bluuebunny/crossref_metadata_2025 huggingface dataset:
Altered Spontaneous Brain Activity in Patients With Idiopathic Trigeminal Neuralgia
Authors: Yuan Jie , Cao Song , Huang Yue , Zhang Yi , Xie Peng , Zhang Yu , Fu Bao , Zhang Tijiang , Song Ganjun , Yu Tian , Zhang Mazhong
Published: December 2017

Objectives:

To identify the changes of local coherence and intrinsic brain activity in resting-state idiopathic trigeminal neuralgia (ITN) patients by using regional homogeneity (ReHo) and fractional aptitude of low-frequency fluctuation (fALFF) analysis.

Methods:

ReHo and fALFF were analyzed in 23 ITN patients and 23 age-matched and sex-matched pain-free controls to detect the functional abnormality in the brains of ITN patients. Correlations between ReHo and fALFF were analyses. ITN pain intensity were also assessed in the ITN group.

Results:

Compared with pain-free controls, ITN patients exhibited significantly abnormal ReHo and fALFF in several brain regions, including the cerebellum, cingulate cortex, temporal lobe, putamen, occipital lobe, limbic lobe, precuneus, insula, medial, and superior frontal gyrus compared with healthy controls. Correlation analysis showed that ReHo values of several altered brain areas positively correlated with visual analog scale values. But no correlation was found between fALFF and visual analog scale.

Discussion:

Our results showed that ITN patients exhibited significantly abnormal spontaneous brain activity in several brain regions that are involved in pain modulation and perception. The present study reflects the maladaptive process of daily pain attacks and may enhance the understanding of how chronic pain affects local intrinsic brain activity.
Evaluating the Performance of a Visually Guided Hearing Aid Using a Dynamic Auditory-Visual Word Congruence Task
Authors: Roverud Elin , Best Virginia , Mason Christine R. , Streeter Timothy , Kidd Gerald
Published: December 2017

Objectives:

The “visually guided hearing aid” (VGHA), consisting of a beamforming microphone array steered by eye gaze, is an experimental device being tested for effectiveness in laboratory settings. Previous studies have found that beamforming without visual steering can provide significant benefits (relative to natural binaural listening) for speech identification in spatialized speech or noise maskers when sound sources are fixed in location. The aim of the present study was to evaluate the performance of the VGHA in listening conditions in which target speech could switch locations unpredictably, requiring visual steering of the beamforming. To address this aim, the present study tested an experimental simulation of the VGHA in a newly designed dynamic auditory-visual word congruence task.

Design:

Ten young normal-hearing (NH) and 11 young hearing-impaired (HI) adults participated. On each trial, three simultaneous spoken words were presented from three source positions (−30, 0, and 30o azimuth). An auditory-visual word congruence task was used in which participants indicated whether there was a match between the word printed on a screen at a location corresponding to the target source and the spoken target word presented acoustically from that location. Performance was compared for a natural binaural condition (stimuli presented using impulse responses measured on KEMAR), a simulated VGHA condition (BEAM), and a hybrid condition that combined lowpass-filtered KEMAR and highpass-filtered BEAM information (BEAMAR). In some blocks, the target remained fixed at one location across trials, and in other blocks, the target could transition in location between one trial and the next with a fixed but low probability.

Results:

Large individual variability in performance was observed. There were significant benefits for the hybrid BEAMAR condition relative to the KEMAR condition on average for both NH and HI groups when the targets were fixed. Although not apparent in the averaged data, some individuals showed BEAM benefits relative to KEMAR. Under dynamic conditions, BEAM and BEAMAR performance dropped significantly immediately following a target location transition. However, performance recovered by the second word in the sequence and was sustained until the next transition.

Conclusions:

When performance was assessed using an auditory-visual word congruence task, the benefits of beamforming reported previously were generally preserved under dynamic conditions in which the target source could move unpredictably from one location to another (i.e., performance recovered rapidly following source transitions) while the observer steered the beamforming via eye gaze, for both young NH and young HI groups.
Social Development in Children With Early Cochlear Implants: Normative Comparisons and Predictive Factors, Including Bilateral Implantation
Authors: Sarant Julia Z. , Harris David C. , Galvin Karyn L. , Bennet Lisa A. , Canagasabey Manasi , Busby Peter A.
Published: December 2017

Objectives:

There are mixed results regarding psychosocial development in children with cochlear implants (CIs) compared with children with normal hearing (NH), and the effect of bilateral CIs has not yet been investigated. This study aimed to investigate whether social development differed between NH children and those with early CIs, and to identify new predictors of psychosocial development in children with early CIs.

Design:

The psychosocial development, cognitive and language abilities of 159 children were measured as part of a longitudinal outcomes study of children with CIs. Parental involvement was also assessed.

Results:

The children in this study did not differ significantly from their peers with NH in terms of their psychosocial development, except with regard to Prosocial Behavior, with parents reporting significantly poorer development in this area. Having bilateral CIs predicted significantly fewer difficulties with psychosocial development, with earlier age at implantation increasing the effect size of the second CI for Emotional Symptoms and Peer Problems. Receptive language ability, higher parent education, later birth order, high parent involvement, and female gender predicted significantly fewer parent reports of psychosocial problems. Higher child cognitive ability and greater screen time predicted significantly greater reported psychosocial difficulties. Marginal effects modeling quantified the effects of changes in the predictive factors examined.

