bluuebunny/crossref_metadata_2025_split huggingface dataset:
Undergraduate dentistry students’ perception of difficulties regarding endodontic treatment
Authors: Tavares Lorrane G. , Lima Stella M. F. , Lima Miriane G. , Arruda Marcos P. , Menegazzi Thiago C. , Rezende Taia M. B. 
Published: August 2018

AbstractThe present study aimed to identify students’ perceptions of endodontic treatment at a Brazilian university through a survey, which analysed student profiles and their difficulties in 2016. One hundred and two students who had experienced endodontic, laboratory or clinical procedures answered a survey based on their experiences, regarding their perceptions, experience and self‐confidence levels. Results demonstrated that there was no significant difficulty among students regarding anaesthesia, rubber dam use, chamber access, working length determination, instrumentation, root filling and temporary restoration procedures during endodontic treatment. However, problems were observed regarding radiographic examination (mainly in separating root canals) and the choice of intracanal medication. The present study also raised a question regarding dental education: how can endodontic education be improved by addressing students' perceived difficulties? Evaluating the major student difficulties during root canal therapy can help the improvement of teaching strategies during preclinical and clinical teaching.
High prevalence of early onset anaemia amongst Aboriginal and Torres Strait Islander infants in remote northern Australia
Authors: Aquino Danielle , Leonard Dympna , Hadgraft Nyssa , Marley Julia V. 
Published: August 2018

AbstractObjectivesTo describe baseline growth and prevalence of anaemia in Aboriginal and Torres Strait Islander infants and young children enrolled in a nutrition promotion and anaemia prevention program in remote northern Australia.DesignRetrospective review of most recent growth parameters and haemoglobin records during the 3 months prior to and 1 month after recruitment into a prospective study conducted between 25 May 2010 and 6 May 2012.SettingPrimary health care clinics in six remote Aboriginal communities (east Kimberley, Western Australia (n = 1); Northern Territory (n = 4); Cape York, Queensland (n = 1)).ParticipantsTwo hundred and sixty‐two of the estimated 311 (84%) Aboriginal and Torres Strait Islander infants and young children aged 6–24 months residing in participating communities.Main outcome measuresPrevalence of anaemia, stunting, underweight and overweight at recruitment.ResultsAt recruitment, 42% of participants were anaemic, 18% stunted, 5% underweight and 5% overweight. Anaemia prevalence was higher than estimates (26–27%) in routine surveillance programs in remote communities and substantially higher than estimates (1.8–4.9%) in the general Australian population. One‐quarter of participants were anaemic prior to 6 months of age.ConclusionsThe unexpectedly high prevalence of anaemia and stunting in these communities highlight the need for continued preventive health programs focused on ensuring adequate nutrition amongst infants, young children and their mothers. The early onset of anaemia and stunting suggests a comprehensive anaemia prevention approach is needed, including greater emphasis on maternal and pre‐pregnancy health and nutrition to increase infants’ iron stores at birth and sustain these to 6 months of age.
Quality of life in coeliac disease: item reduction, scale development and psychometric evaluation of the Coeliac Disease Assessment Questionnaire (CDAQ)
Authors: Crocker Helen , Jenkinson Crispin , Peters Michele 
Published: August 2018

SummaryBackgroundA better understanding of coeliac disease can be achieved by assessing health‐related quality of life alongside clinical factors. Existing patient‐reported outcome measures (PROMs) evaluating quality of life in coeliac disease have not been developed in accordance with the US Food and Drug Administration guidelines.AimTo develop a PROM in accordance with best practice guidelines, capturing all aspects of quality of life important to adults with coeliac disease.MethodsCandidate items for the Coeliac Disease Assessment Questionnaire (CDAQ) were refined through item appraisal, expert review, cognitive interviews, and a translatability assessment. A cross‐sectional survey determined further item reduction and the CDAQ's structure. The final CDAQ was administered alongside the Short Form Health Survey Version 2 (SF?36v2) in a second survey to assess construct validity and test‐retest reliability.ResultsPre‐testing the 64 candidate items revealed a range of issues which guided their refinement and reduction, resulting in the final CDAQ with 32 items representing 5 subscales: stigma (eight items), dietary burden (eight items), symptoms (five items), social isolation (five items), and worries and concerns (six items). Cronbach's alpha ranged between 0.82 and 0.88 for all domains. Further results showed CDAQ scores were more strongly correlated with the SF‐36v2's mental health dimensions, as expected. Intraclass correlation coefficients ranged from 0.79 to 0.89.ConclusionThe CDAQ is a reliable and valid coeliac‐specific measure that captures all aspects of quality of life important to adults with coeliac disease. Further work is underway to assess the CDAQ's responsiveness to change.
Emicizumab‐mediated haemostatic function in patients with haemophilia A is down‐regulated by activated protein C through inactivation of activated factor V
Authors: Yada Koji , Nogami Keiji , Shinozawa Keiko , Kitazawa Takehisa , Hattori Kunihiro , Amano Kagehiro , Fukutake Katsuyuki , Shima Midori 
Published: August 2018

