bluuebunny/crossref_metadata_2025_split huggingface dataset:
Discursive strategies and change
Authors: Lux Julia 
Published: January 2019

AbstractIn times of crisis, comparative capitalism analysis has difficulties differentiating crisis symptoms and effects from trends that may be more long-term. In this paper, I propose that by looking at the discursive strategies of central actors within the political economy, we may improve our understanding of capitalist trajectories. Drawing on Regulation Theory and Gramsci, the main empirical argument is that the French accumulation regime and its regulation are changing to a more explicitly export-oriented and financialised capitalism. This is underscored by the political project of capital-friendly austerity corresponding to a shift in the relationship of forces, the establishment of a neoliberal understanding of competitiveness, and the fading-out of purchasing power. The theoretical contribution of the paper is to integrate more closely critical discourse analysis with a critical political economy perspective.
Technology and second language pronunciation
Authors: Levis John M. 
Published: January 2019

Abstract
This issue addresses the intersection of technology and pronunciation, discussing past, current and future uses of technology, the
use of technology for researching L2 pronunciation, for training instructors, and for teaching learners. Technology is put forth
as an essential and interconnected element of second language pronunciation. The topic grew out of the 8th Pronunciation in Second
Language Learning and Teaching conference, held in August 2016 in Calgary, Alberta.
High Variability [Pronunciation] Training (HVPT)
Authors: Thomson Ron I. 
Published: January 2019

AbstractThis article is a critical research synthesis of 32 studies that used the High Variability Phonetic Training (HVPT) technique to teach learners to better perceive and produce L2 sounds. Taken together, the studies surveyed provide compelling evidence that HVPT is a very effective pronunciation training tool, and that resulting improvement is long-lasting. The analysis of this research also helps to explain why very few teachers have heard of this empirically-driven approach to pronunciation instruction: HVPT studies are largely published in technically oriented journals; few are accessible to language teachers. A variety of obstacles to the widespread use of HVPT are discussed, and some possible solutions are provided.
Plenary talk
Authors: Levis John M. 
Published: January 2019

AbstractSecond language pronunciation is undergoing dramatic changes in research visibility, in the intelligibility-centered goals that drive the field, and in the ways that technology is being deployed to address new needs. This plenary delineates problems that face the field as it has grown. I suggest the reasons that technology must be a critical part of the future of L2 pronunciation and the ways in which technology use can help to address problems facing future growth. These reasons include providing the support teachers need, individualizing instruction, providing ways to ensure that intelligibility-based instruction adheres to effective goals, combining information in unusual and innovative ways, taking advantage of multi-modality in instruction and delivering varied types of feedback, and researching pronunciation learning and teaching processes.
Breeding of a cordycepin-resistant and adenosine kinase-deficient sake yeast strain that accumulates high levels of S-adenosylmethionine
Authors: Kanai Muneyoshi , Yasuda Norito , Morimoto Tomoko , Yoshida Satoko , Nishibori Nahoko , Mizunuma Masaki , Fujii Tsutomu , Iefuji Haruyuki 
Published: January 2019

ABSTRACT
Adenosine kinase (ADO1)-deficient mutants can be obtained from cordycepin-resistant strains, and the disruption of ADO1 causes S-adenosylmethionine (SAM) accumulation. To breed a high-SAM-accumulating yeast strain without genetic manipulation for industrial purposes, we bred a cordycepin-resistant strain using sake yeast kyokai No. 9 as the parent strain with a mutation in adenosine kinase (ADO1) and acquired high-SAM-accumulating strain. In the bred strain (NY9-10), a single mutation (T258I) was present in the ADO1, and this mutation site is an ATP binding site and is highly conserved during evolution. Moreover, it was suggested that high accumulation of SAM and cordycepin resistance in NY9-10 was due to functional deficiency of ADO1 by this mutation. This strain is not a genetically-modified organism and can be employed for use in the food and medicine industry such as mass production and sake making.
Raman spectroscopy as a quick tool to assess purity of extracellular vesicle preparations and predict their functionality
Authors: Gualerzi Alice , Kooijmans Sander Alexander Antonius , Niada Stefania , Picciolini Silvia , Brini Anna Teresa , Camussi Giovanni , Bedoni Marzia 
Published: January 2019

