bluuebunny/crossref_metadata_2025_split huggingface dataset:
Readability Assessment of Patient Education Materials on Major Otolaryngology Association Websites
Authors: Eloy Jean Anderson , Li Shawn , Kasabwala Khushabu , Agarwal Nitin , Hansberry David R. , Baredes Soly , Setzen Michael 
Published: August 2012

ObjectiveVarious otolaryngology associations provide Internet‐based patient education material (IPEM) to the general public. However, this information may be written above the fourth‐ to sixth‐grade reading level recommended by the American Medical Association (AMA) and National Institutes of Health (NIH). The purpose of this study was to assess the readability of otolaryngology‐related IPEMs on various otolaryngology association websites and to determine whether they are above the recommended reading level for patient education materials.Study Design and SettingAnalysis of patient education materials from 9 major otolaryngology association websites.MethodsThe readability of 262 otolaryngology‐related IPEMs was assessed with 8 numerical and 2 graphical readability tools. Averages were evaluated against national recommendations and between each source using analysis of variance (ANOVA) with post hoc Tukey’s honestly significant difference (HSD) analysis. Mean readability scores for each otolaryngology association website were compared.ResultsMean website readability scores using Flesch Reading Ease test, Flesch‐Kincaid Grade Level, Coleman‐Liau Index, SMOG grading, Gunning Fog Index, New Dale‐Chall Readability Formula, FORCAST Formula, New Fog Count Test, Raygor Readability Estimate, and the Fry Readability Graph ranged from 20.0 to 57.8, 9.7 to 17.1, 10.7 to 15.9, 11.6 to 18.2, 10.9 to 15.0, 8.6 to 16.0, 10.4 to 12.1, 8.5 to 11.8, 10.5 to 17.0, and 10.0 to 17.0, respectively. ANOVA results indicate a significant difference (P <. 05) between the websites for each individual assessment.ConclusionThe IPEMs found on all otolaryngology association websites exceed the recommended fourth‐ to sixth‐grade reading level.
A randomized controlled pilot study assessing the feasibility of combined motor–cognitive training and its effect on gait characteristics in the elderly
Authors: de Bruin Eling D , van het Reve Eva , Murer Kurt 
Published: August 2012

Objective: (1) To develop a motor–cognition training programme; (2) to evaluate the ability to recruit and retain elderly people; (3) to assess the effects of the interventions. Design: Pilot randomized controlled trial. Setting: Assisted living facility. Participants: Sixteen subjects (11 female) living in an assisted living facility were randomized to a motor or motor–cognition group. Interventions: Both groups received machine-driven strength training and balance exercises for 45 minutes, twice weekly, for 12 weeks. In addition, the motor–cognition group received computerized training for attention 3–5 times per week for 10 weeks. Main outcome measures: Baseline and post-intervention (12 weeks) assessments focused on recruitment, attrition and adherence. Secondary outcome measures assessed dual-task costs of gait (velocity, cadence, step time, step length), expanded timed get-up-and-go, falls efficacy and reaction time. Results: Of 35 subjects initially approached, 16 started and 14 completed the study, resulting in 46% recruitment, 19% attrition and >80% adherence rates. There is more evidence of altered levels in the motor–cognitive treatment group with significant differences in average change for fear of falling ( P = 0.017) and foot reaction time ( P = 0.046). No statistical significance was reached for gait parameters. Conclusions: Motor–cognition training is feasible and shows trends to stronger improvement in walking and reaction time. The application in a main study is deemed feasible. A minimum of ±55 subjects per group are required to achieve a power of 80% at the 5% level of significance based on step length and considering the expectable attrition rate in a required larger scale study.
Chinese adaptation and validation of the patellofemoral pain severity scale
Authors: Cheung Roy TH , Ngai Shirley PC , Lam Priscillia L , Chiu Joseph KW , Fung Eric YH 
Published: August 2012

