bluuebunny/crossref_metadata_2025 huggingface dataset:
To Be Both Prophet and Pastor
Authors: Cline David P.
Published: May 2017

This chapter focuses on the growth of SIM as it recruited more students for interracial ministry placements. Notable placements included students who interned with Martin Luther King, Jr. and his father Martin Luther “Daddy” King, Sr. James Forbes, a young black minister, spent his summer with a laregly white Baptist church in Chapel Hill, North Carolina; Forbes would later in his career become the minister of the famous Riverside Church in New York City.
Seminarians in the Secular City
Authors: Cline David P.
Published: May 2017

As SIM grew in size and geographic breadth, it also began to post more and more students in churches in urban areas and to learn that the problems of the city were far greater than those directly concerning the churches themselves. Thus SIM began to address concerns such as housing, unemployment, entrenched poverty, educational gaps, and more by developing a series of urban ministry programs in major cities across the country. In SIM’s final three years, its shifted its focus away from the interracial pastoral exchanges that had definied its early years and put most of its efforts into the new urban ministry programs.
Seminaries in the Storm
Authors: Cline David P.
Published: May 2017

The final chapter documents the mainline churches and seminaries in the late sixties experiencing a series of crises in reponse to the great change of the decade. As inner city church membership declined, seminarians sought greater relevance and “authenticity” from their institutions and in their education. In 1968, this was capped off by death of Martin Luther King, and the Columbia Strike and the supportive response at neighboring Union Theological Seminary. As the nation turned its attention outward toward the war in Vietnam and inward toward increasingly volatile urban situtations, SIM was unable to attract needed financial support to continue its growing decentralized program of urban ministry projects, and it disbanded in late spring of 1968.
The Sternest Feature of War
Authors: Dilbeck D. H.
Published: May 2017

Chapter four considers how consistenly Union armies adhered to the Lieber code and its underlying moral vision of a hard yet human war by investigating the Union’s use of formal retaliation against Confederate soldiers in the latter half of the conflict. Through several case studies of the Union’s consideration and use of retalition, this chapter demonstrates that Union officials did by and large follow the letter and spirit of the Lieber code in the use of retaliation. The chapter argues that while most Union officials remained wary of formal retaliation against captured Confederate soldiers, they saw the tool as a way to punish and curtail the worst abuses in war committed by Confederates.
Even in the Midst of an Enemy’s Country the Dictates of Humanity Must at Least Be Observed
Authors: Dilbeck D. H.
Published: May 2017

Chapter five considers how consistenly Union armies adhered to the Lieber code and its underlying moral vision of a hard yet human war by investigating the Union army’s treatment of civilians and their property in two notoious campaigns: Philip H. Sheridan's 1864 Shenandoah Valley Campaign and William Tecumseh Sherman's March to the Sea and through South Carolina. These campaigns witnessed great destruction (often utterly unwarranted) and also persistent restraint. Federals' moral vision of hard yet humane warfare inspired both, for many Union soldiers believed both were necessary in a justly waged war.
The World in Black and White
Authors: Foote Lorien
Published: May 2017

When escaped Union prisoners travelled through South Carolina, they received food, information, shelter, and guidance from slaves, who interpreted the mass escapes through their religious beliefs as a sign of the jubilee. These encounters accelerated the collapse of slavery because slaves recognized the mass escapes as an opportune moment for escalated resistance against the Confederate state. Interactions with slaves challenged the racial attitudes of escaped Union prisoners. Planter resistance to slave impressment undermined Confederate defense of South Carolina and created conditions that allowed slaves to aid escaped prisoners.
They Cover the Land like the Locusts of Egypt
Authors: Foote Lorien
Published: May 2017

When the Confederate and state government in South Carolina proved unable to respond to the threatening alliance between escaped Union prisoners, slaves, and deserters, citizens of the state took over the functions of security in their neighborhoods and withdrew from state-sponsored efforts to recruit men for the Confederate reserves and the state militia to defend the state against the threatened invasion of Union armies under Sherman. The government of South Carolina ceased to function in significant portions of the state during the last three months of 1864. This is an important reason for the utter lack of resistance to Sherman’s invasion of the state.
Guardian Angels
Authors: Foote Lorien
Published: May 2017

When escaped Union prisoners traveled through North Carolina, they encountered regions where the home front had collapsed into a battle front. Families of deserters engaged in violent resistance to Confederate conscription and battled the North Carolina home guard. Unionist families engaged in guerrilla warfare against Confederate supporters. These households resisting the Confederate government mobilized their resources, including children, to aid escaped prisoners. Cultural assumptions about gender, civilization, and romance governed interactions between escaped Union prisoners and Appalachian women.
Rolling Tape
Authors: Jarrett Michael
Published: May 2017

