bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cerebral Oxygen Metabolism Before and After RBC Transfusion in Infants Following Major Surgical Procedures
Authors: Neunhoeffer Felix , Hofbeck Michael , Schuhmann Martin Ulrich , Fuchs Jörg , Schlensak Christian , Esslinger Martin , Gerbig Ines , Icheva Vanya , Heimberg Ellen , Kumpf Matthias , Michel Jörg 
Published: February 2018

Objective:
Although infants following major surgery frequently require RBC transfusions, there is still controversy concerning the best definition for requirement of transfusion in the individual patient. The aim of this study was to determine the impact of RBC transfusion on cerebral oxygen metabolism in noncardiac and cardiac postsurgical infants.

Design:
Prospective observational cohort study.

Setting:
Pediatric critical care unit of a tertiary referral center.

Patients:
Fifty-eight infants (15 after pediatric surgery and 43 after cardiac surgery) with anemia requiring RBC transfusion were included.

Interventions:
RBC transfusion.

Measurements and Main Results:
We measured noninvasively regional cerebral oxygen saturation and microperfusion (relative cerebral blood flow) using tissue spectrometry and laser Doppler flowmetry before and after RBC transfusion. Cerebral fractional tissue oxygen extraction and approximated cerebral metabolic rate of oxygen were calculated. Fifty-eight RBC transfusions in 58 patients were monitored (15 after general surgery, 24 after cardiac surgery resulting in acyanotic biventricular physiology and 19 in functionally univentricular hearts including hypoplastic left heart following neonatal palliation). The posttransfusion hemoglobin concentrations increased significantly (9.7 g/dL vs 12.8 g/dL; 9.7 g/dL vs 13.8 g/dL; 13.1 g/dL vs 15.6 g/dL; p < 0.001, respectively). Posttransfusion cerebral oxygen saturation was significantly higher than pretransfusion (61% [51–78] vs 72% [59–89]; p < 0.001; 58% [35–77] vs 71% [57–88]; p < 0.001; 51% [37–61] vs 58% [42–73]; p = 0.007). Cerebral fractional tissue oxygen extraction decreased posttransfusion significantly 0.37 (0.16–0.47) and 0.27 (0.07–039), p = 0.002; 0.40 (0.2–0.62) vs 0.26 (0.11–0.57), p = 0.001; 0.42 (0.23–0.52) vs 0.32 (0.1–0.42), p = 0.017. Cerebral blood flow and approximated cerebral metabolic rate of oxygen showed no significant change during the observation period. The increase in cerebral oxygen saturation and the decrease in cerebral fractional tissue oxygen extraction were most pronounced in patients after cardiac surgery with a pretransfusion cerebral fractional tissue oxygen extraction greater than or equal to 0.4.

Conclusion:
Following RBC transfusion, cerebral oxygen saturation increases and cerebral fractional tissue oxygen extraction decreases. The data suggest that cerebral oxygenation in postoperative infants with cerebral fractional tissue oxygen extraction greater than or equal to 0.4 may be at risk in instable hemodynamic or respiratory situations.
Life-Threatening Accidental Intravenous Epinephrine Overdose in a 12-Year-Old Boy
Authors: André Maya Caroline , Hammer Jürg 
Published: February 2018

Abstract
Reports on accidental intravenous epinephrine overdose in children are extremely rare, although medication errors in the management of pediatric anaphylaxis seem to be frequent. We report a case of a 12-year-old boy presenting with a long-lasting skin rash and dyspnea who was incorrectly diagnosed with early anaphylactic shock and was treated with 10-fold the recommended dose administered by the wrong route (intravenous instead of intramuscular). He reacted with acute loss of consciousness and acute cardiorespiratory failure due to arterial hypotension, ischemic heart failure, and severe pulmonary edema. He responded rapidly to mechanical ventilation, treatment with diuretics, and low-dose inotropes and recovered without sequelae. Despite this ultimately favorable outcome, we report this case to remind the scientific community that inadvertent and accidental epinephrine overdosing is probably an underrecognized event, which can result in potentially lethal complications. Heightening the awareness of the personnel, implementing safety precautions for the dosage and the route of administration, stocking of prefilled intramuscular dose syringes for emergency use in anaphylaxis and, ideally, introducing a standardized drug order form should reduce potential risks and facilitate proper and optimal treatment for all acutely ill children.
Intoxication From Accidental Marijuana Ingestion in Pediatric Patients: What May Lie Ahead
Authors: Boadu Osei , Gombolay Grace Y. , Caviness Verne S. , El Saleeby Chadi M. 
Published: February 2018

