bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of ultrasound determination of fetal head position on mode of delivery: a pragmatic randomized trial
Authors: Popowski T. , Porcher R. , Fort J. , Javoise S. , Rozenberg P. 
Published: January 2015

AbstractObjectiveTo evaluate the influence of ultrasound determination of fetal head position on mode of delivery.MethodsThis was a pragmatic open‐label randomized controlled trial that included women with a singleton pregnancy in the vertex presentation at ≥ 37 weeks' gestation, cervical dilation ≥ 8 cm and who received epidural anesthesia. Women were assigned randomly to undergo either digital vaginal examination (VE group) or both digital vaginal and ultrasound examinations (VE+US group) to determine fetal head position. When the ultrasound and digital vaginal findings were inconsistent in the VE+US group, the ultrasound result was used for clinical management. The primary outcome assessed was operative delivery (Cesarean or instrumental vaginal delivery), and maternal and fetal morbidity were also assessed.ResultsThe VE and VE+US groups included 959 and 944 women, respectively. The overall rate of operative delivery was significantly higher in the VE+US group than in the VE group: 33.7% vs 27.1%, respectively (relative risk (RR), 1.24 (95% CI, 1.08–1.43)), as was the rate of Cesarean delivery: 7.8% vs 4.9%, respectively (RR, 1.60 (95% CI, 1.12–2.28)). The rate of instrumental vaginal delivery was also higher, albeit not significantly: 25.8% in the VE+US group vs 22.2% in the VE group (RR, 1.16 (95% CI, 0.99–1.37)). Neonatal outcomes did not differ between the two groups. When analysis was restricted to instrumental vaginal deliveries only, maternal and neonatal morbidity outcomes were similar in both groups.ConclusionCorrection of fetal occiput position, determined initially by digital vaginal examination, using systematic ultrasound examination did not improve management of labor and increased the rate of operative delivery without decreasing maternal and neonatal morbidity. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.
Management of Retropharyngeal Node Metastases from Thyroid Carcinoma
Authors: Hartl Dana M. , Leboulleux Sophie , Vélayoudom‐Céphise Fritz‐Line , Mirghani Haïtham , Déandréis Désirée , Schlumberger Martin 
Published: January 2015

AbstractBackgroundLymph node metastases are relatively common in thyroid carcinoma, but retropharyngeal nodes (RPN) are rare. Management may be surgical or non‐surgical, according to the context of the disease.MethodsSystematic review of cases reported in the literature and report of 5 cases.ResultsMost case series report surgical management, via a cervical or transoral approach. RPN was the specific object of 26 case series, with a total of 85 patients, with surgery performed in 22/26 studies. Our 5 cases illustrated various strategies in the multidisciplinary management, with surgery for three patients (also with 131I in one case), targeted therapy for one patient with concurrent distant metastases, and watch and wait for one elderly patient.ConclusionsManagement of RPN is not always surgical. Discussion of options in a multidisciplinary tumor board setting may optimize care.
A 2-year follow-up study of patients participating in our transcranial pulsating electromagnetic fields augmentation in treatment-resistant depression
Authors: Bech Per , Lindberg Lone , Straasø Birgit , Larsen Erik Roj 
Published: January 2015

ObjectiveWe have made a 2-year follow-up study to evaluate the effect of repeated transcranial pulsating electromagnetic fields (T-PEMF) augmentation in patients who had achieved remission but later on relapsed, as well as to identify factors contributing to treatment-resistant depression in patients who did not respond to T-PEMF.MethodsUsing the Longitudinal Expert Assessment of All Data approach the patients were classified in four groups: A: patients who achieved remission; B: patients with doubtful effect; C: patients with no effect; and D: patients who were hard-to-assess.ResultsIn group A, comprising 27 patients, 13 had relapsed; they obtained a clear remission after a repeated course of T-PEMF augmentation. In group D, comprising 16 patients, we identified misdiagnostic factors both concerning the event of remission after the previous T-PEMF augmentation and concerning the aetiology (psychosocial stressors and co-morbid conditions). Compared with the other groups, the group D patients had a smaller number of previous episodes (p=0.09) and a longer duration of the current episode (p=0.01).ConclusionT-PEMF has an effect among patients who relapsed after remission with the first series of T-PEMF. Treatment-resistant depression is a condition that has a high degree of multivariate problems. Misuse of alcohol or drugs, severe somatic disorders and other psychosocial problems may need other kinds of treatment before T-PEMF augmentation.
Magnetostrophic balance as the optimal state for turbulent magnetoconvection
Authors: King Eric M. , Aurnou Jonathan M. 
Published: January 2015

