bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Hearing Result and Graft Uptake Rate between Temporalis Fascia and Tragal Cartilage in Endoscopic Myringoplasty
Authors: Shrestha B. L. , Shakya S. , Pradhan A. , Dhakal A. , KC A. K. , Shrestha K. S. , Pokharel M. 
Published: April 2023

Background There are different methods to repair the perforation of the tympanic membrane. Recently cartilage has been used for the repair and results are comparable to temporalis fascia. For surgical procedure endoscope had added good assistance in middle ear surgery. Though the one hand technique the image quality and results are on par with the use of a microscope.
Objective To compare the graft uptake rate and hearing results between temporalis fascia and tragal cartilage in endoscopic myringoplasty.
Method This is a prospective, longitudinal study conducted among 50 patients who underwent endoscopic myringoplasty using temporalis fascia and tragal cartilage with 25 patients in each group. The hearing was assessed by comparing pre with post-operative ABG (Air bone gap) and ABG closure in speech frequencies (500Hz, 1 KHz, 2 KHz, 4 KHz). The status of graft and hearing results was evaluated on 6 months of follow up in both the groups.
Result Out of total 25 patients enrolled for study in both (temporalis fascia and cartilage) groups, 23 (92%) patients in each group had graft uptaken. The audiological gain in the temporalis fascia group was 11.37±0.32 dB whereas in the tragal cartilage group it was 14.56±1.22dB. The audiological gain between the two groups did not show any statistically significant (p = 0.765). However, the pre and post-operative hearing difference was statistically significant in both temporalis fascia and tragal cartilage group.
Conclusion Tragal cartilage has similar graft uptake rate and hearing gain when compared with temporalis fascia in endoscopic myringoplasty. Hence, tragal cartilage can be used for myringoplasty whenever required without any fear of deterioration in hearing.
Developing a National Consensus of the Physiotherapy Entry-Level Business and Practice Management Core Curriculum Competencies: A Delphi Study
Authors: Hopkins-Rosseel Diana , Yardley Darryl , Turnnidge Jennifer , Dalgarno Nancy , Kolomitro Klodiana 
Published: April 2023

Purpose: Physiotherapists need to develop strong business acumen to make informed decisions, drive positive outcomes, and thrive in their practice. Competencies in these areas are partially reflected in the Competency Profile for Physiotherapists in Canada; however, there is little consistency in how these are applied across academic institutions. The purpose of this study was to develop a set of foundational entry-to-practice (ETP) competencies related to business and practice management (BPM) that can prepare physiotherapy students for work in all Canadian health care service sectors upon graduation. Method: We undertook a modified Delphi study. An online call for participants was circulated via the Canadian Physiotherapy Association’s Private Practice and Leadership Divisions, Canadian provincial and territorial physiotherapy regulators, and 15 Canadian university physiotherapy programmes. Individuals in the profession with known expertise in management and/or business were also invited to participate. Results: Two rounds of the Delphi were necessary to reach consensus. Forty-one participants were included in the first round of Delphi including academics, regulators, registered physiotherapists, and senior students. Twenty-one (51%) participated in round 2 of the study. Sixty-six ETP BPM foundational curriculum competencies, within nine domains, reached consensus (via the Delphi process). Conclusions: Consideration of the ETP competencies in the areas of business and practice management derived with this national Delphi process may enhance and harmonize the physiotherapy curricula across Canada.
Exploring the Education and Practice Experiences of Pelvic Health Physiotherapists in Canada: A Qualitative Descriptive Study
Authors: Scodras Stephanie , Ripat Jacquie , Colquhoun Heather , Yeung Euson , Jaglal Susan B. , Salbach Nancy M. 
Published: April 2023

Purpose: Pelvic health physiotherapy involves sensitive practices including internal assessment and treatment of the pelvic floor. Pelvic health physiotherapy education is not standardized in Canada, which may lead to diverse experiences. The purpose of this study was to explore the education and practice experiences of pelvic health physiotherapists in Canada. Method: This descriptive qualitative study used semi-structured interviews with physiotherapists providing pelvic health services in Canada and a reflexive thematic analysis approach. Results: Based on interviews with 20 pelvic health physiotherapists (19 women and one man) from six provinces, we identified four themes: the right fit, managing vulnerability, the holistic nature of pelvic health physiotherapy, and entering pelvic health physiotherapy requires thoughtful consideration. Participants described pelvic health physiotherapy as the right fit for themselves personally and professionally. The clinical practice involved managing their patients, and their own vulnerability and taking a holistic and biopsychosocial approach to treating patients with pelvic health conditions. Participants described the importance of mentorship and a supportive clinical environment when entering the field. Conclusions: This study provides an understanding of pelvic health physiotherapists’ experiences, which can help to guide the advancement of pelvic health physiotherapy education and practice supports in Canada.
UJI KINERJA ALAT BOOSTER FERMENTASI TAPE KETAN
Authors: Rifky Muhammad , Lisdawati Ayu Novia 
Published: April 2023

