bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of psychosocial problems in children with type 1 diabetes and their families: the added value of using standardised questionnaires in addition to clinical estimations of nurses and paediatricians
Authors: Boogerd Emiel A , Damhuis Anouk MA , van Alfen‐van der Velden Janiëlle (A)AEM , Steeghs Marley CCH , Noordam Cees , Verhaak Chris M , Vermaes Ignace PR 
Published: March 2015

Aims and objectivesTo investigate the assessment of psychosocial problems in children with type 1 diabetes by means of clinical estimations made by nurses and paediatricians and by using standardised questionnaires.BackgroundAlthough children with type 1 diabetes and their parents show increased risk for psychosocial problems, standardised assessment of these problems lacks in diabetes care.DesignBy comparing these different modes of assessment, using a cross‐sectional design, information about the additional value of using standardised questionnaires is provided.MethodsParticipants were 110 children with type 1 diabetes (aged 4–16), their parents, and healthcare professionals. Children filled out the Strengths and Difficulties Questionnaire and the Paediatric Quality of Life Inventory, Diabetes Module. Parents filled out the Strengths and Difficulties Questionnaire parent‐report and the Parenting Stress Index. Independently, nurses and paediatricians filled out a short questionnaire, which assessed their clinical estimations of the children's psychosocial problems and quality of life, and parents' levels of parenting stress. Reports of children and parents were compared to clinical estimations.ResultsChildren in our sample showed more psychosocial problems and lower health‐related quality of life than their healthy peers. In approximately half of the children, dichotomous estimations by healthcare professionals and dichotomised reports by patients and parents were in agreement. In 10% of the children, no psychosocial problems were present according to professionals' estimations, although patients and parents‐reported psychosocial problems. In 40%, psychosocial problems were present according to professionals' estimations, although parents and patients did not report psychosocial problems.ConclusionChildren with type 1 diabetes show more psychosocial problems than healthy children. Professionals seem to tend towards overestimating psychosocial problems.Relevance to clinical practiceExtending the assessment of psychosocial problems with routine screening on patient‐reported outcomes, using validated questionnaires, could be of additional value in tailoring care to the needs of the individual child and parents.
Potential utilization of expanded function dental auxiliaries to place restoratives
Authors: Darling Brian G. , Kanellis Michael J. , McKernan Susan C. , Damiano Peter C. 
Published: March 2015

AbstractObjectivesThe Affordable Care Act is predicted to increase dental benefits coverage for millions of Americans. Utilization of expanded function dental auxiliaries (EFDAs) can contribute to increased workforce capacity. Iowa currently allows EFDAs to perform certain nonrestorative procedures. This study investigated dentists' willingness to use auxiliaries for restorative procedures in order inform recent discussions about expanding scope of practice for EFDAs to include such procedures.MethodsThis study examined responses from 677 primary care dentists who responded to the 2013 Survey of Iowa Dentists (response rate = 59 percent). The authors performed univariate and bivariate analyses (χ2 and t‐tests) to examine characteristics of dentists who indicated willingness to utilize an auxiliary for newly proposed restorative functions.ResultsThirty‐seven percent of respondents indicated they would delegate at least one of the newly proposed restorative functions to an auxiliary. Pediatric dentists were significantly more likely to be willing to delegate (P = 0.042). Placing stainless steel crowns was most acceptable (31.9 percent of respondents), followed by amalgam restorations (22.3 percent), and composites (18.6 percent).ConclusionsMany dentists are willing to delegate reversible restorative procedures. Increasing scope of practice for auxiliaries may increase capacity of the existing dental workforce and improve access for newly insured populations. Expanding scope of practice for dental auxiliaries offers a viable mechanism to rapidly increase states' dental capacity in response to rising demands for dental care, including newly insured Medicaid populations.
Dyspareunia and Sexual Dysfunction after Vaginal Delivery in Thai Primiparous Women with Episiotomy
Authors: Chayachinda Chenchit , Titapant Vitaya , Ungkanungdecha Anuree 
Published: March 2015

Abstract

Introduction
Episiotomy remains commonly practiced in Thailand. There are limited data on its impacts on sexuality among Asian women during the first postdelivery year.

