bluuebunny/crossref_metadata_2025 huggingface dataset:
Cholangiocarcinoma with concurrent ovarian adenocarcinoma in a green iguana (Iguana iguana)
Authors: Lindemann Dana M , Eshar David , Lin Denise , Narayanan Sanjeev K
Published: March 2017

Green iguanas with gastrointestinal, hepatic, and reproductive disease may present to the veterinary clinic displaying non-specific clinical signs, necessitating a thorough clinical evaluation. A 15-year-old intact female green iguana (Iguana iguana) presented with a 3-week history of decreased appetite and coelomic distension. A complete blood count and plasma biochemistry analysis showed anaemia and leukopenia with an absolute lymphopenia; decreased sodium and chloride concentrations; and increased phosphorus, potassium, aspartate transaminase, and uric acid concentrations. Whole body radiographs revealed a large, round, homogenous soft tissue opacity structure in the coelom. Ultrasonography confirmed a thin-walled cystic structure located in the cranial coelomic cavity. An exploratory coeliotomy revealed a large hepatic cyst, diffusely abnormal hepatic parenchyma, and cysts on the right ovary. The right ovary and hepatic cyst were surgically excised, however the iguana died under general anesthesia. Histopathology provided a diagnosis of multifocal cholangiocarcinoma and ovarian papillary adenocarcinoma. This case report alerts the clinician to the clinical presentation, anaesthetic protocol, surgical intervention, and challenges associated with the diagnosis of a large cystic cholangiocarcinoma in a pet green iguana.
Staged lengthening and reconstruction for children with a leg-length discrepancy after excision of an osteosarcoma around the knee
Authors: Kang S. , Lee J. S. , Park J. , Park S-S.
Published: March 2017

Aims

Children treated for osteosarcoma around the knee often have a substantial leg-length discrepancy at skeletal maturity. The aim of this study was to investigate the results of staged skeletal reconstruction after a leg lengthening procedure using an external fixator in these patients.

Patients and Methods

We reviewed 11 patients who underwent staged reconstruction with either an arthroplasty (n = 6) or an arthrodesis (n = 5). A control group of 11 patients who had undergone wide excision and concurrent reconstruction with an arthroplasty were matched for gender, location, and size of tumour. We investigated the change in leg-length discrepancy, function as assessed by the Musculoskeletal Tumor Society Scale (MSTS) score and complications.

Results

A mean 5.2 cm (1.7 to 8.9) of lengthening was achieved. The mean MSTS scores significantly improved after staged reconstruction (p = 0.003) but were still worse than those of the control group (p = 0.049). However, the MSTS scores of the arthroplasty subgroup were comparable with those of the controls, although the extensor lag was greater and the range of movement was less. The patient group experienced more complications, but all of these resolved.

Conclusion

Approximately 5 cm of lengthening and significant functional improvement can be achieved by staged reconstruction and lengthening, without major complications. Although it has limitations, this method of treatment seems to be a satisfactory surgical option for growing children with a significant leg-length discrepancy after excision of an osteosarcoma around the knee. Cite this article: Bone Joint J 2017;99-B:401–8.
Proximal femoral replacement in contemporary revision total hip arthroplasty for severe femoral bone loss
Authors: Viste A. , Perry K. I. , Taunton M. J. , Hanssen A. D. , Abdel M. P.
Published: March 2017

Aims

Loss or absence of proximal femoral bone in revision total hip arthroplasty (THA) remains a significant challenge. While the main indication for the use of proximal femoral replacements (PFRs) is in the treatment of malignant disease, they have a valuable role in revision THA for loosening, fracture and infection in patients with bone loss. Our aim was to determine the clinical outcomes, implant survivorship, and complications of PFRs used in revision THA for indications other than malignancy.

Patients and Methods

A retrospective review of 44 patients who underwent revision THA using a PFR between 2000 and 2013 was undertaken. Their mean age was 79 years (53 to 97); 31 (70%) were women. The bone loss was classified as Paprosky IIIB or IV in all patients. The mean follow-up was six years (2 to 12), at which time 22 patients had died and five were lost to follow-up.

Results

The mean Harris Hip Score improved from 42.8 (25.9 to 82.9) pre-operatively to 68.5 (21.0 to 87.7) post-operatively (p = 0.0009). A total of two PFRs had been revised, one for periprosthetic infection eight years post-operatively and one for aseptic loosening six years post-operatively. The Kaplan-Meier survivorship free of any revision or removal of an implant was 86% at five years and 66% years at ten years. A total of 12 patients (27%) had a complication including six with a dislocation.

Conclusion

PFRs provide a useful salvage option for patients, particularly the elderly with massive proximal femoral bone loss who require revision THA, with significant clinical improvement. While the survivorship of the implant is good at five years, dislocation continues to be the most common complication. The judicious use of larger femoral heads, dual-mobility constructs, or constrained liners may help to minimise the risk of dislocation. Cite this article: Bone Joint J 2017;99-B:325–9.
Assessment of the equivalence of a generic to a branded femoral stem
Authors: Hothi H. , Henckel J. , Shearing P. , Holme T. , Cerquiglini A. , Laura A. Di , Atrey A. , Skinner J. , Hart A.
Published: March 2017

Aims

The aim of this study was to compare the design of the generic OptiStem XTR femoral stem with the established Exeter femoral stem.

Materials and Methods

We obtained five boxed, as manufactured, implants of both designs at random (ten in total). Two examiners were blinded to the implant design and independently measured the mass, volume, trunnion surface topography, trunnion roughness, trunnion cone angle, Caput-Collum-Diaphyseal (CCD) angle, femoral offset, stem length, neck length, and the width and roughness of the polished stem shaft using peer-reviewed methods. We then compared the stems using these parameters.

