bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of ‘TRY’: an algorithm for neonatal continuous positive airways pressure in low-income settings
Authors: Crehan Caroline , Colbourn Tim , Heys Michelle , Molyneux Elizabeth 
Published: March 2018

BackgroundNon-invasive respiratory support using bubble continuous positive airway pressure (bCPAP) is useful in treating babies with respiratory distress syndrome. Despite its proven clinical and cost-effectiveness, implementation is hampered by the inappropriate administration of bCPAP in low-resource settings. A clinical algorithm—‘TRY’ (based on Tone: good; Respiratory distress; Yes, heart rate above 100 beats/min)—has been developed to correctly identify which newborns would benefit most from bCPAP in a teaching hospital in Malawi.ObjectiveTo evaluate the reliability, sensitivity and specificity of TRY when employed by nurses in a Malawian district hospital.MethodsNursing staff in a Malawian district hospital baby unit were asked, over a 2-month period, to complete TRY assessments for every newly admitted baby with the following inclusion criteria: clinical evidence of respiratory distress and/or birth weight less than 1.3 kg. A visiting paediatrician, blinded to nurses’ assessments, concurrently assessed each baby, providing both a TRY assessment and a clinical decision regarding the need for CPAP administration. Inter-rater reliability was calculated comparing nursing and paediatrician TRY assessment outcomes. Sensitivity and specificity were estimated comparing nurse TRY assessments against the paediatrician’s clinical decision.ResultsTwo hundred and eighty-seven infants were admitted during the study period; 145 (51%) of these met the inclusion criteria, and of these 57 (39%) received joint assessments. The inter-rater reliability was high (kappa 0.822). Sensitivity and specificity were 92% and 96%, respectively.ConclusionsDistrict hospital nurses, using the TRY-CPAP algorithm, reliably identified babies that might benefit from bCPAP and thus improved its effective implementation.
Pharmacokinetic study of isoniazid and pyrazinamide in children: impact of age and nutritional status
Authors: Dayal Rajeshwar , Singh Yatish , Agarwal Dipti , Kumar Manoj , Swaminathan Soumya , Ramachandran Geetha , Kumar Santosh , Narayan Shamrendra , Goyal Ankur , Kumar A K Hemant 
Published: March 2018

ObjectivesTo evaluate pharmacokinetics of first-line antitubercular drugs, isoniazid (INH) and pyrazinamide (PZA), with revised WHO dosages and to assess its adequacy in relation to age and nutritional status.DesignObservational study.SettingThis study was conducted at Sarojini Naidu Medical College, Agra, and National Institute for Research in Tuberculosis, Chennai.Patients40 subjects diagnosed with tuberculosis were registered in the study and started on daily first-line antitubercular regimen based on the revised WHO guidelines.InterventionsBlood samples were collected at 0, 2, 4, 6 and 8 hours from these subjects after 15 days of treatment for drug estimations.Main outcome measureThe measurement of drug concentrations (maximum peak concentration (Cmax) and area under the time –concentration curve (AUC0–8 hours)) for INH and PZA. Appropriate statistical methods were used to evaluate the impact of age and nutritional status on pharmacokinetic variables.ResultsFor INH, the difference in drug exposures in children <3 years (Cmax 3.18 µg/mL and AUC0–8 hours15.76 µg/mL hour) and children >3 years (Cmax3.05 µg/mL and AUC0–8 hours 14.37 µg/mL hour) was not significant (P=0.94, P=0.81, respectively). The drug levels in children with low body mass index (BMI) (Cmax3.08 µg/mL; AUC0–8 hours14.81 µg/mL hour) were also comparable with their normal counterparts (Cmax3.09 µg/mL, P=0.99; AUC0–8 hours 14.69 µg/mL hour, P=0.82). PZA drug exposures obtained in children less than 3 years (Cmax29.22 µg/mL, AUC0–8 hours 155.45 µg/mL hour) were significantly lower compared with drug levels in children above 3 years (Cmax 37.12 µg/mL, P=0.03; AUC 202.63 µg/mL hour, P value=0.01). Children with low BMI had significantly lower drug concentrations (Cmax 31.90 µg/mL, AUC0–8 hours167.64 µg/mL hour) when compared with normal counterparts (Cmax 37.60 µg/mL, P=0.02; AUC0–8 hours 208.77 µg/mL hour, P=0.01).ConclusionsThe revised WHO drug dosages were found to be adequate for INH with respect to age and nutritional status, whereas PZA showed significantly lower drug levels in children <3 years and in malnourished children.
Clinicians’ gaze behaviour in simulated paediatric emergencies
Authors: McNaughten Ben , Hart Caroline , Gallagher Stephen , Junk Carol , Coulter Patricia , Thompson Andrew , Bourke Thomas 
Published: March 2018

