bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can Undergraduate Paramedic and Nursing Students Accurately Estimate Patient Age and Weight?
Authors: Williams Brett , Boyle Malcolm , O'Meara Peter 
Published: October 2013

Introduction:Accurate estimation of a patient's age and weight are skills expected of all healthcare clinicians, including paramedics and nurses. It is necessary because patients may be unable to communicate such information due to unconsciousness or an altered state of conscious. Age and weight estimation influence calculation for medication dosages, defibrillation, equipment sizing, and other invasive procedures such as intubation. The objective of this study was to identify whether undergraduate paramedic and nursing students were able to accurately estimate a patient's age and weight based on digital patient photos.Methods:A prospective, observational study involving undergraduate paramedic and nursing students from two Australian universities was used to estimate the age and weight of seven patients (adult and pediatric). Each patient image appeared in a PowerPointTMpresentation for 15 seconds, followed by a short pause, with the next patient image commencing automatically.Results:The findings demonstrated variable accuracy in age and weight estimation of the patients. Age estimations of pediatric patients were more accurate than estimations for adult patients. The majority of patient weights were under-estimated, with university undergraduate students in one university displaying similar estimations to the other university counterparts.Conclusions:Results from this study identified variations in students' ability to accurately estimate a patient's age and weight. This study shows that consideration should be given to age and weight estimation education, which could be incorporated into undergraduate healthcare curriculum.
Mass-Gathering Medical Care: Retrospective Analysis of Patient Presentations over Five Years at a Multi-Day Mass Gathering
Authors: Grant William D. , Nacca Nicholas E. , Prince Louise A. , Scott Jay M. 
Published: October 2013

Introduction:There is a scarcity of analytical data regarding mass-gathering medical care. The purpose of this study was to identify and evaluate the range and nature of illness and injury for patrons of an annual, multi-day, mass gathering.Methods:Encounter data from all patients seen by emergency physicians at the New York State Fair Infirmary during the past five years were analyzed. From these data, a category list was consolidated to 36 reasons for the visit based on chief complaint, nursing notes, and physician notes. The most common reasons for being seen by a physician were analyzed to determine age and gender discrepancies.Results:The average number of attendees at the Fair per year from 2004–2008 was 950,973. Emergency physicians evaluated a total of 2,075 patients from 2004–2008. The average patient presentation rate over the past four years (2005–2008) was 4.8 ±1.1/10,000 patrons. The average transport to hospital rate over the past four years was 2.7 ±1.1/100,000 patrons. The average age of all patients seen was 34.4 ±21.6 years, and 58.1% of the patients were female. The most common reasons to seek medical attention included: dehydration/heat-related illness (11.4%); abrasion/laceration (10.6%); and fall-related injury (10.2%). Two groups, dehydration/heat-related illness 74% (t (4) = 2.90, p <0.05), and fall-related injury (68%; t (4) = 5.17, p <0.05) were disproportionately female. There also was a direct relationship between age and female gender within the fall-related injury category (χ2 (1, n = 213) = 11.41, p <0.05).Conclusions:Patron data from fairs and expositions is a valuable resource for studying mass-gathering medical care. A majority (58%) of patients seen at the infirmary were female. The most common reason for being seen was dehydration/ heat-related illness, which heavily favored females, but favored no age groups. The abrasion/laceration category did not contribute to the gender discrepancy. Patients who fell tended to be females >40 years of age. Further analysis is required to determine the reason for the gender discrepancies. Planners of multi-day mass gatherings should develop public education programs and evaluate their impact on the at-risk populations identified by this analysis.
Attomolar DNA detection with chiral nanorod assemblies
Authors: Ma Wei , Kuang Hua , Xu Liguang , Ding Li , Xu Chuanlai , Wang Libing , Kotov Nicholas A. 
Published: October 2013

