bluuebunny/crossref_metadata_2025 huggingface dataset:
Cediranib Plus FOLFOX/CAPOX Versus Placebo Plus FOLFOX/CAPOX in Patients With Previously Untreated Metastatic Colorectal Cancer: A Randomized, Double-Blind, Phase III Study (HORIZON II)
Authors: Hoff Paulo M. , Hochhaus Andreas , Pestalozzi Bernhard C. , Tebbutt Niall C. , Li Jin , Kim Tae Won , Koynov Krassimir D. , Kurteva Galina , Pintér Tamás , Cheng Ying , van Eyll Brigitte , Pike Laura , Fielding Anitra , Robertson Jane D. , Saunders Mark P.
Published: September 2012

Purpose

Cediranib is a highly potent inhibitor of vascular endothelial growth factor (VEGF) signaling with activity against all three VEGF receptors. HORIZON II [Cediranib (AZD2171, RECENTIN) in Addition to Chemotherapy Versus Placebo Plus Chemotherapy in Patients With Untreated Metastatic Colorectal Cancer] assessed infusional fluorouracil, leucovorin, and oxaliplatin/capecitabine and oxaliplatin (FOLFOX/CAPOX) with or without cediranib in patients with previously untreated metastatic colorectal cancer (mCRC).

Patients and Methods

Eligible patients were initially randomly assigned 1:1:1 to receive cediranib (20 or 30 mg per day) or placebo plus FOLFOX/CAPOX. In an early analysis of this and two other cediranib studies (HORIZON I [Cediranib Plus FOLFOX6 Versus Bevacizumab Plus FOLFOX6 in Patients With Previously Treated Metastatic Colorectal Cancer] and HORIZON III [Cediranib Plus FOLFOX6 Versus Bevacizumab Plus FOLFOX6 in Patients With Untreated Metastatic Colorectal Cancer]), the 20-mg dose met the predefined criteria for continuation. Subsequent patients were randomly assigned 2:1 to the cediranib 20 mg or placebo arms. Progression-free survival (PFS) and overall survival (OS) were coprimary end points.

Results

In all, 860 patients received cediranib 20 mg (n = 502) or placebo (n = 358). The addition of cediranib to FOLFOX/CAPOX resulted in PFS prolongation (hazard ratio [HR], 0.84; 95% CI, 0.73 to 0.98; P = .0121; median PFS, 8.6 months for cediranib v 8.3 months for placebo) but had no impact on OS (HR, 0.94; 95% CI, 0.79 to 1.12; P = .5707; median OS, 19.7 months for cediranib v 18.9 months for placebo). There were no significant differences in the secondary end points of objective response rate, duration of response, or liver resection rate. Median chemotherapy dose-intensity was decreased by approximately 10% in patients treated with cediranib. Adverse events (AEs) associated with cediranib were manageable.

Conclusion

Addition of cediranib 20 mg to FOLFOX/CAPOX resulted in a modest PFS prolongation, but no significant difference in OS. The cediranib AE profile was consistent with those from previous studies. Because of the lack of improvement in OS, cediranib plus an oxaliplatin-based regimen cannot be recommended as a treatment for patients with mCRC.
Aflibercept and Docetaxel Versus Docetaxel Alone After Platinum Failure in Patients With Advanced or Metastatic Non–Small-Cell Lung Cancer: A Randomized, Controlled Phase III Trial
Authors: Ramlau Rodryg , Gorbunova Vera , Ciuleanu Tudor Eliade , Novello Silvia , Ozguroglu Mustafa , Goksel Tuncay , Baldotto Clarissa , Bennouna Jaafar , Shepherd Frances A. , Le-Guennec Solenn , Rey Augustin , Miller Vincent , Thatcher Nicholas , Scagliotti Giorgio
Published: September 2012

Purpose

To compare the efficacy of aflibercept (ziv-aflibercept), a recombinant human fusion protein targeting the vascular endothelial growth factor (VEGF) pathway, with or without docetaxel in platinum-pretreated patients with advanced or metastatic nonsquamous non–small-cell lung cancer.

Patients and Methods

In this international, double-blind, placebo-controlled phase III trial, 913 patients were randomly assigned to (ziv-)aflibercept 6 mg/kg intravenous (IV; n = 456) or IV placebo (n = 457), both administered every 3 weeks and in combination with docetaxel 75 mg/m2. The primary end point was overall survival (OS). Other efficacy outcomes, safety, and immunogenicity were also assessed.

