bluuebunny/crossref_metadata_2025 huggingface dataset:
The Cognitive-cultural Economy
Authors: Phelps Nicholas A.
Published: July 2017

This chapter considers the in-between geography of an economy associated ever more with the consumption of signs and symbols. It also looks at the rise of a cognitive-cultural economy in the social life of commodities constructed by intermediaries and played out in arenas and considers debates over the status of the contemporary economy as primarily cognitive or cultural. The rise of brands and branding and consumption is organized in and around retail and tourism enclaves and the agglomerations that comprise our major cities. The economy between sign and symbol is a particularly hard middle ground to penetrate in analytical terms but also in normative terms. It is this economy of signs and symbols that best illustrates the strengths of post-modern analysis, but which least lends itself to clear and unambiguous policy interventions since politics and policy pronouncements are open to infinite critique for their cultural intolerance or insensitivity.
Conclusion
Authors: Phelps Nicholas A.
Published: July 2017

This book has argued the value of refocusing economic geography towards the economy apparent in between cities and nations. It has also suggested a limited arsenal of concepts that might be deployed when analysing the economy of interplaces. Nevertheless, this chapter concludes the book by noting some of the themes and issues omitted in its preceding discussions. It goes on to offer a critical discussion of the normative agendas associated with intermediaries, agglomerations, enclaves, networks, and arenas. It briefly notes some departure points for future economic geography research raised as a result of this consideration of the economy of interplaces.
Crispus Attucks and the Black Freedom Struggle, 1950s–1970s
Authors: Kachun Mitch
Published: July 2017

As the integrationist civil rights movement took shape, Attucks became one of the most prominent black figures to enter elementary and secondary school curricula and textbooks. In most mainstream texts he became merely a token black presence, yet some white commentators took issue with even this superficial elevation to the status of Revolutionary patriot, reviving the contention that Attucks was no more than a rabble-rousing ruffian. Meanwhile, black writers characterized him as everything from a peaceful integrationist to an Afrocentric rebel to a sellout Uncle Tom. Attucks was now more present than ever in the nation’s public schools and popular culture, but widespread disagreement remained regarding his status as a national hero to be honored by all, an embodiment of race pride, a symbol of violence and disorder, or an irrelevant nobody who should be forgotten.
Crispus Attucks from the Bicentennial to the Culture Wars, 1970s–1990s
Authors: Kachun Mitch
Published: July 2017

The 1976 bicentennial brought greater mainstream attention to Attucks and black participation in the Revolution as well as increasing opportunities to disseminate interpretations of Attucks and other African American heroes in schools and through ever-expanding mass media exposure over the subsequent decades. Attucks was becoming a standard figure in most popular American history textbooks and was featured even more visibly in mainstream culture outside the classroom. Of all the competing versions of Attucks circulating at that time, it was the taken-for-granted Revolutionary token that seemed most prominent in the nation’s collective memory; for many, he was a bland symbol of a romanticized American Revolution and an unthreatening black patriotism. By the end of the twentieth century, Attucks had, to a large degree, become a black American hero of the Revolution, though one who was still marginalized within the nation’s story.
Accelerometry Shows Inpatients With Acute Medical or Surgical Conditions Spend Little Time Upright and Are Highly Sedentary: Systematic Review
Authors: Baldwin Claire , van Kessel Gisela , Phillips Anna , Johnston Kylie
Published: July 2017

Background

Physical inactivity and sedentary behaviors have significant and independent effects on health. The use of wearable monitors to measure these constructs in people who are hospitalized with an acute illness is rapidly expanding, but has not been systematically described.

Purpose

The purpose of this study was to review the use of accelerometer monitoring with inpatients who are acutely ill, including what activity and sedentary behaviors have been measured and how active or sedentary inpatients are.

Data Sources

Databases used were MEDLINE, EMBASE, CINAHL, and Scopus.

Study Selection

Quantitative studies of adults with an acute medical or surgical hospital admission, on whom an accelerometer was used to measure a physical activity or sedentary behavior, were selected.

Data Extraction and Data Synthesis

Procedures were completed independently by 2 reviewers, with differences resolved and cross-checked by a third reviewer. Forty-two studies were identified that recruited people who had medical diagnoses (n = 10), stroke (n = 5), critical illness (n = 3), acute exacerbations of lung disease (n = 7), cardiac conditions (n = 7), or who were postsurgery (n = 10). Physical activities or sedentary behaviors were reported in terms of time spent in a particular posture (lying/sitting, standing/stepping), active/inactive, or at a particular activity intensity. Physical activity was also reported as step count, number of episodes or postural transitions, and bouts. Inpatients spent 93% to 98.8% (range) of their hospital stay sedentary, and in most studies completed <1,000 steps/day despite up to 50 postural transitions/day. No study reported sedentary bouts. Many studies controlled for preadmission function as part of the recruitment strategy or analysis or both.

Limitations

Heterogeneity in monitoring devices (17 models), protocols, and variable definitions limited comparability between studies and clinical groups to descriptive synthesis without meta-analysis.

