bluuebunny/crossref_metadata_2025_split huggingface dataset:
LO21: Consistency of CTAS scores by presenting complaint pre and post eCTAS implementation in 35 emergency departments across Ontario
Authors: McLeod S. , Thompson C. , Borgundvaag B. , Thabane L. , Ovens H. , Scott S. , Ahmed T. , Grewal K. , McCarron J. , Filsinger B. , Mittmann N. , Worster A. , Agoritsas T. , Guyatt G. 
Published: May 2020

Introduction: eCTAS is a real time electronic triage decision-support tool designed to improve patient safety and quality of care by standardizing the application of the Canadian Triage and Acuity Scale (CTAS). The tool dynamically calculates a recommended CTAS score based on the presenting complaint, vital signs and selected clinical modifiers. The primary objective was to assess consistency of CTAS score distributions across 35 emergency departments (EDs) by 16 presenting complaints pre and post eCTAS implementation. Methods: This retrospective cohort study used population-based administrative data from January 2016 to December 2018 from all hospital EDs in Ontario that had implemented eCTAS with at least 9 months of data. Following a 3-month stabilization period, we compared data for 6 months post-eCTAS implementation to the same 6-month period the previous year (pre-implementation) to account for potential seasonal variation, patient volume and case-mix. We included triage encounters of adult (≥18 years) patients if they had one of 16 pre-specified high-volume, presenting complaints. A paired-samples t-test was used to determine consistency by estimating the absolute difference in CTAS distribution for each presenting complaint, by each hospital, pre and post eCTAS implementation, compared to the overall average of the 35 EDs. Results: There were 183,231 triage encounters in the pre-eCTAS cohort and 179,983 in the post-eCTAS cohort from 35 EDs across the province. Triage scores were more consistent with the overall average after eCTAS implementation in 6 (37.5%) presenting complaints: chest pain (cardiac features) (p < 0.001), extremity weakness/symptoms of cerebrovascular accident (p < 0.001), fever (p < 0.001), shortness of breath (p < 0.001), syncope (p = 0.02), and hyperglycemia (p = 0.03). Triage consistency was similar pre and post eCTAS implementation for the presenting complaints of altered level of consciousness, anxiety/situational crisis, confusion, depression/suicidal/deliberate self-harm, general weakness, head injury, palpitations, seizure, substance misuse/intoxication or vertigo. Conclusion: A standardized, electronic approach to performing triage assessments increased consistency in CTAS scores across many, but not all, high-volume CEDIS complaints. This does not reflect triage accuracy, as there are no known benchmarks for triage accuracy. Improvements in consistency were greatest for sentinel presenting complaints with a minimum allowable CTAS score.
LO30: Optimizing diagnostic testing processes to improve emergency department throughput: a systematic review
Authors: Grant K. , Bayley C. , Lang E. , Innes G. 
Published: May 2020

Introduction: Emergency Department (ED) crowding is an intensifying crisis. While input, throughput, and output factors all contribute to crowding, throughput factors are the most dependent on ED staff and process. Diagnostic testing is a fundamental ED process that has not been systematically evaluated. We present a systematic review of interventions designed to reduce ED length of stay (LOS) by optimizing laboratory or imaging turnaround time, or by introducing point-of-care testing (POCT). Methods: We conducted systematic database searches in Medline, Embase, CINAHL, and the Cochrane Central Register of Controlled Trials without filters or language restrictions, of all interventions on diagnostic technology that affected ED throughput (PROSPERO:CRD42019125651). Studies were screened by two independent reviewers. Study quality was assessed using the Cochrane ROB-2 tools for randomized controlled trials (RCTs), and the National Heart, Lung, and Blood Institute tool for all other study designs. Results: 18 studies met inclusion criteria (Cohen's kappa = 0.69). Study results were not pooled due to high statistical heterogeneity as assessed by chi-squared and I-squared statistics. 12 POCT intervention studies reported LOS changes ranging from -114 to + 8 minutes (-26.8% to + 3.8%), although three were non-significant findings. Four studies that initiated POCT or lab-ordering at triage reported LOS reductions ranging from 22 to 174 minutes, but only one of these, at 29 minutes (16%), was statistically significant. One study of improved laboratory troponin processing reported a LOS reduction of 43 minutes (12.3%). Another, which allowed triage nurses to order ankle x-rays using the Ottawa ankle rules, reported a non-significant LOS reduction of 28 minutes for patients with ankle injuries. LOS improvements reflected the population of patients who underwent the testing modality, rather than overall ED LOS. Seven studies had low risk of bias, 11 studies had some risk of bias, and no studies had high risk of bias (Cohen's kappa = 0.58). Conclusion: Eleven of 18 diagnostic testing studies reported LOS reductions. POCT was the most common intervention type, and usually reduced EDLOS within relevant patient subsets, while triage-initiated testing generally did not. To aid widespread adoption, future research should focus on interrupted time series or RCT designs, and more comprehensive descriptions of the contextual factors affecting implementation of these interventions.
LO43: First Nations emergency care visits in Alberta: Descriptive results of a retrospective cohort study
Authors: McLane P. , Barnabe C. , Holroyd B. , Colquhoun A. , Bill L. , Fitzpatrick K. , Rittenbach K. , Healy C. , Bull H. , Crawler M. , Firth L. , Jacobs T. , Twin D. , Rosychuk R. 
Published: May 2020

