bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can pulse check by the photoplethysmography sensor on a smart watch replace carotid artery palpation during cardiopulmonary resuscitation in cardiac arrest patients? a prospective observational diagnostic accuracy study
Authors: Lee Yoonje , Shin Hyungoo , Choi Hyuk Joong , Kim Changsun 
Published: February 2019

ObjectiveThe purpose of this study was to assess whether a photoplethysmography (PPG) sensor in a smart watch can accurately recognise the return of spontaneous circulation (ROSC) in cardiac arrest patients compared with carotid artery palpation.MethodsThis prospective observational study was conducted on 50 out-of-hospital cardiac arrest patients who visited the emergency department (ED) of one tertiary hospital. As soon as the patient arrived at the ED, advanced cardiac life support was carried out immediately. At this time, three smart watches were attached to the carotid artery, forehead and wrist and were checked for pulse measurements every 2 min. In the case of ROSC, blood pressure, heart rate and heart rate regularity were confirmed, and pulse was simultaneously measured at three sites with smart watches. In the case of no ROSC, only the pulse was measured at three sites with the smart watches.ResultsThere were 33 males (66%) and the mean age was 68±11.57 years. In 14 patients (28%), spontaneous circulation was recovered through cardiopulmonary resuscitation, and all survived. The sensitivity and specificity of manual palpation were 78.6% and 90.4%, respectively. False-positive and false-negative rates were 9.6% and 21.4%, respectively. Smart watches at all three sites had the same or higher sensitivity than manual palpation. The sensitivity of the smart watch was the highest, at 100%, in the carotid region and the lowest, at 78.6%, in the wrist region. The specificity of the smart watch was the highest, at 100%, in the wrist region and the lowest, at 78.7%, in the carotid region.ConclusionCompared with manual pulse check, the PPG sensor embedded in the smart watch showed the same sensitivity and a higher specificity for recognising ROSC when measured at the wrist.
Temporal trends in severe morbidity and mortality associated with ectopic pregnancy requiring hospitalisation in Washington State, USA: a population-based study
Authors: Lisonkova Sarka , Tan Justin , Wen Qi , Abdellatif Lobna , Richter Lindsay L , Alfaraj Sukainah , Yong Paul J , Bedaiwy Mohamed A 
Published: February 2019

ObjectiveTo examine temporal trend in maternal mortality/severe morbidity associated with hospitalisation due to ectopic pregnancy.DesignA population-based observational study.Setting and participantsAll women hospitalised for ectopic pregnancy in Washington State, USA, 1987–2014 (n=20 418). The main composite outcome of severe morbidity/mortality included death, sepsis, need for transfusion, hysterectomy and systemic or organ failure, identified by diagnostic and procedure codes from hospitalisation files. Severe morbidity/mortality due to ectopic pregnancy were expressed as incidence ratios among women of reproductive age (15–64 years) and among women hospitalised for ectopic pregnancy. Comparisons were made between 1987–1991 (reference) and 2010–2014 using ratios of incidence ratios (RR) and ratio differences (RD). The Cochran-Armitage test for trend assessed statistical significance; logistic regression was used to obtain adjusted OR (AOR) and 95% CI, adjusted for demographic factors and comorbidity.ResultsHospitalisation for ectopic pregnancy declined from 0.89 to 0.16 per 1000 reproductive age women between 1987–1991 and 2010–2014 (p<0.001). Among reproductive age women, ectopic pregnancy mortality remained stable (0.03 per 100 000); and mortality/severe morbidity increased among women aged 25–34 years (p=0.022). Among women hospitalised for ectopic pregnancy, mortality increased from 0.29 to 1.65 per 1000 between 1987–1991 and 2010–2015 (p=0.06); severe morbidity/mortality increased from 3.85% to 19.63% (RR=5.10, 95% CI 4.36 to 5.98; RD=15.78 per 100 women, 95% CI 13.90 to 17.66; AOR for 1-year change was 1.08, 95% CI 1.07 to 1.08).ConclusionsHospitalisation for ectopic pregnancy declined in Washington State, USA, between 1987 and 2014; however, mortality/severe morbidity associated with ectopic pregnancy increased in female population aged 25–34 years.
Protocol for a scoping review on the conceptualisation of learning in undergraduate clinical nursing practice
Authors: Stoffels Malou , Peerdeman Saskia M , Daelmans Hester E M , Ket Johannes C F , Kusurkar Rashmi A 
Published: February 2019

