bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation, Uptake, and Culture Change: Results of a Key Informant Study of a Workplace Mental Health Training Program in Police Organizations in Canada
Authors: Knaak Stephanie , Luong Dorothy , McLean Robyn , Szeto Andrew , Dobson Keith S. 
Published: May 2019

Background: Organizational characteristics and attributes are critical issues to consider when implementing and evaluating workplace training. This study was a qualitative examination of the organizational context as it pertained to the implementation of a workplace mental health program called Road to Mental Readiness (R2MR) in police organizations in Canada. Methods: We conducted a qualitative key informant study in 9 different policing organizations in Canada. Results: The central theme of “successful cultural uptake” emerged as key to R2MR’s implementation and the ability to facilitate broader culture change. Successful cultural uptake was enabled by several contextual factors, including organizational readiness, strong leadership support, ensuring good group dynamics, credibility of the trainers, implementing widely and thoroughly, and implementing R2MR as one piece of a larger puzzle. Successful cultural uptake was also described as enabling R2MR’s impact for broader cultural change within the organization. This enablement occurred through enhanced dialogue about mental health and the introduction of a common language, a supportive workplace culture, increased help seeking, and organizational momentum for additional mental health programming and policy initiatives. Conclusion: Successful uptake of R2MR has the potential to lead to promote change within policing organizations. The model derived from our research may function as a tool or roadmap to help guide other organizations in the process of or planning to implement R2MR or a similar intervention.
Evaluation of Pharmacist Medication Review Service in an Outpatient Heart Failure Clinic
Authors: Yates Lauren , Valente Megan , Wadsworth Christina 
Published: May 2019

Purpose: The purpose of this study was to evaluate the impact of pharmacist medication reviews on drug-related problems (DRPs) in a population with ambulatory heart failure (HF). Methods: The HF pharmacist medication review service incorporated a comprehensive medication review note provided to the cardiologist in a HF clinic. A retrospective chart review was performed on 64 control patients with no previous pharmacist review and 64 intervention patients who had a pharmacist medication review. The primary end point was the number of DRPs identified per patient in the intervention group 2 weeks after pharmacist medication review compared to the number of DRPs identified per patient in the control group. Results: The average DRPs per patient was reduced from 2.80 to 1.95 in intervention group after pharmacist intervention. There was a statistically significant difference between the average DRPs per patient in the control and intervention groups, 2.55 DRPs versus 1.95 DRPs per patient, respectively ( P = .016). Medication adherence (78%), renal dosing (67%), hypertension (58%), and HF DRPs (55%) had the highest acceptance rate. The majority of DRP recommendations in the intervention (87%) and control groups (87%) were high-impact recommendations. Conclusions: Pharmacist medication reviews in an ambulatory HF clinic lead to significantly fewer DRPs.
Vasoactive Agents for Adult Septic Shock: An Update and Review
Authors: Dalimonte Mark A. , DeGrado Jeremy R. , Anger Kevin E. 
Published: May 2019

Purpose The objective of this article is to discuss the pharmacology, side effects, and clinical application of vasoactive therapy in the management of adult septic shock. Summary Sepsis is one of the most common reasons for admission to an intensive care unit with the incidence estimated to be greater than 750 000 cases per year in the United States. Clinicians should understand the basic pharmacology of available vasoactive agents to allow for routine and complex management of septic shock. Conclusion While advances in research, identification, and early implementation of best practices for the treatment of sepsis has reduced mortality, rates remain high. Vasopressors and inotropes remain part of the core therapeutic modalities of sepsis management. Norepinephrine is the first-line vasopressor of choice for septic shock, though secondary vasopressors can be used depending on the patient’s circumstances.
Racial and Ethnic Differences in Limiting Life-Sustaining Treatment in Trauma Patients
Authors: Hanna Kamil , Palmer James , Castanon Lourdes , Zeeshan Muhammad , Hamidi Mohammad , Kulvatunyou Narong , Gries Lynn , Joseph Bellal 
Published: May 2019

