bluuebunny/crossref_metadata_2025 huggingface dataset:
Taxonomic notes on Grosourdya muriculata (Orchidaceae: Epidendroideae: Vandeae: Aeridinae), a little known endemic orchid from the Andaman & Nicobar Islands, India
Authors: Mishra Sanjay , Vivek C. P. , Ekka Gautam Anuj , Singh Lal Ji
Published: January 2019

Grosourdya muriculata (Rchb.f.) R. Rice (Orchidaceae) is a little known epiphytic, endemic orchid from the Andaman & Nicobar Islands in India.  The present article provides the detailed taxonomy, ecology, distribution, conservation status, and photographic account of the species.  The data collected from field surveys indicates that the status of the species needs to be downgraded to Near Threatened as per the criteria of IUCN (2018).
Functional sperm assessments of African Lion Panthera leo (Mammalia: Carnivora: Felidae) in field conditions
Authors: Barbosa Thiesa Butterby Soler , Angrimani Daniel De Souza Ramos , Rui Bruno Rogério , Losano João Diego De Agostini , Bicudo Luana De Cássia , Blank Marcel Henrique , Nichi Marcilio , Pizzutto Cristiane Schilbach
Published: January 2019

Wild African Lion Panthera leo populations are decreasing due to inbreeding and reduced genetic variability.  Thus, the use of assisted reproduction in the species could one day become essential.  Before this is possible, however, studies need to be conducted on the basic reproductive traits of  the species, especially those regarding sperm cells.  This study aimed to analyze the semen of African Lions in field conditions.  We included seven captive African Lions in our study.  The animals were chemically restrained and electro-ejaculated.  Twenty sperm samples were selected and analyzed for sperm motility and progressive motility, sperm motility index, and sperm morphology.  In addition, the samples were analyzed for membrane and acrosome integrity (hypoosmotic swelling test and fast green/rose Bengal dyes, respectively) and assessed for cytochemical activity of the mitochondria.  We found that sperm motility rate was 75.25%±2.03, progressive motility rate was 3.25%±0.10, and sperm motility index was 70.12%±1.71.  We found morphologic abnormalities roughly at the expected rate with 34.61%±7.22 of the sperm cells having an intact plasma membrane and acrosome integrity of 92.27%±2.73; high mitochondrial activity was 54.26±4.88% and absence of mitochondrial activity was 2.72±0.68% in the sperm cells.  These findings show that conventional tests for sperm motility and sperm morphology bring about the expected results for lions according scientific literature.  Though a hypoosmotic swelling test may be performed using different concentrations, it might lead to a higher number of sperm cells with membrane damage.  Fast green/rose Bengal stain and 3’3 diaminobenzidine assay, however, can be used in sperm analysis of lions in field conditions.
Annotated checklist and conservation status of mammals of Fars Province, southern Iran
Authors: Zarei Fatah , Kafaei Sasan , Esmaeili Hamid Reza
Published: January 2019

Our purpose in this study was to gather all previously published data and our own data of extensive field expeditions and camera trapping to present a general view of the Fars mammals.  The mammals of Fars Province, southern Iran, comprise of 72 species in 53 genera, 28 families and seven orders.  The most diverse order is  Chiroptera with 23 species or 31.9% of the mammalian fauna, followed by Carnivora and Rodentia (each with 18 species, 25%).  The most diverse family is Vespertilionidae with nine species or 12.5% of the mammalian fauna, followed by Rhinopomatidae and Muridae, each with eight species or 11.1% of the mammalian fauna, Felidae and Canidae (each with five species, 6.9%), respectively.  Sixteen families have only one species each.  The Fars Province is the type locality of Triaenops persicus Dobson, 1871, Eptesicus serotinus shiraziensis (Dobson, 1871), Microtus irani Thomas, 1921, and Apodemus witherbyi (Thomas, 1902). Five species are listed in the Appendix I, eight species in the Appendix II, and eight species in the Appendix III of the Convention on International Trade in Endangered Species (CITES).  In addition, three species are considered as endangered and nine species as protected species based on the rules and regulations/laws of the Iranian Department of the Environment (DOE).  The Asiatic Lion Panthera leo persica Meyer, 1826 is extirpated in Iran.  Among the reported species, 60 species (83.3%) are considered as Least Concern (LC), two species as Not Evaluated (2.7%), one species as Data Deficient (1.4%), six species (8.3%) as Vulnerable (VU), and three species (4.2%) as Near Threatened (NT) in the IUCN Red List of Threatened Species.  The current checklist shows that the mammalian fauna of Fars Province is rich and taxonomically diverse, and the provided information will be necessary for the development of competent and pragmatic management plans and effective conservation policies.
Feeding trails of Dugong Dugong dugon (Müller, 1776) (Mammalia: Sirenia: Dugongidae) in the Gulf of Kachchh, western coast of India
Authors: Apte Deepak , Parasharya Dishannt , Patel Bhavik
Published: January 2019

Dugong Dugong dugon (Müller, 1776) is the only herbivorous marine mammal distributed along the tropical and subtropical oceans of the Indo-Pacific regions.  The record of the species in India is mainly from the east coast including Andaman and Gulf of Mannar.  In this note the authors have recorded feeding trails of Dugong on the Halodule uninervis meadow in the Gulf of Kachchh, i.e., northwestern part of India. Most of the records of this species from this area are stranding records.  This is the second record of the trail from this region.
New records of Chrysomya putoria and C. thanomthini (Diptera: Calliphoridae) from India, with a revised key to the known Indian species
Authors: Bharti Meenakshi
Published: January 2019

