bluuebunny/crossref_metadata_2025 huggingface dataset:
Addressing the bereavement needs of children in school: An evaluation of bereavement training for school communities
Authors: McManus Elaine , Paul Sally
Published: February 2019

The role of schools in both educating children about loss and change and supporting bereavement experiences is emphasised, yet, school staff report low confidence in being able to support children when someone dies. This article reports on an evaluation of bereavement training that was offered to eight schools in Scotland and aimed to assist school communities to develop knowledge and confidence in engaging and supporting bereaved children. Pre and post questionnaires were used to measure the confidence, beliefs and values of 282 school staff that attended the training. Two focus groups were held for 6–18 months following the training to gain an understanding of the longer-term impact. Findings suggest that participants viewed bereavement support as part of their role and that a short and targeted bereavement-training programme can contribute to raising the awareness and confidence of school staff to respond to the needs of bereaved children.
Heterosexual women’s support for trans-inclusive bathroom legislation depends on the degree to which they perceive trans women as a threat
Authors: Outten H. Robert , Lee Timothy , Lawrence Marcella E.
Published: February 2019

Drawing on social identity perspectives and theories concerning intergroup threat, we examined if heterosexual women’s support for two types of trans-inclusive bathroom legislation depended on whether they perceived trans women as a threat to women as a whole. Participants read about a hypothetical trans-inclusive bathroom bill that was either described as increasing public gender-neutral bathrooms or allowing trans women to access public women-only bathrooms. Surprisingly, bill support did not significantly differ across conditions. Consistent with predictions, intergroup threat was negatively associated with bill support and moderated the effect of bathroom bill type on bill support. Highly threatened women were significantly more supportive when the legislation was described as increasing gender-neutral bathrooms versus allowing trans women to use women-only bathrooms. Conversely, women who were not particularly threatened were significantly more supportive of the hypothetical legislation when it was described as allowing trans women to use women-only bathrooms.
TYRO3: A potential therapeutic target in cancer
Authors: Hsu Pei-Ling , Jou Jonathan , Tsai Shaw-Jenq
Published: February 2019

TYRO3 belongs to the TAM (TYRO3, AXL, and MER) receptor family, a unique subfamily of the receptor tyrosine kinases. Members of TAM family share the same ligand, growth arrest-specific 6, and protein S. Although the signal transduction pathways of TYRO3 have not been evaluated in detail, overexpression and activation of TYRO3 receptor tyrosine kinase have been reported to promote cell proliferation, survival, tumorigenesis, migration, invasion, epithelial-mesenchymal transition, or chemoresistance in several human cancers. Targeting TYRO3 could break the kinase signaling, stimulate antitumor immunity, reduce tumor cell survival, and regain drug sensitivity. To date, there is no specific TYRO3-targeted drug, the effectiveness of targeting TYRO3 in cancer is worthy of further investigations. In this review, we present an update on molecular biology of TYRO3, summarize the development of potential inhibitors of TAM family members, and provide new insights in TYRO3-targeted treatment.

Impact statement

Cancer is among the leading causes of death worldwide. In 2016, 8.9 million people are estimated to have died from various forms of cancer. The current treatments, including surgery with chemotherapy and/or radiation therapy, are not effective enough to provide full protection from cancer, which highlights the need for developing novel therapy strategies. In this review, we summarize the molecular biology of a unique member of a subfamily of receptor tyrosine kinase, TYRO3 and discuss the new insights in TYRO3-targeted treatment for cancer therapy.
Mutual promotion of FGF21 and PPARγ attenuates hypoxia-induced pulmonary hypertension
Authors: Cai Gexiang , Liu Jingjing , Wang Meibin , Su Lihuang , Cai Mengsi , Huang Kate , Li Xiuchun , Li Manxiang , Wang Liangxing , Huang Xiaoying
Published: February 2019

Fibroblast growth factor 21 (FGF21), a primarily liver-derived endocrine factor, has the beneficial effect of protecting blood vessels. Peroxisome proliferator-activated receptor γ (PPARγ), a ligand-activated nuclear transcription factor, has been reported to effectively inhibit pulmonary hypertension (PH). The purpose of this study is to investigate the role of FGF21 in hypoxia-induced PH (HPH) and explore the relationship between FGF21 and PPARγ in this disorder. Adult C57BL/6 mice were subjected to four weeks of hypoxia to establish a PH model. The effects of FGF21 and PPARγ agonists and antagonists were investigated in HPH mice, as well as the relationship between FGF21 and PPARγ in this model. Moreover, we investigated the underlying mechanisms of this relationship between FGF21 and PPARγ in vivo and in vitro. In vivo, we found that hypoxia resulted in pulmonary hypertension, right ventricular hypertrophy, pulmonary arterial remodeling, and pulmonary arterial collagen deposition. Furthermore, hypoxia decreased FGF21 and PPARγ levels. These changes were reversed by exogenous FGF21 and a PPARγ agonist and were further enhanced by a PPARγ antagonist. The hypoxia-induced decrease in β-klotho (KLB) expression was improved by the PPARγ agonist and further reduced by the PPARγ antagonist. Exogenous FGF21 increased adenosine monophosphate-activated protein kinase (AMPK) phosphorylation (Thr172) and PPARγ coactivator-1α (PGC-1α) expression in PH mouse lung homogenates. In vitro, we found that knockdown of AMPK or using an AMPK antagonist inhibited the FGF21-mediated up-regulation of PPARγ expression, and the PPARγ-mediated up-regulation of FGF21 expression was inhibited by knockdown of KLB. These results indicated that FGF21 exerts protective effects in inhibiting HPH. FGF21 and PPARγ mutually promote each other’s expression in HPH via the AMPK/PGC-1α pathway and KLB protein.

