bluuebunny/crossref_metadata_2025_split huggingface dataset:
Electroimmobilization as an Alternative Method to Chemical Immobilization of Larval Fish
Authors: Nguyen Phong L. , Yefimov Benjamin A. , Coffin Allison , Cooper Cynthia 
Published: April 2019

AbstractElectroimmobilization is commonly used in field and hatchery settings for juvenile to adult fish; however, its use in laboratory studies is limited, specifically with larval fish. Here, we describe the use of electroimmobilization for temporary immobilization of larval fish, with Zebrafish Danio rerio as the species of interest. We quantified immobilization duration and survival of larvae for 72 h after exposure to a range of electrical settings and electric waveforms. We also compared effects of electroimmobilization between two wild‐type strains and between larvae 4 days postfertilization (dpf) and 7 dpf. Our results indicate that an electrical power density level of 10,406 μW/cm3 (corresponding to a 10V setting with our experimental parameters) was ineffective at immobilizing fish, regardless of waveform; however, mean immobilization duration increased with an increase in applied power density, which was longest (mean ± SE = 100 ± 11 s) when using a pulsed direct current at a power density of 860,000 μW/cm3. Significant differences in mean immobilization duration and survival between strains were not detected for larvae exposed to the same setting. However, 7‐dpf larvae exposed to the same setting as 4‐dpf larvae had significantly longer immobilization durations across all treatment groups. Survival of 4‐dpf larvae within any given electroimmobilization treatment ranged from 80% to 100%, which was comparable to chemical immobilization with tricaine methanesulfonate or to age‐matched controls. Survival of 7‐dpf larvae ranged from 48% to 90% depending on electroimmobilization treatment, but survival of age‐matched controls was 65%; thus, lower survival of 7‐dpf larvae in treatment groups cannot be attributed specifically to electroimmobilization. These findings indicate that electroimmobilization can be a valuable tool for rapidly immobilizing larval fish in laboratory research, but we caution that it should only be used for short‐duration procedures.
Evaluation of a new goal-directed training curriculum for point-of-care ultrasound in the emergency department: impact on physician self-confidence and ultrasound skills
Authors: Shi Di , Liu Jihai , Xu Jun , Zhu Huadong , Yu Xuezhong 
Published: April 2019

Abstract
Purpose
Developing countries need effective and efficient training curriculum for the point-of-care ultrasound (POCUS) in the emergency department (ED). We have developed a new goal-directed training curriculum focusing on critical POCUS procedures used in ED.

Methods
To evaluate the impact of the new POCUS curriculum on ED physicians’ performance/self-confidence, we carried out a quasi-experimental trial at ED training center of Peking Union Medical College Hospital, in which we trained two groups of physicians using either traditional curriculum or the new goal-directed curriculum. We measured the confidence in performing Focused Assessment with Sonography in Trauma, thoracic, vascular, ultrasound-guided puncture, echocardiography and undifferentiated shock diagnostic ultrasound at baseline, training completion and 1 month after training. We also measured the performance skills at the time of training completion. The relative value of the new curriculum was evaluated by differences in the confidence and performance measurements, with control for baseline measurements and confounding characteristics in univariate analyses and multivariate linear regression models.

Results
After training, both groups of trainees reported significantly increased self-confidence in performing POCUS as compared with baseline. Trainees with the new curriculum had statistically significant higher self-confidence increase and performance scores (p < 0.05), e.g., increase in confidence for diagnosis of undifferentiated shock at training completion = 3.14 vs. 1.85, 1 month after training = 2.22 vs. 1.56, for new and traditional curriculum, respectively. The new curriculum also resulted in a higher number of shock POCUS done within 1 month after training: 1.73 vs. 0, and higher overall performance scores: 165 vs. 113. The findings were robust when controlling for imbalanced baseline characteristics in multivariate regression models.

