bluuebunny/crossref_metadata_2025_split huggingface dataset:
The ambulance nurse experiences of non‐conveying patients
Authors: Höglund Erik , Schröder Agneta , Möller Margareta , Andersson‐Hagiwara Magnus , Ohlsson‐Nevo Emma 
Published: July 2018

AbstractAims and objectivesTo explore ambulance nurses' (ANs) experiences of non‐conveying patients to alternate levels of care.BackgroundIncreases in ambulance utilisation and in the number of patients seeking ambulance care who do not require medical supervision or treatment during transport have led to increased nonconveyance (NC) and referral to other levels of care.DesignA qualitative interview study was conducted using an inductive research approach.MethodsThe study was conducted in a region in the middle of Sweden during 2016–2017. Twenty nurses were recruited from the ambulance departments in the region. A conventional content analysis was used to analyse the interviews. The study followed the COREQ checklist.ResultsThe ANs experienced NC as a complex and difficult task that carried a large amount of responsibility. They wanted to be professional, spend time with the patient and find the best solution for him or her. These needs conflicted with the ANs' desire to be available for assignments with a higher priority. The ANs could feel frustrated when they perceived that ambulance resources were being misused and when it was difficult to follow the NC guidelines.ConclusionIf ANs are expected to nonconvey patients seeking ambulance care, they need a formal mandate, knowledge and access to primary health care.Relevance to clinical practiceThis study provides new knowledge regarding the work situation of ANs in relation to NC. These findings can guide future research and can be used by policymakers and ambulance organisations to highlight areas that need to evolve to improve patient care.
Conceptions of professional work in contemporary health care—Perspectives from registered nurses in somatic care: A phenomenographic study
Authors: Persson Ulrika , Carlson Elisabeth 
Published: July 2018

AbstractAims and objectivesTo explore the variation of registered nurses’ conceptions of the professional work in contemporary somatic health care.BackgroundThe turnover of registered nurses has consistently been high in recent years. This implies that competence is at risk of disappearing from patient care, which might lead to an increase in organisational costs and a decreased quality of care. Therefore, management at all levels within healthcare organisations is trying to find ways to make use of available nursing resources more efficiently. This could imply new views on nurses’ professional work in future.DesignQualitative design with a phenomenographic approach.MethodsSemistructured interviews with registered nurses in somatic care.ResultFour descriptive categories emerged: registered nurse as an expert in nursing, registered nurse as a close collaborator to the patients, registered nurse as a coordinator and leader and registered nurse as an administrator.ConclusionsThe registered nurses’ conception of their work is being experts in nursing and having a key role in leading the care forward. They perceive that they are important in coordinating the care to guarantee that the patient receives the right competence. Registered nurses perceive their work to be most important when working in close interaction with the patients, whereas the organisation is perceived as an obstacle to achieve this.Relevance to clinical practiceThis result may be a contribution to understand what registered nurses conceive is their work. The result can also help identifying factors influencing registered nurses intent to stay. Thus, it is of importance for managers to involve the professionals in the development of clinical care, as well as allowing professionals to influence higher‐level organisational changes to ensure quality in care and patient safety.
Significance of gestational weight gain in spontaneous onset of labor at term
Authors: Tanaka Kei , Muraoka Yuma , Honda Riku , Izawa Tomoko , Tanigaki Shinji , Kobayashi Yoichi , Iwashita Mitsutoshi 
Published: July 2018

