bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and validation of a Web‐based malignancy risk‐stratification system of thyroid nodules
Authors: Zhang Bin , Pei Shufang , Chen Qiuying , Dong Yuhao , Zhang Lu , Mo Xiaokai , Cong Shuzhen , Zhang Shuixing 
Published: May 2020

AbstractObjectivesPrevious publications on risk‐stratification systems for malignant thyroid nodules were based on conventional ultrasound only. We aimed to develop a practical and simplified prediction model for categorizing the malignancy risk of thyroid nodules based on clinical data, biochemical data, conventional ultrasound and real‐time elastography.DesignRetrospective cohort study.PatientsA total of 2818 patients (1890 female, mean age, 45.5 ± 13.2 years) with 2850 thyroid nodules were retrospectively evaluated between April 2011 and October 2016. 26.8% nodules were malignant.MeasurementsWe used a randomly divided sample of 80% of the nodules to perform a multivariate logistic regression analysis. Cut‐points were determined to create a risk‐stratification scoring system. Patients were classified as having low, moderate and high probability of malignancy according to their scores. We validated the models to the remaining 20% of the nodules. The area under the curve (AUC) was used to evaluate the discrimination ability of the systems.ResultsTen variables were selected as predictors of malignancy. The point‐based scoring systems with and without elasticity score achieved similar AUCs of 0.916 (95% confidence interval [CI]: 0.885‐0.948) and 0.906 (95% CI: 0.872‐0.941) when validated. Malignancy risk was segmented from 0% to 100.0% and was positively associated with an increase in risk scores. We then developed a Web‐based risk‐stratification system of thyroid nodules (http: thynodscore.com).ConclusionA simple and reliable Web‐based risk‐stratification system could be practically used in stratifying the risk of malignancy in thyroid nodules.
Subclinical thyroid dysfunction in the first trimester of pregnancy: ‘Disease’ versus physiological (pulsatile) variation in TSH concentrations
Authors: Lewandowski Krzysztof C. , Garnysz Karolina , Horzelski Wojciech , Kawalec Joanna , Budzen Karolina , Grzesiak Mariusz , Lewinski Andrzej 
Published: May 2020

AbstractBackgroundThere is no universal consensus regarding cut‐off points for TSH in pregnancy, so concentrations of 2.5 or 4.0 mIU/L were suggested for first trimester (Endocrine Society [2012] and ATA [2017] guidelines, respectively). Yet, the impact of physiological variation in TSH secretion has not been assessed.Subjects and MethodsWe assessed baseline concentrations of free T4, free T3 and TSH at 30‐minute intervals (between 7.00 and 9.00 hours) in 110 healthy pregnant women, age 30.2 ± 6.0 years, 9.9 ± 2.4 weeks of gestation, and in 19 female controls, age 28.9 ± 10.7.ResultsMean TSH concentrations in pregnant women were 1.62 ± 1.26 mIU/L and on average varied by 39.5% (dispersion between the highest and the lowest TSH), with no difference in TSH variation between pregnant women and controls. Taking into account the highest TSH out of five consecutive measurements, TSH >2.5 mIU/L and TSH above 4.0 mIU/L were found in 23 (20.9%) and 10 (9.1%) pregnant women, respectively. In contrast, when the lowest TSH value was considered, then concentrations of TSH >2.5 mIU/L and >4.0 mIU/L were found in 14 (12.7%) and 4 (3.6%) women, respectively. This discrepancy was even more pronounced in aTPO‐negative subjects (21 [21.2%] vs 8 [8.1%] women, for TSH >2.5 mIU/L, and six [6.06%] vs one [1.01%], for TSH >4.0 mIU/L). Furthermore, either six (5.4%) or 10 (9.1%) women had TSH concentrations below 0.1 mIU/L.ConclusionsIn a significant number of patients, diagnosis of subclinical thyroid dysfunction could be erroneously made not as a result of ‘disease’, but as a result of physiological variation in TSH concentrations.
Endoscopic management of pancreatic diseases in patients with surgically altered anatomy: clinical outcomes of combination of double‐balloon endoscopy‐ and endoscopic ultrasound‐guided interventions
Authors: Kogure Hirofumi , Sato Tatsuya , Nakai Yousuke , Ishigaki Kazunaga , Hakuta Ryunosuke , Saito Kei , Saito Tomotaka , Takahara Naminatsu , Hamada Tsuyoshi , Mizuno Suguru , Yamada Atsuo , Tada Minoru , Isayama Hiroyuki , Koike Kazuhiko 
Published: May 2020