Results

Patient characteristics were balanced between arms; 12.3% of patients had received prior bevacizumab. (Ziv-)Aflibercept did not improve OS (hazard ratio [HR], 1.01; 95% CI, 0.87 to 1.17; stratified log-rank P = .90). The median OS was 10.1 months (95% CI, 9.2 to 11.6 months) for (ziv-)aflibercept and 10.4 months (95% CI, 9.2 to 11.9 months) for placebo. In exploratory analyses, median progression-free survival was 5.2 months (95% CI, 4.4 to 5.6 months) for (ziv-)aflibercept versus 4.1 months (95% CI, 3.5 to 4.3 months) for placebo (HR, 0.82; 95% CI, 0.72 to 0.94; P = .0035); overall response rate was 23.3% of evaluable patients (95% CI, 19.1% to 27.4%) in the (ziv-)aflibercept arm versus 8.9% (95% CI, 6.1% to 11.6%; P < .001) in the placebo arm. Grade ≥ 3 adverse events occurring more frequently in the (ziv-)aflibercept arm versus the placebo arm were neutropenia (28.0% v 21.1%, respectively), fatigue (11.1% v 4.2%, respectively), stomatitis (8.8% v 0.7%, respectively), and hypertension (7.3% v 0.9%, respectively).

Conclusion

The addition of (ziv-)aflibercept to standard docetaxel therapy did not improve OS. In exploratory analyses, secondary efficacy end points did seem to be improved in the (ziv-)aflibercept arm. The study regimen was associated with increased toxicities, consistent with known anti-VEGF and chemotherapy-induced events.
The essential polysome-associated RNA-binding protein RBP42 targets mRNAs involved in Trypanosoma brucei energy metabolism
Authors: Das Anish , Morales Rachel , Banday Mahrukh , Garcia Stacey , Hao Li , Cross George A.M. , Estevez Antonio M. , Bellofatto Vivian
Published: September 2012

RNA-binding proteins that target mRNA coding regions are emerging as regulators of post-transcriptional processes in eukaryotes. Here we describe a newly identified RNA-binding protein, RBP42, which targets the coding region of mRNAs in the insect form of the African trypanosome, Trypanosoma brucei. RBP42 is an essential protein and associates with polysome-bound mRNAs in the cytoplasm. A global survey of RBP42-bound mRNAs was performed by applying HITS-CLIP technology, which captures protein–RNA interactions in vivo using UV light. Specific RBP42–mRNA interactions, as well as mRNA interactions with a known RNA-binding protein, were purified using specific antibodies. Target RNA sequences were identified and quantified using high-throughput RNA sequencing. Analysis revealed that RBP42 bound mainly within the coding region of mRNAs that encode proteins involved in cellular energy metabolism. Although the mechanism of RBP42's function is unclear at present, we speculate that RBP42 plays a critical role in modulating T. brucei energy metabolism.
“Actual” and Perceptual Effects of Category Spanning
Authors: Negro Giacomo , Leung Ming D.
Published: September 2012

Literature to date has demonstrated that producers and products spanning multiple categories have inferior market performance. However, two related but distinct explanations exist as to the source of such a discount. One explanation suggests that “actual” skills are degraded when producers attempt to engage across diverse categories. Another explanation involves perceptual fit to category representations held by an audience as the cause. These two explanations tend to be confounded in archival studies because external observers, responsible for the evaluation of market performance, are often aware of both the identity of producers and the underlying characteristics of their products. This leaves researchers unable to empirically separate effects. We present an analysis conducted in a setting in which it was possible to distinguish the two mechanisms: critics’ ratings of the same wines through “blind” and “nonblind” tastings. The findings indicate that after controlling for the value of ratings assigned blindly, the wines made by wineries spanning styles continue to receive lower ratings in the nonblind situation.
Burr Under the Saddle: How Media Coverage Influences Strategic Change
Authors: Bednar Michael K. , Boivie Steven , Prince Nicholas R.
Published: September 2012

In this paper we introduce a new antecedent to the strategic change literature by examining the effect of media coverage on the extent of strategic change. Specifically, we examine how negative media coverage may prompt firms to make changes to their resource allocations and then explore how the makeup of the board and firm performance can moderate this relationship. We develop a theoretical framework to explain why media coverage may affect strategic change and then test our theory with a longitudinal analysis of 250 firms over a four-year period. The empirical results lend support to our theory of media influence on strategic change and suggest that the evaluations of firms by outside constituents may influence the decision making of executives.
Looking Up and Looking Out: Career Mobility Effects of Demographic Similarity Among Professionals
Authors: McGinn Kathleen L. , Milkman Katherine L.
Published: September 2012

We investigate the role of workgroup gender and race composition on the career mobility of professionals in “up-or-out” organizations. We develop a nuanced perspective on the potential career mobility effects of workgroup demography by integrating the social identification processes of cohesion, competition, and comparison. Using five years of personnel data from a large law firm, we examine the influence of demographic match with workgroup superiors and workgroup peers on attorneys’ likelihood of turnover and promotion. Survival analyses reveal that higher proportions of same-sex superiors enhance junior professionals’ career mobility. On the flip side, we observe mobility costs accruing to professionals in workgroups with higher proportions of same-sex and same-race peers. Qualitative data offer insights into the social identification processes underlying demographic similarity effects on turnover and promotion in professional service organizations.
Hardware Implementation and Steady-State Analysis of ZVS-PWM Cuk Converter Based MPPT for Solar PV Module
Authors: Muthusamy M. Vaigundamoorthi , Ramadoss Ramesh R.
Published: September 2012

