bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of an advanced practice nurse‐led delirium education and training programme
Authors: Lieow J.L.M. , Chen F.S.M. , Song G. , Tang P.S. , Kowitlawakul Y. , Mukhopadhyay A. 
Published: May 2019

AimTo develop an education and training programme to enhance bedside nurses’ knowledge, competency and compliance in accurately performing delirium screening in intensive care units.BackgroundDelirium in intensive care units is associated with several poor patient outcomes. Delirium detection can be improved by enhancing nurses’ knowledge, competency and compliance in accurately performing delirium screening.MethodsA descriptive quantitative study with pretest–post‐test design was adopted. There were 245 nurses from five intensive care units who participated in the study. Multiple‐choice questions were used to assess nurses’ knowledge change before and after the education programme. Competency was assessed before and 2 months after the programme by simulation with a standardized patient, followed by real patients at the bedside. Compliance data on screening were collected from the documentation of the Richmond Agitation–Sedation Scale and the Confusion Assessment Method for the ICU before and 3 and 10 months after the programme. Data collection took 1 year, from June 2014 to May 2015.ResultsDespite nurses’ improved knowledge and good competency, delirium screening documentations after 3 months were poor. However, screening documentations subsequently improved when measured at 10 months, following further emphasis by the senior nursing staff.Implications for nursing practice and policyNursing administrators and bedside nurses need to be involved in the policy‐making process and plan a training programme for the new nursing staff in the high‐risk areas. A short refreshment course should be offered to the nursing staff 3 months after the initial training programme.ConclusionsImproved knowledge and competency in assessment did not improve compliance and documentation of delirium screening. Therefore, it is important to reinforce nurses’ compliance of delirium screening over time.
How service‐users with intellectual disabilities understand challenging behaviour and approaches to managing it
Authors: Clarke Aoife , Dagnan Dave , Smith Ian C. 
Published: May 2019

AbstractBackgroundThis study explored understandings that service‐users with intellectual disabilities and challenging behaviour held around their behaviour, what shaped these understandings, and the relationship between how behaviours are managed and well‐being.MethodsEight participants (three female, five male) partook in individual semi‐structured qualitative interviews. Interviews were transcribed and analysed using interpretative phenomenological analysis.ResultsThree master themes emerged from this analysis: (a) challenging behaviour can be explained via an internal or external frame of reference, with each framework having different implications for how participants attempted to manage behaviour. (b) Positive relationships provide a long‐term buffer to challenging behaviour, with positive relationships with family, staff and peers operating through different mechanisms to achieve this. (c) A greater ability to exert power and control in day‐to‐day life was perceived to reduce challenging behaviour in the long term.ConclusionsImplications for practice are discussed.
Is Fair Pricing Possible? An Analysis of Participating Life Insurance Portfolios
Authors: Orozco‐Garcia Carolina , Schmeiser Hato 
Published: May 2019

AbstractAbstractPooling individual customers with different inception dates into a single legal entity may generate intergenerational subsidies that are accentuated when the insurer has limited liability. This article aims to investigate whether an insurer can charge fair premiums while simultaneously ensuring identical levels of default risk—measured by the value of the default put option ratio—for all generations. The decision variables for achieving these goals are asset allocation and the amount of the insurer's equity capital. We propose an accounting framework where the insurer controls for insolvency positions annually after the first contract is issued. Additionally, a run‐off framework is developed where the insurer does not declare bankruptcy in case of an insolvency, but instead stops issuing new policies and runs the company until the assets are exhausted or the last policyholder is paid. We find that intergenerational subsidies and different levels of default risk per generation cannot be avoided whenever we face a positive default risk. © 2014 Wiley Periodicals, Inc. Jrl Fut Mark
Latitudinal Gradient of UV Attenuation Along the Highly Transparent Red Sea Basin
Authors: Overmans Sebastian , Agustí Susana 
Published: May 2019