ObjectivesIn patients with surgically altered anatomy, endoscopic treatment of pancreatic diseases is technically challenging. We aimed to evaluate the feasibility, effectiveness, and safety of an interchangeable combination of double‐balloon endoscope‐assisted ERP (DB‐ERP) and endoscopic ultrasonography‐guided pancreatic duct drainage (EUS‐PD) in this clinical setting.MethodsConsecutive patients with surgically altered anatomy undergoing endoscopic treatment (DB‐ERP, EUS‐PD, or both) for pancreatic diseases were studied. The primary outcome was technical success; secondary outcomes were clinical success and adverse events.ResultsForty patients who underwent DB‐ERP (38) and EUS‐PD (2) as an initial intervention were retrospectively studied. Indications for intervention included 18 pancreaticojejunostomy anastomotic stricture (PJAS), four pancreatic duct stone (PDS), four pancreatic fistula (PF), 11 PJAS with PDS, and three PJAS with PF. Prior surgical reconstruction was 26 Billroth‐II, 13 Roux‐en‐Y, and one Imanaga reconstruction. Along with salvage procedures including three DB‐ERP and seven EUS‐PD, the overall technical success rates of DB‐ERP and EUS‐PD were 70.7% (29/41) and 100% (9/9), respectively. Clinical success was achieved in 85.0% (34/40) by combination of DB‐ERP and EUS‐PD; successful drainage for PJAS, complete removal of PDS, and resolution of PF were achieved in 90.6%, 80.0%, and 71.4%, respectively. Adverse event rates were 12.2% (5/41; one perforation, and four pancreatitis) in DB‐ERP and 55.6% (5/9; three pancreatic leakage, and two abdominal pain) in EUS‐PD.ConclusionsA combination of DB‐ERP and EUS‐PD can achieve high technical and clinical success for pancreatic diseases in surgically altered anatomy patients. A prospective multicenter study to investigate an appropriate treatment algorithm is warranted.
Functional outcomes and patient satisfaction following inpatient treatment for childhood‐onset schizophrenia spectrum disorders vs non‐psychotic disorders in children in the United Kingdom
Authors: Galitzer Hayley , Anagnostopoulou Nefeli , Alba Anca , Gaete Jorge , Dima Danai , Kyriakopoulos Marinos 
Published: May 2020

AbstractAimThe aim of this study was to compare clinical characteristics and treatment outcomes between children with Childhood‐onset schizophrenia spectrum disorders (COSS) and children with other severe non‐psychotic psychiatric conditions (non‐COSS), all admitted to a national mental health inpatient children's unit.MethodsWe conducted a retrospective study of all children discharged from a national children's inpatient unit in the United Kingdom, between 2009 and 2018. We compared functional and treatment outcomes and satisfaction with treatment in COSS with non‐COSS in the whole sample and separately for male and female patients.ResultsA total of 211 children (55% boys) were included in the sample. The mean age on admission was 129.7 months (10.8 years; age range, 6‐12).Twenty cases were diagnosed with COSS (9.5%). In the whole sample, COSS patients had significantly lower Children's Global Assessment Scale (CGAS) scores on admission compared to non‐COSS (P = .006). There was a trend towards children with COSS as a group having a longer admission (M = 194.6 days, SD = 125.4) compared to non‐COSS (M = 135.8 days, SD = 86.2), (P = .053). Females with COSS seemed to have more significant differences compared to females with non‐COSS, in particular, longer admissions (P = .016) and worse CGAS scores at discharge (P = .04), whilst in males, these differences seemed to be attenuated.ConclusionsChildren with COSS have lower functioning at the point of inpatient admission and possibly longer admissions, but similar satisfaction with treatment at discharge from hospital compared with non‐COSS. Females with COSS may have worse functional outcomes compared to non‐COSS at discharge.
The education of academically gifted students in South Korea: Innovative approaches in shadow education
Authors: Kim Young Chun , Jo Jaeseong , Jung Jung‐Hoon 
Published: May 2020

