bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving drug chart documentation in elective surgical patient admissions.
Authors: Thompson Alice 
Published: February 2014

AbstractNational Institute for Health and Care Excellence (NICE) guidelines state that all healthcare organisations should put policies in place for medication reconciliation on admission. At Croydon University Hospital a medication history had previously been taken in Foundation Year 1 (FY1) preoperative clinics. However, when these clinics were deemed unnecessary, this opportunity for drug chart documentation was lost, along with an awareness of this responsibility among the FY1s. As a result patients were being admitted to wards without adequate drug chart documentation which resulted in a serious untoward incident occurring. This project aimed to increase awareness among FY1s of this responsibility and as a result increase drug chart documentation in postoperative elective surgical patients.The drug charts of 40 postoperative elective surgical patients admitted to all surgical wards were reviewed over a 2 week period. 12.5% (4/32) of patients taking regular medication had these correctly prescribed, with 'high risk medication omissions' found in 7.5% (3/40). Documentation of an allergy status was absent in 17.5% (7/40) of patients, including 5% (2/40) of whom had a known drug allergy.To create awareness of this responsibility, first, a presentation was given to the FY1s, second, posters to prompt action were placed on the elective surgical wards, and finally, the Director of Medical Education emailed the FY1s reiterating these facts. We then reviewed the drug charts of 45 elective postoperative patients over a 2 week period following these interventions.The results showed: correct prescription of regular medications improved to 48% (16/33); ‘high risk medication omissions' reduced to 4% (2/45); documentation of allergy status on the drug charts increased to 87% (39/45); failure to document a known drug allergy on the drug chart fell to 2% (1/45); and patients with a ‘high risk medication omission' or an undocumented known drug allergy decreased from 12.5% (5/40) to 7 % (3/45).This study has highlighted an area in which medication reconciliation and drug chart documentation were inadequate, and posed a risk to patient safety. Interventions designed to educate the FY1s and inform them of their responsibility improved standards in regular medication prescription and allergy documentation. However, leaving the onus with the FY1s was not enough to achieve adequate drug chart documentation. Further project cycles may therefore require the implementation of a step within the patient admission protocol in the preoperative ward that requires the nursing staff to contact the team's doctor when the patient arrives in hospital to ensure satisfactory drug chart documentation. In addition, collaboration with the pharmacists could also allow a 'best possible medication history' to be taken on the day of admission and thus reduce risk to patient safety.
Homoclinic Solutions for a Class of Second Order Nonautonomous Singular Hamiltonian Systems
Authors: Zhang Ziheng , Liao Fang-Fang , Wong Patricia J. Y. 
Published: February 2014

We are concerned with the existence of homoclinic solutions for the following second order nonautonomous singular Hamiltonian systemsu¨+atWuu=0, (HS) where-∞<t<+∞,u=u1,u2, …,uN∈ℝNN≥3,a:ℝ→ℝis a continuous bounded function, and the potentialW:ℝN∖{ξ}→ℝhas a singularity at0≠ξ∈ℝN, andWuuis the gradient ofWatu. The novelty of this paper is that, for the case thatN≥3and (HS) is nonautonomous (neither periodic nor almost periodic), we show that (HS) possesses at least one nontrivial homoclinic solution. Our main hypotheses are the strong force condition of Gordon and the uniqueness of a global maximum ofW. Different from the cases that (HS) is autonomousat≡1or (HS) is periodic or almost periodic, as far as we know, this is the first result concerning the case that (HS) is nonautonomous andN≥3. Besides the usual conditions onW, we need the assumption thata′t<0for allt∈ℝto guarantee the existence of homoclinic solution. Recent results in the literature are generalized and significantly improved.
Improving the Efficacy of Chemoradiation with Targeted Agents
Authors: Morgan Meredith A. , Parsels Leslie A. , Maybaum Jonathan , Lawrence Theodore S. 
Published: February 2014

