bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and impact of obesity in people with haemophilia: Review of literature and expert discussion around implementing weight management guidelines
Authors: Kahan S. , Cuker A. , Kushner R. F. , Maahs J. , Recht M. , Wadden T. , Willis T. , Majumdar S. , Ungar D. , Cooper D. 
Published: June 2017

Obesity affects more than 35% of Americans, increasing the risk of more than 200 comorbid conditions, impaired quality of life and premature mortality. This review aimed to summarize literature published over the past 15 years regarding the prevalence and impact of obesity in people with haemophilia (PWH) and to discuss implementing general guidelines for weight management in the context of the haemophilia comprehensive care team. Although few studies have assessed the effects of obesity on haemophilia‐specific outcomes, existing evidence indicates an important impact of weight status on lower extremity joint range of motion and functional disability, with potentially important effects on overall quality of life. Data regarding bleeding tendency in PWH with coexisting obesity are largely inconclusive; however, some individuals may experience reduced joint bleeds following moderate weight loss. Additionally, conventional weight‐based dosing of factor replacement therapy leads to increased treatment costs for PWH with obesity or overweight, suggesting pharmacoeconomic benefits of weight loss. Evidence‐based recommendations for weight loss include behavioural strategies to reduce caloric intake and increase physical activity, pharmacotherapy and surgical therapy in appropriate patients. Unique considerations in PWH include bleed‐related risks with physical activity; thus, healthcare professionals should advise patients on types and intensities of, and approaches to, physical activity, how to adjust treatment to accommodate exercise and how to manage potential activity‐related bleeding. Increasing awareness of these issues may improve identification of PWH with coexisting obesity and referral to appropriate specialists, with potentially wide‐ranging benefits in overall health and well‐being.
Co‐morbidities and bleeding in elderly patients with haemophilia—A survey of the German, Austrian and Swiss Society of Thrombosis and Haemostasis Research (GTH)
Authors: Miesbach W. , Reitter‐Pfoertner S.‐E. , Klamroth R. , Langer F. , Wolf H.‐H. , Tiede A. , Siegmund B. , Scholz U. , Müller P. R. , Eichler H. , Pabinger I. 
Published: June 2017

BackgroundNowadays patients with haemophilia survive longer due to improvements in haemophilia care. It has been hypothesized that the bleeding type and frequency may vary with age and are influenced by co‐morbidities and co‐medication in elderly patients.ObjectivesTo investigate a large group of patients older than 60 years of age with haemophilia concerning haemophilia treatment, bleeding pattern changes, co‐morbidities, co‐medication, bleeding sites and patient mortality.MethodsA retrospective multi‐centre data collection study was initiated on behalf of the German, Austrian and Swiss Society of Thrombosis and Haemostasis Research (GTH). Parameters of interest were investigated over the 5 years prior to study entry.ResultsA total of 185 haemophilia patients (mean age, 69.0±7.0 years, 29% with severe haemophilia) were included in the study. Regular prophylaxis was performed in 30% of the patients with severe haemophilia. In total, the annual bleeding rate was 2.49 and in patients with severe haemophilia 5.61, mostly caused by joint bleeds. Hypertension was the most common co‐morbidity, but it occurred significantly less frequently than in an age‐matched general population older than 70 years; 12% of the patients suffered from ischaemic heart disease, and 13% of the patients received anticoagulant or antiplatelet therapy. Within the observation period, 17% of the patients with severe haemophilia developed a higher frequency of bleeding symptoms, which was significantly associated with the use of antiplatelet or anticoagulant drugs.ConclusionsThe most common co‐morbidity of the patient population was hypertension, a considerable part had ischemic heart disease and antiplatelet or anticoagulant drugs.
The PU‐PROM: A patient‐reported outcome measure for peptic ulcer disease
Authors: Liu Na , Lv Jing , Liu Jinchun , Zhang Yanbo 
Published: June 2017

