bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of PEWS on Perceived Quality of Care During Deterioration in Children With Cancer Hospitalized in Different Resource-Settings
Authors: Garza Marcela , Graetz Dylan E. , Kaye Erica C. , Ferrara Gia , Rodriguez Mario , Soberanis Vásquez Dora Judith , Méndez Aceituno Alejandra , Antillon-Klussmann Federico , Gattuso Jami S. , Mandrell Belinda N. , Baker Justin N. , Rodriguez-Galindo Carlos , Agulnik Asya 
Published: June 2021

BackgroundChildren with cancer are at high risk for clinical deterioration and subsequent mortality. Pediatric Early Warning Systems (PEWS) have proven to reduce the frequency of clinical deterioration in hospitalized patients. This qualitative study evaluates provider perspectives on the impact of PEWS on quality of care during deterioration events in a high-resource and a resource-limited setting.MethodsWe conducted semi-structured interviews with 83 healthcare staff (nurses, pediatricians, oncology fellows, and intensivists) involved in recent deterioration events at two pediatric oncology hospitals of different resource levels: St. Jude Children’s Research Hospital (SJCRH; n = 42) and Unidad Nacional de Oncología Pediátrica (UNOP; n = 41). Interviews were conducted in the participant’s native language (English or Spanish), translated into English, and transcribed. Transcripts were coded and analyzed inductively.ResultsProviders discussed both positive and negative perspectives of clinical deterioration events. Content analysis revealed “teamwork,” “experience with deterioration,” “early awareness,” and “effective communication” as themes associated with positive perception of events, which contributed to patient safety. Negative themes included “lack of communication,” “inexperience with deterioration,” “challenges with technology”, “limited material resources,” “false positive score,” and “objective tool.” Participants representing all disciplines across both institutions shared similar positive opinions. Negative opinions, however, differed between the two institutions, with providers at UNOP highlighting limited resources while those at SJCRH expressing concerns about technology misuse.ConclusionProviders that care for children with cancer find PEWS valuable to improve the quality of hospital care, regardless of hospital resource-level. Identified challenges, including inadequate critical care resources and challenges with technology, differ by hospital resource-level. These findings build on growing data demonstrating the positive impact of PEWS on quality of care and encourage wide dissemination of PEWS in clinical practice.
Effects of Surgery on Prognosis of Young Women With Operable Breast Cancer in Different Marital Statuses: A Population-Based Cohort Study
Authors: Zhang Junsheng , Yang Ciqiu , Zhang Yi , Ji Fei , Gao Hongfei , Zhuang Xiaosheng , Li Weiping , Pan Weijun , Shen Bo , Zhang Tingfeng , Chen Yuanqi , Wang Kun 
Published: June 2021

BackgroundThe influence of surgical approaches [including mastectomy, breast-conserving therapy (BCT) and post-mastectomy breast reconstruction (PMBR) on prognosis of young women (&lt;40 years old) with operable breast cancer has not been determined yet, and this might vary in patients with different marital statuses. Therefore, we aimed to investigate the effect of surgery on survival outcomes for young women with operable breast cancer in different marital statuses.MethodsWe used the Surveillance, Epidemiology, and End Results (SEER) database to identify young women with operable breast cancer between 2004 and 2016, who underwent mastectomy, BCT or PMBR. We assessed overall survival (OS) and breast cancer-specific survival (BCSS) using the Kaplan–Meier method and hazard ratios using multivariate Cox proportional hazard regression.ResultsCompared to mastectomy, both of BCT and PMBR conferred better OS (BCT: HR = 0.79, 95%CI: 0.69–0.90, p &lt;0.001; PMBR: HR = 0.70, 95%CI: 0.63–0.78, p &lt;0.001) and BCSS (BCT: HR = 0.79, 95%CI: 0.69–0.91, p = 0.001; PMBR: HR = 0.73, 95%CI: 0.65–0.81, p &lt;0.001), but there was no significant difference of survival between BCT and PMBR group. The survival benefit of BCT compared to mastectomy remained significant in unmarried young women (OS: HR = 0.68, 95%CI: 0.55–0.83, p &lt;0.001; BCSS: HR = 0.69, 95%CI: 0.56–0.86, p = 0.001) but not in the married (OS: HR = 0.89, 95%CI: 0.75–1.05, p = 0.177; BCSS: HR = 0.89, 95%CI: 0.75–1.05, p = 0.161), while no matter married or not, PMBR group had better OS and BCSS than mastectomy group but not BCT group.ConclusionBoth of BCT and PMBR had improved survival compared to mastectomy for young women with operable breast cancer. The survival benefit of BCT compared to mastectomy remained significant in unmarried patients but not in married patients.
Computer-Aided Diagnosis Evaluation of the Correlation Between Magnetic Resonance Imaging With Molecular Subtypes in Breast Cancer
Authors: Meng Wei , Sun Yunfeng , Qian Haibin , Chen Xiaodan , Yu Qiujie , Abiyasi Nanding , Yan Shaolei , Peng Haiyong , Zhang Hongxia , Zhang Xiushi 
Published: June 2021

