bluuebunny/crossref_metadata_2025_split huggingface dataset:
Critical Care Performance in a Simulated Military Aircraft Cabin Environment
Authors: McNeill Margaret M. 
Published: April 2018

BACKGROUNDCritical Care Air Transport Teams care for 5% to 10% of injured patients who are transported on military aircraft to definitive treatment facilities. Little is known about how the aeromedical evacuation environment affects care.OBJECTIVESTo determine the effects of 2 stressors of flight, altitude-induced hypoxia and aircraft noise, and to examine the contributions of fatigue and clinical experience on cognitive and physiological performance of the Critical Care Air Transport Team.METHODSThis repeated measures 2 × 2 × 4 factorial study included 60 military nurses. The participants completed a simulated patient care scenario under aircraft cabin noise and altitude conditions. Differences in cognitive and physiological performance were analyzed using repeated measures analysis of variance. A multiple regression model was developed to determine the independent contributions of fatigue and clinical experience.RESULTSCritical care scores (P = .02) and errors and omissions (P = .047) were negatively affected by noise. Noise was associated with increased respiratory rate (P = .02). Critical care scores (P &lt; .001) and errors and omissions (P = .002) worsened with altitude-induced hypoxemia. Heart rate and respiratory rate increased with altitude-induced hypoxemia; oxygen saturation decreased (P &lt; .001 for all 3 variables).CONCLUSIONIn a simulated military aircraft environment, the care of critically ill patients was significantly affected by noise and altitude-induced hypoxemia. The participants did not report much fatigue and experience did not play a role, contrary to most findings in the literature.
Factors That Affect Pain Management in Aeromedical Evacuation: An Ethnographic Approach
Authors: Hatzfeld Jennifer , Serres Jennifer , Dukes Susan 
Published: April 2018

BACKGROUND
Pain management is a challenge in the transport setting, but actual factors that influence pain have not been assessed systematically.

OBJECTIVE
To describe the environmental factors and social context that affect pain management in military aeromedical evacuation.

METHODS
Field notes were taken throughout flight, including observational measures of pain, environmental factors, and interactions between the patient and crew. Data collection was completed on 8 missions and 16 patients; common themes were identified that should be considered in the management of pain in aeromedical evacuation.

RESULTS
Communication was a key problem primarily to aircraft noise, the reluctance of patients to speak with crew members while they were wearing headsets, and limited time to assess for pain and provide patient education. Seating and litters appeared to be uncomfortable for ambulatory and litter patients, and preparatory guidance on pain management did not address the stressors of flight or transportation phases. Another compounding factor was the psychological distress, particularly among those leaving a combat zone before the anticipated end of a deployment. Throughout the flight, the military culture of independence, stoicism, and camaraderie also was clearly evident.

CONCLUSIONS
Barriers to communication, comfort, and patient education are well known to transport nurses, but it is important to understand the overall effect they have on the management of pain. Developing solutions to address these factors should be a priority to ensure pain is adequately managed throughout transport.
Pressure Injury Development in Patients Treated by Critical Care Air Transport Teams: A Case-Control Study
Authors: Dukes Susan F. , Maupin Genny M. , Thomas Marilyn E. , Mortimer Darcy L. 
Published: April 2018

BACKGROUNDThe US Air Force transports critically ill patients from all over the world, with transport times commonly ranging from 6 to 11 hours. Few outcome measures have been tracked for these patients. Traditional methods to prevent pressure injuries in civilian hospitals are often not feasible in the military transport environment.OBJECTIVESThe incidence rate and risk factors are described of en route–related pressure injuries for patients overseen by the Critical Care Air Transport Team.METHODSThis retrospective, case-control, medical records review investigated risk factors for pressure injury in patients who developed a pressure injury after their transport flight compared with those with no documented pressure injuries.RESULTSThe pressure injury rate was 4.9%. Between 2008 and 2012, 141 patients in whom pressure injuries developed and who had received care by the team were matched with 141 patients cared for by the team but did not have pressure injury. According to regression analysis, body mass index and 2 or more Critical Care Air Transport Team transports per patient were associated with pressure injury development.CONCLUSIONAlthough the pressure injury rate of 4.9% in this cohort of patients is consistent with that reported by civilian critical care units, the rate must be interpreted with caution, because civilian study data frequently represent the entire intensive care unit length of stay. Targeted interventions for patients with increased body mass index and 2 or more critical care air transports per patient may help decrease the development of pressure injury in these patients.
Blocking IL-2 Signal In Vivo with an IL-2 Antagonist Reduces Tumor Growth through the Control of Regulatory T Cells
Authors: Carmenate Tania , Ortíz Yaquelín , Enamorado Michel , García-Martínez Karina , Avellanet Janet , Moreno Ernesto , Graça Luis , León Kalet 
Published: April 2018

