bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accuracy of intracranial pressure monitoring: systematic review and meta-analysis
Authors: Zacchetti Lucia , Magnoni Sandra , Di Corte Federica , Zanier Elisa R. , Stocchetti Nino 
Published: November 2015

Abstract
Introduction
Intracranial pressure (ICP) measurement is used to tailor interventions and to assist in formulating the prognosis for traumatic brain injury patients. Accurate data are therefore essential. The aim of this study was to verify the accuracy of ICP monitoring systems on the basis of a literature review.

Methods
A PubMed search was conducted from 1982 to 2014, plus additional references from the selected papers. Accuracy was defined as the degree of correspondence between the pressure read by the catheter and a reference “real” ICP measurement. Studies comparing simultaneous readings from at least two catheters were included. Drift was defined as the loss of accuracy over the monitoring period. Meta-analyses of data from the studies were used to estimate the overall mean difference between simultaneous ICP measurements and their variability. Individual studies were weighted using both a fixed and a random effects model.

Results
Of 163 articles screened, 83 compared two intracranial catheters: 64 reported accuracy and 37 drift (some reported both). Of these, 10 and 17, respectively, fulfilled the inclusion criteria for accuracy and zero drift analysis. The combined mean differences between probes were 1.5 mmHg (95 % confidence interval (CI) 0.7–2.3) with the random effects model and 1.6 mmHg (95 % CI 1.3–1.9) with the fixed effects model. The reported mean drift over a long observation period was 0.75 mmHg. No relation was found with the duration of monitoring or differences between various probes.

Conclusions
This study confirms that the average error between ICP measures is clinically negligible. The random effects model, however, indicates that a high percentage of readings may vary over a wide range, with clinical implications both for future comparison studies and for daily care.
The course of diaphragm atrophy in ventilated patients assessed with ultrasound: a longitudinal cohort study
Authors: Schepens Tom , Verbrugghe Walter , Dams Karolien , Corthouts Bob , Parizel Paul M. , Jorens Philippe G. 
Published: November 2015

Abstract
Introduction
Mechanical ventilation and the effect of respiratory muscle unloading on the diaphragm cause ventilator-induced diaphragmatic dysfunction (VIDD). Atrophy of the diaphragmatic muscle is a major part of VIDD, and has a rapid onset in most animal models. We wanted to assess the clinical evolution and risk factors for VIDD in an adult intensive care unit (ICU) by measuring diaphragm thickness using ultrasound.

Method
We performed a single-centre observational cohort study, including 54 mechanically ventilated patients. The right hemidiaphragm was measured daily at the zone of apposition on the midaxillary line.

Results
Mean baseline thickness was 1.9 mm (SD ± 0.4 mm), and mean nadir was 1.3 mm (SD ± 0.4 mm), corresponding with a mean change in thickness of 32 % (95 % CI 27–37 %). Length of mechanical ventilation (MV) was associated with the degree of atrophy, whereas other known risk factors for muscle atrophy in an ICU were not. The largest decrease in thickness occurred during the first 72 hours of MV.

Conclusions
Diaphragm atrophy occurs quickly in mechanically ventilated patients and can accurately be monitored using ultrasound. Length of MV, as opposed to other variables, is associated with the degree of atrophy.

Clinical trial registration
Clinicaltrials.gov NCT02299986. Registered 10/11/2014
Gathered by Invention: Additive Forms and Inference in Gascoigne’s Poesy
Authors: Heffernan Megan 
Published: November 2015

Abstract
From the perspectives of both literary form and the history of the book, volumes of gathered poetry illustrate the fundamental incoherence of handpress-era texts. This essay considers the flexible web of connections in poetic miscellanies as an imaginative response to that basic disorder. Reading the organization of two editions of George Gascoigne’s work, it explores the dynamic exchanges between poems and commercial textual features and finds in those feedback loops an ambitious projection of the larger form of the book. Far from a simple or inherent unity, this paratactic structure uses poetry to span the physical juxtapositions of books made by diverse agents of the press. By forging an inferential engagement with the design of the volume, Gascoigne resisted a system of publication bent on dispersing his writing and folded nonauthorial devices into the most elemental workings of poetic form.
Suspended Judgments: Skepticism and the Pact of Fictionality in Cervantes’s Picaresque Novellas
Authors: Fuchs Barbara 
Published: November 2015

AbstractWhile Cervantes’s playfulness with perspectivism and his skepticism in Don Quijote have been abundantly noted, the skepticism of the Novelas ejemplares is equally striking. Examining the tension between exemplarity and skepticism—the one offering models for behavior that presume belief, the other encouraging instead a productive doubt—suggests that Cervantes advances a fully engaged fictionality as an alternative to the exemplary text. In particular, “Rinconete y Cortadillo” and the dyad of “El casamiento engañoso/El coloquio de los perros” show that the picaresque allows him to probe a broader readerly skepticism, extending beyond irony to epistemological questions of the truth of narratives and how they might be assessed.
Boy Meets Camera: Christopher Isherwood, Sergei Tretiakov, and the Queer Potential of the First Five-Year Plan
Authors: Salton-Cox Glyn 
Published: November 2015