The A&R man became a record producer with the development of magnetic tape (a spoil of World War II) and the introduction of the vinyl long-playing record by Columbia Records in 1948. Producers could capture on tape—for reproduction and sale on records—jazz that had routinely happened for many years only on various stages. When recording technology caught up with the actual practice of improvising musicians, jazz discovered an ideal form in the "album." George Avakian's visionary work with Duke Ellington, Miles Davis, Erroll Garner, Buck Clayton, and Dave Brubeck realized what could be done with the new format and technology. The productions of Milt Gabler, Bob Weinstock, Esmond Edwards, Don Schlitten Teo Macero, Bob Thiele, Orrin Keepnews, Nesuhi Ertegun, Creed Taylor, Lester Koenig, Nat Hentoff ushered in a golden age for jazz.
Laying Down Tracks
Authors: Jarrett Michael
Published: May 2017

Recording jazz onto multitrack tape meant that, while music continued to be captured onto tape in studios, albums could be constructed in postproduction: analogous to the way movies were shot on soundstages and assembled in editing rooms. Some musicians—especially Miles Davis and his jazz fusion bands—directed improvisations in the recording studio and left the task of assembling albums to their producers. Audiences for such albums heard, not studio games of cut 'n' paste, but tracks that resembled the turn-on-a-dime musical performances they heard in concert—performances which imitated techniques devised in postproduction. Enabling the naiveté of this audience is an overarching truth: jazz production almost always uses available technologies to ensure that in-the-moment performances are recorded (and, later, reproduced) as perfectly as possible.
Why Regulate Medicines?
Authors: Kinch Michael
Published: May 2017

The prehistory of the modern pharmaceutical era is recounted, with emphasis upon the products, including the emergence of snake oil remedies, tapeworm diets and dangerous yet contemporary quack medicines such as Laetrile. As the magnitude of public outrage increased at the turn of the last century, the rise of yellow journalism highlighted spectacles that revealed further abuses and propelled high profile muckrakers to target adulterated products, including an emerging product known as Coca-Cola. As scientific understanding of infection grew, so did the potential for abuse, which culminated in a life-saving and revolutionary pre-antibiotic sulfa drug. However, the adulteratoin of this new breakthrough medicine resulted in the poisoning of more than 100 children in 1938. The disaster arose when a form of the drug was targeted at young by using a sweet elixir, which gained its taste by dissolving the medicine in radiator fluid. The resulting tragedy ushered in the era of the modern Food and Drug Administration (FDA).
Dreams of Greatness
Authors: Kinch Michael
Published: May 2017

This chapter details the birth of the pharmaceutical industry, whose roots trace back more than six millennia. While modern society struggles with opiate addiction, the problem is centuries old and fostered a literal trade war in the form of the Opium Wars of the 19th century and whose scars still muddle international relations of China with the West today. During this same time period, improvements in understanding opium facilitated the discovery of new and more potent products that nurtured modern companies such as Merck & Co. Perhaps no other discovery has impacted the industry or public health as much as antibiotics and we trace the history of these medicines and debunk misunderstandings and misattributions associated with their discovery. The impact of antibiotics was propelled by the Second World War, which also gave rise to the first treatments for cancer when two top-secret projects, one at Yale and another resulting from an audacious raid by the Luftwaffe upon an Italian port town, unexpectedly revealed the life-saving implications of mustard gas. Finally, we relate the triumphant and turbulent relationships that gave rise to the discoveyr of insulin and its widespread distribution by a paragon of “ethical pharmaceuticals”, Eli Lilly & Company.
Blockbusters and Bombs
Authors: Kinch Michael
Published: May 2017

The first indications of future trouble are identified. For most of history, new medicines arise from nature but this approach came into question as evidenced by the development of the cancer drug Taxol. As understanding of biology and chemistry incraesed, a degree of over-confidence arose as researchers assumed that new technologies would allow them to predict the most effective medicines. These changes were a response to an environment confronting twin pressures in the form of rising generic medicines coupled with ever more costly research and development activities needed to develop new products to replace those devastated by generic competition. These issues were exacerbated by a rising dependence upon “blockbuster” products, which conveyed short-term revenues but inevitably needed to be replaced by even more profitable products once generic competition intervened. Dependence on blockbusters was exemplified by the story of ulcer medicines, which was disrupted by an audacious study by an investigator who used himself as a Guinea pig to make his point. As such risks increased, the industry became more cautious and the race was on to make incremental improvements upon competitors’ products. All the while the cost of developing new medicines continued to escalate.
Three Views of a Train Wreck
Authors: Kinch Michael
Published: May 2017

Despite and arguably because of the enormous public health benefits arising from the introduction of new medicines, the industry is in the midst of crisis. We detail in this chapter the decline in research and development efficiency, which has been termed “Eroom's Law,” a playful inversion of the bettern known Moore's Law of Computing. An explanation of declining efficiency follows as is a brief summary of some remedies taken by many biopharmaceutical entities, including the abandonment of therapeutics targeting particularly difficult indications such as Alzheimer's disease and antibiotics. We also convey how the industry has developed into a sort of food chain, with smaller companies and government grants supporting the earliest stages of research, which are then acquired by medium-sized companies, which in turn are consolidated into large companies. This food chain is fundamentally in doubt based on shrinking Federal spending on research combined with a decline in venture capital support for early-stage start-ups.
Introduction
Authors: Livingston James
Published: May 2017