AbstractThe tropical and subtropical oceans experience intense incident ultraviolet radiation (280–400 nm) while their water columns are thought to be highly transparent. This combination represents a high potential for harmful effects on organisms, yet only few reports on the UV penetration properties of oligotrophic tropical waters exist. Here, we present the pattern of UV attenuation over a wide latitudinal range of the oligotrophic Red Sea. We recorded spectroradiometer profiles of PAR and UV, together with chlorophyll‐a (Chl‐a) and light absorption by chromophoric dissolved organic matter (CDOM) to determine the contribution of phytoplankton and CDOM toward UV attenuation. Transparency to UV exhibited a distinct latitudinal gradient, with the lowest and highest diffuse attenuation coefficients at 313 nm (Kd (313)) of 0.130 m−1 and 0.357 m−1 observed at the northern coast off Duba, and in the south close to the Farasan islands, respectively. Phytoplankton and CDOM both modulated UV attenuation, but CDOM was found to be the key driver despite the lack of riverine inputs. We confirm that ultraviolet radiation can reach deeper into the Red Sea than previously described, which means its potential to act as a stressor and selective driver for Red Sea organisms may have been underestimated to date.
The feedback‐related negativity indexes prediction error in active but not observational learning
Authors: Burnside Rebecca , Fischer Adrian G. , Ullsperger Markus 
Published: May 2019

AbstractReinforcement learning (RL) theory states that learning is driven by prediction errors (PEs)—the discrepancy between the predicted and actual outcome of an action. When participants learn from their own actions, PEs correlate with the feedback‐related negativity (FRN), but it is not clear if the FRN reflects a PE in observational learning. We use a model‐based regression analysis of single‐trial event‐related potentials to determine if the FRN in observational learning is PE driven. Twenty participants (16 female) learned the stimulus‐outcome contingencies for a probabilistic three‐armed bandit task. They played in pairs, with the acting and observing player switching every one to three trials. An RL‐learning algorithm was fit to participants' choices in the task to extract individual PE estimates for every trial of the experiment. In the acting condition, model‐estimated PEs covaried positively with neural signal at electrode FCz, 200–350 ms after outcome presentation, which is a typical time frame for the FRN. There was no PE effect in the observation condition in the same time frame. From 300 ms the outcome correlated negatively with the frontal P300 component at FCz and parietal P300 at Pz. At Pz the effect was greater in the acting than the observing condition. The frontal and parietal P300 components have been linked to attentional reorienting and stimulus value updating, respectively. These findings indicate that observed outcomes undergo processing that is distinguishable from directly experienced outcomes in the time windows of the FRN and P3b but that attention dedicated to the two outcomes types is comparable.
Shoulder internal and external rotation strength and prediction of subsequent injury in water‐polo players
Authors: Hams Andrea H. , Evans Kerrie , Adams Roger , Waddington Gordon , Witchalls Jeremy 
Published: May 2019

Water‐polo players have greater isokinetic shoulder strength than age‐matched controls. Due to the repetitive demands of throwing, however, water‐polo players demonstrate an altered strength ratio, with greater internal rotation (IR) strength relative to external rotation (ER). The relationship between shoulder strength and risk of shoulder injury is unknown. In addition, the effect on test position for strength testing on the reliability of handheld dynamometry (HHD) in this population is not known. The aims were to determine the: (a) Inter‐rater reliability of HHD testing of IR and ER strength in two positions: neutral and 90°abduction‐90°ER (90‐90) and (b) relationship between preseason shoulder strength and occurrence of future injury in sub‐elite water‐polo players. Two assessors measured shoulder IR and ER strength using HHD in 15 water‐polo players across two testing days. Athletes were followed over a 6‐month period, and injury was assessed and recorded by the team physiotherapist. Measurement of water‐polo players' isometric IR and ER strength in the clinical setting had good to excellent inter‐rater reliability; however, systematic error was observed in the neutral position but not the 90‐90 position. Irrespective of testing position, the neutral and 90‐90 test position showed a significant difference (P = 0.01) in absolute preseason IR and ER mean strength between prospectively injured and non‐injured players. There was no significant difference in strength ratio or strength normalized for body mass index. These results suggest that preseason strength testing may help identify players at risk of in‐season shoulder injury.
Mandatory occupational welfare: Severance pay as an unemployment compensation instrument
Authors: Ozkan Umut Riza 
Published: May 2019

