bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of neighbourhood socioeconomic status on overweight and obesity in children 2–15 years of different ethnic groups
Authors: de Wilde J A , Eilander M , Middelkoop B J C 
Published: December 2018

AbstractBackgroundStudies on the influence of neighbourhood socioeconomic status (N-SES) on overweight and obesity rates in children from different ethnic backgrounds are scarce. This study investigated the differential effect of N-SES on overweight (including obesity) and obesity prevalence in different ethnic groups, and if N-SES explains ethnic differences in the prevalence of overweight and obesity.DesignA population based study of 109 766 body mass index (BMI) measurements of 86 209 children 2–15 years of Dutch, Turkish, Moroccan and South Asian descent. BMI class was determined with The International Obesity Task Force, and South Asian specific BMI cut-offs. WHO BMI criteria were applied for reference purposes. The effect of N-SES on prevalence rates was studied with generalized linear mixed models.ResultsNeighbourhood SES was negatively associated with overweight and obesity. However, the effect of N-SES on overweight was stronger in Dutch children (OR 0.75, 95% CI 0.73–0.77) than in Turkish (OR 0.86, 95% CI 0.82–0.90), Moroccan (OR 0.91, 95% CI 0.86–0.97) and South Asian (OR 0.90, 95% CI 0.84–0.96) children. The influence of N-SES on obesity showed a similar pattern, except for Moroccan children in whom obesity prevalence remained stable over the whole N-SES range. At the same N-SES, overweight and obesity prevalence was significantly higher in Turkish, Moroccan and especially South Asian children compared with Dutch children. Adjusting for N-SES attenuated the ethnic differences.ConclusionsNeighbourhood SES was negatively associated with overweight and obesity rates in all ethnic groups, but only partly explained the ethnic differences in overweight and obesity prevalence.
Across borders: thoughts and considerations about cultural preservation among immigrant clinicians
Authors: Ashing Kimlin Tam , Dawkins-Moultin Lenna , George Marshalee , Antoine Gerard M , Nunez-Smith Marcella , Pérez-Stable Eliseo J 
Published: December 2018

Abstract
Immigrant clinicians make up 20–28% of the health workforce in many high-income countries, including Australia, Britain, Canada and the USA. Yet, the preserved culture of immigrant clinicians remains largely invisible in the medical literature and discourse. Research on immigrant clinicians primarily attends to medical professional requirements for the adopted country (medical board examination eligibility, fellowship training and licensing). Cultural preservation among immigrant clinicians has not been adequately considered or studied.
This paper highlights this notable gap in healthcare delivery and health services research relevant to immigrant clinicians. We propose it is worthwhile to explore possible relationships between immigrant clinicians’ preserved culture and clinical practices and outcomes since immigrant clinicians cross borders with their academic training as well as their culture. The sparse literature regarding immigrant clinicians suggests culture influences health beliefs, attitudes about the meaning of illness and clinical practice decisions. Additionally, immigrant clinicians are more likely to serve rural, low-income populations; communities with high density of ethnic minorities and immigrants; and areas with primary care shortage. Therefore, cultural preservation among immigrant clinicians may have important implications for public health and health disparities. This area of inquiry is important, if not urgent, in health services research.
The Smithsonian at war
Authors: Redman Samuel 
Published: December 2018

Abstract
This article describes the Smithsonian Institution’s involvement in World War ii. For a brief (but active) period the Smithsonian assisted the Army, Navy, and other war agencies. Museum staff eagerly shared ideas and information they had spent generations gathering; they were also willing to embrace the war effort as an opportunity to expand collections. While many museum contributions to the war effort were not made public, a book series on natural history and culture published by museum experts came to be known as the War Background Studies. Examining the Smithsonian’s response to ‘total war’, this article argues that the transformations experienced by the museum were largely temporary, with uneven levels of impact; it also explores how numerous significant intellectuals debated the museum’s future role in post-war society.
Robust Forecast Evaluation of Expected Shortfall*
Authors: Ziegel Johanna F , Krüger Fabian , Jordan Alexander , Fasciati Fernando 
Published: December 2018

AbstractMotivated by the Basel III regulations, recent studies have considered joint forecasts of Value-at-Risk and Expected Shortfall. A large family of scoring functions can be used to evaluate forecast performance in this context. However, little intuitive or empirical guidance is currently available, which renders the choice of scoring function awkward in practice. We therefore develop graphical checks of whether one forecast method dominates another under a relevant class of scoring functions, and propose an associated hypothesis test. We illustrate these tools with simulation examples and an empirical analysis of S&P 500 and DAX returns.
Support for Private Members’ Bills in the United Kingdom and Japan
Authors: Moriue Shota 
Published: December 2018

