bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peoples’ Experiences With Pouches (PEWP) Study: Ostomate–Provider Interactions
Authors: Miller Leslie Riggle , Peck B Mitchell 
Published: July 2019

Background: Minimal research focuses on interactions between providers and new ostomy patients. Studies show that provider communication is important for patient health outcomes. Objective: The purpose of this study was to investigate ostomy patients’ perceptions of provider communication following surgery and whether interactions adequately prepare ostomy patients to care for their new appliance. Method: Using a nonprobability national sample of 381 ostomy patients, we conducted a retrospective quantitative study. We measured adequacy of provider communication from self-reports from ostomy patients. Results: The results show that almost half of the sample (49%) reported receiving inadequate communication from providers. We also found a relationship between ostomy patients’ educational level and their perceptions of receiving adequate communication. Notably, patients with lower educational attainment reported receiving adequate communication up to 4 times more than patients with higher educational attainment. Conclusion: Our results suggest that not only do ostomy patients need better communication from providers following their surgery but also patients with higher educational attainment appear to expect more information from providers than patients with lower educational attainment.
COO and MYC/BCL2 status do not predict outcome among patients with stage I/II DLBCL: a retrospective multicenter study
Authors: Barraclough Allison , Alzahrani Musa , Ettrup Marianne Schmidt , Bishton Mark , van Vliet Chris , Farinha Pedro , Gould Clare , Birch Simone , Sehn Laurie H. , Sovani Vishakha , Ward Mitchell Steven , Augustson Bradley , Biccler Jorne , Connors Joseph M. , Scott David W. , Gandhi Maher K. , Savage Kerry J. , El-Galaly Tarec , Villa Diego , Cheah Chan Yoon 
Published: July 2019

Abstract
In advanced-stage diffuse large B-cell lymphoma (DLBCL), the presence of an activated B-cell phenotype or a non–germinal center (GCB) phenotype, coexpression of MYC and BCL2 by immunohistochemistry, and the cooccurrence of MYC and BCL2 or BCL6 rearrangements are associated with inferior outcomes. It is unclear whether these variables remain prognostic in stage I/II patients. In this retrospective study, we evaluated the prognostic impact of cell of origin (COO), as well as dual-expressor (DE) status and molecular double-hit (DH) status, in stage I/II DLBCL by positron emission tomography with computed tomography (PET-CT). A total of 211 patients treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone)–like regimens, with or without radiotherapy, was included. The median follow-up in the entire cohort was 4 years (range, 0.4-9.4), with estimated 4-year progression-free survival (PFS) and overall survival (OS) rates of 85% (95% confidence interval [CI], 79-89) and 88% (95% CI, 83-92), respectively. By univariable analysis, DE (PFS: hazard ratio [HR], 1.27; 95% CI, 0.58-2.81, P = .55 and OS: HR, 1.40; 95% CI, 0.60-3.30; P = .44), DH (PFS: HR, 1.21; 95% CI, 0.27-5.31; P = .80 and OS: HR, 0.61; 95% CI, 0.08-4.73; P = .64), and non-GCB status (PFS: HR, 1.59; 95% CI, 0.83-3.03; P = .16 and OS: HR, 1.80; 95% CI, 0.89-3.67; P = .10) were associated with poorer outcomes. In patients with PET-CT–defined stage I/II DLBCL treated with R-CHOP–like therapy, with or without radiation, COO and DE and DH status were not significantly associated with inferior PFS or OS.
How long is (too) long?
Authors: Völlm Birgit 
Published: July 2019

SummaryForensic psychiatric services care for patients who present with a mental disorder as well as a risk to themselves or others, and have usually been convicted of an offence. Their needs are complex and the length of stay (LoS) in forensic settings is long. LoS is affected by patient factors as well as legal and policy issues. Owing to the considerable economic and ethical issues surrounding lengthy stays in highly restrictive settings, it is crucial that a strategy is developed for how to deal with this patient group.Declaration of interestNone.
Patient-Perceived Lack of Choice in Receipt of Radioactive Iodine for Treatment of Differentiated Thyroid Cancer
Authors: Wallner Lauren P. , Reyes-Gastelum David , Hamilton Ann S. , Ward Kevin C. , Hawley Sarah T. , Haymart Megan R. 
Published: July 2019

