bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ongoing effects of eConsultation in nephrology on hospital referral rates: An observational study
Authors: Boom Victor EA , van der Kamp Laura T , van Zuilen Arjan D , De Ranitz Wendela L , Bos Willem Jan , Jellema Wilbert T , Mui Kwok Wai , Later Alexander F , Prinssen Monique , Kaasjager Karin 
Published: August 2020

Introduction eConsultation in nephrology is an innovative way for general practitioners (GPs) to consult a nephrologist. Studies have shown that questions from GPs can be answered and intended referrals can be avoided by eConsultation. However, follow-up data are lacking. The primary aim of this study was therefore to assess whether patients for whom a referral to the outpatient clinic of a medical specialist was avoided in the short term were not then referred for the same problem within one year after the eConsultation. Methods All eConsultations sent between June 2017 and April 2018 to seven nephrologists in three different hospitals in The Netherlands were included. Exclusion criteria were duplications and missing data on follow-up. Data were obtained from the eConsultation application forms and from GP medical records. Results A total of 173 eConsultations were included. Of the 32 patients for whom a referral was initially prevented, 91% (95% confidence interval 75–98) had not been referred to a specialist for the same problem within one year after the eConsultation. Discussion eConsultation in the field of nephrology can prevent referrals in the long term. It can therefore contribute to a more modern and efficient health-care system in which chronic care is provided by GPs in close proximity to patients, while specialist support is easily available and accessible through eConsultation when necessary.
Acquiring allophonic structure and phonetic detail in a bilingual community: The production of laterals by Sylheti-English bilingual children
Authors: Kirkham Sam , McCarthy Kathleen M. 
Published: August 2020

Aims and objectives: In this study, we consider the acquisition of allophonic contrast and phonetic detail in lateral consonants by second-generation Sylheti-English bilingual children in London, UK. Design/methodology/approach: Acoustic analysis was conducted on productions of /l/ by Sylheti bilingual children, Sylheti monolingual adults and English monolingual children. Data and analysis: Tokens of /l/ were elicited across initial, medial and final word positions from 14 bilingual Sylheti-English children, 10 monolingual English children, and 4 monolingual Sylheti adults. Acoustic measurements of F2–F1 were analysed using Bayesian linear mixed-effects modelling. Findings and conclusions: Our results show that bilingual children produce monolingual-like positional patterns in Sylheti, with very clear laterals in all positions. In contrast, bilinguals produce monolingual-like positional allophony in English, but they differ in phonetic detail, with bilinguals producing much clearer laterals than monolingual children across all positions. Originality: This study is the first to examine the development of allophonic contrast and phonetic detail in both of a bilingual’s languages in a contact scenario. This provides new insights into how contact varieties adopt aspects of structure and detail from each language. We also report valuable data from Sylheti-English bilinguals, who are an understudied community. Significance/limitations: Our study highlights the value of considering structural and detailed aspects of cross-linguistic sound systems, whereby one aspect may show monolingual-like patterns and another aspect may show distinctive patterns. We propose that the results in this study represent the development of a new sound system out of language contact, with second-generation bilingual children producing a hybrid system that combines influences from both heritage and host languages.
An evaluation of the presentation and severity of Australian football injury in children
Authors: Simma Leopold , Palmer Cameron S , Ngo Alan , Jowett Helen E , Teague Warwick J 
Published: August 2020

Introduction Child participation in sport is important for physical, cognitive and psychosocial wellbeing. Australian rules football has high participation, but also carries a high risk of injury due to the contact nature of the sport. This study aimed to evaluate changes in the presentation and hospital admission of paediatric Australian rules football-related injuries, and to compare the severity of these injuries with those from other team ball sports. Materials and methods At an Australian paediatric major trauma service, ED and hospital trauma registry data relating to Australian rules football injury between 2009 and 2015 were obtained. Data from other common team ball sports with a shared field of play were also identified. Results During the study period, there were 10,003 ED presentations, and 1110 admissions resulting from team ball sports. With 4751 ED presentations and 616 admissions, Australian rules football accounted for almost one-third of all sports-related presentations and admissions, and around half of the team ball sports cohort. Compared to other team ball sports patients, Australian rules football-related patients were 40% more likely to be admitted, and nearly twice as likely to be classified as severe injury. Australian rules football players presented with different injury patterns were compared to other team ball sports players; admitted players were significantly more likely to have sustained head or neck injuries, and were more than twice as likely to sustain truncal injury. Conclusions Australian rules football is a common cause of ED presentations and results in substantial morbidity, both overall and when compared with other team ball sports. Australian rules football should remain a focus for ongoing and active research into strategies which reduce injury risk.
Publication rate of abstracts from presentations at the British Orthodontic Conference 2009–2014
Authors: Al-Yatama Fai , Pandis Nikolaos , Cobourne Martyn T , Seehra Jadbinder 
Published: August 2020

