bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cultural health literacy: the experiences of Māori in palliative care
Authors: Kidd Jacquie , Black Stella , Blundell Rawiri , Peni Tamati 
Published: May 2018

Abstract: Health literacy is a concept that is frequently applied to the patient’s ability to find and comprehend health information. However, recent literature has included the skill of the health professional and the accessibility of health resources as important factors in the level of health literacy achieved by individuals and populations. In 2014 a qualitative study undertaken in Aotearoa New Zealand, investigated the context of health literacy for Māori in a palliative care setting (Māori are the indigenous people of Aotearoa New Zealand). The study included the experiences of patients, whānau (families), and health professionals. Method: Individual semi-structured interviews were held with 21 patients, whānau and six key informants: a medical specialist, a service leader involved in developing culturally specific responses to patients, two Māori service managers, and two Māori health team leaders. Focus groups were held with a total of 54 health professionals providing palliative care services. Data analysis: A thematic analysis was undertaken using a general inductive approach. The trustworthiness and reliability of the analysis was supported by sharing analysis of the transcripts among the research team. Member checking or respondent validation was used in seeking confirmation of the interim findings at five hui (meetings) with the research communities involved. Findings: This study found that the shock and grief that attends a life-limiting illness made hearing and processing health information very difficult for patients and whānau. Further, ‘hard conversations’ about moving from active treatment to palliative care were often avoided by health professionals, leaving patients and whānau distressed and confused about their choices and prognosis. Finally, poor cultural health literacy on the part of organisations has likely impacted on late access to or avoidance of palliative care for Māori.
Asymétrie de pouvoir dans les partenariats de recherche en santé mondiale : étude qualitative auprès de chercheurs en Côte d’Ivoire
Authors: Gogognon Patrick , Godard Béatrice 
Published: May 2018

Résumé : Contexte : L’asymétrie de pouvoir dans les partenariats de recherche en santé mondiale constitue un enjeu de justice et d’équité pour les institutions de recherche, les chercheurs et les communautés, en particulier dans les pays en développement. Pour les chercheurs, l’asymétrie de pouvoir peut constituer un obstacle pour une recherche efficiente et équitable et ils sont à risque d’être en situation de vulnérabilité. Objectifs : Ces enjeux sont largement discutés dans la littérature mais ce phénomène reste encore étudié au plan théorique et peu de données empiriques sont disponibles, particulièrement dans les pays en développement. Cette étude a donc pour objectifs d’identifier les facteurs et les mécanismes de l’asymétrie de pouvoir en recherche en santé mondiale dans la perspective de chercheurs dans un pays du sud. Méthodologie : Une étude qualitative a été menée auprès de 19 chercheurs dans le domaine de la santé en Côte d’Ivoire. Tous les participants poursuivaient une carrière universitaire d’enseignement et recherche, dont 17 cliniciens en Centre Hospitalier Universitaire et 2 chercheurs non cliniciens. Des entrevues semi-dirigées ont été réalisées pour évaluer leur perception sur les facteurs qui influencent l’asymétrie de pouvoir et les mécanismes par lesquels ils opèrent. Résultats : Deux thèmes principaux émergent de l’analyse des données : les défis du financement et la complexité des relations interpersonnelles dans les partenariats. Discussion : Cette étude montre que la pression sur l’accès aux ressources contribue à détériorer les conditions dans lesquelles les partenariats sont mis en œuvre. Par ailleurs, l’environnement institutionnel de la recherche montre des liens de subordination qui font peser des risques sur l’autonomie des jeunes chercheurs et l’intégrité de leurs travaux. À cet égard nous recommandons une analyse approfondie de l’environnement dans lequel ces partenariats sont mis en œuvre notamment sur les dimensions de reddition de comptes, d’imputabilité et d’intégrité professionnelle.
Determinants and prognosis of high-sensitivity cardiac troponin T peak plasma concentration in patients hospitalized for non-cardiogenic shock
Authors: Caujolle Marie , Allyn Jerome , Brulliard Caroline , Valance Dorothée , Vandroux David , Martinet Olivier , Allou Nicolas 
Published: May 2018

