bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of promoting current local research activities on large monitors on the population’s interest in health-related research: a randomised controlled trial
Authors: Gunnarsson Ronny , Cullen Paul , Heal Clare , Banks Jennifer 
Published: August 2019

ObjectiveThe objectives of this study were threefold: to estimate people’s interest in health-related research, to understand to what extent people appreciate being actively informed about current local health-related research and to investigate whether their interest can be influenced by advertising local current health-related research using large TV monitors.DesignRandomised controlled trial using a stepped wedge design.SettingThe emergency department waiting room at two public hospitals in northern Queensland, Australia.ParticipantsWaiting patients and their accompanying friends and relatives in the emergency department waiting room not requiring immediate medical attention.InterventionsA TV monitor advertising local current health-related research.Main outcome measuresOR for the effect of intervention on changing the interest in health-related research compared with a control group while adjusting for gender, age and socioeconomic standard.ResultsThe intervention significantly increased the short-term interest in health-related research with an OR of 1.3 (1.1–1.7, p=0.0063). We also noted that being female and being older was correlated to a higher interest in health-related researchConclusionsThis study found that proactive information significantly increased the general populations’ interest in health-related research. There are reasonable set up costs involved but the costs for maintaining the system were very low. Hence, it seems reasonable that research-active organisations should give much higher priority to this type of activity.Trial registration numberACTRN12617001085369
Design and protocol of a comprehensive multicentre biobank for abdominal aortic aneurysms
Authors: Jalalzadeh Hamid , Indrakusuma Reza , Blankensteijn Jan D. , Wisselink Willem , Yeung Kak K , Lindeman Jan H N , Hamming Jaap F , Koelemay Mark J W , Legemate Dink A , Balm Ron 
Published: August 2019

IntroductionThe pathophysiology and natural course of abdominal aortic aneurysms (AAAs) are insufficiently understood. In order to improve our understanding, it is imperative to carry out longitudinal research that combines biomarkers with clinical and imaging data measured over multiple time points. Therefore, a multicentre biobank, databank and imagebank has been established in the Netherlands: the ‘Pearl Abdominal Aortic Aneurysm’ (AAA bank).Methods and analysisThe AAA bank is a prospective multicentre observational biobank, databank and imagebank of patients with an AAA. It is embedded within the framework of the Parelsnoer Institute, which facilitates uniform biobanking in all university medical centres (UMCs) in the Netherlands. The AAA bank has been initiated by the two UMCs of Amsterdam UMC and by Leiden University Medical Center. Participants will be followed during AAA follow-up. Clinical data are collected every patient contact. Three types of biomaterials are collected at baseline and during follow-up: blood (including DNA and RNA), urine and AAA tissue if open surgical repair is performed. Imaging data that are obtained as part of clinical care are stored in the imagebank. All data and biomaterials are processed and stored in a standardised manner. AAA growth will be based on multiple measurements and will be analysed with a repeated measures analysis. Potential associations between AAA growth and risk factors that are also measured on multiple time points can be assessed with multivariable mixed-effects models, while potential associations between AAA rupture and risk factors can be tested with a conditional dynamic prediction model with landmarking or with joint models in which linear mixed-effects models are combined with Cox regression.Ethics and disseminationThe AAA bank is approved by the Medical Ethics Board of the Amsterdam UMC (University of Amsterdam).Trial registration numberNCT03320408.
Stratification of inflammatory bowel disease outpatients by disease activity and risk of complications to guide out-of-hospital monitoring: a patient-centred quality improvement project
Authors: Fofaria Rishi K , Barber Susan , Adeleke Yewande , Woodcock Tom , Kamperidis Nikolaos , Mohamed Alaa , Misra Ravi , Shah Ajit , Bailey-Fee Susan , Bluston Howard , Robinson Denise , Tyrrell Tracey , Arebi Naila 
Published: August 2019

