bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cancer Communication Outside of the Physician-Patient Relationship: The Experience of Communicating and Understanding the Meaning of Prognosis
Authors: Adamson Matthew , Cotoc Crina , Choi Kelsey , Notaro Stephen 
Published: March 2019

Research Question: How does the process of engagement and integration of sources of information outside patient–physician interaction affect how individuals with cancer interpret their treatment experience and prognosis? Background: Studies of patient–physician communication of prognosis in oncology highlight areas where misunderstanding occurs: understanding consequences of treatment, likelihood of treatment success, probability of cure, status/progression of illness, and prognosis. Theories proposing mechanisms that underlie this discrepancy cannot account for all instances of misunderstanding, including when complete and direct physician disclosure occurs. Prior research focused on patient–physician communication event(s) and immediate antecedents and consequences. However, less is known about what happens to information once it has been communicated and how a patient’s process to interpret the meaning of their experience affects their understanding of it. Our study explores this question by examining patient communication with sources of information other than treating physicians. Methodology: We conducted 10 semi-structured qualitative interviews with individuals diagnosed with 4 types of cancer at different stages. The interviews were analyzed using inductive qualitative analysis. Results: Participants in our sample consulted a variety of additional sources to give context and understanding to their communicated prognosis. These were important contributors to how they understood their prognosis and incorporated that understanding. They included family, friends/acquaintances, cancer survivors, support/survivor groups, secondary health-care staff, and relevant informational materials. Different motivations for seeking out these sources were also expressed. Participants expressed a link between their understanding of their prognosis and the variety of outside sources they enlisted for input and support.
Pre-fracture medication use as a predictor of 30-day mortality in hip fracture patients: an analysis of 141,201 patients
Authors: Jantzen Christopher , Madsen Christian M , Abrahamsen Bo , Van Der Mark Susanne , Duus Benn R , Howland Jonathan , Lauritzen Jes B , Jørgensen Henrik L 
Published: March 2019

Purpose: To evaluate the predictive value of pre-fracture medication usage on 30-day mortality following a hip fracture. Methods: Information on age, sex, fracture type, time of death and Charlson co-morbidity index (CCI) was collected from the Danish National Patient Registry on all patients above 60 years, sustaining a hip fracture during the period January 1995 to December 2013. Information on drug usage was obtained from the Danish National Prescription Database. Hazard ratios were calculated with 30-day mortality as the outcome. A univariate and 3 multivariate analyses were conducted with increasing adjustments, starting with age, sex and fracture type, adding co-morbidity and dose in the latter. Results: 141,201 patients were included and a total of 12 drugs/drug groups were identified for analysis. Increased mortality was evident in all analyses for antiarrhythmics, beta blockers, proton pump inhibitors, loop diuretics, opioids, acetaminophen and for psycholeptics. For ACE-inhibitors, increased mortality was found in all analyses, except after adjustment for co-morbidity and dose. For thiazide diuretics, a significantly reduced mortality was evident in all but the univariate analyses while NSAIDs and statins were associated with a significantly reduced mortality in all analyses. For calcium channel blockers, an insignificant decrease was found after adjustment for dose. Further analysis showed a dose-response relationship for all drugs except ACE-inhibitors and calcium channel blockers. Conclusion: The study shows a correlation between pre-fracture usage of certain drugs and 30 day mortality after a hip fracture.
Laboratory Detection of First and Repeat Chlamydia Cases Influenced by Testing Patterns: A Population-Based Study
Authors: Thompson Laura H , Nugent Zoann , Wylie John L , Loeppky Carla , Van Caeseele Paul , Blanchard James F , Yu Nancy 
Published: February 2019

