bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perspectives toward brain death diagnosis and management of the potential organ donor
Authors: Victorino João Paulo , Mendes Karina Dal Sasso , Westin Úrsula Marcondes , Magro Jennifer Tatisa Jubileu , Corsi Carlos Alexandre Curylofo , Ventura Carla Aparecida Arena 
Published: August 2018

Background: Organ donation and transplantation represent one of the most important scientific advances over the last decades. Due to the complexity of these procedures and related ethical–legal aspects, however, there are a lot of doubts and uncertainty about the brain death diagnosis and the maintenance of potential organ donor. Aim: To identify and discuss the different meanings and experiences of registered nurses and physicians from an adult intensive care unit in relation to the diagnosis of brain death and the maintenance of potential organ donors for transplantation purposes. Study Design: Participants were registered nurses and physicians from an adult intensive care unit at a University Hospital from Brazil. Data were collected through semi-structured interviews and analyzed using content analysis. Ethical considerations: This study was approved by the University of São Paulo at Ribeirão Preto College of Nursing Research Ethics Committee. Results: Two main categories emerged from the analysis: (1) brain death diagnosis and its implications and (2) maintenance of the potential organ donor and its repercussion in the donation–transplantation process. Six subcategories were also identified: (1.1) understanding the brain death diagnosis as a tool to aid decision-making; (1.2) diagnosis as guarantee of rights; (1.3) difficulties encountered to establish the diagnosis; (1.4) clinical criteria adopted in Brazil and related ethical–legal aspects; (2.1) specificities of care to the brain dead person and outcomes; and (2.2) nurse’s duties toward the brain dead person. Conclusion: Although the brain death diagnosis is scientifically and legally defined in Brazil and the maintenance of the potential organ donor for transplantation purposes has been addressed during the last years, there are still some doubts about the subject, as its understanding varies according to the personal beliefs, culture, and educational background of individuals, including those who work in this scenario.
Is antimicrobial prophylaxis necessary for lymphoma patients? A single centre, real-life experience
Authors: Yıldız Abdulkerim , Öztürk Hacer BA , Albayrak Murat , Pala Çiğdem , Şahin Osman , Maral Senem , Okutan Harika 
Published: August 2018

Background Prophylaxis is strongly recommended in patients with hematological malignancy who are usually at higher risk for infection and neutropenic fever. It is still unclear whether or not there is a definite need for antimicrobial prophylaxis in intermediate-risk hematology patients such as those with lymphoma. Methods A retrospective analysis was made of patients admitted from January 2009 to December 2017 to the Hematology Department of Diskapi Yildirim Beyazit Training and Research Hospital, a tertiary referral hospital in Ankara, Turkey. The study included patients who were diagnosed with any type of lymphoma and given chemotherapy. Routine antimicrobial prophylaxis was administered to 127 lymphoma patients, and not to 65 lymphoma patients. These two groups were compared in respect of the incidence of total infection episodes (IE), febrile neutropenia episodes, and nonneutropenic clinically documented infection episodes. Results For all patients with lymphoma and subtypes of non-Hodgkin lymphoma or Hodgkin lymphoma, no significant difference was determined between the groups in respect of the total incidence of IE, febrile neutropenia and nonneutropenic clinically documented infection both during the first-line chemotherapy and throughout the total follow-up period ( p > 0.05). Patients with prophylaxis had a higher incidence of IE, which was treated with parenteral antibiotics both during the first-line chemotherapy and throughout the total follow-up period ( p < 0.05). Conclusion Antimicrobial prophylaxis was seen to have no effect on the total incidence of infection episode and febrile neutropenia. Therefore, the routine use of antimicrobial prophylaxis should not be recommended for patients with lymphoma.
Digital continuous healthcare and disruptive medical technologies: m-Health and telemedicine skills training for data-driven healthcare
Authors: Sapci A Hasan , Sapci H Aylin 
Published: August 2018

Introduction Disruptive medical technologies, wearable devices and new diagnostic solutions have been shaping the future of healthcare, and the health informatics skills gap has become a major problem for technology-centric healthcare applications. This study evaluated the relationships between a specific practical skills training method and students' confidence in using wireless monitoring devices along with the attitude towards technology adoption. Methods Six practical exercises were developed to provide health informatics technical skills to transfer medical information and display multi-channel biological signals. Two hundred and six undergraduate nursing students received a telemedicine and homecare training course. Their familiarity with various data formats and likelihood to recommend telemedicine and remote monitoring applications were measured. Results The skills training session changed students' attitudes towards remote patient monitoring, and the majority of students provided positive feedback about their confidence in using wireless monitoring devices after the training session. Students stated their plans to use the technology when they start practising and to educate their patients to promote the use of telemedicine. Conclusion We propose a skills training framework that covers (a) telemedicine, (b) m-Health and connected health, (c) health informatics application development, (d) health informatics device innovation, and (e) data science.
Reliability of mobile phone teledentistry in dental diagnosis and treatment planning in mixed dentition
Authors: AlShaya Mohammad Saeed , Assery Mansour K , Pani Sharat Chandra 
Published: August 2018