Telah dilakukan penelitian uji kinerja alat booster fermentasi tape ketan. Penelitian ini bertujuan untuk membuat dan mengetahui kinerja alat booster fermentasi tape dari waktu fermentasi secara konvensional. Alat booster fermentasi tape telah berhasil dibuat melalui beberapa proses utama yaitu mendesain, menyiapkan alat, bahan, memprogram dan merangkai sesuai dengan desain yang telah dibuat. Pada suhu 40ºC masa fermentasi membutuhkan waktu 46 jam merupakan waktu tercepat yang diperoleh dari pengujian dengan nilai kelembaban 52 dan kadar alkohol yang dideteksi sensor MQ3 mencapai 50%
Analisis Tipe Kepemimpinan Aras Tammauni di Kabupaten Mamuju Tengah
Authors: Hidayat Rahmat , Alam Andi Samsu , Syamsu Suhardiman 
Published: April 2023

This study aims to describe and analyze the type of leadership that is applied and the factors that influence the leadership of Aras Tammauni in Central Mamuju District. This research was held in Central Mamuju District. The research method used is a qualitative method, with a descriptive type. Data collection techniques used were interviews, observation and documentation.The results of this study indicate that the leadership of Aras Tamauni succeeded with the type of leadership applied was a type of charismatic, democratic, militaristic and autocratic leadership. The most dominant type of leadership applied is the charismatic type, the dominant type is democratic and the non-dominant type is autocratic and militaristic. Factors that influence: aristocratic descendants, benefactors, community leaders and originators of transmigrants, and the most important figures in the process of forming Central Mamuju as an Autonomous Region.AbstrakPenelitian ini bertujuan untuk menggambarkan dan menganalisis Tipe kepemimpinan yang diterapkan dan faktor-faktor yang mempengaruhi kepemimpian Aras Tammauni di Kabuapten Mamuju Tengah. Penelitian ini diadakan di Kabupaten Mamuju Tengah. Metode penelitian yang digunakan adalah metode kualitatif, dengan tipe deskriptif. Teknik pengumpulan data yang digunakan adalah wawancara, observasi dan dokumentasi. Hasil penelitian ini menunjukan bahwa kepemimpinan Aras Tamauni berhasil dengan tipe kepemimpinan yang diterapkan adalah tipe kepemimpinan kharismatis, demokratis, militeristik dan otokratis. Tipe kepemimpinan yang paling dominan diterapkan adalah tipe kharismatis, tipe yang cukup dominan adalah demokratis serta tipe yang tidak dominan adalah otokratis dan militeristik. Faktor yang mempengaruhi : keturunan bangsawan, dermawan, tokoh masyarakat dan pencetus transmigran, dan tokoh yang paling berperan dalam proses pembentukan Mamuju Tengah sebagai Daerah Otonom.
Adaptive Policies in the Family Hope Program (PKH) to achieve Sustainable Development Goals in Pangkep Regency
Authors: Islamiyah Riska , Haning Moh. Tahir , Hidayat Andi Rahmat 
Published: April 2023

In general, the objectives of this study are: (1) To describe how the implementation of poverty reduction policies through the Family Hope Program (PKH) in achieving the Sustainable Development Goals (SDGs) in Pangkep Regency; (2) To find out the obstacles to the implementation of poverty reduction policies through the Family Hope Program (PKH) in achieving the Sustainable Development Goals (SDGs) in Pangkep Regency. This study used a qualitative descriptive method with informants selected through the snowball technique. Data collection methods used in this study are interviews, observations, and documents related to the research. The data collected was then analyzed using the Interactive Analysis Model of Miles, Huberman & Saldana. Based on the results of the research, the implementation of poverty reduction policies through the Family Hope Program (PKH) in Pangkep Regency concerning assisting the Adaptive Policies theory according to Swanson & Bhadwal (2009), 5 out of 7 indicators have been implemented properly to successfully achieve Goal 1 of SDGs 2030 which related to integrated and forward-looking analysis, automatic policy adjustment, decentralization of decision-making, promoting variation, and formal policy review and continuous learning. However, 2 of them have not been optimal, namely related to multistakeholder deliberation and enabling self-organization and social networking. The research found obstacles in the implementation of these policies were the lack of involvement of the private sector, geographical constraints of the region, and the mindset of the community in receiving assistance.
The Association Between Emotional Expressivity in Autobiographies from Early Adulthood and the Risk of Dementia in the Context of Written Language Skills
Authors: Morrison-Koechl Jill , Fearon Danielle O. , Fernandes Myra A. , Tyas Suzanne L. 
Published: April 2023