Objective: This study validated the Patellofemoral Pain Severity Scale translated into Chinese. Design and setting: The Chinese Patellofemoral Pain Severity Scale was translated from the original English version following standard forward and backward translation procedures recommended by the International Society for Pharmacoeconomics and Outcomes Research. The survey was then conducted in clinical settings by a questionnaire comprising the Chinese Patellofemoral Pain Severity Scale, Kujala Scale and Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index. Subjects: Eighty-four Chinese reading patients with patellofemoral pain were recruited from physical therapy clinics. Main measures: Internal consistency of the translated instrument was measured by Cronbach alpha. Convergent validity was examined by Spearman rank correlation coefficient (rho) tests by comparing its score with the validated Chinese version of the Kujala Scale and the WOMAC Osteoarthritis Index while the test–retest reliability was evaluated by administering the questionnaires twice. Results: Cronbach alpha values of individual questions and their overall value were above 0.85. Strong association was found between the Chinese Patellofemoral Pain Severity Scale and the Kujala Scale (rho = -0.72, p < 0.001). Moderate correlation was also found between Chinese Patellofemoral Pain Severity Scale with the WOMAC Osteoarthritis Index (rho = 0.63, p < 0.001). Excellent test–retest reliability (Intraclass correlation coefficient = 0.98) was demonstrated. Conclusions: The Chinese translated version of the Patellofemoral Pain Severity Scale is a reliable and valid instrument for patients with patellofemoral pain.
Protective effect of lycopene on deltamethrin-induced histological and ultrastructural changes in kidney tissue of rats
Authors: El-Gerbed Mohamed SA 
Published: August 2012

Deltamethrin is globally used in crop protection and control of malaria and other vector-borne diseases. It has a potent insecticidal activity with an appreciable safety margin. However, a number of studies have demonstrated nephrotoxicity of deltamethrin in mammalian and nonmammalian species. Lycopene, a carotenoid occurring naturally in tomatoes, has attracted considerable attention as an antioxidant. This study was focused on investigating the possible protective effect of coadministration of lycopene on deltamethrin toxicity. In this study, male albino rats were divided into four groups of 10 animals each: group I served as control, which received standard diet; group II received oral administration of deltamethrin (1.28 mg/kg per day) for 30 days; group III received both deltamethrin and lycopene (1 mg/kg per day); group IV received lycopene (1 mg/kg per day). After the experiment, the animals were anesthetized and the cytokine, tumor necrosis factor-α (TNF-α), in the serum was measured; the kidney was taken for histological and ultrastructural studies. Deltamethrin significantly increased the TNF-α. The histopathological examination of kidney showed mild necrotic changes. Ultrastructural changes in renal proximal tubules of deltamethrin-treated group included an increased number and irregular shape of mitochondria with sparse fragmented cristae, serious ultrastructural lesions in renal proximal tubular lining cells, vacuolar degeneration in the epithelial cells, increased number of lysosomes and loss of apical microvilli. In addition, focal segmental thickening and the duplication of glomerular basement membrane and podocyte changes were observed. Histopathological and ultrastructural study showed some protective effect of lycopene on kidney tissues.
Impact of probiotic-supplemented diet on the expression level of lactate dehydrogenase in the leukocytes of rabbits
Authors: Ghoneim Magdy AE , Moselhy Said S 
Published: August 2012

Probiotics are known as living, nonpathogenic microorganisms that colonize the intestine and provide benefit to the host. The present study aims to measure one important energy metabolism-related enzyme activity in blood of rabbits fed on probiotics of recommended concentration. In addition, it also aims for the evaluation of the expression level of lactate dehydrogenase (LDH) enzyme using reverse transcriptase-polymerase chain reaction (RT-PCR) technique. Two groups of rabbits are used: control group receiving normal standardized diet and the other probiotic-supplemented group receiving the same diet containing probiotic, namely, Mega acidophilus (200 million cfu/kg body weight/day) for 4 weeks. The obtained results revealed that the rabbits supplemented with probiotics showed a significant decrease in the levels of serum total cholesterol (TC), triacylglycerol, high-density lipoprotein cholesterol (HDL-c) and low-density lipoprotein cholesterol (LDL-c) when compared with control group. Risk factors detected by measuring TC/HDL-c and LDL-c/HDL-c ratios showed statistically significant decrease in probiotic-supplemented rabbits when compared with control group. In addition, blood glucose and total LDH activity were elevated in probiotic-supplemented rabbits when compared with control group. RT-PCR products of LDH-M gene produced two specific amplicons. One amplicon has the expected size of 243 bp from all samples of rabbits as revealed by GelPro software. The level of LDH-M expression was found to be increased in the probiotic-supplemented group. However, unexpected amplicons are produced at 586 bp in all the samples, which may be a dimeric form of the amplified region. It was concluded that this probiotic blend is beneficiary for the metabolic reactions of lipids in the body. Moreover, LDH expression level can be considered as a biomarker for the effect of probiotic and hence monitoring the metabolic changes as reflected from its administration.
Interactive Web-Based Breastfeeding Monitoring
Authors: Ahmed Azza H. , Ouzzani Mourad 
Published: August 2012

