bluuebunny/crossref_metadata_2025 huggingface dataset:
Lung Cancer Care Trajectory at a Canadian Centre: An Evaluation of How Wait Times Affect Clinical Outcomes
Authors: Kasymjanova G. , Small D. , Cohen V. , Jagoe R. T. , Batist G. , Sateren W. , Ernst P. , Pepe C. , Sakr L. , Agulnik J.
Published: November 2017

Background: Lung cancer continues to be one of the most common cancers in Canada, with approximately 28,400 new cases diagnosed each year. Although timely care can contribute substantially to quality of life for patients, it remains unclear whether it also improves patient outcomes. In this work, we used a set of quality indicators that aim to describe the quality of care in lung cancer patients. We assessed adherence with existing guidelines for timeliness of lung cancer care and concordance with existing standards of treatment, and we examined the association between timeliness of care and lung cancer survival. Methods: Patients with lung cancer diagnosed between 2010 and 2015 were identified from the Pulmonary Division Lung Cancer Registry at our centre. Results: We demonstrated that the interdisciplinary pulmonary oncology service successfully treated most of its patients within the recommended wait times. However, there is still work to be done to decrease variation in wait time. Our results demonstrate a significant association between wait time and survival, supporting the need for clinicians to optimize the patient care trajectory. Interpretation: It would be helpful for Canadian clinicians treating patients with lung cancer to have wait time guidelines for all treatment modalities, together with standard definitions for all time intervals. Any reductions in wait times should be balanced against the need for thorough investigation before initiating treatment. We believe that our unique model of care leads to an acceleration of diagnostic steps. Avoiding any delay associated with referral to a medical oncologist for treatment could be an acceptable strategy with respect to reducing wait time.
Impact of the Pan-Canadian Oncology Drug Review on Provincial Concordance with Respect to Cancer Drug Funding Decisions and Time to Funding
Authors: Srikanthan A. , Mai H. , Penner N. , Amir E. , Laupacis A. , Sabharwal M. , Chan K. K. W.
Published: November 2017

Background: The pan-Canadian Oncology Drug Review (pcodr) was implemented in 2011 to address uneven drug coverage and lack of transparency with respect to the various provincial cancer drug review processes in Canada. We evaluated the impact of the pcodr on provincial decision concordance and time from Notice of Compliance (noc) to drug funding. Methods: In a retrospective review, Health Canada’s Drug Product Database was used to identify new indications for cancer drugs between January 2003 and May 2014, and provincial formulary listings for drug-funding dates and decisions between 1 January 2003 and 31 December 2014 were retrieved. Multiple linear models and quantile regressions were used to evaluate changes in time to decision-making before and after the implementation of the pcodr. Agreement of decisions between provinces was evaluated using kappa statistics. Results: Data were available from 9 provinces (all Canadian provinces except Quebec), identifying 88 indications that represented 51 unique cancer drugs. Two provinces lacked available data for all 88 indications at the time of data collection. Interprovincial concordance in drug funding decisions significantly increased after the pcodr’s implementation (Brennan-Prediger coefficient: 0.54 pre-pcodr vs. 0.78 post-pcodr; p = 0.002). Nationwide, the median number of days from Health Canada’s noc date to the date of funding significantly declined (to 393 days from 522 days, p < 0.001). Exploratory analyses excluding provinces with incomplete data did not change the results. Conclusions: After the implementation of the pcodr, greater concordance in cancer drug funding decisions between provinces and decreased time to funding decisions were observed.
Development of an Online, Patient-Centred Decision Aid for Patients with Oropharyngeal Cancer in the Transoral Robotic Surgery Era
Authors: Lam J. S. , Scott G. M. , Palma D. A. , Fung K. , Louie A. V.
Published: November 2017

Background: Radiotherapy (RT) has been the standard treatment for early oropharyngeal cancer, achieving excellent outcomes, but with significant toxicities. Transoral robotic surgery (TORS) has emerged as a promising alternative. A decision aid (DA) can help to establish patient treatment preferences. Methods: A DA was developed and piloted in 40 healthy adult volunteers. Assuming equal oncologic outcomes of the treatments, participants indicated their preference. The treatment trade-off point was then established, and participant perceptions were elicited. Results: More than 80% of participants initially selected TORS for treatment, regardless of facilitator background. For all participants, the treatment trade-off point changed after an average 15% cure benefit. Treatment toxicities, duration, novelty, and perceptions all influenced treatment selection. All subjects valued the DA. Conclusions: A DA developed for early oropharyngeal cancer treatment holds promise in the era of shared decision-making. Assuming equal cure rates, TORS was preferred over RT by healthy volunteers.
Shifting Practice in Definitive Chemoradiation for Localized Esophageal Cancer
Authors: Qu X. M. , Biagi J. J. , Hopman W. M. , Mahmud A.
Published: November 2017

