bluuebunny/crossref_metadata_2025_split huggingface dataset:
Review article: Improving the hospital clinical handover between paramedics and emergency department staff in the deteriorating patient
Authors: Dawson Sarah , King Lindy , Grantham Hugh 
Published: October 2015

AbstractClinical communication and recognising and responding to a deteriorating patient are key current patient safety issues in healthcare. The aim of this literature review is to identify themes associated with aspects of the hospital clinical handover between paramedics and ED staff that can be improved, with a specific focus on the transfer of care of a deteriorating patient. Extensive searches of scholarly literature were conducted using the main medical and nursing electronic databases, including Cumulative Index to Nursing and Allied Health Literature, Medline and PubMed, during 2011 and again in July 2012. Seventeen peer‐reviewed English‐language original quantitative and qualitative studies from 2001 to 2012 were selected and critically appraised using an evaluation tool based on published instruments. Relevant themes identified were: professional relationships, respect and barriers to communication; multiple or repeated handovers; identification of staff in the ED; significance of vital signs; need for a structured handover tool; documentation and other communication methods and education and training to improve handovers. The issues raised in the literature included the need to: produce more complete and concise handovers, create respectful and effective communication, and identify staff in the ED. A structured handover tool such as ISBAR (a mnemonic covering Introduction, Situation, Background, Assessment and Recommendations) would appear to provide a solution to many of these issues. The recording of vital signs and transfer of these data might be improved with better observation systems incorporating early warning strategies. More effective teamwork could be achieved with further clinical communications training.
Removal Kinetics of Antibodies Against Glutamic Acid Decarboxylase by Various Plasmapheresis Modalities in the Treatment of Neurological Disorders
Authors: Ohkubo Atsushi , Okado Tomokazu , Kurashima Naoki , Maeda Takuma , Miyamoto Satoko , Nakamura Ayako , Seshima Hiroshi , Iimori Soichiro , Sohara Eisei , Uchida Shinichi , Rai Tatemitsu 
Published: October 2015

AbstractPlasmapheresis is one of the acute treatment modalities for neurological disorders associated with antibodies against glutamic acid decarboxylase (anti‐GAD). However, there is little information about the removal kinetics of anti‐GAD by various plasmapheresis modalities. Here, we investigated the removal rate of anti‐GAD and fibrinogen (Fib) by immunoadsorption (IA), plasma exchange using a conventional plasma separator (OP‐PE), and plasma exchange using a high cut‐off selective membrane plasma separator (EC‐PE) in two cases of anti‐GAD‐associated neurological diseases. In case 1, IA and OP‐PE were used, and the percent reductions were as follows: anti‐GAD: 38.2% and 69.1% and Fib: 67.7% and 68.2%, respectively. In case 2, OP‐PE and EC‐PE were used, and the percent reductions were as follows: anti‐GAD: 65.8% and 48.5% and Fib: 68.5% and 19.8%, respectively. OP‐PE could remove anti‐GAD more efficiently than IA. Further, EC‐PE could maintain coagulation factors such as Fib better than IA and OP‐PE. It is important to select the appropriate plasmapheresis modality on the basis of the removal kinetics.
Efficacy of Granulocyte and Monocyte Adsorption Apheresis for Treatment of Palmoplantar Pustulosis
Authors: Fujisawa Tomomi , Tawada Chisato , Mizutani Yoko , Doi Tomoaki , Yoshida Shozo , Ogura Shinji , Seishima Mariko 
Published: October 2015

AbstractPalmoplantar pustulosis (PPP) is characterized by neutrophilic pustules with erythema, which are limited to the hands and feet. Although granulocyte and monocyte adsorption apheresis (GMA) has shown remarkable effects on generalized pustular psoriasis, there are few reports of PPP treated with GMA. We treated three refractory PPP patients using GMA weekly for 5 weeks. The skin eruptions were assessed by a 5‐grade score for scales, pustules, and erythema. GMA decreased the total grade from 9 to 2 in patients 1 and 2, and from 7 to 3 in patient 3. The GMA effects were estimated to be excellent in all three patients. Pustule formation and pain disappeared in all cases. The treatment effect lasted for at least 5 months after GMA. GMA was also effective for relieving the arthralgia in one patient, but it recurred at 6 weeks. Based on these findings, GMA could be an effective therapy for refractory PPP.
Relationship Between Tumor Necrosis Factor‐α Release and Granulocyte and Monocyte Adsorption to Cellulose Acetate Beads
Authors: Nishise Shoichi , Abe Yasuhiko , Nomura Eiki , Sato Takeshi , Sasaki Yu , Iwano Daisuke , Yoshizawa Kazuya , Yagi Makoto , Nishise Yuko , Ueno Yoshiyuki 
Published: October 2015

