bluuebunny/crossref_metadata_2025_split huggingface dataset:
The foaming performance evaluation of fibrillated polytetrafluoroethylene and isotactic polypropylene blends
Authors: Zhang Yun , Xin Chunling , Wang Zeming , Mughal Waqas , He Yadong 
Published: May 2019

Polypropylene (PP) foamed products have the advantages of heat and chemical resistance, but it is difficult to foam without modified PP. Traditionally, researchers have used chemical modification to increase the melt strength to improve the foaming properties of PP. In this article, we designed four kinds of screw combinations, and five regions are selected for sampling. The polytetrafluoroethylene (PTFE) and isotactic polypropylene (iPP) were blended by one-step fiber forming method, and then we tested the rheological properties and foaming properties. It is found that the rheological properties of the in situ microfiber composite are significantly improved than the iPP, and the crystallization temperature is also increased. The foaming experiment of the composite showed that the foaming performance of the composite with in situ microfiber morphology was significantly improved compared with the pure iPP performance, and the foaming temperature window of iPP was widened from 3°C to more than 6°C. [Formula: see text]
Application of fast-track surgery in the perioperative period of laparoscopic partial nephrectomy for renal tumors
Authors: Kang Chunmei , Qiao Xueliang , Sun Meiling 
Published: May 2019

Objectives This study aimed to examine application of fast-track surgery (FTS) in the perioperative period of laparoscopic partial nephrectomy for renal tumors, and to discuss its effects and safety. Methods Eighty patients who received laparoscopic partial nephrectomy in urinary surgery from January 2016 to December 2017 were selected and randomly classified as the observation group (n = 40) and control group (n = 40). Traditional treatments were performed in the control group, while FTS was applied in the observation group. The complication rate after the operation was recorded. Results The duration of the operation and intraoperative blood loss were not different between the groups. The duration of anesthesia and fluid transfusion volume on the day of the operation were significantly less in the observation group than in the control group. The rates of infection of the incisional wound, nausea and vomiting, and anastomotic stomal bleeding were not significantly different between the groups. However, the rates of postoperative urinary tract infection, abdominal distension, thirst, hypothermia, and pulmonary infection were significantly lower in the observation group than in the control group. Conclusion Application of FTS in laparoscopic partial nephrectomy contributes to postoperative recovery and reduction of postoperative complications.
Potassium Bromide in the Treatment of Pediatric Refractory Epilepsy
Authors: Kodama Kazuo , Omata Taku , Watanabe Yoshimi , Aoyama Hiromi , Tanabe Yuzo 
Published: May 2019

Objective: We evaluated potassium bromide’s (KBr’s) efficacy and tolerability for pediatric refractory epilepsy. Methods: We retrospectively reviewed the records of 42 patients treated with KBr in our hospital between 2008 and 2016 (age: 4 months to 19 years; mean: 6.2 years). Thirteen of them had 2 seizure types. The treatment durations ranged from 1 month to 6 years (mean: 15.0 months). Results: KBr had an excellent effect (seizure-free status) in 3 patients (7.1%), a moderate effect (>50% reduction in seizure frequency from the pretreatment baseline) in 21 patients (50.0%), and no effect (<50% reduction in seizure frequency from the pretreatment baseline) in 18 patients (42.9%). The effective daily doses ranged from 20 to 80 mg/kg (mean: 50.0 mg/kg). KBr was effective in 59.1% patients with generalized epilepsy (n = 22), 55.6% patients with focal epilepsy (n = 18), and both patients with Dravet syndrome. An excellent or moderate effect was found in 72.2% patients with tonic seizures (n = 18), 66.6% patients with generalized tonic-clonic seizures (n = 6), 75.0% patients with secondary generalized seizures (n = 4), 46.2% patients with focal seizures (n = 13), and 20% patients with infantile spasms (n = 10) but no patients with myoclonic seizures (n = 2). Adverse effects including drowsiness, excitement, and rashes were reported in 13 patients (31.0%). Conclusions: These findings suggest that KBr is particularly effective for tonic seizures, generalized tonic-clonic seizures, and secondary generalized seizures. Although the adverse effects need further attention, KBr should be considered for pediatric refractory epilepsy.
Estimation of data adaptive minimal clinically important difference with a nonconvex optimization procedure
Authors: Zhou Zehua , Zhao Jiwei , Bisson Leslie J. 
Published: May 2019

