bluuebunny/crossref_metadata_2025_split huggingface dataset:
Global guidelines trends and controversies in lower limb venous and lymphatic disease
Authors: Gianesini Sergio , Obi Andrea , Onida Sarah , Baccellieri Domenico , Bissacco Daniele , Borsuk Denis , Campisi Corradino , Campisi Cesare Corrado , Cavezzi Attilio , Chi Yung-wei , Chunga Juan , Corda Domenico , Crippa Angelo , Davies Alun , De Maeseneer Marianne , Diaz Josè , Ferreira Julio , Gasparis Antonios , Intriago Ernesto , Jawien Arkadiusz , Jindal Ravul , Kabnick Lowell , Latorre Alejandro , Lee Byung-Boong , Liew NC , Lurie Fedor , Meissner Mark , Menegatti Erica , Molteni Mauro , Morrison Nick , Mosti Giovanni , Narayanan Sryram , Pannier Felizitas , Parsi Kurosh , Partsch Hugo , Rabe Eberhard , Raffetto Joseph , Raymond-Martimbeau Pauline , Rockson Stanley , Rosukhovski Dmitry , Santiago Fabricio R , Schul Alyssa , Schul Marlin , Shaydakov Evgeny , Sibilla Maria Grazia , Tessari Lorenzo , Tomaselli Fulvio , Urbanek Tomasz , van Rijn Marie Josee , Wakefield Thomas , Wittens Cees , Zamboni Paolo , Bottini Oscar 
Published: September 2019

Guidelines are fundamental in addressing everyday clinical indications and in reporting the current evidence-based data of related scientific investigations. At the same time, a spatial and temporal issue can limit their value. Indeed, variability in the recommendations can be found both among the same nation different scientific societies and among different nations/continents. On the other side, Garcia already published in 2014 data showing how, after three years in average, one out of five recommendations gets outdated (Martinez Garcia LM, Sanabria AJ, Garcia Alvarez E, et al. The validity of recommendations from clinical guidelines: a survival analysis. CMAJ 2014;186(16):1211–1219). The present document reports a narrative literature revision on the major international recommendations in lower limb venous and lymphatic disease management, focusing on the different countries’ guidelines, trends and controversies from all the continents, while identifying new evidence-based data potentially influencing future guidelines. World renowned experts’ opinions are also provided. The document has been written following the recorded round tables scientific discussions held at the vWINter international meeting (22–26 January 2019; Cortina d’Ampezzo, Italy) and the pre- and post-meeting literature search performed by the leading experts.
Neoadjuvant therapy for breast cancer
Authors: Mangone Lucia , Mancuso Pamela , Tagliabue Giovanna , Filiberti Rosa Angela , Carrozzi Giuliano , Iacovacci Silvia , Mazzucco Walter , Tumino Rosario , Minicozzi Pamela , Sant Milena , Giorgi Rossi Paolo 
Published: September 2019

Objective: To evaluate the frequency of neoadjuvant therapy (NT) in women with stage I–III breast cancer in Italy and whether it is influenced by biological characteristics, screening history, and geographic area. Methods: Data from the High Resolution Study conducted in 7 Italian cancer registries were used; they are a representative sample of incident cancers in the study period (2009–2013). Included were 3546 women aged <85 years (groups <50, 50–69, 70–64, and 75+) with stage I–III breast cancer at diagnosis who underwent surgery. Women were classified as receiving NT if they received chemotherapy, target therapy, and/or hormone therapy before the first surgical treatment. Logistic models were built to test the association with biological and contextual variables. Results: Only 8.2% of women (290 cases) underwent NT; the treatment decreases with increasing age (14.5% in age <50 and 2.2% in age 75+), is more frequent in women with negative receptors (14.8%), HER2-positive (15.7%), and triple-negative (15.6%). The multivariable analysis showed the probability of receiving NT is higher in stage III (odds ratio [OR] 3.83; 95% confidence interval [CI] 2.83–5.18), luminal B (OR 1.87; 95% CI 1.27–2.76), triple-negatives (OR 1.88; 95% CI 1.15–3.08), and in symptomatic cancers (OR 1.98; 95% CI 1.13–3.48). Use of NT varied among geographic areas: Reggio Emilia had the highest rates (OR 2.29; 95% CI 1.37–3.82) while Palermo had the lowest (OR 0.41; 95% CI 0.24–0.68). Conclusions: The use of NT in Italy is limited and variable. There are no signs of greater use in hospitals with more advanced care.
Nursing students’ perspective on a caring relationship in clinical supervision
Authors: Honkavuo Leena 
Published: September 2019

