bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developing a pediatric pain service
Authors: Kost‐Byerly Sabine , Chalkiadis George 
Published: September 2012

SummaryPediatric pain services were first established in larger pediatric centers over two decades ago. Children's acute pain was poorly managed at the time owing to misconceptions, safety concerns, and variability in practice. While many larger pediatric centers now have acute pain services, there remains a need for better pain management in facilities and geographic locations with fewer resources. Institutional acknowledgement and desire to change, appropriate staffing, and funding are major obstacles. Better recognition and assessment as well safer and more efficacious treatment of pain are the principal objectives when establishing a pain service. It is important to determine whether the proposed service intends to treat acute, chronic, procedural, and/or cancer and palliative pain as each requires different skills and resources. An ideal and comprehensive pediatric pain service should be equipped to diagnose and treat acute, persistent (chronic), procedural, and cancer/palliative pain. It is not feasible or necessary for every hospital to manage all. Establishing the scope of practice (based on case mix and caseload) in any given hospital will determine which resources are desired. Country‐specific standards, local staffing, and fiscal constraints will influence which resources are available.
New technologies in pediatric anesthesia
Authors: Holtby Helen , Skowno Justin J. , Kor Daryl J. , Flick Randall P. , Uezono Shoichi 
Published: September 2012

SummaryThis article reviews potential pediatric applications of 3 new technologies. (1) Pulse oximetry‐based hemoglobin determination: Hemoglobin determination using spectrophotometric methods recently has been introduced in adults with varied success. This non‐invasive and continuous technology may avoid venipuncture and unnecessary transfusion in children undergoing surgery with major blood loss, premature infants undergoing unexpected and complicated emergency surgery, and children with chronic illness. (2) Continuous cardiac output monitoring: In adults, advanced hemodynamic monitoring such as continuous cardiac output monitoring has been associated with better surgical outcomes. Although it remains unknown whether similar results are applicable to children, current technology enables the monitoring of cardiac output non‐invasively and continuously in pediatric patients. It may be important to integrate the data about cardiac output with other information to facilitate therapeutic interventions. (3) Anesthesia information management systems: Although perioperative electronic anesthesia information management systems are gaining popularity in operating rooms, their potential functions may not be fully appreciated. With advances in information technology, anesthesia information management systems may facilitate bedside clinical decisions, administrative needs, and research in the perioperative setting.
International advocacy for education and safety
Authors: McQueen Kelly A. , Malviya Shobha , Gathuya Zipporah N. , Tyler Donald C. 
Published: September 2012

SummarySurgical safety has emerged as a significant global public health concern with reported mortality rates varying tremendously between developing and industrialized countries. This manuscript reviews some of the challenges encountered in providing safe anesthesia care in the humanitarian space; identifies the difficulties with providing high‐quality education in developing countries; and describes how audits and quality improvement databases enhance our understanding of the nature and causes of harm to patients to inform the development of strategies for improvement.
Implementing checklists in the operating room
Authors: Low Daniel , Walker Isabeau , Heitmiller Eugenie S. 
Published: September 2012

SummaryChecklists have established themselves as a key safety process in the operating room environment. This paper describes the background and context of how checklists have evolved in medicine. It also highlights ongoing challenges with particular attention to the importance of nontechnical skills or human factors training with relation to checklist design, testing and implementation and ongoing coaching.
Automatic assistance to Parkinsonˈs disease diagnosis in DaTSCAN SPECT imaging
Authors: Illán I. A. , Górriz J. M. , Ramírez J. , Segovia F. , Jiménez‐Hoyuela J. M. , Ortega Lozano S. J. 
Published: September 2012