Conclusions:

Psychosocial development in these children with early CIs was found to be similar to that for peers with NH, with the exception of delayed Prosocial Behavior development. Having bilateral CIs predicted significantly better emotional outcomes. A number of new predictive factors were found for psychosocial development. The results of the marginal effects modeling should be shared with parents and professionals to increase their understanding of the impact of changes in predictive factors, particularly in terms of their own contribution to psychosocial outcomes for children with CIs.
Differences in Patient Experience Between Hispanic and Non-Hispanic White Patients Across U.S. Hospitals
Authors: Figueroa Jose F. , Reimold Kimberly E. , Zheng Jie , Orav Endel John
Published: December 2017

Introduction:

Despite the increased emphasis on patient experience, little is known about whether there are meaningful differences in hospital satisfaction between Hispanic and non-Hispanic whites.

Methods:

To determine if satisfaction differs, we used Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey data (2009–2010) reported by hospitals to compare responses between Hispanic and non-Hispanic white patients. Clustered logistic regression models identified within-hospital and between-hospital differences in satisfaction.

Results:

Of the 3,864,938 respondents, 6.2% were Hispanics, who were more often younger and females and less likely to have graduated from high school. Hispanics were overall more likely to recommend their hospital (74.1% vs. 70.9%, p < .001) and to rate it 9 or 10 (72.5% vs. 65.9%, p < .001) than whites. Increased satisfaction among Hispanics was more pronounced when compared with whites within the same hospitals, with significantly higher ratings on all HCAHPS measures. However, hospitals serving a higher percentage of Hispanics had lower satisfaction scores for both Hispanic and white patients than other hospitals.

Conclusion:

There were significant but only modest-sized differences in patient experience between Hispanic and white patients across U.S. hospitals. Hispanics tended to be more satisfied with their care but received care at lower-performing hospitals.
Latin American Consensus for Pediatric Cardiopulmonary Resuscitation 2017: Latin American Pediatric Critical Care Society Pediatric Cardiopulmonary Resuscitation Committee*
Authors: López-Herce Jesús , Almonte Enma , Alvarado Manuel , Bogado Norma Beatriz , Cyunel Mariana , Escalante Raffo , Finardi Christiane , Guzmán Gustavo , Jaramillo-Bustamante Juan C. , Madrid Claudia C. , Matamoros Martha , Moya Luis Augusto , Obando Grania , Reboredo Gaspar , López Lissette R. , Scheu Christian , Valenzuela Alejandro , Yerovi Rocío , Yock-Corrales Adriana
Published: December 2017

Objectives:

To develop a Latin American Consensus about Pediatric Cardiopulmonary Resuscitation. To clarify, reinforce, and adapt some specific recommendations for pediatric patients and to stimulate the implementation of these recommendations in clinical practice.

Design:

Expert consensus recommendations with Delphi methodology.

Setting:

Latin American countries.

Subjects:

Experts in pediatric cardiopulmonary resuscitation from 19 Latin American countries.

Interventions:

Delphi methodology for expert consensus.

Measurements and Main Results:

The goal was to reach consensus with all the participating experts for every recommendation. An agreement of at least 80% of the participating experts had to exist in order to deliver a recommendation. Two Delphi voting rounds were sent out electronically. The experts were asked to score between 1 and 9 their level of agreement for each recommendation. The score was then classified into three groups: strong agreement (score 7–9), moderate agreement (score 4–6), and disagreement (score 1–3). Nineteen experts from 19 countries participated in both voting rounds and in the whole process of drafting the recommendations. Sixteen recommendations about organization of cardiopulmonary resuscitation, prevention, basic resuscitation, advanced resuscitation, and postresuscitation measures were approved. Ten of them had a consensus of 100%. Four of them were agreed by all the participants except one (94.7% consensus). One recommendation was agreed by all except two experts (89.4%), and finally, one was agreed by all except three experts (84.2%). All the recommendations reached a level of agreement.

Conclusions:

This consensus adapts 16 international recommendations to Latin America in order to improve the practice of cardiopulmonary resuscitation in children. Studies should be conducted to analyze the effectiveness of the implementation of these recommendations.
Comparison of Hand Function Between Children With Type 1 Diabetes Mellitus and Children Without Type 1 Diabetes Mellitus
Authors: Atay Canan , Kaya Mutlu Ebru , Taskiran Hanifegul , Ozgen Ilker Tolga
Published: December 2017

Purpose:

This study compared the hand function of children between the ages of 8 and 12 years with type 1 diabetes mellitus (T1DM) with that of children without diabetes.

Methods:

The Modified Jebsen-Taylor Hand Function Test and the Purdue Pegboard Test were used to assess hand function. The Pediatric Quality of Life Inventory 4.0 was used for evaluating health-related quality of life.

