bluuebunny/crossref_metadata_2025_split huggingface dataset:
Higher body mass index and larger waist circumference may be predictors of thyroid carcinoma in patients with Hürthle‐cell lesion/neoplasm fine‐needle aspiration diagnosis
Authors: Arduc Ayse , Dogan Bercem Aycicek , Tuna Mazhar Muslum , Tutuncu Yasemin , Isik Serhat , Berker Dilek , Guler Serdar 
Published: October 2014

SummaryObjectiveHigh body mass index (BMI) has been found to be associated with raised thyroid cancer risk, particularly in women. We examined the associations for BMI and waist circumference (WC) with thyroid cancer risk among women with Hürthle‐cell lesion/neoplasm (HLN) on fine‐needle aspiration biopsy (FNAB) with the hypothesis that BMI and WC could guide the management of these challenging indeterminate lesions.MethodsThis cross‐sectional study included 224 women with HLN who underwent thyroidectomy. In all patients, TSH and thyroid auto‐antibodies were evaluated, and thyroid nodule features were recorded. Patients were grouped according to BMI (<30 or ≥30 kg/m2) and WC (<88 or ≥88 cm). Relationships of thyroid cancer with BMI and WC were assessed using logistic regression analysis.ResultsMean weight, BMI (31·26 ± 5·1 vs 26·47 ± 5·9, P < 0·001), WC (98·23 ± 7·6 vs 86·18 ± 11, P = 0·001), and proportion of patients with high BMI (≥30 kg/m2) (65·9 vs 33·8%, P < 0·001) or large WC (≥88 cm) (84·1 vs 47·9%, P < 0·001) were significantly higher in malignant group compared to benign group. In regression analysis, BMI and WC significantly associated with existence of malignancy. Malignancy risk was 3·819‐fold higher (95% CI: 2·068–7·054) in BMI≥30 kg/m2 group compared to BMI<30 kg/m2, which was independent of TSH and age. Large WC was also associated with increased risk (OR = 5·593, 95% CI: 2·736–11·434). Baseline tumour characteristics were similar according to BMI and WC groups.ConclusionsA great BMI and large WC were associated with higher thyroid cancer risk in patients with FNAB diagnosis of HLN. Further studies are needed to use BMI or WC in the management of patients with HLN.
Analysing empowerment‐oriented email consultation for parents: development of the Guiding the Empowerment Process model
Authors: Nieuwboer Christa C. , Fukkink Ruben G. , Hermanns Jo M. A. 
Published: October 2014

AbstractOnline consultation is increasingly offered by parenting practitioners, but it is not clear if it is feasible to provide empowerment‐oriented support in a single session email consultation. Based on the empowerment theory, we developed the Guiding the Empowerment Process model (GEP model) to evaluate text‐based consultation. By content analysis of the email advice (n = 129; 5997 sentences in total), we investigated the feasibility of the newly developed model (inter‐observer agreement, internal consistency and factor structure) and its validity. Concurrent validity was evaluated by comparing coding results using the GEP model and a Social Support model that partially intersects with empowerment. Results showed good inter‐observer reliability and internal consistency of the GEP model. The results provided evidence for its concurrent validity by a significant correlation of the coding results from the GEP model with the Social Support model, although it was also distinctive. All described techniques which practitioners may employ to guide the parental process towards empowerment were observed in the sample. Also, guidance was provided in all components of the empowerment process. Feasibility of the GEP model for content analysis of email consultation in parental support from a theoretical empowerment perspective has been demonstrated.
Multicenter comparison of laboratory performance in cytomegalovirus and Epstein–Barr virus viral load testing using international standards
Authors: Rychert Jenna , Danziger‐Isakov Lara , Yen‐Lieberman Belinda , Storch Gregory , Buller Richard , Sweet Stewart C. , Mehta Aneesh K. , Cheeseman Jennifer A. , Heeger Peter , Rosenberg Eric S. , Fishman Jay A. 
Published: October 2014

