bluuebunny/crossref_metadata_2025_split huggingface dataset:
AN ANONYMOUS ONLINE SURVEY OF THE VIEWS AND ATTITUDES OF MEDICAL STUDENTS AND JUNIOR DOCTORS TOWARDS PHYSICAL ACTIVITY (PA) TEACHING AND PROMOTION
Authors: Bates Sophie , Kipps Courtney 
Published: June 2013

BackgroundPhysical inactivity is the fourth leading cause of mortality globally according to the WHO. Several recent studies have highlighted that physical activity (PA) is inadequately covered during UK medical school training.This study aims to investigate the frequency of PA questions and advice during routine consultations by medical students and junior doctors.MethodsA link to an anonymous online survey was sent to 195 medical students and 68 junior doctors based at a hospital near London. Thirty-four of the fifty responders were medical students.ResultsLess than a quarter of respondents routinely asked about PA levels in the medical history. In contrast, more than 90 percent always asked about tobacco and alcohol.Fear of offending or alienating patients, lack of knowledge and lack of time were the three most common themes identified by responders when asked about the perceived barriers to giving PA advice.Almost half reported having no teaching on PA guidelines. None of the medical students or junior doctors were able to correctly identify the WHO top 4 global mortality risk factors.Discussion/ConclusionsThis study found that clinical medical students and recent graduates rarely include questions or advice about PA in routine medical consultations.Responders tended to under prioritise physical inactivity as a mortality risk factor, and this may reflect a lack of adequate teaching and emphasis on physical inactivity within medical schools.Fear of offending of alienating patients was the most frequently cited barrier to giving PA advice. This may be due to the inexperience of juniors, or view that labelling someone as physically inactive is stigmatising.This study reaffirms previous findings of low levels of teaching about PA in medical schools and identifies lack of knowledge as one of the prime reasons why PA is neglected in routine medical history taking. This calls for urgent action to include PA teaching as a priority in UK medical school teaching.
DIAGNOSTIC VALUE OF OTTAWA ANKLE RULES: SIMPLE GUIDELINES WITH HIGH SENSITIVITY
Authors: Tayeb Ramim 
Published: June 2013

PurposeAnkle and foot injuries are one of the most common acute sport injuries. The objective was to conduct a study to determine the accuracy of the Ottawa Ankle Rules (OARs) to rule out ankle and midfoot fractures in athletes' population presenting with blunt ankle and midfoot injuries.MethodsTwo physicians assessed the OARs in 1156 athletes and 1329 radiographs. Radiography was performed in each patient after clinical evaluation. Findings were recorded. An expert radiologist who was blinded to clinical exanimation interpreted the radiographs.FindingsOf the 1329 radiographs from ankle and midfoot trauma, 93 ankle and 71 midfoot fractures were diagnosed. All cases with a fracture had a positive OARs result (sensitivity 100% 95% CI; 97–100) and of 1165 radiographs without a fracture, the OARs were negative in 439 cases (specificity 37%; 34–40).The corresponding potential savings in radiographs was 33% using the OAR. The interobserver agreement for our two independent assessors was substantial. (κ=0.79, SE=0.11).ConclusionThis validation study of the OARs in an Iranian athletes' population produced similar results than those published previously in various other settings. We confirmed the previous studies that the OARs could be a reliable tool to exclude fractures and could aid sport medicine physicians make proper decisions on field and in clinic about athletes who suffered from ankle and midfoot trauma. Employing OARs would significantly decrease radiography requests and costs.
Semantic and distributed entity search in the web of data
Authors: Neumayer Robert 
Published: June 2013

