bluuebunny/crossref_metadata_2025_split huggingface dataset:
An assessment of implementation and evaluation phases of strategic plans in Iranian hospitals
Authors: Sadeghifar Jamil , Tofighi Shahram , Roshani Mohamad , Toulideh Zahra , Mohsenpour Seyedramezan , Jafari Mehdi 
Published: October 2017

Objectives: To assess the implementation and evaluation phases of strategic plans in selected hospitals. Methods: We conducted a cross-sectional study of implementation and evaluation of strategic plan in 24 hospitals in 2015, using a questionnaire which consisted of two separate sections for strategic implementation and strategic evaluation. Data were analyzed with SPSS version 18. Results: Nearly one-third of hospitals claimed that they allocate their budget based on priorities and strategic goals. However, it turned out that although goals had been set, no formal announcements had been made. Most of the hospitals stated that they used measures when evaluating the plan. For hospital staff, clarifying the hospital’s priorities was the most important advantage of a strategic plan. Conclusion: There is no clear definition for strategic management in Iranian hospitals, which results in chaotic implementation and control of strategic planning.
The life cycles of six multi-center adaptive clinical trials focused on neurological emergencies developed for the Advancing Regulatory Science initiative of the National Institutes of Health and US Food and Drug Administration: Case studies from the Adaptive Designs Accelerating Promising Treatments Into Trials Project
Authors: Guetterman Timothy C , Fetters Michael D , Mawocha Samkeliso , Legocki Laurie J , Barsan William G , Lewis Roger J , Berry Donald A , Meurer William J 
Published: October 2017

Objectives: Clinical trials are complicated, expensive, time-consuming, and frequently do not lead to discoveries that improve the health of patients with disease. Adaptive clinical trials have emerged as a methodology to provide more flexibility in design elements to better answer scientific questions regarding whether new treatments are efficacious. Limited observational data exist that describe the complex process of designing adaptive clinical trials. To address these issues, the Adaptive Designs Accelerating Promising Treatments Into Trials project developed six, tailored, flexible, adaptive, phase-III clinical trials for neurological emergencies, and investigators prospectively monitored and observed the processes. The objective of this work is to describe the adaptive design development process, the final design, and the current status of the adaptive trial designs that were developed. Methods: To observe and reflect upon the trial development process, we employed a rich, mixed methods evaluation that combined quantitative data from visual analog scale to assess attitudes about adaptive trials, along with in-depth qualitative data about the development process gathered from observations. Results: The Adaptive Designs Accelerating Promising Treatments Into Trials team developed six adaptive clinical trial designs. Across the six designs, 53 attitude surveys were completed at baseline and after the trial planning process completed. Compared to baseline, the participants believed significantly more strongly that the adaptive designs would be accepted by National Institutes of Health review panels and non-researcher clinicians. In addition, after the trial planning process, the participants more strongly believed that the adaptive design would meet the scientific and medical goals of the studies. Conclusion: Introducing the adaptive design at early conceptualization proved critical to successful adoption and implementation of that trial. Involving key stakeholders from several scientific domains early in the process appears to be associated with improved attitudes towards adaptive designs over the life cycle of clinical trial development.
Anatomic Study of Subcoracoid Morphology in 418 Shoulders: Potential Implications for Subcoracoid Impingement
Authors: Dugarte Anthony J. , Davis Rocklend J. , Lynch T. Sean , Schickendantz Mark S. , Farrow Lutul D. 
Published: October 2017

