bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychodynamic case formulations without technical language: a reliability study
Authors: Sørbye Øystein , Dahl Hanne-Sofie J. , Eells Tracy D. , Amlo Svein , Hersoug Anne Grete , Haukvik Unn K. , Hartberg Cecilie B. , Høglend Per Andreas , Ulberg Randi 
Published: October 2019

Abstract

Background
To bridge the gap between symptoms and treatment, constructing case formulations is essential for clinicians. Limited scientific value has been attributed to case formulations because of problems with quality, reliability, and validity. For understanding, communication, and treatment planning beyond each specific clinician-patient dyad, a case formulation must convey valid information concerning the patient, as well as being a reliable source of information regardless of the clinician’s theoretical orientation. The first aim of the present study is to explore the completeness of unstructured psychodynamic formulations, according to four components outlined in the Case Formulation Content Coding Method (CFCCM). The second aim is to estimate the reliability of independent formulations and their components, using similarity ratings of matched versus mismatched cases.

Methods
This study explores psychodynamic case formulations as made by two or more experienced clinicians after listening to an evaluation interview. The clinicians structured the formulations freely, with the sole constraint that technical, theory-laden terminology should be avoided. The formulations were decomposed into components after all formulations had been written.

Results
The results indicated that most formulations were adequately comprehensive, and that overall reliability of the formulations was high (> 0.70) for both experienced and inexperienced clinician raters, although the lower bound reliability estimate of the formulation component deemed most difficult to rate - inferred mechanisms - was marginal, 0.61.

Conclusions
These results were achieved on case formulations made by experienced clinicians using simple experience-near language and minimizing technical concepts, which indicate a communicative quality in the formulations that make them clinically sound.

Trial registration
linicalTrials.gov Identifier: NCT00423462. 10.1007/s00432-018-2781-7., January 18, 2007.
Performance evaluation of Cerenkov luminescence imaging: a comparison of 68Ga with 18F
Authors: olde Heuvel J. , de Wit-van der Veen B. J. , Vyas K. N. , Tuch D. S. , Grootendorst M. R. , Stokkel M. P. M. , Slump C. H. 
Published: October 2019

Abstract

Background
Cerenkov Luminescence Imaging (CLI) is an emerging technology for intraoperative margin assessment. Previous research only evaluated radionuclide 18-Fluorine (18F); however, for future applications in prostate cancer, 68-Gallium (68Ga) seems more suitable, given its higher positron energy. Theoretical calculations predict that 68Ga should offer a higher signal-to-noise ratio than 18F; this is the first experimental confirmation. The aim of this study is to investigate the technical performance of CLI by comparing 68Ga to 18F.

Results
The linearity of the system, detection limit, spatial resolution, and uniformity were determined with the LightPath imaging system. All experiments were conducted with clinically relevant activity levels in vitro, using dedicated phantoms. For both radionuclides, a linear relationship between the activity concentration and detected light yield was observed (R2 = 0.99). 68Ga showed approximately 22 times more detectable Cerenkov signal compared to 18F. The detectable activity concentration after a 120 s exposure time and 2 × 2 binning of 18F was 23.7 kBq/mL and 1.2 kBq/mL for 68Ga. The spatial resolution was 1.31 mm for 18F and 1.40 mm for 68Ga. The coefficient of variance of the uniformity phantom was 0.07 for the central field of view.

Conclusion
68Ga was superior over 18F in terms of light yield and minimal detection limit. However, as could be expected, the resolution was 0.1 mm less for 68Ga. Given the clinical constraints of an acquisition time less than 120 s and a spatial resolution < 2 mm, CLI for intraoperative margin assessment using 68Ga could be feasible.
Understanding early childhood education and care utilization in Canada: implications for demand and oversight
Authors: Varmuza Petr , Perlman Michal , White Linda A. 
Published: October 2019

