bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating Online Continuing Professional Development Regarding Weight Management for Pregnancy Using the New World Kirkpatrick Model
Authors: Walker Ruth , Bennett Christie , Kumar Arunaz , Adamski Melissa , Blumfield Michelle , Mazza Danielle , Truby Helen 
Published: July 2019

Introduction:
Clinical practice guidelines advocate the importance of continuing professional development (CPD) that supports health professionals (HPs) to discuss the sensitive topic of maternal weight management with women. However, there is a lack of accredited CPD related to this important area of preconception and antenatal care. Therefore, aims were to evaluate HPs' reactions to accredited online CPD regarding weight management for pregnancy and their knowledge, attitudes, confidence, and commitment to provide women with advice after completing the course.

Methods:
A mixed-methods evaluation was based on the New World Kirkpatrick Model (NWKM). Accredited online CPD was developed by experts in maternal nutrition and weight management. Participants completed a questionnaire before (n = 136) and after (n = 65) the weight management components of the course. McNemar and Wilcoxon signed-rank tests were used to evaluate paired data (n = 36) (p < .05). Deductive content analyses explored free-text responses (n = 65).

Results:
Participants' reactions to the online CPD were encouraging, facilitating increases in perceptions of the importance of weight management for pregnancy and confidence to provide advice. Quantitative measures assessed no change in participants' knowledge; however, qualitative analyses revealed an increase in participants' knowledge of communication strategies that they intend to apply in practice.

Discussion:
The NWKM facilitated an evaluation of HPs' encouraging reactions to online CPD and the affective constructs of education including attitudes, confidence, and commitment to provide advice. Online CPD should be developed with collaboration between universities/professional associations and health care providers, so that evaluation of organizational change and clinical outcomes is possible.
Adverse Childhood Experiences and Family Resilience Among Children with Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder
Authors: Schneider Mallory , VanOrmer Jessica , Zlomke Kimberly 
Published: July 2019

ABSTRACT:

Objectives:
The purpose of the present study was to (1) examine the differences in adverse childhood experiences (ACEs) among children with autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and comorbid ASD/ADHD and healthy neurodevelopmental controls; (2) explore the levels of family resilience across diagnostic categories; (3) identify the differences in family resilience by the number of ACEs; and (4) explore the interaction between ACEs and the diagnostic category on family resilience.

Method:
Participants were 2083 children between the ages of 6 and 17 years (M = 12.23, SD = 3.36) from the 2016 National Survey of Children's Health. The majority of the sample were male (68.7%) and white (78.6%).

Results:
Overall, youth diagnosed with solely ADHD had the highest number of ACEs (Madj = 1.94). In addition, individuals who endorsed exposure to 1 ACE reported higher levels of family resilience in comparison to those who reported 0 ACEs or 2 or more ACEs. Family resilience did not differ between youth who experienced 2 or more ACEs and youth who experienced 0 ACEs. Youth diagnosed with comorbid ASD/ADHD had the lowest levels of family resilience. Interestingly, family resilience did not differ between ADHD and neurotypical youth.

Conclusion:
Youth diagnosed with ADHD seem to be at the highest risk for ACEs. Those with comorbid ASD/ADHD report the lowest levels of family resilience when controlling for exposure to ACEs. Families of youth with ASD had lower levels of family resilience than those of neurotypical youth when controlling for exposure to ACEs, whereas families of youth with solely ADHD displayed similar levels of family resilience in comparison to neurotypical youth and their families. Results have implications for prevention and intervention with ASD and/or ADHD youth and their families.
Characterizing the Learning-to-Drive Period for Teens with Attention Deficits
Authors: Bishop Haley J. , Curry Allison E. , Stavrinos Despina , Mirman Jessica H. 
Published: July 2019

