bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of surgical site infection (SSI) following gynaecological cancer surgery in the UK: a trainee-led multicentre audit and service evaluation
Authors: O’Donnell Rachel L , Angelopoulos Georgios , Beirne James P , Biliatis Ioannis , Bolton Helen , Bradbury Melissa , Craig Elaine , Gajjar Ketan , Mackintosh Michelle L , MacNab Wendy , Madhuri Thumuluru Kavitha , McComiskey Mark , Myriokefalitaki Eva , Newton Claire L , Ratnavelu Nithya , Taylor Sian E , Thangavelu Amudha , Rhodes Sarah A , Crosbie Emma J , Edmondson Richard J , Wan Yee-Loi Louise 
Published: January 2019

ObjectivesSurgical site infection (SSI) complicates 5% of all surgical procedures in the UK and is a major cause of postoperative morbidity and a substantial drain on healthcare resources. Little is known about the incidence of SSI and its consequences in women undergoing surgery for gynaecological cancer. Our aim was to perform the first national audit of SSI following gynaecological cancer surgery through the establishment of a UK-wide trainee-led research network.Design and settingIn a prospective audit, we collected data from all women undergoing laparotomy for suspected gynaecological cancer at 12 specialist oncology centres in the UK during an 8-week period in 2015. Clinicopathological data were collected, and wound complications and their sequelae were recorded during the 30 days following surgery.ResultsIn total, 339 women underwent laparotomy for suspected gynaecological cancer during the study period. A clinical diagnosis of SSI was made in 54 (16%) women. 33% (18/54) of women with SSI had prolonged hospital stays, and 11/37 (29%) had their adjuvant treatment delayed or cancelled. Multivariate analysis found body mass index (BMI) was the strongest risk factor for SSI (OR 1.08[95% CI 1.03 to 1.14] per 1 kg/m2increase in BMI [p=0.001]). Wound drains (OR 2.92[95% CI 1.41 to 6.04], p=0.004) and staple closure (OR 3.13[95% CI 1.50 to 6.56], p=0.002) were also associated with increased risk of SSI.ConclusionsSSI is common in women undergoing surgery for gynaecological cancer leading to delays in discharge and adjuvant treatment. Resultant delays in adjuvant treatment may impact cancer-specific survival rates. Modifiable factors, such as choice of wound closure material, offer opportunities for reducing SSI and reducing morbidity in these women. There is a clear need for new trials in SSI prevention in this patient group; our trainee-led initiative provides a platform for their successful completion.
Are predominantly western standards and expectations of informed consent in surgery applicable to all? A qualitative study in a tertiary care hospital in Sri Lanka
Authors: Samaranayake Udagedara Mudiyanselage Jayami Esha , Mathangasinghe Yasith , Banagala Anura Sarath Kumara 
Published: January 2019

ObjectiveTo identify the different perceptions on informed surgical consent in a group of Sri Lankan patients.MethodsA qualitative study was conducted in a single surgical unit at a tertiary care hospital from January to May 2018. The protocol conformed to the Declaration of Helsinki. Patients undergoing elective major surgeries were recruited using initial purposive and later theoretical sampling. In-depth interviews were conducted in their native language based on the grounded theory. Initial codes were generated after analysing the transcripts. Constant comparative method was employed during intermediate and advanced coding. Data collection and analyses were conducted simultaneously, until the saturation of the themes. Finally, advanced coding was used for theoretical integrations.ResultsThirty patients (male:female=12:18) were assessed. The mean age was 41±9 years. Sinhalese predominated (50.0%, n=15). Majority underwent thyroidectomy (36.7%, n=11). The generated theory categorises the process of obtaining informed consent in four phases: initial interaction phase, reasoning phase, convincing phase and decision-making phase. Giving consent for surgery was a dependent role between patient, family members and the surgeon, as opposed to an individual decision by the patient. Some patients abstained from asking questions from doctors since doctors were ‘busy’, ‘short-tempered’ or ‘stressed out’. Some found nurses to be more approachable than doctors. Patients admitted that having a bystander while obtaining consent would relieve their stress. They needed doctors to emphasise more on postoperative lifestyle changes and preprocedure counselling at the clinic level. To educate patients about their procedure, some suggested leaflets or booklets to be distributed at the clinic before ward admission. The majority disliked watching educational videos because they were ‘scared’ to look at surgical dissections and blood.ConclusionThe informed consent process should include key elements that are non-culture specific along with elements or practices that consider the cultural norms of the society.
Prevalence of frailty in rural community-dwelling older adults in Kegalle district of Sri Lanka: a population-based cross-sectional study
Authors: Siriwardhana Dhammika Deepani , Weerasinghe Manuj Chrishantha , Rait Greta , Falcaro Milena , Scholes Shaun , Walters Kate R 
Published: January 2019

