bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effectiveness of routine physiotherapy with and without neuromobilization in patients with shoulder impingement syndrome
Authors: Muhammad Akhtar Hunjra  , Hossein Karimi  , Syed Amir Gilani  , Ashfaq Ahmad  , Asim Raza  
Published: October 2020

Abstract
Objective: The purpose of this study was to evaluate the neuromobilization (NM) on the pain and active forward flexion of participants with shoulder impingement syndrome (SIS).
Methods: A randomized control trial was conducted in Social Security Hospital, Gujranwala. The duration of study was September 2016 to March 2018. A sample of 80 participants was selected and allocated in to two groups using computer generator method in simple random sampling technique.
Consent was taken from patients with SIS for this trial. At the first session, participants were randomly assigned to either control group (40) or experimental group (40). After the baseline assessment routine physiotherapy was executed for both groups, while NM was provided to experimental group. Pain and active forward flexion (AFF) were evaluated on baseline, 5th week and 11th week. The data were entered and analyzed using SPSS (version 22.0).
Results: The experimental group compared with control group at 11th week had lower mean pain score 2.15(1.66-2.64) vs 4.90(4.41-5.40); between group difference, 1.82; 95% confidence interval (CI), -2.38 to -1.25; P ? 0.001 and Partial ?2=0.33, similarly with AFF 147.13(142.46-151.79) vs 123.45(118.79-128.11); between group difference ,19.35; 95% CI,(12.86-25.83); P ? 0.001 and Partial ?2=0.30. Over all pain and AFF were improved among experimental group relative to control group at 11th week.
Conclusion: In an experimental setting, the delivery of neuromobilization led to significantly different outcomes in participants than in control group.
Clinical Trial Number: IRCT20190121042445N1.
Keywords: shoulder impingement syndrome, pain, rotator cuff.
Continuous...
PERSEPSI HARGA, KUALITAS PRODUK DAN KETERSEDIAAN KERUPUK AMPLANG TERHADAP LOYALITAS KONSUMEN DI KABUPATEN SAMBAS
Authors: Dian Sari  
Published: October 2020

Ketika konsumen membeli kerupuk amplang, hal awal yang sering diperhatikan calon konsumen adalah harga, kemudian produk yang akan dibeli, kualitas serta ketersediaannya. Kepuasan pasca pembelian akan mendorong konsumen membeli dan mengkonsumsi ulang produk tersebut atau loyal. Sehingga penelitian ini bertujuan untuk mengetahui persepsi harga, kualitas dan ketersediaan produk kerupuk amplang terhadap loyalitas konsumen di Kabupaten Sambas. Lokasi penelitian dilakukan secara sengaja (purposive) dengan beberapa pertimbangan, dimana amplang di kabupaten Sambas termasuk produk yang baru dipasarkan sehingga perlu dilakukan studi mengenai persepsi harga, kualitas produk dan ketersediaan kerupuk amplang terhadap kepuasan konsumen. Jenis penelitian yang dilakukan adalah penelitian deskriptif. Metode pengambilan sampel dilakukan dengan menggunakan metode accidental sampling Dengan jumlah sampel sebanyak 100 orang. Teknik Analisis data menggunakan menggunakan Uji Validitas, Uji Reliabilitas dan analisis Regrasi berganda. Dari hasil penelitian ini diketahui Secara keseluruhan atribut meliputi harga, kualitas dan ketersediaan kerupuk amplang mempunyai pengaruh yang signifikan terhadap loyalitas konsumen.
ANALISIS PENGARUH KUALITAS PELAYANAN TERHADAP KEPUASAN PASIEN RAWAT INAP DI RUMAH SAKIT (Studi di Rumah Sakit Panti Nirmala dan Rumah Sakit Militer di Malang)
Authors: ANSYORI ANIS 
Published: October 2020

