bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do β-Blockers Decrease the Hypermetabolic State in Critically Ill Children With Severe Burns?
Authors: Shan Chew Elaine Chu , Baier Nicole , Lee Jan Hau 
Published: July 2015

BACKGROUND AND OBJECTIVES:
Severe burns result in a hypermetabolic state that is associated with increased morbidity and mortality. We reviewed the literature to determine if there is strong evidence that short-term β-blockers reduce the hypermetabolic state or mortality and length of stay (LOS) compared with no therapy in patients with severe burns.

METHODS:
A literature search of PubMed, Embase, the Cochrane Database of Systematic Reviews, and BestBETs was conducted on the use of adrenergic β-antagonists in burn patients.

RESULTS:
Six randomized controlled trials met the inclusion criteria. Five pediatric trials found that β-blockers reduced the hypermetabolic state (as defined by reduction of cardiac work, rate pressure product, resting energy expenditure, central deposition of fat, and bone mineral loss) and were associated with an improvement in lean muscle mass in patients with severe burns. However, there was no change in LOS or mortality in these children. One adult study in burn patients found shorter LOS in patients treated with β-blockers but no difference in mortality rate. β-blockers were relatively well tolerated, with no differences in adverse effects reported.

CONCLUSIONS:
β-blockers seem to reduce the hypermetabolic state in pediatric patients with burns, but there is insufficient evidence to suggest they have an impact on mortality rates or LOS.
The Influence of Patient Characteristics on the Perceived Value of Inpatient Educational Experiences by Medical Trainees
Authors: Farrell Renée , Mahant Sanjay , Wadhwa Anupma , Bismilla Zia , Zhao Xiu Yan , Martimianakis Tina , Cohen Eyal 
Published: July 2015

BACKGROUND AND OBJECTIVE:
Medical education relies heavily on workplace learning where trainees are educated through their clinical experience. Few studies have explored trainees’ perceptions of the educational value of these patient care experiences. The aim of this study was to identify pediatric patient characteristics that medical trainees perceive as educationally valuable.

METHODS:
Over 2 months, trainees on pediatric inpatient wards ranked the perceived educational value of patients under their care on a 4-point bipolar Likert scale. Three patient characteristics were examined: complex-chronic and noncomplex-chronic preexisting conditions, difficult social circumstances, and rare diseases. Patient-level predictors of cases perceived as educationally valuable (defined as scores ≥3) were examined by using univariate and multivariate analyses.

RESULTS:
A total of 325 patients were rated by 51 trainees (clinical medical students [45%], first-year residents [29%], third-year residents/fellows [26%]). Rare diseases had a higher educational value score (adjusted odds ratio 1.76, 95% confidence interval 1.08–2.88, P = .02). Complex-chronic and noncomplex-chronic preexisting conditions and difficult social circumstances did not affect the perceived educational value.

CONCLUSIONS:
Trainees attribute the most educational value to caring for patients with rare diseases. Although trainees’ perceptions of learning do not necessarily reflect actual learning, they may influence personal interest and limit learning from an educational experience. Knowledge of trainee perceptions of educational experience therefore can direct medical educators’ approaches to inpatient education.
Karol Wojtyla e os níveis de sentido da regra de ouro
Authors: Salles Sergio De Souza , Da Silveira Carlos Frederico Gurgel Calvet 
Published: July 2015

A regra de ouro, o princípio ético segundo o qual devemos fazer aos outros o que nós queremos que nos façam, é também conhecida na tradição cristã como regra de amor ao próximo. O objetivo do presente artigo é examinar a relação entre dois níveis de sentido da regra de ouro nas investigações filosóficas de Karol Wojtyla, anteriores ao seu pontificado. Uma vertente do atual debate sobre a regra deouro diz respeito às suas raízes antropológicas e ao seu sentido ético. A abordagem filosófica de Karol Wojtyla da regra de ouro perpassa tanto a investigação de suas raízes antropológicas quanto de suas exigências éticas. Com efeito, há um sentido pré-ético da regra de ouro em Karol Wojtyla, que está vinculado à sua abordagem fenomenológica da pessoa humana e da vida em comunidade. Nesse nível, a regra deouro é descrita a partir da lógica da autorrealização, que manifesta o valor personalista da ação humana. Por outro lado, há também um segundo sentido propriamente ético da regra de ouro, graças ao qual desenvolve sua perspectiva da doação de si como condição darealização de si mesmo. Nessa perspectiva wojtyliana, o que torna uma regra moral áurea é a sua capacidade de integrar e complementara busca pela própria realização com a realização do outro mediante a doação de si mesmo.
Poder, violência e biopolítica. Diálogos (in)devidos entre H. Arendt e M. Foucault
Authors: M. M. Bartolomé Ruiz Castor 
Published: July 2015