Impact statement

In this study, we reported for the first time that FGF21 alleviated hypoxia-induced pulmonary hypertension through attenuation of increased pulmonary arterial pressure, pulmonary arterial remodeling and collagen deposition in vivo, and we confirmed the mutual promotion of FGF21 and PPARγ in hypoxia-induced pulmonary hypertension. Additionally, we found that FGF21 and PPARγ mutually promote each other’s expression via the AMPK/PGC-1α pathway and KLB protein in vitro and in vivo. Pulmonary hypertension is a progressive and serious pathological phenomenon with a poor prognosis, and current therapies are highly limited. Our results provide novel insight into potential clinical therapies for pulmonary hypertension and establish the possibility of using this drug combination and potential dosage reductions in clinical settings.
Brain natriuretic peptide in pregnant women with heart disease
Authors: Singh Karanvir , Sikka Pooja , Suri Vanita , Prasad Rishikesh , Khullar Madhu , Vijayvergiya Rajesh
Published: February 2019

Background

Plasma brain natriuretic peptide levels were prospectively studied in pregnant women with heart disease.

Methods

Fifty pregnant women with heart disease and 25 controls were evaluated at 24 weeks or under, 30–32 weeks, 34 weeks or more of gestation, and 6 weeks postpartum. Adverse maternal cardiac events were hospitalization for worsening heart failure, stroke, and death.

Results

Thirty-eight (76%) women had rheumatic heart disease. Plasma brain natriuretic peptide levels were (in cases and controls) 118.3 ± 46.5 pg/ml and 66.3 ± 15.9 pg/ml (at 24 weeks or under), 124.8 ± 30.4 pg/ml and 68.4 ± 16.5 pg/ml (30–32 weeks), 135.8 ± 34.9 pg/ml and 68.6 ± 15.6 pg/ml (34 weeks or more), and 110.1 ± 21.9 pg/ml and 65.0 ± 16.1 pg/ml (6 weeks postpartum) (p = .0001). Eighteen women had adverse events. Of these, only 1 had a level less than 100 pg/ml, 12 were between 100 and 200 pg/ml, and 5 more than 200 pg/ml.

Conclusions

Plasma brain natriuretic peptide levels were higher in women with heart disease at all periods of gestation as well as six weeks postpartum. No woman with a plasma brain natriuretic peptide levels of 98 pg/ml or less had an adverse event.
Operative versus non-operative treatment of humeral shaft fractures: A systematic review
Authors: Sargeant Harry William , Farrow Luke , Barker Scott , Kumar Kapil
Published: February 2019

Background

Humeral shaft fractures are common but debate still occurs as to whether these are best managed operatively or non-operatively. We sought to undertake a systematic review and meta-analysis of randomised and non-randomised studies to clarify the optimal treatment.

Methods

We performed a search for all randomised and non-randomised comparative studies on humeral shaft fracture. We included only those with an operative and non-operative cohort in adult patients. We undertook a meta-analysis of the following outcome measures: nonunion, malunion, delayed union, iatrogenic nerve injury and infection. Non-operative management was with a functional brace.

Results

Non-operative management resulted in a significantly higher nonunion rate of 17.6% compared to 6.3% with fixation. Operative management had a significantly higher iatrogenic nerve injury rate of 3.4% and infection rate of 3.7%. All nonunions within the included studies went on to union after plate fixation. There was no significant difference in delayed union or patient reported outcome measures. There was a significantly increased risk of malunion with non-operative treatment however this did not correlate with the outcome.

Discussion

Our findings suggest that in the majority of cases, humeral shaft fractures can be managed with non-operative treatment, and any subsequent nonunion should be treated with plate fixation.
The Impact of Metabolic Syndrome on 30-Day Outcomes Following ORIF for Ankle Fractures
Authors: Xie Jack , Malik Azeem Tariq , Quatman Carmen E. , Ly Thuan V. , Phieffer Laura S. , Khan Safdar N.
Published: February 2019

Introduction: Metabolic syndrome (MetS) is associated with significant postoperative morbidity. Despite an increasing prevalence of MetS in the US population, its impact on postoperative outcomes following ankle fractures remains limited. Materials and Methods: The 2012-2016 American College of Surgeons–National Surgical Quality Improvement Program database was queried for patients undergoing open reduction with internal fixation (ORIF) for ankle fractures using Current Procedural Terminology codes: 27766, 27769, 27792, 27814, 27822, and 27823. The study cohort was divided into 2 groups: MetS versus No MetS. MetS was identified using a predefined criteria as the coexistence of (1) diabetes mellitus, (2) hypertension, and (3) body mass index ≥30 kg/m2. Results: A total of 1013 (6.7%) MetS underwent ORIF for ankle fractures. Following adjustment for baseline differences, MetS was an independent predictor of experiencing any 30-day complication (odds ratio [OR] = 1.35; P = .020), wound complications (OR = 1.67; P = .024), renal complications (OR = 3.54; P = .022), 30-day readmissions (OR = 1.66; P = .001), 30-day unplanned reoperations (OR = 1.69; P = .009) and decreased odds of home discharge (OR = 0.66; P < .001). Conclusion: Patients with MetS undergoing ORIF for ankle fractures are at an increased risk of experiencing adverse 30-day complications, readmissions, and reoperations. Providers should understand the need of appropriate postoperative surveillance in this high-risk group to minimize the risk of poor outcomes.

