bluuebunny/crossref_metadata_2025_split huggingface dataset:
Problems and Their Solutions in a Multicultural Environment According to Pre-service Social Studies Teachers
Authors: Keskin Sevgi Coşkun 
Published: June 2018

Multiculturalism that is a natural consequence of the phenomenon of globalization is a reality that nations cannot ignore nowadays. The social studies course is of special importance at the point of multicultural education. Therefore, there is a need to educate teachers who will teach this lesson consciously and sensitively. This study was conducted to describe problems in a multicultural environment and solution proposals to them based on the discourses of pre-service social studies teachers. The phenomenological approach among qualitative research methods was used in the study. A semi-structured interview form was applied to 110 pre-service social studies teachers. As a result of the coding performed by taking expert opinions, it was determined that the vast majority of the pre-service teachers attributed meanings such as multinational population, the diversity of cultural values, and different races, languages, religions and ethnic structures to multiculturalism. At the point of problems in a multicultural environment, it was observed that they emphasized conflict, social differentiation and division, assimilation, constraints, difficulty of communication and cultural erosion. In the solution of these problems, they suggested regarding differences as wealth and providing education that contains multicultural values.
Treatment after traumatic shoulder dislocation: a systematic review with a network meta-analysis
Authors: Kavaja Lauri , Lähdeoja Tuomas , Malmivaara Antti , Paavola Mika 
Published: June 2018

ObjectiveTo review and compare treatments (1) after primary traumatic shoulder dislocation aimed at minimising the risk of chronic shoulder instability and (2) for chronic post-traumatic shoulder instability.DesignIntervention systematic review with random effects network meta-analysis and direct comparison meta-analyses.Data sourcesElectronic databases (Ovid MEDLINE, Cochrane Clinical Trials Register, Cochrane Database of Systematic Reviews, Embase, Scopus, CINAHL, Ovid MEDLINE Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Ovid MEDLINE Daily, DARE, HTA, NHSEED, Web of Science) and reference lists were searched from inception to 15 January 2018.Eligibility criteria for selecting studiesRandomised trials comparing any interventions either after a first-time, traumatic shoulder dislocation or chronic post-traumatic shoulder instability, with a shoulder instability, function or quality of life outcome.ResultsTwenty-two randomised controlled trials were included. There was moderate quality evidence suggesting that labrum repair reduced the risk of future shoulder dislocation (relative risk 0.15; 95% CI 0.03 to 0.8, p=0.026), and that with non-surgical management 47% of patients did not experience shoulder redislocation. Very low to low-quality evidence suggested no benefit of immobilisation in external rotation versus internal rotation. There was low-quality evidence that an open procedure was superior to arthroscopic surgery for preventing shoulder redislocations.ConclusionsThere was moderate-quality evidence that half of the patients managed with physiotherapy after a first-time traumatic shoulder dislocation did not experience recurrent shoulder dislocations. If chronic instability develops, surgery could be considered. There was no evidence regarding the effectiveness of surgical management for post-traumatic chronic shoulder instability.
Measuring progress towards Sustainable Development Goal 3.8 on universal health coverage in Kenya
Authors: Barasa Edwine , Nguhiu Peter , McIntyre Di 
Published: June 2018

BackgroundThe inclusion of universal health coverage (UHC) as a health-related Sustainable Development Goal has cemented its position as a key global health priority. We aimed to develop a summary measure of UHC for Kenya and track the country’s progress between 2003 and 2013.MethodsWe developed a summary index for UHC by computing the geometrical mean of indicators for the two dimensions of UHC, service coverage (SC) and financial risk protection (FRP). The SC indicator was computed as the geometrical mean of preventive and treatment indicators, while the financial protection indicator was computed as a geometrical mean of an indicator for the incidence of catastrophic healthcare expenditure, and the impoverishing effect of healthcare payments. We analysed data from three waves of two nationally representative household surveys.FindingsThe weighted summary indicator for SC increased from 27.65% (27.13%–28.14%) in 2003 to 41.73% (41.34%–42.12%) in 2013, while the summary indicator for FRP reduced from 69.82% (69.11%–70.51%) in 2003 to 63.78% (63.55%–63.82%) in 2013. Inequities were observed in both these indicators. The weighted summary measure of UHC increased from 43.94% (95% CI 43.48% to 44.38%) in 2003 to 51.55% (95% CI 51.29% to 51.82%) in 2013.ConclusionSignificant gaps exist in Kenya’s quest to achieve UHC. It is imperative that targeted health financing and other health sector reforms are made to achieve this goal. Such reforms should be focused on both, rather than on only either, of the dimensions of UHC.
Stress and its causes in UK gastroenterologists: results of a national survey by the British Society of Gastroenterology
Authors: Gleeson Dermot , O’Shea Christopher , Ellison Howard , Tham Tony C , Douds Andrew C , Goddard Andrew F 
Published: June 2018

