bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investing in Queensland's rural medical leaders: Lessons from the Queensland Rural Generalist Program
Authors: Bond Deanne , Chong Hwee Sin 
Published: May 2020

AbstractObjectiveTo improve the leadership capacity of existing Queensland Rural Generalists and support the emerging leaders needed to assume future leadership roles.DesignA customised leadership program for medical Rural Generalists, embedded in professional standards, was developed and delivered during 2016‐2018. Pre and post‐program and individual module evaluations from two Program cohorts were analysed. Qualitative, semi‐structured phone interviews (n = 30) discussing participant views on leadership in a rural context and their Program experience were also conducted.SettingThe Rural Generalist Leadership for Clinicians Training Program runs over twelve months and includes three residential modules as well as online learning sets.ParticipantsForty‐four participants completed the Program and obtained Associate Fellowship of the Royal Australasian College of Medical Administrators.InterventionsDevelopment and delivery of the Rural Generalist Leadership for Clinicians Training Program.Main outcome measure(s)Participant’s ability to apply Program learning in a rural leadership context. Participant views on leadership in a rural context.ResultsParticipants indicated they benefited most from the ‘understanding self’ and management aspects of the Program such as finance, budgeting, and understanding and navigating broader health system governance. They greatly valued the opportunity to enhance their professional networks and relationships and have since developed a regular forum to assist in the transition from individual leadership development to the development of the broader workforce and organisation.ConclusionThe results of this study suggest that further attention and investment in medical leadership is warranted to support and enable the Rural Generalist workforce to continue to meet the complex, context‐specific needs of the communities within which they deliver vital health services.
British Association of Urological Surgeons suprapubic catheter practice guidelines – revised
Authors: Jane Hall Susan , Harrison Simon , Harding Chris , Reid Sheilagh , Parkinson Richard 
Published: May 2020

AimsTo report the updated and revised British Association of Urological Surgeons (BAUS) guideline on indications, safe insertion and subsequent care of suprapubic catheters (SPCs).MethodsThe existing BAUS guideline on the insertion of SPCs was reviewed and has been updated in light of both activity and outcome data published since the original guideline was written. A systematic review of all new data from 2010 onwards was carried out. This updated guideline is largely evidence‐based but, where evidence was lacking, is based on the consensus of expert opinion from members of the BAUS Section of Female, Neurological and Urodynamic Urology.ResultsSuprapubic catheterization is widely used and generally considered a safe procedure. There is, however, a small risk of serious complications including bowel injury. The BAUS has produced an updated consensus statement on SPC use with the aim of minimizing risks and establishing best practice. Areas for future research and development are also highlighted. This review has been commissioned and approved by the BAUS and the Section of Female, Neurological and Urodynamic Urology.ConclusionsWhile SPC insertion is generally regarded as a safe procedure, the risk of serious morbidity and death must always be considered and outlined to patients. These revised guidelines should assist in minimizing the morbidity associated with SPC usage.
Detection of clinically significant cancer in the anterior prostate by transperineal biopsy
Authors: Cowan Tim , Baker Emily , McCray Gabriella , Reeves Fairleigh , Houlihan Kimberley , Johns‐Putra Lydia 
Published: May 2020

ObjectiveTo determine the incidence of clinically significant prostate cancer (csPCa) detected exclusively in the anterior prostate using transperineal prostate biopsy.Patients and MethodsHistopathology results of all patients who underwent transperineal prostate biopsy between February 2016 and March 2018 at a single institution were assessed for distribution of cancer within the prostate. Patients with cancer found exclusively in the anterior prostate were then compared to those with any cancer found in the posterior or lateral prostate with International Society of Urological Pathology Grade Group 2–5 cancers being considered csPCa.ResultsA total of 508 patients were included. Overall, 12.0% of the cohort had csPCa detected only in anterior biopsies. When stratified by prostate‐specific antigen (PSA) level, 6.6% of men with a PSA level of 4.1–10.0 ng/mL and 8.2% of men with a PSA level of >10.0 ng/mL had csPCa detected in the anterior prostate alone.ConclusionTransperineal biopsy has the ability to diagnose anteriorly located csPCa that would potentially have been missed by the transrectal approach.
Four‐week outcomes of vascular endothelial growth factor inhibitors for neovascular age‐related macular degeneration
Authors: Wiryasaputra Shaan , Nguyen Vuong , Arnold Jennifer J. , Ferrier Ross , Hinchcliffe Peter , Barthelmes Daniel , Gillies Mark C. 
Published: May 2020

