bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mechanics of NiTi Reinforced Self-Healing Materials Producing Crack Closing Loads
Authors: Salowitz Nathan , Correa Ameralys , Moghadam Afsaneh 
Published: November 2017

Self-healing material structures with the inherent capability to mend damage will lead to a paradigm shift in design as fracture may no longer constitute a failure. Generally, there are two techniques of self-healing that operate at different scales, require different approaches and often are dealt with separately; geometric restoration and crack filling/bonding. Geometric restoration uses shape memory materials that can mechanically close fractures after they occur. Crack filling and bonding fills and chemically bonds fractured parts in place.
Materials capable of recovering from complete fractures, that have propagated across the entire component, have typically taken a sparse fiber composite form with a structural matrix encapsulating shape memory fibers. This form of self-healing material has demonstrated the ability recover original bulk geometry. However, lacking bonding, the healed structures have not had the ability to resist subsequent externally applied loads without re-opening the crack.
A new approach of pre-straining the shape memory fibers before curing them in a matrix in the pre-strained state is presented in this paper with basic theory and experimental results. Pre-straining the shape memory fibers before casting them in the matrix causes them to undergo constrained recovery upon activation. Thus, the samples create closing loads across the crack which are capable of withstanding external loads without re-opening.
Persistent bacteraemia caused byStaphylococcus aureusin the gall bladder
Authors: Yu Alexander Tin Han , Cun Tony , Benamu Esther , Renault Cybele 
Published: November 2017

Staphylococcus aureusbacteraemia (SAB) remains a complex disease with a high associated morbidity and mortality, especially when it is able to establish an occult nidus safe from antimicrobial eradication. Without rapid identification and intervention, the nidus can cause persistent relapse of disease, morbidity and mortality. Having a high clinical suspicion for the foci of occultS. aureusis important, and awareness of potential sites of infection is critical and can be life-saving.We present a unique case of a 65-year-old man with end-stage renal disease receiving haemodialysis who developed septic shock from SAB. Despite 18 days of appropriate antibiotics, the patient had persistent high-grade bacteraemia until his gall bladder was ultimately percutaneously drained. The day after drainage, he cleared his blood cultures, although he ultimately passed away as he decided to transition his care to focus on comfort measures.
Developing a classification system for haemoglobin management in patients with end-stage renal disease on haemodialysis: a secondary data analysis
Authors: Kesztyüs Tibor , Simonsmeier Ulrich , Kesztyüs Dorothea 
Published: November 2017

BackgroundOngoing discussion on anaemia management and target haemoglobin (Hb) levels in patients on haemodialysis with erythropoietin treatment require a systematic approach in evaluating current practice. Aim of the present study was to develop a new classification system to easily monitor Hb trajectories and categorise patients on haemodialysis.MethodsRoutine data from five dialysis centres in the USA collected between 2010 and 2016. Data were anonymised and only those from patients with fortnightly Hb values were included in the analysis. Entries on blood parameters and medication were standardised to achieve overall comparability. Data from each patient was grouped in periods of 120 days. Hb values above or below the target level of 10–12 g/dL were counted for each period. Periods were then assigned to Hb-classes according to the number of Hb values out of range per period: Hb-class I with 0–2, Hb-class II for 3–5 and Hb-class III for ≥6 values out of range.ResultsRecords from 3349 patients with fortnightly Hb values, information on haemodialysis data, laboratory parameters correlated to red blood cells and data on medication with erythropoiesis-stimulating agents (ESAs) were available. Patients were 64.4±15.9 years old; 55.0% were men. Statistical analysis revealed significant differences between Hb-classes in all of the examined parameters, except erythrocytes mean corpuscular volume and C reactive protein above the threshold, with more critical values in higher Hb-classes. The usage of ESAs showed a mean difference between Hb-class III and Hb-class I of 6.4 units/day and kilogram body weight in a 120-day period.ConclusionOur classification system allows an easily achievable overview of the patients’ responsiveness and performance of Hb management. Integrated into a disease management programme or continuous quality improvement, the classification delivers an instant appraisal without complex statistical or mathematical processing.
International variations in primary care physician consultation time: a systematic review of 67 countries
Authors: Irving Greg , Neves Ana Luisa , Dambha-Miller Hajira , Oishi Ai , Tagashira Hiroko , Verho Anistasiya , Holden John 
Published: November 2017

