bluuebunny/crossref_metadata_2025_split huggingface dataset:
A systematic review of portable electronic technology for health education in resource-limited settings
Authors: McHenry Megan S. , Fischer Lydia J. , Chun Yeona , Vreeman Rachel C. 
Published: August 2017

Objective: The objective of this study is to conduct a systematic review of the literature of how portable electronic technologies with offline functionality are perceived and used to provide health education in resource-limited settings. Methods: Three reviewers evaluated articles and performed a bibliography search to identify studies describing health education delivered by portable electronic device with offline functionality in low- or middle-income countries. Data extracted included: study population; study design and type of analysis; type of technology used; method of use; setting of technology use; impact on caregivers, patients, or overall health outcomes; and reported limitations. Results: Searches yielded 5514 unique titles. Out of 75 critically reviewed full-text articles, 10 met inclusion criteria. Study locations included Botswana, Peru, Kenya, Thailand, Nigeria, India, Ghana, and Tanzania. Topics addressed included: development of healthcare worker training modules, clinical decision support tools, patient education tools, perceptions and usability of portable electronic technology, and comparisons of technologies and/or mobile applications. Studies primarily looked at the assessment of developed educational modules on trainee health knowledge, perceptions and usability of technology, and comparisons of technologies. Overall, studies reported positive results for portable electronic device-based health education, frequently reporting increased provider/patient knowledge, improved patient outcomes in both quality of care and management, increased provider comfort level with technology, and an environment characterized by increased levels of technology-based, informal learning situations. Negative assessments included high investment costs, lack of technical support, and fear of device theft. Conclusions: While the research is limited, portable electronic educational resources present promising avenues to increase access to effective health education in resource-limited settings, contingent on the development of culturally adapted and functional materials to be used on such devices.
Results of a local combination therapy antibiogram for Pseudomonas aeruginosa isolates: is double worth the trouble?
Authors: Song Matthew , Dilworth Thomas J. , Munson Erik , Davis Jim , Elshaboury Ramy H. 
Published: August 2017

Purpose: To determine the frequency at which fluoroquinolones and aminoglycosides demonstrate in vitro activity against non-urinary, non-skin/skin structure Pseudomonas aeruginosa isolates exhibiting decreased susceptibilities to one or more β-lactam agents. Methods: β-lactam-non-susceptible P. aeruginosa isolates recovered from blood, bone, lower respiratory tract, pleural fluid, cerebrospinal fluid, or peritoneal fluid cultures between October 2010 and October 2014 were reviewed from four community hospitals within a single health-system. Only the first isolate per patient was included for analysis. The likelihood that each isolate was susceptible to a non-β-lactam antimicrobial was then determined and summarized within a combination antibiogram. Results: In total, 179 P. aeruginosa isolates with decreased susceptibilities to one or more β-lactam agents were assessed. Because no appreciable differences in antimicrobial susceptibility profile were observed between hospitals, the isolates were evaluated in aggregate. Susceptibility rates for β-lactam monotherapy ranged from 34% to 75%. Aminoglycosides possessed increased antibacterial activity compared to fluoroquinolones. Tobramycin was the non-β-lactam most likely to expand antimicrobial coverage against β-lactam-non-susceptible P. aeruginosa with activity against 64%, 66%, and 65% of cefepime-, piperacillin-tazobactam-, and meropenem-non-susceptible isolates, respectively ( p < 0.001 for all). Conclusions: The results of this study support the use of aminoglycosides over fluoroquinolones for achieving optimal, empiric antimicrobial combination therapy for P. aeruginosa when dual antimicrobial therapy is clinically necessary. Future efforts aimed at optimizing combination therapy for P. aeruginosa should focus on systemic interventions that limit the selection of fluoroquinolones in combination with β-lactams to expand coverage based on local susceptibility rates.
Dimensions of Phenomenology in Exploring Patient’s Suffering in Long-Life Illnesses
Authors: Al Kalaldeh Mahmoud , Shosha Ghada Abu , Saiah Najah , Salameh Omar 
Published: August 2017

