bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in Telestroke Care Delivery
Authors: Sharma Richa , Zachrison Kori S. , Viswanathan Anand , Matiello Marcelo , Estrada Juan , Anderson Christopher D. , Etherton Mark , Silverman Scott , Rost Natalia S. , Feske Steven K. , Schwamm Lee H. 
Published: March 2020

Background:
Telestroke provides access to vascular neurology expertise for hospitals lacking stroke coverage, and its use has risen rapidly in the past decade. We aim to characterize consultations, spoke behavior, and the relationship between spoke telestroke utilization (number of telestroke consults per year) and spoke alteplase treatment metrics in an academic telestroke network.

Methods and Results:

We analyzed prospectively collected data on all telestroke consults from 2003 to 2018. Trends in network performance and spoke characteristics were analyzed using generalized estimating equations and Kendall τβ nonparametric tests as appropriate. Unadjusted and adjusted linear regression models determined associations between telestroke utilization and treatment metrics. The network included 2 hubs and 43 spokes with 12 803 consults performed during the study period. Network growth overall was +1.8 spokes per year, and median duration of spoke participation was 7.9 years. The numbers of consults and alteplase-treated patients increased annually, even after adjusting for the number of spokes in the network (
P
<0.01 for both). Although times from last seen well to spoke emergency department arrival and to consult request increased, door-to-needle time, time from teleconsult request to callback, and time from teleconsult to alteplase administration all decreased (all
P
<0.01). With time, the network included more spokes without a Primary Stroke Center designation. In adjusted analyses, for every 10 telestroke consults requested by a spoke, the spoke door-to-needle decreased by 1.8 minutes (
P
=0.02), number of patients treated with alteplase was an additional 1.7 (
P
<0.01), and the percent of eligible patients treated with alteplase increased by 8% (
P
=0.03).

Conclusions:
Telestroke network size and utilization increased over time. Increased use of teleconsults was associated with increased and timely use of alteplase. Over time, the delivery of timely emergency care has improved significantly among emergency departments participating in this telestroke network. Replication of these findings in other networks is warranted.
Islamic Charity as (Non)Political in Contemporary Egypt
Authors: Mittermaier Amira 
Published: March 2020

Abstract
Whereas some Muslim-majority countries have centralized alms economies, in others Islamic charity unfolds informally. In Egypt, pious giving occurs on the margins of the state but lies at the heart of society. Egyptians’ daily charitable practices may therefore be read as political in the broad sense proposed by Hannah Arendt: efforts by ordinary citizens to shape the conditions of their collective existence. Although this Arendtian framework helps scholars to think about politics beyond the parameters of the state, even such widened notions of the political are not consistent with how pious givers in Egypt understand their practices. While attending to the poor, pious givers often orient themselves away from the social and material, foregrounding the beyond, paradise and God. Even though the “beyond” is intimately connected to the “here and now,” this decentering of the social poses a provocative challenge to the secular observer’s search for the political.
A Regime Perspective on the North Atlantic Eddy-Driven Jet Response to Sudden Stratospheric Warmings
Authors: Maycock Amanda C. , Masukwedza Gibbon I. T. , Hitchcock Peter , Simpson Isla R. 
Published: March 2020