AbstractObjectivePatient‐reported outcome measure (PROM) conceived to enable description of treatment‐related effects, from the patient perspective, bring the potential to improve in clinical research, and to provide patients with accurate information. Therefore, the aim of this study was to develop a patient‐centred peptic ulcer patient‐reported outcome measure (PU‐PROM) and evaluate its reliability, validity, differential item functioning (DIF) and feasibility.MethodTo develop a conceptual framework and item pool for the PU‐PROM, we performed a literature review and consulted other measures created in China and other countries. Beyond that, we interviewed 10 patients with peptic ulcers, and consulted six key experts to ensure that all germane parameters were included. In the first item selection phase, classical test theory and item response theory were used to select and adjust items to shape the preliminary measure completed by 130 patients and 50 controls. In the next phase, the measure was evaluated used the same methods with 492 patients and 124 controls. Finally, we used the same population in the second item reselection to assess the reliability, validity, DIF and feasibility of the final measure.ResultsThe final peptic ulcer PRO measure comprised four domains (physiology, psychology, society and treatment), with 11 subdomains, and 54 items. The Cronbach's α coefficient of each subdomain for the measure was >0.800. Confirmatory factory analysis indicated that the construct validity fulfilled expectations. Model fit indices, such as RMR, RMSEA, NFI, NNFI, CFI and IFI, showed acceptable fit. The measure showed a good response rate.ConclusionsThe peptic ulcer PRO measure had good reliability, validity, DIF and feasibility, and can be used as a clinical research evaluation instrument with patients with peptic ulcers to assess their condition focus on treatment. This measure may also be applied in other health areas, especially in clinical trials of new drugs, and may be helpful in clinical decision making.
Views of general practice staff about the use of a patient‐oriented treatment decision aid in shared decision making for patients with type 2 diabetes: A mixed‐methods study
Authors: Wildeboer Anita , du Pon Esther , Schuling Jan , Haaijer‐Ruskamp Flora M. , Denig Petra 
Published: June 2017

AbstractBackgroundDecision aids can be used to support shared decision making (SDM). A patient‐oriented treatment decision aid (DA) was developed for type 2 diabetes but its use by general practice staff appeared to be limited.ObjectivesTo explore views of practice staff towards SDM and the DA.DesignA mixed‐methods study within the Dutch PORTDA‐diab trial.Setting and participantsIncluded were 17 practices with staff members who were responsible for routine diabetes care and had worked with the DA, and 209 of their patients.MethodsInterviews were conducted focusing on applicability, usefulness and feasibility of the DA. Interviews were tape‐recorded, transcribed verbatim and subjected to content analysis for identifying and classifying views. Patient‐reported data about the use of the DA were collected. Associations between specific views and use of the DA were tested using Pearson point‐biserial correlation.ResultsThe majority of practice staff expressed positive views towards SDM, which was associated with making more use of the DA. Most of the staff expressed that the DA stimulated a two‐way conversation. By using the DA, several became aware of their paternalistic approach. Some staff experienced a conflict with the content of the DA, which was associated with making less use of the DA.ConclusionsThe DA was considered useful by practice staff to support SDM. A positive view towards SDM was a facilitator, whereas experiencing a conflict with the content of the DA was a barrier for making use of the DA.
Getting on the same page: Communication, patient involvement and shared understanding of “decisions” in oncology
Authors: Leppin Aaron L. , Kunneman Marleen , Hathaway Julie , Fernandez Cara , Montori Victor M. , Tilburt Jon C. 
Published: June 2017

AbstractBackgroundPatients and clinicians do not often agree on whether a decision has been made about cancer care. This could be explained by factors related to communication quality and/or the type of decision being made.MethodsWe used a self‐developed coding scheme to code a random sample of 128 encounters in which patients and clinicians either agreed (n=64) or disagreed (n=64) that a cancer care decision was made and tested for associations between concordance and key communication behaviours. We also identified and characterized cancer care decisions by topic and level of patient involvement and looked for trends.ResultsWe identified 378 cancer care decisions across 128 encounters. Explicit decisions were most commonly made about topics wherein decision control could be easily delegated to a clear and present expert (eg either the patient or the clinician). Related to this, level of patient involvement varied significantly by decision topic. Explicit decisions were rarely made in an observable way about social, non‐clinical or self‐management related topics, although patients and clinicians both reported having made a cancer care decision in encounters where no decisions were observed. We found no association between communication behaviours and concordance in our sample.ConclusionsWhat counts as a “decision” in cancer care may be constructed within disparate social roles that leave many agendas unaddressed and decisions unmade. Changing the content of conversations to encourage explicit decisions about self‐management and life context‐related topics may have greater value in enabling shared understanding than promoting communication behaviours among already high‐performing communicators.
Loss of idealism or realistic optimism? A cross‐sectional analysis of dental hygiene students’ and registered dental hygienists’ professional identity perceptions
Authors: Champine JM , Inglehart MR , Furgeson D , Halaris JF , Fitzgerald M , Danciu TE , Kinney JS 
Published: June 2017

