bluuebunny/crossref_metadata_2025_split huggingface dataset:
Duty Hours in Emergency Medicine: Balancing Patient Safety, Resident Wellness, and the Resident Training Experience: A Consensus Response to the 2008 Institute of Medicine Resident Duty Hours Recommendations
Authors: Wagner Mary Jo , Wolf Stephen , Promes Susan , McGee Doug , Hobgood Cheri , Doty Christopher , McErlean Mara Ann , Janssen Alan , Smith‐Coggins Rebecca , Ling Louis , Mattu Amal , Tantama Stephen , Beeson Michael , Brabson Thomas , Christiansen Greg , King Brent , Luerssen Emily , Muelleman Robert 
Published: September 2010

AbstractRepresentatives of emergency medicine (EM) were asked to develop a consensus report that provided a review of the past and potential future effects of duty hour requirements for EM residency training. In addition to the restrictions made in 2003 by the Accreditation Council for Graduate Medical Education (ACGME), the potential effects of the 2008 Institute of Medicine (IOM) report on resident duty hours were postulated. The elements highlighted include patient safety, resident wellness, and the resident training experience. Many of the changes and recommendations did not affect EM as significantly as other specialties. Current training standards in EM have already emphasized patient safety by requiring continuous on‐site supervision of residents. Resident fatigue has been addressed with restrictions of shift lengths and limitation of consecutive days worked. One recommendation from the IOM was a required 5‐hour rest period for residents on call. Emergency department (ED) patient safety becomes an important concern with the decrease in the availability and in the patient load of a resident consultant that may result from this recommendation. Of greater concern is the already observed slower throughput time for admitted patients waiting for resident care, which will increase ED crowding and decrease patient safety in academic institutions. A balance between being overly prescriptive with duty hour restrictions and trying to improve resident wellness was recommended. Discussion is included regarding the appropriate length of EM training programs if clinical experiences were limited by new duty hour regulations. Finally, this report presents a review of the financing issues associated with any changes.ACADEMIC EMERGENCY MEDICINE 2010; 17:1004–1011 © 2010 by the Society for Academic Emergency Medicine
Factors Related to Missed Diagnosis of Incidental Scabies Infestations in Patients Admitted Through the Emergency Department to Inpatient Services
Authors: Hong Ming‐Yuan , Lee Ching‐Chi , Chuang Ming‐Che , Chao Sheau‐Chiou , Tsai Ming‐Che , Chi Chih‐Hsien 
Published: September 2010

ACADEMIC EMERGENCY MEDICINE 2010; 17:958–964 © 2010 by the Society for Academic Emergency MedicineAbstractObjectives:  Scabies is highly contagious and requires prompt diagnosis and implementation of infection control measures to prevent transmission and outbreaks. This study investigated the clinical and administrative correlates associated with missed diagnosis of scabies in an emergency department (ED).Methods:  This was a retrospective study of patients with incidental scabies infestations who were admitted to a university hospital via the ED during a 4‐year period.Results:  A total of 135 inpatients were identified as having scabies; among them, 111 patients (82%) had visited the ED. Scabies were diagnosed during the ED stay in 39 of 111 patients (35%), while the diagnosis was missed in the ED in 72 patients (65%). Although no geographic clusters suggestive of nosocomial scabies transmission were registered, 160 medical workers and one hospitalized patient received prophylactic treatment due to direct skin‐to‐skin contact with inpatient scabies cases during the study period. Overcrowding (odds ratio [OR] = 8.4; 95% confidence interval [CI] = 1.9 to 38.0) and time constraints (OR = 8.2; 95% CI = 1.9 to 34.7) in the ED were associated with a missed diagnosis of scabies during ED stay. Patients with lower illness severity scores were at higher risk for failure to diagnose and to treat scabies prior to hospital admission (OR = 5.7; 95% CI = 1.6 to 20.9).Conclusions:  Missed diagnoses of scabies during ED stay may result in nosocomial spread and increase the unnecessary use of prophylactic treatments. ED overcrowding, time constraints, and less severe illness compromise ED recognition of scabies. Health care workers should be especially alert for signs of scabies infestations under these conditions.
Prospective Evaluation of Real‐time Use of the Pulmonary Embolism Rule‐out Criteria in an Academic Emergency Department
Authors: Kline Jeffrey A. , Peterson Courtney E. , Steuerwald Michael T. 
Published: September 2010