AbstractReading Christopher Isherwood’s Berlin Stories (1935–39) through an important debate in the Marxist aesthetics of the period between Sergei Tretiakov and Georg Lukács, this article argues that Isherwood’s famous statement “I am a camera” should be reimagined as a declaration of radical antihumanism with key implications for both Marxist and queer theory. In so doing, it proposes that Isherwood’s literary praxis of self-instrumentalization advances a definition of the human that refuses both property ownership and heterosexual monogamy. In light of this new reading, Isherwood’s place in the leftist and queer canons must be reconstituted, as should the relationship between certain strains of Soviet Marxism and queer writing of the period. Far from a lukewarm socialist in his youth who later became a middlebrow bourgeois figure in gay literature, Isherwood offers a queer Marxist contribution to radical literary history; reading him through Tretiakov reveals, moreover, a striking cultural-historical possibility: the queer potential of the First Five-Year Plan (1928–32).
Trans Intelligentsia
Authors: Davy Zowie 
Published: November 2015

Abstract
Katie Herzog's Transtextuality (Senate Bill 48), an installation “depicting 48 portraits of transgender men and women of letters,” took on the mammoth task of displaying portraits of trans pioneers who represent transgender intelligentsia. The celebration of her Western “sitters” is an impressive display, and their academic work has no doubt contributed vast and wide-reaching insights into mine and the lives of some of my trans sisters, brothers, and others. However, her wall of fame, while potentially innocent in its creation, neglects the class, ethnicity/race, sexuality, and other situational aspects of trans writers' lives that may have impacted the performative aspects of knowledge production about (trans) gender beyond the Western imaginary. Although this trans celebration may feel subversive because it challenges the status quo of those whose knowledge counts vis-à-vis cisgender people, we must be constantly drawn to ask, does the subversion suppress others?
Eunuchs Online
Authors: Handy Ariel B. , Johnson Thomas W. 
Published: November 2015

Abstract
The Eunuch Archive (EA) is an online community of individuals who identify as a eunuch or have strong interests in castration. The Eunuch Archive contains various discussion forums ranging from safe castration methods to the physical and psychological impact of androgen deprivation. The EA also contains fictional stories written by EA members, which potentially help both the authors and readers work through extreme castration ideations. “Eunuch” as a gender identity is not limited to the online world. There have been at least ten annual gatherings of EA members, as well as a growing acceptance of eunuchs throughout the world (though still minimal). Many countries are now beginning to offer a third gender as a valid gender identity. Preserving information on sites such as the EA along with other trans* dedicated materials can lead to better understanding of the development of gender identities and can also help individuals who desire emasculation but not necessarily feminization to better understand their gender identity and its history. Preserving the EA fills a gap in trans* archives that has previously been unexplored.
A protocol to examine vision and gait in Parkinson’s disease: impact of cognition and response to visual cues
Authors: Stuart Samuel , Galna Brook , Lord Sue , Rochester Lynn 
Published: November 2015

BackgroundCognitive and visual impairments are common in Parkinson’s disease (PD) and contribute to gait deficit and falls. To date, cognition and vision in gait in PD have been assessed separately. Impact of both functions (which we term ‘visuo-cognition’) on gait however is likely interactive and can be tested using visual sampling (specifically saccadic eye movements) to provide an online behavioural measure of performance. Although experiments using static paradigms show saccadic impairment in PD, few studies have quantified visual sampling during dynamic motor tasks such as gait.This article describes a protocol developed for testing visuo-cognition during gait in order to examine the: 1) independent roles of cognition and vision in gait in PD, 2) interaction between both functions, and 3) role of visuo-cognition in gait in PD.Methods Two groups of older adults (≥50 years old) were recruited; non-demented people with PD (n=60) and age-matched controls (n=40). Participants attended one session and a sub-group (n=25) attended two further sessions in order to establish mobile eye-tracker reliability. Participants walked in a gait laboratory under different attentional (single and dual task), environmental (walk straight, through a door and turning), and cueing (no visual cues and visual cues) conditions. Visual sampling was recorded using synchronised mobile eye-tracker and electrooculography systems, and gait was measured using 3D motion analysis.Discussion This exploratory study examined visuo-cognitive processes and their impact on gait in PD. Improved understanding of the influence of cognitive and visual functions on visual sampling during gait and gait in PD will assist in development of interventions to improve gait and reduce falls risk. This study will also help establish robust mobile eye-tracking methods in older adults and people with PD.
Coordinating Complex Work: Knowledge Networks, Partner Departures, and Client Relationship Performance in a Law Firm
Authors: Briscoe Forrest , Rogan Michelle 
Published: November 2015