Background: Risk factors for dementia, such as Alzheimer’s disease, are complex and span a lifetime. Exploring novel factors, such as characteristics of writing, may provide insight into dementia risk. Objective: To investigate the association between emotional expressivity and risk of dementia in the context of a previously identified risk factor, written language skills. Methods: The Nun Study recruited 678 religious sisters aged 75 + years. Of these, 149 U.S.-born participants had archived autobiographies handwritten at a mean age of 22 years. The autobiographies were scored for frequency of emotion word usage and language skills (e.g., idea density). The association of emotional expressivity and a four-level composite variable (combining high/low emotional expressivity and high/low idea density) with dementia was assessed using logistic regression models adjusted for age, education, and apolipoprotein E. Results: Within the composite variable, odds of dementia increased incrementally, with opposing effects of emotional expressivity across the two idea density levels. Compared to the referent category (low emotional expressivity/high idea density), the risk of dementia increased in those with high emotional expressivity/high idea density (OR = 2.73, 95% CI = 1.05–7.08), while those with low emotional expressivity/low idea density had the highest risk (OR = 18.58, 95% CI = 4.01–86.09). Conclusion: Dementia risk is better captured by inclusion of multiple measures relating to characteristics of writing. Emotional expressivity may be protective when individuals are at increased risk due to poor written language skills (i.e., low idea density), but detrimental when not at risk (i.e., high idea density). Our findings indicate that emotional expressivity is a contextually-dependent novel risk factor for dementia.
Healthcare Costs in the Year Before and After Alzheimer’s Disease Diagnosis: A Danish Register-Based Matched Cohort Study
Authors: Eithz Nanna , Sørensen Jan , Sopina Liza 
Published: April 2023

Background: Alzheimer’s disease (AD) carries a significant economic burden, with costs peaking around the time of diagnosis. However, the cost of diagnosis, including the time leading up to it, has not been studied thoroughly. Furthermore, regionalized healthcare structure could result in differences in the pre-diagnostic costs for people with suspected AD. Objective: This study set out to estimate the excess healthcare costs before and after AD diagnosis compared to a matched non-AD population and to investigate regional variation in AD healthcare costs in Denmark. Methods: We used a register-based cohort of 25,523 matched pairs of new cases of AD and non-AD controls. The healthcare costs included costs on medication, and inpatient-, outpatient-, and primary care visits. Generalized estimating equations were employed to estimate the excess healthcare cost attributable to diagnosing AD, and the variation in costs across regions. Results: Mean excess costs attributable to AD were € 3,284 and € 6,173 in the year before and after diagnosis, respectively. Regional differences in healthcare costs were identified in both the AD and control groups and were more pronounced in patients with AD (PwAD). Conclusion: PwAD incur higher healthcare costs across all cost categories in the year before and after diagnosis. Regional differences in healthcare utilization by PwAD may reveal potential variation in access to healthcare. These findings suggest that a more standardized and targeted diagnostic process may help reduce costs and variation in access to healthcare.
Superior Global Cognition in Oldest-Old Is Associated with Resistance to Neurodegenerative Pathologies: Results from The 90+ Study
Authors: Biswas Roshni , Kawas Claudia , Montine Thomas J. , Bukhari Syed A. , Jiang Luohua , Corrada Maria M. 
Published: April 2023

