bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigating the impact of atmospheric stability on thunderstorm outflow winds and turbulence
Authors: Hawbecker Patrick , Basu Sukanta , Manuel Lance
Published: April 2018

Abstract. Downburst events initialized at various hours during the evening transition
(ET) period are simulated to determine the effects of ambient stability on
the outflow of downburst winds. The simulations are performed using a
pseudo-spectral large eddy simulation model at high resolution to capture
both the large-scale flow and turbulence characteristics of downburst winds.
First, a simulation of the ET is performed to generate realistic initial and
boundary conditions for the subsequent downburst simulations. At each hour in
the ET, an ensemble of downburst simulations is initialized separately from
the ET simulation in which an elevated cooling source within the model domain
generates negatively buoyant air to mimic downburst formation. The simulations show that while the stability regime changes, the ensemble
mean of the peak wind speed remains fairly constant (between
35 and 38 m s−1) and occurs at the lowest model level for each
simulation. However, there is a slight increase in intensity and decrease in
the spread of the maximum outflow winds as stability increases as well as an
increase in the duration over which these strongest winds persist. This appears
to be due to the enhanced maintenance of the ring vortex that results from
the low-level temperature inversion, increased ambient shear, and a lack of
turbulence within the stable cases. Coherent turbulent kinetic energy and
wavelet spectral analysis generally show increased energy in the convective
cases and that energy increases across all scales as the downburst passes.
The Value Relevance of Goodwill: IFRSs and Global Financial Crisis (GFC)
Authors: Li Ng Shir , Taylor Dennis W
Published: April 2018

This study contributes to the issue of accounting for goodwill by examining the impact of changing from the Australian Generally Accepted Accounting Principles (AGAAP) to Australian International Financial Reporting Standards (AIFRS) on goodwill, 3 years (2002 to 2004) before and 3 years (2006 to 2008) after AIFRS adoption. The sample is drawn from top 200 companies listed on the Australian Stock Exchange (ASX). This study applies multiple regressions. The dependent variable is the closing share price 3 months after the balance sheet date. The independent variables consist of earnings per share, book value per share, goodwill in the balance sheet, goodwill in the income statement (goodwill amortisation and goodwill impairment) and goodwill acquisition. The findings indicate that goodwill accounted for in the income statement and balance sheet do not provide increased explanatory power of market value under AIFRS compared to AGAAP. Moreover, the goodwill in the income statement does not show value relevance in year 2007, but became significant in year 2008 during the global financial crisis (GFC). Also, the age of goodwill recorded in the balance sheet does not affect the value relevance of earnings and book value in the post-adoption period. This study contributes new evidence on accounting for goodwill under pre and post-IFRS accounting regimes in Australia. This is also the first study to examine the separate effects of goodwill accounting on earnings and net assets, with special attention given to the period before and during the GFC in capital markets.
Chemical Properties of Inceptisol and Rice Yields Applied with Mixed Source Fertilizer (MSF)
Authors: Syamsiyah Jauhari , Sumarno Sumarno , Suryono Suryono , Sari Winda , Anwar Muhammad
Published: April 2018

One effort that can be done to improve soil fertility and crop yields is fertilization. Fertilization using a mixed source fertilizer (MSF) is an option to overcome the impact of inorganic fertilizer use and organic fertilizer drawbacks. This study aims to evaluate the effects of MSF application on the chemical properties of Inceptisol and rice yields. A field experiment was conducted using a completely randomized block design (RCBD) with two factors and three replications. The first factor was the three formulas of MSF (F1, F2, F3) and the second factor was MSF doses (0, 2.5, 5, 7.5, 10 Mg ha-1). The results show that there is no significant difference on the total soil N, available soil P, plant height and total number of tillers of rice plants applied with the three MSF formulas. The increased MSF doses applied significantly improve the soil chemical properties of Inceptisol and rice yields. The application of 10 Mg ha-1 MSF increases total- N (57.89%), available-P (29.13%), exchangeable-Ca and -Mg (117% and 250%, respectively), plant height (40%) and total number of tillers (43.2%) in comparison to those without MSF application. There are interaction effects between formulas and doses of MSF on the amount of exchangeable-K, organic-C content, and CEC of the soil and rice yields. The application of 10 Mg ha-1 MSF F3 results in better effects on the amount of exchangeable-K, organic-C content and CEC of the soil, and number of productive tillers and rice yields than the application of other MSF formulas. The MSF can be used as an alternatif fertilizer that can improve Inceptisol productivity.
Phosphorus (P) Adsorption Behavior and Harvested P by the Sugarcane (Saccharum officinarum L.) Affected by Inorganic and Organic Fertilizer Applications on an Ultisol
Authors: Lumbanraja Jamalam , Satgada Catur Putra , Sarno Sarno , Utomo Muhajir , Hasibuan Rosma , Dermiyati Dermiyati , Triyono Sugeng
Published: April 2018

