bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and retention of the dental workforce: findings from a regional workforce survey and symposium in England
Authors: Holmes Richard D. , Burford Bryan , Vance Gillian 
Published: March 2020

Abstract
Background
To help promote a flexible and sustainable workforce in dentistry, it is necessary to access accurate and timely data about the structure and nature of the evolving dental team. This paper considers the results and learning from a region-wide dental workforce survey conducted in one area of Health Education England and how the team has changed since the last survey a decade earlier.

Methods
A mixed-methods approach comprised two phases. In Phase 1 a customised workforce questionnaire was sent to all dental practices registered with the Care Quality Commission in the North East of England and North Cumbria in March 2016. Findings then informed Phase 2, a regional symposium held in October 2016, where interactive workshops generated qualitative data that elaborated on factors influencing workforce development.

Results
Of 431 primary dental care practices identified, 228 questionnaires were returned - a 53% response rate. The largest professional groups were dental nurses (n = 1269, 53% by headcount; 50% of fte) and dentists (34% by headcount; 42% by fte), though there had been increases in numbers of all staff groups over the decade, which was most marked for dental therapists (from 1 per 39 dentists to 1 per 8 dentists). The dental team predominantly fell into ‘younger’ age groups (< 46 years age), with evidence of a significant increase in the number of dentists reporting part-time working in a practice since the last survey. Around one third of dental practices reported employing dental nurses with additional skills (n = 74, 32.5%) or dental therapists (n = 73, 32%), and nearly half employed a dental hygienist (n = 104, 46%). However, there was considerable variability in whether these staff actually carried out the range of skills within their scope of practice. Factors shaping workforce development were identified as, the national context, loss of expertise, patients’ health needs and expectations, surgery premises and financial constraints.

Conclusions
The composition and work patterns of the primary care dental workforce have changed markedly over the last decade, though utilisation of skill-mix continues to be constrained. Consideration of factors determining career progression of dentists and dental care professionals is needed to optimise a sustainable future workforce.
Top-ten tips for managing nutritional issues and gastrointestinal symptoms in children with neurological impairment
Authors: Dipasquale Valeria , Gottrand Frederic , Sullivan Peter B. , Romano Claudio 
Published: March 2020

AbstractThe prevalence of children with neurological impairment (NI) presenting feeding difficulties and gastrointestinal symptoms is rising. The most recent guidelines recommend early nutritional assessment and intervention in order to prevent undernutrition and growth failure, along with the proper diagnosis and treatment of some frequent gastrointestinal symptoms, such as gastroesophageal reflux disease (GERD) and constipation, which can further worsen the feeding process and nutritional status. Nonetheless, the nutritional issues and growth deficits of children with NI are often considered to be of low priority or under recognised by healthcare providers. The present article proposes ten top tips that highlight the major points along the nutritional management pathway of NI children. The implementation of these tips in all healthcare settings could potentially improve patient outcomes and reduce morbidity and mortality.
Traumatic brain injury—needs and treatment options in the chronic phase: Study protocol for a randomized controlled community-based intervention
Authors: Borgen Ida Maria H. , Løvstad Marianne , Andelic Nada , Hauger Solveig , Sigurdardottir Solrun , Søberg Helene L. , Sveen Unni , Forslund Marit V. , Kleffelgård Ingerid , Lindstad Marte Ørud , Winter Laraine , Røe Cecilie 
Published: March 2020

