bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multidisciplinary Quality Improvement Intervention to Achieve Sustained Improvement in Hand Hygiene Reliability in a Pediatric Intensive Care Unit
Authors: Albert Ben D. , Petti Chonel , Caraglia Adrianna , Geller Margaret , Horak Robin , Barrett Megan , Hastings Ryan , O’Brien Mary , Ormsby Jennifer , Sandora Thomas J. , Kleinman Monica E. , Priebe Gregory P. , Mehta Nilesh M. 
Published: November 2019

Introduction:
Suboptimal hand hygiene (HH) remains a significant modifiable cause of healthcare-associated infections in the intensive care unit. We report a single-center, quality improvement project aimed at improving adherence to optimal HH among physicians, nurse practitioners, and nursing staff, and to sustain any improvement over time.

Methods:
A key driver diagram was developed to identify 5 primary drivers of change: leadership support, education initiatives, patient-family engagement, increased audit frequency, and individual feedback to promote accountability. We examined HH compliance over 3 years in 3 phases (pre-intervention, intervention, and post-intervention). The intervention period involved a multimodal approach designed to influence unit culture as well as individual HH practice. HH screens were installed outside the patient rooms to provide just-in-time reminders and display of regularly updated HH adherence data for provider groups.

Results:
We recorded 6,563 HH opportunities, providers included nurses (66%), attendings (12%), fellow/resident (16%), and nurse practitioners (NP) (6%). All clinical groups demonstrated HH compliance >90% during the post-intervention period. The improvements in practice were sustained for a year after the intervention.

Conclusion:
Our report highlights modifiable factors that impact HH and may inform quality improvement interventions aimed at improving HH compliance at other centers.
CA1 Hippocampal Pyramidal Cells in Rats, Resuscitated From 8 Minutes of Ventricular Fibrillation Cardiac Arrest, Recover After 20 Weeks of Survival: A Retrospective Pilot Study
Authors: Weihs Wolfgang , Warenits Alexandra-Maria , Ettl Florian , Magnet Ingrid Anna Maria , Herkner Harald , Kramer Anne Margarethe , Teubenbacher Ursula , Lobmeyr Elisabeth , Schriefl Christoph , Clodi Christian , Bauder Barbara , Tiboldi Akos , Holzer Michael , Janata Andreas , Högler Sandra 
Published: November 2019

ABSTRACT

Purpose:
The cornu ammonis 1 (CA1) region of the hippocampus is specifically vulnerable to global ischemia. We hypothesized that histopathological outcome in a ventricular fibrillation cardiac arrest (VFCA) rat model depends on the time point of the examination.

Methods:
Male Sprague-Dawley rats were put into VFCA for 8 min, received chest compressions for 2 min, and were defibrillated to achieve return of spontaneous circulation. Animals surviving for 80 min, 14 days and 140 days were compared with controls. Viable neurons were counted in a 500 μm sector of the CA1 region and layer thickness measured. Microglia cells and astrocytes were counted in a 250×300 μm2 aspect.

Results:
Control and 80 min surviving animals had similar numbers of pyramidal neurons in the CA1 region. In 14 days and 140 days survivors neuron numbers and layer thickness were severely diminished compared with controls (P < 0.001). Two-thirds of the 140 days survivors showed significantly more viable neurons than the last third. Microglia was increased in 14 days survivors compared with controls and 140 days survivors, while astrocytes increased in 14 days and 140 days survivors compared with controls (P < 0.001). 140 days survivors had significantly higher astrocyte counts compared with 14 days survivors.

