bluuebunny/crossref_metadata_2025 huggingface dataset:
Correlations Among Hospital Quality Measures: What “Hospital Compare” Data Tell Us
Authors: Hu Jianhui , Jordan Jack , Rubinfeld Ilan , Schreiber Michelle , Waterman Brian , Nerenz David
Published: January 2017

A number of quality rating systems to rank health care providers have been developed over the years with the intention of helping consumers make informed health care purchasing decisions. Many use sets of individual quality measures to calculate a global rating. The utility of a global rating for consumer choice hinges on the relationships among included measures and the extent to which they jointly reflect an underlying dimension of quality. Publicly reported data on 4 quality domains—complication, mortality, readmission, and patient safety—from Centers for Medicare & Medicaid Services’ Hospital Compare website were used to examine correlations among individual measures within each measure group (within-group correlations) and correlations between pairs of measures across different measure groups (between-group correlations). Modest within-group correlations were found in only 2 domains (mortality and readmission), and there were no meaningful between-group associations. These findings raise questions about whether consumers can reliably depend on global quality ratings to make informed decisions.
Conditional Motivated Reasoning
Authors: Dickerson Bradley T. , Ondercin Heather L.
Published: January 2017

Using motivated reasoning, voters rely on partisanship as a heuristic for evaluating the economy in belief-preserving ways. Yet recent findings show that these motivations may be restricted by a range of contextual factors. We argue that partisan motivations in economic perceptions are moderated by the local economic context. As conditions worsen, a negative information environment leads in-partisans to political ambivalence that reduces confidence in party cues when evaluating the economy. As conditions improve, the motivation for in-partisans to rely on party cues is restored. As positive information has been shown to be less influential for opinion formation than negative information, and out-group members tend to be most prone to motivated reasoning, the economic context should moderate the political motivations of out-partisans to a lesser extent than in-partisans. A multilevel analysis of the 1980 to 2012 American National Election Studies supplemented with state-level data on unemployment and per capita disposable income supports this argument. The effects of in-party attachments on economic perceptions are diminished as economic conditions deteriorate and grow stronger as conditions improve. Moreover, the conditional effects of economic performance on subjective perceptions are stronger for in-partisans than for out-partisans.
Dynamics of Senate Retirements
Authors: Masthay Theodore J. , Overby L. Marvin
Published: January 2017

Although there is a large literature on the career decisions of House members, there is a dearth of critical scholarship examining retirement decisions in the Senate. This study aims to address this under-explored topic and identify the key factors in Senate retirement decisions. With a less demanding election schedule, greater power afforded to individual senators, more prestige attached to the office, and fewer attractive options for progressive ambition, we find that Senate retirement decisions differ substantially from patterns observed in the House. Among other things, the partisan retirement differential that is so obvious and persistent in the House (with Republican MCs retiring at higher rates than Democrats) is markedly absent in the Senate. We explore this and other inter-chamber differences, discussing both their empirical and normative ramifications, and noting their importance for our understanding not only of the two chambers but also of the two parties.
Exercise- and Psychosocial-Based Interventions to Improve Daily Activity in Heart Failure: A Pilot Study
Authors: Shoemaker Michael J. , Oberholtzer Nicole L. , Jongekrijg Lance E. , Bowen Travis E. , Cartwright Kelly , Hanson Kim , Serba Deb , Dickinson Michael G. , Kowalk Amy
Published: January 2017

In individuals with heart failure (HF), low daily activity is associated with a poorer prognosis. The purpose of this pilot study was to investigate the effects of two home-based interventions on the primary HF-related outcome of daily activity and secondary outcomes of exercise tolerance, HF-related health status, and lower extremity functional strength in 16 patients with HF and implanted Medtronic implantable cardioverter defibrillator and cardiac resynchronization devices using a single-blind, randomized controlled pilot trial. Interventions were either daily activity feedback and encouragement or health coaching and home-based exercise. There were no significant differences in primary or secondary outcomes either between or within groups. Three subjects in each treatment group improved in two or more secondary outcomes, and only one improved in daily activity. Although the present pilot study incorporated both exercise and psychosocial components in the intervention, there was no effect on daily activity, perhaps because readiness for behavioral change was not accounted for either in group stratification/allocation or inclusion criteria.
The Mathematical Modelling of the Performance of Noise Barriers
Authors: Hothersall D. C.
Published: January 2017

Analytical and numerical methods of modelling the acoustic performance of road traffic noise barriers are discussed, in particular the solution of the wave equation using boundary elements. Results are presented for a range of barrier profiles in the form of Insertion Loss spectra and the mean Insertion Loss for a broad band source characteristic of road traffic noise averaged over a range of representative receiver positions. The performance of barriers comprising multiple screens is considered. Comparison is made with the results of experimental modelling.
Sound Insulation of Acoustic Louvres and Open Screens
Authors: Lyons Richard
Published: January 2017