Work means everything to us. For centuries — since, say, 1650 — we’ve believed that it builds character (punctuality, initiative, honesty, self-discipline, and so forth). We’ve also believed that the market in labor, where we go to find work, has been relatively efficient in allocating opportunities and incomes. And we’ve believed that even if it sucks, the job gives meaning, purpose, and structure to our everyday lives — at any rate we’re pretty sure that it gets us out of bed, pays the bills, makes us feel responsible, and keeps us away from daytime TV....
Labor and the Essence of Man
Authors: Livingston James
Published: May 2017

This chapter describes the intellectual history of full employment. It shows how the left of today has inherited its preoccupation with labor from Hegel. It shows how Americans continue to cling to the Protestant Work Ethic.
Flocculation of dissolved organic matter controls the distribution of iron in boreal estuarine sediments
Authors: Jilbert Tom , Asmala Eero , Schröder Christian , Tiihonen Rosa , Myllykangas Jukka-Pekka , Virtasalo Joonas J. , Kotilainen Aarno , Peltola Pasi , Ekholm Päivi , Hietanen Susanna
Published: May 2017

Abstract. Iron (Fe) plays a key role in sedimentary diagenetic processes in coastal systems, participating in various redox reactions and influencing the burial of organic carbon. Large amounts of Fe enter the marine environment from boreal river catchments associated with dissolved organic matter (DOM). However, the fate of this Fe pool in estuarine sediments has not been extensively studied. Here we show that flocculation of DOM along salinity gradients in an estuary of the northern Baltic Sea efficiently transfers Fe from the dissolved phase into particulate material that accumulates in the sediments. Consequently, we observe a decline with distance offshore in both the Fe content of the sediments and proportion of terrestrial material in the sedimentary organic matter pool. Mössbauer spectroscopy and sequential extractions suggest that large amounts of Fe in sediments of the upper estuarine zone are associated with organic matter as unsulfidized Fe (II) complexes, or present in the form of ferrihydrite, implying a direct transfer of flocculated material to the sediments. Accordingly, the contribution of these components to the total sedimentary Fe declines with distance offshore while other Fe phases become proportionally more important. Sediment core records show that the observed lateral distribution of Fe minerals has remained similar over recent decades, despite variable Fe inputs from anthropogenic sources and eutrophication of the coastal zone. Pore water data suggest that the vertical zonation of diagenetic processes in the sediments is influenced by both the availability of Fe and by bottom water salinity, which controls the availability of sulfate (SO42−).
A model study of warming-induced phosphorus–oxygen feedbacks in open-ocean oxygen minimum zones on millennial timescales
Authors: Niemeyer Daniela , Kemena Tronje P. , Meissner Katrin J. , Oschlies Andreas
Published: May 2017

Abstract. Observations indicate an expansion of oxygen minimum zones (OMZs) over the past 50 years, likely related to ongoing deoxygenation caused by reduced oxygen solubility, changes in stratification and circulation, and a potential acceleration of organic matter turnover in a warming climate. The overall area of ocean sediments that are in direct contact with low-oxygen bottom waters also increases with expanding OMZs. This leads to a release of phosphorus from ocean sediments. If anthropogenic carbon dioxide emissions continue unabated, higher temperatures will cause enhanced weathering on land, which, in turn, will increase the phosphorus and alkalinity fluxes into the ocean and therefore raise the ocean's phosphorus inventory even further. A higher availability of phosphorus enhances biological production, remineralisation and oxygen consumption, and might therefore lead to further expansions of OMZs, representing a positive feedback. A negative feedback arises from the enhanced productivity-induced drawdown of carbon and also increased uptake of CO2 due to weathering-induced alkalinity input. This feedback leads to a decrease in atmospheric CO2 and weathering rates. Here, we quantify these two competing feedbacks on millennial timescales for a high CO2 emission scenario. Using the University of Victoria (UVic) Earth System Climate Model of intermediate complexity, our model results suggest that the positive benthic phosphorus release feedback has only a minor impact on the size of OMZs in the next 1000 years. The increase in the marine phosphorus inventory under assumed business-as-usual global warming conditions originates, on millennial timescales, almost exclusively (> 80 %) from the input via terrestrial weathering and causes a 4- to 5-fold expansion of the suboxic water volume in the model.
Numerical modelling landscape and sediment flux response to precipitation rate change
Authors: Armitage John J. , Whittaker Alexander C. , Zakari Mustapha , Campforts Benjamin
Published: May 2017

