bluuebunny/crossref_metadata_2025_split huggingface dataset:
Repetitive transcranial magnetic stimulation in combination with neuromuscular electrical stimulation for treatment of post-stroke dysphagia
Authors: Zhang Chengliang , Zheng Xiuqin , Lu Rulan , Yun Wenwei , Yun Huifang , Zhou Xianju 
Published: October 2018

Objective This study was performed to determine whether repetitive transcranial magnetic stimulation (rTMS) combined with neuromuscular electrical stimulation (NMES) effectively ameliorates dysphagia and how rTMS protocols (bilateral vs. unilateral) combined with NMES can be optimized. Methods Sixty-four patients were randomly divided into four groups using a random distribution table: the sham rTMS plus NMES (Sham-rTMS/NMES), ipsilesional 10-Hz rTMS plus NMES (Ipsi-rTMS/NMES), contralesional 1-Hz rTMS plus NMES (Contra-rTMS/NMES), and bilateral rTMS plus NMES (Bi-rTMS/NMES) groups. Cortical excitability as measured by the amplitude of the motor evoked potential at the mylohyoid muscle cortical representative area, swallowing function as measured by the Standardized Swallowing Assessment, and the degree of dysphagia were evaluated at baseline, after the stimulation course, and at the 1-month follow-up. Results Bi-rTMS/NMES produced higher cortical excitability and better swallowing function recovery. Compared with NMES alone, unilateral rTMS plus NMES had additional effects on cortical excitability and rehabilitation of dysphagia, but there were no differences between the Contra-rTMS/NMES and Ipsi-rTMS/NMES groups. No adverse events occurred. Conclusion The combination of rTMS with NMES was superior to NMES alone in improving the recovery of post-stroke dysphagia, and the combination of bilateral rTMS with NMES was more effective than unilateral rTMS combined with NMES.
Engaging With the Community to Promote Physical Activity in Urban Neighborhoods
Authors: Deatrick Janet A. , Klusaritz Heather , Atkins Rahshida , Bolick Ansley , Bowman Cory , Lado Juan , Schroeder Krista , Lipman Terri H. 
Published: October 2018

Purpose: To describe perceptions of physical activity, opinions, on intergenerational approaches to physical activity and a vision for increasing physical activity in an underresourced urban community. Approach: Focus groups embedded in a large Community-Based Participatory Research Project. Setting: West and Southwest Philadelphia. Participants: 15 parents, 16 youth, and 14 athletic coaches; youth were 13 to 18 years old and attended West Philadelphia schools; parents’ children attended West Philadelphia schools; and coaches worked in West Philadelphia schools. Methods: Six focus groups (2 youth, 2 parent, and 2 coach) were conducted guided by the Socio-Ecological Model; transcriptions were analyzed using a rigorous process of directed content analysis. Results: Factors on all levels of the Socio-Ecological Model influence the perception of and engagement in physical activity for youth and their families. Future strategies to increase engagement in physical activity need to be collaborative and multifaceted. Conclusion: When physical activity is reframed as a broad goal that is normative and gender-neutral, a potential exists to engage youth and their families over their lifetimes; with attention to cross-sector collaboration and resource sharing, engaging and sustainable intergenerational physical activity interventions can be developed to promote health in underresourced urban communities.
Capturing the impact of adolescent inpatient admissions: The Social Connectedness Scale
Authors: Phillips Katy , Lawler Whatson Bridie , Wells Emma , Milson Gordon , Hartley Samantha 
Published: October 2018

Background:Outcome measurement is central to health service provision. In child and adolescent mental health services (CAMHS), there are established tools used to assess symptoms and track progress. However, there is a relative dearth of assessments of subjective well-being or recovery. Social connectedness is a concept linked with well-being and risk in young people. We sought to evaluate the utility and acceptability of a measure of social connectedness in inpatient CAMHS.Method:As part of routine clinical practice, we asked 92 young people (mean age 16 years old) on two inpatient CAMHS wards to complete the Social Connectedness Scale, alongside other assessments, and also comment on its acceptability. We repeated the measure on discharge from the unit.Results:The findings showed that the measure was internally consistent (α = .910) and sensitive to change in this population. Scores also correlated with another self-report measure focusing on well-being and mental distress, but not with clinician-rated measures. Ratings of relevance and ease of understanding were reasonable and young people value social connection.Conclusion:The Social Connectedness Scale might offer an appropriate method of exploring this element of young peoples’ experience and progress, as part of inpatient mental health admissions.
Appropriate secondary prevention and clinical outcomes after acute myocardial infarction according to atherothrombotic risk stratification: The FAST-MI 2010 registry
Authors: Tea Victoria , Bonaca Marc , Chamandi Chekrallah , Iliou Marie-Christine , Lhermusier Thibaut , Aissaoui Nadia , Cayla Guillaume , Angoulvant Denis , Ferrières Jean , Schiele François , Simon Tabassome , Danchin Nicolas , Puymirat Etienne ,   for the FAST-MI investigators
Published: October 2018

