bluuebunny/crossref_metadata_2025 huggingface dataset:
Vascular injury
Authors: Raza Zahid
Published: August 2016

The incidence and type of vascular injury differs in different geographical locations. Blunt and iatrogenic injuries are the two most common causes of vascular trauma in most European countries including the United Kingdom. However, in the United States, most vascular injuries are the result of stab or gunshot wounds. Vascular injuries are associated with high morbidity and mortality. They require a clear concept of the management and timely intervention in order to avoid early and late complications. The management of patients with vascular trauma is complex in view of the diagnostic difficulties and planning the appropriate management strategy. The choice of treatment depends upon the nature and extent of the underlying injury and may require expertise ranging from interventional vascular radiology to specialist vascular surgery.
Principles of child protection and safeguarding
Authors: Pike Alison , Dixit Kalpesh , Smith Hilary
Published: August 2016

Child protection is everybody’s responsibility. All children should be able to grow up in circumstances where they are safe and supported, free from abuse and neglect, so they can achieve their full potential. Doctors play a crucial role in protecting children; early identification of risk can ensure provision of care and support, allowing children to stay healthy, happy, and safe. All doctors must have competencies to recognize abuse and neglect, clearly understand their responsibilities and be able to take effective action appropriate to their role. This chapter will outline why child protection is important, what the principles are in protecting children, and outline the responsibilities of doctors. It will cover recognizing the possibility of abuse, the correct procedures to follow, understanding the greater picture, the importance of good communication, and the very specific areas of consent and confidentiality.
Management of the dying patient in consultation with the palliative care team
Authors: Burke Katharine , Noble Simon , Wee Bee , Noble Bill
Published: August 2016

In this chapter, we include objectives and knowledge set out in the Intercollegiate Surgical Curriculum Module 8 Management of the dying patient. The paragraphs on managing the dying patient in consultation with the palliative care team include an outline of palliative care services available to surgical patients, the drugs used in the management of symptoms, and surgical procedures that palliative care services may have in mind when they call on surgeons for an opinion. You will see at the beginning of some paragraphs, references to e-ELCA, an on-line learning resource for all healthcare professionals involved in care at the end of life, free to those who work in the UK. www.e-elca.org.uk
Organ donation
Authors: Chandak Pankaj , Callaghan Christopher J.
Published: August 2016

Organ shortage remains the greatest challenge in transplantation. Recent organizational changes have led to an increase in the number of deceased donor organs available for transplantation in the UK. Developments include creation of a National Organ Retrieval Service (NORS) and a network of specialist nurses (SN-ODs). Deceased donors may be declared dead using brain death criteria (donation after brain death − DBD) or certified dead after circulatory arrest (donation after circulatory death − DCD). The number of UK DCD donors has risen several fold compared to a modest increase in the number of DBD donors. The challenge during retrieval is to remove organs safely and effectively, with preservation usually comprising a cold flush followed by static cold storage, Cold and warm machine perfusion techniques are increasingly used, especially for ‘marginal’ organs. Allocation schemes for deceased donor organs have to balance equity of access and utility.
Sensory ataxic gait
Authors: Morris John G. , Grattan-Smith Padraic J.
Published: August 2016

This is a chapter on Sensory ataxic gait from the Gait section of A Manual of Neurological Signs. Most of the chapters contain a description of the sign, associated signs, and cases, supported by clinical videos and figures.
Skin Disorders
Authors: Morris John G. , Grattan-Smith Padraic J.
Published: August 2016

This is a chapter on Skin disorders from the Skin disorders section of A Manual of Neurological Signs. Most of the chapters contain a description of the sign, associated signs, and cases, supported by clinical videos and figures.
Global convergence of accounting education
Authors: Sugahara Satoshi , Watty Kim
Published: August 2016

Purpose

The purpose of this paper is to investigate the overall perceptions of accounting academics from Japan and Australia about global convergence of accounting education; and their beliefs about the contextual factors affecting the goal of global convergence.

Design/methodology/approach

The sample of this research was collected via a questionnaire-based survey of accounting academics who were teaching at the undergraduate and postgraduate level in tertiary institutes in Japan and Australia. This study adapted the questionnaire originally used by Sugahara (2013) to extend the survey of accounting academics in Japan, to accounting academics in Australia. The questionnaire administered in this research asked their overall perceptions regarding the convergence of accounting education and associated contextual factors.

Findings

Findings reveal some similarities and differences across contextual factors that influence academic perceptions about global convergence. Further the authors identify a link between academic position and respondent views of global convergence.

Originality/value

The findings of this cross-country study provide insights for the International Accounting Education Standards Boards (IAESB) about the views of a key stakeholder group, accounting academics. Further the authors recommend the development of a communications strategy that targets accounting academics, and better explains the work of the IAESB and the intended value of global convergence using IES.
Effects of positive incentive and negative incentive in knowledge transfer: carrot and stick
Authors: Ding Xiu-Hao , He Yuanqiong , Wu Jiang , Cheng Chen
Published: August 2016

Purpose

Employees play a central role in firms’ knowledge transferal, but knowledge-sharing brings significant costs for employees. Thus, this study aims to explore the components of firms’ incentive systems and how these influence employees’ knowledge-sharing, and also to test whether employees’ knowledge-sharing intentions transform into better knowledge transfer performance at the firm level.

