bluuebunny/crossref_metadata_2025_split huggingface dataset:
Smooth or Stepped? Laboratory Comparison of Enhanced Sonifications for Monitoring Patient Oxygen Saturation
Authors: Collett Renae , Salisbury Isaac , Loeb Robert G. , Sanderson Penelope M. 
Published: June 2019

Background: The pulse oximeter (PO) provides anesthesiologists with continuous visual and auditory information about a patient’s oxygen saturation (SpO2). However, anesthesiologists’ attention is often diverted from visual displays, and clinicians may inaccurately judge SpO2 values when relying on conventional PO auditory tones. We tested whether participants could identify SpO2 value (e.g., “97%”) better with acoustic enhancements that identified three discrete clinical ranges by either changing abruptly at two threshold values (stepped-effects) or changing incrementally with each percentage value of SpO2 (smooth-effects). Method: In all, 79 nonclinicians participated in a between-subjects experiment that compared performance of participants using the stepped-effects display with those who used the smooth-effects display. In both conditions, participants heard sequences of 72 tones whose pitch directly correlated to SpO2 value, and whose value could change incrementally. Primary outcome was percentage of responses that correctly identified the absolute SpO2 percentage, ±1, of the last pulse tone in each sequence. Results: Participants using the stepped-effects auditory tones identified absolute SpO2 percentage more accurately ( M = 53.7%) than participants using the smooth-effects tones ( M = 47.9%, p = .038). Identification of range and detection of transitions between ranges showed even stronger advantages for the stepped-effects display ( p < .005). Conclusion: The stepped-effects display has more pronounced auditory cues at SpO2 range transitions, from which participants can better infer absolute SpO2 values. Further development of a smooth-effects display for this purpose is not necessary.
Blending Human and Machine: Feasibility of Measuring Fatigue Through the Aviation Headset
Authors: Wilson Nicholas , Guragain Bijay , Verma Ajay , Archer Lewis , Tavakolian Kouhyar 
Published: June 2019

Objective To determine viability of drowsiness detection, researchers study the feasibility of photoplethysmogram (PPG) data collection from the geography of the aviation headset, correlating to electrocardiogram (ECG) reference. Background Fatigue has been a probable cause, contributing factor, or a finding in 20% of transportation incidents and accidents studied between January 2001 and December 2012. This operational hazard is particularly troublesome within aviation and airline operations. Method PPG and ECG data were collected synchronously from Federal Aviation Administration (FAA) commercially rated pilots during flight simulation in the window of circadian low (WOCL). Valid PPG and ECG data from 14 participants were analyzed, which yielded approximately 2 hr of data per participant for fatigue-related analysis. Results The results of the study demonstrate clear trends toward decreased heart rate for both ECG and PPG and suggest progression of drowsiness between four separate periods (T1, T2, T3, and T4) selected during the study; however, the mean heart rate change from T1 to T4 was statistically significant. Conclusion The results suggest that ECG and PPG data can be an important tool to observe conditions where drowsiness or fatigue may add risk to the operation. In addition, the data show high correlation between ECG and PPG data, further suggesting that a simpler PPG sensor, mounted within the geography of the aviation headset, may streamline the operationalization of important physiological data. Application Incorporation of PPG sensors and associated signal processing methods into facilitating equipment, such as the aviation headset, may add a layer to operational safety.
Now You Feel It, Now You Don’t: The Effect of Movement, Cue Complexity, and Body Location on Tactile Change Detection
Authors: Gomes Kylie , Betza Scott , Riggs Sara Lu 
Published: June 2019

