bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increasing workplace violence in an Australian adult emergency department
Authors: Nikathil Shradha , Olaussen Alexander , Symons Evan , Gocentas Robert , O'Reilly Gerard , Mitra Biswadev 
Published: November 2017

AbstractObjectiveWorkplace violence (WPV) is an increasingly concerning occupational hazard within the ED. The aim of the present study was to evaluate the incidence and characteristics of WPV in an adult ED.MethodsA retrospective cohort study was conducted to identify the incidence of ED WPV in an adult metropolitan ED. Data were obtained from the activity records of security staff from 1 January 2013 to 31 December 2015 for all incidents of patient‐perpetrated violence. Data on patients identified from these records as requiring security staff intervention for violence in the ED were collected through an explicit chart review. Data on patient illicit drug or alcohol exposure and acute psychiatric diagnoses were also collected.ResultsThere were 1853 episodes of patient‐perpetrated WPV identified over the study period. The incidence of WPV over the 3 years was 103 (95% CI: 98–108) per 10 000 of the presenting population, with a significant increase from 2013 to 2015 (IRR 1.07; 95% CI: 1.04–1.10; P < 0.01). Drug and/or alcohol exposure was observed in 1145 (61.8%) patients. Among the drug‐ and/or alcohol‐affected violent population, three quarters (840/1145 = 73.4%) did not have a concurrent psychiatric diagnosis that required assessment during the violent presentation.ConclusionThe rate of WPV was increasing within this Australian ED during the study period. The majority of violent patients were affected by drugs and/or alcohol in the absence of a psychiatric diagnosis. Interventions to reduce access to and misuse of alcohol and illicit drugs could have a substantial impact on the concerning increase of violence in the ED.
Clinical characteristics of ulcerative colitis‐related colorectal cancer in Chinese patients
Authors: Wang Ya Nan , Li Ji , Zheng Wei Yang , Wu Dong , Yang Hong , Li Yue , Lv Hong , Tan Bei , Shu Hui Jun , Sun Xi Yu , Qian Jia Ming , Wu Bin , Li Jing Nan 
Published: November 2017

OBJECTIVEThe prevalence of ulcerative colitis (UC) in China has been increasing, together with the incidence of ulcerative colitis‐related colorectal cancer (UCRCC). In this study we aimed to investigate the clinical features of UCRCC in Chinese UC patients.METHODSClinical data of patients with UCRCC during January 2003 to December 2016 were retrieved from the Peking Union Medical College Hospital registration database and compared with that of sporadic colorectal cancer (CRC).RESULTSDuring the study period, among the 10 110 patients with CRC 25 were found to have UCRCC, with an average age of 51 years and a median disease duration of 15 years. The cumulative prevalence of UCRCC was 0.25% in all CRC patients, with a significant increase from 2003–2007 to 2013–2016 (P < 0.01). Altogether 14 (56.0%) patients with UCRCC were men, and 5 (20.0%) had a family history of UC or cancer. Four (16.0%) patients had concurrent high‐grade intraepithelial neoplasia with variable differentiated adenocarcinoma at other sites and 19 (59.4%) tumors were moderately or poorly differentiated. Twenty‐three (92.0%) patients underwent surgery, of whom 10 (40%) were at stage III and IV according to the TNM staging system. Compared with the 10 085 patients with sporadic CRC, UCRCC patients were younger (P < 0.01) and were more likely to have descending colon involvement and multifocal lesions (P < 0.01).CONCLUSIONSUCRCC patients have been increasing in recent years. Compared with patients with sporadic CRC, those with UCRCC are younger and are more likely to have descending colon involvement and multifocality.
C‐reactive protein as a predictor of low trough infliximab concentrations in patients who lose response to infliximab
Authors: Boyle Marie P , Moss Alan C , O'Toole Aoibhlinn M , Vaughn Byron , Cheifetz Adam S 
Published: November 2017

