bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using a pedigree-based questionnaire to improve efficiency in a general oncology genetics clinic.
Authors: Gulvin Joshua Michael , Pass Sarah , De Los Rios Patricia , Ma Hilary Y. , Rieber Alyssa G. 
Published: September 2018

66 Background: Genetic counseling has two major components – education and medical history. Our Lyndon B Johnson (LBJ) General Oncology Genetics Clinic includes a diverse patient (pt) group. The majority of pts do not speak English, requiring medical translation, which lengthens encounters. To improve efficiency, a pre-visit genetics questionnaire (GQ) was created to gather pt and family history. Methods: The GQ includes: breast-obstetric history, urologic history, colon history, dermatology, maternal and paternal family history. Between November 2, 2017 and May 10, 2018 pts were contacted before their encounter. The GQ was given to pts, who were encouraged to complete it in advance, return electronically, or bring to the visit. Encounter duration for pts was calculated based on their check in and check out time documented in Epic. A partially completed GQ is defined as leaving a major section blank, like paternal or maternal history. Results: 92 pts were seen in the LBJ Oncology Genetics Clinic. The overall compliance rate for a completed GQ was 37% (Table 1). 51% of the pts were non-English speaking. For pts who completed the GQ, the mean overall cycle time is 55 minutes, which is reduced on average 33.0% compared to those who did not complete the GQ. Encounter duration in minutes, and compliance rate. Conclusions: We demonstrate that using a pedigree-based GQ in an Oncology Genetics Clinic is feasible with non-English speaking pts and can reduce clinic cycle times up to 33%. The greatest reduction in cycle time occurred when a completed GQ was emailed to the clinic. Interestingly, non-English speaking patients had a shorter cycle time compared to English speaking patients, which could be explained by an approximately twice as high compliance rate in the non-English speaking patients, further supporting the association between GQ completion and cycle time reduction. To improve cycle time further, increasing overall compliance rate from 37% provides a future direction.[Table: see text]
Providing oncologic care with access to clinical trials to an underserved and minority population: The Mayo Clinic/Indian Health Service experience.
Authors: Northfelt Donald W. , Chamie Chara , Omar Farhia , Okamoto Janet , Mathews Timothy , Fitch Tom R. 
Published: September 2018

79 Background: Novel mechanisms are needed to provide high quality oncologic clinical care and clinical trial access to underserved and minority populations (UMP). UMP are underrepresented in cancer clinical trials, thus limiting the generalizability of the research. As a National Cancer Institute-Comprehensive Cancer Center, Mayo Clinic has the responsibility to ensure that its cancer care reaches a diverse patient population. Mayo Clinic in Arizona developed a clinical oncology practice in collaboration with the US Indian Health Service at Phoenix Indian Medical Center (PIMC), in part to address these needs. The relationship between Mayo and PIMC is invaluable and serves a crucial need in the community. The Mayo consultants serve as staff physicians in the “Oncology Center of Excellence” at PIMC and see 100 – 200 tribal members annually with new diagnoses of cancer or blood disorders. Being onsite at PIMC allows Mayo consultants to integrate seamlessly into the wider PIMC practice. Methods: Descriptive demographic data from the MCA-PIMC clinical practice were obtained from the PIMC practice database 2008 - 2017. Enrollment of MCA-PIMC patients into MCA cancer clinical trials were prospectively enumerated. Results: Between the time period of 2008-2017, 356 breast cancer patients and 259 colorectal cancer patients were seen by Mayo Clinic oncologists and the PIMC nurse practitioner. During the period of 2016-2017, there were 13 clinical trial referrals from PIMC with 8 of those patients being enrolled in Mayo cancer clinical trials. Conclusions: High quality oncologic clinical care can be provided via unique collaborations between academic oncology program and UMP-focused care provider. This mechanism allows access to cancer clinical trial opportunities for UMP. Prior to the established partnership, there were no Native American patients referred to clinical trials from PIMC, showing the critical pathway that has been forged. Importantly, this is the only known program of its kind in the country. By imbedding the cancer provider in the community, we are able to build trust with the underserved community and create a pathway to a quality care and clinical research.
Integrating mental health professionals into the care team to better recognize and manage delirium in hospitalized oncology patients.
Authors: Hooley Joseph , Ralston Laurel , Marcus Joel Daniel , Best Carolyn , Karius Diana , Koniarczyk Heather , Shepherd Corrine , Carrino Cheryl M , Poole Christa 
Published: September 2018