Introduction: Emergency care serves as an important health resource for First Nations (FN) persons. Previous reporting shows that FN persons visit emergency departments at almost double the rate of non-FN persons. Working collaboratively with FN partners, academic researchers and health authority staff, the objective of this study is to investigate FN emergency care patient visit statistics in Alberta over a five year period. Methods: Through a population-based retrospective cohort study for the period from April 1, 2012 to March 31, 2017, patient demographics and emergency care visit characteristics for status FN patients in Alberta were analyzed and compared to non-FN statistics. Frequencies and percentages (%) describe patients and visits by categorical variables (e.g., Canadian Triage Acuity Scale (CTAS)). Means and standard deviations (medians and interquartile ranges (IQR)) describe continuous variables (e.g., distances) as appropriate for the data distribution. These descriptions are repeated for the FN and non-FN populations, separately. Results: The data set contains 11,686,288 emergency facility visits by 3,024,491 unique persons. FN people make up 4.8% of unique patients and 9.4% of emergency care visits. FN persons live further from emergency facilities than their non-FN counterparts (FN median 6 km, IQR 1-24; vs. non-FN median 4 km, IQR 2-8). FN visits arrive more often by ground ambulance (15.3% vs. 10%). FN visits are more commonly triaged as less acute (59% CTAS levels 4 and 5, compared to non-FN 50.4%). More FN visits end in leaving without completing treatment (6.7% vs. 3.6%). FN visits are more often in the evening – 4:01pm to 12:00am (43.6% vs. 38.1%). Conclusion: In a collaborative validation session, FN Elders and health directors contextualized emergency care presentation in evenings and receiving less acute triage scores as related to difficulties accessing primary care. They explained presentation in evenings, arrival by ambulance, and leaving without completing treatment in terms of issues accessing transport to and from emergency facilities. Many factors interact to determine FN patients’ emergency care visit characteristics and outcomes. Further research needs to separate the impact of FN identity from factors such as reasons for visiting emergency facilities, distance traveled to care, and the size of facility where care is provided.
Legal implications of antibiotic stewardship programs
Authors: Maliha George , Nepps Mary Ellen , Tamma Pranita D , Dodds Ashley Elizabeth , Szymczak Julia E , Kolesar Emma , Hamilton Keith W 
Published: May 2020

AbstractInfectious diseases professional societies, public health agencies, and healthcare regulatory agencies call for antibiotic stewardship programs (ASP) in many healthcare settings. However, medical legal implications of these programs remain largely uncharted territory. Although there is no legal precedent addressing issues of liability and standards of care on this subject, anticipating how the courts may assess questions of medical liability with respect to the various components of ASPs is important to define best practices in ASP operations, not only to manage the potential risk but also to improve patient care. This article seeks to address some of the common processes and interventions involved in antibiotic stewardship and the potential professional liability implications of these activities.
A new geography of civil war: a machine learning approach to measuring the zones of armed conflicts
Authors: Kikuta Kyosuke 
Published: May 2020

