bluuebunny/crossref_metadata_2025_split huggingface dataset:
Servir en tant qu’homme. Les stratégies corporelles des employés de l’hôtellerie de luxe
Authors: Beaumont Amélie 
Published: November 2019

Le travail salarié dans les services aux personnes a été construit historiquement comme une activité à la fois socialement dévalorisée et féminine. En explorant les stratégies corporelles d’un groupe d’hommes employés dans un hôtel de luxe où ils travaillent en contact avec la clientèle, cet article vise à comprendre comment ils incarnent et défendent leur position ancillaire en tant qu’hommes. La notion de répertoires de masculinité est utilisée pour analyser les différents registres dans lesquels ils puisent pour maintenir un ascendant alors qu’ils se sentent fragilisés socialement et sur le plan du genre. Deux facettes sont analysées : leur rapport aux femmes dans l’enceinte de l’hôtel, qu’elles soient clientes ou collègues, et la manière dont ils investissent l’esthétique corporelle au travail et à l’extérieur. L’affirmation de leur position dominante dans les rapports sociaux de sexe leur permet de contrebalancer, voire de réduire leur position dominée dans les rapports sociaux de classe.
Comparing Basic Knowledge in Critical Care Nursing Between Nurses From the United States and Nurses From Other Countries
Authors: Toth Jean C. 
Published: November 2019

• Background No previous research was found that compared basic knowledge in critical care nursing among nurses from different nations. Nurses from outside the United States were invited to participate during reliability testing of the Basic Knowledge Assessment Tool, Version 5.• Purpose To compare basic knowledge in critical care between nurses from the United States and nurses from other countries and to measure the reliability of the Basic Knowledge Assessment Tool, Version 5.• Sample Data were collected for 16 months from 682 critical care nurses: 528 from the United States and 154 from other countries.• Results The Basic Knowledge Assessment Tool, Version 5, was a reliable test for all nurses studied, regardless of country of origin. The level of knowledge of nurses from English-speaking countries other than the United States did not differ from that of nurses from the United States. Scores for nurses from non–English-speaking nations were lower than scores for nurses from the United States. The largest source of variance in scores among all subjects was the length of experience in critical care nursing.• Conclusions The Basic Knowledge Assessment Tool, Version 5, is a valid and reliable tool for assessing critical care nurses from the United States and the other countries studied. Critical care nurses from English-speaking countries scored higher than nurses from countries where the primary language is not English.
Collaborative Practice: Development, Implementation, and Evaluation of a Weaning Protocol for Patients Receiving Mechanical Ventilation
Authors: Grap Mary Jo , Strickland Dale , Tormey Laura , Keane Kim , Lubin Shannon , Emerson Joanne , Winfield Suzanne , Dalby Paul , Townes Regina , Sessler Curtis N. 
Published: November 2019

• Background Use of protocols to reduce weaning time for patients receiving mechanical ventilation helps reduce cost and length of stay. However, implementation of this type of protocol is not easy and requires a consistent collaborative effort.• Objective To provide a systematic approach to the weaning process by developing, implementing, and evaluating a protocol for weaning patients from mechanical ventilation in a medical respiratory intensive care unit.• Methods The weaning protocol used was a modification of a protocol developed by Ely et al. Modifications included a more aggressive approach in proceeding to the spontaneous breathing trial, inclusion of the Richmond Agitation-Sedation Scale, and documentation of the production of secretions.• Results Implementation of the protocol significantly reduced the duration of mechanical ventilation as measured by 8-hour shifts and ventilator days. Although length of stay in the intensive care unit was not significantly reduced (P = .29), a continuing downward trend occurred, from a mean of 8.6 days before the protocol was implemented to 7.9 days during the last 6 months of data collection (P = .07).• Conclusions The need to provide efficient care requires the collaboration of all disciplines involved in providing patients’ care. The weaning protocol introduced in this study demonstrates the benefits of using a collaborative team to identify best practices and implement them in a practice setting.
The Link Between Teamwork and Patients’ Outcomes in Intensive Care Units
Authors: Wheelan Susan A. , Burchill Christian N. , Tilin Felice 
Published: November 2019

