bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting Success for Student Physical Therapists on the National Physical Therapy Examination: Systematic Review and Meta-Analysis
Authors: Wolden Mitch , Hill Brent , Voorhees Sara 
Published: October 2019

Abstract

Background
In physical therapist education, the National Physical Therapy Examination (NPTE) is the predominant measure of student success. Because the NPTE is a high-stakes examination, predicting NPTE performance is important for physical therapist students and programs.

Purpose
The purpose of this study was to determine the relationships between first attempt NPTE performance, physical therapist applicant variables, and physical therapist student variables. The 4 identified physical therapist applicant variables were undergraduate cumulative grade point average (GPA), undergraduate GPA for prerequisite courses, Graduate Record Examination verbal and quantitative subscale scores, and admission scores. The 4 identified physical therapist student variables were first- and third-year physical therapist student GPA, clinical performance scores (first and final clinical experiences), noncognitive student variables, and comprehensive examination scores.

Data Sources
A systematic search was performed using the databases PubMed and EBSCO (1966–2018).

Study Selection
Studies included in the review met the following criteria: the physical therapist education program offered an entry-level master’s or doctorate degree, pertinent data were available for each independent variable, the relationship between the independent variable and the NPTE was investigated, the NPTE was a continuous variable, the program was a US entry-level therapist education program, and the study was peer reviewed.

Data Extraction
Two independent reviewers completed data extraction and quality appraisal using the McMaster Appraisal Tool.

Data Synthesis
Random-effects meta-analyses using the Pearson product-moment correlation coefficient as the measure of effect size was used.

Limitations
Limitations of the review included a lack of homogeneity, high NPTE pass rates, modifications to the McMaster Appraisal Tool, small sample sizes, and publication bias.

Conclusions
No one physical therapist applicant variable should be used as an independent predictor of first attempt NPTE performance. For physical therapist students, first- and third-year physical therapist student GPA had a strong relationship with first attempt NPTE performance; clinical performance had a weak and nonsignificant relationship with first attempt NPTE performance.
A survey on a rural in-hospital population diagnosed with Atrial Fibrillation in west Shewa region, Ethiopia
Authors: Bregani Enrico Rino , Valcarenghi Caterina , Conti Matilde 
Published: October 2019

Abstract

Background
Atrial fibrillation (AF) is the most common sustained arrhythmia seen in clinical practice. It has been extensively studied in Western countries but less is known about developing countries.

Methods
We collected data on a rural population afferent to Wolisso hospital in Ethiopia, analysing epidemiology, clinical and cardiac ultrasound profile.
We enrolled 54 patients with first diagnosis of AF who undertook cardiac ultrasound and a questionnaire about personal and clinical profile.

Results
Enrolled patients were younger than reported in the African urban population (mean age 51 years) and females were symptomatic at a younger age than males (61.8% of females were &lt;50 years old versus 30% of males) and had complicated disease (100% of females had CHF). Rheumatic heart disease (RHD) was found in 38.9% of patients, especially in females (41.1%) and young patients, whereas hypertension (HTN) and degenerative valvular disease were predisposing to AF in old patients.

Conclusion
Low socio-economic level may explain findings we observed, particularly male to female ratio, more relevant than in urban subsets. RHD and HTN are many etiological factors of AF in our small population, so low-cost strategies to prevent their complications are surely cost-effective in rural catchment area of Wolisso hospital.
Viral antigens elicit augmented immune responses in primary Sjögren’s syndrome
Authors: Björk Albin , Thorlacius Gudny Ella , Mofors Johannes , Richardsdotter Andersson Elina , Ivanchenko Margarita , Tingström Joanna , James Tojo , Brokstad Karl A , Cox Rebecca J , Jonsson Roland , Kvarnström Marika , Wahren-Herlenius Marie 
Published: October 2019

Abstract

Objectives
Infections have been suggested in the pathogenesis of primary SS (pSS). Systematic studies of immune responses to microbial antigens in vivo may be performed during vaccination. In the present study, we therefore longitudinally followed patients with pSS and controls during split-virion influenza vaccination to identify pSS-specific cellular, transcriptomic and serological responses.

