bluuebunny/crossref_metadata_2025_split huggingface dataset:
Projecting the future size of the Lebanese pharmacy workforce: forecasts until the year 2050
Authors: Hallit Souheil , Sacre Hala , Hajj Aline , Sili Georges , Zeenny Rony M , Salameh Pascale 
Published: July 2019

Abstract

Background
Despite the rigorous regulations governing the pharmacy profession in Lebanon, the increasing numbers of pharmacy graduates seem to be the greatest threat of demise. No forecast is available to assess the long-term projections of pharmacists supply.

Objective
The objective of this manuscript is to project the future size of the Lebanese pharmacy workforce till 2050 and discuss their potential consequences on the labour market.

Methods
This study was carried out in collaboration with the Lebanese Order of Pharmacists (OPL), where official numbers were retrieved from the registered pharmacists’ database from 2006 to 2017. The data were analyzed as time series using the Auto-Regressive Integrated Moving Average (ARIMA) method. Projected numbers were plotted using Microsoft Excel office.

Results
The ratio of pharmacists to 10 000 inhabitants up till the end of 2017 was estimated at 17.52, compared with a worldwide mean of 5.09, with a continuous increase seen with the coming years, possibly reaching an estimated 41.17 pharmacists per 10 000 inhabitants by the year 2050. The total number of pharmacies increased from 1546 in 2006 up to 3174 at the end of 2017 nationwide, with a major increase seen in Bekaa (206.35%) and South Lebanon (171.08%) governorates, respectively.

Conclusion
Our study shows that the dramatic increase in pharmacy graduates will worsen with time. To curb it, it is important to vote and apply new laws, and initiate a collaborative work between academia, professional associations, and employers from all sectors to find innovative solutions.
Changing the current health system's vision for disease prevention and health promotion
Authors: Madjar B. , Shachaf S. , Zlotnick C. 
Published: July 2019

AimUsing the case of Israel, we examine the confluence of current philosophies of health care along with the historical trends of health promotion/disease prevention services to consider strategies for increasing inclusiveness and for updating and improving their service delivery.BackgroundHealth services in Israel are at a crossroads. Plans to integrate the historic, nurse‐operated, nationwide programme, providing health promotion/disease prevention services to pregnant women and young children for all residents (Tipat Halav) into the National Health Service System's existing Sickness Funds are under discussion.Sources of evidenceUsing a discourse approach, this paper examines the current and historical context of health promotion/disease prevention services. Our history shows an increasingly treatment‐based perspective and dwindling support for inclusive services. In the current health system, Tipat Halav nurses solely provide inclusive health promotion/disease prevention services to pregnant women and young children. Informed by the World Health Organization, a reorientation to health promotion/disease prevention is essential in an ageing society where chronic rather than infectious diseases are the reigning health problems.ConclusionIsrael needs to reorganize the health system using a public health approach that both incorporates existing structures and establishes new ones, such as creating a network to elicit community input, and instituting nurse‐operated clinics designed to provide health promotion/disease prevention services for all ages and all residents.Implications for health and nursing policyThe newly created health system framework demands activism among all health professionals to legislate for an inclusive, holistic orientation. Master's level clinical programmes in community health nursing are vital to ensure the provision of optimal health promotion/disease prevention services.
Fluoroscopy‐guided axillary vein access vs cephalic vein access in pacemaker and defibrillator implantation: Randomized clinical trial of efficacy and safety
Authors: Jiménez‐Díaz Javier , Higuera‐Sobrino Felipe , Piqueras‐Flores Jesús , Pérez‐Díaz Pedro , González‐Marín María Arantzazu 
Published: July 2019

