bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dual loyalties: Everyday ethical problems of registered nurses and physicians in combat zones
Authors: Lundberg Kristina , Kjellström Sofia , Sandman Lars 
Published: August 2017

Background: When healthcare personnel take part in military operations in combat zones, they experience ethical problems related to dual loyalties, that is, when they find themselves torn between expectations of doing caring and military tasks, respectively. Aim: This article aims to describe how Swedish healthcare personnel reason concerning everyday ethical problems related to dual loyalties between care and military tasks when undertaking healthcare in combat zones. Design: Abductive qualitative design. Participants and research context: Individual interviews with 15 registered nurses and physicians assigned for a military operation in Mali. Ethical considerations: The participants signed up voluntarily, and requirements for informed consent and confidentiality were met. The research was approved by the Regional Ethics Review Board in Gothenburg (D no. 816-14; 24 November 2014). Findings: Three main categories emerged: reasons for not undertaking combat duties, reasons for undertaking combat duties and restricted loyalty to military duties, and 14 subcategories. Reasons for not undertaking combat duties were that it was not in their role, not according to ethical codes or humanitarian law or a breach towards patients. Reasons for undertaking combat duties were that humanitarian law does not apply or has to be treated pragmatically or that it is a case of force protection. Shortage of resources and competence were reasons for both doing and not doing military tasks. Under some circumstances, they could imagine undertaking military tasks: when under threat, if unseen or if not needed for healthcare duties. Discussion/conclusion: These discrepant views suggest a lack of a common view on what is ethically acceptable or not, and therefore we suggest further normative discussion on how these everyday ethical problems should be interpreted in the light of humanitarian law and ethical codes of healthcare personnel and following this, further training in ethical reflection before going on military operations.
Use and Impacts of Campbell Systematic Reviews on Policy, Practice, and Research
Authors: Maynard Brandy R. , Dell Nathaniel A. 
Published: August 2017

Aim: This study examines use and impacts of systematic reviews produced by the Campbell Collaboration’s Social Welfare Coordinating Group (SWCG) on practice, policy, and research. Methods: A mixed-method research design was used to examine impacts of 52 systematic reviews published by the SWCG. We conducted author surveys and retrieved multiple sources of bibliometric data. Results: Campbell SWCG reviews were downloaded 136,356 times and cited 3,184 times. Most reviews did not receive significant attention in alternative outlets (i.e., social media). Review authors provided evidence that reviews were used directly to make changes in policy or practice or inform future research. Discussion: Assessing the use and impacts of research is challenging. While downloads and citations provide evidence that these reviews receive attention, it was more difficult to determine the extent to which the reviews were used to impact practice or policy. More work is needed to better track and assess impacts of Campbell reviews.
Hemodynamic effects of low-dose atipamezole in isoflurane-anesthetized cats receiving an infusion of dexmedetomidine
Authors: Martin-Flores Manuel , Sakai Daniel M , Honkavaara Juhana , Campoy Luis 
Published: August 2017

Objectives The objective of this study was to evaluate the cardiovascular effects of low-dose atipamezole administered intravenously to isoflurane-anesthetized cats receiving dexmedetomidine. We hypothesized that atipamezole would increase heart rate (HR) and reduce arterial blood pressure in isoflurane-anesthetized cats receiving dexmedetomidine. Methods Six healthy adult domestic shorthair cats were anesthetized with isoflurane and instrumented for direct arterial pressures and cardiac output (CO) measurements. The cats received a target-controlled infusion of dexmedetomidine (target plasma concentration 10 ng/ml) for 30 mins before administration of atipamezole. Two sequential doses of atipamezole (15 and 30 μg/kg IV) were administered at least 20 mins apart, during dexmedetomidine administration. The effects of dexmedetomidine and each dose of atipamezole on HR, mean arterial blood pressure (MAP), CO and systemic vascular resistance (SVR) were documented. Results Dexmedetomidine reduced the HR by 22%, increased MAP by 78% (both P ⩽0.01), decreased CO by 48% and increased SVR by 58% (both P ⩽0.0003). Administration of atipamezole 15 and 30 μg/kg intravenously increased HR by 8% ( P = 0.006) and 4% ( P = 0.1), respectively. MAP decreased by 39% and 47%, respectively (both P ⩽0.004). Atipamezole 30 μg/kg returned CO and SVR to baseline values. Conclusions and relevance Low doses of atipamezole (15 and 30 μg/kg) administered intravenously to anesthetized cats decreased arterial blood pressure with only marginal increases in HR. Atipamezole 30 μg/kg restored CO and SVR to baseline values before dexmedetomidine administration.
Endovascular Management for Symptomatic Chronic Mesenteric Ischemia: A Single-Center Experience
Authors: Guo Baolei , Guo Daqiao , Xu Xin , Chen Bin , Jiang Junhao , Yang Jue , Shi Zhenyu , Fu Weiguo 
Published: August 2017