AbstractBackgroundInfections with cytomegalovirus (CMV) and Epstein–Barr virus (EBV) remain important in solid organ transplantation. Quantitative viral nucleic acid testing is a major advance to patient management. These assays are limited by a lack of standardization, resulting in viral load measurements that differ among clinical laboratories. The variability in viral load measurements makes interpretation of multicenter clinical trials data difficult. This study compares the current practices in CMV and EBV viral load testing at four large transplant centers participating in multicenter Clinical Trials in Organ Transplantation and the Clinical Trials in Organ Transplantation in Children (CTOT and CTOTC).MethodsViral load testing was performed on well‐defined viral preparations according to standard operating procedures at each site.ResultsAmong centers, CMV viral load testing was accurate compared to WHO International Standards and within acceptable variation for this testing method. Epstein–Barr virus viral load data were more variable and less accurate despite the use of international standards.ConclusionsThese data suggest that comparison of CMV, but not EBV, viral load measurements at these sites is possible using current assays and control standards. Standardization of these assays is facilitated using the WHO International Standards and will allow comparison of viral load results among transplant centers. Assay standardization must be performed prior to initiation of multicenter trials.
Initial combination of linagliptin and metformin compared with linagliptin monotherapy in patients with newly diagnosed type 2 diabetes and marked hyperglycaemia: a randomized, double‐blind, active‐controlled, parallel group, multinational clinical trial
Authors: Ross S. A. , Caballero A. E. , Del Prato S. , Gallwitz B. , Lewis‐D'Agostino D. , Bailes Z. , Thiemann S. , Patel S. , Woerle H.‐J. , von Eynatten M. 
Published: October 2014

AimsTo evaluate glucose‐lowering treatment strategies with linagliptin and metformin in people with newly diagnosed type 2 diabetes and marked hyperglycaemia, a prevalent population for which few dedicated studies of oral antidiabetes drugs have been conducted.MethodsA total of 316 patients, with type 2 diabetes diagnosed for ≤12 months and with glycated haemoglobin (HbA1c) concentration in the range 8.5–12.0%, were randomized 1:1 to double‐blind, free‐combination treatment with linagliptin 5 mg once daily and metformin twice daily (uptitrated to 2000 mg/day maximum) or to linagliptin monotherapy. The primary endpoint was change in HbA1c concentration from baseline at week 24 (per‐protocol completers' cohort: n = 245).ResultsThe mean (standard deviation) age and HbA1c at baseline were 48.8 (11.0) years and 9.8 (1.1)%, respectively. At week 24, the mean ± standard error (s.e.) HbA1c decreased from baseline by –2.8 ± 0.1% with linagliptin/metformin and –2.0 ± 0.1% with linagliptin; a treatment difference of –0.8% (95% confidence interval –1.1 to –0.5; p <0.0001). Similar results were observed in a sensitivity analysis based on intent‐to‐treat principles: adjusted mean ± s.e. changes in HbA1c of –2.7 ± 0.1% and –1.8 ± 0.1%, respectively; treatment difference of –0.9% (95% CI –1.3 to –0.6; p <0.0001). A treatment response of HbA1c <7.0% was achieved by 61 and 40% of patients in the linagliptin/metformin and linagliptin groups, respectively. Few patients experienced drug‐related adverse events (8.8 and 5.7% of patients in the linagliptin/metformin and linagliptin groups, respectively). Hypoglycaemia occurred in 1.9 and 3.2% of patients in the linagliptin/metformin and linagliptin groups, respectively (no severe episodes). Body weight decreased significantly with the combination therapy (–1.3 kg between‐group difference; p =0.0033).ConclusionsLinagliptin in initial combination with metformin in patients with newly diagnosed type 2 diabetes and marked hyperglycaemia, an understudied group, elicited significant improvements in glycaemic control with a low incidence of hypoglycaemia, weight gain or other adverse effects. These results support early combination treatment strategies and suggest that newly diagnosed patients with marked hyperglycaemia may be effectively managed with oral, non‐insulin therapy.
Seeking help for first‐episode psychosis: a family narrative
Authors: Connor Charlotte , Greenfield Sheila , Lester Helen , Channa Sunita , Palmer Colin , Barker Clare , Lavis Anna , Birchwood Max 
Published: October 2014

