bluuebunny/crossref_metadata_2025_split huggingface dataset:
Baggage handler seniority and musculoskeletal symptoms: is heavy lifting in awkward positions associated with the risk of pain?
Authors: Bern Stine Hvid , Brauer Charlotte , Møller Karina Lauenborg , Koblauch Henrik , Thygesen Lau Caspar , Simonsen Erik Bruun , Alkjær Tine , Bonde Jens Peter , Mikkelsen Sigurd 
Published: November 2013

ObjectivesHeavy lifting is associated with musculoskeletal disorders but it is unclear whether it is related to acute reversible effects or to chronic effects from cumulated exposure. The aim of this study was to examine whether musculoskeletal symptoms in Danish airport baggage handlers were associated with their seniority as baggage handler, indicating chronic effects from cumulated workload.MethodsWe established a group of baggage handlers employed at Copenhagen Airport during the period 1983–2012 (n=3092) and a reference group of men in other unskilled occupations with less heavy work (n=2478). Data regarding work history, lifestyle and musculoskeletal symptoms were collected using a self-administered questionnaire (response rate 70.1% among baggage handlers and 68.8% among the reference group).ResultsThe ORs of self-reported musculoskeletal symptoms during the last 12 months in the neck/upper back, lower back, shoulders, elbows, wrists, hips and knees were significantly higher in baggage handlers than in the reference group. These differences were explained by significant linear effects of baggage handler seniority for six anatomical regions. Adjustment for age, body mass index, smoking and leisure-time physical activity did not change these results. The findings were stable over age strata and among present and former baggage handlers.ConclusionsThe risk of musculoskeletal symptoms in six anatomical regions increased with increasing seniority as a baggage handler. This is consistent with the assumption that cumulated heavy lifting may cause chronic or long-lasting musculoskeletal symptoms. However, we cannot exclude that other factors related to baggage handler seniority may explain some of the associations.
The F.R.I.D.A.Y.S. checklist - Preparing our patients for a safe weekend
Authors: Palmer Edward , Richardson Emma , Newcombe Hannah , Borg Cynthia-Michelle 
Published: November 2013

AbstractThere is a higher incidence of mortality and adverse events among inpatients in UK hospitals at the weekend compared to weekdays. The high volume of routine tasks handed over by the weekday doctors on Fridays may be a contributing factor.An audit was carried out on four acute wards on a Friday evening at University Hospital Lewisham (UHL). It demonstrated that most patients had at least one outstanding task that would need completing by the on-call team over the weekend. To address this problem a concise and memorable checklist was created to ensure that routine jobs are completed by the weekday team prior to the weekend.The checklist uses the acronym “F.R.I.D.A.Y.S.” to prompt doctors to hand over weekend bloods, ensure drug charts are reviewed, document a plan for IV fluids, complete discharge summaries, monitor antibiotic levels, dose warfarin, and clearly document the ceiling of care. The F.R.I.D.A.Y.S. checklist was printed onto history paper and integrated into the patient notes on a Friday ward round. The efficacy of the checklist was evaluated by reviewing the number of outstanding jobs on the wards after 17:00 on a Friday in the categories listed.F-PhlebotomyR-Rewrite drug chartI-IV fluidsD-Discharge summariesA-Antibiotic levelsY-Yellow book (warfarin)S-Resuscitation StatusThe number of outstanding jobs on a ward (A) that used F.R.I.D.A.Y.S. was 3 out of a total 132 jobs (2.3%) compared with 47 out of a total of 103 (45.6%) on a ward that did not use the checklist (B).When the F.R.I.D.A.Y.S. checklist is implemented there is an increase in the number of routine jobs that are carried out by the weekday team, and therefore a reduction in workload for the weekend on call team. Patient safety is improved as management decisions are made by a team that is familiar with the patient, and on call teams are able to prioritise emergencies. The cost saving of using the F.R.I.D.A.Y.S. checklist if implemented throughout UHL is estimated at £317,136 per annum.
Alteration of energy metabolism in the pathogenesis of bile duct lesions in primary biliary cirrhosis
Authors: Harada Kenichi , Kakuda Yuko , Sato Yasunori , Ikeda Hiroko , Shimoda Shinji , Yamamoto Yasuhiko , Inoue Hiroshi , Ohta Hajime , Kasashima Satomi , Kawashima Atsuhiro , Nakanuma Yasuni 
Published: November 2013

