bluuebunny/crossref_metadata_2025 huggingface dataset:
Identifying tools for capturing the overall experience of dyspnea in a lung cancer population: The patient’s perspective.
Authors: Gill Gursharan , Liu Aixin , Chan Brandon , Tsui Brandon , Hall Elizabeth , Wong Lauren , Liang Mindy , Sarabia Samantha , Yeung Sabrina , Perez-Cosio Andrea , Brown Catherine , Leung Yvonne , Howell Doris , Liu Geoffrey
Published: February 2017

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Background: Efficient methods of tracking dyspnea can improve quality of care. We asked lung cancer patients to assess five validated patient-reported outcome (PRO) tools and determine whether these tools captured different domains of their dyspnea experience. Methods: This cross-sectional study of adult lung cancer outpatients of all stages utilized touch screen tablets to administer five dyspnea tools (Borg severity (B), Reduced Cancer Dyspnea (R), Breathlessness intensity (I), breathlessness distress (D), and MRC breathlessness (M) scales) that focused on the severity, experience, intensity, extent, and functional impairment of dyspnea, respectively. Patients were then asked whether each tool captured their dyspnea experience. Results: Of 226 lung cancer patients, 120 reported some level of dyspnea, and their responses were analyzed. Median age (range) was 67 (30-97) years; 53% were males; 37% were stage I-II; 56%, were stage III-IV. All the tools except B were completed by over 90% of patients (R 95%, I 93%, D 91%, M 91%). 71% of patients thought that M captured functional impairment well, while 58-62% of patients thought that R, S, A captured experience, intensity and distress well. B had the lowest completion rate (83%) and the lowest patient perception that is captured severity of dyspnea well (49%). Qualitative analysis suggests that most dyspnea is activity-related in this population, which would be consistent with patients favoring M (functional assessment) over B (dyspnea at present in clinic). I+D+M takes under 5 minutes to complete, whilst R takes 5+ minutes alone to complete. Conclusions: In a sample of cancer patients with high prevalence of dyspnea, patients felt four of five tools were useful in capturing various domains of their dyspnea experience. The majority of patients felt that the questions were relevant to their circumstances. I, D, M are appropriate screening tools, whilst R may be useful under specific circumstances. Our next step is the application and evaluation of self management tools in the dyspnea setting using these four tools.
Integrating nursing into oral chemotherapy education.
Authors: Shea Meghan , Weinstein Nancy , Zerillo Jessica A.
Published: February 2017

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Background:The shift of chemotherapy administration from the oncology infusion suite to the home has unwound systems and left patients vulnerable to errors. Many of the safeguards for parenteral chemotherapy, including education by an oncology nurse, are absent for oral chemotherapy. The 2013 American Society of Clinical Oncology/Oncology Nursing Society Standards served as the framework for improving the initiation of oral chemotherapy at Beth Israel Deaconess Medical Center. Methods: Clinicians caring for patients with melanoma and renal cell cancer were surveyed. A team of clinicians, nurses and pharmacist delineated a process map from writing an oral chemotherapy prescription to first follow-up appointment. A retrospective chart review of baseline data provided by a specialty pharmacy revealed 33 patients who initiated oral chemotherapy between July 2014 to July 2015, were not on a clinical trial and had at least two follow-up appointments. The team’s aim is by February 1, 2016 patients initiating oral chemotherapy receive nursing education by the first follow-up visit and at least 50% have documentation of a comprehensive education, including administration, safe handling and side effects. Results: The survey response rate was 9 of 9 (100%). The clinicians ranked patient education as the top priority. Second to time, lack of nursing involvement was identified as the most common contributing factor to patients not receiving a comprehensive education. At baseline, 1 of 33 (3%) patients initiated on oral chemotherapy received education from a nurse. Side effect education was documented in 21 of 33 (64%) clinicians’ notes, though education on safe handling only in 7 of 33 (15%), and education on administration was never documented. Plan-Do-Study-Act cycles are ongoing to implement varied approaches of nursing involvement, including telephone and in-person consultations. Conclusions: Lack of nursing involvement was identified as a missing element in oral chemotherapy care. Because clinicians were engaged, a survey to evaluate the current process succeeded with a high response rate. At baseline, there are significant gaps and variability in current practice, and interventions to provide patients with a comprehensive education are underway.
Engagement in a statewide oral oncolytic collaborative and practice impact.
Authors: Severson Jane Alcyne , Mackler Emily R. , Galiyas Grayce , Petersen Laura , Lindsay Jamie , Salgado Teresa M , Davis Emily , Farris Karen B
Published: February 2017

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Background: The rapid shift to oral oncolytic therapy presents challenges to oncology practitioners. The purpose of this study is to describe how participation in a statewide oral oncolytic improvement collaborative where best practices and resources were shared can readily impact quality of care as measured by national standards. Methods: The Michigan Oncology Quality Consortium (MOQC) hosted a series of learning collaborative sessions focused on topics and deployment of resources specific to oral oncolytic management and quality improvement. Participating practices performed pre/post self-assessments in Oct. 2013 and Apr. 2015 (n = 3). Concordance with national ASCO QOPI and ONS standards was compared, including documentation (5 measures), patient education (7 measures), and follow-up/monitoring (4 measures). A response scale of always, sometimes, and never was used. Specifically, practices were surveyed to assess which evidence-based MOQC resources were implemented: patient intake template, drug-specific self-management guides, start date mailer, medication calendar, primary care physician communication template, Edmonton Symptom Assessment Scale (ESAS), and patient adherence questionnaires. Results: Practice A showed improvement in documentation, patient education, and monitoring. This practice used the initial oral chemotherapy template, ESAS, patient education templates, and patient calendar (Table). Practice B implemented 6 resources and demonstrated improvements in 15 metrics. Practice C implemented 4 resources, namely patient-focused resources, to improve all patient education and monitoring metrics. Conclusions: Use of the collaborative model and supplying oncology teams with scientific evidence, standard workflows, and resources improves concordance with national standards of care. Large-scale deployment of this model program may provide a clinically efficient and effective mechanism to enhance widespread change. [Table: see text]
Implementing patient-reported outcome surveys as part of routine care: Lessons from an academic radiation oncology department.
Authors: Agarwal Ankit , O'Neil Kelly , Kelly Andrea , Keaty Maureen , Whitehouse Colleen , Kalinowski Barbara , Orio Peter F. , Martin Neil E.
Published: February 2017