AimEvaluation of stress and its causes in UK gastroenterologists,DesignQuestionnaire emailed to all 1932 medical members of the British Society of Gastroenterology.ResultsOf 567 respondents (29%), 107 (20%) graded their stress level as 4 or 5 out of 5. Stress levels correlated inversely with self-reported happiness levels (r=−0.60; p<0.001) and with hours slept per night (r=−0.23; p<0.01) and correlated directly with % time off-duty thinking about work (r=0.46; p<0001) and with proportion of nights with broken sleep (r=0.30; p<0.01). Due to stress over the past year, 21% of respondents reported one of the following: consulting their general practitioner (7%), attending occupational health (5%), taking planned time off (7%), taking anxiolytics/antidepressants (6%) and considering suicide (5.5%). These respondents had higher stress and lower happiness levels than the remainder. Stress levels were higher in women and in those working full time but had no other demographic associations.The main causes of stress were excessive clinical work (ranked highest by 47% and most commonly patient-related administration), working conditions beyond control (ranked highest by 15% and most commonly inadequate information technology systems, workspace and secretarial staff) and conflict (ranked highest by 9%). Of eight potential factors, happiness with work showed the closest associations with overall happiness (positive) and overall stress (negative) levels. Talking to someone at work about stress was ranked difficult or impossible by 35%. The highest ranked suggested solutions were relief from some duties and mentoring.ConclusionsStress is common and has objective correlates in UK gastroenterologists. The main cause is excessive workload.
Effects of golf training on cognition in older adults: a randomised controlled trial
Authors: Shimada Hiroyuki , Lee Sangyoon , Akishita Masahiro , Kozaki Koichi , Iijima Katsuya , Nagai Kumiko , Ishii Shinya , Tanaka Masamichi , Koshiba Hitomi , Tanaka Tomoki , Toba Kenji 
Published: June 2018

BackgroundAlthough research indicates that a physically active lifestyle has the potential to prevent cognitive decline and dementia, the optimal type of physical activity/exercise remains unclear. The present study aimed to determine the cognitive benefits of a golf-training programme in community-dwelling older adults.MethodsWe conducted a randomised controlled trial between August 2016 and June 2017 at a general golf course. Participants included 106 Japanese adults aged 65 and older. Participants were randomly assigned to either a 24-week (90–120 min sessions/week) golf-training group or a health education control group. Postintervention changes in Mini-mental State Examination (MMSE) and National Centre for Geriatrics and Gerontology-Functional Assessment Tool scores were regarded as primary outcome measures. Secondary outcome measures included changes in physical performance and Geriatric Depression Scale (GDS) scores.ResultsA total of 100 participants (golf training, n=53; control, n=47) completed the assessments after the 24-week intervention period. The adherence to the golf programme was 96.2% (51/53 participants). Analysis using linear mixed models revealed that the golf training group exhibited significantly greater improvements in immediate logical memory (p=0.033), delayed logical memory (p=0.009) and composite logical memory (p=0.013) scores than the control group. However, no significant changes in MMSE, word memory, Trail Making Test or Symbol Digital Substitution Test scores were observed. In addition, no significant changes in grip strength, walking speed or GDS were observed.ConclusionsGolf-based exercise interventions may improve logical memory in older adults, but no significant changes in other cognitive tests. Further follow-up investigations are required to determine whether the observed effects are associated with delayed onset of mild cognitive impairment or Alzheimer’s disease in older adults.Trial registration numberUMIN-CTR UMIN000024797; Pre-results.
Psychosocial and clinical outcomes of percutaneous versus surgical pulmonary valve implantation
Authors: Andresen Brith , Døhlen Gaute , Diep Lien My , Lindberg Harald , Fosse Erik , Andersen Marit Helen 
Published: June 2018

