bluuebunny/crossref_metadata_2025_split huggingface dataset:
National Policies Fostering Hospice Care Increased Hospice Utilization and Reduced the Invasiveness of End-of-Life Care for Cancer Patients
Authors: Shao Yu-Yun , Hsiue Emily Han-Chung , Hsu Chih-Hung , Yao Chien-An , Chen Ho-Min , Lai Mei-Shu , Cheng Ann-Lii 
Published: April 2017

Abstract

Background
In 2011, two national policies aiming to foster hospice services for terminal cancer patients took effect in Taiwan. The single-payer National Health Insurance of Taiwan started to reimburse full hospice services. The national hospital accreditation program, which graded all hospitals, incorporated hospice utilization in its evaluation. We assessed the impact of these national policies.

Methods
A cohort of 249,394 patients aged ≥18 years who died of cancer between 2008 and 2013 were identified from the National Death Registry. We retrieved utilization data of medical services and compared the health care utilization in the final month of life before and after the implementation of the new policies.

Results
After the policy changes, hospice utilization increased from 20.8% to 36.2%. In a multivariate analysis adjusting for patient demographics, cancer features, and hospital characteristics, hospice utilization significantly increased after 2011 (adjusted odds ratio [AOR] 2.35, p &lt; .001), accompanied by a decrease in intensive care unit (ICU) admissions, invasive mechanical ventilation (IMV), and cardiopulmonary resuscitation (CPR; AORs 0.87, 0.75, and 0.80, respectively; all p &lt; .001). The patients who received hospice services were significantly less likely to receive ICU admissions, IMV, and CPR (AORs 0.20, 0.12, and 0.10, respectively; all p &lt; .001). Hospice utilization was associated with an adjusted net savings of U.S. $696.90 (25.2%, p &lt; .001) per patient in the final month of life.

Conclusion
The national policy changes fostering hospice care significantly increased hospice utilization, decreased invasive end-of-life care, and reduced the medical costs of terminal cancer patients.
Endocrine Therapy Initiation and Medical Oncologist Utilization Among Women Diagnosed with Ductal Carcinoma in Situ
Authors: Anderson Chelsea , Meyer Anne Marie , Wheeler Stephanie B. , Zhou Lei , Reeder-Hayes Katherine E. , Nichols Hazel B. 
Published: April 2017

Abstract

Background
Though randomized clinical trials have demonstrated a reduction in second breast events with endocrine therapy among women with ductal carcinoma in situ (DCIS), use of these therapies remains highly variable. The purpose of this study was to evaluate patient and treatment-related factors associated with endocrine therapy initiation and medical oncology specialty utilization after DCIS.

Materials and Methods
We identified women with a DCIS diagnosis during 2006–2010 in the North Carolina Central Cancer Registry with linked public and private insurance claims in the University of North Carolina Integrated Cancer Information Surveillance System data resource. Multivariable generalized linear regression models were used to estimate risk ratios (RR) and 95% confidence intervals (CI) for endocrine therapy initiation in the year following DCIS diagnosis.

Results
Among 2,090 women with a DCIS diagnosis, 37% initiated endocrine therapy. Initiation was less common among women aged 75+ at diagnosis (RR = 0.79; 95% CI: 0.64–0.97 vs. age 45–54) and women treated with breast-conserving surgery (BCS) who did not receive radiation (RR = 0.63; 95% CI: 0.50–0.78 vs. BCS plus radiation). Consultation with a medical oncologist was strongly associated with endocrine therapy initiation (RR = 1.40; 95% CI: 1.23–1.61). Women who saw a medical oncologist more often had private insurance, higher census tract-level income, hormone receptor positive disease, and treatment with BCS and radiation.

Conclusion
Treatment strategies for DCIS remain controversial. Our data suggest that endocrine therapy is more often used in addition to standard therapies such as BCS plus radiation, rather than as an alternative to radiation.
Association Study Confirmed Three Breast Cancer-Specific Molecular Subtype-Associated Susceptibility Loci in Chinese Han Women
Authors: Xu Yihui , Chen Mengyun , Liu Chenchen , Zhang Xiaowei , Li Wei , Cheng Huaidong , Zhu Jun , Zhang Mingjun , Chen Zhendong , Zhang Bo 
Published: April 2017

Abstract

Background
Breast cancer is a heterogeneous and polygenic disease that can be divided into different molecular subtypes based on histological and genomic features. To date, numerous susceptibility loci of breast cancer have been discovered by genome-wide association studies and may expand the genetic features. However, few loci have been further studied according to molecular subtypes.