Abstract. Laboratory-scale experiments of erosion have demonstrated that landscapes have a natural (or intrinsic) response time to a change in precipitation rate. In the last few decades there has been a growth in the development of numerical models that attempt to capture landscape evolution over long time-scales. Recently, a sub-set of these numerical models have been used to invert river profiles for past tectonic conditions even during variable climatic conditions. However, there is still an uncertainty over validity of the basic assumption of mass transport that are made in deriving these models. In this contribution we therefore return to a principle assumption of sediment transport within the mass balance for surface processes, and explore the sensitivity of the classic end-member landscape evolution models to change in precipitation rates. One end-member model takes the mathematical form of a kinetic wave equation and is known as the stream power model, where sediment is assumed to be transported immediately out of the model domain. The second end-member model takes the form of a diffusion equation, and assumes that the sediment flux is a function of the water flux and slope. We find that both of these end-member models have a response time that has a proportionality to the precipitation rate that follows a negative power law. For the stream power model the exponent on the water flux term must be less than one, and for the sediment transport model the exponent must be greater than one in order to match the observed concavity of natural systems. This difference in exponent means that sediment transport model responds more rapidly to an increase in precipitation rates, on the order of 105 years for a landscape with a scale of 105 m. In nature, landscape response times to a rapid environmental change have been estimated for events such as the Paleocene-Eocene thermal maximum (PETM). In the Spanish Pyrenees, a relatively rapid, 20 to 100 kyr, duration of deposition of gravel during the PETM is observed for a climatic shift that is thought to be towards increased precipitation rates. We suggest the rapid response observed is more easily explained through a diffusive sediment transport model, as (1) this model has a faster response time, consistent with the documented stratigraphic data, and (2) the assumption of instantaneous transport is difficult to justify for the transport of large grain sizes as an alluvial bed-load.
Evaluation of high-resolution GRAMM/GRAL NOx simulations over the city of Zurich, Switzerland
Authors: Berchet Antoine , Zink Katrin , Oettl Dietmar , Brunner Jürg , Emmenegger Lukas , Brunner Dominik
Published: May 2017

Abstract. Hourly NOx concentrations were simulated for the city of Zurich, Switzerland, at 10 m resolution for the years 2013–2014. The simulations were generated with the nested mesoscale meteorology and microscale dispersion model system GRAMM/GRAL (versions v15.12/v14.8) by applying a catalogue-based approach. This approach was specifically designed to enable long-term city-wide building-resolving simulations with affordable computation costs. It relies on a discrete set of possible weather situations and corresponding steady-state flow and dispersion patterns that are pre-computed and then matched hourly with actual meteorological observations. The modelling system was comprehensively evaluated using eight sites continuously monitoring NOx concentrations and 65 passive samplers measuring NO2 concentrations on a 2-weekly basis all over the city. The system was demonstrated to fulfil the European Commission standards for air pollution modelling at nearly all sites. The average spatial distribution was very well represented, despite a general tendency to overestimating the observed concentrations, possibly due to a crude representation of traffic-induced turbulence. The temporal variability of concentrations explained by varying emissions and weather situations was accurately reproduced on different time scales. The seasonal cycle of concentrations, mostly driven by stronger vertical dispersion in summer than in winter, was very well captured in the two year simulation period. Short-term events, such as episodes of particularly high and low concentrations, were detected in most cases by the system, although some unrealistic pollution peaks were occasionally generated, pointing at some limitations of the steady-state approximation. The different patterns of the diurnal cycle of concentrations observed in the city were generally well captured as well. The evaluation confirmed the adequacy of the catalogue-based approach in the context of city scale air pollution modelling. The ability to reproduce not only the spatial gradients but also the hourly temporal variability over multiple years makes the model system particularly suitable for investigating individualized air pollution exposure in the city.
Sand quarry wetlands provide high-quality habitat for native amphibians
Authors: Sievers Michael
Published: May 2017

Abstract. Anthropogenic disturbances to habitats influence the fitness of individual animals, the abundance of their populations, and the composition of their communities. Wetlands in particular are frequently degraded and destroyed, impacting the animals that inhabit these important ecosystems. The creation of wetlands during and following sand extraction processes is inevitable, and thus, sand quarries have the potential to support aquatic animals. To determine how amphibians utilise these wetlands, I conducted nocturnal call surveys at wetlands within the Kables Sands quarry, New South Wales, Australia, and within surrounding reference wetlands, and quantified levels of developmental instability (DI) as a proxy for fitness. Whilst quarry and reference wetlands were largely similar in terms of environmental characteristics, quarry wetlands consistently harboured more amphibian species and individuals. Using unsigned asymmetry as a measure of DI, frogs from the quarry sites exhibited significantly lower levels of DI compared to reference wetlands, indicating that quarry wetlands may be comparatively higher quality. Levels of DI within quarry wetlands also compared favourably to data from healthy frog populations extracted from the literature. Further enhancing the suitability of quarry wetlands would require minimal effort, with potentially significant increases in local and regional biodiversity. Documenting species presence and quantifying individual fitness by measuring limb lengths is an economically and logistically feasible method to assess the health of quarry wetlands. Overall, the methods outlined here provide a powerful, yet simple, tool to assess the overall health and suitability of quarry wetlands that could be easily adopted at quarries throughout the world.
Qualificação dos dados hidrológicos disponíveis na base HIDROWEB/ANA: estações fluviométricas do estado de Goiás
Authors: Roza dos Santos Júnio Gregório , Vespucci Ariel Godinho , Bayer Maximiliano
Published: May 2017

