bluuebunny/crossref_metadata_2025 huggingface dataset:
Linking digital literacy and online information searching strategies of Philippine university students: The moderating role of mindfulness
Authors: Atoy Manny B. , Garcia Francesca Renee O. , Cadungog Rayanne R. , Cua Julius Dominic O. , Mangunay Siena C. , de Guzman Allan B.
Published: January 2020

The extent to which students are able to maximize the potential benefits of information from the online world depends, in great measure, on the development of a set of skills that would make them effective users and decision-makers. While previous studies have revealed the role of prior knowledge, availability of ICT resources and infrastructure in the development of information-type skills, the identification of other unexplored variables remains important in information science. This paper seeks to ascertain the moderating role of mindfulness on digital literacy and online information searching strategies on a select group of university students in the Philippines. Structural equation modeling was used to test a hypothesized model and explore the factors affecting the information-seeking behavior of 321 students from the largest comprehensive university in the Philippines. A multi-aspect instrument, consisting of a robotfoto, and three scales such as the Langer Mindfulness Scale (LMS), Internet Skills Scale (ISS), and Online Information Searching Strategies Inventory (OISSI), was used in this study. Results revealed that digital literacy had a direct positive relationship with the online information searching strategies of students. Surprisingly, mindfulness did not moderate the relationship between digital literacy and online information searching strategies. Further, digital literacy was found to be a mediating factor to university students’ information searching strategies. Implications of these for library practice and policy are discussed in this paper.
Knowledge and Perceptions Regarding Palliative Care Among Religious Leaders in Uasin Gishu County, Kenya: Survey and Focus Group Analysis
Authors: Rialem Faith , Gu Jessie P. , Naanyu Violet , Ali Zipporah , Chege Patrick , Chelagat Dinah , Korir Millicent , Waweru-Siika Wangari , Kussin Peter S.
Published: January 2020

Spirituality and religion are at the core of Kenyan life. Pastoral leaders play a key role in shaping the individual and community’s response to living with chronic and life-threatening illnesses. Involvement of religious leaders would therefore be critical in advocacy and education efforts in palliative care (PC) to address the needs of this population. The goal of this study was to evaluate the knowledge and perceptions of religious leaders in Western Kenya regarding PC. This was a mixed-methods study with 86 religious leaders utilizing a 25-question survey followed by 5-person focus group discussions. Eighty-one percent of participants agreed that pastors should encourage members with life-threatening illnesses to talk about death and dying. However, almost a third of participants (29%) also agreed with the statement that full use of PC can hasten death. The pastors underscored challenges in end-of-life spiritual preparation as well as the importance of traditional beliefs in shaping cultural norms. Pastors supported the need for community-based PC education and additional training in PC for religious leaders. The results of this study confirm the dominant role of religion and spirituality in PC in Kenya. This dominant role in shaping PC is tied closely to Kenyan attitudes and norms surrounding death and dying.
A statistical damage constitutive model considering whole joint shear deformation
Authors: Xie Shijie , Lin Hang , Wang Yixian , Chen Yifan , Xiong Wei , Zhao Yanlin , Du Shigui
Published: January 2020

The whole shear deformation of rock joints significantly affects the long-term behavior and safety of engineering projects. In this paper, a new damage constitutive model related to the Weibull distribution and statistical damage theory is proposed. This model considers the shear stiffness degradation, post-peak softening, and residual phase of rock joints in the whole shearing process. Main works include the three following aspects: First, the phase of initial damage is determined on the assumption that the joint shear failure is regarded as a result of damage evolution, according to the typical joint shear curve and the three-parameter Weibull distribution. Then, a statistical damage evolution model for the whole joint shearing process is introduced to make this model be capable of describing the residual phase of rock joints. Finally, a statistical constitutive model for the whole joint shearing process is proposed by statistical damage theory, and the calculated results of the models are compared to the experimental results. The results indicate that the proposed model shows a good agreement with the experimental examples, and the proposed model can distinctly reflect the effects of residual stress, peak stress, and shear stiffness. In addition, the model parameters can be mathematically confirmed and have distinct physical meanings.
Association Between Sleep Duration, Obesity, and School Failure Among Adolescents
Authors: Litsfeldt Sofie , Ward Teresa M. , Hagell Peter , Garmy Pernilla
Published: January 2020

The aim of this study was to investigate the association between sleep duration, overweight/obesity, and school failure using data obtained from self-reported questionnaires completed by 13- to 15-year-olds in Sweden ( n = 1,363; 50.7% female). The height and weight of the participants were measured by school nurses. A multiple logistic regression analysis was used to analyze the association between sleep duration and overweight/obesity, school failure, and perceived economic situation. A short sleep duration (<7 hr) was associated with overweight/obesity ( p = .001), school failure ( p = .007), and poorer perceived economic situation ( p = .004). Modifying the sleep habits of adolescents is a potential target for obesity intervention as well as for improving school success. This information is particularly well suited for school nurses to disseminate to students and their parents.
Proenkephalin A Adds No Incremental Prognostic Value After Acute Ischemic Stroke
Authors: Gruber Philipp , Fluri Felix , Schweizer Juliane , Luft Andreas , Müller Beat , Christ-Crain Mirjam , Katan Mira
Published: January 2020

Objective:

The aim of this study was to confirm previous observations that proenkephalin A (PENK-A) may serve as prognostic marker in the setting of acute ischemic stroke in a large stroke cohort.