Methods
Patients without treatment (pSSUntr, n = 17), on hydroxychloroquine-treatment (pSSHCQ, n = 8), and healthy controls (n = 16) were included. Antibody titres were determined by ELISA. Plasma proteins were measured by proximity extension assay. Monocyte gene expression was assessed by Nanostring. Routine laboratory tests were performed and clinical disease symptoms were registered by questionnaires.

Results
pSSUntr developed higher vaccine-specific IgG titres compared with controls. Notably, anti-Ro52 autoantibody titres increased in pSSUntr but remained unchanged in pSSHCQ. No changes in disease symptoms including EULAR Sjögren's Syndrome Patient Reported Index score were registered. Twenty-four hours after vaccination, the leucocyte count in pSSUntr decreased, with a concomitant increase of CCL7 in plasma. Transcriptomic analysis in monocytes revealed differential vaccination-related expression of the NEMO/IKBKG gene, and its higher induced expression in pSSUntr associated with higher serological vaccine responses. Moreover, titres of vaccine-specific antibodies were associated with higher vaccination-induced NF-κB signalling and higher steady-state IFN signatures in monocytes, and with the levels of several plasma proteins with soluble PD-1 displaying the strongest association.

Conclusion
We observed augmented innate and adaptive immune responses in pSS following viral antigen exposure suggesting an underlying hyper-responsiveness to immune challenges, supporting a role for infections driving the immunopathology and acting as environmental risk factor for pSS.
Pathways to the Glass Cliff: A Risk Tax for Women and Minority Leaders?
Authors: Glass Christy , Cook Alison 
Published: October 2019

AbstractDo women and racial/ethnic minority leaders pay a risk tax on their way to the top? Theories of the glass cliff have focused on the penalties imposed upon women and minority leaders due to bias and discrimination at the time of appointment to top leadership positions. Much less attention has focused on the strategic agency these leaders exercise in response to bias across the career. This paper advances theory and research on the glass cliff by analyzing the choices, decisions, and priorities of white women and people of color that, across the career, result in their appointment to glass cliff positions. Our analysis relies on in-depth, semi-structured interviews with 33 senior leaders across a range of industries. Our findings suggest that rather than isolated instances of high-risk promotions, glass cliff appointments represent the culmination of a long-term career strategy centered on risk and risk-taking. We find evidence that these leaders pay a significant risk tax in order to achieve upward mobility in their organizations.
Why Medical Residents Do (and Don’t) Speak Up About Organizational Barriers and Opportunities to Improve the Quality of Care
Authors: Voogt Judith J. , Kars Marijke C. , van Rensen Elizabeth L.J. , Schneider Margriet M.E. , Noordegraaf Mirko , van der Schaaf Marieke F. 
Published: October 2019

Purpose
Medical residents are valuable sources of information about the quality of frontline service delivery, but if they do not speak up, their ideas, opinions, and suggestions for improving their work practices cannot be considered. However, speaking up can be difficult for residents. Therefore, the authors have explored both what helps residents speak up about organizational barriers and opportunities to improve the quality of their work and what hinders them from doing so.

Method
The authors conducted an exploratory qualitative interview study with 27 Dutch medical residents in the Netherlands in 2016. They used the critical incident technique for data collection and the constant comparison method of the Qualitative Analysis Guide of Leuven for data analysis.

Results
Three types of incidents in which residents considered speaking up are described. The authors identified 2 main considerations that influenced residents’ decisions about speaking up: Is it safe to speak up, and is speaking up likely to be effective? Residents’ decisions were influenced by personal, team, and organizational aspects of their situations, such as supervisors’ open attitudes, hierarchy, duration of clinical rotations, organization size, and experiences (either vicarious or their own).

Conclusions
Findings from this study indicate that residents tend to be silent when they encounter organizational barriers or opportunities to improve the quality of their work. Perceived effectiveness and safety are important forces that drive and constrain speaking up. The authors provide important starting points to empower medical residents to speak up about their suggestions for change.
Patient Satisfaction With Medical Student Participation in a Longitudinal Integrated Clerkship: A Controlled Trial
Authors: Beard Albertine S. , Candy Amy E. , Anderson Travis J. , Derrico Nicholas P. , Ishani Khalid A. , Gravely Amy A. , Englander Robert , Ercan-Fang Nacide G. 
Published: October 2019

Purpose
To determine whether longitudinal student involvement improves patient satisfaction with care.

