bluuebunny/crossref_metadata_2025 huggingface dataset:
A Majority of Family Physicians Use a Hospitalist Service When Their Patients Require Inpatient Care
Authors: Ivins Douglas , Blackburn Brenna , Peterson Lars E. , Newton Warren P. , Puffer James C.
Published: October 2014

Background:The hospitalist movement in the United States has risen in prominence over the past 2 decades with more physicians practicing as hospitalists. Our objective was to examine different strategies used by family physicians when their patients require inpatient care. Methods: Secondary analysis of a cross-sectional survey of physicians accessing the American Board of Family Medicine Web site in 2011 and the 2011 Area Resource File. Logistic regression assessed for associations between using hospitalists, managing inpatients personally, or with a group partner, and then comparing and contrasting these physicians with health care market characteristics. Results: A total of 3857 physicians had data on practice characteristics and could be geocoded to their county of residence. Compared with other physicians meeting inclusion criteria in the American Board of Family Medicine database, our sample was slightly older and more likely to be female. In all, 54% of respondents reported using hospitalist services while 18% reported managing hospitalized patients themselves. Respondents more likely to use hospitalist services were female and resided in urban areas. However, one third of these physicians living in isolated rural areas reported using hospitalist services. Respondents more likely to personally manage their patients in the hospital were more likely to be male and an international medical graduate. The likelihood of using hospitalist services increased with higher availability of hospitalist services. Conclusions: Overall, a majority of family physicians are using hospitalist services. Family physicians seem more likely to use hospitalist services when they are available which may lead to fragmentation of care.
Hybrid Stage I Palliation in a 1.1 kg, 28-Week Preterm Neonate With Posterior Malalignment Ventricular Septal Defect, Left Ventricular Outflow Tract Obstruction, and Coarctation of the Aorta
Authors: Karani Kunal B. , Zafar Farhan , Morales David L. S. , Goldstein Bryan H.
Published: October 2014

The hybrid stage I procedure has emerged as a less-invasive alternative to the standard surgical Norwood procedure in the palliation of high-risk hypoplastic left heart syndrome and variants. This approach may also benefit patients requiring complex neonatal repair who have significant anatomic and/or perioperative risk factors that either prevent or complicate durable and robust biventricular circulation from being safely achieved. An extremely low-birth weight (1.1 kg) 28-week gestation preterm neonate with postnatal diagnosis of posterior malalignment ventricular septal defect, severe left ventricular outflow tract obstruction, aortic annular hypoplasia, and aortic arch obstruction underwent initial palliation with a hybrid stage I procedure. In this case, hybrid stage I palliation allowed for both somatic and left heart growth followed by ultimate uncomplicated biventricular repair.
Outcomes of a Hepatitis C Screening Protocol in At-Risk Adults With Prior Cardiac Surgery
Authors: Cox Daniel A. , Ginde Salil , Tweddell James S. , Earing Michael G.
Published: October 2014

Background:

Symptoms associated with hepatitis C infection often do not develop until an advanced stage of liver disease. Prior to 1992, reliable testing for hepatitis C was unavailable, resulting in potential patient exposure during cardiopulmonary bypass. As the hepatitis C prevalence in our center was unknown, a screening protocol for patients who underwent surgery prior to 1992 was developed.

Methods:

Patients evaluated in the Wisconsin Adult Congenital Heart Disease program who underwent surgery prior to 1992 were screened for hepatitis C as part of their initial clinical evaluation. The hepatitis C-positive patients were assessed for risk factors, level of hepatic involvement, whether they received treatment, and whether viral clearance was obtained.

Results:

A total of 147 patients (53% male) underwent testing. Seven (4.8%) patients had evidence of chronic hepatitis C infection, which is higher than the Wisconsin reported prevalence of 0.3%. Six of the seven patients had elevated liver enzymes at time of diagnosis. No relationship was found between hepatitis C infection and number of surgeries, year of surgery, or age at surgery. Four patients had hepatitis C genotype 1, but none achieved viral clearance despite three having received treatment. Three had genotype 2, were treated, and had viral clearance. No hepatitis C-positive patient developed cirrhosis or required liver transplant.

Conclusion:

Hepatitis C infection in patients with congenital heart disease who underwent surgical palliation prior to 1992 is common, with prevalence higher than the general population. Our data emphasize the continued importance of screening the high-risk adult congenital heart disease patients.
Effect of Preoperative Angiotensin-Converting Enzyme Inhibitor and Angiotensin II Receptor Blocker Use on Hemodynamic Variables in Pediatric Patients Undergoing Cardiopulmonary Bypass
Authors: Ajuba-Iwuji Chinwe C. , Puttreddy Sahitya , Maxwell Bryan G. , Bembea Melania , Vricella Luca , Heitmiller Eugenie
Published: October 2014

Background:

Some have suggested that children undergoing cardiac surgery who receive angiotensin-converting enzyme (ACE) inhibitors experience a greater degree of hypotension after anesthesia induction and in the immediate postcardiopulmonary bypass period than children who did not receive these drugs. Therefore, we examined the effect of ACE inhibitor/angiotensin II receptor blocker (ARB) therapy on intraoperative hemodynamics and vasopressor use in pediatric patients undergoing cardiac surgery.

