bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does emergency general surgery model affect staff satisfaction, training and working hours?
Authors: Kinnear Ned , Tran Minh , Han Jennie , Jolly Samantha , Herath Matheesha , Hennessey Derek , Dobbins Christopher , Sammour Tarik , Moore James 
Published: December 2019

AbstractBackgroundFew studies have assessed the relationship between different emergency general surgery models and staff satisfaction, operative experience or working hours. The Royal Australasian College of Surgeons recommends maximum on‐call frequency of one‐in‐four for surgeons and registrars.MethodsA cross‐sectional study was conducted of all medium‐ to major‐sized Australian public hospitals offering elective general surgery. At each site, an on‐call general surgery registrar and senior surgeon were invited to participate. Primary outcomes were staff satisfaction and registrar‐perceived operative exposure. Secondary outcomes were working hours.ResultsAmong eligible hospitals, 119/120 (99%) were enrolled. Compared with traditional emergency general surgery models, hybrid or acute surgical unit models were associated with greater surgeon and registrar satisfaction on quantitative (P = 0.012) and qualitative measures. Registrar‐perceived operating exposure was unaffected by emergency general surgery model. Longest duration on‐duty was higher among traditional structures for both registrars (mean 22 versus 15 h; P = 0.0003) and surgeons (mean 59 versus 41 h; P = 0.020). On‐call frequency greater than one‐in‐four was more common in traditional structures for registrars (51% versus 28%; P = 0.012) but not surgeons (6% versus 0%; P = 0.089). Data on average hours per day off‐duty were obtained for registrars only, and were lower in traditional structures (13 versus 15 h; P = 0.00002).ConclusionHybrid or acute surgical unit models may improve staff satisfaction without sacrificing perceived operative exposure. While average maximum duration on‐duty exceeded hazardous thresholds for surgeons regardless of model, unsafe working hours for registrars were more common in traditional structures. General surgical departments should review on‐call rostering to optimize staff and patient safety.
Vancomycin: Audit of American guideline‐based intermittent dose administration with focus on overweight patients
Authors: Koyanagi Mari , Anning Rebecca , Loewenthal Mark , Martin Jennifer H. 
Published: December 2019

AimsVancomycin dosing and monitoring recommendations are poorly adhered to in many institutions internationally, with concerns of treatment failure and propelling antibiotic resistance. The primary aim of this study was to audit the rate of adherence to American guidelines, with particular interest in loading dose administration. The secondary aims were (i) to determine whether or not guideline adherence results in therapeutic concentrations across body mass index (BMI) groups and (ii) to determine whether or not this was in turn associated with morbidity and hospital mortality.MethodData were collected in a single tertiary hospital on all patients who had two or more serum vancomycin concentrations measured.ResultIn total, 107 patients met the inclusion criteria. Overall, 38.3% of patients were commenced on guideline adherent vancomycin doses, and 28.3% of overweight patients received an adherent first dose compared to 51.1% of non‐overweight people (difference 23%, 95% CI 4% to 41%, P = 0.024). Overweight patients were more frequently underdosed compared to non‐overweight patients (P = 0.039). The frequency and proportion of underdosing increased with BMI. Overweight patients spent a smaller fraction of their course within the therapeutic range, although the difference was not statistically significant (difference 7.7%; 95% CI 4% to 19.4%; P = 0.195). The overweight group had longer hospital length of stay (LOS), higher mortality and more treatment failures.ConclusionAdherence to guideline‐based prescription is poor, particularly in overweight patients. Patients who are initially underdosed have fewer therapeutic vancomycin days, regardless of BMI. Overweight patients have increased hospital LOS, hospital mortality and treatment failure.
Eight to eleven‐year follow‐up of immediately loaded implants placed in edentulous maxillae with compromised bone volume and poor bone quality: A prospective cohort study
Authors: Trbakovic Amela , Toljanic Joseph A. , Kumar Vinay V. , Thor Andreas 
Published: December 2019

