bluuebunny/crossref_metadata_2025_split huggingface dataset:
Screening for Delirium: Development and Validation of the Buffalo Delirium Scale for Use in a Home-Based Hospice Setting
Authors: Breier Jennifer M. , Meier Scott T. , Kerr Christopher W. , Wright Scott T. , Grant Pei C. , Depner Rachel M. 
Published: November 2017

Background: Delirium is a challenging occurrence among people at end of life. It can be difficult to detect and treat because of its episodic nature. The Buffalo Delirium Scale (BDS) was designed to identify risk factors for hospice patients in the prodromal stage of delirium. Objective: This study evaluated the psychometric properties of items assessing delirium risk factors related to cognitive problems, psychological distress, and sleep problems. Methods: Hospice nursing staff assessed patients with the 11-item BDS over a 6-month period as part of standard weekly visits to monitor for emerging signs of delirium, for example, sleep patterns, cognition, and behavior. Setting/Participants: The rating period produced 4992 assessments from 817 hospice home care patients. Results: Factor analysis of nurses’ ratings identified 3 factors: (1) cognitive problems, (2) distress, and (3) sleep problems. Coefficient αs for these factors and total score were moderate to high (range = .66-.82). Nurses’ ratings of presence of delirium highly correlated with scores on distress ( r = .40, P < .01), while dementia highly correlated with cognitive problems ( r = .50, P < .01). Analysis of at-risk cases with high BDS total scores where no delirium was assessed indicated that quality sleep may mitigate delirium onset. Conclusion: Preliminary psychometric testing suggests BDS to be a valid and appropriate measure for hospice patients. Use of BDS may help differentiate individuals in prodromal stage of delirium versus dementia. Examination of BDS scores may help identify patients for whom sleep interventions may delay onset of or reduce the frequency of delirium.
Prevalence of Jones Fracture Repair and Impact on Short-Term NFL Participation
Authors: Tu Leigh-Anne , Knapik Derrick M. , Sheehan Joseph , Salata Michael J. , Voos James E. 
Published: November 2017

Background: Elite American football athletes are at high risk for Jones fractures. Fixation is recommended to minimize nonunion and allow early return to play. The purpose of this investigation was to evaluate the prevalence of Jones fracture repair in athletes invited to the National Football League (NFL) Combine and the impact of fracture repair on short-term NFL participation compared to athletes with no history of repair. Methods: A total of 1311 athletes participating in the Combine from 2012 to 2015 were evaluated. Athletes with history of Jones fracture repair were identified. Athlete demographic information was collected while physical examination findings were recorded. Radiographs were evaluated to determine fixation type and the presence of nonunion. Future participation in the NFL was evaluated based on draft status, games played, and games started in the athlete’s first season following the Combine. Results: Fixation was performed for 41 Jones fractures in 40 athletes (3.1%). The highest prevalence was in defensive linemen (n = 10 athletes), with the greatest rate in tight ends (5.1%, n = 4 of 79 athletes). Intramedullary screw fixation was used for all fractures. Incomplete bony union was present in 3 (8%) fractures. Athletes with a history of repair were not at significant risk for going undrafted ( P = .61), playing ( P = .23), or starting ( P = .76) fewer NFL games compared to athletes with no history of repair during athletes’ first NFL season. Conclusion: Athletes with a history of Jones fracture repair were not at significant risk of going undrafted or for diminished participation during their first season in the NFL. Level of Evidence: Level IV, case series.
Association of Retroplacental Blood With Basal Plate Myofibers
Authors: Wyand Rachel , Cramer Stewart F , Oshri Assaf , Heller Debra S 
Published: November 2017