Level of Evidence: Level III
‘For the game, for the world’: An analysis of FIFA’s CSR initiatives
Authors: Woods Chelsea L , Stokes Ashli Q
Published: February 2019

Given the significant and often negative impacts of sport mega-events on host nations, including high costs and lingering environmental challenges, many event organizers, such as the Fédération Internationale de Football Association (FIFA), began implementing corporate social responsibility (CSR) initiatives to generate positive effects while lessening negative perceptions. Despite the growing body of literature examining the practice of sport CSR, research on how global governing sport agencies implement and adapt these programs to reflect the culture of the host is lacking. This study begins to address this gap by exploring how FIFA tailored its CSR initiatives for the 2010 World Cup in South Africa and 2014 event in Brazil. Engaging in CSR is already a daunting task. For FIFA, this challenge was compounded because of the host nations’ complex social, political, and economic concerns, along with skepticism surrounding FIFA’s efforts because of its history of corruption, which recently culminated in an organizational scandal that prompted arrests of high-ranking officials and temporary banishment of its former president. To better investigate CSR using a critical lens, we draw from interdisciplinary research and employ a multi-case study approach to analyze FIFA’s CSR initiatives, arguing that these efforts largely failed to reflect cultural considerations, providing little benefit to Brazilians and South Africans. In doing so, we build upon Zaharna’s in-awareness approach to public relations by merging it with critical CSR research, demonstrating the need for sponsoring organizations to follow an in-awareness approach when practicing international CSR while also adopting participatory approaches that engage members of the affected community to increase and sustain the positive benefits of these initiatives.
Assessment of pharmacologic prophylaxis use against stress ulcer in the medical wards of University of Gondar Hospital
Authors: Horsa Boressa Adugna , Ayele Yohanes , Ayalew Mohammed Biset
Published: February 2019

Background:

Critically ill patients with moderate-to-severe physiologically stressful event are at high risk of developing stress ulcers. The use of pharmacological prophylaxis significantly reduces the incidence of stress ulcer in high-risk patients.

Objective:

The aim of this study was to assess the use of pharmacological prophylaxis for stress ulcer in the medical wards of University of Gondar Hospital.

Methods:

A cross-sectional study design was used. In total, 234 patients were selected through simple random sampling technique. The risk of stress ulcer development was assessed using Evidence-Based Medicine Guideline for stress ulcer prepared by Orlando Regional Medical Center. SPSS version 21 was used for data analysis.

Result:

The most common acute risk factor to stress ulcer was coagulopathy (18.4%), followed by hypoperfusion (9.8%). The concomitant non-steroidal anti-inflammatory drug use (16.7%), mild-to-moderate brain or spinal cord injury (11.1%), and concomitant or recent corticosteroid use (9.4%) were frequently seen risk factors that necessitate administration of a prophylaxis. In total, 82 (35%) study participants were given stress ulcer prophylaxis, among which 52 (63.4%) were given without indication. The most commonly used drug class in the prevention of stress ulcer was proton pump inhibitors (76/82, 92.7%). In total, 43 (18.4%) study subjects were not given stress ulcer prophylaxis while there was clear indication. Patients with a long hospital stay and a diagnosis of central nervous system disorders had significant risk for inappropriate stress ulcer prophylaxis use.

Conclusion:

In this study, inappropriate use of prophylaxis for stress ulcer was common. The higher proportion of inappropriateness was due to the use of stress ulcer prophylaxis while there was no enough indication. We recommend future researchers to assess the cost and impact of inappropriate stress ulcer prophylaxis use, and the physicians should be adherent to the standard guidelines.
An Alternative Mathematical Modeling Approach to Estimating a Reference Life Expectancy
Authors: Stevens Elizabeth R. , Zhou Qinlian , Taksler Glen B. , Nucifora Kimberly A. , Gourevitch Marc , Braithwaite R. Scott
Published: February 2019

Background. Reference life expectancies inform frequently used health metrics, which play an integral role in determining resource allocation and health policy decision making. Existing reference life expectancies are not able to account for variation in geographies, populations, and disease states. Using a computer simulation, we developed a reference life expectancy estimation that considers competing causes of mortality, and is tailored to population characteristics. Methods. We developed a Monte Carlo microsimulation model that explicitly represented the top causes of US mortality in 2014 and the risk factors associated with their onset. The microsimulation follows a birth cohort of hypothetical individuals resembling the population of the United States. To estimate a reference life expectancy, we compared current circumstances with an idealized scenario in which all modifiable risk factors were eliminated and adherence to evidence-based therapies was perfect. We compared estimations of years of potential years life lost with alternative approaches. Results. In the idealized scenario, we estimated that overall life expectancy in the United States would increase by 5.9 years to 84.7 years. Life expectancy for men would increase from 76.4 years to 82.5 years, and life expectancy for women would increase from 81.3 years to 86.8 years. Using age-75 truncation to estimate potential years life lost compared to using the idealized life expectancy underestimated potential health gains overall (38%), disproportionately underestimated potential health gains for women (by 70%) compared to men (by 40%), and disproportionately underestimated the importance of heart disease for white women and black men. Conclusion. Mathematical simulations can be used to estimate an idealized reference life expectancy among a population to better inform and assess progress toward targets to improve population health.
How followers’ emotional stability and cultural value orientations moderate the impact of health-promoting leadership and abusive supervision on health-related resources
Authors: Bregenzer Anita , Felfe Jörg , Bergner Sabine , Jiménez Paul
Published: February 2019