Objective To evaluate the effects that movement, cue complexity, and the location of tactile displays on the body have on tactile change detection. Background Tactile displays have been demonstrated as a means to address data overload by offloading the visual and auditory modalities. However, change blindness—the failure to detect changes in a stimulus when changes coincide with another event or disruption in stimulus continuity—has been demonstrated to affect the tactile modality and may be exacerbated during movement. The complexity of tactile cues and locations of tactile displays on the body may also affect the detection of changes in tactile patterns. Limitations to tactile perception need to be examined. Method Twenty-four participants performed a tactile change detection task while sitting, standing, and walking. Tactile cues varied in complexity and included low, medium, and high complexity cues presented to the arm or back. Results Movement adversely affects tactile change detection as hit rates were the highest while sitting, followed by standing and walking. Cue complexity affected tactile change detection: Low complexity cues resulted in higher detection rates compared with medium and high complexity cues. The arms exhibited better change detection performance than the back. Conclusion The design of tactile displays should consider the effect of movement. Cue complexity should be minimized and decisions about the location of a tactile display should take into account body movements to support tactile perception. Application The findings can provide design guidelines to inform tactile display design for data-rich, complex domains.
Potential of modified puncture method to decrease intravenous indwelling needle-related complications in inpatients with cardiovascular disease
Authors: Liu Yingying , Liu Meili , Han Dan , Xiao Ling , Wu Jine 
Published: June 2019

Objective This study was performed to investigate the potential of a modified puncture method to decrease the incidence of intravenous indwelling needle-related complications in inpatients with cardiovascular disease. Methods From February 2017 to July 2017, 436 consecutive inpatients with cardiovascular disease requiring infusion treatment were recruited and randomly divided into the control group and the treatment group. The standard infusion puncture method was applied in the control group, and a modified puncture method was applied in the treatment group. The incidence of complications and necessary positional adjustments of the intravenous indwelling needle in the two groups were observed. Results The incidence of necessary positional adjustments of the intravenous indwelling needle was significantly lower in the treatment group than control group (16.5% versus 5.0%, respectively). The incidences of redness at the puncture point and oozing of blood or fluid at the puncture point were also significantly lower in the treatment group than control group (18.6% versus 4.5% and 12.7% versus 5.5%, respectively). Conclusions The modified puncture method for intravenous indwelling needles can significantly decrease the incidence of complications and positional adjustments during application, which relieves patients’ pain and lightens nurses’ workload.
A phase II study of the combination of docetaxel and bevacizumab for previously treated non-small cell lung cancer
Authors: Shimizu Tetsuo , Nakagawa Yoshiko , Asai Yasuo , Tsujino Ichirou , Takahashi Noriaki , Gon Yasuhiro 
Published: June 2019

Objective The standard therapies for previously treated advanced non-small cell lung cancer (NSCLC) include docetaxel (DOC). Bevacizumab (BV), an antivascular endothelial growth factor (VEGF) antibody, increases the antitumor effect of cytotoxic anticancer agents. A BV-containing combination regimen is recommended as the primary therapy for advanced non-squamous NSCLC. However, the efficacy of DOC + BV is unknown in patients with previously treated advanced NSCLC. We conducted a phase II clinical study of DOC + BV for patients with previously treated advanced non-squamous NSCLC. Methods Twenty-three patients were enrolled in this study from June 2011 through May 2014. Chemotherapy was repeated every 21 days unless there was evidence of disease progression or intolerance to the study treatment. We assessed efficacy and toxicity. Results The median progression-free survival was 30.7 weeks. The response rate was 47.8%. The most common grade ≥3 adverse events were neutropenia (20 patients, 87.0%) and febrile neutropenia (7 patients, 30.4%). Conclusions The combination of DOC and BV often resulted in serious neutropenia, suggesting that this regimen is difficult to tolerate.
The association of self-reported respiratory system diseases with farming activity among farmers of greenhouse vegetables
Authors: Li Jiangping , Li Yanxia , Tian Danian , Yang Huifang , Dong Lijun , Zhu Lingqin 
Published: June 2019

