bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Quantitative Study of the Dimensional Change of Inferior Vena Cava on Computed Tomography During Acute Hemorrhage Shock
Authors: Li Yang 
Published: May 2019

Introduction:The collapsed inferior vena cava (IVC) in computed tomography (CT) images can be found in patients with hypovolemic shock, making it an attractive diagnostic sign in early treatment of trauma patients. However, current research results are controversial.Aim:To examine the dimensional change of IVC during acute hemorrhage through a volume controlled acute hemorrhagic shock model in swine.Methods:Volume controlled hemorrhage was performed in 10 adult Bama minipigs. Enhanced CT scan and hemodynamic monitoring were performed when the cumulative blood loss volume reached 0%, 10%, 20%, 30%, and 40%. The transverse diameter (T) and anteroposterior diameter (AP) of IVC were measured in axial images. Hemodynamic parameters were obtained with a Pulse Contour Cardiac Output (PiCCO) hemodynamic monitor device. Arterial blood samples were also collected for artery blood gas analysis at each time point.Results:As the blood loss volume increased, the collapsibility (T/AP) and cross section area (CSA) of IVC significantly changed in hepatic level and pre-renal level. The significant decrease of the CSA of IVC (shrink) occurred early when the blood loss volume reached only 10%.Discussion:The IVC shrank early but collapsed late during acute hemorrhages in swine. The collapsed IVC on CT scans suggested a severe hypovolemic shock state but not an early indicator for shock.
Required Competencies for Clinical Nurses during the Initial Phase of Disaster Emergence
Authors: Horiuchi Miyuki , Matsuba Ryuichi , Miyazaki Makoto 
Published: May 2019

Introduction:A learning project was launched to prepare for natural disasters such as earthquakes and floods. Competencies were developed for clinical nurses in the Initial phase of disasters as an indicator to build a bridge between daily training and actions during crises. There are two predominant features of the competencies that differ from other works. First was to concentrate only on “the initial phase” of a crisis outbreak. The second was to associate each competence with services and roles of clinical nurses.Methods:The development has been conducted in accordance with the ibstpi® competency development model. First, 50 outlining competencies from earlier studies were selected, like ICN Framework and Disaster Nursing Core Competency for undergraduates in Japan. Then a web-based questionnaire was carried out with a four-point scale of “able,” “probable,” “impossible,” and “cannot understand meaning” for incumbent nurses in order to gauge their adequacy.Results:There were 86 responses with an average of 14 years (1-40) of nursing experience. We compared them in three groups; those with a job post (G1), those with experience of longer than five years (G2), and those with experience of fewer than five years (G3). The average competency score (total 150 points) was 96.7 (67-129) in G1, 88.2 (53-145) in G2 and 80.2 (59-114) in G3.Discussion:The results imply, even in G1, the average score is low at 65/100 points. This may indicate most clinical nurses should make efforts to develop their skills and knowledge of disaster nursing through daily work. Only 32 competencies (G1), 14 (G2), and 5 (G3) were marked as “able” or “probable” by over 80% of responders. Thus with consideration, depending on the result and expert reviews, the competencies determined to be “required” for clinical nurses were finally refined down to 35 items including the premise of ten.
Risk Mapping of Road Traffic Incidents in Greater Kampala Metropolitan Area for Planning of Emergency Medical Services
Authors: Balikuddembe Joseph Kimuli 
Published: May 2019

