bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pediatric Critical Care Transport as a Conduit to Terminal Extubation at Home: A Case Series*
Authors: Noje Corina , Bernier Meghan L. , Costabile Philomena M. , Klein Bruce L. , Kudchadkar Sapna R. 
Published: November 2016

Objectives:
To present our single-center’s experience with three palliative critical care transports home from the PICU for terminal extubation.

Design:
We performed a retrospective chart review of patients transported between January 1, 2012, and December 31, 2014.

Setting:
All cases were identified from our institutional pediatric transport database.

Patients:
Patients were terminally ill children unable to separate from mechanical ventilation in the PICU, who were transported home for terminal extubation and end-of-life care according to their families’ wishes.

Interventions:
Patients underwent palliative care transport home for terminal extubation.

Measurements and Main Results:
The rate of palliative care transports home for terminal extubation during the study period was 2.6 per 100 deaths. The patients were 7 months, 6 years, and 18 years old and had complex chronic conditions. The transfer process was protocolized. The families were approached by the PICU staff during multidisciplinary goals-of-care meetings. Parental expectations were clarified, and home hospice care was arranged pretransfer. All transports were performed by our pediatric critical care transport team, and all terminal extubations were performed by physicians. All patients had unstable medical conditions and urgent needs for transport to comply with the families’ wishes for withdrawal of life support and death at home. As such, all three cases presented similar logistic challenges, including establishing do-not-resuscitate status pretransport, having limited time to organize the transport, and coordinating home palliative care services with available community resources.

Conclusions:
Although a relatively infrequent practice in pediatric critical care, transport home for terminal extubation represents a feasible alternative for families seeking out-of-hospital end-of-life care for their critically ill technology-dependent children. Our single-center experience supports the need for development of formal programs for end-of-life critical care transports to include patient screening tools, palliative care home discharge algorithms, transport protocols, and resource utilization and cost analyses.
Implementation of a Nurse-Driven Sedation Protocol in a PICU Decreases Daily Doses of Midazolam
Authors: Gaillard-Le Roux Bénédicte , Liet Jean-Michel , Bourgoin Pierre , Legrand Arnaud , Roze Jean-Christophe , Joram Nicolas 
Published: November 2016

Objectives:
To evaluate the impact of a nurse-driven sedation protocol on the length of mechanical ventilation, total daily doses of sedatives, and complications of sedation.

Design:
A single-center prospective before and after study was conducted from October 2010 to December 2013.

Setting:
Twelve-bed surgical and medical PICU of the university-affiliated hospital in Nantes, France.

Patients:
A total of 235 patients, between 28 days and 18 years old, requiring mechanical ventilation for at least 24 hours were included in the study; data from 194 patients were analyzed.

Interventions:
During the first study phase, no protocol was used. During the second phase, patients were sedated according to a nurse-driven protocol.

Measurements and Main Results:
In the whole population, the length of mechanical ventilation did not differ between protocol and control groups (protocol, 4 [3–8] vs control, 5 [3–7.5]; p = 0.44). Analyzing age subgroups, the length of mechanical ventilation was significantly shorter in the protocol group than in the control group in children older than 12 months (4 [3–8] vs 5 [2.75–11.25] d; p = 0.04). Daily dose of midazolam decreased during the protocol phase compared with the control phase (1 [0.56–1.8] and 1.2 [0.85–2.4] mg/kg/d, respectively; p = 0.02). No differences were shown regarding other daily dose of drugs. In the control group, 68% of children had more than 20% of COMFORT-behavior scale assessment under the target (oversedation) versus 59% in the protocol group (p = 0.139).

