bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transcending Ontological Schisms in Relationships with Earth, Water, Air, and Ice
Authors: Veland Siri 
Published: May 2017

Abstract
Ontological separations made between earth, water, air, and ice can surreptitiously produce high-risk outcomes in environmental policy processes. Where legislation, risk assessments, land rights, or governance is based on unacknowledged schisms between Earth elements, they produce epistemological blind spots that unwittingly prevent asking critical questions of policy processes and render important connections invisible. This paper investigates a series of cases in which ontological schisms within Earth materials and knowledge systems have or may produce surreptitious outcomes. The article considers a diverse array of examples including managing environmental change in Australia, negotiating mining leases in Papua New Guinea, governing the ice edge in Norway, and climate change in the United States. Each case is presented as an illustration that unsettling ontological boundaries between Earth materials, that is, making their identification and definition an explicit component of land and sea policy and governance, lowers the risk of policy failure. The paper finishes by asking how environmental management might be shaped by relational ontologies. Some possibilities offered through transdisciplinary and adaptive management approaches are promising for intercultural collaboration, but this paper suggests a transformation is needed in how we consider our relations with each other and with Earth systems under rapid change. A new method or framework may be insufficient, and new ways of relating may be required. Acknowledging uncertainties in fundamental categorizations and structures can open discussions to ask novel questions of our relationships with Earth systems and imagine solutions to environmental crises and injustices.
Diverse veterans’ pre- and post-intervention perceptions of home telemental health for posttraumatic stress disorder delivered via tablet
Authors: Whealin Julia M , King L , Shore P , Spira JL 
Published: May 2017

Objectives Home telemental health services have the potential to overcome many individual and systemic barriers to care facing military veterans with posttraumatic stress disorder. However, little is known about the home telemental health-related attitudes and experiences of highly underserved rural or ethnically, racially diverse veterans. This study evaluated whether ethnically/racially diverse U.S. veterans residing in the rural Pacific Islands would find the delivery of evidence-based treatment for posttraumatic stress disorder via home telemental health tablet devices useful and helpful. Method Clinicians located in a central urban location delivered Cognitive Processing Therapy for posttraumatic stress disorder directly into patients’ homes via a tablet device and secure WiFi connection. Pre- and post-treatment measures were collected from a clinical sample of 47 veterans (average age: 49.3 years). Most (74.4%) self-identified as being of ethnic/racial minority background. Attitudinal, satisfaction, and usability scales were collected from home telemental health engaging ( n = 29) and non-engaging ( n = 18) veterans. Results Ratings on measures of home telemental health comfort, satisfaction with care, and usability were uniformly positive. Veterans were equally open to receiving mental health services at home via home telemental health or in the clinic. In the case of services for a physical problem, however, veterans preferred in-clinic care. Following treatment, veterans’ attitudinal scores increased on items such as “There is enough therapist contact in home telemental health interventions.” However, a small portion of veterans (7%) reported having technical or privacy concerns. Conclusion The provision of evidence-based posttraumatic stress disorder treatment directly into the patients’ homes proved feasible and was well received by the large majority of rural ethnically/racially diverse veterans.
High Hemoglobin Is an Independent Risk Factor for the Development of Hemolysis During Pediatric Extracorporeal Life Support
Authors: Jenks Christopher L. , Zia Ayesha , Venkataraman Ramgopal , Raman Lakshmi 
Published: May 2017

Objective: To evaluate risk factors for hemolysis in pediatric extracorporeal life support. Design: Retrospective, single-center study. Setting: Pediatric intensive care unit. Patients: Two hundred thirty-six children who received extracorporeal membrane oxygenation. Interventions: None. Measurements and Main Results: Risk factors for hemolysis were retrospectively analyzed from a single center in a total of 236 neonatal and pediatric patients who received extracorporeal membrane oxygenation support (ECMO). There was no difference in the incidence of hemolysis between centrifugal (127 patients) and roller head (109 patients) pump type or between venoarterial and venovenous ECMO. High hemoglobin (Hb) was found to be an independent risk factor for hemolysis in both pump types. The Hb level >12 g/dL was significant in the roller group and the Hb level >13 g/dL was significant in the centrifugal group for the development of hemolysis for the cumulative ECMO run. The presence of high Hb levels on any given day increased the risk of hemolysis for that day of the ECMO run regardless of ECMO pump type. Higher revolutions per minute (RPMs) and higher inlet pressures on any given day increased the risk for the development of hemolysis in the centrifugal pump. Lower inlet venous pressures and RPMs were not associated with hemolysis in the roller group. Conclusions: An Hb level greater than 13 g/dL was associated with an increased risk of hemolysis, and a high Hb on a given day was associated with a significantly higher risk of hemolysis on the same day. Higher RPMs and lower inlet venous pressures were associated with an increased risk of hemolysis in the centrifugal pump only.
Determinants Perception and Experiences of Beneficiaries of a Hospital-based Community Health Insurance in Coastal Karnataka in India
Authors: Reshmi Bhageerathy , Nair Sreekumaran , Unnikrishnan Bhaskaran 
Published: May 2017

