bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rethinking the Cooling Out Hypothesis for the 21st Century: The Impact of Financial Aid on Students’ Educational Goals
Authors: Broton Katharine M. 
Published: January 2019

Background: Most community college students from low-income families have ambitious educational degree goals, but only a small fraction attains them. For many decades, sociologists have primarily attributed this problem to a cooling out process in which college practitioners diminish students’ educational ambitions using academic reorientation processes that encourage the least-promising students to lower their degree goals. The cooling out explanation focuses exclusively on the actions of institutional community college actors rather than other factors affecting student decisions and thus has been used to vilify community colleges as engines of inequality. Objective: This article addresses an alternative hypothesis, considering whether student financial aid, the ubiquitous and multifaceted system that community college actors mainly do not control, influences students’ educational goals. Method and Results: Using data from an experimental study of need-based financial aid in Wisconsin, I find that a private grant program, which triggered a repackaging of students’ financial aid awards, decreased the educational degree aspirations and expectations of 2-year college students, on average. Contributions and Implications: Although counterintuitive, this finding is consistent with the idea that the complex manner in which aid is delivered creates confusion and uncertainty about the actual costs of college. While these lowered degree goals persisted over time, they did not affect degree attainment rates, suggesting students’ expectations may be more malleable and less consequential than prior research suggests. This article demonstrates that the observed cooling out phenomenon is not necessarily the result of a meritocratic sorting system and involves processes previously neglected by sociological theory. A more robust model of college choices is needed.
Safety and efficacy of a urine alkalinization protocol developed for high-dose methotrexate patients during intravenous bicarbonate shortage
Authors: Roy Amanda M , Lei Matthew , Lou Uvette 
Published: January 2019

Purpose Urinary alkalinization with intravenous sodium bicarbonate is standard during high-dose methotrexate administration. Due to a national intravenous sodium bicarbonate shortage, a urinary alkalinization protocol involving hyperhydration with intravenous fluids, oral bicarbonate, and intravenous or oral acetazolamide was utilized from 10 April to 30 May 2017 (“shortage protocol”). This study compared outcomes between protocols. Methods A single-center, retrospective chart review was conducted for adults who received methotrexate ≥500 mg/m2 on ≥ two occasions, at least once during each protocol, between 19 February and 19 July 2017. Results Eighteen patients (50% male), median age 65 years, received 76 total high-dose methotrexate cycles. Shortage protocol was used in 37 cycles (48.7%). Mean time to methotrexate clearance did not differ between groups (p = ns). Mean time to urinary alkalinization and duration of hospitalization were not statistically different (p = 0.49 and 0.23, respectively). Average total bicarbonate administered per 24 hours was higher in standard protocol (p < 0.05), but hydration rates were similar (p = 0.73). Creatinine clearance and urine output on days 1 and 2 post-high-dose methotrexate did not significantly differ (creatinine clearance day 1, p = 0.27; creatinine clearance day 2, p = 0.55; urine output day 1, p = 0.62; urine output day 2, p = 0.60). Interruptions in alkalinization were significantly higher during shortage (0.41 ± 0.75 instances of urine pH < 7 during standard vs. 1.3 ± 1.7 under shortage, p < 0.05).
The impact of the Glasgow Prognostic Score on survival in second-line chemotherapy for metastatic colorectal cancer patients with BRAF V600E mutation
Authors: Mitani Seiichiro , Taniguchi Hiroya , Sugiyama Keiji , Masuishi Toshiki , Honda Kazunori , Narita Yukiya , Kadowaki Shigenori , Ura Takashi , Ando Masashi , Tajika Masahiro , Yatabe Yasushi , Muro Kei 
Published: January 2019

