bluuebunny/crossref_metadata_2025_split huggingface dataset:
Decision-making in crisis resolution and home treatment teams: The AWARE framework
Authors: Lombardo Chiara , Santos Mónica , Van Bortel Tine , Croos Robert , Arensman Ella , Kar Ray Manaan 
Published: November 2018

Aims and methodThe aim of the study is to improve patient safety by identifying factors influencing gatekeeping decisions by crisis resolution and home treatment teams. A theoretical sampling method was used to recruit clinicians. Semi-structured interviews to elicit various aspects of clinical decision-making were carried out. The transcripts were thematically analysed using a grounded theory approach.ResultsPatient needs (safety and treatment) was the primary driver behind decisions. The research also revealed that information gathered was processed using heuristics. We identified five key themes (anxiety, weighting, agenda, resource and experience), which were constructed into an acronym ‘AWARE’.Clinical implicationsAWARE provides a framework to make explicit drivers for decision-making that are often implicit. Incorporating these drivers into reflective practice will help staff be more mindful of undue influences and result in improved clinical decisions.Declaration of interestNone.
Clinical pharmacy workload in medical and surgical patients: effect of patient partition, disease complexity and Major Disease Category
Authors: Stuchbery Peter , Kong David C M , DeSantis Giovanna N , Lo Sing Kai 
Published: November 2018

AbstractObjectivesThe aim of this study was to measure the time spent providing clinical pharmacy services to individual patient episodes for general medical and surgical patients and to measure the effect of patient presentation and complexity on this workload.MethodsWe conducted a 5-month study at The Northern Hospital and Western Hospital in Melbourne, Australia, during 2006. Pharmacists recorded a defined range of activities that they provided for individual patients, including the actual times required for these tasks. A customised database, linked to the two hospitals' patient administration systems, stored these data according to the specific patient episode number. We then examined the influence of patient presentation and complexity on clinical pharmacy activities provided.Key findingsDuring intervals when pharmacists recorded the time required to conduct activities, the average time required to perform the medication history and reconciliation exercise on 3052 occasions was 9.6 ± 4.5 min. The 1844 interventions required an average of 5.9 ± 3.0 min, clinical review of the patient's medical record required 5.5 ± 2.7 min and medication order review required 3.5 ± 1.3 min. For all of these activities, the time required was greater for medical patients than for surgical patients and greater for patients whose Diagnosis Related Group classification included a complication or co-morbidity. The average time required to perform all clinical pharmacy activities for 4625 completed patient episodes was 22.4 ± 16.7 min and was again greater for medical patients and for patients with a complication or co-morbidity.ConclusionsThe times required to perform a range of clinical pharmacy activities for individual patients was affected by whether the patients were medical or surgical patients. Furthermore, the existence of co-morbidities or complications affected these times. The methodology has potential application for other patient presentations and in other practice settings.
Rilke’s Lyric Lies
Authors: Molde Klas 
Published: November 2018

Abstract
This essay addresses the question of lying in the lyric with reference to both canonical and lesser-known works by Rilke, including several of his relatively neglected poems in French. Taking as a point of departure Rilke’s late lyric “Mensonges,” the essay proceeds via a series of close readings to formulate his poetics of lies and deception in positive terms. Special attention is given to the relationship of fraudulence to lyric form, animation, and praise. Ultimately, Rilke’s lesson is not to lie more but to lie better. Thus he puts on display a fundamental lyric operation: From its inception as counter-mythology, presupposing the existence of myth that it can either affirm or critique, the lyric does not present an alternative between enchantment and disenchantment but rather—in negotiating between the two—shows us the agency we have in fashioning our enchantments as well as our embarrassments.
Exploring landscapes of brain morphogenesis with organoids
Authors: Jabaudon Denis , Lancaster Madeline 
Published: November 2018