AbstractAimTo investigate the significance of gestational weight gain (GWG) in association with the spontaneous onset of labor at term.MethodsA retrospective cohort study on 985 pregnant women (629 nullipara and 356 pluripara) who delivered singleton babies at term was conducted. We reviewed the maternal demographics (age, parity, prepregnancy body mass index [BMI]) and the perinatal outcomes (gestational age [GA] and the type [spontaneous or induced] of labor onset, and GWG). The subjects were categorized by prepregnancy BMI and GWG. The rates of spontaneous onset of labor were compared between the nullipara and pluripara groups. Kaplan–Meier survival analysis was applied to evaluate the time to spontaneous labor according to prepregnancy BMI and GWG. A Cox proportional hazards model was used to determine the independent predictive factor for spontaneous onset of labor.ResultsIn both the nullipara and pluripara group, women with prepregnancy obesity were less likely to enter spontaneous labor. In nullipara, women with excessive weight gain were less likely to enter spontaneous labor. In pluripara, women with poor gain were more likely to enter spontaneous labor. In the multivariate model, GWG was independently associated with the spontaneous onset of labor in both nullipara (hazard ratio [HR] 0.83, 95% confidence interval [CI] 0.75–0.98, P = 0.03) and pluripara (HR 0.82, 95% CI 0.64–0.93, P = 0.005).ConclusionGreater maternal weight gain was significantly associated with longer gestation and a decreased likelihood of spontaneous onset of labor at term.
Magnetic resonance imaging of masticatory muscles in basset hounds
Authors: Lorek A. , Spencer S. E. , Dennis R. 
Published: July 2018

ObjectivesTo describe low‐ and high‐field MRI characteristics of occult masticatory muscle lesions in basset hounds.Materials and MethodsRetrospective review of the MR images of the heads of 44 basset hounds that had been imaged for reasons unrelated to suspected muscle disease.ResultsIn most basset hounds, there was reduced bulk of the superficial part of the temporalis and masseter muscles together with bilaterally symmetrical T2W and T1W hyperintense signal with reduced contrast enhancement compared to normal muscle. Interpretation of various pulse sequences suggested that the affected muscle areas contained adipose tissue with no evidence of inflammation, and this was confirmed on biopsy in one dog. This pattern of changes is different from MRI changes in inflammatory myopathies.Clinical SignificancePoor muscle bulk and MRI signal changes in the superficial parts of the temporalis and masseter muscles in basset hounds appear to be normal findings in this breed and should not be misinterpreted as evidence of an inflammatory myopathy.
“Doubtful accepting”: A grounded theory study of living with cardiac resynchronization therapy
Authors: Dehghanzadeh Shadi , Dehghan Nayeri Nahid , Varaei Shokoh 
Published: July 2018

AbstractHeart failure is associated with low quality of life and a high mortality rate. There is limited information about patients' experiences of living with cardiac resynchronization therapy (CRT). In the present study, we sought to explore the process of living with CRT defibrillator. This qualitative study was completed from December 2014 to April 2016 using a grounded theory approach. Twenty semistructured interviews were held with 17 patients with heart failure. Data analysis was done via a previously‐published approach. The core category of the process of living with the device is “doubtful accepting”. This process includes three sequential phases: losing integrity, attempting to cope with the device, and coexisting. The process takes place in a context of barriers and facilitators, and results in a wide spectrum of outcomes, from frustration to empowerment. Nurses' awareness of this process can help them provide higher quality care, strengthen facilitators and reduce barriers to the process, and enable patients to effectively use coping strategies.
Topical rapamycin (sirolimus) for the treatment of uncomplicated tufted angiomas in two children and review of the literature
Authors: Burleigh Angela , Kanigsberg Nordau , Lam Joseph M. 
Published: July 2018

AbstractThe mTOR inhibitor rapamycin is used systemically for the treatment of vascular lesions. We report the first use of topical rapamycin for the successful treatment of two cases of tufted angioma. The evidence for the use of topical rapamycin in other dermatologic conditions is summarized to aid in clinical decision making on preparations and anticipated side effects.
Effects of adiponectin during in vitro maturation of goat oocytes: MEK 1/2 pathway and gene expression pattern
Authors: Gomes Elizabete T. , Costa Joana Amélia S. , Silva Diogo Manoel F. , Al Shebli Wasim , Azevedo Marina L. , Monteiro Jr Pedro L. J. , Araújo Silva Robespierre A. J. , Santos Filho Antônio S. , Guerra Maria Madalena P. , Bartolomeu Claudio Coutinho , Wischral Aurea , Batista André M. 
Published: July 2018

