cutoff value of baseline Ang-2 in discrimination of liver cirrhosis (F4) from F0-F3 was > 630 pg/ml with 85.71% sensitivity and 84.85% specificity. A statistically significant decline of Ang-2 (from 464.3±237.2 pg/ml to 401.3±277.1 pg/ml) was noted after the achievement of SVR12 with a p-value < 0.001. Regression of liver fibrosis in this study is defined as a decrease of more than or equal to one stage in liver fibrosis. Lower baseline fibrosis stages and other non-invasive scoring systems (FIB-4 and APRI scores) were associated with regression of fibrosis following successful DAAs treatment. However, higher baseline Ang-2 levels were significantly associated with non-regression of fibrosis, and at a cutoff of >680 pg/ml, it might predict non-regression of fibrosis after successful eradication of HCV with DAAs with 93.33% sensitivity and 70% specificity.

Conclusions

Angiopoietin-2 can be a useful predictor of fibrosis regression in chronic HCV patients receiving direct-acting antiviral agents. Elevated baseline Angiopoietin-2 and advanced fibrosis stages may predict non-regression of liver fibrosis.
Toll-like receptor 5 and Toll-like receptor 9 single nucleotide polymorphisms and risk of systemic lupus erythematosus and nephritis in Egyptian patients
Authors: Gharbia Ola Mohammad , Bassiouni Sherine Abdel Rahman , Zaki Maysaa El Sayed , El-Beah Shimaa Mohsen , El-Desoky Manal Mohamed , Elmansoury Eman Adel , Abdelsalam Mostafa
Published: December 2021

Background

Toll-like (TLRs) play a crucial role in both adaptive and innate immunity. The aim of the present study was to assess the association of TLR5-rs5744168, TLR9-rs187084, and TLR9-rs352140 single nucleotide polymorphisms (SNPs) with susceptibility to systemic lupus erythematosus (SLE) and lupus nephritis (LN) in Egyptian patients.

Results

The C allele and homozygous CC genotype of the TLR9-rs352140 in co-dominant and recessive models were more prevalent in SLE patients than controls (P = 0.047, P = 0.017, and P = 0.005 respectively). In contrast, allelic and genotyping distribution of TLR5-rs5744168 and TLR9-rs187084 SNPs showed no association with the risk of SLE. The T allele of the TLR5-rs5744168 was more prevalent in LN patients than controls (P = 0.021). The homozygous TT genotype of TLR5-rs5744168 SNP was more prevalent in LN patients in the co-dominant and the recessive models than controls (P = 0.036 and P = 0.011 respectively). The C allele of the TLR9-rs352140 was more prevalent in LN patients than controls (P = 0.015). The homozygous CC genotype of the TLR9-rs352140 SNP was more prevalent in LN than controls in co-dominant and recessive models (P = 0.002 and P < 0.001). In the recessive model of the TLR5-rs5744168 SNP, the TT genotype was found in 3.2% of the SLE patients while none of the SLE patients without LN or controls had TT genotype (P = 0.036). Also, in the recessive model of the TLR9-rs352140 SNP, the CC genotype was significantly more frequent in SLE patients with LN than without LN (44.4% vs 29.9%, P = 0.045).

Conclusion

Our results support the potential role of TLR5-rs5744168 SNP and TLR9-rs3532140 SNP not only in increasing the risk for development of SLE, but also in increasing the risk of LN in SLE patients among the Egyptian population.
Incorporating terrain specific beaching within a lagrangian transport plastics model for Lake Erie
Authors: Daily Juliette , Onink Victor , Jongedijk Cleo E. , Laufkötter Charlotte , Hoffman Matthew J.
Published: December 2021

Mass estimates of plastic pollution in the Great Lakes based on surface samples differ by orders of magnitude from what is predicted by production and input rates. It has been theorized that a potential location of this missing plastic is on beaches and in nearshore water. We incorporate a terrain dependent beaching model to an existing hydrodynamic model for Lake Erie which includes three dimensional advection, turbulent mixing, density driven sinking, and deposition into the sediment. When examining parameter choices, in all simulations the majority of plastic in the lake is beached, potentially identifying a reservoir holding a large percentage of the lake’s plastic which in previous studies has not been taken into account. The absolute amount of beached plastic is dependent on the parameter choices. We also find beached plastic does not accumulate homogeneously through the lake, with eastern regions of the lake, especially those downstream of population centers, most likely to be impacted. This effort constitutes a step towards identifying sinks of missing plastic in large bodies of water.
Neonatal Screening for Hyperthyroidism Proof of Concept
Authors: Banigé Maïa , Kariyawasam Dulanjalee , Gauthereau Valerie , Luton Dominique , Polak Michel
Published: December 2021