Abstract
This study examined early childhood education and care (ECEC) utilization in Canada, focusing on use of unlicensed home child care (HCC) from an equity perspective. Data from the 2011 cycle of the General Social Survey (GSS) were used. Across Canada, parent responses reveal that 16.6% of children between the age of 12 months and entry to school were in unlicensed HCC. Another 24% of working parents reported having no regular form of non-parental childcare. Families with higher incomes were more likely to report using center-based care. Conversely, lower-income working parents with lower levels of education were more likely to use unlicensed HCC or report using no non-parental care at all. Comparison of parent responses in Ontario, however, where government estimates for the number of licensed and unlicensed HCC spaces are available, revealed that more parents report that their children are in licensed HCC than is possible. The lack of accurate parental reporting calls into question a key assumption of current regulatory systems, which is that parents are informed consumers of ECEC services. Given that many parents misreport the type of HCC their children use, and the equity concerns raised by the overall utilization patterns we found, we argue that governments need to take a more active role in oversight and support of HCC.
A case of primary breast angiosarcoma with multiple discontinuous small lesions
Authors: Sasahara Asako , Tanabe Masahiko , Hayashi Kanako , Konishi Takaaki , Oya Mariko , Sakiyama Kana , Morizono Arisa , Harada Mayumi , Otsuji Kazutaka , Ishibashi Yuko , Sato Ayaka , Kikuchi Yasuko , Niwa Takayoshi , Hinata Munetoshi , Nishioka Kotoe , Seto Yasuyuki 
Published: October 2019

Abstract

Background
Angiosarcoma of the breast is rare. It carries a poor prognosis because of its high risk of local recurrence and distant metastases. Presently, there are still no established systemic therapies. Thus, the main treatment strategy for breast angiosarcoma is complete resection. This underscores the importance of closely monitoring the spread of the tumor lesion, particularly for multifocal angiosarcoma, and to plan an optimal operative procedure. We herein present the successful surgical treatment of a rare case of multifocal primary breast angiosarcoma.

Case presentation
A 43-year-old woman visited our hospital with a growing lump on her right breast accompanied by pain. Clinical and radiological examinations revealed a well-circumscribed 40-mm-diameter tumor at the inner lower quadrant of her right breast. Histological examination of a needle biopsy specimen revealed angiosarcoma. Based on a precise evaluation of the tumor by contrast-enhanced MRI and contrast-enhanced CT scan, a wide local excision with sufficient margins was performed. In the resected specimen, three discontinuous small lesions of angiosarcoma were observed around the main tumor. Therefore, total mastectomy was additionally performed. Pathological examination revealed two other small nodules of angiosarcoma in the remnant right breast, which appeared to be close but not continuous to the defective part of the initial resection. Postoperative follow-up at 1 year showed no signs of recurrence or distant metastasis. Multifocal primary breast angiosarcoma is extremely rare with only two previous reports describing its multifocality.

Conclusions
Owing to its rarity, a standardized surgical treatment for breast angiosarcoma remains controversial. Our case suggests that primary breast angiosarcoma may occasionally present with multifocal tumor. Thus, it is important to keep in mind the multifocality of breast angiosarcoma when assessing its spread by diagnostic imaging and when planning the surgical strategy.
Robot-assisted laparoscopic surgery after placing a self-expanding metallic stent for malignant rectal obstruction: a case report
Authors: Takeyama Hiroshi , Danno Katsuki , Nishigaki Takahiko , Yamashita Masafumi , Yamazaki Masami , Yamakita Tsuyoshi , Nishihara Akihiro , Taniguchi Hirokazu , Mizutani Masayo , Nakamichi Itsuko , Yura Mamoru , Ikeda Kimimasa , Oka Yoshio 
Published: October 2019

Abstract

Background
Approximately 20% of colorectal cancer patients show complete or incomplete bowel obstruction as an early symptom. Preoperative nonsurgical decompression such as placing a self-expanding metallic stent for malignant colorectal obstruction has been shown to be effective for reducing perioperative morbidity and mortality. However, there is a lack of published studies reporting robot-assisted laparoscopic surgery (RALS) after self-expanding metallic stent (SEMS) placement for malignant rectal obstruction (MRO). To our knowledge, this is the first report to do so.

Case presentation
An 80-year-old man with incomplete paralysis of the lower limbs as well as bladder–rectal disorder due to a spine fracture sustained in a fall accident 26 years ago presented with lower abdominal pain and vomiting. Abdominal multi-detector computed tomography revealed an obstructive rectal tumor with distended bowel on the oral side. Emergency colonoscopy was performed, and an SEMS placed. The patency of SEMS and decompression of the distended bowel was confirmed, and elective RALS was performed 29 days after SEMS placement. To our knowledge, this is the first report of RALS after decompression with SEMS placement for MRO.

Conclusions
RALS after SEMS placement is a safe and feasible therapeutic strategy for MRO.
Anasarca, steatorrhea, and hypoalbuminemia 18 years after total gastrectomy: a case report
Authors: Igata Yu , Okubo So , Ohkura Yu , Ueno Masaki , Udagawa Harushi 
Published: October 2019

Abstract

Background
Pancreatic exocrine insufficiency (PEI) is known to occur after total gastrectomy. We experienced a case of PEI occurring 18 years after surgery, leading to a potentially fatal condition of capillary leak syndrome (CLS).