BackgroundThere is a demand for additional alternative methods that can allow the differentiation of the breast tumor into molecular subtypes precisely and conveniently.PurposeThe present study aimed to determine suitable optimal classifiers and investigate the general applicability of computer-aided diagnosis (CAD) to associate between the breast cancer molecular subtype and the extracted MR imaging features.MethodsWe analyzed a total of 264 patients (mean age: 47.9 ± 9.7 years; range: 19–81 years) with 264 masses (mean size: 28.6 ± 15.86 mm; range: 5–91 mm) using a Unet model and Gradient Tree Boosting for segmentation and classification.ResultsThe tumors were segmented clearly by the Unet model automatically. All the extracted features which including the shape features,the texture features of the tumors and the clinical features were input into the classifiers for classification, and the results showed that the GTB classifier is superior to other classifiers, which achieved F1-Score 0.72, AUC 0.81 and score 0.71. Analyzed the different features combinations, we founded that the texture features associated with the clinical features are the optimal features to different the breast cancer subtypes.ConclusionCAD is feasible to differentiate the breast cancer subtypes, automatical segmentation were feasible by Unet model and the extracted texture features from breast MR imaging with the clinical features can be used to help differentiating the molecular subtype. Moreover, in the clinical features, BPE and age characteristics have the best potential for subtype.
Androgen Deprivation Therapy Combined With Particle Therapy for Prostate Cancer: A Systematic Review
Authors: Petersen Stine Elleberg , Høyer Morten 
Published: June 2021

PurposeThere is high-level evidence for addition of androgen deprivation therapy to photon-based radiotherapy of the prostate in intermediate- and high-risk prostate cancer. Little is known about the value of ADT in particle therapy of prostate cancer. We are conducting a systematic review on biochemical disease-free survival, overall survival, and morbidity after combined particle therapy and ADT for prostate cancer.MethodsA thorough search in PubMed, Embase, Scopus, and Web of Science databases were conducted, searching for relevant studies. Clinical studies on prostate cancer and the treatment combination of particle therapy and androgen deprivation therapy were included. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered on PROSPERO (CRD42021230801).ResultsA total of 298 papers were identified. Fifteen papers reporting on 7,202 patients after proton or carbon-ion therapy for localized prostate cancer where a fraction or all patients received ADT were selected for analysis. Three thousand five hundred and nineteen (49%) of the patients had received combined ADT and particle therapy. Primarily high-risk (87%), to a lesser extent intermediate-risk (34%) and low-risk patients (12%) received ADT. There were no comparative studies on the effect of ADT in patients treated with particles and no studies identified ADT as an independent prognostic factor related to survival outcomes.ConclusionsThe review found no evidence to support that the effects on biochemical disease-free survival and morbidity of combining ADT to particle therapy differs from the ADT effects in conventional photon based radiotherapy. The available data on the topic is limited.
Change Process in Coaching: Interplay of Nonverbal Synchrony, Working Alliance, Self-Regulation, and Goal Attainment
Authors: Erdös Tünde , Ramseyer Fabian T. 
Published: June 2021