Design/methodology/approach

This study collected data in China, and 219 usable questionnaires were collected. Then, this study used a structure equation model by LISREL for hypotheses testing.

Findings

This study finds that positive economic incentives, positive relational incentives and negative relational incentives all increase employees’ knowledge-sharing intentions, contributing to firms’ improved knowledge-transfer performance. Thus, both positive and negative incentives and both economic and relational incentives exert influences on employees’ knowledge-sharing activities.

Practical implications

Because employees have both material and emotional needs and always want to approach good things and avoid bad things, firms should take measures to make their incentive systems more comprehensive. Then, employees can be motivated to share their knowledge effectively.

Originality/value

Existing studies have mainly explored the effects of positive economic incentives on knowledge transferal. Because individuals have both a promotion self-regulatory focus associated with an approach motivation and a prevention self-regulatory focus associated with an avoidance motivation, and because they have both material and emotional needs, this study classifies incentives into three types and confirms their effectiveness for motivating employees to share knowledge.
Antecedent factors of business planning in the new venture emergence in China
Authors: Long Dan , Geng Lan , Shakeel Muhammad
Published: August 2016

Purpose

The purpose of this paper is to build a research model from the perspectives of entrepreneur and entrepreneurial opportunity examining the effects of entrepreneurial growth aspiration and the innovativeness of entrepreneurial opportunity and their interactive effect on the business planning in the new venture emergence.

Design/methodology/approach

Six hypotheses are put forward and examined by hierarchical multiple linear regression and multiple logistic regression. The data of this paper are based on the first two rounds of survey data from Chinese Panel Study of Entrepreneurial Dynamics.

Findings

The empirical results show that entrepreneurial growth aspiration has significant positive effects on the business planning, namely, compared to the comfortable size entrepreneurs, the growth-oriented entrepreneurs are more likely to do the business planning in the new venture emergence. Different from prior discoveries, the innovativeness of opportunity has no effect on the business planning, but it positively influences the time of doing business planning, and entrepreneurial growth aspiration has a positive moderate effect on this relationship.

Research limitations/implications

Entrepreneurial growth aspiration in this paper is divided into growth-oriented entrepreneur and comfortable size entrepreneur from the single perspective of scale. Future research should define growth aspiration as a continuous variable in light of several dimensionalities.

Practical implications

The findings are useful for entrepreneurs to make rational and effective decisions whether to do business planning and when to do on the basis of their growth aspiration and the innovativeness of opportunity. The growth-oriented entrepreneur should do the business planning in the new venture emergence. The higher innovative the opportunity is, the latter the entrepreneur had better do the business planning. Besides, it provides the theoretical foundation for entrepreneurship training courses about business planning offered by governments, educational institutions and social training institutions.

Originality/value

This paper absorbs growth aspiration into the analysis framework about business planning based on expectancy theory, making up for deficiencies that prior researches excessively focus on entrepreneurial experience and opportunity. Additionally, the study will inspire scholars to research the mechanism of action relative to business planning from the interactive relationship between entrepreneur and entrepreneurial opportunity.
Effect of food experience on tourist satisfaction: the case of Indonesia
Authors: Babolian Hendijani Roozbeh
Published: August 2016

Purpose

The paper aims to investigate food-related experiences among international tourists visiting Indonesia and the effect of food on their overall satisfaction.

Design/methodology/approach

Data were collected through self-administrated questionnaires that were distributed randomly to tourists at Jakarta International Airport and some tourist areas around Jakarta. Statistical analyses such as factor analysis, multiple linear regression and descriptive analysis were used to analyze the data.

Findings

The findings of the multiple linear regression analysis showed that “heritage” and “ingredients” were significant factors that affected the overall satisfaction of tourists. Results imply that destinations can have differentiated themselves through using their unique foods.

Practical implications

A major contribution of this study is its implications for practitioners in the tourism industry for developing marketing strategies.

Originality/value

This study was one of the first to examine the effect of food experiences on the overall satisfaction of tourists in Indonesia.
Fairness in the local movements of tourists within a destination: justice perceptions, bus services, and destination loyalty
Authors: Zoghbi-Manrique-de-Lara Pablo , Guerra-Báez Rita M.
Published: August 2016

Purpose

This paper aims to incorporate the justice framework of hospitality and marketing literature into the bus service user research to extend our knowledge about whether and why visitors on a local daytrip within a travel destination display behavioral intentions to revisit that destination. Because prior studies show that perceived justice leads customers to positive outcomes, the authors suggest that when bus service is provided fairly, it is more able to elicit feelings of satisfaction with the bus service in same-day visitors. This satisfactory context, in turn, leads same-day visitors to experience feelings of destination loyalty.

