bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-Care Practices Among Adult Type 2 Diabetes Patients With and Without Peripheral Neuropathy: A Cross-Sectional Study at Tertiary Healthcare Settings in Ethiopia
Authors: Gode Mezgebu , Aga Fekadu , Hailu Aklil 
Published: June 2021

Background Type 2 diabetes mellitus (T2D) has become a global health challenge. Diabetic peripheral neuropathy (DPN) is one of the common comorbidities of T2D that may affect the ability to perform diabetes self-care. Purpose To compare self-care practices between adult T2D patients with and without comorbid DPN and identify factors predicting self-care practices. Methods In this cross-sectional study, conducted at tertiary hospitals in Ethiopia, a total of 216 (108 with DNP and 108 without DNP) participants completed an interviewer-administered questionnaire including measures of diabetes self-care practices, self-evaluated peripheral neuropathy, self-efficacy, diabetes knowledge, and social support. Results Adult T2D patients with comorbid DPN had lower dietary (P< 0.001), exercise (P< 0.001), blood glucose testing (P = 0.001), and foot (P = 0.007) self-care practice than those without DPN. Social support is a significant predictor of dietary self-care in both groups while predicting foot self-care and blood glucose testing in those with comorbid DPN. Moreover, occupation, education, and having a glucometer are significant predictors of diabetes self-care practice in both groups. Conclusion This study found that adult T2D patients with comorbid DPN have poorer diabetes self-care practice than those without comorbid DPN. Interventions should focus on addressing social support and access to a glucometer in order to improve diabetes self-care practices in adult T2D patients with comorbid DPN.
Obtaining the Best Possible Medication History at Hospital Admission: Description of a Pharmacy Technician-Driven Program to Identify Medication Discrepancies
Authors: Kabir Rubiya , Liaw Samantha , Cerise Jane , Yi Jungen , Mulvany Colm , Qiu Michael , Beizer Judith L. , Sinvani Liron D. 
Published: June 2021

Purpose: Describe the process of obtaining the best possible medication history (BPMH) by Certified Pharmacy Technicians (CPhTs) on hospital admission to identify medication discrepancies. Methods: Cross-sectional, descriptive study conducted between December 2016 and June 2017 at a quaternary center in New York, including all patients 18 years and older admitted to the medicine service through the Emergency Department (ED) and seen by a CPhT. CPhTs obtained the BPMH using a systematic approach involving a standardized interview, checking medications with secondary sources and updating the electronic health record (EHR). Medication discrepancies were identified and categorized by type and risk. Summary statistics were provided as average and standard deviation (SD) for continuous variables, and as frequencies and percentages for categorical variables. Multivariable regression was used to test for associations between patient factors and presence of a medication discrepancy. Results: Of the 3,087 patient visits, the average age was 69 (SD 17.8), 54% were female (n = 1652) and 65% white (n = 2017); comorbidity score breakdown was: 0 (25%, n = 757), 1-2 (33%, n = 1023), 3-4 (23%, n = 699), > 4 (20%, n = 608). The average number of home and discharge medications were 10 (SD 6.1) and 10 (SD 5.4), respectively. The average time spent obtaining the BPMH was 30.6 minutes (SD 12.9). 69% of patients (n = 2130) had at least 1 discrepancy with an average of 4.2 (SD 4.6), of which 43% (n = 920) included high-risk medications. Having a medication discrepancy was associated with a higher number of home medications (p < 0.0001) comorbidities (p < 0.0001), and source of information (p < 0.04). Conclusion: Obtaining the BPMH by CPhTs on hospital admission frequently identifies medication discrepancies. Further studies are needed to evaluate the association between obtaining the BPMH and clinical outcomes.
Publication of Pharmacy Residency Research: A 12-Year Cohort From an Academic Medical Center
Authors: Swan Joshua T. , Rizk Elsie , Kwak Namhee , Guastadisegni Jessica , Thompson-Moore Nathaniel , Liebl Michael G. 
Published: June 2021