Significance
What sets the strength of a planet’s magnetic field? Theory suggests that there exists a “sweet spot” for magnetic field generation, in which the constraining influences of the Coriolis force (from planetary rotation) and Lorentz force (from the magnetic field) partially cancel, and the convective flow that generates magnetic energy is maximally efficient. However, this predicted optimal state, termed the magnetostrophic regime, has not yet been observed in computational dynamo simulations and has never been tested in a real, turbulent liquid metal, and so its existence has recently been called into question. Here, we report the first-ever, to our knowledge, turbulent magnetostrophic convection experiments. We observe that the magnetostrophic regime is, in fact, maximally efficient, substantiating the application of magnetostrophic theory to planets.
Managing public−private partnerships: dealing with business-culture influences
Authors: Tijhuis Wilco 
Published: January 2015

Purpose
– The purpose of this paper is to investigate and analyze actual developments within PPP-projects, and the influences of business-cultures in the management-processes of such international PPP-projects. The paper focusses especially on the procurement, during which potential project-partners are being selected.

Design/methodology/approach
– The researcher adopted a recent model from literature for analyzing business-cultures within construction processes; especially the so called “3C-Model” was used, earlier developed and published within construction-management literature. Based on analysis of literature and comparable situations, conclusions and recommendations have been made for managing international PPP-projects, especially in the project-partners selection phase.

Findings
– Actual approaches within international PPP-projects do need a more structured approach during the selection of the project-partners. It is suggested to use more past-performance information, not only based on financials and/or organizational data/experiences, but also on behavioral (business-culture) data/experiences. This information needs to be structured in a proper way. Suggestions are given focussing on discussion and future-outlook.

Research limitations/implications
– It would be useful to test the findings on further actual cases, testing the further implications of the outcome.

Practical implications
– A better understanding of business-cultures’ influences increases the awareness of project-participants for the advantage of the suggested extra selection-criteria. This might reduce the risk for conflicts during the project-execution in the total project life-cycle.

Social implications
– When improving the actual practices of selection suitable parties for actual and future PPP-projects, it is of great value to be as effective as possible within this selection process. Especially, because this approach can prevent for several unpleasant situations afterwards during the operation-time (life-cycle) of the PPP-project. In this way, a proper handling of business-culture’s influence can save clients and other stakeholders involved (society) a large amount of possible conflicts (claims, etc.) afterwards.

Originality/value
– The proposed approach contributes to a better understanding of project-processes and its stakeholders (i.e. especially the – foreseen – project-participants). Current selection-processes still do not adopt a structured approach for incorporating past-performance behavioral data/experiences; so structuring and using them properly can result in more successful PPP-projects within a fast growing international PPP-market.
Effect of ISO 9001 non-conformity process on cost of poor quality in capital-intensive sectors
Authors: Chiarini Andrea 
Published: January 2015

Purpose
– The purpose of this paper is to investigate whether there are differences in terms of the effect of the ISO 9001 non-conformity process on the cost of poor quality in different sectors. In particular, to investigate the effect on six sectors of companies which manufacture their products mainly through machines and plant (i.e. capital-intensive companies). An additional aim is to understand what the reasons for these differences are and why ISO 9001 has limitations in reducing the different categories of costs of poor quality.