ContentsRecent studies have shown that adiponectin, an adipokine predominantly produced by adipose tissue, regulates several reproductive processes. However, the mechanisms of action of adiponectin on the maturation of goat oocytes remain to be determined. The aim of this study was to investigate whether (a) adiponectin influences the meiotic maturation of goat oocytes; (b) MAPK MEK 1/2 mediates the effects of adiponectin; and 3) adiponectin differentially affects mRNA relative abundance of genes relevant for adiponectin signal transduction in goat oocytes. The addition of adiponectin (5 μg/ml) during the maturation of goat oocytes resulted in a higher percentage of successful nuclear maturation compared to those of the group without adiponectin (p < 0.05). Adiponectin‐stimulated nuclear oocyte maturation was significantly impaired by a mitogen‐activated protein kinase MEK 1/2 inhibitor, U0126 (p < 0.05). There was no evidence of any adiponectin‐induced difference in the relative transcript abundances of AdipoR1, AdipoR2, AMPKα1, AMPKα2, PPARα and PPARγ genes. In conclusion, these results indicate that adiponectin has a positive effect on the meiotic maturation of goat oocytes through the MAPK MEK 1/2 pathway. Furthermore, the adiponectin does not affect the relative abundance of genes relevant for adiponectin signal transduction in goat oocytes.
Objective measurements of the atlantoaxial joint on radiographs performed without flexion can increase the confidence of diagnosis of atlantoaxial instability in toy breed dogs
Authors: Cummings Kelly R. , Vilaplana Grosso Federico , Moore George E. , Rochat Mark , Thomovsky Stephanie A. , Bentley R. Timothy 
Published: July 2018

AbstractToy breed dogs are overrepresented for atlantoaxial instability. Radiography is a standard diagnostic test, however published toy breed‐specific radiographic measurements are lacking and diagnosis remains largely subjective. Aims of this retrospective, diagnostic accuracy study were to describe normal values and determine whether some quantitative radiographic criteria strongly support a diagnosis of atlantoaxial instability specific to toy breed dogs. Neutral lateral and ventrodorsal radiographs of 102 toy breed dogs (92 control, 10 affected) were reviewed. The median C1‐C2 overlap (the distance of overlap between the C2 spinous process and the dorsal arch of C1) was +4.65 mm in control dogs and –5.00 mm in atlantoaxial instability cases. A C1‐C2 overlap ≤ +1.55 mm was the most sensitive (100%) and specific (94.5%) radiographic measurement in the diagnosis of atlantoaxial instability. Three relative measurements were performed: the ventral atlantodental interval to dorsal atlantodental interval ratio, the dens/C2 ratio, and the C1‐C2 angle. These three relative measurements had good specificity (94.5, 86.9, and 98.9%, respectively), lower sensitivity (80.0, 66.7, and 60.0%, respectively), and were not influenced by body weight (P > 0.05). Absolute measurements (including absolute dens length and atlantoaxial distance) were significantly correlated with body weight (P < 0.05) diminishing their utility in the diagnosis of atlantoaxial instability. Decreased C1‐C2 overlap strongly supports atlantoaxial instability. The ventral atlantodental interval/dorsal atlantodental interval ratio, dens/C2 ratio, and C1‐C2 angle may provide further support but may be normal in individual cases.
Prevalence of Group I Salmonella Kentucky in domestic food animals from Pennsylvania and overlap with human clinical CRISPR sequence types
Authors: Rauch Hallie E. , Vosik Dorothy , Kariyawasam Subhashinie , M’ikanatha Nkuchia , Shariat Nikki W. 
Published: July 2018

