bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long‐term outcome after stifle arthroscopy in 82 Western performance horses (2003–2010)
Authors: McCoy Annette M. , Smith Rebecca L. , Herrera Stephanie , Kawcak Christopher E. , McIlwraith C. Wayne , Goodrich Laurie R. 
Published: June 2019

AbstractObjectiveTo report the outcome of horses engaged in Western performance disciplines after stifle arthroscopy and identify prognostic factors for return to performance.Study designRetrospective case series.Sample populationEighty‐two Western performance horses undergoing stifle arthroscopy.MethodsMedical records were reviewed for horses involved in athletic performance/training for various Western performance disciplines and undergoing arthroscopy for lameness localized to the stifle. Follow‐up was obtained ≥2 years postoperatively by telephone interviews with the owners. Preoperative and intraoperative findings as well as postoperative treatment were analyzed for their association with return to athletic performance as the primary outcome of interest.ResultsThe most common disciplines represented were cutting (n = 38), Western pleasure (n = 13), and reining (n = 13). Approximately 40% (32/82) of horses returned to intended use after surgery. Increased age, higher degree of lameness, longer duration of lameness, and the presence of partial‐thickness cartilage lesions decreased the odds of returning to athletic performance. Postoperative therapies (intra‐articular: stem cells, corticosteroids, interleukin‐1 receptor antagonist protein, hyaluronic acid/polysulfated glycosaminoglycans; systemic: nonsteroid anti‐inflammatory drugs, hyaluronic acid/polysulfated glycosaminoglycans, oral joint supplements) did not affect the odds of returning to intended use.ConclusionLess than half of the Western performance horses that underwent stifle arthroscopy returned to intended use. Older age, longer duration of lameness, and presence of partial‐thickness cartilage lesions affected the odds of a horse returning to intended use. Postoperative therapies did not affect the outcome in this population.Clinical significanceThe prognosis of Western performance horses undergoing stifle arthroscopy is as guarded as that previously reported in horses of other disciplines.
Microorganisms and spatial distribution of the sinkholes of the Yucatan Peninsula, underestimated biotechnological potential?
Authors: Moreno‐Pérez Pablo Antonio , Hernández‐Téllez Marivel , Ramirez‐Durán Ninfa , Gamboa‐Angulo Marcela , Isaac‐Olivé Keila 
Published: June 2019

AbstractObjective:To detect the spatial distribution of the sinkholes of the Peninsula of Yucatan (SPY) and identify those cenotes where microorganisms have been registered.Methods:The geographic coordinates of the SPYs were obtained from various databases, as well as from scientific publications relating to the terminology ‘sinkholes’, ‘karst systems’ and ‘cenotes’. All coordinates were transformed into the Universal Transverse Mercator reference system (UTM) with datum WGS84. An infrared composite image was created with 432 RGB bands from the Landsat 8 satellite. The points with the location of the cenotes were imported into the Software TerrSet.Results:Total 1026 coordinates of sinkholes were recorded in the Yucatan Peninsula. In 18 sinkholes (<2%), microorganisms have been recovered and identified in various taxonomic levels, and only 6 sinkholes (<0.6%) has their biotechnological potential been evaluated.Conclusions:The microorganisms that inhabit the sinkholes of the Yucatan Peninsula are a reservoir with practically unexplored biotechnological potential.
Improving incidence trends of severe intraventricular haemorrhages in preterm infants <32 weeks gestation: a cohort study
Authors: Yeo Kee Thai , Thomas Reji , Chow Sharon SW , Bolisetty Srinivas , Haslam Ross , Tarnow-Mordi William , Lui Kei 
Published: June 2019