AbstractWhere do armed conflicts occur? In applied studies, we may take ad hoc approaches to answer this question. In some regression studies, for instance, a single conflict event can cause an entire province to be classified as a conflict zone. In this paper, I fill this void of knowledge by developing a machine learning method that is less dependent on the areal-unit assumptions and can flexibly estimate conflict zones. I apply the method to a conflict event dataset and create a new dataset of conflict zones. A replication of Daskin and Pringle (2018, Nature 553, 328–332) with the new dataset indicates that the effect of civil war on mammal populations is much smaller than the original estimate.
The Cannero Castle (Italy): Development of Radiocarbon Dating Methodologies in the Framework of the Layered Double Hydroxide Mortars
Authors: Ricci Giulia , Secco Michele , Marzaioli Fabio , Terrasi Filippo , Passariello Isabella , Addis Anna , Lampugnani Paolo , Artioli Gilberto 
Published: May 2020

ABSTRACTThe mortar samples of the Castle of Cannero (Lake Maggiore, Italy) have been characterized and radiocarbon (14C) dated. The presence of LDH phases was identified. The hydraulic reaction was evaluated by a multi-analytical approach. Careful extraction, preparation and purification of the binder fraction have been performed. Contaminations due to LDH phases have been removed allowing reliable absolute dating of the structures.Non-hydraulic lime-based mortars represent only part of the binding materials found in archaeological and historical structures, and a new challenge is the application of 14C dating techniques on mortars that feature hydraulic reactions. This research work aims at 14C dating a series of Mg-rich hydraulic mortars from the Castle of Cannero (Lake Maggiore, Italy), from which both charcoals and mortar samples were collected. A multi-analytical approach employing X-ray powder diffraction (XRPD), optical microscopy (OM), and scanning electron microscopy/energy-dispersive microanalysis (SEM-EDS) was adopted in order to carefully characterize the samples. A wet gravimetric separation for the extraction of the fine fraction mainly composed by the mortar binder was carried out and the binder fraction was characterized by XRPD in order to investigate the presence of contaminants. The binding fractions are characterized by the widespread occurrence of hydrotalcite-type minerals, considered contaminants in 14C dating of mortars because of their capability to exchange carbonate anions even after the hardening process. A further purification treatment by thermal decomposition was performed before 14C dating by AMS. The obtained dates were consistent with archaeological expectations, confirming the potential of the developed purification methodology for hydraulic mortars dating.
State First? A Disaggregation and Empirical Interrogation
Authors: Andersen David , Doucette Jonathan 
Published: May 2020

AbstractThis letter is the first to systematically scrutinize the multifaceted claim that a strong state promotes democratic development. It analyzes new Varieties of Democracy data from 1789 to 2015 to specify and examine eight different versions of this ‘state-first’ argument in analyses that span the entire era of modern democracy. The authors document that high levels of bureaucratic quality at the time of the first democratic transition and during democratic spells are positively associated with democratic survival and deepening. By contrast, state capacity has no robust effects on democratic survival or deepening and does not condition the impact of bureaucratic quality. These findings underline the importance of particular features of a strong state as well as the importance of a disaggregated approach. They imply that democratic development is better aided by strengthening the impartiality of bureaucratic organizations than by building capacity for territorial control.
AN EXTENSION OF A RESULT OF ERDŐS AND ZAREMBA
Authors: WEBER MICHEL JEAN GEORGES 
Published: May 2020

AbstractErdös and Zaremba showed that
$ \limsup_{n\to \infty} \frac{\Phi(n)}{(\log\log n)^2}=e^\gamma$
, γ being Euler’s constant, where
$\Phi(n)=\sum_{d|n} \frac{\log d}{d}$
.We extend this result to the function
$\Psi(n)= \sum_{d|n} \frac{(\log d )(\log\log d)}{d}$
and some other functions. We show that
$ \limsup_{n\to \infty}\, \frac{\Psi(n)}{(\log\log n)^2(\log\log\log n)}\,=\, e^\gamma$
. The proof requires a new approach. As an application, we prove that for any
$\eta>1$
, any finite sequence of reals
$\{c_k, k\in K\}$
,
$\sum_{k,\ell\in K} c_kc_\ell \, \frac{\gcd(k,\ell)^{2}}{k\ell} \le C(\eta) \sum_{\nu\in K} c_\nu^2(\log\log\log \nu)^\eta \Psi(\nu)$
, where C(η) depends on η only. This improves a recent result obtained by the author.
Technological properties of beneficial bacteria from the dairy environment and development of a fermented milk with the beneficial strain Lactobacillus casei MRUV6
Authors: Colombo Monique , Todorov Svetoslav D. , Carvalho Antonio F. , Nero Luís A. 
Published: May 2020