Conclusions:
Implementation of a nurse-driven sedation protocol in a PICU is feasible and safe, allowed a decrease in daily dose of benzodiazepines, and decreased the duration of mechanical ventilation in older patients.
Bedside Ultrasound for the Diagnosis of Abnormal Diaphragmatic Motion in Children After Heart Surgery
Authors: Gil-Juanmiquel Laura , Gratacós Margarida , Castilla-Fernández Yolanda , Piqueras Joaquim , Baust Tracy , Raguer Nuria , Balcells Joan , Perez-Hoyos Santiago , Abella Raul F. , Sanchez-de-Toledo Joan 
Published: November 2016

Objective:To assess the utility of bedside ultrasound combining B- and M-mode in the diagnosis of abnormal diaphragmatic motion in children after heart surgery.Design:Prospective post hoc blinded comparison of ultrasound performed by two different intensivists and fluoroscopy results with electromyography.Setting:Tertiary university hospital.Subjects:Children with suspected abnormal diaphragmatic motion after heart surgery.Interventions:None.Measurements and Main Results:Abnormal diaphragmatic motion was suspected in 26 children. Electromyography confirmed the diagnosis in 20 of 24 children (83.3%). The overall occurrence rate of abnormal diaphragmatic motion during the study period was 7.5%. Median patient age was 5 months (range, 16 d to 14 yr). Sensitivity and specificity of chest ultrasound performed at the bedside by the two intensivists (91% and 92% and 92% and 95%, respectively) were higher than those obtained by fluoroscopy (87% and 83%). Interobserver agreement (k) between both intensivists was 0.957 (95% CI, 0.87–100).Conclusions:Chest ultrasound performed by intensivists is a valid tool for the diagnosis of diaphragmatic paralysis, presenting greater sensitivity and specificity than fluoroscopy. Chest ultrasound should be routinely used after pediatric heart surgery given its reliability, reproducibility, availability, and safety.
Length filtration of the separable states
Authors: Chen Lin , Ðoković Dragomir Ž. 
Published: November 2016

We investigate the separable states
ρ
of an arbitrary multi-partite quantum system with Hilbert space

H

of dimension
d
. The length
L
(
ρ
) of
ρ
is defined as the smallest number of pure product states having
ρ
as their mixture. The length filtration of the set of separable states,

S

, is the increasing chain

∅
⊊

S

1
′

⊆

S

2
′

⊆
⋯

, where

S

i
′

=
{
ρ
∈

S

:
L
(
ρ
)
≤
i
}

. We define the maximum length,

L

max

=

max

ρ
∈

S

L
(
ρ
)

, critical length,
L
crit
, and yet another special length,
L
c
, which was defined by a simple formula in one of our previous papers. The critical length indicates the first term in the length filtration whose dimension is equal to

Dim

S

. We show that in general
d
≤
L
c
≤
L
crit
≤
L
max
≤
d
2
. We conjecture that the equality
L
crit
=
L
c
holds for all finite-dimensional multi-partite quantum systems. Our main result is that
L
crit
=
L
c
for the bipartite systems having a single qubit as one of the parties. This is accomplished by computing the rank of the Jacobian matrix of a suitable map having

S

as its range.
Thirty per cent contrast in secondary-electron imaging by scanning field-emission microscopy
Authors: Zanin D. A. , De Pietro L. G. , Peter Q. , Kostanyan A. , Cabrera H. , Vindigni A. , Bähler Th. , Pescia D. , Ramsperger U. 
Published: November 2016

We perform scanning tunnelling microscopy (STM) in a regime where primary electrons are field-emitted from the tip and excite secondary electrons out of the target—the scanning field-emission microscopy regime (SFM). In the SFM mode, a secondary-electron contrast as high as 30% is observed when imaging a monoatomic step between a clean W(110)- and an Fe-covered W(110)-terrace. This is a figure of contrast comparable to STM. The apparent width of the monoatomic step attains the 1
nm
mark, i.e. it is only marginally worse than the corresponding width observed in STM. The origin of the unexpected strong contrast in SFM is the material dependence of the secondary-electron yield and not the dependence of the transported current on the tip–target distance, typical of STM: accordingly, we expect that a technology combining STM and SFM will highlight complementary aspects of a surface while simultaneously making electrons, selected with nanometre spatial precision, available to a macroscopic environment for further processing.
netDx: Interpretable patient classification using integrated patient similarity networks
Authors: Pai Shraddha , Hui Shirley , Isserlin Ruth , Shah Muhammad A , Kaka Hussam , Bader Gary D 
Published: November 2016

