bluuebunny/crossref_metadata_2025 huggingface dataset:
Twelve-week intradialytic cycling exercise improves physical functional performance with gain in muscle strength and endurance: a randomized controlled trial
Authors: Yeh Mei-Ling , Wang Mei-Hua , Hsu Chin-Che , Liu Yueh-Min
Published: June 2020

Objective:

To evaluate the effect of intradialytic cycling exercise on physical functional performance with gain in muscle strength and endurance in end-stage renal disease patients with haemodialysis.

Design:

Randomized controlled trial, with repeated measurements at baseline and after 4, 8, and 12 weeks of intradialytic cycling exercise.

Setting:

A 50-bed haemodialysis centre in a regional hospital in Taiwan.

Subjects:

Seventy-six regular haemodialysis patients, recruited and equally and randomly assigned to exercise and control groups.

Intervention:

The intradialytic cycling exercise was performed for 12 weeks and comprised warm-up, main, and cool-down exercise phases. A stationary cycling equipment was used, which involved aerobic and resistance modalities. The intensity was maintained at somewhat hard exertion. Each intradialytic cycling exercise was implemented for 30 minutes, starting at the second hour of treatment.

Main measure:

Measured outcomes were 6-minute walk distance, time taken to complete 10 sit-to-stand-to-sit cycles and number of sit-to-stand-to-sit cycles in 60 seconds.

Results:

Average (standard deviation) participant age was 55.47 (13.00) years. Therefore, the 6-minute walk distance was significantly different at weeks 8 ( P = 0.01) and 12 ( P < 0.001) in the exercise group compared with that in the control group at baseline. Notably, sit-to-stand-to-sit outcomes ( P = 0.01) significantly influenced the 6-minute walk distance. Sit-to-stand-to-sit outcomes significantly improved in the exercise group ( P < 0.05).

Conclusion:

Twelve-week intradialytic exercise for patients on haemodialysis can improve physical functional performance with gain muscle strength and endurance. This is a safe and effective method for improving health.
Effects on shoulder pain and disability of teaching patients with shoulder pain a home-based exercise program: a randomized controlled trial
Authors: Santello Giovanna , Rossi Denise Martineli , Martins Jaqueline , Libardoni Thiele de Cássia , de Oliveira Anamaria Siriani
Published: June 2020

Objective:

To investigate the effect on shoulder pain and disability of teaching patients with shoulder pain how to undertake a home-based exercise program.

Design:

A randomized controlled trial conducted from September 2015 to January 2016.

Setting:

Participants’ home.

Participants:

Sixty participants with shoulder pain who were waiting for physiotherapeutic treatment.

Interventions:

The control group ( n = 30) received minimal education about their shoulder condition and instructions to continue their activities as normal. The intervention group ( n = 30) received a two-month home exercise program with one-hour sessions delivered by a physiotherapist to begin and one month after the program for exercise instructions.

Main measures:

The primary outcome was change in the Shoulder Pain and Disability Index (SPADI). The secondary outcomes included change in the numeric pain rating scale and medication intake for pain relief.

Results:

The patients’ average age was 54.3 (13.8) years. SPADI scores at baseline were 60.9 (16.5) in the intervention and 64.7 (15.3) in the control group. After two months, the SPADI scores decreased to 18.8 (28.6) and to 61.4 (24.0), respectively, in the intervention and control groups with an estimated mean difference of 40.0, effect size: 1.61. The intervention group showed a reduced pain intensity (estimated mean difference: 3.7, effect size: 2.43) and medication intake (chi-square: 0.001). The number needed to treat was 1.2 for one patient to have a SPADI score <20.

Conclusion:

Teaching patients with shoulder pain how to undertake a home-based exercise program improved shoulder function and reduced pain intensity and medication intake over two months.
Developing a Clinical Decision Support Tool for Appropriate Antibiotic Prescribing in Australian General Practice: A Simulation Study
Authors: Manski-Nankervis Jo-Anne , Biezen Ruby , Thursky Karin , Boyle Douglas , Clark Malcolm , Lo Sean , Buising Kirsty
Published: June 2020

Background. Inappropriate antibiotic prescribing can lead to antimicrobial resistance and drug side effects. Tools that assist general practitioners (GPs) in prescribing decisions may help to optimize prescribing. The aim of this study was to explore the use, acceptability, and feasibility of a clinical decision support (CDS) tool that incorporates evidence-based guidelines and consumer information that integrates with the electronic medical record (EMR). Methods. Eight GPs completed an interview and brief survey after participating in 2 simulated consultations. The survey consisted of demographic questions, perception of realism and representativeness of consultations, Post-Study System Usability Questionnaire, and System Usability Scale. Qualitative data were analyzed using framework analysis. Video data were reviewed, with length of consultation and time spent using the CDS tool documented. Results. Survey responses indicated that all GPs thought the consultations were “real” and representative of real-life consultations; 7 of 8 GPs were satisfied with usability of the tool. Key qualitative findings included that the tool assisted with clinical decision making and informed appropriate antibiotic prescribing. Accessibility and ease of use, including content (guideline and patient education resources), layout, and format, were key factors that determined whether GPs said that they would access the tool in everyday practice. Integration of the tool at multiple sites within the EMR facilitated access to guidelines and assisted in ensuring that the tool fit the clinical workflow. Conclusion. Our CDS tool was acceptable to GPs. Key features required for the tool were easy navigation, clear and useful guideline content, ability to fit into the clinical workflow, and incorporation into the EMR. Piloting of the tool in general practices to assess the impact and feasibility of use in real-world consultations will now be undertaken.
New Copies of Old Classics: Early Manuscripts of Khakheperreseneb and The Instruction of a Man for His Son
Authors: Hagen Fredrik
Published: June 2020

