bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative Vancomycin Administration for Surgical Site Prophylaxis: Plasma and Soft-Tissue Concentrations in Pediatric Neurosurgical and Orthopedic Patients
Authors: Brooks Peterson Melissa , Cohen Mindy N. , O’Neill Brent R. , Garg Sumeet , Child Jason , Henthorn Thomas K. , Galinkin Jeffrey G. 
Published: August 2019

BACKGROUND:
Vancomycin is used for antibiotic prophylaxis in pediatric surgical patients without a complete understanding of plasma and soft-tissue pharmacokinetics. Guidelines recommend incision within 60 minutes after administration; however, tissue vancomycin concentrations at that early time may not be therapeutic. We conducted a study of plasma and skin concentrations in pediatric neurosurgical and orthopedic patients to characterize intraoperative vancomycin pharmacokinetics.

METHODS:
Patients (0.1–18.8 years of age) undergoing posterior spinal fusion (n = 30) or ventriculoperitoneal shunt placement (n = 30) received intravenous vancomycin 15 mg/kg (maximum 1000 mg) over 1 hour. Skin was biopsied at incision and skin closure. Blood samples were collected at incision, at 2 and 4 hours intraoperatively, and at closure. Population pharmacokinetic analysis was performed to characterize pharmacokinetic parameter estimates and to develop a model of intraoperative plasma and skin vancomycin concentrations versus time.

RESULTS:
Pharmacokinetic analysis included data from 59 subjects, 130 plasma samples, and 107 skin samples. A 2-compartment model, volume of the central (V

c
) and volume of the peripheral compartment (V

2
), proved to have the best fit. Stepwise covariate selection yielded a significant relationship for body surface area on elimination clearance and body weight on V

2
. Skin vancomycin concentrations rose continuously during surgery. Modeling predicted that equilibration of skin and plasma vancomycin concentrations took ≥5 hours.

CONCLUSIONS:
Skin vancomycin concentrations immediately after a preoperative dose are relatively low compared with concentrations at the end of surgery. It may be advisable to extend the time between dose and incision if higher skin concentrations are desired at the start of surgery.
Identification and phylogenetic analysis of oral Veillonella species isolated from the saliva of Japanese children
Authors: Djais Ariadna A. , Theodorea Citra Fragrantia , Mashima Izumi , Otomo Maiko , Saitoh Masato , Nakazawa Futoshi 
Published: August 2019

Background:As the most frequent infectious disease among children worldwide, dental caries have a strong relationship with oral hygiene status, specifically in the development of infection. However, the study regarding the identification and distribution of oralVeillonellaare limited. The oralVeillonellacommunity may affected by the differences in geographical location, age, diet, lifestyle, socio-economic status and oral hygiene status. Here, we studied the oral hygiene status by examining the composition and proportion of oralVeillonellaspecies in saliva of Japanese children.Methods:Microbial samples collected from 15 Japanese children divided into three oral hygiene groups were cultured under anaerobic conditions after homogenization and dilution, and inoculated onto brain heart infusion and selective mediumVeillonellaagar. Genomic DNA was extracted from each isolate.Veillonellaspecies were detected by one-step PCR usingrpoBspecies-specific primers. To analyse the phylogenetic properties of the unknownVeillonellastrains, PCR amplification and sequence analysis ofrpoBwere conducted for 10 representative strains.Results:AlthoughV. rogosaewas found as the predominant species among all groups, its prevalence was significantly lower in the children with poor oral hygiene than in those with good oral hygiene.V. parvulawas the prevalent species in the poor oral hygiene group. Approximately 10% of the isolatedVeillonellastrains were not classified to any established species; the phylogenetic analysis showed that they were most closely related toV.infantiumConclusions:This study demonstrates that the composition and proportion of oralVeillonellaspecies in the saliva of Japanese children is correlated with different oral hygiene status. Changes in detection ratios ofV. parvulaandV. rogosaecan be useful indicators of oral hygiene status. Furthermore, new strains closely related toV. infantiumwere isolated from the saliva of Japanese children.
Event Motivation Study of Wine Festival Visitors in Maharashtra
Authors: Kotur Kaddi Anupama 
Published: August 2019