ObjectiveTo describe the average primary care physician consultation length in economically developed and low-income/middle-income countries, and to examine the relationship between consultation length and organisational-level economic, and health outcomes.Design and outcome measuresThis is a systematic review of published and grey literature in English, Chinese, Japanese, Spanish, Portuguese and Russian languages from 1946 to 2016, for articles reporting on primary care physician consultation lengths. Data were extracted and analysed for quality, and linear regression models were constructed to examine the relationship between consultation length and health service outcomes.ResultsOne hundred and seventy nine studies were identified from 111 publications covering 28 570 712 consultations in 67 countries. Average consultation length differed across the world, ranging from 48 s in Bangladesh to 22.5 min in Sweden. We found that 18 countries representing about 50% of the global population spend 5 min or less with their primary care physicians. We also found significant associations between consultation length and healthcare spending per capita, admissions to hospital with ambulatory sensitive conditions such as diabetes, primary care physician density, physician efficiency and physician satisfaction.ConclusionThere are international variations in consultation length, and it is concerning that a large proportion of the global population have only a few minutes with their primary care physicians. Such a short consultation length is likely to adversely affect patient healthcare and physician workload and stress.
Impact of prenatal diagnosis on survival of newborns with four congenital heart defects: a prospective, population-based cohort study in France (the EPICARD Study)
Authors: Khoshnood Babak , Lelong Nathalie , Houyel Lucile , Bonnet Damien , Ballon Morgane , Jouannic Jean-Marie , Goffinet François 
Published: November 2017

Objectives(1) Assess the population-level probability of prenatal diagnosis and termination of pregnancy for fetal anomaly for four major congenital heart defects; (2) Examine, using population-based data, the relation between timing of (prenatal vs postnatal) diagnosis and risk of infant (ie, < 1 year) mortality for four major congenital heart defects (CHDs).DesignPopulation-based cohort (the EPIdémiologie des CARDiopathies congénitales) study.SettingGreater Paris area (Paris and its surrounding suburbs).PatientsThree hundred and fifty-four cases of four major CHDs, including functionally univentricular heart (FUH, N=132), d-transposition of great arteries (d-TGA, N=85), tetralogy of Fallot (TOF, N=60) and coarctation of aorta (CoA, N=77). Statistical analysis included the Mantel-Haenszel method and a test of homogeneity of risk ratios.ResultsApproximately 95% of FUH, more than two-thirds of d-TGA and TOF, and 40% of CoA were prenatally diagnosed. Overall, we did not find any statistically significant association between timing of (prenatal vs postnatal) diagnosis of CHD and risk of infant mortality (Mantel-Haenszel risk ratio 1.1, 95% CI 0.5 – 2.7); and the differences between the risk ratios of the association between prenatal diagnosis and infant mortality across the four CHDs was not statistically significant.ConclusionThese results imply that at least in the settings where specialised services are readily available, survival may no longer be the most relevant outcome, or the best criterion, for evaluating the impact of prenatal diagnosis on the outcome of CHD. The beneficial effects of prenatal diagnosis may be better sought by looking at more ’subtle' or long-term neurodevelopmental outcomes.
Diagnostic utility of appetite loss in addition to existing prediction models for community-acquired pneumonia in the elderly: a prospective diagnostic study in acute care hospitals in Japan
Authors: Takada Toshihiko , Yamamoto Yosuke , Terada Kazuhiko , Ohta Mitsuyasu , Mikami Wakako , Yokota Hajime , Hayashi Michio , Miyashita Jun , Azuma Teruhisa , Fukuma Shingo , Fukuhara Shunichi 
Published: November 2017

