bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genitourinary cancer patients have worse baseline semen parameters than healthy sperm bankers
Authors: Xu R. , Centola G. M. , Tanrikut C. 
Published: February 2019

AbstractBackgroundWhile the spermatotoxic properties of cancer treatments such as chemotherapy and radiation therapy are widely recognized, the effect of malignancy itself on male fertility is not clearly understood.ObjectivesTo determine whether malignancy is associated with diminished semen quality prior to spermatotoxic treatment among sperm bankers.Materials and MethodsRetrospective database review of de‐identified records was obtained for all episodes of sperm banking performed at a cryobank from January 2004 to May 2017 for one of the following reasons: ‘future use’ (e.g., military deployment and gender reassignment); infertility; benign disease; and malignancy, further categorized as testicular, other genitourinary (GU), solid non‐GU, hematologic, or unspecified. Dependent variables of interest were ejaculatory volume, sperm concentration, % motility, and total motile sperm count (TMSC), as well as post‐thaw TMSC.ResultsA total of 1558 patients met the inclusion criteria. Multivariable regression analysis on log‐transformed data controlling for age demonstrated decreased ejaculatory volume and sperm concentration, % motility, and TMSC in the infertility group as compared to the ‘future use’ group (p < 0.001). Testicular cancer was associated with decreased sperm concentration, TMSC, and post‐thaw TMSC (p < 0.001); other GU malignancy was associated with decreased ejaculatory volume (p < 0.001). Benign disease, solid non‐GU malignancy, hematologic malignancy, and unspecified malignancy were not associated with decreased parameters.DiscussionIn addition to sperm bankers with known fertility issues, sperm bankers with testicular and other GU malignancy had worse baseline semen parameters as compared to individuals pursuing banking for future use. These findings can inform patient counseling and consent prior to sperm banking and disease treatment.ConclusionIndividuals with testicular and other GU malignancy who banked spermatozoa before undergoing spermatotoxic therapy demonstrated worse baseline semen parameters as compared to individuals banking spermatozoa for non‐medical reasons.
Clinical and biological features of paediatric acute myeloid leukaemia (AML) with primary induction failure in the Japanese Paediatric Leukaemia/Lymphoma Study Group AML‐05 study
Authors: Miyamura Takako , Moritake Hiroshi , Nakayama Hideki , Tanaka Shiro , Tomizawa Daisuke , Shiba Norio , Saito Akiko M. , Tawa Akio , Shimada Akira , Iwamoto Shotaro , Hayashi Yasuhide , Koike Takashi , Horibe Keizo , Manabe Atsushi , Mizutani Shuki , Taga Takashi , Adachi Souichi 
Published: February 2019

SummaryThe prognosis of paediatric acute myeloid leukaemia (AML) with primary induction failure (PIF) is extremely poor, and effective treatment strategies have not been established. We investigated the clinical and biological features of paediatric AML patients with PIF registered to the Japanese Paediatric Leukaemia/Lymphoma Study Group AML‐05 study. The 3‐year overall survival rate of the 41 PIF patients was 19.0%. High leucocyte count, M7 morphology, and unfavourable genetic aberrations, such as FLT3‐internal tandem duplication, NUP98‐NSD1 and high MECOM or PRDM16 expression, were risk factors for PIF. More effective treatment strategies based on leukaemia biology need to be urgently explored.
Innovations in Practice: CUES‐Ed: an in‐service evaluation of a new universal cognitive behavioural early mental health intervention programme for primary school children
Authors: Redfern Anna , Jolley Suzanne , Bracegirdle Karen , Browning Sophie , Plant Debbie 
Published: February 2019

