bluuebunny/crossref_metadata_2025_split huggingface dataset:
Palliative care referral and associated outcomes among patients with cancer in the last 2 weeks of life
Authors: Ledoux Mathilde , Rhondali Wadih , Lafumas Véronique , Berthiller Julien , Teissere Marion , Piegay Céline , Couray-Targe Sandrine , Schott Anne-Marie , Bruera Eduardo , Filbet Marilène 
Published: September 2015

BackgroundPalliative care (PC) improves the quality of life of patients with advanced cancer. Our aim was to describe PC referral among patients with advanced cancer, and associated outcomes in an academic medical centre.MethodsWe reviewed the medical records of 536 inpatients with cancer who had died in 2010. Our retrospective study compared patients who accessed PC services with those who did not. Statistical analysis was conducted using non-parametric tests due to non-normal distribution. We also conducted a multivariate analysis using a logistic regression model including age, gender, type of cancer and metastatic status.ResultsOut of 536 patients, 239 (45%) had PC referral. The most common cancer types were respiratory (22%) and gastrointestinal (19%). Patients with breast cancer (OR 23.76; CI 6.12 to 92.18) and gynaecological cancer (OR 7.64; CI 2.61 to 22.35) had greater PC access than patients with respiratory or haematological cancer. Patients referred to PC had significantly less chemotherapy in the last 2 weeks of life than non-referred patients, with 22 patients (9%) vs 59 (19%; p<0.001). PC-referred patients had significantly fewer admissions to intensive care units in the last month of life than non-referred patients, with 14 (6%) vs 58 (20%; p<0.001).ConclusionsThere was a large variation in access to PC according to the type of cancer. There is a need to improve collaboration between the PC service and the respiratory, cancer and haematology specialists. Further research will be required to determine the modality and the impact of this collaboration.
Suture needle handling in the operating theatre; what is the safest method? A survey of surgical nursing opinion
Authors: Williams Georgina J , Nicolaou Marios , Athanasiou Thanos , Coleman David 
Published: September 2015

IntroductionSuture needle handling methods vary extensively between units. Securing the needle tip by locking it against the shaft of the needle holder prior to transfer (protected method) has been suggested to improve safety, although this is not evidence based. Some teams prefer to transfer the needle mounted perpendicularly to the needle holders with the tip exposed (unprotected method). We investigated scrub nurses’ preferred method of needle transfer, and noted the safety of each by investigating their experience of needlestick injuries (NSIs).MethodScrub nurses from Oxford University Hospitals Trust, Chelsea and Westminster and Wexham Park Hospitals were surveyed anonymously between November 2013 and August 2014. Nurses selected their preferred method (protected, unprotected or either), and indicated previous NSIs with either technique. Multinomial regression analysis and χ2with Yates correction were used to assess associations.ResultsOne hundred and seven scrub nurses from 12 specialities were interviewed. 80/107 (75%) preferred protected transfer, 20/107 (19%) preferred unprotected transfer and 7/107 (6%) expressed no preference. There was no significant association between needle-mounting preference and years of scrub experience or speciality. Significant differences between preferences and four of the six hospitals were observed. Nine (9/107, 8%) scrub nurses reported NSIs with the protected method compared with 40 (40/107, 37%) in the unprotected group, this difference being statistically significant (p<0.001, χ2=25.17). Five (5/107, 5%) reported NSIs with both methods.ConclusionsProtected needle transfer seems safer than the unprotected method. Needle-handling guidelines and appropriate training are required to help prevent the occurrence of NSIs in the operating theatre.
Systemic lupus erythematosus complicated by diffuse alveolar haemorrhage: risk factors, therapy and survival
Authors: Kazzaz Nayef M , Coit Patrick , Lewis Emily E , McCune W Joseph , Sawalha Amr H , Knight Jason S 
Published: September 2015