Purpose:In this work, an approach to computer aided diagnosis (CAD) system is proposed as a decision‐making aid in Parkinsonian syndrome (PS) detection. This tool, intended for physicians, entails fully automatic preprocessing, normalization, and classification procedures for brain single‐photon emission computed tomography images.Methods:Ioflupane[123I]FP‐CIT images are used to provide in vivo information of the dopamine transporter density. These images are preprocessed using an automated template‐based registration followed by two proposed approaches for intensity normalization. A support vector machine (SVM) is used and compared to other statistical classifiers in order to achieve an effective diagnosis using whole brain images in combination with voxel selection masks.Results:The CAD system is evaluated using a database consisting of 208 DaTSCAN images (100 controls, 108 PS). SVM‐based classification is the most efficient choice when masked brain images are used. The generalization performance is estimated to be 89.02 (90.41–87.62)% sensitivity and 93.21 (92.24–94.18)% specificity. The area under the curve can take values of 0.9681 (0.9641–0.9722) when the image intensity is normalized to a maximum value, as derived from the receiver operating characteristics curves.Conclusions:The present analysis allows to evaluate the impact of the design elements for the development of a CAD‐system when all the information encoded in the scans is considered. In this way, the proposed CAD‐system shows interesting properties for clinical use, such as being fast, automatic, and robust.
ACOUSTICAL STANDARDS NEWS
Authors: Blaeser Susan B. , Schomer Paul D. 
Published: September 2012

American National Standards (ANSI Standards) developed by Accredited Standards Committees S1, S2, S3, and S12 in the areas of acoustics, mechanical vibration and shock, bioacoustics, and noise, respectively, are published by the Acoustical Society of America (ASA). In addition to these standards, ASA publishes catalogs of Acoustical Standards, both National and International. To receive copies of the latest Standards Catalogs, please contact Susan B. Blaeser.
Comments are welcomed on all material in Acoustical Standards News.
This Acoustical Standards News section in JASA, as well as the National and International Catalogs of Acoustical Standards, and other information on the Standards Program of the Acoustical Society of America, are available via the ASA home page: http://acousticalsociety.org.
Honouring patient's resuscitation wishes: a multiphased effort to improve identification and documentation
Authors: Schiebel Nicola , Henrickson Parker Sarah , Bessette Richard R , Cleveland Eric J , Neeley J Paul , Warfield Karen T , Barth Mellissa M , Gaines Kim A , Naessens James M 
Published: September 2012

BackgroundDo Not Resuscitate (DNR) orders are intended to safeguard patients' autonomy and prevent unwanted resuscitative care. However, DNR orders may be miscommunicated between health care providers, leading to errors honoring patient wishes during cardiac arrest events. This project focused on improving accuracy of DNR ordering processes for an academic, tertiary care hospital.InterventionWe describe a performance improvement process and outcomes for implementation of an inpatient electronic ordering system that included an automated, decentralized printing process for resuscitation status armbands. Specific phases of this project involved: (a) identification of common factors contributing to errors honoring patients‘ resuscitation wishes, (b) design of an electronic ordering process, (c) design and integration of a new DNR armband and (d) evaluation of the impact of changes on communication accuracy. The primary outcome was percentage of patients with incorrect designation of resuscitation status on armbands compared to the active resuscitation order in the electronic medical record.ResultsAfter implementation of an electronic ordering process we identified that 37/196 (19%) patients had an armband that did not reflect their documented wishes versus 2/103 (2%) after integration of automated armband printing into the process (p<0.001). No armband discrepancies were found after the first two weeks of post-implementation audits.ConclusionsDesign and implementation of an electronic ordering and armband labeling process reduced discrepancies between patient wishes and the armband labeling of the patient's desired DNR status. It is anticipated that these improvements will reduce the risk of adverse outcomes, and better align clinical processes with patient wishes.
Concurrent tries with efficient non-blocking snapshots
Authors: Prokopec Aleksandar , Bronson Nathan Grasso , Bagwell Phil , Odersky Martin 
Published: September 2012

