bluuebunny/crossref_metadata_2025_split huggingface dataset:
Terrorism and mental illness: a pragmatic approach for the clinician
Authors: Ho Cyrus S.H. , Quek Tian Ci , Ho Roger C.M. , Choo Carol C. 
Published: December 2018

SUMMARYTerrorism is a complex problem that is highly relevant in contemporary society, underscoring the need for greater understanding as well as cross-disciplinary and international research in this area. Controversies surround potential associations between mental illness and terrorism, many due to the limited and conflicting existing research, and mental health professionals’ duties to their patients versus society and the state. In this article, we review the literature, discuss clinical implications and the role of psychiatrists in anti-terrorism efforts. We also propose a simplified framework that may be incorporated into clinical practice to screen for potential terrorist tendencies.LEARNING OBJECTIVES•Understand the landscape and recent advances in the research of terrorism•Appreciate the importance and role of mental health professionals in preventing patients from engaging in terrorist activities•Understand how to assess risk of patients engaging in terrorist activitiesDECLARATION OF INTERESTNone.
Patient-Reported Outcomes Over 5 Years After Whole- or Partial-Breast Radiotherapy: Longitudinal Analysis of the IMPORT LOW (CRUK/06/003) Phase III Randomized Controlled Trial
Authors: Bhattacharya Indrani S. , Haviland Joanne S. , Kirby Anna M. , Kirwan Cliona C. , Hopwood Penelope , Yarnold John R. , Bliss Judith M. , Coles Charlotte E. ,   on behalf of the IMPORT Trialists
Published: December 2018

Purpose IMPORT LOW demonstrated noninferiority of partial-breast and reduced-dose radiotherapy versus whole-breast radiotherapy for local relapse and similar or reduced toxicity at 5 years. Comprehensive patient-reported outcome measures collected at serial time points are now reported. Patients and Methods IMPORT LOW recruited women with low-risk breast cancer after breast-conserving surgery. Patients were randomly assigned to 40 Gy whole-breast radiotherapy (control), 36 Gy whole-breast and 40 Gy partial-breast radiotherapy (reduced-dose), or 40 Gy partial-breast radiotherapy only (partial-breast) in 15 fractions. European Organisation for Research and Treatment of Cancer Quality of Life Questionnaires Core 30 and Breast Cancer–Specific Module, Body Image Scale, protocol-specific items, and the Hospital Anxiety and Depression Scale were administered at baseline, 6 months, and 1, 2, and 5 years. Patterns of moderate/marked adverse effects (AEs) were assessed using longitudinal regression models, and baseline predictors were investigated. Results A total of 41 of 71 centers participated in the patient-reported outcome measures substudy; 1,265 (95%) of 1,333 patients consented, and 557 (58%) of 962 reported no moderate/marked AEs at 5 years. Breast appearance change was most prevalent and persisted over time (approximately 20% at each time point). Prevalence of breast hardness, pain, oversensitivity, edema, and skin changes reduced over time ( P < .001 for each), whereas breast shrinkage increased ( P < .001). Analysis by treatment group showed average number of AEs per person was lower in partial-breast (incidence rate ratio, 0.77; 95% CI, 0.71 to 0.84; P < .001) and reduced-dose (incidence rate ratio, 0.83; 95% CI, 0.76 to 0.90; P < .001) versus whole-breast group and decreased over time in all groups. Younger age, larger breast size/surgical deficit, lymph node positivity, and higher levels of anxiety/depression were baseline predictors of subsequent AE reporting. Conclusion Most AEs reduced over time, with fewer AEs in the partial-breast and reduced-dose groups. Baseline predictors for AE reporting were identified. These findings will facilitate informed discussion and shared decision making for future patients receiving moderately hypofractionated breast radiotherapy.
Evaluating Barriers and Opportunities in Delivering High-Quality Oncology Care in a Resource-Limited Setting Using a Comprehensive Needs Assessment Tool
Authors: Nwachukwu Chika R. , Mudasiru Omobola , Million Lynn , Sheth Shruti , Qamoos Hope , Onah Joseph O. , Okemini Anita , Rhodes Mojisola , Barry Michele , Banjo Adekunbiola A. , Habeebu Muhameed , Olasinde Tajudeen A. , Bhatt Ami S. 
Published: December 2018

