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$\textbf{Purpose}$: Automatic quantification of longitudinal changes in PET scans for lymphoma patients has proven challenging, as residual disease in interim-therapy scans is often subtle and difficult to detect. Our goal was to develop a longitudinally-aware segmentation network (LAS-Net) that can quantify serial PET/CT images for pediatric Hodgkin lymphoma patients. $\textbf{Materials and Methods}$: This retrospective study included baseline (PET1) and interim (PET2) PET/CT images from 297 patients enrolled in two Children's Oncology Group clinical trials (AHOD1331 and AHOD0831). LAS-Net incorporates longitudinal cross-attention, allowing relevant features from PET1 to inform the analysis of PET2. Model performance was evaluated using Dice coefficients for PET1 and detection F1 scores for PET2. Additionally, we extracted and compared quantitative PET metrics, including metabolic tumor volume (MTV) and total lesion glycolysis (TLG) in PET1, as well as qPET and $\Delta$SUVmax in PET2, against physician measurements. We quantified their agreement using Spearman's $\rho$ correlations and employed bootstrap resampling for statistical analysis. $\textbf{Results}$: LAS-Net detected residual lymphoma in PET2 with an F1 score of 0.606 (precision/recall: 0.615/0.600), outperforming all comparator methods (P<0.01). For baseline segmentation, LAS-Net achieved a mean Dice score of 0.772. In PET quantification, LAS-Net's measurements of qPET, $\Delta$SUVmax, MTV and TLG were strongly correlated with physician measurements, with Spearman's $\rho$ of 0.78, 0.80, 0.93 and 0.96, respectively. The performance remained high, with a slight decrease, in an external testing cohort. $\textbf{Conclusion}$: LAS-Net achieved high performance in quantifying PET metrics across serial scans, highlighting the value of longitudinal awareness in evaluating multi-time-point imaging datasets., Comment: 6 figures, 4 tables in the main text

BackgroundPediatric metabolic-associated fatty liver disease (MAFLD) is a global health problem, with lifestyle modification as its major therapeutic strategy. Rigorous characterization of dietary content on MAFLD in children is lacking. We hypothesized an objectively measured healthier diet would positively modulate MAFLD.MethodsDiet was assessed using the Nutrition Data System for Research in children enrolled from 10 tertiary clinical centers to determine the Healthy Eating Index (HEI, 0-100) and individual food components.ResultsIn all, 119 children were included (13.3 ± 2.7 y), 80 (67%) male, 67 (18%) White, and 90 (76%) Hispanic, with an average body mass index Z-score of 2.2 ± 0.5. Diet was classified as low HEI < 47.94 (n = 39), mid HEI ≥ 47.94 and < 58.89 (n = 41), or high HEI ≥ 58.89 (n=39). Children with high HEI (healthier diet) had lower body weight (p = 0.005) and more favorable lipids. Mean serum triglycerides for low, mid, and high HEI were 163, 148, and 120 mg/dL, respectively; p = 0.04 mid versus high, p = 0.01 low versus high. Mean HDL was 38, 41 and 43 mg/dL; p = 0.02 low vs high. Less severe steatosis was noted with added sugar ≤ 10% of calories (p = 0.03). Higher lobular inflammation is associated with a higher percentage of calories from fat (OR (95% CI) = 0.95 (0.91-1.00), p = 0.04).ConclusionsIn children with MAFLD, high HEI is associated with lower body weight and more favorable lipids, while added sugar and fat intake has individual histologic features. Differential consumption of major dietary components may modify both metabolic risk factors and histologic liver injury, highlighting the importance of objective diet assessments in children with MAFLD.

In this work, we propose a computational framework that leverages existing out-of-language data to create a conversational agent for the delivery of Self-Attachment Technique (SAT) in Mandarin. Our framework does not require large-scale human translations, yet it achieves a comparable performance whilst also maintaining safety and reliability. We propose two different methods of augmenting available response data through empathetic rewriting. We evaluate our chatbot against a previous, English-only SAT chatbot through non-clinical human trials (N=42), each lasting five days, and quantitatively show that we are able to attain a comparable level of performance to the English SAT chatbot. We provide qualitative analysis on the limitations of our study and suggestions with the aim of guiding future improvements.

