bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical risk management – a 3‐year experience of team timeout in 18 081 ophthalmic patients
Authors: Weingessel Birgit , Haas Michaela , Vécsei Christina , Vécsei‐Marlovits Pia Veronika 
Published: July 2016

AbstractPurposeClinical risk management aims to identify, analyse and avoid errors and risks systematically to improve patient's safety. Preoperative checklists to prevent mistakes have gained importance in the last few years. A so‐called team timeout checklist was introduced in October 2011 at the Department of Ophthalmology, Hietzing Hospital, Vienna. The purpose of the study is to evaluate the benefits and demonstrate the value of team timeout.MethodsAfter the team timeout had been in use for 6 months, all near misses that occurred over a period of 34 months were assigned to the following groups: wrong side, wrong lens, wrong patient and miscellaneous.ResultsEighteen thousand and eighty‐one surgeries were performed in the specified period; 53 cases of ‘wrong side’ and 52 cases of ‘wrong intraocular lens’ were noted. Ninety‐six near misses concerned the patients’ data and 38 concerned documentation. A reduction of near misses was noted after an adaptation phase of 3 months.ConclusionsTeam timeout proved valuable, as it improved the patients' safety with minimum effort. Errors may occur despite several preoperative controls and can be detected by performing team timeout.
Surgical responses and outcomes of bilateral lateral rectus recession in exotropia with cerebral palsy
Authors: Ma Dae Joong , Yang Hee Kyung , Hwang Jeong‐Min 
Published: July 2016

AbstractPurposeTo determine surgical responses and outcomes of bilateral lateral rectus (BLR) recession in exotropes with cerebral palsy (CP) and to compare the results with exotropes without CP.MethodsForty‐one exotropes with CP and 82 age‐ and type (intermittent or constant)‐matched exotropes without CP who underwent BLR recession by one surgeon (J‐M.H.) were evaluated. Main outcome measures were surgical responses, factors affecting surgical response, success rates, cumulative probabilities of success and recurrence, and drifts of ocular alignment towards exodeviation after surgery (exodrift).ResultsThe surgical responses of BLR recession were not significantly different between both groups (p = 0.136). After a mean follow‐up period of 2 years, success rates showed no significant difference between the two groups (p = 1.000). The cumulative probabilities of success and recurrence were not significantly different between the two groups (p = 0.770 and 0.754, respectively). The rate of recurrence per person‐year during follow‐up was 16.7% in patients with CP and 20.2% in patients without CP. The amount of exodrift showed no significant difference between both groups (p = 0.118).ConclusionsExotropes with CP showed a similar surgical response, an amount of exodrift, cumulative success and recurrence rates after BLR recession compared to exotropes without CP.
Endothelium‐in versus endothelium‐out for Descemet membrane endothelial keratoplasty graft preparation and implantation
Authors: Parekh Mohit , Ruzza Alessandro , Ferrari Stefano , Ahmad Sajjad , Kaye Stephen , Ponzin Diego , Romano Vito 
Published: July 2016

AbstractPurposeTo evaluate the difference between endothelium‐in and endothelium‐out for Descemet membrane endothelial keratoplasty (DMEK) preparation and implantation using injection method.MethodsThe study was a randomized, comparative, institutional, laboratory investigation. Eighteen human donor corneas were included. A total of 9.5 mm DMEK grafts were stripped and restored on the corneal base with a hinge and preserved in the deswelling medium. The grafts were detached from the hinge and either manually tri‐folded with the endothelium on the inside, or allowed to spontaneously roll in phosphate‐buffered saline (PBS) with endothelium outwards. The corneas were mounted on an artificial anterior chamber (AAC) and four incisions made using a 15° eye knife for the side ports and slit knife to create a 3.0 mm incision for delivery of the graft into the AAC. The grafts with endothelium‐in (endo‐in) were pulled into a cartridge, whereas those with endothelium‐out (endo‐out) were aspirated using a modified Jones tube. Both were delivered using an injection method. Central and peripheral endothelial cell density (pre‐ and post‐delivery and after removal), time of preparation and unfolding were measured.ResultsEndothelial cell loss postimplantation was 10.53% (±2.82) with endo‐in (n = 9) compared to 7.56% (±14.74) with endo‐out (n = 9) (p > 0.05). Preparation and unfolding time was 4.43 min (±3.43) and 0.96 min (±1.10) for endo‐in compared to 1.68 min (±0.57) and 4.92 min (±4.21) for endo‐out. A statistical significance between endo‐in and endo‐out for loading (p = 0.04) and unfolding (p = 0.023) time was observed.ConclusionsDescemet membrane endothelial keratoplasty tissues can be tri‐folded (endo‐in) with no significantly less cell loss as compared to endo‐out. Spontaneous unfolding of endo‐in may reduce overall time and surgical manipulation.
Malignant pleural mesothelioma with lacrimal gland metastasis
Authors: Hanafi Hanida , Verdijk Rob M. , Paridaens Dion 
Published: July 2016

