bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proactive versus reactive feeding tube (FT) placement in head and neck cancer patients (HNC pts) receiving chemoradiation (CRT).
Authors: Sivananth Thunnisa , Quinn Maureen , Stortz Rae-Ann , Palma David A. , Francis Peggy , Kuruvilla Sara , Nichols Anthony C. , Warner Andrew , Winquist Eric 
Published: November 2019

11 Background: Most HNC pts treated with CRT develop severe treatment-related oropharyngeal mucositis. For pts with adequate nutritional status and swallowing function prior to CRT the optimal approach to nutritional management remains undefined. A subset of pts will require FTs to complete treatment, but at least 50% of pts with prophylactic FTs never use them (Madhoun 2011). At our center we have used a "reactive" approach which minimizes exposure to unnecessary FT placement. However, some pts suffer nutritional crises resulting in hospitalization, treatment interruption, and higher risks of complications from FT placement. We investigated the impact of a more proactive approach to FT placement in our pts. Methods: HNC pts treated with CRT who received a FT during treatment 2014-2018 were retrospectively identified from electronic medical records and clinical data extracted. "Proactive" FTs were not considered medically necessary but were placed within 15 days of starting CRT. Primary outcomes of interest were weight loss during CRT (WTL), FT complications, length of hospital stay and FT duration. Uni- and multivariate analyses were done and p values < 0.05 considered of interest. Results: 124 pts were identified: 87% male, median age 62.5 yrs (39-80) and 67% oropharyngeal primary. All received platinum-based chemotherapy or cetuximab (8 pts). 19 FTs were considered medically necessary, 94 were placed reactively and 11 placed proactively; 91% were percutaneous and 94% were used. Median weight was 79.0 kg (27.6-165.7) prior to CRT and 71.2 kg (26.8-148.2) after. Median WTL was 9.9% (-13.9 to 33.3%). Proactive FT placement was associated with less WTL (p = 0.045). WTL was greater in pts over age 65 (OR 11.6 [1.4-97.6]). Hospital stay was longer for pts who had reactive FT. Females had longer FT duration (p = 0.005). Conclusions: These data suggest that when a reactive approach to FT placement is used, earlier FT placement during CRT is more effective at reducing weight loss and hospitalization time in this population. Specific criteria for pt selection with this approach should be defined. Further research to define the optimal approach to nutritional management in HNC pts receiving CRT is needed.
High/low dose dexamethasone with physical activity for cancer-related fatigue in patients with advanced cancer: A phase II randomized double blind study.
Authors: Yennu Sriram , Valero Vicente , Lim Bora , Booser Daniel J. , Hernandez Carolina Diaz , Lu Zhanni , Liu Diane D. , Busaidy Naifa Lamki , Reuben James M. , Williams Janet L. , Hess Kenneth R. , Basen-Engquist Karen , Bruera Eduardo 
Published: November 2019

110 Background: Cancer-related-fatigue (CRF) is the most debilitating symptom in patients with advanced cancer. Physical activity (PA) improves CRF with lower adherence in advanced cancer. Dexamethasone (Dex) improves CRF but has long-term side effects. The purpose of the study was to determine whether a brief course of Dex improves adherence to PA for CRF management. Methods: Advanced cancer patients with CRF ≥ 4/10 on Edmonton Symptom Assessment Scale (ESAS) were eligible. Patients were randomized to either 4mg of Dex (LoDex) or 8mg of Dex (HiDex) orally BID for 7 days Plus standardized aerobic and resistance exercise for 4 weeks. Change in the Functional Assessment of Chronic Illness-Fatigue (FACIT-F) fatigue subscale from baseline to Day 8 (primary outcome) and Day 29 were assessed. Secondary outcomes included changes in fatigue (ESAS, PROMIS, MFSI), Sleep Quality (PSQI), fasting blood glucose, and myopathy. Results: Total evaluable patients were 60 (31 LoDex and 29 HiDex arms). The study was feasible (N = 60/67 were evaluable); 84% and 65% LoDex, and 96% and 68% Hi Dex were adherent to aerobic and resistance exercise, respectively [All Patients were adherent to study medication]. There was no significant difference in grade 3+ AE’s between the two arms (P = 0. 92). The FACIT fatigue subscale Cohen’s d in Lo Dex was 0.90 (P < 0.001) and 0.94(P < 0.001); and Hi Dex was 0.86(P < 0.001); and 1.05(P < 0.001) at Day 8 and Day 29, respectively. Similar improvement was found for ESAS Fatigue (P < 0.001), MFSI total (P = 0.005), and PROMIS –fatigue total (P = 0.005). Mixed model analysis showed significant improvement in FACIT-F fatigue scores at Day 8 (P = 0.0006), Day 15 (P = 0.0002), and D (P = 0.0018). There was no significant difference between the two arms at Day 8 and Day 29 in fatigue scores, myopathy, fasting blood glucose levels, symptom distress, and sleep quality scores. Conclusions: Short course of dexamethasone Plus physical activity resulted in sustained and robust improvement in CRF outcomes for upto 3 weeks after discontinuation of steroids suggesting possible priming effects of steroids helped to sustain physical activity. Further larger studies are justified. Clinical trial information: NCT02491632.
Health care utilization and patient-related outcomes in patients with malignant bowel obstruction admitted to a United States safety net hospital.
Authors: Mukthinuthalapati Vijaya Venkatasubbaraya Pavan Kedar Vijaya Venkatasubbar , Putta Aakash , Vohra Ishaan , Katiyar Vatsala , Moturi Krishna , Mullane Michael Russell , Gupta Shweta 
Published: November 2019