In the wake of the post-pandemic era, marked by social isolation and surging rates of depression and anxiety, conversational agents based on digital psychotherapy can play an influential role compared to traditional therapy sessions. In this work, we develop a voice-capable chatbot in Farsi to guide users through Self-Attachment (SAT), a novel, self-administered, holistic psychological technique based on attachment theory. Our chatbot uses a dynamic array of rule-based and classification-based modules to comprehend user input throughout the conversation and navigates a dialogue flowchart accordingly, recommending appropriate SAT exercises that depend on the user's emotional and mental state. In particular, we collect a dataset of over 6,000 utterances and develop a novel sentiment-analysis module that classifies user sentiment into 12 classes, with accuracy above 92%. To keep the conversation novel and engaging, the chatbot's responses are retrieved from a large dataset of utterances created with the aid of Farsi GPT-2 and a reinforcement learning approach, thus requiring minimal human annotation. Our chatbot also offers a question-answering module, called SAT Teacher, to answer users' questions about the principles of Self-Attachment. Finally, we design a cross-platform application as the bot's user interface. We evaluate our platform in a ten-day human study with N=52 volunteers from the non-clinical population, who have had over 2,000 dialogues in total with the chatbot. The results indicate that the platform was engaging to most users (75%), 72% felt better after the interactions, and 74% were satisfied with the SAT Teacher's performance.

This paper studies ensembling in the era of Large Vision-Language Models (LVLMs). Ensembling is a classical method to combine different models to get increased performance. In the recent work on Encyclopedic-VQA the authors examine a wide variety of models to solve their task: from vanilla LVLMs, to models including the caption as extra context, to models augmented with Lens-based retrieval of Wikipedia pages. Intuitively these models are highly complementary, which should make them ideal for ensembling. Indeed, an oracle experiment shows potential gains from 48.8% accuracy (the best single model) all the way up to 67% (best possible ensemble). So it is a trivial exercise to create an ensemble with substantial real gains. Or is it?, Comment: 4th I Can't Believe It's Not Better Workshop (co-located with NeurIPS 2023)

In this work, we present a new dataset and a computational strategy for a digital coach that aims to guide users in practicing the protocols of self-attachment therapy. Our framework augments a rule-based conversational agent with a deep-learning classifier for identifying the underlying emotion in a user's text response, as well as a deep-learning assisted retrieval method for producing novel, fluent and empathetic utterances. We also craft a set of human-like personas that users can choose to interact with. Our goal is to achieve a high level of engagement during virtual therapy sessions. We evaluate the effectiveness of our framework in a non-clinical trial with N=16 participants, all of whom have had at least four interactions with the agent over the course of five days. We find that our platform is consistently rated higher for empathy, user engagement and usefulness than the simple rule-based framework. Finally, we provide guidelines to further improve the design and performance of the application, in accordance with the feedback received.

BackgroundTransmural healing (TH) is associated with better long-term outcomes in Crohn disease (CD), whereas pretreatment ileal gene signatures encoding myeloid inflammatory responses and extracellular matrix production are associated with stricturing. We aimed to develop a predictive model for ileal TH and to identify ileal genes and microbes associated with baseline luminal narrowing (LN), a precursor to strictures.Materials and methodsBaseline small bowel imaging obtained in the RISK pediatric CD cohort study was graded for LN. Ileal gene expression was determined by RNASeq, and the ileal microbial community composition was characterized using 16S rRNA amplicon sequencing. Clinical, demographic, radiologic, and genomic variables were tested for association with baseline LN and future TH.ResultsAfter controlling for ileal location, baseline ileal LN (odds ratio [OR], 0.3; 95% confidence interval [CI], 0.1-0.8), increasing serum albumin (OR, 4; 95% CI, 1.3-12.3), and anti-Saccharomyces cerevisiae antibodies IgG serology (OR, 0.97; 95% CI, 0.95-1) were associated with subsequent TH. A multivariable regression model including these factors had excellent discriminant power for TH (area under the curve, 0.86; positive predictive value, 80%; negative predictive value, 87%). Patients with baseline LN exhibited increased Enterobacteriaceae and inflammatory and extracellular matrix gene signatures, coupled with reduced levels of butyrate-producing commensals and a respiratory electron transport gene signature. Taxa including Lachnospiraceae and the genus Roseburia were associated with increased respiratory and decreased inflammatory gene signatures, and Aggregatibacter and Blautia bacteria were associated with reduced extracellular matrix gene expression.ConclusionsPediatric patients with CD with LN at diagnosis are less likely to achieve TH. The association between specific microbiota, wound healing gene programs, and LN may suggest future therapeutic targets.