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Background: We sought to implement patient reported outcomes (PRO) surveys to measure the acute and late effects of radiation treatment at a multisite academic medical center. Methods: Over the course of 18 months we addressed survey identification and implementation hurdles. Many existing validated instruments were designed for clinical research and are not ideally suited for either routine care or for the tracking of acute toxicities of radiation therapy. A physician and a nurse champion for each disease site identified or created situation- and site-specific tools based on validated questionnaires form the literature. Our aim was for questionnaires to be no longer than 20 - 30 questions. Using iPads, we deployed an institutionally-developed survey platform integrated with scheduling within the clinic. We surveyed physicians, nurses, and residents 3 months following the implementation of PROMs to assess their general response to the initiative. Results: Thirty-seven PRO measures comprised of 640 questions were implemented for all disease sites in adult patients at 6 departmental locations treating a total of 350 patients daily. Following implementation in January of 2015, > 13,000 surveys have been completed through the end of September 2015. Each question took on average approximately 14 seconds to complete and common surveys took approximately 10 minutes. Of 36 departmental provider respondents (50% response rate overall), 47% stated that they use the PROMs in their daily practice. The majority of respondents felt that the PROs were valuable (67%) and relevant (75%) either usually, most of the time or always. Only 33% felt the quality of their care was enhanced usually or most of the time while 53% felt the PROs engaged patients in a better understanding of their own care. Conclusions: We successfully implemented disease site- and context-specific PROs across a large, academic radiation oncology department. Although we have achieved widespread adoption and some subjective impression of care improvement among providers, further work is necessary to reduce barriers to their clinical use and to leverage them for systematic improvements in care.
Has venous thromboembolism (VTE) prophylaxis made any difference for solid tumor inpatients at Princess Margaret Cancer Center (PM)?
Authors: Wang Tian Qi , Tan Carmen , Atenafu Eshetu G. , Seki Jack Toshimine
Published: February 2017

98

Background: VTE represents a significant risk for morbidity and mortality in cancer patients. Hospitalized solid tumor patients at PM are especially at risk (15% of inpatients experienced a VTE event in 2004 when prophylaxis rate was 19%). Institution-wide VTE prophylaxis policy was implemented, and prophylaxis uptake reached nearly 97% in Sept 2012. We are interested in whether the prophylaxis policy made any impact in reducing VTE incidences over time. Our objective is to compare inpatient VTE frequency before and after the implementation of the VTE prophylaxis policy (IPP) in Sept 2012 at PM. Methods: This retrospective study evaluated VTE frequency before and after IPP for all inpatients admitted to the 17A/B solid tumor units during the fiscal years 2007 to 2015. Eligible patients were those who became symptomatic and diagnosed 48 hours post hospital admission, as identified through the Discharge Abstract Database (DAD). Prophylaxis recipients were those without active bleeding and were not receiving treatment anticoagulant for a previous VTE. Results: 66 inpatients were identified to have developed VTE (table). The majority of inpatients who developed VTE had brain, lung, colorectal, pancreatic, or ovarian cancer. 83.3% of patients had a PADUA risk score of 4 or greater. From April 2007 to Sept 2012, 1 patient developed VTE every 105.7 patient visits (48 patients developed VTE in 5075 patient visits). From Sept 2012 to March 2015, 1 patient developed VTE every 112.6 patient visits (18 patients developed VTE in 2026 patient visits). Odds ratio of 0.9388 (CI = 0.5448-1.6177) showed lower VTE risk for patients on prophylaxis during admission. Conclusions: There appeared to be a decreasing trend in the frequency of VTE post-IPP, for cancer inpatients within a limited population. [Table: see text]
Development of an integrated practice unit: Utilizing a lean approach to impact value of care for brain tumor patients.
Authors: Kwon Ivy , Ahn Christine , White Preston , Liau Linda M. , Cloughesy Timothy Francis , Nghiemphu Phioanh Leia
Published: February 2017

99

Background: Lack of care coordination across subspecialty departments involved in the treatment of brain tumor patients at our institution has negatively impacted patient outcomes, patient experience, and costs. Meanwhile, value-based health care has become increasingly relevant as a means to respond to changing payment structures and improve quality. With the aim to increase value, we restructured medical practice across the continuum of care for brain tumor patients by developing a virtual (non co-located) Integrated Practice Unit (IPU). Methods: From June 2014 to August 2015, we engaged a core team of physicians and administrators from Neurosurgery, Neuro-Oncology, Radiation Oncology, Neuroradiology and Neuropathology to re-design care pathways for the following diagnoses: glioma, metastatic cancer to the brain, and meningioma. We applied lean methodology to map out current state, identify root causes, and develop an implementation plan based on our analyses. Results: Root causes uncovered included: 1) multiple entry points into the system, 2) silo-ed intake processes, 3) varied scheduling processes across and within departments, and 4) no consensus regarding timing and ownership of follow-up care for patients for each diagnosis. Preliminary solutions generated included: 1) developing a centralized communication point and triage process, 2) standardizing requests at intake and obtaining blanket authorizations for select services, 3) standardizing scheduling workflows across departments, 4) delineating the timing and nature of necessary post-operative appointments, and 5) onboarding a nurse navigator to optimize care coordination. Shared metrics to be monitored over time were developed and include time from scheduled-to-seen for initial consults, proportion of patients with post-operative appointments scheduled prior to discharge, number of readmissions within 30 days, patient satisfaction, and costs. Conclusions: Value-based care redesign around the development of an IPU for brain tumor patients has the potential to meaningfully impact patient outcomes, patient experience, and reduce costs in the delivery of care.
Activating NOTCH1 Mutations Define a Distinct Subgroup of Patients With Adenoid Cystic Carcinoma Who Have Poor Prognosis, Propensity to Bone and Liver Metastasis, and Potential Responsiveness to Notch1 Inhibitors
Authors: Ferrarotto Renata , Mitani Yoshitsugu , Diao Lixia , Guijarro Irene , Wang Jing , Zweidler-McKay Patrick , Bell Diana , William William N. , Glisson Bonnie S. , Wick Michael J. , Kapoun Ann M. , Patnaik Amita , Eckhardt Gail , Munster Pamela , Faoro Leonardo , Dupont Jakob , Lee J. Jack , Futreal Andrew , El-Naggar Adel K. , Heymach John V.
Published: February 2017

