bluuebunny/crossref_metadata_2025_split huggingface dataset:
Negative recollections regarding doctor–patient interactions among men receiving a prostate cancer diagnosis: a qualitative study of patient experiences in Japan
Authors: Torishima Masako , Urao Michiko , Nakayama Takeo , Kosugi Shinji 
Published: January 2020

ObjectivesTo explore the negative recollections of prostate cancer patients regarding the attitudes and language used by the doctors in delivering their diagnoses in Japan, in order to improve patient-centred communication.Design and settingThis is a qualitative secondary analysis of the prostate cancer narrative data from the Database of Individual Patients’ Experiences-Japan archives. A thematic analysis was conducted regarding negative recollections of doctors’ words/attitudes when delivering a cancer diagnosis. Recruitment was based on maximum variation sampling. Participants were recruited from medical institutions, patient associations and through media advertisements.ParticipantsMen with a diagnosis of prostate cancer (n=51).FindingsOf the 51 participants, 17 had negative recollections of the doctors’ words/attitudes during the delivery of the cancer diagnosis. After thematic analysis, 11 categories emerged: ‘Surprised by the abrupt disclosure of the diagnosis’, ‘Displeased by the direct disclosure of the diagnosis to the patient in the absence of family members’, ‘Unable to accept the doctor’s negative words in the explanations’, ‘Unable to understand the doctor’s technical jargon’, ‘Distrust due to failure in diagnosis based on previous examinations’, ‘Aggrieved at the doctor’s unwillingness to allow questions’, ‘Dissatisfied with explanations involving facts only’, ‘Indignant over the unexpected disclosure of life expectancy’, ‘Unable to accept the doctor’s blame for the delay in the initial hospital visit’, ‘Uncomfortable with the usage of inappropriate metaphors’ and ‘Pessimistic thoughts despite optimistic explanations’.ConclusionsIt is clear that patients have recollections of a variety of negative experiences regarding the words/attitudes of their doctors at the time they received their prostate cancer diagnosis. Thus, the use of narrative data would facilitate the appropriate application of commonly used guidelines for the delivery of cancer diagnoses tailored to individual patients in clinical practice.
Are adverse events in newly trained home dialysis patients related to learning styles? A single-centre retrospective study from Toronto, Canada
Authors: Auguste Bourne Lewis , Girsberger Michael , Kennedy Claire , Srithongkul Thatsaphan , McGrath-Chong Margaret , Bargman Joanne , Chan Christopher T 
Published: January 2020

ObjectivesHome haemodialysis (HD) and peritoneal dialysis (PD) have seen growth in utilisation around the globe over the last few years. However, home dialysis, with its attendant technical complexity and risk of adverse events continues to pose challenges for wider adoption. We examined whether differences in patients’ learning styles are associated with differing risk of adverse events in both home HD and PD patients.DesignRetrospective cohort study.SettingTertiary care hospital in Toronto, Ontario, Canada.ParticipantsOne hundred and eighteen prevalent adult (≥18 years) home dialysis patients (40 PD and 78 home HD) were enrolled. Patients on home dialysis for less than 6 months or receiving home nursing assistance for dialysis were excluded from the study.InterventionsEnrolled patients completed (VARK) Visual, Aural, Reading-writing and Kinesthetic questionnaires to determine learning styles.Primary and secondary outcome measuresHome HD and PD adverse events were identified within 6 months of completing home dialysis training. Event rates were then stratified and compared according to learning styles.ResultsThirty patients had a total of 53 adverse events. We used logistic regression analysis to determine unadjusted and adjusted ORs for a single adverse event. Non-visual learners were 4.35 times more likely to have an adverse event (p=0.001). After adjusting for age, gender, dialysis modality, training duration, dialysis vintage, prior renal replacement therapy, visual impairment, education and literacy, an adverse event was still four times more likely among non-visual learners compared to visual learners (p=0.008). A subgroup analysis of home HD patients showed adverse events were more likely among non-visual learners (OR 11.1; p=0.003), whereas PD patients showed a trend for more adverse events in non-visual learners (OR: 1.60; p=0.694).ConclusionsDifferent learning styles in home dialysis patients exist. Visual learning styles are associated with fewer adverse events in home dialysis patients within the first 6 months of completing training. Individualisation of home dialysis training by learning style is warranted.
Acceptability of artificial intelligence (AI)-enabled chatbots, video consultations and live webchats as online platforms for sexual health advice
Authors: Nadarzynski Tom , Bayley Jake , Llewellyn Carrie , Kidsley Sally , Graham Cynthia Ann 
Published: January 2020