ABSTRACTExtracellular vesicles (EVs) from a variety of stem cell sources are believed to harbour regenerative capacity, which may be exploited for therapeutic purposes. Because of EV interaction with other soluble secreted factors, EV activity may depend on the employed purification method, which limits cross‐study comparisons and therapeutic development. Raman spectroscopy (RS) is a quick and easy method to assess EV purity and composition, giving in‐depth biochemical overview on EV preparation. Hereby, we show how this method can be used to characterise EVs isolated from human liver stem cells and bone marrow mesenchymal stem/stromal cells by means of conventional ultracentrifugation (UC) and size exclusion chromatography (SEC) protocols. The obtained EV preparations were demonstrated to be characterised by different degrees of purity and a specific Raman fingerprint that represents both the cell source and the isolation procedure used. Moreover, RS provided useful hints to explore the factors underlying the functional diversity of EV preparations from the same cell source, thus representing a valuable tool to assess EV quality prior to functional assays or therapeutic application.
Contraindications, Risks, and Safety Precautions for Stress Testing
Authors: Thomas Gregory S. , Ellestad Myrvin H. 
Published: January 2019

Abstract
The chapter Contraindications, Risks, and Safety Precautions for Exercise Testing details the absolute and relative contraindications to exercise testing. A common contraindication is exercise testing within 48 hours of a myocardial infarction (MI). Indications for termination the exercise test are reviewed to maximize patient safety and include development of moderate angina, a progressive decrease in systolic blood pressure with continued exercise, ≥1 ST segment elevation in an electrocardiographic lead without Q waves, and generally if a patient develops a ≥2 mm increase in ST depression from baseline. The mortality rate for exercise testing approximates 0.3 per 10,000 (0.03%).
Rhythm and Conduction Disturbances in Stress Testing
Authors: Thomas Gregory S. , Balouch Maryam 
Published: January 2019

Abstract
The chapter Rhythm and Conduction Disturbances in Stress Testing reviews the frequency and significance of arrhythmias and conduction abnormalities precipitated by exercise. Case examples are provided. PVCs occurring prior to, during exercise, or during recovery all modestly increase the risk of all-cause mortality in patients with and without known coronary artery disease (CAD). Ventricular tachycardia and premature ventricular complexes are often not reproducible on a subsequent exercise test. Exercise induced left bundle branch block (LBBB) predicts increased risk of the presence of CAD, all cause mortality, and often permanent LBBB. Differentiating wide complex tachycardia during exercise testing between supraventricular tachycardia and ventricular tachycardia can be challenging. The Wellens, Brugada, and Vereckei algorithms to distinguish between these arrhythmias are detailed and compared.
Assessing Patient State and Efficacy
Authors: Cravero Joseph P. 
Published: January 2019

Abstract
Pediatric procedural sedation is required for a wide variety of interventions ranging from nonstimulating imaging procedures to painful minor surgeries and other tests. The measurement of how well a given sedation strategy has met the requirements for a procedure is not well codified by simply noting the depth of sedation provided. Patients may be deeply sedated but thrashing about during a painful procedure, and they may be almost awake and perfectly tolerating a minor procedure. Procedural sedation must be measured using a rubric that appreciates the “state” of the patient and qualifies his or her movement, stress, pain, and safety at any specific time point during the procedure. The ability to control these factors and provide an acceptable state for the patient and the proceduralist should be the standard for measuring the quality of sedation provision for children.
Sedation Effects
Authors: Landrigan-Ossar Mary , Vanderhoek Samuel 
Published: January 2019