BackgroundInflammatory bowel disease (IBD) is a chronic relapsing-remitting condition affecting 600 000 people in the UK. Traditionally, patients attend outpatient clinics for monitoring regardless of their symptoms or risk of developing complications. This can lead to a mismatch between need and access: patients in remission given elective appointments displace those in need of urgent specialist attention. Novel initiatives implemented in the UK to improve outpatient monitoring have often required a well-maintained patient registry, empowered patients and significant information technology support.Design and strategyIn this large-scale quality improvement project at St Mark’s Hospital, a tertiary centre for IBD, we stratified over 1000 patients attending three non-complex IBD clinics over 12 months according to disease activity and risk profile. The aim was to offer a choice and subsequently transfer 50% of eligible patients to specialist nurse-led telephone clinics and demonstrate non-inferior satisfaction levels to existing outpatient follow-up. We also sought to ensure there was timely access to a newly established rapid access clinic for patients requiring urgent specialist attention.A core project team consisting of healthcare professionals, patients and quality improvement scientists met regularly. The team tested and scaled up interventions using ‘Plan-Do-Study-Act’ cycles within the ‘Model for Improvement’ framework and analysed data continuously using statistical process charts.ResultsOver 12 months, the average number of eligible patients transferred to telephone clinics rose from 17.6% (42/239) using a questionnaire method to 59.3% (73/123) using active discussion in clinic. Patient satisfaction scores remained high and non-inferior to baseline scores in face-to-face clinics. The median waiting time to be seen in the rapid access clinic was 6.5 days.ConclusionThis is the first published study to report on the successful stratification of patients with IBD based on disease activity and risk of complications to create a more responsive, sustainable and patient-centred model for IBD monitoring.
Exploring stakeholder perceptions around implementation of the Operating Room Black Box for patient safety research: a qualitative study using the theoretical domains framework
Authors: Etherington Cole , Usama Aya , Patey Andrea M , Trudel Chantal , Przybylak-Brouillard Antoine , Presseau Justin , Grimshaw Jeremy M , Boet Sylvain 
Published: August 2019

BackgroundSystematically observing clinical performance in the operating room (OR) to support patient safety initiatives faces numerous logistical and methodological challenges. These may be solved by new audio-video recording technologies like the OR Black Box, which is a tool similar to black boxes in aviation. This study aimed to identify barriers and enablers that may influence patients’, clinicians’ and senior leadership team members’ support of the OR Black Box in order to guide its future implementation.MethodsPatients, clinicians and senior leadership team members were recruited to participate in semistructured interviews informed by the theoretical domains framework (TDF) to identify factors relevant to planning OR Black Box implementation. Deidentified interview transcripts were analysed in duplicate following a TDF coding structure.ResultsData saturation was achieved at 15 patients, 17 clinicians and 9 senior leadership team members. Seven domains were relevant for patients, nine for clinicians and four for senior leadership. Knowledge and Beliefs about consequences were barriers and enablers for all three groups. Memory, attention and decision processes and Social influences were enablers for both clinicians and senior leadership. Environmental context and resources, Emotion and Behavioural regulation were found to be barriers and enablers for both clinicians and patients. Social/professional role and identity and Reinforcement were enablers for patients only and Optimism and Intentions were barriers and enablers to clinicians.ConclusionsWhile most stakeholders were supportive of the OR Black Box, we identified many key areas that need to be addressed during its implementation. It is critical to ensure all stakeholders have adequate and accurate information about the OR Black Box system and research goals, and that the OR Black Box is positioned as a patient safety initiative for learning from and improving practice.
Surgical trainees’ experience of pregnancy, maternity and paternity leave: a cross-sectional study
Authors: Mohan Helen , Ali Oroog , Gokani Vimal , McGoldrick Ciara , Smitham Peter , Fitzgerald J Edward F , Harries Rhiannon 
Published: August 2019

