bluuebunny/crossref_metadata_2025_split huggingface dataset:
Further Evidence That Sleep Deprivation Effects and the Vigilance Decrement Are Functionally Equivalent: Comment on Altmann (2018)
Authors: Gunzelmann Glenn , Veksler Bella 
Published: January 2018

AbstractVeksler and Gunzelmann (2018) argue that the vigilance decrement and the deleterious effects of sleep loss reflect functionally equivalent degradations in cognitive processing and performance. Our account is implemented in a cognitive architecture, where these factors produce breakdowns in goal‐directed cognitive processing that we refer to as microlapses. Altmann (2018) raises a number of challenges to microlapses as a unified account of these deficits. Under scrutiny, however, the challenges do little to discredit the theory or conclusions in the original paper. In our response, we address the most serious challenges. In so doing, we provide additional support for the theory and mechanisms, and we highlight opportunities for extending their explanatory breadth.
Meeting (or not) at the street level? A literature review on street‐level research in public management, social policy and social work
Authors: Nothdurfter Urban , Hermans Koen 
Published: January 2018

This literature review analyses the adoption and development of a street‐level perspective in public management, social policy and social work. The last years have seen a prominent revival of a perspective based on Michael Lipsky's street‐level bureaucracy approach in the debates conducted within all three disciplinary fields. Based on 71 key publications in public management, social policy and social work, the review analyses the adoption of the street‐level bureaucracy approach during the period 2005–2015, pointing out the main themes of the debate within, as well as overlaps and differences between, the three disciplines. The findings show the potential of better integrating the different perspectives and taking stock of the articulated debate. Lastly, the review discerns a common viewpoint for further street‐level research, emphasising its importance for the critical analysis and understanding of street‐level work as a vital dimension of responsive and accountable institutions and as a decisive moment to shape positive policy outcomes on the ground.Key Practitioner Message: • The use of discretion by frontline practitioners and their role as policy actors on the ground has become an important focus of research; • This literature review shows that the debate has gone far beyond discussing discretion as an all‐or‐nothing issue, pointing out both positive and negative aspects of discretion and developing comprehensive frameworks to explain the use of discretion at the street‐level; • However, street‐level research has traditionally rather neglected the notion of professionalism. The social work literature brings in the perspective of professionalism; more research efforts are needed to better explore and explain how professionalism matters in relation to challenges and dilemmas of different policy and practice fields.
Accuracy of a new elastomeric impression material for complete‐arch dental implant impressions
Authors: Baig Mirza R. , Buzayan Muaiyed M. , Yunus Norsiah 
Published: January 2018

AbstractAimThe aim of the present study was to assess the accuracy of multi‐unit dental implant casts obtained from two elastomeric impression materials, vinyl polyether silicone (VPES) and polyether (PE), and to test the effect of splinting of impression copings on the accuracy of implant casts.MethodsForty direct impressions of a mandibular reference model fitted with six dental implants and multibase abutments were made using VPES and PE, and implant casts were poured (N = 20). The VPES and PE groups were split into four subgroups of five each, based on splinting type: (a) no splinting; (b) bite registration polyether; (c) bite registration addition silicone; and (d) autopolymerizing acrylic resin. The accuracy of implant‐abutment replica positions was calculated on the experimental casts, in terms of interimplant distances in the x, y, and z‐axes, using a coordinate measuring machine; values were compared with those measured on the reference model. Data were analyzed using non‐parametrical Kruskal‐Wallis and Mann‐Whitney tests at α = .05.ResultsThe differences between the two impression materials, VPES and PE, regardless of splinting type, were not statistically significant (P>.05). Non‐splinting and splinting groups were also not significantly different for both PE and VPES (P>.05).ConclusionsThe accuracy of VPES impression material seemed comparable with PE for multi‐implant abutment‐level impressions. Splinting had no effect on the accuracy of implant impressions.
Association between breast milk intake at 9–10 months of age and growth and development among Malawian young children
Authors: Kumwenda Chiza , Hemsworth Jaimie , Phuka John , Ashorn Ulla , Arimond Mary , Maleta Kenneth , Prado Elizabeth L. , Haskell Marjorie J. , Dewey Kathryn G. , Ashorn Per 
Published: January 2018