Background: Some oldest-old individuals can maintain superior cognition despite advanced age. Little is known about the neuropathological changes in the brains of oldest-old superior cognitive performers. Objective: Our objective was to examine the associations between Alzheimer’s disease (AD) and non-AD neuropathologic features in relation to superior cognitive performance in oldest-old individuals. Methods: We analyzed brain autopsy data from 102 participants with normal cognition from The 90+ Study. Superior global cognitive performers (SGCP) were defined as having Mini-Mental State Examination (MMSE) score ≥28 in the last visit 12 to 2 months before death. To examine the associations between individual and multiple comorbid neuropathologic features with SGCP status we used multiple logistic regression models adjusting for age, sex, and education. Results: Alzheimer’s disease neuropathological change (ADNC) and low levels of vascular pathologic change were not associated with superior cognition. In contrast, participants with limbic (OR = 8.37; 95% CI: 1.48–47.44) and neocortical (OR = 10.80;95% CI: 1.03–113.82) Lewy body disease (LBD), or with hippocampal sclerosis (HS) (OR = 5.28; 95% CI: 1.10–25.47) were more likely to be non-SGCP. High total burden of multiple comorbid neuropathologic features was associated with a lower likelihood of being SGCP. Conclusion: Oldest-old superior cognitive performers were resilient to ADNC and low levels of vascular pathologic change and were resistant to non-AD neurodegenerative changes and multiple comorbid neuropathologic features. Understanding the factors underlying the ability of superior cognitive performers to resist these changes might provide useful insights on maintenance of superior cognition despite advanced age.
Visit-to-Visit Blood Pressure Variability and Cognitive Decline in Apolipoprotein ɛ4 Carriers versus Apolipoprotein ɛ3 Homozygotes
Authors: Sible Isabel J. , Nation Daniel A. ,   the Alzheimer’s Disease Neuroimaging Initiative
Published: April 2023

Background: Blood pressure variability (BPV) is associated with cognitive decline and Alzheimer’s disease (AD), but relationships with AD risk gene apolipoprotein ( APOE) ɛ4 remain understudied. Objective: Examined the longitudinal relationship between BPV and cognitive change in APOE ɛ4 carriers and APOE ɛ3 homozygotes. Methods: 1,194 Alzheimer’s Disease Neuroimaging Initiative participants (554 APOE ɛ4 carriers) underwent 3-4 blood pressure measurements between study baseline and 12-month follow-up. Visit-to-visit BPV was calculated as variability independent of mean over these 12 months. Participants subsequently underwent ≥1 neuropsychological exam at 12-month follow-up or later (up to 156 months later). Composite scores for the domains of memory, language, executive function, and visuospatial abilities were determined. Linear mixed models examined the 3-way interaction of BPV× APOE ɛ4 carrier status x time predicting change in composite scores. Results: Higher systolic BPV predicted greater decline in memory (+1 SD increase of BPV: β= –0.001, p < 0.001) and language ( β= –0.002, p < 0.0001) among APOE ɛ4 carriers, but not APOE ɛ3 homozygotes (memory: +1 SD increase of BPV: β= 0.0001, p = 0.57; language: β= 0.0001, p = 0.72). Systolic BPV was not significantly associated with change in executive function or visuospatial abilities in APOE ɛ4 carriers ( ps = 0.08–0.16) or APOE ɛ3 homozygotes ( ps = 0.48–0.12). Conclusion: Cognitive decline associated with high BPV may be specifically accelerated among APOE ɛ4 carriers.
Fortasyn Connect Improves Neuropsychiatric Symptoms in Patients with Mild Cognitive Impairment and Dementia: Results from a Retrospective Real-World Study
Authors: Aguilar-Barberà Miquel , Soler-Girabau Paquita , Tabuenca-Martín Ana Isabel , Prieto-del Val Laura 
Published: April 2023

