bluuebunny/crossref_metadata_2025 huggingface dataset:
Intravascular Cooling Device Versus Esophageal Heat Exchanger for Mild Therapeutic Hypothermia in an Experimental Setting
Authors: Schroeder Daniel C. , Maul Alexandra C. , Guschlbauer Maria , Finke Simon-Richard , de la Puente Bethencourt David , Becker Ingrid , Padosch Stephan A. , Hohn Andreas , Annecke Thorsten , Böttiger Bernd W. , Sterner-Kock Anja , Herff Holger
Published: November 2018

BACKGROUND:

Targeted temperature management is a standard therapy for unconscious survivors of cardiac arrest. To date, multiple cooling methods are available including invasive intravascular cooling devices (IVDs), which are widely used in the clinical setting. Recently, esophageal heat exchangers (EHEs) have been developed providing cooling via the esophagus that is located close to the aorta and inferior vena cava. The objective was to compare mean cooling rates, as well as differences, to target temperature during maintenance and the rewarming period of IVD and EHE.

METHODS:

The study was conducted in 16 female domestic pigs. After randomization to either IVD or EHE (n = 8/group), core body temperature was reduced to 33°C. After 24 hours of maintenance (33°C), animals were rewarmed using a target rate of 0.25°C/h for 10 hours. All cooling phases were steered by a closed-loop feedback system between the internal jugular vein and the chiller. After euthanasia, laryngeal and esophageal tissue was harvested for histopathological examination.

RESULTS:

Mean cooling rates (4.0°C/h ± 0.4°C/h for IVD and 2.4°C/h ± 0.3°C/h for EHE; P < .0008) and time to target temperature (85.1 ± 9.2 minutes for IVD and 142.0 ± 21.2 minutes for EHE; P = .0008) were different. Mean difference to target temperature during maintenance (0.07°C ± 0.05°C for IVD and 0.08°C ± 0.10°C for EHE; P = .496) and mean rewarming rates (0.2°C/h ± 0.1°C/h for IVD and 0.3°C/h ± 0.2°C/h for EHE; P = .226) were similar. Relevant laryngeal or esophageal tissue damage could not be detected. There were no significant differences in undesired side effects (eg, bradycardia or tachycardia, hypokalemia or hyperkalemia, hypoglycemia or hyperglycemia, hypotension, overcooling, or shivering).

CONCLUSIONS:

After insertion, target temperatures could be reached faster by IVD compared to EHE. Cooling performance of IVD and EHE did not significantly differ in maintaining target temperature during a targeted temperature management process and in active rewarming protocols according to intensive care unit guidelines in this experimental setting.
Trends in Authorship in Anesthesiology Journals
Authors: Miller Joanna , Chuba Emuejevoke , Deiner Stacie , DeMaria Samuel , Katz Daniel
Published: November 2018

Despite increasing representation in medicine, women continue to be a minority in academic practice and leadership, especially in male-dominated fields like anesthesiology. Differences in compensation and participation in leadership may represent barriers to career advancement for women in anesthesiology. Key factors for promotion in academic anesthesiology are research, funding, and publication. As such, designation as a first or senior author on a publication in a professional journal may act as currency for promotion. Here, we examine the prevalence of female first and senior authorship of original research articles published in Anesthesiology and Anesthesia & Analgesia during the years 2002, 2007, 2012, and 2017. Other manuscript characteristics assessed in relation to author gender included study type, subspecialty topic, and total number of authors. Of 2600 manuscripts studied, analysis of authorship by year demonstrated an increase in female first authorship, senior authorship, and editorial board membership by 10%, 9%, and 6%, respectively. Women made up a higher percentage of first authors on manuscripts with female senior authors. More nonexperimental studies had female senior authors than experimental studies. Female first authors had greater representation in the subspecialties of neuroanesthesia, obstetrical anesthesia, pain management, and pediatric anesthesia. Median number of authors was unrelated to senior author gender. This study shows increasing female first and senior authorship, as well as editorial board composition in 2 popular, high-impact anesthesiology journals. Recognizing gender-based trends in publications is important to develop strategies for the recruitment, retention, and advancement of women in anesthesiology.
A Stategy for Rural Development in Greece: The Case od Island Areas
Authors: Maravegias Napoleon , Doukas Yannis El.
Published: November 2018

The idea that Rural Areas are identified with Agricultural Sector is outdated as it cannot correspond towards the current framework of the european agrarian sector. The present paper attempts to examine the Rural Areas from a new angle in an effort to seek out data that will lead to a different and far more effective strategy of rural development. A special focus will be given on the greek island Rural Areas as an example of how the issue of multifunctionality and the directions of the Common Agricultural Policy (CAP) could be implemented. Additionally, the paper will also attempt to note the importance of the place-based rather than the sectoral approach, giving priority to investments rather than subsidies. Lastly, special mention is made of the need for improvement horizontally cutting across funding policies for the implementation of a rural policy.
Η Υλοποίηση της Πολιτικής Συνοχής της ΕΕ στην Ελλάδα, 2007-2013: Ένας Ενδιάμεσος Απολογισμός
Authors: Ανδρέου Γιώργος , Παπαδάκης Μαρίνος
Published: November 2018

The aim of this article is to identify the factors that have affected the implementation of the Programmes falling under Greece’s National Strategic Reference Framework (NSRF). The relevant analysis is inspired by historical institutionalism and relies on an explanatory framework based on the double distinction between conjectural and structural factors on the one hand and external and domestic factors on the other hand.
Ο Σύγχρονος Ρόλος της Αυτοδιοίκησης
Authors: Μπακογιάννης Κώστας
Published: November 2018

