bluuebunny/crossref_metadata_2025_split huggingface dataset:
Single Pilot Operations in Domestic Commercial Aviation
Authors: Vu Kim-Phuong L. , Lachter Joel , Battiste Vernol , Strybel Thomas Z. 
Published: July 2018

Objective: To provide an overview of concepts of operation for single pilot operations (SPO) and a synthesis of recently published work evaluating these concepts. Background: Advances in technology have made it possible for a commercial aircraft to be flown by a single pilot under normal conditions, and research is being conducted to examine the feasibility of implementing SPO for commercial aviation. Method: Context leading up to the consideration of SPO for commercial flight is provided, including the benefits and challenges. Recent studies examining issues relating to automation, operations, and communications in the SPO context are presented. Results: A number of concepts have been proposed and tested for SPO, and no one concept has been shown to be superior. Single pilots were able to successfully resolve off-nominal scenarios with either the ground-support or cockpit-automation tools examined. However, the technologies developed in support of these concepts are in prototype forms and need further development. Conclusion: There have been no obvious “show stoppers” for moving toward SPO. However, the current state of research is in its initial stages, and more research is needed to examine other challenges associated with SPO. Moreover, human factors researchers must continue to be involved in the development of the new tools and technologies to support SPO to ensure their effectiveness. Application: The research issues highlighted in the context of SPO reflect issues that are associated with the process of reducing crew members or providing remote support of operators and, more generally, human interactions with increasingly autonomous systems.
A Clinical Care Pathway to Reduce ICU Usage in Head and Neck Microvascular Reconstruction
Authors: Morse Elliot , Henderson Cara , Carafeno Tracy , Dibble Jacqueline , Longley Peter , Chan Edwin , Judson Benjamin , Yarbrough Wendell G. , Sasaki Clarence , Mehra Saral 
Published: July 2018

ObjectiveTo design and implement a postoperative clinical care pathway designed to reduce intensive care usage on length of stay, readmission rates, and surgical complications in head and neck free flap patients.MethodsA postoperative clinical care pathway detailing timelines for patient care was developed by a multispecialty team. In total, 108 matched patients receiving free tissue transfer for reconstruction of head and neck defects in the year before (prepathway), year after (early pathway), and second year after (late pathway) pathway implementation were compared based on postoperative length of stay, 30‐day readmission rate, intensive care unit (ICU) admission, and rates of medical/surgical complications.ResultsMedian length of stay decreased from 10 to 7.5 and 7 days in the pre‐, early, and late‐pathway groups, respectively (P =. 012). Readmission rate decreased from 16% in the prepathway group to 0% and 3% in the early and late‐pathway groups. The number of patients admitted to the ICU postoperatively decreased from 100% to 36% and 6% in the pre‐, early, and late‐pathway groups, respectively (P =. 025). The rates of surgical and medical complications were equivalent.DiscussionThis pathway effectively reduced ICU admission, length of stay, and readmission rates, without increasing postoperative complications. These outcomes were sustainable over 2 years.Implications for PracticeFree flap patients may not require routine ICU admission and may be taken off ventilatory support in the operating room. This effectively reduces costly resource use in this patient population. Similar pathways could be introduced at other institutions.
A Randomized Single‐Blinded Trial of Posttonsillectomy Liposomal Bupivacaine among Adult Patients
Authors: Olson Michael D. , Moore Eric J. , Price Daniel L. 
Published: July 2018

