bluuebunny/crossref_metadata_2025 huggingface dataset:
Do School Discipline Policies Treat Students Fairly? Evidence From Arkansas
Authors: Anderson Kaitlin P. , Ritter Gary W.
Published: September 2018

It is well documented that Black students are more likely to receive expulsions and suspensions than their White peers. These disparities are troubling, but researchers and policy makers need more information to fully understand the issue. We use 3 years (2010-2011 through 2012-2013) of state-wide student- and discipline incident-level data to assess whether non-White students are receiving harsher disciplinary consequences than their White peers for similar infractions and with similar behavioral history. We find that Black students received more severe (longer) punishments than their White peers for the same types of infractions, but that these disproportionalities are primarily across rather than within schools.
Policy, Poverty, and Student Achievement: An Exploration of the Impact of State Policies
Authors: Alexander Nicola A. , Jang Sung Tae
Published: September 2018

This article explores the associations between the achievement of economically disadvantaged students and the presence of state policies that include student achievement in teacher evaluations. We looked at student achievement across all 50 states from 2007 through 2013. A simple comparison of states with and without the policy suggested that economically disadvantaged students had similar or slightly lower reading and lower math achievement in those states with the policy than in states without it. Once state context was considered, we found that states that included student achievement in teacher assessment policies had slightly higher reading achievement among economically disadvantaged students than they would have had otherwise. We found no similar impact on math achievement. This policy did not reduce the gaps in achievement between economically disadvantaged students and their more affluent peers. Combined, these findings indicate that including student achievement in teacher assessment models did not eliminate poverty-induced educational disparities in the system.
Performance Funding and Historically Black Colleges and Universities: An Assessment of Financial Incentives and Baccalaureate Degree Production
Authors: Boland William Casey
Published: September 2018

Pay-for-performance has become a state finance policy du jour for public postsecondary institutions. A total of 35 states currently distribute varying amounts of appropriations to colleges and universities based on outcome measures. This study uses a difference-in-differences quasi-experimental technique to assess the impact of performance-based funding on public 4-year Historically Black Colleges and Universities (HBCUs). It also includes separate analyses on the older and newer models of performance funding throughout the United States. This study finds little evidence of a significant effect on improvement in baccalaureate degree attainment in public 4-year HBCUs that receive some apportionment of state appropriations through performance-based funding.
Long Sleep Duration Is Associated With Increased Frailty Risk in Older Community-Dwelling Adults
Authors: Baniak Lynn M. , Yang Kyeongra , Choi JiYeon , Chasens Eileen R.
Published: September 2018

Objective: To examine whether sleep duration is correlated with increased frailty risk and investigate the determinants of frailty status. Method: Data on 3,632 participants from the 2011 to 2014 National Health and Nutrition Examination Survey (NHANES, community-dwelling >60 years, 52.1% prefrail, 13.6% frail, 55% women) were used. Frailty status was categorized by Fried Phenotype (robust, prefrail, and frail) with customized criteria for the NHANES data set. Hours of self-reported sleep duration were categorized as short (⩽6), normal (7-9), and long (⩾10). Multinomial regression analysis identified risk factors for each frailty state. Results: Only long sleep duration was associated with increased odds (2.86 [1.09-7.50]) of being characterized as frail but not prefrail. Frail and prefrail states had shared risk factors but also had many distinct to each state. Discussion: Sleep duration is a potential, modifiable therapeutic target for frailty management. Multicomponent interventions should be tailored for frailty status.
A novel variable-stiffness flexible manipulator actuated by shape memory alloy for minimally invasive surgery
Authors: Cao Yanfei , Ju Feng , Zhang Lei , Bai Dongming , Qi Fei , Chen Bai
Published: September 2018

This article presents a novel variable-stiffness flexible manipulator for minimally invasive surgery. Each module of the proposed manipulator contains a variable-stiffness mechanism actuated by proactive deformation of shape memory alloy. Due to low driving current, apparent mechanical deformation, suitable phase transformation temperature and biocompatibility of shape memory alloy wire actuation, it is well suited for the manipulator applied in minimally invasive surgery, where variable stiffness is urgently required. In this article, the conceptual design, elastic modulus model, thermo-electric model, stiffness controlling method and finite element method simulation for a single module of the proposed variable-stiffness flexible manipulator are presented. Moreover, the memory shape setting experiment of shape memory alloy wire and fabrication of the single module are carried out. Finally, stiffness characterizations of the mechanism and the single module are studied separately, theoretically and experimentally.
Crossing the gain line: Migration, sport and national belonging on Facebook
Authors: Aguirre Alwin C , Bell Allan
Published: September 2018

Hosting the Rugby World Cup in 2011 offered a chance for New Zealand to showcase itself on the world stage, but also provided immigrants to the country an opening to assert their legitimate place in the nation. We present the particular case of Leslie, a Filipina migrant, and her Facebook activities during the tournament. Approaching these texts through the frameworks of liminality and timescale-differentiated identity construction along with Social Actor Network Analysis, we unravel the discourses of national belonging facilitated by the interaction of social media and a sporting mega-event. Our analysis shows that Facebook’s semiotic affordances, interconnectivity and ability to bridge time and distance allowed Leslie to be part of the collective by performing an emerging identity as a New Zealander. As a result, she transcended the identity of being an other in New Zealand to – at least for this period – take on one of national belonging.
Incidence and Characteristics of Midfoot Injuries
Authors: Ponkilainen Ville T. , Laine Heikki-Jussi , Mäenpää Heikki M , Mattila Ville M. , Haapasalo Heidi H.
Published: September 2018

Background:

The epidemiology of midfoot injuries is poorly known. It has been estimated that the incidence of Lisfranc injuries (intra-articular injury in the tarsometatarsal joint) is 1/55 000 person-years and the incidence of Chopart injuries (intra-articular injury in the talonavicular and calcaneocuboidal joint) 4/100 000 person-years. The purpose of our study was to assess the computed tomography (CT) imaging–based incidence (per 100 000 person-years) and trauma mechanisms of midfoot injuries.

