bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary care physicians experiences of caring for cancer survivors: Toward developing a primary care-responsive cancer survivorship research agenda.
Authors: O'Malley Denalee M. , Davis Stacy N. , Crabtree Benjamin F , Hudson Shawna V. 
Published: March 2017

97 Background: Understanding of the ecology of primary care can inform efforts that aim to build primary care capacity to address cancer survivorship issues. This study describes the experiences of primary care physicians (PCPs) delivering care to cancer survivors. Methods: Semi-structured in-depth interviews were conducted with PCPs (n=30) across two NCI-funded studies of cancer survivorship in primary care. PCPs were recruited from primary care practices enrolled in a qualitative case study of cancer survivorship in patient centered medical homes (R01 CA176545; n=21) and from a sample recruited for the formative development of a primary care mHealth and health coaching interventions for cancer survivors (R01 CA176838; n=9). Interviews averaged 30 minutes, were audio-recorded and transcribed verbatim. A multi-step immersion/crystallization approach was used to identify emergent themes using Atlas.ti. Results: PCPs stated that their role in cancer survivorship care varies widely and is often shaped by patient characteristics. These characteristics include: patient expectations of the PCPs role; the patient’s ability to provide clinical details about their cancer and its treatment; and the status of patient relationship with cancer treatment team. PCPs described having incomplete information and recounted experiences of cancer survivors presenting for visits motivated by fear of disease recurrence. PCPs described the tensions around having to make decisions about further additional testing versus offering support about recurrence of fears with incomplete clinical information. PCPs also expressed a need for basic clinical information and surveillance plans to be integrated into existing systems of care (e.g. electronic medical record systems and registries), citing immunization schedules as a potential model. Conclusions: The lack of clinical information to inform cancer survivors’ care remains a critical challenge to PCPs. Survivorship care plans are a proposed strategy to rectify informational deficits; however, further evaluation of how effectively care plans integrate into primary care systems and processes are needed.
Understanding primary care provider (PCP) experiences with survivorship care plans (SCPs) and informational needs when caring for cancer survivors.
Authors: Garces Natalie , Eaton Tara , Robinson Myra M , York Beth , Bailey-Dorton Chasse Margot , Brick Wendy G. 
Published: March 2017

98 Background: Survivorship advocate organizations, including the Commission on Cancer and the American College of Surgeons, have proposed SCPs as one solution to help meet the post-treatment needs of cancer survivors and improve coordination of care between provider types. Though there have been a few recent studies investigating PCP evaluation of SCPs and their survivorship informational needs, widespread incorporation of PCP and other provider types’ perspectives on survivorship care planning and SCPs is lacking. Methods: Levine Cancer Institute emailed 598 surveys to PCPs and obstetrics and gynecology (OBGYN) providers affiliated with Carolinas HealthCare System. 159 surveys were returned (26.6% response rate) between February and August 2016. Results: Nearly half of providers reported having received a SCP (42.4%, 67 of 158) and the vast majority of those who did (95.5%, 64 of 67) found them useful. Providers stated that the most useful parts of the SCP for their practice needs were the surveillance recommendations (50.0%) and the treatment summary (45.3%). Respondents indicated the most challenging part of caring for cancer survivors is knowing the recommended surveillance tests/schedule/who is the responsible provider to order tests (53.8%) and knowing what late-effects of treatment to look out for (20.2%). The majority (77.7%) of providers reported using Up-to-Date to guide them in their care of patients who have completed cancer treatment. Providers indicated that guidelines for identifying and managing late (44.9%) and lingering (32.7%) effects of treatment would be the most helpful resources in caring for cancer survivors. Finally, providers reported interest in attending future CME conferences on surveillance (73.4%), managing late (57.8%) and lingering (54.1%) effects, and integrative and alternative therapies (24.8%). Conclusions: Preliminary findings from this internal survey suggest PCPs and OBGYNs may find SCPs useful and may need additional resources to guide their care of cancer survivors. We recommend formal study of preferences for SCP content among these understudied provider groups in the coordination of survivorship care.
A Contemporary Medicolegal Analysis of Implanted Devices for Chronic Pain Management
Authors: Abrecht Christopher R. , Greenberg Penny , Song Ellen , Urman Richard D. , Rathmell James P. 
Published: March 2017

BACKGROUND:
Analysis of closed malpractice claims allows the study of rare but serious complications and likely results in improved patient safety by raising awareness of such complications. Clinical studies and closed claims analyses have previously reported on the common complications associated with intrathecal drug delivery systems (IDDS) and spinal cord stimulators (SCS). This study provides a contemporary analysis of claims from within the past 10 years.