AbstractIntroductionThe most widespread venous sites of access for implantation intravenous implantable cardiac electronic device (CIED) are the cephalic and subclavian vein. Fluoroscopy‐guided axillary venous access is an alternative, but efficacy and safety have not been studied under equal conditions. The aim of the present study is to compare the efficacy and safety of fluoroscopy‐guided axillary vs cephalic vein access in CIED implant.Methods and ResultsTwo hundred and forty patients were randomized to receive CIED implantation by the fluoroscopy‐guided axillary vein access vs cephalic vein access. The implantation success, the procedure times and the complications were recorded. A comparison of the results of operators was made. The success rate of the randomized venous access was superior in the axillary group than in cephalic (98.3% vs 76.7%, P < .001). Time to access (6.8 ± 3.1 minute vs 13.1 ± 5.8 minutes, P < .001) and implantation duration was significantly shorter in the axillary group than in the cephalic group (42.3 ± 11.6 minutes vs 50.5 ± 13.3 minutes, P < .001). There was no difference in the incidence of complication and inter‐operator success rate, complications rate and time to access.ConclusionThe fluoroscopy‐guided axillary venous access is safe and has a better success rate and faster execution time compared with the cephalic vein access. When the results were compared among the study operators, neither in the axillary nor in the cephalic group there were differences in the success rate, the complication rate, and the time to access.Trial Registration: www.clinicaltrials.gov, NCT03860090
Differences in the electrophysiological findings of repeat ablation between patients who first underwent cryoballoon ablation and radiofrequency catheter ablation for paroxysmal atrial fibrillation
Authors: Inamura Yukihiro , Nitta Junichi , Inaba Osamu , Kono Toshikazu , Ikenouchi Takashi , Murata Kazuya , Takamiya Tomomasa , Sato Akira , Matsumura Yutaka , Takahashi Yoshihide , Goya Masahiko , Hirao Kenzo 
Published: July 2019

AbstractIntroductionSeveral studies have revealed that second‐generation cryoballoon (CB)‐based pulmonary vein (PV) isolation is noninferior to radiofrequency (RF)‐based PV isolation for patients with drug‐refractory paroxysmal atrial fibrillation (AF). However, electrophysiological differences in repeat ablation remain unclear.Methods and ResultsThis study examined electrophysiological differences during the repeat ablation between patients who first underwent RF catheter ablation and CB ablation; PV durability and non‐PV AF foci were assessed for these patients. We enrolled 919 and 491 patients who underwent CB ablation (CB group) and RF catheter ablation (RF group), respectively, for paroxysmal AF between January 2013 and June 2017 at our institution. PV isolation using RF ablation involved the left atrium (LA) antrum and part of the LA posterior wall. After 2 years of follow‐up, 62 and 80 patients in the CB and RF groups, respectively, underwent repeat ablation. PV reconnections were more frequent in the RF group than in the CB group (left superior PV: 46.2% and 14.5%, P < .001; left inferior PV: 35.0% and 11.2%,
P = .001; right superior PV: 40.0% and 22.6%,
P = .031; right inferior PV: 36.2% and 19.4%,
P = .039; PVs: 39.8% and 16.9%,
P < .001). LA AF foci were more frequent in the CB group than in the RF group (27.4% and 7.5%;
P = .002). Other non‐PV foci were prevalent in both groups.ConclusionFewer LA‐PV reconnections occurred with CB ablation. However, extensive PV isolation may eliminate many LA AF foci.
Lesion distribution after cryoballoon ablation and hotballoon ablation: Late‐gadolinium enhancement magnetic resonance imaging analysis
Authors: Akita Tomomi , Kiuchi Kunihiko , Fukuzawa Koji , Shimane Akira , Matsuyama Sonoko , Takami Mitsuru , Kurose Jun , Oonishi Hiroyuki , Shigeru Mayumi , Nagamatsu Yu‐Ichi , Suehiro Hideya , Takemoto Makoto , Nakamura Toshihiro , Sakai Jun , Yatomi Atsusuke , Mori Shumpei , Shimoyama Shinsuke , Negi Noriyuki , Kyotani Katsusuke , Hirata Ken‐Ichi 
Published: July 2019

