bluuebunny/crossref_metadata_2025_split huggingface dataset:
Capacity for consciousness under ketamine anaesthesia is selectively associated with activity in posteromedial cortex in rats
Authors: Arena A , Juel B E , Comolatti R , Thon S , Storm J F 
Published: March 2022

Abstract
It remains unclear how specific cortical regions contribute to the brain’s overall capacity for consciousness. Clarifying this could help distinguish between theories of consciousness. Here, we investigate the association between markers of regionally specific (de)activation and the brain’s overall capacity for consciousness. We recorded electroencephalographic responses to cortical electrical stimulation in six rats and computed Perturbational Complexity Index state-transition (PCIST), which has been extensively validated as an index of the capacity for consciousness in humans. We also estimated the balance between activation and inhibition of specific cortical areas with the ratio between high and low frequency power from spontaneous electroencephalographic activity at each electrode. We repeated these measurements during wakefulness, and during two levels of ketamine anaesthesia: with the minimal dose needed to induce behavioural unresponsiveness and twice this dose. We found that PCIST was only slightly reduced from wakefulness to light ketamine anaesthesia, but dropped significantly with deeper anaesthesia. The high-dose effect was selectively associated with reduced high frequency/low frequency ratio in the posteromedial cortex, which strongly correlated with PCIST. Conversely, behavioural unresponsiveness induced by light ketamine anaesthesia was associated with similar spectral changes in frontal, but not posterior cortical regions. Thus, activity in the posteromedial cortex correlates with the capacity for consciousness, as assessed by PCIST, during different depths of ketamine anaesthesia, in rats, independently of behaviour. These results are discussed in relation to different theories of consciousness.
Quo vadis, OHADA Private International Law?
Authors: Monsenepwo Justin 
Published: March 2022

Abstract
Twenty-eight years after the creation of the Organization for the Harmonization of Business Law in Africa (OHADA), private international law remains a “Cinderella subject” in western and central Africa. Indeed, there are no coherent sets of rules regarding the law applicable to contractual obligations, international jurisdiction, as well as the recognition and enforcement of foreign judgments under OHADA law. This article contends that the main reason behind the lesser importance given to private international law in the OHADA region can be found in OHADA’s unification technique itself: OHADA unifies (and does not merely harmonize) business law. Its Uniform Acts are directly applicable and overriding in all the Member States; therefore, one could (erroneously) think that courts would never have to grapple with difficult questions as to which Member State’s law would apply to a dispute falling within the scope of a Uniform Act, as the laws of all the Member States would yield the same results. This article demonstrates that the Uniform Acts are incomplete either because they contain gaps or because they sometimes refer to the national legislations of the Member States. Thus, the unification of the substantive rules does not eliminate the need for the existence and the unification of conflict-of-laws rules. Moreover, this article provides a tour d’horizon of the existing seldom private international law rules under OHADA law. Additionally, it suggests new avenues for the development of a future OHADA legislation on the law applicable to contractual obligations, international jurisdiction, as well as the recognition and enforcement of foreign judgments.
Medical Detoxification for Nonopioid Substances Is Associated With Lower Likelihood of Subsequent Linkage to Substance Use Disorder Treatment
Authors: MacKinnon Laura , Choi JinCheol , Kennedy Mary Clare , Brar Rupinder , Milloy M-J , Hayashi Kanna , Socías Maria Eugenia 
Published: March 2022

Background
Although factors associated with completion of medical detoxification treatment for substance use disorders (SUD) are well described, there is limited information on barriers and facilitators to subsequent linkage to SUD treatment in the community. This study aimed to evaluate correlates of successful linkage to community SUD treatment on discharge.

Methods
Data were drawn from 2 prospective cohorts of people who use unregulated drugs in Vancouver, Canada between December 2012 and May 2018. Multivariable generalized estimating equations were used to investigate factors associated with linkage to community SUD treatment in the 6-month period after attending detoxification treatment.

Results
Of the 264 detoxification treatment encounters contributed by 178 people who use unregulated drugs, these were most often (n = 104, 39%) related to polysubstance use, and the majority (n = 174, 66%) resulted in subsequent linkage to community treatment. In the multivariable analysis, compared to attending detoxification treatment for opioid use, attending detoxification treatment for stimulants (adjusted odds ratio [AOR] = 0.23, 95% confidence interval [CI] : 0.10–0.51) and alcohol (AOR = 0.17, 95% CI: 0.06–0.54) were associated with lower odds of subsequent linkage to community treatment. Conversely, later calendar year of detoxification treatment remained associated with higher odds (AOR = 1.23, 95% CI: 1.06–1.42).

