bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patients’ experience of communication and handling of symptomatic adverse events in breast cancer patients receiving adjuvant chemotherapy
Authors: Bæksted Christina Witt , Nissen Aase , Knoop Ann S. , Pappot Helle 
Published: November 2019

Abstract
Background
The study is based on a national cluster randomized trial investigating the effect of electronic patient-reported outcomes (ePRO) on treatment outcomes in breast cancer patients receiving adjuvant chemotherapy. All 13 oncology departments (11 clusters) treating breast cancer patients in Denmark were randomized to use electronic patient-reported outcomes with real-time clinician feedback (ePRO arm) to track symptoms or usual care for eliciting symptoms using a short paper tracking list (usual care arm). The impact of ePRO on clinical outcomes were examined, which is reported elsewhere. The purpose of the present study was to examine patient-reported experience measure (PREM) regarding communication and handling of side effects/symptoms.

Methods
For this sub-study, patient representatives were involved in the development of a PREM questionnaire. Patients enrolled in the cluster randomized trial completed the PREM questionnaire at their last treatment visit. Semi-structured telephone-interviews were performed with a subgroup of patients. The interviews were based on an interview guide comprised of the questions from the PREM questionnaire and aimed to elaborate on the PREM questionnaire data.

Results
A 12 item PREM questionnaire was developed in partnership with patient representatives. In total, 439 out of 682 patients (64.4%) included patients completed the PREM questionnaire. Telephone semi-structured interviews were performed with 22 patients. In total, 52% (ePRO arm) and 65% (usual care arm) reported having talked with the oncologist/nurse about their responses in the tracking systems before each chemotherapy cycle. Fewer patients in the ePRO arm compared to the usual care arm experienced side effects/symptoms not included in the side effect questionnaire. Patients experienced high satisfaction with oncologists’ and nurses’ handling of side effects/symptoms.

Conclusions
Patients experienced high satisfaction with oncologists’ and nurses’ handling of chemotherapy adverse events. The study indicates a need for a more comprehensive side effect questionnaire as tracking system covering more symptoms than the one used in usual care today.

Trial registration
Clinicaltrials.gov identifier NCT02996201. Registered 19 December 2016, retrospectively registered.
Exploring website gist through rapid serial visual presentation
Authors: Owens Justin W. , Chaparro Barbara S. , Palmer Evan M. 
Published: November 2019

Abstract
Background
Users can make judgments about web pages in a glance. Little research has explored what semantic information can be extracted from a web page within a single fixation or what mental representations users have of web pages, but the scene perception literature provides a framework for understanding how viewers can extract and represent diverse semantic information from scenes in a glance. The purpose of this research was (1) to explore whether semantic information about a web page could be extracted within a single fixation and (2) to explore the effects of size and resolution on extracting this information. Using a rapid serial visual presentation (RSVP) paradigm, Experiment 1 explored whether certain semantic categories of websites (i.e., news, search, shopping, and social networks/blogs) could be detected within a RSVP stream of web page stimuli. Natural scenes, which have been shown to be detectable within a single fixation in the literature, served as a baseline for comparison. Experiment 2 examined the effects of stimulus size and resolution on observers’ ability to detect the presence of website categories using similar methods.

Results
Findings from this research demonstrate that users have conceptual models of websites that allow detection of web pages from a fixation’s worth of stimulus exposure, when provided additional time for processing. For website categories other than search, detection performance decreased significantly when web elements were no longer discernible due to decreases in size and/or resolution. The implications of this research are that website conceptual models rely more on page elements and less on the spatial relationship between these elements.

Conclusions
Participants can detect websites accurately when they were displayed for less than a fixation and when the participants were allowed additional processing time. Subjective comments and stimulus onset asynchrony data suggested that participants likely relied on local features for the detection of website targets for several website categories. This notion was supported when the size and/or resolution of stimuli were decreased to the extent that web elements were indistinguishable. This demonstrates that schemas or conceptualizations of websites provided information sufficient to detect websites from approximately 140 ms of stimulus exposure.
Genetic improvement of Bacillus thuringiensis against the cotton bollworm, Earias vitella (Fab.) (Lepidoptera: Noctuidae), to improve the cotton yield in Pakistan
Authors: Yunus Fakhar-un-Nisa , Raza Ghulam , Makhdoom Rahat , Zaheer Hafsa 
Published: November 2019

