bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dispatcher-assisted cardiopulmonary resuscitation for traumatic patients with out-of-hospital cardiac arrest
Authors: Lu Chien-Hsin , Fang Pin-Hui , Lin Chih-Hao 
Published: November 2019

Abstract

Background
Resuscitation efforts for traumatic patients with out-of-hospital cardiac arrest (OHCA) are not always futile. Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) during emergency calls could increase the rate of bystander cardiopulmonary resuscitation (CPR) and thus may enhance survival and neurologic outcomes of non-traumatic OHCA. This study aimed to examine the effectiveness of DA-CPR for traumatic OHCA.

Methods
A retrospective cohort study was conducted using an Utstein-style population database with data from January 1, 2014, to December 31, 2016, in Tainan City, Taiwan. Voice recordings of emergency calls were retrospectively retrieved and reviewed. The primary outcome was an achievement of sustained (≥2 h) return of spontaneous circulation (ROSC); the secondary outcomes were prehospital ROSC, ever ROSC, survival at discharge and favourable neurologic status at discharge. Statistical significance was set at a p-value of less than 0.05.

Results
A total of 4526 OHCA cases were enrolled. Traumatic OHCA cases (n = 560, 12.4%), compared to medical OHCA cases (n = 3966, 87.6%), were less likely to have bystander CPR (10.7% vs. 31.7%, p < 0.001) and initially shockable rhythms (7.1% vs. 12.5%, p < 0.001). Regarding DA-CPR performance, traumatic OHCA cases were less likely to have dispatcher recognition of cardiac arrest (6.3% vs. 42.0%, p < 0.001), dispatcher initiation of bystander CPR (5.4% vs. 37.6%, p < 0.001), or any dispatcher delivery of CPR instructions (2.7% vs. 20.3%, p < 0.001). Stepwise logistic regression analysis showed that witnessed cardiac arrests (aOR 1.70, 95% CI 1.10–2.62; p = 0.017) and transportation to level 1 centers (aOR 1.99, 95% CI 1.27–3.13; p = 0.003) were significantly associated with achievement of sustained ROSC in traumatic OHCA cases, while DA-CPR-related variables were not (All p > 0.05).

Conclusions
DA-CPR was not associated with better outcomes for traumatic OHCA in achieving a sustained ROSC. The DA-CPR program for traumatic OHCAs needs further studies to validate its effectiveness and practicability, especially in the communities where rules for the termination of resuscitation in prehospital settings do not exist.
Parental Mental Health, Fathers’ Involvement and Bedtime Resistance in Infants
Authors: Ragni Benedetta , De Stasio Simona , Barni Daniela , Gentile Simonetta , Giampaolo Rosaria 
Published: November 2019

AbstractBackgroundAround the age of 6 months, difficulties in settling to sleep and frequent night awakenings are generally occurring in 20 to 30% of infants. According to the transactional model parental factors can play a significant role in influencing infant sleep development. The purpose of the current study was to explore the combined effect of infants’ factors (temperament and sleep onset problems), and parental factors (parental mental health in terms of post-partum affective disorders, consistent bedtime routines and fathers’ involvement at bedtime), on infant bedtime difficulties (e.g. fussing, crying or protesting), including both maternal and paternal perspectives.MethodsSixty Italian intact two-parent families of infants (34 boys and 26 girls) ageing from 8 to 12 months (M = 10.73, SD = 2.54) were enrolled in the study. The parents filled out self-report questionnaires to measure the aforementioned variables. To investigate which infant and parental factors predicted infants’ bedtime difficulties, two multiple linear regressions (MR), one for fathers and one for mothers, and relative weight analyses (RWA) were conducted.ResultsWith regard to infants’ bedtime difficulties reported by fathers (R2 = .35) they were explained by infant involvement in constant bedtime routines (β = −.35,p = .030) and paternal involvement at bedtime (β = −.45,p = .007). Instead infants’ bedtime difficulties reported by mothers (R2 = .32) were explained by minutes the child taken to fall asleep (β = .24,p = .04), infant involvement in constant bedtime routines (β = −.31,p = .01) and bedtime paternal involvement (β = −.27,p = .05).ConclusionsThe main results of this study emphasized the protective role of consistent bedtime routines and bedtime paternal involvement in reducing infants’ bedtime difficulties perceived both from mothers and fathers. Future research could help to raise awareness and improve understanding of the familial influences on children’s sleep, providing recommendations for educating families, school professionals, healthcare providers, and the general public on risk and protective factors that could play a meaningful role in infants and children’s developing sleep patterns.
Design, planning and implementation lessons learnt from a surgical multi-centre randomised controlled trial
Authors: Biggs Katie , Hind Daniel , Bradburn Mike , Swaby Lizzie , Brown Steve 
Published: November 2019