Health-related resources at work are crucial for followers to stay healthy and to cope with job demands. This study investigates the impact of health-promoting leadership as well as abusive supervision on followers’ social and task resources as antecedents of their health. Moreover, it examines whether the impact of leadership on followers’ health-related resources depends on the followers’ emotional stability and cultural value orientations (i.e. power distance and collectivism). A total of 503 employees from Austria, Germany and Slovenia took part in this online study and provided information on their leaders’ health-promoting behaviour and abusive supervision as well as on their own emotional stability, perceived power distance and collectivism. The results of a hierarchical regression analysis strongly support the importance of simultaneously assessing health-promoting leadership and abusive supervision when predicting task and social resources. Abusive supervision added incremental variance above health-promoting leadership when followers’ task resources were predicted. Moreover, the results suggest that followers benefit from or suffer differently under perceived leadership: high power distance enhances the positive effect of health-promoting leadership on followers’ social resources, while collectivism strengthens the negative impact of abusive supervision on followers’ social resources. Finally, emotionally stable followers who are working with highly abusive leaders experience a stronger threat to their resources compared to emotionally stable followers who are working with less abusive leaders. These results contribute to a deeper understanding of how leaders impact those resources known to influence followers’ health. They further show that follower personality and cultural value orientations determine the impact of leadership behaviour on health-related resources.
A Systematic Review of the Impact of Surgical Special Care Units on Patient Outcomes and Health Care Resource Utilization
Authors: Mendis Nicholas , Hamilton Gavin M. , McIsaac Daniel I. , Fergusson Dean A. , Wunsch Hannah , Dubois Daniel , Montroy Joshua , Chassé Michaël , Turgeon Alexis F. , McIntyre Lauralyn , McDonald Heather , Yang Homer , Sampson Sonia D. , McCartney Colin J. L. , Shorr Risa , Denault André , Lalu Manoj M.
Published: February 2019

Perioperative intermediate care units (termed surgical special care units) have been widely implemented across health systems because they are believed to improve surveillance and management of high-risk surgical patients. Our objective was to conduct a systematic review to investigate the effects of a 3-level model of perioperative care delivery (ie, ward, surgical special care unit, or intensive care unit) compared to a 2-level model of care (ie, ward, intensive care unit) on postoperative outcomes. Our protocol was registered with PROSPERO, the international prospective register of systematic reviews (CRD42015025155). Randomized controlled studies and nonrandomized comparator studies were included. We performed a systematic search of Medline, Cumulative Index to Nursing and Allied Health Literature, Embase, and the Cochrane library (inception – 11/2017). The primary outcome was mortality; secondary outcomes included length of stay and hospital costs. We identified 1995 citations with our search, and 21 studies met eligibility criteria (2 randomized controlled studies and 19 nonrandomized comparator studies; 44,134 patients in total). Surgical special care units were characterized by continuous monitoring (12 studies), the absence of mechanical ventilation (8 studies), nurse-to-patient ratios (range, 1:2–1:4), and number of beds (median: 5; range: 3–33). Thirteen studies reported on mortality. Notable findings included no observed difference in overall in-hospital mortality, but an apparent increase in intensive care unit mortality in a 3-level model of care. This may reflect a decanting of lower acuity patients from the intensive care unit to the surgical special care unit. No significant difference was found in hospital length of stay; however, 2 studies demonstrated reductions in hospital costs with the implementation of a surgical special care unit. Significant clinical and methodological heterogeneity precluded pooled analysis. Given the prevalence of surgical special care units, the results of our review suggest that additional methodologically rigorous investigations are needed to understand the effect of these units on the surgical population.
High-Flow Nasal Oxygen Improves Safe Apnea Time in Morbidly Obese Patients Undergoing General Anesthesia: A Randomized Controlled Trial
Authors: Wong David T. , Dallaire Amelie , Singh Kawal Preet , Madhusudan Poorna , Jackson Timothy , Singh Mandeep , Wong Jean , Chung Frances
Published: February 2019

BACKGROUND:

Morbidly obese patients undergoing general anesthesia are at risk of hypoxemia during anesthesia induction. High-flow nasal oxygenation use during anesthesia induction prolongs safe apnea time in nonobese surgical patients. The primary objective of our study was to compare safe apnea time, between patients given high-flow nasal oxygenation or conventional facemask oxygenation during anesthesia induction, in morbidly obese surgical patients.

