bluuebunny/crossref_metadata_2025_split huggingface dataset:
DECISION MAKING AND SAFETY IN AMBULANCE SERVICE TRANSITIONS
Authors: O'Hara R , Johnson M , Hirst E , Weyman A , Shaw D , Mortimer P , Newman C , Storey M , Turner J , Mason S , Quinn T , Shewan J , Siriwardena A N 
Published: April 2015

IntroductionDecisions made by ambulance staff are often time-critical and based on limited information. Wrong decisions could have serious consequences for patients but little is known about areas of risk associated with decisions about patient care. We aimed to examine system influences on decision making in the ambulance service setting focusing on paramedic roles.MethodAn exploratory mixed methods qualitative study was conducted in three Ambulance Service Trusts. A document search and 16 interviews were conducted to understand service delivery in each Trust, how they link with other services and potential influences on decisions about patient care. Researchers observed ambulance crews on 34 shifts and 10 paramedics completed ‘digital diaries’ to report challenges for decision making or patient safety. Three focus groups with staff (N=21) and three with service users (N=23) were held to explore their views on decision making and patient safety. Data were charted to produce a typology of decisions then coded and thematically analysed to identify influences on those decisions.FindingsNine types of decision were identified, ranging from specialist emergency pathways to non-conveyance. Influences on these decisions included communication with Control Room staff; patient assessment, decision support and alternative options to ED conveyance. Seven main issues influencing patient safety in decision making were identified: meeting demand; performance and priorities; access to care options; risk aversion; education, training and professional development for crews; communication and feedback to crews; resources and safety culture.ConclusionsA range of decisions are made by ambulance staff in complex, time bound changing conditions. Training and development and access to alternative options to ED conveyance were identified as particularly important issues.
INVESTIGATING THE UNDERSTANDING, USE AND EXPERIENCES OF OLDER PEOPLE IN LINCOLNSHIRE ACCESSING EMERGENCY AND URGENT SERVICES VIA 999 AND NHS 111: A SCOPING STUDY
Authors: Togher Fiona , Windle Karen , Essam Nadya , Hardwick Jialin , Phung Viet-Hai , Vowles Valerie 
Published: April 2015

IntroductionDuring 2011/12, East Midlands Ambulance Service (EMAS) received 776,000 emergency 999 calls of which 36% (277,000) did not require transportation to hospital. Inappropriate calls can be due to public misunderstanding of when it is appropriate to ring 999. NHS 111 is an alternative free telephone service that enables the public to access health care advice or resources when the matter is urgent but not a 999 emergency. However knowing which service to telephone is not always easy and such a decision can be particularly difficult for older people as symptom presentation across complex co-morbidities can be atypical.A mixed method scoping project was carried out to explore the understanding, use and experiences of emergency (999) and urgent services (NHS 111) by older people aged 65 and over. Here, we report findings from the qualitative workstream.MethodsSemi-structured interviews and focus groups (n=25) using a topic guide were carried out with a purposive sample of older people who had used the 999 ambulance service and/or the NHS 111 service in the East Midlands.ResultsWe found a lack of awareness as to the remit of NHS 111 and confusion as to when this number should be phoned. Older people's expectations of 111 seemed to be analogous to other primary care services. As a consequence, participants were often dissatisfied with the service response; it neither provided useful advice nor reassurance. Greater satisfaction was reported with the call handling process and hospital transportation through EMAS (999) and older people's reported rationale for phoning 999 would seem to suggest appropriate service use.ConclusionDeveloping a greater understanding of how older people decide to contact a service would support future policy and practice implementation. If the remit of a service is unclear and accompanying publicity confusing, older people will continue to dial 999.
A SYSTEMATIC REVIEW OF LITERATURE ON THE CARE OF OLDER PEOPLE WHO FALL AND USE OUT-OF-HOSPITAL EMERGENCY SERVICES
Authors: Halter Mary , Chatters Robin , Koniotou Marina , Evans Bridie 
Published: April 2015

