bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and Efficacy of a Propofol and Ketamine Based Procedural Sedation Protocol in Children with Cerebral Palsy Undergoing Botulinum Toxin A Injections
Authors: Louer Ryan , McKinney Renee C. , Abu‐Sultaneh Samer , Lutfi Riad , Abulebda Kamal 
Published: February 2019

BackgroundPediatric patients with cerebral palsy often undergo intramuscular botulinum toxin (BoNT‐A) injections. These injections can be painful and may require procedural sedation. An ideal sedation protocol has yet to be elucidated.ObjectiveTo investigate the safety and efficacy of a propofol and ketamine based sedation protocol in pediatric patients with cerebral palsy requiring BoNT‐A injections.DesignRetrospective chart review.SettingThe sedations took place in a procedural sedation suite at a tertiary children's hospital from February 2013 through September 2017.Patients164 patients with diagnoses of cerebral palsy undergoing propofol and ketamine based sedation for injections with botulinum toxin A.MethodsAn initial bolus of 0.5 mg/kg ketamine followed by a 2 mg/kg bolus of propofol was administered with supplemental boluses of propofol as needed to achieve deep sedation during the intramuscular BoNT‐A injections.Main Outcome MeasurementsPropofol dosages, adverse events, serious adverse events, and sedation time parameters were reviewed.Results345 sedations were successfully performed on 164 patients. The median total dose of propofol was 4.7 mg/kg (interquartile range [IQR]: 3.5, 6.3). Adverse events were encountered in 10.1% of procedures including hypoxemia responsive to supplemental oxygen (9.6%) and transient apnea (1.4%). The mean procedure time, recovery time, and total sedation time were 10, 11 and 33 minutes, respectively. With regard to patient variables, including age, weight, dose of propofol, sedation time, and Gross Motor Function Classification System classification, there was no association with increased incidence of adverse events.ConclusionOur sedation protocol of propofol and ketamine is safe and effective in children with cerebral palsy undergoing procedural sedation for intramuscular injections with BoNT‐A. The adverse events encountered appeared to be related to airway and respiratory complications secondary to musculoskeletal deformities, emphasizing the importance of airway monitoring and management in these patients.LevelIV.
Preparation of hierarchically structured PCL superhydrophobic membrane via alternate electrospinning/electrospraying techniques
Authors: Zhang Guohui , Wang Panpan , Zhang Xiaoxiao , Xiang Chunhui , Li Lili 
Published: February 2019

ABSTRACTSuperhydrophobic polycaprolactone (PCL) membranes with hierarchical structure were fabricated via alternate electrospinning/electrospraying techniques. Electrospun PCL/methyl silicone oil (PCL/MSO) nanofibers were employed as substrate. PCL/MSO‐PCL microspheres (PCL/MSO‐PCLMS) hierarchical membrane was prepared via electrosprayed PCLMSas an additional layer on the substrate. Field emission scanning electron microscopy images showed the formation of hierarchical PCL/MSO‐PCLMSmembranes. Compared to pure PCL fibers substrate (120 ± 1.3°), the water contact angle (WCA) of MSO‐modified PCL membrane was 142 ± 0.7°. The most interesting observation was that the WCA of PCLMSwithout any modification could be achieved to 146 ± 2.8°. On this basis, PCL/MSO‐PCLMShierarchical membrane possessed superhydrophobic surface with 150 ± 0.6° of WCA. The excellent surface roughness and air‐pocket capacity of hierarchical membranes would make the membranes more hydrophobic. The maximum oil (n‐hexane) adsorption capacity of PCL/MSO‐PCLMSmembrane was 32.53 g g−1. Oil–water separation efficiencies of the superhydrophobic membranes were all higher than 99.93% after 10 cycles. The hierarchically structured PCL superhydrophobic membranes indicate the potential applications of environmentally friendly biopolymers as separation membranes. © 2019 Wiley Periodicals, Inc. J. Polym. Sci., Part B: Polym. Phys.2019,57, 421–430
Thermodynamic features of perfectly crystalline poly(3‐hexylthiophene) based on Flory's relation
Authors: Alizadehaghdam Mina , Siegenführ Silvia , Abbasi Farhang , Reiter Günter 
Published: February 2019

