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Abstract Objective To determine the effect of fentanyl on the induction dose and minimum infusion rate of alfaxalone required to prevent movement in response to a noxious stimulus (MIR NM) in dogs. Study design Experimental crossover design. Animals A group of six healthy, adult, intact female mixed-breed dogs, weighing 19.7 ± 1.3 kg. Methods Dogs were randomly administered one of three treatments at weekly intervals: premedication with 0.9% saline (treatment A), fentanyl 5 μg kg–1 (treatment ALF) or fentanyl 10 μg kg–1 (treatment AHF), administered intravenously over 5 minutes. Anesthesia was induced 5 minutes later with incremental doses of alfaxalone to achieve intubation and was maintained for 90 minutes in A with alfaxalone (0.12 mg kg–1 minute–1), in ALF with alfaxalone (0.09 mg kg–1 minute–1) and fentanyl (0.1 μg kg–1 minute–1) and in AHF with alfaxalone (0.06 mg kg–1 minute–1) and fentanyl (0.2 μg kg–1 minute–1). The alfaxalone infusion was increased or decreased by 0.006 mg kg–1 minute–1 based on positive or negative response to antebrachium stimulation (50 V, 50 Hz, 10 ms). Data were analyzed using a mixed-model anova and presented as least squares means ± standard error. Results Alfaxalone induction doses were 3.50 ± 0.13 (A), 2.17 ± 0.10 (ALF) and 1.67 ± 0.10 mg kg–1 (AHF) and differed among treatments (p < 0.05). Alfaxalone MIR NM was 0.17 ± 0.01 (A), 0.10 ± 0.01 (ALF) and 0.07 ± 0.01 mg kg–1 minute–1 (AHF) and differed among treatments. ALF and AHF decreased the MIR NM by 44 ± 8% and 62 ± 5%, respectively (p < 0.05). Plasma alfaxalone concentrations at MIR NM were 5.82 ± 0.48 (A), 4.40 ± 0.34 (ALF) and 2.28 ± 0.09 μg mL–1 (AHF). Conclusions and clinical relevance Fentanyl, at the doses studied, significantly decreased the alfaxalone induction dose and MIR NM. [ABSTRACT FROM AUTHOR]

Directed medical play is used to reduce children's pain and distress during medical treatment. In this pilot study, young children who attended the burn clinic received either directed medical play provided by a child life specialist or standard preparation from the burn clinic nurse to prepare for their first dressing change. Data were collected using validated instruments. Children who participated in medical play experienced less distress during their dressing change ( M = 0.5, n = 12) than did those receiving standard preparation ( M = 2.0, n = 9). Children who received standard care reported a 2-point increase in pain during the procedure, whereas children who participated in medical play reported a 1-point increase. Change in parental anxiety was similar for both groups. Parent satisfaction was higher for caregivers who observed medical play than standard preparation. Although all findings were in the hypothesized direction, none was statically significant, most likely because of the small sample size. [ABSTRACT FROM AUTHOR]

The following study considers the spatial distribution, grade and seasonal variation of waste-heat from industrial sectors in the United Kingdom in 2018. Opportunities to offset the emissions caused by heat generation through the use of waste-heat recovery schemes have been examined. Reducing heat waste is a key intermediate step in avoiding climate disaster until fully decarbonised industrial practices have been developed and implemented. The findings of this study are presented as a 'UK waste heat map'. Data containing information on the natural gas consumption of different industries are used as a proxy for waste heat. This report finds that waste heat is concentrated around densely populated areas and areas with a traditionally strong industrial base. Such areas generate a large amount of the waste heat suitable for heat reuse, such as in a district heating scheme. The total waste heat from UK industry and electricity generation is estimated to be nearly 391,000 GWh per year. The data are represented in the accompanying UK waste heat map as point location data and by waste heat per Local Authority. Opportunities have been identified within each major industrial sector to reclaim and utilise this waste heat. • Waste heat from UK industry are mapped to identify potential waste-heat recovery. • UK industrial waste heat was estimated to be 391,000 GWh in 2018. • Waste heat is concentrated in areas of high population density. • Report details the methodology behind and interpretation of the UK waste heat map. • District heating from certain industries could increase reliance on natural gas. [ABSTRACT FROM AUTHOR]