Conclusions

Hospitalized patients were highly inactive, especially those with medical admissions, based on time and step parameters. Accelerometer monitoring of sedentary behavior patterns was less reported and warrants further research.
The Effectiveness of EMLA as a Primary Dressing on Painful Chronic Leg Ulcers: A Pilot Randomized Controlled Trial
Authors: Purcell Anne , Buckley Thomas , Fethney Judith , King Jennie , Moyle Wendy , Marshall Andrea P.
Published: July 2017

OBJECTIVE:

To evaluate the effectiveness of the eutectic mixture of local anesthetics (EMLA; Aspen Pharmacare, St. Leonards, New South Wales, Australia) as a primary dressing on painful chronic leg ulcers.

DESIGN:

A pilot randomized controlled trial.

SETTING:

The study was conducted across 6 community nursing procedure clinics located in a community nursing service in New South Wales, Australia.

PARTICIPANTS:

Sixty participants with painful chronic leg ulcers of varied etiology were recruited into the study.

INTERVENTION:

Participants were randomly assigned to an intervention (daily EMLA use for 4 weeks as a primary dressing) or a standard wound care group.

MAIN OUTCOME MEASURE:

The effectiveness of EMLA on wound-related pain intensity before, during, and after dressing change.

MAIN RESULTS:

Mean pain scores were similar between the 2 groups at baseline (P = .84). During dressing change, mean pain scores across the 4-week intervention period were significantly lower in the intervention compared with the control group (intervention group: mean, 3.39 [SD, 2.16]; control group: mean, 4.82 [SD, 2.27]; P = .02). Mean pain scores after dressing change were also significantly lower for the intervention group over the 4-week intervention period (intervention group: mean, 2.71 [SD, 1.94]; control group: mean, 3.92 [SD, 2.03]; P = .03).

CONCLUSIONS:

Data from this pilot study suggest that EMLA as a primary dressing may be effective in reducing chronic leg ulcer pain during and after dressing change and warrant further evaluation.
Screening Adolescents for Alcohol Use: Tracking Practice Trends of Massachusetts Pediatricians
Authors: Levy Sharon , Ziemnik Rosemary E. , Harris Sion K. , Rabinow Lily , Breen Louise , Fluet Christina , Strother Heather , Straus John H.
Published: July 2017

Objectives:

Substance use screening is a recommended component of routine healthcare for adolescents. A 2008 survey of Massachusetts primary care physicians found high rates of screening, but low rates of validated tool use, leading to the concern that physicians may be missing substance use-related problems and disorders. In an effort to improve practice, a cross-disciplinary group developed and distributed an adolescent screening, brief intervention, and referral to treatment toolkit in 2009. A new survey of Massachusetts primary care physicians was conducted in 2014; this report describes its findings, and compares them to those from 2008.

Methods:

A survey was mailed to a randomly selected sample of Massachusetts primary care physicians listed in the state Board of Registration in Medicine database. Item response frequencies were computed. Multiple logistic regression modeling was used to compare 2008 and 2014 responses, while controlling for any demographic differences between samples.

Results:

Pediatrician respondents in 2014 (analysis N = 130) reported a high rate of annually screening patients for alcohol use (96.2%), but only 56.2% reported using a validated screening tool. Rates of screening and validated tool use were higher in 2014 than 2008. Insufficient knowledge as a reported barrier to screening decreased from 2008 to 2014. However, lack of time or staff resources remained key perceived barriers to screening.

Conclusions:

Our findings suggest that adolescent alcohol use screening practices among Massachusetts pediatricians have improved in recent years, during a time of national and statewide efforts to educate physicians. However, opportunities for practice improvement remain.
Efficacy of Intra-Articular Botulinum Toxin in Osteoarticular Joint Pain
Authors: Courseau Mathilde , Salle Pascale Vergne , Ranoux Danièle , de Pouilly Lachatre Anais
Published: July 2017

Objective:

This study was conducted with the aim of evaluating the efficacy of intra-articular injections of botulinum toxin type A (BT-A) into the painful joint diseases through a systematic review of the literature and a meta-analysis of controlled randomized trials. Intra-articular therapies (corticosteroids, hyaluronic acid) have limited efficacy and run a risk of toxicity in patients with joint pain. New therapeutic options are needed to treat painful osteoarticular disease.

Methods:

We searched via Pubmed, American College of Rheumatology, and European League Against Rheumatism congresses, and gray literature for the studies reported until June 2016 and addressing the issue of BT intra-articular injections in patients with refractory joint pain. Randomized trials were included. For the meta-analysis, we compared a numeric rating scale (NRS) from 0 to 10 before treatment and at 1 or 2 months and 6 months after in the BT-A and the control groups for each study. We also compared separately low dose and high dose of BT at 1 or 2 months’ evaluation.

