ResearchPad - world https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[In the aftermath: the legacy of measles in Samoa]]> https://www.researchpad.co/article/elastic_article_13556 <![CDATA[Prisons are “in no way equipped” to deal with COVID-19]]> https://www.researchpad.co/article/elastic_article_12952 <![CDATA[Safety and Efficacy of Bedside Peritoneal Dialysis Catheter Placement in the COVID-19 Era: Initial Experience at a New York City Hospital]]> https://www.researchpad.co/article/elastic_article_10722 Acute kidney injury (AKI) requiring renal replacement therapy (RRT) is common in critically ill patients with COVID-19. Unparalleled numbers of patients with AKI and shortage of dialysis machines and operative resources prompted consideration of expanded use of urgent-start peritoneal dialysis (PD) and evaluation of the safety and efficacy of bedside surgical placement of PD catheters.Study designBedside, open PD catheter insertions were performed in early April 2020, at a large academic center in New York City. Patients with SARS-CoV-2 infection and AKI and ambulatory patients with chronic kidney disease and impending need for RRT were included. Detailed surgical technique is described.ResultsFourteen catheters were placed at the bedside over 2 weeks, 11 in critically ill COVID-19 patients and three in ambulatory patients. Mean patient age was 61.9 years (43–83), and mean body mass index was 27.1 (20–37.6); four patients had prior abdominal surgery. All catheters were placed successfully without routine radiographic studies or intraoperative complications. One patient (7%) experienced primary nonfunction of the catheter requiring HD. One patient had limited intraperitoneal bleeding while anticoagulated, which was managed by mechanical compression of the abdominal wall and temporarily holding anticoagulation. All other catheters had an adequate function at 3–18 days of follow-up.ConclusionsBedside placement of PD catheters is safe and effective in ICU and outpatient clinic settings. Our surgical protocols allowed for optimization of critical hospital resources, minimization of hazardous exposure to healthcare providers and a broader application of urgent-start PD in selected patients. Long-term follow-up is warranted. ]]> <![CDATA[Editorial]]> https://www.researchpad.co/article/Ne6be8bc0-4d85-4c3d-9616-d5e1b2f54352 Editorial

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<![CDATA[Conservation of terrestrial invertebrates: a review of IUCN and regional Red Lists for ]]> https://www.researchpad.co/article/Ne05b9250-c0fe-4d47-98c6-0075a3f0204d Red Listing of Threatened species is recognized as the most objective approach for evaluating extinction risk of living organisms which can be applied at global or national scales. Invertebrates account for nearly 97% of all animals on the planet but are insufficiently represented in the IUCN Red Lists at both scales. To analyze the occurrence of species present in regional Red Lists, accounts of 48 different countries and regions all over the world were consulted and all data about myriapods () ever assessed in Red Lists at any level assembled. Myriapod species assessments were found in eleven regional Red Lists; however, no overlap between the species included in the global IUCN Red List and the regional ones was established. This means that myriapod species considered threatened at regional level may not be eligible for international funding specific for protection of native threatened species (more than US$ 25 million were available in the last decade) as most financial instruments tend to support only threatened species included in the IUCN Red List. As the lack of financial resources may limit protection for species in risk of extinction, it is urgent to increase the possibilities of getting financial support for implementation of measures for their protection. A Red List of all species recorded in Red Lists at national or local (596) and global (210) scales totaling 806 species is presented. This list shows for the first time an overview of the current conservation status of species. Here, the urgent need of establishing a Specialist Group in the Species Survival Commission of IUCN is also stressed.

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<![CDATA[Aurivillius’s “Neue oder wenig bekannte Coleoptera Longicornia” (1886–1927), the correct years and page numbers]]> https://www.researchpad.co/article/N32852a43-207d-46ef-bccc-87cd8f6fc58f
Abstract

Aurivillius’s work entitled “Neue oder wenig bekannte ColeopteraLongicornia” was published in parts over a period of over four decades. There were two page numbers on most pages of these publications, one ordered by Aurivillius, the other by the journal. Historically, different authors have used different page numbers, and sometimes different years for these publications, which has caused chaos in the citations. Herein, accurate dates of publications for this work, and correct page numbers that should be used are provided and discussed.