Materials and Methods
We genotyped 23 recently discovered single nucleotide polymorphisms using the Sequenom iPLEX platform in a female Chinese cohort of 3,036 breast cancer patients (2,935 samples matched molecular subtypes) and 3,036 healthy controls.

Results
Through a stratification analysis, 5q11.2/MAP3K1 (rs16886034, rs16886364, rs16886397, rs1017226, rs16886448) and 7q32.3/LINC-PINT (rs4593472) were associated with Luminal A, and 10q26.1/FGFR2 (rs35054928) was associated with Luminal B.

Conclusion
In our study, breast cancer-specific molecular subtype-associated susceptibility loci were confirmed in Chinese Han women, which contributes to a better genetic understanding of breast cancer in different molecular subtypes.
Clinical Variant Classification: A Comparison of Public Databases and a Commercial Testing Laboratory
Authors: Gradishar William , Johnson KariAnne , Brown Krystal , Mundt Erin , Manley Susan 
Published: April 2017

Abstract

Background
There is a growing move to consult public databases following receipt of a genetic test result from a clinical laboratory; however, the well-documented limitations of these databases call into question how often clinicians will encounter discordant variant classifications that may introduce uncertainty into patient management. Here, we evaluate discordance in BRCA1 and BRCA2 variant classifications between a single commercial testing laboratory and a public database commonly consulted in clinical practice.

Materials and Methods
BRCA1 and BRCA2 variant classifications were obtained from ClinVar and compared with the classifications from a reference laboratory. Full concordance and discordance were determined for variants whose ClinVar entries were of the same pathogenicity (pathogenic, benign, or uncertain). Variants with conflicting ClinVar classifications were considered partially concordant if ≥1 of the listed classifications agreed with the reference laboratory classification.

Results
Four thousand two hundred and fifty unique BRCA1 and BRCA2 variants were available for analysis. Overall, 73.2% of classifications were fully concordant and 12.3% were partially concordant. The remaining 14.5% of variants had discordant classifications, most of which had a definitive classification (pathogenic or benign) from the reference laboratory compared with an uncertain classification in ClinVar (14.0%).

Conclusion
Here, we show that discrepant classifications between a public database and single reference laboratory potentially account for 26.7% of variants in BRCA1 and BRCA2. The time and expertise required of clinicians to research these discordant classifications call into question the practicality of checking all test results against a database and suggest that discordant classifications should be interpreted with these limitations in mind.
Public Servants' Right to Strike in Lesotho, Botswana and South Africa – A Comparative Study
Authors: Cohen Tamara , Matee Letlhogonolo 
Published: April 2017

Restrictions on the rights of public officers to strike are permitted by the Constitutions of Lesotho, Botswana and South Africa, where such limitations are reasonable, necessary and justifiable in a democratic society. The limitation of this right in the context of public servants is endorsed by the ILO in the Freedom of Association Digest of Decisions and Principles which holds that "[t]he right to strike can be restricted or even prohibited in the public service or in essential services in so far as a strike there could cause serious hardship to the national community and provided that these limitations are accompanied by certain compensatory guarantees".[1]
Public officers in Lesotho are deprived of the right to join trade unions or to strike, without exception or justification. Furthermore in Lesotho no dispute resolution mechanism exists to effectively facilitate the final resolution of disputes of interest in the public sector.
This paper considers whether the limitations imposed on the freedom and right to strike of public officers in Lesotho are in breach of international obligations and are reasonable and justifiable in a free and democratic society committed to the rule of law. In so doing a comparative analysis of the jurisdictions of South Africa and Botswana is undertaken. It concludes that Lesotho is in breach of its obligations as a member state of the ILO and its constitutional commitment to freedom of association and needs to be urgently addressed.
DATAS DE SEMEADURA PARA O CULTIVO EM SUCESSÃO SOJA-MILHO SAFRINHA BASEADAS NA PRODUTIVIDADE PARA AS REGIÕES DE MARINGÁ - PR E CHAPECÓ - SC
Authors: Arakaki Allison Massami , Minuzzi Rosandro Boligon 
Published: April 2017