AimDifferences in the gaze behaviour of experts and novices are described in aviation and surgery. This study sought to describe the gaze behaviour of clinicians from different training backgrounds during a simulated paediatric emergency.MethodsClinicians from four clinical areas undertook a simulated emergency. Participants wore SMI (SensoMotoric Instruments) eye tracking glasses. We measured the fixation count and dwell time on predefined areas of interest and the time taken to key clinical interventions.ResultsPaediatric intensive care unit (PICU) consultants performed best and focused longer on the chest and airway. Paediatric consultants and trainees spent longer looking at the defibrillator and algorithm (51 180 ms and 50 551 ms, respectively) than the PICU and paediatric emergency medicine consultants.ConclusionsThis study is the first to describe differences in the gaze behaviour between experts and novices in a resuscitation. They mirror those described in aviation and surgery. Further research is needed to evaluate the potential use of eye tracking as an educational tool.
From whom do physicians obtain consent for surgery?
Authors: Jarayedi Zahra , Asghari Fariba 
Published: March 2018

ObjectiveTo evaluate the knowledge and performance of surgical residents regarding the person from whom informed consent should be taken for surgery and from whom the consent is taken in practice.Materials and methodsThis study was done in 2013. The population of this study was all residents of urology, surgery, orthopaedic surgery and gynaecology of Tehran and Iran University of Medical Sciences. The study tool was a self-administered questionnaire, containing questions on their knowledge and performance regarding informed consent acquisition from patients with different conditions in terms of age, sex, marital status and their capacity to make treatment decisions.ResultsA total of 213 residents participated in the study (response rate=51.9%). The mean score of the participants’ knowledge was 72.95 out of 100. There was no significant correlation between the residents’ knowledge and performance. Regarding a competent married male patient, 98.2% of the residents knew that the person’s consent was enough, but only 63.6% obtained informed consent only from the patient. These percentages were 69% and 19.7% for a competent married female patient, respectively. For a competent single male patient, 90.9% of the residents were aware that the patient’s consent was enough, while only 40% of the residents obtained informed consent only from the patient. These percentages were 65.3% and 16% for a competent single female patient, respectively.ConclusionDespite the residents’ average knowledge of patient autonomy, this right is not observed for female patients, and their treatment is subject to consent acquisition from other family members.
The VITAL study and overall pooled analysis with the VIPS non-invasive stroke detection device
Authors: Kellner Christopher P , Sauvageau Eric , Snyder Kenneth V , Fargen Kyle M , Arthur Adam S , Turner Raymond D , Alexandrov Andrei V 
Published: March 2018

IntroductionEffective triage of patients with emergent large vessel occlusion (ELVO) to endovascular therapy capable centers may decrease time to treatment and improve outcome for these patients. Here we performed a derivation study to evaluate the accuracy of a portable, non-invasive, and easy to use severe stroke detector.MethodsThe volumetric impedance phase shift spectroscopy (VIPS) device was used to assign a bioimpedance asymmetry score to 248 subjects across three cohorts, including 41 subjects presenting as acute stroke codes at a major comprehensive stroke center (CSC), 79 healthy volunteers, and 128 patients presenting to CSCs with a wide variety of brain pathology including additional stroke codes. Diagnostic parameters were calculated for the ability of the device to discern (1) severe stroke from minor stroke and (2) severe stroke from all other subjects. Patients with intracranial hardware were excluded from the analysis.ResultsThe VIPS device was able to differentiate severe stroke from minor strokes with a sensitivity of 93% (95% CI 83 to 98), specificity of 92% (95% CI 75 to 99), and an area under the curve (AUC) of 0.93 (95% CI 0.85 to 0.97). The device was able to differentiate severe stroke from all other subjects with a sensitivity of 93% (95% CI 83 to 98), specificity of 87% (95% CI 81 to 92), and an AUC of 0.95 (95% CI 0.89 to 0.96).ConclusionThe VIPS device is a portable, non-invasive, and easy to use tool that may aid in the detection of severe stroke, including ELVO, with a sensitivity of 93% and specificity of 92% in this derivation study. This device has the potential to improve the triage of patients suffering severe stroke.
Quarrying Companies Royal Engineers in World War II: contributions to military infrastructure within the UK and to Allied forces during the North African, Italian and NW Europe campaigns
Authors: Rose Edward P. F. 
Published: March 2018

