bluuebunny/crossref_metadata_2025_split huggingface dataset:
ДИНАМІКА ЗМІН БІОХІМІЧНИХ ПОКАЗНИКІВ КРОВІ ТА СТРУКТУР КІРКОВОЇ РЕЧОВИНИ НИРОК БІЛИХ ЩУРІВ ЗА УМОВ ТОКСИЧНОГО УРАЖЕННЯ ПЕЧІНКИ
Authors: Yavorska S. I. , Lisnychuk N. Ye. , Yaroshenko T. Ya. , Reminetskyy B. Ya. , Yavorska-Skrabut I. M. 
Published: October 2020

Вступ. Високий рівень захворюваності на токсичні гепатити з розвитком поліорганної недостатності зумовлює актуальність дослідження змін біохімічних показників крові та з’ясування об’єктивних морфометричних змін структур нефронів, що характеризують морфофункціональні зміни нирок при токсичному ураженні печінки.
Мета дослідження – вивчити динаміку змін біохімічних показників крові, а також морфологічних змін структур кіркової речовини нирок білих щурів за умов експериментального токсичного ураження печінки.
Методи дослідження. Експеримент виконано на 30-ти білих безпородних щурах-самцях, яких було поділено на 3 групи. Моделлю токсичного гепатиту слугувала інтоксикація тетрахлорметаном, який вводили через день внутрішньошлунково у вигляді 50 % олійного розчину в дозі 2 г/кг маси тіла. Тривалість експерименту становила 2 і 14 діб. У крові визначали концентрацію загального білірубіну, сечовини, креатиніну, активність аланін- і аспар­татамінотрансфераз. Для гістологічних досліджень забирали матеріал з кіркової речовини нирок, виготовляли гістологічні препарати і фарбували їх гематоксиліном та еозином.
Результати й обговорення. У крові тварин з токсичним гепатитом на 2-гу і 14-ту доби проведення експерименту вміст загального білірубіну збільшувався у 2,4 та 3,2 раза. Підвищення активності внутрішньоклітинних ензимів аланін- і аспартатамінотрансфераз у 9,5 та 17,4 і 14,1 та 7,3 раза у відповідні терміни експерименту вказувало на інтенсивне ушкодження клітин печінки. При цьому відзначено погіршення функціонального стану нирок, про що свідчило зростання концентрації сечовини у крові в 1,8 та 2,2 раза і креатиніну в 1,2 та 2,3 раза у відповідні терміни. Гістологічно у кірковій речовині нирок було виявлено ознаки порушення гемодинаміки, встановлено наявність ниркових тілець з ознаками як гіпертрофії, так і гіпотрофії. Їх співвідношення змінювалось протягом досліду. Водно­час відбувалися звуження просвіту проксимальних звивистих канальців, зменшення площі їх епітеліоцитів та розвиток дистрофічних змін. Відповідні параметри дистальних звивистих канальців зазнавали менш виражених змін.
Висновки. Токсичне ураження печінки викликало ушкодження клітинних мембран гепатоцитів, суттєво підвищу­валась активність аланін- і аспартатамінотрансфераз, загального білірубіну. Погіршувався функціональний стан нирок. Водночас встановлено зміни структурних компонентів кіркової речовини нирок на тлі гемодинамічних порушень.
After-Action Reviews and Long-Term Performance: An Experimental Examination in the Context of an Emergency Simulation
Authors: Muñoz Gonzalo J. , Cortéz Diego A. , Álvarez Constanza B. , Raggio Juan A. , Concha Antonia , Rojas Francisca I. , Arthur Winfred , Fischer Bastián M. , Rodriguez Sebastián 
Published: October 2020