METHODS:
We performed a closed claims analysis for a period January 1, 2009 to December 31, 2013 for cases with pain medicine as the primary service. These cases were identified using the Controlled Risk Insurance Company (CRICO) Comparative Benchmarking System (CBS), a database containing more than 300,000 malpractice claims from more than 400 academic and community institutions, representing approximately 30% of malpractice cases in the United States. The clinical narratives, which included medical files, claims files, depositions, and expert witness testimony, were reviewed by the authors, as were the CRICO coded variables, which included algorithmically determined contributing factors to the patient injury.

RESULTS:
Intrathecal drug delivery systems represented 17 of the closed claims; spinal cord stimulators represented 11 of the closed claims. The most common chronic pain diagnoses for which a device was implanted included failed back surgery syndrome and spasticity. The average total incurred for pain medicine claims was $166,028. Damaging events included IDDS refill errors (eg, subcutaneous administration of medication, reprogramming errors), intraoperative nerve damage, and postoperative infection (eg, epidural abscess, meningitis). High-severity outcomes included nerve damage (eg, paraplegia) and death. Medium-severity outcomes included drug reactions (eg, respiratory arrest from opioid overdose) and the need for reoperation. For both IDDS and SCS, deficits in technical skill were the most common contributing factor to injury, followed by deficits in clinical judgment, communication, and documentation.

CONCLUSIONS:
Implanted devices used for pain management involve a significant risk of morbidity and mortality. Proper education of providers and patients is essential. Providers must acquire the technical skills required for the implantation and refilling of these devices and the clinical skills required for the identification and management of complications such as intrathecal granuloma. Proper patient selection and clear communication between the provider and the patient about these possible complications are of paramount importance.
Tanshinone IIA Attenuates Sevoflurane Neurotoxicity in Neonatal Mice
Authors: Xia Yimeng , Xu Heng , Jia Chenfei , Hu Xiaodong , Kang Yu , Yang Xiaoxuan , Xue Qingsheng , Tao Guorong , Yu Buwei 
Published: March 2017

BACKGROUND:
Sevoflurane is the most widely used inhalational anesthetic in pediatric medicine. Despite this, sevoflurane has been reported to exert potentially neurotoxic effects on the developing brain. Clinical interventions and treatments for these effects are limited. Tanshinone IIA (Tan IIA), extracted from Salvia miltiorrhiza (Danshen), has been documented to alleviate cognitive decline in traditional applications. Therefore, we hypothesized that preadministration of Tan IIA may attenuate sevoflurane-induced neurotoxicity, suggesting that Tan IIA is a new and promising drug capable of counteracting the effects of cognitive dysfunction produced by general anesthetics.

METHODS:
To test this hypothesis, neonatal C57 mice (P6) were exposed to 3% sevoflurane for 2 hours with or without Tan IIA pretreatment at a dose of 10 mg/kg or 20 mg/kg for 3 consecutive days. Cognitive behavior tests such as open field tests and fear conditioning were performed to evaluate locomotor and cognitive function at P31 and P32. At P8, other separate tests, including TdT mediated dUTP Nick End Labeling (TUNEL) assay, immunohistochemistry, Western blotting, enzyme-linked immunosorbent assay, and electron microscopy, were performed. The mean differences among groups were compared using 1-way analysis of variance followed by Bonferroni post hoc multiple comparison tests.