Este ensaio tem por objetivo apresentar uma crítica das teses naturalistas da violência. O marco da crítica diz respeito à naturalização da violência, que induz a assimilação do poder como uma forma de violência. Para tanto, retomamos as teses de Hannah Arendt e Michel Foucault sobre o poder e a violência. O objetivo não é elencar as diferenças entre estes autores sobre o tema, que ficam explícitas no desenvolvimento do ensaio, mas mostrar as suas concordâncias a respeito da crítica do poder como algo sinônimo de violência.
A Filosofia da História como o lugar de efetivação da liberdade no Sistema da Ciência Hegeliano
Authors: Julião José Nicolao 
Published: July 2015

Em Hegel, mais do que em qualquer outro filósofo que o antecedeu, a história ganha estatuto filosófico fundamental, pois o seuinteresse por ela está presente em todas as partes de sua filosofia. Para Hegel, a filosofia é história universal (Weltgeschichte), ou seja, história do progresso na consciência da liberdade. E, enquanto processo de ampliação da liberdade, a história ganha um lugar de destaque no sistema hegeliano, aparece na última parte do espírito objetivo, como história universal, efetivando, desta maneira, a estrutura ontológica e metodológica do conceito liberdade apresentado no último livro da Ciência da Lógica. O objeto deste estudo é, portanto a Filosofia da História Universal compreendida como um universo efetivo da ampliação da liberdade e do pensamento filosófico que consideramos como o encerramento sistemático da filosofia de Hegel, dado que as partes que compõem o espírito absoluto – arte, religião e filosofia – são independentes, compreendendo cada uma em si mesma um sistema acabado. Em suma, o nosso objetivo é precisamente o de demonstrar o lugar de destaque que ocupa a história universal no Sistema da Ciência hegeliano.
Short Term Vocational Skill Test in Nepalese Context
Authors: Pasa Rajan Binayek 
Published: July 2015

This paper assesses the possible contribution of short term vocational skill tested graduates and labour migration in foreign employment and remittances to Nepalese economy. An attempt has also been made to assess the role of effective skill testing system that can be provided even in local level as for equal accessibility to all skilled workforces throughout the country. Producing skill tested graduates is known to be a process of human capital formation that is equally benefitted to self and society. Due to easy access of government policy, Nepalese youths are working in international labour market and at a time when the country's major economic indicators are not favorable, the remittances have played a vital role in national economic growth. Though remittances earning is a boon to the economy, the facilities are inadequate to back up the increasing trend of migration. Inadequate knowledge on skill testing system and lack of skill training and poor opportunities to involve in trade specific work are some of bottlenecks to Nepalese youths. This paper suggests that formulation and effective implementation of short term vocational skill testing system in local level is the need of today so that most of foreign labour migrants can grab semi-skilled employment opportunities through specific vocational skill tested certification. The government needs to play a proactive role to promote foreign employment by inducting and adhering to the policy of socio-economic development and human capital formation. Replicating the status and impact of short term vocational skill tested graduates and migrated labour in foreign employment, state mechanism has to be endorsed in our national context for development and promotion of skill testing mechanism in local level and regularization of foreign employment. In such a situation, majority of youths could get opportunities to take skill tested certificate that can encourage them to become a vocational skill and trade occupation specific. Such types of work specification could ultimately increase working efficiency and productivity of each workforce and economic prosperity of the country.DOI: http://dx.doi.org/10.3126/jtd.v1i0.13091 Journal of Training and Development Vol.1 2015: 54-61
Integrating risk management data in quality improvement initiatives within an academic neurosurgery department
Authors: McLaughlin Nancy , Garrett Matthew C. , Emami Leila , Foss Sarah K. , Klohn Johanna L. , Martin Neil A. 
Published: July 2015

OBJECT
While malpractice litigation has had many negative impacts on health care delivery systems, information extracted from lawsuits could potentially guide toward venues to improve care. The authors present a comprehensive review of lawsuits within a tertiary academic neurosurgical department and report institutional and departmental strategies to mitigate liability by integrating risk management data with quality improvement initiatives.