Abstract

Background
Increasingly, pragmatic randomised controlled trials are being used to evaluate surgical interventions, although they present particular difficulties in regards to recruitment and retention.

Methods
Procedures and processes related to implementation of a multi-centre pragmatic surgical randomised controlled trial are discussed. In this surgical trial, forecasting of consent rates based on similar trials and micro-costing of study activities with research partners were undertaken and a video was produced targeting recruiting staff with the aim of aiding recruitment. The baseline assessments were reviewed to ensure the timing did not impact on the outcome. Attrition due to procedure waiting time was monitored and data were triangulated for the primary outcome to ensure adequate follow-up data.

Results
Forecasting and costing ensured that the recruitment window was of adequate length and adequate resource was available for study procedures at multiple clinics in each hospital. Recruiting staff found the recruitment video useful. The comparison of patient-reported data collected prior to randomisation and prior to treatment provided confidence in the baseline data. Knowledge of participant dropout due to delays in treatment meant we were able to increase the recruitment target in a timely fashion, and along with the triangulation of data sources, this ensured adequate follow-up of randomised participants.

Conclusions
This paper provides a range of evidence-based and experience-based approaches which, collectively, resulted in meeting our study objectives and from which lessons may be transferable.

Trial registration
ISRCTN, ISRCTN41394716. Registered on 10 May 2012.
UKCRN Study ID: 12486.
Direct qPCR is a sensitive approach to detect Mycoplasma contamination in U937 cell cultures
Authors: Baaity Zain , Breunig Sven , Önder Kamil , Somogyvári Ferenc 
Published: November 2019

AbstractObjectiveWe aim to directly detectMycoplasmaDNA in a U937 suspension cell culture without using DNA purification. In order to makeMycoplasmacontamination monitoring easier, we optimized a commercially available quantitative PCR (qPCR)-based detection kit. We compared the sensitivity of direct qPCR against qPCR with a purified DNA template.ResultsOur findings indicate that qPCR worked optimally with a 6 μl sample volume and a 52 °C annealing-extension temperature. We were able to decrease the annealing-extension step time from 60 to 20 s without any major decrease in reaction sensitivity. The total cycle time of optimized direct qPCR was 65 min. The optimized qPCR protocol was used to detectMycoplasmaDNA before and after DNA purification. Our findings indicate that direct qPCR had a higher sensitivity than regular qPCR. Ct levels produced by direct qPCR with 6 μl templates were almost identical to Ct levels produced by regular qPCR with DNA purified from a 60 μl cell culture sample (23.42 vs 23.49 average Ct levels, respectively). The optimized direct qPCR protocol was successfully applied to monitor the elimination ofMycoplasmacontamination from U937 cell cultures.
Thoracic stomach syndrome after whole-stomach esophagectomy for esophageal cancer mimicking tension pneumothorax: a case report
Authors: Hasegawa Daisuke , Komura Hidefumi , Katsuta Ken , Kawaji Takahiro , Nishida Osamu 
Published: November 2019

Abstract

Background
Sudden onset of respiratory failure is one of the most fearful manifestations in intensive care units. Among the differential diagnoses of respiratory failure, tension pneumothorax is a life-threatening disease that requires immediate invasive intervention to drain the air from the thoracic cavity. However, other etiologies with manifestations similar to those of tension pneumothorax should also be considered after whole-stomach esophagectomy for esophageal cancer. We report a rare case of a patient with thoracic stomach syndrome mimicking tension pneumothorax after esophagectomy with whole-stomach reconstruction.