AbstractShadow education contributes to the learning and academic careers of Korean students. It benefits, in particular, gifted students who are strongly motivated and who outperform their peers academically. In this study, we explored the innovative characteristics of shadow education curricula for gifted students in terms of curricular programmes, methods, and teaching‐learning materials. Also, we explored how shadow education practices meet the academic abilities and needs of students. Informed by a literature review and qualitative research methods, the results reveal how common shadow education is; effects of shadow education; and innovative elements used in shadow education for gifted students in Korea. Overall, we found that shadow education plays a crucial role in gifted education; it is a necessary component for understanding academic excellence among students in Korea. The findings are helpful for teachers, curriculum developers, and policymakers as they explore how public schooling can help to support strongly motivated and academically advanced students.
Psychosocial profiles and their predictors in epilepsy using patient‐reported outcomes and machine learning
Authors: Josephson Colin B. , Engbers Jordan D. T. , Wang Meng , Perera Kevin , Roach Pamela , Sajobi Tolulope T. , Wiebe Samuel ,   Calgary Comprehensive Epilepsy Program collaborators
Published: May 2020

AbstractObjectiveTo apply unsupervised machine learning to patient‐reported outcomes to identify clusters of epilepsy patients exhibiting unique psychosocial characteristics.MethodsConsecutive outpatients seen at the Calgary Comprehensive Epilepsy Program outpatient clinics with complete patient‐reported outcome measures on quality of life, health state valuation, depression, and epilepsy severity and disability were studied. Data were acquired at each patient's first clinic visit. We used k‐means++ to segregate the population into three unique clusters. We then used multinomial regression to determine factors that were statistically associated with patient assignment to each cluster.ResultsWe identified 462 consecutive patients with complete patient‐reported outcome measure (PROM) data. Post hoc analysis of each cluster revealed one reporting elevated measures of psychosocial health on all five PROMs ("high psychosocial health" cluster), one with intermediate measures ("intermediate" cluster), and one with poor overall measures of psychosocial health ("poor psychosocial health" cluster). Failing to achieve at least 1 year of seizure freedom (relative risk [RR] = 4.34, 95% confidence interval [CI] = 2.13‐9.09) predicted placement in the "intermediate" cluster relative to the "high" cluster. In addition, failing to achieve seizure freedom, social determinants of health, including the need for partially or completely subsidized income support (RR = 6.10, 95% CI = 2.79‐13.31, P < .001) and inability to drive (RR = 4.03, 95% CI = 1.6‐10.00, P = .003), and a history of a psychiatric disorder (RR = 3.16, 95% CI = 1.46‐6.85, P = .003) were associated with the "poor" cluster relative to the "high" cluster.SignificanceSeizure‐related factors appear to drive placement in the "intermediate" cluster, with social determinants driving placement in the "poor" cluster, suggesting a threshold effect. Precision intervention based on cluster assignment, with an initial emphasis on improving social support and careful titration of medications for those reporting the worst psychosocial health, could help optimize health for patients with epilepsy.
The Role of Constructiveness in Interparental Conflict for Mothers' Perception of Children's Health
Authors: Zemp Martina , Jockers Marlene , Mata Jutta 
Published: May 2020

ObjectiveTo examine how constructiveness in interparental conflict affects mothers' perception of children's psychological and physical health and whether coparenting and positive parenting mediate these effects.BackgroundChildren exposed to high levels of interparental conflict are at elevated risk of developing health problems. However, previous research suggests that constructive and destructive interparental conflict may affect children's health differently.MethodMothers (n = 289) with at least one child aged 3.5 to 8 years completed an online survey about parenting, coparenting, interparental conflict, and different aspects of child health.ResultsResults suggest that higher constructiveness in interparental conflict is related to fewer emotional problems, less pain, and fewer infectious diseases in children, independent of gender. The effects were fully mediated by coparenting.ConclusionConstructive interparental conflict promotes children's physical and psychological health and coparenting emerged as an important mechanism for this
link.ImplicationsEnhancement of constructive interparental conflict and coparenting are promising avenues to foster children's healthy development.
Use of p53 immunohistochemistry in conjunction with routine histology improves risk stratification of patients with Barrett’s oesophagus during routine clinical care
Authors: Tokuyama Minami , Geisler Daniel , Deitrick Christopher , Fasanella Kenneth E , Chennat Jennifer S , McGrath Kevin M , Pai Reetesh K , Davison Jon M 
Published: May 2020