AbstractWorld Health Organization recommends exclusive breastfeeding for infants for the first 6 months of life, followed by introduction of nutritious complementary foods alongside breastfeeding. Breast milk remains a significant source of nourishment in the second half of infancy and beyond; however, it is not clear whether more breast milk is always better. The present study was designed to determine the association between amount of breast milk intake at 9–10 months of age and infant growth and development by 12–18 months of age. The study was nested in a randomized controlled trial conducted in Malawi. Regression analysis was used to determine associations between breast milk intake and growth and development. Mean (SD) breast milk intake at 9–10 months of age was 752 (244) g/day. Mean (SD) length‐for‐age z‐score at 12 months and change in length‐for‐age z‐score between 12 and 18 months were −1.69 (1.0) and −0.17 (0.6), respectively. At 18 months, mean (SD) expressive vocabulary score was 32 (24) words and median (interquartile range) skills successfully performed for fine, gross, and overall motor skills were 21 (19–22), 18 (16–19), and 38 (26–40), respectively. Breast milk intake (g/day) was not associated with either growth or development. Proportion of total energy intake from breast milk was negatively associated with fine motor (β = −0.18,p = .015) but not other developmental scores in models adjusted for potential confounders. Among Malawian infants, neither breast milk intake nor percent of total energy intake from breast milk at 9–10 months was positively associated with subsequent growth between 12 and 18 months, or development at 18 months.
Evaluation of the stability and stratification of propofol and ketamine mixtures for pediatric anesthesia
Authors: Izgi Murat , Basaran Betul , Muderrisoglu Ahmet , Ankay Yilbas Aysun , Uluer Mehmet S. , Celebioglu Bilge 
Published: January 2018

SummaryBackgroundThe combination of propofol and ketamine is commonly used for total intravenous anesthesia. These drugs can be delivered in different syringes or in the same syringe. We hypothesized that the drugs might separate and different concentrations of each drug could be found in different parts of the syringe during the procedure period when they were mixed in 1 syringe.MethodsTwelve 60‐mL polypropylene syringes were prepared by mixing propofol and ketamine as 4 groups on the basis of propofol/ketamine mixture ratios (5:1 and 6.7:1) and propofol solution concentrations. Syringes were placed upright in the vertical position into a rack and kept at room temperature (21.5‐22.5°C), in daylight conditions and were not moved for 360 minutes. Samples of the mixture were taken from both the top and the bottom of the syringe. The first 1 mL of the samples was discarded, the following second 1 mL of the samples was filtered using 0.2‐μm polytetrafluoroethylene filters and measured twice (n = 6). Samples were taken at the following time intervals: T0, T10, T30, T60, T90, T120, T180, T240, T300, and T360 min. Syringes were checked visually for any color change and separation lines between the drugs.ResultsThere were no significant differences between the propofol and ketamine concentrations of the top and bottom samples in all 4 groups. In addition, there were no statistically significant changes of propofol and ketamine concentrations of samples over 360 minutes in any of the 4 groups. No visual changes were observed during 6 hours’ observation.ConclusionThe results of our measurements demonstrated that mixtures of propofol (1% and 2%) and ketamine at 5:1 and 6.7:1 ratios could be used in terms of mixture homogeneity and stability in a polypropylene syringe during a 6‐hour period at room temperature.
Sprint performance and propulsion asymmetries on an ergometer in trained high‐ and low‐point wheelchair rugby players
Authors: Goosey‐Tolfrey V. L. , Vegter R. J. K. , Mason B. S. , Paulson T. A. W. , Lenton J. P. , van der Scheer J. W. , van der Woude L. H. V. 
Published: January 2018