Background: The efficacy of carboplatin–paclitaxel in the trimodality setting was demonstrated in the cross trial. Because of better tolerance, that regimen has been adopted as an alternative for patients receiving definitive chemoradiation (dCRT). The purpose of our study was to compare outcomes in patients with localized esophageal and gastroesophageal junction (GEJ) cancer who received dCRT using either platinum–5-fluorouracil (5FU) or carboplatin–paclitaxel. Methods: Medical records and outcomes for all patients diagnosed with localized carcinoma of the esophagus and GEJ at our centre between 2008 and 2015 were reviewed. All patients who underwent dCRT using cisplatin–5FU, carboplatin–5FU, or carboplatin–paclitaxel were included. Results: The 73 identified patients (34 cisplatin–5FU, 13 carboplatin–5FU, 26 carboplatin–paclitaxel) were all prescribed concomitant radiotherapy of 50 Gy in 25 daily fractions. The diagnosis was adenocarcinoma in 64% and squamous cell carcinoma in 36%. Median overall survival (OS) duration for the cisplatin–5FU group was 28 months [95% confidence interval (CI): 19 to 41 months], with a 3-year OS rate of 44%, in contrast to the 15 months (95% CI: 11 to 17 months) and 15% in the carboplatin–paclitaxel group (log-rank p = 0.0047). Median OS duration for the carboplatin–5FU group was 17 months (95% CI: 11 to 68 months) with a 3-year OS rate of 31%. Adjusting for patient and disease factors, better OS durations and rates were associated with cisplatin–5FU (hazard ratio: 0.34; p = 0.0016) and carboplatin–5FU (hazard ratio: 0.55; p = 0.20) than with carboplatin–paclitaxel. Conclusions: In a dCRT regimen, a better OS is associated with cisplatin–5FU than with carboplatin–paclitaxel. Clinical trials to determine optimal chemotherapy regimens are warranted for patients who are not suitable for surgery.
Breast Cancer and Dermatomyositis: A Case Study and Literature Review
Authors: Hendren E. , Vinik O. , Faragalla H. , Haq R.
Published: November 2017

A 49-year-old woman presents with an extensive violaceous rash, rapidly progressive proximal muscle weakness, and dysphagia to solids, consistent with a diagnosis of dermatomyositis. Two weeks later, she palpates a mass in her left breast and is diagnosed with her2-positive metastatic invasive ductal carcinoma of the breast. There is a well-established association between dermatomyositis and malignancy. However, the specific association between breast cancer and dermatomyositis has not been well characterized. No guideline for oncologists managing these patients has been established. Recently, 3 cases of breast cancer and dermatomyositis were diagnosed at our institution. A review of the literature was pursued to characterize the association between breast cancer and dermatomyositis. A review of 178 papers identified 22 cases of breast cancer with dermatomyositis. Most patients (71%) presented with stage iii or iv breast cancer. The median time between the diagnosis of breast cancer and the onset of dermatomyositis symptoms was 1 month. Three quarters of the patients were steroid-responsive and able to taper. Half the women with follow-up data experienced a documented cancer relapse associated with a new flare of cutaneous symptoms. The presence of dermatomyositis appears to be associated with more-advanced breast cancer stage and is most commonly associated with invasive ductal carcinoma. In our review, treatment of cancer alone is insufficient to adequately control the cutaneous and myopathic manifestations of dermatomyositis, which can significantly affect quality of life. A multidisciplinary approach, including close collaboration with rheumatologists and dermatologists, is therefore important in the diagnosis and management of oncology patients with dermatomyositis.
Coordination of Radiologic and Clinical Care Reduces the Wait Time to Breast Cancer Diagnosis
Authors: McKevitt E. C. , Dingee C. K. , Warburton R. , Pao J. S. , Brown C. J. , Wilson C. , Kuusk U.
Published: November 2017

Background: In 2009, a Rapid Access Breast Clinic (RABC) was opened at our urban hospital. Compared with the traditional system (TS), the navigated care through the clinic was associated with a significantly shorter time to surgical consultation. Since 2009, many radiology facilities have introduced facilitated-care pathways for patients with breast pathology. Our objective was to determine if that change in diagnostic imaging pathways had eliminated the advantage in time to care previously shown for the RABC. Methods: All patients seen in the RABC and the office-based TS in November–December 2012 were included in the analysis. A retrospective chart review tabulated demographic, surgeon, pathology, and radiologic data, including time intervals to care for all patients. The results were compared with data from 2009. Results: In 2012, time from presentation to surgical consultation was less for the RABC group than for the TS group (36 days vs. 73 days, p < 0.001) for both malignant (31 days vs. 55 days, p = 0.008) and benign diagnoses (43 days vs. 79 days, p < 0.001). Comparing the 2012 results with results from 2009, a decline in mean wait time was observed for the TS group (86 days vs. 73 days, p = 0.02). Compared with patients having investigations in the TS, RABC patients with cancer were more likely to undergo surgery within 60 days of presentation (33% vs. 15%, p = 0.04). Conclusions: The coordination of radiology and clinical care reduces wait times for diagnosis and surgery in breast cancer. To achieve recommended targets, we recommend implementation of more systematic coordination of care for a breast cancer diagnosis and of navigation to surgeons for patients needing surgical care.
The Experience of Patients with Cancer during Diagnosis and Treatment Planning: A Descriptive Study of Canadian Survey Results
Authors: Coronado A. C. , Tran K. , Chadder J. , Niu J. , Fung S. , Louzado C. , Rahal R.
Published: November 2017