Methods:

All CT studies performed due to acute injury of the foot and ankle region between January 1, 2012, and December 31, 2016, at Tampere University Hospital were reviewed. Patients presenting with an injury in the midfoot region in the CT scan were included in this study, and their records were retrospectively evaluated to assess patient characteristics.

Results:

During the 5-year study period, 953 foot and ankle CT scans were obtained because of an acute injury of the foot and ankle. Altogether, 464 foot injuries were found. Of these, 307 affected the midfoot area: 233 (75.9%) the Lisfranc joint area, 56 (18.2%) the Chopart joint area, and 18 (5.9%) were combined injuries or miscellaneous injuries in the midfoot. The incidence of all midfoot injuries was 12.1/100 000 person-years. The incidence of Lisfranc injuries was 9.2/100 000 person-years. The incidence of Chopart injuries was 2.2/100 000 person-years.

Conclusions:

The incidence of Lisfranc injuries was higher and the incidence of Chopart injuries lower than previously estimated. More than two-thirds of the midfoot injuries in this study were nondisplaced (<2 mm displacement in fracture or joint) and were caused by low-energy trauma.

Level of Evidence:

Level III, epidemiologic study.
Financial Engineering by City Governments: Factors Associated with the Use of Debt-Related Derivatives
Authors: Singla Akheil , Luby Martin J.
Published: September 2018

Despite significant coverage in the financial press in recent years, financial engineering by city governments via the use of financial derivatives such as interest rate swaps remain an understudied area of urban financial policy. Indeed, press accounts and other case or conceptual urban studies research emphasizing the downside of these transactions are some of the only sources of information on these instruments. These stories and studies often allude to or speculate on a more basic question: Why would a government choose to enter into a complex financial instrument like a debt-related derivative? This research posits three exploratory hypotheses—financial health, financial experience and/or financial sector influence, and governance structure—culled from media accounts and the urban studies literature on the use of debt-related derivatives by city governments in the United States. It empirically explores these hypotheses by examining the various fiscal, financial, and issuer characteristics of the largest 50 U.S. cities and their choice of whether to use debt-related derivatives. The research finds that the characteristics of government most associated with debt-related derivative use are declining financial condition, increased financial experience and/or financial sector influence, and prior use of interest rate swaps.
Linking Water Infrastructure, Public Health, and Sea Level Rise: Integrated Assessment of Flood Resilience in Coastal Cities
Authors: Allen Thomas R. , Crawford Thomas , Montz Burrell , Whitehead Jessica , Lovelace Susan , Hanks Armon D. , Christensen Ariel R. , Kearney Gregory D.
Published: September 2018

Coastal community water infrastructure is increasingly vulnerable to climate-sensitive coastal hazards. Tides, storm surges, rainfall, and salt intrusion affect infrastructure and human health. In case studies of Charleston, South Carolina, and Morehead City, North Carolina, USA, this project sought to advance risk assessment of urban water and wastewater infrastructure and identify linkages to human health impacts as risk evolves with sea level rise. The methodology integrates community infrastructure, health care, emergency resources, geospatial simulation, and a tabletop exercise with planners, emergency managers, public utilities, and health care providers. Resilience is assessed by community participants using interactive online maps, susceptibility indices, and a resilience matrix. Results highlight differential vulnerability, population susceptibility, and elevation uncertainty. We observe similar trends of increasing magnitude, frequency, and impact of flood events on water infrastructure and public health as sea level rises. Implications for tackling challenges across sectors are highlighted for improving coastal resilience.
Homicide Investigations in Context: Exploring Explanations for the Divergent Impacts of Victim Race, Gender, Elderly Victims, and Firearms on Homicide Clearances
Authors: Regoeczi Wendy C. , Jarvis John , Mancik Ashley
Published: September 2018

Studies examining factors influencing homicide clearances have produced consistent findings for child victims, arguments, and incident location. Conclusions have been far more varied regarding the social location of the victim and incident attributes such as firearms. Using homicides reported to the National Incident-Based Reporting System (NIBRS) between 2008 and 2012, the current study uses Conjunctive Analysis of Case Configurations (CACC) to analyze combinations of victim and incident attributes most likely to lead to cleared homicides. In doing so, we assess the variable impacts of victim gender, race, elderly victims, and firearms across contexts to understand their inconsistent effects in the prior literature.
What can managers learn online? Investigating possibilities for active understanding in the online MBA classroom
Authors: Goumaa Rasha , Anderson Lisa , Zundel Mike
Published: September 2018