Considering the growing interest among Indian travellers in wine tourism within the country and outside, it becomes pertinent to examine the wine enthusiasts‟ consumer psychology in order to have a deeper understanding of the wine tourism market in India. This study is conducted with a three-fold objective of (a) Profiling wine festival visitors based on socio – demographic characteristics; (b) Examining whether any motivational differences exist across male and female visitors of the festival; and (c)Identifying major driving factors that attract visitors to the wine festival. Seven motivating factors were identified and ranked, of which, unwinding& relaxing, exploring new wines and spending time with family and friends were ranked most important motivators for participating in the wine festival. Friedman‟s Rank Sum Test was performed for confirming significance. In order to analyse the motivational differences across male and female visitors, Mann- Whitney Test was used to test for any significant differences. The socio-demographic profiles of the wine festival visitors were assessed in order to understand the market segment of wine consumers who present a high conversion possibility as potential wine tourists. The study is aimed at forming the basis for further research on wine tourism management in Maharashtra and also contributing to research literature in wine tourism in India.
Film Induced Tourism: A Study in Indian Outbound Tourism
Authors: Mitta Nitin , Anjaneyaswamy G 
Published: August 2019

It is widely believed that nothing unites India more than Cricket and Bollywood. Indian spending on foreign travel has increased to four fold as compared to that in the year 2000. While entire Europe and USA are still struggling to come out of recession, as per an estimate, Indian travellers are expected to grow to 50 million from 9 million. These statistics have enticed tourism boards across the world to find multiple avenues to have maximum share of this ever growing pie. Indian middle class is riding high on its growing affluence, and is exploring new locales and destinations to satisfy its craving for the distinct holiday experience. Indian outbound market is sending strong growth signals to the Tourism Boards and National Tourism Boards (NTBs) globally, who have been experimenting for novel ways to tap this market within their restricted resources. Recent studies by global researchers have established the positive influence of films, on people‟s travel decisions, especially to the respective locations and destinations featured on the silver screen. With its glossy and larger than life portrayal in the films, some of these destinations have successfully captured the imagination of movie goers and enticed them to visit the places where films are believed to be shot. Unlike the promotional films made for tourism boards, films are considered more authentic as coming from a third party, hence portrayed with a neutral approach. Through this paper, we have tried addressing the concerns in quantifying the impact of film-induced tourism. We have also covered the factors responsible for hindrance or limiting the impact on destination promotion, which was shown in the particular film.
Perceived Risks; Prominent Dimensions among Tourists from South India
Authors: Antony Jose K 
Published: August 2019

Making travel decisions is never an easy task as tourists will have to consider numerous factors revolving around time, finance, transportation, destinations and activities. Travel decisions are normally made with no expectation of any kind of economic or material returns; intangible results such as pleasure and satisfaction are expected. Therefore, the tourist consumption behavior will involve elements of risk taking. Actions of tourists will regularly yield results and consequences that they may not always be able to anticipate with any approximating degree of certainty, and some of these are at least likely to turn unpleasant. Today, tourists are rarely in a state of mind to anticipate the exact probabilities or risks associated with their purchases. Numerous dimensions of perceived risk have already been identified, such as risks associated with Age, Gender, Income, Personality, Satisfaction, Past Experience, Culture, Nationality and Destination Image. Some of these dimensions appeared more prominent than the others, namely Health Risk, Financial Risk, Time Risk, Safety and Security Risk, and Information and Communication Risk. Research on perceived risk related to tourism has most often been neglected, and in-depth studies on the same have not been extensively undertaken, especially on the South Indian tourists. In this context, the study proposes to investigate the risk perception of tourists travelling from South India.
Sustainability Issue in Tourism: A Case Study of Yuksam Village, Sikkim
Authors: Rubita Irengbam 
Published: August 2019

