bluuebunny/crossref_metadata_2025 huggingface dataset:
A Systematic Review of Psychological Trauma Interventions for Juvenile Offenders
Authors: Rhoden Michelle-Ann , Macgowan Mark J. , Huang Hui
Published: February 2019

Purpose:

This review discusses the efficacy of trauma-specific interventions among juvenile offenders.

Method:

The reviewers conducted a comprehensive search of trauma intervention studies completed in the United States in peer-reviewed journals, highlighting their methodological rigor by using the risk of bias tool for quantitative studies and Wu, Wyant, and Fraser's guidelines for qualitative studies.

Results:

Sixteen studies met the inclusion criteria; fourteen studies used quantitative and two used qualitative research designs. Nine studies reported medium to large effects on post-traumatic stress disorder (PTSD) symptoms and five assessed externalizing behavioral problems. Eye movement desensitization and reprocessing therapy demonstrated the most rigor and had the largest reductions on PTSD symptoms followed by trauma-focused cognitive behavioral therapy. Art therapy was the most rigorous qualitative study, but the intervention did not focus on reducing trauma symptoms.

Discussion:

Overall, most interventions were effective in reducing participants’ PTSD symptoms, but little is known about their effects on externalizing behavioral problems.
Assessing Relationships Between Muslim Physicians’ Religiosity and End-of-Life Health-Care Attitudes and Treatment Recommendations: An Exploratory National Survey
Authors: Duivenbode Rosie , Hall Stephen , Padela Aasim I.
Published: February 2019

Background:

Research demonstrates that the attitudes of religious physicians toward end-of-life care treatment can differ substantially from their nonreligious colleagues. While there are various religious perspectives regarding treatment near the end of life, the attitudes of Muslim physicians in this area are largely unknown.

Objective:

This article attempts to fill in this gap by presenting American Muslim physician attitudes toward end-of-life care decision-making and by examining associations between physician religiosity and these attitudes.

Methods:

A randomized national sample of 626 Muslim physicians completed a mailed questionnaire assessing religiosity and end-of-life care attitudes. Religiosity, religious practice, and bioethics resource utilization were analyzed as predictors of quality-of-life considerations, attitudes regarding withholding and withdrawing life-sustaining treatment, and end-of-life treatment recommendations at the bivariate and multivariable level.

Results:

Two-hundred fifty-five (41% response rate) respondents completed surveys. Most physicians reported that religion was either very or the most important part of their life (89%). Physicians who reported consulting Islamic bioethics literature more often had higher odds of recommending active treatment over hospice care in an end-of-life case vignette. Physicians who were more religious had higher odds of viewing withdrawal of life-sustaining treatment more ethically and psychologically challenging than withholding it and had lower odds of agreeing that one should always comply with a competent patient’s request to withdraw life-sustaining treatment.

Discussion:

Religiosity appears to impact Muslim physician attitudes toward various aspects of end-of-life health-care decision-making. Greater research is needed to evaluate how this relationship manifests itself in patient care conversations and shared clinical decision-making in the hospital.
Fibrous Dysplasia and Juvenile Psammomatoid Ossifying Fibroma: A Case of Mistaken Identity
Authors: Turin Sergey Y. , Purnell Chad , Gosain Arun K.
Published: February 2019

Juvenile psammomatoid ossifying fibroma (JPOF) is a rare benign osseous tumor, usually presenting in the midface. There are many similarities in location, presentation, and radiographic appearance between fibrous dysplasia (FD) and JPOF. Awareness of this entity is important for craniofacial surgeons, as surgical timing and intraoperative management differ between these tumors. Findings that should raise suspicion of JPOF preoperatively include rapid growth, a shell of cortical bone surrounding the lesion, and clearly demarcated borders of the lesion on imaging, as opposed to a gradual transition between normal and abnormal bone. Definitive excision is the treatment of choice, and earlier surgery may provide better results by addressing the lesion at the smallest size possible. In contrast to FD, JPOF is not known to “burn out,” so there is minimal benefit to be gained from delay. We present a summary of the evidence for diagnosis and treatment of JPOF as well our experience with JPOF in an 11-year-old female who was initially diagnosed with FD. We aim to draw attention to the similar presentations of these entities so the reader will be able to more accurately manage these patients.
Trauma-Focused Family Therapy With Children and Their Families
Authors: Boyer Wanda
Published: February 2019

Family life is considered to be a context in which children can safely learn life skills such as managing and directing their cognitive, physical, emotional, and behavioral responses to events as a way to achieve a sense of purpose and mastery in life. Traumatic events such as natural disasters, serious accidents, and violence in our homes, schools, or communities may alter an individual’s ability to manage cognitive, physical, emotional, and behavioral functioning. Trauma can significantly affect children and their families, impacting relationships, interactions, and their context. There is evidence to support the use of family therapy with children who have experienced trauma. Family support can improve interactions and relationships and can assist children in resolving trauma symptomology. Trauma-focused cognitive behavioral therapy (TF-CBT) is professionally recognized as an evidence-based intervention. There are also TF-CBT intervention derivations that have been developed to support children experiencing trauma. TF-CBT and TF-CBT intervention derivations are explored in this article including core components of evidence-based trauma-focused family therapy necessary to support traumatized children and their families. Discussion also includes the importance and evidence-based support for honoring cultural diversity and including optimism and hope into family experiences as both a preventative and interventive measure to manage trauma symptomology.
Algorithm for Management of Periprosthetic Ankle Fractures
Authors: Lazarides Alexander L. , Vovos Tyler J. , Reddy Gireesh B. , DeOrio James K. , Easley Mark E. , Nunley James A. , Adams Samuel B.
Published: February 2019