ImportancePediatric guidelines for the management of nonalcoholic fatty liver disease (NAFLD) recommend a healthy diet as treatment. Reduction of sugary foods and beverages is a plausible but unproven treatment.ObjectiveTo determine the effects of a diet low in free sugars (those sugars added to foods and beverages and occurring naturally in fruit juices) in adolescent boys with NAFLD.Design, setting, and participantsAn open-label, 8-week randomized clinical trial of adolescent boys aged 11 to 16 years with histologically diagnosed NAFLD and evidence of active disease (hepatic steatosis >10% and alanine aminotransferase level ≥45 U/L) randomized 1:1 to an intervention diet group or usual diet group at 2 US academic clinical research centers from August 2015 to July 2017; final date of follow-up was September 2017.InterventionsThe intervention diet consisted of individualized menu planning and provision of study meals for the entire household to restrict free sugar intake to less than 3% of daily calories for 8 weeks. Twice-weekly telephone calls assessed diet adherence. Usual diet participants consumed their regular diet.Main outcomes and measuresThe primary outcome was change in hepatic steatosis estimated by magnetic resonance imaging proton density fat fraction measurement between baseline and 8 weeks. The minimal clinically important difference was assumed to be 4%. There were 12 secondary outcomes, including change in alanine aminotransferase level and diet adherence.ResultsForty adolescent boys were randomly assigned to either the intervention diet group or the usual diet group (20 per group; mean [SD] age, 13.0 [1.9] years; most were Hispanic [95%]) and all completed the trial. The mean decrease in hepatic steatosis from baseline to week 8 was significantly greater for the intervention diet group (25% to 17%) vs the usual diet group (21% to 20%) and the adjusted week 8 mean difference was -6.23% (95% CI, -9.45% to -3.02%; P < .001). Of the 12 prespecifi

BackgroundThe liver R2* value is widely used as a measure of liver iron but may be confounded by the presence of hepatic steatosis and other covariates.PurposeTo identify the most influential covariates for liver R2* values in patients with nonalcoholic fatty liver disease (NAFLD).Study typeRetrospective analysis of prospectively acquired data.PopulationBaseline data from 204 subjects enrolled in NAFLD/NASH (nonalcoholic steatohepatitis) treatment trials.Field strength1.5T and 3T; chemical-shift encoded multiecho gradient echo.AssessmentCorrelation between liver proton density fat fraction and R2*; assessment for demographic, metabolic, laboratory, MRI-derived, and histological covariates of liver R2*.Statistical testsPearson's and Spearman's correlations; univariate analysis; gradient boosting machines (GBM) multivariable machine-learning method.ResultsHepatic proton density fat fraction (PDFF) was the most strongly correlated covariate for R2* at both 1.5T (r = 0.652, P < 0.0001) and at 3T (r = 0.586, P < 0.0001). In the GBM analysis, hepatic PDFF was the most influential covariate for hepatic R2*, with relative influences (RIs) of 61.3% at 1.5T and 47.5% at 3T; less influential covariates had RIs of up to 11.5% at 1.5T and 16.7% at 3T. Nonhepatocellular iron was weakly associated with R2* at 3T only (RI 6.7%), and hepatocellular iron was not associated with R2* at either field strength.Data conclusionHepatic PDFF is the most influential covariate for R2* at both 1.5T and 3T; nonhepatocellular iron deposition is weakly associated with liver R2* at 3T only.Level of evidence4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:1456-1466.