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<![CDATA[Rapid Least Concern: towards automating Red List assessments]]> https://www.researchpad.co/article/Ndbf7aafe-793c-495b-b62f-51261e0873ab
Abstract

Background

The IUCN Red List of Threatened SpeciesTM (hereafter the Red List) is an important global resource for conservation that supports conservation planning, safeguarding critical habitat and monitoring biodiversity change (Rodrigues et al. 2006). However, a major shortcoming of the Red List is that most of the world's described species have not yet been assessed and published on the Red List (Bachman et al. 2019Eisenhauer et al. 2019). Conservation efforts can be better supported if the Red List is expanded to achieve greater coverage of mega-diverse groups of organisms such as plants, fungi and invertebrates. There is, therefore, an urgent need to speed up the Red List assessment and documentation workflow.

One reason for this lack of species coverage is that a manual and relatively time-consuming procedure is usually employed to assess and document species. A recent update of Red List documentation standards (IUCN 2013) reduced the data requirements for publishing non-threatened or 'Least Concern' species on the Red List. The majority of the required fields for Least Concern plant species can be found in existing open-access data sources or can be easily calculated. There is an opportunity to consolidate these data and analyses into a simple application to fast-track the publication of Least Concern assessments for plants. There could be as many as 250,000 species of plants (60%) likely to be categorised as Least Concern (Bachman et al. 2019), for which automatically generated assessments could considerably reduce the outlay of time and valuable resources for Red Listing, allowing attention and resources to be dedicated to the assessment of those species most likely to be threatened.

New information

We present a web application, Rapid Least Concern, that addresses the challenge of accelerating the generation and documentation of Least Concern Red List assessments. Rapid Least Concern utilises open-source datasets, such as the Global Biodiversity Information Facility (GBIF) and Plants of the World Online (POWO) through a simple web interface. Initially, the application is intended for use on plants, but it could be extended to other groups, depending on the availability of equivalent datasets for these groups.

Rapid Least Concern users can assess a single species or upload a list of species that are assessed in a batch operation. The batch operation can either utilise georeferenced occurrence data from GBIF or occurrence data provided by the user. The output includes a series of CSV files and a point map file that meet the minimum data requirements for a Least Concern Red List assessment (IUCN 2013). The CSV files are compliant with the IUCN Red List SIS Connect system that transfers the data files to the IUCN database and, pending quality control checks and review, publication on the Red List.

We outline the knowledge gap this application aims to fill and describe how the application works. We demonstrate a use-case for Rapid Least Concern as part of an ongoing initiative to complete a global Red List assessment of all native species for the United Kingdom Overseas Territory of Bermuda.

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<![CDATA[The world woodlouse flies (Diptera, Rhinophoridae)]]> https://www.researchpad.co/article/Nae993fba-0a08-49f2-958c-66b0401d3b94
Abstract