AbstractTumor necrosis factor‐α, (TNF)‐α, a proinflammatory cytokine, is produced by activated granulocytes and monocytes (GMs) and implicated as a major factor in inflammatory bowel disease (IBD) pathogenesis. Reduction of TNF‐α should improve IBD pathology. GM adsorptive apheresis (GMA) is an effective therapy for inflammatory disorders including IBD. GM adsorption to cellulose acetate (CA) beads induces anti‐inflammatory cytokine release, although these effects on TNF‐α release are not clarified. We hypothesized that GMA may inhibit TNF‐α release. The aim of the present study was to clarify the effects of GM adsorption to CA beads on TNF‐α release in vitro. Peripheral blood was incubated with and without CA beads and TNF‐α was measured. For comparison, TNF‐α was measured in another lipopolysaccharide (LPS)‐containing peripheral blood sample incubated similarly. The amount of TNF‐α in blood samples incubated with CA beads was significantly higher than in those incubated without beads, although it was significantly lower than TNF‐α incubated with LPS‐containing sample without beads. The amount of TNF‐α after incubation with CA beads positively correlated with GM adsorption ratio. GM adsorption to CA beads induced a small amount of TNF‐α release. This is the first report on TNF‐α release induced via GM adsorption stimuli. The biological effects of TNF‐α release during GM adsorption need to be clarified.
Taxonomic review of genus Evergestis Hübner (Lepidoptera: Crambidae) from Northeast China
Authors: Qi Mu‐jie , Park Bo‐Sun , Li Cheng‐de , Le Xuanvi , Bae Yang‐Seop 
Published: October 2015

AbstractFour species of the genus Evergestis Hübner, 1816–1826 are recognized from NE China, of which E. pallidata (Hufnagel 1767) is reported for the first time from China. The adults and genitalia of the species are briefly redescribed and illustrated with their distributional ranges, host plants and biology. A key to species of the genus based on the external characters is provided.
Characterisation of Pectobacterium wasabiae and Pectobacterium carotovorum subsp. carotovorum isolates from diseased potato plants in Finland
Authors: Pasanen M. , Laurila J. , Brader G. , Palva E.T. , Ahola V. , van der Wolf J. , Hannukkala A. , Pirhonen M. 
Published: October 2015

AbstractTo identify bacteria causing soft rot and blackleg in potato in Finland, pectinolytic enterobacteria were isolated from diseased potato stems and tubers. In addition to isolates identified as Pectobacterium atrosepticum and Dickeya sp., many of the isolated strains were identified as Pectobacterium carotovorum subsp. carotovorum. Phylogenetic analysis and biochemical tests indicated that one of the isolates from potato stems resembled Pectobacterium wasabiae. Furthermore, two blackleg‐causing P. carotovorum strains recently isolated in Europe clustered with P. wasabiae, suggesting that at least some of these isolates were originally misidentified. All the other Finnish P. carotovorum isolates resembled the subsp. carotovorum type strain in biochemical tests but could be clustered into two distinct groups in the phylogenetic analysis. One of the groups mainly contained strains isolated from diseased tubers, whereas the other mainly included isolates from potato stems. In contrast to the tuber isolates, the stem isolates lacked genes in Type III secretion genes, were not able to elicit a hypersensitive response in tobacco leaves and produced only small amounts of autoinducers in the stationary phase in vitro. P. wasabiae isolate was able to cause similar amount of blackleg‐like symptoms as P. atrosepticum in a field experiment with vacuum‐infiltrated tubers, whereas both P. atrosepticum and P. carotovorum isolates reduced emergence and delayed growth more than P. wasabiae. Our findings confirm the presence of P. wasabiae in Finland and show that the Finnish P. carotovorum subsp. carotovorum isolates can be divided into two groups with specific characteristics and possibly also different ecologies.
What small rural emergency departments do: A systematic review of observational studies
Authors: Baker Tim , Dawson Samantha L. 
Published: October 2015