AbstractObjectivesThe dental hygiene profession in the U.S. is in the process of establishing a direct access model of care and contributing to the creation of the profession of a dental therapist. The objectives were to analyse the professional role perceptions of dental hygiene students and registered dental hygienists in these times of change. Specifically, it was explored whether dental hygiene students’ current professional identities differ (i) from their expected future identities, and (ii) from dental hygienists’ current and (iii) past identities.MethodsSurvey data were collected from 215 dental hygiene students concerning their present and future role perceptions, and from 352 registered dental hygienists concerning their present and past professional identity perceptions.ResultsStudents’ future professional identity perceptions were even more positive than their very positive current perceptions of their professional role components. Students’ current perceptions of professional pride, professional ambition, work ethic and patient relations were more positive than dental hygienists’ current perceptions of these professional role components. A comparison of students’ current perceptions with dental hygienists’ current and retrospective descriptions showed that students were more positive than dental hygienists in each case.ConclusionsThe fact that dental hygienists had less positive role perceptions than dental hygiene students might lead to the conclusion that a loss of idealism occurs over the course of a professional lifespan. However, dental hygienists actually improved their role perceptions over time and students’ future descriptions were more positive than their current descriptions, supporting the interpretation that realistic optimism dominates professional role perceptions in these times of change.
Distribution and hypoxia‐regulation of haemocyanin in springtails (Collembola)
Authors: Flachsbarth S. , Kruse M. , Burmester T. 
Published: June 2017

AbstractHaemocyanin is the copper‐containing respiratory protein present in many arthropods. In the hexapods, respiratory proteins had long been considered unnecessary as sufficient O2was thought to be obtained via the trachea. Nevertheless, many ametabolous and hemimetabolous hexapod species actually possess haemocyanin. Here we investigated the occurrence of haemocyanin in Collembola (springtails). Haemocyanin was found in 22 collembolan species of the suborders Symphypleona, Tomoceroidea and Entomobryomorpha, demonstrating its widespread occurrence. No haemocyanin was identified in 16 species of these taxa, and it appears to be absent in Poduromorpha. The presence of haemocyanin does not correlate with either the phylogenetic history or lifestyle of the investigated species. We further investigated the function of haemocyanin inFolsomia candida(Entomobryomorpha) by applying different hypoxia regimes. Whereas short‐term (1 h) and mild (10% O2) hypoxia led to a decrease in haemocyanin mRNA, strong hypoxia (24 h, 1.5% O2) resulted in a ∼4300‐fold increase in haemocyanin expression. Hypoxia induction of haemocyanin could not be demonstrated in evolutionarily more advanced Hexapoda, where it is restricted to the embryo. The results indicate (1) an important role of haemocyanin in the oxygen supply ofF. candida, which may be adaptive in the potentially hypoxic environment in the soil, and (2) a change in haemocyanin function in hexapod evolution.
Underuse of risk assessment and overuse of computed tomography pulmonary angiography in patients with suspected pulmonary thromboembolism
Authors: Perera Michael , Aggarwal Leena , Scott Ian A. , Cocks Nicholas 
Published: June 2017