AbstractIn the present study, CryIAc (Crystal protein) gene was cloned under Cry3A promoter, which is known to express vegetatively as a sporulation independent promoter, transformed into acrystalliferous strain of Bacillus thuringiensis. Its potential was evaluated as a strain to be used for formulation development against the spotted cotton bollworm Earias vitella (Fab.) (Lepidoptera: Noctuidae), the major pest of cotton, the important cash crop in Pakistan. The crystal protein produced in a new strain, i.e., Bt1, had comparable potency as of crystal protein produced during sporulation. The new strain Bt1 had the maximum expression of Cry1Ac protein during the vegetative stage, i.e., in the first 24 h, thereby reducing the growth period until crystal protein production, from 72 to 24 h. In addition, crystal protein produced during vegetative stage under Cry3A promoter remained encapsulated within the cells, which could protect them from UV degradation and was independent of sporulation; therefore; it did not produce spores and thus is not a source to spread Bt spores in the environment. It can, therefore, be called as an environmentally friendly pesticide to control cotton pest especially bollworms and ultimately improve the yield of cotton.
Endovascular treatment of hepatic arterioportal fistula complicated with giant portal vein aneurysm via percutaneous transhepatic US guided hepatic artery access: a case report and review of the literature
Authors: Oguslu Umut , Uyanik Sadik Ahmet , Gümüş Burçak 
Published: November 2019

Abstract
Background
Hepatic arterioportal fistulas are rare, abnormal, direct communications between hepatic artery and portal venous system. Treatment options shifted from surgery to endovascular interventions. Catheterization may be challenging. We report a case of a hepatic arterioportal fistula treated successfuly with Amplatzer Vascular Plug II via percutaneous transhepatic hepatic artery access after failed transfemoral approach.

Case presentation
58 year old woman presented with right heart failure, kidney insufficiency and massive ascites related to portal hypertension caused by hepatic arterioportal fistula. She had a history of previous abdominal surgery. Colour Doppler ultrasound and computed tomography revealed a giant portal vein aneurysm related to large hepatic areterioportal fistula. Endovascular treatment was planned. Catheterization of the hepatic artery could not be realized due to severe tortuosity and angulation of the celiac artery and its branches. Access to the hepatic artery was obtained directly via percutaneous transhepatic route and fistula site was embolized with Amplatzer Vascular Plug II and coils. Immediate thrombosis of the aneurysm sac and draining portal vein was observed. Patients clinical status improved dramatically.

Conclusion
Transcatheter embolization is the first choice of the treatment of hepatic arterioportal fistulas but the type of the therapy should be tailored to the patient and interventional radiologist should decide the access site depending on his own experience if the routine endovascular access can not be obtained.
Prospective trial examining safety and efficacy of microcurrent stimulation for the treatment of sinus pain and congestion
Authors: Goldsobel Alan B. , Prabhakar Niveditha , Gurfein Blake T. 
Published: November 2019

Abstract
Background
Inflammation and swelling of the sinus and nasal mucosa are commonly caused by viral infection, bacterial infection, or exposure to allergens and irritants. Sinonasal inflammation can cause symptoms of nasal congestion, facial pressure, and rhinogenic facial pain or “sinus pain”. A previous randomized controlled study demonstrated that acute treatment with non-invasive periorbital microcurrent stimulation resulted in a rapid and clinically meaningful reduction in self-report of sinus pain that significantly outperformed sham control treatment. Here, we assessed the acute durability of microcurrent pain relief and longitudinal effects of 4 weeks of daily microcurrent treatment in patients presenting with sinus pain.

Methods
Thirty subjects with moderate facial pain (numeric rating scale ≥5) attributed to self-reported sinonasal disease were enrolled in a single-arm, prospective interventional study. At enrollment, subjects were given a microcurrent treatment device and written instructions and self-administered the device to the bilateral periorbital regions for 5 mins. Subjects were instructed to treat themselves at home once daily and up to four times daily as needed for 4 weeks. Pain was measured both acutely and weekly during the 4 weeks of treatment using the numeric rating scale. Congestion and medication use data were collected weekly using the Congestion Quantifier 7 (CQ7) and medication diary, respectively.