Chrysomya putoria (Wiedemann, 1830) and C. thanomthini Kurahashi & Tumrasvin, 1977 were recorded for the first time from India.  The species were collected from an altitude of 2,000m in the Himalaya.  An updated key to the Indian species of the genus Chrysomya Robineau-Desvoidy, 1830 is provided herein.
Cerebral White Matter Hyperintensities, Kidney Function Decline, and Recurrent Stroke After Intensive Blood Pressure Lowering: Results From the Secondary Prevention of Small Subcortical Strokes (SPS3) Trial
Authors: Ikeme Jesse C. , Pergola Pablo E. , Scherzer Rebecca , Shlipak Michael G. , Catanese Luciana , McClure Leslie A. , Benavente Oscar R. , Peralta Carmen A.
Published: January 2019

Background

We aimed to determine whether cerebral white matter hyperintensities (
WMHs
) can distinguish stroke survivors susceptible to rapid kidney function decline from intensive blood pressure (
BP
) lowering.

Methods and Results

The SPS3 (Secondary Prevention of Small Subcortical Strokes) trial randomized participants with recent lacunar stroke to systolic
BP
targets of 130 to 149 and <130 mm Hg. We included 2454 participants with
WMH
measured by clinical magnetic resonance imaging at baseline and serum creatinine measured during follow‐up. We tested interactions between
BP
target and
WMH
burden on the incidence of rapid kidney function decline (≥30% decrease from baseline estimated glomerular filtration rate at 1‐year follow‐up) and recurrent stroke. Rapid kidney function decline incidence was 11.0% in the lower‐
BP
‐target arm and 8.1% in the higher‐target arm (odds ratio=1.40; 95% CI=1.07–1.84). Odds ratio for rapid kidney function decline between lower‐ and higher‐target groups ranged from 1.26 in the lowest
WMH
tertile (95%
CI
, 0.80–1.98) to 1.71 in the highest tertile (95%
CI
, 1.05–2.80;
P
for interaction=0.65). Overall incidence of recurrent stroke was 7.9% in the lower‐target arm and 9.6% in the higher‐target arm (hazard ratio=0.80; 95%
CI
, 0.63–1.03). Hazard ratio for recurrent stroke in the lower‐target group was 1.13 (95%
CI
, 0.73–1.75) within the lowest
WMH
tertile compared with 0.73 (95%
CI
, 0.49–1.09) within the highest
WMH
tertile (
P
for interaction=0.04).

Conclusions

Participants with higher
WMH
burden appeared to experience greater benefit from intensive
BP
lowering in prevention of recurrent stroke. By contrast, intensive
BP
lowering increased the odds of kidney function decline, but
WMH
burden did not significantly distinguish this risk.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
00059306.
Metoprolol Inhibits Profibrotic Remodeling of Epicardial Adipose Tissue in a Canine Model of Chronic Obstructive Sleep Apnea
Authors: Dai Hui , Yuan Yue , Yin Shuangli , Zhang Yun , Han Yu , Sun Li , Li Tiankai , Xu Jicheng , Sheng Li , Gong Yongtai , Li Yue
Published: January 2019

Background

Whether chronic obstructive sleep apnea (
OSA
) could promote epicardial adipose tissue (
EAT
) secretion of profibrotic adipokines, and thereby contribute to atrial fibrosis, and the potential therapeutic effects of metoprolol remain unknown.

Methods and Results

A chronic
OSA
canine model was established by repeatedly clamping the endotracheal tube for and then reopening it for 4 hours every other day for 12 weeks. In a metoprolol treatment group, metoprolol succinate was administered daily for 12 weeks. The
EAT
infiltration and left atrial fibrosis were examined. The expressions of adipokines secreted by
EAT
and hypoxic 3T3‐L1 adipocytes were detected. The changes in collagen synthesis, transforming growth factor‐β1 expression, and cell differentiation and proliferation in cardiac fibroblasts induced by hypoxic 3T3‐L1 adipocyte‐derived conditioned medium were further analyzed. Chronic
OSA
induced infiltration of
EAT
into the left atrium.
OSA
enhanced the profibrotic effect of
EAT
on the adjacent atrial myocardium. Moreover,
OSA
induced profibrotic cytokine secretion from
EAT
. We also found that hypoxia induced adipokine secretion in cultured adipocytes, and the medium conditioned by the hypoxic adipocytes increased collagen and transforming growth factor‐β1 protein expression and cell proliferation of cardiac fibroblasts. More importantly, metoprolol attenuated infiltration of
EAT
and alleviated the profibrotic effect of
EAT
by inhibiting adipokine secretion. Metoprolol also inhibited hypoxia‐induced adipokine secretion in adipocytes and thereby blocked the hypoxic adipocyte–derived conditioned medium–induced fibrotic response of cardiac fibroblasts.

