bluuebunny/crossref_metadata_2025 huggingface dataset:
The Quality of Interactions Between Staff and Residents With Cognitive Impairment in Nursing Homes
Authors: Paudel Anju , Resnick Barbara , Galik Elizabeth
Published: July 2019

Background:

Positive and effective staff–resident interactions are imperative to adequately assess and meet the needs of cognitively impaired residents in nursing homes and optimize their quality of life.

Aim:

The purpose of this study was to quantify, describe, and analyze the interaction between staff and cognitively impaired residents in nursing homes, using the Quality of Interaction Schedule (QuIS).

Method:

This descriptive analysis utilized baseline data from the first 2 cohorts in a randomized clinical trial including 341 residents from 35 nursing homes.

Results:

Five hundred fifty-six staff–resident interactions were evaluated; majority were positive (n = 466, 83.8%) and the remaining were either neutral (n = 60, 10.8%) or negative (n = 30, 5.4%). The quality of interactions varied by interaction location, interpersonal distance, and resident participation.

Conclusion:

Future research should focus on decreasing the negative/neutral interactions and explore staff characteristics (eg, gender, level of experience) and facility factors (eg, size, ownership) that might influence the quality of interactions.
Behavioral Treatment of Trichotillomania in a College Woman: A Case Study
Authors: Boppana Shilpa , Gross Alan
Published: July 2019

Trichotillomania (TTM) is a disorder that involves repetitive pulling of one’s hair to the point of hair loss and clinically significant distress or functional impairment. Using Diagnostic and Statistical Manual of Mental Disorders-5 ( DSM-5) criteria, which include repeated attempts to decrease or stop pulling, the 12-month prevalence of TTM is 1% to 2%. Treatment commonly involves behavior therapies. These behavior therapies conceptualize TTM using operant learning theory and explain hair-pulling behavior as caused and maintained by environmental antecedents and consequences interacting with an individual’s biological makeup. This clinical case study describes use of an Acceptance and Commitment Therapy Enhanced Behavior Therapy for Trichotillomania (AEBT-T) protocol to facilitate treatment of a 20-year-old woman who was referred for TTM. The client remained in treatment for 14 months. After the completion of 32 therapy sessions, the client reported significantly reduced hair-pulling and anxiety, as well as increased engagement in valued activities. Implications of these findings are discussed, with an emphasis on the challenges of treating TTM in a college population.
“Chance Takers Are Accident Makers”: Are Patients With Epilepsy Really Taking a Chance When They Drive?
Authors: Joshi Charuta N. , Vossler David G. , Spanaki Marianne , Draszowki Joseph F. , Towne Alan R. ,   Members of the Treatments Committee of the American Epilepsy Society
Published: July 2019

This review compiles scientific data about the real dangers faced by people with epilepsy (PWE) who drive. Those include risks of motor vehicle accidents (MVA) in PWE as compared with controls (individuals without epilepsy) and as compared with persons with other medical conditions that impact fitness to drive. Data regarding Accident rates as related to seizure free intervals (SFI), single vs. multiple seizure events, and/or antiseizure drug (ASD) taper and reintroduction are discussed. Variation in state, national, and international laws and guidance for non-commercial and commercial drivers is highlighted, along with some related reasons for driving restrictions. The review concludes by emphasizing the importance of physicians educating patients about local driving laws and about risks of ASD non-adherence. The need for a broader, multi-stakeholder re-examination of driving regulations for PWE is noted.
Comparison of Ultrasound-Accelerated Versus Multi-Hole Infusion Catheter-Directed Thrombolysis for the Treatment of Acute Limb Ischemia
Authors: Chait Jesse , Aurshina Afsha , Marks Natalie , Hingorani Anil , Ascher Enrico
Published: July 2019

Objective:

Thrombolytic therapy is widely used in the treatment of arterial occlusions causing acute limb ischemia (ALI); however, knowledge regarding the efficacy of the different catheter systems available is scarce. The objective of this study was to compare the safety and efficacy of 2 catheter-directed infusion systems for intra-arterial thrombolysis in the setting of ALI.

Methods:

A retrospective analysis was conducted to study all catheter-directed thrombolysis procedures performed over 32 months in patients diagnosed with ALI. Patients with thrombosis in both native arteries and bypass grafts were included. Patients with contraindications to thrombolysis, or those receiving thrombolysis for deep venous thrombosis, were excluded. The duration of thrombolysis, amount of thrombolytic agent, and technical success rate were recorded. Technical success was defined as complete or near-complete resolution of thrombus burden, allowing for further intervention. Data were stratified to include location of thrombus, procedural complications, mortality, and rates of limb loss.

Results:

Ninety-one patients met inclusion criteria. Among them, Uni-Fuse and EKOS catheters were used in 69 and 22 patients, respectively. The mean age of the population was 71 (standard deviation [SD]: ±1.5) for patients treated with the EKOS catheter and 70 years (SD: ±2.6) for patients receiving thrombolysis with Uni-Fuse. There was no significant difference in the mean infusion duration (1.65 vs 1.9 days), volume of tissue plasminogen activator (44.6 vs 48.2 mg), or technical success rate (72% vs 86%) between the Uni-Fuse and EKOS cohorts ( P > .3). Furthermore, there was no difference in major limb loss or compartment syndrome between each group ( P > .4). The overall complication rate was 14% in both groups, with a 30-day mortality rate of 4% when treated with either catheter system.

