bluuebunny/crossref_metadata_2025_split huggingface dataset:
Equilibration Time Required for Respiratory System Compliance and Oxygenation Response Following Changes in Positive End-Expiratory Pressure in Mechanically Ventilated Children
Authors: Smallwood Craig D. , Walsh Brian K. , Arnold John H. , Gouldstone Andrew 
Published: February 2018

Objectives:
Increases in positive end-expiratory pressure are implemented to improve oxygenation through the recruitment and stabilization of collapsed alveoli. However, the time it takes for a positive end-expiratory pressure change to have maximum effect upon oxygenation and pulmonary compliance has not been adequately described in children. Therefore, we sought to quantify the time required for oxygenation and pulmonary system compliance changes in children requiring mechanical ventilation.

Design:
Retrospective analysis of continuous data.

Settings:
Multidisciplinary ICU of a pediatric university hospital.

Patients:
Mechanically ventilated pediatric subjects.

Interventions:
A case was eligible for analysis if during a 90-minute window following an increase in positive end-expiratory pressure, no other changes to the ventilator were made, ventilator and physiologic data were continuously available and a positive oxygenation response was observed. Time to 90% (T90) of the maximum change in oxygenation and compliance was computed. Differences between oxygenation and compliance T90 were compared using a paired t test. The effect of severity of illness (by oxygen saturation index) upon oxygenation and compliance was analyzed.

Measurements and Main Results:
A total of 200 subjects were enrolled and 1,150 positive end-expiratory pressure change cases were analyzed. Of these, 54 subjects with 171 positive end-expiratory pressure change case were included in the analysis (67% were responders).
Changes in dynamic compliance (T90 = 38 min) preceded changes in oxygenation (T90 = 71 min; p < 0.001). Oxygenation response differed depending on severity of illness quantified by oxygen saturation index; lung dysfunction was associated with a longer response time (p = 0.001).

Conclusions:
T90 requires 38 and 71 minutes for dynamic pulmonary compliance and oxygenation, respectively; the latter was directly observed to be dependent upon severity of illness. To our knowledge, this is the first report of oxygenation and compliance equilibration data following positive end-expiratory pressure increases in pediatric mechanically ventilated subjects.
A General Lack of IgG Against Pertussis Toxin in Chinese Pregnant Women and Newborns
Authors: Meng Qing-hong , Luo Jie , Yang Fan , Shen Ying-jie , Li Li , Li Li-jun , Shi Wei , Wang Ya-juan , Yao Kai-hu 
Published: February 2018

Background:To investigate the level of pertussis-related antibodies in pregnant women and newborns.Methods:A total of 286 serum samples from healthy pregnant women and 221 cord samples from newborns were collected in 2016 in Beijing. A routine blood sample from pregnant women was obtained at 35 weeks of gestational age, and cord samples were collected in 20 minutes after delivery. The values from cord samples were used as the infant values. Anti-pertussis toxin (PT) IgG concentration was measured by ELISA (Euroimmun, Lübeck, Germany) using purified PT as a coating antigen. Newborns with anti-PT IgG ≤40 IU/mL in cord samples were considered to be unprotected against pertussis. Anti-PT IgG ≥100 IU/mL was considered to be indicative of a recent pertussis infection in pregnant women.Results:The anti-PT IgG concentration below the lower limit of detection (<5 IU/mL) occurred in 74.1% (212/286) of pregnant women and 66.5% (147/221) of newborns. Even with detectable anti-PT antibodies, the majority of pregnant women (79.7%, 59/74) and newborns (73.0%, 54/74) had antibody level of 5 to <20 IU/mL, and 13.5% (10/74) of pregnant and 14.9% (11/74) of newborns had antibody level of 20 to <40 IU/mL. The 75% percentiles for anti-PT IgG of pregnant women and newborns were 5.08 and 6.98 IU/mL, respectively. The prevalence of unprotected newborns as defined by anti-PT IgG ≤40 IU/mL was 95.9% (202/211). The prevalence of recent pertussis infection in pregnant women as defined by anti-PT IgG ≥100 was 0.7% (2/286).Conclusions:The pregnant women and newborns were generally lack of protective antibody and are vulnerable to pertussis in Beijing, China. Although acellular pertussis vaccine is administrated in infancy in China, a booster vaccination to pregnant women should be considered for protecting young infants who are too young to start pertussis vaccination.
Rehabilitation Reduced Readmission and Mortality Risks in Patients With Stroke or Transient Ischemic Attack
Authors: Chang Ku-Chou , Hung Jen-Wen , Lee Hsuei-Chen , Yen Chu-Ling , Wu Ching-Yi , Yang Chung-Lin , Huang Yu-Ching , Lin Pei-Li , Wang Hui-Hsuan 
Published: February 2018

