bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic disease self‐management programs for Aboriginal and Torres Strait Islander people: Factors influencing participation in an urban setting
Authors: Parmenter Joni , Basit Tabinda , Nelson Alison , Crawford Emma , Kitter Bryony 
Published: May 2019

AbstractIssue addressedEvidence suggests that participation in a Chronic Disease Self‐Management (CDSM) program improves the health of clients. Many factors are known to influence participation in these programs for the broader Australian population. However, less is known about why Aboriginal and Torres Strait Islanders choose to participate. This study identifies key factors that support or enable Aboriginal and Torres Strait Islanders to participate in a CDSM program in an urban setting.MethodsTwelve focus groups were undertaken with a total of 102 participants who were diagnosed with or at risk of chronic disease. These participants were recruited from the Work It Out program, a CDSM program comprising exercise and health education. The Work It Out program is specifically designed for Aboriginal and Torres Strait Islanders and delivered by an Aboriginal led and community‐controlled organisation in South‐East and Central Queensland. The study received ethical clearance through the Behavioural and Social Sciences Ethical Review Committee at The University of Queensland (Approval Number 2011001283).ResultsFindings indicate that key features of program design based on a culturally responsive approach influences participation. The main features are as follows: providing easy access to the program; permitting flexibility in attendance; a group environment; the approach of program staff that prioritises relationship building; personalised and integrated care; communicating result regularly; and ensuring community ownership of the program.ConclusionThese findings are useful to consider when designing a health program for Aboriginal and Torres Strait Islanders. Programs which are culturally responsive and include the design features identified in this study are more likely to increase participation amongst Aboriginal and Torres Strait Islanders.So What?Increasing participation of Aboriginal and Torres Strait Islanders in CDSM programs using the design features identified in the paper may contribute significantly in closing the health disparity gap.
Inhibitory effects of indirubin‐3′‐monoxime against human osteosarcoma
Authors: Zhang Yi , Song Lu , Li Jiazhen , Zhang Yan , Lu Xinchang , Zhang Bin 
Published: May 2019

AbstractIndirubin is widely used as the active component of “Dangui Luhui Wan” in ancient China. However, its effects against the osteosarcoma (OS), the most common primary malignancy, are still unknown. In our present study, we investigated the effects of the Indirubin‐3′‐monoxime (I3M), a derivative of indirubin with better water solubility, against the OS cells. We found I3M inhibited OS cell proliferation in a dose‐dependent manner. Flow cytometry assays showed that I3M could not only induce OS cell apoptosis in a time‐ and dose‐dependent manner but also regulate the cell cycle distribution. Additionally, we demonstrated that several Bcl‐2 family members, cyclin‐dependent kinases (CDKs) and cyclins contributed to this process. Furthermore, out data verified that I3M suppressed OS cell migration and invasion by decreasing MMP‐2 and MMP‐9 levels. Moreover, survivin and focal adhesion kinase (FAK) might play important roles in the anti‐OS effects of I3M. The administration of I3M also inhibited the OS cell growth in mice. Taken together, our results indicated the inhibitory effects of I3M against human OS and thus might be an efficient candidate for OS chemotherapy.
Physical examination training for pharmacy residents in adult patient care programs: A survey of program directors
Authors: Watson Kristin , Leon Nicholas , Reed Brent N. , Levit Matthew B. , Devabhakthuni Sandeep 
Published: May 2019

AbstractPurposeTo determine the type and frequency of formalized (structured education developed to meet a set of predefined goals and provide educational content and learning materials) and nonformalized physical examination (PE) training offered to pharmacy residents in adult patient care‐focused residency programs in the United States and Puerto Rico.MethodsA survey was distributed to a random sample of 1000 postgraduate year one and two adult patient care residency program directors. Participants were queried to determine if they offered PE training and the types of training offered. Barriers to and reasons for not providing PE training were assessed. Descriptive statistics were performed.ResultsThere were 122 respondents. Thirteen (10.7%) programs provide formalized PE training and six of these were postgraduate year 1 residencies (46.2%). Informal PE training resources were provided in 97/117 (82.9%) programs. The duration and scope of training programs varied. Forty‐four of 116 (37.9%) responding programs required components of the PE in one or more rotations. The most commonly cited reasons for those who have not considered a formalized training program (n = 94) were that performing a PE is not part of the residency program (56.4%), lack of perceived value (45.7%), that PE is not part of the practice of the organization (43.6%), lack of trained clinicians (35.1%), lack of awareness that this type of training is available (35.1%), and lack of time in the schedule (31.9%) (respondents were able to select more than one).ConclusionMany pharmacy organizations endorse PE, yet formalized PE training does not appear to be routinely offered in adult patient care‐focused residency programs. Reasons for not offering a formalized training program suggest that raising awareness of the benefits of pharmacists learning PE is warranted. As pharmacists seek provider status, the need to increase PE training in pharmacy residency programs may be necessary.
Ex vivo quantitative analysis of human corneal stroma dehydration by near‐infrared absorption spectroscopy
Authors: Qi Pengfei , Sun Lu , Ma Jiaonan , Yao Jiali , Lin Lie , Zhang Lin , Wang Yan , Liu Weiwei 
Published: May 2019