Introduction:Compared to high-income countries, low and middle-income countries (LMICs) bear the heaviest brunt of road traffic incidents (RTIs), which is a serious public health and development burden. Like other LMICs, Uganda has been experiencing a worryingly high burden of RTIs and their associated impacts with the highest number of all the total registered RTIs in Uganda registered in the Greater Kampala Metropolitan Area (GKMA). This places a tremendous demand on the few existing emergency medical services (EMS) to adequately respond to those affected.Aim:To aid in better planning of EMS for the victims of RTIs by using risk mapping of RTIs in the GKMA.Methods:A mixed methodological approach involving a systematic review, Delphi panel technique, retrospective data analysis, and a cross-sectional method.Results:With Uganda progressing forward as envisaged in its “Vision 2040,” the GKMA, which is the country’s political and socioeconomic epicenter, is experiencing significant changes in terms of population growth. This has significantly increased RTIs, which puts pressure on the pre-hospital emergency care for those affected unless necessary actions are taken.Discussion:Therefore, the road safety vis-à-vis injury prevention measures, which are needed to reduce the burden of RTIs, should be multifaceted in nature so that they closely correlate with the ongoing dynamics that cause them, particularly in the GKMA which experiences the highest number of RTIs and Uganda as a whole. The WHO “Safe System Approach” is desirable for this purpose as it represents the most appropriate approach because it is broad enough to comprehensively manage any of the ongoing dynamics (political, socio-cultural or economical) that are known to contribute to RTIs.
A Sense of Trust, the Norwegian Way of Improving Medical On-Scene Managing Major Tunnel Incidents: An Interview Study
Authors: Hylander Johan , Saveman Britt-Inger , Gyllencreutz Lina 
Published: May 2019

Introduction:Norway is a country with many road tunnels and therefore also has experience with rescue operations in tunnel environments. Major incidents always challenge involved emergency services’ management skills. Oslo, Norway has a specially trained medical on-scene commander, a function already existing in police and rescue service. Intra-agency communication and management of personnel are essential factors for a successful rescue effort.Aim:To investigate the medical management provided by the specially trained Norwegian medical on-scene commander in relation to tunnel incidents.Methods:Interviews were conducted with six of the seven medical on-scene commanders in Oslo. The collected data were analyzed using qualitative content analysis.Results:An overarching theme emerged: A need for mutual understanding of the tunnel incident. The medical on-scene commanders established guidelines for response in collaboration with the other emergency services. By creating a sense of trust, the collaboration between the emergency services became more fluent. Socializing outside of work resulted in improved reliance on their counterparts in the other services. The management also included that the medical on-scene commander supervised his personnel on site by providing support using knowledge of the risk object and surrounding area.Discussion:A forum for the emergency services on-scene commanders where they share ideas and knowledge, improve the on-scene intra-agency communication, and trust is desirable. A culture of trust between the organizations is needed for a mutual understanding. Further research on this subject is needed in other contexts and countries.
Study of Guardians’ Recognition of Children’s Safety After a Disaster
Authors: Kawasaki Hiromi , Yamasaki Satoko , Tsunematsu Miwako , Kashima Saori , Teramoto Chie , Shintaku Hazuki , Kihara Akihiro 
Published: May 2019

Introduction:In Japan, after an earthquake, or when there is a heavy downpour, transportation is affected and guardians of children may not be able to reach home in time from the office. In elementary schools, because the guardian is unable to come and pick up the child, the teacher needs to ensure that the children are protected, and therefore, bears enormous responsibility. Since commuting times to work are long, guardians need to instate measures for the safety of their children.Aim:This study aims to clarify guardians’ recognition of children’s safety in the event of a disaster, and examine the corresponding challenge they face in terms of commuting distance.Methods:The subjects are 2,181 guardians of children in four elementary schools near places where landslides had occurred in Hiroshima city in 2014. The questionnaires distributed throughout the school produced 1,027 valid responses. Guardians were divided based on commuting distance into two groups; one of whom were within 3-km commuting distance and the other of more than 3 km. The two groups were compared for their recognition of children’s safety using a chi-square test.Results:Children’s safety in school was a concern for 73.9% of guardians. The safety of school buildings in case of a disaster was a cause of concern for 80% of guardians who are close commuters, and 73.9% of guardians whose commute distance is longer (P = 0.015). The fact that children cannot return home was a cause of worry for 33.9% of guardians whose workplace is nearby, and for 29.9% whose workplace was distant (P=0.044).Discussion:Most parents, especially guardians going to work far away, do not recognize that they cannot reach home, and therefore, need to think about providing safety measures for their children in the disaster.
Tabletop Simulation Exercise of Critically Ill Patient Evacuation from a Hospital Fire
Authors: Noh Jiyoung , Chung Hyun Soo , Jin Hye Mi , Hur Jayoung , Kim Min Ji , Kang Chan Mi , Lee Ga Hyun 
Published: May 2019