Results:

Duration of writing was found to be significantly longer on the dominant side of the T1DM group compared with the children without T1DM. The durations of card turning, moving large, light objects, and large, heavy objects on the nondominant side of the T1DM group were also found to be significantly longer than those in the children without T1DM. The total scale score of health-related quality of life was significantly lower in the T1DM group compared with the children without T1DM.

Conclusions:

T1DM affects hand function, particularly the dominant side for writing and nondominant side for card turning and moving large objects.
Satisfaction of Patients With Spinal Cord Injury With Self-Care Teaching by Nurses: Is It Influenced by Learning Readiness?
Authors: Wagner Debra L. , Olinzock Barbara J. , Pasicolan Elena , Lee Orapin , Velarde Jean
Published: December 2017

Purpose:

The aims of the study were to measure satisfaction of patients with a spinal cord injury (SCI) with discharge teaching by nurses and to examine the relationship between their stage of learning readiness and satisfaction.

Design:

Quasi-experimental.

Method:

Ninety-seven patients were surveyed to determine satisfaction using the Modified Client Satisfaction Tool; nurses determined the stage of learning readiness for patients with SCI using the Olinzock Model. Satisfaction scores were analyzed with ANOVA F and chi-square tests and correlated with learning readiness stage using t tests.

Findings:

Results showed no relationship between the stage of learning readiness and satisfaction. Patients indicated satisfaction regardless of the stage of learning readiness. Those commenting “nurses don’t teach” were significantly less satisfied with self-care teaching.

Conclusion:

The perception of patients with SCI of the role of the nurse as teacher influences satisfaction with discharge teaching by nurses.

Clinical Relevance:

Nurses may need to consider changes in their practice to help patients realize their role as teacher.
Experiences of Older Adults After Hip Fracture: An Integrative Review
Authors: Ehlers Monica M. , Nielsen Claus V. , Bjerrum Merete B.
Published: December 2017

Purpose

The aim of the study was to identify and synthesize scientific evidence on older adults' experience after hip fracture in relation to their physical and mental health, functional performance, and participation and to determine which personal or social factors influence functional capacity after hip fracture.

Design

Integrative review.

Methods

Eleven qualitative or quantitative papers published between 2001 and 2015 were analyzed using integrative review methodology as described by Whittemore and Knafl.

Results

Older adults experienced pain and decline in personal and instrumental activities of daily living and used adaptation strategies to cope with the hip fracture.

Conclusion

Hip fracture affected the older adults' mobility, body image, mental health, and capacity for participation.

Clinical Relevance

Pain measurement tools focusing on various perspectives of health as well as rehabilitation programs focusing on changes in body function and body image and increased awareness of vulnerability in older adults may promote functional capacity after hip fracture.
Effects of a Short-term Mindfulness-Based Intervention on Comfort of Stroke Survivors Undergoing Inpatient Rehabilitation
Authors: Wang Mian , Liao Weijing , Chen Xiaoli
Published: December 2017

Purpose

The aim of the study was to evaluate the effectiveness of a modified short-term mindfulness-based intervention on improving the mindfulness, comfort, and ambulation ability of stroke survivors undergoing inpatient rehabilitation in Wuhan, China.

Design

A two-group, nonrandomized, nonconcurrent design was used.

Method

Participants undergoing inpatient rehabilitation were nonrandomly divided into control group (n = 25) and intervention group (n = 25) to avoid possible ethical discrimination as well as interaction among participants. The control group received routine care; the intervention group received a 2-week mindfulness-based intervention, which included weekly 1.5-hour group practice, individual daily practice, and routine care. Data were collected using questionnaires and assessments of ambulation before and after 2 weeks of observation.

Findings

Improvement on the Mindful Attention Awareness Scale score, the overall score of the Shortened General Comfort Questionnaire, and the scores of the physical, psychospiritual, and sociocultural subscales in the intervention group was greater than those in the control group (p < .05). No significant difference (p > .05) was observed between the two groups when comparing scores of the environmental subscale of Shortened General Comfort Questionnaire, Berg Balance Scale, 10-Meter Walk Test, and Functional Ambulation Classification scale.

Conclusions and Clinical Relevance

A 2-week mindfulness-based intervention can significantly improve stroke survivors’ mindfulness and comfort but does not significantly affect ambulation ability.
Validation of a Scale to Assess Patients’ Comprehension of Frequently Used Cardiology Terminology: The Cardiac TERM Scale in Brazilian Portuguese
Authors: Ghisi Gabriela Lima de Melo , dos Santos Rafaella Zulianello , Britto Raquel R. , Bonin Christiani Decker Batista , Servio Thaianne Cavalcante , Schmidt Luiz Fernando , Benetti Magnus , Grace Sherry L.
Published: December 2017

Purpose

The aim of this study was to psychometrically validate the translation of a questionnaire on patient understanding of cardiology terminology (TERM) to Brazilian Portuguese.

Design

After piloting the translation and cross-cultural adaptation, the 16-item TERM questionnaire was psychometrically tested.

Methods

Internal and test–retest reliability, as well as validity, were assessed in 322 cardiac patients.