PURPOSE For many patients with differentiated thyroid cancer, use of radioactive iodine (RAI) does not improve survival or reduce recurrence risk. Yet there is wide variation in RAI use, emphasizing the importance of understanding patient perspectives regarding RAI decision making. PATIENTS AND METHODS All eligible patients diagnosed with thyroid cancer from 2014 to 2015 from the Georgia and Los Angeles SEER registries were surveyed (N = 2,632; response rate, 63%). Patients in whom selective RAI use is recommended were included in this analysis (n = 1,319). Patients were asked whether they felt like they had a choice to receive RAI (yes or no), how strongly their physician recommended RAI (5-point Likert-type scale), whether they received RAI (yes or no), and how satisfied they were with their RAI decision (more [score of 4 or greater] v less). Multivariable, weighted logistic regression with multiple imputation was used to assess the associations between patient characteristics and perception of no RAI choice and between perception of no RAI choice with receipt of RAI and decision satisfaction. RESULTS More than half of respondents (55.8%) perceived they did not have an RAI choice, and the majority of patients (75.9%) received RAI. The odds of perceiving no RAI choice was greater among those whose physician strongly recommended RAI (adjusted odds ratio [OR], 1.56; 95% CI, 1.13 to 2.17). Patients who perceived they did not have an RAI choice were more likely to receive RAI (adjusted OR, 2.50; 95% CI, 1.64 to 3.82) and report lower decision satisfaction (adjusted OR, 2.31; 95% CI, 1.67 to 3.20). CONCLUSION Many patients did not feel they had a choice about whether to receive RAI. Patients who perceived they did not have a choice were more likely to receive RAI and report lower decision satisfaction, suggesting a need for more shared decision making to reduce overtreatment.
Standardization of Education of Patients With Cancer in a Low- and Middle-Income Country: A Quality Improvement Project Using the Cancer and You Booklet
Authors: Habimana Olivier , Mukeshimana Vestine , Ahishakiye Albertine , Makuza Protais , Hategekimana Vedaste , Muhayimana Clemence , Dushimana Emmanuel , Shyirambere Cyprien , Haley Jennifer , Urusaro Sandra , Kennell-Heiling Stephanie , Buswell Lori 
Published: July 2019

PURPOSE The Butaro Cancer Centre of Excellence is the first comprehensive referral cancer center in Rwanda and at its inception did not have a standardized patient education program. Partners in Health/Inshuti Mu Buzima and the Rwandan Ministry of Health conducted a quality improvement project to increase patient knowledge by implementing a standardized oncology education program using picture-based and culturally appropriate materials designed for patients with cancer in low- and middle-income countries. METHODS Four Rwandan nurses were trained to provide patient education using the Cancer and You education booklet created by Global Oncology. A pre- and post-test design was used to evaluate patients’ knowledge of cancer, treatment, and management of adverse effects. Nurses administered a posteducation questionnaire in Kinyarwanda to determine patients’ level of satisfaction with the education session and booklet. The four nurses were interviewed at the completion of the project for their feedback. A total of 40 oncology patients were included in the pilot project, of which 85% reported completing primary school or less. RESULTS On average, participants improved 19% (95% CI, 13.9% to 24.1%; standard deviation, 16%) from pre- to postevaluation, demonstrating a significant increase in knowledge ( P ≤ .001). Nearly all patients (97.5%) reported that they were either satisfied or very satisfied with the education program. Oncology nurses gave positive feedback, highlighting that it was helpful to have a standard tool for education with descriptive illustrations for those patients with low literacy. CONCLUSION Implementation of a standardized patient education program demonstrated a statistically significant increase in patient knowledge and a high level of satisfaction among patients and nurses. The project serves as an example for other low- and middle-income countries looking to standardize oncology patient education.
Delivery Hospital Characteristics and Postpartum Maternal Mortality: A National Case–Control Study in France
Authors: Saucedo Monica , Bouvier-Colle Marie-Hélène , Blondel Béatrice , Bonnet Marie-Pierre , Deneux-Tharaux Catherine ,   for the ENCMM Study Group
Published: July 2019

BACKGROUND:
The variability in resources for managing critical events among maternity hospitals may impact maternal safety. Our main objective was to assess the risk of postpartum maternal death according to hospitals’ organizational characteristics. A secondary objective aimed to assess the specific risk of death due to postpartum hemorrhage (PPH).