Objetivou-se neste estudo definir os melhores períodos de semeadura para o cultivo em sucessão soja e milho safrinha em sistemas de plantio direto e convencional para as regiões de Maringá (PR) e Chapecó (SC) baseado, principalmente na redução de produtividade. Foram utilizados dados meteorológicos de janeiro de 1991 a junho de 2015 pertencentes ao Instituto Nacional de Meteorologia (INMET) dos referidos municípios. Para a definição dos períodos de semeadura favoráveis considerou-se dois critérios: 1º) baseado no estresse térmico, o período onde decêndio tiver probabilidade inferior a 20% de ocorrência de geada e temperatura media diária do ar abaixo de 10°C; e 2º) baseado na redução da produtividade em decorrência do estresse hídrico, por falta de água para ambas as culturas, com simulações que variaram em função de diferentes datas de semeadura espaçadas num período de 10 dias e definidas de acordo com os resultados obtidos pelo primeiro critério. Concluiu-se que em Maringá, não há uma barreira climática para a sucessão de soja e milho safrinha. Para Chapecó, o plantio de milho safrinha é recomendado, desde que o ciclo não atinja o terceiro decêndio de junho.
QUALIDADE DE QUEIJOS MINAS FRESCAL PRODUZIDOS E COMERCIALIZADOS INFORMALMENTE EM AGROINDÚSTRIAS FAMILIARES
Authors: Vinha Mariana Barboza , De Oliveira Pinto Cláudia Lúcia , Vanetti Maria Cristina Dantas , Souza Maria Regina De Miranda , Chaves José Benício Paes 
Published: April 2017

Nesta pesquisa relacionaram-se as condições de produção e de comercialização de queijos Minas Frescal produzidos em agroindústrias familiares informais do Município de Viçosa, MG, com a qualidade higiênicosanitária do produto. Foram coletadas 77 (38 +39) amostras de queijos Minas Frescal provenientes de agroindústrias familiares, não inspecionadas. As amostras foram coletadas na fonte de produção e em seus respectivos pontos de comercialização. As condições de produção e de comercialização também foram avaliadas. As agroindústriasapresentaram baixo grau de adequação às Boas Práticas de Fabricação (BPF) e alto percentual de amostras em desacordo com os padrões microbiológicos, o que indica relação direta entre grau de atendimento aos requisitos de BPF e a qualidade do produto final. A qualidade higiênico-sanitária dos queijos foi insatisfatória associadaao alto índice de contaminação por bactérias do grupo coliformes e por estafilococos coagulase positiva. Detectouse a presença de Listeria monocytogenes em uma amostra de queijo. A presença de Salmonella sp não foi constatada em nenhuma das amostras. A adoção de medidas orientativas, o cumprimento das BPF e a melhoria das condições de comercialização do produto são medidas necessárias para aperfeiçoar a qualidade dos queijos produzidos, prevenir a ocorrência de doenças associadas ao consumo de queijos contaminados, reduzir as perdaseconômicas de modo a garantir a continuidade da atividade em pequenas agroindústrias familiares.
Geophysical and physicochemical characterization of organic waste contamination of hydrolithofacies in the coastal dumpsite of Akwa Ibom State, southern Nigeria
Authors: Ibuot Johnson C. , Okeke Francisca N. , George Nyakno J. , Obiora Daniel N. 
Published: April 2017

Abstract
Geophysical and physicochemical methods were carried out to examine the effect of leachate on groundwater in a dumpsite location in Akwa Ibom State, Nigeria. This was done to ascertain the level of organic contamination in the wells located in the study area. The analysis of water samples from boreholes close to the dumpsite was done to constrain the interpretation of electrical resistivity data on the reality of the effect imposed by dumpsite leachate on the hydrolithofacies. The resistivity values of the underlying layers were observed to be lower than the overlying layer, an effect which may be associated with the infiltration of leachate into the underlying layers. The geohydrolayer resistivities range from 78.4 to 1,669.8 Ωm. The contour maps generated display the variations of the parameters. The elevation contour map indicates the flow of groundwater in a southwest–northeast direction which also depicts the direction of leachate flow. The physicochemical water samples show differences in concentrations of the physicochemical parameters. The concentrations of the ions in the water samples measured are compared with the WHO standard for drinking water. The sodium absorption ratio and sodium percentage show that the groundwater within the dumpsite has no negative effect on the subsurface.
Alcohol Consumption and Age in Thailand from 2006 to 2011: An Exploration of Non-Linear Relationships
Authors: Changpetch Pannapa , Haughton Dominique 
Published: April 2017

Background:
In this paper, we investigate how household alcohol consumption in Thailand relates to the age of the head of household.