The field and laboratory experimental studies were conducted to determine the phosphorus (P) adsorption behavior employing Langmuir Method and yield of sugarcane as affected by compost and inorganic fertilizer applications, and to determine the correlations between the Langmuir parameters and the availability of P in soil or harvested P by the sugarcane. Both field and lab experiments were arranged in a randomized block design, consisting of five treatments (A= 100% NPK, B=100% compost, C=100% NPK + 50% compost, D= 50% NPK + 100%, compost, and E= no fertilizer).  Each treatment was replicated three times. Field and laboratory studies were carried out in the sugarcane field and in the Laboratory of Soil Science, the University of Lampung for Langmuir P studies, respectively. The results showed that the applications of 100% NPK plus 50% organic fertilizer, and 100% NPK resulted in the highest amount of available-P in the soil, the lowest maximum adsorption of P (Xm) and the lowest relative bonding energy of P (km); as well as the highest effect on the increase of sugarcane production. On the other hand, the treatments of no fertilizer and the 100% organic fertilizer resulted in the highest maximum adsorption of P (Xm) and the lowest sugar production. There were very significant negative correlations between the maximum adsorption of P (Xm) and soil P, harvested P by the sugarcane and stem biomass; while similar trend but no significant correlations between the relative bonding energy of P (km) and soil P, harvested P, leaf biomass and stem biomass were detected.
Management of Articular Cartilage Defects in the Glenohumeral Joint
Authors: Seidl Adam J. , Kraeutler Matthew J.
Published: April 2018

Articular cartilage defects are not often encountered in the glenohumeral joint. These lesions are typically found in patients with shoulder trauma, recurrent instability, or previous surgical treatment. Diagnosis can be difficult; these defects are often found incidentally during arthroscopic or open surgical management of other pathology. Initial management of isolated glenohumeral chondral defects is nonsurgical and includes physical therapy and/or corticosteroid injections. If nonsurgical treatment is unsuccessful, patients may undergo surgery. Because these lesions occur infrequently, few studies have documented surgical techniques and outcomes. Surgical strategies include arthroscopic débridement, microfracture surgery, osteochondral autograft or allograft transplantation, autologous chondrocyte implantation, and particulated juvenile allograft cartilage implantation.
Mixed Treatment Comparisons for Nonsurgical Treatment of Knee Osteoarthritis: A Network Meta-analysis
Authors: Jevsevar David S. , Shores Peter B. , Mullen Kyle , Schulte Danielle M. , Brown Gregory A. , Cummins Deborah S.
Published: April 2018

Introduction:

Knee osteoarthritis (KOA) is a significant health problem with lifetime risk of development estimated to be 45%. Effective nonsurgical treatments are needed for the management of symptoms.

Methods:

We designed a network meta-analysis to determine clinically relevant effectiveness of nonsteroidal anti-inflammatory drugs, acetaminophen, intra-articular (IA) corticosteroids, IA platelet-rich plasma, and IA hyaluronic acid compared with each other as well as with oral and IA placebos. We used PubMed, EMBASE, and Cochrane Central Register of Controlled Trials to perform a systematic search of KOA treatments with no date limits and last search on October 7, 2015. Article inclusion criteria considered the following: target population, randomized controlled study design, English language, human subjects, treatments and outcomes of interest, ≥30 patients per group, and consistent follow-up. Using the best available evidence, two abstractors independently extracted pain and function data at or near the most common follow-up time.

Results:

For pain, all active treatments showed significance over oral placebo, with IA corticosteroids having the largest magnitude of effect and significant difference only over IA placebo. For function, no IA treatments showed significance compared with either placebo, and naproxen was the only treatment showing clinical significance compared with oral placebo. Cumulative probabilities showed naproxen to be the most effective individual treatment, and when combined with IA corticosteroids, it is the most probable to improve pain and function.

Discussion:

Naproxen ranked most effective among conservative treatments of KOA and should be considered when treating pain and function because of its relative safety and low cost. The best available evidence was analyzed, but there were instances of inconsistency in the design and duration among articles, potentially affecting uniform data inclusion.
Surgical Management of Osteoarthritis of the Knee
Authors: Quinn Robert H. , Murray Jayson N. , Pezold Ryan , Sevarino Kaitlyn S.
Published: April 2018

The American Academy of Orthopaedic Surgeons has developed Appropriate Use Criteria (AUC) for Surgical Management of Osteoarthritis of the Knee. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The Surgical Management of Osteoarthritis of the Knee AUC clinical patient scenarios were derived from indications of patients under consideration for surgical treatment of osteoarthritis of the knee as well as from current evidence-based clinical practice guidelines and supporting literature to identify the appropriateness of the three treatments. The 864 patient scenarios and 3 treatments were developed by the writing panel, a group of clinicians who are specialists in this AUC topic. Next, a separate, multidisciplinary, voting panel (made up of specialists and nonspecialists) rated the appropriateness of treatment of each patient scenario using a 9-point scale to designate a treatment as Appropriate (median rating, 7 to 9), May Be Appropriate (median rating, 4 to 6), or Rarely Appropriate (median rating, 1 to 3).
A Reclaimed Wastewater Allocation Optimization Model for Agricultural Irrigation
Authors: Aljanabi Ahmed A. , Mays Larry W. , Fox Peter
Published: April 2018