Background: Patients’ suffering has been increasingly investigated by health-care researchers especially in the chronically ill. Suffering is viewed as a progressive negative consequence that associated with pain, impaired self-esteem, and social alienation. This qualitative evidence synthesis aimed to provide further insights into the application of phenomenology in explaining suffering among patients with chronic illnesses. Methods: Studies included in this qualitative evidence synthesis study were retrieved by searching from the following electronic databases: CINAHL, PubMed Central, and EBSCO. Findings: Phenomenology is regarded as influential to generate in-depth evidence about suffering that are grounded in chronically ill patients’ perspectives. The philosophical constructs of suffering suggested fundamental dimensions such as stress, distress, hopelessness, and depression along with pain. Evidence encompasses the entire manifestation of suffering in which all interrelated meanings are understood and referred to a unique structure. Hermeneutic phenomenology was adopted as an effective strategy to elucidate human experience leading to the discovery of the embedded meanings of life experience. Conclusion: The phenomenological approach provides nursing research with the pathway to explore patients’ suffering experiences in the chronically ill.
Management of rivaroxaban- or apixaban-associated major bleeding with prothrombin complex concentrates: a cohort study
Authors: Majeed Ammar , Ågren Anna , Holmström Margareta , Bruzelius Maria , Chaireti Roza , Odeberg Jacob , Hempel Eva-Lotta , Magnusson Maria , Frisk Tony , Schulman Sam 
Published: August 2017

Key Points
PCCs for the management of major bleeding in patients on rivaroxaban or apixaban is an effective strategy in most cases. The thromboembolic complication rate in this setting is low and comparable with that of anticoagulation discontinuation without reversal.
Severe reduction of free-form ADAMTS13, unbound to von Willebrand factor, in plasma of patients with HELLP syndrome
Authors: Yoshida Yoko , Matsumoto Masanori , Yagi Hideo , Isonishi Ayami , Sakai Kazuya , Hayakawa Masaki , Hori Yuji , Sado Toshiyuki , Kobayashi Hiroshi , Fujimura Yoshihiro 
Published: August 2017

Key Points
Severely decreased ADAMTS13 unbound to VWF may play a key role in the pathogenesis of HELLP syndrome. A qualitative ADAMTS13 assay may be important for diagnosing HELLP syndrome.
Differences in immune response to anesthetics used for day surgery versus hospitalization surgery for breast cancer patients
Authors: Kim Ryungsa , Kawai Ami , Wakisaka Megumi , Funaoka Yuri , Ohtani Shoichiro , Ito Mitsuya , Kadoya Takayuki , Okada Morihito 
Published: August 2017

AbstractBackgroundSurgery/anesthetic technique‐stimulated immunosuppression may be associated with outcome for cancer patients. Here, the immune responses of patients undergoing day surgery versus hospitalization surgery for breast cancer were compared in a prospective study.MethodsBetween February 2012 and August 2014, 21 breast cancer patients underwent day surgery and 16 breast cancer patients underwent hospitalization surgery. The former group received lidocaine/propofol/pethidine, while propofol/systemic opioid‐ and sevoflurane/propofol/systemic opioid‐based anesthesia were administered to the latter group. Surgical stress response was evaluated based on time of operation and amount of bleeding during operation. Immune function was assessed based on natural killer (NK) cell activity, CD4/8 T cell ratio, and cytokine levels of IL‐6 and IL‐10 that were detected before surgery, after surgery, and on the first postoperative day.ResultsOperation time did not differ between the two groups. Blood loss was significantly less for the hospitalization surgery group. No change in NK cell activity was observed for either group, although the CD4/8 T cell ratio increased transiently following day surgery. Levels of IL‐6 increased significantly in both groups following surgery, and these levels tended to be higher in the hospitalization surgery group. One patient who underwent hospitalization surgery had higher levels of IL‐10.ConclusionsThere were few differences in immune response between the two groups, potentially since a majority of the hospitalization surgery patients received propofol‐based anesthesia. We hypothesize that the use of volatile anesthetic/opioid analgesia in hospitalization surgery has a greater influence on immune function in breast cancer patients than local anesthetic/propofol‐based anesthesia in day surgery.
Extracellular vesicles: how they interact with endothelium, potentially contributing to metastatic cancer cell implants
Authors: Bern Murray M. 
Published: August 2017

AbstractExtracellular vesicles (EV) are blebs of cellular membranes, which entrap small portions of subjacent cytosol. They are released from a variety of cells, circulate in the blood for an unknown length of time and come to rest on endothelial surfaces. They contribute to an array of physiologic pathways, the complexity of which is still being investigated. They contribute to metastatic malignant cell implants and tumor‐related angiogenesis, possibly abetted by the tissue factor that they carry. It is thought that the adherence of the EV to endothelium is dependent upon a combination of their P‐selectin glycoprotein ligand‐1 and exposed phosphatidylserine, the latter of which is normally hidden on the inner bilayer of the intact cellular membrane. This manuscript reviews what is known about EV origins, their clearance from the circulation and how they contribute to malignant cell implants upon endothelium surfaces and subsequent tumor growth.
Superparamagnetism in ground and airborne electromagnetics: Geometrical and physical controls
Authors: Macnae James 
Published: August 2017

