bluuebunny/crossref_metadata_2025_split huggingface dataset:
ELF and Communication Strategies: Are They Taken into Account in ELT Materials?
Authors: Vettorel Paola 
Published: January 2018

The complex and varied sociolinguistic reality of World Englishes and English as a Lingua Franca (ELF) has important implications for English Language Teaching (ELT). Besides questioning the validity of the ‘native speaker model’, the complexity of Global Englishes raises several issues, both at a theoretical and at an applied level, particularly for teaching. A plurilithic rather than a monolithic (monolingual/monocultural) perspective is called for, one that can make learners aware of the different roles, contexts, linguistic and functional varieties of English, so that they can be prepared to effectively interact with speakers of different Englishes and in English as a Lingua Franca contexts. Communication strategies have been shown to have a particularly significant role in English as a Lingua Franca communication, that is characterized by negotiation and co-construction of meaning; in these encounters, where different linguacultures meet, ELF speakers employ a range of pragmatic strategies to solve, or pre-empt, (potential) non-understandings often drawing on their plurilingual repertoires, too. Communication strategies can thus be said to play a fundamental role in effective communication, particularly in contexts where English is used as an international Lingua Franca. In this light, it would seem important for ELT materials to include activities aimed at raising awareness and promoting practice of communication strategies, so that they can become an integral part of English as a Foreign Language (EFL) and English as a Second Language (ESL) classroom practices towards the development of communicative ‘capability’. This article will illustrate a study investigating whether ELT materials addressed at Italian upper secondary school students include activities and tasks related to communication strategies. The examination of textbooks published by Italian and international publishers from the 1990s to 2015 shows that, apart from a few interesting cases, consistent attention has not been given to this important area. Implications for further research on the inclusion of communication strategies in ELT will also be set forward.
A qualitative investigation into the patient-centered goal-setting practices of allied health clinicians working in rehabilitation
Authors: Cameron Lisa J , Somerville Lisa M , Naismith Catherine E , Watterson Dina , Maric Valentina , Lannin Natasha A 
Published: January 2018

Objective: To explore the ways clinicians engage rehabilitation patients in patient-centered goal setting and identify factors influencing the goal-setting process. Design: Ethnographic study utilizing observed practice—thematic analysis. Setting: Four rehabilitation wards of a large metropolitan hospital in Melbourne, Australia. Subjects: Participants included 17 rehabilitation patients, 18 allied health clinicians and one family member. Disciplines represented were speech pathology, occupational therapy, social work and physiotherapy. Method: Multiple qualitative methods were used. A total of 18 routine goal-setting interviews between clinicians and patients were audio recorded and transcribed. Together with associated entries in the patient medical record, transcripts were coded and developed into themes using thematic analysis. Finally, focus groups with clinicians were conducted to validate themes identified. Results: Three themes were identified describing factors which influence patient centeredness: “a goal-setting collaboration”—the interpersonal exchange between client and clinician; “the environment”—physical, temporal and structural; and “clinician self-awareness”—clinicians’ insight into the ways they influence goal setting. The practice of patient-centered goal setting varied considerably between clinicians. Goals developed were strongly influenced by the clinician’s views, although strategies of respect for the patient and reflective listening skills increased patient participation and the patient centeredness of goals developed. Conclusion: Goals developed with rehabilitation patients are more likely to be patient-centered when the interaction encourages the patient to express their needs and preferences, and these are heard by the clinician. For this to influence treatment, it must occur in an environment structured to support and value patient-centered goals.
Macroscopic Rotator Cuff Tendinopathy and Histopathology Do Not Predict Repair Outcomes of Rotator Cuff Tears
Authors: Sethi Paul M. , Sheth Chirag D. , Pauzenberger Leo , McCarthy Mary Beth R. , Cote Mark P. , Soneson Emma , Miller Seth , Mazzocca Augustus D. 
Published: January 2018

