bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contrary effects of coenzyme Q10 and vitamin E after testicular ischemia/reperfusion in a rat model validated with glucose metabolism imaging
Authors: Arda Ersan , Yuksel Ilkan , Akdere Hakan , Akdeniz Esra , Yalta Tülin D , Aktoz Tevfik , Altun Gulay D 
Published: October 2019

Objective: To evaluate the efficacy of antioxidants in cellular-level post-ischemia/reperfusion injury of the testis and to validate these effects with 18F-fluorodeoxyglucose positron emission tomography. Methods: Fifty-six adult male rats were randomly divided into seven groups—Group 1: sham; Group 2: ischemia/reperfusion only group; Group 3: ischemia was induced and vitamin E (100 mg/kg) was administered intraperitoneally 30 min before reperfusion; Group 4: vitamin E was given intraperitoneally without ischemia/reperfusion; Group 5: ischemia was induced and coenzyme Q10 (10 mg/body weight) was administered intraperitoneally 30 min before reperfusion; Group 6: coenzyme Q10 was administered intraperitoneally without ischemia/reperfusion; Group 7: ischemia was induced and coenzyme Q10 + vitamin E was administered intraperitoneally 30 min before reperfusion. After detorsion, fluorodeoxyglucose was applied to all groups according to the animals’ weight and fluorodeoxyglucose positron emission tomography was performed after 1 h. In pursuit of imaging, orchiectomy was performed for histopathological and biochemical evaluations. Results: A significant effect of group on catalase, maximum standardized uptake value, and seminiferous tubule diameters (p < 0.005) was observed. According to this, combining ischemia/reperfusion with vitamin E increased the maximum standardized uptake value significantly higher than in all other groups; in addition, catalase was significantly higher than in Groups 4–6. Histopathological outcomes revealed that “sham” had significantly larger seminiferous tubule diameter than Groups 2–4. Also, “ischemia/reperfusion” was the only group which had significantly smaller seminiferous tubule diameters than Groups 6 and 7. Conclusion: In contrast to vitamin E, coenzyme Q10 provided remarkable regression of oxidative stress–induced enzymes and revealed consistent effects on histopathological outcomes, which were validated with fluorodeoxyglucose positron emission tomography imaging.
Development of a Social Skills Education Game for Elementary School Students
Authors: Okada Yoshiko , Matsuda Toshiki 
Published: October 2019

Background. The latest Japanese National Curriculum emphasized the importance of active learning as well as communication skills in various subject areas. Following this trend, the social skills education (SSE) approach was adopted to promote and improve skills that facilitate interpersonal conflict resolution in elementary school students. Aim. This study developed a card game to help elementary school teachers perform SSE. The aims were to convince students to contemplate alternative solutions to problems in a way that incorporates suggestions from other students and to motivate children to think about problem solving in a social context. Methods. Our card game was developed based on Matsuda’s warp and woof model of problem-solving that emphasizes generating ideas concerning trade-off resolution in problem-solving. We then tested the game in a sample of 74 fourth grade (9-10 years old) elementary school students. Results. The findings suggest that the students understood the importance of considering new alternatives for trade-off resolution by playing our game. Conclusions. Despite the limitations of our study, such as the small sample size, our findings demonstrated that the game was successful in teaching most students the necessity of reaching a consensus in situations involving conflicting opinions.
The Detrimental Effects of Punishment and Reward on Cooperation in the Industrial Waste Illegal Dumping Game
Authors: Kitakaji Yoko , Ohnuma Susumu 
Published: October 2019