Conclusions:
The amount and type of brain lesions present after global ischemia depend on the survival time. A consistent reduction in pyramidal cells in the CA1 region was present in all animals 14 days after VFCA, but in two-thirds of animals a repopulation of pyramidal cells seems to have taken place after 140 days.
Performance of the Safer Nursing Care Tool to measure nurse staffing requirements in acute hospitals: a multi-centre observational study
Authors: Griffiths Peter , Saville Christina , Ball Jane E , Culliford David , Pattison Natalie , Monks Thomas 
Published: November 2019

AbstractObjectivesTo determine the precision of nurse staffing establishments estimated using the SNCT patient classification system, and to assess whether the recommended staff levels correspond with professional judgements of adequate staffing.Setting / population81 medical/surgical units in 4 acute care hospitals.MethodsNurses assessed patients using the SNCT and reported on the adequacy of staffing at least daily for one year. Bootstrap samples of varying sizes were used to estimate the precision of the tool’s recommendations for the number of nurses to employ on each unit. Multi-level regression models were used to assess the association between shortfalls from the measured staffing requirement and nurses’ assessments of adequate staffing.ResultsThe recommended minimum sample of 20 days allowed the required number to employ to be estimated with a mean precision of 4.1%. For most units, much larger samples were required to estimate establishments within +/- 1 whole time staff member. Every registered nurse hour per patient day shortfall in staffing was associated with an 11% decrease in the odds of nurses reporting that there were enough staff to provide quality care and a 14% increase in the odds of reporting that necessary nursing care was left undone. No threshold indicating an optimal staffing level was observed. Surgical specialty, patient turnover and more single bedded rooms were associated with lower odds of staffing adequacy.ConclusionsThe SNCT can provide reliable estimates of the number of nurses to employ on a unit, but larger samples than the recommended minimum are usually required. The SNCT provides a measure of nursing workload that correlates with professional judgements, but the recommended staffing levels may not be optimal. Some sources of systematic variations in staffing requirements for some units are not accounted for. SNCT measurements are a potentially useful adjunct to professional judgement, but cannot replace it.
Serum proteomics expands on high-affinity antibodies in immunized rabbits than deep B-cell repertoire sequencing alone
Authors: Bonissone Stefano R. , Lima Thiago , Harris Katherine , Davison Laura , Avanzino Brian , Trinklein Nathan , Castellana Natalie , Patel Anand 
Published: November 2019

AbstractRabbits are a model for immunology studies, and monoclonal antibodies developed from rabbits have been sought after to empower immunoassays in a variety of applications. High-throughput characterization of circulating serum antibodies in response to specific antigens is highly impactful for both humoral immunology studies and antibody development. A combination of high throughput sequencing of antibody transcripts from B cells and proteomic analysis of serum antibodies, an approach referred to as immunoproteogenomics, is applied to profile the immune response of rabbits toβ-galactosidase (Beta-gal) in both recombinant antigen and peptide antigen immunization formats. The use of intact protein antigen resulted in observing 56.3% more heavy chains CDR3s in serum than immunization with peptide antigens. Additionally, sampling peripheral blood mononuclear cells (PBMCs) for B-cell repertoire sequencing at different time points throughout the immunization was found to capture 47.8%-72.8% of total proteomically observed heavy chain CDR3s, and would serve well in replacing sequencing the B cell rich, but more difficult to access spleen or bone marrow compartments. Despite B-cell repertoire sequencing to depths of 2M to 10M reads, we found proteomic evidence supporting at least 10% of serum antibodies are still missed. Further improvements to proteomic analysis techniques would enable more precise characterization of antibodies circulating in serum and determine antibody protein sequences missed by repertoire sequencing.
How artistic directors motivate the consistency of artists’ performance
Authors: Ricotta Anthony G. , Fan Susan K. , Dwyer Rocky J. 
Published: November 2019

Purpose
The purpose of this paper is to explore what motivation strategies live-entertainment artistic directors (ADs) use to increase consistency in their employees’ performances.

Design/methodology/approach
The purpose of this qualitative case study was to explore the research question: what motivation strategies do live-entertainment ADs use to improve consistency in employee performance? Semistructured face-to-face interviews with artistic and senior ADs of a large international live-entertainment company’s US division participated in the study. In addition to the interviews, a further analysis of archival records of artists’ evaluations, and written company documents regarding performance evaluation to understand the ADs’ strategies were completed. Finally, self-reported interview data compared to AD evaluations of artists from randomly selected prior years verified the ADs practices.