Introduction:Recent hospital fire incidents in South Korea have heightened the importance of patient evacuation. Moving patients from an intensive care unit (ICU) or emergency department (ED) setting is a challenge due to the complexity of moving acutely unwell patients who are reliant on invasive monitoring and organ support. Despite the importance of patient evacuation, the readiness of ICU and ED for urgent evacuation has not been assessed.Aim:To enhance the readiness and competencies of workers from ICU and ED in the evacuation of patients during a simulated tabletop fire exercise.Methods:A tabletop simulation exercise was developed by the Center for Disaster Relief, Training, and Research referencing the fire evacuation manual developed by the hospital’s ICU and ED. The scenario consisted of evacuating patients horizontally and vertically from each department. The participants’ actions were assessed using a checklist. A debriefing was completed after the exercise to discuss the gaps observed. A post-survey questionnaire was used to evaluate the exercise and assess the perception changes of the participants. All pre-to-post differences within subjects were analyzed with paired t-tests.Results:A total of 22 and 29 people participated in the exercise from ICU and ED, respectively. Knowledge and confidence improved post-exercise for both ICU and ED scenarios (p<0.05). Course satisfaction was 7.9 and 8.7, respectively for ICU and ED exercise. Correct performance rates for ICU and ED were 59% and 58%, respectively. Common gaps noted for both ICU and ED were wearing protective masks, patient hand-over communication, and preparation for resources.Discussion:There need to be exercises to recognize system gaps in place for hospital fire evacuation preparedness. Tabletop simulation exercises are ideal tools for this purpose. Although this was a short 90-minute exercise, this increased familiarity with the evacuation plan, tested the plan, and allowed for identification of gaps.
Uniform Guideline on Risk Characterization for Approval of Mass Gatherings
Authors: Pot Vincent , Cock Johan de , Leeuwen Jan van 
Published: May 2019

Introduction:Mass gatherings may have far-reaching effects on medical care because of the potential high load on the health care system. In preparation of large events (mass gatherings), such as music festivals or marathons, an extended risk assessment forms the basis for issuing advice on health and safety and possible necessary precautionary measures. In the Netherlands, the 25 regional Public Health Directors are responsible for public health and safety. This includes responsibility for advice on large-scale events, based on which the local authorities (e.g. the mayor) decide on the approval. Health care professionals are looking for better tools with regard to the arising dilemmas around responsibilities and risks. Also, as new forms of events are created, uniform (safety) regulations are lacking. GGD GHOR Netherlands (Dutch Society of the regional Public Health Services [GGD] and Major Incident Medical Planning and Coordination Offices [GHOR]) has updated the existing national guideline in collaboration with the Academic Network for Applied Public Health and Emergency Management (Anaphem). The focus was on improving the guideline by including all current expertise and experience in the field.Methods:Various expert sessions were held in 2017 and 2018 to collect all relevant knowledge, evidence, and experience that is currently accessible to develop an improved uniform approach for risk assessment and process steps.Results:A new dynamic national guideline, including factsheets in various topics being effective by 2019. As a result, a list of topics is formulated for further research.Discussion:The new guideline includes the current knowledge and raised awareness among the experts of some important gaps in current evidence on several topics.
Using Clinically Based Vignettes to Further Develop a Mass Gathering Triage Tool
Authors: Ranse Jamie , Cannon Matt , Roitman Rebecca , Morphet Julia 
Published: May 2019