• Background Links between teamwork and outcomes have been established in a number of fields. Investigations into this link in healthcare have yielded equivocal results.
• Objective To examine the relationship between the level of self-identified teamwork in the intensive care unit and patients’ outcomes.
• Method A total of 394 staff members of 17 intensive care units completed the Group Development Questionnaire and a demographic survey. The questionnaire is a reliable and valid measure of team development and effectiveness. Each unit’s predicted and actual mortality rates for the month in which data were collected were obtained. Pearson product moment correlations and analyses of variance were used to analyze the data.
• Results Staff members of units with mortality rates that were lower than predicted perceived their teams as functioning at higher stages of group development. They perceived their team members as less dependent and more trusting than did staff members of units with mortality rates that were higher than predicted. Staff members of high-performing units also perceived their teams as more structured and organized than did staff members of lower-performing units.
• Conclusions The results of this study and others establish a link between teamwork and patients’ outcomes in intensive care units. The evidence is sufficient to warrant the implementation of strategies designed to improve the level of teamwork and collaboration among staff members in intensive care units.
Time in Bed After Electrophysiological Procedures (TIBS IV): A Pilot Study
Authors: Gianakos Susan , Keeling Arlene W. , Haines David , Haugh Kathryn 
Published: November 2019

• Background Electrophysiological studies of the heart became commonplace in the past decade. Like cardiac catheterizations, electrophysiological studies are often considered “same day” procedures; patients are admitted in the morning, undergo the procedure, recover for several hours while confined to bed, and then are discharged from the hospital. The requisite time in bed varies widely between institutions where electrophysiological studies are performed. Little has been published about the optimal time that patients should remain in bed.• Objective To determine if the requisite time in bed could be safely reduced by 2 hours for patients recovering from electrophysiological studies done via a femoral venous approach.• Methods An experimental-control group design was used. A total of 68 patients were randomized to 2 hours (n = 31) or 4 hours (n = 37) of bed rest. Groups were comparable in age and sex. Both groups were observed for 5 hours after the procedure.• Results The incidence of bleeding did not differ significantly between the experimental and control groups. Bleeding occurred in only 1 patient.• Conclusions The required 4 hours of bed rest after an electrophysiological study done via a femoral vein approach can safely be reduced to 2 hours. Early ambulation has implications for decreasing the cost of nursing care after the procedure and decreasing length of hospital stay, thus optimizing utilization of beds for recovery.
Comparison of Traditional and Disposable Bed Baths in Critically Ill Patients
Authors: Larson Elaine L. , Ciliberti Theresa , Chantler Christopher , Abraham Jolly , Lazaro Editha M. , Venturanza Majella , Pancholi Preeti 
Published: November 2019

• Background For bedridden patients unable to perform personal hygiene measures because of acute illness or chronic debilitation, the bed bath, with either the traditional basin or, more recently, disposable baths, has long been a measure for improving hygiene and comfort.
• Objective To compare the traditional basin bed bath with a prepackaged disposable bed bath in terms of 4 outcomes: time and quality of bath, microbial counts on the skin, nurses’ satisfaction, and costs.
• Methods Forty patients in surgical, medical, or cardiothoracic intensive care units received both types of bath on different days. Baths were observed, timed, and scored for quality. Cultures of the periumbilicus and groin were obtained before and after each bath. At the end of the study, nurses were interviewed about their preferences.
• Results Neither total quality scores nor microbial counts differed significantly between the 2 bath types. Significantly fewer products (P &lt; .001) and less time were used, cost was lower, and nurses’ ratings were significantly better with the disposable bath.
• Conclusion The disposable bath is a desirable form of bathing for patients who are unable to bathe themselves in critical care and long-term care settings, and it may even be preferable to the traditional basin bath.
Clinical Comparison of Automatic, Noninvasive Measurements of Blood Pressure in the Forearm and Upper Arm
Authors: Schell Kathleen , Bradley Elisabeth , Bucher Linda , Seckel Maureen , Lyons Denise , Wakai Sandra , Bartell Deborah , Carson Elizabeth , Chichester Melanie , Foraker Teresa , Simpson Kathleen 
Published: November 2019