Objectives: The purpose of this study was to describe and explore potential driving factors of trends in reported chlamydia infections over time in Manitoba, Canada. Methods: Surveillance and laboratory testing data from Manitoba Health, Seniors and Active Living were analysed using SAS v9.4. Kaplan-Meier plots of time from the first to second chlamydia infection were constructed, and Cox proportional hazards regression was used to estimate the risk of second repeat chlamydia infections in males and females. Results: Overall, the number of reported infections found mirrored the number of tests conducted. From 2008 to 2014, the number of first infections found among females decreased as the number of first tests conducted among females also decreased. Between 2008 and 2012, the number of repeat tests among females increased and was accompanied by an increase in the number of repeat positive results from 2009 to 2013. From 2008 to 2016, the number of repeat tests and repeat positive results increased steadily among males. Conclusions: Chlamydia infection rates consistently included a subset composed of repeat infections. The number of cases identified appears to mirror testing volumes, drawing into question incidence calculations that do not include testing volumes. Summary Box: 1) What is the current understanding of this subject? Chlamydia incidence is high in Manitoba, particularly among young women and in northern Manitoba. 2) What does this report add to the literature? This report suggests that incidence calculated using case-based surveillance data alone does not provide an accurate estimate of chlamydia incidence in Manitoba and is heavily influenced by testing patterns. 3) What are the implications for public health practice? In general, improving testing rates in clinical practices as well as through the provision of rapid services in non-clinical venues could result in higher screening and treatment rates. In turn, this could lead to a better understanding of true disease occurrence.
Fracture of the Port Catheter and Migration Into the Coronary Sinus: Case Report and Brief Review of the Literature
Authors: Lukito Antonia Anna , Pranata Raymond , Huang Ian , Thengker Alvin , Wirawan Marco 
Published: February 2019

Introduction: Totally implantable venous device has a good safety profile, although certain complications may occur. Late mechanical complications include catheter fracture and cardiac migration which are rarely occurring in approximately 0.1% to 1% of patients. Case presentation: A 33-year-old woman referred by the surgical oncologist for port catheter fragment extraction through endovascular approach. She was asymptomatic on presentation and has a history of hypertension and smoking. Chest X-ray showed a port catheter fragment previously thought to be in the right atrium at the level of 8-9 thoracic vertebrae (right heart catheterization showed that the port catheter fragment was in the coronary sinus). Angiography of the right outflow tract indicates that the fragment was not in the outflow tract or pulmonary arteries but posterior to it. It was concluded that the port catheter fragment had migrated deep into the coronary sinus and the snare was unable to pull the fragment. It was deemed unfeasible to remove the fragment through the endovascular approach. Discussion: The port catheter fracture had migrated entirely into the coronary sinus and to the deep of our knowledge; this was the fourth case reported in the current literature. We tried to do a review of previous similar case reports; interestingly, this was the only case where the fragmented catheter was situated deep within the coronary sinus without any part of the fragment projected to the right atrium. This made the retrieval of the fragment much more difficult with a high chance of failure. Conclusions: Migration of totally implantable venous device into coronary sinus is a rare but possible complication and might be difficult to remove if the position is unfavorable.
Review of services to inform clinical frameworks for adolescents and young adults with severe, persistent and complex mental illness
Authors: Woody Charlotte , Baxter Amanda , Wright Eryn , Gossip Kate , Leitch Elizabeth , Whiteford Harvey , Scott James G 
Published: March 2019

Objective: Severe, persistent and complex mental illness (SPCMI) affects a small proportion of young people but is associated with severe disability and a large burden on families and health services. This article identifies and describes service models for adolescents and young adults with SPCMI. Methods: A systematic search was conducted for services for young people aged 12–25 years with SPCMI. The review sought service models providing extended care and/or multidisciplinary services to meet the complex and long-term needs of this population. Results: A total of 43 sources were identified. Evidence of effectiveness was found for both community- and bed-based services. Specific components suggested as important in service delivery included care provided by multidisciplinary teams, consumer and family involvement in care planning, intensive case management and service integration through the continuum of care. Conclusion: Clinical frameworks for this population must incorporate effective community care integrated with inpatient treatment of short duration. Frameworks require consumer and family-centred care with flexibility to support progression through developmental stages and tasks while addressing issues related to risk management, fluctuation in illness severity and stages of recovery. A continuum of care is necessary to meet the needs that arise from SPCMI in adolescents and young adults.
Patient awareness of orthodontic mobile phone apps
Authors: Sharif Mohammad Owaise , Siddiqui Nausheen Rashida , Hodges Samantha Jayne 
Published: March 2019