AbstractChemoradiation is the standard therapy for the majority of inoperable, locally advanced cancers. Although there is a need to improve chemoradiation efficacy, normal-tissue toxicity limits our ability to give additional chemotherapy or higher doses of radiation. Thus, there is excitement about the addition of molecularly targeted agents, which tend to be less toxic than chemotherapy, to chemoradiation regimens. Unfortunately, initial empiric attempts have not been successful. This review will focus on the evidence that supports rational combinations of targeted agents with chemoradiation, with an emphasis on agents that target the DNA damage response and radiation-induced membrane signaling.Significance: Too often, clinical trials are designed without comprehensive preclinical investigation. To design more rational trials of targeted agents with chemoradiation, it is necessary to understand the complex biology underlying the interactions between the targeted agent and chemoradiation. Thorough preclinical studies to evaluate key issues such as mechanisms of interaction, scheduling, selection of the appropriate patients through the use of biomarkers, and normal-tissue toxicity will lead to improved clinical trial designs and patient outcomes. Cancer Discov; 4(3); 280–91. ©2014 AACR.
Unilateral Intracranial Arteriopathy in Pediatric Stroke
Authors: Yeon Je Young , Shin Hyung Jin , Seol Ho Jun , Kim Jong-Soo , Hong Seung-Chyul 
Published: February 2014

Background and Purpose—
The nonprogressive, often reversible, unilateral arteriopathy known as transient (focal) cerebral arteriopathy has become a leading cause of childhood arterial ischemic stroke. However, it is not a well-recognized arteriopathy in East Asian countries where moyamoya disease is prevalent.

Methods—
We retrospectively reviewed 74 children and adolescents (<18 years) with arterial ischemic stroke and intracranial arteriopathy to identify 29 patients with unilateral large-artery arteriopathy mainly in the anterior circulation. Among them, 25 patients who fulfilled the following inclusion criteria were analyzed to determine the angiographic course and outcome: (1) repeated vascular imaging at least twice and (2) absence of thrombotic disorders or cardiac diseases.

Results—
The course of unilateral arteriopathy was classified as reversible in 17 patients (68%), progressive in 5 (20%), and stable in 3 (12%). Nine of the 17 patients with reversible arteriopathy exhibited initial worsening of the arteriopathy mostly within 1 month, but the worsened arteriopathy began to improve within 3 months and continued to improve even after a few years. Two of these 9 patients experienced stroke progression at 6 days. Of the variables analyzed, infarction involving the basal ganglia (15 of 17) and arterial beading on angiography performed within 2 weeks (10 of 12) were associated with reversible arteriopathy. Involvement of the ipsilateral posterior cerebral artery was rare (1 of 17).

Conclusions—
The possibility of reversible arteriopathy should be suspected in children and adolescents presenting with arterial ischemic stroke and unilateral arteriopathy.
Jewish Court Physicians in the Mamluk Sultanate during the First Half of the 8th/14th Century
Authors: Mazor Amir 
Published: February 2014

Abstract
It is usually accepted among modern scholars that the Mamluk period marked a drastic decline in the position of non-Muslims. Jews and Christians were exposed to increasing persecutions and, inter alia, could not serve as great physicians unless they converted to Islam. Against these assumptions, the article discusses new data regarding three Jewish court physicians from the first half of the 8th/14th century. Despite being under a strong pressure to convert, these doctors gained honorable positions and a high social status in the Mamluk sultanate. As erudite physicians and skillful practitioners, they were integrated with the highest circles of the political, military and especially intellectual Muslim elite of their time.
Cross-border Healthcare in Spain and the Implementation of the Directive 2011/24/eu on the Application of Patient’s Rights in Cross-border Healthcare
Authors: Requejo M.ª Teresa 
Published: February 2014

Abstract
This work describes and assesses the implementation of the Cross-border Healthcare Directive in Spain. Although implementation has not yet taken place, the Government has already adopted a draft implementing regulation, on which this article is based. In addition, this article deals with a number of other rules that have been adopted in Spain, which are not strictly aimed at the implementation of the Directive but which are expected to facilitate its implementation and to help cement its effectiveness.
Implementation of the Patients’ Rights in Cross-border Healthcare Directive in Latvia
Authors: Olsena Solvita 
Published: February 2014

