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Appropriateness

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https://www.readbyqxmd.com/read/29356463/spatial-barriers-impact-upon-appropriate-delivery-of-radiotherapy-in-breast-cancer-patients
#1
Fabrizio Stracci, Fortunato Bianconi, Chiara Lupi, Manuela Margaritelli, Alessio Gili, Cynthia Aristei
Radiotherapy (RT) is the standard treatment for breast cancer patients after conserving surgery or mastectomy when patients are at high risk of relapse. Major obstacles to appropriate RT delivery are journey times. Since studies on access to RT were carried out mostly in large countries, this study investigated factors in an Italian region and the influence of RT delivery on survival. A total of 4735 female candidates for RT were included in the study. A geographic information system calculated journey times from patients' homes and surgery hospitals to RT centers...
January 22, 2018: Cancer Medicine
https://www.readbyqxmd.com/read/29356459/costs-of-immune-responses-are-related-to-host-body-size-and-lifespan
#2
Amber J Brace, Marc J Lajeunesse, Daniel R Ardia, Dana M Hawley, James S Adelman, Katherine L Buchanan, Jeanne M Fair, Jennifer L Grindstaff, Kevin D Matson, Lynn B Martin
A central assumption in ecological immunology is that immune responses are costly, with costs manifesting directly (e.g., increases in metabolic rate and increased amino acid usage) or as tradeoffs with other life processes (e.g., reduced growth and reproductive success). Across taxa, host longevity, timing of maturity, and reproductive effort affect the organization of immune systems. It is reasonable, therefore, to expect that these and related factors should also affect immune activation costs. Specifically, species that spread their breeding efforts over a long lifetime should experience lower immune costs than those that mature and breed quickly and die comparatively early...
June 2017: Journal of Experimental Zoology. Part A, Ecological and Integrative Physiology
https://www.readbyqxmd.com/read/29356457/seasonal-variation-and-correlation-between-corticosterone-and-the-antioxidant-uric-acid-during-stress-in-the-northern-cardinal-cardinalis-cardinalis
#3
Jonathan W Haskins, Frank A Spizzoucco, Brian G Walker
Glucocorticoids modify metabolism and other physiological processes in order to mount an appropriate response to stress. This stress response is affected by a combination of seasonal changes, life-history events, and environmental factors. Determining seasonal variability and the potential connection between stress hormones and metabolism is fundamental in understanding seasonal physiological changes in animals. Here, we compared an indicator of stress (corticosterone) with an indicator of metabolic activity (uric acid-a non-enzymatic antioxidant and end product of protein metabolism) during capture and restraint in Northern Cardinals (Cardinalis cardinalis) during fall, winter, spring, and summer...
July 2017: Journal of Experimental Zoology. Part A, Ecological and Integrative Physiology
https://www.readbyqxmd.com/read/29356451/gene-encoding-the-ctp-synthetase-as-an-appropriate-molecular-tool-for-identification-and-phylogenetic-study-of-the-family-bifidobacteriaceae
#4
Jiří Killer, Chahrazed Mekadim, Radko Pechar, Věra Bunešová, Jakub Mrázek, Eva Vlková
An alternative molecular marker with respect to the 16S rRNA gene demonstrating better identification and phylogenetic parameters has not been designed for the whole Bifidobacteriaceae family, which includes the genus Bifidobacterium and scardovial genera. Therefore, the aim of the study was to find such a gene in available genomic sequences, suggest appropriate means and conditions for asmplification and sequencing of the desired region of the selected gene in various strains of the bacterial family and verify the importance in classification and phylogeny...
January 22, 2018: MicrobiologyOpen
https://www.readbyqxmd.com/read/29356351/how-adolescents-decide-on-bariatric-surgery-an-interpretative-phenomenological-analysis
#5
J Doyle, S Colville, P Brown, D Christie
The National Institute of Clinical Excellence states that bariatric surgery may be considered for adolescents with severe obesity in 'exceptional circumstances'. However, it is not clear what is deemed to be exceptional, and there is a lack of long-term outcomes data or research, which would inform patient selection. This is an in-depth qualitative study involving five adolescents who had previously undergone bariatric surgery (between 1 and 3 years postoperatively) and four who were being assessed for the treatment...