METHODS
The Comprehensive Risk Intelligence Tool database was interrogated to extract claims/suits abstracts concerning neurosurgical cases that were closed from January 2008 to December 2012. Variables included demographics of the claimant, type of procedure performed (if any), claim description, insured information, case outcome, clinical summary, contributing factors and subfactors, amount incurred for indemnity and expenses, and independent expert opinion in regard to whether the standard of care was met.

RESULTS
During the study period, the Department of Neurosurgery received the most lawsuits of all surgical specialties (30 of 172), leading to a total incurred payment of $4,949,867. Of these lawsuits, 21 involved spinal pathologies and 9 cranial pathologies. The largest group of suits was from patients with challenging medical conditions who underwent uneventful surgeries and postoperative courses but filed lawsuits when they did not see the benefits for which they were hoping; 85% of these claims were withdrawn by the plaintiffs. The most commonly cited contributing factors included clinical judgment (20 of 30), technical skill (19 of 30), and communication (6 of 30).

CONCLUSIONS
While all medical and surgical subspecialties must deal with the issue of malpractice and liability, neurosurgery is most affected both in terms of the number of suits filed as well as monetary amounts awarded. To use the suits as learning tools for the faculty and residents and minimize the associated costs, quality initiatives addressing the most frequent contributing factors should be instituted in care redesign strategies, enabling strategic alignment of quality improvement and risk management efforts.
Microendoscopy-guided percutaneous cordotomy for intractable pain: case series of 24 patients
Authors: Fonoff Erich Talamoni , Lopez William Omar Contreras , de Oliveira Ywzhe Sifuentes Almeida , Teixeira Manoel Jacobsen 
Published: July 2015

OBJECT
The aim of this study was to show that microendoscopic guidance using a double-channel technique could be safely applied during percutaneous cordotomy and provides clear real-time visualization of the spinal cord and surrounding structures during the entire procedure.

METHODS
Twenty-four adult patients with intractable cancer pain were treated by microendoscopic-guided percutaneous radiofrequency (RF) cordotomy using the double-channel technique under local anesthesia. A percutaneous lateral puncture was performed initially under fluoroscopy guidance to localize the target. When the subarachnoid space was reached by the guiding cannula, the endoscope was inserted for visualization of the spinal cord and surrounding structures. After target visualization, a second needle was inserted to guide the RF electrode. Cordotomy was performed by a standard RF method.

RESULTS
The microendoscopic double-channel approach provided real-time visualization of the target in 91% of the cases. The other 9% of procedures were performed by the single-channel technique. Significant analgesia was achieved in over 90% of the cases. Two patients had transient ataxia that lasted for a few weeks until total recovery.

CONCLUSIONS
The use of percutaneous microendoscopic cordotomy with the double-channel technique is useful for specific manipulations of the spinal cord. It provides real-time visualization of the RF probe, thereby adding a degree of safety to the procedure.
“Rescue” of bilateral subthalamic stimulation by bilateral pallidal stimulation: case report
Authors: Matias Caio M. , Silva Danilo , Machado Andre G. , Cooper Scott E. 
Published: July 2015