The article publishes a set of three previously unknown writing boards from the Carnarvon and Carter excavations in the lower Asasif area at Thebes in the period 1908–13. Dated on palaeographical grounds to the Second Intermediate Period, they constitute the earliest manuscripts identified so far of two classical literary compositions: Khakheperreseneb and The Instruction of a Man for His Son. The extant text is transcribed and translated, with a brief philological commentary, and it is hypothesised that another literary passage found on two of the boards, in three copies, is the otherwise unattested continuation of Khakheperreseneb.
Large Drill Holes Are Still Present in the Long Term After Arthroscopic Bankart Repair With Absorbable Tacks: An 18-Year Randomized Prospective Study
Authors: Constantinou Christina Chrysanthou , Sernert Ninni , Rostgård-Christensen Lars , Kartus Jüri
Published: June 2020

Background:

Studies have demonstrated the development of an osseous reaction at the drill sites of anchors after arthroscopic shoulder surgery.

Purpose:

To investigate the drill-hole size at 18 years after arthroscopic Bankart repair using either fast polygluconate acid (PGA) or slow polylevolactic acid (PLLA) absorbable tacks and to compare the functional outcomes and development of osteoarthritis.

Study design:

Randomized controlled trial; Level of evidence, 2.

Methods:

40 patients with unidirectional anterior shoulder instability, treated with arthroscopic Bankart repair, were randomized into the PGA group (n = 20) or the PLLA group (n = 20). Plain radiographs of both shoulders, as well as computed tomography (CT) images of the operated shoulder, were used to evaluate the drill-hole size, volume, and degenerative changes. Functional outcomes were assessed by use of the Rowe score, Constant score, and Western Ontario Shoulder Instability (WOSI) index.

Results:

Of the 40 patients, 32 patients returned for the follow-up (15 PGA and 17 PLLA). No significant differences were found in the population characteristics between the study groups. The mean follow-up time was 18 years for both groups. No significant differences were seen in range of motion, strength in abduction, or Constant, Rowe, and WOSI scores between the groups. Recurrence rate was 33% in the PGA group and 6% in the PLLA group during the follow-up period ( P = .07). The drill-hole appearance on plain radiographs (invisible/hardly visible/visible/cystic) was 11/2/2/0 and 6/5/5/1 for the PGA and PLLA groups, respectively ( P = .036). The mean ± SD drill-hole volume as estimated on CT images was 89 ± 94 and 184 ± 158 mm3 in the PGA and PLLA groups, respectively ( P = .051). Degenerative changes (normal/minor/moderate/severe) on plain radiographs were 7/4/4/0 and 3/8/5/1 for the PGA and PLLA groups, respectively ( P = .21), and on CT images were 5/7/3/0 and 2/6/6/3 for the PGA and PLLA groups, respectively ( P = .030).

Conclusion:

This long-term follow-up study demonstrated that the PLLA group had significantly more visible drill holes than the PGA group on plain radiographs. However, this difference was not evident on CT imaging, with both groups having several visible cystic drill holes and a substantial drill-hole volume defect. No significant differences were found between the study groups in terms of clinical outcomes.
Diagnostic Accuracy of Physical Examination Tests in Core Muscle Injury
Authors: Kurowicki Jennifer , Kraeutler Matthew J. , Dávila Castrodad Iciar M. , Hahn Alexander K. , Simone Erica S. , Kelly Michael A. , Talishinskiy Toghrul , Scillia Anthony J.
Published: June 2020

Background:

Core muscle injury (CMI), often referred to as a sports hernia, is a common cause of groin pain in athletes characterized by concomitant injury to the insertion of the adductor longus and the rectus abdominis muscles. Currently, the literature on CMI is sparse with no standardized physical examination tests used in the diagnosis of this type of injury.

Purpose:

To determine the diagnostic accuracy of various physical examination tests in the diagnosis of CMI.

Study Design:

Cohort study (Diagnosis); Level of evidence, 3.

Methods:

A consecutive series of patients evaluated by the senior author with symptoms consistent with CMI were included. Four physical examination tests were routinely performed in these patients by the senior author and were noted in each patient’s chart as positive or negative: (1) pain with resisted cross-body sit-up in figure-of-4 position, (2) pain with straight-leg sit-up, (3) pain with resisted hip flexion in external rotation (external rotation Stinchfield test), and (4) the presence of an adductor contracture. CMI was independently diagnosed by a reference standard (magnetic resonance imaging [MRI]). All MRI scans were read by a musculoskeletal fellowship-trained radiologist. The sensitivity and specificity of each physical examination test alone and in combination were calculated based on this reference standard.