AbstractPurposeTo describe a rare clinical case of biopsy‐proven metastatic mesothelioma of the lacrimal gland which responded well to chemo and radiation therapy.MethodsInterventional case report.ResultsA 55‐year‐old woman with an untreated malignant biopsy‐proven pleural mesothelioma presented with right proptosis, diplopia and hypoglobus. Magnetic resonance imaging showed an aggressive lacrimal gland tumour with bony erosion. A biopsy concluded a diagnosis of metastatic mesothelioma of the lacrimal gland. Her lacrimal and lung tumours showed a marked regression following palliative chemo (carboplatin) and radiation therapy.ConclusionsMalignant pleural mesothelioma may metastasize to the orbit, including the lacrimal gland. A combined chemo and radiation therapy may reduce the size of the metastatic and primary tumour.
Right services to right patients at right time in right setting in Tays Eye Centre
Authors: Tuulonen Anja , Kataja Marko , Syvänen Ulla , Miettunen Sirpa , Uusitalo Hannu 
Published: July 2016

AbstractPurposeThe report describes the concepts behind procedures implemented in Tays Eye Centre to enable improved access to care and improved productivity.MethodsThe strategy was developed in 2009 after hospital district decided to construct a new eye hospital which was opened in 2012. The following principles were implemented: (i) identification of high‐volume patient groups: the ‘big four’ eye diseases accounting for 70% of patient visits and costs: age‐related macular degeneration (AMD), glaucoma, retinal diseases and cataract; (ii) stratification and prioritization of patient care based on risk of permanent visual disability; (iii) standardization of services for low‐risk patients; (iv) maximization of productivity; and (v) shared care. The impact of the new strategy on access to care and productivity is reported for years 2011–2015.ResultsIn 2011–2015, the total number of services provided increased 46% while the work contribution increased 15%. The number of referrals increased 76% and the number of outpatient appointments increased 2.5‐fold. Simultaneously, the number of delayed follow‐up visits decreased to zero. Age‐related macular degeneration (AMD) injections increased 1.8‐fold. However, after 50% yearly increase in Age‐related macular degeneration (AMD) injections, a plateau was reached in 2014 with a 3% decline in 2014–2015 with no changes in treatment indications. In the beginning of 2016, the number of injections has started to increase again (+9% compared to 2015). The total number of surgical procedures increased 98%. The annual number of cataract surgeries increased 64% and bilateral surgeries from 11% to 39%.ConclusionRevised operational concepts and new facilities together with a 15% increase in work contribution led to a 46% increase in overall productivity, improved access to care and the clearance of delayed services. Efforts continue to further refine cost‐effective care and to define the appropriate levels of services.
Thermoresponsive Polymers with Lower Critical Solution Temperature‐ or Upper Critical Solution Temperature‐Type Phase Behaviour Do Not Induce Toxicity to Human Endothelial Cells
Authors: Ji Yuejia , Zhu Mengxiang , Gong Yu , Tang Haoyu , Li Juan , Cao Yi 
Published: July 2016

AbstractThermoresponsive polymers have gained extensive attention as biomedical materials especially for targeted drug delivery systems. We have recently developed water‐soluble polypeptide‐based thermoresponsive polymers that exhibit lower critical solution temperature (LCST)‐ or upper critical solution temperature (UCST)‐type phase behaviours. In this study, the toxicity of these polymers to human umbilical vein endothelial cells (HUVECs) was investigated to assess the safety and biocompatibility. Up to 100 μg/ml, thermoresponsive polymers did not induce cytotoxicity to HUVECs, showing as unaltered mitochondrial viability assessed as cell counting kit‐8 (CCK‐8) assay and membrane integrity assessed as lactate dehydrogenase (LDH) assay. Inflammatory response, assessed as the release of chemokine‐soluble monocyte chemotactic protein 1 (sMCP‐1) and interleukin‐8 (IL‐8) as well as cytokine IL‐6, was not significantly affected by the polymers. In addition, 1 μM thapsigargin (TG), an endoplasmic reticulum (ER) stress inducer, significantly decreased mitochondrial viability, but did not affect membrane integrity or inflammatory response. The presence of thermoresponsive polymers with LCST‐type phase behaviour did not further affect the effects of TG. In conclusion, the thermoresponsive polymers used in this study are not toxic to endothelial cells and therefore could be further considered as safe materials for biomedical applications.
Technology enhanced teaching and learning in South African higher education – A rearview of a 20 year journey
Authors: Ng'ambi Dick , Brown Cheryl , Bozalek Vivienne , Gachago Daniela , Wood Denise 
Published: July 2016