The mobility of individual managers has long presented a problem for firms in knowledge-intensive industries. Shifting to more complex work often reduces the importance of a single individual’s knowledge for the firm’s exchange relationships because complex work requires inputs from a broader set of the firm’s members. Although complex work decreases the likelihood that a single individual can shift the exchange relationship to another firm, we propose that it increases the vulnerability of the firm’s performance to departures of those individual managers who act as coordinators of knowledge. This leads us to focus on how the internal knowledge network formed to maintain each relationship can compound or mitigate the loss of a coordinating manager. Using original data on client relationships from a law firm, we examine the effect of internal knowledge networks and lead partner departures on the performance of the relationships. Supporting our argument, we find that the negative performance effect of a lead partner departure is greater when the network has high knowledge heterogeneity and involves more experts and lower when the network has high cohesion.This paper was accepted by Jesper Sørensen, organizations.
Pre-hospital paediatric seizures: midazolam versus diazepam
Authors: Broughton William 
Published: November 2015

This literature review aims to scope the current evidence for use of diazepam and midazolam for managing seizures in children, with particular focus on pre-hospital management. Many emergency departments now use buccal midazolam as first-line treatment for managing paediatric seizures, while ambulance services continue to use diazepam via the rectal (PR) or intravenous (IV) route. This review concludes that the evidence for the continued use of diazepam by ambulance services should be reconsidered if we are to provide the best standard of care for our paediatric patients—and move our treatment in line with best practice, and what is considered the norm in a hospital setting.
Increasing objectivity in the assessment of interpersonal skills and attitude
Authors: Tanner Kieron 
Published: November 2015

The concept of failure to fail has become more widely discussed in paramedic practice over recent years; however, it has been observed that on occasion mentors and managers experience challenges around the non-practical components of paramedic practice. Consideration has been given to identifying those elements of practice which can be more challenging to encapsulate, with the aim of providing objective feedback and where necessary set pass/fail standards. A non-practical skills matrix has been developed for consideration by those responsible for the development of ambulance staff and students. The proposal encourages qualities of the burgeoning concept of distributive leadership, incorporates elements of the document Towards a New Model of Leadership for the NHS ( Department of Health (DH), 2013a ), and having been mindful of the NHS response to the failings of Mid-Staffordshire and the findings of both Lord Francis’ and the Health Ombudsman ( Parliamentary and Health Service Ombudsman, 2011 ; DH, 2013b ), it responsibly aims to aid in the implementation of aspects of the recommendations capturing the current drive towards improved demonstrable compassion in UK care delivery.
An integrated ABCDE approach to managing medical emergencies using CRM principles
Authors: Logarajah Sri , Alinier Guillaume 
Published: November 2015

Background: There is increasing recognition of the vital role of non-technical skills in managing medical emergencies. An ABCDE approach has been very successful in training healthcare professionals in technical skills. Using a similar structure is likely to enhance successful application of their non-technical counter parts in clinical practice whether it is in the hospital or pre-hospital setting. Aim and Methods: To further promote safe patient care, teaching and learning aids currently used to implement crisis resource management skills, non-technical skills and human factors were identified and grouped in a way that facilitates memorisation. Results: Tools are available in the form of lists, tables and algorithms to identify behavioural markers of different components of non-technical skills and aspects of crisis resource management (CRM) and human factors. They require the need to memorise a list of items or a checklist. We have successfully used a visual aid representing these key CRM principles as a radial diagram, combined with a flow chart representing ABCDE approach for technical skills. Grouping them together in a format to embed in memory, combined with a visual aid representing the application nature of the principles, is likely to complement the existing tools in matching the learning style of more healthcare professionals. This inherently promotes the more widespread use of the principles, and hence has the potential to enhance patient safety. Conclusions: The proposed radial diagram, alongside the mnemonic alphabetical grouping, can be used to introduce the CRM principles and to provide effective feedback. This mnemonic is likely to help embed the CRM principles and enable recall in clinical practice to increase patient safety. The effectiveness of this aid could be tested using simulation of medical emergencies while training multiprofessional teams.
Potential use of amiodarone to treat new-onset AF in the pre-hospital setting
Authors: Brown Philip 
Published: November 2015

