bluuebunny/crossref_metadata_2025_split huggingface dataset:
Common late complications of longitudinal forefoot amputations in neuropathic foot treatment
Authors: Macedo Rodrigo Sousa , Macedo Lucas Sousa , Sakaki Marcos Hideyo , Sposeto Rafael Barban , Ortiz Rafael Trevisan , de Andrade Corsato Marcos , Godoy-Santos Alexandre Leme , Fernandes Túlio Diniz 
Published: June 2021

Objective:To describe and quantify the complications arising in consecutive neuropathic patients undergoing partial longitudinal amputations of the foot.Method:A retrospective study was conducted with data collected from the medical records of patients monitored at the Insensitive Foot Clinic of the Foot and Ankle Group of our institution who underwent partial amputation of foot rays from 2000 to 2016.Results:A total of 28 patients met the inclusion criteria, with a total of 31 amputated/partially amputated feet. Of these, 18 (58.1%) feet were amputated/partially amputated due to diabetes, seven (22.6%) due to leprosy, two (6.5%) due to alcoholic neuropathy, two (6.5%) secondary to traumatic peripheral nerve injury, and two (6.5%) due to other causes. Fifth ray amputation was the most frequent type (n=12). The cause of amputation was the presence of an infected ulcer in 93.6% of the samples. At a mean follow-up time of 60 months, 13 (41.9%) feet required new amputations—five (38.5%) transtibial, five (38.5%) transmetatarsal, two (15.4%) of the toes, and one (7.7%) at Chopart's joint. Patients with diabetes had a 50.0% reamputation rate. Patients who initially underwent amputation of the fifth ray had a 58.3% reamputation rate.Conclusion:Partial longitudinal amputation of the foot in neuropathic patients exhibited a high reoperation rate, especially in patients with diabetes or in patients with initial amputation of the peripheral rays. Declaration of interest: The authors have no conflicts of interest.
Histological and clinical evaluation of wound healing in pressure ulcers: a novel animal model
Authors: Sami Diana G , Abdellatif Ahmed 
Published: June 2021

Objective:Pressure ulcers (PUs) are a major healthcare problem, commonly associated with older people, patients who are bedbound and patients with diabetes. The impact of PUs can decrease patients' quality of life, and lead to high morbidity and mortality rates. In this study, we aimed to describe a novel PU model that simulates pressure ulcers in humans to provide a research tool for new drug testing.Method:Diabetes was induced using streptozocin in 75 adult Sprague Dawley rats. To create the PU, skin was sandwiched between two magnets, one of them implanted below the panniculus carnosus muscle and the other above the skin. The model was tested on nondiabetic rats and diabetic rats, each with pressure ulcers, compared to nondiabetic rats with excisional wounds.Results:Results showed that the PU model in diabetic (p-value<0.000001) and non-diabetic rats (p-value<0.05) exhibited significantly delayed healing (no healing over 21 days) compared with the excisional wound that was completely healed by day 21.Conclusion:Diabetic rats showed significant changes in intact skin compared with non-diabetic rats, as well as a significant delay in the healing process compared with the non-diabetic group. By effectively impairing the skin contraction otherwise seen in the rats, and thereby delaying healing and making it similar to that seen in hard-to-heal PUs in humans, this model provides an effective tool for wound healing research.
Pain and analgesics in patients with hard-to-heal ulcers: using telemedicine or standard consultations
Authors: Wickström Hanna , Öien Rut F , Midlöv Patrik , Anderberg Peter , Fagerström Cecilia 
Published: June 2021

