bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intracorneal stromal hemorrhage in dogs and its associations with ocular and systemic disease: 39 cases
Authors: Violette Nathaniel P. , Ledbetter Eric C. 
Published: January 2016

AbstractObjectiveTo describe clinical features of dogs diagnosed with stromal intracorneal hemorrhage (ICH).Animals studiedRetrospective case series of 39 dogs (44 eyes) withICH.ProceduresMedical records of dogs evaluated by the Cornell University ophthalmology service were searched to identify animals with a clinical diagnosis ofICHbetween 2005 and 2014. Signalment and clinical details, including concurrent ocular disease, concurrent systemic disease, diagnostic tests performed, outcome of hemorrhage, presenting client complaint, and treatment, were recorded.ResultsIntracorneal hemorrhage was identified in 44 eyes of 39 dogs. The mean (±standard deviation) age of dogs was 11.5 years (±2.8 years). The Bichon Frise breed and older dogs were statistically over‐represented relative to the entire ophthalmology service canine referral population during the same time period. Concurrent ocular disease was present in 40 eyes (91%) and included keratoconjunctivitis sicca, cataracts, and corneal ulcers. Twenty‐three dogs (59%) suffered from concurrent systemic disease, most frequently diabetes mellitus, hyperadrenocorticism, hypothyroidism, and systemic hypertension. Less commonly, life‐threatening systemic conditions were identified in dogs withICHincluding immune‐mediated hemolytic anemia, immune‐mediated thrombocytopenia, metastatic neoplasia, and sepsis. Intracorneal hemorrhage was found in all corneal locations, and corneal vascularization was present in each affected eye.ConclusionsIntracorneal hemorrhage is an uncommon condition in dogs that occurs in association with corneal vascularization. The risk ofICHmay be increased due to certain ocular and systemic diseases. Although uncommon,ICHmay also be an ocular manifestation of severe immune‐mediated, infectious, and neoplastic systemic diseases in dogs.
Outcomes of an Oral Care Protocol in Postmechanically Ventilated Patients
Authors: Chipps Esther M. , Carr Michele , Kearney Rachel , MacDermott Jennifer , Von Visger Tania , Calvitti Kristin , Vermillion Brenda , Weber Michele L. , Newton Cheryl , St. Clair Jamie , Harper Dorina , Yamokoski Todd , Belcher Marcia , Ali Naeem , Hoet Armando E. , Van Balen Joany , Holloman Christopher , Landers Timothy 
Published: January 2016

ABSTRACTBackgroundOral care is standard practice to prevent hospital‐associated infections while patients are intubated and in the intensive care unit. Following extubation and transfer, infections remain an important risk for patients, but less attention is paid to oral care. Few studies have assessed the impact of oral care in recently extubated acutely ill patients.AimsTo develop an evidence‐based oral care protocol for hospitalized patients and determine the impact of this protocol on health outcomes in recently extubated patients.MethodsIn this randomized controlled trial, subjects were randomized to usual care or an intervention protocol that included tooth brushing, tongue scraping, flossing, mouth rinsing, and lip care. Major outcome measures were the revised THROAT (R‐THROAT; oral cavity assessment) and overall prevalence of methicillin‐sensitive Staphylococcus aureus and methicillin‐resistant S. aureus on oral cultures.ResultsSeventy‐four subjects were randomized. As measured by the R‐THROAT, oral cavity health improved over time in both groups, but the intervention group demonstrated significantly more improvement than the control group (R‐THROAT score improved by 1.97 intervention vs. 0.87 control; p = .04). Two categories, tongue and mouth comfort, demonstrated the most significant improvement. There was no difference in MSSA/MRSA colonization between the groups at the conclusion of the study. Overall, subjects in the intervention group were more satisfied with their protocol than subjects in the usual care group.Linking Evidence to ActionThis study offers an important evaluation of an oral care protocol after extubation. Results demonstrated improvement in the oral cavity assessment with the designed oral care protocol. Patients expressed a preference for the intervention protocol, which included a battery‐operated toothbrush, higher‐quality toothpaste and mouth rinse, tongue scraper, floss, and lip balm. The implementation of an oral care protocol specifically addressing patients in the immediate postintubation is essential.
A Systematic Review of Journal Clubs for Nurses
Authors: Häggman‐Laitila Arja , Mattila Lea‐Riitta , Melender Hanna‐Leena 
Published: January 2016

