bluuebunny/crossref_metadata_2025_split huggingface dataset:
General Surgery Residency and Emergency General Surgery Service Reduces Readmission Rates and Length of Stay in Nonoperative Small Bowel Obstruction
Authors: Manning Sarah Waterman , Orr Scotta L. , Mastriani Katherine S. 
Published: September 2020

Background Nonoperative management of adhesive small bowel obstruction (ASBO) results in resolution for the majority of patients. Previous studies have demonstrated that outcomes for patients with ASBO are improved when patients are admitted to a surgical service, but the effect of general surgery resident coverage is unclear. This study measures quality outcomes for patients with ASBO after the establishment of a new general surgery residency program. Methods An institutional review board-approved retrospective chart review of admissions for ASBO was conducted following the implementation of a protocol for ASBO nested within a newly developed resident-run emergency general surgery (EGS) service. Patients successfully treated without operative intervention were analyzed. Results During the study period, 612 patients were admitted for ASBO. After initiation of the residency, 74% of ASBO were admitted to a surgical service compared with 35% prior to residency ( P < .01). Length of stay was reduced by 0.77 days ( P = .016), average direct total cost per patient was reduced by 24% ( P = .002), and 30-day readmissions were reduced by 35.7% ( P = .046). There was no significant difference in mortality (1.4% vs 1.0%). Discussion Admission to a resident-run surgical service was associated with statistically significant improvement in outcomes for patients with ASBO. These data corroborate prior studies demonstrating the positive impact of residency programs on patient outcomes and provide additional evidence that general surgery residency programs improve outcomes for patients with surgical disease.
Continuous versus intermittent bolus milk feeding in preterm infants: a meta-analysis
Authors: Ye Juan , Chen Hong , Zhang Hong-Gang 
Published: September 2020

Objectives To analyze the evidence comparing the benefits and risks of continuous versus intermittent milk feeding in low birth weight (LBW) infants. Methods Three electronic databases were searched and screened to identify randomized controlled trials of continuous and intermittent milk feeding of LBW infants up to October 2016. Results Eight trials were included in this meta-analysis. Continuous feeding had no effect on days to full feeds and time to regain birth weight. There were no significant differences in the number of apneas, invasive ventilation, changes in body length, occipitofrontal circumference, skinfold thickness, and total protein, and in the number of stools between the two feeding strategies. Continuous feeding was associated with higher gastric residual volume, noninvasive ventilation, weight gain, increase in bilirubin, and longer nil by mouth. There were no significant differences in adverse events and confounders between the two feeding strategies. Conclusions Continuous milk feeding was superior to intermittent feeding in LBW infants in terms of weight gain. However, continuous feeding was also associated with increased nil by mouth duration, increased bilirubin, increased noninvasive support, and increased gastric residuals. Continuous feeding thus confers advantages in terms of weight gain, but also has disadvantages compared with bolus feeding.
Immune-related adverse events associated with immune checkpoint inhibitors in patients with cancer
Authors: Sengul Samanci Nilay , Cikman Duygu Ilke , Oruc Kerem , Bedir Sahin , Çelik Emir , Degerli Ezgi , Derin Sumeyra , Demirelli Fuat Hulusi , Özgüroğlu Mustafa 
Published: September 2020

Introduction: With the widespread use of immune checkpoint inhibitors (ICIs), we are facing challenges in the management of immune-related adverse events (irAEs). We aimed to characterize the spectrum of toxicity, management, and outcomes for irAEs. Methods: Patients who were treated with at least one ICI in clinical trials, expanded access programs, or routine clinical practice were included. Clinical and laboratory parameters were collected retrospectively to determine the incidence of irAEs, methods of management, and treatment outcomes. Results: A total of 255 patients were screened retrospectively. Of these, 71 (27.8%) patients developed irAEs. More than 2 different types of irAEs were detected in 16 (6.2%) out of 255 patients. A total of 3177 doses were given to 255 patients. In 93 (2.9%) of the 3177 doses, 1 episode of irAEs was experienced. A total of 22 out of 93 (23.7%) episodes were reported as grade 1, 49 (52.7%) as grade 2, 19 (20.4%) as grade 3, and 3 (3.2%) as grade 4. The most frequently seen irAEs were pneumonitis, hepatitis, and hypothyroidism. With regard to treatment, 39 out of 93 episodes (42%) of any grade irAEs occurred after anti–programmed cell death-1 therapy, 47 (50.5%) occurred following administration of anti–programmed death-ligand 1, and 7 (7.5%) occurred after combination treatments. Conclusion: With the increased use of immunotherapeutic agents, increased awareness and early recognition are required for effective management of irAEs. Our experience as a single institution might be of use for health care providers in oncology.
Primer on Aircraft Induced Clouds and Their Global Warming Mitigation Options
Authors: Sherry Lance , Thompson Terrence 
Published: September 2020

