bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contrast-enhanced digital breast tomosythesis and breast MRI to monitor response to neoadjuvant chemotherapy: patient tolerance and preference
Authors: Savaridas Sarah L , Whelehan Patsy , Warwick Violet R , Vinnicombe Sarah J , Evans Andrew J 
Published: February 2022

Objective:
Contrast-enhanced digital breast tomosynthesis (CE-DBT) is a novel imaging technique, combining contrast-enhanced spectral mammography and tomosynthesis. This may offer an alternative imaging technique to breast MRI for monitoring of response to neoadjuvant chemotherapy. This paper addresses patient experience and preference regarding the two techniques.

Methods:
Conducted as part of a prospective pilot study; patients were asked to complete questionnaires pertaining to their experience of CE-DBT and MRI following pre-treatment and end-of-treatment imaging. Questionnaires consisted of eight questions answered on a categorical scale, two using a visual analogue scale (VAS), and a question to indicate preference of imaging technique. Statistical analysis was performed with Wilcoxon signed rank test and McNemar test for related samples using SPSS v. 25.

Results:
18 patients were enrolled in the pilot study. Matched CE-DBT and MRI questionnaires were completed after 22 patient episodes. Patient preference was indicated after 31 patient episodes. Overall, on 77% of occasions patients preferred CE-DBT with no difference between pre-treatment and end-of-treatment imaging. Overall experience (p = 0.008), non-breast pain (p = 0.046), anxiety measured using VAS (p = 0.003), and feeling of being put at ease by staff (p = 0.023) was better for CE-DBT. However, more breast pain was experienced during CE-DBT when measured on both VAS (p = 0.011) and categorical scale (p = 0.021).

Conclusion:
Our paper suggests that patients prefer CE-DBT to MRI, adding further evidence in favour of contrast-enhanced mammographic techniques.

Advances in knowledge:
Contrast mammographic techniques offer an alternative, more accessible imaging technique to breast MRI. Whilst other studies have addressed patient experience of contrast-enhanced spectral mammography, this is the first study to directly explore patient preference for CE-DBT over MRI in the setting of neoadjuvant chemotherapy, finding that overall, patients preferred CE-DBT despite the relatively long breast compression.
A network of empirical ethics teams embedded in research programmes across multiple sites: opportunities and challenges in contributing to COVID-19 research and responses
Authors: Ngwenya Nothando , Ilo Van Nuil Jennifer , Nyirenda Deborah , Chambers Mary , Cheah Phaik Yeong , Seeley Janet , Chi Primus , Mafuleka Lindiwe , Nkosi Busisiwe , Kamuya Dorcas , Davies Alun , Schneiders Mira Leonie , Mumba Noni , Dlamini Siphephelo , Desmond Nicola , Marsh Vicki , Rippon Dinnah , Parker Michael , Molyneux Sassy 
Published: February 2022

Covid-19 continues to teach the global community important lessons about preparedness for research and effective action to respond to emerging health threats. We share the COVID-19 experiences of a pre-existing cross-site ethics network-the Global Health Bioethics Network-which brings together researchers and practitioners from Africa, Europe, and South east Asia. We describe the network and its members and activities, and the work-related opportunities and challenges we faced over a one-year period during the pandemic. We highlight the value of having strong and long-term empirical ethics networks embedded across diverse research institutions to be able to: 1) identify and share relevant ethics challenges and research questions and ways of ’doing research’; 2) work with key stakeholders to identify appropriate ways to contribute to the emerging health issue response – e.g. through ethics oversight, community engagement, and advisory roles at different levels; and 3) learn from each other and from diverse contexts to advocate for positive change at multiple levels. It is our view that being both embedded and long term offers particular opportunities in terms of deep institutional and contextual knowledge and relationships with and access to a wide range of stakeholders in place. Being networked offers opportunities to draw upon a wide range of expertise and perspectives operating at multiple levels, and to bring together internal and external perspectives (i.e. different positionalities). Long term funding means that the people and resources are in place and ready to respond in a timely way. However, many tensions and challenges remain, including difficulties in negotiating power and politics regarding roles that researchers and research institutions play in an emergency, and the position of empirical ethics activities in programmes of research more specifically. We discuss some of these tensions and challenges, and consider the implications for our own and similar networks in future.
OXIGENAÇÃO POR MEMBRANA EXTRACORPÓREA (ECMO) NO TRATAMENTO DE PACIENTES COM COVID-19: REVISÃO SISTEMÁTICA
Authors: Costa Araujo Amanda , Uezato Junior Délcio , Felipe Giambona Rente Arthur , Port Nascimento Dafne 
Published: February 2022

