bluuebunny/crossref_metadata_2025_split huggingface dataset:
Breast cancer application protocol: a randomised controlled trial to evaluate a self-management app for breast cancer survivors
Authors: Cheng Andy S K , Liu Xiangyu , Ng Peter H F , Kwok Cindy T T , Zeng Yingchun , Feuerstein Michael 
Published: July 2020

IntroductionThe eHealth technologies that are being designed for chronic disease constitute a global trend towards health assessment and self-management. However, most of these approaches tend to focus on a single symptom or problem rather than on the multiple problems that are characteristic of many of these chronic illnesses. The aim of this study is to examine the effectiveness of and adherence to a self-management application (app) that identifies multiple problem areas related to surviving breast cancer as the targeted chronic illness.Methods and analysisThis is a randomised controlled study. Eligible participants will be allocated randomly into either an intervention group or a control group at a 1:1 ratio. The intervention group will be assigned to the self-management app (‘Be-with-You’), while the control group will use a general health app (‘Sham’ app). The primary outcomes will include the differences between the two groups in their health literacy, problem-solving skills and self-management skills. The secondary outcomes will include group differences in self-efficacy, readiness for change and health-related quality of life. All of these outcomes will be measured at baseline and at 4 weeks and 12 weeks after intervention. In addition, usability of these two mobile apps will be measured at 4 weeks and 12 weeks after intervention. The planned sample size is 476.Ethics and disseminationThe Human Subjects Ethics Sub-committee of The Hong Kong Polytechnic University approved the study (HSEARS20190922001, 24 September 2019). Dissemination of findings will occur at the local, national and international levels.Trial registration numberChiCTR1900026244.
Nurses’ decision-making about cancer patients’ end-of-life skin care in Wales: an exploratory mixed-method vignette study protocol
Authors: Samuriwo Ray , Lovell-Smith Candida , Anstey Sally , Job Claire , Hopkinson Jane 
Published: July 2020

IntroductionPatients with cancer are at high risk of developing pressure ulcers at the end of life as a result of their underlying condition or cancer treatment. There are many guidelines which set out best practice with regard to end-of-life skin care. However, the complexity of palliative cancer care often means that it is challenging for nurses to make the appropriate person-centred decisions about end-of-life skin care. This study seeks to explore the perceived importance that nurses place on different factors in their end-of-life skin care for patients with cancer. The utility, face validity and content validity of a prototype decision-making tool for end-of-life skin care will also be evaluated.Methods and analysisA mixed-method design will be used to gather data from primary and secondary care nurses working in different hospitals and local authority areas across Wales. Clinical vignettes will be used to gather qualitative and quantitative data from nurses in individual interviews. Qualitative data will be subject to thematic analysis and quantitative data will be subject to descriptive statistical analysis. Qualitative and quantitative data will then be synthesised, which will enhance the rigour of this study, and pertinently inform the further development of an end-of-life skin care decision-making tool for patients with cancer.Ethics and disseminationEthical approval to undertake the study has been granted by Cardiff University School of Healthcare Sciences Research Governance and Ethics Screening Committee. Informed consent will be obtained in writing from all the participants in this study. The results of this study will be disseminated through journal articles, as well as presentations at national and international conferences. We will also report our findings to patient and public involvement groups with an interest in improving cancer care, palliative care as well as skin care.
How good is online information on fibromyalgia? An analysis of quality and readability of websites on fibromyalgia in Spanish
Authors: Alioshkin Cheneguin Arturo , Salvat Salvat Isabel , Romay Barrero Helena , Torres Lacomba María 
Published: July 2020