Results:

A total of 81 patients were included in this study. MRI was positive for a CMI in 39 patients (48%) overall. Both the cross-body sit-up test and the presence of an adductor contracture were found to have a sensitivity of 100% (specificity, 3% for both). The external rotation Stinchfield test was found to have the highest specificity of 60% (sensitivity, 15%). The sensitivity of all 4 physical examination tests in combination was found to be 100% (specificity, 0%).

Conclusion:

Certain physical examination maneuvers can be used to assist in the diagnosis of a CMI. The cross-body sit-up test and the presence of an adductor contracture are highly sensitive but nonspecific tests for CMI and therefore should be used in conjunction with diagnostic imaging before deciding on an appropriate treatment course.
The Influence of Evidence-Based Exercise and Age Reattribution on Physical Function in Hispanic Older Adults: Results From the ¡Caminemos! Randomized Controlled Trial
Authors: Burrows Brett , Andrade Flavia Cristina Drumond , Piedra Lissette , Xu Shuo , Aguiñaga Susan , Steinberg Nessa , Sarkisian Catherine , Hernandez Rosalba
Published: June 2020

Older Hispanics routinely exhibit unhealthy beliefs about “normal” aging trajectories, particularly related to exercise and physical function. We evaluated the prospective effects of age reattribution on physical function in older Hispanics. Participants ( n = 565, ≥60 years) were randomly assigned into (a) treatment group—attribution-retraining, or (b) control group—health education. Each group separately engaged in four weekly 1-hr group discussions and 1-hr exercise classes, followed by monthly maintenance sessions. The Short Physical Performance Battery (SPPB) measured physical function throughout the 24-month intervention. No significant difference in physical function between intervention arms was evident over time. However, both groups experienced significant improvements in physical function at 24 months (β = 0.43, 95% confidence interval [CI] = [0.16, 0.70]). Participating in the exercise intervention was associated with improvements in physical function, although no additional gains were apparent for age attribution-retraining. Future research should consider strengthening or modifying intervention content for age reattribution or dosage received.
Local Voices on Health Care Communication Issues and Insights on Latino Cultural Constructs
Authors: Magaña Dalia
Published: June 2020

Structural issues in the health care delivery system can disproportionately affect language minority patients who require interpretation services. This qualitative study addresses the issues Spanish-speaking Latinos face in obtaining health care by examining the experiences of 25 Spanish speakers in California’s Central Valley, a medically underserved area. The following barriers to communication emerged in the findings: time-restricted interactions, unfriendly encounters, discrimination, issues in interpreting, miscommunication, and opposition to providers. We report participants’ recommendations for improving health care communication, including the need for friendlier and more attentive services, more Spanish-speaking providers, and more time with providers. We argue that these recommendations are in line with Latino cultural constructs: confianza (trust), familismo (family-orientation), personalismo (friendliness), respeto (respect), and simpatía (kindness). This study raises awareness about how language use and intercultural competence affect health care communication by centering the voices of Spanish speakers across numerous contextualized examples.
Risk of Acute Kidney Injury in Combat-Injured Patients Associated With Concomitant Vancomycin and Extended-Spectrum β-Lactam Antibiotic Use
Authors: Yabes Joseph M. , Stewart Laveta , Shaikh Faraz , Robben Paul M. , Petfield Joseph L. , Ganesan Anuradha , Campbell Wesley R. , Tribble David R. , Blyth Dana M.
Published: June 2020

Background:

Multidrug-resistant infections complicating combat-related trauma necessitate the use of broad-spectrum antimicrobials. Recent literature posits an association between vancomycin (VANC) and piperacillin–tazobactam (VPT) combination therapy and acute kidney injury (AKI). We examined whether therapy with VPT was associated with an increased risk of AKI compared to VANC and other broad-spectrum β-lactam antibiotics (VBL) following combat-related injuries.

Methods:

Patients within the Trauma Infectious Disease Outcomes Study (TIDOS) who received ≥48 hours concomitant VPT or VBL started within 24 hours of each other were assessed. Exclusion criteria were receipt of renal replacement therapy and baseline creatinine >1.5 mg/dL. Acute kidney injury was defined by meeting any of the Risk, Injury, Failure, Loss, End Stage Renal Disease (RIFLE), AKIN, or VANC consensus guidelines criteria 3 to 7 days after therapy initiation. Variables significantly associated with AKI were used in inverse probability treatment weighting to perform univariate and subsequent logistic regression multivariate modeling to determine significant risk factors for AKI.

Results:

Sixty-one patients who received VPT and 207 who received VBL were included. Both groups had a median age of 24 years and initial median creatinine of 0.7 mg/dL. The VBL patients were more likely to have sustained blast injuries ( P = .001) and received nephrotoxic agents (amphotericin [ P = .002] and aminoglycosides [ P < .001]). In the VBL group, AKI incidence was 9.7% compared to 13.1% in the VPT group ( P = .438). Multivariate analysis identified a relative risk of 1.727 (95% CI: 1.027-2.765) for AKI associated with VPT exposure. Acute kidney injury severity generally met RIFLE Risk criteria and was 1 day in duration. Only 1 patient had persistent renal dysfunction 30 days after therapy completion.