BackgroundOlder people who fall have been a priority area for the NHS since the publication of the National Service Framework for Older People. Evidence suggests falls prevention can reduce further falls. With rising numbers using Emergency Departments, there is a policy shift for ambulances to convey fewer patients and efforts to refer falls patients to other servicesObjectiveTo review evidence about impact and implementation of interventions delivered by emergency medical services to treat older people who fall to reduce emergency admissions to hospital.MethodWe undertook a systematic literature search of 18 electronic databases and reference lists. References were downloaded into biographic software, screened by one of three researchers against pre-defined inclusion criteria. Data were systematically extracted and assessed for methodological quality; whilst narrative synthesis was used to analyze findings.ResultsThrough our searching and screening process we identified 12 international studies. Interventions fell into two groups: (1) on-scene screening during patient assessment or triage at 999 call to refer them for falls prevention treatment or hospital conveyance; and (2) retrospective screening and referral to fall prevention treatment.Up to half of patients screened on-scene were conveyed to hospital and referrals to falls services were low, except where undertaken automatically. One trial reported patients had fewer falls and increased confidence after undergoing rehabilitation; additionally, they found there was a significant reduction in ambulance calls over 12 months. The quality of studies was weak and data were very heterogeneous, limiting comparison and quality of results. DiscussionDespite national priority about preventing falls and calls for reduced emergency department use, there are few studies and weak evidence about the most effective ways to support paramedics to use alternative treatments to target best treatment for older people who fall.
Suspect anaphylaxis following intravenous buprenorphine administration in a dog
Authors: Rossanese Matteo , Rigotti Clara 
Published: April 2015

A seven‐month‐old French Mastiff was scheduled to undergo exploratory laparotomy for the removal of gastric foreign bodies. Buprenorphine 20 μg/kg was administered intravenously as preanaesthetic medication. Five minutes after the injection, tachypnoea, dyspnoea, cyanosis and tachycardia developed; periorbital, labial and lingual oedema were also noted. Anaesthesia was induced with 4 mg/kg of propofol, and laryngeal visualisation revealed severe laryngeal oedema. The trachea was intubated with a 6 mm endotracheal tube and anaesthesia was maintained with isoflurane in oxygen. Fluid therapy was started and glucocorticoids were administered. The exploratory laparotomy was completed and gastric foreign bodies were removed. A temporary tracheostomy was performed as no improvement of the laryngeal oedema was detected. The patient recovered uneventfully and after 48 hours the tracheostomy tube was removed successfully. The reaction may be attributed to histamine release following injection of buprenorphine.
From spolia to recycling: the reuse of traditional construction materials in built heritage and its role in sustainability today: a review
Authors: Frangipane Anna 
Published: April 2015

Abstract
The reuse of traditional construction materials attests to their high value over the long term. In fact, the practice has always demonstrated the inherent value of traditional raw materials and their products in confronting the issues of sustainability, in the broader sense of preserving resources – material and immaterial – for future generations. Throughout the history of building, the symbolic value of spolia (i.e. the use of ancient architectural elements in new construction) has gone hand-in-hand with the practice of recycling, demonstrating, at various levels, an intrinsic awareness of reuse as a tool for minimizing waste of materials and energy. Today, sustainability is rarely considered from a long-term perspective, and when it is, the approach tends to be from a broad theoretical standpoint. In the past, however, it was a common and necessary aspect of construction management, when the waste of materials was a forbidden luxury. This paper presents a review of the reuse of geomaterials, mainly stone, throughout the Italian history of construction, indicating major examples selected for their value as memorable references, describing common practices from antiquity to modern times, and concluding with a description of the actual state of the art of the practice, based on very recent and outstanding cases.
Blocking IL1β Pathway Following Paclitaxel Chemotherapy Slightly Inhibits Primary Tumor Growth but Promotes Spontaneous Metastasis
Authors: Voloshin Tali , Alishekevitz Dror , Kaneti Limor , Miller Valeria , Isakov Elina , Kaplanov Irena , Voronov Elena , Fremder Ella , Benhar Moran , Machluf Marcelle , Apte Ron N. , Shaked Yuval 
Published: April 2015