Conclusion
We conclude that a goal-directed, intensive but brief ED POCUS curriculum significantly increases trainee self-confidence, performance, and promote trainees to perform more procedures.
A Perioperative Small Dose of Dexamethasone Enhances Postoperative Recovery by Reducing Volume and Inflammatory Contents in Wound Drainage After Thyroid Surgery: A Double‐Blinded, Randomized, Prospective Study
Authors: Zhang Huiwen , Lu Jie , Wu Qiang , Wu Bo , Xu Cheng , Fan Youben , Zhou Quanhong 
Published: April 2019

AbstractBackgroundThe aims of this study were to assess the effect of perioperative dexamethasone on postoperative thyroid surgery recovery using measures of wound drainage volume and C‐reactive protein (CRP) levels and leukocyte counts.Materials and methodsFrom January to September 2014, healthy patients, aged between 18 and 65 years, had elective thyroid surgery in the tertiary hospital. Eligible patients were randomized into either group D (dexamethasone 0.1 mg/kg IV) or group S (saline IV) after anesthesia induction. At the end of surgery, a drainage tube was placed at the thyroid bed with a negative pressure ball connected outside the wound. Drainage fluids were collected after thyroid surgery. The fluid volume and the levels of C‐reactive protein and leukocyte counts inside were analyzed. All patients were followed up for 1 month.ResultsThe median total drainage in group D (n = 103) was 43 ml (IQR: 21–83 ml), and 68 ml (IQR: 35–104 ml) in group S (n = 111), P = 0.002. More patients in group D were discharged on postoperative day 2 (74.8% vs. 54.1%, P = 0.002). The CRP levels and leukocyte counts were much less in group D than in group S (P = 0.002 and P < 0.001, respectively). Two patients (one in each group) had wound infections 1 week after surgery that healed one additional week later.ConclusionsOne perioperative small dose of dexamethasone reduced wound drainage volume and inflammatory content after thyroid surgery, thereby possibly contributing to early recovery. The effects of dexamethasone have never been evaluated before under these conditions.Registration number:NCT02304250 (http://www.clinicaltrials.gov).
Applied phenomenology: why it is safe to ignore the epoché
Authors: Zahavi Dan 
Published: April 2019

AbstractThe question of whether a proper phenomenological investigation and analysis requires one to perform the epoché and the reduction has not only been discussed within phenomenological philosophy. It is also very much a question that has been hotly debated within qualitative research. Amedeo Giorgi, in particular, has insisted that no scientific research can claim phenomenological status unless it is supported by some use of the epoché and reduction. Giorgi partially bases this claim on ideas found in Husserl’s writings on phenomenological psychology. In the present paper, I discuss Husserl’s ideas and argue that while the epoché and the reduction are crucial for transcendental phenomenology, it is much more questionable whether they are also relevant for a non-philosophical application of phenomenology.
Future Demand for Total Joint Arthroplasty Drives Renewed Interest in Arthroplasty Fellowship
Authors: Sloan Matthew , Premkumar Ajay , Sheth Neil P. 
Published: April 2019

Background Total joint arthroplasty (TJA) procedure volume has increased continuously in the USA, but prior reports have suggested that orthopedic surgeon supply may not meet future demand due to retirement and waning interest in arthroplasty fellowships. Purposes We sought to evaluate trends in growth in the number of orthopedic surgeons, orthopedic residents, and arthroplasty fellowships, in order to predict changes in future TJA procedure volume per surgeon. Methods We retrospectively reviewed data from 1995 to 2017 from the American Academy of Orthopaedic Surgeons, the National Residency Matching Program, American Osteopathic Association Residency Match, the San Francisco Match, and the National Inpatient Sample. Annual volume growth in the rate of TJA procedures and in orthopedic surgeons, residents, and fellows was determined. Results TJA procedure volume increased 129%, orthopedic surgeon volume increased 15.6%, and orthopedic resident volume increased 29.4%. The percentage of filled arthroplasty fellowship positions increased from 81.9 to 96.4%, and the number of arthroplasty fellowship positions increased 33.5%. Mean surgeon age increased from 50.9 to 56.5 years. By 2030, we estimate 90.1 TJA procedures per surgeon will be performed annually, a 57% increase from 2014. Over the same time period, we project mean orthopedic surgeon age to reach 62.4 years, if current growth rate persists. Conclusion During the study period, orthopedic surgeon, resident, and arthroplasty fellow volume have increased, although at a slower rate than TJA procedure growth. Renewed interest in arthroplasty fellowships has been demonstrated by an increase in the number and near complete filling of all available positions.
Is there a positive side to sensation seeking? Trajectories of sensation seeking and impulsivity may have unique outcomes in young adulthood
Authors: Yoneda Tomiko , Ames Megan E. , Leadbeater Bonnie J. 
Published: April 2019