Conclusion:

In this young and previously healthy, severely ill combat-injured population, VPT was associated with nearly twice the risk of AKI compared to VBL. Nevertheless, AKI was of low severity, short duration, and had high rates of renal recovery.
Violent Inclusion: Disability and the Nation in Polish 1950s and 1960s Young Adult Literature
Authors: Pamula Natalia
Published: June 2020

This article belongs to the special cluster, “Family, Gender and (dis)Abled Bodies after 1953”, guest-edited by Maike Lehmann and Alexandra Oberländer.

My article “Violent Inclusion: Disability and the Nation in Polish 1950s and 1960s Young Adult Literature” analyzes representations of physical and sensory disability in some of the most popular young adult novels published in 1950s and 1960s Poland written by Krystyna Siesicka, Jadwiga Korczakowska, Irena Krzywicka, Jadwiga Ruth-Charlewska, and Hanna Mortkowicz-Olczakowa. It argues that the recurring trope that connects the novels—the overcoming of disability—serves as a synecdoche for the Polish nation overcoming the catastrophe of World War II. Moreover, it shows that compulsory rehabilitation functions as a way of including disabled subjects into a Polish post-war society. At the same time, participation in the “rehabilitative regime” constitutes a patriotic duty for a disabled Polish child or teenager and paves a way to a socialist citizenship. Rehabilitation is always successful and culminates with a child or teenager transforming into an able-bodied socialist citizen reminding of a successful, yet sacrificial, reconstruction process of Poland. My article focuses on the sites of the overcoming of disability showing that Polish nature, whether it is a sea or woods, is crucial to the healing of a disabled subject. This way, the writers accentuate the connection between Polish nature and land and a “healthy” body, thus reconsolidating their fantasy of “Polishness.” What the novels ultimately testify to is the emergence of an embodied socialist subjectivity constructed through the corporeal rehabilitative practices and internalization of socialist values.
Between East and West: Government–Nonprofit Relations in Welfare Provision in Post-Socialist Central Europe
Authors: Cox Terry
Published: June 2020

This article reviews the main developments in social welfare provision in East Central Europe (ECE), the emergence of nonprofit organizations as welfare providers, and changing nonprofit–government relations in social welfare provision since the early 1990s. In assessing the strengths and weaknesses of nonprofit organization (NPO)–government relations in social welfare provision in ECE, the article suggests that after establishing a firm basis by the mid-2000s, to varying degrees in different countries, nonprofits have not been able to maintain a secure independent role in the face of fluctuating government attitudes to their role and growing competition from private sector and church organizations.
A hierarchical adaptive control framework of path tracking and roll stability for intelligent heavy vehicle with MPC
Authors: Tian Yantao , Huang Kai , Cao Xuanhao , Liu Yulong , Ji Xuewu
Published: June 2020

Roll stability is a major concern in the path tracking process of intelligent heavy vehicles in emergency steering maneuvers. Due to the coupling of lateral and roll motions of heavy vehicle, steering actions for path tracking may come into conflict with that for roll stability. In this paper, a hierarchical adaptive control framework composed of a supervisor, an upper controller and a lower controller is developed to mediate conflicting objectives of path tracking and roll stability via steering control. In the supervisor, path tracking control mode or cooperative control mode of path tracking and roll stability is determined by the predicted rollover index, and a weight function is introduced to balance the control objectives of path tracking and roll stability in cooperative control mode. Then, in order to achieve multi-objective real-time optimization, model predictive control with varying optimization weights is used in the upper controller to calculate the desired front steer angle. The lower controller which integrates the real electrically assisted hydraulic steering system based on Proportional-Integral-Derivative control is designed to control steering wheel angle. Simulation and hardware-in-loop implementation results in double lane change scenario show that the proposed hierarchical adaptive control framework can enhance roll stability in emergency steering maneuvers while keeping the accuracy of path tracking for intelligent heavy vehicle within an acceptable range.
Large aircraft reliability study as important aspect of the aircraft systems' design changes and improvements
Authors: Balicki Włodzimierz , Głowacki Paweł , Loroch Leszek
Published: June 2020

Along with the increase in air traffic, the number of reported aviation events also increases. The authors have performed processing of the data included in the European Coordination Centre for Aviation Incident Reporting Systems (ECCAIRS) analyzing large aircraft reliability and safety of their operations considering events according to ICAO aviation occurrence categories. The airframe systems are the biggest contributor to the total number of reported events which occurred on the Polish registered large aircraft in the years 2008–2018. Failures of these systems caused more than 23% of total reported aviation events. Based on the ECCAIRS data, determination of occurrence categories essential for aviation safety was performed with the assessment of their safety risk level. Also, detailed airframe systems' reliability study was carried out in order to assess the real reason of their failures. Airframe systems' faults were assigned to the specific ATA chapters and then to each of their sections. The most frequently occurring defects of each unit of the particular airframe system were identified. The results of this analysis may support the decisions of supervisory authorities in the areas where security threats are most important. They can also help aircraft operators with identification of the airframe units which require special attention, and as support in improvement of safety analysis. Identification of significant parts due to the frequency of malfunctions of the system components can be a support for designers who have the information needed to improve the design of specific airframe system.
Investigation of DNA damage, oxidative stress, and inflammation in synthetic cannabinoid users
Authors: Guler EM , Bektay MY , Akyildiz AG , Sisman BH , Izzettin FV , Kocyigit A
Published: June 2020

Background:

The widespread use of synthetic cannabinoids (SCs) among youth has become an important public health problem. Several life-threatening side effects of SC have been reported, including cardiovascular, gastrointestinal, neurological, renal, metabolic, ophthalmologic, and pulmonary effects, besides skin toxicity and hepatotoxicity.