AbstractCorneal water content and hydrodynamics are critical indicators of eye health. In this work, a convenient method based on near‐infrared absorption spectroscopy (NIRA) was presented to measure the relative water content of the corneal stroma ex vivo, which paves the way to measure corneal water content in vivo. The relative water content of fresh corneal stroma during dehydration under natural conditions (temperature, 25.8 ± 0.3°C; humidity, 7.2% ± 0.9%) was monitored in real time, and the characteristic time τ when the relative water content dropped to 90% of the fresh corneal stroma was 140.1 ± 30.6 s. Furthermore, the change in the relative water content over time was found to be linear with a dehydration rate of 0.071% per second, consistent with indirect optical coherence pachymetry but with superior reproducibility and precision. Provided that the NIRA spectrometer is changed to a reflection structure from the current transmission configuration, the NIRA method proposed in this work has great potential for in vivo measurement with the advantages of non‐contact, high precision and low cost.
Evaluation of Weight Thresholds for Pediatric Patients to Use Adult Dosage of Therapeutic Monoclonal Antibodies
Authors: Yang Nicholas , Xu Melissa C. , Yao Zhenling 
Published: May 2019

AbstractWith increasing interest in enrolling adolescent patients in adult trials, a question often arises: when can pediatric patients use adult dosages? For currently approved therapeutic monoclonal antibodies (mAbs) with equivalent adult and pediatric indications, body weight thresholds for pediatric patients to receive adult doses vary from 30 to 75 kg. Our objective is to determine if a consistent weight threshold can be recommended for therapeutic mAbs with wide therapeutic windows. Simulations were run to predict exposure using a population pharmacokinetic model describing the typical PK characteristics of a mAb with linear elimination. Simulated steady‐state areas under the concentration‐time curves (AUCss) were compared between pediatric and adult populations. Exponent values of 0.50, 0.75, and 1.0 for the allometric relationship of weight on clearance were also evaluated. Following administration of the same fixed adult dosage in pediatric subjects above a given threshold, median AUCss in the pediatric subjects increased with decreasing weight thresholds. Pediatrics with a minimum weight of 40 kg had median AUCss within 20% to 30% above adult median AUCss when the reference adult population had a median weight ≤80 kg. Higher relative pediatric exposures were seen in lower‐weight pediatric subjects when the weight exponent on clearance was >0.75. Simulations suggested that a weight threshold of 40 kg could generally be considered for pediatric subjects to receive the adult dosage for therapeutic mAbs with linear pharmacokinetics. Weight threshold selection should be based on considerations of therapeutic index of the drug product, weight distribution of the reference adult population, and magnitude of weight effect on pharmacokinetic parameters.
Midazolam Limited Sampling Strategy With a Population Pharmacokinetic Approach to Simultaneously Estimate Cytochrome P450 (CYP) 3A Constitutive, Inhibition, and Induction/Activation Conditions in Healthy Adults
Authors: Yang Jincheng , Nikanjam Mina , Capparelli Edmund V. , Tsunoda Shirley M. , Greenberg Howard E. , Penzak Scott R. , Stoch S. Aubrey , Bertino Joseph S. , Nafziger Anne N. , Ma Joseph D. 
Published: May 2019