This paper reviews the problem of measuring sound insulation of acoustic louvres and other open screens. A survey of manufacturers in the UK shows that there is little agreement on a test method and performance data is often provided using several indices. The most commonly used method, ISO 140, is inappropriate for acoustic devices with transmission losses of 15dB or less. A review is given of the terminology and methods of measurement used, other non-standard methods are considered and a more suitable method, using impulse response techniques, is proposed. This method does not require special acoustic facilities. Results obtained by impulse methods are compared with standard reverberant room measurements and for screens offering more than 15dB insulation the agreement is promising.
A Simplified Method for Field Measurement of Airborne Sound and Impact Sound Insulation in Buildings
Authors: Min Liang , Dasheng W.U. , Xiying Zhang
Published: January 2017

A simplified method is investigated to be developed for use by building control inspectors or persons undertaking a similar role to allow a fast and simple check to be carried out on both air-borne and impact sound insulation between rooms. This paper proposes a short test method, in which a standard impact noise source is employed as a simplified source and one third octave band sound level measurement is simplified by A-weighting.
Determination of The Scattering Parameters of Fittings in Industrial Buildings for Use in Computer Based Factory Noise Prediction Models: Part 2 – Scale Model Experiments
Authors: Akil H.A. , Oldham D.J
Published: January 2017

In a companion paper results obtained from computer simulation1 have demonstrated that the sound propagation characteristics of disproportionate rooms are determined by the product of the fitting parameters scattering cross-section (Q) and absorption coefficient (αobst) of fittings. It was also proposed that the absorption of a fitting as measured in a conventional reverberation chamber is equivalent to four times the product of those two parameters. This suggests that measurement of fitting absorption in a conventional reverberation chamber could provide the data required for input into current computer based factory noise prediction models.

Since both parameters are required as inputs to computer models it would be necessary to separate them in some way from the data obtained in the reverberation chamber. In this paper two methods for determining the scattering parameters of fittings in industrial buildings based upon acoustical measurements are described. The accuracy of these is compared with that resulting from the application of a geometrical measurement method to determine the scattering cross-section (Q) of various shapes of model scatterers employed in experimental work employing 1:20 acoustic scale models. The values of Q obtained from each method were used to predict sound characteristics a model disproportionate chamber using RAYSCAT. The predicted results obtained from the computer model by inputting the values of Q determined using the acoustical measurement methods were found to be more accurate than those using the geometrical measurement method.
A Comparison between Different Multiple Input Array Processing Techniques for the Localisation of Correlated Acoustic Sources
Authors: Gargouri Y. , Amaidia G. , Wagstaff P.R.
Published: January 2017

The localisation of acoustic sources using linear microphone arrays permits source positions and power levels to be evaluated. The identification of the positions of the principal sources is essential before noise reduction methods can be defined. The work presented here concentrates on problems associated with multiple and partially coherent sources. Conventional processing techniques have limited resolution for a restricted number of transducers which can be resolved using high resolution techniques. Experiments showed the limitations of high resolution methods when dealing with correlated sources. Techniques based on the use of reference signals from selected sources were studied to try and solve this problem. This approach consists of pre-processing the cross spectral matrix in a specific way using multiple-input multiple-output (MIMO) methods. This enables the independent contributions of sources to be localised even for relatively high values of inter-source correlation.
The Effect of Design Changes on Sound Transmission through a Building
Authors: Craik Robert J.M.
Published: January 2017

A statistical energy analysis model of a building was used to assess the effect of design changes on sound transmission. Systematic changes were made to the material properties (density, Young's modulus, Poisson's ratio and internal loss factor) and to the dimensions (thickness and room size).

These changes resulted in a redistribution of the energy throughout the building causing the noise level to go up in some rooms and to go down in others. For each case examined it was found that the effect of several changes could be estimated from the sum of the individual changes. Thus a change of 20% in the density resulted in approximately double the change in DnTw that was obtained from a 10% change in density. The same additive effect was also found to apply if more than one variable was changed at the same time. Thus the change in DnTw resulting from a small change in Young's modulus for the floors and a small change in the density of the walls can be estimated from the sum of the two individual effects.

Changes to the thickness and density of the walls and floors have the greatest effect on sound transmission whilst changes to Young's modulus and Poisson's ratio have a much smaller effect. Damping can also have a significant effect on transmission particularly far from the source.
The Impact Sound Insulation of Pre-Loaded Timber Floating Floors on a Concrete Slab
Authors: Stewart Michael A. , MacKenzie David J. , Mackenzie Robin K.
Published: January 2017

When impact sound tests are carried out in new and refurbished flats there is not normally a load on the floor. When the flat is occupied however, loading due to furniture, appliances, people etc, will occur which compresses the resilient layer if a floating floor construction has been used. The effect this has on impact sound insulation is considered in this paper. Impact sound transmission through a chipboard floating floor on battens supported on a concrete floor has been measured when static loads were placed on the chipboard – the loads were in the range 20 kg/m3 to 160 kg/m2. Three different resilient layers under the battens were tested: 25 mm mineral wool quilt, resilient battens and resilient battens on 13 mm mineral wool quilt. The weighted standardised impact sound pressure level (L'nTw) increased by 0.5 dB to 5 dB with the larger increases for the greater loads. Further measurements were made after the floating floors had been left under a static load of 200 kg/m2 for six months: there was an additional increase in L'nTw of 1.5 dB. Finally, measurements were compared with floors where the resilient layers had been soaked to simulate water leakage from baths, pipes etc; there was no significant difference in results.
Determination of Acoustical Impedance of Absorbing Surfaces by Two-Microphone Transfer Function Techniques: Effect of Absorption Mechanism
Authors: Waddington D.C. , Orlowski R.J.
Published: January 2017