AbstractThis study focuses on the conceptual and empirical development of severance pay (SP)/redundancy pay schemes established through centralized collective agreements (in Nordic countries) and legislation for unemployment compensation. It argues that these “mandatory” occupational welfare benefits have been neglected in social policy debates due to the ambiguity in their conceptualization, overemphasis on their cost implications, and the nonrecognition of their redistributive effects. The study offers quantitative indicators to analyse SPsapos; redistributive structure (coverage,generosity, and benefitequality) during the Global Recession in Canada, the United Kingdom, Australia, Ireland, France, Germany, Austria, Spain, Portugal, Denmark, and Sweden. The findings demonstrate that SP schemes possess distinctive elements in Southern European, Continental European, Anglo‐Saxon, and Nordic clusters. The indicators are also used to analyse the interplay between these schemes and unemployment insurance/assistance in these clusters.
Epiglottopexy for the treatment of epiglottic retroversion in 2 horses
Authors: Curtiss Alexandra L. , Parente Eric J. 
Published: May 2019

AbstractObjectiveTo report an epiglottopexy technique for the treatment of epiglottic retroversion (ER) in 2 horses.Study designCase report.AnimalsA 2‐year‐old thoroughbred gelding and a 6‐year‐old standardbred gelding, both with ER.MethodsEpiglottic retroversion was diagnosed via exercising endoscopic examination in both horses. Epiglottopexy technique was performed in both cases.ResultsBoth horses returned to previous racing class within 1 year after surgery. Repeat exercising endoscopy of 1 horse 6 months postoperatively revealed resolution of the ER.ConclusionEpiglottopexy should be considered for treatment of ER in the equine athlete.Clinical significancePreviously reported surgical techniques for ER in the equine athlete have not resulted in horses returning to previous performance level. The technique reported here resulted in both horses achieving athletic status.
Electronic palliative care coordination systems (EPaCCS): a systematic review
Authors: Leniz Javiera , Weil Anna , Higginson Irene J , Sleeman Katherine E 
Published: May 2019

ObjectivesTo systematically search, evaluate and report the state of the science of electronic palliative care coordination systems (EPaCCS).MethodsWe searched CINAHL, MEDLINE, Embase, the Cochrane Library and grey literature for articles evaluating or discussing electronic systems to facilitate sharing of information about advance care plans. Two independent review authors screened full‐text articles for inclusion, assessed quality and extracted data.ResultsIn total, 30 articles and reports were included. Of the 26 articles, 14 were ‘expert opinion’ articles (editorials, discussion papers or commentaries), 9 were observational studies (cross-sectional, retrospective cohort studies or service evaluations), 2 were qualitative studies and 1 a mixed-methods study. No study had an experimental design. Quantitative studies described the proportion of people with EPaCCS dying in their preferred place, and associations between EPaCCS use and hospital utilisation. Qualitative, mixed-methods studies and reports described the burden of inputting data and difficulties with IT systems as main challenges of implementing EPaCCS.ConclusionsMuch of the current scientific literature on EPaCCS comprises expert opinion, and there is an absence of experimental studies evaluating the impact of EPaCCS on end-of-life outcomes. Given the current drive for national roll-out of EPaCCS by 2020, it is essential that rigorous evaluation of EPaCCS is prioritised.
Design-Level and Code-Level Security Analysis of IoT Devices
Authors: Tabrizi Farid Molazem , Pattabiraman Karthik 
Published: May 2019

The Internet of Things (IoT) is playing an important role in different aspects of our lives. Smart grids, smart cars, and medical devices all incorporate IoT devices as key components. The ubiquity and criticality of these devices make them an attractive target for attackers. Therefore, we need techniques to analyze their security so that we can address their potential vulnerabilities. IoT devices, unlike remote servers, are user-facing and, therefore, an attacker may interact with them more extensively, e.g., via physical access. Existing techniques for analyzing security of IoT devices either rely on a pre-defined set of attacks and, therefore, have limited effect or do not consider the specific capabilities the attackers have against IoT devices.
Security analysis techniques may operate at the design-level, leveraging abstraction to avoid state-space explosion, or at the code-level for ensuring accuracy. In this article, we introduce two techniques, one at the design-level, and the other at the code-level, to analyze security of IoT devices, and compare their effectiveness. The former technique uses model checking, while the latter uses symbolic execution, to find attacks based on the attacker’s capabilities. We evaluate our techniques on an open source smart meter. We find that our code-level analysis technique is able to find three times more attacks and complete the analysis in half the time, compared to the design-level analysis technique, with no false positives.
Cross-limb dynamics of postural tremor due to limb loading to fatigue: neural overflow but not coupling
Authors: Morrison Steven , Kavanagh Justin J. , Newell Karl M. 
Published: May 2019