Rumah Sakit Panti Nirmala merupakan salah satu Rumah Sakit Swasta di Malang, adalah Rumah Sakit yang sudah terakreditasi , melayani semua lapisan masyarakat yang memerlukan jasa pelayanan Rumah Sakit. Sedangkan Rumah Sakit Militer merupakan satu-satunya rumah sakit militer di Malang sudah terakreditasi , adalah Rumah Sakit, disamping melayani Militer juga melayani masyarakat umum.
Terdapat banyak kesamaan karakteristik maupun kinerja dari kedua rumah sakit diatas, sehingga ingin diketahui apakah ada perbedaan kepuasan yang diperoleh oleh pelanggan diantara kedua rumah sakit tersebut dengan tolok ukur kualitas pelayanan yang diberikan.
Tujuan penelitian ini adalah untuk mengetahui pengaruh faktor-faktor kualitas pelayanan (dimensi keandalan, daya tangkap, kepastian, empati, bukti fisik) terhadap kepuasan pasien rawat inap di Rumah Sakit Panti Nirmala Malang dan Rumah Sakit Militer di Malang. Dan faktor yang paling besar pengaruhnya terhadap kepuasan pasien rawat inap di kedua rumah sakit tersebut serta perbandingan Dimensi Mutu kedua Rumah Sakit.

Penelitian ini menggunakan metode cross sectional. Data dikumpulkan melalui penyebaran kuesioner kepada pasien rawat inap di kedua rumah sakit. Sebelum kuesioner disebar,dilakukan uji coba kepada 30 orang pasien untuk mengetahui validitas dan reliabilitas dari kuesioner. 200 orang pasien dari kedua rumah sakit dilibatkan dalam penelitian ini. Data yang diperoleh kemudian dianalisis dengan teknis statistik regresi dan uji t-test.

Hasil penelitian menunjukkan bahwa terdapat pengaruh dari kualitas pelayanan terhadap kepuasan pasien di kedua rumah sakit. Namun tingkat kepuasan yang terbentuk ternyata tidak seluruhnya dibentuk dari kelima aspek atau atribut dari dimensi mutu. Untuk RS Panti Nirmala, kepuasan pasien terutama didapat dari kontribusi aspek reliability dan empathy. Sedangkan bagi RS Militer, kepuasan pasien didapat dari kontribusi aspek tangible, empathy dan responsibility. Selain itu, terdapat kemiripan karakterestik diantara pasien rawat inap dikedua Rumah Sakit. Kemiripan tersebut dalam hal karakteristik umur, tingkat pendidikan, dan pekerjaan. Kemiripan karakterestik responden ini berdampak kepada kemiripan persepsi dari responden tersebut dalam menilai pelayanan Rawat inap dari kedua Rumah Sakit, hal ini dapat dilihat dari kesamaan persepsi terhadap variabel tangible, reliability, assurance, emphaty dan responsibility. Kecuali aspek responsibility kedua Rumah Sakit memiliki penilaian yang sama dari responden terhadap aspek Tangible, Reliability, Assurance, dan Emphaty
Clinical comparative analysis of monophasic and multiphasic acute disseminated encephalomyelitis in adults
Authors: Zang Wei-Zhou , Yang Hong , Li Dan , Zhao Zheng-Da , Sun Ya-Jing , Xia Ming-Rong , Jiang Shan , Zhang Jie-Wen 
Published: October 2020

IntroductionThis study aims to explore the clinical features and prognostic factors for relapse of acute disseminated encephalomyelitis (ADEM) in adults.Material and methods56 patients with ADEM were retrospectively analyzed. The epidemiological characteristics, clinical manifestations, laboratory features, magnetic resonance imaging (MRI), treatment and prognosis data of these patients were analyzed using the χ2 test for categorical variables and Mann-Whitney U-test for continuous variables. Then, the clinical characteristics and recurrence factors were summarized.Results56 patients with ADEM, based on the criteria of the International Pediatric Multiple Sclerosis Study Group, were recruited to the study. Among these patients, 31 were male and 25 were female. Furthermore, 13 patients had multiphasic ADEM, and 29 patients (52%) had definite incentive factors before onset. The commonest presenting symptoms and signs were fever (36%), disturbance of consciousness (52%), mental disorder (38%), seizure (14%), headache and dizziness (43%), optic neuritis (34%), autonomic nervous system symptoms (43%), limb paralysis or abnormal sensation (73%), and unilateral or bilateral pyramidal tract signs (48%). Inflammatory changes in the cerebrospinal fluid were prominent. MRI T2-weighted and fluid-attenuated inversion recovery images displayed multiple or large flaky high signals, and the lesions were usually different in the number and distribution of these lesions. Intravenous corticosteroids and/or immunoglobulin were still important treatments in the acute phase. After treatment, 38 patients completely recovered, 9 patients had neurologic deficits, and 9 patients died.ConclusionsADEM in adults is not uncommon, its clinical features are complex and varied, and some of these are multiphasic. There may be some potential clinical predictors at first onset.
Over autonome auto’s, een bestuurderloze toekomst en nieuwe risico’s
Authors: Vellinga N.E. 
Published: October 2020