Climate change, pollution, civil conflicts, political instability, and a high rate of population growth all contribute to water shortages in Iraq which are predicted to increase in the future. Due to the importance of agriculture in Iraq which forms more than 75 percent of total demand, a sustainable agricultural water allocation scheme is necessary to find practical and applicable water conservation measures that helps mitigate the impact of potential droughts and water shortages. An agricultural irrigation reclaimed wastewater allocation optimization model was developed to optimally allocate crops and reclaimed wastewater (RW) on cultivated farmlands in order to maximize the net benefit. The optimization model is formulated using mixed-integer nonlinear programming (MINLP) solved by the branch and reduce optimization navigator (BARON) in the general algebraic mathematical solver (GAMS). The model maximizes the net farm income to determine the cultivated crop assigned to each farmland using three types of reclaimed wastewater (RW); tertiary treated wastewater; secondary treated wastewater; and primary treated wastewater. Constraints in the optimization model include: (1) reclaimed wastewater availability constraints and (2) irrigated farmlands constraints. The optimization model has been applied to 7045 hectares of farms located in the Alrustumia district to the south east of Baghdad, Iraq with 5.5 × 105 m3/d of treated wastewater. The use of tertiary treated wastewater provided the greatest net benefit under most scenarios evaluated while primary effluent provided the lowest net benefit as only low value crops could be cultivated.
Minorities’ Heritage Language Planning and National Multilingual Capacity Building
Authors: Yan Li
Published: April 2018

As an important part of a nation’s soft power, national multilingual capacity refers to a nation’s ability to use a variety of languages acquired in dealing with domestic and international affairs in the development of a nation. The nation-security-oriented language planning in the post-9/11 America is closely related with the teaching, using and developing of the minorities’ heritage languages, which has to some extent facilitated the America’s national multilingual capacity. Taking National Security Language Initiative proposed by the American federal government as an example, this paper suggests that minorities’ heritage language planning be an endogenous shortcut to build the national multilingual capacity. Furthermore, the relationship between minorities’ heritage language planning and national multilingual capacity building is established by matching the five key parameters in heritage language planning with the five components of national multilingual capacity respectively, i.e., exploring the correlations between languages planning, talent planning, education planning, industry planning, policy planning and national multilingual resources capacity, individual’s multilingual capacity, national multilingual education capacity, national multilingual service capacity and national multilingual management capacity in detail by using an analytical method.
The Pragmatic Strategies of Concealment in Bush’s Speech of Announcing War Against Iraq in 2003
Authors: Aziz Rana Naji , Al-Duleimi Abbas Deygan Darweesh
Published: April 2018

Concealment is the act of intentionally withholding information for some purposes. It is the mode of using language to hide information and intentions. The current study aims at finding out the pragmatic aspects of concealment. In accordance with the aim of the paper, it is hypothesized that the phenomena of concealment basically targets achieving persuasion and self- defense. The most important findings yielded by the analysis reveal that the main pragmatic aspects utilized in issuing concealment are breaching Grice's maxims, pragma-rhetorical devices, deictic expressions and positive politeness strategies.
Speech Acts in the Facebook Status Updates Posted by an Apostate
Authors: Mohamad Azweed , Rashid Radzuwan Ab , Yunus Kamariah , Rahman Shireena Basree Abdul , Darus Saadiyah , Musa Razali , Teh Kamarul Shukri Mat
Published: April 2018

This paper discusses the speech acts in Facebook Status Updates posted by an apostate of Islam. The Facebook Timeline was observed for a duration of two years (January 2015 to December 2016). More than 4000 postings were made in the data collection period. However, only 648 postings are related to apostasy. The data were classified according to the types of speech acts. Expressive speech act is the most frequent speech act (33%, n=215), followed by the directive (27%, n=177), assertive (22%, n=141), and commissive (18%, n=115), respectively. Based on the speech acts used, it is discernible that the apostate attempts to engage other Facebook users and persuade them into accepting her ideology while gaining their support. This paper is novel in the sense that it puts forth the social actions of an apostate which is very scarce in literature. It is also methodologically innovative as it uses social media postings as a tool to explore the apostate’s social actions in an online space.
Issues of Knowledge and Organizational Creativity: A Phenomenological Approach
Authors: Bombała Bronisław
Published: April 2018

In contemporary science, where “creativity” is one of the key issues, researchers have been talking more and more often about “creative economy”. The impact of creativity on the development of an enterprise is increasingly often taken into consideration by both entrepreneurs and managers.  The purpose of this paper is to analyze organizational creativity by the use of phenomenological approach. Phenomenological approach allows for a thorough exploration of factors that are important both for the development of a human and sustainable organizational development.
Polityka społeczna – wybrane zagadnienia.
Skrypt dla studentów
Authors: Podkowińska Monika
Published: April 2018

-
Non‑Financial Methods of Motivation at Work
– The Self‑Determination Theory Perspective
Authors: Szulawski Michał
Published: April 2018

The article describes the implications of the self‑determination theory in non‑
‑financial methods of motivating workers in companies. The self‑determination
theory and the related research suggest that in order to develop intrinsic motivation and integrated forms of extrinsic motivation at work, the three
universal needs of autonomy, competence and relatedness have to be fulfilled. The
article gives examples of work organization and work situations where the needs
are not satisfied, and presents the ways of communication between the managers
and coworkers and work organization, which support the development of the
desired forms of motivation through the three universal needs.
Working Conditions in the Context of Building Employer Image
Authors: Gableta Małgorzata , Cierniak‑Emerych Anna , Pietroń‑Pyszczek Agata
Published: April 2018

