bluuebunny/crossref_metadata_2025_split huggingface dataset:
Direct measurement of TEM lamella thickness in FIB‐SEM
Authors: CONLAN A.P. , TILLOTSON E. , RAKOWSKI A. , COOPER D. , HAIGH S.J. 
Published: December 2019

SummaryTransmission electron microscope (TEM) specimen preparation by focused ion beam (FIB) milling requires delicate polishing of a thin window of material during the final stages of the procedure. Over or underpolishing is common and requires extra microscope resources to correct. Despite some methods for lamella thickness measurement being available, the majority of users judge the final polishing step subjectively from scanning electron microscope (SEM) images acquired between milling steps. Here we demonstrate successful thickness determination of thin silicon lamellae using calibrated secondary electron detectors in a FIB‐SEM dual‐beam chamber. Unlike previous thickness measurement methods it does not require long acquisition times, the use of in‐chamber scanning transmission electron microscope (STEM) or energy dispersive x‐ray spectroscopy detectors. The calibration aligns a SEM image to an electron energy loss spectroscopy (EELS) map of lamella thickness acquired in a TEM. This calibration reveals the greyscale‐thickness dependence of two secondary electron SEM detectors: the through‐lens detector (TLD) and the in‐chamber electron detector (ICE). It was found that lamella thickness estimation for TLD images is accurate for areas thinner than 0.4 t/λ, whilst ICE images are most accurate for areas thicker than 0.5 t/λ up to 1.1 t/λ. The procedure presented here allows objective lamella thickness determination during the final stages of FIB specimen preparation using conventional imaging modes for common secondary electron detectors.Lay DescriptionSuccessful analysis of a material in a transmission electron microscope requires very thin windows of the material to be fabricated. Despite the quality of this analysis relying heavily on the thickness of the window, measuring thickness during window fabrication is not common practice.The authors show that it is possible to measure the thickness of the window directly in a focused‐ion‐beam chamber with a scanning electron microscope without altering the fabrication procedure, and using electron detectors common to most microscopes.
A personalized computational model predicts cancer risk level of oral potentially malignant disorders and its web application for promotion of non‐invasive screening
Authors: Wang Xiangjian , Yang Jin , Wei Changlei , Zhou Gang , Wu Lanyan , Gao Qinghong , He Xin , Shi Jiahong , Mei Yingying , Liu Ying , Shi Xueke , Wu Fanglong , Luo Jingjing , Guo Yiqing , Zhou Qizhi , Yin Jiaxin , Hu Tao , Lin Mei , Liang Zhi , Zhou Hongmei 
Published: December 2019

AbstractBackgroundDespite their high accuracy to recognize oral potentially malignant disorders (OPMDs) with cancer risk, non‐invasive oral assays are poor in discerning whether the risk is high or low. However, it is critical to identify the risk levels, since high‐risk patients need active intervention, while low‐risk ones simply need to be follow‐up. This study aimed at developing a personalized computational model to predict cancer risk level of OPMDs and explore its potential web application in OPMDs screening.MethodsEach enrolled patient was subjected to the following procedure: personal information collection, non‐invasive oral examination, oral tissue biopsy and histopathological analysis, treatment, and follow‐up. Patients were randomly divided into a training set (N = 159) and a test set (N = 107). Random forest was used to establish classification models. A baseline model (model‐B) and a personalized model (model‐P) were created. The former used the non‐invasive scores only, while the latter was incremented with appropriate personal features.ResultsWe compared the respective performance of cancer risk level prediction by model‐B, model‐P, and clinical experts. Our data suggested that all three have a similar level of specificity around 90%. In contrast, the sensitivity of model‐P is beyond 80% and superior to the other two. The improvement of sensitivity by model‐P reduced the misclassification of high‐risk patients as low‐risk ones. We deployed model‐P in web.opmd-risk.com, which can be freely and conveniently accessed.ConclusionWe have proposed a novel machine‐learning model for precise and cost‐effective OPMDs screening, which integrates clinical examinations, machine learning, and information technology.
Survey of antibiotic use among hospitalised children in a hospital in Northeast China over a 4‐year period
Authors: Zhang Min , Ma Xin Yu , Feng Zhi Qiang , Gao Ling 
Published: December 2019