AimPrimary biliary cirrhosis (PBC) is characterised by antimitochondrial antibody against the pyruvate dehydrogenase complex (PDC) and chronic non-suppurative destructive cholangitis (CNSDC). Pyruvate oxidation to acetyl-CoA by PDC is a key step in the glycolytic system. Oestrogen-related receptor-α (ERRα) is functionally activated by inducible coactivators such as peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α) and Bcl-3. Moreover, the PGC-1α–ERRα axis interrupts glycolytic metabolism through the upregulation of pyruvate dehydrogenase kinase, isozyme 4 (PDK4), which functionally inhibits PDC-E1α and stimulates fatty acid oxidation. In this study, we investigated the PGC-1α–ERRα axis to clarify PDC dysfunction in CNSDC of PBC.MethodsThe expression of PGC-1α, Bcl-3, ERRα, PDK4 and PDC-E1α was examined by immunohistochemistry in liver sections from patients with PBC and controls. The expression of these molecules, the activity of mitochondrial dehydrogenase and PDC, and their alterations by starvation, a treatment used to induce PGC-1α expression, were examined in cultured human biliary epithelial cells (BECs).ResultsThe nuclear expression of PGC-1α, Bcl-3 and ERRα was exclusively observed in CNSDC of PBC. Moreover, the expression of PDK4 and PDC-E1α was enhanced in CNSDC of PBC. In cultured BECs, the amplification of Bcl-3 and PDK4 mRNAs by reverse-transcription-PCR and mitochondrial dehydrogenase activity were markedly increased but PDC activity was decreased according to the upregulation of PGC-1α.ConclusionsIn CNSDC of PBC, the activation of the ERRα–PGC-1α axis was exclusively observed, suggesting the interference of PDC-related glycolytic function and the induction of the fatty acid degradation system. The switching of the cellular energy system is possibly associated with the pathogenesis of CNSDC in PBC.
Inactive lifestyles and obesity in Chilean youth: Individual costs in health-related choices
Authors: Correa-Burrows Paulina , Burrows Raquel A 
Published: November 2013

Objective: A recent economic approach suggests that people do not account for the long-term implications of unhealthy behaviours, preventing them from performing a fully rational trade-off between current benefits and future costs, leading to negative health outcomes. We examined whether the current allocation of time to physical activity among young people leads to outcomes that may affect their well being as youth and their longer–term life prospects. Design: The study group comprised a random sample of 1692 high-school students (14.8±0.7 years old) from urban Santiago, Chile attending private and non-private schools. Setting: We measured physical activity habits accounting for time spent in class, studying and screen-based entertainment, hours of daily recreational activity and hours of weekly scheduled exercise. Obesity and abdominal obesity were diagnosed according to CDC/NCHS 2000, NHANES III and IDF criteria, respectively. Method: Logistic regression analysis was performed to assess the relationship between current physical activity habits, confounders and the likelihood of suffering from obesity and abdominal obesity. Results: Young people reporting the lowest allocation of time to physical activity, scheduled exercise and active play showed a higher risk of obesity and abdominal obesity. Those reporting moderate allocation of time to physical activity, scheduled exercise and active play were more likely to suffer from central obesity as defined by IDF criteria. Study participants attending partially subsidized schools showed the highest risk of obesity and central obesity. Conclusions: In this sample, young people appear not to be employing optimal strategies for making weight-related choices, since reduced physical activity, obesity and central obesity are proximate causes of metabolic and cardiovascular disorders.
Changes of cardiac troponin I and operative mortality of coronary artery bypass
Authors: Moon Mi Hyoung , Song Hyun , Wang Young Pil , Jo Keon Hyun , Kim Chi Kyung , Cho Kyu Do 
Published: November 2013

