bluuebunny/crossref_metadata_2025_split huggingface dataset:
Establishment of a national severe maternal morbidity preventability review in New Zealand
Authors: MacDonald Evelyn Jane , Geller Stacie E. , Lawton Beverley 
Published: July 2016

AbstractSevere maternal morbidity (SMM) review is an accepted quality measure to evaluate maternity care standards. Assessment of the potential preventability of SMM enables identification of factors and themes to inform clinical training and policy to improve maternal outcomes. The present report outlines the introduction of a national/regional external case review system using multidisciplinary panels to assess potential preventability of SMM, to assist other health jurisdictions to establish similar processes. Implementation steps are outlined including ethics, engagement with health services, recruitment and training of panel clinicians, identifying and preparing cases, and structuring meetings. More than 100 clinicians from all District Health Boards in New Zealand were recruited to form six panels. From August 2013, each panel met quarterly to review. By August 2015, 374 anonymized cases had been reviewed for potential preventability and practice improvement themes. This process established a quality monitoring tool to quantitate potential preventability of SMM, and identify practice and policy themes that can be reported locally and nationally for quality improvement. To our knowledge, this is the first national SMM preventability review using an internationally validated tool enabling intercountry comparisons. On the basis of this research, the New Zealand Ministry of Health funded the translation of the process to ongoing SMM national preventability review.
Conducting and publishing design science research
Authors: van Aken Joan , Chandrasekaran Aravind , Halman Joop 
Published: July 2016

AbstractThe new Design Science department at the Journal of Operations Management invites submissions using a design science research strategy for operations management (OM) issues. The objective of this strategy is to develop knowledge that can be used in a direct and specific way to design and implement actions, processes or systems aimed at achieving desired outcomes. This knowledge is developed by engaging with real‐life OM problems or opportunities. Manuscripts submitted to this department will be evaluated on pragmatic validity and practical relevance. Because design science research (DSR) differs in some important aspects from other OM research strategies, this essay examines in some depth its challenges and possible solutions.
Responsive regulation for water PPP: Balancing commitment and adaptability in the face of uncertainty
Authors: House Schuyler 
Published: July 2016

AbstractPublic–private partnerships (PPPs) can potentially overcome financial, quality, and efficiency issues common to public service provision in developing cities. The management of long-term infrastructure PPP requires complex administrative and regulatory inputs and sound institutional underpinnings to ensure partners’ commitment to the contract over long time frames. Additionally, PPP governance typically necessitates adaptation mechanisms in order to accommodate high degrees of uncertainty and deal with changing operational conditions and new information. This paper proposes that PPP performance – both relational and instrumental – is contingent on a delicate, dynamic balance of credible commitment and adaptive capacity. Comparative case analysis offers a dynamic picture of how rules, relationships, and the quality of regulation shape a PPP's capacity to adapt to external shocks and new information. The cases also demonstrate the tradeoffs of promoting fidelity to the partnership agreement and making needed adjustments to contract settings and further show that PPP resilience may be positive or negative. For example, high degrees of uncertainty in the operating environment can lock in the PPP decision and, thus, promote survival at the cost of instrumental performance.
Uncertainty, ambiguity and adaptive flood forecasting
Authors: Wasson R J 
Published: July 2016

Abstract
Reliable long-term flood forecasts are needed because floods, among environmental disasters worldwide, do most damage to lives and property, a problem that is likely to increase as climate changes. The objective of this paper is to critically examine scientific approaches to flood forecasting under deep uncertainty and ambiguity as input to flood policy, and to explore alternative approaches to the development of better forecasts along with the necessary organizational support. This therefore a paper on science policy Aleatory (i.e. frequentist) probability estimates have dominated the science, attached to which are irreducible uncertainties. The lower priority given to finding a physical theory of floods means that ambiguity is high, particularly in relation to choosing a probability density function for forecasting. The historical development of flood forecasting is analyzed within the Uncertainty-Ambiguity Matrix of Schrader, S. Riggs, W.M., and Smith, R.P. (1993). Choice over uncertainty and ambiguity in technical problem solving. Journal of Engineering and Technology Management, 10, 13–99 showing that considerable uncertainty and ambiguity exist and are likely to continue. The way forward appears to be a mix of: broadening the information input to forecasts by engaging many disciplines, Bayesian analyses of probabilities, scenario analyses of catastrophic floods based on all available evidence, and adaptive forecasting in the face of climate change.
Medir la empatía en estudiantes de medicina, las diferencias por género y nivel de educación médica: identificación de una taxonomía de los estudiantes
Authors: Ferreira Duarte Marta Isabel , Barata Raposo Mário Lino , Fonseca da Silva Farinha Rodrigues Paulo Joaquim , Castelo Branco Miguel 
Published: July 2016