ObjectiveTo assess the content, quality and readability of websites with information on fibromyalgia in Spanish.MethodsWebsites were retrieved entering the keyword ‘fibromyalgia’ in Google, Yahoo! and Bing, and by searching records of patients associations in Spain and Latin America. The Bermúdez-Tamayo and DISCERN questionnaires were employed for evaluating quality and content, and INFLESZ for readability. Statistical analysis was conducted using IBM SPSSV.24 (Chicago, USA).ResultsThree hundred and five websites were found. After applying the exclusion criteria, 73 websites were analysed. Websites retrieved by search engines obtained median scores of 27.0 (interquartile interval (IQI): 24.5–32.0) with DISCERN, 35.0 (IQI: 31.0–40.5) with Bermúdez-Tamayo and 53.7 (IQI: 47.4–56.2) with INFLESZ, whereas those from patients associations scored 21.0 (IQI: 19.2–23.8), 26.0 (IQI: 25.0–31.0) and 51.7 (IQI: 47.9–55.1), respectively. In general, content was not up-to-date.ConclusionsOverall quality was medium-low, content quality was very low and readability was poor. Further effort is needed to guarantee meeting quality criteria and accessing updated, relevant, and legible information.This study exposes the quality and readability of websites on fibromyalgia in Spanish, which can help healthcare workers to better appraise this resource and its potential influence on the development of the pathology.
What is a good death? A critical discourse policy analysis
Authors: Borgstrom Erica 
Published: July 2020

ObjectiveThe concept of a good death is a motivating factor for end of life care policy; this article examines what English end-of-life care (EOLC) policy defines as a good death.MethodsCritical discourse analysis of policy documents and policy-promoting materials published between 2008 and 2016.ResultsPolicy explicitly defines a good death as having the following attributes: being treated as an individual, with dignity and respect; being without pain and other symptoms; being in familiar surroundings and being in the company of close family and/or friends. Critical discourse analysis of 54 documents found that rather than just being an outcome or event, descriptions of what makes a death good also include many processes. A more extended definition includes: the person receives holistic EOLC; the dying person is treated with dignity and respect; the death is not sudden and unexpected; people are prepared and have ideally done some advance care planning; people are aware that someone is dying and openly discuss this; on knowing the dying person’s preferences, all involved are to work towards achieving these; the place of death is important; the person’s family are involved and the needs of the bereaved are considered.ConclusionThis analysis indicates the complex nature of the current discourses around good death in EOLC policy, which often focuses on care rather than death. Policy should focus on outlining what quality end-of-life care looks like, rather than assume ‘good death’ is a suitable outcome statement.
Milestones: a mixed methods study of an educational intervention to improve care of the dying
Authors: Mooney Michelle , Bright Rebecca , Vickerstaff Victoria , Stirling Caroline , Yardley Sarah 
Published: July 2020

BackgroundApproximately 460 000 people die annually in England. Three-quarters of these deaths are expected. Health Education England is prioritising upskilling of clinical staff in response to reports of poor care quality in the last days of life in acute hospitals, where almost half of all deaths occur. This study explores the impact of an end-of-life care (EoLC) educational intervention,Milestones, in acute hospital trusts in Greater London.MethodsThis is a mixed methods study. Learners completed a questionnaire pre- (n=452), immediately post- (n=488) and 3 to 8 months post- (n=37) intervention. The questionnaire measured learner confidence in EoLC covering the National Health Service adopted ‘Priorities for the Care of the Dying Person’. Paired t-tests were used to determine statistically significant difference in learner confidence pre- and post-intervention. A convenience sample of learners (n=7) and educators (n=5) were recruited to qualitative semi-structured interviews that sought to understand if, how and whyMilestonesworked. Data were analysed using a thematic approach.ResultsA statistically significant increase in learner confidence across all five priorities of care’ was sustained up to 8 months (p<0.001). Interviewees wanted to discuss wider challenges in EoLC related to the organisations and cultural contexts in which they worked. Concerns included balancing hope when decision-making, learning as a multidisciplinary team and emotional impact.ConclusionThe findings suggest thatMilestonesis a flexible, beneficial resource for teaching EoLC that facilitates enhanced learner engagement. Understanding generated about wider concerns can inform future educational material development, organisational process and research study design.
What does informal access to misoprostol in Colombia look like? A mystery client methodology in Bogotá and the Coffee Axis
Authors: Moore Ann M , Blades Nakeisha , Ortiz Juliette , Whitehead Hannah , Villarreal Cristina 
Published: July 2020

