bluuebunny/crossref_metadata_2025 huggingface dataset:
Hybrid response surface methodology–artificial neural network optimization of drying process of banana slices in a forced convective dryer
Authors: Taheri-Garavand Amin , Karimi Fatemeh , Karimi Mahmoud , Lotfi Valiullah , Khoobbakht Golmohammad
Published: December 2017

The aim of the study is to fit models for predicting surfaces using the response surface methodology and the artificial neural network to optimize for obtaining the maximum acceptability using desirability functions methodology in a hot air drying process of banana slices. The drying air temperature, air velocity, and drying time were chosen as independent factors and moisture content, drying rate, energy efficiency, and exergy efficiency were dependent variables or responses in the mentioned drying process. A rotatable central composite design as an adequate method was used to develop models for the responses in the response surface methodology. Moreover, isoresponse contour plots were useful to predict the results by performing only a limited set of experiments. The optimum operating conditions obtained from the artificial neural network models were moisture content 0.14 g/g, drying rate 1.03 g water/g h, energy efficiency 0.61, and exergy efficiency 0.91, when the air temperature, air velocity, and drying time values were equal to −0.42 (74.2 ℃), 1.00 (1.50 m/s), and −0.17 (2.50 h) in the coded units, respectively.
Plaque-like Myofibroblastic Tumor: 2 Cases of This Unusual Dermal Tumor Which Occurs in Infancy and Early Childhood
Authors: Sekar Thivya , Mushtaq Jameel , AlBadry Waleed , Soole Frederick , Nagy Anita , Powell Barry , Chong Heung
Published: December 2017

Plaque-like myofibroblastic tumor (PLMT) is a rare dermal spindle cell tumor which occurs in infancy or childhood within the first 4 years of life. The tumor is often pruritic and mostly presents on the lower back. We describe 2 cases with characteristic clinical and histological features of this entity, thus adding to the 10 cases which have so far been reported. Histologically, the lesion resembles a dermatofibroma. However, diffuse and uniform immunohistochemical staining with smooth muscle actin favors a myofibroblastic lineage. PLMT should be considered in the differential diagnosis of a dermal spindle cell tumor in the pediatric age-group.
Plasma Cytochrome c Detection Using a Highly Sensitive Electrochemiluminescence Enzyme-Linked Immunosorbent Assay
Authors: Radhakrishnan Jeejabai , Origenes Rovi , Littlejohn Gina , Nikolich Sanja , Choi Eunjung , Smite Sharon , Lamoureux Lorissa , Baetiong Alvin , Shah Manoj , Gazmuri Raúl J
Published: December 2017

Background:

Cytochrome c is an intermembrane mitochondrial protein that is released to the bloodstream following mitochondrial injury.

Methods and results:

We developed an electrochemiluminescence immunoassay to measure cytochrome c in human and rat plasma, which showed high sensitivity with broad dynamic range (2-1200 ng/mL in humans and 5-500 ng/mL in rat) and high assay reproducibility (inter-assay coefficient <6% in humans and <10% in rat). In patients after blunt trauma, plasma cytochrome c directly correlated with injury severity. In rats after cardiac resuscitation, plasma cytochrome c inversely correlated with survival and responsiveness to mitochondrial protective interventions.

Conclusions:

The cytochrome c assays herein presented have high sensitivity, wide dynamic range, and high reproducibility well suited for biomarker of mitochondrial injury.
The Effects of Astym Therapy® on a Child With Spastic Diplegic Cerebral Palsy
Authors: Miller Mandi M , Ray Jessica M , Van Zant R Scott
Published: December 2017

Purpose:

Limited research exists regarding use of Astym® therapy with neurologic conditions. The purpose of this case was to describe using Astym therapy in treating spastic diplegic cerebral palsy (CP).

Case description:

A 6-year-old female was treated more than 9 months (36 sessions) for decreased flexibility, muscle weakness, spasticity, and abnormal gait.

Examination findings:

Gait performed with articulated ankle-foot orthoses (75% of the time) or foot orthosis (25%); lack of active dorsiflexion (DF); lack of heel strike during gait; spasticity in hamstrings, gastrocnemius, hip adductors; hamstring flexibility (90/90 test position) 50° right and 60° left; gastrocnemius flexibility neutral bilaterally; and Peabody Developmental Motor Scales, second edition (PDMS-2) age equivalence (in months) 23 locomotion, 25 object manipulation, and 21 stationary tasks. Therapeutic interventions included Astym therapy, stretching, strengthening, neuromuscular reeducation, and gait training.

Outcomes:

At 6 months, flexibility improved bilaterally to 10° past neutral in gastrocnemius and 0° in hamstrings. The PDMS-2 age equivalence scores were 27 locomotion, 32 object manipulation, and 28 stationary tasks. At discharge, patient ambulated full-time with foot orthosis, exhibiting improved stride length bilaterally with active ankle DF to initiate heel strike. Spasticity was unchanged.

