bluuebunny/crossref_metadata_2025_split huggingface dataset:
The size of the labor wards: is bigger better when it comes to patient safety?
Authors: Milland Maria , Christoffersen Jens K. , Hedegaard Morten 
Published: September 2013

AbstractObjectiveTo assess possible associations between the size of labor units and the frequency of approved obstetric claims.DesignA nationwide retrospective descriptive study.SettingDenmark.PopulationAll patients seeking financial compensation due to obstetric injuries occurring between 1995 and 2009.MethodsIn all, 1440 anonymized obstetrics claims were reviewed; 1326 were included in the study. Information regarding the annual number of deliveries for each place of injury was retrieved from the National Birth Registry.Main outcome measuresObstetric injuries approved by the Danish Patient Insurance Association categorized by labor unit size.ResultsThe overall approval rate for submitted claims was 39.7%. Large labor units (3000–3999 deliveries/year) were found to have a lower approval rate (34.2%), compared with very large (≥4000 deliveries/year, 38.6%), intermediate (1000–2999 deliveries/year, 41.7%), and small (<1000 deliveries/year, 50.0%) units, (p < 0.05). The majority of compensation claims were approved with reference to the “specialist rule,” assuming that if an experienced specialist had conducted the treatment differently the injury could have been avoided. Claims from small units showed a trend for being more often based on the specialist rule than seen in larger units (p < 0.05, test for trend).ConclusionThe results may reflect that large labor units are living up to the principle of best practice to a greater degree. Several factors can be linked to the size of the labor unit and a better availability of in‐house obstetricians as well as auxiliary specialists could be part of the explanation.
Synthetic Biology: A Utilitarian Perspective
Authors: Smith Kevin 
Published: September 2013

AbstractI examine the positive and negative features of synthetic biology (‘SynBio’) from a utilitarian ethical perspective. The potential beneficial outcomes from SynBio in the context of medicine are substantial; however it is not presently possible to predict precise outcomes due to the nascent state of the field. Potential negative outcomes from SynBio also exist, including iatrogenesis and bioterrorism; however it is not yet possible to quantify these risks. I argue that the application of a ‘precautionary’ approach to SynBio is ethically fraught, as is the notion that SynBio‐associated knowledge ought to be restricted. I conclude that utilitarians ought to support a broadly laissez‐faire stance in respect of SynBio.
Efficient Interpolation of Articulated Shapes Using Mixed Shape Spaces
Authors: Marras S. , Cashman T. J. , Hormann K. 
Published: September 2013

AbstractInterpolation between compatible triangle meshes that represent different poses of some object is a fundamental operation in geometry processing. A common approach is to consider the static input shapes as points in a suitable shape space and then use simple linear interpolation in this space to find an interpolated shape. In this paper, we present a new interpolation technique that is particularly tailored for meshes that represent articulated shapes. It is up to an order of magnitude faster than state‐of‐the‐art methods and gives very similar results. To achieve this, our approach introduces a novel shape space that takes advantage of the underlying structure of articulated shapes and distinguishes between rigid parts and non‐rigid joints. This allows us to use fast vertex interpolation on the rigid parts and resort to comparatively slow edge‐based interpolation only for the joints.
Focusing on outcomes and methods in removable prosthodontics trials: a systematic review
Authors: de Souza Raphael F. , Ahmadi Motahareh , Ribeiro Adriana B. , Emami Elham 
Published: September 2013

AbstractObjectivesThe aim of this study was to systematically examine the outcomes of interest of trials in removable prosthodontics and to assess their overall quality.Material and methodsElectronic databases were searched up to August 2011 and complemented by hand searching for published randomized controlled trials (RCTs) in the field of removable prosthodontics in the six major prosthodontic and implant journals. The primary outcome of RCTs was considered as the outcome of interest of this review, and only manuscripts in which the study's primary outcome was reported in the abstract were included. Outcomes were classified according to the Strength of Recommendation Taxonomy (SORT) classification. The quality of individual reports of RCTs was assessed following the Cochrane Handbook for Systematic Reviews of Interventions (Higgins & Green, www.cochrane-handbook.org).ResultsThe search retrieved 86 reports of RCTs. Among these publications, 43% reported a patient‐oriented primary outcome. Most of the publications did not present a clear description of sequence generation (54%) or allocation concealment (65%). Blinding of participants, clinicians, and outcomes assessors was not applicable or reported in most trials. Handling of withdrawals and losses was adequate in 52% of trials.ConclusionsAlthough published RCTs in removable prosthodontics have increased over time, efforts should be made to increase patient‐reported outcomes and the methodological quality of these reports. Such improvement will lead to a better body of evidence in the field, thus providing increased support for clinical decision‐making.
Design and Testing of Small Interfering RNAs (siRNAs) Targeted Against Equine TNF‐α and IL1‐β in Equine Synoviocyte Cultures – Preliminary Findings
Authors: Morgan R.E. , Hunt J.A. , Tew S.R. , Clegg P.D. , Innes J.F. 
Published: September 2013

