bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome following physician supervised prehospital resuscitation: a retrospective study
Authors: Mikkelsen Søren , Krüger Andreas J , Zwisler Stine T , Brøchner Anne C 
Published: January 2015

BackgroundPrehospital care provided by specially trained, physician-based emergency services (P-EMS) is an integrated part of the emergency medical systems in many developed countries. To what extent P-EMS increases survival and favourable outcomes is still unclear. The aim of the study was thus to investigate ambulance runs initially assigned ‘life-saving missions’ with emphasis on long-term outcome in patients treated by the Mobile Emergency Care Unit (MECU) in Odense, DenmarkMethodsAll MECU runs are registered in a database by the attending physician, stating, among other parameters, the treatment given, outcome of the treatment and the patient's diagnosis. Over a period of 80 months from May 1 2006 to December 31 2012, all missions in which the outcome of the treatment was registered as ‘life saving’ were scrutinised. Initial outcome, level of competence of the caretaker and diagnosis of each patient were manually established in each case in a combined audit of the prehospital database, the discharge summary of the MECU and the medical records from the hospital. Outcome parameters were final outcome, the aetiology of the life-threatening condition and the level of competences necessary to treat the patient.ResultsOf 25 647 patients treated by the MECU, 701 (2.7%) received prehospital ‘life saving treatment’. In 596 (2.3%) patients this treatment exceeded the competences of the attending emergency medical technician or paramedic. Of these patients, 225 (0.9%) were ultimately discharged to their own home.ConclusionsThe present study demonstrates that anaesthesiologist administrated prehospital therapy increases the level of treatment modalities leading to an increased survival in relation to a prehospital system consisting of emergency medical technicians and paramedics alone and thus supports the concept of applying specialists in anaesthesiology in the prehospital setting especially when treating patients with cardiac arrest, patients in need of respiratory support and trauma patients.
Improving early recognition of delirium using SQiD (Single Question to identify Delirium): a hospital based quality improvement project
Authors: McCleary Elaine , Cumming Pamela 
Published: January 2015

AbstractDelirium is a serious condition associated with poor outcomes which can be prevented and treated if recognised early. Older people and people with dementia or severe illness are more at risk of delirium. SQiD is a simple prompt question which asks, "Is this patient more confused than before?" Focusing specifically on patients aged 75 and over, this project aimed to increase awareness and usage of SQiD to help improve early recognition of delirium, in accordance with the Healthcare Improvement Scotland national initiative. This project was carried out by two student nurses during an eight week clinical placement in the acute surgical receiving unit (ASRU) of Ninewells Hospital, Dundee, Scotland.Qualitative and quantitative methodology was used to establish baseline data which revealed that only 35% of the multidisciplinary team (MDT) were aware of SQiD, with only 15% using SQiD. Initial activities involved raising awareness of SQiD by means of information cards and posters. Once awareness was raised, the usage of the SQiD question by nurses was tested. Finally, the SQiD question was incorporated into the nursing care round forms and usage recorded. Following these awareness raising activities we noted an increase of 83% awareness and 20% use of SQiD. Incorporating the SQiD question into the hourly care round forms increased awareness to 100% and usage to 50%.Although this small scale project could be viewed as a success, the requirements for sustainability depend upon further implementation and spreading of the change. Sustained improvement is also dependent upon the implementation of the care rounds.As nursing students, undertaking this improvement project has provided valuable lessons in both quality improvement science and personal learning. The improved knowledge and understanding of effective communication and the intricacies of team working is transferrable and can be applied to future nursing practice.
An observational study of PM10and hospital admissions for acute exacerbations of chronic respiratory disease in Tasmania, Australia 1992–2002
Authors: Mészáros D , Markos J , FitzGerald D G , Walters E H , Wood-Baker R 
Published: January 2015