METHODS:

Research ethics board approval was obtained. Elective surgical patients ≥18 years with body mass index ≥40 kg·m−2 were included. Patients with severe comorbidity, gastric reflux disease, known difficult airway, or nasal obstruction were excluded. After obtaining informed consent patients were randomized. In the intervention (high-flow nasal oxygenation) group, preoxygenation was provided by 100% nasal oxygen for 3 minutes at 40 L·minute−1; in the control group, preoxygenation was delivered using a facemask with 100% oxygen, targeting end-tidal O2 >85%. Anesthesia was induced with propofol, remifentanil, and rocuronium. Bag-mask ventilation was not performed. At 2 minutes after rocuronium, videolaryngoscopy was performed. If the laryngoscopy grade was I or II, laryngoscope was left in place and the study was continued; if grade III or IV was observed, the patient was excluded from the study. During the apnea period, high-flow nasal oxygenation patients received nasal oxygen at 60 L·minute−1; control group patients received no supplemental oxygen. The primary outcome, safe apnea time, was reached when oxygen saturation measured by pulse oximetry (Spo
2) fell to 95% or maximum 6 minutes of apnea. The patient was then intubated. T tests and χ2 analyses were used to compare groups. P < .05 was considered significant.

RESULTS:

Forty patients completed the study. Baseline parameters were comparable between groups. Safe apnea time was significantly longer (261.4 ± 77.7 vs 185.5 ± 52.9 seconds; mean difference [95% CI], 75.9 [33.3–118.5]; P = .001) and the minimum peri-intubation Spo
2 was higher (91.0 ± 3.5 vs 88.0 ± 4.8; mean difference [95% CI], 3.1 [0.4–5.7]; P = .026) in the high-flow nasal oxygenation group compared to the control group.

CONCLUSIONS:

High-flow nasal oxygenation, compared to conventional oxygenation, provided a longer safe apnea time by 76 seconds (40%) and higher minimum Spo
2 in morbidly obese patients during anesthesia induction. High-flow oxygenation use should be considered in morbidly obese surgical patients.
Regional Anesthesia for Pediatric Ophthalmic Surgery: A Review of the Literature
Authors: Jean Yuel-Kai , Kam David , Gayer Steven , Palte Howard D. , Stein Alecia L. S.
Published: February 2019

Ophthalmic pediatric regional anesthesia has been widely described, but infrequently used. This review summarizes the available evidence supporting the use of conduction anesthesia in pediatric ophthalmic surgery. Key anatomic differences in axial length, intraocular pressure, and available orbital space between young children and adults impact conduct of ophthalmic regional anesthesia. The eye is near adult size at birth and completes its growth rapidly while the orbit does not. This results in significantly diminished extraocular orbital volumes for local anesthetic deposition. Needle-based blocks are categorized by relation of the needle to the extraocular muscle cone (ie, intraconal or extraconal) and in the cannula-based block, by description of the potential space deep to the Tenon capsule. In children, blocks are placed after induction of anesthesia by a pediatric anesthesiologist or ophthalmologist, via anatomic landmarks or under ultrasonography. Ocular conduction anesthesia confers several advantages for eye surgery including analgesia, akinesia, ablation of the oculocardiac reflex, and reduction of postoperative nausea and vomiting. Short (16 mm), blunt-tip needles are preferred because of altered globe-to-orbit ratios in children. Soft-tip cannulae of varying length have been demonstrated as safe in sub-Tenon blockade. Ultrasound technology facilitates direct, real-time visualization of needle position and local anesthetic spread and reduces inadvertent intraconal needle placement. The developing eye is vulnerable to thermal and mechanical insults, so ocular-rated transducers are mandated. The adjuvant hyaluronidase improves ocular akinesia, decreases local anesthetic dosage requirements, and improves initial block success; meanwhile, dexmedetomidine increases local anesthetic potency and prolongs duration of analgesia without an increase in adverse events. Intraconal blockade is a relative contraindication in neonates and infants, retinoblastoma surgery, and in the presence of posterior staphylomas and buphthalmos. Specific considerations include pertinent pediatric ophthalmologic topics, block placement in the syndromic child, and potential adverse effects associated with each technique. Recommendations based on our experience at a busy academic ophthalmologic tertiary referral center are provided.
Postoperative Myocardial Injury in Middle-Aged and Elderly Patients Following Curative Resection of Esophageal Cancer With Aggressive or Standard Body Temperature Management: A Randomized Controlled Trial
Authors: Zhang Zuojing , Xu Meiying , Wu Dehua , Zhang Xiaofeng , Wu Jingxiang
Published: February 2019

BACKGROUND:

Risk of intraoperative hypothermia is relatively high in middle-aged and elderly patients undergoing curative resection of esophageal cancer, which may cause myocardial ischemia during the early postoperative period. The objective of this study was to compare aggressive or standard body temperature management for lowering the incidence of postoperative myocardial injury that was assessed by troponin levels collected at a priori defined set times in these patients.

METHODS:

Seventy patients undergoing elective curative resection of esophageal cancer were randomly assigned to undergo aggressive body temperature management (nasopharyngeal temperature ≥36°C) or standard body temperature management (n = 35 in each arm). The primary outcome was myocardial injury, defined as the occurrence of elevated troponin I (>0.06 µg/L) or elevated high-sensitivity troponin T (≥0.065, or 0.02 µg/L≤ high-sensitivity troponin T <0.065 µg/L, but with an absolute change of at least 0.005 µg/L) or both during 2 days after surgery. Secondary outcomes included (1) severe arrhythmia, including atrial fibrillation, supraventricular tachycardia, frequent premature ventricular contractions intraoperatively or during 3 days postoperatively; (2) hypoxemia or metabolic acidosis during the first 12 h postoperatively; and (3) deep vein thrombosis or pulmonary embolism during 3 days postoperatively.