Introduction: Mobile phone applications (apps) can be engaging, accessible, versatile and have the potential to improve patient care. In 2017, 354 orthodontic apps were reported to be available, many of them targeted at patients; however, the awareness and usage of apps among orthodontic patients was unreported. Aim: The primary aim of this study was to assess patients’ current awareness of orthodontic apps. Methods: One hundred orthodontic patients (50 new and 50 in treatment) completed a questionnaire designed to explore their awareness, access to and utilisation of orthodontic apps and social media to support orthodontic treatment. Furthermore, their willingness to engage with and use an app to aid with orthodontic treatment was explored. There were no age restrictions or exclusion criteria. Results: Ninety percent of patients had access to a smartphone, of which 73% belonged to them (rather than a parent/relative). Apple was the most popular platform (56%) followed by Android (26%). Only 7% of patients were aware that apps were available to help with orthodontic treatment and no patients had previously used an app related to orthodontics. However, 87% of patients stated that they would be willing to use an app to support treatment. Twenty-one percent of patients had previously looked up information on social media, with YouTube being the most popular platform. Conclusion: Current awareness of the availability of apps is poor, despite the finding that 87% of patients reported they would be willing to use an app to aid with orthodontic treatment. Given the availability of apps targeted at orthodontic patients, there is a need to assess the quality of these apps and, if appropriate, navigate patients towards high-quality, effective apps.
Correlation between radiographic parameters for the prediction of palatally impacted maxillary canines
Authors: Malik Durr e Shahwar , Fida Mubassar , Sukhia Rashna Hoshang 
Published: March 2019

Objective: This study aimed to identify radiographic parameters on routine orthopantomograms to aid in early diagnosis of palatally impacted canines. Design: Split-mouth case-control study. Setting: Single-centre university dental hospital. Methods: Thirty-three individuals with palatally impacted canines and non-impacted contra-lateral teeth were recruited. Radiographic variables angle A, angle B, angle C, distance D, sector class and depth of vertical impaction were measured for both groups. Mann–Whitney U test and Spearman’s correlation coefficient were used to analyse significant differences and association between variables with sector class and depth of vertical impaction, respectively. Logistic regression analysis determined radiographic parameters as predictors of palatal impaction. Results: Significant differences were seen between sector class, depth of vertical impaction and the radiographic parameters between cases and controls ( P ⩽ 0.001). For cases, strong correlation was found for angle C between the impacted canine and occlusal plane (r = −0.28, P = 0.022) and perpendicular distance D of impacted canine to the occlusal plane (r = 0.81, P ⩽ 0.001) with the depth of vertical impaction. Logistic regression analysis showed the odds of canine impaction increase with an increase in angle B and angle C. Conclusions: Our study showed that greater depth of vertical impaction, sector class, increased perpendicular distance and reduced angulation from occlusal plane resulted in palatal impaction of permanent maxillary canines. The odds of palatal canine impaction increase nearly twofold with every 10 increase in angle B and angle C.
Altered morpho-functional features of bones in autoimmune disease-prone BXSB/MpJ-Yaa mice
Authors: Namba Takashi , Ichii Osamu , Nakamura Teppei , Masum Md Abdul , Otani Yuki , Otsuka-Kanazawa Saori , Hosny Ali Elewa Yaser , Kon Yasuhiro 
Published: March 2019

