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[Direct admission of patients to doctors' offices by prehospital emergency services-an effective method to relieve emergency departments? : Analysis of routine pre- and in-hospital emergency data].

Med Klin Intensivmed Notfmed 2021 Sep 1. Epub 2021 Sep 1.

Notfall- und Akutmedizin, Charité - Universitätsmedizin Berlin Campus Virchow-Klinikum und Campus Mitte, Augustenburger Platz 1, 13353, Berlin, Deutschland.

Background: In the 2018 advisory opinion concerning the realignment of healthcare, it is advocated that in order to relieve pressure on emergency departments (ED) prehospital medical emergency services should be given the option to directly transport suitable patients to doctors' offices.

Objectives: To determine the prevalence of patients treated by prehospital emergency services that have the potential to be directly allocated to a primary care provider.

Materials And Methods: Preclinical and clinical data of adult patients who in a 2-month period were transported to the ED of a university hospital by an ambulance were evaluated. Read More

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September 2021

A project report on the switch from in-class to online tuition in the preparatory course for the knowledge examination for foreign physicians - guidelines for the organization of the online summer semester 2020 at the faculty of medicine of the Westfälische Wilhelms-Universität of Münster.

GMS J Med Educ 2021 15;38(5):Doc88. Epub 2021 Jun 15.

Westfälische Wilhelms-Universität Münster, Institute of medical education, Münster, Germany.

In Germany, foreign physicians are a fixed component of the medical profession. According to the German Medical Licensure Act, physicians having completed their qualification in another country are required to pass a knowledge examination which falls within the competence of examination offices or the regional governments. The preparatory course consists of 10 modules. Read More

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Prevalence and Correlates of Illicit Drug Use among Norwegian Nightlife Patrons.

Subst Use Misuse 2021 12;56(11):1697-1706. Epub 2021 Jul 12.

Section of Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway.

Background: Nightclubs and bars are recreational settings with extensive availability and consumption of alcohol and recreational drugs.

Objectives: This study aims to determine the proportion of nightclub patrons in Norway that tested positive for illicit drugs, moreover, we examined the correlation between positive test results and demographic and substance use characteristics.

Methods: Patrons were recruited outside nightclubs on Friday and Saturday nights between 10:00 pm and 04:00 am. Read More

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Is the weekend effect true in acute stroke patients at tertiary stroke center?

J Neurol Sci 2021 08 24;427:117557. Epub 2021 Jun 24.

Department of Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. Electronic address:

Background: There is contradicting evidence on the outcome of emergency patients treated during weekends versus weekdays. We studied if outcome of ischemic stroke patients receiving intravenous thrombolysis (IVT) differs according to the treatment time.

Methods: Our retrospective study included consecutive patients receiving IVT within 4. Read More

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Lecture start time and sleep characteristics: Analysis of daily diaries of undergraduate students from the LoST-Sleep project.

Sleep Health 2021 Jun 27. Epub 2021 Jun 27.

School of Psychology, University of Lincoln, Lincoln, UK; Lincoln Sleep Research Centre (LiSReC), University of Lincoln, Lincoln, UK; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. Electronic address:

Objectives: Emerging evidence shows that later high school start times are associated with increased sleep duration; however, little is known if this extends to the university setting. This study investigated associations of first lecture start times with sleep characteristics among university students.

Design: Daily diaries. Read More

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Size does matter: An exploration of the relationship between licensed venue capacity and on-premise assaults.

Alcohol Clin Exp Res 2021 06 22;45(6):1298-1303. Epub 2021 Jun 22.

School of Psychology, Deakin University, Geelong, Vic., Australia.

Aims: Venue capacity has been proposed as a factor associated with increased number of violent incidents on-premises, though no specific research has demonstrated this association, and instead has tended to focus on the relationship between crowding and aggression. The aim of current paper is to investigate the association between venue capacity and the number of violent incidents on-premises.