Conclusion:

This study suggests that a standard multi-hole infusion catheter demonstrates similar clinical safety and efficacy as the ultrasound-accelerated EKOS system in the treatment of ALI.
Computerized Cognitive Training in Multiple Sclerosis: A Systematic Review and Meta-analysis
Authors: Lampit Amit , Heine Josephine , Finke Carsten , Barnett Michael H. , Valenzuela Michael , Wolf Anna , Leung Isabella H. K. , Hill Nicole T. M.
Published: July 2019

Background. Cognitive impairments are common in people with multiple sclerosis (MS). Systematic reviews reported promising evidence for various cognitive interventions in this population. Computerized cognitive training (CCT) has strong evidence for safety and efficacy in several populations, but its effects in MS have yet to be specified. Objective. We aimed to synthesize the evidence from randomized controlled trials (RCTs) investigating the effects of CCT on cognitive, psychosocial, and functional outcomes in adults with MS. Method. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and CENTRAL from inception to March 2019. We calculated standardized mean difference (Hedges’ g) of change from baseline in untrained measures of cognition, individual domains, psychosocial functioning, and daily function between CCT and control groups using a random-effects model. Results. A total of 20 RCTs encompassing 982 participants (78% with relapsing-remitting MS) were included. The overall cognitive effect size was moderate ( g = 0.30; 95% CI = 0.18-0.43), with no evidence of small-study effect or between-study heterogeneity (prediction interval = 0.17-0.44). Small to moderate effect sizes were found for attention/processing speed, executive functions, and verbal and visuospatial memory. Evidence for working memory, fatigue, and psychosocial and daily functioning were inconclusive. Cognitive effects waned without further training. Conclusions. CCT is efficacious for overall and key cognitive domains in adults with MS, but efficacy on other outcomes and in progressive subtypes remains unclear. Long-term and well-powered trials with diverse cohorts are needed to optimize and maintain the efficacy of CCT, investigate transfer to daily living, and determine who can benefit and whether CCT is a cost-effective strategy to attenuate cognitive decline in MS.
Role of Interhemispheric Cortical Interactions in Poststroke Motor Function
Authors: Palmer Jacqueline A. , Wheaton Lewis A. , Gray Whitney A. , Saltão da Silva Mary Alice , Wolf Steven L. , Borich Michael R.
Published: July 2019

Background/Objective. We investigated interhemispheric interactions in stroke survivors by measuring transcranial magnetic stimulation (TMS)–evoked cortical coherence. We tested the effect of TMS on interhemispheric coherence during rest and active muscle contraction and compared coherence in stroke and older adults. We evaluated the relationships between interhemispheric coherence, paretic motor function, and the ipsilateral cortical silent period (iSP). Methods. Participants with (n = 19) and without (n = 14) chronic stroke either rested or maintained a contraction of the ipsilateral hand muscle during simultaneous recordings of evoked responses to TMS of the ipsilesional/nondominant (i/ndM1) and contralesional/dominant (c/dM1) primary motor cortex with EEG and in the hand muscle with EMG. We calculated pre- and post-TMS interhemispheric beta coherence (15-30 Hz) between motor areas in both conditions and the iSP duration during the active condition. Results. During active i/ndM1 TMS, interhemispheric coherence increased immediately following TMS in controls but not in stroke. Coherence during active cM1 TMS was greater than iM1 TMS in the stroke group. Coherence during active iM1 TMS was less in stroke participants and was negatively associated with measures of paretic arm motor function. Paretic iSP was longer compared with controls and negatively associated with clinical measures of manual dexterity. There was no relationship between coherence and. iSP for either group. No within- or between-group differences in coherence were observed at rest. Conclusions. TMS-evoked cortical coherence during hand muscle activation can index interhemispheric interactions associated with poststroke motor function and potentially offer new insights into neural mechanisms influencing functional recovery.
Robot-Assisted Arm Training in Chronic Stroke: Addition of Transition-to-Task Practice
Authors: Conroy Susan S. , Wittenberg George F. , Krebs Hermano I. , Zhan Min , Bever Christopher T. , Whitall Jill
Published: July 2019

Background. Robot-assisted therapy provides high-intensity arm rehabilitation that can significantly reduce stroke-related upper extremity (UE) deficits. Motor improvement has been shown at the joints trained, but generalization to real-world function has not been profound. Objective. To investigate the efficacy of robot-assisted therapy combined with therapist-assisted task training versus robot-assisted therapy alone on motor outcomes and use in participants with moderate to severe chronic stroke-related arm disability. Methods. This was a single-blind randomized controlled trial of two 12-week robot-assisted interventions; 45 participants were stratified by Fugl-Meyer (FMA) impairment (mean 21 ± 1.36) to 60 minutes of robot therapy (RT; n = 22) or 45 minutes of RT combined with 15 minutes therapist-assisted transition-to-task training (TTT; n = 23). The primary outcome was the mean FMA change at week 12 using a linear mixed-model analysis. A subanalysis included the Wolf Motor Function Test (WMFT) and Stroke Impact Scale (SIS), with significance P <.05. Results. There was no significant 12-week difference in FMA change between groups, and mean FMA gains were 2.87 ± 0.70 and 4.81 ± 0.68 for RT and TTT, respectively. TTT had greater 12-week secondary outcome improvements in the log WMFT (−0.52 ± 0.06 vs −0.18 ± 0.06; P = .01) and SIS hand (20.52 ± 2.94 vs 8.27 ± 3.03; P = .03). Conclusion. Chronic UE motor deficits are responsive to intensive robot-assisted therapy of 45 or 60 minutes per session duration. The replacement of part of the robotic training with nonrobotic tasks did not reduce treatment effect and may benefit stroke-affected hand use and motor task performance.
Valve-in-Valve TAVR: State-of-the-Art Review
Authors: Edelman J. James , Khan Jaffar M. , Rogers Toby , Shults Christian , Satler Lowell F. , Ben-Dor I. Itsik , Waksman Ron , Thourani Vinod H.
Published: July 2019