Methods:

In a retrospective cohort study of patients younger than 18 years who underwent cardiopulmonary bypass between March 1, 2010, and April 1, 2011, we compared intraoperative hemodynamics and vasopressor use between patients who received preoperative ACE inhibitor/ARB therapy and those who did not. The primary outcome was vasoactive infusion score after cardiopulmonary bypass.

Results:

The occurrence of hypotension did not differ significantly between the ACE inhibitor/ARB group and the control group during induction of anesthesia or at any time point after cardiopulmonary bypass. At 0, 30, 60, and 90 minutes after cessation of cardiopulmonary bypass, patients on ACE inhibitor/ARB therapy tended to have a higher vasoactive infusion score (7.1, 7.6, 9.4, and 11.3) than patients in the control group (6.3, 6.1, 6.0, and 6.7). Although this difference became more pronounced over time, it did not reach statistical significance.

Conclusion:

The use of preoperative ACE inhibitors and ARBs in pediatric patients undergoing cardiac surgery did not significantly increase the incidence of hypotension after induction of anesthesia and did not increase significantly the vasoconstrictor requirements upon weaning from cardiopulmonary bypass; however, additional prospective studies are needed.
Central Venous Lines Are a Risk Factor for Chylothorax in Infants After Cardiac Surgery
Authors: Borasino Santiago , Diaz Franco , Masri Kamal El , Dabal Robert J. , Alten Jeffrey A.
Published: October 2014

Objective:

Chylothorax complicates congenital heart disease (CHD) surgery and may be associated with significant morbidity. Etiology of chylothorax is multifactorial, and it has been associated with deep venous thrombosis and obstruction from central venous lines (CVLs) in patients without CHD. We sought to determine whether CVL insertion site was associated with the occurrence of chylothorax in infants after cardiac surgery.

Design:

Retrospective cohort of patients less than one year of age who underwent CHD surgery requiring cardiopulmonary bypass from 2008 to 2012. Chylothorax was identified by clinical diagnosis and/or laboratory findings (milky effusion, fluid with >100 mg/dL of triglycerides and/or >80% of lymphocytes). Central venous lines insertion site was verified by reviewing procedure notes and chest x-rays. Internal jugular (IJ), subclavian vein, and femoral vein (FV) CVLs were used during the study period.

Results:

Three hundred and ninety-two patients were included (mean age 97 days, mean weight 4.5 kg). Sixty-two (15.8%) of these patients developed chylothorax after surgery. Patients with chylothorax had longer bypass time ( P = .02), longer cross-clamp time ( P = .03), higher RACHS-1 category ( P = .03), and more frequent upper body CVLs (IJ or subclavian vein; P = .03). There was no significant association with age, gender, preoperative weight, and height. Multivariate analysis showed patients with a CVL in the upper body (IJ or subclavian vein) were almost two times more likely to develop a chylothorax than patients who had FV CVL, (odds ratio = 1.9, 95% confidence interval = 1.05-5.60; P = .044).

Conclusion:

Postoperative chylothorax is associated with line insertion in the upper body (subclavian vein and IJ). Avoidance of CVLs in these locations may decrease its incidence.
Promoting Self-Determination and Transition Planning Using Technology
Authors: Van Laarhoven-Myers Traci E. , Van Laarhoven Toni R. , Smith Thomas J. , Johnson Heather , Olson Justin
Published: October 2014

Despite the Individuals With Disabilities Education Act’s (IDEA) mandates for student involvement in the Individualized Education Program (IEP) process, several researchers have demonstrated limited student participation. One method for encouraging self-advocacy and active IEP participation is to teach students to communicate their hopes, dreams, and goals through technology. The purpose of the study was to measure student and parent satisfaction with Project Multimedia for Youth to Voice Outcomes Individually Created for Empowerment (MY VOICE), a 3-year project aimed at supporting students with developmental disabilities through the use of multimedia to have a voice in their transition planning and IEP meetings. Results indicated students were satisfied with the project and their parents were significantly more satisfied with the outcomes of the IEP process when the project was in place for four of six measured variables.
An antiapoptotic role for telomerase RNA in human immune cells independent of telomere integrity or telomerase enzymatic activity
Authors: Gazzaniga Francesca S. , Blackburn Elizabeth H.
Published: October 2014

Key Points

Telomerase RNA component hTR, but not the core enzymatic protein component hTERT, protects T cells from apoptosis. hTR prevents dexamethasone-induced apoptosis specifically when in a telomerase enzymatically inactive state.
How I treat splanchnic vein thrombosis
Authors: Ageno Walter , Dentali Francesco , Squizzato Alessandro
Published: October 2014

