bluuebunny/crossref_metadata_2025_split huggingface dataset:
Challenges of Anesthesia in Low- and Middle-Income Countries: A Cross-Sectional Survey of Access to Safe Obstetric Anesthesia in East Africa
Authors: Epiu Isabella , Tindimwebwa Jossy Verel Bahe , Mijumbi Cephas , Chokwe Thomas M. , Lugazia Edwin , Ndarugirire Francois , Twagirumugabe Theogene , Dubowitz Gerald 
Published: December 2016

BACKGROUND:
The United Nations 2015 Millennium Development Goals targeted a 75% reduction in maternal mortality. However, in spite of this goal, the number of maternal deaths per 100,000 live births remains unacceptably high across Sub-Saharan Africa. Because many of these deaths could likely be averted with access to safe surgery, including cesarean delivery, we set out to assess the capacity to provide safe anesthetic care for mothers in the main referral hospitals in East Africa.

METHODS:
A cross-sectional survey was conducted at 5 main referral hospitals in East Africa: Uganda, Kenya, Tanzania, Rwanda, and Burundi. Using a questionnaire based on the World Federation of the Societies of Anesthesiologists (WFSA) international guidelines for safe anesthesia, we interviewed anesthetists in these hospitals, key informants from the Ministry of Health and National Anesthesia Society of each country (Supplemental Digital Content, http://links.lww.com/AA/B561).

RESULTS:
Using the WFSA checklist as a guide, none of respondents had all the necessary requirements available to provide safe obstetric anesthesia, and only 7% reported adequate anesthesia staffing. Availability of monitors was limited, and those that were available were often nonfunctional. The paucity of local protocols, and lack of intensive care unit services, also contributed significantly to poor maternal outcomes. For a population of 142.9 million in the East African community, there were only 237 anesthesiologists, with a workforce density of 0.08 in Uganda, 0.39 in Kenya, 0.05 in Tanzania, 0.13 in Rwanda, and 0.02 anesthesiologists in Burundi per 100,000 population in each country.

CONCLUSIONS:
We identified significant shortages of both the personnel and equipment needed to provide safe anesthetic care for obstetric surgical cases across East Africa. There is a need to increase the number of physician anesthetists, to improve the training of nonphysician anesthesia providers, and to develop management protocols for obstetric patients requiring anesthesia. This will strengthen health systems and improve surgical outcomes in developing countries. More funding is required for training physician anesthetists if developing countries are to reach the targeted specialist workforce density of the Lancet Commission on Global Surgery of 20 surgical, anesthetic, and obstetric physicians per 100,000 population by 2030.
Isoflurane Impairs Motor Function Recovery by Increasing Neuroapoptosis and Degeneration During Spinal Ischemia–Reperfusion Injury in Rats
Authors: Fang Shih-Yuan , Lee Jung-Shun , Roan Jun-Neng , Tsai Yu-Chuan , Lam Chen-Fuh 
Published: December 2016

BACKGROUND:
Spinal cord ischemia (SCI) leads to variable degrees of neurologic deficit in patients undergoing major cardiovascular surgery. The effect of intraoperative neuroprotection against SCI and the subsequent ischemia–reperfusion injury is still limited. Because isoflurane is a commonly used anesthetic agent during major operation, and its neuroprotective and neurotoxicity effects have both been discussed, this study aimed to investigate the effect of isoflurane on the spinal cord’s functional recovery in a rat model of cord ischemia.

METHODS:
Rats were randomly anesthetized by parenteral anesthetic (Zoletil®) and isoflurane (0% and 1.5% v/v in oxygen). Cord ischemia was induced by cross-clamping of thoracic aorta at the level of T5, and cord perfusion was resumed after 25 minutes. The motor function was assessed independently up to 48 hours after reperfusion. Spinal cords were harvested and analyzed for molecular and histologic changes.

RESULTS:
The locomotor rating scale was significantly reduced in rats that received isoflurane treatment during SCI at 12 to 48 hours after reperfusion. Isoflurane enhanced the expression of heme oxygenase-1, glial fibrillary acidic protein, cleaved caspase-3, and Iba-1 in the spinal cord. Increased apoptotic cells and the presence of axonal damage were also observed in the histologic sections.