AimsSynovial inflammation is characterised by increases in catabolic cytokines, notably tumour necrosis factor‐α (TNF‐α) and interleukin‐1β (IL‐1β); to understand their role in equine arthritis, model systems to evaluate small interfering RNAs (siRNAs) targeted against these cytokines are being developed. Specifically, we aim to investigate the change in TNF‐α and IL‐1β expression following transfection of equine synoviocytes with TNF‐α siRNA and IL‐1β siRNA. It is hypothesised that gene expression would decrease following treatment with siRNAs, and that off‐target effects would not be induced.MethodsSynovium from healthy metacarpophalangeal joints of 6 horses was digested using 0.2% trypsin and 0.2% collagenase type‐II. Synoviocytes were cultured in DMEM with 10% FCS, with and without 1 μg/ml LPS, and with and without one of 3 siRNAs at 20 nmol: generic scrambled control siRNA, TNF‐α siRNA or IL‐1β siRNA. Gene expression was analysed with RT‐qPCR for TNF‐α and IL‐1β; GAPDH was used for normalisation.ResultsThe patterns of TNF‐α gene expression in 2 experiments were similar; expression levels decreased (51%) relative to LPS stimulated controls when using TNF‐α siRNA. Efficiency of transfection with the IL‐1β siRNA was less reliable: expression levels of IL‐1β actually increased when using IL‐1β siRNA.ConclusionsThe pattern of TNF‐α gene expression supported our hypothesis but the degree of gene knockdown was disappointing. This may be due to a number of reasons; LPS concentration, siRNA transfection method, or siRNA sequence. The IL‐1β siRNA did not work in these experiments and indeed may be inducing ‘off‐target’ effects. The mixed culture of synoviocytes used was predominantly synovial fibroblasts. Further work will be carried out using peripheral blood mononuclear cells, and multiple siRNA sequences.Practical significanceTraumatic arthritis is common in Thoroughbred racehorses and is a significant cause of wastage in the industry.Ethical animal researchApproval was granted by the Liverpool University Ethics Committee. Sources of funding: Rhiannon Morgan is in receipt of a Veterinary Research Training Scholarship from the Horserace Betting Levy Board. Competing interests: None.
Risks of Synovial Sepsis Following Intrasynovial Medication in Ambulatory Practice, 2006–2011: 9456 Intrasynovial Injections
Authors: Smith L. , Palmer L. , Shepherd M. , Steven W.N. , Dallas R. , Baldwin G. , Sommerville G. , Hawthorne T. , Ramzan P. 
Published: September 2013

