bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychometric Properties of the Chinese Version of the Occupational Fatigue Exhaustion/Recovery Scale: A Test in a Nursing Population
Authors: FANG Jin-Bo , ZHOU Chun-Fen , HUANG Jing , QIU Chang-Jian 
Published: December 2017

ABSTRACT

Background:
The Occupational Fatigue Exhaustion/Recovery Scale (OFER) was designed to assess occupational fatigue in nurses. Although the original English version of this instrument has shown high degrees of reliability and validity, a Chinese version of this scale has yet to be verified.

Purpose:
The aim of this study was to evaluate the psychometric properties of the OFER in a population of Chinese nurses.

Methods:
The scale was translated using translation and back-translation. The validities and reliabilities were evaluated on 923 qualified participants using content validity index, concurrent validity, factorial validity, internal consistency reliability, and test–retest reliability.

Results:
The content validity index for the OFER was .92. The correlation coefficients between the scores of the OFER subscales and the criteria in this study (varying from −.498 to .705) verified that the OFER has acceptable concurrent validity. Principal component analysis and confirmatory factor analysis revealed that three factors correspond to the structure of the original instrument and that recovery mediates the relationship between acute and chronic fatigue. The Cronbach’s alpha for the chronic fatigue, acute fatigue, and intershift recovery subscales were .83, .85, and .86, respectively. Test–retest reliabilities with correlation coefficients from .61 to .78 were found in the three subscales.

Conclusions/Implications for Practice:
OFER is a reliable and valid instrument for assessing work-related fatigue in Chinese nurses. However, further improvement of the acute fatigue subscale is recommended. The OFER has the potential to elicit information that is useful for assessing fatigue in nurses in China. Furthermore, as it differentiates between acute and chronic fatigue, OFER may be an effective tool for guiding the development and implementation of various, related intervention measures.
Test–Retest Reliability of the APTA Professionalism in Physical Therapy: Core Values Self-Assessment Tool in DPT Students
Authors: Denton Jason , Fike David S. , Walk Matt , Jackson Chad 
Published: December 2017

Study Design.
Test–retest reliability study.

Introduction.
Promoting professionalism is one of the key components of APTA's Vision 2020. The PTCVSA tool is used in PT educational programs as an assessment tool and to facilitate reflection. The tool is also in its initial use as a research tool with PTs. The psychometric properties of this tool have not been established.

Methods.
Participants completed the PTCVSA tool on two occasions using a test–retest design. A total of 96 PT students, including 50 first-year and 46 second-year students, completed both tests. Psychometric testing was undertaken, including internal consistency using Cronbach α and test–retest reliability.

Results.
Internal consistency (Cronbach α) of the individual core values ranged from .713 (accountability) to .934 (social responsibility). The test–retest reliability intraclass correlation coefficient (ICC) for the entire tool was .753 overall. Test–retest reliability was marginal (.625) in first-year students but was acceptable (.798) in second-year students. Intraclass correlation coefficient values for individual core values ranged from .538 (accountability) to .787 (social responsibility).

Discussion.
Although the PTCVSA may continue to be a valuable self-reflection tool for all students in PT education programs, it was not a reliable measurement tool in the first-year students participating in this study.

Conclusion.
In this preliminary investigation, the PTCVSA demonstrated acceptable reliability as a measurement tool for self-assessment of professional behaviors in second-year students who have been in a clinical experience.
Systematic Review of Assessments That Evaluate Clinical Decision Making, Clinical Reasoning, and Critical Thinking Changes After Simulation Participation
Authors: Macauley Kelly , Brudvig Tracy J. , Kadakia Manasvi , Bonneville Madeleine 
Published: December 2017

Background and Purpose.
Increasingly, simulation experiences are augmenting and replacing portions of classroom and clinical education time. The purposes of this systematic review were to (1) systematically review the literature to determine whether simulated experiences impact the development of clinical decision making (CDM), clinical reasoning (CR), or critical thinking (CT) in students in health professional educational programs, (2) assess the quality of evidence for the effectiveness of simulation in developing CDM, CR, or CT in health professions students, (3) compare the effectiveness of simulated experiences to usual teaching methods in developing CDM, CR, and CT in health profession education students, and (4) identify and characterize assessment tools used to measure CDM, CR, and CT in the selected studies.

