bluuebunny/crossref_metadata_2025_split huggingface dataset:
Advanced practice nurses, registered nurses and medical practice assistants in new care models in Swiss primary care: a focused ethnography of their professional roles
Authors: Josi Renata , Bianchi Monica 
Published: December 2019

ObjectivesWe aimed to analyse roles and tasks of advanced practice nurses (APNs), registered nurses (RNs) without advanced practice education and medical practice assistants (MPAs) with regard to chronic care in Swiss primary care (PC). The objective of this study was to explore the potential of new care models, involving these health professionals, which could meet changing future healthcare needs.DesignAn ethnographic design comprising semi-structured interviews and non-participant observations was conducted.SettingHealth professionals who worked in 10 primary care practices in the German-speaking part of Switzerland were included in the study.ParticipantsIn total, 16 interviews were conducted with four APNs, six MPAs, two RNs and four general practitioners (GPs). Nine of the health professionals were subsequently observed in their primary care practice.ResultsAPNs and MPAs were both involved in chronic care in the PC practice. While APNs cared for older, multimorbid patients with more complex needs, MPAs were involved in counselling of younger patients with chronic disease such as type 2 diabetes. Additionally, APNs were involved in many home visits and visits in elderly peoples — and nursing homes. APNs worked with a high degree of autonomy while MPAs had worked mostly in delegation. Task division between GPs and APNs or MPAs was not clear in every case yet.ConclusionsAPNs and MPAs have a high potential to contribute to optimal care in new care models, which address needs of the elderly population. The experience from our sample may inform international health policymakers and practitioners about the tasks and responsibilities those health professionals can take over in PC when implementing new models of care. The practical experience with new models of care involving APNs and MPAs may also influence the future regulation with regard to the scope of practice of these health professionals in Switzerland.
Intermittent theta burst stimulation applied during early rehabilitation after stroke: study protocol for a randomised controlled trial
Authors: Hensel Lukas , Grefkes Christian , Tscherpel Caroline , Ringmaier Corinna , Kraus Daria , Hamacher Stefanie , Volz Lukas J , Fink Gereon R 
Published: December 2019

IntroductionIntermittent theta burst stimulation (iTBS) applied to primary motor cortex (M1) has been shown to modulate both the excitability and connectivity of the motor system. A recent proof-of-principle study, based on a small group of hospitalised patients with acute ischemic stroke, suggested that iTBS applied to the ipsilesional M1 combined with physical therapy early after stroke can amplify motor recovery with lasting after effects. A randomised controlled clinical trial using a double-blind design is warranted to justify the implementation of iTBS-assisted motor rehabilitation in neurorehabilitation from an acute ischaemic stroke.Methods/designWe investigate the effects of daily iTBS on early motor rehabilitation after stroke in an investigator-initiated, longitudinal randomised controlled trial. Patients (n=150) with hemiparesis receive either iTBS (600 pulses) applied to the ipsilesional motor cortex (M1) or a control stimulation (ie, coil placement over the parieto-occipital vertex in parallel to the interhemispheric fissure and with a tilt of 45°). On 8 consecutive workdays, a 45 min arm-centred motor training follows the intervention . The relative grip strength, defined as the grip force ratios of the affected and unaffected hands, serves as the primary outcome parameter. Secondary outcome parameters are measures of arm function (Action Research Arm Test, Fugl-Meyer Motor Scale), stroke severity (National Institutes of Health Stroke Scale), stroke-induced disability (modified Rankin Scale, Barthel Index), duration of inpatient rehabilitation, quality of life (EuroQol 5D), motor evoked potentials and the resting motor threshold of the ipsilesional M1.Ethics and disseminationThe study was approved by the Ethics Commission of the Medical Faculty, University of Cologne, Germany (reference number 15-343). Data will be disseminated through peer-reviewed publications and presentations at conferences. Study title: Theta-Burst Stimulation in Early Rehabilitation after Stroke (acronym: TheSiReS). Study registration at German Registry for Clinical Trials (DRKS00008963) and at ClinicalTrials.gov (NCT02910024).
‘It’s difficult, it’s life changing what happens to you’ patient perspective on life with chronic hypersensitivity pneumonitis: a qualitative study
Authors: Aronson Kerri I , Hayward Bradley J , Robbins Laura , Kaner Robert J , Martinez Fernando J , Safford Monika M 
Published: December 2019

