bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors That Contribute to a Sense of Belonging in Business Students on a Small 4-Year Public Commuter Campus in the Midwest
Authors: Whitten Donna , James Adrian , Roberts Cynthia
Published: August 2017

Institutions of higher education are increasingly focused on student outcomes such as persistence. This study investigated factors that contribute to a sense of belonging, a key contributor to persistence, in business students attending a small 4-year public commuter campus in the Midwest. A survey was administered to students in an introductory business course with a first-year experience component to examine three categories of variables: student demographics, faculty interventions, and student activities. Using logistic regression, three faculty interventions showed a significant correlation with sense of belonging: faculty encouragement, faculty empowerment, and faculty interest. These results suggest that when commuter campuses are successful in cultivating caring, positive relationships between students and faculty, their student’s sense of belonging may be enhanced and persistence improved. This is important because these factors are within the control of a commuter campus, which tends to have fewer options and more challenges in enhancing persistence than residential campuses.
Effectiveness of the conservative therapy for spontaneous isolated iliac artery dissection: Preliminary results
Authors: Liang Zhuhong , Guo Weiwei , Du Chunhua , Xie Yingdi
Published: August 2017

Purpose

To investigate the effectiveness of conservative therapy for spontaneous isolated iliac artery dissection (SIIAD).

Methods

From February 2006 to May 2016, all patients with SIIAD were included and analyzed. The diagnosis of SIIAD was made based on contrast-enhanced computed tomography. The imaging morphologic characteristics, treatments, and outcomes for each patient were analyzed.

Results

A total of 11 patients (10 male and 1 female, age 71.1 ± 7.8 years) were included in this study. Of the 11 patients, 8 patients were asymptomatic and the SIIADs were discovered during the course of computed tomography for other diseases, and 3 patients were symptomatic. Initial computed tomography findings: iliac arterial calcification ( n = 7); compression of the true lumen ( n = 6), with stenosis of the true lumen from 25% to 50% ( n = 3) and ≥ 50% ( n = 3); thrombosed false lumen partially ( n = 4), and no thrombosis in false lumen ( n = 7); dissecting aneurysm ( n = 11); entry points ( n = 11); re-entry points ( n = 1); no dissection extended to the internal iliac or common femoral artery. Conservative treatment was performed in six patients, and the remaining five patients need no treatment. During 23.3 ± 14.2 months follow-up, none recurred symptoms and signs of symptomatic SIIAD; partial remodeling of SIIAD was achieved in four patients, and the remaining seven patients with no change of SIIAD. There was no presence of new false lumen enhancement on contrast-enhanced computed tomography during follow-up.

Conclusions

SIIAD without arterial rupture or lower limb necrosis can be safely treated with conservative therapy.
The European Union, Agriculture, and the Tropics: Public Financial Incentives to Enhance Food Security and Expansion of Production Contracts
Authors: Bryan Endres A. , Endres Renata
Published: August 2017

Member States of the European Union have strong historical ties to agriculture in tropical regions based on colonial history and accompanying trade flows. Attempts to reverse the extractive nature of these relationships through public finance investments in sustainable intensification and the linking of smallholders to new markets could enhance food security and rural development. Public sector financing of public–private partnerships to support these efforts, however, may create dominant positions for large agricultural companies. Moreover, the expanded use of agricultural production contracts by these firms may give rise to a variety of legal and social issues, especially when one party to the agreement lacks economic bargaining power. On the other hand, production contracts can enable small-scale farmers to mitigate risk, establish more predictable income streams, and access new market opportunities. Public development funds promoting reformation of smallholder farming operations need to consider the consequences of the expanded use of production contracts.
The Forests of the Amazon and Cerrado Moderate Regional Climate and Are the Key to the Future
Authors: Coe Michael T. , Brando Paulo M. , Deegan Linda A. , Macedo Marcia N. , Neill Christopher , Silvério Divino V.
Published: August 2017

The role of tropical forests in climate is most often expressed in terms of the carbon they keep out of the atmosphere if deforestation is avoided or the carbon they remove from the atmosphere as they grow. The direct role of forests, particularly in the tropics, in maintaining low surface temperatures and relatively high precipitation has been underappreciated. Recent studies in the Brazilian agricultural frontier indicate that tropical deforestation, for pasture and crop production, has led to significant regional climate change in the last 40 years of a scale much larger than that attributed to the carbon released from deforestation. Deforestation reduces net surface radiation and evapotranspiration, thus increasing sensible heat flux and land surface temperature. In Mato Grosso state, the temperature of the forested Xingu Indigenous Park is 3℃ cooler than the surrounding mosaic of pasturelands, croplands, and remaining forest fragments. In the neighboring state of Rondônia, rainfall has significantly decreased and the dry season lengthened as deforestation occurred. Numerical model studies strongly suggest that Brazil’s agricultural frontier will be much warmer and dryer in coming decades as greenhouse gas concentrations increase. Thus, in Brazil, it is becoming clear that, because of their capacity to moderate regional climate, preserving tropical forests will be a key component of mitigating exogenously driven future climate change.
Anthropocene semiosis
Authors: Clark Nigel
Published: August 2017