Superparamagnetic (SPM) effects are not uncommon in ground and airborne electromagnetic (AEM) geophysical data, with sources in the regolith typically being maghemite grains. Using laboratory parameters for maghemite and the Néel equation, a typical geophysical electromagnetic (EM) system is only sensitive to maghemites with dimensions in the 9–12 nm range. The power-law decay observed in a [Formula: see text] system depends on the magnetic nanoparticle volume distribution: Log normally distributed volumes centered on the detection window produce approximately [Formula: see text] decays after the electromagnetic responses have vanished. If most of the nanoparticles are smaller than the center of the system sensitivity, the power-law decays faster than the [Formula: see text] result, if most nanoparticles are larger, a response slower than [Formula: see text] results. Geologic origins of regolith maghemite favor a thin-layer geometry in the near surface. Shape-demagnetization effects imply that SPM responses observed will only arise from magnetization in the horizontal plane. For a ground transmitter, this is the very small area directly under the transmitter loop wire, causing only locally detectable effects. For an airborne transmitter, an extensive radial ring in which the magnetic field is subhorizontal is not demagnetized, and this results in detectable SPM airborne anomalies. For SPM sources in hard rock, a magnetization model consisting of spherical particles enclosed in a finite volume is adapted for SPM. This model shows that the falloff in SPM amplitude with airborne system altitude is rapid for surficial and finite-bedrock sources. As a result, fixed-wing surveys with a transmitter at a 90 m or higher altitude is much less likely to show SPM effects in the EM data. Because the secondary magnetic field of spherical particles is parallel to the transmitter dipole source direction at a colocated receiver, the model explains the empirical observation that concentric loop AEM systems do not detect any [Formula: see text]-component of an SPM response.
Intravesical rAd–IFNα/Syn3 for Patients With High-Grade, Bacillus Calmette-Guerin–Refractory or Relapsed Non–Muscle-Invasive Bladder Cancer: A Phase II Randomized Study
Authors: Shore Neal D. , Boorjian Stephen A. , Canter Daniel J. , Ogan Kenneth , Karsh Lawrence I. , Downs Tracy M. , Gomella Leonard G. , Kamat Ashish M. , Lotan Yair , Svatek Robert S. , Bivalacqua Trinity J. , Grubb Robert L. , Krupski Tracey L. , Lerner Seth P. , Woods Michael E. , Inman Brant A. , Milowsky Matthew I. , Boyd Alan , Treasure F. Peter , Gregory Gillian , Sawutz David G. , Yla-Herttuala Seppo , Parker Nigel R. , Dinney Colin P.N. 
Published: August 2017

Purpose Many patients with high-risk non–muscle-invasive bladder cancer (NMIBC) are either refractory to bacillus Calmette-Guerin (BCG) treatment or may experience disease relapse. We assessed the efficacy and safety of recombinant adenovirus interferon alfa with Syn3 (rAd–IFNα/Syn3), a replication-deficient recombinant adenovirus gene transfer vector, for patients with high-grade (HG) BCG-refractory or relapsed NMIBC. Methods In this open-label, multicenter (n = 13), parallel-arm, phase II study ( ClinicalTrials.gov identifier: NCT01687244), 43 patients with HG BCG-refractory or relapsed NMIBC received intravesical rAd–IFNα/Syn3 (randomly assigned 1:1 to 1 × 1011 viral particles (vp)/mL or 3 × 1011 vp/mL). Patients who responded at months 3, 6, and 9 were retreated at months 4, 7, and 10. The primary end point was 12-month HG recurrence-free survival (RFS). All patients who received at least one dose were included in efficacy and safety analyses. Results Forty patients received rAd–IFNα/Syn3 (1 × 1011 vp/mL, n = 21; 3 × 1011 vp/mL, n = 19) between November 5, 2012, and April 8, 2015. Fourteen patients (35.0%; 90% CI, 22.6% to 49.2%) remained free of HG recurrence 12 months after initial treatment. Comparable 12-month HG RFS was noted for both doses. Of these 14 patients, two experienced recurrence at 21 and 28 months, respectively, after treatment initiation, and one died as a result of an upper tract tumor at 17 months without a recurrence. rAd–IFNα/Syn3 was well tolerated; no grade four or five adverse events (AEs) occurred, and no patient discontinued treatment because of an adverse event. The most frequently reported drug-related AEs were micturition urgency (n = 16; 40%), dysuria (n = 16; 40%), fatigue (n = 13; 32.5%), pollakiuria (n = 11; 28%), and hematuria and nocturia (n = 10 each; 25%). Conclusion rAd—IFNα/Syn3 was well tolerated. It demonstrated promising efficacy for patients with HG NMIBC after BCG therapy who were unable or unwilling to undergo radical cystectomy.
Radiological distribution of brain metastases and its implication for the hippocampus avoidance in whole brain radiotherapy approach
Authors: Han Yi-Min , Cai Gang , Chai Wei-Min , Xu Cheng , Cao Lu , Ou Dan , Chen Jia-Yi , Kirova Youlia M. 
Published: August 2017