Both the growth and ubiquitous character of the Internet have had a profound effect on how we access and consume data and information. More recently, the Semantic Web, an extension of the current Web has come increasingly relevant due to its widespread adoption.
The Web of Data (WoD) is an extension of the current web, where not only documents are interlinked by means of hyperlinks but also data in terms of predicates. Specifically, it describes objects, entities or "things" in terms of their attributes and their relationships, using RDF data (and often is used equivalently to Linked Data). Given its growth, there is a strong need for making this wealth of knowledge accessible by keyword search (the de-facto standard paradigm for accessing information online).
The goal of this thesis is to provide new techniques for accessing this data, i.e., to leverage its full potential to end users. We therefore address the following four main issues: a) how can the Web of Data be searched by means of keyword search?, b) what sets apart search in the WoD from traditional web search?, c) how can these elements be used in a sound and effective way?, and d) How can the techniques be adapted to a distributed environment?
To this end, we develop techniques for effectively searching WoD sources. We build upon and formalise existing entity modelling approaches within a generative language modelling framework, and compare them experimentally using standard test collections. We show that these models outperform the current state-of-the-art in terms of retrieval effectiveness, however, this is done at the cost of abandoning a large part of the semantics behind the data. We propose a novel entity model capable of preserving the semantics associated with entities, without sacrificing retrieval effectiveness. We further show how these approaches can be applied in the distributed context, both with low (federated search) and high numbers (Peer-to-peer or P2P) of independent repositories, collections, or nodes.

The main contributions are as follows:

We develop a hybrid approach to search in the Web of Data, using elements from traditional information retrieval and structured retrieval alike.

We formalise our approaches in a language model setting.

We discuss and analyse based on our empirical evaluation and provide insights into the entity search problem.

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A Cohort Study of Metformin Exposure and Survival in Patients with Stage I–III Colorectal Cancer
Authors: Spillane Susan , Bennett Kathleen , Sharp Linda , Barron Thomas I. 
Published: June 2013

Abstract
Background: Preclinical evidence suggests a beneficial effect of metformin in colorectal cancer. This study aimed to investigate associations between metformin exposure and colorectal cancer–specific survival using population-level data.
Methods: Adult patients with stage I–III colorectal cancer diagnosed from 2001 to 2006 were identified from the National Cancer Registry Ireland. Use of metformin and other antidiabetic medications was determined from a linked national prescription claims database. Multivariate Cox regression was used to estimate hazard ratios (HR) with 95% confidence intervals (CI) for associations between prediagnostic metformin exposure (versus nonmetformin antidiabetic drugs) and colorectal cancer–specific mortality. Models were stratified by antidiabetic drug coprescription and intensity of metformin exposure.
Results: The cohort included 207 diabetics who received metformin, 108 diabetics not exposed to metformin, and 3,501 nondiabetic patients. In multivariate analyses, a nonsignificant reduction in colorectal cancer–specific mortality was observed for metformin-exposed patients relative to other treated diabetics (HR, 0.61; 95% CI, 0.37–1.01). In stratified analyses, no significant association was observed for patients receiving low-intensity metformin or metformin in combination with other antidiabetic drugs. High-intensity exclusive metformin use was associated with a significant reduction in colorectal cancer–specific mortality (HR, 0.44; 95% CI, 0.20–0.95).
Conclusions: Significant associations between metformin exposure and colorectal cancer–specific mortality were observed only for high-intensity exclusive metformin use in the diabetic cohort.
Impact: This study provides moderate evidence of an association between metformin exposure and improved colorectal cancer survival in a diabetic population. Additional studies in larger cohorts, with detailed information on diabetes severity, are required to confirm these results. Cancer Epidemiol Biomarkers Prev; 22(8); 1364–73. ©2013 AACR.
Breast cancer mortality trends in England and the assessment of the effectiveness of mammography screening: population-based study
Authors: Mukhtar Toqir K , Yeates David RG , Goldacre Michael J 
Published: June 2013