RationaleChronic hypersensitivity pneumonitis (CHP) is a distinct form of interstitial lung disease caused by an inhaled environmental antigen. Some patients with CHP develop progressive pulmonary fibrosis and varying degrees of symptom severity, with heterogeneous impact on functioning and overall well-being. There are no universally accepted diagnostic criteria, few FDA-approved (Food and Drug Administration) therapies and no standardised approach to identifying an antigen. The impact that living with CHP has on patients’ quality of life is understudied, preventing the identification of patient-centred research questions and endpoints for future CHP clinical trials.ObjectivesWe explored patients’ experiences, perceptions and expectations of living with CHP.MethodsWe conducted semistructured interviews with patients with CHP. Patients were recruited using a purposive heterogeneous sampling strategy. Interviews were audio recorded and transcribed verbatim. Data were analysed using the grounded theory method.ResultsEighteen patients were interviewed. Six major themes emerged from the interviews: (1) suffering due to lack of knowledge and uncertainty, (2) hypervigilance, (3) psychosocial, (4) physical impacts, (5) interpersonal and (6) self-perception and identity. The need to identify and avoid an antigen played a prominent role across the themes and subthemes.ConclusionsWe identified several key influences on quality of life in patients with CHP that have not been adequately explored. The prevalence of these influences should be quantified, and they should be included in quality of life assessment and should guide the development of targeted interventions to improve quality of life in this patient population.
A preliminary strategy for screening the combination of active components based on Bu–Shen–Yi–Qi Decoction for bronchial asthma
Authors: Yan Chen , Luo Qingli , Ma Cheng , Liu Jiaqi , Dong Jingcheng 
Published: December 2019

Objective: The anti-asthma herbal medicine Bu–Shen–Yi–Qi Decoction (BSYQ Decoction), a combination of three traditional Chinese medicine herbs developed in our lab, has shown demonstrated efficacy in Ovalbumin (OVA)-induced acute bronchial asthma. However, the obscure substances, multiple potential targets and the unclear molecular mechanisms are obstacles to control drug quality, stability and standardization. Multi-component formulae with a clear pharmacodynamic material and specific mechanism are an innovation worth exploring. They may also partly reserve a potential synergistic and additive effect compared with single components extracted from traditional Chinese herbs. This study was designed to select three standard multi-component formulae of the combination of effective components preliminarily based on four effective components [total flavonoids of Herba Epimedii ([Formula: see text]; Astragalus polysaccharide ([Formula: see text]; Astragaloside ([Formula: see text]; and Catalpol ([Formula: see text]] in BSYQ Decoction.Methods: OVA-induced asthmatic murine models were established. A uniform design was applied to select 10 proportions from four target components, and 3 formulae which showed best effect aimed at IFN-[Formula: see text], IL-4 and IgE in the serum respectively were screened based on stepwise regression analysis.Results: According to the regression analysis, Formula I ([Formula: see text]:[Formula: see text]:[Formula: see text]:6:29), Formula II ([Formula: see text]:[Formula: see text]:[Formula: see text]:8:2) and Formula III ([Formula: see text]:[Formula: see text]:[Formula: see text]:[Formula: see text]:50:8:2) are the three potential proper ratios for the new multi-component formula aimed at serum IFN-[Formula: see text], IL-4 and IgE in OVA-induced asthma mice, respectively.Conclusion: Three multi-component formulae derived from BSYQ Decoction could exert anti-inflammatory effect against OVA-induced asthma, which might provide evidences and lay foundations for further study of standard modern Chinese drug for treating asthma based on BSYQ Decoction.
Jesús Soto en el Pabellón venezolano de 1967
Authors: Chávez Herrera Moisés Orlando 
Published: December 2019

