bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mental health services need action on organisational culture and justice
Authors: Looi Jeffrey C.L. , Allison Stephen , Bastiampillai Tarun , Kisely Stephen R. 
Published: June 2022

Objective A commentary on the usefulness of the concepts of organisational culture, organisational climate and justice on the quality and safety of mental health services and how conditions may be improved. Conclusions Organisational culture, organisational climate and justice impact upon the quality and safety of care, as well as well-being of staff, in mental health services. Psychiatrists and trainees, should consider, act and advocate for improved organisational culture, climate and justice. Improvement in these organisational domains can be achieved, through a coordinated framework that acts across all levels of administration, mid-level management and frontline clinical staff.
Evaluation of the FreeStyle Libre, a flash glucose monitoring system, in client-owned cats with diabetes mellitus
Authors: Knies Marieke , Teske Erik , Kooistra Hans 
Published: June 2022

Objectives Home blood glucose monitoring using a portable blood glucose meter is important in the management of feline diabetes mellitus, but taking blood samples may be stressful for owners and cats. A flash glucose monitoring system measuring interstitial glucose, such as the FreeStyle Libre, overcomes some of these drawbacks. The aim of this study was to evaluate the practical use and analytical and clinical accuracy of the FreeStyle Libre in 41 client-owned diabetic cats. Methods In this prospective study, interstitial glucose concentrations were measured with the FreeStyle Libre and compared with blood glucose concentrations measured with a portable blood glucose meter (AlphaTRAK) on days 1, 7 or 8 and 14 after application of the device. Cat behaviour during application, location, skin reaction at the attachment site and owner satisfaction were assessed. Accuracy was determined by fulfilment of ISO 15197:2013 criteria, including Bland–Altman plotting and error grid analysis. Results Placing the device was easy, with 70% of cats showing no reaction. Most sensors were placed on the thoracic wall. Skin reactions at the attachment site were not present or mild in almost all cats. Owners were very satisfied with the use of the FreeStyle Libre. Median functional life of the sensor was 10 days (range 1–14). Good correlation was found between interstitial and blood glucose measurements (rho[r] = 0.88, P <0.0001). Fifty-three percent of interstitial glucose concentrations were within a maximum deviation of 15% from blood glucose concentrations and 92.7% were within the safe risk zones 0 and 1 of the surveillance error grid. Conclusions and relevance The flash glucose monitoring system was easy to use and owners of diabetic cats were satisfied with its use. Although the device did not completely fulfil ISO requirements, it is sufficiently accurate for glucose monitoring in diabetic cats.
Use of tetrasodium EDTA acid for the treatment of intraluminal obstruction of subcutaneous ureteral bypass devices
Authors: Duval Valerie , Dunn Marilyn , Vachon Catherine 
Published: June 2022

Objectives The aim of this study was to evaluate the efficacy and tolerability of a 4% tetrasodium EDTA (tEDTA) infusion protocol in the subcutaneous ureteral bypass (SUB) devices of cats with intraluminal obstruction at a veterinary teaching hospital between July 2017 and April 2020. Methods This was a retrospective controlled study. Cats with an obstructed SUB device underwent a 4% tEDTA infusion protocol. Obstruction of the device was diagnosed based on renal pelvic dilation, dilatation of the ureter, mineralized material within the device (cystostomy or nephrostomy catheters) seen on ultrasound, the absence of visible bubbles within the renal pelvis and/or urinary bladder following ultrasound-guided flushing of the device with saline. Results A total of 16 tEDTA infusion protocols were performed in 14 cats. The infusion protocol was considered successful in 11/16 SUB devices (68.8%). Six devices (n = 6/11; 54.5%) had recurrence of obstruction with a median time of 87 days. One or more episodes of self-limiting pollakiuria and/or hematuria following infusion was seen in eight patients (n = 8/14; 57.1%). Conclusions and relevance Infusions of 4% tEDTA successfully relieved intraluminal obstruction in patients with occluded SUB devices; however, the recurrence of obstruction was common. Additional studies evaluating case selection and optimal protocols are warranted.
Using root cause analysis as a tool to reduce central venous catheters in haemodialysis patients
Authors: Balson Laura , Stevenson Tamasin , Baharani Jyoti 
Published: June 2022