RESULTS:

Incidence of postoperative 2-day myocardial injury was 8.6% (3/35) among patients receiving aggressive body temperature management and 31.4% (11/35) among patients receiving standard body temperature management (P = .017, χ2). Relative risk of myocardial injury in the aggressive body temperature management group was 0.27 (95% CI, 0.08–0.89). Incidence of intra- and postoperative 3-day severe cardiac arrhythmia was 2.9% (1/35) among patients receiving aggressive body temperature management and 28.6% (10/35) among patients receiving standard body temperature management. Incidence of postoperative 12-h hypoxia was 17.1% (6/35) with aggressive body temperature management and 40.0% (14/35) with standard body temperature management. Incidence of postoperative 12-h metabolic acidosis was 20% (7/35) among patients receiving aggressive body temperature management and 48.6% (17/35) among patients receiving standard body temperature management. Incidence of postoperative 3-day deep vein thrombosis or pulmonary embolism was 0% (0/35) with aggressive body temperature management and 2.9% (1/35) with standard body temperature management.

CONCLUSIONS:

Aggressive body temperature management may be associated with a lower incidence of postoperative myocardial injury.
Prevalence and Multivariable Factors Associated With Preoperative Cognitive Impairment in Outpatient Surgery in the United States
Authors: Gaulton Timothy G. , Eckenhoff Roderic G. , Neuman Mark D.
Published: February 2019

Preoperative cognitive impairment increases the risk of adverse events after surgery but its prevalence in outpatient surgery has not been defined. We aimed to determine the prevalence and multivariable factors associated with cognitive impairment in individuals who present for outpatient surgery. We used data from the Health and Retirement Study, a longitudinal panel survey of older Americans. Of 1836 participants who reported having outpatient surgery, we found that 16.1% had evidence of cognitive impairment. Significant multivariable factors associated with preoperative cognitive impairment included non-Hispanic African American race, prior stroke, preoperative functional dependence, and lower socioeconomic status and education level.
I Tweet, Therefore I Learn: An Analysis of Twitter Use Across Anesthesiology Conferences
Authors: Schwenk Eric S. , Jaremko Kellie M. , Park Brian H. , Stiegler Marjorie A. , Gamble Jamison G. , Chu Larry F. , Utengen Audun , Mariano Edward R.
Published: February 2019

BACKGROUND:

Twitter in anesthesiology conferences promotes rapid science dissemination, global audience participation, and real-time updates of simultaneous sessions. We designed this study to determine if an association exists between conference attendance/registration and 4 defined Twitter metrics.

METHODS:

Using publicly available data through the Symplur Healthcare Hashtags Project and the Symplur Signals, we collected data on total tweets, impressions, retweets, and replies as 4 primary outcome metrics for all registered anesthesiology conferences occurring from May 1, 2016 to April 30, 2017. The number of Twitter participants, defined as users who contributed a tweet, retweet, or reply 3 days before through 3 days after the conference, was collected. We also collected influencer data as determined by mentions (number of times a user is referenced). Two authors independently verified the categories for influencers assigned by Symplur. Conference demographic data were obtained by e-mail inquiries. Associations between meeting attendees/registrants and Twitter metrics, between Twitter participants and the metrics, and between physician influencers and Twitter participants were tested using Spearman rho.

RESULTS:

Fourteen conferences with 63,180 tweets were included. With the American Society of Anesthesiologists annual meeting included, the correlations between meeting attendance/registration and total tweets (r
s = 0.588; P = .074), impressions (r
s = 0.527; P = .117), and retweets (r
s = 0.539; P = .108) were not statistically significant; for replies, it was moderately positive (r
s = 0.648; P = .043). Without the American Society of Anesthesiologists annual meeting, total tweets (r
s = 0.433; P = .244), impressions (r
s = 0.350; P = .356), retweets (r
s = 0.367; P = .332), and replies (r
s = 0.517; P = .154) were not statistically significant. Secondary outcomes include a highly positive correlation between Twitter participation and total tweets (r
s = 0.855; P < .001), very highly positive correlations between Twitter participation and impressions (r
s = 0.938; P < .001), retweets (r
s = 0.925; P < .001), and a moderately positive correlation between Twitter participation and replies (r
s = 0.652; P = .044). Doctors were top influencers in 8 of 14 conferences, and the number of physician influencers in the top 10 influencers list at each conference had a moderately positive correlation with Twitter participation (r
s = 0.602; P = .023).

CONCLUSIONS:

We observed that the number of Twitter participants for a conference is positively associated with Twitter activity metrics. No relationship between conference size and Twitter metrics was observed. Physician influencers may be an important driver of participants.
Anesthesia myTIPreport: A Web-Based Tool for Real-Time Evaluation of Accreditation Council for Graduate Medical Education’s Milestone Competencies and Clinical Feedback to Residents
Authors: Chen Fei , Arora Harendra , Zvara David A. , Connolly AnnaMarie , Martinelli Susan M.
Published: February 2019

Feedback in clinical education is essential but challenged by multiple barriers. This report describes the use of myTIPreport, a web-based tool, which streamlines the dual purpose of milestone evaluation and real-time feedback from faculty to residents in a US anesthesiology program. In a 6-month trial, faculty members and residents used myTIPreport for daily clinical feedback. We believe myTIPreport will be a valuable tool for clinical feedback given further refinement of the tool and improved faculty and resident development on program use.
Exploring privilege through feminist gender training
Authors: Ferguson Lucy
Published: February 2019