ResumoO presente artigo pretende realizar uma qualificação dos dados das estações fluviométricas do estado de Goiás, no Brasil, registradas na base de dados hidrológicos HidroWeb. A partir de três parâmetros: periodicidade, continuidade e atualidade, elaborou-se um Índice de Qualidade que permitiu mensurar o nível de confiabilidade dos registros de cota e vazão hídrica armazenados no portal. Dessa forma o índice possibilitou classificar as estações em satisfatórias, razoáveis e insatisfatórias. E assim, concluiu-se que 66,37% ou 274 das 413 estações fluviométricas do estado se enquadram como insatisfatórias, pois não fornecem séries históricas longas e contínuas, prejudicando assim o planejamento de uso dos recursos hídricos, tornando o monitoramento das águas superficiais um desafio.Palavras-chave: HidroWeb, estações fluviométricas, dados hidrológicos, Índice de Qualidade. AbstractThis paper aims to realize a qualification of stations fluviometric data of the state of Goiás in Brazil, registered in hydrological database HidroWeb. From three parameters: periodicity, continuity and topicality, a Quality Index was drawn up that has allowed us to measure the reliability's level of quota and water flow records stored in the database. Thus, the index has enabled us to classify the stations as satisfactory, moderate and unsatisfactory. Therefore, we concluded that there 66.37% or 274 of 413 fluviometric stations in the state are classified as unsatisfactory, because they don't produce historical and continuous series, affecting like this the use of water resources planning and makes a challenge the surface water monitoring.Keywords: HidroWeb, fluviometric stations, hydrilogicals data, Quality Index. ResumenEste artículo tiene como objetivo realizar una calificación de los datos de las estaciones fluviométricas en el estado de Goiás, que hacen parte de la base HIDROWEB. A partir de la selección de tres parámetros: la periodicidad,  la continuidad y la actualidad de los datos, se elaboró un Índice de Calidad que permite medir el nivel de confiabilidad de los registros de cota y caudal  de agua almacenados en el portal. Así, la aplicación de este índice posibilitó clasificar las estaciones hidrológicas en estaciones en satisfactorias, razonables e insatisfactorias. Los resultados permiten concluir que 66,37% o 274 de 413 estaciones fluviométricas del estado presentan informaciones insatisfactorias, perjudicando así, la planificación  y gestión de los recursos hídricos. De esta manera, el monitoreo de aguas superficiales se convierte en un desafío. Palabras clave: HidroWeb, estaciones fluviométricas, datos hidrológicos, Índice de Calidad.
KAFKA, NIETZSCHE E DUAS PARÁBOLAS
Authors: Burnett Henry
Published: May 2017

O artigo desenvolve uma leitura em paralelo de dois textos: um trecho de Der tolle Mensch (§ 125 d’A gaia ciência, de Nietzsche) e a parábola Ein commentar (aforismo de Kafka). Não procurando realizar uma análise comparada, procura-se apontar algumas aproximações e alguns distanciamentos. Como mediadores desta tentativa de leitura, utilizamos uma carta de Walter Benjamin e os comentários de Modesto Carone sobre a parábola de Kafka.
AUTOGENEALOGIA E REIVINDICAÇÃO DE OBJETIVIDADE MORAL EM NIETZSCHE
Authors: Viesenteiner Jorge Luiz
Published: May 2017

O objetivo do artigo é articular os conceitos de autogenealogia e de reivindicação de objetividade moral, na medida em que exploro a fecundidade da noção de autorreferencialidade do argumento autogenealógico, e de uma concepção deflacionada de objetividade, onde o mais importante é o controle sobre o conteúdo dos juízos morais, e menos a verdade correspondencial desses juízos. Para isso, lanço mão de algumas categorias do debate contemporâneo em metaética, de modo sustentar que Nietzsche ocupa uma posição não-cognitivista, mas com algum sucesso de reivindicação de objetividade moral.
Relationship between Bioimpedance-determined Body Composition and Peritoneal Transport in Peritoneal Dialysis
Authors: da Costa Bernardo M. , Del Peso Gloria , Bajo Maria Auxiliadora , Carreño Gilda , Ferreira Marta , Ferreira Carina , Selgas Rafael
Published: May 2017

Purpose

In peritoneal dialysis (PD) patients, body fluid homeostasis is dependent on peritoneal elimination of water and solutes. Patients with less favorable peritoneal transport parameters should be more overhydrated. Despite this, the association between faster transport and overhydration (OH) is weak, and the factors that influence hydration status are still poorly characterized. Modified peritoneal equilibration tests (PET) offer us new parameters that might correlate better with hydration status, like free water transport (FWT). The aim of this study was thus to establish the relationships between new peritoneal transport parameters and body composition parameters estimated by bioimpedance spectroscopy (BIS).

Methods

Prospective observational study on incident PD patients with a baseline and 1-year follow-up evaluation.

Results

61 patients were included in the baseline evaluation, 19 of whom had a 1-year follow-up evaluation; 67.2% were fluid overloaded. There was a negative correlation between D/P creatinine and FWT (r = -0.598, p = 0.000). The fraction of FWT was negatively correlated with OH (r = -0.302, p = 0.018). Peritoneal protein losses (PPL) were also correlated with OH (r = 0.287, p = 0.028). There were no significant differences in OH according to small-solute transport status or fluid output parameters. After 1 year, we observed a significant worsening of renal function and an improvement in 24-hour ultrafiltration (UF) and hydration status, but we detected no differences in peritoneal transport of water or solutes that could explain these changes.