Background Recently, cardiac troponin I has been used to detect myocardial injury because of its superior cardiac specificity. However, there has been debate about the appropriate timing and cutoff level of cardiac troponin I to detect perioperative myocardial injury after coronary artery bypass grafting. The objective of this study was to define the relationship between operative mortality and changes in cardiac troponin I after isolated coronary artery bypass. Patients and methods A retrospective analysis was carried out on data of 218 isolated coronary artery bypass patients who were operated on between June 2009 and February 2012. All patients followed an institutional perioperative management protocol that included 6 cardiac troponin I measurements (preoperatively and 0, 12, 24, 36, and 48 h after coronary artery bypass). According to the patterns of cardiac troponin I, the patient cohort was divided into 2 groups. Group 1 was patients in whom cardiac troponin I levels decreased 24 h after the operation, and group 2 comprised the patients with cardiac troponin I levels that did not decrease or even increased after 24 h. Results The operative mortality was 4.1% (9/218). Group 2 showed significantly higher mortality (5/25, 20%) than group 1 (4/193, 2.1%). Conclusion An elevated cardiac troponin I level is common after coronary artery bypass. A persistently high level of cardiac troponin I after 24 h is an important predictor of operative mortality after coronary artery bypass surgery.
Endovenous laser ablation of varicose veins with the 1470 nm diode laser using a radial fiber – 1-year follow-up
Authors: von Hodenberg E , Zerweck C , Knittel M , Zeller T , Schwarz T 
Published: November 2013

Background: Endovenous laser ablation is one of the most accepted treatment options for insufficient great and small saphenous veins. The aim of this study was to investigate the long-term efficacy and safety of the radial fiber (ELVeS-radial kit™) for the 1470 nm diode laser in a 1-year follow-up. Methods: A total of 308 lower limbs with primary insufficiency of great and small saphenous veins or insufficient tributaries were included in the prospective observational cohort study. The primary efficacy endpoint of the study was ultrasonographic proven elimination of venous reflux after at least 1 year. Secondary efficacy and further safety end points after 1 year were as follows: (1) sonographic exclusion of recanalization of the treated vein segments, (2) deep vein thrombosis, clinical pulmonary embolism or superficial vein thrombosis as defined by objective testing, (3) death from any cause, (4) persistent clinical complaints such as pain and paresthesia, (5) recurrent varicose veins. Patient satisfaction was assessed using a CIVIQ-2 questionnaire after 1 year. Results: Follow-up could be completed in 91.2% of the patients. Excellent efficacy numbers with 99.6% occlusion of the treated varicose veins as elimination of reflux could be demonstrated. After 1 year, 96% of the treated veins disappeared completely sonographically; one recanalization was observed. No deep vein thrombosis or pulmonary embolism occurred, three superficial vein thrombosis were diagnosed in follow-up examinations. Four patients died, not related to pulmonary embolism. No persistent pain or paresthesia occurred in the follow-up. Recurrent varicose veins were diagnosed in 10 patients (2.81%). Conclusion: One-year follow-up showed that endovenous laser treatment of varicose veins with 1470 nm diode laser using the radial fiber is highly effective, also regarding in a 1-year follow-up.
Home-based palliative care: A systematic literature review of the self-reported unmet needs of patients and carers
Authors: Ventura Adriana D , Burney Susan , Brooker Joanne , Fletcher Jane , Ricciardelli Lina 
Published: November 2013

Background: There have been many studies on the unmet needs of palliative care patients and carers from the perspective of bereaved caregivers. However, the unmet needs of palliative care patients and carers from the perspective of current patients and their carers have received little research attention. Aim: As home-based services have become one of the main delivery models of palliative care, the aim of this review was to describe, evaluate and summarise the literature on the unmet needs of palliative home care patients and carers. Design: The systematic review of qualitative and quantitative studies was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data sources: PubMed, CINAHL, Embase, MEDLINE, PsycINFO, AMED and CareSearch were searched to find empirical studies on the self-reported unmet needs of palliative home care patients and carers. Results: Nine qualitative studies, three quantitative studies and three mixed-design studies were identified. The most frequently reported unmet need was effective communication with health-care professionals, the lack of which negatively impacted on the care received by patients and carers. Physical care needs were met, which indicates that the examined palliative home care services were delivering satisfactory care in this domain, but lacking in other areas. Conclusions: The focus therefore should be on improving other aspects of patient care, including communication by health professionals to prevent or reduce suffering in areas such as psychosocial domains. Valid and reliable quantitative measures of unmet needs in palliative care are needed to examine this area more rigorously.
End-of-life care and achieving preferences for place of death in England: Results of a population-based survey using the VOICES-SF questionnaire
Authors: Hunt Katherine J , Shlomo Natalie , Addington-Hall Julia 
Published: November 2013