Many experiments have shown independence of the index finger dynamics under bilateral postural tremor protocols. Here we investigated in young adults the dynamics of bilateral multidirectional postural tremor and forearm muscle activity under the progressively fatiguing conditions supporting an external weight to the point of induced postural failure. When no loads were applied, tremor in the vertical (VT) and mediolateral (ML) directions was similar with prominent peaks within 2- to 4-Hz and 8- to 12-Hz bandwidths. Contrastingly tremor in the anterior-posterior (AP) direction was characterized by a single peak between 0 and 2 Hz. Although no tremor coupling occurred cross limbs, strong within-limb coupling was found between ML and VT directions when no loads were applied (coherence range: 0.77–0.85), implying that these oscillations are related and likely derived from mechanical sources. Applying an external load to the index finger(s) led to significant increases in the amplitude of VT tremor and EMG activity within that limb but also caused increases in tremor directions not aligned with the gravitational vector (AP and ML). Significant increases in VT and ML tremor and EMG activity in the contralateral (unloaded) limb were also found when a single index finger was loaded; however, this bilateral increase did not align with increases in interlimb coupling (coherence <0.21). The effects of fatigue caused by prolonged loading were widespread, affecting tremor and muscle activity in both limbs through a combination of neural and mechanical mechanisms. The single- and dual-limb loading to fatigue increased neural overflow but not tremor coupling between the index fingers. NEW & NOTEWORTHY This study investigated bilateral multidirectional tremor under unloaded and loaded conditions. We found that tremor in the mediolateral and vertical directions within a limb were strongly coupled, a result not reported previously. Furthermore, when holding a weight to failure, tremor in all directions increased. Tremor also increased in the contralateral (unloaded) limb despite no interlimb coupling. This contralateral increase in tremor following loading a limb until fatigue is hypothesized to stem from motor-overflow effects.
ФАРМАКОЛОГІЧНЕ ОБҐРУНТУВАННЯ ВИБОРУ АКТИВНИХ ФАРМАЦЕВТИЧНИХ ІНГРЕДІЄНТІВ ДЛЯ МІСЦЕВОГО ЛІКУВАННЯ ОПІКІВ НА МОДЕЛІ АСЕПТИЧНОЇ ОПІКОВОЇ РАНИ В ЩУРІВ
Authors: Vons B. V. , Grochovuy T. A. 
Published: May 2019

Вступ. Опіки – ушкодження тканин, викликані дією високої температури, хімічних речовин (кислот, лугів, солей важких металів), електричного струму, сонячних і рентгенівських променів, а також деяких медикаментозних засобів. Проблема лікування опікових ран як в Україні, так і в всьому світі є актуальною на сьогодні. Питома вага опіків становить від 5,6 до 10 %, вони займають третє місце в структурі загального травматизму. В Україні щорічно реєструють приблизно 80 тисяч опечених, з яких діти складають 10 % (так, у 2017 р. від опіків в Україні постраждало 7605 дітей). Тому створення нової групи оригінальних вітчизняних лікарських засобів, які б стимулювали регенераторні процеси шкіри та покращували загоєння опікових ран, актуальним на даний час.
Мета дослідження – вивчити лікувальну ефективність вибраних активних фармацевтичних інгредієнтів при опіковій травмі.
Методи дослідження. Експерименти проводили на статевозрілих щурах лінії Вістар обох статей. Термічні опіки II ступеня (відповідно до клінічної класифікації) відтворювали на поголеній ділянці шкіри спини в асептичних умовах під тіопенталовим наркозом. З метою створення м’якого лікарського засобу для місцевого лікування опіків проведено скринінг вибраних зразків з різними активними фармацевтичними інгредієнтами хімічного, природного та біологічного походження.
Результати й обговорення. У результаті проведення біологічних досліджень на моделі поверхневої опікової рани встановлено високу ранозагоювальну активність м’якої лікарської форми на основі водного витягу з кріоліофілізованої ксенодерми шкіри свині. Процес загоєння триває в середньому 17 днів. Цей діючий компонент сприяв скороченню термінів загоєння опіків на 4 доби порівняно з групою контрольної патології та на 2–3 доби порівняно з іншими субстанціями, які підлягали експериментальному дослідженню.
Висновок. Доведено ефективність використання біологічного матеріалу, а саме кріоліофілізованої ксенодерми шкіри свині, як активного фармацевтичного інгредієнта для місцевого лікування опіків.
The tadpole of the Narrow-mouthed Frog Microhyla fissipes from Vietnam (Anura: Microhylidae)
Authors: HENDRIX RALF , GAWOR ANNA , VENCES MIGUEL , ZIEGLER THOMAS 
Published: May 2019

