bluuebunny/crossref_metadata_2025_split huggingface dataset:
Teaching End-of-Life Communication in Intensive Care Medicine: Review of the Existing Literature and Implications for Future Curricula
Authors: Zante Bjoern , Schefold Joerg C. 
Published: June 2017

Objectives: End-of-life (EOL) situations are common in the intensive care unit (ICU). Poor communication in respective situations may result in conflict and/or post-traumatic stress disorder in patients’ next of kin. Thus, training for EOL communication seems pivotal. Primary objective of the current report was to identify approaches for educational programs in the ICU with regard to EOL communication as well as to conclude on implications for future curricula. Materials and Methods: A literature review in MEDLINE, EMBASE, and PsychINFO was performed. A total of 3484 articles published between 2000 until 2016 were assessed for eligibility. Nine articles reporting on education in EOL communication in the ICU were identified and analyzed further. Results: The duration of EOL workshops ranged from 3 hours to 3 days, with several different educational methods being applied. Mounting data suggest improved comfort, preparedness, and communication performance in EOL providers following specific EOL training. Due to missing data, the effect of EOL training programs on respective patients’ next of kin remains unclear. Conclusion: Few scientific investigations focus on EOL communication in intensive care medicine. The available evidence points to increased comfort and EOL communication performance following specific individual EOL training. Given the general importance of EOL communication, we suggest implementation of educational EOL programs. When developing future educational programs, educators should consider previous experience of participants, clearly defined objectives based on institutional needs, and critical care society recommendations to ensure best benefit of all involved parties.
Reporting More but Moving Less? The Complex Relationship between Acculturation and Physical Activity Among US Adults
Authors: Zan Hua , Fan Jessie X. 
Published: June 2017

Purpose: To investigate the association between acculturation and physical activity (PA). Design: Cross sectional. Setting: The National Health and Nutrition Examination Surveys (NHANES) 2003 to 2006. Subjects: A total of 4029 adults (aged 20-64), including 2063 men and 1966 women. Measures: The outcome measures included both self-reported PA and device-assessed PA. The acculturation measure was constructed based on nativity, language use at home, and length of residence in the United States. Analysis: Regressions with domain analysis were conducted to adjust for the influence of confounding factors and complex survey design. Results: For men, self-reported PA increased with acculturation, especially leisure-time PA. However, device-assessed PA decreased with acculturation. For women, the results were more mixed. Conclusion: All evidence considered, we concluded that PA decreased with acculturation for US men.
Effects of Carisoprodol, Phenylbutazone and Antazoline
Authors: Lien Linda L. , Lien Eric J. 
Published: June 2017

Carisoprodol at 100 mg/Kg dosage level was found to increase the pentobarbital induced sleeping time in mice significantly, while phenylbutazone at 14 mg/Kg did not cause a significant change. The sex difference of the pentobarbital sleeping time was found to be dose dependent. The female mice were found to be more sensitive to the dose increase than the male. Carisoprodol at 50 mg/Kg level did not reduce the motor activity significantly. Antazoline phosphate at 14 mg/Kg reduced the motor activity by 34 percent. When these two drugs were given together the motility was reduced by more than 50 percent (P<0.005).
Management of Empty Pesticide Containers—A Study of Practices in Santa Cruz, Bolivia
Authors: Huici Omar , Skovgaard Marlene , Condarco Guido , Jørs Erik , Jensen Olaf Chresten 
Published: June 2017

Aims: The mismanagement of empty containers of pesticides, posing a risk to the environment and the health of people, has motivated the promotion of international policies and guidelines to mitigate such problems. Despite these guidelines, attention to this problem is inadequate in Bolivia. The objective was to study the knowledge and practical management of the containers and to implement a responsible management plan for empty pesticide containers. Methods: This study implemented the project from 2014 to 2016 in 2 municipalities of the Department of Santa Cruz. Integral and participatory processes of information, education, and training were used. A questionnaire study among pesticide users was used to investigate knowledge and management of the empty pesticide containers. Results: The authorities and the population responded to the program by taking a critical and active approach to the problem, improving their responsible practices, and 5500 kg of empty containers were collected. The cross-sectional study showed that 93% of the empty containers were disposed of in vulnerable places; 62% of the population did not know what triple washing is; 60% felt discomfort, headache, and/or dizziness while using pesticides; and 31% of the empty containers had pesticide residue inside them. Conclusions: The study illustrates a complex situation, mainly caused by lack of knowledge and clear guidelines. We recommend documentation of the social, economic, and productive characteristics of the region before any municipal program action is undertaken. The key element to sustainable change is an informed and coordinated participation of all actors.
The effects on anxiety and quality of life of breast cancer patients following completion of the first cycle of chemotherapy
Authors: Charalambous Andreas , Kaite Charis P , Charalambous Melanie , Tistsi Theologia , Kouta Christiana 
Published: June 2017