Online MBAs have become integral to business schools’ portfolios and the number of MBA students opting for an online version looks set to grow. In the wake of well-documented critiques of traditional MBA formats, this expansion prompted us to examine the potential for critically reflexive learning ideals in asynchronous MBA learning environments. Building on the Community of Inquiry (CoI) model, we elaborate elements of Bakhtin and Shotter’s dialogism to develop the notion of ‘active understanding’ as a means to study an online MBA classroom. We present two illustrative episodes to show how aspects of active understanding may unfold, and we point to the role of infrastructure, curriculum and instructor interventions in developing more genuine dialogical exchanges. Our findings suggest that online MBA course designers can learn from CoI approaches to which we add that critically reflexive learning is situationally sensitive; requiring the capacity to create and recognize nuance and difference in the written communication; making the other the focus of learning. We conclude with implications for pedagogy and technology infrastructure.
The aftermath of burn injury from the child’s perspective: A qualitative study
Authors: Egberts Marthe R , Geenen Rinie , de Jong Alette EE , Hofland Helma WC , Van Loey Nancy EE
Published: September 2018

A burn injury event and subsequent hospitalization are potentially distressing for children. To elucidate the child’s experience of pediatric burn injury, children’s reflections on the burn event and its aftermath were examined. Semi-structured interviews were conducted with eight children (12–17 years old). Using thematic analysis, interview transcripts were coded and codes were combined into overarching categories. Three categories were identified: vivid memories; the importance of parental support; psychosocial impact and coping. Implications for care are discussed in terms of assessing children’s appraisals, paying attention to the parent’s role, and preparing families for potential psychological barriers after discharge.
(Re)making smoking: Of packets and practice
Authors: Dennis Simone , Alexiou Helen
Published: September 2018

Taking as foundational the well-established anthropological idea that material things can be determinative of expectations and practice, the authors advance the notion that packets are constitutive of smoking in the era of smokefree legislation. Adorned with warnings, graphic messaging and particular colouration, they say that packets do not simply respond to the ‘problem’ of smoking; they are actively involved in remaking it anew, in, with and for the smokefree context, in which smoking is purposefully denormalized. Focusing in the main on the graphic images that ‘plain’ packets bear, they track and trace this constitutional force via sensory means, attending particularly to a reworking of the role presently accorded to vision in the Australian government’s public health ‘view’ that assumes a stark separation between the cigarette packet and the respondent smoker.
Single-use of endodontic hand files: perceptions and practise
Authors: Buchanan Glynn Dale , Warren Nichola
Published: September 2018

Background:

The concept of single-use of endodontic files remains controversial in the published literature. The extent and attitudes concerning the single-use of endodontic hand files is currently unknown in many countries.

Aim:

The prevalence and perceptions regarding the single-use of endodontic files was investigated in this descriptive observational study.

Methods:

A questionnaire regarding the perceptions and usage protocols of endodontic files was developed. Twenty-seven South African dental practices were included in this study. Participation was voluntary.

Results:

None of the respondents reported single-use of endodontic hand files. Several decontamination methods were used by the respondents for reprocessing endodontic files.

Discussion:

Financial constraints were reported as the primary reason for the reuse of endodontic files. As no standardised method of reprocessing these instruments exists for South Africa, written guidelines on this subject should be developed.
The Leaders of Leadership Preparation Programs: A Study of Program Coordinators at UCEA-Member Institutions
Authors: Ingle W. Kyle , Marshall Joanne M. , Hackmann Donald G.
Published: September 2018

Using a cross-sectional survey, we collected data from program coordinators at UCEA-member institutions to understand the various roles, time investments, and cost commitments associated with program coordination, including incentives institutions provide (or do not provide) for assuming such responsibilities. We seek to improve our understanding of the work and role(s) program coordinators play, the time commitments they report, and the types of incentives provided for assuming the role of program coordination of educational leadership programs. Understanding these roles help us understand how best to support these leaders in administering quality preparation programs.
A Good Case of Recurrent Pneumonia
Authors: Bhargava Ankit , Eisenstadt Rachel , Shih Jennifer A. , Sueblinvong Viranuj
Published: September 2018

Bordetella bronchiseptica infection is a common cause of pneumonia in animals but rarely causes disease in humans. Additionally, coinfection with Pneumocystis jirovecii is very uncommon and is occasionally seen in patients with acquired immunodeficiency syndrome (AIDS). We report a case of a 61-year-old HIV-negative man, who presented with hypoxic respiratory failure 2 days after completion of systemic intravenous antibiotic treatment for B bronchiseptica. His past medical history was significant for a benign thymoma. The patient was found to be coinfected with B bronchiseptica and P jirovecii. Laboratory results showed panhypogammaglobulinemia and low absolute B- and CD4 T-cells. Therefore, the patient was diagnosed with Good’s syndrome. However, despite treatment with intravenous antibiotics and intravenous immunoglobulin, the patient continued to deteriorate and expired. This patient demonstrates the importance of recognizing this rare immunodeficiency early in order to improve morbidity and mortality. Furthermore, this case highlights the importance of early immunoglobulin screening in the presence of asymptomatic thymoma.
Chilaiditi Syndrome Complicated by Cecal Perforation in the Setting of Scleroderma
Authors: Sunkara Tagore , Rawla Prashanth , Yarlagadda Krishna Sowjanya , Baltazar Gerald A. , Gaduputi Vinaya
Published: September 2018

Chilaiditi syndrome is a very rare disorder characterized by abdominal pain due to the entrapment of the colon between the liver and the diaphragm. However, it is rare to have bowel perforation as a complication of this syndrome with only 2 cases reported to date. In this article, we present the case of a 56-year-old woman with medical history of scleroderma who presents with abdominal pain and was found to have colonic perforation from Chilaiditi syndrome. She was also incidentally found to have cecal adenocarcinoma. Sometimes abdominal pain in patients with Chilaiditi syndrome may be more than benign and calls for increased attention from clinicians regarding this.
Phenotypic analysis of antibiotic resistance and genotypic study of the vacA, cagA, iceA, oipA and babA genotypes of the Helicobacter pylori strains isolated from raw milk
Authors: Ranjbar Reza , Farsani Farid Yadollahi , Dehkordi Farhad Safarpoor
Published: September 2018

Background

Foods with animal origins and particularly milk play a considerable role in transmission of Helicobacter pylori. The current study was performed to assess phenotypic characters of antibiotic resistance and genotyping pattern of vacA, cagA, iceA, oipA and babA2 alleles amongst the H. pylori strains isolated from raw milk.