ObjectiveTo determine whether liposomal bupivacaine (Exparel) is safe and effective in the management of posttonsillectomy pain among adult patients.Study DesignA prospective single‐blind randomized controlled trial.SettingAn academic quaternary care center (Mayo Clinic, Rochester, Minnesota).Subjects and MethodsFrom May 2015 to December 2016, 39 patients were randomized to receive oral pain medication and 8 mL of injected liposomal bupivacaine or oral pain medication alone for treatment of their posttonsillectomy pain. Visual analog scale pain intensity scores, oral pain medication usage, liquid oral intake, and complications were recorded for 2 weeks after the procedure.ResultsThirty‐nine patients were randomized, with 17 patients in the liposomal bupivacaine group and 22 in the control group. Fifteen patients in the liposomal bupivacaine group and 18 patients in the control group completed the study. Pain intensity score on postoperative day 1 (P =. 043) proved to be the only statistically significant result, with no difference noted in pain scores on postoperative days 2 to 14. There was no difference in pain medication usage, liquid oral intake, postoperative hemorrhage, or adverse events between groups.ConclusionsThe injection of liposomal bupivacaine in the posttonsillectomy wound bed demonstrates improved pain intensity scores for the first 24 hours after surgery with no adverse complications noted in comparison with patients who did not receive the injection. Given the limited pain reduction and increased cost, use of liposomal bupivacaine in adult tonsillectomy patients appears to have minimal indication for use.
Efficacy of EGF and Gelatin Sponge for Traumatic Tympanic Membrane Perforations: A Randomized Controlled Study
Authors: Lou Zheng Cai , Lou Zihan 
Published: July 2018

ObjectiveTo compare the outcomes of epidermal growth factor (EGF) and gelatin sponge patch treatments for traumatic tympanic membrane perforations.Study DesignProspective, randomized, controlled.SettingUniversity‐affiliated teaching hospital.Subjects and MethodsIn total, 141 perforations encompassing >50% of the eardrum were randomly divided into 3 groups: EGF (n = 47), gelatin sponge patch (n = 47), and observation (n = 47). The edges of the perforations were not approximated. The closure rate, mean closure time, and infection rate were evaluated at 6 months and the related factors analyzed.ResultsA total of 135 perforations were analyzed. At 6 months, the closure rates were 97.8%, 86.7%, and 82.2% in the EGF, gelatin sponge patch, and spontaneous healing groups, respectively (P =. 054). The mean ± SD closure time was 11.12 ± 4.60, 13.67 ± 5.37, and 25.65 ± 13.32 days in the EGF, gelatin sponge patch, and spontaneous healing groups, respectively (P <. 001). In addition, the presence of infection was not significantly associated with rate of closure in any group.ConclusionsAs compared with spontaneous healing, daily application of EGF and gelatin sponge patching reduced the closure time of traumatic tympanic membrane perforations. EGF treatment had a higher closure rate and shorter closure time but resulted in otorrhea. By contrast, gelatin sponge patches did not improve the closure rate or cause otorrhea but required repeated patch removal and reapplication. Thus, the appropriate treatment should be selected according to patient need.
Intracytoplasmic sperm injection outcome of ejaculated spermatozoa from a man with mosaic Klinefelter's Syndrome: case report and literature review
Authors: Yu Yang , Xi Qi , Jing Jili , Li Linlin , Zhang Hongguo , Liu Ruizhi , Pan Yuan 
Published: July 2018

Objective To report a case of abortion after intracytoplasmic sperm injection (ICSI) with ejaculated spermatozoa obtained from a man with mosaic Klinefelter’s syndrome. Methods Sperm nuclei from the patient were analyzed by fluorescence in situ hybridization, and the disomy frequencies for chromosome 18 and the sex chromosomes were determined. A literature review of the ICSI outcome of ejaculated sperm in patients with Klinefelter’s syndrome was also performed. Results A total of 108 spermatozoa nuclei were analyzed. Of these, 102 sperm cells were normal with an X18 (55.56%) or Y18 (38.89%) chromosome pattern. Three cells with XX18 (2.78%) and three cells with YY18 (2.78%) signals were detected. The fetus stopped developing in the eighth week. The karyotype determined by an analysis of the abortive tissue was 46, XY. The literature review identified a total of 12 patients who were analyzed in 11 reports. The fertilization rate was 80.9%, and the live birth rate per transfer was 71.4%. Conclusions ICSI with ejaculated spermatozoa from men with Klinefelter’s syndrome can lead to pregnancy, for which the risk of transmission of chromosomal aneuploidy is low.
Closed Tea Estates: A Case Study of the Dooars Region of West Bengal, India
Authors: Roy Nirmal Chandra , Biswas Debasish 
Published: July 2018