RESULTS:
Repeated exposure to sevoflurane leads to significant cognitive impairment in mice, which may be explained by increased apoptosis, overexpression of neuroinflammatory markers, and changes in synaptic ultrastructure. Interestingly, preadministration of Tan IIA ameliorated these neurocognitive deficits, as shown by increased freezing percentages on the fear conditioning test (sevoflurane+Tan IIA [20 mg/kg] versus sevoflurane, mean difference, 19, 99% confidence interval for difference, 6.4–31, P < .0001, n = 6). The treatment also reduced the percentage of TUNEL-positive nuclei (sevoflurane versus sevoflurane+Tan IIA [20 mg/kg], 2.6, 0.73–4.5, P = .0004, n = 6) and the normalized expression of cleaved caspase-3 (sevoflurane versus sevoflurane+Tan IIA [20 mg/kg], 0.27, 0.02–0.51, P = .0046, n = 5). Moreover, it attenuated the production of the neuroinflammatory mediators interleukin (IL)-1β and IL-6 (normalized sevoflurane versus sevoflurane+Tan IIA [20 mg/kg]: IL-1β: 0.75, 0.47–1.0; P < .0001; IL-6: 0.66, 0.35–0.97; P < .0001; n = 10 per group). Finally, based on measurements of postsynaptic density, the treatment preserved synaptic ultrastructure (sevoflurane+Tan IIA [20 mg/kg] versus sevoflurane, 42, 20–66; P < .0001; n = 12 per group).

CONCLUSIONS:
These results indicate that Tan IIA can alleviate sevoflurane-induced neurobehavioral abnormalities and may decrease neuroapoptosis and neuroinflammation.
Evaluation of Lung Function and Clinical Features of the Ultrasound-Guided Stellate Ganglion Block With 2 Different Concentrations of a Local Anesthetic: A Randomized Controlled Trial
Authors: Kim Won-Joong , Park Hahck Soo , Yi Myung Sub , Koo Gill-Hoi , Shin Hwa-Yong 
Published: March 2017

BACKGROUND:
One possible complication of stellate ganglion block (SGB) is respiratory compromise. No study has yet addressed the comparison of its effect on lung function and clinical features, including Horner’s syndrome, changes in temperature, sensory and motor functions, and adverse events of lower versus higher concentrations (LC and HC, respectively) of local anesthetics in an ultrasound-guided SGB.

METHODS:
Fifty patients were randomized into 1 of 2 groups: the LC group (5 mL of 0.5% mepivacaine) and the HC group (5 mL of 1% mepivacaine). One anesthesiologist performed a C6- SGB under ultrasound guidance. Our primary objective was to compare LC and HC of a local anesthetic in terms of its effect on lung function, and the secondary objective was to compare the clinical features between LC and HC of a local anesthetic. Lung function was compared between the 2 groups using the Mann-Whitney U test.

RESULTS:
The forced vital capacity at 20 minutes post-SGB was not significantly different between the HC and the LC groups (P = .360); the median difference (95% confidence intervals [CI]) was 1 (−1 to 8). Other parameters of lung function were comparable with the forced vital capacity. Patients in the HC group had significantly greater sensory changes than those in the LC group (% decrease compared with the unblocked side); 95.4 ± 2.1 (CI: 91.11–99.73) vs 87.3 ± 3.5 (CI: 80.12–94.49).

CONCLUSIONS:
Lung function between the LC and HC groups after SGB did not differ significantly. Clinical features between the 2 groups also did not differ clinically, except that patients in the HC group had significantly greater sensory loss in the C6 dermatomes.
From the Archives to the Streets
Authors: Hendrickson Burleigh 
Published: March 2017

AbstractIn the spring of 1968, activists across the globe took to the streets and clashed with authorities to protest neo-imperialism, oppressive regimes, and the postcolonial order of things. While there is no shortage of archival material documenting this type of activism during France's mai 68, this is often not the case for similar activism in places like Tunisia and Senegal. This article discusses the importance of personal archives and oral histories for analyzing lesser-known activism of the 1960s and 1970s in the former French empire. On the one hand, oral histories can help clarify archival material; on the other hand, they can further muddy politically charged narratives where past, present, and future collide. Through an analysis of interviews conducted with 1968 participants in France, Tunisia, and Senegal, I uncover the promises and perils of expanding conventional notions of the archive for the study of the “global 1960s.”Au printemps 1968, des militants autour du monde ont affronté les forces de l'ordre dans la rue pour protester contre le néo-impérialisme et les régimes postcoloniaux oppressifs. Tandis qu'il y a beaucoup d'archives sur ce type de militantisme dans le mai 68 français, ce n'est pas le cas pour les mouvements en Tunisie et au Sénégal. Cet article vise à capter l'importance des archives privées et de l'histoire orale pour l'analyse des mouvements minorés aux années 1960 dans l'ancien empire français. D'une part, l'histoire orale peut clarifier le contenu des archives ; d'autre part, elle sert à embrouiller les récits politiques où le passé, le présent et le futur se heurtent. L'analyse des entretiens menés en France, en Tunisie et au Sénégal dévoile des avantages et des pièges associés à l'expansion de la notion traditionnelle des archives pour l'étude des « années 68 ».
Massive ear keloids: Natural history, evaluation of risk factors and recommendation for preventive measures – A retrospective case series
Authors: Tirgan Michael 
Published: March 2017