AbstractIn this research paper we describe the technological properties of beneficial lactic acid bacteria (LAB) obtained from a dairy production chain and the development of a fermented milk produced with Lactobacillus casei MRUV6. Fifteen LAB isolates (Lactobacillus sp., Pediococcus sp. and Weissela sp.) presented acidifying abilities (pH ranges from 0.73 to 2.11), were able to produce diacetyl (except by 5 isolates) and exopolysaccharides, and two were proteolytic. L. casei MRUV6 was selected for producing a fermented milk, stored up to 35 d at 4 and 10°C. Counts on MRS agar with added vancomycin (10 mg/l) and MRS agar with added bile salts (1.5% w/v) ranged from 9.7 to 9.9 log CFU/g, independently of the tested conditions, indicating stability and intestinal resistance of L. casei MRUV6, despite some significant differences (P < 0.05). The study demonstrated the technological potential of a potential probiotic candidate strain, L. casei MRUV6, to be used as a starter culture in the dairy industry.
The College Textbook Acquisitions Review
Authors: Rockwood Irving E. 
Published: May 2020

While there is considerable variation among college publishers with respect to the type of projects they are willing to consider, the process by which such projects are evaluated is remarkably similar from house to house. Invariably, that process involves the use of “outside” reviewers to whom proposals being given serious consideration are sent for evaluation. Thus, unlike trade publishers, who rely heavily on their own instincts when considering projects for publication, college textbook publishers seldom publish materials that have not first been reviewed, and by and large approved, by a group of potential adopters.There are two major types of reviews commissioned by textbook publishers: developmental reviews and acquisitions reviews. The former are commissioned after a manuscript has been contracted for publication but before it has actually been published. Developmental reviews are intended to help an author (and publisher) “develop” a manuscript deemed sufficiently promising to warrant publication.
The First Telecasts of Congress
Authors: Swain Susan M. 
Published: May 2020

When C-SPAN began satellite-transmitted telecasts of the U.S. House of Representaives in March 1979, three million cable homes were wired to receive its service. Weekdays, between the hours of 10:00 a.m. and 6:00 p.m. live Congressional debates could be piped into the livingrooms of interested cable subscribers. Four C-SPAN employees labored on the project and when the House was dark, they typed up the text for video billboards that announced their next Congressional telecast.Over the next eight years, C-SPAN grew dramatically. Today, 135 employees work for C-SPAN in fields as diverse as programming, marketing, accounting, and newsletter publication. C-SPAN is on the air 24 hours a day with two channels of public affairs programming. The core of C-SPAN's fare is still the U.S. House debates; C-SPAN II, created in 1986, offers live coverage of Senate debates.
Nebraska Documents and Sources
Authors: Miewald Robert , Sittig Robert 
Published: May 2020

If the American states are political laboratories, then Nebraska has performed its share of experiments, the most impressive, as the following bibliography indicates, being the unicameral, nonpartisan legislature. There are other notable features, also worthy of comparative study. For example, the state is just now ending a sixteen-year trial of setting state sales and income tax rates by members of the executive branch rather than by the legislature. The ways in which Nebraskans resolve their grievances with state administrators, manage their water resources, impeach their public officials, and provide their electrical power are also out of the ordinary.Nebraskans can be unpredictable and the political life of the state continues to bewilder the careful observer. Superficially, it might appear that the turmoil of the early years, from the battles over statehood through the Populist movement, has reached a condition of placidity approaching dullness.
Teaching Political Communications as a Skill
Authors: Kaid Lynda Lee 
Published: May 2020

