bluuebunny/crossref_metadata_2025_split huggingface dataset:
Friendly, but not “friends”: Understanding and describing teacher–student relationship for productive and safe small group work
Authors: Gamble Blakey Althea , Chambers Stuart 
Published: May 2020

Introduction: Small group work is increasingly used as an educational tool in the health sciences and can have a potentially broad remit: to develop student knowledge and thinking, cultivate the values necessary for professional practice, but also, in doing so, to protect students from mistreatment. Small group teachers can, thus, find it hard to understand what an effective teacher–student relationship in small group teaching might “look like”. We sought to identify, clarify and describe characteristics essential to an effective teacher–student relationship, aiming to add to literature about the type of relationship that helps a teacher reach educational goals but, specifically, one that fully addresses the potential risks of necessarily close teacher–student contact. Method: As part of a larger action research project, we gathered qualitative data from: interviews with six medical teacher participants, observations and video-recordings of their teaching, participants’ personal reflective journals and group discussions about teaching practice. We used a grounded theory approach to analyse our data. Results: Over time, participants identified, tested and evaluated two essential characteristics to describe the teacher–student relationship that allowed teachers to meet their desired goals in small group work: 1) friendly and 2) not “friends”. Conclusions: This description of “relationship” for small group teaching is easily understood and pragmatic and, thus, potentially transferable across many health science small group teaching contexts.
Average lost work productivity due to non-fatal injuries by type in the USA
Authors: Peterson Cora , Xu Likang , Barnett Sarah Beth L 
Published: May 2020

ObjectiveTo estimate the average lost work productivity due to non-fatal injuries in the USA comprehensively by injury type.MethodsThe attributable average number and value of lost work days in the year following non-fatal emergency department (ED)–treated injuries were estimated by injury mechanism (eg, fall) and body region (eg, head and neck) among individuals age 18–64 with employer health insurance injured 1 October 2014 through 30 September 2015 as reported in MarketScan medical claims and Health and Productivity Management databases. Workplace, short-term disability and workers’ compensation absences were assessed. Multivariable regression models compared lost work days among injury patients and matched controls during the year following injured patients’ ED visit, controlling for demographic, clinical and health insurance factors. Lost work days were valued using an average US daily market production estimate. Costs are 2015 USD.ResultsThe 1-year per-person average number and value of lost work days due to all types of non-fatal injuries combined were approximately 11 days and US$1590. The range by injury mechanism was 1.5 days (US$210) for bites and stings to 44.1 days (US$6196) for motorcycle injuries. The range by body region was 4.0 days (US$567) for other head, face and neck injuries to 19.8 days (US$2787) for traumatic brain injuries.Conclusions and relevanceInjuries are costly and preventable. Accurate estimates of attributable lost work productivity are important to monitor the economic burden of injuries and help to prioritise cost-effective public health prevention activities.
A prospective, controlled study of non-motor effects of subthalamic stimulation in Parkinson’s disease: results at the 36-month follow-up
Authors: Jost Stefanie Theresa , Sauerbier Anna , Visser-Vandewalle Veerle , Ashkan Keyoumars , Silverdale Monty , Evans Julian , Loehrer Philipp A , Rizos Alexandra , Petry-Schmelzer Jan Niklas , Reker Paul , Fink Gereon Rudolf , Franklin Jeremy , Samuel Michael , Schnitzler Alfons , Barbe Michael Thomas , Antonini Angelo , Martinez-Martin Pablo , Timmermann Lars , Ray-Chaudhuri K , Dafsari Haidar S 
Published: May 2020