Objective The present study examined the effectiveness of after-action reviews (AARs; also known as debriefing) in mitigating skill decay. Background Research on the long-term effectiveness of AARs is meager. To address this gap in the literature, we conducted an experimental study that also overcomes some research design issues that characterize the limited extant research. Method Eighty-four participants were randomly assigned to an AAR or non-AAR condition and trained to operate a PC-based fire emergency simulator. During the initial acquisition phase, individuals in the AAR condition were allowed to review their performance after each practice session, whereas individuals in the non-AAR condition completed a filler task. About 12 weeks later, participants returned to the lab to complete four additional practice sessions using a similar scenario (i.e., the retention and reacquisition phase). Results The performance of participants in the AAR condition degraded more after nonuse but also recovered faster than the performance of participants in the non-AAR condition, although these effects were fairly small and not statistically significant. Conclusion Consistent with the limited research on the long-term effectiveness of AARs, our findings failed to support their effectiveness as a decay-prevention intervention. Because the present study was conducted in a laboratory setting using a relatively small sample of undergraduate students, additional research is warranted. Application Based on the results of the present study, we suggest some additional strategies that trainers might consider to support long-term skill retention when using AARs.
A Group-Based Walking Study to Enhance Physical Activity Among Older Adults: The Role of Social Engagement
Authors: Liu Yujun , Lachman Margie E. 
Published: October 2020

Objectives. The aim of this study was to explore social engagement and social comparisons as mechanisms to increase physical activity among older adults. Methods. Participants (N = 60, mean age = 65.7) were randomly assigned to one of two conditions. Participants in the treatment condition used the application to track their daily walking steps and interact via text messages with their group members for 4 weeks. Participants in the control group used the application only to track their own walking steps. Outcome variables included mean weekly steps, exercise self-efficacy, and social engagement. Results. The results revealed that participants in the experimental condition significantly increased their mean weekly steps and social engagement from the pretest to the posttest whereas the control group did not. These effects were maintained at the 1-month follow up. Discussion. The study expands our understanding of the motivational role of social engagement and social comparison in increasing PA among older adults.
Venous thromboembolism after ultrasound guided foam sclerotherapy
Authors: de Aguiar Eduardo T , dos Santos Jorgete B , Carvalho Danielle D 
Published: October 2020

Objective To analyze prevalence of venous thromboembolism (VTE) after ultrasound guided foam sclerotherapy. Method Clinical retrospective study with patients treated from 2004 to 2014. Charts with incomplete data and follow-up less than 60 days were excluded. Polidocanol foam (Tessari method) was used. The primary outcome was the prevalence of VTE and the secondary were possible risk factors. Chi-square test and Marascuillo prodecure were applied at a significance level of 5%. Results 2,616 patients were included with 4,712 lower limbs treated. The mean age was 50.7±0.86, in majority female, 83.7%. VTE occurred in 0.49% (pulmonary embolism 0,3%) in a mean time of 44.0±42.2 days. Male gender, personal or family history of phlebitis or DVT and high caliber varicose veins were significantly associated to VTE. Conclusion incidence of VTE is low, male gender, personal or family history of VTE and caliber of varicose veins greater than 7 mm increased the risk.
Organizational commitment among physicians: A systematic literature review
Authors: Hoff Timothy , Lee Do Rim , Prout Kathryn 
Published: October 2020

Purpose Physicians work increasingly in larger organizations across different health care delivery systems. This systematic review examines the published empirical literature on organizational commitment among physicians within an international context. Design A systematic, PRISMA-guided review examining studies of organizational commitment among physicians published over time. Four article databases and a combination of appropriate search terms aided in identifying relevant articles. Findings Key findings include: (a) physicians, regardless of country, personal characteristics, type of job, or place of employment generally have lower levels of organizational commitment than other health care workers; (b) work- and job-related variables, particular age and job satisfaction, shape physicians’ organizational commitment; and (c) organizational commitment and the factors that shape it are similar across physicians working in different health systems. Review implications: Organizational commitment should remain central for researchers to study in most health systems internationally. Larger samples, longitudinal research, and greater use of theory are design improvements that will strengthen the extant research. The findings imply that if healthcare organizations create workplaces that make physicians feel in control, do not overwhelm them with work, provide a supportive culture, enhance their ability to give input, and keep them job satisfied, they may gain enhanced organizational commitment. Originality and value: To our knowledge, this is the first review of research examining organizational commitment among physicians. It is a resource for researchers and managers interested in learning more about aligning physician thinking and behavior with health care organizations.
Proton magnetic resonance spectroscopy (1H-MRS) in rheumatic autoimmune diseases: A systematic review
Authors: Frittoli Renan Bazuco , Pereira Danilo Rodrigues , Rittner Leticia , Appenzeller Simone 
Published: October 2020