Results:

In a total of 269 selected articles, 8 were analyzed and 6 studies were included in the meta-analysis involving a total of 382 patients. On comparing the NRS rating for 5 trials, at 1 or 2 months irrespective of the dose of BT, 4 trials showed a positive effect of BT compared with the control on the NRS and 1 found no effect; the overall weighted mean difference [95% confidence interval (CI)] was −1.10 (−1.62, −0.58) (P<0.0001, I
2=63%). Among the 4 trials with a low dose of BT (100 U), comparing NRS at 1 or 2 months, 3 trials showed significant results with a positive effect of BT-A injection compared with the control on the NRS; the fourth study failed to find any effect. The overall weighted mean difference (95% CI) was −0.95 (−0.02, −1.88) (P=0.05, I
2=67%). In the 2 trials using a high dose of BT (200 U) comparing NRS at 1 or 2 months, there was an almost zero effect of BT, with an overall weighted mean difference (95% CI) of 0.13 (−0.55, 0.81) (P=0.71, I
2=0%). In the 3 trials comparing NRS at 6 months there was an overall weighted mean difference (95% CI) of −0.57 (−1.98, 0.83) (P=0.42, I
2=73%).

Conclusions:

BT-A intra-articular injections have short-term benefits with a statistically significant decrease in the NRS pain score of around 1 point in patients with refractory joint pain. A decrease in the pain score was also observed at 6 months but with a nonsignificant result.
Longitudinal Postoperative Course of Pain and Dysfunction Following Total Knee Arthroplasty
Authors: Hadlandsmyth Katherine , Zimmerman M.Bridget , Wajid Roohina , Sluka Kathleen A. , Herr Keela , Clark Charles R. , Noiseux Nicolas O. , Callaghan John J. , Rakel Barbara A.
Published: July 2017

Objectives:

Although the majority of patients undergoing total knee arthroplasty (TKA) report substantial improvement in pain and function, a significant subset experience persistent postsurgical pain and dysfunction. Better understanding of the longitudinal postoperative course is needed, including the association between patient status following physical rehabilitation at 6-weeks post-TKA, to 6-months outcomes. This study aims to described the postoperative course of TKA and examine variables associated with change in pain and functioning between 6-weeks and 6-months post-TKA.

Methods:

In this longitudinal study of 223 participants, assessments of analgesic intake, depression, anxiety, pain catastrophizing, dysfunction, resting and range of motion pain, and pain sensitivity were completed at 6-weeks post-TKA. Analgesic intake, pain ratings, and dysfunction data were also collected at 6-months post-TKA. Pain and dysfunction ratings were divided into none-mild and moderate-severe categories.

Results:

Between 6-weeks and 6-months post-TKA, 75% of the sample stayed in the same pain category, 20% improved, and 5% worsened. In terms of functional changes between 6 weeks and 6 months, 65% of the sample stayed in the same functional category, whereas 31% improved and 5% worsened.

Discussion:

These findings demonstrate that the majority of patients’ pain and functioning remains stable between 6 weeks and 6 months post-TKA. However, a notable subset continues to improve or worsen in pain and functioning and the current study identifies variables associated with these changes.
Closed Continuous Irrigation With Lidocaine and Immediate Mobilization for Treatment of Pyogenic Tenosynovitis
Authors: Knackstedt Rebecca , Tyler Joyce , Bernard Steven
Published: July 2017

Pyogenic flexor tenosynovitis treatment consists of either closed continuous irrigation with sterile saline or antibiotic solution, or open debridement and irrigation. These treatment approaches serve to resolve the infection, but are extremely painful and residual stiffness can be devastating to the patient. We describe herein our approach to managing pyogenic flexor tenosynovitis. To provide continuous irrigation, a butterfly catheter with needle removed is utilized with irrigation holes cut into the tubing. The catheter is inserted into the tendon sheath at the level of the Al pulley and brought out at the level of the A5 pulley. A knot is tied in the end of the catheter for retention, eliminating the need for sutures. Immediately postoperative, continuous irrigation with sterile saline mixed with lidocaine is initiated and is titrated to achieve pain-free motion in the finger. Occupational therapy begins an aggressive course of active and passive range of motion exercises immediate postoperatively, which is continued for the remainder of hospitalization. Our approach of continuous infusion of a lidocaine solution allows for pain-free movement immediately postoperatively to mechanically debride tissue, as well as allow for early active range of motion. We have obtained excelleepaknt results with this technique in all of our cases.
Is There a Role for Enterohormones in the Gastroparesis of Critically Ill Patients?
Authors: Santacruz Carlos A. , Quintairos Amanda , Righy Claudia , Crippa Ilaria A. , Couto Lucio , Imbault Virginie , Wasineeart Mongkolpun , De Ryckere Mathieu , Preiser Jean-Charles
Published: July 2017

Objectives:

Delayed gastric emptying occurs in critically ill patients and impairs the delivery, digestion, and absorption of enteral feeding. A pathophysiologic role of the enterohormones peptide YY and ghrelin is supported by preclinical data. To compare the circulating plasma levels of peptide YY and ghrelin in control subjects and in critically ill patients, during feeding and fasting, and to search for a correlation with gastric emptying.

Design:

A prospective observational trial.

Settings:

Mixed ICU of an academic hospital.

Subjects:

Healthy volunteers and patients expected to stay in ICU for at least 3 days in whom enteral nutrition was indicated.

Interventions:

None.

