bluuebunny/crossref_metadata_2025_split huggingface dataset:
Saturday allied health services for geriatric evaluation and management: A controlled before‐and‐after trial
Authors: Taylor Nicholas F. , Lawler Katherine , Brusco Natasha K. , Peiris Casey L. , Harding Katherine E. , Scroggie Grant D. , Boyd Jude N. , Wilton Anita M. , Coker Freya , Ferraro John G. , Shields Nora 
Published: May 2019

AbstractObjectiveTo assess the effect of Saturday allied health services on a geriatric evaluation and management ward.MethodsA controlled before‐and‐after trial at two wards. Allied health services were added to usual weekday staffing on Saturdays for 6 months on the experimental ward. Length of stay, functional independence, readmissions, discharge destination and costs were evaluated at pre‐intervention (N = 331) and intervention (N = 462).ResultsRelative to the comparison ward, the experimental ward had longer length of stay (mean 7.8 days, 95% CI 4.7‐10.8), fewer readmissions (mean 3.1 days, 95% CI 0.6‐5.7) and no difference in the proportion discharged home. Cost‐effectiveness demonstrated no significant difference in cost ($2639, 95% CI $‐386 to $5647) and functional independence gain (3.6 units, 95% CI 0.8‐6.5) favouring the experimental ward.ConclusionThese findings do not support the provision of additional Saturday allied health services in geriatric evaluation and management to reduce length of stay.
Help, I'm a specialist!—Perspectives of recently qualified geriatricians on the experiences and challenges of working as a consultant geriatrician
Authors: Simpkins Daniel Mark , Hohenberg Mark Ian , Naganathan Vasikaran , White Kate 
Published: May 2019

AbstractObjectiveTo gain insights into the experience and challenges faced by Australasian geriatricians who have recently made the transition from advanced trainee to consultant.MethodsAn interpretative exploratory qualitative study. Geriatricians with five or less years of experience as consultants were recruited by email. Data were collected through semi‐structured interviews, with themes identified through open axial coding.ResultsRespondents (n = 20) experienced a transition period in which they adjusted to the roles of final decision‐maker and manager. Respondents felt relatively confident with their clinical skills, but under‐prepared for non‐clinical roles associated with becoming a consultant. Most respondents described challenges with career planning. Support networks were considered critical.ConclusionsThis is the first study in Australasia exploring the transition from trainee to consultant geriatrician. Training programs should endeavour to create “consultant‐like roles” during advanced training and address non‐clinical competencies. Participants perceived that there should be more emphasis on career planning and mentorship.
Patterns of prostate‐specific antigen testing by remoteness of residence and socio‐economic status: An Australian population‐based study
Authors: Calopedos Ross J. S. , Bang Albert , Baade Peter , Yu Xue Q. , Ruthven Stephen , Patel Manish I. , Smith David P. 
Published: May 2019

AbstractObjectiveDescribes the variation in prostate cancer testing by the remoteness of residence and socio‐economic status groups in Australia.DesignA national population‐based descriptive study using Medicare data extracted by the Department of Health (formerly the Department of Health and Ageing).SettingAustralia.ParticipantsAll men, with a Medicare‐reimbursed prostate‐specific antigen test conducted in Australia between 2002 and 2017, were included. We focused on “screening and case finding” tests (Medicare Benefits Schedule item number 66655) from 1 April 2005 to 31 December 2009, to describe testing differences in subgroups. Groups were categorised into State and Territory, socio‐economic status and region of residence. A negative binomial regression model was fitted to measure the incidence rate ratios of those who had a screening prostate‐specific antigen test by group.Main outcome measuresAge‐standardised testing rates and incidence rate ratios.ResultsBetween 2002 and 2017, 11 588 775 screening prostate‐specific antigen tests were reimbursed by the Department of Human Services. During 2005‐2009, 52% of all Australian men, aged 40 years and over, had a screening test. The incidence rate ratios differed by State and Territory. Men aged 40 years and over, living in very remote areas, were 43% less likely to have had a screening test than residents of major cities. Prostate‐specific antigen testing rates fell in all age groups between 2007 and 2009 and 2017.ConclusionsThe prostate‐specific antigen testing behaviour differs between community groups in Australia. Men were less likely to have had a screening prostate‐specific antigen test the farther they lived from the major cities. This highlights the need for a more targeted approach to achieve an equitable and evidence‐based prostate cancer care across all sectors of the community.
Snapshot of medication abortion provision in the primary health care setting of regional and rural Victoria
Authors: de Moel‐Mandel Caroline , Graham Melissa , Taket Ann 
Published: May 2019