Understanding the limitation of solely relying on statistical significance, researchers have proposed methods to draw biomedical conclusions based on clinical significance. The minimal clinically important significance is one of the most fundamental concepts to study clinical significance. Based on an anchor question usually available in the patients' reported outcome, Hedayat et al. presented a method to estimate minimal clinically important significance using the classification technique. However, their method implicitly requires that the binary outcome of the anchor question is equally likely, i.e. the balanced outcome assumption. This assumption cannot be guaranteed a priori when one designs the study; hence, it cannot be satisfied in general. In this paper, we propose a data adaptive method, which can overcome this limitation. Compared to Hedayat et al., our method uses a faster gradient based algorithm and adopts a more flexible structure of the minimal clinically important significance at the individual level. We conduct comprehensive simulation studies and apply our method to the chondral lesions and meniscus procedure study to demonstrate its usefulness and also its outperformance.
Patient advocacy in nursing: A concept analysis
Authors: Abbasinia Mohammad , Ahmadi Fazlollah , Kazemnejad Anoshirvan 
Published: May 2019

Background: The concept of patient advocacy is still poorly understood and not clearly conceptualized. Therefore, there is a gap between the ideal of patient advocacy and the reality of practice. In order to increase nursing actions as a patient advocate, a comprehensive and clear definition of this concept is necessary. Research objective: This study aimed to offer a comprehensive and clear definition of patient advocacy. Research design: A total of 46 articles and 2 books published between 1850 and 2016 and related to the concept of patient advocacy were selected from six databases and considered for concept analysis based on Rodgers’ evolutionary approach. Ethical considerations: This study was approved by the Research Ethics Committee of Tarbiat Modares University. Findings: The attributes of patient advocacy are safeguarding (track medical errors, and protecting patients from incompetency or misconduct of co-workers and other members of healthcare team), apprising (providing information about the patient’s diagnosis, treatment, and prognosis, suggesting alternatives of healthcare, and providing information about discharge program), valuing (maintaining self-control, enabling patients to make decisions freely, maintaining individualization and humanity, maintaining patient privacy, and acting in the patients’ values, culture, beliefs, and preferences), mediating (liaison between patients, families, and healthcare professionals, being patients’ voice, and communicate patient preferences and cultural values to members of the healthcare team), and championing social justice in the provision of healthcare (confronting inappropriate policies or rules in the healthcare system, identifying and correcting inequalities in delivery of health services, and facilitating access to community health services and health resources). Discussion and conclusion: The analysis of this concept can help to develop educational or managerial theories, design instruments for evaluating the performance of nurses in patient advocacy, develop strategies for enhancing patient advocacy, and improve the safety and quality of nursing care in the community and healthcare system.
Correlation between corneal involvement and anterior chamber flare in epidemic keratoconjunctivitis
Authors: Kiyat Pelin , Palamar Melis , Yilmaz Suzan Guven , Emre Sinan 
Published: May 2019

Purpose: To investigate the correlation between corneal involvement and anterior chamber flare using a laser flare meter in eyes with epidemic keratoconjunctivitis. Methods: A total of 82 eyes of 50 (32 female and 18 male) consecutive patients with epidemic keratoconjuctivitis were evaluated. Besides complete opthalmic examination, anterior chamber flare measurements with laser flare meter (FM 600, Kowa, Kowa Company Ltd., Nagoya, Japan) were performed. The relationship between corneal involvement, subepithelial deposits, and anterior chamber flare was assessed. Results: The mean age of the patients was 36.32 ± 18.77 (range 4–75) years and the mean duration of complaints was 5.28 ± 2.65 (range 1–12) days. The biomicroscopic findings were conjunctival hyperemia in 82 (100%), follicular reaction in 66 (80.5%), eyelid edema in 56 (68.3%), punctate epitheliopathy in 38 (46.3%), and subepithelial deposits in 36 (43.9%) eyes. The mean flare value was 17.35 ± 12.62 (range 2.0–45.0) photons/ms. Flare measurements were significantly higher in eyes with subepithelial deposits (p < 0.001). Conclusions: Subepithelial deposits seem to occur in eyes with higher anterior chamber inflammation in epidemic keratoconjunctivitis. The laser flare meter might be a useful tool to predict subepithelial deposit development in these patients.
Anatomic study on the blood supply to the femoral head following hip resurfacing using the posterior approach
Authors: Alsheri Mohammed , Bali Kamal , Railton Pamela , Ponjevic Dragana , Matyas John , Powell James 
Published: May 2019

