bluuebunny/crossref_metadata_2025_split huggingface dataset:
Turnover behavior among US government employees
Authors: Hur Hyungjo , Hawley Joshua 
Published: May 2019

High employee turnover is a critical policy issue for public managers to solve. The US government is concerned about slowing turnover rates, which have accelerated from 14–15% to more than 18% since the Great Recession. Explanations for increases in employee departure are more difficult to pin down. The expected wave of baby-boomer retirements did not materialize and cannot explain turnover. The impact of the Great Recession on employment makes it more difficult to theorize about the relationship between employee–organizational fit and turnover. This study analyzes US government employees’ turnover using data from the 2003, 2006, 2010, and 2013 editions of the National Survey of College Graduates. The data provide a unique opportunity to study cohorts of US government workers before and after the recession. Statistical models of employee turnover focus on comparing the factors that lead to employee departure. The exodus of workers from government offices can be explained more by the fit between the individual and organizational needs than by a mismatch between the skills required in the job and the needs of the organization. The results show that when there is a mismatch between individual skill level and the skills in their job, individuals are more likely to move within government. Workers that made job changes after the recession (2010–2013) had a greater gap in organizational fit than those that made job changes prior to the recession (2003–2006). Points for practitioners This study describes turnover in public organizations and provides conclusions showing how managers can minimize the risk of turnover to ensure effective government. Public managers should modify management policies to meet the needs of modern-day employees and make the government more resilient within changing work environments. Organizations can begin to mitigate turnover rates during hiring by matching employment opportunities with the job skills and expectations of candidates through careful hiring, appropriate placement, and providing employee training and support.
Torsion of ovarian endometrioma in pregnancy: a case report and review of the literature
Authors: Hua Dingchao , Zhao Peng , Jiang Lianyun 
Published: May 2019

Adnexal torsion induced by an endometrioma has seldom been reported. Because of its rarity and its complexity in respect of fetal health during pregnancy, the diagnosis and treatment is challenging. We report a 25-year-old primigravida in the eighth week of gestation presenting with acute onset lower abdominal pain. A pelvic ultrasonography showed an intrauterine single viable embryo with a right ovarian cyst measuring 6 × 6 cm in diameter. Exploratory laparotomy revealed torsion of the right adnexa by 360°. After a right adnexectomy was performed, the patient proceeded to full-term pregnancy. Adnexal torsion is defined as rotation of > 45° in the long axis of the adnexae. Its occurrence during gestation is reported as 2%, accounting for 2.7% of surgical emergencies in pregnant women. Most cases are caused by dermoid and functional ovarian cysts. Because of the rarity of torsion induced by an endometrioma, the diagnosis and treatment are challenging. In poor-resource conditions, a diagnostic laparoscopy (or laparotomy) remains a logical method of diagnosis, offering simultaneous therapeutic options.
Clinical efficacy of extracorporeal shockwave therapy for knee osteoarthritis: a systematic review and meta-regression of randomized controlled trials
Authors: Liao Chun-De , Tsauo Jau-Yih , Liou Tsan-Hon , Chen Hung-Chou , Huang Shih-Wei 
Published: May 2019

Objective: This study determined the clinical efficacy of extracorporeal shockwave therapy and the predictors of its efficacy for knee osteoarthritis. Data Sources: Electronic databases and search engines, namely MEDLINE, PubMed, EMBASE, Cochrane Library Database, Physiotherapy Evidence Database (PEDro), China Academic Journals Full-text Database, and Google Scholar, were searched until 5 March 2019, for randomized controlled trials without restrictions on language and publication year. Review Methods: Eligible trials and extracted data were identified by two independent investigators. The included articles were subjected to a meta-analysis and risk of bias assessment. Outcomes of interest included treatment success rate, pain, and physical function outcomes. A meta-regression analysis was performed to determine the predictors of treatment outcomes following shockwave therapy. Results: We included 50 trials (4844 patients) with a median (range) PEDro score of 6 (5–9). Meta-analyses results revealed an overall significant effect favoring shockwave therapy on the treatment success rate (odds ratio 3.22, 95% confidence interval (CI) 2.21–4.69, P < 0.00001; heterogeneity ( I2) = 62%), pain reduction (standardized mean difference (SMD) −2.02, 95% CI −2.38 to −1.67, P < 0.00001; I2 = 95%), and Western Ontario and McMaster Universities Osteoarthritis Index function outcome (SMD −2.71, 95% CI −3.50 to −1.92, P < 0.00001; I2 = 97%). Follow-up duration and energy flux density were independent significant predictors of shockwave efficacy. Conclusion: Shockwave therapy is beneficial for knee osteoarthritis. Shockwave dosage, particularly the energy level and intervention duration, may have different contributions to treatment efficacy.
Moving stroke rehabilitation evidence into practice: a systematic review of randomized controlled trials
Authors: Bird Marie-Louise , Miller Tiev , Connell Louise A , Eng Janice J 
Published: May 2019