Design/methodology/approach
– The paper is based on a questionnaire administered to a sample of 42 companies divided into six different sectors: chemical, pharmaceutical, mechanical, food, ceramic and steel. Respondents were asked to give a percentage score for the contribution the ISO 9001 non-conformity process makes to the reduction in total cost of poor quality and to its categories: scrap, rework, machine stoppage, re-inspections, rejected products and recall cost. A one-way Anova test was applied to the means of the percentage scores to determine whether there are differences between the means of the total cost of poor quality and its categories. Qualitative comments and suggestions from the companies provided information that helped explain the reasons for such differences.

Findings
– The results of the research show that there is no difference within and between the sectors in the means of the total cost of poor quality and scrap cost, whereas there are significant differences in the means of the other costs of poor quality between the six sectors. The ISO 9001 non-conformity process has limitations in reducing the costs of poor quality and suggestions concerning the limitations of ISO 9001 in the Research and Development process emerge.

Research limitations/implications
– The generalizability of the research findings is limited because of the use of just six sectors of capital-intensive companies. Further research about differences in different sectors is needed.

Practical implications
– The implications of this research are useful for consultants and managers who want to understand what the limitations of the ISO 9001 non-conformity process are on the cost of poor quality in the six sectors. The findings clearly show how, together with ISO 9001, they should take into account other improvement processes such as periodic maintenance and revamping.

Originality/value
– The paper discusses in a quantitative way and for the first time the effects of the ISO 9001 non-conformity process on the cost of poor quality.
A systemic approach to quality improvement in public health services
Authors: Sahel Amina , Alaoui Belghiti Abdelali , DeBrouwere Vincent , Valente Soares Filomena , Kegels Guy , Belkaab Nejoua , Godin Isabelle , Ablefoni Sabine , Schneider Anselm , Dujardin Bruno 
Published: January 2015

Purpose
– The purpose of this paper is to discuss the results of the first four years of implementation of a quality program called “Quality Contest” (QC). This program was implemented from 2007 onward to improve the quality of hospital services by the Moroccan Ministry of Health. The peculiarity of this intervention, held every 18 months, is that it combines several approaches (self-evaluation, external audits with feedback, hospital ranking, awards and performance disclosure) and focuses on the quality of management.

Design/methodology/approach
– The assessment tool used to evaluate the quality of hospital management consists of 80 items. In each contest, a score is attributed to each item based on the score given for self-evaluation and the score given by external auditors. The sum of these scores allows the global performance score of the hospital to be obtained. To compare the performances over time and among hospitals, Wilcoxon signed-rank, Wilcoxon–Mann–Whitney and Kruskal–Wallis statistical tests were used.

Findings
– The results of the QC organized between 2007 and 2010 revealed that the hospitals participating in all the three contests had significantly improved their performance levels in terms of the quality of management. There was also a significant association between the number of times hospitals participated in the QC and the performance scores attained.

Originality/value
– The paper reports an original quality improvement approach in a developing country that succeeded in triggering sustainable improvement dynamics by combining support (feedback) with reward (prizes) and pressure measures (ranking, performance disclosure).
Self‐reported preparedness of New Zealand acute care providers to mass emergencies before the Canterbury Earthquakes: A national survey
Authors: Al‐Shaqsi Sultan , Gauld Robin , McBride David , Al‐Kashmiri Ammar , Al‐Harthy Abdullah 
Published: January 2015

