bluuebunny/crossref_metadata_2025_split huggingface dataset:
Competency based training in robotic surgery: benchmark scores for virtual reality robotic simulation
Authors: Raison Nicholas , Ahmed Kamran , Fossati Nicola , Buffi Nicolò , Mottrie Alexandre , Dasgupta Prokar , Van Der Poel Henk 
Published: November 2016

ObjectivesTo develop benchmark scores of competency for use within a competency based virtual reality (VR) robotic training curriculum.Subjects and MethodsThis longitudinal, observational study analysed results from nine European Association of Urology hands‐on‐training courses in VR simulation. In all, 223 participants ranging from novice to expert robotic surgeons completed 1565 exercises. Competency was set at 75% of the mean expert score. Benchmark scores for all general performance metrics generated by the simulator were calculated. Assessment exercises were selected by expert consensus and through learning‐curve analysis. Three basic skill and two advanced skill exercises were identified.ResultsBenchmark scores based on expert performance offered viable targets for novice and intermediate trainees in robotic surgery. Novice participants met the competency standards for most basic skill exercises; however, advanced exercises were significantly more challenging. Intermediate participants performed better across the seven metrics but still did not achieve the benchmark standard in the more difficult exercises.ConclusionBenchmark scores derived from expert performances offer relevant and challenging scores for trainees to achieve during VR simulation training. Objective feedback allows both participants and trainers to monitor educational progress and ensures that training remains effective. Furthermore, the well‐defined goals set through benchmarking offer clear targets for trainees and enable training to move to a more efficient competency based curriculum.
U.S. Military Children and the Wartime Deployments of Family Members
Authors: MacDermid Wadsworth Shelley , Bailey Keisha M. , Coppola Elizabeth C. 
Published: November 2016

AbstractIn 2014, 1.8 million American children lived in military families, and they represented only a fraction of the U.S. children exposed directly to parents' wartime deployments over the past 15 years. In this article, we summarize recent research about military children in U.S. families and propose directions for research. Emerging from studies across the country are troubling elevations in levels of risky behaviors and mental health problems in military children, particularly when their parents have been deployed. The experiences of children in military families can help us understand risk and resilience not just in military children but in children in the general population.
Urinary tract and genital infections in patients with type 2 diabetes treated with sodium‐glucose co‐transporter 2 inhibitors: A meta‐analysis of randomized controlled trials
Authors: Li Dandan , Wang Tiansheng , Shen Su , Fang Zhenwei , Dong Yue , Tang Huilin 
Published: November 2016

AimsTo evaluate the effects of different sodium‐glucose co‐transporter 2 (SGLT2) inhibitors on the risk of urinary tract infections (UTIs) and genital infections in patients with type 2 diabetes mellitus (T2DM).Materials and methodsWe systematically searched PubMed, Embase, CENTRAL, and ClinicalTrials.gov from inception to October 9, 2016 to identify randomized controlled trials (RCTs) reporting the occurrence of UTIs and genital infections in patients with T2DM treated with SGLT2 inhibitors. Pairwise and network meta‐analyses were performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Meta‐regression was performed to assess explanatory factors that might influence effect size.ResultsA total of 52 RCTs involving 36 689 patients were eligible for our meta‐analysis. Canagliflozin, dapagliflozin and empagliflozin were associated with a higher risk of genital infections than placebo, with ORs ranging from 3.21 (95% CI 2.08‐4.93) for dapagliflozin 2.5 mg to 5.23 (95% CI 3.86‐7.09) for canagliflozin 300 mg. Only dapagliflozin 10 mg led to significantly more UTIs than placebo. The increased risk of UTIs and genital infections seemed to have a dose–response relationship for dapagliflozin only. No factors that had a significant modification effect on these infectious events were detected in meta‐regression analysis.ConclusionsThe present study found that canagliflozin, dapagliflozin and empagliflozin were associated with a significantly higher risk of genital infections compared with placebo and other active treatments. Only dapagliflozin had a dose–response relationship with UTIs and genital infections.
Nutritional considerations for horses with colitis. Part 1: Nutrients and enteral nutrition
Authors: Bozorgmanesh R. , Magdesian K. G. 
Published: November 2016