Results

We found that the OptiStems were lighter (p < 0.001), had a rougher trunnion surface (p <  0.001) with a greater spacing and depth of the machined threads (p < 0.001), had greater trunnion cone angles (p = 0.007), and a smaller radius at the top of the trunnion (p = 0.007). There was no difference in stem volume (p = 0.643), CCD angle (p = 0.788), offset (p = 0.993), neck length (p = 0.344), stem length (p = 0.808), shaft width (p = 0.058 to 0.720) or roughness of the polished surface (p = 0.536).

Conclusion

This preliminary investigation found that whilst there were similarities between the two designs, the generic OptiStem is different to the branded Exeter design. Cite this article: Bone Joint J 2017;99-B:310–16.
Aspiring to excellence in surgical training
Authors: Khan MEA , Jordan AD , Vig S
Published: March 2017

What do junior doctors think about surgical training?
Group-texting between junior doctors in surgery
Authors: Donati-Bourne J , Cooke PW
Published: March 2017

Just how much of a threat to communication skills development and information governance is it?
Digital pathology
Authors: Bracey Tim
Published: March 2017

Can scanning and storing the contents of microscope slides simplify the logistical challenges faced by pathologists today?
Les disparus civils européens de la guerre d’Algérie. Processus de construction d’une cause victimaire militante
Authors: Comtat Emmanuelle
Published: March 2017

Este artículo examina cómo colectivos pro-Argelia francesa han colaborado en el reconocimiento de los desaparecidos civiles europeos de la guerra de Argelia. Se analiza el proceso de construcción de esta causa desde 1962, las estrategias de los militantes y también las conexiones políticas de los activistas para inscribir el problema de las desapariciones forzadas en la agenda política del gobierno de Francia. Asimismo, se observa cómo el reconocimiento de la figura de la víctima y su reapropiación por los grupos memorialistas buscan en primer término la rehabilitación de la Argelia francesa y se inscriben en los conflictos sobre las memorias postcoloniales más que en un proceso de reconciliación. Este artículo se inscribe en los estudios sobre las movilizaciones colectivas y en los trabajos sobre los repertorios de acción utilizados por los activistas. El trabajo se apoya en el análisis de entrevistas semi-estructuradas con líderes de las asociaciones de retornados de Argelia y con familiares de las víctimas.
Aplicação de um algoritmo genético ao problema de rodízio de tripulações do sistema de transporte público urbano
Authors: Martins Leandro Do Carmo , Silva Gustavo Peixoto
Published: March 2017

Este trabalho aborda a resolução do Problema de Rodízio de Tripulações (PRT) de empresas do sistema de trans-porte público. O PRT consiste em atribuir uma sequência de jornadas de trabalho aos tripulantes de uma empresa para um dado horizonte de planejamento, com o intuito de minimizar seus custos totais. O custo fixo é dado pelo número de tripulações necessárias para realizar todas as jornadas e os custos variáveis correspondem ao total de horas extras ou ociosas, acumuladas por cada tripulação no período. Na resolução deste problema, são consideradas tanto as restrições operacionais quanto as restrições trabalhistas de uma dada empresa. Neste trabalho, o PRT foi resolvido em duas etapas: a primeira consiste em atribuir os dias de folga, minimizando o número de tripulações. A segunda etapa consiste em alocar as jornadas a serem realizadas, minimizando as horas extras e ociosas no período. As duas etapas foram resolvidas utilizando um Algoritmo Genético ainda não aplicado em casos brasileiros. O algoritmo foi desenvolvido para resolver um caso real e seus resultados foram comparados com a solução exata de um modelo de Programação Linear Inteira, mostrando ser competitivo.
Deutsche Kolonialgeschichte(n)
Authors: Bürger Christiane
Published: March 2017

Die Geschichte des kolonialen Namibias - und damit der Genozid an den Herero und Nama in den Jahren 1904 bis 1908 - avancierte in den letzten Jahren zum Politikum. Der Anerkennung des Genozids durch die Bundesregierung im Jahr 2016 gingen jahrzehntelange historiografische Kontroversen voraus, die jedoch bislang kaum Beachtung fanden. Christiane Bürger zeigt, wie der nach dem Zweiten Weltkrieg als weitestgehend verdrängt geltende koloniale Genozid in der DDR und BRD vor dem Hintergrund kolonialapologetischer Erzählungen der ersten Jahrhunderthälfte verhandelt wurde - und beleuchtet damit die Historiografie- und Wissensgeschichte der aktuellen Debatten.
Choreografische Praxis
Authors: Barthel Gitta
Published: March 2017

Vermittlung, Tanzkunst und Kulturelle Bildung stehen in engem Zusammenhang. Gitta Barthel stellt künstlerisch-kulturelle Projekte vor, in denen Choreograf_innen mit heterogenen Gruppen arbeiten. Sie erschließt Vermittlung als immanenten Bestandteil von Choreografie und liefert eine faszinierende Zusammenstellung von Vermittlungspraktiken und Aufmerksamkeitslenkungen. Theoretische Ausgangspunkte bilden die tanzwissenschaftliche Reflexion zu Praktiken des erweiterten Choreografiebegriffes und die Betrachtung des Bedingungsgefüges gegenwärtiger Tanzvermittlung aus der Perspektive des Kreativitätsdispositivs. Die in der praxeologischen Tanzwissenschaft verortete Studie trägt Erkenntnisse zur Tanzpädagogik ebenso wie zur Kulturellen Bildung bei.
Effect of the legal system country of European commercial banks on the financial distress
Authors: Baklouti Nizar , Gautier FrÃ©dÃ©ric , Aubert FranÃ§ois
Published: March 2017