50 Background: Malignant bowel obstruction (MBO) and gastric outlet obstruction (GOO) can be a late complication of intra-abdominal malignancy with a poor prognosis. Most studies about its outcomes have focused on survival. There is paucity of studies assessing health care utilization and end of life care decisions. Methods: We retrospectively collected data from the electronic medical record of patients admitted with MBO or GOO at a safety-net hospital in Chicago, US between January 2013 and December 2017. The charts were analyzed for outcomes related to end of life care and health care utilization. The outcomes were compared by across three broad treatment arms: those that received surgical intervention, those that received venting gastrostomy (VG) and those that were treated medically alone. Results: Forty-six patients were identified of which 31 were admitted with MBO. 25 (54%) of them were due to stage IV cancers. Mean age of study population was 61 years. Surgical management, VG and medical management were done in 17, 8 and 21 patients respectively. There was no difference in ICU admission rate, length of stay of index admission, 90 day-readmission rate or mean visits to the ER between the groups. Patients receiving venting gastrostomy tube had highest rate of oral solid food tolerability. Twenty-eight patients died or were enrolled in hospice within a median of 115 days. Conclusions: All modalities of treatment had similar health utilization measures in patients with MBO and GOO. Surgical management, if feasible, has the longest time to hospice enrollment or death and should be offered to patients who are suitable. [Table: see text]
Breast Cancer Care Quality in South Africa’s Public Health System: An Evaluation Using American Society of Clinical Oncology/National Quality Forum Measures
Authors: O’Neil Daniel S. , Chen Wenlong Carl , Ayeni Oluwatosin , Nietz Sarah , Buccimazza Ines , Singh Urishka , Čačala Sharon , Stopforth Laura , Joffe Maureen , Crew Katherine D. , Jacobson Judith S. , Neugut Alfred I. , Ruff Paul , Cubasch Herbert 
Published: November 2019

PURPOSE The quality of breast cancer care in sub-Saharan Africa contributes to the region’s dismal breast cancer mortality. ASCO has issued quality measures focusing on delivery of adjuvant chemotherapy, radiotherapy, and endocrine therapy. We applied these measures in five South African public hospitals and analyzed factors associated with care concordance. MATERIALS AND METHODS Among 1,736 women with breast cancer who were enrolled in the South African Breast Cancer and HIV Outcomes study over 24 months, we evaluated care using ASCO’s three measures. We also evaluated adjuvant chemotherapy receipt in 957 women with an indication. We used logistic regression to estimate associations between measure-concordant care and patient factors. RESULTS Of 235 women with hormone receptor–negative cancer, 173 (74%) began adjuvant chemotherapy within 120 days from diagnosis. Of 194 patients who received breast-conserving surgery, 73 (37%) began radiotherapy within 365 days from diagnosis. Of 999 women with hormone receptor–positive cancer, 719 (72%) initiated endocrine therapy within 365 days from diagnosis. Chemotherapy and radiotherapy measure-concordant care were more common among women residing < 20 km from the hospital (odds ratio [OR], 1.79; 95% CI, 1.32 to 2.44 and OR, 3.17; 95% CI, 1.57 to 6.42). Endocrine therapy measure-concordant care was more common among English-speaking women (OR, 2.12; 95% CI, 1.12 to 4.02). Participating hospitals varied in care concordance. HIV infection did not affect care quality. CONCLUSION More timely delivery of chemotherapy, radiotherapy, and endocrine therapy is needed in South Africa, particularly for women living > 20 km from the hospital or not speaking English. Focused quality improvement efforts could support that goal.
Imagining Otherwise
Authors: Van Asselt Bess Collins 
Published: November 2019