ABSTRACT
The field of developmental neuroscience is benefitting from recent technological advances that allow access to organogenesis in vitro via organoid preparations. These methods have been applied to better understanding neural identity, and have opened up a window into the early events that occur during development of the human brain. However, current approaches are not without their limitations, and although brain organoids and other in vitro paradigms recapitulate many processes with remarkable fidelity, there are clear differences between brain organoid development in vitro and brain development in vivo. These topics were discussed extensively at a recent workshop organized by The Company of Biologists entitled ‘Thinking beyond the dish: taking in vitro neural differentiation to the next level’. Here, we summarize the common themes that emerged from the workshop and highlight some of the limitations and the potential of this emerging technology. In particular, we discuss how organoids can help us understand not only healthy and diseased brain, but also explore new arrays of cellular behaviors.
Lithuanian Literary Magazine Kulturos barai –Cultural Mission in a Modern Way
Authors: Urbanaviciute Asta 
Published: November 2018

The aim of this article is to present shortly the regulations and aims of Lithuaniaʼs cultural policy concerning cultural publications, to introduce publishing models of one of the biggest and most important Lithuanian literary publications Kulturos baraiand to discuss its importance for the Lithuanian literary society. For a small country, culture is one of the most important features of its identity and that is why we need to recognize the enduring value and mission of literary media – to inform about literary life, to influence public taste, to be an active part of culture, a tool for societal education, and the space in which creators can express themselves. On the other hand, increasing globalization and changing society needs may raise a question if literary publications perform their mission in a modern way, if culture is not equaled to a narrower art concept. Kulturos baraiis one of more than 20 Lithuanian literary periodicals with long tradition. Started in 1965 as an amateur publication, thanks to influential authors the magazine turned into a publication which is intended to shape the cultural strategy. In 1988, public discussion events organized by Kulturos baraigave an impetus to create the Reform Movement in Lithuania. At that time the whole cultural situation was changing in Lithuania – when Reform Movement was established, culture started to be understood as the basis for identity, and literary publications became the space which assisted to return memory. Literary pages were unprofitable for the mass media which had just been born, however, they were important as a sign of prestige. Kulturos barai, having played an important role in shaping the cultural taste in society several decades ago, still remains one of the most progressive and most modern literary publications, which performs its content management and dissemination organization in the best possible way. The research is based on the interview with an editor-in-chief of the magazine Kulturos barai.
Association between the metabolically healthy obese phenotype and the risk of myocardial infarction: results from the Kailuan study
Authors: Xu Yijie , Li Haibin , Wang Anxin , Su Zhaoping , Yang Guang , Luo Yanxia , Tao Lixin , Chen Shuohua , Wu Shouling , Wang Youxin , Guo Xiuhua 
Published: November 2018

Objective
This study aimed to determine if the metabolically healthy obese (MHO) is associated with an increased risk of myocardial infarction (MI) in Chinese population.

Design
The Kailuan study is a community-based prospective cohort study.

Methods
BMI and metabolic syndrome (MetS) were assessed in 91 866 participants without a history of MI or stroke. Participants were categorised into six mutually exclusive groups according to the BMI-MetS status: normal weight (BMI:  ≤ 18.5to < 24.0 kg/m2) without MetS (MH-NW), normal weight with MetS (MUH-NW), overweight (BMI:  ≤ 24.0to < 28.0 kg/m2) without MetS (MH-OW), overweight with MetS (MUH-OW), obese (BMI ≥ 28.0 kg/m2) without MetS (MHO) and obese with MetS (MUO). The hazard ratio (HR) with 95% CI was calculated for the incidence of MI using a multivariable Cox model.

Results
A total of 6745 (7.34%) individuals were classified as MHO. During a median 8-year follow-up, 1167 (1.27%) participants developed MI. The MHO group had an increased risk of MI (HR: 1.76, 95% CI: 1.37–2.25) in comparison with the MH-NW group after adjusting for potential confounding variables. After a similar adjustment, the risk of MI was significantly elevated in the MUH-NW (HR: 1.62, 95% CI: 1.28–2.05), MUH-OW (HR: 1.98, 95% CI: 1.67–2.35) and MUO group (HR: 2.06, 95% CI: 1.70–2.49).