Objective To investigate whether mortality statistics show an effect of mammographic screening on population-based breast cancer mortality in England. Design Joinpoint regression analyses, and other analyses, of population-based mortality data. Setting Analysis of mortality rates in the Oxford region, UK (1979–2009) because, unlike the rest of England, all causes of death mentioned on each death certificate for its residents (not just the underlying cause) are available prior to commencement of the English National Breast Screening Programme (NHSBSP). In addition, analysis of English national breast cancer mortality rates (1971–2009). Participants Women who died from breast cancer in the Oxford region (1979--2009) and England (1971--2009) Main outcome measures Age-specific mortality rates, and age-standardized mortality rates. Joinpoint regression analysis was used to estimate years (‘joinpoints’) in which trends changed, and annual percentage change between joinpoints, with confidence intervals. Results In the Oxford region, trends for breast cancer mortality based on underlying cause and on mentions were very similar. For all ages combined, mortality rates peaked for both underlying cause and mentions in 1985 and then started to decline, prior to the introduction of the NHSBSP in 1988. Between 1979 and 2009, for mortality measured as underlying cause, rates declined by −2.1% (95% CI −2.7 to −1.4) per year for women aged 40–49 years (unscreened), and by the same percentage per year (−2.1% [−2.4 to −1.7]) for women aged 50–64 years (screened). In England, the first estimated changes in trend occurred prior to the introduction of screening, or before screening was likely to have had an effect (between 1982 and 1989). Thereafter, the downward trend was greatest in women aged under 40 years: −2.0% per year (−2.8 to −1.2) in 1988–2001 and −5.0% per year (−6.7 to −3.3) in 2001–2009. There was no evidence that declines in mortality rates were consistently greater in women in age groups and cohorts that had been screened at all, or screened several times, than in other (unscreened) women, in the same time periods. Conclusions Mortality statistics do not show an effect of mammographic screening on population-based breast cancer mortality in England.
Transtibial Versus Anteromedial Portal Technique in Single-Bundle Anterior Cruciate Ligament Reconstruction
Authors: Wang Hongsheng , Fleischli James E. , Zheng Naiquan (Nigel) 
Published: June 2013

Background: In anterior cruciate ligament (ACL) reconstruction, the transtibial (TT) technique often creates a nonanatomically placed femoral tunnel, which is a frequent cause of surgical failure and postsurgical knee instability. Several studies reported that drilling the femoral tunnel through an anteromedial portal (AMP) yields a more anatomic tunnel position compared with the TT technique. Purpose: To compare the effectiveness of these two surgical techniques in restoring the intact knee joint kinematics during a physiological loading situation. Study Design: Controlled laboratory study. Methods: Twenty-four patients (TT, n = 12; AMP, n = 12; sex, weight, and height matched, and half with dominant leg involved) who underwent unilateral single-bundle ACL reconstruction by the same surgeon were recruited. Twenty healthy patients with no history of lower limb injuries were recruited as the control group. Tibiofemoral joint motion in 6 degrees of freedom (3 translations and 3 rotations) was determined during level walking by using a least mean square–based optimization algorithm. A redundant marker set was used to improve the accuracy of the motion analysis. Knee joint kinematics as well as spatiotemporal parameters were compared between these two techniques. Results: The AMP technique restored the anterior-posterior translation of the knee joint, while the TT technique resulted in significantly greater (TT, 22.2 mm vs controls, 13.2 mm; P < .01) anterior femoral translations than in the healthy controls during the swing phase. Excessive femoral external (tibial internal) rotation (3.8°; P < .05) was found at midstance in the knees that were reconstructed using the TT technique; using the AMP technique, the external rotation offset was greatly reduced during the stance phase. However, knees repaired using the AMP technique were significantly less extended (5°; P < .05) compared with the knees of the controls during the late stance phase. Neither surgical technique restored the superior-inferior femoral translation to the intact level during the swing phase. Conclusion: The AMP technique better restores the anterior-posterior translation during the swing phase and femoral external rotation at midstance than the TT technique does. However, the AMP technique is also correlated with an extension loss during the late stance phase. Clinical Relevance: The AMP femoral tunnel drilling technique can improve overall knee joint stability, but the increased difficulty with full extension may need to be considered.
Emotion Recognition in Mild Cognitive Impairment
Authors: McCade Donna , Savage Greg , Guastella Adam , Hickie Ian B. , Lewis Simon J. G. , Naismith Sharon L. 
Published: June 2013

