bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the use of responsive art therapy in an inpatient child and adolescent mental health services unit
Authors: Nielsen Fran , Isobel Sophie , Starling Jean 
Published: January 2019

Objectives: We describe the use of responsive art therapy in an inpatient child and adolescent mental health services unit, including its acceptability rated through a satisfaction questionnaire. Methods: A patient satisfaction questionnaire was developed to collect feedback from 46 adolescents. Images from therapy were photographed and collated looking for patterns across diagnoses and stages of treatment. Results: Adolescents reported that art therapy helped them learn how to express themselves safely (80%) and understand how their thoughts related to their feelings (78%). Conclusions: Responsive art therapy was a useful strategy to support the safe expression of distress and was seen as a positive experience by adolescents in inpatient mental health care.
IL-17F, rather than IL-17A, underlies airway inflammation in a steroid-insensitive toluene diisocyanate-induced asthma model
Authors: Chen Rongchang , Zhang Qingling , Chen Shuyu , Tang Haixiong , Huang Peikai , Wei Shushan , Liang Zhenyu , Chen Xin , Tao Ailin , Yao Lihong 
Published: January 2019

Steroid insensitivity constitutes a major problem for asthma management. Toluene diisocyanate (TDI) is one of the leading allergens of asthma that induces both T-helper Th2 and Th17 responses, and is often associated with poor responsiveness to steroid treatment in the clinic.We sought to evaluate the effects of inhaled and systemic steroids on a TDI-induced asthma model and to find how interleukin (IL)-17A and IL-17F function in this model. BALB/c mice were exposed to TDI for generating an asthma model and were treated with inhaled fluticasone propionate, systemic prednisone, anti-IL-17A, anti-IL-17F, recombinant IL-17A or IL-17F.Both fluticasone propionate and prednisone showed no effects on TDI-induced airway hyperresponsiveness (AHR), bronchial neutrophilia and eosinophilia, and epithelial goblet cell metaplasia. TDI-induced Th2 and Th17 signatures were not suppressed by fluticasone propionate or prednisone. Treatment with anti-IL-17A after TDI exposure led to increased AHR, aggravated mucus production and airway eosinophil recruitment, accompanied by amplified Th2 responses, whereas anti-IL-17F ameliorated TDI-induced AHR and airway neutrophilia, with decreased Th17 responses. Recombinant IL-17A and IL-17F showed opposite effects to the monoclonal antibodies.IL-17A and IL-17F exert distinct biological effects during airway inflammation of a TDI-induced asthma model, which is unresponsive to both inhaled and systemic steroids.
Dual bronchodilation with tiotropium/olodaterol further reduces activity-related breathlessnessversustiotropium alone in COPD
Authors: Maltais François , Aumann Joseph-Leon , Kirsten Anne-Marie , Nadreau Éric , Macesic Hemani , Jin Xidong , Hamilton Alan , O'Donnell Denis E. 
Published: January 2019

The 3-min constant speed shuttle test (CSST) was used to examine the effect of tiotropium/olodaterol compared with tiotropium at reducing activity-related breathlessness in patients with chronic obstructive pulmonary disease (COPD).This was a randomised, double-blind, two-period crossover study including COPD patients with moderate to severe pulmonary impairment, lung hyperinflation at rest and a Mahler Baseline Dyspnoea Index <8. Patients received 6 weeks of tiotropium/olodaterol 5/5 µg and tiotropium 5 µg in a randomised order with a 3-week washout period. The speed for the 3-min CSST was determined for each patient such that an intensity of breathing discomfort ≥4 (“somewhat severe”) on the modified Borg scale was reached at the end of a completed 3-min CSST.After 6 weeks, there was a decrease in the intensity of breathlessness (Borg dyspnoea score) at the end of the 3-min CSST from baseline with both tiotropium (mean –0.968, 95% CI −1.238– −0.698; n=100) and tiotropium/olodaterol (mean −1.325, 95% CI −1.594– −1.056; n=101). The decrease in breathlessness was statistically significantly greater with tiotropium/olodaterolversustiotropium (treatment difference −0.357, 95% CI −0.661– −0.053; p=0.0217).Tiotropium/olodaterol reduced activity-related breathlessness more than tiotropium in dyspnoeic patients with moderate to severe COPD exhibiting lung hyperinflation.
Perioperative Teaching and Feedback: How are we doing in Canadian OTL-HNS programs?
Authors: Chaudhry Z. , Campagna-Vaillancourt M. , Husein M. , Varshney R. , Roth K. , Gooi A. , Nguyen Lhp 
Published: January 2019