Background. Many studies have shown that sanctions promote cooperation in social dilemma situations. However, it has also been suggested that sanctions have a negative effect. The interactions among people and systems need to be considered to examine the consequences of sanctions. Aim. We examined whether rewards and mutual punishment increased non-cooperation. We regarded illegal industrial waste dumping as a social dilemma in which everyone bears the burden of the cost of illegal dumping, legal treatment is cooperative behavior, and illegal dumping is non-cooperative behavior. Method. We used the Industrial Waste Illegal Dumping Game. This game simulates the structure of industrial waste treatment (incomplete surveillance, various industries with different roles and payoffs, cost of cooperation, etc.) in addition to the social dilemma structure. Players take on roles in industrial waste treatment, negotiating and dealing with other players, and treating industrial waste. We set three conditions. In the reward condition, players can earn rewards by rapidly treating industrial waste. In the mutual punishment condition, players can mutually monitor and punish each other. In the control condition, neither reward nor punishment exists. Results. Non-cooperation occurred more frequently in the reward condition than in the control condition. Conversely, there was no difference in non-cooperation between the mutual punishment and control conditions. Players under the reward condition did not gather information proactively, and information on benefits was not shared. Conclusion. This study showed that sanctions caused non-cooperation. Social dynamics should be considered when evaluating the effectiveness of sanctions. Gaming allows us to examine social consequences, including social dynamics, which leads to discoveries not possible through traditional methods.
Optical coherence tomography angiography and arterial hypertension: A role in identifying subclinical microvascular damage?
Authors: Donati Simone , Maresca Andrea Maria , Cattaneo Jennifer , Grossi Alessandra , Mazzola Marco , Caprani Simona Maria , Premoli Laura , Docchio Franco , Rizzoni Damiano , Guasti Luigina , Azzolini Claudio 
Published: October 2019

Introduction: To evaluate retinal microvasculature modifications by means of optical coherence tomography angiography in human subjects diagnosed with arterial hypertension and to assess potential clinical relevance for early diagnosis. Methods: A cross-sectional study of 30 subjects affected by arterial hypertension compared to a matched cohort of healthy patients was conducted. Patients were evaluated by the Outpatient Clinic for Hypertension and the Retina Center, University of Insubria, Varese, Italy. Patients were divided into three groups: Group 1—healthy subjects, Group 2—patients first diagnosed with hypertension, and Group 3—patients with treated hypertension. Optical coherence tomography angiography was performed applying different analysis protocols for macula and optic disk, using an AngioVue OCTA System on an Optovue device. Morphological data were compared to and correlated with clinical vascular parameters, to evaluate preclinical microvascular damage. Results: A significant reduction in deep vascular layer density (Group 1: 59.2% ± 1.5% standard deviation; Group 2: 59.2% ± 2.2% standard deviation; Group 3: 57.8% ± 2.6% standard deviation; p < 0.05) as well as an enlargement of the deep foveal avascular zone area (Group 1: 0.34 ± 0.09 mm2; Group 2: 0.36 ± 0.07 mm2; Group 3: 0.39 ± 0.1 mm2; p < 0.05) was measured in patients with first diagnosed hypertension and in treated patients compared to healthy subjects. We also observed a significant decrease in mean foveal choroidal thickness in affected patients compared to controls (Group 1: 319.68 ± 61.72 µm standard deviation; Group 2: 251.04 ± 63.1 µm standard deviation; Group 3: 262.65 ± 51.08 µm standard deviation; p < 0.05). Our preliminary data did not show a significant correlation with microalbuminuria levels. Discussion: Retinal vascular density showed pathological modifications between healthy subjects and hypertensive patients. These preliminary findings suggest that optical coherence tomography angiography may identify pathological markers of an early hypertensive damage and help monitor disease progression with potential therapeutic advantages.
Prospective clinical study using radiostereometric analysis (RSA) to evaluate fixation of a modular cemented polished femoral stem
Authors: Richardson C Glen , Laende Elise K , Gross Michael , Dunbar Michael J 
Published: October 2019

Background: The long-term clinical success of cemented polished tapered femoral components has been demonstrated in prospective as well as registry studies. This stem design type has also been well studied with radiostereometric analysis (RSA) and provides a standard to evaluate alternative designs of polished tapered cemented femoral components. This prospective study evaluates the subsidence of a polished cemented stem with a modular neck design utilising RSA. Methods: 26 patients were prospectively enrolled in the study and 23 were available for RSA analysis at 2 years. Results: The average subsidence of the femoral implant was 1.1 mm (SD 0.4 mm) at 2 years post operation. There were no revisions in this group, specifically no failures of the modular stem-neck design as has been seen with other implants. Conclusions: The RSA subsidence pattern at 2 years of this cemented femoral stem is similar to other successful designs with long-term follow-up. The implications over time of stem neck modularity for cemented polished tapered femoral components requires further evaluation.
Early Introduction of Dermatology Clinical Skills in Medical Training
Authors: Blakely Kim , Bahrani Bahar , Doiron Philip , Dahlke Erin 
Published: October 2019