Conclusions
Only two-thirds of detoxification treatment encounters in Vancouver were subsequently linked to community SUD treatment, with those related to nonopioid substances being less likely. Findings suggest the need for tailored interventions for specific substances to improve linkage to SUD treatment in the community on discharge.
Triple Threat: Response to the Crises of COVID-19, Homelessness, and Opioid Use Disorder With a Novel Approach to Buprenorphine Delivery: A Case Series
Authors: Samuel Lysa , Caygill-Walsh Rory , Suen Leslie W. , Mohebbi Sheila , Geier Michelle 
Published: March 2022

Objectives
In the setting of a 50% increase in opioid overdose deaths, the coronavirus disease 2019 crisis opened housing opportunities in the form of Shelter in Place (SIP) hotels to homeless San Francisco residents. Many who entered SIP hotels had opioid use disorder. In fall 2020, Community Behavioral Health Services Pharmacy partnered with SIP hotel medical staff to launch a pilot project, where on-site SIP medical providers prescribed buprenor-phine (BUP) and clinical pharmacists hand-delivered BUP to SIP residents to increase BUP initiation and engagement.

Methods
A retrospective chart review of 3 patients living in SIP hotels starting BUP to demonstrate the feasibility of a SIP hotel BUP delivery program.

Results
In all 3 cases, patients were able to start and continue BUP with on-site medical staff visits and delivery of medications by pharmacists. Each case highlights different barriers that were overcome by this system.

Conclusions
Our findings suggest that this system of onsite medical care with pharmacist delivery is possible and has the potential to allow for greater outreach and increased ease of obtaining medications for patients.
Workforce Requirements for Skin Cancer and Related Skin Tumors Continue to Increase: Clinicians Expend an Average of 1,740 Full-Time Effort Years Annually
Authors: Peck Gabrielle M. , Fleischer Alan B. 
Published: March 2022

BACKGROUND
With an aging population, estimating workforce requirements for management of common conditions such as skin cancer will be necessary to meet the health care needs of the American people.

OBJECTIVE
The authors aimed to estimate the workforce requirements for managing skin cancer and other skin tumors.

MATERIALS AND METHODS
The authors conducted a population-based, cross-sectional analysis using data from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey between the years 2007 and 2016, the most recent years available. The significance threshold was set at a p-value <.05.

RESULTS
The full-time effort of 1,740 (95% confidence interval: 1,340–2,220) clinicians is required to care for skin cancer and other skin tumors each year. The full-time effort years necessary for management of melanoma (p = .006), keratinocytic carcinoma (p < .0001), actinic keratosis (p < .0001), and all skin cancers and tumors (p < .0001) were significantly increasing from 2007 to 2016.

CONCLUSION
Clinicians expend a significant amount of time managing skin cancer and other skin tumors, and the time required for management increased over the study period. These workforce requirement trends can likely be attributed to increased prevalence and incidence rates of cutaneous malignancy secondary to an aging population and increased whole-body skin examinations.
Ramsar, Iran, as a Natural Radiobiological Surrogate for Mars
Authors: Welsh James S. , Bevelacqua Joseph J. , Mortazavi S.M.J. 
Published: March 2022

Abstract
Terrestrial experiments involving acute exposures of low-LET radiation on inbred lab animals are quick, simple, and inexpensive but are relatively uninformative about the real radiobiological hazards of planned manned space missions. A more predictive model could involve human beings chronically exposed to “space-like” high-LET radiation. Such radiation exposure has been ongoing for thousands of years in Ramsar, Iran, and some other high-LET high background radiation regions on Earth. Examining the health of Ramsar residents can be illuminating and potentially relevant to space missions.
Obesity Impacts Hospitalizations for Bacterial Pneumonia
Authors: Abusalim Abdul-Rahman I. , Inegbenijie Inegbenose P. 
Published: March 2022

Background
Community-acquired pneumonia is a significant cause of morbidity and mortality worldwide caused by a wide variety of micro-organisms, most commonly bacterial. The study aimed to compare the mortality rates and secondary complications of disease severity in obese and nonobese with bacterial pneumonia (bPNE).