Methods:

The plasma concentration of PENK-A was measured within 72 hours of symptom onset in 320 consecutively enrolled patients with stroke. The primary outcome measures were unfavorable functional outcome (modified Rankin Scale score 0-2 vs 3-6) and mortality within 90 days. Logistic and cox proportional regression analyses were fitted to estimate odds ratios (ORs), hazard ratios (HRs) and 95% confidence intervals (CIs), respectively, for the association between PENK-A and the primary outcome measures.

Results:

After adjusting for demographic and vascular risk factors, PENK-A was neither independently associated with functional outcome (OR: 1.29, 95% CI: 0.16-10.35) nor mortality (HR: 1.02, 95% CI: 0.14-7.33).

Conclusion:

Among patients with acute stroke, PENK-A does not serve as an independent prognostic marker in this external validation cohort.
Robust load transport by an overhead crane with respect to cable length uncertainties
Authors: Martínez-Cercós Daniel , Guéry-Odelin David , Muga Juan Gonzalo
Published: January 2020

We exploit a Fourier method to inverse engineer fast load transport protocols for an overhead crane, which is robust with respect to the deviation of cable length, corresponding to an ideal value. In the small oscillations regime, the protocols guarantee final adiabatic energies, i.e. null excitation with respect to the initial energy, regardless of the initial conditions. We demonstrate with calculations for the exact dynamics the stability of this result.
Fuzzy adaptive robust proportional–integral–derivative control optimized by the multi-objective grasshopper optimization algorithm for a nonlinear quadrotor
Authors: Mahmoodabadi Mohammad Javad , Rezaee Babak Nima
Published: January 2020

Proportional–integral–derivative is one of the most applicable control methods in industry. Although it is simple and effective in most cases, it does not provide robustness against disturbances and may not perform well in cases with uncertainties and nonlinearities. In this study, a fuzzy adaptive robust proportional–integral–derivative controller is used to control a nonlinear 4 degree-of-freedom quadrotor. An adaptation mechanism is submitted to the proportional–integral–derivative controller for updating the proportional, derivative, and integral gains of proportional–integral–derivative control. Furthermore, a sliding surface is generated and submitted to the adaptation mechanism for better regulation of proportional–integral–derivative gains. Afterward, a fuzzy engine is applied to regulate the sliding surface for better performance of the adaptive proportional–integral–derivative when there are disturbance and uncertainties. The multi-objective grasshopper optimization algorithm is implemented on the control system for the regulation of the control system parameters to minimize the error and control effort of the proposed hybrid control system. Finally, the obtained results are presented for a nonlinear 4 degree-of-freedom multi-purpose (for marine, ground, and aerial maneuvers) quadrotor system designed and built in Sirjan University of Technology, Sirjan, Iran, to assure the effectiveness of this technique.
Analysis of complete vibration bandgaps in a new periodic lattice model using the differential quadrature method
Authors: Hajhosseini Mohammad
Published: January 2020

In this study, a new periodic lattice model with special vibration-absorbing properties is introduced. This periodic structure consists of the connected beam elements with circular cross-sections. Four models with different sets of cross-sectional radii are considered for this periodic lattice. The theoretical equations of longitudinal, torsional, and transverse vibrations of beams are solved using the combination of generalized differential quadrature and generalized differential quadrature rule methods to calculate the first three complete bandgaps. Investigating the effects of geometrical parameters on the bandgaps shows that all bands are close to each other for specific values of the cross-sectional radii. Having close bandgaps means that this periodic structure has a relatively wide bandgap in total. Furthermore, this wide band can move to low-frequency ranges by changing the lattice thickness. Absorbing both in-plane and out-of-plane vibrations over a wide bandgap at low-frequency ranges makes this periodic lattice a good vibration absorber. Verification of the analytical method using ANSYS software shows that the combination of generalized differential quadrature and generalized differential quadrature rule methods can be used for vibration analysis of two- or three-dimensional structures such as frames and trusses with high accuracy.
Transparency and Accountability—The Case of Public Procurement Practices in Switzerland
Authors: Mabillard Vincent , Zumofen Raphaël
Published: January 2020

This article assesses the links between accountability and transparency in the case of the public procurement system in Switzerland. It focuses on the relationship between the two concepts through the prism of the theoretical frameworks developed by previous authors, using data gathered through experts’ interviews. Findings demonstrate that the relationship can be bidirectional and highlight the importance of both the nature and the quality of information. It also redefines the various ways around which transparency and accountability interrelate by extending the previous contributions on the matter. It especially points out that transparency and accountability can be more easily implemented together with proactive dissemination of information. At the same time, mechanisms of control should also exist to ensure more accountable governmental organizations. In this sense, all experts insist on the necessity to keep efficient surveillance bodies in place.
Affective atmospheres of sensemaking and learning: Workplace meetings as aesthetic and anaesthetic
Authors: Vitry Chloé , Sage Daniel , Dainty Andrew
Published: January 2020

