bluuebunny/crossref_metadata_2025_split huggingface dataset:
Social distribution of tobacco smoking, alcohol drinking and obesity in the French West Indies
Authors: Auguste Aviane , Dugas Julien , Menvielle Gwenn , Barul Christine , Richard Jean-Baptiste , Luce Danièle 
Published: October 2019

Abstract

Background
Tobacco smoking, alcohol and obesity are important risk factors for a number of non-communicable diseases. The prevalence of these risk factors differ by socioeconomic group in most populations, but this socially stratified distribution may depend on the social and cultural context. Little information on this topic is currently available in the Caribbean. The aim of this study was to describe the distribution of tobacco smoking, alcohol drinking and obesity by several socioeconomic determinants in the French West Indies (FWI).

Methods
We used data from a cross-sectional health survey conducted in Guadeloupe and Martinique in 2014 in a representative sample of the population aged 15–75 years (n = 4054). All analyses were stratified by gender, and encompassed sample weights, calculated to account for the sampling design and correct for non-response. For each risk factor, we calculated weighted prevalence by income, educational level, occupational class and having hot water at home. Poisson regression models were used to estimate age-adjusted prevalence ratios (PR) and 95% confidence intervals (CI).

Results
Current smoking and harmful chronic alcohol use were more common in men than in women (PR = 1.80, 95% CI = 1.55–2.09; PR = 4.53, 95% CI = 3.38–6.09 respectively). On the other hand, the prevalence of obesity was higher in women than in men (PR = 0.67, 95% CI = 0.57–0.79). Higher education, higher occupational class and higher income were associated with lower prevalence of harmful alcohol drinking in men (PR = 0.43, 95% CI = 0.25–0.72; PR = 0.73, 95% CI = 0.53–1.01; PR = 0.72, 95% CI = 0.51–1.03 respectively), but not in women. For tobacco smoking, no variation by socioeconomic status was observed in men whereas the prevalence of current smoking was higher among women with higher occupational class (PR = 1.47, 95% CI = 1.13–1.91) and higher income (PR = 1.50, 95% CI = 1.11–2.03). In women, a lower prevalence of obesity was associated with a higher income (PR = 0.43, 95% CI = 0.33–0.56), a higher occupational class (PR = 0.63, 95% CI = 0.50–0.80), a higher educational level (PR = 0.36, 95% CI = 0.26–0.50) and having hot water at home (PR = 0.65, 95% CI = 0.54–0.80).

Conclusion
Women of high socio-economic status were significantly more likely to be smokers, whereas alcohol drinking in men and obesity in women were inversely associated with socioeconomic status.
Think twice before stent insertion for renal artery aneurysm with elusive etiology: a case report
Authors: Zhang Jian-zhong , Zhang Peng , Wu Li-yang , Wang Yong , Gao Kun , Huang Qiang , Wang Xiao-hui 
Published: October 2019

Abstract

Background
Endovascular treatment has been recognized as the first line therapy for renal artery aneurysm (RAA). However, RAA related with malignancies had been sporadically reported in the literature. Stent insertion should be contraindicated for RAAs with malignant etiology, whereas surgery be optimal.

Case presentation
A 40-year-old female underwent covered stent insertion to exclude the left RAA for suspected Takayasu arteritis in a reginal hospital. Three months later the RAA recurred with sign of threatened rupture, and the patient was transferred for salvage embolization with coils and thrombin injection. However, 20 days after the embolization procedure, multiple painful subcutaneous nodules developed in her flanks. Undifferentiated sarcoma was revealed by the pathological biopsy of the nodules. The RAA in this case was most likely related with the malignancy.

Conclusion
Malignancy was the most likely etiology behind recurrent aneurysm in this case. Definite diagnosis is mandatory for interventional radiologists before stent insertion for treatment of RAA.
Rapid high throughput template preparation (rHTTP) method: a novel cost effective method of direct PCR for a wide range of plants
Authors: Choudhary Prassan , Das Sudipta , Chakdar Hillol , Singh Arjun , Goswami Sanjay Kumar , Saxena Anil Kumar 
Published: October 2019

Abstract

Background
Conventional plant DNA isolation methods are complex, time consuming and require technical expertise. These limitations were overcome using the DNA isolation kits which, however significantly add to the research costs. Hence the present study was aimed to develop a high throughput, rapid and inexpensive method of PCR ready DNA template preparation from plant materials.