Purpose: The aim of this study was to assess the determinants and prognostic value of high-sensitivity cardiac troponin T peak plasma concentration in intensive care unit patients with non-cardiogenic shock. Material and methods: A prospective observational cohort study was conducted in a single intensive care unit between November 2014 and December 2015. Results: During the study period, 206 patients were hospitalized in the intensive care unit for non-cardiogenic shock and the median peak high-sensitivity cardiac troponin T was 55.1 [24.5–136] pg/mL. A multivariate analysis combining all variables showed that higher body mass index ( t = 2.52, P = 0.01), lower left ventricular systolic function ( t = −2.73, P = 0.007), higher white blood cell count ( t = 3.72, P = 0.0001), lower creatinine clearance ( t = −2.84, P = 0.0005), higher lactate level ( t = 2.62, P = 0.01) and ST-segment depression ( t = 3.98, P = 0.0001) best correlated with log10-transformed high-sensitivity cardiac troponin T peak plasma concentration. After multivariate analysis, the high-sensitivity cardiac troponin T peak was not associated with a significant reduction of in-hospital mortality (adjusted odds ratio = 0.99 (95% confidence interval: 0.93–1.02)). Conclusion: High-sensitivity cardiac troponin T elevation was very common in patients hospitalized for non-cardiogenic shock. The factors significantly associated with high-sensitivity cardiac troponin T peak plasma concentration were higher body mass index, decreased left ventricular systolic ejection fraction, higher leucocyte count, decreased renal function, increased lactate level, and ST-segment depression. The high-sensitivity cardiac troponin T peak was not significantly associated with in-hospital mortality in this setting.
Age and Other Risk Factors Influencing Long-Term Mortality in Patients With Traumatic Cervical Spine Fracture
Authors: Bank Matthew , Gibbs Katie , Sison Cristina , Kutub Nawshin , Papatheodorou Angelos , Lee Samuel , Stein Adam , Bloom Ona 
Published: May 2018

Objective: To identify clinical or demographic variables that influence long-term mortality, as well as in-hospital mortality, with a particular focus on the effects of age. Summary and Background Data: Cervical spine fractures with or without spinal cord injury (SCI) disproportionately impact the elderly who constitute an increasing percentage of the US population. Methods: We analyzed data collected for 10 years at a state-designated level I trauma center to identify variables that influenced in-hospital and long-term mortality among elderly patients with traumatic cervical spine fracture with or without SCI. Acute in-hospital mortality was determined from hospital records and long-term mortality within the study period (2003-2013) was determined from the National Death Index. Univariate and multivariate regression analyses were used to identify factors influencing survival. Results: Data from patients (N = 632) with cervical spine fractures were analyzed, the majority (66%) of whom were geriatric (older than age 64). Most patients (62%) had a mild/moderate injury severity score (ISS; median, interquartile range: 6, 5). Patients with SCI had significantly longer lengths of stay (14.1 days), days on a ventilator (3.5 days), and higher ISS (14.9) than patients without SCI ( P < .0001 for all). Falls were the leading mechanism of injury for patients older than age 64. Univariate analysis identified that long-term survival decreased significantly for all patients older than age 65 (hazard ratio [HR]: 1.07; P < .0001). Multivariate analysis demonstrated age (HR: 1.08; P < .0001), gender (HR: 1.60; P < .0007), and SCI status (HR: 1.45, P < .02) significantly influenced survival during the study period. Conclusion: This study identified age, gender, and SCI status as significant variables for this study population influencing long-term survival among patients with cervical spine fractures. Our results support the growing notion that cervical spine injuries in geriatric patients with trauma may warrant additional research.
Oxidative modifications of extracellular matrix promote the second wave of inflammation via β2 integrins
Authors: Yakubenko Valentin P. , Cui Kui , Ardell Christopher L. , Brown Kathleen E. , West Xiaoxia Z. , Gao Detao , Stefl Samantha , Salomon Robert G. , Podrez Eugene A. , Byzova Tatiana V. 
Published: May 2018

Key PointsRecruitment of neutrophils generates phospholipid oxidation and formation of CEP adducts with extracellular matrix proteins. CEP–protein adducts form inflammatory-specific substrate for αMβ2 and αDβ2 integrin-mediated macrophage migration during inflammation.
How I safely transfuse patients with sickle-cell disease and manage delayed hemolytic transfusion reactions
Authors: Pirenne France , Yazdanbakhsh Karina 
Published: May 2018