Method
The authors conducted a satisfaction survey of patients followed by 10 University of Minnesota Medical School students enrolled in 2016–2017 in the Veterans Affairs Longitudinal Undergraduate Medical Education (VALUE) program, a longitudinal integrated clerkship at the Minneapolis Veterans Health Care System. Students were embedded in an ambulatory practice with primary preceptors who assigned students a panel of 14 to 32 patients to follow longitudinally in inpatient and outpatient settings. Control patients, matched on disease severity, were chosen from the preceptor’s panel. Two to five months after the students completed the VALUE program, the authors conducted a phone survey of the VALUE and control patients using a validated, customized questionnaire.

Results
Results are reported from 97 VALUE patients (63% response rate) and 72 controls (47% response rate) who had similar baseline characteristics. Compared with control patients, VALUE patients reported greater satisfaction with explanations provided by their health care provider, their provider’s knowledge of their personal history, and their provider’s looking out for their best interests (P < .05). Patients in the VALUE panel selected the top category more often than control patients for overall satisfaction with their health care (65% vs 43%, P < .05).

Conclusions
The results of this controlled trial demonstrate that VALUE student longitudinal participation in patient care improves patient satisfaction and patient-perceived quality of health care for VALUE patients compared with controls matched by primary care provider and disease severity. These findings may have implications outside the Veterans Administration population.
Is Modified K-line a Powerful Tool of Surgical Decision Making for Patients With Cervical Spondylotic Myelopathy?
Authors: Hirai Takashi , Yoshii Toshitaka , Inose Hiroyuki , Yuasa Masato , Yamada Tsuyoshi , Ushio Shuta , Onuma Hiroaki , Hirai Keigo , Kobayashi Yutaka , Utagawa Kurando , Hashimoto Jun , Kawabata Atsuyuki , Sakai Kenichiro , Kato Tsuyoshi , Kawabata Shigenori , Okawa Atsushi 
Published: October 2019

Study Design:
Prospective observational single-center study.

Objective:
To evaluate anterior decompression and fusion (ADF) or posterior surgery (PS) for patients with cervical spondylotic myelopathy (CSM) using the modified K-line (mK-line) and to compare clinical and radiologic outcomes between these 2 techniques.

Summary of Background Data:
The authors have previously reported that insufficient posterior decompression is often seen after laminoplasty for CSM in patients with preoperative anterior clearance of the spinal cord <4 mm on the basis of the mK-line. However, to our knowledge, no study has investigated the role, if any, of the mK-line in surgical decision making for patients with CSM.

Methods:
A total of 87 patients were enrolled who underwent surgery for treatment of CSM between 2011 and 2015 at our hospital and who could be followed up for at least 2 years. ADF was selected as a more favorable procedure than PS in patients with anterior spinal clearance of <4 mm on preoperative midsagittal magnetic resonance imaging. On the basis of the Japanese Orthopedic Association (JOA) scoring system for cervical myelopathy, the rate of recovery of the JOA scores at 2 years after surgery was investigated as a clinical outcome to compare these 2 groups.

Results:
Mean age was 65.1 (±12.9) years in the ADF group (n=26) and 70.5 (±8.6) years in the PS group (n=61). In the PS group, 10 patients underwent posterior decompression with fusion. Mean preoperative and postoperative JOA scores were 10.5 and 14.1 points in the ADF group and 9.8 and 13.1 points in the PS group, respectively, showing no significant difference in recovery rate of JOA score between the ADF (58.9%) and PS (47.1%) groups. However, patients with a minimum interval between the mK-line and the anterior compression factor on the midsagittal image (minimum interval of the spinal cord) <4 mm tended to have unsatisfactory outcomes (recovery rate 29.6%) compared with patients with minimum interval of the spinal cord >4 mm (53.6%, P=0.07) in the PS group.