The main objective of this paper is to design and implement a ZVS-PWM Cuk converter to extract maximum power from solar PV module which uses Adaptive Perturb and Observer (APAO) algorithm. ZVS-PWM cuk converter is the interface between the solar PV panel and load. In order to improve electromagnetic compatibility and to reduce the switching losses across the switches, the soft switching (ZVS) has been implemented for Cuk converter, resulting in high converter conversion efficiency with less EMI at high-frequency operation. The harmonic content that each of the converter circuit produces is examined using FFT analysis. The implemented adaptive PAO algorithm improves the steady state stability and dynamic response when compared to the conventional PAO method. This algorithm is simulated using MATLAB/Simulink and implemented using ATMEGA16 micro controller. Hardware validation is carried out for the converter with the solar PV panel with rating of 37W, and operating at 25 kHz.
Compulsion to Rule in Plato’s Republic
Authors: Buckels Christopher
Published: September 2012

Three problems threaten any account of philosophical rule in the Republic. First, Socrates is supposed to show that acting justly is always beneficial, but instead he extols the benefits of having a just soul. He leaves little reason to believe practical justice and psychic justice are connected and thus to believe that philosophers will act justly. In response to this problem, I show that just acts produce just souls. Since philosophers want to have just souls, they will act justly. Second, Socrates’ alleged aim is to demonstrate that justice is beneficial, but philosophers, who have to give up a life of philosophy to rule, actually appear to be harmed by ruling. I explain that, since the founders of the city justly command them to rule, philosophers cannot, in fact, obtain a better life, and so ruling does not harm them. Third, it seems incongruous that philosophers, who should, as just people, jump at the opportunity to rule Kallipolis, must be compelled to rule. I show that Plato carefully constructs an educational system that produces rulers who do not want to rule, since such rulers alone will rule best.
Evaluation of the effect of statin use on the acenocoumarol and phenprocoumon maintenance dose
Authors: van Schie Rianne M.F. , Verhoef Talitha I. , Boejharat Saskia B. , Schalekamp Tom , Wessels Judith A.M. , le Cessie Saskia , Rosendaal Frits R. , van der Meer Felix J.M. , de Boer Anthonius , Maitland-van der Zee Anke-Hilse
Published: September 2012

Background: Statins and coumarins are prescribed in combination on a regular basis. Some case reports suggested that statins might affect the dose requirements of coumarins. The aim of the study was to investigate whether acenocoumarol and phenprocoumon maintenance doses are influenced by statin use.

Methods: The Pre-EU-PACT database was used, which contains information on 471 acenocoumarol and 624 phenprocoumon users. The influence of individual statins on the acenocoumarol and phenprocoumon maintenance dose was investigated by comparing unadjusted and adjusted mean differences of the maintenance dose between statin and non-statin users.

Results: Lower adjusted acenocoumarol dose requirements were observed for patients using atorvastatin, simvastatin, pravastatin, and rosuvastatin. These patients had a reduction in adjusted mean acenocoumarol maintenance dose of 0.11, 0.29, 0.38, and 0.69 mg/day, respectively, compared with a mean adjusted dose of 2.60 mg/day for the patients not using a statin. There was no significant effect of statin use on unadjusted and adjusted phenprocoumon maintenance dose (p=0.23 and p=0.35, respectively).

Conclusions: Mean acenocoumarol maintenance dosages were decreased when acenocoumarol is co-administered with the different statins. Statin use does not affect phenprocoumon maintenance doses significantly.
Sorption isotherms of thermally modified wood
Authors: Olek Wiesław , Majka Jerzy , Czajkowski Łukasz
Published: September 2012

The hygroscopic properties of thermally modified wood have been studied in terms of adsorption and desorption processes. Poplar (Populus spp.) and European beech (Fagus sylvatica L.) were in focus. The obtained isotherms were parameterized with the models of Hailwood-Horrobin, Guggenheim-Anderson-deBoer, generalized D’Arcy and Watt, and Yanniotis and Blahovec. The changes in equilibrium moisture content (EMC) were quantified, and the accessibility of water vapor to the sorption sites was determined. The monolayer and multilayer sorption was studied and the sorption isotherms were classified. All sorption isotherms were type II, and the type was not changed after the modification. The monolayer sorption was found to be responsible for the reduction in EMC after thermal modification. The observed increase in the hysteresis coefficient was explained by the reorganization of the wood ultrastructure.
Adult separation anxiety during pregnancy and its relationship to depression and anxiety
Authors: Eapen Valsamma , Johnston Deborah , Apler Alex , Rees Susan , Silove Derrick M.
Published: September 2012

Aims: The current study, the first of its kind, investigated the overlap between adult separation anxiety (ASA) and the symptoms of depression and anxiety in the context of pregnancy.

Methods: Women attending an antenatal clinic were screened using the Adult Separation Anxiety Scale (ASA-27). As most perinatal clinics use the Edinburgh Depression Scale (EDS), this study explored the relationship between ASA and the anxiety and depression symptoms by comparing the ASA-27 scores with the scores on the EDS. A subsample including both screen positives and screen negatives on ASA-27 was clinically interviewed using the Mini International Neuropsychiatric Interview (MINI).