The world Rhinophoridae are catalogued, recognising 33 genera and 177 species. Nomenclatural information is provided for all genus-group and species-group names, including lists of synonyms and name-bearing type data. Species distributions are recorded by country. A key to the world genera is presented. Four new genera are erected to accommodate five new species, which do not fit within any of the current generic concepts in Rhinophoridae, according to the results of a morphology-based phylogenetic analysis: Marshallicona Cerretti & Pape with type species Marshallicona quitu Cerretti & Pape, gen. et sp. nov. (Ecuador); Maurhinophora Cerretti & Pape with type species Maurhinophora indoceanica Cerretti & Pape, gen. et sp. nov. (Mauritius); Neotarsina Cerretti & Pape with type species Neotarsina caraibica Cerretti & Pape, gen. et sp. nov. (Trinidad and Tobago) and Neotarsina andina Cerretti & Pape, sp. nov. (Peru); Kinabalumyia Cerretti & Pape with type species Kinabalumyia pinax Cerretti & Pape, gen. et sp. nov. (Malaysia, Sabah). The genus Aporeomyia Pape & Shima (type species Aporeomyia antennalis Pape & Shima), originally assigned to Tachinidae, is here reassigned to Rhinophoridae based on a reassessment of the homologies of the male terminalia. The following five species-group names, which were previously treated as junior synonyms or nomina dubia, are recognised as valid species names: Acompomintho caucasica (Villeneuve, 1908), stat. rev. [from nomen dubium to valid species]; Acompomintho sinensis (Villeneuve, 1936), stat. rev. [from nomen dubium to valid species]; Stevenia bertei (Rondani, 1865), stat. rev. [from nomen dubium to valid species]; Stevenia sardoa Villeneuve, 1920, stat. rev. [from junior synonym of Rhinophora deceptoria Loew, 1847 to valid species]; Stevenia subalbida (Villeneuve, 1911), stat. rev. [from junior synonym of Rhinophora deceptoria Loew, 1847 to valid species]. Reversal of precedence is invoked for the following case of subjective synonymy to promote stability in nomenclature: Rhinophora lepida (Meigen, 1824), nomen protectum, and Musca parcus Harris, 1780: 144, nomen oblitum. New generic and specific synonymies are proposed for the following two names: Mimodexia Rohdendorf, 1935, junior synonym of Tromodesia Rondani, 1856, syn. nov. and Ptilocheta tacchetti Rondani, 1865, junior synonym of Stevenia obscuripennis (Loew, 1847), syn. nov. The following new combinations are proposed: Acompomintho sinensis (Villeneuve, 1936), comb. nov. [transferred from Tricogena Robineau-Desvoidy, 1830]; Tromodesia guzari (Rohdendorf, 1935), comb. nov. [transferred from Mimodexia Rohdendorf, 1935]; Tromodesia intermedia (Rohdendorf, 1935), comb. nov. [transferred from Mimodexia Rohdendorf, 1935]; Tromodesia lindneriana (Rohdendorf, 1961), comb. nov. [transferred from Mimodexia Rohdendorf, 1935]; Tromodesia magnifica (Rohdendorf, 1935), comb. nov. [transferred from Mimodexia Rohdendorf, 1935]; Tromodesia obscurior (Rohdendorf, 1935), comb. nov. [transferred from Mimodexia Rohdendorf, 1935]; Tromodesia pallidissima (Rohdendorf, 1935), comb. nov. [transferred from Mimodexia Rohdendorf, 1935]; Tromodesia setiventris (Rohdendorf, 1935), comb. nov. [transferred from Mimodexia Rohdendorf, 1935] and Tromodesia shachrudi (Rohdendorf, 1935), comb. nov. [transferred from Mimodexia Rohdendorf, 1935].

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<![CDATA[State of clinical pain research in Nepal: a systematic scoping review]]> https://www.researchpad.co/article/N229772b2-3e88-422e-b89a-fe7905cfa30c

Supplemental Digital Content is Available in the Text.

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<![CDATA[Cross-cultural adaptation, test–retest reliability, and construct validity of the Thai version of the University of Washington Pain-Related Self-Efficacy Scale]]> https://www.researchpad.co/article/Na5cbcfda-ccba-4e44-9f36-f60e128d6207

Abstract

Introduction:

One psychosocial factor in the biopsychosocial model is pain-related self-efficacy, which has been shown to be a strong predictor of response to pain treatment.

Objectives:

To cross-culturally adapt the University of Washington Pain-Related Self-Efficacy Scale (UW-PRSE6) into Thai and evaluate its psychometric properties.

Methods:

The study was approved by the Chulalongkorn University Human Ethics Committee (COA No. 156/2018). The original UW-PRSE6 was cross-culturally adapted using the Functional Assessment of Chronic Illness Therapy translation methodology. Two hundred forty-one individuals with chronic low back pain completed the Thai version of UW-PRSE6 (T-UW-PRSE6), Thai Fear Avoidance Beliefs Questionnaire (T-FABQ), and Thai Medical Outcome Study Short-Form 36 (T-SF-36). A subset of 152 participants completed the T-UW-PRSE6 again after a 7-day interval. Cronbach's alpha and intraclass correlation coefficients were calculated to estimate internal consistency and test–retest reliability, respectively. The construct validity of the T-UW-PRSE6 was evaluated by computing Spearman correlation coefficients between the T-UW-PRSE6 score and the measures of the validity criterion variables.

Results:

The T-UW-PRSE6 had good internal consistency (Cronbach's alpha = 0.85) and moderate test–retest reliability (intraclass correlation coefficient [2,1] = 0.72). The T-UW-PRSE6 was negatively correlated with the T-FABQ Work and Physical Activity subscales (rs = −0.34 and −0.34, respectively) and positively correlated with the General Health, Physical Functioning, Role Physical, Role Emotional, Social Functioning, Bodily Pain, Vitality, and Mental Health scales of the T-SF-36 (rs = 0.38, 0.42, 0.54, 0.51, 0.47, 0.54, 0.41, and 0.40, respectively).