ABSTRACTPoly(3‐hexylthiophene) (P3HT) as a conjugated polymer has many electrical and photovoltaic applications. However, reliable values for the equilibrium melting temperature () and for the enthalpy of fusion of a perfect P3HT crystal () are still in doubt. In the published works, ranges from 33 to 99 J/g. Here, the melting point of P3HT in P3HT‐diluent mixtures is measured with changing the diluent concentration. By satisfying the requirements of Flory relation, “working with the same polymer crystals” and “working in the equilibrium state,” usually neglected in the literature, a reliable value of = 83 ± 2 J/g is obtained. The reported values for of P3HT are also in a wide range, 260‑300 °C. In this work, accurate applying of the Hoffman‐Weeks relation, against the effects of lamellar thickening, yields = 272 ± 2 °C rather than 300 ± 2°C reported in the literature. © 2019 Wiley Periodicals, Inc. J. Polym. Sci., Part B: Polym. Phys. 2019, 57, 431–437
Relationship of fatigue with cognitive performance in women with early‐stage breast cancer over 2 years
Authors: Gullett Joseph M. , Cohen Ronald A. , Yang Gee Su , Menzies Victoria S. , Fieo Robert A. , Kelly Debra L. , Starkweather Angela R. , Jackson‐Cook Colleen K. , Lyon Debra E. 
Published: February 2019

AbstractObjectiveFatigue and cognitive dysfunction are major concerns for women with early‐stage breast cancer during treatment and into survivorship. However, interrelationships of these phenomena and their temporal patterns over time are not well documented, thus limiting the strategies for symptom management interventions. In this study, changes in fatigue across treatment phases and the relationship among fatigue severity and its functional impact with objective cognitive performance were examined.MethodsParticipants (N = 75) were assessed at five time points beginning prior to chemotherapy to 24 months after initial chemotherapy. Fatigue severity and impact were measured on the Brief Fatigue Inventory. Central nervous system (CNS) Vital Signs was used to measure performance based cognitive testing. Temporal changes in fatigue were examined, as well as the relationship between fatigue and cognitive performance, at each time point using linear mixed effect models.ResultsSeverity of fatigue varied as a function of phase of treatment. Fatigue severity and its functional impact were moderate at baseline, increased significantly during chemotherapy, and returned to near baseline levels by 2 years. At each time point, fatigue severity and impact were significantly associated with diminished processing speed and complex attention performance.ConclusionsA strong association between fatigue and objective cognitive performance suggests that they are likely functionally related. That cognitive deficits were evident at baseline, whereas fatigue was more chemotherapy dependent, implicates that two symptoms share some common bases but may differ in underlying mechanisms and severity over time. This knowledge provides a basis for introducing strategies for tailored symptom management that vary over time.
Characterizing death acceptance among patients with cancer
Authors: Philipp Rebecca , Mehnert Anja , Lo Chris , Müller Volkmar , Reck Martin , Vehling Sigrun 
Published: February 2019

AbstractObjectiveDeath acceptance may indicate positive adaptation in cancer patients. Little is known about what characterizes patients with different levels of death acceptance or its impact on psychological distress. We aimed to broaden the understanding of death acceptance by exploring associated demographic, medical, and psychological characteristics.MethodsAt baseline, we studied 307 mixed cancer patients attending the University Cancer Center Hamburg and a specialized lung cancer center (age M = 59.6, 69% female, 69% advanced cancer). At 1‐year follow‐up, 153 patients participated. We assessed death acceptance using the validated Life Attitude Profile–Revised. Patients further completed the Memorial Symptom Assessment Scale, the Demoralization Scale, the Patient Health Questionnaire, and the Generalized Anxiety Disorder Questionnaire. Statistical analyses included multinomial and hierarchical regression analyses.ResultsAt baseline, mean death acceptance was 4.33 (standard deviation [SD] = 1.3, range 1‐7). There was no change to follow‐up (P = 0.26). When all variables were entered simultaneously, patients who experienced high death acceptance were more likely to be older (odds ratio [OR] = 1.04; 95% confidence interval [CI], 1.01‐1.07), male (OR = 3.59; 95% CI, 1.35‐9.56), widowed (OR = 3.24; 95% CI, 1.01‐10.41), and diagnosed with stage IV (OR = 2.44; 95% CI, 1.27‐4.71). They were less likely to be diagnosed with lung cancer (OR = 0.20; 95% CI, 0.07‐0.58), and their death acceptance was lower with every month since diagnosis (OR = 0.99; 95% CI, 0.98‐0.99). High death acceptance predicted lower demoralization and anxiety at follow‐up but not depression.ConclusionsHigh death acceptance was adaptive. It predicted lower existential distress and anxiety after 1 year. Advanced cancer did not preclude death acceptance, supporting the exploration of death‐related concerns in psychosocial interventions.
Experimental Implementation of a Quantum Autoencoder via Quantum Adders
Authors: Ding Yongcheng , Lamata Lucas , Sanz Mikel , Chen Xi , Solano Enrique 
Published: February 2019