ObjectiveDiagnosis of community-acquired pneumonia (CAP) in the elderly is often delayed because of atypical presentation and non-specific symptoms, such as appetite loss, falls and disturbance in consciousness. The aim of this study was to investigate the external validity of existing prediction models and the added value of the non-specific symptoms for the diagnosis of CAP in elderly patients.DesignProspective cohort study.SettingGeneral medicine departments of three teaching hospitals in Japan.ParticipantsA total of 109 elderly patients who consulted for upper respiratory symptoms between 1 October 2014 and 30 September 2016.Main outcome measuresThe reference standard for CAP was chest radiograph evaluated by two certified radiologists. The existing models were externally validated for diagnostic performance by calibration plot and discrimination. To evaluate the additional value of the non-specific symptoms to the existing prediction models, we developed an extended logistic regression model. Calibration, discrimination, category-free net reclassification improvement (NRI) and decision curve analysis (DCA) were investigated in the extended model.ResultsAmong the existing models, the model by van Vugt demonstrated the best performance, with an area under the curve of 0.75(95% CI 0.63 to 0.88); calibration plot showed good fit despite a significant Hosmer-Lemeshow test (p=0.017). Among the non-specific symptoms, appetite loss had positive likelihood ratio of 3.2 (2.0–5.3), negative likelihood ratio of 0.4 (0.2–0.7) and OR of 7.7 (3.0–19.7). Addition of appetite loss to the model by van Vugt led to improved calibration at p=0.48, NRI of 0.53 (p=0.019) and higher net benefit by DCA.ConclusionsInformation on appetite loss improved the performance of an existing model for the diagnosis of CAP in the elderly.
Diagnostic performance of an acoustic-based system for coronary artery disease risk stratification
Authors: Winther Simon , Nissen Louise , Schmidt Samuel Emil , Westra Jelmer Sybren , Rasmussen Laust Dupont , Knudsen Lars Lyhne , Madsen Lene Helleskov , Kirk Johansen Jane , Larsen Bjarke Skogstad , Struijk Johannes Jan , Frost Lars , Holm Niels Ramsing , Christiansen Evald Høj , Botker Hans Erik , Bøttcher Morten 
Published: November 2017

ObjectiveDiagnosing coronary artery disease (CAD) continues to require substantial healthcare resources. Acoustic analysis of transcutaneous heart sounds of cardiac movement and intracoronary turbulence due to obstructive coronary disease could potentially change this. The aim of this study was thus to test the diagnostic accuracy of a new portable acoustic device for detection of CAD.MethodsWe included 1675 patients consecutively with low to intermediate likelihood of CAD who had been referred for cardiac CT angiography. If significant obstruction was suspected in any coronary segment, patients were referred to invasive angiography and fractional flow reserve (FFR) assessment. Heart sound analysis was performed in all patients. A predefined acoustic CAD-score algorithm was evaluated; subsequently, we developed and validated an updated CAD-score algorithm that included both acoustic features and clinical risk factors. Low risk is indicated by a CAD-score value ≤20.ResultsHaemodynamically significant CAD assessed from FFR was present in 145 (10.0%) patients. In the entire cohort, the predefined CAD-score had a sensitivity of 63% and a specificity of 44%. In total, 50% had an updated CAD-score value ≤20. At this cut-off, sensitivity was 81% (95% CI 73% to 87%), specificity 53% (95% CI 50% to 56%), positive predictive value 16% (95% CI 13% to 18%) and negative predictive value 96% (95% CI 95% to 98%) for diagnosing haemodynamically significant CAD.ConclusionSound-based detection of CAD enables risk stratification superior to clinical risk scores. With a negative predictive value of 96%, this new acoustic rule-out system could potentially supplement clinical assessment to guide decisions on the need for further diagnostic investigation.Trial registration numberClinicalTrials.gov identifier NCT02264717; Results.
Surgical safety checklist training: a national study of undergraduate medical and nursing student teaching, understanding and influencing factors
Authors: Kilduff Caroline Laura Stephanie , Leith Thomas Oliver , Drake Thomas M , Fitzgerald J Edward F 
Published: November 2017

