bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Intranasal Dexmedetomidine and Oral Pentobarbital Sedation for Transthoracic Echocardiography in Infants and Toddlers: A Prospective, Randomized, Double-Blind Trial
Authors: Miller Jeffrey W. , Ding Lili , Gunter Joel B. , Lam Jennifer E. , Lin Erica P. , Paquin Joanna R. , Li Bi Lian , Spaeth James P. , Kreeger Renee N. , Divanovic Allison , Mahmoud Mohamed , Loepke Andreas W. 
Published: January 2018

BACKGROUND:
Acquisition of transthoracic echocardiographic (TTEcho) images in children often requires sedation. The optimal sedative for TTEcho has not been determined. Children with congenital heart disease are repeatedly exposed to sedatives and anesthetics that may affect brain development. Dexmedetomidine, which in animals alters brain structure to a lesser degree, may offer advantages in this vulnerable population.

METHODS:
A prospective, randomized, double-blind trial enrolled 280 children 3–24 months of age undergoing outpatient TTEcho, comparing 2.5 µg·kg−
1 intranasal dexmedetomidine to 5 mg·kg−1 oral pentobarbital. Rescue sedation, for both groups, was intranasal dexmedetomidine 1 µg·kg−1. The primary outcome was adequate sedation within 30 minutes without rescue sedation, assessed by blinded personnel. Secondary outcomes included number of sonographer pauses, image quality in relation to motion artifacts, and parental satisfaction.

RESULTS:
Success rates with a single dose were not different between sedation techniques; 85% in the pentobarbital group and 84% in the dexmedetomidine group (P = .8697). Median onset of adequate sedation was marginally faster with pentobarbital (16.5 [interquartile range, 13–21] vs 18 [16–23] minutes for dexmedetomidine [P = .0095]). Time from drug administration to discharge was not different (P = .8238) at 70.5 (64–83) minutes with pentobarbital and 70 (63–82) minutes with dexmedetomidine. Ninety-five percent of sedation failures with pentobarbital and 100% of dexmedetomidine failures had successful rescue sedation with intranasal dexmedetomidine.

CONCLUSIONS:
Intranasal dexmedetomidine was comparable to oral pentobarbital sedation for TTEcho sedation in infants and did not increase the risk of clinically important adverse events. Intranasal dexmedetomidine appears to be an effective “rescue” sedative for both failed pentobarbital and dexmedetomidine sedation. Dexmedetomidine could be a safer option for repeated sedation in children, but further studies are needed to assess long-term consequence of repeated sedation in this high-risk population.
Outcomes of surgery in patients aged ≥90 years in the general surgical setting
Authors: Sudlow A , Tuffaha H , Stearns AT , Shaikh IA 
Published: January 2018

Introduction An increasing proportion of the population is living into their nineties and beyond. These high risk patients are now presenting more frequently to both elective and emergency surgical services. There is limited research looking at outcomes of general surgical procedures in nonagenarians and centenarians to guide surgeons assessing these cases. Methods A retrospective analysis was conducted of all patients aged ≥90 years undergoing elective and emergency general surgical procedures at a tertiary care facility between 2009 and 2015. Vascular, breast and endocrine procedures were excluded. Patient demographics and characteristics were collated. Primary outcomes were 30-day and 90-day mortality rates. The impact of ASA (American Society of Anesthesiologists) grade, operation severity and emergency presentation was assessed using multivariate analysis. Results Overall, 161 patients (58 elective, 103 emergency) were identified for inclusion in the study. The mean patient age was 92.8 years (range: 90–106 years). The 90-day mortality rates were 5.2% and 19.4% for elective and emergency procedures respectively (p=0.013). The median survival was 29 and 19 months respectively (p=0.001). Emergency and major gastrointestinal operations were associated with a significant increase in mortality. Patients undergoing emergency major colonic or upper gastrointestinal surgery had a 90-day mortality rate of 53.8%. Conclusions The risk for patients aged over 90 years having an elective procedure differs significantly in the short term from those having emergency surgery. In selected cases, elective surgery carries an acceptable mortality risk. Emergency surgery is associated with a significantly increased risk of death, particularly after major gastrointestinal resections.
The Patient Concerns Inventory integrated as part of routine head and neck cancer follow-up consultations: frequency, case-mix, and items initiated by the patient
Authors: Rogers SN , Thomson F , Lowe D 
Published: January 2018

