Retrosternal Percutaneous Tracheostomy: An Approach for Predictably Impossible Classic Tracheostomy

Percutaneous tracheostomy is a routine procedure in intensive care units. In cases of very low position of the larynx, cervical spine deformation, morbid obesity, or neck tumor, performance of the classic tracheostomy is inapplicable. Retrosternal approach to tracheostomy in such 20 patients is herein reported. After preoperative neck computerized tomography to define the neck anatomy, a small suprasternal incision followed by a short retrosternal tissue dissection to expose the trachea was done; the trachea was then catheterized at the level of the 2nd ring in the usual tracheostomy manner. The immediate and late (≥6 months) outcomes were similar to that of the standard tracheostomy. Thus, percutaneous retrosternal tracheostomy is safe in patients with abnormal positioning of the trachea or neck constitution. It is a bedside applicable technique, that, however, requires caution to avoid hazardous vascular complications

Negative emotions boost users activity at BBC Forum

We present an empirical study of user activity in online BBC discussion forums, measured by the number of posts written by individual debaters and the average sentiment of these posts. Nearly 2.5 million posts from over 18 thousand users were investigated. Scale free distributions were observed for activity in individual discussion threads as well as for overall activity. The number of unique users in a thread normalized by the thread length decays with thread length, suggesting that thread life is sustained by mutual discussions rather than by independent comments. Automatic sentiment analysis shows that most posts contain negative emotions and the most active users in individual threads express predominantly negative sentiments. It follows that the average emotion of longer threads is more negative and that threads can be sustained by negative comments. An agent based computer simulation model has been used to reproduce several essential characteristics of the analyzed system. The model stresses the role of discussions between users, especially emotionally laden quarrels between supporters of opposite opinions, and represents many observed statistics of the forum.Comment: 29 pages, 6 figure

Invited Commentaries on the Future of Frontline Research

This article contains a set of six invited commentaries written by leading scholars, expressing varied perspectives on the future of frontline research and on the frontline domain itself. The article accompanies the Journal of Service Research special issue on organizational frontlines. In their commentaries, the authors share insightful views on areas of personal interest ranging from employee emotion and customer relationship building to the effect of technology and its implementation at the organizational frontline. Included within each commentary are managerial insights and suggestions for needed research in the highlighted area

Emotions in business-to-business service relationships

Emotion in business-to-business service relationships regarding cargo services is explored. The service relationship is characterised by mutual trust and cooperation. Contact is mainly via telephone or e-mail with some face-to-face interactions and participants providing a complex, multi-skilled seamless service. Experience rather than training plays a vital role with long-term service relationships built up and maintained. Emotional sensitivity is acquired partly by experience and a repeat customer base but mainly through a genuine desire to help and get to know others. In contrast to the view of emotional labour bringing managerial control or adverse affects to service staff, the emotion engendered by this work is authentic expression bringing personal satisfaction

An exploration of concepts of community through a case study of UK university web production

The paper explores the inter-relation and differences between the concepts of occupational community, community of practice, online community and social network. It uses as a case study illustration the domain of UK university web site production and specifically a listserv for those involved in it. Different latent occupational communities are explored, and the potential for the listserv to help realize these as an active sense of community is considered. The listserv is not (for most participants) a tight knit community of practice, indeed it fails many criteria for an online community. It is perhaps best conceived as a loose knit network of practice, valued for information, implicit support and for the maintenance of weak ties. Through the analysis the case for using strict definitions of the theoretical concepts is made

Identification of Lipases Involved in PBAN Stimulated Pheromone Production in Bombyx mori Using the DGE and RNAi Approaches

BACKGROUND: Pheromone biosynthesis activating neuropeptide (PBAN) is a neurohormone that regulates sex pheromone synthesis in female moths. Bombyx mori is a model organism that has been used to explore the signal transduction pattern of PBAN, which is mediated by a G-protein coupled receptor (GPCR). Although significant progress has been made in elucidating PBAN-regulated lipolysis that releases the precursor of the sex pheromone, little is known about the molecular components involved in this step. To better elucidate the molecular mechanisms of PBAN-stimulated lipolysis of cytoplasmic lipid droplets (LDs), the associated lipase genes involved in PBAN- regulated sex pheromone biosynthesis were identified using digital gene expression (DGE) and subsequent RNA interference (RNAi). RESULTS: Three DGE libraries were constructed from pheromone glands (PGs) at different developed stages, namely, 72 hours before eclosion (-72 h), new emergence (0 h) and 72 h after eclosion (72 h), to investigate the gene expression profiles during PG development. The DGE evaluated over 5.6 million clean tags in each PG sample and revealed numerous genes that were differentially expressed at these stages. Most importantly, seven lipases were found to be richly expressed during the key stage of sex pheromone synthesis and release (new emergence). RNAi-mediated knockdown confirmed for the first time that four of these seven lipases play important roles in sex pheromone synthesis. CONCLUSION: This study has identified four lipases directly involved in PBAN-stimulated sex pheromone biosynthesis, which improve our understanding of the lipases involved in releasing bombykol precursors from triacylglycerols (TAGs) within the cytoplasmic LDs

What do we know about emotional labour in nursing? A narrative review

Nurses have to manage their emotions and the expression of emotion to perform best care, and their behaviours pass through emotional labour (EL). However, EL seems to be an under-appreciated aspect of caring work and there is no synthetic portrait of literature about EL in the nursing profession. This review was conducted to synthesise and to critically analyse the literature in the nursing field related to EL. Twenty-seven papers were included and analysed with a narrative approach, where two main themes were found: EL strategies and EL antecedents and consequences. Hence, EL is a multidimensional, complex concept and it represents a nursing competence to provide the best care. Moreover, nurses have a high awareness of EL as a professional competence, which is a fundamental element to balance engagement with an appropriate degree of detachment to accomplish tasks for best practice, and to provide high-quality patient care