Purpose Despite recognition of both the growing cancer burden in low- and middle-income countries and the disproportionately high mortality rates in these settings, delivery of high-quality cancer care remains a challenge. The disparities in cancer care outcomes for many geographic regions result from barriers that are likely complex and understudied. This study describes the development and use of a streamlined needs assessment questionnaire (NAQ) to understand the barriers to providing quality cancer care, identifies areas for improvement, and formulates recommendations for implementation. Methods Using a comprehensive NAQ, in-depth interviews were conducted with 17 hospital staff involved in cancer care at two teaching hospitals in Nigeria. Data were analyzed using content analysis and organized into a framework with preset codes and emergent codes, where applicable. Results Data from the interviews were organized into six broad themes: staff, stuff, system, space, lack of palliative care, and provider bias, with key barriers within themes including: financial, infrastructural, lack of awareness, limited human capacity resources, lack of palliative care, and provider perspective on patient-related barriers to cancer care. Specific solutions based on ability to reasonably implement were subcategorized into short-, medium-, and long-term goals. Conclusion This study provides a framework for a streamlined initial needs assessment and a unique discussion on the barriers to high-quality oncology care that are prevalent in resource-constrained settings. We report the feasibility of collecting and organizing data using a streamlined NAQ and provide a thorough and in-depth understanding of the challenges in this setting. Knowledge gained from the assessments will inform steps to improve oncology cancer in these settings.
1-2-3 Project: A Quality Improvement Initiative to Normalize and Systematize Palliative Care for All Patients With Cancer in the Outpatient Clinic Setting
Authors: Desai Anjali V. , Klimek Virginia M. , Chow Kimberly , Epstein Andrew S. , Bernal Camila , Anderson Kelly , Okpako Molly , Rawlins-Duell Robin , Kramer Dana , Romano Danielle , Goldberg Jessica I. , Nelson Judith E. 
Published: December 2018

Background: Prior work to integrate early palliative care in oncology has focused on patients with advanced cancer and primarily on palliative care consultation. We developed this outpatient clinic initiative for newly diagnosed patients at any stage, emphasizing primary (nonspecialist) palliative care by oncology teams, with enhanced access to palliative care specialists. Methods: We piloted the project in two medical oncology specialty clinics (for patients with myelodysplastic syndrome and GI cancer, respectively) to establish feasibility. On a visit-based schedule, patients systematically reported symptoms, information/decision-making preferences, and illness understanding. They also participated in discussions of their core values with their oncology nurse. Oncology teams were first responders to palliative care needs, whereas specialists were available for clinician support and direct patient consultation. Results: All 58 eligible patients were enrolled. In both clinics, patient self-reports documented a heavy symptom burden. Information/decision-making preferences and illness understanding levels varied across patients. Patients prepared new advance directives. Oncology nurses documented discussions of core values. Requests for palliative care consultation decreased over time as oncology teams embraced their primary palliative care role with coaching from the specialists. Clinic workflow and patient volume were maintained. Conclusion: Our pilot experience suggests that in outpatient oncology clinics, a structured, scheduled, and systematic approach is feasible to deliver palliative care to newly diagnosed patients with cancer at any stage and throughout their illness trajectory. This novel approach identified important, actionable palliative care needs, relying primarily on oncology teams to respond to these needs, while enhancing access to palliative care specialist input. Expansion to additional clinics will allow evaluation of scalability and generalizability, along with measurement of a broader range of important outcomes.
Measuring the Impact of Academic Cancer Network Development on Clinical Integration, Quality of Care, and Patient Satisfaction
Authors: Chiang Anne C. , Lake Jessica , Sinanis Naralys , Brandt Debra , Kanowitz Jane , Kidwai Wajih , Kortmansky Jeremy , LaSala Johanna , Orell Jeffrey , Sabbath Kert , Tara Harold , Engelking Constance , Shomsky Lisa , Fradkin Monica , Adelson Kerin , Uscinski Kathleen , Vest Kevin , Lyons Catherine , Lemay Arthur , Lopman Abe , Fuchs Charles S. , Lilenbaum Rogerio 
Published: December 2018