Introduction: Differences in health care between racial and ethnic groups exist. The literature suggests that African Americans and Hispanics prefer more aggressive treatment at the end of life. The aim of this study is to assess racial and ethnic differences in limiting life-sustaining treatment (LLST) after trauma. Study Design: We performed a 2-year (2013-2014) retrospective analysis of Trauma Quality Improvement Program database. Patients with age ≥16 and Injury Severity Score (ISS) ≥ 16 were included. Outcome measures were the incidence and the predictors of LLST. Multivariable logistic regression was performed to control for confounding variables. Results: A total of 97 024 patients were identified. Mean age was 49 (21) years, 68% were male, 68% were white, and 14% were Hispanic. The overall incidence of LLST was 7.2%. Based on race, LLST was selected as consistent with goals of care more often in white when compared to African American individuals who experience serious traumatic injury (8.0% vs 4.5%; P < .001). Based on ethnicity, LLST was more often selected in non-Hispanics (7.5% vs 5.2%, P < .001) when compared to Hispanics. On regression analysis, the independent predictors of LLST were white race (odds ratio [OR]: 2.7 [1.6–4.4], P = .02), non-Hispanic ethnicity (OR: 1.9 [1.4-4.6]; P = .03), severe head injury (OR: 1.7 [1.1-3.2]; P = .04), and ISS (OR: 3.1 [2.4-5.1]; P < .01). Conclusions: Differences exist in selecting LLST between different racial and ethnic groups in severe trauma. African Americans and Hispanics are less likely to select LLST when compared to whites and non-Hispanics. Further studies are required to analyze the factors associated with selecting LLST in African Americans and Hispanics.
Asymmetric semantic interaction in Jedek-Jahai bilinguals: Spatial language in a small-scale, non-standardized, egalitarian, long-term multilingual setting in Malaysia
Authors: Yager Joanne , Gullberg Marianne 
Published: May 2019

Aims and objectives/purpose/research questions: We investigate semantic interaction in bilinguals’ topological relations descriptions in a small-scale, non-standardized, egalitarian, long-term multilingual setting in Malaysia. Design/methodology/approach: Two groups of bilingual speakers of Jedek and Jahai (8 Jedek-identifying, 6 Jahai-identifying bilinguals) and two groups of monolingual Jedek and Jahai speakers (15 Jedek, 3 Jahai speakers) described the Topological Relations Picture Series in a director-matcher task, the bilinguals completing the task in both Jedek and Jahai. Data and analysis: We compare the semantic boundaries of Jedek and Jahai topological relation markers (TRMs) as used by the monolingual and bilingual groups in extension maps and congruence analyses. The analyses focus on the TRM klɛŋ, which is identical in form but semantically different in the two varieties. Findings/conclusions: We find evidence for asymmetric interaction in the expression of topological relations in Jedek and Jahai, with bidirectional influences in the Jahai-identifying bilinguals and a unidirectional influence of Jedek on Jahai in the Jedek-identifying bilinguals. This is commensurate with predictions based on Muysken’s framework of bilingual optimization strategies. Originality: The analyses shed new light on the nature of semantic interaction in bilingual systems by providing evidence from hitherto understudied bilingual language production in small-scale, non-standardized, egalitarian settings. Significance/implications: The results suggest that Muysken’s model is useful for understanding different bilingual outcomes, and highlight the complexity and connectedness of bilingual semantic systems. They also stress the need for more work in a variety of bilingual settings if we are to more fully understand the nature of bilingual systems.
Horizontal acquisition of hydrogen conversion ability and other habitat adaptations in the Hydrogenovibrio strains SP-41 and XCL-2
Authors: Gonnella Giorgio , Adam Nicole , Perner Mirjam 
Published: May 2019

Abstract
Background
Obligate sulfur oxidizing chemolithoauthotrophic strains of Hydrogenovibrio crunogenus have been isolated from multiple hydrothermal vent associated habitats. However, a hydrogenase gene cluster (encoding the hydrogen converting enzyme and its maturation/assembly machinery) detected on the first sequenced H. crunogenus strain (XCL-2) suggested that hydrogen conversion may also play a role in this organism. Yet, numerous experiments have underlined XCL-2’s inability to consume hydrogen under the tested conditions. A recent study showed that the closely related strain SP-41 contains a homolog of the XCL-2 hydrogenase (a group 1b [NiFe]-hydrogenase), but that it can indeed use hydrogen. Hence, the question remained unresolved, why SP-41 is capable of using hydrogen, while XCL-2 is not.

