bluuebunny/crossref_metadata_2025_split huggingface dataset:
Seizure onset predicts its type
Authors: Donos Cristian , Maliia Mihai Dragos , Dümpelmann Matthias , Schulze‐Bonhage Andreas 
Published: January 2018

SummaryObjectiveEpilepsy is characterized by transient alterations in brain synchronization resulting in seizures with a wide spectrum of manifestations. Seizure severity and risks for patients depend on the evolution and spread of the hypersynchronous discharges. With standard visual inspection and pattern classification, this evolution could not be predicted early on. It is still unclear to what degree the seizure onset zone determines seizure severity. Such information would improve our understanding of ictal epileptic activity and the existing electroencephalogram (EEG)‐based warning and intervention systems, providing specific reactions to upcoming seizure types. We investigate the possibility of predicting the future development of an epileptic seizure during the first seconds of recordings after their electrographic onset.MethodsBased on intracranial EEG recordings of 493 ictal events from 26 patients with focal epilepsy, a set of 25 time and frequency domain features was computed using nonoverlapping 1‐second time windows, from the first 3, 5, and 10 seconds of ictal EEG. Three random forest classifiers were trained to predict the future evolution of the seizure, distinguishing between subclinical events, focal onset aware and impaired awareness, and focal to bilateral tonic–clonic seizures.ResultsResults show that early seizure type prediction is possible based on a single EEG channel located in the seizure onset zone with correct prediction rates of 76.2 ± 14.5% for distinguishing subclinical electrographic events from clinically manifest seizures, 75 ± 16.8% for distinguishing focal onset seizures that are or are not bilateral tonic–clonic, and 71.4 ± 17.2% for distinguishing between focal onset seizures with or without impaired awareness. All predictions are above the chance level (P < .01).SignificanceThese findings provide the basis for developing systems for specific early warning of patients and health care providers, and for targeting EEG‐based closed‐loop intervention approaches to electrographic patterns with a high inherent risk to become clinically manifest.
Ultrasonographic examination of the quadriceps femoris muscle: Normal images and findings
Authors: Denoix J.‐M. , Coudry V. 
Published: January 2018

SummaryIn the paper written by Ogden et al. (2019) in this edition of Equine Veterinary Education, a complete tear of the vastus medialis muscle was considered as the cause of the lateral luxation of the patella in a 2‐day‐old cob colt. As muscle tears can be documented with ultrasound, this short commentary is presenting normal ultrasonographic images of the quadriceps femoris (QF) muscle and findings on two clinical cases.
Long‐term effects of flow regulation by dams simplify fish functional diversity
Authors: Oliveira Anielly G. , Baumgartner Matheus T. , Gomes Luiz C. , Dias Rosa M. , Agostinho Angelo A. 
Published: January 2018

AbstractThe long‐term impact of river regulation on fish functional diversity by a dam immediately upstream from the upper Paraná River floodplain, Brazil, was evaluated. It was expected that the resulting alterations in natural flow, downstream from the dam, would negatively impact fish species, resulting in a functional simplification of the ichthyofauna. In addition, this effect was expected to be more pronounced in the directly affected main channel of the Paraná River than in its tributaries, the Baía and Ivinhema rivers.Fish were sampled before (pre) and after (post) dam closure (the intervention). The functional traits used were diet, habitat use, mouth position, migration, parental care, internal fertilisation and maximum total length. Differences in trait composition between periods (pre and post) were tested using aPERMANOVAmain‐test. An indicator value analysis (IndVal) was applied to identify which traits significantly increased or decreased in abundance after the intervention. The indexes used were functional richness (FRic), Rao's quadratic entropy (FDQ) and functional redundancy (FRed). The intervention analysis based on linear models for time series was used to evaluate differences in these indexes over time.Traits most representative during pre‐intervention were large‐bodied species with long reproductive migrations, pelagic, with subterminal and superior mouths, and herbivorous. Traits most representative during the post‐intervention were omnivorous species, with parental care, benthopelagic and insectivorous, which typically characterise fishes that inhabit stable environments.FRic decreased in Paraná and Baía rivers after the construction of the dam. However, the Ivinhema River showed an increase in meanFRic in the post‐intervention period.FDQdecreased substantially in all three rivers, whileFRed increased.The combined results ofFRic,FDQandFRed corroborate the functional simplification hypothesis expected from flow regulation by dams on functional diversity. As expected, the most pronounced simplification occurred in the Paraná River. Therefore, hydroelectric power plants can act as environmental filters strongly selecting functional traits of the downstream fish fauna, generating long‐lasting impacts on ecosystem functioning and services.
‘On being the right size’ – Do aliens follow the rules?
Authors: van der Geer Alexandra A.E. , Lomolino Mark V. , Lyras George 
Published: January 2018