AbstractChanges to the preferred states, or regime behavior, of the North Atlantic eddy-driven jet (EDJ) following a major sudden stratospheric warming (SSW) is examined using a large ensemble experiment from the Canadian Middle Atmosphere Model in which the stratosphere is nudged toward an SSW. In the 3 months following the SSW (January–March), the North Atlantic EDJ shifts equatorward by ~3°, on average; this arises from an increased occurrence of the EDJ’s south regime and reductions in its north and central regimes. Qualitatively similar behavior is shown in a reanalysis dataset. We show that under SSW conditions the south regime becomes more persistent and that this can explain the overall increase in the EDJ latitude decorrelation time scale. A cluster analysis reveals that, following the SSW, the south EDJ regime is characterized by weaker low-level baroclinicity and eddy heat fluxes in the North Atlantic Ocean. We hypothesize, therefore, that the increased persistence of the south regime is related to the weaker baroclinicity leading to slower growth rates of the unstable modes and hence a slower buildup of eddy heat flux, which has been shown to precede EDJ transitions. In the North Atlantic sector, the surface response to the SSW projects onto a negative North Atlantic Oscillation (NAO) pattern, with almost no change in the east Atlantic (EA) pattern. This behavior appears to be distinct from the modeled intrinsic variability in the EDJ, where the jet latitude index captures variations in both the NAO and EA patterns. The results offer new insight into the mechanisms for stratosphere–troposphere coupling following SSWs.
Decision Quality Among Parents Who Are Offered Ventilation Tube Insertion for Their Children
Authors: Newby Maxwell D. , Zalzal Habib G. , Ramadan Jad , Kellermeyer Brian M. , Carr Michele M. 
Published: March 2020

Objective: To develop a Decision Quality (DQ) tool to measure parents’ DQ concerning ventilation tube (VT) insertion in their children. Method: Parental survey during 2017 to 2018 in a tertiary care pediatric otolaryngology clinic comparing a validated Decisional Conflict (DC) scale with a DQ instrument including Shared Decision-Making (SDM) scale, parental treatment goals, and knowledge about VT. Results: Of 100 parent participants, 83% were mothers and 14% were fathers. 94% elected VT insertion, 6% elected monitoring or deferred the decision. 44% of the patients were <18 months, 42% were 19 months to 3 years, and the rest were older. The mean DC score was 8.26 out of 100 (95% CI 4.82-11.69), indicating low DC. Mean DQ score was 82.45 out of 100 (95% CI 80.18-84.72), including mean SDM of 87.71 (95% CI 83.53-91.88,), mean knowledge score of 87.5% (95% CI 84.56-91.59) and mean values score of 7.16 (95% CI 6.90-7.41). Comparisons between those who elected VT and those who did not showed that electors had lower DC scores (7.15 vs 24.74, P < .001), higher DQ scores (83.00 vs 72.61, P = .028) with higher SDM scores (88.70 vs 70.22, P = .044) and higher values score (7.20 vs 6.36, P = .034). Cronbach alpha for the DQ scale was 0.76. Spearman’s rho for DQ score versus DC score was −0.458, P < .001. Conclusions: DQ, as measured with this tool, was higher when parents chose to place tubes. Our DQ instrument has potential use for study of why parents may decline VT when their child meets criteria for them.
Concession Stand Operation in a Centrally-Managed Program
Authors: Johnson Carl A. 
Published: March 2020

The article by Dr. Jacobus tenBroek, “The Eighty-third Congress and the Blind,” which appeared in the January New Outlook discussed, among other matters, legislation relating to vending or concession stands. Dr. tenBroek is certainly correct that changes brought about in the vending stand program by Public Law 565 are confusing and are a mixture of progress and retardation. However, we feel that Dr. tenBroek's strong negative reaction to the control type program needs to be balanced by facts which come from experience with both individually-operated stands and a centrally-managed plan. Further, there is a lack of reference material in our literature relating to vending or concession stand operation, and we hope that this article, together with Dr. tenBroek's, will stimulate increased thinking about an enterprise which offers one of the most feasible employment opportunities for visually handicapped individuals. Mr. Johnson, now the manager of our Cleveland program, has had fourteen years of experience in concession stand operation with Ohio State Services for the Blind and with our agency. He has written the following story of our operation in Cleveland which we submit in the hope that our experience may be of some interest to others.— Allan W. Sherman, Executive Director, Cleveland Society for the Blind
Classified Corner
Authors: Campbell Mary Dranga 
Published: March 2020

This department is a New Outlook service to readers, who wish to publish notices of positions open for application as well as those who are seeking employment in the field of work for the blind or deaf-blind. No charge is made and we will print as many as space will permit. The publishers do not vouch for statements of advertisers. We also will print without charge miscellaneous notices of interest to professional workers which are of a non-commercial nature. All other advertising will be accepted at rates which are available on request.
Safety for Visually Impaired Children
Authors: Gibbons Helen 
Published: March 2020