AbstractIntroductionPulmonary vein isolation (PVI) lesions after cryoballoon ablation (CBA) are wide and continuous, however, the distribution can depend on the pulmonary vein (PV) size. We sought to assess the relationship between the lesion distribution and PV size after CBA and hotballoon ablation (HBA).Methods and ResultsA total of 80 consecutive patients who underwent PVI were enrolled (40 with CBA). The lesions were visualized by late‐gadolinium enhancement magnetic resonance imaging. The lesion width, lesion gaps, and distance from the PV ostium (PVos) to distal lesion edge (DLE) were assessed. If the DLE extended inside the PV, the value was expressed as a negative value. Although the lesion width was significantly wider in the CB group (7.8 ± 2.0 vs 4.9 ± 1.0 mm, P < .001), the number of lesion gaps was significantly less in the HB group (2.9 ± 2.4 vs 1.3 ± 1.4 gaps, P = .001). The distance from the PVos to DLE was a negative value in both groups, but the impact was significantly greater (−1.5 ± 1.8 vs −0.2 ± 1.2 mm, P < .001) and negatively correlated with PV size in the CB group, but not in HB group (r = −0.27, P = .007). The AF recurrence 12 months after the procedure did not differ (5 [12.5%] of 40 in the CB group vs 4 [10%] of 40 in the HB group, P = .695).ConclusionsThe PVI lesions after HBA were characterized by (a) narrower, but (b) more continuous, (c) smaller lesion inside the PV, and (d) irrespective of PV size as compared to that after CBA.
Performance of Person‐Fit Statistics Under Model Misspecification
Authors: Hong Seong Eun , Monroe Scott , Falk Carl F. 
Published: July 2019

AbstractIn educational and psychological measurement, a person‐fit statistic (PFS) is designed to identify aberrant response patterns. For parametric PFSs, valid inference depends on several assumptions, one of which is that the item response theory (IRT) model is correctly specified. Previous studies have used empirical data sets to explore the effects of model misspecification on PFSs. We further this line of research by using a simulation study, which allows us to explore issues that may be of interest to practitioners. Results show that, depending on the generating and analysis item models, Type I error rates at fixed values of the latent variable may be greatly inflated, even when the aggregate rates are relatively accurate. Results also show that misspecification is most likely to affect PFSs for examinees with extreme latent variable scores. Two empirical data analyses are used to illustrate the importance of model specification.
Effect of a 7‐day acute inpatient neurophysiotherapy service on physiotherapy provision, length of stay, and patient experience
Authors: McGlinchey Mark P. , Buttery Charlotte 
Published: July 2019

AbstractRationale, aims, and objectivesNational policy, guided by research, suggests several patient and service benefits achieved by providing 7‐day health care. Therefore, a 7‐day inpatient neurophysiotherapy service was introduced at a large teaching hospital in London. The study's aim was to evaluate the effect of the 7‐day service on physiotherapy provision, length of stay (LOS), and patient experience.MethodBaseline data from the 5‐day service were collected for 6 months. Data included time to first neurophysiotherapy assessment, average number of sessions per week, total number of physiotherapy minutes provided, physiotherapy LOS, and hospital LOS. Once 7‐day working (7DW) commenced, involving daily physiotherapy for all patients applicable for physiotherapy, data were collected for 6 months and compared with the 5‐day service. Patient and carer feedback were also obtained through structured interviews from a sample of patients and their carers.ResultsData from 286 patients (148 patients pre and 138 patients post 7DW) were analysed. Post 7DW, the percentage of patients seen by a physiotherapist within 24 hours increased from 69.9% to 94.9%. Patients also received more physiotherapy sessions per week during their hospital LOS. For demographically similar patients, physiotherapy LOS (24.8‐17.4 d, P = .02) and total hospital LOS (32‐23.4 d, P = .04) significantly reduced. Twenty‐four structured interviews were completed (17 patients and seven carers). Carers preferred a 7‐day physiotherapy service as it was perceived to provide more physiotherapy for patients. However, patients valued the consistency of seeing the same therapist during the 5‐day service, as this was perceived to develop therapeutic relationships and result in faster treatment progression.ConclusionsThis study has demonstrated that 7DW can improve timely access to more intensive physiotherapy whilst reducing LOS for demographically similar patients. Whilst patients and carers liked having daily physiotherapy, consideration is required to ensure consistency of therapists treating patients.
Histopathological changes induced by the digenean intestinal parasite Masenia nkomatiensis Dumbo, Dos Santos, & Avenant‐Oldewage, 2019 of the catfish Clarias gariepinus (Burchell) from Incomati Basin, Mozambique
Authors: Dumbo José Chissiua , Avenant‐Oldewage Annemariè 
Published: July 2019