ObjectiveTo describe the trend and risk factors for severe intraventricular haemorrhage (IVH) among infants <32 weeks gestation.DesignPopulation-based cohort study.SettingAustralia and New Zealand.PatientsAll preterm infants <32 weeks gestation in the Australian and New Zealand Neonatal Network (ANZNN) from 1995 to 2012.InterventionsComparison of IVH incidence between 6-year epochs.Main outcome measuresOverall IVH and severe IVH incidence.ResultsA total of 60 068 infants were included, and overall survival to discharge increased from 89% to 93% over the three epochs. As the percentage of infants with IVH decreased from 23.6% to 21.3% and 21.4% (p<0.001) from epoch 1 to 3, respectively, fewer survivors had severe IVH (4.0%, 3.3% and 2.8%, respectively, p<0.001). Over time, there were fewer antenatal complications, higher antenatal steroid usage and more caesarean-section births. Fewer infants were intubated at birth, had low 5 min Apgar score, had sepsis or pneumothorax needing drainage. Adjusted for perinatal confounders, there was significant reduction in odds of severe IVH from epoch 1 to 3 (adjusted OR (AOR) 0.8, 95% CI 0.7 to 0.9). Factors associated with development of severe IVH include no antenatal steroids (AOR 1.7, 95% CI 1.5 to 1.9), male (AOR 1.3, 95% CI 1.2 to 1.4), 5 min Apgar score <7 (AOR 2.0, 95% CI 1.9 to 2.2), intubated at birth (AOR 2.0, 95% CI 1.8 to 2.2), extremely low gestational age (AOR 4.0, 95% CI 3.7 to 4.4), outborn (AOR 1.6, 95% CI 1.5 to 1.8) and vaginal delivery (AOR 1.4, 95% CI 1.3 to 1.6).ConclusionsAlong with increased survival among infants born <32 weeks gestation, the incidence of severe IVH has decreased over the 18 years, especially in the most recent period. This coincided with reduction in rates of risk factors for severe IVH development.
Resuscitation of preterm infants in the Philippines: a national survey of resources and practice
Authors: Hayden Dean , Villanueva-Uy Maria Esterlita , Mendoza Maria Katrina , Wilkinson Dominic 
Published: June 2019

ObjectiveThere is a high incidence of preterm birth in low-income and middle-income countries where healthcare resources are often limited and may influence decision making. We aimed to explore the interplay between resource limitations and resuscitation practices for extremely preterm infants (EPIs) in neonatal intensive care units (NICUs) across the Philippines.MethodsWe conducted a national survey of NICUs in the Philippines. Institutions were classified according to sector (private/public), region and level. Respondents were asked about unit capacity, availability of ventilators and surfactant, resuscitation practices and estimated survival rates for EPIs of different gestational ages.ResultsRespondents from 103/228 hospitals completed the survey (response rate 45%). Public hospitals reported more commonly experiencing shortages of ventilators than private hospitals (85%vs23%, p<0.001). Surfactant was more likely to be available in city hospitals than regional/district hospitals (p<0.05) and in hospitals classified as Level III/IV than I/II (p<0.05). The financial capacity of parents was a major factor influencing treatment options. Survival rates for EPIs were estimated to be higher in private than public institutions. Resuscitation practice varied; active treatment was generally considered optional for EPIs from 25 weeks’ gestation and usually provided after 27–28 weeks’ gestation.ConclusionOur survey revealed considerable disparities in NICU resource availability between different types of hospitals in the Philippines. Variation was observed between hospitals as to when resuscitation would be provided for EPIs. National guidelines may generate greater consistency of care yet would need to reflect the variable context for decisions in the Philippines.
Rho-associated protein kinase inhibitor induced morphological changes in type VI collagen in the human trabecular meshwork
Authors: Okamoto Mizu , Nagahara Miyuki , Tajiri Takuma , Nakamura Naoya , Fukunishi Nahoko , Nagahara Kentaro 
Published: June 2019