ObjectivesWhile diffuse alveolar haemorrhage (DAH) is recognised as a life-threatening complication of systemic lupus erythematosus (SLE), little is known about its risk factors and response to treatment. We describe 22 cases of DAH in a US lupus cohort of approximately 1000 patients, and compare them to 66 controls from the same outpatient cohort.MethodsWe captured variables pertaining to diagnoses of SLE and secondary antiphospholipid syndrome (APS), and analysed them by univariate testing. Those variables with p values <0.05 were then further considered in a multivariate model. Kaplan-Meier curves were constructed for each group, and survival was analysed by Log-rank test.ResultsOf the 22 patients with DAH, 59% were diagnosed with DAH within 5 years of lupus diagnosis. By univariate testing, several manifestations of SLE and APS were more common in patients with DAH, including history of thrombocytopenia, cardiac valve disease, low C3, leucopenia, neuropsychiatric features, haemolysis, arterial thrombosis, lupus anticoagulant, secondary APS and low C4. On multivariate analysis, history of thrombocytopenia and low C3 were maintained as independent risk factors. Importantly, only two patients had platelet counts <50 000/µL at the time of the DAH episode, arguing that DAH was not simply a haemorrhagic complication of thrombocytopenia. All patients were treated with increased immunosuppression, including various combinations of corticosteroids, plasmapheresis, cyclophosphamide, rituximab and mycophenolate mofetil. Notably, all patients in the cohort survived their initial episode of DAH. While the patients with DAH did well in the short-term, their long-term survival was significantly worse than controls. Several of the deaths were attributable to thrombotic complications after recovering from DAH.ConclusionsTo the best of our knowledge, this is the largest case–control study of lupus DAH to date. History of thrombocytopenia was strongly predictive of DAH (OR ∼40). A number of APS manifestations correlated with DAH by univariate analysis, and deserve further consideration in larger studies.
Non-convulsive status epilepticus: a practical approach to diagnosis in confused older people
Authors: Woodford Henry John , George James , Jackson Margaret 
Published: September 2015

ABSTRACT
Non-convulsive status epilepticus (NCSE) presents with minimal seizure activity clinically, but with evidence on EEG. It is a recognised cause of delirium in older people, but prevalence estimates vary widely. As delirium is a common presentation in older people and because NCSE is potentially reversible, an improved diagnostic ability in this group could be highly beneficial. EEG testing is required to make a definitive diagnosis, but this may be difficult due to access to testing, patient adherence and result interpretation. NCSE has two commonly recognised forms: complex partial status epilepticus (CPSE) and absence status epilepticus (ASE). Clinical features associated with NCSE in older people presenting with confusion include a reduction in level of arousal; aphasia or interrupted speech; myoclonus or subtle jerking; staring; automatisms; perseveration or echolalia; increased tone; nystagmus or eye deviation; emotional lability; disinhibition and anosagnosia. Risk factors include female sex, a history of epilepsy or a tonic–clonic seizure around the time of onset, and recent discontinuation of benzodiazepines. A practical approach to the diagnosis of NCSE in older people is suggested based upon the presence of clinical features suggestive of NCSE and local access to EEG testing.
Educação médica em terapêuticas não convencionais
Authors: Teixeira Marcus Zulian , Lin Chin An 
Published: September 2015

<p>A demanda da população pela medicina alternativa e complementar (CAM) vem aumentando substancialmente nas últimas décadas, exigindo dos médicos noções básicas dessas diversas terapias, a fim de que possam orientar os pacientes em tratamentos diferentes dos que estão habituados a prescrever. Assim sendo, compete às escolas de medicina propiciar aos estudantes o conhecimento das evidências científicas, dos pressupostos teóricos e das abordagens práticas empregadas por estas distintas formas de tratamento. A presente revisão tem o propósito de fomentar a discussão sobre o ensino de terapêuticas não convencionais nas escolas de medicina, enfocando o interesse da população e da classe médica, a importância das iniciativas na graduação e na pós-graduação (residência), e as perspectivas da educação médica em terapêuticas não convencionais.</p>
Anamnese, exame clínico e exames complementares como testes diagnósticos
Authors: Benseñor Isabela M. 
Published: September 2015