We describe a non-blocking concurrent hash trie based on shared-memory single-word compare-and-swap instructions. The hash trie supports standard mutable lock-free operations such as insertion, removal, lookup and their conditional variants. To ensure space-efficiency, removal operations compress the trie when necessary.
We show how to implement an efficient lock-free snapshot operation for concurrent hash tries. The snapshot operation uses a single-word compare-and-swap and avoids copying the data structure eagerly. Snapshots are used to implement consistent iterators and a linearizable size retrieval. We compare concurrent hash trie performance with other concurrent data structures and evaluate the performance of the snapshot operation.
A work-stealing scheduler for X10's task parallelism with suspension
Authors: Tardieu Olivier , Wang Haichuan , Lin Haibo 
Published: September 2012

The X10 programming language is intended to ease the programming of scalable concurrent and distributed applications. X10 augments a familiar imperative object-oriented programming model with constructs to support light-weight asynchronous tasks as well as execution across multiple address spaces. A crucial aspect of X10's runtime system is the scheduling of concurrent tasks. Work-stealing schedulers have been shown to efficiently load balance fine-grain divide-and-conquer task-parallel program on SMPs and multicores. But X10 is not limited to shared-memory fork-join parallelism. X10 permits tasks to suspend and synchronize by means of conditional atomic blocks and remote task invocations.
In this paper, we demonstrate that work-stealing scheduling principles are applicable to a rich programming language such as X10, achieving performance at scale without compromising expressivity, ease of use, or portability. We design and implement a portable work-stealing execution engine for X10. While this engine is biased toward the efficient execution of fork-join parallelism in shared memory, it handles the full X10 language, especially conditional atomic blocks and distribution.
We show that this engine improves the run time of a series of benchmark programs by several orders of magnitude when used in combination with the C++ backend compiler and runtime for X10. It achieves scaling comparable to state-of-the art work-stealing scheduler implementations---the Cilk++ compiler and the Java fork/join framework---despite the dramatic increase in generality.
Synchronization views for event-loop actors
Authors: De Koster Joeri , Marr Stefan , D'Hondt Theo 
Published: September 2012

The actor model has already proven itself as an interesting concurrency model that avoids issues such as deadlocks and race conditions by construction, and thus facilitates concurrent programming. The tradeoff is that it sacrifices expressiveness and efficiency especially with respect to data parallelism. However, many standard solutions to computationally expensive problems employ data parallel algorithms for better performance on parallel systems.
We identified three problems that inhibit the use of data-parallel algorithms within the actor model. Firstly, one of the main properties of the actor model, the fact that no data is shared, is one of the most severe performance bottlenecks. Especially the fact that shared state can not be read truly in parallel. Secondly, the actor model on its own does not provide a mechanism to specify extra synchronization conditions on batches of messages which leads to event-level data-races. And lastly, programmers are forced to write code in a continuation-passing style (CPS) to handle typical request-response situations. However, CPS breaks the sequential flow of the code and is often hard to understand, which increases complexity and lowers maintainability.
We proposes synchronization views to solve these three issues without compromising the semantic properties of the actor model. Thus, the resulting concurrency model maintains deadlock-freedom, avoids low-level race conditions, and keeps the semantics of macro-step execution.
Cranial Irradiation Increases Risk of Stroke in Pediatric Brain Tumor Survivors
Authors: Campen Cynthia J. , Kranick Sarah M. , Kasner Scott E. , Kessler Sudha K. , Zimmerman Robert A. , Lustig Robert , Phillips Peter C. , Storm Phillip B. , Smith Sabrina E. , Ichord Rebecca , Fisher Michael J. 
Published: September 2012

Background and Purpose—
The purposes of this study were to determine the incidence of neurovascular events as late complications in pediatric patients with brain tumor and to evaluate radiation as a risk factor.

Methods—
Patients were ascertained using the tumor database of a pediatric tertiary care center. Included patients had a primary brain tumor, age birth to 21 years, initial treatment January 1, 1993, to December 31, 2002, and at least 2 visits with neuro-oncology. Radiation exposure included: whole brain, whole brain plus a focal boost, or focal brain. The primary outcome was stroke or transient ischemic attack.