83 Background: Delirium is a common neuropsychiatric condition associated with increased morbidity and mortality, length of hospitalization, and distress. The prevalence of delirium in cancer ranges from 10% to 30% in hospitalized patients and up to 85% in terminally ill cancer patients. Rates of delirium on Cleveland Clinic’s inpatient oncology units were lower than expected. Our goal was to integrate mental health professionals into the care team to assist with better recognition and management of delirium. Methods: Education was developed for a range of caregivers, including physicians, nurses, and advanced practice providers. It was facilitated by a psychiatrist, psychologist, and clinical social workers, and included proper identification of both hyper- and hypoactive delirium through use of the Brief Confusion Assessment Method (bCAM) and use of a delirium order set to treat and manage patients identified as positive for delirium. An important component of this education included a proper assessment and comparison of patients’ current mental status compared to their true baseline prior to hospitalization. Additional integration directly into the care team included participation of the psychiatrist, psychologist, and clinical social workers into each team’s multidisciplinary rounds to facilitate discussions around delirium and its appropriate management, and separate targeted rounding which included one-to-one education with front-line caregivers. Results: During the first year of integration, substantial improvements were noted. The percentage of patients identified as positive for delirium through bCAM screening increased from 3.4% to 15.8% after 12 months, and utilization of the delirium order set increased from 11.1% to 58.3%. Additionally, the average nursing unit length of stay (LOS) for delirium-positive patients decreased by more than 2 days compared to baseline. Conclusions: Integration of mental health providers into the care team to assist with recognizing and managing patients with delirium and to provide direct education to front-line caregivers has helped to rapidly improve delirium identification and management for oncology inpatients.
Cost of care for patients with metastatic castration-resistant prostate cancer initiating on docetaxel versus oral targeted therapies in the United States.
Authors: Wu Bingcao , Li Sophia , Tunceli Ozgur , Song Ji , Pericone Chris , Ding Zhijie , Behl Ajay S. , Srivastava Ayush , Dawson Nancy Ann 
Published: September 2018

88 Background: Abiraterone acetate + prednisone and enzalutamide are approved oral targeted therapies (OTT) for metastatic castration-resistant prostate cancer (mCRPC) which have significant clinical benefit. However, their impact on healthcare cost relative to docetaxel (DOC) is not well understood. Methods: This retrospective cohort study used combined claims data from Truven MarketScan Commercial and Medicare Supplement Plan databases. Males ≥18 years with ≥1 prostate cancer diagnosis and a subsequent metastasis diagnosis were indexed on the first claim date of DOC or OTT between 1/1/2012 and 12/31/2016. ≥1 claim for an androgen deprivation therapy during the 12-month continuous enrollment period prior to metastasis was required; patients with end stage renal disease or other primary cancer were excluded. All-cause per patient per year (PPPY) costs were estimated in 2016 US dollars. A generalized linear model was used to compare adjusted costs between DOC and OTT cohorts. Results: A total of 1,159 and 200 mCRPC patients initiated on OTT and DOC, respectively. Mean follow up time for both cohorts was 1.2 years. Mean age of OTT patients was 75.1 (Standard Deviation = 10.7) years and mean Quan-Charlson Comorbidity Index (QCI) was 3.2 (1.9). Mean age of DOC patients was 65.9 (9.1) years; mean QCI was 2.9 (1.8). 21% of OTT and 56% of DOC patients were commercially insured. Following treatment initiation, total mean unadjusted all-cause PPPY costs were $144,350 ($80,606) and $137,814 ($84,405) for OTT and DOC cohort, respectively. The primary cost drivers were utilization of treatments indicated for mCRPC, outpatient encounters and inpatient hospitalizations. Total adjusted PPPY costs were higher for OTT than DOC patients ($141,008 vs. $125,318, p = 0.0012), mainly due to higher costs of treatments indicated for mCRPC ($80,443 vs. $55,820, p < .0001). Medical costs (excluding mCRPC treatment) for OTT initiated patients were lower ($54,570 vs. $64,614, p = 0.0128). Conclusions: In a real-world setting, initiation on OTT was associated with higher overall cost of care for mCRPC compared with DOC. However, the cost of medical services was significantly lower when initiated on OTT.
Inclusion of health-related quality-of-life data in oncology drug reimbursement submissions in Canada: A review of submissions to the pan-Canadian Oncology Drug Review.
Authors: Raymakers Adam JN , Regier Dean , Peacock Stuart 
Published: September 2018