ABSTRACT:Objective:Motor vehicle collisions are the leading cause of death among teenagers, accounting for approximately 1 in 3 deaths for this age group. A number of factors increase crash risk for teen drivers, including vulnerability to distraction, poor judgment, propensity to engage in risky driving behaviors, and inexperience. These factors may be of particular concern and exacerbated among teens learning to drive with attention deficits. To our knowledge, our study is among the first to systematically investigate the experiences of novice adolescent drivers with attention deficits during the learner period of a Graduated Drivers Licensing program.Method:Survey and on-road driving assessment (ODA) data were used to examine parent and teen confidence in the teens' driving ability, driving practice frequency, diversity of driving practice environments, and driving errors among teens with attention deficits as defined by attention-deficit/hyperactivity disorder (ADHD) diagnosis or parent-reported trouble staying focused (TSF).Results:When teens' driving skill was evaluated at the conclusion of the learner period, teens with ADHD exhibited more driving errors than their typically developing (TD) counterparts (p= 0.034). Teens with TSF were more likely to have their ODA terminated (p= 0.019), had marginally lower overall driving scores (p= 0.098), and exhibited more critical driving errors (p= 0.01) compared with TD teens.Conclusion:These findings may have implications on the learning-to-drive period for adolescents with attention deficits. Adjustments may need to be made to the learner period for teens with attention deficits to account for attention impairments and to better instill safe driving behavior.
Pacemakers, Deep Brain Stimulators, Cochlear Implants, and Nerve Stimulators: A Review of Common Devices Encountered in the Dermatologic Surgery Patient
Authors: Tripathi Shivani V. , Hurst Eva A. 
Published: July 2019

BACKGROUND
In dermatologic and procedural surgery settings, there are commonly encountered devices in patients. Safe surgical planning requires familiarity with these devices.

OBJECTIVE
To review the current implanted devices in patients and recommendations for surgical planning around these devices.

METHODS AND MATERIALS
A comprehensive review using PubMed and published device recommendations was performed, searching for those most relevant to dermatologic surgery.

RESULTS
Devices such as pacemakers and implantable cardiac defibrillators, deep brain stimulators, cochlear implants, and various nerve stimulators are potential devices that may be encountered in patients and specific recommendations exist for each of these devices.

CONCLUSION
Dermatologic surgeons' knowledge of implanted devices in patients is paramout to safe surgical procedures.
A Sensitive LC-MS/MS Assay for the Quantification of Methadone and its Metabolites in Dried Blood Spots: Comparison With Plasma
Authors: Davari Baharak , Kotecha Nidhi , Clavijo Claudia F. , Thomas James J. , Rzasa-Lynn Rachael , Galinkin Jeffrey L. , Christians Uwe , Sempio Cristina 
Published: July 2019

Introduction:
Methadone, a synthetic narcotic, is widely used both in adults and children for pain control and as a replacement drug in opioid use disorder to prevent craving and withdrawal. To support clinical pharmacokinetic trials in neonates, infants, and children, the authors developed and validated a novel, automated, highly sensitive liquid chromatography–electrospray–tandem mass spectrometry ionization (LC-ESI-MS/MS) method for the quantification of methadone and its metabolites, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) and 2-ethyl-5-methyl-3,3-diphenylpyraline (EMDP), in samples collected as dried blood spots.

Methods:
Blood was spiked with different concentrations of methadone, EDDP, and EMDP, and blood drops were applied to filter paper cards. Punches of 6.4 mm were removed from the cards, and 600 µL of protein precipitation solution (methanol/0.2M ZnSO4, 7:3, vol/vol) containing the internal standards (methadone-d9 and EDDP-d5) at a concentration of 1 mcg/L was added. The extracts were analyzed using LC-ESI-MS/MS in combination with online extraction. The mass spectrometer was run in the positive multiple reaction monitoring mode, and the total run time was 3.2 minutes.

Results:
For the dried blood spots, the assay has a lower limit of quantification of 0.1 mcg/L for methadone, EDDP, and EMDP. The range of reliable response for methadone for the ion transition m/z = 310.2→265.1 was 0.1–100 mcg/L and for the ion transition m/z = 310.2→223.1 5–1000 mcg/L. For EDDP, on the range of reliable response for the ion transition, m/z = 278.2→234.3 was 0.1–100 mcg/L and for the ion transition m/z = 278.2→186.1 5–1000 mcg/L. The calibration range for EMDP was 0.1–100 mcg/L. Accuracy (85%–115%) and imprecision (<15%) met predefined acceptance criteria.