AimsAbnormal p53 protein expression detected by immunohistochemistry (IHC) in Barrett’s oesophagus (BO) is reported to be a prognostic biomarker for progression to high‐grade dysplasia (HGD) or oesophageal adenocarcinoma (OAC). We evaluated our use of p53 IHC for patients with BO under surveillance from 2010 to 2016 in a single academic institution.Methods and resultsWe identified 78 patients under surveillance for BO who had biopsies evaluated for abnormal p53 expression in conjunction with routine histology and 892 patients who had histological evaluation alone. All available p53 IHC slides were rescored as wild‐type or abnormal. We evaluated the risk of subsequent diagnosis with HGD and OAC. p53‐tested patients were significantly more likely to be diagnosed with indefinite dysplasia (IND) or low‐grade dysplasia (LGD), compared to patients who were not tested (79.5 versus 10.8%, P = 7.4 × 10−40). Almost half (46.9%) of patients with abnormal p53 expression were diagnosed with HGD or OAC within 5 years, compared to 5.9% with wild‐type p53, and 7.6% of patients not tested (P = 2.6 × 10−18). However, this difference was heavily influenced by other risk factors, including dysplasia grade, in multivariate analyses. In the subgroup of patients diagnosed with IND (n = 109), abnormal p53 expression was associated with a fourfold increase (1.2–13.3, P = 0.023) in risk of HGD/OAC relative to untested patients diagnosed with IND, independent of other risk factors.ConclusionIn patients under surveillance for BO in a single academic institution, we found evidence that selective use of p53 IHC in conjunction with routine histology modestly improved risk stratification by identifying patients with IND at higher risk of a subsequent diagnosis of HGD or OAC.
Dysfunctional breathing treated with continuous positive airway pressure in newly diagnosed obstructive sleep apnoea: a prospective cohort study
Authors: Barnett Adrian , Sriram Krishna B. , Hay Karen E. , Simpson Graham 
Published: May 2020

AbstractA prospective cohort study investigating patients with obstructive sleep apnoea (OSA) was conducted to determine the prevalence of dysfunctional breathing and if continuous positive airway pressure (CPAP) therapy improves associated symptoms. Almost half of newly diagnosed patients with OSA had dysfunctional breathing and CPAP was not an effective treatment. Dysfunctional breathing is common in patients with OSA.
Multicomponent bulk metal nitride (Nb1/3Ta1/3Ti1/3)N1−δ synthesis via reaction flash sintering and characterizations
Authors: Mondal Santanu , Durygin Andriy , Drozd Vadym , Belisario Jose , Cheng Zhe 
Published: May 2020

AbstractIn this research, near fully dense single phase bulk multicomponent transition metal nitride (Nb1/3Ta1/3Ti1/3)N1−δ has been successfully synthesized from mixed commercial powders of NbN, TaN and TiN via reaction flash sintering technique. This was performed with an applied pressure of ~ 35 MPa at 25°C under a constant DC electric field (~24‐32 V/cm). The flash event, which is the abrupt increase in current (up to ~ 25.2 A/mm2) and temperature, occurred without preheating. The threshold power dissipation on the sample right before the flash is ~ 0.7 W/mm3. The formation of single phase (Nb1/3Ta1/3Ti1/3)N1−δ random solid solution and its compositional uniformity were confirmed by XRD and EDS, respectively. The effects of ball milling duration and limiting current density on phase formation were studied. Simulation based on Joule heating provides an estimate of the ultimate sample temperature of ~ 1850°C. Vickers hardness of the obtained (Nb1/3Ta1/3Ti1/3)N1−δ is 17.6 ± 0.6 GPa, which is comparable to similarly flash sintered ingredient binary nitrides of TaN and NbN. TGA in air shows that the oxidation resistance of (Nb1/3Ta1/3Ti1/3)N1−δ is better than that of TaN and NbN but inferior to TiN. The study demonstrates that reaction flash sintering can be a highly efficient technique for synthesizing bulk multicomponent ceramics for both material fundamental investigations and application development.
The pre‐Medical Emergency Team response: Nurses' decision‐making escalating deterioration to treating teams using urgent review criteria
Authors: Bingham Gordon , Fossum Mariann , Hughes Leanne , Digby Robin , Bucknall Tracey 
Published: May 2020