This study examines the effect of the legal system on the governance of banks and hence on financial distress. We compare corporate governance to the legal system in 18 countries of the European Union to explain the relationship between financial distress and bank governance. Using a sample of 147 commercial banks, we find that the effect of the legal system really counts. The results also suggest that banks operating in common law and civil law countries tend the concentration of ownership and board size to the effect of increasing the likelihood of financial distress. This study contributes to research in the governance of enterprise to provide empirical evidence that the legal system has the power to influence the financial health of banks.
Steelworkers in Struggle
Authors: Smith Julia
Published: March 2017

Ahmed White's vivid and deeply researched account of the Little Steel strike of 1937 makes an important contribution to our understanding of U.S. labor history, union organizing, and class conflict. It illustrates the tactical complexity of strikes, reveals the power and ruthlessness of employers, and demonstrates the risks of relying on the state to secure justice for working people.Click here to purchase a PDF version of this article at the Monthly Review website.
Ghana’s foreign policy: Some regional and national interests
Authors: Sanusi Hajj , Adu-Gyamfi Samuel
Published: March 2017

Dr. Kwame Nkrumah`s Non-Aligned policy has been a key variable in Ghana`s foreign policy, and successive regimes after Nhrumah have pursued this policy in various ways. Since its political reforms in 1992, Ghana has established itself as an anchor in political dispensation on the African continent. In the sub-region, Ghana is seen by other countries as a leader by exhibiting its competences and maturity in political change and good governance, and its peacekeeping involvement in the subfield. Whiles Ghana takes credit for these attributes; her response to regional issues has not always been as readily forthcoming as in others. This paper seeks to analyze Ghana`s foreign policy directions in the sub-Saharan region, and ECOWAS. How consistence or inconsistence has Ghana been, in the implementation of foreign policy objectives within the ECOWAS, between the periods of 1992-2016. The paper leads the hypothesis that, lack of a well-defined and articulated defence policy document has somewhat resulted in inconsistencies in responding to crises in the region.
A Rather Crude Feminism
Authors: Middleton Jason
Published: March 2017

Postfeminist ideology “takes feminism into account” by framing liberal feminist principles as already achieved, thus preempting a more radical feminist politics that it constructs as both unpleasant and irrelevant. In a corresponding mode, postfeminist cultural objects derive their power in part by preempting feminist critique with irony. It is precisely this ideological double bind that the comedian Amy Schumer confronts. This essay analyzes how Schumer develops a feminist critique of the knotty problems of postfeminist ideology. Postfeminism casts feminism as abject, as the “repulsive and disgusting” monster that perpetually endangers the “empowered” postfeminist woman of today. But Schumer inverts this construction: in her show's sketches, postfeminism as an ideological formation materializes in an array of comic abjections to which Schumer's persona is subject. In short, the condition of postfeminism is one of abjection. The comic hyperbole of Schumer's character's abjections, combined with her uncritical complicity, invokes for the viewer feminist solutions.
“Fat Woman in a Car”
Authors: Sinha Suvadip
Published: March 2017

“Fat lady in the theatre,” “Fat woman in car,” and “Mother of 9 children” are some of the roles attributed to Uma Devi Khatri, aka Tun Tun, in her Wikipedia filmography. Tun Tun, regularly typecast and often appearing for a few seconds without any narrative consequence, was a household name, yet her star persona has yet to garner much attention. This essay takes up this lack of attention, scholarly and archival, to speculate on a connection between Tun Tun's corporeal excess and the narrative inconsequentiality she was expected to occupy. Looking beyond her image as a superfluous comedienne, this essay investigates the narrative of Tun Tun as an ambiguous one that can be interpreted, in spite of its subversive potential, as reinforcing normative codes of ideal womanhood.
Associations between serum levels of calcium, parathyroid hormone and future risk of venous thromboembolism: the Tromsø study
Authors: Lerstad Gunhild , Brodin Ellen E , Svartberg Johan , Jorde Rolf , Brox Jan , Brækkan Sigrid K , Hansen John-Bjarne
Published: March 2017

Objective

The relationship between serum levels of calcium, parathyroid hormone (PTH) and risk of venous thromboembolism (VTE) has not been addressed in population-based cohorts. We investigated the associations between serum levels of calcium and PTH, with future risk of VTE in a general adult population.

Design

Population-based cohort.

Methods

A total of 27 712 subjects (25–87 years) who participated in Tromsø 4 (1994–1995) and Tromsø 5 (2001–2002) surveys were included in the study, and total calcium and PTH were measured in 27 685 and 8547 subjects respectively. Incident VTE was recorded through December 31, 2012. Cox-regression models with calcium and PTH as time-varying exposures were used to calculate hazard ratios (HR) of VTE by quartiles of calcium and PTH. Quartiles of calcium and PTH were also combined to assess the effect of discordants of both PTH and calcium (e.g. highest and lowest quartiles of both calcium and PTH) on VTE risk using the middle two quartiles as reference.

Results

There were 712 VTEs during 15.0 years of median follow-up. Serum levels of calcium and PTH were not associated with risk of VTE. However, subjects with discordant high serum levels of both calcium and PTH (calcium ≥2.45 mmol/L and PTH ≥4.0 pmol/L) had increased risk of VTE compared to those in subjects with normal calcium and PTH (multivariable HR: 1.78, 95% CI: 1.12–2.84).