Μια μέρα, ο TeddyKollek, ένας επιτυχημένος Δήμαρχος της Ιερουσαλήμ τιςδεκαετίες του ’80 και του ’90, περικυκλωμένος από θρησκευτικούς ηγέτες,Εβραίους, Μουσουλμάνους και Χριστιανούς που έριζαν για την πρόσβαση στουςΑγίους Τόπους, και έχοντας αγανακτήσει από τον αέναο καβγά τους, τους είπε το εξής: Κύριοι, αφήστε τα κηρύγματα και θα σας φτιάξω τις αποχετεύσεις!Αυτό ακριβώς ονομάζεται αυτοδιοίκηση. Το να δίνουμε πραγματικές λύσεις σεπραγματικά προβλήματα. Να ξεπερνάμε αυτά που μας χωρίζουν και να ενώνουμε δυνάμεις για να κάνουμε καλύτερες τις ζωές των ανθρώπων. Να γνωρίζουμε από μέσα τα ζητήματα που ανακύπτουν, γιατί ζούμε και κινούμαστε στον ίδιο χώρο μεαυτά.
Τοπική Διακυβέρνηση και Πολιτική: Το Πεδίο της Εταιρικής Κοινωνικής Ευθύνης
Authors: Ταλιούρης Ευάγγελος , Μαραβέγιας Ναπολέων
Published: November 2018

Corporate Social Responsibility is a policy making fi eld that highlights the signifi cance of business potential role and contribution to Europe’s sustainable development, via the empowerment of responsible entrepreneurship initiatives towards society wellbeing, market competitiveness and environmental sustainability. Moreover, the concept of CSR is traditionally related with business ethics and administration fi elds, as well as corporations’ stakeholder management. Furthermore, the policy evolution of CSR in Europe was mainly developed via its implicit and explicit characteristics at the beginning of the ‘90s. The CSR was accompanied with the perspectives about the state’s role in a global society as well as the overall policy framework of EU in sustainable development, social welfare, competiveness and other international initiatives. The policy making process of CSR became more explicit in EU at the beginning of 21st century, and since then is a signifi cant policy fi eld for European institutions, member states and regions. In Greece, the CSR is considered nowadays as a developing policy fi eld both at national and local level, which seems to infl uence regional development policy and generate stakeholder synergies towards environmental sustainability, employment generation, social capital improvement and responsible entrepreneurship.
Η χρηματοδότηση του ενεργειακού τομέα της Ελλάδας από ευρωπαϊκούς πόρους. Μια κριτική προσέγγιση.
Authors: Λιαργκόβας Παναγιώτης , Αποστολόπουλος Νικόλαος
Published: November 2018

In the present article, an effort is made to approach, analyze, evaluate and make inferences about the actions and initiatives of the energy sector of the previous funding periods which were funded by European resources, so as to shed light on the problems that occurred during their planning and realization. It is also attempted to highlight the positive aspects, the weaknesses, the comparative advantages and disadvantages, the occurring opportunities and the difficulties that are formed by a competitive environment. The aim of this article is to submit concrete proposals that will assist to achieve a smooth, safe, relentless and unfailing exploitation of the resources that Greece possesses in the new funding period 2014-2020.
Masahisa Fujita, Paul Krugman και Anthony J. Venables The Spatial Economy: Cities, Regions, and International Trade
Authors: Λύκος Μαρτίνος
Published: November 2018

Δε διατίθεται περίληψη
Ο δημοσιονομικός έλεγχος των δαπανών των ΟΤΑ από το ελεγκτικό συνέδριο
Authors: Ρασούλης Αλκιβιάδης , Χαντζάρας Θάνος
Published: November 2018

Δεν διατίθεται περίληψη
Βιώσιμη ανάπτυξη στην ελληνική περιφέρεια. Η περίπτωση του νησιωτικού χώρου
Authors: Σπύρου Σπυρίδων
Published: November 2018

Δεν διατίθεται περίληψη
Περιφερειακή Ανάπτυξη
Authors: Αραμπατζής Γαρύφαλλος
Published: November 2018

Δεν διατίθεται περίληψη
Urban Economics
Authors: Λύκος Μαρτίνος
Published: November 2018

Δεν διατίθεται περίληψη
Research and technology in E.U. towards 2020. Upgrade or stagnation? What the impact on Greece?
Authors: Χρυσομαλλίδης Χαράλαμπος
Published: November 2018

The article presents future E.U. policy in the area of research, technology and innovation towards 2020. The analysis is based on Strategy “Europe 2020” and European Commission’s proposal on EU budget for the period 2014-2020. The goal is to examine whether or not these decisions and proposals lead to public policy’s upgrade and to seek the impact that they have on Greece, on its research community and on domestic public policy.
Νέο ΕΣΠΑ - ΣΕΣ Φιλοσοφία & Στόχοι
Authors: Χατζηδάκης Κωστής
Published: November 2018

Δεν διατίθεται
On the awkwardness of spatial development theories against the crisis
Authors: Καυκαλάς Γρηγόρης
Published: November 2018

The presentation of the main argument starts with a synopsis of the successive efforts, sucesses and failures, of spatial development planning, especially after the energy crisis of the 1970s. The second step focuses upon the local/global relationships as a question of multi-level spatial integration. This symbiotic relationship intensifi es with the pace of globalisation and transcends national economies and even international groupings. Finally, instead of conclusion there is a comment on the resilience of regions with reference to the recent economioc crisis.
Philip McCann - Modern Urban and Regional Economics
Authors: Λύκος Μαρτίνος
Published: November 2018

Δεν διατίθεται
Introduction: Acting (on) the Text: the Case of New Media
Authors: Kalyva Eve , Physentzides Christos
Published: November 2018