Antithrombotic treatment of splanchnic vein thrombosis (SVT) is a clinical challenge. Depending on the site of thrombosis, patients are at risk of developing liver insufficiency, portal hypertension, or bowel infarction and may experience recurrence in both the splanchnic veins and other vein segments. To prevent recurrence, anticoagulant therapy should be started as soon as possible after diagnosis and is often continued for an indefinite period of time. However, active bleeding is not infrequent at the time of SVT diagnosis, and major risk factors for bleeding, such as esophageal varices or a low platelet count, are frequently present in these patients. In real-world clinical practice, a proportion of SVT patients are left untreated because the risks associated with anticoagulant therapy are felt to exceed its benefits. However, the majority of patients receive anticoagulant drugs, with heterogeneous timing of initiation, drug choice, and dosages. Evidence to drive treatment decisions is limited because no randomized controlled trials have been carried out in these patients. This review provides practical guidance for the use of anticoagulant drugs in patients presenting with SVT, including symptomatic as well as incidentally detected events.
Single-agent GVHD prophylaxis with posttransplantation cyclophosphamide after myeloablative, HLA-matched BMT for AML, ALL, and MDS
Authors: Kanakry Christopher G. , Tsai Hua-Ling , Bolaños-Meade Javier , Smith B. Douglas , Gojo Ivana , Kanakry Jennifer A. , Kasamon Yvette L. , Gladstone Douglas E. , Matsui William , Borrello Ivan , Huff Carol Ann , Swinnen Lode J. , Powell Jonathan D. , Pratz Keith W. , DeZern Amy E. , Showel Margaret M. , McDevitt Michael A. , Brodsky Robert A. , Levis Mark J. , Ambinder Richard F. , Fuchs Ephraim J. , Rosner Gary L. , Jones Richard J. , Luznik Leo
Published: October 2014

Key Points

Posttransplantation cyclophosphamide is effective as sole GVHD prophylaxis for myeloablative HLA-matched–related or –unrelated BMT. Despite low chronic GVHD with PTCy, relapse and survival are comparable with outcomes reported using other GVHD prophylactic approaches.
Common fixed points for a pair of mappings satisfying contractive conditions of integral type
Authors: Liu Zeqing , Zou Xiaochen , Kang Shin Min , Ume Jeong Sheok
Published: October 2014

Four common fixed point theorems for a pair of weakly compatible mappings satisfying contractive conditions of integral type in metric spaces are proved. The existence result of bounded solutions for a system of functional equations arising in dynamic programming is discussed by using one of the common fixed point theorems obtained in this paper. An example is given to illustrate that our results extend properly two fixed point theorems due to Branciari and Rhoades.

MSC:54H25.
Cerebral tissue saturation, the next step in cardiopulmonary resuscitation management?
Authors: Genbrugge Cornelia , Boer Willem , Meex Ingrid , Jans Frank , Dens Jo , De Deyne Cathy
Published: October 2014

No abstract
Tectonic framework of the Barra de São João Graben, Campos Basin, Brazil: Insights from gravity data interpretation
Authors: Adriano Leandro B. , Menezes Paulo T. L. , Cunha Alan S.
Published: October 2014

The Barra de São João Graben (BSJG), shallow water Campos Basin, is part of the Cenozoic rift system that runs parallel to the Brazilian continental margin. This system was formed in an event that caused the reactivation of the main Precambrian shear zones of southeastern Brazil in the Paleocene. We proposed a new structural framework of BSJG based on gravity data interpretation. Magnetic data, one available 2D seismic line, and a density well-log of a nearby well were used as constraints to our interpretation. To estimate the top of the basement structure, we separated the gravity effects of deep sources from the shallow basement (residual anomaly). Then, we performed a 2D modeling exercise, in which we kept fixed the basement topography and the density of the sediments, to estimate the density of the basement rocks. Next, we inverted the residual anomaly to recover the depth to the top of the basement. This interpretation strategy allowed the identification of a complex structural framework with three main fault systems: a northeast–southwest-trending normal fault system, a northwest–southeast-trending transfer fault system, and an east–west-trending transfer fault system. These trends divided the graben into several internal highs and lows. Our interpretation was corroborated by the magnetic anomalies. The existence of ultradense and strongly magnetized elongated bodies in the basement was interpreted as ophiolite bodies that were probably obducted by the time of the shutdown of the Proterozoic Adamastor Ocean.
Hybrid target-oriented salt interpretation in the Gulf of Mexico
Authors: Maranganti Ravi , Agnihotri Yogesh
Published: October 2014

The top-down method for salt interpretation starts with the search for salt-sediment interfaces, which begins at the shallowest depths and progressively moves deeper. This search is typically conducted on intermediate seismic products such as sediment flood, salt flood volumes, overhang sediment flood, and overhang salt flood depth migrations. However, with this approach, poorly imaged subsalt areas become known only after spending considerable time interpreting intermediate salt features. We evaluated a new method for streamlining this traditional approach to salt-model building wherein a reference salt geometry was obtained earlier in the salt interpretation process. Having a reference seismic volume helped to identify poorly imaged subsalt targets much sooner. A hybrid of model-based and data-based interpretations was then performed for the poorly imaged subsalt areas, whereby interpretation was completed by proposing geologically viable models that were continuously verified by their impact on geophysical (seismic) data. In poorly imaged areas, we looked bottom-up, rather than top-down, to establish a salt geometry that best fit the geologic model as well as the geophysical data. Our hybrid target-oriented approach is useful for not only reducing the interpretation cycle time but also for improving images beneath the salt.
Whole-Exome Sequencing Identifies Homozygous GPR161 Mutation in a Family with Pituitary Stalk Interruption Syndrome
Authors: Karaca Ender , Buyukkaya Ramazan , Pehlivan Davut , Charng Wu-Lin , Yaykasli Kursat O. , Bayram Yavuz , Gambin Tomasz , Withers Marjorie , Atik Mehmed M. , Arslanoglu Ilknur , Bolu Semih , Erdin Serkan , Buyukkaya Ayla , Yaykasli Emine , Jhangiani Shalini N. , Muzny Donna M. , Gibbs Richard A. , Lupski James R.
Published: October 2014