Differentiation of job expectations maintained by persons employed in
business entities is also evident with regard to working conditions.  Proper
realisation of these expectations does have a notable impact upon employer image
– an attribute of growing significance in the modern Polish labour market. The
focus of this paper is placed on the process of building the employer image, as
expressed in the employer’s observance of employee interests and other activities
designed to increase their job satisfaction. The research is based, predominantly,
on the results of empirical studies on observance of employee interests in business
setting. The findings seem to corroborate the view that an employer’s approach
to the formulation of working conditions is largely influenced by employees’
traits and the attributes of the organisational culture, which both have a notable
impact upon the differentiation of employer images as viewed from the employer’s
standpoint.
Diversity Management in the Organisational Identity Context –
Empirical Evidence of Research on Organisational Culture
of Managerial and Non‑Managerial Staff
Authors: Gadomska‑Lila Katarzyna
Published: April 2018

The article discusses the problem of diversity management in the organisational
identity context, referring to the organisational position and its place in the
organisational hierarchy. It presents differences between the managerial and
non-managerial staff with respect to perceiving organisational culture, especially
its crucial element – values. It also presents the core of diversity management in
the organisational identity context. The main thesis is presented by describing
empirical evidence of research conducted in a subsidiary of an Asian corporation.
Self‑Engaging Organisation in Polish Reality
Authors: Juchnowicz Marta
Published: April 2018

The concept of self‑engaging organisation should be the basis of a contemporary personnel function. Its assumptions determine the human capital management of an organisation which is based on a positive organisational culture and atmosphere. The concept requires the application of a  specific system and tools.  Employee empowerment and relevant interpersonal relationships within the organisation are essential requirements for its implementation. The purpose of empirical research was to assess these conditions in Polish companies, considering the diversity of human capital, i.e. age, education level, seniority and professional rank. The analysis was based on the results of a survey conducted on a sample of 1.002 executive employees participating in the implementation of separate manufacturing processes. The results of the research indicate numerous limitations to the broad applicability of the concept of a self‑engaging organisation in Polish reality. It is situationally determined by the diversity of human capital, especially in terms of age and employment form. The assumptions of a  self‑engaging organisation, however, are the necessary objective in the perspective of increasing innovation of Polish companies, i.e. the need to unleash creativity and continuous staff development. Thus, they set the direction of changes in the psychological contract and human capital management tools.
Variety of Psychological Contracts and Their Conditions
Authors: Ludwiczyński Antoni , Szmidt Czesław
Published: April 2018

The problems of psychological contracts have been investigated by world scientific circles for years now. In Poland this concept is relatively unknown. The goal of this study is to present selected elements from the theories discussing the genesis, the essence, main types and dynamics of such contracts. It also presents the results of empirical tests concerning an influence of four selected features characterizing researched employees (sex, age, position and form of employment) upon the contents of their psychological contracts. The study proves the existence of considerable differences observed in the measured dimensions. This fact should call upon the employers for taking actively into consideration this particular variety when managing the people in organisations.
Professionalism in Management and Performance in Sports Organizations
Authors: Schmidt Joanna
Published: April 2018

The aim of this article is to present and analyse the importance of professional management in sports organizations in the context of the results achieved by these organizations. The research presented in this article was based on Fribourg Management Model for Non‑Profit Organizations. The research was conducted among a randomly selected, representative sample of Polish sports organizations, from October to December 2015. A total of 381 organizations were surveyed. The results show that the key role in the results achieved by sports organizations in Poland is played primarily by the resources acquired, especially by the involved board members, the sponsors and the ability to raise financial resources. Professionalization of management is also important for the results achieved by the organization, both in general terms and when looking closer at its individual aspects.
Семантичні інновації в структурі українського художнього дискурсу
Authors: Kononenko Witalij
Published: April 2018

The article deals with innovative changes in the lexical semantics system due to social
and intralingual factors. The emergence of new nominations is accompanied by an expansion
of their semantic structure. Searching for new linguo-aesthetic means modern Ukrainian
writers enrich the language resources with the new semantic content as well as diversify
associative and fi gurative system.
Алюзійні паралелі в модерних українських текстах: семантичні
характеристики міфологічних та біблійних імен
Authors: Petryna Chrystyna
Published: April 2018

The article deals with the issue of the update of allusive proper names in the modern
fi ctional discourse. The functional and semantic features of allusive proper names are
determined. Proper names are examined as a polyvalent component of the image formation,
and as the means of decoding the sense structure of a text. The analysis of a semantic
transformation process of the names and their stylistic value is performed.
Історико-літературні концепції Леоніда Білецького
Authors: Chorob Stepan
Published: April 2018

This article investigates critical literary and methodological concepts of the Ukrainian
letters history suggested and developed by the Ukrainian diaspora scholar Leonid Bilets’kyi
(1882-1955). The author of this article aims not only at showing their novelty in the 20-50s
of the previous century, but also at proving that their topicality places them in the contemporary
development of the national science regarding the Ukrainian literature history.
Література польського позитивізму та натуралізму в ідейно-естетичній
рецепції Івана Франка
Authors: Holod Roman
Published: April 2018