ObjectiveThis prospective non-randomised study was performed to compare the psychosocial function and clinical outcomes following surgical and percutaneous implantation of a pulmonary valve at 3 months and 1 year after treatment.MethodsAll patients were consecutively admitted for treatment by either method from June 2011 to October 2014. The data of 20 patients treated with the percutaneous technique and 14 patients treated with open heart surgery were compared. Psychosocial function was measured by the Achenbach System of Empirically Based Assessment (ASEBA). We used linear mixed-effect models to investigate group changes between the psychosocial function and clinical data of 34 patients with congenital pulmonary valve disease.ResultsA significant difference in favour of the percutaneous pulmonary valve implantation group was observed regarding the ASEBA scores, specifically in the Thought problems subscale at 1 year (p=0.015), Attention problems subscale at 3 months (p=0.016) and 1 year (p=0.007) after treatment. After adjustment for the right ventricle to pulmonary artery pressure gradient at 3 months, a significant change in the Attention problems subscale (p=0.038) was noted in the percutaneous group. The New York Heart Association functional score significantly improved in both groups. The measured right ventricle to pulmonary artery pressure gradient was reduced significantly in both groups at 1 year.ConclusionsBoth methods led to significant clinical improvement. Thought and attention problems such as intrusive behaviour significantly decreased only in patients who underwent the percutaneous procedure. Complications as reintervention, bleeding and arrhythmia were only observed in the open surgery group.
Elevated plasma levels of TIMP-3 are associated with a higher risk of acute respiratory distress syndrome and death following severe isolated traumatic brain injury
Authors: Hendrickson Carolyn M , Gibb Stuart L , Miyazawa Byron Y , Keating Sheila M , Ross Erin , Conroy Amanda S , Calfee Carolyn S , Pati Shibani , Cohen Mitchell J 
Published: June 2018

BackgroundComplications after injury, such as acute respiratory distress syndrome (ARDS), are common after traumatic brain injury (TBI) and associated with poor clinical outcomes. The mechanisms driving non-neurologic organ dysfunction after TBI are not well understood. Tissue inhibitor of matrix metalloproteinase-3 (TIMP-3) is a regulator of matrix metalloproteinase activity, inflammation, and vascular permeability, and hence has plausibility as a biomarker for the systemic response to TBI.MethodsIn a retrospective study of 182 patients with severe isolated TBI, we measured TIMP-3 in plasma obtained on emergency department arrival. We used non-parametric tests and logistic regression analyses to test the association of TIMP-3 with the incidence of ARDS within 8 days of admission and in-hospital mortality.ResultsTIMP-3 was significantly higher among subjects who developed ARDS compared with those who did not (median 2810 pg/mL vs.2260 pg/mL, p=0.008), and significantly higher among subjects who died than among those who survived to discharge (median 2960 pg/mL vs.2080 pg/mL, p<0.001). In an unadjusted logistic regression model, for each SD increase in plasma TIMP-3, the odds of ARDS increased significantly, OR 1.5 (95% CI 1.1 to 2.1). This association was only attenuated in multivariate models, OR 1.4 (95% CI 1.0 to 2.0). In an unadjusted logistic regression model, for each SD increase in plasma TIMP-3, the odds of death increased significantly, OR 1.7 (95% CI 1.2 to 2.3). The magnitude of this association was greater in a multivariate model adjusted for markers of injury severity, OR 1.9 (95% CI 1.2 to 2.8).DiscussionTIMP-3 may play an important role in the biology of the systemic response to brain injury in humans. Along with clinical and demographic data, early measurements of plasma biomarkers such as TIMP-3 may help identify patients at higher risk of ARDS and death after severe isolated TBI.Level of evidenceIII.
Big Jets model with CPT invariance and dynamics of expansion with quantum Yang–Mills gravity
Authors: Hsu Jong-Ping , Hsu Leonardo , Katz Daniel 
Published: June 2018