ABSTRACTIntroductionHigh levels of sensation seeking and impulsivity in adolescence are typically associated with risky behaviours; limited research has examined the relation of these traits to positive outcomes. Given that adolescence is a sensitive developmental period that can impact success later in life, we adopt the Positive Youth Development Framework to better understand how the development of self‐reported sensation seeking and impulsivity may be differentially related to positive markers of early adulthood.MethodData are from the Victoria Healthy Youth Survey (T1 N = 662; 52% female), a six‐wave longitudinal cohort study of Canadian youth. Parallel process latent class growth analysis estimated trajectories of sensation seeking and impulsivity identifying classes of youth (ages 14–28). Controlling for baseline age, sex, and socio‐economic status, linear regression analyses examined how longitudinal patterns (classes) of sensation seeking and impulsivity were related to positive markers of early adulthood.ResultsThree classes of youth were identified. These varied in levels and trajectories of change in sensation seeking (Ss) and impulsivity (I): LowSs‐LowI, 26%; HighSs‐HighI, 35%; ModerateSs‐LowI, 38%. In young adulthood (T6; ages 22–29), youth in the LowSs‐LowI and ModerateSs‐LowI classes had significantly higher educational and occupational achievement, and lower financial strain, compared to youth in the HighSs‐HighI class. Further, the ModerateSs‐LowI class was associated with the highest levels of income and well‐being.ConclusionsFindings identified differential trajectories of sensation seeking and impulsivity, with youth in the ModerateSs‐LowI class, followed by the LowSs‐LowI class, reporting the most positive outcomes in young adulthood.
Mandatory Multilateralism
Authors: Criddle Evan J. , Fox-Decent Evan 
Published: April 2019

AbstractThis Article challenges the conventional wisdom that states are always free to choose whether to participate in multilateral regimes. International law often mandates multilateralism to ensure that state laws and practices are compatible with sovereign equality and joint stewardship. The Article maps mandatory multilateralism's domain, defines its requirements, and examines its application to three controversies: the South China Sea dispute, the United States’ withdrawal from the 2015 Paris Agreement, and Bolivia's case against Chile in the International Court of Justice.
Health-related quality of life of coronary artery bypass grafting and percutaneous transluminal coronary artery angioplasty patients: 1-year follow-up
Authors: Kattainen Eija , Sintonen Harri , Kettunen Raimo , Meriläinen Pirkko 
Published: April 2019