BackgroundEarlier childhood interventions to reduce mental health vulnerability are a global health priority yet poorly implemented. Barriers include negotiating health/education interfaces, and mixed outcomes, particularly for vulnerable children. CUES‐Ed aimed to address these barriers, comprising a cognitive behavioural early intervention targeting mental health vulnerability in 7–10 year‐olds, with integrated evaluation, delivered through close liaison with stakeholders. Following 2 years of ad hoc delivery, relationship‐building, and refining the intervention and evaluation, we report on implementation and in‐service outcomes for local schools completing the standardised CUES‐Ed programme.MethodWe evaluated delivery from 01/2017 to 07/2017 across n = 12 schools (n = 23 classes, n = 638 pupils, n = 35 teachers). Eight one‐hour weekly sessions (S1‐S8) were delivered by mental health professionals with teachers present. Pupil‐reported wellbeing/distress and emotional/behavioural difficulties were assessed at S1 and S8; pupil free text feedback/ratings and teacher ratings at S8. Two classes (n = 60) completed outcomes whilst awaiting CUES‐Ed, forming a naturalistic waitlist.ResultsAt S8, pupil‐reported outcome data were obtained from 535 and feedback/ratings from 577 pupils, respectively. Thematic analysis of feedback indicated positive subjective impact. Vulnerable children (defined as self‐rated borderline/clinical cut‐off baselines scores on the wellbeing/distress and emotional/behavioural difficulties measures) improved with medium pre‐post effect sizes (d = 0.46–0.65), and small, but consistent, effects compared to waitlist.ConclusionIn‐service evaluation suggests a feasible model of delivery, good acceptability and potential to improve outcomes for vulnerable children. Controlled evaluation is now indicated.
Defining the role of surgical drainage in paediatric deep neck space infections
Authors: Wilkie Mark D. , De Sujata , Krishnan Madhankumar 
Published: February 2019

ObjectivesSurgical drainage is the traditional mainstay of treatment of paediatric deep neck space infection (DNSI), but recently non‐operative management in selected cases has been advocated. We sought to identify any characteristics predictive of requirement for surgical intervention.DesignRetrospective cohort study using receiver operating characteristics analyses.SettingTertiary referral paediatric hospital.ParticipantsChildren (≤16 years) with a radiologically confirmed diagnosis of retro‐ or parapharyngeal abscess over a ten‐year period.Main outcome measuresPredictive value of clinical and radiological variables in determining the requirement for surgical intervention. Length of hospital stay (LoS) was also examined.ResultsNinety‐three children were studied, 15 (16.1%) of whom underwent immediate surgery, 42 (45.2%) of whom underwent delayed surgery following an initial period of conservative management, and 36 (38.7%) of whom were managed conservatively. Age, WCC and CRP were not predictive of the need for surgical drainage. Radiological abscess diameter, however, was predictive of requirement surgery (AUC = 0.85 [95% CI ± 0.09] P = 0.02), with a cut‐off value of 2.5 cm determined assuming equal weight to sensitivity and specificity. All DNSIs were successfully treated with no adverse outcomes, and there was no significant difference in LoS between groups. In those managed surgically, outcome and LoS did not depend on yield of pus.ConclusionsSelected paediatric DNSIs can be successfully managed conservatively, with abscess diameter >2.5 cm a significant predictor of need for surgical intervention. Any benefit of surgery does not appear to depend on intra‐operative yield of pus.
Fetal iGRASP cine CMR assisting in prenatal diagnosis of complicated cardiac malformation with impact on delivery planning
Authors: Bhat Misha , Haris Kostas , Bidhult Sebastian , Liuba Petru , Aletras Anthony H. , Hedström Erik 
Published: February 2019

SummaryLimited visualization of the fetal heart and vessels by fetal ultrasound due to suboptimal fetal position, patient habitus and skeletal calcification may lead to missed diagnosis, overdiagnosis and parental uncertainty. Counselling and delivery planning may in those cases also be tentative. The recent fetal cardiac magnetic resonance (CMR) reconstruction method utilizing tiny golden‐angle iGRASP (iterative Golden‐angle RAdial Sparse Parallel MRI) allows for cine imaging of the fetal heart for use in clinical practice. This case describes an unbalanced common atrioventricular canal where limited ultrasound image quality and visibility of the aortic arch precluded confirming or ruling out presence of a ventricular septal defect. Need of prostaglandins or neonatal intervention was thus uncertain. Cardiovascular magnetic resonance imaging confirmed ultrasound findings and added value by ruling out a significant ventricular septal defect and diagnosing arch hypoplasia. This confirmed the need of patient relocation for delivery at a paediatric cardiothoracic surgery centre and prostaglandins could be initiated before the standard postnatal ultrasound. The applied CMR method can thus improve diagnosis of complicated fetal cardiac malformation and has direct clinical impact.
Individual and spatial variation are as important as species‐level variation to the trophic complexity of a lentic food web
Authors: Feiner Zachary S. , Foley Carolyn J. , Swihart Robert K. , Bootsma Harvey , Czesny Sergiusz , Janssen John , Rinchard Jacques , Höök Tomas O. 
Published: February 2019