Over autonome auto’s, een bestuurderloze toekomst en nieuwe risico’s
De komst van volledig zelfrijdende of autonome auto’s doet vele juridische vragen rijzen doordat zelfrijdende auto’s geen bestuurder hebben. Deze vragen rijzen onder meer ten aanzien van de toepassing van bepalingen van het RVV 1990 en de WVW 1994 die de bestuurder als normadressaat hebben. Daarnaast komen aspecten van cybersecurity aan bod in dit artikel. Er wordt in deze bijdrage onder meer een voorstel tot wijziging van artikel 6 WVW 1994 gedaan, om zo te voorzien in een bestuurderloze toekomst.
A Theory of Indexical Shift
Authors: Deal Amy Rose 
Published: October 2020

A comprehensive overview of the semantics and syntax of indexical shift that develops a constrained typology of the phenomenon across languages.
The phenomenon of indexical shift—whereby indexicals embedded in speech or attitude reports draw their meaning from an attitude event rather than the utterance context—has been reported in languages spanning five continents and at least ten language families. In this book, Amy Rose Deal offers a comprehensive overview of the semantics and syntax of indexical shift and develops a constrained typology of the phenomenon across languages—a picture of variation that is both rich enough to capture the known facts and restrictive enough to make predictions about currently unknown data points. Deal draws on studies of indexical shift in a broad range of languages, focusing especially on Nez Perce, Zazaki, Korean, and Uyghur.
Using new data from fieldwork, Deal presents an in-depth case study of indexical shift in the Nez Perce language, and uses this evidence to propose a novel theoretical approach based on the meaning and grammar of shifty operators. She explores several dimensions of variation related to indexical shift across and within languages, showing how the cross-linguistic patterns can be explained (and constrained) within the shifty operator view. Finally, she contrasts indexical shift with surface-similar phenomena, clarifying the controls needed to test the constrained typology on new data sets.
Ecological stoichiometry of plant leaves, litter and soils in a secondary forest on China’s Loess Plateau
Authors: Wang Zongfei , Zheng Fenli 
Published: October 2020

Ecological stoichiometry can reveal nutrient cycles in soil and plant ecosystems and their interactions. However, the ecological stoichiometry characteristics of leaf-litter-soil system of dominant grasses, shrubs and trees are still unclear as are their intrinsic relationship during vegetation restoration. This study selected three dominant plant types of grasses (Imperata cylindrica (I. cylindrica) and Artemisiasacrorum (A.sacrorum)), shrubs (Sophora viciifolia (S. viciifolia) and Hippophae rhamnoides (H. rhamnoides)) and trees (Quercus liaotungensis (Q. liaotungensis) and Betula platyphylla (B. platyphylla)) in secondary forest areas of the Chinese Loess Plateau to investigate ecological stoichiometric characteristics and their intrinsic relationships in leaf-litter-soil systems. The results indicated that N concentration and N:P ratios in leaf and litter were highest in shrubland; leaf P concentration in grassland was highest and litter in forestland had the highest P concentration. Soil C, N and P concentrations were highest in forestland (P < 0.05) and declined with soil depth. Based on the theory that leaf N:P ratio indicates nutritional limitation of plant growth, this study concluded that grass and shrub growth was limited by N and P element, respectively, and forest growth was limited by both of N and P elements. The relationships between the N concentration in soil, leaf and litter was not significant (P >0.5), but the soil P concentration was significantly correlated with litter P concentration (P < 0.05). These finding enhance understanding of nutrient limitations in different plant communities during vegetation restoration and provide insights for better management of vegetation restoration.
Heparin-binding protein as a novel biomarker for sepsis-related acute kidney injury
Authors: Pajenda Sahra , Figurek Andreja , Wagner Ludwig , Gerges Daniela , Schmidt Alice , Herkner Harald , Winnicki Wolfgang 
Published: October 2020