Background: Impaired emotion recognition in dementia is associated with increased patient agitation, behavior management difficulties, and caregiver burden. Emerging evidence supports the presence of very early emotion recognition difficulties in mild cognitive impairment (MCI); however, the relationship between these impairments and psychosocial measures is not yet explored. Methods: Emotion recognition abilities of 27 patients with nonamnestic MCI (naMCI), 29 patients with amnestic MCI (aMCI), and 22 control participants were assessed. Self-report measures assessed patient functional disability, while informants rated the degree of burden they experienced. Results: Difficulties in recognizing anger was evident in the amnestic subtype. Although both the patient groups reported greater social functioning disability, compared with the controls, a relationship between social dysfunction and anger recognition was evident only for patients with naMCI. A significant association was found between burden and anger recognition in patients with aMCI. Conclusions: Impaired emotion recognition abilities impact MCI subtypes differentially. Interventions targeted at patients with MCI, and caregivers are warranted.
Weight Status in Adolescence Is Associated With Later Life Functional Limitations
Authors: Vasunilashorn Sarinnapha , Martinson Melissa L. 
Published: June 2013

Objectives: This study examines the relationship between weight status in adolescence and later life functional limitations. Method: We use the Wisconsin Longitudinal Study to characterize the relationship between standardized relative body mass ascertained from high school photograph portraits in 1957 and self-reported functional imitations in 2004. Results: Compared to individuals with normal body mass, those who were overweight in high school had poorer later life physical function, with observed gender differences. Women who were underweight in adolescence had better functioning in older adulthood than their normal weight counterparts. This relationship, however, was not found among men. Conclusions: These findings underscore the long-term consequences of being overweight in adolescence on the functional disadvantages conferred in late life.
A relational understanding of sibling experiences of children with rare life-limiting conditions
Authors: Malcolm Cari , Gibson Faith , Adams Sally , Anderson Gillian , Forbat Liz 
Published: June 2013

Mucopolysaccharidoses (MPS) and Batten disease are rare life-limiting conditions (LLCs) characterised by progressive and permanent physical and cognitive decline. The impact of such conditions on families, and notably on siblings, has not yet been described or documented. This paper presents data from a UK-wide study that sought to understand the family experience of supporting a child with the rare degenerative LLCs of MPS and Batten disease. The aim of this paper is to report sibling experiences related to these rare degenerative and progressive conditions, in order to inform the future development of supportive interventions. Eight siblings of children with MPS ( n = 7) and Batten Disease ( n = 1) participated in semi-structured qualitative interviews. A card sort technique was utilised to support and engage the children. Siblings are clearly impacted emotionally, pragmatically and relationally by the ill health of another child in the family. The data indicate four key themes which demonstrate impacts on siblings: perceptions of the condition and its symptoms, impact on daily life, emotional consequences and ways of coping. Siblings often had considerable knowledge of the condition and took on important roles in symptom management. However, these experiences were in the context of managing relationships within the family (often protecting parents from an awareness of how much they knew) and relationships at school (including distraction from learning and being bullied by peers). The data highlight how sibling experiences are generated through a combination of negative disability discourses and support through peers and family members. The data indicate how these features shift as a consequence of witnessing the advancement of their brother’s or sister’s condition and the emotional sequelae of disease progression. Exploration of siblings’ experiences of living with such rare progressive and degenerative LLCs suggest the focus of interventions to support this group should address their emotional health and ways to overcome isolation and build connections with other siblings who share their unique experiences. Critically, the data suggest that sibling support should be cognisant of the trajectory of the illness as well as the family, school and peer relational contexts that siblings inhabit.
Retaining Pharmacists in Rural Canada
Authors: Woodend A. Kirsten , Cooper Janet , Buske Lynda , Marcus Louise , Chauhan Tara S. , Little Lisa , Teperman Lee , Adams Owen 
Published: June 2013