Abstract
Marijuana is the most commonly used illicit drug. In young children, there are relatively few reports in the literature of acute marijuana intoxication. Here, we describe the case of a previously healthy 2-year-old girl who presented with clinical seizures. A urine toxicology screen showed elevated levels of tetrahydrocannabinol. The source of the drug was not identified. After a short stay in the hospital, the patient fully recovered with only supportive measures. In this report, we also summarize all domestic and international cases of marijuana intoxication in children younger than 6 years, in conjunction with the number of exposures in children of similar age identified by the US National Poison Data System. This report highlights what is becoming a more common problem. As cannabis continues to be decriminalized across the United States with its increasingly diverse modes of delivery, the potential for accidental exposure in infants and young children also rises. Clinicians should now routinely consider marijuana intoxication in children who present with acute neurological abnormalities.
The Use of Chest Computed Tomographic Angiography in Blunt Trauma Pediatric Population
Authors: Hasadia Rabea , DuBose Joseph , Peleg Kobi , Stephenson Jacob , Givon Adi ,   Israel Trauma Group, Kessel Boris 
Published: February 2018

Introduction
Blunt chest trauma in children is common. Although rare, associated major thoracic vascular injuries (TVIs) are lethal potential sequelae of these mechanisms. The preferred study for definitive diagnosis of TVI in stable patients is computed tomographic angiography imaging of the chest. This imaging modality is, however, associated with high doses of ionizing radiation that represent significant carcinogenic risk for pediatric patients. The aim of the present investigation was to define the incidence of TVI among blunt pediatric trauma patients in an effort to better elucidate the usefulness of computed tomographic angiography use in this population.

Methods
A retrospective cohort study was conducted including all blunt pediatric (age < 14 y) trauma victims registered in Israeli National Trauma Registry maintained by Gertner Institute for Epidemiology and Health Policy Research between the years 1997 and 2015. Data collected included age, sex, mechanism of injury, Glasgow Coma Scale, Injury Severity Score, and incidence of chest named vessel injuries. Statistical analysis was performed using SAS statistical software version 9.2 (SAS Institute Inc, Cary, NC).

Results
Among 433,325 blunt trauma victims, 119,821patients were younger than 14 years. Twelve (0.0001%, 12/119821) of these children were diagnosed with TVI. The most common mechanism in this group was pedestrian hit by a car. Mortality was 41.7% (5/12).

Conclusions
Thoracic vascular injury is exceptionally rare among pediatric blunt trauma victims but does contribute to the high morbidity and mortality seen with blunt chest trauma. Computed tomographic angiography, with its associated radiation exposure risk, should not be used as a standard tool after trauma in injured children. Clinical protocols are needed in this population to minimize radiation risk while allowing prompt identification of life-threatening injuries.
Evaluation of Predictors of Mortality Associated With Childhood Heart Failure in Nigeria
Authors: Sadoh Wilson E. , Okperi Blessing , Ikhurionan Paul , Monday Promise , Sadoh Ayebo E. 
Published: February 2018

Objective
The aim of this study was to evaluate the predictors of mortality in childhood heart failure (HF) in 2 tertiary hospitals.

Methods
A 51-month retrospective review of case notes of children with HF admitted into children's emergency rooms of 2 tertiary centers in Southern Nigeria was done. Bio-data and certain sociodemographic variables including mortality were abstracted. Bivariate and multivariate analyses were done to evaluate the predictors of mortality in HF.