AbstractQuantum autoencoders allow for reducing the amount of resources in a quantum computation by mapping the original Hilbert space onto a reduced space with the relevant information. Recently, it is proposed to employ approximate quantum adders to implement quantum autoencoders in quantum technologies. Here, the experimental implementation of this proposal in the Rigetti cloud quantum computer is carried out employing up to three qubits. The experimental fidelities are in good agreement with the theoretical prediction, thus proving the feasibility to realize quantum autoencoders via quantum adders in state‐of‐the‐art superconducting quantum technologies.
The bank capital channel and bank profits
Authors: Orzechowski Paul E. 
Published: February 2019

AbstractThis paper develops a microeconomic model of banking to highlight an endogenous loan creation process that emerges from bank profits via the capital accumulation of retained earnings and uses a simple bank capital‐loan multiplier to illustrate constraints on lending. The study also analyzes how sufficient net interest margins are important for banks to maintain lending portfolios and avoid financial fragility. The model offers support to bank capital channel (BKC) economists by illustrating how changes in interest rates may influence bank lending through the bank's internal capital accumulation growth rate and on a bank's portfolio choices.
Combination of BMSCs‐laden acellular nerve xenografts transplantation and G‐CSF administration promotes sciatic nerve regeneration
Authors: Jia Hua , Wang Ying , Chen Jiao , Li Jun‐Ping , Han Huai‐Qin , Tong Xiao‐Jie , He Zhong‐Yi , Ma Wen‐Zhi 
Published: February 2019

AbstractPeripheral nerve gaps often lead to interrupted innervation, manifesting as severe sensory and motor dysfunctions. The repairs of the nerve injuries have not achieved satisfactory curative effects in clinic. The transplantation of bone marrow stromal cells (BMSCs)‐laden acellular nerve xenografts (ANX) has been proven more effective than the acellular nerve allografting. Besides, granulocyte colony‐stimulating factor (G‐CSF) can inhibit inflammation and apoptosis, and thus is conducive to the microenvironmental improvement of axonal regeneration. This study aims to investigate the joint effect of BMSCs‐seeded ANX grafting and G‐CSF administration, and explore the relevant mechanisms. Adult SD rats were divided into five groups randomly: ANX group, ANX combined with G‐CSF group, BMSCs‐laden ANX group, BMSCs‐laden ANX combined with G‐CSF group, and autograft group. Eight weeks after transplantation, the detection of praxiology and neuroelectrophysiology was conducted, and then the morphology of the regenerated nerves was analyzed. The inflammatory response and apoptosis in the nerve grafts as well as the expression of the growth‐promoting factors in the regenerated tissues were further assayed. G‐CSF intervention and BMSCs implanting synergistically promoted peripheral nerve regeneration and functional recovery following ANX bridging, and the restoration effect was matchable with that of the autologous nerve grafting. Moreover, local inflammation was alleviated, the apoptosis of the seeded BMSCs was decreased, and the levels of the neuromodulatory factors were elevated. In conclusion, the union application of BMSCs‐implanted ANX and G‐CSF ameliorated the niche of neurotization and advanced nerve regeneration substantially. The strategy achieved the favorable effectiveness as an alternative to the autotransplantation.
Molecular characterization of Anaplasma and Ehrlichia in ixodid ticks and reservoir hosts from Palestine: a pilot survey
Authors: Zaid Taher , Ereqat Suheir , Nasereddin Abdelmajeed , Al‐Jawabreh Amer , Abdelkader Ahmad , Abdeen Ziad 
Published: February 2019

