bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceptions, experiences and expectations of physicians regarding the role of pharmacists in low-income and middle-income countries: the case of Tehran hospital settings
Authors: Alipour Fatemeh , Peiravian Farzad , Mehralian Gholamhossein 
Published: February 2018

ObjectivePharmacists play a pivotal role in the health continuum, and the perceptions and expectations of physicians towards pharmacists have been reported as a key factor in the interprofessional relationship. This study aimed to elicit the perceptions and expectations of physicians towards the role of pharmacists in hospitals to clarify the level of interaction between physicians and pharmacists in hospital settings.DesignA cross-sectional survey using a self-administered questionnaire was conducted to collect data in 2016.MethodsA cross-sectional study was carried out at 20 large government hospitals in Tehran Province. Data was collected using a questionnaire consisting of four sections. It includes a section on demographic profile and three sections to measure the perceptions of physicians towards pharmacists, the expectations of physicians and their experiences with pharmacists, respectively.ResultsMore than two-thirds of physicians (67.2%) agreed that pharmacists were a reliable source of general drug information. The majority of physicians (90.6%) expected pharmacists to advise their patients about the dose and administration of their medications. Almost half of the physicians (51.6%) agreed that they were usually informed by pharmacists regarding potential problems in their prescriptions. Both senior and junior residents had the view that pharmacists would inform them if any potential problems with their prescriptions were discovered (P=0.04).ConclusionThis study demonstrated that physicians had positive view on pharmacists’ clinically defined roles and also accepted pharmacists as a valuable source of general drug information. However, the perceptions and expectations of physicians towards pharmacists did not match their real experience. Therefore, improving the awareness of physicians about the benefits of interprofessional collaboration with pharmacists seems to be a key step towards the implementation of pharmaceutical care practices in Iran.
What’s the headline on your mind right now? How reflection guides simulation-based faculty development in a master class
Authors: Kolbe Michaela , Rudolph Jenny W 
Published: February 2018

IntroductionThe demand for highly skilled simulation-based healthcare educators (SBEs) is growing. SBEs charged with developing other SBEs need to be able to model and conduct high-quality feedback conversations and ‘debrief the debriefing’. Direct, non-threatening feedback is one of the strongest predictors of improved performance in health professions education. However, it is a difficult skill to develop. Developing SBEs who can coach and support other SBEs is an important part of the faculty development pipeline. Yet we know little about how they get better at skilled feedback and the ability to reflect on it. There is scant evidence about their thoughts, feelings and dilemmas about this advanced learning process. To address this gap, we examined advanced SBE’s subjective experience as they grappled with challenges in a 4-day advanced SBE course. Their reflections will help target faculty development efforts.MethodsUsing a repeated, identical free-writing task, we asked “What is the headline for what is on your mind right now?”ResultsA five-theme mosaic of self-guiding reflections emerged: (1) metacognitions about one’s learning process, (2) evaluations of sessions or tools, (3) notes to self, (4) anticipations of applying the new skills in the future, and (5) tolerating the tension between pleasant and unpleasant emotions.ConclusionsThe results extend simulation-based education science by advocating the motivational role of noting inconsistencies between one’s intention and impact and the central role of self-regulation, emotion, and experiencing feedback and debriefing from multiple perspectives for improving advanced skills of SBEs. Recommendations for faculty development are discussed.
Investigation of dielectric behavior of the PVC/BaTiO3composite in low-frequencies
Authors: Berrag A. , Belkhiat S. , Madani L. 
Published: February 2018

Polyvinyl chloride (PVC) is widely used as insulator in electrical engineering especially as cable insulation sheaths. In order to improve the dielectric properties, polymers are mixed with ceramics. In this paper, PVC composites with different weight percentages 2 wt.%, 5 wt.%, 8 wt.% and 10 wt.% were prepared and investigated. Loss index ([Formula: see text]) and dielectric constant ([Formula: see text]) have been measured using an impedance analyzer RLC. Fourier transform infrared (FTIR) spectroscopy, scanning electron microscopy (SEM) equipped with energy dispersive X-ray (EDX) have been used as characterization techniques. The incorporation of BaTiO3does not modify the crystallinity and the morphology of the PVC but reduces the space charges, therefore the dielectric losses. The frequency response analysis has been followed in the frequency ranges (20–140 Hz and 115–1 MHz). Relaxation frequencies have been evaluated in each frequency range. Experimental measurements have been validated using Cole–Cole’s model. Experimental results show well that BaTiO3as a filler improves the dielectric properties of PVC.
A wideband CMOS single-ended low noise amplifier employing negative resistance technique
Authors: Guo Benqing , Chen Hongpeng , Wang Xuebing , Chen Jun , Li Yueyue , Jin Haiyan , Yang Yongjun 
Published: February 2018