An increasing number of surgically implanted bioprostheses will require re-intervention for structural valve deterioration. Valve-in-valve transcatheter aortic valve replacement (ViV TAVR) has become an alternative to reoperative surgery, currently approved for high-risk and inoperable patients. Challenges to the technique include higher rates of prosthesis–patient mismatch and coronary obstruction, compared to native valve TAVR. Herein, we review results of ViV TAVR and novel techniques to overcome the aforementioned challenges.
Why Me? Challenges Associated With Recruiting Participants for a Study Focusing on “Wealthy Men”: Reflections From Fieldwork Conducted in Tanzania
Authors: Deane Kevin , Wamoyi Joyce , Mgunga Samwel , Changalucha John
Published: July 2019

It is well-known that conducting research with elite groups presents a range of unique methodological challenges including gaining access to and recruiting a demographic group that is underrepresented if not entirely absent from most research. This issue is particularly pronounced when the research topic is sensitive or potentially politicized and conducted in low-income settings in which large wealth inequalities are apparent. Drawing on recent experiences from fieldwork conducted in Tanzania that aimed to explore attitudes toward HIV testing among wealthy men, we reflect on significant challenges in the recruitment process. These included the framing of the research project, the (often unspoken) politicized subtext of the (sensitive) research, the socioeconomic climate, and the navigation of time requirements. Our experiences suggest that a careful consideration of these methodological issues will help researchers recruit elite participants and ensure that data are collected from appropriate samples.
The Opportunities and Challenges of Using Photo-Elicitation in Child-Centered Constructivist Grounded Theory Research
Authors: Poku Brenda Agyeiwaa , Caress Ann-Louise , Kirk Susan
Published: July 2019

In the last three decades, there has been a growing interest in listening to children’s voices in child health research. Ensuring an appropriate level of dialogical engagement with children calls for participatory methods. Auto-driven photo-elicitation interviews (PEIs) are a powerful approach to obtain rich data from children. This article discusses the opportunities and challenges of using auto-driven PEIs in a health-related child-centered constructivist grounded theory study conducted in a poor-resourced country. Our experience shows that while the approach is effective for facilitating co-construction of data with children and for addressing the ethical and methodological issues associated with child-centered research in the context of a developing country, it is narrow on its own. Broadening the term to “picture-elicitation interviews” to allow for the inclusion of other forms of images would make the method more adaptable and inclusive. This would give children the flexibility of choosing pictorial options that best suit them and also help child participants and researchers address the practical and cultural challenges associated with the use of auto-driven PEI in a poor-resourced country.
“A Space Where People Get It”: A Methodological Reflection of Arts-Informed Community-Based Participatory Research With Nonbinary Youth
Authors: Furman Ellis , Singh Amandeep K. , Wilson Ciann , D’Alessandro Fil , Miller Zev
Published: July 2019

This article is a methodological reflection of Bye Bye Binary, a community-based participatory research project (CBPR) that explored nonbinary youths’ experiences of identity development, engagement in activism, discrimination, and mental health in Ontario, Canada. The arts-informed method of body mapping was employed in a workshop format to garner the experiences of 10 nonbinary youth (aged 16–25), in conjunction with additional qualitative methods (i.e., individual interviews and reflective notes). Findings suggest that the body-mapping workshop fostered a safe environment that promoted idea generation, affirmation, self-exploration, and connections through a shared identity, thus creating “a space where people get it.” Methodological challenges that arose throughout the process are discussed, including engagement in art as “awkward,” barriers of limited time and funding, participant recruitment, and collaboration and integration. Lastly, the authors reflect on their learnings engaging in CBPR and provide insights into how researchers can move forward and apply these methods and processes into their own work engaging in arts-informed research or with nonbinary individuals.
Blade shape optimization of an aircraft propeller using space mapping surrogates
Authors: Toman Usama T , Hassan Abdel-Karim SO , Owis Farouk M , Mohamed Ahmed SA
Published: July 2019