The article is dedicated to Franko’s scientifi c reception of Polish positivism and naturalism
literature as well as historical and theoretic interpretation of Polish writers achievements
of the above mentioned stream in the context of the international, Polish and Ukrainian
literature processes.
The value of popularization activities of Ivan Franko concerning the achievements of
French naturalism in Polish literature is determined as well as the value of enriching
Ukrainian literature with the achievements of Polish naturalists. The peculiarities of national
variants of naturalism are as well observed in comparison with an international invariant.
Геній i втраченa батьківщинa
Authors: Sobol Walentyna
Published: April 2018

This ar ticle aims at presenting the fate of two brilliant musicians and composers –
Alexander Koshitsa (1875–1944) and Sergei Rachmaninov (1873–1943). The author of this
article traces historical patterns of the tragedy of these genii who were forced to emigrate,
could not return to their homeland but made it famous through their phenomenal talent
shown in the world. The article analyzes materials presented in the archives of Alexander
and Tatiana Koshitziv in Winnipeg, as well as the latest scientifi c research. The author concludes that Alexander Koshits and his choir had a mission of propagating Ukrainian songs and spiritual music in Europe and the USA.
Test of fatigue crack growth in welded specimens subjected to bending
Authors: Lewandowski Janusz , Rozumek Dariusz , Hepner Maria
Published: April 2018

The paper presents the test results on the fatigue crack growth under cyclic bending specimens at constant moment amplitude made of S355 steel with fillet welds. Plane specimens with stress concentrators in form of the external two-sided blunt notches were tested. The tests were performed under constant value of the stress ratio R = –1 without and after heat treatment. The article also presents the test results of the microstructure of welded joints taking into account changes in the material after heat treatment and the impact of these changes on the fatigue life of specimens.
Keywords: welded joints, fatigue cracks length, number of cycle, bending, microstructure
Association Between Thiopurine S-Methyltransferase (TPMT) Genetic Variants and Infection in Pediatric Heart Transplant Recipients Treated With Azathioprine: A Multi-Institutional Analysis
Authors: Green Dionna J. , Duong Son Q. , Burckart Gilbert J. , Sissung Tristan , Price Douglas K. , Figg William D. , Brooks Maria M. , Chinnock Richard , Canter Charles , Addonizio Linda , Bernstein Daniel , Naftel David C. , Zeevi Adriana , Kirklin James K. , Webber Steven A. , Feingold Brian
Published: April 2018

OBJECTIVES Bone marrow suppression is a common adverse effect of the immunosuppressive drug azathioprine. Polymorphisms in the gene encoding thiopurine S-methyltransferase (TPMT) can alter the metabolism of azathioprine, resulting in marrow toxicity and life-threatening infection. In a multicenter cohort of pediatric heart transplant (HT) recipients, we determined the frequency of TPMT genetic variation and assessed whether azathioprine-treated recipients with TPMT variants were at increased risk of infection.

METHODS We genotyped TPMT in 264 pediatric HT recipients for the presence of the TPMT*2, TPMT*3A, and TPMT*3C variant alleles. Data on infection episodes and azathioprine use were collected as part of each patient's participation in the Pediatric Heart Transplant Study. We performed unadjusted Kaplan-Meier analyses comparing infection outcomes between groups.

RESULTS TPMT variants were identified in 26 pediatric HT recipients (10%): *3A (n = 17), *3C (n = 8), and *2 (n = 1). Among those with a variant allele, *3C was most prevalent in black patients (4 of 5) and *3A most prevalent among white and Hispanic patients (16 of 20). Among 175 recipients (66%) who received azathioprine as part of the initial immunosuppressive regimen, we found no difference in the number of infections at 1 year after HT (0.7 ± 1.3; range, 0–6 versus 0.5 ± 0.9; range, 0–3; p = 0.60) or in freedom from infection and bacterial infection between non-variant and variant carriers. There was 1 infection-related death in each group.

CONCLUSIONS In this multicenter cohort of pediatric HT recipients, the prevalence of TPMT variants was similar across racial/ethnic groups to what has been previously reported in non-pediatric HT populations. We found no association between variant alleles and infection in the first year after HT. Because clinically detected cytopenia could have prompted dose adjustment or cessation, we recommend future studies assess the relationship of genotype to leukopenia/neutropenia in the pediatric transplantation population.
Use of Arginine Hydrochloride in the Treatment of Metabolic Alkalosis or Hypochloremia in Pediatric Patients
Authors: Sierra Caroline M. , Hernandez Elvin A. , Parbuoni Kristine A.
Published: April 2018

OBJECTIVES Dosing of arginine for treatment of hypochloremia or metabolic alkalosis is laborious and has inherent variability in dose selection. The primary objective of this study was to determine the efficacy of arginine in the treatment of metabolic alkalosis and hypochloremia. Secondary objectives were to determine an optimal dose, route, and frequency for arginine administration in the treatment of these conditions.

METHODS This single center, retrospective, descriptive study was conducted in children who received arginine for treatment of hypochloremia or metabolic alkalosis. Treatment success was assessed by measuring serum chloride and bicarbonate concentrations after arginine administration.