Methods: Venue capacity data (the maximum capacity listed on the liquor license) were obtained for all venues in central Melbourne from 2010 until 2016. Read More

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Induction of labour from 39 weeks in low-risk multiparas with ripe cervixes: A randomised controlled trial.

Aust N Z J Obstet Gynaecol 2021 Jun 5. Epub 2021 Jun 5.

Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Background: Induction of labour (IOL) in low-risk nulliparas at 39 weeks reduces caesarean delivery. Multiparas with ripe cervixes typically have vaginal delivery within eight hours. Delivery at night and weekend are associated with higher maternal and neonatal mortality. Read More

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The impact of late-night alcohol restrictions on ambulance call-outs in entertainment precincts.

Drug Alcohol Rev 2021 Jul 20;40(5):708-716. Epub 2021 May 20.

Eastern Health Clinical School, Monash University, Melbourne, Australia.

Introduction: In July 2016, the Queensland Government introduced the Tackling Alcohol-Fuelled Violence (TAFV) policy to address alcohol-related harm in entertainment precincts [safe night precincts (SNP)]. Additional measures were introduced in February and July 2017. We aim to examine the impact of the policy on Queensland Ambulance Service call-outs in Fortitude Valley, Surfers Paradise, all 15 SNP suburbs combined and statewide. Read More

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The impact of liquor legislation changes on police-recorded serious assault in Queensland, Australia.

Drug Alcohol Rev 2021 Jul 20;40(5):717-727. Epub 2021 May 20.

School of Psychology, Deakin University, Geelong, Australia.

Introduction And Aims: In July 2016, the Queensland government introduced the Tackling Alcohol-Fuelled Violence policy, with some amendments over the subsequent 12 months. Key measures included restricting alcohol sales to 3 am in safe night precincts (SNPs), limiting the annual number of extended trading permits (i.e. Read More

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Sleep among Obstetrics and Gynecology Trainees: Results from a Yoga-Based Wellness Initiative.

Am J Perinatol 2021 May 3. Epub 2021 May 3.

Department of Biomedical and Health Informatics, University of Missouri-Kansas City, Kansas City, Missouri.

Objective:  This study aimed to determine the feasibility of using a wrist-based fitness tracking device to assess sleep among Obstetrics and Gynecology (OBGYN) trainees who engaged in a yoga-based wellness program. We also sought to evaluate the effects of yoga on sleep.

Study Design:  A quality improvement initiative consisting of an 8-week wellness program of weekly yoga classes, nutrition, and physical challenges was implemented for OBGYN residents and Maternal-Fetal Medicine fellows. Read More

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Percutaneous coronary intervention during on- and off-hours in patients with ST-segment elevation myocardial infarction.

Hellenic J Cardiol 2021 May-Jun;62(3):212-218. Epub 2021 Feb 1.

Faculty of Medicine and Health Science, Jan Kochanowski University, 25-317, Kielce, Poland.

Objective: There are conflicting data on the clinical outcomes of percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) based on the time of admission to the catheterization laboratory. Thus, we aimed to assess clinical outcomes in an unselected cohort of consecutive patients with STEMI treated with PCI during on-and-off hours of work.

Methods: A total of 99,783 patients were included in the analysis. Read More

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Quantifying Radiology Resident Fatigue: Analysis of Preliminary Reports.

Radiology 2021 Mar 26;298(3):632-639. Epub 2021 Jan 26.

From the Department of Radiology, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland.

Background Workloads in radiology departments have constantly increased over the past decades. The resulting radiologist fatigue is considered a rising problem that affects diagnostic accuracy. Purpose To investigate whether data mining of quantitative parameters from the report proofreading process can reveal daytime and shift-dependent trends in report similarity as a surrogate marker for resident fatigue. Read More

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Covid-19 shocks to education supply: how 200,000 U.S. households dealt with the sudden shift to distance learning.