Methods
Concentration of SDS in lysis buffer, amount of starting material, period and temperature for lysis were optimized for obtaining PCR ready templates from plant materials. The method was tested using RAPD and ITS specific primers for different plant species like rice, wheat, mustard, pea, soybean, pigeonpea, tomato, maize, march lilly, bougainvillea, Indian blanket flower, nerium, petunia, purple pirouette petunia, moses-in-the-cradle, golden cane palm, duranta, periwinkle, chrysanthemum and two xerophytes viz. Dipterygium glaucum and Crotaleria burhia. SSR markers RM18398 and RM26108 showed successful amplification in rice varieties Improved Pusa Basmati 1 and KS Dev 12. The effectiveness of the method was tested using fresh as well as 1 year old tissues. The storability of the lysate was also tested.

Results
In this report, we developed a novel method called rapid high throughput template preparation (rHTTP) method to prepare PCR ready DNA templates. Most striking feature of this technique is that it can be done anywhere where water can be boiled by any means. Using rHTTP method, PCR ready templates can be prepared in just 10 min. Robust and reproducible amplification for all the test plants were recorded with RAPD, plant ITS primers and SSR markers following this method. rHTTP methods works well for both fresh as well as old plant tissues. The lysates had a shelf life of 1 month when stored at 4 °C and 3 days when stored at room temperature.

Conclusions
rHTTP method has several advantages over the other protocols like ease of execution, no requirement of tissue grinding/liquid nitrogen/hazardous chemicals and above all, equally effective for both fresh and old samples. Using this method, costs per prep comes down ~ 10–50 times as compared to most commercial kits. This method can be used for on-field experiments like molecular diagnostics, varietal identification etc.
End-of-life and palliative care of patients on maintenance hemodialysis treatment: a focus group study
Authors: Axelsson Lena , Benzein Eva , Lindberg Jenny , Persson Carina 
Published: October 2019

Abstract

Background
Despite complex illness trajectories and a high symptom burden, palliative care has been sub-optimal for patients with end-stage kidney disease and hemodialysis treatment who have a high rate of hospitalization and intensive care towards end of life. There is a growing awareness that further development of palliative care is required to meet the needs of these patients and their family members. In this process, it is important to explore healthcare professionals’ views on provision of care. The aim of this study was therefore to describe nurses’ and physicians’ perspectives on end-of-life and palliative care of patients treated with maintenance hemodialysis.

Methods
Four focus group interviews were conducted with renal nurses (17) and physicians (5) in Sweden. Qualitative content analysis was used to analyze data.

Results
Participants were committed to giving the best possible care to their patients, but there were challenges and barriers to providing quality palliative care in nephrology settings. Professionals described palliative care as end-of-life care associated with hemodialysis withdrawal or palliative dialysis, but also identified care needs and possibilities that are in line with an earlier integrated palliative approach. This was perceived as complex from an organizational point of view. Participants identified challenges related to coordination of care and different perspectives on care responsibilities that impacted symptom management and patients’ quality of life. Communication issues relating to the provision of palliative care were revealed where the hemodialysis setting was regarded as an impediment, and personal and professional experiences, beliefs and knowledge were considered of major importance.

Conclusions
Nurses and physicians identified a need for the improvement of both late and earlier palliative care approaches. The results highlighted a requirement for and possibilities of training, counselling and support of health care professionals in the dialysis context. Further, multi-professional palliative care collaborations should be developed to improve the coordination and organization of end-of-life and palliative care of patients and their family members. A climate allowing conversations about advance care planning throughout the illness trajectory may facilitate the gradual integration of palliative care alongside life-prolonging treatment for improved support of patients and families.
Diagnostic challenges: low-grade adenosarcoma on deep endometriosis
Authors: Vilches Jimenez Jose Carlos , Villegas Muñoz Emilia , González Poveda Iván , Santos Lorente David , Sanchez Pérez Belinda , Jimenez Lopez Jesús S. 
Published: October 2019

Abstract

Background
Müllerian adenosarcoma is a rare malignancy. These tumors occur mainly in the uterus, but also in extrauterine locations, usually related to endometriosis. Because of their rarity, there is limited data on optimal management strategies.

Case presentation
We present a 44-year-old woman with a history of endometriosis who consults for chronic pelvic pain. In the imaging tests, a heterogeneous mass is observed that impresses endometriosis, encompassing the uterus and left appendage. Surgery is performed by finding an extrauterine adenosarcoma that affected the uterus, ovary and bladder wall.

