bluuebunny/crossref_metadata_2025_split huggingface dataset:
The relationship among plasma copeptin, carboxyhemoglobin, and lactate levels in carbon monoxide poisoning
Authors: Ozkan S , Salt O , Durukan P , Sen A , Bulbul E , Duman A , Kavalci C 
Published: November 2019

Objective: The aim of our study is to determine whether there is a change in the plasma levels of copeptin and there is a relationship among the plasma levels of carboxyhemoglobin (COHb), lactate, and copeptin levels in patients presenting to the emergency department with carbon monoxide (CO) poisoning. Methods: Fifty-seven patients admitted to the emergency department with CO poisoning were included in the study. The blood samples of the patients were collected on arrival 0th, 6th, and 12th hours for copeptin, lactate, and COHb levels. Data were analyzed using SPSS-17 statistical software. Results: Arrival serum copeptin levels of the patients were compared to copeptin levels of healthy individuals and a statistically significant difference was found between them ( p = 0.008). There was a statistically significant difference between the arrival levels of copeptin and 6th-hour ( p = 0.006) and 12th-hour ( p = 0.001) levels of copeptin. There was no significant difference between 6th-hour and 12th-hour copeptin levels ( p = 0.51). In terms of serum lactate levels, there was a significant difference between arrival and 6th h ( p < 0.001), arrival and 12th h ( p < 0.001), and 6th and 12th h ( p < 0.001). Likewise, in terms of serum COHb levels, there was a significant difference between arrival and 6th h ( p < 0.001), arrival and 12th h ( p < 0.001), and 6th and 12th h ( p < 0.001). There was a positive correlation between COHb and lactate levels on arrival ( r = 0.52; p = 0.001). Conclusion: Copeptin as a stress hormone can be used in the diagnosis and monitoring of patients with CO poisoning. However, the copeptin level was not superior to COHb and lactate levels.
Whether States Have Capacity to Sustain Projected Growth in GST Collection During the GST Compensation Period?
Authors: Mukherjee Sacchidananda 
Published: November 2019

Achieving harmonisation in design, structure and administration of taxes on goods and services was the major driving force behind the introduction of goods and services tax (GST) in India. Goods and services tax subsumes many taxes from both union and state tax bases. Achieving tax harmonisation in a federal system curtails fiscal autonomy of both the union and sub-national governments and therefore faces steep resistance. Revenue uncertainty associated with any tax reform is a major cause for concern for all governments and therefore the assurance of revenue protection given by the union government to states helped to achieve broad consensus in favour of GST. On average, state taxes subsumed under the GST used to contribute two-third of own tax revenue and finance one-third of total expenditure for general category states. Unlike the union government, states have limited taxation power (tax handles) to generate additional revenue to cope up with any major revenue shortfall on account of GST collection. Therefore, the revenue protection enshrined under the GST Compensation Act has played an important role behind introduction of GST in India. This has also helped the GST Council to experiment with design, structure and administration of GST during the GST compensation period (first 5 years of GST implementation) to moderate the impact of GST on Indian economy as well as facilitate ease of tax compliance. Given the ongoing shortfall in GST collection, many scholars believe that liberal GST revenue protection granted under the GST Compensation Act to states is unjustifiable. The GST compensation period will be over by June 2022, and thereafter GST collection of individual states is expected to depend on their tax capacity as well as tax effort. It is worthy to investigate whether states have tax capacity to sustain 14 per cent growth rate in tax collection, as projected in the GST Compensation Act. The objective of this article is to estimate tax capacity of the states with reference to major tax revenue subsumed under GST and see whether states could sustain 14 per cent growth in their GST collection during the GST compensation period if they put adequate tax effort. JEL Classification: H21, H68, H71, H77
Cross-Cultural Learning in Gameplay: BAFÁ BAFÁ, Persuasive Technology, and the Exploration of Intercultural Sensitivity
Authors: Wendorf Muhamad Jessica , Yang Fan 
Published: November 2019