SummaryActivated protein C (APC) inactivates activated factor V (FVa) and moderates FVIIIa by restricting FV cofactor function. Emicizumab is a humanized anti‐FIXa/FX bispecific monoclonal antibody that mimicks FVIIIa cofactor function. In recent clinical trials in haemophilia A patients, once‐weekly subcutaneous administration of emicizumab was remarkably effective in preventing bleeding events, but the mechanisms controlling the regulation of emicizumab‐mediated haemostasis remain to be explored. We investigated the role of APC‐mediated reactions in these circumstances. APC dose‐dependently depressed thrombin generation (TG) initiated by emicizumab in FVIII‐deficient plasmas, and in normal plasmas preincubated with an anti‐FVIII antibody (FVIII‐depleted). FVIIIa‐independent FXa generation with emicizumab was not affected by the presence of APC, protein S and FV. The results suggested that APC‐induced down‐regulation of emicizumab‐dependent TG was accomplished by direct inactivation of FVa. The addition of APC to emicizumab mixed with FVIII‐depleted FV‐deficient plasma in the presence of various concentrations of exogenous FV demonstrated similar attenuation of TG, irrespective of specific FV concentrations. Emicizumab‐related TG in FVIII‐depleted FVLeiden plasma was decreased by APC more than that observed with native FVLeiden plasma. The findings indicated that emicizumab‐driven haemostasis was down regulated by APC‐mediated FVa inactivation in plasma from haemophilia A patients without or with FV defects.
Consensus on BCR‐ABL1 reporting in chronic myeloid leukaemia in the UK
Authors: Cross Nicholas C. P. , White Helen E. , Evans Paul A. S. , Hancock Jeremy , Copland Mhairi , Milojkovic Dragana , Mason Joanne , Craine Sandra , Mead Adam J. 
Published: August 2018

SummaryFor patients with chronic myeloid leukaemia (CML), treatment guidelines recommend monitoring response to treatment with tyrosine kinase inhibitors (TKIs) by testing the BCR‐ABL1 fusion gene transcript level using reverse transcriptase quantitative polymerase chain reaction. Despite recent efforts to standardise protocols for BCR‐ABL1 testing, some variability remains among laboratories in the UK regarding the techniques used and the approach to reporting results. This increases the risk of misinterpretation of results by both clinicians and patients. An expert panel met to discuss current issues surrounding BCR‐ABL1 testing in the UK and to develop guidance for laboratories, with emphasis on the optimal approach to reporting laboratory results. Topics included the minimum required information to include in the laboratory report, units of measurement, test sensitivity and BCR‐ABL1 transcript variants. To aid communication between laboratories and clinics, standard forms were generated that could be used by (i) clinics when submitting samples to laboratories, and (ii) laboratories when reporting results to clinics. Standardising the way in which BCR‐ABL1 test results are reported from laboratories to clinics should help to improve communication, interpretation of results and patient care.
Implementation of multiparametric magnetic resonance imaging technology for evaluation of patients with suspicion for prostate cancer in the clinical practice setting
Authors: Shah Paras H. , Patel Vinay R. , Moreira Daniel M. , George Arvin K. , Alom Manaf , Kozel Zachary , Joshi Vidhu , Ben‐Levi Eran , Villani Robert , Yaskiv Oksana , Kavoussi Louis R. , Vira Manish , Olsson Carl O. , Rastinehad Ardeshir R. 
Published: August 2018