Background: Numerous studies have identified factors that may affect the chances of rotator cuff healing after surgery. Intraoperative tendon quality may be used to predict healing and to determine type of repair and/or consideration of augmentation. There are no data that correlate how gross tendon morphology and degree of tendinopathy affect patient outcome or postoperative tendon healing. Purpose/Hypothesis: The purposes of this study were to (1) compare the gross appearance of the tendon edge during arthroscopic rotator cuff repair with its histological degree of tendinopathy and (2) determine if gross appearance correlated with postoperative repair integrity. The hypothesis was that gross (macroscopic) tendon with normal thickness, no delamination, and elastic tissue before repair would have a correlation with low Bonar scores, higher postoperative American Shoulder and Elbow Surgeons (ASES) scores, and increased rates of postoperative tendon healing on ultrasound. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 105 patients undergoing repair of medium-size (1-3 cm) full-thickness rotator cuff tears were enrolled in the study. Intraoperatively, the supraspinatus tendon was rated on thickness, fraying, and stiffness. Tendon tissue was recovered for histological analysis based on the Bonar scoring system. Postoperative ASES and ultrasound assessment of healing were obtained 1 year after repair. Correlation between gross appearance of the tendon and rotator cuff histology was determined. Results: Of the 105 patients, 85 were followed the study to completion. The mean age of the patients was 61.6 years; Bonar score, 7.5; preoperative ASES score, 49; and postoperative ASES score, 86. Ninety-one percent of repairs were intact on ultrasound. Gross appearance of torn rotator cuff tendon tissue did not correlate with histological appearance. Neither histological (Bonar) score nor gross appearance correlated with multivariate analysis of ASES score, postoperative repair status, or demographic data. Conclusion: The degree of tendinopathy did not correlate with morphological appearance of the tendon. Neither of these parameters correlated with healing or patient outcome. This study suggests that the degree of tendinopathy, unlike muscle atrophy, may not be predictive of outcomes and that, on appearance, poor quality tendon has adequate healing capacity. Therefore, abnormal gross tendon appearance should not affect the repair effort or technique.
Incidence and Definition of Sepsis and Associated Organ Dysfunction
Authors: Dremsizov T.T. , Kellum J.A. , Angus D.C. 
Published: January 2018

Aims To discuss the incidence, outcome and predisposing factors to systemic inflammatory response syndrome (SIRS), sepsis, and multiple organ failure. Methods A qualitative review of the literature. Results Case definitions of sepsis and severe sepsis, though clarified recently, are still arbitrary. It seems, however, that SIRS is not useful in identifying severe sepsis while organ failure has become a cornerstone for this definition. Incidence of severe sepsis appears to be approximately 10% of all ICU admissions, totaling nearly one million cases annually in the U.S. alone, and rising. Mortality associated with these events is still high, especially among ICU patients. Recent studies have been demonstrating an association between a variety of genetic polymorphisms and progression to and dying from sepsis. Conclusion Recently there has been an increasing amount of information enabling characterization of the epidemiology of sepsis, which may help to direct appropriate care in the coming years.
Prolonged Daily Intermittent Renal Replacement Therapy in ICU Patients by ICU Nurses and ICU Physicians
Authors: Naka T. , Baldwin I. , Bellomo R. , Fealy N. , Wan L. 
Published: January 2018

Objectives Prolonged daily intermittent renal replacement therapy (PDIRRT) has been proposed as a new form of treatment for severe acute renal failure (ARF). However, this treatment has so far implied a) full dependence on nephrological input, b) lack of any convective clearance and c) limited purification of dialysate water. The aim of this study was to establish the feasibility and safety of performing PDIRRT in the ICU with a) no nephrological input, b) the addition of some convective clearance with on-line fluid replacement and c) a new advanced water purification system. Design Prospective observational study. Patients Fourteen patients treated with PDIRRT. Setting ICU of tertiary institution. Interventions Treatment of patients with severe ARF and critical illness with PDIRRT. Prescription of treatment by ICU physicians. Conduct of treatment by ICU nurses. Use of combined convective and diffusive therapy with on-line generation of fluid replacement, application of a double-filtration water purification system. Measurements and Main Results We prospectively collected demographic, biochemical, hemodynamic and clinical data in 14 patients, who received 30 PDIRRT treatments for a cumulative treatment time of 205.4 hours. The mean age was 57.9 ± 16.0. Eight patients were male and 6 female. Their mean APACHE II score was 24.6 ± 5.9 and their SAPS II score was 41.7 ± 18.8. PDIRRT was used after at least 24 hours of initial stabilization with continuous veno-venous hemofiltration (CVVH). Blood flow was kept at 100ml/min dialysate flow at 200 ml/min and convective clearance varied from 21 ml/min to 33 ml/min. All patients were either anuric or oliguric (UO < 400 ml/day). Ten patients were on mechanical ventilation and 11 patients on vasopressor support. Mean treatment session time was 6.9 ± 1.8 hours. The mean pre-PDIRRT urea was 19.2 ± 6.9 mmol/L and the creatinine was 274 ± 116 μmol/L. The mean pre-PDIRRT lactate was 2.95 ± 2.24 mmol/L. Following treatment, all had significantly decreased to 13.2 ± 6.3 mmol/L, 215 ± 95 μmol/L and 2.25 ± 1.61 mmol/L, respectively (p=<0.0001, <0.0001, <0.05). Bicarbonate levels remained stable during treatment (23.0 ± 3.8 mmol/L to 23.1 ± 2.5 mmol/L). Mean norepinephrine dose changed from 8.8 ± 11.9 μg/min to 12.9 ± 27.0 μg/min after treatment (NS). There were no complications of therapy. Patient ICU survival was 71.4%. Conclusions PDIRRT with combined diffusive and convective clearance is an efficacious form of renal replacement, which can be safely and effectively conducted by ICU nurses following prescription by ICU physicians without any nephrological involvement and with adequate double filtration water purification.
Hemoglobin Normalization Results in Lower Dialysis Dose, Despite High Dialysate Flow. Single Needle Offers Inadequate Dialysis
Authors: Vlassopoulos D.A. , Hadjiyannakos D.K. , Koutala K.G. , Iliopoulos A.N. , Diamantopoulou N.V. , Marioli S.I. 
Published: January 2018