AbstractIntroductionUse of the WHO surgical safety checklist is consistently recognised to reduce harm caused by human error during the perioperative period. Inconsistent engagement is considered to contribute to persistence of surgical Never Events in the National Health Service. Most medical and nursing graduates will join teams responsible for the perioperative care of patients, therefore appropriate undergraduate surgical safety training is needed.AimsTo investigate UK medical and nursing undergraduate experience of the surgical safety checklist training.MethodsAn eight-item electronic questionnaire was distributed electronically to 32 medical schools and 72 nursing schools. Analysis was conducted for the two cohorts, and responses from final year students were included.Results87/224 (38.8%) of medical students received teaching on the surgical safety checklist, compared with 380/711 (52.0%) of nursing students. 172/224 (76.8%) of medical students and 489/711 (66.9%) of nursing students understood its purpose and 8/224 (3.6%) medical students and 54/711 (7.4%) nursing students reported never being included in the Time Out. After adjusting for confounding factors, provision of formal teaching in checklist use increased understanding significantly (OR 50.39 (14.07 to 325.79, P&lt;0.001)), as did routine student involvement in time outs (OR 5.72 (2.36 to 14.58, P&lt;0.001)).DiscussionKnowledge of perioperative patient safety systems and the ability to participate in safety protocols are important skills that should be formally taught at the undergraduate level. Results of this study show that UK undergraduate surgical safety checklist training does not meet the minimum standards set by the WHO.
Antipsychotic-induced hyperprolactinaemia: case studies and review
Authors: Mittal Shweta , Prasad Suveera , Ghosh Adwaita 
Published: November 2017

AbstractAntipsychotics are a known cause of hyperprolactinaemia and can be associated with significant health issues in short term and long term. The effects vary with gender and age of the individual and can contribute towards non-concordance and hence relapse in mental health of our patients. Clinicians need to educate the patients about this significant side effect of not only antipsychotic medications but other medications causing hyperprolactinaemia commonly prescribed in primary care.
Young adult smokers’ perceptions of plain packs, numbered packs and pack inserts in Turkey: a focus group study
Authors: Mucan Burcu , Moodie Crawford 
Published: November 2017

IntroductionThe Turkish Government’s ‘National Tobacco Control Program 2015–2018’ included plans to introduce plain packaging and also a ban on brand names on cigarette packs, allowing only assigned numbers on packs. We explored perceptions of these proposed measures, and also pack inserts with cessation messages, another novel way of using the packaging to communicate with consumers.MethodsEight focus groups were conducted with 47 young adult smokers in Manisa and Kutahya (Turkey) in December 2016. Participants were shown three straight-edged plain cigarette packs, as required in Australia, and then three bevelled-edged plain packs, as permitted in the UK. They were then shown plain packs with numbers rather than brand names, and finally three pack inserts with messages encouraging quitting or offering tips on how to do so. Participants were asked about their perceptions of each.ResultsPlain packs were considered unappealing and off-putting, although the bevelled-edged packs were viewed more favourably than the straight-edged packs. Numbered packs were thought by some to diminish the appeal created by the brand name and potentially decrease interest among never smokers and newer smokers. Pack inserts were thought to have less of an impact than the on-pack warnings, but could potentially help discourage initiation and encourage cessation.ConclusionsThat bevelled-edged plain packs were perceived more positively than straight-edged plain packs is relevant to countries planning to introduce plain packaging. The study provides a first insight into smokers’ perceptions of a ban on brand names, which was perceived to reduce appeal among young people.
Acute Compartment Syndrome of Upper Extremities with Tendon Ruptures
Authors: Suzuki Taku , Yamabe Eiko , Iwamoto Takuji , Suzuki Katsuji , Yamada Harumoto , Sato Kazuki 
Published: November 2017