AbstractAlthough infrequently associated with illness in humans, Salmonella enterica, subsp. enterica serovar Kentucky is the most common non‐clinical, non‐human serovar reported in the United States, being largely found in poultry and poultry products, as well as being associated with cattle. This serovar is polyphyletic and can be separated into two groups, Group I and II, based on CRISPR‐typing analysis. In Salmonella Kentucky isolates from human clinical samples in Pennsylvania, both lineages are equally represented. The goal of this study was to determine whether both groups were also represented in domestic food animals in Pennsylvania. We analysed the CRISPR arrays from 67 Salmonella Kentucky isolates used PCR and sequencing of CRISPR arrays or analysis of whole genome sequences to analyse the CRISPR arrays and Across a collection of 67 Salmonella Kentucky isolates that includes those collected from farms, veterinary clinical samples as well as isolates from retail meats, we show that Group I Salmonella Kentucky are the exclusive lineage present. We reveal that the specific subtype of over a quarter of these animal isolates are also found to be responsible for causing human salmonellosis in the same region over the same time period.
Incipient and Subclinical Tuberculosis: a Clinical Review of Early Stages and Progression of Infection
Authors: Drain Paul K. , Bajema Kristina L. , Dowdy David , Dheda Keertan , Naidoo Kogieleum , Schumacher Samuel G. , Ma Shuyi , Meermeier Erin , Lewinsohn David M. , Sherman David R. 
Published: July 2018

SUMMARYTuberculosis (TB) is the leading infectious cause of mortality worldwide, due in part to a limited understanding of its clinical pathogenic spectrum of infection and disease. Historically, scientific research, diagnostic testing, and drug treatment have focused on addressing one of two disease states: latent TB infection or active TB disease. Recent research has clearly demonstrated that human TB infection, from latent infection to active disease, exists within a continuous spectrum of metabolic bacterial activity and antagonistic immunological responses. This revised understanding leads us to propose two additional clinical states: incipient and subclinical TB. The recognition of incipient and subclinical TB, which helps divide latent and active TB along the clinical disease spectrum, provides opportunities for the development of diagnostic and therapeutic interventions to prevent progression to active TB disease and transmission of TB bacilli. In this report, we review the current understanding of the pathogenesis, immunology, clinical epidemiology, diagnosis, treatment, and prevention of both incipient and subclinical TB, two emerging clinical states of an ancient bacterium.
Cross-sectional analysis of ethnic differences in fall prevalence in urban dwellers aged 55 years and over in the Malaysian Elders Longitudinal Research study
Authors: Alex Deepa , Khor Hui Min , Chin Ai Vyrn , Hairi Noran Naqiah , Othman Sajaratulnisah , Khoo Selina Phaik Kin , Bahyah Kamaruzzaman Shahrul , Tan Maw Pin 
Published: July 2018

ObjectivesFalls represent major health issues within the older population. In low/middle-income Asian countries, falls in older adults remain an area which has yet to be studied in detail. Using data from the Malaysian Elders Longitudinal Research (MELoR), we have estimated the prevalence of falls among older persons in an urban population, and performed ethnic comparisons in the prevalence of falls.DesignCross-sectional analysis was carried out using the first wave data from MELoR which is a longitudinal study.SettingUrban community dwellers in a middle-income South East Asian country.Participants1565 participants aged ≥55 years were selected by simple random sampling from the electoral rolls of three parliamentary constituencies.Outcome measuresConsenting participants from the MELoR study were asked the question ‘Have you fallen down in the past 12 months?’ during their computer-assisted home-based interviews. Logistic regression analyses were conducted to compare the prevalence of falls among various ethnic groups.ResultsThe overall estimated prevalence of falls for individuals aged 55 years and over adjusted to the population of Kuala Lumpur was 18.9%. The estimated prevalence of falls for the three ethnic populations of Malays, Chinese and Indian aged 55 years and over was 16.2%, 19.4% and 23.8%, respectively. Following adjustment for ethnic discrepancies in age, gender, marital status and education attainment, the Indian ethnicity remained an independent predictor of falls in our population (relative risk=1.45, 95% CI 1.08 to 1.85).ConclusionThe prevalence of falls in this study is comparable to other previous Asian studies, but appears lower than Western studies. The predisposition of the Indian ethnic group to falls has not been previously reported. Further studies may be needed to elucidate the causes for the ethnic differences in fall prevalence.
Short-term postoperative outcomes of colorectal cancer among patients with chronic liver disease: a national population-based study
Authors: Lee Ko-Chao , Chung Kuan-Chih , Chen Hong-Hwa , Cheng Kung-Chuan , Wu Kuen-Lin , Lu Chien-Chang 
Published: July 2018