Background Skin diseases are among the most common diseases encountered by healthcare professionals. Despite this, dedicated dermatology teaching is limited in most Canadian medical school training programs. This is especially true of clinical skills training. Objectives To determine the impact of early introduction of dermatology clinical skills in Canadian undergraduate medical training. Secondary objectives included examining the impact of having sessions co-led by a clinician with expertise in the field of dermatology. Methods A half-day dermatology clinical skills session was introduced in the University of Toronto preclerkship medical school during the dermatology week. Sessions were co-led by staff or resident dermatologists. Sessions were evaluated using student pre- and postclinical skills test scores, as well as experience questionnaires completed by both tutors and students. Results The clinical skills session was well received by both students and tutors, with no cumulative score less than 4.34 on a 5-point Likert scale. The majority of students agreed or strongly agreed that the introduction of clinical skills in the early years of the curriculum facilitated learning consolidation (99.5%). Comparison of pre- and post-test scores showed that students’ dermatology comprehension improved by an average of 12.1% following completion of the session. In questionnaire responses, students and nondermatology co-tutors emphasized the impact of having an expert in the field of dermatology co-lead the session. Conclusions Students valued early clinical skills exposure to dermatology and felt it enhanced their knowledge and abilities. This study demonstrates learning consolidation when dermatologic didactic teachings are paired with practical clinical skills sessions.
Clinicopathological features in membranous nephropathy with cancer: A retrospective single-center study and literature review
Authors: Zhang Dan , Zhang Chong , Bian Fan , Zhang Wenzhu , Jiang Gengru , Zou Jun 
Published: October 2019

Background: Membranous nephropathy is the most common glomerular disease related to malignancy. However, it is difficult to distinguish between true malignancy-related membranous nephropathy and idiopathic membranous nephropathy coincident with cancer. It has been reported that phospholipase A2 receptor (PLA2R) is the first autoantigen involved in idiopathic membranous nephropathy and thrombospondin type-1 domain-containing 7A (THSD7A) may have a close relationship with malignancy-related membranous nephropathy. Therefore, the aim of this study was to compare the clinicopathological characteristics between membranous nephropathy patients with cancer and idiopathic membranous nephropathy patients without cancer to better detect malignancy-related membranous nephropathy, including glomerular PLA2R and THSD7A depositions and their circulating antibodies, together with glomerular IgG4 deposition. Methods: Twelve membranous nephropathy patients with cancer and 257 idiopathic membranous nephropathy patients without cancer were included in this study and had been followed up for more than 1 year. The glomerular expression of PLA2R, THSD7A, and IgG4 was analyzed by immunohistochemistry. Circulating anti-PLA2R and anti-THSD7A antibodies were assessed by enzyme-linked immunosorbent assay and indirect immunofluorescence testing, respectively. Results: Membranous nephropathy patients with cancer were significantly older and had higher serum creatinine and a lower estimated glomerular filtration rate than idiopathic membranous nephropathy patients ( P<0.05). The positive rates of glomerular PLA2R and IgG4 depositions and circulating anti-PLA2R antibodies in membranous nephropathy patients with cancer were significantly lower than those in idiopathic membranous nephropathy patients without cancer ( P<0.01). Conclusion: The absence of glomerular PLA2R deposition and negative circulating anti-PLA2R antibodies, along with negative glomerular IgG4 staining, may be useful clues to more accurately screen underlying malignancies in membranous nephropathy patients.
The right of adults to education: A comparative analysis from the Portuguese and Italian policy agenda
Authors: Barros Rosanna , Biasin Chiara 
Published: October 2019