METHODS:
This national population-based case–control study included all 2007–2009 postpartum maternal deaths from the national confidential enquiry (n = 147 cases) and a 2010 national representative sample of parturients (n = 14,639 controls). To adjust for referral bias, cases were classified by time when the condition/complication responsible for the death occurred: postpartum maternal deaths due to conditions present before delivery (n = 66) or during or after delivery (n = 81). Characteristics of delivery hospitals included 24/7 on-site availability of an anesthesiologist and an obstetrician, level of perinatal care, number of deliveries annually, and their teaching and profit status. In teaching and other nonprofit hospitals in France, obstetric care is organized on the principle of collective team-based management, while in for-profit hospitals, this organization is based mostly on that of “one woman–one doctor.” Logistic regression models were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for postpartum maternal death.

RESULTS:
The risk of maternal death from prepartum conditions was lower for women who gave birth in for-profit compared with teaching hospitals (aOR, 0.3; 95% CI, 0.1–0.8; P = .02) and in hospitals with <1500 vs ≥1500 annual deliveries (aOR, 0.4; 95% CI, 0.1–0.9; P = .02). Conversely, the risk of postpartum maternal death from complications occurring during or after delivery was higher for women who delivered in for-profit compared with teaching hospitals (aOR, 2.8; 95% CI, 1.3–6.0; P = .009), as was the risk of death from PPH in for-profit versus nonprofit hospitals (aOR, 2.8; 95% CI, 1.2–6.5; P = .019).

CONCLUSIONS:
After adjustment for the referral bias related to prepartum morbidity, the risk of postpartum maternal mortality in France differs according to the hospital’s organizational characteristics.
Effects of Perioperative Administration of Acetaminophen on Postoperative Shivering: A Randomized, Triple-Blind, Placebo-Controlled Trial
Authors: Kinjo Takehiro , Tadokoro Takahiro , Tokushige Akihiro , Zamami Taketo , Taira Sumire , Ikehara Yumi , Tsuhako Chiemi , Ohtsu Hiroshi , Ueda Shinichiro , Kakinohana Manabu 
Published: July 2019

BACKGROUND:
In this randomized, triple-blind, placebo-controlled trial, we tested the hypothesis that perioperative acetaminophen administration has a prophylactic effect on postoperative shivering.

METHODS:
Forty-five women scheduled for gynecological laparotomy were randomized to either the acetaminophen or the placebo groups. After induction of general anesthesia, the test drug (acetaminophen 15 mg/kg) or placebo (0.9% saline) was intravenously administered over 15 minutes. The primary outcome measure was the incidence of severe postoperative shivering (ie, shivering score >2) in the postanesthesia care unit, where patients stayed for 30 minutes after their emergence from anesthesia. For the secondary outcomes, core body temperature (BT) was recorded at the forehead just before anesthesia induction (time 0 [T0]), at the start of surgery (time 1 [T1]), at the end of surgery (time 2 [T2]), at the initiation of postoperative observation in the postanesthesia care unit (time 3 [T3]), and 30 minutes after T3 (time 4 [T4]). At 1 hour after T4 (ie, time 5 [T5]), the BT was recorded from the axilla (BTA). Primary outcome was analyzed using a χ2 test. BT recorded at the forehead (BTF) and BTA were analyzed using a 2-way repeated-measures analysis of variance (ANOVA) and a 2-sample t test, respectively. For all comparisons, a P value <.05 was considered statistically significant.

RESULTS:
The study duration was 2 years. Of the 45 patients initially enrolled, 8 patients were excluded. The acetaminophen and placebo groups included 18 and 19 patients, respectively. The incidence of severe postoperative shivering in the postanesthesia care unit was significantly lower in the acetaminophen group (22.2%) than in the placebo group (73.7%) (relative risk, 0.302; 95% confidence interval, 0.122–0.746; P = .005). Two-way repeated-measures ANOVA showed a significant effect of time (F
4,140 = 54.8; P < .001) and a significant time by treatment interaction (F
4,140 = 9.61; P < .001) but did not show a main effect of the treatment (F
1,35 = 1.83; P = .185) in BTF. Moreover, BTA at T5 was significantly lower in the acetaminophen group (mean [standard deviation {SD}], 37.2°C [0.48°C]) than in the placebo group (37.9°C [0.63°C]; P < .001).