AbstractIn the last 20 years, the South African higher education has changed significantly, influenced by global trends national development goals and pressure from local educational imperatives, in the context of a digitally networked world. Shifts in technology enhanced pedagogical practices and in discourses around information and communication technologies (ICTs) have had varying degrees of influence in higher education. This paper takes a rearview of a 20‐year journey of technology enhanced learning in South African higher education. An analysis of literature view is presented chronologically in four phases: phase 1 (1996–2000), phase 2 (2001–05), phase 3 (2006–10) and phase 4 (2011–16). In phase 1 technology was used predominantly for drill and practice, computer‐aided instruction, with growing consciousness of the digital divide. In phase 2 institutions primarily focused on building ICT infrastructure, democratizing information, policy development and research; they sought to compare the effectiveness of teaching with or without technology. During phase 3 institutions began to include ICTs in their strategic directions, digital divide debates focused on epistemological access, and they also began to conduct research with a pedagogical agenda. In phase 4 mobile learning and social media came to the fore. The research agenda shifted from whether students would use technology to how to exploit what students already use to transform teaching and learning practices. The paper concludes that South Africa's higher education institutions have moved from being solely responsible for both their own relatively poor ICT infrastructure and education provision to cloud‐based ICT infrastructure with “unlimited” educational resources that are freely, openly and easily available within and beyond the institution. Although mobile and social media are more evident now than ever before, teaching and learning practice in South African higher education remains largely unchanged.
Antagonism of the proinflammatory and pronociceptive actions of canonical and biased agonists of protease‐activated receptor‐2
Authors: Lieu T , Savage E , Zhao P , Edgington‐Mitchell L , Barlow N , Bron R , Poole D P , McLean P , Lohman R‐J , Fairlie D P , Bunnett N W 
Published: July 2016

AbstractBackground and PurposeDiverse proteases cleave protease‐activated receptor‐2 (PAR2) on primary sensory neurons and epithelial cells to evoke pain and inflammation. Trypsin and tryptase activate PAR2 by a canonical mechanism that entails cleavage within the extracellular N‐terminus revealing a tethered ligand that activates the cleaved receptor. Cathepsin‐S and elastase are biased agonists that cleave PAR2 at different sites to activate distinct signalling pathways. Although PAR2 is a therapeutic target for inflammatory and painful diseases, the divergent mechanisms of proteolytic activation complicate the development of therapeutically useful antagonists.Experimental ApproachWe investigated whether the PAR2 antagonist GB88 inhibits protease‐evoked activation of nociceptors and protease‐stimulated oedema and hyperalgesia in rodents.Key ResultsIntraplantar injection of trypsin, cathespsin‐S or elastase stimulated mechanical and thermal hyperalgesia and oedema in mice. Oral GB88 or par2 deletion inhibited the algesic and proinflammatory actions of all three proteases, but did not affect basal responses. GB88 also prevented pronociceptive and proinflammatory effects of the PAR2‐selective agonists 2‐furoyl‐LIGRLO‐NH2 and AC264613. GB88 did not affect capsaicin‐evoked hyperalgesia or inflammation. Trypsin, cathepsin‐S and elastase increased [Ca2+]i in rat nociceptors, which expressed PAR2. GB88 inhibited this activation of nociceptors by all three proteases, but did not affect capsaicin‐evoked activation of nociceptors or inhibit the catalytic activity of the three proteases.Conclusions and ImplicationsGB88 inhibits the capacity of canonical and biased protease agonists of PAR2 to cause nociception and inflammation.
Design, synthesis, and in vitro antimicrobial activity of hydrazide–hydrazones of 2‐substituted acetic acid
Authors: Popiołek Łukasz , Biernasiuk Anna 
Published: July 2016