Conclusions

Serum levels of calcium and PTH separately were not associated with future risk of VTE, but subjects with high levels of both calcium and PTH had increased risk of VTE compared to those in subjects with normal levels.
Changes in the management and comorbidities of acromegaly over three decades: the French Acromegaly Registry
Authors: Maione Luigi , Brue Thierry , Beckers Albert , Delemer Brigitte , Petrossians Patrick , Borson-Chazot Françoise , Chabre Olivier , François Patrick , Bertherat Jérôme , Cortet-Rudelli Christine , Chanson Philippe , _ _
Published: March 2017

Context

Acromegaly is a rare disease associated with chronic multisystem complications. National registries have been created in several countries.

Design

The French Registry contains data on acromegaly epidemiology, management and comorbidities recorded over more than three decades, retrospectively until 1999 and prospectively from 1999 to 2012.

Results

Data could be analyzed for 999 of the 1034 patients included in the registry (46% males). Disease control, defined as IGF-I normalization (adjusted for age and sex), was achieved in 75% of patients at the last follow-up visit. Half the patients with uncontrolled disease had IGF-I levels below 1.5 times the upper limit of normal (ULN). The proportion of patients with surgically cured disease did not change markedly over time, whereas the proportion of patients with uncontrolled disease fell and the proportion of patients with medically controlled disease rose. Cardiovascular, metabolic, respiratory and rheumatologic comorbidities and their outcomes were recorded for most patients, and no noteworthy overall deterioration was noted over time. Cancer occurred in 10% of patients, for a standardized incidence ratio of 1.34 (95% CI: 0.94–1.87) in men and 1.24 (0.77–1.73) in women. Forty-one patients died during follow-up, for a standardized mortality ratio of 1.05 (0.70–1.42). Most deaths were due to cancer.

Conclusions

The majority of patients with acromegaly now have successful disease control thanks to the multistep management. The incidence of comorbidities following diagnosis of acromegaly is very low. Life expectancy is now close to that of the general population, probably owing to better management of the GH/IGF-I excess and comorbidities.
Ovarian fragment sizes affect viability and morphology of preantral follicles during storage at 4°C
Authors: Gastal G D A , Alves B G , Alves K A , Souza M E M , Vieira A D , Varela A S , Figueiredo J R , Feugang J M , Lucia T , Gastal E L
Published: March 2017

The method of transportation and the conditions imposed on the ovarian tissue are pivotal aspects for the success of ovarian tissue cryopreservation (OTC). The aim of this study was to evaluate the effect of the size of the ovarian tissue (e.g. whole ovary, biopsy size and transplant size) during different times of storage (0, 6, 12 and 24 h) on the structural integrity of equine ovarian tissue transported at 4°C. Eighteen pairs of ovaries from young mares (<10 years old) were harvested in a slaughterhouse and processed to simulate the fragment sizes (biopsy and transplant size groups) or kept intact (whole ovary group) and stored at 4°C for up to 24 h in α-MEM-enriched solution. The effect of the size of the ovarian tissue was observed on the morphology of preantral follicles, stromal cell density, DNA fragmentation and mitochondrial membrane potential. The results showed that (i) biopsy size fragments had more morphologically normal preantral follicles after 24 h of storage at 4°C; (ii) mitochondrial membrane potential was the lowest during each storage time when the whole ovary was used; (iii) DNA fragmentation rate in the ovarian cells of all sizes of fragments increased as storage was prolonged and (iv) transplant size fragments had increased stromal cell density during storage at cool temperature. In conclusion, the biopsy size fragment was the best to preserve follicle morphology for long storage (24 h); however, transportation/storage should be prior determined according to the distance (time of transportation) between patient and reproduction centers/clinics.
Primary Infected Left Ventricular Pseudoaneurysm and the Use of Omental Flap
Authors: Aru Giorgio Maria , Kim Tad , Aru Roberto Giorgio , Vinson Mary Carolyn
Published: March 2017

A 55-year-old man with autoimmune deficiency syndrome presented with an infected left ventricular pseudoaneurysm and sepsis. The aneurysmectomy consisted of a Dor-style pericardial patch plus debridement of the abscess cavities. The infected pseudoaneurysm recurred, much larger, within five months due to persistent infected abscess cavities. The second repair was done without a Dor-style patch and with an omental flap. No recurrence has occurred one year after the second repair, but the patient has asymptomatic, partial gastric herniation inside the pericardium. This is the first description of a primary infected left ventricular pseudoaneurysm. The omental flap contributed to the successful treatment.
Early Clinical Outcome of Mitral Valve Replacement Using a Newly Designed Stentless Mitral Valve for Failure of Initial Mitral Valve Repair
Authors: Nishida Hidefumi , Kasegawa Hitoshi , Kin Hajime , Takanashi Shuichiro
Published: March 2017

Here we report the early outcome of mitral valve replacement using a newly designed stentless mitral valve for failure of initial mitral valve repair. Mitral valve plasty (MVP) for mitral regurgitation is currently a standard technique performed worldwide. However, whether mitral valve repair should be performed for patients with advanced leaflet damage or complicated pathology remains controversial. Mitral valve replacement might be feasible for patients who have undergone failed initial MVP; however, it is not an optimal treatment because of poor valve durability and the need for anticoagulative therapy. We report two cases of successful mitral valve replacement using a newly designed stentless mitral valve made of fresh autologous pericardium, which may have a potential benefit over mitral valve repair or mitral valve replacement with a mechanical or bioprosthetic valve.
Utility of Omentoplasty in Mediastinitis Treatment following Sternotomy
Authors: Colak Abdurrahim , Kaya Ugur , Ceviz Münacettin , Becit Necip , Sevil Fehimcan , Kocak Hikmet
Published: March 2017