Case presentation
A 49-year-old Asian woman was admitted to our intensive care unit after esophagectomy for esophageal cancer with whole-stomach reconstruction while under sedation and intubated. Despite initial stable vital signs, the patient rapidly developed tachypnea, low blood pressure, and low oxygen saturation. Chest radiography revealed a mediastinal shift and led to a presumptive diagnosis of tension pneumothorax. Hence, an aspiration catheter was inserted into the right pleural space. However, her clinical symptoms did not improve. Chest computed tomography was performed, which revealed a significantly distended reconstructed stomach that was compressing the nearby lung parenchyma. Her respiration improved immediately after nasogastric tube placement. After the procedure, we successfully extubated the patient.

Conclusions
Similar to tension pneumothorax, thoracic stomach syndrome requires immediate drainage of air from the thoracic cavity. However, unlike tension pneumothorax, this condition requires nasogastric tube insertion, which is the only way to safely remove the accumulated air and avoid possible complications that could occur due to percutaneous drainage. For patient safety, it might be clinically important to place nasogastric tubes after esophagectomy with whole-stomach reconstruction, even if radiographic guidance is required. In addition, clinicians should consider thoracic stomach syndrome as one of the differential diagnoses of respiratory failure after whole-stomach esophagectomy.
Review of Tibetan Pastoralists and Development: Negotiating the Future of Grassland Livelihoods edited by Andreas Gruschke and Ingo Breuer
Authors: Nyima Yonten 
Published: November 2019

Book details
Gruschke A and Breuer I (eds.)
Tibetan Pastoralists and Development: Negotiating the Future of Grassland Livelihoods
Wiesbaden, Germany
Reichert Verlag, 2017
240 pages, ISBN: 9783954902422
Factors that affect Israeli paramedics’ decision to quit the profession: a mixed methods study
Authors: Dopelt Keren , Wacht Oren , Strugo Refael , Miller Rami , Kushnir Talma 
Published: November 2019

Abstract

Background
The rate of Israeli paramedics leaving the profession has been increasing in recent years: 50% leave the profession in three years, for the most part before retirement. While approximately 2500 paramedics have been trained, only about a third of them are still active.
The number of paramedics per 100,000 in Israel is only 8, compared to around 66 in the US, and in light of the shortage of paramedics it is important to enhance retention rates. The purpose of the study was to examine the factors related to paramedics leaving the profession in Israel.

Methods
1. An online survey was sent to 1000 paramedics via Email. 533 were recruited of whom 200 have left the profession. Questions included demographics, job satisfaction, and reasons for leaving or remaining in the profession.
2. In-depth interviews with 15 paramedics who left the profession.

Results
Out of 1000 emails sent, 533 Paramedics responded, of which 200 paramedics who left the profession responded (73% left five years after completing training and 93% after 10 years). Among these former paramedics, choosing the paramedic profession was based mainly on an idealistic sense of mission and eagerness to help others, yet leaving the paramedic profession was related to extrinsic factors: lack of career options, extensive and strenuous physical demands accompanied by unrewarding salaries, unusually long work hours, and shift work that negatively affected family and personal life.

Conclusions
It seems that work conditions, including the lack of opportunities for promotion, lack of professional prospects, and inappropriate compensation for hard work are crucial factors in the decision to leave.