No abstract (available).
“All the moments in our lives occupy the same space”: Tracing the Space of Memory in Tim Wright’s In Search of Oldton
Authors: Nadkarni Samira
Published: November 2018

Tim Wright‘s 2004 creative memory project, In Search of Oldton, is concerned with a need to reconcile a personal and collective cultural understanding of a recent predigital past with the present. Its complicated and fragmented landscape is produced by the remediation of repurposed pre-digital artefacts, and traversal of its space engages with the manner in which technology is increasingly mediating interaction between the urban landscapes and their inhabitants. This paper seeks to examine the manner in which Oldton‘s ludic-constructive play with memory engages with the psychogeographic understanding of the production of space and place through the user‘s interaction with the work, and its consequent commentary on the expansion of social interactions within a contemporary social apparatus so as to include the technology that makes these interactions possible.
How to Undo Things with Codes: New Writing Mechanisms and the Un/archivable Dis/appearing text
Authors: Markopoulou Athina
Published: November 2018

The discourses of criticism are being transformed at the same time that our writing mechanisms are undergoing a major change. Reflecting on the relationship between our writing tools and our perceptions and taking programmability and interactivity as the main characteristics of new writing media, this essay attempts an approach to how that which is new in scriptural techniques, that is to say, programmability and interactivity, are undoing our perception of such notions as the archive and embodiment. The two works which are here commented contain the conditions of unwriting their written trace; the interactor who makes the text appear paradoxically also causes its disappearance by acts of destruction or dispersion. In the case of AGRIPPA (A Book of The Dead), William Gibson reserves for the reader the role of the destructor of the text through an extreme gesture of interaction which destines the work to erasure and calls for the retrieval of a text that contains the conditions of its own death. In the case of Garry Hill‘s Writing Corpora, the body‘s acts are created of, create and are turned against writing, they embody and disperse the writing traces, while the body experiences the shift from inscription to embodiment.
Language Amplifications and Visualisations in Michael Joyce’s was and Alexandra Grant’s babel
Authors: Rapatzikou Tatiani G.
Published: November 2018

This article focuses on Michael Joyce‘s novel was and Alexandra Grant‘s painting babel in an attempt to explore what changes occur when moving between media, language codes and materials. Grant‘s painting is a response to Joyce‘s print-bound novel. Her work serves as a remediation as well as a reconceptualisation of Joyce‘s textual endeavor. In examining these works, we can locate a dynamic relation across the patterns of visual and verbal communication that they create. Joyce‘s and Grant‘s collaboration breaks new ground not only in terms of understanding how different media function but also by introducing an experiential and participatory form of narrative development. Through their engagement with different media, these works create narratives that are visually, verbally, spatially and conceptually challenging.
Brooker Will, Hunting the Dark Knight: Twenty-First Century Batman.
Authors: Marazi Katherine
Published: November 2018

No abstract (available).
The Transformative Potential of Imoinda: An Interview with Joan Anim-Addo
Authors: Marchi Lisa , Anim-Addo Joan
Published: November 2018

No abstract (available).
Introduction: History and Contemporary Literature
Authors: Harrison Christine , Spiropoulou Angeliki
Published: November 2018

No abstract (available).
Spatialising Early and Late Modernity: Representations of London in Peter Ackroyd’s The House of Dr. Dee and Hawksmoor
Authors: Harrison Christine
Published: November 2018

Peter Ackroyd’s Hawksmoor (1985) and The House of Dr. Dee (1993) are examples of a distinctive British form of contemporary experimental historical fiction, and through representations of London they explore the popular dimension of early modernity, showing how the capital’s spaces both embodied and produced multiple modernity, as well as the unsung pre-modern allegiances that critiqued modern forms. While the novels’ respective Renaissance and post-Restoration settings allow them to explore different stages in the development of both London modernity and resistant forms, their juxtaposition of early and late modern narratives establishes a compelling parallel between early modern and late twentieth-century London. Both sets of narratives also stage a shift away from modern forms towards inherited pre-modern allegiances, connecting this to a new relationship with the capital’s inheritance of pre-Reformation and Gothic built space, as well as an equivalent tradition of London writing, one in which Ackroyd’s novels themselves participate.
History and Literature: An Interview with Hayden White
Authors: Spiropoulou Angeliki , White Hayden
Published: November 2018

No abstract (available).
Maria Koundoura. Transnational Culture, Transnational Identity: The Politics and Ethics of Global Culture Exchange
Authors: Freitas Vivek
Published: November 2018

No abstract (available).
Walter Benjamin, Radio Benjamin Ed. Lecia Rosenthal. Trans. Jonathan Lutes.
Authors: Bromley Αmy
Published: November 2018

No abstract (available).
Agonistic Equality in Rancière and Spinoza
Authors: Vardoulakis Dimitris
Published: November 2018

Jacques Rancière’s conception of equality as an axiomatic presupposition of the political is important, because it bypasses the tradition which defines equality in terms of Aristotle’s conception of geometric equality. In this paper, I show that Rancière’s theory both espouses a monism, according to which inequality implies equality, and relies on a concept of the free will, which is incompatible with monism. I highlight this tension by bringing Rancière’s theory into conversation with the great monist of the philosophical tradition, Baruch Spinoza.
The Politics of Violence and the Mediatisation of Urban Spaces on Stage: Anna Deavere Smith’s Twilight: Los Angeles, 1992 and José Rivera’s Marisol
Authors: Blatanis Konstantinos
Published: November 2018