Background: The Multistakeholder Framework of Rurality project was funded by Health Canada's Rural and Remote Health Innovations Initiative. The aim of this project was to develop a tool to assist rural communities with health human resource planning and to help governments and communities in recruiting and retaining health care providers in rural and remote communities. Methods: A national survey was sent to nurses, physicians, and pharmacists living in rural or remote communities to determine, among other factors, satisfaction with their personal and professional lives in those communities. One of the questions asked in the survey was “Do you plan to be in practice in the community in two years?” Results: Completed surveys were returned by 1019 pharmacists. Pharmacists who were married, had children living at home, were between the ages of 35 and 54 years, and had between 6 and 24 years in practice were more likely to say they would remain in the community. Communities where there were better working hours, better availability of coverage and backup, higher earning potential, and greater opportunities were more likely to retain pharmacists, as were communities where there were better opportunities for family members. Pharmacists were also more likely to state an intention to remain in communities where they had a sense of belonging and a sense of being appreciated. Multivariate predictors of pharmacists' intent to remain were children living at home, professional factors, and personal factors. Conclusions/Implications: Despite some study limitations, the results presented here could be used to help communities select pharmacists who are most likely to remain in practice in the communities for longer periods. Community attributes such as distance to large population centres cannot be changed, but attributes that contribute to personal and professional satisfaction could be altered.
On the Front Line of Smoking Cessation: Pharmacists' Practices and Self-Perception
Authors: Brewster Joan M. , Ashley Mary Jane , Laurier Claudine , Dioso Rachel , Victor J. Charles , Ferrence Roberta , Cohen Joanna 
Published: June 2013

Background: Pharmacists can be effective in helping patients to quit smoking, and opportunities for such interaction have been facilitated by legislative change making nicotine replacement therapy (NRT) available without prescription in Canada. However, there are no previous studies of Canadian pharmacists' preparation for, perception of, or practices regarding their roles in smoking cessation. Methods: Practising community pharmacists in four Canadian provinces were surveyed about their tobacco-related education and knowledge, practice environment, perceptions of their roles and practices related to helping people quit smoking, and factors perceived to facilitate tobacco-related practice. Results: A corrected response rate of 72% was obtained, giving a weighted n of 960 responses. Most pharmacists reported good or excellent knowledge of the health effects of smoking and the use of NRT in smoking cessation. Fewer reported being knowledgeable about behavioural approaches to quitting smoking. Advising patients about NRT was seen as a more important role for pharmacists than giving patients pamphlets or behavioural counselling. Pharmacists' reported practices corresponded to their knowledge and judged importance of roles; pharmacists were not proactive in approaching patients about smoking, but when smokers were identified, pharmacists gave brief advice about the use of NRT. Respondents reported that their smoking cessation practice was facilitated by their own knowledge and skills, patients' interest in quitting, opportunities for patient interaction, and the support of pharmacy management for patient counselling. Conclusions: Improving pharmacist education in patient counselling and behavioural approaches to smoking cessation would help to develop skills in initiating discussions about smoking and would give pharmacists a wider range of options to help patients quit smoking.
Corticosteroids and Multiple Sclerosis: To Treat or Not to Treat?
Authors: Namaka Mike , St-Laurent Carol , Vandenbosch Raelene , Gill Ranbir , Ruhlen Dana , Melanson Maria 
Published: June 2013

Although a rare disease, multiple sclerosis (MS) has a high prevalence rate in Canada and affects many Canadians and their families. An autoimmune disease of the central nervous system, it results in the destruction of the myelin sheath that surrounds the nerve axons. High-dose IV steroid therapy is often used to treat an acute exacerbation in MS. Steroids have immunosuppressant effects that work to decrease the autoimmune pathology component of the disease and to reduce the inflammation around the nerve axon, thereby promoting closer contact of the damaged myelin and subsequently partially restoring adequate electrical nerve conduction to reduce symptoms. The high prevalence rate of MS in Canada makes it vital for pharmacists to become more aware of the different aspects of the disease and how these relate to therapy. The pharmacist should be aware of the adverse effects and impact of high-dose IV steroids in MS patients. The purpose of this review is threefold: 1) to provide a better understanding of MS pathology; 2) to contribute a systematic review of steroids; and 3) to assist in the clinical decision-making process and in the counselling requirements for patients on high-dose steroids.