bluuebunny/crossref_metadata_2025_split huggingface dataset:
Drifting Fish Aggregating Devices (FADs)
Authors: Hanich Quentin , Davis Ruth , Holmes Glen , Amidjogbe Elizabeth-Rose , Campbell Brooke 
Published: August 2019

Abstract
This article describes the proliferation of drifting fish aggregating devices (FADs) and analyses subsequent legal questions that arise for fisheries and marine litter management over who is responsible for FADs during their drifting stage. This follows recent concerns about unlicensed FADs drifting through closed areas. This article analyses a case study of the Western and Central Pacific Fisheries Commission (WCPFC) in order to determine State obligations to manage drifting FADs. Analysis concludes that a drifting FAD in the WCPFC Area is ‘fishing’ from deployment to recovery, thereby creating obligations to monitor, control and report drifting FADs, consistent with broader obligations for coastal and flag States. The article recommends strengthening regional management in three ways: implement regional drifting FAD monitoring systems; control deployment of drifting FADs so as to promote recovery and minimize lost gear; and define appropriate responses for FADs that drift into national or closed waters without a license.
How to Express Hail Intensity—Modeling the Hailstone Size Distribution
Authors: Grieser Juergen , Hill Marc 
Published: August 2019

AbstractThe local intensity of hail can be expressed by a variety of variables, such as hail kinetic energy, maximum hailstone size, and radar reflectivity–driven algorithms. All of these variables are connected by the hailstone size distribution. In the United States, the Community Collaborative Rain, Hail and Snow Network (CoCoRaHS) provides more than 37 000 observations that describe the diameter of the smallest, average, and largest hailstone; duration of hail; and overall hailstone number density. We use these data and the assumption of an exponential hailstone size distribution aloft to model the rate of hailstones hitting the ground per unit area, time, and hailstone size bin during the passage of a hailstorm. We found that total hail kinetic energy is proportional to the diameter of the largest hailstone to a power of less than 2. To validate these results, we compared them with hailpad observations of the largest hailstone diameters and hail kinetic energies in southwestern France. As an example application, we calculate the probability mass function for the largest hailstone observed by a hailpad given the largest hailstone occurring in its vicinity. We use this model at Risk Management Solutions, Ltd. (RMS), to calculate the vulnerability of subjects at risk as a function of the diameter of the largest hailstone.
Effects of Text Enhancement, Identical Prescription-Package Names, Visual Cues, and Verbal Provocation on Visual Searches of Look-Alike Drug Names: A Simulation and Eye-Tracking Study
Authors: Wang Hailiang , Or Calvin K. L. 
Published: August 2019

Objective Simulation and eye tracking were used to examine the effects of text enhancement, identical prescription-package names, visual cues, and verbal provocation on visual searches of look-alike drug names. Background Look-alike drug names can cause confusion and medication errors, which jeopardize patient safety. The effectiveness of many strategies that may prevent these problems requires evaluation. Method We conducted two experiments that were based on a four-way, repeated-measures design. The within-subject factors were text enhancement, identical prescription-package names, visual cues, and verbal provocation. In Experiment 1, 40 nurses searched for and selected a target drug from an array of drug packages on a pharmacy shelf mock-up. In Experiment 2, the eye movements of another 40 nurses were tracked while they performed a computer-based drug search task. Results Text enhancement had no significant effect on the drug search. Nurses selected the target drugs more quickly and easily when the prescriptions and drug packages shared identical drug name formats. The use of a visual cue to direct nurses’ attention facilitated their visual searches and improved their eye gaze behaviors. The nurses reported greater mental effort if they were provoked verbally during the drug search. Conclusion Efficient and practical strategies should be adopted for designs that facilitate accurate drug search. Among these strategies are using identical name appearances on drug prescriptions and packages, using a visual cue to direct nurses’ attention, and avoiding rushing nurses while they are concentrating. Application The findings aim to inspire recommendations for work system designs that will improve the visual search of look-alike drug names.
Sensitivity in ethical decision-making: The experiences of nurse managers
Authors: Roshanzadeh Mostafa , Vanaki Zohreh , Sadooghiasl Afsaneh 
Published: August 2019