Introduction The National Institute for Health and Care Excellence guidance Improving Supportive and Palliative Care for Adults with Cancer (2004) and the Cancer Reform Strategy (2007) support the premise that assessment and discussion of patients’ needs for physical, social, psychological, and spiritual wellbeing should be undertaken during oncology follow-up. We report the use of the Patient Concerns Inventory in a routine head and neck cancer clinic setting over a seven-year period, summarising the number of available clinics, the number of patients completing the inventory within a clinic, the range of clinical characteristics and the concerns they wanted to discuss. Methods The data were analysed from oncology follow-up clinics between 1 August 2007 and 10 December 2014. Audit approval was given by the Clinical Audit Department, University Hospital Aintree. Results There were 386 patients with 1198 inventories completed at 220 clinics, median 6 (range 4–7) per clinic. The most common concerns raised by patients across all the clinic consultations were dry mouth (34%), fear of recurrence (33%), sore mouth (26%), dental health (25%), chewing (22%) and fatigue/tiredness (21%). Conclusions The incorporation of the Patient Concerns Inventory as part of routine oncology clinics allows for a more patient initiated and focused consultation available to the majority of patients throughout their follow-up. The inventory allows for greater opportunity to provide holistic targeted multiprofessional intervention and support.
Introduction into the NHS of magnetic sphincter augmentation: an innovative surgical therapy for reflux – results and challenges
Authors: Prakash D , Campbell B , Wajed S 
Published: January 2018

Introduction Gastro-oesophageal reflux disease (GORD) is a common, chronic debilitating condition. Surgical management traditionally involves fundoplication. Magnetic sphincter augmentation (MSA) is a new definitive treatment. We describe our experience of introducing this innovative therapy into NHS practice and report the early clinical outcomes. Methods MSA was introduced into NHS practice following successful acceptance of a cost-effective business plan and close observation of National Institute for Health and Care Excellence (NICE) recommendations for new procedures, including a carefully planned prospective data collection over a two-year follow-up period. Results Forty-seven patients underwent MSA over the 40-month period. Reflux health-related quality of life (GERD-HRQL) was significantly improved after the procedure and maintained at one- and two-year (P < 0.0001) follow-up. Drug dependency went from 100% at baseline to 2.6% and 8.7% after one and two years. High levels of patient satisfaction were reported. There were no adverse events. Conclusions MSA is highly effective in the treatment of uncomplicated GORD, with durable results and an excellent safety profile. This laparoscopic, minimally invasive procedure provides a good alternative for patients where surgical anatomy is unaltered. Our experience demonstrates that innovative technology can be incorporated into NHS practice with an acceptable business plan and compliance with NICE recommendations.
Book Reviews
Authors: Pfeifer Karen , Sullivan Antony T. 
Published: January 2018

Abstract
The Ba’thification of Iraq: Saddam Hussein’s Totalitarianism, Aaron M. Faust (2015) Austin, TX: University of Texas Press, 296 pp., ISBN: 9781477305577, h/bk, $55.00
A History of the Iraq Crisis: France, the United States, and Iraq, 1991–2003, Frederic Bozo (2016) Washington, DC and New York: Woodrow Wilson Center Press and Columbia University Press, Epilogue, Afterword, Notes, Bibliography, and Index, 381 pp., ISBN: 9780231704441, h/bk, $55.00
Assessment of Hazardous Substances in Electrical Cables: Implementation of RoHS Regulations in India
Authors: Rambabu U. , Balaram V. , Ratheesh R. , Chatterjee S. , Kishore Babu M. , Munirathnam N. R. 
Published: January 2018