ObjectivesTo investigate the impact of implementing magnetic resonance imaging (MRI) and ultrasonography fusion technology on biopsy and prostate cancer (PCa) detection rates in men presenting with clinical suspicion for PCa in the clinical practice setting.Patients and MethodsWe performed a review of 1 808 consecutive men referred for elevated prostate‐specific antigen (PSA) level between 2011 and 2014. The study population was divided into two groups based on whether MRI was used as a risk stratification tool. Univariable and multivariable analyses of biopsy rates and overall and clinically significant PCa detection rates between groups were performed.ResultsThe MRI and PSA‐only groups consisted of 1 020 and 788 patients, respectively. A total of 465 patients (45.6%) in the MRI group and 442 (56.1%) in the PSA‐only group underwent biopsy, corresponding to an 18.7% decrease in the proportion of patients receiving biopsy in the MRI group (P < 0.001). Overall PCa (56.8% vs 40.7%; P < 0.001) and clinically significant PCa detection (47.3% vs 31.0%; P < 0.001) was significantly higher in the MRI vs the PSA‐only group. In logistic regression analyses, the odds of overall PCa detection (odds ratio [OR] 1.74, 95% confidence interval [CI] 1.29–2.35; P < 0.001) and clinically significant PCa detection (OR 2.04, 95% CI 1.48–2.80; P < 0.001) were higher in the MRI than in the PSA‐only group after adjusting for clinically relevant PCa variables.ConclusionAmong men presenting with clinical suspicion for PCa, addition of MRI increases detection of clinically significant cancers while reducing prostate biopsy rates when implemented in a clinical practice setting.
Prognostic evaluation of perinephric fat, renal sinus fat, and renal vein invasion for patients with pathological stage T3a clear‐cell renal cell carcinoma
Authors: Shah Paras H. , Lyon Timothy D. , Lohse Christine M. , Cheville John C. , Leibovich Bradley C. , Boorjian Stephen A. , Thompson R. Houston 
Published: August 2018

ObjectiveTo investigate the prognostic significance of various patterns of extrarenal extension that comprise pathological stage T3a clear‐cell renal cell carcinoma (ccRCC) amongst patients undergoing nephrectomy for non‐metastatic disease.Patients and MethodsA retrospective review of 563 patients who underwent radical nephrectomy for pathologically confirmed T3aN0/NxM0 ccRCC between 1970 and 2011 was performed. All pathological slides were re‐reviewed by one urological pathologist. Associations of patterns of extrarenal extension (perinephric fat [PF], renal sinus fat [SF], and renal vein [RV], in isolation or in any combination) with disease progression, cancer‐specific mortality (CSM), and all‐cause mortality were evaluated on multivariable analyses.ResultsOverall, PF invasion, renal SF invasion, and RV tumour thrombus were present in 144 (26%), 51 (9%), and 163 (29%) patients, respectively, with multiple patterns of extrarenal extension identified in 205 (36%) patients. There were no significant differences in survival outcomes for isolated involvement of PF, renal SF, or RV. However, patients with multiple patterns of extrarenal extension were at significantly increased risk of disease progression (hazard ratio [HR] 1.31, 95% confidence interval [CI] 1.04–1.65; P = 0.020), CSM (HR 1.64, 95% CI 1.27–2.12; P < 0.001), and all‐cause mortality (HR 1.32, 95% CI 1.08–1.61; P = 0.008).ConclusionsThe presence of multiple patterns of extrarenal extension is associated with a higher risk of disease progression and cancer‐related death after radical nephrectomy compared to isolated involvement of the PF, renal SF, or RV, which carry similar prognostic weight. If validated, these findings may help refine risk stratification of non‐metastatic T3a RCC by distinguishing patients with multiple vs one pattern of extrarenal extension.
Mothers, daughters, and learning to labour: Framing work through gender and generation
Authors: Worth Nancy 
Published: August 2018