Background: Haemodialysis remains the most common modality of renal replacement therapy. National and international guidelines continue to promote arteriovenous fistulas or grafts as the preferred vascular access for haemodialysis, given the increased risks associated with use of central venous catheters (CVCs). Our renal centre pursues a ‘fistula first’ culture and uses root cause analysis and a patient safety incident based approach to meet the recommended standards of minimal CVC use in dialysis patients. Methods: We undertook a retrospective observational review looking at patterns of CVC use amongst our patients to identify themes and changes over time. Using data collected over a 5 year period, we examined 100 patient safety incidents involving CVC use in planned haemodialysis patients. We used a contributory factors framework to identify systemic contributors to each incident. Results: During the study period our centre achieved the national standard of at least 60% of incident dialysis patients commencing planned haemodialysis via arteriovenous access. About 26% of cases of CVC use in incident dialysis patients were deemed potentially avoidable. The most common contributory factor identified in these cases was poor communication. Conclusions: Using a root cause analysis based methodology to examine CVC use in haemodialysis is a novel approach to quality improvement in this area. Our methodology can be used as a framework by other centres to optimise the provision of safe, effective, and timely vascular access for dialysis, with multiple benefits for both renal services and individual patients.
An Examination of Melanoma Detection and Characteristics at a Nova Scotia Tertiary Care Centre, From 2015-2019
Authors: Tsai Meng-Chiao , Hodgson Kevin , Sandila Navjot , Bosworth Alia , Hull Peter R. 
Published: June 2022

Background Melanoma is one of the most common cancers in Canada, 1 with the highest incidence in Nova Scotia (NS). Objectives To describe the demographics, lesion characteristics, and diagnostic accuracy of suspected melanomas excised at the largest center in NS. Methods The dermatopathology database was interrogated for cases of possible melanoma from 2015 through 2019. Age, gender, site of lesion, pathologic diagnosis, Breslow depth, and equivocal pathology were assessed. Results 984 lesions had a clinical diagnosis of possible melanoma, identifying 301 melanomas. Of these, 142 (47%) were melanoma in situ (MIS) which in females occurred mostly on the extremities, while in males the head predominated. For invasive melanoma (IM), the extremities remained predominant for women, while the back was most common in men. Lower extremity lesions were more likely to be invasive and female patients were more likely to present with them at a younger age compared to males. The pathology was challenging for 23.94% of MIS, and 16.18% of IM. A mean of 3.1 lesions were excised for every melanoma identified. Conclusions Early diagnosis of melanoma is challenging clinically and pathologically. Our melanoma detection rate was 31%, with an increasing trend in the proportion of MIS, and decreasing trend in the proportion of IM over the years. Almost 50% of melanomas were detected in early stages, supporting positive outcomes. Melanomas were more common on extremities in females and the back in males. Melanomas on the lower limbs were more likely to be invasive regardless of gender.
The Experiences and Perceptions of Sexually Abused Children as Participants in the Legal Process: Key Conclusions From a Scoping Literature Review
Authors: Field Noa , Katz Carmit 
Published: June 2022

Child sexual abuse (CSA) is a phenomenon that receives attention from researchers and practitioners worldwide. An unknown percent of cases are disclosed bravely by children to authorities. One part of those children’s journey can involve the legal process, which aims to decide whether a crime happened and, if so, to sentence the offender. To do so, a considerable amount of evidence is required. Part of what makes CSA cases complex is that the child’s word is often the only evidence. There are growing discussions concerning the importance of children’s participation in the legal process, pointing to its contribution to practitioners’ decision-making as well as children’s wellbeing. The current scoping review aimed to examine the existing knowledge regarding how children experience and perceive participation in the legal process following CSA. Although this issue has been previously addressed, the current study was designed to systematically spotlight studies that pinpoint children’s perceptions and experiences. Using PRISMA guidelines, 17 manuscripts in peer-reviewed journals over the last 11 years were identified. The analysis yielded a major theme of children’s need for validation, with four subthemes relating to the need to be protected, the need to be seen and heard, the need to be believed, and the need to be provided with support. The themes and how they relate to other aspects of sexually abused children’s lives are discussed as well as practical implications for future studies. The main conclusion relates to the necessity for a holistic approach with children throughout the legal process.
Clinical relevance of endoscopic peri-appendiceal red patch in ulcerative colitis patients
Authors: Reijntjes Maud A. , Heuthorst Lianne , Gecse Krisztina , Mookhoek Aart , Bemelman Willem A. , Buskens Christianne J. 
Published: June 2022