AbstractAimTo assess whether mammalian species introduced onto islands across the globe have evolved to exhibit body size patterns consistent with the ‘island rule,’, and to test an ecological explanation for body size evolution of insular mammals.LocationIslands worldwide.MethodsWe assembled data on body mass, geographical characteristics (latitude, maximum elevation) and ecological communities (number of mammalian competitors, predators and prey) for 385 introduced populations across 285 islands, comprising 56 species of extant, non‐volant mammals. We used linear regression, ANCOVA and regression tree analyses to test whether introduced populations of mammals exhibit the island rule pattern, whether the degree of body size change increased with time in isolation and whether residual variation about the general trend can be attributed to the geographical and ecological characteristics of the islands.ResultsIntroduced populations follow the predicted island rule trend, with body size shifts more pronounced for populations with greater residence times on the islands. Small mammals evolved to larger body sizes in lower latitudes and on islands with limited topographic relief. Consistent with our hypothesis on the ecology of evolution, body size of insular introduced populations was influenced by co‐occurring species of mammalian competitors, predators and prey.ConclusionThe island rule is a pervasive pattern, exhibited across a broad span of geographical regions, taxa, time periods and, as evidenced here, for introduced as well as native mammals. Time in isolation impacts body size evolution profoundly. Body size shift of introduced mammals was much more pronounced with increasing residence times, yet far less than that exhibited by native, palaeo‐insular mammals (residence times > 10,000 years). Given the antiquity of many species introductions, it appears that much of what we view as the natural character and ecological dynamics of recent insular communities may have been rendered artefacts of ancient colonizations by humans and commensals.
The implementation of a successful medication safety program in a primary care
Authors: Khalil Hanan , Lee Sarah 
Published: January 2018

AbstractRationale, aims, and objectivesImproving patient safety is now a government priority in many economically developed and underdeveloped countries. Various medication safety interventions and programs that have been described in the literature focus on hospital settings, and only very few studies report on the implementation of such interventions in primary care.The main objectives of this study were firstly to describe the steps involved for the successful implementation of a medication safety program in primary care in rural Australia and secondly to report on its evaluation and provide recommendations for future initiatives.MethodThe implementation of the medication safety program within the study organization included several steps, and these were as follows: collection of baseline medications incidents within the organization over the last 2 years, delivery of a medication safety training to clinicians working within the organization, formation of a medication safety group, and implementation of the newly developed medication safety guidelines within the organization. Clinicians' knowledge, behaviour, confidence, and satisfaction were also collected before and after the implementation.ResultsThe results show that medication safety training has improved clinicians' knowledge, confidence, behaviour, and utilization positively. There was a significant increase in the clinicians' confidence and satisfaction in applying the training to their daily practice (P value of 0.02).The implementation of the medication safety program across the study organization sites relied on 3 main stages. These were connect and communicate, collaboration, and consolidation. In the first stage of the project, we focused on identifying the key issues contributing to medication errors across the organization using an evidence‐based approach to identify the types of medications errors.ConclusionThe success of the implementation of a collaborative medication safety program within a large organization is dependent on emphasizing a wide culture of patient safety and understanding the medication incident reports within an organization.
A study of environmental factors affecting nurses’ comfort and protection in wearing N95 respirators during bedside procedures
Authors: Or Peggy PL , Chung Joanne WY , Wong Thomas KS 
Published: January 2018