Context:

Pituitary stalk interruption syndrome (PSIS) is a rare, congenital anomaly of the pituitary gland characterized by pituitary gland insufficiency, thin or discontinuous pituitary stalk, anterior pituitary hypoplasia, and ectopic positioning of the posterior pituitary gland (neurohypophysis). The clinical presentation of patients with PSIS varies from isolated growth hormone (GH) deficiency to combined pituitary insufficiency and accompanying extrapituitary findings. Mutations in HESX1, LHX4, OTX2, SOX3, and PROKR2 have been associated with PSIS in less than 5% of cases; thus, the underlying genetic etiology for the vast majority of cases remains to be determined.

Objective:

We applied whole-exome sequencing (WES) to a consanguineous family with two affected siblings who have pituitary gland insufficiency and radiographic findings of hypoplastic (thin) pituitary gland, empty sella, ectopic neurohypophysis, and interrupted pitiutary stalk—characteristic clinical diagnostic findings of PSIS.

Design and Participants:

WES was applied to two affected and one unaffected siblings.

Results:

WES of two affected and one unaffected sibling revealed a unique homozygous missense mutation in GPR161, which encodes the orphan G protein–coupled receptor 161, a protein responsible for transducing extracellular signals across the plasma membrane into the cell.

Conclusion:

Mutations of GPR161 may be implicated as a potential novel cause of PSIS.
Estrogen-Induced CCN1 Is Critical for Establishment of Endometriosis-Like Lesions in Mice
Authors: Zhao Yuechao , Li Quanxi , Katzenellenbogen Benita S. , Lau Lester F. , Taylor Robert N. , Bagchi Indrani C. , Bagchi Milan K.
Published: October 2014

Endometriosis is a prevalent gynecological disorder in which endometrial tissue proliferates in extrauterine sites, such as the peritoneal cavity, eventually giving rise to painful, invasive lesions. Dysregulated estradiol (E) signaling has been implicated in this condition. However, the molecular mechanisms that operate downstream of E in the ectopic endometrial tissue are unknown. To investigate these mechanisms, we used a mouse model of endometriosis. Endometrial tissue from donor mice was surgically transplanted on the peritoneal surface of immunocompetent syngeneic recipient mice, leading to the establishment of cystic endometriosis-like lesions. Our studies revealed that treatment with E led to an approximately 3-fold increase in the lesion size within a week of transplantation. E also caused a concomitant stimulation in the expression of connective tissue growth factor/Cyr61/Nov (CCN1), a secreted cysteine-rich matricellular protein, in the lesions. Interestingly, CCN1 is highly expressed in human ectopic endometriotic lesions. To address its role in endometriosis, endometrial tissue from Ccn1-null donor mice was transplanted in wild-type recipient mice. The resulting ectopic lesions were reduced up to 75% in size compared with wild-type lesions due to diminished cell proliferation and cyst formation. Notably, loss of CCN1 also disrupted the development of vascular networks in the ectopic lesions and reduced the expression of several angiogenic factors, such as vascular endothelial growth factor-A and vascular endothelial growth factor-C. These results suggest that CCN1, acting downstream of E, critically controls cell proliferation and neovascularization, which support the growth and survival of endometriotic tissue at ectopic sites. Blockade of CCN1 signaling during the early stages of lesion establishment may provide a therapeutic avenue to control endometriosis.
Enhanced sensory sampling precedes self-initiated locomotion in an electric fish
Authors: Jun James J. , Longtin André , Maler Leonard
Published: October 2014

Cortical activity precedes self-initiated movements by several seconds in mammals; this observation has led into inquiries on the nature of volition. Preparatory neural activity is known to be associated with decision making and movement planning. Self-initiated locomotion has been linked to increased active sensory sampling; however, the precise temporal relationship between sensory acquisition and voluntary movement initiation has not been established. Based on long-term monitoring of sensory sampling activity that is readily observable in freely behaving pulse-type electric fish, we show that heightened sensory acquisition precedes spontaneous initiation of swimming. Gymnotus sp. revealed a bimodal distribution of electric organ discharge rate (EODR) demonstrating down- and up-states of sensory sampling and neural activity; movements only occurred during up-states and up-states were initiated before movement onset. EODR during voluntary swimming initiation exhibited greater trial-to-trial variability than the sound-evoked increases in EODR. The sampling variability declined after voluntary movement onset as previously observed for the neural variability associated with decision making in primates. Spontaneous movements occurred randomly without a characteristic timescale, and no significant temporal correlation was found between successive movement intervals. Using statistical analyses of spontaneous exploratory behaviours and associated preparatory sensory sampling increase, we conclude that electric fish exhibit key attributes of volitional movements, and that voluntary behaviours in vertebrates may generally be preceded by increased sensory sampling. Our results suggest that comparative studies of the neural basis of volition may therefore be possible in pulse-type electric fish, given the substantial homologies between the telencephali of teleost fish and mammals.
Databases for lncRNAs: a comparative evaluation of emerging tools
Authors: Fritah Sabrina , Niclou Simone P. , Azuaje Francisco
Published: October 2014