Abstract
This article explores the life history of Sam, a queer and transgender youth of color who contests standardized futures in secondary schools. Sam's school life is rife with expectations that seek to confine Sam and their way of being in the world. In response to their school life, Sam forwards new ways of thinking of the future that rely on remaining present, contesting identity politics and questioning the contours of humanity.
Strain and shear wave ultrasound elastography in evaluation of chronic inflammatory disorders of major salivary glands
Authors: Elbeblawy Yasmein Maher , Eshaq Amer Mohamed Maha 
Published: November 2019

Objective: The aim of this study was to assess chronic inflammatory conditions of major salivary glands by ultrasound elastography. Methods: 21 patients with chronic inflammatory conditions of major salivary glands and 21 healthy adult volunteers were included in this study. All participants underwent B-mode sonography and ultrasound elastography. The diagnostic performance of strain ratio and shear wave velocity was evaluated by sensitivity and specificity at the optimum cutoff point and the area under the receiver operating characteristic curve. Results: Cases showed statistically significant higher median strain ratio of parotid and submandibular gland than control group (p-value = 0.001). Total cases showed statistically significant higher median scores than control group (p-value < 0.001). At cut-off value of (1.13); diagnostic accuracy, sensitivity and specificity were 97.6, 95.2 and 100% respectively with AUROC 0.954 and confidence interval: 0.840–0.995. Cases showed statistically significant higher median shear wave velocity of parotid gland than control group (p-value = 0.022), with no statistically significant difference in submandibular gland in the two groups (p-value = 0.216). Total cases showed statistically significant higher median scores than control group (p-value < 0.001). At cut-off value of (23.5), diagnostic accuracy was 78.6% with a sensitivity of 81% and specificity of 76.2% with 0.819 AUROC and onfidence interval :0.669–0.920. Conclusion: Our initial experience suggests that elastography may be potentially useful for diagnosis of chronic inflammatory conditions of the major salivary glands. This conclusion needs to be further validated large sample studies.
The new evidence-based policy: public participation between ‘hard evidence’ and democracy in practice
Authors: Pallett Helen 
Published: November 2019

Background:Debates about evidence-based policy (EBP) were revived in the UK in the 2010s in the context of civil service reform and changing practices of policy making, including institutionalisation of public participation in science policy making.

Aims and objectives:This paper aims to explore this revival of interest in EBP in the context of the Government-funded public participation programme Sciencewise, which supports and promotes public dialogues in science policy making. It is based on in-depth ethnographic study of the programme during 2013, considering the impacts on Sciencewise practices and working understandings of engaging in the EBP debate. There is a particular focus on the advantages and disadvantages of categorising public participation as a source of evidence-based policy as opposed to presenting participation as a democratic act which is separate from discussions of EBP.

Key conclusions:At different times Sciencewise actors moved between these stances in order to gain credibility and attention for their work, and to situate the outcomes of public participation processes in a broader policy context. In some instances the presentation of outputs from public participation processes as legitimate evidence for policy gave them greater influence and enriched broader discussions about the meaning and practice of open policy. However, it also frequently led to their dismissal on methodological grounds, inhibiting serious engagement with their outputs and challenging internal frameworks for evaluation and learning.
Multitarget Stool DNA Test Performance in an Average-Risk Colorectal Cancer Screening Population
Authors: Bosch L.J.W. , Melotte V. , Mongera S. , Daenen K.L.J. , Coupé V.M.H. , van Turenhout S.T. , Stoop E.M. , de Wijkerslooth T.R. , Mulder C.J.J. , Rausch C. , Kuipers E.J. , Dekker E. , Domanico M.J. , Lidgard G.P. , Berger B.M. , van Engeland M. , Carvalho B. , Meijer G.A. 
Published: November 2019

INTRODUCTION:
We set out to evaluate the performance of a multitarget stool DNA (MT-sDNA) in an average-risk colonoscopy-controlled colorectal cancer (CRC) screening population. MT-sDNA stool test results were evaluated against fecal immunochemical test (FIT) results for the detection of different lesions, including molecularly defined high-risk adenomas and several other tumor characteristics.