OBJECTIVELow serum infliximab concentrations are associated with an increased risk of loss of response in inflammatory bowel disease (IBD). The objective of this study was to evaluate the test characteristics of C‐reactive protein (CRP) in identifying low serum infliximab concentrations in patients with IBD.METHODSWe measured serum infliximab concentrations and CRP levels in patients who experienced deteriorating symptoms while on infliximab (the reactive cohort). Receiver operating characteristic (ROC) curves were used to determine the CRP concentration threshold that identified an infliximab concentration <3 μg/mL at the time of loss of response. These CRP thresholds for infliximab concentration <3 μg/mL were then tested in a separate validation cohort.RESULTSThe reactive cohort contained 111 patients and the validation cohort contained 139 patients. In 41% of participants, serum infliximab concentration was <3 μg/mL. In the reactive cohort, the area under the ROC curve for CRP to identify an infliximab concentration <3 μg/mL was 0.70 (95% confidence interval [CI] 0.50–0.80, P = 0.02). A CRP level above 12 mg/L in the preceding 90 days provided a 90% specificity for the later detection of infliximab concentration <3 μg/mL. These test characteristics were similar in the validation cohort.CONCLUSIONCRP levels over 12 mg/L exhibit a high specificity for identifying patients with an infliximab concentration <3 μg/mL. CRP may be cost‐effective for identifying patients with low concentrations of infliximab at the time of, or at risk of, loss of response.
Impaired competence in flagellar mutants of Bacillus subtilis is connected to the regulatory network governed by DegU
Authors: Hölscher Theresa , Schiklang Tina , Dragoš Anna , Dietel Anne‐Kathrin , Kost Christian , Kovács Ákos T. 
Published: November 2017

SummaryThe competent state is a developmentally distinct phase, in which bacteria are able to take up and integrate exogenous DNA into their genome. Bacillus subtilis is one of the naturally competent bacterial species and the domesticated laboratory strain 168 is easily transformable. In this study, we report a reduced transformation frequency of B. subtilis mutants lacking functional and structural flagellar components. This includes hag, the gene encoding the flagellin protein forming the filament of the flagellum. We confirm that the observed decrease of the transformation frequency is due to reduced expression of competence genes, particularly of the main competence regulator gene comK. The impaired competence is due to an increase in the phosphorylated form of the response regulator DegU, which is involved in regulation of both flagellar motility and competence. Altogether, our study identified a close link between motility and natural competence in B. subtilis suggesting that hindrance in motility has great impact on differentiation of this bacterium not restricted only to the transition towards sessile growth stage.
Validating performance of TRISS, TARN and NORMIT survival prediction models in a Norwegian trauma population
Authors: Skaga N. O. , Eken T. , Søvik S. 
Published: November 2017

IntroductionAnatomic injury, physiological derangement, age, injury mechanism and pre‐injury comorbidity are well‐founded predictors of trauma outcome. Statistical prediction models may have poorer discrimination, calibration and accuracy when applied in new locations. We aimed to compare the TRISS, TARN and NORMIT survival prediction models in a Norwegian trauma population.MethodsConsecutive patients admitted to Oslo University Hospital Ullevål within 24 h after injury, with Injury Severity Score ≥ 10, proximal penetrating injuries, or received by trauma team, were studied. Original NORMIT coefficients were updated in a derivation dataset (NORMIT 2; n = 5923; 2005–2009). TRISS, TARN and NORMIT prediction models were evaluated in the validation dataset (n = 6348; 2010–2013) using two different AIS editions for injury coding. Exclusion due to missing data was 0.26%. Outcome was 30‐day mortality. Validation included AUROC, scaled Brier statistics, and calibration plots.ResultsThe NORMIT models had significantly better discrimination, calibration, and overall fit than the TRISS 09, TARN 09 and TARN 12 models. The updated NORMIT 2 had higher numerical values of AUROC and scaled Brier than the original NORMIT, but with overlapping 95%CI. Overlapping 95%CI for AUROCs and Discrimination slopes indicated that the TARN and TRISS models performed similarly. Calibration plots showed tight and consistent predictions over all Ps strata for NORMIT 2 run on AIS'98 coded data, and only little deterioration when AIS'08 data was substituted.ConclusionsIn a Norwegian trauma population, the updated Norwegian survival prediction model in trauma (NORMIT 2) performed better than well‐established British and US alternatives. External validation of these three models in other Nordic populations is warranted.
A prototype small‐bore ventilation catheter with a cuff: cuff inflation optimizes ventilation with the Ventrain
Authors: de Wolf M. W. P. , van der Beek T. , Hamaekers A. E. , Theunissen M. , Enk D. 
Published: November 2017