Conclusions
MHO subjects showed a substantially higher risk of MI in comparison with MH-NW subjects. That said, even without measurable metabolic abnormalities, obesity was associated with a higher risk of MI.
A Low Resolution Epistasis Mapping Approach To Identify Chromosome Arm Interactions in Allohexaploid Wheat
Authors: Santantonio Nicholas , Jannink Jean-Luc , Sorrells Mark 
Published: November 2018

AbstractEpistasis is an important contributor to genetic variance. In inbred populations, pairwise epistasis is present as additive by additive interactions. Testing for epistasis presents a multiple testing problem as the pairwise search space for modest numbers of markers is large. Single markers do not necessarily track functional units of interacting chromatin as well as haplotype based methods do. To harness the power of multiple markers while minimizing the number of tests conducted, we present a low resolution test for epistatic interactions across whole chromosome arms. Epistasis covariance matrices were constructed from the additive covariances of individual chromosome arms. These covariances were subsequently used to estimate an epistatic variance parameter while correcting for background additive and epistatic effects. We find significant epistasis for 2% of the interactions tested for four agronomic traits in a winter wheat breeding population. Interactions across homeologous chromosome arms were identified, but were less abundant than other chromosome arm pair interactions. The homeologous chromosome arm pair 4BL/4DL showed a strong negative relationship between additive and interaction effects that may be indicative of functional redundancy. Several chromosome arms appeared to act as hubs in an interaction network, suggesting that they may contain important regulatory factors. The differential patterns of epistasis across different traits demonstrate that detection of epistatic interactions is robust when correcting for background additive and epistatic effects in the population. The low resolution epistasis mapping method presented here identifies important epistatic interactions with a limited number of statistical tests at the cost of low precision.
Prevalencia del consumo de sustancias psicoactivas y la aparición de la enfermedad mental en adolescentes
Authors: Marín Madrigal Carlos , Calderón Barboza José 
Published: November 2018

El objetivo de este trabajo es presentar los resultados de una investigación secundaria acerca de la prevalencia del consumo de sustancias psicoactivas (SPA) en la población adolescente con enfermedad mental en comparación con los adolescentes que no padecen enfermedad mental. Se formuló una pregunta según el acrónimo “PICO” (pacientes, intervención, comparación, resultados); posteriormente, se buscó información en distintas bases de datos sugeridas en el curso de Práctica Clínica Basada en la Evidencia, impartido por el Programa de Colaboración para la Investigación de Enfermería Basada en la Evidencia de Costa Rica (CIEBE-CR). Para la búsqueda de información se efectuó una revisión de artículos científicos en Medline Plus, PudMed y EBSCO Host, con el fin de recuperar la mayor cantidad de información. Después de establecer los criterios de inclusión y exclusión y realizar un análisis crítico, se seleccionó cuatro documentos que dieron respuesta a la pregunta planteada. Se detectó 58 documentos relacionados con el tema de los cuales solo cuatro cumplían criterios de calidad que establece el Critical Appraisal Skills Programme español (CASPe) para responder a la pregunta clínica. Se evidencia cómo en la niñez la psicopatología se reconoce cada vez más como un factor de riesgo en cuanto al uso de sustancias psicoactivas. Se concluye que los adolescentes con patología mental tienen una mayor prevalencia al uso de sustancias psicoactivas en comparación con los adolescentes que no padecen enfermedad mental.
Efectividad en la suplementación con omega 3 (Pescado) y vitamina D durante el periodo gestacional para la prevención de diversas alergias en el lactante de 0-1 año de edad
Authors: Vargas Gómez Dennia , Rodríguez González Diana 
Published: November 2018

El objetivo de esta investigación fue describir la efectividad de la suplementación con omega 3 (pescado) y vitamina D durante la etapa gestacional para la prevención de diversas alergias en el lactante de 0 a 1 año. Se presenta los resultados de una compilación y categorización de la mejor evidencia científica disponible. Se aplicó la metodología sugerida para la práctica clínica basada en la evidencia, la cual inició con el establecimiento de una pregunta clínica seguido por la búsqueda de la información en las bases de datos Medline, Science Direct y Cochrane Library, obteniendo 334 artículos de los cuales al aplicar los criterios de selección se conservan 9. Luego se llevó a cabo un análisis crítico utilizando la plataforma FLC 2.0 y clasificando la evidencia por su calidad y grados de recomendación según Canadian Task Force on Preventive Health Care. Se concluye que a pesar de que los beneficios de la vitamina D y el omega 3 son múltiples, y que el uso en conjunto de ambos en el embarazo, podría significar una mejora no solo sobre la salud materna sino también sobre el feto y lactante; al no contar con estudios con resultados contundentes, no se puede generalizar o recomendar en la práctica clínica
Perspectivas do conhecimento da bioética pelos acadêmicos de saúde para atuação profissional
Authors: Biondo Chrisne Santana , Rosa Randson Souza , Antunes Ferraz Mariana Oliveira , Yarid Sérgio Donha 
Published: November 2018