ObjectiveTo examine 36-month effects of bilateral subthalamic nucleus deep brain stimulation (STN-DBS) on non-motor symptoms (NMS) compared with standard-of-care medical treatment (MED) in Parkinson’s disease (PD).MethodsHere we report the 36-month follow-up of a prospective, observational, controlled, international multicentre study of the NILS cohort. Assessments included NMSScale (NMSS), PDQuestionnaire-8 (PDQ-8), Scales for Outcomes in PD (SCOPA)-motor examination, -activities of daily living, and -complications, and levodopa equivalent daily dose (LEDD). Propensity score matching resulted in a pseudo-randomised sub-cohort balancing baseline demographic and clinical characteristics between the STN-DBS and MED groups. Within-group longitudinal outcome changes were analysed using Wilcoxon signed-rank and between-group differences of change scores with Mann-Whitney U test. Strength of clinical responses was quantified with Cohen’s effect size. In addition, bivariate correlations of change scores were explored.ResultsPropensity score matching applied on the cohort of 151 patients (STN-DBS n=67, MED n=84) resulted in a well-balanced sub-cohort including 38 patients per group. After 36 months, STN-DBS significantly improved NMSS, PDQ-8, SCOPA-motor examination and -complications and reduced LEDD. Significant between-group differences, all favouring STN-DBS, were found for NMSS, SCOPA-motor complications, LEDD (large effects), motor examination and PDQ-8 (moderate effects). Furthermore, significant differences were found for the sleep/fatigue, urinary (large effects) and miscellaneous NMSS domains (moderate effects). NMSS total and PDQ-8 change scores correlated significantly.ConclusionsThis study provides Class IIb evidence for beneficial effects of STN-DBS on NMS at 36-month follow-up which also correlated with quality of life improvements. This highlights the importance of NMS for DBS outcomes assessments.
Simple budget-neutral tool to improve intraoperative communication
Authors: Dougherty James , Slowey Charlie , Hermon Anne , Wolpaw Jed 
Published: May 2020

AbstractBackgroundCommunication failure is a common cause of medical errors and adverse events. Within the operating room (OR), there are many barriers to good communication, which can adversely affect patient outcome.ObjectiveImplementing a simple, cost-neutral tool aimed at improving intraoperative communication and engagement.MethodsThree anaesthesiology residents collected data using a data sheet and tailored surveys distributed to OR staff. Data were collected over a 2-week period in 2019, with 1 week each of preintervention and postintervention data collection. The intervention consisted of wearing OR caps displaying the first name and role of the anaesthesia resident clearly on the front.ResultsA total of 20 data sheets and 48 preintervention and postintervention surveys were collected for a response rate of 57%. There was a statistically significant increase in OR staff knowledge of the anaesthesia resident’s name (66% vs 100%, p=&lt;0.001), an increase in the mean number of times the surgical providers addressed the anaesthesia residents (3.6 vs 7.8, p=0.0074) and an increase in the mean number of times the surgical providers addressed them by their first name (0.7 vs 4, p=0.0067). Comments received during the intervention were positive with overwhelming support.ConclusionsThis study demonstrated that a simple, cost-effective intervention can result in dramatic improvement in intraoperative communication and engagement between teams.
Egalitarianism in surgical training: let equity prevail
Authors: Robinson David Bryan Thomas , Hopkins Luke , James Osian Penri , Brown Chris , Powell Arfon GMT , Abdelrahman Tarig , Hemington-Gorse Sarah , Walsh Leona , Egan Richard John , Lewis Wyn 
Published: May 2020

AbstractThis study aimed to quantify core surgical trainee (CST) differential attainment (DA) related to three cohorts; white UK graduate (White UKG) versus black and minority ethnic UKG (BME UKG) versus international medical graduates (IMGs). The primary outcome measures were annual review of competence progression (ARCP) outcome, intercollegiate Membership of the Royal College of Surgeons (iMRCS) examination pass and national training number (NTN) selection. Intercollegiate Surgical Curriculum Programme (ISCP) portfolios of 264 consecutive CSTs (2010–2017, 168 white UKG, 66 BME UKG, 30 IMG) from a single UK regional post graduate medical region (Wales) were examined. Data collected prospectively over an 8-year time period was analysed retrospectively. ARCP outcomes were similar irrespective of ethnicity or nationality (ARCP outcome 1, white UKG 60.7% vs BME UKG 62.1% vs IMG 53.3%, p=0.395). iMRCS pass rates for white UKG vs BME UKG vs IMG were 71.4% vs 71.2% vs 50.0% (p=0.042), respectively. NTN success rates for white UKG vs BME UKG vs IMG were 36.9% vs 36.4% vs 6.7% (p=0.023), respectively. On multivariable analysis, operative experience (OR 1.002, 95% CI 1.001 to 1.004, p=0.004), bootcamp attendance (OR 2.615, 95% CI 1.403 to 4.871, p=0.002), and UKG (OR 7.081, 95% CI 1.556 to 32.230, p=0.011), were associated with NTN appointment. Although outcomes related to BME DA were equitable, important DA variation was apparent among IMGs, with iMRCS pass 21.4% lower and NTN success sixfold less likely than UKG. Targeted counter measures are required to let equity prevail in UK CST programmes.
One in five patients with rapidly and persistently controlled early rheumatoid arthritis report poor well-being after 1 year of treatment
Authors: Van der Elst Kristien , Verschueren Patrick , De Cock Diederik , De Groef An , Stouten Veerle , Pazmino Sofia , Vriezekolk Johanna , Joly Johan , Moons Philip , Westhovens René 
Published: May 2020