Measurements and Main Results:

Plasma peptide YY and ghrelin (enzyme-linked immunosorbent assay) were measured once in 10 fasting volunteers (controls) and daily from admission until day 5 of the ICU stay in 30 critically ill patients (median [interquartile range] age 63 [57–67] yr, median [interquartile range] Acute Physiology and Chronic Health Evaluation II score 21 [14–24]). Eight patients could not be fed (fasting group). In fed patients, 13 never had a gastric residual volume higher than 250 mL (low gastric residual volume group), in contrast to the high gastric residual volume group (n = 9). The plasma levels of peptide YY did not differ between patients (6.4 [0–18.1] pg/mL) and controls (4.8 [0.3–17.7] pg/mL). Ghrelin levels were lower in patients than in control (213 [54.4–522.7] vs 1,435 [1,321.9–1,869.3] pg/mL; p < 0.05). Plasma peptide YY or ghrelin did not differ between fasting and fed patients or between the high and low gastric residual volume groups.

Conclusions:

In critically ill patients, plasma concentration of ghrelin significantly differs from that of controls, irrespective of the feeding status. No correlation was found between the temporal profile of ghrelin or peptide YY plasma concentration with bedside functional assessment of gastric emptying.
Palpebral Anthrax
Authors: Bozpolat Adil , Atici Didem , Tekerek Nazan Ulgen , Arslan Duran
Published: July 2017

A 13-year-old male patient presented with a complaint of swelling of the left eye starting 3 days ago. Bullous lesion and purulent discharge were present on his left eyelids. Bacillus anthracis was shown in culture and diagnosis was confirmed. Oculocutaneous anthrax is a rare condition, but the diagnosis should be considered in patients with a painless necrotizing ulcer.
Should First-line Empiric Treatment Strategies for Neonates Cover Coagulase-negative Staphylococcal Infections in Kenya?
Authors: Seale Anna C. , Obiero Christina W. , Jones Kelsey D. , Barsosio Hellen C. , Thitiri Johnstone , Ngari Moses , Morpeth Susan , Mohammed Shebe , Fegan Gregory , Mturi Neema , Berkley James A.
Published: July 2017

Background:

Neonatal mortality remains high in sub-Saharan Africa, and a third of deaths are estimated to result from infection. While coagulase-negative staphylococci (CoNS) are leading neonatal pathogens in resource-rich settings, their role, and the need for early anti-Staphylococcal treatment in empiric antibiotic guidelines, is unknown in sub-Saharan Africa.

Methods:

We examined systematic clinical and microbiologic surveillance data from all neonatal admissions to Kilifi County Hospital (1998–2013) to determine associated case fatality and/or prolonged duration of admission associated with CoNS in neonates treated according to standard World Health Organization guidelines.

Results:

CoNS was isolated from blood culture in 995 of 9552 (10%) neonates. Case fatality among neonates with CoNS isolated from blood did not differ from other neonatal admissions (P = 0.2), and duration of admission was not prolonged [odds ratio (OR) = 0.9 (0.7–1.0), P = 0.040]. Neonates with CoNS were more likely to have convulsions [OR = 1.4 (1.0–1.8), P = 0.031] but less likely to have impaired consciousness or severe indrawing [OR = 0.8 (0.7–0.9), P = 0.025; OR = 0.9 (0.7–1.0), P = 0.065].

Conclusions:

CoNS isolation in blood cultures at admission was not associated with adverse clinical outcomes in neonates treated according to standard World Health Organization guidelines for hospital care in this setting. There is no evidence that first-line antimicrobial treatment guidelines should be altered to increase cover for CoNS infections in neonates in this setting.
Peripheral oxytocin receptors inhibit the nociceptive input signal to spinal dorsal horn wide-dynamic-range neurons
Authors: González-Hernández Abimael , Manzano-García Alfredo , Martínez-Lorenzana Guadalupe , Tello-García Irma A. , Carranza Martha , Arámburo Carlos , Condés-Lara Miguel
Published: July 2017

Oxytocin (OT) has emerged as a mediator of endogenous analgesia in behavioral and electrophysiological experiments. In fact, OT receptors (OTRs) in the spinal dorsal horn participate in a selective inhibition of the neuronal activity mediated by Aδ and C fibers but not Aβ fibers. This study shows that OTRs are expressed in the terminal nerve endings and are able to inhibit nociceptive neuronal firing. Indeed, local peripheral OT blocked the first sensorial activity of Aδ and C fibers recorded in the spinal cord neurons. Furthermore, using the formalin behavioral nociceptive test, we demonstrated that only ipsilateral OTR activation inhibits pain behavior. Our data are reinforced by the fact that the OTR protein is expressed in the sciatic nerve. Consistent with this, immunofluorescence of primary afferent fibers suggest that OTRs could be located in nociceptive-specific terminals of the skin. Taken together, our results suggest that OTRs could be found in nociceptive terminals and that on activation they are able to inhibit nociceptive input.
CRP/Albumin Ratio
Authors: Gibson David J. , Hartery Karen , Doherty Jayne , Nolan Jack , Keegan Denise , Byrne Kathryn , Martin Sean T. , Buckley Maire , Sheridan Juliette , Horgan Gareth , Mulcahy Hugh E. , Cullen Garret , Doherty Glen A.
Published: July 2017

Introduction:

Identifying hospitalized patients with acute severe ulcerative colitis (ASUC) who will be refractory to corticosteroid therapy and require rescue therapy remains difficult. Hypoalbuminemia worsens with time during hospitalization and is associated with rapid clearance of and reduced response to infliximab (IFX) rescue. Early use of rescue therapy may therefore be more effective. Simple clinical and laboratory predictors of corticosteroid responsiveness would facilitate earlier use of rescue therapy.