Based on particle physics, the fundamental CPT invariance suggests a Big Jets model for the beginning of the universe, in which two oppositely directed jets evolved into a gigantic “matter half-universe” and a gigantic “antimatter half-universe” after annihilation and decay processes. In the geometric-optics limit, quantum Yang–Mills gravity with [Formula: see text] translational gauge symmetry in flat spacetime leads to an effective metric tensor in the Hamilton–Jacobi equation for macroscopic objects. This effective metric tensor does not exist in the wave equations of quantum particles. For cosmological expansion, we assume that an “effective metric tensor” for spacetime geometry based on Yang–Mills gravity corresponds to the usual FLRW form. Dynamical equations of expansion for the matter half-universe are obtained and solved. The time-dependent scale factors and the estimated age of the universes, [Formula: see text] yr, based on Yang–Mills gravity are consistent with experiments. CPT invariance implies that the same evolution process and dynamics of cosmic expansion also hold for the distant “antimatter half-universe”.
Mutational Analysis Identifies Therapeutic Biomarkers in Inflammatory Bowel Disease–Associated Colorectal Cancers
Authors: Din Shahida , Wong Kim , Mueller Mike F. , Oniscu Anca , Hewinson James , Black Catherine J. , Miller Martin L. , Jiménez-Sánchez Alejandro , Rabbie Roy , Rashid Mamunar , Satsangi Jack , Adams David J. , Arends Mark J. 
Published: June 2018

AbstractPurpose: Inflammatory bowel disease–associated colorectal cancers (IBD-CRC) are associated with a higher mortality than sporadic colorectal cancers. The poorly defined molecular pathogenesis of IBD-CRCs limits development of effective prevention, detection, and treatment strategies. We aimed to identify biomarkers using whole-exome sequencing of IBD-CRCs to guide individualized management.Experimental Design: Whole-exome sequencing was performed on 34 formalin-fixed paraffin-embedded primary IBD-CRCs and 31 matched normal lymph nodes. Computational methods were used to identify somatic point mutations, small insertions and deletions, mutational signatures, and somatic copy number alterations. Mismatch repair status was examined.Results: Hypermutation was observed in 27% of IBD-CRCs. All hypermutated cancers were from the proximal colon; all but one of the cancers with hypermutation had defective mismatch repair or somatic mutations in the proofreading domain of DNA POLE. Hypermutated IBD-CRCs had increased numbers of predicted neo-epitopes, which could be exploited using immunotherapy. We identified six distinct mutation signatures in IBD-CRCs, three of which corresponded to known mechanisms of mutagenesis. Driver genes were also identified.Conclusions: IBD-CRCs should be evaluated for hypermutation and defective mismatch repair to identify patients with a higher neo-epitope load who may benefit from immunotherapies. Prospective trials are required to determine whether IHC to detect loss of MLH1 expression in dysplastic colonic tissue could identify patients at increased risk of developing IBD-CRC. We identified mutations in genes in IBD-CRCs with hypermutation that might be targeted therapeutically. These approaches would complement and individualize surveillance and treatment programs. Clin Cancer Res; 24(20); 5133–42. ©2018 AACR.
Investigation of a Thromboxane A
2
Receptor–Based Vaccine for Managing Thrombogenesis
Authors: Alshbool Fatima Z. , Karim Zubair A. , Espinosa Enma V. Paez , Lin Olivia A. , Khasawneh Fadi T. 
Published: June 2018

Background

Despite the well‐established role for the thromboxane A
2
receptor (
TPR
) in the development of thrombotic disorders, none of the antagonists developed to date has been approved for clinical use. To this end, we have previously shown that an antibody targeted against
TPR
's ligand‐binding domain inhibits platelet activation and thrombus formation, without exerting any effects on hemostasis. Thus, the goal of the present studies is to design a novel
TPR
‐based vaccine, demonstrate its ability to trigger an immune response, and characterize its antiplatelet and antithrombotic activity.