Background: BRAF (v-raf murine sarcoma viral oncogene homolog B1) V600E mutant colorectal cancer is associated with short survival. Recently, clinical trials have been conducted to improve outcomes of second or later lines of chemotherapy. However, there is a paucity of reference data pertaining to outcomes of second-line chemotherapy and prognostic factors that are relevant only to BRAF mutant patients. Patients and methods: We retrospectively reviewed metastatic colorectal cancer patients with BRAF V600E mutation who underwent second-line chemotherapy between January 2007 and March 2017. We evaluated treatment outcomes and performed prognostic analyses. Results: A total of 52 patients were included. The median progression-free survival and overall survival (OS) were 2.5 [95% confidence interval (CI) = 1.91–4.11] and 6.5 (95% CI = 4.30–9.63) months, respectively. Overall response and disease control rates were 7% and 48%, respectively. All the regimens which elicited a partial response included BRAF inhibitors in combination with anti-epidermal growth factor receptor (EGFR) antibodies. Therefore, the overall response was 0% after exclusion of patients treated with study drugs. Multivariate analysis for OS revealed that the Glasgow Prognostic Score (GPS), elevated lactate dehydrogenase, and poor performance status were independent prognostic factors. In particular, survival curves according to the GPS stratified the patients into distinct risk groups. The median OSs in patients with GPS of 0, 1, and 2 were 9.9, 5.0, and 1.9 months, respectively. Conclusions: Outcomes of second-line chemotherapy for metastatic colorectal cancer patients with BRAF V600E mutation were extremely poor. GPS may be useful in future clinical trials.
Analysis of risk factors for deep venous thrombosis in patients with gynecological malignant tumor: A clinical study
Authors: Li Qun , Xue Yinling , Peng Yuan , Li Lin 
Published: January 2019

Objectives: To determine the clinical characteristics and risk factors of Deep Venous Thrombosis (DVT) in patients with gynecological malignant tumor, facilitating gynecologists better prevent the fatal complication.
Methods: The patients with gynecological malignant tumor treated in department of gynecology of our hospital between May 2013 and May 2018 were reviewed retrospectively. The clinical data of patients including gender, age, tumor staging, adenocarcinoma, surgery, operation time, hypertension, hyperlipemia, diabetes, coronary heart disease, radiotherapy, chemotherapy, hospital stay, and postoperative rehabilitation exercise were collected to analyze the clinical characteristics of patients and determine the risk factors of DVT.
Results: In the current study, 67 patients were included in DVT group, and 554 patients were included in Non-DVT group. There were significant differences in age, hypertension, hyperlipemia, operation time, adenocarcinoma, tumor staging, radiotherapy and postoperative rehabilitation exercises between DVT and non-DVT groups (p<0.05). However, there was no significant differences in gender, coronary heart disease, diabetes, surgical treatment and hospital stay (p>0.05). In multivariate analysis, the factors including age, hypertension, adenocarcinoma, radiotherapy, and hyperlipemia were independent risk factors, while rehabilitation exercise was protective factor for DVT.
Conclusion: In cases of gynecological malignant tumor, DVT screening should be given due importance, especially for those patients with old age, hypertension, hyperlipemia, adenocarcinoma, or history of radiotherapy. Rehabilitation exercise should be encouraged in these patients.
How to cite this:Li Q, Xue Y, Peng Y, Li L. Analysis of risk factors for deep venous thrombosis in patients with gynecological malignant tumor: A clinical study. Pak J Med Sci. 2019;35(1):195-199. doi: https://doi.org/10.12669/pjms.35.1.365
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.
XW-100: First FDA CLIA-Waived CBC Analyzer Designed for Physician Office Use
Authors: Wu Alan H B , Sellers Jill 
Published: January 2019

Abstract

Background
The XW-100 hematology analyzer (Sysmex America) is the first complete blood count (CBC) instrument waived by the US Food and Drug Administration. This analyzer also tests for a 3-part white blood cell count differential.

Methods
The XW-100 analyzer was evaluated for preanalytical specimen variables including the need for mixing, specimen storage conditions, freeze–thaw cycles, the effect of under filling of tubes, precision, linearity, carryover, limits of the blank, detection, and quantification and interferences from common and CBC-specific substances. The clinical study examined 586 blood samples from 6 CLIA-waived clinical sites and 6 paired moderately complex sites. The point-of-care sites had different medical specialties and were using inexperienced operators. The results of 8 measurements and 4 calculated parameters were compared to a moderately complex point-of-care hematology analyzer (pocH-100i, Sysmex).