Objectives Several studies have investigated the link between agricultural activities of open-field farmers and the prevalence of respiratory diseases, but the relationship with greenhouse vegetable farmers remains unclear. Methods A total of 1,366 participants from four villages in China provided information about their agricultural activities and symptoms of diagnosed respiratory system diseases. The Poisson regression model and zero-inflated Poisson regression model were used to assess the association between diseases, symptoms, and agricultural activities. Results The prevalence of respiratory diseases was 3.59%, and the rates of four main symptoms (cough, tachypnea, chest distress, and hemoptysis) were 17.21%, 8.56%, 10.25%, and 1.61%, respectively. Mix spray of pesticides associated with cough, tachypnea and chest distress, 1.740-, 3.385- and 2.882-fold likelihood were found than hand spray, and the significant association were detected in empty, general information, life-style information adjusted models. Conclusions The relationship between agricultural activities and respiratory diseases is unclear. However, use of the mix spray method of pesticide application may increase the risk of cough, tachypnea, and chest distress.
Differential efficacy of non-invasive vagus nerve stimulation for the acute treatment of episodic and chronic cluster headache: A meta-analysis
Authors: de Coo Ilse F , Marin Juana CA , Silberstein Stephen D , Friedman Deborah I , Gaul Charly , McClure Candace K , Tyagi Alok , Liebler Eric , Tepper Stewart J , Ferrari Michel D , Goadsby Peter J 
Published: June 2019

Background Two randomized, double-blind, sham-controlled trials (ACT1, ACT2) evaluated non-invasive vagus nerve stimulation (nVNS) as acute treatment for cluster headache. We analyzed pooled ACT1/ACT2 data to increase statistical power and gain insight into the differential efficacy of nVNS in episodic and chronic cluster headache. Methods Data extracted from ACT1 and ACT2 were pooled using a fixed-effects model. Main outcome measures were the primary endpoints of each study. This was the proportion of participants whose first treated attack improved from moderate (2), severe (3), or very severe (4) pain intensity to mild (1) or nil (0) for ACT1 and the proportion of treated attacks whose pain intensity improved from 2–4 to 0 for ACT2. Results The pooled population included 225 participants (episodic: n = 112; chronic: n = 113) from ACT1 (n = 133) and ACT2 (n = 92) in the nVNS (n = 108) and sham (n = 117) groups. Interaction was shown between treatment group and cluster headache subtype ( p < 0.05). nVNS was superior to sham in episodic but not chronic cluster headache (both endpoints p < 0.01). Only four patients discontinued the studies due to adverse events. Conclusions nVNS is a well-tolerated and effective acute treatment for episodic cluster headache. Trial registration The studies were registered at clinicaltrials.gov (ACT1: NCT01792817; ACT2: NCT01958125).
Field-testing the Euro-MCD Instrument: Experienced outcomes of moral case deliberation
Authors: de Snoo-Trimp Janine C , Molewijk Bert , Ursin Gøril , Brinchmann Berit Støre , Widdershoven Guy AM , de Vet Henrica CW , Svantesson Mia 
Published: June 2019

Background: Moral case deliberation is a form of clinical ethics support to help healthcare professionals in dealing with ethically difficult situations. There is a lack of evidence about what outcomes healthcare professionals experience in daily practice after moral case deliberations. The Euro-MCD Instrument was developed to measure outcomes, based on the literature, a Delphi panel, and content validity testing. To examine relevance of items and adequateness of domains, a field study is needed. Aim: To describe experienced outcomes after participating in a series of moral case deliberations, both during sessions and in daily practice, and to explore correlations between items to further validate the Euro-MCD Instrument. Methods: In Sweden, the Netherlands, and Norway, healthcare institutions that planned a series of moral case deliberations were invited. Closed responses were quantitatively analyzed. The factor structure of the instrument was tested using exploratory factor analyses. Ethical considerations: The study was approved in Sweden by a review board. In Norway and the Netherlands, data services and review boards were informed about the study. Results: The Euro-MCD Instrument was completed by 443 and 247 healthcare professionals after four and eight moral case deliberations, respectively. They experienced especially outcomes related to a better collaboration with co-workers and outcomes about individual moral reflexivity and attitude, both during sessions and in daily practice. Outcomes were experienced to a higher extent during sessions than in daily practice. The factor structure revealed four domains of outcomes, which did not confirm the six Euro-MCD domains. Conclusion: Field-testing the Euro-MCD Instrument showed the most frequently experienced outcomes and which outcomes correlated with each other. When revising the instrument, domains should be reconsidered, combined with theory about underlying concepts. In the future, a feasible and valid instrument will be presented to get insight into how moral case deliberation supports and improves healthcare.
Is it time to include people with intellectual disabilities in Royal Australian and New Zealand College of Psychiatrists’ treatment guidelines?
Authors: Hill Harry 
Published: June 2019