AimsTo investigate morphological changes in type VI collagen in the human trabecular meshwork associated with the rho kinase inhibitor ripasudil.MethodsThis cross-sectional study evaluated the effects of ripasudil eye drop administration (RA) or no ripasudil eye drop administration (NRA) in patients with primary open-angle glaucoma (POAG; age range 60–80 years) who underwent conventional outflow reconstruction between December 2015 and September 2016 at Tokai University Hachioji Hospital. The juxtacanalicular tissue was removed and imaged using transmission electron microscopy. Type VI collagen comprises cross-banded aggregates with transverse bands 30 nm apart repeating every 105 nm. The transverse bands are called the outer rod-like region (ORR) and the intervals are called the inner rod-like region (IRR). The waveform intensity in the type VI collagen was analysed in electron micrographs using Fourier transformation to detect the IRR and ORR borders.ResultsTen eyes of 10 patients were included (n=5/group). The baseline characteristics did not differ significantly between groups. ORR width was significantly smaller in the RA group (37.85±3.43 nm) than in the NRA group (50.62±5.23 nm, p<0.05), whereas IRR width was significantly greater in the RA group (70.68±10.84 nm) than in the NRA group (58.19±5.34 nm, p<0.05). Morphological changes in the type VI collagen total width tended to correlate with the duration of ripasudil administration (r=0.9, p=0.08).ConclusionsRipasudil administration in patients with POAG induced morphological changes in type VI collagen. Patients with POAG administered RA had a significantly smaller ORR width and a significantly greater IRR width than patients with POAG not administered RA.
Small interface changes have dramatic impacts: how mandatory fields in electronic medical records increased pertussis vaccination rates in Australian obstetric patients
Authors: Orefice Roberto , Quinlivan Julie A 
Published: June 2019

IntroductionElectronic health records have been widely introduced into clinical practice. The aim of this study was to determine whether a small interface change could improve compliance with a key quality indicator, namely antenatal pertussis vaccination.MethodsAudits were performed between 1–31 July 2015 and 1–31 July 2017 of all deliveries at the Centenary Hospital for Women and Children to determine compliance with antenatal pertussis vaccination. The single difference between time points was changing the interface so the antenatal pertussis vaccination field became compulsory.Results275 and 299 women delivered in the audit periods. Vaccination rates almost doubled (52.7% vs 91.4%, p<0.0001).ConclusionSmall interface changes increase compliance. Interface change could be considered for key quality outcomes in patient care.
Reliability of comorbidity scores derived from administrative data in the tertiary hospital intensive care setting: a cross-sectional study
Authors: Hua-Gen Li Michael , Hutchinson Anastasia , Tacey Mark , Duke Graeme 
Published: June 2019

BackgroundHospital reporting systems commonly use administrative data to calculate comorbidity scores in order to provide risk-adjustment to outcome indicators.ObjectiveWe aimed to elucidate the level of agreement between administrative coding data and medical chart review for extraction of comorbidities included in the Charlson Comorbidity Index (CCI) and Elixhauser Index (EI) for patients admitted to the intensive care unit of a university-affiliated hospital.MethodWe conducted an examination of a random cross-section of 100 patient episodes over 12 months (July 2012 to June 2013) for the 19 CCI and 30 EI comorbidities reported in administrative data and the manual medical record system. CCI and EI comorbidities were collected in order to ascertain the difference in mean indices, detect any systematic bias, and ascertain inter-rater agreement.ResultsWe found reasonable inter-rater agreement (kappa (κ) coefficient ≥0.4) for cardiorespiratory and oncological comorbidities, but little agreement (κ<0.4) for other comorbidities. Comorbidity indices derived from administrative data were significantly lower than from chart review: −0.81 (95% CI − 1.29 to − 0.33;p=0.001) for CCI, and −2.57 (95% CI −4.46 to −0.68;p=0.008) for EI.ConclusionWhile cardiorespiratory and oncological comorbidities were reliably coded in administrative data, most other comorbidities were under-reported and an unreliable source for estimation of CCI or EI in intensive care patients. Further examination of a large multicentre population is required to confirm our findings.
Lessons learned from a comprehensive electronic patient record procurement process—implications for healthcare organisations
Authors: Priestman W , Collins R , Vigne H , Sridharan S , Seamer L , Bowen D , Sebire N J 
Published: June 2019