AbstractObjectiveThis study aimed to identify enablers and barriers to the provision of medication abortion in the primary health care setting of regional and rural areas of Victoria, Australia.DesignAn online cross‐sectional questionnaire was used.SettingRegional and rural areas of Victoria, Australia.ParticipantsThirty‐nine GPs and 30 primary health care nurses.Main outcome measuresAbortion views, medication abortion knowledge and practice, interest in medication abortion training and provision, and perceived uptake barriers.ResultsMost participants reported being consulted by women with unintended pregnancies and most of them included abortion counselling in their consultation. However, familiarity with provision of medication abortion was limited, and only five GPs and two primary health care nurses were currently medication abortion providers. The majority of participants expressed a high level of interest in receiving medication abortion training, but indicated a wide range of barriers to service provision, such as a lack of training opportunities, legal uncertainties or surgical access concerns in case of complications.ConclusionsFindings demonstrate the need for education on medication abortion and training opportunities. Most identified barriers to service uptake are addressable and relate to a lack of local support services, including the absence of a 24‐hour contact advice service, insufficient follow‐up access and a lack of local ultrasound facilities. These barriers require educational programs at professional, organisational and community level to ensure that interested rural and regional primary health care providers can start offering medication abortion for their patients.
Requirement for urgent tracheal intubation after traumatic injury: a retrospective analysis of 11,010 patients in the Trauma Audit Research Network database
Authors: Crewdson K. , Fragoso‐Iniguez M. , Lockey D. J. 
Published: May 2019

SummaryAdvanced airway management is a treatment priority in trauma care. It is likely that a proportion of patients who receive urgent airway management on arrival in the emergency department represent an unmet demand for airway intervention in the pre‐hospital phase. This study aimed to investigate emergency airway practice in major trauma patients and establish any unmet demand in this patient group. A retrospective review of the Trauma Audit and Research Network database was performed to identify airway intervention(s) performed for patients admitted to major trauma centres in England from 01 April 2012 to 27 June 2016. In total, 11,010 patients had airway interventions: 4375 patients (43%) had their tracheas intubated in the pre‐hospital setting compared with 5889 patients (57%) in the emergency department. Of the patients whose tracheas were intubated in the emergency department, this was done within 30 min of hospital arrival in 3264 patients (75%). Excluding tracheal intubation, 1593 patients had a pre‐hospital airway intervention of which 881 (55%) subsequently had their trachea intubated in the emergency department; tracheal intubation was done within 30 min of arrival in the majority of these cases (805 patients (91%)). Over 70% of emergency department tracheal intubations in patients with traumatic injuries were performed within 30 min of hospital arrival; this suggests there may be an unmet demand in pre‐hospital advanced airway management for trauma patients in England.
Management of peripartum intra‐abdominal hypertension and abdominal compartment syndrome
Authors: Lozada M. James , Goyal Varun , Levin Danielle , Walden Rachel L. , Osmundson Sarah S. , Pacheco Luis D. , Malbrain Manu L. N. G. 
Published: May 2019

AbstractNormal pregnancy leads to a state of chronically increased intra‐abdominal pressure. Obstetric and non‐obstetric conditions may increase intra‐abdominal pressure further, causing intra‐abdominal hypertension and abdominal compartment syndrome, which leads to maternal organ dysfunction and a compromised fetal state. Limited medical literature exists to guide treatment of pregnant women with these conditions. In this state‐of‐the‐art review, we propose a diagnostic and treatment algorithm for the management of peripartum intra‐abdominal hypertension and abdominal compartment syndrome, informed by newly available studies.
Bullying, pain and analgesic use in school‐age children
Authors: Garmy Pernilla , Hansson Erika , Vilhjálmsson Rúnar , Kristjánsdóttir Gudrún 
Published: May 2019