AbstractThis paper presents a qualitative case study of millennial women in Canada, focusing on how they build meaning and understand “success” in their working lives through a gendered and generational lens. I draw on daughter‐mother interview dyads to offer the framing of an intergenerational labour geography, situating mothers as an important source of work values and expectations for their millennial daughters. I argue that different generations of women have their own sense of “normative competence” or an awareness of expected skills and behaviours around work and family life. Invoking a relational perspective, different definitions and expectations for success in one's working life are grounded not just in the workplace, but also the home, as mothers and daughters endeavour to understand each other. Here, issues of recognition become paramount, as daughters’ beliefs, choices, and experiences may be more or less recognizable to their mothers. My aim is to reveal the complexity within worker identities of millennial women, moving beyond the “factory gates” of the workplace, to think about how young women build meaning and understand “success” at this stage in their working lives.
Quality of goal setting in pediatric rehabilitation—A SMART approach
Authors: Bexelius Annemarie , Carlberg Eva Brogren , Löwing Kristina 
Published: August 2018

AbstractBackgroundSetting goals for treatment is often the core of the rehabilitation process. The quality of the set goals has however rarely been evaluated. The aims of this study were therefore to assess the quality of goals set in clinical practice of pediatric rehabilitation using SMART criteria (Specific, Measurable, Achievable, Relevant, and Timed) and to assess if the goals were considered relevant from both a client perspective and expertise perspective.MethodsIn a retrospective multicase study, a total of 161 goals from 42 children with disabilities (cerebral palsy, n = 22; Down syndrome, n = 16; and developmental disability, n = 4) were assessed. The children were 1.5–5.5 years and had previously participated in goal‐directed, activity‐focused therapy at four pediatric rehabilitation centers. Collaborative goal setting had been used to define the desired treatment outcome. The quality of the goals was assessed using defined SMART criteria.ResultsSpecific: All goals could be reliably linked to International Classification of Functioning, Disability and Health—Children and Youth version chapters within the Activity/Participation domain. Measurable: A total of 75% of the goals were rated as having a well‐defined scaling; in 20%, the scaling was less clear, and in 5%, a scaling could not be determined. Achievable: A total of 80% of the goals were attained. Relevant: All goals were set in collaboration with the family and could therefore be considered relevant from a client perspective. Relevancy judged from a professional perspective was strengthened by the fact that age, baseline status, and diagnosis had an influence on the choice of goals. Timed: All goals were set within a specific time frame.ConclusionsThe goals set in clinical practice showed high quality with respect to the SMART criteria. The most difficult part was the construction of the goal attainment scale. The goals settled in clinical practice were considered relevant from both a client perspective and expertise perspective.
A replicable, low‐burden mechanism for observing, recording, and analysing mother–child interaction in population research
Authors: Levickis Penny , Reilly Sheena , Girolametto Luigi , Ukoumunne Obioha C. , Wake Melissa 
Published: August 2018

AbstractBackgroundThere is growing evidence that specific styles of parent–child interaction benefit child development, particularly child language development. Direct observational techniques help clarify the behaviours and styles within parent–child interactions that may influence child language outcomes; however, these techniques tend to be labour‐intensive and costly. We report on the development of a replicable, low‐burden mechanism for observing and coding specific maternal linguistic behaviours in a population‐based cohort of 2‐year‐olds.MethodsThe coding scheme was developed as part of a prospective, longitudinal study examining the associations between maternal responsive behaviours and child language outcomes in slow‐to‐talk toddlers. In the first phase of the study, three coding systems were tested by coding five sample parent–toddler interactions and then comparing them based on (a) the ease of method and thus likely intrarater and interrater reliability and (b) the number of data points. The second phase was to demonstrate how the chosen method could be used in practice with a large at‐risk group of toddlers.ResultsOf the three coding systems explored, the Observer® XT software was selected for ease of use and because detailed coding of free‐play videos could be achieved in close to real time. Intrarater and interrater reliability were established in 251 mother–child free‐play videos, producing high intraclass correlation coefficients of 0.95 to 0.99 for the six behaviours.ConclusionsThe study provides evidence that numerous parent–child interactions can be rigourously yet efficiently coded without substantial information loss. The observational mechanism in the current study has been fully developed and is shown to be feasible for research purposes focusing on parent–toddler interactions. However, further testing of the observational mechanism is required to examine whether the same results could be produced if coding was conducted “live” and for shorter duration thereby making it readily useable for clinicians.
Mixed‐methods content and sentiment analysis of adolescents’ voice diaries describing daily experiences with asthma and self‐management decision‐making
Authors: Mammen Jennifer R. , Java James J. , Rhee Hyekyun , Butz Arlene M. , Halterman Jill S. , Arcoleo Kimberly 
Published: August 2018

