bluuebunny/crossref_metadata_2025_split huggingface dataset:
Definitions and Historical Perspectives in Environmental Forensics
Authors: Toranzos Gary A. , Cano Raúl J. 
Published: March 2018

ABSTRACT

Environmental forensics is a tool that uses chemical, physical, and statistical techniques to investigate contaminants in the environment as a means to determine attribution for legal purposes. Environmental microbiology is a branch of science that has benefited from the use of metagenomics. The term microbial forensics, which includes nucleic acid sequencing methods, is now used to investigate the sources of microorganisms for attribution purposes as well. Environmental microbial forensics can fully address the questions that must be answered for attribution of causation and subsequent remedial actions within a reasonably short time frame. Although
sensu stricto
forensics refers to obtaining scientific evidence to be presented during legal proceedings, the term
sensu lato
is used as a description of the procedures used to reconstruct previous events, such as contamination. The term microbial forensics was first used to describe a forensic science approach for attribution purposes, specifically for bioterror as a purposeful release of pathogen microorganisms, but it also especially refers to investigations on the inadvertent or accidental release of pathogenic agents. However, microbial forensics can be used to determine the source of a microorganism or a group of microorganisms, regardless of whether they are pathogenic or not. Microbial forensics has limitations, but it should be used as part of a toolbox of methods to be relied upon when doing forensic studies. Environmental microbial forensics can only benefit from the development of new methods, and we already are experiencing a paradigm change in terms of approaches to the forensic sciences.
Incidence of delirium in the Canadian emergency department and its consequences on hospital length of stay: a prospective observational multicentre cohort study
Authors: Émond Marcel , Boucher Valérie , Carmichael Pierre-Hugues , Voyer Philippe , Pelletier Mathieu , Gouin Émilie , Daoust Raoul , Berthelot Simon , Lamontagne Marie-Eve , Morin Michèle , Lemire Stéphane , Minh Vu Thien Tuong , Nadeau Alexandra , Rheault Marcel , Juneau Lucille , Le Sage Natalie , Lee Jacques 
Published: March 2018

ObjectiveWe aim to determine the incidence of delirium and describe its impacts on hospital length of stay (LOS) among non-delirious community-dwelling older adults with an 8-hour exposure to the emergency department (ED) environment.DesignThis is a prospective observational multicentre cohort study (March–July 2015). Patients were assessed two times per day during their entire ED stay and up to 24 hours on hospital ward.SettingThe study took place in four Canadian EDs.Participants338 included patients: (1) aged ≥65 years; (2) who had an ED stay ≥8 hours; (3) were admitted to hospital ward and (4) were independent/semi-independent.Main outcome(s) and measure(s)The primary outcomes of this study were incident delirium in the ED or within 24 hours of ward admission and ED and hospital LOS. Functional and cognitive status were assessed using validated Older Americans Resources and Services and the modified Telephone Interview for Cognitive Status tools. The Confusion Assessment Method was used to detect incident delirium. Univariate and multivariate analyses were conducted to evaluate outcomes.ResultsMean age was 76.8 (±8.1), 17.7% were aged >85 years old and 48.8% were men. The mean incidence of delirium was 12.1% (n=41). Median IQR ED LOS was 32.4 (24.5–47.9) hours and hospital LOS was 146.6 (75.2–267.8) hours. Adjusted mean hospital LOS was increased by 105.4 hours (4.4 days) (95% CI 25.1 to 162.0, P<0.001) for patients who developed an episode of delirium compared with non-delirious patient.ConclusionsAn incident delirium was observed in one of eight independent/semi-independent older adults after an 8-hour ED exposure. An episode of delirium increases hospital LOS by 4 days and therefore has important implications for patients and could contribute to ED overcrowding through a deleterious feedback loop.
Patterns and trends of potentially inappropriate high-density lipoprotein cholesterol testing in Australian adults at high risk of cardiovascular disease from 2008 to 2014: analysis of linked individual patient data from the Australian Medicare Benefits Schedule and Pharmaceutical Benefits Scheme
Authors: Hajati Farshid , Atlantis Evan , Bell Katy J L , Girosi Federico 
Published: March 2018