Background In order to achieve the goals of the healthcare system, nursing managers are required to comply with ethical principles in decision-making. In complex and challenging healthcare settings, it is shown that the managers’ mere awareness of ethics does not suffice and managers need to be sensitive toward making ethical decisions. Aim To explore nursing managers and their sensitivity toward ethical decision-making by analyzing their related experiences. Method The current study has been conducted in Iran in 2017 through a qualitative content analysis approach. Nineteen nurse managers were selected purposefully from different hospitals in Tehran. Data were collected using semi-structured, in-depth, face-to-face interviews, and after transcription, they were analyzed according to the Graneheim and Lundman method. Ethical considerations The research was approved by the ethics committee of Tarbiat Modares University, Tehran, Iran. Participants were informed about the purpose of the study and submitted written informed consents regarding their participation. The principle of autonomy, confidentiality, and anonymity was taken into account in data collection. Results Fifteen subcategories, three categories (assertiveness, commitment, and insight), and one theme of excellent decision-making were the results of data analysis. Discussion Findings showed that nursing managers’ sensitivity to ethical decision-making allows them to make the best decision by insight, commitment, and assertiveness. Making a morally excellent decision ensures that ethical principles are followed in the healthcare system. Conclusion Considering that most managers are committed to making ethical decisions, it is required to develop the scope of their insights even further using a professional management and ethical principles training program. Also, by addressing some of the ethical barriers at personal and organizational levels, the assertiveness in managers can be improved, which in turn can facilitate their ethical decision-making.
Comparison of four inflation techniques on endotracheal tube cuff pressure using a feline airway simulator
Authors: White Donna M , Makara Mariano , Martinez-Taboada Fernando 
Published: August 2019

Objectives The aim of this study was to compare four inflation techniques on endotracheal tube cuff (ETC) pressure using a feline airway simulator. Methods Ten participants used four different endotracheal cuff inflation techniques to inflate the cuff of a low-pressure, high-volume endotracheal tube within a feline airway simulator. The simulator replicated an average-sized feline trachea, intubated with a 4.5 mm endotracheal tube, connected to a circle breathing system and pressure-controlled ventilation with oxygen and medical air. Participants inflated the ETC: by pilot balloon palpation (P); by instilling the minimum occlusive volume (MOV) required for loss of airway leaks during mechanical ventilation; until a passive release of pressure with use of a loss-of-resistance syringe (LOR); and with use of a syringe with a digital pressure reader (D) specifically designed for endotracheal cuff inflation. Intracuff pressure was measured by a manometer obscured to participants. The ideal pressure was considered to be between 20 and 30 cmH2O. Data were analysed by Shapiro–Wilk, Kruskal–Wallis and χ2 tests, as appropriate. Results Participants were eight veterinarians and two veterinary nurses with additional training in anaesthesia. Measured median intracuff pressures for P, MOV, LOR and D, respectively, were 25 cmH2O (range 4–74 cmH2O), 41 cmH2O (range 4–70 cmH2O), 31 cmH2O (range 18–64 cmH2O) and 22 cmH2O (range 20–30 cmH2O). D performed significantly better ( P <0.001) than all other techniques, with no difference between the other techniques. Conclusions and relevance Use of D for cuff inflation achieved optimal cuff pressures. There may be high operator-dependent variability in the cuff pressures achieved with the use of P, MOV or LOR inflation techniques. As such, a cuff manometer is recommended when using any of these techniques.
Snuff box radial artery access for arteriovenous fistula intervention
Authors: Hull Jeffrey , Workman Stephanie , Heath Jean Isabell 
Published: August 2019