Conclusions

Chronic
OSA
enhanced the profibrotic effect of
EAT
on the neighboring atrial myocardium by stimulating the secretion of profibrotic adipokines from
EAT
, which was significantly attenuated by metoprolol. This study gives insights into mechanisms underlying
OSA
‐induced atrial fibrillation and also provides experimental evidence for the protective effects of metoprolol.
Massonia inaequalis (Asparagaceae, Scilloideae), a distinct new species from South Africa
Authors: MARTÍNEZ-AZORÍN MARIO , PINTER MICHAEL , CRESPO MANUEL B. , ALONSO VARGAS MARÍA ÁNGELES , WETSCHNIG WOLFGANG
Published: January 2019

Asparagaceae subfamily Scilloideae, tribe Hyacintheae is alternatively regarded as Hyacinthaceae subfam. Hyacinthoideae, a treatment we favour. Additional information on generic circumscriptions in Hyacinthoideae can be found in Martínez-Azorín et al. (2013, 2014a, 2014b), Pinter et al. (2013) and Wetschnig et al. (2014).
Studies in the Neotropical Apocynaceae LII: A synopsis of Laxoplumeria with three new species
Authors: MORALES J. FRANCISCO , MORAIS ISA LUCIA DE
Published: January 2019

This synopsis provides a key, genus description, synonymy, species descriptions, distribution, habitat, vernacular names (when available), specimens examined, illustrations and distribution map for the five species of Laxoplumeria known. A new synonym (L. macrophylla) is proposed and three new species (L. aberrans, L. longipetiolata, L. verticillata) are described.
A new species and a new record of Clitopilus and a description of C. orientalis from India based on morphology and molecular phylogeny
Authors: RAJ K. N. ANIL , MANIMOHAN PATINJAREVEETTIL
Published: January 2019

Three species of Clitopilus, C. albidus sp. nov., C. subscyphoides and C. orientalis, are described from Kerala State, India, based on morphology and molecular phylogeny. Comprehensive descriptions, photographs, and comparisons with phenetically similar and phylogenetically related species are provided. The RNA polymerase II genes (rpb2) of the three species were sequenced and analyzed. In addition, the nuclear ribosomal internal transcribed spacer regions (ITS) and the nuclear ribosomal large subunit (nLSU) genes were sequenced and used in BLAST searches to find similar sequences. Phylogenetic analyses based on rpb2 sequences performed using both Maximum Likelihood (ML) and Bayesian Analysis (BA) methods supported the novelty of C. albidus and its placement within the genus Clitopilus. C. subscyphoides and C. orientalis are the first and second record respectively of these species from India.
Taxonomic revision of the family Eosentomidae (Hexapoda: Protura) from Japan
Authors: NAKAMURA OSAMI
Published: January 2019

The family Eosentomidae from Japan is revised. A new genus, Osientomon, is erected and a new species is ascribed to this genus. This new genus is characterized by the short, setiform sensillum g, absence of sensilla e and b'1 on foretarsus, and S-shaped processus sternalis and duck’s head type caput processus on the female squama genitalis. Two new species are added to the genus Pseudanisentomon and 19 new species and 1 new record of the genus Eosentomon are described. As a result, 43 species belonging to 4 genera are now recognized from Japan. Taxonomic keys are provided for the identification of the genera and species from Japan.
Epipleoneura angeloi (Odonata: Protoneuridae), a new species from the central region of Brazil
Authors: PESSACQ P. , COSTA J. M.
Published: January 2019

Epipleoneura angeloi sp. nov., is described and illustrated based on males from Mato Grosso and Goiás states, central region of Brazil.
Tanaidacea (Crustacea: Peracarida) from the Southern French Polynesia Expedition, 2014. I. Tanaidomorpha
Authors: BIRD GRAHAM J.
Published: January 2019

Shallow-water and littoral tanaids from the Southern French Polynesia Expedition, 2014 to Rapa Iti, Morane, Taravai and Mangareva, were examined with the tanaidomorphs represented by nine taxa, four of them described as new species within the genera Chondrochelia, Poorea, Triparatanais, and Zeuxoides. A new paratanaid genus is established, Periparatanais n. gen., and Nobili’s Tanais seurati is rediscovered and redescribed as a species distinct from the Hawai’ian Zeuxo insularis n. comb. A broad comparison of tanaid faunas across the Polynesian and eastern Indo-Pacific regions based on the Marine Ecosystems of the World (MEOW) classification shows almost no species-level correspondences but several genera within four apseudomorphan and three tanaidomorphan families are consistently present.
Party Positions, Asset Ownership, and Economic Voting
Authors: Hellwig Timothy , McAllister Ian
Published: January 2019

Conventional wisdom holds that asset owners favor parties on the center-right. This assumption, however, ignores the possibility that party positions may shift over time and across contexts. The electoral payoff from ownership thus depends on how the policies of the major parties treat those assets. In this article, we argue that the prediction that asset holders support right-of-center parties rests on the position-taking strategies of parties. We test this expectation with evidence from six elections in Australia and with a dataset of post-election surveys in 25 advanced democracies. Utilizing different measures for key concepts, both analyses support our claims. Study findings identify the supply side of electoral competition as an important condition for patrimonial economic voting and, more generally, confirm the role of parties in mobilizing voters around issues on which they have a competitive advantage.
The Effects of Althesin on the Electroencephalograph
Authors: Saady Albert , Hicks R. G.
Published: January 2019

The EEG was continuously recorded on 43 patients who received Althesin. A basic pattern for this drug, typical of most general anaesthetic agents at a level of light surgical anaesthesia, was established. Four significant levels of change could be discriminated in the EEG following administration of incremental boluses of undiluted Althesin, reflecting deeper levels of anaesthesia. These ranged from a mild slowing of the dominant rhythms to burst-suppression activity at the deepest level reached with larger doses. The EEG demonstrated that althesin has a rapid onset and a short duration and that recovery is rapid and complete after continuous infusion.
A Comparison of Alfentanil Requirements in European and Asian Patients during General Anaesthesia
Authors: Aun C. , Houghton I. T. , Chan K. , Carley R. H. , Salmon N. P. , Lams Y. M. , Thornton J. A.
Published: January 2019