BackgroundVentilation through small‐diameter tubes typically precludes use of a cuff as this will impede the necessary passive outflow of gas alongside the tube's outer surface. Ventrain assists expiration and enables oxygenation and normoventilation through small‐bore cannulas or catheters, particularly in obstructed airways. A small‐bore ventilation catheter (SBVC; 40 cm long, 2.2 mm inner diameter) with a separate pressure monitoring lumen and a cuff was developed. Efficacy of oxygenation and ventilation with Ventrain through this catheter was investigated in sealed and open airways in a porcine cross‐over study.MethodsSix pigs were ventilated with Ventrain (15 l/min oxygen, frequency 30 breaths per min, I : E‐ratio 1 : 1) through the SBVC, both with the cuff inflated and deflated. Prior to each test they were ventilated conventionally until steady state was achieved.ResultsWith an inflated cuff, PaO2 rose instantly and remained elevated (median [range] PaO2 61 [52–69] kPa after 30 min; P = 0.027 compared to baseline). PaCO2 remained stable at 4.9 [4.2–6.2] kPa. After cuff deflation, PaO2 was significantly lower (9 [5–28] kPa at 10 min, P = 0.028) and interventional ventilation had to be stopped prematurely in five pigs as PaCO2 exceeded 10.6 kPa. Pulmonary artery pressures increased markedly in these pigs. Intratracheal pressures were kept between 5 and 20 cmH2O with the cuff inflated, but never exceeded 2 cmH2O after cuff deflation.ConclusionThe SBVC combines the benefits of a small diameter airway and a cuff. Cuff inflation optimizes oxygenation and ventilation with Ventrain.
Taxonomic revision of the Euploea alcathoe complex (Lepidoptera: Nymphalidae) from Australia and New Guinea
Authors: Lambkin Trevor A , Braby Michael F , Eastwood Rodney G , Zalucki Myron P 
Published: November 2017

AbstractEuploea alcathoe (Godart, [1819]) (Danainae: Danaini) comprises a taxonomic complex, with recent authors recognising one or two species and numerous subspecies throughout its relatively small geographical range. We determined the taxonomic status of populations from northern Australia by integrating data from ecology, larval colour pattern and morphology, adult morphology (wing morphometrics, wing pattern elements and male genitalia) and molecules (mtDNA). We also investigated the broad distribution of phenotypes based on wing pattern maculation throughout mainland New Guinea and its adjacent islands. Available evidence indicates that Euploea eichhorni Staudinger, 1884, stat. rev. from northern Queensland is allopatric and phenotypically and genotypically distinct from E. alcathoe, with 11 phenotypic character state differences in larval pattern and morphology, adult wing pattern and male genitalia, as well as significant differences in wing shape and in frequency distribution of the number of white spots. Genetic data and divergence time estimates based on COI revealed that E. eichhorni and E. alcathoe are reciprocally monophyletic with a mean pairwise divergence of 0.9% and with E. eichhorni comprising only a single unique haplotype. Phylogeographic analysis suggests E. eichhorni diverged as a peripheral isolate from E. alcathoe, most likely during the Late Pleistocene. In the Wet Tropics of northern Queensland, larvae of E. eichhorni specialise on the vine Gymnanthera oblonga (Burm.f.) P.S. Green (Apocynaceae) growing in coastal, broadleaf paperbark swampland, a larval host plant also used by E. alcathoe. A lectotype male of E. eichhorni is designated, with Cooktown, Queensland as the type locality. Euploea alcathoe enastri Fenner, 1991, from the Northern Territory is maintained because it was found to be allopatric, phenotypically distinct, with at least one diagnosable character state (larger number of forewing subapical spots among males), and genetically divergent according to population genetic structure compared with Euploea alcathoe misenus from Torres Strait. Based on our review of E. alcathoe from New Guinea and Torres Strait, we found that populations from at least the southern coastline of New Guinea differed little phenotypically from E. alcathoe misenus; thus, we regard the subspecies Euploea aethiops monaeses Fruhstorfer, 1910, syn. nov. and E. alecto rothschildiana Hulstaert, 1923, syn. nov. as junior synonyms of E. alcathoe misenus Miskin, 1890.
Uniform national guidelines do not prevent wide variations in the clinical application of phototherapy for neonatal jaundice
Authors: Mreihil Khalaf , Nakstad Britt , Stensvold Hans Jørgen , Benth Jūratė Šaltytė , Hansen Thor Willy Ruud ,   the Norwegian NICU Phototherapy Study Group,   the Norwegian Neonatal Network
Published: November 2017