Interest in this paper centres on two exemplary cases of two entirely different modes of dramatisation and theatrical practice which, nonetheless, share a common goal. The two works studied here aim at a critical reconsideration of the political issues which surround intensely violent events that have marked American mega cities over the past three decades. Furthermore, both plays aspire to articulate an original statement on the ways in which these issues routinely fall prey to the hegemony of monolithic and sterile media representations of urban spaces. Anna Deavere Smith’s vigorous exploration of the reserves of documentary drama and theatre in Twilight: Los Angeles, 1992 (1993) is read alongside and juxtaposed to José Rivera’s innovative and exceptional use of magic realism for the stage in Marisol (1992). The question of political efficacy in both cases is thoroughly examined here in relation to how profitably these works showcase acts of interrogating mass media appropriations of identified city riots and instances of social unrest. Attention is devoted to the ways in which Smith’s verbatim documentation of the city in turmoil as well as Rivera’s surreal and dystopian account of liminal experiences of disenfranchised urban constituents may lead audience members to reassess their own habits of negotiating political demands and relating to moments of crisis.
Of PIGS and Archipelagoes
Authors: Lloyd David
Published: November 2018

No abstract (available).
Zone of Passions: a Queer Re-imagining of Cyprus’s “No Man’s Land”
Authors: Stavrou Karayanni Stavros
Published: November 2018

Focusing on a selection of literary and critical texts, this article explores the Dead Zone as a space that is decidedly queer in its undecidability, unspeakability, and resistance to normalisation; a landscape where desire, apprehension, and memory play themselves out. Rereading this zone as queer space allows us imaginings of Cyprus beyond the normalising regimes of the island’s north and south. And, such re-reading also invites a reconceptualisation of the Dead Zone as a profoundly ambiguous geographical site, political space, and imaginary topos.
A Selected Fiction? Lawrence Durrell and the Overgrown Typescript of Bitter Lemons
Authors: Roessel David
Published: November 2018

This article looks at previously unmined archival documents in order to explore the preand post-publication history of Lawrence Durrell’s Bitter Lemons, a travelogue written during the ‘emergency years’ of the EOKA campaign against British rule and for union with Greece. It examines the ways in which paratextual documents surrounding this publication history illuminate the awkward, sometimes contradictory, relationship between Durrell’s book and the last years of the British colonial government in Cyprus, a government for which Durrell worked as an employee in the Public Information Office.
Introduction: Configuring Cultural Amnesia
Authors: Lampropoulos Apostolos , Markidou Vassiliki
Published: November 2018

No abstract (available).
The Amnesiac Consciousness of the Contemporary Holocaust Novel: Lily Brett’s Too Many Men and Jonathan Safran Foer’s Everything Is Illuminated
Authors: Hunter Anna
Published: November 2018

No abstract (available).
Young Joseph A.; Braziel Jana Evans(eds.), Erasing Public Memory: Race, Aesthetics, and Cultural Amnesia in the Americas.
Authors: Arapoglou Eleftheria
Published: November 2018

No abstract (available).
Towards a 'Theatre of Impossible Forgiveness': Ama Ata Aidoo and the Dilemma of Slavery
Authors: Axiotou Georgia
Published: November 2018

No abstract (available).
Rosen Carol, Sam Shepard: A 'Poetic Rodeo.'; Callens Johan, Dis/Figuring Sam Shepard
Authors: Blatanis Konstantinos
Published: November 2018

No abstract (available).
Realism’s Concealed Realities
Authors: Billington Josie , Davis Philip
Published: November 2018

Challenging hostile characterisations of realism, this article argues that nineteenth-century realist fiction achieves a double loyalty: loyal to the subject matter of ostensibly mundane reality but loyal also to how life might be in the truer reality of a world in better shape—a world often hidden distortedly within this one, confined inside people too small and compromised to help re-shape it. As a consequence, the article seeks to show that, in its hidden or apparently tiny subtleties, realism has been more radically experimental with reality than it has been given credit for. Its immanent realist metaphysic, established in place of a lost or unattainable primary reality, demanded new formal agility to reach or express the “really real” not otherwise accessible to ordinary human perception or available to characters themselves. Yet realism’s technical innovations were so undemonstratively faithful to their medium as to risk being obscured and unacknowledged within it.
Investing in Realism: An Interview with Bruce Robbins
Authors: Robbins Bruce , Despotopoulou Anna
Published: November 2018

No abstract (available).
Poovey Mary, Genres of the Credit Economy: Mediating Value in Eighteenth- and Nineteenth-Century Britain.
Authors: Spathopoulou Filomachi
Published: November 2018

No abstract (available).
Putting Peripheral Poetries on the Map: Helen of Troy Rewritten by Helias Layios
Authors: Filippakopoulou Maria
Published: November 2018

What are the conditions under which poetry of the periphery produces a poetico-discursive event with the power to affect Eurocentric letters? Using insights from global literature theorists such as Franco Moretti and Roberto Schwarz as well as analysis proper to translation practice I aim to test the argument that ‘minor’ style may become an affect of distinction precisely because it embodies material features of the proletarised literary margins. To this end, I translate and read the ode to Helen (of Troy) by Greek lyrical poet Helias Layios alongside and against poetry retellings of The Iliad by H.D. and Christopher Logue. The analysis, forming integral part of the translation brief, brings to light the full extent of Layios’s achievement in its capacity to affect the lyrical range achieved in English by the two other poets within the subgenre of creative rewritings of the classics. Taken as a sample of minor poetry with global resonance, it is shown to provide ammunition for the extension of literary relevance that is translation’s glocality mandate.
Challenging Tongues: The “Irreducible Hybridity” of Language in Contemporary Bilingual Poetry
Authors: Pfeffer Laura
Published: November 2018

