bluuebunny/crossref_metadata_2025_split huggingface dataset:
An investigation into the effects of a virtual reality system on phantom limb pain: a pilot study
Authors: Kulkarni Jai , Pettifer Steve , Turner Sue , Richardson Cliff 
Published: July 2019

Background: There is no first-line treatment available for phantom limb pain (PLP). For some years, there has been interest in the use of mirrors and other techniques based on visual feedback. Unfortunately, up until now, all published studies have had methodological weaknesses with two recent systematic reviews concluding that therapies of this kind need more evidence to support their use. Aim: To evaluate the effects of a virtual reality (VR) activity on PLP. Methods: This was a prospective pilot study of upper limb amputees using questionnaires to evaluate a VR system. Eleven participants were recruited, with nine completing all three sessions of VR. Participants undertook three sessions of VR, one a month for 3 months. Outcome measures were PLP pain intensity using an 11-point numerical rating scale (NRS), number of PLP episodes and duration of the PLP episodes. All participants were also asked for their judgement of change. Open-ended questions captured the qualitative experience of all aspects of the VR experience. Results: The mean PLP pain score following three VR sessions reduced (6.11 v 3.56) but this was not a statistical difference (t = 2.1, df = 8, p = 0.07). No statistical difference was found for the number of PLP episodes (Pearson chi-square = 3.43, df = 2, p = 0.18) or the duration of each PLP episode (Pearson chi-square = 22.50, df = 16, p = 0.13). Three groups emerged: those whose pain reduced (the majority), those whose pain remained the same (small number) and one those whose pain increased slightly. Discussion: There is insufficient evidence from these results to identify an effect of VR on PLP; however, this is a small group and qualitatively most were content with the treatment and wanted a longer trial.
Ambulatory Training Program to Expand Procedural Skills in Primary Care
Authors: Fortuna Robert J. , Marston Bethany , Messing Susan , Wagoner Gunnar , Pulcino Tiffany L. , Bingemann Todd , Caiola Enrico , Scofield Steven , Nead Karen , Robbins Brett W 
Published: July 2019

Introduction: Outpatient procedures are an important component of primary care, yet few programs incorporate procedural training into their curriculum. We examined a 4-year procedural curriculum to improve understanding of ambulatory procedures and increase the number of procedures performed. Methods: A total of 56 resident and 8 faculty physicians participated in a procedural curriculum directed at joint injections (knee, shoulder, elbow, trochanteric bursa, carpal tunnel, wrist, and ankle), subdermal contraceptive insertion/removal, skin biopsies, and ultrasound use in primary care. We administered annual surveys and used generalized estimating equations to model changes. Results: Across the 4 years, there was an average 96% response rate. Mean comfort level with the indications for procedures increased for both resident (62.5 to 78.8; P < .0001) and faculty physicians (61.5 to 94.8; P < .0001). Similarly, mean comfort with performing procedures increased for both resident (32.1 to 62.3; P < .0001) and faculty physicians (42.2 to 85.4; P < .0001). Residents’ comfort level performing procedures increased for all individual procedures measured. The mean number of procedures performed per year increased for resident (1.9 to 8.2; P < .0001) and faculty physicians (14.7 to 25.2; P = .087). Conclusions: A longitudinal ambulatory-based procedural curriculum can increase resident and faculty physician understanding and comfort performing primary-care-based procedures. This, in turn, increased the total number of procedures performed.
Evaluating the Impact of Secure Mobile Messaging on Communication and Cancer Care Team Satisfaction in a Large Radiation Oncology Clinic
Authors: Arscott W. Tristram , Gray Kathleen , Kuska Dennis , Nagda Suneel , Lustig Robert , Alonso-Basanta Michelle , Metz James M. , Jones Joshua 
Published: July 2019

