bluuebunny/crossref_metadata_2025_split huggingface dataset:
Noise levels in veterinary operating rooms and factors that contribute to their variations
Authors: Dornbusch Josephine , Boston Sarah , Colee James 
Published: July 2018

AbstractObjectiveTo quantify noise levels in veterinary operating rooms (OR) and evaluate factors affecting them.Study designPilot study.Sample populationSeventy‐seven small‐animal surgical procedures at the University of Florida College of Veterinary Medicine Small Animal Hospital.MethodsA decibel‐measuring device was used to measure mean A‐weighted, median, and maximum decibel readings within the OR. The number of people present in the OR, the number of people scrubbed in, the surgery service, and whether or not music was playing were recorded.ResultsThe mean, median, and maximum decibel levels for all surgeries were 71.7 A‐weighted decibels [dB(A)], 69.4 dB(A), and 90.3 dB(A), respectively. Neurologic surgeries were associated with higher noise levels. OR with music playing were louder than those without music (P < .001). None of the other factors evaluated were associated with noise levels.ConclusionNeurological surgeries and playing music in the OR were associated with higher noise levels. The average noise levels in our veterinary OR were high and exceeded World Health Organization (WHO) recommendations.Clinical significanceThis is the first published study to quantify noise levels in a veterinary OR. Noise levels that exceed WHO recommended levels warrant additional investigation for potential side effects on surgical patients and OR staff.
Biomechanical evaluation of 6 transarticular tibiotarsal immobilization methods in canine cadaveric limbs
Authors: Sugiyama Takanori , Woodward Andrew , Ryan Stewart D. 
Published: July 2018

AbstractObjectiveTo determine the effects of 6 types of transarticular immobilization techniques on tibiotarsal joint angles during stimulated weight bearing.Study designCanine ex vivo biomechanical study.Sample populationCanine cadaveric pelvic limbs (n = 15).MethodsA validation study was conducted to determine tibiotarsal flexion before and after transection of the superficial digital flexor tendon in 5 canine cadaveric limbs without tibiotarsal joint immobilization. Six transarticular tibiotarsal immobilization techniques were tested sequentially in 10 canine cadaveric pelvic limbs. The tibiotarsal joint angles were measured from lateral projection radiographs before and during axial loading of 200 N. Mixed linear models were applied to determine the effects of the immobilization techniques on change in tibiotarsal joint angle under loading.ResultsThere was no change of tibiotarsal joint angle between extended digits and flexed digits under both unloaded and loaded conditions. Change in tibiotarsal joint angles did not differ among any of the immobilization techniques tested here (mean change 1.36°, range 0‐5). The main contributor to variance in angle explained by the final model was associated with the random effect for limb.ConclusionChanges in tibiotarsal joint angles during single static loading in canine cadaveric limbs for the 6 immobilization techniques were minimal.Clinical significanceThe 6 techniques appear equally effective at limiting tibiotarsal joint flexion during single axial loading of 200 N. Cyclic mechanical testing of these techniques is recommended to support our findings and validate their clinical application.
Biogeography and early emergence of the genusDidelphis(Didelphimorphia, Mammalia)
Authors: Dias Cayo A. R. , Perini Fernando A. 
Published: July 2018

AbstractThe genusDidelphiscomprises six species of relatively large‐sized New World marsupials ranging from Argentina to Canada. Most of the diversity of the genus occurs in the Neotropical region, where two groups of species are currently recognized: theDidelphis marsupialisgroup, includingD. marsupialisandD. aurita,and theD. albiventrisgroup comprisingD. albiventris,D. imperfectaandD. pernigra. The genus also includesD. virginiana,the only livingDidelphisspecies reaching the Nearctic region.Didelphis'wide latitudinal distribution, wide range of environments in which it can be found as well as the disjunct, and spatially complementary distributions shown by its species raise some questions regarding the historical biogeography of the genus and how it relates to the geological and climatic events of the Plio‐Pleistocene. The present study is aimed at answering biogeographic and historical questions concerning the evolution ofDidelphis.We employed molecular methods to infer a multi‐locus time‐calibrated phylogeny including allDidelphisspecies which served as a framework for biogeographic analyses. Our results suggest that the basalmost divergence inDidelphisis an event older than previously thought, probably having taken place at some point betweenca.4.3 and 7.4 Mya following a vicariant event. Our results also suggest a northern South American origin for the genus, and that it possibly expanded its range to North America before the GABI. Climatic‐driven modifications in Neotropical environments during the late Pliocene and early Pleistocene favored the dispersion to new ecosystems triggering the emergence of new lineages.
Nebulised surfactant to reduce severity of respiratory distress: a blinded, parallel, randomised controlled trial
Authors: Minocchieri Stefan , Berry Clare A , Pillow J Jane 
Published: July 2018