Results
The case notes of 289 children were analyzed, consisting of 153 males (52.9%) and 142 infants (49.1%). Lower respiratory tract infections, 121 (41.9%), were the commonest causes of HF. Twenty-eight children (9.7%) died. In multivariate analyses, only late presentation (P < 0.0001) was an independent predictor of mortality in HF.

Conclusion
Education of the populace about early presentation to hospital is imperative to prevent unnecessary deaths associated with HF.
Socioeconomic Position and Age-Related Disparities in Regional Cerebral Blood Flow Within the Prefrontal Cortex
Authors: Hackman Daniel A. , Kuan Dora C-H. , Manuck Stephen B. , Gianaros Peter J. 
Published: February 2018

ABSTRACT

Objective
Socioeconomic position (SEP) is associated with cerebrovascular health and brain function, particularly in prefrontal cortex and medial temporal lobe regions that exhibit plasticity across the life course. However, it is unknown whether SEP associates with resting cerebral blood flow (CBF), an indicator of baseline brain function, in these regions in midlife, and whether the association is (a) period specific, with independent associations for childhood and adulthood SEP, or driven by life course SEP, and (b) explained by a persistent disparity, widening disparity, or the leveling of disparities with age.

Methods
To address these questions, we analyzed cerebral perfusion derived by magnetic resonance imaging in a cross-sectional study of healthy adults (N = 443) who reported on childhood and adult SEP. Main effects were examined as an index of persistent disparity and age by SEP interactions as reflecting widening or leveling disparities.

Results
Stable high SEP across the lifespan was associated with higher global CBF and regional CBF (rCBF) in inferior frontal gyrus. However, childhood SEP was associated with rCBF in middle frontal gyrus, as moderated by age (β = 0.04, p = .035): rCBF was inversely associated with age only for those whose parents had a high school education or below. No associations were observed for the hippocampus or amygdala.

Conclusions
Life course SEP associations with rCBF in prefrontal cortex are suggestive of persistent disparities, whereas the age by childhood SEP interaction suggests that childhood disadvantage relates to a widening disparity, independent of global differences. These differential patterns in midlife may relate to disparities in later-life cerebrovascular and neurocognitive outcomes.
Conceptualisation of intellectual capital in analysts’ narratives: a performative view
Authors: Abhayawansa Subhash , Aleksanyan Mark , Cuganesan Suresh 
Published: February 2018

Purpose
The purpose of this paper is to test the performativity of intellectual capital (IC) from the perspective of sell-side analysts, a type of actor who consumes and creates IC information and in whose practice IC information plays a significant role.

Design/methodology/approach
The empirical component of the study comprises a narrative analysis of the text of a large corpus of sell-side analysts’ initiation coverage reports. The authors adopt Mouritsen’s (2006) performative and ostensive conceptualisations of IC as the theoretical framework.

Findings
The authors find that the identities and properties of IC elements are variable, dynamic and transformative. The relevance of IC elements in the eyes of analysts is conditional on the context, temporally contingent and bestowed indirectly. IC elements are attributed to firm value both directly, in a linear manner, and indirectly, via various non-linear interrelationships established with other IC elements, tangible capital and financial capital.

Research limitations/implications
This study challenges the conventional IC research paradigm and contributes towards a performativity-inspired conceptualisation of IC and a resultant situated model of IC in place of a predictive model.

Originality/value
This is the first study to apply a performative lens to study IC identities, roles and relationships from the perspective of a field of practice that is external to the organisation where IC is hosted. Examining IC from analysts’ perspective is important because not only can it provide an alternative perspective of IC, it also enables an understanding of analysts’ field of practice.
Activation policies in action
Authors: Coletto Diego , Guglielmi Simona 
Published: February 2018