The aim of this article is to explore sensemaking and learning processes with and through affective atmospheres. We engage with recent research within the ‘affective turn’ across the social sciences and humanities to conceptualize the significance of quasi-autonomous affective atmospheres that emanate from, and also condition, collectives of humans and non-humans. Drawing on this atmospheric scholarship, we propose and elaborate an atmospheric analysis of sensemaking and learning processes to examine how such atmospheres aesthetically transform, and anaesthetically constrain, the potential of bodies, including our own as researchers, to affect and be affected to sense and learn. Through empirical engagement with workplace meetings in a UK housebuilding firm, our analysis contributes by explaining how such atmospheres condition sensemaking that both registers the disorganizing novelty of events and reduces such ambiguity and equivocality to enable purposeful action. While extant research has suggested how the interplay of these two dimensions of sensemaking enables learning, our analysis contributes by drawing attention to how the production, maintenance and transformation of specific atmospheres in workplace meetings imbues affects that condition these two dimensions of sensemaking. Such atmospheres thus constitute vital, yet seldom discussed, phenomena in conditioning learning within organizational life.
Considering the practices of the classification of societies – A step towards indigenization
Authors: Gamsakhurdia Vladimer Lado
Published: January 2020

The reasonability of the construction of classificatory rankings of societies and related theoretical implications are considered in this paper. I argue that existing classificatory rankings are based on the essentialist views and represent societies as homogenous entities whereas they ignore intra-societal variety. Moreover, the quantitative methodology and methods which underlie those rankings are based on the etic approach and use concepts and indicators which are constructed in the west and don’t reflect indigenous socio-cultural dynamics. Besides, existing rankings simply equalize particular aspects to the whole societal development. For example, gross domestic product is equalized to the level of societal development; however, it actually can’t fully reflect even the situation in the economic field. Though it can be still reasonable to use such impersonal indicators as gross domestic product or longevity which are based entirely on impersonal data and are free from subjective interpretations, for the exploration of general tendencies in particular fields, however, we should restrain ourselves from invalid generalizations. Krys et al. proposed to elaborate culturally sensitive approach, however, still remained in frame of the etic approach, whereas I argue that the only way for the comprehensive and deeper assessment of the level of societal development is to construct a fully emic and indigenous approach that implies the usage of only locally constructed concepts during the definition of indicators. Those indigenous concepts most probably won’t be translatable to other languages that make the aim of the creation of a unified scale theoretically impossible; however, this is the only way for getting valid results at least concerning particular societies with current methodological apparatus. The solution to this issue requires further theoretical development and methodological innovations.
Update on the Surgical Treatment of Pancreatic Neuroendocrine Tumors
Authors: Jeune F. , Taibi A. , Gaujoux S.
Published: January 2020

Background and Aims:

Pancreatic neuroendocrine tumors (PNET) arise from uncontrolled proliferation of neuroendocrine cell and further genetic alterations that may induce hormone secretion such as glucagon/insulin/gastrin/VIP. Their incidence is rapidelly growing, especially because of the frequent incidental diagnosis of small asymptomatic non-functionnal neuroendocrine tumors with the widespread use of cross-sectional imaging. The vast majority of pancreatic neuroendocrine tumors are sporadic but up to 5%–10% of them arise from genetic syndromes, the main one being Multiple Endocrine Neopalsm type 1 (MEN1). Appropriate management of patients with PNET is a complex challenge for surgeons, and require extensive medical collaboration. This review aims to summarize major and recent updates regarding the medico-surgical management of PNETs.

Material and Methods:

Review of pertinent English language literature.

Results:

This article provides a concise summary of the clinical presentation, diagnosis, surgical management, alternative treatments and follow up of PNETs.

Conclusion:

PNET are a rare, heterogeneous group of neoplasms with a generally favorable prognosis at least compared to pancreatic adenocarcinoma. Surgical resection is the cornerstone of their management, particularly for localized disease, and should always be discussed in multidisciplinary tumor board.
Quality of Life in Diabetic Foot Ulcer: Associated Factors and the Impact of Anxiety/Depression and Adherence to Self-Care
Authors: Polikandrioti Maria , Vasilopoulos Georgios , Koutelekos Ioannis , Panoutsopoulos Georgios , Gerogianni Georgia , Babatsikou Fotoula , Zartaloudi Afroditi , Toulia Georgia
Published: January 2020