ObjectiveTo evaluate if nebulised surfactant reduces intubation requirement in preterm infants with respiratory distress treated with nasal continuous positive airway pressure (nCPAP).DesignDouble blind, parallel, stratified, randomised control trial.SettingSole tertiary neonatal unit in West Australia.PatientsPreterm infants (290–336 weeks’ gestational age, GA) less than 4 hours of age requiring 22%–30% supplemental oxygen, with informed parental written consent.InterventionsInfants were randomised within strata (290–316 and 320–336 weeks’ GA) to bubble nCPAP or bubble nCPAP and nebulised surfactant (200 mg/kg: poractant alfa) using a customised vibrating membrane nebuliser (eFlow neonatal). Surfactant nebulisation (100 mg/kg) was repeated after 12 hours for persistent supplemental oxygen requirement.Main outcome measuresThe primary outcomes were requirement for intubation and duration of mechanical ventilation at 72 hours. Data analysis followed the intention-to-treat principle.Results360 of 606 assessed infants were eligible; 64 of 360 infants were enrolled and randomised (n=32/group). Surfactant nebulisation reduced the requirement for intubation within 72 hours: 11 of 32 infants were intubated after continuous positive airway pressure (CPAP) and nebulised surfactant compared with 22 of 32 infants receiving CPAP alone (relative risk (95% CI)=0.526 (0.292 to 0.950)). The reduced requirement for intubation was limited to the 320–336 weeks’ GA stratum. The median (range) duration of ventilation in the first 72 hours was not different between the intervention (0 (0–62) hours) and control (9 (0–64) hours; p=0.220) groups. There were no major adverse events.ConclusionsEarly postnatal nebulised surfactant may reduce the need for intubation in the first 3 days of life compared with nCPAP alone in infants born at 290–336 weeks’ GA with mild respiratory distress syndrome. Confirmation requires further adequately powered studies.Trial registration numberACTRN12610000857000.
Sexual orientation-related disparities in employment, health insurance, healthcare access and health-related quality of life: a cohort study of US male and female adolescents and young adults
Authors: Charlton Brittany M , Gordon Allegra R , Reisner Sari L , Sarda Vishnudas , Samnaliev Mihail , Austin S Bryn 
Published: July 2018

ObjectiveTo investigate sexual orientation-related disparities in employment and healthcare, including potential contributions to health-related quality of life (HRQL).SettingGrowing Up Today Study, a USA-based longitudinal cohort that began in 1996; predominantly composed of participants who are white and of middle-to-high socioeconomic positions.Participants9914 participants 18–32 years old at the most recent follow-up questionnaire.Primary outcome measureIn 2013, participants reported if, in the last year, they had been unemployed, uninsured or lacked healthcare access (routine physical exam). Participants completed the EQ-5D-5L, a validated, preference-weighted measurement of HRQL. After adjusting for potential confounders, we used sex-stratified, log-binomial models to calculate the association of sexual orientation with employment, health insurance and healthcare access, while examining if these variables attenuated the sexual orientation-related HRQL disparities.ResultsSexual minority women and men were about twice as likely as their respective heterosexual counterparts to have been unemployed and uninsured. For example, the risk ratio (95% CI) of uninsured bisexual women was 3.76 (2.42 to 5.85) and of unemployed mostly heterosexual men was 1.82 (1.30 to 2.54). Routine physical examination was not different across sexual orientation groups (p>0.05). All sexual minority subgroups had worse HRQL than heterosexuals (p<0.05) across the five EQ-5D-5L dimensions (mobility, self-care, usual activities, pain/discomfort and anxiety/depression). Controlling for employment and health insurance did not substantially attenuate the existing sexual orientation-related HRQL disparities.ConclusionsResearch on sexual orientation-related disparities in employment and healthcare has often been limited to comparisons between cohabitating different-sex and same-sex adult couples, overlooking sexual minority subgroups (eg, bisexuals vs lesbians), non-cohabitating populations and young people. Less is known about sexual orientation-related disparities in HRQL including potential contributions from employment and healthcare. The current study documents that disparities in employment, health insurance and various HRQL dimensions are pervasive across sexual minority subgroups, non-cohabitating couples and youth in families of middle-to-high socioeconomic positions.
Prevalence and associated factors of post-traumatic stress disorder among emergency responders of Addis Ababa Fire and Emergency Control and Prevention Service Authority, Ethiopia: institution-based, cross-sectional study
Authors: Bezabh Yodit Habtamu , Abebe Solomon Mekonnen , Fanta Tolesa , Tadese Agitu , Tulu Mikiyas 
Published: July 2018