AbstractObjectiveSmall rural emergency facilities are an important part of emergency care in many countries. We performed a systematic review of observational studies to determine what is known about the patients these small rural emergency facilities treat, what types of interventions they undertake and how well they perform.MethodsPubmed/Medline and Embase databases were systematically reviewed between 1980 and the present. Studies were included if they described hospital‐affiliated emergency care facilities which were open 24‐hours every day, and described themselves as rural, non‐urban or non‐metropolitan. Studies were excluded if facilities saw more than 15 000 patients annually. Study quality was assessed using 12 previously described indicators. Key activity and performance data were reported for individual studies but not numerically combined between studies.ResultsThe search strategy found 19 studies that included quantitative data on activity and performance. Nine studies were from Canada, six were from Australia and four from the United States. The settings and scales used varied widely. Few studies adhered to methodological recommendations. The most common presentation was for injury or poisoning (30–53%). The number of patients requiring attention within 15 min was small (2.5–2.8%). Nurses treated many patients without physician input.ConclusionsThere is only enough evidence in the literature to make the most basic inferences about what small rural emergency departments do. To allow evidence‐based improvement, descriptive studies must employ measures and methods validated in the wider emergency medicine literature, and other research techniques should be considered.
Comparison of appendicectomy outcomes: acute surgical versus traditional pathway
Authors: Pillai Sandhya , Hsee Li , Pun Andy , Mathur Sachin , Civil Ian 
Published: October 2015

AbstractIntroductionThe acute surgical unit (ASU) is an evolving novel concept introduced to address the challenge of maintaining key performance indicators (KPIs) in the face of an increasing acute workload.MethodsThe aim of this retrospective study was to compare the performance of the ASU (from June 2008 to December 2010) at Auckland City Hospital with the traditional model (from January 2006 to May 2008) and benchmark the results against other similar published studies. The analysis was on the basis of KPIs for 1857 appendicectomies, which form a large volume of acute surgical presentations.ResultsOur results show significant improvement in length of stay (2.8 days, 2.6 days, P = 0.0001) and proportion of daytime operations (59.4%, 65.8%, P = 0.004), in keeping with other studies on benchmarking.ConclusionThe introduction of ASU has led to significant improvements in some KPIs for appendicectomy outcomes in the face of an increasing workload.
Exercise Hemodynamics During Extended Continuous Flow Left Ventricular Assist Device Support: The Response of Systemic Cardiovascular Parameters and Pump Performance
Authors: Martina Jerson , Jonge Nicolaas , Rutten Marcel , Kirkels J. Hans , Klöpping Corinne , Rodermans Ben , Sukkel Eveline , Hulstein Nelienke , Mol Bas , Lahpor Jaap 
Published: October 2015

AbstractPatients on continuous flow left ventricular assist devices (cf‐LVADs) are able to return to an active lifestyle and perform all sorts of physical activities. This study aims to evaluate exercise hemodynamics in patients with a HeartMate II cf‐LVAD (HM II). Thirty (30) patients underwent a bicycle exercise test. Along with exercise capacity, systemic cardiovascular responses and pump performance were evaluated at 6 and 12 months after HM II implantation. From rest to maximum exercise, heart rate increased from 87 ± 14 to 140 ± 32 beats/minute (bpm) (P < 0.01), while systolic arterial blood pressure increased from 93 ± 12 to 116 ± 21 mm Hg (P < 0.01). Total cardiac output (TCO) increased from 4.1 ± 1.1 to 8.5 ± 2.8 L/min (P < 0.01) while pump flow increased less, from 5.1 ± 0.7 to 6.4 ± 0.6 L/min (P < 0.01). Systemic vascular resistance (SVR) decreased from 1776 ± 750 to 1013 ± 383 dynes.s/cm5 (P < 0.001) and showed the strongest correlation with TCO (r = −0.72; P < 0.01). Exercise capacity was affected by older age, while blood pressure increased significantly in men compared with women. Exercise capacity remained consistent at 6 and 12 months after HM II implantation, 51% ± 13% and 52% ± 13% of predicted VO2max for normal subjects corrected for age and gender. In conclusion, pump flow of the HM II may contribute partially to TCO during exercise, while SVR was the strongest determinant of TCO.
Vertebral fractures in two alpaca crias with rickets syndrome
Authors: Stieger‐Vanegas SM , Garret R , McKenzie EC , Löhr CV 
Published: October 2015