Background:

Evidence on the management of and outcomes from periprosthetic fractures about a total ankle replacement (TAR) are limited. The purpose of this study was to develop an algorithm for the management of patients with postoperative periprosthetic fractures about a TAR.

Methods:

This was a retrospective analysis of patients undergoing a TAR from 2007 through 2017 with a subsequent periprosthetic fracture >4 weeks from index surgery. Implant stability was defined radiographically and intraoperatively where appropriate. Univariate and multivariate analyses were used to identify differences in outcomes. Thirty-two patients were identified with a remote TAR periprosthetic fracture with an average follow-up of 26 months (range, 3-104 months).

Results:

Most fractures were located about the medial malleolus (62.5%); the majority of fractures (75%) were deemed to have stable implants. Fractures of the talus always had unstable implants and always required revision TAR surgery (100%, P = .0002). There was no difference in patient-reported outcomes between stable and unstable fractures at an average of 36 months. In a multivariate analysis, fracture location (talus), less time to fracture, and implant type were found to be predictive of unstable implants ( P < .001). Implant stability was independently associated with the need for revision surgery ( P < .049). Nonoperative treatment was independently associated with treatment failure ( P < .001).

Conclusion:

The majority of stable fractures about a TAR required operative fixation. Management with immobilization was fraught with a high rate of subsequent surgical intervention. We found that fractures about the talus required revision TAR surgery or arthrodesis.

Level of Evidence:

Level III, retrospective cohort study.
Reviewing How Preservice Teachers Are Prepared to Teach Reading Processes: What the Literature Suggests and Overlooks
Authors: Hikida Michiko , Chamberlain Katharine , Tily Susan , Daly-Lesch Anne , Warner Jayce R. , Schallert Diane L.
Published: February 2019

Today’s world requires attention to all aspects of initial literacy teacher preparation, including how and what preservice teachers learn about the component processes of reading. To address this imperative, a review was conducted of articles published from 2000 to 2018 identified through the CITE-ITEL database ( https://cite.edb.utexas.edu ) that reported findings related to reading processes and initial teacher preparation. After an inductive analytic process, the authors organize findings into five focus areas: (a) definitions and delimitations of reading processes, (b) studies of preservice teachers’ beliefs about teaching reading processes, (c) research identifying preservice teachers’ knowledge gaps and misconceptions, (d) intervention studies aimed at increasing preservice teachers’ knowledge, and (e) studies detailing the application of knowledge about reading processes into contexts of pedagogical practice. The discussion considers the current gaps in how reading processes and literacy are conceptualized and possible areas of inquiry related to preservice teacher education and reading processes.
Recurrent Non Immune Fetal Hydrops Associated With IPEX Syndrome
Authors: Shanes Elisheva , Propst Lauren , Ouyang David W , Ernst Linda M
Published: February 2019

Immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) is a clinical syndrome associated with mutations in FOXP3 and consequent abnormalities of T regulatory cells. Affected males typically die in infancy or early childhood from a variety of autoimmune conditions. Reports of recurrent pregnancy loss of male fetuses in these families have been accompanied by descriptions of nonimmune fetal hydrops, with or without additional fetal anomalies. Here, we report an additional family affected by IPEX with a novel mutation leading to recurrent second trimester fetal hydrops and intrauterine fetal demise with associated fetal anomalies. This report underscores how careful genetic and pathologic analysis of even midtrimester fetuses can provide important information impacting an entire family. It also further substantiates the use of broad, symptom-targeted genetic screening panels in cases of recurrent pregnancy loss even in the absence of a remarkable pedigree.
Aflibercept: A review of its effect on the treatment of exudative age-related macular degeneration
Authors: Papadopoulos Zois
Published: February 2019