ObjectivesSexual and reproductive health (SRH) services are undergoing a digital transformation. This study explored the acceptability of three digital services, (i) video consultations via Skype, (ii) live webchats with a health advisor and (iii) artificial intelligence (AI)-enabled chatbots, as potential platforms for SRH advice.MethodsA pencil-and-paper 33-item survey was distributed in three clinics in Hampshire, UK for patients attending SRH services. Logistic regressions were performed to identify the correlates of acceptability.ResultsIn total, 257 patients (57% women, 50% aged <25 years) completed the survey. As the first point of contact, 70% preferred face-to-face consultations, 17% telephone consultation, 10% webchats and 3% video consultations. Most would be willing to use video consultations (58%) and webchat facilities (73%) for ongoing care, but only 40% found AI chatbots acceptable. Younger age (<25 years) (OR 2.43, 95% CI 1.35 to 4.38), White ethnicity (OR 2.87, 95% CI 1.30 to 6.34), past sexually transmitted infection (STI) diagnosis (OR 2.05, 95% CI 1.07 to 3.95), self-reported STI symptoms (OR 0.58, 95% CI 0.34 to 0.97), smartphone ownership (OR 16.0, 95% CI 3.64 to 70.5) and the preference for a SRH smartphone application (OR 1.95, 95% CI 1.13 to 3.35) were associated with video consultations, webchats or chatbots acceptability.ConclusionsAlthough video consultations and webchat services appear acceptable, there is currently little support for SRH chatbots. The findings demonstrate a preference for human interaction in SRH services. Policymakers and intervention developers need to ensure that digital transformation is not only cost-effective but also acceptable to users, easily accessible and equitable to all populations using SRH services.
The impact of upper limb exercise on function, daily activities and quality of life in systemic lupus erythematosus: a pilot randomised controlled trial
Authors: Keramiotou Kyriaki , Anagnostou Christos , Kataxaki Evangelia , Galanos Antonios , Sfikakis Petros P , Tektonidou Maria G 
Published: January 2020

ObjectiveTo assess the effect of upper limb exercise on hand function, daily activities performance and quality of life of patients with systemic lupus erythematosus (SLE).MethodsWe performed a pilot randomised, 24-week follow-up, unmasked controlled trial. Inclusion criteria were upper limb arthralgias, a Disabilities of Arm, Shoulder and Hand (DASH) questionnaire score >10 and a stable treatment over the past 3 months. Patients were randomly allocated in the routine care (control) or exercise group that received an individually tailored 30-min daily upper-limb exercise programme by a hand therapist for 12 weeks. We evaluated at 0, 6, 12 and 24 weeks the performance of daily activities for both groups with DASH questionnaire and Health Assessment Questionnaire (HAQ), the grip and pinch strength with Jamar dynamometer and pinch gauge tool, respectively, the dexterity with Purdue pegboard test, the quality of life with Lupus Quality of Life (LupusQoL) Questionnaire and the pain level by Visual Analogue Scale (VAS) score.ResultsFrom 293 consecutive SLE patients, data from 32 patients allocated to the exercise group and 30 to the control group were analysed. There was a significant difference between the two groups in percentage changes of DASH, HAQ, grip strength, pinch strength, LupusQoL-physical health and fatigue, and VAS scores from baseline to 6, 12 and 24 weeks, and from baseline to 12 weeks for dexterity test (p<0.001). No interaction was observed between exercise and disease activity or medication use at baseline and during the observation period.ConclusionUpper-limb exercise significantly improves hand function, pain, daily activity performance and quality of life in SLE.Trial registration numberNCT03802578.
Methionine dietary supplementation potentiates ionizing radiation-induced gastrointestinal syndrome
Authors: Miousse Isabelle R. , Ewing Laura E. , Skinner Charles M. , Pathak Rupak , Garg Sarita , Kutanzi Kristy R. , Melnyk Stepan , Hauer-Jensen Martin , Koturbash Igor 
Published: January 2020