ObjectiveTo assess the prevalence and associated factors of post-traumatic stress disorder (PTSD) among emergency responders at Addis Ababa Fire and Emergency Control and Prevention Service Authority, Ethiopia.DesignInstitution-based, cross-sectional design.SettingThe study was conducted at the Fire and Emergency Control and Prevention Service Authority, Addis Ababa, Ethiopia.Participants603 emergency responders who worked in the Fire and Emergency Control and Prevention Authority during the study period.MeasurementData were collected using a self-administered questionnaire: an adaptation of the standardised PTSD Checklist–Civilian Version. The questionnaire was administered to subjects on duty. Social support was measured using the Oslo 3-Item Social Support Scale, while other stressful life events were measured using the List of Threatening Experiences, that is, experiencing one or more stressful life events in the last 6 months. Reliability and construct validity were verified. To be diagnosed with PTSD, a subject must display at least three different types of symptoms at once. Coded variables were entered into Epi Info V.3.5.1 and then exported to SPSS V.20 for analysis. Descriptive and bivariate and multivariate logistic regressions and 95% CI were employed to establish and test statistically significant associations.ResultsA total of 603 subjects participated in the study, with 19.9% prevalence rate of PTSD (95% CI 16.9 to 23.1). The study found family history of mental illness (adjusted OR (AOR)=2.82; 95% CI 1.65 to 4.84), longer years of service (AOR=2.67; 95% CI 1.54 to 4.63), as well as prolonged exposure to emergency situations (AOR=0.44; 95% CI 0.24 to 0.84) and road traffic accidents (AOR=2.71; 95% CI 1.67 to 4.42) as significant predictors of PTSD among emergency responders.ConclusionThe prevalence of PTSD was high among the study population. Family history of mental illness, length of service, duration of exposure and type of exposure were found to be associated with PTSD. Mental health education and linking emergency responders with available mental health services/facilities should be prioritised to mitigate the problem.
Can a bothersome course of pelvic pain from mid-pregnancy to birth be predicted? A Norwegian prospective longitudinal SMS-Track study
Authors: Malmqvist Stefan , Kjaermann Inger , Andersen Knut , Gausel Anne Marie , Økland Inger , Larsen Jan Petter , Bronnick Kolbjorn S 
Published: July 2018