AbstractAimTo describe nurses' decision‐making, experiences and perceptions of escalating deteriorating patients to the treating medical team using urgent clinical review criteria.DesignA qualitative design comprising individual in‐depth interviews with nurses from a major Australian metropolitan tertiary teaching hospital.MethodA purposive sample of 30 Registered Nurses from nine surgical and medical wards were interviewed in April 2018 using semi‐structured interviews. An inductive thematic analysis was conducted.ResultsIdentified themes included: detecting the deterioration; countering the problem; getting a response; and challenges faced in the process of escalation. Nurses reported an important awareness, sense of responsibility, and critical thinking to ensure the safe management and escalation of deteriorating patients. However, barriers to escalation necessitated individual workarounds and organizational structures to mitigate patient risk.ConclusionThis study supports the importance of communication between clinical teams and recognizes that it is crucial to enable a fail‐safe experience for patients and families. Recognition of disciplinary contributions to patients' goals of care is required to better understand and address the prevalence of deteriorating patients. Our study is among the first to explore the actual experience of nurses who articulate balancing uncertainty and managing complex team dynamics on wards for patients experiencing deteriorating health status. The information may assist in determining team training strategies and structures to facilitate patient management during deterioration.ImpactThis is among the first study to investigate barriers influencing decision‐making of RNs prior to escalation using qualitative methods. This study provides a foundation to inform and develop policies and strategies aimed at ensuring escalation occurs for deteriorating patients.
Exploring the ability of individuals with an intellectual disability to generate and use a compassionate image
Authors: Brougham Laura , Pert Carol , Jahoda Andrew 
Published: May 2020

AbstractBackgroundThere is a growing interest in adapting third‐wave therapies such as mindfulness for people who have intellectual disabilities. This study explored their ability to generate and use a compassionate image.MethodNineteen people with an intellectual disability and twenty people without were recruited from further education colleges. A compassion‐focused therapy technique was adapted to help participants generate their own compassionate image, and examine whether they could use their images in potentially distressing situations.ResultsWith appropriate support, participants with intellectual disabilities were just as able as those without disabilities to generate their own compassionate image. They were also able to generate self‐soothing statements.ConclusionsThe participants’ success in generating compassionate images suggests this approach may have clinical utility with people who have intellectual disabilities. The next question is whether this client group can use this technique to deal with personally salient stressors.
Students' self‐report and observed learning orientations in blended university course design: How are they related to each other and to academic performance?
Authors: Han Feifei , Pardo Abelardo , Ellis Robert A. 
Published: May 2020

AbstractThis study examines the extent to which the learning orientations identified by student self‐reports and the observation of their online learning events were related to each other and to their academic performance. The participants were 322 first‐year engineering undergraduates, who were enrolled in a blended course. Using students' self‐report on a questionnaire about their approaches to learning and perceptions of the blended learning environment, ‘understanding’ and ‘reproducing’ learning orientations were identified. Using observations of student activity online, a Hidden Markov Model (HMM) and agglomerative sequence clustering detected four qualitatively different patterns of online learning orientations. Cross‐tabulations showed significant and logical associations amongst the learning orientations derived by the self‐report and observational methods. Significant differences were also consistently found in the students' academic performance across the mid‐term and final assessments based on their learning orientations detected by both self‐report and observational methods, results which have important implications for learning research.
SARS‐CoV‐2 lgM/lgG antibody detection confirms the infection after three negative nucleic acid detection
Authors: Li Hua , Pan Jue , Su Yi , Wang Beili , Ge Junbo 
Published: May 2020

AbstractAn ongoing outbreak of viral pneumonia was caused by a novel coronavirus in China in 2019. By March 19, over 200 thousand confirmed cases of SARS‐CoV‐2 infection and over 9000 deaths have been reported throughout the world. For this infectious disease, nucleic acid detection is still the gold standard for pathogenic detection. However, nucleic acid detection takes a long time and has relatively high "false negative"; therefore, we need urgently a convenient and accurate detection method to make up for this deficiency. In this article, we will show such technical characteristics of lgM/lgG serum antibody detection, compared with nucleic acid detection.