bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypertonic sodium lactate improves fluid balance and hemodynamics in porcine endotoxic shock
Authors: Duburcq Thibault , Favory Raphaël , Mathieu Daniel , Hubert Thomas , Mangalaboyi Jacques , Gmyr Valery , Quintane Laurence , Maboudou Patrice , Pattou François , Jourdain Mercé 
Published: September 2014

Abstract
Introduction
Based on the potential interest in sodium lactate as an energy substrate and resuscitative fluid, we investigated the effects of hypertonic sodium lactate in a porcine endotoxic shock.

Methods
Fifteen anesthetized, mechanically ventilated pigs were challenged with intravenous infusion of E. coli endotoxin. Three groups of five animals were randomly assigned to receive 5 mL/kg/h of different fluids: a treatment group received hypertonic sodium lactate 11.2% (HSL group); an isotonic control group receiving 0.9% NaCl (NC group); a hypertonic control group with the same amount of osmoles and sodium than HSL group receiving hypertonic sodium bicarbonate 8.4% (HSB group). Hemodynamic and oxygenation variables, urine output and fluid balance were measured at baseline and at 30, 60, 120, 210 and 300 min. Skin microvascular blood flow at rest and during reactive hyperemia was obtained using a laser Doppler flowmetry technique. Results were given as median with interquartile ranges.

Results
Endotoxin infusion resulted in hypodynamic shock. At 300 min, hemodynamics and oxygenation were significantly enhanced in HSL group: mean arterial pressure (103 [81–120] mmHg vs. 49 [41–62] in NC group vs. 71 [60–78] in HSB group), cardiac index (1.6 [1.2–1.8] L/min/m2 vs. 0.9 [0.5–1.1] in NC group vs. 1.3 [0.9–1.6] in HSB group) and partial pressure of oxygen (366 [308–392] mmHg vs. 166 [130–206] in NC group vs. 277 [189–303] in HSB group). At the same time, microvascular reactivity was significantly better in HSL group with a lower venoarterial CO2 tension difference (5.5 [4–10] mmHg vs. 17 [14–25] in NC group vs. 14 [12–15] in HSB group). The cumulative fluid balance was lower in HSL group (-325 [-655; -150] mL) compared to NC (+560 [+230; +900] mL, p = 0.008) and HSB (+185 [-110; +645] mL, p = 0.03) groups.

Conclusions
In our hypodynamic model of endotoxic shock, infusion of hypertonic sodium lactate improves hemodynamic and microvascular reactivity with a negative fluid balance and a better oxygenation.
Automatic design algorithms for securing the ground contact stability of mobile cranes
Authors: Lee Donghoon , Park Jun Young , Ho Jongkwan , Kim Sunkuk 
Published: September 2014

Abstract

Background
Mobile cranes overturn due to excessive lifting, heavy wind, or when appropriate ground contact pressure is not secured. Such accidents can be prevented by reviewing the force conveyed from the outrigger to the ground upon lifting, as well as the soil bearing force. The stability review of mobile crane overturn is classified into the following stages: reviewing lifting conditions, mobile crane selection and reviewing ground contact stability. However, a precise review of ground contact stability requires expertise and is extremely time-consuming. Thus, this study develops automatic design algorithms for securing the ground stability of mobile cranes for easy and quick stability reviews.

Methods
The stability review method and the algorithm models are created in connection with the proposed conceptual process. The algorithms proposed in this study conduct simulations for all possible candidate cases, save the results in a database, review practical alternatives, and select the solution that minimizes cost. To verify the effectiveness of the automatic design model, a case project was selected and the algorithm was applied assuming several conditions.

Results
Developed algorithms can select candidate cranes according to lifting conditions and design plates through simulations easily and quickly, and design components required for ground contact plate design are collected to build the database that allows easier and quicker stability review.