Pressure is increasing on all industrial sectors to address climate sustainability, not only for the welfare of the planet, but also to preserve the customer base and manage operating costs. The aviation industry has a unique opportunity to halve its global radiative forcing (RF) contribution by minimizing the generation of aircraft induced clouds (AIC). These anthropogenic (human-made) condensation trails create a greenhouse effect by absorbing or directing back to Earth approximately 33% of emitted outgoing thermal longwave radiation. The effect of AIC accounts for 2% of the Earth's total anthropogenic RF. The effect of reducing AIC on global warming is immediate (unlike CO2 emissions which have a 2-decade delay in affecting global warming). This paper describes the physics of AIC formation and RF to identify candidate interventions to reduce AIC RF: 1) reduce the quantity of soot generated, 2) reduce or eliminate ice crystal formation, and 3) modify RF properties of AIC. The highest utility and lowest costs is to reduce ice crystal formation by avoiding cruise flight levels in the atmospheric conditions that are conducive to AIC generation. Reducing soot through drop-in biofuels, and synthetic fuels, require significant investment to scale production. Options that require the redesign of jet engines or use of alternative fuels such as liquid natural gas and liquid hydrogen, require significant research and turn-over of the existing fleets. Fuel additives to suppress ice crystal formation, change the RF properties of ice crystals, or both, are still nascent research topics. The implications and limitations are discussed.
Group-based Compassion-focused Therapy on Experiential Avoidance, Meaning-in-life, and Sense of Coherence in Female Survivors of Intimate Partner Violence with PTSD: A Randomized Controlled Trial
Authors: Daneshvar Somayeh , Shafiei Masumeh , Basharpoor Sajjad 
Published: September 2020

The current study was carried out to investigate the effects of compassion-focused therapy (CFT) on experiential avoidance, meaning-in-life, and sense of coherence (SoC) in women suffering from post-traumatic stress disorder (PTSD) due to the intimate partner violence (IPV). 42 women suffering from PTSD due to the IPV exposure were randomized to the two groups of experimental and control (21 per group). All participants completed the questionnaires of experiential avoidance, meaning-in-life, and SoC as pre-test measures. The experimental group received eight sessions of CFT, while the controls did not receive any treatment. After that, all subjects responded to the questionnaires of experiential avoidance, meaning-in-life, and SoC as the post-test measures. Data were analyzed using one-way repeated measures MANOVA. Subjects of the experimental group indicated a greater reduction in post-test scores of experiential avoidance, and a significant rise in the level of meaning-in-life and its subscales including the presence of meaning-in-life and search for meaning-in-life when compared to the controls. Nevertheless, there was no change in the level of SoC as a function of CFT. Applying CFT can result in reducing experiential avoidance and raising the meaning of life in women with PTSD due to IPV exposure. CFT is highly recommended to strengthen the well-being of patients with PTSD and reduce the PTSD symptoms.
Medicolegal Implications of Mild Neurocognitive Disorder
Authors: Bejenaru Anca , Ellison James M. 
Published: September 2020