Conclusion:

The T-UW-PRSE6 demonstrated acceptable psychometric properties for assessing pain-related self-efficacy in individuals with chronic low back pain, making available a measure for facilitating future cross-cultural research on pain self-efficacy.

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<![CDATA[Introduction for special issue on pain in developing countries]]> https://www.researchpad.co/article/N02c9d5ca-2124-4f9b-af22-bfc8b57f19ea ]]> <![CDATA[What does digitalization hold for the creation of real-world evidence?]]> https://www.researchpad.co/article/N5c3d7ae8-1538-467d-ab49-6558684f4b16

Abstract

Health-related information is increasingly being collected and stored digitally. These data, either structured or unstructured, are becoming the ubiquitous assets that might enable us to comprehensively map out a patient’s health journey from an asymptomatic state of wellness to disease onset and its trajectory. These new data could provide rich real-world evidence for better clinical care and research, if they can be accessed, linked and analyzed—all of which are possible. In this review, these opportunities will be explored through a case vignette of a patient with OA, followed by discussion on how this digitalized real-world evidence could best be utilized, as well as the challenges of data access, quality and maintaining public trust.

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<![CDATA[Adding value to real-world data: the role of biomarkers]]> https://www.researchpad.co/article/Naa54ec5b-ac89-4e1f-8a8d-61be032aef2b

Abstract

Adding biomarker information to real world datasets (e.g. biomarker data collected into disease/drug registries) can enhance mechanistic understanding of intra-patient differences in disease trajectories and differences in important clinical outcomes. Biomarkers can detect pathologies present early in disease potentially paving the way for preventative intervention strategies, which may help patients to avoid disability, poor treatment outcome, disease sequelae and premature mortality. However, adding biomarker data to real world datasets comes with a number of important challenges including sample collection and storage, study design and data analysis and interpretation. In this narrative review we will consider the benefits and challenges of adding biomarker data to real world datasets and discuss how biomarker data have added to our understanding of complex diseases, focusing on rheumatoid arthritis.

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<![CDATA[Molecular-cytogenetic analysis of diploid wheatgrass Thinopyrum bessarabicum (Savul. and Rayss) A. Löve]]> https://www.researchpad.co/article/N132c46a6-058a-43be-8037-f9710368a01f
Abstract

Thinopyrum bessarabicum (T. Săvulescu & T. Rayss, 1923) A. Löve, 1980 is diploid (2n=2x=14, JJ or EbEb), perennial self-fertilizing rhizomatous maritime beach grass, which is phylogenetically close to another diploid wheatgrass species, Agropyron elongatum (N. Host, 1797) P. de Beauvois, 1812. The detailed karyotype of Th. bessarabicum was constructed based on FISH with six DNA probes representing 5S and 45S rRNA gene families and four tandem repeats. We found that the combination of pAesp_SAT86 (= pTa-713) probe with pSc119.2 or pAs1/ pTa-535 allows the precise identification of all J-genome chromosomes. Comparison of our data with the results of other authors showed that karyotypically Th. bessarabicum is distinct from A. elongatum. On the other hand, differences between the J-genome chromosomes of Th. bessarabicum and the chromosomes of hexaploid Th. intermedium (N. Host, 1797) M. Barkworth & D.R. Dewey, 1985 and decaploid Th. ponticum (J. Podpěra, 1902) Z.–W. Liu & R.–C. Wang, 1993 in the distribution of rDNA loci and hybridization patterns of pSc119.2 and pAs1 probes could be an indicative of (1) this diploid species was probably not involved in the origin of these polyploids or (2) it could has contributed the J-genome to Th. intermedium and Th. ponticum, but it was substantially modified over the course of speciation

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<![CDATA[Increasing sika deer population density may change resource use by larval dung beetles]]> https://www.researchpad.co/article/N8cd3ee58-c057-4e17-9e0d-6a1ba00b0cfd