Background: Communication with health care providers during diagnosis and treatment planning is of special importance because it can influence a patient’s emotional state, attitude, and decisions about their care. Qualitative evidence suggests that some patients experience poor communication with health care providers and have negative experiences when receiving their cancer diagnosis. Here, we use survey data from 8 provinces to present findings about the experiences of Canadian patients, specifically with respect to patient–provider communication, during the diagnosis and treatment planning phases of their cancer care. Methods: Data from the Ambulatory Oncology Patient Satisfaction Survey, representing 17,809 survey respondents, were obtained for the study. Most respondents (92%) felt that their care provider told them of their cancer diagnosis in a sensitive manner. Results: Most respondents (95%) also felt that they were provided with enough information about their planned cancer treatment. In contrast, more than half the respondents who had emotional concerns upon diagnosis (56%) were not referred to services that could help with their anxieties and fears. Also, 18% of respondents reported that they were not given the opportunity to discuss treatment options with a care provider, and 17% reported that their care providers did not consider their travel concerns while planning for treatment. Conclusions: Measuring the patient experience allows for an understanding of how well the cancer control system is addressing the physical, emotional, and practical needs of patients during diagnosis and treatment planning. Although results suggest high levels of patient satisfaction with some aspects of care, quality improvement efforts are still needed to provide person-centred care.
Auditory P300 in Noise in Younger and Older Adults
Authors: McCullagh Jennifer , Shinn Jennifer B.
Published: November 2017

Background:Older adults often report difficulty hearing in background noise which is not completely attributable to peripheral hearing loss. Although age-related declines in cognition and hearing in background noise occur, the underlying age-related changes in processing of auditory
stimuli in background noise has yet to be fully understood. The auditory P300 has the potential to elucidate the effects of age on auditory and cognitive processing of stimuli in background noise, but additional research is warranted.Purpose:The purpose of this study was to investigate
age-related differences in cognitive processing of auditory stimuli by evoking the auditory P300 at multiple signal-to-noise ratios (SNRs).Research Design:A two-group, repeated measures study design was used.Study Sample:A convenience sample of 35 participants, 15 older adults
(mean age of 66.4 yr) and 20 younger adults (mean age of 21.1 yr), participated in the study. All participants had negative otologic and neurological histories.Data Collection and Analysis:The auditory P300 was evoked using an oddball paradigm with 500 (frequent) and 1000 Hz (target)
tonal stimuli in quiet and in the presence of background noise at +20, +10, and 0 SNRs. P300 amplitudes and latencies were measured in each condition for every participant. Repeated measures analyses of variance were conducted for the amplitude and latency measures of the P300 for each group.Results:Results
from this study demonstrated P300 latencies were significantly longer in older adults in noise at the most challenging condition (0 SNR) compared with the quiet condition and between the +10 SNR and 0 SNR conditions. Although older adults had significantly longer P300 latencies compared with
younger adults, no significant group by listening condition interaction existed. No significant P300 amplitude differences were found for group, noise, or group × listening condition interactions.Conclusions:Results provide evidence that auditory cortical processing, regardless
of age, is poorer at more difficult SNRs. However, results also demonstrate that older adults perform significantly poorer than younger adults. This supports the notion that some degree of age-related decline in synchronous firing and rate of transmission of the auditory cortical neurons contributing
to the auditory P300 exists. Studies are needed to further understand the impact of noise on auditory cortical processing across populations.
Energy Dissipation and Nonthermal Diffusion on Interstellar Ice Grains
Authors: Fredon A. , Lamberts T. , Cuppen H. M.
Published: November 2017

Interstellar dust grains are known to facilitate chemical reactions by acting as a meeting place and adsorbing energy. This process strongly depends on the ability of the reactive species to effectively diffuse over the surface. The cold temperatures around 10 K strongly hamper this for species other than H and H2. However, complex organic molecules have been observed in the gas phase at these cold conditions, indicating that their formation, as well as their return to the gas phase, should be effective. Here, we show how the energy released following surface reactions can be employed to solve both problems by inducing desorption or diffusion. To this purpose, we have performed thousands of Molecular Dynamics simulations to quantify the outcome of an energy dissipation process. Admolecules on top of a crystalline water surface have been given translational energy between 0.5 and 5 eV. Three different surface species are considered (CO2, H2O, and CH4), spanning a range in binding energies, number of internal degrees of freedom, and molecular weights. The admolecules are found to be able to travel up to several hundreds of angstroms before coming to a stand still, allowing for follow-up reactions en route. The probability of travel beyond any particular radius, as determined by our simulations, shows the same r dependence for all three admolecule species. Furthermore, we have been able to quantify the desorption probability, which depends on the binding energy of the species and the translational excitation. We provide expressions that can be incorporated in astrochemical models to predict grain surface formation and return into the gas phase of these products.
Contemporaneous Imaging Comparisons of the Spotted Giant σ Geminorum Using Interferometric, Spectroscopic, and Photometric Data
Authors: Roettenbacher Rachael M. , Monnier John D. , Korhonen Heidi , Harmon Robert O. , Baron Fabien , Hackman Thomas , Henry Gregory W. , Schaefer Gail H. , Strassmeier Klaus G. , Weber Michael , Brummelaar Theo A. ten
Published: November 2017

Nearby active stars with relatively rapid rotation and large starspot structures offer the opportunity to compare interferometric, spectroscopic, and photometric imaging techniques. In this paper, we image a spotted star with three different methods for the first time. The giant primary star of the RS Canum Venaticorum binary σ Geminorum (σ Gem) was imaged for two epochs of interferometric, high-resolution spectroscopic, and photometric observations. The light curves from the reconstructions show good agreement with the observed light curves, supported by the longitudinally consistent spot features on the different maps. However, there is strong disagreement in the spot latitudes across the methods.
Doppler Shift Oscillations from a Hot Line Observed by IRIS
Authors: Li D. , Ning Z. J. , Huang Y. , Chen N.-H. , Zhang Q. M. , Su Y. N. , Su W.
Published: November 2017