ObjectivesTo identify and characterise a subgroup of patients with early rheumatoid arthritis (RA) reporting not feeling well 1 year after treatment initiation despite achieving optimal disease control according to current treatment standards.MethodsThis observational study included participants of the Care in early RA trial with a rapid and sustained response (DAS28CRP<2.6) from week 16 until year 1 after starting the first RA treatment. Feeling well was assessed at year 1, using five patient-reported outcomes (PROs): pain, fatigue, physical functioning, RA-related quality of life and sleep quality. K-means clustering assigned patients to a cluster based on these PROs. Cohen’s d effect size estimated cluster differences at treatment initiation and week 16, for the five clustering PROs, coping behaviour, illness perceptions and social support.ResultsAnalyses revealed three clusters. Of 140 patients, 77.9% were assigned to the ‘concordant to disease activity’ cluster, 9.3% to the ‘dominant fatigue’ cluster and 12.9% to the ‘dominant pain and fatigue’ cluster. Large differences in pain and fatigue reporting were found at week 16 when comparing the ‘concordant’ with the ‘dominant pain and fatigue’ or the ‘dominant fatigue’ cluster. Small differences in reporting were found for the other PROs. Illness perceptions and coping style also differed in the ‘concordant’ cluster.ConclusionsAlthough most patients reported PRO scores in concordance with their well-controlled disease activity, one in five persistent treatment responders reported not feeling well at year 1. These patients reported higher pain and fatigue, and different illness perceptions and coping strategies early in the disease course.
Efficacy of mycophenolate mofetil as a remission induction therapy in antineutrophil cytoplasmic antibody-associated vasculitis—a meta-analysis
Authors: Kuzuya Kentaro , Morita Takayoshi , Kumanogoh Atsushi 
Published: May 2020

ObjectivesA few studies on antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) treatments have shown the therapeutic efficacy of mycophenolate mofetil (MMF). However, the therapeutic efficacy of MMF compared with that of cyclophosphamide (CYC) in patients with AAV has not been established. We conducted a systematic review and meta-analysis to assess the efficacy of MMF as a remission induction therapy in patients with AAV comparing it with the efficacy of CYC.MethodsWe searched randomised controlled trials (RCTs) comparing the efficacy of MMF with that of CYC in patients with AAV on three different websites: PubMed, Cochrane Library and Google Scholar. We compared the difference in the relative risk (RR) of each outcome based on a Mantel-Haenszel random-effects model.ResultsWe analysed data from four RCTs with 300 patients for the study. The 6-month remission rate (RR 1.09, 95% CI 0.86 to 1.38, p=0.48), the 6-month ANCA negativity (RR 1.31, 95% CI 0.91 to 1.90, p=0.15) and the long-term relapse rate (RR 1.36, 95% CI 0.80 to 2.31, p=0.26) were all similar between the two treatments. The rates of death, infection and leucopenia were also similar between the two groups (RR 1.05, 95% CI 0.40 to 2.74, p=0.93; RR 1.26, 95% CI 0.79 to 2.01, p=0.33; RR 0.45, 95% CI 0.16 to 1.32, p=0.15, respectively).ConclusionsWe found no difference between the therapeutic efficacy of MMF and that of CYC in patients with AAV. MMF may be an alternative remission induction therapy in patients with non-life-threatening AAV.
Unification of flavor SU(3) analyses of heavy Hadron weak decays
Authors: He Xiao-Gang , Shi Yu-Ji , Wang Wei 
Published: May 2020

AbstractAnalyses of heavy mesons and baryons hadronic charmless decays using the flavor SU(3) symemtry can be formulated in two different forms. One is to construct the SU(3) irreducible representation amplitude by decomposing effective Hamiltonian, and the other is to draw the topological diagrams. In the flavor SU(3) limit, we study various $$B/D\rightarrow PP,VP,VV$$B/D→PP,VP,VV, $$B_c\rightarrow DP/DV$$Bc→DP/DV decays, and two-body nonleptonic decays of beauty/charm baryons, and demonstrate that when all terms are included these two ways of analyzing the decay amplitudes are completely equivalent. Furthermore we clarify some confusions in drawing topological diagrams using different ways of describing beauty/charm baryons.
The Atud gabbro–diorite complex: glimpse of the Cryogenian mixing, assimilation, storage and homogenization zone beneath the Eastern Desert of Egypt
Authors: Stern Robert J. , Ali Kamal , Asimow Paul D. , Azer Mokhles K. , Leybourne Matthew I. , Mubarak Heba S. , Ren Minghua , Romer Rolf L. , Whitehouse Martin J. 
Published: May 2020