Methionine is an essential amino acid needed for a variety of processes in living organisms. Ionizing radiation depletes tissue methionine concentrations and leads to the loss of DNA methylation and decreased synthesis of glutathione. In this study, we aimed to investigate the effects of methionine dietary supplementation in CBA/CaJ mice after exposure to doses ranging from 3 to 8.5 Gy of 137Cs of total body irradiation. We report that mice fed a methionine-supplemented diet (MSD; 19.5 vs. 6.5 mg/kg in a methionine-adequate diet, MAD) developed acute radiation toxicity at doses as low as 3 Gy. Partial body irradiation performed with hindlimb shielding resulted in a 50% mortality rate in MSD-fed mice exposed to 8.5 Gy, suggesting prevalence of radiation-induced gastrointestinal syndrome in the development of acute radiation toxicity. Analysis of the intestinal microbiome demonstrated shifts in the gut ecology, observed along with the development of leaky gut syndrome and bacterial translocation into the liver. Normal gut physiology impairment was facilitated by alterations in the one-carbon metabolism pathway and was exhibited as decreases in circulating citrulline levels mirrored by decreased intestinal mucosal surface area and the number of surviving crypts. In conclusion, we demonstrate that a relevant excess of methionine dietary intake exacerbates the detrimental effects of exposure to ionizing radiation in the small intestine. NEW & NOTEWORTHY Methionine supplementation, instead of an anticipated health-promoting effect, sensitizes mice to gastrointestinal radiation syndrome. Mechanistically, excess of methionine negatively affects intestinal ecology, leading to a cascade of physiological, biochemical, and molecular alterations that impair normal gut response to a clinically relevant genotoxic stressor. These findings speak toward increasing the role of registered dietitians during cancer therapy and the necessity of a solid scientific background behind the sales of dietary supplements and claims regarding their benefits.
IL6 Induces an IL22+ CD8+ T-cell Subset with Potent Antitumor Function
Authors: St. Paul Michael , Saibil Samuel D. , Lien Scott C. , Han SeongJun , Sayad Azin , Mulder David T. , Garcia-Batres Carlos R. , Elford Alisha R. , Israni-Winger Kavita , Robert-Tissot Céline , Zon Michael , Katz Sarah Rachel , Shaw Patricia A. , Clarke Blaise A. , Bernardini Marcus Q. , Nguyen Linh T. , Haibe-Kains Benjamin , Pugh Trevor J. , Ohashi Pamela S. 
Published: January 2020

AbstractCD8+ T cells can be polarized into several different subsets as defined by the cytokines they produce and the transcription factors that govern their differentiation. Here, we identified the polarizing conditions to induce an IL22-producing CD8+ Tc22 subset, which is dependent on IL6 and the aryl hydrocarbon receptor transcription factor. Further characterization showed that this subset was highly cytolytic and expressed a distinct cytokine profile and transcriptome relative to other subsets. In addition, polarized Tc22 were able to control tumor growth as well as, if not better than, the traditional IFNγ-producing Tc1 subset. Tc22s were also found to infiltrate the tumors of human patients with ovarian cancer, comprising up to approximately 30% of expanded CD8+ tumor-infiltrating lymphocytes (TIL). Importantly, IL22 production in these CD8+ TILs correlated with improved recurrence-free survival. Given the antitumor properties of Tc22 cells, it may be prudent to polarize T cells to the Tc22 lineage when using chimeric antigen receptor (CAR)-T or T-cell receptor (TCR) transduction–based immunotherapies.
Readmissions after Acute Kidney Injury during Left Ventricular Assist Device Implantation Hospitalization
Authors: Walther Carl P. , Winkelmayer Wolfgang C. , Deswal Anita , Niu Jingbo , Navaneethan Sankar D. 
Published: January 2020