Contemporary bilingual poetry provides readers with an opportunity to explore and better understand how contemporary artists address the reality of their linguistic contexts. These works pose a challenge to traditional canonical (often national) literatures; furthermore, bilingual poets are keenly attuned to the ways language use represents the personal and political values at stake for their cultures. Bilingual poetry functions as a site of translation where languages interact within the text without traditional demarcations of original and translated text, representing a larger ideological challenge to institutional hierarchies that are often imposed on language. Perhaps unsurprisingly, the Internet has fostered bilingual poetry; the quality and proliferation of these works emphasise the need for more critical recognition of this form of expression. The friction, fluidity, cacophony, and subversive impulse of bilingual poetry embodies the convergence of enmity and rapport experienced by the very real speech communities that give them context.
McElduff Siobhán and Sciarrino Enrica (eds.), Complicating the History of Western Translation. The Ancient Mediterranean in Perspective.
Authors: Athanasiadou Kyriaki
Published: November 2018

No abstract (available).
Classical Temper and Creative Ingenuity in Osofisan’s Tegonni: An African Antigone
Authors: Owoeye Omolara Kikelomo
Published: November 2018

This essay closely reads Osofisan‘s Tegonni: An African Antigone in the light of its classical antecedent and critically examines the playwright‘s deconstruction of Sophocles‘s Antigone as manifested in the thematic preoccupation, style, linguistic mediums and mythical contents of Tegonni. Through an exploration of the play, the feminist, Marxist and postcolonial agenda of the author is discussed together with his emphasis on local history and oral tradition. In spite of the author‘s recourse to colonial history and other local literary and non-literary materials, this essay argues that the play is still analogous to the classical play as both plays are affiliated in terms of plot, characterisation and ending. The essay ends with the proposition that Osofisan questions existing political and aesthetic structures and traditions, by demystifying supernatural claims on human existence and promoting a radical ideology based on the Marxist convictions of equity and egalitarianism while standing on the Hellenist platform.
Chanter Tina, Whose Antigone? The Tragic Marginalization of Slavery.
Authors: Giannakopoulos Giorgos
Published: November 2018

No abstract (available).
Exploding Magazines: Byron’s The Siege of Corinth, Francesco Morosini and the Destruction of the Parthenon
Authors: Roessel David
Published: November 2018

This paper links several threads connected to Byron‟s least regarded Turkish Tale. Why, when the English Parliament decided in June 1816 to purchase the Elgin Marbles for the British Museum, did Byron appear to be silent on a subject that he had expressed strong feelings about some years earlier? Why, when he attacked Lord Elgin on the Parthenon marbles, did he not link him in infamy with Francesco Morosini, who had fired the shot that blew up the Parthenon? And why, in The Siege of Corinth, did Byron intentionally depart from the account in his historical source?My paper argues that The Siege of Corinth, one of his Turkish Tales that includes a conflict between Venetians and Turks, a siege, and an explosion, contains within it Byron‟s reflections on these issues The Siege of Corinth, in short, has more layers than have previously been explored.
Continuous surgical multi-level extrapleural block for video-assisted thoracoscopic surgery: a retrospective study assessing its efficacy as pain relief following lobectomy and wedge resection
Authors: Larsson Mark , Öwall Anders , Sartipy Ulrik , Franco-Cereceda Anders , Johansson Barbro , Jakobsson Jan G.
Published: November 2018

Background: Video-assisted thoracoscopic surgery (VATS) causes less postoperative pain than thoracotomy; however, adequate analgesia remains vital. As part of a multi-modal postoperative analgesia, a continuous surgeon-placed extrapleural block catheter is an option. The aim of this retrospective study was to evaluate the analgesic efficacy of a continuous extrapleural block as part of a multimodal analgesic regimen after VATS in general, and VATS lobectomy and wedge resection in particular.

Methods: Case records for patients having undergone VATS surgery and been provided a multi-level continuous extrapleural block with an elastomeric pump infusing levobupivacaine 2.7 mg/ml at a rate of 5 ml/h during 2015 and 2016 were reviewed. Pain (Numeric Rating Scale) at rest and mobilisation as well as opioid requirement (daily, postoperative days 0-3, as well as accumulated) were analysed.   

Results: In all, 454 records were reviewed: 150 wedge resections, 264 lobectomies and 40 miscellaneous cases. At rest, pain was mild median NRS rated 3-3-1-1 for postoperative day (POD) 0 to 3, during movement, pain was rated moderate during POD 0 and 1 and mild the remaining days (median NRS 4-4-3-3 for POD 0-3). The proportion of patients exhibiting mild pain at rest increased from 55% on POD 0 to 81 % on POD 3. The percentage of patients experiencing severe pain at rest decreased from 15% to 6%. Median oxycodone consumption was 10 mg per day for POD 1-3. Pain after VATS wedge resection was significantly lower at POD 1 and 3 compared to pain after VATS lobectomy.

Conclusion: We found a continuous surgeon-placed extrapleural catheter block to be a valuable and seemingly safe addition to our multimodal procedure specific analgesia after VATS. Whether the efficacy of the block can be improved by increasing local anaesthetic and/or adding adjuncts warrants further investigation.
Hand hygiene and handwashing: key to preventing the transfer of pathogens
Authors: Ford Claire , Park Laura J
Published: November 2018

Claire Ford, Lecturer, Adult Nursing ( claire.ford@northumbria.ac.uk ), and Laura J Park, Graduate Tutor, of Northumbria University, describe how to maintain good skin health to reduce the risk of infection
Impact of clinical placements on graduates' choice of first staff-nurse post
Authors: Wareing Mark , Taylor Renate , Wilson Aileen , Sharples Adrienne
Published: November 2018