Background: Behavioral and psychological symptoms of dementia (BPSD) manifest in the early stages of the disease and impair patients’ and caregivers’ quality of life. Objective: To assess the effectiveness of the nutritional supplement Fortasyn Connect on BPSD for 12 months in people with mild cognitive impairment (MCI) and dementia in clinical practice. Methods: Retrospective, national, single-center study of 236 patients (158 MCI and 78 dementia; 55.1% of AD etiology). BPSD were assessed with the Neuropsychiatric Inventory (NPI) at month 3, 6, and 12. Cognition (Mini-Mental State Examination, MMSE), depression (Geriatric Depression Scale, GDS), and everyday functioning (Blessed Dementia Scale, BLS-D; Rapid Disability Rating Scale 2, RDRS2) were also evaluated. Results: Total NPI score, caregiver impact, and symptoms of depression, anxiety, apathy, and irritability improved after 3, 6, and 12 months from Fortasyn Connect initiation ( p < 0.001). NPI decreases were more pronounced when baseline NPI score was higher than > 20 points ( p < 0.001). The benefit was independent of gender, age, diagnosis, etiology, or concomitant treatment ( p < 0.0001), although larger decreases in NPI total score were observed in MCI patients ( p < 0.0001). After 12 months, GDS scores decreased ( p = 0.042), and MMSE, BLS-D, and RDRS 2 scores remained stable. Conclusion: Fortasyn Connect improved BPSD over at least a year in patients with MCI and dementia. Depression, anxiety, apathy, and irritability were the symptoms that improved the most. The benefit was independent of patients’ characteristics and treatment but was greater if prescribed early and when baseline NPI scores were higher.
Insulin Homeostasis Mediates the Relationship Between Cardiorespiratory Fitness and Cognitive Speed in Aging Adults
Authors: McIntyre Clayton C. , Gaitán Julian M. , Edmunds Kyle J. , Lose Sarah R. , Bendlin Barbara B. , Sager Mark , Asthana Sanjay , Johnson Sterling C. , Okonkwo Ozioma C. 
Published: April 2023

Background: Cardiorespiratory fitness (CRF) supports cognition, though it is unclear what mechanisms underly this relationship. Insulin resistance adversely affects cognition but can be reduced with habitual exercise. Objective: We investigated whether insulin resistance statistically mediates the relationship between CRF and cognition. Methods: In our observational study, we included n = 1,131 cognitively unimpaired, nondiabetic older adults from a cohort characterized by elevated Alzheimer’s disease (AD) risk. We estimated CRF (eCRF) using a validated equation that takes age, sex, body mass index, resting heart rate, and habitual physical activity as inputs. The Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) quantified insulin resistance. Standardized cognitive factor scores for cognitive speed/flexibility, working memory, verbal learning/memory, and immediate memory were calculated from a battery of neuropsychological tests. Linear regression models and bootstrapped estimates of indirect effects were used to determine whether HOMA-IR mediated significant relationships between eCRF and cognition. Results: eCRF was positively associated with cognitive speed/flexibility ( p = 0.034). When controlling for HOMA-IR, eCRF was no longer associated with cognitive speed/flexibility ( p = 0.383). HOMA-IR had a significant indirect effect on the eCRF-cognition relationship ( B = 0.025, CI = [0.003,0.051]). eCRF was not associated with working memory ( p = 0.236), immediate memory ( p = 0.345), or verbal learning/memory ( p = 0.650). Conclusion: Among older adults at risk for AD, peripheral insulin resistance mediates the relationship between CRF and cognitive speed.
18F-AV45 PET and MRI Reveal the Influencing Factors of Alzheimer’s Disease Biomarkers in Subjective Cognitive Decline Population
Authors: Zhao Zixiao , Wang Jie , Wang Ying , Liu Xia , He Kun , Guo Qihao , Xie Fang , Huang Qi , Li Zijing 
Published: April 2023

Background: Subjective cognitive decline (SCD) is a self-perceived decline in cognitive ability, which exhibits no objective impairment but increased risk of conversion to mild cognitive impairment and Alzheimer’s disease (AD). Objective: To investigate how influencing factors (risk gene, age, sex, and education) affect amyloid-β (Aβ) deposition and gray matter (GM) atrophy in SCD population. Methods: 281 SCD subjects were included in this study, who underwent clinical evaluation, cognitive ability assessment, apolipoprotein E ( APOE) genotyping, 18F-Florbetapir positron emission computed tomography, and magnetic resonance imaging screening. Two-sample t tests and analysis of variance were performed based on voxel-wise outcome. Results: In 281 SCD subjects with an average age of 63.86, 194 subjects (69.04%) were females, and 56 subjects carried APOE ɛ4 genes. Statistical results revealed APOE ɛ4 gene, age, and sex influenced Aβ deposition in different brain regions; moreover, only the interaction exhibited between age and APOE ɛ4 genes. The GM atrophy of hippocampal, amygdala, precentral, and occipital lobes occurred in the group age over 60. The GM volume of the hippocampal, frontal, and occipital lobe in females was less than males. Education had an effect only on cognitive function. Conclusion: In SCD, APOE ɛ4 gene, age, and sex significantly influenced Aβ deposition and APOE ɛ4 gene can interact with age in impacting Aβ deposition. Both age and sex can affect GM atrophy. The results suggested that female SCD with APOE ɛ4 genes and aged more than 60 years old might exhibit advanced AD biomarkers.