<b><i>Background:</i></b> Acute kidney injury (AKI) frequently complicates hospitalizations for left ventricular assist device (LVAD) implantation. Little is known about the relationship of AKI with subsequent readmissions, and we investigated the relationship of AKI during LVAD implantation hospitalization with all-cause and cause-specific 30-day readmissions. <b><i>Methods:</i></b> We used a United States (US) nationwide all-payer administrative database, identifying patients who underwent implantable LVAD placement 2010–2015. Patients were classified into 3 mutually exclusive groups based on presence and severity of AKI during the LVAD placement hospitalization: no AKI, AKI, and AKI requiring dialysis (AKI-D). Outcomes were all-cause and cause-specific 30-day readmissions. <b><i>Results:</i></b> Within 30 days after discharge 25.4% of patients were readmitted. Of those without AKI, 23.9% were readmitted, compared to 25.5% of those with AKI and 42.2% of those with AKI-D. Compared to no AKI (adjusted for demographics, index hospitalization and chronic comorbidity factors, and year), odds of 30-day readmission were 2.18 (95% CI 1.37–3.49) times higher for those with AKI-D, whereas those with AKI not requiring dialysis had similar 30-day readmission risk (OR 1.03 [95% CI 0.89–1.20]). Those with AKI-D had higher risk of 30-day readmission for infection (OR 2.02 [95% CI 1.13–3.61]), gastrointestinal (GI) bleed (2.32 [95% CI 1.24–4.34]), and kidney disease (13.9 [95% CI 4.0–48]). There was no increased risk for stroke readmission with AKI or AKI-D. <b><i>Conclusion:</i></b> AKI-D was associated with highest ­30-day readmission risk, possibly related to negatively synergistic effects of LVAD, kidney dysfunction, and dialysis related factors on infection and GI bleeding risks. AKI alone was not associated with increased readmission risk.
Absence of Coronary Artery Calcium During Positron Emission Tomography Stress Testing in Patients Without Known Coronary Artery Disease Identifies Individuals With Very Low Risk of Cardiac Events
Authors: Le Viet T. , Knight Stacey , Min David B. , McCubrey Raymond O. , Horne Benjamin D. , Jensen Kurt R. , Meredith Kent G. , Mason Steven M. , Lappé Donald L. , Anderson Jeffrey L. , Muhlestein Joseph B. , Knowlton Kirk U. 
Published: January 2020

Background:
Myocardial perfusion imaging, including positron emission tomography/computed tomography (PET/CT), is often used to assess for high-grade coronary artery disease (CAD) requiring revascularization. The use of coronary artery calcium (CAC) to predict risk of major adverse cardiovascular events in asymptomatic patients is accepted. However, little is known regarding the use of CAC in PET/CT patients without known CAD in identifying patients unlikely to need revascularization. Here, we determined whether the absence of CAC, using low-dose attenuation correction CT obtained during the PET/CT, identifies patients unlikely to undergo coronary revascularization within 90 days of a PET/CT.

Methods:
Patients, without a history of CAD and no elevation in troponin, referred for PET/CT at Intermountain Medical Center were studied (n=5528). The presence of CAC was visually assessed using low-dose attenuation correction CT. The association between CAC and 90-day high-grade CAD and revascularization were assessed. Longer-term (up to 4 years) major adverse cardiovascular events, including all-cause death, myocardial infarction, and late revascularization (>90 days), were examined.

Results:

There were 2510 (45.4%) patients in CAC-present group and 3018 (54.6%) patients in CAC-absent group. The CAC-absent group, compared with the CAC-present group, was less likely to undergo coronary angiography (3.4% versus 10.2%,
P
<0.0001), have high-grade CAD (0.5% versus 6.5%,
P
<0.0001), and receive revascularization (0.4% versus 5.8%, [adjusted odds ratio =0.09; 95% CI, 0.05–0.16];
P
<0.0001). In patients with an ischemic burden >10%, the CAC-absent group was associated with reduced revascularization (
P
<0.0001). Longer-term major adverse cardiovascular events were lower in the CAC-absent (2.4%) compared with the CAC-present (6.9%) group (adjusted hazard ratio, 0.45 [95% CI, 0.34–0.60];
P
<0.0001).

Conclusions:
The absence of CAC on low-dose attenuation correction CT identifies PET/CT patients unlikely to have high-grade CAD or require revascularization within 90 days and unlikely to experience longer-term major adverse cardiovascular events. The prognostic value of CAC, beyond ischemic burden, suggests its potential as a first-step screening tool in intermediate-risk patients to identify those who do not need coronary revascularization.
The Tiberian Pronunciation Tradition of Biblical Hebrew, Volume 2
Authors: Khan Geoffrey 
Published: January 2020