Este escrito deriva de la tesis presentada en la VIII Maestría de Historia de la Arquitectura y del Urbanismo en la Universidad Central de Venezuela, titulada Villanueva y el Pabellón de Venezuela en la Expo 67: una obra de arte total. Aquí se estudia la labor que Jesús Soto tuvo en el proceso de creación de una escultura que se ubicó en uno de los cubos del pabellón, detallando su proceso de concepción, desarrollo y culminación, a lo largo del trabajo colaborativo que lideró Carlos Raúl Villanueva. Asimismo, se hace un estudio de los significados filosófico-artísticos y una revisión sobre el concepto de modernidad que se muestra y esconde en la esencia de la pieza.
Hospital Factors Associated With Interhospital Transfer Destination for Stroke in the Northeast United States
Authors: Zachrison Kori S. , Onnela Jukka‐Pekka , Reeves Mathew J. , Hernandez Adrian , Camargo Carlos A. , Zhao Xin , Matsouaka Roland A. , Goldstein Joshua N. , Metlay Joshua P. , Schwamm Lee H. 
Published: December 2019

Background
We aimed to determine if there is an association between hospital quality and the likelihood of a given hospital being a preferred transfer destination for stroke patients.

Methods and Results

Data from Medicare claims identified acute ischemic stroke transferred between 394 northeast
US
hospitals from 2007 to 2011. Hospitals were categorized as transferring (n=136), retaining (n=241), or receiving (n=17) hospitals based on the proportion of acute ischemic stroke encounters transferred or received. We identified all 6409 potential dyads of sending and receiving hospitals, and categorized dyads as connected if ≥5 patients were transferred between the hospitals annually (n=82). We used logistic regression to identify hospital characteristics associated with establishing a connected dyad, exploring the effect of adjusting for different quality measures and outcomes. We also adjusted for driving distance between hospitals, receiving hospital stroke volume, and the number of hospitals in the receiving hospital referral region. The odds of establishing a transfer connection increased when rate of alteplase administration increased at the receiving hospital or decreased at the sending hospital, however this finding did not hold after applying a potential strategy to adjust for clustering. Receiving hospital performance on 90‐day home time was not associated with likelihood of transfer connection.

Conclusions

Among northeast
US
hospitals, we found that differences in hospital quality, specifically higher levels of alteplase administration, may be associated with increased likelihood of being a transfer destination. Further research is needed to better understand acute ischemic stroke transfer patterns to optimize stroke transfer systems.
Dual Coaptation of Facial Nerve Using Masseteric Branch of Trigeminal Nerve for Iatrogenic Facial Palsy: Preliminary Reports
Authors: Lee Yoon Se , Ahn Joong Ho , Park Hong Ju , Lee Ho Jun , Bae Mi Rye , Roh Jong-Lyel , Choi Seung-Ho , Nam Soon Yuhl , Kim Sang Yoon 
Published: December 2019

Objectives: Immediate facial nerve substitution or graft technique has been used for the repair of facial nerve defects occurring as a result of tumour dissection. However, some patients report unsatisfactory outcomes, such as difficulty in maintaining resting or smiling symmetry, due to persistent flaccid facial palsy. Here we evaluated the functional outcomes of transferring the masseteric branch of the trigeminal nerve to the facial nerve adjunct to facial nerve graft. Methods: We reviewed the medical records of seven patients who underwent facial reanimation surgery between 2014 and 2016. The patients were divided into two groups according to the type of facial reanimation surgery: group A, masseteric nerve innervation with interposition graft; group B, interposition graft only. The postoperative resting symmetry and dynamic movement were compared. Results: Facial contraction was first observed in group A at 4 months and in group B at 7.3 months. Most of the patients achieved reliable resting symmetry; however, one patient in group B exhibited unsatisfactory facial weakness on the affected side. Group A patients showed better dynamic movement than group B patients. Eye closure, oral excursion and oral continence were better in group A than in group B patients. Smile symmetry in both groups was similar due to hyperkinetic movement in group A patients and flaccidity in group B patients. Conclusions: Dual innervation of the masseteric branch of the trigeminal nerve improves the dynamic movement of paralysed facial muscles and shortens the recovery period in patients with iatrogenic facial palsy.
Correlations of MIF polymorphism and serum levels of MIF with glucocorticoid sensitivity of sudden sensorineural hearing loss
Authors: Zhu Wen-Yan , Jin Xin , Ma Yong-Chi , Liu Zhi-Biao 
Published: December 2019