Background. Serious games have the potential to provide benefits that beyonds entertainment value. Recent growth in the empirical research of serious games shows their abilities to deliver prosocial messages. Aim. This study aims to examine the use of games in the management of cultural schemas as well as moderating intercultural sensitivity and intercultural communication competence. Moreover, this study explores how and why simulation games, such as BAFÁ BAFÁ, function as persuasive technologies (PTs) effectively motivating individuals into behavior change. Method. An experimental study with three conditions (game, reading, and control) was conducted to examine the effects of BAFÁ BAFÁ on enhancing participants’ intercultural sensitivity as well as communication competence compared to reading intercultural materials or regular activity. Results. Both intercultural sensitivity and communication competence were measured with multi-dimensional scales, and the results of the multi-variate analyses indicated that the intercultural simulation game BAFÁ BAFÁ can facilitate the increase of participants’ intercultural sensitivity and communication competence.
Assessment of treatment outcomes in hyperthyroid cats treated with an orally administered fixed dose of radioiodine
Authors: Yu Lucia , Lacorcia Lauren , Finch Sue , Johnstone Thurid 
Published: November 2019

Objectives The aims of this study were to describe the treatment outcomes following oral administration of a fixed dose (138 MBq; 3.7 mCi) of radioiodine in hyperthyroid cats and to examine the correlation between total thyroxine (TT4) concentrations before and after treatment. Methods This was a retrospective cohort study that documented the TT4 concentration and clinicopathological parameters at the time of diagnosis and after treatment. Logistic regression was used to assess the relationship between TT4 concentrations before and after treatment. The difference in pre- and post-treatment variables between cats that had TT4 concentrations below or within the reference interval (RI) was compared by the Mann–Whitney U-test. Results Of 161 cats, 133 (82.6%) cats had TT4 concentrations within the RI, four (2.5%) cats had TT4 concentrations above the RI and 24 (14.9%) cats had TT4 concentrations below the RI after treatment. The severity of hyperthyroidism at diagnosis, as measured by the percentage of TT4 elevation above the upper limit of the RI, had no impact on the odds of cats having low TT4 concentrations after treatment (odds ratio 1.00; 95% confidence interval 0.96–1.05; P = 0.828). Conclusions and relevance When using an orally administered fixed dose of radioiodine for the treatment of feline hyperthyroidism, TT4 concentrations at diagnosis cannot be used to predict TT4 concentrations after treatment. The proportion of cats with TT4 concentrations below the lower limit of the RI after treatment was 14.9%. Further work is required to optimise oral radioiodine dosing to achieve maximal euthyroid outcomes.
Diroximel fumarate (DRF) in patients with relapsing–remitting multiple sclerosis: Interim safety and efficacy results from the phase 3 EVOLVE-MS-1 study
Authors: Naismith Robert T , Wolinsky Jerry S , Wundes Annette , LaGanke Christopher , Arnold Douglas L , Obradovic Dragana , Freedman Mark S , Gudesblatt Mark , Ziemssen Tjalf , Kandinov Boris , Bidollari Ilda , Lopez-Bresnahan Maria , Nangia Narinder , Rezendes David , Yang Lili , Chen Hailu , Liu Shifang , Hanna Jerome , Miller Catherine , Leigh-Pemberton Richard 
Published: November 2019