Methods

Six-hundred and thirty raw milk samples were collected and cultured on Wilkins Chalgren anaerobe media. Antibiotic resistance and genotyping patterns were studied using disk diffusion and PCR, respectively.

Results

Sixty-seven out of 630 (10.63%) raw milk samples were positive for H. pylori. Ovine raw milk (17.27%) samples had the highest prevalence of H. pylori, while camel (5.00%) had the lowest. H. pylori strains harbored the highest prevalence of resistance against ampicillin (82.08%), tetracycline (76.11%), amoxicillin (74.62%), metronidazole (65.67%) and erythromycin (53.73%). Prevalence of resistance against more than 10 types of antibiotics was 17.91%. VacA s1a (83.58%), m1a (80.59%), s2 (77.61%) and m2 (68.65%), cagA (73.13%) and babA2 (44.77%) were the most commonly detected genotypes. We found that S1am1a (56.71%), s2m1a (56.71%), s1 am2 (43.28%) and s2 m2 (43.28%) were the most commonly detected genotyping pattern. Frequency of cagA-, oipA- and babA2- genotypes were 26.86%, 62.68% and 55.22%, respectively. We found that S1a/cagA+/iceA1/oipA−/babA2- (28.35%), m1a/cagA+/iceA1/oipA−/babA2- (28.35%) and s2/cagA+/iceA1/oipA−/babA2- (26.86%) were the most commonly detected combined genotyping pattern.

Conclusions

Simultaneous presence of vacA, cagA, iceA, oipA and babA2 genotypes in antibiotic resistant H. pylori strains indicates important public health issue regarding the consumption of raw milk. However, additional researches are required to find molecular genetic homology and other epidemiological aspects of H. pylori in milk.
Factors associated with bacteraemia due to multidrug-resistant organisms among bacteraemic patients with multidrug-resistant organism carriage: a case control study
Authors: Mascitti Hélène , Duran Clara , Nemo Elisabeth-Marie , Bouchand Frédérique , Câlin Ruxandra , Descatha Alexis , Gaillard Jean-Louis , Lawrence Christine , Davido Benjamin , Barbier François , Dinh Aurélien
Published: September 2018

Background

Infections caused by multidrug-resistant organisms (MDRO) are emerging worldwide. Physicians are increasingly faced with the question of whether patients need empiric antibiotic treatment covering these pathogens. This question is especially essential among MDRO carriers. We aim to determine the occurrence of MDRO bacteraemia among bacteraemic patients colonized with MDRO, and the associated factors with MDRO bacteraemia among this population.

Methods

We performed a retrospective monocentric study among MDRO carriers hospitalized with bacteraemia between January 2013 and August 2016 in a French hospital. We compared characteristics of patients with MDRO and non-MDRO bacteraemia.

Results

Overall, 368 episodes of bacteraemia were reviewed; 98/368 (26.6%) occurred among MDRO carriers.

Main colonizing bacteria were extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (40/98; 40.8%), ESBL-producing Klebsiella pneumoniae (35/98; 35.7%); methicillin-resistant Staphylococcus aureus (26/98; 26.5%) and multidrug-resistant Pseudomonas aeruginosa (PA) (12/98; 12.2%).

There was no significant difference considering population with MDRO bacteraemia vs. non-MDRO bacteraemia, except for immunosuppression [OR 2.86; p = 0.0207], severity of the episode [OR 3.13; p = 0.0232], carriage of PA [OR 5.24; p = 0.0395], and hospital-acquired infection [OR 2.49; p = 0.034].

In the multivariate analysis, factors significantly associated with MDRO bacteraemia among colonized patient were only immunosuppression [OR = 2.96; p = 0.0354] and the hospital-acquired origin of bacteraemia [OR = 2.62; p = 0.0427].

Conclusions

According to our study, occurrence of bacteraemia due to MDRO among MDRO carriers was high. Factors associated with MDRO bacteraemia were severity of the episode and hospital-acquired origin of the bacteraemia. Thus, during bacteraemia among patients colonized with MDRO, if such characteristics are present, broad-spectrum antimicrobial treatment is recommended.
Estimating the creep behavior of glass-fiber-reinforced polyamide considering the effects of crystallinity and fiber volume fraction
Authors: Sakai Takenobu , Hirai Yuto , Somiya Satoshi
Published: September 2018

Background

The time-temperature superposition principle (TTSP) is often used to estimate the viscoelastic behavior of polymers. It can also be used to evaluate the influence of a given variable, or set of variables, on viscoelastic properties. In this research, the effects of time, temperature, fiber volume fraction and the relative crystallinity of polyamide (PA) and glass fiber-reinforced polyamide (GFRPA) were investigated using the time-temperature superposition principle to estimate viscoelastic behavior under each set of conditions.

Methods

The crystallinities of PA and GFRPA, which ranged from 33 to 45%, were controlled by adjusting the duration of crystallization as 250 °C. Creep tests were carried out with these materials, and creep compliance curves of each condition were obtained.