IntroductionIn 2006, abortion was decriminalised in Colombia under certain circumstances. Yet, women avail themselves of ways to terminate pregnancy outside of the formal health system. This study explored how drug sellers engage with women who attempt to purchase misoprostol from them.MethodsA mapping exercise was undertaken to list small-chain and independent drug stores in two regions in Colombia. A sample (n=558) of drug stores was selected from this list and visited by mystery clients between November and December 2017. Mystery clients sought to obtain a medication to bring back a delayed period, and described the experience, the information obtained and the medications proffered in exit interviews.ResultsMisoprostol was offered for purchase in 15% of the visits; in half of visits, only information about misoprostol was shared, while no information about misoprostol was provided on the remaining visits. Over half of sellers who refused to sell any medication provided referrals, most commonly to an abortion provider. Among visits which included discussion of misoprostol, two out of five sellers provided dosage instructions with most recommending the minimum adequate dosage. Mystery clients received little information on the physical effects to expect with the use of misoprostol and possible complications.ConclusionsAs misoprostol is being obtained from some drug sellers without a prescription, capacitating this cadre with at least a minimum of standardised information on dosage, routes of administration and expected effects and outcomes have the potential to improve reproductive health outcomes for women who choose to terminate pregnancies this way in Colombia.
Augmentation of pulmonary blood flow and cardiac output by non-invasive external ventilation late after Fontan palliation
Authors: Charla Pradeepkumar , Karur Gauri Rani , Yamamura Kenichiro , Yoo Shi-Joon , Granton John T , Oechslin Erwin N , Shah Ashish , Benson Leland N , Honjo Osami , Mertens Luc , Alonso-Gonzalez Rafael , Hanneman Kate , Wald Rachel M 
Published: July 2020

ObjectivesAlthough a life-preserving surgery for children with single ventricle physiology, the Fontan palliation is associated with striking morbidity and mortality with advancing age. Our primary objective was to evaluate the impact of non-invasive, external, thoraco-abdominal ventilation on pulmonary blood flow (PBF) and cardiac output (CO) as measured by cardiovascular magnetic resonance (CMR) imaging in adult Fontan subjects.MethodsAdults with a dominant left ventricle post-Fontan palliation (lateral tunnel or extracardiac connections) and healthy controls matched by sex and age were studied. We evaluated vascular flows using phase-contrast CMR imaging during unassisted breathing, negative pressure ventilation (NPV) and biphasic ventilation (BPV). Measurements were made within target vessels (aorta, pulmonary arteries, vena cavae and Fontan circuit) at baseline and during each ventilation mode.ResultsTen Fontan subjects (50% male, 24.5 years (IQR 20.8–34.0)) and 10 matched controls were studied. Changes in PBF and CO, respectively, were greater following BPV as compared with NPV. In subjects during NPV, PBF increased by 8% (Δ0.20 L/min/m2(0.10–0.53), p=0.011) while CO did not change significantly (Δ0.17 L/min/m2(−0.11–0.23), p=0.432); during BPV, PBF increased by 25% (Δ0.61 L/min/m2(0.20–0.84), p=0.002) and CO increased by 16% (Δ0.47 L/min/m2(0.21–0.71), p=0.010). Following BPV, change in PBF and CO were both significantly higher in subjects versus controls (0.61 L/min/m2(0.2–0.84) vs −0.27 L/min/m2(−0.55–0.13), p=0.001; and 0.47 L/min/m2(0.21–0.71) vs 0.07 L/min/m2(−0.47–0.33), p=0.034, respectively).ConclusionExternal ventilation acutely augments PBF and CO in adult Fontan subjects. Confirmation of these findings in larger populations with longer duration of ventilation and extended follow-up will be required to determine sustainability of haemodynamic effects.
Role of daily anal stimulation for intractable functional constipation in infants
Authors: Zhu Tianqi , Sun Xiaoyi , Zhu Dan , You Qian , Wan Xiaoting , Meng Xinyao , Feng Jiexiong 
Published: July 2020