AbstractPatient classification has widespread biomedical and clinical applications, including diagnosis, prognosis and treatment response prediction. A clinically useful prediction algorithm should be accurate, generalizable, be able to integrate diverse data types, and handle sparse data. A clinical predictor based on genomic data needs to be easily interpretable to drive hypothesis-driven research into new treatments. We describe netDx, a novel supervised patient classification framework based on patient similarity networks. netDx meets the above criteria and particularly excels at data integration and model interpretability. As a machine learning method, netDx demonstrates consistently excellent performance in a cancer survival benchmark across four cancer types by integrating up to six genomic and clinical data types. In these tests, netDx has significantly higher average performance than most other machine-learning approaches across most cancer types and its best model outperforms all other methods for two cancer types. In comparison to traditional machine learning-based patient classifiers, netDx results are more interpretable, visualizing the decision boundary in the context of patient similarity space. When patient similarity is defined by pathway-level gene expression, netDx identifies biological pathways important for outcome prediction, as demonstrated in diverse data sets of breast cancer and asthma. Thus, netDx can serve both as a patient classifier and as a tool for discovery of biological features characteristic of disease. We provide a software complete implementation of netDx along with sample files and automation workflows in R.
Can you catch Ebola from a stork bite? Inductive reasoning influences on zoonosis risk perception
Authors: Davis Tyler , Goldwater Micah B. , Ireland Molly E. , Gaylord Nicholas , Van Allen Jason 
Published: November 2016

AbstractEmerging zoonoses are a prominent global health threat. Human beliefs are central to drivers of emerging zoonoses, yet little is known about the factors that influence perceived risks of animal contact. We present an inductive account of zoonosis risk perception, suggesting that beliefs about the range of animals that are able to transmit diseases to each other influence zoonosis risk perception. Consistent with our account, in Study 1, we find that participants who endorse higher likelihoods of cross-species disease transmission have stronger intention to report animal bites. In Study 2, using real world descriptions of Ebola virus from the WHO and CDC, we find that communications conveying a broader range of animals as susceptible increase intentions to report animal bites and decrease perceived safety of wild game meat. These results suggest that cognitive factors may be harnessed to modulate zoonosis risk perception and combat emerging infectious diseases.
Fine-scale temporal analysis of genotype-dependent mortality at settlement in the Pacific oysterCrassostrea gigas
Authors: Plough Louis V 
Published: November 2016

AbstractSettlement and metamorphosis mark a critical transition in the life cycle of marine invertebrates, during which larvae undergo substantial morphological, sensory, and genetic changes. High mortality during or after metamorphosis is commonly observed in both wild and hatchery settings, however, the underlying causes of this mortality remain poorly understood. Previous pair-crossing experiments with the Pacific oyster,Crassostrea gigasshowed that substantial genotype-dependent mortality (GDM) occurs around metamorphosis, but, owing to sparse temporal sampling, it remains unknown whether mortality occurs just before, during, or after settlement. In this laboratory study, microsatellite marker segregation ratios were followed daily throughout the settlement and metamorphosis of an inbred, F2cross of the Pacific oyster to examine the fine-scale patterns of GDM in larvae and spat. Genetic control of settlement timing was also examined using a quantitative trait locus (QTL) mapping approach. Settlement occurred over nine days (day 18 to day 27 post-fertilization) with 68% of individuals settling on an early (day 19) and a late (day 24) time point. Tracking the survival of spat for 40 days after initial settlement revealed almost no post-settlement mortality. Temporal analysis revealed that three of 11 loci exhibited segregation distortion at metamorphosis, one of which (Cg205) was followed throughout settlement. Alternative temporal patterns of selection against each homozygote atCg205suggest possible defects in both the competency pathway (inability to initiate metamorphosis) and the morphogenesis pathway (mortality during the metamorphic transition). QTL mapping of settlement timing identified three individual and one epistatic QTL (29% of the variance explained), however, two of these loci were closely linked to markers exhibiting GDM at metamorphosis, thus making it difficult to distinguish between genetic variance in settlement timing and differential mortality early or late in settlement. Overall, results from this study highlight the complex temporal patterns of viability selection during metamorphosis and show that endogenous mortality during the larval-juvenile transition appears to be focused during or just prior to metamorphosis. Fine-scale experimental analysis of settlement can reveal important genetic insights into larval settlement behavior and the sources of larval mortality, and future studies should be able to further dissect the functional targets of selection during metamorphosis.
Visual processing mode switching regulated by VIP cells
Authors: Hoon Lee Jung , Mihalas Stefan 
Published: November 2016