AbstractWe have previously described a midazolam limited sampling strategy employing a population pharmacokinetic (PK) approach to estimate constitutive cytochrome P450 (CYP) 3A activity. This study evaluated expansion of this approach to estimate CYP3A constitutive, inhibitory, and induction activities. Midazolam concentrations (n = 4441) from adults (n = 152) were obtained from previous studies after single, oral, or intravenous administration with intensive sample collection. Data were fit to a 2‐compartment population PK model that incorporated CYP3A conditions as covariates for clearance (CL), volume of distribution, and bioavailability (F). Limited sampling models using single– or 2–time point concentrations were compared with full PK profiles using the empiric Bayesian post hoc estimations of midazolam area under the plasma concentration–time curve derived from the population PK model. Ketoconazole, rifampin, and pleconaril were significant covariates of CL, while ketoconazole, rifampin, and grapefruit juice were significant covariates for F. Typical midazolam CL and F estimates were 32.9 L/h and 0.31 for the constituent state, while the ratio of inducer/inhibitor for midazolam CL and CL/F for the induced/inhibited (rifampin/ketoconazole) states were 14.2 and 85.3. Upon comparison to the population PK model, the majority of evaluated single– and 2–time point limited sampling models estimated area under the plasma concentration–time curve had unacceptable r2 and/or unacceptable bias and precision. Exclusively during CYP3A inhibitory conditions, the 4‐ and 6‐hour limited sampling model had acceptable limits of r2, bias, and precision. Consequently, development of a single– or 2–time point midazolam limited sampling model for general, widespread use to simultaneously evaluate various CYP3A conditions remains elusive.
Patient perspectives on the process and outcomes of psychiatric genetic counseling: An “Empowering Encounter”
Authors: Semaka Alicia , Austin Jehannine 
Published: May 2019

AbstractGenetic counseling (GC) for individuals with mental illness (MI) has been shown to improve patient outcomes, such as increased empowerment and self‐efficacy. However, we do not understand how the process of GC results in these improvements or what aspects of the process are critical. In this qualitative study, we explored the process and outcome of psychiatric GC from the patient's perspective. Ten Canadian adults with a diagnosed MI were interviewed prior to, and 1 month following, psychiatric GC. Interview transcripts were analyzed using Grounded Theory methodology and generated a theoretical framework that describes the process and outcomes of psychiatric GC from the patient's perspective. Participants described the counseling process to be an “empowering encounter” and identified specific attributes of the process and characteristics of the counselor that contributed to their empowerment. Participants gained a new perspective on the cause and management of their MI, which seemed to facilitate a deeper acceptance of their condition. Consequently, participants reported being empowered and feeling less shame, blame, and guilt; which reportedly made them more able to manage their MI and protect their mental health; and more open to talking about their condition with family and friends. This study provides a better understanding of how the process of GC influences patient outcomes and highlights features of the process that maximize patient benefit.
Anterior cervical pain syndrome: Risk factors, variations in hyolaryngeal anatomy, and treatments
Authors: Dewan Karuna , Yang Christine , Penta Mrudula 
Published: May 2019

ObjectiveAnterior cervical pain syndromes (ACPS) are a poorly understood entity associated with lateral neck discomfort when talking, chewing, or yawning, and with occasional excruciating pain and dysphagia. This investigation aims to describe patients with ACPS presenting symptoms and treatments.Study DesignRetrospective chart review of all patients with ACPS presenting to a tertiary care laryngology practice in 1 year.MethodsAll patients diagnosed with ACPS for 1 year were reviewed. Patient gender, age, body mass index (BMI), and pain triggers were documented. The hyolaryngeal complex was measured on computed tomography (CT) scans of the neck. Treatments were recorded.ResultsNine patients were diagnosed with an ACPS in a 1‐year period. Sixty‐seven percent were female with an average age of 47.3 years ± 16.6. The average BMI of a patient with ACPS was 24.8 ± 3.69. The most common symptom was point tenderness at the lateral aspect of the hyoid or superior cornu of the thyroid cartilage (89%). Pain triggers included speaking (67%), head turn (56%), chewing (44%), yawning (56%), and swallowing (56%). On CT imaging, eight of nine patients had abnormalities of the hyoid bone or the superior cornu of the thyroid cartilage, correlating 100% with point tenderness location. Treatments include physical therapy (33%), steroid injection (44%), lidocaine injection (22%), and surgical intervention (56%).ConclusionACPS is a frustrating condition for patients and physicians. Evaluation of anterior cervical pain with point tenderness should include imaging measurement of the thyrohyoid complex. Effective treatments include local steroid injection and surgical resection of the abnormal structure.Level of Evidence4Laryngoscope, 130:702–705, 2020
Tooth defects of EEC and AEC syndrome caused by heterozygous TP63 mutations in three Chinese families and genotype‐phenotype correlation analyses of TP63‐related disorders
Authors: Zheng Jinglei , Liu Haochen , Zhan Yuan , Liu Yang , Wong Sing‐Wai , Cai Tao , Feng Hailan , Han Dong 
Published: May 2019