Methods:

Given that high levels of SC can lead to oxidative stress, DNA damage, and inflammation, it has been aimed in this study to investigate the effects of SC in aspects of primary DNA damage, plasma total oxidant status (TOS)/total antioxidant status (TAS), thiol–disulfide homeostasis, myeloperoxidase (MPO) level, and cytokine levels (interleukin 1 beta (IL-1β), interleukin 6 (IL-6), and tumor necrosis factor-alpha (TNF-α)) of 40 SC users (SCUs) in Turkey.

Results:

Mean plasma TOS levels were significantly higher in the SCUs group than in the healthy group (HG). Similarly, mononuclear leukocyte DNA damage, plasma TOS, MPO activity, disulfide, oxidative stress index levels, IL-1β, IL-6, and TNF-α levels were significantly higher in the SCU group than in the HG, whereas plasma TAS, total, and native thiol levels were significantly lower in the SCU group than in the HG.

Conclusion:

It is concluded that SC can cause increase in oxidative stress and in inflammatory processes in addition to its potential for DNA damage. Additional studies with larger sample sizes and longer durations should be held to understand more specific outcomes of SC use.
DNA Methylation-based Diagnostic and Prognostic Biomarkers for Glioblastoma
Authors: Tang Yunliang , Qing Cheng , Wang Jiao , Zeng Zhenguo
Published: June 2020

Glioblastomas are the most common primary central nervous system malignancy tumor in adults. Glioblastoma patients have poor prognosis, with an average survival period of approximately 14 mo after diagnosis. To date, there are a limited number of effective treatment methods for glioblastoma, and its molecular mechanisms remain elusive. In this article, we analyzed the key biomarkers and pathways in glioblastoma patients based on gene expression and DNA methylation datasets. The 60 hypomethylated/upregulated genes and 110 hypermethylated/downregulated genes were identified in GSE50923, GSE50161, and GSE116520 microarrays. Functional enrichment analyses indicated that these methylated-differentially expressed genes were primarily involved in collagen fibril organization, chemical synaptic transmission, extracellular matrix-receptor interaction, and GABAergic synapse. The hub genes were screened from a protein–protein interaction network; in selected genes, increased NMB mRNA level was associated with favorable overall survival, while elevated CHI3L1, POSTN, S100A4, LOX, S100A11, IGFBP2, SLC12A5, VSNL1, and RGS4 mRNA levels were associated with poor overall survival in glioblastoma patients. Additionally, CHI3L1, S100A4, LOX, and S100A11 expressions were negatively correlated with their corresponding methylation status. Furthermore, the receiver-operator characteristic curve analysis indicated that CHI3L1, S100A4, LOX, and S100A11 can also serve as highly specific and sensitive diagnostic biomarkers for glioblastoma patients. Collectively, our study revealed the possible methylated-differentially expressed genes and associated pathways in glioblastoma and identified four DNA methylation-based biomarkers of glioblastoma. These results may provide insight on diagnostic and prognostic biomarkers, and therapeutic targets in glioblastoma.
Energy Drinks Consumption Is Associated With Reduced Sleep Duration and Increased Energy-Dense Fast Foods Consumption Among School Students: A Cross-Sectional Study
Authors: Almulla Aisha Abdalla , Faris Mo’ez Al-Islam E.
Published: June 2020

The study aimed to investigate the prevalence of energy drinks (EDs) consumption and its relationship with sociodemographic characteristics, eating habits, sleep duration, physical activity, and screen time among school students. A cross-sectional study was carried out with a total of 1611 students aged 10 to 18 years from the United Arab Emirates. ED consumption among school students was 27%, with less than half consumed at least one can of EDs 1 to 3 days per week. ED consumers were less likely to meet recommended sleep duration (37% vs 62%, P < .001), more likely to consume high energy-dense fast foods (33% vs 20%, P < .001), and more likely to spend more than 6 hours in front of a screen (40.5% vs 32.3%, P < .001). Students aged 14 to 18 years were twice as likely to consume EDs as students aged 10 to 13 years ( P < .001). Overall, the use of EDs was associated with male sex, older age, not meeting sleep recommendations, high energy-dense fast food consumption, and spending a longer time in front of a screen. Educational intervention programs about ED consumption and healthy lifestyle habits are highly recommended.
Mental health nurse psychotherapists are well situated to improve service shortfalls in Australia: findings from a qualitative study
Authors: Hurley John , Lakeman Richard , Cashin Andrew , Ryan Tom
Published: June 2020

Objective:

This paper reports the capabilities of mental health nurse (MHN) psychotherapists in Australia and their perceptions on how to best utilize their skills.

Method:

An MHN is a registered nurse with recognized specialist qualifications in mental health nursing. One hundred and fifty three MHNs completed an online survey; 12 were interviewed.

Results:

Three themes were derived from a qualitative analysis of the aggregated data: psychotherapy skills of MHN psychotherapists are under-utilized; these nurses bridge gaps between biomedical and psychosocial service provision; and equitable access to rebates in the primary care sector is an obstacle to enabling access to services.