Aims and objectivesTo investigate room temperature and relative humidity affecting nurses’ comfort and protection in wearing N95 respirators during clinical bedside procedures.BackgroundN95 respirators are most commonly used to protect healthcare workers against airborne diseases. The elastic head straps required for tight‐fit may cause headache, facial pain and/or ear lobe discomfort. Although some past fit test results showed that these respirators are likely to fit comfortably, in reality, any discomfort from use may influence negatively their appeal and acceptability and thus lower their effectiveness to protect the wearers.DesignThis study used a comparative study design to compare nurses’ comfort and protection in wearing N95 respirator during clinical nursing procedures.MethodThe participants (84) were first‐year undergraduate nursing students from a university in Hong Kong. They were divided randomly into four groups (A, B, C and D), with 21 in each group. In this study, they performed the Personal Respirator Sampling Test (PRST), a self‐developed portable, real‐time fit test method based on the conventional fit test set‐up. After this, they were asked to complete a usability questionnaire, which was used to record their evaluations of the six perceptions of comfort of wearing N95 respirators.ResultsThe participants expressed being comfortable with the respirators at warm temperatures of 20 to 24°C. For those participants in Group A who had performed fit tests and fit checks, they did not feel hot nor had difficulties with breathing. However, they did feel tightness in the respirators and experienced discomfort on their ear lobes.ConclusionRoom temperature is the significant factor affecting the comfort in wearing N95 respirators. It is noteworthy that any discomforts from wearing respirators will negatively influence their appeal and proper use. Without doubt, comfortable fit makes healthcare workers more likely use respirators, hence complying with occupational health and safety regulations.Relevance to clinical practiceN95 respirator wearer's comfort is affected by room temperature. Wearer's comfort can affect his/her morale in performing bedside procedures in clinical practice.
Experiences of living kidney donors during the donation process
Authors: Agerskov Hanne , Bistrup Claus , Ludvigsen Mette S. , Pedersen Birthe D. 
Published: January 2018

SUMMARYBackgroundThe shortage of organs from deceased donors has led to more living donation. Furthermore, immunological developments have made it possible to perform kidney transplantation despite preformed antibodies against the donor organ. This has led to a broader recruitment base of living donors.ObjectiveThe objective was to investigate experiences and considerations on becoming, and during the process of being, a living kidney donor.Materials and Methods: Interviews and participant observation were conducted before, during and after the donation. Data were analysed in accordance with Ricoeur's theory of interpretation on three levels: naïve reading, structural analysis and critical interpretation and discussion. Eighteen potential donors over the age of 18 were included.ResultsPotential donors’ decision to donate was based on a desire to help the recipient. At all stages of the process, donors experienced joy, dilemmas, vulnerability and hope. Rejected donors experienced frustration and disappointment. The accepted donors experienced both joy and vulnerability. Interaction between the donor and the recipient and the relatives played a significant role. The transition from being a healthy individual to being a surgical patient was an overwhelming experience.ConclusionThe process of donating a kidney and the return to everyday life involved significant experiences of joy, dilemmas, vulnerability and hope that influenced donors’ lives on physical, psychological and social levels. Support and clear communication from the health professionals was essential.
“The Masks We Wear”: A Qualitative Study of Suicide in Australian Farmers
Authors: Kunde Lisa , Kõlves Kairi , Kelly Brian , Reddy Prasuna , de Leo Diego 
Published: January 2018

AbstractPurposeFarmer suicide is a major public issue in Australia. Using the psychological autopsy method, this study aimed to examine the life and death circumstances of Australian male farmers who died by suicide through verbal reports from their close significant others.MethodsIndividual semistructured interviews were conducted with 12 relatives of male farmers who had died by suicide in Queensland or New South Wales, Australia (2006‐2014). This study followed the COREQ checklist criteria for the reporting of qualitative research.FindingsSix interrelated themes were identified: (1) masculinity, (2) uncertainty and lack of control in farming, (3) feelings of failure in relationships and farming, (4) escalating health problems, (5) maladaptive coping, and (6) acquired capability with access to means.ConclusionsEffective clinical interventions, as well as suicide prevention strategies, need to consider the importance of 3 key issues in suicide among farmers: adherence to masculine norms and socialization; expectations of self in maintaining family traditions and occupation; and a male subtype of depression.
Inter‐rater agreement of novel high‐resolution impedance manometry metrics: Bolus flow time and esophageal impedance integral ratio
Authors: Carlson D. A. , Lin Z. , Kou W. , Pandolfino J. E. 
Published: January 2018