Results—

Of 431 subjects, 14 had 19 events of stroke or transient ischemic attack over a median follow-up of 6.3 years. The incidence rate was 548/100 000 person-years. Overall, 61.5% of subjects received radiation, including 13 of 14 subjects with events. Median time from first radiation to first event was 4.9 years. The stroke/transient ischemic attack hazard ratio for any brain irradiation was 8.0 (95% CI, 1.05–62;
P
=0.045); for the circle of Willis, radiation was 9.0 (95% CI, 1.2–70;
P
=0.035); and for focal noncircle of Willis, radiation was 3.4 (95% CI, 0.21–55;
P
=0.38).

Conclusions—
The incidence of neurovascular events in this population is 100-fold higher than in the general pediatric population and cranial irradiation is an important risk factor. By defining the incidence of this late effect, physicians are better able to counsel parents regarding treatment, monitor patients at risk, and target a population for primary stroke prevention in future studies.
On-line Changing of Thinking about Words: The Effect of Cognitive Context on Neural Responses to Verb Reading
Authors: Papeo Liuba , Rumiati Raffaella Ida , Cecchetto Cinzia , Tomasino Barbara 
Published: September 2012

AbstractActivity in frontocentral motor regions is routinely reported when individuals process action words and is often interpreted as the implicit simulation of the word content. We hypothesized that these neural responses are not invariant components of action word processing but are modulated by the context in which they are evoked. Using fMRI, we assessed the relative weight of stimulus features (i.e., the intrinsic semantics of words) and contextual factors, in eliciting word-related sensorimotor activity. Participants silently read action-related and state verbs after performing a mental rotation task engaging either a motor strategy (i.e., referring visual stimuli to their own bodily movements) or a visuospatial strategy. The mental rotation tasks were used to induce, respectively, a motor and a nonmotor “cognitive context” into the following silent reading. Irrespective of the verb category, reading in the motor context, compared with reading in the nonmotor context, increased the activity in the left primary motor cortex, the bilateral premotor cortex, and the right somatosensory cortex. Thus, the cognitive context induced by the preceding motor strategy-based mental rotation modulated word-related sensorimotor responses, possibly reflecting the strategy of referring a word meaning to one's own bodily activity. This pattern, common to action and state verbs, suggests that the context in which words are encountered prevails over the intrinsic semantics of the stimuli in mediating the recruitment of sensorimotor regions.
Evaluation of Forecast Potential with GCM-Driven Fields for Pollution over an Urban Air Basin
Authors: Goswami Prashant , Baruah J. 
Published: September 2012

AbstractSpecies like suspended particulate matter (SPM), respirable suspended particulate matter (RSPM), sulfur dioxide (SO2), and nitrogen dioxide (NO2) not only act as atmospheric pollutants but also affect long-term climate through radiative and chemical forcing. Earlier work has shown that the daily variations in these species over a location could be simulated quite well by considering daily meteorological fields from NCEP–NCAR reanalysis data in combination with models for natural and anthropogenic sources over Delhi, India. In the present work this possibility is explored by simulating the pollutant concentrations by using forecast fields from an atmospheric general circulation model (AGCM); this takes the model closer to a forecast model. Because of the coarse resolution, however, the present work considers an air basin rather than a detailed spatiotemporal distribution. Although the GCM has been tested at a resolution below 50 km, one of the objectives of the present work is to also compare and assess the impacts of a GCM-generated field with reference to NCEP–NCAR reanalysis data used in earlier work. In the present work the interaction is one way, and active chemistry for the species is not considered; thus the work should be regarded as a minimal forecast model, especially for SO2and NO2. Similarly, although the present work quantifies forecast skill, the skill estimated is again for a minimal configuration as aspects like data assimilation are not considered here. It is shown that the GCM-driven model has skill comparable to skill obtained when using NCEP–NCAR reanalysis data.
The Tropospheric Land–Sea Warming Contrast as the Driver of Tropical Sea Level Pressure Changes
Authors: Bayr Tobias , Dommenget Dietmar 
Published: September 2012