PURPOSE: Communication is crucial in any clinical environment for efficient delivery of care and ensuring patient safety. A 2016 National Database of Nursing Quality Indicators questionnaire indicated poor physician-nurse satisfaction with communication in our department. We addressed gaps in our communication procedures by implementing a communication policy with a secure mobile messaging platform, and we surveyed care team members to evaluate the effectiveness of the implementation. METHODS: We designed a policy around best communication practices and implemented a secure mobile messaging platform, Cureatr, which enables closed-loop, two-way communication that is compliant with the Health Insurance Portability and Accountability Act. Pre- and postimplementation surveys evaluated self-reported impression of efficiency, timeliness, effectiveness, and overall quality of communication, which were scored on a 5-point Likert scale. The number of messages sent was evaluated as a measure of uptake in use, and patient navigation data were queried to measure changes in clinic workflow. RESULTS: After implementation of Cureatr and a communication policy, survey responses demonstrated a clear improvement in staff satisfaction with the efficiency, timeliness, effectiveness, and overall quality of communication. The number of messages sent reflected a progressive increase in use of Cureatr; however, a consistent improvement in clinical workflow as measured by a decrease in patient in-room time was not appreciated. CONCLUSION: Implementing a secure messaging application with a communication policy improved cancer care team satisfaction with communication on all levels. Additional work is needed to evaluate the impact of secure messaging on clinical workflows, patient satisfaction, and staff well-being.
Sex Difference in Corticosterone-Induced Insulin Resistance in Mice
Authors: Kaikaew Kasiphak , Steenbergen Jacobie , van Dijk Theo H , Grefhorst Aldo , Visser Jenny A 
Published: July 2019

AbstractProlonged exposure to glucocorticoids (GCs) causes various metabolic derangements. These include obesity and insulin resistance, as inhibiting glucose utilization in adipose tissues is a major function of GCs. Although adipose tissue distribution and glucose homeostasis are sex-dependently regulated, it has not been evaluated whether GCs affect glucose metabolism and adipose tissue functions in a sex-dependent manner. In this study, high-dose corticosterone (rodent GC) treatment in C57BL/6J mice resulted in nonfasting hyperglycemia in male mice only, whereas both sexes displayed hyperinsulinemia with normal fasting glucose levels, indicative of insulin resistance. Metabolic testing using stable isotope-labeled glucose techniques revealed a sex-specific corticosterone-driven glucose intolerance. Corticosterone treatment increased adipose tissue mass in both sexes, which was reflected by elevated serum leptin levels. However, female mice showed more metabolically protective adaptations of adipose tissues than did male mice, demonstrated by higher serum total and high-molecular-weight adiponectin levels, more hyperplastic morphological changes, and a stronger increase in mRNA expression of adipogenic differentiation markers. Subsequently, in vitro studies in 3T3-L1 (white) and T37i (brown) adipocytes suggest that the increased leptin and adiponectin levels were mainly driven by the elevated insulin levels. In summary, this study demonstrates that GC-induced insulin resistance is more severe in male mice than in female mice, which can be partially explained by a sex-dependent adaptation of adipose tissues.
Getting health information to internally displaced youth in Afghanistan: can mobile phone technology bridge the gap?
Authors: Alami Sayed Omar , Dulli Lisa , Dal Santo Leila , Rastagar Sayed Haroon , Seddiqi Sediq , Hemat Shafiqullah , Machlin Burke Jane , Todd Catherine S. 
Published: July 2019

Background: Afghanistan ranks among the most disadvantaged globally for many key reproductive, maternal, newborn and child health (RMNCH) indicators, despite important gains in the past decade. Youth (15 to 24 years) are a key audience for RMNCH information as they enter adulthood, marry and begin families; however, reaching Afghan youth with health information is challenging. Internally displaced persons (IDPs), including youth, experience additional challenges to obtaining health-related information and services. This study measured current and preferred RMNCH information channels to explore the feasibility of using mobile phone technology to provide RMNCH information to IDP youth in Afghanistan. Methods: We conducted a sub-group analysis of survey data from a mixed-methods, cross-sectional, formative assessment to understand current access to RMNCH information. The target population for this analysis includes 15-25-year-old male and female IDP youth from three Afghan Provinces. Survey data were collected using a structured questionnaire administered through face-to-face interviews. Data were analyzed descriptively. Results: A total of 450 IDP youth were surveyed in the three provinces (225 male and 225 female). Access to RMNCH information outside of health facilities was limited. Mobile phone ownership was nearly universal among male participants, yet considerably lower among females; nearly all participants without personal phones reported access to phones when needed. Although few participants spontaneously mentioned mobile phones as a preferred source of RMNCH information, most male and female respondents reported they would be very or somewhat likely to use a free, mobile-phone-based system to access such information if offered. Conclusions: Given widespread access and considerable interest voiced by participants, mobile phones may be a viable way to reach IDP youth with important RMNCH health information in this fragile setting. Interventions should be designed and pilot-tested to identify the most appropriate platforms and information content and to further document feasibility and acceptability.
Advances in tumour endoprostheses: a systematic review
Authors: Smolle Maria A. , Andreou Dimosthenis , Tunn Per-Ulf , Leithner Andreas 
Published: July 2019