Aims
The aim was to study dyspareunia and sexual function at 3–12 months after vaginal delivery in Thai primiparous women with episiotomy.

Methods
A total of 190 participants were approached on Day 2 postpartum. Of these, 93 sexually active women were evaluated for dyspareunia and sexual function at 3 months by using 10-cm visual analog scale and the validated Thai version of Female Sexual Function Index (TFSFI). TFSFI &lt; 26.5 was defined as having potential sexual dysfunction. At 6 and 12 months, sexual function was evaluated by telephone interview.

Main Outcome Measures
The prevalence of dyspareunia at 3 months and the changes of TFSFI scores during the first postdelivery year were the main outcome measures.

Results
The average age of the participants, over 90% of whom were high school finishers, was 24. Their partners were around 3 years older, and the median partnership duration was 3 years. At 3 months, 30.1% of participants reported dyspareunia. There was no association between dyspareunia and the following characteristics: pre-pregnancy dyspareunia, newborn's head circumference and birthweight and breast-feeding (P &gt; 0.05 for all). Sexual dysfunction was demonstrated in 66.7% at 3 months, 31.0% at 6 months, and 14.9% at 12 months. From 3 to 12 months, the median TFSFI scores in all domains increased significantly. There was no difference of the scores in all domains at 3 and 12 months between women with and without dyspareunia at 3 months. However, at 6 months, those without dyspareunia had better scores in pain, orgasm, satisfaction, and total scores (P &lt; 0.05 for all).

Conclusion
Dyspareunia at 3 months is common in Thai primiparous women with episiotomy. Those with dyspareunia have a slower resumption of normal sexual function.
An expert panel‐based study on recognition of gastro‐esophageal reflux in difficult esophageal pH‐impedance tracings
Authors: Smits M. J. , Loots C. M. , van Wijk M. P. , Bredenoord A. J. , Benninga M. A. , Smout A. J. P. M. 
Published: March 2015

AbstractBackgroundDespite existing criteria for scoring gastro‐esophageal reflux (GER) in esophageal multichannel pH‐impedance measurement (pH‐I) tracings, inter‐ and intra‐rater variability is large and agreement with automated analysis is poor. To identify parameters of difficult to analyze pH‐I patterns and combine these into a statistical model that can identify GER episodes with an international consensus as gold standard.MethodsTwenty‐one experts from 10 countries were asked to mark GER presence for adult and pediatric pH‐I patterns in an online pre‐assessment. During a consensus meeting, experts voted on patterns not reaching majority consensus (>70% agreement). Agreement was calculated between raters, between consensus and individual raters, and between consensus and software generated automated analysis. With eight selected parameters, multiple logistic regression analysis was performed to describe an algorithm sensitive and specific for detection of GER.Key ResultsMajority consensus was reached for 35/79 episodes in the online pre‐assessment (interrater κ = 0.332). Mean agreement between pre‐assessment scores and final consensus was moderate (κ = 0.466). Combining eight pH‐I parameters did not result in a statistically significant model able to identify presence of GER. Recognizing a pattern as retrograde is the best indicator of GER, with 100% sensitivity and 81% specificity with expert consensus as gold standard.Conclusions & InferencesAgreement between experts scoring difficult impedance patterns for presence or absence of GER is poor. Combining several characteristics into a statistical model did not improve diagnostic accuracy. Only the parameter ‘retrograde propagation pattern’ is an indicator of GER in difficult pH‐I patterns.
MUC1/SEC and MUC1/Y overexpression is associated with inflammation in Sjögren's syndrome
Authors: Sung HH , Castro I , González S , Aguilera S , Smorodinsky NI , Quest AFG , Bahamondes V , Alliende C , Cortés J , Molina C , Urzúa U , Barrera M‐J , Hermoso M , Herrera L , Leyton C , González M‐J 
Published: March 2015