Methods
This was an observational cohort study of the National Inpatient Sample. The primary outcome was inpatient mortality. The secondary outcomes included sepsis, septic shock, acute respiratory failure, pulmonary embolism, need for mechanical ventilation, length of hospital stay, and total hospital charges. The findings were analyzed and compared with nonobese patients.

Results and interpretation
Patients with obesity class I/II and class III, had lower odds of inpatient mortality (adjusted odds ratio [aOR], 0.77; 95% confidence interval [CI], 0.67–0.88; P < 0.001 and aOR, 0.73; 95% CI, 0.64–0.88; P < 0.001, respectively) compared with nonobese patients with bPNE. There was a decrease in odds of having sepsis (aOR, 0.81; 95% CI, 0.70–0.93; P = 0.004) and septic shock (aOR, 0.67; 95% CI, 0.49–0.92; P = 0.014) in patients with obesity class I/II as compared with nonobese patients.
Patients with obesity class III were associated with higher odds of acute respiratory failure (aOR, 1.51; 95% CI, 1.46–1.58; P < 0.001), acute respiratory distress syndrome (aOR, 1.37; 95% CI, 1.13–1.66; P < 0.001), mechanical ventilation (aOR, 1.49; 95% CI, 1.36–1.64; P < 0.001), deep vein thrombosis (aOR, 1.34; 95% CI, 1.18–1.54; P < 0.001), pulmonary embolism (aOR, 1.42; 95% CI, 1.22–1.67; P < 0.001), as well as increased total hospital charges and length of hospital stay as compared with nonobese patients.

Conclusions
Both obesity class I/II and class III were found to be associated with lower odds of inpatient mortality in patients admitted with bPNE, the reported obesity paradox. Obesity continues to be associated with significantly increased health care utilization, which may have a long-term impact on the population if the trend toward a higher proportion of obese patients continues.
The Mobile Stroke Unit Nurse: An International Exploration of Their Scope of Practice, Education, and Training
Authors: Coote Skye , Mackey Elizabeth , Alexandrov Anne W. , Cadilhac Dominique A. , Alexandrov Andrei V. , Easton Damien , Zhao Henry , Langenberg Francesca , Bivard Andrew , Stephenson Michael , Parsons Mark W. , Campbell Bruce C.V. , Donnan Geoffrey A. , Davis Stephen M. , Middleton Sandy 
Published: March 2022

ABSTRACT

BACKGROUND: Mobile stroke units (MSUs) are ambulance-based prehospital stroke care services. Through immediate roadside assessment and onboard brain imaging, MSUs provide faster stroke management with improved patient outcomes. Mobile stroke units have enabled the development of expanded scope of practice for stroke nurses; however, there is limited published evidence about these evolving prehospital acute nursing roles. AIMS: The aim of this study was to explore the expanded scope of practice of nurses working on MSUs by identifying MSUs with onboard nurses; describing the roles and responsibilities, training, and experience of MSU nurses, through a search of the literature; and describing 2 international MSU services incorporating nurses from Memphis, Tennessee, and Melbourne, Australia. METHODS: We searched PubMed, CINAHL, and the Joanna Briggs Institute Evidence-Based Practice database using the terms “mobile stroke unit” and “nurse.” Existing MSUs were identified through the PRE-hospital Stroke Treatment Organization to determine models that involved nurses. We describe 2 MSUs involving nurses: one in Memphis and one in Melbourne, led by 2 of our authors. RESULTS: Ninety articles were found describing 15 MSUs; however, staffing details were lacking, and it is unknown how many employ nurses. Nine articles described the role of the nurse, but role specifics, training, and expertise were largely undocumented. The MSU in Memphis, the only unit to be staffed exclusively by onboard nurse practitioners, is supported by a neurologist who consults via telephone. The Melbourne MSU plans to trial a nurse-led telemedicine model in the near future. CONCLUSION: We lack information on how many MSUs employ nurses, and the nurses' scope of practice, training, and expertise. Expert stroke nurse practitioners can safely perform many of the tasks undertaken by the onboard neurologist, making a nurse-led telemedicine model an effective and potentially cost-effective model that should be considered for all MSUs.
Implementation of a New Clinical Testing Tool to Assess Patients During Ictal and Postictal Periods
Authors: Ouchida Sumika , Nikpour Armin , Senturias Maricar , Pears Toni E. , Fairbrother Greg 
Published: March 2022

