bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frank William Westhoff (1863–1938): A Music Education Leader of the Progressive Era
Authors: Hash Phillip M. 
Published: June 2020

The purpose of this study was to examine the life and work of Frank William Westhoff (1863–1938), a leader in music education during the progressive era (circa 1890s–1950s). Research questions focused on his work as a music supervisor, teacher educator, pedagogue, and textbook author. I also explored Westhoff’s contributions to the profession and influence on music education. Westhoff was born in St. Charles County, Missouri, in 1863. He moved to Decatur, Illinois, in 1884, and in 1893 he began supervising music in the city’s public schools. From 1901 to 1935, Westhoff served as music instructor at ISNU, where he taught methods classes, directed ensembles, and supervised music in the local public schools. He died in Normal, Illinois, in 1938. Although Westhoff was not as prominent a figure in music education as those who led the field on a national level during his time, he played an important role in sustaining, perpetuating, and expanding school music on a regional basis throughout much of the progressive era. He was a founding member of Music Supervisors’ National Conference at Keokuk, Iowa, in 1907, and published numerous compositions and didactic materials, including a statewide curriculum that helped standardize music instruction in Illinois.
Carotid artery webs in embolic stroke of undetermined source with large intracranial vessel occlusion
Authors: Labeyrie Marc-Antoine , Serrano Fabiola , Civelli Vittorio , Jourdaine Clément , Reiner Peggy , Saint-Maurice Jean-Pierre , Chabriat Hugues , Houdart Emmanuel 
Published: June 2020

Background Whether carotid artery web can be considered as a potential source of arterial thromboembolism in ischemic stroke remains uncertain. Aims In a large sample of individuals with large intracranial artery occlusion, we compared the prevalence of carotid artery webs between patients with and without embolic stroke of undetermined source. Methods In a single-center study of consecutive patients with anterior circulation ischemic stroke referred for mechanical thrombectomy, the presence of carotid artery web was systematically assessed by two independent readers. Thereafter, its prevalence was compared between patients with and without embolic stroke of undetermined source. Results Among 466 patients of whom 12% were considered to have had an embolic stroke of undetermined source, ipsilateral carotid artery web was detected in 1.9% (confidence interval 95% = 0.7–3.1). Ipsilateral carotid artery web was more frequent in embolic stroke of undetermined source than in the rest of the sample (10.7% (confidence interval 95% = 2.7–18.7] vs. 0.7% (0–1.5), P < 0.001). This difference remains significant after adjustment for sex, age, and vascular risk factor (odds ratio: 12.5 (2.1–72), P = 0.005) or after exclusion of patients with any other bulb wall thickening ( P = 0.025). In contrast, the difference of prevalence of contralateral carotid artery web between the two groups did not reach statistical significance (2.4% vs. 1.9%, P = 0.6). Conclusions Our results suggest that the presence of a carotid artery web might be considered as a potential source of large intracranial artery embolism. Longitudinal studies are needed to assess the exact risk of recurrence associated with these lesions.
Pituitary dysfunction in patients with ANCA associated vasculitis: prevalence, presentation, and outcomes
Authors: Li Chunjia , Zou Yu , Lu Xin , Wang Guochun , Shu Xiaoming 
Published: June 2020

Background: The antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) are rare multisystem autoimmune diseases characterized by inflammatory cell infiltration causing necrosis of small blood vessels. Pituitary involvement in AAV is poorly described. This study aimed to describe the prevalence, clinical characteristics, and outcomes of pituitary involvement in patients with AAV. Methods: A total of 150 patients diagnosed with AAV and hospitalized in the China–Japan Friendship Hospital between 2009 and 2019 were enrolled in this retrospective study. Patients diagnosed with pituitary involvement in AAV were selected for inclusion. Results: Three patients (2%) were identified with pituitary involvement. Two patients had positive ANCA titers, one with proteinase 3 positive and one with myeloperoxidase positive antibodies. Pituitary dysfunction presented as an initial symptom in one patient and developed over the course of the diseases in the other two patients. All three patients had abnormal hormones. Among them, two patients had an enlarged pituitary, shown by magnetic resonance images (MRIs), and one patient had a normal sized pituitary, shown by MRI, but presented with increased linear radioactivity uptake in the pituitary fossa by positron emission tomography-computed tomography. All patients were treated with corticosteroid and immunosuppressive therapy. Both pituitary dysfunction and vasculitis were in remission. Conclusion: Pituitary involvement is uncommon in AAV and it can occur at any point during AAV. The main clinical manifestations are central diabetes insipidus and panhypopituitarism. Immunosuppressive therapy could significantly alleviate clinical symptoms as well as pituitary imaging.
Traumatic rib head subluxation through the intervertebral foramen causing spinal cord contusive injury in a cat
Authors: Lisiewicz Natalie , Green Matthew , Targett Mike , Lowrie Mark 
Published: June 2020