AbstractObjectives:  The pulmonary embolism rule‐out criteria (PERC rule) is a nine‐component decision rule derived to exclude pulmonary embolism (PE) without the use of formal diagnostic testing (D‐dimer, computed tomography pulmonary angiography, ventilation–perfusion lung scanning, or venous ultrasonography) when all nine components are negative (“PERC negative”). This study examined whether clinicians who document PERC negative also document results of all nine components of the PERC rule.Methods:  This was a pilot study at a single‐center, urban teaching emergency department (ED) with a residency program in emergency medicine. Patients were over 17 years of age with at least one of nine predefined chief complaints. Clinicians were asked three questions regarding suspicion for PE, intent to use the PERC rule, and the result. Charts were independently reviewed by two authors for fidelity of the nine PERC components. Patients were followed for PE outcome at 14 days.Results:  The study examined 526 patients cared for by 82 clinicians, who indicated suspicion for PE in 183 of 526 (35%) and intent to use the PERC rule in 115 of 526 (22%) cases, of whom 65 of 115 were documented as PERC negative. No formal test for PE was ordered in 49 of 65 (75%), and 46 of 49 had incomplete documentation to support PERC negative. The most common deficiency was omission of two risk factors for PE in the rule (prior venous thromboembolism or recent surgery). Six patients had PE diagnosed within 14 days, but none of these had been deemed PERC negative.Conclusions:  Clinicians seldom document all nine data elements of the PERC rule in patients they deem PERC negative. These data suggest the need for paper or electronic aids to support use of the PERC rule.ACADEMIC EMERGENCY MEDICINE 2010; 17:1016–1019 © 2010 by the Society for Academic Emergency Medicine
Why Bystanders Decline Telephone Cardiac Resuscitation Advice
Authors: Dami Fabrice , Carron Pierre‐Nicolas , Praz Laurent , Fuchs Vincent , Yersin Bertrand 
Published: September 2010

AbstractObjectives:  The aim of this study was to evaluate the rate and reason for refusal of telephone‐based cardiopulmonary resuscitation (CPR) instruction by bystanders after the implementation of the dispatch center’s systematic telephone CPR protocol.Methods:  Over a 15‐month period the authors prospectively collected all case records from the emergency medical services (EMS) dispatch center when CPR had been proposed to the bystander calling in and recorded the reason for declining or not performing that the bystander spontaneously mentioned. All pediatric and adult traumatic and nontraumatic cases were included. Situations when resuscitation had been spontaneously initiated by bystanders were excluded.Results:  During the study period, dispatchers proposed CPR on 264 occasions: 232 adult nontraumatic cases, 17 adult traumatic cases, and 15 pediatric (traumatic and nontraumatic) cases. The proposal was accepted in 163 cases (61.7%, 95% confidence interval [CI] = 54.6% to 66.5%), and CPR was eventually performed in 134 cases (51%, 95% CI = 43.2% to 55.3%). In 35 of the cases where resuscitation was not carried out, the condition of the patient or conditions at the scene made this decision medically appropriate. Of the remaining 95 cases, 55 were due to physical limitations of the caller, and 33 were due to emotional distress.Conclusions:  The telephone CPR acceptance rate of 62% in this study is comparable to those of other similar studies. Because bystanders’ physical condition is one of the keys to success, the rate may not improve as the population ages.ACADEMIC EMERGENCY MEDICINE 2010; 17:1012–1015 © 2010 by the Society for Academic Emergency Medicine
Stomatology and odontology: perspectives of Spanish professors and senior lecturers in dentistry
Authors: Seoane J. , Diz‐Dios P. , Martinez‐Insua A. , Varela‐Centelles P. , Nash D. A. 
Published: September 2010