AbstractBackgroundTraumatic brain injury (TBI) is often associated with life-long medical, cognitive, emotional, and behavioral changes. Although long-lasting disabilities are expected, research on effective treatment options in the chronic phase of TBI is scarce.Methods/designThis study protocol describes a randomized controlled trial (RCT) aimed at evaluating the effectiveness of a goal-oriented and community-based intervention for increasing community integration, quality of life, and functional independence in the chronic phase of complicated mild to severe TBI. Participants will be recruited from Oslo University Hospital, Norway. Patients aged 18–72 years living at home with MRI/CT-verified intracranial abnormalities, a TBI diagnosis, a time since injury of ≥ 2 years, and who experience either current TBI-related problems or restrictions in community integration will be included. The 120 participants will be randomized 1:1 to either (a) an intervention group, which will receive an in-home intervention program over 4 months, or (b) a control group receiving standard care in the municipalities. The intervention will consist of six home visits and two telephone contacts with a rehabilitation professional. A SMART-goal approach will be adopted to target the individual’s self-reported TBI difficulties in everyday life. Primary outcomes will be self-reported quality of life and participation. Secondary outcomes include symptom burden, emotional functioning, and clinician-assessed global outcome and need for rehabilitation services. Outcomes will be evaluated at baseline and 4–5 and 12 months after baseline. Caregiver burden and general health will be assessed in participating family members. Goal attainment and acceptability will be evaluated in the intervention group. A process evaluation will be carried out to evaluate protocol adherence, and a cost-effectiveness analysis will be applied if the intervention is found to be effective.DiscussionThe current study provides an innovative approach to rehabilitation in the chronic phase of TBI evaluated using an RCT design that may inform treatment planning, health policies, and coordination of patient care. Further, the study may demonstrate new modes of establishing collaboration and knowledge transition between specialized rehabilitation facilities and local rehabilitation services that may improve patient outcomes.Trial registrationClinicalTrials.gov,NCT03545594. Registered on June 4th, 2018.
Biological potential alterations of migratory chondrogenic progenitor cells during knee osteoarthritic progression
Authors: Wang Yu-Xing , Zhao Zhi-Dong , Wang Qian , Li Zhong-Li , Huang Ya , Zhao Sen , Hu Wei , Liang Jia-Wu , Li Pei-Lin , Wang Hua , Mao Ning , Wu Chu-Tse , Zhu Heng 
Published: March 2020

Abstract
Background
Although increasing studies have demonstrated that chondrogenic progenitor cells (CPCs) remain present in human osteoarthritic cartilage, the biological alterations of the CPCs from the less diseased lateral tibial condyle and the more diseased medial condyle of same patient remain to be investigated.

Methods
CPCs were isolated from paired grade 1–2 and grade 3–4 osteoarthritic cartilage by virtue of cell migratory capacities. The cell morphology, immunophenotype, self-renewal, multi-differentiation, and cell migration of these CPCs were evaluated. Additionally, the distributions of CD105+/CD271+ cells in OA osteochondral specimen were determined. Furthermore, a high-throughput mRNA sequencing was performed.

Results
Migratory CPCs (mCPCs) robustly outgrew from mildly collagenases-digested osteoarthritic cartilages. The mCPCs from grade 3–4 cartilages (mCPCs, grades 3–4) harbored morphological characteristics, cell proliferation, and colony formation capacity that were similar to those of the mCPCs from the grade 1–2 OA cartilages (mCPCs, grades 1–2). However, the mCPCs (grades 3–4) highly expressed CD271. In addition, the mCPCs (grades 3–4) showed enhanced osteo-adipogenic activities and decreased chondrogenic capacity. Furthermore, the mCPCs (grades 3–4) exhibited stronger cell migration in response to osteoarthritis synovial fluids. More CD105+/CD271+ cells resided in grade 3–4 articular cartilages. Moreover, the results of mRNA sequencing showed that mCPCs (grades 3–4) expressed higher migratory molecules.

Conclusions
Our data suggest that more mCPCs (grades 3–4) migrate to injured articular cartilages but with enhanced osteo-adipogenic and decreased chondrogenic capacity, which might explain the pathological changes of mCPCs during the progression of OA from early to late stages. Thus, these dysfunctional mCPCs might be optional cell targets for OA therapies.
The social health impact of Eritrean refugees on the host communities: the case of May-ayni refugee camp, Northern Ethiopia
Authors: Gebrehiwet Kahsay , Abrha Fitsum , Gebreyesus Hailay , Teweldemedhin Mebrahtu 
Published: March 2020

Abstract
Objective
Migration is a contemporary global issue and the exodus of refugees may potentially posit new social health challenges in the host communities. Ethiopia is a host to the second largest refugee population in Africa. The aim of this study was to explore the health impacts by the Eritrean refugees in May-ayni camp, North West Tigrai on the host community. The research used a qualitative exploratory approach. Participants were recruited using a purposive sampling technique. The primary sources of the data were in-depth interviews of 20 key informants, and focus group discussions with 30 refugees and 30 members of the host community. Transcription and translation was done verbatim and finally thematic analysis was done using an inductive approach.