We analysed gabbroic and dioritic rocks from the Atud igneous complex in the Eastern Desert of Egypt to understand better the formation of juvenile continental crust of the Arabian–Nubian Shield. Our results show that the rocks are the same age (U–Pb zircon ages of 694.5 ± 2.1 Ma for two diorites and 695.3 ± 3.4 Ma for one gabbronorite). These are partial melts of the mantle and related fractionates (εNd
690
= +4.2 to +7.3,
87
Sr/
86
Sr
i
= 0.70246–0.70268, zircon δ
18
O ∼ +5‰). Trace element patterns indicate that Atud magmas formed above a subduction zone as part of a large and long-lived (
c
. 60 myr) convergent margin. Atud complex igneous rocks belong to a larger metagabbro–epidiorite–diorite complex that formed as a deep crustal mush into which new pulses of mafic magma were periodically emplaced, incorporated and evolved. The petrological evolution can be explained by fractional crystallization of mafic magma plus variable plagioclase accumulation in a mid- to lower crustal MASH zone. The Atud igneous complex shows that mantle partial melting and fractional crystallization and plagioclase accumulation were important for Cryogenian crust formation in this part of the Arabian–Nubian Shield.

Supplementary material:
Analytical methods and data, calculated equilibrium mineral temperatures, results of petrogenetic modeling, and cathodluminesence images of zircons can be found at
https://doi.org/10.6084/m9.figshare.c.4958822
Prostaglandin E1 Inhibits GLI2 Amplification–Associated Activation of the Hedgehog Pathway and Drug Refractory Tumor Growth
Authors: Wu Fujia , Zhang Chenze , Zhao Chen , Wu Hao , Teng Zhaoqian , Jiang Tao , Wang Yu 
Published: May 2020

Abstract

Aberrant activation of the Hedgehog (HH) signaling pathway underlines the initiation and progression of a multitude of cancers. The effectiveness of the leading drugs vismodegib (GDC-0449) and sonidegib (LDE225), both Smoothened (SMO) antagonists, is compromised by acquisition of mutations that alter pathway components, notably secondary mutations in SMO and amplification of GLI2, a transcriptional mediator at the end of the pathway. Pharmacologic blockade of GLI2 activity could ultimately overcome these diversified refractory mechanisms, which would also be effective in a broader spectrum of primary tumors than current SMO antagonists. To this end, we conducted a high-content screening directly analyzing the ciliary translocation of GLI2, a key event for GLI2 activation in HH signal transduction. Several prostaglandin compounds were shown to inhibit accumulation of GLI2 within the primary cilium (PC). In particular, prostaglandin E1 (PGE1), an FDA-approved drug, is a potent GLI2 antagonist that overcame resistance mechanisms of both SMO mutagenesis and GLI2 amplification. Consistent with a role in HH pathway regulation, EP4 receptor localized to the PC. Mechanistically, PGE1 inhibited HH signaling through the EP4 receptor, enhancing cAMP-PKA activity, which promoted phosphorylation and degradation of GLI2 via the ubiquitination pathway. PGE1 also effectively inhibited the growth of drug refractory human medulloblastoma xenografts. Together, these results identify PGE1 and other prostaglandins as potential templates for complementary therapeutic development to circumvent resistance to current generation SMO antagonists in use in the clinic.

Significance:
These findings show that PGE1 exhibits pan-inhibition against multiple drug refractory activities for Hedgehog-targeted therapies and elicits significant antitumor effects in xenograft models of drug refractory human medulloblastoma mimicking GLI2 amplification.
Association of NOS3 and ANGPT2 Gene Polymorphisms with Survival in Patients with Hepatocellular Carcinoma Receiving Sorafenib: Results of the Multicenter Prospective INNOVATE Study
Authors: Casadei-Gardini Andrea , Marisi Giorgia , Dadduzio Vincenzo , Gramantieri Laura , Faloppi Luca , Ulivi Paola , Foschi Francesco Giuseppe , Tamburini Emiliano , Vivaldi Caterina , Rizzato Mario Domenico , Ielasi Luca , Canale Matteo , Conti Fabio , Rudnas Britt , Fornaro Lorenzo , Silvestris Nicola , Silletta Marianna , Cardellino Giovanni Gerardo , Lonardi Sara , Fornari Francesca , Orsi Giulia , Rovesti Giulia , Zagonel Vittorina , Cascinu Stefano , Scartozzi Mario 
Published: May 2020

Abstract

Purpose:
After 10 years of clinical practice and research studies, there are still no validated prognostic or predictive factors of response to sorafenib for hepatocellular carcinoma (HCC). On the basis of the results of our two retrospective studies, we designed the multicenter INNOVATE study with the aim to validate the role of nitric oxide synthase 3 (NOS3) and ANGPT2 polymorphisms in patients with HCC treated with sorafenib [NCT02786342].