ObjectiveParticulate matter with a diameter below 10 µ (PM10) has been a major concern in the Tamar Valley, Launceston, where wood heaters are extensively used. We examined the relationship between PM10levels, meteorological variables, respiratory medications and hospital admissions for respiratory disease over the decade 1992–2002.MethodsPM10levels were provided by the Department of Primary Industry Water, Parks and Environment, and meteorological variables from the Bureau of Meteorology. We obtained hospital discharge codes for the Launceston General Hospital. Poisson regression was used for statistical analyses.ResultsMean daily PM10levels declined from 50.7 to 16.5 μg/m3. Hospitalisations for asthma decreased from 29 to 21 per month, whereas chronic obstructive pulmonary disease (COPD) increased and bronchitis/bronchiolitis remained unchanged. We found a 10 μg/m3increase in PM10to be associated with a 4% increase in admissions for acute bronchitis/bronchiolitis (p0.05), but no association with asthma or COPD was found. All respiratory diseases showed seasonal patterns of hospitalisation.ConclusionsThis is the first long-term study in Australia to demonstrate an association between PM10levels and respiratory diseases. Reducing exposure to PM10may decrease hospital admissions for respiratory diseases.ImplicationBetter preventive measures, including sustained public health initiatives to combat air pollution, are required to reduce respiratory morbidity.
Composition of Periphyton Community on Water Hyacinth (Eichhornia crassipes): In Analysis of Environmental Characteristics at Ejirin Part of Epe Lagoon in Southwestern Nigeria
Authors: Inyang A. I. , Sunday K. E. , Nwankwo D. I. 
Published: January 2015

The composition of periphyton community on water hyacinth was investigated at Ejirin, part of Epe Lagoon, in relation to environmental characteristics from December 2012 to May 2013. A total of 14,536 individuals of 104 species belonging to five divisions were identified, with Bacillariophyta (82.69%), Cyanobacteria (10.43%), Chlorophyta (5.63%), and Euglenophyta (1.15%). The total species abundance observed showed a strong correlation with rainfall (r = 0.745) and strongly significant correlation with TDS (r=0.836*;P >0.05). Biochemical oxygen demand value remained (BOD)≤4.8 mg/L while Shannon-Wiener index value remained (Hs)≤ 1.47. The presence of the following organisms could be used as an indicator of environmentally stressed aquatic ecosystem: euglenoids, blue green algae,Nitzschia palea,Surirellasp.,Pinnulariasp.,Gomphonema parvulum,Mougeotiasp.,Spirogyrasp.,Trachelomonas affinis(Lemm.), andT. ensifera Daday; T. gibberosaPlayf. andPhormidium articulatum;Lyngbya intermedia;Cymbella ventricosa;Eunotia arcus;Surirella linearisandClosterium parvulumNag.
Immunity in Head and Neck Cancer
Authors: Schoenfeld Jonathan D. 
Published: January 2015

Abstract
Head and neck cancers are a diverse group of malignancies that includes an increasing number of virally mediated cancers in addition to tumors caused by tobacco and alcohol use. In both cases, tumor development is intimately related to the host immune system, and the status of an endogenous antitumor response is likely prognostic. Virally mediated cancers provide unique targets for preventive vaccines that generate immune responses directed against virus-associated antigens. Once head and neck tumors develop, they are commonly treated with surgery, radiotherapy, and/or chemotherapy. These treatments are associated with significant toxicities, and despite this, subgroups of patients respond poorly and are likely to relapse and die of their disease. Tumor immunotherapy may allow for improvements in both treatment-associated toxicity and outcome. In addition to providing specific targets for therapeutic vaccines and adoptive therapy, virally associated cancers may also be particularly dependent on immune checkpoints; therefore, immune checkpoint inhibitors are being actively tested for these diseases. Cancers that are not virally mediated may also respond to immunotherapies, and biomarkers that could predict response to immunotherapy irrespective of viral status are being evaluated. Multiple ongoing studies are testing benefits of immunotherapy in the management of metastatic squamous cell carcinoma of the head and neck. Early promising results pave the way for future studies that will expand testing to nonmetastatic diseases and other types of head and neck cancers. Prospects of combining various immunotherapies and more established treatments such as chemotherapy and radiotherapy are very intriguing and may provide synergistic benefits. Cancer Immunol Res; 3(1); 12–17. ©2015 AACR.
Inhibitor development in haemophilia according to concentrate
Authors: Lassila Riita , Peyvandi Flora , Calizzani Gabriele , Gatt Alex , Lambert Thierry , Windyga Jerzy , Iorio Alfonso , Gilman Estelle , Makris Michael , Fischer Kathelijn 
Published: January 2015