AbstractBackgroundAccurate symptom assessment remains challenging in teen populations. Little is known of usual symptom/response patterns, and self‐reported paper diaries have traditionally low compliance rates. Therefore, we used concurrent digital voice diaries to capture daily asthma experiences.Objective(a) To qualitatively explore usual symptom patterns and self‐management responses and (b) to quantitatively explore relationships between symptom severity and sentiment scores (a marker of emotional response to events).MethodsFourteen minority and nonminority teenagers (age 13‐17) with controlled (50%) and uncontrolled asthma used digital recorders to report about their asthma once daily over 14 days. Dairy entries were coded for symptom frequency, severity, type, and self‐management responses, while sentiment analysis was used to evaluate the emotional valence of diary entries and to explore whether increased symptom levels correlated with greater negative sentiment.ResultsSymptom frequency and severity recorded in voice diaries were much higher than teens indicated at baseline and were discordant with clinical assessments of asthma control. Of 175 entries, teens had symptoms 69.1% of days (121/175) and severe symptoms on one‐third of these. Atypical symptoms (coughing, throat clearing) were reported twice as often as traditional symptoms (wheezing, chest tightness) and often not recognized as asthma, but rather attributed to being “sick” (25.6% of symptom days). Teens frequently minimized symptoms, used rescue and controller medication inconsistently, and resorted to alternative strategies to manage symptoms. Sentiment was not significantly correlated with assessed control (β = 0.14, P = 0.28), but for teens reporting severe symptoms, sentiment scores decreased by 0.31 relative to teens without symptoms (P = 0.006).Conclusions and Clinical RelevanceTeens may minimize symptoms and have greater symptom frequency and severity than is recognized by themselves or providers. Screening for specific symptoms including coughing, throat clearing, and respiratory illness may be needed to identify those experiencing burden from asthma.
Value of protected areas to avian persistence across 20 years of climate and land‐use change
Authors: Peach Michelle A. , Cohen Jonathan B. , Frair Jacqueline L. , Zuckerberg Benjamin , Sullivan Patrick , Porter William F. , Lang Corey 
Published: August 2018

AbstractEstablishing protected areas, where human activities and land cover changes are restricted, is among the most widely used strategies for biodiversity conservation. This practice is based on the assumption that protected areas buffer species from processes that drive extinction. However, protected areas can maintain biodiversity in the face of climate change and subsequent shifts in distributions have been questioned. We evaluated the degree to which protected areas influenced colonization and extinction patterns of 97 avian species over 20 years in the northeastern United States. We fitted single‐visit dynamic occupancy models to data from Breeding Bird Atlases to quantify the magnitude of the effect of drivers of local colonization and extinction (e.g., climate, land cover, and amount of protected area) in heterogeneous landscapes that varied in the amount of area under protection. Colonization and extinction probabilities improved as the amount of protected area increased, but these effects were conditional on landscape context and species characteristics. In this forest‐dominated region, benefits of additional land protection were greatest when both forest cover in a grid square and amount of protected area in neighboring grid squares were low. Effects did not vary with species’ migratory habit or conservation status. Increasing the amounts of land protection benefitted the range margins species but not the core range species. The greatest improvements in colonization and extinction rates accrued for forest birds relative to open‐habitat or generalist species. Overall, protected areas stemmed extinction more than they promoted colonization. Our results indicate that land protection remains a viable conservation strategy despite changing habitat and climate, as protected areas both reduce the risk of local extinction and facilitate movement into new areas. Our findings suggest conservation in the face of climate change favors creation of new protected areas over enlarging existing ones as the optimal strategy to reduce extinction and provide stepping stones for the greatest number of species.