Background:
It remains unclear whether rehabilitation has an impact on reducing the long-term risk of mortality or readmission following stroke or transient ischemic attack (TIA).

Objectives:
To investigate the association between the dosage and continuation of rehabilitation and the risk of outcome events (OEs) after stroke or TIA.

Research Design:
A retrospective cohort study using Taiwan’s National Health Insurance database.

Subjects:
In total, 4594 patients admitted with first-ever acute stroke or TIA were followed-up for 32 months.

Measures:
The occurrence of 3 OEs: (1) vascular readmissions/all-cause mortality [vascular event (VE)], (2) all-cause readmissions/mortality (OE1), and (3) all-cause mortality (OE2), in model 1: none, low-intensity, and high-intensity rehabilitation; and model 2: inpatient plus/or outpatient rehabilitation.

Results:
Comparing with patients without rehabilitation, in model 1, patients receiving low-intensity rehabilitation had a lower risk of VE [Hazard ratio (HR), 0.77; 95% CI, 0.68–0.87] and OE1 (HR, 0.77; CI, 0.71–0.84), but not OE2 (HR, 0.91; CI, 0.77–1.07). Patients receiving high-intensity rehabilitation had lower risks of all VE (HR, 0.68; CI, 0.58–0.79), OE1 (HR, 0.79; CI, 0.71–0.88), and OE2 (HR, 0.56; CI, 0.44–0.71). In model 2, patients receiving inpatient plus outpatient rehabilitation had a lowest risk of VE (HR, 0.55; CI, 0.47–0.65), OE1 (HR, 0.65; CI, 0.58–0.72), and OE2 (HR, 0.45; CI, 0.35–0.59). Sensitivity analysis with TIA excluded rendered the similar trend. Subgroup analyses found that the positive effect was not demonstrated in hemorrhagic stroke patients.

Conclusions:
Rehabilitation use was associated with reduction of readmissions/mortality risks following stroke or TIA. The optimal intensity and duration of rehabilitation and the discrepancy shown in hemorrhagic stroke need further clarification.
Downward Trend in Pediatric Resident Laryngoscopy Participation in PICUs
Authors: Gabrani Aayush , Kojima Taiki , Sanders Ronald C. , Shenoi Asha , Montgomery Vicki , Parsons Simon J. , Gangadharan Sandeep , Nett Sholeen , Napolitano Natalie , Tarquinio Keiko , Simon Dennis W. , Lee Anthony , Emeriaud Guillaume , Adu-Darko Michelle , Giuliano John S. , Meyer Keith , Graciano Ana Lia , Turner David A. , Krawiec Conrad , Bakar Adnan M. , Polikoff Lee A. , Parker Margaret , Harwayne-Gidansky Ilana , Crulli Benjamin , Vanderford Paula , Breuer Ryan K. , Gradidge Eleanor , Branca Aline , Grater-Welt Lily B. , Tellez David , Wright Lisa V. , Pinto Matthew , Nadkarni Vinay , Nishisaki Akira 
Published: February 2018

Objectives:
As of July 2013, pediatric resident trainee guidelines in the United States no longer require proficiency in nonneonatal tracheal intubation. We hypothesized that laryngoscopy by pediatric residents has decreased over time, with a more pronounced decrease after this guideline change.

