bluuebunny/crossref_metadata_2025_split huggingface dataset:
Healthcare staff attitudes towards the use of electronic cigarettes (‘e-cigarettes’) compared with a local trust policy
Authors: Pippard Benjamin J , Shipley Mark D 
Published: August 2016

Background: E-cigarette use has risen dramatically in recent years, despite uncertainty over long-term health effects and concerns regarding efficacy as a smoking cessation device. Currently, there is no legislation prohibiting use in public, though many trusts have extended the NHS Smokefree policy to include e-cigarettes. The successful implementation of such policy is, however, unclear. Aim: This study examined staff attitudes towards the use of e-cigarettes in a hospital environment with respect to enforcement of a local trust smoking policy. Methods: A total of 79 healthcare professionals working at South Tyneside District Hospital, South Shields, completed a written questionnaire regarding use of e-cigarettes, particularly views on use in public and on hospital premises. Factors influencing the likelihood of individuals to challenge the use of e-cigarettes were assessed. Results: In all, 45% of respondents thought that e-cigarettes should be allowed in public places, though a majority (62%) favoured use on hospital grounds compared to within hospital buildings (18%). Over 50% of respondents were unaware of trust policy relating to e-cigarettes and only 25% had ever challenged someone using a device. Roughly, one-third reported that they would still not challenge someone in future, despite being informed of trust policy. Fear of abuse was the most cited reason for not challenging. Expressed concerns of e-cigarette use related to fire risk, ‘normalising’ smoking behaviour and uncertainty of long-term effects. Conclusion: Most staff do not enforce trust policy regarding e-cigarette use. This reflects variation in opinion over use, poor awareness of the policy itself and perceived barriers to implementation, including fear of abuse. Addressing these issues through staff education sessions may help successful future implementation.
A case of iloperidone overdose in a 27-year-old man with cocaine abuse
Authors: Amon Jin , Stephen Elsa , El-Mallakh Rif S 
Published: August 2016

Introduction: Iloperidone is a recently introduced antipsychotic medication. It is approved for the treatment of schizophrenia. There are no published reports of iloperidone overdosage, but there are eight cases that have been reported to the US Food and Drug Administration. Case report: A case of a 27-year-old man who took 84 mg of iloperidone while also smoking cocaine is described. He developed a prolonged QTc (527 ms) without arrhythmias and respiratory failure with mandated respiratory support. He ultimately recovered without sequelae. Discussion: The information regarding previous cases of toxicity on the US Food and Drug Administration website is incomplete. However, there were no fatalities due to iloperidone over-ingestion. Prolongation of the QTc may be a common feature.
Creating Virtual Integration and Improved Oncology Care Quality Through a Co-Management Services Agreement
Authors: Hartung Nicole L.W. , Henschel Rhonda M. , Smith Katie B. , Gesme Dean H. 
Published: August 2016

Purpose: Implementation of a co-management services agreement (Co-MSA) creates agreed-upon cancer care delivery quality metrics, a forum for discussion of service line oversight, and virtually integrated care without institutional employment of oncologists. The goal of this project was to demonstrate that a Co-MSA improved predefined quality metrics and provided enhanced communications between a health system’s oncology service line and a group of independent oncologists. Methods: Iterative planning discussions were scheduled biweekly over an 18-month period. Contractual, quality, and clinical data with benchmarking were considered in the creation of the Co-MSA. Review of the first year’s implementation occurred through examination of the metric achievements and qualitative themes that arose through committee meetings, clinical implementation processes, and cross-organizational discussions. Results: Metrics designed for the Co-MSA included improved adherence to the breast cancer, colon cancer, and non–small-cell lung cancer level I pathways; improvement of the medical oncology physician communication component of the hospital system’s Hospital Consumer Assessment of Healthcare Providers and Systems survey scores; and increased delivery of survivorship care plans to appropriate patients. Nonquantifiable themes from the first year of implementation included the need for technology to collect data, both organizations needing a wider understanding of quality improvement techniques, and a need for greater executive leadership involvement. Conclusion: In its first year, the Co-MSA resulted in improvement of the delivery of survivorship care plans and adherence to value pathways powered by the National Comprehensive Cancer Network. Improvement of Hospital Consumer Assessment of Healthcare Providers and Systems scores did not occur.
Impact of an Analgesia-Based Sedation Protocol on Mechanically Ventilated Patients in a Medical Intensive Care Unit
Authors: Faust Andrew C. , Rajan Pearl , Sheperd Lyndsay A. , Alvarez Carlos A. , McCorstin Phyllis , Doebele Rebecca L. 
Published: August 2016