Background: Mediastinal infection is one of the most serious complications that occurs following open-heart surgery by sternotomy. In the present study, omentoplasty was initially and aggressively used to treat the infection and prevent the recurrence caused by bones in cases of mediastinitis following open-heart surgery at our clinic.Methods: Among the 3656 patients who underwent surgery at our department of cardiovascular surgery between January 1996 and December 2012, omentoplasty as a treatment for mediastinitis was applied to 19 (0.51%) patients (of which 13 were males) following sternotomy. The cases were revised on the 15th day following the first surgery and/or when there was a suspicion of mediastinal infection. The necrotic skin, subcutaneous tissue, and bone tissue were resected, and all the affected sternal tissues were removed until healthy hemorrhagic areas were reached. Results: The average age of the patients was between 49 and 81 years (mean: 65.7 ± 10.5 years). The mean age of the men was 66.08 ± 12.7 years (age range: 49-81 years) and that of the women was 63.2 ± 6.8 years (age range: 55-71 years). The male to female ratio was 2:1, and in both the male and female groups, the approximate age ranged from 55 and 70 years. In the intraoperative cultures received from wound cases, the most common agent of infection was methicillin-resistant coagulase-negative staphylococci. Purulent leaks from eight patients stopped in approximately 4 days. Purulent leaks from the other 11 patients continued until the 6th day, and thus, medical dressing also continued, after which the leaks stopped on the 15th day. The approximate postoperative hospital stay was 32 days (range: 13-63 days). Conclusion: Omentoplasty in heart surgery can be considered an effective method when used to control infection and treat secondary poststernotomy mediastinitis.
Prediction of Prolonged Ventilation after Coronary Artery Bypass Grafting: Data from an Artificial Neural Network
Authors: Wise Eric Stephen , Stonko David P. , Glaser Zachary A. , Garcia Kelly L. , Huang Jennifer J. , Kim Justine S. , Kallos Justiss A. , Starnes Joseph R. , Fleming Jacob W. , Hocking Kyle M. , Brophy Colleen M. , Eagle Susan S.
Published: March 2017

Objectives: The need for mechanical ventilation 24 hours after coronary artery bypass grafting (CABG) is considered a morbidity by the Society of Thoracic Surgeons. The purpose of this investigation was twofold: to identify simple preoperative patient factors independently associated with prolonged ventilation and to optimize prediction and early identification of patients prone to prolonged ventilation using an artificial neural network (ANN).Methods: Using the institutional Adult Cardiac Database, 738 patients who underwent CABG since 2005 were reviewed for preoperative factors independently associated with prolonged postoperative ventilation. Prediction of prolonged ventilation from the identified variables was modeled using both “traditional” multiple logistic regression and an ANN. The two models were compared using Pearson r2 and area under the curve (AUC) parameters.Results: Of 738 included patients, 14% (104/738) required mechanical ventilation ≥ 24 hours postoperatively. Upon multivariate analysis, higher body-mass index (BMI; odds ratio [OR] 1.10 per unit, P < 0.001), lower ejection fraction (OR 0.97 per %, P = 0.01) and use of cardiopulmonary bypass (OR 2.59, P = 0.02) were independently predictive of prolonged ventilation. The Pearson r2 and AUC of the multivariate nominal logistic regression model were 0.086 and 0.698 ± 0.05, respectively; analogous statistics of the ANN model were 0.159 and 0.732 ± 0.05, respectively.BMI, ejection fraction and cardiopulmonary bypass represent three simple factors that may predict prolonged ventilation after CABG. Early identification of these patients can be optimized using an ANN, an emerging paradigm for clinical outcomes modeling that may consider complex relationships among these variables.
Thrombosis of the Right Internal Jugular Vein is Not a Contraindication to Ambulatory Veno-Venous Extracorporeal Membrane Oxygenation with a Bicaval Dual-Lumen, Single Cannula System
Authors: Kronfli Anthony , Pasrija Chetan , Shah Aakash , Ghoreishi Mehrdad , Garcia Jose P , Pham Si M , Sanchez Pablo G , Kon Zachary N
Published: March 2017

Background: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is an ever-emerging method of managing respiratory failure in patients who are refractory to conventional mechanical ventilatory support. An increasingly common method of cannulation involves placement of a bicaval dual-lumen, single cannula via the right internal jugular (IJ) vein. Thrombus in this vein has been considered a contraindication for cannula placement. Case report: A 45-year-old Hispanic male presented with bleomycin-induced respiratory failure resulting in acute respiratory distress syndrome (ARDS). Ambulatory VV-ECMO support was initiated, and during surgical cannula placement an occlusive thrombus was noted in the right IJ vein. A tract was dilated and the cannula was placed without any thromboembolic complications.Conclusion: This case demonstrates that cannulation for ambulatory VV-ECMO in the setting of an occlusive IJ thrombus can be safe and feasible.
Novel Goal-Directed Hemodynamic Optimization Therapy Based on Major Vasopressor during Corrective Cardiac Surgery in Patients with Severe Pulmonary Arterial Hypertension: A Pilot Study
Authors: Li Shuwen , Ma Qing , Yang Yanwei , Lu Jiakai , Zhang Zhiquan , Jin Mu , Cheng Weiping
Published: March 2017