ObjectivePatients with colorectal carcinoma (CRC) with pre-existing chronic liver disease (CLD) had a significantly higher 30-day mortality after CRC surgery compared with healthy controls. This study investigated the factors associated with postoperative complications and in-hospital mortality in patients with CRC with coexisting CLD (excluding cirrhosis) who underwent colorectal surgery.DesignA retrospective, observational, population-based study.SettingData were sourced from the National Inpatient Sample database, a part of the Healthcare Cost and Utilisation Project.ParticipantsThis study analysed 7463 inpatients with CRC who underwent colorectal surgery on admission between 2005 and 2014.Primary and secondary outcome measuresThe primary endpoint of this study was the prevalence of postoperative complications, and the secondary endpoint was in-hospital mortality.ResultsIn the CLD group, 36.27% of patients had chronic hepatitis C, 28.36% had non-alcoholic fatty liver disease and 31.19% had other types of CLD. The median hospital stay was 7.0 (5.0–10.0) days in patients with no postoperative complications vs 17.0 (10.0–26.0) days, 8.0 (6.0–12.0) days, 8.0 (6.0–17.0) days, 9.0 (8.0–14.0) days and 10.5 (7.0–17.0) days for patients with postoperative infection, postoperative bleeding, cardiac arrest/heart failure, respiratory complications and digestive complications, respectively (all p<0.05). The presence of CLD was significantly associated with higher risk of postoperative bleeding (adjusted OR (aOR)=1.64, 95% CI 1.15 to 2.34, p=0.007). The presence of CLD (aOR=1.98, 95% CI 1.39 to 2.82, p<0.001) and length of hospital stay (aOR=1.06, 95% CI 1.04 to 1.08, p<0.001) were significantly associated with higher risk of in-hospital mortality. However, hyperlipidaemia was associated with a significantly lower risk of mortality (aOR=0.46, 95% CI 0.28 to 0.75, p=0.002).ConclusionsPostoperative complications prolonged the length of hospital stay. The presence of CLD and hyperlipidaemia were important factors impacting postoperative complications and in-hospital mortality in patients with CRC with underlying CLD.
Short-term and long-term revision rates after lumbar spine discectomy versus laminectomy: a population-based cohort study
Authors: Kao Feng-Chen , Hsu Yao-Chun , Wang Chang-Bi , Tu Yuan-Kun , Liu Pao-Hsin 
Published: July 2018

Background/objectiveDegenerative diseases of the lumbar spine were managed with discectomy or laminectomy. This study aimed to compare these two surgical treatments in the postoperative revision rates.DesignA population-based cohort study from analysis of a healthcare database.SettingData were gathered from the Taiwan National Health Insurance Research Database (NHIRD).ParticipantsWe enrolled 16 048 patients (4450 women and 11 598 men) with a mean age of 40.34 years who underwent lumbar discectomy or laminectomy for the first time between 1 January 1997 and 31 December 2007. All patients were followed up for 5 years or until death.ResultsRevision rate within 3 months of the index surgery was significantly higher in patients who underwent discectomy (2.75%) than in those who underwent laminectomy (1.18%; p<0.0001). This difference persisted over the first year following the index surgery (3.38% vs 2.57%). One year afterwards, the revision rates were similar between the discectomy (9.75%) and laminectomy (9.69%) groups. The final spinal fusion surgery rates were also similar between the groups (11.25% vs 12.08%).ConclusionThe revision rate after lumbar discectomy was higher than that after laminectomy within 1 year of the index surgery. However, differences were not identified between patient groups for the two procedures with respect to long-term revision rates and the proportion of patients who required final spinal fusion surgery.