Results
Here, we present the genome sequence of the SP-41 strain and compare it to that of the XCL-2 strain. We show that the chromosome of SP-41 codes for a further hydrogenase gene cluster, including two additional hydrogenases: the first appears to be a group 1d periplasmic membrane-anchored hydrogenase, and the second a group 2b sensory hydrogenase. The region where these genes are located was likely acquired horizontally and exhibits similarity to other Hydrogenovibrio species (H. thermophilus MA2-6 and H. marinus MH-110 T) and other hydrogen oxidizing Proteobacteria (Cupriavidus necator H16 and Ghiorsea bivora TAG-1 T). The genomes of XCL-2 and SP-41 show a strong conservation in gene order. However, several short genomic regions are not contained in the genome of the other strain. These exclusive regions are often associated with signs of DNA mobility, such as genes coding for transposases. They code for transport systems and/or extend the metabolic potential of the strains.

Conclusions
Our results suggest that horizontal gene transfer plays an important role in shaping the genomes of these strains, as a likely mechanism for habitat adaptation, including, but not limited to the transfer of the hydrogen conversion ability.
Leucocyte- and platelet-rich fibrin as a rescue therapy for small-to-medium-sized complex wounds of the lower extremities
Authors: Ozer Kadri , Colak Ozlem 
Published: May 2019

Abstract

Background
Generally, advanced wound care resources are applied for complex wounds that pose a challenge to the medical and nursing teams. In this report, the use of leukocyte- and platelet-rich fibrin (L-PRF) is emphasized for complex wounds as an alternative, simple, inexpensive, time-saving process that does not require hospitalization and has a healing potential over that of bare soft tissue, including bone, tendon, and ligaments. The aim of this study is to extend the use of L-PRF in small-to-moderate-sized complex wounds of lower extremities in which L-PRF maintains the sensitive structures viable.

Methods
Between January 2016 and December 2017, 17 small-to-moderate-sized complex wounds of lower extremities treated with L-PRF were recruited from the plastic and reconstructive surgery clinic in Aydin State Hospital, Turkey. The treatment was administered twice per week in the outpatient clinic. Depending on the size and extension of the complex wound, two to five blood samples were collected into 8.5 ml dry, glass vacuum tubes with no anticoagulant, and samples were immediately centrifuged at 1630×g for 5 min to obtain L-PRF. Complete healing was defined as the day of complete wound epithelialization.

Results
The median values of the initial wound size and wound duration were 12 cm2 (interquartile range, 6 to 23 cm2) and 8 months before first admission (interquartile range, 4 to 18 months), respectively. All wounds showed significant improvements after L-PRF therapy and full closure after a median of 18 months, with an interquartile range of 11 to 34 months of L-PRF applications. There were recurrences of wounds during the first 6 months after therapy. No adverse events were observed.

Conclusions
Our results add to the growing evidence that L-PRF treatments protect and maintain bare soft tissue structures viable, facilitate the formation of granulation tissue and epithelization, and remarkably reduce the need for additional soft tissue surgeries in small-to-medium-sized complex wounds.
Cost of depression among adults in England in 2000
Authors: Thomas Christine M. , Morris Stephen 
Published: May 2019

BackgroundThe cost of depression in the UK was estimated at £33.5 billion almost: adecade ago. The shift to community-based management for depression alongside the availability of more accurate data have allowed these estimates to be revised.AimsTo calculate the total cost of depression in adults in England during 2000.MethodRecorded data on health service use by patients with depression were analysed and the cost of treating patients was calculated. The cost of working life lost was estimated from sickness benefit claims and the number of registered deaths of patients with depression.ResultsThe total cost of adult depression was estimated at over £9 billion, of which £370 million represents direct treatment costs. There were 109.7 million working days lost and 2615 deaths due to depression in 2000.ConclusionsDespite awareness campaigns and the availability of effective treatments, depression remains a considerable burden on both society and the individual, especially in terms of incapacity to work.
Biochemical terrorism: Too awful to contemplate, too serious to ignore
Authors: Alexander David Alan , Klein Susan 
Published: May 2019