Results: Women with ASA were significantly more likely to be screened positive for depression (EDS total score) and anxiety (EDS-3A anxiety subscale) than those without ASA. The diagnosis of ASA disorder in this population had only a moderate but significant association with the diagnoses of generalized anxiety disorder [χ2(1)=25.9, P=0.000, Φ=0.443] and major depression [χ2(1)=16, P=0.000, Φ=0.348] made using the MINI.

Conclusion: Adult separation anxiety warrants independent assessment in order to tailor appropriate interventions for the individual subtypes of anxiety in the perinatal period.
Neuroactive steroids, their metabolites, and neuroinflammation
Authors: Giatti Silvia , Boraso Mariaserena , Melcangi Roberto Cosimo , Viviani Barbara
Published: September 2012

Neuroinflammation represents a common feature of many neurodegenerative diseases implicated both in their onset and progression. Neuroactive steroids act as physiological regulators and protective agents in the nervous system. Therefore, the attention of biomedical research has been recently addressed in evaluating whether neuroactive steroids, such as progestagens, androgens, and estrogens may also affect neuroinflammatory pathways. Observations so far obtained suggest a general anti-inflammatory effect with a beneficial relapse on several neurodegenerative experimental models, thus confirming the potentiality of a neuroprotective strategy based on neuroactive steroids. In this scenario, neuroactive steroid metabolism and the sophisticated machinery involved in their signaling are becoming especially attractive. In particular, because metabolism of neuroactive steroids as well as expression of their receptors is affected during the course of neurodegenerative events, a crucial role of progesterone and testosterone metabolites in modulating neuroinflammation and neurodegeneration may be proposed. In the present review, we will address this issue, providing evidence supporting the hypothesis that the efficacy of neuroactive steroids could be improved through the use of their metabolites.
Medical Errors in US Pediatric Inpatients With Chronic Conditions
Authors: Ahuja Namrata , Zhao Weiyan , Xiang Huiyun
Published: September 2012

OBJECTIVE:

To investigate the association between chronic conditions and iatrogenic medical errors in US pediatric inpatients.

METHODS:

The 2006 Kids’ Inpatient Database (KID) was analyzed. Medical errors were defined by using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Medical error rates per 100 hospital discharges and per 1000 inpatient days were calculated. Logistic regression models were fitted to study the association between number of chronic conditions and medical errors, controlling for patient characteristics, hospital characteristics, disease severity, and length of stay.

RESULTS:

In the 2006 KID, 22.3% of pediatric inpatients had 1 chronic condition, 9.8% had 2 chronic conditions, and 12.0% had ≥3 chronic conditions. The overall medical error rate per 100 discharges was 3.0 (95% confidence interval [CI]: 2.8–3.3); it was 5.3 (95% CI: 4.9–5.7) in children with chronic conditions and 1.3 (95% CI: 1.2–1.3) in children without chronic conditions. The medical error rate per 1000 inpatient days was also higher in children with chronic conditions. The association between chronic conditions and medical errors remained statistically significant in logistic regression models adjusting for patient characteristics, hospital characteristics, disease severity, and length of stay. In the adjusted model, the odds ratio of medical errors for children with 1 chronic condition was 1.40 (95% CI: 1.32–1.48); for children with 2 conditions, the OR was 1.55 (95% CI: 1.45–1.66); and for children with 3 conditions, the OR was 1.66 (95% CI: 1.53–1.81).

CONCLUSIONS:

The number of chronic conditions was significantly associated with iatrogenic medical errors in pediatric inpatients.
Five-Year Follow-up of Harms and Benefits of Behavioral Infant Sleep Intervention: Randomized Trial
Authors: Price Anna M.H. , Wake Melissa , Ukoumunne Obioha C. , Hiscock Harriet
Published: September 2012

BACKGROUND AND OBJECTIVES:

Randomized trials have demonstrated the short- to medium-term effectiveness of behavioral infant sleep interventions. However, concerns persist that they may harm children’s emotional development and subsequent mental health. This study aimed to determine long-term harms and/or benefits of an infant behavioral sleep program at age 6 years on (1) child, (2) child-parent, and (3) maternal outcomes.

METHODS:

Three hundred twenty-six children (173 intervention) with parent-reported sleep problems at age 7 months were selected from a population sample of 692 infants recruited from well-child centers. The study was a 5-year follow-up of a population-based cluster-randomized trial. Allocation was concealed and researchers (but not parents) were blinded to group allocation. Behavioral techniques were delivered over 1 to 3 individual nurse consultations at infant age 8 to 10 months, versus usual care. The main outcomes measured were (1) child mental health, sleep, psychosocial functioning, stress regulation; (2) child-parent relationship; and (3) maternal mental health and parenting styles.