Introdução: O uso da Oxigenação por Membrana Extracorpórea (ECMO) vem sendo estudado no tratamento de pacientes com COVID-19, uma vez que essa terapia já demonstrou resultados favoráveis em outras patologias. Objetivos: Verificar a efetividade do uso da ECMO nos pacientes com insuficiência respiratória aguda grave causada pelo COVID-19. Material e Métodos: Para seleção dos artigos utilizou-se os descritores controlados (DECS): ("Extracorporeal Membrane Oxygenation*" OR ECMO OR "Extracorporeal Life Support*" OR ECLS) AND ("COVID*" OR Coronavirus OR "SARS*"). As buscas foram realizadas nas bases de dados COCHRANE LIBRARY, PubMed, EMBASE e CINAHL. As variáveis analisadas foram os benefícios e a segurança desse tratamento, bem como se houve a redução da taxa de mortalidade, as contra-indicações e os riscos com esse tratamento. Resultados: Após a consulta nas bases de dados 292 artigos foram identificados utilizando os descritores mencionados acima, dos quais 11 foram incluídos nesse estudo após todo o processo de seleção. Os pacientes que necessitaram de ECMO eram predominantemente idosos que possuíam como fatores de risco: hipertensão arterial sistêmica, doença meningocócica e obesidade. As principais complicações encontradas foram fenômenos hemorrágicos e tromboembólicos. Discussão: As características laboratoriais, pode-se observar principalmente um aumento do nível de lactato, linfopenia e aumento da proteína C reativa. Os dados encontrados vão de encontro a outros estudos sobre o tema. Conclusão: Portanto, por se tratar de uma condição de saúde recentemente estudada, é necessário que novos estudos sejam conduzidos para confirmar a eficácia da ECMO em pacientes com COVID-19.
AMPLIANDO AS POSSIBILIDADES DO JOGO BEM, COM A INSERÇÃO DE EXPRESSÕES ARITMÉTICAS
Authors: Fernandes André Luis Bitencourt 
Published: February 2022

Os educadores encontram diversos desafios no sistema educacional. Um dos maiores desafios é a proposta pedagógica da escola em lidar com os limites e as possibilidades da educação inclusiva (GARDOU e DEVELAY, 2005). O uso das tecnologias da informação e comunicação (TIC) é um dos meios utilizados para potencializar o processo educativo, contemplando o estímulo das habilidades do educando com necessidades educacionais especiais. A partir de metodologias e recursos pedagógicos diferenciados, é possível expandir as possibilidades de aprendizagem do sujeito e promover condições para um acompanhamento educacional adequado, eficaz e que ofereça aos aprendizes condições de acesso e permanência no sistema educacional (RICOY e COUTO, 2009).A pessoa com deficiência visual (DV), por exemplo, necessita que o contexto educacional tenha um olhar sensível para suas especificidades. Partindo dessa premissa, é fundamental que o professor se mantenha em constante processo formativo, sempre atento aos anseios dos educandos.Diversas mídias, como jogos (eletrônicos ou não), vídeos, simulações e outros, funcionam como ferramentas capazes de auxiliar os professores nesse campo, quando utilizadas como Objetos de Aprendizagem (OA). Auxiliados pelas TIC, esses Objetos de Aprendizagem têm a finalidade de despertar o interesse e estimular a capacidade e o desenvolvimento do educando. O computador é o principal responsável pela propagação dos OA; a partir dele, é possível criar um ambiente lúdico de forma a auxiliar o processo de ensino-aprendizagem dos educandos (CUNHA, 2007). Uma proposta pedagógica com uma base fundamentada em jogos computacionais pode contribuir, não somente para o processo de inclusão das pessoas com deficiência visual, como também para aquisição de conhecimento (ARAÚJO, 1997). A partir desse contexto, este trabalho visa contribuir para que o processo educacional se torne cada vez mais democrático e inclusivo, sobretudo digitalmente, dando continuidade ao trabalho de Rafael Macêdo (MACÊDO et al, 2015).Esta ferramenta foi desenvolvida em linguagem de programação Java, com recursos de síntese de voz, para que indivíduos com deficiência visual possam desfrutar de todas as características e benefícios do Objeto de Aprendizagem. A dinâmica do jogo funciona a partir de um tabuleiro preenchido com expressões aritméticas, no qual o usuário deve descobrir qual expressão corresponde a um determinado resultado que lhe é dado. Dessa forma, a cada acerto, a célula correspondente do tabuleiro é apagada, até que então todas sejam eliminadas e o jogador conclua o jogo.
La familia Coconeta y El armario de Elena: dos micropiezas desconocidas de Max Aub
Authors: Lázaro Sanz Esther 
Published: February 2022