Purpose

Adenoid cystic carcinomas (ACCs) represent a heterogeneous group of chemotherapy refractory tumors, with a subset demonstrating an aggressive phenotype. We investigated the molecular underpinnings of this phenotype and assessed the Notch1 pathway as a potential therapeutic target.

Methods

We genotyped 102 ACCs that had available pathologic and clinical data. Notch1 activation was assessed by immunohistochemistry for Notch1 intracellular domain. Luciferase reporter assays were used to confirm Notch1 target gene expression in vitro. The Notch1 inhibitor brontictuzumab was tested in patient-derived xenografts from patients with ACC and in a patient with ACC who was enrolled in a phase I study.

Results

NOTCH1 mutations occurred predominantly (14 of 15 patients) in the negative regulatory region and Pro-Glu-Ser-Thr–rich domains, the same two hotspots seen in T-cell acute lymphoblastic leukemias, and led to pathway activation in vitro. NOTCH1-mutant tumors demonstrated significantly higher levels of Notch1 pathway activation than wild-type tumors on the basis of Notch1 intracellular domain staining ( P = .004). NOTCH1 mutations define a distinct aggressive ACC subgroup with a significantly higher likelihood of solid subtype ( P < .001), advanced-stage disease at diagnosis ( P = .02), higher rate of liver and bone metastasis ( P ≤ .02), shorter relapse-free survival (median, 13 v 34 months; P = .01), and shorter overall survival (median 30 v 122 months; P = .001) when compared with NOTCH1 wild-type tumors. Significant tumor growth inhibition with brontictuzumab was observed exclusively in the ACC patient-derived xenograft model that harbored a NOTCH1 activating mutation. Furthermore, an index patient with NOTCH1-mutant ACC had a partial response to brontictuzumab.

Conclusion

NOTCH1 mutations define a distinct disease phenotype characterized by solid histology, liver and bone metastasis, poor prognosis, and potential responsiveness to Notch1 inhibitors. Clinical studies targeting Notch1 in a genotype-defined ACC subgroup are warranted.
Surgical Management of Wild-Type Gastrointestinal Stromal Tumors: A Report From the National Institutes of Health Pediatric and Wildtype GIST Clinic
Authors: Weldon Christopher B. , Madenci Arin L. , Boikos Sosipatros A. , Janeway Katherine A. , George Suzanne , von Mehren Margaret , Pappo Alberto S. , Schiffman Joshua D. , Wright Jennifer , Trent Jonathan C. , Pacak Karel , Stratakis Constantine A. , Helman Lee J. , La Quaglia Michael P.
Published: February 2017

Purpose

Wild-type gastrointestinal stromal tumors (WT-GISTs) that lack KIT or PDGFRA mutations represent a unique subtype of GIST that predominantly affects children. We sought to determine the effect on event-free survival (EFS) of staging variables, extent of resection, and repeat resection of tumors.

Methods

In 2008, a WT-GIST clinic was established at the National Cancer Institute, allowing the development of a large clinical database. We included participants who underwent resection of WT-GIST. Associations with EFS (ie, freedom from disease progression or recurrence) were evaluated using the Kaplan-Meier method and Cox proportional hazards modeling.

Results

Among 76 participants with WT-GISTs, the median follow-up was 4.1 years. Overall EFS (± SE) was 72.6 ± 5.4% at 1 year, 57.6 ± 6.2% at 2 years, 23.7 ± 6.0% at 5 years, and 16.3 ± 5.5% at 10 years postoperatively. Hazard of disease progression or recurrence was significantly increased for patients with metastatic disease (adjusted hazard ratio [AHR], 2.3; 95% CI, 1.0 to 5.1; P = .04) and > 5 mitoses per 50 high-power fields (AHR, 2.5; 95% CI, 1.1 to 6.0; P = .03), whereas there was no significant effect of negative microscopic resection margins (AHR, 0.9; 95% CI, 0.4 to 2.2; P = 0.86). There was no association between type of gastric resection (ie, anatomic v partial/wedge) and EFS ( P = .67). Repeated resection after the initial resection was significantly associated with decreasing postoperative EFS ( P < .01). Five patients (6%) died after initial enrollment in 2008.

Conclusion

WT-GIST is an indolent disease, and most patients survive with disease progression. We found no improvement in EFS with more extensive or serial resections. Disease progression or recurrence may be more closely related to tumor biology than surgical management. These data suggest that resections for WT-GISTs be restricted to the initial procedure and that subsequent resections be performed only to address symptoms such as obstruction or bleeding.
Sentinel Lymph Node Biopsy for Patients With Early-Stage Breast Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update
Authors: Lyman Gary H. , Somerfield Mark R. , Bosserman Linda D. , Perkins Cheryl L. , Weaver Donald L. , Giuliano Armando E.
Published: February 2017

Purpose

To provide current recommendations on the use of sentinel node biopsy (SNB) for patients with early-stage breast cancer.