Propeller performance greatly influences the overall efficiency of the turboprop engines. The aim of this study is to perform a propeller blade shape optimization for maximum aerodynamic efficiency with a minimal number of high-fidelity model evaluations. A physics-based surrogate approach exploiting space mapping is employed for the design process. A space mapping algorithm is utilized, for the first time in the field of propeller design, to link two of the most common propeller analysis models: the classical blade-element momentum theory to be the coarse model; and the high-fidelity computational fluid dynamics tool as the fine model. The numerical computational fluid dynamics simulations are performed using the finite-volume discretization of the Reynolds-averaged Navier–Stokes equations on an adaptive unstructured grid. The optimum design is obtained after few iterations with only 56 computationally expensive computational fluid dynamics simulations. Furthermore, an optimization method based on design of experiments and kriging response surface is used to validate the results and compare the computational efficiency of the two techniques. The results show that space mapping is more computationally efficient.
Potential photoacid generators based on oxime sulfonates
Authors: Plater M John , Harrison William TA , Killah Ross
Published: July 2019

The bis-oxime of acenaphthenequinone and the mono-oxime of benzil have been sulfonated by reaction with 4-methylbenzenesulfonyl chloride and propylsulfonyl chloride. The four sulfonated oximes were characterised by X-ray single-crystal structure determinations. Some photochemical decompositions were studied using a 6-W 254-nm immersion well lamp in dichloromethane. The 4-methylbenzenesulfonate bis-oxime of acenaphthenequinone and the 4-methylbenzenesulfonate mono-oxime of benzil both give 4-methylbenzenesulfonic acid upon irradiation but not 4-methylbenzenesulfinic acid. Fragmentation pathways are discussed. The possible use of these compounds as photoacid generators in polymer resists and the role of secondary reactions to liberate acid is discussed.
Conventional and microwave-irradiated synthesis of new bischalcone derivatives
Authors: Arslan Tayfun , Yaylı Nurettin
Published: July 2019

A series of 12 novel methyl- and halogen-substituted bischalcones containing an azo linkage was synthesized by a Claisen–Schmidt condensation between ( E)-1-{4-[(4-acetyl-2-hydroxyphenyl)diazenyl]phenyl}ethanone and various araldehydes using microwave irradiation and conventional procedures and the results were compared.
An efficient and convenient chloromethylation of some aromatic compounds catalyzed by zinc iodide
Authors: Tang Jian , Liu Hongtao , Zhou Jing , Zhang Xingxian
Published: July 2019

Treatment of a series of aromatic hydrocarbons and O-carbethoxy phenol substrates with a mixture of chlorosulfonic acid and dimethoxymethane in CH2Cl2 catalyzed by zinc iodide affords the corresponding chloromethyl derivatives in good to excellent yields.
Synthesis and fungicidal activity of novel ureido-substituted 1,3-benzoxazines
Authors: Dai Ningning , Tang Zilong , Wang Ming , Peng Lifen , Wan Yichao , Jiao Yinchun
Published: July 2019

Ten novel ureido-substituted 1,3-benzoxazines were synthesized in moderate yields by La(OTf)3-catalyzed reaction of some aldehydes with four ureido-substituted 2-aminomethylphenols which were prepared by a one-pot method. Evaluation of their fungicidal activity revealed that most compounds showed moderate to good activity and one of the ureido-substituted 2-aminomethylphenols showed activity against Rhizoctonia solani and Sclerotonia sclerotiorum comparable to the control compound, chlorothalonil.
Synthesis of functionalized trans-2,3-disubstituted-hexahydrobenzofurans in an aqueous medium using triethanolamine as catalyst
Authors: Abutalebi Ali , Mosslemin Mohammad H , Mohebat Razieh
Published: July 2019

A one-pot, efficient synthesis of seven novel trans-2,3-diacylated hexahydrobenzofuran derivatives has been achieved via a three-component condensation of N-(1-benzyloxycarbonylmethyl)quinolinium bromide with 5,5-dimethyl-1,3-cyclohexanedione (dimedone) and an aromatic aldehyde in the presence of catalytic amounts of triethanolamine in water under reflux conditions. The attractive features of the method are excellent yields and high purity, short reaction times, easy work-up, and use of an inexpensive and non-toxic catalyst.
An adaptive cuckoo optimization algorithm for system design optimization under failure dependencies
Authors: Mellal Mohamed Arezki , Zio Enrico
Published: July 2019

This article presents an algorithm for optimal redundancy and repair team allocation with respect to minimum system cost and a system availability constraint. Four scenarios are considered for the failures occurring in the subsystems of the system: independence, linear dependence, weak dependence, and strong dependence. An adaptive cuckoo optimization algorithm is developed for solving the nonlinear integer optimization problem of allocation. A series–parallel system with six subsystems is considered as a case study for demonstration purposes. The results obtained highlight the good performance of the developed algorithm.
Maintaining the airway
Authors: Sykes Peter , Elliott Lucy , Rowe Matthew
Published: July 2019

Airway-related problems can present in primary care. As first-contact care providers, GPs may encounter a range of airway emergencies that require urgent intervention. Patients may have residual symptoms from procedures such as endotracheal intubation or require specialised airways such as a tracheostomy in the community. This article concentrates on two issues focusing on the adult patient population. First, we discuss emergency airway maintenance in accordance with basic life support. Second, we explore the care of patients living with specialised airways in the community from a physical, psychosocial and emergency perspective.
Finding, Accessing, and Using Secondary Data for Research on Gifted Education and Advanced Academics
Authors: Renbarger Rachel L. , Sulak Tracey N. , Kaul Corina R.
Published: July 2019