BackgroundIt is important not to foster unnecessary public anxiety with regard to the risk of a biochemical terrorist incident, but the authorities need to consider their response strategy, particularly with regard to mental health issues.AimsTo describe the likely effects of a terrorist incident involving biochemical agents and to identify important response issues.MethodLiterature survey.ResultsObservations following conventional terrorist incidents and other major trauma, including biochemical and nuclear accidents, suggest that a biochemical terrorist incident would have widespread public effects. The mental health services should play a major role in designing an effective multi-disciplinary response, particularly with regard to the reduction of public anxiety, identifying at-risk individuals and collaborating with medical and emergency services, as well as providing care for those who develop post-traumatic psychopathology.ConclusionsWe should not feel helpless in the face of a biochemical threat; there is considerable knowledge and experience to be tapped. Awell-designed, well-coordinated and rehearsed strategy based on empirical evidence will do much to reduce public anxiety and increase professional confidence.
Quantitative analysis of sponsorship bias in economic studies of antidepressants
Authors: Baker C. Bruce , Johnsrud Michael T. , Crismon M. Lynn , Rosenheck Robert A. , Woods Scott W. 
Published: May 2019

BackgroundConcern is widespread about potential sponsorship influence on research, especially in pharmacoeconomic studies. Quantitative analysis of possible bias in such studies is limited.AimsTo determine whether there is an association between sponsorship and quantitative outcomes in pharmacoeconomic studies of antidepressants.MethodUsing all identifiable articles with original comparative quantitative cost or cost-effectiveness outcomes for antidepressants, we performed contingency table analyses of study sponsorship and designv. study outcome.ResultsStudies sponsored by selective serotonin reuptake inhibitor (SSR1) manufacturers favoured SSRIs over tricyclic antidepressants more than non-industry-sponsored studies. Studies sponsored by manufacturers of newer antidepressants favoured these drugs more than did non-industry-sponsored studies. Among industry-sponsored studies, modelling studies favoured the sponsor's drug more than did administrative studies. Industry-sponsored modelling studies were more favourable to industry than were non-industry-sponsored ones.ConclusionsPharmacoeconomic studies of antidepressants reveal clear associations of study sponsorship with quantitative outcome.
The Visual Politics of Environmental Justice
Authors: Gabrielson Teena 
Published: May 2019

AbstractThis article examines the visual politics at work in website photographs depicting environmental justice issues in the United States. Based on roughly 580 web-published photos collected from environmental justice organizations, the Environmental Protection Agency, the mainstream media, and traditional environmental organizations in the US, this article examines variations in how the subjects of environmental justice are represented and the potential meaning of these representations for viewers. The article identifies three particular photographic genres that serve as landmarks within the environmental justice visual terrain: the fence-line photo, the portrait, and the protest snapshot. Drawing on the literatures of environmental political theory and black visual culture, I position the photos of contemporary environmental justice within the larger discursive, visual, and political contexts that infuse them with meaning. In interpreting these meanings, I argue that a more inclusive socio-ecological politics requires visual strategies that resist racialized ways of seeing while making visible the injustice of disproportionate environmental impacts on low-income communities and people of color.
The Archive and the Lake
Authors: Tola Miriam 
Published: May 2019

Abstract
Located in the Prenestino neighborhood of Rome, Italy, the former chemical-textile plant Ex-SNIA Viscosa has been a site of labor exploitation, toxicity, and struggle since the 1920s. Comprising postindustrial ruins, an urban lake, and myriad species, the area has been reclaimed by activists engaged in a project of governance from below. This essay begins by exploring how the entwinement of fascist biopolitics and the chemical industry that occurred at the Ex-SNIA from the 1920s to the 1950s affected human and nonhuman bodies. Building on insights from feminist science studies and histories of industrial hazards, the author examines how memories of toxic labor, environmental transformation, and workers’ resistance have been reactivated in the ongoing project of reclaiming the Ex-SNIA and keeping it off-limits from urban speculation. Drawing on archival research, interviews with activists, and sustained attention to the human and nonhuman entities that make up the area, the essay argues that the intimacy with past contestations of labor toxicity is key in the production of the Ex-SNIA as a commons. What has been emerging in Rome, is a cosmopolitical commons that points to the transformation of dominant regimes of property and governance, while also challenging approaches to the commons that rely on the distinction between active human collectives and malleable resources.
Relationship of Foot Strike Pattern and Landing Impacts during a Marathon
Authors: RUDER MATTHEW , JAMISON STEVE T. , TENFORDE ADAM , MULLOY FRANCIS , DAVIS IRENE S. 
Published: May 2019