AbstractIntroductionDisasters occur more frequently. Acute care providers are the first to respond to mass emergencies from the healthcare sector. The preparedness of acute care providers in New Zealand to respond to mass emergencies has not been previously studied.ObjectiveTo assess the self‐reported training and experience of New Zealand acute care providers to respond to mass emergencies and the factors associated with strong preparedness.MethodsA cross‐sectional national survey of 1500 acute care providers in New Zealand carried out between 2009 and 2010. The survey assessed experience, training and self‐reported preparedness. It also determined the factors associated with strong perceived preparedness.ResultsThe response rate to this survey was 60.7%. Nurses had a higher response rate than doctors or paramedics. Only 29.2% of acute care providers reported responding to a previous mass emergency event. There were 53.5% of acute care providers who reported having formal training in how to deal with mass emergencies, whereas 58.1% of participants reported that they were aware of their role during a healthcare mass emergency response. The factors associated with self‐reported strong preparedness to deal with mass emergencies included: being a paramedic, previous training, participation in a drill, willingness to report to work during an infection or man‐made emergency, ability to triage and general awareness of the role during a mass emergency.ConclusionAlmost half of New Zealand acute healthcare providers have no training in dealing with mass emergency events. Training and general awareness of the role during a mass emergency response were the main factors associated with strong self‐reported preparedness of acute care providers. The apparent efficacy of training allied to lack of availability means that it should be a national priority.
Redesigning emergency patient flow with timely quality care at the Alfred
Authors: Lowthian Judy , Curtis Andrea , Straney Lahn , McKimm Amy , Keogh Martin , Stripp Andrew 
Published: January 2015

AbstractObjectivesThe 4 h National Emergency Access Target was introduced in 2011. The Alfred Hospital in Melbourne implemented a hospital‐wide clinical service framework, Timely Quality Care (TQC), to enhance patient experience and care quality by improving timeliness of interventions and investigations through the emergency episode and admission to discharge in 2012. We evaluated TQC's effect on achieving the National Emergency Access Target and associated safety and quality indicators.MethodsRetrospective analysis with piecewise regression of 215 125 ED attendances before/after implementation, November 2009 to August 2013; with comparison of proportions of patients discharged, admitted or transferred from ED within 4 h of arrival; left at risk; unplanned ED re‐attendances up to 28 days; ED length of stay; and in‐hospital mortality.ResultsThe percentage of patients admitted, discharged or transferred within 4 h rose from 60% in 2010, to 74% in 2013. Median ED length of stay decreased significantly. Rate of unplanned ED re‐presentations decreased by 27%, 22% and 17% within 24 h, 48 h and 7 days, respectively; and patient numbers leaving at risk halved from 8% to 4%. Mortality for admitted patients declined from 3.5% to 2.2%. All results were statistically significant.Conclusions and future directionsTQC resulted in improvement in timeliness of care for emergency patients without compromising safety and quality. Success is attributed to effective engagement of stakeholders with a hospital‐wide approach to redesigning the care pathway and establishing a new set of principles that underpin care from the time of ED arrival.
Paediatric ECMO at low‐volume paediatric cardiac centres in the Nordic countries
Authors: VEIEN M. , LINDBERG L. , TYNKKYNEN P. , RAVN H. B. 
Published: January 2015

BackgroundExtracorporeal membrane oxygenation (ECMO) is a life‐saving resource‐intensive technology for patients with respiratory and/or circulatory failure. We aimed to evaluate outcome data from three Nordic paediatric centres comparing with data from the International Registry of the Extracorporeal Life Support Organization (ELSO) and selected high‐volume single‐centre studies.MethodsOne‐hundred nineteen patients < 19 years from 2002 to 2012 were enrolled. Data on demographics and outcome were collected using a standardised registration form. Outcome data were compared with the ELSO registry and high‐volume single‐centre studies.ResultsDemographics, indications and diagnosis were similar to the ELSO register. Survival after ECMO was similar to outcome data from the ELSO register, apart from paediatric cardiac ECMO, where a significantly better survival to discharge was seen in the Nordic centres (68% vs. 49%; P = 0.03). Comparison with high‐volume centres in the period after 2005 demonstrated a significantly better survival after cardiac ECMO in a single high‐volume centre study, whereas four studies had significantly lower survival after cardiac ECMO. No significant difference was seen in children receiving respiratory ECMO in the Nordic centres and high‐volume centres.ConclusionsSurvival after ECMO in three low‐volume Nordic centres demonstrated comparable outcome data with ELSO data and data from high‐volume centres. We believe regular quality assurance surveys, as the present study, should be performed in order to maintain excellent therapy within the individual ECMO centres.
Duration of untreated psychosis and pathway to care in Riyadh, Saudi Arabia
Authors: Al Fayez Hanan , Lappin Julia , Murray Robin , Boydell Jane 
Published: January 2015