Discussion:

Astym therapy was effective in treating a child with spastic diplegic CP, resulting in enhanced strength, flexibility, and gait.
A full numerical solution to the coupled cam–roller and roller–pin contact in heavily loaded cam–roller follower mechanisms
Authors: Alakhramsing Shivam S , de Rooij Matthijn B , Schipper Dirk J , van Drogen Mark
Published: December 2017

In cam–roller follower units two lubricated contacts may be distinguished, namely the cam–roller contact and roller–pin contact. The former is a nonconformal contact while the latter is conformal contact. In an earlier work a detailed transient finite line contact elastohydrodynamic lubrication model for the cam–roller contact was developed. In this work a detailed transient elastohydrodynamic lubrication model for the roller–pin contact is developed and coupled to the earlier developed cam–roller contact elastohydrodynamic lubrication model via a roller friction model. For the transient analysis a heavily loaded cam–roller follower unit is analyzed. It is shown that likewise the cam–roller contact, the roller–pin contact also inhibits typical finite line contact elastohydrodynamic lubrication characteristics at high loads. The importance of including elastic deformation for analyzing lubrication conditions in the roller–pin contact is highlighted here, as it significantly enhances the film thickness and friction coefficient. Other main findings are that for heavily loaded cam–roller follower units, as studied in this work, transient effects and roller slippage are negligible, and the roller–pin contact is associated with the highest power losses. Finally, due to the nontypical elastohydrodynamic lubrication characteristics of both cam–roller and roller–pin contact numerical analysis becomes inevitable for the evaluation of the film thicknesses, power losses, and maximum pressures.
‘The expertness of his healer’: Diagnosis, disclosure and the power of a profession
Authors: Jutel Annemarie
Published: December 2017

Diagnosis is one of medicine’s most important tools. It structures the relationship between patient and diagnostician, organises illness and provides access to resources. In this article, I reveal how the manner in which a serious diagnosis is revealed creates a kind of ‘epistemic posture’ reinforcing the power of medical knowledge, and contributing to medical authority. To achieve this, I explore historical material written by and for doctors about the disclosure of difficult diagnoses. Using historical data for sociological purposes follows Zerubavel, who asserts that phenomena should be studied across eras, media and cultures. I have chosen to focus on how diagnostic disclosure, as described by mid-19th to mid-20th century doctors, serves to promote the profession of medicine. The means of revealing a diagnosis served as a demonstration of, and a means for deflecting threats to, medicine’s esoteric nature. The historical data provide a novel approach for understanding how diagnosis operates, even today, to confirm the professional status of the doctor.
Computational fluid dynamics simulation of wind-driven inter-unit dispersion around multi-storey buildings: Upstream building effect
Authors: Dai Y. W. , Mak C. M. , Ai Z. T.
Published: December 2017

Previous studies on inter-unit dispersion around multi-storey buildings focused mostly on an isolated building. Considering that the presence of an upstream building(s) would significantly modify the airflow pattern around a downstream building, this study intends to investigate the influence of such changed airflow patterns on inter-unit dispersion characteristics around a multi-storey building due to wind effect. Computational fluid dynamics (CFD) method in the framework of Reynolds-averaged Navier-stokes modelling was employed to predict the coupled outdoor and indoor airflow field, and the tracer gas technique was used to simulate the dispersion of infectious agents between units. Based on the predicted concentration field, a mass conservation based parameter, namely re-entry ratio, was used to evaluate quantitatively the inter-unit dispersion possibilities and thus assess risks along different routes. The presence of upstream building(s) could disrupt the strong impingement of approaching flows but brings a more complex and irregular airflow pattern around the downstream multi-storey buildings, leading to a more scattered distribution of re-entry ratio values among different units and uncertain dispersion routes. Generally, the tracer gas concentration in most units was lower than those in an isolated building, although very high concentrations were found in some specific areas.
Dynamic measurement of newly formed carbonyl compounds in vapors from electronic cigarettes
Authors: Sala Cecilia , Medana Claudio , Pellegrino Raffaele , Aigotti Riccardo , Bello Federica Dal , Bianchi Giancarlo , Davoli Enrico
Published: December 2017

Recently, the formation of carbonyl compound within e-cigarettes usage has been reported. The aim of this study was to develop a new analytical method for the direct analysis of carbonyl compounds in vaporized liquids. Two different types of e-cigarettes and different puff’s duration have been evaluated, using a modified smoking machine for vapor generation. An isotopic dilution approach, based on deuterated internal standard addition to the e-liquid before filling the e-cigarette tank, has been developed. Carbonyl compounds have been sampled in vapors using a direct, simple, solid-phase microextraction technique with on-fiber derivatization. Related oximes have been analyzed by gas chromatography/mass spectrometry technique. Results confirmed that new carbonyl compounds are formed during the vaping process, and that formation depends both from the heating device and from puffing topography.
Serum glycosylation characterization of osteonecrosis of the femoral head by mass spectrometry
Authors: Song Ting , Chen Peng , Stroble Carol , Ruhaak L Renee , Wang Haibin , Li Ziqi , He Wei , Lebrilla Carlito B
Published: December 2017