Materials and Methods:

Retrospective study of a prospectively maintained database of 3600 patients attending a single center was conducted. Patients with histologically confirmed ulcerative colitis admitted with ASUC over a 5-year period from January 2010 to December 2014 were identified. All patients initially received intravenous corticosteroids. Patient demographics were collected; C-reactive protein (CRP) and albumin levels were recorded at baseline and during admission. Receiver operating characteristic statistics were used to determine the optimal stool frequency, CRP, albumin, and CRP/albumin ratio (CAR) to predict steroid response.

Results:

A total of 124 ASUC patients were admitted during a 5-year period. Median follow-up was 2.3 years. A total of 62 patients (50%) were steroid responsive, 55 patients (44%) received rescue IFX, 22 patients (18%) required colectomy within 30 days of admission, whereas a further 14 (11%) required colectomy during follow-up. By receiver operating characteristic statistics, day 3 CAR was a more accurate marker of steroid responsiveness than day 3 CRP or day 3 albumin alone [area under curve=0.75 (P<0.001)]. The optimal CAR to predict response to steroids on day 3 was 0.85 (sensitivity 70%, specificity 76%). When combined with D3 stool frequency, specificity improved to 83%. If at day 3, CAR was >0.85 and stool frequency was >3, the relative risk of steroid nonresponse was significantly raised at 3.9 (95% confidence interval, 2.1-7.2).

Conclusions:

Raised D3 CAR is an early predictor of steroid-refractory ASUC. When combined with D3 stool frequency, its predictive ability improves. In patients with predicted steroid nonresponse, early introduction of rescue IFX at this stage may be more effective, before serum albumin falls profoundly.
A nutritional approach for managing irritable bowel syndrome
Authors: Bhesania Natalie , Cresci Gail A.M.
Published: July 2017

Purpose of review

Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder (FGID) encountered by the pediatrician and consultant. The primary focus of this review is to provide an update on beneficial nutritional interventions for managing this patient population with discussion on gut microbiome effects.

Recent findings

A common complaint among the pediatric population is IBS-related recurrent abdominal pain. The prevalence of IBS is estimated to range between 6 and 14% and is defined by the Rome III criteria for FGIDs. Recent studies highlight the role of nutritional interventions in mitigating symptoms of IBS. Although eliminating foods that aggravate IBS gastrointestinal symptoms have become a main nutritional approach for acute management of IBS, recent literature reflects how this may impact the gut microbiome and potentially have long-term implications.

There are emerging studies suggesting IBS symptomatic improvement with different dietary interventions in the pediatric population, but most of what is known at this time has been extrapolated from the adult literature.
Eye Movement Disorders Following Allogeneic Bone Marrow Transplantation on FK506 (Tacrolimus) and Ganciclovir
Authors: Karagun Barbaros S. , Akbas Tugana , Arpaci Taner , Antmen Bulent
Published: July 2017

FK506 (tacrolimus) is an immunosuppressive drug and more potent than cyclosporine. FK506 is widely used for immunosuppression in the prevention and treatment of graft-versus-host disease after allogeneic bone marrow transplantation and solid organ transplantation. Neurotoxicity is a recognized complication of FK506 therapy, but ptosis and weakness of eye abduction unilaterally has not been reported in association with FK506 administration to date. We discuss a 13-year-old male patient who developed ptosis and weakness of eye abduction unilaterally 90 days after transplantation with bone marrow from an unrelated donor, for acute lymphoblastic leukemia in this case report. FK506 therapy was administered for graft-versus-host disease prophylaxis and CMV infection was treated with ganciclovir. The physical examination findings completely resolved 72 to 96 hours after concomitant FK506 and ganciclovir treatment were terminated.
Identifying Risk for Acute Kidney Injury in Infants and Children Following Cardiac Arrest*
Authors: Neumayr Tara M. , Gill Jeff , Fitzgerald Julie C. , Gazit Avihu Z. , Pineda Jose A. , Berg Robert A. , Dean J. Michael , Moler Frank W. , Doctor Allan
Published: July 2017

Objectives:

Our goal was to identify risk factors for acute kidney injury in children surviving cardiac arrest.

Design:

Retrospective analysis of a public access dataset.

Setting:

Fifteen children’s hospitals associated with the Pediatric Emergency Care Applied Research Network.

Patients:

Two hundred ninety-six subjects between 1 day and 18 years old who experienced in-hospital or out-of-hospital cardiac arrest between July 1, 2003, and December 31, 2004.

Interventions:

None.

Measurements and Main Results:

Our primary outcome was development of acute kidney injury as defined by the Acute Kidney Injury Network criteria. An ordinal probit model was developed. We found six critical explanatory variables, including total number of epinephrine doses, postcardiac arrest blood pressure, arrest location, presence of a chronic lung condition, pH, and presence of an abnormal baseline creatinine. Total number of epinephrine doses received as well as rate of epinephrine dosing impacted acute kidney injury risk and severity of acute kidney injury.