Based on recent mtDNA analyses, Microhyla fissipes Boulenger was removed from the synonymy with M. ornata (Duméril & Bibron) by Matsui et al. (2005),where previously it had been placed by Parker (1934). M. fissipes inhabits southern China (type locality: Taiwan) and large parts of Southeast Asia, including the north-ern Malay Peninsula (Matsui et al. 2005). As a contribution to future comprehensive revisions of larval mor-phology of Microhyla Tschudi, we here provide a detailed description of external morphology of reliably identified tadpoles recently collected from the Truong Son mountain range, central Vietnam.
Neurology residents’ knowledge of the management of headache
Authors: Kristoffersen Espen Saxhaug , Faiz Kashif Waqar , Winsvold Bendik Slagsvold 
Published: May 2019

Background In Norway, as in most other countries, the training program for clinical neurology has no mandatory headache program. Knowledge in headache management must therefore be acquired during everyday clinical training. The objectives of this study were to investigate neurology residents’ knowledge of headache. Methods A questionnaire survey was undertaken among neurology residents in Norway. Results All 17 neurological departments in Norway participated, and 143 residents responded (86%). Sixty percent were women, mean age was 32.5 years, and the respondents had an average of 28 months clinical training in neurology. Fifty-six percent knew the approximate prevalence of migraine and chronic headache. Thirty-seven percent asked their patients about disability, quality of life, and social functioning at every consultation. Further, 72% would prescribe prophylaxis for chronic tension-type headache and 97% for very frequent migraine. One third wrongly stated that use of the most common headache prophylactics could lead to medication-overuse headache. Headache diaries were used regularly by 63% for diagnostic purposes, and 73% requested an MRI for all long-lasting headaches referred to neurological outpatient clinics. Conclusion Although a major public health problem, headache knowledge is moderate at best, and its management clearly varies. There is an unmet need for a better and more structured headache training program in Norway.
Neurovascular Lesions in Pediatric Epilepsy
Authors: Kassiri J. , Rajapakse T. , Wheatley M. , Sinclair D. B. 
Published: May 2019

Introduction: Neurovascular lesions are rare and understudied in the pediatric population. Their initial presentation can range from seizures to focal neurologic deficits, as well as headaches. The goal of this study was to examine the clinical presentation and natural history of neurovascular lesions in children with epilepsy. Methods: We reviewed all pediatric epilepsy patients with neurovascular lesions diagnosed between 2006 and 2018 at the University of Alberta and the Stollery Children’s Hospital, Edmonton, Canada. Initial clinical presentation and brain imaging, as well as long-term epilepsy and postsurgical outcome, were assessed. Results: Of the 14 patients, 10 patients had an initial presentation of focal seizures with impaired awareness, whereas 2 patients presented with headache, 1 presented with visual field defects as well as chronic headaches, and 1 with decreased level of consciousness. Seven patients had cavernous angiomas, 6 had arteriovenous malformation, and 1 patient had an arteriovenous fistula. Notably, all patients with cavernous angiomas and 4 of 6 patients with arteriovenous malformations presented with seizures. Among 9 of the 14 who underwent neurovascular corrective surgery, all 9 patients required long-term antiepileptic treatment of at least 1 antiepileptic drug for seizure control after the operation. Conclusion: In this novel case series, we describe focal seizures as the initial presentation of pediatric neurovascular lesions. This clinical presentation appears to be independent of the type of neurovascular lesion. Furthermore, unlike our pediatric surgical patients with epilepsy due to other causes, seizure freedom following neurovascular surgery is limited, and patients require long-term antiepileptic treatment.