In this study, 30 hydrazide–hydrazones of phenylacetic (3–10) and hydroxyacetic acid (11–32) were synthesized by the condensation reaction of appropriate 2‐substituted acetic acid hydrazide with different aromatic aldehydes. The obtained compounds were characterized by spectral data and evaluated in vitro for their potential antimicrobial activities against a panel of reference strains of micro‐organisms, including Gram‐positive bacteria, Gram‐negative bacteria, and fungi belonging to the Candida spp. The results from our antimicrobial assays indicated that among synthesized compounds 3–32, especially compounds 6, 14, and 26 showed high bactericidal activity (MIC = 0.488–7.81 μg/ml) against reference Gram‐positive bacteria, and in some cases, their activity was even better than that of commonly used antibiotics, such as cefuroxime or ampicillin.
Environmental Contaminants and Child Development
Authors: Trentacosta Christopher J. , Davis‐Kean Pamela , Mitchell Colter , Hyde Luke , Dolinoy Dana 
Published: July 2016

AbstractDevelopmental scientists have long been interested in how the environment influences children's development. However, with few exceptions, they have not researched how exposure to contaminants in the physical environment affects developmental processes. Children are uniquely at risk for exposure to contaminants because they drink more, eat more, and breathe more air than adults as a proportion of their body weight. In this article, we provide an ecosystems perspective to illustrate how contexts—from the prenatal environment and neighborhood‐level exposure to laws and policies—contribute to children's exposure to contaminants. We also discuss four mechanisms that account for how and when exposure to contaminants affects children, and we provide examples to spur research on these mechanisms. We conclude with recommendations to foster integrative science where developmental science interacts with environmental health and toxicology.
Combined Magnesium/Polyethylene Glycol Facilitates the Neuroprotective Effects of Magnesium in Traumatic Brain Injury at a Reduced Magnesium Dose
Authors: Busingye Diana S. , Turner Renée J. , Vink Robert 
Published: July 2016

SummaryAimsWhile a number of studies have shown that free magnesium (Mg) decline is a feature of traumatic brain injury (TBI), poor central penetration of Mg has potentially limited clinical translation. This study examines whether polyethylene glycol (PEG) facilitates central penetration of Mg after TBI, increasing neuroprotection while simultaneously reducing the dose requirements for Mg.MethodsRats were exposed to diffuse TBI and administered intravenous MgCl2 either alone (254 μmol/kg or 25.4 μmol/kg) or in combination with PEG (1 g/kg PEG) at 30‐min postinjury. Vehicle‐treated (saline or PEG) and sham animals served as controls. All animals were subsequently assessed for blood‐brain barrier permeability and edema at 5 h, and functional outcome for 1 week postinjury.ResultsOptimal dose (254 μmol/kg) MgCl2 or Mg PEG significantly improved all outcome parameters compared to vehicle or PEG controls. Intravenous administration of 10% MgCl2 alone (25.4 μmol/kg) had no beneficial effect on any of the outcome parameters, whereas 10% Mg in PEG had the same beneficial effects as optimal dose Mg administration.ConclusionPolyethylene glycol facilitates central penetration of Mg following TBI, reducing the concentration of Mg required to confer neuroprotection while simultaneously reducing the risks associated with high peripheral Mg concentration.
Cerebral Functional Reorganization in Ischemic Stroke after Repetitive Transcranial Magnetic Stimulation: An fMRI Study
Authors: Li Jing , Zhang Xue‐Wei , Zuo Zhen‐Tao , Lu Jie , Meng Chun‐Ling , Fang Hong‐Ying , Xue Rong , Fan Yong , Guan Yu‐Zhou , Zhang Wei‐Hong 
Published: July 2016

SummaryAimsOur study aimed to figure out brain functional reorganization evidence after repetitive transcranial magnetic stimulation (rTMS) using the resting‐state functional magnetic resonance imaging (rsfMRI).MethodsTwelve patients with unilateral subcortex lesion in the middle cerebral artery territory were recruited. Seven of them received a 10‐day rTMS treatment beginning at about 5 days after stroke onset. The remaining five received sham treatment. RsfMRI and motor functional scores were obtained before and after rTMS or sham rTMS.ResultsThe rTMS group showed motor recovery according to the behavioral testing scores, while there was no significant difference of motor functional scores in the sham group before and after the sham rTMS. It proved that rTMS facilitates motor recovery of early ischemic stroke patients. Compared with the sham, the rTMS treatment group achieved increased functional connectivity (FC) between ipsilesional M1 and contralesional M1, supplementary motor area, bilateral thalamus, and contralesional postcentral gyrus. And decreased FC was found between ipsilesional M1 and ipsilesional M1, postcentral gyrus and inferior and middle frontal gyrus.ConclusionIncreased or decreased FC detected by rsfMRI is an important finding to understand the mechanism of brain functional reorganization. The rTMS treatment is a promising therapeutic approach to facilitate motor rehabilitation for early stroke patients.
Are there differences in outcome after elective sigmoidectomy for diverticular disease and for cancer? A national inpatient study
Authors: Ilyas M. I. M. , Zangbar B. , Nfonsam V. N. , Maegawa F. A. , Joseph B. A. , Patel J. A. , Wexner S. D. 
Published: July 2016