North East India is blessed with abundant tourism resources, which are unique in their own way. The flora and fauna of this region is regarded as one of the seven most bio-diverse regions of the world. Among the States in this region, Sikkim is quite a popular destination with both the domestic and international tourists. It is perhaps the only state, where one can travel 3500 meters above the sea-level in a space of 160 km. Sikkim is thus a trekker‟s paradise, offering a unique opportunity to trek to Mt. Kangchen-Dzonga. The gateway to this mountain is a small village called Yuksam in South Sikkim. Trends reveal that Yuksam is in the developmental stage of increasing growth of tourist influx, which would also have implications on the infrastructure, environment, natural resources, culture and eco-tourism of this village. So this paper aims to study how tourism in Sikkim, Yuksam in particular, can be sustained.
Conceptualizing Destination Performance Evaluation for Internal Destination Benchmarking: A Review
Authors: K Thomas Toney 
Published: August 2019

Benchmarking the performance of tourism in a tourist destination is an extremely complex and challenging task because of its interdisciplinary nature and due to the involvement of many sectors, components and elements. Integrating the different sectors and synergizing the tourism system function are major issues as the tourism industry requires different levels of involvement with diverse interests. Since tourism is one of the key areas of economic transformation in developing countries, it is essential to enhance destination image, positioning, and ultimately to achieve market leadership which can contribute significantly to communities and nations. It is important to evaluate the performance of the tourist destination in order to stabilize the growth of tourism in the most competitive and sustainable manner. This study explains the construction of Index Core Components and performance evaluation methods for internal tourist destination benchmarking using literature reviews. The findings revealed that a new conceptual model can be used by incorporating major sectors, components and elements of tourism to measure individual performance of the selected Index Core Components.
ОСОБЕННОСТИ ПОКАЗАТЕЛЕЙ СУТОЧНОГО МОНИТОРИРОВАНИЯ АРТЕРИАЛЬНОГО ДАВЛЕНИЯ У МУЖЧИН С ХРОНИЧЕСКОЙ ОБСТРУКТИВНОЙ БОЛЕЗНЬЮ ЛЕГКИХ В УСЛОВИЯХ КОМОРБИДНОСТИ
Authors: Kozlov Evgeny Vyacheslavovich , Yaskevich Roman Anatolyevich , Moskalenko Olga Leonidovna , Kochergina Ksenia Nikolaevna 
Published: August 2019

Цель. Изучить особенности показателей суточного мониторирования артериального давления (СМАД) у мужчин с хронической обструктивной болезнью легких (ХОБЛ) в условиях коморбидности.Материалы и методы. Обследовано 44 пациента мужского пола с ХОБЛ в сочетании с артериальной гипертонией (АГ) и 21 пациент с ХОБЛ без АГ. В группу сравнения вошло 32 пациента с АГ без ХОБЛ. Протокол исследования включал: клинические, инструментальные и лабораторные методы исследования.Результаты. Сравнительный анализ изучаемых показателей СМАД в исследуемых группах позволил выделить следующие особенности. У пациентов с ХОБЛ в условиях коморбидности выявлены более высокие среднесуточные показатели артериального давления (АД) и повышение вариабельности АД, которое может рассматриваться в качестве фактора риска неблагоприятного прогноза заболевания. Установлены статистически значимые различия по показателям величины утреннего подъема (ВУП) и скорости утреннего подъема (СУП). У пациентов ХОБЛ в условиях коморбидности преобладали патологические типы суточной кривой АД «нон-диппер» и «найт-пикер», характеризующиеся, прежде всего, недостаточной степенью ночного снижения АД.Заключение. Установлено, что у пациентов с ХОБЛ в условиях коморбидности имеются не только нарушения вариабельности АД, но и более выраженные изменения суточного профиля АД в сравнении с другими группами.
Experiences of nurses and other health workers participating in a reflective course on compassion-based care
Authors: Donald Graeme , Wilson Ian , McCarthy Jodie , Hall Ian , Crossley Brenda , Adshead Paula , Shaw Vanessa , Dunne Ross , Dwyer Trish 
Published: August 2019

Background: the risk of compassion fatigue in healthcare staff is real, especially when considering the current financial pressures. A course in compassion-based care (CBC) was delivered to mental health staff at a hospital in north-west England, with the intention of rehabilitating ward culture and, subsequently, improving patient experience. Aims: to explore staff experiences of participating in the CBC course. Methods: a qualitative study using semi-structured interviews with participants (n=12) was conducted. All staff attending the course were eligible and were invited to participate. Interview transcripts were thematically analysed. Findings: five themes characterising participant experience emerged from the data: meeting a need; creating the space; reorientation; prioritising self-care; and influencing team dynamics. Data overwhelmingly indicated the success of the CBC course. Conclusion: the CBC course appeared to have a profound effect on participants; it should be considered for further rollout and evaluation.
Hypotension at emergency department admission and hospital-acquired pressure ulcers in older patients: prospective study
Authors: Gong Xiang , Chen Hong-Lin , Shen Jun-Hua , Zhu Bao-Feng 
Published: August 2019