Methods and Results

We used a mouse keyhole limpet hemocyanin/peptide‐based vaccination approach rationalized over the
TPR
ligand‐binding domain (ie, the C‐terminus of the second extracellular loop). The biological activity of this vaccine was assessed in the context of platelets and thrombotic diseases, and using a host of in vitro and in vivo platelet function experiments. Our results revealed that the
TPR
C‐terminus of the second extracellular loop vaccine, in mice: (1) triggered an immune response, which resulted in the development of a C‐terminus of the second extracellular loop antibody; (2) did not affect expression of major platelet integrins (eg, glycoprotein IIb‐IIIa); (3) selectively inhibited
TPR
‐mediated platelet aggregation, platelet‐leukocyte aggregation, integrin glycoprotein IIb‐IIIa activation, as well as dense and α granule release; (4) significantly prolonged thrombus formation; and (5) did so without impairing physiological hemostasis.

Conclusions

Collectively, our findings shed light on
TPR
's structural biological features, and demonstrate that the C‐terminus of the second extracellular loop domain may define a new therapeutic target and a
TPR
vaccine‐based approach that should have therapeutic applications.
Meeting Metalheads
Authors: Mulder André 
Published: June 2018

This article explores the world view, social position and psychological make-up of people who listen to metal music (metalheads) and the cultural reactions to this genre in order to prepare for an encounter with metalheads in religious education and youth ministry. Only when teachers and youth ministers can connect with the world view of young people can they fulfil their hermeneutical-didactical task of fostering religious identity. Using the spiritual model of Waaijman, the concept of ‘meeting a stranger’ is introduced as a spiritual exercise for teachers to open themselves to the questions of life these students are meditating. Religious motives regarding hospitality to strangers stimulate an open attitude for a fruitful dialogue. A short theory of pain, based on content analysis of 81 songs, demonstrates not only the serious character of the lyrics of metal music but also their role in sustaining metalheads in their struggles.
Validity and Reliability of the Dying Care Process and Outcome Scales Before and After Death From the Bereaved Family Members’ Perspective
Authors: Kanno Yusuke , Sato Kazuki , Shimizu Megumi , Funamizu Yuko , Andoh Hideaki , Kishino Megumi , Senaga Tomomi , Takahashi Tetsu , Miyashita Mitsunori 
Published: June 2018

Objective: There are no instruments evaluating the processes and outcomes of dying care right before and after death. Therefore, we developed and examined the validity and reliability of 2 scales for evaluating dying care processes and outcomes before and after death. Methods: A cross-sectional, anonymous questionnaire was administered to bereaved family members of patients with cancer who had died in 5 facilities. We evaluated the Dying Care Process Scale for Bereaved Family Members (DPS-B) and the Dying Care Outcome Scale for Bereaved Family Members (DOS-B) with 345 bereaved family members. Results: A factor analysis revealed that DPS-B and DOS-B each consisted of 4 subscales. For the DPS-B, they were “symptom management,” “respect for the patient’s dignity before and after death,” “explanation to the family,” and “family care.” For the DOS-B, they were “peaceful dying process for the patient,” “being respected as a person before and after death,” “good relationship between the patient and family,” and “peaceful dying process for the family.” Both DPS-B and DOS-B had sufficient convergent and discriminative validity, sufficient internal consistency (DPS-B: α = 0.91 and subscales’ αs = 0.78-0.91; DOS-B: α = 0.91 and subscales’ αs = 0.78-0.94), and sufficient test–retest reliability (DPS-B: intraclass correlation coefficient [ICC] of total score = 0.79 and subscales = 0.55-0.79; DOS-B: ICC of total score = 0.88 and subscales = 0.70-0.88). Significance of Results: Both DPS-B and DOS-B are valid and reliable scales for evaluating the dying care processes and outcomes before and after death from the bereaved family members’ perspectives.