The vast majority of the human transcriptome does not code for proteins. Advances in transcriptome arrays and deep sequencing are giving rise to a fast accumulation of large data sets, particularly of long noncoding RNAs (lncRNAs). Although it is clear that individual lncRNAs may play important and diverse biological roles, there is a large gap between the number of existing lncRNAs and their known relation to molecular/cellular function. This and related information have recently been gathered in several databases dedicated to lncRNA research. Here, we review the content of general and more specialized databases on lncRNAs. We evaluate these resources in terms of the quality of annotations, the reporting of validated or predicted molecular associations, and their integration with other resources and computational analysis tools. We illustrate our findings using known and novel cancer-related lncRNAs. Finally, we discuss limitations and highlight potential future directions for these databases to help delineating functions associated with lncRNAs.
Information System for Underground Coal Mining Output Prediction
Authors: Линник  , Linnik Yuriy , Линник  , Linnik Vladimir
Published: October 2014

The results related to studies of indicators characterizing mechanical properties and features of coal layers’

geological structure, such as resistance to cutting for coal, layer, solid inclusions and intermediate rocks

as well as their specific content in the layer have been presented in this paper. Based on physical ideas of

how the coal layer properties influence the coal-face winning assembly’s final control elements reliability an

integrated indicator of coal layers’ breaking characteristics assessment, called the indicator of equivalent

coal layers resistance to cutting Ae has been offered. This indicator’s physical meaning is that it assesses

the coal layer’s ability to cause average loads affecting breaking final control elements’ degradation

failures characterized by indicator of coal resistance to cutting, and peak loads affecting sudden failures

characterized by a value of a generalized indicator of layer heterogeneities’ content and properties.

Practical meaning of Ae index is that it allows assess coal mining machine’s working conditions not by a set

of characteristics , but by one characteristic , when performing calculations related to coal-mining machines’

parameters definition, these machines’ performance, and other technological parameters of wide place and

coal mine as a whole.
Methodius of Olympus – one of the Greek sources of Kontakia by Romanos the Melodist
Authors: Heszen Agniesz
Published: October 2014

Methodius of Olympus – one of the Greek sources of Kontakia by Romanos the Melodist

In this article the author compares Thecla’s Hymn from Methodius of Olympus’s Symposium with some kontakia by Romanos the Melodist. The analysis of a few stanzas of Thecla’s Hymn shows that this work can be a model for the kontakia. Methodius in his song gives examples of heroes of the Old and New Testament that sing a refrain. Romanos in their kontakia made a similar structure, the refrain is variously linked to stanzas and often spoken by different characters.
Madame Door of Brixia. The mystery of Catullus 67
Authors: Klęczar Aleksandra
Published: October 2014

Madame Door of Brixia. The mystery of Catullus 67

The text deals with Catullus’ carmen 67, a problematic and unclear poem, set in Brescia and dealing with the motifs of marriage and infidelity. It analyses a number of problems crucial for the text: the question of its genre, the possible identity of the characters in this little domestic drama and the role of the addressee: the door of the family house.
The Value of Operational Flexibility in the Presence of Input and Output Price Uncertainties with Oil Refining Applications
Authors: Dong Lingxiu , Kouvelis Panos , Wu Xiaole
Published: October 2014

Refining is indispensable to almost every natural-resource-based commodity industry. It involves a series of complex processes that transform inputs with a wide range of quality characteristics into refined finished products sold to end markets. In this paper, we take the perspective of a profit-maximizing refiner that considers upgrading its existing simple refinery to include intermediate-conversion flexibility, i.e., the capability of converting heavy intermediate components to light ones. We present a stylized two-stage stochastic programming model of a petroleum refinery to investigate the value drivers of conversion flexibility and the impact of input and output market conditions on its economic potential. Conversion flexibility adds value to refineries by either transforming a nonprofitable situation into a profitable one (referred to as purchase benefit) or improving profitability of an already profitable situation (referred to as unit revenue benefit). In a real-data-calibrated numerical study, we find the value of conversion flexibility (VoC) to be significant, accounting for 40% of the expected profit with conversion, and the purchase benefit and unit revenue benefit are equally important. Contrary to the intuition that, as a recourse action, conversion offers higher value for greater input price volatility, we find that VoC may decrease in input price volatility as a result of the differential impacts of increasing price volatility on the purchase benefit and the unit revenue benefit. Refineries also vary in their range flexibility, i.e., the ability to accommodate a narrow or wide range of inputs of different quality levels. Whether the range flexibility increases or decreases the value of conversion flexibility is affected by the direction in which the refinery expands its processing range and the heaviness of crude oils.

This paper was accepted by Martin Lariviere, operations management.
Women's expectations and experiences of childbirth in a Kenyan public hospital
Authors: Okwako Joseph M , Symon Andrew G
Published: October 2014

Objective:

To explore women's expectations and experiences of childbirth in a Kenyan Level 4 Public Hospital.

Design:

One-to-one semi-structured interviews conducted from January–March 2012 using interpretative phenomenological analysis.

Participants:

A purposive sample (n=7) was interviewed antenatally and postnatally.

Results:

Three major themes emerged: anticipating labour and birth; going through labour and birth; the impact of childbirth. All wanted a natural birth with tolerable labour pain. Women hoped for a good birthing environment, especially having a supportive nurse. Most viewed their childbirth experience as good, but voiced concerns about negative attitudes and unsupportive behaviour: women felt isolated and neglected, describing qualified nurses as inconsiderate and unresponsive to their needs.