Background/Purpose Proton magnetic resonance spectroscopy (1H-MRS) has been shown to be an important non-invasive tool to quantify neuronal loss or damage in the investigation of central nervous system (CNS) disorders. The purpose of this article is to discuss the clinical utility of 1H-MRS in determining CNS involvement in individuals with rheumatic autoimmune diseases. Methods This study is a systematic review of the literature, conducted during the month of November and December of 2019 of articles published in the last 16 years (2003-2019). The search for relevant references was done through the exploration of electronic databases (PubMed/Medline and Embase). We searched for studied including systemic lupus erythematosus (SLE), systemic sclerosis (SSc), juvenile idiopathic arthritis, rheumatoid arthritis (RA), psoriasis, Sjögren's syndrome (pSS), vasculitis and Behçet. Only studies published after 2003 and with more than 20 patients were included. Results We included 26 articles. NAA/Cr ratios were significant lower and Cho/Cr ratios increased in several brain regions in SLE, SS, RA, SSc. Associations with disease activity, inflammatory markers, CNS manifestations and comorbidities was variable across studies and diseases. Conclusion The presence of neurometabolite abnormalities in patients without ouvert CNS manifestations, suggests that systemic inflammation, atherosclerosis or abnormal vascular reactivity may be associated with subclinical CNS manifestations. MRS may be a usefull non-invasive method for screening patients with risk for CNS manifestations.
Escape the Womb: A Maternal Emergency
Authors: Hardie Lori , Gill Amanda , Lee Stephanie , Shiveley Jody 
Published: October 2020

Background. Due to advanced maternal age, obesity, drug use, and other comorbidities, the frequency of maternal cardiac arrest continues to rise nationally and in our Midwestern community hospital. While still a relatively rare occurrence, the national rise in maternal mortality rates has created a need for population-specific resuscitation education for caregivers of obstetric patients. Educators are challenged with creating engaging, meaningful education that is inexpensive and effective. Educational escape rooms challenge participants to discover clues, solve puzzles, progress through the game and ultimately escape the room. The format offers team problem-solving and experiential learning with immediate feedback in an enjoyable atmosphere. Aim. In order to provide an interprofessional and economical educational intervention for labor and delivery teams, the authors created an escape room focused on principles of effective maternal resuscitation. Method. Participants completed an evaluation tool measuring perceptions of content clarity and confidence, and an author created pre-test and post-test to measure knowledge of cardiopulmonary resuscitation medications and interventions for the obstetric patient. Results and Conclusions. Comparison of aggregated pre- and post-test showed an 11% increase in knowledge scores. All participants self-evaluation showed improved clarity and confidence and described the activity as a fun way to learn and reinforce knowledge.
Assessment of patients’ understanding of and adherence to oral anticancer medication (OAM): Results of a cross-sectional institutional pilot study
Authors: Rodday Angie Mae , Hackenyos Douglas , Masood Raisa , Savidge Nicole , Lin Mingqian , Weidner Ruth Ann , Parsons Susan K 
Published: October 2020

Background Although oral anticancer medications (OAM) provide opportunity for treatment at home, challenges include prescription filling, monitoring side effects, safe handling, and adherence. We assessed understanding of and adherence to OAM in vulnerable patients. Methods This 2018 pilot study defined vulnerable patients based on Chinese language, older age (≥65 years), and subsidized insurance. All participants had a cancer diagnosis and were taking an OAM filled through the hospital’s specialty pharmacy. Participants reported on OAM taking (days per week, times per day, special instructions) and handling (handling, storage, disposal). The specialty pharmacist classified patient-reported responses about OAM taking and handling as adequate or inadequate. OAM regimens were classified by complexity. Results Of 61 eligible patients, 55 participated. Mean age was 68 years (standard deviation [SD] = 12) and 53% were female. Patient subgroups were: 27% Chinese, 64% ≥65 years, and 9% subsidized insurance. Forty-nine percent were on frontline therapy and median time on OAM was 1 year (Quartile 1 = 0.4, Quartile 3 = 1.7). Adequacy of OAM taking (30%) and handling (15%) were low; 15% had adequacy in both. Adequacy of OAM taking and handling did not vary by patient subgroup or regimen complexity. Mean patient-reported adherence was high (5.4, SD = 1, possible range 1–6) and did not vary by adequacy of OAM taking or handling. Conclusions Understanding of OAM taking and handling in this group of vulnerable patients was low and did not align with patient-reported adherence. Future interventions should ensure that patients understand how to safely take and handle OAM, thereby optimizing their therapeutic potential.
Assessment of Canadian patient education material for oncology pharmaceutics
Authors: van Ballegooie Courtney 
Published: October 2020