Case presentation
The case is a 58-year-old man on a healthy diet who underwent total gastrectomy 18 years before. He was admitted for a 3-month history of anasarca, steatorrhea, and hypoalbuminemia. An episode of fever occurred during workup, followed by pulmonary edema and shock. The patient was transferred to the intensive care unit and was started on fluid management with albumin infusion. A multidisciplinary team meeting was held, and a clinical diagnosis of PEI resulted in CLS was made and we started administration of oral pancrelipase to show clinical improvement. The patient was discharged, and he remained asymptomatic for 13 months.

Conclusion
In a post-gastrectomy patient with malnutrition, PEI should be suspected regardless of the period since surgery. When recognized, immediate replenishment of albumin and pancreatic enzymes should be initiated to prevent clinical deterioration.
Metachronous rectal metastasis from pulmonary adenocarcinoma after 11 years of chemo-, immuno-, and radiotherapy for recurrent lesions: a case report
Authors: Suzuki Yozo , Imasato Mitsunobu , Nakahara Yujiro , Naito Atsushi , Mikamori Manabu , Ohtsuka Masahisa , Furukawa Kenta , Moon Jeong Ho , Asaoka Tadafumi , Kishi Kentaro , Yasuoka Hironao , Komuta Kiyoshi , Akamatsu Hiroki 
Published: October 2019

Abstract

Background
Rectal metastasis from pulmonary adenocarcinoma is rare, and it has been regarded as an end-stage phenomenon. Recently, however, advances in lung cancer treatment have improved the chance of long-term survival of patients with unresectable distant metastases. We describe the occurrence and management of metastatic spread of a pulmonary carcinoma to the rectum.

Case presentation
The patient was a 79-year-old woman who had undergone thoracoscopic left lobectomy for pulmonary adenocarcinoma and then, over the next 11 years, various drugs (carboplatin + paclitaxel (as adjuvant therapy), gefitinib, gemcitabine + vinorelbine, S1 (an oral 5-fluorouracil-based drug), carboplatin + pemetrexed + bevacizumab, erlotinib, nivolumab, afatinib, and carboplatin+ S1) were administered, especially for hilar and mediastinal lymph node recurrences. During the eleventh postoperative year, left and right iliac bone metastases were detected, and radiation therapy was undertaken for local control of these lesions. When 18F-fluorodeoxyglucose positron emission tomography was performed for evaluation of the disease, tracer accumulation in the upper rectum was seen. Colonoscopic examination of the rectum revealed an intramural mass with central ulceration, and the mass was diagnosed histologically as an adenocarcinoma. The bone metastases appeared to be controlled, and the patient’s performance status was good, but she had suffered constipation for about a year and desired treatment. Thus, laparoscopic low anterior resection was performed. Histopathologic analysis revealed a moderately differentiated adenocarcinoma existing mainly between the submucosa and serosa, and immunohistochemical analysis showed the tumor to be positive for cytokeratin (CK) 7, negative for CK20, positive for thyroid transcription factor-1, and negative for special AT-rich sequence-binding protein 2 and caudal type homeobox 2, confirming the diagnosis of rectal metastasis from the primary pulmonary adenocarcinoma. The patient recovered well without any change in her functional status. Systemic chemotherapy was resumed, and she continues to do well, now 6 months after surgery.

Conclusions
Surgery may be a good option for the management of an isolated rectal metastasis from pulmonary cancer in patients whose functional status is good.
Randomized Trial of Lenalidomide Versus Observation in Smoldering Multiple Myeloma
Authors: Lonial Sagar , Jacobus Susanna , Fonseca Rafael , Weiss Matthias , Kumar Shaji , Orlowski Robert Z. , Kaufman Jonathan L. , Yacoub Abdulraheem M. , Buadi Francis K. , O’Brien Timothy , Matous Jeffrey V. , Anderson Daniel M. , Emmons Robert V. , Mahindra Anuj , Wagner Lynne I. , Dhodapkar Madhav V. , Rajkumar S. Vincent 
Published: October 2019