SummaryInhibitor development represents the most serious side effect of haemophilia treatment. Any difference in risk of inhibitor formation depending on the product used might be of clinical relevance. It was this study’s objective to assess inhibitor development according to clotting factor concentrate in severe haemophilia A and B. The European Haemophilia Safety Surveillance (EUHASS) was set up as a study monitoring adverse events overall and according to concentrate. Since October 2008, inhibitors were reported at least quarterly. Number of treated patients was reported annually, specifying the number of patients completing 50 exposure days (Previously Untreated Patients, PUPs) without inhibitor development. Cumulative incidence, incidence rates and 95 % confidence intervals (CI) were calculated. Data from October 1, 2008 to December 31, 2012 were analysed for 68 centres that validated their data. Inhibitors developed in 108/417 (26 %; CI 22–30 %) PUPs with severe haemophilia A and 5/72 (7 %; CI 2–16%) PUPs with severe haemophilia B. For Previously Treated Patients (PTPs), 26 inhibitors developed in 17,667 treatment years [0.15/100 treatment years; CI 0.10–0.22) for severe haemophilia A and 1/2836 (0.04/100; (CI 0.00–0.20) for severe haemophilia B. Differences between plasma-derived and recombinant concentrates, or among the different recombinant FVIII concentrates were investigated. In conclusion, while confirming the expected rates of inhibitors in PUPs and PTPs, no class or brand related differences were observed.
Genetic and Clinical Risk Prediction Model for Postoperative Atrial Fibrillation
Authors: Kolek Matthew J. , Muehlschlegel J. Daniel , Bush William S. , Parvez Babar , Murray Katherine T. , Stein C. Michael , Shoemaker M. Benjamin , Blair Marcia A. , Kor Kaylen C. , Roden Dan M. , Donahue Brian S. , Fox Amanda A. , Shernan Stanton K. , Collard Charles D. , Body Simon C. , Darbar Dawood 
Published: January 2015

Background—
Postoperative atrial fibrillation (PoAF) is common after coronary artery bypass grafting. We previously showed that atrial fibrillation susceptibility single nucleotide polymorphisms (SNPs) at the chromosome 4q25 locus are associated with PoAF. Here, we tested the hypothesis that a combined clinical and genetic model incorporating atrial fibrillation risk SNPs would be superior to a clinical-only model.

Methods and Results—

We developed and externally validated clinical and clinical/genetic risk models for PoAF. The discovery and validation cohorts included 556 and 1164 patients, respectively. Clinical variables previously associated with PoAF and 13 SNPs at loci associated with atrial fibrillation in genome-wide association studies were considered. PoAF occurred in 30% and 29% of patients in the discovery and validation cohorts, respectively. In the discovery cohort, a logistic regression model with clinical factors had good discrimination, with an area under the receiver operator characteristic curve of 0.76. The addition of 10 SNPs to the clinical model did not improve discrimination (area under receiver operator characteristic curve, 0.78;
P
=0.14 for difference between the 2 models). In the validation cohort, the clinical model had good discrimination (area under the receiver operator characteristic curve, 0.69) and addition of genetic variables resulted in a marginal improvement in discrimination (area under receiver operator characteristic curve, 0.72;
P
<0.0001).

Conclusions—
We developed and validated a model for the prediction of PoAF containing common clinical variables. Addition of atrial fibrillation susceptibility SNPs did not improve model performance. Tools to accurately predict PoAF are needed to risk stratify patients undergoing coronary artery bypass grafting and identify candidates for prophylactic therapies.
Turbulent Mixing in Shallow Trade Wind Cumuli: Dependence on Cloud Life Cycle
Authors: Schmeissner T. , Shaw R. A. , Ditas J. , Stratmann F. , Wendisch M. , Siebert H. 
Published: January 2015