Secondary data analysis can benefit researchers of advanced academics by providing large sample sizes and a variety of data on multiple topics. However, using secondary data comes with unique challenges. This article will outline how gifted education researchers can find, access, and use secondary data. Data are available on children from birth to adulthood and are typically accessed through the Inter-university Consortium for Political and Social Research (ICPSR) or the National Center for Education Statistics (NCES). The majority of data sources have public-use files available, but some sensitive data may require special permissions. This article includes examples of advanced academic research that used popular databases along with software options for utilizing available data. We conclude with considerations researchers should take into account when considering using secondary data analysis, such as computer memory and technical skills.
Analysis of a Point-of-Care HbA1c Assay: Is It Time for an HbA1c Error Grid?
Authors: Krouwer Jan S.
Published: July 2019

In an article in Journal of Diabetes Science and Technology, Arnold et al have presented a thorough study of imprecision components for a point-of-care hemoglobin A1c (HbA1c) assay. An interesting and innovative approach is the combination of data from different studies to arrive at a total error estimate. But total error has the oxymoron feature of estimating performance for most (95%) but not all of the results. An HbA1c error grid would provide the severity for results that exceed the 6% requirement. Since this device is intended for Clinical Laboratory Improvement Amendments waived labs and allows for finger-stick samples, monitoring the Food and Drug Administration adverse event database (MAUDE, Manufacturer and User Facility Device Experience) is recommended.
Tyrosinase Inhibition Activity of Monoterpene Glucosides From Brugmansia arborea Flowers
Authors: Kim Hyoung-Geun , Ko Jung-Hwan , Oh Hyun-Ji , Kwon Jung-Hwa , Oh Eun-Ji , Oh Seon M. , Lee Yeong-Geun , Lee Dae Y. , Baek Nam-In
Published: July 2019

Three monoterpene glucosides were isolated from the flowers of Brugmansia arborea L. using repeated silica gel and octadecyl SiO2 column chromatography. Based on spectroscopic data including 1d-NMR (1H, 13C, and distortionless enhancement by polarization transfer (DEPT)), 2D-NMR (gradient correlation spectroscopy (gCOSY), gradient heteronuclear single quantum coherence (gHSQC), and gradient heteronuclear multiple bond coherence (gHMBC)), Infrared Spectroscophy, and Mass Spectroscophy, the glucosides were identified as citronellol O- β-D-glucopyranoside (1), jasminoside N (2), and jasminoside P (3). The EtOAc ( Brugmansia arborea Flowers ethyl acetate fraction [BAFE]) and n-BuOH ( Brugmansia arborea Flowers n-butanol fraction [BAFB]) fractions showed high inhibition of tyrosinase activity (BAFE: IC50 = 68.0 and BAFB: IC50 = 59.3 μg/mL), and all isolated monoterpenes inhibited tyrosinase activity (1: IC50 = 156.5, 2: IC50 = 198.2, and 3: IC50 = 191.0 μM).
Stereotype Formation but No Dissociation: Contradicting Statistics Reduce Explicit and Implicit Stereotypes Engendered by Disproportional Crime Reporting
Authors: Jabold Philipp
Published: July 2019

This study investigated the formation of criminal stereotypes about novel groups. Over 2 days, 316 participants from Prolific Academic read either equal or unequal proportions of crime reports about fictitious groups, Laapians and Niffians. On the second day, additional crime statistics indicating equal crime rates among both groups or control statistics were presented. Unequal crime reporting resulted in explicit ( d = .44, p < .001) and implicit ( d = .23, p = .001) stereotypes assessed with an Implicit Association Test, while equal reporting did not. On the second day, only explicit stereotypes increased in the unequal crime reporting condition ( d = .25, p = .025). Contrary to predictions of the associative-propositional evaluation model, but congruent with De Houwer’s single-process propositional model, crime statistics contradicting the learned regularities reduced both explicit ( d = −.43, p = .010) and implicit stereotypes ( d = −.20, p = .003).
Tinnitus perception mediates the relationship between physiological and psychological problems among patients
Authors: Abbas Jaffar , Aqeel Muhammad , Jaffar A. , Nurunnabi Mohammad , Bano Shaher
Published: July 2019

The current study is the first substantial investigation to determine whether tinnitus perception mediates the relationship between physiological and psychological problems (PP). Simple random sampling, with a cross-sectional design, was used to collect data from 100 adult patients (males = 60; females = 40) diagnosed with chronic tinnitus. Subjects were approached through various public and private hospitals, at their respective Audiology and Ear, Nose, and Throat departments in Rawalpindi and Lahore, Pakistan. Participants underwent complete physiological and psychological tinnitus evaluations, such as tinnitus matching and audiometry, as well as assessments using standardized tinnitus instruments. The mediation analyses revealed an indirect relationship with hearing loss (HL) and PP (e.g., anxiety, stress, depression, mood swings) in tinnitus patients. These findings suggest that physiological problems such as tinnitus and HL might contribute to the development of psychological symptoms.
Allergy-Related Diseases and Risk of Breast Cancer: The Role of Skewed Immune System on This Association
Authors: Sadeghi Fatemeh , Shirkhoda Mohammad
Published: July 2019

Background

The role of allergy in breast cancer (BC) development remains inconclusive. A comprehensive review article is required to present and discuss all findings on this topic and to clarify the association between allergic disorders and the risk of BC.