Recommendations
A joint committee of the Ministries of Health, Justice, and Finance and MDA (Magen David Adom, the national EMS in Israel) should be established for the purpose of improving the conditions and modalities of employment of paramedics and providing appropriate emotional support for paramedics who are exposed daily to work under extreme conditions of stress and human suffering. A joint effort could greatly reduce rates of leaving, training costs, and costs incidental to turnover, as well as increase job satisfaction. Moreover, regulating the profession and expanding the scope of practice to new fields like community paramedicine as part of the EMS service and expanding the scope of physician assistants as an academic profession can create opportunities for advancement and diversity at work that will help retain paramedics in the profession.
Research on the micromotion characteristics of a chaff cloud
Authors: Li Ran , Hao Xinhong , Li Ping 
Published: November 2019

Abstract
This paper reports the investigation on the micromotion characteristics of chaff dipoles and a chaff cloud. Micromotion models of chaff dipoles and steady-state chaff clouds are discussed. Fourier transform method and time-frequency method are used to study the micromotion features of chaff dipoles, in the energy domain and time-frequency domain, respectively. Based on the characteristic parameters in these two domains, the simulation results show that there are micro-Doppler frequency components in the echo signals from chaff dipoles, and these frequency components vary periodically. Then, the micro-Doppler frequencies of chaff cloud are obtained based on the method of multipoint synthesis. Finally, the experimental results of chaff dipoles dispersion verify the micromotion characteristics of chaff dipoles and chaff cloud obtained by using the empirical mode decomposition method and the short-time Fourier transform method.
How to overcome political and legal barriers to the implementation of a drug consumption room: an application of the policy agenda framework to the Belgian situation
Authors: Smith Pierre , Favril Louis , Delhauteur Dominique , Vander Laenen Freya , Nicaise Pablo 
Published: November 2019

AbstractBackgroundFor more than 30 years, drug consumption rooms (DCRs) have been implemented in Western countries. DCRs are supported by a large body of evidence about public safety and public health effectiveness. However, a political consensus has never been achieved in Belgium on amending the existing law that explicitly penalises the supply of a room for facilitating drug use. Despite this adverse legal and policy framework, a DCR opened in the city of Liège in 2018. In this case report, we applied the theoretical framework proposed by Shiffman and Smith for policy agenda setting, in order to describe and assess how political and legal barriers were overcome in the process of opening the DCR.Case presentationFor some years, fieldworkers and some city policymakers argued for DCR implementation in Belgium, but without gaining the support of the national authorities, mainly for ideological reasons. In order to address this debate, a feasibility study of DCR implementation in Belgian cities was commissioned. At the national level, an institutional debate took place about the political responsibility for DCRs as a public health intervention, as health care is mainly a matter of regional policy. The lack of consensus led to a situation of political deadlock. Meanwhile, the publication of the study report and the context of local elections offered an opportunity for Liège authorities to reignite the local debate on DCRs. At the local level, law enforcement, care professionals, residents, users, and the press were all involved in the implementation process. Therefore, a local consensus was formed and despite the absence of any national legal change, the DCR opened 1 month before the local elections. It has been working without major medical or legal incident since then. Incidentally, the mayor of Liège was re-elected.ConclusionsAlthough the lack of a legal framework may engender instability and affect longer-term effectiveness, the DCR implementation in Liège was successful and was based on a local consensus and effective communication rather than on an appropriate legal framework. The experience provides lessons for other cities that are considering opening a DCR despite an adverse legal and political context.
Magnitude and causes of first-line antiretroviral therapy regimen changes among HIV patients in Ethiopia: a systematic review and meta-analysis
Authors: Ataro Zerihun , Motbaynor Birhanu , Weldegebreal Fitsum , Sisay Mekonnen , Tesfa Tewodros , Mitiku Habtamu , Marami Dadi , Teklemariam Zelalem , Shewamene Zewdneh 
Published: November 2019