Results

Using these creep compliance curves, the master curves for temperature, and the grand master curves for crystallinity and for fiber volume fraction were generated to show the relationships between fiber volume fraction, crystallinity, and viscoelastic parameters. Furthermore, the great-grand master curve for crystallinity and fiber volume fraction was generated to predict creep behavior in an arbitrarily condition. The predicted data were in good agreement with experimental results.

Conclusions

A method for estimating creep deformation taking into account the effects of influencing variables was developed. The time-temperature superposition principle (TTSP) was applied to the effects of the fiber volume fraction and crystallinity. Grand master curves for crystallinity and fiber volume fraction were obtained by shifting the corresponding master curves. This study demonstrates that the creep behaviors of fiber-reinforced plastics can be estimated using these shift factors and a great-grand master curve. This method yielded estimates of creep deformation that fitted well with experimental results. Based on our findings, it should be possible to control creep deformation in plastics or fiber-reinforced resins by controlling the fiber volume fraction and the crystallinity of the matrix material.
Multimodal General Anesthesia: Theory and Practice
Authors: Brown Emery N. , Pavone Kara J. , Naranjo Marusa
Published: September 2018

Balanced general anesthesia, the most common management strategy used in anesthesia care, entails the administration of different drugs together to create the anesthetic state. Anesthesiologists developed this approach to avoid sole reliance on ether for general anesthesia maintenance. Balanced general anesthesia uses less of each drug than if the drug were administered alone, thereby increasing the likelihood of its desired effects and reducing the likelihood of its side effects. To manage nociception intraoperatively and pain postoperatively, the current practice of balanced general anesthesia relies almost exclusively on opioids. While opioids are the most effective antinociceptive agents, they have undesirable side effects. Moreover, overreliance on opioids has contributed to the opioid epidemic in the United States. Spurred by concern of opioid overuse, balanced general anesthesia strategies are now using more agents to create the anesthetic state. Under these approaches, called “multimodal general anesthesia,” the additional drugs may include agents with specific central nervous system targets such as dexmedetomidine and ones with less specific targets, such as magnesium. It is postulated that use of more agents at smaller doses further maximizes desired effects while minimizing side effects. Although this approach appears to maximize the benefit-to-side effect ratio, no rational strategy has been provided for choosing the drug combinations. Nociception induced by surgery is the primary reason for placing a patient in a state of general anesthesia. Hence, any rational strategy should focus on nociception control intraoperatively and pain control postoperatively. In this Special Article, we review the anatomy and physiology of the nociceptive and arousal circuits, and the mechanisms through which commonly used anesthetics and anesthetic adjuncts act in these systems. We propose a rational strategy for multimodal general anesthesia predicated on choosing a combination of agents that act at different targets in the nociceptive system to control nociception intraoperatively and pain postoperatively. Because these agents also decrease arousal, the doses of hypnotics and/or inhaled ethers needed to control unconsciousness are reduced. Effective use of this strategy requires simultaneous monitoring of antinociception and level of unconsciousness. We illustrate the application of this strategy by summarizing anesthetic management for 4 representative surgeries.
Effects of Intraoperative Infusion of Esmolol on Systemic and Pulmonary Inflammation in a Porcine Experimental Model of Lung Resection Surgery
Authors: Garutti Ignacio , Rancan Lisa , Abubakra Selma , Simón Carlos , Paredes Sergio Damian , Ortega Javier , Huerta Luis , Ramos Silvia , Vara Elena
Published: September 2018

BACKGROUND:

Lung resection surgery (LRS) is associated with systemic and pulmonary inflammation, which can affect postoperative outcomes. Activation of β-adrenergic receptors increases the expression of proinflammatory and anti-inflammatory mediators, and their blockade may attenuate the systemic inflammatory response. The aim of this study was to analyze the effect of a continuous perioperative intravenous perfusion of esmolol on postoperative pulmonary edema in an experimental model of LRS requiring periods of one-lung ventilation (OLV).

METHODS:

Twenty-four large white pigs were randomly assigned to 3 groups: control (CON), esmolol (ESM), and sham. The ESM group received an intravenous esmolol bolus (0.5 mg/kg) and then an esmolol infusion (0.05 mg·kg−1·minute−1) throughout the procedure. The CON group received the same volume of 0.9% saline solution as the ESM group plus a continual infusion of saline. The sham group underwent a left thoracotomy without LRS or OLV. At the end of the LRS, the animals were awakened, and after 24 hours, they underwent general anesthesia again. Lung biopsies and plasma samples were obtained to analyze the levels and expression of inflammatory mediators, and the animals also received a bronchoalveolar lavage.

RESULTS:

At 24 hours after the operation, the ESM group had less lung edema and lower expression of the proinflammatory biomarkers tumor necrosis factor (TNF) and interleukin (IL)-1 compared to the CON group for both lung lobes. For the mediastinal lobe biopsies, the mean difference and 95% confidence interval (CI) between the groups for edema, TNF, and IL-1 were 14.3 (95% CI, 5.6–23.1), P = .002; 0.19 (95% CI, 0.07–0.32), P = .002; and 0.13 (95% CI, 0.04–0.22), P = .006, respectively. In the left upper lobe, the mean differences for edema, TNF, and IL-1 were 12.4 (95% CI, 4.2–20.6), P = .003; 0.25 (95% CI, 0.12–0.37), P < .001; and 0.3 (95% CI, 0.08–0.53), P = .009.