Background: Pharmacy residency programs provide research training experiences to residents, and publication is considered an indicator of high-quality research experiences. Objective: This study described attributes of pharmacy residents, residency programs, and residency major research projects and their associations with the outcome of publication in a peer-reviewed journal. Methods: Pharmacy residents who graduated from one academic medical center between 2001 and 2012 were invited to participate via an electronic survey distributed in February 2014. The survey collected attributes of the resident, residency program, and research project. The outcome of publication was self-reported by residents in 2014 and updated in July 2019 using a validated search strategy. Results: This study included 53 resident graduates representing 66 major pharmacy residency projects. Eighteen (27%) projects were published, occurring at an average of 13.8 months after residency graduation. The outcome of publication was more likely for residents with human subjects research experience prior to PGY1 training, residency programs that cultivated resident expertise in Institutional Review Board submission and statistical analysis, and projects with Institutional Review Board approval, a larger number of co-investigators, non-pharmacy co-investigators, and a larger sample size. Conclusion: This cohort of residents, programs, and projects at an academic medical center identified many modifiable attributes that were associated with successful publication of resident research projects. Unfortunately, residency projects rarely used study design features that attenuate bias. Residents and preceptors were perceived as having limited expertise with statistical analysis and database management, which underscores the need to develop research infrastructure to enhance research training for pharmacy students, residents, and preceptors.
The effect of attitude towards work on professional commitment
Authors: Tuna Rujnan , Sahin Safiye 
Published: June 2021

Background: Professional commitment, which constitutes one of the criteria of the professionalisation process, is directly affected by attitude towards the work, constituting the content of nursing profession. Aim: This study was conducted to determine the effect of nurses’ attitudes towards work on their professional commitment. Methods: This study is a cross-sectional and analytical study. The data were collected from 293 nurses working at different units in a public hospital between April 2019 and May 2019. The data collection tool includes a 10-question participant information form, the Nurses’ Professional Commitment Scale and the Attitude Towards Work Scale. Variables were analysed using multiple linear regression. Results: The nurses obtained high scores from overall professional commitment and attitude towards work scales and their subscales. Significant differences were found in the scale total and its subscales caused especially by the variables of professional experience, position, income level and the status of willingly choosing the profession ( p < 0.05). Nursing professional commitment was predicted by ‘content of the work’, (β = 0.32, p < 0.01), ‘working conditions’ (β = 0.38, p < 0.01), ‘co-workers’ (β = 0.30, p < 0.01) and ‘compensation’ (β = 0.21, p < 0.01), which accounted for 25.6% of the variance in nursing professional commitment. Ethical considerations: Ethics committee approval and institutional permissions were obtained. The participants were informed about the study and written consent was obtained. Conclusions: The nurses who had an increasing duration of professional experience, were working in managerial position, found their income level sufficient and chose the profession willingly had higher professional commitment and attitudes towards work. In addition, a significant correlation was found between nurses’ professional commitment and their attitudes towards work, and nurses’ professional commitments were explained with their attitudes towards work. It is important to increase and strengthen the attitude towards work that affects nurses’ professional commitments.
Article 3(5) TEU a decade on: Revisiting ‘strict observance of international law’ in the text and context of other EU values
Authors: Dunbar Rupert 
Published: June 2021

Article 3(5) of the Treaty on the European Union concerns EU external relations and was a new provision of the Lisbon Treaty. It has been seized upon by scholars for its reference to ‘strict observance of international law’ by the EU in its relations with the wider world. However, recent case law in the Court of Justice of the European Union has demonstrated little movement towards this supposed ideal. This article supports the fact that rigid and unquestioning adherence to international law has not emerged in case law, particularly as Article 3(5) TEU also mandates that the Union ‘uphold and promote its values and interests’. By taking a broader view of both the text and context of Article 3(5) TEU in EU law as a whole, and through consideration of the limited demands international law places on domestic courts, the article argues that – contrary to current literature – a more expressly balanced approach towards respect for international law is required and should be nurtured in the case law.
A comparative study of teriflunomide and dimethyl fumarate within the Swedish MS Registry
Authors: Hillert Jan , Tsai Jon A , Nouhi Mona , Glaser Anna , Spelman Tim 
Published: June 2021

