bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exposure of health workers in primary health care to glutaraldehyde
Authors: González Jara M Angel , Mora Hidalgo Alfonso , Avalos Gulin J Carlos , López Albiach Marcos , Muñoz Ortiz Laura , Torán Monserrat Pere , Esteva Ollé Xavier 
Published: November 2013

AbstractBackgroundIn order to avoid proliferation of microorganisms, cleaning, disinfection and sterilisation in health centres is of utmost importance hence reducing exposure of workers to biological agents and of clients that attend these health centres to potential infections. One of the most commonly-used chemical is glutaraldehyde. The effects of its exposure are well known in the hospital setting; however there is very little information available with regards to the primary health care domain.ObjectiveTo determine and measure the exposure of health workers in Primary Health Care Centres. Environmental to glutaraldehyde and staff concentration will be measured and compared with regulated Occupational Exposure Limits.Methods/DesignObservational, cross-sectional and multi-centre study. The study population will be composed of any health professionals in contact with the chemical substance that work in the Primary Health Care Centres in the areas of Barcelonès Nord, Maresme, and Barcelona city belonging to the Catalan Institute of Health.Data will be collected from 1) Glutaraldhyde consumption from the previous 4 years in the health centres under study. 2) Semi-structured interviews and key informants to gather information related to glutaraldehyde exposure. 3) Sampling of the substance in the processes considered to be high exposure.DiscussionAlthough glutaraldehyde is extensively used in health centres, scientific literature only deals with certain occupational hazards in the hospital setting.This study attempts to take an in-depth look into the risk factors and environmental conditions that exist in the primary care workplace with exposure to glutaraldehyde.
Fibroblast growth factor 19 entry into brain
Authors: Hsuchou Hung , Pan Weihong , Kastin Abba J 
Published: November 2013

Abstract

Background
Fibroblast growth factor (FGF)-19, an endocrine FGF protein mainly produced by the ileum, stimulates metabolic activity and alleviates obesity. FGF19 modulates metabolism after either intravenous or intracerebroventricular injection, and its receptor FGFR4 is present in the hypothalamus. This led to the question whether blood-borne FGF19 crosses the blood-brain barrier (BBB) to exert its metabolic effects.

Methods
We determined the pharmacokinetics of FGF19 permeation from blood to brain in comparison with its distribution in peripheral organs. Multiple-time regression analysis after intravenous bolus injection, in-situ brain perfusion, and HPLC assays were performed.

Results
FGF19 was relatively stable in blood and in the brain compartment. Significant influx was seen in the presence of excess unlabeled FGF19 in blood. This coincided with a slower decline of 125I-FGF19 in blood which suggested there was decreased clearance or peripheral tissue uptake. In support of an altered pattern of peripheral processing of 125I-FGF19 by excess unlabeled FGF19, the high influx to liver was significantly attenuated, whereas the minimal renal uptake was linearly accelerated. In the present setting, we did not detect a saturable transport of FGF19 across the BBB, as the entry rate of 125I-FGF19 was not altered by excess unlabeled FGF19 or its mouse homologue FGF15 during in-situ brain perfusion.

Conclusion
FGF19 remained stable in the blood and brain compartments for up to 10 min. Its influx to the brain was non-linear, non-saturable, and affected by its blood concentration and distribution in peripheral organs. Liver showed a robust and specific uptake of FGF19 that could be inhibited by the presence of excess unlabeled FGF19, whereas kidney clearance was dose-dependent.
A home-based health information acquisition system
Authors: Yan Yan , Li Qi , Li Heping , Zhang Xuejun , Wang Lei 
Published: November 2013