Background Full secondary prevention medication regimen is often under-prescribed after acute myocardial infarction. Design The purpose of this study was to analyse the relationship between prescription of appropriate secondary prevention treatment at discharge and long-term clinical outcomes according to risk level defined by the Thrombolysis In Myocardial Infarction (TIMI) Risk Score for Secondary Prevention (TRS-2P) after acute myocardial infarction. Methods We used data from the 2010 French Registry of Acute ST-Elevation or non-ST-elevation Myocardial Infarction (FAST-MI) registry, including 4169 consecutive acute myocardial infarction patients admitted to cardiac intensive care units in France. Level of risk was stratified in three groups using the TRS-2P score: group 1 (low-risk; TRS-2P=0/1); group 2 (intermediate-risk; TRS-2P=2); and group 3 (high-risk; TRS-2P≥3). Appropriate secondary prevention treatment was defined according to the latest guidelines (dual antiplatelet therapy and moderate/high dose statins for all; new-P2Y12 inhibitors, angiotensin-converting-enzyme inhibitor/angiotensin-receptor-blockers and beta-blockers as indicated). Results Prevalence of groups 1, 2 and 3 was 46%, 25% and 29% respectively. Appropriate secondary prevention treatment at discharge was used in 39.5%, 37% and 28% of each group, respectively. After multivariate adjustment, evidence-based treatments at discharge were associated with lower rates of major adverse cardiovascular events (death, re-myocardial infarction or stroke) at five years especially in high-risk patients: hazard ratio = 0.82 (95% confidence interval: 0.59–1.12, p = 0.21) in group 1, 0.74 (0.54–1.01; p = 0.06) in group 2, and 0.64 (0.52–0.79, p < 0.001) in group 3. Conclusions Use of appropriate secondary prevention treatment at discharge was inversely correlated with patient risk. The increased hazard related to lack of prescription of recommended medications was much larger in high-risk patients. Specific efforts should be directed at better prescription of recommended treatment, particularly in high-risk patients.
Dual cholinergic signals regulate daily migration of hematopoietic stem cells and leukocytes
Authors: García-García Andrés , Korn Claudia , García-Fernández María , Domingues Olivia , Villadiego Javier , Martín-Pérez Daniel , Isern Joan , Bejarano-García José A. , Zimmer Jacques , Pérez-Simón José A. , Toledo-Aral Juan J. , Michel Tatiana , Airaksinen Matti S. , Méndez-Ferrer Simón 
Published: October 2018

AbstractHematopoietic stem and progenitor cells (HSPCs) and leukocytes circulate between the bone marrow (BM) and peripheral blood following circadian oscillations. Autonomic sympathetic noradrenergic signals have been shown to regulate HSPC and leukocyte trafficking, but the role of the cholinergic branch has remained unexplored. We have investigated the role of the cholinergic nervous system in the regulation of day/night traffic of HSPCs and leukocytes in mice. We show here that the autonomic cholinergic nervous system (including parasympathetic and sympathetic) dually regulates daily migration of HSPCs and leukocytes. At night, central parasympathetic cholinergic signals dampen sympathetic noradrenergic tone and decrease BM egress of HSPCs and leukocytes. However, during the daytime, derepressed sympathetic noradrenergic activity causes predominant BM egress of HSPCs and leukocytes via β3–adrenergic receptor. This egress is locally supported by light-triggered sympathetic cholinergic activity, which inhibits BM vascular cell adhesion and homing. In summary, central (parasympathetic) and local (sympathetic) cholinergic signals regulate day/night oscillations of circulating HSPCs and leukocytes. This study shows how both branches of the autonomic nervous system cooperate to orchestrate daily traffic of HSPCs and leukocytes.
Short-course regimens of rifapentine plus isoniazid to treat latent tuberculosis infection in older Chinese patients: a randomised controlled study
Authors: Gao Lei , Zhang Haoran , Xin Henan , Liu Jianmin , Pan Shouguo , Li Xiangwei , Guan Ling , Shen Fei , Liu Zisen , Wang Dakuan , Guan Xueling , Yan Jiaoxia , Li Hengjing , Feng Boxuan , Cao Xuefang , Chen Yu , Cui Wei , Zhang Zongde , Ma Yu , Chen Xiaoyou , Zhou Xinhua , Jin Qi 
Published: October 2018

