bluuebunny/crossref_metadata_2025_split huggingface dataset:
51 Working Collaboratively: Geriatrician Input in Older Patients Undergoing Emergency Laparotomy Reduces Overall Length of Stay - A Complete Audit Loop
Authors: Khan K A , Richters M , Mubarak A , Thorn C , Chalstrey S , Gunasekera S 
Published: February 2020

Abstract

Background
Great Western Hospital is a busy district general hospital with a catchment population of 340,000. Target population of this study was elderly patients aged &gt;70 undergoing Emergency Laparotomy (EL).

Introduction
Approximately 8% of the population is aged over 75 years and operations in this patient group account for 23% of all surgical procedures. The 2010 National Confidential Enquiry into Patient Outcome and Death report “An Age Old Problem”, suggested routine daily input from Geriatrics should be available to elderly patients undergoing surgery.
This study focuses at the impact of Geriatrician input for EL patients with primary outcome of reduction in Length of Stay (LoS).

Methods
The service was designed with allocation of 4 hours per week of Consultant Geriatrician and 2.5 days per week of a Clinical Innovation Fellow (CIF) time. The existing team of surgical junior doctors, nursing and allied health professionals carried out plans suggested by the geriatrician.
Retrospective data (Prior to service initiation) for the emergency laparotomy patients &gt;70 years, was collected from December 2015-May 2016.
Prospective data collected from February 2018 – July 2018 for EL patients aged &gt; 70, patients with inpatient stay &gt; 7 days, patients with delirium/ inpatient falls.
Length of stay and Inpatient mortality were compared between the two cohorts.

Intervention
Prior to the establishment of this service the medical support was provided on ad-hoc basis. Funding was obtained from local postgraduate medical education for CIF and twice weekly consultant led ward rounds were carried out.
Patients were recruited from hospital database and from a referrals book kept at surgical ward.

Results
45 patients were included in prospective study and Mean LoS was 17.8 days, which was reduced from 22.5 days prior to Geriatrician involvement (N=56).
Average 4.7 days per patient were saved.
IP mortality was 8.8% (2/4 deaths were palliative resections) after geriatrician input compared to 8.9% previously.
6.6% of patients had a new medical diagnosis, 24.4% patients were followed up in prospective cohort.

Conclusions
This study suggests the regular geriatrician input reduces the inpatient LoS. A day stay at surgical ward costs roughly £250, for 45 patients in last six months it saved approximately £52,875.
57 Improving Patient Centred Care On An Acute Older Persons Unit: A Quality Improvement Project
Authors: Meldrum T 
Published: February 2020

Abstract

Topic
Improving patient centred care through the implementation of an occupational therapy assessment that is framed by ‘gold standard’ intervention of comprehensive geriatric assessment (CGA) and Canadian Model of Occupational Performance and Engagement (CMOP-E). Occupational therapy staff had limited knowledge of the CGA process.

Intervention
Implementation of an adapted occupational therapy assessment form that reflects the CMOP-E and addresses the domains of the CGA; using the Plan, Do, Study, Act methodology to support a sequential cycle of change over a three month period (Dec 2019 – Feb 2019). The form also addresses patient centred care and personalised care planning. An education session was undertaken with occupational therapy staff to increase the knowledge and understanding of the CGA process resulting in more effective participation in multidisciplinary team (MDT) meetings.

Improvement
The above intervention resulted in successful implementation of an adapted occupational therapy assessment form for older people addressing the domains of the CGA within the CMOP-E framework and encompassing patient centred care. Occupational therapy staff had increased confidence with their knowledge of the CGA and participation in MDT meetings and patients felt more involved in their care.

Discussion
It is possible to have both an evidenced MDT model of practice and a uni-professional occupational therapy model working alongside each other to provide patient centred care and effectively address the complex needs of frail, older people.
66 The Use of Proton Pump Inhibitors in An Older Population in A Tertiary Hospital: A Patient Safety Issue?
Authors: Rafee S 
Published: February 2020

Abstract

Background
PPIs form part of the most commonly prescribed medications in Ireland. There has been emerging concern regarding the risks associated with their chronic use. PPI use has been linked with clostridium difficile infection, pneumonia, hypomagnesaemia, nephrotoxicity, hyponatraemia as well as many other GI and non GI pathologies including dementia. Therefore there has been emerging concern regarding their chronic use. The aim of our audit was to identify the spot prevalence and appropriateness of PPI use for gastro-protection in an older population of medical inpatients in accordance with NICE 2014 PPI guidance “Management of dyspepsia in adults in primary care.”