Objective

We aimed to explain the association between atopy, different types of allergic disorders, and the risk of BC. Moreover, we explored the immunological mechanism behind this association.

Methods

We electronically reviewed publications in PubMed from 1979 to 2018 relating to atopy, allergy, asthma, atopic dermatitis, allergic rhinitis, food allergy, drug allergy, immunoglobulin E (IgE) or prick test, and BC.

Results

Most of the identified studies demonstrated nonsignificant results. However, the pattern of the results indicated an increased risk of BC in individuals with a history of allergies. The majority of studies reported higher prevalence of atopic dermatitis and allergic rhinitis among individuals with BC compared to the control groups. Similarity, most of the studies revealed an increased risk of BC among people with a positive history of atopic using IgE specific or prick test. However, a null association was reported in most of the asthmatic studies, and controversial results were detected in the individuals with history of food and drug allergies.

Conclusion

The majority of findings were not statistically significant. Moreover, bias and other methodological problems are the major issues, which make it challenging to compare the findings of different studies and reach a strong conclusive result. However, the pattern of the results from most studies indicated that allergic diseases might be associated with an increased risk of BC. Skewed immune system toward T-helper 2 might have an important role in this association.
Corruption in Olympic Sports: Prevalence Estimations of Match Fixing Among German Squad Athletes
Authors: Frenger Monika , Emrich Eike , Pitsch Werner
Published: July 2019

Although match fixing threatens the integrity of competitions in sport, studies on the prevalence of match fixing are scarce. We measured the prevalence of competition manipulation by German elite athletes and the total percentage of these athletes who had been asked to participate in match fixing by using the randomized response technique. Approximately 8% of the athletes were asked to participate in match fixing, and approximately 7.5% were actually involved in competition manipulation during their careers. More than 30% of athletes reported an attempt to illegally influence referees’ decisions, but only 4.9% had ever directly participated in such attempts. Only the parameter of the financial status provides a different perspective. In general, this study shows that the dissemination of deviant behavior is not extremely high.
Trends in Publications on the Anterior Cruciate Ligament Over the Past 40 Years on PubMed
Authors: Kambhampati Srinivas B.S. , Vaishya Raju
Published: July 2019

Background:

The anterior cruciate ligament (ACL) is the most commonly operated ligament of the knee. Details on the top journals, universities, and authors on the topic would be helpful to identify the sources of information for clinical and research queries as well as to observe trends for future research and identify universities/authors of particular interest for training or to follow their research.

Purpose:

To consolidate information from PubMed on the ACL from 1979 to 2018, spanning 40 years.

Study Design:

Cross-sectional study.

Methods:

A search of the PubMed database was conducted for the ACL, and 18,696 articles published over the past 40 years were analyzed for further details. These details included the number of publications per year, top 10 journals publishing on the ACL, top 10 first authors publishing articles on the ACL, and number of articles published with specific keywords. Data were also sought from the Scopus database regarding the top universities and countries publishing on the ACL. The coauthorship of articles and co-occurrence of terms in titles were also analyzed using VOSviewer.

Results:

There was a steady increase in the yearly average number of publications from 1979 to 2018. The top journal and top author publishing on the ACL were The American Journal of Sports Medicine and Freddie H. Fu, respectively. The most articles published by a first author were by K. Donald Shelbourne. Time-based links of Dr Fu to other authors were represented as VOSviewer output. Most occurrences of specific keywords in the title were also studied and listed. The United States was the most published country, and 8 of the top 10 universities that published were from this country.

Conclusion:

There has been a steady increase in the number of articles published in PubMed since 1979. It appears that interest on the topic of the ACL has not decreased or stabilized but rather increased significantly over the past few years. This article quantifies the increased interest and could act as a baseline for future studies to compare.
Internet-Based Interventions for Adults With Hearing Loss, Tinnitus, and Vestibular Disorders: A Systematic Review and Meta-Analysis
Authors: Beukes Eldré W. , Manchaiah Vinaya , Allen Peter M. , Baguley David M. , Andersson Gerhard
Published: July 2019

Internet-based interventions have been developed to improve access to audiovestibular health care. This review aimed to identify outcomes of Internet interventions for adults with hearing loss, tinnitus, and vestibular disorders. Electronic databases and manual searches were performed to identify studies meeting eligibility for inclusion. Fifteen studies (1,811 participants) met the inclusion criteria, with nine studies targeting tinnitus distress, five considering hearing loss, and one for vestibular difficulties. Only the tinnitus and hearing loss Internet intervention studies were eligible for data synthesis. Internet-based interventions for hearing loss were diverse. Overall, they showed no significant effects, although a statistically significant moderate effect ( d = 0.59) was found after removing the study with the highest risk of bias (as a result of high attrition). Most Internet-based interventions for tinnitus provided cognitive behavioural therapy. They yielded statistically significant mean effect sizes for reducing tinnitus distress compared with both inactive ( d = 0.59) and active controls ( d = 0.32). Significant effects were also present for the secondary outcomes of anxiety, depression, insomnia, and quality of life (combined effect d = 0.28). Only Internet-based interventions for tinnitus evaluated the 1-year postintervention effects indicated that results were maintained long term ( d = 0.45). Scientific study quality was appraised using the Grading of Recommendations Assessment, Development and Evaluation approach and found to vary from very low to moderate. This review indicates the potential of Internet interventions for tinnitus to provide evidence-based accessible care. There is a need for additional high-quality evidence before conclusive results can be established regarding the effects of audiovestibular Internet interventions.
Neuroendocrine Tumors in Pediatrics
Authors: Farooqui Zainab Azam , Chauhan Aman
Published: July 2019