AbstractBackgroundAntiretroviral therapy (ART) has markedly decreased the morbidity and mortality due to HIV/AIDS. ART regimen change is a major challenge for the sustainability of human immunodeficiency virus (HIV) treatment program. This is found to be a major concern among HIV/AIDS patients in a resource-limited setting, where treatment options are limited.ObjectivesThe aim of this review is to generate the best available evidence regarding the magnitude of first-line antiretroviral therapy regimen change and the causes for regimen change among HIV patients on ART in Ethiopia.MethodsThe reviewed studies were accessed through electronic web-based search strategy from PubMed Medline, EMBASE, Hinari, Springer link and Google Scholar. Data were extracted using Microsoft Excel and exported to Stata software version 13 for analyses. The overall pooled estimation of outcomes was calculated using a random-effect model of DerSimonian–Laird method at 95% confidence level. Heterogeneity of studies was determined using I2statistics. For the magnitude of regimen change, the presence of publication bias was evaluated using the Begg’s and Egger’s tests. The protocol of this systematic review and meta-analysis was registered in the Prospero database with reference number ID: CRD42018099742. The published methodology is available from:https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=99742.ResultsA total of 22 studies published between the years 2012 and 2018 were included. Out of 22 articles, 14 articles reported the magnitude of regimen change and consisted of 13,668 HIV patients. The estimated national pooled magnitude of regimen change was 37% (95% CI: 34, 44%; Range: 15.1–63.8%) with degree of heterogeneity (I2), 98.7%;p-value < 0.001. Seventeen articles were used to identify the causes for first-line antiretroviral therapy regimen change. The major causes identified were toxicity, 58% (95% CI: 46, 69%; Range: 14.4–88.5%); TB co-morbidity, 12% (95% CI: 8, 16%; Range: 0.8–31.7%); treatment failure, 7% (95% CI: 5, 9%; Range: 0.4–24.4%); and pregnancy, 5% (95% CI: 4, 7%; Range: 0.6–11.9%).ConclusionsThe original first-line regimen was changed in one-third of HIV patients on ART in Ethiopia. Toxicity of the drugs, TB co-morbidity, treatment failure, and pregnancy were the main causes for the change of the first-line regimen among HIV patients on antiretroviral therapy.
Sympatric Atlantic puffins and razorbills show contrasting responses to adverse marine conditions during winter foraging within the North Sea
Authors: St. John Glew Katie , Wanless Sarah , Harris Michael P. , Daunt Francis , Erikstad Kjell Einar , Strøm Hallvard , Speakman John R. , Kürten Benjamin , Trueman Clive N. 
Published: November 2019

Abstract

Background
Natural environments are dynamic systems with conditions varying across years. Higher trophic level consumers may respond to changes in the distribution and quality of available prey by moving to locate new resources or by switching diets. In order to persist, sympatric species with similar ecological niches may show contrasting foraging responses to changes in environmental conditions. However, in marine environments this assertion remains largely untested for highly mobile predators outside the breeding season because of the challenges of quantifying foraging location and trophic position under contrasting conditions.

Method
Differences in overwinter survival rates of two populations of North Sea seabirds (Atlantic puffins (Fratercula arctica) and razorbills (Alca torda)) indicated that environmental conditions differed between 2007/08 (low survival and thus poor conditions) and 2014/15 (higher survival, favourable conditions). We used a combination of bird-borne data loggers and stable isotope analyses to test 1) whether these sympatric species showed consistent responses with respect to foraging location and trophic position to these contrasting winter conditions during periods when body and cheek feathers were being grown (moult) and 2) whether any observed changes in moult locations and diet could be related to the abundance and distribution of potential prey species of differing energetic quality.

Results
Puffins and razorbills showed divergent foraging responses to contrasting winter conditions. Puffins foraging in the North Sea used broadly similar foraging locations during moult in both winters. However, puffin diet significantly differed, with a lower average trophic position in the winter characterised by lower survival rates. By contrast, razorbills’ trophic position increased in the poor survival winter and the population foraged in more distant southerly waters of the North Sea.

Conclusions
Populations of North Sea puffins and razorbills showed contrasting foraging responses when environmental conditions, as indicated by overwinter survival differed. Conservation of mobile predators, many of which are in sharp decline, may benefit from dynamic spatial based management approaches focusing on behavioural changes in response to changing environmental conditions, particularly during life history stages associated with increased mortality.