The purpose of this study was to examine the propulsion asymmetries of wheelchair athletes while sprinting on an instrumented, dual‐roller ergometer system. Eighteen experienced wheelchair rugby players (8 low point (LP) (class ≤1.5) and 10 high point (HP) (class ≥2.0)) performed a 15‐second sprint in their sports wheelchair on the instrumented ergometer. Asymmetry was defined as the difference in distance and power output (PO) between left and right sides when the best side reached 28 m. Propulsion techniques were quantified based on torque and velocity data. HP players covered an average 3 m further than the LP players (P = .002) and achieved faster sprint times than LP players (6.95 ± 0.89 vs 8.03 ± 0.68 seconds, P = .005) and at the time the best player finished (5.96 seconds). Higher peak POs (667 ± 108 vs 357 ± 78 W, P = .0001) and greater peak speeds that were also evident were for HP players (4.80 ± 0.71 vs 4.09 ± 0.45 m/s, P = .011). Greater asymmetries were found in HP players for distance (1.86 ± 1.43 vs 0.70 ± 0.65 m, P = .016), absolute peak PO (P = .049), and speed (0.35 ± 0.25 vs 0.11 ± 0.10 m/s, P = .009). Although HP players had faster sprint times over 28 m (achieved by a higher PO), high standard deviations show the heterogeneity within the two groups (eg, some LP players were better than HP players). Quantification of asymmetries is important not only for classifiers but also for sports practitioners wishing to improve performance as they could be addressed through training and/or wheelchair configuration.
Reduced left ventricular filling following blood volume extraction does not result in compensatory augmentation of cardiac mechanics
Authors: Lord Rachel , MacLeod David , George Keith , Oxborough David , Shave Rob , Stembridge Mike 
Published: January 2018

New Findings
What is the central question of this study?
A reduction in left ventricular (LV) filling, and concomitant increase in heart rate, augments LV mechanics to maintain stroke volume (SV); however, the impact of reduced LV filling in isolation on SV and LV mechanics is currently unknown.

What is the main finding and its importance?
An isolated decrease in LV filling did not provoke a compensatory increase in mechanics to maintain SV; in contrast, LV mechanics and SV were reduced. These data indicate that when LV filling is reduced without changes in heart rate, LV mechanics do not compensate to maintain SV.

AbstractAn acute non‐invasive reduction in preload has been shown to augment cardiac mechanics to maintain stroke volume and cardiac output. Such interventions induce concomitant changes in heart rate, whereas blood volume extraction reduces preload without changes in heart rate. Therefore, the purpose of this study was to determine whether a preload reduction in isolation resulted in augmented stroke volume achieved via enhanced cardiac mechanics. Nine healthy volunteers (four female, age 29 ± 11 years) underwent echocardiography for the assessment of left ventricular (LV) volumes and mechanics in a supine position at baseline and end extraction after the controlled removal of 25% of total blood volume (1062 ± 342 ml). Arterial blood pressure was monitored continuously by a pressure transducer attached to an indwelling radial artery catheter. Heart rate and total peripheral resistance were unchanged from baseline to end extraction, but systolic blood pressure was reduced (from 148 to 127 mmHg). From baseline to end extraction there were significant reductions in left ventricular end‐diastolic volume (from 89 to 71 ml) and stroke volume (from 56 to 37 ml); however, there was no change in LV twist, basal or apical rotation. In contrast, LV longitudinal strain (from −20 to −17%) and basal circumferential strain (from −22 to −19%) were significantly reduced from baseline to end extraction. In conclusion, a reduction in preload during blood volume extraction does not result in compensatory changes in stroke volume or cardiac mechanics. Our data suggest that LV strain is dependent on LV filling and consequent geometry, whereas LV twist could be mediated by heart rate.
The QseG Lipoprotein Impacts the Virulence of Enterohemorrhagic Escherichia coli and Citrobacter rodentium and Regulates Flagellar Phase Variation in Salmonella enterica Serovar Typhimurium
Authors: Cameron Elizabeth A. , Gruber Charley C. , Ritchie Jennifer M. , Waldor Matthew K. , Sperandio Vanessa 
Published: January 2018