Methods:
We use datasets drawn from socio-economic surveys of Thai households conducted during the period of 2006–2011, and we use Treenet, a data-mining technique, to investigate nonlinear relationships between response and predictors. Our study shows that households with a head of household aged between 25 and 30 years old were the most likely to consume alcohol at home and that this likelihood decreased after the age of 30.

Results:
Our results also reveal that the proportion of total household expenditure allocated to alcohol decreased over time, but in different ways for different age groups. Moreover, we find that the gaps in alcohol spending across the different age groups tend to become smaller over time. Our results suggest that Thai government policies seem to have been accompanied by a relative decrease in alcohol consumption by younger groups.
The Study on the Awareness, Knowledge and Perception of Malaria among Selected Secondary School Students in Akure Metropolis, Nigeria
Authors: Oluyemi Omoya F. , Oluyemi Ajayi K. 
Published: April 2017

Background:
The negligence of health education and promotion has contributed to increase in morbidity and mortality of malaria among children.

Method:
This study was carried out in selected secondary schools in Akure, South-western Nigeria to assess the level of awareness, knowledge and perceptive of the use of treated mosquito nets among children of age group 9 and 17 years. 200 pieces of questionnaires were distributed randomly to the respondents.

Results and Discussion:
Demographic information of respondents, awareness, knowledge and perception on malaria was obtained. 96% of the respondents know that mosquito transmits malaria parasite. The respondents’ knowledge on the symptoms of malaria as persistence headache was 94% while 6% wrongly said itching and bleeding were among the symptoms of malaria. 74% have experienced mosquito bites while 26% haven't experienced it. Sleeping under treated net by the respondents was poor as only 2% of them always sleep under insecticide treated net and 44% never sleep under it. Although, awareness of malaria among the secondary school students is high, there is a high percentage (%) of the respondents who never sleep under insecticide treated net.

Conclusion:
Therefore, health education on awareness of insecticide-treated net should be emphasised for successful elimination of malaria.
What is Sudden Cardiac Death?
Authors: Gill James R. , Lange Rachel A. , Azar Omar P. 
Published: April 2017

Sudden cardiac death (SCD) is a rapid, unexpected death due to cardiac causes. The differential diagnosis includes diseases from all four structural divisions of the heart: the blood vessels, myocardium, valves, and conduction system. Although ischemic heart disease is a common cause of SCD, acute myocardial infarcts and/or coronary thromboses are not always detected and are not required to make the diagnosis of death due to atherosclerotic coronary disease. Some people die suddenly from heart disease with a grossly and microscopically normal heart. Molecular analysis of some of these autopsy-negative, sudden unexplained deaths (SUD) may detect putative cardiac channel mutations. There are three SCD scenarios that are of particular interest to forensic pathologists: sudden cardiac deaths in young athletes, during criminal altercations (homicide by heart attack), and in other hostile environments. In young athletes, most sudden deaths involve cardiac disease and include cardiomyopathies, congenital coronary artery anomalies, myocarditis, and channelopathies. One must, however, consider other causes in these deaths (e.g., commotio cordis, hyperthermia, sickle cell trait). Homicide-by-heart-attack deaths are those in which the cause of death is an acute exacerbation of underlying cardiac disease, however, the manner is homicide because a criminal act triggered the lethal pathologic cascade. A sudden cardiac arrest may occur in hostile locations with resultant trauma (e.g., while driving a motor vehicle). When the event occurs in the bathtub or other body of water, the question of whether the person died naturally from heart disease or unnaturally from trauma (e.g., drowning) often arises. One should not be mislead by the initial physical surroundings of the death (i.e., in a motor vehicle collision, or swimming pool) and fail to distinguish a natural sudden death from an accidental one.
Death Certification - Revisiting the Primary CDC and Name Literature
Authors: Nashelsky Marcus 
Published: April 2017

