bluuebunny/crossref_metadata_2025_split huggingface dataset:
Case-based clinical reasoning in feline medicine
Authors: Canfield Paul J , Whitehead Martin L , Johnson Robert , O’Brien Carolyn R , Malik Richard 
Published: March 2016

Aim: This is Article 2 of a three-part series on clinical reasoning that encourages practitioners to explore and understand how they think and make case-based decisions. It is hoped that, in the process, they will learn to trust their intuition but, at the same time, put in place safeguards to diminish the impact of bias and misguided logic on their diagnostic decision-making. Series outline: Article 1, published in the January 2016 issue of JFMS, discussed the relative merits and shortcomings of System 1 thinking (immediate and unconscious) and System 2 thinking (effortful and analytical). This second article examines ways of managing cognitive error, particularly the negative impact of bias, when making a diagnosis. Article 3, to appear in the May 2016 issue, explores the use of heuristics (mental short cuts) and illness scripts in diagnostic reasoning.
Comparison of Methods for Determining Aerobic Exercise Intensity Using Heart Rate in Acute Leukemia Patients Prior to Induction Chemotherapy
Authors: Story Christina , Bryant Ashley Leak , Phillips Brett , Bailey Charlotte , Shields Edgar W. , Battaglini Claudio 
Published: March 2016

Introduction: Cardiopulmonary exercise testing (CPET), the gold standard of cardiopulmonary evaluation, is used to determine VO2 levels at different aerobic exercise training intensities; however, it may not be feasible to conduct CPET in all clinical settings. Aims: To compare the heart rate reserve (HRR) and percent of 220-age methods for prescribing cycle ergometry exercise intensity using heart rate (HR) against the HRs obtained during a CPET in adults undergoing treatment for acute leukemia (AL). Methods: In this exploratory study, part of a larger randomized controlled trial, 14 adults with AL completed CPET on a cycle ergometer with indirect calorimetry within 96 hr of admission to a cancer hospital to determine VO2peak and HR corresponding to low (40% VO2peak), moderate (60% VO2peak), and high (75% VO2peak) exercise intensities. Analyses of variance were used to compare estimated HR for each intensity level using the HRR and percent of 220-age methods with HR determined via VO2peak. Results: HR corresponding to low-intensity exercise differed significantly across all three methods ( p ≤ .05). No significant differences were observed between HR estimated via the percent of 220-age method and determined via VO2peak at moderate (100 ± 8 and 113 ± 24 bpm, p = .122) or high intensities (125 ± 10 and 123 ± 25 bpm, p = .994). Conclusion: In adults with AL, HR-based methods for defining aerobic exercise intensities should be used with caution. At low intensity, neither should be used, while at moderate and high intensities, the percent of 220-age equation might serve as an adequate substitute for CPET.
Cluster-randomized trials: A closer look
Authors: McRae Andrew D , Taljaard Monica , Weijer Charles 
Published: March 2016

Background: The cluster-randomized trial is the methodology of choice for evaluating interventions administered at the group level such as public health and healthcare quality improvement interventions. Because of unique features of this design, it can be difficult to apply standard research ethics guidelines to cluster-randomized trials. The Ottawa Statement on the Ethical Design and Conduct of Cluster-Randomized Trials provides researchers and research ethics committees with comprehensive guidance on the ethical design, conduct and review of cluster-randomized trials. The Ottawa Statement supplements current national and international research ethics guidelines with guidance that is specific to cluster-randomized trials. In a recently published commentary, three examples drawn from the ClinicalTrials.gov registry were used to illustrate challenges associated with the cluster-randomized trial design. The commentary argued that the Ottawa Statement fails to provide comprehensive ethical guidance. In this article, we illustrate the application of the Ottawa Statement to the three trials. We challenge the conclusions reached in the commentary by demonstrating that an ethical analysis requires complete information. We correct some misperceptions about the cluster-randomized trial design. Methods: We collected essential additional information by contacting the authors of trials and by referring to published trial articles. We used the Ottawa Statement to conduct an ethical analysis of each trial and to address a number of substantive concerns raised regarding the identification of study participants, informed consent and harm benefit analysis. Results: In the two cases in which we were able to obtain detailed study information, we were able to complete the ethical analysis prescribed by the Ottawa Statement. Conclusion: The Ottawa Statement does provide a useful framework for the ethical design, review and conduct of cluster-randomized trials.
Clinical and radiological outcome after mechanical thrombectomy in acute ischemic stroke: What matters?
Authors: Kaschka Iris N , Kloska Stephan P , Struffert Tobias , Engelhorn Tobias , Gölitz Philipp , Kurka Natalia , Köhrmann Martin , Schwab Stefan , Doerfler Arnd 
Published: March 2016