BACKGROUND:
Recent attention to adverse effects of intensive care unit (ICU) sedation has led to the use of strategies that target a “lighter” depth of sedation. Among these strategies are “analgosedation” protocols, which prioritize pain management and preferentially use IV opioids before administration of continuously infused sedatives such as propofol or midazolam. We hypothesized that using an analgosedation protocol would result in a shorter duration of mechanical ventilation than a protocol with greater emphasis on IV sedatives

METHODS:
We conducted a retrospective study comparing the duration of mechanical ventilation before and after implementation of an analgosedation protocol in a 24-bed medical ICU. Patients were aged 18 years or older and required mechanical ventilation where a light level of sedation was clinically appropriate. Exclusion criteria included a clinical need for deeper levels of sedation or tracheal intubation confined to the perioperative period.

RESULTS:
Seventy-nine patients were included in the postimplementation group and 65 in the preimplementation group. After adjustment for baseline covariates, introduction of the 2013 analgosedation protocol was associated with a decreased duration of mechanical ventilation (−26.62 hours; 95% confidence interval, − 44.98 to −8.26, P = 0.005). Patients managed with the analgosedation protocol experienced a lighter level of sedation (median Richmond Agitation-Sedation Scale, −2.57 vs −1.25, P = 0.001) and improved pain management (median Critical-Care Pain Observation Tool score, 2.0 vs 1.5, P = 0.03). The use of continuously infused sedatives was reduced by 54.3% (92.3% vs 38.0%, P < 0.001).

CONCLUSIONS:
Our findings suggest that implementation of an analgosedation protocol was associated with an overall lighter level of sedation, shorter mean ventilator duration, and a reduced use of continuous infusion sedatives. Further studies are needed to assess the impact of such protocols on ICU delirium.
Seeing is believing: multi-scale spatio-temporal imaging towards in vivo cell biology
Authors: Follain Gautier , Mercier Luc , Osmani Naël , Harlepp Sébastien , Goetz Jacky G. 
Published: August 2016

ABSTRACT
Life is driven by a set of biological events that are naturally dynamic and tightly orchestrated from the single molecule to entire organisms. Although biochemistry and molecular biology have been essential in deciphering signaling at a cellular and organismal level, biological imaging has been instrumental for unraveling life processes across multiple scales. Imaging methods have considerably improved over the past decades and now allow to grasp the inner workings of proteins, organelles, cells, organs and whole organisms. Not only do they allow us to visualize these events in their most-relevant context but also to accurately quantify underlying biomechanical features and, so, provide essential information for their understanding. In this Commentary, we review a palette of imaging (and biophysical) methods that are available to the scientific community for elucidating a wide array of biological events. We cover the most-recent developments in intravital imaging, light-sheet microscopy, super-resolution imaging, and correlative light and electron microscopy. In addition, we illustrate how these technologies have led to important insights in cell biology, from the molecular to the whole-organism resolution. Altogether, this review offers a snapshot of the current and state-of-the-art imaging methods that will contribute to the understanding of life and disease.
Visualizing red blood cell sickling and the effects of inhibition of sphingosine kinase 1 using soft X-ray tomography
Authors: Darrow Michele C. , Zhang Yujin , Cinquin Bertrand P. , Smith Elizabeth A. , Boudreau Rosanne , Rochat Ryan H. , Schmid Michael F. , Xia Yang , Larabell Carolyn A. , Chiu Wah 
Published: August 2016

