bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypoglycemia associated with disseminated metastatic tonsillar squamous cell carcinoma producing insulin‐like growth factor‐I in a Pomeranian dog
Authors: Azuma Kazushi , Asakawa Makoto , Konno Toshiaki , Fukuda Shoko , Goto Asakawa Midori 
Published: July 2019

AbstractA 13‐year‐old spayed female Pomeranian dog was presented for persistent, severe hypoglycemia (37 mg/dL; reference interval [RI] 75‐128 mg/dL). Progressive nonregenerative anemia (hematocrit 23.3%‐15.9%; RI 37.0%‐55.0%) and severe thrombocytopenia (36 000/µL; RI 200‐500 000/µL) were also noted. The serum insulin concentration was low (0.24 ng/mL; RI 0.302‐1.277 ng/mL). Computed tomography revealed multiple splenic nodules (1‐6 mm in diameter) and several hepatic nodules (7.6, 12 mm in diameter). Ultrasound‐guided fine‐needle aspiration of the splenic and hepatic nodules revealed low numbers of epithelial cells with mild cellular atypia, suggestive of a metastatic epithelial tumor, but the primary site was unknown at that time. On careful oral examination under general anesthesia, an enlarged right tonsil was noted grossly, and histopathologic examination of the tonsil diagnosed squamous cell carcinoma. Bone marrow aspirates and biopsies of the splenic and hepatic nodules were performed; all samples were diagnosed as metastatic carcinoma on histopathologic examination. No nodules were present in the pancreas, despite careful palpation during exploratory laparotomy. On immunohistochemistry, the neoplastic cells were positive for cytokeratin AE1/3 and insulin‐like growth factor (IGF)‐I but were negative for chromogranin A, PGP9.5, insulin, and inconclusive for IGF‐II. This is the first report of a primary IGF‐I‐producing squamous cell carcinoma in the tonsil of a dog with metastases to bone marrow, liver, and spleen, resulting in hypoglycemia.
Evaluation of damage area on fibre epoxy composites using digital image processing
Authors: Arul Jose P. , Sasikumar T. , Arun Bose P. , Prabhu N. 
Published: July 2019

In this paper, fibre epoxy composite specimens are prepared by hand lay-up method with stacking sequences (04/±452)s. Five specimens are prepared with the same dimensions and named as S1, S2, S3, S4, and S5. These specimens are tested for impact analysis using a drop-weight apparatus (DWA-Ceast9350) at energy levels of 25, 30, and 35 J, followed by tensile testing using a universal testing machine (Dak9103). The damaged areas of the impacted specimens are examined by digital image processing, numerically simulated ABAQUS software, and scanning electron microscopy, followed by tensile strength results. The results of the experiment reveal that when the impact energy increases, the damage area increases, the tensile strength decreases, and the cracks formed during impact are shown in scanning electron microscope imaging. The homogeneity and isotropy of the composite are identified by the Feret ratio and circular shape factor.
Exploring Empathy, Compassion Fatigue, and Burnout among Feral Cat Caregivers
Authors: Young Robert L. , Thompson Carol Y. 
Published: July 2019

Abstract
Based on four years of ethnographic observations, interviews, and full participation, this research elucidates the emotional dynamics and consequences of feral cat caregiving across a variety of interactional settings. Such caregiving is often conducted in the context of a lack of understanding from otherwise sympathetic friends and relatives and opposition and stigmatization from others who are unsympathetic to the work. We find that the ability of caregivers to take the role of the nonhuman other facilitates genuine empathic concern, which allows caregivers to provide relatively successful and ongoing care. Unfortunately, the combination of emotional stress and compassion fatigue, combined with frequent setbacks and a substantial dearth of organizational and economic support of caregivers’ efforts, often leads to disillusionment, cynicism, and burnout. In addition to elucidating the social and emotional problems of our respondents, we also offer a conceptual and theoretical framework to guide further research on this and related topics.
Exploring the Relationship between Socio-Demographic Background and Empathy toward Nonhuman Animals in Working Horse Caretakers
Authors: Luna Daniela , Vásquez Rodrigo A. , Tadich Tamara 
Published: July 2019