In the third of a series of papers on the measurement of acoustical impedance of absorbing surfaces using the two-microphone transfer function technique, the influence of surface absorption mechanism upon the measured impedance is described. The results from measurements of the impedance of bulk reactors are compared with values obtained from theoretical models. Materials investigated are an inhomogeneous polyurethane foam, a distributed resonance absorber, and a twin layer foam. This paper also investigates how the measurement technique behaves with samples which are bulk reacting and have surface roughness. A rough surfaced polyurethane foam sample is used. The results indicate that at frequencies for which the surface irregularities are small in comparison to the wavelength, the material can be accurately characterised by the acoustical impedance acting at an effective plane. For higher frequencies it is thought that the measuring technique becomes inaccurate due to scattering of sound by the surface roughness, and the consequent breakdown of the sound field prediction methods.
Two Methods of Modelling a Curved Surface in a Ray Tracing Model
Authors: Shield B.M. , Yang L.N.
Published: January 2017

This paper describes two methods of modelling a curved surface in ray tracing computer models: an approximate method in which the surface is modelled as a series of planes, and an exact method which uses the precise analytical description of the surface. The focusing effects predicted using the two models in a hypothetical cylindrical space have been examined and compared. It was found that the approximate method of modelling the curved surface predicted focusing effects that were significantly different from those predicted using the exact method. However, the larger the number of planes used in the approximation, the closer the agreement between the two methods. The effects of source position and number of sources on focusing were also examined, and showed that focusing effects are stronger when the source position is on the axis of the cylinder. Propagation of sound across and along the cylinder has also been studied.
Leisure Places Downstairs: A Pleasure or a Failure?
Authors: Asselineau M.
Published: January 2017

One of the urban environment challenges is to manage to locate such leisure places as cinemas, restaurants, or even discotheques, as close as possible to living quarters. While this can be reasonably achieved in brand new buildings, with careful acoustical and urban planning and engineering, it often proves tricky, or even impossible, to achieve in the kind of older buildings that usually are to be found at the core of European cities.

Whenever any benefit results from the presence of such leisure places close to homes, the neighbourhood can much more readily accept the acoustical implications. However, when no thought is given to the acoustical problems, the technical and relational efforts needed to correct the situation often prove to be beyond the capabilities of the operators.

Over the years, the authorities have tried to brush up community noise regulations so that they can cope with the new trends that include low frequency noise involving music.
A study of multiple sclerosis patients with magnetic resonance spectroscopic imaging
Authors: Peters AR , Geelen JAG , denBoer JA , Prevo RL , Minderhoud JM , 's-Gravenmade EJ
Published: January 2017

Eleven patients with clinically definite MS and three healthy controls were investigated by magnetic resonance spectroscopic imaging. The data sets were analysed for all voxels containing white matter only. We classify these voxels in healthy controls as normal white matter (NWM), and in MS patients as normal-appearing white matter unaffected by MS lesions (NAWM) or white matter affected by MS lesions. The spectra belonging to the voxels were analysed for content of cholines, creatines and N-ocetylasportote (NAA), and compared as a group. It was found that lesions differ from white matter in chemical composition and, moreover, that normal-appearing white matter differs from healthy white matter. Specifically, levels of NAA are lower in patients. There seems to be a linear relation between the composition of white matter and the expanded disability status scale value for the patient The presence of lactate could not be established, and no unambiguous differences were found between patients with relapsing-remitting and relapsing-progressive disease.
The effectiveness of telephone-delivered psychological therapies for depression and anxiety: A systematic review
Authors: Coughtrey Anna E , Pistrang Nancy
Published: January 2017

Objectives

The telephone is increasingly used to deliver psychological therapies for common mental health problems. This review addressed the following question: are evidence-based psychological therapies for adults with depression and/or anxiety effective in reducing psychological symptoms when delivered over the telephone?

Method

A systematic search for articles published over a 25-year period (January 1991–May 2016) was performed using the databases PsycINFO, PubMed and Web of Science. Citation searches, manual searches of bibliographies of relevant papers, and hand searches of key journals were also conducted. The quality of the studies included for review was assessed using the Effective Public Health Practice Project Quality Assessment Tool.

Results

Fourteen studies met inclusion criteria for the review. Ten reported findings from telephone treatment for depression and four for anxiety. Nine studies used randomised controlled designs, two used quasi-experimental designs and three used uncontrolled designs. Thirteen studies reported reductions in symptoms of depression or anxiety. Cohen’s d ranged from 0.25–1.98 (median = 0.61) for controlled studies and from 1.13–1.90 (median = 1.26) for uncontrolled studies. Only four studies reported clinically significant change.