While affirming their more-than-human concerns, Ruddick ((2017) Rethinking the subject, reimagining worlds. Dialogues in Human Geography (this issue).) proposes that there are limits to the capacity of relational ontologies to deal with the conflicting demands and extensive temporalities of the Anthropocene crisis. This commentary probes her alternative notions of a forcefulness and generativity that exceeds individuated bodies and of a semiosis that inheres in the workings of ecological and Earth systems.
Grounding our subjectivity in the semiotic web
Authors: Ruddick Susan M
Published: August 2017

In their responses to my framing of the ecological crisis as an ontological crisis, my interlocutors raise questions about the relationship between ontology and ethics; whether and how attention to affect and a reimagined ontology can cope with the demands that we face when thinking of ethics on a planetary scale; the implications of contemporary actions in deep time; and whether thinking through affect leads us to a perspective divorced from History. In response to Gandy and Jasper, I address misplaced charges of anthropocentrism, claims I abandon the subject, and claims I privilege affect in a way that ignores reason. In response to Sharp, Stark, and Clark, I elaborate (a) the ways in which we can proceed from a reimagined ontology to ethics through a more critical engagement with contemporary scholars (e.g. Buchanan and Wehelyie, who leaven the concept of assemblage), (b) the selective engagement of western philosophers as a kind of pars destruens to a western concept of the subject, and (c) the richness of an approach based on semiosis, which uncovers the communicative relations between a vast array of actors and actants and offers both a different vision of plenitude and the potential for wider range of alliances. I propose this as a prolegomenon to a reimagined future and expanded sense of human subjectivity—one which would acknowledge, celebrate, and promote a maximal biodiversity, in recognition of the ultimate dependence of humans on the workings of nonhuman others.
Assemblages without systems
Authors: Farías Ignacio
Published: August 2017

Briassoulis’ work is an invitation to think human responses to environmental degradation by means of assemblage theory. Introducing an analytical position beyond positivist and constructivist conceptualizations of ecological systems, Briassoulis’ article redirects our attention to the situated practices of assembling the heterogeneous actors that shape socio-natural environments. The consequences of such move, however, are not fully followed through. The notion of socio-ecological systems remains unchallenged, as response assemblages (RAs) are imagined to be constituted within such systems. The effectiveness of RAs is assessed in evolutionary terms by focussing on their ‘fit’, thus positing nature as their ultimate arbiter. By addressing these issues, this article prepares the ground for studying the cosmopolitics of RAs as involving an experimental practice aimed at composing the world.
Why stop at response?
Authors: Head Lesley
Published: August 2017

The broad question around which I frame my dialogue with Briassoulis’s paper is, why stop at response? I consider this question with three connected subquestions. Why is it only the response part of the subject matter that needs assemblage thinking? Can other conceptualizations – environmental degradation, socioecological systems – remain intact within an assemblage approach? And does the concept of response itself imply a linear kind of causality arguably incompatible with assemblages?
EFL Teachers’ Multiple Intelligences and Their Classroom Practice
Authors: Dolati Zahra , Tahriri Abdorreza
Published: August 2017

This study sought to investigate whether there are differences among EFL instructors of various intelligence types in terms of the types of activities that they implement in their classes. It also sought to investigate teachers’ perceptions about the theory of multiple intelligences. To this end, 30 male and female EFL instructors teaching the same textbook with the same method of teaching participated in the present study. To gather the data, three successive sessions of each class were observed and the class activities were recorded through an observation schedule. Semistructured interviews were also carried out to explore the teachers’ perceptions of multiple intelligences. And finally, teachers’ dominant type of intelligence was determined by Multiple Intelligences Checklist. The results of one-way ANOVA and post hoc test revealed that only teachers of logical-mathematical type were influenced by their dominant intelligence type and other intelligence types did not exert a significant influence on the types of activities being implemented in the classes. The results of this study can be a fillip at least for teachers with logical-mathematical intelligence to be careful about their dominant intelligence type, not allowing it to affect their teaching and to compel them to use activities in line with their dominant intelligence.
Patient-Centered Obstetric Care in the Age of Cell-Free Fetal DNA Prenatal Screening
Authors: Agatisa Patricia K , Mercer Mary Beth , Mitchum Ariane , Coleridge Marissa B , Farrell Ruth M
Published: August 2017

Purpose:

The clinical introduction of innovative prenatal genetic technologies challenges patients and providers to find new ways of fostering informed decision-making in a setting characterized by complexity and uncertainty. As prenatal genetic technology advances, important questions remain about how to structure patient-centered conversations that effectively prepare pregnant patients to make informed choices about the different genetic conditions for which this new form screening may be used.