Abstract
It is a common arrangement in different legislatures that individual members who are not ministers can bring forward bills (private members’ bills), but the drafting of a bill may involve certain technicalities that are usually outside their knowledge. How, then, do legislators prepare the text of private members’ bills? This article presents the way in which support is provided to those members who seek to introduce their bills in the UK Parliament, the Scottish Parliament, the National Assembly for Wales, the Northern Ireland Assembly, and the National Diet of Japan. It then discusses two common challenges for such support: how to avoid the risk that demand will outstrip supply and how to make sure that the drafting of private members’ bills meets the quality standards (if any).
The Pattern of Tpeak-Tend Interval and QTdis, and Pdis in Children with Brucellosis
Authors: Çetin Mecnun , Turfan Nevzat , Karaman Kamuran , Yaşar Akkız Şahin , Güven Burcu , Tunçdemir Perihan 
Published: December 2018

AbstractObjectiveTo investigate the effect of inflammation on the conducting system of the heart in patients diagnosed with brucellosis.MethodsA total of 42 patients diagnosed with brucellosis and 39 age and sex-matched healthy children were enrolled into the study. Pre- and post-treatment electrocardiographic parameters in brucellosis and control group were recorded from an electrocardiogram for each patient.ResultsThe results indicated that the parameters including Pmax, Pdis, QTmax, QTdis, QTcdis, Tp-edis interval and Tp-emax/QTmax and Tp-emax/QTcmax ratios, which are known to be key indicators for the prediction of severe atrial or ventricular arrhythmia and sudden cardiac death and also important parameters used as the indicators for the non-invasive evaluation of the transmural heterogeneity were significantly longer in the study group compared with the control group (p < 0.05).ConclusionIn this study, it was determined that the brucella disease had more cardiac involvement than thought, and this was more in the subclinical form of cardiac involvement.
Gastric responses to acute psychological stress in climacteric women: a pilot study
Authors: Huerta-Franco María Raquel , Vargas-Luna Miguel , Somoza Ximena , Delgadillo-Holtfort Isabel , Balleza-Ordaz Marco , Kashina Svetlana 
Published: December 2018

Abstract

Objective:
Women exhibit reduced ovarian sex hormones during the menopausal period that result in well-known physical and psychological symptoms. However, symptoms related to gastric motility (GM) have not been thoroughly investigated. We hypothesized that stress response gastric motility (SRGM) is lower in postmenopausal (PM) and perimenopausal (PERIM) women than in premenopausal (PREM) women. Estrogenic decline leads to neuroendocrine changes in different areas of the brain. These changes can result in hypothalamic vasomotor symptoms, disorders in eating behaviours, and altered blood pressure, in addition to psychological disorders such as stress, anxiety, depression, and irritability related to alterations in the limbic system.

Methods:
In this pilot study, 55 PREM, PERIM, and PM women were clinically evaluated using the Nowack stress profile (SP) and State-Trait Anxiety Inventory (STAI). GM was assessed via electrical bioimpedance using two psychological stress tests (Stroop and Raven tests).

Results:
Basal SP and STAI-anxiety test scores were similar among the three groups of women (P > 0.05). PERIM women had lower GM in the basal state (P < 0.05) than did other women. PREM and PM women had significantly decreased GM during the stress tests (P < 0.05). However, PERIM did not exhibit GM changes during stress tests (P > 0.05).

Conclusion:
Changes in sex hormones during PERIM may affect GM and SRGM.
Knee osteoarthritis and menopausal hormone therapy in postmenopausal women: a nationwide cross-sectional study
Authors: Jung Jae Hyun , Bang Cho Hee , Song Gwan Gyu , Kim Cholhee , Kim Jae-Hoon , Choi Sung Jae 
Published: December 2018

Abstract

Objective:
The incidence of osteoarthritis (OA) increases after menopause, and may be related to hormonal changes in women. Estrogen deficiency is known to affect the development of OA, and menopausal hormone therapy (MHT) is suggested to be related to the development of OA. However, the relationship between knee OA and MHT remains controversial. The association between knee OA prevalence and MHT was investigated using large-scale national data.

Methods:
Data were collected from 4,766 postmenopausal women from the Korea National Health and Nutrition Examination Survey (2009-2012). MHT was defined as regular hormone medication for ≥1 year, and demographic and lifestyle variables were compared between the MHT and non-MHT groups. Knee OA was defined according to symptoms and radiographic findings.

Results:
In the multiple logistic regression models, the OA odds ratio was 0.70 for the MHT group (95% confidence interval 0.50-0.99), compared with the non-MHT group.