AbstractThe intestines of 154 Clarias gariepinus were examined of which 29 were naturally infected with Masenia nkomatiensis, and of these, seven (intensity ranging from 8 to 231) were examined for pathology. Destruction of the epithelium covering the villi, detachment of epithelial cells and parts of villi were observed. Excessive mucus secretion occurred in the vicinity of the worm and catarrh was observed, indicative of an inflammatory response. The number of mucous and mast cells was higher at the attachment site than at an area 5,000 µm away and in uninfected individuals, suggesting that the parasite triggered a localized innate immune response. The number of neutrophils, basophils and lymphocytes in infected tissue was not significantly different from uninfected tissue confirming that no acquired immune response was produced against the maseniid. The caecae in the anterior part of the parasites' intestine consisted of convoluted epithelium forming invaginations or “crypts.” Contraction of the thick layer of circular muscle fibres of the caeca facilitates the movement of digested material. Observation of digested host cells and cell debris within the caecae provides further evidence that M. nkomatiensis is consuming host cells.
Extraordinary grip strength and specialized myology in the hyper‐derived hand of Perodicticus potto?
Authors: Boettcher Marissa L. , Leonard Kaitlyn C. , Dickinson Edwin , Herrel Anthony , Hartstone‐Rose Adam 
Published: July 2019

AbstractPrevious behavioral reports of the African lorisid, Perodicticus potto, have speculated that these animals have an extraordinary grip strength. This ability is hypothesized to be facilitated by a range of anatomical features within the forelimb, ranging from the presence of a retia mirabilia in its wrist to the hyper‐abduction of its pollex. Despite numerous behavioral reports, however, this claim of extraordinary grip strength has not been empirically substantiated. This study quantifies the physiological cross‐sectional area of the digital flexor muscles within P. potto. These data are compared with a broad primate sample, including several similarly sized strepsirrhines. Contrary to expectation, we found that P. potto actually has relatively below‐average digital flexor PCSA. However, we identified other myological characteristics in the upper limb of P. potto that were unexpected, including the largest brachioradialis muscle (an elbow flexor) among our primate sample, and – despite P. potto having only a vestigial second digit – an independent digital extensor indicis that is absent in almost a quarter of our primate sample.
Global sex differences in personality: Replication with an open online dataset
Authors: Kaiser Tim , Del Giudice Marco , Booth Tom 
Published: July 2019

AbstractObjectiveSex differences in personality are a matter of continuing debate. In a study on the United States standardization sample of Cattell's 16PF (fifth edition), Del Giudice and colleagues (2012; PLoS ONE, 7, e29265) estimated global sex differences in personality with multigroup covariance and mean structure analysis. The study found a surprisingly large multivariate effect, D = 2.71. Here we replicated the original analysis with an open online dataset employing an equivalent version of the 16PF.MethodWe closely replicated the original MG‐MCSA analysis on N = 21,567 U.S. participants (63% females, age 16–90); for robustness, we also analyzed N = 31,637 participants across English‐speaking countries (61% females, age 16–90).ResultsThe size of global sex differences was D = 2.06 in the United States and D = 2.10 across English‐speaking countries. Parcel‐allocation variability analysis showed that results were robust to changes in parceling (U.S.: median D = 2.09, IQR [1.89, 2.37]; English‐speaking countries: median D = 2.17, IQR [1.98, 2.47]).ConclusionsOur results corroborate the original study (with a comparable if somewhat smaller effect size) and provide new information on the impact of parcel allocation. We discuss the implications of these and similar findings for the psychology of sex differences.
Looking on the bright side of life: Gratitude and experiences of interpersonal transgressions in adulthood and daily life
Authors: Stieger Mirjam , Hill Patrick L. , Allemand Mathias 
Published: July 2019

AbstractObjectiveGratitude plays an important role in individual and social well‐being. However, less is known about the link between gratitude and experiences of interpersonal stressors. The current research examined the associations between gratitude and interpersonal transgressions.MethodOne cross‐sectional study with a broad age range and two daily diary studies (total N = 2,348; total age range: 18–91) were used to test the associations on the between‐ and within‐person level.ResultsA consistent result across all studies was that dispositionally grateful individuals tended to report fewer interpersonal transgressions than less grateful people. In turn, people who generally reported more interpersonal transgressions were less grateful in daily life. Moreover, higher gratitude on one specific day was associated with fewer reported transgressions on the same day. However, the results from the daily diary studies indicated differences between the samples. Whereas gratitude was consistently associated with interpersonal transgressions in one daily diary sample, the findings in the second daily diary sample were less consistent.ConclusionThe present findings suggest that grateful people tend to perceive their social exchanges differently and/or actually experience fewer interpersonal transgressions. Future work is needed to test the underlying mechanisms of this negative association.
Common ground among beech forest development stages: Matrix versus stage‐typical live tree structure
Authors: Peck JeriLynn E. , Zenner Eric K. 
Published: July 2019