A pesar de cultivar todos los géneros, y aunque se le conozca más como narrador, el teatro tuvo siempre un lugar preferente para Max Aub, emblemático autor del exilio republicano de 1939. Así lo atestiguan no solo su medio centenar de obras dramáticas publicadas en vida, sino también sus cerca de treinta piezas inéditas. Entre unas y otras, se encuentran también piezas teatrales breves insertas en obras de otros géneros que han pasado desapercibidas por la crítica, u obras que se publicaron de manera póstuma en ediciones de coleccionista. Es el caso de las dos micropiezas a las que está dedicado este trabajo, La familia Coconeta y El armario de Elena, donde Aub propone un juego autoficcional en el que convierte tanto a su familia como a él mismo en personajes de obras breves en la estética del absurdo y cuya finalidad es puramente lúdica. En estas páginas analizamos el contenido de ambas piezas, tratamos de descifrar sus claves y subrayar su intertextualidad y su transculturalidad, así como indagamos en el proceso de su escritura a partir de los materiales textuales localizados en varios archivos internacionales.
Understanding educational change: Agency-structure dynamics in a novel design and making environment
Authors: Kumpulainen Kristiina , Kajamaa Anu , Rajala Antti 
Published: February 2022

This study investigates agency-structure dynamics in students and teachers’ social activity in a novel design and making environment in the context of the Finnish school system, which has recently undergone major curricular reform. Understanding that agency is an important mediator of educational change, we ask the following questions: How are agency-structure dynamics manifested in the social activity of students and their teachers in a novel design and making environment? How do agency-structure dynamics create possibilities and obstacles for educational change? The data comprise 65 hours of video recordings and field notes of the social activity of students aged 9–12 years old (N = 94) and their teachers collected over a period of one semester. Our study shows how the introduction of the novel learning environment created a boundary space in which traditional teacher-centered activity patterns interacted and came into tension with student-centered modes of teaching and learning. Our study reveals three distinctive agency-structure dynamics that illuminate how the agentive actions of both teachers and students stabilized existing teacher-centered practices and, at other, times ruptured and broke away from existing patterns, thus giving rise to possibilities for educational change.
Valoración de la calidad de atención a pacientes que solicitan interrupción tardía de la gestación
Authors: Moreno Estela , Suñol Sandra , Giménez Yolanda , Palacio Montse , Arranz Ángela , Gómez Olga 
Published: February 2022

Objetivo. Evaluar la experiencia de las pacientes en proceso de interrupción voluntaria del embarazo por malformaciones fetales graves o incurables por encima de las 22 semanas de gestación. Material y métodos. Se realizó un estudio piloto descriptivo de corte transversal empleando un cuestionario ad hoc con 15 preguntas relacionadas con la calidad de atención y el proceso de pérdida gestacional desarrolladas por un equipo multidisciplinar del Hospital Clínic de Barcelona. La calidad de la atención se evaluó mediante una puntuación de 0 a 10 puntos. Resultados. La puntuación global de la atención prestada fue de 9,45. El ruido ambiental en las diferentes instalaciones hospitalarias fue puntuado con un 5,98/10 y el tiempo desde el parto hasta el alta obtuvieron una puntuación de 6,22. A todas las pacientes se les ofreció contacto con su bebé, pero al 58 % de las familias les hubiera gustado recibir además de las huellas otros recuerdos y al 47 % hubiera deseado hacer fotografías a su bebé. Además, el 37 % de las familias dijeron que hubiesen pasado más tiempo con su bebé. Finalmente, el 53 % de las familias refirió la necesidad de requerir apoyo psicológico o suporte emocional, tanto durante el ingreso hospitalario como en el puerperio. Conclusión. La valoración general de la atención prestada fue adecuada, aunque algunos aspectos podrían mejorarse. La realización de una encuesta a las familias sometidas a un IVE tardío es un método útil para evaluar la calidad de la atención brindada y diseñar acciones de mejora.
Thin-disk multipass amplifier delivering sub-400 fs pulses with excellent beam quality at an average power of 1 kW
Authors: Loescher André , Bienert Florian , Röcker Christoph , Graf Thomas , Gorjan Martin , der Au Jürg Aus , Ahmed Marwan Abdou 
Published: February 2022