ObjectiveOur main objective was to describe the prevalence and associated sociodemographic factors of frailty and pre-frailty in rural community-dwelling older adults in Kegalle district of Sri Lanka.DesignCommunity-based cross-sectional study.SettingThe study was conducted in rural areas of Kegalle district in Sri Lanka.ParticipantsA total of 746 community-dwelling older adults aged ≥60 years were included in the study.ResultsThe prevalence of frailty and pre-frailty in rural Kegalle district was 15.2% (95% CI 12.3% to 18.6%) and 48.5% (95% CI 43.8% to 53.2%), respectively. We found a strong association between age and both frailty and pre-frailty. There were strong associations between longest-held occupation and frailty and education level and pre-frailty.ConclusionsThe prevalence of frailty in this rural Sri Lankan older population was high compared with high-income and upper middle-income countries. The profile of health and social care services in Sri Lanka needs to address frailty and its consequences.
Prevention of child mental health problems in Southeastern Europe: a multicentre sequential study to adapt, optimise and test the parenting programme ‘Parenting for Lifelong Health for Young Children’, protocol for stage 1, the feasibility study
Authors: Frantz Inga , Foran Heather M , Lachman Jamie M , Jansen Elena , Hutchings Judy , Băban Adriana , Fang Xiangming , Gardner Frances , Lesco Galina , Raleva Marija , Ward Catherine L , Williams Margiad Elen , Heinrichs Nina 
Published: January 2019

IntroductionFamilies in low-income and middle-income countries (LMICs) face multiple challenges (eg, poverty and adverse childhood experiences) that increase the risk for child mental health problems, while the context may provide them with few resources. Existing prevention-oriented parenting programmes have been shown to be effective in reducing child behaviour problems and associated risk factors. This project has the overall goal of adapting, implementing and testing a parenting intervention in three Southeastern European LMIC and uses the Multiphase Optimisation Strategy and dimensions of the Reach, Effectiveness, Adoption, Implementation and Maintenance framework. It is implemented over three phases: (1) preparation, (2) optimisation and (3) evaluation. The preparation phase, the subject of this paper, involves the adaptation and feasibility piloting of the parenting programme.Methods and analysisThis protocol describes the assessment of an evidence-informed indicated prevention programme for families with children aged 2–9 years (Parenting for Lifelong Health for Young Children) for implementation in FYR of Macedonia, Republic of Moldova and Romania. In this phase, officials, experts, parents and practitioners are interviewed to explore their views of suitability and needs for further adaptation. In addition, a small pre–post pilot study will test the feasibility of the programme and its implementation as well as the evaluation measures in the three countries with 40 families per country site (n=120). Quantitative data analysis will comprise a psychometric analysis of measures, testing pre–post differences using ANCOVA, χ2tests and regression analysis. For qualitative data analysis, a thematic approach within an experiential framework will be applied.Ethics and disseminationThe ethics review board of the Alpen-Adria University Klagenfurt and ethical review boards in the three LMIC sites have approved the study.Trial registration numberNCT03552250.
Parallel and serial mediation analysis between pain, anxiety, depression, fatigue and nausea, vomiting and retching within a randomised controlled trial in patients with breast and prostate cancer
Authors: Charalambous Andreas , Giannakopoulou Margarita , Bozas Evaggelos , Paikousis Lefkios 
Published: January 2019