Methods.
The study design was a systematic review. PubMed, Ovid, Cochrane Database of Systematic Reviews, Google Scholar, EdITLib, and ERIC were searched for articles published in English from January 2000 until March 2017. Thirty-one articles met the inclusion criteria: 1 mixed methods study, 3 qualitative studies, and 27 quantitative studies. Articles were assessed using the Mixed Methods Appraisal Tool for the mixed methods study, the McMaster University Critical Review Form—Qualitative Studies for qualitative studies, and the Evaluation Guidelines for Rating the Quality of an Intervention Study.

Results.
The results demonstrate that simulation improves CDM, CT, or CR. The outcomes from the studies revealed that more repetitions in a simulated environment produced greater changes. Six outcome measures were identified, which assessed the desired constructs.

Discussion and Conclusion.
Future research investigating each tool across health care disciplines is needed. The optimal number of simulated encounters needed for improvement in decision making, thinking, and reasoning in physical therapy will be beneficial.
Benign Paroxysmal Positional Vertigo (BPPV) in Children and Adolescents: Clinical Features and Response to Therapy in 110 Pediatric Patients
Authors: Brodsky Jacob R. , Lipson Sophie , Wilber Jared , Zhou Guangwei 
Published: December 2017

Objective:
This study aimed to characterize the clinical features and outcomes of benign paroxysmal positional vertigo (BPPV) in the pediatric population.

Study Design:
Retrospective case review.

Setting:
Tertiary care center.

Patients:
One hundred ten patients, aged 5 to 19 years old, diagnosed with BPPV.

Main Outcome Measures:
Patient demographics, comorbidities, canal involvement, response to treatment, and incidence of recurrence.

Results:
BPPV was diagnosed in 19.8% of patients seen for dizziness during the study period. Patient age ranged 5 to 19 years old (mean =13.4 ± 3.4 yr). Female:male ratio was 3:2. The most prevalent comorbidities were concussion (n = 42, 38.2%) and migraine disorders (n = 33, 30.0%). Average time to diagnosis from symptom onset was 178.2 ± 190.8 days. The posterior canal was most frequently affected (n = 80, 72.7%), followed by the lateral canal (n = 37, 33.6%) and superior canal (n = 21, 19.1%), and 36.4% (n = 40) of patients had multiple canals affected. Treatment requiring more than or equal to five maneuvers to achieve resolution was observed in 11.8% of cases (n = 13). Recurrence was observed in 18.2% of cases. A logistic regression analysis demonstrated that patients with vestibular migraine or benign paroxysmal vertigo of childhood had five times higher odds of recurrence of BPPV, p = 0.003, 95% [1.735, 15.342], than those who did not have either.

Conclusions:
BPPV is a relatively common cause of dizziness in the pediatric population. Children and adolescents with BPPV can be successfully treated with repositioning maneuvers but may be at risk for treatment resistance and recurrence. Increased awareness of BPPV in pediatric patients may reduce delays in identification and treatment.
Correlations Between the Degree of Endolymphatic Hydrops and Symptoms and Audiological Test Results in Patients With Menière's Disease: A Reevaluation
Authors: Yang Shiyin , Zhu Huaming , Zhu Bijun , Wang Hui , Chen Zhengnong , Wu Yaqin , Chen Bin , Shi Haibo , Li Yuehua , Zou Jing , Yin Shankai 
Published: December 2017

Objective:
This study was performed to reevaluate the diagnostic significance of clinically well-accepted audiological tests in indicating endolymphatic hydrops (EH) in Menière's disease (MD).

Study Design:
Retrospective case review.

Settings:
Hospital.

Patients:
Fifty patients (52 affected ears) diagnosed with MD were enrolled.

Intervention:
Diagnostic.

Main Outcome Measure:
To analyze the correlations between endolymphatic hydrops and results of audiological test including the pure-tone audiometry threshold, suprathreshold function tests, electrocochleogram, and glycerol test.

Results:
Three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging demonstrated EH in either the vestibule or cochlea to various degrees in all of the MD patients, 24 hours after intratympanic gadolinium chelate injection. Both vestibular and cochlear EH were significantly correlated with PTA threshold. However, EH was not associated with alternate binaural loudness balance or the tone decay test, although a correlation was observed with the short-increment sensitivity index. There was also a correlation between vestibular EH, but not cochlear EH, and the negative summating potential/action potential (–SP/AP) ratio. Neither vestibular EH nor cochlear EH was correlated with the glycerol test results. In addition, the frequency of vertigo attacks, the existence of tinnitus, and aural fullness did not correlate with EH.