Patients and Methods:
This prospective multicenter study was conducted at 10 centers in Italy. All eligible patients received a continuous oral treatment with 400 mg of sorafenib twice daily. Genotyping analysis was performed for NOS3 (rs2070744) and ANGPT2 SNPs (rs55633437). The primary outcome was progression-free survival (PFS), whereas secondary outcomes included overall survival (OS) and disease-control rate.

Results:
A total of 165 patients were enrolled between March 2016 and June 2018. NOS3 rs2070744 CC/CT genotypes were significantly associated with a higher median PFS (5.9 months vs. 2.4 months; HR = 0.43; P = 0.0007) and OS (15.7 months vs. 8.6 months; HR = 0.38; P &lt; 0.0001) compared with TT genotype. There was no statistically significant association between ANGPT2 rs55633437 TT/GT genotypes and PFS (2.4 months vs. 5.7 months; HR = 1.93; P = 0.0833) and OS (15.1 months vs. 13.0 months; HR = 2.68; P = 0.55) when compared with the other genotype. Following adjustment for clinical covariates, multivariate analysis confirmed NOS3 as an independent prognostic factor for PFS (HR = 0.50; P = 0.0128) and OS (HR = 0.29; P = 0.0041).

Conclusions:
The INNOVATE study met the primary endpoint, confirming that patients with advanced HCC with NOS3 rs2070744 CC/CT genotypes had a better prognosis with respect to TT genotype patients.
The Unity of Composite Substance: The Scholastic Background to the Vinculum Substantiale in Leibniz’s Correspondence with Des Bosses
Authors: Anfray Jean-Pascal 
Published: May 2020

Abstract
This paper explores the scholastic context of the discussion about the unity of the composite or corporeal substance and the nature of the vinculum substantiale or substantial bond in Leibniz’s correspondence with Des Bosses. Three prominent scholastic views are examined: Duns Scotus’s antireductionist account of the composite substance as an entity irreducible to its essential parts (i.e., matter and substantial form); Ockham’s parts-whole identity thesis, which entails a reductionist view of the composite substance; and Suárez’s explanation of the unity of composite substance through the presence of a substantial mode of union. It is then shown that Leibniz initially combines a reductionist account of the composite substance, with the vinculum playing the role of bond among the component monads. In his last letters, he moves away from this to an antireductionist account of the composite substance, with which he now identifies the vinculum.
Fighting Excessive Pharmaceutical Prices: Evaluating the Options
Authors: den Exter André 
Published: May 2020

Abstract
New treatment options for various cancer therapies appear to be extremely expensive and prices may increase further. The affordability and availability of life-saving medicines is therefore a key issue in the national health policies of all countries. International and European law grant several price-reducing options, including compulsory licensing. Still, countries are reluctant to apply for compulsory licensing and/or other regulatory options to curtail pharmaceutical prices. Why is that? Evaluating the options will support health policy decision-making on safeguarding access to affordable innovative medicines.
The War on Terror as a Business: Lessons from Kenya and the Somalia Interventions
Authors: Campbell Horace G. 
Published: May 2020

Abstract
The documented evidence of the Kenyan military collaborating with the so-called forces of terror in Somalia to maintain their accumulation of approximately $400 million every year hardly made the international headlines as the leaders of Kenya have been rehabilitated into the ranks of those allied to US imperialism in waging a war on terror. There is an examination of the links between the US intelligence forces and the Kenyan cartels in keeping alive the terror threat in Somalia. Very few scholars have followed up on the revelations of the role of the Central Intelligence Agency (CIA) in funding those who matured into what is now called terror groups in Somalia through the Alliance for the Restoration of Peace and Counter-Terrorism. The challenge for scholars for peace will be to penetrate the US Africa Command shibboleths on ‘failed states’ in order to work for a program of peace and reconstruction in Africa. In the conclusion, the paper will argue that the withdrawal of the Kenyan troops from Somalia and demilitarization of security will be a concrete step to break up the cartels that are in the business of terror.