Since the end of the nineteenth century, it has been found that there has been a steady trend of the closure of tea estates in the sub-Himalayan region of Bengal. Besides that, a number of tea estates in the same region have not been operating properly. All these have made workers vulnerable. But this tea-producing region is monadic, and it produced during 2016–2017 358.53 million kg of tea; whereas the total production of India was 1,250.49 million kg. Evidence shows that 16 tea estates of the Duncan Group alone had been virtually closed in 2015 in the Dooars region. As a consequence, nearly 20,000 workers became jobless and subsequently several workers of the closed tea estates died of starvation and malnutrition. Further, some records have mentioned that from 2000 to 2015, 1,400 people had died in 17 closed tea estates in West Bengal. A lion’s portion of deaths has occurred in the Dooars region. In this case, an attempt has been made to unveil the root causes of the closure of tea estates located in the Dooars region in West Bengal.
The evaluation of a home-based paediatric nursing service: concept and design development using the Kirkpatrick model
Authors: Jones Catherine , Fraser Jennifer , Randall Sue 
Published: July 2018

Background A new paediatric hospital-in-the-home nursing service required evaluation. Aims To determine whether the education and training provided for nursing staff employed in the service was effective. Methods This paper presents the way in which a training evaluation model supported the design and evaluation of a training programme for registered nurses working in an out-of-hospital, home-based nursing service for paediatric patients. Results The Kirkpatrick model provides a framework for evaluating the effectiveness of workforce training for any industry including healthcare (Kirkpatrick, 2009). Conclusions That the Kirkpatrick model is an appropriate framework to evaluate a nursing training programme, but it is imperative to evaluate all levels of the model to be able to ascertain the success of the training and the impact on clinical practice.
A nurse-led audit on the incidence and management of inadvertent hypothermia in an operating theatre department of an Irish hospital
Authors: Healy Kathy , O’Sullivan Anne , McCarthy Lavinia 
Published: July 2018

Inadvertent perioperative hypothermia (IPH) is a common problem associated with perioperative patients which can have significant consequences for them during surgery and in the immediate postoperative period. Recognising and managing IPH remains an important aspect of perioperative nursing and is a significant factor in maintaining patient safety, achieving positive surgical outcomes and patient satisfaction. A nurse-led clinical audit was undertaken in the operating theatre department of a major teaching hospital in Ireland to establish the incidence and management of IPH in the department. One hundred (n = 100) patients were included in the audit, both children and adults. Results of the audit were used to inform quality improvement initiatives, with the purpose of improving patient care standards in the operating theatre department in that hospital.
Measuring Geographic and Wealth Inequalities in Health Distribution as Tools for Identifying Priority Health Inequalities and the Underprivileged Populations
Authors: Shawky Sherine 
Published: July 2018

Background Currently, there is no consensus on standard measure that can be routinely part of the health information systems to alert countries to inequalities in health and identify the priority health inequality conditions. Objectives To identify the health inequality measures relevant for assessing geographic and wealth inequalities; use the measures as a demonstration to what can happen in practice to recognize the geographic and wealth-related priority health inequalities within a country; and identify the geographic and wealth underprivileged populations. Method Egypt data were used as demonstration. Pearson coefficient of correlation was calculated to compare the various geographic and wealth health inequality measures. T test was used to identify significant correlations. The relevant inequality measures were used to rank geographic and wealth health inequalities and identify the underprivileged populations. Results The wealth inequalities in health measured by the concentration index provide a familiar and perform adequately in identifying economic inequalities in health. However, the geographic health inequalities identified by the index of dissimilarity appear to provide a more comprehensive profile of health inequalities within a country. Conclusion There is a need for a feasible inequality measure in the health information systems. A country’s geographic health distribution measured by the index of dissimilarity appears to provide a feasible first-step alarm to inform and guide the uptake of equity-sensitive policies.
A factor VIII–nanobody fusion protein forming an ultrastable complex with VWF: effect on clearance and antibody formation
Authors: Muczynski Vincent , Casari Caterina , Moreau François , Aymé Gabriel , Kawecki Charlotte , Legendre Paulette , Proulle Valerie , Christophe Olivier D. , Denis Cécile V. , Lenting Peter J. 
Published: July 2018