A wideband common-gate CMOS low noise amplifier with negative resistance technique is proposed. A novel single-ended negative resistance structure is employed to improve gain and noise of the LNA. The inductor resonating is adopted at the input stage and load stage to meet wideband matching and compensate gain roll-off at higher frequencies. Implemented in a 0.18 [Formula: see text]m CMOS technology, the proposed LNA demonstrates in simulations a maximal gain of 16.4 dB across the 3 dB bandwidth of 0.2–3 GHz. The in-band noise figure of 3.4–4.7 dB is obtained while the IIP3 of 5.3–6.8 dBm and IIP2 of 12.5–17.2 dBm are post-simulated in the designed frequency band. The LNA core consumes a power dissipation of 3.8 mW under a 1.5 V power supply.
Surface plasmon resonance fiber optic biosensor-based graphene and photonic crystal
Authors: Tong Kai , Guo Jia , Dang Peng , Wang Meiyu , Wang Fucheng , Zhang Yungang , Wang Meiting 
Published: February 2018

A new sensor — transverse electric (TE) polarized excite surface plasmon resonance (SPR) fiber optic biosensor is proposed. The graphene is the plasma layer. The transfer matrix method and the finite difference time domain method are applied to conduct the numerical simulation of the four layers (fiber core/photonic crystals/graphene/sample) of fiber optic biosensor. The results show that the relationship between refractive index and resonant wavelength is linear and the sensitivity of the fiber optic biosensor reaches 1942 nm/RIU.
Water transport and homeostasis as a major function of erythrocytes
Authors: Sugie Joseph , Intaglietta Marcos , Sung Lanping Amy 
Published: February 2018

Erythrocytes have long been known to change volumes and shapes in response to different salt concentrations. Aquaporin-1 (AQP1) was discovered in their membranes more than 20 yr ago. The physiological roles of volume changes and AQP1 expression, however, have remained unclear. We propose that rapid water exchange through AQP1 coupled with large capacity for volume change may allow erythrocytes to play an important role in water regulation. In this study, we showed that erythrocytes in situ gradually reduced their volumes by 39% in response to the hyperosmotic corticomedullary gradient within mouse kidneys. AQP1 knockout (KO) erythrocytes, however, displayed only minimal reduction. Constructing a microfluidic device resembling capillary flow with an extracellular fluorescent reporter demonstrated that water exchanges between erythrocytes and their hypotonic or hypertonic surroundings in vitro reached steady state in ~60 ms. AQP1 KO erythrocytes, however, did not show significant change. To simulate the water transport in circulation, we built basic units consisting of three compartments (i.e., erythrocyte, plasma, and interstitial fluid) using Kedem-Katchalsky equations for membrane transport, and connected multiple units to account for the blood flow. These simulations agreed with experimental results. Importantly, volume-changing erythrocytes in capillaries always “increase” the osmotic gradient between plasma and interstitial fluid, making them function as “micropumps” to speed up the regulation of local osmolarity. Trillions of these micropumps, mobile throughout the body, may further contribute to water homeostasis. These insights suggest that the enhanced exchange of water, in addition to O2and CO2, may well be the third major function of erythrocytes.NEW & NOTEWORTHY Physiological roles of erythrocyte volume change and aquaporin-1 were proposed and investigated here. We conclude that fast water transport by aquaporin-1 coupled with large volume-change capacity allows erythrocytes to enhance water exchange with local tissues. Furthermore, their huge number and mobility allow them to contribute to body water homeostasis.
Questionnaire-Based Survey on Gastrointestinal Bleeding and Management of Antithrombotic Agents during Endoscopy Among Asian Countries
Authors: Tsuruoka Nanae , Iwakiri Ryuichi , Sakata Yasuhisa , Fujimoto Kazuma , Kamiya Takeshi , Joh Takashi , Tokunaga Kengo , Takahashi Shin’ichi , Kinoshita Yoshikazu , Uchiyama Kazuhiko , Naito Yuji , Nagahara Akihito , Watanabe Toshio , Chan Francis K. L. , Hahm Ki-Baik , Kachintorn Udom , Fock Kwong Ming , Syam Ari Fahrial , Rani Abdul Aziz , Sollano Jose D. , Zhu Qi 
Published: February 2018