Case summary A 4-year-old cat involved in a road traffic accident presented with paraparesis, which was worse on the right-hand side. Neurolocalisation was to the T3–L3 spinal cord segments. Survey radiographs showed rib fractures but no definitive diagnosis for the paraparesis. CT revealed fracture of the dorsal rim and a T9 rib subluxation through the intervertebral foramen at T8–T9. This caused a contusive spinal injury. Treatment consisted of rest and analgesia. The cat recovered well, with the owner reporting no abnormalities 5 months following the injury. Relevance and novel information Road traffic accidents are a common cause of injury in the cat population, with a significant number having thoracic injuries. These include rib injures such as fractures. This is the first reported case of a traumatic rib subluxation causing a contusive injury in the spinal cord of any species. Previously reported rib subluxations have been seen in humans with spinal deformities. Conservative management in this case was sufficient.
Symmetries in Muscle Torque and Landing Kinematics Are Associated With Maintenance of Sports Participation at 5 to 10 Years After ACL Reconstruction in Young Men
Authors: Hetsroni Iftach , Wiener Yohay , Ben-Sira David , Iacono Antonio Dello , Marom Niv , van Stee Mischa , Ayalon Moshe 
Published: June 2020

Background: Long-term maintenance of sports participation is important for young men undergoing anterior cruciate ligament (ACL) reconstruction. Identifying biomechanical characteristics in patients who achieve this goal can assist in elaborating rehabilitation programs and in identifying successful recovery, but this has rarely been investigated. Purpose: To test the association between maintenance of sports participation at 5 to 10 years after ACL reconstruction and measures of force production and landing biomechanics in men. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 30 men who underwent isolated ACL reconstruction were examined. At 5- to 10-year follow-up, associations were tested between reported outcomes of sports maintenance and objective biomechanical measures. The biomechanical tests included isokinetic knee torque and lower limb kinetics and kinematics during landing tasks. Measurements for each limb were conducted separately, and side-to-side symmetry indices (SI) were calculated. Subgroups included SI greater than +10% (ie, extreme positive), SI lower than –10% (ie, extreme negative), and SI between –10% and +10% (ie, symmetric). Results: At follow-up, concentric knee torque in the operated limb correlated with Tegner and Marx scores ( r = 0.42-0.47; P ≤ .05). Regarding the SI of knee torque, the highest Tegner, Marx, and KOOS (Knee injury and Osteoarthritis Outcome Score) results were associated with symmetry, as opposed to patients with extreme positive or extreme negative SIs ( P < .05). As for landing kinematics, Tegner score negatively correlated with knee range of motion (ROM) in the operated limb ( r = –0.38; P ≤ .05). With regard to SI, hip and knee ROM correlated with Tegner, IKDC, and KOOS scores ( r = 0.41-0.51; P ≤ .05). Specifically, the highest sports participation levels were associated with achieving symmetric hip and knee ROM but also with extreme positive SIs, as opposed to patients with extreme negative SIs ( P < .03), indicating substantially higher ROM in the uninjured limb as compared with the operated limb. Conclusion: At 5 to 10 years after ACL reconstruction, maintenance of sports participation was associated with symmetric side-to-side concentric knee torque and with producing greater attenuation of hip and knee ROM during the drop jump landing in the operated limb. Therefore, eccentric load programs that can improve attenuation-phase kinematics during landing tasks may be valuable in addition to concentric training and may facilitate enhanced long-term outcomes.
Perceived Patient Safety Competence of Baccalaureate Nursing Students: A Descriptive Comparative Study
Authors: Rebeschi Lisa M. 
Published: June 2020