Background: Chronic mesenteric ischemia (CMI) is an uncommon condition encountered by clinicians. Presentation may vary from asymptomatic to classical intestinal ischemia, although a clear pathophysiology has yet to be elucidated. Here, we have presented our institution’s experience in the management of symptomatic CMI. Methods: From February 2007 to February 2016, a retrospective study was performed of all consecutive patients with symptomatic CMI managed by endovascular treatment (ET). We reviewed these patients’ demographics, comorbidities, clinical presentations, and treatment modalities. Perioperative and midterm outcomes included technical success, clinical symptom relief, complications, symptomatic recurrence, mortality, restenosis, and reintervention. Results: Thirty-five mesenteric arteries (74.3% stenotic/25.7% occluded) identified in 32 patients (12 females, 20 males) were treated with endovascular procedures. There were no 30-day deaths; the perioperative complication rate was 12.5%. Overall, the median postprocedural time to symptom relief was 7.6 days (range: 1-30 days). Twenty-two (68.8%) had complete remission of symptom, whereas 7 (21.9%) had partial improvement in symptom after ET. After a mean follow-up of 35.4 (25.9) months, 5 (15.6%) patients developed recurrent symptoms, with 4 requiring reinterventions. The primary patency was 93.7%, 82.6%, and 73.1% at 12, 24, and 36 months, respectively, and the freedom from symptomatic recurrence was 90.6%, 84.0%, 84.0%, and 84.0% at 6, 12, 24, and 36 months, respectively. Conclusions: Endovascular treatment for patients with CMI had a high technical success rate and satisfactory clinical outcomes. Symptomatic recurrence was not frequent but found mainly within 12 months following the initial procedure.
Quantitative seismic characterization of CO2 at the Sleipner storage site, North Sea
Authors: Dupuy Bastien , Romdhane Anouar , Eliasson Peder , Querendez Etor , Yan Hong , Torres Verónica A. , Ghaderi Amir 
Published: August 2017

Reliable quantification of carbon dioxide ([Formula: see text]) properties and saturation is crucial in the monitoring of [Formula: see text] underground storage projects. We have focused on quantitative seismic characterization of [Formula: see text] at the Sleipner storage pilot site. We evaluate a methodology combining high-resolution seismic waveform tomography, with uncertainty quantification and rock physics inversion. We use full-waveform inversion (FWI) to provide high-resolution estimates of P-wave velocity [Formula: see text] and perform an evaluation of the reliability of the derived model based on posterior covariance matrix analysis. To get realistic estimates of [Formula: see text] saturation, we implement advanced rock physics models taking into account effective fluid phase theory and patchy saturation. We determine through sensitivity tests that the estimation of [Formula: see text] saturation is possible even when using only the P-wave velocity as input. After a characterization of rock frame properties based on log data prior to the [Formula: see text] injection at Sleipner, we apply our two-step methodology. The FWI result provides clear indications of the injected [Formula: see text] plume being observed as low-velocity zones corresponding to thin [Formula: see text] filled layers. Several tests, varying the rock physics model and [Formula: see text] properties, are then performed to estimate [Formula: see text] saturation. The results suggest saturations reaching 30%–35% in the thin sand layers and up to 75% when patchy mixing is considered. We have carried out a joint estimation of saturation with distribution type and, even if the inversion is not well-constrained due to limited input data, we conclude that the [Formula: see text] has an intermediate pattern between uniform and patchy mixing, which leads to saturation levels of approximately [Formula: see text]. It is worth noting that the 2D section used in this work is located 533 m east of the injection point. We also conclude that the joint estimation of [Formula: see text] properties with saturation is not crucial and consequently that knowing the pressure and temperature state of the reservoir does not prevent reliable estimation of [Formula: see text] saturation.
Arsenic Trioxide Consolidation Allows Anthracycline Dose Reduction for Pediatric Patients With Acute Promyelocytic Leukemia: Report From the Children's Oncology Group Phase III Historically Controlled Trial AAML0631
Authors: Kutny Matthew A. , Alonzo Todd A. , Gerbing Robert B. , Wang Yi-Cheng , Raimondi Susana C. , Hirsch Betsy A. , Fu Cecilia H. , Meshinchi Soheil , Gamis Alan S. , Feusner James H. , Gregory John J. 
Published: August 2017