AbstractBackgroundInternationally, supporting surgical trainees during pregnancy, maternity and paternity leave is essential for trainee well-being and for retention of high-calibre surgeons, regardless of their parental status. This study sought to determine the current experience of surgical trainees regarding pregnancy, maternity and paternity leave.MethodsA cross-sectional anonymised electronic voluntary survey of all surgical trainees working in the UK and Ireland was distributed via the Association of Surgeons in Training and the British Orthopaedic Trainees’ Association.ResultsThere were 876 complete responses, of whom 61.4% (n=555) were female. 46.5% (258/555) had been pregnant during surgical training. The majority (51.9%, n=134/258) stopped night on-call shifts by 30 weeks’ gestation. The most common reason for this was concerns related to tiredness and maternal health. 41% did not have rest facilities available on night shifts. 27.1% (n=70/258) of trainees did not feel supported by their department during pregnancy, and 17.1% (n=50/258) found the process of arranging maternity leave difficult or very difficult. 61% (n=118/193) of trainees felt they had returned to their normal level of working within 6 months of returning to work after maternity leave, while a significant minority took longer. 25% (n=33/135) of trainees found arranging paternity leave difficult or very difficult, and the most common source of information regarding paternity leave was other trainees.ConclusionOver a quarter of surgical trainees felt unsupported by their department during pregnancy, while a quarter of male trainees experience difficulty in arranging paternity leave. Efforts must be made to ensure support is available in pregnancy and maternity/paternity leave.
Alcohol-induced microtubule acetylation leads to the accumulation of large, immobile lipid droplets
Authors: Groebner Jennifer L. , Girón-Bravo Marlene T. , Rothberg Mia L. , Adhikari Raghabendra , Tuma Dean J. , Tuma Pamela L. 
Published: August 2019

Although steatosis (fatty liver) is a clinically well-described early stage of alcoholic liver disease, surprisingly little is known about how it promotes hepatotoxicity. We have shown that ethanol consumption leads to microtubule hyperacetylation that can explain ethanol-induced defects in protein trafficking. Because almost all steps of the lipid droplet life cycle are microtubule dependent and because microtubule acetylation promotes adipogenesis, we examined droplet dynamics in ethanol-treated cells. In WIF-B cells treated with ethanol and/or oleic acid (a fatty acid associated with the “Western” diet), we found that ethanol dramatically increased lipid droplet numbers and led to the formation of large, peripherally located droplets. Enhanced droplet formation required alcohol dehydrogenase-mediated ethanol metabolism, and peripheral droplet distributions required intact microtubules. We also determined that ethanol-induced microtubule acetylation led to impaired droplet degradation. Live-cell imaging revealed that droplet motility was microtubule dependent and that droplets were virtually stationary in ethanol-treated cells. To determine more directly whether microtubule hyperacetylation could explain impaired droplet motility, we overexpressed the tubulin-specific acetyltransferase αTAT1 to promote microtubule acetylation in the absence of alcohol. Droplet motility was impaired in αTAT1-expressing cells but to a lesser extent than in ethanol-treated cells. However, in both cases, the large immotile droplets (but not small motile ones) colocalized with dynein and dynactin (but not kinesin), implying that altered droplet-motor microtubule interactions may explain altered dynamics. These studies further suggest that modulating cellular acetylation is a potential strategy for treating alcoholic liver disease.NEW & NOTEWORTHY Chronic alcohol consumption with the “Western diet” enhances the development of fatty liver and leads to impaired droplet motility, which may have serious deletrious effects on hepatocyte function.
Asynchronous action potential discharge in human muscle sympathetic nerve activity
Authors: Klassen Stephen A. , Moir M. Erin , Limberg Jacqueline K. , Baker Sarah E. , Nicholson Wayne T. , Curry Timothy B. , Joyner Michael J. , Shoemaker J. Kevin 
Published: August 2019