RESULTS:

Two hundred twenty-five families (69%) participated. There was no evidence of differences between intervention and control families for any outcome, including (1) children’s emotional (P = .8) and conduct behavior scores (P = .6), sleep problems (9% vs 7%, P = .2), sleep habits score (P = .4), parent- (P = .7) and child-reported (P = .8) psychosocial functioning, chronic stress (29% vs 22%, P = .4); (2) child-parent closeness (P = .1) and conflict (P = .4), global relationship (P = .9), disinhibited attachment (P = .3); and (3) parent depression, anxiety, and stress scores (P = .9) or authoritative parenting (63% vs 59%, P = .5).

CONCLUSIONS:

Behavioral sleep techniques have no marked long-lasting effects (positive or negative). Parents and health professionals can confidently use these techniques to reduce the short- to medium-term burden of infant sleep problems and maternal depression.
Pediatric Residency Training Director Tobacco Survey II
Authors: Hymowitz Norman , Schwab Joseph V.
Published: September 2012

OBJECTIVE:

To assess the current status of pediatric residency training on tobacco use and smoke exposure.

METHODS:

A nationwide survey of all pediatric residency training directors in the United States was conducted from November 2010 to May 2011 via use of surveymonkey.com. The survey assessed training director characteristics, attitudes and beliefs about pediatricians’ role in addressing tobacco control in patients and parents, past training in tobacco use and smoke exposure, inclusion of tobacco control in their training curriculum, and barriers to inclusion. Data are presented as percentages, with χ2 tests of significance.

RESULTS:

Sixty-five percent of programs included tobacco control in the curriculum, and training directors who received past training in tobacco prevention and control were significantly more likely to include tobacco use and smoke exposure than those without training. The vast majority of training programs focused on health effects as opposed to intervention, failed to employ active learning to teach tobacco intervention skills, did not evaluate resident tobacco knowledge and skills, and did not encourage use of medications to help parents quit smoking.

CONCLUSIONS:

Pediatric residency training programs must do more to prepare residents to address tobacco use and smoke exposure. Given the many competing priorities of residency training, there is a need to explore new ways of integrating tobacco control into the 3-year curriculum.
Decline in Gastroenteritis-Related Triage Calls After Rotavirus Vaccine Licensure
Authors: Williams Derek J. , Edwards Kathryn M. , Payne Daniel C. , Manning Judith , Parashar Umesh D. , Lopman Benjamin A.
Published: September 2012

OBJECTIVE:

We sought to determine the impact of rotavirus vaccine implementation on gastroenteritis (GE)-related calls to a large telephone triage service in Tennessee.

METHODS:

Total and GE-related calls received by the Vanderbilt Telephone Triage Program for children <5 years of age were examined from May 1, 2004 to April 30, 2010. Time series adapted Poisson regression models were used to compare weekly GE-related call proportions between the prevaccine (May 2004 to April 2007) and postlicensure (May 2007 to April 2010) periods. Separate models compared GE-related call proportions in the historical rotavirus (February to April) and nonrotavirus (May to January) seasons. Associations between call data and laboratory-confirmed rotavirus detections and regionally reported norovirus activity were also assessed.

RESULTS:

There were 156 362 total calls and 19 731 GE-related calls. Annual GE-related call proportions declined by 8% (95% confidence interval, 3%–12%) in the postlicensure period; declines ranging from 23% to 31% occurred during the historical rotavirus season in all 3 postlicensure years. No declines occurred in the nonrotavirus season. After vaccine licensure, reductions in laboratory-confirmed rotavirus activity were associated with declines in GE-related call proportions. Peak GE-related call proportions in the postlicensure period occurred earlier than in prevaccine years and were not strongly associated with laboratory-confirmed rotavirus but instead showed good correlation with norovirus outbreaks.

CONCLUSIONS:

A decline in GE-related call proportions among young children after rotavirus vaccine licensure was documented by using a novel surveillance platform that captures mild GE not detected in other surveillance systems. Since rotavirus vaccine licensure, peak call proportions correlate with regional norovirus activity, highlighting the role of that pathogen in community GE.
Resident Work Hour Changes in Children’s Hospitals: Impact on Staffing Patterns and Workforce Needs
Authors: Freed Gary L. , Dunham Kelly M. , Moran Lauren M. , Spera Laura
Published: September 2012

BACKGROUND AND OBJECTIVE:

Changes to the structure and nature of resident duty hour assignments can create compensatory workforce needs in hospital or outpatient settings to ensure appropriate patient care. The objective of this study was to understand what, if any, adjustments children’s hospitals have made in staffing and assignments of specific duties during the past 2 years as a result of residency duty hour changes, and what changes are anticipated in the upcoming 2 years.

METHODS:

Mail survey to chief executive officers and chief operating officers of 114 freestanding children’s hospitals or children’s hospitals within a larger hospital.