Alfentanil requirements were compared in thirty-six Asian and forty-three European patients during general anaesthesia with muscle relaxants. Alfentanil infusion at 5 μg/kg/min was started immediately after induction with thiopentone and alcuronium. The infusion rate was reduced to 0.5 μg/kg/min after ten minutes. An incremental dose of 5 μg/kg/min for five minutes was given on each occasion when anaesthesia was clinically judged to be inadequate. Recovery parameters were recorded. Pharmacokinetics were also studied in five Europeans, four Chinese and four Nepalese. The dosage of alfentanil required was comparable in both Asian and European patients, but recovery was slower in the Asian patients. The elimination half-life in the Chinese and the Nepalese were both significantly shorter than that of the Europeans (P < 0.05), but at the time of recovery of spontaneous ventilation, the mean plasma concentrations were not significantly different.
Altered Aminoglycoside Pharmacokinetics in the Critically Ill
Authors: Beckhouse M. J. , Whyte I. M. , Byth P. L. , Napier J. C. , Smith A. J.
Published: January 2019

We studied prospectively 49 patients being treated in an intensive care unit with aminoglycosides for gram-negative sepsis. Pharmacokinetic data were calculated from three post-dose serum levels using a one-compartment model. Doses required to achieve peak levels between 5 and 10 mg/l with trough levels approximately 1.0 mg/l ranged between 2 and 12 mg/kg per day (mean dose 7 mg/kg per day). During therapy 60% of the patients had a change in their apparent volume of distribution (Vd) of greater than 20%. These patients were likely to have confirmed infection and to be febrile at the start of treatment. Two to three weeks after discharge ten patients were restudied after a single dose of aminoglycoside. There was a reduction in mean Vd from 0.24 to 0.18 l/kg (P < 0.02). Critically ill patients have significantly larger volumes of distribution and may require larger doses per kilogram of body weight of aminoglycoside to achieve therapeutic concentrations. Due to considerable variation in kinetic parameters, the use of standard doses or dosing nomograms is not recommeded.
Effect of “Renal-Dose” Dopamine on Renal Function following Cardiac Surgery
Authors: Myles P. S. , Buckland M. R. , Schenk N. J. , Cannon G. B. , Langley M. , Davis B. B. , Weeks A. M.
Published: January 2019

The efficacy of renal-dose dopamine to improve renal function or reduce renal impairment was studied in 52 patients undergoing elective coronary artery bypass surgery. The patients were prospectively randomised in a double-blind fashion to receive dopamine at 200 μg/min (group D) or placebo (group P) from induction for 24 hours. Although dopamine improved haemodynamics, there was no effect on urine output at 4 hours (D = 917, P=1231 ml: P = 0.066); urine output at 24 hours (D=3659, P=3304 ml: P = 0.36); creatinine clearance at 0–4 hours (D = 104, P=127 ml/min: P = 0.27); creatinine clearance on admission to ICU-4 hours (D=94.8, P=83.4 ml/min: P = 0.48); creatinine clearance at 20–24 hours (D = 91.2, P=107 ml/min: P = 0.48); free-water clearance at 0–4 hours (D=29.6, P= -59.8 ml/hr: P = 0.069); free-water clearance at 20–24 hours (D=43.2, P= -48.9 ml/hr: P = 0.55). The incidence of transient renal impairment was similar in both groups (D=36%, P=50%: P = 0.65). Our study failed to demonstrate that routine prophylactic renal-dose dopamine is associated with improvement in renal function, or with prevention of transient renal impairment in patients undergoing coronary artery bypass surgery.
The Australian Incident Monitoring Study: An Analysis of 2000 Incident Reports
Authors: Webb R. K. , Currie M. , Morgan C. A. , Williamson J. A. , Mackay P. , Russell W. J. , Runciman W. B.
Published: January 2019

The Australian Patient Safety Foundation was formed in 1987; it was decided to set up and co-ordinate the Australian Incident Monitoring Study as a function of this Foundation; 90 hospitals and practices joined the study. Participating anaesthetists were invited to report, on an anonymous and voluntary basis, any unintended incident which reduced, or could have reduced, the safety margin for a patient. Any incident could be reported, not only those which were deemed “preventable” or were thought to involve human error. The Mark I AIMS form was developed which incorporated features and concepts from several other studies. All the incidents in this symposium were reported using this form, which contains general instructions to the reporter, key words and space for a narrative of the incident, structured sections for what happened (with subsections for circuitry incidents, circuitry involved, equipment involved, pharmacological incidents and airway incidents), why it happened (with subsections for factors contributing to the incident, factors minimising the incident and suggested corrective strategies), the type of anaesthesia and procedure, monitors in use, when and where the incident happened, the experience of the personnel involved, patient age and a classification of patient outcome. Enrolment, reporting and data-handling procedures are described. Data on patient outcome are presented; this is correlated with the stages at which the incident occurred and with the ASA status of the patients. The locations at which the incidents occurred and the types of procedures, the sets of incidents analysed in detail and a breakdown of the incidents due to drugs are also presented. The pattern and relative frequencies of the various categories of incidents are similar to those in “closed-claims” studies, suggesting that AIMS should provide information of relevance to those wishing to develop strategies to reduce the incidence and/or impact of incidents and accidents.
Oesophageal Intubation: An Analysis of 2000 Incident Reports
Authors: Holland R. , Webb R. K. , Runciman W. B.
Published: January 2019