AbstractEcological complexity may improve ecosystem function, stability and adaptability to natural and anthropogenic disturbances. Intraspecific trophic variation can represent a significant component of total community variation and can influence food web structure and function. Thus, understanding how trophic niches are partitioned between intraspecific and interspecific processes could improve our understanding of food web dynamics. We examined gut contents, fatty acids and stable isotope ratios in round goby (Neogobius melanostomus) and yellow perch (Perca flavescens) across six sites in Lake Michigan, USA, to determine patterns in intra‐ and interspecific trophic composition (i.e., mean gut or fatty acid composition) and diversity (i.e., the diversity of gut items or fatty acids). We also examined relationships between fatty acid diversity and gut content characteristics to understand potential mechanisms shaping individual trophic phenotypes. There was significant variation in both trophic composition and diversity among sites, and individual and spatial variation was as important to total trophic variation as species identity. Round goby that consumed dreissenid mussels had more diverse fatty acid profiles than those that consumed other benthic invertebrates, whereas yellow perch fatty acid diversity was not related to gut content composition. Our results confirm that intraspecific variation in resource use can be as important to trophic dynamics as interspecific variation, and that spatial variation in lower level food web processes or habitat may strongly structure local food web dynamics. Individual‐level examination of trophic diversity, in concert with trophic composition, could provide additional information about the resilience, function and adaptability of local food webs.
Age‐ and sex‐specific reference intervals for hematologic analytes in Chinese children
Authors: Zhang Xiaoan , Ding Yanzi , Zhang Yurong , Xing Jinfang , Dai Yanpeng , Yuan Enwu 
Published: February 2019

AbstractIntroductionReference intervals for pediatric laboratory tests need to be interpreted in the context of age‐ and sex‐dependent dynamics. However, few reference intervals for healthy ethnic Han Chinese children have previously attempted to establish using large sample sizes. As such, there are no national hematological standards in China for pediatric reference intervals.MethodsWe used a direct method to enroll a total of 2164 healthy 1‐ to 7‐year‐old children from Henan province. Hematological reference intervals were established by analyzing venous blood sample data on 17 hematologic analytes. The reference values for different ages and sexes were estimated using both parametric methods (mean ± 2 SD) and nonparametric methods (2.5‐97.5th percentiles).ResultsWe provided reference intervals for 17 hematologic analytes including red blood count, hemoglobin concentration, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and red cell distribution width, white blood count and differential count as well as platelet count and related parameters.ConclusionWe established age‐ and sex‐specific reference intervals that can provide more evidence‐based guidance for the diagnosis and treatment for pediatric diseases. Our findings provide the basis for the next step in establishing national blood testing standards.
Barriers and facilitators for community pharmacists’ participation in pharmacy practice research: a survey
Authors: Kuipers Esther , Wensing Michel , De Smet Peter A G M , Teichert Martina 
Published: February 2019

Abstract

Objectives
The aim of this study was to explore pharmacists’ barriers and facilitators regarding participation in pharmacy practice research.

Methods
We conducted an online cross-sectional survey in 1974 community pharmacies in the Netherlands.

Key findings
A total of 252 pharmacists completed the questionnaire. The majority agreed that participation in research should be part of daily practice. Efficient time investment and a clear benefit for general professional knowledge, patient care and pharmacy organisation were the most important facilitating factors.