Introduction Patient safety is an issue of utmost concern within health care. An interrelated approach between nursing education and practice is needed. For more than a decade, nursing education programs have responded to calls for curricular reform, integrating strategies to prepare graduates for safe nursing practice. Objectives The purpose of the descriptive study was to examine self-perceived safety competencies among baccalaureate (BSN) nursing students at end of program ( n = 72) using the Health Professional Education in Patient Safety Survey. In addition to the objective of describing self-perceived safety competencies of BSN students, another objective was to investigate any significant differences in self-perceived competencies between traditional 4-year and accelerated 12-month program students. Methods A descriptive comparative design was used with a purposive sample of baccalaureate nursing students from both traditional and accelerated second-degree programs at a comprehensive university in the Northeast. Results Students rated self-confidence with patient safety learned in the clinical environment higher than within the classroom setting. Overall, students reported a high level of self-confidence within each of the seven patient safety dimensions with knowledge gained from the clinical setting higher than knowledge gained from the classroom setting. Paired t-test analyses revealed statistically significant differences ( p < .05) between self-confidence gained in classroom and clinical environments with communicating effectively and managing safety risks. Independent t-test analyses revealed accelerated students reported lower self-confidence than traditional students, with statistically significant differences ( p < .05) in dimensions of culture of safety, working in teams, managing safety risks, and disclosing adverse events/close calls. Conclusion In most patient safety dimensions, students felt confident with their competencies within each of the dimensions of patient safety. Results also revealed that accelerated second-degree students report lower confidence with their knowledge of patient safety gained from classroom and clinical settings. Nursing programs must continue to emphasize a culture of safety within the nursing curriculum.
The influence of labelling on symbolic understanding and dual representation in autism spectrum condition
Authors: Wainwright Bethany R , Allen Melissa L , Cain Kate 
Published: June 2020

Background and aims Children with autism spectrum condition often have specific difficulties understanding that pictorial symbols refer to real-world objects in the environment. We investigated the influence of labelling on the symbolic understanding and dual representation of children with autism spectrum condition. Methods Children with autism spectrum condition and typically developing children were shown four coloured photographs of objects that had different functions across four separate trials. The participants were given either a novel label alongside a description of the object’s function or a description of the object’s function without a label. Children were then given 30 seconds to interact with an array of stimuli (pictures and objects) in a mapping test and in a generalisation test for each trial. This exploration phase allowed for spontaneous word–picture–referent mapping through free-play, providing an implicit measure of symbolic understanding. Results We found no significant difference in word–picture–referent mapping between groups and conditions. Both groups more often performed the described action on the target object in the exploration phase regardless of condition. Conclusions and implications Our results suggest that a spontaneous measure of symbolic understanding (such as free-play) may reveal competencies in word–picture–referent mapping in autism spectrum condition.
Phosphate starvation enhances phagocytosis of Mycobacterium bovis/BCG by macrophages
Authors: Espinosa-Cueto Patricia , Magallanes-Puebla Alejandro , Mancilla Raul 
Published: June 2020

AbstractBackgroundTuberculosis is an important health problem worldwide. The only available vaccine isM. bovis/BCG, an attenuated mycobacterium that activates the innate and the acquired immune system after being phagocytosed by macrophages and dendritic cells. Vaccination fails to prevent adult pulmonary tuberculosis although it may have a protective effect in childhood infection. Understanding how BCG interacts with macrophages and other immunocompetent cells is crucial to develop new vaccines.ResultsIn this study we showed that macrophages phagocytoseM. bovis/BCG bacilli with higher efficiency when they are cultured without phosphate. We isolated mycobacterial membranes to search for mycobacterial molecules that could be involved in these processes; by immunoblot, it was found that the plasma membranes of phosphate-deprived bacilli express the adhesins PstS-1, LpqH, LprG, and the APA antigen. These proteins are not detected in membranes of bacilli grown with usual amounts of phosphate.ConclusionsThe interest of our observations is to show that under the metabolic stress implied in phosphate deprivation, mycobacteria respond upregulating adhesins that could improve their capacity to infect macrophages. These observations are relevant to understand howM. bovis/BCG induces protective immunity.
Effects of LED photoperiods and light qualities on in vitro growth and chlorophyll fluorescence of Cunninghamia lanceolata
Authors: Xu Yuanyuan , Yang Mei , Cheng Fei , Liu Shinan , Liang Yuyao 
Published: June 2020