Abstract
Recognizing pain in nonhuman animals and empathy toward them is important for modulating human-animal relationships and animal welfare. Few studies have assessed pain recognition and empathic responses toward animals based on socio-demographic characteristics, and even fewer have examined them in socioeconomically marginalized individuals. To address this issue, four instruments were applied to 100 working horse caretakers. The socio-demographic and quality of life instruments were applied as interviews, and afterward two rating scales measuring empathy toward animals and the willingness to attribute pain to horses, in a diversity of painful conditions, were filled out. The results indicate that working horse caretakers have high levels of empathy and the willingness to attribute a high intensity of pain to equines in diverse situations that imply pain, but that neither socio-demographic status nor satisfaction with life quality were correlated with empathy toward animals or the willingness to attribute pain to horses.
Multisensory, Multi-Tasking Performance of Older Adults With and Without Subjective Cognitive Decline
Authors: Carr Sophie , Pichora-Fuller M. Kathleen , Li Karen Z. H. , Phillips Natalie , Campos Jennifer L. 
Published: July 2019

Abstract
As the population ages, it is increasingly important to detect non-normative cognitive declines as early as possible. Measures of combined sensory–motor–cognitive functioning may be early markers for identifying individuals who are at increased risk of developing dementia. Further, older adults experiencing subjective cognitive decline (SCD) may have elevated risk of dementia compared to those without SCD. Tasks involving complex, multisensory interactions reflective of everyday challenges may be particularly sensitive to subjectively perceived, pre-clinical declines. In the current study, older adults with and without SCD were asked to simultaneously perform a standing balance task and a listening task under increasingly challenging sensory/cognitive/motor conditions using a dual-task paradigm in a realistic, immersive virtual environment. It was hypothesized that, compared to older adults without SCD, those with SCD would exhibit greater decrements in postural control and listening response accuracy as sensory/motor/cognitive loads increased. However, counter to predictions, older adults with SCD demonstrated greater reductions in postural sway under more challenging dual-task conditions than those without SCD. Across both groups, poorer postural task performance was associated with poorer cognitive function and speech-in-noise thresholds measured with standard baseline tests. Poorer listening task performance was associated with poorer global cognitive function, poorer mobility, and poorer speech-in-noise detection. Overall, the results provide additional support for the growing evidence demonstrating associations between sensory, motor, and cognitive functioning and contribute to an evolving consideration of how best to categorize and characterize SCD in a way that guides strategies for screening, assessment, and intervention.
Advanced monoenergetic reconstruction technique in dual-energy computed tomography for evaluation of vascular anatomy before adrenal vein sampling
Authors: Nakayama Keita , Shimohira Masashi , Nakagawa Motoo , Ozawa Yoshiyuki , Sawada Yusuke , Ohta Kengo , Ohashi Kazuya , Shibamoto Yuta 
Published: July 2019

BackgroundIn adrenal vein sampling, selecting the right adrenal vein is technically difficult and it is important to evaluate the right adrenal vein anatomy before adrenal vein sampling. The advanced monoenergetic reconstruction technique has recently become available and we hypothesized that this technique may be useful.PurposeTo evaluate the usefulness of the advanced monoenergetic reconstruction technique in dual-energy computed tomography (CT; advanced monoenergetic images) for evaluation of vascular anatomy before adrenal vein sampling.Material and MethodsTwenty-one patients underwent three-phase (20, 30, and 70 s) contrast-enhanced CT before adrenal vein sampling. Advanced monoenergetic images were reconstructed at 40 keV and analyzed objectively and subjectively in comparison with the standard 120-kVp images. As objective evaluation, the signal-to-noise ratio and contrast-to-noise ratio of the right adrenal vein were assessed. As subjective evaluation, two radiologists assessed the delineation of the right adrenal vein using a 5-point Likert scale (1 = poor, 5 = excellent). Furthermore, the technical success rate of adrenal vein sampling and procedure time were also evaluated.ResultsThere was no difference in the signal-to-noise ratio between the two groups. The contrast-to-noise ratios of the right adrenal vein of advanced monoenergetic images were higher than those of the standard images ( P < 0.05). The Likert scores of advanced monoenergetic images were higher than those of the standard images ( P < 0.05). The technical success rate of adrenal vein sampling was 95% (20/21) and the median of procedure time was 103 min (range = 59–197 min).ConclusionAdvanced monoenergetic imaging appears to be useful in the delineation of the right adrenal vein before adrenal vein sampling.
Occupational therapists’ perspectives on the implementation of client-centred practice in Tanzania
Authors: Mshanga Dominick , Duncan Eve M , Buchanan Helen 
Published: July 2019