Design/methodology/approach

Data were collected from 105 day visitors on 48 bus arrivals to Las Palmas city from the southern area of Gran Canaria Island (Spain). The authors used partial least squares regression (SmartPLS 20) to test the relationships.

Findings

Although the studied relationships may be dynamic over time, and a cross-sectional method might seem useless in accounting for them, results support that the more fairly the bus operator treats the daytrip visitors, the more they express intentions to revisit the destination, with service satisfaction acting as a full mediator that explains this link.

Practical implications

These findings suggest that by promoting fair treatment on local daytrips, the travel destination, through the bus transport, is communicating to same-day visitors a collective effort to provide happy and successful local visits within the destination, thus contributing to the overall attractiveness of the destination.

Originality/value

This paper is one of the first empirical studies to provide a justice-based framework for understanding why tourists’ experiences during their local movements by bus within a destination could encourage these tourists to revisit the destination.
HIV outcomes at a Canadian remand centre
Authors: Subramanian Yazhini , Khan Muhammad Naeem , Berger Sara , Foisy Michelle , Singh Ameeta , Woods Dan , Pyne Diane , Ahmed Rabia
Published: August 2016

Purpose

The purpose of this paper is to assess the impact of short-term incarceration on antiretroviral therapy (ART) adherence, virologic suppression, and engagement and retention in community care post-release.

Design/methodology/approach

A retrospective chart review of patients who attended the human immunodeficiency virus (HIV) Outreach Clinic at a Canadian remand center between September 2007 and December 2011 was carried out. Data extraction included CD4 lymphocyte count, HIV viral load, ART prescription refills, and community engagement and retention during and one-year pre- and post-incarceration.

Findings

Outpatient engagement increased by 23 percent (p=0.01), as did ART adherence (55.2-70.7 percent, p=0.01), following incarceration. Retention into community care did not significantly improve following incarceration (22.4 percent pre-incarceration to 25.9 percent post-release, p=0.8). There was a trend toward improved virologic suppression (less than 40 copies/ml; 50-77.8 percent (p=0.08)) during incarceration and 70. 4 percent sustained this one-year post-incarceration (p=0.70).

Originality/value

The impact of short-term incarceration in a Canadian context of universal health coverage has not been previously reported and could have significant implications in optimizing HIV patient outcomes given the large number of HIV-positive patients cycling through short-term remand centers.
A QFD-based expert system for industrial truck selection in manufacturing organizations
Authors: Chakraborty Shankar , Prasad Kanika
Published: August 2016

Purpose

Availability of accurate quantity of materials, at correct place and at right time is extremely critical for increasing production effectiveness of any manufacturing organization. This can be achieved through employing an appropriate material handling equipment (MHE) capable of performing the desired operation. Therefore, choosing a right MHE from the available options is a key concern for the success, growth and competitiveness of a manufacturing organization. The purpose of this paper is to describe the design and development of an expert system based on quality function deployment (QFD) methodology in Visual Basic 6.0 for selecting the most appropriate industrial truck which is a commonly practiced MHE in any manufacturing organization.

Design/methodology/approach

A QFD-based approach is adopted to incorporate customers’ needs into the evaluation criteria on the basis of which industrial truck selection is carried out. The applicability of the developed expert system in solving industrial truck selection problems is demonstrated using two illustrative examples.

Findings

While applying this QFD-based model, CPCD 80x manufactured by Heli is recognized as the most suitable forklift truck for transporting unitized loads within a manufacturing unit with some spatial constraints, and for loading/unloading packages/boxes/cartons and place them at the desired locations in a manufacturing unit, ETV 216 manufactured by Jungheinrich evolves out as the most suitable reach truck.

Originality/value

Till date, numerous research articles have been published suggesting the applications of various mathematical models, multi-criteria decision-making methods and knowledge-based systems for solving MHE selection problems, and it is intriguing to note that none of the previously adopted methods has proposed a systematic procedure for selection of the evaluation criteria and interrelated the needs of customers with the technical specifications of MHEs while identifying the best alternative for performing a specified operation. These issues can be addressed through application of this developed QFD-based expert system, which can translate customers’ needs into organizational functions that are implementable in the decision-making/selection procedure.
Investigating the alternative paradigms of manufacturing competence: an empirical study
Authors: Jain Bhurchand , Adil Gajendra K. , Ananthakumar Usha
Published: August 2016

Purpose

The purpose of this paper is to explore the relationship of strategic manufacturing effectiveness utilizing the four-stage model of Hayes and Wheelwright (H-W) with overall performance of manufacturing, market alignment and production competence (PC). In addition, it attempts to understand the relationship of strategic manufacturing effectiveness with manufacturing capability development modes, strategic groups of companies and the nature of improvement programs being employed.

Design/methodology/approach

Structured questionnaire was used to capture data from manufacturing organizations. Responses from managers of 47 Indian manufacturing companies were used to test the seven propositions that were developed to examine the paradigms of manufacturing competence.

Findings

The analysis revealed that the strategic manufacturing effectiveness of manufacturing companies based on H-W’s four-stage model has significant positive correlation with the overall performance of manufacturing and PC of the company. Further, the analysis substantiated the relationship of strategic manufacturing effectiveness with capability development process and the nature of improvement programs.