Background: It is well known that acute compartment syndrome is associated with fracture of the forearm, while involvement of soft tissue injury including musculotendinous injury remains unclear. The purpose of this study was to evaluate the soft tissue involvement, including musculotendinous ruptures, in acute compartment syndrome of the upper limb.Methods: We retrospectively enrolled 16 patients who underwent surgical treatment for acute compartment syndrome of the upper extremity. The average age of the patients was 47 years (range, 14 to 79) and the mean follow-up period after the surgery was 15 months (range, 12 to 29). Complications included at least one presentation at the final follow up of sensory disturbances or motor disturbances. We examined the presence of musculotendinous injury mechanism of injury, presence of fracture, the performance of skin grafting, and complications.Results: Mechanism of injury of “caught in a machine” was found in six cases. Three of these patients had musculotendinous ruptures and all muscle tears were revealed by intraoperative findings. No patients had muscle ruptures with other injury mechanisms. Seven out of 16 patients (44%) developed complications at final follow-up. Skin grafting was performed in six patients, and five of these patients developed complications. Only one of the nine patients without complications underwent skin grafting.Conclusions: In cases of high-energy injuries, the surgeon should suspect the presence of a musculotendinous injury prior to surgery.
The ‘Te’ Technique for Restoring Fingertip Stability Post Traumatic Acro-Osteolysis – A Report and Review of Management Options
Authors: Lin Yu-Te , Loh Charles Yuen Yung 
Published: November 2017

Background: Fractures of the distal phalanx can result in bony non-union, resulting in acro-osteolysis and subsequent fingertip instability due to soft tissue dissociation from bone. Conventional methods of treating this involve osseous fixation, but do not address the laxity and lack of soft tissue stability with bone. Current techniques also do not address the management of such conditions if bony fragments are too small to reduce. We present a novel method that addresses both soft tissue and bony deformity in this condition.Methods: A review of current techniques in the literature is provided as well as an in depth description of our technique using a representative case.Results: Follow-up results and photographs are presented in this article. Functional assessment is also provided in the article as part of the follow-up.Conclusions: This technique is applicable for cases where severe resorption of distal phalanx has occurred, leaving little or no purchase for bony fixation. Hence, the technique can not only be applied post traumatic acro-osteolysis, but also other conditions where secondary soft tissue lengthening occurs and fingertip instability is formed as a result.
Orogeny and the collapse of the Devonian Prairie Evaporite karst in Western Canada: impact on the overlying Cretaceous Athabasca Oil Sands
Authors: Broughton Paul L. 
Published: November 2017

Abstract

The Middle Devonian Prairie Evaporite Formation accumulated up to 200 m of halite-dominated beds across Western Canada in a salt basin extending from northern Alberta southeastwards into southern Saskatchewan and western North Dakota. A 1000 km long salt dissolution trend along the eastern basin margin resulted in the removal of 100–150 m of halite–anhydrite beds. A second salt dissolution trend removed up to 200 m of section across southern Saskatchewan. The removal of the halite-dominated beds and the collapse of the overlying strata responded to regional aquifer and vertical water flows driven by compaction up-structure to the NE towards the eastern margins of the foreland Alberta and intracratonic Williston constituent basins of the Western Canadian Sedimentary Basin. Flows resulting in dissolution trends in the deepening Alberta foreland basin were responses to Middle Jurassic–Early Cretaceous Columbian orogenic tectonism, in contrast with the multiple Paleozoic and Mesozoic dissolution stages across the southern Saskatchewan area of the northern Williston basin. Water flows along the Devonian Keg River strata migrated into the overlying Prairie Evaporite salt beds. The dissolution fronts advanced along multi-kilometre long NW- and NE-oriented sets of fault–fracture lineaments resulting from orogenic Precambrian block movements propagated into the overlying Devonian strata. The Athabasca Oil Sands accumulated above a 300 km long segment of the dissolution trend along the eastern margin of the evaporite basin. An unusually low 1:2 thickness ratio of removed salt beds to overlying strata resulted in significant structural controls on the deposition of the overlying Cretaceous McMurray Formation point bar complexes. Fluvial point bars up to 6 km long and tens of metres thick collinearly aligned along fairways tens of kilometres long, following the halite dissolution trends 200 m below. These sand reservoirs trapped Laramide oil migration into the area. Biodegradation followed, resulting in a trillion barrel resource. A final stage of salt removal occurred with the influx of subglacial meltwaters, rejuvenating 10 km
2
Cretaceous collapses across southern Saskatchewan.