ImportancePediatric guidelines for the management of nonalcoholic fatty liver disease (NAFLD) recommend a healthy diet as treatment. Reduction of sugary foods and beverages is a plausible but unproven treatment.ObjectiveTo determine the effects of a diet low in free sugars (those sugars added to foods and beverages and occurring naturally in fruit juices) in adolescent boys with NAFLD.Design, setting, and participantsAn open-label, 8-week randomized clinical trial of adolescent boys aged 11 to 16 years with histologically diagnosed NAFLD and evidence of active disease (hepatic steatosis >10% and alanine aminotransferase level ≥45 U/L) randomized 1:1 to an intervention diet group or usual diet group at 2 US academic clinical research centers from August 2015 to July 2017; final date of follow-up was September 2017.InterventionsThe intervention diet consisted of individualized menu planning and provision of study meals for the entire household to restrict free sugar intake to less than 3% of daily calories for 8 weeks. Twice-weekly telephone calls assessed diet adherence. Usual diet participants consumed their regular diet.Main outcomes and measuresThe primary outcome was change in hepatic steatosis estimated by magnetic resonance imaging proton density fat fraction measurement between baseline and 8 weeks. The minimal clinically important difference was assumed to be 4%. There were 12 secondary outcomes, including change in alanine aminotransferase level and diet adherence.ResultsForty adolescent boys were randomly assigned to either the intervention diet group or the usual diet group (20 per group; mean [SD] age, 13.0 [1.9] years; most were Hispanic [95%]) and all completed the trial. The mean decrease in hepatic steatosis from baseline to week 8 was significantly greater for the intervention diet group (25% to 17%) vs the usual diet group (21% to 20%) and the adjusted week 8 mean difference was -6.23% (95% CI, -9.45% to -3.02%; P < .001). Of the 12 prespecifi

BackgroundThe liver R2* value is widely used as a measure of liver iron but may be confounded by the presence of hepatic steatosis and other covariates.PurposeTo identify the most influential covariates for liver R2* values in patients with nonalcoholic fatty liver disease (NAFLD).Study typeRetrospective analysis of prospectively acquired data.PopulationBaseline data from 204 subjects enrolled in NAFLD/NASH (nonalcoholic steatohepatitis) treatment trials.Field strength1.5T and 3T; chemical-shift encoded multiecho gradient echo.AssessmentCorrelation between liver proton density fat fraction and R2*; assessment for demographic, metabolic, laboratory, MRI-derived, and histological covariates of liver R2*.Statistical testsPearson's and Spearman's correlations; univariate analysis; gradient boosting machines (GBM) multivariable machine-learning method.ResultsHepatic proton density fat fraction (PDFF) was the most strongly correlated covariate for R2* at both 1.5T (r = 0.652, P < 0.0001) and at 3T (r = 0.586, P < 0.0001). In the GBM analysis, hepatic PDFF was the most influential covariate for hepatic R2*, with relative influences (RIs) of 61.3% at 1.5T and 47.5% at 3T; less influential covariates had RIs of up to 11.5% at 1.5T and 16.7% at 3T. Nonhepatocellular iron was weakly associated with R2* at 3T only (RI 6.7%), and hepatocellular iron was not associated with R2* at either field strength.Data conclusionHepatic PDFF is the most influential covariate for R2* at both 1.5T and 3T; nonhepatocellular iron deposition is weakly associated with liver R2* at 3T only.Level of evidence4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:1456-1466.

We assessed the performance of magnetic resonance imaging (MRI) proton density fat fraction (PDFF) in children to stratify hepatic steatosis grade before and after treatment in the Cysteamine Bitartrate Delayed-Release for the Treatment of Nonalcoholic Fatty Liver Disease in Children (CyNCh) trial, using centrally scored histology as reference. Participants had multiecho 1.5 Tesla (T) or 3T MRI on scanners from three manufacturers. Of 169 enrolled children, 110 (65%) and 83 (49%) had MRI and liver biopsy at baseline and at end of treatment (EOT; 52 weeks), respectively. At baseline, 17% (19 of 110), 28% (31 of 110), and 55% (60 of 110) of liver biopsies showed grades 1, 2, and 3 histological steatosis; corresponding PDFF (mean ± SD) values were 10.9 ± 4.1%, 18.4 ± 6.2%, and 25.7 ± 9.7%, respectively. PDFF classified grade 1 versus 2-3 and 1-2 versus 3 steatosis with areas under receiving operator characteristic curves (AUROCs) of 0.87 (95% confidence interval [CI], 0.80, 0.94) and 0.79 (0.70, 0.87), respectively. PDFF cutoffs at 90% specificity were 17.5% for grades 2-3 steatosis and 23.3% for grade 3 steatosis. At EOT, 47% (39 of 83), 41% (34 of 83), and 12% (10 of 83) of biopsies showed improved, unchanged, and worsened steatosis grade, respectively, with corresponding PDFF (mean ± SD) changes of -7.8 ± 6.3%, -1.2 ± 7.8%, and 4.9 ± 5.0%, respectively. PDFF change classified steatosis grade improvement and worsening with AUROCs (95% CIs) of 0.76 (0.66, 0.87) and 0.83 (0.73, 0.92), respectively. PDFF change cut-off values at 90% specificity were -11.0% and +5.5% for improvement and worsening.ConclusionMRI-estimated PDFF has high diagnostic accuracy to both classify and predict histological steatosis grade and change in histological steatosis grade in children with NAFLD. (Hepatology 2018;67:858-872).