ObjectivesWe examine the extent to which the adult Australian population on lipid-lowering medications receives the level of high-density lipoprotein cholesterol (HDL-C) testing recommended by national guidelines.DataWe analysed records from 7 years (2008–2014) of the 10% publicly available sample of deidentified, individual level, linked Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) electronic databases of Australia.MethodsThe PBS data were used to identify individuals on stable prescriptions of lipid-lowering treatment. The MBS data were used to estimate the annual frequency of HDL-C testing. We developed a methodology to address the issue of ‘episode coning’ in the MBS data, which causes an undercounting of pathology tests. We used a published figure on the proportion of unreported HDL-C tests to correct for the undercounting and estimate the probability that an HDL-C test was performed. We judged appropriateness of testing frequency by comparing the HDL-C testing rate to guidelines’ recommendations of annual testing for people at high risk for cardiovascular disease.ResultsWe estimated that approximately 49% of the population on stable lipid-lowering treatment did not receive any HDL-C test in a given year. We also found that approximately 19% of the same population received two or more HDL-C tests within the year. These levels of underutilisation and overutilisation have been changing at an average rate of 2% and −4% a year, respectively, since 2009. The yearly expenditure associated with test overutilisation was approximately $A4.3 million during the study period, while the cost averted because of test underutilisation was approximately $A11.3 million a year.ConclusionsWe found that approximately half of Australians on stable lipid-lowering treatment may be having fewer HDL-C testing than recommended by national guidelines, while nearly one-fifth are having more tests than recommended.
Agreement between electronic and paper Epworth Sleepiness Scale responses in obstructive sleep apnoea: secondary analysis of a randomised controlled trial undertaken in a specialised tertiary care clinic
Authors: Chen Lily , Chapman Julia L , Yee Brendon J , Wong Keith K H , Grunstein Ronald R , Marshall Nathaniel S , Miller Christopher B 
Published: March 2018

ObjectivesOriginally developed as a paper questionnaire, the electronic Epworth Sleepiness Scale (ESS) is widely used in sleep clinics and sleep population research. Despite potential differences between computer-based and conventional questionnaire delivery, studies have not evaluated the agreement between electronic and paper versions of the ESS. Given the widespread use of the ESS, a bias between results would present considerable data concerns. Thus, the aim of this study was to examine agreement between electronic and paper ESS responses in obstructive sleep apnoea (OSA).DesignWe undertook a secondary analysis of baseline data from a randomised controlled trial (ANZCTR: ACTRN12611000847910).SettingData were collected in a tertiary sleep research laboratory located in Sydney, Australia.ParticipantsData were analysed from 112 adult patients with OSA.MeasurementsPatients were given the English version of the ESS as part of a battery of sleep laboratory questionnaires. They completed electronic and subsequently paper ESS questionnaires on the same day.ResultsWe found no significant difference between electronic and paper ESS questionnaires (mean=0.1, SD=2.1, 95% CI −0.3 to 0.5, P=0.57) or heteroscedasticity. There was no evidence of bias along the range of the measure. 95% limits of agreement at 4.3 and −4.1 were comparable with previous data.ConclusionsWe found no evidence of bias between electronic and paper ESS questionnaires in this sample of patients with OSA, as the two formats displayed sufficient agreement to be clinically comparable. Regardless of severity, patients reported the same level of daytime sleepiness with the same level of accuracy across both measures.Trial registration numberACTRN12611000847910; Pre-results.
What integrated care means from an older person’s perspective? A scoping review protocol
Authors: Mittinty Manasi Murthy , Marshall Amy , Harvey Gillian 
Published: March 2018