AbstractAimDelayed help‐seeking can have serious consequences for young people with first‐episode psychosis (FEP), in terms of treatment response and outcome. Young people's narratives about help‐seeking are important to understand why delays occur; however, as the majority of help‐seeking is initiated by family members, through a general practitioner (GP), family narratives are also of interest. The aim of this study was to explore help‐seeking for FEP, including first contact with a GP.MethodA semistructured interview was developed using a topic guide. Framework analysis was used to analyse data and a deductive qualitative method for applied research. The study was set in Birmingham, UK. Participants were interviewed separately by researchers. Joint coding and identification of 14 complete family dyads was then explored for emerging patterns within the family context.ResultsFamily responses to FEP that had an impact on help‐seeking behaviour included withdrawal, normalization, stigma, fear and guilt; poor knowledge of availability, and means of access to mental health services was also important. Help‐seeking was usually instigated by a family member through a GP, although this was not the case for two of our families, and while contact with GP was generally described as a positive experience for several families, it was hindered by poor communication and lack of engagement.ConclusionFamilies play a key role in facilitating help‐seeking for FEP, but attempts are often derailed by complex family responses to illness. Public mental health interventions should focus on increasing community awareness of psychosis and improving access and alternative routes to mental health services. However, improvements will have little impact unless primary care and other help‐seeking sources engage in open and easy dialogue with the families and young people trying to access their specialist services.
Lungeing on hard and soft surfaces: Movement symmetry of trotting horses considered sound by their owners
Authors: Pfau T. , Jennings C. , Mitchell H. , Olsen E. , Walker A. , Egenvall A. , Tröster S. , Weller R. , Rhodin M. 
Published: October 2014

SummaryReasons for performing studyLungeing is often part of the clinical lameness examination. The difference in movement symmetry, which is a commonly employed lameness measure, has not been quantified between surfaces.ObjectivesTo compare head and pelvic movement symmetry between surfaces and reins during lungeing.Study designQuantitative gait analysis in 23 horses considered sound by their owners.MethodsTwenty‐three horses were assessed in‐hand and on the lunge on both reins on hard and soft surfaces with inertial sensors. Seven movement symmetry parameters were quantified and used to establish 2 groups, namely symmetrical (n = 9) and forelimb‐lame horses (n = 14), based on values from straight‐line assessment. Movement symmetry values for left rein measurements were side corrected to allow comparison of the amount of movement symmetry between reins. A mixed model (P<0.05) was used to study effects on movement symmetry of surface (hard/soft) and rein (inside/outside with respect to movement symmetry on the straight).ResultsIn forelimb‐lame horses, surface and rein were identified as significantly affecting all head movement symmetry measures (rein, all P<0.0001; surface, all P<0.042). In the symmetrical group, no significant influence of surface or rein was identified for head movement symmetry (rein, all P>0.245; surface, all P>0.073). No significant influence of surface or rein was identified for any of the pelvic movement symmetry measures in either group.ConclusionsWhile more symmetrical horses showed a consistent amount of movement symmetry across surfaces/reins, horses objectively quantified as lame on the straight showed decreased movement symmetry during lungeing, in particular with the lame limb on the inside of a hard circle. The variation within group questions straight‐line movement symmetry as a sole measure of lameness without quantification of movement symmetry on the lunge, ideally on hard and soft surfaces to evaluate differences between reins and surfaces. In future, thresholds for lungeing need to be determined using simultaneous visual and objective assessment.
Incidence of palmar process fractures of the distal phalanx and association with front hoof conformation in foals
Authors: Faramarzi B. , McMicking H. , Halland S. , Kaneps A. , Dobson H. 
Published: October 2014