Conclusions:
Disrupted ionic homeostasis in the inner ear, but not the EH, may contribute to changes in the –SP/AP ratio. The relevance of glycerol test in identifying EH through detection of hearing changes needs further investigation in the future.
Electronic Medical Record Alert Associated With Reduced Opioid and Benzodiazepine Coprescribing in High-risk Veteran Patients
Authors: Malte Carol A. , Berger Douglas , Saxon Andrew J. , Hagedorn Hildi J. , Achtmeyer Carol E. , Mariano Anthony J. , Hawkins Eric J. 
Published: December 2017

Background:
Over the past decade, overdoses involving opioids and benzodiazepines have risen at alarming rates, making reductions in coprescribing of these medications a priority, particularly among patients who may be susceptible to adverse events due to high-risk conditions.

Objectives:
This quality improvement project evaluated the effectiveness of a medication alert designed to reduce opioid and benzodiazepine coprescribing among Veterans with known high-risk conditions (substance use, sleep apnea, suicide-risk, age 65 and above) at 1 Veterans Affairs (VA) health care system.

Methods:
Prescribers were exposed to the point-of-prescribing alert for 12 months. For each high-risk cohort we used interrupted time series design to examine population trends in coprescribing 12 months after alert launch adjusting for coprescribing 12 months before launch, demographics and clinical covariates. Trends at the alert site were compared with those of a similar VA health care system without the alert. Secondary analyses examined population trends in opioid and benzodiazepine prescribing separately.

Results:
Over 12 months, the alert activated for 1332 patients. Proportions of patients with concurrent prescriptions decreased significantly postalert launch among substance use [adjusted odds ratio (AOR)=0.97; 95% confidence interval (CI)=0.96–0.99; 12-month decrease=25.0%], sleep apnea (AOR=0.97, 95% CI=0.95–0.98, 12-month decrease=38.5%), and suicide-risk (AOR=0.94, 95% CI=0.91–0.98, 12-month decrease=61.5%) cohorts at the alert site. Decreases in coprescribing were significantly different from the comparison site among suicide-risk (AOR=0.92, 95% CI=0.86–0.97) and sleep apnea (AOR=0.98, 95% CI=0.96–1.00) cohorts. Significant decreases in benzodiazepine prescribing trends were observed at the alert site only.

Conclusions:
Medication alerts hold promise as a means of reducing opioid and benzodiazepine coprescribing among certain high-risk groups.
CD32 Expression of Different Memory T Cell Subpopulations in the Blood and Lymph Nodal Tissue of HIV Patients and Healthy Controls Correlates With Immune Activation
Authors: Wittner Melanie , Dunay Gábor A. , Kummer Silke , Bockhorn Maximillian , Hüfner Anja , Schmiedel Stefan , Degen Olaf , van Lunzen Jan , Eberhard Johanna M. , Schulze zur Wiesch Julian 
Published: December 2017

Background:
Recently, CD32 has been described to be a specific surface marker of latently HIV-infected CD4+ T cells, but little is known about the frequency and distribution of CD32 expression on naive and memory CD8+ and CD4+ T cell populations in HIV patients and healthy individuals.

Methods:
We studied peripheral blood samples of 36 HIV-1–infected patients [23 viremic patients / 13 antiretroviral therapy(ART)–treated] and healthy individuals (n = 14) as well as cells from lymph nodes (8 HIV infected, 5 controls) using a multiparametric flow cytometry panel determining surface expression of CD3, CD8, CD4, CD45RA, CCR7, CD27, CD25, CD127, CCR5, CCR6, CXCR4, CD38, HLA-DR, TIGIT, and PD-1.

Results:
Overall, expression of CD32 on total peripheral CD4+ T cells between viremic HIV patients, ART-treated and healthy individuals only slightly differed (mean values 1.501%, 0.2785%, and 0.2343%, respectively). However, the level of expression was significantly higher in peripheral and lymph nodal memory CD4+ T cell subpopulations of viremic patients compared with ART-treated patients and healthy controls. CD32+ CD4+ T cells showed higher immune activation and higher expression of CXCR4+ than their CD32− counterparts. Furthermore, expression of CD32 on total CD4+ T cells and memory T cell populations correlated with general immune activation regardless of the infection status.