The subject of this article is the right of adults to education, with a focus on the critical analysis of education policy. We discuss human rights as a framework for citizenship in two national contexts of Southern Europe with the purpose of underlining key differences and similarities in countries with diverse histories but a similarly high number of low-qualified adults among their population. In view of the above, this paper provides a detailed historical context for adult education policy in those countries and expounds on how current Portuguese and Italian educational policy agendas have considered the right of adults to education in the context of their democratic regimes. For critical analysis we use Tomaševski’s theoretical 4A framework, built mainly for school contexts, and apply it to adult education policy. The objective is to understand ways of realizing the right of adults to education by means of policy measures undertaken by governments in those national states. Thus, we employed as an object of analysis the study of availability, accessibility, acceptability and adaptability of adult education and learning against the backdrop of current changes occurring in Europe. This heuristic exercise makes a significant contribution to adult education literature in times of neoliberal trends.
Comparative efficacy of exercise and anti-hypertensive pharmacological interventions in reducing blood pressure in people with hypertension: A network meta-analysis
Authors: Noone Chris , Leahy Joy , Morrissey Eimear C , Newell John , Newell Micheál , Dwyer Christopher P , Murphy Jane , Doyle Frank , Murphy Andrew W , Molloy Gerard J 
Published: October 2019

Abstract

Aims
This analysis aims to estimate the comparative efficacy of anti-hypertensive medications and exercise interventions on systolic and diastolic blood pressure reduction in people with hypertension.

Methods
A systematic review was conducted focusing on randomised controlled trials (RCTs) of exercise interventions and first-line anti-hypertensives where blood pressure reduction was the primary outcome in those with hypertension. Network meta-analyses were conducted to generate estimates of comparative efficacy.

Results
We identified 93 RCTs (N = 32,404, mean age in RCTs: 39–70 years) which compared placebo or usual care with first-line antihypertensives including angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, calcium channel blockers and thiazide-like diuretics and exercise interventions including aerobic training and dynamic resistance training. Of these, there were 81 (87%) trials related to medications (n = 31,347, 97%) and 12 (13%) trials related to exercise (n = 1057, 3%). The point estimates suggested that antihypertensive medications were more effective than exercise but there was insufficient evidence to suggest that first-line medications significantly reduced blood pressure to a greater extent than did the exercise interventions. Of the first-line treatments, angiotensin receptor blockers and calcium channel blockers had the highest treatment ranking, while exercise had the second lowest treatment ranking, followed by control conditions.

Conclusion
The current evidence base with a bias towards medication research may partly explain the circumspection around the efficacy of exercise in guidelines and practice. Clinicians may justifiably consider exercise for low risk hypertension patients who confirm a preference for such an approach.
Health literacy is independently and inversely associated with carotid artery plaques and cardiovascular risk
Authors: Lindahl Bernt , Norberg Margareta , Johansson Helene , Lindvall Kristina , Ng Nawi , Nordin Maria , Nordin Steven , Näslund Ulf , Persson Amanda , Vanoli Davide , Schulz Peter J 
Published: October 2019

Aims Health literacy, the degree to which individuals understand and act upon health information, may have a pivotal role in the prevention of cardiovascular disease (CVD), with low health literacy potentially explaining poorer adherence to prevention guidelines. We investigated the associations between health literacy, ultrasound-detected carotid atherosclerosis and cardiovascular risk factors. Methods Baseline data (cross-sectional analysis) from a randomized controlled trial, integrated within the Västerbotten Intervention Program, Northern Sweden, was used. We included 3459 individuals, aged 40 or 50 years with ≥1 conventional risk factor or aged 60 years old. The participants underwent clinical examination, blood sampling, carotid ultrasound assessment of intima-media wall thickness (CIMT) and plaque formation, and answered a questionnaire on health literacy – the Brief Health Literacy Screen. The European Systematic Coronary Risk Evaluation and Framingham Risk Score were calculated. Results About 20% of the participants had low health literacy. Low health literacy was independently associated with the presence of ultrasound-detected carotid artery plaques after adjustment for age and education, odds ratio (95% confidence interval) 1.54 (1.28–1.85), demonstrating a similar level of risk as for smoking. Health literacy was associated with CIMT in men. Low health literacy was associated with higher CVD risk scores. Sensitivity analyses with low health literacy set to 9% or 30% of the study sample, respectively, yielded essentially the same results. Conclusions Low health literacy was independently associated with carotid artery plaques and a high level of CVD risk scores. Presenting health information in a fashion that is understood by all patients may improve preventive efforts.
Predictors and prognosis of delirium among older subjects in cardiac intensive care unit: focus on potentially preventable forms
Authors: Mossello Enrico , Baroncini Caterina , Pecorella Laura , Giulietti Chiara , Chiti Maurizio , Caldi Francesca , Cavallini Maria Chiara , Simoni David , Baldasseroni Samuele , Fumagalli Stefano , Valoti Paolo , Stroppa Stefano , Parenti Katia , Ungar Andrea , Masotti Giulio , Marchionni Niccolò , Bari Mauro Di 
Published: October 2019