AimsTo determine the incidence of synovial sepsis following intra‐articular and intrathecal injections. Synovial sepsis is a serious potential complication of intrasynovial medication.MethodsAvailable case records for all horses receiving intrasynovial medications (ISMs) performed by 9 ambulatory clinicians were examined over 5 years (2006–2011). Intrasynovial medications were defined as therapeutic interventions, based on clinical history and orthopaedic examination; nontherapeutic injections for diagnostic analgesia were excluded. Routine protocol was not to clip injection sites; the skin was prepared using standard aseptic technique. Scrupulous aseptic injection technique was employed at all times. All horses were under the care of a single practice, dealing with mainly Thoroughbred racehorses. Records were cross‐referenced against synovial cytology submissions and hospital admissions for synovial sepsis. Development of 2 out of 4 clinicopathological signs of synovial sepsis (lameness, joint distension, synovial white blood cell count >10,000/l, synovial total protein >25 g/l) within 8 weeks of medication of the same synovial space was considered to represent a post medication complication (PMC). Failure of the PMC to resolve with conservative therapy was considered to represent post medication synovial sepsis (PMSS).ResultsDuring the study period 9456 ISMs were recorded, in 4332 sessions, in 1732 horses. Corticosteroids were included in 92.3% of ISMs, 94.8% included amikacin and 0.15% (14/9456) included polysulphated glycosaminoglycans (PSGAGs). Twelve horses developed PMC (0.0013% ISM), 4 horses developed PMSS (0.0004% ISM). All 4 horses returned to use following joint lavage. Administration of intrasynovial PSGAGs, was significantly associated with PMSS (P<0.0001 OR = 787 95% CI 145–20,337). Intrasynovial medications that included amikacin were less likely to develop PSSM (P = 0.005 OR = 0.0181 95% CI 0.0019–0.174); however if the PSGAGs group was excluded the difference became nonsignificant (P = 0.0981).Conclusions and practical significanceThe risk of iatrogenic sepsis following intrasynovial medication is extremely low. Intrasynovial medication with PSGAGs should be avoided without concomitant antimicrobials.AcknowledgementsA. Wilson and K. Batteate for case collation.Ethical animal researchNot required by this Congress: retrospective analysis of case records. Sources of funding: None. Competing interests: None.
In vivo Evaluation of Acoustoelastography in the Normal Equine Superficial Digital Flexor Tendon
Authors: Brounts S.H. , Ellison M.E. , Duenwald‐Kuehl S. , Forrest L. , Vanderby Jr R. 
Published: September 2013

IntroductionSuperficial digital flexor tendon (SDFT) injury is common in athletic horses. Recovery requires balancing rest and controlled exercise, resulting in high risk of re‐injury. It is difficult to determine the level of work the damaged tissue can sustain based on serial ultrasound examination alone. However, as small changes in sonographic appearance are associated with large changes in biomechanical strength, it is difficult to determine the degree of activity the tissue can sustain.AimsAcoustoelastography (AEG) is a new ultrasound‐based model to evaluate tendon function. Acoustoelastography deduces stiffness gradient, the rate of change of normalised stiffness as a function of strain, by analysing the changes in echo intensity observed in cine loops captured from gradually deforming tendon. The goal of this project was to establish a reproducible method for applying AEG in the normal equine SDFT.MethodsFifteen horses with no history of lameness and normal lameness examinations were recruited with informed owner consent and in accordance with the University Research Animal Resources Center. Stiffness gradient index (SGI) and dispersion values (DV) for the palmar SDFT were evaluated at 3 sites (5, 10 and 15 cm distal to the accessory carpal bone [DACB]) by 2 observers. Lifting of the contralateral forelimb during image acquisition resulted in the required SDFT deformation. Interobserver repeatability, intraobserver repeatability, and right‐to‐left limb symmetry were evaluated.ResultsThe SGIs and DVs for the SDFT at different locations, as well as effects of age or gender, showed no statistical difference (P>0.05). Interclass correlations evaluating repeatability within the same observer, between observers, and symmetry between right and left limbs demonstrated excellent agreement.Conclusions and practical significanceThis study shows that AEG is a feasible and repeatable technique for measuring stiffness gradients in normal equine SDFTs. This study will provide the basis for developing a simple, noninvasive evaluation of tendon function that could vastly improve the ability to detect, monitor and treat tendon injuries.Ethical animal researchAll animal protocols were approved by the University of Wisconsin Research Animal Resources Center. Client‐owned horses were used for the study and informed consent was obtained. Sources of funding: Research supported by Companion Animal Grant through University of Wisconsin. Competing interests: Co‐author/collaborator Ray Vanderby has patent on acoustoelastography post processing ultrasound‐based tissue evaluation technique.
A Girth Designed to Avoid Peak Pressure Locations Increases Limb Protraction and Flexion During Flight
Authors: Murray R. , Guire R. , Fisher M. , Fairfax V. 
Published: September 2013