Diabetic foot ulcer (DFU) is a major complication of diabetes mellitus that needs a multidisciplinary approach. The purpose of this study was to assess the impact of patients’ characteristics, anxiety/depression, and adherence to guidelines on the QoL of patients with diabetic ulcer. The sample of the study consisted of 195 patients. Data collected by the completion of SF-36 Health Survey, the Hospital Anxiety and Depression Scale, and a questionnaire that measured adherence to self-care activities. Patients had moderate- to high-quality levels in emotional well-being, pain, social functioning, and energy/fatigue (median: 68, 68, 63, and 60, respectively), while they had low levels of quality in physical functioning, role physical, and role emotional (median: 21, 0, and 33, respectively). In their general health, patients had moderate levels (median: 50). High levels of anxiety and depression were observed in 13.8% and 20.0% of the participants, respectively. After multiple regression, regarding general QoL, patients living in the capital city had 9.89 points worse general health than patients living in Attica (β = −9.89, 95% confidence interval [CI] = −16.86 to 2.93, P = .006). Patients with moderate or high levels of anxiety had 9.37 and 16.08 points, respectively, worse general health than those with low levels (β = −9.37, 95% CI = −17.04 to 1.70, P = .017, and β = −16.08, 95% CI = −26.65 to −5.51, P = .003, respectively). Clinically, these findings may help health professionals attain effective treatment of emotional burden to DFU patients and increase adherence to self-care.
Motor-Equivalent Intersegmental Coordination Is Impaired in Chronic Stroke
Authors: Subramanian Sandeep K. , Baniña Melanie C. , Sambasivan Krithika , Haentjens Katherine , Finestone Hillel M. , Sveistrup Heidi , Levin Mindy F.
Published: January 2020

Background. Kinematic abundance permits using different movement patterns for task completion. Individuals poststroke may take advantage of abundance by using compensatory trunk displacement to overcome upper limb (UL) movement deficits. However, movement adaptation in tasks requiring specific intersegment coordination may remain limited. Objective. We tested movement adaptation in both arms of individuals with chronic stroke (n = 16) and nondominant arms of controls (n = 12) using 2 no-vision reaching tasks involving trunk movement (40 trials/arm). Methods. In the “stationary hand task” (SHT), subjects maintained the hand motionless over a target while leaning the trunk forward. In the “reaching hand task” (RHT), subjects reached to the target while leaning forward. For both tasks, trunk movement was unexpectedly blocked in 40% of trials to assess the influence of trunk movement on adaptive arm positioning or reaching. UL sensorimotor impairment, activity, and sitting balance were assessed in the stroke group. The primary outcome measure for SHT was gain ( g), defined as the extent to which trunk displacement contributing to hand motion was offset by appropriate changes in UL movements ( g = 1: complete compensation) and endpoint deviation for RHT. Results. Individuals poststroke had lower gains and greater endpoint deviation using the more-affected compared with less-affected UL and controls. Those with less sensorimotor impairment, greater activity levels, and better sitting balance had higher gains and smaller endpoint deviations. Lower gains were associated with diminished UL adaptability. Conclusions. Tests of condition-specific adaptability of interjoint coordination may be used to measure UL adaptability and changes in adaptability with treatment.
Effects of Exercise Intensity on Acute Circulating Molecular Responses Poststroke
Authors: Boyne Pierce , Meyrose Colleen , Westover Jennifer , Whitesel Dustyn , Hatter Kristal , Reisman Darcy S. , Carl Daniel , Khoury Jane C. , Gerson Myron , Kissela Brett , Dunning Kari
Published: January 2020

Background. Exercise intensity can influence functional recovery after stroke, but the mechanisms remain poorly understood. Objective. In chronic stroke, an intensity-dependent increase in circulating brain-derived neurotrophic factor (BDNF) was previously found during vigorous exercise. Using the same serum samples, this study tested acute effects of exercise intensity on other circulating molecules related to neuroplasticity, including vascular-endothelial growth factor (VEGF), insulin-like growth factor-1 (IGF1), and cortisol, with some updated analyses involving BDNF. Methods. Using a repeated-measures design, 16 participants with chronic stroke performed 3 exercise protocols in random order: treadmill high-intensity interval training (HIT-treadmill), seated-stepper HIT (HIT-stepper), and treadmill moderate-intensity continuous exercise (MCT-treadmill). Serum molecular changes were compared between protocols. Mediation and effect modification analyses were also performed. Results. VEGF significantly increased during HIT-treadmill, IGF1 increased during both HIT protocols and cortisol nonsignificantly decreased during each protocol. VEGF response was significantly greater for HIT-treadmill versus MCT-treadmill when controlling for baseline. Blood lactate positively mediated the effect of HIT on BDNF and cortisol. Peak treadmill speed positively mediated effects on BDNF and VEGF. Participants with comfortable gait speed ≥0.4 m/s had significantly lower VEGF and higher IGF1 responses, with a lower cortisol response during MCT-treadmill. Conclusions. BDNF and VEGF are promising serum molecules to include in future studies testing intensity-dependent mechanisms of exercise on neurologic recovery. Fast training speed and anaerobic intensity appear to be critical ingredients for eliciting these molecular responses. Serum molecular response differences between gait speed subgroups provide a possible biologic basis for previously observed differences in training responsiveness.
The Power of Charisma: Investigating the Neglected Citizen–Politician Linkage in Hugo Chávez's Venezuela
Authors: Andrews-Lee Caitlin
Published: January 2020