Rev Econ Househ 2021 Jan 18:1-28. Epub 2021 Jan 18.

Greylock McKinnon Associates, 1100 17th Street NW, Suite 300, Washington, DC 20036 USA.

Among the extraordinary shocks to household life caused by the Covid-19 pandemic was the sudden shift to distance learning in K-12 schools. Gone were Monday through Friday routines of school day, extracurricular activities, and evening homework; schools scrambled to launch alternative delivery systems, expecting parents to step in and spend significant amounts of time helping children continue to learn. This study examines the sudden shift to distance learning using data from U. Read More

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January 2021

Changes in the incidence of assault after restrictions on late-night alcohol sales in New Zealand: evaluation of a natural experiment using hospitalization and police data.

Addiction 2021 04 16;116(4):788-798. Epub 2020 Aug 16.

Department of Preventive and Social Medicine, University of Otago Medical School, Dunedin, New Zealand.

Aims: To estimate the effect of national restrictions on late-night availability of alcohol on alcohol-related assault at a population level as indicated by (1) change in hospitalizations for weekend assaults and (2) change in the proportion of assaults documented by police that occur at night.

Design: Evaluation of a natural experiment, involving: (1) pre-post comparisons of age-specific incidence rates, adjusted for seasonality and background trend using Poisson regression; and (2) interrupted time-series analyses, using seasonal autoregressive integrated moving average (SARIMA) models of national data with no control site.

Setting: New Zealand. Read More

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Impact of the weekend effect on outcome after microsurgical clipping of ruptured intracranial aneurysms.

Acta Neurochir (Wien) 2021 03 5;163(3):783-791. Epub 2021 Jan 5.

Center for Neurosurgery, Medical Faculty and University Hospital, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.

Background: The "weekend effect" describes the assumption that weekend and/or on-call duty admission of emergency patients is associated with increased morbidity and mortality rates. For aneurysmal subarachnoid hemorrhage, we investigated, whether presentation out of regular working hours and microsurgical clipping at nighttime correlates with worse patient outcome.

Methods: This is a retrospective review of consecutive patients that underwent microsurgical clipping of an acutely ruptured aneurysm at our institution between 2010 and 2019. Read More

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Patient Preferences For Specialty Pharmacy Services: A Stated Preference Discrete-Choice Experiment in China.

Front Public Health 2020 9;8:597389. Epub 2020 Dec 9.

West China School of Pharmacy, Sichuan University, Chengdu, Sichuan, China.

To survey, analyze, and ascertain the preferences for specialty pharmacy services among patients requiring complex care and to provide evidence to support specialty pharmacy service decision-making in China. To identify essential service attributes and levels, a review of the literature, discussions with specialty pharmacy managers and a pilot questionnaire were conducted. A D-efficient fractional factorial design was used to generate the discrete-choice experiment (DCE) questionnaire. Read More

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The value of identification scanner technology in monitoring and detecting banned patrons in entertainment precincts.

Drug Alcohol Rev 2020 Dec 9. Epub 2020 Dec 9.

Centre for Health Services Research, The University of Queensland, Brisbane, Australia.

Introduction And Aims: Networked identification (ID) scanner technology is a novel approach to collecting licensed venue attendance data, and potentially reducing alcohol-related violence by detecting banned patrons. Using ID scanner data from three Queensland entertainment precincts (Safe Night Precincts; SNPs), we aim to: (i) examine patterns in patron attendance to licensed venues; and (ii) examine patterns in the detection of banned patrons.

Design And Methods: We conducted descriptive analyses of licensed venue patron entries between 1 October 2017 and 30 June 2019. Read More

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December 2020

A Randomized Phase I Study to Evaluate the Safety, Tolerability, and Pharmacokinetics of Recombinant Erwinia Asparaginase (JZP-458) in Healthy Adult Volunteers.

Clin Transl Sci 2021 05 23;14(3):870-879. Epub 2021 Mar 23.