AbstractQuestionsDoubt has recently been shed on the validity of the European patch mosaic‐forest life cycle model involving the assignment of stages of development to natural forests. To partially explain the inconsistency in development stage assignment, we ask: does the high neighborhood‐scale structural heterogeneity inherent to old‐growth beech forests subject to small‐scale gap dynamics transcend development stages?LocationNatural Oriental beech (Fagus orientalisLipsky) forests in four regions of the Elborz Mountain range in northern Iran.MethodsNatural tree neighborhoods at three different scales (ca. 112, 508, and 1,228 m2) were identified within 1.0 ha plots in each of the three main development stages (Initial, Optimum, Decay) in each region using the spatially explicit Delaunay‐triangulation‐based floating neighborhood approach. The diameter distribution across all neighborhoods in all three stages was summarized using Principal Components Analysis. Neighborhoods exhibiting shared structure among stages were identified as those within one standard deviation of the centroid of the 2D ordination space.ResultsShared neighborhoods, which were highly heterogeneous with a weakly rotated sigmoid size class structure, were found to consistently occur in ca. 10%–20% of neighborhoods in all three development stages. Only neighborhoods more than one, and particularly more than two, standard deviations from the centroid differed among development stages in size class structure, with stage‐typical distributions observed in each development stage (i.e., negative exponential in the Initial stage, normal in the Optimum, and bimodal in the Decay).ConclusionsRegardless of development stage, forested beech stands subject to a small‐scale disturbance regime share a common core of tree neighborhoods with similar, heterogeneous live tree structure. We conjecture that this structure reflects temporal and spatial variation in gap dynamics, with variously aged but relatively newer gap patches with relatively high within‐patch homogeneity nested within a matrix of the highly heterogeneous neighborhoods that develop in the absence of recent disturbance.
The impact of neonatal unit policies on breast milk feeding at discharge of moderate preterm infants: The EPIPAGE‐2 cohort study
Authors: Mitha Ayoub , Piedvache Aurélie , Khoshnood Babak , Fresson Jeanne , Glorieux Isabelle , Roué Jean‐Michel , Blondel Béatrice , Durox Mélanie , Burguet Antoine , Ancel Pierre‐Yves , Kaminski Monique , Pierrat Véronique 
Published: July 2019

AbstractFacilitating factors and barriers to breast milk feeding (BMF) for preterm infants have been mainly studied in very preterm populations, but little is known about moderate preterm infants. We aimed to analyze hospital unit characteristics and BMF policies associated with BMF at discharge for infants born at 32 to 34 weeks' gestation. EPIPAGE‐2, a French national cohort of preterm births, included 883 infants born at 32 to 34 weeks' gestation. We investigated kangaroo care in the first 24 hr, early involvement of parents in feeding support, volume of the unit, BMF information given to mothers hospitalized for threatened preterm delivery, protocols for BMF, presence of a professional trained in human lactation, unit training in neurodevelopmental care, and regional BMF initiation rates in the general population. Multilevel logistic regression analysis was used to investigate associations between unit policies and BMF at discharge, adjusted for individual characteristics and estimating odds ratios (ORs) and 95% confidence intervals (CIs). Overall, 59% (490/828) of infants received BMF at discharge (27% to 87% between units). Rates of BMF at discharge were higher with kangaroo care (adjusted OR 2.03 [95% CI 1.01, 4.10]), early involvement of parents in feeding support (1.94 [1.23, 3.04]), unit training in a neurodevelopmental care programme (2.57 [1.18, 5.60]), and in regions with a high level of BMF initiation in the general population (1.85 [1.05, 3.28]). Creating synergies by interventions at the unit and population level may reduce the variability in BMF rates at discharge for moderate preterm infants.