bluuebunny/crossref_metadata_2025_split huggingface dataset:
Potential value of non-echo-planar diffusion-weighted imaging of the nasopharynx: a primary study for differential diagnosis between recurrent nasopharyngeal carcinoma and post-chemoradiation fibrosis
Authors: Huang Wenhui , Liu Jing , Zhang Bin , Liang Long , Luo Xiaoning , Mei Yingjie , Zhang Shuixing 
Published: January 2019

Background Distinguishing recurrent nasopharyngeal carcinoma (rNPC) from post-therapeutic inflammatory changes remains a challenging clinical problem. Purpose To qualitatively and quantitatively evaluate image quality and compare the diagnostic value of non-echo-planar diffusion-weighted imaging (DWI) based on turbo spin-echo (TSE) and echo-planar imaging (EPI), to distinguish rNPC from post-chemoradiation fibrosis. Material and Methods Twenty-seven patients with newly diagnosed rNPC and 35 with biopsy-proven post-chemoradiation fibrosis were categorized into tumor and fibrosis groups, respectively. All patients underwent TSE and EP-DWI on a 3-T magnetic resonance unit. The image quality, lesion conspicuity, and distortions of the EPI and TSE images were qualitatively evaluated by two radiologists. The apparent diffusion coefficient values (ADCs), signal-to-noise ratios (SNRs), and contrast-to-noise ratios (CNRs) of the two sequences were also compared. Results The image quality scores indicated that TSE significantly improved image quality and reduced distortion of the nasopharyngeal lesions. Its SNR was slightly lower and CNR was significantly higher than those of EPI. The mean ADCs of the rNPC and post-chemoradiation fibrosis groups showed a significant difference in both sequences ( P < 0.001). However, the ADCs of rNPC on EP-DWI showed a wide variation and more importantly, they appreciably overlapped with those of post-chemoradiation fibrosis. The area under the curve was 0.932 in TSE, which was significantly larger than 0.835 in EPI. Conclusions The images of nasopharyngeal lesions obtained with TSE-DWI were of better quality and higher diagnostic capability than those obtained with EP-DWI for differential diagnosis between rNPC and post-treatment sequelae.
Short-term effect of intravitreal conbercept injection on major and macular branch retinal vein occlusion
Authors: Tao Yuan , Huang Chao , Liu Min , Sun Liyuan , Li Linlin , Wei Yuhua , Yu Xiaoting , Wang Hong 
Published: January 2019

Objective To evaluate the effectiveness of intravitreal conbercept injection on major and macular branch retinal vein occlusion (BRVO). Methods This retrospective analysis involved 43 patients with BRVO (major BRVO n = 24; macular BRVO, n = 19) who were diagnosed by fluorescein fundus angiography (FFA) and injected with intravitreal conbercept. The following outcomes were measured at baseline and follow-up (1-6 months): best-corrected visual acuity (BCVA), central foveal thickness (CFT), total retinal volume in a 6-mm diameter section of the macula, choroidal thickness under the central fovea of the macula, relative area of retinal hemorrhage, complications, and times when repeated injection was performed. Results There were significant differences between the two groups in terms of BCVA, CFT, and total retinal volume in a 6-mm diameter section of the macula at 6 months after treatment. Choroidal thickness under the central fovea of the macula and relative area of retinal hemorrhage showed no significant differences between the two groups at 6 months after treatment; however, they significantly differed from baseline measurements. Conclusion In general, intravitreal injection of conbercept may have a better short-term effect in patients with macular BRVO than in patients with major BRVO.
Stress distribution in a mandibular premolar after separated nickel-titanium instrument removal and root canal preparation: a three-dimensional finite element analysis
Authors: Ni Na , Ye Jing , Wang Liyuan , Shen Simin , Han Lei , Wang Yuxia 
Published: January 2019

Objective This study used finite element analysis (FEA) to assess the von Mises stresses of a mandibular first premolar after removing a separated instrument with an ultrasonic technique. Methods FEA models of the original and treated mandibular first premolar were reconstructed, and three models (the original canal, size 30/taper 0.04 canal, and separated instrument removal canal) were created. Two-direction (vertical and lateral) loading patterns were simulated with a 175-N force. The maximum von Mises stresses of the models within the roots from the apex to the cervical region were collected and summarized. Results Under vertical and lateral loads, all maximal values in the three models were localized in the straight-line access region. Compared with the original model (model 1), the treated models (models 2 and 3) had greater maximum stress values from the apex to the cervical region. Greater differences in the maximum von Mises stresses between models 2 and 3 were present in the straight-line access region. Conclusions Separated instrument removal caused changes in stress distribution and increases in stress concentration in the straight-line access region of roots.
Understanding the meaning and use of occupational engagement: Findings from a scoping review
Authors: Black Melissa H , Milbourn Ben , Desjardins Kyle , Sylvester Victoria , Parrant Kimberley , Buchanan Angus 
Published: January 2019