Conclusions
To encourage pharmacists’ participation, researchers should offer clear instructions, possibilities for flexible time management, simple patient inclusion, task delegation and no additional contacts with healthcare professionals due to the research.
The effects of augmented reality on students' academic achievement and motivation in a biology course
Authors: Erbas Cagdas , Demirer Veysel 
Published: February 2019

AbstractThis study aimed to investigate the effects of augmented reality (AR) activities on students' academic achievement and motivation in a biology course. For this purpose, a mixed study was conducted, and a pretest and posttest control group model was used. In addition, the opinions of the experimental group students and the teacher about the AR activities were taken, and classroom observations were made during the study. The study group consisted of 40 (22 female and 18 male) ninth‐grade biology course students. The control group followed the biology course programme, whereas the experimental group students conducted AR activities in addition to the course programme using tablets. Consequently, it was found that the motivation of the students in the experimental group increased more than that of the students in the control group. However, no significant difference was found between the academic achievement scores of the groups. The teacher and the students stated that AR activities might be effective in increasing course success and motivation.
E‐cigarettes and the clinical encounter: Physician perspectives on e‐cigarette safety, effectiveness, and patient educational needs
Authors: Kollath‐Cattano Christy , Dorman Tyler , Albano Andrew W. , Jindal Meenu , Strayer Scott M. , Thrasher James F. 
Published: February 2019

AbstractRationale, aims, and objectivesThere is limited research on how health care providers approach the topic of e‐cigarettes in clinical encounters, especially in conjunction with other best‐practice recommendations for smoking cessation. This qualitative study explored physician perceptions and recommendations involving e‐cigarettes in the context of smoking cessation counselling, including their opinions about the implementation and content of patient educational materials that focus on e‐cigarettes.MethodsSemistructured interviews were conducted with 15 physicians from family medicine, internal medicine, and obstetrics/gynaecology (OB/GYN).ResultsPhysicians did not routinely assess e‐cigarette use among patients and reported that discussions were often initiated by patients. Only a minority of participants discussed e‐cigarettes in conjunction with other best‐practice recommendations for smoking cessation. Most others were more ambivalent about e‐cigarette safety and effectiveness for cessation and did not address the topic, unless patients were already using e‐cigarettes. Almost all, however, agreed that more research on e‐cigarettes was needed. Physicians expressed an interest in having enhanced discussions about e‐cigarettes with their patients and in using patient educational materials to accomplish this. Physicians recommended that these materials not actively promote e‐cigarettes and be tailored to patients based on their demographics and motivation to quit.ConclusionsPhysicians were open to improving their smoking cessation counselling and to integrating new patient educational materials that addressed e‐cigarettes. Patient educational materials that provide tailored information about e‐cigarettes could potentially be used initiate e‐cigarette discussions and inform smokers about what is known vs unknown about e‐cigarettes.
Patients admitted to more research‐active hospitals have more confidence in staff and are better informed about their condition and medication: Results from a retrospective cross‐sectional study
Authors: Jonker Leon , Fisher Stacey Jayne , Dagnan Dave 
Published: February 2019

AbstractRationale, aims and objectivesClinical research activity in hospitals is associated with reduced mortality and improved overall care quality. In England, the latter is a compound score of several elements and both staff and inpatient feedback form part of the Care Quality Commission (CQC) ratings. The objective of this study was to determine if NHS Trusts' National Institute for Health Research (NIHR) study activity data correlates with specific outcomes from national NHS staff and patient surveys.MethodRetrospective cohort design involving data for 129 English NHS hospital Trusts, including scores from recent national NHS staff and inpatient surveys and NIHR data. Statistical approach involved Spearman correlation analyses, with cut‐off P value ≤ 0.01 for qualification for subsequent principal component analysis (correlation coefficient cut‐off value 0.20).ResultsOutcomes of one staff survey question (staff recommendation of the organization as a place to work or receive treatment) and multiple outcomes of inpatient survey questions were positively associated with increased NIHR‐adopted clinical research activity. Better quality of information provision to patients was the dominant theme, though a higher degree of observed staff teamwork, more confidence in the treating doctors, and a better overall inpatient experience also correlated significantly. The number of different studies contributed more to positive associations with survey outcomes compared with the number of recruited participants into research.ConclusionsSurvey elements of the CQC appraisal of English NHS Hospital Trusts are significantly associated with increased clinical research activity levels; it appears to drive better information provision to inpatients—particularly around medicine management—and contribute to a better inpatient experience overall, whilst staff are more likely to recommend their own organization. Despite clinical research activity forming a very small fraction of overall NHS activity, it has an indirect positive effect on staff and Trust performance that is measurable at patient level.
Homelessness among youth who identify as LGBTQ+: A systematic review
Authors: McCann Edward , Brown Michael 
Published: February 2019