IntroductionAccording to the 2013 WHO Global Forum on Innovation for Ageing Populations, disabilities and morbidities associated with ageing could be minimised by accessing preventive care. One way of improving the management of multimorbidity in the older population is through the provision of ‘integrated care’. Although integrated care means different things to different people, it typically symbolises continuity in care, thus preventing older patients' from falling through gaps in the health care system. Many initiatives have attempted to improve the integration of care; however, these are typically designed from a particular policy or system perspective. Relatively little is known about patient expectations and experiences of integrated care, which is vital for developing and implementing better models of care. The proposed scoping review aims to map literature on older patients'’ views, expectations, experiences and perspectives of integrated care.Methods and analysisMultiple electronic databases including PubMed, Web of Science, Embase, PsychInfo, Google Scholar, Cochrane Library, CINAHL and ProQuest Dissertations will be searched for appropriate articles between August and December 2017. Reference lists of selected articles will also be searched for similar articles. Two experienced researchers will conduct an initial search of the literature to identify relevant articles. Abstracts of the identified articles will be reviewed collectively by two researchers to identify potential further studies. Full texts of the potential studies will be sourced and screened for the inclusion criteria. Appropriate qualitative and quantitative methods will be used to extract data from each included study.Ethics and disseminationThe scoping review will synthesise findings from studies reporting on patients’ views and expectations of integrated care. This review expects to find information relating to facilitators and barriers of integrated care from an older person’s perspective. The findings from the review will be applied when working with stakeholders representing older people, healthcare, aged care and community providers, researchers and policy makers to develop and evaluate a more locally tailored and person-centred approach to integrated care.
Long-term clinical parameters after switching to nocturnal haemodialysis: a Dutch propensity-score-matched cohort study comparing patients on nocturnal haemodialysis with patients on three-times-a-week haemodialysis/haemodiafiltration
Authors: Jansz Thijs Thomas , Özyilmaz Akin , Grooteman Muriel P C , Hoekstra Tiny , Romijn Marieke , Blankestijn Peter J , Bots Michael L , van Jaarsveld Brigit C 
Published: March 2018

ObjectivesNocturnal haemodialysis (NHD), characterised by 8-hour sessions ≥3 times a week, is known to improve clinical parameters in the short term compared with conventional-schedule haemodialysis (HD), generally 3×3.5–4 hours a week. We studied long-term effects of NHD and used patients on conventional HD/haemodiafiltration (HDF) as controls.DesignFour-year prospective follow-up of patients who switched to NHD; we compared patients with patients on HD/HDF using propensity score matching.Setting28 Dutch dialysis centres.ParticipantsWe included 159 patients starting with NHD any time since 2004, aged 56.7±12.9 years, with median dialysis vintage 2.3 (0.9–5.1) years. We propensity-score matched 100 patients on NHD to 100 on HD/HDF.Primary and secondary outcome measuresControl of hypertension (predialysis blood pressure, number of antihypertensives), phosphate (phosphate, number of phosphate binders), nutritional status and inflammation (albumin, C reactive protein and postdialysis weight) and anaemia (erythropoiesis-stimulating agent (ESA) resistance).ResultsSwitching to NHD was associated with a non-significant reduction of antihypertensives compared with HD/HDF (OR <2 types 2.17, 95% CI 0.86 to 5.50, P=0.11); and a prolonged lower need for phosphate binders (OR <2 types 1.83, 95% CI 1.10 to 3.03, P=0.02). NHD was not associated with significant changes in blood pressure or phosphate. NHD was associated with significantly higher albumin over time compared with HD/HDF (0.70 g/L/year, 95% CI 0.10 to 1.30, P=0.02). ESA resistance decreased significantly in NHD compared with HD/HDF, resulting in a 33% lower ESA dose in the long term.ConclusionsAfter switching to NHD, the lower need for antihypertensives, phosphate binders and ESA persists for at least 4 years. These sustained improvements in NHD contrast significantly with the course of these parameters during continued treatment with conventional-schedule HD and HDF. NHD provides an optimal form of dialysis, also suitable for patients expected to have a long waiting time for transplantation or those convicted to indefinite dialysis.
A tailored strategy for designing the Walk-Copenhagen (WALK-Cph) intervention to increase mobility in hospitalised older medical patients: a protocol for the qualitative part of the WALK-Cph project
Authors: Kirk Jeanette Wassar , Bodilsen Ann Christine , Tjørnhøj-Thomsen Tine , Pedersen Mette Merete , Bandholm Thomas , Husted Rasmus Skov , Poulsen Lise Kronborg , Petersen Janne , Andersen Ove , Nilsen Per 
Published: March 2018