Background: Increasing evidence is suggesting appendectomy as an alternative treatment for ulcerative colitis (UC), especially in case of histological appendiceal inflammation. Therefore, preoperative identification of appendiceal inflammation could be beneficial. This study aimed to assess the prevalence of peri-appendiceal red patch (PARP) on colonoscopy. In addition, prognostic relevance of PARP for disease course and its predictive value for histological appendiceal inflammation in patients undergoing appendectomy was assessed. Methods: UC patients undergoing colonoscopy in 2014/2015 were included to determine PARP-prevalence in a cross-sectional study. Findings were correlated to patient and disease characteristics, upscaling of treatment and colectomy rates after cross-sectional colonoscopy. In patients undergoing appendiceal resection, histopathological inflammation was assessed using the Robarts Histopathology Index (RHI). Results: In total, 249 patients were included of which 17.7% (44/249) had a PARP. Patients with PARP were significantly younger with a shorter disease course. The majority of patients with PARP (61.4%) was in endoscopic remission. Patients with PARP required more upscaling of medical therapy (81.8% vs. 58.0%, p < 0.01), and more PARP patients underwent colectomy (13.6% vs. 4.9%, p = 0.04). Patients with PARP had a higher median RHI in resection specimens (14 vs. 7, p < 0.01). Conclusion: PARP was present during colonoscopy regardless disease activity and was predominantly found in UC patients with younger age and shorter disease duration. PARP patients had a more severe course of UC, and in case of appendectomy, more severe histopathological appendiceal inflammation. Appendectomy as an experimental therapy for UC has been suggested to be predominantly effective in UC patients with appendiceal inflammation. This study demonstrates that presence of a PARP on colonoscopy predicts appendiceal inflammation. After consensus has been reached on the therapeutic effect of appendectomy, assessing PARP presence during colonoscopy could therefore contribute to identifying patients most likely to respond.
Gender dimorphism in survival of patients with lymph node metastasis of bladder cancer
Authors: Guo Yadong , Zheng Zongtai , Zhang Wentao , Mao Shiyu , Yang Fuhan , Li Wei , Yan Yang , Yao Xudong 
Published: June 2022

Background: The effect of gender on the prognosis of bladder cancer (BCa) in different metastatic sites is insufficiently understood. We aimed to assess the impact and potential mechanisms of a combination of gender dimorphism and BCa metastasis sites on the risk of death. Methods: Independent predictors of overall survival and cancer-specific survival were analyzed after stratification by gender and metastasis sites from the Surveillance, Epidemiology, and End Results database. Furthermore, gender-differentially expressed genes (DEGs) and function-enriched annotations for patients with lymph node metastasis (LNM) were identified from The Cancer Genome Atlas (TCGA) database. A gender-associated signature was constructed in TCGA and validated in the IMvigor210 trial, and the magnetic resonance imaging-based radiomics signature was developed in our center to predict the gender-associated signature. Results: In patients with metastatic BCa, the most common site of metastasis is bone in men and lung in women. Moreover, stratified by sex, LNM had a better prognosis in men than visceral metastasis, which was not observed in female. Similarly, stratified by the metastasis site, the prognosis of men in patients with LNM is better than that of women, which was not observed in visceral metastasis patients. Enrichment of DEGs between sexes in patients with LNM may be related to metastasis and tumor immunity, especially the role of neutrophils. Moreover, the gender-associated signature is related to the clinicopathological characteristics of patients, and patients in the high-risk group had worse survival outcomes, and higher susceptibility to cisplatin, docetaxel, camptothecin, and paclitaxel. A nomogram combined with the signature and clinical staging showed significant predictive power in survival prediction. Furthermore, patients with high radiomics scores had a strong tendency for high-risk group. Conclusion: These results may improve the understanding of the differences in tumor biology between sexes and thus provide additional evidence for individualized treatment in BCa.
Rehabilitation Variability Following Osteochondral Autograft and Allograft Transplantation of the Knee
Authors: Crowley Stephen G. , Pedersen Anthony , Fortney Thomas A. , Swindell Hasani W. , Saltzman Bryan M. , Popkin Charles A. , Trofa David P. 
Published: June 2022