PurposeThe Children’s Oncology Group AAML0631 trial for newly diagnosed pediatric acute promyelocytic leukemia (APL) was a phase III historically controlled trial to determine the survival of patients receiving arsenic trioxide (ATO) consolidation and reduced doses of anthracyclines.Patients and MethodsPatients age 2 to 21 years with de novo APL confirmed by PML-RARα polymerase chain reaction were stratified as standard risk (SR) or high risk (HR) on the basis of diagnostic WBC count. All patients received all-trans retinoic acid (ATRA) during induction, each consolidation course, and maintenance. All patients received two cycles of ATO therapy during consolidation 1, an additional two (SR) or three (HR) consolidation courses that included high-dose cytarabine and anthracycline, and maintenance therapy comprising ATRA, oral methotrexate, and mercaptopurine.ResultsOne hundred one patients (66 SR and 35 HR) were evaluable for outcome. The 3-year overall survival was 94%, and event-free survival (EFS) was 91%. For SR and HR patients with APL, the overall survival was 98% versus 86% ( P = .003), and EFS was 95% versus 83% ( P = .03), respectively. The EFS for SR patients in AAML0631 was noninferior to that of patients in the AIDA 0493 historical control, which used a significantly higher anthracycline dose and did not include ATO consolidation. Relapse risk for patients in AAML0631 from end consolidation 1 (after ATO treatment) was only 4% at 3 years and did not differ significantly between SR and HR patients.ConclusionATO consolidation cycles were well tolerated in pediatric patients with APL and allowed significant reduction in cumulative anthracycline doses while maintaining excellent survival and a low relapse risk for both SR and HR patients with APL.
Hydrogen Sulfide and Sulfate Prebiotic Stimulates the Secretion of GLP-1 and Improves Glycemia in Male Mice
Authors: Pichette Jennifer , Fynn-Sackey Nancy , Gagnon Jeffrey 
Published: August 2017

Abstract
Recently, the gastrointestinal microbiome, and its metabolites, has emerged as a potential regulator of host metabolism. However, to date little is known on the precise mechanisms of how this regulation occurs. Hydrogen sulfide (H2S) is abundantly produced in the colon by sulfate-reducing bacteria (SRB). H2S is a bioactive gas that plays regulatory roles in many systems, including metabolic hormone regulation. This gas metabolite is produced in close proximity to the glucagonlike peptide-1 (GLP-1)–secreting cells in the gut epithelium. GLP-1 is a peptide hormone that plays pivotal roles in both glucose homeostasis and appetite regulation. We hypothesized that H2S can directly regulate GLP-1 secretion. We demonstrated that H2S donors (NaHS and GYY4137) directly stimulate GLP-1 secretion in murine L-cells (GLUTag) and that this occurs through p38 mitogen-activated protein kinase without affecting cell viability. We then increased SRB in mice by supplementing the diet with a prebiotic chondroitin sulfate for 4 weeks. Mice treated with chondroitin sulfate had elevated Desulfovibrio piger levels in the feces and increased colonic and fecal H2S concentration. These animals also had enhanced GLP-1 and insulin secretion, improved oral glucose tolerance, and reduced food consumption. These results indicate that H2S plays a stimulatory role in GLP-1 secretion and that sulfate prebiotics can enhance GLP-1 release and its downstream metabolic actions.
Evaluating the results of mentorship training for community midwives in Sindh, Pakistan
Authors: Sayani Amber Hussain , Jan Rafat , Lennox Susan , Mohammad Yasmin Jan , Awan Safia 
Published: August 2017