Introduction The aim of the study was to test the reliability of mobile phone teledentistry in the diagnosis and treatment planning of dental caries of children in mixed dentition. Methods A total of 57 cases, aged 6–12 years, among six examiners were used yielding 342 comparisons. The patients were examined by a dentist who was calibrated in the recording of oral findings in children using the World Health Organization (WHO) oral health assessment form for children (version 2013), which served as the gold standard for diagnosis. Six paediatric dentists calibrated using the same WHO form served as the teledentistry group and made their diagnoses using only the images sent to them without the use of radiographs. The pictures obtained were stored on an online cloud platform (Google Drive). The sharing links for these pictures were forwarded to participating dentists using a social media application (WhatsApp Messenger, Facebook Corp., Mountain View, CA). Results This study showed greater sensitivity than specificity, and though both sensitivity and specificity were constantly above 80%, it can be stated that the current model has a higher chance of false positive results than false negative results. The reliability of teledentistry in this study is greater in primary teeth than in permanent teeth. Discussion Although the use of teledentistry without radiographs is not as accurate as clinical examination, mobile phone teledentistry offers acceptable reliability for the initial diagnosis of caries in children.
Telehealth interventions for schizophrenia-spectrum disorders and clinical high-risk for psychosis individuals: A scoping review
Authors: Santesteban-Echarri Olga , Piskulic Danijela , Nyman Rowen K , Addington Jean 
Published: August 2018

Background Despite its increased use in mental health, both health care provision by telehealth and research are in the early stages. Videoconferencing, a telehealth subfield, has been mainly used for the medication management and delivery of psychological treatments for mood, adjustment and anxiety disorders, and to a lesser extent for psychotic disorders. Objectives The focus of this scoping review is on studies using videoconferencing for intervention for individuals with a diagnosis of schizophrenia-spectrum disorder and those who may be considered to be in the very early stages of psychosis (clinical high risk). The aim of this review is to assess the feasibility, acceptability and clinical benefits of videoconferencing interventions and compare them with face-to-face interventions for this population. Methods A scoping review of peer-reviewed original research on the use of videoconferencing for intervention purposes in individuals with a schizophrenia-spectrum disorder or at clinical high risk. Results Out of 13,750 citations, 60 articles were retrieved for detailed evaluation, resulting in 14 eligible studies ( N = 439 individuals). There was no study reporting on videoconferencing interventions for individuals at clinical high risk. All the studies reported that videoconferencing implementation was feasible, and most of them described high acceptance by individuals with a schizophrenia-spectrum disorder. However, selection bias of studies was high, and overall methodological quality was poor. Conclusion Videoconferencing interventions seem feasible for participants with schizophrenia-spectrum disorder who showed high acceptance of this intervention modality.
Long-Term Outcome of Direct Relief of Subaortic Stenosis in Single Ventricle Patients
Authors: Rijnberg Friso M. , Sojak Vladimir , Blom Nico A. , Hazekamp Mark G. 
Published: August 2018

Background: Single ventricle patients with unrestrictive pulmonary blood flow and (potential) subaortic stenosis are challenging to manage and optimal surgical strategy is unknown. Direct relief of subaortic stenosis by enlargement of the ventricular septal defect and/or subaortic chamber has generally been replaced by a Damus-Kaye-Stansel or Norwood procedure due to concerns of iatrogenic heart block, reobstruction, or ventricular dysfunction. Studies reporting long-term outcome after the direct approach are limited. The aim of our study was to describe and analyze our experience with direct relief of subaortic stenosis in single ventricle patients. Methods: Demographic data, characteristics, and pre-operative, operative and outcome details were collected for children undergoing direct relief of subaortic stenosis between 1989 and 2016. Results: Twenty-three patients (median age: 7.4 months, range: 10 days to 5.5 years) underwent direct relief of subaortic stenosis. Complete follow-up was available for all patients (median: 15.6 years, range: 34 days to 26.3 years). Seven (30%) patients had recurrence of subaortic stenosis. One (4%) patient developed complete heart block and one patient developed moderate ventricular dysfunction. Five (50%) patients developed a (pseudo)aneurysm at site of the patch and ventriculotomy. There were two perioperative deaths. Eighty-six percent of patients underwent a successful Fontan procedure. Conclusions: Direct relief of subaortic stenosis is associated with a substantial risk of reobstruction and patch (pseudo)aneurysm formation. However, risk of heart block is low and long-term outcome is good with the majority of patients reaching Fontan completion. In our opinion, the direct approach appears to be a good and relatively simple procedure in selected cases for the treatment of subaortic stenosis.
Gender gaps in the path to adulthood for young females and males in six African countries from the 1990s to the 2010s
Authors: Mariara Jane , McKay Andy , Newell Andy , Rienzo Cinzia 
Published: August 2018