Discussion:
This assay allows for the measurement of small volume blood samples without the need for an intravenous blood draw, and thus, it is suitable for pharmacokinetics studies and therapeutic drug monitoring in pediatric patients.
Impact of CYP2C19 Phenotypes on Clinical Efficacy of Stiripentol in Japanese Patients With Dravet Syndrome
Authors: Yamamoto Yoshiaki , Takahashi Yukitoshi , Ikeda Hiroko , Imai Katsumi , Kagawa Yoshiyuki , Inoue Yushi 
Published: July 2019

Background:
Stiripentol is a strong inhibitor of CYP2C19 and CYP3A4. This study compared the effect of stiripentol on the pharmacokinetics of clobazam and N-desmethyl-clobazam (NCLB; an active metabolite of clobazam) between different CYP2C19 phenotypes. We also evaluated the clinical impact of CYP2C19 phenotypes in Japanese patients with Dravet syndrome receiving a combination of valproic acid, clobazam, and stiripentol.

Methods:
We retrospectively reviewed 241 blood samples from 64 patients (aged 1–40 years) and calculated the concentration/dose (CD) ratio [serum level (ng/mL) divided by dose (mg/kg)] for clobazam and NCLB. Based on their CYP2C19 genotypes, patients were classified as extensive metabolizers (EM group: CYP2C19*1/*1, *1/*2, or *1/*3) or poor metabolizers (PM group: CYP2C19*2/*2, *3/*3, or *2/*3). We also reviewed the clinical records of 56 patients who commenced stiripentol therapy and calculated the retention rate for stiripentol therapy over an observation period of 208 weeks.

Results:
Concomitant administration of stiripentol led to a marked increase in the CD ratio of clobazam (1.8-fold in the EM group and 1.5-fold in the PM group). In addition, stiripentol increased the CD ratio of NCLB by 6.6-fold in the EM group, but decreased it by 0.7-fold in the PM group. The estimated retention rate with stiripentol therapy was higher, and the duration of retention was longer in the EM group than in the PM group (1378 versus 933 days, P < 0.001). In patients with the PM phenotype, the adjusted hazard ratio for ceasing stiripentol therapy was 6.7 (95% confidence interval: 1.8–24.7, P < 0.005).

Conclusions:
The effect of stiripentol on the pharmacokinetics of NCLB was significantly different between patients with the EM and PM phenotypes, which could influence the clinical response of Japanese patients with Dravet syndrome receiving the combination of valproic acid, clobazam, and stiripentol.
Reassessment of Internal Thyroid Doses to 1,080 Children Examined in a Screening Survey after the 2011 Fukushima Nuclear Disaster
Authors: Kim Eunjoo , Yajima Kazuaki , Hashimoto Shozo , Tani Kotaro , Igarashi Yu , Iimoto Takeshi , Ishigure Nobuhito , Tatsuzaki Hideo , Akashi Makoto , Kurihara Osamu 
Published: July 2019