Introduction It is theorized that occupational therapy practice is underpinned by the construct of occupational engagement, with a focus on examining the subjective meaning of occupation. The theoretical definition of occupational engagement presents significant challenges to its use, evaluation, and measurement within evidence-based contemporary occupational therapy practice. Method A scoping review was conducted to examine how occupational engagement is defined within occupational therapy literature and how occupational engagement is evaluated. Results Twenty-six journal articles were identified. Definitions were fragmented and inconsistent across studies. Key themes relating to definitions of occupational engagement included active involvement in occupation, finding value and meaning, balanced engagement, subjective experience of engagement, developing identity through occupation, and social and environmental interactions. Measures seeking to understand occupational engagement were varied across studies, with a consistent measure applied only in the area of mental health. Conclusion The lack of consistency in definitions and measurement of occupational engagement presents significant issues for occupational therapy practice and evaluation. There is a need for a common definition of occupational engagement to be applied in the literature. Outcome measures seeking to understand occupational engagement are also required; however, these rely on a clearly defined construct.
Patient-Controlled Analgesia in Children
Authors: Gaukroger P. B. , Tomkins D. P. , van der Walt J. H. 
Published: January 2019

The use of patient-controlled analgesia is described for forty children who had undergone major orthopaedic or general surgery. Ages ranged from 6 to 18 years (mean 11.4 years) and PCA was used for an average of 46.2 hours postoperatively. Morphine requirements overall averaged 40.5 μg/kg/hr (SD 22.6). Requirements for the first six hours were not significantly different to a similar period 24 hours later. There was a large individual variation for patients undergoing similar procedures. Patients undergoing scoliosis surgery required significantly more morphine than any other group of patients. Problems with patient-controlled analgesia have been of a minor nature. We conclude that patient-controlled analgesia is a suitable and safe method of pain relief for paediatric patients and that the lower age limit is that at which a child can understand the concept after suitable explanation. In this study children as young as six years were able to successfully use the method.
Characterization of Interphase Environmental Degradation at Elevated Temperature of Fibre-Reinforced Titanium Matrix Composites
Authors: Matikas Theodore E. 
Published: January 2019

Fibre reinforced metallic composite materials are being considered for a number of applications because of their attractive mechanical properties as compared to monolithic metallic alloys. An engineered interphase, including the bond strength between the composite's constituents, contributes to a large extent to the improvement of strength and stiffness properties of this class of materials. However, in high temperature applications, where combination of cyclic loading with environmental effects is expected, consideration should be given to interphase degradation, especially in the vicinity of stress risers, such as notches and holes. The applicability of damage tolerance analysis in structural components made of titanium matrix composite materials designed to operate under high temperature environments would depend on the availability of adequate characterization methods for the evaluation of interfacial degradation. The objective of this paper is to provide a basic understanding of interfacial degradation mechanisms due to oxidation in environmentally exposed titanium-based composites subjected to cyclic stresses. A non-destructive method has been developed enabling high-resolution monitoring of interfacial damage initiation and accumulation as well as surface/subsurface cracking behaviour during interrupted fatigue tests. This nondestructive technique is based on surface acoustic wave propagation in the composites and can detect minute changes in elastic properties of the interfacial region due to elevated temperatures as well as oxygen effects.
Preparation and Physicochemical Evaluation of Paste-Paste Calcium Hydroxide Based Dental Cement and the Effect of Replacement of Glycol Disalicylate by Methyl Salicylate on its Basic Properties
Authors: Nezafati Nader , Hesaraki Saeed , Shahrezaee Mostafa 
Published: January 2019

Dycal® is a paste-paste calcium hydroxide dental cement uses as pulp capping and liner in dentistry. First paste (base paste) contains titanium dioxide and barium sulphate in glycol disalicylate and second paste (catalyst paste) contains calcium hydroxide, zinc oxide and zinc stearate in ethyl toluene sulphonamide. Equal amounts of base and catalyst paste were mixed together and a hard mass is obtained after a certain time. The set material consists of TiO2, ZnO (fillers), BaSO4 (radiopacifier) and free unreacted Ca(OH)2 dispersed in an amorphous calcium phenolate matrix. This unreacted calcium hydroxide is responsible for biological properties of Dycal® (antibacterial and formation of reparative dentin). In this research Dycal® has been fabricated and furthermore glycol disalicylate was gradually replaced by methyl salicylate up to 20 % in base paste. Cements were characterized by X-ray diffraction (XRD) and Fourier transform infra-red (FTIR) and scanning electron microscopy (SEM). Also effect of the replacement was investigated on setting time, water solubility, pH and compressive strength of the cement. Results showed that unreacted calcium hydroxide decreased in set cement when methyl salicylate increase in base paste and therefore, and pH of distilled water containing cement decrease by this replacement. Setting time and water solubility also decreased when methyl salicylate increased in base paste (from 5.5 to 3 min and 4.5% to 2.5% respectively). The compressive strength showed no changes by this replacement.
Synthesis and Analysis of Mn3O4@Graphene Nanocomposites for Supercapacitors
Authors: Zhu Mingfu , Fu Ruimin 
Published: January 2019