Jazz Pharmaceuticals, Palo Alto, California, USA.

L-asparaginase has been an important component of acute lymphoblastic leukemia (ALL) therapy for over 40 years, and is standard therapy during ALL induction and consolidation treatment. L-asparaginases are immunogenic and can induce hypersensitivity reactions; inability to receive asparaginase has been associated with poor patient outcomes. There are L-asparaginases of varied bacterial origins, with the most commonly used being Escherichia coli (E. Read More

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Effect of off-hour versus work-hour thrombolysis for acute ischemic stroke on emergency department patients' outcome: a retrospective study.

Eur J Emerg Med 2021 Apr;28(2):104-110

Departments of Internal Medicine, Emergency Medicine Section, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.

Objective: Early management of patients with acute ischemic stroke is crucial regardless of the time of presentation. The aim of the study was to evaluate the effect of off-hours management of patients with ischemic stroke that underwent thrombolytic therapy in the emergency department.

Methods: This is a single-center retrospective study included ischemic stroke patients who received thrombolysis in the emergency department from January 2009 to April 2017. Read More

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In-House Anesthesia and Interventional Radiology Technologist Support Optimize Mechanical Thrombectomy Workflow after Hours.

J Stroke Cerebrovasc Dis 2020 Nov 21;29(11):105246. Epub 2020 Aug 21.

Department of Neurology, University of Iowa Carver College of Medicine, Comprehensive Stroke Center, Iowa City, IA; Department of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, IA; Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, IA. Electronic address:

Background And Purpose: Prior literature suggests after-hours delay leads to poor functional outcomes in stroke patients undergoing thrombectomy. We aimed to evaluate the impact of time of presentation on mechanical thrombectomy (MT) metrics and its association with long-term functional outcome in an Interventional Radiology (IR) suite equipped operating room (OR) setting.

Methods: Retrospective review of prospectively maintained database on all stroke patients undergoing mechanical thrombectomy between January 2015 and December 2018 at our CSC. Read More

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November 2020

An evaluation of emergency general surgery transfers and a call for standardization of practices.

Surgery 2021 03 1;169(3):567-572. Epub 2020 Oct 1.

Department of Surgery, Division of Surgical Oncology, University of Louisville, KY. Electronic address:

Background: There is an increasing trend toward regionalization of emergency general surgery, which burdens patients. The absence of a standardized, emergency general surgery transfer algorithm creates the potential for unnecessary transfers. The aim of this study was to evaluate clinical reasoning prompting emergency general surgery transfers and to initiate a discussion for optimal emergency general surgery use. Read More

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Surgery out of office hours for type A aortic dissection: does night-time and weekend surgery worsen outcome?

Interact Cardiovasc Thorac Surg 2020 12;31(6):806-812

University Clinic for Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria.

Objectives: Immediate surgical repair for type A aortic dissection is gold standard and at most centres is performed by the surgeon on call during night-time and weekends. The objective was to evaluate whether emergency surgery during night-time or weekends has an influence on 30-day mortality.

Methods: In 319 patients undergoing surgery for type A aortic dissection, skin incision was documented. Read More

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December 2020

Effect of a 6 am-9 am Dedicated Orthopaedic Trauma Room on Hip Fracture Outcomes in a Community Level II Trauma Center.

J Orthop Trauma 2021 May;35(5):245-251

Department of Orthopaedic Surgery Henry Ford Macomb Hospital, Clinton Township, MI.

Objective: To assess the outcomes of elderly hip fracture surgeries performed 12 months before and 12 months after the implementation of a daily 6 am-9 am dedicated orthopaedic trauma room (DOTR) at a Level II community trauma center.

Design: Retrospective cohort study.

Setting: Level II academic trauma center. Read More

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Impact of off-hour endovascular therapy on outcomes for acute ischemic stroke: insights from STAR.

J Neurointerv Surg 2021 Aug 8;13(8):693-696. Epub 2020 Sep 8.