Abstract
This article addresses the causes of the large-scale tropical sea level pressure (SLP) changes during climate change. The analysis presented here is based on model simulations, observed trends, and the seasonal cycle. In all three cases the regional changes of tropospheric temperature (Ttropos) and SLP are strongly related to each other [considerably more strongly than (sea) surface temperature and SLP]. This relationship basically follows the Bjerknes circulation theorem, with relatively low regional SLP where there is relatively high Ttropos and vice versa. A simple physical model suggests a tropical SLP response to horizontally inhomogeneous warming in the tropical Ttropos, with a sensitivity coefficient of about −1.7 hPa K−1. This relationship explains a large fraction of observed and predicted changes in the tropical SLP.
It is shown that in climate change model simulations the tropospheric land–sea warming contrast is the most significant structure in the regional Ttropos changes relative to the tropical mean changes. Since the land–sea warming contrast exists in the absence of any atmospheric circulation changes, it can be argued that the large-scale response of tropical SLP changes is to first order a response to the tropical land–sea warming contrast. Furthermore, as the land–sea warming contrast is mostly moisture dependent, the models predict a stronger warming and decreasing SLP in the drier regions from South America to Africa and a weaker warming and increasing SLP over the wetter Indo-Pacific warm pool region. This suggests an increase in the potential for deep convection conditions over the Atlantic sector and a decrease over the Indo-Pacific warm pool region in the future.
GPS Dropwindsonde and WSR-88D Observations of Tropical Cyclone Vertical Wind Profiles and Their Characteristics
Authors: Giammanco Ian M. , Schroeder John L. , Powell Mark D. 
Published: September 2012

Abstract
The characteristics of tropical cyclone vertical wind profiles and their associated wind speed peaks below 1.5 km were examined through the use of a large number of GPS dropwindsondes (GPS sondes) and radar-derived velocity–azimuth display (VAD) profiles. Composite wind profiles were generated to document the mean structure of tropical cyclone vertical wind profiles and their changes with storm-relative position. Composite profiles were observed to change as the radius decreased inward toward the radius of maximum winds. Profiles also varied between three azimuthal sectors. At landfall, wind profiles exhibited changes with radial distance and differences were observed between those within offshore and onshore flow regimes. The observations support a general reduction in boundary layer depth with decreasing radial distance. Wind profiles with peaks at low altitudes were typically confined to radii less than 60 km, near and radially inward from the radius of maximum winds. Wind speed maxima, when scaled by a layer mean wind, decreased in magnitude as the radius decreased. At landfall, composite profiles showed a distinct low-level wind speed maximum in the eyewall region with significant differences between the onshore and offshore flow regimes.
Hispanic Acculturation, Psychosocial Functioning, and Routine Support for Diabetes Self-Management
Authors: Scollan-Koliopoulos Melissa , Schechter Clyde B. , Caban Arlene , Walker Elizabeth A. 
Published: September 2012

Purpose The purpose of this study was to describe the relationship between Spanish language-based acculturation, psychosocial coping with diabetes, and perceptions of social support obtainment for the daily management of diabetes. Methods Adults (N = 209) were surveyed by telephone about Hispanic ethnicity, depressed mood (PHQ-8), anxiety and worry over diabetes, social burden due to diabetes, diabetes control, and physical function (Diabetes-39), and Spanish language-based acculturation (n = 101, Hispanic only). Results Significant associations revealed a relationship between less language-based acculturation with other contextual factors (gender, family demands, disease severity), and depressed mood and social burden of disease. Acculturation alone explained little about psychosocial coping. Individuals with poor psychosocial coping were more likely to have routine daily help with diabetes self- management, with acculturation explaining little about who obtains help. Conclusions Hispanic values such as placing a priority on providing help to friends and family likely have more to do with psychosocial coping with diabetes than does language preference or proficiency. Individuals with poor psychosocial functioning may benefit from external social support when family support is not present to help with the routine management of diabetes.