Background:Psychological literature emphasizes that self-regulation is important as goal intentions, goal setting, or implementation intention does not automatically result in effective results in coaching. The question which coaching strategies to apply to strengthening clients' self-regulatory capacities as prerequisites of effective change outcomes remains a black box in coaching.Method:This quantitative study explored clients' self-regulatory mechanisms by addressing how nonverbal synchrony influences clients' cognitive and emotional self-regulation across sessions. One hundred eighty-four coach–client pairs and their evolving change process were observed over 8 months. Video-recorded sessions were assessed with motion energy analysis to automatically capture coach and client nonverbal behavior and quantify nonverbal synchrony at the level of the dyad.Results:Synchrony was differentially associated with clients' post-session questionnaires on result-oriented problem-reflection and self-reflection, affect balance, and working alliance. Network analyses suggested that the association between synchrony and other process variables did not correspond to the previously found positive association between synchrony and positive aspects of alliance or outcome. Instead, this association depended on the level of perceived outcome.Discussion:Coaching success may be predicted by process variables assessed after each session: goal reflection, alliance, and mood all predict successful coaching. The assessment of nonverbal synchrony suggests a state-dependent effect of embodied processes on a coaching outcome that warrants further inspection.
You Pretend, I Laugh: Associations Between Dyadic Pretend Play and Children's Display of Positive Emotions
Authors: Rao Zhen , Gibson Jenny L. 
Published: June 2021

Background: Understanding how pretend play is related to positive emotions is important for supporting children's development and promoting their wellbeing. However, previous studies have mainly examined this association at individual levels and overlooked the potential links at interpersonal levels. This is an important knowledge gap because pretend play is commonly performed in social contexts. The current study investigates how peer pretend play is associated with children's display of positive emotions at both individual and dyadic levels.Methods: One hundred and eight Chinese children (Mage = 8.95 years, SD = 0.99, 51.9% girls) were observed playing in peer dyads with toys. An interaction of 10 min was coded for each child's pretend play behavior, social and emotional pretend play themes, and display of positive emotions. Multilevel modeling was used to examine age and gender differences in peer pretend play. Actor–Partner Interdependence Models (APIM) were estimated to test the hypothesized associations between dyadic pretend play and children' display of positive emotions.Results: Compared to children whose playmates engaged in less pretend play, children whose playmates engaged in more pretend play were more likely to display positive emotions (p = 0.021). Additionally, children's display of positive emotions was predicted by both their own (p = 0.027) and their playmate's (p = 0.01) pretend play with emotional themes. Compared to younger children, older children were less likely to engage in pretend play (p = 0.002), but more likely to engage in pretend play with social themes (p = 0.03) when the total frequency of pretend play was controlled for. Boys were 4.9 times and 2.16 times as likely as girls to create aggressive pretend themes (p &lt; 0.001) and non-aggressive negative pretend themes (p = 0.007), respectively. No significant gender differences were found in positive pretend themes.Conclusions: Pretending with peers may increase not only children's own, but also their play partner's display of positive emotions. Pretend play may not simply decline in middle childhood as previously assumed.
Can Leaders Prevent Technology From Backfiring? Empowering Leadership as a Double-Edged Sword for Technostress in Care
Authors: Bauwens Robin , Denissen Marith , Van Beurden Jeske , Coun Martine 
Published: June 2021

Purpose: Recent studies have called for more contextual studies of technostress and the role leaders can have in this experience. While technostress is an increasingly prevalent and severe phenomenon in care professions, limited studies have addressed its potential negative consequences for employee well-being and quality of care delivered in this sector or, more importantly, examined how the adverse consequences of technostress could be mitigated. Therefore, the present study addresses this gap by investigating how technostress in childcare affects quality of care delivered via emotional exhaustion and what influence empowering leadership plays in this relationship.Design/methodology approach: Incorporating the views of 339 Dutch childcare workers, this study tests a model in which technostress influences quality of care delivered, mediated by emotional exhaustion and moderated by empowering leadership.Findings: Results confirm that techno-invasion and techno-overload predict higher emotional exhaustion and lower quality of care delivered among childcare workers. Empowering leadership reduced the influence of techno-invasion on emotional exhaustion but strengthened the influence of techno-overload.Originality/value: Our results provide childcare organizations with relevant information on the increasing use of ICT that influences both childcare workers' well-being and quality of care they deliver. Important implications are suggested for leadership geared at stimulating employees' responsibility and accountability for different dimensions of technostress.
Surgical Resection of Primary Tumors Provides Survival Benefits for Lung Cancer Patients With Unexpected Pleural Dissemination
Authors: Fan Liwen , Yang Haitang , Han Ke , Zhao Yang , Gao Wen , Schmid Ralph A. , Yao Feng , Zhao Heng 
Published: June 2021