RESULTS:

Response rate was 65.4%. Respondents from more than half of hospitals (57%, N = 36) reported increasing the overall full-time equivalent (FTE) of hospitalists in response to the 2011 resident work hour changes. Forty-eight percent (N = 30) increased the overall FTE of pediatric nurse practitioners (PNPs), and 42% (N = 27) increased the FTE of neonatal nurse practitioners (NNPs). Most hospitals plan to increase the number of hospitalists (69%, N = 44), PNPs (59%, N = 37), or pediatric attending physicians (56%, N = 35) over the next 2 years. Forty-three percent (N = 27) of hospitals plan to increase the number of NNPs over the next 2 years, and a quarter plan to increase physician assistants (25%, N = 16) or pediatric house staff (24%, N = 15).

CONCLUSIONS:

Changes in work hours for pediatric residents appear to have an impact on workforce planning within pediatric hospitals. Decreases in available resident work hours will create an increasing demand, primarily for nonresident physicians, PNPs, and NNPs.
Recommendations for Prevention and Control of Influenza in Children, 2012–2013
Authors:   COMMITTEE ON INFECTIOUS DISEASES, Brady Michael T. , Byington Carrie L. , Davies H. Dele , Edwards Kathryn M. , Glode Mary P. , Jackson Mary Anne , Keyserling Harry L. , Maldonado Yvonne A. , Murray Dennis L. , Orenstein Walter A. , Schutze Gordon E. , Willoughby Rodney E. , Zaoutis Theoklis E.
Published: September 2012

The purpose of this statement is to update recommendations for routine use of trivalent seasonal influenza vaccine and antiviral medications for the prevention and treatment of influenza in children. The key points for the upcoming 2012–2013 season are: (1) this year’s trivalent influenza vaccine contains A/California/7/2009 (H1N1)–like antigen (derived from influenza A [H1N1] pdm09 [pH1N1] virus); A/Victoria/361/2011 (H3N2)–like antigen; and B/Wisconsin/1/2010–like antigen (the influenza A [H3N2] and B antigens differ from those contained in the 2010–2011 and 2011–2012 seasonal vaccines); (2) annual universal influenza immunization is indicated; and (3) an updated dosing algorithm for administration of influenza vaccine to children 6 months through 8 years of age has been created. Pediatricians, nurses, and all health care personnel should promote influenza vaccine use and infection control measures. In addition, pediatricians should promptly identify influenza infections to enable rapid treatment, when indicated, to reduce morbidity and mortality.
Workover and Completion Operations in East Java Sour Gas Field, Indonesia
Authors: Haris A. , Purwanto B. , Sasongko D. , Darmawan G. R. , Yulianto I. , Soekmono O. , Kurniawan P. , Susilo S. D. , Kurniawan S. , Mailangkay L.
Published: September 2012

Nowadays many exploration and production companies have high interest in producing deep, high pressure gas reservoirs that contain sour gas. Carbonates in East Java, Indonesia faced challenges related to workover and completion operations that are prone to kick-loss cycles based on the drilling experiences.

The presence of hydrogen sulfide (H2S) and carbon dioxide (CO2) in the formation made the completion operation dangerous and difficult to be carried out in the field where is adjacent to a populated area, thereby increasing the requirement and need to prevent the release of sour gases during completion operations.

Well completion design with consideration of sour gas kick and the requirement of Corrosion Resistant Alloy (CRA) tubular running procedure to comply with health, safety and environment (HSE), have increased the complexity of operation.

This paper explains the brief completion design considerations, operations in the field, and how these operations could be performed safely.
Addressing and managing reliance and potential impacts on biodiversity and ecosystem services of Oil & Gas global operations
Authors: Palliggiano Diana , Baizhigitova Assel , Pavanel Elena , Marconi Michèle , Howard Pippa , Reed Timothy , Sali Jason , Pedroni Paola M.
Published: September 2012

eni is committed to operating beyond compliance for biodiversity conservation and the retention of functional ecosystems in all areas and phases of the project lifecycle. In exploration and production (e&p) terms, this means the systematic recognition and integration of biodiversity and ecosystem services (BES) management into all site operations globally, taking into account local circumstances, international best practices and newly adopted concepts.

This requires understanding how onshore and offshore activities interact with different environments (e.g. forests, deserts, deep water) through science-based assessments that take full account of BES values for company operations and local communities. These enable the detection, measurement and management, through targeted action planning, of an operation's reliance and potential impacts on BES. Outcomes are incorporated into existing environmental management practice, allowing transferability within the company.

Over the past decade, FFI has worked in partnership with eni e&p Division to help use applied ecology in the development of company best practice for BES assessment and management. This has been piloted in operating sites in sensitive environments (Italy, Ecuador, Norway and Alaska) and has led to an improved environmental management system, incorporating sectoral best practices.

The partnership is now focused on evaluating the company's global exposure to BES-related risks and highlighting important operating sites where BES-related opportunities exist, leading to the implementation of site-specific BES assessments and action plans at priority sites.