AbstractBackgroundThere is a lack of long‐term evaluations of immediately loaded implants in patients with compromised maxillary bone.PurposeTo evaluate long‐term survival and success of immediately loaded implants in subjects with poor maxillary bone quality and volume.Material and methodsFollow‐up was performed on subjects who received six implants loaded within 24 hours with screw‐retained fixed prostheses. Twenty‐five subjects with limited bone (Lekholm and Zarb, quantity 3 and 4, and quality C and D) were included in the study. Nineteen participated in the radiographic examination and of these 17 participated in the clinical examination at the last visit. Evaluations of marginal bone loss were performed at 1, 3, 5, and 8‐11 years. The last clinical examination included removal of the prosthesis followed by registration of: plaque, pus, pocket depth, bleeding upon probing, mobility, and percussion testing.ResultsThe mean follow‐up was 9 years and 2 months (101‐131 months) after surgery and showed a cumulative implant survival rate of 81.9% and success rate of 74.7%. Mean marginal bone loss was 1.29 mm (SD 2.47 mm range 0‐11 mm) with a mean pocket depth of 3.1 mm (SD 2.4 mm, range 1.5‐13.5 mm). 42.5% of the implants showed plaque retention and 72.2% showed bleeding on probing.ConclusionThis nonaugmenting immediate loaded implant protocol for maxillary edentulous patients is a satisfactory solution for selected patients.
An unmet need: Patients with smell and taste disorders
Authors: Erskine Sally E. , Philpott Carl M. 
Published: December 2019

AbstractObjectivesThere are large numbers of patients with olfactory disturbance in the UK and shortfalls in assessment and support amongst mainstream practice in both primary and secondary care leading to significant quality‐of‐life impairment and potential missed diagnoses. The aim of this study was to determine the key themes which can be identified from the accounts of anosmia sufferers and to identify important areas to target for future research or service development.DesignQualitative analysis of written patient accounts from patients corresponding with a tertiary smell and taste clinic in the UK. This qualitative study utilised unstructured written patient accounts from consenting patients experiencing olfactory disturbances received by the smell and taste clinic. Framework analysis was performed using Nvivo 10 software.SettingTertiary smell and taste clinic.ParticipantsConsenting patients who contacted the smell and taste clinic with accounts of their experiences.Main outcome measuresThemes generated by qualitative analysis with Nvivo software.ResultsAccounts submitted by 71 participants were included in the analysis; age range 31‐80 years, 45 females, 26 males. Themes identified include negative emotional impact, feelings of isolation, impaired relationships and daily functioning, impact on physical health and the difficulty and financial burden of seeking help.ConclusionsOlfactory disturbances have a wide‐ranging impact on the lives of sufferers, compounded by a lack of knowledge of the disorder amongst clinicians. There is a role for further support and education both for sufferers and for clinicians, as well as a need to improve our understanding of olfactory disturbance.
Mucormycosis in lung transplant recipients: A systematic review of the literature and a case series
Authors: Wand Ori , Unterman Avraham , Izhakian Shimon , Fridel Ludmila , Kramer Mordechai R. 
Published: December 2019

AbstractBackgroundMucormycosis is a rare infection in lung transplant recipients (LTR). Our objective was to better define the clinical presentation and optimal management of this frequently lethal infection.MethodsA systematic review of the literature was performed to identify all published cases of mucormycosis in LTR using PubMed/MEDLINE. These cases were analyzed together with a new case series from our clinic.ResultsLiterature search yielded 44 articles matching the inclusion criteria, describing 121 cases. Six additional cases were identified from our clinic. Data regarding infection site and outcome were available for a total of 53 patients. The lungs were the most common site of infection (62%), followed by rhinocerebral and disseminated disease. Most cases (78%) developed in the first post‐transplant year, with over 40% of them in the first month. Additional risk factors for mucormycosis were identified in over half of the patients. Surgical debridement was uncommon in pulmonary infection (9%). Posaconazole therapy was used in 35% of cases, mostly in combination with amphotericin B. Overall mortality was 32% but varied according to site of infection.ConclusionMucormycosis in LTRs tends to be an early post‐surgical infection, associated with additional risk factors and intensified immunosuppressive states, and most often affects the lungs, where surgical debridement is rarely feasible. Posaconazole as first‐line therapy should be further explored.
Assessing neurophysiological changes associated with combined transcranial direct current stimulation and cognitive‐emotional training for treatment‐resistant depression
Authors: Nikolin Stevan , Martin Donel , Loo Colleen K. , Iacoviello Brian M. , Boonstra Tjeerd W. 
Published: December 2019