Charisma has long been considered a powerful tool for leaders worldwide to rise to greatness. Yet we have given less attention to the way in which charismatic leaders develop deep, unmediated emotional bonds with their followers. I propose a compact theory that explains how charismatic attachments form, overwhelm alternative linkage types, and facilitate the development of powerful and potentially enduring political movements. To illustrate the theory, I turn to Hugo Chávez’s Bolivarian movement in Venezuela. Firstly, the analysis of a 2007 survey from the Latin American Public Opinion Project demonstrates the disproportionate influence of charisma on citizens’ attachments to Bolivarianism relative to competing factors. Next, six original focus groups conducted with Bolivarian followers in 2016 illustrate the mechanisms underlying the followers’ surprisingly resilient loyalty, not only to the leader but also to his overarching movement. The results suggest that affective political attachments can help sustain charismatic movements after their founders disappear.
Party Systems and Factionalism in Timor-Leste
Authors: Shoesmith Dennis
Published: January 2020

This study identifies and explains the factors that have shaped the evolution of the competitive political party system in East Timor from its beginnings in the 1970s to the difficult and sometimes violent transition since independence in 2002 towards a semi-developed competitive party system. It reviews the organizational character of the two major Parties: FRETILIN and the CNRT and the minor parties in the national parliament and the nature of intra-party factionalism in contemporary politics in what is an under-institutionalized and a predominantly personalistic system.
The Experiences of Faculty of Color in Departments of Educational Leadership and Administration: The Role of Emotional and Social Intelligence in Navigating Promotion and Tenure to Achieve the Rank of Associate Professor
Authors: Guillaume Rene O.
Published: January 2020

This article presents the findings from a qualitative phenomenological study with 21 Faculty of Color in departments of educational leadership and administration who were tenured within the past 7 years. An emphasis was placed on examining the role of emotional and social intelligence as the participants successfully navigated the promotion and tenure process. Results of the study provide three themes: Sense of Belonging Through Community, Understanding Self, and Strategic Recognition of Organizational Environment. Participants were able to draw on the competencies of self-awareness, organizational awareness, and relationship building in ways that positively impacted their tenure and promotion journey.
Quantification of pleural effusions on thoracic ultrasound in acute heart failure
Authors: Lindner Moritz , Thomas Richard , Claggett Brian , Lewis Eldrin F , Groarke John , Merz Allison A , Silverman Montane B , Swamy Varsha , Rivero Jose , Hohenstein Christian , Solomon Scott D , McMurray John JV , Steigner Michael L , Platz Elke
Published: January 2020

Background:

Although pleural effusions are common among patients with acute heart failure, the relevance of pleural effusion size assessed on thoracic ultrasound has not been investigated systematically.

Methods:

In this prospective observational study, we included patients hospitalised for acute heart failure and performed a thoracic ultrasound early after admission (thoracic ultrasound 1) and at discharge (thoracic ultrasound 2) independently of routine clinical management. A semiquantitative score was applied offline blinded to clinical findings to categorise and monitor pleural effusion size.

Results:

Among 188 patients (median age 72 years, 62% men, 78% white, median left ventricular ejection fraction 38%), pleural effusions on thoracic ultrasound 1 were present in 66% of patients and decreased in size during the hospitalisation in 75% based on the pleural effusion score (P<0.0001). Higher values of the pleural effusion score were associated with higher pleural effusion volumes on computed tomography (P<0.001), higher NT-pro brain natriuretic peptide values (P=0.001) and a greater number of B-lines on lung ultrasound (P=0.004). Nevertheless, 47% of patients were discharged with persistent pleural effusions, 19% with large effusions. However, higher values of the pleural effusion score on thoracic ultrasound 2 did not identify patients at increased risk of 90-day heart failure rehospitalisations or death (adjusted hazard ratio (HR) 1.05, 95% confidence interval (CI) 0.92–1.19; P=0.46) whereas seven or more B-lines on lung ultrasound at discharge were independently associated with adverse events (adjusted HR 2.43, 95% CI 1.11–5.37; P=0.027).

Conclusion:

Among patients with acute heart failure, pleural effusions are associated with other clinical, imaging and laboratory markers of congestion and improve with heart failure therapy. The prognostic relevance of persistent pleural effusions at discharge should be investigated in larger studies.
Guideline adherence and long-term clinical outcomes in patients with acute myocardial infarction: a Japanese Registry of Acute Myocardial Infarction Diagnosed by Universal Definition (J-MINUET) substudy
Authors: Wada Hideki , Ogita Manabu , Suwa Satoru , Nakao Koichi , Ozaki Yukio , Kimura Kazuo , Ako Junya , Noguchi Teruo , Yasuda Satoshi , Fujimoto Kazuteru , Nakama Yasuharu , Morita Takashi , Shimizu Wataru , Saito Yoshihiko , Hirohata Atsushi , Morita Yasuhiro , Inoue Teruo , Okamura Atsunori , Mano Toshiaki , Hirata Kazuhito , Tanabe Kengo , Shibata Yoshisato , Owa Mafumi , Tsujita Kenichi , Funayama Hiroshi , Kokubu Nobuaki , Kozuma Ken , Uemura Shiro , Toubaru Tetsuya , Saku Keijiro , Oshima Shigeru , Nishimura Kunihiro , Miyamoto Yoshihiro , Ogawa Hisao , Ishihara Masaharu , Sato Tadaya , Kyono Hiroyuki , Tobaru Tetsuya , Sone Takahito , Sone Yasuhiro , Fujino Masashi , Nishimura Kunihiko , Kotani Junichi , Okura Hiroyuki , Uematsu Masaaki , Uemura Shirou , Hokimoto Seiji
Published: January 2020

Background:

The association between guideline adherence and long-term outcomes in patients with acute myocardial infarction in real-world clinical practice remains unclear.