Design:
Prospective cohort study.

Setting:
Twenty-five PICUs at various children’s hospitals across the United States.

Patients:
Tracheal intubations performed in PICUs from July 2010 to June 2016 in the multicenter tracheal intubation database (National Emergency Airway Registry for Children).

Intervention:
None.

Measurements and Main Results:
Prospective cohort study in which all primary tracheal intubations occurring in the United States from July 2010 to June 2016 in the multicenter tracheal intubation database (National Emergency Airway Registry for Children) were analyzed. Participating PICU leaders were also asked to describe their local airway management training for residents. Resident participation trends over time, stratified by presence of a Pediatric Critical Care Medicine fellowship and airway training curriculum for residents, were described. A total of 9,203 tracheal intubations from 25 PICUs were reported. Pediatric residents participated in 16% of tracheal intubations as first laryngoscopists: 14% in PICUs with a Pediatric Critical Care Medicine fellowship and 34% in PICUs without one (p < 0.001). Resident participation decreased significantly over time (3.4% per year; p < 0.001). The decrease was significant in ICUs with a Pediatric Critical Care Medicine fellowship (p < 0.001) but not in ICUs without one (p = 0.73). After adjusting for site-level clustering, patient characteristics, and Pediatric Critical Care Medicine fellowship presence, the Accreditation Council for Graduate Medical Education guideline change was not associated with lower participation by residents (odds ratio, 0.86; 95% CI, 0.59–1.24; p = 0.43). The downward trend of resident participation was similar regardless of the presence of an airway curriculum for residents.

Conclusion:
Laryngoscopy by pediatric residents has substantially decreased over time. This downward trend was not associated with the 2013 Accreditation Council for Graduate Medical Education change in residency requirements.
Epidemiology of Pediatric Critical Care Transport in Northern Alberta and the Western Arctic
Authors: Kawaguchi Atsushi , Nielsen Charlene C. , G. Guerra Gonzalo , Saunders L. Duncan , Yasui Yutaka , DeCaen Allan 
Published: February 2018

Objective:
Specialized pediatric critical care transport teams are essential to pediatric retrieval systems. This study aims to describe the contemporary transports performed by a Canadian pediatric critical care transport team and to compare the treatment and outcomes of children referred from high-level care (hospitals offering pediatric services where an adult ICU exists) and nonhigh-level care (all other hospitals) hospitals.

Design:
A descriptive cohort study.

Setting:
The Stollery Children’s Hospital in Edmonton, Alberta, Western Canada.

Patients:
Children younger than 17 years old transported by the transport team from referral hospitals within the Stollery Children’s Hospital catchment area to Stollery Children’s Hospital between 1998 and 2015.

Interventions:
None.

Measurements and Main Results:
Characteristics of transports, patient demographics presenting vital signs, and outcomes were described overall and compared by transport-related time and referral hospital types (high-level care and nonhigh-level care). In total, 3,352 transports met the inclusion criteria; 1,049 were retrieved from eight high-level care hospitals and 2,303 from 53 nonhigh-level care hospitals; the median one-way transport distance was 383 kilometers, and 70% of the transports were air transports. The annual number of transports has increased during the study period. The PICU admission rate was between 40% and 55%. Transports from high-level care hospitals had significantly higher odds of being admitted to the PICU (odds ratio, 1.96; 95% CI, 1.31–2.93). The odds of intubation at the referral hospital were higher in the high-level care group, but the odds of intubation upon PICU admission was similar between the two groups. Mortality during or after transport was not significantly different between high-level care and nonhigh-level care hospitals.