Conclusions:

Areas of commonality and disagreement reflect individual and unique perspectives. There was some variation concerning preference for birth partner support, a cultural factor not reflected in the current international literature. These findings also confirm earlier negative reports concerning childbirth in certain Kenyan public hospitals. While the magnitude of negative birth experiences identified in this study was not as alarming as that identified in previous reports, it confirms that some women in Kenya do not have a fulfilling birth experience.
Nursing and midwifery at the crossroads—new challenges, new successes
Authors: Richens Yana
Published: October 2014

In April this year I was invited by Stellenbosch University in South Africa to conduct two workshops and give a keynote speech at their first International Nursing Conference. The title of the conference was Nursing and midwifery at the crossroads—new challenges, new successes. The conference was certainly a great success, with inspirational speakers and great presentations. These are three presentations which were given during the conference. As Kofi Annan once said ‘Knowledge is power. Information is liberating. Education is the premise of progress, in every society, in every family’. So I would like to share these with you, the speakers have given their permission.
Women's views and experience of their maternity care at a referral hospital in Ghana
Authors: Floyd Liz , Coulter Nicole , Asamoah Susana , Agyare-Asante Rebecca
Published: October 2014

Reducing death and morbidity by promoting high quality maternal and newborn care is a key goal for global health programmes. A recent systematic review defined quality care as preventive and supportive care with effective treatment for problems when they arise ( Renfrew et al, 2014 ). It showed that women want health professionals who combine clinical skills with interpersonal competence. This article describes a qualitative study to explore the experiences of eleven newly delivered women at a large referral hospital in Accra, to identify which factors contributed to a positive or negative birth experience. The study found that women's satisfaction or dissatisfaction were due to their perceptions of clinical competency (basic, practical, timely monitoring and treatment) and emotional support (respect, kindness and reassurance).
Pregnant women's awareness of antenatal danger signs and birth preparedness in rural Gambia
Authors: Jatta Fatou O , Lu Yu-Ying , Chang Chin-Lung , Liu Chieh-Yu
Published: October 2014

Aim:

The objectives of this study were to explore pregnant women's awareness of antenatal danger signs and birth preparedness as well as to identify associated factors in rural Gambia.

Methods:

A clinic-based cross-sectional study design was conducted at seven public health centres in rural Gambia involving a convenience sample of 145 pregnant women attending antenatal care services.

Results:

The study revealed that 61% of the pregnant women interviewed were aware of antenatal danger signs. In step wise multiple linear analyses, awareness of antenatal danger signs was significantly predicted by age, marital status and being advised on danger signs during antenatal visits. However, birth preparedness was low (14%) and multivariate logistic analyses showed that preparation was higher among literate women (OR= 5.12), employed women (OR=6.17), women with four or more antenatal visits (OR=4.62) and women with high awareness scores (OR=1.31).

Conclusion:

This study revealed a high level of awareness of antenatal danger signs despite deficiencies in the knowledge of some life threatening ones. However, the level of birth preparedness was low in the rural population studied. There is need to intensify efforts to provide health education on awareness of danger signs as well as to encourage birth preparation among pregnant women.
Factors influencing use of antenatal care and delivery services in Gwagwalada Area Council, Nigeria
Authors: Oyetunde Modupe Olusola , Eleri Grace Orieoma
Published: October 2014

Background:

Complications due to pregnancy and labour are among the leading causes of death and disability in women of child-bearing age in developing countries ( World Health Organization (WHO), UNICEF, UNFPA and World Bank, 2010 ). The provision and utilisation of antenatal and delivery services aim to decrease Nigeria's high maternal mortality rate. This study aimed to identify factors influencing the use of these services in Gwagwalada Area Council, Abuja, Nigeria.

Method:

This descriptive study was conducted over 6 weeks. The study involved 230 women aged 15–49 years whose recent birth was within the previous year prior to the survey. A 45-item structured questionnaire was used for data collection.

Results:

The majority of the women (94.2%) received antenatal care at an approved health care facility. Sixty-four percent registered for antenatal care during the second trimester while 66.7% attended antenatal care ≥four times. Eighty-four percent of the respondents received all the recommended antenatal care. Delivery services in the health facilities were used by 87.0% of participants—12.0% delivered at home. The husbands' educational level and occupation positively affected the pattern of use of these services P<0.05. Perceived importance of antenatal care, attitude of health workers and cost of care were the most important factors that influenced service use.

Conclusion:

The utilisation of these services needs to be sustained by improving the socioeconomic status of partners; improving the attitude of the health providers and subsidising the cost of antenatal and delivery services.
Activities for Remembrance Day
Authors: Neville Sarah
Published: October 2014

In the never-ending policy download that we are forced to interpret and evidence we have now been told to teach British values from the age of two, but exactly how can we do this?
Lynch syndrome: natural history and care of the patient
Authors: Clancy Tara
Published: October 2014

Lynch syndrome (LS), previously known as hereditary nonpolyposis colorectal cancer (HNPCC), is an autosomal dominantly inherited condition. It is characterised by the development of colorectal cancer (CRC), endometrial cancer, and other cancers. This article will review the clinical and genetic aspects of LS. It will outline the diagnostic criteria for the condition and how to identify patients or families with LS. It will also review bowel and other screening recommendations, surgical options, and highlight some counselling issues.
Assessing the willingness to change: optimising behaviour change in the management of chronic eye conditions
Authors: Drury Vicki , Chiang Peggy PC , Tey Ching Siong , Soon Hasita JT , Aw Ai Tee
Published: October 2014

Background:

Globally, low vision self-management programmes remain relatively novel, with limited discussion on how acceptance, motivation and readiness to change affect successful and sustainable behaviour change.