ABSTRACT

The QseEF histidine kinase/response regulator system modulates expression of enterohemorrhagic
Escherichia coli
(EHEC) and
Salmonella enterica
serovar Typhimurium virulence genes in response to the host neurotransmitters epinephrine and norepinephrine.
qseG
, which encodes an outer membrane lipoprotein, is cotranscribed with
qseEF
in these enteric pathogens, but there is little knowledge of its role in virulence. Here, we found that in EHEC QseG interacts with the type III secretion system (T3SS) gate protein SepL and modulates the kinetics of attaching and effacing (AE) lesion formation on tissue-cultured cells. Moreover, an EHEC Δ
qseG
mutant had reduced intestinal colonization in an infant rabbit model. Additionally, in
Citrobacter rodentium
, an AE lesion-forming pathogen like EHEC, QseG is required for full virulence in a mouse model. In
S
. Typhimurium, we found that QseG regulates the phase switch between the two flagellin types, FliC and FljB. In an
S
. Typhimurium Δ
qseG
mutant, the phase-variable promoter for
fljB
is preferentially switched into the “on” position, leading to overproduction of this phase two flagellin. In infection of tissue-cultured cells, the
S
. Typhimurium Δ
qseG
mutant provokes increased inflammatory cytokine production versus the wild type;
in vivo
, in a murine infection model, the Δ
qseG
strain caused a more severe inflammatory response and was attenuated versus the wild-type strain. Collectively, our findings demonstrate that QseG is important for full virulence in several enteric pathogens and controls flagellar phase variation in
S
. Typhimurium, and they highlight both the complexity and conservation of the regulatory networks that control the virulence of enteric pathogens.
Ecology and Evolution of Chromosomal Gene Transfer between Environmental Microorganisms and Pathogens
Authors: Martínez José Luis 
Published: January 2018

ABSTRACT
Inspection of the genomes of bacterial pathogens indicates that their pathogenic potential relies, at least in part, on the activity of different elements that have been acquired by horizontal gene transfer from other (usually unknown) microorganisms. Similarly, in the case of resistance to antibiotics, besides mutation-driven resistance, the incorporation of novel resistance genes is a widespread evolutionary procedure for the acquisition of this phenotype. Current information in the field supports the idea that most (if not all) genes acquired by horizontal gene transfer by bacterial pathogens and contributing to their virulence potential or to antibiotic resistance originate in environmental, not human-pathogenic, microorganisms. Herein I discuss the potential functions that the genes that are dubbed virulence or antibiotic resistance genes may have in their original hosts in nonclinical, natural ecosystems. In addition, I discuss the potential bottlenecks modulating the transfer of virulence and antibiotic resistance determinants and the consequences in terms of speciation of acquiring one or another of both categories of genes. Finally, I propose that exaptation, a process by which a change of function is achieved by a change of habitat and not by changes in the element with the new functionality, is the basis of the evolution of virulence determinants and of antibiotic resistance genes.
P09 ‘there’s no place like home’: reducing paediatric discharge steps
Authors: Emma Barbour , Catherine Collins , Niamh Mclister 
Published: January 2018

AimTo determine the efficiency of dispensing paediatric discharges at dispensary vs ward level.MethodA data collection form was designed for use during a two-phase audit. During the first week of data collection, the turnaround time of dispensing discharges in the dispensary was collected. In the second week, the turnaround time of dispensing discharges at ward level on the paediatric ward was recorded.The dispensary standard of a 60 min turnaround for medium priority discharges1 was used for both weeks. Medical, surgical and ENT prescriptions were all included in the audit.ResultsInformation relating to 23 discharges was collected during week one at dispensary level. In week 2, 21 discharges were assessed.When assessing the minimum and maximum time taken from when a patient was informed of their discharge to medications being given, there was a reduction of 98 min when completed at ward level for minimum time and 75 min for the maximum time.The average turnaround time for dispensing prescriptions was 94 min at dispensary level and 26 min at ward level. Only 57% of discharges completed in the dispensary met the standard turnaround time of 60 min compared to 100% completed at ward level. Discharge prescription turnaround time was decreased by 72% when completed at ward level.In total sixteen discharge steps were identified using the traditional dispensary based method for discharges. These ranged from the patient being told they can go home on the ward round to the prescription being written and sent to pharmacy, and finally returned to the ward for transfer to the patient.The process of dispensing discharges at ward level enabled a reduction of 50% of the sixteen steps, subsequently expediting the discharge process.ConclusionWhen discharges were completed at ward level standards were met 100% of the time and a reduction in eight discharge steps was accomplished. Thus highlighting that a ward level dispensing service is necessary on the paediatric ward in this District General Hospital.ReferenceWallace K. Prescription Tracker System (PTS). Patient services District General Hospital2014.
P9 Paediatric prescribing: boosting the basics to reduce errors
Authors: Carter Benjamin , Ives Rosie 
Published: January 2018