AbstractWith the development of health consciousness and growing of the aging population, the healthcare demand becomes more and more important. At the same time, recent rapid growth in mobile computing technologies enables telemedicine applications operations on mobile devices. The technologies and demands accelerated different kinds of home-based devices for the aged healthcare and medical treatment. Our focus is on the design of an information system for in-home healthcare, and a new household acquisition terminal device which integrated electrocardiogram (ECG), blood oxygen, blood pressure and body temperature acquirement functions. A set-top box based manipulation method was adopted for operators, the physiological data could be acquired by the corresponding detectors. The parameters were collected and transmitted by set-top box and were received by the data server and sent to the medical staff of a hospital or healthcare center, professional healthcare advice or clinical diagnosis would be provided. Simultaneously, the collected parameters and the feedback clinic advice was stored on the servers which could be accessed by long distance clients such as a mobile smart phone user. The proposed system involved multiple physiologic parameters which led to great potential for universality, and in the terminal side the set-top box and IPTV screen shared scenario brought ease of use. Further progresses were made in the product upgrade because the shared IPTV screen was employed, which might be improved with the family demand. The acquirement instrument got a certification of China State Food and Drug Administration. The entire system was built for commercial achievements and the acquired data had great potential in disease screening and public hygiene research.
Antimicrobial stewardship auditing of patients reviewed by infectious diseases physicians in a tertiary university hospital
Authors: Yeo Chay Leng , Wu Jia En , Chung Gladys Wei-Teng , Chan Douglas Su-Gin , Chen Hui Hiong , Hsu Li Yang 
Published: November 2013

Abstract

Background
The optimal way for antimicrobial stewardship programs (ASPs) to interact with existing infectious disease physician (IDP) services within the same institution is unknown. In our institution, IDPs and our prospective audit and feedback ASP operate independently, with occasionally differing recommendations offered for the same inpatient. We performed a retrospective audit on inpatients that had been reviewed by both IDPs and ASP within a 7-day period, focusing on cases where different therapy-modifying recommendations had been offered. We analyzed the outcomes in inpatients where the ASP recommendations were accepted and compared these with the inpatients where the IDP recommendations were accepted instead. Outcomes assessed were 30-day mortality post-ASP review, unplanned re-admission within 30 days post-discharge from hospital, and clinical deterioration at 7 days post-ASP review.

Findings
There were 143 (18.9%) patients where differing recommendations had been offered, with primary physicians accepting 69.9% of ASP recommendations. No significant differences in terms of demographics, clinical characteristics, 30-day mortality, and re-admission rates were observed, although clinical deterioration rates were lower in patients where the ASP recommendation was accepted (8.0% vs. 27.9%; p = 0.002). On multivariate analysis, hematology-oncology inpatients were associated with unplanned readmission. Increasing age and hematology-oncology inpatients were associated with clinical deterioration 7 days post-recommendation, whereas acceptance of ASP recommendations was protective. No characteristic was independently associated with 30-day mortality.

Conclusion
In conclusion, independent reviews by both IDPs and ASPs can be compatible within large tertiary hospitals, providing primary physicians even in situations of conflicting recommendations viable alternative antimicrobial prescribing advice.
A Confederacy of Dunces: mental illness in the life and
work of John Kennedy Toole
Authors: Pal Abhijit 
Published: November 2013

SummaryThis article examines the life and work of John Kennedy Toole, focusing on
his 1981 Pulitzer Prize winning novel A Confederacy of
Dunces. Toole finished the novel in 1966 and, after failing to
rework his manuscript to his editor's satisfaction, he shelved the project.
Following this, he displayed symptoms typical of paranoid schizophrenia and
he took his own life at the age of 31. In his novel, Toole parodies both
psychoanalysis and the practice of psychiatry at the time, with a strong
overlap with the emerging perspectives critical of psychiatry popularised by
figures such as Szasz, Laing and Foucault. Toole's life and work have
relevance for psychiatrists interested in the relationship between
creativity and mental illness, attitudes towards psychiatry in the 1960s,
and the interplay between societal values and judgements of mental
health.
Safeguarding vulnerable adults: the psychiatrist's roles and
responsibilities
Authors: Hodgson Richard , Rheade Jude 
Published: November 2013

SummaryFor decades society has recognised that children are vulnerable and so it
has sought to protect them. However, similar legal protection for adults who
may be equally vulnerable has been neglected. The incremental introduction
of legislation and reports in the UK, along with guidelines on good
practice, now afford adults safeguarding procedures similar to those for
children. This article offers a practical overview of these developments. In
addition, it highlights some of the dilemmas that face practitioners in this
evolving arena, as legislation and policy do not anticipate the diverse
scenarios in which mental healthcare professionals may be involved.
Decisions made can be subject to legal challenge, so it is important that
psychiatrists understand their role as well as the role of their
organisation in this complex area.
Payment by results: validating care cluster allocation in the real world
Authors: Bekas Stavros , Michev Orlin 
Published: November 2013