SummaryThe equine colon is the primary site of fibre digestion and water absorption. It is therefore not surprising that colitis and associated colonic dysfunction can result in severe nutritional derangements, which can be exacerbated by reduced feed intake in affected horses. Dietary management of colitis is important for optimum recovery. In broad terms, it should prioritise provision of nutrients to horses that otherwise have reduced appetites. In some forms, such as right dorsal colitis, as well as those with chronicity, nutritional recommendations include restricting or eliminating long‐stem roughage from the diet and feeding a complete pelleted diet. Voluntary enteral nutrition is preferred, but horses that are not ingesting enough to meet the minimum recommended requirements as outlined, should be fed via nasogastric tube (if tolerated – no reflux, no ileus and no colic present; faecal output present). Parenteral nutrition may be necessary in some cases, as some colitis cases do not tolerate enteral feeding for reasons such as colic, intestinal dysmotility or abdominal distension. Timing and constitution of nutritional intervention is vital and should be tailored to the individual patient to prevent further complications of the disease process.
Acupuncture and traditional Chinese veterinary medicine for treatment of a mare with rectal paralysis
Authors: Sleeper M. M. , Fishman K. , MacKay R. J. , Brown M. , Bauck A. G. , Xie H. 
Published: November 2016

SummaryAn 8‐year‐old Appaloosa mare with rectal paralysis due to a cosmetic ethanol ‘tail block’ was treated with traditional Chinese veterinary medicine treatments including acupuncture and herbal medicine. Her rectal and tail tone gradually improved after the treatment. At 4 months after initial presentation, the mare was able to produce faecal piles on a regular basis, and manual evacuations were no longer needed. Significant improvement was within 30 days of beginning treatment. At 8 months, the owner indicated that the mare had normal defaecation, was able to swish the tail from side to side and lift the tail to urinate, and had no evidence of straining to defaecate or colic.
Influence of Escherichia coli chaperone DnaK on protein immunogenicity
Authors: Ratanji Kirsty D. , Derrick Jeremy P. , Kimber Ian , Thorpe Robin , Wadhwa Meenu , Dearman Rebecca J. 
Published: November 2016

SummaryThe production of anti‐drug antibodies can impact significantly upon the safety and efficacy of biotherapeutics. It is known that various factors, including aggregation and the presence of process‐related impurities, can modify and augment the immunogenic potential of proteins. The purpose of the investigations reported here was to characterize in mice the influence of aggregation and host cell protein impurities on the immunogenicity of a humanized single‐chain antibody variable fragment (scFv), and mouse albumin. Host cell protein impurities within an scFv preparation purified from Escherichia coli displayed adjuvant‐like activity for responses to the scFv in BALB/c strain mice. The 70 000 MW E. coli chaperone protein DnaK was identified as a key contaminant of scFv by mass spectrometric analysis. Preparations of scFv lacking detectable DnaK were spiked with recombinant E. coli DnaK to mimic the process‐related impurity. Mice were immunized with monomeric and aggregated preparations, with and without 0·1% DnaK by mass. Aggregation alone enhanced IgM and IgG2a antibody responses, but had no significant effect on total IgG or IgG1 responses. The addition of DnaK further enhanced IgG and IgG2a antibody responses, but only in the presence of aggregated protein. DnaK was shown to be associated with the aggregated scFv by Western blot analysis. Experiments with mouse albumin showed an overall increase in immunogenicity with protein aggregation alone, and the presence of DnaK increased the vigour of the IgG2a antibody response further. Collectively these data reveal that DnaK has the potential to modify and enhance immunogenicity when associated with aggregated protein.
Case management effectiveness in reducing hospital use: a systematic review
Authors: Joo J.Y. , Liu M.F. 
Published: November 2016