AbstractIn this paper, we study on a comparative basis the school-to-work transition of young women and young men in six countries in sub-Saharan Africa, and we examine how this has evolved over recent years, based on the data collected by Demographic and Health Surveys. We examine educational attainments and the nature of early jobs young people are able to obtain, as well as considering their relationship to marriage and fertility outcomes, factors which are likely to be particularly relevant for young women. A pooled regression analysis shows that educational levels have increased substantially and gender gaps have narrowed in most countries. Access to better jobs has improved much more slowly with unchanging gender gaps in most countries, so that agriculture is still the dominant sector of employment for most young men and women. We model correlates of key educational outcomes and access to different types of jobs those controlling for individual- and household-level characteristics, including marital status, presence of children and wealth. Attaining a high level of education is unsurprisingly critical for access to the best jobs and is also associated with young women delaying marriage and childbearing.
Uncertainty quantification for inverse problems with weak partial-differential-equation constraints
Authors: Fang Zhilong , Da Silva Curt , Kuske Rachel , Herrmann Felix J. 
Published: August 2018

In statistical inverse problems, the objective is a complete statistical description of unknown parameters from noisy observations to quantify uncertainties in unknown parameters. We consider inverse problems with partial-differential-equation (PDE) constraints, which are applicable to many seismic problems. Bayesian inference is one of the most widely used approaches to precisely quantify statistics through a posterior distribution, incorporating uncertainties in observed data, modeling kernel, and prior knowledge of parameters. Typically when formulating the posterior distribution, the PDE constraints are required to be exactly satisfied, resulting in a highly nonlinear forward map and a posterior distribution with many local maxima. These drawbacks make it difficult to find an appropriate approximation for the posterior distribution. Another complicating factor is that traditional Markov chain Monte Carlo (MCMC) methods are known to converge slowly for realistically sized problems. To overcome these drawbacks, we relax the PDE constraints by introducing an auxiliary variable, which allows for Gaussian errors in the PDE and yields a bilinear posterior distribution with weak PDE constraints that is more amenable to uncertainty quantification because of its special structure. We determine that for a particular range of variance choices for the PDE misfit term, the new posterior distribution has fewer modes and can be well-approximated by a Gaussian distribution, which can then be sampled in a straightforward manner. Because it is prohibitively expensive to explicitly construct the dense covariance matrix of the Gaussian approximation for problems with more than [Formula: see text] unknowns, we have developed a method to implicitly construct it, which enables efficient sampling. We apply this framework to 2D seismic inverse problems with 1800 and 92,455 unknown parameters. The results illustrate that our framework can produce comparable statistical quantities with those produced by conventional MCMC-type methods while requiring far fewer PDE solves, which are the main computational bottlenecks in these problems.
Application of instantaneous-frequency attribute and gamma-ray wireline logs in the delineation of lithology in Serbin field, Southeast Texas: A case study
Authors: Ogiesoba Osareni C. , Ambrose William A. , Loucks Robert G. 
Published: August 2018

Although Serbin field in Southeast Texas was discovered in 1987, lithologic and petrophysical properties in the southeastern part of the field have not been fully evaluated. We have generated instantaneous frequency from 3D seismic data and predicted gamma-ray response volume from seismic attributes. By extracting maps of the instantaneous frequency and gamma-ray response along interpreted horizons, and crossplotting the instantaneous frequency against gamma-ray logs and integrating core data, we generated lithology maps to identify shale-prone zones that stratigraphically trapped hydrocarbons in the southeastern part of the field. We determine that Serbin field is separated into two areas: (1) a high-frequency, high-gamma-ray, and high-acoustic-impedance area in the northwest and (2) a low-frequency, low-gamma-ray, and low-acoustic-impedance area located in the southeast. By developing a lithologic map and relating it to the corresponding instantaneous-frequency map and log data, we also find that the southeastern part of the field can be divided into three zones: (1) zone 1, composed of approximately 0.7–2.7 m (approximately 2–8 ft) thick sandstone-rich beds of moderate frequency (25–30 Hz); (2) zone 2, composed of high-frequency (33–60 Hz) shale-rich zones that serve as stratigraphic-trapping-mechanisms; and (3) zone 3, composed of approximately 1.7–4 m (approximately 5–13 ft) thick sandstone-rich beds of low frequency (0–18 Hz) and relatively high porosity. These methods can be applied in other areas of the field with limited well control.
Prostate Cancer Radiotherapy: An Evolving Paradigm
Authors: Catton Charles N. , Lukka Himu , Martin Jarad 
Published: August 2018

