bluuebunny/crossref_metadata_2025_split huggingface dataset:
Restrictive interventions in Victorian emergency departments: A study of current clinical practice
Authors: Knott Jonathan , Gerdtz Marie , Dobson Sheriden , Daniel Catherine , Graudins Andis , Mitra Biswadev , Bartley Bruce , Chapman Pauline 
Published: November 2019

AbstractObjectiveTo determine current clinical practices for managing behavioural emergencies within Victorian public hospital EDs.MethodsA multi‐centre retrospective study involving all patients who attended ED in 2016 at the Alfred, Ballarat, Dandenong, Geelong and Royal Melbourne Hospitals. The primary outcome was the rate of patient presentations with at least one restrictive intervention. Secondary outcomes included the rate of security calls for unarmed threats (Code Grey), legal status under the Mental Health Act at both the time of ED arrival and the restrictive intervention, and intervention details. For each site, data on 100 patients who had a restrictive intervention were randomly extracted for indication and methods of restraint.ResultsIn 2016, 327 454 patients presented to the five EDs; the Code Grey rate was 1.49% (95% CI 1.45–1.54). Within the Code Grey population, 942 had at least one restrictive intervention (24.3%, 95% CI 23.0–25.7). Details were extracted on 494 patients. The majority (62.8%, 95% CI 58.4–67.1) were restrained under a Duty of Care. Physical restraint was used for 165 (33.4%, 95% CI 29.3–37.8) patients, 296 were mechanically restrained (59.9%, 95% CI 55.4–64.3), median mechanical restraint time 180 min (IQR 75–360), and 388 chemically restrained (78.5%, 95% CI 74.6–82.0).ConclusionsRestrictive interventions in the ED largely occurred under a Duty of Care. Care of patients managed under legislation that covers assessment and treatment of mental illness has a strong clinical governance framework and focus on minimising restrictive interventions. However, this is not applied to the majority of patients who experience restraint in Victorian EDs.
Effect of the Geriatric Emergency Department Intervention on outcomes of care for residents of aged care facilities: A non‐randomised trial
Authors: Marsden Elizabeth , Taylor Andrea , Wallis Marianne , Craswell Alison , Broadbent Marc , Barnett Adrian , Crilly Julia 
Published: November 2019

AbstractObjectiveAs the population of Australia ages, EDs will experience an increasing frequency of presentations of older adults from residential aged care facilities (RACFs). These presentations are often complex and time consuming in the chaotic and potentially hazardous ED environment. The Geriatric Emergency Department Intervention (GEDI) model was developed to optimise the care of frail older adults, especially RACF residents, in the ED. The aim of the present study was to evaluate the effectiveness of the GEDI model on the primary outcomes of disposition (admission, discharge or death) and ED length of stay for residents of RACFs, presenting to an ED in regional Queensland, Australia.MethodsGEDI is a nurse‐led, physician‐championed, innovative model delivered by advanced practice nurses with expertise in gerontology. This quasi‐experimental pragmatic study compared outcomes for RACF residents who presented to a regional Queensland ED during three time periods: pre‐GEDI, interim GEDI and post‐GEDI implementation of the GEDI model. Outcomes included disposition, ED length of stay, ED re‐presentation and mortality.ResultsA significant increase in the likelihood of discharge from ED (hazard ratio 1.15, 95% confidence interval 1.05–1.26) and reductions in ED length of stay (hazard ratio 1.49, 95% confidence interval 1.24–1.78) were evident for RACF residents following the implementation of the GEDI intervention. There were no differences in mortality, ED re‐presentation or in‐hospital length of stay between the three time periods.ConclusionThere is a paucity of evidence to support the implementation of nurse‐led teams in EDs designed to target older adults living in RACFs. The GEDI model was effective in reducing ED length of stay while increasing the likelihood of safe discharge for RACF residents.
End‐tidal capnography provides reliable ventilatory monitoring for non‐intubated patients presenting after sedative overdose to the emergency department
Authors: Millane Teri , Greene Shaun , Rotella Joe‐Anthony , Leang Yit Hung 
Published: November 2019