IntroductionLearning in the clinical setting is a major form of learning in undergraduate nursing education. In spite of this, how nursing students learn in clinical practice is still largely unknown. Moreover, there is no conceptual clarity on learning in practice in the current literature. This paper aims to set up a protocol for a scoping review of the literature in order to map different conceptualisations of learning in practice in undergraduate clinical nursing education in the hospital setting. The operationalisations of different concepts will be compared and the findings of the studies will be synthesised.Methods and analysisThis scoping review will be guided by the methodological framework proposed by Arksey and O’Malley and refined by Levacet al.and the Joanna Briggs Institute. The search strategy will be developed together with a medical information specialist and the search will be performed in electronic databases (PubMed, EBSCO/ERIC and EBSCO/CINAHL). In a first search, we will identify concepts that are used as an equivalent to learning in practice. Next, we will search for studies operationalising these concepts in undergraduate nursing education. Finally, we will check reference lists for additional publications. Abstracts and full-text studies will independently be screened by two researchers. All studies that have ‘learning in undergraduate clinical nursing practice’ as their main topic and that include a definition and operationalisation of an equivalent to learning in clinical practice, will be considered for inclusion. We will chart different conceptualisations and their theoretical underpinnings, as well as reported learning opportunities, informal and formal aspects of learning, social aspects of learning and gaps in the literature.Ethics and disseminationThis review will help design future studies on learning in clinical nursing practice using well-defined and agreed on terminology. The results will be disseminated through journal publications and conference presentations.
Retrospective cohort analysis of real-life decisions about end-of-life care preferences in a Southeast Asian country
Authors: Tan Woan Shin , Bajpai Ram , Ho Andy Hau Yan , Low Chan Kee , Car Josip 
Published: February 2019

ObjectiveTo describe the end-of-life care preferences of individuals, and to examine the influence of age and gender on these preferences.Design, setting and participantsA retrospective cohort study was conducted. Participants included all adults (≥21 years old) (n=3380) who had completed a statement of their preferences as part of a national Advance Care Planning (ACP) programme in Singapore. Data were extracted from the national and Tan Tock Seng Hospital ACP database.Main measuresEnd-of-life care preferences were obtained from the ACP document and differentiated by health status (healthy, chronically ill or diagnosed with advanced illnesses). To analyse the data, descriptive statistics and logistic regression analysis were used.ResultsAcross healthy and chronically ill patients, the majority did not opt for cardiopulmonary resuscitation (CPR) or other life-sustaining measures. Among individuals with advanced illnesses, 94% preferred not to attempt CPR but 69% still preferred to receive some form of active medical treatment. Approximately 40% chose to be cared for, and to die at home. Age and sex significantly predict preferences in those with advanced illnesses. Older age (>=75 years) showed higher odds for home as preferred place of care (OR 1.52; 95% CI 1.23 to 1.89) and place of death (OR 1.29; 95% CI 1.03 to 1.61) and lower odds for CPR (OR 0.31; 95% CI 0.18 to 0.54) and full treatment (OR 0.32; 95% CI 0.17 to 0.62). Being female was associated with lower odds for home as preferred place of care (OR 0.69; 95% CI 0.57 to 0.84) and place of death (OR 0.70; 95% CI 0.57 to 0.85) and higher odds for full treatment (OR 2.35; 95% CI 1.18 to 4.68).ConclusionThe majority preferred to not proceed with life-sustaining treatments, but there was still a strong preference to receive some form of limited treatment. Better understanding of end-of-life care preferences through ACP can better guide end-of-life care programme planning, and resource allocation decisions.
Do baby boomers feel healthier than earlier cohorts after retirement age? The Lausanne cohort Lc65+ study
Authors: Henchoz Yves , von Gunten Armin , Büla Christophe , Seematter-Bagnoud Laurence , Nanchen David , Démonet Jean-Francois , Blanco Juan-Manuel , Santos-Eggimann Brigitte 
Published: February 2019