AbstractAcquired resistance to therapy is a major obstacle in clinical oncology, and little is known about the contributing mechanisms of the host response to therapy. Here, we show that the proinflammatory cytokine IL1β is overexpressed in response to paclitaxel chemotherapy in macrophages, subsequently promoting the invasive properties of malignant cells. In accordance, blocking IL1β, or its receptor, using either genetic or pharmacologic approach, results in slight retardation of primary tumor growth; however, it accelerates metastasis spread. Tumors from mice treated with combined therapy of paclitaxel and the IL1 receptor antagonist anakinra exhibit increased number of M2 macrophages and vessel leakiness when compared with paclitaxel monotherapy-treated mice, indicating a prometastatic role of M2 macrophages in the IL1β-deprived microenvironment. Taken together, these findings demonstrate the dual effects of blocking the IL1 pathway on tumor growth. Accordingly, treatments using “add-on” drugs to conventional therapy should be investigated in appropriate tumor models consisting of primary tumors and their metastases. Mol Cancer Ther; 14(6); 1385–94. ©2015 AACR.
Incidence, Management, and Immediate- and Long-Term Outcomes After Iatrogenic Aortic Dissection During Diagnostic or Interventional Coronary Procedures
Authors: Núñez-Gil Iván J. , Bautista Daniel , Cerrato Enrico , Salinas Pablo , Varbella Ferdinando , Omedè Pierluigi , Ugo Fabrizio , Ielasi Alfonso , Giammaria Massimo , Moreno Raúl , Pérez-Vizcayno María José , Escaned Javier , De Agustin José Alberto , Feltes Gisela , Macaya Carlos , Fernández-Ortiz Antonio 
Published: April 2015

Background—
Aortic dissection type A is a disease with high mortality. Iatrogenic aortic dissection after interventional procedures is infrequent, and prognostic data are scarce. Our objective was to analyze its incidence, patient profile, and long-term prognosis.

Methods and Results—
Between 2000 and 2014, we retrospectively analyzed 74 patients with dissection of the ascending aorta. Clinical and procedural data were reviewed, and later, we performed a prospective clinical follow-up by telephone or in the office. The incidence of aortic dissection was 0.06%. Our patients, predominantly male (67.6%), had a mean age of 66.9±10.8 years. With multiple cardiovascular risk factors, the main reason for cardiac catheterization was an acute coronary syndrome (n=54). The complication was detected acutely in all, trying to engage the right coronary artery in 47 and the left main artery in 30 and after other maneuvers in 2, mostly complex therapeutic procedures (78.4%). A coronary artery was involved in 45 patients (60.8%). Thirty-five patients underwent an angioplasty and stent implantation; 3 had cardiac surgery; and 36 were managed conservatively. Two patients died of cardiogenic shock after the dissection. After a median follow-up of 51.2 months (range, 16.4–104.8 months), none of the remaining patients developed complications as a result of the dissection, progression, ischemia, pain, or dissection recurrence.

Conclusions—
Iatrogenic catheter dissection of the aorta is a rare complication that carries an excellent short- and long-term prognosis with the adoption of a conservative approach. When a coronary artery is involved as an entry point, it usually can be safely sealed with a stent with good long-term outcomes.
Preprocedural N‐Terminal Pro‐Brain Natriuretic Peptide (NT‐proBNP) Is Similar to the Mehran Contrast‐Induced Nephropathy (CIN) Score in Predicting CIN Following Elective Coronary Angiography
Authors: Liu Yong , He Yi‐ting , Tan Ning , Chen Ji‐yan , Liu Yuan‐hui , Yang Da‐hao , Huang Shui‐Jin , Ye Piao , Li Hua‐long , Ran Peng , Duan Chong‐yang , Chen Shi‐qun , Zhou Ying‐ling , Chen Ping‐Yan 
Published: April 2015

Background
N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) has been associated with important risk factors for contrast‐induced nephropathy (CIN). However, few studies have investigated the predictive value of NT‐proBNP itself. This study investigated whether levels of preprocedural NT‐proBNP could predict CIN after elective coronary angiography as effectively as the Mehran CIN score.