AimsTo monitor the adherence to defined quality standard of prescribing in paediatric practice within Western Sussex Hospitals NHS Foundation Trust (WSHT). By identifying deficient areas, teaching and training can then be tailored to improve performance and safety.MethodA prospective audit of paediatric drug charts was performed at both WSHT sites (St Richards and Worthing General Hospitals) once weekly over a one month period. Drug charts were excluded only if no medications were yet prescribed. 22 patients audited from St Richard’s (SRH) and 34 from Worthing (WGH) were audited. Doctors within the department were aware the audit was ongoing and received feedback during the audit period about areas where improvement was needed as it would be unethical to not address prescribing issues in a timely manner.Data was collected using a standardised list of ten quality standards:Completion of all patient demographic informationWhether all prescriptions are legibleCompletion of allergy sectionAppriopriate prescribing unit useEnsuring all antibiotics have a written duration and indicationAny patient on oxygen must have it prescribedNo unapproved generic medications namesAll PRN medictions should have dose and maximum frequencyPrescribers need to sign and stamp prescriptionsPerfection: All quality standards met.ResultsThe majority of quality markers were well adhered to.Criteria of legibility, allergies, appropriate unit use, PRN dose and frequency, signed and stamped were met in over 90% of the charts audited at both sites.Demographic information was consistently poorly completed over both sites (SRH=59.1%, WGH=61.8%) and antibiotic duration/indication completion was particularly poor in St Richard’s Hospital (64.3% at SRH vs 95% at WGH).Very few patients audited were on oxygen (1 at SRH and 2 at WGH), only one of these patients had oxygen prescribed.Across the month 67.6% of the charts audited at Worthing achieved perfection and 50% of the charts at St Richards.ConclusionThe main conclusion drawn from this audit was that generally prescribing practises are good but that demographic completion is a particular area of weakness at both hospitals. It could be argued that these omissions are less of a safety risk than prescribing errors such as unclear drug unit but omission of the patients details at the top of the prescription page may increase the risk of a drug being prescribed on the incorrect patients’ chart and lead to a significant ‘wrong patient’ type drug error.One of the main limitations of the audit was that as it was undertaken in summer, where patients with respiratory disease and oxygen requirement are typically fewer and accordingly only 3 patients audited were on oxygen, this limited data suggests that oxygen prescribing is another area of weakness but an increased data set is needed to validate this finding.This audit was successful at allowing us to highlight areas of poorer practice and thus where prescribing training should be targeted at both hospitals.
Review of extraocular muscle biopsies and utility of biopsy in extraocular muscle enlargement
Authors: Eade Edwina L , Hardy Thomas G , McKelvie Penelope A , McNab Alan A 
Published: January 2018

AimsTo review the distribution of pathology in extraocular muscle (EOM) biopsies performed at a tertiary orbital centre, identify clinical and imaging features which are associated with benign or malignant diseases and indicate when biopsy is necessary for EOM enlargement.MethodsRetrospective case series including 93 patients with EOM enlargement who underwent an EOM biopsy. Clinical, radiological and histopathological information was recorded from the medical records. Statistical analysis was used to compare variables between patients with malignant and benign biopsies.ResultsThe median age of subjects was 61.1 years. Forty-eight cases (52%) were benign and 45 (48%) were malignant. Those with malignant pathology were significantly older (P<0.0001). Males were more likely affected by a benign disease and females by a malignancy (P=0.029). A history of malignancy (P<0.0001) and diplopia (P=0.029) were significant factors in predicting a malignancy. Pain (P=0.005) and eyelid erythema (P=0.001) were more likely in benign conditions. Idiopathic orbital inflammation was the most common benign diagnosis and lymphoma the most common malignancy.ConclusionsBiopsy is warranted in those with an atypical presentation of EOM enlargement or suspected of having a malignancy. Some features such as age, gender, pain, diplopia, history of malignancy and eyelid erythema may help indicate a particular diagnosis; however, clinical features and imaging findings are often not pathognomonic of each disease.