Osteonecrosis of the femoral head is a recalcitrant and paralyzing disease often discovered in the end stage at the time of diagnosis, which is often performed by physical examination and diagnostic imaging. Osteonecrosis of the femoral head is typically caused by trauma or long-term steroid use. There are over 30 million patients in the US taking steroids, and roughly 40% will develop osteonecrosis of the femoral head. However, the exact pathophysiological process is not well understood. This study aims to examine the alteration in serum glycosylation of osteonecrosis of the femoral head using the state-of-the-art analytical tools to provide more chemical data for pathophysiology research and possibly biomarker discovery. A training set containing 27 serum samples from steroid-induced osteonecrosis of the femoral head patients and 25 from gender- and age-matched controls was collected and analyzed. Glycosylation of whole serum and site-specific glycosylation of immunoglobulins are characterized using electrospray ionization-Q-time of flight and electrospray ionization-Triple-Quadruple via multiple reaction monitoring, respectively. The whole serum glycosylation analysis yielded 14 N-glycan compositions and multiple reaction monitoring yielded eight glycopeptides that were altered between cases and controls with statistical significance. The increase of nonsialylated, nonfucosylated N-glycans and decrease of fucosylated N-glycans are associated with the development of osteonecrosis of the femoral head. Glycosylation is a posttranslational protein modification and is apparently affected by osteonecrosis of the femoral head. Future studies with a larger cohort and patients from earlier stage will be performed to assess these potential markers’ value in disease onset.
Design follows politics? The visualization of political orientation in newspaper page layout
Authors: Schindler Johanna , Müller Philipp
Published: December 2017

This article explores how the political orientation of newspapers is reflected in their page layout. The authors compare the layouts of five German national quality newspapers exemplarily and exploratively in a combination of quantitative and qualitative analyses. Dimensions of comparison are typography, size, colouration, quantity and arrangement of elements. Results show systematic differences between the page layouts of left-wing and right-wing newspapers. These differences are reflected in the contrast of traditional and contemporary styles and also in the use of ideologically charged typography and colours. In addition, the size of headlines seems to be dependent on political extremity. Graphic design seems to work as an ideological symbol system with different layout styles quite consistently representing partisan positions. If media users could come to learn and recognize such visual patterns, layout could function as a visual frame for political messages.
Merging the components of a finite mixture using posterior probabilities
Authors: Comas-Cufí Marc , Martín-Fernández Josep A , Mateu-Figueras Glòria
Published: December 2017

Methods in parametric cluster analysis commonly assume data can be modelled by means of a finite mixture of distributions. However, associating each mixture component to one cluster is frequently misleading because different mixture components can overlap, and then, associated clusters can overlap too suggesting a unique cluster. A number of approaches have already been proposed to construct the clusters by merging components using the posterior probabilities. This article presents a generic approach for building a hierarchy of mixture components that integrates and generalizes some techniques proposed earlier in the literature. Using this proposal, two new techniques based on the log-ratio of posterior probabilities are introduced. Moreover, to decide the final number of clusters, two new methods are presented. Simulated and real datasets are used to illustrate this methodology.
Managing identity in a host setting: School social workers' strategies for better interprofessional work in New Zealand schools
Authors: Beddoe Liz
Published: December 2017

Social workers in New Zealand other schools work with other school professionals to respond to potential child maltreatment in the school setting, but little is reported about their experience of interprofessional collaboration. An exploratory qualitative study focused on school professionals’ process when responding to child maltreatment. The author conducted 20 semi-structured telephone interviews with social workers to explore their interprofessional work with teaching professionals. Many challenges were reported including power imbalances; resource issues, especially inadequate time given their placement in multiple schools; marginalisation, and teachers’ inconsistent understanding of the social work role. Social workers reported relationship-based strategies to manage these challenges, and a sense of pride and identity was apparent in these accounts. Patient relationship building was a key strategy to build respect and understanding of social work knowledge and skills. A reading of Bourdieu's discussion of social distinction suggests social work is often perceived as a profession lacking the confidence of the “distinguished possessor” of capital and more of the uncertainty of the “pretentious challenger”. A professional capital framework, that positions school-based social workers as ‘guests’ in a host setting, is useful in understanding these dynamics and how social workers choose to respond. This study suggests that preparation for school social work might usefully focus on interprofessional working and in particular support the development of conscious, principled yet pragmatic relationship-building skills to bridge the gap between the teaching and social work professions and improve the welfare of children.
The negotiation of the relationship between home and school in the mind of grade 6 students in an international school in Qatar
Authors: Frangie Maha
Published: December 2017

This paper aims at deepening the understanding of how the relation between home and school is negotiated in the mind of Grade 6 students attending an International Baccalaureate (IB) school in Qatar. Students reported mainly frustration and confusion. The Thematic Coding Analysis used in the study revealed two strategies students use to negotiate between the different settings, including submitting to parental authority and raising their parents’ awareness about IB. The analysis also highlighted the importance of student voice in bridging the gap between home and school.
Early Outcomes of the t-Branch Off-the-Shelf Multibranched Stent-Graft in Urgent Thoracoabdominal Aortic Aneurysm Repair
Authors: Spanos Konstantinos , Kölbel Tilo , Theodorakopoulou Myrto , Heidemann Franziska , Rohlffs Fiona , Debus Eike Sebastian , Tsilimparis Nikolaos
Published: December 2017