Background: Subcoracoid impingement has been implicated as a cause of anterior shoulder pain and subscapularis tendon tears. Purpose/Hypothesis: The purpose of this study was to evaluate the bony anatomy of the coracoid process and the subcoracoid space. We hypothesized that age-related changes that may contribute to subcoracoid impingement occur in the subcoracoid space. Study Design: Descriptive laboratory study. Methods: In total, 418 skeletal shoulder specimens were included in this study. We utilized 214 shoulders from a young cohort (25-35 years of age) and 204 shoulders from an older cohort (>55 years of age) for comparison. We evaluated several morphological characteristics of the coracoid process and the subcoracoid space: coracoid width, coracoid shape, coracoid thickness, and subcoracoid distance. Each coracoid was observed for the presence of spurring or other morphological changes. Results: The mean anteroposterior (AP) thickness of the coracoid tip was 7.9 and 9.4 mm in our young female and male cohorts, respectively, while the mean AP thickness was 8.1 and 9.7 mm in our older female and male cohorts, respectively. The coracoid tip was hooked in 31 of 108 young female shoulders compared with 55 of 102 older female shoulders, and the coracoid tip was hooked in 25 of 106 young male shoulders compared with 45 of 102 older male shoulders. The mean subcoracoid distance in neutral rotation was 14.8 and 12.5 mm in young and older female shoulders, respectively, while the mean subcoracoid distance in internal rotation in these same cohorts was 8.7 and 7.0 mm, respectively. The mean subcoracoid distance in neutral rotation was 14.8 and 13.3 mm in young and older male shoulders, respectively, while the mean subcoracoid distance in internal rotation was 8.6 and 8.1 mm in young and older male shoulders, respectively. Conclusion: The principal findings of our study demonstrate that anatomic changes implicated in subcoracoid impingement may be developmental and worsen with age. The subcoracoid space was narrower in our older cohort of shoulders. Additionally, these older shoulders also had a greater AP width and a more hooked coracoid compared with young shoulders. Clinical Relevance: Narrowing of the subcoracoid space has been shown to be implicated as a cause of anterior shoulder pain and subscapularis tendon tears. This is the first study to show that the morphological changes implicated in subcoracoid impingement become more prevalent with age. This may help to explain the increasing prevalence of subscapularis tendon tears in older patients. Furthermore, subcoracoid decompression may be seen as an option for older patients with anterior shoulder pain and subscapularis tendon tears.
Relationship of Echocardiography and Carotid Doppler With Macular Parameters in Retinal Vein Occlusions: A Retrospective Analysis
Authors: Madanagopalan V. G. , Singh Bibha 
Published: October 2017

Aim: To find the relationship of cardiac dimensions and valvular flow rates in echocardiography and carotid parameters in Doppler imaging with macular variables in retinal vein occlusions (RVOs) and to identify macular parameters in RVO that may predict cardiovascular morbidity. Methods: A retrospective observational study was done with 17 patients with central RVO (CRVO) and 13 patients with branch RVO (BRVO). Best-corrected distance visual acuity (BCVA) and spectral domain optical coherence tomography parameters such as central macular volume (CMV) and total macular volume (TMV) were noted. Details of echocardiography and carotid Doppler were retrieved. Relationship of BCVA, CMV, and TMV with cardiac dimensions and valvular flow rates and carotid flow velocities was analyzed. Results: Correlation showed significant association between BCVA and ipsilateral internal carotid (IC) to common carotid (CC) peak systolic velocity (PSV) ratio in eyes with CRVO and BRVO ( r = .50, P = .04, and r = .64, P = .02, respectively). Significant association of TMV and left ventricular end systolic diameter (LVs) was seen in CRVO ( r = .69, P = .002). Association was also noted between higher IC PSV and poor BCVA, higher IC to CC PSV ratio to poor BCVA, and larger LVs with higher TMV ( P < .03 for all). In patients with BRVO, association was noted between higher IC to CC PSV ratio to poor BCVA, lesser ejection fraction (EF) with poor BCVA, and lesser EF with higher CMV ( P < .03 for all). Conclusions: In our study eyes with RVO, decreased BCVA was related to carotid narrowing. Decreased BCVA in BRVO was also related to decreased EF. Consistently larger macular volumes in our study eyes with RVO were related to suboptimal cardiac function identified by larger end systolic diameters and lesser EF. Our pilot study has thus showed that a quantitative relationship exists between macular parameters and cardiovascular variables in RVO.
Association Between HIV Infection and Cancer Stage at Presentation at the Uganda Cancer Institute
Authors: Menon Manoj P. , Coghill Anna , Mutyaba Innocent O. , Phipps Warren T. , Okuku Fred M. , Harlan John M. , Orem Jackson , Casper Corey 
Published: October 2017