Neuroendocrine cells are dispersed diffusely throughout many organ systems in the body and hence neuroendocrine tumors (NETs) can arise from almost anywhere in the body. NETs are considered rare tumors, and the current incidence is reported to be about 6 cases in 100 000 in adults and about 2.8 cases per million in the pediatric age group. Despite the indolent nature of these tumors, they have the potential for metastasis and significant morbidity. NETs can be asymptomatic at the time of diagnosis or can present with flushing, diarrhea, wheezing, weight loss, and fatigue among other symptoms. Due to the ambiguity of presenting symptoms, it is not uncommon for NETs to be diagnosed late in the disease course. Despite low incidence, the prevalence of the disease is high since patients live for many years and sometimes decades. Early detection of well-differentiated NETs has excellent outcomes with the majority of early-stage diseases being cured with surgical resection alone. There have been recent advancements in the management of metastatic progressive NETs with approval of peptide receptor radionuclide therapy, telotristat, and everolimus. Awareness of these rare tumors and its management is crucial for optimal management. This article will focus on pediatric NETs and current advances in its management.
Developing a Competency Framework for Population Health Graduate Students Through Student and Faculty Collaboration
Authors: Miller Laura , Brushett Sara , Ayn Caitlyn , Furlotte Kirk , Jackson Lois , MacQuarrie Madison , Massie Ariane S. , Mathias Holly , McKay Madeleine , Meisner Brad A. , Moritz Lauren , Stilwell Christie , Weeks Lori E.
Published: July 2019

Defining competencies within health disciplines is important because it provides a shared understanding of the fundamental knowledge, skills, and attitudes necessary for research and practice while also offering a practical reference point for academic preparation and professional development. However, existing literature regarding competency frameworks does not address the unique needs of interdisciplinary population health research graduate students. The purpose of this project was to understand the competencies desired by interdisciplinary population health research graduate students within the Healthy Populations Institute (HPI) at Dalhousie University and to create a competency framework on which training and program development could be based. A student-led initiative was undertaken to identify core competencies necessary for interdisciplinary population health research graduate students from both traditional (e.g., health promotion) and nontraditional health (e.g., political science) backgrounds. Data were collected and analyzed via three phases: environmental scan, community resource mapping, and consultations with HPI research scholars. Through the environmental scan, core competencies and guiding principles were identified. Community resource mapping of local employment, volunteer, educational, and/or skill-building opportunities resulted in the development of a database. Consultations confirmed the validity of competencies identified in the scan and elicited further resources and suggestions for educational and professional skill development. This project resulted in a unique competency framework that will inform ongoing program development and foster additional opportunities for graduate students within HPI. The process of creating this framework may also be of value to other universities wishing to develop or refine their own set of competencies.
The Reliability of 2-Station Clerkship Objective Structured Clinical Examinations in Isolation and in Aggregate
Authors: Bernard Aaron W , Feinn Richard , Ceccolini Gabbriel , Brown Robert , Rosenberg Ilene , Trymbulak Walter , VanCott Christine
Published: July 2019

Background:

Most medical schools in the United States report having a 5- to 10-station objective structured clinical examination (OSCE) at the end of the core clerkship phase of the curriculum to assess clinical skills. We set out to investigate an alternative OSCE structure in which each clerkship has a 2-station OSCE. This study looked to determine the reliability of clerkship OSCEs in isolation to inform composite clerkship grading, as well as the reliability in aggregate, as a potential alternative to an end-of-third-year examination.

Design:

Clerkship OSCE data from the 2017-2018 academic year were analyzed: the generalizability coefficient (ρ2) and index of dependability (φ) were calculated for clerkships in isolation and in aggregate using variance components analysis.

Results:

In all, 93 students completed all examinations. The average generalizability coefficient for the individual clerkships was .47. Most often, the largest variance component was the interaction between the student and the station, indicating inconsistency in the performance of students between the 2 stations. Aggregate clerkship OSCE analysis demonstrated good reliability for consistency (ρ2 = .80). About one-third (33.8%) of the variance can be attributed to students, 8.2% can be attributed to the student by clerkship interaction, and 42.6% can be attributed to the student by block interaction, indicating that students’ relative performances varied by block.

Conclusions:

Two-station clerkship OSCEs have poor to fair reliability, and this should inform the weighting of the composite clerkship grade. Aggregating data results in good reliability. The largest source of variance in the aggregate was student by block, suggesting testing over several blocks may have advantages compared with a single day examination.
Rate of Improvement in Outcomes Measures After Reverse Total Shoulder Arthroplasty: A Longitudinal Study With 2-Year Follow-up
Authors: Shields Edward , Koueiter Denise M , Wiater J Michael
Published: July 2019

Background

Few studies report rate of improvement following reverse total shoulder arthroplasty (RTSA) in a single cohort. The purpose of this study was to compare functional scores following RTSA across postoperative time points in patients who have follow-up scores available at all selected time points.