Abstract
IL-2 is critical for peripheral tolerance mediated by regulatory T (Treg) cells, which represent an obstacle for effective cancer immunotherapy. Although IL-2 is important for effector (E) T cell function, it has been hypothesized that therapies blocking IL-2 signals weaken Treg cell activity, promoting immune responses. This hypothesis has been partially tested using anti–IL-2 or anti–IL-2R Abs with antitumor effects that cannot be exclusively attributed to lack of IL-2 signaling in vivo. In this work, we pursued an alternative strategy to block IL-2 signaling in vivo, taking advantage of the trimeric structure of the IL-2R. We designed an IL-2 mutant that conserves the capacity to bind to the αβ-chains of the IL-2R but not to the γc-chain, thus having a reduced signaling capacity. We show our IL-2 mutein inhibits IL-2 Treg cell–dependent differentiation and expansion. Moreover, treatment with IL-2 mutein reduces Treg cell numbers and impairs tumor growth in mice. A mathematical model was used to better understand the effect of the mutein on Treg and E T cells, suggesting suitable strategies to improve its design. Our results show that it is enough to transiently inhibit IL-2 signaling to bias E and Treg cell balance in vivo toward immunity.
Tuning T Cell Signaling Sensitivity Alters the Behavior of CD4+ T Cells during an Immune Response
Authors: Milam Ashley A. Viehmann , Bartleson Juliet M. , Donermeyer David L. , Horvath Stephen , Durai Vivek , Raju Saravanan , Yu Haiyang , Redmann Veronika , Zinselmeyer Bernd , White J. Michael , Murphy Kenneth M. , Allen Paul M. 
Published: April 2018

Abstract
Intricate processes in the thymus and periphery help curb the development and activation of autoreactive T cells. The subtle signals that govern these processes are an area of great interest, but tuning TCR sensitivity for the purpose of affecting T cell behavior remains technically challenging. Previously, our laboratory described the derivation of two TCR-transgenic CD4 T cell mouse lines, LLO56 and LLO118, which recognize the same cognate Listeria epitope with the same affinity. Despite the similarity of the two TCRs, LLO56 cells respond poorly in a primary infection whereas LLO118 cells respond robustly. Phenotypic examination of both lines revealed a substantial difference in their surface of expression of CD5, which serves as a dependable readout of the self-reactivity of a cell. We hypothesized that the increased interaction with self by the CD5-high LLO56 was mediated through TCR signaling, and was involved in the characteristic weak primary response of LLO56 to infection. To explore this issue, we generated an inducible knock-in mouse expressing the self-sensitizing voltage-gated sodium channel Scn5a. Overexpression of Scn5a in peripheral T cells via the CD4-Cre promoter resulted in increased TCR-proximal signaling. Further, Scn5a-expressing LLO118 cells, after transfer into BL6 recipient mice, displayed an impaired response during infection relative to wild-type LLO118 cells. In this way, we were able to demonstrate that tuning of TCR sensitivity to self can be used to alter in vivo immune responses. Overall, these studies highlight the critical relationship between TCR–self-pMHC interaction and an immune response to infection.
Measurements of aerosol and CCN properties in the Mackenzie River delta (Canadian Arctic) during spring–summer transition in May 2014
Authors: Herenz Paul , Wex Heike , Henning Silvia , Kristensen Thomas Bjerring , Rubach Florian , Roth Anja , Borrmann Stephan , Bozem Heiko , Schulz Hannes , Stratmann Frank 
Published: April 2018