Abstract
Globally, the use of plastics in electrical and electronic equipment (EEE) and home appliances as alternatives to aluminum and steel has been increased rapidly. As a result, the sustainable recycling of plastics in the Indian informal sector has been complicated by hazardous additive substances. In plastics, lead and cadmium compounds are mainly applied as pigments and stabilizing agents. As per the directive of the Restriction of Hazardous Substances (RoHS), for all homogenous materials in the manufacture of various types of EEE, the application of lead, mercury, hexavalent chromium (Cr6+), polybrominated biphenyls (PBBs), and polybrominated diphenyl ethers (PBDEs) is restricted to a maximum level of 1,000 μg/g and especially cadmium to a maximum level of 100 μg/g. In the present work, five electrical cables of various colors and gauges, available in the local market (Hyderabad, India), were chosen for a case study. As per the norms of IEC62321, Electrotechnical Products—Determination of Six Regulated Substances (Lead, Mercury, Cadmium, Hexavalent Chromium, Polybrominated Biphenlys, Polybrominated Diphenyl Ethers), the prescreening using Energy Dispersive X-ray Fluorescence (EDXRF) spectrometer showed the presence of lead only in all cables against the six restricted substances with variable concentrations with color as well as thickness. The maximum lead content observed was ∼31,000 μg/g in black cables with a 2.5-mm2 thickness. The measured lead content using EDXRF spectrometry has cross-checked with other well-established analytical techniques: Atomic Absorption Spectrometry (AAS), Inductively Coupled Plasma Optical Emission Spectrometry (ICP-OES), and Inductively Coupled Plasma Mass Spectrometry (ICP-MS), and the results were found to be comparable. The spiking studies of lead showed that the obtained results by EDXRF spectrometry were within the acceptable range (accuracy limit of 100 ± 20 %). From the results obtained, it is concluded that the content of lead tested in all the electrical cables selected was more than 1,000 μg/g and hence found to be noncompliant as per RoHS regulation.
Viscoelastic Asphalt Pavement Simulations and Simplified Elastic Pavement Models Based on an “Equivalent Asphalt Modulus” Concept
Authors: Bodin D. , Chupin O. , Denneman E. 
Published: January 2018

Abstract
Asphalt pavements exhibit viscoelastic behavior resulting in deflections, strains, and stresses varying with both temperature and traffic speed. For structural thickness design against fatigue cracking, the material response is typically assumed to be linear elastic to simplify the calculation of the critical horizontal strain at the bottom of the asphalt layer. An asphalt modulus representing the response of the materials under average conditions for both temperature and traffic speed is generally adopted in the simplified pavement model. This paper presents a method to determine an equivalent asphalt modulus (EAM) for the asphalt layer. The EAM, when used in the linear elastic analysis of a pavement, will result in a resilient response in terms of the critical strain criterion that is equivalent to the response of that structure when calculated using viscoelastic modeling. The methodology of this paper included a qualitative comparison of the EAM approach with published field results. Two thick asphalt pavement configurations representative of typical French pavement designs were considered in this paper. Results showed expected trends of the equivalent asphalt modulus with changes in traffic speed and temperature. The application of time–temperature superposition principle allowed building pseudo-master curves for the EAM dataset. The effect of different asphalt temperature and different traffic speed on the viscoelastic strains was qualitatively validated against the trends observed under full-scale testing.
Implementation and Improvement of Pediatric Asthma Guideline Improves Hospital-Based Care
Authors: Johnson David P. , Arnold Donald H. , Gay James C. , Grisso Alison , O’Connor Michael G. , O’Kelley Ellen , Moore Paul E. 
Published: January 2018

BACKGROUND:
Standardized pediatric asthma care has been shown to improve measures in specific hospital areas, but to our knowledge, the implementation of an asthma clinical practice guideline (CPG) has not been demonstrated to be associated with improved hospital-wide outcomes. We sought to implement and refine a pediatric asthma CPG to improve outcomes and throughput for the emergency department (ED), inpatient care, and the ICU.