AbstractPurposeWe investigated the usage of antibiotic utilisation rate (AUR) among Chinese hospitalised children over a 4‐year period to determine clinical characteristics.Design and MethodsAUR, antibiotic type and antibiotic use in combination were analysed among hospitalised children of the affiliated hospital of Beihua University in Northeast China from January 2015 to December 2018. The linear prediction was used to investigate the trends of antibiotics use in combination and AUR, and autoregressive integrated moving average model was used to predict AUR in 2019.ResultsA total of 2,981 inpatients were admitted to the hospital during the study period. The AUR from 2015 to 2018 was 91.51%, 92.67%, 91.30%, and 93.00%, respectively. AUR was associated with season (p < .01), the peak period was found to be from November to January in 2019 (R2 = 0.802). The etiological delivery rate had increased (p < .01). Pneumonia was the main disease in children for which they received antibiotics. The combination of multidrug (≥3 agents used) had increased (p < .01) over the study period.Practice ImplicationsAUR was stable among hospitalised children in a hospital. Cephalosporin and macrolide antibiotics were the main antibiotic types, and the combination of multidrug had increased, more attention should be paid to the use of antibiotics in hospitalised children.
Health literacy in adolescents with sickle cell disease: The influence of caregiver health literacy
Authors: Caldwell Elizabeth P. 
Published: December 2019

AbstractPurposeAfter patients with sickle cell disease (SCD) transfer from pediatric care to adult care, significant morbidity and mortality occurs. There are many possible contributors to the success or failure of this transition. One hypothesis is that health literacy influences this transition from pediatric to adult health care. The purpose of this study was twofold: (a) to examine the relationship between caregiver and adolescent health literacy levels in adolescents with SCD; and (b) to further describe individual traits contributing to health literacy levels in adolescents with SCD as described by pilot data.Design and MethodsThis cross‐sectional, descriptive correlational study included the administration of the newest vital sign (NVS) health literacy instrument to 59 dyads of adolescent patients with SCD and their caregivers in a large, tertiary care center in Dallas, Texas. Convenience sampling was utilized for recruitment. Caregiver health literacy levels, age, current grade level, annual household income, caregiver education level, number of annual healthcare encounters, and adolescent health literacy levels were correlated to determine relationships amongst variables.ResultsThere was no significant relationship between caregiver and adolescent health literacy levels in this population. Adolescent health literacy NVS scores were positively correlated with adolescent age,r(58) = .468,p < .001, caregiver income,r(46) = .293,p = .023, and caregiver highest education level,r(56) = .318,p = .008. Only adolescent age was a significant predictor of adolescent health literacy NVS scores,β = .485 (standard error [SE] = .109),p = .001. None of the other predictors in the model were significant, including the relationship between caregiver and adolescent health literacy NVS scores,β = .065 (SE = .131),p = .633. In addition, although caregiver income and highest education level were positively correlated with adolescent health literacy NVS scores in the bivariate analysis, these relationships were nonsignificant while controlling for each other, adolescent age, and the other variables in the model.Practice ImplicationsThis study gives insight on potential practice and research initiatives to evaluate the health literacy of adolescents, with and without SCD, both now and in the future.
Association between family management and asthma control in children with asthma
Authors: Han Li , Shangguan Jing , Yu Guiling , Li Ting , Wu Yujie , Zhou Yunping , Liu Panpan , Wang Aimin 
Published: December 2019

AbstractPurposeThe purpose of this study is to investigate the association between family management and asthma control in children with asthma.Design and MethodsThis cross‐sectional descriptive study recruited 142 children with asthma and their parents. We used the Family Management Measure (FaMM), the Childhood Asthma Control Test (C‐ACT), and fractional exhaled nitric oxide (FeNO) detectors to assess family management and asthma control. The McNemar's test was used to determine the proportional difference between C‐ACT and FeNO in evaluating asthma control. Pearson correlation analysis and multiple linear regression analysis were used to assess the relationship between family management and asthma control in children with asthma.ResultsThere was no significant difference in the proportion of C‐ACT and FeNO in evaluating asthma control (McNemar's test p = .593). Child's Daily Life, Condition Management Ability, and Parental Mutuality were positively correlated with C‐ACT (r = 0.398 to 0.655; all p < .05) and negatively correlated with FeNO (r = −0.245 to −0.402; all p < .05); Condition Management Effort, Family Life Difficulty, and View of Condition Impact were negatively correlated with C‐ACT (r = −0.416 to −0.672; all p < .05) and positively with FeNO (r = 0.248 to 0.427; all p < 0.05). Child's Daily Life, Condition Management Effort, and View of Condition Impact dimensions significantly predicted the C‐ACT results, and the Condition Management Effort and View of Condition Impact dimensions significantly predicted the FeNO results (p < .05).Practical ImplicationsPediatric nurses could provide family management education for parents to improve asthma control in children. In addition, pediatric nurses might assess asthma control condition of asthmatic children in combination with C‐ACT and FeNO levels.
Seed production and dispersal limit treeline advance in the Pyrenees
Authors: Anadon‐Rosell Alba , Talavera Marc , Ninot Josep M. , Carrillo Empar , Batllori Enric 
Published: December 2019