Objective: The primary objective of this study was to investigate the publication rate of scientific abstracts presented at the British Orthodontic Conference 2009–2014. Predictors of full-text publications after presentation of abstracts were explored. Design: Cross-sectional study. Materials and methods: Details of abstracts were retrieved from the conference programmes. Abstracts were screened and full-text publications identified by a single author with discrepancies discussed. Two electronic databases were searched to identify full-text publication of abstracts presented at the British Orthodontic Conference during 2009–2014. Study characteristics were recorded in a prespecified data collection sheet. Descriptive and correlation statistics were calculated. Multivariable Cox regression modelling was implemented in order to assess the effect of predictors on the instance of probability of publication. Results: A total of 225 abstracts (148 poster presentations and 77 oral presentations) were identified. Observational studies were frequent (60%) and significant results were reported in 38.7% of abstracts. The rate of full-text publication after abstract presentation was 46.2% with a mean time to publication of 18.3 ± 18.7 months. Authors based at both university and hospitals (Hazard ratio: 2.63, 95% confidence interval [CI] 1.26–5.47, P=0.01) had a higher instant probability of publication compared to university only, whereas diagnostic studies (Hazard ratio: 0.18, 95% CI 0.04–0.74, P=0.02) had lower instant probability of publication compared to systematic reviews. Conclusion: Over 50% of study abstracts presented at the British Orthodontic Conference during 2009–2014 remain unpublished. Author affiliation and study type appear to influence full text publication. In order to reduce publication bias within the literature, publication of full-text articles by authors of presented abstracts is encouraged.
Redefining education and politics: On the paradoxical relation between two separate spheres
Authors: Vlieghe Joris , Zamojski Piotr 
Published: August 2020

In this contribution to the Special Issue on the instrumentalisation of education, we focus on the relation between politics and education, as today there is a dominant discourse on rendering education subservient to the realisation of political aims. Rather than analysing the many ways in which such instrumentalisation takes place, we propose to develop an ontological account that articulates the basic attitude that a political and an educational engagement respectively demand. Our main source of inspiration was Arendt’s claim that education should be conceived of as an autonomous and separate sphere, that is, as being meaningful in and of itself, and without any need for an external justification (e.g. in political terms). Taking this standpoint further we will argue that the unique logic of education can be conceived of in terms of unconditional love for the present world. This affirmative attitude is precisely what makes education educational. Conversely, this calls for a redefinition of the logic that -- following Schmitt -- characterises the political, which we will show to be predicated upon a dialectical relation with the world that consists of an attitude of hate towards the present, in view of an ever deferred hoped-for ideal future. This leads us to reconsider the relation that education as an autonomous sphere of human life enters with politics. In order to theorise this kind relation we refer to the idea of pure means, introduced by Agamben .
UK consensus guidelines for the delivery of unexpected news in obstetric ultrasound: The ASCKS framework
Authors: Johnson Judith , Arezina Jane , Tomlin Liz , Alt Siobhan , Arnold Jon , Bailey Sarah , Beety Hannah , Bender-Atik Ruth , Bryant Louise , Coates Jen , Collinge Sam , Fishburn Jo , Fisher Jane , Fowler Jan , Glanville Tracey , Hallett Julian , Harley-Roberts Ailith , Harrison Gill , Horwood Karen , Hynes Catriona , Kimm Lindsay , McGuinness Alison , Potter Lucy , Powell Liane , Ramsay Janelle , Shakes Pieta , Sicklen Roxanne , Sims Alexander , Stacey Tomasina , Sumra Anushka , Thomas Samantha , Todd Karen , Torrington Jacquie , Trueman Rebecca , Walsh Lorraine , Watkins Katherine , Yaz Gill , Hardicre Natasha K 
Published: August 2020