Conclusions

There is a poor relationship between kidney/peritoneal function parameters and body composition parameters. The fraction of FWT and PPL may be underestimated markers of peritoneal health and of its contribution to the hydration status.
Dynamic Mechanical Analysis of Carbon Nanotube-Reinforced Nanocomposites
Authors: Her Shiuh-Chuan , Lin Kuan-Yu
Published: May 2017

Background

To predict the mechanical properties of multiwalled carbon nanotube (MWCNT)–reinforced polymers, it is necessary to understand the role of the nanotube-polymer interface with regard to load transfer and the formation of the interphase region. The main objective of this study was to explore and attempt to clarify the reinforcement mechanisms of MWCNTs in epoxy matrix.

Methods

Nanocomposites were fabricated by adding different amounts of MWCNTs to epoxy resin. Tensile test and dynamic mechanical analysis (DMA) were conducted to investigate the effect of MWCNT contents on the mechanical properties and thermal stability of nanocomposites.

Results

Compared with the neat epoxy, nanocomposite reinforced with 1 wt% of MWCNTs exhibited an increase of 152% and 54% in Young's modulus and tensile strength, respectively.

Conclusions

Dynamic mechanical analysis demonstrates that both the storage modulus and glass transition temperature tend to increase with the addition of MWCNTs. Scanning electron microscopy (SEM) observations reveal that uniform dispersion and strong interfacial adhesion between the MWCNTs and epoxy are achieved, resulting in the improvement of mechanical properties and thermal stability as compared with neat epoxy.
Urinary Artificial Sphincter ZSI 375 for Treatment of Stress Urinary Incontinence in Men: 5 and 7 Years Follow-Up Report
Authors: Llorens Christophe , Pottek Tobias
Published: May 2017

Study Design

This is a retrospective, non-randomised study.

Objectives

The aim of this study was to evaluate safety and efficacy of artificial urinary sphincter ZSI 375 inserted in male patients with stress urinary incontinence (SUI).

Methods

Between May 2009 and January 2017, 45 men with SUI underwent ZSI 375 device insertion. Operations were performed in two French centres by one surgeon. Complications and pad used to manage continence were recorded.

Results

From May 2009 to January 2012, 45 patients with a mean age of 70.42 years underwent placement of the ZSI 375 device in France. The most common cause for incontinence was radical prostatectomy (RP, 33/45 ­patients, 73.33%). The minimal period of incontinence was 6 months. Twenty-seven out of 45 patients (60.00%) had a severe incontinence (at least four pads per day), 13 patients (28.89%) had moderate incontinence (three pads per day) and five patients (11.11%) had two pads per day. With a long follow-up, the ZSI 375 device was considered to be successful in 73.33% patients after 5 years (60 months) and 72% of patients after 7 years (84 months). The infection rate was 2.2 % affecting one in 45 patients. Six out of 45 patients presented a urethral erosion (13.33%). Mechanical failure with a revision occurred in three patients (6.67%).

Conclusions

The ZSI 375 device is a safe and effective device to treat severe SUI in men.
Physician's perspective on point-of-care ultrasound: Experience at a tertiary care emergency department in Qatar
Authors: Chaudhry Sohaib , Bashir Khalid , Bashir Israr , Cameron Peter
Published: May 2017

Background: Point-of-care ultrasound is an invaluable tool in the diagnosis and management of many conditions presenting to emergency departments across the world. It has also improved the success rate of invasive bedside procedures.

Objectives: This study aimed to investigate the current utilization of point of care ultrasound in a large tertiary care emergency department in the Middle East and to identify barriers to its utilization.

Methods: A cross sectional survey of emergency physician's experience with ultrasound was conducted, examining training, exposure and barriers to use. This paper-based survey was completed by the participants in the presence of study authors to improve compliance. Data was collected over a period of two months, from October to November 2014.

Results: One hundred and five (105) physicians participated in the survey. Fifty-six physicians had prior training in ultrasonography from courses approved by The Royal College of Emergency Medicine in the United Kingdom, and The Royal College of Physicians and Surgeons of Canada. Twenty-two physicians had undertaken other non-accredited ultrasound courses. All of them reported an improvement in their procedural skills by employing ultrasound. Perceived lack of time in the Emergency Department was the main barrier to scanning. Other hurdles included a deficiency of trained personnel for guidance, shortage of equipment and a lack of experience and interest. Hands on training were stated as the preferred method for enhancing ultrasonography skills.