<p>As principais ferramentas de que o médico dispõe para fazer o diagnóstico do paciente são anamnese e exame clínico. Hampton et al. em 1970 mostrou, em 80 pacientes ambulatoriais na Inglaterra que a anamnese isolada era responsável por 82,5% dos diagnósticos, exame clínico por mais 8,75% e exames complementares por mais 8,75%. Estudo realizado no HCFMUSP mostrou que a anamnese era responsável por 40,4% dos diagnósticos, exame clínico por mais 29,4% e exames complementares por mais 29,5%. O exame de laboratório ou de imagem, sempre traz informação sobre a sensibilidade e a especificidade do método; mas não se costuma ensinar a sensibilidade e a especificidade de dados de anamnese ou de manobras do exame clínico. Os resultados de um teste diagnóstico quando comparados a um padrão-ouro permitem a construção de uma table 2 x 2 com quatro possíveis interpretações dos resultados: (1) verdadeiro-positivo, quando positivo na presença da doença; (2) falso-positivo, se o teste revelar-se positivo em paciente sem doença; (3) verdadeiro-negativo, se o teste é negativo e o indivíduo não tem doença; (4) falso-negativo, se o teste é negativo na presença de doença. A partir desses dados pode-se calcular a sensibilidade, a especificidade, o valor preditivo positivo e negativo e as razões de verossimilhança positiva e negativa. A interpretação das informações coletadas na anamnese e no exame clínico como testes diagnósticos refina seu papel na investigação clínica em relação ao diagnóstico final. Os gastos com saúde são finitos e limitados ao orçamento público, e mesmo em um hospital terciário há restrições à realização desses exames causada pelo desbalanço entre demanda e capacidade de realização dos exames. A utilização desse tipo de ferramenta permite priorizar os pacientes que mais precisarão do exame complementar, e como consequência, leva a um melhor gerenciamento do sistema de saúde como um todo.</p>
Development of Network Synchronization Predicts Language Abilities
Authors: Doesburg Sam M. , Tingling Keriann , MacDonald Matt J. , Pang Elizabeth W. 
Published: September 2015

Abstract
Synchronization of oscillations among brain areas is understood to mediate network communication supporting cognition, perception, and language. How task-dependent synchronization during word production develops throughout childhood and adolescence, as well as how such network coherence is related to the development of language abilities, remains poorly understood. To address this, we recorded magnetoencephalography while 73 participants aged 4–18 years performed a verb generation task. Atlas-guided source reconstruction was performed, and phase synchronization among regions was calculated. Task-dependent increases in synchronization were observed in the theta, alpha, and beta frequency ranges, and network synchronization differences were observed between age groups. Task-dependent synchronization was strongest in the theta band, as were differences between age groups. Network topologies were calculated for brain regions associated with verb generation and were significantly associated with both age and language abilities. These findings establish the maturational trajectory of network synchronization underlying expressive language abilities throughout childhood and adolescence and provide the first evidence for an association between large-scale neurophysiological network synchronization and individual differences in the development of language abilities.
The Role of Dopamine in Temporal Uncertainty
Authors: Tomassini Alessandro , Ruge Diane , Galea Joseph M. , Penny William , Bestmann Sven 
Published: September 2015