Background Studies indicate there is a need to improve the delivery of unexpected news via obstetric ultrasound, but there have been few advances in this area. One factor preventing improvement has been a lack of consensus regarding the appropriate phrases and behaviours which sonographers and ultrasound practitioners should use in these situations. Aims To develop consensus guidelines for unexpected news delivery in Early Pregnancy Unit and Fetal Anomaly Screening Programme NHS settings. Methods A workshop was conducted to identify priorities and reach consensus on areas of contention. Contributors included interdisciplinary healthcare professionals, policy experts, representatives from third-sector organisations, lay experts and academic researchers ( n = 28). Written and verbal feedback was used to draft initial guidance which was then circulated amongst the wider writing group ( n = 39). Revisions were undertaken until consensus was reached. Results Consensus guidelines were developed outlining the behaviours and phrases which should be used during scans where unexpected findings are identified. Specific recommendations included that: honest and clear communication should be prioritised, even with uncertain findings; technical terms should be used, but these should be written down together with their lay interpretations; unless expectant parents use other terminology (e.g. ‘foetus’), the term ‘baby’ should be used as a default, even in early pregnancy; at the initial news disclosure, communication should focus on information provision. Expectant parents should not be asked to make decisions during the scan. Conclusions These recommendations can be used to develop and improve news delivery interventions in obstetric ultrasound settings. The full guidelines can be accessed online as supplemental material and at https://doi.org/10.5518/100/24 .
An ethnographic exploration of the social organisation of general practice nurses’ knowledge use: more than ‘mindlines’?
Authors: Carrier Judith 
Published: August 2020

Aim To explore contextual, organisational and educational issues impacting on access to, and application of knowledge to everyday practice by general practice nurses, working in two rural primary-care practices in the UK. Background Changes in primary-care healthcare delivery have resulted in substantive changes to practice nurses’ roles. Practice nurses have taken on enhanced roles for which they were not prepared for in their initial training, little is known about how they access and apply knowledge. Methods Ethnographic methods were used to gather data. Results Practice nurses take a blended approach to knowledge use, using elements of evidence-based practice to support professional judgement. This is subject to several contextual influences, organisational, educational and from individual patients. Tensions exist between the position in which general practice nurses are situated and the nature in which knowledge is disseminated and used in primary care. Whilst examples of clinical mindlines were evident, these differed to those previously observed in general practitioners, practice nurses did not always have the mindline on which to draw and used an approach to practice that resembled ‘bricoleur activity’. Conclusions The way in which general practice is structured results in variance in organisational structural arrangements for sharing and disseminating of knowledge. Despite a supportive organisational culture towards knowledge sharing, the position in which practice nurses are situated limits opportunities for discussion and reformulation of knowledge. Practice nurses are, however, prepared to adapt knowledge to meet the needs of individual patients.
Comparative Evaluation of Synovial Multipotent Stem Cells and Meniscal Chondrocytes for Capability of Fibrocartilage Reconstruction
Authors: Lee Jisoo , Jang Seoyoung , Kwon JunPyo , Oh Tong In , Lee EunAh 
Published: August 2020