Results
The precision was &lt;6% for all analytics, and there was no carryover noted. Samples containing interfering substances were appropriately flagged or suppressed by the instrument. The correlation to the predicate analyzer was highly concordant, producing near unity slope and intercept and minimal bias. Delays from sample collection to testing resulted in decreased performance. The percentage of samples inside the allowable error was &gt;98.8% for all parameters studied.

Conclusion
This CLIA-waived hematology analyzer produces acceptable results and can be used in offices and clinics.
Transition of Methotrexate Polyglutamate Drug Monitoring Assay from Venipuncture to Capillary Blood-Based Collection Method in Rheumatic Diseases
Authors: Brady Kelley , Qu Ying , Stimson Deborah , Apilado Robert , Vezza Alexander Roberta , Reddy Smitha , Chitkara Puja , Conklin John , O'Malley Tyler , Ibarra Claudia , Dervieux Thierry 
Published: January 2019

Abstract

Objective
Methotrexate (MTX) polyglutamate (MTXPG3) levels from isolated red blood cells (RBCs) collected by venipuncture have clinical utility in guiding MTX dosing for patients with rheumatoid arthritis (RA). Our objective was to transition this RBC-based therapeutic drug monitoring (TDM) assay to dried capillary blood collected by fingerstick.

Methods
Patients with RA treated with MTX were enrolled. Specimens were collected by fingerstick (volumetric absorptive microsampler) and venipuncture to measure MTXPG3 from dried capillary blood, total venous blood, and isolated RBCs. MTXPG3 levels from dried capillary blood were measured using LC-MS/MS, converted to RBC equivalent (nmol/L), and compared with those from isolated RBCs (reference method). Following transition to fingerstick collection, comparability in the distributions of dried capillary and venipuncture-based RBC MTXPG3 levels was assessed using the Kolmogorov–Smirnov (K-S) test.

Results
Intraday and interday precision ranged from 2.0% to 10.9% and 3.1% to 10.8%, respectively, at MTXPG3 concentrations ranging from 5 to 100 nmol/L. In 106 participants treated with MTX, MTXPG3 levels from total venous and dried capillary blood were comparable [slope = 0.97 (95% CI, 0.92–1.03); R 2 = 0.92]. Dried capillary blood MTXPG3 converted to RBC equivalent was similar to levels from isolated RBCs (30 ± 18 nmol/L vs 33 ± 19 nmol/L; n = 106). After implementation in the clinical laboratory, RBC equivalents MTXPG3 from the fingerstick method were similar to levels from venipuncture [39 ± 22 nmol/L (n = 825) vs 39 ± 24 nmol/L (n = 47935)] (K-S test P = 0.09). Underexposure to MTX (MTXPG3 ≤5 nmol/L RBCs) was detected in 7.0% and 8.5% patient specimens collected using the fingerstick and venipuncture methods, respectively.

Conclusion
Capillary blood MTXPG3 levels can be used to guide MTX dosing in TDM practice.
The Impact of Secondary Environmental Variables on OECD Healthcare Efficiency: A Robust Conditional Approach
Authors: Gearhart Richard 
Published: January 2019

Abstract
In this paper, I estimate country-level efficiency using a newer order-m estimator where I condition efficiency estimates on secondary environmental variables. This allows me to identify which variables influence the effectiveness of a healthcare delivery system. I find that not controlling for secondary environmental variables leads to the average OECD country being 11% inefficient; after controlling for demographics and economic (social protection) environmental variables, inefficiency reduces to 7% (5%). This provides evidence that a substantial part of the inefficiencies of a healthcare system is related to demographics, socioeconomics, and the structure of the healthcare delivery system. Using the second-stage results, I find lower healthcare spending, both as a percent of GDP and total out-of-pocket, as well as more of the population covered by public health insurance, is related to better efficiency. Lower fertility rates, lower immigration rates, higher incomes, and lower pharmaceutical doses are also consistent with better healthcare efficiency. Lastly, a healthcare system that provides a basic benefits package but allows for purchase of private health insurance, with moderate gatekeeping and flexibility to increase the budget for healthcare through public and private financing, are the most efficient healthcare systems.
Investment, technological progress and energy efficiency
Authors: Díaz Antonia , Puch Luis A. 
Published: January 2019