AbstractAimThe aim of this study was to examine whether the self‐reported use of analgesics is associated with being a victim of bullying.MethodsThis cross‐sectional, school‐based survey included all students in grades 6 (11 years old), 8 (13 years old) and 10 (15 years old) in Iceland (response rate: 84%; n = 11 018). The students filled out an anonymous standardised questionnaire: the Icelandic Contribution to the International Health Behavior in School‐Aged Children (HBSC) Study.ResultsBeing bullied was associated with increased use of analgesics even after controlling for self‐reported pain.ConclusionBullying occurs in all schools, and its effects on health are pervasive. Interventions aimed at reducing bullying and promoting health in schools are important and may reduce the use of analgesics in adolescents.
Worse global intellectual and worse neuropsychological functioning in preterm‐born children at preschool age: a meta‐analysis
Authors: Arpi Elena , D'Amico Roberto , Lucaccioni Laura , Bedetti Luca , Berardi Alberto , Ferrari Fabrizio 
Published: May 2019

AbstractAimPreterm births (<32 weeks of gestational age) are associated with cognitive problems that are difficult to diagnose in infancy but potentially detectable at preschool age. This review aimed to evaluate the extent to which total intelligence quotient (IQ) and neuropsychological functions at ages three to five years differ between children born at <32 weeks gestational age or < 1500 g birth weight and children born at term. The secondary aim was to determine whether cognitive performance differs between extremely preterm (EPT)/extremely low birth weight (ELBW) children and very preterm (VPT) or very low birth weight (VLBW) children.MethodsPubMed and PsycINFO databases were searched for cohort studies comparing IQ and neuropsychological functions in term‐born and preterm‐born children born after 1994.ResultsAt ages three to five years, preterm‐born children, compared with term‐born ones, had worse IQ mean score (d = −0.77 [95% confidence interval −0.88 to −0.66]), attention, memory, visuomotor integration skill and executive functions. No differences were found between VPT/VLBW and EPT/ELBW children.ConclusionPreterm‐born children showed poorer IQ and neuropsychological functions compared with term‐born subjects already at preschool age. The extent of differences is similar to that detected at a later age.
Detection of indocyanine green fluorescence to determine tumor location during laparoscopic gastrectomy for gastric cancer: Results of a prospective study
Authors: Tanaka Chie , Kanda Mitsuro , Funasaka Kohei , Miyahara Ryoji , Murotani Kenta , Tanaka Yuri , Takeda Shigeomi , Kobayashi Daisuke , Hirooka Yoshiki , Fujiwara Michitaka , Goto Hidemi , Kodera Yasuhiro 
Published: May 2019

AbstractIntroductionIn laparoscopic gastrectomy, a method to locate the margin of an early‐stage cancerous lesion that is invisible from the serosal surface and impalpable during laparoscopic procedures is needed to determine an appropriate transection line. We conducted a prospective study to develop a new marking method using preoperative submucosal injection of indocyanine green (ICG).MethodsPatients undergoing laparoscopic gastrectomy for T1 gastric cancer were recruited. The first 11 patients comprised the learning set and the subsequent 18 patients the validation set. ICG was endoscopically injected in the submucosal layer of the stomach approximately 1 cm away from the tumor edge 1 or 3 days before surgery. The diameters of the visualized ICG were compared with those of a conventional marking method using India ink in 10 historical controls.ResultsIn the learning set, the optimal amount of ICG was determined to be 0.1 mL at a concentration of 0.5 mg/mL. In the validation set, the same procedure was repeated. No technical problems or adverse reactions related to ICG injection were observed. In all cases, ICG was successfully detected, and negative surgical margins were pathologically confirmed. The mean long diameter of the visualized ICG fluorescence measured at the mucosal surface of the stomach was significantly smaller in the current study than in the historical controls in whom India ink was used (21 vs 52 mm, P < 0.0001).ConclusionsThe preoperative submucosal ICG marking was safely performed and successfully detected without excessive blurring during laparoscopic gastrectomy.
Going beyond children's single‐text comprehension: The role of fundamental and higher‐level skills in 4th graders’ multiple‐document comprehension
Authors: Florit Elena , Cain Kate , Mason Lucia 
Published: May 2019