Background: Strategies that promote higher exclusive breastfeeding rate and duration are highly recommended. To date, no study has tested the feasibility of Web-based monitoring among breastfeeding mothers. Goals: To develop an interactive Web-based breastfeeding monitoring system (LACTOR) and examine its feasibility, usability, and acceptability among breastfeeding mothers. Methods: A prospective, descriptive, mixed-methods study was conducted. Mothers who met the study inclusion criteria were recruited from mother infant units in 2 Midwestern hospitals in the United States. Mothers were asked to enter their breastfeeding data daily through the system for 30 days and then submit an online exit survey. This survey consisted of a system usability scale and mothers’ perceptions form. Twenty-six mother/infant dyads completed the study. Results: The Feasibility of LACTOR was established by mothers’ compliance in entering their breastfeeding data. The mean was 8.87 (SD = 1.21) daily entries, and the range was 6-13 times per day. Usability scale total mean score was 3.35 (SD = 0.33; scale range 0-4). Ninety-two percent of the mothers thought that they did not need to learn many skills before they started to use LACTOR and did not need any technical support. Mothers reported that the monitoring was beneficial and gave them the chance to track their infants’ feeding patterns and detect any problems early. Conclusions: This study demonstrated the feasibility of LACTOR, and it was user-friendly and acceptable among mothers. Further studies to test its effect on breastfeeding outcomes are needed.
A micro-mechanical model for statistically unidirectional and randomly distributed fibre-reinforced solids
Authors: Brighenti Roberto , Scorza Daniela 
Published: August 2012

The use of reinforcing fibres in structural materials has been known since ancient time as an effective, simple and economic way to enhance their mechanical characteristics. Among the main mechanical properties that can be improved by such reinforcing techniques the tensile strength, the fracture and fatigue resistance, the wear resistance, the durability etc, can be referred. For the above-mentioned reasons, a tremendous effort in theoretical and experimental research on fibre-reinforced composite (FRC) materials has been made in order to develop suitable models capable of accurately describing the mechanical behaviour of such class of materials, at least at a macroscopic level. In the present paper, an energy-based homogenisation approach to model the mechanical behaviour of fibre-reinforced materials is developed by considering the possibility of fibre debonding and breaking, in order to obtain the macro constitutive equations. Furthermore, the effective spatial distribution of the fibres is accounted for by using its description in terms of probabilistic concepts; the case of randomly spatial-oriented fibres is also considered as a particular case by introducing a uniform probability distribution function. Some peculiarities of the model are outlined by discussing some simple examples in which the effects of different values of the involved parameters are considered.
Impaired regulatory function and enhanced intrathecal activation of B cells in neuromyelitis optica: distinct from multiple sclerosis
Authors: Quan Chao , Yu Hai , Qiao Jian , Xiao Baoguo , Zhao Guixian , Wu Zhiying , Li Zhenxin , Lu Chuanzhen 
Published: August 2012