Background: Surgery is not generally recommended for non-small cell lung cancer (NSCLC) patients with malignant pleural dissemination (PD). However, in some cases, PD is found unexpectedly during surgery. There is no consensus on whether surgical intervention can provide survival benefit for them. We investigated the role of surgery in NSCLC patients with unexpected PD by a cohort study.Methods: Clinical data of consecutive patients who intended to undergo radical surgery for NSCLC between January 2010 and December 2015 at Shanghai Chest Hospital and Huadong Hospital were collected from a lung cancer database. Patients diagnosed with unexpected malignant pleural nodules intraoperatively were enrolled in this retrospective study.Results: A total of 181 NSCLC patients were diagnosed with unexpected malignant PD intraoperatively and confirmed with postoperatively histological examinations. Out of these, 80 (44.2%) patients received pleural nodule biopsies alone, and 101 (55.8%) received primary tumor resection (47 with sublobar resection and 54 with lobectomy). The median progression-free survival and overall survival for all patients were 13 and 41 months respectively. Patients in the resection group had significantly better progression-free survival (19.0 vs. 10.0 months, P &lt; 0.0001) and overall survival (48.0 vs. 33.0 months, P &lt; 0.0001) than patients in the biopsy group. In the resection group, there was no statistical difference between patients with sublobar resection and lobectomy (P = 0.34). Univariate and multivariate analyses identified primary tumor resection, targeted adjuvant therapy, and tumor size (≤ 3 cm) as independent prognostic factors.Conclusions: NSCLC patients with unexpected intraoperative PD potentially benefited from surgical resection of the primary tumor and multidisciplinary targeted therapy, particularly when tumor size did not exceed 3 cm. Our data demonstrated that the resection type was not associated with survival differences, which remains to be defined with a larger sample size.
Experiences of out-of-hours task-shifting from GPs: a systematic review of qualitative studies
Authors: Lyness Emily , Parker Jennifer , Willcox Merlin L , Dambha-Miller Hajira 
Published: June 2021

BackgroundThe current GP workforce is insufficient to manage rising demand in patient care within out-of-hours (OOH) primary care services. To meet this challenge, non-medical practitioners (NMPs) are employed to fulfil tasks traditionally carried out by GPs. It is important to learn from experiences of task-shifting in this setting to inform optimal delivery of care.AimTo synthesise qualitative evidence of experiences of task-shifting in the OOH primary care setting.Design & settingSystematic review of qualitative studies and thematic synthesis.MethodElectronic searches were conducted across CINAHL (Cumulative Index of Nursing and Allied Health Literature), PsychINFO, Cochrane, MEDLINE, Embase, and OpenGrey for qualitative studies of urgent or OOH primary care services, utilising task-shifting or role delegation. Included articles were quality appraised and key findings collated through thematic synthesis.ResultsA total of 2497 studies were screened, of which six met the inclusion criteria. These included interviews with 15 advanced nurse practitioners (ANPs), three physician assistants (PAs), two paramedics, and a focus group of 22 GPs, and focus groups with 33 nurses. Key findings highlight the importance of clearly defining and communicating the scope of practice of NMPs, and of building their confidence by appropriate training, support, and mentoring.ConclusionWhile NMPs may have the potential to make a substantial contribution to OOH primary care services, there has been very little research on experiences of task-shifting. Evidence to date highlights the need for further training specific to OOH services. Mentorship and support to manage the sometimes challenging cases presenting to OOH could enable more effective OOH services and better patient care.
Le caveau Saint-Lubin de la cathédrale de Chartres, d’après un dessin de 1678 de la collection Cronstedt
Authors: Degand Hervé 
Published: June 2021

Saint-Lubin’s burial vault in Chartres Cathedral, according to a drawing of 1678 in the Cronsted Collection.
Among the hundreds of drawings bought in Paris between 1731 and 1737 by the Swedish architect C.J. Cronsted, now at the National Museum in Stockholm, a dozen feature the medieval French architecture and three of which, signed F.J., feature monuments in Chartres. The “Plan et coupe du caveau Saint-Lubin de la cathédrale’’ dated July 1678 was ignored in recent publications ; though it gives original information on the vaults of the crypt and confirms the contemporary measurements by André Félibien and Claude Estienne, to which it could be related.
Urbanisme national-socialiste en France, les projets pour le « Nouveau Strasbourg », 1940-1944
Authors: Leclerc Bénédicte 
Published: June 2021