BackgroundChildren's comprehension of single texts relies on both foundational and higher‐level skills. These are also assumed to support multiple‐document comprehension, but their relative importance has not been examined, to date. Multiple‐document comprehension additionally requires the identification and use of information about each document's source.AimsThis study examined multiple‐document comprehension in primary school‐aged children. It sought to determine the relative importance of skills proposed to be common to both single‐text and multiple‐document comprehension (word reading fluency, verbal working memory, comprehension monitoring) and specific to the latter (source use). Single‐text comprehension and prior topic knowledge were considered as moderator and control.SampleParticipants were 94 children in the fourth year (mean age = 9; 7 years; 52% females).MethodsChildren read three documents on each of two topics (chocolate and video games). Multiple‐document comprehension and source use were assessed through short essays. Independent measures of the fundamental and higher‐level skills were used.ResultsThere was a significant direct and indirect influence of word reading fluency on comprehension of multiple documents on videogames and also an indirect influence of comprehension monitoring. Indirect influences of word reading fluency and comprehension monitoring on multiple‐document comprehension for both topics were also apparent. Verbal working memory was not a unique predictor. When source information was identified, it was included to support the argument in the composition.ConclusionsEfficient word reading, comprehension monitoring, and single‐text comprehension are important for multiple‐document comprehension in young readers. Implications of these findings and differences between the two document sets are discussed.
Effect of inoculum density on human‐induced pluripotent stem cell expansion in 3D bioreactors
Authors: Greuel Selina , Hanci Güngör , Böhme Mike , Miki Toshio , Schubert Frank , Sittinger Michael , Mandenius Carl‐Fredrik , Zeilinger Katrin , Freyer Nora 
Published: May 2019

AbstractObjectiveFor optimized expansion of human‐induced pluripotent stem cells (hiPSCs) with regards to clinical applications, we investigated the influence of the inoculum density on the expansion procedure in 3D hollow‐fibre bioreactors.Materials and MethodsAnalytical‐scale bioreactors with a cell compartment volume of 3 mL or a large‐scale bioreactor with a cell compartment volume of 17 mL were used and inoculated with either 10 × 106 or 50 × 106 hiPSCs. Cells were cultured in bioreactors over 15 days; daily measurements of biochemical parameters were performed. At the end of the experiment, the CellTiter‐Blue® Assay was used for culture activity evaluation and cell quantification. Also, cell compartment sections were removed for gene expression and immunohistochemistry analysis.ResultsThe results revealed significantly higher values for cell metabolism, cell activity and cell yields when using the higher inoculation number, but also a more distinct differentiation. As large inoculation numbers require cost and time‐extensive pre‐expansion, low inoculation numbers may be used preferably for long‐term expansion of hiPSCs. Expansion of hiPSCs in the large‐scale bioreactor led to a successful production of 5.4 × 109 hiPSCs, thereby achieving sufficient cell amounts for clinical applications.ConclusionsIn conclusion, the results show a significant effect of the inoculum density on cell expansion, differentiation and production of hiPSCs, emphasizing the importance of the inoculum density for downstream applications of hiPSCs. Furthermore, the bioreactor technology was successfully applied for controlled and scalable production of hiPSCs for clinical use.
Incidence of cervical high‐grade squamous intraepithelial lesions and squamous cell carcinoma in women with high‐risk human papillomavirus and normal cervical cytology: A retrospective analysis of 1858 cases stratified by age and human papillomavirus genotype
Authors: Gu Liying , Hong Zubei , Gao Hua , Qiu Lihua , Di Wen 
Published: May 2019