Methods
We audited the prevalence of PPI use in medically admitted patients aged ≥65 years at our institution and the use of PPIs within this population.
Patients' admission proforma, clinical notes, and drug kardex were reviewed. We collected: age, gender, past medical history, drug list, and laboratory results. This data was used to identify the prevalence and appropriateness of PPI use.

Results
The total number of medically admitted patients aged ≥65 years was 107. 52(48.5%) were prescribed PPIs. Of the 52, only 7(13.4%) had an appropriate indication:
Five patients had concomitant prescription of low dose Aspirin ± clopidogrel and a documented history of gastritis/esophagitis/duodenitis.
One patient had a hiatus hernia and gastro-esophageal reflux disease.
One patient had chronic NSAID use due to arthritis.
Subgroup analysis showed 46/52 were prescribed high dose PPI without indication.

Conclusions
Our audit confirms this showing that almost 50% of patients aged ≥ 65y admitted to our hospital have been prescribed PPIs. Furthermore, PPI prescriptions were only appropriate in 13.4%. In line with recent guidelines, NICE PPI guidance 2014 and AGA Best Practice Guidelines, our data shows there is scope to rationalise PPI use in older people with resultant cost savings and reduction in complications.
102 Process Evaluation Exploring the Delivery and Uptake of Posture and Mobility Training for Staff in Care Homes
Authors: Williams R , Clarke D , Graham L , Hawkins R , Cundill B , Ellwood A , Farrin A , Fisher J , Goodwin M , Holland M , Hull K , Hulme C , Kelly C , Forster A 
Published: February 2020

Abstract

Introduction
Provision of care for care home residents with complex needs is challenging. Physiotherapists can play a major role in enhancing the confidence, skills and abilities of care home staff. The Skilful Care Training Package (SCTP) aims to provide staff with an understanding of good posture and training in skilled facilitation of movement. This process evaluation explored barriers and facilitators to delivery and uptake of the SCTP within the context of a feasibility cluster randomised controlled trial (cRCT) in 10 care homes.

Methods
A mixed methods process evaluation, incorporating non-participant observations and interviews, conducted in the five care homes receiving the SCTP intervention. Interviews were audio recorded and transcribed verbatim; resident conversations were captured via a Dictaphone and/or field-notes. Data analysis used the Framework approach.

Results
Fourteen staff training sessions were observed. Interviews with 22 staff and four trainers, and 13 conversations with residents were completed. Five factors influenced delivery and uptake of the SCTP:Organisational factors: strategies to publicise and facilitate access to training improved attendance; a convenient training location and trainer flexibility encouraged attendance and staff engagement.Intervention delivery: a practical participatory element to the training was highly valued; adapting the training to meet the needs of the homes was well-received.Engagement and interaction: relating training to workplace and residents’ experiences engaged staff; high levels of engagement and positive interaction within the training sessions were reported; challenges relating to staff hierarchy affected training delivery in some homes.Intervention content: posture and mobility elements were seen as important; however, some repetition with prior training was highlighted.Training impact: there were indications that staff adopted SCTP techniques. Staff reported an increase in their wellbeing and confidence in movement facilitation; cascade training was reported in some homes.

Conclusions
Training was well-received, and feedback on its impact was largely positive. Practical elements were viewed favourably over classroom-based learning. Intervention content should be revised to optimise focus and avoid overlap with other training.
Individual variation in migratory behavior in a subarctic partial migrant shorebird
Authors: Méndez Verónica , Alves José A , Þórisson Böðvar , Marca Alina , Gunnarsson Tómas G , Gill Jennifer A 
Published: February 2020