AbstractTransfusions can be a life-saving treatment of patients with sickle-cell disease (SCD). However, availability of matched units can be limiting because of distinctive blood group polymorphisms in patients of African descent. Development of antibodies against the transfused red blood cells (RBCs), resulting in delayed hemolytic transfusion reactions (DHTRs), can be life-threatening and pose unique challenges for this population with regard to treatment strategies and transfusion management protocols. In cases where the transfused cells and the patient’s own RBCs are destroyed, diagnosis of DHTR can be difficult because symptoms may mimic vaso-occlusive crisis, and frequently, antibodies are undetectable. Guidelines are needed for early diagnosis of DHTR because treatment may need to include temporarily withholding any new transfusions to avoid further hemolysis. Also needed are case-control studies to optimally tailor treatments based on the severity of DHTR and develop preventive transfusion strategies for patients at DHTR risk. Here, we will review gaps in knowledge and describe through case studies our recommended approach to prevent alloimmunization and to diagnose and treat symptomatic DHTRs for which complementary mechanistic studies to understand their pathogenesis are sorely needed.
African-American race and mortality in interstitial lung disease: a multicentre propensity-matched analysis
Authors: Adegunsoye Ayodeji , Oldham Justin M. , Bellam Shashi K. , Chung Jonathan H. , Chung Paul A. , Biblowitz Kathleen M. , Montner Steven , Lee Cathryn , Hsu Scully , Husain Aliya N. , Vij Rekha , Mutlu Gokhan , Noth Imre , Churpek Matthew M. , Strek Mary E. 
Published: May 2018

We studied whether African-American race is associated with younger age and decreased survival time at diagnosis of interstitial lung disease (ILD).We performed a multicentre, propensity score-matched analysis of patients with an ILD diagnosis followed at five US hospitals between 2006 and 2016. African-Americans were matched with patients of other races based on a time-dependent propensity score calculated from multiple patient, physiological, diagnostic and hospital characteristics. Multivariable logistic regression models were used. All-cause mortality and hospitalisations were compared between race-stratified patient cohorts with ILD, and sensitivity analyses were performed.The study included 1640 patients with ILD, 13% of whom were African-American, followed over 5041 person-years. When compared with patients of other races, African-Americans with ILD were younger at diagnosis (56 yearsversus67 years), but in the propensity-matched analyses had greater survival (hazard ratio 0.46, 95% CI 0.28–0.77; p=0.003) despite similar risk of respiratory hospitalisations (relative risk 1.04, 95% CI 0.83–1.31; p=0.709), and similar GAP-ILD (gender–age–physiology-ILD) scores at study entry. Sensitivity analyses in a separate cohort of 9503 patients with code-based ILD diagnosis demonstrated a similar association of baseline demographic characteristics with all-cause mortality.We conclude that African-Americans demonstrate a unique phenotype associated with younger age at ILD diagnosis and perhaps longer survival time.
Pressures from long term environmental change at the shrines and temples of Nikkō
Authors: Brimblecombe Peter , Hayashi Mikiko 
Published: May 2018

Abstract

Background
Important historic buildings at Nikkō are designated National Treasures of Japan or important cultural properties and illustrate notable architectural styles. We examine the records of damaging events and environmental change to estimate that changing balance of threats to guiding strategic planning and protection of the buildings and associated intangible heritage.

Methods
Historic records from Nikkō allow past damage to be assessed along with projections of likely future threats. Simple non parametric statistics, Lorenz curves and its associated Gini coefficient aids interpretation of observations.

Results
Earthquakes have long represented a threat, but mostly to fixed stone structures. Flooding may be as growing problem, but historically river management has improved. Increasing warmth may mean an increase in the threat of fungal attack. However, insect attack on wood has been a particular problem as recent years have seen damage by wood boring insects, particularly at Sanbutsudō in the temple complex of Rinnō-ji. Although warmer climates may enhance the abundance of insects such as P. cylindricum the life cycle of this rare anobiid is not well understood. The risk of forest fires tends to be higher in drought period, but summer rainfall may well increase at Nikkō. Additionally good forestry practice can reduce this risk. Future changes to climate are likely to alter the flowering dates and the arrival of autumn colours.