Background/aim: Health policy places emphasis on enabling patients to die in their place of choice, and increasing the proportion of home deaths. In this article, we seek to explore reported preferences for place of death and experiences of care in a population-based sample of deaths from all causes. Design: Self-completion post-bereavement survey. Setting/Participants: Census of deaths registered in two health districts between October 2009 and April 2010. Views of Informal Carers – Evaluation of Services Short Form was sent to each informant (n = 1422; usually bereaved relative) 6–12 months post-bereavement. Results: Response was 33%. In all, 35.7% of respondents reported that the deceased said where they wanted to die, and 49.3% of these were reported to achieve this. Whilist 73.9% of those who were reported to have a preference cited home as the preferred place, only 13.3% of the sample died at home. Cancer patients were more likely to be reported to achieve preferences than patients with other conditions (p < .01). Being reported to have a record of preferences for place of death increased the likelihood of dying at home (odds ratio = 22.10). When rating care in the last 2 days, respondents were more likely to rate ‘excellent’ or ‘good’ for nursing care (p < .01), relief of pain (p < .01) and other symptoms (p < .01), emotional support (p < .01) and privacy of patient’s environment (p < .01) if their relative died in their preferred place. Conclusions: More work is needed to encourage people to talk about their preferences at the end of life: this should not be restricted to those known to be dying. Increasing knowledge and achievement of preferences for place of death may also improve end-of-life care.
Rabbit hepatic arterial anatomy variations: implications on experimental design
Authors: Tam Alda L , Melancon Marites P , Ensor Joe , Liu Yang , Dixon Katherine , McWatters Amanda , Gupta Sanjay 
Published: November 2013

Background The VX2 rabbit model of liver cancer is commonly used to evaluate the efficacy of locoregional anticancer therapy and knowledge of the hepatic arterial anatomy in the rabbit is important for catheter-directed experiments. Purpose To describe the normal anatomy and anatomic variations of the celiac axis and hepatic artery in the rabbit. Material and Methods Angiograms of 222 rabbits were retrospectively reviewed. The branching pattern of the celiac axis was classified and the diameters of the major branches were measured. Paired t-tests were used to compare the difference between the average sizes of arteries. Results Variant celiac axis or hepatic artery anatomy was noted in 25.9% of angiograms, with the gastric branches arising from the proper hepatic artery in 23.3% of cases. The celiac axis could be successfully classified into one of five distinct branching patterns in 193 (86.9%) cases. The mean diameters of the right and left hepatic arteries were 0.67 mm (95% CI [0.64, 0.7]) and 1.25 mm (95% CI [1.19, 1.31]), respectively. The mean diameters of the medial and lateral branches of the left hepatic artery were 0.63 mm (95% CI [0.6, 0.67]) and 0.91 mm (95% CI [0.86, 0.96]), respectively. The right hepatic artery was significantly smaller than the left hepatic artery and the lateral branch of the left hepatic artery (all P values <0.0001). Conclusion Arterial variants in the rabbit are not uncommon. The proper hepatic artery often gives origin to gastric artery branches. To facilitate superselective intra-arterial intervention, the left lateral lobe of the liver should be targeted for tumor implantation because of the significant size difference between the right and left hepatic arteries.
Risk factors of radiation dose in patients undergoing peripherally-inserted central catheter procedure using conventional angiography equipment and flat panel detector-based mobile C-arm fluoroscopy
Authors: Lee TaeBum , Shin Sung Wook , Choi Dongil , Cho Sung Ki , Hyun Dongho , Do Young Soo , Jeon SungChae , Cha BoKyung , Bok Eun Kyung , Kim Seonwoo 
Published: November 2013