Purpose The HIV epidemic has contributed to the increasing incidence of cancer in sub-Saharan Africa, where most patients with cancer present at an advanced stage. However, improved access to HIV care and treatment centers in sub-Saharan Africa may facilitate earlier diagnosis of cancer among patients who are HIV positive. To test this hypothesis, we characterized the stage of cancer and evaluated the factors associated with advanced stage at presentation among patients in Uganda. Methods We conducted a retrospective analysis of adult patients with any of four specific cancers who presented for care in Kampala, Uganda, between 2003 and 2010. Demographic, clinical, and laboratory data were abstracted from the medical record, together with the outcome measure of advanced stage of disease (clinical stage III or IV). We identified measures for inclusion in a multivariate logistic regression model. Results We analyzed 731 patients with both AIDS-defining cancers (cervical [43.1%], and non-Hodgkin lymphoma [18.3%]), and non–AIDS-defining cancers (breast [30.0%] and Hodgkin lymphoma [8.6%]). Nearly 80% of all patients presented at an advanced stage and 37% had HIV infection. More than 90% of patients were symptomatic and the median duration of symptoms before presentation was 5 months. In the multivariate model, HIV-positive patients were less likely to present at an advanced stage as were patients with higher hemoglobin and fewer symptoms. Conclusion Patients with limited access to primary care may present with advanced cancer because of a delay in diagnosis. However, patients with HIV now have better access to clinical care. Use of this growing infrastructure to increase cancer screening and referral is promising and deserves continued support, because the prognosis of HIV-positive patients with advanced cancer is characterized by poor survival globally.
Outpatient Treatment of Deep Vein Thrombosis in the United States: The Reasons for Geographic and Racial Differences in Stroke Study
Authors: Douce Daniel , McClure Leslie A. , Lutsey Pamela , Cushman Mary , Zakai Neil A. 
Published: October 2017

BACKGROUNDOutpatient versus inpatient treatment of deep vein thrombosis (DVT) is believed to result in equivalent outcomes with decreased costs. Little is known about the adoption of outpatient DVT treatment in the United States.OBJECTIVETo describe the uptake of outpatient DVT treatment in the United States and understand how comorbidities and socioeconomic conditions impact the decision to treat as an outpatient.DESIGN AND SETTINGThe Reasons for Geographic and Racial Differences in Stroke cohort study recruited 30,329 participants between 2003 and 2007. DVT events were ascertained through 2011.MEASUREMENTSMultivariable logistic regression was used to determine the correlates of outpatient treatment of DVT accounting for age, sex, race, education, income, urban or rural residence, and region of residence.RESULTSOf 379 venous thromboembolism events, 141 participants had a DVT without diagnosed pulmonary embolism and that did not occur during hospitalization. Overall, 28% (39 of 141) of participants with DVT were treated as outpatients. In a multivariable model, the odds ratio for outpatient versus inpatient DVT treatment was 4.16 (95% confidence interval [CI], 1.25‐13.79) for urban versus rural dwellers, 3.29 (95% CI, 1.30‐8.30) for white versus black patients, 2.41 (95% CI, 1.06‐5.47) for women versus men, and 1.90 (95% CI, 1.19‐3.02) for every 10 years younger in age. Living outside the southeastern United States and having higher education and income were not statistically significantly associated with outpatient treatment.CONCLUSIONSDespite known safety and efficacy, only 28% of participants with DVT received outpatient treatment. This study highlights populations in which efforts could be made to reduce hospital admissions.
Anatomy and physiology, 3. The blood
Authors: Peate Ian 
Published: October 2017

Although the primary function of blood is to deliver oxygen and nutrients to—and remove waste from—body cells, the blood also performs a number of other functions. The specific functions of blood include defence against disease and distribution of heat, as well as maintenance of homeostasis. This article provides an overview of this life-saving fluid. It emphasises the need for the healthcare assistant and assistant practitioner (HCA and AP) to develop an understanding of blood and its various functions in illness and health. Understanding the function of blood can help the HCA and AP to offer people care that is safe, effective and informed. The article considers the components of blood. The various functions of blood, including its role in transportation, regulation and protection, are described. The article offers a glossary of terms that can help the HCA and AP in understanding some of the terms that have been used. A short quiz is provided to help reinforce the learning.
Oncometabolites: A New Paradigm for Oncology, Metabolism, and the Clinical Laboratory
Authors: Collins Rebecca R J , Patel Khushbu , Putnam William C , Kapur Payal , Rakheja Dinesh 
Published: October 2017

Abstract

BACKGROUND
Pediatric clinical laboratories commonly measure tricarboxylic acid cycle intermediates for screening, diagnosis, and monitoring of specific inborn errors of metabolism, such as organic acidurias. In the past decade, the same tricarboxylic acid cycle metabolites have been implicated and studied in cancer. The accumulation of these metabolites in certain cancers not only serves as a biomarker but also directly contributes to cellular transformation, therefore earning them the designation of oncometabolites.