Objective: To investigate the relationship between admission hypotension and hospital acquired pressure ulcers (PU) among older patients in an emergency department. Methods: The study was a prospective cohort conducted between March and May 2017 in the emergency department of a tertiary care hospital in Eastern China. Data on PUs and possible PU risk factors were collected using a pre-designed form. Multivariate logistic regression was used to calculate the adjusted odds ratio (OR). Results: A total of 157 older patients were included in the study. PU incidence was 8.3%, with 95% confidence interval (CI) of 4.5 to 13.7%. The majority (76.9%) of PUs developed in the first three days of admission. On admission, 28 patients were found to be hypotensive, and 129 non-hypotensive. In the hypotensive group, PU incidence was 21.4% (6/28), and 5.4% (7/129) in the non-hypotensive group, respectively. The crude OR was 4.753 (95%CI: 1.183 to 18.086). After adjustment by patients' age, admission to emergency intensive care unit and if requiring assistance to move, the adjusted OR of hypotension on admission for PU risk was 1.755 (95%CI: 1.356 to 3.224). Conclusion: Our study showed that admission hypotension was an independent risk factor of PU among elderly patients in emergency department. However, this conclusion should be confirmed by further studies with large sample size.
Detection of bacteria in burn wounds with a novel handheld autofluorescence wound imaging device: a pilot study
Authors: Pijpe Anouk , Ozdemir Yildiz , Sinnige Jan C. , Kwa Kelly A.A. , Middelkoop Esther , Meij-de Vries Annebeth 
Published: August 2019

Objective: To compare the detection of bacteria in burn wounds between an bacterial fluorescence imaging device MolecuLight i:X, (Canada), and standard microbiological swabs. Methods: Wounds were swabbed three times on one occasion; once with a standard swab, once with a high-fluorescent area swab, indicating a bacterial load >104 colony-forming units (CFU)/gram and a finally with a non-fluorescent (nF) area swab. Proportion agreement of the microbiological results was calculated and the accuracy of the device to detect relevant bacteria was assessed. Results: A total of 14 patients with 20 wounds participated in the study. Median post-burn day at sampling time was 21 days. Of the 20 wounds, nine had a positive swab result in either of the three swabs, and 11 showed a highfluorescent area. Overall, positive and negative proportion agreement between standard swab and high-fluorescent swab sample results were 100%. Sensitivity, specificity, positive and negative predictive values of presence of high-fluorescence were 78%, 64%, 64%, and 78%, respectively. For Pseudomonas aeruginosa detection, these results were 100%, 70%, 44% and 100%, respectively. Conclusion: The diagnostic accuracy of the bacterial fluorescence imaging device to detect relevant bacteria in burn wounds was moderate and the reliability was equal to standard swabbing. Further research in larger sample sizes and on the relevance of minimal bacterial load and its potential to help with Pseudomonas aeruginosa management is needed.
Securing split-thickness skin grafts using negative-pressure wound therapy without suture fixation
Authors: Inatomi Yusuke , Kadota Hideki , Kamizono Kenichi , Hanada Masuo , Yoshida Sei 
Published: August 2019