There were 35 oesophageal intubations in the first 2000 incidents reported to the Australian Incident Monitoring Study (AIMS). These reports confirm existing impressions that misplacement of the endotracheal tube can occur in trained as well as untrained hands, and that auscultation is an unreliable test. On the other hand, the value of capnography is emphasised, with no false positives in the 16 cases in which the instrument was used. There was one false negative. Over the 4 years of the AIMS study, reports have declined in frequency. It is possible that the early detection of oesophageal intubation by capnography has altered its status to the extent that anaesthetists no longer regard it as a “critical” incident. It is highly recommended that the presence of the expected concentration of carbon dioxide in expired air be confirmed by capnography immediately after any endotracheal intubation.
Peritonsillar Infiltration with Bupivacaine for Paediatric Tonsillectomy
Authors: Stuart J. C. , Macgregor F. B. , Cairns C. S. , Chandrachud H. R.
Published: January 2019

In a double-blind study forty-two children scheduled for elective adenotonsillectomy were randomized to receive peritonsillar infiltration, following induction of anaesthesia, with either 0.25% plain bupivacaine or 0.9% saline, 0.5 ml/kg to a maximum of 10 ml. The children were assessed on awakening, and then 10 minutes, 1 hour, 4 hours and 24 hours later. On each occasion the observer gave the child a pain score from 1 (no pain) to 5 (severe pain). The scores on awakening and after 10 minutes were significantly lower in the bupivacaine group (P< 0.05, Mann-Whitney U test). Thereafter there was no difference between the groups. The authors conclude that peritonsillar infiltration with bupivacaine is only moderately useful as analgesia for children having tonsillectomy.
Obtaining Consent for Organ Donation in Nine NSW Metropolitan Hospitals
Authors: Chapman J. R. , Hibberd A. D. , Mccosker C. , Thompson J. F. , Ross W. , Mahony J. , Byth P. , Macdonald G. J.
Published: January 2019

Organ donation rates vary markedly around the world. In an attempt to analyse why some patients’ families are not asked about organ donation, the case notes of 6080 patients who died over a twelve-month period from April 1991 to March 1992 in nine hospitals in Sydney, NSW, were studied. Irreversible coma occurred in 515 patients. Of these, 177 were considered to be potentially brain dead donors, 126 of whom had a formal diagnosis of brain death. The clinicians caring for the patients at the time of death were asked at follow-up about the reasons for not considering donation, or the reasons for family refusal.

Consent to proceed to organ donation was requested in 112 cases (49 donated and 63 refused) and not requested in 65. Analysis of the proportions asked and consenting in each hospital revealed no correlation. Half of the families refusing gave no reason (24/50) while eleven gave religious or cultural reasons, and six expressed a desire to prevent mutilation of the body as their primary reason for not consenting. There was universal failure to gain consent from families when the patient was not in an Intensive Care Unit. Analysis of those patients of whom consent was not sought showed that they died more quickly after admission, were older and died from causes other than trauma or intracranial haemorrhage. The odds of the family being asked dropped by about half as the age increased from one group to the next.

Increases in organ donation may be achieved by ensuring that potential donors reach intensive care units; that criteria for medical suitability for donation are unambiguous and widely known; and that changes occur in public attitudes to consent for donation.
Can Cadaveric Organ Donation Rates be Improved?
Authors: Thompson J. F. , Hibberd A. D. , Mohacsi P. J. , Chapman J. R. , Macdonald G. J. , Mahony J. F.
Published: January 2019

There are many reasons why potential cadaveric organ donors may fail to become actual donors. These include permission refusal by the next of kin, incorrect assumptions about medical suitability and, occasionally, an excessive workload in the intensive care unit. Some potential donors currently regarded in Australia as “unrealistic” might become actual donors if attitudes were to change towards ventilation of patients with a clearly hopeless prognosis who have expressed a wish to be organ donors. “Required request” legislation ignores the wishes of the potential donor and “presumed consent” laws also present some ethical difficulties, but a suggested “required response” process could ensure that an individual's wishes concerning organ donation would be known and able to be carried out after death. For the present, however, it is clear that operating within existing Australian legislation and abiding by currently accepted codes of practice, we can still find considerable scope for improving cadaveric organ donation rates.
Comparison of Halothane, Enflurane and Isoflurane Kidney Effects through Alanine Aminopeptidase/Urine Creatinine Values
Authors: Dural O. , Kanbak M. , Ciliv G. , Aypar U. , Erdem K.
Published: January 2019

The kidney effects of halothane, enflurane and isoflurane were evaluated by using the ratio of urinary excretion of alanine aminopeptidase (AAP) to urine creatinine. Thirty patients in ASA class 1 or 2 were studied. None had renal disease nor received nephrotoxic drugs.