We assessed the performance of magnetic resonance imaging (MRI) proton density fat fraction (PDFF) in children to stratify hepatic steatosis grade before and after treatment in the Cysteamine Bitartrate Delayed-Release for the Treatment of Nonalcoholic Fatty Liver Disease in Children (CyNCh) trial, using centrally scored histology as reference. Participants had multiecho 1.5 Tesla (T) or 3T MRI on scanners from three manufacturers. Of 169 enrolled children, 110 (65%) and 83 (49%) had MRI and liver biopsy at baseline and at end of treatment (EOT; 52 weeks), respectively. At baseline, 17% (19 of 110), 28% (31 of 110), and 55% (60 of 110) of liver biopsies showed grades 1, 2, and 3 histological steatosis; corresponding PDFF (mean ± SD) values were 10.9 ± 4.1%, 18.4 ± 6.2%, and 25.7 ± 9.7%, respectively. PDFF classified grade 1 versus 2-3 and 1-2 versus 3 steatosis with areas under receiving operator characteristic curves (AUROCs) of 0.87 (95% confidence interval [CI], 0.80, 0.94) and 0.79 (0.70, 0.87), respectively. PDFF cutoffs at 90% specificity were 17.5% for grades 2-3 steatosis and 23.3% for grade 3 steatosis. At EOT, 47% (39 of 83), 41% (34 of 83), and 12% (10 of 83) of biopsies showed improved, unchanged, and worsened steatosis grade, respectively, with corresponding PDFF (mean ± SD) changes of -7.8 ± 6.3%, -1.2 ± 7.8%, and 4.9 ± 5.0%, respectively. PDFF change classified steatosis grade improvement and worsening with AUROCs (95% CIs) of 0.76 (0.66, 0.87) and 0.83 (0.73, 0.92), respectively. PDFF change cut-off values at 90% specificity were -11.0% and +5.5% for improvement and worsening.ConclusionMRI-estimated PDFF has high diagnostic accuracy to both classify and predict histological steatosis grade and change in histological steatosis grade in children with NAFLD. (Hepatology 2018;67:858-872).

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Item does not contain fulltext, PURPOSE: The accurate harvesting of a sentinel node in breast cancer includes a sequence of procedures with components from different medical specialities, including nuclear medicine, radiology, surgical oncology and pathology. The aim of this document is to provide general information about sentinel lymph node detection in breast cancer patients. METHODS: The Society of Nuclear Medicine and Molecular Imaging (SNMMI) and the European Association of Nuclear Medicine (EANM) have written and approved these guidelines to promote the use of nuclear medicine procedures with high quality. The final result has been discussed by distinguished experts from the EANM Oncology Committee, the SNMMI and the European Society of Surgical Oncology (ESSO). CONCLUSION: The present guidelines for nuclear medicine practitioners offer assistance in optimizing the diagnostic information from the SLN procedure. These guidelines describe protocols currently used routinely, but do not include all existing procedures. They should therefore not be taken as exclusive of other nuclear medicine modalities that can be used to obtain comparable results. It is important to remember that the resources and facilities available for patient care may vary.