An easy arc discharge method was developed to synthesize nanocomposites composed of Mn3O4 nanoparticles loaded on graphene sheets. The morphology and structure of the obtained nanocomposites were analysed via X-ray diffraction, Raman spectroscopy, and transmission electron microscopy. The electrochemical behaviour of the product was evaluated via cyclic voltammetry and alternating current impedance. Results showed that Mn3O4 was dispersed homogeneously on the surface of graphene. The supercapacitor constructed by graphene/Mn3O4 as the positive electrode showed both high capacitance and good electronic conduction, which may lead to the development of nanocomposites with great potential for applications in biosensors and electrode material analysis.
Remunerated patient care services and injections by pharmacists: An international update
Authors: Houle Sherilyn K. D. , Carter Caitlin A. , Tsuyuki Ross T. , Grindrod Kelly A. 
Published: January 2019

Objectives: Recognizing pharmacists’ increasing roles as primary care providers, programs offering remuneration for patient care services and the administration of injections by pharmacists continue to be implemented. The objective of this article is to provide an update on remuneration programs available to pharmacists internationally for nondispensing services. Data sources: Systematic searches for relevant articles published from January 2013 to February 2018 across PubMed (MEDLINE), Embase, International Pharmaceutical Abstracts, Cochrane Library, Econlit, Scopus and Web of Science. Gray literature searches, including targeted searches of websites of payers and pharmacy associations, were also performed. Study selection: Programs were included if they were newly introduced or had changes to patient eligibility criteria and fees since previously published reviews and if they were established programs offered by third-party payers for activities separate from dispensing. Data extraction: Descriptive information on each program was extracted, including the program’s jurisdiction (country and state, provincial or regional level, as applicable), payer, service description, patient eligibility criteria and fee structure. Results: Over the 5-year period studied, 95 new programs for noninjection patient care services and 37 programs for pharmacist-administered injections were introduced. Large ranges in fees offered for similar programs were observed across programs, even within the same country or region, at an average of $US 71 for an initial medication review, $19 for follow-ups to these reviews, $18 for prescription adaptations and $13 for injection administration. Apart from some smoking cessation programs in England, which offered incentive payments for successful quits, all services were remunerated on a fee-for-service basis, often in the form of a flat fee regardless of the time spent providing the service. Conclusion: Although funding for pharmacists’ activities continues to show growth, concerns identified in previous reviews persist, including the great variability in remunerated activities, patient eligibility and fees. These issues may limit opportunities for multijurisdictional program and service outcome evaluation. Can Pharm J (Ott) 2019;152:xx-xx.
Evaluation of Linearity and Interference Effect on SMBG and POCT Devices, Showing Drastic High Values, Low Values, or Error Messages
Authors: Sai Shizuki , Urata Mitsunori , Ogawa Iwao 
Published: January 2019

Background: When a patient with diabetes measures blood glucose levels using a simple blood glucose meter, an error message or abnormal value may be displayed because of interfering substances, potentially leading to unnecessary medical treatment. Methods: Here, we tested 10 self-monitoring of blood glucose (SMBG) and point-of-care testing (POCT) devices to investigate under what conditions they fail to measure blood glucose levels or display abnormal values instead. We also evaluated the influence and linearity of several well-known interfering substances and hematocrit (Ht). Each adjusted sample was measured by each device twice and the values compared with the reference values. Results: Linearity was favorable in all but one model. The impact of the interfering substances and Ht has been confirmed in many SMBG and POCT devices. In particular, some models showed significant pseudo-high or -low levels for samples that contained ascorbic acid, which is used widely in infusion solutions. Three devices showed error messages to avoid presenting a false value. Conclusions: Since pseudo-high levels may result in the excessive administration of insulin and lead to adverse events, this report serves as a critical reminder of the importance of device choice for specific indications. Three new devices have safety functions that prevent the showing of false values.
Model-Based Tool for Personalized Adjustment of Basal Insulin Supply in Patients With Intensified Conventional Insulin Therapy
Authors: Vogt Lutz , Thomas Andreas , Fritzsche Gert , Heinke Peter , Kohnert Klaus-Dieter , Salzsieder Eckhard 
Published: January 2019