Objectives:The aim of the study was to compare the health-related quality of life (HRQoL) of patients undergoing coronary artery bypass grafting (CABG) or percutaneous transluminal coronary angioplasty (PTCA) before the interventions and 6 and 12 months afterward, and to compare their HRQoL also with that of the general population.Methods:The sample (n = 615) consisted of consecutive coronary artery disease patients treated with elective CABG (n = 432) or PTCA (n = 183). The baseline data before the treatments were collected by structured interview, the follow-up data mainly by mailed self-administered questionnaires. HRQoL was measured by the 15D. For comparisons, the groups were standardized for differences in socioeconomic and clinical characteristics with a regression analysis.Results:At baseline, the average 15D scores of the patient groups were 0.752 (95 percent confidence interval [CI], 0.743–0.761) in CABG and 0.730 (95 percent CI, 0.716–0.744) in PTCA. After standardization, the difference between the groups was statistically significant but not clinically important. These scores were significantly worse (statistically and clinically) than the score of 0.883 (95 percent CI, 0.871–0.879) in the general population sample matched with the gender and age distribution of the patients. By 6 months, the CABG and PTCA patients had experienced a statistically significant and clinically important improvement to 0.858 (95 percent CI, 0.844–0.872) and 0.824 (95 percent CI, 0.806–0.842), respectively. No significant change took place in either group from 6 to 12 months.Conclusions:Both CABG and PTCA produces an approximately similar, clinically important improvement in HRQoL in 1-year follow-up.
Quality appraisal of pediatric health economic evaluations
Authors: Ungar Wendy J. , Santos Maria T. 
Published: April 2019

Objectives: This study was undertaken to appraise the quality of published pediatric economic evaluations.Methods: Two independent reviewers appraised 149 randomly selected pediatric health economic studies. Data were collected from full economic evaluations published between 1980 and 1999. Economic evaluations of interventions, programs, and services aimed at neonates to adolescents were included. The Pediatric Quality Appraisal Questionnaire (PQAQ) was used for appraisal. The PQAQ is a 57-item instrument with 13 domains scored from 0 to 1 and one descriptive domain, each corresponding to a key aspect of health economic methodology. The primary outcome was the score for each domain. Additional analyses examined the global rating, the distribution of analytic technique, and the association between domain score and analytic technique.Results: A total of 38 percent of publications were very good to excellent, whereas 43 percent were fair or worse. Although the Discounting, Target Population, Economic Evaluation, Conclusions, and Comparators domains exhibited good quality (0.74 to 0.78), the papers were of poor quality for Conflict of Interest, Incremental Analysis, and Perspective (0.32 to 0.39). Analytic technique was a significant predictor of quality for study design-related domains, with cost-utility analyses demonstrating the highest domain scores.Conclusions: Domains closely related to the elements of economic evaluation demonstrated medium to high quality. However, domains related to analysis fared poorly and are worthy of further methodological research to improve the use of health economic methods in children.
Effects of the increase in co-payments from 20 to 30 percent on the compliance rate of patients with hypertension or diabetes mellitus in the Employed Health Insurance System
Authors: Babazono Akira , Miyazaki Motonobu , Imatoh Takuya , Une Hiroshi , Yamamoto Eiji , Tsuda Toshihide , Tanaka Kiyoshi , Tanihara Shinichi 
Published: April 2019

Objectives:How to contain medical expenditures is a universal problem. The Japanese government has increased patient co-payments to control it. The purpose of this study is to clarify whether the increase in co-payments to 30 percent prevented patients with hypertension or diabetes mellitus from receiving necessary care in the Employee Health Insurance System.Methods:The subjects were 211 patients with hypertension and 66 patients with diabetes mellitus who regularly visited physicians from October 2001 to March 2002 and were defined as a cohort that needed health care, and their medical indicators were examined between April and September 2002 (prestage) and between April and September 2003 (poststage).Results:In the hypertensive patients with no complications, the compliance rate was 89.9 percent and 88.0 percent in the prestage, and poststage, respectively, showing no significant change. In the hypertensive patients with complications, the compliance rate was 90.5 percent and 92.1 percent in the prestage and poststage, respectively, showing no significant change. In the diabetic patients with complications, the compliance rate was 77.5 percent and 79.2 percent, in the prestage and poststage, respectively, with no significant change. In the diabetic patients with no complications, however, the compliance rate was 83.7 percent and 66.7 percent, in the prestage and poststage, respectively. A significant decrease was observed among diabetic patients without complications.Conclusions:Increasing co-payments reduced necessary preventive care in diabetic patients without complications.
Economic analysis of the implementation of autologous transfusion technologies throughout England
Authors: Dixon Simon , James Virge , Hind Daniel , Currie Craig J. 
Published: April 2019