Purpose Peer reviewers' knowledge of author identity may influence review content, quality, and recommendations. Therefore, the International Journal of Radiation Oncology, Biology, Physics ("Red Journal") implemented double-blinded peer review in 2011. Given the relatively small size of the specialty and the high frequency of preliminary abstract presentations, we sought to evaluate attitudes, the efficacy of blinding, and the potential impact on the disposition of submissions. Methods and Materials In May through August 2012, all Red Journal reviewers and 1 author per manuscript completed questionnaires regarding demographics, attitudes, and perceptions of success of blinding. We also evaluated correlates of the outcomes of peer review. Results Questionnaires were received from 408 authors and 519 reviewers (100%). The majority of respondents favored double blinding; 6% of authors and 13% of reviewers disagreed that double blinding should continue in the Red Journal. In all, 50% of the reviewers did not suspect the identity of the author of the paper that they reviewed; 19% of reviewers believed that they could identify the author(s), and 31% suspected that they could. Similarly, 23% believed that they knew the institution(s) from which the paper originated, and 34% suspected that they did. Among those who at least suspected author identity, 42% indicated that prior presentations served as a clue, and 57% indicated that literature referenced did so. Of those who at least suspected origin and provided details (n=133), 13% were entirely incorrect. Rejection was more common in 2012 than 2011, and submissions from last authors with higher H-indices (>21) were more likely to survive initial review, without evidence of interactions between submission year and author gender or H-index. Conclusions In a relatively small specialty in which preliminary research presentations are common and occur in a limited number of venues, reviewers are often familiar with research findings and suspect author identity even when manuscript review is blinded. Nevertheless, blinding appears to be effective in many cases, and support for continuing blinding was strong. [ABSTRACT FROM AUTHOR]

Introduction: Programs and services available through the aging services network can help community-dwelling older adults to age in place but are often not discussed in routine primary care. The primary care liaison was developed as a novel integration intervention to address this disconnect.Methods: Employed by an Area Agency on Aging, primary care liaisons performed outreach to primary care with the goal of raising awareness of community-based programs, resources, and services available to older adults and their caregivers and facilitating referrals. The evaluation of the primary care liaison model, conducted from December 2015 to February 2019, used the Reach, Effectiveness, Adoption, Implementation, Maintenance framework and assessed reach (number of clinics contacted), adoption (number of referrals to the Area Agency on Aging), implementation (number of follow-up contacts with a practice), and effectiveness (proportion of referrals reached and provided relevant resources).Results: The primary care liaisons contacted a median of 18.5 clinics per month (IQR=15-31). Primary care referrals averaged >100 per month, and referrals increased over time. Successful follow-up outreach visits had a median of 3 (IQR=2-10), and follow-up contacts had a median of 3 (IQR=1-7) per practice. Three quarters of caregivers for people with dementia reached by Area Agency on Aging staff were provided with information about relevant resources.Conclusions: The primary care liaison model is feasible, fosters ongoing interactions between primary care and Area Agencies on Aging, and connects older adults and their caregivers to relevant programs and services. Adoption of the primary care liaison model by other Area Agencies on Aging across the U.S. may help further the vision of optimized health and well-being of older adults. [ABSTRACT FROM AUTHOR]

Frailty is an age-related, multi-dimensional state of decreased physiologic reserve that results in diminished resiliency and increased vulnerability to stressors. It has proven to be an excellent predictor of unfavorable health outcomes in the older surgical population. There is agreement in recommending that a frailty evaluation should be part of the preoperative assessment in the elderly. However, the consensus is still building with regards to how it should affect perioperative care. The Society for Perioperative Assessment and Quality Improvement (SPAQI) convened experts in the fields of gerontology, anesthesiology and preoperative assessment to outline practical steps for clinicians to assess and address frailty in elderly patients who require elective intermediate or high risk surgery. These recommendations summarize evidence-based principles of measuring and screening for frailty, as well as basic interventions that can help improve patient outcomes. [ABSTRACT FROM AUTHOR]

Purpose To evaluate characteristics associated with higher rates of acceptance for original manuscripts submitted for publication to the International Journal of Radiation Oncology • Biology • Physics (IJROBP) and describe the fate of rejected manuscripts. Methods and Materials Manuscripts submitted to the IJROBP from May 1, 2010, to August 31, 2010, and May 1, 2012, to August 31, 2012, were evaluated for author demographics and acceptance status. A PubMed search was performed for each IJROBP -rejected manuscript to ascertain whether the manuscript was ultimately published elsewhere. The Impact Factor of the accepting journal and the number of citations of the published manuscript were also collected. Results Of the 500 included manuscripts, 172 (34.4%) were accepted and 328 (65.6%) were rejected. There was no significant difference in acceptance rates according to gender or degree of the submitting author, but there were significant differences seen based on the submitting author's country, rank, and h-index. On multivariate analysis, earlier year submitted ( P <.0001) and higher author h-index ( P =.006) remained significantly associated with acceptance into the IJROBP . Two hundred thirty-five IJROBP -rejected manuscripts (71.7%) were ultimately published in a PubMed-listed journal as of July 2014. There were no significant differences in any submitting author characteristics. Journals accepting IJROBP -rejected manuscripts had a lower median [interquartile range] 2013 impact factor compared with the IJROBP (2.45 [1.53-3.71] vs 4.176). The IJROBP -rejected manuscripts ultimately published elsewhere had a lower median [interquartile range] number of citations (1 [0-4] vs 6 [2-11]; P <.001), which persisted on multivariate analysis. Conclusions The acceptance rate for manuscripts submitted to the IJROBP is approximately one-third, and approximately 70% of rejected manuscripts are ultimately published in other PubMed-listed journals, but these ultimate-destination journals usually have a lower impact factor, leading to fewer citations and overall visibility. [ABSTRACT FROM AUTHOR]