CONCLUSIONS:
Our findings in patients undergoing gynecological laparotomy suggest that perioperative acetaminophen administration can prevent postoperative severe shivering. This prophylactic effect might be due to suppressing the postoperative increase in the BT set point, rather than lowering the threshold for shivering, as observed with clonidine.
Identification of the building blocks of ventricular septation in monitor lizards (Varanidae)
Authors: Hanemaaijer Jermo , Gregorovicova Martina , Nielsen Jan M. , Moorman Antoon F. M , Wang Tobias , Planken R. Nils , Christoffels Vincent M. , Sedmera David , Jensen Bjarke 
Published: July 2019

ABSTRACT
Among lizards, only monitor lizards (Varanidae) have a functionally divided cardiac ventricle. The division results from the combined function of three partial septa, which may be homologous to the ventricular septum of mammals and archosaurs. We show in developing monitors that two septa, the ‘muscular ridge’ and ‘bulbuslamelle’, express the evolutionarily conserved transcription factors Tbx5, Irx1 and Irx2, orthologues of which mark the mammalian ventricular septum. Compaction of embryonic trabeculae contributes to the formation of these septa. The septa are positioned, however, to the right of the atrioventricular junction and they do not participate in the separation of incoming atrial blood streams. That separation is accomplished by the ‘vertical septum’, which expresses Tbx3 and Tbx5 and orchestrates the formation of the electrical conduction axis embedded in the ventricular septum. These expression patterns are more pronounced in monitors than in other lizards, and are associated with a deep electrical activation near the vertical septum, in contrast to the primitive base-to-apex activation of other lizards. We conclude that evolutionarily conserved transcriptional programmes may underlie the formation of the ventricular septa of monitors.
Integration of Wnt and FGF signaling in the Xenopus gastrula at TCF and Ets binding sites shows the importance of short-range repression by TCF in patterning the marginal zone
Authors: Kjolby Rachel A. S. , Truchado-Garcia Marta , Iruvanti Suvruta , Harland Richard M. 
Published: July 2019

ABSTRACT
During Xenopus gastrulation, Wnt and FGF signaling pathways cooperate to induce posterior structures. Wnt target expression around the blastopore falls into two main categories: a horseshoe shape with a dorsal gap, as in Wnt8 expression; or a ring, as in FGF8 expression. Using ChIP-seq, we show, surprisingly, that the FGF signaling mediator Ets2 binds near all Wnt target genes. However, β-catenin preferentially binds at the promoters of genes with horseshoe patterns, but further from the promoters of genes with ring patterns. Manipulation of FGF or Wnt signaling demonstrated that ‘ring’ genes are responsive to FGF signaling at the dorsal midline, whereas ‘horseshoe’ genes are predominantly regulated by Wnt signaling. We suggest that, in the absence of active β-catenin at the dorsal midline, the DNA-binding protein TCF binds and actively represses gene activity only when close to the promoter. In contrast, genes without functional TCF sites at the promoter may be predominantly regulated by Ets at the dorsal midline and are expressed in a ring. These results suggest recruitment of only short-range repressors to potential Wnt targets in the Xenopus gastrula.
Mitochondrial genotype influences the response to cold stress in the European green crab, Carcinus maenas
Authors: Coyle Aspen E. , Voss Erin R. , Tepolt Carolyn K. , Carlon David B. 
Published: July 2019

ABSTRACT
Hybrid zones provide natural experiments in recombination within and between genomes that may have strong effects on organismal fitness. On the East Coast of North America, two distinct lineages of the European green crab (Carcinus maenas) have been introduced in the last two centuries. These two lineages with putatively different adaptive properties have hybridized along the coast of the eastern Gulf of Maine, producing new nuclear and mitochondrial combinations that show clinal variation correlated with water temperature. To test the hypothesis that mitochondrial or nuclear genes have effects on thermal tolerance, we first measured the response to cold stress in crabs collected throughout the hybrid zone, then sequenced the mitochondrial CO1 gene and two nuclear single nucleotide polymorphisms (SNPs) representative of nuclear genetic lineage. Mitochondrial haplotype had a strong association with the ability of crabs to right themselves at 4.5°C that was sex specific: haplotypes originally from northern Europe gave male crabs an advantage while there was no haplotype effect on righting in female crabs. By contrast, the two nuclear SNPs that were significant outliers in a comparison between northern and southern C. maenas populations had no effect on righting response at low temperature. These results add C. maenas to the shortlist of ectotherms in which mitochondrial variation has been shown to affect thermal tolerance, and suggest that natural selection is shaping the structure of the hybrid zone across the Gulf of Maine. Our limited genomic sampling does not eliminate the strong possibility that mito-nuclear co-adaptation may play a role in the differences in thermal phenotypes documented here. Linkage between mitochondrial genotype and thermal tolerance suggests a role for local adaptation in promoting the spread of invasive populations of C. maenas around the world.
Enforcement of Human Rights: Effectiveness of International Legislation
Authors: Mukhopadhyay Devarshi 
Published: July 2019