Objective This study explored the relationship between macrophage migration inhibitory factor (MIF) gene polymorphism (−173G/C) and glucocorticoid sensitivity in sudden sensorineural hearing loss (SSNHL). Methods A total of 120 patients with SSNHL were divided into a glucocorticoid-sensitive group and a glucocorticoid-resistant group. A group of 93 healthy individuals served as the control group. Serum MIF levels of the participants were measured and MIF genotyping was performed. Results The frequency of the MIF −173C allele was significantly higher in glucocorticoid-sensitive patients than in glucocorticoid-resistant patients. Serum MIF levels were significantly higher in SSNHL patients than in healthy controls, and higher in the glucocorticoid-sensitive group than in the glucocorticoid-resistant group of SSNHL patients, which was unexpected. Compared with patients with the GG genotype, patients with the −173C allele (GC and CC genotypes) had significantly higher levels of serum MIF and superoxide dismutase activity and lower levels of tumor necrosis factor-α and malondialdehyde. Conclusion The MIF −173G/C polymorphism is associated with glucocorticoid sensitivity in SSNHL patients. The C allele can result in higher MIF production, reduced oxidative stress, and greater glucocorticoid sensitivity.
Coping with Institutional and Financial Crises in the Sixteenth and Seventeenth Centuries: Ensuring the Survival of Ottoman Royal Waqfs
Authors: Orbay Kayhan 
Published: December 2019

The Ottoman Empire had inherited the waqf (charitable foundation) as an institutionalized form of charity from the Near Eastern Islamic states, which had preceded it. Over time, new forms of charitable foundations emerged, while with the expansion of the Empire, waqfs grew in number and spread geographically. Donors created over fifty thousand charitable foundations, making them into the most widespread institution in Ottoman history. Some waqfs, the largest ones in particular, survived for many centuries. However, sometimes continued functioning was under severe threat, due to wars, epidemics, natural disasters, and rebellions. To overcome financial straits, the waqfs resorted to a variety of measures. Occasionally, a royal waqf in difficulty received assistance from other foundations established by sultans and/or their relatives. Administrators reduced current expenditures, sometimes even suspending salaries and charitable services. Moreover, through long-term lease contracts involving substantial down payments by the lessees, waqf administrators often raised the money needed to restore damaged properties. In the present paper, we study Ottoman royal waqfs when exposed to adversities and financial hardships. As administrators reacted with considerable flexibility, the claim that the waqfs were rigid institutions is in obvious need of revision.
‘Popular’ Imagery in the Late Ottoman Periphery: The Wall Paintings in Village Mosques of Denizli Province
Authors: Değirmenci Tülün 
Published: December 2019

Among the spaces conveying rich information on Anatolian social structure, mosques occupy a special place. In pre-modern societies, village and small-town mosques were not only places of worship, but served as foci of education and sociability, hosting visitors or travellers on occasion. While the architecture of village mosques is usually very simple, the furnishings can be elaborate, turning these modest structures into mirrors reflecting village culture, and thereby the culture of the Ottoman periphery. The present article focuses on eighteenth- and nineteenth-century painted mosques in the Turkish province of Denizli and environs, which display a remarkable unity of style and iconography. In the secondary literature, these works of art usually appear as products of so-called ‘Westernization’. By contrast, this study argues that they are outputs of Ottoman popular culture. Tangible from the seventeenth century onwards, the sociocultural dynamics and life practices specific to the Ottoman periphery have given this artwork its peculiar form. Thus, this study encourages researchers to rethink Anatolian conservatism, as it demonstrates that in the pre-modern era, mosques were not the well-protected spaces, distant from everyday life that they are today. Rather, in the period under study, village mosques could be ‘ambiguous’ spaces seamlessly joining varying spheres of life and belief.
Effect of Board Diversity, Promoter’s Presence and Multiple Directorships on Firm Performance
Authors: Limbasiya Nailesh , Shukla Hitesh 
Published: December 2019