Objective: To compare consultations carried out via video with those performed in person for patients with painful, hard-to-heal ulcers, with a focus on ulcer pain and pain treatment. A further aim was to investigate predictors for pain and pain treatment. Method: This was a register-based, quasi-experimental study based on data from the Swedish Registry of Ulcer Treatment (RUT). A total of 100 patients with hard-to-heal ulcers diagnosed via video consultation were compared with 1888 patients diagnosed in person with regard to pain assessment, intensity and treatment. Ulcer pain intensity was assessed by the visual analogue scale (VAS). Normally distributed variables (age, VAS) were compared between consultation groups using Student's t-test. Non-normally distributed variables (ulcer size, ulcer duration) were compared using the Mann–Whitney U-test, except for healing time, which was analysed with a log-rank test. Categorical variables (gender, ulcer aetiology and prescribed analgesics) were compared using Pearson's chi-square test (χ2). A p value of less than 0.05 was considered to indicate statistical significance. Predictors for pain and pain treatment were analysed in multiple regression analyses. Results: The results showed a high presence of pain; 71% of patients with pain reported severe ulcer pain. There was no significant difference in ability to assess pain by VAS in the group diagnosed via video consultation (90%) compared with the group diagnosed in person (86%) (χ2, p=0.233). A significantly higher amount of prescribed analgesics was found for patients diagnosed via video (84%) compared with patients diagnosed by in-person assessment (68%) (χ2, p=0.044). Predictors for high-intensity pain were female gender or ulcers due to inflammatory vessel disease, while the predictors for receiving analgesics were older age, longer healing time and being diagnosed via video consultation. Conclusion: To identify, assess and treat ulcer pain is equally possible via video as by in-person consultation. The results of this study confirm that patients with hard-to-heal ulcers suffer from high-intensity ulcer pain, with a discrepancy between pain and pain relief. Further well-designed randomised controlled studies are necessary to understand how best to deploy telemedicine in ulcer pain treatment.
Diabetic foot ulcer management in a multidisciplinary foot centre: one-year healing, amputation and mortality rate
Authors: Van Georges Ha , Amouyal Chloe , Bourron Olivier , Aubert Carole , Carlier Aurelie , Mosbah Helene , Fourniols Eric , Cluzel Philippe , Couture Tihbault , Hartemann Agnes 
Published: June 2021

Objective:To describe the rates of healing, major amputation and mortality after 12 months in patients with a new diabetic foot ulcer (DFU) and their care in a French diabetic foot service (DFS).Method:A prospective single-centre study including patients from March 2009 to December 2010. The length of time to healing, minor amputation, major amputation and mortality rate after inclusion were analysed using the Kaplan–Meier method.Results:Some 347 patients were included (3% lost to follow-up), with a median follow-up (IQR) of 19 (12–24) months. The mean (SD) age was 65±12 years, 68% were male, and the median duration of the ulcer was 49 (19–120) days. Complications of the DFU were ischaemia (70%), infection (55%) and osteomyelitis (47%). Of the patients, 50% were inpatients in the DFS at inclusion (median duration of hospitalisation 26 (15–41) days). The rate of healing at one year was 67% (95% confidence interval (CI): 61–72); of major amputation 10% (95% CI: 7–17); of minor amputation 19% (95% CI: 14–25), and the death rate was 9% (95% CI: 7–13). Using an adjusted hazard ratio, the predictive factors of healing were perfusion and the area of the wound. The risk factors for a major amputation were active smoking and osteomyelitis. The risk factors for mortality were perfusion and age.Conclusion:This study confirms the need to treat DFUs rapidly, in a multidisciplinary DFS.
Correlation between vitamin D levels and hard-to-heal wounds: a systematic review
Authors: Smith Karen , Hewlings Susan 
Published: June 2021

Objective: Hard-to-heal wounds are a major biological, psychological, social and financial burden on both individual patients and the broader health system. They are associated with a variety of comorbidities and have a complex aetiology, but are typically associated with nutritional deficiencies, such as low vitamin D levels. This systematic literature review evaluates the current research regarding the connection between inadequate vitamin D status and wound healing. Method: PubMed and EBSCO databases were searched following PRISMA guidelines for primary research studies relating to pressure ulcers, diabetic ulcers or venous ulcers and vitamin D status. Results: A total of 10 studies, involving 2359 participants, met the inclusion criteria. There was a strong correlation between low levels of 25-hydroxyvitamin D and the presence of all three types of hard-to-heal wounds. Conclusion: Research suggests a correlation between low vitamin D levels and hard-to-heal wounds. However, it is not clear if the relationship is causal or only correlational. There is also emerging evidence on the use of vitamin D supplementation for the treatment of hard-to-heal wounds. More research is needed to understand the correlation between vitamin D and hard-to-heal wounds.
Topical cream containing nanoparticles with vitamin E to prevent radiodermatitis in women with breast cancer: a clinical trial protocol
Authors: Schmidt Fernanda Mateus Queiróz , González Carol V. Serna , Mattar Rodrigo Calixto , Lopes Luciana Biagini , dos Santos Marinilce Fagundes , de Gouveia Santos Vera L.C. 
Published: June 2021