CONTENT
D-2-hydroxyglutarate, L-2-hydroxyglutarate, succinate, and fumarate are the currently recognized oncometabolites. They are structurally similar and share metabolic proximity in the tricarboxylic acid cycle. As a result, they promote tumorigenesis in cancer cells through similar mechanisms. This review summarizes the currently understood common and distinct biological features of these compounds. In addition, we will review the current laboratory methodologies that can be used to quantify these metabolites and their downstream targets.

SUMMARY
Oncometabolites play an important role in cancer biology. The metabolic pathways that lead to the production of oncometabolites and the downstream signaling pathways that are activated by oncometabolites represent potential therapeutic targets. Clinical laboratories have a critical role to play in the management of oncometabolite-associated cancers through development and validation of sensitive and specific assays that measure oncometabolites and their downstream effectors. These assays can be used as screening tools and for follow-up to measure response to treatment, as well as to detect minimal residual disease and recurrence.
Loi, nationalité et mariages mixtes entre Français et autochtones : Le cas de l’arrêt du Conseil supérieur de la Louisiane du 18 décembre 1728
Authors: De Sainte-Marie Alice Bairoch 
Published: October 2017

Abstract
Did Native people have the same rights as French people in the colonies during the seventeenth and eighteenth centuries? They did, according to a law enacted in all the colonies. Indeed, once converted, aboriginal people could go and live in France, get married to French people, and inherit their wealth. However, the implementation of this law, which was specific to the French colonies, posed some problems. Marriages between French settlers and aboriginal women constituted a non-negligible loss of income for the colony. The law allowed an aboriginal widow to inherit the goods and wealth of her deceased husband. In these cases, the French judges, among other members of Louisiana’s Conseil superieur, were faced with the dilemma of either upholding the missionary vocation of the French colonies of the seventeenth and eighteenth centuries-a vocation used to justify the colonization of the New World-or preventing the loss of part of the colony’s wealth.
The Legacy of New France : Law and Social Cohesion between Quebec and the Illinois Country, 1763–1790
Authors: Englebert Robert 
Published: October 2017

Abstract
En 1763, le traité de Paris a mis fin à la guerre de Sept Ans. Ce traité amena des changements géopolitiques profonds car il transféra les colonies du vaste empire français d’Amérique septentrionale aux Anglais, aux Espagnols et, plus tard, aux Américains. Dans les années qui suivirent la fin du conflit, l’incertitude politique provoqua d’ailleurs beaucoup d’inquiétude parmi les créoles français de l’intérieur du continent, surtout concernant la préservation de leurs droits de propriétés et de leurs droits civils. Les créoles français adressèrent donc de nombreuses pétitions pour s’assurer de la reconnaissance de leurs droits comme sujets et citoyens. Il reste toutefois à mieux comprendre comment les anciennes lois françaises furent préservées, voire renforcées, sous les nouveaux régimes impériaux. Cet article examine comment les créoles français ont utilisé la loi de l’Ancien régime (la coutume de paris) et, en particulier, la procuration, pour gérer leurs successions familiales entre le pays des Illinois et le Canada après la guerre de Sept Ans. Il démontre qu’en faisant appel à cette loi pour préserver leurs propriétés familiales, les créoles français ont réussi à maintenir une cohésion sociale en Amérique française, cohésion qui s’étendait bien au-delà des nouvelles frontières coloniales.
The Real “Maid of Saint Phillippe”: Kate Chopin’s French Colonial Heritage
Authors: Stepenoff Bonnie 
Published: October 2017