Context

Early treatment is essential to avoid the cardiac complication of neonatal hyperthyroidism (NH). Our results have direct implications for clinical care.

Objective

NH can cause potentially fatal neonatal thyrotoxicosis. Here, we have evaluated the feasibility of neonatal hyperthyroidism screening using the thyroid-stimulating hormone value in dried blood collected routinely on filter paper on the third postnatal day of life for congenital hypothyroidism screening.

Methods

Retrospective case–control study. Cases were identified using data from our previously published study of 280 000 infants born in 10 maternity units in France in 2007-2014. Controls were identified among the 1 362 564 infants born in the Ile-de-France region during the same period.

Results

A screening thyroid-stimulating hormone level below 0.18 mIU/L on the third postnatal day had 71% (95% CI 44-90%) sensitivity, 99% (95% CI 99-100%) specificity, 81% (95% CI 74-86%) positive predictive value, and 98% (95% CI 97-99%) negative predictive value for detecting severe NH. By univariate regression analysis, the screening thyroid-stimulating hormone value was the strongest predictor of NH (P < .00001), with an area under the receiver-operating characteristics curve of 0.98 (95% CI 0.95-1.0). Expected frequencies were not significantly different from observed frequencies (Hosmer–Lemeshow test, P = .99).

Conclusion

The screening thyroid-stimulating hormone test can be used to detect severe NH, the optimal cut-off being 0.18 mIU/L. The additional cost compared with screening for congenital hypothyroidism would be small. Infants with neonatal hyperthyroidism would benefit from an earlier diagnosis with treatment initiation at the presymptomatic stage in many cases, ensuring optimal outcomes.
Improvization as a factor of compository and performance interpretation of modern instrumental music (on the example of “Solo-Solissimo” for violin by K. Tsepkolenko)
Authors: Maidenberg-todorova Kira , Khoroshavina Olena , Hodina Inna , Voronovskaya Olga
Published: December 2021

The purpose of the work is to study the mechanisms of formation of the composer's language on the example of modern instrumental music and to determine the relationship between the composer's plan and the interpretive-performing view of the author's text. Interpretive-performing and comparative analytical approaches in combination with the source method allow identifying the ratio of stable and mobile elements of the author's work, as well as distinguishing between composer's and performer's interpretation of the work. The scientific novelty of the work is the comparative analysis of K. Tsepkolenko's work "Solo-Solissimo №1" for solo violin, as well as the performance versions of this work considered for the first time in the text of the work. The considered performance versions represent two different interpretive approaches to the analyzed work. In Carmella Tsepkolenko's "Solo Solissimo" by Peter Shepard Skaverd, the figure of the performer is felt more than the personality of the composer. This attitude is formed through the free handling of the text in those segments where it is not provided by the author, as well as through the use of their own intonation material at the time of improvisation. Dan Auerbach and Myroslava Kotorovych set the task to convey the author's model of the text, using the composer's intonation material in the improvisational fragment. Thus, improvisation in the considered work is an integral part of the compositional and performing sphere of musical expression. It is thanks to the performer's improvisational skill that the work is filled with content, its genre and style identification from lyrical and philosophical color to dramatic and expressive sphere. The performance of "Solo-solissimo" requires great skill from the violinist, not only technical virtuosity, but also mental, that is required by the author's compositional concept, which is the program basis of the composition. We believe that the intention of this work is, above all, to represent the stylistic competencies of the performer as an unleashed actor-improviser.
Azerbaycan folklor türlerinden olan “meyhana”nin diğer halaklarin müzik türleriyle benzer yönleri
Authors: Rahimova Aytac
Published: December 2021