Objectives: Breast cancer patients as part of their treatment need to undergo various forms of chemotherapy. This is considered as a burdensome experience for many patients often leading to significant levels of anxiety. The aim of the study was to explore the anxiety levels and any correlations to the quality of life of women with breast cancer that were undergoing chemotherapy. Methods: This was a cross-sectional study utilizing an explanatory sequential design. Data were collected from 355 women with breast cancer with the Self Anxiety Scale, the EORTC QLQ-C30, the EORTC QLQ-BR23 and sociodemographic questionnaires. Further insight to patients’ experiences was given through 12 in-depth interviews. Results: Anxiety scores ranged between 24 and 75 (45.7 ± 10.11), with 44% reporting serious or/and intense anxiety. The results revealed statistically significant differences on patients’ anxiety levels depending on their source of support. Overall, patients’ global health-related quality of life was found to be low to average 55.91 ± 17.94. The results showed low emotional functioning (49.30 ± 29.12), low role functions (56.34 ± 27.50) and low sexual functioning (24.93 ± 20.75). Patients also reported experiencing problems with fatigue (49.04 ± 29.12), insomnia (44.32 ± 32.97), hair loss (48.25 ± 38.32) and arm symptoms (36.53 ± 23.71). Patients being solely supported by the family experienced higher anxiety levels (p < 0.001) and lower quality of life (p < 0.001). There was a statistically significant negative correlation between anxiety and quality of life (r = −0.623, p < 0.001). Statistically significant differences were also found in relation to demographics, anxiety and quality of life. The interviews provided further evidence on the impact of anxiety on patients’ lives. Conclusion: The time following the completion of the first cycle of chemotherapy is associated with anxiety and lower quality of life levels in breast cancer patients. Healthcare providers should consider the supportive healthcare needs from the beginning of chemotherapy in patients to optimize their conventional and supportive healthcare outcomes.
The influence of bicipital groove morphology on the stability of the long head of the biceps tendon
Authors: Yoo Jae Chul , Iyyampillai Geethan , Park Dongjun , Koh Kyoung-Hwan 
Published: June 2017

Purpose: We aimed to evaluate the influence of the bony morphology of the bicipital groove on the stability of the long head of the biceps tendon (LHBT). Methods: Among the patients who underwent magnetic resonance imaging of the shoulder at our outpatient clinic in 2012, those aged >40 years were included. After excluding cases with complete tear or unclear positioning of the biceps tendon, 464 shoulders were analyzed according to the position of the LHBT with respect to the bicipital groove. Shoulders with subluxation or dislocation of the LHBT were labeled as having unstable LHBT, while those with the LHBT located in the bicipital groove were labeled as having stable LHBT. The bony morphology of the bicipital groove was measured in terms of opening angle, medial wall angle, and depth. A shallow bicipital groove was defined as having an opening angle >94°, concurrent with earlier studies. We compared shoulders with stable and unstable LHBT regarding bicipital bony morphology. We also compared shoulders with normal and shallow grooves regarding tendon stability. Results: Shoulders with stable and unstable LHBT differed significantly regarding bony morphology. Shoulders with unstable LHBT showed a shallower mean depth (by 0.3 mm; p = 0.008), a smaller mean medial angle (by 2.2°; p = 0.014), and a larger mean opening angle (by 3.7°; p = 0.016). Bony morphology characterized by a shallow groove was significantly associated with increased prevalence of instability defined as LHBT subluxation or dislocation ( p = 0.011). Conclusion: A shallow bicipital groove, identified by the larger opening angle, smaller medial angle, and shallower depth, may represent a predisposing factor for biceps tendon instability.
Immune checkpoints in chronic obstructive pulmonary disease
Authors: Wilkinson Tom M.A. 
Published: June 2017