RESULTS Of the 464 orders analyzed, 177 met inclusion criteria in 82 unique patients. Fifty percent (n = 81) of arginine administrations used to manage hypochloremia saw normalization of abnormal chloride levels, and 83% (n = 62) of arginine administrations used to treat metabolic alkalosis saw normalization of abnormal bicarbonate levels. Patients who received arginine to resolve hypochloremia were statistically significantly more likely to have their hypochloremia resolve if they used alternative dosing methods compared to established dosing methods (76 vs. 5, p = 0.001). However, this relationship was not seen for patients with metabolic alkalosis (11 vs. 51, p = 1.000). The median percentage of calculated daily dose of arginine needed for resolution of hypochloremia was 59% and was 35% for metabolic alkalosis.

CONCLUSIONS Arginine is effective to improve metabolic alkalosis and hypochloremia. Established dosing methods are not more effective than other methods in resolving metabolic alkalosis or hypochloremia. Further prospective studies are warranted to validate these results.
Effects of Methadone on Corrected Q-T Interval Prolongation in Critically Ill Children
Authors: Heath Travis S. , Greenberg Rachel G. , Hupp Susan R. , Turner David A. , Hornik Christoph P. , Zimmerman Kanecia O.
Published: April 2018

OBJECTIVES This study aimed to determine the association between methadone use and corrected Q-T interval (QTc) prolongation in critically ill children

METHODS A retrospective cohort study of critically ill children receiving methadone at a tertiary care pediatric hospital was conducted. Patients younger than 19 years who had been admitted to the intensive care unit between January 1, 2009, and June 21, 2013, who had received methadone while inpatients, and who had had electrocardiograms (ECGs) performed within 30 days before and after methadone initiation were included. The primary outcome was the net change in QTc interval between baseline and postmethadone ECGs. Secondary outcomes included percent change in QTc interval and the proportion of patients whose QTc intervals changed from normal to prolonged following methadone initiation. We also evaluated potential predictors of QTc interval prolongation, including age, sex, admission diagnosis category, exposure to other QTc-prolonging medications, presence of congenital heart disease or known arrhythmias, and methadone daily dose and route of administration.

RESULTS Sixty-four patients met the inclusion criteria. The median (25th, 75th percentiles) change in QTc interval following methadone initiation was −8 msec (−34, 13.5 msec; p = 0.19). Five patients (8%) had a baseline normal QTc interval that became prolonged after methadone initiation. We identified no statistically significant predictors of QTc prolongation after methadone initiation.

CONCLUSIONS In this dedicated pediatric safety study, methadone initiation did not result in prolongation of the QTc interval. Although these findings suggest methadone initiation may not have a substantial effect of QTc prolongation in critically ill children, a controlled, prospective evaluation in this population remains warranted.
Evaluation of Timing and Dosing of Caffeine Citrate in Preterm Neonates for the Prevention of Bronchopulmonary Dysplasia
Authors: Shenk Eleni E. , Bondi Deborah S. , Pellerite Matthew M. , Sriram Sudhir
Published: April 2018

OBJECTIVE The aim of this study was to evaluate the timing and dosing of caffeine therapy in relation to the development of bronchopulmonary dysplasia (BPD).

METHODS This was a single-center, retrospective cohort study comparing early (days of life 0–2) to late (day of life 3 or greater) caffeine initiation in extremely low birth weight neonates, with a secondary analysis of large (10 mg/kg/day) to small dose (5 mg/kg/day) caffeine.

RESULTS There were 138 patients in the primary timing analysis. The early caffeine group had a lower incidence and reduced odds of the composite outcome of BPD or all-cause mortality, compared with the late caffeine group (64% vs. 88%, respectively; adjusted p < 0.05; adjusted OR 0.36 [95% CI 0.13–0.98]). No statistically significant difference was found between dosing groups (p = 0.29) in the primary outcome; however, there was a lower rate of patent ductus arteriosus requiring treatment (p = 0.05) and decreased likelihood of discharging home on oxygen (p = 0.02) in the large-dose group compared with the small-dose group.

CONCLUSIONS Early caffeine initiation significantly decreased the incidence of BPD or all-cause mortality in extremely low birth weight neonates. Patients receiving large-dose caffeine had improved secondary outcomes, although no difference in BPD was noted. Further studies are needed to determine the optimal dosing of caffeine.
Safety of Extended Interval Tobramycin in Cystic Fibrosis Patients Less Than 6 Years Old
Authors: Arends Alexandria , Pettit Rebecca
Published: April 2018

OBJECTIVES The primary objective of this study was to assess the nephrotoxicity and ototoxicity risks of extended interval tobramycin in cystic fibrosis (CF) patients who are <6 years old. A secondary objective included analyzing pharmacokinetic parameters in this age group.

METHODS A retrospective chart review was conducted of patients with CF who were <6 years old, admitted for an acute pulmonary exacerbation from January 1, 2003, to January 1, 2014, and treated with intravenous tobramycin.