Methods and Results

We retrospectively observed 2248 patients who underwent elective coronary angiography. The predictive value of preprocedural NT‐proBNP for CIN was assessed by receiver operating characteristic and multivariable logistic regression analysis. The 50 patients (2.2%) who developed CIN had higher Mehran risk scores (9.5±5.1 versus 4.8±3.8), and higher preprocedural levels of NT‐proBNP (5320±7423 versus 1078±2548 pg/mL,
P
<0.001). Receiver operating characteristic analysis revealed that NT‐proBNP was not significantly different from the Mehran CIN score in predicting CIN (C=0.7657 versus C=0.7729,
P
=0.8431). An NT‐proBNP cutoff value of 682 pg/mL predicted CIN with 78% sensitivity and 70% specificity. Multivariable analysis suggested that, after adjustment for other risk factors, NT‐proBNP >682 pg/mL was significantly associated with CIN (odds ratio: 4.007, 95% CI: 1.950 to 8.234;
P
<0.001) and risk of death (hazard ratio: 2.53; 95% CI: 1.49 to 4.30;
P
=0.0006).

Conclusions
Preprocedural NT‐proBNP >682 pg/mL was significantly associated with the risk of CIN and death. NT‐proBNP, like the Mehran CIN score, may be another useful and rapid screening tool for CIN and death risk assessment, identifying subjects who need therapeutic measures to prevent CIN.
A Novel Missense Mutation of NOG Interferes With the Dimerization of NOG and Causes Proximal Symphalangism Syndrome in a Chinese Family
Authors: Pang Xiuhong , Wang Zhaoyan , Chai Yongchuan , Chen Hongsai , Li Lei , Sun Lianhua , Jia Huan , Wu Hao , Yang Tao 
Published: April 2015

Objectives: NOG is an antagonist to bone morphogenetic proteins and plays an important role in proper bone and joint development. Dominant mutations in NOG may lead to a series of symphalangism spectrum disorders. In this study, we aimed to identify the genetic cause and the pathogenic mechanism of an autosomal dominant disorder with cosegregating proximal symphalangism and conductive hearing impairment in a Chinese family. Methods: Mutation screening of NOG was performed in the affected family members by polymerase chain reaction (PCR) amplification and direct sequencing. Western blotting analysis of NOG was performed in the leukocyte samples of the family members. Results: A novel p.W150C heterozygous mutation in NOG was identified cosegregating with the proximal symphalangism disorder in the family. Western blotting analysis showed that the p.W150C mutation interferes with the dimerization of the mutant NOG. Conclusions: Our results agreed with previously published results of in vitro studies and suggested that impaired dimerization of mutant NOG is an important pathogenic mechanism for the NOG-related symphalangism spectrum disorder.
Vascular endothelial growth factor-A mRNA gene expression in clinical phases of multiple sclerosis
Authors: Rasol Hoiyda A Abdel , Helmy Hanan , El-Mously Sherine , Aziz Margeret A , El bahaie Hossam 
Published: April 2015

Background Vascular endothelial growth factor A stimulates angiogenesis, but is also pro-inflammatory and plays an important role in the development of neurological disease. This study aimed to investigate whether vascular endothelial growth factor A mRNA expression could be used as a marker for the prediction of susceptibility to multiple sclerosis and relate vascular endothelial growth factor to the clinical phases of multiple sclerosis. Methods This was a cross-sectional study, consisting of a total of 60 subjects with multiple sclerosis and 20 healthy controls. Subjects were subjected to history taking, neurological examination and peripheral blood sampling for vascular endothelial growth factor A mRNA gene expression. Vascular endothelial growth factor A gene expression was measured by real-time polymerase chain reaction using the SYBR Green technique. Results Vascular endothelial growth factor A mRNA gene expression level was significantly lower in the multiple sclerosis group than in the healthy control group ( P < 0.001). Vascular endothelial growth factor A mRNA gene expression level was higher in relapsing remitting multiple sclerosis (RRMS) patients than in those in remission ( P < 0.001) and in relapsing remitting multiple sclerosis compared with secondary progressive multiple sclerosis ( P < 0.001). There was no correlation between vascular endothelial growth factor A gene expression levels and duration of disease, multiple sclerosis progression index or expanded disability status scale. Conclusions A lower vascular endothelial growth factor A mRNA gene expression level was independently associated with a higher risk of multiple sclerosis.
Elastic modulus of low-density lipoprotein as potential indicator of its oxidation
Authors: Takeda Seiji , Subagyo Agus , Hui Shu-Ping , Fuda Hirotoshi , Shrestha Rojeet , Sueoka Kazuhisa , Chiba Hitoshi 
Published: April 2015