AbstractAimThe postoperative outcome after elective sigmoidectomy for diverticulitis has not been compared to that for cancer. The study aimed to evaluate the differences in the postoperative outcome after sigmoidectomy for diverticular disease and cancer.MethodThe National Inpatient Sample Database was used to identify patients who underwent elective sigmoid resection for diverticular disease or cancer between 2004 and 2011. After excluding patients with metastatic cancer and preoperative weight loss, sigmoid cancer and diverticulitis patients were matched using propensity score, controlling for age, gender, race, type of operation (open vs laparoscopic) and comorbidities. The end‐points of interest were infective complications, reoperation, anastomotic leakage, rebleeding, length of hospital stay and in‐hospital mortality.ResultsAfter propensity score matching (diverticulitis 11 192 patients, sigmoid cancer 11 192 patients), the mean age was 65 ± 12.5 years, 53.8% were male and 61.5% were Caucasian. Only 18.0% of the operations were done by laparoscopy. The overall complication rate was 17.7% and the in‐hospital mortality rate was 0.9%. The diverticulitis group had a higher rate of surgical site infection (3.2% vs 2.6%, P = 0.004), intra‐abdominal abscess formation (1.2% vs 0.4%, P < 0.0001) and reoperation (6.1% vs 4.1%, P < 0.0001) compared with the cancer group. The cancer group had a higher incidence of pneumonia (1.9% vs 1.5%, P = 0.01) and anastomotic leakage (9.2% vs 8.3%, P = 0.001). There was no difference in sepsis, deep vein thrombosis, respiratory failure, renal failure, rebleeding, overall complication rate or length of hospital stay. Subgroup analysis showed a higher in‐hospital mortality for cancer than for diverticulitis patients whether resected by open or by laparoscopic surgery.ConclusionAlthough elective sigmoidectomy for diverticular disease has a higher risk of infective complications, elective sigmoidectomy for cancer has a higher risk of anastomotic leakage.
Surgical management of fistulating perianal Crohn's disease: a UK survey
Authors: Lee M. J. , Heywood N. , Sagar P. M. , Brown S. R. , Fearnhead N. S. ,   pCD Collaborators
Published: July 2016

AbstractAimAround one‐third of patients with Crohn's disease are affected by Crohn's fistula‐in‐ano (pCD). It typically follows a chronic course and patients undergo long‐term medical and surgical therapy. We set out to describe current surgical practice in the management of pCD in the UK.MethodA survey of surgical management of pCD was designed by an expert group of colorectal surgeons and gastroenterologists. This assessed acute, elective, multidisciplinary and definitive surgical management. A pilot of the questionnaire was undertaken at the 2015 meeting of the Digestive Disease Federation. The survey was refined and distributed nationally through the trainee collaborative networks.ResultsNational rollout obtained responses from 133 of 179 surgeons approached (response rate 74.3%). At first operation, 32% of surgeons would always consider drainage of sepsis and 31.1% would place a draining seton. At first elective operation, 66.6% would routinely insert of draining seton, and 84.4% would avoid cutting seton. An IBD multidisciplinary team was available to 87.6% of respondents, although only 25.1% routinely discussed pCD patients. Anti‐tumour necrosis factor‐alpha therapy was routinely considered by 64.2%, although 44.2% left medical management to gastroenterologists. Common definitive procedures were removal of the seton only (70.7%), fistulotomy (57.1%), advancement flap (38.9%), fistula plug (36.4%) and ligation of intersphincteric track (LIFT) procedure (31.8%). Indications for diverting stoma or proctectomy were intractable sepsis, incontinence and poor quality of life.ConclusionThis survey has demonstrated areas of common practice, but has also highlighted divergent practice including choices of definitive surgery and multimodal management. Practical guidelines are required to support colorectal surgeons in the UK.