Conclusions:

MHN psychotherapists are a potentially valuable resource to patients in tertiary and primary health care. They offer capacity to increase access to specialist psychotherapy services for complex and high risk groups, while being additionally capable of meeting patients’ physical and social needs. Equitable access to current funding streams including Medicare rebates can enable these outcomes.
A review of de Broglie particle–wave mechanical systems
Authors: Hill James M
Published: June 2020

The existence of the so-called ‘dark’ issues of mechanics implies that our present accounting for mass and energy is incorrect in terms of applicability on a cosmological scale, and the question arises as to where the difficulty might lie. The phenomenon of quantum entanglement indicates that systems of particles exist that individually display certain characteristics, while collectively the same characteristic is absent simply because it has cancelled out between individual particles. It may therefore be necessary to develop theoretical frameworks in which long-held conservation beliefs do not necessarily always apply. The present paper summarises the formulation described in earlier papers (Hill, JM. On the formal origin of dark energy. Z Angew Math Phys 2018; 69:133-145; Hill, JM. Some further comments on special relativity and dark energy. Z Angew Math Phys 2019; 70: 5–14; Hill, JM. Special relativity, de Broglie waves, dark energy and quantum mechanics. Z Angew Math Phys 2019; 70: 131–153.), which provides a framework that allows exceptions to the law that matter cannot be created or destroyed. In these papers, it is proposed that dark energy arises from conventional mechanical theory, neglecting the work done in the direction of time and consequently neglecting the de Broglie wave energy [Formula: see text]. These papers develop expressions for the de Broglie wave energy [Formula: see text] by making a distinction between particle energy [Formula: see text] and the total work done by the particle [Formula: see text], that which accumulates from both a spatial physical force [Formula: see text] and a force [Formula: see text] in the direction of time. In any experiment, either particles or de Broglie waves are reported, so that only one of [Formula: see text] or [Formula: see text] is physically measured, and particles appear for [Formula: see text] and de Broglie waves occur for [Formula: see text], but in either event both a measurable and an immeasurable energy exists. Conventional quantum mechanics operates under circumstances such that [Formula: see text] vanishes and [Formula: see text] becomes purely imaginary. If both [Formula: see text] and [Formula: see text] are generated as the gradient of a potential, the total particle energy is necessarily conserved in the conventional manner.
The Contribution of Therapeutic Horseback Riding to the Improvement of Executive Functions and Self-Esteem Among Children With ADHD
Authors: Aviv Tal-li Matild , Katz Yaacov Julian , Berant Ety
Published: June 2020

Background: Attention deficit hyperactive disorder (ADHD) is associated with difficulties in executive functions (EFs), ( assessed by questionnaires) and self-esteem. Objective: To examine the contribution of therapeutic horseback riding to the EFs’ improvement and self-esteem. Method: In total, 123 Israeli children diagnosed with ADHD participated in the study. The study group participated in 20 weeks of therapeutic horseback riding sessions in addition to receiving medication, whereas the control group received only medication. The children and their mothers filled out questionnaires before treatment, at the end of treatment, and 12 weeks after the treatment ended. To examine changes in the children’s EFs and self-esteem, a series of latent growth models (LGMs) were conducted. Results: Therapeutic horseback riding contributed to the improvement of EFs and self-esteem. Improved self-esteem predicted subsequent improvement in EFs. Conclusion: Therapeutic horseback riding is an effective therapeutic method to improve EFs and self-esteem among children with ADHD.
Do Histologic Features Help Predict Colectomy in Pediatric Patients Presenting With Acute Severe Colitis?
Authors: Green Nicole , Lee Dale , Wahbeh Ghassan , Pacheco M Cristina
Published: June 2020

Background

Multiple prior studies have looked at clinical and laboratory parameters in ulcerative colitis to predict prognosis, but individual histologic features of inflammation and their prognostic significance have not been well studied. The purpose of our study was to determine whether histologic features at presentation with acute severe colitis predict colectomy in pediatric patients.

Methods

Patients were identified retrospectively through the gastroenterology and pathology databases. Demographic information, duration of disease, laboratory data, endoscopic appearance at scope, and histologic features of inflammation were reviewed along with medical therapies. Patients who underwent surgery within 90 days of hospitalization were compared to those who did not.

Results

Fifty patients with acute severe colitis, defined as Pediatric Ulcerative Colitis Activity Index ≥65, were included. Sixteen patients had colectomies performed within 90 days of presentation. No statistically significant difference was found between the surgery and no-surgery groups for patient age, albumin, hemoglobin, or C-reactive protein, though hemoglobin trended toward significance, P = .05. The endoscopic Mayo score and histologic features of inflammation (architectural changes, chronic inflammation, eosinophils, neutrophils within the lamina propria, neutrophils in epithelium, crypt destruction, and ulceration) were similar between groups.