National-socialist urbanisation in France, schemes for the “Nouveau Strasbourg ” (1940-1944).
After their victory in June 1940, the nazis started a new political reorganisation which included the annexation of the Alsace region to the Bade Land and a new status for Strasbourg as the capital of the New Upper Rhine province. A competition was organised by Albert Speer in January 1941 for the plan of the “Nouveau Strasbourg”, Hitler himself had made a sketch. The drawings and representations of five of the eight projects then proposed have been kept ; they are unequalled as a testimony of the nazi techniques and architectural designs on the French territory.
Le marbre MA 441 du Louvre et les copies du type de l’Apollon Sauroctone
Authors: Martinez Jean-Luc 
Published: June 2021

The marble MA 441 in the Louvre and the Apollo Sauroctone-type copies.
The copy of the Apollo Sauroctone in the Musée du Louvre, from the Borghese Collection, has been the subject of a detailed technical study in the perspective of a cleaning and a possible restoration. The comparison with the other known copies allows one to judge the exceptional qualities of the ancient and modern restorations of the Louvre copy. It should be used as the reference in the study of the Apollo Sauroctone carved type, in preference to the replicas in the Vatican and in the Villa Albani. The attempts to define the original type of the Apollo Sauroctone from the comparison of the copies are doomed to failure as long as the exact nature of the restorations is not taken into account.
Les arcades du cloître de l’abbaye Saint-Aubin d’Angers (1128-1151)
Authors: Wu Fang-Cheng 
Published: June 2021

The arcades of the Saint-Aubin Abbey Cloister in Angers.
The arcades, the refectory door and the Saint-Aubin Tower are the only romanesque vestiges of the Saint-Aubin Abbey in Angers. The study of the arcades and the door permits a distinction between two successive phases in the building site. The whole of the high arcades can be dated of 1130-1140 ; the evolution of their waterleaf ornementation preludes to the disappearance of the motif. The carving of the gemelled arcades testifies on the contrary to the broadening of the decorative repertory in Anjou around 1140. The sources could be found in the contemporary manuscripts produced in England and in the Northern part of France, but the problem of the relationships with the first gothic monuments of Ile-de-France and with Saint-Étienne de Toulouse must also be considered.
Un décor italien en France au début de la Renaissance : les pilastres du Sépulcre de Solesmes
Authors: Soldini Simone 
Published: June 2021

The pilasters of the Solesmes Abbey. An Italian ornementation in Trance at the beginning of the Renaissance.
What is the origin of the carved ornementation of the pilasters of the Sepulchre at Solesmes (1494-1496) ? The present inquiry takes place in the context of a study of the italian sources of the new carved ornementation in french buildings at the beginning of the Renaissance (1495-1510), with the introduction of forms “all’antica”, and the decline of gothic art. Until now the stylistic analysis of the Sepulchre has focused on the figures and neglected the ornaments. The previous tentatives of attribution remain hypothetical. The vegetal ornaments, the candelabra and other details recall in fact these same motifs used on the pilasters of lombardian monuments slightly anterior or contemporary. The idea of the influence of Mantegna’s prints is an hypothesis confirming their lombardian origin but it is unsufficient by itself.
Le motif du dauphin sur les chapiteaux renaissants à Florence
Authors: Duffault Catherine 
Published: June 2021

The dolphin motif in the Renaissance capitals in Florence.
In the sampling of 230 florentine capitals listed by the author, 45 % exhibit the motif of the dolphin. The animal being since Antiquity assimilated to a fish, the florentine carvings, wich derive from corinthian models, reproduce several mythological features of the fish but move away from the model by some irrealistic aspects and by a vegetal hybrid. The analysis of the location of the motif on the capital brings to light a new type in comparison with the ancient models ; the success of the “convergent dolphins” as an angle motive constitute the most salient phenomenon, perhaps due to the influence of the heraldic ornementation of the Palazzo Ducale in Urbino.