AimThis systematic review synthesizes recent evidence of the effectiveness of case management in reducing hospital use by individuals with chronic illnesses.BackgroundHospital use by individuals with chronic illnesses accounts for 66% of healthcare costs in the United States. its has been cited as care coordination that can reduce healthcare costs; however, its effectiveness in improving hospital use outcomes is contradictory, and no review has yet synthesized recent studies of case management with respect to hospital use outcomes.MethodsThis systematic review followed the Cochrane processes and was guided by use of PRISMA statements. Five electronic databases were searched to obtain randomized controlled trials published within the last 10 years that evaluated case management hospital use as a primary outcome by individuals with chronic illnesses.ResultsTen studies published between 2007 and 2015 were retrieved and assessed for risk of methodological bias. All studies used case management as an intervention, focused on transitional care services and reported hospital use, including readmissions and emergency department and hospital visits, as a primary outcome. Analysis of the studies showed that case management greatly reduced hospital readmissions and emergency department visits.LimitationsOnly studies published in English were searched, and retrieved studies tended to report positive results.ConclusionsThere was strong evidence of significant reductions in hospital use with case management as an intervention. However, other results about the efffectiveness of case management remain mixed; more rigorously designed studies with case management interventions are needed.Implications for nursing and health policyThe complexity and cost of chronic illnesses means that case management should be considered as a tool to improve quality of care and lower healthcare costs.
Association between dermoscopic and reflectance confocal microscopy features of cutaneous melanoma with BRAF mutational status
Authors: Bombonato C. , Ribero S. , Pozzobon F.C. , Puig‐Butille J.A. , Badenas C. , Carrera C. , Malvehy J. , Moscarella E. , Lallas A. , Piana S. , Puig S. , Argenziano G. , Longo C. 
Published: November 2016

AbstractBackgroundMelanomas harbouring common genetic mutations might share certain morphological features detectable with dermoscopy and reflectance confocal microscopy. BRAF mutational status is crucial for the management of metastatic melanoma.ObjectivesTo correlate the dermoscopic characteristics of primary cutaneous melanomas with BRAF mutational status. Furthermore, a subset of tumours has also been analysed for the presence of possible confocal features that might be linked with BRAF status.MethodsRetrospectively acquired dermoscopic and confocal images of patients with melanoma in tertiary referral academic centres: Skin Cancer Unit in Reggio Emilia and at the Melanoma Unit in Barcelona. Kruskal–Wallis test, logistic regressions, univariate and multivariate analyses have been performed to find dermoscopic and confocal features significantly correlated with BRAF mutational status.ResultsDermoscopically, the presence of irregular peripheral streaks and ulceration were positive predictors of BRAF‐mutated melanomas with a statistically significance value, while dotted vessels were more represented in wild‐type melanomas. None of the evaluated reflectance confocal microscopy features were correlated with genetic profiling.ConclusionsUlceration and irregular peripheral streaks represent dermoscopic feature indicative for BRAF‐mutated melanoma, while dotted vessels are suggestive for wild‐type melanoma.
Using transient elastography to predict hepatocellular carcinoma recurrence after radiofrequency ablation
Authors: Lee Yu Rim , Park Soo Young , Kim Seung Up , Jang Se Young , Tak Won Young , Kweon Young Oh , Kim Beom Kyung , Park Jun Yong , Kim Do Young , Ahn Sang Hoon , Han Kwang‐Hyub , Hur Keun 
Published: November 2016