Background: The effective treatment of neuromyelitis optica (NMO) with rituximab has suggested an important role for B cells in NMO pathogenesis. Objective: To explore the antibody-independent function of B cells in NMO and relapsing–remitting multiple sclerosis (RRMS). Methods: Fifty-one NMO patients and 42 RRMS patients in an acute relapse phase and 37 healthy controls (HC) were enrolled in the study. The B cell expression of B cell activating factor receptor (BAFF-R), CXCR5 and very late antigen-4 (VLA-4), the B cell production of interleukin (IL)-10 and interferon (IFN)-γ and the proportion of circulating memory and CD19+CD24highCD38high regulatory B cells were evaluated by flow cytometry. The cerebrospinal fluid (CSF) levels of BAFF and CXCL13 were determined by enzyme-linked immunosorbent assay (ELISA). Results: The CD19+CD24highCD38high regulatory B cell levels and the B cell expression of IL-10 were significantly lower in NMO patients than in RRMS patients and the HC. In aquaporin-4 antibody (AQP4-ab)-positive NMO patients, the B cell IL-10 production and CD19+CD24highCD38high regulatory B cell levels were even lower than in AQP4-ab-negative NMO patients. The CSF BAFF and CXCL13 levels were significantly higher in NMO patients than in patients with RRMS and other non-inflammatory neurologic diseases (ONDs). Conclusions: The immuno-regulatory properties of B cells are significantly impaired in NMO patients and particularly in AQP4-ab-positive NMO patients. The elevated CSF levels of BAFF and CXCL13 in NMO suggest an enhanced intrathecal B cell recruitment and activation. Our results further define the distinct immunological nature of NMO and RRMS from the B cell perspective.
Understanding the dementia diagnosis: The impact on the caregiving experience
Authors: Stokes Laura A , Combes Helen , Stokes Graham 
Published: August 2012

Objectives: There is a paucity of research surrounding disclosure from the perspective of caring partners, therefore this research explores how caring partners understand and make sense of diagnostic information. Method: Semi-structured interviews were conducted with 10 spouses of people with dementia. Interviews aimed to elicit participants’ understanding of dementia and the way that information was used to make sense of dementia. Interviewee accounts were analysed using interpretative phenomenological analysis. Results: Four main themes emerged: lack of information; personal understanding and implications for adjustment; societal understanding and persistent stigma; and lack of partnership working. Conclusions: The analysis indicated a lack of information and continued support following a diagnosis. In the absence of information and support, caring partners described difficulty understanding and adjusting to behavioural, physical and psychological changes in their partner. A greater understanding of the condition was beneficial in terms of adjustment and emotional responses to a partner.
Some thoughts on sample size: A Bayesian-frequentist hybrid approach
Authors: Lan KK Gordan , Wittes Janet T 
Published: August 2012

Background Traditional calculations of sample size do not formally incorporate uncertainty about the likely effect size. Use of a normal prior to express that uncertainty, as recently recommended, can lead to power that does not approach 1 as the sample size approaches infinity. Purpose To provide approaches for calculating sample size and power that formally incorporate uncertainty about effect size. The relevant formulas should ensure that power approaches one as sample size increases indefinitely and should be easy to calculate. Methods We examine normal, truncated normal, and gamma priors for effect size computationally and demonstrate analytically an approach to approximating the power for a truncated normal prior. We also propose a simple compromise method that requires a moderately larger sample size than the one derived from the fixed effect method. Results Use of a realistic prior distribution instead of a fixed treatment effect is likely to increase the sample size required for a Phase 3 trial. The standard fixed effect method for moving from estimates of effect size obtained in a Phase 2 trial to the sample size of a Phase 3 trial ignores the variability inherent in the estimate from Phase 2. Truncated normal priors appear to require unrealistically large sample sizes while gamma priors appear to place too much probability on large effect sizes and therefore produce unrealistically high power. Limitations The article deals with a few examples and a limited range of parameters. It does not deal explicitly with binary or time-to-failure data. Conclusions Use of the standard fixed approach to sample size calculation often yields a sample size leading to lower power than desired. Other natural parametric priors lead either to unacceptably large sample sizes or to unrealistically high power. We recommend an approach that is a compromise between assuming a fixed effect size and assigning a normal prior to the effect size.
Isometric Shoulder Strength Reference Values for Physically Active Collegiate Males and Females
Authors: Westrick Richard B. , Duffey Michele L. , Cameron Kenneth L. , Gerber J. Parry , Owens Brett D. 
Published: August 2012