ABSTRACTBackgroundTwo previous systematic reviews describe studies on journal clubs from 1995 to 2007.AimsTo gather, assess, and synthesize the current empirical evidence on implementation of journal clubs, influencing factors, and outcomes of journal clubs in promoting evidence‐based nursing.Design: A systematic review based on the procedure of the Centre for Reviews and Dissemination.Data Sources and MethodsCochrane, CINAHL, and PubMed Medline databases were sought from 2008 to 2015. The final data consisted of 10 studies. Articles’ references were searched manually. The quality appraisal was made according to study design. Data were analyzed by qualitative content analysis and narrative synthesis.ResultsThe analyses produced four main categories with 14 subcategories that described the journal clubs: organization, conduct of meetings, influencing factors, and intervention outcomes. Journal clubs had been carried out in a fairly uniform manner in different nursing communities. There remains a lack of evidence on journal clubs’ impact on evidence‐based nursing (EBN) implementation, which challenges the development of journal clubs’ content and methods.Linking Evidence to ActionBecause journal clubs have achieved a uniform and easy‐to‐follow manner that is suitable for different nursing contexts and provide multiple positive outcomes, they are recommended for EBN. In work communities, journal clubs should be combined with other well‐known factors that promote EBN implementation. The assessment of the outcomes of journal clubs should cover all learning categories of EBN with a focus on medium‐ to long‐term effectiveness. The evaluation of the effectiveness of journal clubs on patient care is of great importance for future studies.
Draft Genome Sequence of an
Enterobacter
Species Associated with Illnesses and Powdered Infant Formula
Authors: Jackson Emily E. , Ogrodzki Pauline , Pascoe Ben , Sheppard Samuel K. , Forsythe Stephen J. 
Published: January 2016

ABSTRACT

This is the first report of the draft genome sequence of an
Enterobacter
species that may have been transmitted from powdered infant formula (PIF) to infants, resulting in illness.
Enterobacter
spp. are currently permitted in PIF, but the transmission of this strain indicates that the microbiological criteria for PIF may need revision.
Draft Genome Sequence of Alternaria alternata ATCC 34957
Authors: Nguyen Hai D. T. , Lewis Christopher T. , Lévesque C. André , Gräfenhan Tom 
Published: January 2016

ABSTRACT

We report the draft genome sequence of
Alternaria alternata
ATCC 34957. This strain was previously reported to produce alternariol and alternariol monomethyl ether on weathered grain sorghum. The genome was sequenced with PacBio technology and assembled into 27 scaffolds with a total genome size of 33.5 Mb.
Systematic review of the toxicity of short-course oral corticosteroids in children
Authors: Aljebab Fahad , Choonara Imti , Conroy Sharon 
Published: January 2016