Aims The aim of the study was to measure the impact of the mentorship training on the community midwives' knowledge, perceptions, and willingness to mentor. Methods A quasi-experimental pre- and post-design was used. A total of 50 community midwives were educated about mentorship, and data were collected through pre- and post-test questionnaires, and a 3-month follow-up. Findings There was a significant improvement in the knowledge of community midwives about mentorship (P=<0.001) and their willingness to mentor (P=<0.001). Their perceptions about the cost versus benefit of mentoring had improved (P=<0.001). During the follow-up, the majority of participants reported that they had begun working as a mentor. Conclusions Mentorship training was found to be effective in improving the knowledge, perceptions, and willingness of community midwives to mentor. A larger study in a different area of Pakistan is also recommended using a similar scheme.
Durham and Cleveland police firearms unit tactical team medics: lessons from the first six years
Authors: Carr Gavin , Doyle Pete , Wheatley Sean , Kyle Tony , Mellor Adrian 
Published: August 2017

Background. Since 2007 Durham and Cleveland Firearms Police have trained a small number of firearms police officers to an enhanced level of first aid qualification. This article reviews the history of this programme, the patient report forms submitted during the period 2013-2016 and analyses the types of incidents attended. Methods: 66 PRFS were interrogated and analysed from a four-year period between Jan 2013 and Dec 2016. There was a marked increase in PRFs submitted during that time. Over half the casualties were male, resulting from assault (15) 21%), road traffic collisions (14)19%) and deliberate self-harm (14)19%). The most frequent medical interventions were wound dressing and direct pressure, airway manoeuvres and Oxygen therapy. On-scene times with patients prior to handover to NHS staff ranged from 0->60 mins. 0-20 minutes (22), 20-40 minutes (15), 40-60 minutes (10) and >60 minutes (1). Discussion: This data shows that the TTMs provide a useful medical response often arriving before other medical provision is on scene. Despite the primary role being to respond to firearms trauma, officers have dealt with a range of medical scenarios and provided a range of interventions.
Which factors influence the rate of failure following metal-on-metal hip arthroplasty revision surgery performed for adverse reactions to metal debris?
Authors: Matharu G. S. , Judge A. , Pandit H. G. , Murray D. W. 
Published: August 2017

Aims To determine the outcomes following revision surgery of metal-on-metal hip arthroplasties (MoMHA) performed for adverse reactions to metal debris (ARMD), and to identify factors predictive of re-revision. Patients and Methods We performed a retrospective observational study using National Joint Registry (NJR) data on 2535 MoMHAs undergoing revision surgery for ARMD between 2008 and 2014. The outcomes studied following revision were intra-operative complications, mortality and re-revision surgery. Predictors of re-revision were identified using competing-risk regression modelling. Results Intra-operative complications occurred in 40 revisions (1.6%). The cumulative five-year patient survival rate was 95.9% (95% confidence intervals (CI) 92.3 to 97.8). Re-revision surgery was performed in 192 hips (7.6%). The cumulative five-year implant survival rate was 89.5% (95% CI 87.3 to 91.3). Predictors of re-revision were high body mass index at revision (subhazard ratio (SHR) 1.06 per kg/m2 increase, 95% CI 1.02 to 1.09), modular component only revisions (head and liner with or without taper adapter; SHR 2.01, 95% CI 1.19 to 3.38), ceramic-on-ceramic revision bearings (SHR 1.86, 95% CI 1.23 to 2.80), and acetabular bone grafting (SHR 2.10, 95% CI 1.43 to 3.07). These four factors remained predictive of re-revision when the missing data were imputed. Conclusion The short-term risk of re-revision following MoMHA revision surgery performed for ARMD was comparable with that reported in the NJR following all-cause non-MoMHA revision surgery. However, the factors predictive of re-revision included those which could be modified by the surgeon, suggesting that rates of failure following ARMD revision may be reduced further. Cite this article: Bone Joint J 2017;99-B:1020–7.
The correlation between Salter’s criteria for avascular necrosis of the femoral head and Kalamchi’s prognostic classification following the treatment of developmental dysplasia of the hip
Authors: Tsukagoshi Y. , Kamegaya M. , Kamada H. , Saisu T. , Morita M. , Kakizaki J. , Tomaru Y. , Yamazaki M. 
Published: August 2017