Conclusions

The findings indicate that telephone-delivered interventions show promise in reducing symptoms of depression and anxiety. Further research is required to establish the types of interventions that are most effective and the characteristics of clients who find them beneficial.
Critical analysis of e-health readiness assessment frameworks: suitability for application in developing countries
Authors: Mauco Kabelo Leonard , Scott Richard E , Mars Maurice
Published: January 2017

Introduction

e-Health is an innovative way to make health services more effective and efficient and application is increasing worldwide. e-Health represents a substantial ICT investment and its failure usually results in substantial losses in time, money (including opportunity costs) and effort. Therefore it is important to assess e-health readiness prior to implementation. Several frameworks have been published on e-health readiness assessment, under various circumstances and geographical regions of the world. However, their utility for the developing world is unknown.

Methods

A literature review and analysis of published e-health readiness assessment frameworks or models was performed to determine if any are appropriate for broad assessment of e-health readiness in the developing world. A total of 13 papers described e-health readiness in different settings.

Results and Discussion

Eight types of e-health readiness were identified and no paper directly addressed all of these. The frameworks were based upon varying assumptions and perspectives. There was no underlying unifying theory underpinning the frameworks. Few assessed government and societal readiness, and none cultural readiness; all are important in the developing world. While the shortcomings of existing frameworks have been highlighted, most contain aspects that are relevant and can be drawn on when developing a framework and assessment tools for the developing world. What emerged is the need to develop different assessment tools for the various stakeholder sectors. This is an area that needs further research before attempting to develop a more generic framework for the developing world.
Validity of the Model for Assessment of Telemedicine: A Delphi study
Authors: Kidholm Kristian , Jensen Lise K , Kjølhede Tue , Nielsen Emilie , Horup Mette B
Published: January 2017

Introduction

In 2009, the Model for Assessment of Telemedicine (MAST) was developed within the MethoTelemed project as a framework for description of the effectiveness of telemedicine applications. The goal was for the assessments to be used as basis for decision-making in healthcare systems. Since then, MAST has been used in many European telemedicine studies and is now the most widely used model for assessment of telemedicine. The aim of this study was to assess the face validity of MAST.

Methods

A modified Delphi process was carried out and included a workshop with a sample of healthcare decision makers. A total of 56 decision makers and experts in telemedicine were invited and 19 persons participated in the two Delphi rounds. Thirteen hospitals or regional health authorities from 12 European countries and six research organisations were represented in the final sample. The participants were asked to assess the importance of the different domains and topics in MAST on a 0–3 Likert scale.

Results

All respondents completed the two rounds. Based on the answers, the face validity of all MAST domains was confirmed, since all domains were considered moderately or highly important by more than 80% of the respondents.

Discussion

Even though the study confirmed the validity of MAST, a number of supplements and improvements regarding study design and data collection were suggested. When considering the results it should be noticed that the sample size was small and larger studies are needed to confirm the results.
The comparison of telerehabilitation and face-to-face rehabilitation after total knee arthroplasty: A systematic review and meta-analysis
Authors: Jiang Shuihua , Xiang Jie , Gao Xiuming , Guo Kaijin , Liu Baohua
Published: January 2017

Introduction

The objective of this study was to assess the efficacy of telerehabilitation for patients after total knee arthroplasty (TKA) compared with face-to-face rehabilitation.

Methods

Medline, SCOPUS, Google Scholar, EMBASE, Springer, Science Direct, and Cochrane databases were searched electronically. Relevant journals and references of studies included were hand-searched for randomized controlled trials (RCTs) regarding the efficacy of telerehabilitation on functional recovery in patients after TKA. Two reviewers independently performed data extraction and quality assessment. Data were analysed using RevMan 5.3 software and Stata 12.0 software.

Results

Four RCTs involving 442 patients were included in the meta-analysis. Overall, compared with face-to-face rehabilitation, telerehabilitation could achieve comparable pain relief (mean difference = 0.52; 95% confidence interval (CI) = −0.20 to 1.24; p = 0.16) and better Western Ontario and McMaster Universities Osteoarthritis Index improvement (mean difference = 1.13; 95% CI = 0.23 to 2.02; p = 0.014). In addition, telerehabilitation treatment resulted in a significantly higher extension range ( p < 0.00001) and quadriceps strength ( p = 0.0002) than face-to-face rehabilitation.