Death certification is performed by clinical physicians, physician medical examiners, and coroners. Some states also permit certification by nurses and physician assistants. The certifier enters specific disease and/or injury information on the death certificate to summarize the medical process(es) that culminated in death. These data condense a decedent's significant medical history and, in aggregate, present a year-to-year (or longer) view of disease and injury prevalence in the United States. The United States Centers for Disease Control and Prevention (CDC) is the umbrella organization that collects and processes all death certificate data. CDC publications are considered the primary guiding literature for completion of the medical portion of a death certificate; an expanded discussion of manner of death is provided by a National Association of Medical Examiners (NAME) publication. All certifiers should be familiar with the CDC death certification concepts; a subset of certifiers (medical examiners and coroners) will also have a working knowledge of the NAME death certification concepts. Inevitably, there will be incremental drift in an individual's practice over time. This work intends to succinctly restate the current rules of death certification as defined by the CDC and, to a lesser degree, as interpreted by NAME. Gaps are also identified. This work is not a comprehensive review of the many nuances or special circumstances of death certification.
Toxicology Analysis for Pathologists: A Review of the Available Techniques and Technologies, Including Recommendations for Best Practice
Authors: Chatterton Craig , Osselton M. David 
Published: April 2017

The success of the forensic postmortem investigation that is suspected to involve drugs or poisons depends on the toxicologist and pathologist/medical examiner working closely together as a team. The pathologist relies on the experience and analytical skills of the toxicology laboratory to provide answers concerning the possible presence of drugs in autopsy specimens; however, in order that this may be successful, the toxicologist relies on the pathologist to provide appropriate specimens for analysis. The role of the forensic toxicologist is to then identify drugs or toxins in the human body tissues and to offer an interpretation as to whether or not their presence may be a contributory factor to the death. This review will consider the scope of toxicology analysis in relation to forensic investigations, outline the processes undertaken in the forensic laboratory and offer guidance to assist the medical examiner who may wish to employ near-body drug screening. The review will also demonstrate the importance of specimen collection at autopsy and relate this to the techniques available in the forensic toxicology laboratory; recommendations for appropriate specimen preservation and storage will also be discussed. The pathologist and toxicologist must work closely as a team to ensure that poisoning is not missed.
STUDI KOMPARATIF PENGGUNAAN METODE PEMBELAJARAN BERBASIS MASALAH (PROBLEM BASED LEARNING) DAN METODE PEMBELAJARAN PENYELESAIAN MASALAH (PROBLEM SOLVING) DALAM MENINGKATKAN KEMAMPUAN BERPIKIR KREATIF SISWA
Authors: Solihat Ai Nur 
Published: April 2017

Penelitian ini bertujuan untuk mengetahui perbedaan kemampuan berpikir kreatif siswa yang mendapatkan perlakuan metode pembelajaran berbasis masalah (problem based learning) dan metode pembelajaran pemecahan masalah (problem solving) pada mata pelajaran ekonomi.
Metode penelitian yang digunakan adalah metode kuasi eksperimen, dengan subyek penelitian terdiri dari tiga kelas yaitu kelas X.4 (kelas problem solving), X.5 (kelas PBL) dan X.6 (kelas kontrol). Pengumpulan data dilakukan dengan tes tertulis, observasi, dan kuesioner yang diberikan guru kepada siswa. Pengolahan data dilakukan dengan uji t (paired-sample t-test) dan independent sample t-test menggunakan aplikasi program SPSS. 21.
Berdasarkan hasil penelitian menunjukkan bahwa terdapat perbedaan kemampuan berpikir kreatif siswa pada kelas yang menggunakan metode pembelajaran berbasis masalah (problem based learning/PBL) sebelum dan sesudah perlakuan. Terdapat perbedaan kemampuan berpikir kreatif siswa pada kelas yang menggunakan metode pemecahan masalah (problem solving) sebelum dan sesudah perlakuan. Terdapat perbedaan kemampuan berpikir kreatif siswa yang menggunakan metode pembelajaran berbasis masalah (Problem based learning/PBL) dan metode pembelajaran konvensional sesudah perlakuan (treatment). Terdapat perbedaan peningkatan kemampuan berpikir kreatif siswa yang menggunakan metode pembelajaran penyelesaian masalah (problem solving) dan metode pembelajaran konvensional sesudah perlakuan (treatment). Akan tetapi, tidak terdapat perbedaan peningkatan kemampuan berpikir kreatif siswa yang menggunakan metode pembelajaran berbasis masalah (Problem based learning) dan metode pembelajaran penyelesaian masalah (problem solving) sesudah perlakuan (treatment).