Objectives:This study aims to provide the first estimates of the costs and effects of the large scale introduction of autologous transfusion technologies into the United Kingdom National Health Service.Methods:A model was constructed to allow disparate data sources to be combined to produce estimates of the scale, costs, and effects of introducing four interventions. The interventions considered were preparing patients for surgery (PPS) clinics, preoperative autologous donation (PAD), intraoperative cell salvage (ICS), and postoperative cell salvage (PoCS).Results:The key determinants of cost per operation are the anticipated level of reductions in blood use, the mean level of blood use, mean length of stay, and the cost of the technology. The results show the potential for considerable reductions in blood use. The greatest reductions are anticipated to be through the use of PPS and ICS. Vascular surgery, transplant surgery, and cardiothoracic surgery appear to be the specialties that will benefit most from the technologies.Conclusions:Several simplifications were used in the production of these estimates; consequently, caution should be used in their interpretation and use. Despite the drawbacks in the methods used in the study, the model shows the scale of the issue, the importance of gathering better data, and the form that data must take. Such preliminary modeling exercises are essential for rational policy development and to direct future research and discussion among stakeholders.
End-user involvement in health technology assessment (HTA) development: A way to increase impact
Authors: McGregor Maurice , Brophy James M. 
Published: April 2019

Objectives: A mechanism to increase the influence of Health Technology Assessments (HTAs) on hospital policy decisions was developed.Methods: We describe the process and results of an experiment in which a local in-hospital HTA unit was created to provide sound evidence on technology acquisition issues, and to formulate locally appropriate policy recommendations. The Unit consists of a small technical staff that accesses and synthesizes the evidence incorporating local health and economic data, and a Policy Committee that develops policy recommendations based on this evidence. It represents administration, health-care professionals, patients, and representatives of the clinical disciplines affected by each issue. The level of success of the Unit was independently evaluated.Results: To date, 16 reports have been completed, each within 2–4 months. Five recommended unrestricted use, seven recommended rejection, and four recommended very limited use of the technology in question. All have been incorporated into hospital policy. Budget impact is estimated at approximately $3 million of savings per year.Conclusions: This local in-house HTA agency has had a major impact on the adoption of new technology. Probable reasons for success are (i) relevance (selection of topics by administration with on-site production of HTAs allowing them to incorporate local data and reflect local needs), (ii) timeliness, and (iii) formulation of policy reflecting community values by a local representative committee. Because over one third of all health-care costs are incurred in the hospital, diffusion of this model could have a significant effect on the quantity and quality of health-care spending.
“Impressions of Plants Themselves”: Materializing Eco-Archival Practices with Anna Atkins'sPhotographs of British Algae
Authors: Garascia Ann 
Published: April 2019

Three ghostly white plants float suspended atop the Prussian-blue background of a 27 x 21 cm print (fig. 1). Their leafy fronds are so exquisitely fine that in some places the blue bleeds through their tissues to expose delicate quiltings of veins and willowy inflorescences. Opaque white patches mottle each of the plants to signal where multiple layers of plant flesh overlap. The interplay of shapes, color, and textures in the image captures an atmospheric effect of alien beauty, nearly incomprehensible. That is, until the small label at the bottom of the print in meticulous penmanship informs us that we are looking atDelessaria sanguinea,a type of red algae commonly known as “Sea Beech.” This is one in the thousand-plus body of images that comprises Anna Atkins'sPhotographs of British Algae: Cyanotype Impressions. Dedicated to documenting England's native seaweed, ferns, and flowering plants, Atkins's photographic botanical project ranged about a decade (October 1843–53) and resulted in multiple editions she would give to friends and cultural institutions. While she primarily helmed the project herself, she occasionally included her father, zoologist and photography enthusiast John Children. For the last couple albums, she enlisted as a co-creator her “like a sister” Anne Dixon, who collected, arranged, and developed the images alongside Atkins.