Introduction: Pulmonary arterial hypertension (PAH) is a common and fatal complication of congenital heart disease (CHD). PAH-CHD increases the risk for postoperative complications. Recent evidence suggests that perioperative goal-directed hemodynamic optimization therapy (GDHOT) significantly improves outcomes in surgery patients. Standard GDHOT is based on major solution volume, vasodilators and inotropic therapy, while novel GDHOT is based on major vasopressor and inotropic therapy. Therefore, we tested whether standard or novel GDHOT improves surgical outcomes in PAH-CHD patients. Methods: Forty PAH-CHD patients with a ventricular septal defect (VSD) and mean pulmonary arterial pressure (mPAP) >50 mmHg, who were scheduled for corrective surgery, were randomly assigned to 2 groups: SG (study group, n = 20) and CG (control group, n = 20). SG patients received perioperative hemodynamic therapy guided by novel GDHOT, while CG patients received standard GDHOT. Outcome data were recorded up to 28 days postoperatively. Ventilator time, length of ICU stay, and mortality were the primary endpoints.Results: There were no significant differences in preoperative data, surgical procedure, and hospital mortality rates between the 2 groups. Time of mechanical ventilation and length of ICU stay were significantly shorter in SG patients compared to CG patients (P < .05, n = 20). Patients in SG showed a significantly increased systemic vascular resistance index and decreased cardiac index, but no change in pulmonary vascular resistance index at 12 and 24 hours after surgery compared to the controls (P < .05). Patients in SG had significantly decreased PAP, pulmonary arterial pressure/systemic arterial pressure (Pp/Ps), and RVSWI (right ventricular stroke work index) at 12 and 24 hours after surgery (P < .05, respectively). Patients in SG also showed significantly decreased central venous pressure at 4, 12, and 24 hours after surgery compared to those treated with standard protocol (P < .05).Conclusion: Our study provides clinical evidence that perioperative goal-directed hemodynamic optimization therapy based on major vasopressor is associated with reduced duration of postoperative respiratory support, and length of ICU stay in PAH-CHD patients undergoing elective surgery. These outcomes, then, may be linked to improved hemodynamics and preservation of right ventricular dynamic function.
Massive Pulmonary Embolism Treated with Catheter Therapy and Extracorporeal Membrane Oxygenation
Authors: Teman Nicholas R , Xiao Jianzhou T. , Tribble Curtis G
Published: March 2017

Massive pulmonary embolism (PE) is associated with significant morbidity and mortality.  Treatment for massive PE can include systemic thrombolysis and catheter-directed therapy. We present the case of a patient with massive PE successfully treated with catheter-directed therapy, using extracorporeal membrane oxygenation for hemodynamic support, and discuss some of the potential complications associated with this therapy.
Pump Thrombosis following HeartMate II Left Ventricular Assist Device Implantation in a Patient with Aspirin and Plavix Resistance
Authors: Ghodsizad Ali , Badiye A. , Zeriouh M. , Pae W. , Koerner M.M. , Loebe M.
Published: March 2017

Despite advances in pump technology, thromboembolic events and pump thrombosis are potentially life-threatening complications in patients with continuous flow ventricular assist devices. Here we describe a patient with pump thrombosis following LVAD HeartMate II implantation presenting with Aspirin and Plavix resistance and signs of acute hemolysis as manifested by high LDH, changing pump power, pulse index and reduced pump flows.
Grandmother Rules: Crucial Conversations with Patients and Families
Authors: Tribble, MD Curt
Published: March 2017

I matriculated at the same medical school from which my father graduated 22 years earlier. This coincidence gave me the opportunity to use his advice, based on his experiences as a student, to seek out some of the school’s best and most memorable teachers.
Care System Redesign for Preterm Children After Discharge From the NICU
Authors: Kuo Dennis Z. , Lyle Robert E. , Casey Patrick H. , Stille Christopher J.
Published: March 2017

Approximately 1 in 8 children in the United States are born preterm. Existing guidelines and research examine the cost of prematurity from the NICU stay and developmental surveillance and outcomes after discharge from the NICU. Preterm children are at greater risk for excess hospitalizations, outpatient visits, and societal costs after NICU discharge. Improved delivery of care and health promotion from the community setting, particularly from the patient-centered medical home, may result in improved growth, health, and development, with accompanying reduction of post-NICU discharge costs and encounters. There has been comparatively little focus on how to promote health and wellness for children born preterm, particularly for community-based providers and payers. Accordingly, health care delivery for NICU graduates is often fragmented, with little guidance on medical management beyond tertiary care follow-up. In this article, we use what is known about chronic care and practice transformation models to present a framework for health care system redesign for children born preterm. We discuss the rationale for NICU graduates as a priority population for health system redesign. Promotion of health and wellness for children born preterm who are discharged to the community setting entails population health management from the patient-centered medical home; comanagement, clinical care protocols, and clinical support from the tertiary care-based tertiary care-based center; and a favorable payer strategy that emphasizes support for chronic care management. Practical suggestions are provided for the practicing physician for the child born preterm as health care systems are redesigned.
Noise Pollution and Arterial Hypertension
Authors: Münzel Thomas ,   Center for Cardiology, University Medical Center Mainz, Mainz, Germany, Sørensen Mette ,   Danish Cancer Society Research Center, Copenhagen, Denmark
Published: March 2017