January 21, 2018: Clinical Obesity
https://www.readbyqxmd.com/read/29356340/overweight-or-underweight-and-the-risk-of-decline-in-activities-of-daily-living-in-a-22-year-cohort-study-of-a-japanese-sample
#6
Shohei Okamoto, Tomonori Okamura, Daisuke Sugiyama, Takehito Hayakawa, Yasuyuki Nakamura, Naoko Miyagawa, Shuji Kurita, Naoyuki Takashima, Takayoshi Ohkubo, Aya Kadota, Akira Fujiyoshi, Katsuyuki Miura, Akira Okayama, Hirotsugu Ueshima
AIM: The present study aimed to clarify the association between body mass index (BMI) and the activities of daily living (ADL). Although BMI is likely to be concerned regarding the relationship with specific diseases or mortality, few studies have focused on the relationship of BMI and ADL. METHODS: A total of 3353 Japanese participants of a 22-year cohort study from 1990 to 2012 aged 45-74 years at baseline were divided into four groups according to their BMI levels: ≤18...
January 22, 2018: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29356333/limitations-of-vaginal-birth-after-cesarean-success-prediction
#7
Patrick Thornton
The Society for Maternal-Fetal Medicine endorses an algorithm for estimating the probability of successful vaginal birth for women undergoing trial of labor after cesarean (TOLAC). The algorithm is available online in the form of an easy-to-use calculator. This calculator has significant limitations that are easily overlooked by women and providers alike. The calculator has much greater positive than negative predictive power, and it cannot predict unsuccessful TOLAC or uterine rupture. Furthermore, the calculator cannot predict rare catastrophes, such as unplanned hysterectomy, permanent injury, or death...
January 22, 2018: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/29356207/mexiletine-or-catheter-ablation-after-amiodarone-failure-in-the-vanish-trial
#8
Marc W Deyell, Christian Steinberg, Steve Doucette, Ratika Parkash, Isabelle Nault, Chris Gray, Vidal Essebag, Martin Gardner, Laurence D Sterns, Jeff S Healey, Tomasz Hruczkowski, Lena Rivard, Peter Leong-Sit, Pablo B Nery, John L Sapp
INTRODUCTION: In patients with ischemic heart disease and ventricular tachycardia (VT) refractory to high dose amiodarone, the two most common therapeutic options are adjunctive mexiletine therapy or catheter ablation. There is little existing data on the efficacy of these strategies. We examined the relative efficacy of adjunctive mexiletine and catheter ablation among patients enrolled in the VANISH trial. METHODS: All subjects enrolled in the VANISH trial who had VT refractory to high dose (≥ 300 mg daily) amiodarone at baseline were included...
January 22, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29356176/tools-of-the-trade-improving-nurses-ability-to-access-and-evaluate-research
#9
Martha R Sleutel, John W Bullion, Ronnie Sullivan
AIM: To evaluate the effect of a manager-required RN competency on staff nurses' perceived knowledge, ability and frequency of information-seeking activities. BACKGROUND: Basing clinical practice on research and standards of care is essential to delivering appropriate care with optimal outcomes. Nurses' information-seeking abilities are critical for acquiring evidence-based answers to aid clinical decision-making, yet nurses under-utilize library resources and report barriers...
January 22, 2018: Journal of Nursing Management
https://www.readbyqxmd.com/read/29356170/t-cell-papulosis-associated-with-b-cell-malignancy-a-distinctive-clinicopathologic-entity
#10
L V Visseaux, A D Durlach, S B Barete, M B B Beylot-Barry, N B Bonnet, A F C Chassine, N F Franck, G H Herve, C L Leclec'h, L M Machet, S I O Ingen-Housz-Oro, T P Petrella, B V Vergier, N O Ortonne, F G Grange
BACKGROUND: A distinctive eruption referred to as "insect bite-like reaction", or "eosinophilic dermatosis of hematologic malignancy" has been described during the course of hematological B-cell malignancies (BCM). However, its clinical evolution, histopathological features and pathogenesis remain unclear. OBJECTIVES: To characterize this eruption and to investigate its pathogenesis and relationship with the underlying BCM. METHODS: In this multicenter retrospective study of the French Study Group on Cutaneous Lymphomas, 37 patients with a BCM and a cutaneous eruption consisting in chronic and/or recurrent papules, papulo-vesicles and/or nodules were included...