AbstractTick‐borne anaplasmosis and ehrlichiosis are clinically important emerging zoonoses usually overlooked by veterinarians and physicians alike. This study aimed at detecting and genetically characterizing Ehrlichia and Anaplasma species in ixodid ticks and their animal hosts from the West Bank, Palestine. A total of 723 ixodid ticks belonging to three genera (Rhipicephalus, Hyalomma, Haemaphysalis) were collected from dogs, sheep, goats and camels. In addition, 189 blood samples were collected from dogs, sheep, camels, horses and a goat from the West Bank, Palestine. All tick and blood samples were investigated for the presence of Anaplasma and Ehrlichia targeting a 345 bp fragment of the 16S rRNA gene followed by sequence analysis. The infection rate of Anaplasma spp. in ticks was 6.5% (47/723). Anaplasma platys was identified in 28% (13/47) of them. Whereas, based on a partial sequence (851 bp) of msp4 gene, 38% (18/47) were identified as A. ovis. The species of the remaining 16 positive samples (16/47, 34%) could not be identified. Simultaneously, the infection rate of Ehrlichia spp. in the ticks was 0.6% (4/723). Three of which were E. canis and one was Ehrlichia spp. The infection rate of A. platys in dogs’ blood samples was 10% (13/135), while it was 1.5% (2/135) for E. canis. The infection rate of Anaplasma in sheep blood samples was 40% (19/47), out of which 26% (5/19) were caused by A. ovis as revealed by msp4‐PCR. Implementation of purely‐spatial analysis by saTScan for all cases of Anaplasma revealed two statistically significant clusters in two districts; Tubas town and Majdal‐Bani‐Fadil village on the western hills of the Jordan Valley. Most cases of Anaplasma (83%) were from rural areas where life cycle components (vector, host and reservoir) abundantly interact. This study is the first in Palestine to reveal the presence of Anaplasma and Ehrlichia in ticks, dogs and sheep providing crucial platform for future epidemiological surveys and control strategies in the country and region.
Feasibility and Safety of Laparoscopic Partial Splenectomy: A Systematic Review
Authors: Liu Gangshan , Fan Ying 
Published: February 2019

AbstractBackgroundLaparoscopic partial splenectomy (LPS) is a challenging procedure. The aim of this review was to evaluate its feasibility, safety, and potential benefits.MethodsWe conducted a comprehensive review for the years 1995–2018 to retrieve all relevant articles.ResultsA total of 44 studies with 252 patients undergoing LPS were reviewed. Six studies described combined operations. Ranges of operative time and estimated blood loss were 50–225 min and 0–1200 ml, respectively. There are eight patients need blood transfusion in 231 patients with available data. The conversion rate was 3.6% (9/252). Overall, 27 patients (10.7%;27/252) developed postoperative or intraoperative complications. Overall mortality was 0% (0/252). The length of postoperative stay (POS) varied (1–11 days). Among four comparative studies, one showed LPS could reduce POS than laparoscopic total splenectomy (LTS) (LTS 5.4 ± 1.8 days, LPS 4.2 ± 0.8 days, p = 0.027) and complications (pleural effusion (LTS 9/22, LPS 0/15, p = 0.005), splenic vein thrombosis (LTS 10/22, LPS 0/15, p = 0.002)). Another comparative study showed LPS may benefit emergency patients. However, one comparative study showed LPS was associated with more pain, longer time to oral intake, and longer POS in children with hereditary spherocytosis. The fourth comparative study showed robotic subtotal splenectomy was comparable to laparoscopy in terms of POS and complication. The main benefits were lower blood loss, vascular dissection time, and a better evaluation of splenic remnant volume.ConclusionsIn early series of highly selected patients, LPS appears to be feasible and safe when performed by experienced laparoscopic surgeons.
Implications of various effort-sharing approaches for national carbon budgets and emission pathways
Authors: van den Berg Nicole J. , van Soest Heleen L. , Hof Andries F. , den Elzen Michel G. J. , van Vuuren Detlef P. , Chen Wenying , Drouet Laurent , Emmerling Johannes , Fujimori Shinichiro , Höhne Niklas , Kõberle Alexandre C. , McCollum David , Schaeffer Roberto , Shekhar Swapnil , Vishwanathan Saritha Sudharmma , Vrontisi Zoi , Blok Kornelis 
Published: February 2019