Methods:

Focus groups were conducted with 23 pregnant women to identify informational needs and decision-making preferences regarding emerging and anticipated applications of cell-free fetal DNA screening, the newest form of prenatal genetic screening.

Results:

Participants were in favor of obtaining more genetic information about the fetus than provided by conventional screens but acknowledged the challenges inherent in navigating the unique complexities of the decision-making process. The provider–patient relationship was seen as an important resource to navigate the associated uncertainties at each stage of the screening process. Participants emphasized the need for initiatives to support a personalized, accurate, and unbiased discussion about prenatal genetic risk and assessment.

Conclusion:

Continued advances in prenatal genetic screening call for new approaches to structure patient-centered communication to facilitate increasingly complex decisions about fetal genetic risk and assessment.
Activity of Eribulin in Patients With Advanced Liposarcoma Demonstrated in a Subgroup Analysis From a Randomized Phase III Study of Eribulin Versus Dacarbazine
Authors: Demetri George D. , Schöffski Patrick , Grignani Giovanni , Blay Jean-Yves , Maki Robert G. , Van Tine Brian A. , Alcindor Thierry , Jones Robin L. , D’Adamo David R. , Guo Matthew , Chawla Sant
Published: August 2017

Purpose

A phase III study comparing eribulin with dacarbazine in patients with advanced liposarcoma (LPS) or leiomyosarcoma showed a significant improvement in overall survival (OS) for the eribulin arm, with a manageable toxicity profile. We now report the histology-specific subgroup analysis of the efficacy and safety of eribulin compared with dacarbazine in patients with LPS, an independently randomized stratified subgroup of this phase III trial.

Methods

Patients ≥ 18 years with advanced or metastatic dedifferentiated, myxoid/round cell, or pleomorphic LPS incurable by surgery or radiotherapy were included. Patients with Eastern Cooperative Oncology Group performance status ≤ 2 and two or more prior systemic treatment regimens, including one with anthracycline, were randomly assigned 1:1 to receive eribulin mesylate (1.4 mg/m2 intravenously on days 1 and 8) or dacarbazine (850, 1,000, or 1,200 mg/m2 intravenously on day 1) every 21 days. OS, progression-free survival (PFS), and safety were analyzed.

Results

In the LPS subgroup, OS was significantly improved: 15.6 versus 8.4 months (hazard ratio, 0.51; 95% CI, 0.35 to 0.75; P < .001) with eribulin versus dacarbazine, respectively. Longer OS with eribulin was observed in all LPS histologic subtypes and in all geographic regions evaluated. PFS was also improved with eribulin versus dacarbazine (2.9 v 1.7 months, respectively; hazard ratio, 0.52; 95% CI, 0.35 to 0.78; P = .0015). Adverse events were similar between arms.

Conclusion

In patients with previously treated LPS, eribulin was associated with significantly superior OS and PFS compared with dacarbazine. Eribulin represents an important treatment option for patients with LPS, a sarcoma subtype for which limited effective systemic treatments are available. Further studies are justified to explore the role of eribulin in earlier lines of therapy as well as in combination with other agents.
Age at Exposure to Surgery and Anesthesia in Children and Association With Mental Disorder Diagnosis
Authors: Ing Caleb , Sun Ming , Olfson Mark , DiMaggio Charles J. , Sun Lena S. , Wall Melanie M. , Li Guohua
Published: August 2017

BACKGROUND:

Animals exposed to anesthetics during specific age periods of brain development experience neurotoxicity, with neurodevelopmental changes subsequently observed during adulthood. The corresponding vulnerable age in children, however, is unknown.

METHODS:

An observational cohort study was performed using a longitudinal dataset constructed by linking individual-level Medicaid claims from Texas and New York from 1999 to 2010. This dataset was evaluated to determine whether the timing of exposure to anesthesia ≤5 years of age for a single common procedure (pyloromyotomy, inguinal hernia, circumcision outside the perinatal period, or tonsillectomy and/or adenoidectomy) is associated with increased subsequent risk of diagnoses for any mental disorder, or specifically developmental delay (DD) such as reading and language disorders, and attention deficit hyperactivity disorder (ADHD). Exposure to anesthesia and surgery was evaluated in 11 separate age at exposure categories: ≤28 days old, >28 days and ≤6 months, >6 months and ≤1 year, and 6-month age intervals between >1 year old and ≤5 years old. For each exposed child, 5 children matched on propensity score calculated using sociodemographic and clinical covariates were selected for comparison. Cox proportional hazards models were used to measure the hazard ratio of a mental disorder diagnosis associated with exposure to surgery and anesthesia.