Methods

PubMed and the Cochrane Library were searched for randomized controlled trials, systematic reviews, meta-analyses, and clinical practice guidelines from 2012 through July 2016. An Update Panel reviewed the identified abstracts.

Results

Of the eight publications identified and reviewed, none prompted a change in the 2014 recommendations, which are reaffirmed by the updated literature review.

Conclusion

Women without sentinel lymph node (SLN) metastases should not receive axillary lymph node dissection (ALND). Women with one to two metastatic SLNs who are planning to undergo breast-conserving surgery with whole-breast radiotherapy should not undergo ALND (in most cases). Women with SLN metastases who will undergo mastectomy should be offered ALND. These three recommendations are based on randomized controlled trials. Women with operable breast cancer and multicentric tumors, with ductal carcinoma in situ, who will undergo mastectomy, who previously underwent breast and/or axillary surgery, or who received preoperative/neoadjuvant systemic therapy may be offered SNB. Women who have large or locally advanced invasive breast cancer (tumor size T3/T4), inflammatory breast cancer, or ductal carcinoma in situ (when breast-conserving surgery is planned) or are pregnant should not undergo SNB.
Experience With Computerized Chemotherapy Order Entry
Authors: DuBeshter Brent , Walsh Carolyn J. , Altobelli Kim , Loughner John , Angel Cynthia
Published: February 2017

Purpose

The elimination of errors related to chemotherapy administration remains an elusive goal. Computerized order entry has been shown to reduce errors. We assessed a chemotherapy computer order entry system for errors related to dosing and for the time required to prepare chemotherapy orders.

Methods

A prospective study of all patients treated with chemotherapy over a 12-month period was performed. Chemotherapy order sets done via computerized order entry were reviewed for errors related to drug selection, dose calculations, decimal-point errors, and for exceeding a warning level set within the system. We also measured the time required to produce three order sets by hand versus by computer.

Results

There were no errors in dose calculations, decimal points, or drug selection for 2,558 drug administrations in 235 patients treated with 26 different chemotherapy regimens. The dose warning level was exceeded in 152 (6%) of drug administrations, but never without user permission to override the warning. The average time saved per order set using computer order entry was 10 minutes (P < .05).

Conclusion

By using computer order entry with error-checking algorithms, it may be possible to eliminate a number of types of errors associated with chemotherapy administration without sacrificing efficiency.
Quality Performance Improvement With the Implementation of Standard Chemotherapy Order Forms
Authors: Dumasia Lena , Harris Ellen , Drelichman Anibal
Published: February 2017

Purpose

Before October 2000, physicians in our institution handwrote chemotherapy orders on blank order sheets. There was no standard to which the physician could include variables that were crucial to the completeness of a chemotherapy order. For this reason, chemotherapy orders were frequently incomplete and had to be adjusted by the pharmacist after discussing the missing variables with the ordering physician. As a part of our goal to minimize errors, standard chemotherapy forms were initiated at our institution in October 2000.

Methods

The first standard form implemented was a written order form that constituted a standard of the ideal variables necessary to accurately complete chemotherapy orders. These variables were the diagnosis, regimen, height, weight, body surface area (BSA), route, frequency, duration and chemotherapy dose and calculation based upon BSA. The next updated form was an electronic version similar to the original, and was implemented in April 2002.

Results

From February 1999 to March 2000, using the traditional unstandardized blank order sheets, the average order completeness was 45%. After the standard written forms were introduced, from October 2000 to March 2002, the average chemotherapy order completeness was 81%, an improvement of 36%. Completeness improved to an average of 93% from April 2002 to December 2003, after the implementation of the electronic chemotherapy form.

Conclusion

Chemotherapy order completeness improves considerably through the standardization of chemotherapy order forms. The electronic forms show an additional improvement over handwritten forms. Electronic standardization of chemotherapy forms should be adopted as a best-practice model in hematology-oncology practices throughout the country.
Food Insecurity Among Cancer Patients in Kentucky: A Pilot Study
Authors: Simmons Leigh Ann , Modesitt Susan C. , Brody Amanda C. , Leggin Allison B.
Published: February 2017

Purpose

Food insecurity is defined as being uncertain of having enough food due to insufficient money or other resources. The purpose of this study was to examine the construct and correlates of food insecurity in a sample of cancer patients in Kentucky.

Patients and Methods

Data were collected in the waiting rooms of the chemotherapy, hematology/oncology, and gynecology/oncology clinics of a university cancer center, and included 115 cancer patients actively receiving treatment (mean age, 55.85 years; range, 23 to 88 years) who completed a series of standardized measures to assess food insecurity status and psychological and nutritional well-being. Descriptive statistics and independent samples t tests were used to assess the prevalence of food insecurity in the sample, and to identify differences between the persons who were food insecure and food secure.

Results

The prevalence rates of food insecurity and food insecurity with hunger in the sample were 17.4% and 7.8%, respectively, which are higher than in the general population. Food-insecure patients had statistically significant higher levels of nutritional risk, depression, and financial strain, and lower quality of life compared with food secure patients. Fifty-five percent of food insecure patients reported not taking a prescribed medication because they could not afford it, versus 12.8% of food-secure patients (P = .002).