Because animal feces contain organic matter and plant seeds, dung beetles (Scarabaeinae) are important for the circulation of materials and secondary seed dispersal through burying feces. Dung beetles are usually generalists and use the feces of various mammals. Additionally, the larval stages have access to feces from only one mammal species leaving them susceptible to changes in animal fauna and variations in animal populations. Here, we explain the effects of resource availability changes associated with sika deer (Cervus nippon) overabundance on dung beetle larvae feeding habits in Japan. δ15N values were notably higher in raccoon dog and badger dung than in that of other mammals. A dung beetle breeding experiment revealed that the δ15N values of dung beetle exoskeletons that had fed on deer feces during their larval stage were significantly lower than those of beetles that had fed on raccoon dog feces. The δ15N values of the adult exoskeleton were significantly lower in a deer high-density area than in a low-density area in large dung beetles only. It is possible that the high-quality feces, such as those of omnivores, preferred by the large beetles decrease in availability with an increase in deer dung; large beetles may therefore be unable to obtain sufficient high-quality feces and resort to using large amounts of low-quality deer feces. Small dung beetles may use the easily obtained feces that is in high abundance and they may also use deer feces more frequently with increases in deer density. These findings suggest that a larval resource shift associated with deer overabundance may affect ecosystem functions such as soil nutrient cycling and seed dispersal.

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<![CDATA[The chinchilla animal model for hearing science and noise-induced hearing loss]]> https://www.researchpad.co/article/N91b4e0e3-b64e-48f9-81d6-1b93dd8c6d13

The chinchilla animal model for noise-induced hearing loss has an extensive history spanning more than 50 years. Many behavioral, anatomical, and physiological characteristics of the chinchilla make it a valuable animal model for hearing science. These include similarities with human hearing frequency and intensity sensitivity, the ability to be trained behaviorally with acoustic stimuli relevant to human hearing, a docile nature that allows many physiological measures to be made in an awake state, physiological robustness that allows for data to be collected from all levels of the auditory system, and the ability to model various types of conductive and sensorineural hearing losses that mimic pathologies observed in humans. Given these attributes, chinchillas have been used repeatedly to study anatomical, physiological, and behavioral effects of continuous and impulse noise exposures that produce either temporary or permanent threshold shifts. Based on the mechanistic insights from noise-exposure studies, chinchillas have also been used in pre-clinical drug studies for the prevention and rescue of noise-induced hearing loss. This review paper highlights the role of the chinchilla model in hearing science, its important contributions, and its advantages and limitations.

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<![CDATA[Review of the evidence regarding the use of antenatal multiple micronutrient supplementation in low‐ and middle‐income countries]]> https://www.researchpad.co/article/N45b3f96e-f5a4-4f28-8167-1cabf298880c

Abstract

Inadequate micronutrient intakes are relatively common in low‐ and middle‐income countries (LMICs), especially among pregnant women, who have increased micronutrient requirements. This can lead to an increase in adverse pregnancy and birth outcomes. This review presents the conclusions of a task force that set out to assess the prevalence of inadequate micronutrient intakes and adverse birth outcomes in LMICs; the data from trials comparing multiple micronutrient supplements (MMS) that contain iron and folic acid (IFA) with IFA supplements alone; the risks of reaching the upper intake levels with MMS; and the cost‐effectiveness of MMS compared with IFA. Recent meta‐analyses demonstrate that MMS can reduce the risks of preterm birth, low birth weight, and small for gestational age in comparison with IFA alone. An individual‐participant data meta‐analysis also revealed even greater benefits for anemic and underweight women and female infants. Importantly, there was no increased risk of harm for the pregnant women or their infants with MMS. These data suggest that countries with inadequate micronutrient intakes should consider supplementing pregnant women with MMS as a cost‐effective method to reduce the risk of adverse birth outcomes.

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<![CDATA[Physician-based on-scene airway management in severely injured patients and in-hospital consequences: is the misplaced intubation an underestimated danger in trauma management?]]> https://www.researchpad.co/article/5ca114d3d5eed0c484572730

Background

Endotracheal intubation (ETI) is the gold standard for the out-of-hospital emergency airway management in severely injured patients. Due to time-critical circumstances, poor patient presentation and hostile environments, it may be prone for mechanical complications and failure.

Methods

In a retrospective study (January 2011 to December 2013), all patients who underwent out-of-hospital ETI before admittance to a level 1 trauma center were analyzed consecutively. Patients with supraglottic airways, being under cardiopulmonary resuscitation and interfacility transports were excluded. The main study endpoint was the incidence of unrecognized tube malposition; secondary endpoints were Glasgow Outcome Scale (GOS) and in-hospital mortality adjusted to on-scene Glasgow Coma Scale (GCS), Injury Severity Score (ISS), Abbreviated Injury Scale head (AIS head), and on-scene time.