AbstractObjectiveTo assess the ability of end‐tidal capnography to provide continuous ventilatory monitoring in sedated, non‐intubated ED patients following sedative overdose.MethodsObservational study undertaken in a tertiary hospital ED. Patient ventilation was assessed using capnography over 60 min.ResultsCapnography provided uninterrupted monitoring for 99% of total study time. Capnography detected all episodes of hypoxia detected by SpO2 monitoring. Changes in capnography preceded 70% of hypoxic episodes detected by SpO2. There were no major adverse events or incidents of device failure.ConclusionCapnography provided reliable measurement of ventilatory function in sedated non‐intubated, poisoned ED patients.
Context‐dependent responses of food‐hoarding to competitors in Apodemus peninsulae: implications for coexistence among asymmetrical species
Authors: NIU Hongyu , ZHANG Jie , WANG Zhiyong , HUANG Guangchuan , PENG Chao , ZHANG Hongmao 
Published: November 2019

AbstractSuperior species may have distinct advantages over subordinates within asymmetrical interactions among sympatric animals. However, exactly how the subordinate species coexists with superior species is unknown. In the forests west of Beijing City, intense asymmetrical interactions of food competition exist among granivorous rodents (e.g. Apodemus peninsulae, Niviventer confucianus, Sciurotamias davidianus and Tscherskia triton) that have broadly overlapping habitats and diets but have varied body size (range 15–300 g), hoarding habits (scatter vs larder) and/or daily rhythm (diurnal vs nocturnal). The smallest rodent, A. peninsulae, which typically faces high competitive pressure from larger rodents, is an ideal model to explore how subordinate species coexist with superior species. Under semi‐natural enclosure conditions, we tested responses of seed‐hoarding behavior in A. peninsulae to intraspecific and interspecific competitors in the situations of pre‐competition (without competitor), competition (with competitor) and post‐competition (competitor removed). The results showed that for A. peninsulae, the intensity of larder‐hoarding increased and the intensity of scatter‐hoarding declined in the presence of intraspecifics and S. davidianus, whereas A. peninsulae ceased foraging and hoarding in the presence of N. confucianus and T. triton. A. peninsulae reduced intensity of hoarding outside the nest and moved more seeds into the nest for larder‐hoarding under competition from intraspecific individuals and S. davidianus. In most cases, the experimental animals could recover to their original state of pre‐competition when competitors were removed. These results suggest that subordinate species contextually regulate their food‐hoarding strategies according to different competitors, promoting species coexistence among sympatric animals that have asymmetrical food competition.
Impact of Buckwheat Fermented Milk Combined with High‐Fat Diet on Rats’ Gut Microbiota and Short‐Chain Fatty Acids
Authors: Zhou Yiming , Jiang Qingyi , Zhao Shen , Yan Beibei , Zhou Xiaoli 
Published: November 2019

AbstractThe aim of this study was to evaluate the effect of buckwheat fermented milk on intestinal flora and short‐chain fatty acids (SCFAs) of rats fed a high‐fat diet (HFD). Buckwheat fermented milk was made with Lactobacillus plantarum ST‐Ⅲ, Lactobacillus bulgaricus, and Streptococcus thermophilus. Thirty‐six males C57BL/6 rats (aged 3 weeks and with 9 to 12 g weight) were subjected to a 2‐week adaptive period on a normal diet. After a week of acclimatization, the rats were randomly divided into three groups with 12 rats in each group. The high‐fat diet with fermented milk (HFDFM) group received HFD supplemented with fermented milk, and the high‐fat diet supplemented with buckwheat fermented milk (HFDBFM) group received HFD plus buckwheat fermented milk. Besides, the gavage dose was 0.4 mL/day. After the feedings, colon levels of cytokines and antioxidant indices of the liver, colon, and duodenum tissues were measured. The composition of intestinal flora of rats and the content of SCFAs were determined by gas chromatography‐mass spectrometry and Illumina high‐throughput sequencing technology. Supplementation with buckwheat fermented milk significantly inhibited the increases in lipopolysaccharide levels in colon and antioxidant indexes in the HFD‐fed rats. In addition, buckwheat fermented milk could significantly enhance Firmicutes and decrease Bacteroidetes compared to HFDFM. In addition, SCFA concentrations in HFDBFM were higher than other groups. In conclusion, buckwheat fermented milk can alleviate the damage of HFD to intestinal flora of rats. It modulates microbiota composition and SCFA concentrations to balance the intestinal environment, which will benefit to rats’ intestinal health.Practical ApplicationThis study explored the effect of buckwheat fermented milk on the regulation of intestinal microflora and SCFAs in rats fed a high‐fat diet. It provides new ideas for the development of buckwheat fermented food.
Camera transects as a method to monitor high temporal and spatial ephemerality of flying nocturnal insects
Authors: Ruczyński Ireneusz , Hałat Zuzanna , Zegarek Marcin , Borowik Tomasz , Dechmann Dina K. N. 
Published: November 2019

Abstract

The current global decline of insects will have profound cascading effects as insects serve numerous roles in ecosystems. Effective but simple methods are needed to describe spatial and temporal distribution of flying insects in detail. This applies especially to important but short‐lived phenomena such as insect swarms.