Conclusions: There has been underutilization of point-of-care ultrasound by emergency physicians. Availability of dedicated time, equipment, supervision and training will help to increase its usage.
Measles outbreak among Pakistani community living in Qatar, Spring 2015
Authors: Elbardiny Aiman Aly , Al-Romaihi Hamad , Nadeem Shazia , Al-Thani Shk. Mohammed , Khogali Hayat S , Farag Elmoubasher , Ganesan Nandakumar
Published: May 2017

Background: Measles is a highly contagious respiratory disease caused by a virus that can be serious in all age groups. However, measles complications more like to occur in children younger than five years and adult older than 20 years. Qatar is one of the Eastern Mediterranean (EMR) countries that are committed to achieving measles elimination target by 2015. However, Qatar has been experiencing a measles outbreak mainly due to a unique population characteristic, which includes highly transient expatriate population.

Objectives: To describe the incidence and morbidity to measles outbreak among the Pakistani community living in Abu Hamour area in spring 2015.

Methods: Data collection was done through the system of mandatory notification of the Health Protection and communicable disease control department (HP&CDC). All notified cases were interviewed with standardized questionnaire that are distributed to the families during the vaccination campaign. The information about disease complications was obtained from Health care facilities. Clinical case definition was adopted from world health organization (WHO).

Results: A total of 36 cases were diagnosed with measles from mid-March until end of April 2015. The index case was traveled recently to Pakistan, hence this outbreak was associated with the imported virus. Most of cases were from Pakistani community living in Abu Hamour area and the age distribution of cases was more of younger age groups (especially the 1–4 year group). Concerning measles vaccination history, all reported cases never vaccinated before. Conjunctivitis (36.1%) followed by gastroenteritis (30.6%) were the most common complications.

Conclusion: An accumulation of non-immune individuals led to this outbreak. Catch-up vaccination campaigns targeting a younger age group of a particular immigrant community are needed to close critical immunity gaps.
Qatar ambulance service and Hamad General Hospital Emergency Department staff's perception of current patient handover practice
Authors: Jundi Ibrahim , Abujaber Ahmad , Alinier Guillaume , Campbell Craig , Meyer John , Al Shaikh Loua , Cameron Peter , Rull Sandra , Kamel Hany , Govender Kevin
Published: May 2017

Background: The handover process is meant to ensure patient safety and maintain continuity of care through endorsement of critical patient information. This study evaluates staff's perceptions about the current patient handover process effectiveness between Ambulance Service (AS) and Emergency Department (ED) clinicians. It may help identify barriers and contributing factors to an effective patient handover.

Methods: An electronic questionnaire was circulated to all ED doctors/nurses and AS staff (Estimated N = 1,000). 400 questionnaires were completed of which 92 did not meet the inclusion criteria. Respondents were 43% AS staff, 29% ED nurses, and 28% ED doctors. A 4-point Likert scale (1 = strongly disagree-4 = strongly agree) was used. The mean was calculated for every variable to determine each group perception. One-way ANOVA tested the relationship between demographics and perceptions’ variables.

Results: Although 62% of respondents believe the current handover process is safe and 65% believe AS staff report all critical information, 70% of respondents think that it causes AS/ED staff conflicts, and 72% believe the current handover process needs changing. ANOVA test revealed significant differences in the mean between study groups’ handover safety perceptions. Interestingly, ED nurses expressed more safety concern (2.43) than ED doctors (2.58) and AS staff (2.82) with p-value < 0.05. The main perceived barriers to effective handover were: Lack of handover protocol (89%); Lack of a standardized handover tool (89%); Fragmented communication (85%); and Frequent interruptions (82%). 93% of the respondents believe the use of a standardized handover tool will improve the patient handover process despite 67% of them not knowing any standardized handover tool.

Conclusion: The lack of handover protocol and a standardized tool leads to significant variation and is a patient safety concern due to potential loss of critical information. We believe that a mutually agreed standardized handover tool such as ISBAR would reduce handover variation and ensure quality.
Optimising the patient compartment design of ambulances in Qatar
Authors: Hutton David , Alinier Guillaume , Meyer John
Published: May 2017

Background: The ambulance patient compartment is a working environment where paramedics provide care to patients at times of distress. It needs to meet a number of functional requirements under various conditions whilst being practical and safe for its occupants. Their design varies greatly internationally and often nationally. This study aims to review the current design of Qatar's ambulances to ensure the safe journey of its users whilst making it very appropriate for patient care delivery during transport.

Methods: This study was ethically approved as a quality improvement project. The literature was extensively reviewed with regards to patient compartment design. Three focus groups sessions were organised each with 8 experienced participants out of a total population of 800–900 paramedics, to examine the current ambulance patient compartment layout.

Results: The focus group sessions conducted with a total of 24 paramedics, each with over a year of experience as independent practitioner, identified that improvements can be made to the current ambulance design for patient care and paramedic safety, including the different positioning of consumables and equipment, altered seat design, modified storage cabinets, and the use of better passenger restraints. It was also identified that improving the quality of driving skills through training and education will also have a positive impact on safety and comfort.