Introducción: La empatía es el papel mediador de la relación médico-paciente. A través de este proceso el profesional busca entender el marco de referencia del paciente y también para establecer una relación de transparencia, el respeto mutuo, la confianza y la comprensión profunda.
Objetivo: Este estudio tiene como objetivo analizar las percepciones de los estudiantes de medicina acerca de la importancia de la empatía en la relación médico-paciente y analizar la existencia de diferencias de género y en los diferentes años de la carrera. También se pretende identificar una taxonomía de los estudiantes basada en sus percepciones de la empatía.
Método: Este estudio transversal se llevó a cabo entre los estudiantes de pregrado de medicina. Un total de 208 estudiantes de medicina respondió a la Escala Jefferson de empatía médica del estudiante versión en portugués. Se utilizó análisis de componentes principales con rotación varimax para identificar el número y composición de factores surgido. Las puntuaciones de los factores retenidos fueron sometidos a un análisis de clusters para identificar diferentes grupos de estudiantes basados en la dimensión de la empatía. Un análisis Oneway-ANOVA y los test post-hoc de Tukey han soportado la agrupación identificada.
Resultados: Este estudio presenta diferencias estadísticamente significativas entre los géneros, es decir, los individuos femeninos revelan puntuaciones más altas que los individuos de sexo masculino, la empatía aumenta durante el curso, pero sin diferencias estadísticamente significativas. Seis factores emergieron del análisis factorial y tres de ellos son dimensiones de empatía que se encuentran en otros estudios: «la adopción de perspectivas», «atención humanitaria» y «colocarse en lugar de los otros». El análisis de clusters divide a los alumnos en cinco grupos, de acuerdo con las dimensiones de la empatía identificadas.
Conclusiones: Es posible concluir que, en esta escuela de medicina en Portugal, las mujeres son más empáticas que los hombres, y, a medida que atraviesan los diferentes años en el curso en general, la empatía crece. Se recomienda llevar a cabo un estudio longitudinal, con el fin de seguir la evolución de estos estudiantes y analizar los factores que contribuyen para el aumento de las características de empatía.
Validación de los cuestionarios CVP-35 y MBI-HSS para calidad de vida profesional y burnout en residentes
Authors: Rivera-Ávila Dulce Adelaida , Rivera-Hermosillo Julio César , González-Galindo Cuitláhuac 
Published: July 2016

Introducción: La calidad de vida profesional (CVP) es el equilibrio de las demandas y recursos laborales/personales: es importante relacionar la CVP con el estado patológico del profesional «quemado/burnout» producto de la falta de adecuación entre las exigencias del cargo y las capacidades personales. No se han validado los cuestionarios para calidad de vida profesional CVP-35 y el MBI-HSS para burnout en formato autoaplicable.
Objetivo: Validar los cuestionarios CVP-35 y MBI-HSS mediante autoaplicación en línea.
Método: Estudio observacional, prospectivo, transversal, multicéntrico, y analítico. Muestra: médicos residentes del ISSSTE nacional, en curso de especialidad o subespecialidad médica durante el 2015-2016 y que aceptaron participar proporcionando su correo y consentimiento. Recibieron vía e-mail instrucciones para el llenado y envío en junio-julio del 2015.
Resultados: Un total de 360 residentes enviaron respuesta; 17 fueron excluidos por responder más de una vez, obteniéndose una muestra definitiva de n = 338, procedente de 19 sedes a nivel nacional. Validación CVP-35: 35 ítems escala Likert 5 puntos, = 0.93, KMO = 0.9, prueba de esfericidad de Barlett p < 0.001. Ocho factores con eigenvalores > 1 explicaron 62.5% de varianza total (demandas del puesto, apoyo directivo, motivación intrínseca, apoyo del equipo, realimentación institucional, calidad de vida percibida, demandas físicas y personales, y apoyo económico). Validación MBI-HSS: 22 ítems escala Likert 7 puntos, = 0.885, KMO = 0.886, prueba de esfericidad de Barlett p < 0.001. Tres factores (agotamiento emocional, realización personal, despersonalización) con eigenvalores > 1 explicaron 51.17% de varianza total. Los diferentes dominios del CVP-35 y del MBI-HSS tuvieron una distribución normal, calculándose el coeficiente de correlación de Pearson. Correlaciones significativas > 0.3: el dominio de agotamiento emocional del MBI-HSS correlacionó positivamente con los dominios del CVP-35 demandas del trabajo, r = 0.399 (p < 0.0001), y peor calidad de vida percibida, r = 0.409 (p < 0.0001). El dominio realización personal de MBI-HSS correlacionó con el de motivación intrínseca del CVP-35, r = 0.379 (p < 0.0001).
Conclusiones: Ambos instrumentos (CVP-35 y MBI-HSS) demostraron fiabilidad y validez para la autoaplicación en línea en médicos residentes.
Postoperative oxycodone in breast cancer surgery: What factors associate with analgesic plasma concentrations?
Authors: Cajanus Kristiina , Neuvonen Mikko , Kaunisto Mari , Koskela Outi , Neuvonen Pertti J. , Niemi Mikko , Kalso Eija 
Published: July 2016