Conclusions:
Follow-up studies will have to further evaluate CD32 as marker of latently HIV-infected CD4+ T cells since other host-related variables such as immune activation seem to influence CD32 expression regardless of the infection status.
HIV Drug Resistance in Adults Receiving Early vs. Delayed Antiretroviral Therapy: HPTN 052
Authors: Palumbo Philip J. , Fogel Jessica M. , Hudelson Sarah E. , Wilson Ethan A. , Hart Stephen , Hovind Laura , Piwowar-Manning Estelle , Wallis Carole , Papathanasopoulos Maria A. , Morgado Mariza G. , Saravanan Shanmugam , Tripathy Srikanth , Eron Joseph J. , Gallant Joel E. , McCauley Marybeth , Gamble Theresa , Hosseinipour Mina C. , Kumarasamy Nagalingeswaran , Hakim James G. , Pilotto Jose H. , Kumwenda Johnstone , Akelo Victor , Godbole Sheela V. , Santos Breno R. , Grinsztejn Beatriz , Panchia Ravindre , Chariyalertsak Suwat , Makhema Joseph , Badal-Faesen Sharlaa , Chen Ying Q. , Cohen Myron S. , Eshleman Susan H. 
Published: December 2017

Introduction:
We evaluated HIV drug resistance in adults who received early vs. delayed antiretroviral therapy (ART) in a multinational trial [HIV Prevention Trials Network (HPTN) 052, enrollment 2005–2010]. In HPTN 052, 1763 index participants were randomized to start ART at a CD4 cell count of 350–550 cells/mm3 (early ART arm) or <250 cells/mm3 (delayed ART arm). In May 2011, interim study results showed benefit of early ART, and all participants were offered ART regardless of CD4 cell count; the study ended in 2015.

Methods:
Virologic failure was defined as 2 consecutive viral loads >1000 copies/mL >24 weeks after ART initiation. Drug resistance testing was performed for pretreatment (baseline) and failure samples from participants with virologic failure.

Results:
HIV genotyping results were obtained for 211/249 participants (128 early ART arm and 83 delayed ART arm) with virologic failure. Drug resistance was detected in 4.7% of participants at baseline; 35.5% had new resistance at failure. In univariate analysis, the frequency of new resistance at failure was lower among participants in the early ART arm (compared with delayed ART arm, P = 0.06; compared with delayed ART arm with ART initiation before May 2011, P = 0.032). In multivariate analysis, higher baseline viral load (P = 0.0008) and ART regimen (efavirenz/lamivudine/zidovudine compared with other regimens, P = 0.024) were independently associated with higher risk of new resistance at failure.

Conclusions:
In HPTN 052, the frequency of new drug resistance at virologic failure was lower in adults with early ART initiation. The main factor associated with reduced drug resistance with early ART was lower baseline viral load.
Early diagnosis using canonical discriminant analysis of innate immune receptor gene expression profiles in a murine infectious or sterile systemic inflammation model
Authors: Tajima Goro , Tokunaga Ayako , Umehara Takahiro , Ikematsu Kazuya , Miyamoto Junya , Sato Shuntaro , Tasaki Osamu 
Published: December 2017

BACKGROUND
Infection in patients with systemic inflammation is difficult to diagnose with a single biomarker. We aimed to clarify the time course of change in the gene expression profile of innate immune receptors in infectious or sterile inflammation and to establish an early diagnostic method using canonical discriminant analysis (CDA) of the gene expression profile.

METHODS
To compare infectious and sterile inflammation, we used cecal ligation and puncture (CLP) and 20% full-thickness burn injury (Burn) models. C57BL/6 mice underwent sham treatment (n = 9 × three groups), CLP (n = 12 × three groups), or Burn (n = 12 × three groups) injury. Mice were killed at 6, 12, and 24 hours after injury, and total RNA was extracted from whole blood. We used quantitative real-time polymerase chain reaction to investigate gene expression of innate immune receptors Toll-like receptor 2 (TLR2), TLR4, TLR9, NLRP3 (nucleotide-binding oligomerization domain-like receptor family pyrin domain containing 3), and retinoic acid–inducible gene I. To evaluate all gene expression together as patterns, each value was standardized, and CDA was performed at each time point.

RESULTS
Gene expression of TLR2 and TLR4 was already significantly increased in both CLP and Burn compared with sham mice at 6 hours after injury (p < 0.05). Gene expression of TLR9 was significantly decreased in CLP compared with sham and Burn mice at 12 hours and 24 hours after injury (p < 0.05) but not at 6 hours. Gene expression of NLRP3 was significantly increased in CLP and Burn compared with sham mice at 6 hours and 24 hours after injury (p < 0.05). In the CDA, each group showed distinctive gene expression patterns at only 6 hours after injury. Each group was clearly classified, and the classification error rates were 0% at all of the time points.