Methods:

We investigated 3283 consecutive patients with acute myocardial infarction who were selected from a prospective, nation-wide, multicentre registry (J-MINUET) database covering 28 institutions in Japan between July 2012 and March 2014. Among the 2757 eligible patients, we evaluated the use of seven guideline-recommended therapies, including urgent revascularisation, door-to-balloon time of 90 minutes or less, and five discharge medications (P2Y12 inhibitors on aspirin, beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, statins, lipid-lowering drugs). The primary endpoint was a composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, cardiac failure and urgent revascularisation for unstable angina up to 3 years.

Results:

The overall median composite guideline adherence was 85.7%. Patients were divided into the following three groups: complete (100%) adherence group (n=862); moderate adherence (75% to <100%) group (n=911); and low adherence (0–75%) group (n=984). The rate of adverse cardiovascular events was significantly lower in the complete adherence group than in the low and moderate adherence groups (log rank P<0.0001). Multivariate Cox regression analysis showed complete guideline adherence was also significantly associated with lower adverse cardiovascular events compared with low guideline adherence (hazard ratio 0.66; 95% confidence interval 0.52–0.85; P=0.001).

Conclusion:

The use of guideline-based therapies for patients with acute myocardial infarction in contemporary clinical practice was associated with significant decreases in adverse long-term clinical outcomes.

Trial registration:

UMIN Unique trial Number: UMIN000010037
Atraumatic splenic rupture was attributed to intra-cystic haemorrhage and hypersplenism in a patient with cirrhosis and portal hypertension: A case report
Authors: Li Hao , Guan Dongyao , Xu Junqiang , Jin Enhao , Sun Shu
Published: January 2020

Liver cirrhosis with splenomegaly and portal hypertension has been described in the medical literature as increasing the risk of splenic rupture. We report a case of atraumatic splenic rupture in a male with liver cirrhosis associated with splenomegaly, which was further complicated by hypersplenism and intra-cystic haemorrhage in the spleen. The 56-year-old man was hospitalized because of sudden onset of intermittent pain in the left quadrant abdomen with no history of trauma. Upon admission, the patient presented no fever, palpable abdominal tenderness, splenomegaly, and hypersplenism. Enhanced computed tomography revealed a splenic subcapsular haematoma connected to a cystic mass located at the splenic hilum and free fluid in the abdomen, which is indicative of splenic rupture. The patient underwent immediate laparotomy and splenectomy followed by proper management. Post-surgery diagnostic microscopy indicated liver steatosis, perivenular fibrosis, and regenerative nodules, which are suggestive of cirrhosis. The patient was discharged from the hospital with an uneventful recovery.
Correlation between fat signal ratio on T1-weighted MRI in the lower vertebral bodies and age, comparing 1.5-T and 3-T scanners
Authors: Sieron Dominik , Drakopoulos Dionysios , Loebelenz Laura I , Schroeder Christophe , Ebner Lukas , Obmann Verena C , Huber Adrian T , Christe Andreas
Published: January 2020

Background

The hypothesis was that the fat-dependent T1 signal intensity in vertebral bodies increases with age due to red-yellow marrow conversion.

Purpose

To analyze the increasing fatty conversion of red bone marrow with age.

Material and Methods

A continuous sample of 524 patients (age range 2–96 years) with normal lumbar spine MRIs (T11–L5) was retrospectively selected in order to get a representative sample from our 1.5-T and 3-T MRI units (Siemens, Erlangen, Germany). Four radiologists read the images independently. Absolute T1 signal intensities were measured in the lower vertebral bodies and standardized by dividing their value by the signal of the subcutaneous fat on lumbar and sacral level.

Results

The standardized T1 signal correlated significantly with patients’ age at the 1.5-T unit, with the best correlation demonstrated by thoracic vertebra T11, followed by lumbar vertebra L1, with correlation coefficients (R) of 0.64 (95% CI 0.53–0.72, P < 0.0001) and 0.49 (95% CI 0.38–0.59, P < 0.0001), respectively. For women and men, the R values were similar in thoracic vertebra T11 at 0.62 (95% CI 0.49–0.72) and 0.64 (95% CI 0.44–0.77), respectively. The vertebral signal correlated significantly better with age in the 1.5-T compared to the 3-T unit on all vertebral levels: the best R value of the 3-T unit was only 0.20 (95% CI 0.09–0.30, P < 0.0001). Our study showed an average increase of the relative T1 signal in T11 of 10% per decade.