Objectives Diagnosed clinical abruption showing blood clot should be signed out in the pathology report as retroplacental hemorrhage with or without parenchymal indentation, and submitted clot separate from the placenta should be weighed. In our experience, some cases sent as clinical abruptions have been cases of morbid adherence. This study was undertaken to evaluate the association of retroplacental blood with basal plate myofibers (BPMF). Methods One hundred fifty-six placentas reviewed by a board-certified pediatric pathologist at a community hospital were evaluated for significant retroplacental blood. Basal plates were reviewed for deviations from normal. Results Of the 156 placentas, 33 (21%) had significant retroplacental blood; 21/156 (13%) had a separate clot, of which 11/21 (52%) had BPMF. Eleven BPMF-associated separate clots ranged from 10.5 to 60 g (average 23), while the clots of 10 cases with no demonstrated BPMF ranged from 19 to 440 g (average 82), tending to be larger ( p < .03). Basal plate damage prior to delivery was noted in both sets of placentas. BPMF placentas could have myometrial damage prior to delivery. Conclusions Since BPMF may confer a risk for accreta in a subsequent pregnancy, submission of a separate clot with the placenta should lead the pathologist to evaluate for basal plate myofibers on H&E and consider if there is an evidence-based indication to do an actin stain, before presuming a diagnosis of abruption.
Children’s language exposure and parental language attitudes in Russian-as-a-heritage-language acquisition by bilingual and multilingual children in Canada
Authors: Makarova Veronika , Terekhova Natalia , Mousavi Amin 
Published: November 2017

Aims and Objectives/Purpose/Research Questions: The research study presented in this paper aims to describe some aspects of the maintenance of Russian as a heritage language among bilingual/multilingual children in Saskatchewan, Canada. The study focuses on the relationship between parents’ language attitudes and children’s language exposure on the one hand and child language proficiency on the other hand. The research questions are as follows. What are the language attitudes of Russian-speaking parents in minority settings? Is there a connection between parents’ language attitudes and children’s language proficiency? What is the scope of Russian language exposure of bilingual/multilingual children within and outside of the family? Is there a connection between this exposure and children’s language proficiency? Design/Methodology/Approach: The study was conducted within a Variationist Sociolinguistics framework. The following methods were employed in the study: a questionnaire study of parents’ language attitudes and of language use within and outside the family; an assessment of children’s speech production based on narratives elicited from children with the help of pictures (language proficiency parameters). Data and Analysis: Thirty parents (aged 31–43) and children (aged 5–7) participated in the study. The questionnaire addressed to parents included 52 demographic and research questions. A statistical analysis of parents’ language attitudes and language use by parents and their children as measured against language proficiency parameters was conducted with the help of correlation analysis. Findings/Conclusions: Study results indicate that Russian-speaking parents in Saskatchewan are interested in passing Russian to their children. The study also suggests that language exposure parameters, as well as language attitudes held by parents, correlate with children’s heritage language fluency. Originality: The study indicates that even in environments unfavorable for heritage language maintenance, a child can still successfully acquire Russian as a heritage language. Significance/Implications: The study clarifies the set of parameters relevant for heritage language maintenance among bilingual/multilingual children. It also suggests the importance of bilingualism/multilingualism for some groups of the immigrant population in Canada.
Type of early bilingualism and its effect on the acoustic realization of allophonic variants: Early sequential and simultaneous bilinguals
Authors: Amengual Mark 
Published: November 2017

Aims and Objectives/Purpose/Research Questions: This study examines the acoustic realization of phrase-initial voiced stops (/b, d, g/) and intervocalic voiced approximants ([β, ð, ɣ]) in Spanish by three groups of Spanish–English bilinguals: simultaneous bilinguals, early sequential bilinguals, and late second language (L2) Spanish learners to investigate if the type of early bilingualism has an effect on the acoustic realization of language-specific phonological processes. Design/Methodology/Approach: Early bilinguals were divided into two groups (simultaneous and sequential bilinguals), and together with late learners (L2 Spanish learners) they were recorded producing words eliciting phrase-initial and intervocalic voiced stops. Data and Analysis: The acoustic analyses examined the difference between the intensity minimum during the consonant and the intensity maximum of the following tautosyllabic vowel (intensity difference). The dataset comprised a total of 3,569 acoustic measurements. Findings/Conclusions: The group of early sequential bilinguals shows a significantly stronger tendency to produce a more lenited intervocalic segment than simultaneous bilinguals and L2 learners, who produce a more constricted realization. These data indicate that simultaneous bilinguals and L2 learners, who were exposed to English since birth, differ from early bilinguals who were exclusively exposed to Spanish for the first years of their life when applying the Spanish allophonic rule governing the distribution of voiced stops and spirants. Originality: This is one of the first studies that investigates the effects of the type of early bilingualism on bilingual phonetic performance in adulthood, especially in terms of bilingual phonetic production. These novel data examine the acoustic realization of Spanish heritage speakers, a largely understudied bilingual population. Significance/Implications: The findings suggest that the type of early bilingualism in language development, even at a very early age, still has consequences on the acoustic realization of allophonic variants in adulthood.
Examining the Impact of HRD Practices on Organizational Commitment and Intention to Stay Within Selected Software Companies in India
Authors: Uraon Ram Shankar 
Published: November 2017