AbstractObjectiveTo retrospectively analyse the incidence of high‐grade squamous intraepithelial lesions (HSILs) and squamous cell carcinoma (SCC) in women of different ages with high‐risk (HR) human papillomavirus (HPV) but with normal cytology test results stratified by age and HPV genotype.MethodsIn total, 1858 women with HR‐HPV infection but with a normal smear who received a colposcopy and biopsy between 2015 and 2016 at our institution were included. The pathological results were retrospectively analysed after stratifying by age and HPV genotype.ResultsAmong the 1858 cases, the HSIL% in women aged 21‐29 years (10.54%) was significantly different from that in women aged 40‐49 years (19.85%; P < 0.05), whereas there was no significant difference in the HSIL% among women aged 21‐29 years and those in the other age groups (P > 0.05). In total, 295 cases had single HPV16 infection. The HSIL% in patients with HPV16/18 infection was >15%, and the 40‐49‐year age group had the highest percentage at 48.48%. For other HR‐HPV infections, the HSIL and SCC incidence rate was 10.41%, and there was no significant difference among the age groups; thus, women with other types of viral infections, regardless of age, should be referred to colposcopy.ConclusionsAlthough HPV16 is the HPV with the highest risk, other HR‐HPV infections can also cause a high percentage of HSILs and SCC in women with normal cytology. Therefore, it is necessary to refer HR‐HPV‐infected women aged ≥21 years for colposcopy in a timely manner to exclude potential cervical intraepithelial neoplasia and cervical cancer.
The relationship between multidimensional economic well‐being and children’s mental health, physical health, and executive function development in South Africa
Authors: Turbeville Ashley , Aber J. Lawrence , Weinberg Sharon L. , Richter Linda , van Heerden Alastair 
Published: May 2019

AbstractConceptualizing both economic well‐being (EWB) and children's development as multidimensional constructs, the present study examines their association using bioecological developmental theory and structural equation modeling with Zulu children (ages 7–10) in KwaZulu‐Natal, a highly impoverished region of South Africa (N = 1,958). Relative EWB within impoverished communities consists of three dimensions: material assets (durable goods and living environment), fiscal appraisal (subjective experiences of access to/allocation of resources), and fiscal capacity (monetary inflow/outflow). Children's development also is measured across multiple dimensions: physical health, mental health, and executive functioning. In addition to an overall association between EWB and children's development across outcomes, the sub‐dimensions of EWB are differentially related to aspects of children's development. The dimension of material assets exhibits the greatest association with child outcomes, while fiscal capacity exhibits the least. Implications of these findings are discussed, including the use of multidimensional approaches to measuring EWB to understand, more clearly, its relationship to multiple dimensions of children's development. A video abstract of this article can be viewed at https://www.youtube.com/watch?v=ZcawZ6oOt-Q
Predictors of treatment response in type‐2 diabetes patients initiating basal‐supported oral therapy with insulin glargine 100 U/mL: A sub‐analysis of the Titration and OPtimisation (TOP) registry
Authors: Pfohl Martin , Pscherer Stefan , Fritsche Andreas , Anderten Helmut , Borck Anja , Pegelow Katrin , Bramlage Peter , Seufert Jochen 
Published: May 2019

AbstractThe aim of this study was to identify predictors of long‐term response to the initiation of basal‐supported oral therapy (BOT) with insulin glargine (IGlar‐100). Patients from the observational TOP registry were grouped based on those who had achieved (responders) and those who had not achieved (non‐responders) their HBA1c target and/or FBG ≤110 mg/dL 12 months after IGlar‐100 initiation. Independent predictors of treatment response were identified by regression analysis. Data for 2444 patients were analysed (responders, n = 1610; non‐responders, n = 834). Although the IGlar‐100 dose increase over 12 months was larger for non‐responders (+12.83 vs +9.46 U/d; P < 0.0001), the corresponding decrease in HbA1c was smaller (−0.88% vs −1.57%). Independent predictors of response included lower BMI (OR, 0.97; 95% CI, 0.95‐1.00), lower FBG (OR, 0.98; 95% CI, 0.97‐0.98) and HbA1c values at baseline (OR, 0.24; 95% CI, 0.18‐0.31), a less ambitious HbA1c target (OR, 5.07; 95% CI, 3.37‐7.63) and bedtime administration of IGlar‐100 (OR, 1.55; 95% CI, 1.12‐2.14). In conclusion, HbA1c was the clinically most significant baseline characteristic predictive of response to BOT. This may suggest an advantage of IGlar‐100 initiation prior to excessive hyperglycaemia escalation.