Purpose: The aim of this article is to retrospectively compare snuff box radial artery access with direct fistula access for radiocephalic fistula intervention. Materials and Methods: Review of 68 consecutive radiocephalic interventions between April 2013 and April 2017 was performed. The snuff box radial access was performed under ultrasound guidance with the hand in a neutral position (thumb up). The snuff box radial artery was entered distal to the extensor pollicis longus, over the trapezium bone. Hand held pressure was applied for hemostasis. The procedure times, success, and complications of snuff box radial artery access procedures were reviewed. Results: Snuff box radial artery access was used in 25% (17/68) of radiocephalic fistula interventions. All access procedures were successful. Snuff box radial artery access was only used in cases involving the proximal fistula. Lesions treated from snuff box radial artery access approach included 19% (10/54) of fistula stenosis, 50% (1/2) thrombosis, 63% (5/8) immature fistulae, 100% (1/1) steal syndrome, and none of the (0/5) symptomatic outflow occlusions. The mean procedure times for snuff box radial artery access and direct fistula access were not significant at 29.1 ± 16.3 min (range = 10–81) and 26.8 ± 14.0 min (range = 5–70), respectively (p < 0.57). Minor hematoma occurred in 12% (2/17) snuff box radial artery access and 2% (1/51) direct fistula access. There were no major complications. Conclusion: Snuff box radial access was used successfully for radiocephalic fistula intervention with procedure times similar to direct fistula access without major complications.
Effortful control and attention as predictors of cognition in children born preterm
Authors: Nobre Fabíola DA , Gaspardo Claudia M , Linhares Maria Beatriz Martins 
Published: August 2019

Background: Preterm childbirth increases the risk of developmental problems. The aim of the present study was to examine the effects of temperament and attention on the cognition of school-age children who were born preterm, controlling for socioeconomic variables. Material and Methods: The sample was composed of 50 six-year-old children who were born preterm with very low birth weight. The children were evaluated using the Wechsler Intelligence Scale for Children (WISC-III) and the Cancellation Attention Test. The mothers were interviewed using the Children’s Behavior Questionnaire (CBQ). Statistical multiple linear regression analyses were performed. Results: 70% of the children presented average or above-average full intellectual quotient (IQ). In the attention total score, 74% of the children were also within the average range or above. High verbal IQ associated with high maternal schooling explained 73% variability of the full IQ. High attention and maternal schooling, associated with children’s temperament with more effortful control, explained 35% variability of the verbal IQ. High attention, associated with high maternal schooling and socioeconomic level, explained 37% variability of the performance IQ. The neonatal clinical variables (gestational age, birth weight, 5th-minute Apgar, and length of stay in neonatal intensive care unit (NICU) and hospital) were not predictors of cognitive outcomes. Conclusion: The majority of the children who were born preterm presented average or above-average cognitive and attentional performances at school age, demonstrating potential resources for learning. Taken together, attention and temperament, associated with maternal schooling and socioeconomic status, were predictors of cognitive outcomes of children born preterm at school age.
Stereotactic Ablative Radiotherapy for Prostate Cancer—The Treatment Results of 500 Patients and Analysis of Failures
Authors: Miszczyk Leszek , Namysł-Kaletka Agnieszka , Napieralska Aleksandra , Kraszkiewicz Małgorzata , Miszczyk Marcin , Woźniak Grzegorz , Stąpór-Fudzińska Małgorzata , Głowacki Grzegorz , Tukiendorf Andrzej 
Published: August 2019

Objective: Stereotactic ablative radiotherapy is a very promising approach for the treatment of patients with prostate cancer. The aim of this study was to evaluate the clinical tolerance, effectiveness, patterns of failure, and attempt to define predictive factors based on our experience. Methods: The cohort consists of 264 low-risk and 236 intermediate-risk consecutive patients treated at one institution. Prostate-specific antigen (PSA), adverse effects, and androgen deprivation therapy (ADT) usage were noted. Results: Median follow-up was 31.3 months. Over 90% of the patients reported no gastrointestinal toxicity. There were 4 occurrences of G3+ sequelae. 75% patients had no genitourinary toxicity at first month, and up to 90% during the rest of follow-up, with only 1 case of G3 adverse event. The toxicity was more pronounced in patients with higher PSA concentrations. Prior to stereotactic ablative radiotherapy, the mean PSA was 7.59 and 277 patients used ADT. The PSA decreased for up to 20 months before reaching a plateau. The decline was slower, and PSA levels were higher in patients without ADT. A total of 15 treatment failures occured in a median time of 19.9 months. Higher PSA concentrations were connected with higher failure rates, even in the first month and prior to reaching Phoenix criterion. Conclusion: CyberKnife-based stereotactic ablative radiotherapy of low-risk and intermediate-risk prostate cancer patients is an effective and well-tolerated modality of treatment. PSA is the most important predictive factor. The evolution of PSA concentration in a particular subgroup of patients suggests that ADT in intermediate-risk cases could improve long-term results.
Risk Factors, Etiology, and Clinical Outcome of Ischemic Stroke in Young Adults Admitted in a Tertiary Care Hospital in India
Authors: Karri Madhavi , Ramasamy Balakrishnan 
Published: August 2019