Abstract
In order to safely provide sedation, the practitioner must have a complete understanding of the range of effects of the medication regimens. While these drugs provide anxiolysis, hypnosis and analgesia, these actions come at a price. Sedatives and analgesics have specific, generally depressive effects on the central nervous control of respiratory drive. Peripherally they act on the control and tone of airway musculature and depress airway reflexes. These actions vary according to class of drug and may act in synergy. This section will review some of the common effects on the airway of most sedation medications. A brief discussion of patients with special airway considerations is also included.
Techniques for Managing the Airway
Authors: Landrigan-Ossar Mary , Vanderhoek Samuel 
Published: January 2019

Abstract
Most if not all sedation medications negatively affect the patency of the airway, most commonly secondary to soft tissue obstruction, although central apnea may also occur. The techniques available for managing the pediatric airway during sedation are myriad, and deciding which one to use depends on a variety of considerations. These include factors such as the level of sedation required for the procedure, the anticipated duration of the procedure, the remoteness of the patient from the provider, the child’s medical condition, and any airway conditions the child may have. The overarching goal is to maximize the child’s safety and mitigate the risk of airway consequences that the sedation may pose. This section discusses effective positioning, oxygen administration, chin left, jaw thrust, and use of oropharyngeal and nasopharyngeal airways, along with laryngeal mask airway placement and (briefly) endotracheal intubation.
Prescreening
Authors: LaViolette Deborah 
Published: January 2019

Abstract
The process of prescreening procedural sedation patients has a critical impact on the safety, efficiency, and quality of a sedation service. Prescreening is a multilevel process that ideally starts at the time of scheduling and allows the sedationist to discern physical or mental health issues that may put the patient at higher risk during a sedated procedure. Foreknowledge of risk indicators enables the sedationist to be better prepared or to refer the patient to a different setting for the procedure. Prescreening also ensures that the patient and family have the logistical information needed for them to be in the correct place at the correct time and properly prepared so that the sedation can be completed safely and efficiently. Prescreening also affords excellence in patient satisfaction.
Observation
Authors: Faulk Debra J. 
Published: January 2019

Abstract
Assessing a child’s level of sedation is critical to the safe provision of sedation for diagnostic and therapeutic procedures. Providers must recognize when patients enter deeper than intended levels of sedation where cardiorespiratory compromise can occur and promptly intervene to prevent clinical deterioration. Observational scales and processed EEG monitors have been used to assess levels of sedation. In circumstances where there is physical separation of provider and patient, increased vigilance and frequency of monitoring physiologic parameters is critical. The use of capnography to monitor respiratory function should be employed in these situations.
Follow-up
Authors: Reilly Lorie 
Published: January 2019

Abstract
Follow-up is an important part of the pediatric sedation process. Follow-up may be performed in several different ways, such as a telephone call, direct contact with the patient and family, a mailed questionnaire, or an in-person visit (e.g., inpatient). Adverse events that occur after the postsedation discharge and are reported during the follow-up process should be documented in the medical record, because this is important and useful information for future sedation encounters. During follow-up some of the topics for discussion with the parent may include any change in the child’s activity level, appetite, sleep pattern, or behavior. An evaluation of patient/family satisfaction may be incorporated into the follow-up.
Minor Adverse Events
Authors: Chumpitazi Corrie E. 
Published: January 2019

Abstract
The incidence of sedation-related adverse events depends on the medications administered, the characteristics of the procedure, and preexisting patient factors. Minor adverse sedation-related events may present inconvenience or transient discomfort to the patient and, if recognized and supported in a timely manner by the sedationist, will not usually result in physiologic or psychological harm to the patient. Postprocedure vomiting, transient hypoxemia, mild hypotension, emergence reactions, and prolonged recovery times are examples of minor events. The relative likelihood of events of this type (1 of every 200 sedation episodes) provides significant impetus for effective preparation and training for sedationists to effectively respond to or preempt them. These “minor” events can still progress to more significant harm.
Procedural Aspects Affecting Sedation Care
Authors: Stormorken Anne 
Published: January 2019