• Background When the upper arm (area from shoulder to elbow) is inaccessible and/or a standard-sized blood pressure cuff does not fit, some healthcare workers use the forearm to measure blood pressure.
• Objective To compare automatic noninvasive measurements of blood pressure in the upper arm and forearm.
• Methods A descriptive, correlational comparison study was conducted in the emergency department of a 1071-bed teaching hospital. Subjects were 204 English-speaking patients 6 to 91 years old in medically stable condition who had entered the department on foot or by wheelchair and who had no exclusions to using their left upper extremity. A Welch Allyn Vital Signs 420 series monitor was used to measure blood pressure in the left upper arm and forearm with the subject seated and the upper arm or forearm at heart level.
• Results Pearson r correlation coefficients between measurements in the upper arm and forearm were 0.88 for systolic blood pressure and 0.76 for diastolic blood pressure (P &lt; .001 for both). Mean systolic pressures, but not mean diastolic pressures, in the upper arm and forearm differed significantly (t = 2.07, P = .04). A Bland-Altman analysis indicated that the distances between the mean values and the limits of agreement for the 2 sites ranged from 15 mm Hg (mean arterial pressure) to 18.4 mm Hg (systolic pressure).
• Conclusions Despite strict attention to correct cuff size and placement of the upper arm or forearm at heart level, measurements of blood pressure obtained noninvasively in the arm and forearm of seated patients in stable condition are not interchangeable.
Factors That Enable or Complicate End-of-Life Transitions in Critical Care
Authors: Badger James M. 
Published: November 2019

• Background Nurses in medical intensive care units are routinely involved in negotiations to maintain or withdraw life support. How nurses move from aggressively attempting to extend life to letting life end is not well understood.• Objective To explore nurses’ experiences of moving from cure- to comfort-oriented care and to describe factors that inhibit or facilitate such transitions.• Method A descriptive qualitative research design with brief observation of participants and focus group interviews was used. Participants were 19 female and 5 male nurses in an 18-bed medical intensive care unit in a 719-bed acute care hospital in the northeastern United States.• Results The transition point between cure- and comfort-oriented care was unclear. Nurses reported that the patient’s age, misunderstanding of the illness by the patient’s family, family discord, and shifting medical care decisions made end-of-life transitions difficult. Conversely, developing a consensus among patients, patients’ families, and staff about the direction of medical therapy; exhausting treatment options; and patients’ lack of response to aggressive medical interventions helped nurses move toward comfort care.• Conclusions The most distressing situations for staff were dealing with younger patients with an acute life-threatening illness and performing futile care on elderly patients. End-of-life transitions were difficult when patients’ families had conflicts or were indecisive about terminating treatment and when physicians kept offering options that were unlikely to change patients’ prognosis. The most important factor enabling nurses to move from cure- to comfort-oriented care was developing a consensus about the treatment.
Discriminating Between Right Coronary Artery and Circumflex Artery Occlusion by Using a Noninvasive 18-Lead Electrocardiogram
Authors: Wung Shu-Fen 
Published: November 2019

• Background Differentiating occlusion of the circumflex branch of the left coronary artery (also called the circumflex artery) from occlusion of the right coronary artery is often difficult because either may be associated with a pattern of acute inferior myocardial infarction on the electrocardiogram.
• Objectives To determine if an inexpensive 18-lead electrocardiogram can provide useful information in differentiating sites of coronary occlusion.
• Methods Continuous 18-lead electrocardiograms, including standard 12-lead, right ventricular, and posterior leads, were recorded in 38 and 50 subjects undergoing percutaneous coronary interventions in the right coronary artery and the circumflex artery, respectively.
• ResultsST-segment elevation in the posterior leads was twice as frequent during occlusion of the circumflex artery as during right coronary occlusion (P &lt; .001). ST-segment elevation in the right ventricular leads and inferior leads occurred more often during occlusion of the right coronary artery than during occlusion of the circumflex artery. ST-segment depression in lead aVL is highly suggestive of right coronary occlusion, whereas ST-segment elevation in posterior leads without depression of the ST segment in lead aVL is highly sensitive and specific for occlusion of the circumflex artery.
• Conclusions ST-segment changes in the 18-lead electrocardiogram can be used to differentiate between occlusions of the circumflex artery and occlusions of the right coronary artery. Knowing which vessel is occluded before percutaneous coronary intervention can help in planning the procedure and recognizing when patients are at high risk for disturbances in conduction at the atrioventricular node.
Early Pneumoperitoneum After Percutaneous Endoscopic Gastrostomy in Intensive Care Patients: Sign of Possible Bowel Injury
Authors: Milanchi Siamak , Allins Alexander 
Published: November 2019