Drawing together a number of unaddressed concerns from a range of literatures, this article explores ways of working on privilege in gender training. It calls for feminist gender training that is reflexive, focused on process and grounded in the transformative potential of gender-training moments and encounters. Drawing on black feminist thought and privilege studies, the article engages with the challenges of working on privilege, using feminist pedagogical principles and examples from practice to guide the discussion. New and innovative ways of ‘doing’ feminist gender training are proposed in the spirit of summoning our ‘transformative courage’ to collaboratively construct a feminist gender training that explicitly engages with privilege in order to facilitate tangible, lasting transformation for gender equality.
New Means of Workplace Surveillance
Authors: Manokha Ivan
Published: February 2019

Workplace surveillance and the invasion of employee privacy have always been present under capitalism. Historically, this has mostly involved the combination of visual observation and abstract time, focusing on employee performance. However, the development of new information and communication technologies has brought important changes to the manner in which employers control employee productivity. Such digitalization or datafication of employees constitutes a qualitative change in the history of workplace surveillance—a change that reduces workers, their performance and bodies, to lines of code and flows of data to be scrutinized and manipulated.
A Novel Integration of PCM with Wind-Catcher Skin Material in Order to Increase Heat Transfer Rate
Authors: Seidabadi Leila , Ghadamian Hossein , Aminy Mohammad
Published: February 2019

In this research, a comprehensive simulation study including 3-D Dynamic time-dependent has been performed for Phase Change Materials (PCMs) applicant as a thermal storage integrated with the wind-catcher-wall in order to reduce the temperature difference (As a sustainable cooling method) in the MATLAB open-source–code software. By means of 3-D Dynamic time-dependent, as a final finding, the temperature drop (Cooling purpose) was obtained 25 degrees at about 7 working hours. Passive cooling can be considered as a viable and attractive strategy for the sustainable concept, opposed to mitigation of energy consumption and Green House Gas (GHG) simultaneously. One of the traditional-old-age famous passive cooling systems that are still being applied nowadays is wind-catcher as an energy system. The wind catcher sustain natural ventilation and cooling in buildings through wind-driven airflow as well as temperature difference. Windcatchers can save the electrical energy used to provide thermal comfort during the hot climate in summer case of the year, especially during the peak hours contributed to energy carriers’ consumptions. In this study, by proposing a new design of the windcatchers, attempts have been made to improve the energy efficiency of passive cooling methods. Besides, the application of new efficient methods for the purpose of thermal energy storage (PCM) as a sub-system is a chosen method to increase energy efficiency. By applying energy storage systems in addition to increase system energy performance and reliability, the target of reducing energy consumption is achieved.© 2019. CBIORE-IJRED. All rights reservedArticle History: Received May 18th 2018; Received in revised form October 5th  2018; Accepted January 5th 2019; Available onlineHow to Cite This Article: Seidabadi, L., Ghadamian, H, and Aminy, M. (2019) A Novel Integration of PCM with Wind-Catcher Skin Material in Order to Increase Heat Transfer Rate. Int. Journal of Renewable Energy Development, 8(1), 1-6.https://doi.org/10.14710/ijred.8.1.1-6
Analysing the Possibility of Extracting Energy from Ocean Waves in Cabo-Verde to Produce Clean Electricity - Case-Study: the Leeward Islands
Authors: Leger Monteiro Wilson Madaleno , Sarmento António
Published: February 2019

This work analyses the possibility of extracting energy from the ocean waves around the Leeward Islands of Cabo-Verde. This study was based on 31 years of wave and wind data, obtained through the SOWFIA - Streamlining of Ocean Wave Farm Impact Assessment, at 16° N-24° W. Then, the SWAN - Simulating Waves Nearshores - was used to perform the wave transformations to the shore. As the number of waves is very high, the cluster analysis and the Non-Parametric Wilcoxon Test were used to reduce the computing time by SWAN. The results pointed to the South of these islands and the East Coast of Maio island as the best locations for wave energy extraction. The use of the power matrix of some commercial devices that are available, such as Wave Dragon (7 MW), Pelamis (750 kW) and AquaBuoy (250 kW), allowed to estimate the best devices scale factors that leads to their best Capacity Factor (CF), at the target regions. Thus, the Wave Dragon is the most indicated device (CF=71%), at the scale of 0.3, followed by AquaBuoy scaled by 0.4 (CF=57%) and Pelamis scaled by 0.5, with CF=26%. However, in a natural scale, AquaBuoy is the most efficient device (CF = 18.8%) in comparison to the Wave Dragon (CF=17%) and Pelamis (CF=15%). AquaBuoy presented the best cost-benefit ratio (C/B = 0.135 USD/kWh) followed by Wave Dragon (C/B= 0.235 USD/kWh) and Pelamis (C/B = 0.390 USD/kWh). The limitation of the number of Wave Energy Converters to implement the wave power plant affects negatively the cost of its investment.©2019. CBIORE-IJRED. All rights reservedArticle History: Received March 27th 2018; Received in revised form October 16th 2018; Accepted January 5th 2019; Available onlineHow to Cite This Article: Monteiro, W.M.L., and Sarmento, A (2019). Analysing the Possibility of Extracting Energy from Ocean Waves in Cabo-Verde to Produce Clean Electricity - Case-Study: The Leeward Islands. Int. Journal of Renewable Energy Development, 8(1), 103-112https://doi.org/10.14710/ijred.8.1.103-112
Experimental and Numerical Investigation of Nanofluid Usage in a Plate Heat Exchanger for Performance Improvement
Authors: Sözen Adnan , Khanları Ataollah , Çiftçi Erdem
Published: February 2019