AbstractMigratory behavior can differ markedly amongst individuals within populations or species. Understanding the factors influencing this variation is key to understanding how current environmental changes might influence migratory propensity and the distribution and abundance of migratory species across their range. Here, we investigate variation in migratory behavior of the partially migratory Eurasian oystercatcher (Haematopus ostralegus) population breeding in Iceland. We use the resightings of color-ringed adults and stable isotopes to determine whether individuals migrate or remain in Iceland during winter and test whether individual migratory strategies vary in relation to sex, body size, and breeding location. We also explore individual consistency in migratory strategy and test whether assortative mating with respect to strategy occurs in this population. The proportion of migrants and residents varied greatly across breeding locations but not with respect to sex or body size. Individuals were consistent in migratory strategy between years and there was no evidence of assortative mating by migratory strategy. We use these findings to explore factors underlying the evolution and maintenance of partial migration at high latitudes.
ColocML: machine learning quantifies co-localization between mass spectrometry images
Authors: Ovchinnikova Katja , Stuart Lachlan , Rakhlin Alexander , Nikolenko Sergey , Alexandrov Theodore 
Published: February 2020

Abstract

Motivation
Imaging mass spectrometry (imaging MS) is a prominent technique for capturing distributions of molecules in tissue sections. Various computational methods for imaging MS rely on quantifying spatial correlations between ion images, referred to as co-localization. However, no comprehensive evaluation of co-localization measures has ever been performed; this leads to arbitrary choices and hinders method development.

Results
We present ColocML, a machine learning approach addressing this gap. With the help of 42 imaging MS experts from nine laboratories, we created a gold standard of 2210 pairs of ion images ranked by their co-localization. We evaluated existing co-localization measures and developed novel measures using term frequency–inverse document frequency and deep neural networks. The semi-supervised deep learning Pi model and the cosine score applied after median thresholding performed the best (Spearman 0.797 and 0.794 with expert rankings, respectively). We illustrate these measures by inferring co-localization properties of 10 273 molecules from 3685 public METASPACE datasets.

Availability and implementation
https://github.com/metaspace2020/coloc.

Supplementary information
Supplementary data are available at Bioinformatics online.
Critical Comments on “Assessment of the Thermodynamic Properties of DL-p-Mentha-1,8-diene, 4-Isopropyl-1-Methylcyclohexene (DL-Limonene) by Inverse Gas Chromatography (IGC)”
Authors: Acree William E 
Published: February 2020

Abstract
A polemic is given regarding the calculated thermodynamic quantities reported in the published paper by Farschi and coworkers. The graph used to calculate the molar heat of sorption of organic probe molecules onto the liquid DL-limonene stationary phase erroneously plots the reciprocal of the centigrade temperatures, rather than the reciprocal of the Kelvin temperatures. Molar heats of vaporization of the organic probe molecules reported in the paper are abnormally small and are not in accord with published values determined from calorimetric and vapor pressure measurements.
Hand Hygiene Compliance at Critical Points of Care
Authors: Chang Nai-Chung Nelson , Reisinger Heather Schacht , Schweizer Marin L , Jones ichael , Chrischilles Elizabeth , Chorazy Margaret , Huskins Charles , Herwaldt Loreen 
Published: February 2020

Abstract

Background
Most articles on hand hygiene report either overall compliance or compliance with specific hand hygiene moments. These moments vary in the level of risk to patients if healthcare workers (HCWs) are noncompliant. We assessed how task type affected HCWs’ hand hygiene compliance.

Methods
We linked consecutive tasks individual HCWs performed during the Strategies to Reduce Transmission of Antimicrobial Resistant Bacteria in Intensive Care Units (STAR*ICU) study into care sequences and identified task pairs—2 consecutive tasks and the intervening hand hygiene opportunity. We defined tasks as critical and/or contaminating. We determined the odds of critical and contaminating tasks occurring, and the odds of hand hygiene compliance using logistic regression for transition with a random effect adjusting for isolation precautions, glove use, HCW type, and compliance at prior opportunities.

Results
Healthcare workers were less likely to do hand hygiene before critical tasks than before other tasks (adjusted odds ratio [aOR], 0.97 [95% confidence interval {CI}, .95–.98]) and more likely to do hand hygiene after contaminating tasks than after other tasks (aOR, 1.12 [95% CI, 1.10–1.13]). Nurses were more likely to perform both critical and contaminating tasks, but nurses’ hand hygiene compliance was better than physicians’ (aOR, 0.94 [95% CI, .91–.97]) and other HCWs’ compliance (aOR, 0.87 [95% CI, .87–.94]).