Conclusions: It has been recognised that current practitioners' (users) involvement, as opposed to managers, is critical to the appropriate design of the ambulance patient's compartment. They have valuable feedback to provide on the current design from a practical aspect but do not always have their own safety in mind. Based on our study findings the recommendations are to introduce a structured driver-training programme and begin a process of redesigning the patient compartment to test the above recommendations using prototyping and simulation techniques to minimise costs and maximise benefits.
Pre- and post-assessment of conjugated vaccine (MenAfriVac) and case-based surveillance system implementation 2010–2015, Sudan
Authors: Hussein Safaa Ibrahim Musa , Bashab Hind Mohammed , Hassan Deena Mohamed Abdegader , Khogali Hayat Salaheldein
Published: May 2017

Objective: Since 1998 seasonal epidemic meningitis has been a recurrent problem in Sudan with a variation in the severity between seasons. Mass vaccination campaign with conjugated vaccine (MenAfriVac) for Neisseria meningitidis A was implemented in Sudan since October 2012, since then case base surveillance of meningitis was implemented. The target age group was 1–30 years. Measuring of meningitis trends in three years pre and post the campaign against NmA is mandatory to assess the impact of introducing (MenAfriVac) vaccine.

Objective: To describe the epidemiological profile of NmA in Sudan, 2010–2015.

Methods: Descriptive study using data of notable suspected meningitis cases by national surveillance system.

Results: EpiInfo 7 software used to analyze the data. 2010–2012 a total of 4273 suspected cases were reported (13.08/100,000 Attack Rate (AR)) with 185 deaths (4.35% Case Fatality Rate (CFR)). The most effected Age-Group was ( < 5) representing 62% of cases, 61% of cases were observed among males and 39% among female. The positivity rate of NmA was 4.2%. 2013–2015 After MenAfriVac® and case-based surveillance implementation; a total of 794 suspected cases were reported (4.5/100,000 AR) with 59 deaths (7.0% CFR), the most effected Age-Groups were (1–4) representing 40.3% of cases following by Age-Groups ( < 1) representing 39.7% of cases, 64% of cases among male and 36% among female. The positivity rate of NmA was 0%, no confirmed case of NmA was reported.

Conclusion: Introducing of MenAfriVac® proved to be an effective strategy contributed to decrease the overall number of meningitis suspected cases in Sudan.
Monitoring of toxic metals in dietary supplements before they marketed in Qatar
Authors: Azimi Salman , Arram Noha Reda
Published: May 2017

The consumption of dietary supplements is widely spread and on the rise in Qatar market. Toxic metals like mercury, lead, cadmium and arsenic can be naturally present in dietary supplements and can pose harmful effects on human health. Pharmacy and Drug Control Department; SCH has been involved in proper counselling of these products before they are marketed to Qatar. In this study Two hundred and thirty five different dietary products (capsule, liquid or powder form) were analyzed which were submitted to our department for registration. Inductively Coupled Plasma-Mass Spectrometer (ICP-MS) and Mercury Analyzer are used to monitor toxic metals that exceed United States Pharmacopeia (USP) maximum limits. Samples were digested with HNO3+HCl (5:1) by utilizing closed vessel microwave system. The validity of the applied method was assessed by the analysis of standard reference material (SRM 1548a), and the recoveries were 100 ± 10% of the certified value for 4 metals. Among the 235 samples, 13 samples contained lead (Pb) exceed the USP limit while 2 samples with arsenic (As) above the limit. No sample contained Cd and Hg above the limits. Pharmacy and Drug Control Department is taking action and monitoring toxic levels of Hg, Pb, Cd and As in herbal and dietary supplements before they market in Qatar by using state of the art technology for the safety of public and for the better health of peoples living in Qatar.
Changing culture through conversation: An action research inquiry on the adverse incident review process
Authors: Campbell Craig Brendan , Al Shaikh Loua Asad Hanna , Kuhne Jorg , Castle Nicholas , Patel Ameeta , Alinier Guillaume Henry , Bowen James , Sayo Joel , Ramos Roumel , Meyer John
Published: May 2017

Background: Clinical governance requires having a process for adverse incident review and management to ensure the organisation ‘learns from its mistakes’ to prevent repetition. How leadership implements this system may enhance learning and patient safety, or have the unintended consequence of raising alarm, possible demotivation, and staff becoming risk-averse. The impact of the existing Ambulance Service incident management process was assessed from an organizational culture aspect.

Methods: Action research uses iterative and collaborative cycles of study, action, and reflection to not only understand a complex situation by holding an attitude of inquiry but also to bring about positive change. Dialogue and narrative enquiry were used to collect data using a grounded theory approach for data interpretation. Dialogue was used both for reflection and for initiating change at various levels within the Service.

Results: Initial data indicated a moderate fear culture in the Service, with staff becoming risk averse in the clinical environment due to concerns of being called for investigation. Dialogue sessions were held with key role players highlighting the experiences of staff. The impact of these conversations were reflected on and the outcomes of this reflection was used to frame further dialogue. Narrative (stories) of staff experiences were collected and used in the dialogue to highlight the impact of the adverse incident review system on staff morale. Based on these conversations, leadership made changes, including developing new incident review process with peer involvement, changing leaders of the process and an increased focus on communicating feedback to staff. As one staff member noted the mood in the corridors is much lighter.

Conclusion: Action research provides an effective method for leaders, working in the real world environment, in dealing with the complex issues to bring about positive change, both in quality and patient safety, and staff satisfaction point of view.