We developed, tested and implemented a non‐invasive unbiased method with camera transects to measure spatio‐temporal fluctuations in the abundance of nocturnal flying insects in different habitats. To test the sensitivity of the method, we then tested for the influence of environmental factors on this abundance.

Our results show that the method is useful for the temporal and spatial comparison of insect abundances. Astonishingly, over 90% of the 63,180 photos lacked insects. We found profound differences in insect abundance and dynamic changes between the studied habitats. Photos with a large number of insects were rare, but occurred predominantly during the warmest period (June/July) and shortly after sunset.

Our findings emphasize the importance of quantifying the dynamics of flying insects at a high spatio‐temporal resolution. This method can be expanded to monitor long‐ and short‐term changes in nocturnal insect abundance even at continental scales. With proper development, the camera transects we describe could be used for insect monitoring similar to the way camera traps are used to monitor terrestrial vertebrate populations, and could become an important tool for addressing the current mass disappearances of insects.
Habitat selection and genetic diversity of a reintroduced ‘refugee species’
Authors: Abicair K. , Manning A. D. , Ford F. , Newport J. , Banks S. C. 
Published: November 2019

AbstractA ‘refugee’ species is one with a current distribution that has been restricted to a subset of their former niche by threatening processes. Conservation opportunities for such species can be limited by a poor understanding of habitat requirements, where habitat models are based on current distributions and not the innate capacity of the animal to survive where threats are managed. We examined patterns of habitat selection by a putative refugee species, the threatened New Holland mousePseudomys novaehollandiae, following reintroduction into historic habitat (habitat that corresponds to a currently unoccupied component of its former niche). Current New Holland mouse populations exist predominantly in coastal heath habitat of select vegetation and fire history, and these environmental conditions differ greatly to those found across the species historical distribution. Using a novel, non‐invasive method of detection for the species, we investigated patterns of habitat selection following reintroduction into historic habitat, where the species primary threat of exotic predators has been removed. We also assessed the changes in genetic diversity measures across three stages of the reintroduction process (before, during and after) using microsatellite markers, to reflect on past efforts in maintaining genetic diversity. We found that historic habitat can still support New Holland mouse populations and identified more diverse potential habitat for the species. We also identified loss of alleles and an increased inbreeding coefficient at the captive breeding stage, but these findings were not statistically significant. This study expands on our limited understanding of habitat requirements and the fundamental niche of the New Holland mouse, highlighting new potential conservation opportunities.
Thailand's Policy Challenges
Authors: Nikomborirak Deunden 
Published: November 2019

AbstractThailand's real gross domestic product growth has fallen to a permanently lower trend, making it the worst performer in the Southeastern Asian region. The export sector, the country's long‐standing growth engine, has sputtered due to the declining competitiveness of the manufacturing sector. Chronic political instability during the last two decades has resulted in the adoption of short‐sighted policies, in particular, populist policies designed specifically to garner votes rather than improve the long‐term productivity of the business sector. The military coup was expected to restore political stability and end costly populist policies introduced by elected civil governments. Unfortunately, as the military government develops its long‐term political aspirations, it, too, seeks the assistance of populist policies to ensure its political success. Thailand has promulgated laws and regulations to ensure fiscal discipline, but it has yet to be seen whether the letter of the law can help prevent such populist policies in practice.
S‐1 plus cisplatin as first‐line treatment of patients with advanced non‐small cell lung cancer in Taiwan
Authors: Lai Chun‐Liang , Wei Yu‐Fen , Hsia Te‐Chun , Chang Gee‐Chen , Wu Jiun‐Ting , Chen Jung‐Yueh , Chen Yuh‐Min 
Published: November 2019