AbstractImportanceTo assess early outcomes of intravitreal vascular endothelial growth factor (VEGF) inhibitor treatment in neovascular age‐related macular degeneration (nAMD) before patients have a chance to miss or discontinue treatment.BackgroundIntravitreal VEGF inhibitors used to treat nAMD have been compared in various ways. The present study compared the 4‐week responses to the first injection of either aflibercept, bevacizumab, or ranibizumab.DesignObservational study.ParticipantsTreatment‐naïve nAMD patients with visual acuity (VA) taken 22 to 48 days after the first treatment with an intravitreal VEGF inhibitor.MethodsAn observational study from a prospectively designed database.Main outcome measuresVA change from baseline and proportion of eyes judged active 22 to 48 days after the first treatment.ResultsThe overall mean (95% confidence interval [CI]) VA change at 4 weeks was +3.7 (3.3, 4.0) letters. No pairwise comparisons in crude VA change or VA change after multivariate adjustment between the three agents were significant. However, after multivariate adjustment, more eyes treated with bevacizumab (90%) had active disease 4 weeks after the first injection than ranibizumab (84%; P = .013) and aflibercept (82%; P = .004). Older age, higher baseline vision and larger lesions were associated with lower VA change.ConclusionThere was no significant difference in VA gains amongst all three drugs but ranibizumab and aflibercept seemed to be more efficacious in quelling disease activity 4 weeks after the first treatment. VA change after the first injection was driven largely by baseline characteristics such as age, baseline VA and lesion size.
Decision‐making for older patients undergoing emergency laparotomy: defining patient and clinician values and priorities
Authors: Law J. , Welch C. , Javanmard‐Emamghissi H. , Clark M. , Bisset C. N. , O’Neil P. , Moug S. J. ,   the ELF study group
Published: May 2020

AbstractAimThere remains limited knowledge on what patients value and prioritize in their decision to undergo emergency laparotomy (ELap) and during their subsequent recovery. The aim of this study was to explore factors in decision‐making and to reach a consensus amongst patients on the 10 most important priorities in decision‐making in ELap.MethodsPatients aged over 65 years who had required an ELap decision within the preceding 12 months (regardless of management) were identified and invited to attend a modified Delphi process focus group.ResultsA total of 20 participants attended: eight patients, four relatives and eight perioperative specialists. The perioperative specialists group defined 12 important factors for perioperative decision‐making. The patient group agreed that only six (50%) of these factors were important: independence, postoperative complications, readmission to hospital, requirement for stoma formation, delirium (including long‐term cognition) and presence of an advocate (such as a friend or family member). Open discussion refined multiple themes. Agreement was reached by patients and relatives about 10 factors that they valued as most important in their ELap patient journey: return to independence, realistic expectations, postoperative complications, what to expect postoperatively, readmission to hospital, nutrition, postoperative communication, stoma, follow‐up and delirium.ConclusionPatients and clinicians have different values and priorities when discussing the risks and implications of undergoing ELap. Patients value quality of life outcomes, in particular, the formation of a stoma, returning to their own home and remaining independent. This work is the first to combine both perspectives to guide future ELap research outcomes.
Appraisals of Self in the Caregiver Role as Made by Married Custodial Grandparents
Authors: Smith Gregory C. , Lee Jeongeun 
Published: May 2020

ObjectiveWe examined how married custodial grandparents from the same household appraise the impact of caring for a grandchild on their sense of self, and how these appraisals are related to their psychological well‐being.BackgroundThis study is important because there is scant information on how custodial grandmothers and grandfathers both experience their caregiver role, even though 70% of these grandparents are married.MethodFour competing measurement and structural models from the combined perspectives of the stress process model and the two‐factor model of caregivers' psychological well‐being were tested with 193 married grandmothers and grandfathers.ResultsThe best fitting model was one in which two positive (personal gain and satisfaction) and two negative (loss of self and role captivity) appraisals emerged as distinct first‐order constructs. Both negative appraisals correlated highest with negative affect, and both positive appraisals correlated highest with positive affect. The measurement and structural components of this model were largely invariant by grandparent gender. Mean comparisons showed that grandmothers reported significantly higher negative appraisals than grandfathers, with the latter reporting significantly greater perceived gain in the caregiving role. Bivariate correlations between grandmothers' and grandfathers' appraisals were nonsignificant for perceived gain and loss of self and of only moderate magnitude for caregiver satisfaction and role captivity.ConclusionsGiven that appraisals are a core component of coping with stressors, our findings have important practice implications and point to meaningful directions for future research regarding custodial grandparent families.
A broad theoretical investigation of R‐3, R3c, and R‐3c polymorphs of FeCrO3
Authors: Lacerda Luis Henrique da Silveira , de Lazaro Sergio Ricardo 
Published: May 2020