Discussion

Telerehabilitation should be recommended for patients after TKA because of its comparable pain control and better improvement of functional recovery as compared to face-to-face rehabilitation.
Bridging Therapies and Liver Transplantation in Acute Liver Failure; 10 Years of MARS Experience from Finland
Authors: Kantola T. , Ilmakunnas M. , Koivusalo A.-M. , Isoniemi H.
Published: January 2017

Acute liver failure is a life-threatening condition in the absence of liver transplantation option. The aetiology of liver failure is the most important factor determining the probability of native liver recovery and prognosis of the patient. Extracorporeal liver assist devices like MARS (Molecular Adsorbent Recirculating System) may buy time for native liver recovery or serve as bridging therapy to liver transplantation, with reduced risk of cerebral complications. MARS treatment may alleviate hepatic encephalopathy even in patients with a completely necrotic liver. Taking this into account, better prognostic markers than hepatic encephalopathy should be used to assess the need for liver transplantation in acute liver failure.
Long-Term Results of Liver Transplantation
Authors: Åberg F. , Isoniemi H. , Höckerstedt K.
Published: January 2017

Liver transplantation (LT) is an established therapy associated with a dramatic improvement in patients' life expectancy. With improved early-term management, current 10-year patient survival rates in many indications exceed 70%. Life-long immunosuppressive therapy may, however, be accompanied by considerable long-term toxicity: most importantly, renal dysfunction, cardiovascular disease, and cancer, which, in addition to recurrence of the primary liver disease, emerge as key contributors to late mortality. Chronic kidney disease cumulatively affects up to 28% of patients by ten years after LT. Various factors can contribute to renal impairment, but perioperative acute kidney injury, calcineurin inhibitor toxicity, hypertension, and diabetes are considered most important. LT patients demonstrate 3-fold risk for cardiovascular events, which seems to result mostly from an excess of traditional risk factors, mainly hypertension and diabetes. The cumulative cancer incidence reaches 16–42% by 20 years after LT, and cancer rates are 2- to 4-fold higher among LT patients than among matched controls. Highest rates are for nonmelanoma skin cancer (3- to 70-fold) and lymphoma (8- to 29-fold). The liver graft usually displays uncomplicated function in the long term. Most common causes for chronic graft dysfunction include disease recurrence and biliary problems. LT generally restores patients' quality of life to a level comparable with that of the general population, with only minor deficits in some areas. Thus, long-term survival after LT is impressive, and despite these long-term complications, patients' quality of life remains comparable with that of the general population.
Treatment of Biliary Complications after Laparoscopic Cholecystectomy
Authors: Nordin A. , Grönroos J. M. , Mäkisalo H.
Published: January 2017

The incidence of iatrogenic bile duct injury remains high despite increased awareness of the problem. This major complication following laparoscopic cholecystectomy (LC) has a significant impact on patient's well-being and even survival despite seemingly adequate therapy. The management of bile duct injury (BDI) includes education to avoid the insult, proper and early diagnosis and preferably early treatment. It is of utmost importance to involve experienced hepatobiliary surgeon early enough to perform corrective reconstruction or to plan other therapies with a multidisciplinary team including interventional radiologist and advanced endoscopist. The selection of correct therapy at the earliest possible phase has significant effect on patient outcome. The treatment options are surgery and endoscopy, either immediately or delayed.

By constant and continuous analysis of the problem and information to the surgical community it should be possible to decrease the prevalence of iatrogenic BDI and even to avoid it.
Surgery of Biliary Atresia
Authors: Pakarinen M. P. , Rintala R. J.
Published: January 2017

Biliary atresia (BA) is a progressive fibro-obliterative cholangiopathy of unclear etiology affecting varying degrees of both extra- and intrahepatic biliary tree resulting in obstructive bile flow and cholestasis in neonates. The diagnostic work-up is designed to diagnose or rule out BA without any unnecessary delay. Kasai portoenterostomy is a palliative operation performed to establish bile drainage from microscopic bile ductules that remain in the porta hepatis. It is advantageous to perform portoenterostomy as early after birth as possible for better chances of success. Actuarial native liver 5-year survival rates range from 30% to 60% after portoenterostomy, and about 20% of all patients undergoing Kasai portoenterostomy during infancy survive into adulthood with their native liver. Portoenterostomy remains as the first line operative treatment in BA while liver transplantation serves as a salvage treatment when portoenterostomy fails or liver function gradually deteriorates after initially successful establishment of bile flow.
Contraction of Gluteal Maximus Muscle on Increase of Intra-Abdominal Pressure: Role in the Fecal Continence Mechanism
Authors: Shafik Ahmed , Olfat El Sibai  , Shafik Ali A. , Shafik Ismail A.
Published: January 2017

The gluteus maximus muscle (GMM) appears to contract with increased intra-abdominal pressure (IAP). The hypothesis that GMM contraction with increased IAP was investigated. The study comprised 32 healthy volunteers. IAP was measured by intravesical catheter. The response of electromyography of the GMM and external anal sphincter to sudden momentary and slow sustained straining was registered. The procedure was repeated after individual urinary bladder and GMM anesthetization. Sudden straining increased electromyographic activity of the external anal sphincter and GMM. Slow, sustained straining raised electromyographic activity of the gluteus maximus and external sphincter at differing degrees depending on straining intensity. The anesthetized gluteus maximus or urinary bladder did not respond to straining. The suggested GMM contraction on straining seems mediated through a reflex that is called “straining-gluteal reflex.” This reflex appears to assist anal closure through extended and laterally rotated femur induced by gluteus contraction.
Cerebral Perfusion Imaging in Hemodynamic Stroke: Be Aware of the Pattern
Authors: Siemund R. , Cronqvist M. , Andsberg G. , Ramgren B. , Knutsson L. , Holtås S.
Published: January 2017

Reduction of the cerebral perfusion pressure caused by vessel occlusion or stenosis is a cause of neurological symptoms and border-zone infarctions. The aim of this article is to describe perfusion patterns in hemodynamic stroke, to give a practical approach for the assessment of colour encoded CT- and MR-perfusion maps and to demonstrate the clinical use of comprehensive imaging in the workup of patients with hemodynamic stroke.