Objective: The aim of this study was to investigate the effectiveness of interventions aimed at moving research evidence into stroke rehabilitation practice through changing the practice of clinicians. Data sources: EMBASE, CINAHL, Cochrane and MEDLINE databases were searched from 1980 to April 2019. International trial registries and reference lists of included studies completed our search. Review methods: Randomized controlled trials that involved interventions aiming to change the practice of clinicians working in stroke rehabilitation were included. Bias was evaluated using RevMan to generate a risk of bias table. Evidence quality was evaluated using GRADE criteria. Results: A total of 16 trials were included (250 sites, 14,689 patients), evaluating a range of interventions including facilitation, audit and feedback, education and reminders. Of which, 11 studies included multicomponent interventions (using a combination of interventions). Four used educational interventions alone, and one used electronic reminders. Risk of bias was generally low. Overall, the GRADE criteria indicated that this body of literature was of low quality. This review found higher efficacy of trials which targeted fewer outcomes. Subgroup analysis indicated moderate-level GRADE evidence (103 sites, 10,877 patients) that trials which included both site facilitation and tailoring for local factors were effective in changing clinical practice. The effect size of these varied (odds ratio: 1.63–4.9). Education interventions alone were not effective. Conclusion: A large range of interventions are used to facilitate clinical practice change. Education is commonly used, but in isolation is not effective. Multicomponent interventions including facilitation and tailoring to local settings can change clinical practice and are more effective when targeting fewer changes.
Enormous primary renal diffuse large B-cell lymphoma: A case report and literature review
Authors: Cheng Xu , Huang Zhichao , Li Daiqiang , Wang Yinhuai 
Published: May 2019

Introduction Primary renal lymphoma is a rare malignant lymphoma that is difficult to differentiate from renal cell carcinoma. Positron emission tomography/computed tomography and image-guided percutaneous biopsy are valuable tools for diagnosis. Case report A 64-year-old woman presented with a 2-year history of repeated right waist pain and a 1-month history of nausea, vomiting, and frequent and urgent urination. A computed tomography scan showed a huge mass that was initially considered to be renal cell carcinoma at the upper pole of the right kidney. The mass had invaded the renal pelvis, narrowed the right renal artery, and constricted the inferior vena cava and liver. Postoperative examination of the tumor confirmed lymphoma. We herein present this case and its multidisciplinary team management. Conclusion Multidisciplinary team management is efficient for preoperative assessment and surgery in difficult and high-risk cases. Based on our literature review, we suggest biopsy before chemotherapy whenever possible. Chemotherapy can be implemented after surgery for better survival outcomes.
Energy and Nutrient Intakes of Rural Nigerian Schoolchildren: Relationship With Dietary Diversity
Authors: Ayogu Rufina 
Published: May 2019

Background: Undernutrition among schoolchildren is a prevalent public health problem which may be due to inadequate energy and nutrient intakes associated with low dietary diversity. Objective: This study assessed dietary diversity scores (DDS), energy and nutrient intakes of schoolchildren (6-15 years), and risks factors of DDS and determined if energy and nutrient intakes were dependent on dietary diversity. Methods: The study involved a 2-stage random sampling of 90 schoolchildren. Dietary diversity and nutrient intake data were obtained through a 3-day weighed food intake. Analysis of variance, t test, and χ2 with Cochran-Mantel-Haenszel test were used to determine relationships among and between variables; P < .05 was reported as significant. Results: Few (22.2%) had high DDS with no significant difference ( P > .05) between age groups and sex. Children from male headed households were more likely to have medium DDS (odds ratio [OR] = 3.231; 95% confidence interval [CI] = 1.037-10.070) than those from female headed households ( P < .05). Low nutrient intakes were observed among 85.6% for niacin, 76.7% for calcium, 72.2% for riboflavin, 54.4% for protein, 32.2% for thiamine, and 15.6% for vitamin C. Among boys, prevalence of inadequate riboflavin intake was significantly ( P < .05) higher among 6- to 9-year-olds. Among girls, prevalence of inadequate vitamin A intake was significantly ( P < .01) higher among 10 to 15-year-olds. Children with adequate intakes of iron (OR = 0.744, 95% CI = 0.653-0.847) and thiamine (OR = 5.651, 95% CI = 1.214-26.310) were more likely to have high DDS. Conclusion: The schoolchildren had low energy and nutrient intakes. Iron and thiamine, intakes were dependent on DDS.
Aminocaproic Acid for the Reversal of Alteplase: A Case Series
Authors: Verkerk Brittany S. , Berger Karen , Lesch Christine A. 
Published: May 2019