AbstractThe responses of neurons in mouse primary visual cortex (V1) to visual stimuli depend on behavioral states. Specifically, surround suppression is reduced during locomotion. Although locomotion-induced vasoactive intestinal polypeptide positive (VIP) interneuron depolarization can account for the reduction of surround suppression, the functions of VIP cell depolarization are not fully understood. Here we utilize a firing rate model and a computational model to elucidate the potential functions of VIP cell depolarization during locomotion. Our analyses suggest 1) that surround suppression sharpens the visual responses in V1 to a stationary scene, 2) that depolarized VIP cells enhance V1 responses to moving objects by reducing self-induced surround suppression and 3) that during locomotion V1 neuron responses to some features of the moving objects can be selectively enhanced. Thus, VIP cells regulate surround suppression to allow pyramidal neurons to optimally encode visual information independent of behavioral state.
Sleep regulation of the distribution of cortical firing rates
Authors: Levenstein Daniel , Watson Brendon O. , Rinzel John , Buzsáki György 
Published: November 2016

ABSTRACTSleep is thought to mediate mnemonic and homeostatic functions. However, the mechanism by which this brain state can implement both the “selective” plasticity needed to consolidate novel memory traces as well as the “general” plasticity necessary to maintain a well-functioning neuronal system is unclear. Recent findings show that both of these functions differentially affect neurons based on their intrinsic firing rate, a ubiquitous neuronal heterogeneity. Furthermore, they are both implemented by the NREM slow oscillation, which also distinguishes neurons based on firing rate during sequential activity at the DOWN->UP transition. These findings suggest a mechanism by which spiking activity during the slow oscillation acts to maintain network statistics that promote a skewed distribution of neuronal firing rates, and “perturbation” of that activity by hippocampal replay acts to integrate new memory traces into the existing cortical network.
Motherhood: an impediment to workplace progression? The case of Cyprus
Authors: Socratous Maria , Galloway Laura , Kamenou-Aigbekaen Nicolina 
Published: November 2016

Purpose
The purpose of this paper is to identify potential explanations on why motherhood affects the non-progression of women, in Cyprus, to the top of the organisational ladder.

Design/methodology/approach
For the purposes of the study a qualitative approach was taken and semi-structured interviews were used. The interviews were conducted with specific, preselected employment groups. These were chartered accountants from the Big Four (PWC, Deloitte, Ernst & Young, KPMG) companies in Cyprus and academics working at the University of Cyprus.

Findings
It has been identified through the interviews that women in Cyprus are faced with impediments on their way to the upper levels of the organisational ladder. The reasons for this vary and one of the most important is the motherhood effect. In particular, the research suggests that cultural norms and perceptions that women should be the primary caregiver are a barrier to advancement for women and there is a lack of family friendly policies and childcare facilities at least in the organisations included in this study.

