bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perioperative nursing: maintaining momentum and staying safe
Authors: McGarry Jon R , Pope Catherine , Green Sue M 
Published: December 2018

Background: Perioperative practice underpins one of the key activities of many healthcare services, but the work of perioperative nurses is little known. A better understanding of their work is important to enable articulation of their contribution to clinical practice. Aim: This study observed the practice of perioperative nurses and explored how they described their role. Methods: Using ethnographic observation and interview, 85 hours’ observation of 11 nurses were undertaken, and 8 nurses were interviewed. Results: Thematic analysis was undertaken enabling themes to emerge with two being identified. The first, ‘maintaining momentum’, described the need to keep people and equipment moving. The second, ‘accounting for safety’, referred to the need to keep the patient safe during this dangerous period. Tension between these two phenomena was apparent. Conclusions: Perioperative nurses describe one of their key roles as maintaining the momentum of the patient’s journey through the operating theatre, but having to balance this with the need to ensure the patient’s safety. A core component of the perioperative nurse’s work is thus management of the tension between these two elements. This study illuminated how these nurses understand their practice.
A Comparative Study of the Reverse Sural Fascio-Cutaneous Flap Outcomes in the Management of Foot and Ankle Soft Tissue Defects in Diabetic and Trauma Patients
Authors: Assi Chahine , Samaha Camille , Chamoun Moussa Moussa , Hayek Tony , Yammine Kaissar 
Published: December 2018

Introduction. Soft tissue defects in the distal leg and foot are challenging conditions for reconstruction. The widely used reverse sural fascio-cutaneous flap (RSFCF) has been reported with large variation in complication frequency. Some authors reported higher complications in the diabetic population when compared with trauma patients. We compared the reliability of the RSFCF in treating such defects among both populations. Methods. This is a retrospective series with a prospective data collection of 24 patients (11 with type 2 diabetes and 13 in trauma settings) treated with an ipsilateral RSFCF for soft tissue defects of the distal leg and the rear foot. Healing events and complications were recorded and compared for both groups. The mean follow-up was 32 months. Results. Diabetic group versus trauma group showed the following results; mean flap healing time of 24 versus 22 days, donor site healing time of 14 versus 16 days, 1 total flap necrosis in both groups, 3 versus 2 cases of skin edge necrosis, 2 cases of temporary venous congestion in both groups, and 8 versus 10 cases of transient hypoesthesia of the lateral border of the foot. No infection was encountered in both groups and no recurrence of infection in the primary infected diabetic patients. Conclusions. We found the RSFCF to be useful, reproducible, and reliable in treating soft tissue defects with a very low frequency of serious complications. Diabetic patients were found to have similar outcomes when compared with trauma patients. Therefore, diabetes might not be a major factor of flap failure. Levels of Evidence: Level III: Therapeutic
Validation of a Simple Tool for Electronic Documentation of Behavioral Responses to Anesthesia Induction
Authors: Winterberg Abby V. , Ding Lili , Hill Lauren M. , Stubbeman Bobbie L. , Varughese Anna M. 
Published: December 2018

BACKGROUND:
Anxiety and distress behaviors during anesthesia induction are associated with negative postoperative outcomes for pediatric patients. Documenting behavioral responses to induction is useful to evaluate induction quality at hospitals and to optimize future anesthetics for returning patients, but we lack a simple tool for clinical documentation. The Induction Compliance Checklist is a tool for grading induction behaviors that is well validated for research purposes, but it is not practical for routine documentation in busy clinical practice settings. The Child Induction Behavioral Assessment tool was developed to provide a simple and easy to use electronic tool for clinical documentation of induction behaviors. The aim of this study was to test the Child Induction Behavioral Assessment tool’s concurrent validity with the Induction Compliance Checklist and the interrater reliability.

METHODS:
This prospective, observational study included 384 pediatric patients undergoing anesthesia inhalation induction. Concurrent validity with the Induction Compliance Checklist and interrater reliability of the Child Induction Behavioral Assessment were evaluated. Two researchers alternated scoring the Induction Compliance Checklist. The 2 researchers independently scored the Child Induction Behavioral Assessment. The anesthesia clinician caring for the patient also independently scored the Child Induction Behavioral Assessment by completing their routine documentation in the patient’s medical record. Two age groups were evaluated (ages 1–3 and 4–12 years old).