AbstractNanoscale plasmonic assemblies display exceptionally strong chiral optical activity. So far, their structural design was primarily driven by challenges related to metamaterials whose practical applications are remote. Here we demonstrate that gold nanorods assembled by the polymerase chain reaction into DNA-bridged chiral systems have promising analytical applications. The chiroplasmonic activity of side-by-side assembled patterns is attributed to a 7–9 degree twist between the nanorod axes. This results in a strong polarization rotation that matches theoretical expectations. The amplitude of the bisignate ‘wave’ in the circular dichroism spectra of side-by-side assemblies demonstrates excellent linearity with the amount of target DNA. The limit of detection for DNA using side-by-side assemblies is as low as 3.7 aM. This chiroplasmonic method may be particularly useful for biological analytes larger than 2–5 nm which are difficult to detect by methods based on plasmon coupling and ‘hot spots’. Circular polarization increases for inter-nanorod gaps between 2 and 20 nm when plasmonic coupling rapidly decreases. Reaching the attomolar limit of detection for simple and reliable bioanalysis of oligonucleotides may have a crucial role in DNA biomarker detection for early diagnostics of different diseases, forensics and environmental monitoring.
Adaptation of novel H7N9 influenza A virus to human receptors
Authors: Dortmans J. C. F. M. , Dekkers J. , Wickramasinghe I. N. Ambepitiya , Verheije M. H. , Rottier P. J. M. , van Kuppeveld F. J. M. , de Vries E. , de Haan C. A. M. 
Published: October 2013

AbstractThe emergence of the novel H7N9 influenza A virus (IAV) has caused global concerns about the ability of this virus to spread between humans. Analysis of the receptor-binding properties of this virus using a recombinant protein approach in combination with fetuin-binding, glycan array and human tissue-binding assays demonstrates increased binding of H7 to both α2-6 and α2-8 sialosides as well as reduced binding to α2-3-linked SIAs compared to a closely related avian H7N9 virus from 2008. These differences could be attributed to substitutions Q226L and G186V. Analysis of the enzymatic activity of the neuraminidase N9 protein indicated a reduced sialidase activity, consistent with the reduced binding of H7 to α2-3 sialosides. However, the novel H7N9 virus still preferred binding to α2-3- over α2-6-linked SIAs and was not able to efficiently bind to epithelial cells of human trachea in contrast to seasonal IAV, consistent with its limited human-to-human transmission.
The Case of Lauris Kaplinski: A Guide to a Semiotic Reading of Incitement of Hatred in Modern Criminal Justice
Authors: Verenich Vadim 
Published: October 2013

AbstractCriminal justice is the area of law where we are closest to an overview of the semiotic processes through a succession of organizational contexts. We start with the first call to the police and conclude with the criminal trial or appeal. The main stages in the process may be characterized as (police) investigation, the exercise of prosecutorial discretion by public officials, and the trial. The attention of legal philosophers and semioticians alike has been directed primarily toward the last. However, it is important to draw attention also to the earlier stages, and to the possibilities that exist of fitting them within a single semiotic framework of analysis.
The Constitutive Role of Emotions in the Discursive Construction of the “People”: A Look into Obama’s 2008 “Race Speech”
Authors: Pérez Hernández Carlos Andrés 
Published: October 2013

AbstractThis article examines the semiotic and rhetorical mechanisms by which Obama’s “race speech” builds a mutual identification between Blacks and Whites; it emphasizes the importance of locus communis commonplace and “equivalential links” (Laclau 2005, 94). It also looks at how Obama himself constructs his identity in order to appeal to a racially and politically heterogeneous audience. In addition, it attempts to identify and explain some elements of the speech that may carry heightened emotional content and that may induce a distancing or identification reaction in an audience. From the theoretical standpoint, the article brings to bear the Tartu-Moscow School of Semiotics understanding of metaphor and meaning-generation mechanisms on the Laclauian post-Marxist poststructural concept of the “people,” in order to explain how metaphors participate in the construction of a “people” during a presidential campaign. In terms of cognitive theory, it draws on Lakoff and Johnson’s understanding of metaphorical thinking ([1980] 2003) and Castells’s elaboration on emotions in relation to political cognition (2009). The sociological perspective on emotions aids in the analysis of emotions in social interaction (Turner and Stets 2009). The contribution of this article lies in the semiotic analysis of the role of emotion-evoking elements of the race speech that may indicate a constitutive role in the formation of a “people.”
Innovative Solution to Sharp Waste Management in a Tertiary Care Hospital in Karachi, Pakistan
Authors: Qaiser Seher , Arif Ambreen , Quaid Saeed , Ahsan Tasnim , Riaz Kashif , Niaz Saad , Qureshi Huma , Ahmed Waquaruddin , Alam Syed Ejaz 
Published: October 2013