CONCLUSIONS:

Our results suggest that esmolol reduces lung edema and inflammatory responses in the intraoperative and postoperative periods in animals that underwent LRS with OLV.
Performance of Air Seal of Flexible Reinforced Laryngeal Mask Airway in Thyroid Surgery Compared With Endotracheal Tube: A Randomized Controlled Trial
Authors: Gong Yahong , Wang Jin , Xu Xiaohan , Li Jianjin , Song Ruiyue , Yi Jie
Published: September 2018

BACKGROUND:

Flexible reinforced laryngeal mask airway (FLMA®) has gained popularity in thyroid surgery, but air leak and displacement are still concerns.

METHODS:

In this randomized, single-blinded, noninferiority, controlled trial, we randomized patients scheduled for elective radical thyroidectomy to an endotracheal tube (ETT) group or a FLMA group. The primary outcomes were ventilation leak volume, peak airway pressure, and partial pressure of end-tidal carbon dioxide (Petco
2). Data for primary outcomes were collected after insertion of ETT/FLMA, at incision, and at 10-minute intervals during surgery. Ten milliliters, 5 cm H2O, and 10 mm Hg were used as the noninferiority deltas for ventilation leak volume, peak airway pressure, and Petco
2, respectively. We assessed noninferiority of FLMA to ETT on the primary outcomes over time using the results of a linear mixed-effects model. The position of FLMA mask was evaluated before and after surgery, and the airway complications were recorded.

RESULTS:

A total of 132 patients were included: 65 in ETT group and 67 in FLMA group. Differences (FLMA group minus ETT group) of ventilation leak volume, peak airway pressure, and Petco
2 from the mixed-effects models were 2.09 mL (98.3% confidence interval [CI], –6.46 to 10.64), −0.60 cm H2O (98.3% CI, –2.15 to 0.96), and 1.02 mm Hg (98.3% CI, 0.04–1.99), respectively. Score of fiber-optic position of FLMA was significantly higher after surgery than before. There was no severe shift, loss of the mask seal, regurgitation, or aspiration in the FLMA group. One patient in the FLMA group experienced brief and easily controlled laryngospasm.

CONCLUSIONS:

In thyroid surgery, FLMA is noninferior to ETT in the peak airway pressure and Petco
2 although mild to moderate mask shift could occur during surgical manipulation. There is no evidence for a higher complication rate when FLMA is used.
Ultrasound-Assisted Technology Versus the Conventional Landmark Location Method in Spinal Anesthesia for Cesarean Delivery in Obese Parturients: A Randomized Controlled Trial
Authors: Li Mengzhu , Ni Xiu , Xu Zhendong , Shen Fuyi , Song Yingcai , Li Qian , Liu Zhiqiang
Published: September 2018

BACKGROUND:

Spinal anesthesia, which is commonly used in cesarean deliveries, is often difficult to perform in obese parturients because of poorly palpable surface landmarks and positioning challenges. This study aimed to evaluate the benefits of ultrasound-assisted technology for performing spinal anesthesia in obese parturients.

METHODS:

Parturients with a body mass index (BMI) ≥30 kg/m2 scheduled for elective cesarean delivery were randomized to undergo spinal anesthesia using the conventional landmark location technique (landmark group, n = 40) or prepuncture ultrasound examination (ultrasound group, n = 40). All participants underwent spinal anesthesia in the lateral position. The primary outcome was the first-attempt success rate. Secondary outcomes were the number of skin punctures and needle passes, procedure times, patient satisfaction, changes in the intended interspace, and incidence of complications.

RESULTS:

The ultrasound group had a significantly higher first-attempt success rate (87.5% vs 52.5%; P = .001), fewer cases requiring >10 needle passes (1 vs 17; P < .001), and fewer skin punctures and needle passes (P < .001 for both). There was no statistically significant difference in the time taken to identify the needle insertion site between the 2 groups (202.5 vs 272.0 seconds; P = .580). Both the spinal injection time and total procedure time were significantly longer in the landmark group (P < .001). Patient satisfaction scores were significantly higher in the ultrasound group (P = .001). Among patients with BMI between 30 and 34.9 kg/m2, there was no statistically significant difference in the first-attempt success rate (P = .407), number of cases with >10 needle passes (P = .231), spinal injection time (P = .081), or total procedure time (P = .729); however, more time was required to identify the needle insertion site in the ultrasound group (P < .001). For patients with BMI between 35 and 43 kg/m2, the ultrasound group had a significantly higher first-attempt success rate (P ≤ .041), fewer cases with >10 needle passes (P ≤ .01), and shorter procedure times, including the time required to identify the needle insertion site (P < .001).

CONCLUSIONS:

Prepuncture ultrasound examination can facilitate spinal anesthesia in the lateral position in obese parturients (35 kg/m2 ≤ BMI ≤ 43 kg/m2) by improving the first-attempt success rate, reducing the number of needle passes and puncture attempts, shortening the total procedure time, and improving patient satisfaction.
A Predictive Model for Determining Patients Not Requiring Prolonged Hospital Length of Stay After Elective Primary Total Hip Arthroplasty
Authors: Gabriel Rodney A. , Sharma Beamy S. , Doan Christina N. , Jiang Xiaoqian , Schmidt Ulrich H. , Vaida Florin
Published: September 2018

BACKGROUND:

Hospital length of stay (LOS) is an important quality metric for total hip arthroplasty. Accurately predicting LOS is important to expectantly manage bed utilization and other hospital resources. We aimed to develop a predictive model for determining patients who do not require prolonged LOS.