What strategies are employed by the sympathetic system to communicate with the circulation? Muscle sympathetic nerve activity (MSNA) occurs in bursts of synchronous action potential (AP) discharge, yet whether between-burst asynchronous AP firing exists remains unknown. Using multiunit microneurography and a continuous wavelet transform to isolate APs, we studied AP synchronicity within human MSNA. Asynchronous APs were defined as those which occurred between bursts. Experiment 1 quantified AP synchronicity in eight individuals at baseline (BSL), −10 mmHg lower body negative pressure (LBNP), −40 mmHg LBNP, and end-expiratory apnea (APN). At BSL, 33 ± 12% of total AP activity was asynchronous. Asynchronous discharge was unchanged from BSL (67 ± 37 AP/min) to −10 mmHg LBNP (69 ± 33 AP/min), −40 mmHg LBNP (83 ± 68 AP/min), or APN (62 ± 39 AP/min). Across all conditions, asynchronous AP probability and frequency decreased with increasing AP size. Experiment 2 examined the impact of the ganglia on AP synchronicity by using nicotinic blockade (trimethaphan). The largest asynchronous APs were derecruited from BSL (11 ± 4 asynchronous AP clusters) to the last minute of the trimethaphan infusion with visible bursts (7 ± 2 asynchronous AP clusters). However, the 6 ± 2 smallest asynchronous AP clusters could not be blocked by trimethaphan and persisted to fire 100 ± 0% asynchronously without forming bursts. Nonnicotinic ganglionic mechanisms affect some, but not all, asynchronous activity. The fundamental behavior of human MSNA contains between-burst asynchronous AP discharge, which accounts for a considerable amount of BSL activity. NEW & NOTEWORTHY Historically, sympathetic nerve activity destined for the blood vessels supplying skeletal muscle (MSNA) has been characterized by spontaneous bursts formed by synchronous action potential (AP) discharge. However, this study found a considerable amount (~30% during baseline) of sympathetic AP discharge to fire asynchronously between bursts of human MSNA. Trimethaphan infusion revealed that nonnicotinic ganglionic mechanisms contribute to some, but not all, asynchronous discharge. Asynchronous sympathetic AP discharge represents a fundamental behavior of MSNA.
Risk Factors for Unruptured Intracranial Aneurysms and Subarachnoid Hemorrhage in a Prospective Population-Based Study
Authors: Müller Tomm B. , Vik Anne , Romundstad Pål R. , Sandvei Marie Søfteland 
Published: August 2019

Background and Purpose—
We wanted to evaluate potential risk factors for unruptured intracranial aneurysms (UIAs) and aneurysmal subarachnoid hemorrhage (aSAH) in a large, prospective study of the general population with risk factors collected before the detection of UIA or aSAH.

Methods—
All residents ≥20 years were invited to the HUNT (The Nord-Trøndelag Health Study). In this study, 89 951 participants were included. The study included standardized measurements of blood pressure and self-administered questionnaires. Cases of UIA and aSAH from 1999 to 2014 were identified using hospital records and the Norwegian Cause of Death Register. Hazard ratios with CIs were estimated using Cox regression analysis.

Results—

The detection rate of UIA was 8.2 per 100 000 person-years (97 patients). Current smoking (hazard ratio, 4.1; 95% CI, 2.4–7.1) and female sex (hazard ratio, 2.8; 95% CI, 1.7–4.5) were associated with markedly increased risk of UIA, but we found no association with systolic blood pressure (
P
for trend 0.62). The incidence of aSAH was 9.9 per 100 000 person-years (117 patients). The most important risk factors for aSAH were current smoking, female sex and increasing blood pressure (
P
for trend 0.006 for systolic blood pressure).

Conclusions—
In contrast to previous studies on risk factors of UIA, we found no association with systolic blood pressure. However, there was a strong association between systolic blood pressure and aSAH in the same population. Current smoking and female sex were associated with both diseases.
Can Normic Laws Save Hempel’s Model of Historical Explanation? a Critique of Schurz’ Approach
Authors: Schumann Gunnar 
Published: August 2019

Abstract
I critically discuss Gerhard Schurz’ improved version of Hempel’s covering law model as the model appropriate for human action explanation in the historical sciences. Schurz takes so-called “normic laws” as the best means to save Hempel’s covering law model from the objection that there are no strict laws in historiography. I criticize Schurz approach in two respects: 1) Schurz falsely takes Dray’s account of historical explanations to be a normic law account. 2) Human action explanation in terms of goals and means-ends-beliefs are not based on normic laws at all, for the explanandum (the action) in an explanation follows from the volitional and doxastic premises (the explanans) alone. To show this, I argue that there is a conceptual connection between volition and action, rooted in our actual usage of volitional concepts. Ultimately, a difference in principle between the methods of explanation in science and historiography has to be acknowledged.
Aerodynamic Resistance Parameterization for Heterogeneous Surfaces Using a Covariance Function Approach in Spectral Space
Authors: Kröniger Konstantin , Katul Gabriel G. , De Roo Frederik , Brugger Peter , Mauder Matthias 
Published: August 2019