Five patients with different duration cause and degree of hemodynamic stroke were selected. The patients shared the typical presentation with fluctuating and transient symptoms. All were examined by MR or CT angiography and MR or CT perfusion in the symptomatic phase. All patients were examined with diffusion weighted imaging. All five cases showed the altered perfusion patterns of hemodynamic insufficiency with a slight or marked increase in CBV in the supply area of the affected vessel and only slightly reduced or maintained CBF. The perfusion disturbances were most easily detected on the MTT maps. Border-zone infarctions were seen in all cases.

The typical pattern for hemodynamic insufficiency is characterized by increased CBV, normal or decreased CBF and prolonged MTT in the affected areas. The increased CBV is the hallmark of stressed autoregulation. Reading the color-encoded perfusion maps enables a quick and robust assessment of the cerebral perfusion and its characteristic patterns. Internal border-zone infarctions can be regarded as a marker for hemodynamic insufficiency. Finding of the typical rosary-like pattern of DWI lesions should call for further work up.
Clinical Characteristics of Dural Arteriovenous Shunts in 446 Patients of Three Different Ethnicities
Authors: Geibprasert S. , Krings T. , Pereira V. , Pongpech S. , Piske R. , Lasjaunias P.
Published: January 2017

Dural arteriovenous shunts (DAVSs) developing in either the ventral, dorsal or lateral epidural spaces (VE, DE and LE-shunts) predictably drain in either cranio/spino-fugal or-petal directions. Associated conditions like venous outflow restrictions (VOR) may be responsible for changes in this drainage pattern. The goal of this study was to compare demographic, angiographic and clinical characteristics of different types of DAVS in Europe, South America, and Asia to find out whether the same clinical profile is present in different ethnicities.

Charts and angiographic films of 446 patients with DAVS from three hospitals in Europe, Asia and South America were retrospectively evaluated. Clinical symptoms were separated into benign and aggressive and the presence or absence of cortical venous reflux (CVR) and VOR was noted.

LE-shunts were present in elderly men and were always associated with CVR resulting in aggressive symptoms. VE-shunts were present in females and almost always had benign symptoms. There were no differences among the three populations for these shunts. DE-shunts in the Asian population were more aggressive secondary to a higher rate of VOR with associated CVR.

VE-shunts rarely lead to CVR even in the presence of VOR, whereas LE-shunts invariably lead to CVR, irrespective of the population investigated. CVR in DE-shunts is not related to the primary disease (i.e. the shunt itself) but to associated factors that led to VOR. Since the occurrence of these varied between different ethnicities, DE-shunts were aggressive in the Asian population and benign in the European and South American populations.
Elastase-Induced Aneurysm in Swine: Proof of Feasibility in a First Case
Authors: Goericke S.L. , Parohl N. , Albert J. , Dudda M. , Forsting M.
Published: January 2017

This is the first description of a modified endovascular elastase-induced aneurysm model in swine. The advantage of this model is the combination of an aneurysm of true vessel continuation with arterial wall and the possibility of using large femoral access devices. Imaging revealed a successful aneurysm creation at the origin of the right CCA. High personal and financial expense and partial thrombus formation might limit the routine use and this model might be reserved for exclusive issues.
Endovascular Transvenous Embolization Combined with Direct Punction of the Sinus Pericranii
Authors: Kessler I.M. , Esmanhoto B. , Riva R. , Mounayer C.
Published: January 2017

Sinus Pericranii is a rare venous anomaly in which the communication between the intraand extracranial venous system is constituted by a network of thin-walled veins that form a varix on the external table of the skull. This varix is continuous with the pericranial veins of the scalp. We describe a 31-year-old woman with frontal sinus pericranii treated using an original endovascular technique by transvenous approach combined with direct punction.
Does Oxidative Stress Play a Role in the Pathogenesis of Urticarias?
Authors: Cassano N. , De Meo M. , Scoppio B.M. , Loviglio M.C. , Del Vecchio S. , Vena G.A.
Published: January 2017

Radical oxygen species (ROS) modulate various cellular processes and are involved in physiologic and pathologic conditions, including inflammation. There is growing evidence that supports the existence of an abnormal redox status in some chronic inflammatory skin diseases, including contact dermatitis, atopic dermatitis and psoriasis. This review introduces some general aspects on the role of oxidative stress in cutaneous inflammation, with special emphasis on urticarias, summarizing recent novel findings derived from the study of physical urticarias and chronic idiopathic urticaria.
The Safety of Immunotherapy in Patients with Allergic Asthma and Allergic Rhinitis
Authors: Ilonidis G. , Anogianakis G. , Theofilogiannakos E. K. , Anogeianaki A. , Giannakoylas C. , Trakatelli M. , Economidis D.
Published: January 2017