94 Background: For health technologies, and cancer treatments specifically, economic evaluation is often used to assess the value of new treatments. The preferred approach to economic evaluation is often cost-utility analysis (CUA). In CUA, incremental costs and benefits of a new treatment and a standard of care are calculated with benefits quantified using the quality-adjusted life-year (QALY); the QALY attempts to account for the quantity and quality of life (using a utility weight). The utility weight often comes from a generic, preference-based measure of health-related quality of life (HRQoL), such as the 5-dimension EuroQol measure (EQ-5D). Many submissions for reimbursement by manufacturers, and indeed many clinical trials, still do not include HRQoL data which may result in lower quality submissions and thus, sub-optimal decisions. Methods: We reviewed submissions to the pan-Canadian Oncology Drug Review (pCODR), the body charged with making reimbursement recommendations in Canada. We reviewed submissions from those first recorded (August 2012) to the present (June 2018). Only submissions that were completed (status listed as 'Notification to Implement Issued') were included. Upon completion, three documents are produced by pCODR: the final recommendation from the pCODR Expert Review Committee, the final clinical guidance report, and the final economic guidance report. All three documents were searched for how HRQoL was incorporated into the economic evaluation. Results: In total, 135 submissions were made to pCODR over the period. Of these, 107 (79.3%) had been completed and met the criteria for inclusion. In most studies, the incremental gain in QALYs from the new technology was small (in 2017 submissions the mean QALY gain was 1.1 QALYs). In addition, few studies reported an original measure of HRQoL, with most citing previously completed studies of variable relevance and quality. Conclusions: Our results indicate that manufacturers should improve the collection of HRQoL data of patients alongside clinical trials. This would enhance the focus on patients and improve decision-making around reimbursement of treatments.
Reduced Insulin Receptor Expression and Altered DNA Methylation in Fat Tissues and Blood of Women With GDM and Offspring
Authors: Ott Raffael , Melchior Kerstin , Stupin Jens H , Ziska Thomas , Schellong Karen , Henrich Wolfgang , Rancourt Rebecca C , Plagemann Andreas 
Published: September 2018