Background Nursing students spend approximately half of their time in clinical practice. It is important that clinical supervisors understand nursing students’ path of learning and can support their growth and development during the different and multifaceted learning situations offered in the clinical-practice period. Objective Based on nursing students’ perspective and rooted in the didactics of caring science, to examine how a learning and constructive caring relationship between nursing students and supervisors in clinical practice can be formed. Design Qualitative and quantitative concurrent triangulation design of mixed methods. Methods Focus group interviews with Finnish nursing students (n = 21) in the qualitative part of the study. In the quantitative part, a closed questionnaire with closed answers was analysed using descriptive statistics. The analysis process was conducted using inductive content analysis. Ethical considerations Ethical issues were considered throughout the research process according to ethical principles and scientific guidelines. Informed consent was obtained from the informants, confidentiality regarding the data material was guaranteed and quotations were anonymized. Results A caring relationship between nursing students and supervisors is based on mutual respect, the ethos of responsibility, motivation, willingness and professionalism. Dignity and a caring ethical approach, where nursing students feel they belong, are recognized, seen and heard enables learning and professional development. It is also significant that the supervisor’s actions and reflections are ethically defensible, equal and protect nursing students from suffering and various power relationships in clinical practice. Conclusion A good cooperative relationship and shared responsibility between the nurse education institution, which offers theory and prepares nursing students for the encounter with clinical practice and the healthcare organizations is crucial for enabling a caring relationship in clinical supervision.
PY-RATE ADVENTURES: A 2D Platform Serious Game for Learning the Basic Concepts of Programming With Python
Authors: Sideris Grigorios , Xinogalos Stelios 
Published: September 2019

Background. Learning programming is a cognitively demanding field of study accompanied with various difficulties. Although there is a high demand in the market for programmers, software analysts and engineers, a high dropout rate is recorded in relevant fields of study. Serious games are a promising means of engaging students in learning programming by giving them more incentives and making the process of learning programming concepts and languages more entertaining. Aim. This article introduces a new serious game called PY-RATE ADVENTURES, which aims to assist young students in their introduction to the basic programming concepts using Python. The game does not have any prerequisites and is suitable for players with no previous knowledge of programming. This article aims to present important information regarding the analysis, design and pilot evaluation of PY-RATE ADVENTURES. Method. The game was evaluated by 31 people that had recently graduated or were students of an Interdepartmental Programme of Postgraduate Studies in Information Systems. The participants voluntarily played the game and answered a questionnaire based on the MEEGA+ model, after their hands on experience with the game. This questionnaire’s purpose was to evaluate PY-RATE ADVENTURES in terms of perceived player experience and short-term learning. Results. The participants positively evaluated the game almost in all the elements of player experience. Furthermore, the majority of the users consider that the game helped them to learn basic programming concepts in Python and stated that they would prefer to learn programming with this game rather than other teaching methods. Conclusion. The positive results of the pilot evaluation give us the motivation to proceed and evaluate the game with students in secondary education, in order to extract stronger and generalisable conclusions regarding the impact of the game as an educational tool for learning programming concepts.
An Exploratory Study of Person-Centered Care in a Large Urban Hemodialysis Program in Canada Using a Qualitative Case-Study Methodology
Authors: Lewis Rachel A. , Benzies Karen M. , MacRae Jennifer , Thomas Chandra , Tonelli Marcello 
Published: September 2019