Bones play crucial roles in motility, electrolyte metabolism, and immunity. Clinical cases have suggested bone dysfunction in several systemic autoimmune diseases. This study exhibited altered bone morpho-functions in BXSB/MpJ- Yaa as a murine autoimmune disease model. During clinical examinations, the serum Ca level was significantly higher in BXSB/MpJ- Yaa than the healthy control BXSB/MpJ at the early stage (two to four months), but that in BXSB/MpJ- Yaa decreased with advancing age. Further, the increase of urinary Ca with nephritis and white blood cells with mild anemia proceeded in BXSB/MpJ- Yaa with advancing age. The thyroid and parathyroid gland morphologies and serum parathormone level did not differ among strains, but the tibia was smaller in BXSB/MpJ- Yaa than in BXSB/MpJ especially during the late stage (six months). Histologically, osteoclasts and osteoblasts showed increased and decreased tendencies, respectively, in BXSB/MpJ- Yaa during the early stage, and osteoclasts and bone area significantly increased and decreased, respectively, compared with BXSB/MpJ at later stages. The bone morphological indices were affected by the expression of BXSB/MpJ- Yaa mutation genes and inflammatory genes in BXSB/MpJ- Yaa. In conclusion, systemic autoimmune diseases in BXSB/MpJ- Yaa are associated with the morpho-functional abnormalities of bones, calcium dynamics, and hematopoiesis, and each factor contributes to forming the phenotypes in this disease. Impact statement Bone disease, such as osteoporosis and rheumatoid arthritis, increases because of the progression of an aging society. Autoimmune disease are important and predisposing factors for the pathogenesis of the bone disease; however, the pathological mechanism is unclear. We have demonstrated that systemic autoimmune disease in BXSB/MpJ- Yaa is closely associated with the morpho-functional abnormalities of bones including bone marrow and has complicated pathology. The abnormalities are characterized by altered regulations of serum calcium, anemia tendency, and hematopoiesis with increased WBCs and decreased PLs, short length and low mass of long bones, imbalance in the populations of osteoclasts and osteoblasts, and increased expression of candidate genes for causing and/or exacerbating their phenotypes. Therefore, BXSB/MpJ- Yaa serves as a model to elucidate bone phenotypes in systemic autoimmune disease that would be affected by the factors in the bone as well as the other immune and/or mineral metabolism organs both in human and experimental medicine.
Different morphological and gene expression profile in placentas of the same sickle cell anemia patient in pregnancies of opposite outcomes
Authors: Baptista Letícia C , Figueira Camilla O , Souza Bruno B , Fertrin Kleber Y , Antolini Arthur , Costa Fernando F , de Melo Mônica B , Costa Maria Laura 
Published: March 2019

Environmentally induced changes in placental morphological and molecular phenotypes may provide relevant insight towards pathophysiology of diseases. Sickle cell disease (SCD) is a common inherited hemoglobin disorder characterized by chronic hemolytic anemia and vaso-occlusive crisis. SCD leads to higher morbidity and mortality, especially during pregnancy, with increased risk of preeclampsia (PE). To compare clinical findings, placental morphology, and gene expression in villous placental tissue using next generation sequencing. We included five cases. Two placentas from the same woman with homozygous SCD that had been pregnant twice and had different maternal and fetal outcomes (one early onset PE/eclampsia and a mostly non-complicated pregnancy); an early onset PE, a fetal growth restriction and a term, non-complicated pregnancy. Sixty-four differentially expressed genes were observed in the SCD+PE case, in comparison with the placenta from the SCD without PE, based on fold change. Among these genes, 59 were upregulated and 5 were downregulated. Enrichment analysis indicated two significant biological processes: response to copper ion (CYP1A1, AOC1, AQP1, and ATP5D) and triglyceride-rich lipoprotein particle clearance (GPIHBP1, APOC1, and APOE). The rare opportunity to evaluate the same patient in two different pregnancies, of opposing outcomes, and compare to other conditions of known placental and vascular/inflammatory involvement, may further the understanding of the pathophysiology of PE in SCD. Our results suggest that the clinical association between SCD and PE may be supported by common pathophysiological mechanisms, but that pathways involving response to copper and triglyceride metabolism could be important drivers of PE pathophysiology. Impact statement Environmentally induced changes in placental morphological and molecular phenotypes may provide relevant insight towards pathophysiology of diseases. The rare opportunity to evaluate the same patient, with sickle cell anemia (SCA), in two different pregnancies, of opposite outcomes (one early onset severe preeclampsia (PE) and the other mostly non-complicated) can prove such concept. In addition, the comparison to other conditions of known placental and vascular/inflammatory involvement strengthens such findings. Our results suggest that the clinical association between SCA and PE can be supported by common pathophysiological mechanisms, but that pathways involving response to copper and triglyceride metabolism may be important drivers of the pathophysiology of PE. Future studies using in a larger number of samples should confirm these findings and explore pathways involved in the pathophysiology of PE and its relationship with SCA.
Analysis of mRNA Expression Patterns in Peripheral Blood Cells of 3 Patients With Cancer After the First Fraction of 2 Gy Irradiation: An Integrated Case Report and Systematic Review
Authors: Nie Yue-Hua , Liu Xiao-Dan , Huang Ruixue , Xie Da-Fei , Yin Wen-Jun , Guan Hua , Yu Zi-Jian , Zhou Ping-Kun 
Published: February 2019