Objective: Little is known about the efficacy of products aiming to prevent radiodermatitis, which affects between 90–95% of women with breast cancer. The use of antioxidants is promising, however, there is a lack of evidenceon their effectiveness. Here, the authors present a clinical trial protocol to evaluate the effects of applying a cream containing nanoparticles with vitamin E to prevent radiodermatitis in patients with breast cancer. Method: The protocol recommends that 108 women with breast cancer, receiving radiotherapy, are included in this triple-blinded, randomized, controlled study at an oncology hospital. Patients will be divided in three groups of 36 individuals each: group A will receive a cream with lipid nanoparticles and vitamin E, group B will receive a cream without nanoparticles nor vitamin E, and group C will receive a cream with nanoparticles without vitamin E. The primary endpoints will evaluate the incidence, degree, and time of onset of radiodermatitis. The secondary endpoints will focus on the quality of life, symptoms, and local temperature. Patients will be assessed three times a week, from the start of their radiotherapy treatment to two weeks after the last session. This protocol was approved by the research ethics committee of the institutions involved and registered on an international trials database.
The online student experience: A MAC-ICE thematic structure
Authors: Henry Mel 
Published: June 2021

Attracting and retaining students in a COVID-distanced online higher education market is more important than ever. With limited access to campus, extensive student choice, and precarious institutional revenue, understanding what makes a positive online student experience in the eyes of students themselves, is vital for institutional survival. Through an in-depth case study of online first-year university students, this research identified six themes that describe students’ lived experiences of online education (OE), summarised as a motivation, ability, circumstances – interaction, curriculum, environment, or MAC-ICE, thematic structure of the online student experience (OSE). Where online students are deeply motivated, possess the skills to participate effectively in online university education, and are situated in conducive circumstances, they may be well placed for a positive student experience. Supplementing this, universities may facilitate a quality OSE through meaningful interaction with instructors, peers, and course content; flexible, challenging, and relevant curricula; and a reliable, innovative learning environment commensurate with the on-campus student experience. The rich description provided by this research enables generation of propositions about students’ experiences of OE, and suggests opportunities to enhance the OSE through consideration of identified themes.

Implications for practice or policy:

The OSE can be described by students’ motivation, ability, and circumstances, alongside institutional interaction, curriculum, and environment.
OE may be perceived to involve more work, greater concentration, better time management, more self-regulation, and a heavier reliance on technology, than on-campus education.
OE research may be confounded, where particular MAC-ICE themes are insufficiently considered.
Online student outcomes may be increased through purposeful consideration of all MAC-ICE themes.
Effects of smartphone-based collaborative vlog projects on EFL learners’ speaking performance and learning engagement
Authors: Huang Hui-Wen 
Published: June 2021

This study examined how smartphone-based collaborative video projects influenced English as a Foreign Language (EFL) learners’ speaking performance and learning engagement using blended learning in China. The collaborative video projects helped students engage in two smartphone-based video filming tasks to combine language learning with real-life experiences simultaneously. A total of 65 college students used smartphones to participate in 3-minute collaborative video tasks that were related to the learning context of the classroom textbook. Qualitative and quantitative data were collected during this 8-week intervention. This included pretest and post-test speaking scores, a questionnaire on group collaboration, students’ final reflections and focus group interviews. A paired-sample t test, descriptive analysis and qualitative content analysis were used to analyse the data. The results indicate that students’ speaking abilities were significantly improved at the end of the intervention. They enjoyed group collaboration in the video projects and appreciated acquiring digital media production skills. Interview results highlight the opportunities for and challenges of the educational application of video projects in EFL classrooms.