Abstract
Eight Quarrying Companies Royal Engineers were raised during World War II, the first four in 1940. Unable to deploy to France as planned, these were used initially for bomb disposal, but from January 1941 companies 851 and 854 (succeeded in 1942 by 857) quarried stone for the construction of two military ports in western Scotland. In early to mid-1943, these companies were sent to support Allied forces in the North African Campaign and, from December 1943, the subsequent Italian Campaign. Other companies initially focused on ports and airfields associated with operations in the Atlantic: Company 853 quarried from 1941 to 1942 in Northern Ireland; Company 855 was deployed in 1941 to Poolewe in NW Scotland, before assignment in 1942–43 to Gibraltar; and companies 125 and 856 quarried from 1942 to 1943 on the Faroe Islands. Four companies were successively employed from 1942 to 1944 quarrying in Oxfordshire to aid the construction of a Central Ordnance Depot. Although three companies were operational in the Mediterranean region, the other five were united in 1944 to form a Quarry Group to support Allied operations in Normandy and the subsequent campaign across northern France, Belgium and into Germany. All eight received some geological guidance; all were disbanded before 1947.
The landslip-damaged Roman fort at Lympne in SE England
Authors: Bromhead Edward Nicholas 
Published: March 2018

Abstract

The late third century Roman fort at Lympne in Kent, one of a series known as the Saxon Shore forts, is one of the earliest substantial stone-built fortifications in SE England. It was sited on the lower slopes of an escarpment, the remnant of a former coastal slope, eroded principally into Early Cretaceous clays capped with sandy limestones. At this location, the escarpment rises to
c.
100 m above sea-level. Several episodes of landslip damage during the 17 centuries since its construction can be distinguished, based on evidence of various kinds: notably, the reconstruction of its original layout; the results of both geotechnical and archaeological site investigations; historical evidence; and analogy with sites and experience in adjacent lengths of the escarpment. The landslip damage manifests itself through the toppling and displacement of the curtain wall and projecting towers or bastions of the fort. The specific engineering geological interest arising from discoveries on site is the attribution of the damage to a small number of episodes of major movement rather than to creep; the magnitude of the movements associated with each episode; and the evidence as to their nature and date.
Ten-Year Survival of End-Stage Renal Disease Patients Treated with High-Efficiency Online Hemodiafiltration: A Cohort Study of a Center in South East Asia
Authors: Tiranathanagul Khajohn , Susantitaphong Paweena , Srisawat Nattachai , Mahatanan Nanta , Tungsanga Kriang , Praditpornsilpa Kearkiat , Eiam-Ong Somchai 
Published: March 2018

<b><i>Background:</i></b> Recently, in the first hemodiafiltration (HDF) experience report from South East Asia (SEA), we reported a 3-year prospective study demonstrating the various short-term benefits of high-efficiency online HDF (OL-HDF) over high-flux hemodialysis (HD). Very few long-term survival reports of high-efficiency OL-HDF are available and the data are heterogeneous and incomplete. <b><i>Objectives:</i></b> The present historical cohort study was conducted to determine the long-term survival and outcome of high-efficiency OL-HDF-treated patients. <b><i>Methods:</i></b> Sixty-six high-efficiency OL-HDF treated patients at a center in SEA were included in the study. The prescription included blood and dialysis fluid flow rates of 400 and 800 mL/min, respectively. The post- or pre-dilution substitution fluid of 100 or 200 mL/min, respectively, was prescribed. <b><i>Results:</i></b> Of 66 HDF patients, whose age was 57.4 ± 14.0 years, there were 38 (58%) females. The majority of comorbidity was diabetes (36%). There were 33 (50%) incident HDF cases that were prescribed OL-HDF at the dialysis initiation and 33 (50%) prevalent HDF cases that were switched from HD to OL-HDF. The 1-, 3-, 5-, and 10-year survival rate were 95.1, 83.4, 77.7, and 61.8% respectively. The mean survival time was 8.99 ± 0.64 years. There were 15 transplantations and 15 deaths during this study periods. The 2 major causes of death were cardiovascular (33.3%) and infectious diseases (20%). Serum ferritin was the only parameter that correlated with mortality (HR 1.004, <i>p</i> = 0.005). There was comparable survival between incident and prevalent HDF cases. The survival after transplantation of a sub-group of patients who received kidney transplantation (KT) was not different from that of the overall HDF patients (<i>p</i> = 0.93). <b><i>Conclusions:</i></b> High-efficiency OL-HDF could provide an excellent long-term survival nearly comparable to the KT sub-group.
The Rosa Luxemburg Myth: A Critique of Luxemburg’s Politics in Poland (1893–1919)
Authors: Blanc Eric 
Published: March 2018