ABSTRACT
Sickle cell disease is a destructive genetic disorder characterized by the formation of fibrils of deoxygenated hemoglobin, leading to the red blood cell (RBC) morphology changes that underlie the clinical manifestations of this disease. Using cryogenic soft X-ray tomography (SXT), we characterized the morphology of sickled RBCs in terms of volume and the number of protrusions per cell. We were able to identify statistically a relationship between the number of protrusions and the volume of the cell, which is known to correlate to the severity of sickling. This structural polymorphism allows for the classification of the stages of the sickling process. Recent studies have shown that elevated sphingosine kinase 1 (Sphk1)-mediated sphingosine 1-phosphate production contributes to sickling. Here, we further demonstrate that compound 5C, an inhibitor of Sphk1, has anti-sickling properties. Additionally, the variation in cellular morphology upon treatment suggests that this drug acts to delay the sickling process. SXT is an effective tool that can be used to identify the morphology of the sickling process and assess the effectiveness of potential therapeutics.
Unit testing, model validation, and biological simulation
Authors: Sarma Gopal P. , Jacobs Travis W. , Watts Mark D. , Ghayoomie S. Vahid , Larson Stephen D. , Gerkin Richard C. 
Published: August 2016

The growth of the software industry has gone hand in hand with the development of tools and cultural practices for ensuring the reliability of complex pieces of software. These tools and practices are now acknowledged to be essential to the management of modern software. As computational models and methods have become increasingly common in the biological sciences, it is important to examine how these practices can accelerate biological software development and improve research quality. In this article, we give a focused case study of our experience with the practices of unit testing and test-driven development in OpenWorm, an open-science project aimed at modeling Caenorhabditis elegans. We identify and discuss the challenges of incorporating test-driven development into a heterogeneous, data-driven project, as well as the role of model validation tests, a category of tests unique to software which expresses scientific models.
HCAs undertaking special observation of patients with neurological conditions
Authors: Flynn Sarah , Prescott Trish , Jinks Annette 
Published: August 2016

This paper reports on a study carried out at an acute neurosciences hospital trust. The aim was to evaluate the effectiveness of a training programme for healthcare assistants undertaking special observation of patients. Some patients being cared for at the hospital have neurological complaints that are accompanied by confusion and agitation and require close observation in order to preserve their own and other's safety. The literature review revealed an abundance of literature related to special observation in mental health care. However, there is very little research related to the care of patients with neurological conditions. Some 20 experienced, female healthcare assistants (HCAs) took part in a training programme on special observation of patients. Attitudes to undertaking special observation at the start of the study were negative. The training programme included topics such as communication, management of extreme agitation, de-escalation strategies and diversional activities. Participants' confidence levels concerning assessment for suitable activities, using distraction techniques, de-escalation and restraint methods, increased on completion of the programme. It is concluded that caring for confused patients in acute hospital settings may sometimes be a passive, non-therapeutic type activity. Increasing the range of patient activities available and encouraging meaningful interactions with carers and patients will improve the caring experience for all concerned.
Enzyme Replacement or Substrate Reduction? A Review of Gaucher Disease Treatment Options
Authors: Van Rossum Alison , Holsopple Megan 
Published: August 2016

Background Gaucher disease is a rare lysosomal storage disease resulting from a deficiency or reduced activity in the acid β-glucocosidase enzyme. Only 1 treatment option was available for 15 years, but several new treatment options have come to market since 2003. Objective The article will detail the pathophysiology and review current therapies in the literature for all 3 major clinical types of Gaucher disease, with a focus on considerations for selecting therapy in type 1 disease. Methods Extracted and summarized applicable studies and reviews from Cochrane Review, ClinicalTrials.gov , CINAHL, IPA, and PubMed. Results Enzyme replacement therapy is preferred for the management of Gaucher disease. Current literature does not favor any enzyme replacement product over another. However, velaglucerase alfa and taliglucerase alfa theoretically have a lower risk of immunogenicity reactions compared with imiglucerase. Alternative treatments for type 1 disease include substrate reduction therapy; however, these treatments require evaluation of patient-specific variables (eg, genotype evaluation, renal function) and consideration of adverse effect and dosing profiles. Evaluation of current literature found no substrate reduction therapy is preferred over another. There are no approved therapies for type 2 and type 3 disease, but enzyme replacement therapy may be used with limited efficacy for symptom management. Conclusion Enzyme replacement therapy is preferred for treating type 1 Gaucher disease and substrate replacement therapy may be considered in patients who do not tolerate or cannot receive enzyme replacement therapy.
‘One country, three systems’: The recruitment of administrative elites in Portugal, 1999–2009
Authors: Nunes Filipe Abreu 
Published: August 2016