Conclusion

T1 fat signal ratio increases with age in the vertebral bodies, which could help estimating the age of a person. Best age correlation was found when measuring T1 signal in T11, standardized by the sacral subcutaneous fat signal and using a 1.5-T MRI.
Review of Experimental Social Behavioral Interventions for Preschool Children: An Evidenced-Based Synthesis
Authors: Hall Tonya
Published: January 2020

Preschool students are expelled from educational settings at higher rates than any other students, and this may serve to be problematic across their lifespan. One of the primary reasons reported is due to their display of social behavioral problems within the preschool classroom. A historical review of social behavioral interventions for preschool children in classroom settings was provided. Moreover, a meta-analysis of recent evidenced-based social behavioral interventions for children with and without disabilities in preschool classrooms was conducted. In addition, 10 research questions were addressed that included the identification of studies using the most rigorous designs. Results from 14 studies in 12 peer-reviewed journals (2007–2017) were provided that indicated variations in range and scientific rigor with two studies meeting the highest standards of rigor. Suggestions for future research were offered.
Psychometric Properties of the Sources of Counseling Self Efficacy in a Sample of Malaysian Secondary School Counselors
Authors: Pei-Boon Ooi , Wan Jaafar Wan Marzuki , Chin-Siang Ang , Nee-Nee Chan
Published: January 2020

Self-efficacy has been considered an essential mediator and predictor of individual counseling performance. As there is no existing scale to measure counseling self-efficacy in the counseling domain, the Sources of Middle School Mathematics Self-Efficacy Scale was modified in this study. The purpose of this study is to examine the psychometric properties of the Sources of Counseling Self-Efficacy Scale, Malaysia (SCSE-M) in a sample of 541 Malaysian secondary school counselors. In addition, it aims to also examine the invariance between registered and non-registered counselors. The results reveal that the SCSE-M four-factor model (social persuasion, mastery experience, vicarious learning, and physiological and affective state) has good fit and is appropriate in the domain-specific counseling profession. In terms of validity and reliability, SCSE-M reported good internal consistency and support for configural, metric, and scalar invariance among registered and non-registered counselors. The generalizability of the results should be considered as tentative and limited to public secondary schools’ counselors who were the sample in this study. More research is needed in the other private, international, primary, and tertiary counseling sectors to determine the appropriateness of the SCSE-M for use in the counseling domain in Malaysia.
Agency and Deliberative Communication in the Classroom
Authors: Tavernaro-Haidarian Leyla
Published: January 2020

Among many challenges in the space of education in the global South, we find that curricula are often out of touch with the contextual reality of students and that classroom or lecture-hall sizes are too big to engage a critical majority. Therefore, reimagining educational processes, or aspects thereof, becomes imperative. This article proposes that cultivating relational models of communication in the classroom is particularly useful in empowering students to connect with, participate, and actively co-shape the content and process of curricula and that it does so by casting agency as the freedom to work “with” rather than “against” or independently of the status quo. It also captures and reflects on the experience of a group of students and facilitators who employed such an approach in their classroom.
Future of Work: An Empirical Study to Understand Expectations of the Millennials from Organizations
Authors: Chopra Anjali , Bhilare Priyanka
Published: January 2020

Technological disruptions are connecting the digital world with the physical one, encouraging new innovations such as artificial intelligence (AI), self-driving cars, robotics, and a globally connected economy, which in turn is changing the role of employees at the workplace. Given the changing dynamic work environment, the present study which is exploratory in nature attempts to understand the expectations, attitudes, and priorities of millennials from their future workplace. Specifically, this study focuses on millennials who are undergoing their education and will be entering the workforce. A combination of random sampling and convenience sampling was used to arrive at a sample size of 140. While millennials are technologically proficient, their expectations go beyond being technically superior. The findings from this research clearly suggest that millennials are looking for strong mentors both in their education and work environment and want a road map to help them grow. Reward and recognition of their ideas is very important and more than online course and e-learning modules, gaining exposure by working in cross-functional teams and with subject matters is important. Organizations should keep in mind the expectations and needs of this diverse group, which would help them while strategizing their recruitment, onboarding, and retention policies.
Radiofrequency Microdebridement as an Adjunct to Arthroscopic Surgical Treatment for Recalcitrant Gluteal Tendinopathy: A Double-Blind, Randomized Controlled Trial
Authors: Blakey Caroline M. , O’Donnell John , Klaber Ianiv , Singh Parminder , Arora Manit , Takla Amir , Fitzpatrick Jane
Published: January 2020

Background:

Recalcitrant greater trochanteric pain is increasingly recognized as an indication for surgical intervention. The arthroscopic approach has become rapidly more common than the open alternative.

Hypothesis:

Patients undergoing radiofrequency microdebridement (RFMD) as an adjunct to arthroscopic gluteal bursectomy (AGB) and iliotibial band release (ITBR) will experience better functional improvement than AGB and ITBR alone at 1 year.

Study Design:

Randomized controlled trial; Level of evidence, 2.

Methods:

A total of 33 patients with failed nonoperative treatment of gluteal tendinopathy were randomly allocated to undergo AGB/ITBR or AGB/ITBR + RFMD. Full-thickness tears were excluded. The primary outcome measure was the modified Harris Hip Score (mHHS) at 52 weeks. Secondary outcome measures included the mHHS, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale (VAS) for pain, and 12-item Short Form Health Survey (SF-12), which were evaluated at 0, 6, 12, 24, and 52 weeks. Statistical significance was defined as P < .05.