Purpose: This article analyses the effect of board diversity on the financial performance of non-financial firms listed in the Nifty Index. Specifically, it examines the mediation effect of the promoter’s presence and multiple directorships on the financial performance of the firm, that is, return on net worth (RONW), return on equity (ROE) and its sales growth. Methodology: The article uses the hierarchical regression model to analyse the effect of board diversity on financial performance. The presence of the promoters on the board and multiple directorships are taken as the control variables. Findings: Empirical results show the significant effect of the promoter’s presence on the board on the firm’s earnings and a significant positive effect of firm age, board size, age diversity and experience diversity on the financial performance. However, we do not find any statistically significant relationship between firm size and financial performance in any model. The results also show that the age and experience of the female directors are significantly less compared to the male directors. However, the age and experience of the non-executive directors and independent directors are found to be higher among the other positions held by the directors. We also find a negative relationship between multiple directorships in other firms and the financial performance of the firm. Value: The article proposes that there should be a greater number of independent directors in a firm that has its promoter on the board. One recommendation for the board is to reduce the number of directorships held in other boards to ensure more constructive contribution towards the firm’s financial performance. The article studies the effect of the promoter’s presence on the board and multiple directorships held by board members on the financial performance of the firm.
Effect of Apatinib on Serum CD4+CD25+ T cells, NK Cells, and T Cells Subgroup in Malignant Tumor
Authors: Luo Hui-Qin , He Yi-Fu , Chen Wen-Ju , Yan Ying , Wu Shu-Sheng , Hu Xiao-Xiu , Ke Li-Hong , Niu Jia-Yu , Li Hui-Min , Xu Hui-jun 
Published: December 2019

Objective: The immune makers including CD4+CD25+ T cells, natural killer cells, and T cells subgroup were retrospectively analyzed to find the relationship between apatinib and the immune system in the patients treated with apatinib. Method: Forty-two patients with advanced malignant tumors orally took apatinib as treatment and 16 patients with the same situation did not take apatinib as a control group. These patients were all included in the study, and they orally received apatinib 500 mg daily as monotherapy or combination. The treatment was continued until disease progression or intolerable toxicity. CD4+CD25+ T cells, natural killer cells, and T cells subgroup were detected before and 1 month after therapy for all the patients. The relationship between the changing number of immune cells and progression-free survival was analyzed in this study. Result: For the apatinib group, the rate of CD4+CD25+ T cells significantly increased ( P = .048). The median progression-free survival was 3.25 months for the 42 patients. The median progression-free survival in the patients with the rate of CD4+CD25+ T cells increased and decreased was 5.8 months and 2.9 months, respectively ( P = .012). Multivariate analysis found the increased rate of CD4+CD25+ T cells was an independent prognostic factor for a longer progression-free survival. The rate of natural killer cells and T cells subgroup did not change much after apatinib therapy, and they were not independent prognostic factors for progression-free survival. Conclusion: The rate of CD4+CD25+ T cells is very important in patients with apatinib treatment. The changing number of CD4+CD25+ T cells may be a good indicator for apatinib prognosis. Natural killer cells and T cells subgroup did not change much after apatinib, and they were not independent prognostic factors for progression-free survival.
Post-sepsis syndrome – an evolving entity that afflicts survivors of sepsis
Authors: Mostel Zachary , Perl Abraham , Marck Matthew , Mehdi Syed F. , Lowell Barbara , Bathija Sagar , Santosh Ramchandani , Pavlov Valentin A. , Chavan Sangeeta S. , Roth Jesse 
Published: December 2019

AbstractBackgroundThe sequelae of sepsis were once thought to be independent of sepsis itself and assumed to be either comorbid to sick patients or complications of critical illness. Recent studies have reported consistent patterns of functional disabilities in sepsis survivors that can last from months to years after symptoms of active sepsis had resolved.BodyPost-sepsis syndrome is an emerging pathological entity that has garnered significant interest amongst clinicians and researchers over the last two decades. It is marked by a significantly increased risk of death and a poor health-related quality of life associated with a constellation of long-term effects that persist following the patient’s bout with sepsis. These include neurocognitive impairment, functional disability, psychological deficits, and worsening medical conditions.ConclusionThis “post-sepsis syndrome” has been the subject of active preclinical and clinical research providing new mechanistic insights and approaches linked to survivor well-being. Here we review important aspects of these research efforts and goals of care for patients who survive sepsis.