We present a detailed investigation of the Doppler shift oscillations in a hot loop during an M7.1 flare on 2014 October 27 observed by the Interface Region Imaging Spectrograph. The periodic oscillations are observed in the Doppler shift of Fe xxi 1354.09 Å (log

T
∼
7.05

), and the dominant period is about 3.1 minutes. However, such 3.1 minute oscillations are not found in the line-integrated intensity of Fe xxi 1354.09 Å, AIA EUV fluxes, or microwave emissions. Solar Dynamics Observatory/AIA and Hinode/XRT imaging observations indicate that the Doppler shift oscillations locate at the hot loop-top region (≥11 MK). Moreover, the differential emission measure results show that the temperature is increasing rapidly when the Doppler shift oscillates, but the number density does not exhibit the corresponding increases nor oscillations, implying that the flare loop is likely to oscillate in an incompressible mode. All of these facts suggest that the Doppler shift oscillations at the shorter period are most likely the standing kink oscillations in a flare loop. Meanwhile, a longer period of about 10 minutes is identified in the time series of Doppler shift and line-integrated intensity, GOES SXR fluxes, and AIA EUV light curves, indicating the periodic energy release in this flare, which may be caused by a slow mode wave.
The AGN–Star Formation Connection: Future Prospects with JWST
Authors: Kirkpatrick Allison , Alberts Stacey , Pope Alexandra , Barro Guillermo , Bonato Matteo , Kocevski Dale D. , Pérez-González Pablo , Rieke George H. , Rodríguez-Muñoz Lucia , Sajina Anna , Grogin Norman A. , Mantha Kameswara Bharadwaj , Pandya Viraj , Pforr Janine , Salvato Mara , Santini Paola
Published: November 2017

The bulk of the stellar growth over cosmic time is dominated by IR-luminous galaxies at cosmic noon (

z
=
1
–
2

), many of which harbor a hidden active galactic nucleus (AGN). We use state-of-the-art infrared color diagnostics, combining Spitzer and Herschel observations, to separate dust-obscured AGNs from dusty star-forming galaxies (SFGs) in the CANDELS and COSMOS surveys. We calculate 24 μm counts of SFGs, AGN/star-forming “Composites,” and AGNs. AGNs and Composites dominate the counts above 0.8 mJy at 24 μm, and Composites form at least 25% of an IR sample even to faint detection limits. We develop methods to use the Mid-Infrared Instrument (MIRI) on JWST to identify dust-obscured AGNs and Composite galaxies from

z
∼
1
–
2

. With the sensitivity and spacing of MIRI filters, we will detect >4 times as many AGN hosts as with Spitzer/IRAC criteria. Any star formation rates based on the 7.7 μm PAH feature (likely to be applied to MIRI photometry) must be corrected for the contribution of the AGN, or the star formation rate will be overestimated by ∼35% for cases where the AGN provides half the IR luminosity and ∼50% when the AGN accounts for 90% of the luminosity. Finally, we demonstrate that our MIRI color technique can select AGNs with an Eddington ratio of

λ

Edd

∼
0.01

and will identify AGN hosts with a higher specific star formation rate than X-ray techniques alone. JWST/MIRI will enable critical steps forward in identifying and understanding dust-obscured AGNs and the link to their host galaxies.
Near-infrared Variability of Obscured and Unobscured X-Ray-selected AGNs in the COSMOS Field
Authors: Sánchez P. , Lira P. , Cartier R. , Pérez V. , Miranda N. , Yovaniniz C. , Arévalo P. , Milvang-Jensen B. , Fynbo J. , Dunlop J. , Coppi P. , Marchesi S.
Published: November 2017

We present our statistical study of near-infrared (NIR) variability of X-ray-selected active galactic nuclei (AGNs) in the COSMOS field, using UltraVISTA data. This is the largest sample of AGN light curves in YJHKs
bands, making it possible to have a global description of the nature of AGNs for a large range of redshifts and for different levels of obscuration. To characterize the variability properties of the sources, we computed the structure function. Our results show that there is an anticorrelation between the structure function A parameter (variability amplitude) and the wavelength of emission and a weak anticorrelation between A and the bolometric luminosity. We find that broad-line (BL) AGNs have a considerably larger fraction of variable sources than narrow-line (NL) AGNs and that they have different distributions of the A parameter. We find evidence that suggests that most of the low-luminosity variable NL sources correspond to BL AGNs, where the host galaxy could be damping the variability signal. For high-luminosity variable NL sources, we propose that they can be examples of “true type II” AGNs or BL AGNs with limited spectral coverage, which results in missing the BL emission. We also find that the fraction of variable sources classified as unobscured in the X-ray is smaller than the fraction of variable sources unobscured in the optical range. We present evidence that this is related to the differences in the origin of the obscuration in the optical and X-ray regimes.
L’impact de la T2A sur la gestion des établissements publics de santé
Authors: Burnel Philippe
Published: November 2017