ObjectiveTo explore if pregnant women with pelvic girdle pain (PGP), subgrouped following the results from two clinical tests with high validity and reliability, differ in demographic characteristics and weekly amount of days with bothersome symptoms through the second half of pregnancy.DesignA prospective longitudinal cohort study.ParticipantsPregnant women with pelvic and lumbopelvic pain due for their second-trimester routine ultrasound examination.SettingObstetric outpatient clinic at Stavanger University Hospital, Norway.MethodsWomen reporting pelvic and lumbopelvic pain completed a questionnaire on demographic and clinical features. They were clinically examined following a test procedure recommended in the European guidelines for the diagnosis and treatment of PGP. Women without pain symptoms completed a questionnaire on demographic data. All women were followed weekly through an SMS-Track survey until delivery.Primary and secondary outcome measuresThe outcome measures were the results from clinical diagnostic tests for PGP and the number of days per week with bothersome pelvic pain.Results503 women participated. 42% (212/503) reported pain in the lumbopelvic region and 39% (196/503) fulfilled the criteria for a probable PGP diagnosis. 27% (137/503) reported both the posterior pelvic pain provocation (P4) and the active straight leg raise (ASLR) tests positive at baseline in week 18, revealing 7.55 (95% CI 5.54 to 10.29) times higher mean number of days with bothersome pelvic pain compared with women with both tests negative. They presented the highest scores for workload, depressed mood, pain level, body mass index, Oswestry Disability Index and the number of previous pregnancies. Exercising regularly before and during pregnancy was more common in women with negative tests.ConclusionIf both P4 and ASLR tests were positive mid-pregnancy, a persistent bothersome pelvic pain of more than 5 days per week throughout the remainder of pregnancy could be predicted. Increased individual control over work situation and an active lifestyle, including regular exercise before and during pregnancy, may serve as a PGP prophylactic.
Cohort profile: the Martinique Cancer Registry and the quality of life prostate cancer cohort (QoL Prostate-MQ): challenges and prospects for reducing disparities in the Caribbean
Authors: Joachim Clarisse , Veronique-Baudin Jacqueline , Almont Thierry , Ulric-Gervaise Stephen , Macni Jonathan , Pierre-Louis Olivier , Godaert Lidvine , Drame Moustapha , Novella Jean-Luc , Farid Karim , Vinh-Hung Vincent , Escarmant Patrick 
Published: July 2018

PurposeRecording cancer data in cancer registries is essential for producing reliable population-based data for service planning, monitoring and evaluation. Prostate cancer (PCa) remains the most frequent type of cancer in terms of incidence and mortality in men in the Caribbean. The quality of life PCa cohort will assess quality of life and patient outcomes in Martinique using a digital platform for patient-reported outcome measures.ParticipantsThe Martinique Cancer Registry database is the largest clinical database among the French population-based cancer registries in the Caribbean, including more than 38 000 cancer cases, with 1650 new cancer cases per year, including 550 new PCa cases per year (2010–2014 latest period). In 2018, follow-up will include vital status, assessment of quality of life with the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ) Core 30 and the Prostate cancer module QLQ-PR25. Urinary incontinence and erectile dysfunction recorded prior to treatment will be analysed 1 and 5 years after treatment.Findings to dateThe registry includes data on circumstances of diagnosis, clinical stage at diagnosis. For PCa, the registry includes blood prostate-specific antigen level at the time of diagnosis, Gleason score and primary treatment.Future plansFurther studies will provide detailed data regarding the quality of diagnosis and management of patients with PCa in Martinique; analysing quality of care will be the next challenge.Quality of life and patient outcomes will be evaluated using a digital platform for patient-reported outcome measurement and electronic records.
Effects of retinopathy and chronic kidney disease on long-term mortality in type 2 diabetic inpatients with normal urinary albumin or protein: a retrospective cohort study
Authors: Li Yu-Hsuan , Sheu Wayne H-H , Lee I-Te 
Published: July 2018

ObjectiveNormoalbuminuric chronic kidney disease (NA-CKD) is recognised as a distinct phenotype of diabetic kidney disease, but the role of diabetic retinopathy (DR) in predicting long-term mortality among these patients remains unclear. Here, we aimed to investigate the effects of DR and CKD on mortality in type 2 diabetic patients with normoalbuminuria.DesignWe conducted this study as a retrospective cohort study.SettingWe collected clinical information from the medical records of a public medical centre in central Taiwan.ParticipantsPatients with type 2 diabetes (n=665) who were hospitalised due to poor glucose control were consecutively enrolled and followed for a median of 6.7 years (IQR 4.1‒9.6 years). Patients with either urinary protein excretion >150 mg/day or urine albumin excretion >30 mg/day were excluded.Primary outcome measureAll-cause mortality served as the primary follow-up outcome, and the mortality data were obtained from the national registry in Taiwan.ResultsThe patients with CKD and DR showed the highest mortality rate (log-rank p<0.001). The risks of all-cause mortality (HR 2.263; 95% CI 1.551 to 3.302) and cardiovascular mortality (HR 2.471; 95% CI 1.421 to 4.297) were significantly greater in patients with CKD and DR than in those without CKD or DR, after adjusting for the associated risk factors.ConclusionsDR is an independent predictor for all-cause and cardiovascular mortality in type 2 diabetic inpatients with normoalbuminuria. Moreover, DR with CKD shows the highest risks of all-cause and cardiovascular mortality among these patients. Funduscopy screening can provide additive information on mortality in patients with type 2 diabetes, even among those with NA-CKD.
Cohort study evaluating pressure ulcer management in clinical practice in the UK following initial presentation in the community: costs and outcomes
Authors: Guest Julian F , Fuller Graham W , Vowden Peter , Vowden Kathryn Ruth 
Published: July 2018