Abstract
The bottom-up approach of the Nationally Determined Contributions (NDCs) in the Paris Agreement has led countries to self-determine their greenhouse gas (GHG) emission reduction targets. The planned ‘ratcheting-up’ process, which aims to ensure that the NDCs comply with the overall goal of limiting global average temperature increase to well below 2 °C or even 1.5 °C, will most likely include some evaluation of ‘fairness’ of these reduction targets. In the literature, fairness has been discussed around equity principles, for which many different effort-sharing approaches have been proposed. In this research, we analysed how country-level emission targets and carbon budgets can be derived based on such criteria. We apply novel methods directly based on the global carbon budget, and, for comparison, more commonly used methods using GHG mitigation pathways. For both, we studied the following approaches: equal cumulative per capita emissions, contraction and convergence, grandfathering, greenhouse development rights and ability to pay. As the results critically depend on parameter settings, we used the wide authorship from a range of countries included in this paper to determine default settings and sensitivity analyses. Results show that effort-sharing approaches that (i) calculate required reduction targets in carbon budgets (relative to baseline budgets) and/or (ii) take into account historical emissions when determining carbon budgets can lead to (large) negative remaining carbon budgets for developed countries. This is the case for the equal cumulative per capita approach and especially the greenhouse development rights approach. Furthermore, for developed countries, all effort-sharing approaches except grandfathering lead to more stringent budgets than cost-optimal budgets, indicating that cost-optimal approaches do not lead to outcomes that can be regarded as fair according to most effort-sharing approaches.
Using machine learning for communication classification
Authors: Penczynski Stefan P. 
Published: February 2019

AbstractThe present study explores the value of machine learning techniques in the classification of communication content in experiments. Previously human-coded datasets are used to both train and test algorithm-generated models that relate word counts to categories. For various games, the computer models of the classification are able to match out-of-sample the human classification to a considerable extent. The analysis raises hope that the substantial effort going into such studies can be reduced by using computer algorithms for classification. This would enable a quick and replicable analysis of large-scale datasets at reasonable costs and widen the applicability of such approaches. The paper gives an easily accessible technical introduction into the computational method.
Fixed-point solutions to the regress problem in normative uncertainty
Authors: Trammell Philip 
Published: February 2019

AbstractWhen we are faced with a choice among acts, but are uncertain about the true state of the world, we may be uncertain about the acts’ “choiceworthiness”. Decision theories guide our choice by making normative claims about how we should respond to this uncertainty. If we are unsure which decision theory is correct, however, we may remain unsure of what we ought to do. Given this decision-theoretic uncertainty, meta-theories attempt to resolve the conflicts between our decision theories...but we may be unsure which meta-theory is correct as well. This reasoning can launch a regress of ever-higher-order uncertainty, which may leave one forever uncertain about what one ought to do. There is, fortunately, a class of circumstances under which this regress is not a problem. If one holds a cardinal understanding of subjective choiceworthiness, and accepts certain other criteria (which are too weak to specify any particular decision theory), one’s hierarchy of metanormative uncertainty ultimately converges to precise definitions of “subjective choiceworthiness” for any finite set of acts. If one allows the metanormative regress to extend to the transfinite ordinals, the convergence criteria can be weakened further. Finally, the structure of these results applies straightforwardly not just to decision-theoretic uncertainty, but also to other varieties of normative uncertainty, such as moral uncertainty.
Animated stories of medical error as a&nbsp;means of teaching undergraduates patient safety: an evaluation study
Authors: Cooper Kerri , Hatfield Emma , Yeomans James 
Published: February 2019

Background Storytelling is a powerful form of communication which can improve attention and lead to lasting behavioural changes. Addressing the need to incorporate patient safety teaching into undergraduate medical curricula, it was hypothesized that medical students could benefit from hearing clinician stories of medical error. The medium of animation was considered to be a potentially engaging means of presenting stories of error to a large audience.
Methods Three animated videos were developed to accompany audio recordings of junior doctors describing their experiences of a serious incident or near-miss event. The videos were delivered to 200 final-year medical students with a subsequent large-group discussion directed at understanding contributory factors. An evaluative questionnaire exploring learners’ reactions and modification of beliefs and perception was distributed. The questionnaire included questions rated on a modified Likert scale and a free-text box. A mixed-methods analysis was conducted with descriptive statistics and qualitative content analysis of the free-text responses.
Results Of the 200 students who attended, 104 completed the questionnaire and 83 completed free-text feedback. Most students responded positively to hearing stories of medical error and felt that the animated videos improved their engagement while the voice recordings helped bring the cases to life. The majority of students agreed the session would impact on their future practice.
Conclusion This pilot study confirmed that undergraduate students consider animated, personal stories of medical error an effective, engaging means of learning about patient safety. Longitudinal studies are required to confirm if measurable behaviour change is achieved.