Objective The aim of this study is to assess the variability of postoperative rehabilitation protocols used by orthopedic surgery residency programs for osteochondral autograft transplantation (OAT) and osteochondral allograft transplantation (OCA) of the knee. Design Online postoperative OAT and OCA rehabilitation protocols from US orthopedic programs and the scientific literature were reviewed. A custom scoring rubric was developed to analyze each protocol for the presence of discrete rehabilitation modalities and the timing of each intervention. Results A total of 16 programs (10.3%) from 155 US academic orthopedic programs published online protocols and a total of 35 protocols were analyzed. Twenty-one protocols (88%) recommended immediate postoperative bracing following OAT and 17 protocols (100%) recommended immediate postoperative bracing following OCA. The average time protocols permitted weight-bearing as tolerated (WBAT) was 5.2 weeks (range = 0-8 weeks) following OAT and 6.2 weeks (range = 0-8 weeks) following OCA. There was considerable variation in the inclusion and timing of strength, proprioception, agility, and pivoting exercises. Following OAT, 2 protocols (8%) recommended functional testing as criteria for return to sport at an average time of 12.0 weeks (range = 12-24 weeks). Following OCA, 1 protocol (6%) recommended functional testing as criteria for return to sport at an average time of 12.0 weeks (range = 12-24 weeks). Conclusion A minority of US academic orthopedic programs publish OAT and OCA rehabilitation protocols online. Among the protocols currently available, there is significant variability in the inclusion of specific rehabilitation components and timing of many modalities. Evidence-based standardization of elements of postoperative rehabilitation may help improve patient care and subsequent outcomes.
Routine Stress-Rest Tc-99m MIBI Myocardial Perfusion Scintigraphy Underestimates Ischemia and Viability
Authors: Ora Manish , Pradhan Prasanta Kumar , Garg Naveen , Kheruka Subhash 
Published: June 2022

Objective: The study included patients with known or suspected coronary artery disease. It aimed to demonstrate the incremental value of the routine nitrate augmentation in stress-rest technetium-99m methoxyisobutylisonitrile (Tc-99m MIBI) myocardial perfusion scintigraphy (MPS). Material and Methods: Standard stress and rest MPS was performed, followed by a second rest study with isosorbide dinitrate intervention within 5 days. The redistribution of Tc-99m MIBI was compared between stress and rest images, and interpretation of the study done as normal, scarred, and ischemia ± mixed lesion groups. The rest studies were compared with the rest nitrate studies. Summed rest score (SRS) and summed rest nitrate score (SRNS) were calculated. The summed difference score (SDS) of SRS and SRNS was calculated for each group. Results: A total of 50 patients were included in the study. Based on the routine MPS, patients were divided into the scar (n = 20), ischemia (n = 18), and normal (n = 12) groups. After the administration of nitrate, a significant fall in the blood pressure ( P < .001) and an increase in the heart rate ( P < .001) were noted. SDS was not significant in the normal MPS group (0.17 ± 0.57, P = .19). In comparison, substantial SDS was found in the ischemia ± mixed lesion (4.33 ± 3.43) and scarred (3.5 ± 3.15), respectively (both P < .001). Percentage improvement in the SRS from SRNS was found less than 2% for normal MPS while 18% and 29% for scarred and mixed groups, respectively. Conclusion: Routine MPS (stress followed by rest) underestimate ischemia and viability, which can be significantly reduced by utilizing nitrate augmentation in all patients with abnormal stress MPS. This could lead to a significant change in the extent and severity of ischemia and viability.
Research on the Influence of Multiple Parameters on the Responses of a B-type Subway Train
Authors: Liu Yanwen , Yang Bing , Xiao Shoune , Zhu Tao , Yang Guangwu , Xiu Ruixian 
Published: June 2022