BackgroundThis study describes learning from procurement of a comprehensive electronic patient record (EPR/electronic health record (EHR)), system for a specialist clinical academic institution.MethodRetrospective review of procurement process in addition to evaluation of peer-reviewed literature in the field.ResultsMain lessons learned include the importance of detailed preparation of organisational requirements/specifications and organisational ‘readiness’. Early staff involvement, resulting in ownership of the selected system by the organisation was a key achievement. The scoring process used required significant resource commitment but, despite being extensive in scope, provided relatively poor distinction between suppliers, despite significant variation in supplier self-scoring. Other elements, such as demonstrations and site visits, provided superior evaluation of functional abilities, and specification requirements should be regarded as threshold evaluation.ConclusionWhile principles should be followed, the procurement process must be modified to meet the needs of the specific organisation, in terms of its clinical activities, digital maturity, existing infrastructure and budget.
Interventions to improve the use of EMRs in primary health care: a systematic review and meta-analysis
Authors: Hamade Noura , Terry Amanda , Malvankar-Mehta Monali 
Published: June 2019

BackgroundElectronic medical record (EMR) adoption in primary care has grown exponentially since their introduction in the 1970s. However, without their properusebenefits cannot be achieved. This includes: 1) the complete and safe documentation of patient information; 2) improved coordination of care; 3) reduced errors and 4) more involved patients. Theuseof EMRs is defined by practitioners using EMRs and their features to perform daily practice functions.ObjectiveThe purpose of this systematic review was to identify interventions aimed at improving EMR use in primary healthcare settings.MethodsTen online databases were searched to identify studies conducted in primary healthcare settings aimed at implementing interventions to observe the use of EMRs and directly measure the use of EMR functions or outcomes effected by the use of EMR functions.ResultsOf 2098 identified studies, 12 were included in the review. Results showed that interventions focused on the use of EMR functions, including referrals, electronic communication, reminders, use of clinical decision support systems and workflow management support functions, were five times more likely to show improvements in EMR use compared with controls. Interventions focused on data quality were five and a half times more likely to show improvements in EMR use compared with controls.ConclusionsIndividuals in primary healthcare settings aiming to improve EMR use would benefit from implementing interventions focused on EMR feature add-ons such as clinical decision support systems and customised referral templates, and provisions of educational materials, or financial incentives targeted at improving the use of EMR functions and data quality.
Large retrospective analysis on frailty assessment in primary care: electronic Frailty Index versus frailty coding
Authors: Millares-Martin Pablo 
Published: June 2019

BackgroundPrimary care in UK is expected to use tools such as the electronic Frailty Index (eFI) to identify patients with frailty, which should be then validated and coded accordingly.AimTo assess the influence of organisation and software on how eFI score and direct clinical validation occurs across practices in Leeds.MethodThe ‘minimum necessary’ anonymised patient data required for the study (recorded eFI scores and frailty codes – mild, moderate or severe – with their dates of entry) was requested to the Health and Care Hub of the NHS Leeds Clinical Commissioning Group. Data from 44 185 patients from 104 practices using two different clinical software were collected. Descriptive statistics was carried out using SPSS software.Results42 593 patients had a frailty code, 8881 had an eFI code. 7341 had both types of entry, and correlation between eFI and coded level of frailty was as expected high (85.3%), but there was statistically significant variation depending on practice and software used. When results did not match, there was a tendency to overstate, to code a level of frailty above the value to be assigned based on the numeric value of eFI, and it was more so on those practices using SystmOne software compared with those using EMIS Web.ConclusionsAlthough correlation was generally good, the variability encountered would indicate the need for training and also for software improvements to reduce current disparity and facilitate validation, so frailty level is adequately recorded.
Short-term adoption rates for a web-based portal within the intranet of a hospital information system
Authors: Kotoulas Athanasios , Stratis Ioannis , Goumenidis Theodoros , Lambrou George , Koutsouris Dimitrios - Dionysios 
Published: June 2019