Anemia correction by erythropoietin favorably affects dialysis outcome but may also reduce dialysis efficiency increasing morbidity and mortality. Single needle dialysis (SN) and high dialysate flow (DF) are dialysis variations. We studied the effect of hemoglobin (Hb) normalization on dialysis adequacy under high DF. We also compared double needle (DN) and SN dialysis efficiency. Seventeen stable anuric patients (13 M, 4 F), aged 62 (40–90), on hemodialysis for 48 months (8–204), were studied in two, 6 months apart, periods of low (A) and high Hb (B), during a midweek 4 h dialysis with DN and SN. DF was 500 in A and 800ml/min in B. Rebound urea samples, 20 min post dialysis, were used for computer calculated double pool urea kinetics. Hb levels were 128±8 g/L (B) vs. 119±14 g/L (A), P<0.03. Despite the use of higher DF less dialysis was delivered in B vs. A, under DN or SN (DN: URR 64.8±5.8 vs. 69.7±5.2%, Kt/Vequil. 1.09±0.19 vs. 1.26±0.21, nPCR 1.37±0.29 vs. 1.60±0.36g/kg/day, changes <0.001, SN: URR 49.7±7.5% vs. 52.6±8.8%, Kt/Vequil. 0.74±0.16 vs. 0.82±0.23, nPCR 1.05±0.33 vs. 1.20±0.31, changes NS). SN was found significantly (P<0.001) less efficient than DN in A and B. Serum creatinine drop was significantly (P<0.001) less in both periods with SN vs. DN. Hb (SN in B) correlated inversely to Kt/V (r = –0.5705, P<0.02) and URR (r = –0.6432, P=0.005). Hb correction to normality is associated with a decrease in dialysis efficiency. The use of high dialysate flow does not compensate for this loss. SN delivers inadequate dialysis independently of dialysate flow or hemoglobin concentration.
In vitro Models to Test Orthopedic Biomaterials in View of Their Clinical Application in Osteoporotic Bone
Authors: Torricelli P. , Fini M. , Giavaresi G. , Giardino R. 
Published: January 2018

The development of in vitro cell cultures, in association with in vivo experimentation, greatly improved the characterization of biomaterials for orthopedic devices before their clinical use. In recent years an increasing interest has arisen in the use of both pathological osteoblast cultures and animal models to perform in vitro and in vivo tests on biomaterial behavior. A growing number of prostheses, in fact, are implanted in osteoporotic patients, due to the increasing age of the population. Moreover, the presence of osteoporosis may affect bone-biomaterial osteointegration in these patients. The present paper is a literature review and, after a short description of in vitro studies for characterization of osteoblasts derived from osteoporotic bone, the results of in vitro studies on biomaterial biocompatibility and osteointegration rate in the presence of osteoporotic bone derived osteoblast cultures are reported. Pathological cell culture models are able to demonstrate the different behavior of osteoblasts in response to biomaterials, when comparing normal and pathological conditions.
In Vitro and in Vivo Hemocompatibility Evaluation of Graphite Coated Polyester Vascular Grafts
Authors: Arabi H. , Mirzadeh H. , Ahmadi S.H. , Amanpour S. , Rabbani S. , Abdi A. 
Published: January 2018