Objective Meniscus tissue is composed of highly aligned type I collagen embedded with cartilaginous matrix. This histological feature endows mechanical properties, such as tensile strength along the direction of the collagen alignment and endurance to compressive load induced by weight bearing. The main objective of this study was to compare the fibrocartilage construction capability of different cell sources in the presence of mechanical stimuli. Design Synovial multipotent stem cells (SvMSCs) and meniscal chondrocytes (MCs) from immature and mature rabbits were maintained under similar conditions for comparative evaluation of growth characteristics and senescence tendency. The differentiation potential of cell sources, including fibrocartilage generation, were comparatively evaluated. To determine the capability of fibrocartilage generation, cultured cell sheets were rolled up to produce cable-form tissue and subjected to chondrogenic induction in the presence or absence of static tension. Results Although SvMSCs showed superior cell growth characteristics during in vitro cell expansion, senescence-associated β-galactosidase expression was consistently higher, compared with MCs. MCs showed glycosaminoglycan (GAG)-rich matrix formation during default in vitro chondrogenesis. While application of static tension significantly reduced GAG production, MCs continued to show robust tissue growth. SvMSCs showed inferior chondrogenic differentiation and diminished tissue growth in the presence of static tension. Conclusions While SvMSCs produced fibrous tissue during default in vitro chondrogenesis, their fibrocartilage generation potential in the presence of static tension was significantly lower, compared with MCs. Our results support evaluation of cellular response to tensile stimulus as a decisive factor in determining the ideal cell source for fibrocartilage reconstruction.
New-onset Psychosis in an Immunosuppressed Patient With Kidney Transplantation: An Educational Case Report
Authors: Mappin-Kasirer Benjamin , Hoffman Lawrence , Sandal Shaifali 
Published: August 2020

Rationale: New-onset psychosis in an immunosuppressed patient post-kidney transplantation (KT) is a diagnostic challenge. A broad differential diagnosis merits consideration; however, an approach to this differential diagnosis remains to be outlined in the literature. Also, when and how to modify the maintenance immunosuppressive regimen remains a significant area of controversy. Presenting concerns: A 23-year-old male, known for X-linked Alport syndrome for which he had undergone KT 1 year prior, presented with a 1-week history of disorganized speech, bizarre behavior, religious delusions, and visual hallucinations. Diagnoses: After ruling out infectious, metabolic, autoimmune, and structural causes, immunosuppressant medications were changed from tacrolimus to cyclosporine. The patient did not improve after this change, and a second opinion consultation with a transplant psychiatrist led to a diagnosis of primary first-episode psychosis, later refined to bipolar disorder type I. Interventions: The patient was started on risperidone, which led to a significant improvement in his symptoms. Outcomes: Twelve months after discharge, his mood and behavior had returned to baseline on aripiprazole, bupropion, and citalopram. However, he developed acute allograft rejection, prompting a change from cyclosporine back to tacrolimus, with stability of his mental state and graft function. Teaching points: This report offers learners an extensive and organized differential diagnosis to the work up of psychosis post kidney transplantation. A complete history, with input from collateral sources, and a systematic approach to the differential diagnosis, are crucial and should not be overshadowed by the risk of immunosuppressant-related neurotoxicity. We underscore the importance of multi-disciplinary management and comprehensive psychosocial assessment and re-assessment to refine the diagnosis. We also report the successful re-introduction of tacrolimus once the diagnosis of a primary psychiatric disorder is confirmed. Finally, we offer a simplified approach that can aid in distinguishing between a primary psychiatric diagnosis versus tacrolimus-associated psychosis.
A Systematic Review of Treatment Strategies for the Prevention of Junctional Complications After Long-Segment Fusions in the Osteoporotic Spine
Authors: Echt Murray , Ranson William , Steinberger Jeremy , Yassari Reza , Cho Samuel K. 
Published: August 2020