Purpose: To assess the short-term outcomes of the multibranched off-the-shelf t-Branch stent-graft for urgent thoracoabdominal aortic aneurysm (TAAA) repair and to evaluate the impact on outcomes of the learning curve and adherence to the instruction for use (IFU). Methods: Between 2014 and 2017, 42 patients (mean age 73.3±7 years; 26 men) underwent urgent TAAA treatment using the t-Branch stent-graft [18 in the early (2014–2015) period and 24 in the late (2016–2017) period]. Nearly half the patients were symptomatic (n=18) and 12 had contained rupture. Aneurysm diameter >80 mm was present in 12 (mean diameter 77.7±13.2 mm). Nineteen patients did not meet the IFU for the t-Branch due to target vessel anatomy. The primary endpoints were spinal cord ischemia (SCI), renal function impairment, and 30-day mortality. Target vessel patency and endoleak incidence were assessed at 30 days. Multivariate analyses examined associations between perioperative variables and outcomes; the results are presented as the odds ratio (OR) and 95% confidence interval (CI). Results: The technical success rate was 93% (39/42). Successful catheterization was achieved in 150/155 target vessels (97%). The postoperative SCI rate was 21% (5 paraplegia/4 transient paraparesis) and was correlated with age (OR 1.26, 95% CI 1.01 to 1.56, p=0.04). The renal function impairment rate was 23% (10/42; 2 temporary, 2 permanent dialysis) and was correlated with early experience (OR 7.74, 95% CI 1.3 to 43.9, p=0.019). The 30-day mortality was 14% (no intraoperative deaths); no factor was associated with mortality. During the first month, the incidences of type I, II, and III endoleaks were 0%, 43%, and 0%, respectively; branch patency was 99% (150/151). Procedure time decreased in the later experience (479±333 vs 407±25 minutes, p=0.09), though it was increased in cases outside the IFU (497±135 vs 389±118 minutes, p=0.009), along with fluoroscopy time (121±48 vs 92±33 minutes, p=0.036). Conclusion: Endovascular repair of urgent TAAA using the t-Branch is a feasible treatment option with acceptable 30-day mortality and morbidity in terms of SCI and renal function impairment. Adherence to the IFU prolonged procedure time but had no effect on outcomes. Increased experience of such cases over time may improve outcomes.
In-plane shear behavior of 3D warp-knitted spacer fabrics: Part II—Effect of structural parameters
Authors: Arumugam Veerakumar , Mishra Rajesh , Tunak Maros , Militky Jiri
Published: December 2017

The objective of this work is to study the in-plane shear behavior of 3D warp-knitted spacer knitted fabrics by using a picture frame fixture. This part aims to investigate the effects of structural parameters on the shear stress and energy absorption of warp-knitted spacer fabrics. A group of warp-knitted spacer fabrics was produced on a double-needle bar Raschel machine by varying their structural parameters including spacer yarn fineness, fabric thickness, and outer layer structure. The effects of fabric structural parameters on the shear properties of the spacer fabrics were tested and analyzed based on the nonlinear behavior of shear stress versus shear angle and the deformation mechanism. During loading process, the series of surface images were acquired in certain interval at different positions. These images were processed in image analysis software to obtain the full-field displacement and shear angles at chosen points on the surface of test specimen. The potential shear behavior of the fabric was identified with support of the shear stress–strain curve, work done, and efficiency at different shear stages. The regression model was used to establish the elastic deformation properties to obtain the shear results. Advance statistical evaluation and two-way analysis of variance are used to analyze the significance of various factors such as thickness, spacer yarn diameter, and surface structures on energy absorption at maximum shear load and deformation.
Process analysis of spray atomization of dissolved polymers for manufacturing of blood-compatible textile implants
Authors: Nadzeyka Ingo , Bolle Eleonore , Moos Martin , Kunitz Paula , Steinseifer Ulrich , Schmitz-Rode Thomas
Published: December 2017

The use of porous polymer materials for vascular prostheses demonstrates promising results. Fleece-like non-woven structures can be generated by atomization of dissolved polycarbonate urethanes. This article focuses on the manufacturing process for the fleece structures. The solution is atomized through a high-volume low-pressure nozzle. The solvent evaporates during time of flight to target, so that small fibres are formed from each drop of solution. By using different rotating molds and positioning systems, tubular shapes or open surfaces can be generated. The manufacturing process is described in detail. The usability of different grades of polycarbonate urethane is tested and the time necessary for evaporation of the solvent from the mesh is assessed. The influence of several basic parameters on the mechanical properties of the generated non-woven material is analysed and discussed.
Disciplinary (Per)Mutations of Ethnography
Authors: Carter Thomas F.
Published: December 2017