Implications for practice or policy:

Integrating collaborative vlog projects in EFL classrooms can stimulate students’ speaking performance.
Student-made collaborative vlogs can help students develop 21st century skills, especially in digital media production.
Smartphone-based vlog projects can increase learners’ engagement and enhance their group collaboration skills.
Ultrasound Neuromodulation: Integrating Medicine and Engineering for Neurological Disease Treatment
Authors: Chen Yuhao , Li Yue , Du Meng , Yu Jinsui , Gao Fei , Yuan Zhen , Chen Zhiyi 
Published: June 2021

Abstract
Neurological diseases associated with dysfunctions of neural circuits, including Alzheimer’s disease (AD), depression and epilepsy, have been increasingly prevalent. To tackle these issues, artificial stimulation or regulation of specific neural circuits and nuclei are employed to alleviate or cure certain neurological diseases. In particular, ultrasound neuromodulation has been an emerging interdisciplinary approach, which integrates medicine and engineering methodologies in the treatment. With the development of medicine and engineering, ultrasound neuromodulation has gradually been applied in the treatment of central nervous system diseases. In this review, we aimed to summarize the mechanism of ultrasound neuromodulation and the advances of focused ultrasound (FUS) in neuromodulation in recent years, with a special emphasis on its application in central nervous system disease treatment. FUS showed great feasibility in the treatment of epilepsy, tremor, AD, depression, and brain trauma. We also suggested future directions of ultrasound neuromodulation in clinical settings, with a focus on its fusion with genetic engineering or nanotechnology.
Consumer engagement behavior perspective in social media: Mediating role and impact on brand equity
Authors: Zailskaite-Jakste Ligita , Minelgaite Inga 
Published: June 2021

This study analyzes marketing communication (MC) impact on brand equity (BE) in social media (SM) seeking to identify mediating role of consumer engagement behavior (CEB) between generated functional and hedonic content on brand equity (BE). The CEB is divided into three levels: consuming, contributing, and creating. A survey-based empirical study with 402 respondents was conducted in the Eastern Europe country Lithuania. The implemented five control variables disclosed new mediation tracks and the good fit of the model, with the main findings of the research being that CEB occurring via SM platforms mediates the relationship between marketing communication and BE.
These outcomes suggest that companies seeking to make an impact on BE through CEB in level creation, should develop company-created utilitarian content which may engage consumers, extending the reach of their content and helping to facilitate long-term brand loyalty.
Keywords: marketing communication; consumer engagement behavior; social media; brand equity.
The commercial banks’ credit risk efficiency: Empirical evidence from Kosovo
Authors: Sahiti Arbana , Sahiti Arben 
Published: June 2021

Commercial banks' credit risk management is a function that focuses on events that may affect the achievement of objectives. Improper management will result in negative consequences or results. Therefore, banks usually pay more attention to events with a higher probability and impact of a direct loss of revenue and capital than events that may result in positive effects. This research adopts secondary data and seeks to analyze credit risk management of commercial banks in Kosovo through a developed DEA (Data Envelopment Analysis) model. The study covers seven commercial banks in Kosovo for the period 2008-2016 and uses Tobit regression to determine credit risk efficiency. The estimation results show a statistically significant positive relationship between bank efficiency, capital adequacy, and loans. Moreover, the study found that banks' efficiency factors, including profitability, deposits, costs, banks size, GDP growth, and inflation, are not statistically significant.
HOTS QUESTIONING ABILITY AND HOTS PERCEPTION OF LANGUAGE TEACHERS IN INDONESIA
Authors: Gozali Imelda , Lie Anita , Tamah Siti Mina , Jemadi Fransiskus 
Published: June 2021