Considerable improvement has been achieved in the way in which exudative age-related macular degeneration is conventionally treated and in the associated visual outcomes and prognosis, thanks to the agents with effects against vascular endothelial growth factor (anti-VEGF). By comparison to earlier treatment approaches that involved the use of lasers, the anti-VEGF agents have made it possible to accomplish more positive visual and anatomical outcomes in cases of exudative age-related macular degeneration. Indeed, owing to their positive effects, anti-VEGF agents have quickly come to be considered the gold standard for the treatment of wet age-related macular degeneration. Aflibercept, the most recently approved intravitreally administered anti-VEGF, seems to mark another milestone in the treatment of wet age-related macular degeneration. This anti-VEGF agent presents a series of singular pharmacodynamic and pharmacokinetic attributes that provide it a number of biological benefits in relation to the treatment of choroidal neovascularization compared to other agents. These attributes include high level of affinity for the VEGF-A factor, an intravitreal half-life of great length, as well as the ability to serve as an antagonist for other growth factors besides VEGF. The impact of Aflibercept on the manner in which exudative age-related macular degeneration is managed was demonstrated by thoroughly reviewing the related literature. The present review article highlights the pharmacology, pharmacokinetics, safety and effectiveness of this anti-VEGF agent as well as the landmark clinical studies that have been carried out to establish this drug as a gold standard in the therapy of neovascular age-related macular degeneration. In addition, studies regarding the outcomes and effectiveness of the various dosage regimens, either as monotherapy or in combination with other agents, are also reviewed.
Flaunting our assets. Making the most of the Nordic registry goldmine: Cerebral palsy as an example
Authors: Alriksson-Schmidt Ann I. , Jeglinsky-Kankainen Ira F. D. , Jahnsen Reidun B. , Hollung Sandra J. , Andersen Guro L. , HÄgglund Gunnar V.
Published: February 2019

Aims:To describe the early experiences of a Nordic multidisciplinary cerebral palsy (CP) registry research program combining data from national medical quality registries, follow-up programs and cohort data, in addition to data from other national registries; to explore the scientific and practical uses of such research, and provide recommendations for facilitating similar work in the future. Methods: The work was divided into three themes: medical outcomes, social and public health outcomes, and health economics; and three cross-cutting teams: a reference team, a challenge team, and a communication and dissemination team. Initially each country will perform domestic research, and in the second stage data will be merged across all Nordic countries. Data from national registries with vital statistics, education and work, social benefits, and healthcare will be used. Comparisons will be matched for both the individuals with CP and their parents. Results: Initial work has been done on agreeing which variables to request from the respective agencies and planning the correct procedures and steps required to acquire the data. As of 2018, Sweden, Norway, and Finland have received approved ethics board applications. Iceland and Denmark are waiting for their approvals. A webpage and a platform for internal communication have been created. Conclusions: Nordic register research has great potential. Linking national CP quality registries and follow-up programs with other large national registries holds particular promise because problems identified through research can be applied at a population level. It is imperative that ethical clearance and data delivery processes are streamlined and transparent, and that data variables are measured the same way in the different countries.
Migration, not migrants, is the problem: Delinquency among migrants and non-migrants in Switzerland and ex-Yugoslavia
Authors: Killias Martin , Lukash Anastasiia
Published: February 2019

The nexus between migration and crime has been studied over nearly a century across many countries from all continents. Research has concentrated on comparisons of migrants (or their offspring) with natives. Comparisons between migrants and comparable samples from their countries of origin have not been undertaken so far, however, because data were usually limited to the host country. The International Self-Reported Delinquency Study (ISRD-3, Enzmann et al., 2018) allows this gap to be overcome. In Switzerland, with its large immigrant minority – one student in two has roots in a foreign country – migrants of different backgrounds can be compared with native Swiss and with students who attend schools in ex-Yugoslavia where many migrants are from. We compare data on self-reported offences and victimization in the family collected through interviews with some 4000 juveniles in Switzerland and more than 6000 students of the same age in four countries of ex-Yugoslavia (Bosnia-Herzegovina, Serbia, Kosovo, Macedonia). Native-born youths in Switzerland report fewer offences than their immigrant peers, including those from ex-Yugoslavia. Although differences between students from ex-Yugoslavia and other foreign countries are relatively small, juveniles in ex-Yugoslavia report far lower offending rates than immigrants of the same age in Switzerland. Their rates are similar or lower than among native Swiss students. Further, rates of physical punishment and maltreatment are higher among immigrants than among non-migrants in Switzerland and in ex-Yugoslavia. We conclude that cultural background is unrelated to delinquency and parental punishment, but the experience of migrating goes along with violence within the family and self-reported offending. Differences exist between various family constellations, students born or with at least one parent born in Switzerland committing fewer offences and experiencing less parental violence.
Breaking the Taboo: Sexual Assault in Late Life as a Multifaceted Phenomenon—Toward an Integrative Theoretical Framework
Authors: Band-Winterstein Tova , Goldblatt Hadass , Lev Sagit
Published: February 2019

Sexual assault (SA) in late life has been receiving growing attention over the past two decades. It is directed primarily against older women and has been the least frequently reported form of abuse. Despite the growing awareness and body of knowledge on this phenomenon, the theoretical framework is still limited. Therefore, the aim of the present article is to suggest a theoretical conceptualization of the multifaceted phenomenon of sexual assault against women in late life (SAWLL). This conceptualization has been developed through several stages: (a) identification of three grounded fields of inquiry that are relevant to SAWLL: SA, elder mistreatment, and intimate partner violence; (b) classification of SAWLL along four paths: (1) ongoing SA in the context of lifelong IPV; (2) SA beginning in old age in the family within the community, involving spouses, family members, caregivers, dating mates, and so on; (3) ongoing SA, continuing in institutions, perpetrated by family members; and (4) SA in institutions, beginning in old age, relating to staff, residents, and family members; (c) We suggest three additional theoretical perspectives: trauma, a life-course perspective, and social constructionism, which provide further in-depth knowledge for understanding SAWLL. The combination of the three abovementioned stages composes an integrative theoretical framework, addressing SAWLL as a multifaceted phenomenon.
On state-space compression and state reachability retrieval of Petri nets
Authors: Ren Huorong , Xu Jin , Liang Ye , Rehman Ateekh Ur , Umer Usama
Published: February 2019