RESULTS:
Clinicians’ and researchers’ Child Induction Behavioral Assessment scores demonstrated a strong correlation with the Induction Compliance Checklist (P < .0001). There was an excellent agreement between the 2 researchers’ Child Induction Behavioral Assessment scores for the younger and older age groups, respectively (Kappa [95% CI] = 0.97 (0.94–0.99); K = 0.94 (0.89–0.99)]. The agreement between the researchers and the 117 clinicians who documented Child Induction Behavioral Assessment assessments in the medical record was good overall (intraclass correlation coefficient = 0.70), with fair agreement with the 1- to 3-year-old patients (intraclass correlation coefficient = 0.56) and good agreement for the 4- to 12-year-old patients (intraclass correlation coefficient = 0.74).

CONCLUSIONS:
The Child Induction Behavioral Assessment scale is a simple and practical electronic tool used to document pediatric behavioral responses to anesthesia inductions. This study provides evidence of the tool’s validity and reliability for inhalation inductions. Future research is needed at other hospitals to confirm validity.
Association of Preoperative Serum Chloride Levels With Mortality and Morbidity After Noncardiac Surgery: A Retrospective Cohort Study
Authors: Oh Tak Kyu , Do Sang-Hwan , Jeon Young-Tae , Kim Jinhee , Na Hyo-Seok , Hwang Jung-Won 
Published: December 2018

BACKGROUND:
Postoperative hyperchloremia is known to be related to increases in mortality and morbidity after surgery. However, the relationship between preoperative hyperchloremia and hypochloremia and postoperative mortality and morbidity is not well established. Our aim was to evaluate the relationship between preoperative hyperchloremia or hypochloremia, as assessed using preoperative serum chloride tests, and 90-day mortality and morbidity after noncardiac surgery.

METHODS:
In this retrospective cohort study, we reviewed the medical records of patients >20 years of age who underwent noncardiac surgery between January 2010 and December 2016. Patients were categorized into one of the following groups on the basis of the results of serum chloride testing performed within 1 month before surgery: normochloremia, 97–110 mmol·L−1; hyperchloremia, >110 mmol·L−1; and hypochloremia, <97 mmol·L−1. The primary end point of this study was the difference in postoperative 90-day mortality among the preoperative serum chloride groups. The secondary end point was the difference in postoperative acute kidney injury incidence among the preoperative serum chloride groups.

RESULTS:
A total of 106,505 patients were included in the final analysis (2147 were allocated to the preoperative hypochloremia group and 617 to the hyperchloremia group). Multivariable Cox regression analysis revealed significantly increased 90-day mortality in the hypochloremia (hazard ratio, 1.46; 95% CI, 1.16–1.84; P = .001) and hyperchloremia (hazard ratio, 1.76; 95% CI, 1.13–2.73; P = .013) groups when compared with the normochloremia group. In addition, multivariable logistic regression analysis revealed a 1.83-fold increased odds of acute kidney injury in the preoperative hypochloremia group when compared with the normochloremia group (odds ratio, 1.83; 95% CI, 1.53–2.19; P < .001).

CONCLUSIONS:
Preoperative hypochloremia and hyperchloremia were related to increased 90-day mortality after noncardiac surgery. In addition, preoperative hypochloremia was related to an increased risk for postoperative acute kidney injury.
Weeding Out the Problem: The Impact of Preoperative Cannabinoid Use on Pain in the Perioperative Period
Authors: Liu Christopher W. , Bhatia Anuj , Buzon-Tan Arlene , Walker Susan , Ilangomaran Dharini , Kara Jamal , Venkatraghavan Lakshmikumar , Prabhu Atul J. 
Published: December 2018

BACKGROUND:
The recreational and medical use of cannabinoids has been increasing. While most studies and reviews have focused on the role of cannabinoids in the management of acute pain, no study has examined the postoperative outcomes of surgical candidates who are on cannabinoids preoperatively. This retrospective cohort study examined the impact of preoperative cannabinoid use on postoperative pain scores and pain-related outcomes in patients undergoing major orthopedic surgery.