Background: Person-centered care (PCC) can benefit patients, clinical staff, and health care organizations, but has not yet been widely adopted into practice. Hemodialysis is a unique care environment in which clinical staff can be involved with patients for protracted periods of time each week and often over a number of years. While kidney care is arguably more holistic than other chronic condition management programs, most patients requiring hemodialysis do not receive care that is optimally person-centered. Objective: The purpose of this research was to explore how care is experienced and provided in a large urban hemodialysis program in western Canada in relation to key principles of PCC. In addition, we wanted to understand what factors at an individual, unit, and organizational level facilitate or inhibit PCC in this environment. Methods: We used a qualitative case-study approach to explore multiple perspectives of care provision using a number of data sources including semi-structured interviews with patients, family members, clinical staff, and administrative staff, as well as observing patterns of clinical practice in local hemodialysis units. Findings: In our study of a single hemodialysis program, we found limited evidence of PCC. Overall, patients reported that their care was good and they had positive relationships with their care team. However, they did not feel involved in decisions regarding their care or consider it to be individualized. In general, providers acknowledged the potential benefits of PCC but were constrained in their practice by a number of factors, including individual perceptions of their role, a prescriptive care environment, and an organizational focus on managing demand. Conclusions: Evidence of PCC within hemodialysis services was limited, with a number of individual, unit level, and organizational barriers mitigating against its adoption and spread.
Hair Cortisol Concentration and Mental Disorder in Children With Chronic Physical Illness
Authors: Kornelsen Emily , Buchan M. Claire , Gonzalez Andrea , Ferro Mark A. 
Published: September 2019

Background To examine changes in hair cortisol concentrations (HCC) in children with chronic physical illness and identify patterns of association between HCC and mental comorbidity. Methods A sample of 50 children aged 6 to 16 years were recruited within six months of being diagnosed with a chronic physical illness. Data were collected via hair samples, structured interviews, and behavioral checklists. Results There was no change in HCC over six months. Baseline HCC was associated with internalizing—odds ratio (OR) = 1.29 (90% confidence interval (CI): 1.01–1.66)—and externalizing disorders—OR = 1.32 (90% CI: 1.07–1.64). Externalizing disorder at six months was associated with elevated baseline—OR = 1.25 (90% CI: 1.02–1.53)—and six-month HCC—OR = 1.25 (90% CI: 1.02–1.54). Associations between HCC and mental disorder weakened over time, and for internalizing disorders, changed direction (i.e., inverse association), albeit not significantly. Conclusion Results provide preliminary evidence that physiological stress, measured using HCC, may be implicated in the relationship between physical and mental illness, and these associations align with attenuated stress responses over time.
Persistence of skewed X-chromosome inactivation in pre-B acute lymphoblastic leukemia of a female ATRX mutation carrier
Authors: Bradley Christian P. , Chen Cai , Oetjen Karolyn A. , Yan Cheng , Panjwani Reema , Hauffe Sara , Calvo Katherine R. , Yuan Constance , Patel Prapti Arvind , Montgomery Nathan D. , Foster Matthew C. , Battiwalla Minoo , Barrett A. John , Gibbons Richard J. , Ito Sawa 
Published: September 2019

Key Points
Leukemic blasts of a female carrier of an ATRX germline mutation have persistently skewed inactivation of the X chromosome. Germline mutation in leukemia needs to be interpreted with caution because it is not always pathologic.
Perceptions and intervention preferences of Moroccan adolescents, parents, and teachers regarding risks and protective factors for risky sexual behaviors leading to sexually transmitted infections in adolescents: qualitative findings
Authors: El Kazdouh Hicham , El-Ammari Abdelghaffar , Bouftini Siham , El Fakir Samira , El Achhab Youness 
Published: September 2019