METHODS:

This was a retrospective single-institution study analyzing patients undergoing elective unilateral primary total hip arthroplasty from 2014 to 2016. The primary outcome of interest was LOS less than or equal to the expected duration, defined as ≤3 days. Multivariable logistic regression was performed to generate a model for this outcome, and a point-based calculator was designed. The model was built on a training set, and performance was assessed on a validation set. The area under the receiver operating characteristic curve and the Hosmer–Lemeshow test were calculated to determine discriminatory ability and goodness-of-fit, respectively. Predictive models using other machine learning techniques (ridge regression, Lasso, and random forest) were created, and model performances were compared.

RESULTS:

The point-based score calculator included 9 variables: age, opioid use, metabolic equivalents score, sex, anemia, chronic obstructive pulmonary disease, hypertension, obesity, and primary anesthesia type. The area under the receiver operating characteristic curve of the calculator on the validation set was 0.735 (95% confidence interval, 0.675–0.787) and demonstrated adequate goodness-of-fit (Hosmer–Lemeshow test,P= .37). When using a score of 12 as a threshold for predicting outcome, the positive predictive value was 86.1%.

CONCLUSIONS:

A predictive model that can help identify patients at higher odds for not requiring a prolonged hospital LOS was developed and may aid hospital administrators in strategically planning bed availability to reduce both overcrowding and underutilization when coordinating with surgical volume.
Predatory Open-Access Publishing in Anesthesiology
Authors: Cortegiani Andrea , Longhini Federico , Sanfilippo Filippo , Raineri Santi Maurizio , Gregoretti Cesare , Giarratano Antonino
Published: September 2018

Predatory publishing is an exploitative fraudulent open-access publishing model that applies charges under the pretense of legitimate publishing operations without actually providing the editorial services associated with legitimate journals. The aim of this study was to analyze this phenomenon in the field of anesthesiology and related specialties (intensive care, critical and respiratory medicine, pain medicine, and emergency care). Two authors independently surveyed a freely accessible, constantly updated version of the original Beall lists of potential, possible, or probable predatory publishers and standalone journals. We identified 212 journals from 83 publishers, and the total number of published articles was 12,871. The reported location of most publishers was in the United States. In 43% of cases (37/84), the reported location was judged as “unreliable” after being checked using the 3-dimensional view in Google Maps. Six journals were indexed in PubMed. Although 6 journals were declared to be indexed in the Directory of Open Access Journals, none were actually registered. The median article processing charge was 634.5 US dollars (interquartile range, 275–1005 US dollars). Several journals reported false indexing/registration in the Committee on Publication Ethics and International Committee of Medical Journal Editors registries and Google Scholar. Only 32% (67/212) reported the name of the editor-in-chief. Rules for ethics/scientific misconduct were reported in only 24% of cases (50/212). In conclusion, potential or probable predatory open-access publishers and journals are widely present in the broad field of anesthesiology and related specialties. Researchers should carefully check journals’ reported information, including location, editorial board, indexing, and rules for ethics when submitting their manuscripts to open-access journals.
Programmed Intermittent Bolus Regimen for Erector Spinae Plane Blocks in Children: A Retrospective Review of a Single-Institution Experience
Authors: Munshey Farrukh , Caruso Thomas J. , Wang Ellen Y. , Tsui Ban C. H.
Published: September 2018

With few published reports on erector spinae plane block use in children, limited guidance on perioperative local anesthetic dosing exists. We present a series of 22 patients who received erector spinae plane catheters with programmed intermittent bolus for various surgeries. Median loading dose of 0.4 mL/kg (interquartile range [IQR], 0.1 mL/kg) ropivacaine 0.5%, intraoperative bolus of 0.3 mL/kg/h (IQR, 0.1 mL/kg) ropivacaine 0.2%, and a postoperative programmed intermittent bolus regimen of maximum 0.6 mg/kg/h resulted in highest pain scores on postoperative day 1 with a median score of 1.7 of 10 (IQR, 1.8) and highest morphine equivalents consumed on postoperative day 2 with a median score of 0.16 mg/kg up to 120 hours after surgery.
Is Tube Thermosoftening Helpful for Videolaryngoscope-Guided Nasotracheal Intubation?:
Authors: Kim Eun Mi , Chung Mi Hwa , Lee Mi Hyeon , Choi Eun Mi , Jun In-Jung , Yun Tae Hyung , Ko Yong Kuk , Kim Jin Hwan , Jun Joo Hyun
Published: September 2018

BACKGROUND:

Thermosoftening of the endotracheal tube (ETT) and telescoping the ETT into a rubber catheter have been suggested as a method for reducing epistaxis during nasotracheal intubation (NTI). However, thermosoftening technique is known to make it difficult to navigate the ETT into trachea without the use of Magill forceps during NTI. The cuff inflation technique has been suggested as an effective alternative to the use of Magill forceps to improve the oropharyngeal navigation of the ETT, irrespective of their stiffness, during direct laryngoscope-guided NTI. We evaluated whether thermosoftening of the ETT telescoped into rubber catheters has an additional benefit in reducing nasal injury. Simultaneously, we also evaluated whether thermosoftening of the ETT worsened orotracheal navigability during cuff inflation-supplemented videolaryngoscope-guided NTI.

METHODS:

One hundred forty patients were randomly assigned to 1 of the 2 groups depending on whether the ETT was softened by warming or not. The primary outcome was the incidence of epistaxis during NTI. The secondary outcome was nasotracheal navigability of the ETT, assessed by navigation grade and time required for insertion of ETT in each phase (from nose to oropharynx, from oropharynx to glottic inlet aided by cuff inflation if needed, and from glottic inlet to trachea).