Groups 1, 2 and 3 received halothane, enflurane and isoflurane respectively. Creatinine and AAP activities in urine spot tests, serum creatinine and BUN levels were determined preoperatively and on the first and second postoperative days. Urine AAP activity and AAP/urine creatinine values increased significantly on the first and second postoperative days compared with the preoperative values in all groups (P<0.05). The present study did not reveal any significant difference in the kidney effects of halothane, enflurane and isoflurane through AAP/creatinine in spot urine values.
Measurement of Neuromuscular Blockade—A Comparsion between a New “Homemade” Force Displacement Transducer and the Accelerometer
Authors: Newell S. , Brimacombe J.
Published: January 2019

Train-of-four (TOF) ratios are compared between a new homemade force pressure transducer and a commercially available accelerometer. Twenty adult patients were studied and 600 simultaneous TOF ratio pairs were recorded during anaesthesia with varying degrees of muscle relaxation. Laboratory testing revealed that the output from the homemade device was linear up to 900 g and that there was a linear relationship between the output from the new device and the accelerometer (y = 0.802x + 5.167, R = 0.943, t=69, P < 0.0001). Although the homemade device underestimates the accelerometer TOF ratio by 20%, it is a reliable and economic alternative to commercially available products for measuring TOF ratios.
A Meta-Analysis on the Efficacy of Epidural Corticosteroids in the Treatment of Sciatica
Authors: Watts R. W. , Silagy C. A.
Published: January 2019

The efficacy of epidural corticosteroids in the treatment of sciatica was investigated by meta-analysis of all randomized controlled trials. Eleven suitable trials of good quality were identified involving a total of 907 patients.

The use of epidural (caudal or lumbar) steroid in the short-term (up to 60 days) increased the odds ratio (OR) of pain relief (>75% improvement) to 2.61 (95% CI 1.90–3.77) when compared with placebo. Despite some variations in trial characteristics there was little evidence of significant heterogeneity (P=0.07). When the trials were analysed for near or total relief of pain in the short-term the OR is 2.79 (95% CI 1.92–4.06), for heterogeneity (P=0.07). For longterm relief of pain (up to 12 months) the OR is 1.87 (95% CI 1.31–2.68).

Efficacy is independent of the route of injection; for caudal epidural steroid the OR is 3.80 (95% CI 1.36–10.6) and for the lumbar epidural steroid 2.43 (95% CI 1.77–3.74).

Adverse events included dural tap (2.5%), transient headache (2.3%) and a transient increase in pain (1.9%). There were no reported longterm adverse events.

In conclusion we present quantitative evidence from meta-analysis of pooled data from randomized trials that epidural administration of corticosteroids is effective in the management of lumbosacral radicular pain.
The Perioperative System: A New Approach to Managing Elective Surgery
Authors: Kerridge R. , Lee A. , Latchford E. , Beehan S. J. , Hillman K. M.
Published: January 2019

A Perioperative Service has recently been introduced at Liverpool Hospital, a 460-bed university teaching hospital. This provides a co-ordinated system for managing all elective surgical patients from the time an admission is booked until hospital discharge. This paper describes the patient assessment, structure and staff requirements, benefits of and problems encountered with this service.

The patient's preoperative preparation occurs before hospital admission. Where possible, patients are admitted on the day of procedure, either as a day-only patient, or a day-of-surgery patient. Patients are initially admitted to a specifically designed Perioperative Unit, adjacent to the Operating Theatre Suite. Patients do not enter the surgical wards until after their operation. Planning of the hospital discharge process commences at the time of booking for operation.

Introduction of the Perioperative Service was staged process commencing in mid-1992. The hospital admits approximately 6,400 elective surgery cases each year. From July 1992 to December 1994, day-only patients were approximately 45% of these cases. Day-of-surgery admission patients increased from 6% to 35% of all cases over the same period. Appproximately 22% of elective surgical cases were seen in the Perioperative Clinic.

As the Perioerative Service became fully operational, the average length of stay for elective surgical procedures fell. There has been a reduction in the areas of cancellations due to unavailablity of beds, inappropriate preparation of patients, and non-attendance of patients for booked procedures. Patient acceptance is high. The existence of a perioperative system facilitates the planning and management of elective surgery with maximum quality and efficiency.
Respiratory Drive and Pulmonary Mechanics during Haemodialysis with Ultrafiltration in Ventilated Patients
Authors: Huang C. C. , Tsai Y. H. , Lin M. C. , Yang C. T. , Hsieh M. J. , Lan R. S.
Published: January 2019

The improvements of respiratory drive and pulmonary mechanics which follow haemodialysis with ultrafiltration in mechanically ventilated renal failure patients seem predictable but have not been studied before.

In this study, 14 renal failure patients with stable haemodynamics mechanically ventilated with pressure support ventilation (PSV) were enrolled. Respiratory drive (represented as P0.1), pulmonary mechanics, breathing pattern, arterial blood gas and haemodynamics were measured according to the time schedule: pre-dialysis (Time 0), and at 60, 120, 180, 240 minutes thereafter.

Following the removal of excess lung water during haemodialysis, auto-PEEP and patient's work of breathing (WOBp) decreased gradually. P0.1 lessened progressively along with the improvement in pulmonary mechanics. The changes in auto-PEEP and WOBp correlated closely to the pre- and post-dialysis decline of P0.1 (ΔP0.1). There was a negative, moderately significant correlation between the amount of fluid ultrafiltrated during dialysis (ΔUF) and the ΔP0.1 (R = -0.54). The breathing pattern remained stable during dialysis. No hypoventilation or hypoxaemia occurred despite the development of metabolic alkalosis induced by bicarbonate dialysate.

We have shown that respiratory drive decreases gradually during bicarbonate haemodialysis. The improvements of pulmonary mechanics, rather than the rapid alkalization of body fluids, responds to the decrease of P0.1 in renal failure patients ventilated with PSV.
Predicting Difficult Intubation—A Comprehensive Scoring System
Authors: Nath G. , Sekar M.
Published: January 2019

A study was conducted in an attempt to devise a simple and more accurate method of predicting difficult intubation.