AbstractThe curricula of dental faculties in many countries of the European Union can be described as odontological. The faculties of some of the countries who have become and are becoming members of the European Community have traditionally educated dentists in the stomatological tradition. In 1987, the Spanish dental education system initiated movement from the stomatological model to the odontological. Both models have their respective strengths and weaknesses. This study surveyed professors and senior lecturers in Spain’s public dental faculties to assess their perspectives on 10 items related to the tension between the odontological and the stomatological approach to preparing dentists. Amongst other things, the results of the study indicate that the respondents believe the odontological model, with its emphasis on strengthening technical qualifications, may not prepare individuals for dental practice better than the stomatology tradition; and that the odontological model results in the loss of the strength of the stomatological model, that is, the strong foundation in clinical medicine. The suggestion is advanced that European dental educators consider revising the odontology curriculum to strengthen the education of dental students in clinical medicine. A curriculum in which dental and medical students share the first 3 years of study could accomplish this. It is further suggested that subsequent years in the curriculum be flexible enough for students to earn degrees in both dentistry and medicine, if desired. Such an approach is not inconsistent with the accepted profile and competencies of the European dentist.
The relationship between formative and summative assessment of undergraduates in oral surgery
Authors: Anziani Helen , Durham Justin , Moore Undrell 
Published: September 2010

AbstractIntroduction:  Regular, on‐going formative assessments or a more comprehensive end of program summative assessment can be used to assess student’s progress. The literature is scarce regarding the use of both types of assessment coincidentally and if the outcomes of formative assessments can predict the grades achieved summatively. This paper investigates whether there is any correlation between the formative assessments used in routine clinical contacts in the Newcastle course and the final summative assessment grade.Materials and methods:  The logbooks of 72 third year dental students were examined to collect data on the gradings achieved for formative and summative assessments. The categories of history and presentation, local anaesthesia, extraction and overall grades for each were compared using Spearman’s Rho.Results:  Six logbooks were incomplete so were omitted from analysis (n = 66). In the formative assessment, the total number of teeth extracted was 1913, giving a mean per student of 29 (SD = 6.88). In the summative assessment, 15 students failed on their first attempt but all subsequently passed on resit.Discussion:  Positive correlation was found within each of the two types of assessment but no correlation was found between the overall grades for the formative and summative assessment. The overall grade achieved by a student in the formative assessment does not appear to predict their grade in the summative. The use of both assessments is beneficial, however, their use together must be considered carefully to avoid confusing students.
Minor and trace inorganic components of toothpastes
Authors: BRUNE DAG 
Published: September 2010

Abstract –Elements present in minor or trace quantities in various toothpastes available in Scandinavia have been quantitatively assayed by means of emission spectrography and neutron activation analysis. The elements antimony, arsenic, mercury or selenium were observed at levels less than 2 parts/106. Boron, gallium, iron, magnesium, manganese and titanium occurred at levels between 0.001 and 1 %. Cadmium, copper, lead, nickel and tin could not be identified. The detection limit for these elements amounted to 10 parts/106. The amounts of any of these elements which could be transferred to the body after swallowing toothpaste during brushing, have been compared with daily intake of similar elements through food and drinks, and found to be small compared to the diet intake except in the case of titanium. The intake of titanium from toothpaste could exceed the diet intake five times.
Bone resorption stimulated by lipopolysaccharides from Bacteroides, Fusobacterium and Veillonella, and by the lipid A and the polysaccharide part of Fusobacterium lipopolyccharide
Authors: SVEEN KJELL , SKAUG NILS 
Published: September 2010