Aims and methodTo validate care cluster allocation for payment by results (PbR) in mental health and to evaluate clustering and auditing methodologies. We applied exclusion criteria to the patient population of a mental health trust. An automated validation compared cluster with expected ICD-10 codes or scores on the Health of the Nation Outcome Scales (HoNOS) and Mental Health Clustering Tool (MHCT). Six hundred ‘mismatched’ cases were reviewed in depth to better understand the reasons why these cases appeared misclustered.ResultsThere was a significant mismatch between ICD-10 codes, HoNOS and MHCT scores and allocated care cluster, with differences between services and localities. Some clusters appeared to be more accurately allocated. The ‘deep dive’ analysis indicated that most mismatches occurred because psychosis was allocated to a non-psychotic cluster and vice versa, but also as a result of inherent weaknesses of the MHCT.Clinical implicationsHigh levels of inappropriate care cluster allocation highlight the need to improve practice. Weaknesses in the MHCT and ICD-10 coding mean that the final arbiter should be clinical judgement. Auditing will, by necessity, have a significant margin of error.
Patients' awareness of the mental health tribunal and capacity to make requests
Authors: Galappathie Nuwan , Harsh Rajendra Kumar , Thomas Mathew , Begum Amina , Kelly Danielle 
Published: November 2013

Aims and methodTo evaluate patient awareness of the mental health tribunal and identify any association between capacity to request a tribunal and frequency of completed hearings. A cohort of detained patients within a secure hospital were assessed and data for past tribunals evaluated by presence of capacity and mode of application.ResultsOf the 65 patients evaluated, 78% were aware of the tribunal's power to discharge, 14% were aware of its power to recommend leave and 4% were aware of its power to recommend transfer; 12% lacked capacity to request a tribunal. Patients with capacity received more completed hearings per year than those without, both overall (0.58 v. 0.29 per year, P = 0.04) and by patient application (0.45 v. 0.12 per year, P = 0.03).Clinical implicationsHospital managers should ensure that all detained patients have regular assessments of their capacity to request a tribunal and that those who lack capacity are referred to the Secretary of State when it is considered that a tribunal would be in their best interests. Hospital managers should consider referring such cases to the Secretary of State every 12 months.
Endurance Exercise Training Up-Regulates Lipolytic Proteins and Reduces Triglyceride Content in Skeletal Muscle of Obese Subjects
Authors: Louche Katie , Badin Pierre-Marie , Montastier Emilie , Laurens Claire , Bourlier Virginie , de Glisezinski Isabelle , Thalamas Claire , Viguerie Nathalie , Langin Dominique , Moro Cedric 
Published: November 2013

Context:
Skeletal muscle lipase and intramyocellular triglyceride (IMTG) play a role in obesity-related metabolic disorders.

Objectives:
The aim of the present study was to investigate the impact of 8 weeks of endurance exercise training on IMTG content and lipolytic proteins in obese male subjects.

Design and Volunteers:
Ten obese subjects completed an 8-week supervised endurance exercise training intervention in which vastus lateralis muscle biopsy samples were collected before and after training.

Main Outcome Measures:
Clinical characteristics and ex vivo substrate oxidation rates were measured pre- and posttraining. Skeletal muscle lipid content and lipolytic protein expression were also investigated.

Results:
Our data show that exercise training reduced IMTG content by 42% (P &lt; .01) and increased skeletal muscle oxidative capacity, whereas no change in total diacylglycerol content and glucose oxidation was found. Exercise training up-regulated adipose triglyceride lipase, perilipin (PLIN) 3 protein, and PLIN5 protein contents in skeletal muscle despite no change in mRNA levels. Training also increased hormone sensitive–lipase Ser660 phosphorylation. No significant changes in comparative gene identification 58, G0/G1 switch gene 2, and PLIN2 protein and mRNA levels were observed in response to training. Interestingly, we noted a strong relationship between skeletal muscle comparative gene identification 58 and mitochondrial respiratory chain complex I protein contents at baseline (r = 0.87, P &lt; .0001).