Objective Recent studies have shown the efficacy of mechanical thrombectomy in acute ischemic stroke. We sought to identify prognostic parameters for clinical and radiological outcome after mechanical thrombectomy. Methods In 34 patients (age 72 ± 13 years, 64.7% women) with acute occlusion of the distal ICA and/or M1 segment who were treated with mechanical thrombectomy, the Spearman correlation was performed to assess potential prognostic outcome parameters (age, NIHSS, ASPECT, thrombus length (TL), clot burden score (CBS), relative filling time delay (rFTD), time to recanalization (TTR) and TICI score). The modified Rankin scale (mRS) and the Alberta Stroke Program Early CT (ASPECT) score were used for clinical and radiological outcome, respectively. Receiver operating characteristic (ROC) analysis was performed to assess parameters predicting favorable clinical (ΔmRS ≤ 2) and radiological outcome (ΔASPECT ≤ 2). Results Variables associated with favorable clinical outcome included NIHSS, TL, TTR and TICI score ( p ≤ 0.01) with NIHSS ≤ 15 ( p = 0.001, area under the curve (AUC) 0.87), TL ≤ 2 cm ( p = 0.017, AUC 0.75), TTR ≤ 231 min ( p = 0.001 AUC 0.88) and TICI ≥ 2b ( p = 0.050, AUC 0.70). Shorter TTR and higher TICI scores were associated with favorable radiological outcome ( p < 0.001) with TTR ≤ 224 min ( p = 0.023, AUC 0.77) and TICI ≥ 2b ( p = 0.000, AUC 0.86). Conclusion Fast and complete recanalization is essential to achieve a favorable radiological and functional outcome after mechanical thrombectomy in acute ischemic stroke. Age, CBS and collateral supply play a subordinate role.
Problem-based learning case writing by students based on early years clinical attachments: a focus group evaluation
Authors: Idowu Yewande , Muir Elizabeth , Easton Graham 
Published: March 2016

Objectives To evaluate the perception of medical students of the new approach to problem-based learning which involves students writing their own problem-based learning cases based on their recent clinical attachment, and team assessment. Design Focus group interviews with students using purposive sampling. Transcripts of the audio recordings were analysed using thematic analysis. Setting Imperial College School of Medicine, London. Participants Medical students in the second year of the MBBS course, who attended the problem-based learning case writing session. Main outcome measures To elicit the students’ views about problem-based learning case writing and team assessment. Results The following broad themes emerged: effect of group dynamics on the process; importance of defining the tutor’s role; role of summative assessment; feedback as a learning tool and the skills developed during the process. Conclusions Overall the students found the new approach, writing problem-based learning cases based on patients seen during their clinical attachments, useful in helping them to gain a better understanding about the problem-based learning process, promoting creativity and reinforcing the importance of team work and peer assessment which are vital professional skills. Further tutor development and guidance for students about the new approach was found to be important in ensuring it is a good learning experience. We hope this evaluation will be of use to other institutions considering introducing students’ case writing to problem-based learning.
The impact of the European Working Time Directive 10 years on: views of the UK medical graduates of 2002 surveyed in 2013–2014
Authors: Lambert Trevor W , Smith Fay , Goldacre Michael J 
Published: March 2016