ObjectiveFunctional constipation is one of the most common problems in pediatric gastroenterology. The aim of the present study was to evaluate the effectiveness of daily anal stimulation in infants with intractable functional constipation (IFC). Our evaluation was based on clinical improvement and on changes in manometric parameters through time.MethodsInfants with IFC treated between January 2018 and December 2019 were included in this retrospective study. Treatment processing included daily anal stimulation for infants and psychological counseling for parents. All cases underwent a complete intervention program and were evaluated for improvement in symptoms and for changes in anorectal manometry within 1 year of follow-up.ResultsA total of 161 patients were included in this study. Positive response was achieved in all patients. Frequency of defecation, change in stool form and decrease in the defecatory pain were significantly relieved in all infants after intervention. On anorectal manometry, no significant difference was found in the peristaltic frequency of distal rectum before and after treatment. There was a significant increase in the mean amplitude of peristalsis and improvement in the rhythm after intervention. In the 1 year of follow-up, three patients had recurrence of constipation requiring colectomy.ConclusionIn terms of the high clinical efficacy and limited side effects, daily anal stimulation may be included in the initial part of an intervention program for IFC in infants.
Doped holographic fermionic system
Authors: Huang Wenjun , Fu Guoyang , Zhang Dan , Zhou Zhenhua , Wu Jian-Pin 
Published: July 2020

AbstractWe construct a two-current model. It includes two gauge fields, which introduce the doping effect, and a neutral scalar field. And then we numerically construct an AdS black brane geometry with scalar hair. Over this background, we study the fermionic system with the pseudoscalar Yukawa coupling. Some universal properties from the pseudoscalar Yukawa coupling are revealed. In particular, as the coupling increases, there is a transfer of the spectral weight from the low energy band to the high energy band. The transfer is over low energy scales but not over all energy scales. The peculiar properties are also explored. The study shows that with the increase of the doping, the gap opens more difficult. It indicates that there is a competition between the pseudoscalar Yukawa coupling and the doping.
Efficient Authorization of Graph-database Queries in an Attribute-supporting ReBAC Model
Authors: Rizvi Syed Zain Raza , Fong Philip W. L. 
Published: July 2020

Neo4j is a popular graph database that offers two versions: an
enterprise edition
and a
community edition
. The enterprise edition offers customizable Role-based Access Control features through custom developed
procedures
, while the community edition does not offer any access control support. Being a graph database, Neo4j appears to be a natural application for Relationship-Based Access Control (ReBAC), an access control paradigm where authorization decisions are based on relationships between subjects and resources in the system (i.e., an authorization graph). In this article, we present AReBAC, an attribute-supporting ReBAC model for Neo4j that provides finer-grained access control by operating over resources instead of procedures. AReBAC employs Nano-Cypher, a declarative policy language based on Neo4j’s Cypher query language, the result of which allows us to weave database queries with access control policies and evaluate both simultaneously. Evaluating the combined query and policy produces a result that (i) matches the search criteria, and (ii) the requesting subject is authorized to access. AReBAC is accompanied by the algorithms and their implementation required for the realization of the presented ideas, including
GP-Eval,
a query evaluation algorithm. We also introduce Live-End Backjumping (LBJ), a backtracking scheme that provides a significant performance boost over conflict-directed backjumping for evaluating queries. As demonstrated in our previous work, the original version of
GP-Eval
already performs significantly faster than the Neo4j’s Cypher evaluation engine. The optimized version of
GP-Eval
, which employs LBJ, further improves the performance significantly, thereby demonstrating the capabilities of the technique.
Comparação de metodologias para determinação de gordura e avaliação do conteúdo de cálcio e fósforo em petiscos para cães
Authors: Zafalon Rafael Vessecchi Amorim , Rodrigues Roberta Bueno Ayres , Conti Renata Maria Consentino , Perini Mariana Pamplona , Rentas Mariana Fragoso , Vendramini Thiago Henrique Annibale , Risolia Larissa Wunsche , Macedo Henrique Tobaro , Brunetto Marcio Antonio 
Published: July 2020