Conclusions
Healthcare workers were more likely to do hand hygiene after contaminating tasks than before critical tasks, suggesting that habits and a feeling of disgust may influence hand hygiene compliance. This information could be incorporated into interventions to improve hand hygiene practices, particularly before critical tasks and after contaminating tasks.
A Modified Semi-automated Resorcinol Method for the Determination of Inulin
Authors: Steele Thomas H 
Published: February 2020

Abstract
A semi-automated resorcinol method for the determination of inulin in plasma and urine specimens, using standard AutoAnalyzer modules, is described. Plasma and other protein-containing fluids undergo a preliminary manual protein precipitation procedure. The deproteinized specimens are processed at a rate of 50/hr, with a high degree of accuracy and precision. The superiority of the present method is largely due to the elimination of small acid-resistant pump tubes from the manifold. This is possible because reagents are premixed prior to aspiration into the system, allowing simplification of manifold design over other automated methods.
Measurement of sodium valproate in serum by direct-insertion chemical-ionization/mass spectrometry.
Authors: Schier G M , Gan I E , Halpern B , Korth J 
Published: February 2020

Abstract
To quantitatively determine sodium valproate, we use a stable isotope-labeled internal standard and chemical-ionization/mass spectrometry, without prior chromatographic separation. The technique is rapid, simple, sensitive, and provides for the routine analysis of 100 microL of serum with good within-day and day-to-day precision. The technique also allows for the simultaneous determination of phenobarbital, mephobarbital, carbamazepine, primidone, and phenytoin.
"High-pressure" liquid chromatography of sulfisoxazole and N4-acetylsulfisoxazole in body fluids.
Authors: Jung D , Oie S 
Published: February 2020

Abstract
We describe a simple, rapid chromatographic method for separating and quantitatively determining sulfisoxazole and its N4-acetyl metabolite in plasma and urine. A 100-micro L sample of plasma or urine is combined with 200 micro L of a solution containing 12 mg/L of the internal standard, N4-acetylsulfamethoxazole, in absolute methanol and centrifuged to obtain a clear supernatant solution. This solution is then eluted through a 10-micron microparticulate column with a mobile phase of 32/68 (by vol) methanol/sodium acetate buffer (0.01 mol/L, pH 4.7), at a flow rate of 1.2 mL/min. The eluted sompounds are detected by their absorption at 254 nm. We calculated concentration from the peak-height ratios of sulfisoxazole or N4-acetylsulfisoxazole to N4-acetylsulfamethoxazole. The peak-height ratio was linear with concentration in the range 0.05--200 mg/L for both drug and metabolite in plasma and urine. Because this assay can be completed within 30 min of obtaining a blood or urine sample, it should be a valuable tool in clinical drug monitoring and pharmacokinetic studies.
Immobilized-enzyme rate-determination method for glucose analysis.
Authors: Sokol L , Garber C , Shults M , Updike S 
Published: February 2020

Abstract
We present a rate-determination method for analyzing glucose. A glucose enzyme electrode serves as the sensor and is made by placing a gel-immobilized layer of glucose oxidase over the tip of a Clark-type O2 electrode. The electrode membrane is made of Teflon and is derivatized by etching with a suspension of colloidal sodium metal in organic solvent. The enzyme is coupled to the membrane surface by use of paraformaldehyde. The immobilized-enzyme method is compared with a similar solution-enzyme method and with the National Glucose Reference method. The immobilized enzyme method compares favorably with the solution-enzyme method and offers the advantages of simplicity, economy of enzyme, and linearity over a greater range of concentration.
Simultaneous liquid-chromatographic determination of zinc protoporphyrin IX, protoporphyrin IX, and coproporphyrin in whole blood.
Authors: Gotelli G R , Wall J H , Kabra P M , Marton L J 
Published: February 2020