Conclusions:
The current transport system has multiple priorities with regard to efficiency and quality. The medical services at referral hospitals may affect the likelihood of PICU admission and subsequent PICU length of stay; however, no negative impact was observed in other outcomes including mortality.
Optimal Insertion Depth for Endotracheal Tubes in Extremely Low-Birth-Weight Infants
Authors: Leung Cheung 
Published: February 2018

Objective:
To determine the optimal endotracheal tube insertion depth in extremely low-birth-weight infants based on the association between endotracheal tube depth and gestational age, body weight, body length, and head and chest circumferences at birth.

Design:
Retrospective chart review.

Setting:
Neonatal ICU at a medical center.

Patients:
Fifty-two hospitalized extremely low-birth-weight infants in our neonatal ICU.

Interventions:
None.

Measurements and Main Results:
Data regarding gestational age, body weight, body length (crown–heel length), head and chest circumferences, and final endotracheal tube depth were retrieved from the medical records of 52 newborn infants weighing less than or equal to 1,000 g at birth (boys, 29; girls, 23). The mean gestational age was 25.1 (range, 22–32) weeks, and the mean body weight was 724.5 (range, 400–1,000) g. Of the endotracheal tubes used, 3%, 87%, and 10% of endotracheal tubes were of size 2.0, 2.5, and 3.0, respectively. Linear regression analysis revealed a significant association between endotracheal tube depth and gestational age, body weight, body length, head, and chest circumferences (p < 0.001). Body weight had the highest coefficient of determination (r2 = 0.497), followed by body length (0.458), with all other variables having values of less than 0.4.

Conclusions:
In extremely low-birth-weight infants, a linear association exists between endotracheal tube insertion depth and gestational age, body weight, body length, chest, and head circumferences at birth. Although body weight is the most accurate method for predicting endotracheal tube insertion depth, body length is also appropriate and is more favorable than body weight in delivery room resuscitation. Although no substitute for radiologic confirmation exists, a tape measure that can convert body length to endotracheal tube depth may be helpful.
Intravenous Thrombolysis at 3.5 Hours From Onset of Pediatric Acute Ischemic Stroke
Authors: Waring Elizabeth D. , Milling Truman J. , Warach Steven 
Published: February 2018

Abstract
Acute thrombolysis has a proven benefit for adults presenting with acute ischemic stroke, but data within the pediatric population are extremely limited. We report the case of a 14-year-old girl who presented with right-sided weakness and ataxia, loss of sensation, and altered mental status. Magnetic resonance imaging with diffusion-weighted imaging showed an acute lesion in the distribution of the left posterior cerebral artery, and magnetic resonance angiogram demonstrated occlusion of the third branch of the left posterior cerebral artery. With parental consent, clinicians decided to infuse an adult dose of weight-adjusted intravenous alteplase at 3.5 hours from onset of symptoms, with subsequent improvement in National Institutes of Health Stroke Scale score from 11 to 3. Computed tomography angiogram at 24 hours showed recanalization of the occluded vessel with no evidence of intracranial hemorrhage. Stroke Scale score at discharge was 3, with modified Rankin Scale scores at discharge of 1 and at 90 days of 0. This case highlights the importance of magnetic resonance imaging in diagnosing pediatric acute ischemic stroke and suggests consideration of thrombolysis in select confirmed pediatric stroke cases. However, a rigorous evidence base is lacking, and clinical trials have not been successful in recruiting patients.
Perhaps the Dodo should have accounted for human beings? Accounts of humanity and (its) extinction
Authors: Gray Rob , Milne Markus J. 
Published: February 2018