AbstractThe FeCrO3 is a semiconductor founded in nature as a mineral. Such material exists in three different polymorphs whose properties have been few studied. Therefore, this work has performed a broad computational investigation based on a DFT approach aiming to present the nonreported properties; such as optoelectronic, photocatalytic, and phase stability under pressure. The results have indicated that the magnetic properties of the bulk for the three polymorphs present an antiferromagnetic overall ordering, being the residual magnetism experimentally reported caused by a morphology magnetization and not by a specific surface outcrop. Likewise, as electronic as photocatalytic properties predictions have suggested a bandgap in agreement to interest for applications in chemical processes; however, but the corundum phase has shown a significant photocatalytic activity due to charge carriers’ stability. In particular, the R3c phase of the FeCrO3 has presented a multiferroic behavior, since a magnetoelectric coupling is expected. From all the results exposed in this work, we propose that the FeCrO3 material can be suggested as a high‐level candidate for technological purposes.
Dimensions of group home culture as predictors of quality of life outcomes
Authors: Humphreys Lincoln , Bigby Christine , Iacono Teresa 
Published: May 2020

AbstractBackgroundResearch has shown that there is variability in quality of life (QOL) outcomes for people with intellectual disabilities who live in group homes. The aim was to examine dimensions of group home culture as predictors of QOL outcomes.MethodThe Group Home Culture Scale (GHCS) was used to measure staff perceptions of culture in 23 group homes. QOL data were available from 98 people with intellectual disabilities. Multilevel modelling was used to examine the associations between the GHCS subscales and four QOL‐dependent variables.ResultsOf the GHCS subscales, Effective Team Leadership and Alignment of Staff with Organizational Values significantly predicted residents’ engagement in activities. Supporting Well‐Being significantly predicted residents’ community involvement. None of the GHCS subscales significantly predicted domestic participation and choice making.ConclusionsThe findings suggest that strategies to improve Effective Team Leadership and Supporting Well‐Being dimensions of culture may contribute to enhancing certain QOL outcomes.
Sirtuin 3 is essential for hypertension‐induced cardiac fibrosis via mediating pericyte transition
Authors: Su Han , Zeng Heng , Liu Bo , Chen Jian‐Xiong 
Published: May 2020

AbstractHypertension is the key factor for the development of cardiac fibrosis and diastolic dysfunction. Our previous study showed that knockout of sirtuin 3 (SIRT3) resulted in diastolic dysfunction in mice. In the present study, we explored the role of SIRT3 in angiotensin II (Ang‐II)–induced cardiac fibrosis and pericyte‐myofibroblast transition. NG2 tracing reporter NG2‐DsRed mouse was crossed with wild‐type (WT) mice and SIRT3KO mice. Cardiac function, cardiac fibrosis and reactive oxygen species (ROS) were measured. Mice infused with Ang‐II for 28 days showed a significant reduction of SIRT3 expression in the mouse hearts. Knockout of SIRT3 sensitized Ang‐II‐induced elevation of isovolumic relaxation time (IVRT) and reduction of ejection fraction (EF) and fractional shortening (FS). Ang‐II‐induced cardiac fibrosis, capillary rarefaction and hypertrophy were further enhanced by knockout of SIRT3. NG2 pericyte tracing reporter mice infused with Ang‐II had a significantly increased number of NG2‐DsRed pericyte in the heart. Knockout of SIRT3 further enhanced Ang‐II‐induced increase of pericytes. To examine pericyte‐myofibroblast/fibroblast transition, DsRed pericytes were co‐stained with FSP‐1 and α‐SMA. Ang‐II infusion led to a significant increase in numbers of DsRed+/FSP‐1+ and DsRed+/α‐SMA+ cells, while SIRT3KO further developed pericyte‐myofibroblast/fibroblast transition. In addition, knockout of SIRT3 promoted Ang‐II‐induced NADPH oxidase‐derived ROS formation together with increased expression of transforming growth factor beta 1 (TGF‐β1). We concluded that Ang‐II induced cardiac fibrosis partly by the mechanisms involving SIRT3‐mediated pericyte‐myofibroblast/fibroblast transition and ROS‐TGF‐β1 pathway.
Viral encephalopathy and retinopathy is endemic in wild groupers (genus Epinephelus spp.) of the Algerian coast
Authors: Boukedjouta Rachid , Pretto Tobia , Abbadi Miriam , Biasini Lorena , Toffan Anna , Mezali Karim 
Published: May 2020