This study is part of a larger-scale research aimed at mapping the pedagogical competence of teachers of English and Indonesian Language across three cities of differing demographic features in Indonesia. As a subset of the study, this paper focused on investigating the ability to formulate higher-order thinking (HOT) questions in the classroom among the teachers, as well as getting their perception about applying HOTS in their classes. The mapping was done by comparing the abilities across teachers’ regions, years of service, and subjects taught (English and Indonesian Language). This research was designed as a case study involving quantitative and qualitative data analyses, with 15 (fifteen) secondary school teachers as the participants. Data were collected through classroom observations, document (lesson plan) analyses, as well as teachers’ interviews. Quantitative analysis was performed on the teachers’ scores in formulating HOTS questions, while teaching documents and transcripts were coded for qualitative analysis. Although the statistical results revealed no significant difference between the HOTS questioning scores of the teachers in the different regions and years of service, qualitative data suggested that language medium, as shown by the difference between English and Indonesian Language teachers, might be an important factor affecting the abilities of teachers to ask HOT questions, as well as their perception of the applicability of HOTS in their classes. The inquiry into the teachers’ perceptions of HOTS also displayed a gap between teachers in the bigger city and those in more remote regions, as well as between the novices and the practitioners.
GENRE ANALYSIS OF MINUTES OF MEETINGS CONDUCTED IN ENGLISH BY THAI ENGINEERS
Authors: Changpueng Piyatida , Patpong Pattama 
Published: June 2021

Meetings are one of the common activities that play an important role in the field of business. For the community of Thai engineers, meetings become the salient aspects of their work, and therefore the effective writing of minutes of meetings is required. As such a writing is essential in the field, analyzing the corpus of the minutes of meetings would shed a light the patterns of meaning instantiated through those minutes. A corpus of 115 minutes of meetings were collected and analyzed using the genre analysis framework (moves and steps) of Swales (1990), Bhatia (1993), and Thaweewong (2006). Further, the lexico-grammatical features e.g., tenses and voices instantiated through the meetings were examined. Results of the analysis showed that Thai engineers use e-mail as the medium in writing the minutes in two ways: using regular e-mail messages (e-mail form) and using the company form. In terms of moves, there were seven common moves observed in the writing of the minutes: (1) the heading; (2) an opening salutation; (3) establishing a correspondence chain; (4) the content of the meeting; (5) a closing correspondence chain; (6) a closing salutation; and (7) attaching a document. In terms of lexicogrammar, there are some prominent features such as the simple present tense, active voice, noun phrases, proper nouns, abbreviations, and key word lists. The results above can be further utilized by course designers when developing the materials for their course. It is expected that the knowledge of moves and lexico-gramamtical features can help engineering students and novice engineers practice writing the minutes of meetings effectively.
DEVELOPING STUDENTS’ INTERCULTURAL COMMUNICATIVE COMPETENCE THROUGH CULTURAL TEXT-BASED TEACHING
Authors: Permatasari Indah , Andriyanti Erna 
Published: June 2021

Teaching a foreign language needs to include its relevant culture as the context of the language use. However, studies indicate that many English lecturers in Indonesia have not integrated culture yet in their teaching materials, resulting in students’ low intercultural communicative competence (ICC). This three-cycle class action research was aimed to improve the ICC of first semester students majoring in metallurgy engineering through cultural text-based intercultural teaching. It was designed to overcome problems related to the limited opportunity for speaking practice and insufficient cultural contents in the English materials. Classroom observations and interviews with 22 students and the lecturer revealed that this cultural text-based intercultural teaching was practical to improve the students’ ICC. The integration of cultural texts in various forms: pictures, mind-maps, reading passages, and videos relevant to the subject field, enables the students to interact indirectly with the cultures of people from diverse communities. Answering questions and discussing language and cultural elements as well as the contents of the texts shapes their critical thinking. Their achievement in the role-play is the reflection of their improved ICC and shows their enhanced English skills. Nevertheless, the students’ limited grammatical knowledge and lack of writing practice became constraints during their writing test. Further studies might investigate the solution for this problem, especially related to the effectiveness of this intercultural teaching in other subject areas.