Background Discrepancies between resident and faculty perceptions regarding optimal teaching and feedback during surgery are well known but these differences have not yet been described in Otolaryngology - Head and Neck Surgery (OTL-HNS). The objectives were thus to compare faculty and resident perceptions of perioperative teaching and feedback in OTL-HNS residency programs across Canada with the aim of highlighting potential areas for improvement. Methods An anonymous electronic questionnaire was distributed to residents and teaching faculty in OTL-HNS across Canada with additional paper copies distributed at four institutions. Surveys consisted of ratings on a 5-point Likert scale and open-ended questions. Responses among groups were analysed with the Wilcoxon-Mann Whitney test, while thematic analysis was used for the open-ended questions. Results A total of 143 teaching faculty and residents responded with statistically significant differences on 11 out of 25 variables. Namely, faculty reported higher rates of pre and intra-operative teaching compared to resident reports. Faculty also felt they gave adequate feedback on residents’ strengths and technical skills contrary to what the residents thought. Both groups did agree however that pre-operative discussion is not consistently done, nor is feedback consistently given or sought. Conclusion Faculty and residents in OTL-HNS residency programs disagree on the frequency and optimal timing of peri-operative teaching and feedback. This difference in perception emphasizes the need for a more structured approach to feedback delivery including explicitly stating when feedback is being given, and the overall need for better communication between residents and staff.
Autologous Transplantation, Consolidation, and Maintenance Therapy in Multiple Myeloma: Results of the BMT CTN 0702 Trial
Authors: Stadtmauer Edward A. , Pasquini Marcelo C. , Blackwell Beth , Hari Parameswaran , Bashey Asad , Devine Steven , Efebera Yvonne , Ganguly Siddharta , Gasparetto Cristina , Geller Nancy , Horowitz Mary M. , Koreth John , Knust Kristin , Landau Heather , Brunstein Claudio , McCarthy Philip , Nelson Courtney , Qazilbash Muzaffar H. , Shah Nina , Vesole David H. , Vij Ravi , Vogl Dan T. , Giralt Sergio , Somlo George , Krishnan Amrita 
Published: January 2019

PURPOSESingle-cycle melphalan 200 mg/m2and autologous hematopoietic cell transplantation (AHCT) followed by lenalidomide (len) maintenance have improved progression-free survival (PFS) and overall survival (OS) for transplantation-eligible patients with multiple myeloma (MM). We designed a prospective, randomized, phase III study to test additional interventions to improve PFS by comparing AHCT, tandem AHCT (AHCT/AHCT), and AHCT and four subsequent cycles of len, bortezomib, and dexamethasone (RVD; AHCT + RVD), all followed by len until disease progression.PATIENTS AND METHODSPatients with symptomatic MM within 12 months from starting therapy and without progression who were age 70 years or younger were randomly assigned to AHCT/AHCT + len (n = 247), AHCT + RVD + len (n = 254), or AHCT + len (n = 257). The primary end point was 38-month PFS.RESULTSThe study population had a median age of 56 years (range, 20 to 70 years); 24% of patients had high-risk MM, 73% had a triple-drug regimen as initial therapy, and 18% were in complete response at enrollment. The 38-month PFS rate was 58.5% (95% CI, 51.7% to 64.6%) for AHCT/AHCT + len, 57.8% (95% CI, 51.4% to 63.7%) for AHCT + RVD + len, and 53.9% (95% CI, 47.4% to 60%) for AHCT + len. For AHCT/AHCT + len, AHCT + RVD + len, and AHCT + len, the OS rates were 81.8% (95% CI, 76.2% to 86.2%), 85.4% (95% CI, 80.4% to 89.3%), and 83.7% (95% CI, 78.4% to 87.8%), respectively, and the complete response rates at 1 year were 50.5% (n = 192), 58.4% (n = 209), and 47.1% (n = 208), respectively. Toxicity profiles and development of second primary malignancies were similar across treatment arms.CONCLUSIONSecond AHCT or RVD consolidation as post-AHCT interventions for the up-front treatment of transplantation-eligible patients with MM did not improve PFS or OS. Single AHCT and len should remain as the standard approach for this population.
Randomized Phase II Trial Comparing Site-Specific Treatment Based on Gene Expression Profiling With Carboplatin and Paclitaxel for Patients With Cancer of Unknown Primary Site
Authors: Hayashi Hidetoshi , Kurata Takayasu , Takiguchi Yuichi , Arai Makoto , Takeda Koji , Akiyoshi Kohei , Matsumoto Koji , Onoe Takuma , Mukai Hirofumi , Matsubara Nobuaki , Minami Hironobu , Toyoda Masanori , Onozawa Yusuke , Ono Akira , Fujita Yoshihiko , Sakai Kazuko , Koh Yasuhiro , Takeuchi Ayano , Ohashi Yasuo , Nishio Kazuto , Nakagawa Kazuhiko 
Published: January 2019