ObjectivesTo evaluate the expression and localization of MUC1/SEC and MUC1/Y isoforms in labial salivary glands (LSG) from Sjögren's syndrome patients (SS patients), as well as their in vitro expression induced by cytokines.Subjects and methodsLabial salivary gland from 27 primary SS patients and 22 non‐SS sicca subjects were studied. Relative MUC1/SEC and MUC1/Y mRNA levels were determined by qPCR and protein levels by Western blotting. Induction of mucin mRNAs was assayed in vitro. Immunohistochemistry was used for localization.ResultsRelative MUC1/SEC and MUC1/Y mRNA and protein levels were significantly higher in LSG from SS patients. These mRNAs were induced by cytokines. MUC1/SEC and MUC1/Y were detected in acini apical region of control LSGs, and significant cytoplasmic accumulation was observed in acini of SS patients. MUC1/Y localized in acinar nuclei and cytoplasm of inflammatory cells of LSG from SS patients. A strong positive correlation was observed between cellular MUC1/SEC levels and glandular function determined by scintigraphy.ConclusionsWe show for the first time that MUC1/SEC and MUC1/Y are expressed in LSG of both SS patients and non‐SS sicca subjects. The observed overexpression and aberrant localization of MUC1/SEC and MUC1/Y and their induction by pro‐inflammatory cytokines may favor the perpetuation of the inflammatory environment that disrupts the salivary glandular homeostasis in SS patients.
Electrocardiographic and Electrophysiologic Effects of Dexmedetomidine on Children
Authors: ERGUL YAKUP , UNSAL SERKAN , OZYILMAZ ISA , OZTURK ERKUT , CARUS HAYAT , GUZELTAS ALPER 
Published: March 2015

BackgroundDexmedetomidine (DEX) is a highly selective alpha‐2‐adrenergic agonist approved for short‐term sedation and monitored anesthesia care in adults. Its effects on the electrocardiography and cardiac conduction tissue are not well described in the literature. Therefore, we aimed to characterize the electrocardiographic and electrophysiologic effects of DEX in children.MethodsTwenty children (11 boys and nine girls) between the ages of eight and 17 undergoing electrophysiology study and ablation of the supraventricular tachycardia had hemodynamic and cardiac electrophysiologic variables measured before and during the administration of DEX (1 microgram/kg IV over 10 minutes followed by a 10‐minute continuous infusion of 0.5 microgram/kg/h).ResultsA significant decrease in heart rate was seen after the administration of DEX, but the systolic‐diastolic‐mean arterial pressure, respiratory rate, and end‐tidal carbon dioxide did not change. Corrected sinus node recovery times and baseline sinus cycle lengths, which are markers of sinus nodal function, were both lengthened with the administration of DEX. Atrioventricular (AV) nodal function, as evidenced by the Wenckebach cycle length, the ventriculoatrial block cycle length, and AV nodal effective refractory periods, was lengthened significantly. We also found that DEX increased the atrial refractory period and diminished atrial excitability.ConclusionsDEX significantly depressed sinus and AV nodal function in pediatric patients without significant electrocardiogram interval changes, other than a trend toward lower heart rates. Although no spontaneous AV nodal block and no clinically significant bradycardia were seen, we recommend that DEX be used with caution in patients at risk for bradycardia and/or AV nodal dysfunction due to its associated comorbidities.
Informed consent procedures with cognitively impaired patients: A review of ethics and best practices
Authors: Fields Lindy Marie , Calvert James Douglas 
Published: March 2015