Originality/value
This paper sheds light into a previously under-researched area; gender equality in Cyprus. The author also denotes the problems a mother is faced with on her way to the top of the organisational ladder and that culture is of utmost importance with regards to the role of women in the society and the workplace in Cyprus and elsewhere.
Racial dissimilarity and diversity climate effect organizational identification
Authors: Cole Brooklyn , Jones Raymond J. , Russell Lisa M. 
Published: November 2016

PurposeThe purpose of this paper is to empirically examine the relationship between psychological diversity climate (PDC) and organizational identification (OID) when influenced by racial dissimilarity between the subordinate and supervisor.Design/methodology/approachOrdinary least squares hierarchical regression analysis was run for hypotheses testing.FindingsThree of the four hypothesized relationships were supported. Support was found for the direct relationship between PDC and OID. The moderator race was significant thus also supported. The moderator of dissimilarity was not supported. Finally the three-way interaction with race and dissimilarity was supported.Practical implicationsOID is an important variable for overall organizational success. OID influences a wealth of organizationally relevant outcomes including turnover intentions. Considering higher turnover exists for minority employees, understanding how diversity climate perceptions vary by employee race and therefore impact OID differently, helps managers when making decisions about various initiatives.Originality/valueThis study is the first the authors know of to investigate the impact of dissimilarity on the PDC-OID relationship.
Local tropical forest restoration strategies affect tree recruitment more strongly than does landscape forest cover
Authors: Holl Karen D. , Reid John Leighton , Chaves‐Fallas José Miguel , Oviedo‐Brenes Federico , Zahawi Rakan A. 
Published: November 2016

Summary

Developing restoration strategies that accelerate natural successional processes and are resource‐efficient is critical to facilitating tropical forest recovery across millions of hectares of deforested lands in the tropics.

We compared tree recruitment after a decade in three restoration treatments (natural regeneration, applied nucleation/island tree planting and plantation) and nearby reference forest in the premontane rain forest zone in southern Costa Rica. The study was replicated at 13 sites with a range of surrounding forest cover, enabling us to evaluate the relative influence of local restoration treatments and landscape forest cover on tree recruitment.

Density of small‐seeded (<5 mm), animal‐dispersed recruits was lower in natural regeneration than in applied nucleation, plantation or reference forest plots. Species richness, species density and density of medium (5–10 mm)‐ and large (>10 mm)‐seeded, animal‐dispersed recruits were greatest in reference forest, intermediate in applied nucleation and plantation and lowest in natural regeneration plots.

Recruit composition differed substantially between reference forest and all restoration treatments. In general, plantation recruit composition was more similar to reference forests and natural regeneration least similar; however, there was high within‐treatment variation.

Models suggested weak support for the effect of surrounding forest cover on tropical tree recruit density and composition, as compared to restoration treatment and site conditions (e.g. elevation), in this intermediate forest cover landscape.

Synthesis and applications. Applied nucleation appears to be a cost‐effective strategy as compared to plantation‐style planting to accelerate tropical forest recovery regardless of the amount of forest cover immediately adjacent to the site. However, even with active restoration interventions, forest recovery is a multidecade process that proceeds at highly variable rates.
Writing the patient down and out: the construal of the patient in medical certificates of disability
Authors: Aarseth Guri , Natvig Bård , Engebretsen Eivind , Maagerø Eva , Lie Anne Helene Kveim 
Published: November 2016

AbstractWe analysed a set of medical certificates to investigate howGPs portray patients who seek disability benefits in Norway, focusing on patient centredness, agency and involvement. We performed a qualitative linguistic analysis of 33 medical certificates collected throughout Norway that were strategically selected based on the patients’ sex, age and diagnosis. We found that patients were represented as passive carriers of symptoms, in whom agency was low, failed, conditional or non‐existing, or as passive objects of the actions of impersonalised others. Conversely, symptoms were foregrounded as independent and powerful actors. The patient's experience of illness was sometimes reported, but the perspective of theGPtended to be doctor oriented, rather than patient centred. The policy of the social services, which emphasises patient involvement, patient centredness and work, rather than social benefits, was almost completely absent from these medical certificates. If medical certificates are to be a valid basis for decisions within the social services, we suggest that doctor paternalism in these documents must give way to considering the patient as an involved and co‐responsible individual in the processes of disability assessment.