Tumour endoprostheses have facilitated limb-salvage procedures in primary bone and soft tissue sarcomas, and are increasingly being used in symptomatic metastases of the long bones. The objective of the present review was to analyse articles published over the last three years on tumour endoprostheses and to summarize current knowledge on this topic. The NCBI PubMed webpage was used to identify original articles published between January 2015 and April 2018 in journals with an impact factor in the top 25.9% of the respective category (orthopaedics, multidisciplinary sciences). The following search-terms were used: tumour endoprosthesis, advances tumour endoprosthesis, tumour megaprosthesis, prosthetic reconstruction AND tumour. We identified 347 original articles, of which 53 complied with the abovementioned criteria. Articles were categorized into (1) tumour endoprostheses in the shoulder girdle, (2) tumour endoprostheses in the proximal femur, (3) tumour endoprostheses of the knee region, (4) tumour endoprostheses in the pelvis, (5) (expandable) prostheses in children and (6) long-term results of tumour endoprostheses. The topics of interest covered by the selected studies largely matched with the main research questions stated at a consensus meeting, with survival outcome of orthopaedic implants being the most commonly raised research question. As many studies reported on the risk of deep infections, research in the future should also focus on potential preventive methods in endoprosthetic tumour reconstruction. Cite this article: EFORT Open Rev 2019;4:445-459. DOI: 10.1302/2058-5241.4.180081
Quando o futebol é de mulheres: suspeitas, regulações e transgressões no campo dos gêneros e sexualidades
Authors: Moreira Maria de Fátima Salum , Prado Vagner Matias do , Cavaleiro Maria Cristina 
Published: July 2019

O estudo discute a percepção que jovens jogadoras de futebol possuem de si mesmas, frente às relações de gênero e sexualidade a partir de pesquisa que envolveu observações de treinos e seis entrevistas semiestruturadas com uma equipe feminina de município do interior paulista. Ao compreender as sexualidades e o gênero como construções sócio-históricas, problematiza-se a prática do futebol e os dispositivos que produzem “modos de ser mulher” a partir de políticas normalizadoras. Conclui-se que regimes normativos de gênero regulam os corpos das jovens atletas frente a um esporte considerado como masculino; gerenciam modos possíveis de estilização corporal das jogadoras; e instituem regras que visam afastá-las de uma possível aproximação com o desejo lesbiano. Tais achados desvelam o futebol como prática social generificada e generificante, produtora de corpos/subjetividades que são gerenciados pelos dispositivos de gênero e sexualidade. Também permitem (re)pensar as relações estabelecidas entre gênero, sexualidade e práticas corporais.
PALAVRAS-CHAVE: Futebol Feminino. Relações de Gênero. Lesbofobia.
Fatores favorecedores e comprometedores na qualidade acadêmica do ensino de Odontologia
Authors: Medina Patrícia Figueiredo , Bezerra Teresa Olinda Caminha , Gouvêa Cresus Vinicius Depes de 
Published: July 2019

O estudo objetivou identificar os fatores favorecedores e os comprometedores da qualidade do ensino do curso de graduação em Odontologia da Universidade Federal Fluminense. Trata-se de uma pesquisa exploratória realizada em duas etapas distintas, porém com enfoque integrado. As percepções dos professores e dos alunos foram coletadas por meio de questionários. Para a análise dos dados utilizou-se a Análise de Conteúdo, a estatística descritiva e inferencial. Verificou-se que, na visão acadêmica dos segmentos estudados, o principal fator favorecedor foi qualidade do corpo docente e comprometimento. Já em relação aos comprometedores foram apontados como principais: falta de componentes tais como: competência, motivação, assiduidade, comprometimento e comportamento democrático, por parte de alguns professores; falta de integração e interdisciplinaridade entre as disciplinas; programas curriculares tradicionais, antigos e deficientes.
PALAVRAS-CHAVE: Ensino de Odontologia. Qualidade do ensino. Diretrizes Curriculares. Fatores favorecedores e comprometedores.
Imagens dos cientistas Jean-Baptiste de Lamarck e Charles Darwin: o que alunos concluintes do ensino médio sabem sobre eles?
Authors: Breunig Eduarda Tais , Amaral Aléxia Santos , Goldschmidt Andréa Inês 
Published: July 2019