Methods

A prospective database was retrospectively queried for patients with functional outcome data from preoperatively and after RTSA at 3 to 6 months, 1 year, and 2 years, excluding any patients with data missing at these points. All patients included had measures from every time point. Collected outcomes included American Shoulder and Elbow Surgeons (ASES), visual analog scale pain, subjective shoulder value (SSV), and range of motion.

Results

Outcomes from 173 shoulders were analyzed. Average age was 68 ± 9 years, 68% were females, and 15% were revision cases. The average preoperative ASES score (33 ± 17) improved to 73 ± 18 at 3 to 6 months, 80 ± 19 at 1 year, and 81 ± 19 at 2 years after RTSA. Only outcomes at 1 and 2 years were not significantly different ( P = 1.0). SSV scores and forward elevation followed this pattern, with large improvements in the first 3 to 6 months, then reaching a plateau at 1 year. External and internal rotations did not improve by 3 to 6 months, but did significantly improve by 1 year, and remained stable through 2 years. Pain scores improved from 6.8 points before surgery to roughly 1.3 points at all subsequent time points.

Conclusions

Patients undergoing RTSA can expect significant reductions in pain and the majority of their functional gains to occur in the first 6 months after surgery. At 12 months after RTSA, the average patient will achieve maximal improvement.
Unexpected Gallbladder Metastasis of Clear Cell Renal Carcinoma
Authors: White Ian , Smith Shane , Rizkalla Kamilia , Davies Edward
Published: July 2019

Renal cell carcinoma (RCC) commonly metastasizes to areas such as the lungs, liver, bone, brain, adrenals, and lymph nodes. We present a rare case of a 59-year-old female patient with RCC metastasis to the gallbladder. The patient had undergone right nephrectomy for RCC more than 6 years prior to the metastasis. During routine follow-up, a polypoid lesion of the gallbladder was identified. Laparoscopic cholecystectomy was performed, and pathologic examination of the specimen revealed metastatic RCC. The patient was completely asymptomatic, which reinforces the importance of postoperative follow-up. Renal cell carcinoma is one of the few common malignancies for which there is good evidence of survival benefit from surgical resection of the metastatic tumours.
Diagnostic Value of TROP-2 and CK19 Expression in Papillary Thyroid Carcinoma in Both Surgical and Cytological Specimens
Authors: Abdou Asmaa Gaber , Shabaan Mohammed , Abdallha Rania , Nabil Nehal
Published: July 2019

Papillary thyroid carcinoma (PTC) represents the most common primary malignant thyroid tumor and its diagnosis is dependent on the presence of classic nuclear features that are sometimes seen in some non-neoplastic and benign lesions. Several immunohistochemical markers are used individually or in combination to help in differentiation of PTC from mimickers. The aim of the current study was to assess the diagnostic value of TROP-2 and cytokeratin 19 (CK19) expression in differentiating PTC from other mimickers both singly and in combination. The current study was carried out on 77 surgical specimens (56 PTC and 21 non-neoplastic cases) and 12 cytological specimens (4 THY2, 6 THY4, and 2 THY5). TROP-2 was negative in 81% of non-neoplastic surgical specimens and in 100% of THY2 cytological specimens while it was positive in 71.4% of PTC surgical specimens and 100% of THY4/THY5 cytological specimens. Sensitivity and specificity of TROP-2 positive expression for diagnosis of PTC in surgical specimens reached 71% and 81%, respectively, while it reached 100% for both in cytological specimens. Cytokeratin 19 showed positive expression in 85.7% of non-neoplastic surgical specimens and in 92.9% of PTC surgical specimens. Cytokeratin 19 showed negative expression in 75% of Thy2 cases while it was positive in all studied Thy4 and Thy5 cases. Sensitivity and specificity of CK19 total estimated score for diagnosis of PTC in surgical specimens were 78.6% and 66.7%, respectively, while it reached 100% and 75% in cytological specimens. Positive TROP-2 and CK19 expression in PTC were associated with lymph node metastasis. TROP-2 is a specific rather than sensitive marker while CK19 is a sensitive rather than specific marker in differentiating PTC from other mimickers in surgical specimens. The diagnostic validity of both markers was superior in diagnosis of classic PTC compared with follicular variant PTC. TROP-2 is superior to CK19 in diagnosis of PTC in cytological specimens. Both TROP-2 and CK19 could be used preoperatively in adjunct to hematoxylin and eosin for more confident diagnosis of thyroid cytology and along with radiology as predictors of lymph node metastasis.
A Statewide Early Childhood Alternative Teacher Preparation Program Delivered via Synchronous Video Conference
Authors: Fiechtl Barbara J. , Hager Karen D.
Published: July 2019

This article describes a statewide online alternative teacher preparation program in early childhood special education. The history and evolution of the program is explained along with the programmatic changes that resulted from working with noncertified teachers with a wide variety of backgrounds in both rural and urban districts. Challenges and solutions for providing coursework and supervision via distance to all areas of a state will be presented.