AbstractContextAltered expression of the insulin receptor (IR) in adipose tissue (AT) could contribute to gestational diabetes mellitus (GDM) etiopathogenesis. Transcriptional regulation via epigenetic mechanisms (e.g., DNA methylation) may play a critical role. However, the human IR promoter DNA methylation patterns and involvement in gene expression are unknown.ObjectiveWe evaluated IR mRNA and protein expression accompanied by targeted DNA methylation analyses in AT and blood cells of women with GDM and their offspring.DesignProspective observational study.SettingAcademic clinic and research unit.ParticipantsGDM-affected (n = 25) and matched control (n = 30) mother-child dyads.Main Outcome MeasuresMaternal IR gene and protein expression in paired subcutaneous (SAT) and visceral adipose tissue samples (VAT). DNA methylation levels in IR promoter and intronic regions in maternal AT and blood cells of mother-offspring pairs.ResultsIn SAT and VAT, IR mRNA/protein expressions were significantly reduced in women with GDMs (P &lt; 0.05). The decrease in VAT was more pronounced and independent of maternal body mass index. VAT IR protein levels were inversely associated with key maternal and neonatal anthropometric and metabolic parameters (P &lt; 0.05). DNA methylation patterns were similar across tissues, with significant yet small size alterations between groups in mothers and offspring (P &lt; 0.05).ConclusionDecreased IR levels in AT may be a relevant pathogenic factor in GDM, affecting materno-fetal metabolism. Further investigation of causal factors for IR dysregulation is necessary, especially in VAT. Potential functional and/or clinical roles of altered DNA methylation also should be evaluated.
Attitudes toward French Women's Suffrage on the Eve of World War I
Authors: Chenut Helen 
Published: September 2018

Abstract
This article addresses the issue of elite male opinion in France toward women's suffrage on the eve of World War I. It is based on three poorly known sources from the years 1910–13—two published opinion surveys and the entries in an essay contest sponsored by the Académie des Sciences Morales et Politiques—revealing the attitudes of a sample of male social and political elites. Their opinions can be divided into three broad categories: those in favor, those firmly opposed, and those who expressed qualified support. Social conservatism with regard to change in general appeared to be an important element in male resistance. Those opposed or offering only qualified support adopted two major strands of reasoning: the reassertion of hierarchical sexual difference supported by nature, accompanied by the fear of sex warfare; and dissatisfaction with the existing form of “universal” manhood suffrage, leading to a call for electoral reform that would take precedence over any change in women's political status. But a surprising number also appeared uncertain, even ambivalent or ignorant, about the goals of the suffrage movement.
Cet article interroge les opinions des hommes éminents en France sur le suffrage féminin à la veille de la Grande Guerre. L'étude examine trois sources peu connues—deux sondages d'opinion et dix soumissions dans un concours d'essais organisé par l'Académie des sciences morales et politiques—qui forment un échantillon des sentiments des élites sociales et politiques. Il en sort trois catégories principales de l'opinion : les hommes qui soutenaient l'égalité des sexes et les droits politiques des femmes ; ceux qui se montraient résolument contre le suffrage des femmes ; et ceux qui exprimaient leur confusion, ambiguïté, ou encore, ignorance sur la question posée. En fait, on retrouve dans la résistance masculine un conservatisme à l'égard de tout changement social. Les adversaires et ceux qui ont exprimé un soutien limité ont adopté deux types de raisonnement : l'affirmation de la hiérarchie de la différence sexuelle, associée à la peur de la guerre des sexes ; et le mécontentement à l'égard du suffrage « universel » masculin avec la demande de réformer le système électoral avant d'aborder les droits politiques des femmes.
A newly discovered neural stem cell population is generated by the optic lobe neuroepithelium during embryogenesis in Drosophila melanogaster
Authors: Hakes Anna E. , Otsuki Leo , Brand Andrea H. 
Published: September 2018

ABSTRACT
Neural stem cells must balance symmetric and asymmetric cell divisions to generate a functioning brain of the correct size. In both the developing Drosophila visual system and mammalian cerebral cortex, symmetrically dividing neuroepithelial cells transform gradually into asymmetrically dividing progenitors that generate neurons and glia. As a result, it has been widely accepted that stem cells in these tissues switch from a symmetric, expansive phase of cell divisions to a later neurogenic phase of cell divisions. In the Drosophila optic lobe, this switch is thought to occur during larval development. However, we have found that neuroepithelial cells start to produce neuroblasts during embryonic development, demonstrating a much earlier role for neuroblasts in the developing visual system. These neuroblasts undergo neurogenic divisions, enter quiescence and are retained post-embryonically, together with neuroepithelial cells. Later in development, neuroepithelial cells undergo further cell divisions before transforming into larval neuroblasts. Our results demonstrate that the optic lobe neuroepithelium gives rise to neurons and glia over 60 h earlier than was thought previously.
San Diego pelvic osteotomy in patients with closed triradiate cartilage
Authors: Murar J. , Dias L. S. , Swaroop V. T. 
Published: September 2018