We present an improved multipass amplifier design, enabling the amplification of ultrashort pulses with excellent beam quality to more than 1 kW of average output power. 260 fs short pulses at an average power of 105 W and a repetition rate of 1 MHz were directly amplified up to an average power of 1033 W. The pulse duration at this power level was measured to be 388 fs assuming a Gaussian temporal shape. This corresponds to a peak power of 2.5 GW. The power stability was measured to be 0.16% RMS over a duration of more than two hours at a sampling rate of 2 Hz. High beam quality is proven with measured values of

M

x

2

= 1

.16

in the horizontal and

M

y

2

= 1

.19

in the vertical plane according to ISO Standard 11146.
The development of surgical risk score and evaluation of necrotizing soft tissue infection in 161 Naja atra envenomed patients
Authors: Lai Chih-Sheng , Liu Po-Yu , Lee Chi-Hsin , Ho Cheng-Hsuan , Chen Wei-Ling , Lai Kuo-Lung , Su Hung-Yuan , Lin Wen-Loung , Chung Kuo-Chen , Yang Yi-Yuan , You Chung-Wei , Chen Kuang-Ting , Mao Yan-Chiao 
Published: February 2022

Background
Naja atra bites cause wound necrosis, secondary infection, and necrotizing soft tissue infection (NSTI) requiring repetitive surgeries. Little information is known about the predictors for surgery after these bites.

Materials and methods
We retrospectively evaluated 161 patients envenomed by N. atra, 80 of whom underwent surgery because of wound necrosis and infection. We compared the patients’ variables between surgical and non-surgical groups. To construct a surgical risk score, we converted the regression coefficients of the significant factors in the multivariate logistic regression into integers. We also examined the deep tissue cultures and pathological findings of the debrided tissue.

Results
A lower limb as the bite site, a ≥3 swelling grade, bullae or blister formation, gastrointestinal (GI) effects, and fever were significantly associated with surgery in the multivariate logistic regression analysis. The surgical risk scores for these variables were 1, 1, 2, 1, and 2, respectively. At a ≥3-point cutoff value, the model has 71.8% sensitivity and 88.5% specificity for predicting surgery, with an area under the receiver operating characteristic curve of 0.88. The histopathological examinations of the debrided tissues supported the diagnosis of snakebite-induced NSTI. Twelve bacterial species were isolated during the initial surgery and eleven during subsequent surgeries.

Discussion and conclusions
From the clinical perspective, swelling, bullae or blister formation, GI effects, and fever appeared quickly after the bite and before surgery. The predictive value of these factors for surgery was acceptable, with a ≥3-point risk score. The common laboratory parameters did not always predict the outcomes of N. atra bites without proper wound examination. Our study supported the diagnosis of NSTI and demonstrated the changes in bacteriology during the surgeries, which can have therapeutic implications for N. atra bites.
Did the severity of appendicitis increase during the COVID-19 pandemic?
Authors: Chang Yao-Jen , Chen Li-Ju , Chang Yun-Jau 
Published: February 2022