Abstract

Aims
Parenteral oxycodone is increasingly used worldwide to manage perioperative pain. Oxycodone doses required for adequate analgesia vary significantly between individuals. Our study investigated whether an analgesic plasma concentration could be determined for oxycodone and which factors affect it.

Methods
1000 women undergoing breast cancer surgery were recruited to the study. Demographic data were collected and their cold and heat pain sensitivity and anxiety scores were measured preoperatively. After surgery, rest and motion pain intensities were measured. Intravenous oxycodone was administered until the patients reported satisfactory pain relief (NRS <4/10). At this point, plasma concentrations of oxycodone and its metabolites were determined. A second plasma sample for oxycodone deter-mination was taken when the patient requested a new dose of oxycodone. Genomic DNA was extracted from whole blood samples and the patients were genotyped for CYP2D6, CYP3A4 and CYP3A5 variants.

Results
The two oxycodone concentrations showed a strong correlation (r =0.84). The pain intensity measured during motion before oxycodone dosing correlated significantly with the plasma oxycodone concentration (geometric mean 35.3 ng/ml and CV	% 66.4) required to achieve satisfactory analgesia (r = 0.38, p = 1.5 x 10-33). The most important factors associating with postoperative pain intensity were type of surgery (breast conserving or mastectomy with or without axillary clearance) and the age of the patient. Older patients reported lower pain scores and required smaller oxycodone concentrations for satisfactory analgesia. CYP2D6, CYP3A5 or CYP3A4 genotypes did not significantly affect the oxycodone concentrations, but CYP2D6 genotype significantly affected the formation of the metabolites oxymorphone and noroxymorphone. CYP3A4 and CYP3A5 genotypes did not affect the metabolite formation.

Conclusions
Our results indicate that the more pain the patient experiences postoperatively the greater her minimum plasma oxycodone concentration must be to achieve satisfactory analgesia. Type of surgery and age significantly affect postoperative pain intensity.
Retrospective analysis of pediatric patients with CRPS
Authors: Kiehelä L. , Pouttu J. , Hamunen K. 
Published: July 2016

Abstract

Aims
The aim of the study was to describe the clinical features and clinical pathway of pediatric CRPS patients in HUH Children’s Hospital.

Methods
This retrospective study included patients admitted to the pediatric pain clinic for CRPS during six years 2008-2013. Data on time from the first symptoms to diagnosis, first appointment at the pain clinic, and symptom resolution, as well as demographic and clinical symptoms were extracted from patient records.

Results
Forty patients were clinically diagnosed with CRPS during the time period without using the Budapest Criteria. 75% of the patients were female, median age was 12, and in 90% of the cases the CRPS was localized in the lower extremity. The median time from first symptoms to the CRPS diagnosis was 8.5 weeks (range 0-47), to first appointment with the pain physician 10 weeks (range 2-47), and to symptom resolution 35 weeks (range 10-131). Eleven out of forty patients (27.5%) were not symptom-free at the end of the treatment period. Most common clinical finding was allodynia or hyperalgesia of the afflicted area (70%).