AbstractTranscranial direct current stimulation (tDCS), a form of non‐invasive brain stimulation, is a promising treatment for depression. Recent research suggests that tDCS efficacy can be augmented using concurrent cognitive‐emotional training (CET). However, the neurophysiological changes associated with this combined intervention remain to be elucidated. We therefore examined the effects of tDCS combined with CET using electroencephalography (EEG). A total of 20 participants with treatment‐resistant depression took part in this open‐label study and received 18 sessions over 6 weeks of tDCS and concurrent CET. Resting‐state and task‐related EEG during a 3‐back working memory task were acquired at baseline and immediately following the treatment course. Results showed an improvement in mood and working memory accuracy, but not response time, following the intervention. We did not find significant effects of the intervention on resting‐state power spectral density (frontal theta and alpha asymmetry), time–frequency power (alpha event‐related desynchronisation and theta event‐related synchronisation) or event‐related potentials (P2 and P3 components). We therefore identified little evidence of neurophysiological changes associated with treatment using tDCS and concurrent CET, despite significant improvements in mood and near‐transfer effects of cognitive training to working memory accuracy. Further research incorporating a sham‐controlled group may be necessary to identify the neurophysiological effects of the intervention.
From theory to experiments for testing the proximate mechanisms of mast seeding: an agenda for an experimental ecology
Authors: Bogdziewicz Michał , Ascoli Davide , Hacket‐Pain Andrew , Koenig Walter D. , Pearse Ian , Pesendorfer Mario , Satake Akiko , Thomas Peter , Vacchiano Giorgio , Wohlgemuth Thomas , Tanentzap Andrew 
Published: December 2019

AbstractHighly variable and synchronised production of seeds by plant populations, known as masting, is implicated in many important ecological processes, but how it arises remains poorly understood. The lack of experimental studies prevents underlying mechanisms from being explicitly tested, and thereby precludes meaningful predictions on the consequences of changing environments for plant reproductive patterns and global vegetation dynamics. Here we review the most relevant proximate drivers of masting and outline a research agenda that takes the biology of masting from a largely observational field of ecology to one rooted in mechanistic understanding. We divide the experimental framework into three main processes: resource dynamics, pollen limitation and genetic and hormonal regulation, and illustrate how specific predictions about proximate mechanisms can be tested, highlighting the few successful experiments as examples. We envision that the experiments we outline will deliver new insights into how and why masting patterns might respond to a changing environment.
Towards routine DNA metabarcoding of macroinvertebrates using bulk samples for freshwater bioassessment: Effects of debris and storage conditions on the recovery of target taxa
Authors: Nichols Susan J. , Kefford Ben J. , Campbell Catriona D. , Bylemans Jonas , Chandler Eloise , Bray Jonathan P. , Shackleton Michael , Robinson Katie L. , Carew Melissa E. , Furlan Elise M. 
Published: December 2019

Abstract

Macroinvertebrates are commonly sampled for bioassessment of freshwater ecosystems. However, current bioassessment protocols involve laborious sorting of the animals from the debris (sample matrix) and morphological identification, where species level identifications are often difficult. DNA metabarcoding has the potential to improve bioassessment by reducing the time taken to process samples and improve the accuracy and speed of macroinvertebrate species identification.

In this study, we evaluated DNA metabarcoding of macroinvertebrate samples, which include macroinvertebrates and the debris collected in the sample nets, to test if bulk, unsorted samples can be used to assess macroinvertebrate diversity. First, we tested if the sample matrix prevented the detection of six target macroinvertebrate taxa when DNA metabarcoding. Second, we tested if sample storage influenced the detection of the same six target macroinvertebrates. We also explored different levels of replication at the sample, sub‐sample, and polymerase chain reaction levels and compared the overall macroinvertebrate families detected using DNA metabarcoding to those identified morphologically.