Le présent article a pour objet de faire un point, après 12 ans de mise en œuvre, sur les effets induits par la tarification à l’activité (T2A) sur la gestion et l’organisation des établissements publics de santé (EPS). Il met en évidence, en s’appuyant sur la littérature, que les effets attendus en termes d’efficience ne se sont que partiellement réalisés. Les EPS n’ont pas révisé en profondeur leurs processus et leurs organisations se contentant de mesures d’ajustement sur les charges variables. Il s’ensuit une dégradation des conditions de travail et une perte de sens qui affecte les personnels soignants et, parfois médicaux. Pour dépasser ces limites, cet article explore les voies d’un approche réellement médico-économique centrée sur la refonte des processus de prise en charge en se fondant sur ce qui motive l’action des personnels soignants : les dynamiques du progrès médical qui offre des opportunités nouvelles et la recherche de l’amélioration de la qualité des soins.
Des coûts aux tarifs par pathologie. Les enseignements d’une tentative de transposition de la T2A au système de financement hospitalier belge
Authors: Ruyssen M. , Leclercq P. , Martins D. , Pirson M.
Published: November 2017

Le système de financement des hôpitaux belges est critiqué pour sa complexité et son manque de transparence. Dans ce contexte, le ministère a exprimé sa volonté de réformer le système actuel en prenant exemple sur les expériences étrangères de financement à la pathologie. L’objectif principal de cet article est de décrire la problématique du passage d’un calcul de coût par pathologie à l’élaboration de tarifs en s’appuyant sur une expérience concrète réalisée en Belgique sur base de l’expérience T2A. Concrètement, les données de 2012 de dix hôpitaux belges sont utilisées afin d’analyser la possibilité de transposer la méthode française de construction des tarifs à la pathologie (T2A) au contexte belge. Un périmètre de tarification est défini sur base des dotations globales reçues par ces 10 hôpitaux et en cohérence avec la méthode française. Celui-ci représente 35,62% du chiffre d’affaires total de ces 10 hôpitaux. L’écart entre la dotation initiale et le montant après répartition sur base des tarifs par pathologie varie de -11,94% à +15,38% selon l’hôpital. Nous concluons que la création d’une tarification à la pathologie en Belgique nécessite un travail approfondi visant à définir la base tarifaire. L’impact prévisible de la réforme du financement devrait inciter les hôpitaux à accorder une plus grande attention à la maitrise de leurs coûts qu’à la progression de leurs chiffres d’affaires. Le Ministère des Affaires Sociales devrait mettre en place un système standardisé de calcul des coûts par pathologie pour disposer d’une échelle nationale (ou d’échelles régionales) des coûts.
Chapitre 5. Santé et Big data : l’émergence d’un droit d’infrastructure dans l’espace numérique
Authors: Devillier Nathalie
Published: November 2017

Dans le domaine de la santé, les objets connectés, les applications mobiles et les communautés en ligne génèrent une énorme quantité de données. Cependant, les données de santé bénéficient d’une définition juridique et protection précise en tant que données sensibles, alors que les données de bien-être n’ont aucun régime juridique spécifique. Dès lors que ces données peuvent contribuer à identifier l’état de santé des individus, des atteintes à la confidentialité et à la vie privée sont possibles. De récentes affaires européennes (CEDH, CJUE) réaffirment les droits fondamentaux des citoyens à la vie privée et familiale et à un recours effectif. De telles décisions contribuent à limiter le mésusage des méga données en santé au sens large, y compris dans le domaine de la santé.
Le débat sur le « moral bioenhancement » entre dressage & perfectionnement
Authors: Adorno Francesco Paolo
Published: November 2017

Les discours et pratiques relevant de l’augmentation de notre volonté morale ( moral enhancement ) par voie médicamenteuse illustrent un cas où la volonté de réussir pousse la volonté à reconnaître ses limites physiologiques. Dès lors que nos choix résultent, entre autres choses, de certains taux de neurotransmetteurs dans nos cerveaux, l’absorption de certaines substances chimiques peut nous aider à « mieux vouloir », c’est-à-dire à choisir ce que nous ne choisissons pas spontanément, mais que nous devrions vouloir choisir, si notre désir (subjectif) pouvait s’aligner sur notre intérêt (objectif). Cette morale médicamentée prétend court-circuiter notre volonté spontanée pour imposer cet alignement par la force irrésistible de la chimie.
Prendre la mesure du renoncement négocié
Authors: Vidal Geneviève
Published: November 2017

L’injonction numérique conduit à un renoncement au cœur duquel des négociations se déploient. La dialectique du renoncement négocié ouvre sur une recherche critique sur les usages numériques visant à cerner les enjeux des stratégies de l’ordre informationnel et communicationnel.
Les media du XXI e siècle
Authors: Hansen Mark B. N. , Citton Yves
Published: November 2017

Un nouveau type de media, propres au XXI e  siècle, ne s’adresse plus à nos consciences, ni même à nos perceptions, mais vise à connecter automatiquement différents points de sensibilité du monde (y compris au sein de notre propre corps), sans plus s’adresser à des « sujets » humains. L’internet des objets a pour vocation de fonctionner tout seul, sans se laisser entraver par l’erratisme des volontés subjectives, ni ralentir par les aléas de délibérations collectives – comme une vaste architecture de choix agencés pour notre bien, mais par des programmes. C’est bien un nouveau type de médialité qu’il faut reconnaître ici, appelant de nouveaux types d’interventions.
Prêter attention au commun qui vient
Authors: Ingold Tim
Published: November 2017