Research limitations/implications

This exploratory study is based on a small sample of manufacturing companies with diversity and hence it may not be representative of all industry sectors. Second, it has used several scales for measuring the relevant constructs which themselves are not proven, hence, the findings should be taken with caution.

Originality/value

This is an initial research focussing on the relationships among different elements of manufacturing competence such as manufacturing capabilities, PC, manufacturing capability development mode and overall performance of manufacturing with strategic manufacturing effectiveness using H-W model. H-W model was primarily proposed as an audit tool for managers, was hitherto not adequately studied in relation to other paradigms of manufacturing competence.
Intangible dynamics in financial services
Authors: Erickson Scott , Rothberg Helen N.
Published: August 2016

Purpose

The purpose of this paper is to examine a range of metrics concerning knowledge and related intangible assets in financial service industries. The metrics are then analyzed according to theory from several disciplines so as to better understand intangible dynamics, the relationship between different intangibles. Guidance is provided in terms of valuing knowledge and pursuing competitive intelligence (CI) based on the unique characteristics of financial services intangibles.

Design/methodology/approach

Data are drawn from a large database and supplemented with other sources. The primary database includes a considerable collection of publicly available financial results combined with proprietary data from a CI consultancy. Results on knowledge asset-levels and CI activity, by industry sector, are presented as well as the degree to which big data is employed.

Findings

Financial services show high levels of big data, low levels of knowledge assets, and high levels of CI activity. In some ways, these differing valuations of intangibles by different parties are counterintuitive, but they can be explained with reference to theory and a deeper understanding of the intangible dynamics.

Research limitations/implications

The results allow a deeper understanding of the relationship between data, information, knowledge (explicit and tacit), and intelligence in a specific industry. Given the uniqueness of the financial services results, these findings provide considerable insight into how intangibles strategies and applications can differ by industry.

Practical implications

These results provide direction to financial services decision-makers concerning investment in knowledge management systems (limited), CI initiatives (aggressive), and big data (aggressive).

Originality/value

The paper brings unique data to the table and brings together theory from a number of disparate fields of study, providing a different perspective on the interplay of knowledge, intelligence, and data in financial services.
Older people’s forums in the United Kingdom: civic engagement and activism reviewed
Authors: Manthorpe Jill , Harris Jess , Mauger Sam
Published: August 2016

Purpose

The purpose of this paper is to review the literature on UK older people’s forums. Forums seek to influence statutory responses to ageing, and enable older people to speak up on matters important to them. The review examined three facets of forums: their membership, structures, and effectiveness.

Design/methodology/approach

Methods included searching databases, internet, and specialist libraries for materials relating to older people’s forums. Key points were extracted and source material described but not subject to quality appraisal. Relevant non-UK studies are included to draw contrast and comparisons.

Findings

Several studies and reports have explored forum members’ socio-demographic profiles, motivations and triggers for joining and the two-way rewards of participation. However, membership remains a minority activity, with only a small percentage of members actively engaged and the review highlights gaps in the literature on widening participation. Both statutory and voluntary sectors have supported forum development and sustainability. There is little data on formal structures but some exploration of the informal communications and behaviours that sustain them has been undertaken. Forums are viewed as effective but resource intensive. The size and representativeness of the membership, strength of influence and deployment of members’ expertise are all identified as potential contributors to effectiveness.

Research limitations/implications

Some material may not have been accessible and there is potential bias by greater inclusion of journal published materials than other possible sources. Material was not quality appraised, and research literature and self-reporting by forums are presented alongside each other.

Practical implications

Practitioners should familiarise themselves with current older people’s organisations locally to ensure that consultations are broad and reach different groups. While partnerships with voluntary sector health and care providers are encouraged some of these groups may not wish to represent all older people. Wider reach may provide multiple perspectives. Help in kind as well as financial resources may be welcomed by older people’s groups, such as meeting spaces, assistance with administration, and briefings that are accessible. Offering to meet with older people’s forums to discuss matters regularly may provide insight into experiences of services and changing needs earlier than professional feedback. Dismissing older people’s forums as made up of the “usual suspects” is likely to be unfair and unhelpful to building up positive relationships.

Originality/value

The review provides a preliminary assessment of the size and scope of research and grey literature on UK older people’s forums, synthesising points of similarity and difference and identifying clear gaps in the evidence.
Biofuels 2020: Biorefineries based on lignocellulosic materials
Authors: Valdivia Miguel , Galan Jose Luis , Laffarga Joaquina , Ramos Juan‐Luis
Published: August 2016