We found that the presence of the sample matrix did not interfere with or inhibit the detection of the six target macroinvertebrate taxa. Furthermore, we found that the various sample storage methods did not affect target macroinvertebrate detection. The reliability of detection of the target macroinvertebrates improved as hierarchical levels of replication were combined. We found strong overlap between the detection of overall macroinvertebrate family diversity when comparing DNA metabarcoding to morphological identification.

Extracting DNA from the bulk macroinvertebrate samples that included the sample matrix and using this for DNA metabarcoding could improve bioassessment by removing the need for laborious sorting of samples. Furthermore, DNA metabarcoding detection of the six target taxa was not dependent on sample storage of up to 1 year in 95% ethanol, at room temperature or after heating. DNA metabarcoding had the advantage of identifying macroinvertebrate species, but good DNA barcode libraries are needed for widespread species identifications. Further investigation should focus on including multiple samples with different macroinvertebrate composition and densities to refine and standardise bulk sample processing protocols, and on building comprehensive DNA barcode libraries for aquatic macroinvertebrates.
Employment volatility in lagging and advanced regions: The Italian case
Authors: Duran Hasan Engin , Fratesi Ugo 
Published: December 2019

AbstractThe presence of cycles characterizes all economic systems, but economic cycles have differentiated spatial impacts. Some regions have broader cycles with respect to the country, while others tend to be less responsive to shocks and hence have narrower cycles. Being exposed to broader cycles, that is, greater volatility, may increase the strain on a regional economic system. This paper investigates the different responsiveness to cyclical forces and volatility of regions in the long run. It does so by using quarterly employment data for the Nuts2 Italian regions over almost 40 years before and during the period 1978–2016. Explored in particular are the cross‐regional variations in employment volatility and the reasons for the patterns observed, as well as whether they have changed the following different macroeconomic policy regimes. The paper identifies the break dates of different regimes, and these regime changes will be related to policy modifications, such as the implementation of the European Monetary Union. The determinants of this regional volatility appear to be quite stable, so that the changes in volatility are explained by how these determinants have changed overtime and how they are unevenly distributed in space. In particular, the lagging regions of the country suffer, in addition to lower production and income, from higher volatility due to a structure which is weaker and more unstable. Volatility can hence be an additional issue for lagging regions.
Estimating the thickness of a faulted mechanical layer based on fault spacing: An example from Miyako‐jima Island, southern Ryukyu Arc, Japan
Authors: Maeda Sumire , Otsubo Makoto , Asahina Daisuke , Furuno Yuki 
Published: December 2019

AbstractThe thickness of the mechanical layer that hosts a group of faults can be estimated from the spacing of saturated faults (i.e. the constant spacing between faults when the fault system is fully developed and has attained its final fault density). We measured fault spacing for a group of saturated active normal faults on Miyako‐jima Island (southern Ryukyu Arc, Japan) and estimated the thickness of the faulted mechanical layer. The measured fault spacing is 1.30 ±0.14 km, and the thickness of the mechanical layer is < 3 km, which is the upper limit of the seismogenic zone. This faulted mechanical layer corresponds to a sedimentary layer in which earthquakes cannot occur. Results indicate that the shallow (< 3 km depth) normal faults on Miyako‐jima Island do not have the potential to cause medium‐size earthquakes as individual faults. The origin of the shallow normal faults might be related to the presence of a larger‐scale, deeper fault. The results indicate that fault spacing provides important information on the potential magnitude of earthquakes associated with active faults.
A lack of therapeutic engagement and consumer input in acute inpatient care planning limits fully accountable mental health nursing practice
Authors: Rio Josephien H. M. , Fuller Jeffrey , Taylor Kerry , Muir‐Cochrane Eimear 
Published: December 2019