Abstract
In this paper we propose a theory to study how the aggregate demand of energy responds to energy prices and technical innovations that affect the price of energy services. In our theory, energy use is determined by the interaction of the choice of Energy Saving Technical Change with energy prices and Investment Specific Technical Change (ISTC). The key mechanism is that the energy saving technology is embodied in capital vintages as a requirement that determines their energy intensity. We show that higher ISTC that increases the quality of capital goods is an energy saving device and, therefore, a substitute for Energy Saving Technical Change (ESTC). However, higher ISTC that rises the efficiency in producing capital goods is energy consuming and fosters ESTC to compensate for the amount of energy required by the new investment. A higher price of energy also induces a higher level of ESTC, but the aggregate amount of energy used may not be affected as investment does not change. These effects are amplified with rising prices of energy. Thus, our theory can be used to test when and how we should see a rebound effect in energy use at the aggregate level and to evaluate the aggregate effect of any policy aiming to reduce energy use.
Concept characteristics and variation in lexical diversity in two Dutch dialect areas
Authors: Franco Karlien , Geeraerts Dirk , Speelman Dirk , Van Hout Roeland 
Published: January 2019

AbstractLexical diversity, the amount of lexical variation shown by a particular concept, varies between concepts. For the conceptdrunk, for instance, nearly 3000 English expressions exist, includingblitzed, intoxicated, andhammered. For the conceptsober, however, a significantly smaller number of lexical items is available, likesoberorabstinent. While earlier variation studies have revealed that meaning-related concept characteristics correlate with the amount of lexical variation, these studies were limited in scope, being restricted to one semantic field and to one dialect area, that of the Limburgish dialects of Dutch. In this paper, we investigate whether the impact of concept characteristics, viz. vagueness, lack of salience and proneness to affect, is manifest in a similar way in other dialects and other semantic fields. In particular, by extending the scope of the earlier studies to other carefully selected semantic fields, we investigate the generalizability of the impact of concept characteristics to the lexicon as a whole. The quantitative approach that we employ to measure concept characteristics and lexical diversity methodologically advances the study of linguistic variation. Theoretically, this paper contributes to the further development of Cognitive Sociolinguistics by showcasing how meaning can be a source of lexical diversity.
Proximal and distal deictics and the construal of narrative time
Authors: Dancygier Barbara 
Published: January 2019

Abstract
This paper proposes an approach to narrative deixis which offers a coherent analysis of the respective roles of proximal and distal deictic expressions (demonstratives as well as temporal and locative adverbs). The paper starts by arguing that fictional narratives require an approach to deixis which modifies a number of broadly held assumptions, especially as regards the interaction between tense and other deictic forms. It then considers the widely discussed instance of the temporal adverb now in the context of Past Tense. The second part of the paper gives special focus to demonstratives in narrative fiction, showing their role in temporal construals. It argues that both temporal and demonstrative expressions are primarily used to serve narrative viewpoint construction (which includes but is not limited to temporal viewpoint). Examples from several novels are then used to show how the proximal and distal choices of demonstratives, temporal adverbs and locative adverbs structure narrative viewpoint, including narrative representation of character experience. The paper concludes by proposing that in the context of fictional narratives the proximal/distal contrast is more relevant to meaning emergence than individual aspects of deixis, and that the construal of time can be achieved through the whole spectrum of deictic forms, not just tense and temporal adverbs such as now and then.
Toolbox of teaching strategies
Authors: Pan Lei , Xi Hui-Qin , Shen Xiao-Wei , Zhang Chen-Yu 
Published: January 2019