Conclusions:
The prevalence of knee OA was lower in participants with MHT than in those without MHT.
The 15th Annual Warren K. Sinclair Keynote Address—Jus•ti•fied and Com•men•su•rate
Authors: Rosenstein Marvin 
Published: December 2018

Abstract
When patients are exposed to ionizing radiation for medical diagnosis or treatment, the procedure being performed should be justified, and the amount of ionizing radiation used should be commensurate with the medical purpose. A legal limit on the amount of ionizing radiation used for medical exposure of a patient does not apply. The biological basis for radiation protection of patients is the same as for all other ionizing radiation exposures: prevent or avoid tissue reactions and reduce the probability of stochastic effects (primarily cancer) while maintaining the benefits to the individual and to society. Justifying the clinical procedure as (1) being appropriate for the clinical purpose and (2) being appropriate for an individual patient is in the purview of the clinical community and individual practitioners, respectively. Managing ionizing radiation levels to be commensurate with the medical purpose is becoming a more prominent feature for all types of imaging procedures (to manage the increased probability of cancer). An approach using advisory diagnostic reference levels is finding widespread use throughout the world. A diagnostic reference level is a method for evaluating whether the amount of radiation is unusually high or low for a particular imaging procedure.
Radiation Protection Responsibility in Brachytherapy
Authors: Thomadsen Bruce 
Published: December 2018

Abstract
Radiation protection in brachytherapy entails protecting members of the public, radiation professionals, and the patient from unnecessary radiation, as well as making sure that the radiation used in the patient’s treatment is placed correctly with the correct dose distribution. Protecting members of the public from radiation emanating from brachytherapy sources implanted in a patient was an issue several decades ago, but with modern brachytherapy, the problem has mostly disappeared. The most frequent treatments are either low-dose-rate permanent implants for prostate cancer, or high-dose-rate procedures for gynecological, breast, or skin cancers. Almost all current permanent implants use low-energy photon sources that are shielded by the patient. Similarly, some temporary implants, such as eye plaques that also use low-energy photon sources, incorporate a metallic shield into the applicator. All high-dose-rate brachytherapy takes place in a treatment vault, in a manner similar to external-beam radiotherapy, thus eliminating exposure to members of the public, in the absence of some terrible error or mistake. Modern brachytherapy techniques either eliminate or greatly reduce radiation exposures to the brachytherapy staff also. As noted above, high-dose-rate treatments take place in a heavily shielded vault, and staff remain outside the vault when the source is out of its shielded housing. For low-energy permanent implants, facilities often order the sources loaded into the implant needles by the vendor, reducing the time the procedure staff is exposed to the source. Often, the loaded needles can be shielded while awaiting implantation. Alternatively, individual sources may be placed using a special applicator that shields the staff. Radiation protection of the patient in many respects differs little from how it was decades ago except for greatly increased precision. Assaying the strength of a source of any kind is still essential. As important as verifying the source strength is ensuring that the source will be in the correct location for the desired time. Imaging serves as the main mechanism to guide the implantation and verify source or applicator position. Modern imaging has unveiled anatomy exquisitely and often permits definition of target disease and neighboring normal structures sufficiently to allow very conformal dose distributions. Despite these great advances and capabilities, errors and mistakes (together called failures) still occur. Failures in health care overall are the third leading cause of death in the United States. Most treatment failures result not from equipment problems but from procedures gone wrong. Attention to comprehensive commissioning of both equipment and procedures and risk-based development of quality management procedures helps protect the patient. Patient safety organizations, established by the Agency for Healthcare Research and Quality, work with client facilities to help identify weaknesses in both treatment procedures and quality management and to develop improvements to enhance protection.
Dose Optimization of Hybrid Imaging
Authors: Fahey Frederic H. 
Published: December 2018

Abstract
Hybrid imaging combines the functional and molecular imaging of positron emission computed tomography and single-photon emission computed tomography with the anatomical information available from computed tomography and magnetic resonance imaging. As a result, the clinical utility of positron emission computed tomography/computed tomography and single-photon emission computed tomography/computed tomography has been clearly established in the past 17 y. In addition, the use of positron emission computed tomography/magnetic resonance, which was introduced to the clinic in the past decade, has continued to grow. These multimodality approaches to medical imaging have substantial dosimetric aspects associated with their practice in both adults and children. For positron emission computed tomography/computed tomography and single-photon emission computed tomography/computed tomography, one must consider the radiation dose delivered from both the radiopharmaceutical and the computed tomography portion of the hybrid scan. Whether the computed tomography is to be used solely for attenuation correction, anatomical correlation of patient, or full diagnosis must be taken into account when deciding on the computed tomography acquisition parameters. Even after 17 y, the most appropriate approach to the acquisition of these modalities is not fully established. When appropriately used, positron emission computed tomography/magnetic resonance provides the opportunity for notable dose reduction. In addition to the elimination of the radiation dose from the computed tomography, one may consider the higher sensitivity of the positron emission computed tomography component relative to that used in positron emission computed tomography/computed tomography and the longer acquisition time to reduce the amount of administered activity of the radiopharmaceutical. However, one must realize that magnetic resonance presents a different set of safety concerns outside of those associated with ionizing radiation. As with all medical procedures, the benefits as well as the potential risks of the procedure need to be evaluated in the context of choosing the most appropriate procedure to be performed and the optimization of acquisition protocol to assure high-quality clinical information with the least potential for risk possible.
NCRP Vision for the Future and Program Area Committee Activities in 2018
Authors: Boice John D. 
Published: December 2018