The objective of this study was to find out the perceptions of beneficiaries in comparison to non-beneficiaries of a community-based health insurance scheme. Both quantitative and qualitative methods were used to carry out this study; a cross-sectional household survey on 1,639 households was carried out, where the respondents were required to rate the services and facilities of the scheme A focus group discussion (FGD) with both the beneficiaries and non-beneficiaries was also carried out. Overall, the services were rated good except in the case of treatment and inpatient services where the responses were rated average. The study results provide evidence that Community Based Health Insurance (CBHI) schemes can be a viable risk sharing mechanism for the informal sector people who would have otherwise not been covered under any health insurance or health care financing mechanism. Maintaining an affordable premium and including outpatient facilities and preventive treatment would improve the satisfaction level of those who have acceptability towards CBHI schemes.
Cost Accounting in Public Hospitals in Poland
Authors: Rauliajtys-Grzybek M. , Baran W. , Macuda M. 
Published: May 2017

The aim of this article is to assess the cost accounting solutions that are used currently in Polish hospitals. The evaluation covered three main areas that require cost data—management, external reporting and pricing of health services (performed by a regulatory body). The study concerned the costing model that was obligatory for Polish public hospitals in the years 1998–2011 (top-down micro-costing model) and has not yet been replaced by another solution. Different research methods have been used for each of the areas under research, inter alia surveys, direct interviews and case study methods. Empirical results indicate a limited usefulness of the researched costing model in all of the evaluated areas: management, financial reporting and pricing. First, the costing model is used moderately only for the most important management areas, such as planning, control and operational decision making. Second, it does not include the specifics of diagnosis-related groups (DRGs) (basic pricing object) and therefore does not allow for accurate determination of their costs. Third, due to lack of the complex costing methodology the model is used in an unstructured and incoherent manner.
Evaluation of a novel risk assessment method for self-harm associated with Borderline Personality Disorder
Authors: Rao Sathya , Broadbear Jillian H , Thompson Katherine , Correia Anna , Preston Martin , Katz Paul , Trett Robert 
Published: May 2017

Objectives: Borderline personality disorder (BPD) is associated with frequent self-harm and suicidal behaviours. This study compared physician-assessed self-harm risk and intervention choice according to a (i) standard risk assessment and (ii) BPD-specific risk assessment methods. Methods: Forty-five junior and senior mental health physicians were assigned to standard or BPD-specific risk training groups. The assessment utilized a BPD case vignette containing four scenarios describing high/low lethality self-harm and chronic/new patterns of self-harm behaviour. Participants chose from among four interventions, each corresponding to a risk category. Results: Standard and BPD-specific groups were alike in their assessment of self-harm risk. Divergence occurred on intervention choice for assessments of low lethality, chronic risk ( p<.01) and high lethality, chronic risk ( p<.005). Overall, psychiatrists were more likely than their junior colleagues to correctly assess risk and management options. Conclusions: Although standard and BPD-specific methods are well aligned for assessing self harm-associated risk, BPD-specific training raised awareness of BPD-appropriate interventions, particularly in the context of chronic patterns of self-harm behaviour. Wider dissemination of BPD-specific risk training may enhance the confidence of mental health clinicians in identifying the nature of self-harm risk as well as the most clinically appropriate interventions for clients with BPD.
Development and Validation of the PREMM5 Model for Comprehensive Risk Assessment of Lynch Syndrome
Authors: Kastrinos Fay , Uno Hajime , Ukaegbu Chinedu , Alvero Carmelita , McFarland Ashley , Yurgelun Matthew B. , Kulke Matthew H. , Schrag Deborah , Meyerhardt Jeffrey A. , Fuchs Charles S. , Mayer Robert J. , Ng Kimmie , Steyerberg Ewout W. , Syngal Sapna 
Published: May 2017