Conclusion
The results show that environmental changes are likely to affect the material structure and also the nature of celebrations and visitor frequency at Nikkō. Conservation architects and skilled engineers will be challenged by these changes, so need to be well briefed on strategic environmental threats.
The Missing Dimension in Developmental Biology Education
Authors: Hardin Jeff 
Published: May 2018

Note from the Editor Points of View (POV) address issues faced by many people within the life science education community. CBE—Life Sciences Education (CBE-LSE) publishes the POV Feature to present two or more opinions published side-by-side on a common topic. We consider POVs to be “Op-Ed” pieces designed to stimulate thought and dialogue on significant educational issues. They are not meant to be exhaustive treatments of a subject. In this issue, we ask the question, “What are key concepts in developmental biology?” We present three POVs. The first is by CBE-LSE Editor-in-Chief, William Wood, and it is in part based on his experience teaching developmental biology to undergraduates at the University of Colorado, Boulder, including his collaborative experiments in the classroom with Jennifer Knight, the first results of which have been published in CBE-LSE ( Knight and Wood, 2005 ). The second, a partially tongue-in-cheek list of key concepts to convey to students about embryonic development, is by Scott Gilbert (Swarthmore College), author of the leading textbook worldwide for teaching developmental biology, Developmental Biology, 8th ed. (Sinauer Associates, Inc.). The third is by Jeff Hardin (University of Wisconsin–Madison), who has produced Web-based educational materials for teaching developmental biology that are used nationally and internationally for conveying dynamic events during early development (see the WWW feature in this issue by Stark for more details), and who deals with the vexing problem of trying to convey the essential four-dimensional nature of embryonic development to introductory students.
Evidence From Ghana Indicates That Childhood Cancer Treatment in Sub-Saharan Africa Is Very Cost Effective: A Report From the Childhood Cancer 2030 Network
Authors: Renner Lorna , Shah Shivani , Bhakta Nickhill , Denburg Avram , Horton Sue , Gupta Sumit 
Published: May 2018

Purpose No published study to date has examined total cost and cost-effectiveness of maintaining a pediatric oncology treatment center in an African setting, thus limiting childhood cancer advocacy and policy efforts. Methods Within the Korle Bu Teaching Hospital in Accra, Ghana, costing data were gathered for all inputs related to operating a pediatric cancer unit. Cost and volume data for relevant clinical services (eg, laboratory, pathology, medications) were obtained retrospectively or prospectively. Salaries were determined and multiplied by proportion of time dedicated toward pediatric patients with cancer. Costs associated with inpatient bed use, outpatient clinic use, administrative fees, and overhead were estimated. Costs were summed for a total annual operating cost. Cost-effectiveness was calculated based on annual patients with newly diagnosed disease, survival rates, and life expectancy. Results The Korle Bu Teaching Hospital pediatric cancer unit treats on average 170 new diagnoses annually. Total operating cost was $1.7 million/y. Personnel salaries and operating room costs were the most expensive inputs, contributing 45% and 21% of total costs. Together, medications, imaging, radiation, and pathology services accounted for 7%. The cost per disability-adjusted life-year averted was $1,034, less than the Ghanaian per capita income, and thus considered very cost effective as per WHO-CHOICE methodology. Conclusion To our knowledge, this study is the first to examine institution-level costs and cost-effectiveness of a childhood cancer program in an African setting, demonstrating that operating such a program in this setting is very cost effective. These results will inform national childhood cancer strategies in Africa and other low- and middle-income country settings.
Micropatterning as a tool to identify regulatory triggers and kinetics of actin-mediated endothelial mechanosensing
Authors: Gegenfurtner Florian A. , Jahn Berenice , Wagner Helga , Ziegenhain Christoph , Enard Wolfgang , Geistlinger Ludwig , Rädler Joachim O. , Vollmar Angelika M. , Zahler Stefan 
Published: May 2018

ABSTRACT
Developmental processes, such as angiogenesis, are associated with a constant remodeling of the actin cytoskeleton in response to different mechanical stimuli. The mechanosensitive transcription factors MRTF-A (MKL1) and YAP (also known as YAP1) are important mediators of this challenging adaptation process. However, it is as yet unknown whether both pathways respond in an identical or in a divergent manner to a given microenvironmental guidance cue. Here, we use a micropatterning approach to dissect single aspects of cellular behavior in a spatiotemporally controllable setting. Using the exemplary process of angiogenesis, we show that cell–cell contacts and adhesive surface area are shared regulatory parameters of MRTF and YAP on rigid 2D surfaces. By analyzing MRTF and YAP under laminar flow conditions and during cell migration on dumbbell-shaped microstructures, we demonstrate that they exhibit different translocation kinetics. In conclusion, our work promotes the application of micropatterning techniques as a cell biological tool to study mechanosensitive signaling in the context of angiogenesis.
A reforma do Poder Judiciário
Authors: Rocha Cármen Lúcia Antunes 
Published: May 2018