Findings
The finding indicated ADs use multiple techniques geared at improving employee well-being and technical competence, thereby creating an environment conducive to the employees self-determining their consistent behavior in performance.

Practical implications
These findings may offer managers across multiple industries a variety of strategies and techniques to use to improve consistency for their workers.

Originality/value
This study is the one of few that studies manager influence on the motivation of those employees whose job is to entertain others regardless of the employee’s emotional state. From these findings, ADs may determine how to implement workplace safety improvements, expanding employee well-being, which in turn can improve performance consistency.
Internationalization of industrial small-medium enterprises in an emerging country
Authors: Ibarra-Morales Luis Enrique , Blanco-Jimenez Monica , Hurtado-Bringas Beatriz Alejandra 
Published: November 2019

PurposeThe purpose of this paper is to boost the internationalization of companies by implementing key factors that will help them to increase their exports in a context of an emerging country such as Mexico, where very few small- and medium-sized enterprises (SMEs) achieve internationalization.Design/methodology/approachAccording to different theories on the internationalization of companies, five independent variables were designed to measure their effect on the export performance using a multiple regression model on a sample of 95 Mexican industrial SMEs. In this context, the objective of this study is to investigate the impact of the product price, product quality, installed capacity, innovation capacity and financial capacity on the export performance of SMEs; and to identify the factors that are more signiﬁcant.FindingsThe results indicate that innovation has a positive relationship, while the price of the product has a negative relationship with the internationalization of small- and medium-sized enterprises, showing that there is a possibility of overemphasizing the role of both variables in export performance of SMEs, at least in the Mexican context. The rest of the variables were not statistically significant to the generated model, perhaps because they are implicitly considered at the time of exporting and entering international markets.Originality/valueThese results will help companies to focus their efforts on obtaining resources to maintain and expand exports and find new opportunities in foreign markets to grow. They also show that companies can implement different types of internationalization strategies with the study’s variables to achieve better performance.
School board directors’ information needs and financial reporting’s role
Authors: Chen Hanmei , Smith Steven Howard 
Published: November 2019

Purpose
The purpose of this paper is to examine whether Washington State school district financial reporting and budget reporting meet the information needs of school board directors charged with governance.

Design/methodology/approach
Washington State school board directors were surveyed and asked to rank information items’ usefulness in carrying out their governance role. School district annual reports, budgets and websites were examined to determine whether the identified information was reported and easily transparent to those charged with governance and the public.

Findings
Directors rank information on strategic oversight, budget planning and student outcomes as more useful, consistent with the strategic role of new public management. Follow-on analysis of district annual financial reports, budgets and websites reveal that the availability of the information ranked useful by directors is limited. The findings suggest an information gap exists between directors’ information needs and school district reporting. Annual reports and budgets, when provided, often provide typical financial statements and variance data, respectively, rather than reporting on mission-aligned performance measures. The main consequence of the information gap may be compromised decision-making effectiveness.

Originality/value
By directly asking those charged with governance what information they identify as useful and then examining whether the information is reported in the annual report, budget or website, the study links user information needs to information transparency.
Reforming the government budgeting system in Malta
Authors: Ellul Lauren , Hodges Ron 
Published: November 2019

Purpose
The purpose of this paper is to analyse the pre-adoption phase of budgetary reform. Perspectives on the introduction and use of performance information in budgeting are obtained through interviews with current and former senior politicians and civil servants in Malta. Institutional theories are used to analyse the pressures that are perceived as promoting or inhibiting reforms.