Undergraduate students in most disciplines hope to gain some practical experience in applying the principles they learn in the classroom. It is sometimes difficult to provide students with such opportunities for practical experience, but courses in political communication offer abundant possibilities of this type.The political communication course described here is entitled “Mass Media and Politics,” and it seeks to blend both theory and research in political campaigns with mass media skills. Although this particular course is taught in the Radio-Television-Film sequence at the University of Oklahoma, it could easily be adapted to political science courses at any university. In addition to providing an integration of political theory and practical experience in politics, the course has several subsidiary goals: (1) to give students a broader understanding of the modern electoral process, (2) to make students better consumers of political information, (3) to make students more aware of the problems and responsibilities involved in direct participation in the electoral process, and (4) to give students an opportunity to apply political organizational and communication skills in a realistic setting.
A Curriculum Guide for Law-Related Education
Authors: Cline Paul C. , Graham P. Tony 
Published: May 2020

Law-related education is experiencing a growing emphasis in school curriculum throughout the American school system. Educators see the need for it though most are not trained specifically in the law. Therefore, they need as much guidance as possible to help them create a curriculum that is relevant for their students.An excellent way to provide this help is through the development of a well-designed curriculum guide. There have been a few guides developed in law-related education in the last few years such as the one produced by the James Madison Institute on Law-Related Education at James Madison University (Curriculum Guide for Law-Related Education in the Secondary Schools of Virginia, copyright Virginia State Bar).
Using a Supplementary Analytical Unit
Authors: Brisbin Richard A. 
Published: May 2020

As part of efforts to assist political science instructors, the American Political Science Association is currently using a grant from the National Science Foundation to develop and field test Supplementary Analytical Units for political science classes. Developed during the past three years, eight units are now being field tested: Hayard R. Alker, Jr. and Roger Hurwitz, Prisoner's Dilemma; John M. Boyle, Public Service Delivery; Phillip T. Gay, Minority-Majority Group Conflict; Stephen R. Lefevre, Technology Politics; Brian Loveman, The Beer Bottle Crisis; Mark Sproule-Jones, Natural Resources Management; Barbara Ann Stolz, Juvenile Delinquency; and Arnold B. Urken, Markets for Votes.This paper reports on the field test of Stephen Lefevre's Technology Politics unit at Saint Mary's College.
Teaching War and Morality
Authors: Lewy Guenter 
Published: May 2020

In the summer of 1979 the Division of Education Programs of the National Endowment for the Humanities sponsored an institute on “War and Morality” at the University of Massachusetts/ Amherst. The institute was attended by 20 college teachers, including nine political scientists, all of whom have since developed courses on “War and Morality” or added material relating to this subject to existing courses on their own campuses. The following essay is a report on the 1979 summer institute and its local follow-up.When in 1949 the United Nations International Law Commission was asked to codify the law dealing with the methods and means of warfare it declined the task for the reason that “war having been outlawed, the regulation of its conduct has ceased to be relevant”.
A Film Review: The Canadian confederation
Authors: Raabe Conrad 
Published: May 2020

The Canadian Confederation is a 1980 National Film Board of Canada release written, directed, and edited by Joan Henson. This technically competent work begins with the establishment of the Canadian political system, and then gives us glimpses of all major facets of that system from village government in Smithfalls to the paramount halls of power in Ottawa. But this is not all. There are minicourses in Canadian constitutionalism, federal-provincial relations, energy policy, regionalism and regional economic planning, and last but not least, ethnology including native peoples packed into this freeze dried smorgasbord.Some themes receive more treatment than others. The perceived dominant theme is diversity. Senator Maurine Lamontagne sets the tone by pointing out that Canada differs from the United States’ melting pot in that Canada is a mosaic, to use John Porter's enduring image.
Public Policy Administration
Authors: Brumback Richard A. 
Published: May 2020

The teaching of an introductory course in American Government can be a difficult and frustrating endeavor under even the best of circumstances. Given the general level of cynicism and/or lack of interest by large numbers of Americans regarding politics and politicians, the task of generating student enthusiasm, or even mild interest, toward the subject matter can indeed be an arduous one. When the teaching of such a course takes place in a business college, and when the student audience is “captive” to a college requirement that all students must take the course, the task can be rendered considerably more formidable.For the past six years I have been teaching such courses at business colleges — one year at Bryant College in Rhode Island, and the following five years at Bentley College in Massachusetts.