Results
Thirty patients were enrolled and completed the study. Microcurrent therapy rapidly reduced post-treatment numeric rating scale for pain by − 1.2 at 10 mins (p = 0.0076), − 1.6 at 1 hr (p = 0.0007), − 1.9 at 2 hrs (p < 0.0001), − 2.1 at 4 hrs (p < 0.0001), and − 2.1 at 6 hrs (p < 0.0001). With daily microcurrent treatment, numeric rating scale for pain was reduced over 4 weeks by − 1.3 (− 20.1%) after 1 week (p = 0.0018), − 2.1 (− 32.1%) after 2 weeks (p < 0.0001), − 2.4 (− 36.6%) after 3 weeks (p < 0.0001) and − 2.9 (− 43.3%) after 4 weeks (p < 0.0001). For subjects who enrolled with moderate or worse congestion, mean congestion scores (CQ7) were reduced by − 4.2 (− 22.0%) after 1 week (p < 0.0001), − 5.8 (− 33.0%) after 2 weeks (p < 0.0001), − 7.2 (− 37.4%) after 3 weeks (p < 0.0001) and − 8.6 (− 44.3%) after 4 weeks (p < 0.0001) of microcurrent treatment.

Conclusion
Self-administered periorbital microcurrent treatment given at home was efficacious in significantly reducing moderate sinus pain for up to 6 hrs and significantly reducing moderate pain and congestion over 4 weeks of daily use. Microcurrent therapy was found to be safe with only minor side effects that resolved without intervention.

Trial registration
ClinicalTrials.gov, NCT03888274. Registered 25 March 2019. Retroactively registered, https://clinicaltrials.gov/ct2/show/NCT03888274.
Robustness of radiomic features in magnetic resonance imaging: review and a phantom study
Authors: Cattell Renee , Chen Shenglan , Huang Chuan 
Published: November 2019

AbstractRadiomic analysis has exponentially increased the amount of quantitative data that can be extracted from a single image. These imaging biomarkers can aid in the generation of prediction models aimed to further personalized medicine. However, the generalizability of the model is dependent on the robustness of these features. The purpose of this study is to review the current literature regarding robustness of radiomic features on magnetic resonance imaging. Additionally, a phantom study is performed to systematically evaluate the behavior of radiomic features under various conditions (signal to noise ratio, region of interest delineation, voxel size change and normalization methods) using intraclass correlation coefficients. The features extracted in this phantom study include first order, shape, gray level cooccurrence matrix and gray level run length matrix. Many features are found to be non-robust to changing parameters. Feature robustness assessment prior to feature selection, especially in the case of combining multi-institutional data, may be warranted. Further investigation is needed in this area of research.
Comparing pain control using oral acetaminophen versus dorsal penile block in neonatal circumcision
Authors: Ogundoyin Olakayode O. , Olulana Dare I. , Lawal Taiwo A. , Kumolalo Felix O. 
Published: November 2019

Abstract
Background
Circumcision is one of the commonest surgical procedures performed yet the most controversial worldwide. Although various reasons have been suggested in support of circumcision, the pain and stress that accompany it on both neonates and mothers are factors against the procedure. This study compared pain control using oral acetaminophen syrup versus 1% lidocaine injection given as dorsal penile block during neonatal circumcision.

Results
There were 191 neonates in group A and 195 in group B. The mean age at circumcision was 23.71 (SD ± 20.39) days, and mean weight was 3.33 (SD ± 0.74) kg. The mean pain scores for group A immediately and 1 h after circumcision were 4.26 (SD ± 2.48) and 0.37 (SD ± 1.35), respectively. In group B, the mean pain scores immediately and 1 h after circumcision were 3.31 (SD ± 2.59) and 0.35 (SD ± 1.19), respectively.

Conclusion
Penile block gives better pain control in comparison with oral acetaminophen syrup, but both agents are effective and can be combined to provide a long-lasting perioperative anaesthesia and analgesia for circumcision in the hospital setting.
Metrics of Diabetes Risk Are Only Minimally Improved by Exercise Training in Postmenopausal Breast Cancer Survivors
Authors: Viskochil Richard , Blankenship Jennifer M , Makari-Judson Grace , Staudenmayer John , Freedson Patty S , Hankinson Susan E , Braun Barry 
Published: November 2019

Abstract

Context
Insulin resistance is a risk factor for breast cancer recurrence. How exercise training changes fasting and postglucose insulin resistance in breast cancer survivors is unknown.