Keloid disorder (KD) is an inherited wound healing ailment, frequently seen among Africans /African Americans and Asians. Genetics of this disorder continues to be obscure and poorly understood. Clinical manifestation of KD is quite variable and very diverse, spanning from individuals with one or very few small keloidal lesions, to those with numerous and very large lesions covering large portion of their skin. Ears are common locations for development of keloids. Ear piercing is by far the leading triggering factor for ear keloid formation in genetically predisposed individuals. Although there are numerous publications about ear and earlobe keloids, there is a void in medical literature about massive ear keloids. This paper focuses on the natural history of massive ear keloids and risk factors that lead to formation of these life-changing and debilitating tumors and recommendations for prevention.
Expanding the dialogue: The producer as part of the creative triangle
Authors: Milligan Christina 
Published: March 2017

Abstract
As the field of screenwriting studies has developed, the act of writing a screenplay has been dissected from a range of different perspectives. In this article, I explore the creative origins and development of a screenplay, as a producer of the New Zealand made-for-television film Nights in the Gardens of Spain (US title: Kawa, 2011). In the origination of this film, the orthodoxy of conventional development processes was not challenged despite the narrative being an exploration of a challenging subject, that of a married Māori man struggling to reveal and come to terms with his lifelong gay identity in a tribal-based society where many reject such identification. In unravelling the decision-making behind the film’s development, I suggest that the decision to take a conservative path in storytelling, while arguably doing a disservice to the autobiographical novel on which the film was based, nevertheless achieved the intentions of the producers, who saw in the story an opportunity to speak to nonindigenous New Zealanders about the reality of modern middle-class Māori lives. The article considers how this political intention shaped the content of the screenplay and the resulting film, and through this explores the producers’ role in the creative triangle at the centre of screenplay development.
Film in words/words in pictures: Ekphrasis modulations in Peter Handke and Wim Wenders’ cinematic collaborations
Authors: Gonçalo Pablo 
Published: March 2017

Abstract
The article considers a connection between the theories of ekphrasis/enargeia and screenplay studies, and investigates how two different ekphrasis traditions are combined in the film Wings of Desire (1986) in the partnership between its screenwriters, Peter Handke and Wim Wenders. It begins with a brief review of these concepts in Greco-Roman oratory, then moves on to address ekphrasis in media. More specifically, ekphrasis is broached in Peter Handke’s theatre and literary works, which evolve into his screenwriting for Wim Wenders’ films. The article also contrasts the first draft of the screenplay for Wings of Desire with the final film, as it shares and analyses sections of Handke’s verses that are excluded from Wenders’ final film.
Vascular narrowing in pulmonary arterial hypertension is heterogeneous: rethinking resistance
Authors: Rol Nina , Timmer Esther M. , Faes Theo J.C. , Vonk Noordegraaf Anton , Grünberg Katrien , Bogaard Harm‐Jan , Westerhof Nico 
Published: March 2017