PurposeThe purpose of this paper is to understand the process that occurs within public employment offices (PEOs) and its consequences for unemployed people. Specifically, it analysed some practices needed to implement activation programmes developed in some PEO in Lombardy (Italy) and the role of front-line officers, promoting a dialogue between the literature on activation policies on one hand and the literature on street-level bureaucracy on the other.Design/methodology/approachThe fieldwork has been conducted in Lombardy, which is one of most economically developed areas both in Italy and in Europe. The empirical research integrated quantitative and qualitative research tools; specifically a CATI survey of 994 persons; participant and non-participant observations, semi-structured interviews, and an analysis of documents in four PEOs.FindingsThe paper describes and analyses both practices needed to implement activation programmes and the perceptions of the social actors (unemployed people and front-line officers) who build and address these practices daily. Specifically, the attention is focussed on the different forms of discretion used by PEOs’ front-line officers and a mix of technical, relational and psychological support received in the PEOs. Moreover, the authors noticed that the front-line officers’ discretion seemed to be more limited in those parts of the activation process in which it should be more relevant, that is, the identification of training courses aimed at increasing unemployed workers’ skills. Notwithstanding these limits, many users expressed positive opinions of these courses, which could be explained by secondary functions of training courses.Research limitations/implicationsThe qualitative portion of the fieldwork has limited generalisability because it focussed on few PEOs.Practical implicationsThe findings are relevant to policy makers who deal with activation policies and to public and private organisations that implement those policies.Originality/valueMany studies have analysed the implementation of the welfare-to-work model that has oriented the reforms of labour market activation policies in most countries, focussing on the more tangible outcomes (essentially their efficacy in terms of re-employment rates). A growing stream of recent literature has begun to place more attention on the non-economic consequences of activation programmes, focussing mainly on countries with quite a long tradition of activation policies while remaining scant in countries where the implementation of activation programmes is still fragmented and more recent (like Italy). This paper aims to begin filling this gap by improving the knowledge on some non-economic consequences of activation programmes, focussing on user-officer relations and on daily practices in PEOs.
Job search of men and women on long-term social welfare
Authors: Schels Brigitte , Bethmann Arne 
Published: February 2018

PurposeThe purpose of this paper is to examine the job search probability in welfare receipt over time for men and women in different household constellations, because it is a major concern in welfare states that long-term receipt is driven by recipients’ low job search activity.Design/methodology/approachThe paper analyses the likelihood to search for a job for a sample of unemployed recipients of means-tested welfare benefits in Germany. Data basis is the panel study “Labour Market and Social Security” (PASS), and growth curve models are applied in this study.FindingsJob search probability differs by household constellation and gender directly after the onset of welfare receipt; differences are less distinct for changes in job search probability over time. Only welfare recipients without children show a pronounced decline in search probability.Practical implicationsThere is no evidence that welfare recipients’ overall cease to search for a job by and by. Financial incentives alone cannot stimulate the job search of welfare recipients, when the diverse motives of male and female recipients in various household constellations are not considered as well.Originality/valueThis paper is the first to study the long-term development in the job search probability and gender differences by household constellations.
How do ideas and discourses construct youth policies? The case of Hong Kong
Authors: Wong Victor , Au-Yeung Tat Chor 
Published: February 2018

Purpose
The purpose of this paper is to critically examine the youth narratives of Mr Leung Chun-ying, the Chief Executive (CE) of the Hong Kong Special Administrative Region (HKSAR) Government between 2012 and 2017, which steered the directions of youth policies in Hong Kong.

Design/methodology/approach
Informed by the ideational school of institutionalism, a qualitative documentary study was conducted to analyse the policy addresses, speeches, and blog posts delivered by the then CE, which were all available on the website of the HKSAR Government. It was through a thematic analysis of the database that themes and sub-themes were generated for the discussion. Representative verbatim quotes are used for illustrating some of the youth policy ideas and discourses promoted under the Leung’s regime.

Findings
The findings suggest that the governing youth narratives could be categorised into two interrelated themes: behavioural patriotism and economic opportunism. The notions of youth development constructed in the narratives of Leung shape the definition of youth-related problems and solutions in relation to national identity and global competition.