The problem of state-space explosion and state reachability decision has been a focus in Petri net analysis. In this article, some algorithms based on data features of state space are proposed for state-space reduction and reachability analysis in Petri nets. A caching arrangement algorithm for the state reachability graph is proposed to alleviate the memory overhead when all states are generated by a traditional reachability graph generation algorithm. For the reduction of the state space, a compression algorithm based on a hybrid coding is formulated. The changing characteristics of state elements are fully utilized to realize a sharp reduction of the whole state space. For the state reachability analysis, a state reachability retrieval algorithm based on the locally sensitive hashing is reported. In this algorithm, all the states in the compressed state space are distributed to different hash buckets according to the distances among the states, which realize the primary state retrieval efficiently. Then, a state retrieval strategy that reverts the primary retrieved state to its original data is adopted. Finally, the proposed compression and retrieval algorithms are validated on several Petri net models, showing high compression efficiency and exact accuracy of state retrieval.
Optimization analysis of the internal structure of flow-assisted zinc-nickel battery driven by a propeller
Authors: Shou-guang Yao , Sun Xiao-fei , Xiao Ming , Cheng Jie , Sheng Ya-ju
Published: February 2019

This study established a three-dimensional analysis model of the internal flow field of the battery stack with a rotating propeller by using the flow-assisted zinc-nickel battery stack driven by a propeller. The flow of electrolyte in the battery stack was simulated and analyzed. The key design parameters of the battery stack were analyzed and optimized by adjusting the baffle and blade heights, blade speed, and blade number based on the uniformity of the internal flow field of the battery stack. The final simulation results show that the flow field distribution is the most uniform when the baffle and blade are 100 and 140 mm, respectively; from the top of the battery stack, the number of blades is five leaves, and the speed is 600 r/min. This article serves as the basis for the structural design of flow-assisted zinc-nickel battery driven by a propeller.
Numerical analysis on the sloshing of free oil liquid surface under the variable conditions of vehicle
Authors: He Ren , Zhang Enhui , Fan Baowei
Published: February 2019

Oil liquid sloshing is the sloshing of free oil liquid surface in the fuel tank filled partially. The variable conditions of vehicle mainly include braking, acceleration, and deceleration. It is verified that the simulation method is reliable by the test. In this study, numerical simulations are carried out to study the sloshing of free oil liquid surface under the variable conditions of vehicle, and the key factors influencing variable conditions are acceleration value of oil liquid sloshing, the lasted time of acceleration, and the amount of fuel filled. The numerical results of oil liquid sloshing under variable conditions are compared. The results show that the influence of the amount of fuel filled on oil liquid sloshing and evaporative emission is greater than that of the other two factors under the same working conditions. The time-area values of acceleration lasted time of 1 s are bigger than that of 4 s and the time-area values of 50% fuel filled are bigger than that of 25% fuel filled during the same time of sloshing, and the change law of evaporative emission is the same as that of time-area values.
Characterization of neuromas in peripheral nerves and their effects on heterotopic bone formation
Authors: Minarelli Jordan , Davis Eleanor L , Dickerson Austin , Moore William C , Mejia Julio A , Gugala Zbigniew , Olmsted-Davis Elizabeth A , Davis Alan R
Published: February 2019

The formation of neuromas involves expansion of the cellular components of peripheral nerves. The onset of these disorganized tumors involves activation of sensory nerves and neuroinflammation. Particularly problematic in neuroma is arborization of axons leading to extreme, neuropathic pain. The most common sites for neuroma are the ends of transected nerves following injury; however, this rodent model does not reliably result in neuroma formation. In this study, we established a rodent model of neuroma in which the sciatic nerve was loosely ligated with two chromic gut sutures. This model formed neuromas reliably (∼95%), presumably through activation of the neural inflammatory cascade. Resulting neuromas had a disorganized structure and a significant number of replicating cells. Quantification of changes in perineurial and Schwann cells showed a significant increase in these populations. Immunohistochemical analysis showed the presence of β-tubulin 3 in the rapidly expanding nerve and a decrease in neurofilament heavy chain compared to the normal nerve, suggesting the axons forming a disorganized structure. Measurement of the permeability of the blood–nerve barrier shows that it opened almost immediately and remained open as long as 10 days. Studies using an antagonist of the β3-adrenergic receptor (L-748,337) or cromolyn showed a significant reduction in tumor size and cell expansion as determined by flow cytometry, with an improvement in the animal’s gait detected using a Catwalk system. Previous studies in our laboratory have shown that heterotopic ossification is also a result of the activation of neuroinflammation. Since heterotopic ossification and neuroma often occur together in amputees, they were induced in the same limbs of the study animals. More heterotopic bone was formed in animals with neuromas as compared to those without. These data collectively suggest that perturbation of early neuroinflammation with compounds such as L-748,337 and cromolyn may reduce formation of neuromas.
Understanding the impact of neurologic complications in patients with cirrhosis
Authors: Allampati Sanath K , Mullen Kevin D
Published: February 2019