BackgroundShort-course oral corticosteroids are commonly used in children but are known to be associated with adverse drug reactions (ADRs). This review aimed to identify the most common and serious ADRs and to determine their relative risk levels.MethodsA literature search of EMBASE, MEDLINE, International Pharmaceutical Abstracts, CINAHL, Cochrane Library and PubMed was performed with no language restrictions to identify studies in which oral corticosteroids were administered to patients aged 28 days to 18 years of age for up to and including 14 days of treatment. Each database was searched from their earliest dates to December 2013. All studies providing clear information on ADRs were included.ResultsThirty-eight studies including 22 randomised controlled trials (RCTs) met the inclusion criteria. The studies involved a total of 3200 children in whom 850 ADRs were reported. The three most frequent ADRs were vomiting, behavioural changes and sleep disturbance, with respective incidence rates of 5.4%, 4.7% and 4.3% of patients assessed for these ADRs. Infection was one of the most serious ADRs; one child died after contracting varicella zoster. When measured, 144 of 369 patients showed increased blood pressure; 21 of 75 patients showed weight gain; and biochemical hypothalamic–pituitary–adrenal axis suppression was detected in 43 of 53 patients.ConclusionsVomiting, behavioural changes and sleep disturbance were the most frequent ADRs seen when short-course oral corticosteroids were given to children. Increased susceptibility to infection was the most serious ADR.Trial registration numberCRD42014008774. By PROSPERO International prospective register of systematic reviews.
Outcomes After Kidney injury in Surgery (OAKS): protocol for a multicentre, observational cohort study of acute kidney injury following major gastrointestinal and liver surgery
Authors:   STARSurg Collaborative
Published: January 2016

IntroductionAcute kidney injury (AKI) is associated with increased morbidity and mortality following cardiac surgery. Data focusing on the patterns of AKI following major gastrointestinal surgery could inform quality improvement projects and clinical trials, but there is a lack of reliable evidence. This multicentre study aims to determine the incidence and impact of AKI following major gastrointestinal and liver surgery.Methods and analysisThis prospective, collaborative, multicentre cohort study will include consecutive adults undergoing gastrointestinal resection, liver resection or reversal of ileostomy or colostomy. Open and laparoscopic procedures in elective and emergency patients will be included in the study. The primary end point will be the incidence of AKI within 7 days of surgery, identified using an adaptation of the National Algorithm for Detecting Acute Kidney Injury, which is based on the Kidney Disease Improving Global Outcomes (KDIGO) AKI guidelines. Secondary outcomes will include persistent renal dysfunction at discharge and 1 year postoperatively. The 30-day adverse event rate will be measured using the Clavien-Dindo scale. Data on factors that may predispose to the development of AKI will be collected to identify variables associated with AKI. Based on our previous collaborative studies, a minimum of 114 centres are expected to be recruited, contributing over 6500 patients in total.Ethics and disseminationThis study will be registered as clinical audit at each participating hospital. The protocol will be disseminated through local and national medical student networks in the UK and Ireland.
Reducing calls missed by the hospital telephone exchange from 26% to less than 10%
Authors: Bhartia Saru , Bahlvi Zorba , Sharma Irina 
Published: January 2016

AbstractA hospital’s telephone exchange is the first point of contact for patients and their attendants to take appointments, to collect healthcare related information and to connect to the hospital in case of emergencies. At Sitaram Bhartia Institute of Science and Research the doctors, patients, and attendants often complained about the inefficiency of the hospital exchange. In February 2012, a doctor raised her concern of calls not being picked up at the exchange with the senior management and a QI project was initiated to tackle the problem.Baseline data showed that about 26% of incoming calls to the hospital during 8am to 8pm were not being picked up. On the basis of the baseline data, call audits, staff interviews, and observations the project team identified the defects. These defects were categorized under four headings - manpower, equipment, processes, and environment. The team proposed several change ideas. Some of these change ideas were implemented immediately. Three proposed change ideas were tested through individual PDSA cycles. The percentage of missed calls dropped from 26% to 18.1% after the first cycle and then to 9.6% and 6.5% after the subsequent cycles which involved testing of two other additional change ideas. These changes were implemented and a benchmark of no more than 10% calls to be missed was set. For nearly three years we have held the gains and have met the benchmark of missing not more than 10% calls coming to the hospital exchange between 8am to 8pm. The contributing factors to the success have been the involvement of frontline workers, an expert and engaged head of department, and senior leadership support.
A quality improvement project to tackle under-reporting of hazards by doctors by using an anonymous telephone hotline
Authors: Johnson Sarah 
Published: January 2016