Background:
Delirium is a common and potentially preventable condition in older individuals admitted to acute and intensive care wards, associated with negative prognostic effects. Its clinical relevance is being increasingly recognised also in cardiology settings. The aim of the present study was to assess the prevalence, incidence, predictors and prognostic role of delirium in older individuals admitted to two cardiology intensive care units.

Methods:
All patients aged over 65 years consecutively admitted to the two participating cardiology intensive care units were enrolled. Assessment on admission included acute physiological derangement (modified rapid emergency medicine score, REMS), chronic comorbidity, premorbid disability and dementia. The Confusion Assessment Method–Intensive Care Unit was applied daily for delirium detection.

Results:
Of 497 patients (40% women, mean age 79 years), 18% had delirium over the entire cardiology intensive care unit course, half of whom more than 24 hours after admission (incident delirium). Advanced age, a main diagnosis of ST-segment elevation myocardial infarction or acute respiratory failure, modified REMS, comorbidity and dementia were independent predictors of delirium. Adjusting for patient’s features on admission, incident delirium was predicted by invasive procedures (insertion of peripheral arterial catheter, urinary catheter, central venous catheter, naso-gastric tube and intra-aortic balloon pump). In a logistic regression model, delirium was an independent predictor of inhospital mortality (odds ratio 3.18, 95% confidence interval 1.02, 9.93).

Conclusions:
Eighteen per cent of older cardiology intensive care unit patients had delirium, with half of the cases being incident, thus potentially preventable. Invasive procedures were independently associated with incident delirium. Delirium was an independent predictor of inhospital mortality. Awareness of delirium should be increased in the cardiology intensive care unit setting and prevention studies are warranted.
The feasibility and acceptability of using a novel wrist worn cueing device to self-manage drooling problems in people with Parkinson’s disease: A pilot study
Authors: McNaney Roisin , Miller Nick , Vines John , Olivier Patrick , Ladha Karim , Jackson Daniel , Walker Richard 
Published: October 2019

Introduction Daytime drooling is experienced by around 50% of Parkinson’s patients, who fail to swallow saliva in sufficient volume or regularity, despite normal production. This research explored the feasibility and acceptability of using a cueing device, to improve drooling. Methods During a four-week intervention, 28 participants were asked to use a cueing device for 1 h per day. During this time, the device vibrated once-per-minute, reminding the participant to swallow their saliva. A daily diary was used to collect self-report around swallowing severity, frequency, and duration. This was filled out by participants for one week before, four weeks during and for one week immediately after intervention. Diaries were also collected for one week during a follow up, carried out four weeks after intervention finished. Results Participants self-reported benefits in drooling severity ( p = 0.031), frequency ( p ≤ 0.001), and duration ( p = 0.001) after using the device. Improvements were maintained at follow up. Twenty-two participants explicitly reported a positive benefit to their drooling during exit interview. All felt the intervention and device were acceptable and usable. Conclusions Using a cueing device for one month had perceived benefit to drooling severity, frequency and duration in patients with Parkinson’s. Participants accepted the device and treatment protocol.