PURPOSE Although gene expression profiling is a promising diagnostic technique to determine the tissue of origin for patients with cancer of unknown primary site (CUP), no clinical trial has evaluated yet site-specific therapy directed by this approach compared with empirical chemotherapy. We therefore performed a randomized study to assess whether such site-specific therapy improves outcome compared with empirical chemotherapy in previously untreated patients with CUP. PATIENTS AND METHODS Comprehensive gene expression profiling was performed by microarray analysis, and an established algorithm was applied to predict tumor origin. Patients with CUP were randomly assigned (1:1) to receive standard site-specific therapy or empirical paclitaxel and carboplatin (PC). The primary end point was 1-year survival rate. RESULTS One hundred thirty patients were randomly assigned and had sufficient biopsy tissue for molecular analysis. Efficacy analysis was performed for 50 and 51 patients in the site-specific therapy and empirical PC arms, respectively. Cancer types most commonly predicted were pancreatic (21%), gastric (21%), and lymphoma (20%). The 1-year survival rate was 44.0% and 54.9% for site-specific treatment and empirical PC ( P = .264), respectively. Median overall and progression-free survival were 9.8 and 5.1 months, respectively, for site-specific treatment versus 12.5 and 4.8 months for empirical PC ( P = .896 and .550, respectively). Median overall survival (16.7 v 10.6 months; P = .116) and progression-free survival (5.5 v 3.9 months; P = .018) were better for predicted more-responsive than less-responsive tumor types. CONCLUSION Site-specific treatment that was based on microarray profiling did not result in a significant improvement in 1-year survival compared with empirical PC, although prediction of the original site seemed to be of prognostic value.
Intracranial aneurysms at higher clinical risk for rupture demonstrate increased wall enhancement and thinning on multicontrast 3D vessel wall MRI
Authors: Hartman Jason Brett , Watase Hiroko , Sun Jie , Hippe Daniel S , Kim Louis , Levitt Michael , Sekhar Laligam , Balu Niranjan , Hatsukami Thomas , Yuan Chun , Mossa-Basha Mahmud 
Published: January 2019

Objective:
Identification of aneurysms at risk for rupture is important and challenging. We sought to evaluate if intracranial vessel wall (IVW) imaging characteristics of unruptured aneurysms correlate with clinical risk factors for rupture.

Methods:
Patients with unruptured intracranial aneurysms were prospectively recruited and underwent a multi contrast 3D IVW protocol between April 6, 2016 and August 29, 2017. Two independent raters, blinded to aneurysm vulnerability, evaluated each aneurysm for wall enhancement, extent of enhancement in terms of the numbers of quadrants enhancing circumferentially, intensity of enhancement, and qualitative wall thinning. PHASES score was calculated for each aneurysm. Univariate logistic regression analysis was used to compare IVW characteristics between aneurysms at higher clinical risk for rupture (PHASES score &gt; 3) and lower clinical risk for rupture (PHASES score ≤ 3).

Results:
45 patients with 65 unruptured aneurysms were analyzed; 38 aneurysms with PHASES score &gt; 3 (58%) and 27 aneurysms with PHASES score ≤ 3 (42%). Aneurysms with PHASES score &gt; 3 were more likely to demonstrate enhancement (42.1% vs 14.8%, p = 0.022), greater extent of enhancement (mean: 2.9 vs 2.2 quadrants, p = 0.063), and wall thinning (9.2% vs 0%, p = 0.044). Inter-reader agreement was moderate-to-good for the presence (κ = 0.64), extent (κ = 0.64), and intensity of enhancement (κ = 0.60) but relatively low for wall thinning (κ = 0.25).