Objective: The Royal Australian and New Zealand College of Psychiatrists’ (RANZCP) treatment guidelines set the zeitgeist for psychiatric practice in Australasia. This review conceptualises the current approach to treatment of individuals with an intellectual disability and co-occurring mental illness in RANZCP guidelines, and its potential impact. Conclusions: The enduring omission of people with an intellectual disability and co-occurring mental illness from RANZCP clinical guidelines is a missed opportunity in normalising care and optimising outcomes for people with an intellectual disability. There are substantial cultural, political and historical overlays contributing to the ongoing divide between health and disability. In developing psychiatric guidelines, authors should consider including people with co-occurring intellectual disability as a specific population, that requires distinctive consideration.
The impact of substance use on treatment as a compulsory patient
Authors: Vine Ruth , Tibble Holly , Pirkis Jane , Spittal Matthew , Judd Fiona 
Published: June 2019

Objectives:This paper considers the impact of having a diagnosis of substance use disorder on the utilisation of compulsory orders under the Victorian Mental Health Act (2014).Methods:We analysed the subsequent treatment episodes over 2 years of people who had been on a community treatment order for at least 3 months and determined the odds of a further treatment order if there was a diagnosis of substance use at or about the time the index community treatment order ended.Results:An additional diagnosis of a substance use disorder was coded in 47.7% and was associated with significantly increased odds of a subsequent treatment order in the following 2 years for those with a main diagnosis of schizophrenia (AOR = 3.03, p<0.001) and ‘other’ disorders (AOR = 11.60, p=0.002). Those with a main diagnosis of mood disorder had a significant increase in odds for an inpatient treatment order if there was an additional substance use disorder diagnosis (AOR = 3.81, p=0.006).Conclusions:Having an additional diagnosis of substance use disorder was associated with increased likelihood of being placed on an order. This study supports greater emphasis being given to treatment of substance use concurrently with that of mental illness.
A comparative study of lens management in the United Kingdom and India with regard to rhegmatogenous retinal detachment surgery
Authors: Brent Alexander J , Bedi Sahiba , Wakefield Matthew , Banerjee Somnath 
Published: June 2019

Introduction: Lens management in phakic patients with rhegmatogenous retinal detachments undergoing para plana vitrectomy surgery remains controversial among vitreoretinal surgeons. When combined phacovitrectomy is performed, the biometry decisions can be challenging both in the face of macula-off rhegmatogenous retinal detachments and previous refractive surgery. This study analyses current trends in practise. Methods: A scenario-related survey was sent to all members of the British and Eire Association of Vitreoretinal Surgeons and to vitreoretinal surgeons in the northern Indian state of Punjab. Results: In post-laser-assisted in situ keratomileusis patients with a visually significant cataract and a macula-on rhegmatogenous retinal detachment, the majority of British and Eire Association of Vitreoretinal Surgeons members (67.3%) and surgeons in Punjab (91.4%) would perform a stand-alone para plana vitrectomy and defer cataract surgery. When a combined phacovitrectomy is performed in this scenario, the majority of British and Eire Association of Vitreoretinal Surgeons (68%) would implant an intraocular lens (using either Haigis-L or European Society of Cataract and Refractive Surgeons/American Society of Cataract and Refractive Surgeons calculators), whereas the majority of Punjab surgeons (79.3%) would leave the patient aphakic. In a patient with a cataract and macula-off rhegmatogenous retinal detachment undergoing combined phacovitrectomy surgery, without any previous refractive surgery, the majority of British and Eire Association of Vitreoretinal Surgeons members (47.3%) would use the opposite eye biometry, whereas most Punjab surgeons (62.7%) would leave the patient aphakic. Discussion: Vitreoretinal surgeons in both the United Kingdom and Punjab predominantly avoid combined surgery in rhegmatogenous retinal detachment cases, even when faced with a visually significant cataract. When combined phacovitrectomy is performed, most vitreoretinal surgeons preference using the opposite eye biometry for macula-off cases and Haigis-L (myope) or online calculators for post-laser-assisted in situ keratomileusis cases.
Undersizing the Exeter stem in hip hemiarthroplasty increases the risk of periprosthetic fracture
Authors: Korsnes Lars , Gottvall Andreas , Buttazzoni Christian , Mints Michael 
Published: June 2019