Objective: Negative-pressure wound therapy (NPWT) is generally applied as a bolster for split-thickness skin grafts (STSG) after the graft has been secured with sutures or skin staples. In this study, NPWT was applied to secure STSGs without any sutures or staples. Surgical outcomes of using NPWT without sutures was compared with a control group. Methods: Patients with STSGs were divided into two groups: a ‘no suture’ group using only NPWT, and a control group using conventional fixings. In the no suture group, the grafts were covered with meshed wound dressing and ointment. The NPWT foam was placed over the STSG and negative pressure applied. In the control group, grafts were fixed in place using tie-over bolster, securing with fibrin glue, or NPWT after sutures. Results: A total of 30 patients with 35 graft sites participated in the study. The mean rate of graft take in the no suture group was 95.1%, compared with 93.3% in the control group, with no significant difference between them. No graft shearing occurred in the no suture group. Although the difference did not reach statistical significance, mean surgical time in the no suture group (31.5 minutes) tended to be shorter than that in the control group (55.7 minutes). Conclusion: By eliminating sutures, the operation time tended to be shorter, suturing was avoided and suture removal was not required meaning that patients could avoid the pain associated with this procedure. Furthermore, the potential for staple retention and its associated complications was avoided, making this method potentially beneficial for both medical staff and patients.
Un « nouveau » fragment du Περὶ φιλοσοφίας : le papyrus d’Aï Khanoum
Authors: Auffret Thomas 
Published: August 2019

AbstractThis article is devoted to the philosophical fragment found in 1977 in the Bactrian city of Aï Khanum. Both its content and origin are still a matter of dispute among scholars. I provide first a new edition of the three remaining columns of the fragment, based on a new reading of its photographic reproductions. The second part of this paper deals with the difficult problem of its origin. I give new evidence in favour of the hypothesis according to which the transmitted text is a piece of the second book of Aristotle’s lost dialogue Περὶ φιλοσοφίας. First, the comparison between this fragment and the opening lines of Theophrastus’ so-calledMetaphysicssuggests that both of them were written shortly after Plato’s death in the same historical and philosophical context, viz inside the Assos circle. Then, I examine the hypothesis of Louis Robert and Paul Bernard according to which an epigram written at the end of a list of Delphic maxims also found in Aï Khanum must be attributed to Clearchus of Soli, the pupil of Aristotle during the Assos period. The close connection between Clearchus’ main philosophical interests and the first book of Aristotle’s lost dialogue explains why he chose to bring it with him during his journey through the East, and left it in Aï Khanum. Finally, the reconstruction of the general structure of the Περὶ φιλοσοφίας leads to the conclusion that the fragment must come from its second book.
Alessandro di Afrodisia e Proclo sulla dialettica
Authors: Del Forno Davide 
Published: August 2019

Abstract
In this paper I compare Alexander of Aphrodisias’ and Proclus’ conceptions of dialectic by discussing a passage from Alexander’s commentary on Aristotle’s Topics and texts from Proclus’ Platonic Theology and commentary on Plato’s Parmenides. I show how Alexander takes up Aristotle’s view of dialectic as an argumentative technique that has no specific object but can be put in the service of philosophy e. g. to establish first principles. In a key passage, Alexander quotes some lines from the Parmenides to emphasize that this was also Plato’s view on dialectic. By contrast, Proclus uses the Parmenides as a crucial source for his conception of dialectic as the crowning glory of philosophy, and fiercely criticizes such interpretations of the Parmenides as that of Alexander, which reduce it to the illustration of a logical method. I argue that the difference in their conceptions of dialectic lies in Alexander’s positive and Proclus’ negative view on doxa and on its role in knowledge.
Ancient Skepticism and Modern Fiction: Some Political Implications
Authors: Laursen John Christian 
Published: August 2019

AbstractThis article draws out the political implications of some of the avatars of ancient skepticism in modern fiction. It relies on Martha Nussbaum’s claim that fiction can provide some of the best lessons in moral philosophy to refute her claim that ancient skepticism was a bad influence on morals. It surveys references to skepticism from Shakespeare through such diverse writers as Isabel de Charrière, Herman Melville, Mark Twain, Anatole France, and Albert Camus down to recent writers such as Orhan Pamuk and Michel Houellebecq. The most substantial treatment is of Naguib Mahfouz’sCairo Trilogy, which is interpreted in two ways: one, as an example ofisostheniaor equipollence in arguments on both sides of questions about gender in the Islamic world, and two, as the biography of a person who claims to be a self-conscious skeptic. Skepticism emerges as a multi-faceted concept in modern literature, but there are definite references back to the ancient skeptics, including mention of the name Pyrrhonism and knowledge of the writings of Sextus Empiricus. The political implications militate against dogmatic claims to truth and knowledge of a one-dimensional justice.