Conclusion
The algorithms proposed in this study conduct simulations for all possible candidate cases, save the results in a database, review practical alternatives, and select the solution that minimizes cost. Developed processes are useful for analyzing correlations of mobile crane performance, ground contact and soil bearing force reinforcement designs and so forth, and for systematically selecting optimal mobile cranes.
Chemotherapy and Targeted Therapy for Women With Human Epidermal Growth Factor Receptor 2–Negative (or unknown) Advanced Breast Cancer: American Society of Clinical Oncology Clinical Practice Guideline
Authors: Partridge Ann H. , Rumble R. Bryan , Carey Lisa A. , Come Steven E. , Davidson Nancy E. , Di Leo Angelo , Gralow Julie , Hortobagyi Gabriel N. , Moy Beverly , Yee Douglas , Brundage Shelley B. , Danso Michael A. , Wilcox Maggie , Smith Ian E. 
Published: September 2014

Purpose To identify optimal chemo- and targeted therapy for women with human epidermal growth factor 2 (HER2)– negative (or unknown) advanced breast cancer. Methods A systematic review of randomized evidence (including systematic reviews and meta-analyses) from 1993 through to current was completed. Outcomes of interest included survival, progression-free survival, response, quality of life, and adverse effects. Guideline recommendations were evidence based and were agreed on by the Expert Panel via consensus. Results Seventy-nine studies met the inclusion criteria, comprising 20 systematic reviews and/or meta-analyses, 30 trials on first-line treatment, and 29 trials on second-line and subsequent treatment. These trials form the evidence base for the guideline recommendations. Recommendations Endocrine therapy is preferable to chemotherapy as first-line treatment for patients with estrogen receptor–positive metastatic breast cancer unless improvement is medically necessary (eg, immediately life-threatening disease). Single agent is preferable to combination chemotherapy, and longer planned duration improves outcome but must be balanced against toxicity. There is no single optimal first-line or subsequent line chemotherapy, and choice of treatment will be determined by multiple factors including prior therapy, toxicity, performance status, comorbid conditions, and patient preference. The role of bevacizumab remains controversial. Other targeted therapies have not so far been shown to enhance chemotherapy outcome in HER2-negative breast cancer.
Primary Results of ROSE/TRIO-12, a Randomized Placebo-Controlled Phase III Trial Evaluating the Addition of Ramucirumab to First-Line Docetaxel Chemotherapy in Metastatic Breast Cancer
Authors: Mackey John R. , Ramos-Vazquez Manuel , Lipatov Oleg , McCarthy Nicole , Krasnozhon Dmitriy , Semiglazov Vladimir , Manikhas Alexey , Gelmon Karen A. , Konecny Gottfried E. , Webster Marc , Hegg Roberto , Verma Sunil , Gorbunova Vera , Abi Gerges Dany , Thireau Francois , Fung Helena , Simms Lorinda , Buyse Marc , Ibrahim Ayman , Martin Miguel 
Published: September 2014

Purpose Currently, antiangiogenic strategies in metastatic breast cancer have demonstrated modest improvements in progression-free survival (PFS) but not improved quality or duration of survival, warranting evaluation of new agents in a placebo-controlled setting. Ramucirumab is a human immunoglobulin G1 antibody that binds vascular endothelial growth factor receptor-2 and blocks ligand-stimulated activation. The ROSE/TRIO-012 trial evaluated ramucirumab with docetaxel in unresectable, locally recurrent, or metastatic breast cancer. Patients and Methods In this double-blind, placebo-controlled, randomized, multinational phase III trial, 1,144 patients with human epidermal growth factor receptor 2 (HER2) –negative breast cancer who had not received cytotoxic chemotherapy in the advanced setting were randomly assigned at a two-to-one ratio to receive docetaxel 75 mg/m2 plus ramucirumab 10 mg/kg or docetaxel 75 mg/m2 plus placebo once every 3 weeks. Treatment continued until disease progression, unacceptable toxicity, or other withdrawal criteria. Patients were stratified by previous taxane therapy, visceral metastasis, hormone receptor status, and geographic region. An independent data monitoring committee oversaw the trial. The primary end point was investigator-assessed PFS. Results Median PFS in patients treated with ramucirumab plus docetaxel was 9.5 months, compared with 8.2 months in patients who received placebo plus docetaxel (hazard ratio [HR], 0.88; P = .077). Median overall survival was 27.3 months in patients who received ramucirumab plus docetaxel, compared with 27.2 months in patients who received placebo plus docetaxel (HR, 1.01; P = .915). Toxicities seen at significantly higher rates in patients receiving ramucirumab included fatigue, hypertension, febrile neutropenia, palmar-plantar erythrodysesthesia syndrome, and stomatitis. Conclusion Addition of ramucirumab to docetaxel in HER2-negative advanced breast cancer did not meaningfully improve important clinical outcomes.
The Angina Plan: Correcting the misconceptions of patients with coronary heart disease
Authors: MacLean Elizabeth , Patience Fiona , Leslie Stephen 
Published: September 2014