AbstractAn anonymous hazard reporting hotline was established for doctors to use on two general medical wards at Weston General Hospital (WGH) in North Somerset in England during an eight day period in July/August 2014. Doctors were encouraged to report hazards and near misses or just start a conversation about a concern. The existing computer based significant event system remained alongside the hotline and was to be used where actual harm had come to a patient.A team of consultants and quality improvement administrators monitored the hotline on a daily basis, categorized the level of risk being reported and ensured, where possible, that action was taken to address the doctors' concerns. The hotline increased reporting rates from two per month to 25 in eight days. The system identified 13 amber (medium risk) and five red (high risk) hazards which would otherwise not have been known about. This author believes these five high risk reports alone make the case for a new, quicker, easier, and anonymous reporting system for doctors at WGH urgent and irrefutable.
Improving the quality of operative notes by implementing a new electronic template for upper limb surgery at the Royal Derby Hospital.
Authors: Theivendran Kanthan , Hassan Sami , I Clark David 
Published: January 2016

AbstractThe RCS has published clear and succinct guidelines dictating the necessity for the documentation of legible and timely surgical operative notes and exactly what should be included.A baseline study within the upper limb unit at our trust showed a 71.1% adherence with the RCS guidelines with an average delay of typing of notes after dictation was 11.6 days. This quality improvement project designed and developed a bespoke electronic surgical notes template built within an existing database driven software within the Trust. After implementation of the templates we found no delays in full operative notes being typed and a 100% adherence with the RCS guidelines. This project significantly improved the quality and timely production of electronic surgical notes within a sustainable electronic software solution.
Availability of ambulance patient care reports in the emergency department
Authors: Shelton Dominick , Sinclair Paul 
Published: January 2016

AbstractClinical handovers of patient care among healthcare professionals is vulnerable to the loss of important clinical information. A verbal report is typically provided by paramedics and documented by emergency department (ED) triage nurses. Paramedics subsequently complete a patient care report which is submitted electronically. This emergency medical system (EMS) patient care report often contains details of paramedic assessment and management that is not all captured in the nursing triage note. EMS patient care reports are often unavailable for review by emergency physicians and nurses.Two processes occur in the distribution of EMS patient care reports. The first is an external process to the ED that is influenced by the prehospital emergency medical system and results in the report being faxed to the ED. The second process is internal to the ED that requires clerical staff to distribute the fax report to accompany patient charts.A baseline audit measured the percentage of EMS patient care reports that were available to emergency physicians at the time of initial patient assessments and showed a wide variation in the availability of EMS reports. Also measured were the time intervals from patient transfer from EMS to ED stretcher until the EMS report was received by fax (external process measure) and the time from receiving the EMS fax report until distribution to patient chart (internal process measure). These baseline measures showed a wide variation in the time it takes to receive the EMS reports by fax and to distribute reports.Improvement strategies consisted of:1. Educating ED clerical staff about the importance of EMS reports2. Implementing a new process to minimize ED clerical staff handling of EMS reports for nonactive ED patients3. Elimination of the automatic retrieval of old hospital charts and their distribution for ED patients4. Introduction of an electronic dashboard for patients arriving by ambulance to facilitate more efficient distribution of EMS reports.Implementation of change strategies did not result in a significant improvement in the percentage of EMS reports available to emergency physicians at the time of initial patient assessment. However, tracking both external and internal processes that influence EMS report availability showed the internal process time from fax report receipt to distribution significantly improved. This improvement reflected the change strategies that were all directed at improving the internal process.EMS patient care reports are more efficiently processed and distributed in the ED due to change strategies implemented that targeted the ED's internal process of EMS report distribution. The external process responsible for transmitting EMS reports to the ED is the limiting factor that prevents consistent timely access of EMS reports by emergency physicians and will require dedicated improvement strategies.
Combined use of Onyx and coils for transarterial balloon-assisted embolization of traumatic carotid-cavernous fistulas: a report of 16 cases with 17 fistulas
Authors: Zhang Xiang , Guo Wei , Shen Rui , Sun JiPing , Yin Jia , Chen XianZhen , Gao Liang , Chen ZuoQuan , Zhang QuanBin 
Published: January 2016