The juxtaposition of legal sovereignty against
international duty (in the form of fostering greater respect
for human rights across the globe) became one of the
founding attributes of the post World War II political
regime. Several human rights legislations were coined,
deliberated upon, and ratified. However, the fact that
ratification alone has not led to better human rights
regime is something that many would not deny. In fact,
this entire concept of drafting soft law principles has been
cynically questioned by critics, citing the lack of a proper
enforcement mechanism and real legitimacy as reasons
for its failure. Moreover, several empirical studies have
been evidence of the fact that respect for human rights is
more intrinsically connected with ancillary principles
such as a democratic regime, the strength of participation
of civil society, the conflict status of a country and several
others, and not treaty ratification alone. It is this claim
that the researcher has analyzed in the course of this
paper
#DIFERENÇA: CLICAR, POSTAR E COMPARTILHAR
Authors: DE MEDEIROS CRISTIANO SANT'ANNA 
Published: July 2019

Esse artigo, partindo das premissas dos estudos nos/dos/com os cotidianos, entrelaçado com as redes sociais da internet, apresenta uma pesquisa de doutorado, que teve como objetivo pensar com imagens compartilhadas por estudantes do terceiro ano do Ensino Médio, as noções de diferença tecidas com essa prática em suas articulações com as narrativas que engendraram. As imagens foram compartilhadas na rede social da internet Facebook, em grupos criados para este fim, denominados #Diferença e que operaram como dispositivo de pesquisa num contexto que enunciamos como “sociedade do compartilhamento”. As imagens, acompanhadas de suas narrativas/análises, nos deram pistas para pensar nos múltiplos atravessamentos e bricolagens entre imagens e ideias de diferença que são criadas e circulam nas múltiplas redes educativas, proporcionando assim diferentes espaços de debate e aprendizagem.
Urinary incontinence and pelvic organ prolapse in primary care
Authors: Rantell Angie 
Published: July 2019

The National Institute for Health and Care Excellence has released an updated guideline on urinary incontinence and pelvic organ prolapse. Angie Rantell explores the changes and recommendations for patients, highlighting which are relevant to management in primary care In 2019, the National Institute for Health and Care Excellence published a new guideline on urinary incontinence and pelvic organ prolapse. This articles provides an overview of the changes to the recommendations relevant to the primary care setting, mainly related to assessment and conservative management, along with a review of when to refer into specialist services. A brief overview of the changes it has made in secondary care will also be discussed.
DETERMINACIÓN DE LA DISTRIBUCIÓN DE DOSIS EN OBJETO SIMULADOR DE PULMÓN MEDIANTE SIMULACIÓN MONTE CARLO USANDO CÓDIGO PENELOPE
Authors: Apaza Veliz Danny G. , Chahuara Cruz Ruben D. , Sellerico Mamani Pedro P. , Vega Ramírez José L. 
Published: July 2019

La radioterapia es el tratamiento más aplicado a los pacientes que padecen cáncer, donde es irradiado el volumen del tumor, tomando en cuenta diversos criterios para evitar dañar los tejidos sanos, por tanto, es importante tener la certeza de que la dosis suministrada es la correcta. Con el fin de desarrollar un método precisó de verificación del planeamiento de tratamiento se construyo objetos simuladores de pulmón y tejido blando a base de resina epoxi, esferas fenolíticas y carbonato de calcio, estos fueron analizados por microscopia de barrido electrónico y validados mediante simulación Monte Carlo usando código Penélope v.2008 en comparación con publicaciones del Instituto Nacional de Estándares y Tecnología (NIST por sus siglas en ingles). Con esto se evaluó la interacción de la radiación con objetos simuladores homogéneos (pulmón) y heterogéneos (pulmón, tejido blando, pulmón) construidos y simulados. Siendo el principal objetivo de este trabajo el uso de los objetos simuladores en condiciones similares a la que se utiliza en la irradiación de un caso clínico en radioterapia, obteniéndose curvas de porcentaje de dosis a profundidad (PDP) y curvas de perfil de campo para pequeños campos de 1x1cm2 y 2x2cm2, con haces de fotones de 6 MeV de energía.