Abstract –Lipopolysaccharides (LPS) isolated from oral strains of Veillonella, Fusobacterium and Bacteroides stimulated the release of 45Ca from prelabeled fetal rat bones in culture. There was a typical dose‐response relationship berween the quantities of released 45Ca and LPS used for stimulation. Bacteroides‐LPS proved to be the less active inducer of 45Ca release. LPS had no stimulating effect on the release of 45Ca from devitalized bone. The stimulated 45Ca release was paralleled by an increase in the culture midium of hydroxyproline and lactate. This, together with the findings of numerous osteoclasts in stained hisological specimens of the experimental bones, indicates that LPS stimulated the osteoclasts to bone resoption. Heparin, which did not directly induce 45Ca release, potentiated the bone resorption stimulating capability of LPS. The lipid A and the polysaccharide portion of Fusobacterium LPS also stimulated bone resorption and, remarkably, the polysaccharide portion showed the greatest activity. This may explain the mode of action of LPS lacking a typical lipid A. It is suggested that stimulation of osteoclasts by LPS may result from activation of complement by lipid A or its polysaccharide portion.
Restorative resins: abrasion vs. mechanical properties
Authors: JØRGENSEN KNUD DREYER 
Published: September 2010

Abstract –The purpose of the present work was to examine whether it is possible by simple and reliable laboratory tests to evaluate the abrasion by food of Glass 1 restorative resins. The results point to the following main conclusions: for the smooth‐surface resins, i. e. the micro‐filled composites and the unfilled resins, the Wallace hardness test appears to be a valid parameter for abrasion; the greater the depth of penetration of the Vickers diamond of this apparatus, the more severe abrasion is to be expected. The mode of abrasion in this type of resin is scratching. Porosity in the resins strongly enhances the abrasion. For the rough‐surface resins, i. e. the conventional composites, a dual effect of the filler particles was concluded. The filler particles on the one hand protect the matrix against abrasion, but cause, on the other hand, in time an increase of the surface roughness of the composite and thereby via increased friction an increase of the abrasion. Considerations on possible ways to improve the present‐day restorative resins are presented, It is stressed that the results obtained refer only to abrasion of Class 1 fillings by food.
Update on the fellowship exam and its relation to modern educational principles and clinical competency
Authors: Hazell Wayne , Rogers Ian R 
Published: September 2010

AbstractThe Australasian College for Emergency Medicine is committed to a long term process of quality improvement in the fellowship examination and the training programme leading up to it. The process of quality improvement and the rationale for current and future processes are not always clear to the fellowship as a whole.The present article attempts to update the fellowship on the current thinking with regard to the fellowship exam and the work that is being done surrounding this and relevant areas. This is related to some modern educational assessment principles and terminology. More research is required into the relevance of each component of the fellowship exam and its relation to clinical competency, key competencies and good clinical practice. Any subsequent changes to the exam structure must take into account the evidence and be balanced by what is practicable, reasonable and deliverable.
Processes and impediments in moving patients from the emergency department: Pilot study
Authors: Oakley Edward , Braitberg George 
Published: September 2010

AbstractObjective: To assess the impact of an ED‐designed interim orders sheet on patient flow through the ED, and the safety of ED‐directed admission.Methods: The flow of patients through the ED and inpatient length of stay (IPLOS) was retrospectively reviewed on 135 patients who were admitted using interim orders and 125 patients who were admitted after inpatient unit review in the ED.Results: The median time to admission to the ward in the non‐interim orders group was 5.7 h (interquartile range [IQR]: 3.8–8.5), with a range from 1.2 to 15.9 h, and in the interim orders group was 6.3 h (IQR: 4.8–8.0) with a range from 0.5 to 22 h (P = 0.27). The median IPLOS was 4 days (IQR: 2.0–7.0) in the interim orders group, and 4 days (IQR: 2.1–9.0) in the non‐interim orders group (P = 0.19).Conclusion: There was no difference in the time to patient admission, or IPLOS, with the different processes. Almost half of the average ED stay of adults and about one‐third of that of paediatric admissions occurred after the decision to admit was made. Transfer of patients to the ward without inpatient review is appropriate and effective.
Amphetamine‐induced movement disorder
Authors: Downes Michael A , Whyte Ian M 
Published: September 2010