Latent tuberculosis infection (LTBI) management is now a critical component of the World Health Organization's End TB Strategy.In this randomised controlled trial (Chinese Clinical Trial Registryidentifier ChiCTR-IOR-15007202), two short-course regimens with rifapentine plus isoniazid (a 3-month once-weekly regimen and a 2-month twice-weekly regimen) were initially designed to be evaluated for rural residents aged 50–69 years with LTBI in China.Due to the increasingly rapid growth and unexpected high frequency of adverse effects, the treatments were terminated early (after 8 weeks for the once-weekly regimen and after 6 weeks for the twice-weekly regimen). In the modified intention-to-treat analysis on the completed doses, the cumulative rate of active disease during 2 years of follow-up was 1.21% (14 out of 1155) in the untreated controls, 0.78% (10 out of 1284) in the group that received the 8-week once-weekly regimen and 0.46% (six out of 1299) in the group that received the 6-week twice-weekly regimen. The risk of active disease was decreased, with an adjusted hazard ratio of 0.63 (95% CI 0.27–1.43) and 0.41 (95% CI 0.15–1.09) for the treatments, respectively. No significant difference was found in the occurrence of hepatotoxicity (1.02% (13 out of 1279)versus1.17% (15 out of 1279); p=0.704).The short regimens tested must be used with caution among the elderly because of the high rates of adverse effects. Further work is necessary to test the ultrashort regimens in younger people with LTBI.
Distraction-Free Induction Zone: A Quality Improvement Initiative at a Large Academic Children’s Hospital to Improve the Quality and Safety of Anesthetic Care for Our Patients
Authors: Crockett Christy J. , Donahue Brian S. , Vandivier Deana C. 
Published: October 2018

BACKGROUND:
Noise in the operating room may cause distractions during critical periods and impair reliable communication between staff. Even momentary inefficiency while administering anesthesia can lead to errors and serious consequences for the patient. Distractions to an anesthesia provider during critical periods such as induction and emergence are a patient safety issue. Because of concerns regarding unacceptable noise levels and distractions during induction of general anesthesia, our institution developed a quality improvement initiative, the “Distraction-Free Induction Zone.” The specific aim of this project was to decrease the percentage of cases with a distraction, described as music, unnecessary conversations, or loud noises, occurring during induction of general anesthesia in pediatric otolaryngology operating rooms from 61% to 15%.

METHODS:
To complete this quality improvement initiative, a multidisciplinary team used improvement science methods, including The Model for Improvement with interventions tested via Plan-Do-Study-Act cycles. We used tools such as the Key Driver Diagram, Pareto Charts, Process Flow Chart, and Plan-Do-Study-Act worksheets. Data were manually collected and entered weekly in an Excel spreadsheet. Statistical process control methods, including a run chart and a P-control chart, were used for data analysis. Our measure was a composite measure in which observation of 1 of the 3 distractions during induction of general anesthesia categorized the case as a case with a distraction.

RESULTS:
We tested and implemented several interventions via Plan-Do-Study-Act cycles in which 3 main interventions collectively were associated with an observed decrease in distractions during induction of general anesthesia. These included educating the perioperative staff present in the operating room to help them understand that distractions to anesthesia providers represent a patient safety issue, the operating room circulating nurse taking responsibility to pause any music on arrival to the operating room, and the anesthesiologist reminding the staff in the operating room of induction time and/or asking for quiet during induction if a distraction occurs. The percentage of cases with a distraction during induction of general anesthesia in our pediatric otolaryngology operating rooms decreased from 61% to 15% by April 15, 2017 and to 10% by June 5, 2017.