Objective:
Hippocampus avoidance in whole brain radiotherapy (HA-WBRT) offers the feasibility of less-impaired cognitive function than conventional WBRT. The study aims to assess the radiological distribution of brain metastases (BMs) with relation to the hippocampus and peri-hippocampus region as defined by the RTOG 0933 for better understanding of margin definition in HA-WBRT treatment planning.

Methods:
Consecutive patients with diagnosis of BM from enhanced MRI between March 2011 and July 2016 were analysed. The pre-treatment T 1 weighted, T 2 weighted, T 2 flair, three-dimensional spoiled gradient axial and contrast-enhanced axial cranial MR images of 226 patients are examined. The closest distances between the edge of hippocampus and the margin of tumours on different planes were measured.

Results:
A total of 226 patients with 1080 visible metastatic sites were reviewed. The origin of the primary tumors was in 72.6% lung (n = 164), in 45 cases (19.9%) breast cancer and in 7.5% other malignancies (n = 17). There were 758 (70.2%) lesions situated beyond the tentorium. The median size of single lesion was 13.9 ± 14.7 mm. Impossible, it seems that more of the patients are with only one lesion, to verify. The hippocampus involvement was found in 3.1% (n = 7, 95% CI 0.01–0.05) within 5 mm, 5.7% (n = 13, 95% CI 0.03–0.09) within 10mm and 8.4% (n = 19, 95% CI 0.05–0.12) within 20 mm. In multivariate analysis, the number 6 BM or higher was found to be an independent risk factor for hippocampal involvement (HI) (OR: 5.2, 5.38 and 3.84 in 5, 10 and 20 mm).

Conclusion:
This radiological study found that the incidence of hippocampus involvement is low in patients with BM. HA-WBRT can be delivered under the context of complete radiological diagnosis after careful delineation, proper margin definition and individual planning optimization.

Advances in knowledge:
The incidence of HI in patients with initial diagnosis of BM from solid tumours impacts the radiotherapeutic decision. Our radiological data analysed the incidence of HI not only to the conventional 5 mm margin definition, but also expanded to wider margins as 10 and 20 mm from hippocampus, which will help the treatment planning optimization with different technique.
MR imaging characteristics of breast cancer diagnosed during lactation
Authors: Oh Seung Won , Lim Hyo Soon , Moon Sung Min , Kim Jin Woong , Shin Sang Soo , Heo Suk Hee , Lee Ji Shin , Park Min Ho 
Published: August 2017

Objectives:
To describe the MR imaging characteristics of breast cancer diagnosed during lactation and evaluate the usefulness of MR imaging.

Methods:
The MR images of nine patients (age range, 29–37 years) with pathologically confirmed breast carcinoma during lactation were evaluated retrospectively. Background parenchymal enhancement of the lactating mammary tissue was determined. The images were reviewed for evaluation of lesion detection, enhancement type (mass/non-mass), shape, margin, contrast enhancement and time–intensity curve pattern in the dynamic study. The breast MR images after neoadjuvant chemotherapy were also reviewed.

Results:
Although the breasts showed marked (n = 7) or moderate (n = 2) background parenchymal enhancement, MR imaging depicted breast cancer in all patients. All nine tumours were visible as masses. The most common shape and margin of the masses were an irregular mass (n = 5) with an irregular margin (n = 9). Contrast enhancement was heterogeneous or rim enhancement. The predominant kinetic pattern was rapid increase (n = 9) in the initial phase and washout (n = 5) in the delayed phase. Additional sites of cancer other than the index lesion were detected with MR imaging in three patients (33.3%). MR imaging demonstrated partial response in five of six patients who were evaluated for response to chemotherapy.