ObjectiveDespite the popular belief that baby boomers are ageing in better health than previous generations, limited scientific evidence is available since baby boomers have turned retirement age only recently. This study aimed to compare self-reported health status at ages 65–70 years among three cohorts of older people born before, during and at the end (baby boomers) of the Second World War.DesignRepeated cross-sectional population-based study.SettingCommunity in a region of French-speaking Switzerland.ParticipantsCommunity-dwelling older adults who enrolled in the Lausanne cohort 65+ study at ages 65–70 years in 2004 (n=1561), 2009 (n=1489) or 2014 (n=1678).OutcomesNumber of self-reported chronic conditions (from a list of 11) and chronic symptoms (from a list of 11); depressive symptoms; self-rated health (very good, good, average, poor or very poor); fear of disease (not afraid at all, barely afraid, a bit afraid, quite afraid or very afraid); self-perception of ageing; disability in basic and instrumental activities of daily living.ResultsThere was no significant difference between cohorts in the number of self-reported chronic conditions and chronic symptoms as well as the presence of difficulty in basic activities of daily living, depressive symptoms, fear of disease and negative self-perception of ageing. In women only, significant differences between cohorts were observed in self-rated health (p=0.005) and disability in instrumental activities of daily living (p=0.003), but these associations did not remain significant in logistic regression models adjusted for sociodemographic characteristics and unhealthy behaviours.ConclusionsDespite important sociodemographic differences between older baby boomers and earlier cohorts, most health indicators did not suggest any trend towards a compression of morbidity. Future studies comparing these three cohorts at more advanced age are required to further investigate whether differences emerge later in life.
Specific growth rates calculated from CTs in patients with head and neck squamous cell carcinoma: a retrospective study performed in Austria
Authors: Dejaco Daniel , Steinbichler Teresa , Schartinger Volker Hans , Fischer Natalie , Anegg Maria , Dudas Joszef , Posch Andrea , Widmann Gerlig , Riechelmann Herbert 
Published: February 2019

ObjectiveTo provide data on specific growth rates (SGRs) of primary tumours (PT-SGR) and largest pathological cervical lymph nodes (LN-SGR) for head and neck squamous cell carcinoma (HNSCC). To explore PT-SGR’s and LN-SGR’s correlation with selected biomarkers epidermal growth factor receptor (EGFR), Ki67 and CD44.Design and settingRetrospective study performed at a tertiary oncological referral centre in Innsbruck, Austria.ParticipantsAdult patients with incident HNSCC treated with primary radiotherapy (RT) or radiochemotherapy (RCT).Outcome measuresVolumes of the primary tumour (PT-volume) and largest pathological cervical lymph node (LN-volume) were measured in CT scans obtained at time of diagnosis and subsequent planning CTs immediately prior to RT or RCT. SGRs were calculated assuming an exponential growth function. PT-SGR’s and LN-SGR’s correlation with EGFR, Ki67 and CD44 were explored.ResultsIn 123 patients, mean interval between diagnostic and planning CT was 29±21 days. PT-SGR was 1.8±1.8% (mean±SD) per day and was positively correlated with EGFR, Ki67 and CD44 expression (p=0.02; p=0.02; p=0.03). LN-SGR was 1.7±2.0% per day and increased with larger initial LN-volume, was lower in laryngeal cancer (p=0.003) and slowed down with time. LN-SGR was not correlated with EGFR, Ki67 or CD44 expression in primary tumours (p>0.12). New cartilage or bone infiltration occurred in 10 patients and new central lymph node necrosis in 8 patients.ConclusionsHNSCCs are fast-growing tumours for which treatment must not be delayed. Clinical tumour growth rates are influences by EGFR, KI67 and CD44 expression.
Making headlines: an analysis of US government-funded cancer research mentioned in online media
Authors: Maggio Lauren A , Ratcliff Chelsea L , Krakow Melinda , Moorhead Laura L , Enkhbayar Asura , Alperin Juan Pablo 
Published: February 2019

ObjectiveTo characterise how online media coverage of journal articles on cancer funded by the US government varies by cancer type and stage of the cancer control continuum and to compare the disease prevalence rates with the amount of funded research published for each cancer type and with the amount of media attention each receives.DesignA cross-sectional study.SettingThe United States.ParticipantsThe subject of analysis was 11 436 journal articles on cancer funded by the US government published in 2016. These articles were identified via PubMed and characterised as receiving online media attention based on data provided by Altmetric.Results16.8% (n=1925) of articles published on US government-funded research were covered in the media. Published journal articles addressed all common cancers. Frequency of journal articles differed substantially across the common cancers, with breast cancer (n=1284), lung cancer (n=630) and prostate cancer (n=586) being the subject of the most journal articles. Roughly one-fifth to one-fourth of journal articles within each cancer category received online media attention. Media mentions were disproportionate to actual burden of each cancer type (ie, incidence and mortality), with breast cancer articles receiving the most media mentions. Scientific articles also covered the stages of the cancer continuum to varying degrees. Across the 13 most common cancer types, 4.4% (n=206) of articles focused on prevention and control, 11.7% (n=550) on diagnosis and 10.7% (n=502) on therapy.ConclusionsFindings revealed a mismatch between prevalent cancers and cancers highlighted in online media. Further, journal articles on cancer control and prevention received less media attention than other cancer continuum stages. Media mentions were not proportional to actual public cancer burden nor volume of scientific publications in each cancer category. Results highlight a need for continued research on the role of media, especially online media, in research dissemination.
Medicine authentication technology: a quantitative study of incorrect quarantine, average response times and offline issues in a hospital setting
Authors: Naughton Bernard D 
Published: February 2019