ObjectiveCancer treatment is a particularly stressful period for the patient. The reasons vary and include fear of treatment outcome as well as treatment induced side effects. The patient frequently experiences simultaneously various side effects resulting in a diminishing of the patient’s health-related quality of life (HRQoL). The study provides evidence on the co-occurrence and inter-relations between pain, anxiety, depression and fatigue in patients with breast and prostate cancer.DesignThis paper presents a secondary analysis of the data from a randomised control trial designed to test the effectiveness of guided imagery and progressive muscle relaxation on pain, fatigue, anxiety and depression. Non-parametric bootstrapping analyses were used to test the mediational model of anxiety, fatigue and depression as parallel mediators of the relationship between pain and HRQoL.SettingThe study was undertaken at the home setting.ParticipantsIn total 208 patients were included in the study (assigned equally in two groups), referred at the outpatient clinics of the three participating cancer care centres.ResultsThe three mediators fully mediate the relationship between pain and HRQoL indirect effect (IEoverall=−0.3839, 95% CI: lower limit (LL)=−0.5073 to upper limit (UL)=−0.2825) indicating that patients with increased pain are likely to have higher levels of anxiety, fatigue and depression. Gender significantly moderated the mediational effect of Fatigue Index of Moderated Mediation (IMM=−0.2867 SE=0.1526, LL=−0.6127, UL=−0.0226) but did not moderate mediational effect of anxiety (IMM=−0.0709, SE=0.1414, LL=−0.3459, UL=+0.2089). The results show that the three mediators in a serial causal order fully mediate the relationship between pain and HRQoL (IEoverall=−0.384, 95% CI: LL=−0.51 to UL=−0.284) and the ratio of the overall indirect effect to the total effect is 0.8315 (95% CI: LL=0.5683 to UL=1.1718).ConclusionThis work provides evidence that targeting fatigue, anxiety and depression may have a meaningful effect on pain as a related symptom and potentially have a positive impact on HRQoL of patients with breast and prostate cancerTrial registration numberNCT01275872; Post-results.
Home self-administration of intravenous antibiotics as part of an outpatient parenteral antibiotic therapy service: a qualitative study of the perspectives of patients who do not self-administer
Authors: Tonna Antonella , Anthony Geraldine , Tonna Ivan , Paudyal Vibhu , Forbes-McKay Katrina , Laing Rob , Mackenzie Alexander , Falconer Sharon , McCartney Gillian , Stewart Derek 
Published: January 2019

ObjectivesThis study aimed to use a theoretical approach to understand the determinants of behaviour in patients not home self-administering intravenous antibiotics.SettingOutpatient care: included patients were attending an outpatient clinic for intravenous antibiotic administration in the northeast of Scotland.ParticipantsPatients were included if they had received more than 7 days of intravenous antibiotics and were aged 16 years and over. Twenty potential participants were approached, and all agreed to be interviewed. 13 were male with a mean age of 54 years (SD +17.6).OutcomesKey behavioural determinants that influenced patients’ behaviours relating to self-administration of intravenous antibiotics.DesignQualitative, semistructured in-depth interviews were undertaken with a purposive sample of patients. An interview schedule, underpinned by the Theoretical Domains Framework (TDF), was developed, reviewed for credibility and piloted. Interviews were audio-recorded and transcribed verbatim. Data were analysed thematically using the TDF as the coding framework.ResultsThe key behavioural determinants emerging as encouraging patients to self-administer intravenous antibiotics were the perceptions of being sufficiently knowledgeable, skilful and competent and that self-administration afforded the potential to work while administering treatment. The key determinants that impacted their decision not to self-administer were lack of knowledge of available options, a perception that hospital staff are better trained and anxieties of potential complications.ConclusionThough patients are appreciative of the skills and knowledge of hospital staff, there is also a willingness among patients to home self-administer antibiotics. However, the main barrier emerges to be a perceived lack of knowledge of ways of doing this at home. To overcome this, a number of interventions are suggested based on evidence-based behavioural change techniques.
Do golf fans walk the talk? Follow-up of spectators’ beliefs and self-reported physical activity 3 months after they attended a professional golf tournament in the UK
Authors: Murray Andrew D , Hawkes Roger A , Kelly Paul , Grant Liz , Mutrie Nanette 
Published: January 2019