AbstractAimS‐1 combined with cisplatin is known to be noninferior to taxanes plus platinum as the first‐line treatment for patients with advanced nonsmall cell lung cancer (NSCLC) in the Japanese population. This study aimed to evaluate the efficacy and safety profiles of oral S‐1 plus cisplatin (SP) in Taiwanese patients.MethodsPatients with previously untreated stage IIIB or IV NSCLC were prospectively recruited to receive 40‐60 mg of S‐1 twice daily on days 1‐21 plus 60 mg/m2 of cisplatin on day 8 in a 5‐week cycle for up to six cycles.ResultsA total of 55 patients from five cancer centers in Taiwan were enrolled. Among the 46 evaluable patients, those administered with SP achieved disease control rate of 69.6% (partial response, 19.6%; stable disease, 50.0%), with median overall survival and progression‐free survival (PFS) of 15.1 and 5.7 months, respectively. Moreover, a better survival trend was observed in epidermal growth factor receptor mutation‐positive patients versus mutation‐negative patients treated with SP (PFS, 8.6 vs 5.6 months). The most commonly observed treatment‐related adverse events (AEs) were nausea (41.8%), followed by decreased appetite, anemia, and diarrhea. Grade of ≥3 AEs related to the study treatment occurred in 11 patients (20.0%). No febrile neutropenia or treatment‐related death was found in this study.ConclusionsThis study demonstrated that SP is an effective and safe first‐line regimen for Taiwanese patients with advanced NSCLC.
Perinatal care provided for babies born at 23 and 24 weeks of gestation
Authors: Dawes Lisa , Buksh Mariam , Sadler Lynn , Waugh Jason , Groom Katie 
Published: November 2019

In recent years, significant improvements in survival and survival‐free of major morbidity in babies born at 23+0 to 24+6 weeks of gestation have led to a more pro‐active approach to resuscitation at these peri‐viable gestations. Antenatal counselling and interventions, intrapartum care and postnatal advice should be part of the package of care provided to optimise outcomes for these babies and their families. This observational study assesses the perinatal care provided to mothers and their babies who were born at 23 and 24 weeks of gestations over a two‐year period at a tertiary maternity hospital in New Zealand.
Window of opportunity treatment in breast cancer
Authors: Chen Julia , Easwaralingam Neshanth , Warrier Sanjay , Ong Andrew , Carson Emma‐Kate , Mak Cindy , Snook Kylie , Middleton Kate , Parker Andrew , Palmieri Carlo , Spillane Andrew , Mann G. Bruce , Lim Elgene , Segara Davendra 
Published: November 2019

AbstractWindow of opportunity therapies, which involve short‐term administration of systemic therapy between cancer diagnosis and surgery, have raised significant interest in recent years as a mean of assessing the sensitivity of a patient's cancer to therapy prior to surgery. There is now compelling evidence that in patients with early stage hormone‐receptor positive breast cancer, a 2‐week preoperative treatment with standard hormone therapies in a preoperative window period provides important prognostic information, which in turn helps to aid decision‐making regarding treatment options. Changes in short‐term biomarker endpoints such as cell proliferation measured by Ki‐67 can act as surrogate markers of long‐term outcomes. Paired tissues obtained pre‐ and post‐investigational treatment, without having to subject the patient to additional biopsies, can then be used to conduct translational research to investigate predictive biomarkers and pharmacodynamics. In this review, we will examine the utility and challenges of window of opportunities therapies in breast cancer in the current literature, and the current Australian and international trial landscape in this clinical space.
Corneal endothelial cell loss following cataract surgery in patients with pseudoexfoliation syndrome: a 2‐year prospective comparative study
Authors: Kristianslund Olav , Pathak Meeta , Østern Atle Einar , Drolsum Liv 
Published: November 2019

AbstractPurposeTo compare the corneal endothelial cell density (ECD) before and after cataract surgery in patients with and without pseudoexfoliation syndrome (PEX).MethodsIn this prospective study, we compared the ECD in 62 PEX patients with 62 patients without PEX (controls). The mean age was 78.3 ± 6.2 years and 77.2 ± 5.9 years, respectively. Patients were examined before and at 6 months, 1 year and 2 years after cataract surgery. The corneal endothelium was examined with confocal microscopy, and the ECD was counted both automatically and semi‐manually. Nine patients in the PEX group (15%) and 11 patients in the control group (18%) were lost to follow‐up in the 2‐year period. Within the PEX and the control groups, we also compared the ECD between patients with and without glaucoma.ResultsBefore surgery, the ECD (semi‐manual counting) was 2258 ± 342 cells/mm2 in the PEX group and 2322 ± 321 cells/mm2 in the control group (p = 0.29). There were no significant differences in postoperative ECD between these groups at any visit. After 2 years, the ECD had changed by −679 ± 337 cells/mm2 and −704 ± 484 cells/mm2, respectively (p = 0.78). The preoperative ECD was lower in eyes with glaucoma compared to eyes without glaucoma, both within the PEX group (p = 0.05) and the control group (p = 0.03). After surgery, there were no differences between eyes with or without glaucoma.ConclusionThe ECD was not significantly different in PEX eyes compared with control eyes, neither before nor after cataract surgery. However, there seemed to be a lower ECD in eyes with glaucoma before surgery.
Hepatitis C eradication with direct‐acting anti‐virals reduces the risk of variceal bleeding
Authors: Moon Andrew M. , Green Pamela K. , Rockey Don C. , Berry Kristin , Ioannou George N. 
Published: November 2019