• Background Although percutaneous endoscopic gastrostomy may be complicated by iatrogenic bowel injury, most clinicians consider a small pneumoperitoneum on radiographs obtained after the procedure a benign finding of little clinical consequence. The possibility of a relationship between findings of early pneumoperitoneum after percutaneous endoscopic gastrostomy and subsequent iatrogenic bowel injury was examined.• Methods Charts of 85 patients in a surgical intensive care unit who had undergone percutaneous endoscopic gastrostomy between 2000 and 2005 were retrospectively reviewed. All patients had a follow-up upright chest radiograph obtained after percutaneous endoscopic gastrostomy. The charts of 4 patients with radiographs that showed early pneumoperitoneum were reviewed.• Results Findings were clinically significant in 1 of the 4 patients. That patient had a perforated transverse colon that required surgical repair. The other 3 patients had no complications.• Conclusion Pneumoperitoneum after percutaneous endoscopic gastrostomy may be a sign of possible bowel injury and requires further evaluation. It should not be dismissed as benign. Obtaining a chest radiograph after a patient has undergone percutaneous endoscopic gastrostomy is essential.
Foliate Lymphoid Aggregates as Novel Forms of Serous Lymphocyte Entry Sites of Peritoneal B Cells and High-Grade B Cell Lymphomas
Authors: Jia Xinkai , Gábris Fanni , Jacobsen Óli , Bedics Gábor , Botz Bálint , Helyes Zsuzsanna , Kellermayer Zoltán , Vojkovics Dóra , Berta Gergely , Nagy Nándor , Jakus Zoltán , Balogh Péter 
Published: November 2019

Abstract
The cellular homeostasis of lymphoid tissues is determined by the continuous interactions of mobile hematopoietic cells within specialized microenvironments created by sessile stromal cells. In contrast to the lymph nodes and mucosal lymphoid tissues with well-defined entry and exit routes, the movement of leukocytes in the peritoneal cavity is largely unknown. In this study, we report that, in addition to the omental milky spots and fat-associated lymphoid clusters, in mice, the serous surface of the mesenteric adipose streaks contains lymphocyte-rich organoids comprised of a highly compacted leaf-like part connected to the adipose tissue that can also efficiently bind B cells and high-grade B cell lymphoma (diffuse large B cell lymphoma) cells. Denoted as foliate lymphoid aggregates (FLAgs), these structures show incomplete T/B segregation and a partially differentiated stromal architecture. LYVE-1–positive macrophages covering FLAgs efficiently bind i.p. injected normal B cells as well as different types of diffuse large B cell lymphoma cells. Within FLAgs, the lymphocytes compartmentalize according to their chemokine receptor pattern and subsequently migrate toward the mesenteric lymph nodes via the mesenteric lymphatic capillaries. The blood supply of FLAgs includes short vascular segments displaying peripheral lymph node addressin, and the extravasation of lymphocytes to the omental and mesenteric adipose tissues is partly mediated by L-selectin. The appearance of i.p. injected cells in mesenteric lymph nodes suggests that the mesentery-associated lymphatics may also collect leukocytes from the fat-associated lymphoid clusters and FLAgs, thus combining the mucosal and serous exit of mobile leukocytes and increasing the range of drainage sites for the peritoneal expansion of lymphoid malignancies.
Patrolling Monocytes Control NK Cell Expression of Activating and Stimulatory Receptors to Curtail Lung Metastases
Authors: Narasimhan Prakash Babu , Eggert Tobias , Zhu Yanfang Peipei , Marcovecchio Paola , Meyer Melissa A. , Wu Runpei , Hedrick Catherine C. 
Published: November 2019