Patients with cirrhosis may experience neurologic complications, including hepatic encephalopathy. Hepatic encephalopathy may be classified as covert (mild symptoms (e.g. lack of awareness)) or overt (moderate to severe symptoms (e.g. confusion or coma)), and symptoms may overlap with other neurologic conditions (e.g. epilepsy, stroke). Managing hepatic encephalopathy includes identifying and treating precipitating factors (e.g. dehydration). First-line treatment for patients with overt hepatic encephalopathy is typically lactulose; to reduce the risk of overt hepatic encephalopathy recurrence, lactulose plus the nonsystemic antibiotic rifaximin is recommended. Rifaximin reduced the risk of breakthrough overt hepatic encephalopathy by 58% versus placebo over 6 months (p < 0.001; 91% of patients in each group were on concomitant lactulose). However, neither pharmacologic hepatic encephalopathy treatment nor liver transplantation may completely reverse neurologic impairment in patients with hepatic encephalopathy. Additional neurologic considerations for patients with cirrhosis include preventing falls, as well as managing sleep-related issues, hyponatremia, and cerebral edema. Thus, monitoring neurologic impairment is an important component in the management of patients with cirrhosis.
Signed regression: Principle and user guide
Authors: Windal Pierre Marie
Published: February 2019

To our knowledge, there is no linear regression method that systematically ensures that the sign of the coefficients agrees with that of the simple correlation between the dependent variable and each regressor and whose value does not conform to the constraint imposed on them. But this twofold imperative – a coefficient that is positive and sufficiently different from zero for each variable – is often a prerequisite for practitioners working, for example, in the field of consumer satisfaction, where statistical collinearity is the norm. The purpose of this article is to provide them with a formal method that addresses this need and produces results comparable to those of statistically based methods, with strict and systematic conformity to the associated sign.
Facilitating the Transition of Adolescents and Emerging Adults From Care Into Employment in Kampala, Uganda: A Case Study of Uganda Youth Development Link
Authors: Bukuluki Paul Mukisa , Kamya Sarah , Kasirye Rogers , Nabulya Anna
Published: February 2019

Uganda has an increasing number of vulnerable youth in care who require support to transition into adult life. This article explores the agency enablers and the factors which hinder adolescents and emerging adults transitioning from care to adulthood, with an emphasis on the transition into work taking a case study of the Uganda Youth Development Link. Cross-sectional and case study designs were employed using structured questionnaires, focus group discussions, and in-depth interviews. Results show that care programs helped care leavers  gain skills that facilitated self-reliance through employment in the formal sector and self-employment, a savings culture and expansion of social networks. Enablers included the mentors, exchange learning visits, placements with businesses, and positive social support networks. Unaffordable business premises, stigma and discrimination, limited access to credit, and insecurity inhibited successful post care transition. The conclusion emphasizes the importance of agency and structure in the transition out of care in Uganda.
Paraneoplastic glomerular disease: The struggle is real
Authors: Amarapurkar Pooja , Bou-Slaiman Salim , Madrid Bianca , Ladino Marco
Published: February 2019

Over the past decade, the relationships between various kidney disease and cancer have been established, but not fully elucidated. Development of acute kidney injury or chronic kidney disease as a side effect of cancer treatment is not uncommon. However, renal paraneoplastic diseases are rather unique and less known examples of the association between kidney disease and cancer. These conditions are of importance to the nephrologist as they may be the initial presentation of an underlying malignancy and may not respond to the usual therapies used for their non-paraneoplastic variants. This article will discuss the pathogenesis and challenges in management of paraneoplastic glomerular diseases.
Land use change simulation and analysis using a vector cellular automata (CA) model: A case study of Ipswich City, Queensland, Australia
Authors: Lu Yi , Laffan Shawn , Pettit Chris , Cao Min
Published: February 2019

The loss of accuracy in vector-raster conversion has always been an issue for land use change models, particularly for raster based Cellular Automata models. Here we describe a vector-based cellular automata (CA) model that uses land parcels as the basic unit of analysis, and compare its results with a raster CA model. Transition rules are calibrated using an artificial neural network (ANN) and historical land use data. Using Ipswich City in Queensland, Australia as the study area, the simulation results show that the vector and raster CA models achieve 96.64% and 93.88% producer’s spatial accuracy, respectively. In addition, the vector CA model achieves a higher kappa coefficient and more consistent frequency of misclassification, while also having faster processing times. Consequently, the vector-based CA model can be applied to explore regulations of land use transformation in urban growth process, and provide a better understanding of likely urban growth to inform city planners.
Impaired cough suppression in chronic refractory cough
Authors: Cho Peter S.P. , Fletcher Hannah V. , Turner Richard D. , Jolley Caroline J. , Birring Surinder S.
Published: February 2019

Functional brain imaging in individuals with chronic cough demonstrates reduced activation in cortical regions associated with voluntary cough suppression. Little is known about the ability of patients with chronic cough to suppress cough. This study aimed to compare the ability to voluntarily suppress cough during inhaled capsaicin challenge in participants with chronic refractory cough with that in healthy controls. In addition, this study aimed to assess the repeatability of capsaicin challenge test with voluntary cough suppression.