AbstractBackgroundEvidence suggests the potential overuse of computed tomography pulmonary angiography (CTPA) in patients with suspected pulmonary thromboembolism (PTE) in the absence of consistent use of pre‐test clinical prediction rules and D‐dimer assays.AimTo evaluate use and diagnostic utility of clinical prediction rules and D‐dimer assay in patients with suspected PTE and quantify potentially avoidable overuse of CTPA in low risk patients.MethodsA total of 344 consecutive patients undergoing CTPA at a tertiary hospital was studied with regards to the use of D‐dimer assays and clinical prediction rules for PTE. For each patient, a modified Wells score (mWS), revised Geneva score and PISA model were calculated retrospectively; performance characteristics for each rule for PTE were determined with reference to results of CTPA. Results for the mWS and D‐dimer assays (when performed) were used to estimate the overuse of CTPA according to risk category.ResultsUse of a clinical prediction rule was documented in only 5.0% of cases. Of 269 low‐risk patients who had a calculated mWS ≤4, only 64 (23.8%) had a D‐dimer assay performed, with 30 (11.1%) having a PTE on CTPA. Among 75 patients with an mWS >4, 23 (30.7%) had a PTE on CTPA (P < 0.001). Compared to other prediction rules, an mWS>4 had the highest positive predictive value (31.0%) for PTE; all rules demonstrated similar negative predictive values for low‐risk scores (87–89%). After adjusting for an 11% false negative rate for PTE in patients with low‐risk mWS, overuse of CTPA was reported in up to 190 (55.2%) patients.ConclusionMore than 50% of patients with suspected PTE may be subject to unwarranted use of CTPA in the absence of pre‐test clinical prediction rules coupled with D‐dimer assays.
Venous thromboembolism management in Northeast Melbourne: how does it compare to international guidelines and data?
Authors: Lim Hui Y. , Chua Chong C. , Tacey Mark , Sleeman Matthew , Donnan Geoffrey , Nandurkar Harshal , Ho Prahlad 
Published: June 2017

AbstractBackgroundVenous thromboembolism (VTE) is a major cause of morbidity and mortality with significant heterogeneity in its management, both within our local practice and in international guidelines.AimsTo provide a holistic evaluation of ‘real‐world’ Australian experience in the warfarin era, including how we compare to international guidelines.MethodsRetrospective evaluation of VTE from July 2011 to December 2012 at two major hospitals in Melbourne, Australia. These results were compared to recommendations in the international guidelines.ResultsA total of 752 episodes involving 742 patients was identified. Contrary to international guidelines, an unwarranted heritable thrombophilia screen was performed in 22.0% of patients, amounting to a cost of AU$29 000. The duration of anticoagulation was longer compared to international recommendations, although the overall recurrence (3.2/100 person‐years) and clinically significant bleeding rates (2.4/100 person‐years) were comparable to ‘real‐world’ data. Unprovoked VTE (hazard ratio 2.06; P = 0.01) was a risk factor for recurrence, and there was no difference in recurrence between major VTE (proximal deep vein thrombosis (DVT) and/or pulmonary embolism) and isolated distal DVT (3.02 vs 3.94/100 person‐years; P = 0.25). Fourteen patients were subsequently diagnosed with malignancy, and patients with recurrent VTE had increased risk of prospective cancer diagnosis (relative risk 6.68; P < 0.001).ConclusionsWhile our ‘real‐world’ VTE experience during the warfarin era largely correlates with international guidelines, there remains heterogeneity in the management strategies, including excessive thrombophilia screening and longer duration of anticoagulation. This audit highlights the need for national VTE guidelines, as well as prospective auditing of VTE management, in the direct oral anticoagulant era for future comparison.
Supernumeraries in Nicolaides–Baraitser Syndrome
Authors: Al‐Tamimi Bouthayna , Abela Stefan , Jeremiah Huw G. , Evans Robert D. 
Published: June 2017

BackgroundNicolaides–Baraitser Syndrome(NCBRS) is an extremely rare condition which has been reported in only a few cases. NCBRS is a distinct clinical condition with typical clinical features of pre‐ and post‐natal global developmental delay, impaired speech, and seizures. Microcephaly, sparse hair, anteverted alae nasi, undefined philtrum, prominence of distal phalanges and interphalangeal joints, and short metacarpals are also typical of NCBRS.Case ReportThere are no reported cases in the literature of patients with NCBRS presenting with multiple dental impactions, and to the authors’ knowledge, this is the 28th fully documented case of NCBRS and only 75 cases identified as potentially having NCBRS. The clinical features, diagnosis, and course of management are also described.ConclusionAlthough NCBRS is very rare, it is important to assess dental development in view of the possibility of multiple supernumerary teeth which can have detrimental effects on the occlusion.
Physiological processes associated with salinity tolerance in an alfalfa half‐sib family
Authors: Rokebul Anower M. , Peel M. D. , Mott I. W. , Wu Y. 
Published: June 2017