Background: Diroximel fumarate (DRF) is a novel oral fumarate for patients with relapsing–remitting multiple sclerosis (RRMS). DRF and the approved drug dimethyl fumarate yield bioequivalent exposure to the active metabolite monomethyl fumarate; thus, efficacy/safety profiles are expected to be similar. However, DRF’s distinct chemical structure may result in a differentiated gastrointestinal (GI) tolerability profile. Objective: To report interim safety/efficacy findings from patients in the ongoing EVOLVE-MS-1 study. Methods: EVOLVE-MS-1 is an ongoing, open-label, 96-week, phase 3 study assessing DRF safety, tolerability, and efficacy in RRMS patients. Primary endpoint is safety and tolerability; efficacy endpoints are exploratory. Results: As of March 2018, 696 patients were enrolled; median exposure was 59.9 (range: 0.1–98.9) weeks. Adverse events (AEs) occurred in 84.6% (589/696) of patients; the majority were mild (31.2%; 217/696) or moderate (46.8%; 326/696) in severity. Overall treatment discontinuation was 14.9%; 6.3% due to AEs and <1% due to GI AEs. At Week 48, mean number of gadolinium-enhancing lesions was significantly reduced from baseline (77%; p < 0.0001) and adjusted annualized relapse rate was low (0.16; 95% confidence interval: 0.13–0.20). Conclusion: Interim data from EVOLVE-MS-1 suggest DRF is a well-tolerated treatment with a favorable safety/efficacy profile for patients with RRMS.
Reduced neurite density in the brain and cervical spinal cord in relapsing–remitting multiple sclerosis: A NODDI study
Authors: Collorone Sara , Cawley Niamh , Grussu Francesco , Prados Ferran , Tona Francesca , Calvi Alberto , Kanber Baris , Schneider Torben , Kipp Lucas , Zhang Hui , Alexander Daniel C , Thompson Alan J , Toosy Ahmed , Wheeler-Kingshott Claudia AM Gandini , Ciccarelli Olga 
Published: November 2019

Background: Multiple sclerosis (MS) affects both brain and spinal cord. However, studies of the neuraxis with advanced magnetic resonance imaging (MRI) are rare because of long acquisition times. We investigated neurodegeneration in MS brain and cervical spinal cord using neurite orientation dispersion and density imaging (NODDI). Objective: The aim of this study was to investigate possible alterations, and their clinical relevance, in neurite morphology along the brain and cervical spinal cord of relapsing–remitting MS (RRMS) patients. Methods: In total, 28 RRMS patients and 20 healthy controls (HCs) underwent brain and spinal cord NODDI at 3T. Physical and cognitive disability was assessed. Individual maps of orientation dispersion index (ODI) and neurite density index (NDI) in brain and spinal cord were obtained. We examined differences in NODDI measures between groups and the relationships between NODDI metrics and clinical scores using linear regression models adjusted for age, sex and brain tissue volumes or cord cross-sectional area (CSA). Results: Patients showed lower NDI in the brain normal-appearing white matter (WM) and spinal cord WM than HCs. In patients, a lower NDI in the spinal cord WM was associated with higher disability. Conclusion: Reduced neurite density occurs in the neuraxis but, especially when affecting the spinal cord, it may represent a mechanism of disability in MS.
Exploring nursing and allied health perspectives of quality oral care after stroke: A qualitative study
Authors: Ferguson Caleb , George Ajesh , Villarosa Amy R , Kong Ariana C , Bhole Sameer , Ajwani Shilpi 
Published: November 2019

Background: Maintaining good oral health remains a challenge among those hospitalised after stroke. Stroke nurses and allied health clinicians have a potential role in providing oral care, but no studies in Australia to date have explored their perceptions and needs. Aims: To explore the perspectives of nursing and allied health stroke clinicians regarding oral care for stroke patients across acute care and stroke rehabilitation settings. Methods: This study followed an exploratory qualitative design, using a constructivist approach. Participants from two metropolitan public hospitals were purposively recruited to participate in focus groups. Data was thematically analysed. Results: Twenty-one clinicians participated. Clinicians’ knowledge and practices relating to oral healthcare for stroke patients were inadequate. Most staff felt they did not have adequate knowledge, resources and training to administer oral care in this setting and proposed enhancing education of stroke clinicians, patients and informal caregivers, as well as improving quality point of care resources. There was overall support for the integrated dental care after stroke model of care. Discussion: This study revealed many gaps in current care and highlighted areas for improvement. Patients and their caregivers needed to be actively engaged as partners to improve oral healthcare within acute and rehabilitation stroke settings. Conclusion: This study provided insight into nurses’ and allied health stroke clinicians’ current knowledge and practices of oral care in various stroke settings. The findings from this study will inform development of a model of care to train stroke nurses in providing oral care.
Lifelong Learning for Equity and Social Cohesion: A New Challenge for Higher Education
Authors: Halimi Suzy , Hristoskova Stefanka 
Published: November 2019