AbstractAimRecent studies of ‘duration of untreated psychosis’ (DUP) indicate that some patients remain untreated in the community for some time. Considerable emphasis has been placed on reducing the DUP. However, most studies investigating DUP have been conducted in Western countries, where well‐developed primary care systems are available. This study aims to describe DUP and its association with both demographic factors and pathways to care in Riyadh, Saudi Arabia.MethodsA retrospective study of 421 new case records of all Saudi schizophrenia patients over a 2‐year period in six governmental hospitals in Riyadh, Saudi Arabia.ResultsThe median DUP was 1.41 years (interquartile range 0.35–2.81 years). The longest time to contact was 9.86 years but 90% had a DUP shorter than 5 years. Older age at onset, single marital status and higher educational level were associated with shorter DUP. Long DUP was associated with help seeking from traditional healers.ConclusionIn Saudi Arabia, it usually takes longer for patients to seek help from psychiatric services after their first psychosis onset than it does in Western countries. The results suggest that the DUP is influenced by both demographic factors and pathways to care.
Hemodialysis catheter insertion using transrenal approach
Authors: Law Wai Ping , Cheung Chi Yuen , Chan Hoi Wong , Kwok Philip Chong‐hei , Chak Wai Leung , Chau Ka Foon 
Published: January 2015

AbstractWe report a patient suffering from end‐stage renal disease (ESRD) because of lupus nephritis presented with exhausted vascular access after multiple arteriovenous grafts creation and hemodialysis catheters insertion. A rare percutaneous transrenal approach was finally used for the insertion of dialysis catheter. After 2 years, this hemodialysis catheter was complicated by blockage but was successfully replaced by a new catheter via the same site. Our report shows that the transrenal route of hemodialysis catheter insertion can provide a glimpse of hope for those ESRD patients with exhausted vascular access.
Purification of Helicobacter suis Strains From Biphasic Cultures by Single Colony Isolation: Influence on Strain Characteristics
Authors: Liang Jungang , De Bruyne Ellen , Ducatelle Richard , Smet Annemieke , Haesebrouck Freddy , Flahou Bram 
Published: January 2015

BackgroundHelicobacter (H.) suis causes gastritis and decreased weight gain in pigs. It is also the most prevalent non‐Helicobacter pylori Helicobacter species in humans with gastric disease. H. suis is extremely fastidious, and so far, biphasic culture conditions were essential for isolation and culture, making it impossible to obtain single colonies. Hence, cultures obtained from an individual animal may contain multiple H. suis strains, which is undesirable for experiments aiming for instance at investigating H. suis strain differences.Materials and MethodsPure cultures of H. suis were established by growing bacteria as colonies on 1% brucella agar plates, followed by purification and enrichment by biphasic subculture. Characteristics of these single colony‐derived strains were compared with those of their parent strains using multilocus sequence typing (MLST) and by studying bacterium–host interactions using a gastric epithelial cell line and Mongolian gerbil model.ResultsThe purification/enrichment procedure required a nonstop culture of several weeks. For 4 of 17 H. suis strains, MLST revealed differences between parental and single colony‐derived strains. For three of four single colony‐derived strains tested, the cell death‐inducing capacity was higher than for the parental strain. One single colony‐derived strain lost its capacity to colonize Mongolian gerbils. For the four other strains tested, colonization capacity and histopathologic changes were similar to what has been described when using strains with only a history of limited biphasic culture.ConclusionsA method was developed to obtain single colony‐derived H. suis strains, but this procedure may affect the bacterial genotype and phenotype.