Background Evaluation of low-density lipoprotein oxidation is important in the risk assessment of cardiovascular disease. Atomic force microscope is widely used to evaluate the physical properties including stiffness on a single-particle scale. In this study, the effect of low-density lipoprotein oxidation on the low-density lipoprotein stiffness was investigated using an atomic force microscope. Methods Isolated low-density lipoprotein particles with or without oxidation were densely bound to an Au substrate on mica, and then pressed and deformed by the atomic force microscope tip. The stiffness of each low-density lipoprotein particle was estimated as the elastic modulus obtained by the force curve analysis. Biochemical change of low-density lipoprotein due to oxidation was studied by electrophoresis. Results and conclusion The elastic modulus of low-density lipoprotein particles ranged between 0.1 and 2 MPa. The oxidation of low-density lipoprotein increased the number of low-density lipoprotein particles with smaller elastic moduli, indicating the decrease in low-density lipoprotein stiffness. The elastic modulus of low-density lipoprotein might be potentially useful to evaluate low-density lipoprotein oxidation.
The relationship between children’s sensory processing patterns and their leisure preferences and participation patterns
Authors: Ismael Noor T. , Lawson Lisa A. Mische , Cox Jane A. 
Published: April 2015

Background. Sensory processing patterns may be associated with children’s preferences for different activities; however, knowledge about how different sensory processing patterns may relate to children’s participation in leisure activities is scarce. Purpose. This study investigated in what leisure activities children with extreme sensory processing patterns participate and if relationships exist between children’s sensory processing patterns and their leisure preferences and participation patterns. Method. This correlational study analyzed data from children’s Sensory Profiles and reported play and leisure preferences. All 91 children in the sample completed the Children’s Assessment for Participation and Enjoyment (CAPE) and the Preferences for Activities of Children (PAC). Parents of children ages 6 to10 years completed the Sensory Profile, and children ages 11 to 14 years completed the Adolescent/Adult Sensory Profile. Findings. Children with different sensory processing patterns preferred both similar and distinct leisure activities. Low-registration quadrant summary z scores negatively correlated with CAPE overall diversity scores ( rs = –.23, p = .03), sensitivity quadrant summary z scores negatively correlated with preferences for social activities ( rs = –.23, p = .03) and preferences for skill-based activities ( rs = –.22, p = .04), and avoiding quadrant summary z scores negatively correlated with preferences for social activities ( rs = –.26, p =.01). Implications. Children’s sensory preferences are related to leisure preferences and participation.
Complacency and Automation Bias in the Use of Imperfect Automation
Authors: Wickens Christopher D. , Clegg Benjamin A. , Vieane Alex Z. , Sebok Angelia L. 
Published: April 2015

Objective We examine the effects of two different kinds of decision-aiding automation errors on human–automation interaction (HAI), occurring at the first failure following repeated exposure to correctly functioning automation. The two errors are incorrect advice, triggering the automation bias, and missing advice, reflecting complacency. Background Contrasts between analogous automation errors in alerting systems, rather than decision aiding, have revealed that alerting false alarms are more problematic to HAI than alerting misses are. Prior research in decision aiding, although contrasting the two aiding errors (incorrect vs. missing), has confounded error expectancy. Method Participants performed an environmental process control simulation with and without decision aiding. For those with the aid, automation dependence was created through several trials of perfect aiding performance, and an unexpected automation error was then imposed in which automation was either gone (one group) or wrong (a second group). A control group received no automation support. Results The correct aid supported faster and more accurate diagnosis and lower workload. The aid failure degraded all three variables, but “automation wrong” had a much greater effect on accuracy, reflecting the automation bias, than did “automation gone,” reflecting the impact of complacency. Some complacency was manifested for automation gone, by a longer latency and more modest reduction in accuracy. Conclusions Automation wrong, creating the automation bias, appears to be a more problematic form of automation error than automation gone, reflecting complacency. Implications Decision-aiding automation should indicate its lower degree of confidence in uncertain environments to avoid the automation bias.