Aim:

To explore the relationship between acceptance, motivation and readiness to change in a group of people participating in low vision self-management programmes.

Methods:

A participatory action research framework was used with a steering group comprising clinicians and researchers to identify barriers to participation and challenges in the implementation of a self-management low vision programme in Singapore.

Results:

Many participants were not ready to make changes as they not only did not accept their condition, but were also unmotivated to make changes. We also found that the programme did not meet the psychosocial needs of the participants.

Conclusions:

Prior to inclusion in self-management programmes, it is recommended that motivational interviewing strategies are used to assess whether individuals have accepted their condition and are ready and motivated to make changes. It is essential that programmes address issues, such as: the emotional consequences of low vision; grief; communicating feelings; and coping strategies.
New or upgraded nurse call system? It's all in the preparation
Authors: Dewsbury Guy , Ballard Debbie
Published: October 2014

Whether you need a new nurse call system or an upgrade, the keys to a successful transition are careful planning and training. Get these right, say Guy Dewsbury and Debbie Ballard, and everyone will benefit
Supporting an individual in maintaining personal hygiene
Authors: Green Danielle
Published: October 2014

This unit introduces required skills to be able to support individuals in maintaining personal hygiene; good personal hygiene routines; why these are important; and causes of poor personal hygiene
How can your care home adhere to the ‘caring’ key question?
Authors: Frankova Helena
Published: October 2014

This fourth article in our series on preparing for the Care Quality Commission's (CQC) new-style comprehensive inspections focuses on the ‘caring’ question. What can you do to make sure your residential or nursing home can evidence good practice?
How to… manage and support staff when experiencing domestic difficulties
Authors: Ashurst Adrian
Published: October 2014

Adrian Ashurst provides care home managers with some important tips on how to manage and support staff when they experience domestic difficulties
Establishing an Evidence Base for Critical Laboratory Value Thresholds
Authors: Doering Travis A. , Plapp Frederick , Crawford James M.
Published: October 2014

Objectives:

Critical values denote laboratory test results indicating a life-threatening situation. The outcomes of this premise have not been rigorously evaluated.

Methods:

Five years of inpatient admissions were examined for critical or “near-critical” results (total admissions = 165,066; total test results = 872,503). In-hospital mortality was examined as a function of time and degree of test result abnormality.

Results:

Some critical value thresholds appropriately identified patients at risk for death (eg, elevated potassium). Other thresholds were too conservative (elevated hematocrit, hemoglobin) or not conservative enough (elevated lactate). Mortality risk for most critical values was time dependent, but some critical values showed no temporal effect on mortality (elevated activated partial thromboplastin time [APTT], international normalized ratio [INR], and glucose). Following an initial critical result, further worsening was associated with increased mortality. Prior hospital admission within 30 days was a predictor of lower mortality for some (elevated APTT, INR, potassium, and sodium; low glucose, hematocrit, hemoglobin, and potassium) but not other critical values (elevated lactate, glucose, hematocrit, and hemoglobin; low sodium).

Conclusions:

Only a subset of laboratory critical value thresholds was optimally chosen for increased risk of in-hospital mortality, with a time urgency for most but not all critical values. For many tests, a prior hospital admission imparted a decreased risk of in-hospital death.
Production of Alpha Amylase by Bacillus cereus in Submerged Fermentation
Authors: Raplong Helen H. , Odeleye Peter O. , Hammuel Chrinius , Idoko Matthew O. , Asanato Judy I. , Odeke Evelyn H.
Published: October 2014

Microorganisms have the ability to secrete enzymes when they are grown in the presence of certain substrates. Amylases are among the most important industrial enzymes and are of great significance in biotechnological studies. Bacteria belonging to the genus Bacillus were isolated using mannitol egg yolk polymyxin B (MYP) agar a highly selective media for Bacillus cereus isolation. The isolates were tested for α-amylase production on nutrient agar supplemented with starch and in submerged fermentation. The bacteria isolated and identified (using the Microgen Bacillus identification kit) were all Bacillus cereus and SB2 had the largest zone of hydrolysis of 12mm on nutrient agar supplemented with starch as well as the highest enzyme activity of 1.62U/ml. Amylase activity of 2.56U/ml was obtained after 24 hours incubation in submerged fermentation. When amylase enzyme production parameters where optimized, maximum amylase activity was obtained at a pH of 6.5, temperature of 350C, incubation time of 24 hours and 4% inoculums concentration. Bacillus cereus SB2 is a potential isolate for alpha-amylase production with soluble starch as the sole carbon source in submerged fermentation.
Democratising policy theories: enhancing prospects for language justice for Sign Language Peoples
Authors: Batterbury Sarah CE
Published: October 2014