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) orglobus pallidus pars interna (GPi) is well established as a treatment for advanced Parkinson’s disease. In general, one of the 2 targets is chosen based on the clinical features of each patient. Stimulation of both targets could be viewed as redundant, given that the 2 targets are directly connected. However, it is possible that each target has different mechanisms, with clinical effects mediated by orthodromic or antidromic stimulation.
The authors report the case of a patient with severe Parkinson’s disease who had previously undergone bilateral subthalamic stimulation with excellent benefits. However, he presented with significant worsening associated with disease progression and pharmacological treatment, and then underwent bilateral GPi DBS. Follow-up assessment was conducted clinically as well as through blinded ratings of video recordings.
Pallidal DBS may be a safe and useful strategy to manage dystonic features and behavioral complications of subthalamic stimulation and pharmacological management. While combined stimulation was quite successful in the reported patient, further studies with larger samples and longer follow-up periods will be necessary before recommending the addition of pallidal DBS as a routine strategy for patients previously implanted with STN DBS.
Complications and outcomes of vasopressor usage in acute traumatic central cord syndrome
Authors: Readdy William J. , Whetstone William D. , Ferguson Adam R. , Talbott Jason F. , Inoue Tomoo , Saigal Rajiv , Bresnahan Jacqueline C. , Beattie Michael S. , Pan Jonathan Z. , Manley Geoffrey T. , Dhall Sanjay S. 
Published: July 2015

OBJECT
The optimal mean arterial pressure (MAP) for spinal cord perfusion after trauma remains unclear. Although there are published data on MAP goals after spinal cord injury (SCI), the specific blood pressure management for acute traumatic central cord syndrome (ATCCS) and the implications of these interventions have yet to be elucidated. Additionally, the complications of specific vasopressors have not been fully explored in this injury condition.

METHODS
The present study is a retrospective cohort analysis of 34 patients with ATCCS who received any vasopressor to maintain blood pressure above predetermined MAP goals at a single Level 1 trauma center. The collected variables were American Spinal Injury Association (ASIA) grades at admission and discharge, administered vasopressor and associated complications, other interventions and complications, and timing of surgery. The relationship between the 2 most common vasopressors—dopamine and phenylephrine—and complications within the cohort as a whole were explored, and again after stratification by age.

RESULTS
The mean age of the ATCCS patients was 62 years. Dopamine was the most commonly used primary vasopressor (91% of patients), followed by phenylephrine (65%). Vasopressors were administered to maintain MAP goals fora mean of 101 hours. Neurological status improved by a median of 1 ASIA grade in all patients, regardless of the choice of vasopressor. Sixty-four percent of surgical patients underwent decompression within 24 hours. There was no observed relationship between the timing of surgical intervention and the complication rate. Cardiogenic complications associated with vasopressor usage were notable in 68% of patients who received dopamine and 46% of patients who received phenylephrine. These differences were not statistically significant (OR with dopamine 2.50 [95% CI 0.82–7.78], p = 0.105). However, in the subgroup of patients > 55 years, dopamine produced statistically significant increases in the complication rates when compared with phenylephrine (83% vs 50% for dopamine and phenylephrine, respectively; OR with dopamine 5.0 [95% CI 0.99–25.34], p = 0.044).

CONCLUSIONS
Vasopressor usage in ATCCS patients is associated with complication rates that are similar to the reported literature for SCI. Dopamine was associated with a higher risk of complications in patients > 55 years. Given the increased incidence of ATCCS in older populations, determination of MAP goals and vasopressor administration should be carefully considered in these patients. While a randomized control trial on this topic may not be practical, a multiinstitutional prospective study for SCI that includes ATCCS patients as a subpopulation would be useful for examining MAP goals in this population.
Ginkgo leaf sign: a highly predictive imaging feature of spinal meningioma
Authors: Yamaguchi Satoshi , Takeda Masaaki , Takahashi Toshiyuki , Yamahata Hitoshi , Mitsuhara Takafumi , Niiro Tadaaki , Hanakita Junya , Hida Kazutoshi , Arita Kazunori , Kurisu Kaoru 
Published: July 2015

OBJECT
Spinal meningioma and schwannoma are the most common spinal intradural extramedullary tumors, and the differentiation of these 2 tumors by CT and MRI has been a matter of debate. The purpose of this article is to present a case series of spinal meningiomas showing unique imaging features: a combination of a fan-shaped spinal cord and a streak in the tumor. The authors termed the former imaging feature “ginkgo leaf sign” and evaluated its diagnostic value.