There has been a veritable explosion across various disciplines “discovering” ethnography over the past three decades. This article argues that the proliferation of “ethnography” outside anthropological circles has led to some pervasive interrelated misconceptions about ethnography, misconceptions reinforced by some of the reflective debates within anthropology. Consequently, this article argues that the broadening interdisciplinary discussions of “ethnographic methods” obscure the actuality of ethnography. Practitioners in these disciplines often discuss how they use “ethnographic methods,” as if these “methods” are the equivalent of engaging in ethnography. As a result, some rather significant differences in the way disciplines conceive and practice ethnography emerge because of how ethnography itself is conceptualized rather than how it is practiced. Ethnography is not simply an amalgamation of constituent parts; it is a sum greater than its constituent parts. There is more to ethnography than either its methods or its texts. Although ethnography is also about the kinds of stories, narratives, and diverse ways in which knowledge is produced and its findings are presented, ethnography is so much more than a literary endeavor. All the research methods found in ethnography are used in other forms of research, yet said methods, in and of themselves, do not make ethnography unique nor make an ethnography. Ethnography is much larger, profound, and illuminating.
Closeted Womanhood
Authors: Malmrose Ellie
Published: December 2017

ellie malmrose on experiencing the expectations of masculinity without ever being male.
Preoperative assessment of computerized tomography angiography to predict success for crossing long Trans-Atlantic Inter-Society Consensus D lesions using the optical coherence tomography catheter
Authors: Kim Ryan J , Smith Jamie B , Vogel Todd R
Published: December 2017

Objectives

Optical coherence tomography chronic total occlusion catheter, the Ocelot (Avinger Inc., Redwood City, CA), has been utilized to cross Trans-Atlantic Inter-Society Consensus D lesions. This study evaluated the preoperative computerized tomography angiography of chronic total occlusions in the superficial femoral artery to predict clinical success.

Methods

We reviewed all patients who underwent lower extremity procedures with the Ocelot catheter from June 2014 to August 2016. Patients who had a preoperative computerized tomography angiography were evaluated. Final outcomes, plaque morphology, lesion length, calcium surface area, lesion location, and patient characteristics were analyzed.

Results

A total of 107 patients underwent lower extremity interventions with the Ocelot catheter. Seventy patients had a preoperative computerized tomography angiography scan prior to lower extremity intervention and 77% (54) had Trans-Atlantic Inter-Society Consensus D lesions that were crossed. Mean age was 62.8 years and 68.6% were male. Mean chronic total occlusion length was 182.7 mm (170.8 mm crossed vs. 222.6 mm uncrossed, p = 0.03). Calcium distribution differed significantly ( p<.01): circumferential (14.8 vs. 12.5%); eccentric (85 vs. 62.5%); and complete calcium occlusion (0 vs. 25%) for lesions that were crossed and uncrossed, respectively. Significant differences ( p<.0001) were found when calcium occlusion was less than 50% (87 vs. 31%), 51–75% (9.3 vs. 31.2%), and 76–100% (3.7 vs. 37.5%). Total calcium length in crossed lesion was 51.6 mm, and 92.8 mm in uncrossed lesions ( p = 0.10). No significant differences were noted for patient gender, occlusion location (proximal, middle, and distal superficial femoral artery), and kidney function.

Conclusion

The Ocelot catheter is an effective method to cross long Trans-Atlantic Inter-Society Consensus D lesions. Superficial femoral artery lesions longer than 17 cm and focal plaque morphology, specifically a total cross-sectional area of calcium and a calcium surface area greater than 50% were most predictive of failure to cross Trans-Atlantic Inter-Society Consensus D superficial femoral artery lesions. Computerized tomography angiography is an effective tool to predict success for crossing chronic total occlusions using optical coherence tomography technology and a critical consideration for patient selection.
Keeping up, and keeping on: Risk, acceleration and the law-abiding driving offender
Authors: Wells Helen , Savigar Leanne
Published: December 2017

Roads policing is the most likely generator of an adverse-outcome encounter between the general public and the police and is therefore one of the most likely situations in which individuals are confronted with their own ‘law-abidingness’, or lack of it. Despite this, it has so far failed to excite much criminological interest. The article will propose that the concepts of ‘risk’ (as a political as well as sociological concept) and ‘acceleration’ (of technological change, as well as everyday life) can be used to explain the controversial and apparently unsettling image of roads policing in recent years. This article reflects on how speeding offences (researched between 2002–2006) and mobile phone use by drivers (researched between 2013–2016) reveal much about how drivers see themselves, their priorities and the law.
Empowering the police to fight terrorism in Israel
Authors: Metcalfe Christi , Hodge Olivia
Published: December 2017

Police agencies are often seen as reliant on the public to give them the authority and power necessary to carry out their responsibilities, including controlling crime. As many police agencies begin to take on counterterrorism functions, this empowerment of the police is necessary in their fight against terrorism. To our knowledge, no study to date has focused on the empowerment of the police in their counterterrorism role and the factors that influence the willingness of the public to afford the police discretionary authority in terrorism matters. Using a sample of Israeli Jewish adults, we assess the impact of legitimacy-based evaluations, as well as fear of terrorism and political ideologies, on the public’s willingness to empower the police to handle homeland security matters. Police legitimacy and political ideology have a direct impact on police empowerment, while procedural justice, police performance, distributive fairness, and fear of victimization by terrorism also have indirect effects.
Horizontal Violence in the Operating Room
Authors: Hamlin Lois
Published: December 2017