Objectives: The aim of this study was to investigate femoral head perfusion following cadaveric hip resurfacing using the posterior approach. Methods: This cadaveric study involved injecting Higgins India ink into the common iliac arteries and evaluating the distribution of ink in the resurfaced heads using the modified Spalteholz technique. The study consisted of 2 parts. The 1st part involved utilisation of 22 cadaveric hips for establishing the injection and histological technique. The 2nd part of the study included 4 control cadaveric hips and 12 cadaveric hips with posterior approach hip resurfacing. Each specimen was divided into 15 zones (12 head zones and 3 neck zones) to evaluate detailed geographic distribution of dye-containing blood vessels. Results: All 4 controls had good flow of ink to all head zones and the neck region. In all the resurfaced heads, there was good flow to all the neck zones. 6 resurfaced specimens had no dye flow to any of the head zones. In the remaining 6, dye-stained vessels were seen variably in the anterior and middle zones but were consistently absent in the posterior zones of the head. Zones representing the antero-inferior parts of femoral head had the maximum flow of ink, followed by zones representing middle-inferior parts. Conclusions: Posterior approach for hip resurfacing arthroplasty results in vascular insult to the femoral head, with posterior zones more affected than the anterior zones. The persistence of the dye in the intraosseous blood vessels of the neck and in anteroinferior head may be a source of revascularisation of the femoral head after posterior approach hip resurfacing.
Reforming medical regulation: a qualitative study of the implementation of medical revalidation in England, using Normalization Process Theory
Authors: Tazzyman Abigail , Ferguson Jane , Boyd Alan , Bryce Marie , Tredinnick-Rowe John , Price Tristan , Walshe Kieran 
Published: May 2019

Objectives The introduction of medical revalidation in 2012 has been a controversial and radical change to medical regulation in the UK. It involved changes to the way organizations manage medical performance, and to the relationships between doctors, their employers and the professional regulatory body. In this paper, we explore the implementation of medical revalidation, analysing the change process and its consequences for doctors and organizations. Methods We conducted a qualitative investigation of the implementation of revalidation in 15 case study organizations in 2016–2017, collecting documents and undertaking a total of 80 interviews with medical and non-medical staff. We used Normalization Process Theory to frame and structure the analysis. Results Revalidation reforms were largely implemented successfully within and across our case study organizations, with evidence of growing acceptance of the purpose and processes of revalidation. There was an emergent shift from securing doctors’ compliance towards the use of revalidation to strengthen clinical governance, and towards evaluating revalidation processes and seeking to make them more effective. However, there was substantial variation in the implementation and impact of revalidation; it was still not fully understood by many doctors, and revalidation processes were highly reliant on a few key individuals in each organization. The changes brought about by revalidation have had consequences for the way in which doctors construct their identity and the way they relate to the organizations in which they work. Conclusion Despite considerable early scepticism and overt opposition in the medical profession, revalidation has become gradually accepted, embedded and even valued over time. Its impact and effectiveness are still questioned by many stakeholders, and the focus of attention has now shifted towards revising and improving the way revalidation works in practice.
Reliability and validity of the Chinese (Queen Mary Hospital, Hong Kong version) of the Disabilities of the Arm, Shoulder and Hand on patients with upper extremity musculoskeletal disorders in Hong Kong
Authors: K.Y. Chan Rebecca , Leung Y.C. , K.L. Leung Frankie , X.S. Fang Christian , K.P. Cheung Amy , K.C. Lau Tony , K.M. Fung Jo Kamen 
Published: May 2019