Abstract
What is the position of the Portuguese administrative elites in terms of professional autonomy and politicization recruitment patterns? In Portugal there prevails a pattern of professional autonomy at central government; however, this pattern has certain clientelist traits at the local administrative level. The Portuguese case also reveals a new kind of politicization in public administration agencies – in line with what happens in other Western democracies. Portugal has a hybrid administrative elite recruitment pattern, containing elements of professional autonomy at the central government, elements of political control at the agencies level and even clientelist elements at the state local branches.
Justice administration in early modern Portugal: Kingdom and empire in a bureaucratic continuum
Authors: Camarinhas Nuno 
Published: August 2016

Abstract
This article uses the magistracy in early modern Portugal to show a distinctive character in the Portuguese imperial experience that resided in an intense circulation of agents between the kingdom and the colonies. By stressing its early bureaucratic nature, which comes from the notion of royal service, it starts by sketching the institutional framework established during the seventeenth and eighteenth centuries, both in the kingdom and in the colonial domains. It draws a profile of the magistrates that served the crown in this system, emphasizing their heterogeneous character. Finally, using methodologies borrowed from social network analysis, it tries to map the bureaucratic network created throughout the period in an effort to identify recurrences in the movement of agents as well as the absence of movement between given places. The result is a map of judicial bureaucracy in the Portuguese empire.
Utilization of the horizontal ground heat exchanger in the heating and cooling system of a residential building
Authors: Hanuszkiewicz-Drapała Małgorzata , Bury Tomasz 
Published: August 2016

AbstractThis paper presents the results of thermodynamic analyses of a system using a horizontal ground heat exchanger to cool a residential building in summer and heat it in the autumn-winter period. The main heating device is a vapour compression heat pump with the ground as the lower heat source. The aim of the analyses is to examine the impact of heat supply to the ground in the summer period, when the building is cooled, on the operation of the heating system equipped with a heat pump in the next heating season, including electricity consumption. The processes occurring in cooling and heating systems have an unsteady nature. The main results of the calculations are among others the time-dependent values of heat fluxes extracted from or transferred to the ground heat exchanger, the fluxes of heat generated by the heat pump and supplied to the heated building by an additional heat source, the parameters in characteristic points of the systems, the temperature distributions in the ground and the driving electricity consumption in the period under analysis. The paper presents results of analysis of cumulative primary energy consumption of the analyzed systems and cumulative emissions of harmful substances.
Theoretical Comparison of Energy Harvesting Methods for Electret-free Variable-Capacitance Devices
Authors: Stein Aaron L. F. , Sarin Akshay , Hofmann Heath F. 
Published: August 2016

Abstract
Electret-free variable-capacitance energy harvesters are micro-electromechanical systems (MEMs) that generate electrical power from mechanical vibrations. In order to effectively harvest energy from these devices, the power electronic circuitry is extremely important, and can be the difference between generating or losing energy during a harvesting cycle. Four methods of harvesting energy from these devices are known: the Constant Voltage Method, the Constant Charge Method, the Charge Pump Method, and the Constant Charge With Parallel Capacitance Method. All four methods have been reported; however, the literature is lacking a formal comparison of these methods. This paper evaluates these four methods and the new Voltage and Charge Constrained Method while considering power electronic circuit efficiency as a key parameter. By including efficiency as a parameter, new fundamental properties of these devices are derived: a threshold efficiency necessary for energy harvesting, analytical solutions for optimal harvesting conditions, and a realistic comparison of the four methods. A case study demonstrates the advantage of using the Charge Pump method for MEMs applications, and illustrates the use of the new fundamental properties in the design of a circuit topology that is practical for MEMs vibration energy harvesting applications.
Cruise visitors in Agios Nikolaos, Greece. Characteristics, preferences, satisfaction, and overall experience
Authors: Simantiraki Evangelia , Skivalou Maria , Trihas Nikolaos 
Published: August 2016