Results
The findings of this research indicated that the refugees in the May-ayni camp created actual social and health threats to the members of the host communities. The socio-cultural norms of the host peoples were disrupted in terms of their social insecurity and introduction of health related challenges such as the spread of sexually transmitted infections and other reproductive health problems.
Dynamic adaptation of service-based applications: a design for adaptation approach
Authors: De Sanctis Martina , Bucchiarone Antonio , Marconi Annapaola 
Published: March 2020

AbstractA key challenge posed by the Next Generation Internet landscape is that modern service-based applications need to cope withopenandcontinuously evolvingenvironments and to operate under dynamic circumstances (e.g., changes in the users requirements, changes in the availability of resources). Indeed, dynamically discover, select and compose the appropriate services in such environment is a challenging task. Self-adaptation approaches represent effective instruments to tackle this issue, because they allow applications to adapt their behaviours based on their execution environment. Unfortunately, although existing approaches support run-time adaptation, they tend to foresee the adaptation requirements and related solutions at design-time, while working under a "closed-world" assumption. In this article our objective is that of providing a new way of approaching thedesign,operationandrun-time adaptationof service-based applications, by considering the adaptivity as an intrinsic characteristic of applications and from the earliest stages of their development. We propose anovel design for adaptation approachimplementing a complete lifecycle for the continuous development and deployment of service-based applications, by facilitating (i) the continuous integration of new services that can easily join the application, and (ii) the operation of applications under dynamic circumstances, to face theopennessanddynamicityof the environment. The proposed approach has been implemented and evaluated in a real-world case study in the mobility domain. Experimental results demonstrate the effectiveness of our approach and its practical applicability.
Johannes Vermeer’s Mistress and Maid: new discoveries cast light on changes to the composition and the discoloration of some paint passages
Authors: Mahon Dorothy , Centeno Silvia A. , Iacono Margaret , Carό Federico , Stege Heike , Obermeier Andrea 
Published: March 2020

Abstract
Among the thirty-six paintings ascribed to the Dutch seventeenth century artist Johannes Vermeer (1632–1675), Mistress and Maid, in The Frick Collection, stands out for the large-scale figures set against a rather plain background depicting a barely discernible curtain. Although generally accepted as among the late works of the artist and dated to 1667–1668, for decades scholars have continued to puzzle over aspects of this portrayal. When the painting was cleaned and restored in 1952, attempts to understand the seeming lack of finish and simplified composition were hampered by the limited technical means available at that time. In 1968, Hermann Kühn included Mistress and Maid in his groundbreaking technical investigation ‘A Study of the Pigments and the Grounds Used by Jan Vermeer.’ In the present study, imaging by infrared reflectography and macro-X-ray fluorescence (MA-XRF) revealed significant compositional changes and drew focus to areas of suspected color change. Three of the samples taken by Hermann Kühn, and now in the archive of the Doerner Institut in Munich, were re-analyzed, along with a few paint samples taken from areas not examined in the 1968 study, using scanning electron microscopy–energy dispersive X-ray spectroscopy (SEM–EDS) and Raman spectroscopy. These analyses made it possible to further visualize detailed compositional elements in the background of the painting that were later painted out, and to characterize darkening and color changes in different paint passages.
Testing the validity and responsiveness of a new cancer-specific health utility measure (FACT-8D) in relapsed/refractory mantle cell lymphoma, and comparison to EQ-5D-5L
Authors: Herdman Michael , Kerr Cicely , Pavesi Marco , Garside Jamie , Lloyd Andrew , Cubi-Molla Patricia , Devlin Nancy 
Published: March 2020

Abstract
Background
The FACT-8D is a new cancer-specific, preference-based measure (PBM) of health, derived from the Functional Assessment of Cancer Therapy – General (FACT-G) questionnaire. The FACT-8D’s measurement properties have not been tested to date. We assessed it’s validity and responsiveness in relapsed/refractory mantle cell lymphoma (RR MCL) and compared the results to the EQ-5D-5L.

Methods
Blinded analysis of pooled data from a phase 3 clinical trial. FACT-8D baseline and follow-up data (weeks 4, 7, 16, 31) were scored using Australian preference weights, the first available value-set. Convergent validity was assessed by estimating baseline correlations with the FACT-Lym total score, Trial Outcome Index (TOI), FACT-Lym lymphoma-specific sub-scale (LymS), EQ-5D Visual Analog Scale (VAS), and haemoglobin (HgB). Relevant clinical variables were used to categorise patients to test known groups’ validity and responsiveness was investigated using data from baseline (n = 250) and week 31 (n = 130). Results were compared with EQ-5D-5L, scored using the UK 3L crosswalk and the 5L England value-sets.