The effective cooperation of school and home can insure meaningful and safe environment for the visually impaired child in which to develop and learn. However, developing safety responsibilities in children is a long, continuous and sometimes unsatisfying task. Responsible adults can effectively “set the safety stage.” To insure good safety practices in adult years it is essential that more than a set of “do's and don'ts” be learned. Practices will be built on attitudes developed during childhood. The recognition of the rights and responsibilities of ourselves and others—care versus carelessness—is a prime rule.
An Approach for Initiating Educational Programs for the Blind in Asia the Philippine Program, Phase One
Authors: Franks Frank L. , Bridges D. R. 
Published: March 2020

Another advantage of the integrated program cited by Dr. Vitaliano Bernardino, Director, Bureau of Public Schools, Philippines, is its acceptability and attractiveness to the public. All things considered, this system is less expensive than establishing special schools. Assuming there are certain essential requirements common to both systems such as trained teachers, braille reading matter, and other needed facilities, the use of the regularly established school buildings and classrooms for educating the blind makes the integrated system that much cheaper. This is the main reason why, particularly for those countries or school systems that are just beginning to establish programs for educating the blind, this approach seems to offer greater possibilities.17 Of the diversiphased approach itself, Dr. Bernardino recently stated, “We are finding the diversiphased approach most practical and flexible in the context of developing the total Program for the Education of the Blind in the Philippines.”
The Use of Abacus Contests to Increase Interest in Mathematics
Authors: Lewis Marian , Coker Gary 
Published: March 2020

□ A visually handicapped student must take advantage of all the mathematical tools at his disposal. It is not for us to say that one tool is better than another. There are times when a student should use the braillewriter, slate, or some other device. The use of these and the abacus should be an individual matter. We do feel that the abacus offers a more rapid means of computation that most other devices. It does not supplant these others, however, but supplements them in the mathematics program. It has been found that contests stimulate learning in mathematics. Abacus contests were helpful in encouraging students to practice the use of the abacus and in creating more interest in it. The abacus bee was especially valuable because each student was involved on a team basis, and yet was allowed to compete on his own level. This meant that he not only had a good chance to win first place, but that whatever his performance he could usually earn points for his team.
Storytelling and the Blind Child
Authors: Brown Jean D. 
Published: March 2020

□ To recapitulate, remember when selecting stories that it is wise to remain within the blind child's experiential realm. These children frequently have no concept of size, shape, or texture. Some teachers maintain that they are never fully assured as to whether or not a child has perceived correct dimensions. Therefore, preparation of story themes in advance (and after consultation with teachers to insure the particular concept involved has been previously taught or explained) will save valuable time by eliminating many questions and will make the story more effective. Adults need to constantly remember that this old world is new to children, and what experienced adults may take for granted may not be within the realm of the child, especially a blind child, e.g., a trip to a farm or circus. Stories and books are highly valuable aids for they help fill in the gaps of a child's learning experience. Storytellers play the important role of catalyst in bringing books and children together.
A Sex Education Program for Congenitally Blind Adults in a Rehabilitation Center Setting
Authors: Vogel David S. , Muxen Marla J. 
Published: March 2020

During a counseling internship at the Rehabilitation Center for the Blind, Sioux Falls, South Dakota, it became apparent that congenitally blind adults there had little or no knowledge regarding the opposite sex, sex roles, sexual function and process, or socialization. It was noted that these individuals simply had not received basic sexual information either in the home or in school. After noting this need for a sex education program for congenitally blind adults, a curriculum was designed to meet that need. This article presents a summary of the preparation for and presentation of that program to two different class groups in the Sioux Falls facility. The article focuses upon the practical experiences of conducting a sex education course, and on important material of a theoretical nature.
The impact of person–environment–occupation transactions on joint attention in children with autism spectrum disorder: A scoping review
Authors: Ambrose David , MacKenzie Diane E , Ghanouni Parisa 
Published: March 2020