Conclusion
This is a rare case but should be considered in a patient with atypical clinical characteristics or preoperative pathology, so we show the diagnostic and therapeutic strategies carried out for the resolution of the case.
Remarkable rutin-rich Hypericum capitatum extract exhibits anti-inflammatory effects on turpentine oil-induced inflammation in rats
Authors: Farcas Anca D. , Mot Augustin C. , Zagrean-Tuza Cezara , Ticolea Madalina , Sevastre Bogdan , Kulak Muhittin , Silaghi-Dumitrescu Radu , Parvu Alina 
Published: October 2019

Abstract

Background
Natural extracts with beneficial biological activities are nowadays of high interest, in various treatment or prophylaxis. Hypericum capitatum has been known for its curative effects for centuries and its extracts have become of interest due to their distinct activity among other Hypericaceae members. In this study, further light is aimed to be shed on the secondary-metabolites composition of H. capitatum extracts, using chromatographic techniques and Electron paramagnetic resonance profiles in alkaline medium. Considering that no previous works explored the anti-inflammatory activity of H. capitatum, here, an in vivo study is also designed in order to evaluate this property by assessing the impact of one of H. capitatum extracts in ameliorating turpentine oil-induced inflammation on rats and to quantify their blood antioxidants level.

Methods
Chromatographic techniques and Electron paramagnetic resonance spectroscopy were used in order to describe the chemical profile in different parts of the plant. The in vivo study on turpentine-oil induced inflammation in rats included three doses of H. capitatum extract expressed in rutin concentration. Oxidative stress was measured using total oxidative status, total antioxidant capacity, oxidative stress index, 3-nitrotyrosine, nitric oxide, malondialdehyde, superoxide dismutase, catalase and the inflammatory response was evaluated by performing a complete blood cells count and C reactive protein.

Results
The extract was remarkably rich in rutin; however, other polyphenolic-like minor components appeared important in explaining the observed biological properties. The tested extract prevents the increase of inflammation-induced white blood cell count, number of neutrophils, and serum nitric oxide, and did so in a dose-dependent manner, similarly to the positive control—diclofenac. In addition, the same extract appeared to be a good alternative to diclofenac to restore total oxidative status, thiobarbituric active reactive species, total proteins and C reactive proteins. Moreover, antioxidant enzymes such as catalase, superoxide dismutase and total serum thiol concentration were significantly increased by the tested extract.

Conclusions
Due to its powerful reservoir rich in rutin, H. capitatum extract depicted its in vivo antioxidant and anti-inflammatory effects indicating it to be a good alternative to conventional drugs for oxidative stress protection.
A night on call or an overnight shift does not reduce residents’ empathy: a randomized crossover multicenter survey
Authors: Mizobe Michiko , Kataoka Hitomi , Yamagami Hiroshi , Ito Chikao , Koyama Yasuaki , Yawata Erika , Shiga Takashi 
Published: October 2019

Abstract

Background
Studies have shown that sleep deprivation may reduce empathy among medical students. Yet, little is known about the empathy after a night on call or an overnight shift among resident physicians. Hence, we aimed to examine whether a night on call or an overnight shift reduces the physicians’ empathy.

Methods
We conducted a multicenter randomized crossover survey using the Jefferson Scale of Physician Empathy (JSE). A total of 260 physicians who worked at academic hospitals and community hospitals in Japan in 2016 were recruited and randomized into two groups. Group A first completed the JSE prior to a night on call or an overnight shift; then, 8 weeks later, Group A completed the JSE after a night on call or an overnight shift. Group B first completed the JSE after a night on call or an overnight shift; then, 8 weeks later, Group B completed the JSE prior to a night on call or an overnight shift. Statistical analyses were performed to compare the JSE scores of pre- and post-night on call or overnight shifts.

Results
A total of 117 Group A physicians and 112 Group B physicians returned a completed JSE. The overall response rate was 88.08%. There was no significant difference in the JSE scores between pre- and post-night on call or overnight shift. (Group A before night vs Group B after night, p = 0.40, Group A after night vs Group B before night, p = 0.68).

Conclusion
As per our results, a night on call or an overnight shift did not reduce the Japanese physicians’ empathy. To the best of our knowledge, this is the first study on physicians’ empathy after a night on call or an overnight shift.
Linguistic analysis of pediatric residency personal statements: gender differences
Authors: Babal Jessica C. , Gower Aubrey D. , Frohna John G. , Moreno Megan A. 
Published: October 2019

Abstract

Background
All US residency programs require applicants to submit personal statements. Prior studies showed gender differences in personal statement writing, which has implications for gender bias in the application process, but previous studies have not considered the dual influence of specialty-specific values on personal statement writing by applicants of each gender.

Objective
To understand gender differences in pediatric residency personal statements.

Methods
From 2017 to 2018, we performed linguistic analysis of personal statements written by interviewees at a mid-size US pediatrics residency during two prior academic years. We assessed writing tone, communal language, and agentic language. We performed t-tests to evaluate for gender differences, p < 0.05.