Background: Teriflunomide and dimethyl fumarate (DMF) are first-line disease-modifying treatments for multiple sclerosis with similar labels that are used in comparable populations. Objectives: The objective of this study was to compare the effectiveness and persistence of teriflunomide and DMF in a Swedish real-world setting. Methods: All relapsing-remitting multiple sclerosis (RRMS) patients in the Swedish MS registry initiating teriflunomide or DMF were included in the analysis. The primary endpoint was treatment persistence. Propensity score matching was used to adjust comparisons for baseline confounders. Results: A total of 353 teriflunomide patients were successfully matched to 353 DMF. There was no difference in the rate of overall treatment discontinuation by treatment group across the entire observation period (hazard ratio (HR) = 1.12; 95% confidence interval (CI) = 0.91–1.39; p = 0.277; reference = teriflunomide). Annualised relapse rate (ARR) was comparable ( p = 0.237) between DMF (0.07; 95% CI = 0.05–0.10) and teriflunomide (0.09; 95% CI = 0.07–0.12). There was no difference in time to first on-treatment relapse (HR = 0.78; 95% CI = 0.50–1.21), disability progression (HR = 0.55; 95% CI = 0.27–1.12) or confirmed improvement (HR = 1.17; 95% CI = 0.57–2.36). Conclusion: This population-based real-world study reports similarities in treatment persistence, clinical effectiveness and quality of life outcomes between teriflunomide and dimethyl fumarate.
Efficacy of Diagnosing Carpal Tunnel Syndrome Using the Median Nerve Stenosis Rate Measured on Ultrasonographic Sagittal Imagery: Clinical Case-Control Study
Authors: Okura Toshiyuki , Sekimoto Tomohisa , Matsuoka Tomomi , Fukuda Hajime , Hamada Hiroaki , Tajima Takuya , Chosa Etsuo 
Published: June 2021

Background The purpose of the present study was to evaluate the usefulness of the median nerve stenosis rate (MNSR) measured on sagittal sonographic images of the median nerve in the diagnosis of carpal tunnel syndrome (CTS). Methods The study population consisted of 45 hands from 37 patients with idiopathic CTS (CTS group), and 60 hands from 35 asymptomatic healthy subjects (control group). Carpal tunnel syndrome was diagnosed by clinical findings and positive electrophysiological study results. All patients and control subjects underwent ultrasonographic examination. At the carpal tunnel level, the transducer was placed longitudinally to the median nerve, and an image of the longitudinal median nerve was obtained. The minimum median nerve diameter (MND) was measured at the middle part of the capitate level, while the maximum MND was measured at the distal radioulnar joint level. The MNSR was calculated as (1 – minimum MND/maximum MND) × 100 (%). The cross-sectional area of the median nerve was also measured at the level of the pisiform. Results On longitudinal sonographic images, the MNSR was significantly larger in the CTS group than the control group. When the cut-off value of the MNSR was 26.73%, the sensitivity and specificity were 91.1% and 80%, respectively. The area under the receiver operating characteristic curve was larger for the MNSR than for the cross-sectional area. Conclusion The results suggest that the MNSR proposed in the present study may be useful as an auxiliary method for CTS diagnosis on ultrasonographic examination.
Application of digital subtraction angiography in canine hindlimb arteriography
Authors: Wang Xue , Li Lubin , Wang Chengwei , Zhang Shiyong , Wang Jie , Chen Tiannan 
Published: June 2021