Dans cet entretien réalisé en exclusivité pour Multitudes par Martin Givors et Jacopo Rasmi, l’anthropologue Tim Ingold réfléchit aux implications politiques de son travail. Il éclaire ainsi en quoi les questions de lignes, d’attention, d’éducation ou d’habitation dont il parle dans ses travaux touchent profondément à des questions de démocratie et de commun, de liberté et de diversité. Il suggère au passage que l’art et l’anthropologie peuvent entrer ensemble en correspondance avec un renouvellement de la pensée de la démocratie comme manière de mener nos vies en commun par la différentiation et l’attention.
Existe-t-il des territoires kanak ?
Authors: Pantz Pierre-Christophe
Published: November 2017

Depuis plusieurs décennies, la relation fusionnelle des Kanaks avec leur terre ancestrale a été mise en lumière par les sciences humaines. Mais s’agit-il pour autant de territoires , définis d’un point de vue occidental comme des espaces agis, appropriés et délimités par des frontières ? Dans la culture et les langues kanak, le terme de territoire n’existe pas selon cette acception. De la période pré-coloniale, où ils étaient apparentés à un réseau de lieux, de chemins et de géosymboles, jusqu’à la période coloniale, où l’administration a voulu les transformer en réserves, les territoires kanak ont subi de profondes recompositions, qui rendent nécessaires de nouveaux outils conceptuels : ceux de territorialité et de territorialisation.
Remote Automatic Meter Reading System
Authors: Zheng Wenbin , Yang Zhe , Feng Lei , Fu Ping
Published: November 2017

In order to satisfy the development of the cities and the requirements of modern factories, the network of water has been changing the pattern of the city quickly. It is possible to use automatic meter reading technology to read the data of the meters which were only read by human manual to solve the resource supply pipe network monitoring problem as the 2G/3G technology development. We designed a remote wireless automatic meter reading device to achieve the actual needs of users. STM32 works well as the core control devices to satisfy the requirements, combined with surveillance cameras and 3G wireless module to complete the hardware circuit design, which includes STM32 control circuit, sensor data acquisition part, 3G wireless module interface section, the analog video signal processing section and so on. The software was designed according to the users needs, the test results show that the device satisfies the requirements and could be used in the resource monitoring directly.
Developing of Industry 4.0 Applications
Authors: Contreras Juan David , Garcia Jose Isidro , Diaz Juan David
Published: November 2017

The fourth industrial revolution or industry 4.0 has become a trend topic nowadays, this standard-based strategy integrates Smart Factories, Cyber-physical systems, Internet of Things, and Internet of Service with the aim of extended the capacities of the manufacturing systems. Although several authors have presented the advantages of this approach, few papers refer to an architecture that allows the correct implementation of industry 4.0 applications using the guidelines of the reference architecture model (RAMI 4.0). In this way, this article exposes the essential characteristics that allow a manufacturing system to be retrofitting as a correct industry 4.0 application. Specifically, an intelligent manufacturing system under a holonic approach was developed and implemented using standards like FDI, AutomationML and OPC UA according to the RAMI 4.0
Sliding Modes for a Manipulator Arm of 4 Degrees of Freedom
Authors: Valencia Angie , Aviles Oscar , Mauledoux Mauricio
Published: November 2017

The first step in designing a controller for a manipulating arm is to determine its configuration, which means, analyzing the main components that make up the mechanism. A manipulating arm is composed of joints, motors, sensors and other elements, which are linked to conform the different degrees of freedom (generalized coordinates: prismatic, rotational or a combination of both, which is presented as the most unusual), which allow the calculation of the dynamic model implemented to obtain the control specifications [1]. In this paper, the calculation of a controller by sliding modes for a manipulator arm with 4 rotational degrees of freedom will be done, showing the respective results and conclusions at the end.
Septic abdominal gossypiboma: A life threatening surgical site infection
Authors: Gomes Carlos Augusto , Catena Fausto , Soares Junior Cleber , Sartelli Massimo , Di Saverio Salomone , Gomes Felipe Couto , Gomes Camila Couto
Published: November 2017

Gossypiboma is an uncommon surgical iatrogenic complication due to the retention of textile material inside natural cavities, especially in abdomen. An important aspect of gossypiboma is linked to the kind of inflammatory-triggered reaction: aseptic or pyogenic. In pyogenic reactions, granulomas and pus appear as a response to contaminated material left in the abdomen. Most patients are symptomatic, and clinical history and physical examination combined with computed tomography are essential to establish the diagnosis. The complication has similar pathophysiology from intra-abdominal abscess, however, has worse clinical course, poor prognosis and needs operative removal. Therefore, the gossypiboma deserves special attention and should be considered as a severe surgical site infection involving organs and/or spaces. Prevention is the key point to control the complication and is based on a systematic and systematized conference of such materials at the end of an operation. The purpose of this paper is to show for the first time all pathophysiologic steps of pyogenic gossypiboma. Moreover, to remind the risk factors associated to fungal infection (female, age, acute care unit stay, upper intestinal tract perforation, prolonged broad spectrum antibacterial therapy, parenteral nutrition and central venous catheter placement). At the same time, highlight that early antifungal therapy (Candida glabrata), should be kept in mind and should not be neglected as these was the agent involved in this patient’s death. Finally, alert the surgeons about this severe surgical site infection, which may lead to litigation.
Article Commentary: A Role for IR-β in the Free Fatty Acid Mediated Development of Hepatic Insulin Resistance?
Authors: Shah Samit , Cox Arthur G.
Published: November 2017