Abstract
Prèsqu’un siècle après sa mort, Marianne Verdon Richelet est devenue le modèle pour un personnage dans l’histoire courte de Kate Chopin, «The Maid of Saint Philippe », située dans un village français du XVIIIe siècle dans la vallée du Mississippi. Comme son homologue fictif, Marianne était une femme forte et indépendante, mais les événements réels de sa vie ont différé nettement de ceux de l’histoire. Née en France, elle a émigré en Amérique avec ses parents, s’est mariée dans son adolescence et est devenue une jeune veuve. Dans les années 1770, elle s’est installée à Saint Louis avec son deuxième mari, Joseph Verdon. Lorsque le mariage s’est avéré malheureux, elle a défié la convention et a obtenu une séparation juridique avec un contrat qui lui a donné le contrôle de la propriété substantielle et la garde de ses enfants. Vivante comme une femme seule, avec l’aide d’éminents voisins, elle a exploité une entreprise commerciale fructueuse, l’opération des bateaux sur le fleuve. Elle est également devenue la matriarche d’une longue lignée de femmes formidables, y compris sa fille Victoire, qui ont partagé des histoires de Saint Louis avec une arrière-petite-fille nommé Kate. Chopin a romancé les expériences de son ancêtre féminin, soulignant son désir de liberté. Cet article s’appuie sur des sources primaires, y compris les actes de mariage, de biens d’immobilier, et les dossiers du tribunal, pour un aperçu dans la vie d’une femme extraordinaire. Une étude approfondie de ces documents dans le cadre de recherches antérieures sur l’identité sexuelle dans les établissements français par Susan Boyle et d’autres, fait une lumière nouvelle sur la vie sociale, économique et juridique des femmes coloniales françaises en Amérique du Nord.
The gastrointestinal nematodes of Paramelomys lorentzii and Mammelomys spp. (Rodentia: Muridae) with descriptions of a new genus and three new species (Heligmonellidae) from Papua New Guinea and Indonesia
Authors: Smales Lesley R. 
Published: October 2017

AbstractUnidentified cestodes and 14 species of nematode and larvae that could not be placed to family level, were collected from the digestive tracts of 27 individuals of
Genotyping of Acanthamoeba spp. from water sources from Northwestern Iran
Authors: Haniloo Ali , Pezeshki Ali , Mahmmodzadeh Abbas , Kadkhodamohammadi Elnaz 
Published: October 2017

Abstractspp. are free-living amoebae which are ubiquitously distributed worldwide and can be found in the wide range of environments, particularly in various types of water sources, where they able to cause important health problems. In the present study, cultures containing
Gastrointestinal nematodes infections and anthelmintic resistance in grazing sheep in the Eastern Inner Mongolia in China
Authors: Han Tianlong , Wang Min , Zhang Guanghe , Han Dongsheng , Li Xinwei , Liu Guowen , Li Xiaobing , Wang Zhe 
Published: October 2017

AbstractGastrointestinal nematodes (GIN) are a crucial restraint to grazing sheep production worldwide. This study was conducted to determine the infections and anthelmintic resistance (AR) of GIN in pasture-based sheep in the Eastern Inner Mongolia, China. GIN eggs were tested from 600 grazing sheep feces of 10 farms using saturated saline flotation method and McMaster’s method. The egg hatch test (EHT) and the faecal egg count reduction test (FECRT) were used to evaluate resistance of GIN to anthelmintics. We found that the average infection rate was 79.2% (range: 45%-100%). The grand mean faecal egg count (FEC) was 1813.2 eggs per gram (EPG) (range: 0-32400 EPG). There were significant differences in GIN infection among different breeds of sheep. The sequence of infection intensity and infection rate were Small fat tail > Ujimqin > Ju Ud (
A new species of Spauligodon (Nematoda; Oxyuroidea; Pharyngodonidae) and other Nematodes in Cyrtodactylus epiroticus (Squamata; Gekkonidae) from Papua New Guinea
Authors: Bursey Charles R. , Goldberg Stephen R. , Kraus Fred 
Published: October 2017

Abstractsp. nov. from the large intestines of
Further study on Physaloptera clausa Rudolphi, 1819 (Spirurida: Physalopteridae) from the Amur hedgehog Erinaceus amurensis Schrenk (Eulipotyphla: Erinaceidae)
Authors: Chen Hui-Xia , Ju Hui-Dong , Li Yang , Li Liang 
Published: October 2017

AbstractIn the present study, light and scanning electron microscopy (SEM) were used to further study the detailed morphology of