Results
We analyzed personal statements from 85 male and 85 female interviewees. Average word count was 676 words. Personal statements demonstrated analytic writing style with authentic and positive emotional tone. We found no gender differences in communal language for social affiliation (p = 0.31), adjectives (p = 0.49), or orientation (p = 0.48), which deviates from typical gender norms for male language use. Males used agentic language of reward more frequently (p = 0.02).

Conclusions
Findings suggest that social language is valued in pediatrics, a predominantly female specialty, regardless of applicant gender. Use of reward language by males is consistent with previous findings. Future studies should evaluate gender differences in residency applications across specialties to advance understanding of the role gender plays in the application process.
Relational autonomy: what does it mean and how is it used in end-of-life care? A systematic review of argument-based ethics literature
Authors: Gómez-Vírseda Carlos , de Maeseneer Yves , Gastmans Chris 
Published: October 2019

AbstractBackgroundRespect for autonomy is a key concept in contemporary bioethics and end-of-life ethics in particular. Despite this status, an individualistic interpretation of autonomy is being challenged from the perspective of different theoretical traditions. Many authors claim that the principle of respect for autonomy needs to be reconceptualised starting from a relational viewpoint. Along these lines, the notion of relational autonomy is attracting increasing attention in medical ethics. Yet, others argue that relational autonomy needs further clarification in order to be adequately operationalised for medical practice. To this end, we examined the meaning, foundations, and uses of relational autonomy in the specific literature of end-of-life care ethics.MethodsUsing PRESS and PRISMA procedures, we conducted a systematic review of argument-based ethics publications in 8 major databases of biomedical, philosophy, and theology literature that focused on relational autonomy in end-of-life care. Full articles were screened. All included articles were critically appraised, and a synthesis was produced.ResultsFifty publications met our inclusion criteria. Twenty-eight articles were published in the last 5 years; publications were originating from 18 different countries. Results are organized according to: (a) an individualistic interpretation of autonomy; (b) critiques of this individualistic interpretation of autonomy; (c) relational autonomy as theoretically conceptualised; (d) relational autonomy as applied to clinical practice and moral judgment in end-of-life situations.ConclusionsThree main conclusions were reached. First, literature on relational autonomy tends to be more a ‘reaction against’ an individualistic interpretation of autonomy rather than be a positive concept itself. Dichotomic thinking can be overcome by a deeper development of the philosophical foundations of autonomy. Second, relational autonomy is a rich and complex concept, formulated in complementary ways from different philosophical sources. New dialogue among traditionally divergent standpoints will clarify the meaning. Third, our analysis stresses the need for dialogical developments in decision making in end-of-life situations. Integration of these three elements will likely lead to a clearer conceptualisation of relational autonomy in end-of-life care ethics. This should in turn lead to better decision-making in real-life situations.
Nursing students’ perception of the clinical learning environment and supervision in relation to two different supervision models – a comparative cross-sectional study
Authors: Ekstedt Mirjam , Lindblad Marléne , Löfmark Anna 
Published: October 2019

AbstractBackgroundKnowledge concerning nursing students’ experiences of the clinical learning environment and how supervision is carried out is largely lacking. This study compares nursing students’ perceptions of the clinical learning environment and supervision in two different supervision models:peer learning in student-dedicated units,with students working together in pairs and supervised by a “preceptor of the day” (model A), andtraditional supervision, in which each student is assigned to a personal preceptor (model B).MethodsThe study was performed within the nursing programme at a university college in Sweden during students’ clinical placements (semesters 3 and 4) in medical and surgical departments at three different hospitals. Data was collected using the Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale, CLES+T, an instrument tested for reliability and validity, and a second instrument developed for this study to obtain deeper information regarding how students experienced the organisation and content of the supervision. Independent t-tests were used for continuous variables, Mann-Whitney U-tests for ordinal variables, and the chi-square or Fischer’s exact tests for categorical variables.ResultsOverall, the students had positive experiences of the clinical learning environment and supervision in both supervision models. Students supervised in model A had more positive experiences of the cooperation and relationship between student, preceptor, and nurse teacher, and more often than students in model B felt that the ward had an explicit model for supervising students. Students in model A were more positive to having more than one preceptor and felt that this contributed to the assessment of their learning outcomes.ConclusionsA good learning environment for students in clinical placements is dependent on an explicit structure for receiving students, a pedagogical atmosphere where staff take an interest in supervision of students and are easy to approach, and engagement among and collaboration between preceptors and nurse teachers. This study also indicates that supervision based on peer learning in student-dedicated rooms with many preceptors can be more satisfying for students than a model where each student is assigned to a single preceptor.