ObjectiveThe combination of coils and Onyx for the treatment of carotid-cavernous fistulas (CCFs) is an interesting new development. The purpose of the current study is to evaluate our preliminary experience with the combined use of coils and Onyx for the treatment of traumatic CCFs.MethodsBetween April 2009 and July 2014, 16 patients with 17 traumatic CCFs were embolized with the so-called ‘armored concrete’ treatment modality using coils, Onyx-18, and a non-detachable balloon via the transarterial approach. The outcomes were assessed both clinically and radiologically. Digital subtraction angiography (DSA) follow-up was performed 3 or 6 months after endovascular treatment while clinical follow-up was continued until December 2014.ResultsObliteration of the CCFs was obtained with patency of the parent artery in all 16 cases. Follow-up DSA demonstrated stable occlusion of all the fistulas. Symptoms related to the CCFs were either resolved immediately or gradually over 2 months. No worsening of the cranial neuropathies was observed during the follow-up period which averaged 32.6 months.ConclusionsThe ‘armored concrete’ treatment modality using coils, Onyx, and a non-detachable balloon promises to be a safe, economical, and effective alternative in the management of traumatic CCFs.
Planckian corrections to the Friedmann flat equations from thermodynamics at the apparent horizon
Authors: Viaggiu Stefano 
Published: January 2016

In this paper, we use our recently generalized black hole entropy formula to propose a quantum version of the Friedmann equations. In particular, starting from the differential version of the first law of thermodynamics, we are able to find Planckian (noncommutative) corrections to the Friedmann flat equations. The so modified equations are formally similar to the ones present in Gauss–Bonnet gravity, but in the ordinary 3+1 dimensions. As a consequence of these corrections, by considering negative fluctuations in the internal energy that are allowed by quantum field theory, our equations imply a maximum value both for the energy density [Formula: see text] and for the Hubble flow H, i.e. the big bang is ruled out. Conversely, by considering positive quantum fluctuations, we found no maximum for [Formula: see text] and H. Nevertheless, by starting with an early time energy density [Formula: see text], we obtain a value for the scale factor [Formula: see text], implying a finite Planckian universe at t = 0, i.e. the point-like big bang singularity is substituted by a universe of Planckian size at t = 0. Finally, we found possible higher order Planckian terms to our equations together with the related corrections of our generalized Bekenstein–Hawking entropy.
Connections between chiral Lagrangians and QCD sum-rules
Authors: Fariborz Amir H. , Pokraka A. , Steele T. G. 
Published: January 2016

In this paper, it is shown how a chiral Lagrangian framework can be used to derive relationships connecting quark-level QCD correlation functions to mesonic-level two-point functions. Crucial ingredients of this connection are scale factor matrices relating each distinct quark-level substructure (e.g. quark–antiquark, four-quark) to its mesonic counterpart. The scale factors and mixing angles are combined into a projection matrix to obtain the physical (hadronic) projection of the QCD correlation function matrix. Such relationships provide a powerful bridge between chiral Lagrangians and QCD sum-rules that are particularly effective in studies of the substructure of light scalar mesons with multiple complicated resonance shapes and substantial underlying mixings. The validity of these connections is demonstrated for the example of the isotriplet [Formula: see text] system, resulting in an unambiguous determination of the scale factors from the combined inputs of QCD sum-rules and chiral Lagrangians. These scale factors lead to a remarkable agreement between the quark condensates in QCD and the mesonic vacuum expectation values that induce spontaneous chiral symmetry breaking in chiral Lagrangians. This concrete example shows a clear sensitivity to the underlying [Formula: see text]-system mixing angle, illustrating the value of this methodology in extensions to more complicated mesonic systems.