METHODS:
Whole stool samples (n = 1,047) were prospectively collected and subjected to an MT-sDNA test, which tests for KRAS mutations, NDRG4 and BMP3 promoter methylation, and hemoglobin. Results for detecting CRC (n = 7), advanced precancerous lesions (advanced adenoma [AA] and advanced serrated polyps; n = 119), and non-AAs (n = 191) were compared with those of FIT alone (thresholds of 50, 75, and 100 hemoglobin/mL). AAs with high risk of progression were defined by the presence of specific DNA copy number events as measured by low-pass whole genome sequencing.

RESULTS:
The MT-sDNA test was more sensitive than FIT alone in detecting advanced precancerous lesions (46% (55/119) vs 27% (32/119), respectively, P < 0.001). Specificities among individuals with nonadvanced or negative findings (controls) were 89% (791/888) and 93% (828/888) for MT-sDNA and FIT testing, respectively. A positive MT-sDNA test was associated with multiple lesions (P = 0.005), larger lesions (P = 0.03), and lesions with tubulovillous architecture (P = 0.04). The sensitivity of the MT-sDNA test or FIT in detecting individuals with high-risk AAs (n = 19) from individuals with low-risk AAs (n = 52) was not significantly different.

DISCUSSION:
In an average-risk screening population, the MT-sDNA test has an increased sensitivity for detecting advanced precancerous lesions compared with FIT alone. AAs with a high risk of progression were not detected with significantly higher sensitivity by MT-sDNA or FIT.
Rapid and Predictable Evolution of Admixed Populations Between TwoDrosophilaSpecies Pairs
Authors: Matute Daniel R , Comeault Aaron A , Earley Eric , Serrato-Capuchina Antonio , Peede David , Monroy-Eklund Anaïs , Huang Wen , Jones Corbin D , Mackay Trudy F C , Coyne Jerry A 
Published: November 2019

AbstractIn this article, Matute et al. report an experiment in which they generated eight interspecific admixed populations using two species pairs of Drosophila. They found that in both species pairs, and across all experimental replicates...The consequences of hybridization are varied, ranging from the origin of new lineages, introgression of some genes between species, to the extinction of one of the hybridizing species. We generated replicate admixed populations between two pairs of sister species of Drosophila: D. simulans and D. mauritiana; and D. yakuba and D. santomea. Each pair consisted of a continental species and an island endemic. The admixed populations were maintained by random mating in discrete generations for over 20 generations. We assessed morphological, behavioral, and fitness-related traits from each replicate population periodically, and sequenced genomic DNA from the populations at generation 20. For both pairs of species, species-specific traits and their genomes regressed to those of the continental species. A few alleles from the island species persisted, but they tended to be proportionally rare among all sites in the genome and were rarely fixed within the populations. This paucity of alleles from the island species was particularly pronounced on the X-chromosome. These results indicate that nearly all foreign genes were quickly eliminated after hybridization and that selection against the minor species genome might be similar across experimental replicates.
A Ménière-betegség tüneteinek jellegzetességei és a multidiszciplináris megközelítés
Authors: Molnár András , Maihoub Stefani , Fent Zoltán , Tamás László , Szirmai Ágnes 
Published: November 2019

Abstract: Introduction: Ménière’s disease (MD) is a disorder that affects the inner ear, characterized by vertigo, tinnitus, hearing loss and vegetative symptoms. One of the main points of the management of the patients is the analysis of the vertigo diaries. Aim: To identify the typical characteristics of the symptoms and to highlight the importance of multidisciplinary approach. Material and method: 58 (12 male and 46 females, mean age 56.97 ± 10.45 SD) definite MD patients were enrolled in this investigation. The vertigo diaries filled out by the patients were analysed. The statistical analysis was performed using IBM SPSS V24 software. Since the parameters did not show normal distribution, non parametric test (Mann–Whitney U test) was used. Results: Based on the diaries, the most tormenting symptom is vertigo (mean power: 5.38 ± 2.06 SD), the second one is tinnitus (4.54 ± 2.81 SD), and last one is headache (2.77 ± 3.1 SD). Despite the frequent prevalence of associated headache, vestibular migraine could be ruled out in all of the cases. Another important outcome was that the attacks associated with headache were significantly stronger (p = 0.001). In the case of the vegetative symptoms, the association was even much stronger (p<0.01). According to the narrative analysis, the most frequent provocation factors of the attacks were the cold front and stress. Conclusion: Along with the treatment of vertigo, the management of the associated symptoms (headache, vegetative symptoms) is also of great importance. Monitoring the quality of life and psychiatric disorders suggests the importance of multidisciplinary approach. Orv Hetil. 2019; 160(48): 1915–1920.
Trust, self-efficacy, and leadership perception
Authors: Villarreal Coindreau Marcelo José , Llanos Reynoso Luis Felipe Miguel 
Published: November 2019

