bluuebunny/crossref_metadata_2025_split huggingface dataset:
INTERNATIONAL VISITOR EXPERIENCE LEVEL IN URBAN DESTINATIONS IN NAIROBI COUNTY, KENYA
Authors: Mwangi Muhoro Grieveesbon , Eunice Kibiro 
Published: January 2019

The purpose of this research was to examine empirically the international visitor experiences while in urban destinations Nairobi County, Kenya.
Methodology: The research hypothesis was constructed based on previous theoretical and empirical studies. A survey was conducted on 231 departing visitors to collect primary data from January to June 2017. Pearson product-moment correlation coefficient was used to measure the linear correlation between international visitor experiences and urban destinations.
Main findings: The results found out that visitor experience levels have direct positive influence on visitors’ visitation to Nairobi’s urban tourist attractions and thus directly influenced their return intention through their destination satisfaction process.
Implications: Destination managers and tourism organizations particularly service organizations need to take into account of the satisfaction levels and the level of experience of urban visitors to enhance their revisits.
Novelty: The findings of this research have provided to the understanding of valuable practical information about visitors experiences while in urban destinations. This information could be used in promotional strategies, product development, and urban planning frameworks should be geared to meet destination demand and sustainable urban tourism development.
ANALYSIS AND APPLICATION OF TOURISM COMPETITIVE MODELS TO TOURISM DESTINATIONS
Authors: Jackson Saidi Wasi 
Published: January 2019

The article discusses and evaluates theories and models of tourism competitiveness particularly those of Crouch and Ritchie (1999), Dwyer and Kim (2003) and World Economic Forum (2018). Wiklund, J., & Shepherd, D. (2005) the models enable and tries to enlighten more on how they facilitate the understanding and application of tourism competitiveness. World Travel and Tourism Council (2018) competitiveness in the travel and tourism industry is widely preached however, there is no uniform understanding and application of the concepts of competitiveness (Andrades-Caldito L Sánchez-Rivero, M. & Pulido-Fernández J. 2013).
World Travel and Tourism Council (2018) evidently, there are many competitive variations among the top and advanced tourism destinations in the world. Austria is on position one in tourism infrastructural and products competitiveness, France is number one on tourists' visitations but the United States of America and China is number one on receipts/income realized from tourism.
This clearly shows that if the models were perfect and uniformly applied then only one destination could have been number one in all aspects of visitation, infrastructural development, and income generated from the tourism industry. This clearly shows that there is a need for fresh research and development of the models to suffice the variations in the situation. The analysis, evaluation, and comparison of models is based on the research methodology, application (practice), variables used, assumptions and generalizations
Comparative Study of the Effects of Different Fractions of Ficus Exasperata Vahl on Rat Hepatic Mitochondrial Membrane Permeability Transition Pore
Authors: Ehigie Adeola F. , Nwaechefu Olajumoke O. , Anyasor Godswill N. , Oyelere Faith S. , Sangodipe Tosin S. , Ehigie Leonard O. 
Published: January 2019