The Problem Software companies are knowledge-based organizations, they invest considerably on human resource development (HRD) practices to overcome the shortage of competent workforce, to stay competitive in the dynamic and competitive business environment of today. Furthermore, software companies are continuously involved in HRD interventions for the development of employees; problems such as low levels of employee commitment, employee engagement, and employee intention to stay are the biggest challenges. The Solution This study examined the impact of comprehensive HRD practices on organizational commitment (affective, continuance, and normative commitment), and employee intention to stay. In addition, it examined the impacts of organizational commitment on employee intention to stay. Survey responses were collected from 516 employees working in different software companies in India. Data were analyzed using partial least squares (PLS) method. Results showed that HRD practices have positive impacts on employee intention to stay as well as on the three components of organizational commitment. Furthermore, only affective and normative commitments were found to positively affect employees’ intention to stay, whereas relationship between continuance commitment and intention to stay was found to be negative and not significant. The Stakeholders Implications for software companies, HRD professionals, and scholars: First, software companies may like to formulate their strategies keeping organizational commitment and employee intention to stay in focus. Second, human resource (HR) managers are encouraged to develop a metric to assess the value added by each HRD practice in managing attrition. This study contributes to the existing concepts on links between HRD practices and attitudinal variables by suggesting a theoretical framework. Finally, it provides empirical evidence that HRD practices in software companies must be sound to enhance employee intention to stay and organizational commitment in India.
Bidirectional Regulation of Mouse Embryonic Stem Cell Proliferation by Nicotine Is Mediated Through Wnt Signaling Pathway
Authors: Qu Qinglan , Zhang Fengrong , Zhang Xiang , Yin Weihong 
Published: November 2017

Introduction: Nicotine is a key biologically active compound of cigarettes. Although nicotine is a risk factor for various health issues, it may also be beneficial when treated at moderate concentrations. Nicotine has been shown to bidirectionally regulate stem cell proliferation and differentiation depending on the doses applied. It is not clear whether or how nicotine regulates mouse embryonic stem cell (mESC) survival and proliferation. Methods: Mouse embryonic stem cells were cultured in the presence of 0.01, 0.1, 1, or 10 μM nicotine. The effects of nicotine on cell survival and proliferation were examined. The signaling pathway that mediated these effects was analyzed. Results: Cell viability was not affected by nicotine at all 4 concentrations examined. The proliferation of mESCs was promoted by 0.01 and 0.1 μM nicotine and suppressed by 1 and 10 μM. This dose-dependent regulation was mediated through the Wnt/β-catenin pathway. Modulation of Wnt/β-catenin activity either worsens or reverses the effects of nicotine. Conclusions: We have identified a bidirectional function of nicotine on mESC proliferation through regulation of the Wnt/β-catenin pathway and this is associated with different doses. This study suggests that concentration of nicotine is a crucial aspect for consideration when designing research or therapeutic strategies.
Routine colonoscopy, diabetic eye care, mammogram and pap smear screening in vascular surgery patients
Authors: Lee Young , Aurshina Afsha , Lee Aaron J , Ackerman Israel M , Chait Michael , Novak Daniel , Hingorani Anil , Ascher Enrico , Marks Natalie 
Published: November 2017