The production of liquid biofuels to blend with gasoline is of worldwide importance to secure the energy supply while reducing the use of fossil fuels, supporting the development of rural technology with knowledge‐based jobs and mitigating greenhouse gas emissions. Today, engineering for plant construction is accessible and new processes using agricultural residues and municipal solid wastes have reached a good degree of maturity and high conversion yields (almost 90% of polysaccharides are converted into monosaccharides ready for fermentation). For the complete success of the 2G technology, it is still necessary to overcome a number of limitations that prevent a first‐of‐a‐kind plant from operating at nominal capacity. We also claim that the triumph of 2G technology requires the development of favourable logistics to guarantee biomass supply and make all actors (farmers, investors, industrial entrepreneurs, government, others) aware that success relies on agreement advances. The growth of ethanol production for 2020 seems to be secured with a number of 2G plants, but public/private investments are still necessary to enable 2G technology to move on ahead from its very early stages to a more mature consolidated technology.
‘Nobilitas sola est atq; unica Virtus’: Spying and the Politics of Virtue in The Golden Spy; or, A Political Journal of the British Nights Entertainments (1709)
Authors: Wu Jingyue
Published: August 2016

This article reassesses the current scholarly tendency to interpret Charles Gildon's The Golden Spy (1709) as the first fully fledged English object narrative by examining this fiction as a social critique of the reformation of manners movement in the late Stuart period. Special attention is paid to its contemporaneous reception, literary precursors and contributions to the debates concerning moral reform. The article argues that Gildon's fictional experimentation, not least the deployment of narrating spy gold coins, seeks not just to delight by its novelty but also to dynamise contemporary readers' reflection on the godly reformation and its politics of virtue.
Simultaneous quantification of isoniazid, rifampicin, ethambutol and pyrazinamide by liquid chromatography/tandem mass spectrometry
Authors: Prahl Julie B. , Lundqvist Marika , Bahl Justyna M. C. , Johansen Isik S. , Andersen Åse B. , Frimodt‐Møller Niels , Cohen Arieh S.
Published: August 2016

A remediable cause of poor treatment response in drug‐susceptible tuberculosis (TB) patients may be low plasma levels of one or more of the first‐line anti‐TB drugs. The aim of this work was to develop an accurate and precise LC‐MS/MS method for simultaneous quantification of all four first‐line anti‐TB drugs in plasma suitable for therapeutic drug monitoring (TDM). To adjust for degradation and losses during sample preparation, isotopically labeled compounds were used as internal standards. Plasma samples spiked with internal standards were extracted using protein precipitation with methanol and acetonitrile. Simultaneous separation of all four drugs was accomplished with a Chromolith Reversed‐Phase column and mobile phases consisting of water, methanol, ammonium acetate and formic acid with subsequent mass spectrometric quantification. The linear range of the calibration curve for isoniazid was 0.5–10 mg/L, for rifampicin 0.75–30 mg/L, for ethambutol 0.25–10 mg/L and for pyrazinamide 4–80 mg/L. The lower limit of quantification was 0.5 mg/L, 0.75 mg/L, 0.25 mg/L and 4.0 mg/L, respectively. Precision estimated by the coefficient of variation was <15% for all four drugs. The LC‐MS/MS method can readily be used for simultaneous quantification of first‐line anti‐TB drugs in plasma and is well suited for TDM.
Cannabinoid type 1 receptor antagonism ameliorates harmaline‐induced essential tremor in rat
Authors: Abbassian Hassan , Whalley Benjamin J , Sheibani Vahid , Shabani Mohammad
Published: August 2016

Background and Purpose

Essential tremor (ET) is a neurological disorder with unknown aetiology. Its symptoms include cerebellar motor disturbances, cognitive and personality changes, hearing and olfactory deficits. Hyperactivity of excitotoxic cerebellar climbing fibres may underlie essential tremor and has been induced in rodents by systemic harmaline administration. Cannabinoid (CB) receptor agonists can cause motor disturbances; although, there are also anecdotal reports of therapeutic benefits of cannabis in motor disorders. We set out to establish the effects of CB receptor agonism and antagonism on an established rodent model of ET using a battery of accepted behaviour assays in order to determine the risk and therapeutic potential of modulating the endocannabinoid system in ET.

Experimental Approach

Behavioural effects of systemic treatment with a CB receptor agonist (0.1, 0.5 and 1 mg kg−1 WIN55, 212–2) or two CB1 receptor antagonists (1 mg kg−1 AM251 and 10 mg kg−1 rimonabant) on tremor induced in rats by harmaline (30 mg kg−1; i.p.), were assessed using tremor scoring, open field, rotarod, grip and gait tests.

Key Results

Overall, harmaline induced robust tremor that was typically worsened across the measured behavioural domains by CB receptor agonism but ameliorated by CB1 receptor antagonism.

Conclusions and Implications

These results provide the first evidence of the effects of modulating the endocannabinoid system on motor function in the harmaline model of ET. Our data suggest that CB1 receptor manipulation warrants clinical investigation as a therapeutic approach to protection against behavioural disturbances associated with ET.
A comparison of infarct mass by cardiac magnetic resonance and real time myocardial perfusion echocardiography as predictors of major adverse cardiac events following reperfusion for ST elevation myocardial infarction
Authors: Lenz Charles J , Abdelmoneim Sahar S , Anavekar Nandan S , Foley Thomas A , Nhola Lara F , Huang Runqing , Oh Jae K , Mulvagh Sharon L
Published: August 2016

Purpose

Infarct mass as assessed by myocardial‐delayed enhancement imaging on cardiac magnetic resonance (CMR) and myocardial blood flow as assessed by real time myocardial perfusion echocardiography (RT‐MPE) have been shown to predict adverse events following ST elevation myocardial infarction (STEMI). There has been no published comparison of quantitative assessment using these modalities as predictors of clinical outcomes to date. We compared RT‐MPE with CMR for prediction of cardiac events in reperfused STEMI patients.