Conclusions:

This study is the first to identify risk factors for acute kidney injury in children after cardiac arrest. Our findings regarding the impact of epinephrine dosing are of particular interest and suggest potential for epinephrine toxicity with regard to acute kidney injury. The ability to identify and potentially modify risk factors for acute kidney injury after cardiac arrest may lead to improved morbidity and mortality in this population.
An Interprofessional Quality Improvement Initiative to Standardize Pediatric Extubation Readiness Assessment
Authors: Abu-Sultaneh Samer , Hole Acrista J. , Tori Alvaro J. , Benneyworth Brian D. , Lutfi Riad , Mastropietro Christopher W.
Published: July 2017

Objectives:

Establishing protocols to wean mechanical ventilation and assess readiness for extubation, with the goal of minimizing morbidity associated with extubation failure and prolonged mechanical ventilation, have become increasingly important in contemporary PICUs. The aim of this quality improvement initiative is to establish a respiratory therapist–led daily spontaneous breathing trial protocol to standardize extubation readiness assessment and documentation in our PICU.

Design:

A quality improvement project.

Setting:

Single center, tertiary care Children’s Hospital PICU.

Patients:

All intubated patients admitted to PICU requiring conventional mechanical ventilation between February 2013 and January 2016.

Interventions:

A working group of pediatric intensivists, respiratory therapists, nurses, and information technology specialists established the protocol, standardized documentation via the electronic medical record, and planned education. Daily spontaneous breathing trial protocol implementation began in February 2015. All patients on mechanical ventilation were screened daily at approximately 4 am by a respiratory therapist to determine daily spontaneous breathing trial eligibility. If all screening criteria were met, patients were placed on continuous positive airway pressure of 5 cm H2O with pressure support of 8 cm H2O for up to 2 hours. If tolerated, patients would be extubated to supplemental oxygen delivered via nasal cannula in the morning, after intensivist approval. Daily audits were done to assess screening compliance and accuracy of documentation.

Measurements and Main Results:

We analyzed data from 398 mechanically ventilated patients during daily spontaneous breathing trial period (February 2015–January 2016), compared with 833 patients from the pre–daily spontaneous breathing trial period (February 2013–January 2015). During the daily spontaneous breathing trial period, daily screening occurred in 92% of patients. Extubation failure decreased from 7.8% in the pre–daily spontaneous breathing trial period to 4.5% in daily spontaneous breathing trial period. The use of high-flow nasal cannula slightly increased during the project, while there was no change in duration of mechanical ventilation or the use of noninvasive ventilation.

Conclusions:

An interprofessionally developed respiratory therapist–led extubation readiness protocol can be successfully implemented in a busy tertiary care PICU without adverse events.
Narrative Dietary Counseling
Authors: Søndergaard Jakobsen Nina , Kaufmann Lisbeth , Hennesser Yvonne , Kristensen Søren Tange
Published: July 2017

Using cases and empirical data from a research and development project at a Danish prevention center, this study explores whether and how the use of narrative dietary counseling can strengthen dietitians' relationships and collaboration with clients who are chronically ill. The results of the study show that the use of whiteboards and narrative learning strategies, such as exploration, externalization, evaluating questions, and unique outcomes, were experienced by the dietitians to provide advantages over the existing practice, which used motivational interviewing alone. Specifically, narrative dietary counseling empowered clients and improved relationship building and collaboration between client and dietitian.
Anorexia Nervosa and Premenopausal Osteoporosis
Authors: Acosta Laura
Published: July 2017

The premenopausal osteoporosis observed in patients with anorexia nervosa (AN) has traditionally been attributed to depressed ovarian estrogen synthesis. For many years, estrogen replacement was the accepted standard of care. Newer research, however, reveals the multifactorial nature of bone deterioration in the presence of undernutrition and supports a more comprehensive approach to treatment. This case of a young woman with AN-induced osteoporosis highlights the need for interprofessional collaboration among physicians, dietitians, and mental health professionals. It underscores the challenges associated with medical and nutritional management of skeletal decline in the context of an eating disorder.
Integrative meta-analysis reveals that most yeast proteins are very stable
Authors: Wiechecki Keira , Manohar Sandhya , Silva Gustavo , Tchourine Konstantine , Jacob Samson , Valleriani Angelo , Vogel Christine
Published: July 2017

Measurements for protein half-lives in yeastSaccharomyces cerevisiaereported large discrepancies, with median values between minutes to several hours. We present a unifying analysis that provides a consistent half-life estimate, based on our re-analysis of three published and one new dataset of cells grown under similar conditions. We found that degradation of many proteins can be approximated by exponential decay. Protein disappearance was primarily driven by dilution due to cell division, with cell doubling times ranging from ∼2 to 3.5 hours across the four experiments. After adjusting for doubling time, protein half-lives increased to median values between ∼7.5 to ∼40 hours. Half-lives correlated with cell doubling time even after adjustment, implying that slow growth also slows protein degradation. All estimates were validated by multiple means and were robust to different analysis methods. Overall, protein stability correlated with abundance and showed weak enrichment for degradation signals such as degrons and disordered regions. Long-lived proteins often functioned in oxidation-reduction and amino acid synthesis. Short-lived proteins often functioned in ribosome biogenesis. Despite some overall differences in behavior, all methods were able to resolve subtle difference in half-lives of ribosomal proteins, e.g. the short lifespan of RPL10. Finally, our results help the design of future experiments: time series measurements need to cover at least two to three cell doubling times for accurate estimates, exponential decay provides a reasonable proxy for protein stability, and it can be sufficiently estimated with four measurement points.
HTSSIP: an R package for analysis of high throughput sequencing data from nucleic acid stable isotope probing (SIP) experiments
Authors: Youngblut Nicholas D. , Barnett Samuel E. , Buckley Daniel H.
Published: July 2017