Findings

Internal (α = .88) and test–retest reliability (all weighted Kappa > 0.63) exceeded the minimum recommended standards. Criterion validity was supported by significant differences in mean scores by socioeconomic indicators (p < .01). Discriminant validity was supported in that cardiac rehabilitation participants had significantly higher TERM scores (p < .001). Participants did not correctly define any of the terms, and a floor effect was identified in all terms.

Conclusions

The Cardiac TERM Scale was demonstrated to have good reliability and validity.

Clinical Relevance

The scale can be used by healthcare professionals, such as nurses. Results can be used to inform patient education, which could in turn impact patient adherence to medical advice and hence outcomes.
Stroke Survivor and Family Caregiver Reports of Caregiver Engagement in Stroke Care
Authors: Haley William E. , Marino Victoria R. , Sheehan Orla C. , Rhodes J. David , Kissela Brett , Roth David L.
Published: December 2017

Purpose

The aim of the study was to identify areas of caregiver engagement in stroke care as viewed by stroke survivors and family caregivers.

Design

Interviews with stroke survivor/caregiver dyads (N = 71) from a population-based study of incident stroke.

Methods

We interviewed stroke survivors and caregivers about caregiver involvement at multiple stages of stroke care. We assessed similarities and differences between stroke survivor and caregiver reports and analyzed responses to open-ended questions.

Findings

Stroke survivor and caregiver reports of engagement were highly correlated (r = .89), although caregivers reported higher involvement. Open-ended comments suggested that, in about 25% of cases, stroke survivors and caregivers agreed that caregiver engagement led to major improvements in stroke survivor care, most commonly during onset of symptoms.

Conclusions

Stroke survivors and caregivers report significant and impactful caregiver engagement throughout the course of stroke.

Clinical Relevance

Clinicians may enhance stroke care by recognizing and facilitating caregiver efforts across all phases of stroke care.
Improving Orthopedic-Related Postoperative Edema Management in a Rehabilitative Nursing Setting
Authors: Kluga Katie L. , Weber Buchholz Susan , Semanik Pamela A.
Published: December 2017

Purpose

The aim of the study was to reduce postoperative edema in total knee and hip arthroplasty rehabilitation patients.

Design

A pre– and posttest design was used for this quality improvement project at a rehabilitation facility.

Methods

Staff and patient edema education was standardized. Staff pre- and posttests were administered. Patients were interviewed to assess for knowledge of edema management. Chart audits were assessed for edema management and length of stay.

Findings

Average staff knowledge scores (n = 50) increased pre- to posteducational video (64% vs. 70%). Of patients interviewed posteducation (n = 24), 38% were able to list two characteristics of edema. Two chart audits completed pre- and posteducation demonstrated that the majority of patients (n = 30 per group) had edema upon admission (96% vs. 97%). However, length of stay decreased by 3 days (19.2 vs. 16.3).

Conclusion

Standardized postoperative edema education can improve staff and patient edema knowledge and management.

Clinical Relevance

Edema education is recommended for orthopedic patients in rehabilitation facilities.
Exploring the Adaptability of Tai Chi to Stroke Rehabilitation
Authors: Hwang Inok , Song Rhayun , Ahn Sukhee , Lee Myung-ah , Wayne Peter M. , Sohn Min Kyun
Published: December 2017

Purpose

The aim of the study was to assess the feasibility, safety, and preliminary estimates of effectiveness of Tai Chi on functional outcomes in stroke survivors.

Design

A mixed-method study with a single-group repeated-measure design and in-depth interviews.

Methods

Fourteen stroke survivors with hemiplegia were recruited to participate in a Tai Chi program, twice weekly for 12 months. Outcomes included physical function, self-efficacy, and activity of daily living measured at 3-month intervals for 12 months.

Findings

Ten participants (mean age, 68.5 years) completed all assessments with significantly improved balance (χ2 = 14.08, p = .007), flexibility (χ2 = 11.70, p = .020), and self-efficacy (χ2 = 21.84, p < .001) over 12 months. Qualitative results highlighted the positive impact on physical improvement, psychological well-being, social support, and improved confidence in performing activities of daily living.

Conclusion

An adapted Tai Chi program was safe, feasible, and well received in community-dwelling stroke survivors.

Clinical Relevance

The Tai Chi-based rehabilitation program shows promise for improving function and balance outcomes related to fall prevention in stroke survivors.
Stability in Cardiac Attributions Before and After Cardiac Rehabilitation
Authors: Bennett Kymberley K. , Harry Kadie M. , Eways Kalon R. , Wilson Elizabeth J. , Clark Jillian M.R. , Howarter Alisha D. , Murdock Tamera B.
Published: December 2017

Purpose

This study examined temporal patterns in causal attributions generated by patients with cardiovascular disease before and after cardiac rehabilitation (CR).

Design

Qualitative, descriptive survey.

Methods

Eighty-six participants were asked what they believed was the primary cause of their cardiac events. Cardiac attributions were collected at the beginning of CR, at the end of CR, and 15 months after baseline.