Conclusion

In pediatric patients presenting for hospitalization with acute severe colitis, no histologic features of inflammation predicted colectomy within 90 days.
A customized posterior scleral reinforcement for myopic macular hole with retinal detachment and posterior staphyloma: A case report
Authors: Frisina Rino
Published: June 2020

The author describes a customized posterior scleral reinforcement, its manufacturing method, the rationale of its therapeutic effect, and the surgical technique of its implantation. A 54-year-old female patient with a case history of myopic macular hole with retinal detachment and posterior staphyloma, refractory to pars plana vitrectomy and peeling of internal limiting membrane, underwent posterior scleral reinforcement treatment. Retinal reattachment and macular hole closure were obtained. Best corrected visual acuity increased from light perception to 20/160 Snellen. The pars plana vitrectomy is mandatory to remove vitreoretinal tractions and epiretinal membranes; furthermore, the internal limiting membrane peeling makes retina less rigid. However, it may not be sufficient to allow retinal reattachment and it plays no preventive role in limiting posterior staphyloma progression. The rationale of posterior scleral reinforcement is to reduce retinal stretching, to contain posterior staphyloma, and to limit its progression over time.
Catastrophic complication of a hemodialysis catheter: A giant carotid artery pseudoaneurysm
Authors: Çora Ahmet Rıfkı , Çelik Ersin
Published: June 2020

Indwelling a hemodialysis catheter is a common practice in early care of end-stage renal disease patients. Most indwell cases were non-traumatic and non-complicated, but as in our presented case, improper placement of hemodialysis catheter can cause serious complications like pseudoaneurysm, stroke, or airway collapse. We presented a giant extracranial carotid artery pseudoaneurysm after an improper placement and removal of a temporary hemodialysis catheter.
A vision-based active learning convolutional neural network model for concrete surface crack detection
Authors: Wang Zhen , Xu Guoshan , Ding Yong , Wu Bin , Lu Guoyu
Published: June 2020

Concrete surface crack detection based on computer vision, specifically via a convolutional neural network, has drawn increasing attention for replacing manual visual inspection of bridges and buildings. This article proposes a new framework for this task and a sampling and training method based on active learning to treat class imbalances. In particular, the new framework includes a clear definition of two categories of samples, a relevant sliding window technique, data augmentation and annotation methods. The advantages of this framework are that data integrity can be ensured and a very large amount of annotation work can be saved. Training datasets generated with the proposed sampling and training method not only are representative of the original dataset but also highlight samples that are highly complex, yet informative. Based on the proposed framework and sampling and training strategy, AlexNet is re-tuned, validated, tested and compared with an existing network. The investigation revealed outstanding performances of the proposed framework in terms of the detection accuracy, precision and F1 measure due to its nonlinear learning ability, training dataset integrity and active learning strategy.
A numerical study on optimum shape of steel slit dampers
Authors: Aminzadeh Masoud , Kazemi Haleh Sadat , Tavakkoli Seyed Mehdi
Published: June 2020

Steel slit dampers are among the passive energy dissipating devices that have been proposed to improve seismic performance of steel structures. Several experimental and numerical studies have also been carried out to investigate capacity of the dampers in energy dissipation. In this article, a numerical model is developed to obtain optimum boundary shape of the dampers. To achieve this, isogeometric analysis method is utilized as a powerful tool in precise modeling of complex geometries for the purpose of non-linear analysis of the dampers. A conventional steel slit damper shape is modeled by non-uniform rational B-splines, and then, the shape is optimized with the aim of maximizing the structural energy dissipation under a volume constraint. To verify the model, measurements of an experimental test in literature are compared with the model results. A mathematical-based approach is employed for the optimization process and analytical shape sensitivity analysis is performed. As a result of optimization process, a new steel slit damper is suggested and its performance is evaluated via comparing with other shapes suggested in the literature.
Not home-made: Historical and contemporary social policy dynamics in Cameroon
Authors: Hamann Steffi
Published: June 2020

Social policy development trajectories in post-colonial sub-Saharan African states deviate from those in highly industrialized countries. Recent research endeavours established broad patterns of global interdependencies dating back to colonialism. This article contributes to these efforts by presenting a case study of the dynamics animating social policy development in Cameroon. It examines the progressive evolution of global determinants and their impacts on Cameroon’s welfare system over three periods: (1) decolonialization and post-colonial restructuring in the mid-20th century, (2) structural adjustment in response to the 1980s’ debt crisis and (3) the contemporary era of market liberalization driven by accelerated economic globalization. The research draws on a mixed-methods approach involving a document analysis and a survey administered in 400 rural households. Findings indicate that horizontal interdependencies were predominant in the establishment phase of Cameroon’s national social insurance scheme, but eventually gave way to vertical interdependencies in the 1980s. Recent efforts to advance economic liberalization represent a return to horizontal transnational forces, given the growing influence of multinational corporations on the country’s social security landscape. The study reinforces existing research insights in showing that, unlike social protection in the global north, social policy dynamics in Africa tend to actively contribute to the marginalization of underprivileged groups.
“What” and “How”: A New Perspective for Understanding Unawareness in Alzheimer’s Disease Through a Combination of Two Perspectives
Authors: Mayelle Amandine , El Haj Mohamad , Antoine Pascal
Published: June 2020

Objectives:

Assessments of unawareness in Alzheimer’s disease mainly focus on the objects (the “what”) of unawareness. A recent person-centered approach proposes to also assess the processes (the “how”). The present study combines 2 approaches to understand this heterogeneity in assessments of unawareness.