AbstractBackgroundSexual choices and practices of adolescents living in conservative societies, including Morocco, can be influenced either positively or negatively by the prevailing contextual and social norms. These norms not only limit the access to reproductive health information and services but also lead to abstinence among devout adolescents. Thus, identifying contextual risks and protective factors of risky sexual behaviors leading to sexually transmitted infections (STIs) in adolescents, as well as exploring perceptions of adolescents, parents and teachers regarding effective intervention preferences could improve the sexual health of adolescents.MethodsWe conducted a qualitative study using focus group discussions (FGDs) based on the socio-ecological model as a theoretical framework. Sample groups of adolescents, parents, and teachers were selected from two public middle schools (disadvantaged and advantaged according to socio-economic level) in Taza city, Morocco, from May to July 2016. Participants were polled on protective factors and perceived facilitators of risky sexual behaviors leading to sexually transmitted infections (STIs) in adolescents as well on their perception of intervention preferences to reduce the risks. Three sets of data were initially formed, coded, and analyzed using thematic analysis.ResultsSeventeen FGDs were conducted, including 8 groups of adolescents (28 boys and 28 girls, 14–16 years old), 5 groups of parents (21 males and 5 females), and 4 groups of teachers (13 males and 5 females). Five overall themes seemed to influence risky sexual behaviors in adolescents: (1) risky sexual practices and STIs; (2) the adolescent’s social domain; (3) the role of school; (4) media, including internet and social media; and (5) socio-cultural norms. Participants also suggested a number of possible interventions to improve the sexual health of adolescents and to reduce the risk of STIs, which could be applied at multiple levels.ConclusionsSuccessful intervention programs should target the multifaceted factors affecting the adolescent’s sexual behaviors, from the individual to the societal level. Allowing parents, teachers, and adolescents to work together could help reduce the socio-cultural and personal barriers that prevent effective communication about sexuality. Furthermore, schools can play a vital role in reducing risky sexual behaviors and STI acquisition rates in adolescents by promoting sex education in school curriculum and encouraging adolescents to engage in extracurricular activities and awareness campaigns.
Lack of influence by endosymbiont Wolbachia on virus titer in the common bed bug, Cimex lectularius
Authors: Fisher Michael L. , Levine Jay F. , Guy James S. , Mochizuki Hiroyuki , Breen Matthew , Schal Coby , Watson David W. 
Published: September 2019

AbstractBackgroundThe common bed bug,Cimex lectularius, is an obligatory blood-feeding ectoparasite that requires a blood meal to molt and produce eggs. Their frequent biting to obtain blood meals and intimate association with humans increase the potential for disease transmission. However, despite more than 100 years of inquiry into bed bugs as potential disease vectors, they still have not been conclusively linked to any pathogen or disease. This ecological niche is extraordinarily rare, given that nearly every other blood-feeding arthropod is associated with some type of human or zoonotic disease. Bed bugs rely on the bacteriaWolbachiaas an obligate endosymbiont to biosynthesize B vitamins, since they acquire a nutritionally deficient diet, but it is unknown ifWolbachiaconfers additional benefits to its bed bug host. In some insects,Wolbachiainduces resistance to viruses such as Dengue, Chikungunya, West Nile, Drosophila C and Zika, and primes the insect immune system in other blood-feeding insects.Wolbachiamight have evolved a similar role in its mutualistic association with the bed bug. In this study, we evaluated the influence ofWolbachiaon virus replication withinC. lectularius.MethodsWe used feline calicivirus as a model pathogen. We fed 40 bed bugs from an established line ofWolbachia-cured and a line ofWolbachia-positiveC. lectulariusa virus-laden blood meal, and quantified the amount of virus over five time intervals post-feeding. The antibiotic rifampicin was used to cure bed bugs ofWolbachia.ResultsThere was a significant effect of time post-feeding, as the amount of virus declined by ~90% over 10 days in both groups, but no significant difference in virus titer was observed between theWolbachia-positive andWolbachia-cured groups.ConclusionsThese findings suggest that other mechanisms are involved in virus suppression within bed bugs, independent of the influence ofWolbachia, and our conclusions underscore the need for future research.
Intrauterine lidocaine and naproxen for analgesia during intrauterine device insertion: randomized controlled trial
Authors: Miles Shana M. , Shvartsman Katerina , Dunlow Susan 
Published: September 2019

Abstract

Background
This study evaluates oral naproxen and intrauterine instillation of lidocaine for analgesia with intrauterine device (IUD) placement as compared to placebo.