Cell-mediated immune responses are vital to the body's defence against infection and play a key role in tumour immunity. T-cell activation and cytotoxic function is tightly regulated by a series of immune-regulatory receptor–ligand interactions or immune checkpoints. These controls limit immune-mediated damage, particularly in the context of chronic infection. However, prolonged signalling through these axes can lead to progressive loss of T-cell function, termed exhaustion.Understanding of the biology of checkpoints and that exhaustion is reversible has been key to the development of new therapies directed at reversing the dysfunctional status of T-cells, which are dramatically improving outcomes of cancer treatment.Emerging data suggest that immune checkpoint axes are dysregulated in chronic obstructive pulmonary disease (COPD). T-cells from diseased lungs express the key receptor programmed death (PD)1 and demonstrate loss of cytotoxic function. However, the picture is complex with evidence of downregulation of the associated ligand PDL1 on alveolar macrophages. The resulting impact may be excessive T-cell inflammation as a consequence of acute infection, which may contribute to the pattern of exacerbation and lung damage characteristic of COPD. More work is needed to understand these immune controls in COPD before the therapeutic advances seen in lung cancer can be explored.
Rheopheresis in treatment of idiopathic sensorineural sudden hearing loss
Authors: Kostal Milan , Drsata Jakub , Bláha Milan , Lánská Miriam , Chrobok Viktor 
Published: June 2017

Backround Only few therapeutic options exist for patients with refractory sudden idiopathic sensorineural hearing loss (SISHL). Little is known about the efficacy of second-line therapies. Rheopheresis seems to be an effective therapeutic possibility. Methods Between 2012 and 2015, 106 patients with SISHL were enrolled in the study, of whom 52 were refractory to initial treatment. As salvage therapy, these patients were offered either 3 sessions of rheopheresis (33 pts) or intratympanic steroid treatment through MicroWick application (19 pts). Pure tone audiometry was performed at diagnosis, at the 1st month and the 1st year during the follow-up. Results Patients in the rheopheretic arm had higher hearing loss than in the MicroWick arm (81% vs. 52%, p = 0.04). In spite of this, there was a significant improvement for patients in the rheopheretic arm (27% of hearing loss reduction, p < 0.001) after the 1st month and this remained unchanged during the 1st year, while no improvement was seen in the MicroWick arm (0% of hearing loss reduction, p = 0.424). We found no predictive factor for steroid-failure in first-line therapy. Older age ( p = 0.003), presence of vertigo ( p = 0.006) and more profound initial hearing loss ( p < 0.001) were identified as negative prognostic markers. Conclusion Rheopheresis can be used as a potentially effective and safe salvage therapy for patients with cortico-refractory SISHL.
Adjuvant Cyclophosphamide and Docetaxel With or Without Epirubicin for EarlyTOP2A-Normal Breast Cancer: DBCG 07-READ, an Open-Label, Phase III, Randomized Trial
Authors: Ejlertsen Bent , Tuxen Malgorzata K. , Jakobsen Erik Hugger , Jensen Maj-Britt , Knoop Ann Soegaard , Højris Inger , Ewertz Marianne , Balslev Eva , Danø Hella , Vestlev Peter Michael , Kenholm Julia , Nielsen Dorte L. , Bechmann Troels , Andersson Michael , Cold Søren , Nielsen Hanne Melgaard , Maae Else , Carlsen Dorte , Mouridsen Henning T. 
Published: June 2017