Conclusions
Compared to an earlier study performed in our hospital (retrospective study of seven years, n = 18), the number of patients has more than doubled, maybe due to better awareness of the syndrome. Our findings about demographics and localization of CRPS are in agreement with previous literature. Time to reaching diagnosis, the small number of consultations and radiographs show that CRPS is well known among pediatric orthopedic surgeons. Many Budapest criteria that are now considered important diagnostic findings were not highly prevalent in our patients (e.g. prior trauma, color changes of skin), although patient records were not always clear about the findings leading to diagnosis. The Budapest criteria should be used to standardize the diagnosis also in our pediatric patients.
Trait-anxiety and pain intensity predict symptoms related to dysfunctional breathing (DB) in patients with chronic pain
Authors: Nævestad L.S. , Halvorsen S. , Kvarstein G. 
Published: July 2016

Abstract

Aims
The purpose of this cross-sectional study was to inves-tigate the occurrence of symptoms related to dysfunctional breathing (DB) in chronic pain patients and to examine factors associated with these symptoms.

Methods
A questionnaire was sent to 527 adults referred to out-patient pain clinics at Oslo university hospital. The questionnaire provided demographic data, Brief Pain Inventory, Spielberger state- trait anxiety inventory, and Nijmegen questionnaire (NQ). Multiple regression analyses were performed using SPSS.

Results
A total of 108 patients (20%) responded to the questionnaire and was included. Mean age was 49 years and two third of the participants were female. More than four out of ten had a NQ score ≥ 23 (a conservative cutoff value for DB). The median NQ score in the sample was 19. Trait-anxiety (Beta = .412, p < 0.001) and maximal pain intensity during the past week (Beta = .264, p = 0.004) predicted symptoms related to DB even when controlling for age and gender.

Conclusions
The study shows that a large portion of patients with chronic pain experiences symptoms that have been associated with hyperventilation and DB and at a higher level than previously reported. Although trait-anxiety is a strong predictor for symptoms related to DB, we find it interesting that maximal pain intensity during the last week also was associated with these symptoms. The cross-sectional design, low response rate, and lack of diagnoses limit our ability to draw conclusions about causal relationship and extrapolate to a larger populations of patients with chronic pain.
HEMS in Alpine Rescue for Pediatric Emergencies
Authors: Taubenböck Stefan , Lederer Wolfgang , Kaufmann Marc , Kroesen Gunnar 
Published: July 2016

Objective The objective of this study was to describe the pediatric emergencies encountered by the Christophorus-1 helicopter emergency medical service (HEMS) during a period of 2 years. Methods Emergency treatment of pediatric casualties by HEMS was evaluated at a helicopter base. Children up to 14 years who were treated by HEMS emergency physicians from Christophorus-1 during primary missions in the alpine region were retrospectively enrolled. Results Of the 1314 HEMS operations conducted during a 2-year investigation period, pediatric emergencies accounted for 114 (8.7%). Trauma was the most common emergency indication (91.3%) in alpine areas, and 77.5% of the indications were related to skiing and snowboarding; 11.3% of the prehospital pediatric emergencies were classified as life-threatening. Interventions on site were rendered in 46.3% of cases. Mean and SD intervals for approach were 11.0 ± 3.0 minutes; for treatment, 14.0 ± 6.0 minutes; and for transport, 8.0 ± 4.0 minutes. Intervals on site were significantly longer whenever it was necessary to search for an interim landing place ( P < .001) or perform rope extrication ( P < .001). Aggravating environmental conditions such as low temperature (78.8%), rocky terrain (18.8%), or precipitation (12.5%) were common. Conclusions Rapid procedures are preferred to sustained on-scene treatment, particularly when surrounding conditions are hostile. HEMS emergency physicians attempt to keep on-site intervals short and treatment and monitoring to the essential to minimize delay in rescue.
Current state and future of photodynamic therapy for the treatment of head and neck squamous cell carcinoma
Authors: Mimikos Christina , Shafirstein Gal , Arshad Hassan 
Published: July 2016