Background Although peripherally-inserted central catheter (PICC) insertion is commonly performed under fluoroscopic guidance, few reports have addressed performance and dosimetry when PICC is inserted under C-arm fluoroscopy. Purpose To evaluate the risk factors of radiation dose in performing PICC insertion using flat panel detector-based mobile C-arm fluoroscopy and a conventional angiography machine. Material and Methods Ninety-eight patients underwent the PICC procedure using conventional angiography equipment ( n=49) or flat panel detector-based mobile C-arm fluoroscopy ( n=49). Data were prospectively analyzed from July to November 2012. Dose-area product (DAP), tube voltage, tube current, fluoroscopy time, and image quality measured on a 5-point scale were estimated and compared using appropriate statistical tests. Results There were no significant differences in tube voltage, fluoroscopy time, and image quality between conventional angiography and mobile C-arm fluoroscopy. DAP, mean arm tube current, and tube current in chest fluoroscopy were significantly lower in mobile C-arm fluoroscopy than using the conventional angiography machine ( P <0.05). Multivariate analysis identified tube current in chest fluoroscopy, arm tube current, and fluoroscopy equipment as significant risk factors for elevated radiation dose in PICC insertion. Conclusion PICC insertion can be performed using flat panel detector-based mobile C-arm fluoroscopy instead of a conventional angiography machine. Image quality and fluoroscopy time were not different between the two systems and the use of C-arm fluoroscopy significantly reduced radiation dose.
Sphenopalatine ganglion neuromodulation in migraine: What is the rationale?
Authors: Khan Sabrina , Schoenen Jean , Ashina Messoud 
Published: November 2013

Objective The objective of this article is to review the prospect of treating migraine with sphenopalatine ganglion (SPG) neurostimulation. Background Fuelled by preliminary studies showing a beneficial effect in cluster headache patients, the potential of treating migraine with neurostimulation has gained increasing interest within recent years, as current treatment strategies often fail to provide adequate relief from this debilitating headache. Common migraine symptoms include lacrimation, nasal congestion, and conjunctival injection, all parasympathetic manifestations. In addition, studies have suggested that parasympathetic activity may also contribute to the pain of migraineurs. The SPG is the largest extracranial parasympathetic ganglion of the head, innervating the meninges, lacrimal gland, nasal mucosa, and conjunctiva, all structures involved in migraine with cephalic autonomic symptoms. Conclusion We propose two possible mechanisms of action: 1) interrupting the post-ganglionic parasympathetic outflow to inhibit the pain and cephalic autonomic symptoms, and 2) modulating the sensory processing in the trigeminal nucleus caudalis. To further explore SPG stimulation in migraineurs as regards therapeutic potential and mode of action, randomized clinical trials are warranted.
Definitions of medication-overuse headache in population-based studies and their implications on prevalence estimates: A systematic review
Authors: Westergaard Maria L , Hansen Ebba Holme , Glümer Charlotte , Olesen Jes , Jensen Rigmor H 
Published: November 2013

Background Case definitions of medication-overuse headache (MOH) in population-based research have changed over time. This study aims to review MOH prevalence reports with respect to these changes, and to propose a practical case definition for future studies based on the ICHD-3 beta. Methods A systematic literature search was conducted to identify MOH prevalence studies. Findings were summarized according to diagnostic criteria. Results Twenty-seven studies were included. The commonly used case definition for MOH was headache ≥15 days/month with concurrent medication overuse ≥3 months. There were varying definitions for what was considered as overuse. Studies that all used ICHD-2 criteria showed a wide range of prevalence among adults: 0.5%–7.2%. Conclusions There are limits to comparing prevalence of MOH across studies and over time. The wide range of reported prevalence might not only be due to changing criteria, but also the diversity of countries now publishing data. The criterion “headache occurring on ≥15 days per month” with concurrent medication overuse can be applied in population-based studies. However, the new requirement that a respondent must have “a preexisting headache disorder” has not been previously validated. Exclusion of other headache diagnoses by expert evaluation and ancillary examinations is not feasible in large population-based studies.