Design/methodology/approach
The research followed a qualitative approach, using data gathered from documentary sources and empirical evidence collected from semi-structured interviews. Documentary sources were used to provide knowledge, obtaining an understanding of budgeting processes in the Maltese central government. Two categories of interviewee are identified in the analysis: political interviewees, consisting of 7 politicians; and administrative interviewees consisting of 13 senior civil servants.

Findings
The authors find that the current line-item budgeting system is deeply embedded into government practices. Malta’s membership of the European Union and its adoption of the Euro support coercive pressures for reductions in fiscal deficits. Normative pressures appear to be significant and may have a longer-term impact in promoting budgeting reform.

Originality/value
This paper contributes to existing performance-based budgeting literature by studying the pre-adoption phase which has rarely been the focus of previous studies. The study delves into the interaction between institutional and economic forces, an aspect which has been inadequately studied. The access to current and former Prime Ministers and other Ministers of State in this study is unusual. As such, the researchers have been able to obtain the perceptions of political decision makers in a way that might be more difficult to do in larger countries.
Abnormal trading around common factor pricing models
Authors: Wang Jiexin , Han Xue , Huang Emily J. , Yost-Bremm Christopher 
Published: November 2019

PurposeThe purpose of this paper is to investigate the impact of factor-based trading strategies on pricing and volume.Design/methodology/approachThe authors employ a regression discontinuity approach to identify abnormalities in volume or pricing around expected portfolio changes. In addition, the authors characterize more granular effects on pricing and volume as a result of portfolio re-classification through Fama and Macbeth (1973) regressions.FindingsThe authors find that firms which are predicted to transfer among the factor portfolios of Fama and French (1993) exhibit strong and statistically significant short-term variation in stock price and volume. Short-term returns around the cutoff values comprising SMB and HML tend to be temporarily high if the firm is predicted to move into a long component of a factor-mimicking portfolio, and temporarily low if moving into a short component. Similar results are apparent when examining movement in and out of the 25 size and book-to-market sorted test asset portfolios.Practical implicationsThe use of portfolio strategies formulated on the basis of sorting procedures, while once upon a time a niche market in the portfolio management industry, is now ubiquitous. The results of this study raise interesting methodological questions about the pricing implications arising from these common methodologies.Originality/valueThis study makes a number of contributions. First, it contributes to the idea that the publication or dissemination of trading strategies or – more generally – common portfolio sorting methods, leads to effects on pricing and volume through commonly motivated trading pressure. In other words, recipe-like discoveries of advantageous trading strategies lead to a synthetic creation of demand. Second, by noting that a lot of factor-focused trading activity begins around July and August of each year, the study relates to existing literature which documents seasonal variation in stock returns and volume. The findings raise questions about what guides institutional investors’ portfolio allocation decisions and whether these are optimal in aggregate.
The identification and deletion of the polyketide synthase‐nonribosomal peptide synthase gene responsible for the production of the phytotoxic triticone A/B in the wheat fungal pathogen Pyrenophora tritici‐repentis
Authors: Rawlinson Catherine , See Pao Theen , Moolhuijzen Paula , Li Hang , Moffat Caroline S. , Chooi Yit‐Heng , Oliver Richard P. 
Published: November 2019

SummaryThe economically important necrotrophic fungal pathogen, Pyrenophora tritici‐repentis (Ptr), causes tan spot of wheat, a disease typified by foliar necrosis and chlorosis. The culture filtrate of an Australian Ptr isolate, M4, possesses phytotoxic activity and plant bioassay guided discovery led to the purification of necrosis inducing toxins called triticone A and B. High‐resolution LC–MS/MS analysis of the culture filtrate identified an additional 37 triticone‐like compounds. The biosynthetic gene cluster responsible for triticone production (the Ttc cluster) was identified and deletion of TtcA, a hybrid polyketide synthase (PKS)‐nonribosomal peptide synthase (NRPS), abolished production of all triticones. The pathogenicity of mutant (ttcA) strains was not visibly affected in our assays. We hypothesize that triticones possess general antimicrobial activity important for competition in multi‐microbial environments.
Complete natal cleft removal with kite incision in the treatment of extensive sacrococcygeal pilonidal sinus
Authors: Ozdemir Hakan , Unal Ozdemir Zehra , Sunamak Oguzhan 
Published: November 2019