PurposeAdministration of anthracycline and taxane therapy in the adjuvant setting is considered a standard for breast cancer. We evaluated a non–anthracycline-based regimen in TOP2A-normal patients.Patients and MethodsIn this multicenter, open-label, phase III trial, 2,012 women with early TOP2A-normal breast cancer and at least one high-risk factor were randomly assigned to receive six cycles of docetaxel (75 mg/m2) and cyclophosphamide (600 mg/m2) every 3 weeks (DC) or three cycles of epirubicin (90 mg/m2) and cyclophosphamide (600 mg/m2) followed by three cycles of docetaxel (100 mg/m2; EC-D). The primary end point was disease-free survival (DFS) after a median of 5 years of follow-up. Secondary end points were patient-reported toxicity, overall survival (OS), and distant disease–free survival.ResultsAt a median estimated potential follow-up of 69 months, 5-year DFS was 87.9% (95% CI, 85.6% to 89.8%) in the EC-D arm and 88.3% (95% CI, 86.1% to 90.1%) in the DC arm. There was no significant difference in the risk of DFS events (hazard ratio [HR], 1.00; 95% CI, 0.78 to 1.28; P = 1.00), distant disease–free survival (HR, 1.12; 95% CI, 0.86 to 1.47; P = .40), or mortality (HR, 1.15; 95% CI, 0.83 to 1.59; P = .41) in the intent-to-treat analysis. A significant interaction between menopausal status and treatment group was observed for DFS ( P = .04) but not for OS ( P = .07). Patients with grade 3 tumors derived most benefit from DC, and patients with grade 1 to 2 tumors derived most benefit from EC-D (DFS: interaction P = .02; and OS: interaction P = .03). Patients receiving EC-D reported significantly more stomatitis, myalgia or arthralgia, vomiting, nausea, fatigue, and peripheral neuropathy, whereas edema was more frequent after DC.ConclusionThis study provides evidence to support no overall outcome benefit from adjuvant anthracyclines in patients with early TOP2A-normal breast cancer.
From foundations to frontiers: the status and perception of formulation teaching in Canadian English-speaking psychiatry residency programs
Authors: Hickey Catherine , Fleury Gille , Penney Angela 
Published: June 2017

Aim of the studyFormulation is considered a key competence that should be taught during psychiatry training in residency. The scientific literature indicates shortcomings in teaching this clinical skill such as a lack of standardization and clear guidelines. The main objective of this research was to examine psychiatry residents’ perception regarding teaching of formulation in Canadian psychiatry residency programs.Subject or material and methodsAll Canadian psychiatry program directors in English programs were emailed a link for the study survey. The survey had a mix of closed and open-ended questions. With the exception of one Program Director, the survey link was distributed by all of the Program Directors. 116/661 (17.5%) of residents completed the survey.ResultsOverall, results of this survey indicated that residents did not feel very competent in their formulation skills, although they felt this was an important ability. Residents mostly learn it through individual supervision or through mentoring with a senior resident.DiscussionResidents suggested a more structured approach in teaching formulation, as well as adding a small group format or workshops.ConclusionsThis research could provide guidance to educators in developing new curricula in the context of the upcoming transition to the competence-based framework by the Royal College of Physicians and Surgeons of Canada.
Contract Theory: Impact on Biopharmaceutical Alliance Structure and Performance
Authors: Taneri Niyazi , De Meyer Arnoud 
Published: June 2017

Alliances for new product development have been studied extensively in the operations management literature. Alliances between an innovator and a partner create value by utilizing their complementary capabilities. In this paper, we seek to understand what drives the alliance structure: the choice between collaborative alliances where the parties exert joint efforts and sequential alliances where, for the most part, the partner takes over going forward. Our analysis of a data set of over 2,000 biopharmaceutical alliances reveals our main finding: a key role of operational choices is to address contract theoretic concerns faced by an alliance. We also find that aligning the choice with predictions based on contract theory has consequences for performance. Therefore, our analysis not only has descriptive power about the drivers of alliance choice, but also provides valuable insight into the performance and eventual fate of alliances formed. The online appendix is available at https://doi.org/10.1287/msom.2017.0617 .
Intercalary allograft augmented with intramedullary cement and plate fixation is a reliable solution after resection of a diaphyseal tumour
Authors: Gupta S. , Kafchinski L. A. , Gundle K. R. , Saidi K. , Griffin A. M. , Wunder J. S. , Ferguson P. C. 
Published: June 2017