Abstract
The temporal preparation of motor responses to external events (temporal preparation) relies on internal representations of the accumulated elapsed time (temporal representations) before an event occurs and on estimates about its most likely time of occurrence (temporal expectations). The precision (inverse of uncertainty) of temporal preparation, however, is limited by two sources of uncertainty. One is intrinsic to the nervous system and scales with the length of elapsed time such that temporal representations are least precise for longest time durations. The other is external and arises from temporal variability of events in the outside world. The precision of temporal expectations thus decreases if events become more variable in time. It has long been recognized that the processing of time durations within the range of hundreds of milliseconds (interval timing) strongly depends on dopaminergic (DA) transmission. The role of DA for the precision of temporal preparation in humans, however, remains unclear. This study therefore directly assesses the role of DA in the precision of temporal preparation of motor responses in healthy humans. In a placebo-controlled double-blind design using a selective D2-receptor antagonist (sulpiride) and D1/D2 receptor antagonist (haloperidol), participants performed a variable foreperiod reaching task, under different conditions of internal and external temporal uncertainty. DA blockade produced a striking impairment in the ability of extracting temporal expectations across trials and on the precision of temporal representations within a trial. Large Weber fractions for interval timing, estimated by fitting subjective hazard functions, confirmed that this effect was driven by an increased uncertainty in the way participants were experiencing time. This provides novel evidence that DA regulates the precision with which we process time when preparing for an action.
Decoding Episodic Retrieval Processes: Frontoparietal and Medial Temporal Lobe Contributions to Free Recall
Authors: Kragel James E. , Polyn Sean M. 
Published: September 2015

Abstract
Neuroimaging studies of recognition memory have identified distinct patterns of cortical activity associated with two sets of cognitive processes: Recollective processes supporting retrieval of information specifying a probe item's original source are associated with the posterior hippocampus, ventral posterior parietal cortex, and medial pFC. Familiarity processes supporting the correct identification of previously studied probes (in the absence of a recollective response) are associated with activity in anterior medial temporal lobe (MTL) structures including the perirhinal cortex and anterior hippocampus, in addition to lateral prefrontal and dorsal posterior parietal cortex. Here, we address an open question in the cognitive neuroscientific literature: To what extent are these same neurocognitive processes engaged during an internally directed memory search task like free recall? We recorded fMRI activity while participants performed a series of free recall and source recognition trials, and we used a combination of univariate and multivariate analysis techniques to compare neural activation profiles across the two tasks. Univariate analyses showed that posterior MTL regions were commonly associated with recollective processes during source recognition and with free recall responses. Prefrontal and posterior parietal regions were commonly associated with familiarity processes and free recall responses, whereas anterior MTL regions were only associated with familiarity processes during recognition. In contrast with the univariate results, free recall activity patterns characterized using multivariate pattern analysis did not reliably match the neural patterns associated with recollective processes. However, these free recall patterns did reliably match patterns associated with familiarity processes, supporting theories of memory in which common cognitive mechanisms support both item recognition and free recall.
Neural Signatures of Controlled and Automatic Retrieval Processes in Memory-based Decision-making
Authors: Khader Patrick H. , Pachur Thorsten , Weber Lilian A. E. , Jost Kerstin 
Published: September 2015

Abstract
Decision-making often requires retrieval from memory. Drawing on the neural ACT-R theory [Anderson, J. R., Fincham, J. M., Qin, Y., & Stocco, A. A central circuit of the mind. Trends in Cognitive Sciences, 12, 136–143, 2008] and other neural models of memory, we delineated the neural signatures of two fundamental retrieval aspects during decision-making: automatic and controlled activation of memory representations. To disentangle these processes, we combined a paradigm developed to examine neural correlates of selective and sequential memory retrieval in decision-making with a manipulation of associative fan (i.e., the decision options were associated with one, two, or three attributes). The results show that both the automatic activation of all attributes associated with a decision option and the controlled sequential retrieval of specific attributes can be traced in material-specific brain areas. Moreover, the two facets of memory retrieval were associated with distinct activation patterns within the frontoparietal network: The dorsolateral prefrontal cortex was found to reflect increasing retrieval effort during both automatic and controlled activation of attributes. In contrast, the superior parietal cortex only responded to controlled retrieval, arguably reflecting the sequential updating of attribute information in working memory. This dissociation in activation pattern is consistent with ACT-R and constitutes an important step toward a neural model of the retrieval dynamics involved in memory-based decision-making.
Motor System Interactions in the Beta Band Decrease during Loss of Consciousness
Authors: Swann Nicole C. , de Hemptinne Coralie , Maher Ryan B. , Stapleton Catherine A. , Meng Lingzhong , Gelb Adrian W. , Starr Philip A. 
Published: September 2015