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors’ suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice. A urologist referred a 69-year-old man for a radiotherapy opinion regarding a recently diagnosed adenocarcinoma of the prostate. Annual serum prostate-specific antigen (PSA) testing over 7 years demonstrated a rise in PSA from 1.36 ng/mL to 5.8 ng/mL, prompting a transrectal ultrasound that revealed a heterogeneous 37-mL gland containing no visualized hypoechoic nodules. Biopsy disclosed a Gleason score 3+4 (grade group 2) adenocarcinoma of the prostate. The synoptic report stated that six of 14 cores and 17% of the tissue were involved, with the greatest core involvement being 80% at the right apex. Perineural invasion was present without lymphovascular invasion. Disease was present bilaterally at the base, midgland, and apex.His medical history was significant only for treated peptic ulcer disease and he was taking no medication. His International Prostate Symptom Score was six of 35, and he reported being sexually active with good erectile function. There was no family history of prostate cancer. He is retired. Digital rectal examination revealed moderate benign prostatic hypertrophy with no suspicious nodules. A staging computerized tomography (CT) scan of the abdomen and pelvis and a whole-body bone scan ordered by his referring urologist reported no evidence of metastatic disease. The patient had discussed surgical options with his urologist and now wished to consider radiotherapy approaches.
Economic Evaluations of Next-Generation Precision Oncology: A Critical Review
Authors: Weymann Deirdre , Pataky Reka , Regier Dean A. 
Published: August 2018

PurposePrecision oncology has the potential to improve patient health and reduce treatment costs. Yet the up-front cost of genomic testing with next-generation sequencing (NGS) technologies can be prohibitive. Our study is a structured review of economic evaluations of precision oncology informed by NGS. The aim is to characterize the availability and scope of economic evidence.Materials and MethodsWe searched Medline (PubMed), Embase (Ovid), and Web of Science databases for English-language full-text peer-reviewed articles published between 2000 and 2016. We focused our search on articles that estimated the benefit of precision oncology in relation to its costs. We excluded studies that did not undertake full economic evaluations or did not focus on NGS technologies. We reviewed all included studies and summarized key methodological and empirical study characteristics.ResultsFifty-five economic evaluations met our inclusion criteria. The number of published studies increased steadily, from three studies between 2005 and 2007 to 26 between 2014 and 2016. Most studies evaluated multiplex panels (86%). We found testing was frequently used to predict prognosis (67%), to diagnose patients (24%), or to identify targeted therapeutic options (7%). Methods and cost effectiveness differed according to NGS technology, test strategy, and cancer type. Deterministic and probabilistic analyses were typically used to characterize parameter and decision uncertainty (91% and 75%).ConclusionAlthough the availability of economic evidence examining precision oncology increased over time, methods used often did not align with current guidelines. Future evaluations should undertake extensive sensitivity analysis to address all sources of uncertainty associated with rapidly changing NGS technologies. Furthermore, additional research is needed evaluating the cost effectiveness of more comprehensive next-generation technologies before implementing these on a wider scale.
Re-inforcing the cell death army in the fight against breast cancer
Authors: Oudenaarden Clara R. L. , van de Ven Robert A. H. , Derksen Patrick W. B. 
Published: August 2018

ABSTRACT
Metastatic breast cancer is responsible for most breast cancer-related deaths. Disseminated cancer cells have developed an intrinsic ability to resist anchorage-dependent apoptosis (anoikis). Anoikis is caused by the absence of cellular adhesion, a process that underpins lumen formation and maintenance during mammary gland development and homeostasis. In healthy cells, anoikis is mostly governed by B-cell lymphoma-2 (BCL2) protein family members. Metastatic cancer cells, however, have often developed autocrine BCL2-dependent resistance mechanisms to counteract anoikis. In this Review, we discuss how a pro-apoptotic subgroup of the BCL2 protein family, known as the BH3-only proteins, controls apoptosis and anoikis during mammary gland homeostasis and to what extent their inhibition confers tumor suppressive functions in metastatic breast cancer. Specifically, the role of the two pro-apoptotic BH3-only proteins BCL2-modifying factor (BMF) and BCL2-interacting mediator of cell death (BIM) will be discussed here. We assess current developments in treatment that focus on mimicking the function of the BH3-only proteins to induce apoptosis, and consider their applicability to restore normal apoptotic responses in anchorage-independent disseminating tumor cells.