Abstract
Latvia, being one of the eu Member States, has an obligation to implement the rules stated by the Directive 2011/24/eu on Patients’ Rights in Cross-border Healthcare (hereinafter — the Directive) before 25 October 2013 in existing national legislation and practice. Implementation was carried out under pressured circumstances. A National Contact Point has been established, information is provided for patients in Latvian and to some extent in English, the Medical Treatment Risk Fund will start operations to provide compensation for harm, and the restrictions and procedure for prior authorisation have been stated. The need to secure quality of care and patient safety and well as privacy protection are the most challenging tasks for Latvia. It can be concluded that some progress in patients’ rights can be achieved, but it is doubtful if patients’ mobility will be stimulated.
Using Scanpaths as a Learning Method for a Conflict Detection Task of Multiple Target Tracking
Authors: Kang Ziho , Landry Steven J. 
Published: February 2014

Objective: The objective was to determine whether the scanpaths of air traffic controllers (ATCs) could be used to improve the performance of novices in a conflict detection task. Background: Studies in other domains show that novice performance can be improved by exposure to experts’ scanpaths. Whether this effect can be found for an aircraft conflict detection task is unknown. Method: Scanpaths of 25 professional ATCs (“experts”) were recorded using a medium-fidelity air traffic control simulation with realistic scripted traffic that included aircraft pairs that would lose separation. A total of 20 novices were exposed to experts’ scanpaths (“treatment”), and their performance (for both loss of separation detection rates and false alarm rates) was compared to that of 20 novices given no treatment or instructions (“control”) and 20 novices who were verbally instructed to attend to altitude (“instruction-only”). Interviews were held about the helpfulness of the exposure. The scanpaths were analyzed to find pattern differences among the three groups. Results: Chi-square tests showed significant differences for false alarm rates across the three groups ( p = .001). Pairwise Mann–Whitney tests showed that the number of false alarms for the treatment group was significantly lower than that for the control group ( p = .005), and trended lower than the instruction-only group ( p = .08). Treatment group participants responded that experts’ scanpaths helped. Analysis of scanpaths showed an increased tendency of the scanpath treatment group to follow the experts’ scanpath. Conclusion: The scanpath training intervention improved novice performance by reducing false alarms. Application: Implementing experts’ scanpaths into novices’ active learning process shows promise in enhancing training effectiveness and reducing training time.
Military Otolaryngology Resident Case Numbers and Board Passing Rates during the Afghanistan and Iraq Wars
Authors: Scalzitti Nicholas , Brennan Joseph , Bothwell Nici , Brigger Matthew , Ramsey Mitchell , Gallagher Thomas , Maturo Stephen 
Published: February 2014

ObjectiveDuring the wars in Iraq and Afghanistan, the US military has continued to train medical residents despite concern that postgraduate medical education at military training facilities has suffered. This study compares the experience of otolaryngology residents at military programs with the experience of their civilian counterparts.Study DesignRetrospective review.SettingAcademic military medical centers.Subjects and MethodsResident caseload data and board examination passing rates were requested from each of the 6 Department of Defense otolaryngology residency programs for 2001 to 2010. The American Board of Otolaryngology and the Accreditation Council for Graduate Medical Education provided the national averages for resident caseload. National board passing rates from 2004 to 2010 were also obtained. Two‐sample t tests were used to compare the pooled caseloads from the military programs with the national averages. Board passing rates were compared with a test of proportions.ResultsData were available for all but one military program. Regarding total cases, only 2001 and 2003 showed a significant difference (P <. 05), with military residents completing more cases in those years. For individual case categories, the military averages were higher in Otology (299.6 vs 261.2, P =. 033) and Plastics/Reconstruction (248.1 vs 149.2, P =. 003). Only the Head & Neck category significantly favored the national average over the military (278.3 and 226.0, P =. 039). The first‐time board passing rates were identical between the groups (93%).ConclusionOur results suggest that the military otolaryngology residency programs are equal in terms of caseload and board passing rates compared with civilian programs over this time period.
Nanofiber-reinforced myocardial tissue-construct as ventricular assist device
Authors: Guhathakurta Soma , Mathapati Santosh , Bishi Dillip Kumar , Rallapalli Suneel , Cherian Kotturathu Mammen 
Published: February 2014