METHODS:
An urban, quaternary-care children’s hospital developed and implemented an evidence-based, pediatric asthma CPG to standardize care from ED arrival through discharge for all primary diagnosis asthma encounters for patients ≥2 years old without a complex chronic condition. Primary outcomes included ED and inpatient length of stay (LOS), percent ED encounters requiring admission, percent admissions requiring ICU care, and total charges. Balancing measures included the number of asthma discharges between all-cause 30-day readmissions after asthma discharges and asthma relapse within 72 hours. Statistical process control charts were used to monitor and analyze outcomes.

RESULTS:
Analyses included 3650 and 3467 encounters 2 years pre- and postimplementation, respectively. Postimplementation, reductions were seen in ED LOS for treat-and-release patients (3.9 hours vs 3.3 hours), hospital LOS (1.5 days vs 1.3 days), ED encounters requiring admission (23.5% vs 18.8%), admissions requiring ICU (23.0% vs 13.2%), and total charges ($4457 vs $3651). Guideline implementation was not associated with changes in balancing measures.

CONCLUSIONS:
The hospital-wide standardization of a pediatric asthma CPG across hospital units can safely reduce overall hospital resource intensity by reducing LOS, admissions, ICU services, and charges.
Comparison of knowledge, attitude and practice of diabetic patients taking treatment at private and public health centre in an urban area
Authors: Kumar Purushottam , Ankushe Rajendra T. , Doibale Mohan K. , Kuril Bina M. , Andurkar Smita P. , Srivastava Abhay 
Published: January 2018

Background: Diabetes is undoubtedly one of the most challenging health problems of the 21st century. Diabetes and its complications are major causes of early death in most countries. According to IDF approximately 5.1 million people aged between 20 and 79 years died from diabetes in 2013, accounting for 8.4% of global all-cause mortality among people in this age group. With 1.2 million deaths in 2013, this region [SEA] has the second highest number of deaths attributable to diabetes of any of the seven IDF regions. That figure represents 14.2% of all adult deaths in the Region. India is the largest contributor to regional mortality, with 1.1 million deaths attributable to diabetes in 2013. Methods: The study was a cross sectional study to compare the knowledge, attitude and practice of diabetic patients taking treatment at private and public health centre in an urban area. This study was conducted in a city of field practice area of our medical college, during the period of July 2016 to October 2016. We purposively selected 50 diabetic patients from public health centre and 50 diabetic patients from Private health centre. Diabetic patients were interviewed based on our predesigned pretested questionnaire. Results: 54% diabetic patients taking treatment at private health centre had average to good knowledge as compared to 28% at public health centre. 34% diabetic patients taking treatment at private health centre had positive attitude as compared to 6% at public health centre. 20% diabetic patients taking treatment at private health centre had average to good practice as compared to 6% at public health centre. Conclusions: Knowledge, attitude and practice of diabetic patients taking treatment at private health centre were better than taking treatment at public health centre.
O CURRÍCULO E PROJETO PEDAGÓGICO DO CURSO DE LETRAS UFTM DE TRÊS ANOS: CONTRIBUIÇÕES PARA UMA DISCUSSÃO NECESSÁRIA
Authors: Souza Walêska Dayse Dias de 
Published: January 2018

O presente artigo apresenta elementos do currículo que integra o Projeto Pedagógico do Curso de Letras UFTM, inicialmente elaborado para ter duração de três anos, a partir das teorias críticas e pós críticas do currículo discutidas por Silva (1999). Para isso retoma alguns momentos significativos da história do curso com o objetivo de contextualizá-los e mostrar como essas experiências ajudam a construir a identidade do curso a partir da subjetividade dos participantes do processo. Conta, com documentos do Curso de Letras, como foi apresentada a versão inicial do projeto e o processo de reestruturação desencadeado desde então. Como desdobramento do artigo, também organiza algumas reflexões sobre o tema práticas de ensino, utilizando, para isso, a legislação existente e alguns fragmentos do projeto. As práticas de ensino são discutidas, conforme os documentos analisados, em diferentes dimensões. Com este estudo, objetiva-se contribuir com as discussões que se desenvolvem a partir do Projeto Pedagógico do Curso de Letras UFTM, tendo em vista a sua necessidade de avaliação e acompanhamento permanente, além de sua adequação para o currículo de quatro anos que é proposto para as turmas que iniciaram em 2007. Palavras-chave: Currículo. Projeto pedagógico. Práticas de ensino.
Cultural Differences in Auditors' Compliance with Audit Firm Policy on Fraud Risk Assessment Procedures
Authors: Bik Olof , Hooghiemstra Reggy 
Published: January 2018