The concept of horizontal violence is something you may or may not have heard of or know about. However, you will probably have experienced it during your career; and reading about it may make you feel uncomfortable. Indeed, some of you, like myself, may have unknowingly perpetuated it.
Developing a Nurse-Led Cystoscopy Service
Authors: Roxburgh Michelle
Published: December 2017

There is little doubt that nurses can develop practical skills in medical procedures that are comparable to those of medical practitioners. This has been shown where nurses have been trained in flexible sigmoidoscopy (Disario & Sanowski 1993, Maule 1994); similarly, nurses have become part of the surgical cardiac team recovering veins for coronary artery bypass surgery (Holmes 1994). There is also increasing interest and growing demand within the nursing and medical professions for advice and information regarding the development of nurse cystoscopist posts.
Improving Staff Communication: The Role of the Cardiac Theatre Liaison Nurse
Authors: Davidson Kenny
Published: December 2017

‘One of the greatest fears is the fear of the unknown and a few words of explanation from a thoughtful nurse are worth much more than sedation from a doctor.’ (Campbell and Spence 1983).

Kenneth Davidson, a 3M/NATN Award prize winner for 1999, suggests ways in which communication between ward staff and theatre nurses can be improved.
A Risky Business
Authors: Sprague Julie , Williams Marilyn , County Bernadette
Published: December 2017

Just when you get comfortable with life - you've got everything under control and you know what you're doing - along comes someone with a new idea with a change attached to it. From the European Courts, through the Government to the Trust Executive and then the Directorates, change seems to be a constant part of life. Julie Sprague is a theatre nurse who saw an opportunity to make a worthwhile change in her area of practice. This is the acceptable face of change, at clinical practice level, done with involvement and co-operation of colleagues. This article describes that change process together with the theories and rationale which support it.
Creutzfeldt-Jakob Disease: The Story So Far
Authors: Dyke Maureen
Published: December 2017

CJD continues to be an increasing problem for perioperative practitioners to be aware of. Maureen Dyke reviews the implications for perioperative practice.
Professional Vs Commercial: Can They be Reconciled?
Authors: Westwood Fiona
Published: December 2017

This is the first in a series of articles looking at the challenges facing everyone who works in healthcare, whether in the public or private sector. In this article, Fiona Westwood addresses the question: Professional vs Commercial: can they be reconciled? Other questions that will be discussed over the coming months are: What is effective management? What forms of leadership and communication really work? Are we truly patient-focussed? How well do we use our resources? And, is it possible to manage professionals?
Know Your Heart
Authors: Clancy John , McVicar Andrew , Williams Mriga
Published: December 2017

In this article in our Concepts in Anatomy series, Mriga Williams joins John Clancy and Andrew McVicar in an examination of the heart, identifying and describing its component parts, its relationship to the circulatory system and some of the abnormalities it might develop. The article includes a range of activities readers may carry out to test and improve their knowledge. The series is based on the text by John Clancy and Andrew McVicar, Physiology and Anatomy – a homeostatic approach, Arnold, London (in print September 2001).
Reduced Hours and Flexitime
Authors: Fudge Lesley
Published: December 2017

This is the final article in the series on Improving Working Lives. This month the subject of implementing reduced hours and flexitime will be explored. The foundation of all these articles has been the Improving Working Lives Toolkit published by the Department of Health.
Developing a Systematic Review: Trials and Tribulations
Authors: Edwards Peggy , Lipp Allyson
Published: December 2017

The use of surgical face masks remains contentious. The two authors are currently undertaking a systematic review with the Cochrane Collaboration to ascertain their actual effectiveness. This article describes the journey so far in an attempt to encourage other theatre nurses to embark on similar projects.
The Theatre Nurse Role a Review of the Literature
Authors: Pidduck David , Tanner Judith
Published: December 2017

The role of the theatre nurse is complex, multifaceted and requires many skills. Nurses provide physical care such as scrub, circulating duties and anaesthetic assistant duties, and also psychological care for example pre- and postoperative visiting of patients. The overriding theme in the literature is that the nurse must undertake these roles with the patient as the main focus. David Pidduck examines the role of the theatre nurse and points out that the role may have to change in the future. It is the theatre nurse who should change their role before the role is changed for them.
Prone Positioning Made Easy
Authors: Craig Kay
Published: December 2017

Prone positioning of patients may optimise exposure for certain surgical procedures. There have been many published works that discuss the advantages of prone ventilation and how to nurse a patient who is lying in the prone position. However, there are very few empirical studies that describe how to place a patient in the prone position. This article outlines the problems and describes a safe and efficient manoeuvre that minimises the risks, following moving and handling principles (DoH 1992).
Robotic Assisted Surgery: Part One
Authors: Martin Shirley , Murz Yaron , Darzi Ara
Published: December 2017

Since the first laparoscopic cholecystectomies were performed by Muhe in 1986 and Mouret in 1987, minimal access surgery has been widely accepted and applied to many procedures. By the end of the 1990s, surgical robots had emerged in operating theatres around the world. This technology has the potential to revolutionise minimal access surgery.
The Role of the First Assistant in Robotic Assisted Surgery
Authors: Martin Shirley
Published: December 2017