RESULTS The median baseline serum creatinine (SCr) was 0.26 mg/dL among the 31 patients included in the study. Of the 20 patients who experienced increases in SCr, the absolute median increase was 0.065 mg/dL (0.033–0.1 mg/dL). Abnormal audiograms seen in 4 patients are attributable to middle ear effusion present on exam. The median dose of tobramycin was 11.7 mg/kg (11.3–12 mg/kg), the elimination constant was 0.4 hr−1(0.32–0.47 hr−1), half-life was 1.7 hr (1.5–2.1 hr), volume of distribution was 0.37 L/kg (0.31–0.47 L/kg), and median peaks and troughs fell within ranges of 20 to 30 mg/L (20.9–32.7 mg/L) and <0.01 mg/L, respectively.

CONCLUSIONS Extended interval dosing tobramycin is safe in CF patients who are <6 years old. There was no drug-related ototoxicity, and some nephrotoxicity was observed. When dosed at 12 mg/kg, similar pharmacokinetics were seen among all age groups, and concentrations were within the desired range.
A Unique Preparation and Delivery Method for Acitretin for Neonatal Harlequin Ichthyosis
Authors: Damodaran Kriti , Bhutada Alok , Rastogi Shantanu
Published: April 2018

Harlequin ichthyosis is a rare form of congenital ichthyosis with a distinct phenotypic appearance. We describe a case of a newborn baby with harlequin ichthyosis who was treated with an oral formulation of acitretin. The treatment resulted in a satisfactory improvement in the skin condition of the patient. The tolerance to the drug was good with no side effects in the patient. The aim of this case report is to highlight an extemporaneous preparation of acitretin from the commonly available capsule form, which is effective for use in neonates with harlequin ichthyosis. It also highlights the risk of exposure to health care providers to acitretin.
Associação do perfil de usuários frequentes com as características de utilização de um serviço de emergência
Authors: Frango Bianca Campos Teixeira Moniz , Batista Ruth Ester Assayag , Campanharo Cássia Regina Vancini , Okuno Meiry Fernanda Pinto , Lopes Maria Carolina Barbosa Teixeira
Published: April 2018

Objetivo: caracterizar el perfil y la atención de usuarios frecuentes de un servicio de emergencias y asociar sus características sociodemográficas y clínicas con las del servicio. Método: se trata de un estudio retrospectivo y analítico llevado a cabo en el servicio de urgencias de un hospital universitario de la ciudad de San Pablo. Se incluyeron los expedientes de los pacientes que se dirigieron al servicio de emergencias al menos cuatro veces durante doce meses, entre septiembre de 2013 y agosto de 2014. Resultados: Incluidos 480 expedientes (2.808 consultas). Hubo un promedio de 5,85 consultas y la muestra varió de 4 a 28 consultas. Después de la clasificación de riesgo 44,4% de los pacientes fueron clasificados como verde, 13,1% como naranja y 8,1% rojo y la mayoría de estas consultas ocurrieron los lunes. El 69.1% de los pacientes tuvo alta hospitalaria. Los datos indican el carácter no urgente de las consultas. Conclusión: los servicios de emergencias deben elaborar estrategias en conjunto con las unidades básicas de salud para facilitar la gestión de los casos con la finalidad de satisfacer plenamente las necesidades de los usuarios con buena atención, implementando un sistema de flujo de referencia y contra-referencia de los pacientes.
Associação das características sociodemográficas e clínicas com a autoestima das pessoas estomizadas
Authors: Melo Marjorie Dantas Medeiros , Silva Isabelle Pereira da , Oliveira Dannyele Munnyck Silva de , Medeiros Aline Stefhanie de Araújo , Souza Amanda Jéssica Gomes de , Costa Isabelle Katherinne Fernandes
Published: April 2018

En el presente estudio se busca verificar la asociación de las características sociodemográficas y clínicas con la autoestima de las personas ostomizadas. Se trata de un estudio transversal, exploratorio y analítico con muestreo por conveniencia desarrollado en el Centro de Rehabilitación y Habilitaçión de Rio Grande do Norte, en el municipio de Natal. Para la recogida de datos se utilizaron dos instrumentos: uno adaptado en base al desarrollado por Silva (2013) con cuestiones referentes a aspectos sociodemográficos y clínicos; y la Escala de Autoestima de Rosenberg / UNIFESP-EPM (RSES), con contenido relativo a los sentimientos de respeto y aceptación de sí mismo. Con relación a las características sociodemográficas, predominaron el sexo masculino (62,2%), con enseñanza primaria (71,1%); y, entre los aspectos clínicos, personas sin comorbilidades (54,4%) y pacientes con colostomía (80,0%). En cuanto a la asociación de la autoestima con características sociodemográficas y clínicas, sólo se obtuvo significancia estadística con escolaridad (p = 0,007), aunque otros aspectos presentaron resultados cercanos, tales como ingreso (p = 0,091) y presencia de comorbilidades (p = 0,197). Por lo tanto, se constató que sólo hubo asociación estadística significante de autoestima con escolaridad, aunque las otras variables también están relacionadas a la autoestima. Los profesionales de la salud deben considerar estos aspectos para la atención al ostomizado, con énfasis en la escolaridad, porque influye en el entendimiento sobre la condición de la salud, y el acceso a los servicios disponibles, proporcionando cuidados y orientaciones para conseguir una autoestima satisfactoria.
A humanização em unidade de terapia intensiva neonatal sob a ótica dos pais
Authors: Noda Larissa Midori , Alves Maria Virgínia Martins Faria Faddul , Gonçalves Mariana Faria , Silva Fernanda Sotrate da , Fusco Suzimar de Fátima Benato , Avila Marla Andréia Garcia de
Published: April 2018