Abstract
This article challenges widespread uncritical portrayals of Rosa Luxemburg. By examining the politics and practices of Luxemburg and her SDKPiL party in Poland, I show that their commitment to proletarian emancipation was undermined by sectarian and doctrinaire tendencies that contributed to the defeat of Poland’s workers’ revolutions in 1905 and 1918–19. A critical analysis of their approaches to the national question, the Polish Socialist Party, German Social Democracy, and the role of the revolutionary party, undermines the prevailing romanticisation of Luxemburg. I argue that the Polish Socialist Party, Luxemburg’s main political rival, posed a viable Marxist alternative for Poland’s revolutionary movement.
Cooperation or Conflicts: The Development of the Photovoltaic Fields in China and the eu Member States
Authors: Li Xiaohua 
Published: March 2018

Abstract
China and the eu are important economies and among the greatest green-house gas emitters in the world. Therefore, strengthening cooperation between the eu and China in the renewable field is vital to prevent the earth from getting any warmer. However, the renewable field which include energy equipment, products manufacturing, and operating systems, is a huge market that is worth billions of dollars. Because of their different economic interest, a trade war (anti-dumping and countervailing investigation) broke out between China and eu in the pv industry which includes solar panels, solar glass and solar-grade polysilicon. Could there be cooperation between China and eu Member States in the photovoltaic fields instead of conflict? This paper illustrates the development of pv solar energy and the conflict between eu and China, discusses the main support policies in both the eu and China and their influence on cooperation and conflict, and compares the differences in strengths and weaknesses between the eu and China. This paper draws the conclusion that cooperation between China and the eu in the pv industry could be achieved, and industrial policies should be adjusted in order to avoid or alleviate the conflict.
Low Cloud Cover Sensitivity to Biomass-Burning Aerosols and Meteorology over the Southeast Atlantic
Authors: Adebiyi Adeyemi A. , Zuidema Paquita 
Published: March 2018

Abstract
Shortwave-absorbing aerosols seasonally cover and interact with an expansive low-level cloud deck over the southeast Atlantic. Daily anomalies of the MODIS low cloud fraction, fine-mode aerosol optical depth (AODf), and six ERA-Interim meteorological parameters (lower-tropospheric stability, 800-hPa subsidence, 600-hPa specific humidity, 1000- and 800-hPa horizontal temperature advection, and 1000-hPa geopotential height) are constructed spanning July–October (2001–12). A standardized multiple linear regression, whereby the change in the low cloud fraction to each component’s variability is normalized by one standard deviation, facilitates comparison between the different variables. Most cloud–meteorology relationships follow expected behavior for stratocumulus clouds. Of interest is the low cloud–subsidence relationship, whereby increasing subsidence increases low cloud cover between 10° and 20°S but decreases it elsewhere. Increases in AODf increase cloudiness everywhere, independent of other meteorological predictors. The cloud–AODf effect is partially compensated by accompanying increases in the midtropospheric moisture, which is associated with decreases in low cloud cover. This suggests that the free-tropospheric moisture affects the low cloud deck primarily through longwave radiation rather than mixing. The low cloud cover is also more sensitive to aerosol when the vertical distance between the cloud and aerosol layer is relatively small, which is more likely to occur early in the biomass burning season and farther offshore. A parallel statistical analysis that does not include AODf finds altered relationships between the low cloud cover changes and meteorology that can be understood through the aerosol cross-correlations with the meteorological predictors. For example, the low cloud–stability relationship appears stronger if aerosols are not explicitly included.
Wind-Driven Circulation in a Shelf Valley. Part II: Dynamics of the Along-Valley Velocity and Transport
Authors: Zhang Weifeng , Lentz Steven J. 
Published: March 2018