In part one of this series ( BJPN 14 (1) 36–39) the introduction of the da Vinci robotic system was described (Intuitive Surgical, Inc, Mountain View, CA). This second and final part in the series describes the unique role of the first assistant in robotic assisted surgery. In September 2000, the da Vinci robotic system, the first of its kind to be installed in the UK, was introduced to St Mary's Hospital, London.
A SWAB Story
Authors: Lamont Sue
Published: December 2017

This is a tale of when radio-opaque strips in surgical swabs aren't always radio-opaque. Sue Lamont has a 30-year background as a theatre nurse and a theatre manager. Her current role is clinical procurement and risk management coordinator for Surgical Services at the University Hospitals of Leicester NHS Trust. A recent experience illustrated her job's many challenges.
Timesheet Fraud: A Nurse's Responsibility
Authors: McCausland Dermid
Published: December 2017

A nurse is more important than ever in today's NHS. They not only have more responsibility when it comes to the treatment of patients but a greater say in the administration of wards and departments. With this responsibility comes a duty to protect the NHS from those who try to abuse it.
Literature Review of Safe Use of Cricoid Pressure
Authors: Stanton John
Published: December 2017

This article, written by a third year diploma student in operating department practice, examines the literature relating to the safe use of cricoid pressure. To ensure that the patient is adequately protected from acid aspiration syndrome, the anaesthetic practitioner should be aware of the dangers of faulty technique when utilising Sellick's manoeuvre.
Horsley's Wax
Authors: Ellis Harold
Published: December 2017

Anyone who has seen a skull bone flap being turned or the sternum being divided at a median sternotomy will be well aware of the considerable bleeding that can occur in these procedures from the highly vascular red bone marrow inside these structures. They will also, no doubt, have seen the surgeon stem the bleeding by smearing wax – Horsley's bone wax – over the cut surfaces of the bone.
Standardised Analgesia Packs after Day Case Orthopaedic Surgery
Authors: Townsend Rachel , Cox Felicia
Published: December 2017

Two of the advantages of day surgery are less disruption to patients’ lives and the comfort of recovering at home. However, despite advances in analgesic and anaesthetic techniques, pain following day surgery is not well managed: recent studies have shown that between 30–60% of patients suffer moderate to severe pain during the first 24 hours after discharge home following day surgery (Beauregard et al 1998, McGrath et al 2004, Pavlin et al 2004). A significant proportion of patients (25–30%) continue to report pain of this severity at seven days following day surgery (Beauregard et al 1998, Watt-Watson 2004). This article reviews published studies of patient experiences of pain and analgesia consumption after day case surgery and provides a model for the introduction of standardised take-home analgesic packs.
International Networking: Extending the Perioperative Potential
Authors: Woodhead Kate
Published: December 2017

The theme of last year's Congress was Realising Potential. The road to success is always under construction, and there are many choices that we make along the way, such as our partner in life, career, or how we spend spare time. A fortuitous choice of mine was to get involved with the Education Committee of NATN in 1994, as many of my lasting friendships have come as a result of my involvement with this organisation. Much of the richness and variety of life comes from the people we engage with and the networks which we develop.
Decontamination: Back to Basics
Authors: Meredith Susan J , Sjorgen Geoff
Published: December 2017

My invitation from this Journal's Editor, Felicia Cox, to provide a paper for this themed issue, included the sentence ‘I was wondering if you or a colleague would like to contribute a back to basics article on the relevant standards and guidelines for decontamination, including what is compliance?’. The reason it is so interesting to me is that the term ‘back to basics’ implies reverting to a simpler time in life – when by just sticking to the rules, life became easier. However, with decontamination this is not actually true.
Preoperative Consent: How to Make Sure Your Practice is Legal – Part Two
Authors: Corfield Lorraine , Pomeroy Anne
Published: December 2017

The Mental Capacity Act 2005 (MCA) came into force in October 2007. This is now the keystone of the law regarding the assessment of capacity to consent and the treatment of those who lack capacity to consent for themselves. The first article in this two-part series (Corfield & Pomeroy 2008) covered preoperative consent: this article discusses the MCA (with accompanying relevant case law) in more detail by the use of illustrative examples and concentrates on issues that can arise once the patient is in the operating suite.
Does Conventional Practice Prevent Occular Complications in Prone Position Spinal Surgery?
Authors: Haushofer Lisa , Bhattacharyya Mayukh , Isibor Rochester N , Sakka Samir A
Published: December 2017

Postoperative visual loss following spinal surgery in the prone position may be the most limiting to the quality of a patient's life and the most likely to entail medico-legal consequences for medical and theatre personnel. We analyse the incidence of occular complications after 181 consecutive spinal surgery in the prone position in a typical district general hospital setting in the United Kingdom. No patient undergoing spinal surgery in the prone position lasting over 2 hours developed postoperative transient or permanent visual loss or any other occular complication (incidence 0%). Perioperative preventative measures were found to be sufficient to prevent any form of occular complications. We should inform and reassure patients of the reduced risk of occular complications in spinal surgery when sufficient perioperative precautionary measures are taken.
Corneal Transplant Surgery
Authors: McColgan Karen
Published: December 2017