The Council of Europe's project on lifelong learning has addressed a range of issues that it had identified priorities for lifelong learning at a number of inter-governmental meetings during the 1990s. The project was based on the generation of a number of case studies, expert report and national papers from across Europe, these were considered at three workshops held in 1999 and 2000, which focused on the following themes: • Meeting the needs of all students in a changing society; • Application of information and communication technologies in lifelong learning; • Structures and qualifications in lifelong learning. This paper gives an overview of some of the main outcomes of this work and the implications of the findings of the project for governments and institutions, particularly Higher Education Institutions in Europe.
A Critical Review of the U.S. Literature on Race and Adult Education – Implications for Widening Access
Authors: Johnson-Bailey Juanita , Cervero Ronald M. 
Published: November 2019

A commonly stated goal for adult education is its aspiration to create equality of opportunity but often the opposite occurs. The historical treatment of race within adult education in the U.S and Canada serves as an illustration of how leaders within the field have defined what matters and furthermore of their understanding of key issues. The paper argues that to discuss race in adult education, we must recognize the absence of the concept of whiteness. Adult education literature is considered from this position and in particular the paper examines how race has been treated historically in adult education using three perspectives on race that inform contemporary action in adult education. Specific suggestions for widening access for adults in higher education are made. It is argued that rather than ‘a no-barrier thinking’, we need ‘barrier-thinking’ so that we may construct a future where race does not matter. A three-part strategy based on an examination of the hidden curriculum, negotiation for a new educational structure and actively resisting from within an enfranchised position of comfort is set forth for consideration.
Informal Learning: A Neglected Species
Authors: McGivney Veronica 
Published: November 2019

If we want to encourage wider participation in organised learning and promote a culture of lifelong learning then learning should be conceptualised in a broader, more inclusive and less linear way. Despite an ostensible policy interest in informal learning it is largely ignored and the signs are that it will not be given any priority by the English Learning and Skills Councils. This may be because the existence of a hierarchy of what is valued as learning and because informal learning is so disparate and widespread, it is difficult to track what is taking place. As a result it is difficult to assess the outcomes in ways that would be acceptable to policy-makers and funding bodies. To bring about a culture of lifelong learning the assumption that people who do not engage in formal learning are deficient in learning and skills should be challenged. There should be recognition that many who do not engage in formal learning have gained a wealth of knowledge and experience from their informal learning. This means that we must abandon the term ‘non-learner’.
Inhalation with intravenous loading dose of colistin in critically ill patients with pneumonia caused by carbapenem-resistant gram-negative bacteria
Authors: Choe Junsu , Sohn You Min , Jeong Suk Hyeon , Park Hyo Jung , Na Soo Jin , Huh Kyungmin , Suh Gee Young , Jeon Kyeongman 
Published: November 2019

Background: Despite the increasing use of colistin in clinical practice, the optimal dosing, and administration route have not been established. This study aimed to evaluate the clinical outcome and safety of intravenous (IV) colistin with a loading dose (LD) and adjunctive aerosolized (AS) colistin administration in critically ill patients with hospital-acquired pneumonia (HAP) or ventilator-associated pneumonia (VAP) caused by carbapenem-resistant gram-negative bacteria (CRGNB). Methods: We retrospectively reviewed 191 critically ill patients who received colistin for the treatment of HAP or VAP caused by CRGNB. Patients were divided into three groups: non-LD IV (patients received only IV colistin without LD), LD IV (patients received only IV colistin with LD), and AS–LD (patients received IV colistin with LD and adjunctive AS colistin). Results: There was no difference in clinical response between the three groups. However, the rate of microbiological eradication was significantly higher in the AS–LD group (60%) than in the non-LD IV (31%), and LD IV (33%) groups ( p = 0.010). Patients treated with adjunctive AS colistin in combination with LD IV had significantly lower 30-day mortality rates than patients treated with IV colistin alone ( p = 0.027). After adjusting for potential confounding factors, adjunctive AS colistin was still significantly associated with lower mortality (adjusted OR 0.338, CI 95% 0.132–0.864, p = 0.024). However, nephrotoxicity did not change according to the use of LD regimen and AS colistin administration ( p = 0.100). Conclusions: Adjunctive AS colistin in combination with IV colistin with LD was related to an improved 30-day mortality and microbiological outcome without an increase in nephrotoxicity in critically ill patients with HAP and VAP caused by CRGNB. The reviews of this paper are available via the supplemental material section.
In Silico Analysis of an Exercise-Safe Artificial Pancreas With Multistage Model Predictive Control and Insulin Safety System
Authors: Garcia-Tirado Jose , Colmegna Patricio , Corbett John P. , Ozaslan Basak , Breton Marc D. 
Published: November 2019