AbstractWe previously reported an alfalfa half‐sib family, HS‐B, with improved salt tolerance, compared to parental plants, P‐B. In this study, we conducted additional experiments to address potential physiological mechanisms that may contribute to salt tolerance in HS‐B. Vegetatively propagated HS‐B and P‐B plants were treated with a nutrient solution (control) or a nutrient solution containing NaCl (EC = 12 dS/m). Shoots and roots were harvested at various time points after treatment for quantification of proline, soluble sugar, and H2O2 using spectrophotometers. Subcellular localization and quantification of Na in roots were conducted using a Na+‐specific dye under a confocal microscope. HS‐B produced 86 and 89% greater shoot and root dry biomass, respectively, compared to parental plants, P‐B, under salinity in the greenhouse. Under saline conditions the HS‐B shoots accumulated 115% and roots 55% more soluble sugars than P‐B counterparts. The non‐saline HS‐B shoots, however, showed 72% less soluble sugars than the non‐saline P‐B plants. Under saline conditions HS‐B accumulated 39% less proline in shoots, while roots accumulated 56% more proline, compared to their P‐B parents. HS‐B plants also showed a greater reduction of stomatal conductance under mild saline stress. HS‐B shoots and roots contained 3–4 times less reactive oxygen species (H2O2) after salt treatment compared to P‐B plants. Sodium localization and distribution analysis using Na+‐specific dye revealed HS‐B plants accumulated 88% and 48% less Na+ in stele and xylem vessels compared to P‐B. The study provides insights into the potential mechanisms that may contribute to salt tolerance in HS‐B: maintaining RWC by accumulating soluble sugars while reducing transpiration, maintaining healthy status by reducing oxidative stresses, and preventing salt toxicity by reducing accumulation of Na+ inside root cells and xylem.
Fabrication of dense barium zirconate fibers by electrospinning with different complex agents
Authors: Yuan Kangkang , Yu Zhichao , Xu Chonghe , Feng Cong , Gan Xinzhu , Wang Xinqiang , Zhu Luyi , Zhang Guanghui , Xu Dong 
Published: June 2017

AbstractAcetic acid, lactic acid, and trifluoroacetic acid were used as complex agents for the preparation of dense barium zirconate fibers with electrospinning method. The formation of lactate when lactic acid was used as complex agent led to a mild decomposition process which was beneficial for the fabrication of dense barium zirconate fibers. High temperature stable intermediate phase of BaF2 appeared when trifluoroacetic acid was used. The intermediate phase of BaF2 was disadvantageous for pure and dense barium zirconate formation. While water vapor preheat treatment for BaF2 contained fibers was an effective way for the fabrication of pure and dense barium zirconate fibers.
Synthesis and photoluminescence characteristics of blue‐green luminescent aluminum oxynitride
Authors: Genji Kumihiro , Uchino Takashi 
Published: June 2017

AbstractAluminum oxynitride (AlON), which can be regarded a nitrogen‐stabilized cubic γ‐Al2O3, has attracted attention in terms of its good mechanical, chemical, and optical stability. Because of its optical inertness, however, photoluminescence (PL) emission from nominally pure AlON has not been carefully investigated and evaluated. In this work, we prepared visibly luminescent AlON by nitridation of γ‐Al2O3 under N2 atmosphere without adding aluminum nitride (AlN) using a high‐frequency induction heating unit. The resulting AlON exhibits a broad PL emission in the blue/green spectral region under excitation with light of ~260 nm. In the luminescent AlON sample, the excitation and emission events will occur at different sites; the electron transfer from the excitation site to the emission site is preceded by the radiative recombination process. It has also been found that the PL peak wavelength shows an anomalous blue shift by ~50 nm with increasing temperature from 78 to 500 K. The observed temperature dependent PL characteristics are governed by thermalization among multiple emitting levels. Aluminum vacancies and oxygen vacancies, both of which are introduced into the crystalline lattice during nitridation without the presence of AlN, are very likely candidates for the excitation and emission centers, respectively. Hence, the present direct nitridation method provides a simple and effective way to add an additional optical functionality to otherwise optically inactive AlON.