The form of Biblical Hebrew that is presented in printed editions, with vocalization and accent signs, has its origin in medieval manuscripts of the Bible. The vocalization and accent signs are notation systems that were created in Tiberias in the early Islamic period by scholars known as the Tiberian Masoretes, but the oral tradition they represent has roots in antiquity. The grammatical textbooks and reference grammars of Biblical Hebrew in use today are heirs to centuries of tradition of grammatical works on Biblical Hebrew in Europe. The paradox is that this European tradition of Biblical Hebrew grammar did not have direct access to the way the Tiberian Masoretes were pronouncing Biblical Hebrew.
In the last few decades, research of manuscript sources from the medieval Middle East has made it possible to reconstruct with considerable accuracy the pronunciation of the Tiberian Masoretes, which has come to be known as the ‘Tiberian pronunciation tradition’. This book presents the current state of knowledge of the Tiberian pronunciation tradition of Biblical Hebrew and a full edition of one of the key medieval sources, Hidāyat al-Qāriʾ ‘The Guide for the Reader’, by ʾAbū al-Faraj Hārūn. There is also an accompanying oral performance of samples of the reconstructed pronunciation by Alex Foreman. It is hoped that the book will help to break the mould of current grammatical descriptions of Biblical Hebrew and form a bridge between modern traditions of grammar and the school of the Masoretes of Tiberias.
Neurochemical and brain functional changes in the ventromedial prefrontal cortex of first-episode psychosis patients: A combined functional magnetic resonance imaging—proton magnetic resonance spectroscopy study
Authors: Cen Haixin , Xu Jiale , Yang Zhilei , Mei Li , Chen Tianyi , Zhuo Kaiming , Xiang Qiong , Song Zhenghua , Wang Yingchan , Guo Xiaoyun , Wang Jinhong , Jiang Kaida , Xu Yifeng , Li Yao , Liu Dengtang 
Published: January 2020

Objective: Previous studies showed alterations of brain function in the ventromedial prefrontal cortex of schizophrenia patients. Also, neurochemical changes, especially GABA level alteration, have been found in the medial prefrontal cortex of schizophrenia patients. However, the relationship between GABA level in the ventromedial prefrontal cortex and brain functional activity in schizophrenia patients remains unexplored. Methods: In total, 23 drug-naïve, first-episode psychosis patients and 26 matched healthy controls completed the study. The single voxel proton magnetic resonance spectroscopy data were acquired in ventromedial prefrontal cortex region, which was used as the seed region for resting-state functional connectivity analysis. The proton magnetic resonance spectroscopy data were processed to quantify the concentrations of GABA+, glutamine and glutamate, and N-acetylaspartate in ventromedial prefrontal cortex. Spearman correlation analysis was used to examine the relationship between metabolite concentration, functional connectivity and clinical variables. Pearson correlation analysis was used to examine the relationship between GABA+ concentration and functional connectivity value. Results: In first-episode psychosis patients, GABA+ level in ventromedial prefrontal cortex was higher and was positively correlated with ventromedial prefrontal cortex-left middle orbital frontal cortex functional connectivity. N-acetylaspartate level was positively correlated with positive symptoms, and the functional connectivity between ventromedial prefrontal cortex and left precuneus was negatively associated with negative symptoms of first-episode psychosis patients. Conclusion: Our results indicated that ventromedial prefrontal cortex functional connectivity changes were positively correlated with higher local GABA+ level in first-episode psychosis patients. The altered neurochemical concentration and functional connectivity provide insights into the pathology of schizophrenia.
On the Legality of the United States Action of Terminating India’s GSP Status
Authors: Babu R. Rajesh 
Published: January 2020

Since the US Presidential Proclamation terminating India status as a Generalized System of Preferences (GSP) beneficiary with effect from 5 June 2019, questions are raised on the WTO legitimacy of such an action. The US measure, which appears to have a punitive element—a move precipitated by lack of reciprocity from India by not providing ‘equitable and reasonable access’ for US products in Indian markets—challenges the fundamentally premise of the GSP schemes. Since the GSP schemes are established to provide economic and developmental opportunities for developing countries, and once established must be administered as per the 1979 General Agreement on Tariffs and Trade Enabling Clause, meaning it must be on a ‘generalised’, ‘non-reciprocal’ and ‘non-discriminatory’ basis, can India raise a legitimate challenge against the US action at the WTO Dispute Settlement Body? Or can the GSP schemes, being voluntary and unilaterally administered, be structured by developed countries as trade policy tools with stringent trade and non-trade conditionalities? The decision of the Appellate Body in European Communities—Tariff Preferences, the contested nature of the Enabling Clause and the heterogeneous nature of developing countries at the WTO makes the interpretation knotty. In this context, this article provides a brief comment on the legal basis of the Enabling Clause in the WTO framework and the legitimacy of the US action of termination of India from the beneficiary status. Keeping aside the legal question, the author is also of the view that time is ripe for India to consider ‘graduating’ itself from such preferential arrangements and engage in binding obligations that are reciprocal and sustainable. JEL Codes: K33, O24