Introduction: The evidence to support the use of aminocaproic acid for reversal of alteplase is limited to case reports. Current guidelines recommend cryoprecipitate as first-line treatment, or an antifibrinolytic if cryoprecipitate is unavailable or cannot be used. This case series describes the use of aminocaproic acid for alteplase-related hemorrhage. Materials and Methods: Patients who received aminocaproic acid within 48 hours of alteplase from January 1, 2014, to June 30, 2017 were included. Patients were excluded if aminocaproic acid was not administered for an alteplase-related hemorrhage. Thromboembolic complications at 14 days and hemostasis within 24 hours were documented. Results: Sixteen patients received aminocaproic acid for an alteplase-related hemorrhage. Aminocaproic acid was given for hemorrhagic conversion of acute ischemic stroke in 7 of 16 patients and other types of hemorrhages in the remaining patients. Hemostasis occurred in 3 of 10 evaluable patients. Overall mortality was 63% (10/16). Administration of aminocaproic acid varied significantly (50% bolus, 12.5% infusion, 37.5% bolus plus infusion). One of 6 evaluable patients had a thromboembolic event. All patients received concomitant blood products. Cryoprecipitate was administered in 69% (11/16) of patients. Conclusions: There was no clear relationship between the timing or dose of aminocaproic acid and hemostasis, and it is unclear if administration of aminocaproic acid contributes to hemostasis.
Waveform parameters of retrobulbar vessels in glaucoma patients with different demographics and disease severity
Authors: Carichino Lucia , Harris Alon , Lapin Sergey , Guidoboni Giovanna , Cassani Simone , De Silvestri Annalisa , Tinelli Carmine , Milano Giovanni , Siesky Brent , Verticchio Vercellin Alice C 
Published: May 2019

Introduction: To identify novel velocity waveform parameters of the ophthalmic artery and central retinal artery by computer-aided image processing of Doppler ultrasonography measurements, and to evaluate correlations between the waveform parameters and different demographics and disease severity of open-angle glaucoma patients. Methods: Thirty-six images of 36 open-angle glaucoma patients were considered. A semiautomated image processing code was used to detect the digitalized ophthalmic artery and central retinal artery velocity waveforms and to extract the waveform parameters. Concordance correlation coefficient, two-sample t-test, and Pearson’s correlation coefficient were used to test for similarities, differences, and associations among variables. Results: Female glaucoma patients showed a statistically higher ophthalmic artery normalized distance between ascending and descending limb (p = 0.004), hypertensive glaucoma patients a statistically higher ophthalmic artery peak systolic velocity time (p = 0.025), glaucoma patients with hyperlipidemia a statistically higher ophthalmic artery resistivity index (p = 0.023) and a statistically higher ophthalmic artery peak systolic velocity acceleration (p = 0.025), glaucoma patients with cardiovascular diseases a statistically lower central retinal artery normalized distance between ascending and descending limb of the wave (p = 0.033) and a statistically higher central retinal artery period (p = 0.028), and patients with different body mass index a statistically different central retinal artery normalized distance between ascending and descending limb of the wave (p = 0.016). Groups with different disease severity, classified following the Brusini glaucoma staging system 2, showed statistically different central retinal artery normalized distance between ascending and descending limb of the wave (p < 0.001) and central retinal artery period (p = 0.016). No statistical differences were found in regard to race, diabetes status, glaucoma family history, and smoking. Discussion: Ophthalmic artery and central retinal artery computer-aided analysis of velocity waveforms could identify novel waveform parameters capable of differentiating among different demographics and disease severity of open-angle glaucoma patients.
Kappa free light chains is a valid tool in the diagnostics of MS: A large multicenter study
Authors: Leurs CE , Twaalfhoven HAM , Lissenberg-Witte BI , van Pesch V , Dujmovic I , Drulovic J , Castellazzi M , Bellini T , Pugliatti M , Kuhle J , Villar LM , Alvarez-Cermeño JC , Alvarez-Lafuente R , Hegen H , Deisenhammer F , Walchhofer LM , Thouvenot E , Comabella M , Montalban X , Vécsei L , Rajda C , Galimberti D , Scarpini E , Altintas A , Rejdak K , Frederiksen JL , Pihl-Jensen G , Jensen PEH , Khalil M , Voortman MM , Fazekas F , Saiz A , La Puma D , Vercammen M , Vanopdenbosch L , Uitdehaag BMJ , Killestein J , Bridel C , Teunissen C 
Published: May 2019