CONCLUSION:
Our results demonstrate that the administration of inhaled isoflurane in spinal cord ischemia–reperfusion injury impairs the recovery of motor function. This response is associated with the neuronal apoptosis and degeneration. This study highlights the potential adverse effect of isoflurane on the functional recovery of ischemic spinal cord during major aortic surgery.
The developmental transcriptome of contrasting Arctic charr (Salvelinus alpinus) morphs
Authors: Gudbrandsson Johannes , Ahi Ehsan P. , Franzdottir Sigridur R. , Kapralova Kalina H. , Kristjansson Bjarni K. , Steinhaeuser S. Sophie , Maier Valerie H. , Johannesson Isak M. , Snorrason Sigurdur S. , Jonsson Zophonias O. , Palsson Arnar 
Published: December 2016

Species and populations with parallel evolution of specific traits can help illuminate how predictable adaptations and divergence are at the molecular and developmental level. Following the last glacial period, dwarfism and specialized bottom feeding morphology evolved rapidly in several landlocked Arctic charrSalvelinus alpinuspopulations in Iceland. To study the genetic divergence between small benthic morphs and limnetic morphs, we conducted RNA-sequencing charr embryos at four stages in early development. We studied two stocks with contrasting morphologies: the small benthic (SB) charr from Lake Thingvallavatn and Holar aquaculture (AC) charr.The data reveal significant differences in expression of several biological pathways during charr development. There was also an expression difference between SB- and AC-charr in genes involved in energy metabolism and blood coagulation genes. We confirmed differing expression of five genes in whole embryos with qPCR, includinglysozymeandnatterin-likewhich was previously identified as a fish-toxin of a lectin family that may be a putative immunopeptide. We also verified differential expression of 7 genes in the developing head that associated consistently with benthic v.s.limnetic morphology (studied in 4 morphs). Comparison of single nucleotide polymorphism (SNP) frequencies reveals extensive genetic differentiation between the SB and AC-charr (~1300 with more than 50% frequency difference). Curiously, three derived alleles in the otherwise conserved 12s and 16s mitochondrial ribosomal RNA genes are found in benthic charr.The data implicate multiple genes and molecular pathways in divergence of small benthic charr and/or the response of aquaculture charr to domestication. Functional, genetic and population genetic studies on more freshwater and anadromous populations are needed to confirm the specific loci and mutations relating to specific ecological traits in Arctic charr.
Impact of Electricity Pricing Policies on Renewable Energy Investments and Carbon Emissions
Authors: Kök A. Gürhan , Shang Kevin , Yücel Şafak 
Published: December 2016

We investigate the impact of pricing policies (i.e., flat pricing versus peak pricing) on the investment levels of a utility firm in two competing energy sources (renewable and conventional), with a focus on the renewable investment level. We consider generation patterns and intermittency of solar and wind energy in relation to the electricity demand throughout a day. Industry experts generally promote peak pricing policy as it smoothens the demand and reduces inefficiencies in the supply system. We find that the same pricing policy may lead to distinct outcomes for different renewable energy sources due to their generation patterns. Specifically, flat pricing leads to a higher investment level for solar energy, and it can lead to still more investments in wind energy if a considerable amount of wind energy is generated throughout the day. We validate these results by using electricity generation and demand data of the state of Texas. We also show that flat pricing can lead to substantially lower carbon emissions and a higher consumer surplus. Finally, we explore the effect of direct (e.g., tax credit) and indirect (e.g., carbon tax) subsidies on investment levels and carbon emissions. We show that both types of subsidies generally lead to a lower emission level but that indirect subsidies may result in lower renewable energy investments. Our study suggests that reducing carbon emissions through increasing renewable energy investments requires careful attention to the pricing policy and the market characteristics of each region.This paper was accepted by Serguei Netessine, operations management.
Identification of candidate genes in osteoporosis by integrated microarray analysis
Authors: Li J. J. , Wang B. Q. , Fei Q. , Yang Y. , Li D. 
Published: December 2016