AbstractThe dynamics controlling the along-valley (cross shelf) flow in idealized shallow shelf valleys with small to moderate Burger number are investigated, and analytical scales of the along-valley flows are derived. This paper follows Part I, which shows that along-shelf winds in the opposite direction to coastal-trapped wave propagation (upwelling regime) force a strong up-valley flow caused by the formation of a lee wave. In contrast, along-shelf winds in the other direction (downwelling regime) do not generate a lee wave and consequently force a relatively weak net down-valley flow. The valley flows in both regimes are cyclostrophic with O(1) Rossby number. A major difference between the two regimes is the along-shelf length scales of the along-valley flows Lx. In the upwelling regime Lx depends on the valley width Wc and the wavelength λlw of the coastal-trapped lee wave arrested by the along-shelf flow Us. In the downwelling regime Lx depends on the inertial length scale |Us|/f and Wc. The along-valley velocity scale in the upwelling regime, given byis based on potential vorticity (PV) conservation and lee-wave dynamics (Hs and Hc are the shelf and valley depth scales, respectively, and f is the Coriolis parameter). The velocity scale in the downwelling regime, given by is based on PV conservation. The velocity scales are validated by the numerical sensitivity simulations and can be useful for observational studies of along-valley transports. The work provides a framework for investigating cross-shelf transport induced by irregular shelf bathymetry and calls for future studies of this type under realistic environmental conditions and over a broader parameter space.
Multicenter Assessment of Antibiotic Prophylaxis Spectrum on Surgical Infections in Head and Neck Cancer Microvascular Reconstruction
Authors: Veve Michael P. , Greene Joshua B. , Williams Amy M. , Davis Susan L. , Lu Nina , Shnayder Yelizaveta , Li David X. , Noureldine Salem I. , Richmon Jeremy D. , Lin Lawrence O. , Hanasono Matthew M. , Pipkorn Patrik , Jackson Ryan S. , Hornig Joshua D. , Light Tyler , Wax Mark K. , Yiu Yin , Bekeny James , Old Matthew , Hernandez David , Patel Urjeet A. , Ghanem Tamer A. 
Published: March 2018

ObjectiveTo characterize and identify risk factors for 30‐day surgical site infections (SSIs) in patients with head and neck cancer who underwent microvascular reconstruction.Study DesignCross‐sectional study with nested case‐control design.SettingNine American tertiary care centers.Subjects and MethodsHospitalized patients were included if they underwent head and neck cancer microvascular reconstruction from January 2003 to March 2016. Cases were defined as patients who developed 30‐day SSI; controls were patients without SSI at 30 days. Postoperative antibiotic prophylaxis (POABP) regimens were categorized by Gram‐negative (GN) spectrum: no GN coverage, enteric GN coverage, and enteric with antipseudomonal GN coverage. All POABP regimens retained activity against anaerobes and Gram‐positive bacteria. Thirty‐day prevalence of and risk factors for SSI were evaluated.ResultsA total of 1307 patients were included. Thirty‐day SSI occurred in 189 (15%) patients; median time to SSI was 11.5 days (interquartile range, 7‐17). Organisms were isolated in 59% of SSI; methicillin‐resistant Staphylococcus aureus (6%) and Pseudomonas aeruginosa (9%) were uncommon. A total of 1003 (77%) patients had POABP data: no GN (17%), enteric GN (52%), and antipseudomonal GN (31%). Variables independently associated with 30‐day SSI were as follows: female sex (adjusted odds ratio [aOR], 1.6; 95% CI, 1.1‐2.2), no GN POABP (aOR, 2.2; 95% CI, 1.5‐3.3), and surgical duration ≥11.8 hours (aOR, 1.9; 95% CI, 1.3‐2.7). Longer POABP durations (≥6 days) or antipseudomonal POABP had no association with SSI.ConclusionsPOABP without GN coverage was significantly associated with SSI and should be avoided. Antipseudomonal POABP or longer prophylaxis durations (≥6 days) were not protective against SSI. Antimicrobial stewardship interventions should be made to limit unnecessary antibiotic exposures, prevent the emergence of resistant organisms, and improve patient outcomes.