In recent years, the relationship between humans and companion animals has tightened considerably and resulted in the expansion of the range of pet food industry products available in the market. In this context, snacks have gained greater popularity as pet owners seek to please their animals by providing such foods. Due to the growing importance of the snack segment, a need exists for accurate information on the nutritional composition of these products, such as fat concentration. No studies were found that evaluated the effectiveness of different methods applied for determining the content of this nutrient in dog snacks. In addition, too much mineral content can pose health risks. Thus, the objective of this study was to compare three methodologies for determining fat in pet snack products. The moisture, calcium and phosphorus content of each was also determined to compare the obtained results with each value stated on their product labels. Fat determination methods evaluated were ether extract (EE), ether extract after acid hydrolysis (EEHA), and fat content obtained from Ankom XT15 analyzer (ANKOM). Twenty-four snacks produced by 17 companies were evaluated. The results of the three methodologies were compared using the Tukey test. The comparison between the results of the laboratory analysis and the values stated on the labels was performed using descriptive statistics. There was no difference between the three methods evaluated (p = 0.34) regarding fat content. Regarding the nutritional compliance of the labels, 25% (n = 6) of the snacks presented higher moisture content than the declared amount, 50% (n = 12) presented lower fat content, 25% (n = 6) lower phosphorus content and, in 50% (n = 12), the calcium content was not within the minimum and maximum range stated on the label. Therefore, due to the absence of difference between the results, any of the three fat determination methodologies could be used. Regarding compliance of labels for calcium, phosphorus and fat content, greater control over the nutritional composition of these foods is required since most pet owners tend to supply large quantities of snacks to dogs, leading to excessive daily energy intake.
Gestão de riscos no setor público brasileiro: uma nova lógica de accountability?
Authors: Klein Junior Vitor Hugo 
Published: July 2020

Diferentes governos têm adotado a gestão de riscos como parte de um novo padrão de excelência para o controle interno. O modelo de regulação baseado no risco, no entanto, requer a rearticulação do controle em torno de uma nova lógica de accountability, por meio da qual órgãos de controle devem redefinir os limites da ação e responsabilidade pública. As consequências dessa agenda no contexto brasileiro, entretanto, carecem de estudos. Este artigo examina os desafios de implementação da gestão de riscos em um governo estadual, em termos do impacto dessa inovação nas formas de prestação de contas e enforcement de agentes públicos. Com base em 13 rodadas de entrevistas e observação participante, os resultados demonstram que, apesar da gestão de riscos servir para legitimar a expansão do controle interno, a assimilação dessa inovação encontra barreiras na identidade profissional de auditores, na baixa relevância de controles internos e na dificuldade de disclosure de riscos estratégicos. O artigo contribui ao propor que, desacoplada de uma reformulação dos incentivos para a transparência de problemas estruturais, a gestão de riscos tem alcance limitado no enfrentamento de riscos sistêmicos no setor público.
Em movimento: Carpeaux e a última ditadura militar brasileira
Authors: Silva Eduardo Gomes 
Published: July 2020

Após o golpe civil-militar de 1964, Carpeaux transformou sua coluna de política internacional do Correio da Manhã em uma trincheira de oposição à ditadura. Quando o espaço deixou de existir, Carpeaux partiu para outras frentes de batalha, que incluem cerimônias de formatura, imprensa alternativa e uma película de 16 mm.
Situação e presença de um crítico austríaco-brasileiro
Authors: Vilhena Guilherme Mazzafera S. 
Published: July 2020

Procura-se apresentar a vida e obra de Carpeaux, privilegiando sua atuação como crítico literário radicado no Brasil por meio da recuperação de dois ensaios fundamentais de seu percurso, compostos em momentos distintos: “Situação e presença: algumas reflexões sobre a crítica literária” (1941) e “Dialética da literatura brasileira” (1967). Destaca-se a noção de presença, vinculada ao perfil ensaístico de sua escrita, a construção de um locus crítico movente entre a formação europeia e a fruição analítica da literatura brasileira, e a fluida coexistência entre política e literatura em seus escritos.