O objetivo desta investigação foi analisar o conhecimento da bioética pelos acadêmicos da saúde, em uma universidade pública da Bahia. Trata-se de um estudo descritivo, exploratório, com abordagem quantitativa, realizado com 82 acadêmicos que cursavam o último semestre dos cursos da saúde da Universidade Estadual do Sudoeste da Bahia – UESB. Utilizou-se, para a coleta de dados, o questionário de Indicadores Formativos em Bioética em Profissões da Saúde: Inquérito. Os dados demonstraram que os discentes apresentam conhecimento acerca dos objetivos e dos princípios da bioética, porém, quando inferido sobre os conceitos da bioética, alguns participantes apresentaram divergências nas respostas. Conclui-se que o ensino da bioética deve ser feito de forma transdisciplinar, necessitando ainda, da dissociação da bioética e deontologia nas graduações, além de promover espaços de reflexões e conhecimento acerca do tema.
Generalidades de las venas varicosas en miembros inferiores y su tratamiento durante el embarazo: una revisión narrativa
Authors: Rojas Valenciano Ligia Patricia , Escobar Fonseca Henry , Cárdenas Sánchez Pilar , González Bermúdez Jennifer 
Published: November 2018

La enfermedad varicosa es un problema común que afecta a gran parte de la población mundial, principalmente en mujeres, agravado por una condición de embarazo. Esta revisión narrativa tiene el objetivo de conocer la evidencia científica disponible sobre aspectos diagnósticos, factores de riesgo e intervención conservadora o invasiva, incluyendo cirugía de las venas varicosas en miembros inferiores en mujeres embarazadas. La búsqueda bibliográfica se llevó a cabo en las bases de datos PubMed, Biblioteca Cochrane y EBSCO Host entre los años 2009 y 2017. Se recuperó 50 referencias bibliográficas y se seleccionó seis documentos para el análisis. Respecto del diagnóstico se lleva a cabo mediante la observación, examen directo, historia clínica y exámenes más específicos como el doppler. La síntomatología más común que se presenta es el dolor en miembros inferiores, edema, pesadez, prurito y calambres. La intervención para el tratamiento a mujeres embarazadas es la terapia conservadora, aunque solo en casos excepcionales se determinará otro tipo de tratamiento. En este proceso, la educación tiene un rol muy importante en la seguridad de la madre y el feto, cuyo abordaje debe ser dado por un equipo de profesionales en salud. Se concluye que existe controversias respecto de la patogenia de esta morbilidad durante el embarazo, por lo tanto, no se ofrece otros tratamientos distintos a los recomendados desde el año 50, de manera que hay una gran necesidad de llevar a cabo estudios robustos que demuestren cuáles son las mejores medidas profilácticas más novedosas y de tratamiento desde el inicio del embarazo, además de promover la prevención de la aparición posterior, de tal manera que esté asegurada la salud de la mujer y, consecuentemente, la de su bebé.
Enhancing student learning by combining Problem Based Learning and Human Patient Simulation
Authors: Nash Eleanor , Crowther Jane 
Published: November 2018

This article was migrated. The article was not marked as recommended. Problem-based learning (PBL) and Human Patient Simulation (HPS) are two teaching modalities that actively involve and engage students in their learning. PBL and HPS are utilised in Undergraduate Medical Education in the UK, to assist in the development and training of medical students, yet they are frequently used as separate entities in the learning process. Learning is enhanced when students are provided with the opportunity to apply their theoretical learning into a real life context. HPS provides the opportunity for the practical application of theoretical knowledge. By merging the two teaching modalities together, it reinforces existing knowledge gained from PBL. A small-scale, mix-methods, research study was conducted to assess undergraduate students’ learning experience from combined PBL and HPS.
Entre Memorias (Between Memories)
Authors: Dietrich Martha-Cecilia 
Published: November 2018