Introduction Individuals with autism spectrum disorder demonstrate difficulty with joint attention, affecting social and occupational performance. Studies of joint attention in children with autism spectrum disorder employ a variety of instrumentation, environments and occupations. From the occupational therapy perspective, current literature lacks a rigorous analysis of the transactions of person, environment and occupation embedded within the procedures of these studies. The goal of this scoping review was to investigate how these components transact to affect occupational performance. Method Using the Person–Environment–Occupation model as an evaluative lens, a scoping review was completed to summarize person, environment and occupation transactions in studies examining joint attention in children aged 6–12 years with autism spectrum disorder. Results Six studies were included. Findings indicated that simplified social environments and demonstrations of joint attention promoted higher joint attention performance in children with autism spectrum disorder, at the cost of ecological validity. Maintaining ecological validity in complex social environments resulted in lower joint attention performance. Conclusion The Person–Environment–Occupation model can be used to develop an occupational therapy perspective on literature from outside the discipline. There is a relationship between the person, environment, occupation transactions and joint attention in children with autism spectrum disorder.
Hemolysis associated with Impella heart pump positioning: In vitro hemolysis testing and computational fluid dynamics modeling
Authors: Roberts Nicholas , Chandrasekaran Uma , Das Soumen , Qi Zhongwei , Corbett Scott 
Published: March 2020

Introduction: Short-term mechanical circulatory support devices provide temporary hemodynamic support in heart failure and are increasingly used to enable recovery or as a bridge to decision. Blood damage with mechanical circulatory support devices is influenced by many factors, including the magnitude and duration of shear stress and obstruction to blood flow. This study aimed to evaluate the effects of the Impella CP® heart pump positioning on hemolysis using in vitro hemolysis testing and computational fluid dynamics modeling. Methods: The in vitro hemolysis testing was conducted per the recommended Food and Drug Administration and American Society for Testing and Materials guidelines. The bench hemolysis testing and computational fluid dynamics simulation analysis were performed for both normal operating (outlet unobstructed) and outlet-obstructed condition of Impella CP (mimicking outlet on the aortic valve due to improper positioning). Results: The modified index of hemolysis was 2.78 ± 0.69 at normal operating conditions compared to 18.7 ± 7.8 when the Impella CP outlet was obstructed ( p = 0.002). Computational fluid dynamics modeling showed about three times increase in exposure time to regions of high shear stress when the Impella CP outlet was obstructed compared to unobstructed condition, thus supporting the experimental observations. Conclusion: Based on these results, it is recommended to ensure proper placement of Impella CP via regular monitoring using echocardiographic guidance or other methods to minimize the risk of hemolysis associated with an obstructed outflow.
Creating a Competency-Based Medical Education Curriculum for Canadian Diagnostic Radiology Residency (Queen’s Fundamental Innovations in Residency Education)—Part 1: Transition to Discipline and Foundation of Discipline Stages
Authors: Kwan Benjamin Yin Ming , Mbanwi Achire , Cofie Nicholas , Rogoza Christina , Islam Omar , Chung Andrew D. , Dalgarno Nancy , Dagnone Damon , Wang Xi , Mussari Ben 
Published: March 2020