Noise exposure modifies the function of multiple organs and systems. Acute noise exposure – both in laboratory settings where traffic noise is simulated and in real-life working environments – can cause increases in blood pressure, heart rate and cardiac output. This review examines the effects of noise pollution on the cardiovascular system, with a particular focus on non-auditory effects such as noise-induced arterial hypertension.
KERAGAAN SPERMATOZOA UDANG WINDU (Penaeus monodon FAB.)ASAL LAUT DAN TAMBAK
Authors: Lante Samuel , Haryanti Haryanti
Published: March 2017

Pengamatan keragaan spermatozoa induk udang windu (P monodon Fab.) jantan asal laut dan tambak telah dilakukan. Riset ini bertujuan untuk mengetahui keragaan spermatopora, meliputi bobot spermatopora, jumlah, persentase hidup, dan abnormalitas spermatozoa. Sampel induk udang windu diperoleh dari tiga lokasi yaitu dari alam (perairan Sumbawa, Nusa Tenggara Barat, dan Banyuwangi, Jawa timur) dan dari tambak Pejarakan, Bali.
PENGGUNAAN KOLOM KROMATOGRAFI INTERAKSI HIDROFOBIK UNTUK PEMURNIAN KITOSANASE
Authors: Chasanah Ekowati , Suhartono Maggy T. , Putro Sumpeno
Published: March 2017

Penelitian ini bertujuan untuk melihat performansi metode purifikasi dengan kromatografi kolom interaksi hidrofobik untuk memurnikan enzim kitosanase yang diisolasi dari Bacillus licheniformis MB-2. Matriks Butyl Sepharose 4FF lelah digunakan untuk memisahkan enzim kitosanase dari campuran enzim yang ada pada ekstrak kasar.
HUBUNGAN ANTARA KEBERADAAN DURI DENGAN TOKSISITAS KARANG LUNAK DAN SPONGE
Authors: Nursid Muhammad , Wikanta Thamrin , Januar Hedi Indra
Published: March 2017

Penelitian yang bertujuan untuk mengetahui hubungan antara keberadaan duri dengan toksisitas ekstrak metanol karang lunak dan sponge telah dilakukan. Sebanyak 28 jenis ekstrak karang funak dan sponge diuji toksisilasnya menggunakan uji Brine Shrimp Lethality Iest (BSLT). Perbedaan mortalitas Artemia salina akibat pemberian ekstrak diuji dengan uji t dua sampel independen. Korelasi antara keberadaan duri dengan tingkat toksisitas dianalisis dengan korelasi nonparametrik Spearman.
ANALISIS DAYA SAING EKSPOR PRODUK PERIKANAN INDONESIA: PENDEKATAN MODEL REVEALED COMPARATIF ADVANTAGE ( RCA) DAN MODEL CONSTANT MARKET SHARE ANALYSIS (CMSA)
Authors: Aisya Lia Kamelia , Koeshendrajana Sonny , Iqbal M.
Published: March 2017

Riset bertujuan untuk menganalisis daya saing ekspor produk perikanan Indonesia telah dilakukan pada tahun 2004. Secara spesifika, metode Revealed Comparatif Advantages (RCA), dan metode Constant Market Share Analys,s (CMSA) digunakan untuk mengetahui komoditas komoditas yang memiliki tingkat pertumbuhan permintaan yang tinggi atau memiliki tingkat dayasaing yang tinggi baik berupa keunggulan komparatif maupun keunggulan kompetitif agar mendukung kegiatan investasi dan produksi yang menjadikan sektor perikanan sebagai primemover perekonomian yang baru.
Effect of Higher Landau Levels on the Transverse Thermoelectric Conductivity in High-\(T_{c}\) Superconductors
Authors: Tinh Bui Duc
Published: March 2017

We investigate effect of higher Ladau levels on the transverse thermoelectricconductivity \(\alpha_{xy}\), describing the Nernst effect in high-\(T_c\) superconductors, by using the time-dependent Ginzburg-Landau theory in two dimensional model withthermal noise. The transverse thermoelectric conductivity is calculated inthe self-consistent Gaussian approximation. Our results indicate that thehigher Landau levels are, the less these levels contribute to the transversethermoelectric conductivity. Our results are in good agreement with experimental dataon high-Tc superconductor.
Screening of a Small Spherical Macroion by Oppositely Charged Flexible Polyelectrolyte
Authors: Quyen Vu Van , Yen Vu Thi Hai , Toan Nguyen The
Published: March 2017

Electrostatic interactions play important roles in the assembly, the structureand the functions of many biological as well as soft matter systems. In the presence of a macro-ion in aqueous solution, oppositely charged molecules mobilize around it to screen out its electrostatic potential. In this paper, we focus on screening of small macroion by a flexible polyelectrolyteusing Monte-Carlo simulation. It is shown that the condensation of the polyelectrolyte around the macroion shows a first order phase transition from a dense to a dilute concentration of monomers. The width of the condensed region increases with stronger screening or with smaller macro-ion charges. For small macro-ion charge, or when the Coulomb interactions are strongly screened, no complexation between the polyelectrolyte and the macro-ion happens.Additionally, long polyelectrolyte protrudes both tails and loops from the macroion. This is quite different from the case of large macroions where only tails appear. Our results can be used to explain various experimental trends.
A High Q-factor, Easy-to-use, Broadband Ce:LiCAF Laser Cavity Based on Total Internal Reflection
Authors: Ren Arita , Melvin John F Empizo , Yuki Minami , Mui Luong Viet , Takaya Taniguchi , Kohei Yamanoi , Toshihiko Shimizu , Nobuhiko Sarukura , Marilou Cadatal Raduban , Duong Pham Van , Tu Nguyen Xuan , Minh Pham Hong
Published: March 2017