Introduction: The syndromes of mild cognitive impairment (MCI) or mild neurocognitive disorder (MiND), often prodromal to dementia (Major Neurocognitive Disorder), are characterized by acquired clinically significant changes in one or more cognitive domains despite preserved independence. Mild impairment has significant medicolegal consequences for an affected person and their care system. We review the more common etiologies of MiND and provide a systematic review of its medicolegal implications. Methods: We conducted a systematic review of the peer-reviewed English literature on medicolegal aspects of MCI or MiND using comprehensive search terms and expanding our review to include sources cited by these reports. Results: Impairment of memory, executive function, social cognition, judgment, insight or abstraction can alter an individual’s abilities in a variety of areas that include decision making, informed consent, designation of a surrogate decision-maker such as a health care proxy, understanding and management of financial affairs, execution of a will, or safe driving. Conclusion: Even mild cognitive impairment can have significant behavioral consequences. Clinicians can assist care partners and persons with MCI or MiND by alerting them to the medicolegal concerns that often accompany cognitive decline. Early recognition and discussion can help a care system manage medicolegal risk more effectively and promote thoughtful advance planning.
Late Onset Hypocalcemic Seizures in Formula-Fed, Vitamin D Deficient Babies: Revisited
Authors: Qureshi Umar Amin , Bhat Abdus Sami , Jan Muzaffar , Qureshi Uruj 
Published: September 2020

Purpose: Late onset neonatal hypocalcemia (LNH) is defined as hypocalcemia detected after day 3 of life. Its occurrence in babies fed with cow’s milk is well understood. Since the advent of modern-day formulas, the incidence has however decreased. Methods: A prospective descriptive study (January 2017 to December 2017) of LNH seizures in neonates was conducted. LNH was defined as the total serum calcium of less than 7 mg/dL in preterm or less than 8 mg/dL in term newborns after 72 h of life. Results: 14 neonates were presented with myoclonic and focal seizures due to late hypocalcemia. All were formula fed. Their mean serum calcium, phosphorus, alkaline phosphatase, magnesium, 25-OH vitamin D, intact PTH levels were 4.93 mg/dL, 9.19 mg/dL, 244 U/L, 1.2 mg/dL, 30 nmol/L, 38.6 pg/mL, respectively. Mean maternal vitamin D levels were 43 nmol/L. Mean hospital stay was 4 days. Clinical response to treatment was brisk in those who were able to shift to total breast feeding early. Conclusions: LNH in formula-fed and vitamin D deficient babies is not uncommon. Emphasis should be laid on exclusive breast feeding even in vitamin D deplete mothers. However, mothers at risk should be supplemented with vitamin D during pregnancy.
Design and vibration suppression performance of magnetic suspension dynamic vibration absorber
Authors: Jin Chaowu , Dong Yue , Guan Xudong , Zhou Jin , Wang Fan 
Published: September 2020

In this article, a magnetic suspension technique was introduced into the field of vibration absorption. Using the advantage of adjustable control parameters of a magnetic suspension system, a type of a magnetic suspension dynamic vibration absorber that can achieve broadband vibration suppression was designed. First, the theoretical model of a magnetic suspension dynamic vibration absorber was established. Then, the cantilever beam with sinusoidal excitation is seen as the main system of vibration suppression; combined with the fixed point theory (Seto K (2013) Dynamic Vibration Absorber and its Application. Mechanic Industry Press), the specific structure of the magnetic suspension dynamic vibration absorber was designed. Based on that, the simulation study of vibration suppression performance of the magnetic suspension dynamic vibration absorber was carried out. The results indicated that the vibration of the main system at the 1st modal frequency was reduced by 65.38% under the action of the magnetic suspension dynamic vibration absorber, compared with that without the action of the magnetic suspension dynamic vibration absorber. Furthermore, the vibration of the main system can be suppressed in the frequency band of [16 Hz, 32 Hz]. Finally, a vibration test rig of the magnetic suspension dynamic vibration absorber was built up for experimental study. And the results showed that the absorber can decrease the vibration of the main system by 43.03% at the 1st modal frequency compared with that without the action of magnetic suspension dynamic vibration absorber and had a certain suppression effect (decrease varies from 0 to 43.03%) on the vibration of the main system in the frequency band of [20 Hz, 32 Hz].
Hypertriglyceridemia induced by S-1: A novel case report and review of the literature
Authors: Saito Yoshitaka , Takekuma Yoh , Komatsu Yoshito , Sugawara Mitsuru 
Published: September 2020