ABSTRACT

BACKGROUND: A seizure is a sudden, uncontrolled electrical disturbance of the cortical neurons in the brain, which can cause changes in behavior, movements, feelings, and consciousness. Clinical signs and symptoms before, during, and after a seizure can help to determine the seizure onset. The use of standardized clinical testing tools has been reported as being valuable, although also challenging, by some institutions. This study investigated the effectiveness of implementing a new clinical testing tool designed with an emphasis on simplicity for use during and after seizures. METHODS: A pre-and-post evaluation study was conducted from January 2020 to November 2020 in the epilepsy monitoring unit/neurology unit at a hospital in Sydney, Australia. The primary outcome of interest was the incidence of clinical testing during seizures. The secondary outcome of interest was nurse knowledge about clinical testing during a seizure. This knowledge was measured via testing before and after clinical education sessions. The third outcome of interest was nurse confidence regarding the use of the clinical testing tool. The confidence level was measured via posteducation session follow-up surveying. RESULTS: Forty-seven nursing staff (10 neurophysiology nurse technologists and 37 neurology unit nurses) participated in the education program. Forty-four seizures were evaluated. Clinical testing during ictal and postictal periods was performed by nursing staff 82% of the time during 2020, compared with 67% during the 2018 to 2019 preeducation comparison period. This difference was not statistically significant, but it was clinically relevant (P = .07). In addition, the time from seizure alarm to clinical testing improved significantly from a median of 30.5 seconds in 2018 to 2019 to 14 seconds in 2020 (P < .001). CONCLUSION: The tool is easy and convenient for nursing staff to perform clinical examinations accurately during ictal and postictal periods.
Comparison between computed tomography-guided core and fine needle lung biopsy
Authors: Li Yong , Yang Fang , Huang Ya-Yong , Cao Wei 
Published: March 2022

Abstract

Background:
This meta-analysis was conducted to compare the safety and diagnostic performance between computed tomography (CT)-guided core needle biopsy (CNB) and fine-needle aspiration biopsy (FNAB) in lung nodules/masses patients.

Methods:
All relevant studies in the Pubmed, Embase, and Cochrane Library databases that were published as of June 2020 were identified. RevMan version 5.3 was used for all data analyses.

Results:
In total, 9 relevant studies were included in the present meta-analysis. These studies were all retrospective and analyzed outcomes associated with 2175 procedures, including both CT-guided CNB (n = 819) and FNAB (n = 1356) procedures. CNB was associated with significantly higher sample adequacy rates than was FNAB (95.7% vs 85.8%, OR: 0.26; P < .00001), while diagnostic accuracy rates did not differ between these groups (90.1% vs 87.6%, OR: 0.8; P = .46). In addition, no differences in rates of pneumothorax (28.6% vs 23.0%, OR: 1.15; P = .71), hemorrhage (17.3% vs 20.1%, OR: 0.91; P = .62), and chest tube insertion (5.9% vs 4.9%, OR: 1.01; P = .97) were detected between these groups. Significant heterogeneity among included studies was detected for the diagnostic accuracy (I2 = 57%) and pneumothorax (I2 = 77%) endpoints. There were no significant differences between CNB and FNAB with respect to diagnostic accuracy rates for lung nodules (P = .90). In addition, we detected no evidence of significant publication bias.

Conclusions:
CT-guided CNB could achieve better sample adequacy than FNAB did during the lung biopsy procedure. However, the CNB did not show any superiorities in items of diagnostic accuracy and safety.
How Do Oncology Nurses Cope With the Psychological Burden of Caring for Dying Patients?
Authors: Lee Mikyoung , Choe Kwisoon , Kim Sangsuk , Shim Yuhwa 
Published: March 2022