A number of phytochemicals have been established as potent inducers of the mitochondrial membrane permeability transition (MMPT) pore, a transient structure formed in the inner mitochondrial membrane (IMM). There is however no information on the effect of Ficus exasperata (F. exasperata) a popular medicinal plant, on this pore, necessitating this investigation. The in vitro effects of varying concentrations (200, 400, 600, 800 and 1000µg/ml) of the methanol, n-hexane and ethylacetate fractions of leaf and stem of F. exasperata on MMPT pore opening in experimental rat liver were assessed. Opening of MMPT pore was spectrophotometrically assayed under succinate-energized condition using a modified method of Lapidus and Sokolove, 1993<sup>[34]</sup>. The results obtained for the Stem Methanol Fraction (SMF) and Leaf Methanol Fraction (LMF) show significant (P&lt; 0.05) increases in the extents to which MMPT pore opening was induced at all concentrations compared with the control group, with the highest induction observed at 400µg/ml and the least seen at 1000µg/ml. The inductive effects of Leaf n-hexane Fraction (LHF) and Stem n-hexane Fraction (SHF) increased as concentration increased such that the highest induction observed in LHF and SHF were 2.80 and 2.28 fold increases respectively. Leaf Ethylacetate Fraction (LEF) and Stem Ethylacetate Fraction (SEF) of F. exasperata also show a concentration-dependent effect such that the inductive effect decreased as concentration increased i.e. at 200µg/ml of LEF and SEF, 3.97 and 4.25-fold increases were achieved respectively while the least folds in induction were observed at 1000µg/ml for both at 2.0-fold and 1.97-fold respectively. Taken together, all tested fractions of F. exasperata have significant P &lt; 0.05 inductive effect on the MMPT pore opening at all tested concentrations, the most potent fraction being the SEF. We thus conclude that F. exasperata is an effective inducer of the MMPT pore, albeit, different fractions derived from different parts vary in their potency. Also, F. exasperata could find a great use in the treatment of ailments dependent on the induction of the mitochondrial membrane permeability transition pore opening.
Behavioral Interventions Using Consumer Information Technology as Tools to Advance Health Equity
Authors: Bakken Suzanne , Marden Sue , Arteaga S. Sonia , Grossman Lisa , Keselman Alla , Le Phuong-Tu , Creber Ruth Masterson , Powell-Wiley Tiffany M. , Schnall Rebecca , Tabor Derrick , Das Rina , Farhat Tilda 
Published: January 2019

The digital divide related to consumer information technologies (CITs) has diminished, thus increasing the potential to use CITs to overcome barriers of access to health interventions as well as to deliver interventions situated in the context of daily lives. However, the evidence base regarding the use and impact of CIT-enabled interventions in health disparity populations lags behind that for the general population. Literature and case examples are summarized to demonstrate the use of mHealth, telehealth, and social media as behavioral intervention platforms in health disparity populations, identify challenges to achieving their use, describe strategies for overcoming the challenges, and recommend future directions. The evidence base is emerging. However, challenges in design, implementation, and evaluation must be addressed for the promise to be fulfilled. Future directions include (1) improved design methods, (2) enhanced research reporting, (3) advancement of multilevel interventions, (4) rigorous evaluation, (5) efforts to address privacy concerns, and (6) inclusive design and implementation decisions.
Screw Fixation Versus Hemiarthroplasty for Nondisplaced Femoral Neck Fractures in Elderly Patients
Authors: Dolatowski Filip C. , Frihagen Frede , Bartels Stefan , Opland Vidar , Šaltytė Benth Jūratė , Talsnes Ove , Hoelsbrekken Sigurd Erik , Utvåg Stein Erik 
Published: January 2019

Background:
Elderly patients with a displaced femoral neck fracture treated with hip arthroplasty may have better function than those treated with internal fixation. We hypothesized that hemiarthroplasty would be superior to screw fixation with regard to hip function, mobility, pain, quality of life, and the risk of a reoperation in elderly patients with a nondisplaced femoral neck fracture.

Methods:
In a multicenter randomized controlled trial (RCT), Norwegian patients ≥70 years of age with a nondisplaced (valgus impacted or truly nondisplaced) femoral neck fracture were allocated to screw fixation or hemiarthroplasty. Assessors blinded to the type of treatment evaluated hip function with the Harris hip score (HHS) as the primary outcome as well as on the basis of mobility assessed with the timed “Up & Go” (TUG) test, pain as assessed on a numerical rating scale, and quality of life as assessed with the EuroQol-5 Dimension-3 Level (EQ-5D) at 3, 12, and 24 months postsurgery. Results, including reoperations, were assessed with intention-to-treat analysis.