AbstractCommunication between brain areas and how they are influenced by changes in consciousness are not fully understood. One hypothesis is that brain areas communicate via oscillatory processes, utilizing network-specific frequency bands, that can be measured with metrics that reflect between-region interactions, such as coherence and phase amplitude coupling (PAC). To evaluate this hypothesis and understand how these interactions are modulated by state changes, we analyzed electrophysiological recordings in humans at different nodes of one well-studied brain network: the basal ganglia–thalamocortical loops of the motor system during loss of consciousness induced by anesthesia. We recorded simultaneous electrocorticography over primary motor cortex (M1) with local field potentials from subcortical motor regions (either basal ganglia or thalamus) in 15 movement disorder patients during anesthesia (propofol) induction as a part of their surgery for deep brain stimulation. We observed reduced coherence and PAC between M1 and the subcortical nuclei, which was specific to the beta band (∼18–24 Hz). The fact that this pattern occurs selectively in beta underscores the importance of this frequency band in the motor system and supports the idea that oscillatory interactions at specific frequencies are related to the capacity for normal brain function and behavior.
Horse Play in the Canadian West: The Emergence of the Calgary Stampede as Contested Terrain
Authors: Gerber Brittany , Young Kevin 
Published: September 2015

Abstract
As one example of how modern Western societies are increasingly obliged to reconcile questions of civility and justice against common, indeed revered, practices that compromise nonhuman animals, this paper examines the recent history of public debate regarding the use of animals for public entertainment in the Canadian West. Using media-based public dialogue regarding the annual Calgary Stampede (and especially chuckwagon racing) as a case study and couching the high-risk use of horses in the sociological language of “sports-related violence,” the paper explores the various arguments for and against the continued use of horses at the self-proclaimed “Greatest Outdoor Show on Earth” despite unambiguous evidence of the harm that regularly, and sometimes graphically, occurs.
Distributed database system of the New Atlas of Amphibians and Reptiles in Europe: the NA2RE project
Authors: Sillero Neftalí , Oliveira Marco Amaro , Sousa Pedro , Sousa Fátima , Gonçalves-Seco Luís 
Published: September 2015

The Societas Europaea Herpetologica (SEH) decided in 2006 through its Mapping Committee to implement the New Atlas of Amphibians and Reptiles of Europe (NA2RE: http://na2re.ismai.pt) as a chorological database system. Initially designed to be a system of distributed databases, NA2RE quickly evolved to a Spatial Data Infrastructure, a system of geographically distributed systems. Each individual system has a national focus and is implemented in an online network, accessible through standard interfaces, thus allowing for interoperable communication and sharing of spatial-temporal data amongst one another. A Web interface facilitates the access of the user to all participating data systems as if it were one single virtual integrated data-source. Upon user request, the Web interface searches all distributed data-sources for the requested data, integrating the answers in an always updated and interactive map. This infrastructure implements methods for fast actualisation of national observation records, as well as for the use of a common taxonomy and systematics. Using this approach, data duplication is avoided, national systems are maintained in their own countries, and national organisations are responsible for their own data curation and management. The database could be built with different representation levels and resolution levels of data, and filtered according to species conservation matters. We present the first prototype of NA2RE, composed of the last data compilation performed by the SEH (Sillero et al., 2014). This system is implemented using only open source software: PostgreSQL database with PostGIS extension, Geoserver, and OpenLayers.
Technological Democratization: The Potential Role of ICT in Social and Political Transformation in China and Beyond
Authors: Palmer Neal A. , Perkins Douglas D. 
Published: September 2015

AbstractThis paper seeks to understand the role of the Internet and information and communications technology (ICT) in potential democratic movements. We propose an ecological model of technological development and democratization which recognizes that change can occur (1) at individual as well as social levels; (2) on a continuum from oppression to freedom; and (3) in multiple social spheres. Using case studies from China, we suggest that ICT might facilitate democracy on account of its potential transformations and efficiencies in terms of individuals’ relationships to knowledge and information; governments; persons, groups, and nongovernmental organizations; and work and traditional social roles.