AbstractAims and objectivesTo explore homelessness among lesbian, gay, bisexual, transgender, queer/questioning plus (LGBTQ+) youth and to identify their support and care requirements.BackgroundLGBTQ+ youth face many health and societal challenges including issues related to homelessness.DesignA systematic review of qualitative, quantitative and mixed methods studies.MethodsA search of relevant electronic databases was carried out and included the dates August 2008–August 2018 and limited to academic journals and peer‐reviewed empirical studies written in English. Included studies specifically addressed the homeless experiences of youth aged 13–24 years old who identified as LGBTQ+. The PRISMA checklist was used in the review. A quality assessment instrument was used to review all of the selected papers and narrative methods utilised in the synthesis of the research evidence.ResultsThe search resulted in 319 papers, and after applying distinct inclusion criteria, a total of 14 papers were considered suitable for the systematic review. Following analysis, the four main themes identified were stigma, discrimination and exclusion; mental health issues and substance use; sexual risks and vulnerability; and interventions and supports.ConclusionLGBTQ+ homeless youth is a major public health concern that has significant consequences for a young person's physical and psychosocial well‐being.Relevance to clinical practicePractitioners need to be aware of the specific health and support requirements of LGBTQ+ youth in relation to homelessness. Inclusive and holistic care plans should exist that are fully responsive to the distinct needs of this group guided by definitive policies and sound clinical research. The implications for future nursing practice are presented and discussed.
Undiagnosed delirium is frequent and difficult to predict: Results from a prevalence survey of a tertiary hospital
Authors: Lange Peter W. , Lamanna Marissa , Watson Rosie , Maier Andrea B. 
Published: February 2019

AbstractAims and objectivesTo study the prevalence and determinants of undiagnosed delirium in a tertiary hospital.BackgroundDelirium is a common inpatient condition. It is frequently undiagnosed in a variety of settings, but determinants of undiagnosed delirium are largely unknown, and the frequency of undiagnosed delirium across all inpatient units is uncertain. The utility of hospital‐wide screening then is also uncertain.MethodsHospital‐wide prevalence study conducted over 4 months, using a chart‐based method. Gender, age, admitting unit, history of dementia and comorbidity were used in univariate and multivariate analyses to search for differences in patients with no delirium, with undiagnosed delirium and with diagnosed delirium. Sensitivity, specificity and number needed to screen were calculated from proportions in each group. Study was conducted in concordance with STROBE guidelines.ResultsDelirium was prevalent in 12.5% of all patients and undiagnosed in 24.1% of patients. Only age ≥65 years and a history of dementia predicted delirium, and undiagnosed delirium in both univariate and multivariate analyses. Age ≥65 years accounts for 92.3% sensitivity and 50.8% specificity for undiagnosed delirium in this group. History of dementia had a 23.0% sensitivity and 97.0% specificity. Twenty‐eight patients would need to be screened to detect a case of undiagnosed delirium.DiscussionThere was a high rate of delirium and undiagnosed delirium in this cohort. Known risk factors for delirium also independently predict undiagnosed delirium; other factors were not found.ConclusionUndiagnosed delirium is common and difficult to predict from patient baseline characteristics other than age.Relevance to clinical practiceAssessment of all inpatients for delirium is recommended.