AbstractThis work describes betanodavirus infection in two species of groupers (family Serranidae) from the Algerian coast: the dusky grouper Epinephelus marginatus and the golden grouper Epinephelus costae. At necropsy, characteristic clinical signs, external injuries, clouded eyes and brain congestion, generally associated with viral encephalopathy and retinopathy (VER) infection were observed. The partial sequences of RNA1 and RNA2 from two viral strains were obtained, and the phylogenetic analysis revealed the presence of the red‐spotted grouper nervous necrosis virus (RGNNV) genotype closely related to strains previously detected in groupers in the same geographic area. Results obtained in this study support the hypothesis that VER disease is endemic in the Algerian grouper population.
Impact of the sexual abstinence period on the production of seminal reactive oxygen species in patients undergoing intrauterine insemination: A randomized trial
Authors: Degirmenci Yaman , Demirdag Erhan , Guler Ismail , Yildiz Sule , Erdem Mehmet , Erdem Ahmet 
Published: May 2020

AbstractAimTo evaluate whether the duration of sexual abstinence has impact on oxidative stress in semen samples.MethodsOxidative reaction was tested for different levels of reactive oxygen species (ROS) by nitro blue tetrazolium assay in 90 patients with the diagnosis of unexplained or male factor infertility that were grouped into 3 groups as 0–2 (group 1), 3–4 (group 2) and >4 days (group 3) of duration of sexual abstinence. Subsequently, the remaining semen was prepared by gradient method for ovarian stimulation and intrauterine insemination (IUI) cycles to compare pregnancy rates in terms of different levels of ROS and different abstinence periods.ResultsIncreased staining pigment intensity was related to higher level of ROS in >4 days' group as compared to groups 0–2 and 3–4 days (70% vs 43.3% and 50%, P = 0.013 and P = 0.014, respectively). Pregnancy rates significantly decrease with prolonged abstinence period (26.7%, 16.7% and 6.7% in groups 1, 2 and 3, respectively, P = 0.039). Progressive motile sperm count after gradient method of sperm preparation for IUI was highest in 3–4 days of abstinence period than shorter and longer abstinence groups.ConclusionLonger duration of sexual abstinence causes higher oxidative stress and decreases pregnancy rates in IUI cycles.
Delayed rhythm formation of normal‐structured, growth‐restricted fetuses using fetal heart rate monitoring patterns
Authors: Sumiyoshi Kaeko , Kawagoe Yasuyuki , Ohhashi Masanao , Furukawa Seishi , Sameshima Hiroshi , Ikenoue Tsuyomu 
Published: May 2020

AbstractAimsGrowth‐restricted fetuses have delayed rhythm formation in utero. The awake–sleep cycle of fetal heart rate pattern is thought to represent fetal rhythm. We aimed to study if the emergence of rhythm formation on fetal heart rate pattern delays in fetal growth restriction compared to appropriate‐for‐date fetuses.MethodsThis was a retrospective cohort study including 75, normal‐structured, singleton fetuses. Of them, 21 were fetal growth restriction and the remaining 54 were appropriate‐for‐date infants. We examined timing of emergence of rhythm formation on fetal heart rate pattern comparing between fetal growth restriction and appropriate‐for‐date fetuses after adjusting possible confounding factors as outcome measures.ResultsRhythm formation was significantly delayed in fetal growth restriction (<10th percentile) compared to the appropriate‐for‐date subgroups (10–30, 30–50, 50–70 and 70–90th percentile) by 1–2 weeks. After adjusting confounding factors, growth restriction was the only independent variable to delay fetal rhythm formation. One infant for each group had neurodevelopmental disorder and the incidence did not reach statistically significant.ConclusionBased on fetal heart rate pattern analysis, growth‐restricted fetuses show 1–2 weeks delay in rhythm formation compared to appropriate‐for‐date fetuses.
CT‐Based Classification of Acute Cerebral Edema: Association with Intracranial Pressure and Outcome
Authors: Lietke Stefanie , Zausinger Stefan , Patzig Maximilian , Holtmanspötter Markus , Kunz Mathias 
Published: May 2020