Objectives This study aimed to create a myocardial tissue construct by tissue engineering to repair, replace, and regenerate damaged cardiac tissue. Methods and results Human cardiac muscles harvested from a homograft heart retrieval system were decellularized followed by coating with electrospun nanofibers to make them amenable to scaffolding. These processed cardiac tissues were nourished in modified media having ischemic cardiac tissue conditioned media in 6 separate experimental variants, and cord blood mononuclear cells were injected into 4 of them. On the 17th day of culture, the nanofiber-coated scaffolds injected with mononuclear cells and/or reinforced by electrical and mechanical forces, started contracting spontaneously at varying rates, while the control remain noncontractile. Histological staining confirmed the pre-culture acellularity as well as post-culture stem cell viability, and revealed expression of troponin I and cardiac myosin. The acellular processed scaffold when implanted into sheep ischemic myocardial apex revealed transformation into sheep myocardium after 4 months of implantation. Conclusion These results provide direct evidence for the re-cellularization of decellularized cardiac tissue grafts reinforced with a polymer nanofiber coating, by human mononuclear cells injection, leading to generation of a tissue-engineered myocardial construct.
Pontine Microbleeds and Depression in Stroke
Authors: Tang W. K. , Liu X. X. , Chen Y. K. , Abrigo J. , Chu Winnie C. W. , Mok V. C. T. , Ungvari Gabor S. , Wong K. S. 
Published: February 2014

Objectives: Depression is the most common affective disorder following stroke yet the neuroanatomical model of poststroke depression (PSD) remains unclear. This study examined the association between PSD and cerebral microbleeds (CMBs) and hypothesized that CMBs in specific regions would be associated with PSD. Methods: Of the 4766 patients with first ever or recurrent acute ischemic stroke admitted to the Acute Stroke Unit of the Prince of Wales Hospital between June 2004 and October 2010, 229 met the entry criteria and formed the study sample. Patients with a Geriatric Depression Scale score of 7 or above were classified as having PSD. The presence and location of CMBs were evaluated with magnetic resonance imaging. Results: Compared to the non-PSD group, patients with PSD were more likely to have pontine CMBs (32.0% vs 18.2%; P = .019). The presence of pontine CMBs remained an independent predictor of PSD in the multivariate analysis, with an odds ratio of 2.2 ( P = .016). Conclusion: The results suggest that pontine CMBs are associated with a higher risk of developing PSD.
How are ICTs Transforming Civic Space in Singapore?
Authors: Sadoway David 
Published: February 2014

Urban voluntary associations and activists have long sought open civic space for articulating their ideas and ideals. With the advent of Information Communication Technologies (ICTs), civic associational practices have arguably been significantly altered and these changes are in turn transforming civic space—particularly in cities with advanced digital infrastructure and uptake. This research examines two civic environmental groups in order to understand how and why ICTs are transforming civic space in the island city-state of Singapore. The article employs a case comparison of two age-distinct civic associations—Nature Society (Singapore) and Green Drinks Singapore—in order to distinguish the digital activities of established versus nascent civic environmental groups. The article employs a three-part socio-technical framework—focusing on ‘organizational, participatory and spatial’ transformations—for unpacking ICT-linked practices amongst civic associations. The article will also examine the recent rise of informal civic-cyber green groups that both work with and yet paradoxically remain autonomous of established civic associations. The case studies provides evidence of the changing tactics of civic (and cyber) environmentalism and insights into the changing nature of civic space in Singapore.
Hybrid simulation: bringing motivation to the art of teamwork training in the operating room
Authors: Kjellin A. , Hedman L. , Escher C. , Felländer-Tsai L. 
Published: February 2014