Quality clinical placements for pre-registration nursing students are particularly important at a time when there is a recruitment crisis within nursing. A study was conducted to identify what impact clinical placements have on pre-registration adult nursing students' choice of clinical specialty as a newly qualified nurse (NQN). Data were collected from students on their final day of a BSc (Hons) programme at two campus sites at a university in the east of England. Participants judged the desirability of a clinical placement on the basis of the quality of the learning, working and clinical environment and the nature of the specialty. The influence of clinical placements on the choice of first destination of NQNs more than doubles within the final year of study. Clinical placements generate vivid experiences, which exert a strong influence on the first employment destination decisions of NQNs.
Care Quality Commission spotlights effective quality improvement initiatives
Authors: Glasper Alan
Published: November 2018

Emeritus Professor Alan Glasper, from the University of Southampton, discusses a recent report showing how trusts rated as outstanding by the regulator have embedded a culture of change that involves all staff
T-levels: a skills-based qualification
Authors: Foster Sam
Published: November 2018

Sam Foster, Chief Nurse, Oxford University Hospitals, describes preparations under way for T-levels—the latest qualification that young people interested in a career in health care will be able to take
Report of the proceedings of a UK skin safety advisory group
Authors: Browning Paul , Beeckman Dimitri , White Richard , Connolly Roisin , Rodgers Angela , Maclean Gillian , Fumarola Sian , Harker Judy , Murray Victoria , Foster Steve
Published: November 2018

Moisture-associated skin damage, especially incontinence-associated dermatitis, continues to present significant health challenges and requires multidisciplinary input to provide effective prevention and treatment. In the absence of mandatory reporting such damage is under- or wrongfully reported, resulting in a lack of accurate data on prevalence and costs of associated care. In March this year, a multidisciplinary team of experts met in the UK to seek to determine measures to improve patient skin care. They aimed to identify activities to increase awareness and education, collect data, and improve prevention and treatment regimes. This article describes that discussion and the conclusions made by the group, such as the key actions required to effect policy changes.
Managing vascular compromise of hand and digit replantation following traumatic amputation
Authors: Spiers Emma
Published: November 2018

Hands are anatomically complex and have great social, physical and emotional importance. Hand or digit replantation following traumatic partial or complete amputation is a complex injury for nursing staff to understand and manage. The absence of clear guidance, combined with a lack of consensus in the literature gives rise to ambiguity and insufficient understanding of appropriate and effective management. This article aims to outline nursing care of the patient in the first few days following hand or digit reattachment, particularly focusing on the recognition and management of arterial and venous compromise. Complications must be recognised and acted on quickly to give the best chance of survival so it is essential for nurses to have an accurate understanding of the signs, symptoms and management options of vascular compromise. Leech therapy, also discussed, has long been used as a nonsurgical option in the management of venous congestion and is a simple and minimally invasive method of managing congestion.
The bariatric airway
Authors: Wojcikiewicz Thomas , Cousins Jonathan , Margarson Michael
Published: November 2018

The prevalence of obesity in the UK is increasing. Airway management in the obese patient can be challenging. Face mask ventilation is frequently difficult, and while the incidence of difficult laryngoscopy is only marginally raised, the consequences of failed intubation and the rate at which the obese patient desaturates makes this an unforgiving population. Emergence from anaesthesia requires particular care and attention. This article addresses the problems of airway management in the obese patient and looks at measures which can be taken to overcome them.
The role of high flow nasal oxygen therapy in anaesthesia
Authors: Kotwinski David , Paton Laura , Langford Roger
Published: November 2018

The delivery of oxygen is a key component of anaesthetic practice. High flow nasal oxygen therapy is a relatively new addition to more traditional means of oxygenation which provides heated and humidified flows of controlled oxygen/air mixes achieving rates of up to 120 litres/min. The physiological benefits include nasopharyngeal dead space washout, reduced work of breathing, alveolar recruitment, maintained mucociliary function and the ability to provide apnoeic oxygenation. This article considers the current evidence for high flow nasal oxygen therapy in perioperative anaesthetic care during pre-oxygenation and intubation, management of the difficult airway, oxygenation for shared airway surgery, extubation and postoperative support, obstetric and paediatric anaesthesia.
The growing pupil population…
Authors: Claymore Zoe
Published: November 2018

There is a growing demand for secondary school places in England. Zoe Claymore explores what the data tells us and the possible implications for schools and teachers
The results of osteotomy at the base of femoral neck with osteoplasty in restoration of abductor function and strength in slipped capital femoral epiphysis
Authors: Angélico A. C. C. , Garcia L. M. , Icuma T. R. , Herrero C. F. , Maranho D. A.
Published: November 2018

Aims

The aims of this study were to evaluate the abductor function in moderate and severe slipped capital femoral epiphysis (SCFE), comparing the results of a corrective osteotomy at the base of the femoral neck and osteoplasty with 1) in situ epiphysiodesis for mild SCFE, 2) contralateral unaffected hips, and 3) hips from healthy individuals.

Patients and Methods

A total of 24 patients (mean age 14.9 years (sd 1.6); 17 male and seven female patients) with moderate or severe SCFE (28 hips) underwent base of neck osteotomy and osteoplasty between 2012 and 2015. In situ epiphysiodesis was performed in seven contralateral hips with mild slip. A control cohort was composed of 15 healthy individuals (mean age 16.5 years (sd 2.5); six male and nine female patients). The abductor function was assessed using isokinetic dynamometry and range of abduction, with a minimum one-year follow-up.

Results

We found no differences in mean peak abductor torque between the hips that underwent osteotomy and those that received in situ epiphysiodesis (p = 0.63), but the torque was inferior in comparison with contralateral hips without a slip (p < 0.01) and hips from control individuals (p < 0.001). The abduction strength was positively correlated with the range of hip abduction (R = 0.36; p < 0.001).