AbstractBackgroundEctrodactyly‐Ectodermal dysplasia‐Cleft lip/palate (EEC) syndrome and Ankyloblepharon‐Ectodermal defects‐Cleft lip/palate (AEC) syndrome belong to p63 syndromes, a group of rare disorders exhibiting a wide variety of clinical manifestations. TP63 mutations have been reported to be associated with both EEC and AEC.MethodsAnalysis of whole exome sequencing (WES) from patients with EEC or AEC syndrome and Sanger sequencing from family members.ResultsWe confirmed that three Chinese pedigrees affected with EEC or AEC harboring a distinct TP63 mutation, and described novel clinical phenotypes of EEC and AEC, including the presence of cubitus valgus deformity and taurodontism, which were discordant to their classical disease features. We also analyzed the genotype–phenotype correlation based on our findings.ConclusionWe reported that the cubitus valgus deformity in patients with EEC and severe taurodontism in a patient with AEC had not been mentioned previously. Our study expands the phenotypic spectrum of EEC and AEC syndrome.
Deformable phantoms of the prostatic urinary tract for urodynamic investigations
Authors: Ishii Takuro , Ho Chung Kit , Nahas Hassan , Yiu Billy Y. S. , Chee Adrian J. Y. , Yu Alfred C. H. 
Published: May 2019

PurposeAssessment of urethral dynamics is clinically regarded to be important in analyzing the functional impact of pathological features like urethral obstruction, albeit it is difficult to perform directly in vivo. To facilitate such an assessment, urethra phantoms may serve well as investigative tools by reconstructing urethral dynamics based on anthropomorphic factors. Here, our aim is to design a new class of anatomically realistic, deformable urethra phantoms that can simulate the geometric, mechanical, and hydrodynamic characteristics of the male prostatic urethra.MethodsA new lost‐core tube casting protocol was devised. It first involved the drafting of urethra geometry in computer‐aided design software. Next, 3D printing was used to fabricate the urethra geometry and an outer mold. These parts were then used to cast a urinary tract using a polyvinyl alcohol (PVA)‐based material (with 26.6 ± 4.0 kPa Young's elastic modulus). After forming a surrounding tissue‐mimicking slab using an agar–gelatin mixture (with 17.4 ± 3.4 kPa Young's modulus), the completed urethra phantom was connected to a flow circuit that simulates voiding. To assess the fabricated phantoms' morphology, ultrasound imaging was performed over different planes. Also, color Doppler imaging was performed to visualize the flow profile within the urinary tract.ResultsDeformable phantoms were devised for the normal urethra and a diseased urethra with obstruction due to benign prostatic hyperplasia (BPH). During voiding, the short‐axis lumen diameter at the verumontanum of the BPH‐featured phantom (0.91 ± 0.08 mm) was significantly smaller than that for the normal phantom (2.49 ± 0.20 mm). Also, the maximum flow velocity of the BPH‐featured phantom (59.3 ± 5.8 cm/s; without Doppler angle correction) was found to be higher than that of the normal phantom (22.7 ± 9.0 cm/s).ConclusionThe fabricated phantoms were effective in simulating urethra deformation resulting from urine passage during voiding. They can be used for mechanistic studies of urethral dynamics and for the testing of urodynamic diagnostic techniques in urology.
Advanced Optics for the Evaluation of Near‐To‐Eye Displays
Authors: Schuster Norbert , Krüger Udo , Porsch Tobias 
Published: May 2019

AbstractMore and more, the suppliers of near‐to‐eye displays (NED) are seeking cost‐effective imaging luminance and color measurement solutions that are adaptable to their instrument structures. Here, the authors offer a set of formulas that determine the basic parameters of imaging luminance and radiance measurement devices and lenses for different NED‐concepts.
Refractory myasthenia gravis: Characteristics of a portuguese cohort
Authors: Santos Ernestina , Bettencourt Andreia , Duarte Sara , Gabriel Denis , Oliveira Vanessa , da Silva Ana Martins , Costa Paulo Pinho , Lopes Carlos , Gonçalves Guilherme , da Silva Berta Martins , Leite Maria Isabel 
Published: May 2019