Participants with chronic refractory cough and healthy controls underwent inhaled capsaicin challenge tests while attempting to suppress their cough responses. After 5 days, either a conventional capsaicin challenge test with no cough suppression attempt, or a repeat test with an attempt at cough suppression was performed. Threshold capsaicin concentrations required to elicit one, two and five coughs were calculated by interpolation. Objective 24-h cough frequency was measured in individuals with chronic refractory cough.

Healthy controls were able to suppress capsaicin-evoked cough while participants with chronic refractory cough were not. Geometric mean±sdcapsaicin dose thresholds for five coughs with (CS5) and without (C5) suppression attempts were 254.40±3.78versus45.89±3.95 µmol·L−1, respectively, in healthy controls (p=0.033) and 3.34±5.04versus3.86±5.13 µmol·L−1, respectively, in participants with chronic refractory cough (p=0.922). Capsaicin dose thresholds for triggering five coughs with self-attempted cough suppression were significantly lower in participants with chronic refractory cough than in healthy controls; geometric mean±sd4.94±4.43versus261.10±4.34 µmol·L−1, respectively; mean difference (95% CI) 5.72 (4.54–6.91) doubling doses (p<0.001). Repeatability of cough suppression test in both patients and healthy controls was high; intraclass correlation coefficients of log(CS5) values 0.81 and 0.87, respectively. CS5 was associated with objective cough frequency (ρ=−0.514, p=0.029).

Participants with chronic refractory cough were less able to voluntarily suppress capsaicin-evoked cough compared to healthy controls. This may have important implications for the pathophysiology and treatment of chronic cough.
EXERCISE PROGRAMMING FOR RHEUMATOID ARTHRITIS
Authors: Chiarlitti Nathan A. , Sirois Alexandra , Andersen Ross E. , Bartlett Susan J.
Published: February 2019

Apply It!

1) Health care professionals will be able to describe why physical activity promotion and exercise programming is especially important for people with rheumatoid arthritis.

2) Health care professionals will learn the importance of ongoing communication with clients to identify potential barriers to exercise and finding solutions to staying active.

3) Health care professionals will be able to describe how to modify exercise programming to accommodate clients with stiff or swollen joints and suboptimal range of motion associated with rheumatoid arthritis disease activity.
Does Helping John Help Sue? Evidence of Spillovers in Education
Authors: Opper Isaac M.
Published: February 2019

Does the impact of teachers extend beyond the students in their classroom? Using the natural transitions of students from multiple elementary schools into a single middle school, this paper provides a new method for isolating and quantifying peer spillover effects of teaching and shows that ignoring these spillovers underestimates a teacher’s value by at least 30 percent. Because the spillovers also affect teacher value-added estimates, I develop a method of moments estimator of teacher value-added and show that accounting for the spillovers does not have a large impact on the ranking of teachers in New York City. I conclude by showing that the spillovers occur within groups of students who share the same race and gender, which suggests that social networks play a critical role in disseminating the effect. (JEL H75, I21, J15, J16, J45, Z13)
A era da experiência dos pacientes
Authors: Rodrigues Kelly Cristina
Published: February 2019

É uma tendência no mundo aprimorar serviços de saúde a partir do que os pacientes verdadeiramente valorizam, como o acesso à informação e a cuidados individualizados.
De volta para casa
Authors: Migliora Neto Luiz , Romani-Dias Marcello
Published: February 2019

Por que estamos perdendo e como podemos repatriar nossos professores em administração?
O mundo em 2019
Authors: Casarões Guilherme
Published: February 2019

Espera-se que o novo governo brasileiro crie condições para lidar com as turbulências do mundo que nos aguarda em 2019.
Malposition of hemodialysis catheter into the hepatic veins
Authors: Kocak Sibel Yucel , Gumusel Ceren
Published: February 2019

Permanent central vein catheter for hemodialysis is a choice for hemodialysis vascular access. Permanent dialysis catheters may be inserted through the jugular, subclavian and femoral veins. It may be inserted when the patient have short life expectancy or not suitable for fistula operation. There may be so many complications for example malposition, hemorrhage and pneumothorax while inserting central venous catheter. Here we present a 44 year old female hemodialysis patient with a malpositioned permanent hemodialysis catheter, catheter tip was found in hepatic vein after three months of insertion.