Study Design: Systematic review Objectives: Proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) are well-known complications after long-segment fusions in the thoracolumbar spine of osteoporotic patients. Recent advances in anti-resorptive and anabolic medications, instrumentation, surgical technique, and cement augmentation have all aided in the avoidance of junctional kyphosis. In this article, current literature on the prevention of PJK and PJF in the osteoporotic spine is reviewed. Methods: A systematic literature review was conducted using the PubMed/MEDLINE and Embase databases in order to search for the current preventive treatment methods for PJK and PJF published in the literature (1985 to present). Inclusion criteria included (1) published in English, (2) at least 1-year mean and median follow-up, (3) preoperative diagnosis of osteoporosis, (4) at least 3 levels instrumented, and (5) studies of medical treatment or surgical techniques for prevention of junctional kyphosis. Results: The review of the literature yielded 7 studies with low levels of evidence ranging from level II to IV. Treatment strategies reviewed addressed prophylaxis against ligamentous failure, adjacent vertebral compression fracture, and/or bone-implant interface failure. This includes studies on the effect of osteoporosis medication, cement augmentation, multi-rod constructs, and posterior-tension band supplementation. The role of perioperative teriparatide therapy maintains the highest level of evidence. Conclusions: Perioperative teriparatide therapy represents the strongest evidence for preventive treatment, and further clinical trials are warranted. Use of cement augmentation, sublaminar tethers, and multi-rod constructs have low or insufficient evidence for recommendations. Future guidelines for adult spinal deformity correction may consider bone mineral density–adjusted alignment goals.
Structural Allograft Versus Synthetic Interbody Cage for Anterior Cervical Discectomy and Fusion: A Comparison of 1-Year Outcomes From a National Database
Authors: Menon Nandakumar , Turcotte Justin , Patton Chad 
Published: August 2020

Study Design: Observational cohort study. Objective: To compare 1-year perioperative complications between structural allograft (SA) and synthetic cage (SC) for anterior cervical discectomy and fusion (ACDF) using a national database. Methods: The TriNetX Research Network was retrospectively queried. Patients undergoing initial single or multilevel ACDF surgery between October 1, 2015 and April 30, 2019 were propensity score matched based on age and comorbidities. The rates of 1-year revision ACDF surgery and reported diagnoses of pseudoarthrosis, surgical site infection (SSI), and dysphagia were compared between structural allograft and synthetic cage techniques. Results: A comparison of 1-year outcomes between propensity score matched cohorts was conducted on 3056 patients undergoing single-level ACDF and 3510 patients undergoing multilevel ACDF. In single-level ACDF patients, there was no difference in 1-year revision ACDF surgery ( P = .573), reported diagnoses of pseudoarthrosis ( P = .413), SSI ( P = .620), or dysphagia ( P = .529) between SA and SC groups. In multilevel ACDF patients, there was a higher rate of revision surgery (SA 3.8% vs SC 7.3%, odds ratio = 1.982, P < .001) in the SC group, and a higher rate of dysphagia in the SA group (SA 15.9% vs SC 12.9%). Conclusion: While the overall revision and complication rate for single-level ACDF remains low despite interbody graft selection, SC implant selection may result in higher rates of revision surgery in multilevel procedures despite yielding lower rates of dysphagia. Further prospective study is warranted.
Surgery for Lumbar Spinal Stenosis in Patients With Mild Leg Pain Levels Is Associated With Unsatisfactory Outcome
Authors: Sigmundsson Freyr Gauti , Möller Anders , Strömqvist Fredrik 
Published: August 2020

Study Design: Prospective register cohort study. Objectives: The indication for surgery in patients with lumbar spinal stenosis (LSS) is considered to be leg pain and neurogenic claudication (NC). Nevertheless, a significant part of patients operated for LSS have mild leg pain levels defined as leg pain ≤minimally important clinical difference (MICD). Information is lacking on how to inform these patients about the probable outcome of surgery. The objective was to report the outcome of surgery for LSS in patients with a mild preoperative level of leg pain. Methods: A total of 2559 patients operated upon for LSS with preoperative leg pain ≤3 NRS (Numerical Rating Scale) were evaluated for outcome at the 1-year follow-up. NRS for back pain, the Oswestry Disability Index (ODI), and the EuroQol (EQ-5D) were used. Results: In the period 2007 to 2017, we identified 3239 patients (14%) who had mild leg pain (≤3 on the NRS). In this cohort, leg pain increased 0.40 (0.56-0.37) and back pain decreased 1.0 (0.95-1.2) at the 1-year follow up. ODI decreased 11.1 (10.2-11.4) and the EQ-5D increased 0.15 (0.17-0.14). A total of 31% reached successful outcome in terms of back pain, 43% in terms of ODI and 48% in terms of EQ-5D. 63% of the patients were satisfied with the outcome. Conclusion: A minority of patients with mild leg pain levels operated upon for LSS attain MICD for back pain, ODI, and EQ-5D. The results from this study can aid the surgeon in the shared decision-making process before surgery.