We studied systemic reactions associated with immunotherapy in a group of 50 patients with mean age 31.4 years. The group consisted of 36 women and 14 men who followed a three-year immunotherapy treatment with pollen and mite allergen extracts (HAL-Holland Corporation). A total number of 2550 injections were administered. Eight patients developed systemic reactions; 6 had allergic rhinitis and 2 allergic asthma. None developed severe anaphylaxis. Seven of the systemic reactions occurred immediately after injection while one was a late reaction manifested as generalized urticaria, local edema and rubor at the site of the injection. From the 7 patients who showed an immediate reaction, 5 developed generalized urticaria with local edema and rubor at the site of the injection, while 2 presented with bronchial spasm. We did not observe any reaction when the quantity of the extract injection was reduced by 50%. Our study points out that, in the vast majority of cases, immunotherapy is free of severe systemic reactions. Those that occur are associated with the injection of high-density extracts and none of them is severe.
Skin Prick Tests in Patients with Chronic Urticaria
Authors: Ilonidis G. , Anogianakis G. , Theofilogiannakos E. K. , Trakatelli M. , Anogeianaki A. , Trakatelli M. , Economidis D.
Published: January 2017

Acute or chronic urticaria is not a common manifestation of systemic disease. However it affects 15% of the population at least once during their lives. The most common causes of urticaria are allergic. In all, we studied 130 patients (mean age 54.8) with chronic urticaria, 88 women and 42 men, in an effort to identify common causes of urticaria, using environmental and food allergens. 90 of our patients (69.2%) did not present with skin sensitivity. The remaining 40 individuals presented with skin sensitivity: 20 (15.3%) to food allergens, 14 (10.7%) to environmental allergens and 6 patients (4.6%) to both allergens (environmental and food). We note that in chronic urticaria it is unusual to find underlying causes.
A safe transoral surgical approach to parapharyngeal tumor arising from deep lobe of parotid gland
Authors: Casale Manuele , Capuano Francesco , Sabatino Lorenzo , Pace Annalisa , Oliveto Giuseppe , Vella Paola , Moffa Antonio , Salvinelli Fabrizio
Published: January 2017

The management of parapharyngeal tumor is surgical, but the approach remains a challenge. Attention should be paid to avoidance intra-operative bleeding or cranial nerves damage. We report a case of a 67-year-old male complaining of left-ear fullness. A submucosal mass arising from the lateral wall of oropharynx on the left side was observed. Magnetic resonance imaging detected a mass arising from the parotid gland, in particular from the deep lobe, and a fine needle biopsy was compatible with “Warthin tumor.” We performed a mini-invasive transoral approach under magnification, previous isolation of homolateral vessels. The decision on which surgical approach to be used is determined by site, size vascularity, and histology of the tumor. A literature review of the main surgical approaches was performed. We performed a combined transoral dissection under magnification with cervicotomic exposure of the neck vascular bundle allowing to dissect the tumor and manage any intra-operative complications.
Can trichomoniasis cause pharyngitis? A case report
Authors: Carter-Wicker Kitty , Utuama Onameyore , Omole Folashade
Published: January 2017

Objectives:

We report on a heterosexual male with sore throat diagnosed as oral Trichomoniasis vaginalis.

Methods:

A rapid strep test and throat culture were negative. An oropharyngeal swab tested positive for Trichomonas vaginalis using a nucleic acid amplification test (NAAT).

Results and Conclusion:

A detailed sexual history and oropharyngeal swab testing enabled the diagnosis of oral Trichomoniasis vaginalis in a male patient reporting oral sex with a recently infected female. The patient was successfully treated with metronidazole 2 g orally.
Leukemia cutis in a patient with chronic lymphocytic leukemia presenting as bilateral helical nodules
Authors: Raufi Ali , Alsharedi Mohamed , Khelfa Yousef , Griswold Doreen C , Lebowicz Yehuda
Published: January 2017

Chronic lymphocytic leukemia, the most common adult leukemia worldwide, is considered an indolent but incurable non-Hodgkin lymphoma. Leukemia cutis is an uncommon manifestation of chronic lymphocytic leukemia. We present a case of an adult patient who presented with skin lesion of bilateral ears, which led to the diagnosis of chronic lymphocytic leukemia. We also reviewed the cases of auricular involvement in chronic lymphocytic leukemia patients reported in the literature. Local treatment is indicated in case of leukemia cutis; however, systemic treatment is recommended when there are systemic signs and symptoms. Better awareness of disease evolution and prompt diagnosis of this leukemia cutis of chronic lymphocytic leukemia will improve the effectiveness and outcome of its management.
Epidermoid cyst of the uvula in a child
Authors: Daram Shiva , Ulualp Seckin O , Uddin Naseem
Published: January 2017

Objective:

Epidermoid cysts are rarely located in the uvula. To date, epidermoid cyst of the uvula has not been reported in a child at preschool age. We present clinical and histopathological characteristics of an epidermoid cyst in a child with uvula mass.

Methods:

Retrospective chart review.