AimsThe objectives of this article are to discuss ethical issues of informed consent in cognitively impaired patients and review considerations for capacity determination. We will also discuss how to evaluate capacity, determine competence, and obtain informed consent when a patient is deemed incompetent. This review emphasizes how to carry out informed consent procedures when capacity is questionable and discusses measures supported for use when determining cognitively impaired patients' ability to consent.MethodsInformation was gathered from medical and psychological codes of ethics, peer‐reviewed journals, published guidelines from health‐care organizations (e.g.,AmericanMedicalAssociation), and scholarly books.GoogleScholar andPsycINFOwere searched for articles related to ‘informed consent’ and ‘cognitive impairment’ published inEnglish between 1975 and 2014. Relevant sources referenced in retrieved publications were subsequently searched and reviewed.ResultsWe selected 49 sources generated by our search. Sources were included in our review if they presented information related to at least one of our focus areas. These areas included: review of informed consent ethics and procedures, review of cognitive impairment evaluations, recommendations for measuring cognitive capacity, and alternative forms of informed consent.ConclusionsPatients' cognitive impairments can hinder the ability of patients to understand treatment options. Evaluating the capacity of patients with cognitive impairment to understand treatment options is vital for valid informed consent and should be guided by best practices. Thus, proper identification of patients with questionable capacity, capacity evaluation, and determination of competence, as well as reliance upon appropriate alternative consent procedures, are paramount.
Prevalence and determinants of declining versus stable hemoglobin levels in whole blood donors
Authors: Nasserinejad Kazem , van Rosmalen Joost , van den Hurk Katja , Baart Mireille , Hoekstra Trynke , Rizopoulos Dimitris , Lesaffre Emmanuel , de Kort Wim 
Published: March 2015

BACKGROUNDA too short recovery time after blood donation results in a gradual depletion of iron stores and a subsequent decline in hemoglobin (Hb) levels over time. This decline in Hb levels may depend on individual, unobserved characteristics of the donor.STUDY DESIGN AND METHODSWe used a data set of 5388 Dutch blood donors from the Donor InSight study. The statistical analysis is based on a Bayesian growth mixture model, which assumes that each donor belongs to one of several groups. Each group implies a different Hb trajectory, and donors with similar longitudinal trajectories belong to the same group. Analyses were performed for male and female donors separately.RESULTSFor both sexes the model identified four groups of donors. Stable Hb trajectories were found among 14% of male donors and 15% of female donors; declining Hb trajectories were observed in the remaining groups of donors. The percentage of donor deferrals differed strongly between groups.CONCLUSIONThe model can be used to predict to which group a donor belongs, and this prediction can be updated after each donation. This is of high practical importance because early identification of donors with declining Hb levels could help to tailor donation intervals and to prevent iron deficiency and donor deferrals.
Efficacy of Postoperative Antimicrobial Use for Clean Orthopedic Implant Surgery in Dogs: A Prospective Randomized Study in 100 Consecutive Cases
Authors: Pratesi Andrea , Moores Andrew P. , Downes Ciara , Grierson James , Maddox Thomas W. 
Published: March 2015

ObjectivesTo investigate whether administration of postoperative oral antimicrobial drugs has a beneficial effect on preventing surgical site infections (SSI) in clean orthopedic surgery involving stainless steel plating systems.Study DesignRandomized prospective clinical study.AnimalsDogs (n = 97).MethodsOne hundred consecutive cases (97 dogs) that had clean orthopedic surgery requiring stainless steel plate fixation were randomly assigned using a random number generator to either YES group (administration of postoperative oral antimicrobials) or NO group (no administration of postoperative oral antimicrobials). Dogs in YES group were administered oral cefalexin or potentiated amoxicillin for 7 days, whereas dogs in NO group were discharged without oral antibiotics. Minimum follow‐up was 12 months. Multivariable logistic regression was used to determine risk factors for SSI.ResultsOverall postoperative infection rate was 12.9%. Infection occurred in 2 cases (4.3%) administered postoperative oral antimicrobials and in 10 cases (21.3%) not administered postoperative antimicrobials. Total anesthetic time and use of oral antimicrobials were the only significant factors associated with SSI. Use of postoperative antimicrobials was associated with a significant reduction in the risk of infection by ~84% and risk of infection was increased by ~2% for each minute increase in anesthesia time.ConclusionsAdministration of oral postoperative antimicrobials had a protective effect against development of SSI in clean orthopedic implant surgery.
Experimental Study of the Swirling Flow in the Internal Volute of a Centrifugal Compressor
Authors: Ayder E. , Van Den Braembussche R. 
Published: March 2015