BackgroundPrevious research of spectators at professional golf tournaments has highlighted that obtaining exercise/physical activity (PA) can be a motivator to attend, and that spectators can engage in health-enhancing PA while at the event. We assessed whether attending a golf event and receiving an intervention improve knowledge and change attitudes related to physical activity, and self-reported physical activity 3 months later.MethodsFollow-up observational study. Spectators at a European Tour Golf event were given a leaflet about physical activity and health. Three months after that event, we emailed a questionnaire to all 326 spectators who had participated in the original study and provided us their contact details.Results135 spectators (41.4%) completed the questionnaire. Among responders, 68.0% ‘agreed/strongly agreed’ that their knowledge relating to PA had increased, 65.1% agreed/strongly agreed that receiving this information at the event made them consider increasing physical activity in daily life and 40.4% reported that they had increased their physical activity during the 3 months after the golf tournament.Principal findings/conclusionsGolf spectators may contemplate/prepare to increase PA in daily life while a smaller number self-report an increase in PA during the 3 months post intervention at a golf tournament. Spectators’ preferred method for receiving information about ‘active spectating’ is via a big screen. These findings are presented with caution, as respondents may not be representative of all golf spectators.
Randomized controlled trial of a simplified adductor canal block performed for analgesia following total knee arthroplasty
Authors: Swenson Jeffrey D , Pollard Jacob E , Peters Christopher L , Anderson Mike B , Pace Nathan L 
Published: January 2019

Background and objectivesThe objective of the study was to determine if injection of local anesthetic into the vastus medialis and sartorius muscles adjacent to the adductor canal produces sensory changes comparable with adductor canal block (ACB). This could result in a technically easier and potentially safer alternative to ACB.MethodsIn this randomized controlled trial, patients received either ACB (n=20) or a simplified adductor canal (SAC) block performed using a new fenestrated nerve block needle (n=20). The time to perform each block as well as the number of attempts to position the needle were evaluated. A non-inferiority test was used to compare pain scores and opioid requirements for the ACB and the SAC block.ResultsThe SAC block was performed more rapidly, with fewer needle passes, and had a higher success rate than the ACB. Three block failures and two vessel punctures were observed in the ACB group, while none of these events occurred in SAC block patients. Analgesia and opioid consumption for patients treated with the SAC block were not inferior to ACB.ConclusionThe SAC block is technically easier to perform and potentially safer than ACB. This procedure can be performed using easily visible ultrasound landmarks and has the potential for use among a wide range of healthcare providers.Trial registration numberNCT02786888.
The focused assessment with sonography in trauma (FAST) in hypotensive injured patients frequently fails to identify the need for laparotomy: a multi-institutional pragmatic study
Authors: Rowell Susan E , Barbosa Ronald R , Holcomb John B , Fox Erin E , Barton Cassie A , Schreiber Martin A 
Published: January 2019

BackgroundThe ability of focused assessment with sonography for trauma (FAST) to detect clinically significant hemorrhage in hypotensive injured patients remains unclear. We sought to describe the sensitivity and specificity of FAST using findings at laparotomy as the confirmatory test.MethodsPatients from the Prospective Observational Multicenter Major Trauma Transfusion (PROMMTT) study that had a systolic blood pressure < 90mm Hg and underwent FAST were analysed. Results were compared with findings at laparotomy. A therapeutic laparotomy (T-LAP) was defined as an abdominal operation within 6 hours in which a definitive procedure was performed. The sensitivity and specificity of FAST were calculated.ResultsThe cohort included 317 patients that underwent FAST (108 positive, 209 negative). T-LAP was performed in 69% (n=75) of FAST(+) patients and 22% (n=48) of FAST(−) patients. FAST had a sensitivity of 62% and specificity of 83%.ConclusionsIn our multicenter cohort, 22% of FAST(−) patients underwent T-LAP within 6 hours of admission. In hypotensive patients with a negative FAST, clinicians should still maintain a high index of suspicion for significant abdominal hemorrhage.Level of evidenceLevel IV.
Automatic Detection of the Cracks on the Concrete Railway Sleepers
Authors: Tabatabaei Seyed Amir Hossein , Delforouzi Ahmad , Khan Muhammad Hassan , Wesener Tim , Grzegorzek Marcin 
Published: January 2019

A vision-based method for detecting the cracks in the concrete sleepers of the railway tracks will be introduced in this paper. The method is able to detect and partially classify the cracks of the concrete sleepers in two successive steps based on the image processing and pattern recognition techniques. The method has been implemented on the acquired image data frames followed by the analysis, experimental, comparison results and evaluation. The presented results are reasonable which indicates the goodness of the introduced method. The preliminary results of this work have been presented in [A. Delforouzi, A. H. Tabatabaei, M. H. Khan and M. Grzegorzek, A vision-based method for automatic crack detection in railway sleepers, in Kurzynski, M., Wozniak, M., Burduk, R. (eds.), Proceedings of the 10th International Conference on Computer Recognition Systems CORES 2017, Polanica Zdroj, Poland. CORES 2017. Advances in Intelligent Systems and Computing, Vol. 578 (Springer, Cham, 2018), pp. 130–139, doi: 10.1007/978-3-319-59162-9_14].
Adenosine A1receptors and mitochondria: targets of remote ischemic preconditioning
Authors: Paez Diamela T. , Garces Mariana , Calabró Valeria , Bin Eliana P. , D’Annunzio Verónica , del Mauro Julieta , Marchini Timoteo , Höcht Christian , Evelson Pablo , Gelpi Ricardo J. , Donato Martín 
Published: January 2019