Results:

A 5-year-old boy was seen in the pediatric otolaryngology clinic for assessment of a uvula mass. The mass was detected during a tonsillectomy and adenoidectomy performed for sleep-related breathing disorder. The mass was completely removed and the final diagnosis was epidermoid cyst.

Conclusion:

Pediatricians, otolaryngologists, and pathologists should be cognizant of the occurrence of uvular epidermoid cyst in preschool children.
Surgical treatment of a huge kaposiform hemangioendothelioma in the chest wall: A case study
Authors: Guo Xiaonan , Gong Yubin , Dong Changxian
Published: January 2017

Kaposiform hemangioendothelioma, a rare vascular pediatric tumor often associated with Kasabach–Merritt phenomenon, is characterized by severe thrombocytopenia and consumptive coagulopathy. Kaposiform hemangioendothelioma is a severe disease and may progress quickly, resulting in a high mortality. However, standard treatment regimens for Kasabach–Merritt phenomenon have not yet been established. We reported here an infant with a large congenital kaposiform hemangioendothelioma in his chest wall who responded extremely well to surgical excision.
Use of sildenafil citrate in a cat with Eisenmenger’s syndrome and an atrial septal defect
Authors: Chow Ke Shuan , Beijerink Niek J , Ettinger Stephen , Fliegner Reuben , Beatty Julia A , Barrs Vanessa R
Published: January 2017

A 2-year-old male neutered Siamese cat presenting with weakness and dyspnoea was diagnosed with an atrial septal defect and pulmonary hypertension, which resulted in right-to-left shunting (Eisenmenger’s syndrome). The cat was treated with sildenafil (0.25–0.6 mg/kg) for 10 months. There were no apparent treatment-related adverse effects. Improvement in clinical signs was noted, although increasing doses of sildenafil were required. After 10 months the cat significantly deteriorated and was euthanased.
Non-involuting congenital haemangioma of the eyelid: successful treatment with fluroscopic ultrasound guided sclerotherapy and surgical excision
Authors: Christou E , Parsi K
Published: January 2017

We present a case of non-involuting congenital haemangioma (NICH) of the right eyelid which was present at birth as a purpuric macule but increased in size to cause significant obstruction of vision. At four years of age the lesion was treated with fluroscopic ultrasound-guided sclerotherapy using 0.5% sodium tetradecyl suphate foam and surgically debulked 16 days later. Histopathology was negative for glucose transporter-1 stain confirming the diagnosis. The residual segments were subsequently treated in three further sessions of sclerotherapy in the ensuing three years. This treatment approach resulted in a good cosmetic and functional outcome with no associated complications. To our knowledge, this is the first published case of a histologically confirmed NICH treated primarily with sclerotherapy.
Considerations before making a lasting power of attorney
Authors: Knowles Michael
Published: January 2017

The lasting power of attorney (LPA) can be a powerful tool for people living in care; it is also one that should be considered carefully before being signed. In this article, Michael Knowles highlights five important points to consider before making an LPA
How to … combat loneliness in the care home
Authors: Ashurst Adrian
Published: January 2017

Loneliness is a big problem for older people living in long-term care facilities, particularly during the winter months. In this article, Adrian Ashurst explores how staff can provide valuable assistance for individuals who are beginning to feel isolated or alone
Management of venous leg ulcers in the care home
Authors: Todd Marie
Published: January 2017

The prevalence of venous leg ulceration is increasing, particularly among the older population who often present with complex multiple comorbid conditions. In this article, Marie Todd gives an overview of current guidelines and the evidence that supports them
Quality monitoring and use of statistical data in the care home
Authors: Croft Joanne
Published: January 2017

Measuring the quality of multiple homes can be incredibly difficult. In this article, Joanne Croft describes the use of a quality monitoring system, that incorporates both qualitative and quantitative data to provide an accurate overview of each home's performance
Beati mortui qui in Domino moriuntur. Atitudes perante a morte e locais de sepultura dos irmãos franciscanos seculares da cidade de Coimbra (1707-1785)
Authors: Silva Ana Margarida Dias da
Published: January 2017

A Venerável Ordem Terceira da Penitência de S. Francisco de Coimbra garantia aos seus membros benefícios espirituais e materiais, incluindo o acompanhamento dos irmãos à sepultura e os sufrágios por alma dos irmãos falecidos. Os estatutos e memórias da fraternidade permitem compreender a atitude dos terceiros franciscanos seculares perante a morte e quais as obrigações e direitos dos membros da Ordem Terceira de Coimbra. Nos 1653 registos de óbitos da Ordem Terceira  conimbricense, entre 1707 e 1785, colhe-se informação sobre o local de sepultura dos irmãos franciscanos seculares de Coimbra, objetivo do presente trabalho. As igrejas colegiadas de Santiago e de S. Bartolomeu, as igrejas de Santa Justa, de S. Pedro e de S. João de Almedina, o  mosteiro de Santa Cruz, e os conventos de S.  Domingos e de S. Francisco da Ponte congregam o maior número de  enterramentos dos irmãos franciscanos seculares no século XVIII.https://doi.org/10.14195/1645-2259_16_10