Several studies have been conducted to elucidate the role of free fatty acids (FFAs) in the pathogenesis of type 2 diabetes, but the exact molecular mechanism by which FFAs alter glucose metabolism in the liver is still not completely understood. 1 – 4 In a recent publication, Ragheb and coworkers have examined the effect of free fatty acid (FFA) treatment on insulin signaling and insulin resistance by using immunoprecipitation and immunoblotting to study the effect of high concentrations of insulin and FFAs on insulin receptor-beta (IR-β) and downstream elements in the PI3K pathway using the fructose-fed hamster model. 5 Their results clearly show that free fatty acids have an insignificant effect on IR-β and supports previous findings that FFAs lead to insulin resistance in the liver via the PKC-NFκB pathway. 2 , 3
Identification of Stevioside Using Tissue Culture-Derived Stevia (Stevia rebaudiana) Leaves
Authors: Karim Ziaul , Uesugi Daisuke , Nakayama Noriyuki , Hossain M. Monzur , Ishihara Kohji , Hamada Hiroki
Published: November 2017

Stevioside is a natural sweetener from Stevia leaf, which is 300 times sweeter than sugar. It helps to reduce blood sugar levels dramatically and thus can be of benefit to diabetic people. Tissue culture is a very potential modern technology that can be used in large-scale disease-free stevia production throughout the year. We successfully produced stevia plant through in vitro culture for identification of stevioside in this experiment. The present study describes a potential method for identification of stevioside from tissue culture-derived stevia leaf. Stevioside in the sample was identified using HPLC by measuring the retention time. The percentage of stevioside content in the leaf samples was found to be 9.6%. This identification method can be used for commercial production and industrialization of stevia through in vitro culture across the world.
On Message Ribonucleic Acids Targeting to Mitochondria
Authors: Ding Di , Dave Kunjan R. , Bhattacharya Sanjoy K.
Published: November 2017

Mitochondria are subcellular organelles that provide energy for a variety of basic cellular processes in eukaryotic cells. Mitochondria maintain their own genomes and many of their endosymbiont genes are encoded by nuclear genomes. The crosstalk between the mitochondrial and nuclear genomes ensures mitochondrial biogenesis, dynamics and maintenance. Mitochondrial proteins are partly encoded by nucleus and synthesized in the cytosol and partly in the mitochondria coded by mitochondrial genome. The efficiency of transport systems that transport nuclear encoded gene products such as proteins and mRNAs to the mitochondrial vicinity to allow for their translation and/or import are recently receiving wide attention. There is currently no concrete evidence that nuclear encoded mRNA is transported into the mitochondria, however, they can be transported onto the mitochondrial surface and translated at the surface of mitochondria utilizing cytosolic machinery. In this review we present an overview of the recent advances in the mRNA transport, with emphasis on the transport of nuclear-encoded mitochondrial protein mRNA into the mitochondria.
HIPAA, HIPAA, Hooray?: Current Challenges and Initiatives in Health Informatics in the United States
Authors: Joshi Sanjaya
Published: November 2017

A review of the current challenges, trends and initiatives around the various regulations as related to Health Informatics in the United States is presented.

A summary of the functions in a workflow-based approach organized into the process and compliance for HIPAA, secure email and fax communications interfaces, e-prescriptions and patient safety and the health information technology savings claims versus costs follows: • HIPAA compliance is complex; data interoperability and integration remains difficult. • Email and faxing is possible with current over-the-shelf technologies within the purview of the HIPAA Security and Privacy rule. • Integration of e-prescribing and NPI data is an area where health informatics can make a real difference. • Medical errors remain high. • There are no real savings yet from the usage of health information technologies; the costs for implementation remain high, and the business model has not evolved to meet the needs. • Health Information Technology (Health IT) projects continue to have a significant failure rate; Open Source technologies are a viable alternative both for cost reduction and scalability.

A discussion on the macro view of health informatics is also presented within the context of healthcare models and a comparison of the U.S. system against other countries.
Current Challenge in Consumer Health Informatics: Bridging the Gap between Access to Information and Information Understanding
Authors: Alpay Laurence , Verhoef John , Xie Bo , Te'eni Dov , Zwetsloot-Schonk J.H.M.
Published: November 2017

The number of health-related websites has proliferated over the past few years. Health information consumers confront a myriad of health related resources on the internet that have varying levels of quality and are not always easy to comprehend. There is thus a need to help health information consumers to bridge the gap between access to information and information understanding–-i.e. to help consumers understand health related web-based resources so that they can act upon it. At the same time health information consumers are becoming not only more involved in their own health care but also more information technology minded. One way to address this issue is to provide consumers with tailored information that is contextualized and personalized e.g. directly relevant and easily comprehensible to the person's own health situation. This paper presents a current trend in Consumer Health Informatics which focuses on theory-based design and development of contextualized and personalized tools to allow the evolving consumer with varying backgrounds and interests to use online health information efficiently. The proposed approach uses a theoretical framework of communication in order to support the consumer's capacity to understand health-related web-based resources.
Personalizing Drug Selection Using Advanced Clinical Decision Support
Authors: Pestian John , Spencer Malik , Matykiewicz Pawel , Zhang Kejian , Vinks Sander , Glauser Tracy
Published: November 2017