Abstract
Helicopter-borne observations of the impact of turbulent mixing and cloud microphysical properties in shallow trade wind cumuli are presented. The measurements were collected during the Cloud, Aerosol, Radiation and Turbulence in the Trade Wind Regime over Barbados (CARRIBA) project. Basic meteorological parameters (3D wind vector, air temperature, and relative humidity), cloud condensation nuclei concentrations, and cloud microphysical parameters (droplet number, size distribution, and liquid water content) are measured by the Airborne Cloud Turbulence Observation System (ACTOS), which is fixed by a 160-m-long rope underneath a helicopter flying with a true airspeed of approximately 20 m s−1. Clouds at different evolutionary stages were sampled. A total of 300 clouds are classified into actively growing, decelerated, and dissolving clouds. The mixing process of these cloud categories is investigated by correlating the cloud droplet number concentration and cubed droplet mean volume diameter. A significant tendency to more inhomogeneous mixing with increasing cloud lifetime is observed. Furthermore, the mixing process and its effects on droplet number concentration, droplet size, and cloud liquid water content are statistically evaluated. It is found that, in dissolving clouds, liquid water content and droplet number concentration are decreased by about 50% compared to actively growing clouds. Conversely, the droplet size remains almost constant, which can be attributed to the existence of a humid shell around the cloud that prevents cloud droplets from rapid evaporation after entrainment of premoistened air. Moreover, signs of secondary activation are found, which results in a more difficult interpretation of observed mixing diagrams.
A national survey of troponin testing and recommendations for improved practice
Authors: McKeeman Gareth C , Auld Peter W 
Published: January 2015

Background The introduction of troponin assays with higher analytical sensitivity and enhanced performance has produced new challenges for both laboratory and clinician in the optimal investigation of patients with cardiovascular disease. After some years of collective experience with this new generation of assays, this survey aimed to assess the level of consensus that exists regarding their application. Methods A questionnaire was designed, based on a review of published evidence and current opinion, to obtain information on a number of key areas relating to troponin analysis and reporting and was circulated to lead laboratory consultants across the UK and Ireland. Results Completed questionnaires were received from 94 laboratory contacts. Sixty per cent of those who responded had implemented a high-sensitivity troponin assay, with the Roche Cobas troponin T high sensitivity assay the most widely used. It is evident that some confusion remains regarding the definition of high-sensitivity assays and there was considerable variation in practice, even among those using the same manufacturer’s assay. Conclusions There is a need for greater consensus in the approach to the clinical utilization of troponin assays with improved sensitivity and it is important that laboratories are fully aware of the capabilities of their assay and provide useful guidance to users. On the basis of survey findings and the existing evidence base, a number of recommendations have been proposed to improve current practice and enhance patient safety.
Developing occupational therapy students’ practice habits via qualitative inquiry education
Authors: Marterella Abbey L. , Aldrich Rebecca M. 
Published: January 2015

Background Accreditation standards and practice competencies underscore the importance of research for occupational therapy practice, but they do not guide how occupational therapy education addresses research. Despite the prominence of qualitative research in the health professions, there exists a need to articulate how and why qualitative inquiry is taught in occupational therapy education. Purpose We discuss how qualitative inquiry education can develop habits of reflection and reflexivity, criticality, and active engagement in preparation for occupational therapy practice. Key Issues We hold that our students’ professional abilities to practice in a well-reasoned, ethical, and responsive manner are enhanced by experiences with qualitative inquiry and suggest that there is potential in linking qualitative inquiry experiences to professional habit formation in occupational therapy education. Implications In addition to teaching research for its own sake, we suggest that educators can adopt a broader view of how qualitative inquiry functions within occupational therapy education.
Consultation of traditional bone setters instead of doctors: Is it a sociocultural and educational or social insurance problem?
Authors: Gölge Umut Hatay , Kaymaz Burak , Kömürcü Erkam , Eroğlu Mehmet , Göksel Ferdi , Nusran Gürdal 
Published: January 2015