AbstractAimThis study compared the use of phototherapy for neonatal jaundice in all 21 Norwegian neonatal intensive care units (NICUs) from 2013‐2014 to improve practice.MethodsInformation on all types of phototherapy devices was collected, and irradiance was measured from random units at 20 cm and 50 cm from the light source. We gathered information on local practice rules, including the use of single, double or triple phototherapy, how infants were positioned, the frequency of blood sampling, rules for using reflective surfaces and interrupting phototherapy. In every NICU, we asked one nurse with more than five years of experience and one with less than one year to set up phototherapy equipment, then measured the irradiance and distance.ResultsPhotodiodes were the most common of the eight types of phototherapy devices used. Rules for the distance from the device to the infant varied from 10 to 40 cm and in practice they varied from 15 to 48 cm, with irradiance ranging from 11.1–56.1 W/m2. There were significant variations between NICUs with regard to the overall treatment duration and duration in most birthweight categories.ConclusionThere were considerable variations in phototherapy practices among Norwegian NICUs. In particular, the significant variations in duration need to be addressed.
Policy Change and the National Essential Medicines List Development Process in Brazil between 2000 and 2014: Has the Essential Medicine Concept been Abandoned?
Authors: Osorio‐de‐Castro Claudia G. S. , Azeredo Thiago B. , Pepe Vera L. E. , Lopes Luciane C. , Yamauti Sueli , Godman Brian , Gustafsson Lars L. 
Published: November 2017

AbstractBrazil has had a National Essential Medicines List (EML) since 1964. From 2000 to 2010, five consecutive evidence‐based editions were produced, building on the essential medicine concept. In 2012, the government changed course to establish a new paradigm, introducing adoption of new medicines as the main aim within the recommendation process. The objective of the article was to report efforts to develop Brazil's national EML, policy changes from 2000 to 2014, discussing results, challenges and perspectives. Brazilian EML history and development process were collected from legislation, minutes, reports and legal ordinances, from 2000 to 2014. The Brazilian EML and the WHO Model Lists were compared using the Anatomical Therapeutic Chemical system. Overlap between lists was verified, and linear trends were produced. Type of membership, inclusion criteria, procedures, flow and listed medicines varied greatly between the selection committees acting before and after 2012. Paradigm‐changing legislation aiming at linking list compliance to public financing in 2012 produced (i) greater importance given to political and administrative stakeholders, (ii) increasing trends in number of medicines over the years, (iii) decrease in use of WHO Model List as a reference and (iv) substitution of an essential medicines list review and update process by an adoption decision output. Other issues remained unchanged. Insufficient efforts for list implementation, such as lack of physician education, presented consequences to the health system. Substantial efforts were made to produce and update the list from 2000 to 2014. However, continuous and intense health litigation disproves process outcome effectiveness.
Neurocognitive functioning, clinical course and functional outcome in first‐treatment bipolar I disorder patients with and without clinical relapse: A 1‐year follow‐up study
Authors: Demmo Christine , Lagerberg Trine V , Kvitland Levi R , Aminoff Sofie R , Hellvin Tone , Simonsen Carmen , Haatveit Beathe , Andreassen Ole A , Melle Ingrid , Ueland Torill 
Published: November 2017