Objective An increasing emphasis on preventive medicine has been supported by the recent reforms in United States health care system. Majority of the patients seen in vascular surgery clinics are elderly with more extensive medical comorbidities compared to the general population. Thus, these patients would be expected at higher risk for common malignant pathologies such as colon, breast and cervical cancer, and nonmalignant diseases such as diabetic retinopathy. This study looked at the screening compliance of vascular patients compared to data provided by Centers for Disease Control on the national and state levels. Methods The office records of 851 consecutive patients seen in Brooklyn and Staten Island vascular clinics were examined. We queried patients regarding their last colonoscopy, diabetic eye exams, recent mammograms, and Pap smears. Our patient screening compliance was compared between the two clinics as well as to the national and New York state data provided by Centers for Disease Control. Compliance with regard to patient’s age was also examined. Results Patients referred to the Staten Island office have a better colonoscopy compliance compared to the Brooklyn office ( P = .0001) and the national Centers for Disease Control average ( P = .026). Compliance for mammography and cervical cancer screening was higher in Staten Island office compared to the Brooklyn office ( P = .0001, P < .0001), respectively. Compliance was lower for Pap smear ( P = .0273) in Brooklyn when compared to the national average. Compliance for colonoscopy increased with age for both clinics ( P = .001, P < .001), while Pap smear decreased ( P < .001, P = .004). Conclusion Patients in vascular clinics in an urban setting had better adherence to screening protocol than the national and state average, with the exception of female patients for colonoscopy in our Brooklyn vascular office. There exists variability in both patient populations based on sub-specific locality and demographics including socioeconomic status. Overall, however patients in Staten Island had better compliance and adherence to the screening protocol than Brooklyn vascular clinic.
Assessing the knowledge to practice gap: The asthma practices of community pharmacists
Authors: Guirguis Lisa M. 
Published: November 2017

Background: Community pharmacists are well positioned to identify patients with poorly controlled asthma and trained to optimize asthma therapy. Yet, over 90% of patients with asthma live with uncontrolled disease. We sought to understand the current state of asthma management in practice in Alberta and explore the potential use of the Chat, Check and Chart (CCC) model to enhance pharmacists’ care for patients with asthma. Methods: An 18-question survey was used to examine pharmacists’ monitoring of asthma control and prior use of the CCC tools. Descriptive statistics were used to characterize the response rate, sample demographics, asthma management and CCC use. Survey validity and reliability were established. Results: One hundred randomly selected pharmacists completed the online survey with a 40% (100/250) response rate. A third of responding pharmacists reported talking to most patients about asthma symptoms and medication, with a greater focus on talking with patients on new prescriptions over those with ongoing therapies. Fewer than 1 in 10 pharmacists routinely talked to most patients about asthma action plans (AAPs). The majority of pharmacists (76%) were familiar with the CCC model, and 83% of those reported that the CCC model influenced their practice anywhere from somewhat (45%) to a great deal (38%). Both scales had good reliability, and factor analysis provided support for scale validity. Conclusions: There was considerable variability in pharmacists’ activities in monitoring asthma. Pharmacists rarely used AAPs. The CCC model had a high level of self-reported familiarity, use and influence among pharmacists.
Rate of Subtalar Joint Arthrodesis After Retrograde Tibiotalocalcaneal Arthrodesis With Intramedullary Nail Fixation: Evaluation of the RAIN Database
Authors: Dujela Michael , Hyer Christopher F. , Berlet Gregory C. 
Published: November 2017

Background. Hindfoot arthritis or significant deformity involving the ankle and subtalar joint (STJ) is a disabling condition with few salvage options. Many surgeons note a decreased STJ fusion rate compared with ankle union when a retrograde nail construct is used. The purpose of this study was to report the STJ fusion rate of tibiotalocalcaneal (TTC) arthrodesis with retrograde nail. Methods. A chart and radiographic review was performed. TTC fusions performed in patients with osteoarthritis, posttraumatic arthritis, or deformity correction with retrograde nail fixation were included. Exclusion criteria included neuropathy, Charcot arthropathy, and failed total ankle replacement. Results. Ultimately, 66 retrograde TTC fusions (in 63 patients) met inclusion criteria. The average age was 57.0 years. There were 29 female and 34 male patients. Radiographic fusion of the ankle and STJ was demonstrated in 68.2% of the patients. There were 11 cases (16.7%) of ankle arthrodesis with STJ nonunion, 6 cases (9.1%) of STJ fusion but ankle nonunion, and 4 cases (6.1%) of stable radiographic nonunion of both joints. The mean time to subtalar fusion was 112.1 days. One patient required revision surgery and conversion to below-knee amputation. One patient required a CROW walker for assistance with gait. Conclusion. A 22.8% radiographic nonunion rate of the STJ was noted in retrograde TTC fusion. Despite this, patients were stable and pain free. Levels of Evidence: Level IV: Retrospective Case series
Non-aneurysmal subarachnoid hemorrhage: When is a second angiography indicated?
Authors: Bashir Asma , Mikkelsen Ronni , Sørensen Leif , Sunde Niels 
Published: November 2017