Background.Prevalence of hepatitis B and C in Pakistan is 2.5% and 4.5%, respectively. Major cause of these infections is reuse of syringes.Objective.To determine a cost-effective, innovative solution to prevent syringe reuse and break the transmission cycle of blood-borne infections.Study Design, Settings, and Duration.Analytical study in a tertiary care hospital, Jinnah Postgraduate Medical Centre, Karachi, Pakistan, July 2011 to June 2012.Methods.Healthcare workers from 30 wards included in the study were trained on injection safety, use of needle remover and needle pit, and management of needlestick injuries. Each ward was provided with 2 needle-removing devices, and a pit was constructed for disposal of needles. Usage of the device in wards and pit use were monitored regularly.Results.In 28 (93.3%) wards, sharp containers were accessible by public and were slack. Syringes were recapped using both hands in 27 (90%) cases; needlestick injury was reported by 30% of paramedics, while 25 (83.3%) of the interviewed staff had not received any formal training in injection safety. Vigilant monitoring and information sharing led to healthcare workers in 28 (96.5%) wards using the device. Needle containers were emptied in 27 (93.1%) wards, and needle pits were used in 26 (96.3%) wards. Needlestick injury was nil in follow-up.Conclusions.Needle removers permanently disable syringes. The needle pit served as a cost-effective, innovative method for disposal of needles. The intervention resulted in reducing the risk of needlestick injury.
Infection Control Knowledge, Attitudes, and Practices among Healthcare Workers in Addis Ababa, Ethiopia
Authors: Tenna Admasu , Stenehjem Edward A. , Margoles Lindsay , Kacha Ermias , Blumberg Henry M. , Kempker Russell R. 
Published: October 2013

Objective.To better understand hospital infection control practices in Ethiopia.Design.A cross-sectional evaluation of healthcare worker (HCW) knowledge, attitudes, and practices about hand hygiene and tuberculosis (TB) infection control measures.Methods.An anonymous 76-item questionnaire was administered to HCWs at 2 university hospitals in Addis Ababa, Ethiopia. Knowledge items were scored as correct/incorrect. Attitude and practice items were assessed using a Likert scale.Results.In total, 261 surveys were completed by physicians (51%) and nurses (49%). Fifty-one percent of respondents were male; mean age was 30 years. While hand hygiene knowledge was fair, self-reported practice was suboptimal. Physicians reported performing hand hygiene 7% and 48% before and after patient contact, respectively. Barriers for performing hand hygiene included lack of hand hygiene agents (77%), sinks (30%), and proper training (50%) as well as irritation and dryness (67%) caused by hand sanitizer made in accordance with the World Health Organization formulation. TB infection control knowledge was excellent (more than 90% correct). Most HCWs felt that they were at high risk for occupational acquisition of TB (71%) and that proper TB infection control can prevent nosocomial transmission (92%). Only 12% of HCWs regularly wore a mask when caring for TB patients. Only 8% of HCWs reported that masks were regularly available, and 76% cited a lack of infrastructure to isolate suspected/known TB patients.Conclusions.Training HCWs about the importance and proper practice of hand hygiene along with improving hand sanitizer options may improve patient safety. Additionally, enhanced infrastructure is needed to improve TB infection control practices and allay HCW concerns about acquiring TB in the hospital.
Incidence, Classification, and Risk Stratification forCandidaCentral Line–Associated Bloodstream Infections in Pediatric Patients at a Tertiary Care Children's Hospital, 2000–2010
Authors: Klatte J. Michael , Newland Jason G. , Jackson Mary Anne 
Published: October 2013