AbstractAimsPinus uncinata is the major treeline‐forming species in the Pyrenees. Yet, the role of its reproduction and dispersal as drivers of treeline dynamics remains unknown. Here we quantify seed production, dispersal and germination changes along the elevation gradient to assess whether they may constrain the foreseen treeline advance in the Pyrenees.LocationCentral Pyrenees, Catalonia, NE Spain.MethodsWe established four plots along an elevation gradient from the closed subalpine forest to the krummholz zone at five study sites. In each plot, we collected cones from five to six trees, measured their length, and triggered their opening in the laboratory to count the number of empty seeds and the number and weight of full seeds. We used the collected seeds in a germination experiment under controlled conditions in growth chambers. Additionally, we installed seed traps along the forest–alpine grassland transition to measure seed rain for three consecutive years in three of the study sites.ResultsThe number of full seeds per cone decreased along the elevation gradient and was correlated with cone length. However, the proportion of full seeds per cone and their weight did not differ between elevation positions. Seed rain decreased drastically with elevation and no seeds arrived into the alpine grassland traps consistently across study years. Although germination success did not significantly differ between elevation provenances (i.e., elevation position of origin), we found significant differences in germination dynamics between study sites and between elevation provenances within sites.ConclusionsOur results indicate that whereas the viability of Pinus uncinata seeds is not limited by elevation, seed production and dispersal are constraining the ongoing rates of treeline advance in the Pyrenees.
Alcohol consumption is associated with the severity and outcome of acute liver injury/failure
Authors: Puri Puneet , Lee William M. , Fontana Robert J. , Kim Nak‐Kyeong , Durkalski Valerie , McGuire Brendan M. , Liou Iris , Pezzia Carla , Stravitz R. Todd ,   the Acute Liver Failure Study Group
Published: December 2019

AbstractBackground & AimsNon‐medical factors which contribute to the severity of acute liver failure (ALF) remain poorly defined. The association of alcohol consumption on the severity of presentation and outcome were determined in patients with ALF and acute liver injury (ALI) in a large, multicentre registry.MethodsAlcohol consumption during the 6 months prior to study entry was analysed in 1170 patients enrolled in the ALF Study Group Registry. Consumption was categorized as none/minimal (<3 alcoholic beverages/week) or at least moderate (≥3/week). Clinical characteristics, the severity of liver injury at presentation (ALI or ALF) and outcome were compared.ResultsIn patients with acetaminophen (APAP) overdose, at least moderate alcohol consumption was associated with higher peak aminotransferases, bilirubin, creatinine and INR on admission, compared to no/minimal consumption. In patients with non‐APAP ALI/ALF, at least moderate alcohol consumption was associated with higher peak aminotransferases and creatinine. In APAP, non‐APAP or all aetiologies, at least moderate alcohol consumption was associated with a 75%, 89% and 82% higher odds, respectively, of presenting as ALF rather than ALI (all P < .005). At least moderate alcohol consumption increased the odds of death by 45% (P = .01) across all aetiologies. In multivariate analysis, older age, non‐Caucasian race, peak INR, peak bilirubin and at least moderate alcohol consumption were significantly associated with death. Finally, in Kaplan‐Meier analysis of patients with all aetiologies, at least moderate alcohol consumption was associated with decreased time‐dependent survival (P = .002).ConclusionAlcohol consumption adversely affects the presentation and outcome of both APAP‐ and non‐APAP‐induced ALI/ALF.
A qualitative analysis of text message conversations in a breastfeeding peer counselling intervention
Authors: Martinez‐Brockman Josefa L. , Harari Nurit , Goeschel Lori , Bozzi Valerie , Pérez‐Escamilla Rafael 
Published: December 2019

AbstractThe Special Supplemental Nutrition Program for Women, Infants and Children (WIC) breastfeeding peer counselling (BFPC) program supports optimal early life nutrition by providing evidenced‐based breastfeeding protection, promotion, and support. The Lactation Advice Through Texting Can Help (LATCH) study was a randomized controlled trial that tested the effectiveness of a text messaging intervention designed to augment the BFPC program. The purpose of the present study was to understand the topics discussed during the text message exchanges between breastfeeding peer counsellors (PCs) and their clients in the intervention arm of the LATCH study, from the time of enrollment up to two‐weeks postpartum. Text messaging data were first coded and analysed for one‐ and two‐way text message exchanges. Text messages of participants with a high volume of two‐way exchanges were then analysed qualitatively. Four domains were identified in both the prenatal and postpartum periods: the mechanics of breastfeeding, social support, baby's nutrition, and PCs maintaining contact with participants. Additional themes and subthemes identified in the postpartum period included the discussion of breastfeeding problems such as latching trouble engorgement, plugged ducts, pumping, other breastfeeding complications, and resuming breastfeeding if stopped. Two‐way text messaging in the context of the WIC BFPC program provides an immediate and effective method of substantive communication between mothers and their PC.
A comparison of teaching opportunities for rural and urban family medicine residents
Authors: Jattan Aaron , Penner Charles G. , Giesbrecht Marsha , Malin Greg , Au Lillian L. , Archibald Douglas , François José , Dufour Karlyne , Kim George P. 
Published: December 2019