Item does not contain fulltext, PURPOSE: The accurate harvesting of a sentinel node in breast cancer includes a sequence of procedures with components from different medical specialities, including nuclear medicine, radiology, surgical oncology and pathology. The aim of this document is to provide general information about sentinel lymph node detection in breast cancer patients. METHODS: The Society of Nuclear Medicine and Molecular Imaging (SNMMI) and the European Association of Nuclear Medicine (EANM) have written and approved these guidelines to promote the use of nuclear medicine procedures with high quality. The final result has been discussed by distinguished experts from the EANM Oncology Committee, the SNMMI and the European Society of Surgical Oncology (ESSO). CONCLUSION: The present guidelines for nuclear medicine practitioners offer assistance in optimizing the diagnostic information from the SLN procedure. These guidelines describe protocols currently used routinely, but do not include all existing procedures. They should therefore not be taken as exclusive of other nuclear medicine modalities that can be used to obtain comparable results. It is important to remember that the resources and facilities available for patient care may vary.

The purpose of the present study was to compare the way in which terminal cancer patients and their doctors assess the necessities of this particular type of patient. The sample was constituted by 91 patients and 85 doctors selected from different hospitals in Mexico City. The participants from the two samples were asked to answer a printed questionnaire that assessed the relative relevance of medical, psychological, social, economic and spiritual needs of the patients. The questionnaire Assessment of Terminal Cancer Patient Needs (ATCPN) was built based on other similar questionnaires and complemented by items designed by the present work group. The final questionnaire was composed by 38 items that explored the needs of the patients in 5 different areas: medical, psychological, social, economic and spiritual. The questionnaire produced data that suggested its reliability, validity and internal consistency. The results also showed a considerable homogeneity in the assessments produced by the two samples. The highest priority of the patients was having faith in god or in a supreme being; the doctors favored the ability to cope with the feeling of being forsaken. Results were discussed in terms of their congruence with other studies on the subject., El propósito del presente estudio fue el de comparar la forma en que pacientes con cáncer en etapa terminal y médicos evalúan las necesidades de este tipo de pacientes. La muestra estuvo constituida por 91 pacientes y 85 médicos seleccionados de diferentes hospitales de la Ciudad de México. Los integrantes de las muestras contestaron un cuestionario en el cual evaluaron la importancia de las necesidades médicas, psicológicas, sociales, económicas y espirituales de los pacientes. Para evaluar las necesidades de los pacientes terminales se construyó un cuestionario, Evaluación de las Necesidades de Pacientes Oncológicos en Etapa Terminal (ENPOET), basado en otros instrumentos similares y se complementó con reactivos diseñados por el grupo de investigación. El cuestionario fi- nal utilizado estuvo compuesto por 38 afirmaciones que exploraban las necesidades de los pacientes en cinco áreas diferentes: médica, psicológica, social, económica y espiritual. El cuestionario mostró ser válido, confiable y mostró una consistencia interna apropiada. Los resultados mostraron una considerable homogeneidad en las evaluaciones de las dos muestras. La necesidad evaluada más relevante para los pacientes fue “tener fe en Dios o en un Ser Supremo” y para los médicos “no sentirse desamparado”. Los resultados se discutieron en términos de su congruencia con otros estudios sobre el tema.

This paper examines the process undergone in order to preserve what is known today as the Historical Archive of the National Institute of Migration. It studies the legislative process that enabled the Archive’s restoration, as well as the legal and administrative obstacles that have hampered its availability for academic research. It also analyzes the characteristics of the documental sources and explains their thematic classification. Finally, it outlines a research agenda focused on a broad universe of sources that will allow a reexamination of the history of migration in Mexico., El artículo pasa revista al proceso de rescate de lo que hoy conforma el Archivo Histórico del Instituto Nacional de Migración. Se analiza el proceso legislativo que hizo posible ese rescate, así como las dificultades de orden jurídico y administrativo que han determinado que ese archivo aún no se haya abierto a la consulta académica.Por otra parte, se analizan las características de las fuentes documentales explicando el sentido del ordenamiento temático y, finalmente, se esboza una agenda de investigación atenta a un ancho universo documental que permitirá redimensionar los estudios sobre la historia de la migración en México.