Results:

A total of 33 participants (33 hips; 30 female and 3 male; mean age, 58 years) were randomized; 16 patients underwent AGB/ITBR + RFMD, and 17 underwent AGB/ITBR. Participants’ functionality improved in both groups at all time intervals. The mean mHHS score improved from 57.49 ± 10.61 to 77.76 ± 18.40 ( P = .004) and from 58.98 ± 12.33 to 79.96 ± 18.86 ( P = .001) at 52 weeks in the AGB/ITBR and AGB/ITBR + RFMD groups, respectively, although there was no statistically significant difference between groups. There were no device-related adverse events.

Conclusion:

AGB/ITBR led to significant improvements in patients with recalcitrant gluteal tendinopathy. In this small RCT, the addition of RFMD showed no additional benefit to AGB/ITBR but provided a safe adjunct for the surgical management of recalcitrant gluteal tendinopathy.

Registration:

NCT01562366 ( ClinicalTrials.gov identifier).
Glenoid Cartilage Lesions Compromise Outcomes of Surgical Treatment for Posterior Shoulder Instability
Authors: Nourissat Geoffroy , Hardy Marie Beatrice , Garret Jerome , Mansat Pierre , Godenèche Arnaud ,   Société Francophone d’Arthroscopie
Published: January 2020

Background:

Posterior shoulder instability is associated with nonspecific symptoms, including pain, subluxation, and functional impairment, which complicate its diagnosis and management. Owing to the rarity of the condition, there are no present decision tools for its diagnosis and treatment.

Purpose:

To investigate demographic, lesional, and surgical factors that influence functional outcomes in patients treated for posterior shoulder instability.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

We analyzed the clinical and radiographic records of 150 patients treated surgically for isolated posterior shoulder instability at 10 centers between 2000 and 2015, of which 144 were eligible for inclusion: 114 men (79%) and 30 women (21%) (mean ± SD age, 28.7 ± 9.6 years). The mean time between onset of symptoms and surgery was 66 ± 75 months. Shoulder instability was of traumatic origin in 115 patients (80%). The primary treatment was bone-block procedures for 65 patients (45%), posterior Bankart repair for 67 (47%), and capsular plication for 12 (8%). Patients were assessed with the Constant and Walch-Duplay scores at a mean follow-up of 51 ± 32 months (range, 12-159 months). Uni- and multivariable regression analyses were performed to determine associations between clinical scores and sex, age, traumatic origin, type of lesion, type of procedure, and follow-up.

Results:

At final follow-up, subluxations or dislocations recurred in 24 patients (17%). The overall Constant score was 86.2 ± 14.5, with a pain component of 12.6 ± 3.5. The Walch-Duplay score was 79.8 ± 24.2. Multivariable regressions revealed that the presence of a glenoid cartilage lesion was the only factor associated with worse Constant score (beta = –10; P = .013) and Walch-Duplay score (beta = –16.7; P = .024) across all subcomponents.

Conclusion:

The only factor that jeopardized functional outcomes of posterior instability surgery was the presence of glenoid cartilage lesions. Knowing that shoulders with glenoid cartilage lesions are at greater risk of residual pain or instability could help manage patient expectation and justify faster intervention before lesions deteriorate.
Treatment with isoniazid or rifampin for latent tuberculosis infection: population-based study of hepatotoxicity, completion and costs
Authors: Ronald Lisa A. , FitzGerald J. Mark , Bartlett-Esquilant Gillian , Schwartzman Kevin , Benedetti Andrea , Boivin Jean-François , Menzies Dick
Published: January 2020

Clinical trials suggest less hepatotoxicity and better adherence with 4 months rifampin (4R)versus9 months isoniazid (9H) for treating latent tuberculosis infection (LTBI). Our objectives were to compare frequencies of severe hepatic adverse events and treatment completion, and direct health system costs of LTBI regimens 4R and 9H, in the general population of the province of Quebec, Canada, using provincial health administrative data.

Our retrospective cohort included all patients starting rifampin or isoniazid regimens between 2003 and 2007. We estimated hepatotoxicity from hospitalisation records, treatment completion from community pharmacy records and direct costs from billing records and fee schedules. We compared rifampin to isoniazid using logistic (hepatotoxicity), log-binomial (completion), and gamma (costs) regression, with adjustment for age, co-morbidities and other confounders.

10 559 individuals started LTBI treatment (9684 isoniazid; 875 rifampin). Rifampin patients were older with more baseline co-morbidities. Severe hepatotoxicity risk was higher with isoniazid (n=15) than rifampin (n=1), adjusted OR=2.3 (95% CI: 0.3–16.1); there were two liver transplants and one death with isoniazid and none with rifampin. Overall, patients without co-morbidities had lower hepatotoxicity risk (0.1%versus1.0%). 4R completion (53.5%) was higher than 9H (36.9%), adjusted RR=1.5 (95% CI: 1.3–1.7). Mean costs per patient were lower for rifampin than isoniazid: adjusted cost ratio=0.7 (95% CI: 0.5–0.9).

Risk of severe hepatotoxicity and direct costs were lower, and completion was higher, for 4R than 9H, after adjustment for age and co-morbidities. Severe hepatotoxicity resulted in death or liver transplant in three patients receiving 9H, compared with no patients receiving 4R.