AbstractA teaching strategy is a method, which can help students to gain knowledge, deliver information, and improve their learning. Different learning environments, such as clinical teaching, online teaching, and face-to-face traditional learning environments, require different teaching strategies for students. Choosing teaching strategies for a course is very important for nurse educators because various factors should be taken into account to make students meet the learning outcomes. The use of modern technologies in teaching strategies can improve students’ competencies and confidences. The purpose of this article is to create a toolbox integrating ten teaching strategies that can be used in different teaching environments.
Clinical surgery-oriented subject librarian services in medical colleges and schools
Authors: He Qiang 
Published: January 2019

Abstract
Regarding subject librarian services for clinical studies, researchers outside China have been focusing on subject service performance, evidence-based medicine, and comprehensive consulting services. In contrast, Chinese researchers have concentrated on service systems and methods but have not established mature systems and methods for clinical surgery-oriented services. Therefore, subject librarians in medical schools should become involved in clinical research and expand their perspective on medical library research. In addition, they should collaborate with clinicians to improve the overall level of research in hospitals while increasing the impact of subject librarian services in medical colleges and schools.
Construction of an ontology-based nursing knowledge system
Authors: Han Shi-Fan , Zhu Rui-Fang , Xue Jia , Yu Qi , Su Yan-Bing , Wang Xiu-Juan 
Published: January 2019

Abstract
This study proposes the establishment of a knowledge-system ontology in the nursing field. It uses advanced data mining techniques, digital publishing technologies, and new media concepts to comprehensively integrate and deepen nursing knowledge and to aggregate sources of knowledge in specialized technical fields. This study applies all forms of media and transmission channels, such as personal computers and mobile devices, to establish a knowledge-transmission system that provides knowledge services such as knowledge search, update retrieval, evaluation, questions and answers (Q&As), online viewing, information subscription, expert services, push notifications, review forums, and online learning. In doing so, this study creates an authoritative and foundational knowledge service engine for the nursing field, which provides convenient, flexible, and comprehensive knowledge services to members of the nursing industry in a digital format.
Development of an accurate nursing program based on function in chronic venous leg ulcers: protocol for matching function status with nursing interventions using the Delphi survey
Authors: Tang Yi-Fan , Hu Xin-Yu , Zhao Jing , Gu Ze-Juan , Xing Shuang-Shuang , Wang Wei-Yun 
Published: January 2019

Abstract

Objective
Venous leg ulceration (VLU) is one of the complications of lower extremity venous reflux and reflux disorder of severe diseases, with many adverse effects on patient’s work and life. Nowadays, more and more patients with VLU accept wound care in community setting. Clinical nurses generally take care of the patients based on their own experiences. Healing in VLU is an incredibly complex process, which puzzles even experts. The majority of general nurses do not have this level of expertise, especially those nurses serving in community. Function is the basis of nursing activities. Patients always show different clinical manifestations and self-care abilities due to various function states, which cannot be reflected completely by the existing nursing practice. How to describe nursing practice standardized in order to demonstrate the effectiveness of interventions and facilitate interdisciplinary communication is another urgent problem. Therefore, the aim of this project is to develop an accurate nursing program based on function in chronic venous leg ulcers, which can both satisfy the needs of patients and promote nursing revolution.

Methods
This study will use International Classification of Functioning Disability and Health as a framework to choose suitable functions and to filter function classification standards of chronic venous leg ulcers through evidence-based systematic research. Nursing interventions related to VLU are selected based on Nursing Interventions Classification, adding other nursing activities by methods of evidence-based systematic review and clinical observation. Then, nursing interventions and function status are matched through steering committee. Finally, the Delphi survey method is adopted to make nursing program native and scientific.

Conclusions
This study is expected to be very significant and meaningful in using standardized nursing terminology. The nursing program established could better meet the needs of both patients with chronic venous leg ulcers and clinical nurses, promoting the development of wound specialist and standardized nursing language.