Objectives Research in the field of lower extremity vascular disease has increased in popularity over the years. To adequately characterize and validate the effectiveness of vascular interventions, in vivo experimentation in large animals is required. Thus, it is necessary to find a method to detect the shape and density of blood vessels in the lower extremities that can evaluate and verify the treatment measures’ effectiveness and have high accuracy and repeatability. This study characterized factors that determined both the accuracy and overall value of digital subtraction angiography in lower limb arteriography using a canine animal model. Methods Six beagle dogs were anesthetized and immobilized on the motorized table. The femoral artery was accessed using an indwelling needle. A bolus of contrast agent was injected into the access site, and digital subtraction angiography with bolus chase technology was used to collect contrast images for analysis. At the end of the procedure, the anesthetized dogs were euthanized using an overdose of potassium chloride. After confirming the euthanasia of the dogs, the cadavers were taken to the experimental animal center of Xinjiang Medical University and processed by qualified institutional personnel. Results The final arteriographic images of the hind limbs from all six dogs were precise, and the branches of small vessels could be distinguished without any visible artifacts. Conclusions These results suggested that arteriography using digital subtraction angiography could reveal the shape and density of blood vessels in canine animal models. This method has great potential to significantly improve research related to limb ischemia due to its simple and reproducible results.
Estimating somatic maturity in adolescent soccer players: Methodological comparisons
Authors: Salter Jamie , Cumming Sean , Hughes Jonathan D , De Ste Croix Mark 
Published: June 2021

Purpose Monitoring maturation facilitates effective talent development. Various methods of maturity estimation exist with limited knowledge of concordance between methods. This study aims to establish agreement between methods of varied constructs to predict maturity status and compare concordance of methods to categorise players using established thresholds. Methods This study compared four maturity equations using anthropometrical data from 113 male adolescent soccer players (mean ±SD; age, 14.3 ± 1 years) from two academies. Conservative (±1 year) and less conservative (±0.5 years) circa-PHV thresholds were employed. Results Analysis indicates tight (±0.3 year) agreement between maturity offset methods (MO), but broader agreement between MO and predicted adult height methods (–1.5 to 1 year). However, Kappa Cohen k suggests moderate to substantial (44%–67%) and fair to moderate (31%–60%) concordance between methods when using the conservative and less conservative circa-PHV thresholds respectively. Conclusion Despite MO equation iterations claiming to reduce systematic error, they provide very similar estimations. Additionally, practitioners should not use maturity offset and predicted adult height methods interchangeably and are encouraged to apply either method consistently when looking to estimate maturity status or biologically calssify players.
Treating High-Risk TIA and Minor Stroke Patients With Dual Antiplatelet Therapy: A National Survey of Emergency Medicine Physicians
Authors: Liberman Ava L. , Lendaris Andrea R. , Cheng Natalie T. , Kaban Nicole L. , Rostanski Sara K. , Esenwa Charles , Kummer Benjamin R. , Labovitz Daniel L. , Prabhakaran Shyam , Friedman Benjamin W. 
Published: June 2021

Background: Treatment with aspirin plus clopidogrel, dual antiplatelet therapy (DAPT), within 24 hours of high-risk transient ischemic attack (TIA) or minor stroke symptoms to eligible patients is recommended by national guidelines. Whether or not this treatment has been adopted by emergency medicine (EM) physicians is uncertain. Methods: We conducted an online survey of EM physicians in the United States. The survey consisted of 13 multiple choice questions regarding physician characteristics, practice settings, and usual approach to TIA and minor stroke treatment. We report participant characteristics and use chi-squared tests to compare between groups. Results: We included 162 participants in the final study analysis. 103 participants (64%) were in practice for >5 years and 96 (59%) were at nonacademic centers; all were EM board-certified or board-eligible. Only 9 (6%) participants reported that they would start DAPT for minor stroke and 8 (5%) reported that they would start DAPT after high-risk TIA. Aspirin alone was the selected treatment by 81 (50%) participants for minor stroke patients who presented within 24 hours of symptom onset and were not candidates for thrombolysis. For minor stroke, 69 (43%) participants indicated that they would defer medical management to consultants or another team. Similarly, 75 (46%) of participants chose aspirin alone to treat high-risk TIA; 74 (46%) reported they would defer medical management after TIA to consultants or another team. Conclusion: In a survey of EM physicians, we found that the reported rate of DAPT treatment for eligible patients with high-risk TIA and minor stroke was low.
Assessing the accuracy of computed tomography in detecting bony invasion and thickness of squamous cell carcinoma of the scalp
Authors: Boylan Conor T , Gaston Michaela S , Merwaha Puja , Nader Kurdow , Rayatt Sukhbir 
Published: June 2021