El presente estudio tuvo como objeto comprender los significados de humanización de la atención desde la perspectiva de los padres de recién nacidos ingresados en una Unidad de Cuidados Intensivos Neonatales. Se trata de una investigación exploratoria descriptiva de naturaleza cualitativa realizada en 2014, a través de entrevistas semiestructuradas a los padres de niños recién nacidos ingresados en la Unidad de Cuidados Intensivos Neonatales de un hospital del interior del estado de San Pablo. Los datos fueron sometidos a análisis de contenido. Se llevaron a cabo 14 entrevistas y del análisis de los informes surgieron tres categorías: "atención acogedora a los recién nacidos", “relación con los padres” y “comportamiento de los profesionales”. El cuidado humanizado se vislumbra como la manera cómo se cuida y por la relación con los profesionales de salud.
Sobrecarga em acompanhantes de pacientes psiquiátricos internados em hospital geral
Authors: Rezende Nathália Freitas Fernandes , Moll Marciana Fernandes , Ventura Carla Aparecida Arena , Pires Fabiana Cristina
Published: April 2018

El objeto del presente estudio fue identificar los indicadores de sobrecarga mencionados por los cuidadores de pacientes psiquiátricos internados en un hospital general del interior del estado de Minas Gerais. Se trata de un estudio cualitativo y descriptivo realizado durante tres meses de 2016, con una muestra por conveniencia de 10 familiares de pacientes. Se utilizó la entrevista semi-estructurada para la recogida de datos y el análisis de contenido como método de investigación. Se observó que el cuidar de un familiar con trastorno mental puede causar daños físicos y emocionales, además de generar alteraciones en la rutina de los cuidados durante el período de internación. Entre las perspectivas que generan dichos cuidados se destacan el anhelo de que el paciente mejore o que se cure del trastorno mental, sentimientos de culpa y deseos de compartir las responsabilidades de atender al familiar internado. Los datos obtenidos indican la presencia de sobrecarga y que la familia necesita intervenciones que contribuyan a minimizar su sufrimiento.
Motivos atribuídos por usuários à procura de tratamento em um centro de atenção psicossocial álcool e drogas
Authors: Siqueira Daiana Foggiato de , Terra Marlene Gomes , Soccol Keity Laís Siepmman , Canabarro Janaina Lunard , Moreschi Claudete
Published: April 2018

Objetivo: comprender los motivos atribuidos por usuarios de sustancias psicoactivas a la búsqueda de tratamiento en un Centro de Atención Psicosocial Alcohol y Drogas. Método: estudio fenomenológico a la luz de la fenomenología social de Alfred Schütz, realizado en un CAPS ad de la región centro-oeste del estado de Rio Grande do Sul, Brasil. Once usuarios de sustancias psicoactivas que realizaban tratamiento en ese servicio participaron en las entrevistas entre marzo y junio de 2014. Resultados: se entendió el por qué y para qué de los usuarios que buscan tratamiento. Con relación a los motivos por qué , hay dos categorías: por la salud y por las relaciones sociales. En cuanto a los motivos para qué de aquéllos que miran hacia adelante, a lo que esperan lograr, se hallaron dos categorías concretas: reconstrucción de sus relaciones familiares y la expectativa de reinserción social. Conclusión: esta investigación permitió comprender los motivos atribuidos por usuarios de sustancias psicoactivas al buscar tratamiento en un CAPS ad, no sólo en el contexto individual de la acción, sino en un mundo de relaciones con los demás, en el cual existe un significado intersubjetivo, contextualizado en el mundo social.
Strength Training to Improve Gait in People with Multiple Sclerosis
Authors: Mañago Mark M. , Glick Stephanie , Hebert Jeffrey R. , Coote Susan , Schenkman Margaret
Published: April 2018

Background:

There are mixed reports on the effectiveness of strength training to improve gait performance in people with multiple sclerosis (MS), yet the reasons for these inconsistent results are not clear. Therefore, a critical review was conducted to explore dosage, frequency, mode, position, and muscle targets of studies that have included strength training in people with MS.

Methods:

An electronic search was conducted through July 2017. Randomized controlled trials involving people with MS were included that implemented strength training with or without other interventions and assessed 1) strength in the lower extremities and/or trunk and 2) gait speed and/or endurance. Strength and gait results were extracted, along with exercise frequency, intensity, duration, mode, position, and muscle targets.

Results:

Thirteen trials met the inclusion criteria; nine used dosing consistent with recommended guidelines. Overall, six studies reported significant between-group strength improvements, and four reported within-group changes. Four studies reported significant between-group gait improvements for gait speed and/or endurance, and two reported within-group changes. Most exercises were performed on exercise machines while sitting, supine, or prone. The most common intervention target was knee extension.

Conclusions:

Studies generally improved strength, yet only two studies reported potentially meaningful between-group changes in gait. Future strength intervention studies designed to improve gait might consider dosing beyond that of the minimum intensity to improve strength and explore muscles targets, positions, and modes that are task-specific to walking.