This paper illustrates the approach developed to recognise, address and manage reliance and potential impacts of eni e&p global operations on BES. The systematic integration of BES management into onshore and offshore operations, existing and new, includes the global mapping of all operating sites against areas of high biodiversity value, the implementation of site-\specific BES risk/opportunity assessments and action plans for high priority operating sites, and the integration of these evaluations into ESHIAs in all new sites.
New Insights into the Prevention of Serious Injuries and Fatalities
Authors: Apking Theodore D. , Martin Donald K.
Published: September 2012

In recent years, HSE professionals have raised questions about the validity of the accident triangle developed by H.W. Heinrich in the 1930s because of a trend of declining minor injuries yet flat or increasing incidence for serious injuries and fatalities. This pattern is seen to varying degrees across industries at the site, company, and national levels and calls into question fundamental long-standing safety science assumptions. (Figure 1).

As a result, a growing number of safety professionals now question the traditional interpretation and validity of the Heinrich Safety Triangle (HST) —a fundamental concept in occupational safety dating back to the 1930s. The HST states injury frequency increases as severity decreases – i.e., there are more medical treatment cases than lost-time cases, and more lost-time cases than fatalities. The cornerstone interpretation of the HST by the safety community is this: if we reduce the number of less severe injuries, we will reduce the number of more severe injuries as well. In other words, shrink the bottom of the triangle and you also shrink the top.

To better understand the inconsistency between the historic principle of the HST and recent injury and fatality statistics at the national and company level, seven global companies sponsored a study. The objective was to research these questions:
The Role of a Non-Operating Partner in contributing to HSE Excellence
Authors: Lawrie Graeme
Published: September 2012

The Macondo event brought into sharp focus the role and liabilities of non-operating partners in oil and gas developments. One of the partners in this tragic event recently settled liabilities of some $4 Billion, to pay for damages incurred by the operating party. This has raised the question among oil and gas companies, most of whom function as both Operator and Non-Operating Partner, as to what extent they should or could influence the HSE performance of an operating partner.

There are still many conflicting opinions about the role that a non-operating partner should fulfil; from almost no involvement on the one hand to close supervision and direction at the other end of the scale. Non Operating Companies are being held liable for the actions of their operating partners and their contractors, so they must be prepared to take action to ensure that their operating partners develop and maintain HSE excellence throughout the lifetime of the project.
DEVELOPING HOW-TO MANUALS TO STRENGTHEN PROCESS SAFETY IMPLEMENTATION
Authors: Jabar Busari
Published: September 2012

Effective process safety implementation is a challenge in large and multi-sites organizations due to the different nature of operations, organizational structures, work processes and levels of understanding on the requirements. In PETRONAS, despite specific technical standards been developed to specify the requirements, the implementation approach and methodology vary across the operating units. To ensure consistency in the design and implementation of process safety systems and procedures, "how-to" manuals have been developed for each of the elements such as Management of Change, Process Hazards Review, Pre- Startup Safety Review, Process Safety Information etc.

The how-to manuals translate the requirements of specific process safety elements into building blocks or modules describing the program/processes and related activities to manage the elements. Each module contains information such as the activity, the purpose and outputs/deliverables, the method/steps, responsible parties, and the relevant templates, samples, tools and key performance indicators.

The manuals and frameworks provided therein are used as reference by personnel needing guidance in the essentials of specific process safety elements. In addition to the how-to manual developed for each of the process safety elements, a separate manual called "how-to tracker" had also been developed for measuring the implementation progress.

Development of the how-to manuals and tracker had significantly helped the practitioners in ensuring consistency in the approach and implementation of process safety and facilitate the review/assurance processes.
Oil Slicks and Coastal Zones Post Gulf War; A 20-Years Assessment, Employing High-Resolution Satellite Imagery
Authors: Taheri Reza
Published: September 2012

The Gulf-war (1991) resulted in one of the world's biggest environmental disasters, impacts of which are still to be assessed. The post war environmental impacts comprise of multiple dimensions among which only two dimensions have been investigated in this research. The first dimension was to assess the amount of present offshore oil slicks while the second approach was to assess the impacts on coastal areas along the Gulf in a-20-years period (1991–2011) using high resolution satellite imagery.

42 high resolution ASTER (Advanced Spaceborne Thermal Emission and Reflection Radiometer) satellite images have been employed in this research in the TIR (thermal infrared) region of the EM (Electro Magnetic) spectrum to assess the impact of the spill on the coastal zones along the Gulf since 1991. In order to assess and monitor the trend of the oil slick movements during the last 20 years period offshore, thirty (30) Seasonal day time MODIS (Moderate Resolution Imaging Spectroradiometer) satellite images were employed. Following intensive processing and image classification procedures, color composite images of the TIR bands of the ASTER satellite and moderate resolution bands of MODIS were produced.

Fuzzy logic and variograms were employed throughout the processing procedures of the data analysis as powerful tools to reduce uncertainty prior to data analysis.

The processed MODIS images mapped the direction of the movements of slicks in the last 20 years offshore while the processed ASTER images were employed to monitor the gradual impact on the coastal zones along the Gulf during the same 20 years period.

Astonishing results were achieved. Some slicks are still present in the Gulf region and the magnitude of the environmental damage on the coastal areas along the Gulf hasn't decreased in accordance with the standard contingency plans.