Incidence of atrial fibrillation (AF) is high, it is the most prevalent arrhythmia in the UK, Europe and the USA ( Naccarelli et al, 2009 ; Davis et al, 2012 ; Dagres et al, 2013 ) and is associated with significant morbidity, high risk of stroke and mortality ( Cottrell, 2012 ). Clinical guidance from the National Collaborating Centre for Chronic Conditions (NCCCC) (2006) and the National Institute for Health and Care Excellence (NICE) (2006) supports clinicians working in primary and hospital-based emergency care, but not those working in pre-hospital care. Updated guidance from NICE (2014) highlights the importance of providing rapid, personalised, evidence-based care, yet does not provide any guidance for pre-hospital clinicians responding to emergency presentations of AF. Paramedics have knowledge and experience of identifying AF, possess antiarrhythmic, anticoagulant and anti-platelet medications as part of their formulary and possess the necessary skills for obtaining intravenous access. This article reviews the national guidance and available best-evidence to provide safe treatment to patients presenting with new-onset AF and considers areas that merit further research.
Intra-cardiac arrest thrombolysis in the pre-hospital setting: four cases worth considering
Authors: Hitt Andy , Pateman Jane 
Published: November 2015

Background: It has been estimated that over 400 000 people have an out-of-hospital cardiac arrest (OHCA) annually in the United States and Europe combined, of whom fewer than 10% survive to hospital discharge. In up to 70% of cases OHCA is caused by underlying acute coronary disease or pulmonary embolism, and as such the benefits of thrombolytic therapy during resuscitation attempts have been explored without there being a clear conclusion. This paper presents a case series of four victims of OHCA who received thrombolysis, with adjunctive antithrombotic therapy, in the pre-hospital phase of their treatment. Three of these were attended by a critical care paramedic (CCP)—a paramedic with advanced training in emergency care—who received online physician support. The other victim was attended by paramedics and a physician who is experienced in pre-hospital emergency care. Discussion: Although there is much debate about the efficacy of routine administration of thrombolytic therapy during OHCA, cases such as those featured in this paper indicate a need for clinicians to consider the merits of pre-hospital thrombolysis (PHT) based on individual patient characteristics and the circumstances leading to their presenting condition. Conclusions: Lives can be saved with the timely administration of intra-arrest PHT but candidates should be selected with great care. This may be best delivered in systems where clinicians at scene are supported by expert medical advice, allowing clinicians to recognise and treat this small but important group of survivors.
A clinical review of the indications for, and subsequent implementation of, a pilot pre-hospital sepsis pathway within NWAS
Authors: Butterworth Daniel 
Published: November 2015

Aim: Review the clinical evidence for, and introduce a modified ‘Red Flag’ sepsis screening tool, treatment pathway and associated education package into a pilot site within the North West Ambulance Service NHS Trust (NWAS) and evaluate its impact. Methods: Retrospective application of a modified ‘Red Flag’ sepsis screening tool to 259 hospital confirmed cases of sepsis to evaluate the current identification and treatment of sepsis within NWAS. A subsequent prospective pilot launch of the tool within central Manchester in collaboration with Salford Royal Foundation Trust and Central Manchester Foundation Trust hospital emergency departments, collecting and analysing 100 cases of suspected sepsis in which the screening tool has been utilised. Results: The modified ‘Red Flag’ sepsis tool was found to be highly sensitive when applied retrospectively. Only 46% of confirmed severe sepsis cases were found to show hypotension (systolic BP <90 mmHg) pre-hospital. In the pilot, complete analysis of Systemic Inflammatory Response Syndrome (SIRS) criteria and a suspicion and documentation of sepsis increased from 15% to 94%. Compliance with a bundle of care in suspected severe sepsis cases increased from 10% to 90%. Conclusions: The introduction of a modified ‘Red Flag’ screening tool significantly improved pre-hospital sepsis identification and treatment within the pilot site. Paramedics were able to give fluid boluses to normotensive patients in suspected severe sepsis safely without adverse incident.
Falls assessment and prevention in older people: an evaluation of the Crisis Response Service
Authors: Pyer Michelle , Campbell Jackie , Ward Alison , Knights Ashley , Jones Janice 
Published: November 2015

The elderly population of the world is growing, with increasing trends of older people falling and accessing emergency services. The Crisis Response Falls Service in Northamptonshire (UK) was designed to identify health and social care needs, promote independence and limit the impact of falls. This paper presents the findings of an evaluation of the service. A mixed-method approach was applied, drawing on the views of service users (via a survey and telephone interviews) and reviewing existing East Midlands Ambulance Service NHS Trust (EMAS) data with routinely collected data from the service. A decrease in the numbers of patients conveyed to hospital following a fall was observed. Best estimates of financial calculations suggest savings. High levels of patient satisfaction were achieved; patients felt treated with dignity and staff were considered friendly, approachable and well-informed. First responder services can provide positive impacts for those who fall in the community. The development and impact of the CRS shows the importance of evidence-based client centred training to inform the approaches taken to supporting those who fall, and the impact of a strong values based approach on the experiences of patients.