Conclusion:
Aneurysms at higher risk of rupture by PHASES score are more likely to demonstrate wall enhancement, more diffuse enhancement, and wall thinning on IVW.

Advances in knowledge:
This study prospectively compares IVW-detected wall enhancement and thinning between unruptured aneurysms stratified into high and low risk groups by clinical scores (PHASES) of vulnerability.
Disease staging according to international scoring system in newly diagnosed patients with multiple myeloma
Authors: Sheikh Saira Parveen , Irfan Syed Muhammad , Sheikh Sadia Sultan 
Published: January 2019

Objective: To determine the frequency of disease staging according to international scoring system in patients who are newly diagnosed with Multiple Myeloma (MM) at a tertiary care hospital at Karachi.
Methods: This single center, non probability consecutive, cross sectional study was conducted from Nov 11, 2015 to May 11, 2016. After taking informed written consent, detailed history was taken and serum β2 microglobulin and albumin levels were checked to assess the study outcome variable i.e. stage of MM. All the collected information was entered in the prescribed performa.
Results: Eighty newly diagnosed patients with multiple myeloma as per inclusion criteria were included. Sixty seven (83.75%) were male and 13(16.25) were females, with mean age of 58.35+10.077 years. Twenty seven patients (33.75%) were found to have stage-I disease, in 23 (28.75%) stage-II and stage-III in 30 (37.5%).
Conclusion: Multiple myeloma is relatively common in 5th decade, with male predominance. International Staging System have great potential for characterizing and stratifying multiple myeloma and revealed a predominance of advanced stage III disease in our setting.
How to cite this:Shaikh SP, Irfan SM, Sheikh SS. Disease staging according to international scoring system in newly diagnosed patients with multiple myeloma. Pak J Med Sci. 2019;35(1):90-94. doi: https://doi.org/10.12669/pjms.35.1.173
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The effects of participating in nursing student congress and other motivation sources on occupational motivation states of Nursing students: Toros University example
Authors: Sancar Behire , Akan Nazife 
Published: January 2019

Objective: To investigate the effects of participation in nursing student congresses and other motivation sources on students’ occupational motivation states.
Methods: This descriptive pilot study covers 29 students who are studying in nursing department. The answers given to the “Motivation’s Resources and Problems Scale” (MRPS) were evaluated with Mann-Whitney U (MWU) test which is one of the non-parametric tests.
Results: The mean age of participants was 19.2±0.9 years. There was no significant difference between the students who participated and those who did not participate in MRPS total scores. However, even though the difference was not significant, medical vocational high school students’ internal motivation levels were found to be higher than the other school graduates.
Conclusions: There was no significant difference between the ranking of the scores that are acquired from motivation scale and participation status of nursing student in the congress. On the other hand, there are other factors that motivate occupational learning of students. Planning studies about increasing nursing students’ positive motivation sources is suggested.
How to cite this:Sancar B, Akan N. The effects of participating in nursing student congress and other motivation sources on occupational motivation states of Nursing students: Toros University example. Pak J Med Sci. 2019;35(1):271-276. doi: https://doi.org/10.12669/pjms.35.1.403
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
A physiological examination of perceived incorporation during trance
Authors: Wahbeh Helané , Cannard Cedric , Okonsky Jennifer , Delorme Arnaud 
Published: January 2019

Background:Numerous world cultures believe channeling provides genuine information, and channeling rituals in various forms are regularly conducted in both religious and non-religious contexts. Little is known about the physiological correlates of the subjective experience of channeling.Methods:We conducted a prospective within-subject design study with 13 healthy adult trance channels. Participants alternated between 5-minute blocks of channeling and no-channeling three times while electroencephalography (EEG), electrocardiography (ECG), galvanic skin response (GSR), and respiration were collected on two separate days. Voice recordings of the same story read in channeling and no-channeling states were also analyzed. Results:The pre-laboratory survey data about demographics, perception of the source, purpose and utility of channeled information reflected previous reports. Most participants were aware of their experience (rather than in a full trance) and had varying levels of perceived incorporation (i.e. control of their body). Voice analysis showed an increase in voice arousal and power (dB/Hz) differences in the 125 Hz bins between 0 and 625 Hz, and 3625 and 3875 Hz when reading during the channeling state versus control. Despite subjective perceptions of distinctly different states, no substantive differences were seen in EEG frequency power, ECG measures, GSR and respiration.Conclusions:Voice parameters were different between channeling and no-channeling states using rigorous controlled methods, but other physiology measure collected were not. Considering the subjective and phenomenological differences observed, future studies should include other measures such as EEG connectivity analyses, fMRI and biomarkers.
Orthotropic mechano-sorptive creep behavior of Chinese fir during the moisture adsorption process determined in tensile mode via dynamic mechanical analysis (DMA)
Authors: Peng Hui , Jiang Jiali , Lu Jianxiong , Cao Jinzhen 
Published: January 2019