ABSTRACTBACKGROUND AND PURPOSEBrain edema after acute cerebral lesions may lead to raised intracranial pressure (ICP) and worsen outcome. Notwithstanding, no CT‐based scoring system to quantify edema formation exists. This retrospective correlative analysis aimed to establish a valid and definite CT score quantifying brain edema after common acute cerebral lesions.METHODSA total of 169 CT investigations in 60 patients were analyzed: traumatic brain injury (TBI; n = 47), subarachnoid hemorrhage (SAH; n = 70), intracerebral hemorrhage (ICH; n = 42), and ischemic stroke (n = 10). Edema formation was classified as 0: no edema, 1: focal edema confined to 1 lobe, 2: unilateral edema > 1 lobe, 3: bilateral edema, 4: global edema with disappearance of sulcal relief, and 5: global edema with basal cisterns effacement. ICP and Glasgow Outcome Score (GOS) were correlated to edema formation.RESULTSMedian ICP values were 12.0, 14.0, 14.9, 18.2, and 25.9 mm Hg in grades 1‐5, respectively. Edema grading significantly correlated with ICP (r = .51; P < .0001) in focal and global cerebral edema, particularly in patients with TBI, SAH, and ICH (r = .5, P < .001; r = .5; P < .0001; r = .6, P < .0001, respectively). At discharge, 23.7% of patients achieved a GOS of 5 or 4, 65.0% reached a GOS of 3 or 2, and 11.9% died (GOS 1). CT‐score of cerebral edema in all patients correlated with outcome (r = −.3, P = .046).CONCLUSIONThe proposed CT‐based grading of extent of cerebral edema significantly correlated with ICP and outcome in TBI, SAH, and ICH patients and might be helpful for standardized description of CT‐images and as parameter for clinical studies, for example, measuring effects of antiedematous therapies.
Meloxicam ameliorates the systemic inflammatory response syndrome associated with experimentally induced endotoxemia in adult donkeys
Authors: Mendoza Garcia Francisco Javier , Gonzalez‐De Cara Carlos , Aguilera‐Aguilera Raul , Buzon‐Cuevas Antonio , Perez‐Ecija Alejandro 
Published: May 2020

AbstractBackgroundLittle information is available about endotoxemia in donkeys. Characterizing the systemic inflammatory response (SIRS) to lipopolysaccharide (LPS) in donkeys would provide valuable clinical and therapeutic information. The effects of meloxicam on endotoxemia have not been studied in this species.ObjectivesTo study the pathophysiology and gene expression associated with experimentally induced endotoxemia, and evaluate the effects of meloxicam on experimentally induced endotoxemia in donkeys and in equine monocyte cultures.AnimalsSix healthy adult female donkeys.MethodsEndotoxemia was induced by an IV infusion of LPS for 30 minutes. Animals either received 20 mL of saline or 0.6 mg/kg of meloxicam IV after LPS infusion. The experiments lasted 6 hours. Blood samples were collected serially for hematology, serum biochemistry, interleukin measurement, and leukocyte gene expression analysis. Vital signs were recorded throughout the study. Monocyte cultures were used to test the effects of meloxicam on LPS‐activated monocytes.ResultsLipopolysaccharide induced fever, leukopenia, and neutropenia of similar magnitude in both groups, but meloxicam attenuated increases in plasma lactate, tumor necrosis factor‐alpha (TNFα), and interleukin 1β concentrations compared to controls. No differences were detected between groups for cytokine mRNA expression. Furthermore, meloxicam decreased TNFα release in LPS‐activated monocyte cultures.Conclusions and Clinical ImportanceMeloxicam could be a feasible option for the treatment of endotoxemia and SIRS in donkeys. Additional studies are necessary to investigate possible meloxicam‐related posttranscriptional regulation and to compare this drug with other nonsteroidal anti‐inflammatory drugs (NSAIDs) in animals with endotoxemia.