A pesquisa buscou investigar as concepções de setenta e oito alunos de terceiro ano do ensino médio de escolas públicas, a respeito da imagem e do nome de dois cientistas importantes para a Biologia e as implicações destas relacionadas à Ciência, através de dois questionários, compostos por duas partes. Inicialmente foi aplicado o primeiro, que investigou o reconhecimento de cientistas através de imagens sem nomeação e uma segunda parte, contendo outras imagens dos cientistas; porém, nominadas. Os resultados mostraram que o uso de imagens ainda é restrito em sala de aula; não tendo sido reconhecidos de forma significativa nenhum dos cientistas, principalmente, quando não foi mencionado os nomes. Além disso, muitas concepções reducionistas sobre cientistas e sobre a ciência foram identificadas.
PALAVRAS-CHAVE: Cientistas. Educação em Ciências. Ensino de Ciências.
Análise das concepções de formadores de professores de Química acerca da inclusão de alunos com deficiência no ensino superior
Authors: Teixeira Júnior José Gonçalves , Souza Nayara Costa 
Published: July 2019

Este trabalho tem como objetivo investigar as concepções de formadores de professores de Química sobre as possibilidades e potenciais dificuldades para ensinar conceitos químicos para licenciandos com deficiências. Mais do que um diagnóstico, compreende-se que as concepções dos formadores de professores acerca da inclusão influenciam também, as concepções dos futuros professores de Química. Para isso, os formadores de uma instituição de ensino superior foram entrevistados, a fim de levá-los a refletir sobre suas metodologias, as necessidades de adaptação, assim como as possíveis dificuldades em lidar com esses alunos. Os resultados apontaram que, embora alguns dos docentes tenham se mostrado receptivos às possibilidades da educação de alunos com necessidades educacionais especiais, nenhum deles sente-se preparado para atuar na diversidade.
PALAVRAS-CHAVE: Educação inclusiva. Formação de professores de Química. Concepção de professores.
A relation between the curvature ellipse and the curvature parabola
Authors: Benedini Riul P. , Oset Sinha R. 
Published: July 2019

Abstract
At each point in an immersed surface in ℝ4 there is a curvature ellipse in the normal plane which codifies all the local second order geometry of the surface. Recently, at the singular point of a corank 1 singular surface in ℝ3, a curvature parabola in the normal plane which codifies all the local second order geometry has been defined. When projecting a regular surface in ℝ4 to ℝ3 in a tangent direction, corank 1 singularities appear generically. The projection has a cross-cap singularity unless the direction of projection is asymptotic, where more degenerate singularities can appear. In this paper we relate the geometry of an immersed surface in ℝ4 at a certain point to the geometry of the projection of the surface to ℝ3 at the singular point. In particular we relate the curvature ellipse of the surface to the curvature parabola of its singular projection.
Continuous CM-regularity of semihomogeneous vector bundles
Authors: Küronya Alex , Mustopa Yusuf 
Published: July 2019

AbstractWe ask when the CM (Castelnuovo–Mumford) regularity of a vector bundle on a projective varietyXis numerical, and address the case whenXis an abelian variety. We show that the continuous CM-regularity of a semihomogeneous vector bundle on an abelian varietyXis a piecewise-constant function of Chern data, and we also use generic vanishing theory to obtain a sharp upper bound for the continuous CM-regularity of any vector bundle onX. From these results we conclude that the continuous CM-regularity of many semihomogeneous bundles — including many Verlinde bundles whenXis a Jacobian — is both numerical and extremal.
Aristotle and Crossing the Boundaries between the Sciences
Authors: Judson Lindsay 
Published: July 2019

Abstract
On the basis of what Aristotle says in the Posterior Analytics about how sciences are differentiated and about the impermissibility (save in some exceptional cases) of ‘kind-crossing’, many commentators suppose that when it comes to his scientific practice, Aristotle treats the boundaries of the sciences as impermeable, so that if subject-matter X is the business of one science, it simply cannot (save for the exceptional cases) be the business of another. I call this the impermeable boundary theory of the sciences: knowledge is divided into watertight compartments, determined by their distinct genera, and what goes on in one compartment cannot turn up in another. I argue that, even if this is a correct account of Aristotle’s position in the Analytics, the view that he accepts the impermeable boundary theory when it comes to his scientific and philosophical work outside the Analytics is simply untenable.
Homoclinics for singular strong force Lagrangian systems
Authors: Izydorek Marek , Janczewska Joanna , Mawhin Jean 
Published: July 2019