Conclusion

Food insecurity may be an important consideration for clinical oncology practice, especially when caring for individuals of lower socioeconomic status. Further study is warranted, including prospective studies of cancer patients to identify causal relationships among food insecurity, cancer incidence, cancer treatments, and patient outcomes and well-being.
Otantamenetelmien vaikutuksia leimikon hinnoitteluun ja menetelmä puunostajan hinnoittelukustannusten laskemiseksi
Authors: Jalkanen Petri
Published: February 2017

Työssä tutkittiin relaskooppiotannan, ympyräkoealaotannan ja lähimpien puiden otannan ominaisuuksia leimikon hinnoittelussa. Otantamenetelmiä tutkittiin simuloimalla maasto-otantoja viidestä eri leimikosta, jotka on mitattu eri puolilta Itä-Suomea. Leimikkoaineistosta on mitattu puiden koordinaatit sekä useita laadusta ja runkomuodosta kertovia tunnuksia. Tutkimuksessa esitetään hinnoitteluperiaatteet, joiden perusteella vertaillaan hinnoittelumenetelmiä ja kehitetään menetelmä hinnoittelukustannusten laskemiseksi. Hinnoittelumenetelmät rakentuvat otantamenetelmästä ja hintalaskelmasta. Hintalaskelma perustuu runkohinnoitteluun. Kaikissa tutkituissa hinnoittelumenetelmissä käytettiin samaa hintalaskelmaa ja otannan vaikutusta hintoihin tutkittiin laskemalla menetelmien harhat tarkkojen kauppahintojen suhteen. Hinnoittelukustannusten laskennassa hinnoittelun kokonaiskustannukset jaettiin kahteen erikseen laskettavaan osaan, kauppahinnan hajonnasta koituviin kustannuksiin ja työn kustannuksiin. Tulosten mukaan relaskooppiotannat sopivat parhaiten runkohinnoitteluun. Harhavertailut osoittivat, että hintalaskelma on sovitettava käytetyn otantamenetelmän mukaan suurien harhojen välttämiseksi hinnoittelussa.
Kaksijaksoisen kuusi–koivu-sekametsikön kasvu
Authors: Mielikäinen Kari , Valkonen Sauli
Published: February 2017

Tutkimuksessa tarkasteltiin nuoren kuusikon kasvattamista koivuylispuuston alla. Tutkimusongelmana oli selvittää, kuinka paljon tiheydeltään ja kooltaan vaihteleva koivuylispuusto tuottaa puuta ja kuinka paljon se hidastaa kuusikon kehitystä. Tutkimuksessa laadittiin kertamittausaineistoon perustuvat kasvumallit. Niiden lisäksi sovellettiin aiemmassa sekametsätutkimuksessa laadittuja malleja.
Juurilahoa aiheuttavan yksitumaisen Rhizoctonia-sienen torjunta kuumavesikäsittelyllä
Authors: Iivonen Sari , Lilja Arja , Tervo Leo
Published: February 2017

Työssä tutkittiin juurilahoa aiheuttavan yksitumaisen Rhizoctonia sp. -sienen torjuntaa kuumavesikäsittelyllä. Tavoitteena oli selvittää, mikä lämpötila ja upotusaika on riittävä sienen rihmaston ja kestoasteiden eli rihmastopahkojen tuhoamiseksi. Sienen rihmasto tuhoutui jo 75 °C:n lämpötilassa, ja rihmastopahkoille 80 °C:n lämpötila oli riittävän korkea. Upotusaika ei ollut merkitsevä näissä lämpötiloissa. Sen sijaan alemmissa lämpötiloissa ajalla oli vaikutusta sienen kasvuunlähtöön ja kasvunopeuteen, mutta pisinkään käsittely ei tuhonnut rihmastoa täysin 60 °C:ssa tai rihmastopahkoja 75 °C:ssa. Alle 80 °C:n lämpötiloja voidaan pitää riittämättöminä, kun tavoitteena on taudinaiheuttajan torjunta.
Uppskattningar av avverkningsmöjligheterna inom landskapet Åland åren 1997–2026
Authors: Hirvelä Hannu , Härkönen Kari
Published: February 2017

Målet för föreliggande undersökning var att utreda avverkningsmöjligheterna åren 1997–2026 inom landskapet Åland. Avverkningsberäkningarna gjordes med MELA-programmet. Som underlag för beräkningarna användes provyte- och träddata från den nionde riksskogstaxeringen.
Viljelykuusikoiden alkukehityksen malli
Authors: Valkonen Sauli
Published: February 2017

Tutkimuksessa laadittiin kangasmaiden puhtaiden, ilman sekapuuston tai tuhojen aiheuttamia häiriöitä kasvaneiden 0,5–10 m valtapituisten viljelykuusikoiden alkukehitystä kuvaava malliperhe. Siihen kuuluvat yksittäisten kasvatuskelpoisten kuusten pituus- ja paksuuskasvun ja kuolemistodennäköisyyden mallit sekä metsikön valtapituuskehityksen, pituusjakauman ja läpimitan mallit. Tutkimusaineisto koostui 36 tuoreen ja lehtomaisen kankaan istutusmetsiköstä, jotka sijaitsivat tasaisesti Suomen alueella pohjoisinta osaa lukuun ottamatta. Kesto- ja kertakoealoina mitatut metsiköt oli valittu osin subjektiivisesti, osin monivaiheisella otannalla. Niiden ikä vaihteli tutkimusjakson lopussa 11–36 vuoden, valtapituus 1,5–10,8 m ja kasvatuskelpoisten taimien runkoluku 933–3 560 kpl ha välillä. Aineistosta puuttuivat epäonnistuneet viljelykset. Mallit testattiin riippumattomalla aineistolla. Mallien mukaista puuston kehitystä verrattiin kasvu- ja tuotostaulukoiden ja varttuneiden viljelykuusikoiden kasvumallien mukaiseen kehitykseen.–1
Mallit, ennusteet ja simulointi metsätalouden laskentajärjestelmissä
Authors: Kangas Annika , Kangas Jyrki
Published: February 2017