Attempts have been made in this study to prepare a homogeneous and stable coating of graphite on polyester vascular grafts (GPVG) using an electrophoresis method to evaluate thromboresistant and blood compatibility of GPVG in comparison to non-coated PVG and InterGard (collagen sealed PVG) as control. Lactate dehydrogenase (LDH) activity measurement was carried out on all PVG types to evaluate platelet adhesion. To examine tissue reaction GPVG and non-coated sheets of knitted polyester fabric were implanted simultaneously in the dorsal flank of rats subcutaneously. The GPVG, non-coated and control were implanted in descending aorta as end-to-end or end-to-side implantation substitution in 25 sheep for 4–60 weeks. Results showed that the graphite coating on polyester vascular grafts reduced the number of adherent platelets and prevent platelet activation and spreading on the surface in comparison with non-coated and control. Pathological investigation showed inflammatory reactions were totally resolved after 12 weeks and there was no difference in the tissue reaction between graphite coated, non-coated and control patches. All grafts remained patent and there was no significant difference in patency rate between these three types of PVG. We found that GPVG has no need for pre-clotting and it showed lower platelet aggregation, thinner capsule formation and lower calcification after 15 months. However, suturing of GPVG was more difficult in comparison with the other types.
Evaluation of Adaptive Support Ventilation in Paralysed Patients and in a Physical Lung Model
Authors: Belliato M. , Palo A. , Pasero D. , Iotti G.A. , Mojoli F. , Braschi A. 
Published: January 2018

Objective Evaluation of the respiratory pattern selected by the Adaptive Support Ventilation (ASV) in ventilated patients with acute, chronic respiratory failure and normal lungs and in a physical lung model. Design We tested ASV both on patients and in a physical lung model, with a normal level of minute ventilation and with minute ventilation increased by 30%. In each patient, respiratory pattern, mechanics and blood gases were recorded. Setting General ICU of a University Hospital. Results In patients with normal lungs, mean values±SD were: tidal volume (Vt) 558.1±142.4mL, respiratory rate (RR) 12.6±1.3b/min and inspiratory time/total time ratio (Ti/Ttot) 42.4±4.1%; in COPD, mean values±SD were: Vt 724±171mL, RR 9.2±2.7b/min and Ti/Ttot 26.6±10.5%; in restrictive ones, mean values±SD were: Vt 550.2±77.0mL, RR 15.8±2.6b/min, Ti/Ttot 47.5±2.5%. In the lung model, at a normal setting, mean values±SD were: Vt 523±18.5mL, RR 14±0.0b/min, Ti/Ttot 44.0%, in COPD, mean values±SD were: Vt 678±0.0mL, RR 9±0.0b/min, Ti/Ttot 20±0.7%, in restrictive one, mean values±SD were: Vt 513±12.8mL, RR 15±0.0b/min, Ti/Ttot 48±1.5%. In model hyperventilation conditions in a normal setting a Vt of 582±16.6mL, RR 16±0.0b/min, Ti/Ttot 48±0.0% were selected, in the obstructive setting Vt 883±0.0mL, RR 9±0.0b/min, Ti/Ttot 20±0.0% and in a restrictive one Vt 545±8.4mL, RR 18±0.0b/min, Ti/Ttot 50±0.0%. Conclusions In normal patients ASV selected a ventilatory pattern close to the physiological one, in COPD almost a high expiratory time pattern and in restrictive ones a reduced tidal volume pattern. In the model the selection was similar. In the hyperventilation test, ASV chose a balanced increase in both Vt and RR.
The Role of Improved Water Quality on Inflammatory Markers in Patients Undergoing Regular Dialysis
Authors: Rahmati M.A. , Homel P. , Hoenich N.A , Levin R. , Kaysen G. A. , Levin N.W. 
Published: January 2018