Corneal disease is one of the major causes of blindness worldwide. Removal of the damaged cornea and transplant of donated tissue is often the only option available to patients to improve and restore vision. This paper discusses corneal transplant with consideration given to penetrating keratoplasty (PK), a traditional full thickness corneal transplant and three other surgical techniques that offer an alternative to the traditional PK surgery: deep anterior lamellar keratoplasty (DALK), deep lamellar endothelial keratoplasty (DLEK) and limbal stem cell transplant.
The Effectiveness and Safety of Single-Use Disposable Instruments in Cataract Surgery – a Clinical Study Using a Surgeon-Based Survey
Authors: Gupta A , Mercieca K , Fahad B , Biswas S
Published: December 2017

Aim

To compare ease of use, handling, defects and complication rates between single use and reusable instruments in cataract surgery.

Methods

Prospective questionnaire-based study involving ophthalmic surgeons operating during a one-year period.

Results

Results showed better scores in relation to questions regarding ease of use and handling for permanent instruments (p<0.0001). Two complications out of 93 procedures were reported in the reusable group (2.2%) compared to six out of 157 in the disposable group (3.8%) (p = 0.4681).

Conclusions

Disposable instruments in cataract surgery are an acceptable and safe alternative to reusable ones.
Perioperative Nurses' Perceptions and Experiences of Continuing Professional Education
Authors: Tame Susan
Published: December 2017

This article presents an overview of perioperative nurses' perceptions and experiences of continuing professional education (CPE). Four themes emerged from 23 interviews: attitudes and culture (background); deciding to study (going in); student experience (process); and outcomes (going out). My findings indicate transferability of other studies to perioperative nursing, and suggest that CPE is associated with increased social status and doctor-nurse collaboration. My work also illuminates the concept of ‘secret study’.
Medicines Management in the Theatre Suite
Authors: Meadows Chris , Kaul Sunny
Published: December 2017

The safe management of medicines within the theatre complex, from storage to administration, is a key component in preventing patient safety incidents. Simple measures, such as double-checking or clear labelling, can be utilised to reduce the risk of inadvertent drug administration. However, the recognition that human factors contribute to errors has led to more advanced, electronic solutions being utilised. One such automated system, involving barcoding together with visual and auditory cues, is currently under assessment by the National Patient Safety Agency.
Patient Assessment in Recovery
Authors: Brent Rachel
Published: December 2017

Recovery rooms hold an undeniably important place in the perioperative journey for the patient. It is here that possible complications following anaesthesia or surgery can be detected and rectified and patients can be made comfortable before returning to the ward. This article explores the vital aspects of patient assessment which are important for any recovery practitioner to consider.
Electrosurgery in Perioperative Practice
Authors: O'Riley Michael
Published: December 2017

‘The yron is most excellent but that it is offensive to the eye and bringeth the patient to great sorrowe and dread of the burning and the smart’”. Inscription on a 15th century cautery instrument, The Guild of Barber Surgeons, St Audoens Church, Dublin.
Thromboprophylaxis in Orthopaedic Surgery: A Clinical Review
Authors: Rogers Benedict A , Little Nick J
Published: December 2017

Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common cause of cardiovascular mortality and morbidity. Patients undergoing major orthopaedic surgery, including hip and knee arthroplasty, represent a group that is at particularly high risk for VTE, especially patients with risk factors (age >60 years, cancer, prior VTE).
Developing a Paediatric Recovery Course
Authors: Nicholas-Holley Jane
Published: December 2017

There is increasing need for suitably trained perioperative staff to work within the recovery room (or post anaesthetic care unit) especially where our patients are children. There appears to be a lack of paediatric nurses applying for and taking up recovery posts, therefore making recruitment of staff problematic. A solution might be to attract adult registered nurses into this specialist area; however this raises the issues of providing adequate training and development to equip them with the necessary knowledge and skills to care for children.
Clostridium Perfringens: A Flesh-Eating Bacterium Living in Your Garden
Authors: Rothwell Ann
Published: December 2017

Gas gangrene is a painful, rapidly developing and potentially fatal infection despite antibiotic treatment. During the First World War thousands of soldiers died from this disease. Dr Alexis Carrel pioneered a controversial method of irrigating wounds with Dakin's solution to destroy Clostridium perfringens, a bacterium found in heavily fertilised soils that causes gas gangrene. Although this method is no longer used due to the discovery of antibiotics, many of his other ideas, such as scientifically determining the type and number of bacteria and delaying the closure of a wound until the bacteria had been eradicated, are still used today.
Are you Aware of Awareness?
Authors: Ewart Luke
Published: December 2017

This article examines some of the evidence to identify the incidence of awareness with explicit recall following general anaesthesia and whether this incidence is reduced through monitoring of the bispectral index (BIS). It can be concluded from the results of these studies that the use of a protocol to guide anaesthesia delivery can help to reduce the incidence of awareness with explicit recall. However, whether this protocol should be guided by end tidal anaesthetic agent, BIS or some other form of processed electroencephalogram (EEG) cannot be concluded upon until the results of further well designed randomised controlled studies are known.