Objective This study aimed to translate, culturally adopt and validate a Chinese version of the Disabilities of the Arm, Shoulder and Hand (DASH) for use in patients with upper extremity musculoskeletal diseases in Hong Kong. Methods We followed a standard five-stage process: forward translation, synthesis, backward translation, expert panel review and field-testing to achieve linguistic and conceptual equivalence. The version was officially known as Chinese (Queen Mary Hospital, Hong Kong version) DASH. (Chinese QMH,HK version DASH) ( http://www.dash.iwh.on.ca/sites/dash/public/translations/DASH_Chinese_HK_2013.pdf ). Results Its internal consistency was then evaluated with 138 participants suffering from upper extremity musculoskeletal conditions. The results were high in DASH-Disability/Symptom module (DASH-DS) (Cronbach alpha 0.97), DASH-Work module (DASH-W) (Cronbach alpha 0.97) and DASH-Sports / Performing Arts module (DASH-SM) (Cronbach alpha 0.99). The test-retest reliability was evaluated with a subgroup of participants who had completed the Chinese (QMH,HK version) DASH on two occasions, with a median interval of 6.5 days. The results were excellent among DASH-DS Intraclass Correlation Coefficient (ICC) = 0.98 and DASH-W (ICC = 0.90). Good test-retest reliability was found in DASH-SM (ICC = 0.89). Construct validity of DASH-DS showed good correlation with the sub-domains of physical functioning (r = −.564) and social functioning (r = −.544) of the Short Form 36 Health Survey (SF-36). Similarly, construct validity of DASH-W also showed good correlation with the sub-domains of physical functioning (r = −.510) and bodily pain (r = −.503) of SF-36. Conclusion The Chinese (Queen Mary Hospital, Hong Kong version) Disabilities of the Arm, Shoulder and Hand is considered as a reliable and valid instrument that can provide a standardised measure of patient-centred outcomes for patients with upper extremity musculoskeletal disorders in Hong Kong.
Therapeutic effect of pre-operative tirofiban on patients with acute ischemic stroke with mechanical thrombectomy within 6–24 hours
Authors: Luo Ying , Yang Yang , Xie Yang , Yuan Zhengzhou , Li Xiaogang , Li Jinglun 
Published: May 2019

Objective The objective of this study was to investigate and discuss the therapeutic effect of pre-operative tirofiban on patients with acute ischemic stroke (AIS) with mechanical thrombectomy (MT) within 6–24 h. Patients and methods We retrospectively queried our AIS database from January to November 2018, and selected 99 patients with AIS within 6–24 h and evidence of proximal large vessel occlusion who were suitable for MT. They were divided into two groups, group A (with tirofiban, n = 56) and group B (without tirofiban, n = 43), according to whether they were intravenously infused with tirofiban before MT. The baseline characteristics and outcomes of patients were subjected to statistical analysis, including age, gender and risk factors, occlusion site, the time from onset to door, time of door to puncture, baseline National Institutes of Health Stroke Scale (NIHSS), pre-operative Alberta stroke programme early CT (ASPECT) score, angioplasty/stenting, modified Rankin Scale score 0–2 at 3 months, symptomatic haemorrhage and mortality, the time of door to recanalization, endovascular procedure time, 7-day (7d) NIHSS score, and a modified treatment in cerebral infarction (m-TICI) grade of 2b or 3. All of the thrombi were analysed by histopathology. Results The differences in the time of door to recanalization, endovascular procedure time, 7d NIHSS score and the m-TICI were significantly different between groups ( P < 0.05). The other agents were not significantly different between groups ( P > 0.05 each). Histopathological analysis showed that all thrombi contained different amounts of platelets, fibrinogen, Haemamoebas and red blood cells. Conclusion The use of tirofiban before MT can shorten the procedure time and improve the recanalization rate of occluded vessels in AIS patients.
Advances by the Marie Curie project TANGO in thermoacoustics
Authors: Heckl Maria 
Published: May 2019