METHODS:
Outcomes of patients who had major orthopedic surgery at our hospital between April 1, 2015 and June 30, 2017 were reviewed. Data were obtained from Networked Online Processing of Acute Pain Information, a locally developed database for our Acute Pain Service. Propensity score matching was used to balance baselines variables including age, sex, type of surgery, history of depression or anxiety, and perioperative use of regional anesthesia between patients who reported use of cannabinoids and those not on this substance. Intensity of pain with movement in the early postoperative period (defined as up to 36 hours after surgery) was the primary outcome of this study. The secondary outcomes (all in early postoperative period) were pain at rest, opioid consumption, incidence of pruritus, nausea and vomiting, sedation, delirium, constipation, impairment of sleep and physical activity, patient satisfaction with analgesia, and the length of Acute Pain Service follow-up.

RESULTS:
A total of 3793 patients were included in the study. Of these, 155 patients were identified as being on cannabinoids for recreational or medical indications in the preoperative period. After propensity score matching, we compared data from 155 patients who were on cannabinoids and 155 patients who were not on cannabinoids. Patients who were on preoperative cannabinoids had higher pain numerical rating score (median [25th, 75th percentiles]) at rest (5.0 [3.0, 6.1] vs 3.0 [2.0, 5.5], P = .010) and with movement (8.0 [6.0, 9.0] vs 7.0 [3.5, 8.5], P = .003), and a higher incidence of moderate-to-severe pain at rest (62.3% vs 45.5%, respectively, P = .004; odds ratio, 1.98; 95% CI, 1.25–3.14) and with movement (85.7% vs 75.2% respectively, P = .021; odds ratio, 1.98; 95% CI, 1.10–3.57) in the early postoperative period compared to patients who were not on cannabinoids. There was also a higher incidence of sleep interruption in the early postoperative period for patients who used cannabinoids.

CONCLUSIONS:
This retrospective study with propensity-matched cohorts showed that cannabinoid use was associated with higher pain scores and a poorer quality of sleep in the early postoperative period in patients undergoing major orthopedic surgery.
Physical Activity Is Associated with Attenuated Disease Progression in Chronic Obstructive Pulmonary Disease
Authors: DEMEYER HELEEN , DONAIRE-GONZALEZ DAVID , GIMENO-SANTOS ELENA , RAMON MARIA A. , DE BATTLE JORDI , BENET MARTA , SERRA IGNASI , GUERRA STEFANO , FARRERO EVA , RODRIGUEZ ESTHER , FERRER JAUME , SAULEDA JAUME , MONSO EDUARD , GEA JOAQUIM , RODRIGUEZ-ROISIN ROBERTO , AGUSTI ALVAR , ANTÓ JOSEP M. , GARCIA-AYMERICH JUDITH 
Published: December 2018

ABSTRACT

Introduction
Chronic obstructive pulmonary disease (COPD) progression is variable and affects several disease domains, including decline in lung function, exercise capacity, muscle strength, and health status as well as changes in body composition. We aimed to assess the longitudinal association of physical activity (PA) with these a priori selected components of disease progression.

Methods
We studied 114 COPD patients from the PAC-COPD cohort (94% male, mean [SD], 70 yr [8 yr] of age, 54 [16] forced expiratory volume in 1 s % predicted) at baseline and 2.6 yr (0.6 yr) later. Baseline PA was assessed by accelerometry. Multivariable general linear models were built to assess the association between PA and changes in lung function, functional exercise capacity, muscle strength, health status, and body composition. All models were adjusted for confounders and the respective baseline value of each measure.

Results
Per each 1000 steps higher baseline PA, forced expiratory volume in 1 s declined 7 mL less (P < 0.01), forced vital capacity 9 mL less (P = 0.03) and carbon monoxide diffusing capacity 0.10 mL·min−1·mm Hg−1 less (P = 0.04), while the St George’s Respiratory Questionnaire symptom domain deteriorated 0.4 points less (P = 0.03), per year follow-up. Physical activity was not associated with changes in functional exercise capacity, muscle strength, other domains of health status or body composition.