Objectives In order to screen the altered gene expression profile in peripheral blood mononuclear cells of patients with osteoporosis, we performed an integrated analysis of the online microarray studies of osteoporosis. Methods We searched the Gene Expression Omnibus (GEO) database for microarray studies of peripheral blood mononuclear cells in patients with osteoporosis. Subsequently, we integrated gene expression data sets from multiple microarray studies to obtain differentially expressed genes (DEGs) between patients with osteoporosis and normal controls. Gene function analysis was performed to uncover the functions of identified DEGs. Results A total of three microarray studies were selected for integrated analysis. In all, 1125 genes were found to be signiﬁcantly differentially expressed between osteoporosis patients and normal controls, with 373 upregulated and 752 downregulated genes. Positive regulation of the cellular amino metabolic process (gene ontology (GO): 0033240, false discovery rate (FDR) = 1.00E + 00) was significantly enriched under the GO category for biological processes, while for molecular functions, flavin adenine dinucleotide binding (GO: 0050660, FDR = 3.66E-01) and androgen receptor binding (GO: 0050681, FDR = 6.35E-01) were significantly enriched. DEGs were enriched in many osteoporosis-related signalling pathways, including those of mitogen-activated protein kinase (MAPK) and calcium. Protein-protein interaction (PPI) network analysis showed that the significant hub proteins contained ubiquitin specific peptidase 9, X-linked (Degree = 99), ubiquitin specific peptidase 19 (Degree = 57) and ubiquitin conjugating enzyme E2 B (Degree = 57). Conclusion Analysis of gene function of identified differentially expressed genes may expand our understanding of fundamental mechanisms leading to osteoporosis. Moreover, significantly enriched pathways, such as MAPK and calcium, may involve in osteoporosis through osteoblastic differentiation and bone formation. Cite this article: J. J. Li, B. Q. Wang, Q. Fei, Y. Yang, D. Li. Identification of candidate genes in osteoporosis by integrated microarray analysis. Bone Joint Res 2016;5:594–601. DOI: 10.1302/2046-3758.512.BJR-2016-0073.R1.
Classification of full-thickness rotator cuff lesions: a review
Authors: Lädermann Alexandre , Burkhart Stephen S. , Hoffmeyer Pierre , Neyton Lionel , Collin Philippe , Yates Evan , Denard Patrick J. 
Published: December 2016

Rotator cuff lesions (RCL) have considerable variability in location, tear pattern, functional impairment, and repairability. Historical classifications for differentiating these lesions have been based upon factors such as the size and shape of the tear, and the degree of atrophy and fatty infiltration. Additional recent descriptions include bipolar rotator cuff insufficiency, ‘Fosbury flop tears’, and musculotendinous lesions. Recommended treatment is based on the location of the lesion, patient factors and associated pathology, and often includes personal experience and data from case series. Development of a more comprehensive classification which integrates historical and newer descriptions of RCLs may help to guide treatment further.Cite this article: Lädermann A, Burkhart SS, Hoffmeyer P, et al. Classification of full thickness rotator cuff lesions: a review. EFORT Open Rev 2016;1:420-430. DOI: 10.1302/2058-5241.1.160005.
Reporting and Second-Order Problem Solving can Turn Short-Term Fixes into Long-Term Remedies; Fifty Hospital Employees Given Insulin Instead of Influenza Vaccine; Reminder: Eliminating Ratio Expressions; Strength Confusion
Authors: Cohen Michael R. , Smetzer Judy L. 
Published: December 2016

These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural-safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were receivedthrough the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program. Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported directly to ISMP through the ISMP Web site ( www.ismp.org ), by calling 800-FAIL-SAFE, or via e-mail at ismpinfo@ismp.org . ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications.
A Reasonable Alternative to Clozapine in the Chronically Relapsing Smoking Patient? A Retrospective Analysis
Authors: Tomko John R. , Ahmed Nadeem , Kuntz Cynthia , Zick Justine 
Published: December 2016