Objective: Guidelines on the management of antithrombotic therapy for endoscopic procedures vary among countries. Differences in the management of antithrombotic agents for endoscopic procedures between Western and Eastern countries have already been reported. However, no study has investigated the differences among Asian countries. The aim of this study was to examine the differences in the etiology of gastrointestinal bleeding and management of antithrombotic agents during endoscopic procedures between Japan and other Asian countries (OAC). Methods: Questionnaires regarding gastrointestinal bleeding in clinical practice and management of antithrombotic agents during endoscopy were distributed to members of the International Gastroenterology Consensus Symposium Study Group. We analyzed the questionnaire answers and compared the results between Japan and OAC. Results: The cause of and treatment methods for gastrointestinal bleeding differed between Japan and OAC. In Japan, the trend was to continue drugs at the time of biopsy and endoscopic therapy. Even in cases of discontinuation, the drug withdrawal period was as short as <3 days. Thrombotic complications caused by the withdrawal of antithrombotic agents were observed more frequently in Japan (34.78%) than in OAC (22.46%; p = 0.016). Conclusion: Due to differences in guidelines and complications associated with discontinuation of drugs, the antithrombotic withdrawal period in Japan tended to be shorter than that in OAC.
Impact of Atrial Fibrillation During ST-Segment–Elevation Myocardial Infarction on Infarct Characteristics and Prognosis
Authors: Reinstadler Sebastian J. , Stiermaier Thomas , Eitel Charlotte , Fuernau Georg , Saad Mohammed , Pöss Janine , de Waha Suzanne , Mende Meinhard , Desch Steffen , Metzler Bernhard , Thiele Holger , Eitel Ingo 
Published: February 2018

Background—
Atrial fibrillation (AF) is frequently observed in patients with ST-segment–elevation myocardial infarction and associated with worse clinical outcome. However, the mechanisms for this increased risk are not fully understood. The purpose of this study was to investigate the relationship of the presence of AF to cardiac magnetic resonance (CMR) derived myocardial salvage and damage as well as clinical outcomes.

Methods and Results—

This multicenter CMR study enrolled 786 patients with ST-segment–elevation myocardial infarction. CMR parameters (infarct size, myocardial salvage index, microvascular obstruction, and myocardial function) were assessed 3 (interquartile range [IQR], 2–4) days post-ST-segment–elevation myocardial infarction and compared between patients with or without AF during hospitalization. Major adverse cardiac events were assessed as a composite of all-cause death, reinfarction, and new congestive heart failure at 12 months. AF was documented in 48 (6.1%) patients. There was no significant difference in infarct size (18 [IQR, 9–29]% versus 17 [IQR, 9–25]% of left ventricular mass;
P
=0.340), myocardial salvage index (51 [IQR, 34–69] versus 51 [IQR, 33–69];
P
=0.830), or microvascular obstruction (0.6 [IQR, 0–2.0]% versus 0.0 [IQR, 0–1.8]% of left ventricular mass;
P
=0.340) between groups. Patients with AF had significantly lower left ventricular (47 [IQR, 34–54]% versus 51 [IQR, 44–58]%;
P
=0.003) and left atrial (42 [IQR, 17–57]% versus 53 [IQR, 45–59]%;
P
<0.001) ejection fraction. AF was associated with major adverse cardiac events, even when adjusting for clinical risk factors (odds ratio, 2.48 [95% confidence interval, 1.22–5.03];
P
=0.0120) or CMR prognosis markers (odds ratio, 3.77 [95% confidence interval, 1.83–7.79];
P
=0.001).