Introduction: Whether under- or oversizing of the femoral component of cemented hip hemiarthroplasties impacts the risk of periprosthetic fractures (PPF) has only been examined experimentally. This study was carried out to add more knowledge about the risks of PPF in cemented polished tapered hemiarthroplasties. Methods: 20 patients with PPF following hip hemiarthroplasty with cemented Exeter V40 stems were compared to 50 controls who never suffered PPF having received the same type of Exeter hemiprosthesis for the same indication. The difference between stem size and post-hoc radiographic ideal templated size was investigated as a predictor of PPF. Results: Cases had a median size difference to post-hoc templating of –2, while controls had a median size difference of –1 ( p = 0.09). An ROC curve constructed to find an optimal cutoff point in size difference between cases and controls arrived at an area under curve of 63%, with –1.5 as the cutoff. Patients with size differences exceeding –1.5 had a statistically significant increased PPF risk (odds ratio = 3.8, 95% confidence interval, 1.1–13.3, p < 0.05). This group covered 55% of all cases. Conclusion: An implanted femoral component that is 2 or more sizes smaller than the template that is shown to be appropriate will increase the risk of PPF in Exeter hip hemiarthroplasties.
Peripherally inserted central catheter–related thrombosis rate in modern vascular access era—when insertion technique matters: A systematic review and meta-analysis
Authors: Balsorano Paolo , Virgili Gianni , Villa Gianluca , Pittiruti Mauro , Romagnoli Stefano , De Gaudio Angelo Raffaele , Pinelli Fulvio 
Published: June 2019

Background: Technical factors at the moment of catheter insertion might have a role in peripherally inserted central catheter–related thrombotic risk. We performed a systematic review and meta-analysis to define the actual rate of peripherally inserted central catheter–related symptomatic deep vein thrombosis in patients in whom catheter insertion was performed according to ultrasound guidance, appropriate catheter size choice, and proper verification of tip location. Methods: We searched Medline, Embase, and Cochrane Library. Only prospective observational studies published in peer-reviewed journals after 2010 up to November 2018 reporting peripherally inserted central catheter–related deep vein thrombosis rate were included. All studies were of adult patients who underwent peripherally inserted central catheter insertion. Results were restricted to those studies which included in their methods ultrasound guidance for venipuncture, catheter tip location, and a catheter size selection strategy. Random-effect meta-analyses and arcsine transformation for binomial data were performed to pool deep vein thrombosis weighted frequencies. Results: Of the 1441 studies identified, 15 studies involving 5420 patients and 5914 peripherally inserted central catheters fulfilled our inclusion criteria. The weighted frequency of peripherally inserted central catheter–related deep vein thrombosis was 2.4% (95% confidence interval = 1.5–3.3) and remained low in oncologic patients (2.2%, 95% confidence interval = 0.6–3.9). Thrombotic rate was higher in onco-hematologic patients (5.9%, 95% confidence interval = 1.2–10). Considerable heterogeneity (I2 = 74.9) was observed and all studies were considered at high risk of attrition bias. Conclusions: A proper technique is crucial at the moment of peripherally inserted central catheter insertion. Peripherally inserted central catheter–related deep vein thrombosis rate appears to be low when evidence-based technical factors are taken into consideration during the insertion procedure.