PURPOSE Observation is the current standard of care for smoldering multiple myeloma. We hypothesized that early intervention with lenalidomide could delay progression to symptomatic multiple myeloma. METHODS We conducted a randomized trial that assessed the efficacy of single-agent lenalidomide compared with observation in patients with intermediate- or high-risk smoldering multiple myeloma. Lenalidomide was administered orally at a dose of 25 mg on days 1 to 21 of a 28-day cycle. The primary end point was progression-free survival, with disease progression requiring the development of end-organ damage attributable to multiple myeloma and biochemical progression. RESULTS One hundred eighty-two patients were randomly assigned—92 patients to the lenalidomide arm and 90 to the observation arm. Median follow-up is 35 months. Response to therapy was observed in 50% (95% CI, 39% to 61%) of patients in the lenalidomide arm, with no responses in the observation arm. Progression-free survival was significantly longer with lenalidomide compared with observation (hazard ratio, 0.28; 95% CI, 0.12 to 0.62; P = .002). One-, 2-, and 3-year progression-free survival was 98%, 93%, and 91% for the lenalidomide arm versus 89%, 76%, and 66% for the observation arm, respectively. Only six deaths have been reported, two in the lenalidomide arm versus four in the observation arm (hazard ratio for death, 0.46; 95% CI, 0.08 to 2.53). Grade 3 or 4 nonhematologic adverse events occurred in 25 patients (28%) on lenalidomide. CONCLUSION Early intervention with lenalidomide in smoldering multiple myeloma significantly delays progression to symptomatic multiple myeloma and the development of end-organ damage.
Results of a Study Comparing Glycated Albumin to Other Glycemic Indices
Authors: Desouza Cyrus V , Holcomb Richard G , Rosenstock Julio , Frias Juan P , Hsia Stanley H , Klein Eric J , Zhou Rong , Kohzuma Takuji , Fonseca Vivian A 
Published: October 2019

Abstract

Context
Intermediate-term glycemic control metrics fulfill a need for measures beyond hemoglobin A1C.

Objective
Compare glycated albumin (GA), a 14-day blood glucose measure, with other glycemic indices.

Design
24-week prospective study of assay performance.

Setting
8 US clinics.

Participants
Subjects with type 1 (n = 73) and type 2 diabetes (n = 77) undergoing changes to improve glycemic control (n = 98) or with stable diabetes therapy (n = 52).

Interventions
GA, fructosamine, and A1C measured at prespecified intervals. Mean blood glucose (MBG) calculated using weekly self-monitored blood glucose profiles.

Main Outcome Measures
Primary: Pearson correlation between GA and fructosamine. Secondary: magnitude (Spearman correlation) and direction (Kendall correlation) of change of glycemic indices in the first 3 months after a change in diabetes management.

Results
GA was more concordant (60.8%) with changes in MBG than fructosamine (55.5%) or A1C (45.5%). Across all subjects and visits, the GA Pearson correlation with fructosamine was 0.920. Pearson correlations with A1C were 0.655 for GA and 0.515 for fructosamine (P &lt; .001) and with MBG were 0.590 and 0.454, respectively (P &lt; .001). At the individual subject level, Pearson correlations with both A1C and MBG were higher for GA than for fructosamine in 56% of subjects; only 4% of subjects had higher fructosamine correlations with A1C and MBG. GA had a higher Pearson correlation with A1C and MBG in 82% and 70% of subjects, respectively.

Conclusions
Compared with fructosamine, GA correlates significantly better with both short-term MBG and long-term A1C and may be more useful than fructosamine in clinical situations requiring monitoring of intermediate-term glycemic control (NCT02489773).
Biphasic Glucocorticoid Rhythm in One-Month-Old Infants: Reflection of a Developing HPA-Axis?
Authors: Hollanders Jonneke J , van der Voorn Bibian , de Goede Paul , Toorop Alyssa A , Dijkstra Lisette R , Honig Adriaan , Rotteveel Joost , Dolman Koert M , Kalsbeek Andries , Finken Martijn J J 
Published: October 2019

Abstract

Context
The hypothalamus-pituitary-adrenal (HPA) axis displays a diurnal rhythm. However, little is known about its development in early life.

Objective
To describe HPA-axis activity and study possible influencing factors in 1-month-old infants.

Design
Observational.

Setting
Amsterdam University Medical Center, location VU University Medical Center (VUMC), and Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam.

Participants
Fifty-five mother-infant pairs.

Interventions
Collection of breast milk and infants’ saliva 1 month postpartum for analysis of glucocorticoids (GCs; ie, cortisol and cortisone) using liquid chromatography– tandem mass spectrometry.

Main Outcome Measure
GC rhythm in infants’ saliva and associations with vulnerability for maternal psychological distress (increased Hospital Anxiety and Depression Scale [HADS] score) or consultation at the Psychiatric Obstetric Pediatric (POP clinic), season at sampling, sex, and breast milk GC rhythmicity analyzed with SigmaPlot 14.0 software (Systat Software, San Jose, CA, USA) and regression analyses.