Conclusions:
Endurance exercise training coordinately up-regulates fat oxidative capacity and lipolytic protein expression in skeletal muscle of obese subjects. This physiological adaptation probably favors fat oxidation and may alleviate the lipotoxic lipid pressure in skeletal muscle. Enhancement of IMTG turnover may be required for the beneficial metabolic effects of exercise in obesity.
One-pot Microwave Hydrothermal Synthesis of Monodisperse Core–Shell-Structured SnO2@C Microspheres
Authors: Chen Rongrong , Wang Xin , Kong Xiangyang 
Published: November 2013

Abstract
Core–shell-structured SnO2@C microspheres have been synthesized through a one-pot rapid microwave hydrothermal treatment, which is a template-free method with environment-friendly and inexpensive starting materials. The growth mechanism of the core–shell-structured SnO2@C microspheres during the microwave hydrothermal process has been studied by analyzing the morphology evolution of the products at different stages of reaction. This synthesis route possesses the advantages of high production efficiency and low cost, making it a promising method for producing high-performance lithium-ion battery anode material.
Acid-catalyzed Ring-opening Polymerization of γ-Butyrolactone under High-pressure Conditions
Authors: Yamashita Kazuya , Yamamoto Kazuya , Kadokawa Jun-ichi 
Published: November 2013

Abstract
In this study, we found that acid-catalyzed ring-opening polymerization (ROP) of γ-butyrolactone, which showed difficulty progressing in general ROP, took place under high-pressure conditions. The structure of the product was confirmed by the 1H NMR spectrum to be poly(γ-butyrolactone). Furthermore, the Mn values increased with increasing monomer conversions.
Pelvic discontinuity
Authors: Petrie J. , Sassoon A. , Haidukewych G. J. 
Published: November 2013

Pelvic discontinuity represents a rare but challenging problem for orthopaedic surgeons. It is most commonly encountered during revision total hip replacement, but can also result from an iatrogentic acetabular fracture during hip replacement. The general principles in management of pelvic discontinuity include restoration of the continuity between the ilium and the ischium, typically with some form of plating. Bone grafting is frequently required to restore pelvic bone stock. The acetabular component is then impacted, typically using an uncemented, trabecular metal component. Fixation with multiple supplemental screws is performed. For larger defects, a so-called ‘cup–cage’ reconstruction, or a custom triflange implant may be required. Pre-operative CT scanning can greatly assist in planning and evaluating the remaining bone stock available for bony ingrowth. Generally, good results have been reported for constructs that restore stability to the pelvis and allow some form of biologic ingrowth. Cite this article: Bone Joint J 2013;95-B, Supple A:109–13.
Femoral and tibial component rotation in total knee arthroplasty
Authors: Scott R. D. 
Published: November 2013

At least four ways have been described to determine femoral component rotation, and three ways to determine tibial component rotation in total knee replacement (TKR). Each method has its advocates and each has an influence on knee kinematics and the ultimate short and long term success of TKR. Of the four femoral component methods, the author prefers rotating the femoral component in flexion to that amount that establishes a stable symmetrical flexion gap. This judgement is made after the soft tissues of the knee have been balanced in extension.Of the three tibial component methods, the author prefers rotating the tibial component into congruency with the established femoral component rotation with the knee is in extension. This yields a rotationally congruent articulation during weight-bearing and should minimise the torsional forces being transferred through a conforming tibial insert, which could lead to wear to the underside of the tibial polyethylene. Rotating platform components will compensate for any mal-rotation, but can still lead to pain if excessive tibial insert rotation causes soft-tissue impingement.Cite this article: Bone Joint J 2013;95-B, Supple A:140–3.
The dysplastic hip
Authors: Gustke K. 
Published: November 2013