Immediate response is demanding both to remove the existing slicks as well as the shoreline cleanup and restoration, the impacts of which have accumulated over the last 20 years.
Managing Health for Field Operations in Oil and Gas Activities
Authors: Sharpies Philip , Rhodes Anton
Published: September 2012

All companies, both operators and contractors, have a commitment to protect and promote the health of those impacted either directly or indirectly by field operations in the oil and gas industry. This is best achieved by establishing an effective health management system.

In May 2003, the Health Subcommittee of the International Association of Oil & Gas Producers (OGP) published Report No: 343 titled Managing Health for Field Operations in Oil & Gas Activities. The purpose of this guideline was to assist companies working within this sector to achieve and maintain high standards of health management for all people associated with field operations. The aim was to simplify and integrate in to one document the recommendations that the OGP Health Subcommittee considered essential for optimal health management, from conception and throughout the entire duration of the field operation.

This document superseded the three previous OGP documents on field medical support written between 1993 to1995:
Health performance in the oil and gas industry – the results
Authors: Martin Alison
Published: September 2012

During September 2008, 2009 and 2010, members of the OGP/IPIECA health committee piloted a set of 8 leading indicators of health performance within their companies. 2 tools were used: - one that indicated the extent of management of the 8 areas across their companies globally; the second allowed for in-depth analysis at site and corporate level.

The tools were enhanced in response to feedback from member companies and final versions of both tools were used during September 2011 to gauge health performance across the industry. 18 companies took part and many of these had started participating in 2008.

As individual companies have used earlier years' results to identify gaps in their own health management systems, it is pleasing to note that mean values for each health area have improved over the 4 years.

This paper will illustrate the final versions of both tools, actual anonymous results for 2011, trends over time and the potential health benefits to the industry.
Asset Integrity Management System of a Complex Upstream Oil & Gas Plant: The Experience in Val D’Agri Oil Centre
Authors: Carnevale Paolo , Cortina Michele
Published: September 2012

Asset Integrity Management System (AIMS) outlines the ability of an asset to perform its required function effectively and efficiently whilst protecting health, safety and the environment and minimizing associated risks, assuring that the people, systems, processes and resources that deliver integrity are in place, in use and perform when required over the whole asset lifecycle. This paper aims to provide a comprehensive report of the implementation program and experience of AIMS to Val d’Agri Oil Centre, a large and complex 100.000 bbls / day upstream oil & gas plant located in Viggiano (Italy) above the biggest oilfield of Continental Europe with high concentration of H2S, concerning the prevention of major incidents.

This paper will provide practical knowledge on systems and strategies needed to implement an efficient AIMS program in similar organizations and operations, enlightening case studies that will aid in reducing the risk of failure and downtime and ensuring that safety standards are achieved.

The Oil Centre succeeded in implementing a first version of an Asset Integrity Management System (AIMS) between 2010 and the first half of 2011, mainly based on a previously adopted Safety Management System developed in conformity with European and Italian Seveso Legislation (Prevention of Major Accidents). Specific processes and tools implemented included, for example, Risk Assessments and identification of Safety-Critical Elements and Barriers, Maintenance Strategies, Operational and Process Support, Mechanical Integrity Service. A high degree of innovation characterized the risk management approach by the use of the innovative "Process Safety Baseline Risk assessment Tool", developed by eni e&p division for the evaluation and management of major incidents risks. In the second half of 2011, a new program intends to foster the target, within 2012, of improving the AIMS to be more in compliance with OGP guidelines and ISO and CCPS references.

This paper will provide practical knowledge on systems and strategies needed to implement an efficient AIMS program in similar organizations and operations.
INNOVATIVE ENVIRONMENTAL MONITORING FOR UPSTREAM ONSHORE INSTALLATION
Authors: Carnevale Paolo , Di Croce Silvia
Published: September 2012

A comprehensive Environmental Monitoring Project in Val D’Agri (Southern Italy) has been developed for ensuring a continuous management of the environmental impacts of the activities of the eni's Oil Treatment Center, the biggest O&G upstream processing plant in Europe.

This Project, realized in 2011 in a very short time and following a major plant refurbishment, is able to control all the environmental effects of e&p activities in a very large area surrounding the plant (100 km2).

It is characterized by a complete integration of several networks, stations and systems used for simultaneously monitoring air quality, noise, odorous emissions in terms of olfactory nuisance, groundwater and soil quality, ecosystems status (microfauna, macrofauna, carabidiofauna) and ecological biodiversity.

In particular, the odorous emissions monitoring network is designed for assessing at the same time the odour level, using electronic nose technology and human testers, and pollutant concentrations to finally discriminate the origin of the nuisance (related to Oil Center activity or not).

All recorded data are continuously related with operative parameters of the treatment plant, in order to assess and evaluate in real time potentially adverse environmental effects of the upstream activity.

This Project has been realized in a continuous sharing with local environmental control agencies, recognized scientific institutions and universities; it is unique and totally innovative in the Oil&Gas upstream industry for the technologies, instruments and monitoring networks level of integration adopted.

This guarantees the highest environmental protection and preserves the quality of life for the local communities in a sensitive environment.