Introduction:This research builds on a previously developed triage: Mass Gathering Triage Scale (MaGaTT) by Cannon, et al (2017). This tool was targeted towards non-health care professional first responders within mass-gathering events (MGEs). However, this tool had not been evaluated.Aim:To further develop the previously designed MaGaTT using vignettes of clinical cases to: 1) determine variation in decision-making, and 2) inform further tool development prior to real-world testing.Methods:Volunteer members of St. John Ambulance Australia were surveyed using 18 vignettes of de-identified real patient record forms from MGEs covered by St. John Ambulance Australia (NSW) in 2013-2014. Participants were given the MaGaTT and written instructions on its use. Participants triaged 18 patients, recording their decisions on the online survey. Responses against the vignettes were analyzed using Fleiss Kappa [p-bar] measure. A score of 0.61 – 0.8 represented substantial agreement and a score of between 0.41 and 0.6 represented moderate agreement between participants.Results:There were 110 completed responses. The majority of participants were male (n =66, 60%), having completed a Bachelor’s Degree (n =38, 34.5%), and holding the clinical skill level of “first responder” (n=42, 38.2%). The overall agreement [p-bar] for the 18 items was moderate at 0.55. When examined by triage category, the “Resuscitation” category had substantial agreement (0.69), when compared with moderate agreement for “Urgent” (0.52) and “Minor” (0.52) categories.Discussion:This research demonstrates that the MaGaTT can be used with moderate agreement, and substantial agreement within the resuscitation category. This is similar to triage tools internationally, where high levels of agreement relate to triage categories for patients requiring resuscitation when compared to patients requiring lower levels of clinical care. Slight changes have been made to the original MaGaTT as a result of this research.
Prediction of total body tissue weights in Scottish Blackface ewes using computed tomography scanning
Authors: Lambe N.R. , Young M.J. , McLean K.A. , Conington J. , Simm G. 
Published: May 2019

AbstractThirty cull Scottish Blackface ewes were scanned three times over a period of 1 week using X-ray computed tomography (CT). Cross-sectional CT reference scans were taken at seven anatomical sites per ewe: ischium (ISC), femur (FEM), hip (HIP), 5th lumbar vertebra (LV5), 2nd lumbar vertebra (LV2), 8th thoracic vertebra (TV8) and 6th thoracic vertebra (TV6). Ewes were then slaughtered and dissection measurements collected.Results of multiple regression analyses suggested that five reference scans allow accurate prediction of total weights of bone, muscle and fat (carcass and internal). The most informative cross-sectional scans were ISC, HIP, LV5, LV2 and TV8, from which prediction equations were derived. Fat and muscle weights were predicted accurately (R2= 80 to 99%) but bone weight was predicted less accurately (R2= 56%). Repeatabilities were high for the CT measurements used to predict fat and muscle (0•82 to 0•99) but lower for those used to predict bone (0•19 to 0• 86).
Estimating internal pelvic sizes using external body measurements in the double-muscled Belgian Blue beef breed
Authors: Coopman F. , de Smet S. , Gengler N. , Haegeman A. , Jacobs K. , van Poucke M. , Laevens H. , van Zeveren A. , Groen A.F. 
Published: May 2019

AbstractIn the double-muscled (DM) Belgian Blue beef (BBB) breed, caesarean section (CS) is being applied systematically as a management tool to prevent dystocia. As a matter of fact, CS is the only possible way of calving in the breed. High birth weight and a relatively small pelvic area are the main causes of dystocia and, in the DM-BBB breed, the reasons for the systematically applied CS. Selection for lower birth weight and larger pelvic sizes might reduce dystocia and routine CS. Few data on inner pelvic sizes of pedigree animals are available. Using external measurements to estimate the inner pelvic sizes might be an option to resolve this problem. In this study, animals of the DM-BBB breed were measured and weighed on farms and in abattoirs. External and internal pelvic sizes increased with live weight and age of the animals. Gender had a significant influence on inner pelvic traits. Increased muscular conformation was associated with decreased inner pelvic dimensions. Models with weight, gender, age, withers height and outer pelvic width (TcTc) can be used to estimate inner pelvic sizes (R2 between 0•35 and 0•77). The estimated inner pelvic sizes can then be used to genetically evaluate pelvic traits in the DM-BBB breed. Improving weight, withers height and TcTc width in combination with lowering muscular conformation may help to decrease the high rate of caesarean section in the DM-BBB.
Effect of cooking wheat and maize on the performance of newly weaned pigs 1. Age and weight at weaning
Authors: Lawlor P.G. , Lynch P.B. , Caffrey P.J. , O’Doherty J.V. 
Published: May 2019