Combining high throughput sequencing with stable isotope probing (HTS-SIP) is a powerful method for mappingin situmetabolic processes to thousands of microbial taxa. However, accurately mapping metabolic processes to taxa is complex and challenging. Multiple HTS-SIP data analysis methods have been developed, including high-resolution stable isotope probing (HR-SIP), multi-window high-resolution stable isotope probing (MW-HR-SIP), quantitative stable isotope probing (q-SIP), and ΔBD. Currently, the computational tools to perform these analyses are either not publicly available or lack documentation, testing, and developer support. To address this shortfall, we have developed theHTSSIPR package, a toolset for conducting HTS-SIP analyses in a straightforward and easily reproducible manner. TheHTSSIPpackage, along with full documentation and examples, is available from CRAN athttps://cran.r-project.org/web/packages/HTSSIP/index.htmland Github athttps://github.com/nick-youngblut/HTSSIP.
A genetic-based algorithm for recovery: A pilot study
Authors: Pickering Craig , Kiely John , Suraci Bruce , Quigley Charlie , Watson Jake
Published: July 2017

Exercise training creates a number of physical challenges to the body, the overcoming of which drives exercise adaptation. The balance between sufficient stress and recovery is a crucial, but often under-explored, area within exercise training. Genetic variation can also predispose some individuals to a greater need for recovery after exercise. In this pilot study, 18 male soccer players underwent a repeated sprint training session. Countermovement jump (CMJ) heights were recorded immediately pre-and post-training, and at 24-and 48-hours post-training. The reduction in CMJ height was greatest at all post-training time points in subjects with a larger number of gene variants associated with a reduced exercise recovery. This suggests that knowledge of genetic information can be important in individualizing recovery timings and modalities in athletes following training.
Grain-growth engineering and mechanical properties of physical-vapour-deposited InSe platelets
Authors: Teena M. , Kunjomana A. G.
Published: July 2017

The present work demonstrates a novel use of physical vapour deposition for grain-growth engineering by optimizing supersaturation, which led to the evolution of stoichiometric indium monoselenide crystals, employing a custom-fabricated dual-zone furnace. The growth zone was kept at a constant temperature for different experimental runs (673–883 K), while the source zone was kept at a stable temperature of 1123 K. In this way, the temperature difference ΔT= 240–450 K resulted in a significant increase of the mass transport between the zones so as to accomplish bulk crystallization. At comparatively low supersaturation (ΔT= 240 K), the presence of nodules and flakes was observed. When ΔT= 250 K, multiple grains were formed owing to temperature asymmetry at the rough vapour–solid interface. A further increase in supersaturation (ΔT= 330 K) facilitated polyhedral grain growth, with distinct grain boundaries. A subsequent increment in ΔT(400 K) led to evolution of the polycrystalline morphology to well developed hexagonal platelets owing to adsorption of atoms on surface steps and kinks in accordance with the leading-edge growth mechanism. Energy-dispersive analysis by X-rays and X-ray diffraction experiments were carried out to confirm the structure and phase of crystals. Microindentation studies were done to assess the hardness and mechanical stability of the as-grown crystals in response to external loads in order to explore their suitability for solar cell applications. The investigations of bulk vapour phase transport, morphology and strengthening of InSe platelets provide pathways for the production of crystalline textures with versatile properties.
A Peltier-cooled microscope stage for protein crystal post-crystallization treatment
Authors: Dietl Andreas , Kieser Christian , Barends Thomas R. M.
Published: July 2017

Crystals of the multi-enzyme complex hydrazine synthase showed severe diffuse scattering and high mosaicity. Improved diffraction quality was achieved by soaking the crystals in highly concentrated betaine solutions at reduced temperatures. To enable this, a Peltier-cooled microscope stage was developed for the slow cooling of protein crystals immersed in cryoprotectants or other soaking solutions. Both the construction of the stage and its successful application to hydrazine synthase crystals are described.
An efficient reformulation of a multiscale method for the eddy current problem
Authors: Schöbinger Markus , Hollaus Karl , Schöberl Joachim
Published: July 2017

Purpose

This paper aims to improve the efficiency of a numerical method to treat the eddy current problem on a laminated material, where using a mesh that resolves each individual laminate would be too computationally expensive.

Design/methodology/approach

The domain is modeled using a coarse mesh that treats the laminated material as a bulk with averaged properties. The fine-structured behavior is recovered by introducing micro-shape functions in the ansatz space. One such method is analyzed to find further model restrictions.