Abstract
Background
Cunninghamia lanceolata (C. lanceolata) is the main fast-growing timber species in southern China. As an alternative to conventional lighting systems, LED has been demonstrated to be an artificial flexible lighting source for commercial micropropagation. The application of LED can provide rapid propagation of C. lanceolata in vitro culture.

Results
We applied two-factor randomized block design to study the effects of LED photoperiods and light qualities on the growth and chlorophyll fluorescence of C. lanceolata in vitro culture plantlets. In this study, plantlets were exposed to 20 μmol·m− 2·s− 1 irradiance for three photoperiods, 8, 16, and 24 h under the three composite lights, 88.9% red+ 11.1% blue (R/B), 80.0% red+ 10.0% blue+ 10.0% purple (R/B/P), 72.7% red+ 9.1% blue+ 9.1% purple+ 9.1% green (R/B/P/G), as well as white light (12.7% red+ 3.9% blue+ 83.4% green, W) as control. The results showed that: (1) Plant height, dry weight, rooting rate, average root number, length, surface area and volume, chlorophyll, and chlorophyll fluorescence parameters were significantly affected by photoperiods, light qualities and their interactions. (2) Plantlets subjected to photoperiod 16 h had longer root, higher height, rooting rate, root number, and the higher levels of chlorophyll, chlorophyll a/b, Y (II), qP, NPQ/4 and ETRII compared to photoperiods 8 h and 24 h, while Fv/Fm during photoperiod 16 h was lower than 8 h and 24 h. Plantlets exposed to R/B/P/G generated more root and presented higher chlorophyll, Fv/Fo, Y (II), qP, and ETRII than W during photoperiods 8 and 16 h. (3) Total chlorophyll content and ETRII were significant correlated with rooting rate, root length and root volume, while Fv/Fm and ETRII were significant correlated with plant height, average root number and root surface area. (4) 16-R/B/P/G is best for growing C. lanceolata plantlets in vitro.

Conclusions
This study demonstrated the effectiveness of photoperiods and light qualities using LEDs for micropropagation of C. lanceolata. The best plantlets were harvested under 16-R/B/P/G treatment. And there was a correlation between the growth and the chlorophyll and chlorophyll fluorescence of their leaves under different photoperiod and light quality. These results can contribute to improve the micropropagation process of this species.
Pacemaker implantation in patients with major depression, should it be of concern? A case report and literature review
Authors: Che Xiaoru , Abdelwahed Youssef S. , Wang Xiaoyu , Fang Yuanjian , Wang Lihong 
Published: June 2020

Abstract
Background
Psychological adaptation after cardiac pacemaker implantation is a challenge for patients with mental illness.

Case presentation
Here we report a self-harming patient with a psychiatric disorder. A 73-year-old female patient with 16-year coronary heart disease and a 4-year depression was admitted to our hospital for a coma. Two months earlier, the local hospital confirmed that the patient had a second-degree sinoatrial (SA) block (type 2) as well as basal septal hypertrophy with the left ventricular outflow obstruction. Therefore, metoprolol sustained-release tablets 95 mg QD and diltiazem sustained-release tablets 90 mg QD was given as treatment after a pacemaker was implanted. However, the patient had continued complaining about discomfort due to the pacemaker implanted after being discharged from the hospital. Two months later, she attempted to commit suicide by removing her pacemaker and taking 80 sleeping pills. After a series of treatments, the patient improved and was discharged without a pacemaker re-implantation. With continued anti-depression treatment and strengthen family supervision, the patient’s condition is stable now.