Results:
Between February 6, 2012, and February 6, 2015, 111 patients were allocated to screw fixation and 108, to hemiarthroplasty. At the time of follow-up, there was no significant difference in hip function between the screw fixation and hemiarthroplasty groups, with a 24-month HHS (and standard deviation) of 74 ± 19 and 76 ± 17, respectively, and an adjusted mean difference of −2 (95% confidence interval [CI] = −6 to 3; p = 0.499). Patients allocated to hemiarthroplasty were more mobile than those allocated to screw fixation (24-month TUG = 16.6 ± 9.5 versus 20.4 ± 12.8 seconds; adjusted mean difference = 6.2 seconds [95% CI = 1.9 to 10.5 seconds]; p = 0.004). Furthermore, screw fixation was a risk factor for a major reoperation, which was performed in 20% (22) of 110 patients who underwent screw fixation versus 5% (5) of 108 who underwent hemiarthroplasty (relative risk reduction [RRR] = 3.3 [95% CI = 0.7 to 10.0]; number needed to harm [NNH] = 6.5; p = 0.002). The 24-month mortality rate was 36% (40 of 111) for patients allocated to internal fixation and 26% (28 of 108) for those allocated to hemiarthroplasty (RRR = 0.4 [95% CI = −0.1 to 1.1]; p = 0.11). Two patients were lost to follow-up.

Conclusions:
In this multicenter RCT, hemiarthroplasty was not found to be superior to screw fixation in reestablishing hip function as measured by the HHS (the primary outcome). However, hemiarthroplasty led to improved mobility and fewer major reoperations. The findings suggest that certain elderly patients with a nondisplaced femoral neck fracture may benefit from being treated with a latest-generation hemiarthroplasty rather than screw fixation.

Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Postoperative Pain and Opioid Use in Children with Supracondylar Humeral Fractures
Authors: Nelson Susan E. , Adams Alexander J. , Buczek Matthew J. , Anthony Chris A. , Shah Apurva S. 
Published: January 2019

Background:
Effective postoperative analgesia remains a priority in orthopaedic surgery, but concerns with regard to opioid diversion and misuse have brought overdue attention to improving opioid stewardship. Normative data for postoperative pain and opioid use are needed to guide and balance these dual priorities. We aimed to characterize postoperative pain and opioid use for an archetypal pediatric orthopaedic procedure: closed reduction and percutaneous pinning of a supracondylar humeral fracture.

Methods:
Children at a single pediatric trauma center who underwent closed reduction and percutaneous pinning of a supracondylar humeral fracture were enrolled and were prospectively followed. Validated pain scores (Wong-Baker FACES Pain Rating Scale) and opioid utilization data were collected using an automated text message-based protocol on postoperative days 1 to 7, 10, 14, and 21. Data were analyzed with descriptive and univariate statistics.

Results:
Eighty-one patients with a mean age (and standard deviation) of 6.1 ± 2.1 years (62% of whom were male) were enrolled, including 53.1% who had Type-II fractures and 46.9% who had Type-III fractures. The mean pain ratings were highest on arrival to the emergency department (3.5 ± 3.5 points) and the morning of postoperative day 1 (3.5 ± 2.4 points). By postoperative day 3, the mean pain rating decreased to <2 (1.8 ± 1.8 points) and the mean opioid doses decreased to <1 dose (0.8 ± 1.2 doses). Postoperative opioid use decreased in parallel to reported pain (r = 0.972; p < 0.001). The interquartile range of opioid use was 1 to 7 doses, and patients used only 24.1% of the prescribed opioids (mean, 4.8 ± 5.6 doses used and 19.8 ± 7.1 doses prescribed). There was no significant difference (p > 0.05) in pain ratings or opioid use by fracture classification, age, or sex.

Conclusions:
Following closed reduction and percutaneous pinning for supracondylar humeral fracture, pain levels and opioid usage decrease to a clinically unimportant level by postoperative day 3. Patients who report pain scores of ≥6 points following discharge are outliers and should be screened for compartment syndrome or ischemia. Patients used <25% of prescribed opioid medication, suggesting the potential for overprescription and opioid diversion. A prescription for 7 opioid doses after discharge should allow adequate postoperative analgesia in the majority of patients while improving narcotic stewardship.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
What’s New in Adult Reconstructive Knee Surgery
Authors: Taunton Michael J. 
Published: January 2019