CONCLUSIONS:
Using improvement science methods, we observed a decrease in distractions during induction of general anesthesia, improved a process, and encouraged change in culture at a large academic children’s hospital to enhance the quality and safety of the anesthetic care we provide our patients.
Revised Red Data List of Estonian bryophytes
Authors: Ingerpuu Nele , Vellak Kai , Ehrlich Loore 
Published: October 2018

All Estonian bryophyte species (597) that had written records up to 2018 were evaluated against IUCN criteria. More than half of the species belong to the least concern category, but almost one fourth (158) is evaluated as threatened, and one tenth (65) as near threatened. Eleven species are data deficient and 15 species are considered to be regionally extinct from Estonia. To achieve adequate assessment results for a small country, some criteria were adjusted. Changes compared to the previous red list and threats to the species are discussed.
This version replaces the version of the same paper from 2018-08-14.
Medición del clima organizacional con un enfoque de género en la Escuela Politécnica Nacional
Authors: Espinoza-Santeli Genoveva , Jiménez Angélica 
Published: October 2018

La investigación mide el clima organizacional percibido por los docentes de la EPN y determina si existen diferencias cuando se desagregan los resultados por género. La metodología es de naturaleza cuantitativa con una muestra de 61 docentes; la herramienta se construyó considerando dos factores: las dimensiones que son evaluadas con mayor frecuencia por instrumentos psicométricos validados de medición del clima organizacional y los parámetros que determinan discriminación laboral por género establecidos en el Modelo de Equidad de Género. Algunos resultados son: proporcionalmente existe una baja participación de mujeres que desempeñan labores de docencia y un menor porcentaje de contratos con nombramiento; existen diferencias marcadas en cuanto a sueldos y acceso a posiciones de poder; ninguna mujer gana más que la media de hombres y no hay mujeres en puestos directivos, en general, las mujeres consideran que el clima laboral no es adecuado en ninguna de las dimensiones consideradas -toma de decisiones, claridad organizacional, liderazgo y motivación-. En conclusión, la percepción del clima laboral difiere cuando se analizan los resultados desagregados por sexo, las mujeres perciben un clima organizacional inadecuado en tres de las dimensiones analizadas; además, se evidencia la existencia del techo de cristal en esta institución.
Orthodontic/restorative interface part 2
Authors: Hosni Sara , Darcey James , Malik Ovais H 
Published: October 2018

Establishing optimal aesthetics, function and periodontal health in patients with missing teeth is a complex and challenging process, which demands the interaction of several dental specialties for effective multidisciplinary management. The most frequent scenario encountered within the orthodontic-restorative interface is missing teeth; this article focuses on the management of missing teeth, discussing diagnosis, the treatment planning process, treatment outcome and retention. This is demonstrated throughout a series of clinical cases treated within a multidisciplinary team. CPD/Clinical Relevance: The management of patients with missing teeth is often challenging; with a variety of orthodontic and restorative treatment options for the general practitioner.
The aesthetic prosthodontic management of periodontally involved teeth
Authors: Laverty Dominic P , Green David , Van Rensburg JJ Jansen 
Published: October 2018

There are a number of aesthetic issues that may occur as a result of periodontal disease and/or its management and it is a common motivation for patients to seek treatment, particularly when it affects the anterior teeth due to their prominence within the dentition. Clinicians and patients are becoming increasingly aware of the importance of the periodontal/muco-gingival tissues to provide an aesthetic smile and, as a result, this has led to the development of both surgical and prosthodontic techniques to improve or maintain the dental aesthetics. The aim of this article is to provide an overview of the prosthodontic solutions available to improve the aesthetics of retained periodontally involved teeth. CPD/Clinical Relevance: To present an overview of the prosthodontic solutions available to improve the aesthetics of retained periodontally involved teeth.
Evaluating an educational programme for dignity care intervention with community nurses in Ireland
Authors: Connolly Michael , Charnley Karen , Collins Rita , Barry Catriona , McIlfatrick Sonja , Larkin Philip , Brenner Maria , Johnston Bridget 
Published: October 2018