This paper gives an overview of the research performed by the project TANGO – an Initial Training Network (ITN) with an international consortium of seven academic and five industrial partners. TANGO is the acronym for ‘Thermoacoustic and Aeroacoustic Nonlinearities in Green combustors with Orifice structures’). The researchers in TANGO studied many of the intricate physical processes that are involved in thermoacoustic instabilities. The paper is structured in such a way that each section describes a topic investigated by one or more researchers. The topics include: - transition from combustion noise to thermoacoustic instability - development of an early-warning system by detecting the precursor of an instability - analytical flame models based on time-lags - Green's function approach for stability predictions from nonlinear flame models - intrinsic thermoacoustic modes - transport phenomena in swirl waves - model of the flame front as a moving discontinuity - development of efficient numerical codes for instability predictions - heat exchanger tubes inside a combustion chamber A substantial amount of valuable new insight was gained during this four-year project.
Components of compulsory service program for health professionals in low- and middle-income countries: a scoping review
Authors: Antonio CT , Guevarra JP , Medina PN , Avelino MD , Agbon AG , Sepe DC , Bardelosa DD , Cengca MM , Ting ML , Lara AB 
Published: May 2019

Aims: The global health landscape has been characterized by shortfalls and imbalances in human resources for health (HRH), with more health workers concentrated in urban than rural areas. To address this maldistribution, some countries resorted to the implementation of a compulsory service policy for HRH. However, there is no comprehensive documentation describing the different components of such policies. This scoping review aims to determine the components for compulsory service for selected health professionals in low- and middle-income countries (LMICs). Methods: A search was conducted in MEDLINE, PLoS, Scopus, and ProQuest Central, using keywords for ‘compulsory service’, ‘return service’, ‘mandatory service’, ‘physician’, ‘dentist’, ‘nurse’, ‘midwife’, ‘physical therapist’, ‘occupational therapist’, and identified LMICs. A total of 6757 records were retrieved and assessed, from which 41 relevant records were included in the study. Results and conclusions: Common elements of a compulsory service program are the following: a comprehensive master plan, clearly articulated program goals, appropriate education and training, transparent recruitment and placement, strong institutional and system support, competitive benefits and incentives, and active management of exit from the program. Results presented in this article can serve to inform LMICs on policy, guide program development and management, and direct future research in the area of HRH to address challenges in maldistribution.
Factors Associated With Extended Length of Stay and 90-Day Readmission Rates Following ACDF
Authors: Dial Brian L. , Esposito Valentine R. , Danilkowicz Richard , O’Donnell Jeffrey , Sugarman Barrie , Blizzard Daniel J. , Erickson Melissa E. 
Published: May 2019

Study Design: Retrospective. Objective: Identify patient risk factors for extended length of stay (LOS) and 90-day hospital readmissions following elective anterior cervical discectomy and fusion (ACDF). Methods: Included ACDF patients from 2013 to 2017 at a single institution. Eligible patients were subset into LOS <2 and LOS ≥2 days, and no 90-day hospital readmission and yes 90-day hospital readmission. Patient and surgical factors were compared between the LOS and readmission groups. Multivariable logistic regression analysis was utilized to determine the association of independent factors with LOS and 90-day readmission rates. Results: Our sample included 1896 patients; 265 (14%) had LOS ≥2 days, and 121 (6.4%) had a readmission within 90 days of surgery. Patient and surgical factors associated with LOS included patient age ≥65 years (odds ratio [OR] 1.72, 95% confidence interval [CI] 1.15-2.56), marriage (OR 0.57, 95% CI 0.43-0.79), private health insurance (OR 0.28, 95% CI 0.15-0.50), American Society of Anesthesiologists (ASA) score (OR 1.52, 95% CI 1.12-1.86), African American race (OR 1.95, 95% CI 1.38-2.72), and harvesting iliac crest autograft (OR 4.94, 95% CI 2.31-10.8). Patient and surgical factors associated with 90-day hospital readmission included ASA score (OR 1.81, 95% CI 1.32-2.49), length of surgery (OR 1.002, 95% CI 1.001-1.004), and radiculopathy as indication for surgery (OR 0.60, 95% CI 0.39-0.96). Conclusions: Extended LOS and 90-day hospital readmissions may lead to poorer patient outcomes and increased episode of care costs. Our study identified patient and surgical factors associated with extended LOS and 90-day readmission rates. In general, preoperative patient factors affected these outcomes more than surgical factors.