Update
This article was updated on February 6, 2019, because of a previous error. On page 105, in the subsection titled “Outcomes and Design” the sentence that had read “Furthermore, in a retrospective review, Houdek et al.48, at a mean follow-up of 8 years, demonstrated improved survivorship of 9,999 metal-backed compared with 1,645 all-polyethylene tibial components, over all age groups and most BMI categories” now reads “Furthermore, in a retrospective review, Houdek et al.48, at a mean follow-up of 8 years, demonstrated inferior survivorship of 9,999 metal-backed compared with 1,645 all-polyethylene tibial components, over all age groups and most BMI categories.”
An erratum has been published: J Bone Joint Surg Am. 2019 Mar 20;101(6):e26.
Dimensional variations of left-sided double-lumen endobronchial tubes: an observational study
Authors: Hegland Niels , Schnitzler Sebastian , Ellensohn Jan , Steurer Marc P , Weiss Markus , Dullenkopf Alexander 
Published: January 2019

Abstract
Background: Tube size selection is critical in ventilating patient`s lungs using double-lumen endobronchial tubes. Little information about relevant parameters is readily available from manufacturers.
Methods: In this observational study in a benchmark in-vitro setup, several dimensional parameters of four sizes of left-sided double-lumen endobronchial tubes from six different manufacturers were assessed, such as distances and diameters of tube shaft, cuff lengths and diameters as well the angle at the tip.
Results: Endobronchial tubes of ostensibly the same size revealed wide variation in measured parameters between brands from different manufacturers. In some parameters, there was an overlap between different sizes from the same manufacturer, i.e. diameters and distances did not increase with increasing nominal endobronchial tube size. The information about dimensions of endobronchial tubes provided by manufacturers’ leaflets is insufficient.
Conclusions: Endobronchial tube size selection is complicated because clinically relevant parameters are unknown and vary considerably between different manufacturers.
Keywords: Airway management, double-lumen endobronchial tubes
Estimation of costs for monitoring urban water and wastewater networks
Authors: Cabral Marta , Loureiro Dália , Almeida Maria do Céu , Covas Dídia 
Published: January 2019

Abstract
In many water distribution systems, water losses are a major problem and an integrated management strategy is required for both the efficient use of water resources and the minimisation of non-revenue water. For foul sewer systems, the inflow of stormwater and infiltration of groundwater affects the management of both sewer systems and wastewater treatment plants. Monitoring of flows represents a critical task within approaches for control of either water losses in distribution systems and infiltration and rain-induced inflows in foul systems. Implementation of monitoring typically involves the following steps: (i) system information updating and digital mapping; (ii) system zoning; and (iii) system flow monitoring. Costs for monitoring are essential for utilities to estimate more accurately the costs of control of water losses, infiltration and inflow and to support more robust decision-making. Costs and infrastructure data were collected from 20 Portuguese water and wastewater utilities. Multiple linear regression analysis is used to obtain cost functions for meter chambers as a function of the volume and for purchase and installation of flow meters as a function of nominal diameter in water supply systems. For the steps of system information updating, digital mapping and system zoning single unit costs are estimated.
Service Use History of Individuals Enrolling in a Web-Based Suicidal Ideation Treatment Trial: Analysis of Baseline Data
Authors: Wong Quincy JJ , Werner-Seidler Aliza , Torok Michelle , van Spijker Bregje , Calear Alison L , Christensen Helen 
Published: January 2019

Background
A significant recent innovation is the development of internet-based psychological treatments for suicidal thinking. However, we know very little about individuals experiencing suicidal ideation who seek help through Web-based services and, in particular, their previous health service use patterns.

Objective
We aimed to examine service use history and its correlates among adults experiencing suicidal ideation who enrolled in a Web-based suicidal ideation treatment trial.

Methods
We used baseline data of 418 individuals seeking Web-based treatment for their suicidal ideation recruited into a randomized controlled trial of a 6-week Web-based self-help program. Participants at preintervention reported demographic information, clinical characteristics, and health service use over the previous 6 months.

Results
Participants had a high rate of service use in the 6 months before enrolling in the treatment trial (404/418, 96.7% of participants had contact with services). The two most common contact points were general practitioners (385/418, 92.1% of participants) and mental health professionals (295/418, 70.6% of participants). Notably, those with a previous single suicide attempt had lower odds of contact with any service than those with no attempt (odds ratio [OR] 0.21, 95% CI 0.05-0.86; P=.03). Those living in rural or remote areas had lower odds of contacting general practitioners (OR 0.35, 95% CI 0.13-0.91; P=.03) or mental health professionals (OR 0.44, 95% CI 0.23-0.83; P=.01) than those living in metropolitan areas.