Purpose: The Royal College of Physicians and Surgeons of Canada (RCPSC) has mandated the transition of postgraduate medical training in Canada to a competency-based medical education (CBME) model divided into 4 stages of training. As part of the Queen’s University Fundamental Innovations in Residency Education proposal, Queen’s University in Canada is the first institution to transition all of its residency programs simultaneously to this model, including Diagnostic Radiology. The objective of this report is to describe the Queen’s Diagnostic Radiology Residency Program’s implementation of a CBME curriculum. Methods: At Queen’s University, the novel curriculum was developed using the RCPSC’s competency continuum and the CanMEDS framework to create radiology-specific entrustable professional activities (EPAs) and milestones. In addition, new committees and assessment strategies were established. As of July 2015, 3 cohorts of residents (n = 9) have been enrolled in this new curriculum. Results: EPAs, milestones, and methods of evaluation for the Transition to Discipline and Foundations of Discipline stages, as well as the opportunities and challenges associated with the implementation of a competency-based curriculum in a Diagnostic Radiology Residency Program, are described. Challenges include the increased frequency of resident assessments, establishing stage-specific learner expectations, and the creation of volumetric guidelines for case reporting and procedures. Conclusions: Development of a novel CBME curriculum requires significant resources and dedicated administrative time within an academic Radiology department. This article highlights challenges and provides guidance for this process.
Quality dying: An approach to ICD deactivation in the hospital setting
Authors: Turner Suzette , Torabi Sarah , Stilos Kalli 
Published: March 2020

Background: In Canada, cardiovascular disease is the second most common cause of death. A subset of these patients will require a cardiovascular implantable electronic device (CIED). An estimated 200 000 Canadians are living with a CIED. CIEDs can improve life and prevent premature death. However, when patients reach the end of their lives, they can pose a challenge. An example of which is a painful shock delivered from an implantable cardioverter defibrillator (ICD) for an arrhythmia in a dying patient. Receiving a shock at the end of life (EOL) is unacceptable in an age when we aim to ease the suffering of the dying and allow for a comfortable death. Methods: As a quality standard of practice, all clinicians are expected to engage in EOL conversations in patients requiring CIED deactivation. Due to the potential discomfort of an ICD shock, specific conversations about deactivation of an ICD are encouraged. A process improvement approach was developed by our hospital that included an advance care planning simulation lab, electronic documentation and a standardized comfort measures order set that includes addressing the need for ICD deactivation at EOL. Results: EOL conversations are complex. Health care providers have been equally challenged to have conversations about ICD deactivation. Standardization of the process of ICD deactivation ensures an approach to EOL which respects the individuality of patients and promotes quality dying. Conclusion: Our hospital is committed to assisting clinicians to provide quality care by improving conversations about EOL care. On the basis of a synthesis of existing literature, we describe the importance of and the ideal process for having EOL conversations in patients about ICD deactivation at the EOL.
Treatment of humeral condylar fractures and humeral intracondylar fissures in cats with patellar fracture and dental anomaly syndrome
Authors: Chan Alexander JH , Reyes Rodriguez Natalia Andrea , Bailey Steven J , Langley-Hobbs Sorrel J 
Published: March 2020

Objectives The aim of this study is to describe the treatment and outcome of humeral condylar fractures and humeral intracondylar fissures in cats with patellar fracture and dental anomaly syndrome (PADS) and to provide advice on how to manage these cases in practice. Methods Data were collated on cats with PADS that were reported to have sustained humeral fractures or had fractures or fissures of the humerus identified on radiographs. The details of the fractures were recorded in addition to any treatment and outcome information. Results Of the 207 cases reported with PADS, 18 cats (8.7%) were found to have humeral condylar fractures, none of which was known to have resulted from significant trauma. Where treatment occurred, it involved the placement of transcondylar positional or lag screws. In some cases additional implants, including supracondylar bone plates and screws or Kirschner wires (K-wires), were used. Follow-up data revealed that only two cats were euthanased owing to the presence of the humeral fractures, with at least eight achieving some degree of recovery of function. Conclusions and relevance These humeral fractures all have the characteristics of stress insufficiency fractures, being simple isolated fractures that are short oblique, with increased radio-density at the fracture line and occurring following minimal or no trauma. Humeral intracondylar fissures were identified in two cats and it is possible that some of the other fractures may have occurred secondary to pre-existing fissures. To our knowledge, no prior reports exist of fissures in cats that do not meet the criteria for PADS. Surgical repair primarily consisted of the placement of transcondylar lag or positional screws with, in some cases, adjunct implants such as bone plates and screws or K-wires. Though there were insufficient data to determine the prognosis for these fractures in the long term, unlike patellar fractures, many of these fractures will heal if treated appropriately.