AbstractRecreational use of amphetamines is common in Australia and New Zealand when compared with other developed nations. The clinical effects are variable because of the potential of these drugs to increase the proportion of different biogenic amines in the central nervous system (CNS). The substances affected are adrenaline, noradrenaline, serotonin and dopamine. Movement disorders represent one of the less common presentations of amphetamine toxicity but one that health care workers should be aware of nonetheless.
Chest pain in pacemaker patients, the answer is not always antiplatelets and anticoagulants: A four‐case series
Authors: Modi Simon , Cooper Robert , Hall Mark , Wright Jay , Todd Derick 
Published: September 2010

AbstractChest pain in pacemaker patients can be difficult to evaluate due to alterations in QRS and ST segments on the surface ECG. A high prevalence of ischaemic heart disease in this population also serves to influence the differential diagnosis. We highlight four cases, all with simple yet informative imagery, in an attempt to alert clinicians of worrying signs.
Cosmological Arguments from Contingency
Authors: Rasmussen Joshua 
Published: September 2010

AbstractCosmological arguments from contingency attempt to show that there is a necessarily existing god‐like being on the basis of the fact that any concrete things exist at all. Such arguments are built out of the following components: (i) a causal principle that applies to non‐necessary entities of a certain category; (ii) a reason to think that if the causal principle is true, then there would have to be a necessarily existing concrete thing; (iii) a reason to think that the necessarily existing thing would be god‐like. In this essay, I discuss various ways of developing each of these components to produce an argument from contingency, and I point out classic objections and replies along the way. I also make note of some of the most recent developments in arguments from contingency and point out avenues for future research.
Cognitive Science and the Naturalness of Religion
Authors: McCauley Robert N. , Cohen Emma 
Published: September 2010

AbstractCognitive approaches to religious phenomena have attracted considerable interdisciplinary attention since their emergence a couple of decades ago. Proponents offer explanatory accounts of the content and transmission of religious thought and behavior in terms of underlying cognition. A central claim is that the cross‐cultural recurrence and historical persistence of religion is attributable to the cognitive naturalness of religious ideas, i.e., attributable to the readiness, the ease, and the speed with which human minds acquire and process popular religious representations. In this article, we primarily provide an introductory summary of foundational questions, assumptions, and hypotheses in this field, including some discussion of features distinguishing cognitive science approaches to religion from established psychological approaches. Relevant ethnographic and experimental evidence illustrate and substantiate core claims. Finally, we briefly consider the broader implications of these cognitive approaches for the appropriateness of ‘religion’ as an explanatorily useful category in the social sciences.
“A Woman's World”: The University of California, Berkeley, During the Second World War
Authors: Dorn Charles 
Published: September 2010

The fairer sex takes over and the campus becomes a woman's world. They step in and fill the shoes of the departing men and they reveal a wealth of undiscovered ability. The fate of the A.S.U.C. [Associated Students of the University of California] and its activities rests in their hands and they assume the responsibility of their new tasks with sincerity and confidence. —Blue and Gold, University of California, Berkeley, 1943During World War II, female students at the University of California, Berkeley—then the most populous undergraduate campus in American higher education—made significant advances in collegiate life. In growing numbers, women enrolled in male-dominated academic programs, including mathematics, chemistry, and engineering, as they prepared for home-front employment in fields traditionally closed to them. Women also effectively opposed gendered restrictions on extracurricular participation, filling for the first time such influential campus leadership positions as the presidency of Berkeley's student government and editorship of the university's student newspaper. Female students at Berkeley also furthered activist causes during the war years, with the University Young Women's Christian Association (YWCA) serving as one of the most popular outlets for their political engagement. Historically rooted in a mission of Christian fellowship, by the 1940s the University YWCA held progressive positions on many of the nation's central social, political, and economic issues. Throughout the war years, women dedicated to promoting civil liberties, racial equality, and international understanding led the organization in its response to two of the most egregious civil rights violations in U.S. history: racial segregation and Japanese internment.