Objective: To validate kappa free light chain (KFLC) and lambda free light chain (LFLC) indices as a diagnostic biomarker in multiple sclerosis (MS). Methods: We performed a multicenter study including 745 patients from 18 centers (219 controls and 526 clinically isolated syndrome (CIS)/MS patients) with a known oligoclonal IgG band (OCB) status. KFLC and LFLC were measured in paired cerebrospinal fluid (CSF) and serum samples. Gaussian mixture modeling was used to define a cut-off for KFLC and LFLC indexes. Results: The cut-off for the KFLC index was 6.6 (95% confidence interval (CI) = 5.2–138.1). The cut-off for the LFLC index was 6.9 (95% CI = 4.5–22.2). For CIS/MS patients, sensitivity of the KFLC index (0.88; 95% CI = 0.85–0.90) was higher than OCB (0.82; 95%CI = 0.79–0.85; p < 0.001), but specificity (0.83; 95% CI = 0.78–0.88) was lower (OCB = 0.92; 95% CI = 0.89–0.96; p < 0.001). Both sensitivity and specificity for the LFLC index were lower than OCB. Conclusion: Compared with OCB, the KFLC index is more sensitive but less specific for diagnosing CIS/MS. Lacking an elevated KFLC index is more powerful for excluding MS compared with OCB but the latter is more important for ruling in a diagnosis of CIS/MS.
Polysyllabic shortening in Spanish-English bilingual children
Authors: Gibson Todd A , Bernales Carolina 
Published: May 2019

Aims and objectives: Polysyllabic shortening is thought to contribute to the perception of stress-timed rhythm in some languages. Little is known about its use in the speech of children exposed to a language that incorporates it more frequently (e.g. English) and one that incorporates it less frequently (e.g. Spanish). The purpose of the current investigation was to explore polysyllabic shortening in bilingual children’s two languages compared to monolingual Spanish and English comparison groups. Method/Design: We performed a group-level, cross-sectional study comparing the magnitude of polysyllabic shortening for monolingual English- and Spanish-speaking children and Spanish-English bilingual children. Data/Analysis: Sixteen monolingual English speakers, 23 monolingual Spanish speakers, and 16 Spanish-English bilingual speakers produced two- and four-syllable words in English only, Spanish only, or both English and Spanish, respectively. Ages ranged from 4;5 to 7;7 ( M = 5;10, SD = 7 months). English and Spanish words had the same syllable shapes and primary stress locations. Articulation rate was measured by syllables per second. A language history questionnaire and standardized vocabulary test were also administered. Comparisons were made both between and within groups. Results: Both monolingual English and Spanish speakers utilized polysyllabic shortening to similar degrees. Bilingual children produced polysyllabic shortening in English and Spanish to the same degree as their monolingual peers, but they produced it to a greater degree in their own Spanish than in their own English. Conclusion: Polysyllabic shortening might be a universal feature of speech that results from universal phonetic constraints. For the bilingual children, greater use of polysyllabic shortening in Spanish than English may be related to better Spanish than English articulatory control.
Performance of plasminogen activator inhibitor-1 as a biomarker in patients undergoing coronary angiography: Analytical and biological considerations
Authors: Jung Richard G , Simard Trevor , Di Santo Pietro , Labinaz Alisha , Moreland Robert , Duchez Anne-Claire , Majeed Kamran , Motazedian Pouya , Rochman Rebecca , Jung Young , Hibbert Benjamin 
Published: May 2019