AbstractPhotodynamic therapy has shown promise in the treatment of early head and neck squamous cell carcinoma (SCC). In photodynamic therapy (PDT), a light sensitive drug (photosensitizer) and visible light cause cancer cell death by the creation of singlet oxygen and free radicals, inciting an immune response, and vascular collapse. In this paper, we review several studies that demonstrate the effectiveness of PDT in the treatment of early stage SCC of the head and neck, with some showing a similar response rate to surgery. Two cases are presented to illustrate the effectiveness of PDT. Then, new advances are discussed including the discovery of STAT3 crosslinking as a potential biomarker for PDT response and interstitial PDT for locally advanced cancers.
NADIR SHAH'S PECULIAR CENTRAL ASIAN LEGACY: EMPIRE, CONVERSION NARRATIVES, AND THE RISE OF NEW SCHOLARLY DYNASTIES
Authors: Pickett James 
Published: July 2016

AbstractOver the course of the 18th–early 20th centuries, a curious narrative emerged in Central Asia wherein the Turko-Persian monarch Nadir Shah Afshar was converted from Shiʿism to Sunnism by a group of Islamic scholars outside of Bukhara. While this legend was rooted in Nadir Shah's theological ambitions to bring Shiʿism back into the Sunni fold as a fifth school of canonical law, thememoryof that event in the subsequent two centuries was intimately tied to the establishment of several scholarly dynasties, which managed to perpetuate themselves all the way to the Bolshevik Revolution in 1917. This article engages the memory of this mythological conversion to explore sharpening conceptions of sectarian divisions and the role of genealogy in projecting spiritual authority. Most broadly, it argues that—far from a passing depredation—the Afsharid Empire profoundly shaped the geopolitical and social landscape of Persianate Asia.
Flight Characteristics of the B58 Mach 2 Bomber
Authors: Erickson B. A. 
Published: July 2016

The B58 was developed and produced for the United States Air Force by the General Dynamics Corporation, Fort Worth Division, Texas. Until recently the organisation was known as CONVAIR, Fort Worth Division.The B58 provided an abrupt advance in the technology of military aviation. In one step the speed performance of the strategic bomber was more than doubled over that of its predecessors.The development and manufacture of the B58 was accomplished under the Weapons System Management Concept. Development of the aircraft began in 1951 with the origination of design studies. Detail design and manufacturing efforts were started in 1954. Initial flight of the prototype occurred in November of 1956. An exhaustive flight test evaluation programme then ensued in parallel with production of the aircraft. The flight test programme utilised a substantial fleet of B58's, and the combined efforts of the manufacturer and the U.S.A.F.
Space Flight Projects Based on Blue Streak
Authors: Pardoe G. K. C. 
Published: July 2016

Many things have been said in the past year or two about the value of using Blue Streak to launch satellites and probes into space. Practical sense has at last triumphed and we have recently learned, with a great feeling of relief, that the European Space Launcher Organisation (ESLO) is now to be convened and there is now little doubt that a multi-stage satellite launcher rocket will be developed based on Blue Streak.Unfortunately, there has been much misconception and loose thinking surrounding the Blue Streak concept and much unreal speculation on its life expectancy, performance limitations and general capability—mostly under-estimates. I would like therefore to try to summarise the present situation regarding the rocket, its ground facilities and its space applications.
The Problem of Kinetic Heating Associated with Unmanned Re-entry Vehicles
Authors: Craig A. J. 
Published: July 2016

The art and science of re-entering a vehicle into a planetary atmosphere poses many problems, which are today on the edge of man’s mental and industrial capabilities. Re-entering a vehicle into the earth’s atmosphere incurs the following major problems: —(a) Kinetic heating as it passes through the denser regions of the atmosphere. Materials have to be found which can deal with the enormous amounts of heating experienced by the vehicle.(b) Design of a vehicle to withstand large thermal and mechanical shock.(c) Dynamic stability at hypersonic velocities.(d) Accuracy of direction of entry into the atmosphere.(e) Recovery of the capsule after impact, wherever it landed.This paper deals with the kinetic heating aspect of re-entry and shows how present day materials are utilised in restricting the inside temperature of re-entry vehicles to within reasonable limits. Unmanned re-entry is specified because to re-enter a manned capsule puts large restrictions on deceleration and inside temperature limits and hence produces some unique problems which are not covered in this paper.