Method:

We recruited 46 participants from 8 nursing homes. They underwent a semi-structured interview and were assessed using a prediction–performance paradigm. Spearman correlations were calculated, and generalized additive models were established.

Results:

The 2 approaches are associated through cognitive deficits, confrontation with difficulties and identity changes. Objects (the what), mechanisms, and modes of expression (the how) explain at least 29.6% of the variance of unawareness.

Conclusions:

Unawareness is more than simply being unaware of something; it is a synergy between the objects and processes of arousal and expression. Moreover, unawareness extends beyond the disease to include the self. Considering the entire person seems to be necessary.
Association Between Acupoint Selection, Target Symptoms, and Traditional Chinese Medicine Diagnosis in Real-Time Clinical Practice in a Comprehensive Cancer Center
Authors: Liu Wenli , Qdaisat Aiham , Lopez Gabriel , Narayanan Santhosshi , Underwood Susan , Spano Michael , Reddy Akhila , Guo Ying , Yeung Sai-Ching , Bruera Eduardo , Cohen Lorenzo
Published: June 2020

Background: Acupuncture intervention in actual practice is rarely reported and may be different from that applied in acupuncture research. Objectives: To review acupuncture practice in an integrative medicine clinic and characterize the association between targeted symptoms, traditional Chinese medicine (TCM) diagnosis, and acupoint selection. Methods: We reviewed outpatient acupuncture records from March 2016 to April 2018. Statistical analyses were applied to characterize referral symptoms and associated TCM diagnosis as well as acupoint selection. Results: The final analysis included 5393 acupuncture records (1264 patients). Twelve TCM diagnosis components were identified in the referral symptoms of pain, neuropathy, xerostomia, and hot flashes. Pain was associated with 78 different TCM diagnoses (combinations of TCM diagnosis components). Total of 217 different acupoints were used in the acupuncture treatments (1739) for neuropathy. The acupoint yintang was used in 73.8% of the visits for neuropathy, yet only in 26.5% ( P < .001) of the treatments when patients had a TCM diagnosis of qi deficiency, qi stagnation, and blood stagnation. Similarly, both consistencies and variations were seen in acupoint selection with each targeted symptom and its associated TCM diagnoses. Conclusions: TCM diagnosis was not homogeneous among acupuncture treatments for a single referral symptom. In contrast to most of the research on acupuncture for symptom control, there were considerable variations in acupoint selection among treatments for the same symptom in a clinical setting. Future research is needed to examine the clinical relevance of a fixed intervention structure in acupuncture research and the value of individualized acupuncture treatment.
Beneficial “Pharmaceutical Pleiotropy” of Gabapentinoids in Spinal Cord Injury: A Case for Refining Standard-of-Care
Authors: Cragg Jacquelyn J. , Jutzeler Catherine R. , Grassner Lukas , Ramer Matt , Bradke Frank , Kramer John L. K.
Published: June 2020

Spinal cord injury results in devastating neurological deficits accompanied by lifelong disability and significant economic burden. While the development of novel compounds or cell-based interventions for spinal cord injury is unquestionably worthwhile, a complementary approach examines current standards of care and the degree to which these can be optimized to benefit long-term neurological function. Numerous classes of drugs, already in use in the acute phase of spinal cord injury, are intriguing because they (1) readily cross the blood-spinal cord barrier to modulate activity in the central nervous system and (2) are administered during a window of time in which neuroprotection, and even some repair, are feasible. Here, we review a rare case of convergent lines of evidence from both preclinical and human studies to support the early administration of a class of drug (ie, gabapentinoids) to both foster motor recovery and reduce the severity of neuropathic pain.
Time Course of Wrist Hyper-Resistance in Relation to Upper Limb Motor Recovery Early Post Stroke
Authors: Andringa Aukje , Meskers Carel , van de Port Ingrid , van Wegen Erwin , Kwakkel Gert
Published: June 2020

Background. Patients with an upper limb motor impairment are likely to develop wrist hyper-resistance during the first months post stroke. The time course of wrist hyper-resistance in terms of neural and biomechanical components, and their interaction with motor recovery, is poorly understood. Objective. To investigate the time course of neural and biomechanical components of wrist hyper-resistance in relation to upper limb motor recovery in the first 6 months post stroke. Methods. Neural (NC), biomechanical elastic (EC), and viscous (VC) components of wrist hyper-resistance (NeuroFlexor device), and upper limb motor recovery (Fugl-Meyer upper extremity scale [FM-UE]), were assessed in 17 patients within 3 weeks and at 5, 12, and 26 weeks post stroke. Patients were stratified according to the presence of voluntary finger extension (VFE) at baseline. Time course of wrist hyper-resistance components and assumed interaction effects were analyzed using linear mixed models. Results. On average, patients without VFE at baseline (n = 8) showed a significant increase in NC, EC, and VC, and an increase in FM-UE from 13 to 26 points within the first 6 months post stroke. A significant increase in NC within 5 weeks preceded a significant increase in EC between weeks 12 and 26. Patients with VFE at baseline (n = 9) showed, on average, no significant increase in components from baseline to 6 months whereas FM-UE scores improved from 38 to 60 points. Conclusion. Our findings suggest that the development of neural and biomechanical wrist hyper-resistance components in patients with severe baseline motor deficits is determined by lack of spontaneous neurobiological recovery early post stroke.