Conclusions
Higher PA is associated with attenuated decline in lung function and reduced health status (symptoms domain) deterioration in moderate-to-very severe COPD patients.
Cerebral oximetry monitoring in OHCA
Authors: Burrell Lisa , Rice Alan 
Published: December 2018

Background: Cerebral oximetry allows non-invasive, real-time monitoring information of cerebral blood flow. It has recently been used to provide information about cerebral perfusion during resuscitation efforts in cases of cardiac arrest and may give an indication of neurological survival. Most of this information has been obtained during the hospital phase of treatment and little is known about cerebral flow in the prehospital phase. Methods: A systematic review was carried out, with the PubMed and EMBASE databases searched to identify clinical trials where cerebral oximetry monitoring was performed in the prehospital phase of out-of-hospital cardiac arrest. It aimed specifically to answer the following questions: is cerebral oximetry monitoring feasible in the prehospital environment? Can cerebral oximetry be used as a useful marker of the quality of cardiopulmonary resuscitation in the prehospital setting? Can cerebral oximetry be used to assist decisions around prognostication and futility for out-of-hospital cardiac arrest? Results: Five studies were identified for review. Feasibility was demonstrated in four of these. The usefulness of cerebral oximetry in monitoring cardiopulmonary resuscitation has not been well explored in out-of-hospital cardiac arrest. Similarly, data linking intra-arrest cerebral oximetry values and prognosis in out-of-hospital cardiac arrest is sparse. Conclusions: Cerebral oximetry is feasible in out-of-hospital cardiac arrest but its usefulness in guiding resuscitation attempts in this environment remains largely unknown.
Reformationsjubiläum 2017. Rückblick, Ernte und neue Herausforderungen
Authors: Käßmann Margot 
Published: December 2018

Abstract
This contribution offers a retrospective on the events of the year 2017 in Germany from the perspective of the Special Envoy for the Reformation Anniversary (of the EKD). It highlights individual climaxes such as the Kirchentag or the World Exhibition of the Reformation in Wittenberg and appreciates the spirit of ecumenical openness and the global horizon of the celebrations. It also discusses some challenges for present-day Christianity, namely preaching in an environment that is both secular and multi-religious. According to the author, it will be decisive to keep the impact of the anniversary alive in the local church communities beyond the year 2017.
Theologie des Kreuzes aus evangelischer Perspektive in ökumenischer Absicht
Authors: Oberdorfer Bernd 
Published: December 2018

Abstract
In September 2017, the feast of the Exaltation of the Holy Cross in Trier was celebrated ecu­menically. It is within this context that this contribution discusses central traits of Luther’s theology of the cross based on the 1518 Heidelberg Disputation and the 1519 Sermon on Preparing to Die (Sermon von der Bereitung zum Sterben). It then identifies important conse­quences of Luther’s focus on the cross in Christology, his understanding of the Lord’s Supper, and in ethics, and draws reception-historical lines to modern Lutheranism. At the end, consi­derations as to the ecumenical relevance of the theology of the cross are presented.
»… außer denen, die glauben und gute Werke tun …« – Eine Interpretation der Sure al-ʿAsr, Der Nachmittag
Authors: Paulus Christiane , Mosleh Abdalrahman 
Published: December 2018

Abstract
This essay relates the Lutheran idea of the inner coherence of faith and good works to the central surah of the Qur’an, al-‘Asr, which addresses faith and doing good works as well. By means of different interpreters of the Qur’an, especially Faḫr ad-Dīn ar-Razīs and Muḥammad ʿAbduh’s commentaries, the semantic space of this small surah is illuminated: Due to the ambivalence of practice, faith and good works always need to be accompanied by self-critical, interpersonal communication-reminiscent of old Arabic afternoon balancing discussions.
Ein griechischer Papyrus-Codex der Chronikbücher (Ra 880, P.Sinai Gr. 1, ineditum)
Authors: Albrecht Felix 
Published: December 2018

Abstract
The following article presents a preliminary edition of the hitherto unedited and mostly unknown fragments of Papyrus Sinai Gr. 1 (St. Catherine’s Monastery, Mount Sinai), which formed a Greek Codex of the Septuagint books of 1-2Chronicles written on Papyrus (Ms. Rahlfs 880).
Fasce di lana in un papiro latino (P.Masada 723 riedito)
Authors: Bernini Andrea 
Published: December 2018

Abstract
P.Masada 723 is an important source on medical practice within the Roman army. A revision of the text shows the use of woollen bandages for the wounded, and gives us a better understanding of the section referring to the sick. A palaeographical reconsideration of the document proves it to be an example of duplex manus, the phenomenon by which different graphical levels correspond to different textual sections.
Un exemple de lettre adressée à un soufi de Damas au XIIe siècle
Authors: Mouton Jean-Michel , Sourdel Dominique , Sourdel-Thomine Janine 
Published: December 2018