Results

Out of 1176 patients, 151 underwent out-of-hospital ETI. At hospital admission, tube malpositions were recognized in nine patients (5.9%). Accidental and unrecognized esophageal intubation was detected in five patients (3.3%) and bronchial intubation in four patients (2.7%). Although ISS (p=0.053), AIS head (p=0.469), on-scene GCS (p=0.151), on-scene time (p=0.530), GOS (p=0.748) and in-hospital mortality (p=0.431) were similar compared with correctly positioned ETI tubes, three esophageal intubation patients died due to hypoxemic complications.

Discussion

In our study sample, out-of-hospital emergency ETI in severely injured patients was associated with a considerable tube misplacement rate. For safety, increased compliance to consequently use available technologies (eg, capnography, video laryngoscopy) for emergency ETI should be warranted.

Level of evidence

Level of Evidence IIA.

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<![CDATA[World trauma education: hemorrhage control training for healthcare providers in India]]> https://www.researchpad.co/article/5ca114d9d5eed0c484572791

Background

Hemorrhage remains a major cause of death around the world. Eighty percent of trauma patients in India do not receive medical care within the first hour. The etiology of these poor outcomes is multifactorial. We describe findings from the first Stop the Bleed (StB) course recently offered to a group of medical providers in southern India.

Methods

A cross-sectional survey of 101 participants who attended StB trainings in India was performed. Pre-training and post-training questionnaires were collected from each participant. In total, 88 healthcare providers’ responses were analyzed. Three bleeding control skills were presented: wound compression, wound packing, and tourniquet application.

Results

Among participants, only 23.9% had received prior bleeding control training. Participants who reported feeling ‘extremely confident’ responding to an emergency medical situation rose from 68.2% prior to StB training to 94.3% post-training. Regarding hemorrhage control abilities, 37.5% felt extremely confident before the training, compared with 95.5% after the training. For wound packing and tourniquet application, 44.3% and 53.4%, respectively, felt extremely confident pre-training, followed by 97.7% for both skills post-training. Importantly, 90.9% of StB trainees felt comfortable teaching newly acquired hemorrhage control skills. A significant majority of participants said that confidence in their wound packing and tourniquet skills would improve with more realistic mannequins.

Conclusion

To our knowledge, this is the first StB training in India. Disparities in access to care, long transport times, and insufficient numbers of prehospital personnel contribute to its significant trauma burden. Dissemination of these critical life-saving skills into this region and the resulting civilian interventions will increase the number of trauma patients who survive long enough to reach a trauma center. Additionally, considerations should be given to translating the course into local languages to increase program reach.

Level of Evidence

Level IV.

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<![CDATA[Emergency trauma laparotomy and/or thoracotomy in the emergency department: risks and benefits]]> https://www.researchpad.co/article/5ca114c7d5eed0c484572648

Background

It is not mandatory for Japanese trauma centers to have an operating room (OR) and OR team available 24 hours a day/7 days a week. Therefore, emergency laparotomy/thoracotomy is performed in the emergency department (ED). The present study was conducted to assess the safety of this practice.

Methods

The data were reviewed from 88 patients who underwent emergency trauma laparotomy and/or thoracotomy performed by our acute care surgery group during the period from April 2013 to December 2017. Operation was performed in the ED for 43 of 88 patients (51%, ED group), and in the OR for 45 of 88 patients (49%, OR group). The perioperative outcomes of the two groups were compared.

Results

Compared with the OR group, the ED group had a higher Injury Severity Score (30±15 vs. 13±10, p<0.01), greater incidence of blunt trauma (74% (32/43) vs. 36% (16/45), p<0.01), larger volume of red blood cell transfusion (18±18 units vs. 5±10 units, p<0.01), higher incidence of new-onset shock after sedation among patients who received sedation in the ED (59% (17/29) vs. 25% (6/24), p<0.01), and higher in-hospital mortality rate (49% (21/43) vs. 0, p<0.01). All five patients who underwent laparotomy followed by thoracotomy died in the ED; none of these patients underwent preoperative placement of resuscitative endovascular balloon occlusion of the aorta (REBOA). Of the 21 patients in the ED group who died, 17 (81%) died immediately postoperatively; furthermore, 12 of the 22 patients who survived (55%) were not in shock prior to operation.

Discussion

Emergency trauma laparotomy and/or thoracotomy outcomes were related to injury severity. The resources for trauma operations in the ED seemed suboptimal. The outcome of trauma operations may be improved by reviewing the protocols for anesthetic care, and by the usage of REBOA rather than aortic cross-clamping.

Level of evidence

IV

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