How to cite this:Yucel SK, Gumusel C. Malposition of hemodialysis catheter into the hepatic veins. Pak J Med Sci. 2019;35(2):583-585.  doi: https://doi.org/10.12669/pjms.35.2.416

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Safety and efficacy of miltefosine in cutaneous leishmaniasis: An open label, non-comparative study from Balochistan
Authors: Tahir Moizza , Bashir Uzma , Hafeez Javeria , Ghafoor Rabia
Published: February 2019

Background & Objective: Cutaneous Leishmaniasis (CL) is endemic in Baluchistan and treated traditionally with Meglumine antimoniate. Miltefosine appears appealing therapy in cutaneous Leishmaniasis. Our objective was to evaluate safety and efficacy of Miltifossine in treatment of cutaneous Leishmaniasis.

Methods: This experimental study was conducted from 10 September 2017 to 10 May 2018 at Combined Military Hospital Quetta. Total of 42 patients were recruited by purposive sampling technique. Lesional skin smears were stained with giemsa for Leishmania amastigotes under magnification (100 x).Complete blood count, serum urea, creatinine, bilirubin, aspartate aminotransferases (AST), alanine aminotransferase (ALT) were done at the beginning of treatment and then weekly, thereafter. Cap Miltefosine 50 mg (2.5mg/kg) were given as directly observed therapy .Daily observation during treatment phase was done for clinical side effects of therapy. Clinical response was documented at two weeks then at eight weeks. Photographs were taken before and after the therapy. Data was analyzed by SPSS 16.

Results: Complete clinical response was observed in 39 (92.9%) patients and partial clinical response in 1(2.4%) patient. Two patients were lost to follow up at eight weeks. No significant derangements in laboratory profile were noted before and after treatment. Mean duration of treatment was 23.47+SD 4.44 days. Sixteen patients (38.1%) took Miltefosine for 28 days, 12 (28.6%) for 21 days and 9 (25%) for 25 days.

Conclusion: Miltefosine is safe and cost effective treatment for cutaneous Leishmaniasis. It is effective in CL cases not susceptible to antimony compounds.

How to cite this:Tahir M, Bashir U, Hafeez J, Ghafoor R. Safety and efficacy of miltefosine in cutaneous leishmaniasis: An open label, non-comparative study from Balochistan. Pak J Med Sci. 2019;35(2):495-499. doi: https://doi.org/10.12669/pjms.35.2.54

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
shiny-pred: a server for the prediction of protein disordered regions
Authors: Oberti Mauricio , Vaisman Iosif
Published: February 2019

Intrinsically disordered proteins or intrinsically disordered regions (IDR) are segments within a protein chain lacking a stable three-dimensional structure under normal physiological conditions.

Accurate prediction of IDRs is challenging due to their genome wide occurrence and low ratio of disordered residues, making them a difficult target for traditional classification techniques. Existing computational methods mostly rely on sequence profiles to improve accuracy, which is time consuming and computationally expensive.

The shiny-pred application is an ab initio sequence-only disorder predictor implemented in R/Shiny language. In order to make predictions, it uses convolutional neural network models, trained using PDB sequence data. It can be installed on any operating system on which R can be installed and run locally. A public version of the web application can be accessed at https://gmu-binf.shinyapps.io/shiny-pred
Prevalence and diversity of Salmonella isolated from layer farms in central Ecuador
Authors: Salazar Gabriela A. , Guerrero-López Ricardo , Lalaleo Liliana , Avilés-Esquivel Diana , Vinueza-Burgos Christian , Calero-Cáceres William
Published: February 2019

Background: Given the considerable role played by Salmonella in the incidence of food poisoning around the world, surveillance of this infection is prioritized by both food producers and health care authorities. Data remains insufficient concerning the prevalence of Salmonella in poultry systems in Ecuador and in Latin America in general.

Methods: In this study we evaluated the prevalence and diversity of Salmonella serovars in samples taken from 21 layer farms and backyard layers in central Ecuador during August-November 2017.  Salmonella was isolated following standardized methods (ISO 6579) and the serovar determination was carried out by PCR.

Results: A significant presence of Salmonella was detected, with an incidence of 76% (95% confidence interval (CI): 58–94) in farms, 33% (95%CI: 13–53) in pooled cloacal swabs from layer hens, 33% (95%CI: 12–55) on feed samples, and 10% (95%CI: 0–22) in backyard layer feces from traditional local markets. The dominant serovars detected were S. Infantis and S. Typhimurium.

Conclusions: This study forms a basis for further surveillance of Salmonella serovars in layer farms in central Ecuador.
Evolution of a programme to engage school students with health research and science in Kenya
Authors: Davies Alun , Mwangome Nancy , Yeri Betty , Mwango Grace , Mumba Noni , Marsh Vicki , Kamuya Dorcas , Molyneux Sassy , Kinyanjui Samson M. , Jones Caroline
Published: February 2019

Facilitating mutually-beneficial educational activities between researchers and school students is an increasingly popular way for research institutes to engage with communities who host health research, but these activities have rarely been formally examined as a community or public engagement approach in health research. The KEMRI-Wellcome Trust Research Programme (KWTRP) in Kilifi, Kenya, through a Participatory Action Research (PAR) approach involving students, teachers, researchers and education stakeholders, has incorporated ‘school engagement’ as a key component into their community engagement (CE) strategy.