This article describes the process of developing an advanced pharmacogenetics clinical decision support at one of the United States’ leading pediatric academic medical centers. This system, called CHRISTINE, combines clinical and genetic data to identify the optimal drug therapy when treating patients with epilepsy or Attention Deficit Hyperactivity Disorder. In the discussion a description of clinical decision support systems is provided, along with an overview of neurocognitive computing and how it is applied in this setting.
Artificial Neural Networks for Early Prediction of Mortality in Patients with Non Variceal Upper GI Bleeding (UGIB)
Authors: Grossi Enzo , Marmo Riccardo , Intraligi Marco , Buscema Massimo
Published: November 2017

Background

Mortality for non variceal upper gastrointestinal bleeding (UGIB) is clinically relevant in the first 12–24 hours of the onset of haemorrhage and therefore identification of clinical factors predictive of the risk of death before endoscopic examination may allow for early corrective therapeutic intervention.

Aim

1) Identify simple and early clinical variables predictive of the risk of death in patients with non variceal UGIB; 2) assess previsional gain of a predictive model developed with conventional statistics vs. that developed with artificial neural networks (ANNs).

Methods and Results

Analysis was performed on 807 patients with nonvariceal UGIB (527 males, 280 females), as a part of a multicentre Italian study. The mortality was considered “bleeding-related” if occurred within 30 days from the index bleeding episode. A total of 50 independent variables were analysed, 49 of which clinico-anamnestic, all collected prior to endoscopic examination plus the haemoglobin value measured on admission in the emergency department. Death occurred in 42 (5.2%). Conventional statistical techniques (linear discriminant analysis) were compared with ANNs (Twist® system-Semeion) adopting the same result validation protocol with random allocation of the sample in training and testing subsets and subsequent cross-over. ANNs resulted to be significantly more accurate than LDA with an overall accuracy rate near to 90%.

Conclusion

Artificial neural networks technology is highly promising in the development of accurate diagnostic tools designed to recognize patients at high risk of death for UGIB.
Low Serum Alpha-1 Antitrypsin (AAT) in Family Members of Individuals with Autism Correlates with PiMZ Genotype
Authors: Russo Anthony J. , Neville Lauren , Wroge Christine
Published: November 2017

Aim

Deficiency of Alpha-1-antitrypsin (AAT) can be a genetic condition that increases the risk of developing liver, lung and possibly gastrointestinal disease. Since many autistic children also have gastrointestinal disorders, this study was designed to measure serum concentration of AAT and establish AAT genotypes in autistic children, age and gender matched non-autistic siblings, parents and controls.

Subjects and Methods

We used an indirect ELISA with monoclonal IgG to AAT to measure AAT serum concentrations in 71 members from 16 families of individuals with autism and 18 controls (no family history of autism). We used a duplex polymerase chain reaction to detect M, S and Z alleles for alpha-1 antitrypsin expression in 52 members of 12 of the above families.

Results

A significantly high number of autistic family members had lower than normal serum levels of AAT when compared to controls. Autistic children with regressive onset had significantly lower levels of AAT compared to controls, and a significant number of autistic children with low serum AAT also had hyperbilirubinemia, gastrointestinal disease and respiratory problems. We also found that a significantly high number of these individuals had the PiMZ genotype and correspondingly low levels of serum alpha-1 antitrypsin.

Discussion

Knowing that low levels of alpha-1 antitrypsin may be inherited, and that low levels of AAT may be associated with GI disease in autistic children, genotyping autistic children may help identify individuals susceptible to developing digestive problems.
Breath Hydrogen Gas Concentration Linked to Intestinal Gas Distribution and Malabsorption in Patients with Small-bowel Pseudo-obstruction
Authors: Urita Yoshihisa , Watanabe Toshiyasu , Maeda Tadashi , Sasaki Yosuke , Ishihara Susumu , Hike Kazuo , Sanaka Masaki , Nakajima Hitoshi , Sugimoto Motonobu
Published: November 2017

Summary

Background

The patient with colonic obstruction may frequently have bacterial overgrowth and increased breath hydrogen (H2) levels because the bacterium can contact with food residues for longer time. We experienced two cases with intestinal obstruction whose breath H2 concentrations were measured continuously.

Case 1

A 70-year-old woman with small bowel obstruction was treated with a gastric tube. When small bowel gas decreased and colonic gas was demonstrated on the plain abdominal radiograph, the breath H2 concentration increased to 6 ppm and reduced again shortly.

Case 2

A 41-year-old man with functional small bowel obstruction after surgical treatment was treated with intravenous administration of erythromycin. Although the plain abdominal radiograph demonstrated a decrease of small-bowel gas, the breath H2 gas kept the low level. After a clear-liquid meal was supplied, fasting breath H2 concentration increased rapidly to 22 ppm and gradually decreased to 9 ppm despite the fact that the intestinal gas was unchanged on X-ray. A rapid increase of breath H2 concentration may reflect the movement of small bowel contents to the colon in patients with small-bowel pseudo-obstruction or malabsorption following diet progression.

Conclusions

Change in breath H2 concentration had a close association with distribution and movement of intestinal gas.