Abstract
We study the existence of homoclinic solutions for a class of Lagrangian systems
$\begin{array}{}
\frac{d}{dt}
\end{array} $(∇Φ(u̇(t))) + ∇uV(t, u(t)) = 0, where t ∈ ℝ, Φ : ℝ2 → [0, ∞) is a G-function in the sense of Trudinger, V : ℝ × (ℝ2 ∖ {ξ}) → ℝ is a C1-smooth potential with a single well of infinite depth at a point ξ ∈ ℝ2 ∖ {0} and a unique strict global maximum 0 at the origin. Under a strong force condition around the singular point ξ, via minimization of an action integral, we will prove the existence of at least two geometrically distinct homoclinic solutions u± : ℝ → ℝ2 ∖ {ξ}.
Simultaneous Inference of Treatment Effect Modification by Intermediate Response Endpoint Principal Strata with Application to Vaccine Trials
Authors: Zhuang Yingying , Huang Ying , Gilbert Peter B. 
Published: July 2019

Abstract
In randomized clinical trials, researchers are often interested in identifying an inexpensive intermediate study endpoint (typically a biomarker) that is a strong effect modifier of the treatment effect on a longer-term clinical endpoint of interest. Motivated by randomized placebo-controlled preventive vaccine efficacy trials, within the principal stratification framework a pseudo-score type estimator has been proposed to estimate disease risks conditional on the counter-factual biomarker of interest under each treatment assignment to vaccine or placebo, yielding an estimator of biomarker conditional vaccine efficacy. This method can be used for trial designs that use baseline predictors of the biomarker and/or designs that vaccinate disease-free placebo recipients at the end of the trial. In this article, we utilize the pseudo-score estimator to estimate the biomarker conditional vaccine efficacy adjusting for baseline covariates. We also propose a perturbation resampling method for making simultaneous inference on conditional vaccine efficacy over the values of the biomarker. We illustrate our method with datasets from two phase 3 dengue vaccine efficacy trials.
Patients with acute cervical insufficiency without intra-amniotic infection/inflammation treated with cerclage have a good prognosis
Authors: Mönckeberg Max , Valdés Rafael , Kusanovic Juan P. , Schepeler Manuel , Nien Jyh K. , Pertossi Emiliano , Silva Pablo , Silva Karla , Venegas Pía , Guajardo Ulises , Romero Roberto , Illanes Sebastián E. 
Published: July 2019

AbstractBackgroundThe frequency of intra-amniotic infection/inflammation (IAI/I) in patients with midtrimester cervical insufficiency is up to 50%. Our purpose was to determine the perinatal outcomes of cervical cerclage in patients with acute cervical insufficiency with bulging membranes, and to compare the admission-to-delivery interval and pregnancy outcomes according to the results of amniotic fluid (AF) analysis and cerclage placement.MethodsThis was a retrospective cohort study including singleton pregnancies with cervical insufficiency between 15 and 26.9 weeks in two tertiary health centers. IAI/I was defined when at least one of the following criteria was present in AF: (a) a white blood cell (WBC) count >50 cells/mm3; (b) glucose concentration <14 mg/dL; and/or (c) a Gram stain positive for bacteria. Three different groups were compared: (1) absence of IAI/I with placement of a cerclage; (2) amniocentesis not performed with placement of a cerclage; and (3) IAI/I with or without a cerclage.ResultsSeventy patients underwent an amniocentesis to rule out IAI/I. The prevalence of IAI/I was 19%. Forty-seven patients underwent a cerclage. Patients with a cerclage had a longer median admission-to-delivery interval (33 vs. 2 days; P < 0.001) and delivered at a higher median gestational age (27.4 vs. 22.6 weeks; P = 0.001) than those without a cerclage. The neonatal survival rate in the cerclage group was 62% vs. 23% in those without a cerclage (P = 0.01). Patients without IAI/I who underwent a cerclage had a longer median admission-to-delivery interval (43 vs. 1 day; P < 0.001), delivered at a higher median gestational age (28 vs. 22.1 weeks; P = 0.001) and had a higher neonatal survival rate (67% vs. 8%; P < 0.001) than those with IAI/I.ConclusionThe pregnancy outcomes of patients with midtrimester cervical insufficiency and bulging membranes are poor as they have a high prevalence of IAI/I. Therefore, a pre-operative amniocentesis is key to identify the best candidates for the subsequent placement of a cerclage.