Objectives To report doctors’ views about the European Working Time Directive (‘the Directive’). Design Survey of the medical graduates of 2002 (surveyed in 2013–2014). Participants Medical graduates. Setting UK. Main outcome measures Questions on views about the Directive. Results The response rate was 64% (2056/3196). Twelve per cent of respondents agreed that the Directive had benefited senior doctors, 39% that it benefited junior doctors, and 17% that it had benefited the NHS. More women (41%) than men (35%) agreed that the Directive had benefited junior doctors. Surgeons (6%) and adult medical specialists (8%) were least likely to agree that the Directive had benefited senior doctors. Surgeons (20%) were less likely than others to agree that the Directive had benefited junior doctors, whilst specialists in emergency medicine (57%) and psychiatry (52%) were more likely to agree. Surgeons (7%) were least likely to agree that the Directive had benefited the NHS. Most respondents (62%) reported a positive effect upon work–life balance. With regard to quality of patient care, 45% reported a neutral effect, 40% reported a negative effect, and 15% a positive effect. Most respondents (71%) reported a negative effect of the Directive on continuity of patient care, and 71% felt that the Directive had a negative effect upon junior doctors’ training opportunities. Fifty-two per cent reported a negative effect on efficiency in managing patient care. Conclusions Senior doctors agreed that the Directive benefited doctors’ work–life balance. In other respects, they were more negative about it. Surgeons were the least positive about aspects of the Directive.
Workshops that Work: Physician Involvement in Service Training
Authors: Brantley Meredith , Niekamp Cheryl 
Published: March 2016

Physician involvement in service training initiatives can have a significant impact on the patient experience. This paper highlights some of the key components of what makes physician involvement in training engagements successful and includes anecdotes and data to support the findings. Our service training program emerged from a desire to help clinic sections improve the patient experience. Our workshops contained customized materials that addressed service priority areas, as identified by patient satisfaction survey results, for individual clinic sections and included opportunities to practice the concepts introduced in each session. However, we were missing one key ingredient in the recipe for a successful training program — physician involvement. This paper focuses on a best practice in which two physicians took an active role in creating, customizing and delivering service training for their clinic section and made a tremendous impact on their overall patient satisfaction scores and section morale.
Do I Buy It? How AIDET™ Training Changes Residents' Values about Patient Care
Authors: Braverman Andrea Mechanick , Kunkel Elisabeth J. , Katz Leo , Katona Austin , Heavens Teresa , Miller Andrew , Arfaa Jennifer Jasmine 
Published: March 2016

Objectives Acquiring communication and interpersonal skills is an important part of providing patient-centered care and improving patient satisfaction. This study explores whether residents' own values about patient communication can be influenced by training. Methods As part of service excellence, a three-hour communication skills training in AIDET™ (Acknowledge, Introduce, Duration, Explanation, Thank You) was delivered to first and second Post-Graduate Year (PGY) residents (n = 123). A survey was designed to measure the value of patient communication and administered pre/post communication skills training. Results Residents' scores about communication values improved significantly for all areas pre- to post-training for patient communication skills (p<0.04). After training, there was little difference by medical specialty, other than surgical specialties, which showed the greatest increase in valuing requesting permission (p=0.034). Gender was also not associated with differences in values, except men showed a greater increase in valuing sitting down (p=0.021) and introductions (p=0.005) than women who already valued these specific behaviors prior to training. Conclusions Residents value communication, and AIDET™ training is a useful tool to increase the values of good communication and interpersonal skills to enhance service excellence.
Randomized multicenter phase 2 study of pomalidomide, cyclophosphamide, and dexamethasone in relapsed refractory myeloma
Authors: Baz Rachid C. , Martin Thomas G. , Lin Hui-Yi , Zhao Xiuhua , Shain Kenneth H. , Cho Hearn J. , Wolf Jeffrey L. , Mahindra Anuj , Chari Ajai , Sullivan Daniel M. , Nardelli Lisa A. , Lau Kenneth , Alsina Melissa , Jagannath Sundar 
Published: March 2016