Findings

By using a special reformulation, it is possible to eliminate the additional degrees of freedom introduced by the multiscale ansatz at the cost of an additional modeling error that decreases with the laminate thickness.

Originality/value

The paper gives a computationally more efficient approximate variant to a known multiscale method.
Optimal design of angular position sensors
Authors: Zangl Hubert , Faller Lisa-Marie , Granig Wolfgang
Published: July 2017

Purpose

This paper aims to investigate the optimal placement and/or orientation of individual sensor elements within integrated angular position sensors, in particular magnetic sensors based on the Hall effect or magnetoresistive effects under consideration of random deviations (variations in the production process, environmental influences, noise) and correlations of these influences.

Design/methodology/approach

The authors utilize methods from optimal design of experiments to consider random deviations in a system-level model. In this sensor model, they include spatial dependencies of random deviations by means of a Gaussian random field. Based on this, an approach for fast determination of D-optimal designs is presented.

Findings

The results show that the intuitive and commonly used distributions of magnetic field sensors are actually optimal for the determination of in-phase and quadrature signals in the presence of spatial correlations, provided that the number of field sensors is higher or equal to three. However, in the uncorrelated case, the intuitive solutions are not the only optimal solutions or even not optimal at all. It is found that a restriction to symmetric designs is not necessary; thus, the design space can be extended to allow for further improvements, e.g. miniaturization, of such angular position sensors.

Originality/value

The proposed approach allows for the fast optimization based on a system model. Correlated random influences are considered by means of a Gaussian random field, which can be obtained either from measurements or from field simulations, e.g. using the finite element method. As this is done before the actual simulation, such evaluations are not needed during the optimization, which allows for very fast solution of the optimization problem. Therefore, the approach is well suited for application-dependent adjustment of sensor designs.
The creation of national intellectual capital from the perspective of Hofstede’s national culture
Authors: Lee I-Chen , Lin Carol Y.Y. , Lin Te-Yi
Published: July 2017

Purpose

The purpose of this paper is to explain the difference of national intellectual capital from the perspective of national culture and to illustrate how national leaders or policy-makers increase their country’s national intellectual capital.

Design/methodology/approach

The study conducts a descriptive analysis combining the research outcome of Lin and Edvinsson’s (2011) national intellectual capital with Hofstede’s (2001) national culture. The research findings and results of these two studies were compared before running at-test to determine whether countries with relatively high national intellectual capital have a higher level of certain national culture.

Findings

Based on the matching data of 26 countries, the study proposed that countries with certain national culture possess lower intellectual capital. Countries with high intellectual capital tend to exhibit a common culture of low power distance, weak uncertainty avoidance, and individualism.

Practical implications

The study suggests that for a country to enhance its overall intellectual capital, it should strive for a culture of equality, freedom and safety, and an active competitive environment, while avoiding social class distance in order to eliminate insecurity. The study proposes some suggestions to advance the countries’ national intellectual capital. In addition to admit the weakness of their intellectual capital due to cultural reasons, these countries could go a step further to increase their own national intellectual capital by increasing or enhancing certain national cultures if possible.

Originality/value

The study compares national intellectual capital and national culture and finds the relationship between these two sets of constructs. This study proves that national culture not only influences the strategies or behaviors of business level but also the competitiveness of national levels.
Omani tourism and hospitality students’ employment intentions and job preferences
Authors: Atef Tamer , Al Balushi Masooma
Published: July 2017

Purpose

This paper aims to assess receptiveness for Tourism and Hospitality as a career path among students in the Tourism Department of Sultan Qaboos University (College of Arts and Social Sciences), located in the Sultanate of Oman. The following objectives were identified to achieve this aim: assess respondents’ perceptions of tourism and hospitality employment; respondents’ tourism and hospitality employment commitment factors; and respondents’ perceptions of tourism and hospitality jobs.

Design/methodology/approach

A self-administered questionnaire was used to gather data and measure respondents’ perceptions of the subject under investigation. Survey questions were developed from the literature reviewed which provided the framework for the questionnaire. The questionnaire comprises four different question categories: general information; students’ general perception of tourism and hospitality employment; and tourism and hospitality employment commitment factors; students’ perceptions of tourism and hospitality jobs. Data were tested for normality of distribution; then, means were used for data description and ranking; thereafter, the independent-samplest-test and analysis of variance were conducted to test for significance between groups of respondents; the level of significance used wasp≤ 0.05.

Findings

The paper revealed that nearly 41 per cent of the students will continue working in tourism and hospitality for some time. For them, working in the industry is a step on the way, but is not a career path. Only 21.6 per cent are willing to consider tourism and hospitality as their long-term chosen career path. Tourism and hospitality students’ perceptions of the industry tend to be negatively affected as they progress in their study plan. Commitment to employment in Tourism and Hospitality is shaped by four major interrelated factor categories: industry, personality, education and society. The Omani tourism and hospitality industry was not able to project an image that could generate interest among Omanis. Consequently, very few graduates join the Tourism and Hospitality job market, leading to shortages in Omani workers in the industry. The major drawback of such trend is the inability to achieve the Omanization planned figures.

Originality/value

The findings are intended to assist tourism and hospitality educators, employers and policymakers better understand students’ future employment intentions.