Abstract
The dose reconstruction of populations potentially affected by the accident at the Fukushima Daiichi nuclear power plant in March 2011 is of great importance. However, it has been difficult to assess internal thyroid doses to Fukushima residents (mainly from their intake of 131I) due to the lack of direct measurements. For the residents, only about 1,300 data points related to 131I are available, and 1,080 of the data points were obtained from the screening campaign that was conducted by the Nuclear Emergency Response Local Headquarters at the end of March 2011 in Kawamata Town, Iwaki City, and Iitate Village. Here, we reassessed thyroid doses to 1,080 subjects aged ≤15 y old using new age-specific conversion factors to determine 131I thyroid contents from net signals of the devices used, with consideration for the possible uncertainty related to the measurements. The results demonstrated that thyroid equivalent doses to the subjects were <30 mSv (excluding outliers). We also demonstrate dose distributions of each age group from the above three municipalities and those of subjects from Minamisoma City and Fukushima City. One of the findings was that the 131I intake was similar among different age groups in each of the three municipalities. This was consistent with the assumption that ingestion was a dominant route of intake rather than inhalation. The range of thyroid doses to Iitate Village residents was similar to that to Iwaki City residents even though the 131I concentration in tap water was much higher in Iitate Village than Iwaki City. The range of thyroid doses to Minamisoma City residents was similar to that to Iitate Village and Iwaki City residents, and the range for Fukushima City residents was smallest among the five municipalities. Since the major route of intake has remained unclear, this paper presents the plausible upper and lower thyroid doses, between which the actual doses are thought to mostly exist, based on two intake scenarios: single inhalation and repeated ingestion. Further research is thus necessary to extract useful evidence from the individual evacuation behaviors for improving the present internal thyroid dose assessment.
The Radiation Safety Officer as an Advocate for Patient Safety
Authors: Morgan Thomas L. 
Published: July 2019

Abstract
The role of the radiation safety officer is to maintain radiation exposures as low as reasonably achievable. Traditionally, the focus has been on reducing or eliminating unnecessary occupational exposure to employees and ensuring exposure of visitors and members of the public is maintained below regulatory limits. Over the last three decades there has been increasing concern expressed in the medical literature on the potential risks of radiation exposure to patients undergoing diagnostic medical imaging procedures. This paper will discuss the need for advocacy and processes by which the radiation safety officer can expand the focus of a medical radiation safety program to include advocacy for applying the principles and practices of maintaining exposures as low as reasonably achievable to patients.
A Quasi-experimental Study of a Skin Cancer Intervention to Increase Knowledge and Change Behaviors Among Irish Nursing and Agricultural Students
Authors: Siegel Victoria , Everitt-Reynolds Ann , Siegel Leeann 
Published: July 2019

ABSTRACT
Skin cancer rates are increasing in Ireland, making skin cancer prevention a serious public healthcare issue. We replicated a quasi-experimental study assessing the effectiveness of an educational skin cancer intervention. This intervention was effective as an educational adjunct in teaching American nursing students. The current study, conducted at a college in Ireland, was intended to evaluate its effectiveness among Irish nursing (n = 115) and agricultural (n = 60) students. Students were assigned to one control group and two intervention groups: lecture only, and lecture and skin analyzer machine. It was hypothesized that both the lecture-only and lecture and skin analyzer machine groups would have higher posttest scores than the control group in three domains: “knowledge” (skin cancer knowledge), “behavior” (adoption of sun protective behaviors), and “role” (willingness and self-efficacy to assume the role of teaching others about skin cancer). Our findings supported the study’s hypotheses. Among both nursing and agricultural students, both intervention groups had higher scores than the control groups in posttest measures of behavior, knowledge, and role. This study revealed that both the lecture-only and lecture and skin analyzer machine interventions are effective teaching methodologies to personalize the risk of sun damage.
The Lymphatic Theory of Notalgia Paresthetica
Authors: Willeford Carleen 
Published: July 2019

ABSTRACTNotalgia paresthetica is a dermatologic condition with prominent primarily left unilateral pruritis and raised erythematous rash with hyperpigmentation at the medial or inferior scapula. The etiology is unknown. A comprehensive review of the literature was performed with a structured analysis of previous theories. There is no consistent imaging or functional test to support any of the previously proposed mechanisms. A new theory is presented with a unifying theme of all previous treatments and is supported with results of the first electrical impedance myography testing in this condition.
The Effect of Cognitive-Emotional Intervention on Growth and Posttraumatic Stress in Mothers of Children With Cancer: A Randomized Clinical Trial
Authors: Shakiba Mansour , Latifi Arsalan , Navidian Ali 
Published: July 2019

Background:
To diminish the negative impact and improve the positive outcomes on the parents of children with cancer, it is crucial to attend to their problems. This is especially significant in the case of mothers as the main caregivers. The present study aimed at evaluating the efficiency of cognitive-emotional intervention on growth and posttraumatic stress in mothers of children with cancer hospitalized in the chemotherapy ward.