ObjectiveAn intranet portal that combines cost-free, open-source software technology with easy set-up features can be beneficial for daily hospital processes. We describe the short-term adoption rates of a costless content management system (CMS) in the intranet of a tertiary Greek hospital.DesignDashboard statistics of our CMS platform were the implementation assessment of our system.ResultsIn a period of 10 months of running the software, the results indicate the employees overcame ‘Resistance to Change’ status. The average growth rate of end users who exploit the portal services is calculated as 2.73 every 3.3 months.ConclusionWe found our intranet web-based portal to be acceptable and helpful so far. Exploitation of an open-source CMS within the hospital intranet can influence healthcare management and the employees’ way of working as well.
Effectiveness of the eCARE programme: a short message service for asthma monitoring
Authors: Prabhakaran Lathy , Chun Wei Yap 
Published: June 2019

ObjectiveTo evaluate the effectiveness of the upgraded eCARE monitoring system on asthma control in discharged emergency department (ED) patients.MethodsA multicentre randomised controlled study (randomised controlled trial) was done for patients with a primary diagnosis of asthma seen at the EDs in Singapore between 1 March 2013 and 28 February 2015. Those who met the inclusion criteria were randomised into a control group (routine care, n=212) and intervention group (eCARE, n=212). Patients in the intervention group received short message service (SMS) messages according to a structured workﬂow, while patients in the control group did not receive SMS support.ResultsFor patients with poorly controlled asthma at recruitment, the results at 5 weeks showed no statistical difference in the proportion of patients who attained well-controlled asthma between the eCARE and routine care groups. At 3 months, the routine care group had a higher proportion of patients with well-controlled asthma but this was not statistically significant after adjustment for baseline differences using logistic regression. Approximately 95% of patients under the eCARE programme were satisfied with the SMS service.DiscussionPatients in the eCARE programme did not have better asthma control than those receiving routine care. Conversely, patients in the eCARE programme appeared to have poorer asthma control, though a larger sample size will be required to confirm this finding.
An auditory brainstem implant for treatment of unilateral tinnitus: protocol for an interventional pilot study
Authors: van den Berge Minke J C , van Dijk Marc J M C , Metzemaekers Jan D M , Maat Bert , Free Rolien H , van Dijk Pim 
Published: June 2019

IntroductionTinnitus may have a very severe impact on the quality of life. Unfortunately, for many patients, a satisfactory treatment modality is lacking. The auditory brainstem implant (ABI) was originally indicated for hearing restoration in patients with non-functional cochlear nerves, for example, in neurofibromatosis type II. In analogy to a cochlear implant (CI), it has been demonstrated that an ABI may reduce tinnitus as a beneficial side effect. For tinnitus treatment, an ABI may have an advantage over a CI, as cochlear implantation can harm inner ear structures due to its invasiveness, while an ABI is presumed to not damage anatomical structures. This is the first study to implant an ABI to investigate its effect on intractable tinnitus.Methods and analysisIn this pilot study, 10 adults having incapacitating unilateral intractable tinnitus and ipsilateral severe hearing loss will have an ABI implanted. The ABI is switched on 6 weeks after implantation, followed by several fitting sessions aimed at finding an optimal stimulation strategy. The primary outcome will be the change in Tinnitus Functioning Index. Secondary outcomes will be tinnitus burden and quality of life (using Tinnitus Handicap Inventory and Hospital Anxiety and Depression Scale questionnaires), tinnitus characteristics (using Visual Analogue Scale, a tinnitus analysis), safety, audiometric and vestibular function. The end point is set at 1 year after implantation. Follow-up will continue until 5 years after implantation.Ethics and disseminationThe protocol was reviewed and approved by the Institutional Review Board of the University Medical Centre Groningen, The Netherlands (METc 2015/479). The trial is registered atwww.clinicialtrials.govand will be updated if amendments are made. Results of this study will be disseminated in peer-reviewed journals and at scientific conferences.Trial registration numberNCT02630589.Trial statusInclusion of first patient in November 2017. Data collection is in progress. Trial is open for further inclusion. The trial ends at 5 years after inclusion of the last patient.