Abstract
The National Council on Radiation Protection and Measurements’ (NCRP) congressional charter aligns with our vision for the future: to improve radiation protection for the public and workers. This vision is embodied within NCRP’s ongoing initiatives: preparedness for nuclear terrorism, increasing the number of radiation professionals critically needed for the nation, providing new guidance for comprehensive radiation protection in the United States, addressing the protection issues surrounding the ever-increasing use of ionizing radiation in medicine (the focus of this year’s annual meeting), assessing radiation doses to aircrew related to higher altitude and longer flights, providing guidance on emerging radiation issues such as the radioactive waste from hydraulic fracturing, focusing on difficult issues such as high-level waste management, and providing better estimates of radiation risks at low doses within the framework of the Million Person Study of Low-Dose Radiation Health Effects. Cutting-edge initiatives included a reevaluation of the science behind recommendations for lens of the eye dose, recommendations for emergency responders on dosimetry after a major radiological incident, guidance to the National Aeronautics and Space Administration with regard to possible central nervous system effects from galactic cosmic rays (the high-energy, high-mass ions bounding through space), reevaluating the population exposure to medical radiation, and addressing whether the linear no-threshold model is still the best available for purposes of radiation protection (not for risk assessment). To address these initiatives and goals, NCRP has seven program area committees on biology and epidemiology, operational concerns, emergency response and preparedness, medicine, environmental issues and waste management, dosimetry, and communications. The NCRP vision for the future will continue and increase under the leadership of President-Elect Dr. Kathryn D. Held (Massachusetts General Hospital and Harvard Medical School, and current NCRP executive director and chief science officer). The NCRP quest to improve radiation protection for the public is hindered only by limited resources, both human capital and financial.
Radiation Oncology—External-Beam Radiation Therapy
Authors: Martin Melissa C. 
Published: December 2018

Abstract
The application of structural shielding design techniques and goals as outlined in the National Council on Radiation Protection and Measurements Report 151, Structural Shielding Design and Evaluation for Megavoltage X- and Gamma-Ray Radiotherapy Facilities (2005), continues to be the basis for treatment vault design in 2018 with some updated information. Treatment techniques have changed significantly with the dominant usage of intensity-modulated radiation therapy techniques today based on concurrent imaging. Some of the developments in linear accelerator technology over the past 15 y include flattening filter-free modes, which enable higher instantaneous dose rates; three-dimensional conformal radiation therapy resulting in potentially higher workloads since healthy tissue is spared; improved intensity-modulated radiation therapy treatment delivery systems with lower monitor units per centigray delivered than traditional step and shoot intensity-modulated radiation therapy; stereotactic body radiation therapy with higher treatment fractions and increased workloads; and increased use of stereotactic radiosurgery with conventional linear accelerators as well as robotic arm-mounted linear accelerators with higher treatment fractions. These new treatment units also incorporate multiple-energy x-ray beams (2 to 5 MV typical), which require a significant change in the specification of a workload to be used in each vault. As the equipment in radiation oncology departments has evolved to state-of-the-art modalities, the requirements for adequate radiation shielding for these modalities has become more rigorous. Architectural designs no longer depend on standard maze design rectangular rooms. Innovative layouts and utilization of multiple layers of shielding materials allow much greater flexibility in room designs. Maze-less rooms with direct-shielded doors are part of these challenging designs and are very common today. Use of multiple-density concrete blocks allows quicker construction of vaults and requires less space for the equivalent shielding provided. Combinations of high-density or normal-density concrete, steel, and lead are used in designs to make optimum use of available space and cost. Additional shielding needed at the edges of these single- or bi-parting sliding doors as well as baffle designs for heating, ventilation, and air conditioning systems and communication cable penetrations require detailed calculations. Examples of these designs will be given in this presentation. Consideration of the radiation levels around the planned vault must also include adjacent multistory buildings.