Introduction S-1, a compounding agent of tegafur, gimeracil, and oteracil potassium, is one of the most effective chemotherapeutic agents for colorectal cancer. In this case, following S-1 administration, we observed predominant elevation of serum triglyceride. Case report A 49-year-old man with stage IV transverse colon adenocarcinoma received S-1 + irinotecan + bevacizumab. At the end of the S-1 administration period in every course, his serum triglyceride level was found to be elevated. Finally, it reached grade 4, without any symptoms of acute pancreatitis in the fifth course, and fenofibrate 80 mg once a day was administered. Management & outcome: Interestingly, the elevation spontaneously normalized without any pharmacotherapy 14 days after S-1 withdrawal, and this elevation did not occur when S-1 was not administered. Further, fenofibrate administration attenuated the hypertriglyceridemia to grades 1-3, with no complications. Discussion S-1 administration induced hypertriglyceridemia owing to the elevated serum triglyceride; however, a contrasting result was observed in the S-1 withdrawal period and during the S-1-cessation cycle. Since dietary intake was poorer during the S-1 administration period, it is considered that S-1 might have disturbed lipid metabolism. Further, we know that capecitabine, which is a prodrug of fluorouracil, also induces hypertriglyceridemia. As the end product of these medicines is fluorouracil, the presence of fluorouracil or its metabolizing enzymes, the genetic background of the patient might have affected the results. We have to be aware of the risk of asymptomatic and temporal occurrence of hypertriglyceridemia by S-1 administration for the early detection with appropriate pre-emptive treatment.
Investigating perceptions of patient-centred care in orthodontics
Authors: Amin Nima , Cunningham Susan J , Jones Elinor M , Ryan Fiona S 
Published: September 2020

Objectives: To assess and compare patient and clinician perceptions of patient-centredness for adults about to commence active orthodontic treatment, and to assess whether the following variables affected perceptions of patient-centredness: patient gender and age; clinician gender and grade; and stage of treatment. Design: A prospective, cross-sectional questionnaire study. Setting: Eastman Dental Hospital, UCLH NHS Foundation Trust. Participants: A total of 112 adult patients and 30 clinicians completed 224 questionnaires (112 patient and 112 clinician questionnaires). Methods: A validated, dyadic questionnaire, the ‘9-Item Patient Perception of Patient-Centredness’ (PPPC), was used to collect data from both patients and their corresponding clinicians after initial assessment or records/treatment planning consultations. Total PPPC scores (possible score range = 9–36) were calculated for each patient and clinician to ascertain the extent to which they perceived they were engaging in patient-centredness, where higher scores corresponded with better performance. Results: Patients and clinicians perceived high engagement in patient-centredness with median scores of 32/36 and 29/36, respectively. There was a statistically significant difference between total scores with patients perceiving consultations to be more patient-centred than clinicians ( P < 0.001). None of the variables (patient gender and age, clinician gender and grade, stage of treatment) were statistically significant. Conclusion: Patients and clinicians both perceived high engagement in patient-centredness. Patients perceived consultations to be significantly more patient-centred than clinicians ( P < 0.001).
Near-Infrared Fluorescence Cholangiography can be a Useful Adjunct during Emergency Cholecystectomies
Authors: Di Maggio Francesco , Hossain Naveed , De Zanna Andrea , Husain Danya , Bonomo Luca 
Published: September 2020

Background. Emergency cholecystectomy is the gold standard treatment for acute cholecystitis according to National Institute for Health and Care Excellence recommendations. The procedure is feasible but carries a higher risk of iatrogenic injury to the bile duct, which should be considered preventable. Intraoperative fluorescence cholangiography following injection of indocyanine green (ICG) has been reported to aid identification of the extrahepatic bile duct. Data on its feasibility in the context of emergency cholecystectomies are missing. Materials and Methods. Fluorescent ICG was used intraoperatively to enhance the biliary anatomy during 33 consecutive emergency laparoscopic cholecystectomies at our institution. Primary outcomes of surgery were considered the length of hospital stay, conversion to open and complications rate, including bile duct injury. Secondary outcome was operating time. A historical population of emergency cholecystectomies was used as control. Results. There were no common bile duct injuries, no adverse effects from ICG, no conversion to open surgery and no deaths. 90% of patients went home within 48 hours after the operation in the absence of complications. ICG demonstrated intraoperative biliary anatomy allowing greater confidence to the surgeon performing emergency cholecystectomies. Six patients were operated beyond 72 hours from admission, without experiencing any complication Clavien-Dindo ≥3. ICG population had the same post-operative hospitalisation and complications rate of the control group, with a shorter operating time. Conclusion. Intraoperative augmented visualisation of biliary anatomy with ICG cholangiography can be a useful technology tool, with the potential to extend the 72 hours window of safety for emergency cholecystectomies.
Thrombolytic Salvage of the Frostbitten Upper Extremity: A Systematic Review
Authors: Drinane James , Heiman Adee J. , Ricci Joseph A. , Patel Ashit 
Published: September 2020