BackgroundThis study aimed to assess the severity of appendicitis during the coronavirus disease 2019 (COVID-19) pandemic, as patients with appendicitis may procrastinate seeking medical attention during the pandemic.MethodsInformation on patients with appendicitis who were treated at the Taipei City Hospital during the COVID-19 pandemic (January 1, 2020 to June 30, 2020) was retrieved. Patients who were diagnosed with appendicitis and treated at the same hospital from January 1, 2019 to July 1, 2019 were designated as the control group. Multivariate logistic regression analysis was conducted to assess changes in the severity of appendicitis (at a 2-week interval) between the two groups.ResultsWe identified 307 (study group: 149; control group: 158) consecutive patients with appendicitis. The mean age was 46.2 +– 19.8 years. Between the two groups, there were no significant differences in age, sex, comorbidity, surgery type (laparoscopic or open appendectomy) or surgery time. The number of patients in the study group decreased between January 29, 2020 and April 21, 2020, which paralleled the period of spikes in the confirmed COVID-19 cases and restricted daily activities. The percentage of uncomplicated and complicated appendicitis (excluding mild appendicitis or normal appendix) in the study group increased between February 26 and March 10, as well as between April 8 and April 21. In the multivariate regression analysis, the odds of uncomplicated and complicated appendicitis increased in three bi-weeks for the study group but not in the control group.ConclusionThe severity of acute appendicitis might increase during the COVID-19 pandemic, because patients with mild appendicitis (or abdominal pain) may hesitate to seek help.
Use of the “Future Life Map” exercise to improve awareness of career options and opportunities in underrepresented minority undergraduate students pursuing STEM careers
Authors: Whitehead Anne , Alves Nathan J. 
Published: February 2022

Objectives
There has long existed significant underrepresentation of minority students in STEM training and careers. Ongoing efforts to improve opportunities and participation for underrepresented minority students have focused on multiple areas, from increased funding to early exposure to research in STEM. We developed the novel Future Life Map career planning exercise with the goal of contributing to this multi-faceted approach. The exercise emphasizes on the consideration of multiple potential career destinations and routes to those destination. The exercise was designed with the goal of improving participant awareness of options and career planning self-efficacy to improve success and retention of underrepresented minority student participation and retention in STEM.

Methods
We implemented the Future Life Map exercise with 2 separate groups of under-represented minority undergraduate students pursuing careers in STEM. Participants then completed an anonymous survey to evaluate the exercise and describe the value they derived from completing the Future Life Map.

Results
The exercise presentation and its supporting documents were highly rated by participants with >81% of respondents rating it as “very informative” (4 or 5 on a 5-point Likert Scale). Participants reported that they were very likely to recommend the exercise to others (25 of 27 participants) and were likely to repeat the activity for their own future decision making (22 participants). Themes that emerged from participant reporting of the value of the exercise were: increased awareness of career and training options, improved understanding of the research required to make informed career/life decisions, and new awareness of specific information about career options under consideration.

Conclusion
The Future Life Map exercise was successful in improving participant awareness of career options, career planning ability, and helped participants to feel more empowered. This is likely of particular benefit for improving participation and retention of under-represented minority students pursuing careers in STEM.
Chronic pancreatitis is a risk factor for pancreatic cancer and incidence increases with duration of disease: A systematic review and meta-analysis
Authors: Gandhi Sonal , Fuente Jaime de la , Murad Mohammad Hassan , Majumder Shounak 
Published: February 2022

ABSTRACT

Background:
Observational studies have suggested an increased risk of pancreatic ductal adenocarcinoma (PDAC) in patients with acute and chronic pancreatitis. We conducted a systematic review and meta-analysis to evaluate the magnitude of this association and summarize the published epidemiological evidence.

Methods:
We searched electronic databases (MEDLINE, EMBASE, Web of Science, Cochrane, Scopus) and reference lists until January 18, 2021. Studies reporting quantitative association between pancreatitis and PDAC were included and assessed for eligibility, data abstraction, and risk of bias. Standardized incidence ratios (SIR) were pooled using the random-effects model.

Results:
Twenty-five cohort and case-control studies met inclusion criteria. Meta-analysis of 12 chronic pancreatitis (CP) studies demonstrated an increased risk of PDAC in CP patients (SIR: 22.61, 95% confidence interval [CI]: 14.42-35.44). This elevated risk persisted in subgroup analysis of studies that excluded patients diagnosed with PDAC within 2 years of CP diagnosis (SIR: 21.77, 95% CI: 14.43-32.720). The risk was higher in hereditary pancreatitis (HP) (SIR: 63.36, 95% CI: 45.39-88.46). The cumulative incidence rates of PDAC in CP increased with follow up duration. Limited evidence in acute pancreatitis indicates higher PDAC risk in the subset of patients eventually diagnosed with CP. PDAC appears to be uncommon in patients with autoimmune pancreatitis, with 8 reported cases in 358 autoimmune pancreatitis patients across 4 studies.

Discussion:
There is an increased risk of PDAC in patients with CP and incidence rates increase with CP disease duration. Our results indicate that PDAC surveillance may be considered in individuals with long-standing CP.