Conclusions
Individuals enrolling in an electronic health intervention trial have often received treatment from general practitioners or mental health professionals. These services can therefore play an important role in preventing the escalation of suicidal thinking. Enrollment in our Web-based treatment trial suggested, though, that face-to-face health services may not be enough. Our study also highlighted the need to improve the provision of coordinated and assertive care after a suicide attempt, as well as health service availability and utilization for those living in rural and remote areas.

Trial Registration
Australian New Zealand Clinical Trials Registry ACTRN12613000410752; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364016 (Archived by WebCite at http://www.webcitation.org/6vK5FvQXy); Universal Trial Number U1111-1141-6595
Fatores direcionadores da cooperação de pequenas e médias empresas com a universidade: evidências a partir de quatro estudos de caso
Authors: Oliveira Vanessa Parreiras , Garcia Renato De Castro , Bacic Miguel Juan 
Published: January 2019

Este artigo traz novos elementos para a temática da cooperação entre universidades e institutos de pesquisa e empresas por meio da investigação dos fatores direcionadores (drivers) dos relacionamentos cooperativos de pequenas e médias empresas. Para isso, explora os resultados de quatro estudos de caso de relacionamentos cooperativos de pequenas empresas com universidadese institutos de pesquisa no Brasil, os quais mostram que a capacidade de absorção da empresa, a existência de vínculos prévios e as proximidades geográfica e cognitiva entre os agentes são importantes fatores direcionadores do estabelecimento e do desenvolvimento das relações de colaboração.Ademais, evidenciam que a elevada capacidade de absorção da empresa e a proximidade cognitiva entre os agentes podem estimular o estabelecimento de relações de cooperação a maiores distâncias geográficas. Os resultados mostram, ainda, a importância do acesso ao financiamento público para a cooperação, especialmente quando compreendem maior complexidade e risco.
Studi Kelayakan Inaportnet dan Strategi Pengembangan e-business di Pelabuhan Makassar
Authors: Kurniawan Abdi , Seminar Kudang Boro , Iskandar Budhi Hascaryo , Nasution Syahrial 
Published: January 2019

ABSTRAKPelabuhan Makassar merupakan salah satu pelabuhan utama di Indonesia yang berfungsi sebagai salah satu mata rantai yang ada dalam jaringan distribusi barang untuk menunjang pertumbuhan ekonomi di Indonesia Timur dengan memfasilitasi perdagangan antar pulau hingga kegiatan ekspor dan impor. Peningkatan produktifitas pelabuhan perlu diimbangi dengan upaya peningkatan pelayanan, salah satu diantaranya adalah pelayanan dokumen untuk kapal dan barang melalui teknologi informasi. Inaportnet merupakan sebuah portal online yang mampu melayani pengajuan dan pengolahan data serta informasi, pengambilan keputusan penyelesaian dokumen kepabeanan, dan kepelabuhanan secara terpadu dengan prinsip kesatuan, kecepatan pelayanan, konsisten, sederhana, transparan, efisien dan berkelanjutan. Sebagai sebuah proyek yang berskala besar, Inaportnet perlu dinilai kelayakannya karena sebuah studi kelayakan bukan hanya merupakan sebuah dasar pengambilan keputusan terhadap kelanjutan proyek tetapi juga merupakan sebuah persyaratan kelengkapan secara administratif. Kajian ini berfungsi untuk menilai kelayakan penggunaan Inaportnet di Pelabuhan Makassar dari berbagai perspektif serta merumuskan strategi pengembangan e-business di pelabuhan Makassar. Penelitian ini bersifat deskriptif kuantitatif melalui analisis TELOS untuk menentukan kelayakan proyek dan dilanjutkan dengan SWOT untuk perumusan strategi penerapan e-business. Hasil penelitian menunjukkan secara umum bahwa Inaportnet layak untuk diterapkan meskipun terdapat beberapa hambatan terutama dari aspek teknis, ekonomi, legal, operasional, dan penjadwalan. Strategi pengembangan e-business di Pelabuhan Makassar dilakukan melalui konsep Port Community System.