Background Clozapine levels are severely decreased by cigarette smoke hydrocarbons. A new agent that is unaffected by smoking is paliperidone palmitate. Objective The purpose of this study is to retrospectively evaluate hospital readmission and time until readmission for patients prescribed paliperidone palmitate intramuscular injection (PP) as an alternative to oral clozapine for patients with severe schizophrenia who resume smoking following discharge. A secondary analysis was performed to determine whether smoking status alone affects hospital readmission rates in both smoking and nonsmoking clozapine-treated patients. Methods This was a retrospective analysis of all patients who were positive for smoking at admission and readmission who were prescribed clozapine and PP. Smokers were identified by concurrent orders for nicotine replacement. Readmission rates and time until readmission were determined. Data were analyzed utilizing nonparametric statistical methods. Results A total of 133 subjects were identified, including 108 smokers in PP group, 18 smokers in clozapine group, and 7 nonsmoking clozapine patients. Readmission rates were statistically significant between smokers in the clozapine and PP groups, with significantly lower readmission rates in the PP group ( p = .004). In the sub-analysis, hospital readmissions between smokers and nonsmokers in the clozapine group were statistically significant ( p = .027). Results may be influenced by use of a single hospital site, limits of a retrospective analysis, and variation in pharmaceutical preparation. Conclusion PP may be a reasonable alternative to clozapine in severe schizophrenia for patients who continually resume smoking following discharge. Smoking may also be an important predictor of decompensation in smokers prescribed clozapine. A further prospective study is warranted.
Single-Center Retrospective Evaluation of Inhaled Corticosteroid Use for Chronic Obstructive Pulmonary Disease Exacerbation Patients Receiving Systemic Corticosteroids
Authors: Steuber Taylor , Shiltz Dane 
Published: December 2016

Purpose To determine the frequency of inappropriate inhaled corticosteroid (ICS) therapy when it is prescribed concurrently with systemic corticosteroids; to identify cost-savings potential in the setting of chronic obstructive pulmonary disease (COPD) exacerbations. Methods Patients admitted to 1 of 8 hospital locations utilizing an integrated electronic health record within the health system for COPD exacerbations treated with systemic corticosteroids (equivalent to at least 30 mg of oral prednisone) between July 1, 2013 and June 30, 2014 were included in a retrospective chart review. Endpoints assessed included number of ICS, with or without long-acting beta-2 agonists (LABA), respiratory medications potentially wasted due to overlap therapy with systemic corticosteroids, as well as overall cost attributed to drug product, administration products, and respiratory therapy labor cost from potentially inappropriate overlap therapy. Results were extrapolated based on the number of admissions within the specified time period. Length of stay data were also compared between the 2 groups (overlap therapy vs no overlap therapy) to determine whether overlap therapy results in a reduction of hospital stay. Results A total of 10,710 admissions were identified and 74 charts were randomly identified for review. Forty-six (62%) patients received at least one dose of overlapping ICS or ICS/LABA. One hundred forty-two nebulized budesonide vials were wasted along with 43 ICS or ICS/LABA inhalers. A total cost of $8,152.75 was attributed to drug product, administration products, and labor cost. Extrapolating to the 10,710 admissions identified, there would potentially be 20,551 wasted budesonide vials and 6,223 wasted ICS or ICS/LABA inhalers, resulting in an estimated annual cost savings of $1,180,090.03 for the health system. Additionally, length of stay was shorter in the group not receiving overlap therapy compared to the group receiving overlap therapy, but it was not statistically significant (6.8 ± 3.3 days vs 7.3 ± 4.8 days; p = .54). Conclusion Significant cost savings could be accomplished through intervention and appropriate utilization of ICS or ICS/LABA therapy in patients admitted for COPD exacerbations treated with systemic corticosteroids.
From the Editor in Chief
Authors: Doğanay Ahmet 
Published: December 2016

Dear producers and consumers of knowledge,

I would like to share the happiness of being with you again with 6th Volume 3th Issue of Pegem Journal of Education and Instruction (PEGEGOG). I hope you could find time to have a rest after your busy schedule. Initially, I want to thank you for the increasing interest for our journal.
As mentioned before, we had applied to many indexes. Our belief in being accepted to these indexes that we are through evaluation process is increasing day by day. I would like to remind that our journal will have English and Turkish full papers from now on to fulfill the conditions of these indexes.

We shared with you in previous issues and announcements that our journal got high scores by many indexes. I'm pleased to inform you in this issue that the journal's h-index rose to 9. However, our aim is always to have much higher scores. Therefore, we invite you to share studies comprehensive, built on strong theoretical basis, innovative and bringing a vision on various fields of educational sciences increasing the number of readers.