Purpose Current Lynch syndrome (LS) prediction models quantify the risk to an individual of carrying a pathogenic germline mutation in three mismatch repair (MMR) genes: MLH1, MSH2, and MSH6. We developed a new prediction model, PREMM5, that incorporates the genes PMS2 and EPCAM to provide comprehensive LS risk assessment. Patients and Methods PREMM5 was developed to predict the likelihood of a mutation in any of the LS genes by using polytomous logistic regression analysis of clinical and germline data from 18,734 individuals who were tested for all five genes. Predictors of mutation status included sex, age at genetic testing, and proband and family cancer histories. Discrimination was evaluated by the area under the receiver operating characteristic curve (AUC), and clinical impact was determined by decision curve analysis; comparisons were made to the existing PREMM1,2,6 model. External validation of PREMM5 was performed in a clinic-based cohort of 1,058 patients with colorectal cancer. Results Pathogenic mutations were detected in 1,000 (5%) of 18,734 patients in the development cohort; mutations included MLH1 (n = 306), MSH2 (n = 354), MSH6 (n = 177), PMS2 (n = 141), and EPCAM (n = 22). PREMM5 distinguished carriers from noncarriers with an AUC of 0.81 (95% CI, 0.79 to 0.82), and performance was similar in the validation cohort (AUC, 0.83; 95% CI, 0.75 to 0.92). Prediction was more difficult for PMS2 mutations (AUC, 0.64; 95% CI, 0.60 to 0.68) than for other genes. Performance characteristics of PREMM5 exceeded those of PREMM1,2,6. Decision curve analysis supported germline LS testing for PREMM5 scores ≥ 2.5%. Conclusion PREMM5 provides comprehensive risk estimation of all five LS genes and supports LS genetic testing for individuals with scores ≥ 2.5%. At this threshold, PREMM5 provides performance that is superior to the existing PREMM1,2,6 model in the identification of carriers of LS, including those with weaker phenotypes and individuals unaffected by cancer.
Pupillary Reflex for Evaluation of Thoracic Paravertebral Block: A Prospective Observational Feasibility Study
Authors: Duceau Baptiste , Baubillier Mélanie , Bouroche Gaëlle , Albi-Feldzer Aline , Jayr Christian 
Published: May 2017

BACKGROUND:
Although thoracic paravertebral block (TPVB) is recommended in major breast surgery, there is no gold standard to assess the success of TPVB. Pupillary dilation reflex (PDR) is the variation of the pupillary diameter after a noxious stimulus. The objective was to evaluate the feasibility of recording the PDR to assess analgesia in an anesthetized thoracic dermatome after TPVB.

METHODS:
This prospective, observational, single-center study included 32 patients requiring breast surgery under general anesthesia and TPVB. TPVB was performed before surgery under ultrasound guidance with 20 mL of 0.75% ropivacaine. At the end of the surgery, remifentanil was stopped and the PDR was recorded after a 5-second tetanic stimulation (60 mA, 100 Hz) applied to the anterior chest wall. The PDR was defined as the maximal increase in pupil diameter after a standardized noxious stimulus, expressed as a percentage of the initial pupil diameter. The PDR was recorded twice in the same eye for each patient after a stimulus on both the TPVB and the control sides. Postoperative pain scores were recorded in a postanesthesia care unit. The primary outcome was the difference between the PDR on the TPVB and the control sides.

RESULTS:
The median (interquartile range) PDR was 9% (4%–13%) on the TPVB side and 41% (27%–66%) on the control side. There was a significant difference in the PDR between the TPVB and the control sides with a Hodges-Lehmann estimate of absolute difference of 37% points (95% confidence interval, 25–52, P < .001). Median postoperative pain scores (interquartile range) in the postanesthesia care unit were 1 (0–3) at rest and 1 (0–3) during mobilization, respectively. There was a linear correlation between maximal postoperative pain scores and the PDR on the TPVB side with a Pearson’s correlation coefficient r = 0.40 (95% confidence interval, 0.06–0.66, P = .02). No correlation was found between the number of blocked dermatomes and maximal postoperative pain scores (P = .06) or between the number of blocked dermatomes and the PDR on the TPVB side (P = .15).

CONCLUSIONS:
This proof-of-concept trial suggests that the effect of TPVB could be monitored by measuring the PDR after anterior chest wall stimulation in the dermatome of interest.
Comparison of ORAGENE® and Mouthwashed-Based Saliva Collection Methods for Genomic DNA Isolation
Authors: Hassan Ayesha A. 
Published: May 2017

In recent years, saliva has been used as a non-invasive method of obtaining genomic DNA. Two common collection methods include mouthwash and commercially produced saliva kits. Here, a novel comparison between these two collection methods, using Scope® mouthwash and the Oragene®-Discover kit (OGR-250) from DNA Genotek Inc., was conducted to analyze differences in the quantity and quality of the DNA isolated, and cost effectiveness. The Oragene® kit yielded greater quantity of DNA, while Scope® mouthwash was more cost effective. The difference in yield was attributed to the larger volume of saliva obtained from the Oragene® kit. Isolation from both collection methods resulted in similar DNA quality. Depuis quelques années, la salive est utilisée comme une méthode non-invasive pour obtenir de l’ADN génomique. Deux méthodes de collection communes sont par rince-bouche et par des trousses commerciales de collection de salive. Ici, une comparaison entre ces deux méthodes, utilisant la rince-bouche Scope et la trousse Oragene-Discover (OGR-250) de DNA Genotek Ink, a été conduite afin d’analyser les différences dans la quantité et la qualité d’ADN isolée ainsi que dans l’efficacité du coût. La trousse Oragene a recueilli plus d’ADN, alors que Scope était moins cher. La différence en quantité est attribuée au plus grand volume de salive qui est obtenu grâce à l’Oragene. L’isolation par les deux méthodes résultait en une qualité similaire d’ADN.
Design, Prototyping, and Programming of a Bricklaying Robot
Authors: Aguair Mateus L. , Behdinan Kamran 
Published: May 2017