Conclusion:
Preoperative intervention using the mK-line is useful to predict residual cord compression and might homogenize postoperative clinical outcomes in both anterior surgery and PS.
Could Greater Physical Activity Reduce Population Prevalence and Socioeconomic Inequalities in Children’s Mental Health Problems? A Policy Simulation
Authors: Chigogora Sungano , Pearce Anna , Law Catherine , Viner Russell , Chittleborough Catherine , Griffiths Lucy J. , Hope Steven 
Published: October 2019

Background:One in four children 5–16 years (y) of age shows signs of mental health problems in the United Kingdom; risk is higher in economically disadvantaged groups. Greater physical activity is associated with lower risk of internalizing problems such as depression and anxiety. We simulated the potential impact of population-wide physical activity interventions on overall prevalence of internalizing problems, and by family income. Interventions were based on the World Health Organization (WHO) children’s target of 60 minutes (min) of moderate-to-vigorous physical activity per day and trial evidence.Methods:Data were from the UK Millennium Cohort Study, a population-representative cohort of children born in 2000–2002. Household income (5 y) was the exposure; internalizing problems (outcome) were measured using the Strengths and Difficulties Questionnaire (11 y). Of 18,296 singletons, 6,497 had accelerometer physical activity data (mediator, manipulated to simulate interventions) at 7 y. We predicted probabilities of outcome according to exposure in marginal structural models, weighted for attrition and confounding, and adjusted for observed mediator. We then re-estimated probabilities in different physical activity intervention scenarios, assessing income inequalities in internalizing problems with risk ratios (RRs) and differences (RDs) according to income quintile.Results:Simulating universal achievement of the WHO target led to little change in prevalence (10% [95% CI = 8%, 12%]) and socioeconomic inequalities in internalizing problems; RR: 2.2 (1.1, 3.4); RD: 8% [5%,13%]). More modest increases in physical activity achieved weaker results.Conclusions:Our simulations suggest that large increases in moderate-to-vigorous physical activity in the United Kingdom would have little effect on prevalence and inequalities in child mental health problems.
Efficacy and safety of Yukgunja-Tang for treating anorexia in patients with cancer
Authors: Kang Hwi-Joong , Jeong Mi-Kyung , Park So-Jung , Jun Hyeong-Joon , Yoo Hwa-Seung 
Published: October 2019

Abstract

Background:
Anorexia is a common cause of malnutrition and is associated with negative effects on the quality of life (QOL) for patients with cancer. Management of appetite is the key to improving both the QOL and the prognosis for such patients. Yukgunja-tang (YGJT) is a traditional herbal medicine extensively prescribed in Korea as a remedy for various gastrointestinal syndromes. Currently, no standardized herbal medicine treatment exists for patients with cancer who are suffering from anorexia after surgery, chemotherapy, and/or radiotherapy. For that reason, this study aims to examine the efficacy and the safety of using YGJT to treat anorexia in such patients and to establish whether or not YGJT can be recommended as the primary therapy.

Methods:
We will enroll 52 cancer patients diagnosed with anorexia. The enrolled participants will be randomly allocated to 2 groups: The control group will receive nutrition counseling, and the YGJT group will receive nutrition counseling and be administered YGJT at a dose of 3 g twice a day for 4 weeks (a total of 56 doses of 3.0 g per dose). The primary outcome of this study is the change in the score on the anorexia/cachexia subscale (A/CS) of the Functional Assessment of Anorexia/Cachexia Therapy (FAACT). The secondary outcomes are the changes in the FAACT score with the A/CS score excluded, the score on the Visual Analogue Scale (VAS) for appetite, the weight and the body mass index (BMI), and laboratory tests for compounds such as leptin, tumor necrosis factor-α (TNF-α), ghrelin, and IL-6. All variables related to the safety assessment, such as vital signs, electrocardiography results, laboratory test results (CBC, chemistry, urine test), and adverse events, will be documented on the case report form (CRF) at every visit.

Conclusion:
This study is the first randomized controlled trial to investigate the efficacy and the safety of using YGJT for treating patients with cancer-related anorexia in Korea. We designed this study based on previous research about YGJT. This study will serve as a pilot and provide data for planning further clinical trials on herbal medicine and cancer-related anorexia.

Trial registration:
Clinical Research Information Service (CRIS), Republic of Korea, ID: KCT0002847. Registered retrospectively on 3 April 2018.
The constitution and functional prediction of the microbiota in necrotizing enterocolitis with a gestational age of over 28 weeks
Authors: Feng JinXing , He Yu , Liu Dong , Li Luquan , Chen Jingyu , Yu Jialin 
Published: October 2019

Abstract

Background:
To explore the features and function of gut microbiota in necrotizing enterocolitis patients over 28 gestational age weeks through a case-control study.