Purpose Repeat imaging in patients with non-aneurysmal subarachnoid hemorrhage (NASAH) remains controversial. We aim to report our experience with NASAH with different hemorrhage patterns, and to investigate the need for further diagnostic workup to determine the underlying cause of hemorrhage. Method We conducted a retrospective analysis of all spontaneous SAH with an initial negative computed tomography (CT) with angiography (CTA) and/or digital subtraction angiography (DSA) from October 2011 through May 2017. According to the bleeding pattern on the admission CT scan, NASAH was divided into two subgroups: (1) perimesencephalic SAH (PMSAH) and (2) non-perimesencephalic SAH (nPMSAH). Radiological data included the admission CT, CTA, DSA, and magnetic resonance imaging (MRI) with angiography (MRA). Results Seventy-four patients met the inclusion criteria. Thirty-nine (52.7%) patients had PMSAH on the initial CT scan, and 35 (47.3%) had nPMSAH. All underwent CTA and/or DSA revealing no vascular abnormalities. Forty-seven (63.5%) patients underwent subsequent diagnostic workup. DSA was performed in all patients at least once. No abnormalities were found on the repeat DSA or other radiological follow-up studies except in one (1.4%) patient with nPMSAH, in whom a follow-up DSA revealed a small saccular anterior choroidal artery aneurysm, considered to be the source of hemorrhage. Conclusion A repeat DSA may not be needed in case of PMSAH, if the initial negative DSA is technically adequate with absence of hematoma and vasospasm. In contrast, a follow-up DSA should be mandatory for confirming or excluding vascular pathology in case of nPMSAH in order to prevent rebleeding.
Clozapine discontinuation in early schizophrenia: a retrospective case note review of patients under an early intervention service
Authors: Shaker Andrew , Jones Rowena 
Published: November 2017

Aim: Research in patients with treatment-resistant schizophrenia has demonstrated that clozapine discontinuation is associated with poor outcomes. There is, however, a paucity of research investigating the impact of clozapine discontinuation specifically in younger patients with more recent onset schizophrenia. A case note review was therefore conducted to ascertain medium-term prognoses in patients with treatment-resistant schizophrenia under an early intervention service (EIS) following clozapine discontinuation. Methods: The case notes of 25 patients under the care of Birmingham EIS who discontinued clozapine were examined retrospectively. Reasons for discontinuation were recorded. Clinical outcomes including total duration of inpatient or home treatment admission, antipsychotic dose, number of alternative antipsychotics prescribed and adverse events were recorded for both the year before and the year after stopping clozapine. Statistical comparisons of pre- and post-discontinuation clinical outcomes determined whether discontinuation had negative effects. Results: There was no significant difference between the pre- and post-discontinuation clinical status following clozapine discontinuation. More than half (56%) of patients remained stable after stopping clozapine. Mean inpatient or home treatment stay rose from 29.7 to 62.6 days ( p = 0.155), total antipsychotic dose from 50.1% of British National Formulary (BNF) limits to 60.5% ( p = 0.627), number of alternative antipsychotics prescribed from 1.28 to 1.80 ( p = 0.186), number of hospital/home treatment episodes from 0.20 to 0.44 ( p = 0.083) and number of adverse events from 0 to 0.20 ( p = 0.059). Non-compliance was the main reason for discontinuation (44%, n = 11). Conclusions: This is the first clozapine discontinuation study specifically considering EIS patients. Discontinuation did not lead to significant effects on 1 year outcomes, though the study is underpowered. These findings may be used to inform future prospective cohort discontinuation studies.