Background: Maintaining glycemic equilibrium can be challenging for people living with type 1 diabetes (T1D) as many factors (eg, length, type, duration, insulin on board, stress, and training) will impact the metabolic changes triggered by physical activity potentially leading to both hypoglycemia and hyperglycemia. Therefore, and despite the noted health benefits, many individuals with T1D do not exercise as much as their healthy peers. While technology advances have improved glucose control during and immediately after exercise, it remains one of the key limitations of artificial pancreas (AP) systems, largely because stopping insulin at the onset of exercise may not be enough to prevent impending, exercise-induced hypoglycemia. Methods: A hybrid AP algorithm with subject-specific exercise behavior recognition and anticipatory action is designed to prevent hypoglycemic events during and after moderate-intensity exercise. Our approach relies on a number of key innovations, namely, an activity informed premeal bolus calculator, personalized exercise pattern recognition, and a multistage model predictive control (MS-MPC) strategy that can transition between reactive and anticipatory modes. This AP design was evaluated on 100 in silico subjects from the most up-to-date FDA-accepted UVA/Padova metabolic simulator, emulating an outpatient clinical trial setting. Results with a baseline controller, a regular MPC (rMPC), are also included for comparison purposes. Results: In silico experiments reveal that the proposed MS-MPC strategy markedly reduces the number of exercise-related hypoglycemic events (8 vs 68). Conclusion: An anticipatory mode for insulin administration of a monohormonal AP controller reduces the occurrence of hypoglycemia during moderate-intensity exercise.
Mobile Health (mHealth) apps focused on menopause: Are they any good?
Authors: Gkrozou F , Tsonis O , Godden M , Siafaka V , Paschopoulos M 
Published: November 2019

Objective Nowadays, smartphones are becoming an indispensable tool due to the popular use of useful applications (apps) that can be downloaded and installed to aid our everyday lives. The quantity of apps manifested as tools for mobile health (mHealth) is undoubtedly high. The mHealth apps are very popular and cover various and different aspects of health. The first app for women in menopause was presented in 2014. Since then, more apps have been developed. The aim of this study is to identify mHealth apps that address the menopause with a focused view on the degree of medical professional involvement and documented evidence base practice in their design, as well as, underline their potential role in raising awareness regarding health in the community. Methods The official app stores by Google, Apple, Windows and Blackberry were chosen to pool the apps. The keywords used were ‘apps for menopause’, ‘women in menopause’ and ‘menopause’. Eligible apps were selected based on the target consumer, each app’s price, documentation of evidence base practice and documentation of medical professional involvement. Results This search revealed 35 relevant apps, of which 10 were excluded as they were identified as duplicates available for download by more than one app store. Authors excluded also further three mHealth apps, since they were not written in English, and the assessment was difficult due to the language barrier. A total of 22 mHealth menopause apps were included in this study. Medical professional involvement was noted in 27.3% of the mHealth menopause apps, and 22.7% of the total apps used evidence-based information. The mHealth menopause apps were free of charge in 86.4%. Ninety-one percent of the apps were designed for the consumers, while only 9% of them were suitable for medical professionals. Conclusions In conclusion, there is a need to improve the mHealth apps available for menopause, by including more medical staff in their development and by establishing clear regulation around the development and the context of an mHealth app.