Eudosia is still searching for her husband’s remains in the highlands of Ayacucho, Lucero has been in prison for 25 years now for the crime of terrorism against the Peruvian state, and since 2009 the commandos of the counterinsurgency unit Chavin de Huantar recreate and commemorate their heroic military actions to save a nation from the threat of terrorism. Twelve years after the Peruvian Truth and Reconciliation Commission published its final report about the atrocities committed during the internal armed conflict (1980-2000), memories of this period seem more contested than ever.
This film explores the complex legacies of twenty years of violence and war in Peru through practices of remembering. In three audio-visual pieces made in collaboration with relatives of the disappeared, insurgents of the Tupac Amaru Revolutionary Movement (MRTA) and members of the Armed Forces, this documentary aims for creating an on-screen dialogue between memories, which in practice remains elusive.
Characteristics of vascular endothelium in young patients with epilepsy
Authors: Fedin A. I. , Starykh E. V. , Baranova O. A. , Chekanov A. V. , Torshin D. V. 
Published: November 2018

The objective was to study the state of vascular walls in young patients at various stages and various courses of epilepsy.Materialsand methods. We examined 62 patients of young age with focal symptomatic and cryptogenic epilepsy for hanges in their blood vessels. Photoplethysmography combined with a non-invasive diagnostic system (“Angioscan Electronics”, Russia) were used. The patients were divided into 3 groups: 1) patients after a single (first) epileptic seizure; 2) patients with remission; 3) patients with treatment-resistant seizures.Results. We found no structural changes in their blood vessels. However, the occlusion test showed changes in the functional state of large muscle arteries in all groups of epileptic patients. In addition, changes in microcirculatory beds were detected in patients after a single seizure and in those resistant to treatment. Patients after single epileptic seizures showed the largest changes in small resistance arteries and arterioles.Conclusion. The results suggest that functional characteristics of vascular endothelium change in young patients suffering from epilepsy.
Course of epilepsy in patients with clinical manifestations of cranio-cerebral imbalance and a low scf-cranial index
Authors: Larkin V. I. , Stelmakh N. S. 
Published: November 2018

The aim of the study was to assess the course of epilepsy in patients with signs of cranio-cerebral imbalance with a low CSF-cranial index.Materials and methods. We conducted a prospective analysis of clinical, instrumental and laboratory data from the case histories of 78 patients with epileptic seizures (cryptogenic epilepsy). Group I included 36 patients with normal reserve CSF volumes and physiological values of the CSF-cranial index; these patients received standard multicomponent therapy. Group II was comprised of 42 patients with abnormally small reserve CSF spaces and a lower than normal CSF-cranial index; patients in group II received the same treatment as did patients in group I.Results. We found a moderate correlation between the head circumference and the values of the CSF-cranial index. A strong correlation between the seizure occurrence rate and the values of the CSF-cranial index was also found (R=0.32, p=0.0043); the seizure rate correlation with the head circumference was less obvious (R=0.11, p=0.037). Most of the patients in group I had bilateral seizures, whereas in patients of group II the seizures were of a mixed character.Conclusion. The results of this clinical study suggest that the course of epilepsy in patients with a low CSF-cranial index is determined by the severity of anatomical reduction in the CSF dynamics; in most cases of a low CSF-cranial index, the course of epilepsy is severe. These findings should be considered at the starting and the later stages of antiepileptic therapy.
Duration of epilepsy and severity of the disease in neurosurgical patients
Authors: Odintsova G. V. , Aleksandrov M. V. , Ulitin A. Yu. , Koloteva A. V. 
Published: November 2018

The problem of a late referral to surgical treatment in epilepsy was addressed in this study.Objective: To elucidate whether the course of epilepsy is influenced by the duration of the disease.Materials and Methods. A cohort of 91 patients with epilepsy who underwent surgical interventions from 2012 to 2017, were retrospectively studied. The disease dynamics (frequency and type of seizures) as well as the EEG changes were assessed.Results.Of those patients, 77% had epilepsy more than 10 years, and 41% – more than 20 years. The temporal localization was found in 71% of cases, and the extra-temporal – in 29%. In all patients, seizures occurred at least once a month. Secondary generalized seizures were found in 58% of patients, and status epilepticus was observed in 30% of cases.Conclusion.The course of epilepsy in the clinical and neurophysiological terms deteriorates with a long duration of the disease. The present results can be used to determine the optimal time for a referral for surgical treatment.