We report a design of a cerium-doped lithium calcium hexafluoro aluminumate (Ce:LiCaAlF\(_{6}\), Ce:LiCAF) laser resonator based on total internal reflection (TIR). This TIR configuration is established by placing the Ce:LiCAF crystal between two calcium fluoride (CaF\(_{2}\)) Pellin-Broca prisms. The laser resonator exhibits a 289-nm emission with 3.5-nm spectral linewidth and 4.4-ns pulse duration. Results show that the present configuration can be a high Q-factor, easy-to-use, broadband prism resonator suitable as a laser oscillator not only in the ultraviolet (UV) region but also down to vacuum ultraviolet (VUV) wavelengths where alignment is restricted to vacuum environments.
The 3-3-1 Model with Arbitrarily Charged Leptons
Authors: Long Hoang Ngoc , Loi Duong Van , Thao Nguyen Chi , Giang Thanh Huu Hong
Published: March 2017

The gauge  model based on \(\mathrm{SU}(3)_C\otimes \mathrm{SU}(3)_L\otimes \mathrm{U}(1)_X\)  group with arbitrarily electric charged exotic leptons is presented. The mass eigenvalues and eigenstates for  neutral gauge bosons are presented in the general form. We show that in the 3-3-1 models, there always exists triple Higgs self-coupling. The lepton number operator is also presented.
Desarrollo de un módulo experimental de difracción de la luz para un laboratorio de física controlado de forma remota/Development of an experimental module of light diffraction for a physics laboratory remotely controlled
Authors: Pamplona Beron Leidy Esperanza , Calvo Salcedo Andrés Felipe , Molina Cristhian Daniel
Published: March 2017

Este documento presenta el diseño e implementación de un módulo experimental de difracción de la luz para un laboratorio remoto, donde se propone un método novedoso para encontrar las distancias del máximo central a los mínimos secundarios del patrón de difracción utilizando las herramientas que proporciona el procesamiento digital de imágenes y la visión por computador. Para la construcción del módulo se utilizó un diodo láser rojo de punto con longitud de onda de 650nm y un sistema de tres rendijas simples y una circular. Para la adquisición de los datos experimentales se utilizó una cámara web Microsoft LifeCam Studio para realizar la captura del patrón de difracción. El software empleado fue LabVIEWTM que se encarga de la captura, el procesamiento y la comunicación entre el servidor y la interfaz. Además, se contactó a la Institución Educativa Matecaña del municipio de Pereira, donde los estudiantes de grado diez y once y los docentes del área de física realizaron el laboratorio en sus salas de sistemas utilizando las TICs como herramientas educativas para el desarrollo de esta práctica. El error en la medición de cada una de las rendijas no supera el 5%.
A Singleton Type-1 Fuzzy Logic Controller for On-Line Error Compensation During Robotic Welding
Authors: Davila Ignacio , Lopez-Juarez Ismael , Mendez Gerardo Maximiliano , Osorio-Comparan Roman , Lefranc Gaston , Cubillos Claudio
Published: March 2017

During robot welding operations in the manufacturing industry there is a need to modify on-line the welding path due to a mismatch in the position of the components to be welded. These positioning errors are due to multiple factors such as ageing of the components in the conveyor system, clamp fixtures, disturbances, etc. Therefore, robot reprogramming is needed which requires a stop in the production line and consequently an increment in production costs. This article is an extension of [1]a and presents an alternative solution to this problem that involves the use of structured lighting using a low-cost laser beam, a CMOS camera and a Gaussian singleton fuzzy logic controller. To validate the proposed control system, a robotic cell was designed using an industrial KUKA KR16 robot for welding metallic plates. The method was evaluated experimentally under lateral and vertical positioning errors.
The Clinical and Theoretical Trends of Music Therapists: The Israeli Case
Authors: Wiess Chava , Dassa Ayelet , Gilboa Avi
Published: March 2017

In the present study we conducted a first of its kind online survey of music therapists (MTs) in Israel. Though this field has been growing rapidly and to date includes about 700 MTs, there was not yet a survey conducted to adress their fields of interest, and their clinical and theoretical orientations.A total of 107 MTs, 48 of which had more than 8 years of experience (MEMT) and 57 of which had less than 8 years of experience (LEMT), answered an internet survey examining: (a) the instruments and the techniques they use, (b) the populations they work with, and (c) their theoretical orientation. Results indicated significant differences between MEMTs and LEMTs in almost all fields of inquiry.Generally, most of the younger generation is open to more techniques, proficient with more instruments, and uses more music in their work. In a continuously globalizing world, the results of this study are relevant to not only Israeli music therapists, but others as well since the local situation captured in this study can be compared and related to the situations in other countries. Recommendations are provided for places where such studies and surveys have not yet been conducted.
Community Building Through Inclusive Music-Making
Authors: Gosine Jane , Hawksley Deborah , LeMessurier Quinn Susan
Published: March 2017

The objective of this project was to expand the boundaries of regular music therapy sessions at a non-profit organization to include performances and workshops with community musicians. The goals and practices used for persons with physical disabilities prepared participants to benefit from inclusive music-making with local community musicians who had no previous music therapy experience, but whose performing styles were closely aligned with the musical preferences of our participants. The four collaborative workshops, which were held over six months, involved music therapy participants, accredited music therapists, local musicians, and volunteers engaging in music making together where teaching and learning was shared amongst all involved. The workshops were also an important mechanism for raising greater awareness of the needs and abilities of the music therapy participants.