Metsätalouden laskentajärjestelmät pohjautuvat yhä enemmän simuloituihin metsien kehitysennusteisiin, mutta näin saatujen kehitysennusteiden ja -skenaarioiden luotettavuutta ei ole riittävästi tarkasteltu. Tässä artikkelissa esitellään erilaisten puustotunnusten ennustamiseen liittyviä epävarmuuden lähteitä. Lähinnä tarkastellaan mallien jäännösvirheiden ja kertoimien sekä malleissa tarvittavien lähtötietojen virheiden vaikutuksia saataviin ennusteisiin. Lisäksi tarkastellaan esimerkkilaskelman avulla virheiden vaikutuksia metsäsuunnitelmaan. Puustotunnusten ennustamisen lisäksi metsäsuunnittelussa aiheuttavat epävarmuutta esimerkiksi päätöksentekijän tavoitteiden analysointi ja kuvaaminen. Ennustamiseen ja suunnitteluun liittyvät erilaiset epävarmuustekijät ja niiden yhteisvaikutukset tulisikin tuntea nykyistä paremmin. Epävarmuus pitäisi myös pystyä kuvaamaan päätöksentekijälle tämän ymmärtämässä muodossa.
Ekologiseen asiantuntemukseen perustuvan numeerisen mallin tuottaminen metsäalueen biodiversiteetin arviointiin
Authors: Kangas Jyrki , Mononen Ari
Published: February 2017

Tutkimuksessa esitetään delfi-tekniikan ja HERO-nimisen heuristisen optimointimenetelmän tavoiteanalyysiosan yhteiskäyttöön perustuva ekologisen biodiversiteettiasiantuntemuksen mallintamismenetelmä. HEROssa sovellettua tiedustelutekniikkaa käytetään menetelmässä delfin iteratiivisuusperiaatteen mukaisesti. Delfi-tekniikka muodostaa menetelmän lähestymistavan asiantuntemuksen kokoamiseen ja mallinnusprosessin kehikon. HEROn tiedustelutekniikka tuo menetelmään analyyttisen otteen, joka delfistä itsessään puuttuu. Esitetyllä menetelmällä tuotettu malli voidaan sellaisenaan integroida metsäsuunnittelun optimointilaskelmiin.
La dinámica centro‒periferia en el estudio de la ciencia en América Latina: notas para una reflexión historiográfica sobre la Argentina
Authors: Matharan Gabriel
Published: February 2017

El presente trabajo se inscribe en una investigación que indaga en las propuestas historiográficas desarrolladas, desde la década de 1980 hasta la actualidad, en el campo de Ciencia, Tecnología y Sociedad (CTS) en América Latina, para comprender la dinámica «centro‒periferia» en el estudio de la ciencia en este continente. En particular aquí abordamos el estudio de las producciones académicas que son de referencia para la literatura CTS en la Argentina. Para ello, centramos el análisis en los conceptos elaborados para captar las relaciones entre el centro y la periferia. El trabajo muestra la riqueza de los planteos y su relevancia para los debates actuales sobre esta problemática.
Antología de la literatura fantástica de 1940
Authors: Gargatagli Anna
Published: February 2017

La Antología de la literatura fantástica de Borges, Bioy y Silvina Ocampo estableció un canon formal para la literatura argentina futura. En este artículo se analizan el origen, la edición, las traducciones y la función literaria del repertorio. En 1940, año de la primera edición, Borges era autor de algunos de sus relatos más memorables (entre ellos «Tlön, Uqbar, Orbis Tertius», incluido en la Antología); Bioy había publicado La invención de Morel, influyente entonces y todavía; Silvina Ocampo escribiría más tarde algunos de los relatos más inquietantes de la literatura argentina cuyas huellas estaban entrelíneas en Viaje Olvidado que había aparecido en 1937. ¿Por qué se hizo este libro?
Política y estrategias narrativas en El nombre de la rosa (Umberto Eco)
Authors: Corti Enrique C.
Published: February 2017

En el siglo XIV irrumpen, en el pensamiento político medieval y como consecuencia de las disputas entre el emperador y el papado, ciertos pensadores que abordan una filosofía política nueva y opuesta a la precedente: Marsilio de Padua y Guillermo de Ockham fueron precursores, y para el mundo «moderno» su influencia ha sido decisiva. En El nombre de la rosa (NR), es Guillermo de Baskerville quien presta voz a la incipiente doctrina política, y lo hace en consonancia con Marsilio y con Guillermo de Ockham. El artículo presenta el tema de la filosofía política en NR, en un marco de análisis del discurso y las estrategias narrativas de U. Eco en relación a los sentidos de la escritura.
Scenes of Hurt and Rapture: Céline Sciamma's Girlhood
Authors: Wilson Emma
Published: February 2017

Céline Sciamma as writer and director is peculiarly attentive to sensory detail, what things feel like, how they can be touched. This attention can be felt through her collaborative work with director of photography Crystel Fournier, who has worked on all of Sciamma's films to date in a creative collaboration proving just as electric as that between Claire Denis and Agnès Godard. Reflecting on her work to date, linking Girlhood to the earlier films, Didier Péron and Elisabeth Franck-Dumas wrote in Libération that Sciamma makes real the body and emotions of individuals in all their singularity. Intimacy is her real subject in Girlhood. The particular issue in relation to intimacy Sciamma pursues, from Water Lilies on, is that of hurt. She is a filmmaker who in her bodily, affective filmmaking has paid attention to hurt, to abrasion, and to vulnerability; she makes them all part of the robust, adrenaline-pumped feminist politics that pervade her films and their characters. It is this mode of making real—this feeling alive—that Wilson explores in this essay.
El cooperativismo y la industria chiclera en la época posrevolucionaria
Authors: Kawakami Ei
Published: February 2017

A finales de la década de 1920 el gobierno del territorio federal de Quintana Roo intentó introducir el sistema de cooperativas en la industria del chicle, que estaba controlada por las compañías estadounidenses productoras del chewing gum y los contratistas, intermediarios entre las compañías y los trabajadores chicleros. Pero el proyecto fracasó debido a una variedad de factores como la influencia de la Gran Depresión, el boicot por parte de las compañías estadounidenses, la competencia del chicle con otras materias primas, la corrupción e ineficiencia en el gobierno o la distancia entre los gobiernos central y local.