Background: Ischemic stroke in young adults is becoming a rising concern with the increase in vulnerability to traditional risk factors and changing lifestyles. Aim: An overview of risk factors, classification, and clinical outcome of ischemic stroke in young adults (19 to 45 years) has been presented. Methods: Data fulfilling the study criteria from the stroke registry between June 2014 and June 2017 were collected, and a detailed proforma was taken that included history, clinical examination, and routine investigations. Selective investigations such as prothrombotic workup and 24-hour Holter monitoring were performed. Stroke was subclassified using the Trial of Org 10172 in Acute Stroke Treatment criteria. National Institute of Health Stroke Scale (NIHSS) scores at baseline and the modified Rankin score (mRS) scoring after 3 months of patients’ admission were calculated. Results: Out of 223 identified cases of ischemic stroke in young adults, 186 (83.4%) were taken for analysis, constituting 7.3% of the total stroke population of 3,059. Among the cases taken for analysis, 137 were males and 49 were females. A total of 150 patients were among the age group of 36 to 45 years. Dyslipidemia, smoking, and alcohol consumption were prevalent in the study group. Atherosclerotic strokes were predominant in the study population. NIHSS scores at admission had a significant impact on mRS scores after 3 months. In this study, only 4% reported the recurrence of stroke, whereas mortality was about 0.02%. Conclusions: Workup required for ischemic stroke in young adults has always been a diagnostic challenge for physicians who treat the stroke patients, and this must be optimized in all health care centers. Despite extensive workup, 23.66% participants were found to be cryptogenic in this study. The clinical outcome was good in this study with less mortality observed.
Bronchial thermoplasty decreases airway remodelling by blocking epithelium-derived heat shock protein-60 secretion and protein arginine methyltransferase-1 in fibroblasts
Authors: Sun Qingzhu , Fang Lei , Roth Michael , Tang Xuemei , Papakonstantinou Eleni , Zhai Weiqi , Louis Renaud , Heinen Vincent , Schleich Florence N. , Lu Shemin , Savic Spasenjia , Tamm Michael , Stolz Daiana 
Published: August 2019