Introduction Client-centred practice was theorised by occupational therapists in Canada and subsequently introduced into the Tanzanian occupational therapy curriculum. There has been no critique of its relevance for African countries, nor research into occupational therapists’ perspectives of applying client-centred practice in African world contexts. This study aimed to determine the understanding and use of client-centred practice by occupational therapists in Tanzania. Method A descriptive cross-sectional design was used. Working Tanzanian occupational therapists ( n=64) completed a questionnaire based on two existing instruments. Data were analysed using SSPS (version 20.0) and qualitative coding. Results Barriers were shortage of time (79.7%), client-centred practice is too demanding for the client (78.1%) and the therapist and client have different goals (76.6%). Enablers included education about client-centred practice as a student (98.4%), client involvement in planning services (96.9%) and staff and service provider training (96.9%). Three themes were identified: client-centred practice enriches relationships, is difficult to implement, and needs to be supported by increasing human resources, further training and client education. Conclusion The implementation of client-centred practice in Tanzania is compromised by the resource-constrained and hospi-centric health service context. Alternative practice approaches that are aligned with collectivist cultural attitudes could be considered.
Presentation to HIV care and antiretroviral therapy initiation and response in clinical practice from 2003 through 2013
Authors: Pallotta Andrea M , Pirzada Sana A , Shrestha Rabin K , Yen-Lieberman Belinda , Calabrese Leonard H , Taege Alan J , Butler Robert S , Abbas Ume L 
Published: July 2019

Universal HIV screening and treatment initiation of HIV-positive persons are well-established standards. However, late presentation to care is a barrier to early antiretroviral therapy (ART) and prevention of HIV transmission. We sought to determine the immunodeficiency at presentation to care and characterize the initiation and response to ART among HIV-positive persons over 2003–2013 in our urban HIV clinical practice at the Cleveland Clinic. Using a retrospective cohort study design, we assessed the CD4 cell count of HIV-positive patients at entry into care for each year and evaluated the trend over time. For patients who initiated treatment, we assessed the pretreatment CD4 cell count, consistency of timing and regimen with US treatment guidelines, and HIV RNA level at one-year and last follow-up visits. Regression analyses were used to determine predictors of study outcomes. We found that the cohort (N = 452) median CD4 cell count at presentation to care was 297 cells/mm3 (inter-quartile range: 104–479 cells/mm3), without any significant change over time (P = 0.62), and with 37% and 21% of presentations being late and advanced, respectively. Guideline-consistency (85%–100%) and regimen-consistency (41%–100%) were moderate to high and improved over time. Virologic suppression (<400 copies/ml) at one year and last follow-up was high (79% and 92%) and associated with regimen selection and durability. We conclude that CD4 cell count at first presentation to HIV care remained less than 350 cells/mm3 for 11 years in our clinical practice, despite advances in HIV testing and treatment guidelines. Early diagnosis and linkage to care and treatment are critical for ending the HIV epidemic.
Comparing fly-in fly-out and telehealth models for delivering advanced-practice physiotherapy services in regional Queensland: An audit of outcomes and costs
Authors: Cottrell Michelle , Judd Perry , Comans Tracy , Easton Paula , Chang Angela T 
Published: July 2019