The paper argues that policies relating to Sign Language Peoples (SLPs) in the UK are based on an assumption that they are a disability rather than a minority language formation. Consequently, they deliver unsatisfactory outcomes which struggle to reduce linguistic exclusion. Multicultural policies incorporating SLPs’ perspectives would offer greater synergy between policy theories and SLPs’ lived experience. More specifically, democratisation of the policy formulation process could deliver greater social justice for SLPs. Looking forward, the power of transnational networks to provoke national policy change offers a possible way of breaking through existing UK discourse barriers to more democratic SLP-led policy formulation.
From Hot Ellipsoid to Colder Torus: Structure and Temperature Changes of Laser Induced Plasmas
Authors: Rowold K. , Kubitzki M. , Longenecker M. , Hutchison K. , Hüwel L. , Cadwell L.
Published: October 2014

Using time resolved emission spectroscopy we have recorded changes in both shape and spectral content of the light emitting region of laser generated sparks in argon during the first 100 microseconds after the laser pulse.
Rapid Field Screening of Soils for Heavy Metals with Spark-Induced Breakdown Spectroscopy (SIBS)
Authors: Wainner Richard T. , Hunter Amy J. R.
Published: October 2014

Spark-induced breakdown spectroscopy (SIBS) is a new technique that has evolved from the growing field of LIBS. Here we apply portable SIBS technology to the ideally-suited task of detecting small concentrations (10 ppm) of heavy metals in soils.
Using picosecond pulses for gas-phase laser diagnostics
Authors: Settersten T. B.
Published: October 2014

This work provides an introduction to picosecond laser diagnostics. The temporal and spectral characteristics of picosecond pulses, modeling of their interactions with molecules, and examples of gas-phase diagnostic applications are described.
Temperature-dependent absorption by CO2: Implications for UV diagnostics in high-temperature flames
Authors: Schulz Christof , Gronki Joachim , Koch Jon D. , Davidson David F. , Jeffries Jay B. , Hanson Ronald K.
Published: October 2014

Absorption spectra of hot (900 – 3050 K) CO2 have been measured at 190 – 320 nm. A parameter set allows the calculation of absorption cross sections relevant for laser diagnostic in combustion processes.
In-situ flame measurements of NO and CO using Mid-IR QC lasers
Authors: Wehe Shawn D. , Sonnenfroh David M. , Allen Mark G. , Gmachl Claire , Capasso Federico
Published: October 2014

Room-temperature Quantum Cascade Lasers (QCL) allow high-sensitivity measurements of trace gas absorption in the 4.6 to 11 micron wavelength region. Important combustion-generated pollutants such as CO and NO exhibit strong fundamental absorption bands in this region and sub-ppm detection limits are projected. The paper will present initial results for both species obtained in a laboratory flat flame burner.
Development of an Enhanced Cavity Absorption Sensor for Air Monitoring
Authors: Awtry A.R. , Moses M.E. , Miller J.H.
Published: October 2014

The progress on the development of a sensor for the detection of ambient levels of a set of air contaminants is reported. A 1.55 µm external-cavity tunable diode laser is used as a light source that can be incorporated into either Integrated Cavity Output Spectroscopy (ICOS) or cw-Cavity Ringdown Spectroscopy (cw-CRDS). Both techniques exploit the sensitivity enhancements provided by the long effective pathlength from the optical cavity created between two mirrors. Initial experiments of ICOS and cw-CRDS have been performed to determine the sensitivity, selectivity, and reproducibility of this method. In the continuing work, the sensitivity of cw-CRDS will be compared with ICOS to determine which method holds greater promise for a practical sensor.
Theoretical model analysis of the dynamic saturation in cavity ringdown spectroscopy
Authors: Lee Jae Yong , Hahn Jae Won
Published: October 2014

Transient saturation in cavity ringdown spectroscopy is theoretically modeled with coupled rate equations accounting for the dynamics of intracavity photons and absorber population, which permits a recipe for retrieving original spectra in the saturation regime.
Tunable semiconductor laser spectroscopy in hollow optical waveguides
Authors: Fetzer G. J. , Pittner A. S.
Published: October 2014

A spectrometer based on tunable semiconductor lasers and hollow optical waveguides is discussed. Results are presented that characterize the function of the spectrometer in terms of sensitivity, response time, species cross interference and stability.
Microphotonic laser-based sensors for the rapid detection of approach to lower explosion limit for hydrocarbon vapors
Authors: McNesby Kevin L. , Miziolek Andrzej W.
Published: October 2014

Microphotonic sensors for rapid (10 msec) measurement of vapors from hydrocarbon fuels JP-8, DF-2, and gasoline are discussed. Sensors systems include dual wavelength NIR systems, Fourier transform-based systems, and Mid-IR (interband cascade) systems.
Fractionation of aerosol particles produced by laser ablation in ICP-MS analysis
Authors: Koch J. , Feldmann L. , Jakubowski N. , Niemax K.
Published: October 2014

The element composition of aerosol particles produced by laser ablation (laser wavelength: 266 nm; laser pulse length: 5 ns) of brass and steel in Ar and He and deposited on different segments of the transport tube to an Ar ICP have been measured by ICP-MS. Depending on the experimental parameters and the matrix, the element composition of the aerosol particles deposited on different parts of the tube deviated from the stoichiometric element ratios of the bulk and varied along the tube.