BackgroundSepsis-related acute kidney injury (AKI) is associated with high morbidity and mortality among patients. Underlying pathomechanisms include capillary leakage and fluid loss into the interstitial tissue and constant exposure to pathogens results in activation of inflammatory cascades, organ dysfunction and subsequently organ damage.MethodsTo identify novel factors that trigger sepsis-related acute kidney injury, plasma levels of Granzyme A, as representative of a lymphocyte-derived protease, and heparin-binding protein as indicator for neutrophil-derived mediators, were investigated retrospectively in 60 sepsis patients.ResultsWhile no association was found between plasma levels of lymphocyte-derived Granzyme A and the incidence of sepsis-related AKI, sepsis patients with AKI had significantly higher plasma levels of heparin-binding protein compared to those without AKI. This applies both to heparin-binding protein peak values (43.30 ± 23.34 vs. 30.25 ± 15.63 pg/mL;p = 0.005) as well as mean values (27.93 ± 14.39 vs. 22.02 ± 7.65 pg/mL;p = 0.021). Furthermore, a heparin-binding protein cut-off value of 23.89 pg/mL was established for AKI diagnosis.ConclusionThis study identifies the neutrophil-derived heparin-binding protein as a valuable new biomarker for AKI in sepsis. Beyond the diagnostic perspective, this offers prospect for further research on pathogenesis of AKI and novel therapeutic approaches.
Teaching Algebraic Word Problems through Constructivism: The Real Classroom Evidence
Authors: Boadi Augustine , Acquandoh Emmanuel , Adams Alfred Kofi , Kpai Henry , Atteh Evans 
Published: October 2020

Aim: Due to constant effort by educators to find lasting solution to student’s poor performance in classrooms, there is the need to elaborate on the systematic processes that can be adopted and employed in mathematics classroom when teaching algebraic word problems to bring about meaningful learning in improving performance. Therefore, the study gathered data and analyzed it in the end to find out the effect of teaching through constructivism.
Study Design: Action research design was used for the study.
Methodology: The main instrument used for the study was test items (pre-test and post-test). The sample size for the study comprised of forty-six (46) students of which nineteen (19) were female students, and twenty-seven (27) were male students.
Results: In the pre–test (see Table 1), forty- two (42) out of the forty- six (46) students scored marks which are either less than half or half of the 30 marks for the test representing 91.3% of the total number of students as compared to the frequency distribution of the post – test scores (Table 2), where out of the forty six (46) students who took part in the test, thirty-eight (38) of them obtained more than half of the total mark of 30 for the test representing 82.7% of the total students number.
Conclusion: The findings from the results of the study confirmed that the use of constructivist approach of teaching and learning will assist the students to have the opportunity of using their own experience to create their conceptual understanding (ability and capability), which will consequently improve their academic performance. Therefore, it is recommended that regular professional development should be organized for mathematics teachers at all levels to refresh them on practical approaches to teaching mathematics through constructivism.
Targeted Nanotherapeutics for Respiratory Diseases: Cancer, Fibrosis, and Coronavirus
Authors: Majumder Joydeb , Minko Tamara 
Published: October 2020

AbstractSystemic delivery of therapeutics for treatment of lung diseases has several limitations including poor organ distribution of delivered payload with relatively low accumulation of active substances in the lungs and severe adverse side effects. In contrast, nanocarrier based therapeutics provide a broad range of opportunities due to their ability to encapsulate substances with different aqueous solubility, transport distinct types of cargo, target therapeutics specifically to the deceased organ, cell, or cellular organelle limiting adverse side effects and increasing the efficacy of therapy. Moreover, many nanotherapeutics can be delivered by inhalation locally to the lungs avoiding systemic circulation. In addition, nanoscale based delivery systems can be multifunctional, simultaneously carrying out several tasks including diagnostics, treatment and suppression of cellular resistance to the treatment. Nanoscale delivery systems improve the clinical efficacy of conventional therapeutics allowing new approaches for the treatment of respiratory diseases which are difficult to treat or possess intrinsic or acquired resistance to treatment. The present review summarizes recent advances in the development of nanocarrier based therapeutics for local and targeted delivery of drugs, nucleic acids and imaging agents for diagnostics and treatment of various diseases such as cancer, cystic fibrosis, and coronavirus.
Association Between Emergency Medicine Clerkship Diversity Scholarships and Residency Diversity
Authors: Duong David K. , Samuels Elizabeth A. , Boatright Dowin , Wilson Taneisha 
Published: October 2020