Introdução; 1 - A Constituição cidadã talhada, retalhada e retaliada; 2 - A Constituição e o Poder Judiciário; 3 - O Poder Judiciário e a Democracia; 4 - O Poder Judiciário e a Cidadania; Conclusão.
Segurança Nacional e Segurança Pública na Constituição e 1988
Authors: Lazzarini Álvaro 
Published: May 2018

1. Considerações iniciais. 2. Segurança Nacional e Segurança Pública na Constituição da República. 3. Responsabilidade de cada um dos Poderes da República na defesa do Estado de Direito. 4. Segurança Pública e o aperfeiçoamento da Polícia no Brasil. 5. Conclusão.
Auditor do Tribunal de Contas - Concurso público - Dispensa
Authors: Nóbrega Haroldo Ferraz da 
Published: May 2018

- Inconstitucionalidade do art. 79, "caput" e incisos I a IV, da Constituição do Estado de Minas Gerais, que dispensam o concurso público de provas ou de provas e títulos, para a investidura no cargo de Auditor do Tribunal de Contas do Estado. Ofensa ao art. 37, I, da Constituição Federal.- Inconstitucionalidade da expressão, "os mesmos direitos ", inscrita na primeira parte do § 1º do art. 79 da Constituição de Minas. No ponto, dispositivo da Constituição mineira realiza equiparação não permitida pelo § 4º do art. 73 da Constituição Federal. A mesma expressão, "os mesmos direitos ", inscrita na segunda parte do § 1º. do art. 79, não é inconstitucional.- Constitucionalidade do § 2º do art. 79 da Constituição de Minas. Voto vencido do Relator no sentido da inconstitucionalidade, por entender que o citado dispositivo faz exigência não contida no § 4º do art. 733 da Constituição Federal, com ofensa ao art. 40, desta.- Ação direta de inconstitucionalidade julgada procedente, em parte.
Estação ecológica - Propriedade privada - Indenização
Authors: Fonseca Bardia Tupy Vieira 
Published: May 2018

- A criação da Estação Ecológica da Juréia-Itatins, impedindo a exploração de recursos naturais existentes nas áreas por ela abrangidas (Lei n. 6.902, de 1981, art. 7º, § 1º, "b"), implica a indenização das respectivas propriedades, tenha ou não o Estado de São Paulo se apossado fisicamente dos imóveis; situação jurídica que, por si só, mutila a propriedade. Recurso especial não conhecido.
Coordenação gerencial na Administração Pública
Authors: Moreira Neto Diogo de Figueiredo 
Published: May 2018

1. O Estado em mudança. 2. Ressurgimento da sociedade como elemento político. 3.0 foco administrativo no cidadão. 4. As características de ética e eficiência. 5. Experiências contemporâneas de modernização da administração pública. 6. A coordenação gerencial na administração pública. 7. A cooperação gerencial na administração pública. 8. A colaboração gerencial na administração pública. 9. Considerações finais sobre a administração consensual.
Reforma Administrativa (Primeiras impressões)
Authors: Bulos Uadi Lammêgo 
Published: May 2018

1. Administração Pública na reforma administrativa (EC n.19/98) - 2. Motivos determinantes da Reforma administrativa - 3. Linhas gerais da Reforma Administrativa - 4. Reforma administrativa e modelo gerencial de Administração Pública - 5. O insucesso das reformas administrativas - 5.1 Supervalorização do elemento institucional - 5.2 Mentalidade dos destinatários dos preceitos constitucionais reformados- 5.3 Reforma da Constituição como saída para todos os males da Administração Pública - 6. Reforma administrativa, interpretação constitucional e a missão dos juristas - 7. Disposições transitórias da EC n.19/98 - 7.1 Prazo para as entidades da administração indireta revisarem seus estatutos - 7.2 Prazo para a elaboração de lei do usuário de serviços públicos - 7.3 Proibição de excessos das espécies remuneratórias e direito adquirido - 7.4 Prazo para apresentação do projeto de lei complementar - 7.5 Direitos, vantagens e proibições dos servidores - 7.6 Servidores da carreira policial militar e grau hierárquico - 7.7 Servidores civis e seu aproveitamento - 8. Dispositivos constitucionais reformulados.