Introduction Health literacy is an individual’s ability to access, understand, and utilize information in order to create an informed decision regarding their health. Readability plays an integral role in health literacy as complex health information may be inaccessible to those with low health literacy. The aim of this study is to determine the readability of Canadian patient education material (PEM) for oncology related pharmaceutics. Methods Eighty PEMs from Cancer Care Ontario (CCO) and BC Cancer (BCC) were evaluated for their reading level using a Ford, Caylor, Sticht (FORCAST) analysis. Twenty therapies were then randomly selected and converted to plain text to be analyzed further using the Flesch-Kincaid Grade Level (FKGL), the Simple Measure of Gobbledygook (SMOG) Index, the Coleman-Liau Index (CLI), and the Gunning Fog Index (GFI). Results Both PEMs from CCO and BCC were above the recommended reading level with PEMs from CCO, on average, requiring a higher reading level. Within the text, the section which describes side effects was found to be the most complex section of the representative PEMs from BCC. PEMs from BCC which described antibody-based therapies were, on average, more difficult to read than small molecule-based therapies regardless from which section the PEM was being analyzed. These observations were not seen in CCO PEMs. Conclusions Overall, online PEMs from major Canadian cancers associations were written above the recommended reading level. Consideration should be given to revision of these materials, with emphasis on the therapies’ side effects, to allow for greater comprehension amongst a wider target audience.
Alternative graphical displays for the monitoring of epidemic outbreaks, with application to COVID-19 mortality
Authors: Perneger Thomas , Kevorkian Antoine , Grenet Thierry , Gallée Hubert , Gayet-Ageron Angèle 
Published: October 2020

Abstract
Background
Classic epidemic curves – counts of daily events or cumulative events over time –emphasise temporal changes in the growth or size of epidemic outbreaks. Like any graph, these curves have limitations: they are impractical for comparisons of large and small outbreaks or of asynchronous outbreaks, and they do not display the relative growth rate of the epidemic. Our aim was to propose two additional graphical displays for the monitoring of epidemic outbreaks that overcome these limitations.

Methods
The first graph shows the growth of the epidemic as a function of its size; specifically, the logarithm of new cases on a given day, N(t), is plotted against the logarithm of cumulative cases C(t). Logarithm transformations facilitate comparisons of outbreaks of different sizes, and the lack of a time scale overcomes the need to establish a starting time for each outbreak. Notably, on this graph, exponential growth corresponds to a straight line with a slope equal to one. The second graph represents the logarithm of the relative rate of growth of the epidemic over time; specifically, log10(N(t)/C(t-1)) is plotted against time (t) since the 25th event. We applied these methods to daily death counts attributed to COVID-19 in selected countries, reported up to June 5, 2020.

Results
In most countries, the log(N) over log(C) plots showed initially a near-linear increase in COVID-19 deaths, followed by a sharp downturn. They enabled comparisons of small and large outbreaks (e.g., Switzerland vs UK), and identified outbreaks that were still growing at near-exponential rates (e.g., Brazil or India). The plots of log10(N(t)/C(t-1)) over time showed a near-linear decrease (on a log scale) of the relative growth rate of most COVID-19 epidemics, and identified countries in which this decrease failed to set in in the early weeks (e.g., USA) or abated late in the outbreak (e.g., Portugal or Russia).