Total hip replacement for developmental hip dysplasia is challenging. The anatomical deformities on the acetabular and femoral sides are difficult to predict. The Crowe classification is usually used to describe these cases – however, it is not a very helpful tool for pre-operative planning. Small acetabular components, acetabular augments, and modular femoral components should be available for all cases. Regardless of the Crowe classification, the surgeon must be prepared to perform a femoral osteotomy for shortening, or to correct rotation, and/or angulation.Cite this article: Bone Joint J 2013;95-B, Supple A:31–6.
Reducing blood loss after total knee replacement
Authors: Reinhardt K. R. , Osoria H. , Nam D. , Alexiades M. A. , Figgie M. P. , Su E. P. 
Published: November 2013

Blood loss during total knee replacement (TKR) remains a significant concern. In this study, 114 patients underwent TKR, and were divided into two groups based on whether they received a new generation fibrin sealant intra-operatively, or a local infiltration containing adrenaline. Groups were then compared for mean calculated total blood volume (TBV) loss, transfusion rates, and knee range of movement. Mean TBV loss was similar between groups: fibrin sealant mean was 705 ml (281 to 1744), local adrenaline mean was 712 ml (261 to 2308) (p = 0.929). Overall, significantly fewer units of blood were transfused in the fibrin sealant group (seven units) compared with the local adrenaline group (15 units) (p = 0.0479). Per patient transfused, significantly fewer units of blood were transfused in the fibrin sealant group (1.0 units) compared with the local adrenaline group (1.67 units) (p = 0.027), suggesting that the fibrin sealant may reduce the need for multiple unit transfusions. Knee range of movement was similar between groups. From our results, it appears that application of this newer fibrin sealant results in blood loss and transfusion rates that are low and similar to previously applied fibrin sealants. Cite this article: Bone Joint J 2013;95-B, Supple A:135–9.
The painful total hip replacement
Authors: Lanting B. A. , MacDonald S. J. 
Published: November 2013

Total hip replacement (THR) is a very common procedure undertaken in up to 285 000 Americans each year. Patient satisfaction with THR is very high, with improvements in general health, quality of life, and function while at the same time very cost effective. Although the majority of patients have a high degree of satisfaction with their THR, 27% experience some discomfort, and up to 6% experience severe chronic pain. Although it can be difficult to diagnose the cause of the pain in these patients, this clinical issue should be approached systematically and thoroughly. A detailed history and clinical examination can often provide the correct diagnosis and guide the appropriate selection of investigations, which will then serve to confirm the clinical diagnosis made.Cite this article: Bone Joint J 2013;95-B, Supple A:70–3.
Femoroacetabular impingement
Authors: Fayad T. E. , Khan M. A. , Haddad F. S. 
Published: November 2013

Young adults with hip pain secondary to femoroacetabular impingement (FAI) are rapidly being recognised as an important cohort of orthopaedic patients. Interest in FAI has intensified over the last decade since its recognition as a precursor to arthritis of the hip and the number of publications related to the topic has increased exponentially in the last decade. Although not all patients with abnormal hip morphology develop osteoarthritis (OA), those with FAI-related joint damage rapidly develop premature OA. There are no explicit diagnostic criteria or definitive indications for surgical intervention in FAI. Surgery for symptomatic FAI appears to be most effective in younger individuals who have not yet developed irreversible OA. The difficulty in predicting prognosis in FAI means that avoiding unnecessary surgery in asymptomatic individuals, while undertaking intervention in those that are likely to develop premature OA poses a considerable dilemma. FAI treatment in the past has focused on open procedures that carry a potential risk of complications.Recent developments in hip arthroscopy have facilitated a minimally invasive approach to the management of FAI with few complications in expert hands. Acetabular labral preservation and repair appears to provide superior results when compared with debridement alone. Arthroscopic correction of structural abnormalities is increasingly becoming the standard treatment for FAI, however there is a paucity of high-level evidence comparing open and arthroscopic techniques in patients with similar FAI morphology and degree of associated articular cartilage damage. Further research is needed to develop an understanding of the natural course of FAI, the definitive indications for surgery and the long-term outcomes.Cite this article: Bone Joint J 2013;95-B, Supple A:26–30.