Case reportTwo dark‐coloured alpaca crias aged 5 and 5.5 months, respectively, born in September in thePacificNorthwest,USA, were presented for evaluation of acute recumbency.Both crias had cervical spine fractures and one had additional fractures in other locations within the spine. Both crias had valgus deformities of the forelimbs and one had similar deformities of the hindlimbs. Both crias showed characteristic radiological signs of rickets syndrome, including wide, irregular physes, cupping of the metaphyses, bowing of long bones, pathological fractures and enlarged costochondral junctions.One cria responded clinically to treatment with parenteral administration of vitaminD. The other cria was euthanased because of the multiple spinal fractures and postmortem examination supported the diagnosis of rickets syndrome.ConclusionsHypovitaminosisDis associated with abnormal bone formation in young growing animals. The clinical and laboratory findings of rickets syndrome in camelids in thePacificNorthwest, and other regions with low annual sunlight exposure, have been described, although there are only few reports of the radiological signs associated with this condition in camelids and other animals. Additionally, vertebral fractures have not been previously reported in animals with rickets syndrome. Because vertebral fractures were identified in both crias in this report, it suggests that this is a common and clinically important manifestation of the disease in alpaca crias. Hence, in geographic regions with low sunlight exposure, rickets syndrome should be considered as a differential diagnosis in crias presenting with clinical signs consistent with vertebral fracture.
Serological survey for antibodies against bovine viral diarrhoea virus and Neospora caninum in a population of South Australian alpacas (Vicugna pacos)
Authors: Cockcroft PD , Dornin LE , Lambert RC , Perry J , Reichel MP 
Published: October 2015

ObjectiveBovine viral diarrhoea virus (BVDV) and Neospora caninum may cause clinical disease in alpacas. Both diseases are present in the Australian cattle population. The objective of this study was to perform a serological prevalence survey for BVDV and N. caninum exposure in a regional alpaca population of South Australia.MethodsSerum samples were taken from 182 alpacas on 10 farms, which had a combined population of 1308 alpacas. Serological analysis for BVD antibodies was performed using a competitive BVDV antibody ELISA kit. Serological analysis for N. caninum was performed using an anti‐Neospora ELISA with a protein G conjugate.ResultsOf the 182 alpacas sampled, 5 animals located on three properties were positive for BVDV antibodies, constituting a prevalence of 2.7% (95% confidence interval 1–6%). All samples tested negative for N. caninum antibodies.ConclusionThere is a low BVDV seroprevalence and N. caninum is currently either absent or present at a very low prevalence in this population of alpacas in South Australia. There is serological evidence for the presence of both organisms in South Australian beef and dairy cattle herds. Appropriate biosecurity protocols to minimise the risk of introduction and exposure should be a high priority to maintain this favourable status.
Giving Birth with Rape in One's Past: A Qualitative Study
Authors: Halvorsen Lotta , Nerum Hilde , Øian Pål , Sørlie Tore 
Published: October 2015

AbstractBackgroundRape is one of the most traumatizing violations a woman can be subjected to, and leads to extensive health problems, predominantly psychological ones. A large proportion of women develop a form of posttraumatic stress termed Rape Trauma Syndrome. A previous study by our research group has shown that women with a history of rape far more often had an operative delivery in their first birth and those who gave birth vaginally had second stages twice as long as women with no history of sexual assault. The aim of this study is to examine and illuminate how women previously subjected to rape experience giving birth for the first time and their advice on the kind of birth care they regard as good for women with a history of rape.MethodsA semi‐structured interview with 10 women, who had been exposed to rape before their first childbirth. Data on the birth experience were analyzed by qualitative content analysis.ResultsThe main theme was “being back in the rape” with two categories: “reactivation of the rape during labor,” with subcategories “struggle,” “surrender,” and “escape” and “re‐traumatization after birth,” with the subcategories “objectified,” “dirtied,” and “alienated body.”ConclusionA rape trauma can be reactivated during the first childbirth regardless of mode of delivery. After birth, the women found themselves re‐traumatized with the feeling of being dirtied, alienated, and reduced to just a body that another body is to come out of. Birth attendants should acknowledge that the common measures and procedures used during normal birth or cesarean section can contribute to a reactivation of the rape trauma.
The long‐term outcome of patients in the LRF CLL4 trial: the effect of salvage treatment and biological markers in those surviving 10 years
Authors: Else Monica , Wade Rachel , Oscier David , Catovsky Daniel 
Published: October 2015