In the late 1920s the government of the Federal Territory of Quintana Roo introduced the cooperative system in the chicle industry, which was controlled by U.S. chewing-gum companies and its contratistas, intermediaries between the companies and the chicle producers. However, the project ended in failure, because of various factors, including the impact of the Great Depression, U.S. companies’ boycott, the competition between chicle and other raw materials for chewing-gum, the corruption and inefficiencies in the government, or the discord between the local and federal governments.
Fan Mail to Fidel
Authors: Keller Renata
Published: February 2017

This article analyzes the newly-declassified letters that Mexicans and people residing in Mexico sent to the Cuban government in the first decade after the Cuban Revolution. The letters reveal that the Cuban Revolution found supporters among a variety of Mexicans because the events in Cuba reflected their own nation’s history of revolution and U.S. intervention. In addition to praising the Cuban Revolution, the Mexicans who put pen to paper confessed their hopes and fears for their own country. While these letters were ostensibly about Cuba, they in fact reveal more about political culture in 1960s Mexico.

Este artículo analiza las cartas que mexicanos y foráneos residentes en México enviaron al gobierno cubano en la primera década después de la Revolución Cubana. Las cartas revelan que varios mexicanos apoyaron a la revolución porque los eventos en Cuba reflejaban la historia de revolución e intervencionismo estadounidense en México. Asimismo, estos mexicanos describían las ilusiones y miedos sobre su propio país. A pesar de tratar sobre Cuba, estas cartas revelan aún más sobre la cultura política de México en los años sesenta.
Introduction: New Religions in Eastern Europe
Authors: Ališauskienė Milda
Published: February 2017

The introduction to this special issue on new religions in Eastern Europe provides a historical background on the place of new religious movements in the region during the Soviet and post-Soviet era. This includes the varieties of new and alternative religions active in these societies and how this changed after the fall of the Berlin Wall. The guest editor notes several main directions of scholarly research focusing on these new religions and summarizes the four articles included in this special issue, which focus on the Lithuanian neoshamanic community, the pyramid of Merkinė in Lithuania, marketing and branding strategies of contemporary spirituality movements in Estonia, and the Last Testament Church in Siberia, Russia.
Genomic complexity and targeted genes in anaplastic thyroid cancer cell lines
Authors: Woodward Eleanor L , Biloglav Andrea , Ravi Naveen , Yang Minjun , Ekblad Lars , Wennerberg Johan , Paulsson Kajsa
Published: February 2017

Anaplastic thyroid cancer (ATC) is a highly malignant disease with a very short median survival time. Few studies have addressed the underlying somatic mutations, and the genomic landscape of ATC thus remains largely unknown. In the present study, we have ascertained copy number aberrations, gene fusions, gene expression patterns, and mutations in early-passage cells from ten newly established ATC cell lines using single nucleotide polymorphism (SNP) array analysis, RNA sequencing and whole exome sequencing. The ATC cell line genomes were highly complex and displayed signs of replicative stress and genomic instability, including massive aneuploidy and frequent breakpoints in the centromeric regions and in fragile sites. Loss of heterozygosity involving whole chromosomes was common, but there were no signs of previous near-haploidisation events or chromothripsis. A total of 21 fusion genes were detected, including six predicted in-frame fusions; none were recurrent. Global gene expression analysis showed 661 genes to be differentially expressed between ATC and papillary thyroid cancer cell lines, with pathway enrichment analyses showing downregulation of TP53 signalling as well as cell adhesion molecules in ATC. Besides previously known driver events, such as mutations in BRAF, NRAS, TP53 and the TERT promoter, we identified PTPRD and NEGR1 as putative novel target genes in ATC, based on deletions in six and four cell lines, respectively; the latter gene also carried a somatic mutation in one cell line. Taken together, our data provide novel insights into the tumourigenesis of ATC and may be used to identify new therapeutic targets.
Pulmonary Hypertension Therapy and a Systematic Review of Efficacy and Safety of PDE-5 Inhibitors
Authors: Unegbu Chinwe , Noje Corina , Coulson John D. , Segal Jodi B. , Romer Lewis
Published: February 2017

Pulmonary hypertension (PH) is a syndrome that is of growing concern to pediatricians worldwide. Recent data led to concerns about the safety of phosphodiesterase type 5 (PDE5) inhibitors in children and a US Food and Drug Administration safety advisory. Our objective is to provide insight into therapies for PH in children and to systematically review the comparative effectiveness and safety of PDE5 inhibitors in the management of pediatric patients with PH. We searched the following databases through February 2015: Medline, Embase, SCOPUS, and the Cochrane Central Register of Controlled Trials. We included studies that examined PDE5 inhibitor use in children with PH. Allowed comparators were either no medication or other classes of medication for management of PH. Study inclusion was via a 2-stage process with 2 reviewers and a predesigned form. Of 1270 papers identified by the literature search, 21 were included: 8 randomized controlled trials and 13 observational studies (9 retrospective, 4 prospective). There is strong evidence that PDE5 inhibitor use improves echocardiography measurements, cardiac catheterization parameters, and oxygenation compared with baseline or placebo in pediatric patients with PH. Evidence suggests that low- and moderate-dose sildenafil are safe regimens for children. There are a relatively small number of randomized controlled trials that address use of PDE5 inhibitors in pediatric patients with PH. PDE5 inhibitors are effective agents for cardiovascular and oxygenation end points in pediatric PH and important components of a multimodal pharmacotherapeutic approach to this growing challenge. Additional studies are needed to define optimal PH therapy in childhood.
KELAYAKAN FINANSIAL USAHA BUDI DAYA IKAN BANDENG DAN NILA SISTEM KERAMBA JARING APUNG (STUDI KASUS DI PERAIRAN WADUK CTRATA, KABUPATEN CIANJUR - JAWA BARAT)
Authors: Nasution Zahri , Gustiano Rudhy , Suryanti Yanti
Published: February 2017