Purpose: Many US academic centers have acquired community practices to expand their clinical care and research footprint. The objective of this assessment was to determine whether the acquisition and integration of community oncology practices by Yale/Smilow Cancer Hospital improved outcomes in quality of care, disease team integration, clinical trial accrual, and patient satisfaction at network practice sites. Methods: We evaluated quality of care by testing the hypothesis that core Quality Oncology Practice Initiative measures at network sites that were acquired in 2012 were significantly different after their 2016 integration into the network. Clinical and research integration were measured using the number of tumor board case presentations and total accruals in clinical trials. We used Press-Ganey scores to measure patient satisfaction pre- and postintegration. Results: Mean Quality Oncology Practice Initiative scores at Smilow Care Centers were significantly higher in 2016 than in 2012 for core measures related to improvement in tumor staging ( z = 1.33; P < .05), signed consent and documentation plans for antineoplastic treatment ( z = 2.69; P < .01; and z = 2.36; P < .05, respectively), and appropriately quantifying and addressing pain during office visits ( z = 2.95; P < .05; and z = 3.1; P < .01, respectively). A total of 493 cases were presented by care center physicians at the tumor board in 2017 compared with 45 presented in 2013. Compared with 2012, Smilow Care Center clinical trial accrual increased from 25 to 170 patients in 2017. Last, patient satisfaction has remained at greater than the 90th percentile pre- and postintegration. Conclusion: The process of integration facilitates the ability to standardize cancer practice and provides a platform for quality improvement.
Lateral Hypothalamic Mc3R-Expressing Neurons Modulate Locomotor Activity, Energy Expenditure, and Adiposity in Male Mice
Authors: Pei Hongjuan , Patterson Christa M , Sutton Amy K , Burnett Korri H , Myers Martin G , Olson David P 
Published: December 2018

AbstractThe central melanocortin system plays a crucial role in the control of energy balance. Although the decreased energy expenditure and increased adiposity of melanocortin-3 receptor (Mc3R)–null mice suggest the importance of Mc3R-regulated neurons in energy homeostasis, the roles for specific subsets of Mc3R neurons in energy balance have yet to be determined. Because the lateral hypothalamic area (LHA) contributes to the control of energy expenditure and feeding, we generated Mc3rcre mice to determine the roles of LHA Mc3R (Mc3RLHA) neurons in energy homeostasis. We found that Mc3RLHA neurons overlap extensively with LHA neuron markers that contribute to the control of energy balance (neurotensin, galanin, and leptin receptor) and project to brain areas involved in the control of feeding, locomotion, and energy expenditure, consistent with potential roles for Mc3RLHA neurons in these processes. Indeed, selective chemogenetic activation of Mc3RLHA neurons increased locomotor activity and augmented refeeding after a fast. Although the ablation of Mc3RLHA neurons did not alter food intake, mice lacking Mc3RLHA neurons displayed decreased energy expenditure and locomotor activity, along with increased body mass and adiposity. Thus, Mc3R neurons lie within LHA neurocircuitry that modulates locomotor activity and energy expenditure and contribute to energy balance control.
Myosin-II activity generates a dynamic steady state with continuous actin turnover in a minimal actin cortex
Authors: Sonal  , Ganzinger Kristina A. , Vogel Sven K. , Mücksch Jonas , Blumhardt Philipp , Schwille Petra 
Published: December 2018

ABSTRACT
Dynamic reorganization of the actomyosin cytoskeleton allows fast modulation of the cell surface, which is vital for many cellular functions. Myosin-II motors generate the forces required for this remodeling by imparting contractility to actin networks. However, myosin-II activity might also have a more indirect contribution to cytoskeletal dynamics; it has been proposed that myosin activity increases actin turnover in various cellular contexts, presumably by enhancing disassembly. In vitro reconstitution of actomyosin networks has confirmed the role of myosin in actin network disassembly, but the reassembly of actin in these assays was limited by factors such as diffusional constraints and the use of stabilized actin filaments. Here, we present the reconstitution of a minimal dynamic actin cortex, where actin polymerization is catalyzed on the membrane in the presence of myosin-II activity. We demonstrate that myosin activity leads to disassembly and redistribution in this simplified cortex. Consequently, a new dynamic steady state emerges in which the actin network undergoes constant turnover. Our findings suggest a multifaceted role of myosin-II in the dynamics of the eukaryotic actin cortex.
This article has an associated First Person interview with the first author of the paper.
Epigenetic changes around the pX region and spontaneous HTLV-1 transcription are CTCF-independent
Authors: Miura Michi , Miyazato Paola , Satou Yorifumi , Tanaka Yuetsu , Bangham Charles R.M. 
Published: December 2018