Introduction and objective: Target lesion failure continues to limit the efficacy of percutaneous coronary intervention despite advancements in stent design and medical therapy. Identification of biomarkers to risk stratify patients after percutaneous coronary intervention has the potential to focus therapies on cohorts with increased benefits. Plasminogen activator inhibitor-1 has been identified as a candidate biomarker. Herein, we evaluate biological variables which impact plasminogen activator inhibitor-1 levels and analytical characteristics which impact its utility as a biomarker in humans. Methods: Plasma plasminogen activator inhibitor-1 was measured in 689 patients undergoing coronary angiography. Plasminogen activator inhibitor-1 levels were measured. Clinical and procedural characteristics were collected in a prospective registry. Results: Plasma plasminogen activator inhibitor-1 analytical ( CVa = 4.1%), intra-individual ( CVi = 44.0%) and inter-individual ( CVg = 118.6%) variations with reference change value of 122.3% were calculated. Plasminogen activator inhibitor-1 levels were elevated in patients with cardiovascular risk factors, including type 2 diabetes, pre-diabetes, smokers, obesity, hypertension, and daytime variation in procedure and blood draw. Conclusion: Variation in plasma plasminogen activator inhibitor-1 levels is influenced by multiple biological and procedural characteristics. The performance of plasma plasminogen activator inhibitor-1 is consistent with biomarkers in clinical use (N-terminal pro-B-type natriuretic peptide and C-reactive protein) and its applicability is promising.
Prevalence of Dementia Among Older Patients: A Hospital-Based Study in Iran
Authors: Kamalzadeh Leila , Moghaddamnia Moein , Malakouti Seyed Kazem , Rashedi Vahid , Bahrampour Sara , Sharifi Niloufar , Talebi Mina , Sina Farzad , Shariati Behnam 
Published: May 2019

Background: Dementia constitutes a public health hazard in developing countries. The aim of this study was to evaluate the prevalence of dementia and its associated factors in older hospitalized patients. Methods: The participants of this cross-sectional study consisted of older patients admitted to medical wards in Rasoul-e Akram hospital in Tehran, Iran. Mini-Mental State Examination, Mini-Cog test, Geriatric Depression Scale, Activities of Daily Living-Instrumental Activities of Daily Living (ADL-IADL) scale, and socioeconomic questionnaires were used. Results: A total of 205 elderly inpatients were included. The mean age was 71.33 ± 7.35 years; 63.4% of the participants had normal cognitive function, while 36.6% had some degree of cognitive impairment. There was a statistically significant relationship between gender, age, number of children, and occupation and the prevalence of dementia. Conclusion: Appropriate cognitive screening of older patients upon admission to hospitals could help identify potential adverse events and enhance the quality of care for patients with comorbid dementia.
Pilot study on the use of infrared thermal imaging to predict infrainguinal bypass outcome in the immediate post-operative period
Authors: Al Shakarchi J , Inston N , Dabare D , Newman J , Garnham A , Hobbs S , Wall M 
Published: May 2019

Objectives Early bedside post-operative monitoring of infrainguinal bypass surgery is currently based on subjective clinical findings and handheld Doppler signals. Infrared thermal imaging is an objective and reproducible technique that has been proven to be a reliable and accurate method to measure skin temperature. The aim of this prospective study was to assess infrared thermal imaging as a predicting tool of bypass graft outcome in the immediate post-operative period and assess the angiosome concept. Methods This was a prospective cohort study of 25 patients undergoing infrainguinal bypass. Demographic and clinical data were prospectively collected and included gender, age, co-morbidities, pre- and post-operative ankle brachial pressure indices, surgery undertaken and patency of run-off vessels. Infrared thermal imaging was undertaken pre- and post-operatively to assess thermal changes to the feet following revascularisation. Results We found that an increase in temperature from pre- to post-operative was significantly associated with bypass patency. An increase in temperature was found to have a positive predictive value of 75%, a negative predictive value of 100%, a sensitivity of 100% and specificity of 89% for predicting graft patency. Conclusions Infrared thermal imaging can be used to measure temperature related changes of the microcirculation post-operatively and predict bypass outcomes in the immediate post-operative period.