CONCLUSIONS
Canonical discriminant analysis of the gene expression profile of innate immune receptors could be a novel approach for diagnosing the pathophysiology of complicated systemic inflammation from the early stage of injury.
Prevalence of dual clarithromycin and metronidazole resistance in Helicobacter pylori estimated by molecular methods in Santiago, Chile
Authors: Gonzalez-Hormazabal Patricio , Musleh Maher , Escandar Susana , Valladares Hector , Lanzarini Enrique , Castro V. Gonzalo , Jara Lilian , Berger Zoltan 
Published: December 2017

AbstractBackgroundCurrent available treatments for Helicobacter pylori eradication are chosen according to local clarithromycin and metronidazole resistance prevalence. The aim of this study was to estimate, by means of molecular methods, both clarithromycin and metronidazole resistance in gastric mucosa from patients infected with H.pylori.MethodsA total of 191 DNA samples were analyzed. DNA was purified from gastric mucosa obtained from patients who underwent an upper gastrointestinal endoscopy at an university hospital from Santiago, Chile, between 2011 and 2014. H.pylori was detected by real-time PCR. A 5’exonuclease assay was developed to detect A2142G and A2143G mutations among Hpylori-positive samples. rdxA gene was sequenced in samples harboring A2142G and A2143G mutations in order to detect mutations that potentially confer dual clarithromycin and metronidazole resistance.ResultsNinety-three (93) out of 191 DNA samples obtained from gastric mucosa were H. pylori-positive (48.7%). Clarithromycin-resistance was detected in 29 samples (31.2% [95%CI 22.0%-41.6%]). The sequencing of rdxA gene revealed that two samples harbored truncating mutations in rdxA, one sample had an in-frame deletion, and 11 had amino acid changes that likely cause metronidazole resistance.ConclusionsWe estimated a prevalence of clarithomycin-resistance of 31.8% in Santiago, Chile. The proportion of dual clarithromycin and metronidazole resistance could be, at least, 15.0%. Our results require further confirmation. Nevertheless, they are significant as an initial approximation in re-evaluating the guidelines for H.pylori eradication currently used in Chile.
Individual differences in motor noise and adaptation rate are optimally related
Authors: van der Vliet Rick , Frens Maarten A. , de Vreede Linda , Jonker Zeb D. , Ribbers Gerard M. , Selles Ruud W. , van der Geest Jos N. , Donchin Opher 
Published: December 2017

ABSTRACTIndividual variations in motor adaptation rate were recently shown to correlate with movement variability or “motor noise” in a forcefield adaptation task. However, this finding could not be replicated in a meta-analysis of visuomotor adaptation experiments. Possibly, this inconsistency stems from noise being composed of distinct components which relate to adaptation rate in different ways. Indeed, previous modeling and electrophysiological studies have suggested that motor noise can be factored into planning noise, originating from the brain, and execution noise, stemming from the periphery. Were the motor system optimally tuned to these noise sources, planning noise would correlate positively with adaptation rate and execution noise would correlate negatively with adaptation rate, a phenomenon familiar in Kalman filters. To test this prediction, we performed a visuomotor adaptation experiment in 69 subjects. Using a novel Bayesian fitting procedure, we succeeded in applying the well-established state-space model of adaptation to individual data. We found that adaptation rate correlates positively with planning noise (r=0.27; 95%HDI=[0.05 0.50]) and negatively with execution noise (r=−0.41; 95%HDI=[−0.63 −0.16]). In addition, the steady-state Kalman gain calculated from state and execution noise correlated positively with adaptation rate (r = 0.31; 95%HDI = [0.09 0.54]). These results suggest that motor adaptation is tuned to approximate optimal learning, consistent with the “optimal control” framework that has been used to explain motor control. Since motor adaptation is thought to be a largely cerebellar process, the results further suggest the sensitivity of the cerebellum to both planning noise and execution noise.SIGNIFICANCE STATEMENTOur study shows that the adaptation rate is optimally tuned to planning noise and execution noise across individuals. This suggests that motor adaptation is tuned to approximate optimal learning, consistent with “optimal control” approaches to understanding the motor system. In addition, our results imply sensitivity of the cerebellum to both planning noise and execution noise, an idea not previously considered. Finally, our Bayesian statistical approach represents a powerful, novel method for fitting the well-established state-space models that could have an influence on the methodology of the field.