Background and Aims: Crew resource management–based operating room team training will be an evident part of future surgical training. Hybrid simulation in the operating room enables the opportunity for trainees to perform higher fidelity training of technical and non-technical skills in a realistic context. We focus on situational motivation and self-efficacy, two important factors for optimal learning in light of a prototype course for teams of residents in surgery and anesthesiology and nurses. Material and Methods: Authentic operating room teams consisting of residents in anesthesia (n = 2), anesthesia nurses (n = 3), residents in surgery (n = 2), and scrub nurses (n = 6) were, during a one-day course, exposed to four different scenarios. Their situational motivation was self-assessed (ranging from 1 = does not correspond at all to 7 = corresponds exactly) immediately after training, and their self-efficacy (graded from 1 to 7) before and after training. Training was performed in a mock-up operating theater equipped with a hybrid patient simulator (SimMan 3G; Laerdal) and a laparoscopic simulator (Lap Mentor Express; Simbionix). The functionality of the systematic hybrid procedure simulation scenario was evaluated by an exit questionnaire (graded from 1 = disagree entirely to 5 = agree completely). Results and Conclusions: The trainees were mostly intrinsically motivated, engaged for their own sake, and had a rather great degree of self-determination toward the training situation. Self-efficacy among the team members improved significantly from 4 to 6 (median). Overall evaluation showed very good result with a median grading of 5. We conclude that hybrid simulation is feasible and has the possibility to train an authentic operating team in order to improve individual motivation and confidence.
New York Can be Our Nation’s Center for Alzheimer’s Research
Authors: Vann Allan S. 
Published: February 2014

More than 5 million people in this country have Alzheimer's disease, and more than 300,000 of those with Alzheimer's live in New York. By 2025, it is estimated that there will be 350,000 residents living with Alzheimer's in New York. Congressman Steve Israel and New York Assemblyman Charles Lavine issued a joint proposal in June, 2013 suggesting that New York become this country's center for Alzheimer's research. Obviously, they would both like to see increased federal funding, but they also know that we cannot count on that happening. So Israel and Lavine have proposed a $3 billion state bonding initiative to secure sufficient funding to tackle this disease. It would be similar to the bonding initiatives that have made California and Texas this nation's centers for stem cell and cancer research. The bond would provide a dedicated funding stream to support research to find effective means to treat, cure, and eventually prevent Alzheimer's, and fund programs to help people currently dealing with Alzheimer's and their caregivers. New York already has some of the major “ingredients” to make an Alzheimer's bond initiative a success, including 3 of our nation's 29 Alzheimer's Disease Research Centers and some of the finest research facilities in the nation for genetic and neuroscience research. One can only imagine the synergy of having these world class institutions working on cooperative grants and projects with sufficient funding to attract even more world class researchers and scientists to New York to find ways to prevent, treat, and cure Alzheimer's.
Efficacy of a nonsurgical treatment regimen in patients with bisphosphonate-related osteonecrosis of the jaws in Saudi Arabia
Authors: Alsehimy Mohammad M 
Published: February 2014

Objectives: The objective of this study was to evaluate the effectiveness of a nonsurgical treatment regimen in the long-term control of necrotic areas of the jaws and pain in such patients. Methods: A total of 96 patients suffering from the disease were included in this study. All patients received nonsurgical treatment regimen for 10 days, and repeated every 3 months for 2 years. The size of the osteonecrotic lesions was measured and the pain level was self-assessed with a visual analog scale. Results: The patients showed a statistically significant (F = 16.1; p < .01; r2 = .95) gradual decrease in the size of exposed bone areas during the nonsurgical therapy (from 12.5 to 8.8 mm). Pain scores ranged from 0 to 3 score scale. Complete resolution of the disease was observed in some patients. Conclusions: This conservative nonsurgical treatment regimen seems to provide successful treatment in reduction of the sizes of exposed bone areas in the majority of patients.