Abstract
The goals of sedation for both diagnostic and therapeutic procedures are to manage preprocedural anxiety, minimize pain, and allow for successful completion of the procedure without adverse patient outcomes. To plan the appropriate way to achieve these goals, the sedationist must decide whether the procedure will cause the patient pain (invasiveness), the degree of immobility required for the procedure to be completed effectively, and the duration of time for which sedation is needed. If systemic medications are needed to manage the patient and procedural goals, they should be selected based on the duration of sedation necessary. Pain control can often be effectively managed with local injectable or topical techniques. It is the sedationist’s responsibility to choose a medication, or combination of medications, that allows for administration of the lowest dose of drug(s) possible while providing the greatest effective therapeutic effect.
The Child with Cerebral Palsy
Authors: Gillen Jennifer K. , Hojsak Joanne M. 
Published: January 2019

Abstract
Cerebral palsy is a nonprogressive disorder resulting from an injury to the brain before, during, or slightly after birth that affects motor function. Patients with cerebral palsy have a wide range of symptomatology that can affect their risk for complications during anesthesia and procedural sedation. The inherent issues of spasticity and hypotonia affecting skeletal muscle, oropharyngeal muscle function, and gut motility create an increased risk for airway-related adverse events in particular. Contractures may affect the positioning requirements of any procedure or test, thereby affecting the level of sedation needed for patient comfort and procedure completion. Careful preprocedure planning is crucial.
The Premature Infant
Authors: Havidich Jeana E. , Evans Rebecca H. 
Published: January 2019

Abstract
Preterm and former preterm infants present unique challenges for sedation providers. These children represent a heterogeneous high-risk population who frequently require sedation or anesthesia for diagnostic and therapeutic procedures. They have limited physiologic reserve and immature metabolic functions. Prematurity is associated with an increased risk for sedation adverse events, including death. Understanding the anatomic and physiologic differences between preterm and term children is necessary for the development of a sedation plan. One of the most important differences pertains to the airway and respiratory system, so airway management is a critical component of the sedation plan. Preterm neonates have altered pharmacokinetics and pharmacodynamics, so titration of sedative drugs is recommended.
Magnetic Resonance Imaging and Computed Tomography Imaging Sedation
Authors: Rogers Amber 
Published: January 2019

Abstract
Magnetic resonance imaging (MRI) and computed tomography (CT) are among the most common procedures to require some level of pediatric sedation. Although painless, they necessitate immobility for adequate imaging quality. Many children can complete these diagnostic procedures without sedation, and this should be encouraged. If sedation medications are needed, propofol is commonly used to administer deep sedation for these procedures given its fast induction and recovery times, but particularly careful ventilation monitoring with capnography is important for the sedation provider who is physically separated from the patient in the MRI suite. Dexmedetomidine use is increasing in both MRI and CT sedation; its advantages are maintenance of airway tone and possible neuroprotective effects, but its disadvantages are longer induction and recovery times. Safety, efficacy, and efficiency should be carefully considered when coordinating sedation care for MRI and CT procedures.
Radiation Therapy
Authors: McKee Bryan P. , Johnson Nicole M. 
Published: January 2019

Abstract
Radiation therapy is a therapeutic option in the treatment of many childhood cancers. It involves the use of high-energy waves and/or matter that injure and kill cancer cells. Radiation therapy may be delivered to a patient via external, internal, and systemic methods. Procedural sedation is most frequently requested for external radiation therapy. Regardless of the method of external radiation used, patient immobility contributes greatly to successful therapy. The goal of the sedationist in the management of a child undergoing radiation therapy is to maintain the optimal environment in terms of patient safety and immobility so that the radiation oncology team can provide the most effective treatment.
Oncology
Authors: Gale Gordon 
Published: January 2019