ObjectivesDue to limited research on the association between recurrence of mood episodes and the longitudinal course of neurocognitive functioning in early phase bipolar I disorder (BD I), the impact of recurrence on neurocognition remains unclear. Further, a strong correlation between neurocognitive impairment and functional impairment has been demonstrated. The longitudinal relationship between neurocognitive impairment and functional outcome in relation to recurrence is, however, not established.MethodsThe current study investigated the longitudinal relationship between neurocognition, recurrence of mood episodes and functional outcome in a sample of first‐treatment (FT) BD I patients (N = 42), with and without relapse, during a 1‐year follow‐up period. The longitudinal course of neurocognitive functioning in the patients was also compared to that of a group of healthy controls (N = 143).ResultsCompared to both patients with relapse and healthy controls, no‐relapse patients showed neurocognitive improvements. The polarity of the relapse episodes was mostly depressive, and for the no‐relapse patients, reduction of symptoms was associated with neurocognitive improvement. No‐relapse patients showed better global and occupational functioning.ConclusionsThe current study found different neurocognitive and functional trajectories in FT BD I patients with and without relapse, with differences at follow‐up to some degree being mediated by current symptoms. The current findings highlight the importance of treatment focusing on neurocognition and symptom states with the aim of improving functional recovery.
Balancing the Scales: Negotiating Father's Parental Leave Use
Authors: Beglaubter Judy 
Published: November 2017

AbstractStudying couples who shared parental leave presents the opportunity to explore decision‐making processes that may challenge conventional care arrangement typical of early parenthood. Interviews with 33 Canadian heterosexual couples indicate gendered sticking points in the division of official leave time. Whether fathers took leave because of their personal desires or material circumstances, this study finds that men and women did not enter negotiations on a level playing field. Strong cultural support for mothers'–but not fathers'–time with baby tipped the scales toward maternal care giving, even when couples wanted to share parental leave. Nevertheless, financial considerations such as a man's topped‐up pay or woman's career could lessen the weight of mothers’ moral entitlement to the leave time by presenting couples with an alternative logic on which to base their decision making.
Enhancing human aspects of care with young people with muscular dystrophy: Results from a participatory qualitative study with clinicians
Authors: Setchell J. , Thille P. , Abrams T. , McAdam L. C. , Mistry B. , Gibson B. E. 
Published: November 2017

AbstractBackgroundMost research into clinical care of Duchenne or Becker dystrophinopathies (MD) has focused on slowing progressive muscular weakness and extending lifespan. Scarce attention has been paid to the “human” aspects of care such as psychosocial health, living a fulfilling life, or dealing with disability stigma. This study partnered with clinicians to identify and address local and systemic barriers to these human aspects of care.MethodsWe employed a participatory qualitative design at a multidisciplinary MD clinic using 2 methods: (a) ethnographic observations over a 6‐month period of clinic visits of children with MD and families, involving 12 clinicians, and (b) 3 “dialogues” (2‐way discussions) with these clinicians to collaboratively analyze practices and co‐produce recommendations for change.ResultsOur methods produced rich data that, when coanalyzed with clinicians and in consultation with a family advisor, provided deep insights into the practices and underlying assumptions of a neuromuscular clinic. Staff recognized the importance of the human aspects of care but, in reviewing the observational data, identified that it was given insufficient attention in (a) routine clinical processes, (b) clinician‐family patterns of interaction, and (c) staffing allocations.ConclusionAlthough the human aspects of care were important to clinicians in the MD clinic, the routines and nature of the clinic meant these were frequently sidelined for biomedical objectives. We present collaboratively produced practical recommendations toward addressing this disjunction between ideals and practice including developing flexibility to tailor appointment frequency, composition, and length; providing time and physical space for psychosocial aspects of care; and clinician skill building to support child/family expression of “negative” emotions; and discussion of sociopolitical aspects of MD such as living with disability stigma. The study offers a set of considerations that, taking into account individual differences, offer insights for similar clinics elsewhere.
Common Ground and Development
Authors: Bohn Manuel , Köymen Bahar 
Published: November 2017

AbstractLanguage and other forms of communication are inherently ambiguous and therefore require some form of common ground to specify the intended meanings of utterances. Theoretical accounts usually focus on interactions between adults and consider recursive mindreading a prerequisite to establishing common ground. Contrasting these accounts, in this article, we offer a developmental perspective on common ground. We propose that instead of using recursive mindreading, infants rely initially on the expectation that communicative partners act rationally in light of previous interactions, which serves as a starting point for common ground to develop. We describe the changing role of common ground across development. Initially, common ground constrains the meaning of ambiguous communicative acts and facilitates children's acquisition of language. Later in development, common ground makes communication efficient by helping speakers coordinate their actions and intentions, and eventually arrive at recursive mindreading.