abstractThe objective of this study was to determine if weight and age at weaning affect the response of pigs to inclusion of cooked cereal in their post-weaning diet. In experiment 1, pigs (no. = 116) weaned at 17 to 28 days of age and weighing between 4 and 10 kg were individually given for 28 days post weaning, diets based on: (1) uncooked cereal or (2) cooked cereal (steamed and flaked wheat and maize). The gelatinized starch proportion was 0•265, 0•838, 0•203 and 0•745 for uncooked maize, steam flaked maize, uncooked wheat and steam flaked wheat, respectively. Pigs were offered 2•5 kg of starter diet (16•1 MJ digestible energy (DE) per kg and 17•4 g/kg of lysine). This was followed in each case by link diet (15•2 MJ DE per kg and 16•2 g/kg of lysine) to 28 days post weaning. Thereafter, pigs were grouped and given a common weaner diet and a common finisher diet to slaughter. In experiment 2, pigs (no. = 408) were weaned at between 20 and 28 days of age. Pigs were allocated by weight to heavy (7 to 8 kg), medium (6 to 7 kg) and light (5 to 6 kg) groups (24 groups of 17 pigs) and assigned to treatments as in experiment 1 for 26 days. A common weaner diet was offered between day 26 and day 56. In experiment 1, pig weight, food intake, daily gain, food conversion efficiency and carcass measurements were not affected by cooking (P > 0•05). Regression analysis indicated that weight and age at weaning had a significant association with weight at 28 days post weaning for uncooked (R2 = 0•628; P < 0•001) and cooked (R2 = 0•579; P < 0•001) cereal diets. In experiment 2, there was no interaction between weaning weight and cooking (P > 0•05) and no performance benefit resulted from cooking (P > 0•05). In conclusion, steam flaking did not improve pig performance during the treatment period or at any subsequent period.
The effect of genetic merit for milk production and concentrate feeding level on the reproductive performance of Holstein-Friesian cows in a grass-based system
Authors: Kennedy J. , Kennedy J. , Dillon P. , O’Sullivan K. , Buckley F. , Rath M. 
Published: May 2019

AbstractThe objective of the study was to evaluate the effect on reproductive performance of varying level of concentrate supplementation with both high and medium genetic merit cows in a spring calving grass-based system of milk production. The effect of year, cow genetic merit for milk production and concentrate feeding level on milk production, body condition score, live weight, blood metabolites and dry-matter (DM) intake were studied. A repeated measures model with a factorial arrangement of genetic merit and concentrate feeding level was used to do this. Associations between these variables and pregnancy to first service (PREG1), pregnancy to first and second service (PREG12) and overall pregnancy (PREG) rates were assessed using logistic regressions for year 2.Cows were grouped into high (HM) and medium (MM) genetic merit based on their pedigree indices for milk production (PD milk). The HM cows had a PD milk of + 276 (s.d. 100) kg, while the MM cows had mean PD milk of + 81 (s.d. 95) kg. Within genetic merit groupings, cows were assigned to one of three concentrate feeding levels; low (LC), 376 kg; medium (MC), 810 kg; and high (HC), 1540 kg of concentrate per cow per lactation. In year 1, all 78 cows were second lactation animals, while in year 2, 71 cows (previously in year 1) were third lactation and 12 second lactation. All cows calved between February and April, and were presented for rebreeding from late April until late July each year.When treatment means were compared, genotype and concentrate feeding levels had no significant effects on reproductive performance while year was significant for most parameters. Comparing year 2 to year 1 pregnancy rate to first service (P 0•001; 37 v. 64%), pregnancy rate to first and second service (P < 0•05; 64 v. 81%), overall pregnancy rate (P < 0•05; 78 v. 92%) were lower. Also in year 2, cows had significantly higher milk yields at first insemination (36•9 v. 32•3 kg per cow per day), greater live-weight losses from calving to first insemination (-86 v. –53 kg per cow), lower live-weight gain in the 90 days after their first insemination (+ 24•6 v. + 34•2 kg per cow), higher DM intake (20•6 v. 17•3 kg DM per cow per day) and lower plasma glucose concentrations (3•18 v. 3•61 mmol/l) than in year 1.In year 2, there were significant negative associations between the likelihood of PREG12 and both PD milk and live-weight gain in the 90 days after first insemination. The results of this study indicate that continued selection for increased milk production, resulting in greater partitioning of energy to milk production rather than body reserves will reduce reproductive performance and offering higher levels of concentrate supplementation may not alleviate this problem.