Prospective assessments were made in 282 patients and retrospective assessment in 16 patients with regard to 21 anatomical factors which were correlated with the laryngoscopic view at intubation.

Twelve factors correlated significantly with difficult intubation. Four of these were eliminated after multifactorial analysis.

A scoring system was devised, assigning points to each variable based on its discriminative value. A score of 6 or more correctly identified 22 out of the 23 difficult intubations and there were 50 false positives (sensitivity, specificity and PPV of 96%, 82% and 31% respectively). When negative scoring was done for factors favouring easy intubation, false positives were reduced to 36, but only 20 difficult cases could be identified correctly.
Intraoperative Convulsions in a Child with Arthrogryposis
Authors: Ferris P. E.
Published: January 2019

A case of intraoperative convulsions occurring in a child with arthrogryposis multiplex congenita is presented. Arthrogryposis and the anaesthetic management of children with this condition is discussed. Factors which may have contributed to the convulsions are considered.
Do Intensive Care Drug Infusions Support Microbial Growth?
Authors: Graystone S. , Wells M. F. , Farrell D. J.
Published: January 2019

The potential for commonly infused drug solutions to support or inhibit microbial growth was explored in this study. Drugs examined were midazolam HCl, morphine sulphate, fentanyl citrate, pethidine HCl, bupivacaine HCl, atracurium besylate, vecuronium bromide, adrenaline, dopamine, dobutamine, noradrenaline, isoprenaline, glyceryl trinitrate, sodium nitroprusside and propofol. All drugs were studied in both diluted and undiluted forms. Of the 15 medications investigated, all except propofol were found to be bactericidal and to reduce fungal growth.
Race, Gender, and Emotion Work among School Principals
Authors: Ispa-Landa Simone , Thomas Sara
Published: January 2019

Researchers have highlighted how gendered associations of femininity with emotional labor can complicate professional women’s attempts to exercise managerial authority. However, current understandings of how race and gender intersect in professional women’s emotional labor remain limited. We draw on 132 interviews from eight white women and 13 women of color who are novice principals. White women began the principalship wanting to establish themselves as emotionally supportive leaders who were open to others’ influence. They viewed emotional labor as existing in tension with showing authority as a leader. Over time, however, most white women reported adopting more directive practices. By contrast, women of color reported beginning the principalship with a more directive, take-charge leadership style. They viewed emotional labor and authority as part of a blended project and did not talk about these two aspects of leadership as existing in tension. Over time, their self-reported leadership style changed little. We analyze our findings in light of recent theorizing about gender and intersectionality.
Robust overtaking control of autonomous electric vehicle with parameter uncertainties
Authors: Xu Liwei , Zhuang Weichao , Yin Guodong , Li Guangmin , Bian Chentong
Published: January 2019

In this paper, we propose a two-layer overtaking control framework of the autonomous electric ground vehicle, including trajectory planning and tracking control. In the upper layer, a stable overtaking trajectory is derived by considering the duration of the overtaking, driving comfort and vehicle stability simultaneously. Besides, the safety spacing between the overtaking and overtaken vehicles is analyzed to prevent the potential collision. To track the generated reference trajectory precisely, we design a robust model predictive controller adopting the input-to-state stability property in the lower layer to reduce the affection of disturbances and parameter uncertainties. Two driving strategies with different lateral accelerations, that is, mild and aggressive, are simulated to verify the effectiveness of the proposed control framework. By comparing to the driver-vehicle control system, the proposed control framework can not only achieve safe, smooth, and rapid overtaking but also realize the accurate state tracking in the presence of tire cornering stiffness uncertainty.
Home as the Least Restrictive Environment for Students with Medical Disabilities
Authors: Lustig Benjamin C.
Published: January 2019

School leaders have a prominent role on Individual Education Program (IEP) teams and often face very challenging obstacles when determining substantive educational services and placement in the least restrictive environment (LRE) for students with medical disabilities. In absence of federal statutory and regulatory policy, standard legal research methodology was used to determine whether explicit and implicit recommendations existed for school leaders elsewhere in the law for the use of homebound placements for students with medical disabilities under the Individuals with Disabilities Education Act. Homebound instructional services can be an LRE because educational services are provided to students who would be unable to attend school programs and activities.
Looking behind the Curtain
Authors: Drago-Severson Eleanor , Maslin-Ostrowski Patricia , Blum-Destefano Jessica
Published: January 2019

This article extends mixed-methods longitudinal research with school and district leaders (2008–present) about their most pressing leadership challenges. Here—through in-depth, qualitative interviews—we explore how a subsample of 30 principals described and understood their internal experiences of addressing pressing challenges. More specifically, using an adaptive/ technical lens, social-emotional frameworks, and constructive-developmental theory, we illuminate how principals‘ social-emotional and developmental capacities influenced their leadership, and highlight findings with in-depth mini-cases. By focusing on the inner workings of principals’ leadership for managing change, this article offers implications for professional practice and school-wide change locally and globally, leadership preparation, policy, and future research.
Balance of Instructional and Managerial Tasks as it Relates to School Leaders' Self-Efficacy
Authors: McBrayer Juliann Sergi , Jackson Torri , Pannell Summer S. , Sorgen Carl H. , De Blume Antonio P. Gutierrez , Melton Teri Denlea
Published: January 2019