This research study examines the extent to which hierarchical superiors are admired as leaders, and their viewpoints and decisions accepted, based on their direct support and influence on their subordinates’ self-concept and sense of personal efficacy. To this purpose, a 25-item inventory was designed and filled in paper by 157 participants from 26 companies. Once the statistical behavior of the items was tested, it was found, through lineal regression and correlation analyses, that superiors are better accepted and admired as leaders, when they display trust in the capabilities of their subordinates, contribute to improve their self-efficacy, and support them in their duties. On the other hand, it was also found that considering the subordinates’ skills and interests, when assigning tasks and challenges, was highly correlated with self-efficacy improvement These findings are consistent with previous research. However, it will be important to validate them in future studies.RESUMENEsta investigación examina la admiración hacia los superiores jerárquicos como líderes, así como la aceptación de sus puntos de vista y decisiones, a partir de su apoyo directo y de su influencia en el autoconcepto y sentido de eficacia personal de los colaboradores. Para este propósito, se elaboró un inventario de 25 reactivos que fue contestado en papel por 157 participantes de 26 empresas. Tras verificar el comportamiento estadístico de los reactivos, se identificó mediante análisis correlacionales y de regresión, que los superiores jerárquicos son más aceptados y admirados como líderes cuando demuestran confianza en las capacidades de sus colaboradores y contribuyen a mejorar su autoeficacia, además de apoyarlos en el trabajo. Por otra parte, el aprovechamiento de las habilidades e intereses de los colaboradores está altamente correlacionado con la mejora de su autoeficacia. Estos resultados son consistentes con la literatura, pero será importante verificarlos en estudios posteriores.RESUMOEsta pesquisa examina os superiores admiração como líderes e aceitação de seus pontos de vista e decisões do seu suporte direto e sua influência sobre o auto-conceito e senso de eficácia pessoal dos funcionários. Para tanto, um inventário de 25 itens foi elaborado e respondido em papel por 157 participantes de 26 empresas. Depois de verificar o comportamento estatístico dos reagentes, identificadas pela análise de correlação e regressão, os superiores são mais aceito e admirado como líderes quando eles mostram confiança nas habilidades de seus funcionários e ajudar a melhorar a sua auto-eficácia, bem como apoiá-los na trabalhar Por outro lado, o uso das habilidades e interesses dos colaboradores está altamente correlacionado com a melhora de sua autoeficácia. Estes resultados são consistentes com a literatura, mas será importante verificá-los em estudos posteriores.
Poverty and the Poor Approach to mythical Mapuche narrative texts for an intercultural dialogue on development/La Pobreza y el Pobre. Acercamiento a textos míticos narrativos mapuche para un diálogo intercultural sobre el desarrollo
Authors: Villar Olaeta Francisco Javier 
Published: November 2019

ResumenEl artículo muestra una investigación, desde un enfoque científico religioso- que se basa en el paradigma mítico religioso y la hermenéutica narrativa, de naturaleza cualitativa y fenomenológica, de textos narrativos míticos y crónicas para indagar sobre una visión de la pobreza y de los pobres desde el pueblo mapuche, en Chile. La Investigación tuvo como objetivos en primer lugar identificar la figura del pobre en relatos míticos y en otros cuentos de la narrativa tradicional mapuche así como en crónicas actuales que nos acerquen a una comprensión de lo que es la pobreza para el mundo mapuche. Y en segundo lugar compararla con la reflexión crítica social actual sobre el pobre y la pobreza para encontrar confluencias y diferencias en pos de un diálogo reflexivo y propositivo de carácter intercultural que incorpore la dimensión mítico religiosa en la comprensión en Chile de la pobreza y el pobre. Sus resultados, en torno al reforzamiento de conceptos como amistad, dignidad, reconocimiento, riqueza, solidaridad, familia y sociedad entre otros así como la visibilización de la dimensión espiritual religiosa como parte de la comprensión de este fenómeno social a nuestro entender, critican y enriquecen, desde un carácter interdisciplinario, la visión sobre el desarrollo que actualmente se tiene en Chile.