Abstract
The orthotropic viscoelastic creep (VEC) at a constant moisture content (MC) and mechano-sorptive creep (MSC) during the adsorption process were examined for Chinese fir (Cunninghamia lanceolata) under tension at 20, 40, 60 and 80% relative humidity (RH) (30°C). Free swelling was performed on matched specimens based on the strain partition assumption to better understand the characteristics of the mechano-sorptive (MS) phenomenon. Expansion, elastic and time-dependent creep behaviors of radial (R) and tangential (T) specimens were affected by the MC to a higher degree than those of the longitudinal (L) specimen. A higher proportion of elastic strain in total strain was found in the L specimen as compared with transverse specimens, regardless of VEC and MSC. The RH level had a greater effect on relaxation behavior in the L specimen for MSC. According to the three tests, expansion mainly dominated the creep strain during adsorption, especially for the L specimen. The MS strain exerted more influence on transverse specimens and had less contribution to the L specimen. Moreover, under all RH isohume (RHI) conditions, the unstable state contributed to MS strain diminishing as MC approached equilibrium moisture content (EMC). A shorter adsorption time to a new equilibrium state was achieved at the expense of intensifying the unstable state of the wood cell wall.
A “miracle” pregnancy outcome of severe placental abruption
Authors: Ting Joyce Chin Sing , Wong Xiu Sing , Yong Soon Leong , Kang Marcus 
Published: January 2019

Abstract
Severe placental abruption is associated with high maternal and perinatal morbidity and mortality. Prompt delivery is usually mandatory in this situation. We report a case of a 33-year-old woman, gravida 5, para 3 + 1, at 26 weeks + 3 days’ gestation who had severe placental abruption involving 40% of the placental surface complicated with maternal moderate anaemia and thrombocytopenia. In view of the extreme foetal prematurity and stable condition of both mother and foetus, expectant management was undertaken. The pregnancy was further complicated by foetal growth restriction detected 2 weeks later. At 30 weeks of gestation, an emergency caesarean section was performed for foetal distress. The surgery was uneventful and she delivered a live baby with good Apgar scores. This case report illustrates an atypically satisfactory pregnancy outcome of severe placental abruption. Conservative management of severe placental abruption is possible in rare cases, taking into consideration the gestational week as well as the maternal haemodynamic condition and foetal well-being. When severe placental abruption is confounded by severe prematurity, a decision on whether to prolong the pregnancy to improve the perinatal outcome and neonatal survival needs to be carefully weighed against the usual management option of immediate delivery.
Comparison of Al-Zn-Mg Alloy P-MIG Welded Joints Filled with Different Wires
Authors: Dianlong Wang , Guangyun Diao , Zhimin Liang 
Published: January 2019

Abstract
Three kinds of welding filler wires, named ER5356, ER5087 and ER4043, were used to joint 12 mm thick Al-Zn-Mg alloy plate by the pulsed MIG(P-MIG) welding. The microstructure and mechanical properties of the joints were analyzed and compared. The results showed that the average tensile strengths of the joints filled with ER5356, ER5087 and ER4043 were 294 MPa, 313 MPa and 237 MPa, respectively, and the average elongations were 7.9%, 7.6% and 1.6%, respectively. All the joints’s fracture locations were near the fusion boundary. The microhardness test showed that the locations of the lowest hardness were all in the center of cross section. The results revealed that the weld filler by ER5087 was consist of more columnar crystals of larger grain size, while the weld filled by ER5356 was consist of more equiaxed grains of smaller grain size. The microstructure of the weld by ER4043 was typical eutectic dendrites structure.