METHODS
The authors present 7 cases of spinal meningioma having the ginkgo leaf sign. Thirty spinal extramedullary tumors arising lateral or ventrolateral to the spinal cord were studied to evaluate the diagnostic value of the ginkgo leaf sign for spinal meningiomas. Among 30 cases, 12 tumors were spinal meningiomas and 18 tumors from the control group were all schwannomas.

RESULTS
Seven of the 12 spinal meningiomas were positive for the ginkgo leaf sign. The sign was not present in the control group tumors. The overall ability to use the ginkgo leaf sign to detect meningioma indicated a sensitivity of 58%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 78%.

CONCLUSIONS
The ginkgo leaf sign is highly specific to spinal meningiomas arising lateral or ventrolateral to the spinal cord. In the present series, the ginkgo leaf sign was perfectly predictive for spinal meningioma.
Preliminary data on pupal development, lifespan and fertility of Cynomya mortuorum (L., 1761) in Belgium (Diptera: Calliphoridae)
Authors: Braet Yves , Bourguignon Luc , Vanpoucke Sofie , Drome Valérie , Hubrecht Françoise 
Published: July 2015

The calliphorid Cynomya mortuorum (L., 1761) is a species of forensic interest, present mainly in the Palaearctic Region. Nearly nothing is known about its life history.
We provide here the first data regarding pupal weight evolution during the pupal stage, female fertility and life expectancy of the species. At 22°C under a variable regime of temperatures, the egg-to-adult development time was an average of 18.05 ± 0.72 and 18.47 ± 0.67 days for females and males, respectively, in the control group. The pupal stage represented 56.7% of the total development. The development time from egg to adult and the duration of the pupal stage were significantly longer for males than for females. The measurement of pupal weight at the start of the pupal period revealed that female pupae were significantly lighter than male pupae by nearly 20%. This difference between the sexes was also observed for the dry weight of adults. An average decrease of 8.75% was observed throughout the first 8 days of the pupal stage, after which most adults started to emerge. The tested females produced an average of 176.13 ± 66.62 eggs throughout the egg-laying period. The average lifespan after emergence was 12.10 ± 4.09 days for females and 12.60 ± 2.95 days for males, with a median of 12.50 days for both sexes.
Undergraduate Nursing Students’ Experience of Service-Learning: A Phenomenological Study
Authors: Knecht Janet Gavin , Fischer Beth 
Published: July 2015

Background:
Service-learning programs are becoming more evident in baccalaureate nursing curriculums. Anecdotal evidence describing student perceptions has been written; however, research has not been conducted regarding the in-depth student experience of service-learning with vulnerable populations in inner cities.

Method:
This study was conducted using Colaizzi’s descriptive phenomenological method of inquiry. Through purposeful sampling, 10 students were interviewed who have participated in service-learning throughout their sophomore, junior, and senior years of nursing education.

Results:
Five themes were identified—Shattering Stereotypes, Overwhelmed With Their Need, Transitioning to Community Caregiver, Advocating, and Reciprocal Benefits—and a fundamental structure emerged.

Conclusion:

Listening to the voices of students participating in service-learning enables educators to gain an in-depth perspective of their experience and, ultimately, to maximize the service-learning program and improve care delivered to this vulnerable inner city population. [
J Nurs Educ.
2015;54:(7):378–384.]
Nursing Students’ Qualitative Experiences in the Medical–Surgical Clinical Learning Environment: A Cross-Cultural Integrative Review
Authors: Hooven Katie 
Published: July 2015

Background:
The nature of the clinical learning environment has a huge impact on student learning. For instance, research has supported the idea that a positive learning environment increases student learning. Therefore, the ability to gain information from the student perspective about the learning environment is essential to nursing education.

Method:
This article reviews qualitative research on nursing students’ experiences of the clinical learning environment. The significance of the issue, the purpose of the integrative review, the methods used in the literature search, and the results of the review are presented.

Results:
Seventeen studies from 12 countries are identified for review, and six common themes are discussed. An exhaustive literature review revealed that among the 17 articles evaluated, six themes were common.

Conclusion:

The findings indicate the need to continue quality improvement to advance clinical education. [
J Nurs Educ.
2015;54(8):421–429.]