AbstractBackground and AimLiver stiffness (LS) value determined using transient elastography (TE) can be used to assess the degree of liver fibrosis. The study investigated whether TE can predict the recurrence of hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA).MethodsThis study retrospectively enrolled 228 patients with HCC who received TE and RFA as the first‐line treatment for HCC between 2008 and 2015. Cox regression analysis was used to identify independent predictors of HCC recurrence.ResultsThe median age of the study population (170 men and 58 women) was 61 years. During the study period, HCC recurrence and mortality developed in 125 (54.8%) and 37 (16.2%) patients after RFA, respectively. Liver cirrhosis, platelet count, multiple tumors, and LS value were the independent predictors of HCC recurrence. When the study population was stratified into early (< 12 months) and late (≥ 12 months) recurrence groups, LS value was an independent predictor of late recurrence, along with liver cirrhosis and spleen diameter. The risk of late recurrence was higher in patients with LS values of ≥ 13 kPa than in those with LS values of < 13 kPa (adjusted hazard ratio [HR] = 4.507, 95% confidence interval [CI] 2.131–7.724, P < 0.001). Recurrence was the only predictor of overall survival (HR = 18.583, 95% CI 2.424–142.486, P = 0.005).ConclusionsFindings of this study suggest that LS measurement using TE can be a useful predictor of HCC recurrence after RFA.
Preparing Family Caregivers to Recognize Delirium Symptoms in Older Adults After Elective Hip or Knee Arthroplasty
Authors: Bull Margaret J. , Boaz Lesley , Maadooliat Mehdi , Hagle Mary E. , Gettrust Lynn , Greene Maureen T. , Holmes Sue Baird , Saczynski Jane S. 
Published: November 2016

ObjectivesTo test the feasibility of a telephone‐based intervention that prepares family caregivers to recognize delirium symptoms and how to communicate their observations to healthcare providers.DesignMixed‐method, pre–post quasi‐experimental design.SettingA Midwest Veterans Affairs Medical Center and a nonprofit health system.ParticipantsForty‐one family caregiver‐older adult dyads provided consent; 34 completed the intervention.InterventionFour telephone‐based education modules using vignettes were completed during the 3 weeks before the older adult's hospital admission for elective hip or knee replacement. Each module required 20 to 30 minutes.MeasurementsInterviews were conducted before the intervention and 2 weeks and 2 months after the older adult's hospitalization. A researcher completed the Confusion Assessment Method (CAM) and a family caregiver completed the Family Version of the Confusion Assessment Method (FAM‐CAM) 2 days after surgery to assess the older adults for delirium symptoms.ResultsFamily caregivers’ knowledge of delirium symptoms improved significantly from before the intervention to 2 weeks after the intervention and was maintained after the older adult's hospitalization. They also were able to recognize the presence and absence of delirium symptoms in the vignettes included in the intervention and in the older adult after surgery. In 94% of the cases, the family caregiver rating on the FAM‐CAM approximately 2 days after the older adult's surgery agreed with the researcher rating on the CAM. Family caregivers expressed satisfaction with the intervention and stated that the information was helpful.ConclusionDelivery of a telephone‐based intervention appears feasible. All family caregivers who began the program completed the four education modules. Future studies evaluating the effectiveness of the educational program should include a control group.
Immunomodulation by helminths: Similar impact on type 1 and type 2 diabetes?
Authors: Surendar J. , Indulekha K. , Hoerauf A. , Hübner M. P. 
Published: November 2016

SummaryThe incidence of both type 1 (T1D) and type 2 diabetes (T2D) is drastically increasing, and it is predicted that the global prevalence of diabetes will reach almost 600 million cases by 2035. Even though the pathogenesis of both types of diabetes is distinct, the immune system is actively involved in both forms of the disease. Genetic and environmental factors determine the risk to develop T1D. On the other hand, sedentary life style, surplus of food intake and other lifestyle changes contribute to the increase of T2D incidence. Improved sanitation with high‐quality medical treatment is such an environmental factor that has led to a continuous reduction of infectious diseases including helminth infections over the past decades. Recently, a growing body of evidence has implicated a negative association between helminth infections and diabetes in humans as well as animal models. In this review, we discuss studies that have provided evidence for the beneficial impact of helminth infections on T1D and T2D. Possible mechanisms are presented by which helminths prevent T1D onset by mitigating pancreatic inflammation and confer protection against T2D by improving insulin sensitivity, alleviating inflammation, augmenting browning of adipose tissue and improving lipid metabolism and insulin signalling.
Use of the gonadotropin‐releasing hormone (GnRH) stimulation test to monitor gonadal function in intact adult male cats
Authors: Romagnoli S , Baldan A , Righetti C , Fontaine C , Scenna L , Badon T , Stelletta C , Milani C , Cecchetto M , Mollo A 
Published: November 2016