Background: The decisive factor in successful intensive insulin therapy is the ability to deliver need-based-adjusted nutrition-independent insulin dosages at the closest possible approximation to the physiological insulin level. Because this basal insulin requirement is strongly influenced by the patient’s lifestyle, its subtlety is of great importance. This challenge is very different between patients with type 1 diabetes and those with insulin-dependent type 2 diabetes. Furthermore, it is more difficult to finetune a basal insulin dosage with intensified conventional insulin therapy (ICT), due to delayed insulin delivery, compared to insulin pump therapy, which provides continuous delivery of small doses of exclusively short-acting insulin. In all cases, the goal is to achieve an optimal basal delivery rate. Method: We hypothesized that this goal could be achieved with a modeling tool that determined the optimal basal insulin supply based on the patient’s anamnestic data and monitored glucose values. This type of modeling tool has been used in health insurance programs in Germany to improve insulin control in patients that receive ICT. Results: Our retrospective data analysis showed that this modeling tool provided a significant improvement in metabolic control, significant reductions in HbA1c and Q scores, and improved time-in-range values, with reduced daily insulin levels. Conclusion: The model-based basal rate test could provide additional data of the actual effect of the basal insulin adjustment in intensified insulin treated diabetes to the physician or treatment team.
Educational intervention to improve the knowledge, attitude and practice of healthcare professionals regarding pharmacovigilance in South-South Nigeria
Authors: Opadeyi Abimbola O. , Fourrier-Réglat Annie , Isah Ambrose O. 
Published: January 2019

Background: Our aim in this study was to evaluate the effect of a combined educational intervention and year-long monthly text message reinforcements via the Short Messaging System (SMS) on the knowledge, attitude and practice (KAP) of healthcare professionals (HCPs) towards pharmacovigilance. Methods: Six randomly selected teaching hospitals in the South-South zone of Nigeria were randomized in 1:1 ratio into intervention and control groups. The educational intervention consisted of delivering a seminar followed by sending monthly texts message reinforcements via SMS over 12 months. Then a semi-structured questionnaire regarding the KAP of pharmacovigilance was completed by HCPs working in the hospitals after the intervention. Data was analysed descriptively and inferentially. Results: A total of 931 HCPs participated in the post intervention study (596 in the intervention and 335 in the control). The M:F ratio was 1:1.5. According to the KAP questionnaire, a significant difference was observed between the intervention and control groups, regarding knowledge of the types of adverse drug reactions (ADRs). ADR resulting from pharmacological action of the drug (85.6% versus 77%, p = 0.001), the fact that ADRs can persist for a long time; (60.1% versus 53.4%, p = 0.024) and a higher awareness of the ADR reporting form (48.7% versus 18.8%, p < 0.001). Most respondents in the intervention group (68.5% versus 60.6%, p = 0.001) believed they should report ADRs even if they were unsure an ADR has occurred, a greater proportion of HCPs from the intervention group had significantly observed an ADR (82% versus 73.4%, p = 0.001). Furthermore, of the 188 who had ever reported an ADR, 41% from the intervention group used the national ADR reporting form compared with 19.8% from the controls ( p < 0.001). Conclusion: This educational intervention and the use of SMS as a reinforcement tool appeared to have positively impacted on the knowledge and practice of pharmacovigilance in South-South Nigeria with a less-than-impressive change in attitude. Continuous medical education may be required to effect long-lasting changes.
Developing digital applications for tailored communication in orthopaedics using a Research through Design approach
Authors: Groeneveld Bob , Melles Marijke , Vehmeijer Stephan , Mathijssen Nina , Dekkers Tessa , Goossens Richard 
Published: January 2019

Objective Tailored communication and information provision is expected to contribute to patient-centred care (PCC) in total hip arthroplasty (THA). In previous research, three subgroups of THA patients were identified that are similar in their clinical, psychological and communication characteristics. Preliminary subgroup-specific design guidelines were also formulated. Using these insights as a starting point, a theoretical framework was developed for tailored information provision and communication using digital applications. This study aims to refine the framework as well as subgroup-specific design guidelines for digital applications. Methods This study uses a Research through Design (RtD) approach, generating insights both from the development and evaluation of prototypes in the early design stage. Paper-based prototypes will be made for each subgroup and evaluated with patients and care providers. Semi-structured interviews are held with participants exploring their experiences with the prototype. A quasi-experiment with a non-random control cohort is used to validate the qualitative findings. Post-surgery consultations with and without prototype are videotaped and scored using a structured instrument. Results A design diary will be used to summarize design decisions and considerations. Feedback from participants is analysed inductively. Adaptations in subgroup-specific guidelines will be based on comparison of verbal feedback and descriptive statistics from consultations with and without prototype. Conclusions Although mixed-method feasibility studies of digital health interventions are common, this protocol also considers the utility of the early design process and the designer’s perspective for realizing PCC and tailored care.