IntroductionGirths are frequently blamed for veterinary and performance problems, but research into girth/horse interaction is sparse.AimsTo 1) determine location of peak pressure under a range of girths; 2) compare horse gait between horse's standard girth and a girth designed to avoid detected peak pressure locations.MethodsPart 1: Following validation procedures, a calibrated pressure mat placed under the girth of 10 horses was used to determine location of peak pressures. Based on these results, a girth was designed to avoid locations of peak pressure (Girth A). Part 2: Twenty elite horses/riders were included for study based on selection for British Equestrian Federation (BEF) World Class Programme Performance Squad, with no lameness or performance problem. Horses were ridden in Girth A and their standard girth (Girth S) in a crossover design, with riders blinded to girth type. Pressure mat data was acquired from under the girths. High‐speed video was captured in trot, using standard anatomical marker placement. Forelimb and hindlimb protraction, maximal carpal and tarsal flexion during flight were determined. Good repeatability was confirmed.ResultsIn standard girths, peak pressures were located over musculature behind elbow. Pressure mat results revealed maximum forces with Girth S were 22% (left) and 14% (right) greater than Girth A, and peak pressures were 76% (left) and 98% (right) greater (P<0.01 for all). On gait evaluation, girth A was associated with 6–11% greater forelimb protraction, 10–20% greater hindlimb protraction, 4% greater carpal flexion, and 3% greater tarsal flexion than Girth S (P<0.01 for all).Conclusions and practical significancePeak pressures were located where horses are reported to develop pressure sores. Girth A reduced peak pressures under the girth, and improved limb protraction and carpal/tarsal flexion, which may reflect improved posture and comfort.Ethical animal researchThis study involved informed consent of the riders/owners of horses used in the study. Sources of funding: UK Sport lottery funding for the BEF World Class Programme, Fairfax Saddles. Competing interests: Vanessa Fairfax is employed by Fairfax Saddles.
Is the Movement of the Thoracolumbar and Lumbosacral Joints in the Ridden Dressage Horse Affected by Muscle Development?
Authors: Walker V.A. , Tranquille C.A. , Duch S.E. , Northrop A.J. , Spear J. , Brandham J. , Murray R.C. 
Published: September 2013

IntroductionStabilisation of the back is essential for rider support and to moderate intervertebral movement. Epidemiological data has shown that 25% of UK dressage horses had back pain over a 2‐year period (Murray et al. ). It has been established that back pain in sports horses is performance limiting (Stubbs et al. ). Intervertebral range of motion (ROM) and flexion–extension movements of the back have been previously described. However, the relationship between muscle development and ridden ROM has not been investigated.AimsTo investigate the relationship between grade for development of muscles visible on examination and ridden ROM of the thoracolumbar (TL) and lumbosacral (LS) regions of the back.MethodsThirty‐five dressage horses (novice to Grand Prix competition level) were evaluated by an experienced clinician and assigned muscle development grades. High‐speed motion‐capture (250Hz) was used to measure TL and LS angle for 4 strides of collected trot from the left side. Spearman's rank correlation tests were used to test for associations between muscle development grade and ridden angles and ROM.ResultsIncreased development of visible muscle groups was correlated with increased TL and LS flexion at different parts of the stride (Table ). Decreased LS ROM was associated with increase muscle development of the thoracic and lumbar regions.Conclusions and practical significanceResults suggest that increased development of muscle groups visible on examination is important for stabilising the TL and LS regions. Back stabilisation is likely to help support the rider's weight and be involved in protection of the small joints and ligaments of the back. These findings support evaluation of the musculature during a veterinary examination as a guide to TL and LS stability, and the potential importance of visible muscle development in prevention and rehabilitation of ridden back problems.Ethical animal researchStudy approved by AHT Ethical Review Committee. Sources of funding: Funding from the Elise Pilkington Charitable Trust, British Dressage and Dr Wilfrid Bechtolsheimer. Competing interests: None.
Table summarising association of muscle development grade with back angles at specific points of the stride within the hindlimb (HL) and forelimb (FL)

Angle
Point of stride
Muscle group

Thoracolumbar (TL)
HL stance
Lumbosacral, pelvic

HL maximum protraction
Neck, lumbar, lumbosacral, pelvic

FL stance
Neck, lumbar, lumbosacral, pelvic

Lumbosacral (LS)
HL stance
Abdominal, thoracic, lumbar, lumbosacral, pelvic, hindlimb

HL maximum protraction
Abdominal

FL stance
Abdominal, lumbosacral, hindlimb
The Effects of Ambient Temperature and Relative Humidity on Blood Parameters in Horses During Long‐Distance Flights
Authors: Maaskant A. , de Gooijer J‐W. , Tilburg R. , Sloet van Oldruitenborgh‐Oosterbaan M.M. 
Published: September 2013