This study examined school leaders' self-efficacy in relation to time spent on school instructional leadership and managerial tasks. Descriptive statistics yielded a mean score for leadership self-efficacy of 4.1/5.0. For every unit increase in time spent on instructional tasks, leadership self-efficacy scores increased and for every unit increase in time spent on managerial tasks, leadership self-efficacy decreased. In addition, 7% of school leaders spent more than 50% of their time on instructional tasks and 93% spent less than 50% and 45% of school leaders spent more than 50% of their time on management tasks and 55% spent less than 50%.
Charter School Achievements in Texas: Public versus Charter Schools
Authors: Sahin Alpaslan , Willson Victor , Capraro Robert M.
Published: January 2019

This study aimed to investigate the performance of a charter school network, Harmony Public Schools (HPS), in a 3-year longitudinal student-level research study of high school mathematics, reading, and science performance using 2009–2011 Texas Assessment of Knowledge and Skill student data. Propensity-score-matched public (N = 19) and Harmony (N = 11) schools' performances were compared. We conducted a two-level multivariate analysis of covariance on binary outcomes (pass–no pass) for grades 9–11. HPS performed significantly better at grade 9 and worse at grade 11, with no statistical differences at grade 10 in mathematics. Type of school was not significant at either grade 9 or 10 for reading. For science performances, Harmony charter schools performed better at 10th grade and significantly better at 11th grade. Implications of the findings were discussed as to whether charter schools keep their promises of providing quality education.
“For Real Love”: How Black Girls Benefit from a Politicized Ethic of Care
Authors: Lane Monique
Published: January 2019

This article examines the concept of a politicized ethic of care, a teaching philosophy that is commonly rooted in the pedagogies of exemplary Black female teachers. Data from a larger study of a girls' empowerment program at a public high school are used to argue in favor of this pedagogical tradition, which has been proven to facilitate the development of positive social identities and schooling behaviors among African American female students. The author challenges Western and gender-neutral approaches to caring for urban Black girls through an inductive analysis of curricula, in-class video footage, student artifacts, and interviews with former participants. Implications for teacher education research are presented.
Love waves in a nonlocal elastic media with voids
Authors: Kaur Gurwinderpal , Singh Dilbag , Tomar SK
Published: January 2019

The propagation of Love-type waves in a nonlocal elastic layer with voids resting over a nonlocal elastic solid half-space with voids has been studied. Dispersion relations are derived using appropriate boundary conditions of the model. It is found that there exist two fronts of Love-type surface waves that may travel with distinct speeds. The appearance of the second front is purely due to the presence of voids in layered media. Both fronts are found to be dispersive in nature and affected by the presence of the nonlocality parameter. The first front is found to be nonattenuating, independent of void parameters and analogous to the Love wave of classical elasticity, while the second front is attenuating and depends on the presence of void parameters. Each of the fronts is found to face a critical frequency above which it ceases to propagate. For a specific model, the variation of the phase speeds of both the fronts with frequency, nonlocality, voids and thickness parameters is shown graphically. Attenuation coefficient versus frequency for the second front has also been depicted separately. Some particular cases are deduced from the present formulation.
Isolation of micro-vibrations due to reaction wheel assembly using a source-path-receiver approach for quantitative requirements
Authors: Hur Gyunchul
Published: January 2019

A source-path-receiver approach is presented for the design of an isolator for a reaction wheel assembly (RWA) that will reduce angular vibrations of a device on a flexible satellite body. One objective of this study is to determine, with minimum trial and error, the stiffness of a passive isolator for the RWA that will satisfy strict quantitative requirements of receiver vibration. First, based on measurements of blocked forces during operations, the RWA was characterized as a vibration source with lumped parameters. Second, a finite element model of a truss structure with a thick plate on it, chosen as a substitute for a satellite and an imaging device, respectively, was prepared using a commercial finite element tool (ABAQUS), and the model was tuned for accuracy. Then, a way to select the stiffness of the isolators to be installed between the RWA and the truss structure was proposed with minimum trial and error in the total range of frequency and rotation speed to meet the requirements of angular vibration of the receiver part. For the purpose of a comparison, the conventional approach, based simply on vibration transmissibility across a vibration isolator, which cannot take the flexibility of the path structure into account, was used to determine the isolator stiffness. Vibration isolators with stiffnesses determined by both approaches were manufactured and applied to the RWA truss structure, and it was evaluated as to whether or not the quantitative requirement was satisfied.
Pathophysiological Mechanism of Extravasation via Umbilical Venous Catheters
Authors: Hargitai Beata , Toldi Gergely , Marton Tamas , Ramalingam Velmurugan , Ewer Andrew K , Bedford Russell Alison R
Published: January 2019

A rare complication of umbilical venous catheter (UVC) insertion is the extravasation of the infusate into the peritoneal cavity. We report 3 cases of abdominal extravasation of parenteral nutrition (PN) fluid via UVCs. Two of these cases presented as “acute abdomen” which were assumed to be necrotizing enterocolitis clinically; however, during postmortem, PN ascites and liver necrosis were found. A further case is described in an infant with congenital diaphragmatic hernia. While we were unable to ascertain direct vessel perforation by the catheter in any of these cases, based on pathological and histological examination, the proposed mechanism of PN fluid extravasation is leakage through microinjuries of liver vessel walls and necrotic parenchyma. PN extravasation should be considered as a differential diagnosis of acute abdomen when PN is infused via an UVC presumably as PN may have a direct irritant effect on the peritoneum.