ObjectivesThe aim of this study was to estimate the patterns of care and annual levels of healthcare resource use attributable to managing pressure ulcers (PUs) in clinical practice in the community by the UK’s National Health Service (NHS), and the associated costs of patient management.MethodsThis was a retrospective cohort analysis of the records of 209 patients identified within a randomly selected population of 6000 patients with any type of wound obtained from The Health Improvement Network (THIN) Database, who developed a PU in the community and excluded hospital-acquired PUs. Patients’ characteristics, wound-related health outcomes and healthcare resource use were quantified over 12 months from initial presentation, and the corresponding total NHS cost of patient management was estimated at 2015/2016 prices.Results50% of all the PUs healed within 12 months from initial presentation, but this varied between 100% for category 1 ulcers and 21% for category 4 ulcers. The mean time to healing ranged from 1.0 month for a category 1 ulcer to 8 months for a category 3/4 ulcer and 10 months for an unstageable ulcer. Patients were predominantly managed in the community by nurses with minimal clinical involvement of specialist clinicians. Up to 53% of all the ulcers may have been clinically infected at the time of presentation, and 35% of patients subsequently developed a putative wound infection a mean 4.7 months after initial presentation. The mean NHS cost of wound care over 12 months ranged from £1400 for a category 1 ulcer to >£8500 for the other categories of ulcer. Additionally, the cost of managing an unhealed ulcer was 2.4 times more than that of managing a healed ulcer (mean of £5140 vs £12 300 per ulcer).ConclusionThis study provides important insights into a number of aspects of PU management in clinical practice in the community that have been difficult to ascertain from other studies, and provides the best estimate available of NHS resource use and costs with which to inform policy and budgetary decisions.
Prehospital trauma death review in the State of Victoria, Australia: a study protocol
Authors: Mercier Eric , Cameron Peter A , Smith Karen , Beck Ben 
Published: July 2018

IntroductionRegionalised trauma systems have been shown to improve outcomes for trauma patients. However, the evaluation of these trauma systems has been oriented towards in-hospital care. Therefore, the epidemiology and care delivered to the injured patients who died in the prehospital setting remain poorly studied. This study aims to provide an overview of a methodological approach to reviewing trauma deaths in order to assess the preventability, identify areas for improvements in the system of care provided to these patients and evaluate the potential for novel interventions to improve outcomes for seriously injured trauma patients.Methods and analysisThe planned study is a retrospective review of prehospital and early in-hospital (<24 hours) deaths following traumatic out-of-hospital cardiac arrest that were attended by Ambulance Victoria between 2008 and 2014. Eligible patients will be identified from the Victorian Ambulance Cardiac Arrest Registry and linked with the National Coronial Information System. For patients who were transported to hospital, data will be linked the Victoria State Trauma Registry. The project will be undertaken in four phases: (1) survivability assessment; (2) preventability assessment; (3) identification of potential areas for improvement; and (4) identification of potentially useful novel technologies. Survivability assessment will be based on predetermined anatomical injuries considered unsurvivable. For patients with potentially survivable injuries, multidisciplinary expert panel reviews will be conducted to assess the preventability as well as the identification of potential areas for improvement and the utility of novel technologies.Ethics and disseminationThe present study was approved by the Victorian Department of Justice and Regulation HREC (CF/16/272) and the Monash University HREC (CF16/532 – 2016000259). Results of the study will be published in peer-reviewed journals and reports provided to Ambulance Victoria, the Victorian State Trauma Committee and the Victorian State Government Department of Health and Human Services.