AbstractIn idiopathic pulmonary arterial hypertension (PAH), increased pulmonary vascular resistance is associated with structural narrowing of small (resistance) vessels and increased vascular tone. Current information on pulmonary vascular remodeling is mostly limited to averaged increases in wall thickness, but information on number of vessels affected and internal diameter decreases for vessels of different sizes is limited. Our aim was to quantify numbers of affected vessels and their internal diameter decrease for differently sized vessels in PAH in comparison with non‐PAH patients. Internal and external diameters of transversally cut vessels were measured in five control subjects and six PAH patients. Resistance vessels were classified in Strahler orders, internal diameters 13 μm (order 1) to 500 μm (order 8). The number fraction, that is, percentage of affected vessels, and the internal diameter fraction, that is, percentage diameter of normal diameter, were calculated. In PAH, not all resistance vessels are affected. The number fraction is about 30%, that is, 70% of vessels have diameters not different from vessels of control subjects. Within each order, the decrease in diameter of affected vessels is variable with an averaged diameter fraction of 50–70%. Narrowing of resistance vessels is heterogeneous: not all vessels are narrowed, and the decrease in internal diameters, even within a single order, vary largely. This heterogeneous narrowing alone cannot explain the large resistance increase in PAH. We suggest that rarefaction could be an important contributor to the hemodynamic changes.
A personal historic perspective on the role of chloride in skeletal and cardiac muscle
Authors: Hutter Otto F. 
Published: March 2017

AbstractDuring the early decades of the last century, skeletal muscle was held to be impermeable to chloride ions. This theory, based on shaky grounds, was famously falsified by Boyle and Conway in 1941. Two decades later and onwards, the larger part of the resting conductance of skeletal muscle was found to be due to chloride ions, sensitive to the chemical environment, and to be time‐and‐voltage dependent. So, much of the groundwork for the physiological role of chloride ions in skeletal muscle was laid before the game‐changing discovery of chloride channels. The early history of the role of chloride in cardiac muscle, and work on the relative permeability to foreign anions of different muscles are also here covered from a personal perspective.
A biophysical vascular bubble model for devising decompression procedures
Authors: Arieli Ran , Marmur Abraham 
Published: March 2017

AbstractVascular bubble models, which present a realistic biophysical approach, hold great promise for devising suitable diver decompression procedures. Nanobubbles were found to nucleate on a flat hydrophobic surface, expanding to form bubbles after decompression. Such active hydrophobic spots (AHS) were formed from lung surfactants on the luminal aspect of ovine blood vessels. Many of the phenomena observed in these bubbling vessels correlated with those known to occur in diving. On the basis of our previous studies, which proposed a new model for the formation of arterial bubbles, we now suggest the biophysical model presented herein. There are two phases of bubble expansion after decompression. The first is an extended initiation phase, during which nanobubbles are transformed into gas micronuclei and begin to expand. The second, shorter phase is one of simple diffusion‐driven growth, the inert gas tension in the blood remaining almost constant during bubble expansion. Detachment of the bubble occurs when its buoyancy exceeds the intermembrane force. Three mechanisms underlying the appearance of arterial bubbles should be considered: patent foramen ovale, intrapulmonary arteriovenous anastomoses, and the evolution of bubbles in the distal arteries with preference for the spinal cord. Other parameters that may be quantified include age, acclimation, distribution of bubble volume, AHS, individual sensitivity, and frequency of bubble formation. We believe that the vascular bubble model we propose adheres more closely to proven physiological processes. Its predictability may therefore be higher than other models, with appropriate adjustments for decompression illness (DCI) data.
Stem Girdling Affects the Carbon/Nitrogen Imbalance and Oxidative Stress, and Induces Leaf Senescence in Phenological Forms of Beech (Fagus sylvatica)
Authors: Kraj Wojciech 
Published: March 2017

AbstractGirdling was applied to 5-year-old potted beech individuals of early, intermediate and late phenological forms to block assimilate export from leaves. Phloem severance caused accumulation of soluble carbohydrates and starch in leaves and increased the C/N ratio. While the hexose content increased continuously until the end of the experiment, the sucrose and starch contents peaked earlier, depending on the plant’s phenological features. Different rates of chlorophyll degradation and H2O2and TBARS (thiobarbituric acid-reactive substances) production in different phenological forms implied that phloem girdling was the source of oxidative stress and, depending on the phenological form, accelerated leaf senescence to different degrees. The variable rate of the increase in soluble carbohydrate and starch content, characteristic of the different phenological forms, had different modifying effects on the antioxidant activity in leaves. Compared with the early phenological form, the late form was characterized by a smaller increase in H2O2and TBARS content and delayed and slowed chlorophyll and carotenoid degradation. In conjunction with the larger increase in the activity of antioxidant enzymes (catalase, ascorbate peroxidase and superoxide dismutase) induced by carbohydrate accumulation and slower carotenoid degradation, these changes led to the late form having greater resistance to oxidative stress and slower senescence.