Key Points
PomCyDex results in a higher overall response rate than pomalidomide and dexamethasone. PomCyDex is an effective, all oral regimen for refractory myeloma patients.
Prognostic Value of Ki-67 Index, Cytology, and Growth Pattern in Mantle-Cell Lymphoma: Results From Randomized Trials of the European Mantle Cell Lymphoma Network
Authors: Hoster Eva , Rosenwald Andreas , Berger Françoise , Bernd Heinz-Wolfram , Hartmann Sylvia , Loddenkemper Christoph , Barth Thomas F.E. , Brousse Nicole , Pileri Stefano , Rymkiewicz Grzegorz , Kodet Roman , Stilgenbauer Stephan , Forstpointner Roswitha , Thieblemont Catherine , Hallek Michael , Coiffier Bertrand , Vehling-Kaiser Ursula , Bouabdallah Réda , Kanz Lothar , Pfreundschuh Michael , Schmidt Christian , Ribrag Vincent , Hiddemann Wolfgang , Unterhalt Michael , Kluin-Nelemans Johanna C. , Hermine Olivier , Dreyling Martin H. , Klapper Wolfram 
Published: March 2016

Purpose Mantle-cell lymphoma (MCL) is a rather aggressive B-cell malignancy whose considerable variability of individual outcome is associated with clinical characteristics (Mantle Cell Lymphoma International Prognostic Index [MIPI]). The Ki-67 index is a strong independent prognostic factor; however, the biologic MIPI (MIPI-b) distinguishes only two groups, which does not appropriately depict the clinical heterogeneity. By using the cohort from the European MCL Younger and MCL Elderly trials, we aimed to evaluate the additional prognostic impact of cytology and growth pattern and to improve risk stratification with the Ki-67 index and MIPI. Patients and Methods Diagnostic tumor biopsies were reviewed by the European Mantle Cell Lymphoma Pathology Panel to determine Ki-67 index by using published guidelines, cytology, and growth pattern. We evaluated prognostic effects for overall survival (OS) by Cox regression. For the cohort used for MIPI-b development (German Low-Grade Lymphoma Study Group [GLSG] 1996 and GLSG2000), we checked whether the equally weighted combination of Ki-67 index (dichotomized at the validated 30% cutoff) and MIPI risk groups was adequate and compared the prognostic power of this modified combination to MIPI and MIPI-b for the MCL Younger/MCL Elderly cohort. Results The Ki-67 index was assessed in 508 of 832 patients (median age, 62 years). Blastoid cytology was associated with inferior OS independently of MIPI but not independently of the Ki-67 index. Growth pattern was not independently prognostic. The modified combination of the Ki-67 index and MIPI separated four groups with 5-year OS: 85%, 72%, 43%, and 17% (P < .001) and was more discriminative than MIPI and MIPI-b. Conclusion Using the Ki-67 index is superior to using cytology and growth pattern as prognostic factors in MCL. The modified combination of the Ki-67 index and MIPI showed a refined risk stratification, reflecting their strong complementary prognostic effects while integrating the most relevant prognostic factors available in clinical routine.
Review of Golia, Υμνώντας το έθνος
Authors: Papandreou Zeta G 
Published: March 2016

<br /><table class="data" width="100%"><tbody><tr valign="top"><td class="value">Paraskevi Golia, Υμνώντας το έθνος. Ο ρόλος των σχολικών γιορτών στην εθνική και πολιτική διαπαιδαγώγηση 1924-2010 [Praising the nation: The role of national day school commemorations in national and political-education policy, 1924-2010], Thessaloniki: Epikentro, 2011, 445 pp</td></tr></tbody></table>
Information Model as an Instrument for the Analysis of News Discourse
Authors: Добросклонская  , Dobrosklonskaya T. 
Published: March 2016