Objective.To identify risk factors for pediatricCandidacentral line-associated bloodstream infections (CLABSIs).Design.Retrospective case-control study.Setting.Freestanding tertiary care children's hospital.Patients.Patients withCandidaCLABSI from January 31, 2000, through December 31, 2010, compared with age- and year-matched controls.Methods.Demographics, comorbidities, presence of indwelling foreign bodies, exposure to antibiotics or corticosteroids, total parenteral nutrition (TPN) or blood transfusions, complications, and outcome were evaluated. Bivariate and then logistic regression were used to compare temporal trends and risk factors.Results.A total of 160CandidaCLABSI patients (median age, 1.96 years) were compared with 457 controls. Those withCandidaCLABSIs were more likely to have intestinal failure (adjusted odds ratio [aOR], 6.777 [95% confidence interval (CI), 2.315–19.839];P< .001), to have a gastrostomy tube in place (aOR, 4.156 [95% CI, 2.317–7.456];P< .001), and to receive TPN (aOR, 3.897 [95% CI, 2.403–6.319];P< .001) or blood transfusions (aOR, 2.990 [95% CI, 1.841–4.856];P< .001), and they had a 3-fold increase in mortality (aOR, 3.543 [95% CI, 1.501–8.364];P= .004).Candida albicanswas most common, butnon-albicansstrains resistant to amphotericin (C. lusitaniae) and fluconazole (C. glabrataandC. krusei) were also found.Conclusions.Those patients with intestinal failure, gastrostomy tube presence, and/or receipt of TPN and blood transfusions are at increased risk for development ofCandidaCLABSI.
Do the Position and Orientation of the Crosslink Influence the Stiffness of Spinal Instrumentation?
Authors: Wang Zhuo , Sakakibara Toshihiko , Yoshikawa Takamasa , Inaba Tadashi , Kasai Yuichi 
Published: October 2013

Study Design:
Biomechanical study of double-level pedicle screw constructs with or without crosslinks (CL) in an unstable model.

Objectives:
The purpose of this study is to investigate the optimal position and orientation of the CL.

Summary of Background Data:
Several reports have described biomechanical research on such CL, but no definite consensus has been reached regarding the effects. Very few studies have examined the position and orientation of the CL. The question of where and how the CL should be clinically set remains unanswered.

Methods:
Ten cadaveric lumbar spines (L3–L5) of boars were used and 7 models were prepared by the sequential damage and spinal instrumentation of each specimen. Bending stiffness was measured in flexion, extension, lateral bending, and axial rotation for each model using 6-axis material tester under torque of 0 to ±3 N m. Results for each configuration were compared using analysis of variance and the Turkey-Kramer test.

Results:
In flexion, extension, and lateral bending, 7 models showed similar stiffness with no significant differences. In axial rotation, stiffness increased significantly (P<0.05) in the cephalic, central, caudal, and oblique CL models in comparison with that of the no CL model, and stiffness of the horizontal 2 CL and oblique 2 CL models was significantly higher than that of cephalic, central, caudal, and oblique CL models (P<0.05). However, no significant differences in stiffness were seen between cephalic, central, and caudal CL models, between the central and oblique CL models, or between the horizontal and oblique 2 CL models.

Conclusions:
Concomitant use of CLs significantly increased axial rotational stiffness, even though stiffness in flexion, extension, and lateral bending was not increased. In addition, stiffness in axial rotation significantly improved with the use of 2 CLs instead of a single CL, and stiffness was unchanged by position and orientation of CL.
Maintenance of Efficacy and Safety of Rabeprazole in Children With Endoscopically Proven GERD
Authors: Haddad Ibrahim , Kierkus Jaroslaw , Tron Eduardo , Ulmer April , Hu Peter , Silber Steven , Sloan Sheldon , Leitz Gerhard J. 
Published: October 2013

ABSTRACTObjective:The aim of the present study was to evaluate 24‐week maintenance of efficacy and safety of rabeprazole in children with endoscopically proven gastroesophageal reflux disease (GERD).Methods:Children ages 1 to 11 years who achieved endoscopic/histologic healing (defined as grade 0 of the Hetzel‐Dent Classification scale and/or grade 0 of the Histological Features of Reflux Esophagitis scale) in a 12‐week treatment phase were continued on the same dose for an additional 24 weeks during the maintenance phase. The dose was determined by weight: children weighing 6 to 14.9 kg (low‐weight cohort) received 5 or 10 mg and children weighing ≥15 kg (high‐weight cohort) received 10 or 20 mg.Results:Healing was maintained in 90% of children (100% [low‐weight cohort]; 89% [10 mg, high‐weight cohort]; 85% [20 mg, high‐weight cohort]). The Total GERD Symptom and Severity score continued to improve slightly in all of the children across all dose groups (P = 0.026) during the maintenance phase, except the 10‐mg dose group (low‐weight cohort), which experienced a slight worsening of 3.6 points. Overall, 71% children felt better on the GERD Symptom Relief score (P < 0.001); 95% of investigators and 92% of parent/caregivers rated “Good to Excellent” on the Global Treatment Satisfaction scale and Clinical Global Impressions Improvement scale, respectively. Overall incidence of treatment‐emergent adverse events was 63%; upper respiratory tract infections (13%) and vomiting (11%) were the most commonly reported (>10%).Conclusions:Rabeprazole was effective in maintaining endoscopic/histologic healing during a 24‐week maintenance period in children with endoscopically proven GERD. The clinical effect and safety profile were largely similar across dose groups.
Potential of probiotics as pharmaceutical agent: a review
Authors: Sarkar S. 
Published: October 2013