Abstract
The letter published here was probably written during the reign of the Zankid Prince Nūr al-Dīn (1154-1174). It reveals the existence of close links between the ascetic communities of Syria and Iraq, but also between the various Sufi institutions in Damascus flourishing in the city at that time. The main figures of the letter, largely ignored from medieval sources, appear as charismatic characters who testify to the attraction then exerted by mystical circles on the Syrian population.
Diagnostics 4.0: the medical laboratory in digital health
Authors: Neumaier Michael 
Published: December 2018

AbstractDuring recent years, the digital revolution has changed the face of societies including industrial production, economies and peoples’ social lives. From these changes we may extrapolate the developments that digitization of health care will bring to medicine in general and laboratory medicine in particular. Disruptive technologies will fundamentally change the way laboratory tests are going to be ordered, carried out and interpreted in the future, and test results from various sources need to be curated to be of added value for the patient’s condition. Wearables and implantables will quantify the concentrations for an unknown number of laboratory parameters, and the data will be stored in cloud services at the fingertips of the patient as the sovereign of his/her health care data. A 24/7 online availability of health services will strengthen predictive medicine and may enable a vastly improved preventive health care that is supported by deep-learning algorithms for clinical decision-making not only on behalf of the physician, but also the empowered patient (e.g. health bots). This will likely shift the current role of Laboratory Medicine as a central provider of diagnostic information from a “hidden champion” towards a higher visibility redefining the patient-physician-laboratory relationship. For example, accessing digital health data will allow Laboratory Medicine to more efficiently contribute to the medical dialog than is often the case today. From this perspective, this will require major readjustments in the way we execute our profession, and it will also need new concepts of education and continuous professional development.
A transient finding of fetal head entrapment caught in a uterine synechium or amniotic band
Authors: Rives Edward , Denney Jeff M. , Brost Brian C. 
Published: December 2018

Abstract

Background
Uterine synechia are bands of fibrous tissue that when seen on prenatal ultrasound are not felt to pose significant risk to a fetus outside of early pregnancy loss. On the contrary, amniotic bands are diagnosed when bands of amniotic tissue are found to entrap and possible amputate involved fetal parts.

Case presentation
Ultrasound imaging demonstrated a twin pregnancy affected by entrapment of twin B’s head in a uterine synechium versus an amniotic band at 11 weeks + 0 days. The entrapment persisted until the second trimester. After a review of still images and video clips with a fetal surgeon, the patient was scheduled for possible fetal surgery. Upon arrival at 16 weeks + 0 days, the entrapment was observed to have spontaneously resolved. The patient experienced preterm premature rupture of membranes at 17 weeks + 6 days, and developed chorioamnionitis at 18 weeks + 5 days. Shortly after diagnosis with chorioamnionitis, she delivered spontaneously at 18 weeks + 5 days. Postnatal hysteroscopy demonstrated uterine synechium at the uterine fundus, which was resected.

Conclusions
This is the first case of fetal head entrapment by a uterine synechium.
The pragmatics of Spanish postposed wh-interrogatives
Authors: Rosemeyer Malte 
Published: December 2018

AbstractThis study analyzes the pragmatics of in-situwh-and complex barewh-interrogatives such as¿de qué?‘of what?’ in spoken Spanish, developing a typology of their discourse functions. The interpretation of such postposedwh-interrogatives depends on inference processes by the hearer that take as cues both the degree to which the interrogative proposition and the referent of the interrogative pronoun/adverb are cognitively accessible. This relationship follows from the fact that on the basis of the combination of the information states of the interlocutors (i.e. the degree of accessibility of the proposition and the referent ofwh) with the information structure of this type ofwh-interrogatives, the utterer of thewh-interrogative can predict the pragmatic effect of a given postposedwh-interrogative token in the hearer. I establish a hierarchy of the different discourse functions on the basis of their potential to change the current ‘Question under Discussion’ (QuD). In particular, the analysis demonstrates that postposedwh-interrogatives that realize or imply a challenge to a previous utterance by the addressee of the interrogative have weaker pragmatic conditions than other uses. Consequently, I theorize that these uses are crucial for our understanding of the expansion of the use of in-situwh-interrogatives in languages such as French and Brazilian Portuguese.