Methods
This was a randomized, double-blind, placebo-controlled trial. Patients desiring levonorgestrel 52 mg IUD or Copper T380A IUD were randomized into treatment groups. Patients received either oral naproxen 375 mg or placebo approximately 1 h prior to procedure in conjunction with 5 mL of 2% lidocaine or 5 mL of intrauterine saline. The primary outcome was pain with IUD insertion measured on a visual analog scale immediately following the procedure. Prespecified secondary outcomes included physician pain assessment, post procedure analgesia, satisfaction with procedure, satisfaction with IUD, and pain assessment related to IUD type.

Results
From June 4, 2014 to October 28, 2016 a total of 160 women desiring Copper T380A or levonorgestrel 52 mg intrauterine device insertion and meeting study criteria were enrolled and randomized in the study. Of these, 157 (78 in the Copper T380A arm, 79 in the levonorgestrel 52 mg) received study treatment medication. There were 39 in naproxen/lidocaine arm, 39 in placebo/lidocaine arm, 40 in naproxen/placebo arm, and 39 in placebo/placebo arm. There were no differences in the mean pain scores for IUD placement between treatment groups (naproxen/lidocaine 3.38 ± 2.49; lidocaine only 2.87 ± 2.13; naproxen only 3.09 ± 2.18; placebo 3.62 ± 2.45). There was no difference in self-medication post procedure or in satisfaction with the procedure and IUD among women in the treatment arms or by type of IUD.

Conclusion
Naproxen with or without intrauterine lidocaine does not reduce pain with IUD placement.

Clinical trial registration
Clinicaltrials.gov, NCT02769247. Registered May 11, 2016, Retrospectively registered
Mapping differential vulnerabilities and rights: ‘opening’ access to social protection for forcibly displaced populations
Authors: Sabates-Wheeler Rachel 
Published: September 2019

Abstract
In recent years, forcibly displaced populations have attracted enormous media attention as an increasing number of disasters and political conflicts push more and more people to move away from their homes and seek refuge and opportunities in other places. At the same time, political nervousness about the financial and institutional capability of ‘receiving’ locations to adequately respond to the needs of these large-scale population movements contributes to the shrinking space for thinking about the rights and needs of people on the move. It is precisely because of these global trends that the plight of forcibly displaced populations is becoming more precarious and vulnerable, yet standard social protection provision rarely attends to the plight of these people. The purpose of this paper is to elaborate the remit and implications for including a consideration of forcibly displaced populations (including internally displaced people, refugees and asylum seekers) within social protection policy and programming. Drawing on a limited number of recent initiatives, we suggest some ways in which social protection can be ‘opened’ for these groups.
Neovessel as first manifestation of relapse of associated multifocal choroiditis and MEWDS
Authors: Morizot Eduardo , Schiavo Froner Camila 
Published: September 2019

Abstract

Purpose
To report a case of multifocal choroiditis (MC) that has relapsed as choroidal neovascularization in the contralateral eye followed by a mixed aspect of multiple evanescent white dot syndrome (MEWDS) and MC.

Methods
Retrospective case report and literature review. The clinical findings were documented by fluorescein angiography, optical coherence tomography, and optical coherence tomography angiography (OCT-A).

Results
The authors describe the case of a 39-year-old woman with prior ocular history of presumed MEWDS in her left eye, which developed into MC 7 years later in the same eye and 11 years later in the right eye, starting as choroidal neovascularization and developing into MEWDS. OCT-A showed neovessel in a supposedly active MC area outside the macular region in right and left eyes. OCT showed increased choroidal thickness in both eyes and a choroidal neovascularization in the right eye, treated using anti- VEGF therapy.

Conclusion
This case corroborates the proximity of some inflammatory diseases such as MC and MEWDS. OCT-A has opened new horizons for the better understanding of some retinal diseases by providing more thorough and promising morphological analyses using enhanced tools.