Conclusion:
All breast cancers in lactating females in this study were observed on breast MR imaging despite the moderate-to-marked background parenchymal enhancement of lactating mammary tissue.

Advances in knowledge:
MR imaging can be used in the evaluation of disease extent and assessment of therapeutic response after neoadjuvant chemotherapy of breast cancer diagnosed during lactation.
PI-RADS version 2: evaluation of diffusion-weighted imaging interpretation between b = 1000 and b = 1500 s mm–
2
Authors: Kwon Mi-Ri , Kim Chan Kyo , Kim Jae-Hun 
Published: August 2017

Objective:
To investigate the variability of diffusion-weighted imaging (DWI) interpretation of Prostate Imaging Reporting and Data System (PI-RADS) version 2 (v2) in evaluating prostate cancer (PCa).

Methods:
154 patients with PCa underwent multiparametric 3T MRI, followed by radical prostatectomy. DWI with different b values (b = 0, 100, 1000 and 1500 s mm− 2) was obtained. Using the PI-RADS v2, two radiologists independently scored suspicious lesions in each patient and compared DWI of b = 1000 (DWI1000) with 1500 (DWI1500) s mm− 2 .

Results:
On DWI1000 and DWI1500, the intermethod and interobserver agreements of DWI scores were excellent in all patients (κ ≥ 0.873). In each peripheral zone and transition zone DWI scores, both observers showed excellent intermethod agreement between DWI1000 and DWI1500 (κ ≥ 0.897), and interobserver agreement for DWI1000 and DWI1500 was good to excellent (κ ≥ 0.796). For estimating clinically significant cancer, the area under receiver operating characteristics curves of DWI1000 and DWI1500 were 0.710 and 0.724 for observer 1 (p = 0.11), and 0.649 and 0.656 for observer 2 (p = 0.12), respectively.

Conclusion:
The PI-RADS v2 scoring at 3T shows excellent agreement between DWI1000 and DWI1500 in evaluating PCa, with excellent inter-observer agreement.

Advance in knowledge:
DWI using b = 1000 s mm−2 instead of b = 1500 s mm−2 reduces examination time or image distortion, with improved the signal-to-noise ratio.
Future Education Leaders' Needs in Serving Students With Severe Disabilities: A Call for Intentional Preparation
Authors: Robertson Phyllis M. , McCaleb Karen N. , Smith Nancy J. 
Published: August 2017

AbstractQualitative analysis of three discipline-specific focus groups (graduate students in educational leadership/educational administration, curriculum and instruction, and counseling) revealed that these participants are largely unprepared to serve students with extensive and pervasive support needs. Rather, these professionals reported relying upon their ability to learn from others, their personal experiences, and their capacity to “take risks and fake it.” They cited numerous barriers to effective implementation of inclusion revealing that they were often afraid to ask for clarification and support; had limited opportunities for meaningful collaboration; engaged with a system that often placed form over function; and worked with students who experienced segregation, neglect, and isolation. Participants offered suggestions for improving university-based preparation, enhancing professional development, and increasing hands-on learning opportunities along with the need to create a supportive system for educators, students, and their families.
Practice-infused drawing research: ‘Being present’ and ‘making present’
Authors: Bullen Duncan , Fox Jane , Lyon Philippa 
Published: August 2017

Abstract
How can we understand the pivotal value of touch and collaborative processes within two artists’ drawing practice and how do we articulate the generative nature of such practice-based research? Duncan Bullen’s drawing explores the relationship between hand, breath and surface, Jane Fox’s, the semi-resisted action of wind between paper and pencil. Both artists have a shared concern with non-representational drawing processes, an expanded notion of ‘material’ and a focus on the experience of reciprocity between the individual practitioner and the world in which they practice. These concerns are discussed in terms of ‘being present’ and ‘making present’, which this article attempts to conceptualize at an interim stage in the research with reference to theory about drawing, anthropology and meditation practice. The understanding of drawing mobilized here is one in which, as Jane Grisewood argues, ‘seeing’ is not a prerequisite. It is a practice of drawing that is about receiving and being. Lyon, Bullen and Fox are developing a collaborative methodology for this research in which their respective embodied, manual practices of drawing and writing are in dialogue.