BackgroundCancer is a leading cause of death worldwide, and most patients with cancer in South Korea die in hospitals. Oncology nurses experience physical, emotional, and occupational challenges associated with the psychological burden of caring for dying patients.ObjectiveThis study explored the coping strategies used by oncology nurses to deal with the psychological burden of patient deaths.MethodsIn this descriptive qualitative study, 10 oncology nurses who had recently experienced a patient’s death were recruited via snowball sampling. All were female, with a mean age of 32.9 years (range, 27–44 years), and their mean working duration was 9.9 (range, 3-23) years. Participants were interviewed individually face-to-face 3 times, with each interview lasting 1 to 1.5 hours.ResultsOncology nurses coped with the psychological burden of a patient’s death in the following 4 ways: (a) avoiding patient deaths to the extent possible, (b) reflecting upon the meaning of life and death, (c) suppressing their emotional distress over the patient’s death, and (d) becoming kinder and more caring toward people around them.ConclusionsThe findings suggest that oncology nurses struggle to cope with the psychological burden of patient deaths. Oncology nurses are affected both negatively and positively by experiencing death as they provide end-of-life care.Implications for PracticeOncology nurses need education or counseling to reduce the psychological burden of caring for dying patients with cancer. Hospital administrators need to continuously identify ways to reduce the psychological burden of oncology nurses providing end-of-life care.
Antibiotic treatment of acute bacterial skin and skin structure infections
Authors: Russo Alessandro , Vena Antonio , Bassetti Matteo 
Published: March 2022

Purpose of review
Acute bacterial skin and skin structure infections (ABSSSI) are a leading cause of morbidity, with a considerable variety of clinical presentation and a wide range of etiological pathogens. Of importance, the spread of multidrug-resistant (MDR) strains (i.e. methicillin-resistant Staphylococcus aureus or Gram-negative bacteria) is increasingly reported in some regions. in this review, we summarize the current clinical approach to patients with ABSSSI.

Recent findings
Accurate diagnosis and identification of risk factors for MDR pathogens are key determinants for administering appropriate therapy in patients with ABSSSI. In daily clinical practice, this can be critical as there are many features defining the ‘high risk patient’ including both disease and host-associated risk factors.

Summary
Antibiotic therapy should be based according to the different clinical spectrum of disease belonging to the ABSSSI, on the pathogens most likely to be involved and local resistance. Careful evaluation of antibiotic therapy after 48–72 h of initial therapy could help clinicians to early identify patients with treatment failure and to consider an alternative approach. Close monitoring of patients with multiple comorbidities, drug–drug interaction or adverse host factors are also necessary.
Visual Perception of 3D Space and Shape in Time - Part IV - 3D Shape Recognition by 3D Rotation
Authors: Le Caominh , Pedersen Samantha , Chen Nathaniel , Chan Jonathan , Ta Brian , Wilson Patrick , McCarthy Trevor , Barseghyan Emma , Chauhan Anushka , Saif Hind , Tu Jonathan , Wijaya Darren , Zhang Annika , Li Erica , Marangi Camille , Nekarae Setayesh , Wang Felicia , Yanovsky Alice , Afifa Umaima , Carmona Javier , Espino Diego , Schummer Leonard , Gudijanto Phillip , Kaur Gurleen , Lam Andrew , Mar Matthew , Mills Elizabeth , Nevins Alexandra , Ortiz Elijah , Wheeler Kyle , Blaisdell Aaron , Arisaka Katsushi 
Published: March 2022

AbstractHuman vision has a remarkable ability to recognize complex 3D objects such as faces that appear at any size and 3D orientations at any 3D location. If we initially memorize a face only with a normalized size upfront at the object center, the direct comparison between the one-sized memory and an incoming new image would demand tremendous mental frame translations in 7D. How can we perform such a demanding task so promptly as we experience it in our daily lives?This paper specifically addresses the recognition of human faces with arbitrary 3D orientation in the [Roll, Yaw, Pitch] axes. According to our new model ofNHT(Neural Holography Tomography), space is represented by time utilizing the phase of the alpha brainwave. This principle should be applicable to any mental rotation in 3D; thus, it predicts that extra time is required to perceive a rotated face to revolve it back to upright by the constant-speed alpha wave.To assess this hypothesis, we designed a reaction time (RT) experiment, where participants were first asked to memorize sets of upright unfamiliar faces. Following the memorization phase, similar stimuli with a wide range of rotating faces in 3D were presented, and RTs were recorded. As expected, the memorized upfront face was the fastest RT. The excess of the RT was observed proportional to the rotating angle in all [Roll, Yaw, Pitch] axes. Roll had the flattest slope, whereas upper Pitch was the steepest. We suspect that Roll is the swiftest mental operation because it can be conducted by the linear frame translation on the log-polar retinotopy of the visual cortex.