Plate heat exchangers, a compact-type heat exchanger, are commonly used heat transfer devices because of their superior characteristics. Their thermal performances are strongly dependent to working fluid circulating inside the system. The influences of nanofluid utilization as the working fluid in a plate heat exchanger was experimentally and numerically analysed in this study. In order to show off the improvement rate in heat transfer, the experiments were performed by using deionized water and TiO2-deionized water nanofluid. The nanofluid was prepared at the rate of 1.5 % as weighted. A surface-active agent, Triton X-100, was also doped into the mixture at the rate of 0.2% of a final concentration to prevent the sedimentation and flocculation of the nanoparticles inside the solution. The experiments were performed in different temperatures as 40°C, 45°C, 50°C and varying cold fluid mass flow rates as 3,4, 5, 6 and 7 lpm.  In addition, using the experimental data, a numerical simulation was realized by ANSYS Fluent software.  The both results indicate that heat transfer rate in plate heat exchanger can be improved using nanofluid as the working fluid in place of deionized water. The maximum improvement rate in heat transfer was obtained as 11 % in experimental study. It is also seen that experimental and numerical results are in good agreement.©2019. CBIORE-IJRED. All rights reservedArticle History: Received May 18th 2018; Received in revised form October 17th 2018; Accepted January 8th 2019; Available onlineHow to Cite This Article: Sözen, A., Khanlari, A., and Çiftçi, E. (2019) Experimental and Numerical Investigation of Nanofluid Usage in a Plate Heat Exchanger for Performance Improvement. Int. Journal of Renewable Energy Development, 8(1), 27-32.https://doi.org/10.14710/ijred.8.1.27-32
Optimal Parameters Synthesis of Biodiesel From Frying Oils Wastes
Authors: Soulayman Soulayman , Dayoub Ola
Published: February 2019

This study is devoted to produce biodiesel from recycled wastes frying oils (WFO) using commercial grade chemicals in an attempt to help reducing the cost of biodiesel and pollution coming from WFO. The base – catalyzed transesterification method was applied. The variables affecting the yield and characteristics of the biodiesel produced from WFO were studied. Sodium hydroxide is used as catalyst. Different reaction times, different methanol/WFO volume ratios and different catalyst/WFO weight ratios were used with purpose of achieving the best conditions for biodiesel production A series of experiments were carried out, using methanol/WFO volume ratios from 10% to 30% and catalyst/WFO weight ratio from 0.2% to 0.8%. It was found that in treating WFO which contains 0.12% of water by weight and having an acid value of 0.52 mg of KOH/g of oil, and an iodine value 130.42 gI/100 g of oil, no need in acidic pretreatment.  Moreover, it was found that, for WFO with an acidic value of 0.52 mg KOH/gWFOs, results show that a methanol/WFO volume ratio of 13% and a catalyst/WFO weight ratio of 0.4% give the highest yield of methyl esters.  A pilot production unit of 400l/day of production capacity was designed and constructed on the basis of laboratory experiments and the process was verified on the pilot scale.©2019. CBIORE-IJRED. All rights reservedArticle History: Received October 18th 2017; Received in revised form May 17th 2018; Accepted December 8th 2018; Available onlineHow to Cite This Article: Soulayman, S. and Ola, D. (2019) Synthesis Parameters of Biodiesel From Frying Oils Wastes. Int. Journal of Renewable Energy Development, 8(1), 33-39.https://doi.org/10.14710/ijred.8.1.33-39
Electricity Production from Wind Energy By Piezoelectric Material
Authors: Büyükkeskin İkram , Tekin Sezai Alper , Gürel Seyfettin , Genç Mustafa Serdar
Published: February 2019

In recent years, the energy demand has increased, and alternative way of energy production methods are proposed to deal with this phenomenon by scholars. One of the most promising method is piezoelectric materials. These materials can be used for energy production with improving their efficiencies. This work is made with the guidance of one project which aimed to electricity production form wind energy. This method with one prototype is investigated. Two different wind stalk structures are produced with 3-D Printer. These different structures are set up in wind tunnel and it is experimented under different wind speeds and high turbulence flows. As a result, a circular and four-corner wind stalk structures are investigated for low and high turbulence flows in several wind speeds.  To conclude, the produced energy is too small for the systems in market because there are many types of piezoelectric materials for various applications and the problems due to measurement devices. However, piezoelectric materials can be better alternative for classical wind turbines in turbulence flow areas. Therefore, the electricity production from piezoelectric material will be promising method in the future with its advantages.© 2019. CBIORE-IJRED. All rights reservedArticle History: Received May 15th 2018; Received in revised form September 14th 2018; Accepted January 5th 2019; Available onlineHow to Cite This Article: Buyukkseskin, I., Tekin, S. A., Gurel, S., Genc, M S. (2019) Electricity Production from Wind Energy By Piezoelectric Material. International Journal of Renewable Energy Develeopment, 8(1), 41-46.https://doi.org/10.14710/ijred.8.1.41-46