Background: A key aspect to the provision of palliative care is maintaining the dignity of the individual being cared for. Nurses working in the community setting need knowledge and skills to meet the needs of individuals who need palliative care and their families. Dignity Care Intervention Ireland is a community-based pilot project designed to implement a dignity care intervention for individuals with a life-limiting condition living in their own home. As part of the overall intervention, an education programme was developed for nurses working in the community. Method: Completion of a locally-designed questionnaire pre- and post-education. Results: Nurses working in the community setting welcomed and highly valued the Dignity Care Intervention Ireland education programme. There was an overall improvement in the understanding of palliative care for both groups and improved understanding of the principles of palliative care, with self-evaluated competence to apply these principles in daily clinical practice. Conclusion: The importance of education about palliative care to support the delivery of dignity-preserving care cannot be underestimated. Ensuring nurses have the requisite knowledge will enhance future practice development and subsequently improve care for patients with life-limiting conditions and their families.
The 2D lingual appliance – a useful adjunctive treatment
Authors: Hodge Trevor , Baumgaertel Sebastian 
Published: October 2018

The 2D lingual appliance is a popular choice for achieving cost-effective and timely results in carefully selected cases and with the minimum aesthetic impact. This article will describe how to use the appliance and highlight particular areas where introducing it into your clinical practice may be particularly beneficial. CPD/Clinical Relevance: 2D lingual orthodontics is a popular treatment modality and, whilst it is important to recognize the appliance limitations, there are situations where it is an ideal addition to your armamentarium for meeting the expectations of some patients. Awareness of this appliance system should lead to benefits for patients once successfully integrated into clinical practice.
Early treatment of severe class II division 1 malocclusions
Authors: Witwit Shayma , Spary David John 
Published: October 2018

The early orthodontic management of a severe Class II division 1 malocclusion and its advantages are discussed. Two cases are described, both of which were successfully treated on a non-extraction basis, with a phase of functional appliance therapy followed by fixed appliances. CPD/Clinical Relevance: The article outlines how, with careful case selection and early treatment, severe overjets can be successfully treated with orthodontics alone.
A modified intrusion approach for a periodontally compromised adult patient
Authors: Kumar Santosh , Tummuru Yehoshuva Reddy , Lodha Surendra , Sawhney Chand 
Published: October 2018

Loss of periodontal attachment in adults usually manifests as pathological migration, traumatic deep bite and irregular dental spacing, which lead to compromised aesthetics and function. This article describes the interdisciplinary management of an adult patient presenting with severe periodontitis accompanied by marginal bone loss and pathological migration of the upper right anterior teeth. The combination of a modified intrusion procedure of the upper anterior teeth and periodontal therapy led to significant improvement in function and aesthetics. CPD/Clinical Relevance: The modified intrusion technique described in the present case can be a useful alternative to improve the periodontal condition as well as the aesthetics in periodontally compromised adult patients.
Molecular Testing for Detection of Groups A, C, and G β-Hemolytic Streptococci in Pharyngeal Samples from Children
Authors: Van Tam T , Mestas Javier , Dien Bard Jennifer 
Published: October 2018

Abstract

Background
Group A Streptococcus (GAS) and large colony-forming group C (GCS) and G (GGS) β-hemolytic streptococci are important causes of acute pharyngitis in children and adults. Rapid and accurate diagnosis of streptococcal pharyngitis can improve patient care and potentially reduce transmission. In this study, we evaluated the performance of the Lyra Direct Strep (LDS) assay for detection of GAS and GCS/GGS compared with traditional culture methods.

Methods
Pharyngeal samples obtained from 278 children presenting to the emergency department with initial negative GAS rapid antigen detection test (RADT) were used. All samples were cultured as part of routine care and tested in batches using the LDS assay.

Results
Of 278 pharyngeal samples with negative GAS RADT, 37 (13.3%) and 63 (22.7%) patients were positive for GAS by culture and LDS assay, respectively. Four (1.4%) patients were positive for GCS or GGS by culture or LDS assay. The LDS assay demonstrated sensitivity and specificity of 97.6% and 89.0%, respectively, compared with culture as the gold standard. Repeat culture and an alternate PCR showed that 85.7% (24 of 28) of discrepant samples agreed with findings of the LDS assay. Since implementation, the LDS assay shows a positivity rate of 21.0% (281 of 1340) compared with 11.7% (246 of 2110) by culture in the previous year.

Conclusions
We successfully implemented the LDS assay at our institution and have observed a significant increase in the positivity rate of GAS compared with culture. The LDS assay alone allowed for the elimination of β-streptococci screening by culture at our institution.