January 22, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/29356072/flash-forward-a-review-of-flash-glucose-monitoring
#11
REVIEW
L Leelarathna, G Wilmot
The FreeStyle Libre flash glucose monitor became available on prescription (subject to local health authority approval) in all four nations of the UK from November 2017, a watershed moment in the history of diabetes care. Calibration free, the FreeStyle Libre is a disc worn on the arm for 14 days which is designed largely to replace the recommended 4-10 painful finger-stick blood glucose tests required each day for the self-management of diabetes. This review discusses clinical data from randomized and observational studies, considers device accuracy metrics and deliberates its popularity and the potential challenges that this new device brings to diabetes care in the UK...
January 22, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29356022/optical-treatment-of-amblyopia-in-older-children-and-adults-is-essential-prior-to-enrolment-in-a-clinical-trial
#12
Tina Y Gao, Nicola Anstice, Raiju J Babu, Joanna M Black, William R Bobier, Shuan Dai, Cindy X Guo, Robert F Hess, Michelle Jenkins, Yannan Jiang, Lisa Kearns, Lionel Kowal, Carly S Y Lam, Peter C K Pang, Varsha Parag, Jayshree South, Sandra Elfride Staffieri, Angela Wadham, Natalie Walker, Benjamin Thompson
PURPOSE: Optical treatment alone can improve visual acuity (VA) in children with amblyopia, thus clinical trials investigating additional amblyopia therapies (such as patching or videogames) for children require a preceding optical treatment phase. Emerging therapies for adult patients are entering clinical trials. It is unknown whether optical treatment is effective for adults with amblyopia and whether an optical correction phase is required for trials involving adults. METHODS: We examined participants who underwent optical treatment in the Binocular Treatment for Amblyopia using Videogames (BRAVO) clinical trial (ANZCTR ID: ACTRN12613001004752)...
January 22, 2018: Ophthalmic & Physiological Optics: the Journal of the British College of Ophthalmic Opticians (Optometrists)
https://www.readbyqxmd.com/read/29355986/the-role-of-negative-cognitions-emotion-regulation-strategies-and-attachment-style-in-complex-post-traumatic-stress-disorder-implications-for-new-and-existing-therapies
#13
Thanos Karatzias, Mark Shevlin, Philip Hyland, Chris R Brewin, Marylene Cloitre, Aoife Bradley, Neil J Kitchiner, Sandra Jumbe, Jonathan I Bisson, Neil P Roberts
OBJECTIVE: We set out to investigate the association between negative trauma-related cognitions, emotional regulation strategies, and attachment style and complex post-traumatic stress disorder (CPTSD). As the evidence regarding the treatment of CPTSD is emerging, investigating psychological factors that are associated with CPTSD can inform the adaptation or the development of effective interventions for CPTSD. METHOD: A cross-sectional design was employed. Measures of CPTSD, negative trauma-related cognitions, emotion regulation strategies, and attachment style were completed by a British clinical sample of trauma-exposed patients (N = 171)...
January 22, 2018: British Journal of Clinical Psychology
https://www.readbyqxmd.com/read/29355953/investigation-into-the-microstructure-texture-and-rheological-properties-of-chocolate-ganache
#14
Jade McGill, Rich W Hartel
Ganache is a mixture of chocolate and dairy. Although a popular confection, little is known about how it functions as a system. Objectives were to (1) determine if dairy fats and cocoa butter mix in ganache, (2) characterize ganache microstructure, and how structure affects texture and rheology, and (3) identify how changes in chocolate composition alter ganache. Textural analysis, differential scanning calorimetry, stress sweep tests, and microscopy were used to examine ganache formulations that varied in dairy source (cream or butter) or in solid fat content (SFC), composition or type of chocolate...
January 22, 2018: Journal of Food Science
https://www.readbyqxmd.com/read/29355918/oxytocin-receptor-gene-polymorphisms-rs53576-and-early-paternal-care-sensitize-males-to-distressing-female-vocalizations
#15
Anna Truzzi, Jessie Poquérusse, Peipei Setoh, Kazuyuki Shinohara, Marc H Bornstein, Gianluca Esposito
The oxytocinergic system is highly involved in social bonding and early caregiver-infant interactions. Here, we hypothesize that oxytocin receptor (OXTR) gene genotype and parental bonding history interact in influencing social development. To address this question, we assessed adult males' arousal (heart rate changes) in response to different distress vocalizations (human female, human infant and bonobo). Region rs53576 of the OXTR gene was genotyped from buccal mucosa cell samples, and a self-report Parental Bonding Instrument was used (which provide information about parental care or parental overprotection)...