AbstractContextMedical schools of geographically large nations have expanded into rural areas to facilitate the development of a sustainable rural pipeline of physicians. Preceptor, or clinical teacher, recruitment at these sites has been an ongoing challenge. However, residents‐as‐teachers (RaT) curricula have not been modified to support the development of rural teachers. This study aimed to compare teaching opportunities between rural and urban family medicine residents and to identify mechanisms underlying potential differences.MethodsYear‐1 and Year‐2 family medicine residents at seven Canadian institutions participated in a mixed‐methods study utilising a quantitative survey and a qualitative interview. Rural and urban residents rated the quantity and types of teaching opportunities available during their training, from which a chi‐squared analysis was completed. Volunteer respondents participated in a structured interview, from which a thematic analysis was performed.ResultsRural family medicine residents had fewer opportunities to teach compared to their urban colleagues. This discrepancy was seen across multiple domains, including informal opportunities when on family medicine rotations, χ2 (4, n = 242) = 45.26, P < .000, Bonferroni's adjusted P < .000. Thematic analysis centred around determining factors influencing teaching opportunities and identified that the academic context, personal factors and programme factors were key dimensions. Within these dimensions, the number of medical students, a desire to be an educator and administrative support were cited as influences on teaching opportunities.ConclusionsThe lack of teaching opportunities for rural trainees is attributable to a combination of practical and organisational factors revealed through thematic analysis. If rural graduates are not comfortable balancing the demands of service and teaching, this could compound the already prevalent issue of rural preceptor recruitment. It is essential to develop a rural‐focused RaT curriculum to close this gap and produce competent educators who are ready to inspire generations of rural physicians.
Patient Characteristics Following Surgery for Spinal Metastases: A Multicenter Retrospective Study
Authors: Yang Li , Wang Feng , Zhang Hao , Yang Xiong‐gang , Zhang Hao‐ran , Li Ji‐kai , Qiao Rui‐qi , Zhang Guo‐chuan , Hu Yong‐cheng 
Published: December 2019

ObjectivesTo summarize the epidemiological characteristics of patients following surgery for spinal metastases retrospectively and make a univariate analysis to identify independent variables that could affect the operation decision making.MethodsThis was a multicenter retrospective review of patients with spinal metastasis who were treated with surgery from 1 January 2007 to 31 July 2019. Basic clinical data were analyzed retrospectively by univariate analysis to identify independent variables that could affect the decision of operation modalities, including gender, age, spinal metastatic site, Frankel score, Karnofsky performance score (KPS), spinal instability neoplastic score (SINS), visual analogue scale (VAS), Tokuhashi score, urinary and fecal incontinence, spinal pathological fracture, primary tumor, extraspinal metastasis, visceral metastasis, and bone lesion (osteolytic, osteoblastic or mixed).ResultsA total of 580 patients including 332 males and 248 females were enrolled in the study with an average age of 58.26 years old (range, 13–86 years old). The most common spinal metastatic level was the thoracic vertebra (190 [32.76%]), followed by the lumbar vertebra (146 [25.17%]), cervical vertebra (47 [8.10%]), and sacral vertebra (35 [6.03%]). Metastases involving more than two sites of the cervical, thoracic, lumbar, and sacral vertebrae arose in 162 (27.93%) patients. For primary tumor, there were 198 (34.14%) cases of lung cancer, 41 (7.07%) cases of kidney cancer, 39 (6.72%) cases of breast cancer, 38 (6.55%) cases of gastrointestinal cancer, 35 (6.03%) cases of lymphoma and myeloma, 25 (4.31%) cases of prostate cancer, 24 (4.14%) cases of liver cancer, 23 (3.97%) cases of mesenchymal tissue sarcoma, 20 (3.45%) cases of thyroid cancer, and 84 (14.48%) cases were tumor with unknown origin. Sixty‐three (10.86%) patients received minimally invasive surgery, 460 (79.31%) patients received palliative surgery, and the remaining 57 (9.83%) received tumor resection. According to the univariate analysis, the KPS score, SINS score, VAS score, Tokuhashi score, urinary and fecal incontinence, spinal pathological fracture, and bone lesion (osteolytic, osteoblastic or mixed) were independent and favorable factors affecting the surgery modalities.ConclusionsSurgical treatment for spinal metastases was mainly to relieve pain, rebuild spinal stability, improve nerve function, control local tumors, and improve the quality of life of patients. For middle‐aged and elderly patients with good general conditions, severe pain, spinal pathological fracture, spine instability and without urinary and fecal incontinence, early surgical treatment should be actively carried out.