SummaryReasons for performing studyRecent studies indicate a high prevalence of fractures of the palmar processes (PP) of the distal phalanx in foals. However, information on the prevalence of such fractures in different breeds and the effect of predisposing factors, such as hoof conformation, is limited.ObjectivesTo examine the prevalence of distal phalanxPPfractures in foals and report the relationship of distal limb and hoof conformation with the prevalence of fracture.Study designLongitudinal study.MethodsFront hooves of 19 Thoroughbred, Quarter Horse and Arabian foals were examined. Digital radiographic and photographic images of the distal aspect of the forelimbs were taken at ∼2.5 month intervals. Five radiographic projections of each limb were as follows: lateromedial; horizontal beam dorsopalmar; dorso60°proximal‐palmarodistal oblique; dorso60°proximo45°lateral‐palmarodistomedial oblique; and dorso60°proximo45°medial‐palmarodistolateral oblique. The relationship between measurements and the prevalence of fractures was assessed by 3‐wayANOVA.ResultsFractures were found in 74% (n = 14) of the foals during the study period. The prevalences of lateralPPand medialPPfractures were not significantly different. Several hoof measurements were associated withPPfractures. Longer dorsal length of the distal phalanx was associated with medialPPfractures, while smaller lateral angle and shorter lateral palmar length were associated with a higher prevalence of lateralPPfractures.ConclusionsThis study revealed a high prevalence ofPPfractures in young foals, particularly in Thoroughbred foals. The hoof conformation may be one of the contributory factors toPPfractures in foals.
Treatment decision‐making among Canadian youth with severe haemophilia: a qualitative approach
Authors: Lane S. J. , Walker I. , Chan A. K. , Heddle N. M. , Poon M.‐C. , Minuk L. , Jardine L. , Arnold E. , Sholapur N. , Webert K. E. 
Published: October 2014

SummaryThe first generation of young men using primary prophylaxis is coming of age. Important questions regarding the management of severe haemophilia with prophylaxis persist: Can prophylaxis be stopped? At what age? To what effect? Can the regimen be individualized? The reasons why some individuals discontinue or poorly comply with prophylaxis are not well understood. These issues have been explored using predominantly quantitative rese‐arch approaches, yielding little insight into treatment decision‐making from the perspectives of persons with haemophilia (PWH). Positioning the PWH as a source of expertise about their condition and its management, we undertook a qualitative study: (i) to explore and understand the lived experience of young men with severe haemophilia A or B and (ii) to identify the factors and inter‐relationships between factors that affect young men's treatment decision‐making. This manuscript reports primarily on the second objective. A modified Straussian, grounded theory methodology was used for data collection (interviews) and preliminary analysis. The study sample, youth aged 15–29, with severe haemophilia A or B, was chosen selectively and recruited through three Canadian Haemophilia Treatment Centres. We found treatment decision‐making to be multi‐factorial and used the Framework method to analyze the inter‐relationships between factors. A typology of four distinct approaches to treatment was identified: lifestyle routine prophylaxis, situational prophylaxis, strict routine prophylaxis and no prophylaxis. Standardized treatment definitions (i.e.: ‘primary’ and ‘secondary’, ‘prophylaxis’) do not adequately describe the ways participants treat. Naming the variation of approaches documented in this study can improve PWH/provider communication, treatment planning and education.
A comparison of the quality of care in accident and emergency departments in England and the Netherlands as experienced by patients
Authors: Bos Nanne , Seccombe Ian J. , Sturms Leontien M. , Stellato Rebecca , Schrijvers Augustinus J.P. , van Stel Henk F. 
Published: October 2014

AbstractBackgroundMeasuring patients’ experiences to determine health‐care performance and quality of care from their perspective can provide valuable evidence for international improvements in the quality of care. We compare patients’ experiences in Accident & Emergency departments (A&E) in England and the Netherlands and discuss the usefulness of this comparison.MethodsA cross‐sectional survey was conducted among patients attending A&Es aged 18 years and older. In England, 134 A&Es were surveyed. In the Netherlands, nine hospitals participated in the study. Main outcome measures were patients’ experiences represented by six domain scores aggregated on the country level or on the A&E level.ResultsIn England, 43 892 completed questionnaires were received (40%). In the Netherlands, 1865 completed questionnaires were received (42%). Three of six domain scores were significantly higher for patients in the Netherlands: ‘waiting time’ [mean scores of 73.8 (NL) versus 67.2 (ENG)], ‘doctors and nurses’ [mean scores of 85.7 (NL) versus 80.6 (ENG)] and ‘your care and treatment’ [mean scores of 82.6 (NL) and 80.2 (ENG)]. The variance among the English A&Es was large. The best and worst practices on five domains were English.ConclusionsThe mean quality of care in the A&E appeared to be better in the Netherlands on three domains, but the best practices were English A&Es. The within‐country differences between A&Es were much larger than differences between countries. Healthcare performance in the A&E can be compared between countries by surveying patients’ experiences, and there seems much to learn across A&Es both within and among countries.
‘I Blame the Parents’: Analysing Popular Support for the Deficient Household Social Capital Transmission Thesis
Authors: Collins Alan , Cox Joe , Leonard Alan 
Published: October 2014