A detailed study of the swirling flow in a rectangular volute of a centrifugal compressor is presented. The 3D flow field has been measured by means of a five hole probe at six different cross sections for three different operating points of the compressor.
For high mass flow, the large radial velocity component at the diffuser exit creates a strong swirling flow with a forced vortex type of velocity distribution. The centrifugal force resulting from this motion is balanced by the increase of static pressure from the swirl center to the volute wall. Due to the effect of circumferential curvature a zone of high through flow velocity occurs next to the volute inner wall.
Less swirl is generated for optimum mass flow resulting in smaller pressure gradients over the cross section. Low energy fluid accumulates near the inner wall of the cross section.
For low mass flow, a large region of separated flow is observed and more uniform static pressure has been measured over the cross section.
The effect of the tongue on the flow structure in the first and last cross section is also discussed.
This study is the follow-up of previous studies described in ASME paper 89-GT-183 and 90-GT-49. The results obtained verify the previous studies and provide a better understanding of the flow structure inside internal volutes of rectangular cross section.
A Contribution to the Study of Exit Flow Angle in Radial Turbines
Authors: Brizuela Edward A. 
Published: March 2015

The emergence and evolution of relative whirling motions in the exducer region of an Inward Flow Radial Turbine is discussed. Existing models of relative motion are reviewed and expanded by consideration of the effect of centrifugal forces differences arising from velocity gradients. It is shown that the often observed phenomenon of outlet overturn/underturn is inherent to the use of straight-helix exducers.
Explicit mathematical relationships between exit velocities and radius are not available. If, however, such relationships could be considered linear, it is shown that two new reference radii may be identified such that the net outlet properties can be measured or computed at these locations as lump parameters. These radii are different from the often used hydraulic radius.
The new models and reference radii are verified using published experimental data.
Simulation of an Advanced Twin-Spool Industrial Gas Turbine
Authors: Zhu Ping , Saravanamuttoo H. I. H. 
Published: March 2015

A full range mathematical model of the LM-1600 gas turbine has been developed, for future use in EHM studies. No data was available from the manufacturer other than sales brochures giving some design and off-design performance. The model was developed using generalized component characteristics and shows excellent agreement with field data from a pipeline operator.
A new method has been developed for doing the matching calculations, starting from the turbine (hot) end rather than from the compressor operating point. This method permits solution on a PC, and can be used for studying the full range of operating conditions and the development of fault matrices.
3-D Loss Prediction Based on Secondary Flow and Blade Shear Layer Interaction
Authors: Katramatos D. T. , Kaldellis J. K. 
Published: March 2015

The 3-D loss distribution along axial turbomachines has been investigated in the present work. For this purpose, our well documented secondary flow calculation method has been interactively coupled with our fast blade-to-blade shear layer calculation code, in order to predict the complete secondary flow and profile loss distribution.
The presence of an even moderate secondary flow field modifies the flow angle distributions, thus making clear the need of a reliable profile loss prediction method for off-design cases, especially in the presence of separation.
Accordingly, the blade-to-blade code predicts the profile loss distribution and subsequently provides the correct total pressure field for the secondary flow calculation.
The combination of the above mentioned codes finally gives a realistic picture of the flow quantities at any S3 surface along a machine at a minimal computer cost.
Several test cases, including axial compressor and turbine cascades as well as transonic axial compressor blade rows have been investigated. The results are in good agreement with the experimental data and are favourably compared with various recent correlations.
Numerical Simulation of Two-Phase Flow in Combustion Chambers
Authors: Hebrard P. , Courquet J. , Lavergne G. 
Published: March 2015

The purpose of this paper is to describe a new approach in which one uses different kinds of post processing to obtain, from 2D or 3D computation codes, the representation of internal flow inside a combustion chamber as an association of elementary reactors (well stirred, plug flow…)
To reach this goal and, in order to test this method, different computation codes are used for the gas phase description: mean flow computation or unsteady codes like “R.V.M.” (Random Vortex Method) or “F.C.T.” (Flux corrected transport) - For the liquid phase behaviour, we use to kinds of Lagrangian transport schemes: one purely deterministic is linked to the mean gas flow computation, the second one provides individual instantaneous trajectories.
These various approaches are used for two kinds of 2D geometries: the backward facing step and a simplified afterburner geometry. Examples of residence time computations are presented for the liquid and gas phases and the effect of unsteady flow and drop sizes are demonstrated by experimental comparisons.