Key Points
The fusion between FVIII and anti-VWF nanobodies increases affinity for VWF 25-fold without compromising FVIII activity. Stabilized VWF binding results in a twofold enhanced circulatory survival of FVIII and reduced anti-FVIII antibody formation.
Relapsed and refractory nodular lymphocyte-predominant Hodgkin lymphoma: an analysis from the German Hodgkin Study Group
Authors: Eichenauer Dennis A. , Plütschow Annette , Schröder Lena , Fuchs Michael , Böll Boris , von Tresckow Bastian , Diehl Volker , Borchmann Peter , Engert Andreas 
Published: July 2018

Key Points
Patients with relapsed or refractory NLPHL have a favorable overall prognosis. Treatment of relapsed or refractory NLPHL should be chosen individually.
A randomised cross over study to evaluate the performance of a novel ankle dorsiflexion measurement device for novice users
Authors: Worsley Peter R. , Conington Caitlan , Stuart Holly , Patterson Alice , Bader Dan L. 
Published: July 2018

AbstractBackgroundThe ankle joint is a common site of musculoskeletal pathology. Measurement of its functional range of motion is a primary indicator for rehabilitation outcomes in therapy settings. The present study was designed to assess reliability and validity of a new standardised method using a D‐Flex device to assess ankle range of motion.MethodsA cohort of 20 healthy volunteers were recruited to measure the weight‐bearing ankle range of motion using three assessment tools, namely, a goniometer, inclinometer and the D‐Flex measurement devices. Repeated measures were performed both between and within observers for each device over a 48 h period. Performance evaluation of each device and their reliability was assessed using intra‐class correlation coefficients and Bland and Altman plots.ResultsAlthough significant correlations (p < 0.05) were observed between devices, there were large mean differences in ankle range of motion values ranging from 4.3°‐15.7°. The D‐flex produced the highest inter‐ and intra‐rater reliability (ICCs 0.76–0.95), compared to values of 0.55–0.85 and 0.32–0.71 for the goniometer and inclinometer, respectively. The Bland and Altman plots revealed a low mean observer difference for the D‐Flex (mean difference = 0.7°), with the vast majority of data coincident within the 95% confidence intervals. For both the goniometer and inclinometer mean differences were higher, with values of 3.1° and 5.7° respectively.ConclusionThe results of the present study provide evidence to support the use of the D‐Flex system as a valid, portable, and easy to use alternative to the weight‐bearing lunge test when assessing ankle dorsiflexion ROM in healthy participants.
Letter to the editor in response to estimating the burden of antimicrobial resistance: a systematic literature review
Authors: Wozniak Teresa M. 
Published: July 2018

AbstractThe systematic review published by Naylor et al. in April 2018 highlights methodological assumptions and biases that occur in studies investigating the burden of antimicrobial resistance (AMR). They note that, due to both the large diversity of statistical approaches and perspectives chosen, the current evidence base of the burden of AMR is highly variable. Certainly, these conclusions are valid and the authors present a very thorough analysis of the currently published literature with a broad array of drug-bug combinations. But readers are left with limited direction of estimating the current best available estimate of the health and economic burden of AMR. Such estimates are desperately needed to inform clinical management and for priority setting activities and initiative to curbing the global threat of AMR.
PROPAGANDA POLÍTICA NO PRINCIPADO ROMANO: A FAMÍLIA COMO UM ELEMENTO DA CONSTITUIÇÃO
Authors: Taborda Maren Guimarães , Flores Alfredo De J. 
Published: July 2018

Trata o presente ensaio de analisar o momento de transformação da constituição romana, na qual a civitas interferiu na família, servindo a reforma dos costumes de elemento de propaganda. A primeira hipótese explicitada é a de que, em Roma, até a época da instauração da monarquia militar, o direito público não dizia respeito às relações familiares. Com a constituição do principado, surgiu um conjunto normativo que, interferindo diretamente na organização da família e na liberdade de escolha individual, acabou trazendo para o campo da política a solução dos conflitos intrafamiliares, com a criação de procedimentos judiciais públicos, não submetidos à lógica do processo formulário (semiprivado), principalmente para disciplinar as relações sexuais (os juízos públicos de adultérios) e, por conseguinte, equacionar a questão da natalidade. O método utilizado na investigação é o histórico-jurídico, porque a historicidade do direito é constitutiva e parte integrante dos acontecimentos. Ao estilo do realismo histórico, o estudo procura compreender e explicar os fundamentos da prática política e a propaganda, os quais foram as bases do novo regime, com o auxílio dos resultados científicos da investigação histórico-jurídica sobre o tema (revisão bibliográfica) e das fontes documentais primárias (textos de juristas, políticos e historiadores da Antiguidade Clássica).
AS RELAÇÕES REPRODUTORAS NOS ESPAÇOS DE ENSINO
Authors: Do Amaral Augusto Jobim , Martins Fernanda 
Published: July 2018