AimsIntercalary allografts following resection of a primary diaphyseal tumour have high rates of complications and failures. At our institution intercalary allografts are augmented with intramedullary cement and fixed using compression plating. Our aim was to evaluate their long-term outcomes.Patients and MethodsA total of 46 patients underwent reconstruction with an intercalary allograft between 1989 and 2014. The patients had a mean age of 32.8 years (14 to 77). The most common diagnoses were osteosarcoma (n = 16) and chondrosarcoma (n = 9). The location of the tumours was in the femur in 21, the tibia in 16 and the humerus in nine. Function was assessed using the Musculoskeletal Tumor Society (MSTS) scoring system and the Toronto Extremity Salvage Score (TESS). The survival of the graft and the overall survival were assessed using the Kaplan-Meier method.ResultsThe median follow-up was 92 months (4 to 288). The mean MSTS 87 score was 29.1 (19 to 35), the mean MSTS 93 score was 82.2 (50 to 100) and the mean TESS score was 81.2 (43 to 100). Overall survival of the allograft was 84.8%. A total of 15 patients (33%) had a complication. Five allografts were revised for complications and one for local recurrence.ConclusionIntercalary allografts augmented with intramedullary cement and compression plate fixation provide a reliable and durable method of reconstruction after the excision of a primary diaphyseal bone tumour, with high levels of function and satisfaction. Cite this article: Bone Joint J 2017;99-B:973–8.
Proximalisation of the tibial tubercle gives a good outcome in patients undergoing revision total knee arthroplasty who have pseudo patella baja
Authors: Vandeputte F-J. , Vandenneucker H. 
Published: June 2017

AimsThe aim of this study was to compare the outcome of revision total knee arthroplasty (TKA) with and without proximalisation of the tibial tubercle in patients with a failed primary TKA who have pseudo patella baja.Patients and MethodsAll revision TKAs, performed between January 2008 and November 2013 at a tertiary referral University Orthopaedic Department were retrospectively reviewed. Pseudo patella baja was defined using the modified Insall-Salvati and the Blackburne-Peel ratios. A proximalisation of the tibial tubercle was performed in 13 patients with pseudo patella baja who were matched with a control group of 13 patients for gender, age, height, weight, body mass index, length of surgery and Blackburne-Peel ratio. Outcome was assessed two years post-operatively using the Knee Society Score (KSS).ResultsThe increase in KSS was significantly higher in the osteotomy group compared with the control group. The outcome was statistically better in patients in whom proximalisation of > 1 cm had been achieved compared with those in whom the proximalisation was < 1 cm.ConclusionIn this retrospective case-control study, a proximal transfer of the tibial tubercle at revision TKA in patients with pseudo patella baja gives good outcomes without major complications. Cite this article: Bone Joint J 2017;99-B:912–16.
The medium- and long-term outcome of total shoulder arthroplasty for primary glenohumeral osteoarthritis in middle-aged patients
Authors: Sowa B. , Bochenek M. , Bülhoff M. , Zeifang F. , Loew M. , Bruckner T. , Raiss P. 
Published: June 2017

AimsPromising medium-term results from total shoulder arthroplasty (TSA) have been reported for the treatment of primary osteoarthritis in young and middle-aged patients. The aim of this study was to evaluate the long-term functional and radiological outcome of TSA in the middle-aged patient.Patients and MethodsThe data of all patients from the previous medium-term study were available. At a mean follow-up of 13 years (8 to 17), we reviewed 21 patients (12 men, nine women, 21 shoulders) with a mean age of 55 years (37 to 60). The Constant-Murley score (CS) with its subgroups and subjective satisfaction were measured. Radiological signs of implant loosening were analysed.ResultsTwo shoulders (two patients) were revised and in two shoulders of two different patients, revision surgery was recommended. The mean CS increased from 23.3 (10 to 45) pre-operatively to 56.5 (26 to 81; p < 0.0001), but with a decrease in CS from 62.8 (38 to 93) to 56.5 (26 to 81) between medium- and long-term follow-up (p = 0.01). Without revision surgery, 18 patients (95%) rated their result as good or very good. The mean radiolucent line score for the glenoid components increased from 1.8 (0 to 6) to 8.2 (2 to 18) between medium- and long-term follow-up (p < 0.001).ConclusionTSA in young and middle-aged patients leads to improvement in clinical function and a relatively high satisfaction rate. However, clinical or radiological glenoid loosening worsens in the long term. Further studies are needed to optimise the treatment options in this patient population. Cite this article: Bone Joint J 2017;99-B:939–43.