Abstract. Within the framework of the RACEPAC (Radiation–Aerosol–Cloud Experiment in
the Arctic Circle) project, the Arctic aerosol, arriving at a ground-based
station in Tuktoyaktuk (Mackenzie River delta area, Canada), was
characterized during a period of 3 weeks in May 2014. Basic meteorological
parameters and particle number size distributions (PNSDs) were observed and
two distinct types of air masses were found. One type were typical Arctic
haze air masses, termed accumulation-type air masses, characterized by a
monomodal PNSD with a pronounced accumulation mode at sizes above
100 nm. These air masses were observed during a period when back
trajectories indicate an air mass origin in the north-east of Canada. The
other air mass type is characterized by a bimodal PNSD with a clear minimum
around 90 nm and with an Aitken mode consisting of freshly formed
aerosol particles. Back trajectories indicate that these air masses, termed
Aitken-type air masses, originated from the North Pacific. In addition, the
application of the PSCF receptor model shows that air masses with their
origin in active fire areas in central Canada and Siberia, in areas of
industrial anthropogenic pollution (Norilsk and Prudhoe Bay Oil Field) and
the north-west Pacific have
enhanced total particle number concentrations (NCN). Generally,
NCN ranged from 20 to 500 cm−3, while cloud
condensation nuclei (CCN) number concentrations were found to cover a range
from less than 10 up to 250 cm−3 for a supersaturation (SS)
between 0.1 and 0.7 %. The hygroscopicity parameter κ of the
CCN was determined to be 0.23 on average and variations in κ were
largely attributed to measurement uncertainties. Furthermore, simultaneous
PNSD measurements at the ground station and on the Polar 6 research
aircraft were performed. We found a good agreement of ground-based PNSDs
with those measured between 200 and 1200 m. During two of the four
overflights, particle number concentrations at 3000 m were found to
be up to 20 times higher than those measured below 2000 m;
for one of these two flights, PNSDs measured above 2000 m showed a
different shape than those measured at lower altitudes. This is indicative of
long-range transport from lower latitudes into the Arctic that can advect
aerosol from different regions in different heights.
Problems and Prospects of sustainable tourism in the Republic of Kazakhstan
Authors: Allayarov Piratdin , Embergenov Bakhit , Han Si Thu 
Published: April 2018

This survey attempts to identify the existing problems faced by the tourism sector of the Republic of Kazakhstan and to identify the government policies initiated for the betterment of the tourism sector of the country. The methods of data collection, which were used are interviews from the travel and tour agents for the identification of the problems faced by the tourism industry of Kazakhstan and survey from the board members of the tourism companies of Kazakhstan. The method was used to reach logical conclusions and catered individual considerations in line with the research question. Recommendations to propose ways in which the government can improve the sector are given. The impact of sustainable tourism sector on the economy and financial health of Kazakhstan is presented.
Het verlofstelsel in hoger beroep is dood, leve het verlofstelsel
Authors: Pesselse G. 
Published: April 2018

Het verlofstelsel in hoger beroep is dood, leve het verlofstelsel
Dat het verlofstelsel van artikel 410a Sv wordt afgeschaft, is zo goed als zeker. Vrijwel niemand zal er rouwig om zijn. Met de afschaffing van het verlofstelsel in hoger beroep verdwijnt het fenomeen verlofstelsels in het algemeen echter niet van het toneel. Sterker nog, het in de modernisering voorgestelde gematigde grievenstelsel in hoger beroep draagt de kiemen voor een nieuw verlofstelsel in zich. De vraag is: moet het conceptwetsvoorstel voor Boek 5 van het Wetboek van Strafvordering over rechtsmiddelen worden aangevuld met een nieuw verlofstelsel, nu wél behoorlijk vormgegeven?
Atividades gerenciais do enfermeiro na estratégia de saúde da família
Authors: Brondani Junior Davi Antonio , Heck Rita Maria , Ceolin Teila 
Published: April 2018