As reflexões que serão desenvolvidas nesse texto buscam evidenciar as relações de poder e a dominação como mecanismos de reprodução social nos âmbitos de ensino. Ainda pretende apresentar uma possível postura para a prática educativa que questione os antigos métodos de ensino a partir de suas bases epistemológicas. Assim, a partir das teorias de Bourdieu sobre a reprodução de estratificações sociais com base na perpetuação de um ensino impositivo tanto no ambiente familiar quanto escolar, busca-se elaborar uma conexão deste “modelo reprodutor” sugerido pelo autor com as teorias foucaultinas de governabilidade e disciplina desenvolvidos pelas instituições sociais e políticas, presente entre elas o próprio ensino. Julga-se, dessa forma. como condição de possibilidade para a adoção dessa nova postura o respeito ao Outro, através da ética da alteridade, e, no contexto do debate acerca da falência dos monólogos acadêmicos.
Student midwives' education needs and their experience of attending a bereavement education workshop
Authors: Doherty Jean , Coughlan Barbara , Casey Brenda , Lloyd Barbara , Sheehy Lucille , Brosnan Mary , Barry Theresa , McMahon Anne , Cullen Sarah 
Published: July 2018

Background Clinical training should be efficient, intellectually rigorous, and integrated into practice. This interactive workshop was developed to support student midwives in bereavement care. Aims To improve student midwives' confidence in providing bereavement care to parents after pregnancy loss and perinatal death. Methods Two focus groups were held, where students' (n=12) discussed their experiences of attending the workshop, barriers and facilitators to gaining confidence, and any further education needs. Findings All students agreed that the workshop increased their confidence, and said that role-plays were the most beneficial aspect of the day. Lack of exposure and support from mentors and senior staff was seen as the largest barrier to gaining further confidence. Conclusions The results suggest that all students could benefit from a workshop to increase confidence in bereavement care. The content of this workshop can be used in other maternity settings in Ireland and is recommended for all staff members caring for parents after perinatal bereavement or pregnancy loss.
The role of the posterior bundle of the medial collateral ligament in posteromedial rotatory instability of the elbow
Authors: Hwang J-T. , Shields M. N. , Berglund L. J. , Hooke A. W. , Fitzsimmons J. S. , O’Driscoll S. W. 
Published: July 2018

AimsThe aim of this study was to evaluate two hypotheses. First, that disruption of posterior bundle of the medial collateral ligament (PMCL) has to occur for the elbow to subluxate in cases of posteromedial rotatory instability (PMRI) and second, that ulnohumeral contact pressures increase after disruption of the PMCL.Materials and MethodsSix human cadaveric elbows were prepared on a custom-designed apparatus which allowed muscle loading and passive elbow motion under gravitational varus. Joint contact pressures were measured sequentially in the intact elbow (INTACT), followed by an anteromedial subtype two coronoid fracture (COR), a lateral collateral ligament (LCL) tear (COR + LCL), and a PMCL tear (COR + LCL + PMCL).ResultsThere was no subluxation or joint incongruity in the INTACT, COR, and COR + LCL specimens. All specimens in the COR + LCL + PMCL group subluxated under gravity-varus loads. The mean articular contact pressure of the COR + LCL group was significantly higher than those in the INTACT and the COR groups. The mean articular contact pressure of the COR + LCL + PMCL group was significantly higher than that of the INTACT group, but not higher than that of the COR + LCL group.ConclusionIn the presence of an anteromedial fracture and disruption of the LCL, the posterior bundle of the MCL has to be disrupted for gross subluxation of the elbow to occur. However, elevated joint contact pressures are seen after an anteromedial fracture and LCL disruption even in the absence of such subluxation. Cite this article: Bone Joint J 2018;100-B:1060–5.