Materials and Methods

Consecutive STEMI patients with early reperfusion were studied. RT‐MPE and CMR were performed. Perfusion score indices (PSIRT‐MPE and PSICMR) were calculated [sum of segmental perfusion scores/number of segments]. CMR infarct mass (g) and RT‐MPE myocardial blood flow (MBF dB/s) were quantified. Patients were followed for cardiac events (death, nonfatal MI, revascularization, angina, and heart failure).

Results

All 27 patients (age 62±14; follow‐up 3.5±2.6 years) had thrombolysis in myocardial infarction (TIMI) grade 3 flow of infarct vessel. Cardiac events occurred in 17 (63%). Cardiac event patients had higher PSIRT‐MPE, PSICMR, infarct mass, and lower MBF. PSIRT‐MPE cutoff of 0.3 had an AUC of 0.856 (82% sensitivity, 70% specificity), while a PSICMR cutoff of 0.2 had an AUC of 0.765 (76% sensitivity, 60% specificity). Infarct mass and MBF were independent predictors of cardiac events after adjusting for risk factors (hazard ratios: 20.9 [95% CI 1.8–256] P=.02 and 8.1 [95% CI 1.5–78] P=.01, respectively).

Conclusions

Quantitative RT‐MPE performed comparably to CMR for prediction of MACE in STEMI patients supporting a prognostic role for this noninvasive, bedside imaging method.
Late pacemaker lead tip perforation documented by chest CT
Authors: Jain Neeraj , Ravipati Vijay , Kerut Edmund K.
Published: August 2016

Late cardiac perforation by a right ventricular (RV) pacemaker lead may be a challenge to diagnose. Echocardiography often will not adequately demonstrate lead tip migration, but chest computed tomography (CT) readily identifies the lead and tip location. A patient presented one month after dual‐chamber pacemaker implantation with fever, sepsis and failure of RV pacer lead capture. Echocardiography demonstrated vegetations on the RV lead and a pericardial effusion, but the lead tip location could not be identified. CT identified the tip as having migrated through the pericardium into the anterior mediastinum. These complimentary echo and CT findings helped make a diagnosis and direct patient therapy.
Giant calcific pericardial cyst: certainly unexpected during primary percutaneous coronary intervention
Authors: Güvenç Tolga Sinan , Hayıroğlu Mert İlker , Gümüşdağ Ayça , Ekmekçi Ahmet , Erer Hatice Betül , Keskin Muhammed , Eren Mehmet
Published: August 2016

Pericardial cyst is a rare congenital anomaly that is usually diagnosed during evaluation for right‐sided heart failure. We report a 50‐year‐old man with a primary diagnosis of ST‐segment elevation myocardial infarction at admission, whose emergent angiography revealed a calcific mass close to right coronary artery. Further analysis of the mass with computed tomography and three‐dimensional echocardiography revealed a giant pericardial cyst causing partial obstruction of superior vena cava. Unlike previous cases reported, the patient had no symptoms compatible with right‐sided heart failure.
A superimposed cohesive zone model for investigating the fracture properties of concrete–asphalt interface debonding
Authors: Mu F , Vandenbossche J
Published: August 2016

A cohesive zone model is proposed to simulate the interface debonding, a preponderant cause of failure for bonded concrete overlay of asphalt (BCOA). The model is constructed by superimposing four root models, each representing the mechanism of one subcritical failure at the interface zone observed in laboratory experiments. The model parameters are established through an inverse analysis of wedge splitting tests performed on BCOA specimens. These inputs are mainly a function of the materials at the interface zone, such as microtexture and macrotexture, and thus can be expected to be applicable to the numerical simulation of a full scale BCOA slab. For modeling across scales, the impact of specimen size, milling depth and initial flaw size on the model, in terms of peak traction and fracture energy, is also discussed.
Differences in the effect of exercise interventions between prefrail older adults and older adults without frailty: A pilot study
Authors: Takano Eiko , Teranishi Toshio , Watanabe Toyoaki , Ohno Kensuke , Kitaji Shiko , Sawa Shunji , Kanada Yoshikiyo , Toba Kenji , Kondo Izumi
Published: August 2016

Aim

We aimed to clarify whether there are differences in the effect of exercise interventions between prefrail older adults and older adults without frailty.

Methods

The participants were community‐dwelling older adults (mean age 75.1 ± 5.1 years). The participants were instructed to use a training method at home to prevent frailty. The effects of the intervention were evaluated at 4 months. Outcome measures were the Timed Up and Go test, grip strength, one leg balance, knee extension strength and the fall risk index. The present study used the criteria for frailty status of the National Center for Geriatrics and Gerontology in Japan. The studied sample included prefrail participants (n = 17) and robust participants (n = 24). We compared the value of outcome measures before and after the intervention in each group using two‐way repeated measures analysis of variance.