RESULTS:

The ETTs were successfully inserted through the selected nostril of all 140 patients. In the thermosoftening group, the incidence and severity of epistaxis was significantly lower (7% vs 51%; difference of 44.2%; 95% confidence interval, 29.9%–56.2%; P < .001), and the ETT passed through the nasal cavity with lower resistance (P = .001) and less time (P < .001) when compared to the control group. No difference was found in the ease of ETT insertion (navigation grade and time required) from the oropharynx to the glottic inlet (P > .99 and P = .054, respectively) and from the glottic inlet to the trachea (P > .99 and P = .750, respectively) between the 2 groups. In both groups, all ETTs could be navigated into the trachea without the use of Magill forceps.

CONCLUSIONS:

Supplemented with cuff inflation during videolaryngoscope-guided NTI, thermosoftening of the ETT telescoped into rubber catheters has a substantial benefit because it significantly reduces the incidence of epistaxis without worsening the oropharyngeal navigability of the ETT.
Handbuch Mediatektur
Authors: Rostásy Andrea , Sievers Tobias
Published: September 2018

Themenpavillons, Ausstellungen, Museen, Flagship-Stores, Showrooms, Bühnen, Erlebnisinszenierungen, Rauminstallationen - überall begegnen wir der Herausforderung, Medien, Architektur, Interaktion und Narration zusammen mit den Besucher_innen als Einheit zu verstehen und entsprechend zu konzipieren und umzusetzen. Das Handbuch Mediatektur zeigt Methoden und Instrumente dieser Praxis, veranschaulicht Design- und Produktionsprozesse und bietet die notwendigen Grundlagen und Kriterien, Projekte gestalterisch, organisatorisch und ökonomisch zu meistern. Dabei versteht sich das Buch auch als Beitrag zur akademischen Erschließung dieses interdisziplinären Designfeldes. Es richtet sich an Studierende ebenso wie an Professionals etwa aus Kunst und Kultur, Eventmanagement, Architektur und Szenografie, kuratorischer Praxis sowie aus Ausstellungs-, Medien- und Experientialdesign.
Zwitterwesen Unterwasserfilm
Authors: Schwarz Isabelle
Published: September 2018

Jacques-Yves Cousteau und Hans Hass eröffneten in ihren Filmen mit der Weite des medial neu einzunehmenden Naturraums Meer und den begrenzten technischen Bedingungen ein eigenes ästhetisches Spannungsfeld. Mit den ersten Arbeiten dieser beiden Unterwasserfilmer und Tauchpioniere aus den 1940er- und 1950er-Jahren widmet sich Isabelle Schwarz der Frühphase eines neuen Genres, dem u.a. Elemente des Wissenschaftsfilms, das Narrativ von Spiel- und Abenteuerfilm und Analogien zu künstlerischen Richtungen und Positionen eingeschrieben sind. In Bezug auf die Durchmessung des Meeresraumes lassen sich die Filme mit naturkundlichen Expeditionsreisen und ihrer Dokumentation vergleichen. Die Meeresoberfläche wird als Grenze diskutiert, die die weißen Flecken auf der Karte zur Projektionsfläche macht und von jenem trennt, was den Menschen in seinem Verhältnis zur Natur und insbesondere zu den unbekannten Lebensformen ausmacht; dies noch mehr in Gegenüberstellung der Arbeiten des Avantgardisten und Filmemachers Jean Painlevé.
Kosmopolitische Pioniere
Authors: Jain Rohit
Published: September 2018

Aufgewachsen zwischen Schweizer Überfremdungsangst und diasporischer Nostalgie: »Inder_innen der zweiten Generation« verfügten als Kinder kaum über Narrative für ihre Erfahrung der Mehrfachzugehörigkeit. Rohit Jain zeichnet nach, wie diese »unmöglichen« Subjekte inmitten von assimilatorischem Rassismus und warenförmiger Anerkennung in der Schweiz sowie in den diasporischen Räumen eines liberalisierten Indiens neue Lebensentwürfe erfinden. Die transnationale Ethnographie zeigt, wie an der postkolonialen Schnittstelle von dezentralem Kapitalismus, flexibler Staatszugehörigkeit und globaler Populärkultur kosmopolitische Selbstsorge im Widerspruch von Freiheit, Anerkennung und Ausschluss ausgehandelt wird.
Architektur als Akteur?
Authors: Leuenberger Theresia
Published: September 2018

Erfahren Nutzer_innen Gebäude so, wie es sich die Architekt_innen vorgestellt haben? Fühlen sie sich »eingeladen« oder eher »ausgeschlossen«? Mit theoretischen Grundlagen aus Raumsoziologie, Praxistheorie und Akteur-Netzwerk-Theorie definiert und untersucht Theresia Leuenberger Architekturerfahrungen anhand des Kunsthaus Bregenz und der Kunsthal Rotterdam. Mit der Methode der Rekonstruktiven Sozialforschung zeigt sie, wie emotionale und rationale Gehalte von Erfahrungen aufeinander einwirkend Praktiken der Architekturerfahrung konstituieren. Dabei stellt sich heraus, dass diese nur bei übereinstimmenden Subjektpositionen oder im Falle einer Vorzeichnung durch das Gebäude den Vorstellungen der Architekten Peter Zumthor und Rem Koolhaas gleichen.