IntroductionOlder medical patients (>65 years) represent 54% of the admissions to Danish medical and emergency departments. Acute admissions and bed-rest during hospitalisation are independent risk factors for death and dependency in older patients. Even short hospitalisations are associated with increased dependency in activities of daily living after discharge. Interventions that increase mobility during hospitalisation are therefore important. The purpose of this protocol is to describe the intervention design of the WALK-Copenhagen project, aimed at increasing 24 hours mobility in older medical patients during acute hospitalisations and following discharge.Methods and analysisThis study is based on ethnographic fieldwork and interviews. Workshops are used to develop and co-design the intervention in collaboration with key stakeholders (patients, relatives, health professionals and researchers). The theory of cultural learning processes, and the cultural historical activity theory will be used to help us understand the interaction between health professionals, structures and objects in relation to mobility in the medical departments.Ethics and disseminationThe project will adhere to the directives of the Helsinki Declaration. Ethical approval was not required for the study since formal ethical approval is not mandatory for studies that do not involve biomedical issues (I-Suite no: 05078) according to Danish law. Informed consent was obtained for all participants. The results will be disseminated to health professionals, managers, patients and relatives, who will be invited to afternoon meetings where the project will be discussed. The results will be published in peer-reviewed scientific journals and presented at scientific conferences.
Evaluation of spine MRIs in athletes participating in the Rio de Janeiro 2016 Summer Olympic Games
Authors: Wasserman Michael S , Guermazi Ali , Jarraya Mohamed , Engbretsen Lars , AbdelKader Mohamad , Roemer Frank W , Hayashi Daichi , Crema Michel D , Mian Asim Z 
Published: March 2018

Background/aimIn high-level Olympic athletes, many spinal pathologies arise from overuse, while others are the result of acute injury. Our aim is to analyse the epidemiology of spinal pathologies detected on MRI in athletes participating in the 2016 Rio de Janeiro Summer Olympics.MethodsIn this retrospective study, all spine MRIs performed during the 2016 Rio Games were analysed. Descriptive data from the MRIs were tabulated and analysed for disc degeneration, spinal canal and/or neural foraminal narrowing, and acute/chronic fractures. Data were analysed by sport, continent of origin, age and sex.ResultsOf 11 274 athletes participating in the Olympic games, 100 received spine MRI. Fifty-two of the 100 (52%) athletes who received cervical, thoracic and/or lumbar spine MRI showed moderate to severe spinal disease. The highest sport-specific incidence of moderate to severe spine disease was seen in aquatic diving athletes (67%, 3 per 100 divers). Weightlifting had the second highest sport-specific incidence of spine disease (67%, 1.5 per 100 weightlifters). Athletics used the most spine MRIs (31 of 107 MRIs, 29%). European athletes had more spine MRIs than all other continents combined (55 of 107 MRIs, 51%). Athletes over 30 years old had the highest rate of moderate to severe spine disease on MRI (24 of 37 athletes >30 years old, 65%).ConclusionsA high number of the world’s premier athletes demonstrated moderate to severe spine disease on MRI during the 2016 Summer Olympics, including moderate/severe degenerative disc changes with varying degrees of disc bulges and herniations.
MRSA nares swab is a more accurate predictor of MRSA wound infection compared with clinical risk factors in emergency department patients with skin and soft tissue infections
Authors: Acquisto Nicole M , Bodkin Ryan P , Brown Jack E , Graman Paul S , Jones Courtney Marie Cora , Li Timmy , Hardy Dwight J , Dodds Ashley Elizabeth 
Published: March 2018

ObjectivesSkin and soft tissue infections (SSTI) caused by methicillin-resistantStaphylococcus aureus(MRSA) are prevalent in the emergency department (ED). We determined whether MRSA nasal carriage better identifies patients with MRSA wound infection than clinical risk factors or emergency medicine (EM) provider’s choice of discharge prescriptions.MethodsAdult patients presenting to a large academic medical centre ED in the USA with SSTI between May 2010 and November 2011 were screened. Research assistants administered a questionnaire regarding MRSA risk factors, and MRSA nares swab PCR testing, wound culture results and information on antibiotics prescribed at discharge were collected. Measures of classification accuracy for nares swab, individual risk factors and physician’s prescription for MRSA coverage were compared with gold standard wound culture.ResultsDuring the study period, 116 patients with SSTI had both wound cultures and nares swabs for MRSA.S. aureuswas isolated in 59.5%, most often MRSA (75.4%). Thirty patients (25.9%) had a positive MRSA nares swab and culture for a sensitivity of 57.7% and specificity of 92.2%. Positive predictive value (PPV) for MRSA nares swab was 85.7% and positive likelihood ratio was 7.4, while negative predictive value was 72.8% and negative likelihood ratio 0.5. None of the individual risk factors nor EM provider’s prescription for MRSA coverage had a PPV or positive likelihood ratio higher than nares swabs.ConclusionsMRSA nares swab is a more accurate predictor of MRSA wound infection compared with clinical risk factors or EM provider’s choice of antibiotics. MRSA nares swab may be a useful tool in the ED.
Engineering Resilient Collective Adaptive Systems by Self-Stabilisation
Authors: Viroli Mirko , Audrito Giorgio , Beal Jacob , Damiani Ferruccio , Pianini Danilo 
Published: March 2018