AbstractBackgroundPilonidal sinus (PS) is a benign disease for which different treatment modalities are used, varying from non‐surgical treatments to surgical treatments with flap use for big defects. High recurrence is the main problem in complicated cases. We presented complete natal cleft excision with kite incision and fasciocutaneous flap (CNCEF with kite incision) in extensive sacrococcygeal PS.MethodsSeventy‐six patients who underwent CNCEF with kite incision because of extensive PS extending through intergluteal sulcus to the anus, with multiple sinus tracts and recurrent PS were retrospectively analysed. A special incision involving natal cleft and all sinus tracts completely and fasciocutaneous flap, lateralizing median line, was used in all cases. Post‐operative complications and recurrence was recorded.ResultsSixteen (21.1%) patients were operated because of recurrence. The mean age and body mass index were 33.04 ± 6.78 and 29.86 ± 5.46, respectively. The mean hospital stay period and mean operation time was 2.95 ± 0.76 days and 64.33 ± 8.64 min, respectively. The mean drain removal time was 2.78 ± 0.7 days and mean follow‐up was 13.46 ± 4.31 months. There were flap oedema and seroma in one (1.3%) and four (5.3%) of the patients, respectively. Surgical site infection necessitating antibiotic treatment developed in three (3.9%) patients. The overall post‐operative complication rate was 10.5% and there was recurrence in one patient on follow‐up period (1.3%).ConclusionCNCEF with kite incision method, which shifts midline, is a safe and reliable method with acceptable post‐operative complication and recurrence rates in extensive sacrococcygeal PS patients.
Working on Water: Introduction
Authors: Roseman Sharon R. 
Published: November 2019

AbstractThis special issue focuses on the work lives of individuals with jobs that take place on and around boats. This introduction to the special issue “Working on Water” provides an overview of the long history of anthropological research on forms of human work that take place in and around salt and fresh bodies of water, such as food harvesting, watercraft construction, and transportation. It also discusses links between the multidisciplinary “mobilities turn” and research on aquamobilities. The last section introduces the ethnographic papers included in this issue of the journal, which focus on various sectors, including seafood harvesting, coastal tourism, passenger and vehicle ferries, and cargo transportation.
Efficiency analysis for stochastic dynamic facility layout problem using meta‐heuristic, data envelopment analysis and machine learning
Authors: Tayal Akash , Kose Utku , Solanki Arun , Nayyar Anand , Saucedo José Antonio Marmolejo 
Published: November 2019

AbstractThe facility layout problem (FLP) is a combinatorial optimization problem. The performance of the layout design is significantly impacted by diverse, multiple factors. The use of algorithmic or procedural design methodology in ranking and identification of efficient layout is ineffective. In this context, this study proposes a three‐stage methodology where data envelopment analysis (DEA) is augmented with unsupervised and supervised machine learning (ML). In stage 1, unsupervised ML is used for the clustering of the criteria in which the layouts need to be evaluated using homogeneity. Layouts are generated using simulated annealing, chaotic simulated annealing, and hybrid firefly algorithm/chaotic simulated annealing meta‐heuristics. In stage 2, the nonparametric DEA approach is used to identify efficient and inefficient layouts. Finally, supervised ML utilizes the performance frontiers from DEA (efficiency scores) to generate a trained model for getting the unique rankings and predicted efficiency scores of layouts. The proposed methodology overcomes the limitations associated with large datasets that contain many inputs / outputs from the conventional DEA and improves the prediction accuracy of layouts. A Gaussian distribution product demand dataset for time period T = 5 and facility size N = 12 is used to prove the effectiveness of the methodology.