Conclusions—
This CMR study found no major differences in myocardial salvage, infarct size, or microvascular damage in patients with ST-segment–elevation myocardial infarction or without AF. AF was, however, associated with cardiac dysfunction and independently related to major adverse cardiac events.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00712101.
Randomized Comparisons of Double-Dose Clopidogrel or Adjunctive Cilostazol Versus Standard Dual Antiplatelet in Patients With High Posttreatment Platelet Reactivity
Authors: Tang Yi-Da , Wang Wenyao , Yang Min , Zhang Kuo , Chen Jing , Qiao Shubin , Yan Hongbing , Wu Yongjian , Huang Xiaohong , Xu Bo , Gao Runlin , Yang Yuejin , Yuan Xun , Ji Hongwen , Zhou Zhou , Liu Zhaohui , Chen Jue , Yuan Jinqing , Liu Haibo , Qian Jie , Hu Fenghuan , Shao Chunli , Zhao Hanjun , Hua Yihong , Lu Jie 
Published: February 2018

Background:
Patients undergoing percutaneous coronary intervention react differently to antiplatelet drugs. Those with low responsiveness to clopidogrel have a higher risk of cardiac ischemic events. The goal of this study is to conduct a head-to-head comparison of the safety and effectiveness of intensified antiplatelet therapies (either double-dose clopidogrel [DOUBLE] or adjunctive cilostazol [TRIPLE]) and conventional strategy (STANDARD) in patients after percutaneous coronary intervention.

Methods:
In this single-center, randomized, controlled trial, we used thromboelastography, a platelet function test, to select 1078 patients undergoing percutaneous coronary intervention at high thrombotic risk and compared the intensified antiplatelet therapies with standard antiplatelet therapy. The primary outcome was the incidence of major adverse cardiac and cerebrovascular events at 18 months after percutaneous coronary intervention, defined as a composite of all-cause death, myocardial infarction, target vessel revascularization, or stroke. Bleeding Academic Research Consortium defined bleeding complications (types 1, 2, 3, or 5) were the safety end points.

Results:

The primary end point occurred in 52 patients (14.4%) in the STANDARD group, 38 patients (10.6%) in the DOUBLE group, and 30 patients (8.5%) in the TRIPLE group (hazard ratio, 0.720; 95% confidence interval, 0.474–1.094, DOUBLE versus STANDARD; hazard ratio, 0.550; 95% confidence interval, 0.349–0.866, TRIPLE versus STANDARD). No significant difference in the rates of major bleeding (Bleeding Academic Research Consortium grade≥3) was found in the DOUBLE group (3.34% versus 1.93% in STANDARD,
P
=0.133) and the TRIPLE group (2.53% versus 1.93% in STANDARD,
P
=0.240). The rate of Bleeding Academic Research Consortium–defined minor bleeding increased in the DOUBLE group (27.4% versus 20.3% in STANDARD,
P
=0.031), but not in the TRIPLE group (23.6% versus 20.3% in STANDARD,
P
=0.146).

Conclusions:
In patients with low responsiveness to clopidogrel, as measured by thromboelastography, the intensified antiplatelet strategies with adjunctive use of cilostazol significantly improved the clinical outcomes without increasing the risk of major bleeding. Decreased trend of negative outcomes could be observed in patients with double dosage of clopidogrel, but the difference was not significant.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01779401.
Lacunar Infarcts, but Not Perivascular Spaces, Are Predictors of Cognitive Decline in Cerebral Small-Vessel Disease
Authors: Benjamin Philip , Trippier Sarah , Lawrence Andrew J. , Lambert Christian , Zeestraten Eva , Williams Owen A. , Patel Bhavini , Morris Robin G. , Barrick Thomas R. , MacKinnon Andrew D. , Markus Hugh S. 
Published: February 2018

Background and Purpose—
Cerebral small-vessel disease is a major cause of cognitive impairment. Perivascular spaces (PvS) occur in small-vessel disease, but their relationship to cognitive impairment remains uncertain. One reason may be difficulty in distinguishing between lacunes and PvS. We determined the relationship between baseline PvS score and PvS volume with change in cognition over a 5-year follow-up. We compared this to the relationship between baseline lacune count and total lacune volume with cognition. In addition, we examined change in PvS volume over time.