The Angina Plan is a brief cognitive behavioural intervention for patient with stable angina which aims to educate patients and correct cardiac misconceptions, thus improving symptoms and quality of life. It is a simple, inexpensive and effective programme which has been proven to reduce episodes of angina, GTN use, anxiety, depression and physical limitation and increase activity in patients with stable angina. This paper describes the clinical importance of correcting cardiac misconceptions and the potential benefi ts of the Angina Plan. Practical advice on the delivery of the Angina Plan is given and results from a local patient satisfaction survey are reported.
Body fluid: components and disorders of pleural and pericardial fluid
Authors: Peate Ian 
Published: September 2014

Healthcare assistants (HCAs) and assistant practitioners (APs) are constantly striving to provide care that is safe and effective. Understanding how body fluids work, their function and the changes that may occur in ill health, can help HCAs and APs provide care that is informed. Pleural and pericardial fluids are secreted by serous membranes, in ill health patho-physiological changes can occur that can impinge on a person's health and wellbeing. This article provides an overview of both body fluids.
Caring for the person with osteoarthritis
Authors: Peate Ian 
Published: September 2014

Osteoarthritis refers to a clinical syndrome of joint pain accompanied by varying degrees of functional limitation and reduced quality of life. It is the most common form of arthritis and globally one of the leading causes of pain and disability. There are a number of treatment options available to improve quality of life and enhance wellbeing. The healthcare assistant and assistant practitioner, as part of a multidisciplinary team, can contribute positively to the overall quality of care a person with osteoarthritis receives. This article begins by providing an understanding of joints, a key requisite when helping and caring for people with osteoarthritis. The condition is outlined and possible causes discussed. Signs and symptoms, investigations that may be undertaken in order to reach a diagnosis, the care and treatment and the provision of a number of teaching points are given. Finally a glossary of terms is included.
What are assistant practitioners?
Authors: Kilgannon Helen , Mullen Chris 
Published: September 2014

In 2002, NHS and social care organizations in the North West recognized that there were a number of workforce problems. Vacancies were increasing and pressure was mounting for a more flexible and productive workforce. A number of political factors were beginning to impact on workforce planning and development, for example, the European Working Time Directive was introduced, requiring that doctors work no more than a 48-hour week by 2009. In 2002, the majority were working in excess of 60 hours a week. At the same time, the Department of Health published Human Resources in the NHS Plan (2002). This plan detailed the need for the NHS to: ‘build jobs round patients, rather than round professions and to reduce the procession of faces the patient sees’
Workplace stress and bullying: liabilities of the employer
Authors: Dimond Bridgit 
Published: September 2014

Case Scenario Iris works in the intensive care unit at Roger Park Hospital. One of her responsibilities is to arrange the rota for staff cover. As a result of the shortage of intensive care nurses locally, she is compelled to use agency nurses and to plead with her colleagues to work additional shifts or overtime. On some occasions she has been close to asking senior management to consider halting admissions and leaving beds empty, because she is unable to arrange cover. She increasingly finds that she is unable to cope with the situation: she is unable to sleep, she is worrying about work when not on duty and feels that she is close to a nervous breakdown. What is the law?
Selective non-operative management of penetrating liver injuries at a UK tertiary referral centre
Authors: MacGoey P , Navarro A , Beckingham IJ , Cameron IC , Brooks AJ 
Published: September 2014

Introduction Selective non-operative management (SNOM) of penetrating abdominal injuries has increasingly been applied in North America in the last decade. However, there is less acceptance of SNOM among UK surgeons and there are limited data on UK practice. We aimed to review our management of penetrating liver injuries and, specifically, the application of SNOM. Methods A retrospective review was performed of patients presenting with penetrating liver injuries between June 2005 and November 2013. Results Thirty-one patients sustained liver injuries due to penetrating trauma. The vast majority (97%) were due to stab wounds. The median injury severity score was 14 and a quarter of patients had concomitant thoracic injuries. Twelve patients (39%) underwent immediate surgery owing to haemodynamic instability, evisceration, retained weapon or diffuse peritonism. Nineteen patients were stable to undergo computed tomography (CT), ten of whom were selected subsequently for SNOM. SNOM was successful in eight cases. Both patients who failed SNOM had arterial phase contrast extravasation evident on their initial CT. Angioembolisation was not employed in either case. All major complications and the only death occurred in the operatively managed group. No significant complications of SNOM were identified and there were no transfusions in the non-operated group. Those undergoing operative management had longer lengths of stay than those undergoing SNOM (median stay 6.5 vs 3.0 days, p<0.05). Conclusions SNOM is a safe strategy for patients with penetrating liver injuries in a UK setting. Patient selection is critical and CT is a vital triage tool. Arterial phase contrast extravasation may predict failure of SNOM and adjunctive angioembolisation should be considered for this group.
A prospective study on the risk of glove fingertip contamination during draping in joint replacement surgery
Authors: Makki D , Deierl K , Pandit A , Trakru S 
Published: September 2014