Background Vascular thrombosis secondary to frostbite can lead to ischemic tissue damage in severe cases. Threatened extremities may be salvaged with thrombolytics to restore perfusion; however, current data are limited to single institution case series. The authors performed a systematic review to determine the efficacy of thrombolytic therapy in treating upper extremity frostbite. Methods PubMed, EBSCO, and Google Scholar were queried using the keywords “thrombolytics,” “frostbite,” “fibrinolytics,” and “tPA.” Exclusion criteria were failure to delineate anatomic parts injured, failure to report number of limbs salvaged, animal studies, and non-English language publications. Thrombolytic therapy was defined as intraarterial (IA) or intravenous (IV) administration of tissue plasminogen activator (tPA), alteplase, urokinase, streptokinase, or any tPA derivative. Results A total of 42 studies were identified, with 13 satisfying inclusion criteria. Eight studies reported catheter-directed IA thrombolysis, four reported systemic IV administration, and 1 reported both methods. A total of 157 patients received thrombolytics. In all, 73 upper extremity digits were treated by IA route and 136 digits were treated by IV route. Overall upper extremity digit salvage rate was 59%. There was a significantly higher salvage rate in digits treated by the IA route compared to the IV route. Conclusions Thrombolytics, particularly when administered by the intra-arterial route, are emerging as a promising treatment of severe frostbite of the upper extremity, increasing digit salvage rates.
Electronic Diabetes Management System Replaces Paper Insulin Chart: Improved Quality in Diabetes Inpatient Care Processes Due to Digitalization
Authors: Kopanz Julia , Lichtenegger Katharina M. , Koenig Constanze , Libiseller Angela , Mader Julia K. , Donsa Klaus , Truskaller Thomas , Bauer Norbert , Hahn Brigitte , Sendlhofer Gerald , Beck Peter , Höll Bernhard , Sinner Frank , Feichtner Franz , Pieber Thomas R. 
Published: September 2020

Background: GlucoTab, an electronic diabetes management system (eDMS), supports healthcare professionals (HCPs) in inpatient blood glucose (BG) management at point-of-care and was implemented for the first time under routine conditions in a regional hospital to replace the paper insulin chart. Method: To investigate quality of the eDMS for inpatients with type 2 diabetes mellitus a monocentric retrospective before-after evaluation was conducted. We compared documentation possibilities by assessing a blank paper chart vs the eDMS user interface. Further quality aspects were compared by assessing filled-in paper charts ( n = 106) vs filled-in eDMS documentation ( n = 241). HCPs ( n = 59) were interviewed regarding eDMS satisfaction. Results: The eDMS represented an improvement of documentation possibilities by offering a more structured and comprehensive user interface compared to the blank paper chart. The number of good diabetes days averaged to a median value of four days in both groups (paper chart: 4.38 [0-7] vs eDMS: 4.38 [0-7] days). Median daily BG was 170 (117-297) mg/dL vs 168 (86-286) mg/dL and median fasting BG was 152 (95-285) mg/dL vs 145 (69-333) mg/dL, and 0.1% vs 0.4% BG values <54 mg/dL were documented. Diabetes documentation quality improved when using eDMS, for example, documentation of ordered BG measurement frequency (1% vs 100%) and ordered BG targets (0% vs 100%). HCPs stated that by using eDMS errors could be prevented (74%), and digital support of work processes was completed (77%). Time saving was noted by 8 out of 11 HCPs and estimated at 10-15 minutes per patient day by two HCPs. Conclusions: The eDMS completely replaced the paper chart, showed comparable glycemic control, was positively accepted by HCPs, and is suitable for inpatient diabetes management.