Background:The human retrovirus HTLV-1 inserts the viral complementary DNA of 9 kb into the host genome. Both plus- and minus-strands of the provirus are transcribed, respectively from the 5′ and 3′ long terminal repeats (LTR). Plus-strand expression is rapid and intense once activated, whereas the minus-strand is transcribed at a lower, more constant level. To identify how HTLV-1 transcription is regulated, we investigated the epigenetic modifications associated with the onset of spontaneous plus-strand expression and the potential impact of the host factor CTCF.Methods:Patient-derived peripheral blood mononuclear cells (PBMCs) and in vitro HTLV-1-infected T cell clones were examined. Cells were stained for the plus-strand-encoded viral protein Tax, and sorted into Tax+and Tax–populations. Chromatin immunoprecipitation and methylated DNA immunoprecipitation were performed to identify epigenetic modifications in the provirus. Bisulfite-treated DNA fragments from the HTLV-1 LTRs were sequenced. Single-molecule RNA-FISH was performed, targeting HTLV-1 transcripts, for the estimation of transcription kinetics. The CRISPR/Cas9 technique was applied to alter the CTCF-binding site in the provirus, to test the impact of CTCF on the epigenetic modifications.Results:Changes in the histone modifications H3K4me3, H3K9Ac and H3K27Ac were strongly correlated with plus-strand expression. DNA in the body of the provirus was largely methylated except for the pX and 3′ LTR regions, regardless of Tax expression. The plus-strand promoter was hypomethylated when Tax was expressed. Removal of CTCF had no discernible impact on the viral transcription or epigenetic modifications.Conclusions:The histone modifications H3K4me3, H3K9Ac and H3K27Ac are highly dynamic in the HTLV-1 provirus: they show rapid change with the onset of Tax expression, and are reversible. The HTLV-1 provirus has an intrinsic pattern of epigenetic modifications that is independent of both the provirus insertion site and the chromatin architectural protein CTCF which binds to the HTLV-1 provirus.
Prostate Cancer Risk-Associated Single-Nucleotide Polymorphism Affects Prostate-Specific Antigen Glycosylation and Its Function
Authors: Srinivasan Srilakshmi , Stephens Carson , Wilson Emily , Panchadsaram Janaththani , DeVoss Kerry , Koistinen Hannu , Stenman Ulf-Håkan , Brook Mark N , Buckle Ashley M , Klein Robert J , Lilja Hans , Clements Judith , Batra Jyotsna 
Published: December 2018

Abstract

BACKGROUND
Genetic association studies have reported single-nucleotide polymorphisms (SNPs) at chromosome 19q13.3 to be associated with prostate cancer (PCa) risk. Recently, the rs61752561 SNP (Asp84Asn substitution) in exon 3 of the kallikrein-related peptidase 3 (KLK3) gene encoding prostate-specific antigen (PSA) was reported to be strongly associated with PCa risk (P = 2.3 × 10−8). However, the biological contribution of the rs61752561 SNP to PCa risk has not been elucidated.

METHODS
Recombinant PSA protein variants were generated to assess the SNP-mediated biochemical changes by stability and substrate activity assays. PC3 cell–PSA overexpression models were established to evaluate the effect of the SNP on PCa pathogenesis. Genotype-specific correlation of the SNP with total PSA (tPSA) concentrations and free/total (F/T) PSA ratio were determined from serum samples.

RESULTS
Functional analysis showed that the rs61752561 SNP affects PSA stability and structural conformation and creates an extra glycosylation site. This PSA variant had reduced enzymatic activity and the ability to stimulate proliferation and migration of PCa cells. Interestingly, the minor allele is associated with lower tPSA concentrations and high F/T PSA ratio in serum samples, indicating that the amino acid substitution may affect PSA immunoreactivity to the antibodies used in the clinical immunoassays.