Collective adaptive systems are an emerging class of networked computational systems particularly suited for application domains such as smart cities, complex sensor networks, and the Internet of Things. These systems tend to feature large-scale, heterogeneity of communication model (including opportunistic peer-to-peer wireless interaction) and require inherent self-adaptiveness properties to address unforeseen changes in operating conditions. In this context, it is extremely difficult (if not seemingly intractable) to engineer reusable pieces of distributed behaviour to make them provably correct and smoothly composable.
Building on the field calculus, a computational model (and associated toolchain) capturing the notion of aggregate network-level computation, we address this problem with an engineering methodology coupling formal theory and computer simulation. On the one hand, functional properties are addressed by identifying the largest-to-date field calculus fragment generating self-stabilising behaviour, guaranteed to eventually attain a correct and stable final state despite any transient perturbation in state or topology and including highly reusable building blocks for information spreading, aggregation, and time evolution. On the other hand, dynamical properties are addressed by simulation, empirically evaluating the different performances that can be obtained by switching between implementations of building blocks with provably equivalent functional properties. Overall, our methodology sheds light on how to identify core building blocks of collective behaviour and how to select implementations that improve system performance while leaving overall system function and resiliency properties unchanged.
Increased macrophage-derived SPARC precedes collagen deposition in myocardial fibrosis
Authors: McDonald Lindsay T. , Zile Michael R. , Zhang Yuhua , Van Laer An O. , Baicu Catalin F. , Stroud Robert E. , Jones Jeffrey A. , LaRue Amanda C. , Bradshaw Amy D. 
Published: March 2018

Myocardial fibrosis and the resultant increases in left ventricular stiffness represent pivotal consequences of chronic pressure overload (PO) that impact both functional capacity and the rates of morbid and mortal events. However, the time course and cellular mechanisms that underlie PO-induced fibrosis have not been completely defined. Secreted protein acidic and rich in cysteine (SPARC) is a matricellular protein that has been shown to be required for insoluble collagen deposition and increased myocardial stiffness in response to PO in mice. As macrophages are associated with increases in fibrillar collagen, the hypothesis that macrophages represent a source of increased SPARC production in the PO myocardium was tested. The time course of changes in the myocardial macrophage population was compared with changes in procollagen type I mRNA, production of SPARC, fibrillar collagen accumulation, and diastolic stiffness. In PO hearts, mRNA encoding collagen type I was increased at 3 days, whereas increases in levels of total collagen protein did not occur until 1 wk and were followed by increases in insoluble collagen at 2 wk. Increases in muscle stiffness were not detected before increases in insoluble collagen content (>1 wk). Significant increases in myocardial macrophages that coincided with increased SPARC were found but did not coincide with increases in mRNA encoding collagen type I. Furthermore, immunohistochemistry and flow cytometry identified macrophages as a cellular source of SPARC. We conclude that myocardial macrophages play an important role in the time-dependent increases in SPARC that enhance postsynthetic collagen processing, insoluble collagen content, and myocardial stiffness and contribute to the development of fibrosis. NEW & NOTEWORTHY Myocardial fibrosis and the resultant increases in left ventricular and myocardial stiffness represent pivotal consequences of chronic pressure overload. In this study a murine model of cardiac fibrosis induced by pressure overload was used to establish a time course of collagen expression, collagen deposition, and cardiac macrophage expansion.