Introduction The aim of this prospective study was to investigate the risk of contamination of surgical gloves during preparation and draping in joint replacement surgery. Methods During 46 hip and knee replacement procedures, the gloves of orthopaedic consultants (n=5) and registrars (n=3) were assessed for contamination immediately after draping by impression of gloved fingers on blood agar. Contamination was evaluated by the surgeon’s grade, the type of procedure, the role of the assistant and the dominance of the hand. Results A total of 125 pairs of top gloves were examined (79 pairs from registrars and 46 pairs from consultants). Bacterial contamination was isolated on 19 pairs (15.2%) (16 pairs from registrars and 3 pairs from consultants, p=0.04). Coagulase negative staphylococci were the main isolates and contamination was considered low in all cases (1–5 colonies). Contamination was seen more on the dominant hand (16 gloves from dominant hands and 6 from non-dominant hands, p=0.04), on the index finger and thumb. More contaminated gloves were seen in hip arthroplasty procedures (16 pairs from total hip replacements vs 3 pairs from total knee replacements, p=0.02). Conclusions Contamination of glove fingertips during draping in joint replacement procedures is more likely to occur among junior surgeons, in hip rather than knee arthroplasty procedures and on the dominant hand. It is therefore essential that surgeons of different grades replace gloves used in draping to avoid exposing patients to the risk of infection.
The impact of surgeon handedness in total hip replacement
Authors: Pennington N , Redmond A , Stewart T , Stone M 
Published: September 2014

Introduction Total hip replacement (THR) is successful and performed commonly. Component placement is a determinant of outcome. Influence of surgeon handedness on component placement has not been considered previously. This study was a radiographic assessment of component positioning with respect to handedness. Early data from 160 patients are reported. Methods Overall, 160 primary THRs for osteoarthritis were included. Equal numbers of left and right THRs were performed by four surgeons, two right-handed and two left-handed. Postoperative radiography was assessed for THR component position by measurement of leg length inequality, acetabular inclination and centre of rotation. Surgeons’ handedness was assessed using the Edinburgh inventory. Results For leg length inequality, no significant interaction was seen between hip side and surgeon handedness. Acetabular inclination angles showed a statistically significant difference, however, depending on hand dominance, with higher inclination angles recorded when operating on the dominant side. There was a trend towards greater medialisation of the centre of rotation on the non-dominant side although this did not reach statistical significance. Conclusions Surgeon handedness appears to influence acetabular component position during THR but it is one factor of many that interact to achieve a successful outcome.
A cross-specialty survey to assess the application of risk stratified surgery for differentiated thyroid cancer in the UK
Authors: Craig WL , Ramsay CR , Fielding S , Krukowski ZH 
Published: September 2014

Introduction This study describes variability of treatment for differentiated thyroid cancer among thyroid surgeons, in the context of changing patterns of thyroid surgery in the UK. Methods Hospital Episodes Statistics on thyroid operations between 1997 and 2012 were obtained for England. A survey comprising six scenarios of varying ‘risk’ was developed. Patient/tumour information was provided, with five risk stratified or non-risk stratified treatment options. The survey was distributed to UK surgical associations. Respondent demographics were categorised and responses analysed by assigned risk stratified preference. Results From 1997 to 2012, the Hospital Episode Statistics data indicated there was a 55% increase in the annual number of thyroidectomies with a fivefold increase in otolaryngology procedures and a tripling of cancer operations. Of the surgical association members surveyed, 264 respondents reported a thyroid surgery practice. Management varied across and within the six scenarios, and was not related consistently to the level of risk. Associations were demonstrated between overall risk stratified preference and higher volume practice (>25 thyroidectomies per year) (p=0.011), fewer years of consultant practice (p=0.017) and multidisciplinary team participation (p=0.037). Logistic regression revealed fewer years of consultant practice (odds ratio [OR]: 0.96/year in practice, 95% confidence interval [CI]: 0.922–0.997, p=0.036) and caseload of >25/year (OR 1.92, 95% CI: 1.044–3.522, p=0.036) as independent predictors of risk stratified preference. Conclusions There is a substantial contribution to thyroid surgery in the UK by otolaryngology surgeons. Adjusting management according to established case-based risk stratification is not widely applied. Higher caseload was associated with a preference for management tailored to individual risk.
Ethylene polymerization with an alpha-diimine nickel (II) complex covalently supported on SiO2
Authors: Jiang Hongliu , Lu Jinshan 
Published: September 2014