ABSTRACTIntroduction: Some myasthenia gravis (MG) patients are refractory to conventional treatments. Methods: To describe the clinical features of refractory MG (RMG) and explore the association with human leukocyte antigen HLA‐DRB1 alleles, a cohort study of 114 consecutive MG patients was performed. Patients were classified as RMG based on predefined criteria. Results: Twenty‐two patients were found to have RMG (19.3%). There were no differences between non‐RMG and RMG patients with respect to sex, age of onset, abnormal 3‐Hz repetitive nerve stimulation, anti‐acetylcholine receptor antibody positivity, thymectomy, thymoma or thymic hyperplasia, and polyautoimmunity. HLA‐DRB1*03 was more frequent in the non‐RMG vs. control population (P = 3 × 10−6). The HLA‐DRB1*13 allele was less frequent in non‐RMG patients compared with controls (P = 0.002), and less frequent in the non‐RMG group compared with the RMG group (P = 0.003). Discussion: HLA‐DRB1*03 was more common in non‐RMG, and the HLA‐DRB1*13 allele appeared to have a protective role, as reported previously in other autoimmune disorders. Muscle Nerve 60: 188–191, 2019
Optimal trajectory generation and robust flatness–based tracking control of quadrotors
Authors: Abadi Amine , El Amraoui Adnen , Mekki Hassen , Ramdani Nacim 
Published: May 2019

SummaryThis work proposes an optimal trajectory generation and a robust flatness–based tracking controller design to create a new performance guidance module for the quadrotor in dense indoor environments. The properties of the differential flatness, the B‐spline, and the direct collocation method are exploited to convert the constrained optimization problem into a nonlinear programming one, which can be easily resolved by a classic solver. After that, the obtained optimal reference trajectory is applied to the dynamic quadrotor model and two different flatness‐based controllers, namely, one based on feedback linearization and one based on feedforward linearization, are developed and compared to ensure the trajectory tracking despite the existence of disturbances and parametric uncertainties. Numerical simulation is executed to evaluate the proposed optimal trajectory generation approach and the robust tracking strategies. It turns out that the controller based on feedforward linearization outperforms the feedback linearization one in robustness and permits obtaining a performance guidance law for an uncertain quadrotor system.
Efficacy of proton therapy in children with high‐risk and locally recurrent neuroblastoma
Authors: Bagley Alexander F. , Grosshans David R. , Philip Nancy V. , Foster Jennifer , McAleer Mary Frances , McGovern Susan L. , Lassen‐Ramshad Yasmin , Mahajan Anita , Paulino Arnold C. 
Published: May 2019

AbstractPurposeProton therapy is currently used in the management of pediatric tumors to decrease late toxicities. However, one of the criticisms of proton therapy is the limited data regarding efficacy on disease control. The purpose of this study was to examine local and distant control rates after proton therapy for neuroblastoma.Methods and materialsEighteen patients with high‐risk (n = 16) and locally recurrent neuroblastoma (n = 2) were treated with curative intent and received proton therapy to the primary site and up to three post‐induction MIBG‐avid metastatic sites. Primary sites (n = 18) were treated to 21–36 Gy (relative biological effectiveness [RBE]), and metastatic sites (n = 16) were treated to 21–24 Gy (RBE). Local control and survival rates were calculated using the Kaplan–Meier method.ResultsWith a median follow‐up of 60.2 months, two‐ and five‐year local control rates at the irradiated primary site were 94% and 87%, respectively. No failures at irradiated distant metastatic sites were observed. The five‐year progression‐free survival (PFS) was 64%, and the five‐year overall survival (OS) was 94%. The extent of surgical resection was not associated with local control, PFS, or OS. No radiation‐related nephropathy or hepatopathy was reported.ConclusionsExcellent local control was achieved using proton therapy to the primary and post‐induction MIBG‐positive distant sites. The predominant site of failure is progression in post‐induction non‐MIBG‐avid distant sites. Although proton therapy provides high rates of local control with acceptable toxicity for neuroblastoma, further advances in systemic therapy are needed for the improved control of systemic disease.