Findings

Content analyses showed that heredity and behavior were the most commonly generated causes. Most participants showed stability in attributions over time, although we found a trend for more participants endorsing behavioral attributions at the end of the study.

Conclusions

Cardiac attributions remain relatively stable across time.

Clinical Relevance

Cardiac rehabilitation staff should approach patients differently, depending on their causal narratives. Some patients enter CR understanding that behavior played a causal role, whereas some do not. Encouraging appreciation of the importance of behavior in cardiovascular disease onset and recurrence is vital.
The Initiation of Rehabilitation Therapies and Observed Outcomes in Pediatric Traumatic Brain Injury
Authors: Reuter-Rice Karin , Eads Julia K. , Berndt Suzanna , Doser Karoline
Published: December 2017

Purpose

Pediatric traumatic brain injury (TBI) is associated with immense physical, emotional, social, and economic burden. This study examined timing and frequency of rehabilitation services provided by the inpatient interdisciplinary team in children admitted for a TBI. Understanding the timing and frequency of rehabilitation services could guide TBI recovery.

Design and Methods

This is a 3-year prospective observational study of previously healthy children (n = 35) admitted for a TBI to an urban Level 1 trauma hospital. Children with mild, moderate, and severe TBI were included. Initiation and frequency of the interdisciplinary rehabilitation team’s care and neurocognitive-functional outcomes were analyzed. Outcome measures included the Glasgow Outcome Scale-Extended Pediatrics and the Speech Pathology Neurocognitive-Functional Evaluation at hospital discharge and first follow-up visit.

Results

The initiation and the frequency of rehabilitation services were found in all severities of TBI. Timing and frequency of services also aligned with varied severities. Children with moderate TBI showed the most improvement in Glasgow Outcome Scale-Extended Pediatrics and the Speech Pathology Neurocognitive-Functional Evaluation on their first follow-up visit, whereas children with mild and severe TBI demonstrated little change in outcome at their first follow-up visit and had varied services based on their hospital course.

Conclusion

Services by interdisciplinary rehabilitation teams were provided across all brain injury severity groups, despite the lack of comprehensive rehabilitation guidelines. Varied neurocognitive and functional outcome changes measured found children with moderate TBI had the greatest change in outcomes. Further research is warranted to assess the timing and frequency of services and their relationship to neurocognitive-functional outcomes.
Interprofessional Collaboration and Peer Mentors for Bowel Education in Spinal Cord Injury: A Case Consultation
Authors: Cabigon Ralph D. , Wojciechowski Elizabeth , Rosen Lisa , Miller David , Mix Cristina , Chen David
Published: December 2017

Background

Evidence shows that having a bowel management program prevents rehospitalization postacute rehabilitation discharge for persons with a spinal cord injury (SCI). Peer mentors have been used to assist patients in managing their care.

Purpose

The aim of the study was to illustrate how interprofessional collaboration led to utilizing resources of the inpatient rehabilitation facility’s peer mentor program and incorporating peer mentors into bowel education for persons with SCI.

Methods

A descriptive case review of a continuous quality improvement (CQI) project, using an eight-item Likert scale evaluation survey with three open-ended questions to assess the utility of incorporating peer mentors into bowel education.

Findings and Conclusions

Twenty-seven of the 28 participants responded to the survey. Results showed that the education program was useful, should be continued, and include the peer mentors. Responses from open-ended questions included themes related to knowledge, adherence, and taking charge of one’s own care. Interprofessional collaboration and involvement of peer mentors as copresenters in SCI bowel education were feasible.
Rehabilitation Nurses’ Knowledge, Attitudes, and Behaviors for Preventing Urinary Tract Infections From Intermittent Catheterization
Authors: Dawa Tenzin , Randolph Mary , Moyers Penelope , Finch Guthrie Patricia , Frie Brenda , Filer Debra
Published: December 2017

Purpose

The aim of this study was to develop and examine the reliability of a survey to assess knowledge, attitudes, and behaviors (KAB) of rehabilitation nurses for preventing urinary tract infections in persons requiring intermittent catheterization.

Design

Cross-sectional survey with principal component analysis.

Methods

Survey development and administration based on national guidelines.

Findings

Principal component analysis produced three reliable components of KAB explaining 54.5% of response variance. Results indicate that nurses report adequate knowledge and training. Although the facility had an evidence-based online catheterization procedure, staff reported that the procedure was not helpful nor useable. Twenty-eight percent incorrectly identified the root cause of urinary tract infection, and 45% reported that other nurses always washed their hands. Barriers to using standard intermittent catheterization technique were staff, time, and patient variables.

Conclusion

The modified survey is a reliable measure of KAB.

Clinical Relevance

The survey assists with identifying knowledge gaps, customizing education, and changing practice.
Effects of Sanguinate on Systemic and Microcirculatory Variables in a Model of Prolonged Hemorrhagic Shock
Authors: Nugent William H. , Cestero Ramon F. , Ward Kevin , Jubin Ronald , Abuchowski Abe , Song Bjorn K.
Published: December 2017

Background:

Hemorrhage and its complications are the leading cause of preventable death from trauma in young adults, especially in remote locations. To address this, deliverable, shelf-stable resuscitants that provide therapeutic benefits throughout the time course of hemorrhagic shock and the progressive ischemic injury it produces are needed. SANGUINATE
∗
is a novel bovine PEGylated carboxyhemoglobin-based oxygen carrier, which has desirable oxygen-carrying and oncotic properties as well as a CO moiety to maintain microvascular perfusion.