Abstract
The cruise industry is exhibiting a steady significant growth during the recent years worldwide, and it is assessed to have remarkable economic implications for the local economies. The quality of cruise visitors’ experiences at a destination is crucial for the inclusion of that destination on the cruise itineraries. The aim of this paper is to investigate the cruise ship visitors’ off-board experiences in a Mediterranean port of call – Agios Nikolaos on the island of Crete, Greece, providing a better understanding of the main features of cruise customers’ behaviour and expectations from a port of call. Primary research was conducted at the port of Agios Nikolaos during the 2014 cruise season. The 306 filled questionnaires provided useful information related to the visitors’ demographic characteristics, travel motivation, destination perception, satisfaction, and intention to revisit and recommend the town to others. The findings and discussion of this study are useful to the tourism authorities of Agios Nikolaos and other Mediterranean ports of call with similar characteristics, which wish to maximise the benefits of cruise tourism, to industry practitioners, and academic researchers interested in cruise tourism.
Cardiorespiratory and gastrointestinal parasites of dogs in north-west Italy
Authors: Guardone L. , Magi M. , Prati M. C. , Macchioni F. 
Published: August 2016

Summary
The present study was conducted to evaluate the prevalence of gastrointestinal and cardio-respiratory parasites in dogs in Liguria (northwest Italy) which is a region that has scarcely been studied. A total of 450 dogs (260 males and 190 females) were enrolled in the study from 2009 and 2013. All dogs lived in a rural or semi-rural environment in the provinces of Imperia (n = 352) or Savona (n = 98), Liguria. Coprological examinations showed that 197 dogs (43.8 %, CI 38.7-48.9 %) were infected by parasites. Specifically, 3.3 % of the dogs presented only cardio-respiratory species, 32.4 % only intestinal species, and 8.0 % presented a mixed infection.
The most frequent intestinal parasites were Toxocara canis (20 %), Trichuris vulpis (17.8 %), Ancylostomatidae (12 %), Coccidia (2.7 %), Aonchotheca putorii (1.8 %) and Toxascaris leonina (1.8 %). The cardio-respiratory species found were Eucoleus aerophilus (9.6 %), Eucoleus boehmi (1.6 %), Angiostrongylus vasorum (0.7 %), and Crenosoma vulpis (0.2 %). A total of 116 dogs (25.8 %) were parasitized by a single species, multiple infections were observed in 81 dogs (18.0 %) up to a six-order infection.
This preliminary study highlighted that the prevalence of intestinal parasites in investigated area is high. Cardio respiratory parasites were detected in an area that has not been investigated before. The creation of a more extensive sampling programme of the area, on a provincial basis in order to build a more detailed map of prevalences for different species of dog parasites throughout Liguria, a more extensive sampling programme of the area needs to be created - ideally for each province.
Ant Colony Optimization Applied to the Problem of Choosing the Best Combination among M Combinations of Shortest Paths in Transparent Optical Networks
Authors: Brasileiro Ítalo , Santos Iallen , Soares André , Rabêlo Ricardo , Mazullo Felipe 
Published: August 2016

Abstract
This paper presents an attempt to solve the problem of choosing the best combination among the M combinations of shortest paths in optical translucent networks. Fixed routing algorithms demands a single route to each pair of nodes. The existence of multiple shortest paths to some pairs of nodes originates the problem of choose the shortest path which fits better the network requests. The algorithm proposed in this paper is an adaptation of Ant Colony Optimization (ACO) metaheuristic and attempt to define the set of routes that fits in an optimized way the network conditions, resulting in reduced number of blocked requests and better adjusted justice in route distribution. A performance evaluation is conducted in real topologies by simulations, and the proposed algorithm shows better performance between the compared algorithms.