ContentsThe gonadotropin‐releasing hormone (GnRH) stimulation test is a common procedure used to investigate normality of the pituitary‐gonadal axis in mammals. There is very little information on the technique, its efficacy and side effects in small animals and in particular no information for male cats. In dogs, such test is performed by intravenous (IV) administration. With cats, the number of times the animal needs to be restrained for blood sampling should be the least possible. The purpose of this study was to assess efficacy and side effects of the GnRHstimulation test in tomcats comparing theIVwith the intramuscular (IM) route of administration. A GnRHstimulation test was performed in eight adult tomcats throughIMorIVadministration of 50 μg gonadorelin. The response of the pituitary‐gonadal axis was assessed by measuring serum testosterone on blood samples collected prior to and 1 hr following treatment. When considering each single group of cats, the post‐stimulation serum testosterone values were significantly higher than the pre‐treatment ones (p < .05). When comparing the two groups of cats, basal testosterone concentrations did not differ, and also post‐GnRHtestosterone concentrations did not differ. In conclusion, in the cats of our study, the GnRHstimulation test produced the same results following theIMor theIVroute of administration. Therefore, in tomcats, theIMroute can be considered as effective as theIVone and should be preferred when doing a GnRHtest.
Narrative skills predict peer adjustment across elementary school years
Authors: Davidson Alice J. , Walton Marsha D. , Kansal Bhavna , Cohen Robert 
Published: November 2016

AbstractThe importance of peer adjustment in middle childhood coincides with developing social cognitive and discursive skills that include the ability to make personal narrative accounts. Authoring personal stories promotes attention to the sequence of events, the causal connections between events, the moral significance of what has happened, and the motives that drive human action: these skills may be critical for the establishment and maintenance of satisfying peer relationships during elementary school. This study extended previous research by considering whether narrative skills in written stories about peer interactions predicted peer adjustment. As part of an ongoing longitudinal study, 92 children wrote narratives about peer experiences and completed surveys on measures of peer adjustment for two school years. Cross‐lagged panel models indicated that chronological and thematic coherence and reports of moral concerns in narratives in the first year of the study contributed to lower peer disliking in the subsequent academic year. Reports of motives in Year 1 narratives contributed to lower levels of loneliness and peer victimization in Year 2. Writing personal narratives that are coherent and attentive to moral concerns and motives may be especially beneficial for children who have difficulty connecting with peers. We discuss implications for classroom practices.
Daily links between school problems and youth perceptions of interactions with parents: A diary study of school‐to‐home spillover
Authors: Bai Sunhye , Reynolds Bridget M. , Robles Theodore F. , Repetti Rena L. 
Published: November 2016

AbstractThis study examined how academic and peer problems at school are linked to family interactions at home on the same day, using eight consecutive weeks of daily diary data collected from early adolescents (60% female; M age = 11.28, SD = 1.50), mothers and fathers in 47 families. On days when children reported more academic problems at school, they, but not their parents, reported less warmth and more conflict with mothers, and more conflict and less time spent around fathers. These effects were partially explained by same‐day child reports of higher negative mood. Peer problems were less consistently associated with parent‐child interactions over and above the effects of academic problems that day. A one‐time measure of parent‐child relationship quality moderated several daily associations, such that the same‐day link between school problems and child‐report of family interactions was stronger among children who were closer to their parents.