Objectives:

To compare the crystalloid (Lactated Ringer's Solution; LRS), and the colloid (Hextend
†
) standards of care with SANGUINATE in a post “golden hour” resuscitation model.

Methods:

Rats underwent a controlled, stepwise blood withdrawal (45% by volume), were maintained in untreated hemorrhagic shock state for >60 min, resuscitated with a 20% bolus of one of the three test solutions, and observed till demise. Parameters of tissue oxygenation (PISFO2), arteriolar diameters, and mean arterial pressure (MAP) were collected.

Results:

SANGUINATE-treated animals survived significantly longer than those treated with Hextend and LRS. SANGUINATE also significantly increased tissue PISFO2 2 h after resuscitation, whereas LRS and Hextend did not. SANGUINATE also produced a significantly higher MAP, which was hypotensive compared to baseline, that endured until demise.

Conclusions:

Resuscitation with SANGUINATE after prolonged hemorrhagic shock improves survival, MAP, and PISFO2 compared with standard of care plasma expanders. Since the pathologies of hemorrhagic shock and the associated systemic ischemia are progressive, preclinical studies of this nature are essential to determine efficacy of new resuscitants across the range of possible times to treatment.
Testing hypotheses on population dynamics: A test for the inhomogeneous Poisson point process model
Authors: Hohmann Niklas
Published: December 2017

In this paper, a test for hypotheses on population dynamics is presented alongside an implementation of said test for R. The test is based on the assumption that the sample, consisting of points on a time axis, is a realization of a Poisson point process (PPP). There are no restrictions on the shapes of the rate functions that are regulating the PPP, type 2 errors can be calculated and the test is optimal in the sense that it is a uniform most powerful (UMP) test. So for every significance level a, the presented test has a lower type 2 error than every other test having the same significance level a. The test is applicable to all models based on PPPs, including models in spatial dimensions. It can be generalized and expanded in different ways, such as testing larger hypotheses, incorporating prior knowledge, and constructing confidence regions that can be used to obtain upper or lower bounds on rate functions.
Genetic evidence for shared risks across psychiatric disorders and related traits in a Swedish population twin sample
Authors: Taylor Mark J. , Martin Joanna , Lu Yi , Brikell Isabell , Lundström Sebastian , Larsson Henrik , Lichtenstein Paul
Published: December 2017

Psychiatric traits related to categorically-defined psychiatric disorders are heritable and present to varying degrees in the general population. In this study, we test the hypothesis that genetic risk factors associated with psychiatric disorders are also associated with continuous variation in milder population traits. We combine a contemporary twin analytic approach with polygenic risk score (PRS) analyses in a large population-based twin sample. Questionnaires assessing traits of autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), learning difficulties, tic disorders (TD), obsessive-compulsive disorder (OCD), anxiety, major depressive disorder (MDD), mania and psychotic experiences were administered to a large, Swedish twin sample. Individuals with clinical psychiatric diagnoses were identified using the Swedish National Patient Register. Joint categorical/continuous twin modeling was used to estimate genetic correlations between psychiatric diagnoses and continuous traits. PRS for psychiatric disorders were calculated based on independent discovery genetic data. The association between PRS for each disorder and related continuous traits was tested. We found mild to strong genetic correlations between psychiatric diagnoses and corresponding traits (ranging from .31-.69) in the twin analyses. There was also evidence of association between PRS for ASD, ADHD, TD, OCD, anxiety, MDD and schizophrenia with related population traits. These results indicate that genetic factors which predispose to psychiatric disorders are also associated with milder variation in characteristic traits throughout the general population, for many psychiatric phenotypes. This finding supports the conceptualization of psychiatric disorders as the extreme ends of continuous traits.
Exploring the adoption of Lean principles in medical laboratory industry
Authors: Isack Hilma Dhiginina , Mutingi Michael , Kandjeke Hileni , Vashishth Abhishek , Chakraborty Ayon
Published: December 2017

Purpose

As the demand for efficiency and quality in the health-care industry has increased over the past few years, adoption of Lean principles and tools in the medical laboratory industry has become increasingly crucial. The purpose of this study is to explore the level of adoption, barriers and enablers of Lean principles and tools in the Namibian medical laboratory industry.

Design/methodology/approach

A descriptive cross-sectional study was carried out to examine the level of usage, barriers and enablers, impact of Lean tools and to suggest appropriate strategies for adopting Lean in the Namibian medical laboratory services.