Conclusions
A suicide attempt by intentionally removing the permanent pacemaker system was rarely reported. In bradycardia patients with a history of psychological or psychiatric disease, careful evaluation should be done before and after implantation of the pacemaker.
Optimization of impedance-measured reflux events in GORD utilizing acid exposure time
Authors: Horton Anthony J. , Clayton Steven B. 
Published: June 2020

Abstract
Background
Combining impedance with pH monitoring improves the detection and characterization of gastro-oesophageal reflux (GOR), yet the two modalities frequently differ in GOR quantification. Ambulatory 24-h pH-impedance monitoring often reveals more significant oesophageal acid exposure than impedance-measured reflux activity in patients with symptomatic gastro-oesophageal reflux disease (GORD). The purpose of this study is to elucidate the discrepancies between these modalities by assessing the predictive accuracy of impedance compared to acid exposure standards.

Methods
A single-institution, retrospective review of sequential 24-h pH-impedance results of 72 patients with symptomatic GOR off anti-secretory therapy was conducted. Reflux events measured by impedance were stratified by patient position and compared to oesophageal acid exposure time (AET). Oesophageal AET limits for GORD detection were utilized as gold standards to generate serial receiver operator characteristics (ROC) curves to assess the sensitivity and specificity of current impedance GORD detection limits and identify optimized impedance standards based on area under the curve (AUC) analysis.

Results
Mean total AET time was 10.5% (± 9.9%), and 63.8% of patients had elevated AET. By impedance, median GOR frequency was 43 (IQR 21–68), and 22.2% exceeded conventional GOR frequency limits of normal. ROC curve analysis revealed the current impedance standard of > 73 GOR events has a sensitivity of 32.6% and specificity of 96.5% (AUC 0.74) for GORD detection. By AUC analysis, an impedance threshold of > 41 GOR events is optimal for GORD detection (sensitivity 69.6%, specificity 80.7%, AUC 0.83).

Conclusion
Conventional impedance standards for abnormal GOR frequency are weakly sensitive for the detection of GORD, providing a possible explanation to discrepancies in AET and impedance interpretation. Lowering impedance-measured GOR frequency limits to > 41 optimizes sensitivity and specificity while increasing congruence between pH and impedance metrics.
Risk factors for and clinical outcomes of carbapenem non-susceptible gram negative bacilli bacteremia in patients with acute myelogenous leukemia
Authors: Shin Dong Hoon , Shin Dong-Yeop , Kang Chang Kyung , Park Suhyeon , Park Jieun , Jun Kang Il , Kim Taek Soo , Koh Youngil , Hong Jun Shik , Choe Pyoeng Gyun , Park Wan Beom , Kim Nam-Joong , Yoon Sung-soo , Kim Inho , Oh Myoung-don 
Published: June 2020

Abstract
Background
Carbapenem is frequently used when gram negative bacilli (GNB) bacteremia is detected especially in neutropenic patients. Consequently, appropriate treatment could be delayed in GNB bacteremia cases involving organisms which are not susceptible to carbapenem (carba-NS), resulting in a poor clinical outcomes. Here, we explored risk factors for carba-NS GNB bacteremia and its clinical outcomes in patients with acute myelogenous leukemia (AML) that underwent chemotherapy.

Methods
We reviewed all GNB bacteremia cases that occurred during induction or consolidation chemotherapy, over a 15-year period, in a tertiary-care hospital.

Results
Among 489 GNB bacteremia cases from 324 patients, 45 (9.2%) were carba-NS and 444 (90.8%) were carbapenem susceptible GNB. Independent risk factors for carba-NS GNB bacteremia were: carbapenem use at bacteremia onset (adjusted odds ratio [aOR]: 91.2; 95% confidence interval [95%CI]: 29.3–284.1; P < 0.001); isolation of carbapenem-resistant Acinetobacter baumannii (aOR: 19.4, 95%CI: 3.4–112.5; P = 0.001) in the prior year; and days from chemotherapy to GNB bacteremia (aOR: 1.1 per day, 95%CI: 1.1–1.2; P < 0.001). Carba-NS bacteremia was independently associated with in-hospital mortality (aOR: 6.6, 95%CI: 3.0–14.8; P < 0.001).

Conslusion
Carba-NS organisms should be considered for antibiotic selection in AML patients having these risk factors.