AbstractBackgroundNovel high‐resolution impedance manometry (HRIM) metrics of bolus flow time (BFT) and esophageal impedance integral (EII) ratio have demonstrated clinical utility, though the reliability of their analysis has not been assessed. We aimed to evaluate the inter‐rater agreement of the BFT and EII ratio.MethodsHRIM studies including five upright, liquid swallows from 40 adult patients were analyzed by two raters using a customized MATLAB program to generate the BFT and EII ratio. Inter‐rater agreement was assessed using the intraclass correlation coefficient (ICC) for median values generated per patient and also for all 200 swallows.Key ResultsThe ICC (95% confidence interval, CI) for BFT was 0.873 (0.759‐0.933) for median values and 0.838 (0.778‐0.881) for all swallows. The ICC (95% CI) for EII ratio was 0.983 (0.968‐0.991) for median values and 0.905 (0.875‐0.928) for all swallows. Median values for both BFT and EII ratio were similar between the two raters (P‐values .05).Conclusions and InferencesThe BFT and EII ratio can be reliably calculated as supported by generally excellent inter‐rater agreement. Thus, broader utilization of these measures appears feasible and would facilitate further evaluation of their clinical utility.
Success rate of medical thoracoscopy and talc pleurodesis in malignant pleurisy: A single‐centre experience
Authors: Leemans Joke , Dooms Christophe , Ninane Vincent , Yserbyt Jonas 
Published: January 2018

ABSTRACTBackground and objectiveMalignant pleurisy is associated with advanced oncological disease and dyspnoea is the most common presenting symptom. Pleurodesis is the preferred palliative and supportive treatment option, targeting symptom relief. The identification of clinical and endoscopic features that determine the success of talc pleurodesis in malignant pleurisy could guide clinical decision‐making.MethodsAll symptomatic patients with malignant pleurisy subjected to talc pleurodesis through medical thoracoscopy between January 2012 and December 2015 were included. Univariate and multivariate analyses were performed to identify factors associated with successful pleurodesis.ResultsOf the 155 patients, 122 (78%) were classified as having a successful pleurodesis based on clinical and radiological criteria. Factors associated with unsuccessful pleurodesis (univariate analysis) were the presence of pleural adhesions (odds ratio (OR): 0.43 (95% CI: 0.19–0.96); P = 0.04), extensive spread of pleural lesions (OR: 0.17 (95% CI: 0.05–0.59); P = 0.001), the use of systemic corticosteroids (OR: 0.28 (95% CI: 0.10–0.83); P = 0.02) and a prolonged time period between the clinical diagnosis of the pleural effusion and the moment of pleurodesis (OR: 0.14 (95% CI: 0.06–0.32); P < 0.0001). The latter being associated with failure of pleurodesis in a multivariate analysis (OR: 0.08 (95% CI: 0.01–0.25); P < 0.0001). Chest ultrasound prior to pleurodesis showed a sensitivity of 91% and a specificity of 88% in predicting the success of pleurodesis.ConclusionThe success rate of pleurodesis in malignant pleurisy could potentially be enhanced by correct patient selection and early referral for pleurodesis. Ultrasonic assessment of pleural adhesions and potential lung expansion prior to pleurodesis is useful in clinical decision‐making.
Zika virus RNA polymerase chain reaction on the utility channel of a commercial nucleic acid testing system
Authors: Boujnan Mohamed , Duits Ashley J. , Koppelman Marco H.G.M. 
Published: January 2018