Abstract A new strategy has been developed to prepare silica-supported α- diimine nickel (II) complex for ethylene polymerization. The bis(4-allyl-2,6- diisopropylphenyl-imino)acenaphthene was modified by the introduction of reactive Si-Cl end groups, allowing the immobilization of them via the direct reaction of the Si-Cl groups with hydroxyls on the silica surface. The resultant Si-Cl-modified bis(4-allyl-2,6-diisopropylphenyl-imino)acenaphthene ligand and the SiO2 supported ligand were characterized by NMR and FTIR spectroscopic techniques, respectively. The reaction of the supported ligand with (1,2-dimethoxyethane)NiBr2 ((DME)NiBr2) gives rise to silica-supported Ni(II) precatalyst, which exhibits high catalytic activities for ethylene polymerization in the presence of inexpensive general alkylaluminum compounds. According to high-temperature GPC, the polyethylene had average molecular weights in the range 0.246x106---1.217x106 and molecular weight distributions in the range 3.17-3.51. The resultant polyethylenes were confirmed by 13C-NMR to contain significant amounts not only of methyl but also of ethyl, propyl, butyl, amyl, and longer side chains (longer than six carbons).
Synthesis and characterization of new, liquid, branched poly(methylvinylborosiloxanes)
Authors: Chruściel Jerzy , Fejdyś Marzena , Fortuniak Witold 
Published: September 2014

Abstract New liquid branched poly(methylvinylborosiloxanes) (br-PMVBS) of random structure were synthesized in three steps. By reacting boric acid with an excess of dimethyldichlorosilane (Me2SiCl2) in dry ether a “borosiloxane precursor”: tris(chlorodimethylsilyl) borate B(OSiMe2Cl)3 was prepared. In the second step of synthesis ether solution of B(OSiMe2Cl)3 was added to a mixture of appropriate organic chlorosilanes (Me2SiCl2, MeViSiCl2, MeSiCl3, and Me3SiCl) and all reagents were reacted with stoichiometric amounts of water, in the presence of pyridine (as an acceptor of HCl), in dry ether, at low temperature (usually at -10 to 0 C). In order to fully react (“to block”) trace silanol groups, reactions of intermediate PMVBS with additional batches of Me3SiCl were carried out in the third step, C5H5N·HCl was filtered off and washed with a dry ether. The solvent was distilled off from filtrates and low molecular weight siloxane oligomers were removed by a vacuum distillation at 130-150 C. Chemical structures of br-PMVBS were confirmed by elemental analysis and spectroscopic methods (FTIR, emission atomic spectroscopy ICP-AES, and NMR: 1H, 29Si and 11B). On the basis of analysis of their 29Si-NMR spectra the microstructure of polysiloxane chains was proposed. The prepared br-PMVBS had in their structures: triple branching borosiloxane units: BO1.5 and in some cases methylsiloxane moiety CH3SiO1.5 (T). They contained linkages: Si-O-Si, Si-O-B, vinyl(methyl)siloxane functional groups (CH2=CH)MeSiO (Dvi), dimethylsiloxane mers (CH3)2SiO (D), and non-reactive trimethylsiloxy terminal groups (CH3)3SiO0.5 (M), but they did not have: hydroxyl functional groups: Si-OH and B-OH, and sensitive to water B-O-B linkages. Molecular weights of br-PMVBS (Mn = 1500-3300 g/mol; Mw = 3800-7400 g/mol) and their polydispersity (Mw/Mn = 2.0-2.5) were determined by a size exclusion chromatography (SEC).