Abstract
The role of nonclassical, patrolling monocytes in lung tumor metastasis and their functional relationships with other immune cells remain poorly defined. Contributing to these gaps in knowledge is a lack of cellular specificity in commonly used approaches for depleting nonclassical monocytes. To circumvent these limitations and study the role of patrolling monocytes in melanoma metastasis to lungs, we generated C57BL/6J mice in which the Nr4a1 superenhancer E2 subdomain is ablated (E2−/− mice). E2−/− mice lack nonclassical patrolling monocytes but preserve classical monocyte and macrophage numbers and functions. Interestingly, NK cell recruitment and activation were impaired, and metastatic burden was increased in E2−/−mice. E2−/− mice displayed unchanged “educated” (CD11b+CD27+) and “terminally differentiated” (CD11b+CD27−) NK cell frequencies. These perturbations were accompanied by reduced expression of stimulatory receptor Ly49D on educated NK cells and increased expression of inhibitory receptor NKG2A/CD94 on terminally differentiated NK cells. Thus, our work demonstrates that patrolling monocytes play a critical role in preventing lung tumor metastasis via NK cell recruitment and activation.
An Uncommon Presentation of an Uncommon Colonic Neoplasia
Authors: Bodh Vishal , Sharma Rajesh , Sharma Brij 
Published: November 2019

ABSTRACT
Intussusception in adult is a rare clinical entity. The clinical presentation of adult intussusception is often nonspecific. Majority of the cases have been reported as chronic, consistent with partial obstruction. We report a case of a 53‑year‑old male, who presented with chronic diarrhea and vague abdominal discomfort. He was incidentally detected to have colocolic intussusception secondary to colonic lipoma during diagnostic colonoscopy.
Double‑Scope Peroral Endoscopic Myotomy Technique: Light at the End of the Tunnel!
Authors: Bawane Piyush , Mahadevan B. , Jain Mayank , Chenduran S. N. K. , Sridhar C. G. , Ravi R. , Venkataraman Jayanthi 
Published: November 2019

ABSTRACT
Peroral Endoscopic Myotomy has become the preferred therapy for achalasia cardia.An important predictor of the success and safety of this technique remains the correct identification of the Esophago gastric junction and the extent of myotomy. However, this key step may be difficult in a subset of patients. The present case highlights the use of double scope technique to manage such technical issues.
Endoscopic Management of Colonoscopy‑related Perforation
Authors: Khoo Stanley , Chan Wah-Kheong , Mahadeva Sanjiv 
Published: November 2019

ABSTRACT
Colonoscopy‑related perforation is a rare but serious complication. The type of perforation depends on whether it was caused by a diagnostic examination or as a sequelae to a therapeutic procedure. Although traditionally managed by surgery, endoscopic management is increasingly used. This review focuses on the currently available methods of endoscopic management following colonoscopy‑related perforation, together with a brief review of their efficacy. With better development of endoscopic accessories such as through‑the‑scope and over‑the‑scope clips, and increasing experience by endoscopists, it is now recommended that endoscopic management should be the preferred initial treatment modality of colonoscopy‑related perforation.
Gastric Migration of Colonic Self‑expanding Metal Stent: Rare Complication Postcolonic Stenting
Authors: Sundaram Sridhar , Mazumdar Srijan , Patil Prachi , Mehta Shaesta 
Published: November 2019

ABSTRACT
Colonic self‑expanding metal stent (SEMS), although associated with high technical and functional success in malignant colonic obstruction, may be associated with complications such as migration. Furthermore, fistulous tract formation with SEMS in situ has been reported only in few case reports previously. Here, we present a case of colonic SEMS migrating through a gastrocolic fistula into the stomach. There are no previous reports of migration of a colonic SEMS into a proximal segment of the gastrointestinal tract.