Hemodialysis utilizes large quantities of water for the preparation of dialysis fluid. Such water meets national standards and international standards but a considerable disparity exists between such standards with respect to microbiological purity. This study collated and retrospectively analyzed the impact of upgrading water systems from that specified in the US standards to those specified in European standards on clinical measures associated with inflammation in four metropolitan dialysis units for two periods. Two periods were compared, three months prior to and six months post upgrading the water treatment systems. The monthly total erythropoietin dosage and intravenous iron supplementation for each patient were also compared over these periods. Variables with significant pre-post differences were assessed using multivariate models to control for confounding factors. The results indicated significant increases in hemoglobin, ferritin and TSat (all p < 0.0001) and albumin (p = 0.0001) were associated with improvement in water quality. Decreases in CRP and creatinine (both p < 0.0001) were also noted. These findings suggest that the current regulations in the United States set the microbiological limits of water and dialysis fluid inappropriately high, and the limits should be revised downwards, since such an approach is reflected in improvement in markers of inflammation.
Sequential Convective Therapies (SCT): A Prospective Study on Feasibility, Safety, Adequacy and Tolerance of On-Line Hemofiltration and Hemodiafiltration in Sequence
Authors: Petras D. , Fortunato A. , Soffiati G. , Brendolan A. , Bonello M. , Crepaldi C. , Ratanarat R. , Campolo G. , Amato M. , Ronco C. 
Published: January 2018

Sequential dialysis techniques (i.e pure ultrafiltration followed by dialysis) have been used in the past, due to their capability to remove large volumes of fluids without inducing hemodynamic instability. The disadvantages of inadequate efficiency and lack of technology lead to the decline of such methods. Hemofiltration (HF) and hemodiafiltration (HDF) are recently being utilized in a greater proportion thanks to on-line fluid preparation systems. Each process (HF and HDF) has its own benefits in the removal of small, medium and high-molecular weight substances and in hemodynamic stability. Sequential convective therapies (SCT) such as hemofiltration-hemodiafiltration in sequence (HF-HDF) may combine the benefits and eliminate the disadvantages of each method and should be studied in order to explore their potential application in modern dialysis. Furthermore they can be easily applied nowadays, due to the development of new sophisticated dialysis machines. In order to evaluate the feasibility, safety, efficiency and tolerance of different SCT methods we studied 3 schedules: SCT1: 1h pre-dilution HF followed by 3h of postdilution HDF (in the HF mode we lost 25% of the total fluid that had to be removed). SCT2: 1h pre-dilution HF followed by 3h of post-dilution HDF (in the HF mode we lost 50% of the total fluid that had to be removed). SCT3: 2h pre-dilution HF followed by 2h of post-dilution HDF (in the HF mode we lost 50% of the total fluid that had to be removed). We studied 6 chronic hemodialysis patients using the same machine (AK200 ULTRA), with on-line fluid preparation system and the same type of dialyzer (Polyflux 210). SCT schedules were compared to on-line HF, on-line HDF and high flux dialysis performed with the same dialyzers. The treatments resulted safe, easy, feasible and well tolerated with an improved hemodynamic response to high volume convective therapies. Adequacy of treatment was satisfactory in all SCT schedules while middle molecular weight solute clearance and removal resulted higher in treatments with higher convective component. SCT might represent an interesting option for the future especially in patients with hemodynamic instability and requirements for interventions during treatment.
Sleep Disorders in Hemodialyzed Patients – The Role of Comorbidities
Authors: De Santo R.M. , Lucidi F. , Violani C. , Di Iorio B.R. 
Published: January 2018

Background Sleep disorders are very frequent in hemodialyzed patients, but the relationship between these disorders and water withdrawal, urea removal and comorbidities has not been sufficiently clarified. Methods The study comprised a group of 88 patients in good nutritional condition, with target hemoglobin concentration, good control of blood pressure and optimal dry weight. After answering a questionnaire (SDQ) based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) patients were assigned to one of 3 groups: those with no disturbances (no. 20), those with subclinical disorders (n. 35) and insomniacs (n. 33). Yearly fluid and urea withdrawal by dialysis and the Charlson Comorbity Index were measured. Results Sleep disorders were observed in 77.27% of the patients. There was no difference in body fluid and urea withdrawal between groups. In the group of patients with no sleeping disturbances, the Charlson Comorbidity Index was significantly lower (p<0.001) than in patients with subclinical disorders or insomnia and emerged as a strongly associated with sleep disturbances. The study also attributes a predictive role to age, dialytic age, dialysis shift, antihypertensive drugs. The data indicate that, in evaluating sleeping disorders in patients on maintenance hemodialysis, comorbidities should be assessed.