O objetivo deste artigo foi identificar as atividades realizadas pelo enfermeiro atuante na Estratégia de Saúde da Família, enfatizando as ações gerenciais. Este trabalho consistiu em um estudo qualitativo. Os sujeitos do estudo foram cinco enfermeiros que atuavam na ESF em municípios localizados na região sul do Rio Grande do Sul. Os dados foram coletados no período de outubro a novembro de 2008, através da técnica de autorrelato estruturado e foram analisados por temáticas. As ações em saúde realizadas pelos enfermeiros estão de acordo com o preconizado pelo Ministério da Saúde, com exceção das atividades de vigilância em saúde. A função de enfermeiro ainda possui contradições, pois alguns compreendem as atividades gerenciais como desvio do cuidado ao usuário, considerando a assistência e gerenciamento, funções dicotômicas, demonstrando o despreparo em realizar esta tarefa. na Estratégia de Saúde da Família, enfatizando as ações gerenciais. Este trabalho consistiu em um estudo qualitativo. Os sujeitos do estudo foram cinco enfermeiros que atuavam na ESF em municípios localizados na região sul do Rio Grande do Sul. Os dados foram coletados no período de outubro a novembro de 2008, através da técnica de autorrelato estruturado e foram analisados por temáticas. As ações em saúde realizadas pelos enfermeiros estão de acordo com o preconizado pelo Ministério da Saúde, com exceção das atividades de vigilância em saúde. A função de enfermeiro ainda possui contradições, pois alguns compreendem as atividades gerenciais como desvio do cuidado ao usuário, considerando a assistência e gerenciamento, funções dicotômicas, demonstrando o despreparo em realizar esta tarefa.
« J’vois pas pourquoi j’travaillerais pas1 » : le travail salarié des femmes mariées à l’émission télévisée Femme d’aujourd’hui (Société Radio-Canada, 1965-1982)2
Authors: Baillargeon Denyse , Brun Josette , Lebel Estelle 
Published: April 2018

Les auteures proposent une analyse du traitement médiatique du travail salarié des femmes mariées par le magazine télévisuelFemme d’aujourd’huiproduit et diffusé par la Société Radio-Canada, de 1965 à 1982. Leurs résultats montrent que cette question a été amplement débattue et que les animatrices et les journalistes ont fortement encouragé le « recyclage » des mères pour les habiliter à réintégrer le marché du travail. Si l’émission en arrive à être très critique par rapport aux diverses formes de discrimination dont les femmes sont l’objet sur le marché de l’emploi, son discours demeure néanmoins en phase avec les idées féministes libérales dominantes de l’époque dont l’objectif est une meilleure intégration des femmes aux structures sociales existantes, plutôt qu’avec le courant plus radical qui estime que l’égalité des sexes nécessite un changement des modes d’organisation sociale.
Effect of Surgical Weight Loss on Plantar Fasciitis and Health-Care Use
Authors: Boules Mena , Batayyah Esam , Froylich Dvir , Zelisko Andrea , O'Rourke Colin , Brethauer Stacy , El-Hayek Kevin , Boike Allan , Strong Andrew T. , Kroh Matthew 
Published: April 2018

Background:Plantar fasciitis (PF) is one of the most common causes of heel pain. Obesity is recognized as a major factor in PF development, possibly due to increased mechanical loading of the foot due to excess weight. The benefit of bariatric surgery is documented for other comorbidities but not for PF.Methods:A retrospective medical record review was performed for patients with PF identified from a prospectively maintained database of the Cleveland Clinic Bariatric and Metabolic Institute. Age, sex, surgery, excess weight loss, body mass index (BMI), and health-care use related to PF treatment were abstracted. Comparative analyses were stratified by surgery type.Results:Two hundred twenty-eight of 10,305 patients (2.2%) had a documented diagnosis of PF, of whom 163 underwent bariatric surgery and were included in the analysis. Eighty-five percent of patients were women, mean ± SD age was 52.2 ± 9.9 years, and mean ± SD preintervention BMI was 45 ± 7.7. Postoperatively, mean ± SD BMI and excess weight loss were 34.8 ± 7.8 and 51.0% ± 20.4%, respectively. One hundred forty-six patients (90%) achieved resolution of PF and related symptoms. The mean ± SD number of treatment modalities used for PF per patient preoperatively was 1.9 ± 1.0 (P = .25). After surgery, the mean ± SD number of treatment modalities used per patient was reduced to 0.3 ± 0.1 (P = .01).Conclusions:We present new evidence suggesting that reductions in BMI after bariatric surgery may be associated with decreasing the number of visits for PF and may contribute to symptomatic improvement.
Genomic analyses of Northern snakehead (Channa argus) populations in North America
Authors: Resh Carlee A. , Galaska Matthew P. , Mahon Andrew R. 
Published: April 2018