Aims The aim of this study was to evaluate the correlation between Salter’s criteria and Kalamchi’s classification of avascular necrosis in patients treated for developmental dysphasia of the hip (DDH). Patients and Methods The study involved a retrospective analysis of 123 patients (123 hips) with DDH treated by operative and non-operative reduction before the age of two years, with a minimum follow-up of ten years. Salter’s criteria (S1 to S4) were determined from radiographs obtained at one to two years post-reduction, whilst the Kalamchi grade was determined from radiographs obtained at ten or more years of age. Early post-reduction radiographs were also used to evaluate the centre-head distance discrepancy (CHDD) and the occurrence of a dome-shaped deformity of the proximal femoral metaphysis (D-shaped metaphysis). The prognosis was described as good (Kalamchi grade K0 or KI), fair (Kalamchi grade KII) or poor (Kalamchi grade KIII or KIV) for analysis and correlation with the early Salter criteria, CHDD and D-shaped metaphysis. Results S1 and S2 criteria were predictive of a poor prognosis. The outcome following S3, S4 and S3 + S4 varied; 18 (40%) had a good prognosis, 17 (38%) a fair prognosis and ten (22%) a poor prognosis. A CHDD ≥ 10% and a D-shaped metaphysis were also predictive of a poor prognosis. Conclusion The Salter criteria were predictive of the Kalamchi grade of avascular necrosis in patients with DDH aged ten or more years after reduction of the hip. Cite this article: Bone Joint J 2017;99-B:1115–20.
The colonisation of the glenohumeral joint by Propionibacterium acnes is not associated with frozen shoulder but is more likely to occur after an injection into the joint
Authors: Booker S. J. , Boyd M. , Gallacher S. , Evans J. P. , Auckland C. , Kitson J. , Thomas W. , Smith C. D. 
Published: August 2017

Aims Our aim was to investigate the prevalence of Propionibacterium (P.) acnes in the subcutaneous fat and capsule of patients undergoing shoulder surgery for frozen shoulder or instability. Patients and Methods A total of 46 patients undergoing either an arthroscopic capsular release or stabilisation had biopsies taken from the subcutaneous fat and capsule of the shoulder at the time of surgery. These samples were sent for culture in enrichment, and also for Nucleic Acid Amplification testing. The prevalence of P. acnes and other microbes was recorded. Fisher's exact test of binary variables was used to calculate the association with significance set at p < 0.05. Assessment of influence of independent variables including a pre-operative glenohumeral injection, fat colonisation and gender, was undertaken using binary linear regression. Results A total of 25 patients (53%) had P. acnes in one or more tissue samples and 35 (74%) had other bacterial species. The same microbe was found in the subcutaneous fat and the capsule in 13 patients (28%). There was no statistically significant association between the surgical pathology and capsular colonisation with P. acnes (p = 0.18) or mixed identified bacterial species (p = 0.77). Male gender was significantly associated with an increased capsular colonisation of P. acnes (odds ratio (OR) 12.38, 95% confidence interval (CI) 1.43 to 106.77, p = 0.02). A pre-operative glenohumeral injection was significantly associated with capsular P. acnes colonisation (OR 5.63, 95% CI 1.07 to 29.61, p = 0.04. Positive fat colonisation with P. acnes was significantly associated with capsular P. acnes (OR 363, 95% CI 20.90 to 6304.19, p < 0.01). Regression models pseudo R2 found fat colonisation with P. acnes to explain 70% of the variance of the model. Patients who had a pre-operative glenohumeral injection who were found intra-operatively to have fat colonisation with P. acnes had a statistically significant association with colonisation of their capsule with P. acnes (OR 165, 95% CI 13.51 to 2015.24, p < 0.01). Conclusion These results show a statistically significant association between subcutaneous skin P. acnes culture and P. acnes capsular culture, especially when the patient has undergone a previous injection. The results refute the hypothesis that P. acnes causes frozen shoulder. Cite this article: Bone Joint J 2017;99-B:1067–72.