Objective
To evaluate exercise-induced changes in postglucose ingestion insulin concentrations, insulin resistance, and their associations with cancer-relevant biomarkers in breast cancer survivors.

Setting
The University of Massachusetts Kinesiology Department.

Participants
15 postmenopausal breast cancer survivors not meeting the physical activity guidelines (150 min/week of exercise).

Intervention
A supervised 12-week aerobic exercise program (60 min/day, 3–4 days/week).

Main outcome measures
Postglucose ingestion insulin was determined by peak insulin and area under the insulin curve (iAUC) during a 5-sample oral glucose tolerance test. Insulin sensitivity was estimated from the Matsuda composite insulin sensitivity index (C-ISI). Changes in fitness and body composition were determined from submaximal VO2peak and dual energy X-ray absorptiometry.

Results
Participants averaged 156.8 ± 16.6 min/week of supervised exercise. Estimated VO2peak significantly increased (+2.8 ± 1.4 mL/kg/min, P &lt; .05) and body weight significantly decreased (–1.1 ± 0.8 kg, P &lt; .05) following the intervention. There were no differences in fasting insulin, iAUC, C-ISI, or peak insulin following the intervention. Insulin was only significantly lower 120 min following glucose consumption (68.8 ± 34.5 vs 56.2 ± 31.9 uU/mL, P &lt; .05), and there was a significant interaction with past/present aromatase inhibitor (AI) use for peak insulin (–11.99 non-AI vs +13.91 AI uU/mL) and iAUC (-24.03 non-AI vs +32.73 AI uU/mL).

Conclusions
Exercise training had limited overall benefits on insulin concentrations following glucose ingestion in breast cancer survivors but was strongly influenced by AI use.
Use of hPSC-derived 3D organoids and mouse genetics to define the roles of YAP in the development of the esophagus
Authors: Bailey Dominique D. , Zhang Yongchun , van Soldt Benjamin J. , Jiang Ming , Suresh Supriya , Nakagawa Hiroshi , Rustgi Anil K. , Aceves Seema S. , Cardoso Wellington V. , Que Jianwen 
Published: November 2019

ABSTRACT
Balanced progenitor activities are crucial for the development and maintenance of high turn-over organs such as the esophagus. However, the molecular mechanisms regulating these progenitor activities in the esophagus remain to be elucidated. Here, we demonstrated that Yap is required for the proliferation of esophageal progenitor cells (EPCs) in the developing murine esophagus. We found that Yap deficiency reduces EPC proliferation and stratification whereas persistent Yap activation increases cell proliferation and causes aberrant stratification of the developing esophagus. We further demonstrated that the role of YAP signaling is conserved in the developing human esophagus by utilizing 3D human pluripotent stem cell (hPSC)-derived esophageal organoid culture. Taken together, our studies combining loss/gain-of-function murine models and hPSC differentiation support a key role for YAP in the self-renewal of EPCs and stratification of the esophageal epithelium.
Retrospective analysis of reduced energy switching and room switching times on throughput efficiency of a multi-room proton therapy center
Authors: Mah Dennis , Chen Chin Cheng , Nawaz A Omer , Galbreath Greg , Shmulenson Reuven , Lee Nancy , Chon Brian 
Published: November 2019

Objective:
To quantify how a control software upgrade changed beam delivery times and impacted efficiency and capacity of a multiroom proton therapy center.

Methods:
A four-room center treating approximately 90 patients/day, treating for approximately 7 years with optimized operations, underwent a software upgrade which reduced room and energy switching times from approximately 30 to 20 s and approximately 4 s to ~0.5 s, respectively. The center uses radio-frequency identification data to track patient treatments and has software which links this to beam delivery data extracted from the treatment log server. Two 4-month periods, with comparable patient volume, representing periods before and after the software change, were retrospectively analyzed.

Results:
A total of 16,168 and 17,102 fields were analyzed. For bilateral head and neck and prostate patients, the beam waiting time was reduced by nearly a factor of 3 and the beam delivery times were reduced by nearly a factor of 2.5. Room switching times were reduced more modestly. Gantry capacity has increased from approximately 30 patients to 40–45 patients in a 16-h daily operation.