Procedure:
This randomized clinical trial was conducted on 100 mothers of children with cancer who presented to the chemotherapy ward of a hospital located in southeastern Iran in 2018. The eligible mothers were chosen and randomly assigned to intervention and control groups. Mothers in the intervention group as a whole received 5 sessions of cognitive-emotional intervention. The sessions were held twice a week, each lasting 60 to 90 minutes. Sixteen weeks after the intervention, posttest data were collected through the Posttraumatic Stress Disorder Checklist and Posttraumatic Growth Inventory. The data were then analyzed using SPSS 21 utilizing statistical tests including independent and paired t tests, χ2, and covariance analysis.

Results:
The results show that the mean value of posttraumatic stress in mothers of children with cancer after cognitive-emotional training in the intervention group (25.92±5.29) was significantly lower than that in the control group (44.94±11.92; P=0.0001). Moreover, in the posttest, the mean value of posttraumatic growth in the intervention group (92.06±5.50) was significantly more than that in the control group (62.98±15.08; P=0.0001).

Conclusions:
Alleviating posttraumatic stress, the cognitive-emotional intervention proposed in this research had a significant and positive impact on posttraumatic growth in mothers of children diagnosed with cancer. Therefore, implementing this intervention in the chemotherapy department and throughout the course of the children’s treatment is highly recommended for their caregivers, especially mothers of children diagnosed with cancer.
Comparison of Three Gaze-position Calibration Techniques in First Purkinje Image–based Eye Trackers
Authors: Ntodie Michael , Bharadwaj Shrikant R. , Balaji Swaathi , Saunders Kathryn J. , Little Julie-Anne 
Published: July 2019

SIGNIFICANCE
This study highlights potential differences that can arise in gaze-position estimates from first Purkinje image–based eye trackers based on how individual Hirschberg ratios (HRs) are calculated.

PURPOSE
The purpose of this study was to evaluate the accuracy and repeatability of eccentric-viewing, prism-based, and theoretical techniques that are routinely used to calibrate HR in first Purkinje image–based eye trackers.

METHODS
Hirschberg ratios of 28 participants (18 to 40 years old) were obtained using the PlusOptix PowerRef 3 photorefractor and eye tracker. In the gold standard eccentric-viewing technique, participants viewed eccentric targets (±12°, 4° steps) at 2 m. In the prism-based technique, 4 to 16Δ-D base-out and base-in prisms were placed in 4Δ-D steps before an eye occluded with an infrared filter; the fellow eye fixated a target at 1 m. Each participant's HR was calculated as the slope of the linear regression of the shift in Purkinje image relative to the pupil center for each target eccentricity or induced prism power. Theoretical HR was calculated from the participant's corneal curvature and anterior chamber depth measures. Data collection was repeated on another visit using all three techniques to assess repeatability. Data were also obtained from an Indian cohort (n = 30, 18 to 40 years old) using similar protocols.

RESULTS
Hirschberg ratio ranged from 10.61 to 14.63°/mm (median, 11.90°/mm) in the eccentric-viewing technique. The prism-based and theoretical techniques demonstrated inaccuracies of 12 and 4% relative to the eccentric-viewing technique. The 95% limits of agreement of intrasubject variability were ±2.00, ±0.40, and ±0.30°/mm for the prism-based, eccentric-viewing, and theoretical techniques, respectively (P > .05). Intraclass correlation coefficients (95% confidence interval) were 0.99 (0.98 to 1.00) for eccentric, 0.99 (0.99 to 1.00) for theoretical, and 0.88 (0.74 to 0.94) for prism-based techniques. Similar results were found for the Indian cohort.

CONCLUSIONS
The prism-based and theoretical techniques both demonstrated relative inaccuracies in measures of HR compared with the eccentric-viewing technique. The prism-based technique exhibited the poorest repeatability.