Adenosine is involved in classic preconditioning in most species and acts especially through adenosine A1and A3receptors. The aim of the present study was to evaluate whether remote ischemic preconditioning (rIPC) activates adenosine A1receptors and improves mitochondrial function, thereby reducing myocardial infarct size. Isolated rat hearts were subjected to 30 min of global ischemia and 60 min of reperfusion [ischemia-reperfusion (I/R)]. In a second group, before isolation of the heart, a rIPC protocol (3 cycles of hindlimb I/R) was performed. Infarct size was measured with tetrazolium staining, and Akt/endothelial nitric oxide (NO) synthase (eNOS) expression/phosphorylation and mitochondrial function were evaluated after ischemia at 10 and 60 min of reperfusion. As expected, rIPC significantly decreased infarct size. This beneficial effect was abolished only when 8-cyclopentyl-1,3-dipropylxanthine (adenosine A1receptor blocker) and NG-nitro-l-arginine methyl ester (NO synthesis inhibitor) were administered during the reperfusion phase. At the early reperfusion phase, rIPC induced significant Akt and eNOS phosphorylation, which was abolished by the perfusion with an adenosine A1receptor blocker. I/R led to impaired mitochondrial function, which was attenuated by rIPC and mediated by adenosine A1receptors. In conclusion, we demonstrated that rIPC limits myocardial infarct by activation of adenosine A1receptors at early reperfusion in the isolated rat heart. Interestingly, rIPC appears to reduce myocardial infarct size by the Akt/eNOS pathway and improves mitochondrial function during myocardial reperfusion.NEW & NOTEWORTHY Adenosine is involved in classic preconditioning and acts especially through adenosine A1and A3receptors. However, its role in the mechanism of remote ischemic preconditioning is controversial. In this study, we demonstrated that remote ischemic preconditioning activates adenosine A1receptors during early reperfusion, inducing Akt/endothelial nitric oxide synthase phosphorylation and improving mitochondrial function, thereby reducing myocardial infarct size.
Interplay between TRAP1 and Sirtuin-3 Modulates Mitochondrial Respiration and Oxidative Stress to Maintain Stemness of Glioma Stem Cells
Authors: Park Hye-Kyung , Hong Jun-Hee , Oh Young Taek , Kim Sung Soo , Yin Jinlong , Lee An-Jung , Chae Young Chan , Kim Jong Heon , Park Sung-Hye , Park Chul-Kee , Park Myung-Jin , Park Jong Bae , Kang Byoung Heon 
Published: January 2019

Abstract

Glioblastoma (GBM) cancer stem cells (CSC) are primarily responsible for metastatic dissemination, resistance to therapy, and relapse of GBM, the most common and aggressive brain tumor. Development and maintenance of CSCs require orchestrated metabolic rewiring and metabolic adaptation to a changing microenvironment. Here, we show that cooperative interplay between the mitochondrial chaperone TRAP1 and the major mitochondria deacetylase sirtuin-3 (SIRT3) in glioma stem cells (GSC) increases mitochondrial respiratory capacity and reduces production of reactive oxygen species. This metabolic regulation endowed GSCs with metabolic plasticity, facilitated adaptation to stress (particularly reduced nutrient supply), and maintained “stemness.” Inactivation of TRAP1 or SIRT3 compromised their interdependent regulatory mechanisms, leading to metabolic alterations, loss of stemness, and suppression of tumor formation by GSC in vivo. Thus, targeting the metabolic mechanisms regulating interplay between TRAP1 and SIRT3 may provide a novel therapeutic option for intractable patients with GBM.

Significance:
Discovery and functional analysis of a TRAP1–SIRT3 complex in glioma stem cells identify potential target proteins for glioblastoma treatment.