BackgroundThe introduction of northern snakehead (Channa argus; Anabantiformes: Channidae) and their subsequent expansion is one of many problematic biological invasions in the United States. This harmful aquatic invasive species has become established in various parts of the eastern United States, including the Potomac River basin, and has recently become established in the Mississippi River basin in Arkansas. Effective management ofC. argusand prevention of its further spread depends upon knowledge of current population structure in the United States.MethodsNovel methods for invasive species using whole genomic scans provide unprecedented levels of data, which are able to investigate fine scale differences between and within populations of organisms. In this study, we utilize 2b-RAD genomic sequencing to recover 1,007 single-nucleotide polymorphism (SNP) loci from genomic DNA extracted from 165C. argusindividuals: 147 individuals sampled along the East Coast of the United States and 18 individuals sampled throughout Arkansas.ResultsAnalysis of those SNP loci help to resolve existing population structure and recover five genetically distinct populations ofC. argusin the United States. Additionally, information from the SNP loci enable us to begin to calculate the long-term effective population size ranges of this harmful aquatic invasive species. We estimate long-termNeto be 1,840,000–18,400,000 for the Upper Hudson River basin, 4,537,500–45,375,000 for the Lower Hudson River basin, 3,422,500–34,225,000 for the Potomac River basin, 2,715,000–7,150,000 for Philadelphia, and 2,580,000–25,800,000 for Arkansas populations.Discussion and ConclusionsThis work provides evidence for the presence of more genetic populations than previously estimated and estimates population size, showing the invasive potential ofC. argusin the United States. The valuable information gained from this study will allow effective management of the existing populations to avoid expansion and possibly enable future eradication efforts.
Corantes alimentares presentes em alimentos ultraprocessados consumidos por universitários / Food dyes present in ultra-processed foods consumed by university students
Authors: Gama Dayana Nolasco , Polônio Maria Lúcia Teixeira 
Published: April 2018

Objetivo: Descrever os corantes alimentares presentes nos alimentos ultraprocessados consumidos por 273 graduandos de uma universidade pública do Rio de Janeiro. Métodos: Foi caracterizado o perfil sociodemográfico e de saúde a partir de questionário semiestruturado. Consumo de alimentos ultraprocessados foi obtido através do Questionário de Frequência Alimentar (gelatinas, biscoitos recheados, balas e chicletes, refrigerantes, preparados sólidos para refresco, sucos industrializados, temperos prontos e macarrão instantâneo) e os corantes foram identificados nos rótulos dos produtos. Resultados: O consumo de produtos contendo corantes como gelatinas, balas e chicletes, refrigerantes e sucos industrializados foi acima de 80%. Balas e chicletes e temperos prontos tiveram consumo quase diário, sendo 56,9% e 54,1% respectivamente. Conclusão: Identificaram-se quatorze corantes nos rótulos dos produtos industrializados ultraprocessados. Destacaram-se os corantes artificiais caramelos III e IV, bordeuax S, amarelo crepúsculo e tartrazina, e naturais urucum e carmim. Descritores: Corantes de alimentos, hábitos alimentares, risco.
Reproducing Long‐Range Correlations in Global Mean Temperatures in Simple Energy Balance Models
Authors: Meyer Philipp , Hoell Marc , Kantz Holger 
Published: April 2018

AbstractWe study global mean surface temperature records since 1850 and their potential forcings. We find long range correlations by the method of detrended fluctuation analysis in most data sets, in agreement with previous studies. As a predictive model, we employ a zero‐dimensional energy balance model without memory that reproduces temperature data on the timescale of years. Even when driven with white noise, this model generates data that reproduce the observed long‐range correlations. We are able to explain this with theoretical results for the AR(1) process, which demonstrates that even processes with exponentially decaying correlations yield nontrivial detrended fluctuation analysis results if the available data set is too short. This article gives new support to the scepticism about long memory in global mean temperatures and discusses further implications of our findings.
Differentially Fed Metal Frame Antenna With Common Mode Suppression for Biomedical Smartband Applications
Authors: Xu Li‐Jie , Duan Zhu 
Published: April 2018

AbstractThis paper proposes a differentially fed metal frame antenna for biomedical smartband applications. It occupies a planar area of 40 × 20 mm, operating at 2.45‐GHz industrial, scientific, and medical band. The proposed antenna is composed of an external metal frame and an internal metal box acting as ground for electronics. Through a differential feeding to two copper strips located between the metal frame and the metal box, a rectangular ring slot is excited with common mode suppression capability. The antenna prototype is designed in free space, and then adapted to on‐body scenario for both repeater and transmitter cases. Additionally, the proposed differential feeding is modified to the traditional single port, demonstrating the half‐size miniaturization technique. Finally, the simulated results are verified by measurement. The proposed antenna's simple structure and satisfactory performance makes it a perfect candidate for future medical smartband applications, monitoring the physiological parameters of humans for health‐care purposes.