Abstract
We describe a method for simultaneously measuring concentrations of coproporphyrin, zinc protoporphyrin IX, and protoporphyrin IX in whole blood by liquid chromatography, with use of reversed-phase ion-pair system, fluorometric detection, and internal standardization. Each analysis requires 10 microL of whole blood and 15 min total analysis time. Analytical recovery ranged from 84 to 92%, day-to-day precision (CV) from 5 to 12%. Uroporphyrin, though not studied in detail, can also be detected by this method.
Automated multiple flow-injection analysis in clinical chemistry: determination of albumin with bromcresol green.
Authors: Renoe B W , Stewart K K , Beecher G R , Wills M R , Savory J 
Published: February 2020

Abstract
We describe an adaptation of automated multiple flow-injection analysis instrumentation to an analysis for albumin in serum. The bromcresol green reaction was used to test the utility of the system. The approach yielded albumin results with excellent sensitivity, no measurable carryover, a relative standard deviation of less than 1%, good correlations with published procedures, and no measurable interferences. The simplicity and flexibility of the instrumentation and its performance integrity, as indicated by the analytical results, make this a viable clinical chemical tool.
Amniotic fluid phospholipids measured by continuous-development thin-layer chromatography.
Authors: Kolins M D , Epstein E , Civin W H , Weiner S 
Published: February 2020

Abstract
We describe a one-dimensional thin-layer chromatographic system for separation of amniotic fluid phosphatidylcholine, sphingomyelin, phosphatidylglycerol, phosphatidylinositol, phosphatidylserine, and phosphatidylethanolamine in amniotic fluid. We utilize short-bed continuous development and "high performance" thin-layer chromatography. Phospholipids are detected with an antimony molybdate staining reagent and quantitated by transmittance densitometry. This system is more sensitive to changes in lecithin/sphingomyelin ratios than are planimetric evaluations.
Continuous-flow (Autoanalyzer I) analysis for plasma thiocyanate as an index to tobacco smoking.
Authors: Dalferes E R , Webber L S , Radhakrishnamurthy B , Berenson G S 
Published: February 2020

Abstract
We describe a procedure for determining thiocyanate in plasma with a Technicon AutoAnalyzer I, modified with a 50-mm tubular flow cell to increase the sensitivity of thiocyanate detection. The procedure is suitable for distinguishing cigarette smokers from non-smokers, the mean for smokers being 151 (SD 43) micromol/L and for non-smokers 62 (SD 19) micromol/L.
Measurement of anticonvulsants in serum by reversed-phase ion-pair liquid chromatography.
Authors: Christofides J A , Fry D E 
Published: February 2020

Abstract
We describe a method for the simultaneous liquid-chromatographic determination of ethosuximide, ethylphenacemide, primidone, phenobarbital, carbamazepine, and phenytoin in serum. The drugs, together with an internal standard, are extracted into ethyl acetate at pH 7.0. The extract is analyzed isocratically at ambient temperature on a reversed-phase column of "SAS Hypersil" with a mobile phase of acetonitrile/tetrabutyl ammonium phosphate solution (2/8 by volume). The eluted drugs are detected by their absorption at 200 nm, and quantitated from their peak heights as compared with those of extracted standards. The day-to-day CV of the method varied between 5.1 and 9.6% for concentrations ranging from less than therapeutic to toxic. The results, when compared with those by gas chromatography, gave correlation coefficients of 0.936 for phenytoin, 0.977 for phenobarbital, and 0.939 for primidone. No drug interference was found except that amobarbital and ethylphenacemide co-chromatographed.
Kinetic serum creatinine assays. II. A critical evaluation and review.
Authors: Bowers L D , Wong E T 
Published: February 2020

Abstract
We have evaluated the Technicon AutoAnalyzer method, the Beckman Creatinine Analyzer II, DuPont aca, Electro-Nucleonics GEMSAEC, and Instrumentation Laboratory Model 916 kinetic methods for determination of serum creatinine. These methods, which involve the Jaffé reaction, all showed a statistically significant proportional error relative to an ion-exchange pretreatment method for creatinine in 92 serum samples; the GEMSAEC method also showed a bias. The positive interference of several acid metabolites was quantitated in each of the methods. The evidence indicates that bilirubin, although associated with a negative creatinine interference, is not the sole interferent. We determined the magnitude of this interference and studied several methods for minimizing it.