Azerbaycan folklorünün en eski, kendine özgü ve her zaman tartışmalara açık olan türlerinden biri meyhanadır. Bir çok kaynaklarda meyhana, mey – içki, şarap, hana (hane) ise yer, mekan, ev anlamına gelmektedir (Rehimova A. - 2002). Meyhana – doğaçlama bir şekilde söylenilen müzikal – şiirsel türdür. O, vurmalı çalgıların eşliğiyle söylenerek bir nevi resitatif emprovizasyon özelliği taşıyor. Meyhana türünün edebi metnini ise aruz vezninin bahirleri oluşturmaktadır.
Meyhanayı, genellikle iki veya daha fazla şair - icracı doğaçlama şeklinde söyler ki, bu da aşıklık geleneğinden ortaya çıkan değişmeyi (atışmayı) hatırlatmaktadır.
Meyhana ile zahiren benzeyen ve bazı özelliklerine göre onu hatırlatan türler diğer halkların da kültürlerinde mevcuttur. Bunlardan en çok benzeyenleri Rus kültüründeki çastuşkalar ve Amerikan müzik kültüründeki raptır.
Bu çalışmada Azerbaycan’ın meyhana müzik türünün özellikleri incelenerek onun diğer halkların müzik kültürleriyle benzer yönleri araştırılacaktır.
Aspektualität in deutschen Partikel- und Präfixverben
Authors: Stieber Nana-Lena
Published: December 2021

Prefix and particle verbs are part of a systematic way of expressing aspectual structures in German. This article proposes an aspectual analysis of German particle and prefixed verbs, regarding especially their polysemic characteristics, and will give a contrastive comparison with the Italian language. This can be useful given that Italian does not have developed a system of prefixes and particles as German does. Therefore, the Italian translations of German prefixed and particle verbs turns out to use different kinds of expressions, often of a periphrastic nature. This is seen here as an indication in favour of the strongly polysemic verbs in German. The aspectual comparison of both languages will be done using an onomasiological model of aspectuality, which allows the analysis of different kinds of expressions without using specific formal categories.

The first part of this article gives a short introduction and definition of the German verbs. Part two concerns the question of what aspectuality in German is, followed by part three, a quick overview of actual research in the field. Part four explains how a contrastive perspective may be helpful to discover and illuminate the polysemic German prefixed and particle verbs. Part five presents the empirical data used for the purpose of this work. Part six, then, contains the aspectual analysis of the German verbs in their given context. Every German example will be described and compared to its Italian translation. The article will close with a quick summary of the results, focussing especially on the usefulness of a contrastive approach.
Unbestimmte Subjekte: zur problematischen Äquivalenz von deutschem man und italienischem si
Authors: Paschke Peter
Published: December 2021

German sentences with man and Italian sentences with si impersonale or si passivante are often presented as equivalent in contrastive grammars. However, this functional equation proves to be problematic when Italian students refer with man to their own role as authors, such as in: “Darauf wird man aber im folgenden Kapitel eingehen”. Evidently, man cannot refer to the speaker role, while in the same context the Italian si is well suitable. Starting from this interference error, the paper examines the possible range of reference of the two pronouns. It turns out that the most common reading of man and si in both languages is the generic one, which can be paraphrased as “everyone”. Systematic divergences, on the other hand, occur in the particular reading, i. e. when referring to single unspecified subjects. While the German man characterizes the subject as anonymous and does never include listeners or speakers (e. g: Gestern hat man bei uns eingebrochen; man ≈ ‘jemand’, ‘somebody’), the Italian si, according to the verb class (transitive, unergative, unaccusative, etc.), can or must be read as speaker-exclusive (Mi si è raccontato che ...; si ≈ ‘qualcuno’, ‘someone’) or as speaker-inclusive (Ieri si è andati al ristorante; si ≈ ‘noi’, ‘we’). The speaker-inclusive reading also occurs when si is used in academic texts as a substitute for the established form of speaker (author) reference by means of the 1st person plural (noi, ‘we’). In addition to man and si, other forms of indeterminate subjects are examined, namely the non-anaphoric uses of German “sie (pl.)” (Sie haben schon wieder die Preise erhöht.) and of the Italian 3rd person plural null subject (Ti hanno cercato.) as well as the so-called impersonal passive form in German (Es wird gemurmelt.).