Neurological Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.

Background: The off-hour effect has been observed in the medical care of acute ischemic stroke. However, it remains unclear if time of arrival affects revascularization rates and outcomes after endovascular therapy (EVT) for emergent large vessel occlusion (ELVO). We aimed to investigate the clinical outcomes of EVT between on-hour and off-hour admissions. Read More

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Emergency department overutilization following cholecystectomy and inguinal hernia repair.

Surg Endosc 2021 Aug 1;35(8):4750-4755. Epub 2020 Sep 1.

Geisinger Medical Center, 100 North Academy Avenue, Danville, PA, 17821, USA.

Background: Emergency Department (ED) utilization following general surgery procedures is poorly understood and places immense strain on the healthcare system. Inefficient ED utilization is responsible for up to $38 billion in wasteful spending annually. Nearly 56% of ED visits may be avoidable. Read More

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Mechanical thrombectomy: can it be safely delivered out of hours in the UK?

BMC Neurol 2020 Sep 1;20(1):326. Epub 2020 Sep 1.

Department of Stroke Medicine, Royal Stoke University Hospital, Newcastle Road, Stoke-on-Trent, ST4 6QG, UK.

Background: Mechanical thrombectomy was approved by NICE as a treatment for stroke in 2016. However, most of the evidence is from studies conducted during working hours. Only few centres in the UK perform thrombectomies out-of-hours. Read More

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September 2020

Sleep duration trajectories from adolescence to emerging adulthood: Findings from a population-based birth cohort.

J Sleep Res 2021 06 17;30(3):e13155. Epub 2020 Aug 17.

Universidade Federal de Pelotas, Pelotas, Brazil.

This study aimed to describe longitudinal trajectories of sleep duration, among adolescents and adults from the Pelotas (Brazil) 1993 Birth Cohort, as well as characterize different trajectories groups according to socioeconomic, demographic and behavior characteristics. Sleep duration, hours per day (from Monday to Friday), bedtime and wake-up time were self-reported by participants at ages 11, 18 and 22 years. Covariables included socioeconomic, demographic, health and behavior characteristics. Read More

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Variation in timely surgery for hip fracture by day and time of presentation: a nationwide prospective cohort study from the National Hip Fracture Database for England, Wales and Northern Ireland.

BMJ Qual Saf 2021 Jul 12;30(7):559-566. Epub 2020 Aug 12.

Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.

Background And Objective: Several studies report poorer quality healthcare for patients presenting at weekends. Our objective was to examine how timely surgery for patients with hip fracture varies with day and time of their presentation.

Methods: This population-based cohort study used 2017 data from the National Hip Fracture Database, which recorded all patients aged 60 years and over who presented with a hip fracture at a hospital in England, Wales and Northern Ireland. Read More

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Clinical utility of plain-film abdominal radiographs for inpatients outside standard working hours in a large university teaching hospital.

Radiography (Lond) 2021 02 29;27(1):132-135. Epub 2020 Jul 29.

Department of Radiology, University Hospital Galway, Ireland.

Introduction: Plain film abdominal radiographs (PFAs) are frequently the initial investigation ordered for patients with abdominal symptoms. However, increasing use of emergency ultrasound and availability of emergency CT raises the question of whether PFA remains an appropriate first line investigation. We investigated the impact of out of hours (OOH) PFAs on inpatient management. Read More

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February 2021

The workload distribution of acute stroke CT imaging in a level three hospital in Ireland.

Ir J Med Sci 2021 Feb 16;190(1):373-377. Epub 2020 Jul 16.

Naas General Hospital, Naas, Co Kildare, Naas, Ireland.

Background: Interventions for acute ischaemic stroke require brain imaging. Computerised tomography (CT) scanning is the most common method used. In this study, the aim was to investigate the CT workload of acute stroke in an Irish level 3 hospital, seeing approximately 200 acute strokes per year. Read More

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February 2021