Conclusions:
Many proton centers are striving for increased efficiencies. We demonstrated that reductions in energy and room switching time can significantly increase center capacity. Greater potential for further gains would come from improvements in setup and imaging efficiency.

Advances in knowledge:
This paper provides detailed measured data on the effect on treatment times resulting from reducing energy and room switching times under controlled conditions. It helps validate the models of previous investigations to establish treatment capacity of a proton therapy center.
The effectiveness and characteristics of pregnancy yoga interventions: a systematic review protocol
Authors: Corrigan Lisa , Eustace-Cook Jessica , Moran Patrick , Daly Deirdre 
Published: November 2019

Background: The purpose of the proposed review is to systematically examine the clinical effectiveness of pregnancy yoga. The review will use the FITT (frequency, intensity, time/duration and type) principle of physical activity to characterise the different types of yoga interventions that have been evaluated in the included studies. Methods/design: The following electronic databases will be searched using a detailed search strategy: MEDLINE, PsycINFO, EMBASE, CINAHL, WHOLiS, AMED, ScieLo, ASSIA and Web of Science. Randomised control trials and quasi-experimental studies examining pregnancy yoga will be included. Titles, abstracts and full articles will be screened by two investigators independently to identify eligible studies. The Cochrane Collaboration’s Risk of Bias Assessment tool will be used to assess study quality. Quality of the evidence will be evaluated using the GRADE criteria. A standardised data extraction form will be used to extract data. Effect sizes will be estimated using mean differences for continuous outcomes, and relative risks for dichotomous outcome. Where possible, pooling of effect estimates will be done using a random effect model. Discussion: This review will synthesise the best available evidence on the effectiveness of yoga during pregnancy and provide valuable high-quality information for clinicians and health policymakers. Findings will be disseminated through publication in a peer-reviewed journal and presentation at relevant conference proceedings. The review will make recommendations for the appropriate volume, intensity and type of pregnancy yoga for maximum effect and may have implications for policy and practice relating to pregnancy yoga as an intervention. Registration: PROSPERO, CRD42019119916. Registered on 11th January 2019.
Impact on Length of Stay of a Hospital Medicine Emergency Department Boarder Service
Authors: Kobayashi Kimiyoshi J , Knuesel Steven J , White Benjamin A , Bravard Marjory A , Chang Yuchiao , Metlay Joshua P , Raja Ali S , MD Melissa LP Mattison 
Published: November 2019

BACKGROUNDIt is not known whether delivering inpatient care earlier to patients boarding in the emergency department (ED) by a hospitalist‐led team can decrease length of stay (LOS).OBJECTIVETo study the association between care provided by a hospital medicine ED Boarder (EDB) service and LOS.DESIGN, SETTING, AND PARTICIPANTSRetrospective cross‐sectional study (July 1, 2016 to June 30, 2018) conducted at a single, large, urban academic medical center. Patients admitted to general medicine services from the ED were included. EDB patients were defined as those waiting for more than two hours for an inpatient bed. Patients were categorized as covered EDB, noncovered EDB, or nonboarder.INTERVENTIONThe hospital medicine team provided continuous care to covered EDB patients waiting for an inpatient bed.PRIMARY OUTCOME AND MEASURESThe primary outcome was median hospital LOS defined as the time period from ED arrival to hospital departure. Secondary outcomes included ED LOS and 30‐day ED readmission rate.RESULTSThere were 8,776 covered EDB, 5,866 noncovered EDB, and 2,026 nonboarder patients. The EDB service covered 59.9% of eligible patients and 62.9% of total boarding hours. Median hospital LOS was 4.76 (interquartile range [IQR] 2.90‐7.22) days for nonboarders, 4.92 (IQR 3.00‐8.03) days for covered EDB patients, and 5.11 (IQR 3.16‐8.34) days for noncovered EDB (P < .001). Median ED LOS for nonboarders was 5.6 (IQR 4.2‐7.5) hours, 20.7 (IQR 15.8‐24.9) hours for covered EDB, and 10.1 (IQR 7.9‐13.8) hours for noncovered EDB (P < .001). There was no difference in 30‐day ED readmission rates.CONCLUSIONAdmitted patients who were not boarders had the shortest LOS. Among boarded patients, coverage by a hospital medicine‐led EDB service was associated with a reduced hospital LOS.