This paper examines the process undergone in order to preserve what is known today as the Historical Archive of the National Institute of Migration. It studies the legislative process that enabled the Archive’s restoration, as well as the legal and administrative obstacles that have hampered its availability for academic research. It also analyzes the characteristics of the documental sources and explains their thematic classification. Finally, it outlines a research agenda focused on a broad universe of sources that will allow a reexamination of the history of migration in Mexico., El artículo pasa revista al proceso de rescate de lo que hoy conforma el Archivo Histórico del Instituto Nacional de Migración. Se analiza el proceso legislativo que hizo posible ese rescate, así como las dificultades de orden jurídico y administrativo que han determinado que ese archivo aún no se haya abierto a la consulta académica.Por otra parte, se analizan las características de las fuentes documentales explicando el sentido del ordenamiento temático y, finalmente, se esboza una agenda de investigación atenta a un ancho universo documental que permitirá redimensionar los estudios sobre la historia de la migración en México.

The purpose of the present study was to compare the way in which terminal cancer patients and their doctors assess the necessities of this particular type of patient. The sample was constituted by 91 patients and 85 doctors selected from different hospitals in Mexico City. The participants from the two samples were asked to answer a printed questionnaire that assessed the relative relevance of medical, psychological, social, economic and spiritual needs of the patients. The questionnaire Assessment of Terminal Cancer Patient Needs (ATCPN) was built based on other similar questionnaires and complemented by items designed by the present work group. The final questionnaire was composed by 38 items that explored the needs of the patients in 5 different areas: medical, psychological, social, economic and spiritual. The questionnaire produced data that suggested its reliability, validity and internal consistency. The results also showed a considerable homogeneity in the assessments produced by the two samples. The highest priority of the patients was having faith in god or in a supreme being; the doctors favored the ability to cope with the feeling of being forsaken. Results were discussed in terms of their congruence with other studies on the subject., El propósito del presente estudio fue el de comparar la forma en que pacientes con cáncer en etapa terminal y médicos evalúan las necesidades de este tipo de pacientes. La muestra estuvo constituida por 91 pacientes y 85 médicos seleccionados de diferentes hospitales de la Ciudad de México. Los integrantes de las muestras contestaron un cuestionario en el cual evaluaron la importancia de las necesidades médicas, psicológicas, sociales, económicas y espirituales de los pacientes. Para evaluar las necesidades de los pacientes terminales se construyó un cuestionario, Evaluación de las Necesidades de Pacientes Oncológicos en Etapa Terminal (ENPOET), basado en otros instrumentos similares y se complementó con reactivos diseñados por el grupo de investigación. El cuestionario fi- nal utilizado estuvo compuesto por 38 afirmaciones que exploraban las necesidades de los pacientes en cinco áreas diferentes: médica, psicológica, social, económica y espiritual. El cuestionario mostró ser válido, confiable y mostró una consistencia interna apropiada. Los resultados mostraron una considerable homogeneidad en las evaluaciones de las dos muestras. La necesidad evaluada más relevante para los pacientes fue “tener fe en Dios o en un Ser Supremo” y para los médicos “no sentirse desamparado”. Los resultados se discutieron en términos de su congruencia con otros estudios sobre el tema.

306 pages Provider Notes: Engineering Directorate Crew and Thermal Systems Division, CTSD-ADV-474, March 1, 2002

80 pages Provider Notes: Engineering Directorate Crew and Thermal Systems Division, CTSD-ADV-474, March 1, 2001

80 pages Provider Notes: Engineering Directorate Crew and Thermal Systems Division, CTSD-ADV-474, March 1, 2001

306 pages Provider Notes: Engineering Directorate Crew and Thermal Systems Division, CTSD-ADV-474, March 1, 2002

306 pages Provider Notes: Engineering Directorate Crew and Thermal Systems Division, CTSD-ADV-474, March 1, 2002

80 pages Provider Notes: Engineering Directorate Crew and Thermal Systems Division, CTSD-ADV-474, March 1, 2001

306 pages Provider Notes: Engineering Directorate Crew and Thermal Systems Division, CTSD-ADV-474, March 1, 2002

80 pages Provider Notes: Engineering Directorate Crew and Thermal Systems Division, CTSD-ADV-474, March 1, 2001

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