Methods—
Data from the prospective SCANS study (St Georges Cognition and Neuroimaging in Stroke) of patients with symptomatic lacunar stroke and confluent leukoaraiosis were used (n=121). Multimodal magnetic resonance imaging was performed annually for 3 years and neuropsychological testing annually for 5 years. Lacunes were manually identified and distinguished from PvS. PvS were rated using a validated visual rating scale, and PvS volumes calculated using T1-weighted images. Linear mixed-effect models were used to determine the impact of PvS and lacunes on cognition.

Results—
Baseline PvS scores or volumes showed no association with cognitive indices. No change was detectable in PvS volumes over the 3 years. In contrast, baseline lacunes associated with all cognitive indices and predicted cognitive decline over the 5-year follow-up.

Conclusions—
Although a feature of small-vessel disease, PvS are not a predictor of cognitive decline, in contrast to lacunes. This study highlights the importance of carefully differentiating between lacunes and PvS in studies investigating vascular cognitive impairment.
Stroke Self-Management Support Improves Survivors’ Self-Efficacy and Outcome Expectation of Self-Management Behaviors
Authors: Lo Suzanne H.S. , Chang Anne M. , Chau Janita P.C. 
Published: February 2018

Background and Purpose—
Evidence shows self-management programs are associated with improved recovery outcomes. This article reports on the effectiveness of a new nurse-led self-efficacy–based stroke self-management program.

Methods—
A randomized controlled trial of participants recruited from 3 acute stroke units was conducted. The intervention group received the 4-week stroke self-management program. The control group received usual care. All participants were assessed at baseline and 8 weeks after randomization. Data were analyzed using generalized estimating equations. Outcomes included self-efficacy, outcome expectation, and satisfaction with performance of self-management behaviors.

Results—

One hundred twenty-eight participants were randomized with mean age, 67.46 years (SD, 11.95); 59% men; and mean duration poststroke, 45 days (SD, 26.16). At 8 weeks of follow-up in the intention-to-treat population, the intervention group improved significantly in self-efficacy (95% confidence interval, 2.55–12.45;
P
<0.01), outcome expectation (95% confidence interval, 5.47–14.01;
P
<0.01), and satisfaction with performance of self-management behaviors (95% confidence interval, 3.38–13.87;
P
<0.01) compared with the control. Similar results were obtained at 8 weeks of follow-up in the per-protocol population.

Conclusions—
The stroke self-management program improved survivors’ self-efficacy, outcome expectation, and satisfaction with performance of self-management behaviors.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT02112955.
Females and males respond more strongly to duets than to female solos: comparing the function of duet and solo singing in a tropical songbird (Icterus icterus)
Authors: Odom Karan J. , Omland Kevin E. 
Published: February 2018

Abstract
Both females and males of many animals possess elaborate displays, such as solo songs and duets of songbirds. We know little about the function of female song or what selects for duets. To examine their possible functions, we played female solos, duets and a heterospecific control to pairs of troupials (Icterus icterus). Both sexes responded strongly to duets by approaching the playback speaker significantly closer, faster, and more often compared to female solos or the control. Neither sex responded strongly to female solos; troupials approached closer, sang sooner, and duetted more following female solos than the control, but this difference was not significant. Our results indicate that troupial duets pose a greater threat than female solos and female troupial solos are not particularly threatening. Troupial duets may be especially threatening because they indicate the presence of a mated pair, which likely poses a greater territorial threat than lone, unmated birds.
Domestic Political Incentives, Congressional Support, and U.S. Mediation
Authors: Todhunter James P. 
Published: February 2018

AbstractPowerful states have numerous resources that can be mobilized in mediation processes. However, evidence suggests that such states are not more likely to be successful than other mediators. This article examinesU.S.mediations through the lens of foreign policy decision making and argues that leaders make foreign policy decisions primarily with their domestic consequences in mind. Further, it contends that presidential administrations seek to build a record of success in order to improve their domestic political fortunes based on the policy options available to them. The study tests two explanations of foreign policy substitution based on domestic conditions and institutional configurations, the “party cover” and “policy availability” arguments, forU.S.mediations from 1945–1999. Results for the party cover argument are more robust, suggesting that domestic conditions play an important role in the decision to engage in mediation and imply that successful mediation is secondary to domestic politics.