Conclusions
The plot of log(N) over log(C) displays simultaneously the growth and size of an epidemic, and allows easy identification of exponential growth. The plot of the logarithm of the relative growth rate over time highlights an essential parameter of epidemic outbreaks.
Knowledge, skills and attitudes of older people and staff about getting up from the floor following a fall: a qualitative investigation
Authors: Swancutt Dawn R. , Hope Suzy V. , Kent Benjamin P. , Robinson Maria , Goodwin Victoria A. 
Published: October 2020

Abstract
Background
Falls are the most common reason for ambulance callouts resulting in non-conveyance. Even in the absence of injury, only half of those who fall can get themselves up off the floor, often remaining there over an hour, increasing risk of complications.
There are recognized techniques for older people to learn how to get up after a fall, but these are rarely taught. The aim of this study was to develop an understanding of attitudes of older people, carers and health professionals on getting up following a fall.

Methods
A qualitative focus group and semi-structured interviews were conducted with 28 participants, including community-dwelling older people with experience of a non-injurious fall, carers, physiotherapists, occupational therapists, paramedics and first responders. Data were transcribed and analysed systematically using the Framework approach. A stakeholder group of falls experts and service users advised during analysis.

Results
The data highlighted three areas contributing to an individual’s capability to get-up following a fall: the environment (physical and social); physical ability; and degree of self-efficacy (attitude and beliefs about their own ability). These factors fell within the wider context of making a decision about needing help, which included what training and knowledge each person already had to manage their fall response.
Staff described how they balance their responsibilities, prioritising the individual’s immediate needs; this leaves limited time to address capability in the aforementioned three areas. Paramedics, routinely responding to falls, only receive training on getting-up techniques from within their peer-group. Therapists are aware of the skillset to breakdown the getting-up process, but, with limited time, select who to teach these techniques to.

Conclusion
Neither therapists nor ambulance service staff routinely teach strategies on how to get up, meaning that healthcare professionals largely have a reactive role in managing falls. Interventions that address the environment, physical ability and self-efficacy could positively impact on peoples’ capability to get up following a fall. Therefore, a more proactive approach would be to teach people techniques to manage these aspects of future falls and to provide them easily accessible information.
Frailty and healthcare utilisation across care settings among community-dwelling older adults in Singapore
Authors: Ge Lixia , Yap Chun Wei , Heng Bee Hoon , Tan Woan Shin 
Published: October 2020

AbstractBackgroundFrailty is frequently found to be associated with increased healthcare utilisation in western countries, but little is known in Asian population. This study was conducted to investigate the association between frailty and healthcare utilisation in different care settings among community-dwelling older adults in Singapore.MethodsData from a population health survey among community-dwelling adults were linked with an administrative database to retrieve data of healthcare utilisation (including government primary care clinic visits, specialised outpatient clinic visits, emergency department visits, day surgery and hospitalisations) occurred during a six-month look-back period and six-month post-baseline respectively. Baseline frailty status was measured using the five-item FRAIL scale, which was categorised into three groups: robust (0), pre-frail (1–2), and frail (3–5). Negative binomial regression was applied to examine the association between frailty with respective healthcare utilisation (dependent variables), controlling for other confounding variables.ResultsIn our sample of 701 older adults, 64.8% were of robust health, 27.7% were pre-frail, and 7.6% were frail. Compared to the robust group, frail individuals had a higher rate of specialised outpatient clinic visits (incidence rate ratio (IRR): 2.8, 95% confidence interval (CI): 1.2–6.5), emergency department visits (IRR: 3.1, 95%CI: 1.1–8.1), day surgery attendances (IRR: 6.4, 95%CI: 1.3–30.9), and hospitalisations (IRR: 6.7, 95%CI: 2.1–21.1) in the six-month period prior to the baseline and in subsequent 6 months (IRR: 3.3, 95%CI: 1.6–7.1; 6.4, 2.4–17.2; 5.8, 1.3–25.8; 13.1, 4.9–35.0; respectively), controlling for covariates.ConclusionsFrailty was positively associated with the number of specialised outpatient clinic visits, emergency department visits, day surgeries and hospitalisations occurred during 6 months prior to and after the baseline. As frailty is a potentially reversible health state with early screening and intervention, providing preventive activities that delay the onset or progression of frailty should have potential effect on delaying secondary and tertiary care utilisation.