This paper presents the development of a Bricklaying Robot capable of building entire walls. This project was motivated by opportunity of automation in construction, which remains costly and inefficient. Several studies have described specialized robot for masonry works, most of them incorporating the human arm concept that requires complex programming and low productivity. In order to improve this model, an innovative concept of a short arm assembled into a lift platform was introduced in this paper. The robot was modeled in Solidworks®, followed by motion study and dynamic analysis to optimize the model. A prototype in 1/4 scale was built to demonstrate its feasibility, detecting and correcting flaws. The prototype was tested by programming servo motors using Arduino UNO hardware and C ++ code. Finally, robot kinematics was analyzed in a construction site scenario. Concordance between the virtual simulation and the experimental prototype results demonstrated the functionality and effectiveness of the proposed design. The invention of this Bricklaying Robot will represent a technological advancement in developing new mechanisms and codes, which may be responsible for increasing productivity and reducing risks of masonry construction. Future analysis of global bricklaying market might be conducted to prove its commercial viability. Cet article présente le développement d’un robot de maçonnerie capable de construire des murs entiers. Le projet est motivé par une grande possibilité pour l’automatisation dans le bâtiment, un domaine qui reste malsain, coûteux et inefficace. Plusieurs recherches discutent des robots spécialisés pour les travaux de maçonnerie ; la plupart de ces robots utilisent le modèle du bras humain, une conception qui nécessite la programmation complexe et présente une perte de productivité. Cet article a pour but d’améliorer le modèle courant en explorant une nouvelle conception d’un bras court, assemblé comme une plate-forme élévatrice. Ce robot a été conçu en Solidsorks®, et une étude de mouvement et une analyse dynamique ont été menées pour optimiser le modèle. Un prototype à l’échelle 1:4 a été conçu pour démontrer la faisabilité du robot, tout en détectant et corrigeant ses défauts. Le prototype a été évalué par la programmation des servomoteurs, en utilisant du matériel informatique d’Arduino UNO et le langage de programmation C ++. Finalement, la cinématique du robot a été analysée en un scénario de chantier de construction. La fonctionnalité et l’efficacité de la conception proposée ont été démontrées par la concordance entre la simulation virtuelle et les résultats du prototype expérimental. L’invention de ce robot de maçonnerie constituera une avance technologique dans l’étude et le développement de nouveaux mécanismes et des codes informatiques, qui permettront d’améliorer la productivité et réduire les risques de maçonnerie. Une analyse de marché mondial de maçonnerie peut être menée à l’avenir pour vérifier la viabilité commerciale du robot.
The Water Project
Authors: Popp Shantel 
Published: May 2017

This resource was created to embark on a STEM project in grade 8 science class. Students are exposed to four different units during the year in Ontario, including: Cells, Fluids, Systems in Action, and Water Systems. The learning objective was to create a project that linked each of these units together under a “systems” theme and incorporate engineering, math, and technology. Students were able to showcase their learning in a final presentation that highlighted the different components of the STEM project. This includes the pulley schematics, design, and calculations of their water filter and technology implementation. This project uses Google Apps for Education so students can collaborate on the project synchronously and asynchronously, as well as incorporates hard skills like using a microscope, and provides students with the opportunity to design and build techniques. Cette ressource a été créée pour s’embarquer en un projet de STIM en utilisant comme guide le curriculum de science ontarien de la 8e année. Les étudiants apprennent à propos quatre sujets différents pendant l’année scolaire, incluant Les Cellules, Les Fluides, Les Systèmes en Action, et les Systèmes Hydrographiques. L’objectif d’apprentissage était de créer un projet qui liait tous ces sujets ensemble sous un thème commun, les systèmes, et intégrerait aussi l’ingénie, les mathématiques, et la technologie. Les étudiants ont eu la chance de montrer les connaissances qu’ils ont apprises dans une présentation finale qui a souligné les éléments différents du projet. Cela inclut les moufles, la conception, les calculs de leur filtre à eau et l’implémentation de la technologie. Ce projet utilise ‘Google Apps for Education’ pour que les étudiants puissent collaborer sur le projet en synchronie et seule. Il incorpore aussi les compétences du niveau plus élevé, comme l’utilisation d’un microscope et donne les étudiants la chance de développer les stratégies et techniques de la conception et construction.