Methods:
Fecal samples from patients with NEC over 28 gestational week age and matched control cases were collected. DNA of the fecal samples was extracted for 16 s rRNA sequencing to estimate the composition of the microbiota. Functional inference analyses were conducted through PICRUSt based on the sequencing raw data.

Results:
There was no significant difference in the total diversity of microbiota between the fecal samples from the patients with NEC and the controls (P = .40). Propionibacterium was more abundant in the NEC cases than in the controls. Conversely, Lactobacillus, Phascolarctobacterium, and Streptococcus_salivarius were found to be more plentiful in the controls through LEfSe analysis. Functional inference analysis revealed that the xenobiotic biodegradation and metabolic activity was lower in the NEC cases than in the controls (P < .05).

Conclusion:
The NEC cohort with a gestational age of over 28 weeks has a different pattern of microbiota compared with the controls. Functional inference analysis indicated that the potential function of the microbiota may also differ between these groups.
Tongue strengthening exercise is effective in improving the oropharyngeal muscles associated with swallowing in community-dwelling older adults in South Korea
Authors: Park Ji-Su , Lee Sang-Hoon , Jung Sang-Hoon , Choi Jong-Bae , Jung Young-Jin 
Published: October 2019

Abstract

Background
Tongue strengthening exercise (TSE) is a remedial method for the training of swallowing-related muscles in the oropharyngeal phase. However, clinical evidence of its effectiveness is insufficient.

Methods
To investigate the effect of TSE on the oropharyngeal muscles associated with swallowing in older adults, in this study, 40 elder adults living in the community were recruited and assigned to 2 groups. The experimental group performed a TSE with a 1-repetition maximum resistance level of 70%. The exercise was divided into an isometric and isotonic part. The control group did not perform an exercise. We measured the muscle strength and thickness of the tongue and suprahyoid muscles using an Iowa Oral Performance Instrument and ultrasonography.

Results
The experimental group showed a statistically significant increase in tongue muscle strength and thickness in the oral phase (P = .001 and <.001, respectively). In the pharyngeal phase, the experimental group showed a statistically significant increase in the mylohyoid and digastric muscles (suprahyoid muscles) (P = .045 and .019, respectively). The control group showed no statistically significant changes.

Conclusion
TSE is effective in increasing the strength and thickness of the oropharyngeal muscles of elder adults and is recommended for those who are vulnerable to swallowing difficulties.
Nomogram to predict overall survival and disease-specific survival with appendiceal mucinous adenocarcinoma
Authors: Yan Qian , Zheng Wen Jiang , Chen Qing Lian , Wang Bo Qing , Luo Hui Yan , Xue Jiao , Wang Xiong Wen 
Published: October 2019

Abstract
To predict the survival of appendiceal mucinous adenocarcinoma (AMA) by prognostic nomogram.
A total of 3234 patients with AMA were collected from the Surveillance, Epidemiology, and End Results (SEER) database from 1973 to 2015. Univariate and multivariate Cox proportional hazards (PH) regression analyses were used to generate independent prognostic factors. These variables were included in the nomogram to predict overall survival (OS) and disease-specific survival (DSS) at 1-, 3-, and 5- years. These data are validated both internally and externally. The consistency index (C-index) and calibration chart were used to estimate the accuracy of the nomogram.
The study cohort was randomly divided into the training (n = 2155) and validation group (n = 1799). According to univariate and multivariate analyses, age at diagnosis, marital status, sex, histological differentiation, SEER extent of disease, number of local lymph nodes examined, whether they were positive, and surgical methods were independent prognostic factors for OS and DSS. These factors were incorporated into the nomogram. Internal validation in the training cohort showed that the C-index values for nomogram predictions of OS and DSS were 0.73 (95% CI 0.70–0.76) and 0.77 (95% CI 0.73–0.81), respectively. Similarly, the corresponding C-index values in the external validation cohort were 0.76 (95% CI 0.70–0.81) and 0.75 (95% CI 0.71–0.80). The Calibration plots revealed that the actual survival and nomogram prediction had a good consistency.
Build a nomogram in the SEER database to predict OS and DSS in patients with AMA. It can provide accurate and personalised survival prediction for clinicians and patients.