There has been 28 articles sent for publication to our journal. This is good news for our journal and country. On the other hand, I have to indicate that there were critical problems in terms of format within these articles as stated in the previous issue. First of all, unfortunately we had to reject some articles as in many of them there were texts very similar to ones in different articles. At first step, we scan all articles in i-Thenticate program to determine the exact quotations from other resources. After this scan, we reject the articles detected to have exact quotations at a high rate without initiating peer-review process. Apart from that, we also send back the articles not written in an academic format not to disturb our reviewers unnecessarily.

One of the problems with the articles submitted to our journal and we had to reject was about data analysis. The data is the raw information collected from related resources through research aims. These should be analyzed in parallel with these aims. It is necessary to analyze them using statistics for quantitative data and methods such as content analysis or descriptive analysis for qualitative data. Analysis provides the data being transformed into findings and make sense. Especially, in some of document analysis and some qualitative studies, it is seen that data are presented as findings. In some others, data are presented being only described. It is essential that the studies are formed in an article format obeying the rules by the journal and presented for publication afterwards.

As always, we present the six articles got through peer-review process and given DOI number to you dear producers and consumers of knowledge. I wish these studies conducted in various fields of educational sciences will be useful and contribute to theoretical knowledge within the field. Hope to meet within the next issue.

Sincerely yours,
Zahlt sich Akademisierung aus?
Authors: Schäfer Andrea , Gottschall Karin 
Published: December 2016

ZusammenfassungDer Gesundheitssektor in Deutschland ist durch eine steigende Präsenz von Frauen im traditionell von Männern dominierten ärztlichen Berufsfeld und eine leichte Zunahme von Fachkräften mit akademischer Ausbildung in der von Frauen dominierten Kranken- und Altenpflege gekennzeichnet. Was diese Entwicklung für die Einkommen der männlichen und weiblichen Beschäftigten im expansiven Gesundheitswesen bedeutet, ist offen. Der Beitrag untersucht auf Basis von SOEP-Daten für die Jahre 2010-2013 die Einkommensniveaus und -zugewinne auf Basis höherer Bildung für männliche und weibliche Fachkräfte in der Kranken- und Altenpflege und im ärztlichen Berufsfeld. Die Ergebnisse zeigen, dass Frauen im Vergleich zu Männern in allen drei Berufen sowohl geringere Bruttostundenlöhne als auch geringere Bildungsrenditen erzielen, wobei die geschlechtsspezifischen Differenzen bei der akademisierten ärztlichen Tätigkeit geringer sind als in der berufsfachlich geprägten Krankenpflege. Die heterogene und weiterhin expansive Altenpflege ist durch geringe Einkommensniveaus für beide Geschlechter und besonders hohe Bildungsrenditen der männlichen Fachkräfte gekennzeichnet. Diese Differenzen verweisen darauf, dass die Frage, warum Frauen auch bei gleicher Qualifikation geringere Einkommenszuwächse erzielen, weiterer berufsfeldspezifischer Untersuchung bedarf.
Flucht und Migration: Herausforderung für Bildung, Ausbildung und Arbeitsmarktpolitik
Authors: Walwei Ulrich 
Published: December 2016

Zusammenfassung
Die Fluchtmigration stellt in Deutschland aktuell und in der nahen Zukunft eine der größten Herausforderungen für die Arbeitsmarktpolitik dar. Sie ist offenkundig mit zunächst beträchtlichen staatlichen Aufwendungen verbunden. Die These des Überblicksartikels lautet: Wenn die Integration geflüchteter Menschen in den Arbeitsmarkt erfolgreicher verläuft als in der Vergangenheit, sind die anfänglichen Aufwendungen als Investitionen aller Beteiligten zu sehen, aus denen wirtschaftliche Chancen erwachsen können. Ausgangspunkte für den konzeptionell angelegten Beitrag sind vornehmlich Befunde des Instituts für Arbeitsmarkt- und Berufsforschung (IAB) zur quantitativen Entwicklung der Migration in der jüngeren Vergangenheit sowie zur bisherigen Arbeitsmarktintegration von Migranten und Flüchtlingen. Zudem werden die kurz- und längerfristigen Konsequenzen der Fluchtmigration für das Erwerbspersonenpotenzial sowie für Arbeitsmarkt und Beschäftigung erörtert. Auf der Basis vorliegender Informationen zum Bildungs- und Qualifizierungsstand der jüngst geflüchteten Menschen werden schließlich arbeitsmarktpolitische Folgerungen diskutiert.