PurposeThe purpose of this paper is to offer a counter-narrative to accounts of specific species extinction. The authors place humanity’s ways of organising at the core and recognise that only fundamental re-appraisal of humanity’s taken-for-granted narratives offers hope for biodiversity and sustainability. The authors challenge producers of accounts of all sorts to reconsider the context and level of resolution of their accounts. The authors argue that humankind is the root cause of most (if not all) current species extinctions; that such extinctions represent one reason why humanity might itself be threatened with extinction; and why human extinction might be a good thing. The authors need to imagine other, better, futures.Design/methodology/approachThe piece is an essay which assembles a wide range of literature in order to support its contentions.FindingsThere are many individual accounts of species which explore the (albeit very serious) symptoms of a problem without, the authors maintain, examining the systematic source of the problem. The source problem is western mankind’s organisation and somewhat taciturn conception of humanity. There is a lack of accounts offering new possibilities.Research limitations/implicationsThe piece is an essay and, consequently, limited to the quality of the argument presented. The essay suggests that the principal implications relate to how producers of counter-accounts frame their construction of accounts and how accounts of species extinction need to be more cognisant of underlying causes.Practical implicationsWithout substantial change, planetary ecology, including humanity, is very seriously threatened. Imagining a plausible future is a most practical act of faith.Social implicationsThe essay suggests that as accountants the authors might think to approach the counter-accounts with a lower level of resolution: one that is directed towards a more challenging notion of what it is to be human.Originality/valueWhilst building upon the growing sophistication in the understanding of (new) accounts and responding to the emerging literatures on biodiversity, species extinction and utopian vision the authors offer what the authors believe to be a unique suggestion in the accounting literature about the extinction of mankind.
The purposes, promises and compromises of extinction accounting in the UK public sector
Authors: Weir Kenneth 
Published: February 2018

PurposeThe purpose of this paper is to explore the state of extinction accounting, and the motivations for its use in the UK public sector. Prior studies are mostly concerned with corporate attempts to account for species, despite studies in related areas calling for examinations of the public sector context.Design/methodology/approachThe paper analyses the use of extinction accounting in three separate case organisations, conducting a total of 21 interviews across the three cases. Interviews were conducted with a range of organisational participants each having experience with extinction accounting.FindingsInterviews reveal a number of common uses and applications of extinction accounting across the three councils. Practices are used to generate reports on species loss and recovery within each region, and to facilitate planning for species protection and recovery. However, in attempting to use this information, key trade-offs emerge between satisfying economic and ecological criteria, and even trade-offs are created regarding development of protection schemes. This leads to a subversion of extinction accounting.Research limitations/implicationsCommensurate with prior studies in the corporate context, the study finds the presence of an economic logic impinging upon ecological decision making, suggesting that practices of extinction accounting may be affected by the same acknowledged economic motivations that reside in corporate attempts to account for nature.Originality/valueThe paper makes an important contribution by evaluating the public sector context of extinction accounting, which is lacking in existing research. The findings relating to the public sector use of species and extinction information also provide a useful context to understand how relatively new social and environmental accounting practices are deployed in organisations, as well as some indication of their effectiveness and limitations.
Communication of the external auditor with the audit committee
Authors: Compernolle Tiphaine 
Published: February 2018

PurposeThe purpose of this paper is to understand how external auditors communicate with audit committees (ACs).Design/methodology/approachA total of 53 interviews were conducted with participants in the ACs of 22 French companies listed in the CAC 40 index, including external and internal auditors, CFOs, AC chairpersons, and members.FindingsIn multiple accountability relationships, external auditors sit in the middle. They therefore use impression management (IM). While AC members expect them to be transparent, they are also expected to preserve managers’ “face” by sustaining impressions of consistency. The construction of impressions of consistency and transparency takes place mainly backstage, through time-consuming teamwork shared by auditors and CFOs. External auditors have power to make things transparent, but the use of such power is tricky, because it can damage relationships with CFOs. External auditors have a difficult “discrepant role” (Goffman, 1959) to play.Practical implicationsThis study provides insights into what occurs behind the scenes with ACs, which can help regulators think deeper about relationships between external auditors and ACs.Originality/valueThis research makes contribution to governance, IM, and AC literature. It analyzes the AC process from external auditors’ – rather than AC members’ – points of view. Highlighting the AC process backstage, it shows that IM can be carried out collectively toward an internal rather than external audience and demonstrates that external auditors practice rather than limiting IM.