Background Patients consulting bone setters is common in the eastern and south-eastern regions of Turkey. The reasons for consulting bone setters instead of qualified doctors remains unclear. We investigated the characteristics of such patients who consult traditional bone setters after trauma prior to admission to hospital. Methods In the study, 3,422 of 14,080 patients were investigated admitted to hospital between January 2012 and February 2013 with trauma or sequelae of such who were previously treated by bone setters. The characteristics of these patients and the main reasons for consultation of bone setters instead of doctors were recorded. Results Most of the patients consulting bone setters were found to be young adults or children. Generally speaking, the poorly educated prefer bone setters despite having social insurance. The most common reason (29.3%) was a general preference and secondarily (27.1%) the fear of being disabled after medical treatment. However, the most common cause of patients’ consultation at hospital subsequently was due to complications of treatment (46.8%); indeed the complication rate after bone setters’ intervention was found to be 54.8%. Conclusion Although improvements have occurred in the access to and utilisation of healthcare services, consultation by patients of bone setters seems to be a sociocultural and educational issue rather than a problem of lack of medical insurance.
Dose of arm activity training during acute and subacute rehabilitation post stroke: a systematic review of the literature
Authors: Hayward Kathryn S , Brauer Sandra G 
Published: January 2015

Aim: To determine the dose of activity-related arm training undertaken by stroke survivors during acute and subacute rehabilitation. Methods: A systematic review of PubMed, CINAHL and EMBASE up to December 2014 was completed. Studies were eligible if they defined the dose (time or repetitions) of activity-related arm training using observational methods for a cohort of adult stroke survivors receiving acute or subacute rehabilitation. All studies were quality appraised using an evidence-based learning critical appraisal checklist. Data was analysed by method of documented dose per session (minutes, repetitions), environment (acute or subacute rehabilitation) and therapy discipline (physiotherapy, occupational therapy). Results: Ten studies were included: two observed stroke survivors during acute rehabilitation and eight during subacute rehabilitation. During acute rehabilitation, one study reported 4.1 minutes per session during physiotherapy and 11.2 minutes during occupational therapy, while another study reported 5.7 minutes per session during physiotherapy only. During inpatient rehabilitation, activity-related arm training was on average undertaken for 4 minutes per session (range 0.9 to 7.9, n = 4 studies) during physiotherapy and 17 minutes per session (range 9.3 to 28.9, n = 3 studies) during occupational therapy. Repetitions per session were reported by two studies only during subacute rehabilitation. One study reported 23 repetitions per session during physiotherapy and occupational therapy, while another reported 32 repetitions per session across both disciplines. Conclusion: The dose of activity-related arm training during acute and subacute rehabilitation after stroke is limited.
Percutaneous Cholecystostomy is an Effective Definitive Treatment Option for Acute Acalculous Cholecystitis
Authors: Kirkegård J. , Horn T. , Christensen S. D. , Larsen L. P. , Knudsen A. R. , Mortensen F. V. 
Published: January 2015

Aims: Acute acalculous cholecystitis can be treated with percutaneous cholecystostomy in critically ill patients unfit for surgery. However, the evidence on the outcome is sparse. We conducted a retrospective analysis of acute acalculous cholecystitis patients treated with percutaneous cholecystostomy during a 10-year study period. Methods: An observational study of 56 consecutive patients treated with percutaneous cholecystostomy for acute acalculous cholecystitis was conducted in the period from 1 June 2002 to 31 May 2012. All data were obtained by review of medical records. Results: A total of 56 consecutive patients were treated with percutaneous cholecystostomy for acute acalculous cholecystitis. Six patients (10.7%) died within 30 days after the procedure. Percutaneous cholecystostomy could serve as a definitive treatment option in 45 patients (80.4%), whereas 1 patient (1.8%) required cholecystectomy due to recurrence of cholecystitis. Four patients (7.1%) were treated with percutaneous cholecystostomy as a bridging procedure to subsequent elective laparoscopic cholecystectomy within a median of 8.8 months (range: 7.7–33.4 months). There was no significant difference in the risk of cholecystitis recurrence between patients with (6/37) and without (2/3) contrast passage to the duodenum on cholangiography ( p = 0.096). Conclusion: Percutaneous cholecystostomy is successful as a definitive treatment option in the majority of patients with acute acalculous cholecystitis. It is associated with a low rate of mortality and subsequent cholecystectomy.