SummaryBackgroundThe real‐world, long‐term benefits of sustained virologic response (SVR) on the risk of variceal bleeding remain unclear.AimTo assess the association between DAA‐induced SVR and post‐treatment variceal bleedingMethodsWe identified patients who initiated DAA‐only anti‐viral treatments in the United States Veterans Affairs healthcare system from 2013 to 2015. We followed patients until 1 January 2019 for the development of gastro‐oesophageal variceal bleeding defined by diagnostic codes. We used multivariable Cox proportional hazards regression to assess the association between SVR and development of variceal bleeding, adjusting for potential confounders.ResultsAmong 33 582 DAA‐treated patients, 549 (1.6%) developed variceal bleeding after treatment (mean follow‐up 3.1 years). Compared to no SVR, SVR was associated with a significantly lower incidence of variceal bleeding among all patients (0.46 vs 1.26 per 100 patient‐years, adjusted hazard ratio [AHR] 0.66, 95% CI 0.52‐0.83), among patients with pre‐treatment cirrhosis (1.55 vs 2.96 per 100 patient‐years, AHR 0.73, 95% CI 0.57‐0.93) and among patients without pre‐treatment cirrhosis (0.07 vs 0.29 per 100 patient‐years, AHR 0.33, 95% CI 0.17‐0.65). The risk of variceal bleeding after treatment was lower in those who achieved SVR vs no SVR among patients who had non‐bleeding varices (3.5 vs 4.9 per 100 patient‐years) or bleeding varices (12.9 vs 16.4 per 100 patient‐years) diagnosed before treatment, but these differences were not statistically significant in adjusted analyses.ConclusionDAA‐induced SVR is independently associated with a lower risk of variceal bleeding during long‐term follow‐up in patients with and without pre‐treatment cirrhosis. These findings demonstrate an important real‐world benefit of DAA treatment.
Association between thoracic musculoskeletal abnormalities and lung function in preterm infants
Authors: Scavacini Ana Sílvia , Davidson Josy , Wandalsen Gustavo Falbo , Gonçalves Daniela de Melo Miranda , Lanza Fernanda C. , Goulart Ana Lucia , Solé Dirceu , dos Santos Amélia Miyashiro Nunes 
Published: November 2019

AbstractIntroductionIn view of the difficulties and risks of performing lung function tests in infants and the hypothesis that children with abnormal pulmonary test may exhibit thoracic musculoskeletal alterations.ObjectivesThis study aimed to determine the frequency of abnormal lung function and their relationship.Materials and MethodsThis was a cross‐sectional study with children from 6 to 12 months of corrected age, born at a gestational age of <37 weeks and with a birthweight ≤1500 g, who were subjected to a lung function test and photogrammetry––an objective and non‐invasive procedure. To verify the association between the thoracic musculoskeletal abnormalities and measure changes in lung function, univariate linear regression was used. The level of statistical significance was setted at P < 0.05.ResultsOf the 38 infants, 12 (31.6%) exhibited abnormal lung function, including 9 (23.7%) with obstructive function and 3 (7.9%) with restrictive function. A significant association was noted between forced expiratory volume at 0.5 second <−2 z score and the acromion/xiphoid process/acromion angle (β = 4.935); forced vital capacity <−2 z score and the angle of the manubrium/left acromion/trapezium (β = 0.033) and forced expiratory volume at 0.5 second and forced vital capacity ratio <−2 z score and the inframammillary point/xiphoid process/inframammillary point angle (β = 0.043).ConclusionPreterm infants with very low birthweight presented a high frequency of abnormal lung function, particularly obstructive type and thoracic musculoskeletal abnormalities were associated with changes in lung function.