SummaryWith 10+ years follow‐up in the Leukaemia Research Fund (LRF) CLL4 trial, we report the effect of salvage therapy, and the clinical/biological features of the 10‐year survivors treated for chronic lymphocytic leukaemia (CLL). Overall survival (OS) was similar in the three randomized arms. With fludarabine‐plus‐cyclophosphamide (FC), progression‐free survival (PFS) was significantly longer (P < 0·0001), but OS after progression significantly shorter, than in the chlorambucil or fludarabine arms (P < 0·0001). 614/777 patients progressed; 524 received second‐line and 260 third‐line therapy, with significantly better complete remission (CR) rates compared to first‐line in the chlorambucil arm (7% vs. 13% after second‐, 18% after third‐line), but worse in the FC arm (38% vs. 15% after both second and third‐line). OS 10 years after progression was better after a second‐line CR versus a partial response (36% vs. 16%) and better with FC‐based second‐line therapy (including rituximab in 20%) or a stem cell transplant (28%) versus all other treatments (10%, P < 0·0001). The 176 (24%) 10‐year survivors tended to be aged <70 years, with a “good risk” prognostic profile, stage A‐progressive, achieving at least one CR, with a first‐line PFS >3 years and receiving ≤2 lines of treatment. In conclusion, clinical/biological features and salvage treatments both influence the long‐term outcome. Second‐line therapies that induce a CR can improve OS in CLL patients.
Immunology of membranous nephropathy: from animal models to humans
Authors: Sinico R A , Mezzina N , Trezzi B , Ghiggeri GM , Radice A 
Published: October 2015

Summary
Membranous nephropathy (MN), the leading cause of nephrotic syndrome in adults, is characterized by the deposition of subepithelial immune deposits that consist mainly of immunoglobulin (Ig)G and complement. Most of the cases are primary or idiopathic (iMN), while only approximately 25% of the cases are secondary to some known disease such as systemic lupus erythematosus, hepatitis B, drugs and malignancies. Most of our knowledge on the pathogenesis of iMN has relied upon old experimental models (i.e. Heymann nephritis) that have shown that immune deposits are formed in situ by the reaction of autoantibodies against the respective podocyte antigen. Recent findings indicate that podocyte proteins also act as an autoantigen in human iMN. The M-type phospholipase A2 receptor (PLA2R) has been identified as the main target antigen, as it can be found in approximately 70% of iMN patients but only rarely in other glomerulonephritides. Podocytes damage in the experimental model of Heymann nephritis is complement-mediated. In humans, the presence of complement within the subepithelial deposits is well established, but IgG4, which does not activate complement by classical or alternative pathways, represents the predominant subclass of IgG anti-PLA2R. Some evidence suggests that IgG4 anti-PLA2R autoantibodies can bind mannan-binding lectin (MBL) and activate the lectin complement pathway. A genetic background for iMN has been demonstrated by genome-wide association studies that have shown highly significant associations of the PLA2R1 and the human leucocyte antigen (HLA)-DQA1 loci with iMN. In addition to their diagnostic value, anti-PLA2R antibodies may be useful to monitor disease activity and predict response to treatment.
Detection of Geometric Temporal Changes in Point Clouds
Authors: Palma Gianpaolo , Cignoni Paolo , Boubekeur Tamy , Scopigno Roberto 
Published: October 2015

AbstractDetecting geometric changes between two 3D captures of the same location performed at different moments is a critical operation for all systems requiring a precise segmentation between change and no‐change regions. Such application scenarios include 3D surface reconstruction, environment monitoring, natural events management and forensic science. Unfortunately, typical 3D scanning setups cannot provide any one‐to‐one mapping between measured samples in static regions: in particular, both extrinsic and intrinsic sensor parameters may vary over time while sensor noise and outliers additionally corrupt the data. In this paper, we adopt a multi‐scale approach to robustly tackle these issues. Starting from two point clouds, we first remove outliers using a probabilistic operator. Then, we detect the actual change using the implicit surface defined by the point clouds under a Growing Least Square reconstruction that, compared to the classical proximity measure, offers a more robust change/no‐change characterization near the temporal intersection of the scans and in the areas exhibiting different sampling density and direction. The resulting classification is enhanced with a spatial reasoning step to solve critical geometric configurations that are common in man‐made environments. We validate our approach on a synthetic test case and on a collection of real data sets acquired using commodity hardware. Finally, we show how 3D reconstruction benefits from the resulting precise change/no‐change segmentation.