Conclusion

Although the abductor strength was not restored to normal levels, moderate and severe SCFE treated with osteotomy at the base of the femoral neck and osteoplasty showed abductor function similar to in situ epiphysiodesis in hips with less severe displacement. Cite this article: Bone Joint J 2018;100-B:1524–32.
Management and outcome of acral soft-tissue sarcomas
Authors: Dean B. J. F. , Branford-White H. , Giele H. , Critchley P. , Cogswell L. , Athanasou N. , Gibbons C. L. M.
Published: November 2018

Aims

The aim of this study was to evaluate the surgical management and outcome of patients with an acral soft-tissue sarcoma of the hand or foot.

Patients and Methods

We identified 63 patients with an acral soft-tissue sarcoma who presented to our tertiary referral sarcoma service between 2000 and 2016. There were 35 men and 28 women with a mean age of 49 years (sd 21). Of the 63 sarcomas, 27 were in the hands and 36 in the feet. The commonest subtypes were epithelioid sarcoma in the hand (n = 8) and synovial sarcoma in the foot (n = 11).

Results

In 41 patients (65%), the tumour measured less than 5 cm in its largest dimension (median size 3 cm (2 to 6)); 27 patients (43%) were diagnosed after inadvertent excision prior to their referral to the specialist sarcoma unit. After biopsy and staging, primary surgical intervention at the sarcoma unit was excision and limb salvage in 43 (68%), partial (digit or ray) amputation in 14 (22%), and more proximal amputation in six (10%). At final follow up, local recurrence had been treated by one partial amputation and six amputations, resulting in a partial amputation rate of 24% and a proximal amputation rate of 19%. The five-year survival rate was 82%. Patients who underwent inadvertent excision showed no statistically significant difference in survival or local recurrence, but were more likely to undergo amputation (p = 0.008). Large tumour size (> 5 cm) was associated with lower survival (p = 0.04) and a higher risk of local recurrence (p = 0.009;).

Conclusion

Most acral soft-tissue sarcomas measure less than 5 cm at presentation, indicating that while size can be a useful prognostic factor, it should not be used as a diagnostic threshold for referral. Increased tumour size is associated with a higher rate of local recurrence and reduced survival. Sarcoma excision with limb preservation does not result in an increased risk of local recurrence. Cite this article: Bone Joint J 2018;100-B:1518–23.
Economic outcomes associated with deep surgical site infection in patients with an open fracture of the lower limb
Authors: Parker B. , Petrou S. , Masters J. P. M. , Achana F. , Costa M. L.
Published: November 2018

Aims

The aim of this study was to estimate economic outcomes associated with deep surgical site infection (SSI) in patients with an open fracture of the lower limb.

Patients and Methods

A total of 460 patients were recruited from 24 specialist trauma hospitals in the United Kingdom Major Trauma Network. Preference-based health-related quality-of-life outcomes, assessed using the EuroQol EQ-5D-3L and the 6-Item Short-Form Health Survey questionnaire (SF-6D), and economic costs (£, 2014/2015 prices) were measured using participant-completed questionnaires over the 12 months following injury. Descriptive statistics and multivariate regression analysis were used to explore the relationship between deep SSI and health utility scores, quality-adjusted life-years (QALYs), and health and personal social service (PSS) costs.

Results

Deep SSI was associated with lower EQ-5D-3L derived QALYs (adjusted mean difference -0.102, 95% confidence interval (CI) -0.202 to 0.001, p = 0.047) and increased health and social care costs (adjusted mean difference £1950; 95% CI £1383 to £5285, p = 0.250) versus patients without deep SSI over the 12 months following injury.

Conclusion

Deep SSI may lead to significantly impaired health-related quality of life and increased economic costs. Our economic estimates can be used to inform clinical and budgetary service planning and can act as reference data for future economic evaluations of preventive or treatment interventions. Cite this article: Bone Joint J 2018;100-B:1506–10.
Long-term results of acetabular reconstruction using irradiated allograft bone
Authors: Green C. M. , Buckley S. C. , Hamer A. J. , Kerry R. M. , Harrison T. P.
Published: November 2018

Aims

The management of acetabular defects at the time of revision hip arthroplasty surgery is a challenge. This study presents the results of a long-term follow-up study of the use of irradiated allograft bone in acetabular reconstruction.

Patients and Methods

Between 1990 and 2000, 123 hips in 110 patients underwent acetabular reconstruction for aseptic loosening, using impaction bone grafting with frozen, irradiated, and morsellized femoral heads and a cemented acetabular component. A total of 55 men and 55 women with a mean age of 64.3 years (26 to 97) at the time of revision surgery are included in this study.

Results

At a mean follow-up of 16.9 years, there had been 23 revisions (18.7%), including ten for infection, eight for aseptic loosening, and three for dislocation. Of the 66 surviving hips (58 patients) that could be reassessed, 50 hips (42 patients; 75.6%) were still functioning satisfactorily. Union of the graft had occurred in all hips with a surviving implant. Survival analysis for all indications was 80.6% at 15 years (55 patients at risk, 95% confidence interval (CI) 71.1 to 87.2) and 73.7% at 20 years (eight patients at risk, 95% CI 61.6 to 82.5).