ObjectivesTo introduce serialised medicines into an operational hospital dispensary and assess the technical effectiveness of digital medicine authentication (MA) technology under European Union Falsified Medicines Directive (EU FMD) conditions.DesignThirty medicine lines were serialised using 2D data matrix labels and introduced into an operational UK National Health Service (NHS) hospital dispensary. Staff were asked to check medicines for two-dimensional (2D) data matrices and scan those products, in addition to their usual medicine preparation and checking processes. Four per cent of the study medicines were labelled with a 2D barcode which generated a pop-up, identifying the medicine as either authenticated elsewhere (falsified), authenticated here, expired or recalled.SettingAn NHS teaching hospital based in the UK, the same site as the Naughtonet al2016 study.ParticipantsGeneral Pharmaceutical Council registered, accredited accuracy checking technicians and pharmacists.Primary outcome measuresAverage response times, offline issues, instances of incorrect quarantine and workarounds. The EU FMD maximum response time is 300 milliseconds (ms).ResultsDuring the checking stage of medicine preparation, the average response time for MA in this study was 131 ms. However, 4.67% of attempted authentications experienced offline issues, an increase of 4.23% from the previous study. An increase in offline instances existed alongside an increase in incorrect quarantine.ConclusionsDigital drug screening has the capability of operating with average response times which are below the maximum EU FMD limit of 300 ms. However, there was an increased incidence of offline errors and cases of incorrect quarantine. The practical and legal implications of supplying a substandard or falsified medicine during offline periods without prior authentication or withholding supply until online status resumes are not yet fully understood.
Diagnostic accuracy of the Xpert CT/NG and OSOM Trichomonas Rapid assays for point-of-care STI testing among young women in South Africa: a cross-sectional study
Authors: Garrett Nigel , Mitchev Nireshni , Osman Farzana , Naidoo Jessica , Dorward Jienchi , Singh Ravesh , Ngobese Hope , Rompalo Anne , Mlisana Koleka , Mindel Adrian 
Published: February 2019

ObjectivesSyndromic management of sexually transmitted infections (STIs) omits asymptomatic infections, particularly among women. Accurate point-of-care assays may improve STI care in low- and middle-income countries (LMICs). We aimed to evaluate the diagnostic performance of the XpertChlamydia trachomatis/Neisseria gonorrhoeae(CT/NG) and OSOMTrichomonas vaginalis(TV) Test as part of a STI care model for young women in South Africa.DesignDiagnostic evaluation conducted as part of a prospective cohort study (CAPRISA 083) between May 2016 and January 2017.SettingOne large public healthcare facility in central Durban, KwaZulu-Natal, South AfricaParticipants247 women, aged 18–40 years, attending for sexual and reproductive services to the clinic. Pregnant and HIV-positive women were excluded.OutcomesDiagnostic performance of the Xpert CT/NG and OSOM TV assays against the laboratory-based Anyplex II STI-7 Detection. All discordant results were further tested on the Fast Track Diagnostics (FTD) STD9 assay.ResultsWe obtained vaginal swabs from 247 women and found 96.8% (239/247) concordance between Xpert and Anyplex for CT and 100% (247/247) for NG. All eight discrepant CT results were positive on Xpert, but negative on Anyplex. FTD STD9 confirmed three positive and five negative results, giving a confirmed prevalence of CT 15.0% (95% CI 10.5 to 19.4), NG 4.9% (2.2–7.5) and TV 3.2% (1.0–5.4). Sensitivity and specificity of Xpert CT/NG were 100% (100-100) and 97.6% (95.6–99.7) for CT and 100% (100-100) and 100% (100-100) for NG. The sensitivity and specificity of OSOM TV were 75.0% (45.0–100) and 100% (100-100).ConclusionThe Xpert CT/NG showed high accuracy among young South African women and combined with the OSOM TV proved a useful tool in this high HIV/STI burden setting. Further implementation and cost-effectiveness studies are needed to assess the potential role of this assay for diagnostic STI testing in LMICs.Trial registration numberNCT03407586; Pre-results.
Resuscitative endovascular balloon occlusion of the aorta (REBOA): a scoping review protocol concerning indications—advantages and challenges of implementation in traumatic non-compressible torso haemorrhage
Authors: Bekdache Omar , Paradis Tiffany , Shen Yu Bai He , Elbahrawy Aly , Grushka Jeremy , Deckelbaum Dan L , Khwaja Kosar , Fata Paola , Razek Tarek , Beckett Andrew 
Published: February 2019