Findings

Research findings reveal that Lean tools are moderately implemented in most laboratories. Standard operating procedures, root cause analysis, overall equipment effectiveness and visual management are the important Lean tools used in the industry. Results of the survey also show that Lean tools had a positive impact on operational performance, employee motivation, turnaround time and cost reduction. Furthermore, top management involvement, adequate training and proper planning emerged as important enablers, while lack of support from the management, financial constraint and staff resistant to change are major barriers to the adoption of Lean principles in the Namibian medical laboratory industry.

Research limitations/implications

The paper has inherent limitations of survey research, which the authors will overcome by using case studies with medical laboratories.

Practical implications

The findings of the authors’ work will help in widening the application of Lean principles in more medical laboratories in Namibia and in other parts of the world.

Originality/value

The paper is based on numerous health-care studies on Lean. This is one of the few papers investigating the adoption of Lean principles, specifically in medical laboratories, from an emerging economy such as Namibia.
Development of Six Sigma methodology to improve grinding processes
Authors: Noori Behrooz , Latifi Mana
Published: December 2017

Purpose

This paper aims to deploy the Six Sigma methodology to facilitate defect reduction and enhance the bottom-line results of an automotive industry.

Design/methodology/approach

Six Sigma is a business process improvement strategy widely used in manufacturing field for enhancing organizational performance. Six Sigma enables the attainment of defects reduction. In this study, the Six Sigma methodology has been developed with the integration of change management tools.

Findings

Six Sigma has been successfully implemented in the grinding process in automotive engine manufacturing organization. The proposed Six Sigma methodology has been applied to facilitate defect reduction. The developed methodology with linkage of DMAIC (define, measure, analyze, improve and control) and change management techniques reduces defects.

Research limitations/implications

The developed methodology has been implemented in an automotive industrial complex. In future, more number of studies could be conducted, i.e. for mistake proofing. Furthermore, advanced tools and techniques could be included in the methodology for increasing the effectiveness of change management.

Practical implications

The proposed Six Sigma methodology has been successfully implemented in a grinding process of automotive manufacturing organization; in future, the approach could be applied in different industrial sectors with addition of new tools and techniques for improving its effectiveness.

Originality/value

The Six Sigma methodology has been designed and implemented in the grinding process. Researchers have not treated Six Sigma in much detail in the automotive industry. Moreover, previous studies on Six Sigma have not dealt with the grinding process. Besides, most studies in the field of Six Sigma have focused only on DMAIC, but this study adds change management approach to DMAIC.
Livestock grazing reinforces the competitive exclusion of small‐bodied birds by large aggressive birds
Authors: Val James , Eldridge David J. , Travers Samantha K. , Oliver Ian
Published: December 2017

Grazing by domestic livestock is sometimes promoted as a management tool to benefit biodiversity. In many situations, however, it can produce negative outcomes.

Here, we examine the impacts of recent and historic livestock grazing on bird communities in the semi‐arid woodlands in eastern Australia, testing the notion that grazing removes the suppressive effect of structurally complex vegetation on miners, thereby reducing the richness and abundance of small birds.

We used time‐ and area‐limited searches of 108 sites varying in livestock grazing history and intensity, to explore the direct and indirect effects of grazing, habitat complexity and the abundance of aggressive, large‐bodied birds on smaller‐bodied birds using two‐way analysis of variance and structural equation modelling.

Small birds were less abundant and had lower richness in the presence of miners. Our structural equation models indicated that recent grazing had direct suppressive effects on the abundance of miners, and both richness and abundance of all but the largest‐bodied bird groups. However, higher levels of historic livestock grazing reinforced the competitive exclusion of the six small‐bodied bird groups (insectivores, nectarivores, declining woodland birds, small ground‐foraging birds, all small birds and all non‐miners) by aggressive miners via reductions in habitat complexity. Moreover, the strength of any suppressive effects on small birds or positive effects on large birds by miners increased with increasing miner abundance.

Synthesis and applications. Our results highlight the importance of vegetation structural complexity, not only for providing habitat for woodland birds, but also as barriers to the invasion and competitive dominance of miners. Our findings suggest that management actions aimed at reducing tree and shrub density to promote open woodlands are likely to have significant negative consequences for the conservation of small woodland birds.
Conjugal intimacy, gender and modernity in contemporary China
Authors: Liu Jieyu , Bell Eona , Zhang Jiayu
Published: December 2017

The new generation of modernity theorists have forecast the democratization of gender relations within intimate relationships in late‐modern times. Chinese society has undergone rapid and dramatic changes in its unique trajectory of political, social and economic reform. Using China as an example of a region which has been largely ignored in contemporary social theory, this article enters the debate to contest the extent to which conjugal relationships are democratized in line with modernity. We further test the assertion that modern marriages are characterized by increased self‐disclosure and communication between partners. Data from a national survey on Chinese families is analysed in relation to the level of self‐disclosure between husbands and wives; gender division of housework; household decision‐making; and home ownership. We highlight the impact of gender, cohort and location (urban, rural or migrant) on experiences of modernity and draw attention to the material, social and cultural factors which continue to shape conjugal relations in contemporary Chinese society. Based on our findings, we contest the argument that disclosing intimacy between intimate partners is a defining characteristic of modern relationships, and suggest that other social factors may condition degrees of self‐disclosure in marriage. Similarly, we question the extent to which heterosexual conjugal equality is attained: the cultural practices and values of patrilineal family organization, together with material circumstances, continue to influence marital relations in China.
Hot Off the Press: SGEM#196: Gastroparesis—I Feel Like Throwing Up
Authors: Heitz Corey , Morgenstern Justin , Milne William K.
Published: December 2017