Purpose A San Diego pelvic osteotomy is frequently used as part of the surgical treatment of neuromuscular patients with hip displacement. This short-term follow-up study assesses the effectiveness of this osteotomy in patients with closed triradiate cartilage compared with open triradiates. Methods Retrospective review of 43 patients (44 hips) with neuromuscular hip disease who underwent a San Diego pelvic osteotomy to correct hip displacement. In all 24 hips had open triradiate cartilage at the time of surgery and 20 hips were closed. Centre edge angle (CEA), acetabular angle (AA) and Reimer's index (RI) were recorded from preoperative, postoperative and the latest follow-up radiographs and statistical analysis was performed. Results CEA improved by 39° (7° to 69°) in the open group and 30° (9° to 80°) in the closed group from preoperative radiographs to postoperative, with no significant difference in improvement between groups (p = 0.084). There was no significant difference in AA between the open (improved by 11° (3° to 23°)) and closed (improved by 10° (4° to 21°)) groups (p = 0.65). RI improved from 61% to 11% in the open group and 51% to 12% in the closed group. There was no statistically significant difference between groups in RI at preoperative, immediate postoperative and final follow-up radiographs. At latest follow-up, CEA, AA and RI all remained relatively stable in both groups. Conclusions San Diego pelvic osteotomy is equally effective in improving radiographic parameters in neuromuscular patients with both open and closed triradiate cartilage. This study challenges the notion that closed triradiate cartilage is a contraindication to a San Diego pelvic osteotomy. Level of Evidence III
Materiales para una introducción al cine:
Authors: Beceyro Raúl 
Published: September 2018

En el Taller de Cine UNL, como introducción al fenómeno cinematográfico, se exhiben tres películas a sus alumnos: El Ciudadano, de Orson Welles,If... de Lindsay Anderson y Detrás de los olivos, de Abbas Kiarostami. Estos tres films se analizan en clase y los materiales que se utilizan son los que a continuación se presentan.
Aplicação de gráficos de Controle Estatístico de Processos para o monitoramento dos casos de meningite no município de Joinville
Authors: Henning Elisa , Formigoni Carvalho Walter Olga Maria , Alves Custodio Da Cunha , Samohyl Robert Wayne 
Published: September 2018

O monitoramento e controle de epidemias permitem melhor atuação das autoridades sanitárias e a criação de políticas preventivas visando assegurar a saúde da população. A aplicação de gráficos de Controle Estatístico de Processos na saúde pública tem tido uma evolução crescente nos últimos anos. Este artigo tem por objetivo investigar e analisar a aplicação de gráficos de controle para medidas individuais no monitoramento das notificações dos casos de meningite no município de Joinville/SC. Além do gráfico de Shewhart popular pela sua simplicidade, são analisadas também as aplicações de um gráfico do tipo Shewhart modificado, um gráfico de Somas Acumuladas (CUSUM) e para finalizar o de Média Móvel Exponencialmente Ponderada (EWMA). Os dados analisados correspondem às notificações mensais no período entre janeiro de 2008 a dezembro de 2011 e tem origem no Sistema de Informação de Agravos de Notificação (SINAN). Todos os gráficos de controle utilizados mostraram-se viáveis para o monitoramento dos dados. O gráfico de controle do tipo Shewhart sinalizou pontualmente os meses de agosto e novembro de 2010 com maior quantidade de ocorrências. No mesmo ano, os gráficos CUSUM e EWMA indicaram tendência de aumento nos casos de meningite a partir de agosto. Em 2011 também ocorreu do aumento nos casos acontecer, principalmente no final no segundo semestre.