BACKGROUNDSeveral countries have implemented safety strategies to reduce the risk of Zika virus (ZIKV) transmission through blood transfusion. These strategies have included nucleic acid amplification testing (NAT) of blood donations. In this study, a new real‐time polymerase chain reaction (PCR) assay including internal control for the detection of ZIKV on the cobas omni Utility Channel (UC) on the cobas 6800 system is presented.STUDY DESIGN AND METHODSPCR conditions and primer/probe concentrations were optimized on the LightCycler 480 instrument. Optimized conditions were transferred to the cobas omni UC on the cobas 6800 system. Subsequently, the limit of detection (LOD) in plasma and urine, genotype inclusivity, specificity, cross‐reactivity, and clinical sensitivity were determined.RESULTSThe 95% LOD of the ZIKV PCR assay on the cobas 6800 system was 23.0 IU/mL (95% confidence interval [CI], 16.5‐37.5) in plasma and 24.5 IU/mL (95% CI, 13.4‐92.9) in urine. The assay detected African and Asian lineages of ZIKV. The specificity was 100%. The clinical concordance between the newly developed ZIKV PCR assay and the investigational Roche cobas Zika NAT test was 83% (24/29).CONCLUSIONSWe developed a sensitive ZIKV PCR assay on the cobas omni UC on the cobas 6800 system. The assay can be used for large‐scale screening of blood donations for ZIKV or for testing of blood donors returning from areas with ZIKV to avoid temporal deferral. This study also demonstrates that the cobas omni UC on the cobas 6800 system can be used for in‐house–developed PCR assays.
Effect of an oxygen‐generating scaffold on the viability and insulin secretion function of porcine neonatal pancreatic cell clusters
Authors: Lee Eun Mi , Jung Ji‐In , Alam Zahid , Yi Hee‐Gyeong , Kim Heejin , Choi Jin Woo , Hurh Sunghoon , Kim Young June , Jeong Jong Cheol , Yang Jaeseok , Oh Kook‐Hwan , Kim Hee Chan , Lee Byeong Chun , Choi Inho , Cho Dong‐Woo , Ahn Curie 
Published: January 2018

AbstractBackgroundIslet encapsulation techniques have shown limited success in maintaining islet survival and function because encapsulation decreases oxygen supply. In this study, an oxygen‐generating scaffold was fabricated to prevent hypoxic cell damage and improve the viability and insulin secretion of islets.MethodsWe fabricated an oxygen‐generating scaffold by mixing calcium peroxide (CaO2) with polydimethylsiloxane (PDMS). We evaluated the effects of the oxygen‐generating PDMS + CaO2 scaffold on viability, caspase‐3 and caspase‐7 activity, oxygen consumption rate (OCR), glucose‐stimulated insulin secretion (GSIS), hypoxic cell marker expression, and reactive oxygen species (ROS) levels in porcine neonatal pancreatic cell clusters (NPCCs). We also fabricated a microfluidic device that allowed measuring the effects of the oxygen‐generating scaffold on viability.ResultsOxygen generation by the PDMS + CaO2 scaffold was sustained for more than 24 hours in vitro. NPCCs encapsulated in PDMS + CaO2 showed higher viability than NPCCs in PDMS scaffolds and control NPCCs grown without a scaffold. PDMS + CaO2‐encapsulated NPCCs showed lower caspase‐3 and caspase‐7 activity, hypoxic cell expression, and ROS levels, and higher OCR and GSIS than those in PDMS or control cells. Using the microfluidic device, we observed that the viability of PDMS + CaO2‐encapsulated NPCCs was higher than that of PDMS‐encapsulated NPCCs.ConclusionsNPCCs in PDMS + CaO2 scaffolds show higher viability and insulin secretion than do NPCCs in PDMS scaffolds and control cells. Therefore, this oxygen‐generating scaffold has potential for application in future islet transplantation studies.
Observer variation in the delineation of organs at risk for head and neck radiation therapy treatment planning: a systematic review protocol
Authors: Moore Alisha 
Published: January 2018

Review question:
The objective of this review is to examine inter- and intra-observer agreement and reliability in the delineation of head and neck organs at risk (OAR) as part of the radiation therapy treatment planning process.
More specifically, the objectives are to identify:i. The level of agreement and reliability among multiple observers in defining normal tissue in the head and neck region in both computed tomography (CT) and magnetic resonance imaging (MRI) scans.ii. The level of agreement and reliability for single observers at different time points in defining normal tissue in the head and neck region on both CT and MRI scans.iii. The contouring methods used to delineate head and neck organs at risk (OAR) in studies of intra and inter-observer reliability and agreement. Such contouring methods may include the use of software packages, education, technology and multi-modality imaging such as CT and MRI.
The impact of outpatient telehealth compared to standard care on emergency room visits and hospital admissions in pediatric diabetes patients: a systematic review protocol
Authors: Armstrong Katelyn , Moore Mary M. 
Published: January 2018

Review question:
What is the effectiveness of outpatient telehealth compared to standard care on emergency room and hospital admissions in patients aged 0 to 18 years with type 1 or type 2 diabetes?