Conclusion

Acetabular reconstruction using frozen, irradiated, and morsellized allograft bone and a cemented acetabular component is an effective method of treatment. It gives satisfactory long-term results and is comparable to other types of reconstruction. Cite this article: Bone Joint J 2018;100-B:1449–54.
Fitorremediazioa lurzoru kutsatuen kudeaketa iraunkorrerako estrategia gisa
Authors: Gómez-Sagasti María Teresa , Epelde Lur , Barrutia Oihana
Published: November 2018

Iraunkorrak eta (eko)toxikoak izan ohi diren konposatu ez-organiko eta organikoen isurketa masiboek potentzialki kutsatuta egon daitezkeen lurzoruen kopurua izugarri handitu dute. Lurzoruen osasuna (funtzionalitatea) eta kalitatea (emankortasuna) arrisku larrian egoteak eta, ondorioz, giza biziraupena estutasunean jartzeak lurzoru kutsatuen kudeaketa eraginkorra mundu mailako ingurumen-politiken premiazko jomugan paratu du. Gaian sartuta, lan honen helburu nagusiak hauek dira: (i) lurzoru kutsatuen kudeaketaren lege eta jarduera markoa aurkeztea; (ii) lurzoru kutsatuen kudeaketa eta arriskuen ebaluazioa aztertzea, eta, azkenik, (iii) ohiko erremediazio-teknika suntsitzaileen aitzinean, fitorremediazioaren arloan egiten ari diren esfortzu zientifiko-teknikoak argitara ekartzea. Lurzoru kutsatuen kudeaketan aurrerapenak egiteko landu beharreko hariak ere laburki iruzkintzen dira.
Gaztagintzako prentsaketa-teknikak: gure arbasoetatik gaur egunera arte
Authors: Campillo-Robles Jose Miguel , Atxa Ariane , Telleria Laura , Domingo Itxaso
Published: November 2018

Mamiaren prentsaketa prozesu garrantzitsua da gaztagintzan. Horri esker, mamiak gazura galtzen du. Berez, gaztaren kontserbazio egokia lortzeko, mamiaren hezetasuna txikitu behar da. Gainera, prentsaketari esker, gaztaren azala eratzen da, eta gaztari forma egokia ematen zaio. Mendeetan zehar, eskuzko prentsaketa erabili izan da gehienbat, baina XIX. mendearen bukaeratik prentsen erabilera zabaldu da. Orain arte erabilitako prentsaketa-teknikak eta tresneria oso gutxi deskribatu dira bibliografian. Hori dela eta, dokumentu honetan gai honi buruz egindako bilaketa-lana aurkezten dugu; zehazki, Euskal Herrian erabili izan diren prentsaketa-teknikak jasota daude, bai eta zeregin horretan erabili diren tresnak ere.
Konposatu organometalikoak terapia fotodinamikorako
Authors: Sola-Llano Rebeca , Veloso Antonio
Published: November 2018

BODIPY kromoforoei (4,4-difluoro-4-bora-3a,4a-diaza-s-indazeno koloratzaileak) loturiko iridio (III) ziklo metalikoak prestatu eta karakterizatu dira fotosentikortzaile berri eta efizienteak garatu nahian. Diseinu arrazionala dela bide, argi ikusgaia xurgatzeko gai diren konposatuak lortu dira, zeinak oxigeno singletea oso modu efizientean sortzeko gai diren, batzuk leiho klinikora ere gerturatuz; ehunetan sakon barneratzeko gai den argi-eremua dena, hain zuzen. Konposatuen igorpen fosforeszentea, erdibizitza denborak eta kalkulu teorikoak aurrera eraman dira ikusitako fotosentikortzaile-aktibitateari azalpena bilatu nahian, eta emaitza horien guztien arabera, oxigeno singletea sortzearen arduraduna BODIPY unitatea dela ondorioztatu da. In vitro ikertu da terapia fotodinamikorako aktibitatea HeLa zelulekin, eta agerian jarri da konposatuak efizienteki barneratzen direla zeluletan, ez direla toxikoak haientzat ilunpean, eta argiztatzean zelulak hiltzeko gai direla nahiz eta konposatuen kontzentrazioa baxua izan. Hau guztia dela eta, esan daiteke lan honetan deskribatzen diren konplexuak potentzialki egokiak direla teragnosirako agente gisa, fotosentikortzaile-aktibitateaz gain igorpen fluoreszentea ere agertzen baitute.
Fabrikazio gehigarria medikuntza aplikazioetan: joera zientifiko eta teknologikoen zaintza
Authors: Alvarez Meaza Izaskun , Zarrabeitia Bilbao Enara , Martinez de Alegria Mancisidor Itziar , Otaño Michelena Itsaso
Published: November 2018

Medikuntza aplikazioetara bideratutako fabrikazio gehigarriak (MABIFAG) osasun-industria erabat eraldatzeko gaitasuna dauka, eta horrek zientzia eta teknologia munduan hazkunde nabari bat egotera eraman du. Artikulu honen helburua da MABIFAGaren ikerketa egoera ebaluatzea eta zientzia eta teknologia patroiak identifikatzea. Web of Science (WoS) datu-basea eta PatSeer patente datu-basea erabiliz ikerketa esparruak garatu eta bistaratu dira, analizatuz argitalpen urteak, herrialde, aldizkari eta erakunde garrantzitsuenak, gehien aipatu diren artikuluak eta teknologia-jardueren bideak. Emaitza orokorrek azaltzen dute MABIFAG azkar eskuratzen ari dela arreta zientzia ekoizpenean. Ikerketa lanak nagusiki AEBn kontzentratzen dira, eta hangoak dira artikulu gehien argitaratzen dituzten aldizkariak eta gehien aipatu den artikulua ere. Bestalde, artikulu gehien dituzten erakundeak Txina, Singapur eta Hego Koreakoak dira. Patenteen analisiak erakusten du merkatu estrategia AEB, Txina eta Alemaniara bideratuta dagoela, eta onuradun garrantzitsuenak entzumen-osasuna eta hortzetako protesien sektoreetan aritzen direla. «3D print», «In-vitro», «rapid prototype», «scaffold», «tissue», «mesenchimal stem-cells» eta halako terminoek osatzen dute zientziaren panorama intelektuala.