Results
The FACT-8D showed good convergent validity and responsiveness; baseline Pearson correlation coefficients between FACT-8D Index scores and other PRO measures were moderate to very strong (range: 0.49 for the EQ-VAS to 0.79 for FACT TOI) and the size of the change in FACT-8D Index scores at week 31 differed significantly (p < 0.005) between patients categorised as improved, worsened or stable using the FACT-Lym total score, LymS, and HgB. However, when assessing known groups’ validity, FACT-8D failed to discriminate between patients categorised by health status on four of the seven variables analysed. Overall, FACT-8D and EQ-5D-5L performed similarly, although EQ-5D-5L showed better known groups’ validity.

Conclusions
This is the first investigation into the psychometric properties of the FACT-8D. In this RR MCL trial dataset, it showed good convergent validity and responsiveness, but poorer known groups’ validity, and EQ-5D performed as well or better on the tests conducted. The FACT-8D may offer an alternative method to generate utilities for the cost-effectiveness analysis of cancer treatments but needs further testing in other types of cancer patients. Evaluation of utility gains may have been limited by high baseline performance status in this RR MCL trial sample.
Assessing Patients’ Perceptions of Cancer Care Coordination in a Community-Based Setting
Authors: Okado Izumi , Cassel Kevin , Pagano Ian , Holcombe Randall F. 
Published: March 2020

PURPOSE: Effective care coordination (CC) is a hallmark of a high-quality cancer care. However, efforts to improve cancer care delivery are limited by the lack of a clinically useful tool to assess CC. In this study, we examined patients’ perceptions of cancer CC using a novel tool, the Care Coordination Instrument (CCI), and evaluated the quality of the CCI. METHODS: The CCI is a 29-item patient questionnaire that assesses CC across varied practice settings and patient populations overall and for three critical domains of CC: communication, navigation, and operational. We conducted univariable and multivariable regression analyses to identify patient clinical and practice characteristics associated with optimal versus suboptimal CC. RESULTS: Two hundred patients with cancer completed the CCI questionnaire between October 2018 and January 2019, of whom 189 were used for the analysis. The presence of a family caregiver and a diagnosis of a blood cancer were correlated with overall positive reports of CC ( P < .001 and P < .05, respectively). Poorer perceptions of CC were associated with having a head and neck cancer and the absence of family caregiver support. The effects of cancer disease stage and having access to a patient navigator on CC were not statistically significant. CONCLUSION: Integrating a patient-centered tool to assess cancer CC can be a strategy to optimize cancer care delivery. Understanding factors associated with effective and ineffective CC can help inform efforts to improve overall quality of care and care delivery.
Randomized 52-week Phase 2 Trial of Albiglutide Versus Placebo in Adult Patients With Newly Diagnosed Type 1 Diabetes
Authors: Pozzilli Paolo , Bosi Emanuele , Cirkel Deborah , Harris Julia , Leech Nicola , Tinahones Francisco J , Vantyghem Marie-Christine , Vlasakakis Georgios , Ziegler Anette-Gabriele , Janmohamed Salim 
Published: March 2020

Abstract

Context
GLP-1 receptor agonists are an established therapy in patients with type 2 diabetes; however, their role in type 1 diabetes remains to be determined.

Objective
Determine efficacy and safety of once-weekly albiglutide 30 mg (up-titration to 50 mg at week 6) versus placebo together with insulin in patients with new-onset type 1 diabetes and residual insulin production.

Design
52-week, randomized, phase 2 study (NCT02284009).

Methods
A prespecified Bayesian approach, incorporating placebo data from a prior study, allowed for 3:1 (albiglutide:placebo) randomization. The primary endpoint was 52-week change from baseline in mixed meal tolerance test (MMTT) stimulated 2-h plasma C-peptide area under the curve (AUC). Secondary endpoints included metabolic measures and pharmacokinetics of albiglutide.

Results
12/17 (70.6%, placebo) and 40/50 (80.0%, albiglutide) patients completed the study. Within our study, mean (standard deviation) change from baseline to week 52 in MMTT-stimulated 2-h plasma C-peptide AUC was −0.16 nmol/L (0.366) with placebo and −0.13 nmol/L (0.244) with albiglutide. For the primary Bayesian analysis (including prior study data) the posterior treatment difference (95% credible interval) was estimated at 0.12 nmol/L (0–0.24); the probability of a difference ≥0.2 nmol/L between treatments was low (0.097). A transient significant difference in maximum C-peptide was seen at week 28. Otherwise, no significant secondary endpoint differences were noted. On-therapy adverse events were reported in 82.0% (albiglutide) and 76.5% (placebo) of patients.