Results
A significant biphasic GC rhythm was detected in infants, with mean peaks [standard error of the mean, SEM] at 6:53 am [1:01] and 18:36 pm [1:49] for cortisol, and at 8:50 am [1:11] and 19:57 pm [1:13] for cortisone. HADS score, POP consultation, season at sampling, and sex were not associated with the infants’ GC rhythm. Breast milk cortisol maximum was positively associated with infants’ cortisol area-under-the-curve (AUC) increase and maximum. Higher breast milk cortisone AUC increase, AUC ground, and maximum were associated with an earlier maximum in infants. Breast milk and infant GC concentrations were associated between 6:00 am and 9:00 am.

Conclusions
A biphasic GC rhythm, peaking in the morning and evening, was seen in 1-month-old infants at a group level. Breast milk GC parameters might be associated with the infants’ GC rhythm, possibly caused by a signaling effect of breast milk GCs, or as an associative effect of increased mother-infant synchrony. These results contribute to an increased understanding of early life HPA-axis development.
Organic Small Molecule Covalently Functionalized Molybdenum Disulfide Hybrid Material for Optical Limiting
Authors: Gan Fan , Dong Ningning , Liu Zhiwei , Jia Huimei , Wang Jun , Chen Yu 
Published: October 2019

Abstract
Molybdenum disulfide (MoS2) nanosheets are insoluble in any organic solvent, which makes them more difficult to fabricate into thin film devices for nanoelectronics and nonlinear optics. To solve practical solution-processability problems of the MoS2 nanosheets, it would be ideal and feasible to design and synthesize MoS2-based solution-processed organic/polymeric materials. In this work, new organic small molecule covalently modified MoS2 nanosheets (MoS2-CHT) were synthesized through a simple reaction between MoS2 and 6-(9H-carbazol-9-yl)hexane-1-thiol (CHT). Both a DMF solution of MoS2-CHT and a MoS2-CHT/PMMA film exhibited excellent nonlinear optical (NLO) and optical limiting (OL) responses when compared to the MoS2 and MoS2/CHT mixture. As a result, among these materials, the annealed MoS2-CHT/PMMA film showed the largest nonlinear absorption coefficients (βeff) and highest imaginary third-order susceptibilities (Imχ(3)) (997.75 cm/GW and 4.25 × 10−10 esu at 532 nm; 372.62 cm/GW and 3.19 × 10−10 esu at 1064 nm). The enhanced NLO/OL performance of the annealed film could be due to the structural transition of MoS2 in MoS2-CHT from the 1T phase to the 2H phase during the annealing and the possible thermal-induced electron transfer effect between MoS2 and CHT moieties in MoS2-CHT.
Ankle Coordination in Chronic Ankle Instability, Coper, and Control Groups in Running
Authors: KWON YONG UNG , HARRISON KATHRYN , KWEON SANG JIN , WILLIAMS D. S. BLAISE 
Published: October 2019

ABSTRACT

Purpose
Coordination and coordination variability have been used as a measure of the function and flexibility of the sensorimotor system during running. Chronic ankle instability (CAI) is associated with altered sensorimotor system function compared with individuals without CAI. Copers may have adopted protective sensorimotor adaptations to prevent repeated ankle sprains; however, their coordination strategies between the foot and shank have not been investigated. We compared joint coupling angles and coordination variability using vector coding between individuals with CAI, copers, and controls.

Methods
Seventeen individuals with CAI, 17 copers, and 17 controls ran on the treadmill at a fixed speed of 2.68 m·s−1. A 10-s trial of continuous data was collected for kinematic analysis. The first five complete strides were used for vector coding. Means of the vector coding angles and variability of frontal plane ankle motion/transverse plane tibia motion and sagittal plane ankle motion/transverse plane tibia motion (SAK/TT) were calculated. A curve analysis with 90% confidence intervals was performed to detect differences between groups.

Results
Controls demonstrated greater angles of SAK/TT than individuals with CAI and greater angles of FAK/TT than copers during the second half of stance. In general, the control group demonstrated greater variability than individuals with CAI and copers, and copers demonstrated greater variability than individuals with CAI.

Conclusions
Chronic ankle instability and copers demonstrated different coordination strategies than controls during loading and propulsion, adding evidence to support a sensorimotor deficit or compensation. Further, limited variability in people with history of CAI during impact and midstance may contribute to higher risk of reinjury, and be an important area for further research.