AbstractTo obtain improved comprehensive crashworthiness criteria for a B-type subway train, the influence laws of the vehicle design collision weight M and empty stroke D on the train’s collision responses were investigated, and multi-objective optimization and decision-making were performed to minimize TS (total compression displacement along the moving train) and TAMA (the overall mean acceleration along the moving train). Firstly, a one-dimensional train collision dynamics model was established and verified by comparing with the results of the finite element model. Secondly, based on the dynamics model, the influence laws of M and D on the collision responses, such as the energy-absorbing devices’ displacements and absorbed energy, vehicles’ velocity and acceleration, TS, TAMA and the coupling correlation effect were investigated. Then, surrogate models for TS and TAMA were developed using the optimal Latin hypercube method (OLHD) and response surface method (RSM), and multi-objective optimization was conducted using the particle swarm optimization algorithm method (MPOSO). Finally, the entropy method was used to obtain the weight coefficients for TS and TAMA, and multi-objective decision-making was performed. The results indicate that D and M significantly affect the compression displacements and energy absorption of the first three collision interfaces, but have limited impact on the last three collision interfaces. The velocity versus time curves of vehicle M1 and M2 are shifted and parallel with different D. However, the velocity versus time curves of all the vehicles are shifted but gradually divergent with different M. The maximum collision instantaneous accelerations of the vehicles are directly determined by M, but are only slightly affected by D. Under the coupling effect, all concerned collision responses are strongly correlated with M; however, the responses are weakly correlated with D except for the compression displacement at the M2-M3 collision interface and the maximum collision instantaneous acceleration of vehicle M2. The comprehensive crashworthiness criteria of the B-type subway train were significantly improved after multi-objective optimization and decision-making. The research provides more theoretical and engineering application references for the subway train crashworthiness design.
Morphological Heredity of Intermetallic Nb5Si3 Dendrites in Hypereutectic Nb-Si Based Alloys via Non-Equilibrium Solidification
Authors: Guo Yueling , Jia Lina , Lu Wenjun , Zhang Hu 
Published: June 2022

AbstractFor hypereutectic Nb-Si based alloys, primary Nb5Si3 phases typically grow in a faceted mode during equilibrium or near-equilibrium solidification, which damages the ductility and toughness. To address this issue, here we artificially manipulate the growth morphology of Nb5Si3 using electron beam surface melting (EBSM) and subsequent annealing treatments. Results show that such a non-equilibrium solidification pathway enables the transition from faceted growth to non-faceted dendritic growth of Nb5Si3, along with evident microstructure refinement, generation of metastable β-Nb5Si3 phases and elimination of chemical segregation. The transformation from β-Nb5Si3 to α-Nb5Si3 and Nb solid solution (Nbss) particles is triggered by the annealing treatment at 1450 °C for 5 h. Also, we find the annealing-mediated formation of inherited Nb5Si3 dendrites that maintain the dendritic morphology of the original as-solidified β-Nb5Si3 dendrites. This work thus provides a feasible routine to obtain thermally stable and refined α-Nb5Si3 dendrites in hypereutectic Nb-Si based alloys.
Application of a bending vibration method without weighing specimens to the practical wooden members conditions
Authors: Kubojima Yoshitaka , Sonoda Satomi , Kato Hideo 
Published: June 2022

AbstractA vibration test to measure the mass of a specimen without weighing it using the difference between the resonance frequency with an additional mass and that without it (vibration method with additional mass, VAM) was applied to small, clear, and wooden specimens assuming practical situations. An apparatus that provided various end conditions by compressing the ends of the specimens was used in the tests. Bending vibration tests were performed on the specimens installed in the apparatus with/without an additional mass. Because the mass ratio (estimated mass by VAM/measured mass), namely, MVAM/M0, which represents the estimation accuracy of VAM, was stable when the compressive strength was sufficiently large, VAM could be adequately used when the specimen was properly installed in the apparatus. The end condition at maximum compressive stress by the apparatus was an imperfect fixed condition. The MVAM/M0 value greatly deviated from 1 in the specimens with a large height. The deviation in MVAM/M0 from 1 was due to the introduction of the measured resonance frequencies with/without a concentrated mass into the frequency equation that required resonance frequencies under an ideal fixed–fixed condition. A correction method for MVAM/M0 was then proposed.