Conclusion
In newly diagnosed patients with type 1 diabetes, albiglutide 30 to 50 mg weekly for 1 year had no appreciable effect on preserving residual β-cell function versus placebo.
Detecting Recurrence Following Lobectomy for Thyroid Cancer: Role of Thyroglobulin and Thyroglobulin Antibodies
Authors: Ritter Amit , Mizrachi Aviram , Bachar Gideon , Vainer Igor , Shimon Ilan , Hirsch Dania , Diker-Cohen Talia , Duskin-Bitan Hadar , Robenshtok Eyal 
Published: March 2020

Abstract

Background
The use of thyroglobulin (Tg) and thyroglobulin antibodies (TgAb) for detecting disease recurrence is well validated following total thyroidectomy and radioiodine ablation. However, limited data are available for patients treated with thyroid lobectomy.

Methods
Patients who had lobectomy for papillary thyroid cancer followed for &gt;1 year, with sufficient data on Tg and TgAb, including subgroup analysis for Hashimoto’s thyroiditis and contralateral nodules.

Results
One-hundred sixty-seven patients met the inclusion criteria. Average tumor size was 9.5 ± 6 mm. Following lobectomy, Tg was 12.1 ± 14.8 ng/mL. Of 52 patients with Hashimoto’s thyroiditis, 38% had positive TgAb with titers of 438 ± 528 IU/mL, and in patients without TgAb the mean Tg level was 14.7 ± 19.0 ng/mL. In 34 patients with contralateral nodules ≥1 cm, Tg was 15.3 ± 17 ng/mL. During the first 2 years of follow-up, Tg declined ≥1 ng/mL in 42% of patients (by 5.1 ± 3.7 ng/mL), remained stable in 22%, and increased in 36% (by 4.9 ± 5.7 ng/mL). During a mean follow-up of 6.5 years (78 ± 43.5 months), 18 patients had completion thyroidectomy and 12 were diagnosed with contralateral cancer (n = 8) or lymph node metastases (n = 4). In patients with recurrence followed for &gt;2 years, there was a rise in Tg in 3 cases, Tg was stable in 2 cases, and in 1 TgAb decreased from 1534 to 276 IU/mL despite metastatic lymph nodes. Basal Tg and Tg dynamics did not predict disease recurrence.

Conclusions
Serum thyroglobulin used independently is of limited value for predicting or detecting disease recurrence following thyroid lobectomy. Other potential roles of Tg, such as detecting distant metastases following lobectomy, should be further studied.
La production de linge à Paris à l'ère des nouveautés (1520–1620)
Authors: Castres Astrid 
Published: March 2020

Arécis
Au cours du seizième siècle, le linge blanc, gage de propreté et signe de distinction sociale, prit une place grandissante dans l'habit. Au gré des modes de la cour et de la venue d'artisans étrangers qualifiés, ou passés par les Flandres et l'Italie, des nouveautés techniques et formelles (point coupé, dentelles, fraises et porte-fraises, etc.) furent peu à peu introduites dans la capitale du royaume de France. En partant du cas parisien, cet article examine les mutations que connut la production de linge entre 1520 et 1620, à la suite de l'apparition de ces procédés nouveaux. Pour la plupart mis en œuvre et transmis par des femmes, ils conduisent à réfléchir aux particularités d'exercice de savoir-faire féminins ainsi qu'au rôle joué par les lingères et par les ouvrières en linge dans le processus d'innovation textile au début de l'époque moderne.
A sign of cleanliness and of social distinction, white linen played an increasingly important role in dress throughout the sixteenth century. Novelties and new technologies (cutwork, lace, and the construction of ruffs, supportasse, etc.) appeared in French workshops in order to follow courtly fashion trends, and because of the arrival of foreign workers trained in Flanders and in Italy. Focusing on the Parisian case, this article examines the influence of these new processes on linen production between 1520 and 1620. The analysis of these techniques, which were implemented and transmitted mostly by women, leads to a broader reflection on the features of feminine know-how and the role played by women workers in early modern textile innovation.