AbstractSimulating the influence of heterogeneous surfaces on atmospheric flow using mesoscale models (MSM) remains a challenging task, as the resolution of these models usually prohibits resolving important scales of surface heterogeneity. However, surface heterogeneity impacts fluxes of momentum, heat, or moisture, which act as lower boundary conditions for MSM. Even though several approaches for representing subgrid-scale heterogeneities in MSM exist, many of these approaches rely on Monin–Obukhov similarity theory, preventing those models from resolving all scales of surface heterogeneity. To improve upon these residual heterogeneity scales, a novel heterogeneity parameterization is derived by linking the heterogeneous covariance function in spectral space to an associated homogeneous one. This covariance function approach is subsequently used to derive a parameterization of the aerodynamic resistance to heat transfer of the surface layer. Here, the effect of surface heterogeneity enters as a factor applied to the stability correction functions of the bulk similarity approach. To perform a first comparison of the covariance function approach against the conventional bulk similarity and tile approaches, large-eddy simulations (LESs) of distinct surface heterogeneities are conducted. The aerodynamic resistances from these three parameterizations are subsequently tested against the LES reference by resolving the surface heterogeneities with six different test-MSM grids of varying cell dimension. The results of these comparisons show that the covariance function approach proposed here yields the smallest deviations from the LES reference. In addition, the smallest deviation of the covariance function approach to the reference is observed for the LES with the largest surface heterogeneity, which illustrates the advantage of this novel parameterization.
Retrospective analysis of repeated dexamethasone suppression tests – the added value of measuring dexamethasone
Authors: de Graaf Albert J , Mulder AH Leontine , Krabbe Johannes G 
Published: August 2019

Background In the evaluation for hypercortisolism (Cushing’s syndrome), the 1 mg overnight dexamethasone suppression test has an important role, but false-positive results can occur due to low serum dexamethasone. Given the high intraindividual reproducibility of post-dexamethasone suppression test serum cortisol concentrations, we investigated the chance of success of repeating a non-suppressed dexamethasone suppression test if serum dexamethasone is low. Methods We retrospectively analysed the results of 1901 consecutive dexamethasone suppression tests performed in our laboratory from February 2011 to November 2018. Serum dexamethasone and cortisol were measured by LC-MS/MS, and both were reported. The 2.5 and 5th percentiles of serum dexamethasone in suppressed dexamethasone suppression tests were investigated as cut-off value. Then, we retrospectively determined the success rate of repeating an initial, non-suppressed dexamethasone suppression test in 131 patients, stratified by initial serum dexamethasone. Results At serum dexamethasone concentrations between the 2.5 and 5th percentiles (3.2–3.9 nmol/L), significantly more non-suppressed dexamethasone suppression tests were observed (27/67) than in the control group of 1357 tests having serum dexamethasone ⩾6 nmol/L (40% vs. 30%, P = 0.047), indicating that 3.9 nmol/L is the better cut-off. Overall, 40% of non-suppressed dexamethasone suppression tests were repeated, but repeat testing was performed more often when serum dexamethasone was low. In patients who had initial serum dexamethasone below the cut-off of 3.9 nmol/L, a significantly higher chance of having a suppressed repeat dexamethasone suppression test was observed compared to the control group: 57% (31/54) vs. 26% (15/57), P = 0.001. Conclusions Measuring and reporting serum dexamethasone in dexamethasone suppression tests have added value for the selection of patients who might benefit from a repeat dexamethasone suppression test. We suggest a cut-off for serum dexamethasone of ⩾3.9 nmol/L.