Introduction Recruitment of advanced-practice physiotherapists to regional and rural healthcare facilities in Queensland, Australia remains a challenge. To overcome this barrier, two different service delivery models (Fly-In, Fly-Out (FIFO), Telehealth) were trialled by one regional facility. This study aims to describe the economic- and service-related outcomes of these two methods of service delivery. Methods A retrospective audit was conducted where two nine-week time periods were selected for each service delivery model. Outcomes of interests include patient demographics and case-mix, service utilisation, clinical actions, adverse events and costs. Net financial position for both models was calculated based upon costs incurred and revenue generated by service activity. Results A total of 33 appointment slots were recorded for each service delivery model. Patient case-mix was variable, where the Telehealth model predominately involved patients with musculoskeletal spinal conditions managed from a neurosurgical waiting list. Appointment slot utilisation and pattern of referral for further investigations were similar between models. No safety incidents occurred in either service delivery model. An estimated cost-savings of 13% for the Telehealth model could be achieved when compared to the FIFO model. Discussion Telehealth is a safe, efficient and viable option when compared to a traditional in-person outreach service, while providing cost-savings. Telehealth should be seen as a service delivery medium in which sustainable recruitment of advanced-practice physiotherapists to regional and rural healthcare facilities can be achieved.
Health monitoring among asylum seekers and refugees: a state-wide, cross-sectional, population-based study in Germany
Authors: Biddle Louise , Menold Natalja , Bentner Martina , Nöst Stefan , Jahn Rosa , Ziegler Sandra , Bozorgmehr Kayvan 
Published: July 2019

Abstract
Background
Health monitoring in Germany falls short on generating timely, reliable and representative data among migrants, especially transient and marginalized groups such as asylum seekers and refugees (ASR). We aim to advance current health monitoring approaches and obtain reliable estimates on health status and access to essential healthcare services among ASR in Germany’s third largest federal state, Baden-Württemberg.

Methods
We conducted a state-wide, cross-sectional, population-based health monitoring survey in nine languages among ASR and their children in collective accommodation centres in 44 districts. Questionnaire items capturing health status, access to care, and sociodemographic variables were taken from established surveys and translated using a team approach. Random sampling on the level of 1938 accommodation centres with 70,634 ASR was employed to draw a balanced sample of 65 centres with a net sample of 1% of the state’s ASR population. Multilingual field teams recruited eligible participants using a “door-to-door” approach. Parents completed an additional questionnaire on behalf of their children.

Results
The final sample comprised 58 centres with 1843 ASR. Of the total sample expected eligible (N = 987), 41.7% (n = 412) participated in the survey. Overall, 157 households had children and received a children’s questionnaire; 61% (n = 95) of these were returned. Age, sex, and nationality of the included sample were comparable to the total population of asylum applicants in Germany. Adults reported longstanding limitations (16%), bad/very bad general health (19%), pain (25%), chronic illness (40%), depression (46%), and anxiety (45%). 52% utilised primary and 37% specialist care services in the previous 12 months, while reporting unmet needs for primary (31%) and specialist care (32%). Younger and male participants had above-average health status and below-average utilisation compared to older and female ASR.

Conclusions
Our health monitoring survey yielded reliable estimates on health status and health care access among ASR, revealing relevant morbidities and patterns of care. Applying rigorous epidemiological methods in linguistically diverse, transient and marginalized populations is challenging, but feasible. Integration of this approach into state- and nation-wide health monitoring strategies is needed in order to sustain this approach as a health planning tool.
Kneeling ability after total knee replacement
Authors: Wylde Vikki , Artz Neil , Howells Nick , Blom Ashley W. 
Published: July 2019