January 22, 2018: Developmental Psychobiology
https://www.readbyqxmd.com/read/29355914/intraoperative-imaging-technology-to-maximise-extent-of-resection-for-glioma
#16
REVIEW
Michael D Jenkinson, Damiano Giuseppe Barone, Andrew Bryant, Luke Vale, Helen Bulbeck, Theresa A Lawrie, Michael G Hart, Colin Watts
BACKGROUND: Extent of resection is considered to be a prognostic factor in neuro-oncology. Intraoperative imaging technologies are designed to help achieve this goal. It is not clear whether any of these sometimes very expensive tools (or their combination) should be recommended as standard care for people with brain tumours. We set out to determine if intraoperative imaging technology offers any advantage in terms of extent of resection over standard surgery and if any one technology was more effective than another...
January 22, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29355892/the-effect-of-ethnicity-on-the-performance-of-protein-creatinine-ratio-in-the-prediction-of-significant-proteinuria-in-pregnancies-at-risk-of-or-with-established-hypertension-an-implementation-audit-and-cost-implications
#17
Sadia Bhatti, Mark Cordina, Leonie Penna, Roy Sherwood, Tracy Dew, Nikos A Kametas
INTRODUCTION: The replacement of 24-hour urine collection by protein-creatinine ratio (PCR) for the diagnosis of pre-eclampsia has been recently recommended. However, the literature is conflicting and there are concerns on the impact of demographic characteristics on the performance of PCR. MATERIALS AND METHODS: This was an implementation audit of the introduction of PCR in a London Tertiary obstetric unit. The performance of PCR in the prediction of proteinuria ≥300mg/day was assessed in 476 women with suspected pre-eclampsia who completed a 24-hour urine collection and an untimed urine sample for PCR calculation...
January 21, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29355891/where-are-antipsychotics-prescribed-in-nursing-homes-initiated
#18
Yan Zhang, Elena M Letuchy, Ryan M Carnahan
OBJECTIVES: To describe the settings of care in which antipsychotics that nursing home (NH) residents received were likely to have been initiated. DESIGN: Cross-sectional. SETTING: Iowa NHs. PARTICIPANTS: Fee-for-service Medicare beneficiaries who had NH stays between January 1, 2011, and December 31, 2014, and had new use of antipsychotics during their NH stays, defined as no antipsychotic use in NHs in the last 6 months...
January 22, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29355883/optimizing-pain-management-through-opioid-deprescribing
#19
Rachel Lumish, Joshana K Goga, Nicole J Brandt
The use of opioid drug therapy in older adults has increased over the past decade. Although use of opioid drugs may be clinically warranted, ongoing use needs to be monitored closely to evaluate risks and benefits, especially with the potential for adverse events and misuse. An opioid drug deprescribing protocol would provide clinicians with a method to assess an individual's need for opioid agents, as well as a systematic process to taper opioid drug therapy when deemed appropriate. Although more than 60 studies have reported methods for deprescribing, there is currently no established guideline for discontinuing opioid medications...
January 1, 2018: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/29355849/a-whole-animal-platform-to-advance-a-clinical-kinase-inhibitor-into-new-disease-space
#20
Masahiro Sonoshita, Alex P Scopton, Peter M U Ung, Matthew A Murray, Lisa Silber, Andres Y Maldonado, Alexander Real, Avner Schlessinger, Ross L Cagan, Arvin C Dar
Synthetic tailoring of approved drugs for new indications is often difficult, as the most appropriate targets may not be readily apparent, and therefore few roadmaps exist to guide chemistry. Here, we report a multidisciplinary approach for accessing novel target and chemical space starting from an FDA-approved kinase inhibitor. By combining chemical and genetic modifier screening with computational modeling, we identify distinct kinases that strongly enhance ('pro-targets') or limit ('anti-targets') whole-animal activity of the clinical kinase inhibitor sorafenib in a Drosophila medullary thyroid carcinoma (MTC) model...
January 22, 2018: Nature Chemical Biology
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