Research limitations/implications
This study focusses on the previous term of HKSAR Government that cannot fully reveal the extent of policy continuities and changes. Yet, it could outline the overall picture and address the shortcomings of Hong Kong’s current youth policies viewed from both normative and cognitive perspectives. Methodological and analytical implications can be drawn for further studies on policy ideas and discourses.

Originality/value
The paper has two major contributions; the first of which is the illustration of an analytical framework connecting contents, tools, and justification of policies for capturing the dynamics and complexities of youth policies. Second, the findings of this study develop a critical understanding of neoliberal youth policies in both economic and moral senses that pose new challenges to young people and policy makers.
Performance characteristics of two-axial groove journal bearing for different groove angles
Authors: Kadam K.R. , Banwait S.S. 
Published: February 2018

Purpose
Different groove angles are used to study performance characteristics of two-axial groove journal bearing. In this study two grooves are located at ±90º to the load line. The various angles of grooves have been taken as 10° to 40° in the interval of 5°. Different equations such as Reynolds equation, three-dimensional energy equation and heat conduction equation have been solved using finite element method and finite difference method. Pressure distribution in fluid is found by using Reynolds equation. The three-dimensional energy equation is used for temperature distribution in the fluid film and bush. One-dimensional heat conduction equation is used for finding temperature in axial direction for journal. There is a very small effect of groove angle on film thickness, eccentricity ratio and pressure. There is a drastic change in attitude angle and side flow. Result shows that there is maximum power loss at large groove angle. So the smaller groove angle is recommended for two-axial groove journal bearing.

Design/methodology/approach
The finite element method is used for solving Reynolds equation for pressure distribution in fluid. The finite difference method is adopted for finding temperature distribution in bush, fluid and journal.

Findings
Pressure distribution in fluid is found out. Temperature distribution in bush, fluid and journal is found out. There is a very small effect of groove angle on film thickness, eccentricity ratio and pressure.

Research limitations/implications
The groove angle used is from 10 to 40 degree. The power loss is more when angle of groove increases, so smaller groove angle is recommended for this study.

Practical implications
The location of groove angle predicts the distribution of pressure and temperature in journal bearing. It will show the performance characteristics. ±90° angle we will prefer that will get before manufacturing of bearing.

Social implications
Due to this study, we will get predict how the pressure and temperature distribute in the journal. It will give the running condition of bearing as to at what speed and load we will get the maximum temperature and pressure in the bearing.

Originality/value
The finite element method is used for solving the Reynolds equation. Three-dimensional energy equation is solved using the finite difference method. Heat conduction equation is also solved for journal. The C language is used. The code is developed in C language. There are different equations which depend on each other. The temperature is dependent on pressure viscosity of fluid, etc. so C code is preferred.
Correlation of base oil viscosity in grease with vibration severity of damaged rolling bearings
Authors: Jamadar Imran Moulaalli , Vakharia Dipakkumar 
Published: February 2018

Purpose
The main objective of the paper is to explore the theoretical correlation of base oil viscosity in grease and to study the effect of grease grade on mechanical vibrations associated with the damaged rolling bearings.

Design/methodology/approach
For theoretical purposes, formulation theory of dimensional analysis was implemented. Experiments were then performed on the test bearings lubricated with three different types of greases, namely, SKF LGHP2, SKF LGMT3 and SKF LGWA2.

Findings
The numerical results obtained from the theoretical model along with the results of experiments show that the vibration amplitudes of the defective bearings come down to a lower level when it is lubricated with the grease of a higher base oil viscosity.

Research limitations/implications
The promising results from the theoretical model make it usable for the practical rotating machineries applying a variety of the rolling bearings. Consequently, if the bearing is not severely damaged, its performance can be increased by lubricating it with thicker grease.

Originality/value
Despite many significant contributions in the field to detect the presence of defects, not many studies have been performed that relate the lubrication condition of the rolling bearings with the vibration response, because around 50-75% of the bearing failures are attributed to be lubrication related. Hence, there is need to develop a mathematical model that can correlate the vibration severity of the bearings with viscosity of the lubricant oil in the greases along with other design and operating parameters.