Kneeling ability is consistently the poorest patient-rated outcome after total knee replacement (TKR), with 60–80% of patients reporting difficulty kneeling or an inability to kneel. Difficulty kneeling impacts on many activities and areas of life, including activities of daily living, self-care, leisure and social activities, religious activities, employment and getting up after a fall. Given the wide range of activities that involve kneeling, and the expectation that this will be improved with surgery, problems kneeling after TKR are a source of dissatisfaction and disappointment for many patients. Research has found that there is no association between range of motion and self-reported kneeling ability. More research is needed to understand if and how surgical factors contribute to difficulty kneeling after TKR. Discrepancies between patients’ self-reported ability to kneel and observed ability suggests that patients can kneel but elect not to. Reasons for this are multifactorial, including knee pain/discomfort, numbness, fear of harming the prosthesis, co-morbidities and recommendations from health professionals. There is currently no evidence that there is any clinical reason why patients should not kneel on their replaced knee, and reasons for not kneeling could be addressed through education and rehabilitation. There has been little research to evaluate the provision of healthcare services and interventions for patients who find kneeling problematic after TKR. Increased clinical awareness of this poor outcome and research to inform the provision of services is needed to improve patient care and allow patients to return to this important activity. Cite this article: EFORT Open Rev 2019;4:460-467. DOI: 10.1302/2058-5241.4.180085
Martha Graham’s Letter to the World: A dance adaptation of Emily Dickinson
Authors: Simonari Rosella 
Published: July 2019

Letter to the World is a choreography Martha Graham created in 1940 and revised in 1941. It is dedicated to Emily Dickinson, one of her favourite poets. However, it is not a biographical account, but an introspective work, that, in Graham’s words, investigates the New England poet’s ‘inner landscape’. The protagonist is split into two: the One Who Dances who performs the most demanding dance phrases and the One Who Speaks, who utters lines from Dickinson’s poems and letters. The other characters embody emanations of the poet’s personality. The main narrative rotates around the struggle between the One Who Dances and the Ancestress, who embodies the poet’s Puritan tradition and death. The combination of dances and spoken lines provides a unique portrait of the poet.
In this article, I intend to analyse Letter to the World as a dance adaptation of Emily Dickinson. The method through which I will conduct my analysis consists of cultural and dance history, adaptation and narrative theory. First, I will focus on the notion of dance adaptation itself; then, I will present a reconstruction of the piece and proceed to explore the material Graham consulted for her work; after this, I will analyse it in terms of narrative highlighting the way the dances and spoken lines contribute to shaping it; I will conclude with a reflection on the reasons that brought Graham to focus on Dickinson.
The effects of competence, independence, audit work, and communication on the effectiveness of internal audit
Authors: Setyaningrum Dyah , Kuntadi Cris 
Published: July 2019

The purpose of this study was to examine the effect of competence, independence, audit work and communication on internal audit effectiveness. This research is still relevant due to lacking in internal audit function as there are still many corruption cases, especially in the Ministries/Agencies. This is a quantitative research using questionnaires distributed to the auditors in Inspectorate General of the Ministry of Transportation as respondents.Â Inspectorate General of the Ministry of Transportation is one of the institutions with IACM level 3 (integrated) in Indonesia. It showed that competence, communication, and audit work have positive effect on internal audit effectiveness, while independence has no effect on internal audit effectiveness. It implies that the auditors should be equipped with the audit technical competence as well as non-technical competencies relevant with their audit area. Audit work from planning, implementation and post-audit should always comply with audit standard. Effective oral and written communication between the auditor and the auditee should also be enhanced in form of audit reports to the follow-up of audit recommendations. Independence in this study does not affect the effectiveness of the internal audit, because independence is fact is main requirement when conducting audit.
𝔇⊥-parallel normal Jacobi operators for Hopf hypersurfaces in complex two-plane Grassmannians with generalized Tanaka–Webster connection
Authors: Pak Eunmi , Suh Young Jin 
Published: July 2019

Abstract
We study classifying problems for real hypersurfaces in a complex two-plane Grassmannian G
2(ℂ
m+2). In relation to the generalized Tanaka–Webster connection, we consider a new concept of parallel normal Jacobi operator for real hypersurfaces in G
2(ℂ
m+2) and prove that a real hypersurface in G
2(ℂ
m+2) with generalized Tanaka–Webster 𝔇⊥-parallel normal Jacobi operator is locally congruent to an open part of a tube around a totally geodesic quaternionic projective space ℍPn
in G
2(ℂ
m+2), where m = 2n.