Results

There were significant differences for the group effect for one leg balance (P < 0.01), and there were significant differences for the time effect for Timed Up and Go, one leg balance and knee extension strength (P < 0.01). In these outcomes, there were no significant interactions between frailty status and intervention. Four prefrail participants (mean age 78.0 ± 3.8 years) returned to the robust status after the intervention. No participants became frail.

Conclusions

These results suggest that we can expect similar interventional effects for prefrail older adults and robust older adults. It is important that a frail status be prevented in prefrail older adults by using an exercise intervention. Further studies are required to determine the different effects of exercise intervention on prefrail status compared with frailty status in community‐dwelling older adults. Geriatr Gerontol Int 2017; 17: 1265–1269.
Thermoluminescence features of alumina‐mixed borophosphate glasses with Tb3+ ions for dosimetric applications
Authors: Kalpana Tirumalasetti , Sanyal Bhaskar , Gandhi Yerramreddy , Ravi Kumar Vandana , Baskaran Gnanamuthu S. , Bragiel Piotr , Piasecki Michal , Veeraiah Nalluri
Published: August 2016

Amorphous barium borophosphate materials doped with small quantity of terbium ions and with the addition of some amounts of alumina were prepared. Thermoluminescence (TL) characteristics of these glasses were investigated after irradiating them with different doses of γ‐rays (in the range 0.5‐8.0 kGy). The TL emission exhibited a dosimetric peak at about 210°C. The TL output under this glow peak is observed to increase with the γ‐ray dose. For any fixed γ‐ray dose, the TL output is increased with increase in Al2O3 content up to 3.0 mol%, and beyond this concentration, quenching of TL is visualized. The dose response of TL output of these glasses exhibited linear behavior in the dose range 0.5‐4.0 kGy. The mechanisms responsible for TL emission and the variation of TL output with the concentration of Al2O3 are quantitatively discussed in terms of structural defects induced during γ‐ray irradiation. Finally, it is concluded that these glasses are potential materials for dosimetry applications in the dose range 0.5‐4.0 kGy.
Tacrolimus prevents murine cerebral malaria
Authors: Bao Lam Quoc , Nhi Dang My , Huy Nguyen Tien , Hamano Shinjiro , Hirayama Kenji
Published: August 2016

Tacrolimus and mycophenolate mofetil are immunosuppressants frequently used in human organ transplantation. Tacrolimus is also reported to inhibit Plasmodium falciparum growth in vitro. Here, we report that tacrolimus prevented the death from cerebral malaria of Plasmodium berghei ANKA‐infected C57BL/6J mice, but not their death from malaria due to the high parasitaemia and severe anaemia. The mycophenolate mofetil‐treated mice showed higher mortality from cerebral malaria and succumbed to malaria earlier than tacrolimus‐treated littermates. Tacrolimus attenuated the infiltration of mononuclear cells including pathogenic CD8+ T cells into the brain. It appears to prevent murine cerebral malaria through the inhibition of cerebral infiltration of CD8+ T cells.
The impact of surgical site occurrences and the role of closed incision negative pressure therapy
Authors: Willy Christian , Engelhardt Michael , Stichling Marcus , Grauhan Onnen
Published: August 2016

Surgical site occurrences are observed in up to 60% of inpatient surgical procedures in industrialised countries. The most relevant postoperative complication is surgical site infection (SSI) because of its impact on patient outcomes and enormous treatment costs. Literature reviews (‘SSI’, ‘deep sternal wound infections’ (DSWI), ‘closed incision negative pressure wound therapy’ (ciNPT) were performed by electronically searching MEDLINE (PubMed) and subsequently using a ‘snowball’ method of continued searches of the references in the identified publications. Search criteria included publications in all languages, various study types and publication in a peer‐reviewed journal. The SSI literature search identified 1325, the DSWI search 590 and the ciNPT search 103 publications that fulfilled the search criteria. Patient‐related SSI risk factors (diabetes mellitus, obesity, smoking, hypertension, female gender) and operation‐related SSI risk factors (re‐exploration, emergency operations, prolonged ventilation, prolonged operation duration) exist. We found that patient‐ and operation‐related SSI risk factors were often different for each speciality and/or operative procedure. Based on the evidence, we found that high‐risk incisions (sternotomy and incisions in extremities after high‐energy open trauma) are principally recommended for ciNPT use. In ‘lower’‐risk incisions, the addition of patient‐related or operation‐related risk factors justifies the application of ciNPT.
Wound bed preparation: TIME for an update
Authors: Harries Rhiannon L , Bosanquet David C , Harding Keith G
Published: August 2016