Purpose
– Increased evidence for the health benefits of probiotics for health restoration coupled with the consumer's inclination towards a safe, natural and cost-effective substitute for drugs have led application of probiotics as a pharmaceutical agent and are rapidly moving in clinical usage. In this context, this article attempts to highlight the potential of probiotics as a pharmaceutical agent.

Design/methodology/approach
– Endeavor has been made to explore the significance of probiotics for the modulation of gut ecology and their action. Potentiality of probiotics for their exploitation as a pharmaceutical agent has also been justified. Limitations of probiotic therapy and the various considerations for probiotic therapy have also been delineated.

Findings
– Probiotic organisms influence the physiological and pathological process of the host by modifying the intestinal microbiota, thereby affecting human health. Beneficial effects of probiotics as a pharmaceutical agent seem to be strain and dose dependent and more efficacious with their early introduction. Combination of various probiotics proved to be more efficacious than single strain for exhibiting prophylactic activities.

Research limitations/implications
– Reviewed literature indicated that it is difficult to generalize for the beneficial effect of all probiotics for all types of diseases as efficacy of probiotics is strain-dependent and dose-dependent and its clinical application needs long-term investigations.

Practical implications
– Clinical trials have displayed that probiotics may alleviate certain disorders or diseases in humans especially those related to gastro-intestinal tract.

Originality/value
– Ingestion of fermented dairy products containing probiotic cultures may provide health benefits in certain clinical conditions such as antibiotic-associated diarrhoea, rotavirus-associated diarrhoea, inflammatory bowel disease, inflammatory bowel syndrome, allergenic diseases, cancer, Helicobacter pylori infection and lactose-intolerance. Application of probiotics as a pharmaceutical agent is recommended.
Linking packaging to marketing: how packaging is influencing the marketing strategy
Authors: Rundh Bo 
Published: October 2013

Purpose
– The purpose with this paper is to investigate the relationship between packaging and the influence it has on marketing from a management point of view.

Design/methodology/approach
– Based on case studies different packaging solutions are discussed in relation to requirements by customers in the supply chain. Data for the cases were collected by different means including narratives and personal interviews.

Findings
– New packaging solutions offer the prospect of improved functions in the supply chain, delivering protection and preservation before reaching the ultimate customer. It also offers improved opportunities for better information and communication with the customer. However, the possibilities for innovative packaging solutions must be analyzed in relation to increased costs for packaging and the influence they can have on the environment.

Research limitations/implications
– This study extends previous research by linking packaging to the marketing strategy. Even though it is based on four case studies it combines different data sources including both qualitative and quantitative data.

Originality/value
– This paper evaluates the implementation of new packaging solutions in the supply chain from a managerial point of view, discussing benefits against challenges. This paper therefore fulfils an identified need for recognising the importance of packaging in relation to the marketing strategy.
Collective succession planning in librarianship
Authors: Fitsimmons Gary 
Published: October 2013

Purpose
– This article's purpose is to encourage a vision in the profession of librarianship for succession planning.

Design/methodology/approach
– The article springboards from the previous column, showing the natural expansion of the discussion on vision building to include succession planning.

Findings
– The article finds that succession planning is a natural extension of good vision building.

Practical implications
– This is a practical way to practice succession planning regardless of the size or resources of the institution.

Originality/value
– The value of the article is in contributing a solution to the professional problem of how to provide for continuing leadership for our libraries.