Bronchial thermoplasty (BT) is to date the only therapy that provides a lasting reduction in airway wall remodelling. However, the mechanism of action of BT is not well understood. This study aimed to characterise the changes of remodelling regulating signalling pathways by BT in asthma.Bronchoalveolar lavage fluid (BALF) was obtained from eight patients with severe asthma before and after BT. Primary bronchial epithelial cells were isolated from 23 patients before (n=66) and after (n=62) BT. Epithelial cell culture supernatant (Epi.S) was collected and applied to primary fibroblasts.Epithelial cells obtained from asthma patients after BT proliferated significantly faster compared with epithelial cells obtained before BT. In airway fibroblasts, BALF or Epi.S obtained before BT increased CCAAT enhancer-binding protein-β (C/EBPβ) expression, thereby downregulating microRNA-19a. This upregulated extracellular signal-regulated kinase-1/2 (ERK1/2) expression, protein arginine methyltransferase-1 (PRMT1) expression, cell proliferation and mitochondrial mass. BALF or Epi.S obtained after BT reduced the expression of C/EBPβ, ERK1/2, peroxisome proliferator-activated receptor-γ coactivator-1α (PGC1α), PRMT1 and mitochondrial mass in airway fibroblasts. Proteome and transcriptome analyses indicated that epithelial cell-derived heat shock protein-60 (HSP60) is the main mediator of BT effects on fibroblasts. Further analysis suggested that HSP60 regulated PRMT1 expression, which was responsible for the increased mitochondrial mass and α-smooth muscle actin expression by asthmatic fibroblasts. These effects were ablated after BT. These results imply that BT reduces fibroblast remodelling through modifying the function of epithelial cells, especially by reducing HSP60 secretion and subsequent signalling pathways that regulate PRMT1 expression.We therefore hypothesise that BT decreases airway remodelling by blocking epithelium-derived HSP60 secretion and PRMT1 in fibroblasts.
Efficacy and safety of inhaled α1-antitrypsin in patients with severe α1-antitrypsin deficiency and frequent exacerbations of COPD
Authors: Stolk Jan , Tov Naveh , Chapman Kenneth R. , Fernandez Pablo , MacNee William , Hopkinson Nicholas S. , Piitulainen Eeva , Seersholm Niels , Vogelmeier Claus F. , Bals Robert , McElvaney Gerry , Stockley Robert A. 
Published: August 2019

Patients with inherited α1-antitrypsin (AAT) deficiency (ZZ-AATD) and severe chronic obstructive pulmonary disease (COPD) frequently experience exacerbations. We postulated that inhalation of nebulised AAT would be an effective treatment.We randomly assigned 168 patients to receive twice-daily inhalations of 80 mg AAT solution or placebo for 50 weeks. Patients used an electronic diary to capture exacerbations. The primary endpoint was time from randomisation to the first event-based exacerbation. Secondary endpoints included change in the nature of the exacerbation as defined by the Anthonisen criteria. Safety was also assessed.Time to first moderate or severe exacerbation was a median of 112 days (interquartile range (IQR) 40–211 days) for AAT and 140 days (IQR 72–142 days) for placebo (p=0.0952). The mean yearly rate of all exacerbations was 3.12 in the AAT-treated group and 2.67 in the placebo group (p=0.31). More patients receiving AAT reported treatment-related treatment-emergent adverse events compared to placebo (57.5%versus46.9%, respectively) and they were more likely to withdraw from the study. After the first year of the study, when modifications to the handling of the nebuliser were introduced, the rate of safety events in the AAT-treated group dropped to that of the placebo group.We conclude that in AATD patients with severe COPD and frequent exacerbations, AAT inhalation for 50 weeks showed no effect on time to first exacerbation but may have changed the pattern of the episodes.
Let‐7 as biomarker, prognostic indicator, and therapy for precision medicine in cancer
Authors: Chirshev Evgeny , Oberg Kerby C. , Ioffe Yevgeniya J. , Unternaehrer Juli J. 
Published: August 2019

AbstractAbnormal regulation and expression of microRNAs (miRNAs) has been documented in various diseases including cancer. The miRNA let‐7 (MIRLET7) family controls developmental timing and differentiation. Let‐7 loss contributes to carcinogenesis via an increase in its target oncogenes and stemness factors. Let‐7 targets include genes regulating the cell cycle, cell signaling, and maintenance of differentiation. It is categorized as a tumor suppressor because it reduces cancer aggressiveness, chemoresistance, and radioresistance. However, in rare situations let‐7 acts as an oncogene, increasing cancer migration, invasion, chemoresistance, and expression of genes associated with progression and metastasis. Here, we review let‐7 function as tumor suppressor and oncogene, considering let‐7 as a potential diagnostic and prognostic marker, and a therapeutic target for cancer treatment. We explain the complex regulation and function of different let‐7 family members, pointing to abnormal processes involved in carcinogenesis. Let‐7 is a promising option to complement conventional cancer therapy, but requires a tumor specific delivery method to avoid toxicity. While let‐7 therapy is not yet established, we make the case that assessing its tumor presence is crucial when choosing therapy. Clinical data demonstrate that let‐7 can be used as a biomarker for rational precision medicine decisions, resulting in improved patient survival.