AimAt Schiphol Amsterdam airport more horses needed treatment for fever arriving after long‐distance flights (>5 h) from hot and humid places than from temperate climate places. Our aim was to explain this finding by determining blood parameters with predictive value for early onset of illness in horses during commercial long‐distance flights.MethodsBlood was drawn prior to loading (Sample 1), halfway during the flight (Sample 2) and immediately after unloading (Sample 3) from 13 horses shipped from Houston to Amsterdam (test‐group) and from 6 horses shipped from Amsterdam to New York (control‐group) for complete routine screening. Prior to loading both groups had a 5 h resting period at the airport. Before and during the flights ambient air temperature (AT) and relative humidity (RH) were measured in each jet‐stall.ResultsThe AT for the test‐group from loading until take off was 35.3 ± 1.89°C (max. 41.1°C) and RH 41%. For the control‐group AT was 18.2 ± 2.1°C (max. 21.1°C) and RH 65%. From take off to arrival AT and RH for the test‐group were 23.3 ± 3.0°C and 28%, and for the control‐group 20.6° ± 1.4°C and 40%, respectively. Samples 1, 2 and 3 showed in the test‐group higher (P<0.05) urea concentration (4.87 ± 1.06, 5.22 ± 1.06 and 5.06 ± 1.13 mmol/l) and lymphocyte count (3.85 ± 1.06, 3.48 ± 1.55 and 3.20 ± 2.12 109/l) than in the control‐group (3.68 ± 0.53, 4.12 ± 0.59, 4.25 ± 0.58 and 1.95 ± 0.72, 1.97 ± 0.68, 1.83 ± 0.56). In the test‐group lactate concentrations (mmol/l) were significantly higher in Samples 1 and 2 (test‐group 1.53 ± 0.35 and 1.84 ± 0.51; control‐group 1.15 ± 0.83 and 1.35 ± 0.40), and creatinine kinase (iu/l) was higher in Sample 1 (test‐group 326.0 ± 123.04; control‐group 201.2 ± 69.5).Conclusions and practical significanceEarlier studies proved that air transport is less stressful than road transport. This study demonstrates that high AT with moderate RH prior to take off resulted in significant elevation of some blood parameters. These findings support an increased susceptibility to illness, e.g. shipping‐fever in horses after long‐distance flights from hot and humid places.Ethical animal researchApproved by the Ethical Committion of KLM Cargo. Horse owners gave consent for blood sampling. Sources of funding: Team Amstelstreek, Ronde Hoep, the Netherlands; Air France‐KLM‐Martinair Cargo; G. Klatte, Germany. Competing interests: None.
High‐Speed Fluoroscopy: A Novel Method for Dynamic Imaging of the Equine Foot
Authors: Roach J.M. , Williams S.B. , Unt V. , Bryars J. , Pfau T. , Weller R. 
Published: September 2013

AimsThis study describes the distal limb kinematics including intra‐horse and inter‐horse variability, and variability between gaits in sound horses using high‐speed fluoroscopy which allows cineradiographic examination at speed.MethodsDistal limb kinematics were collected at walk and trot from 6 sound horses using a high‐speed fluoroscopy system set over a force plate. The dorsal proximal interphalangeal joint (PIPJ) angle and the dorsal distal interphalangeal joint (DIPJ) angle were repeatedly measured at toe‐on, 25, 50 and 75% stance.ResultsThe PIPJ and DIPJ showed overall extension through stance. The mean (± s.d.) range of motion (ROM) during stance of the PIPJ was 10 ± 3° (walk) and 9 ± 3° (trot) and for the DIPJ was 29 ± 5° (walk) and 27 ± 6° (trot) showing significant differences between strides, gaits and horses (P<0.001).ConclusionsHigh‐speed fluoroscopy allows for kinematic assessment of the distal limb. The ROM of the PIPJ observed was similar to the literature whilst the ROM for DIPJ was less than previously reported.Practical significanceKinematic analysis allows investigation of forces acting on bones, joints, ligaments and tendons. This is of special interest in the foot as the most common site of forelimb lameness in the horse; however, kinematic analysis of the foot has to date been a challenge due to the presence of the hoof capsule. The described method allows reliable assessment of foot kinematics at different gaits and speeds, which can be used for future studies to assess the effectiveness of treatment and monitor disease progression.Ethical animal researchEthical approval was granted by the Royal Veterinary College Ethics Committee. Sources of funding: The Royal Veterinary College. Competing interests: None.