This randomized controlled trial compared haloperidol along with conventional therapy to placebo along with conventional therapy for gastroparesis in the emergency department. The primary outcomes of pain and nausea scores at 1 hour were significantly improved in the haloperidol group, but not in the placebo group. In this summary, we discuss a quality assessment of the article and summarized the social media commentary from the blog post/podcast.
IL‐17 in neonatal health and disease
Authors: Lawrence Shelley M. , Ruoss Jessica Lauren , Wynn James L.
Published: December 2017

Over the last few years, scientific interest in the cytokine IL‐17A has intensified as its role in human health and disease has been elucidated. Discovered almost a quarter century ago, IL‐17A is known to have poor biologic activity when acting alone, but attains robust actions when working synergistically with potent mediators of proinflammatory immune responses, such as IL‐6 and IL‐8. IL‐17A is produced by specialized innate immune cells that protect host barriers from the outside world. Like sentries, these innate immune cells can “sound the alarm” through increased production of IL‐17A, causing activation and recruitment of primed neutrophils and monocytes when pathogens escape initial host defenses. In this way, IL‐17A promulgates mechanisms responsible for pathogen death and clearance. However, when IL‐17A pathways are triggered during fetal development, due to chorioamnionitis or in utero inflammatory conditions, IL‐17A can instigate and/or exacerbate fetal inflammatory responses that increase neonatal morbidities and mortality associated with common neonatal conditions such as sepsis, bronchopulmonary dysplasia (BPD), patent ductus arteriosus (PDA), and necrotizing enterocolitis (NEC). This review details the ontogeny of IL‐17A in the fetus and newborn, discusses how derangements in its production can lead to pathology, and describes known and evolving therapies that may attenuate IL‐17A–mediated human conditions.
Competent Enough to Be Heard? Technicians’ Expectations about Local Stakeholders in Participative Processes
Authors: Lima Maria Luisa , Marques Sibila , Branco Carla , Talayero Fernando , Camilo Cristina
Published: December 2017

The involvement of citizens in environmental decision processes is difficult to implement, and little is known about the psychological mediators for the technicians’ resistance. We tested the hypothesis that the subtle denial of human attributes of local stakeholders (dehumanisation) produces negative expectations regarding the engagement of communities in the decision process, which may ultimately legitimise their exclusion. Three studies were conducted testing this hypothesis, all involving professionals with experience in implementing local projects. In the first two correlational studies we showed that a deficit view regarding local communities, a dehumanised idea of those residents and an unfavourable attitude towards their participation were associated. Furthermore, an experimental study was conducted, manipulating the images of the residents in a 2 warmth (high vs low) × 2 competence (high vs low) between‐subjects design. Results showed that participants that read a description of the local community as being incompetent developed expectations of more violent and less conventional forms of protest. Moreover, the expectation of conventional protest procedures was associated with stronger support for their engagement in the process. These studies show the importance of psychosocial mediators from the technicians’ perspective: an imagined competent public is easier to include in the decision process.
DIAGNOSIS OF JOHNE'S DISEASE IN CATTLE USING MESENTERIC LYMPH NODE BIOPSY: ACCURACY IN CLINICAL SUSPECTS
Authors: PEMBERTON D. H.
Published: December 2017

Histopathological examination of biopsies of mesenteric lymph node obtained from the region of the terminal ileum proved to be a very accurate method of diagnosing Johne's disease in the living animal. Identical conclusions were reached in 100 clinical suspects following examination of either mesenteric lymph nodes alone, or a wider range of routine specimens Including ileum, caecum, colon and ileocaecal lymph nodes. A method of obtaining biopsy specimens from mesenteric lymph nodes is described and is recommended when an early definitive diagnosis Is required.
EFFECT OF ADDING SUPERPHOSPHATE TO THE DRINKING WATER ON THE FERTILITY OF DAIRY COWS
Authors: SCHARP D. W.
Published: December 2017

Mean serum inorganic phosphorus concentrations of cows in an infertile dairy herd of 170 cows in the Hunter Valley increased from less than 4.5 mg/100 ml to greater than 5.8 mg/100 ml after defluorinated superphosphate was added to their drinking water at the rate of 2.5 kg/450 1 once from 1976.

The first service pregnancy rate increased from 36.5% to 63.2%, the mean calving to conception interval decreased from 109 days to 85 days and the number of cows culled each year for infertility fell from 15 to 5.

The pasture fed to the milking cows contained on average >17% crude protein, ≥0.39% phosphorus, ≥9 ppm copper and 38–46 ppm manganese according to the dominant species. The Ca/P ratio ranged from 2 to 5.5:1. Of these, only the Ca/P ratio and the manganese concentrations appeared to be abnormal.