AbstractThis article explores belief in parental deficiency as a causal factor of youth anti‐social behaviour and crime. Empirical interrogation of household interview data from a UK city considers whether there is widespread support for blaming parents. Somewhat surprisingly, lower‐income households and those containing young people, are found to be more likely to consider parental responsibility a problem. Most notably, a tendency to blame the parents strongly associates with a perception that people in the area do not treat each other with respect.
Current management of relapsing‐remitting multiple sclerosis
Authors: Sedal L. , Wilson I. B. , McDonald E. A. 
Published: October 2014

AbstractMultiple sclerosis was without effective disease‐modifying therapy for many years. The introduction of the injectable therapies (interferon and glatiramer acetate) some 20 years ago was considered a major advance. Recent years have heralded a revolution in treatment options with the introduction of intravenous natalizumab and, even more recently, three oral agents. We are currently in a period of determining the best use of these therapies to ensure prevention of disease progression while maintaining patient safety. Despite these new treatments, there are still many patients living with disability as a result of multiple sclerosis and significant attention must be given to symptomatic management.
Amphiregulin promotes the immunosuppressive activity of intrahepatic CD4+ regulatory T cells to impair CD8+ T‐cell immunity against hepatitis B virus infection
Authors: Dai Kai , Huang Ling , Chen Jing , Yang Lihua , Gong Zuojiong 
Published: October 2014

SummaryHepatitis B virus (HBV) infection causes liver diseases and hepatocellular carcinoma. Immunotolerance in HBV‐infected patients is one of the factors that incur failure of HBV clearance and persistent HBV amplification. However, the mechanisms underlying immunotolerance after HBV infection are yet to be thoroughly understood. Using a novel HBV mouse model, we found for the first time that epidermal growth factor receptor (EGFR) is up‐regulated on intrahepatic regulatory T (Treg) cells in HBV‐infected mouse livers. The EGFR‐positive Treg cells are more immunosuppressive than EGFR‐negative Treg cells, demonstrated by higher expression of immunosuppressive cytokines and robust inhibition of CD8+ T‐cell proliferation in vitro. Furthermore, EGFR‐positive Treg cells potently restrain CD8+ T‐cell‐mediated anti‐viral activity, leading to higher HBV burden in hepatocytes. Amphiregulin, a cytokine of the EGF family, is significantly up‐regulated in HBV‐infected livers, but the cellular sources of amphiregulin are still elusive. Amphiregulin promotes the immunosuppressive activity of EGFR‐positive Treg cells in vitro, so as to profoundly inhibit production of anti‐viral components in CD8+ T cells. Taken together, our discovery elucidated a novel mechanism contributing to immunotolerance and viral amplification after HBV infection. Our study may provide new clues for developing therapeutic strategies against HBV infection.
De‐Schooling Art and Design: Illich Redux
Authors: Hardy Tom 
Published: October 2014

AbstractUsing Ivan Illich's seminal works, Deschooling Society and Tools for Conviviality as touchstones, this paper returns to further pursue the thrust of my article in iJADE 25.3 (2006), ‘Domain poisoning: the redundancy of current models of assessment through art’, and might be considered as a more radical addendum. The central strand of Illich's work on ‘deschooling’ is an indictment of the trend to dehumanisation and the counterproductivity which results from institutionalisation. This paper argues that it is time to revisit Illich's call for deschooling with particular reference to the teaching of art and design, and, in turn, to look at the construct of the art teacher for the twenty‐first century as connoisseur/critic/animateur, aloof from the world of domain‐based assessment. As has been suggested many times before within these pages and beyond, accountability makes teachers risk averse. In short, this article suggests that it is time that we took a structural risk and removed this glass ceiling to aspiration while calling for complete deregulation of art and design education and the reinstatement of the art teacher as an autonomous ‘agent of change’.