IntroductionHaemorrhage remains the leading cause of preventable death in trauma. Damage control measures applied to patients in extremis in order to control exsanguinating bleeding from non-compressible torso injuries use different techniques to limit blood flow from the aorta to the rest of the body. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is regaining momentum recently as an adjunct measure that can provide the same results using less invasive approaches. This scoping review aims to provide a comprehensive understanding of the existing literature on REBOA. The objective is to analyse evidence and non-evidence-based medical reports and to describe current gaps in the literature about the best indication and implementation strategies for REBOA.Methods and analysisUsing the five-stage framework of Arksey and O’Malley’s scoping review methodology as a guide, we will perform a systematic search in the following databases: MEDLINE, EMBASE, BIOSIS, COCHRANE CENTRAL, PUBMED and SCOPUS from the earliest available publications. The aim is to identify diverse studies related to the topic of REBOA. For a comprehensive search, we will explore organisational websites, key journals and hand-search reference lists of key studies. Data will be charted and sorted using a descriptive analytical approach.Ethics and disseminationEthics approval is not necessary as the data are collected from publicly available sources and there will be no consultative phase. The results will be disseminated through presentations at local, national, clinical and medical education conferences and through publication in a peer-reviewed journal.
Occupational exposures and incidence of chronic bronchitis and related symptoms over two decades: the European Community Respiratory Health Survey
Authors: Lytras Theodore , Kogevinas Manolis , Kromhout Hans , Carsin Anne-Elie , Antó Josep Maria , Bentouhami Hayat , Weyler Joost , Heinrich Joachim , Nowak Dennis , Urrutia Isabel , Martínez-Moratalla Jesús , Gullón José Antonio , Vega Antonio Pereira , Raherison Semjen Chantal , Pin Isabelle , Demoly Pascal , Leynaert Bénédicte , Villani Simona , Gíslason Thorarinn , Svanes Øistein , Holm Mathias , Forsberg Bertil , Norbäck Dan , Mehta Amar J , Probst-Hensch Nicole , Benke Geza , Jogi Rain , Torén Kjell , Sigsgaard Torben , Schlünssen Vivi , Olivieri Mario , Blanc Paul D , Watkins John , Bono Roberto , Buist A. Sonia , Vermeulen Roel , Jarvis Deborah , Zock Jan-Paul 
Published: January 2019

ObjectivesChronic bronchitis (CB) is an important chronic obstructive pulmonary disease (COPD)-related phenotype, with distinct clinical features and prognostic implications. Occupational exposures have been previously associated with increased risk of CB but few studies have examined this association prospectively using objective exposure assessment. We examined the effect of occupational exposures on CB incidence in the European Community Respiratory Health Survey.MethodsPopulation samples aged 20–44 were randomly selected in 1991–1993, and followed up twice over 20 years. Participants without chronic cough or phlegm at baseline were analysed. Coded job histories during follow-up were linked to the ALOHA Job Exposure Matrix, generating occupational exposure estimates to 12 categories of chemical agents. Their association with CB incidence over both follow-ups was examined with Poisson models using generalised estimating equations.Results8794 participants fulfilled the inclusion criteria, contributing 13 185 observations. Only participants exposed to metals had a higher incidence of CB (relative risk (RR) 1.70, 95% CI 1.16 to 2.50) compared with non-exposed to metals. Mineral dust exposure increased the incidence of chronic phlegm (RR 1.72, 95% CI 1.43 to 2.06). Incidence of chronic phlegm was increased in men exposed to gases/fumes and to solvents and in women exposed to pesticides.ConclusionsOccupational exposures are associated with chronic phlegm and CB, and the evidence is strongest for metals and mineral dust exposure. The observed differences between men and women warrant further investigation.