AbstractIt is mental health consumer's human right to lead a fulfilling life as they are empowered to actively manage their recovery. This can be facilitated through care planning, yet research suggests that the care plan is not routinely created, discussed, or updated in acute mental health settings. Research on care planning and the role of the mental health nurse highlights the importance of therapeutic communication in care plan development. This paper argues that the lack of meaningful care plan discussions between consumers and mental health nurses in an acute setting is a limitation to the practice of fully accountable mental health nursing care. We explore this limitation in quality care provision by examining literature on accountability and conclude that in mental health nursing, accountability is frequently enacted through an overarching focus on the organizational need to manage risks, rather than on therapeutic engagement.
Tojapride prevents CaSR‐mediated NLRP3 inflammasome activation in oesophageal epithelium irritated by acidic bile salts
Authors: Yin Xiao‐Lan , Wu Hao‐Meng , Zhang Bei‐Huang , Zhu Ning‐Wei , Chen Ting , Ma Xiang‐Xue , Zhang Li‐Ying , Lv Lin , Zhang Min , Wang Feng‐Yun , Tang Xu‐Dong 
Published: December 2019

AbstractImpairment of the oesophageal epithelium in patients with reflux oesophagitis (RE) is a cytokine‐mediated injury rather than a chemical burn. The present study was conducted to explore CaSR/NLRP3 inflammasome pathway activation and cytokines IL‐1β and IL‐18 release in oesophageal epithelia injured by refluxates and the effects of Tojapride on that signal regulation. Using a modified RE rat model with Tojapride administration and Tojapride‐pretreated SV40‐immortalized human oesophageal epithelial cells (HET‐1A) exposed to acidic bile salts pretreated with Tojapride, we evaluated the therapeutic effects of Tojapride on oesophageal epithelial barrier function, the expression of CaSR/NLRP3 inflammasome pathway‐related proteins and the release of downstream cytokines in response to acidic bile salt irritation. In vivo, Tojapride treatment ameliorated the general condition and pathological lesions of the oesophageal epithelium in modified RE rats. In addition, Tojapride effectively blocked the CaSR‐mediated NLRP3 inflammasome activation in modified RE rats. In vitro, Tojapride treatment can reverse the harmful effect of acidic bile salts, which reduced transepithelial electrical resistance (TEER), up‐regulated the CaSR‐mediated NLRP3 inflammasome pathway and increased caspase‐1 activity, LDH release and cytokines secretion. Taken together, these data show that Tojapride can prevent CaSR‐mediated NLRP3 inflammasome activation and alleviate oesophageal epithelial injury induced by acidic bile salt exposure.
A novel, fully digital approach to quantifying volume gain after soft tissue graft surgery. A pilot study
Authors: Fons‐Badal Carla , Alonso Pérez‐Barquero Jorge , Martínez‐ Martínez Nuria , Faus‐López Joan , Fons‐Font Antonio , Agustín‐Panadero Rubén 
Published: December 2019

AbstractObjectiveMeasuring soft tissue thickness after mucogingival surgery has traditionally been performed by means of a calibrated transgingival probe. The main aim of this study was to apply a non‐invasive technique based on digital images formatted as Standard Tessellation Language (STL) files to quantify soft tissue volume after connective tissue grafting.Clinical Innovation ReportTen patients who presented Cairo Class I gingival recession were selected for connective tissue grafting using the tunnel technique. In all patients, the initial position of the gingiva and quantity of keratinized tissue were recorded, and gingival recession was scanned with an intra‐oral scanner. Six months after surgery, the same intra‐oral parameters were recorded and compared with the initial registers using digital volumetric analysis software.ResultsComplete root coverage was obtained in most patients (90%), mean coverage being of 2.70 mm with a mean increase in volume of 115.49 mm3 in the treated areas. No pattern was identified that indicated a statistically significant relation between gingival recession and coverage volume in mm3.ConclusionsDigital processing of pre‐ and post‐treatment images makes it possible to measure the volume of tissue gained after tissue graft surgery simply and non‐invasively. The technique is an objective and reproducible method for measuring soft tissue thickness.