Abstract
Pediatric hematology/oncology patients present a unique challenge for procedural sedation because they frequently require repeated painful procedures (lumbar punctures and bone marrow testing) as part of their therapy. These procedures require specific positioning and some degree of immobility for successful completion. This section is a guide to accomplish these procedures with a minimum amount of anxiety and pain. Specifics for local anesthesia, positioning, sedation, and postprocedure care are outlined. Ideally, the children and parents can accept these procedures without the additional fear brought to bear by the anticipation of discomfort. The techniques described are also applicable to any infant or child undergoing these procedures.
Orthopedic
Authors: Hegenbarth Mary A. 
Published: January 2019

Abstract
Sedation is commonly required for orthopedic procedures in children. Typical procedures include reduction and casting of acute injuries such as fractures and dislocations and joint injection and/or aspiration for treatment of juvenile arthritis or diagnosis of infection. Most of these procedures are painful. Adequate analgesia, whether administered systemically or via local/topical anesthesia, is essential. Depending on patient and procedure factors, sedation regimens vary from minimal sedation with agents such as nitrous oxide or midazolam up to deep sedation with agents such as ketamine or propofol.
Neurology
Authors: Sedillo Daniel J. , Zuckerman Samuel L. 
Published: January 2019

Abstract
5Electroencephalograms (EEGs) and brainstem auditory evoked response (BAER) are two types of neurophysiologic tests that are not infrequently performed in the pediatric population. Many children, particularly those older than 5 years, may be able to undergo an EEG or BAER without sedation. However, toddlers and children with autism or pervasive developmental disorder may not be capable of cooperating with the audiologist and thus will require sedation. When selecting a sedative, the sedationist needs to remember that some medications may alter the reliability of the EEG interpretation secondary to direct central nervous system effects. There are more options for sedation medications for a BAER test than for an EEG.
The NICE Guidelines and Pediatric Sedation in the United Kingdom
Authors: Sury Michael , Greenaway Sarah 
Published: January 2019

Abstract
Pediatric procedural sedation is required for children across the globe in a wide variety of circumstances. In the United Kingdom, the National Institute for Health and Clinical Excellence (NICE) is a government organization whose purpose is to provide guidelines to help ensure that patients receive effective, good-value healthcare across the whole of the National Health Service. In 2010 NICE published a guideline for the use of pediatric sedation. The overarching aims were to review the safety and efficacy of sedation for common procedures and to form a consensus view on the necessary resources to do this safely. This chapter summarizes the key recommendations and describes how pediatric sedation has since evolved in the UK.
Physician Training and Perspective
Authors: Carberry Andrea R. , Hollman Gregory A. 
Published: January 2019

Abstract
Institutions vary in their requirements for determining competency and granting privileges for providing moderate and deep procedural sedation. Several specialties outside of anesthesiology routinely provide pediatric procedural sedation services. Attaining sedation competency requires a multitiered approach to education, training, and assessment that encompasses factual knowledge and higher-level cognitive functioning such as clinical decision-making, communication skills, psychomotor skills, and ability to function as a member of a multidisciplinary team. Educational and training methods used to teach procedural sedation include written materials, didactic lectures, interactive small-group sessions, medical simulation, and clinical experience with mentoring. Assessment of procedural sedation knowledge and skills includes written examinations, medical simulation, proctoring, and multisource evaluations.
A Sedation Unit Approach
Authors: Kopec John S. 
Published: January 2019

Abstract
The concept of a pediatric sedation unit developed as the need for a sedation service outside of the operating room became legitimized and essential to hospitals with a large pediatric population. The pediatric sedation unit is an area of a hospital specifically designed and staffed to provide safe sedation to children for invasive and noninvasive procedures outside of the operating room. A well-organized unit offers many benefits to the hospital, including efficiency, cost savings, and patient/family/provider satisfaction. The unit’s design and administration will vary based on the local medical climate and needs of a given region. The unit is highly integrated into the hospital and, once established, is virtually essential to the provision of safe and efficient care of children. Integration with the hospital, study modalities, and subspecialties can be facilitated by easy access to the unit for inpatients and outpatients, enhanced communication using the electronic medical record, an organized scheduling and screening process, and attention to improvement and growth.