Background: Radiation therapy induces acute and chronic radiological toxicity, in particular hematological toxicity (HT). This study aimed to explore the mechanistic clue and potential predictors at the messenger RNA (mRNA) level. Materials and Methods: Peripheral blood was collected from 3 patients with cervical cancer (CC), nasopharynx cancer (NC), and tongue cancer (TC) after the first 2 Gy fraction of radiotherapy (RT). High-throughput sequencing was used to assess mRNA profiles. Results: Eleven genes, such as ALAS2(5-aminolevulinate synthase), SLC4A1(solute carrier family 4 member 1), HBG2(hemoglobin subunit gamma 2), TNFAIP3 (TNF α-induced protein 3), PER1 (period circadian clock 1), CCDC136 (coiled-coil domain containing 136), C9orf84 (chromosome 9 open reading frame 84), IL1B (interleukin 1β), FOSB (FosB protooncogene), NR4A2 (nuclear receptor subfamily 4), PARP15 (polymerase family member 15), had overlapping expression changes in all 3 cancers of which 3 ( ALAS2, FOSB, and HBG2) are suggested as potential predictors for the early diagnosis of HT after RT. Conclusions: ALAS2, FOSB, and HBG2 may be useful predictors of HT in patients after RT. Eleven overlapping expression mRNAs among 3 cancers might be potential predictors for early diagnosis of radiation toxicity in patients.
Comprehension and recall from the informed consent process by phase I healthy volunteers before dose administration
Authors: Tadros Rami , Caughey Gillian E , Johns Sally , Shakib Sepehr 
Published: March 2019

Aims/Background A fundamental part of all clinical trials is informed consent, reflecting the respect for the volunteer’s autonomy. Research participation is voluntary; therefore, certain aspects of the proposed study must be disclosed so that volunteers can make an informed decision. In this study, we aimed to examine the level of comprehension and recall of healthy volunteers from the informed consent process. Methods The study was carried out at a single phase I clinical trials unit. A questionnaire was administered to each volunteer to assess recall of important aspects of the study at the day-1 visit following the informed consent process. The questionnaire contained seven questions regarding study objectives, route, frequency and type of drug administration, adverse effects, number of subjects previously exposed and remuneration. One point was awarded for each correct answer. Results A total of 266 volunteers were administered the questionnaire. The mean total score (±standard deviation) for all volunteers was 4.5 ± 1.1 points out of 7, with a range of 0.8–6.7. For all 10 studies, 91% of volunteers responded correctly when answering about the route of administration, and 90% were able to accurately state the correct payment amount. Only 7% were able to repeat the aims of the study correctly. Conclusion The poor performance of our study volunteers raises concerns about recall of information prior to study drug administration. This has implications for the volunteer’s safety and ability to provide true informed consent. Interventions to improve recall prior to dosing should be undertaken.