CONCLUSIONS
The rs61752561 SNP appears to have a potential role in PCa pathogenesis by changing the glycosylation, protein stability, and PSA activity and may also affect the clinically measured F/T PSA ratio. Accounting for these effects on tPSA concentration and F/T PSA ratio may help to improve the accuracy of the current PSA test.
Art, Nightlife and the Complexities of Participation: New York’s Area (1983–87)
Authors: Houser Craig 
Published: December 2018

Abstract
Art and nightlife have intermixed in many cabarets and nightclubs throughout the modern era, and this project focuses on the New York nightclub Area (1983–87). Inspired by surrealism, neo-dada and pop art, Area’s owners acted as artistscurators, as they reinvented their club approximately every five to six weeks by demolishing and rebuilding it based on quirky themes including ‘Suburbia’, ‘Confinement’ and ‘Natural History’. Sculptures, films, photographs, performance art projects, installations and dioramas were featured, and artists included Karen Finley, Keith Haring and Andy Warhol. Such a club questioned issues related to curating living persons and the stereotypical notions of patronage and spectatorship. This social historical analysis, which touches upon gender and queer theory, examines the ethics of participation and how Area exemplified the intermixing of art and nightlife in New York’s nightclubs.
Compassionate University
Authors: Trail Juliet Jennifer , Cunningham Tim 
Published: December 2018

Over the past decade, the University of Virginia has been experiencing a culture change towards becoming a more contemplative and compassionate institution. The leaders of this change seek, ultimately, to enhance and influence every aspect of the mission and community of this large, prestigious public institution. Of course, multi-layered and pervasive culture change does not occur instantaneously. Rather, the establishment in 2009 of the UVA School of Nursing’s Compassionate Care Initiative, followed by the launch in 2012 of the pan-university UVA Contemplative Sciences Center have led to an array of targeted initiatives that incorporate both the health system – consisting of the School of Nursing, School of Medicine, and the UVA Medical Center – and the university’s academic division, consisting of nine additional schools as well as the ancillary units that support the wider university.
This article provides a set of detailed examples of efforts implemented by these two centers in support of a culture change towards more compassionate teaching, research, patient care, and service. Examples will include:

supporting compassion and self-care through retreats in the School of Nursing and research assessing the impact of this and additional co-curricular programming via cross-sectional survey of nurses
discussion of student, faculty and clinical Ambassadors who serve as compassion mentors across the UVA Health System
consideration of contemplative pedagogy within the UVA undergraduate course Mindfulness & Compassion: Towards Living Fully, Personally & Professionally
discussion of pan-university co-curricular programming serving the university community that seeks to create impact at an institution-wide level.

The impact and outcomes of each example will be considered, individually and as part of a larger shift towards creating a compassionate, contemplative university for the modern era.
Reflecting with Compassion on Student Feedback
Authors: Lowe Wendy Anne 
Published: December 2018

This reflective piece of writing explores the experience of gaining medical student feedback that is negative in the context of teaching social sciences in a medical school. There are a number of different ways in which an educator can explore negative feedback and respond. Some ways may be less helpful than others even though they reflect prevailing dominant thinking within higher education and how students are perceived.
Compassionate pedagogy provides an avenue for allowance of challenging feedback and situations, as well as an unpacking of assumptions made about teaching and medical students, in a way that is respectful of the teacher, student and ultimately the patient. Since the way students are treated can be seen as an exemplar for how they will then go on to view and treat the patient, the compassion gap within universities (that train health professionals to then work with patients) is astonishing as noted by Waddington (2016).
Drawing on theory from the social sciences as well as medical humanities, this paper uses reflective practice (Foley, 2002), critical pedagogy (Freire, 2000) as well as intelligent kindness (Ballett & Campling, 2011) to analyse a student feedback experience within medical education and asks the question of how can compassion be integrated in a biomedical field where the emphasis is on science, with all the implications that has for the learner? This question centres on the relative valuing of objective facts over subjectivity of experience.
Using compassionate pedagogy, some suggestions or, food for thought, are made on how to re-interpret negative student feedback that negotiates the tricky area between social science and medicine, whilst not negating either.