Sejak tahun 1994. ikan bandeng yang asli dari daerah pantai dan laut mulai diusahakan masyarakat diWaduk Cirata. Untuk mengetahui kelayakan finansial usaha budidaya ikan bandengdalam Keramba Jaring Apung (KJA) di Waduk Cirata telah dilakukan suatu penelilian yang berlangsung pada bulan Agustus 2004.
ASPEK-ASPEK SOSIAL BUDAYA DALAM KERANGKA UPAYA PEMBERDAYAAN MASYARAKAT NELAYAN DI INDONESIA
Authors: Hartono Tjahjo Tri , Nasution Zahri
Published: February 2017

Penelitian dengan tujuan menganalisis peran dan pengaruh aspek-aspek sosial budaya masyarakat nelayan terhadap upaya pemberdayaan masyarakat nelayan telah dilakukan pada tahun 2003. Lima dimensi kehidupan, yaitu kesehatan masyarakat, ekonomi, hukum adat, politik, dan tingkah laku beserta faktor-faktor penyusunnya digunakan sebagai indikator kondisi aspek aspek sosial budaya masyarakat nelayan yang diteliti.
KAJIAN KEBIJAKAN PENGEMBANGAN USAHA BUDIDAYA PERIKANAN PADA LAHAN BEKAS GALIAN TAMBANG TIMAH DI PROPINSI KEPULAUAN BANGKA BELITUNG
Authors: Tajerin Tajerin , Manadiyanto Manadiyanto , Pranowo Sapto Adi
Published: February 2017

Potensi lahan bekas galian tambang timah yang sangat luas di Propinsi Kepulauan Bangka Belitung belum termanfaatkan secara optimal. Salah satu upaya pemanfaatan yang dipandang dapat meningkatkan kesejahteraan masyarakat secara luas adalah melalui pengembangan usaha budidaya perikanan.
Sobre Hannah Arendt: ética e racionalidade na sociedade contemporânea
Authors: Tassara Eda Terezinha de Oliveira , Abbud Neuza
Published: February 2017

Resumo: Este ensaio visa refletir sobre como superar obstáculos que se antepõem à capacidade de pensar de forma racional, a capacidade intelectual que envolve a abstração reflexiva e sua elaboração em correspondente argumentação. Parte da constatação de que, se se observa, de um lado, um crescimento na complexidade lógica do pensamento coloquial verbalizado, de outro, percebe-se uma ausência de competência nas operações intelectuais de análise dos processos racionais a ele subjacentes. Ou seja, a racionalidade contemporânea, alimentada pelos processos e produtos de conhecimento gerados através do pensamento abstrato e dedutivo do campo técnico-científico, comunicar-se-ia com a sociedade de maneira naturalizada, sob forma de representação social e, portanto, eivada de aportes ideológicos, de irracionalidades e/ou racionalizações acríticas. Visa-se refletir, então, sobre como subsidiar a superação de obstáculos à universalização do pleno exercício da razão e/ou da hermenêutica da racionalidade, instrumentalizando contrapontos aos impedimentos gerados pela ignorância ou pelas negatividades ou pelos núcleos dogmáticos do pensamento.
A elaboração e seus modelos: Leitura principal, Congresso da IPA em Berlim, Julho de 2007
Authors: Roussillon René
Published: February 2017

Resumo: A elaboração é inerente ao trabalho psicanalítico, é sua própria forma, portanto está sempre presente, mas muda de aspecto, de implicação e de economia de acordo com as exigências deste. Explorarei três modelos de seu funcionamento em função do que está em primeiro plano no trabalho psicanalítico. No primeiro modelo, o que está em questão no trabalho é ajudar a tomada de consciência de um complexo representacional reprimido; o segundo relaciona-se com o trabalho psíquico referente a tornar consciente moções pulsionais ou experiências psíquicas que não puderam ser representadas, de modo que o tempo da análise torna-se o primeiro tempo a posteriori (après-coup); o terceiro é o modelo no qual a representação e a simbolização de uma experiência subjetiva, assim como suas implicações pulsionais, foram realizadas, fazendo o analisando se apropriar subjetivamente destas para poder integrá-las.
Constituição e desenvolvimento do self dialógico e da relação triádica
Authors: Lyra Maria C. D. P. , Scorsi Letícia
Published: February 2017

Resumo: Ressaltamos a importância do estudo da gênese do self dialógico. Propomos que esse self emerge e se desenvolve no processo de comunicação em face do Outro. Tendo como foco a história da díade mãe-bebê nos primeiros oito meses de vida do bebê, sugerimos que tanto os padrões de organização do diálogo - atingindo a forma abreviada do diálogo - como a análise das posições que assume a fala da mãe denotam um processo de diferenciação do bebê como parceiro nesse diálogo. Também, o despontar do bebê como agente e sua subjetividade emergem respaldados no desenrolar da historia construída pela díade. Essa historicidade, possível de ser construída através de uma emergente capacidade do bebê de distanciamento e, portanto, capaz de abstrair as ações do contexto imediato no qual ocorrem, se constitui como um terceiro polo do diálogo, formando, então, uma relação triádica.