Objectives The aim of this study was to ascertain the accuracy of computed tomography (CT) in assessing the presence of bony involvement and thickness of squamous cell carcinoma (SCC) of the scalp. Methods A single-centre retrospective chart review was carried out. Inclusion criteria were scalp SCC, CT between January 2008 and 2018, and the availability of a reference test. Reference tests were either histology, surgical notes or clinical notes. Tabular assessment of accuracy was performed and Student’s t-test, Mann–Whitney U test and Fisher exact test were used in univariable analysis. Accuracy of thickness measurement was calculated using the limits of agreement method, and linear regression was used to examine trend. Results Thirty-nine patients were included. Most patients were male (74.4%), white (97.4%), not immunosuppressed (66.6%) and had poorly differentiated tumours (33.3%). The most common tumour sites were the vertex (28.2%) and temporal region (23.1%). Sensitivity of CT in detecting presence or absence of bony invasion of scalp SCC was 76.9% (95% CI 46.2–94.9%) and specificity was 96.2% (95% CI 80.4-99.9%). Overall accuracy was 89.7% (95% CI 75.8–97.1%), positive predictive value was 90.1% (95% CI 58.7–99.8%) and negative predictive value was 89.3% (95% CI 71.8–97.7%). No significant differences were found comparing patients with an accurate or inaccurate CT scan. Thickness on CT was found to be consistent with histological thickness at the 95% confidence level. Conclusions CT is accurate at assessing the presence of bony involvement and thickness of scalp SCC. This study was limited somewhat by small sample size.
Mapping of electrodermal activity (EDA) during outdoor community-level mobility tasks in individuals with lower-limb amputation
Authors: Cho Erina , Wakeling James M , Pousett Brittany , Pollock Courtney L 
Published: June 2021

Introduction Balance confidence and perception of task challenge is an important construct to measure in rehabilitation of people with lower-limb amputation (LLA). Measurement of electrodermal activity (EDA) captures physiological arousal responses reflecting an individual’s perceived challenge in a task. This study explores the feasibility of the use of EDA during outdoor walking tasks to capture task-specific physiological arousal changes associated with perception of challenge in people with amputation. Objective To develop and demonstrate feasibility of a portable EDA/GPS system mapping physiological arousal while challenging walking balance outdoors in individuals with LLA and controls. Methods Sixteen people (eight with LLA and eight age-/sex-matched controls) completed an outdoor walking course in the community (3 laps). A battery-powered portable device was developed containing EDA/GPS sensors with data logged on a microcontroller. Phasic EDA response was extracted from EDA signal to explore the physiological arousal response to walking tasks. Results Physiological arousal demonstrated task-specific modulation with ascending stairs without a handrail showing higher levels of phasic EDA than walking on a paved incline (p = 0.01) or a gravel decline (p = 0.01) in people with LLA. While evidence of habituation over repeated trials was shown in controls with lap 1 of walking down a gravel decline showing higher levels of phasic EDA than lap 3 (p = 0.01). Phasic EDA maps, representative of arousal levels throughout the walking course, showed individual-specific response. Conclusion Mapping of EDA during outdoor walking is feasible. Modulation of physiological arousal between outdoor walking tasks and over repeated trials is suggestive of clinical utility. Further research is warranted to explore how EDA may be incorporated into assessment of response to outdoor walking amongst individuals following LLA.