Under the conditions of information society special importance is attached
to a systematic and consistent study of the news texts, which are regarded
as the pinnacle of all media discourse, its basic structure around which all
media content is organized. At present the study of news texts applies a
wide range of different methods traditionally used for the analysis of socially
and culture bound discourse – linguistic, sociological, discursive, contentanalysis
etc. However the method specifically designed for the analysis of
the news has not been fully described yet. To fill in this gap the author offers
to use “the information model” that was designed within the framework of
media linguistics – a relatively new but already firmly established branch of
language studies. The article focuses on the use of information model for
the analysis of news discourse, specifically dealing with all its elements –
selection of facts, interpretation, shaping images, forming stereotypes and
cultural-ideological context.
Linguistic Economy Principle in Written Spontaneous Speech (on Texts of Spanish Social Networks Facebook, Twitter, Tuenty)
Authors: Кузьмина  , Kuzmina E. 
Published: March 2016

The article is devoted to methods of linguistic economy and fixing the oral
speech peculiarities in the texts of social networks. The interaction of oral
speech strategies with written text presentation in Internet communication
are considered. The conversational nature of the text with several violations
of a spelling rules, and the print efforts economy, which leads to the
use of unconventional spelling characters, are among the main underlined
peculiarities of colloquial written speech in Spanish social network communication.
Features of Speech Organization of the Corporate System
Authors: Селезнева  , Selezneva Larisa 
Published: March 2016

This article focuses on speech organization of a corporate system, which is
understood as the whole array of texts are created in the framework of one
or another body corporate in relation to the intelligent structure of subjects
of speech. Haierarchical structure is dominated by corporation, all interests
are subordinated to the interests of the сorporation and all language activities
are consistent with the company’s leaders. In speech organization
distinguish groups of texts on the basis of mandatory or voluntary disclosure
by the сorporation, the recipient factor, which is incorporative and captive
audience. In accordance with this, the texts have different communicative
status in speech organization of the сorporation. As a practical material
used the texts of the official sites of several Russian companies.
Main directions of updating and development of educating potential of tourism activities in educational organization
Authors: Нечаев Михаил , Nechaev Mikhail 
Published: March 2016

The article is devoted to solving the problem of actualization, search, implementation and further development
of the educational capacity of school tourism. Using the environmental approach to the organization of educational
space of a school, the potential is defined as the aggregate of the environment cash, its resources and
possibilities. The author, paying attention to the regent function of education in modern education, highlights
the most significant directions of updating of educating potential tourist activity. These are methodical, psychological
and pedagogical, organizational and managerial areas. Methodological direction is the methodical
support of teachers, organizing school tourism, the design and implementation of the activities for updating
and development of educating potential in the unity of curricular and extracurricular activities of students.
Psycho-pedagogical direction focuses on the creation of the child-adult community, self-revelation and selfrealization
potential of the individual as teacher and learner. Managerial direction is the development of
professional and personal qualities of the teacher in the organization and implementation of tourist activity of
pupils. The article presents a scheme of the implementation model of the above areas, which reflects the goals,
objectives and their implementation. The article reveals the essence and summary of the main directions of
development of educating potential of tourism activity in educational organizations. The presented materials
will help in modeling the development of the educational system of school and will help to actualize educational
function of tourism activity.
Recursive Inspection Games
Authors: von Stengel Bernhard 
Published: March 2016

We consider a sequential inspection game where an inspector uses a limited number of inspections over a larger number of time periods to detect a violation (an illegal act) of an inspectee. Compared with earlier models, we allow varying rewards to the inspectee for successful violations. As one possible example, the most valuable reward may be the completion of a sequence of thefts of nuclear material needed to build a nuclear bomb. The inspectee can observe the inspector, but the inspector can only determine if a violation happens during a stage where he inspects, which terminates the game; otherwise the game continues. Under reasonable assumptions for the payoffs, the inspector’s strategy is independent of the number of successful violations. This allows to apply a recursive description of the game, even though this normally assumes fully informed players after each stage. The resulting recursive equation in three variables for the equilibrium payoff of the game, which generalizes several other known equations of this kind, is solved explicitly in terms of sums of binomial coefficients. We also extend this approach to nonzero-sum games and “inspector leadership” where the inspector commits to (the same) randomized inspection schedule, but the inspectee acts legally (rather than mixes as in the simultaneous game) as long as inspections remain.