School engagement activities at KWTRP aim at strengthening the ethical practice of the institution in two ways: through promoting an interest in science and research among school students as a form of benefit-sharing; and through creating forums for dialogue aimed at promoting mutual understanding between researchers and school students.

In this article, we provide a background of CE in Kilifi and describe the diverse ways in which health researchers have engaged with communities and schools in different parts of the world. We then describe the way in which the KWTRP school engagement programme (SEP) was developed and scaled-up. We conclude with a discussion about the challenges, benefits and lessons learnt from the SEP implementation and scale-up in Kilifi, which can inform the establishment of SEPs in other settings.
A review of the effects of ageing on skin integrity and wound healing
Authors: Bonifant Hilary , Holloway Samantha
Published: February 2019

It is well known that advancing age is a factor that affects the normal course of wound healing. The population over the age of 65 years is increasing globally, and this may be accompanied by an increase in the number of individuals experiencing delayed wound healing. There is a breadth of research to show that age-related changes in the epidermis and dermis change the skin's ability to resist damage and injury. In particular, the dermoepidermal junction becomes flattened, which predisposes the tissue to shear and friction forces. Within the dermis, alterations in the amount and structure of collagen also mean that the tissue is much more rigid. Prompt assessment of the skin to identify existing conditions as well as preventive measures is therefore essential. This article discusses the anatomy of the skin and the effects of ageing on the tissues. It also offers some guidance on skin assessment and the basics of skin care.
How to perfect a performance
Authors: Robinson Karen
Published: February 2019

Karen Robinson shares her tips to help you fine tune your management skills so you and your team hit the right notes every time
It's not routine to me!
Authors: Collier Andrew
Published: February 2019

Andrew Collier looks at the risks that can arise if a patient's perceptions are negative
The effect of Muscle Energy Techniques versus cross (X) technique kinesio taping to treat chronic low back dysfunction
Authors: Elshinnawy Ahmed M , Elrazik Reda K Abd , Elatief Emad Eldin Mohamed Abd
Published: February 2019

Background/Aims:

Chronic low back dysfunction is a serious health problem affecting people at some time in their life; it impedes the mobility of the lumbar spine and adjacent joints leading to functional disabilities. Muscle Energy Techniques aim to normalise soft tissue structures, such as shortened or tight muscles, with no direct implication to the joint associated with these soft tissues. Kinesio taping supports damaged structures without restriction of mobility and at the same time may influence some of the mechanisms associated with muscle fatigue, such as blood flow and proprioception. The aim of this study was to investigate the effect of Muscle Energy Techniques and kinesio taping on pain level and spinal mobility in patients with chronic low back dysfunction.

Methods:

A total of 90 patients with chronic low back dysfunction were selected. All participants were randomly allocated into three groups; group A received cross (X) technique kinesio taping and conventional therapy, Group B received cross (X) technique kinesio taping, Muscle Energy Techniques and conventional therapy, Group C received Muscle Energy Techniques and conventional therapy. A visual analogue scale for pain severity and inclinometer for trunk range of motion were used to measure the results.

Results:

Results showed that there was no statistically significant difference between the post-treatment measurements of the three groups.

Conclusions:

A combination between Muscle Energy Techniques and kinesio taping with conventional therapy appears to improve pain and trunk range of motion in patients with chronic low back dysfunction.
Independently getting off the floor: a feasibility study of teaching people with stroke to get up after a fall
Authors: Dean Sarah G , Leon Poltawski , Warmoth Krystal , Goodwin Victoria A , Stiles Victoria H , Taylor Rod S
Published: February 2019

Background:

Falls are common among stroke survivors but many are not taught how to get up again. A technique from an association called Action for Rehabilitation Following Neurological Injury addresses this problem. We investigated the feasibility and safety of teaching this technique to stroke survivors.

Methods:

Stroke survivors (mean 7.1 years post-stroke) with mild-to-moderate disability (mean modified Rankin Score 2.4), who could get up with assistance but not independently, received up to six sessions of training to independently get off the floor. The primary outcome was to independently get off the floor successfully; safety and feasibility were investigated by participant and trainer interviews, biomechanical and video analysis, and an expert panel review.

Findings:

Six of the ten participants managed to independently get off the floor and five of nine retained the skill two months post-training. One to six sessions (median three) were needed to master independently getting off the floor; one minor but no serious adverse events occurred. Expert reviewers indicated training involved an acceptable risk of falls and no concerns for knee and wrist positions.

Conclusions:

This feasibility study indicates that this technique may be useful. It was taught to and safely used by selected stroke survivors. Further assessment of independently getting off the floor has now been part of a pilot randomised controlled trial of Action for Rehabilitation Following Neurological Injury-based stroke rehabilitation.