AbstractObjectiveTo improve resident diversity, emergency medicine (EM) residencies across the United States have implemented financial scholarships to attract visiting medical students underrepresented in medicine (URiM). The impact of these scholarships on changes in residency racial and ethnic diversity is currently unknown. In this study, we describe characteristics of these visiting elective scholarships for underrepresented students and evaluate changes in residency racial and ethnic diversity after program implementation.MethodsFrom 2018 to 2019, we conducted a cross‐sectional survey of EM residency programs with a visiting clerkship rotation scholarship for medical students URiM. Programs were identified for study inclusion using the Society for Academic Emergency Medicine’s online directory of Visiting Elective Scholarship Programs for Underrepresented Minorities. Program characteristics were analyzed descriptively. Changes in residency racial and ethnic diversity were evaluated using an interrupted time series analysis.ResultsOf 34 programs contacted, 20 responded. While there was some variability in funding sources, scholarship amounts, and application review, most scholarships were similar in implementation practices. Of the 20 program respondents, nine were able to provide complete data on residency race and ethnicity and were included in the time series analysis. After program implementation, the time series analysis showed a significant increase in both underrepresented minority EM residents overall and Black and Latinx EM residents in particular.ConclusionEmergency medicine visiting clerkship scholarship programs for medical students URiM vary in funding type and application review but had similar implementation practices. Residency programs increased their racial and ethnic diversity after program implementation. Future investigations are needed to determine specific factors contributing to the successful implementation of scholarship programs.
Earlier detection of hypochondroplasia: A large single‐center UK case series and systematic review
Authors: Sabir Ataf H. , Sheikh Jameela , Singh Ananya , Morley Elizabeth , Cocca Alessandra , Cheung Moira S. , Irving Melita 
Published: October 2020

AbstractHypochondroplasia (HCH) is a rare autosomal dominant skeletal dysplasia condition caused by FGFR3 mutations leading to disproportionate short stature. Classically HCH presents in toddlers or school‐age children, as limb‐to‐trunk disproportion and is often mild and easily overlooked during infancy. We report experiences from a single‐center UK HCH‐cohort of 31 patients, the rate of antenatal HCH detection in our cohort (13/31, 41.9%) and describe relevant case‐data for this subset of 13 patients. Inclusion criteria were patients with confirmed molecular HCH diagnosis (by age 3 years) and presenting with short long‐bones or large head size on antenatal ultrasound scan. We then conducted a systematic literature review using PUBMED and MEDLINE, analyzing patients with HCH and related antenatal findings. Antenatally suspected (with subsequent molecular confirmation) HCH has been reported 15 times in the literature (2004–2019). Key markers (consistent in both groups) included reduced; femur length, humeral length and increased; biparietal diameter and head circumference. HCH is increasingly detected both antenatally and in infancy, contrary to previous descriptions. This is likely due to greater HCH awareness, improved imaging, and easier molecular testing. Thus, one should consider HCH outside the classical presenting period. Studying the natural history of younger patients with HCH is important with the advent of several targeted FGFR3 therapies currently in trials for Achondroplasia, that may soon be trialed in HCH.
Full‐scale evaluation of critical control points and monitors at a reuse facility
Authors: Walker Troy , Boyle Nathan , Stanford Benjamin D , Owen Christine , Biscardi Paul G. 
Published: October 2020

AbstractThe hazard analysis and critical control point (HACCP) process is being widely adopted as a design, control, and operational methodology to maintain the reliability of delivering water quality that is safe for public health. This study applied the HACCP methodology to identify and assess the reliability of critical control points and critical monitors to manage acute and chronic health risks in potable reuse treatment trains. Specifically, a failure analysis was performed for full‐scale ultrafiltration and reverse osmosis critical control points to determine the reliability of critical monitors and their associated impacts on finished water quality. The results supported the use of ultrafiltration and reverse osmosis membranes as critical control points in potable reuse and identified the sensitivities of both current and emerging critical monitoring parameters, including turbidity, total organic carbon, ultraviolet absorbance at 254 nm, conductivity, fluorescence, calcium, sulfate, sucralose, and pressure decay tests.