While the overwhelming majority of wounds heal rapidly, a significant proportion fail to progress through the wound‐healing process. These resultant chronic wounds cause considerable morbidity and are costly to treat. Wound bed preparation, summarised by the TIME (Tissue, Inflammation/infection, Moisture imbalance, Epithelial edge advancement) concept, is a systematic approach for assessing chronic wounds. Each of these components needs to be addressed and optimised to improve the chances of successful wound closure. We present an up‐to‐date literature review of the most important recent aspects of wound bed preparation. While there are many novel therapies that are available to the treating clinician, often, there are limited data on which to assess their clinical value, and a lack of appreciation for adequate wound bed preparation needed before expensive therapy is used to heal a wound.
Local Structural Rearrangements and Evolution of Relaxor State in the Complex Perovskite (Ba1−xPbx) (In0.50Nb0.50) O3
Authors: Anil Adukkadan , Kumar Viswanathan
Published: August 2016

Local structural rearrangements in lead‐based complex perovskites of the type (Ba1−xPbx)(In0.50Nb0.50)O3 responsible for transition from ferroelectric [Ba(In0.50Nb0.50)O3] to relaxor [Pb(In0.50Nb0.50)O3] are examined by careful analysis of their Raman spectra. Subtle changes in the bonding brought about by the differences in the chemical nature of A‐ and B‐site cations have been correlated with the dynamic A–O–B coupling. Deviations in the local structure as a result of such bonding preferences have been confirmed by studying the changes in the Raman spectra when Nb5+ is substituted by Sn4+ as the third B‐site cation.
Low‐Density Open Cellular Silicon Carbide Foams from Sucrose and Silicon Powder
Authors: Vijayan Sujith , Wilson Praveen , Sreeja Remani , Prabhakaran Kuttan
Published: August 2016

Open cellular SiC foams with low densities were prepared by thermo‐foaming and setting (130°C–150°C) of silicon powder dispersions in molten sucrose followed by pyrolysis and reaction sintering at 1500°C. The bubbles generated in the dispersion by water vapor produced by the –OH condensation was stabilized by the adsorption of silicon particles on the air‐molten sucrose interface. The composition of a sucrose‐silicon powder mixture for producing SiC foam without considerable unreacted carbon was optimized. The sucrose in the thermo‐foamed silicon powder dispersion leaves 24 wt% carbon during the pyrolysis. The sintering additives such as alumina and yttria promoted the silicon‐carbon reaction. SiC nanowires with diameters in the range of 35–55 nm and length >10 μm observed on the cell walls as well as in the fractured strut region were grown by both vapor–liquid–solid and vapor–solid mechanisms. Large SiC foam bodies without crack could be prepared as the total shrinkage during pyrolysis and reaction sintering was only ~30 vol%. The relatively low compressive strength (0.06–0.41 MPa) and Young's modulus (14.9–24.2 MPa) observed was due to the large cell size (1.1–1.6 mm) and high porosity (93%–96%).
The EU's Power in the Russia–Ukraine Crisis: Enabled or Constrained?
Authors: Karolewski Ireneusz Pawel , Cross Mai'a K. Davis
Published: August 2016

The article presents conclusions of this Special Issue. It first summarizes the empirical findings of the individual contributions to this Special Issue in terms of whether EU power was enabled or constrained in response to the crisis. Second, the article synthesizes these findings to advance some overarching arguments about the EU as an actor in this crisis, and the types of power that were evident in this case. Third, it examines the significance of the study overall, and highlights some key policy implications. Finally, the article takes a broader perspective, and suggests that this framework is valuable more generally for understanding how various crises might impact the EU as a foreign policy actor.
Getting Patients Walking: A Pilot Study of Mobilizing Older Adult Patients via a Nurse‐Driven Intervention
Authors: King Barbara J. , Steege Linsey M. , Winsor Katie , VanDenbergh Shelly , Brown Cynthia J.
Published: August 2016

Objectives

To develop a system‐based intervention including five components that target barriers to nurse‐initiated patient ambulation.

Design

Pilot study of Mobilizing Older adult patients VIa a Nurse‐driven intervention (MOVIN).

Setting

Twenty‐six bed general medical unit.

Participants

Nursing staff (registered nurses and certified nursing assistants) were recruited to participate in focus groups.

Measurements

Information on frequency and distance patients ambulated and nursing staff documentation of patient ambulation were retrieved from the electronic medical record. Regression discontinuity analysis was used to determine a difference between the preintervention and intervention periods in ambulation occurrence, ambulation distance, and percentage of numeric documentation of ambulation. Thematic analysis was used to analyze focus group interviews.

Results

A statistically significant increase in number of occurrences (t = 4.18, P = .001) and total distance (t = 2.75, P = .01) and a significantly higher positive slope in percentage of numeric documentation was found during the intervention than before the intervention. Thematic analysis identified three central categories (shifting ownership, feeling supported, making ambulation visible) that describe the effect of MOVIN on nursing staff behaviors and perceptions of the intervention.

Conclusion

Decreasing loss of independent ambulation in hospitalized older adults requires new and innovative approaches to addressing barriers that prevent nurse‐initiated patient ambulation. MOVIN is a promising system‐based intervention to promoting patient ambulation and improving outcomes for hospitalized older adults.