ABSTRACT

Purpose
Foot strike patterns (FSP) influence landing mechanics, with rearfoot strike (RFS) runners exhibiting higher impact loading than forefoot strike (FFS) runners. The few studies that included midfoot strike (MFS) runners have typically grouped them together with FFS. In addition, most running studies have been conducted in laboratories. Advances in wearable technology now allow the measurement of runners’ mechanics in their natural environment. The purpose of this study was to examine the relationship between FSP and impacts across a marathon race.

Methods
A total of 222 healthy runners (119 males, 103 females; age, 44.1 ± 10.8 yr) running a marathon race were included. A treadmill assessment was undertaken to determine FSP. An ankle-mounted accelerometer recorded tibial shock (TS) over the course of the marathon. TS was compared between RFS, MFS, and FFS. Correlations between speed and impacts were examined between FSP. TS was also compared at the 10- and 40-km race points.

Results
RFS and MFS runners exhibited similar TS (12.24g ± 3.59g vs 11.82g ± 2.68g, P = 0.46) that was significantly higher (P < 0.001 and P < 0.01, respectively) than FFS runners (9.88g ± 2.51g). In addition, TS increased with speed for both RFS (r = 0.54, P = 0.01) and MFS (r = 0.42, P = 0.02) runners, but not FFS (r = 0.05, P = 0.83). Finally, both speed (P < 0.001) and TS (P < 0.001) were reduced between the 10- and the 40-km race points. However, when normalized for speed, TS was not different (P = 0.84).

Conclusions
RFS and MFS exhibit higher TS than FFS. In addition, RFS and MFS increase TS with speed, whereas FFS do not. These results suggest that the impact loading of MFS is more like RFS than FFS. Finally, TS, when normalized for speed, is similar between the beginning and the end of the race.
On pump harvesting of Left Internal Mammary Artery (LIMA) in unstable patients undergoing coronary artery bypass grafting (CABG) is a safe operative strategy: A pilot study
Authors: Sher-i-Murtaza Muhammad , Baig Mirza Ahmad Raza 
Published: May 2019

Objective: To evaluate the clinical safety of left internal mammary artery (LIMA) harvesting in hemodynamically unstable patients after establishing cardiopulmonary bypass (CPB) in isolated coronary artery bypass graft (CABG) surgery.
Methods: The prospective observational study was conducted at Chaudhry Pervaiz Elahi Institute of Cardiology, Multan, Pakistan, from December 2016 to August 2018. All patients undergoing isolated CABG surgery in which LIMA conduit was harvested after establishing cardiopulmonary bypass because of hemodynamic instability at induction of anaesthesia or during surgery were included in the study. Preoperative, operative and postoperative characteristics of the patients were recorded. Data was analyzed using SPSS 19.
Results: In Forty nine patients including 39 male and 10 female, early CPB had to be established because of hemodynamic instability and afterwards LIMA was harvested. Out of 49, 30 patients presented with CCS class III angina. 37 (75.5%) patients were scheduled on elective coronary surgery waiting list. There were 39 (79.59%) patients who weaned off bypass on mild inotropic support and 4 (8.16%) patients needed IABP support. All patients had multi-vessel coronary artery disease. Mean number of grafts were 3.428±0.577, CPB time was 110.59±25.594 and hospital stay was 5.367±1.424.
Conclusions: The study showed that LIMA can be safely harvested in unstable patients after establishing extracorporeal circulation and by using this operative strategy in patients who need urgent or emergent surgical coronary revascularization LIMA can be safely used as a conduit.
doi: https://doi.org/10.12669/pjms.35.3.988
How to cite this:Sher-i-Murtaza M, Baig MAR. On pump harvesting of Left Internal Mammary Artery (LIMA) in unstable patients undergoing coronary artery bypass grafting (CABG) is a safe operative strategy: A pilot study. Pak J Med Sci. 2019;35(3):605-608. doi: https://doi.org/10.12669/pjms.35.3.988
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