SUMMARY
Internationally operating audit firms rely heavily on global firm policies and audit methodologies to ensure consistency of audits across the globe. However, cultural differences are likely to affect auditors' compliance with such firm-wide systems of control. In this study we use proprietary data from a Big 4's internal quality reviews, involving 1,152 audit engagements from 29 countries, to assess the impact of cross-national cultural differences on auditors' compliance (or not) with the firm's policy in a specific yet crucial and culturally susceptible area of the audit process: fraud risk assessment procedures. We find that collectivism and societal trust are negatively associated, while religiosity is positively associated with compliance with global firm policy. However, we do not find evidence that compliance and power distance are associated. Overall, our findings suggest that cross-national differences in auditors' compliance with global audit firm methodology (or not) are associated with cross-national cultural differences. An implication of our findings is that a uniform local application of global audit methodologies may remain an illusion unless different, targeted approaches for different regions in the world are considered.
Effect of Consumer Awareness of Education Material, Source of Information, and Value of Materialism on Behavior as A Smart Adolescent Consumer
Authors: Setianingrum Mia Fitriyah , Yuliati Lilik Noor 
Published: January 2018

<p>This study aims to analyze the effect of consumer awareness about education material, source of information, and value of materialism toward behavior as smart consumer on junior high school student in urban and rural areas of Bogor. Samples in this study are 9<sup>th </sup>grade junior high school students as much as 125 students that consisting of 62 students in urban and 63 students in rural areas. The sampling technique is cluster random sampling with the consideration that students have obtained consumer education materials on social sciences and Indonesian language for grade 7 to grade 9. Data were collected by self-administered technique using questionnaires. The results showed that there are differences in consumer awareness about education material, source of information, and objective knowledge of students in urban and rural areas. Gender and source of information affect the behavior as smart consumer on junior high school students.</p><p> </p>
Phase Curves of WASP-33b and HD 149026b and a New Correlation between Phase Curve Offset and Irradiation Temperature
Authors: Zhang Michael , Knutson Heather A. , Kataria Tiffany , Schwartz Joel C. , Cowan Nicolas B. , Showman Adam P. , Burrows Adam , Fortney Jonathan J. , Todorov Kamen , Desert Jean-Michel , Agol Eric , Deming Drake 
Published: January 2018

Abstract
We present new 3.6 and 4.5 μm Spitzer phase curves for the highly irradiated hot Jupiter WASP-33b and the unusually dense Saturn-mass planet HD 149026b. As part of this analysis, we develop a new variant of pixel-level decorrelation that is effective at removing intrapixel sensitivity variations for long observations (>10 hr) where the position of the star can vary by a significant fraction of a pixel. Using this algorithm, we measure eclipse depths, phase amplitudes, and phase offsets for both planets at 3.6 and 4.5 μm. We use a simple toy model to show that WASP-33b’s phase offset, albedo, and heat recirculation efficiency are largely similar to those of other hot Jupiters despite its very high irradiation. On the other hand, our fits for HD 149026b prefer a very high albedo. We also compare our results to predictions from general circulation models, and we find that while neither planet matches the models well, the discrepancies for HD 149026b are especially large. We speculate that this may be related to its high bulk metallicity, which could lead to enhanced atmospheric opacities and the formation of reflective cloud layers in localized regions of the atmosphere. We then place these two planets in a broader context by exploring relationships between the temperatures, albedos, heat transport efficiencies, and phase offsets of all planets with published thermal phase curves. We find a striking relationship between phase offset and irradiation temperature: the former drops with increasing temperature until around 3400 K and rises thereafter. Although some aspects of this trend are mirrored in the circulation models, there are notable differences that provide important clues for future modeling efforts.