Background: It is common clinical practice to assess muscle strength during examination of patients following shoulder injury or surgery. Strength comparisons are often made between the patient’s injured and uninjured shoulders, with the uninjured side used as a reference without regard to upper extremity dominance. Despite the importance of strength measurements, little is known about expected normal baselines of the uninjured shoulder. The purpose of this study was to report normative values for isometric shoulder strength for physically active college-age men and women without history of shoulder injury. Methods: University students—546 males (18.8 ± 1.0 years, 75.3 ± 12.2 kg) and 73 females (18.7 ± 0.9 years, 62.6 ± 7.0 kg)—underwent thorough shoulder evaluations by an orthopaedic surgeon and completed bilateral isometric strength measurements with a handheld dynamometer. Variables measured included internal rotation, external rotation, abduction, supine internal rotation and external rotation at 45°, and lower trapezius in prone flexion. Results: Significant differences were found between the dominant and nondominant shoulder for internal rotation, internal rotation at 45°, abduction, and prone flexion in males and in internal rotation at 45° and prone flexion for females ( P ≤ 0.01).
Diagnosis and Treatment of Osteoporosis in High-Risk Patients Prior to Hip Fracture
Authors: Gleason Lauren J. , Menzies Isaura B. , Mendelson Daniel A. , Kates Stephen L. , Friedman Susan M. 
Published: August 2012

Purpose: Hip fractures in older adults are common and serious events. Patients who sustain fragility hip fractures are defined as having osteoporosis. Patients with dementia or a history of a prior fragility fracture are at increased risk of a future fracture. This study assesses prefracture osteoporosis diagnosis and treatment in high-risk groups. Methods: A case–control analysis of a database of all patients age ≥60 years admitted for surgical repair of nonpathological, low-impact femur fracture between May 2005 and October 2010 was performed. Results: Of 1070 patients, 511 (47.8%) had dementia and 435 (40.7%) had been diagnosed with osteoporosis prior to admission. Patients with dementia were more likely to have a diagnosis of osteoporosis prior to their fracture than those without dementia (43.8% vs 37.7%, P < .05). Twenty-five percent of the total study population had been treated with calcium and vitamin D (Cal+D) prior to admission, and 12% with other osteoporosis medications. There was a trend toward patients with dementia being more likely to have been on Cal+D prior to admission (27.6% vs 22.5%, P = .06), but no difference in treatment with other agents (10.8% vs 13.1%, P = .25). Patients with prior fragility fractures were more likely to be on Cal+D (32.3% vs 25.0%, P < .02); however, there was no difference in the use of other osteoporosis medications (12.3% vs 12%, P = .90). Conclusion: Fewer than half of patients that presented with hip fractures were diagnosed with osteoporosis prior to fracture and primary preventative treatment rates were low. Although patients with dementia are more likely to be diagnosed with osteoporosis, they were not more likely to be treated, despite having a greater risk. Additionally, those with prior fragility fractures are often not on preventative treatment. This may represent a missed opportunity for prevention and room for improvement in order to reduce osteoporotic hip fractures.
Comparative evaluation of treatment with low-dose aspirin plus dipyridamole versus aspirin only in patients with acute ischaemic stroke
Authors: Arnarsdottir Lola , Hjalmarsson Clara , Bokemark Lena , Andersson Björn 
Published: August 2012

Abstract

Background
Previous studies have suggested that pre-stroke treatment with low-dose aspirin (A) could reduce the severity of acute ischaemic stroke, but less is known on the effect of pre-stroke treatment with a combination of aspirin and dipyridamole (A + D) and post-stroke effects of these drugs. The aim of the present study was to evaluate the effect of this drug combination on acute and long-term prognosis of ischaemic stroke.

Methods
Patients without atrial fibrillation admitted to the stroke unit with acute ischaemic stroke (n = 554) or TIA (n = 108) were studied during acute hospital care and up to 12 months after discharge from hospital.

Results
Prior to acute stroke 62 patients were treated with A + D while 247 patients were treated with A only. No beneficial effects of the combination A + D compared to A only were noted on stroke severity and/or acute in-hospital mortality. However, survival analysis by Cox-proportional hazard model demonstrated lower 12-months all-cause mortality in patients discharged with A + D (n = 275) compared with patients on A only (HR, 0.52; CI, 0.32-0.86; p = 0.011; n = 262) after adjusting for age, baseline NIHSS, previous stroke, previous myocardial infarction and type 2 diabetes. We also noted a tendency towards lower all-cause mortality at 3 months with use of A + D, but this was not statistically significant (p = 0.12).

Conclusions
Pre-stroke treatment with a combination of low-dose A + D does not reduce the severity of acute stroke, nor does it reduce the acute in-hospital mortality. However, treatment with A + D at discharge from hospital is seemingly associated with lower long-term mortality compared with A only, contrary to the results from previous randomised studies. However, our results must be interpreted with extreme caution considering the non-randomised study design.