RESULTS:

A total of 38,493 children with a single exposure and 192,465 propensity score-matched children unexposed before 5 years of age were included in the analysis. Increased risk of mental disorder diagnosis was observed at all ages at exposure with an overall hazard ratio of 1.26 (95% confidence interval [CI], 1.22–1.30), which did not vary significantly with the timing of exposure. Analysis of DD and ADHD showed similar results, with elevated hazard ratios distributed evenly across all ages, and overall hazard ratios of 1.26 (95% CI, 1.20–1.32) for DD and 1.31 (95% CI, 1.25–1.37) for ADHD.

CONCLUSIONS:

Children who undergo minor surgery requiring anesthesia under age 5 have a small but statistically significant increased risk of mental disorder diagnoses and DD and ADHD diagnoses, but the timing of the surgical procedure does not alter the elevated risks. Based on these findings, there is little support for the concept of delaying a minor procedure to reduce long-term neurodevelopmental risks of anesthesia in children. In evaluating the influence of age at exposure, the types of procedures included may need to be considered, as some procedures are associated with specific comorbid conditions and are only performed at certain ages.
Initiation and Termination of Massive Transfusion Protocols: Current Strategies and Future Prospects
Authors: Foster John C. , Sappenfield Joshua W. , Smith Robert S. , Kiley Sean P.
Published: August 2017

The advent of massive transfusion protocols (MTP) has had a significant positive impact on hemorrhaging trauma patient morbidity and mortality. Nevertheless, societal MTP guidelines and individual MTPs at academic institutions continue to circulate opposing recommendations on topics critical to MTPs. This narrative review discusses up-to-date information on 2 such topics, the initiation and termination of an MTP. The discussion for each begins with a review of the recommendations and supporting literature presented by MTP guidelines from 3 prominent societies, the American Society of Anesthesiologists, the American College of Surgeons, and the task force for Advanced Bleeding Care in Trauma. This is followed by an in-depth analysis of the main components within those recommendations. Societal recommendations on MTP initiation in hemorrhaging trauma patients emphasize the use of retrospectively validated massive transfusion (MT) prediction score, specifically, the Assessment of Blood Consumption and Trauma-Associated Severe Hemorrhage scores. Validation studies have shown that both scoring systems perform similarly. Both scores reliably identify patients that will not require an MT, while simultaneously overpredicting MT requirements. However, each scoring system has its unique advantages and disadvantages, and this review discusses how specific aspects of each scoring system can affect widespread applicability and statistical performance. In addition, we discuss the often overlooked topic of initiating MT in nontrauma patients and the specific tools physicians have to guide the MT initiation decision in this unique setting. Despite the serious complications that can arise with transfusion of large volumes of blood products, there is considerably less research pertinent to the topic of MTP termination. Societal recommendations on MTP termination emphasize applying clinical reasoning to identify patients who have bleeding source control and are adequately resuscitated. This review, however, focuses primarily on the recommendations presented by the Advanced Bleeding Care in Trauma’s MTP guidelines that call for prompt termination of the algorithm-guided model of resuscitation and rapidly transitioning into a resuscitation model guided by laboratory test results. We also discuss the evidence in support of laboratory result–guided resuscitation and how recent literature on viscoelastic hemostatic assays, although limited, highlights the potential to achieve additional benefits from this method of resuscitation.
Performance, morphology and control of power-amplified mandibles in the trap-jaw antMyrmoteras(Hymenoptera: Formicidae)
Authors: Larabee Fredrick J. , Gronenberg Wulfila , Suarez Andrew V.
Published: August 2017

Trap-jaw ants are characterized by high-speed mandibles used for prey capture and defense. Power-amplified mandibles have independently evolved at least four times among ants, with each lineage using different structures as a latch, spring and trigger. We examined two species from the genus Myrmoteras (subfamily Formicinae), whose morphology is unique among trap-jaw ant lineages, and describe the performance characteristics, spring-loading mechanism and neuronal control of Myrmoteras strikes. Like other trap-jaw ants, Myrmoteras latch their jaws open while the large closer muscle loads potential energy in a spring. The latch differs from other lineages and is likely formed by the co-contraction of the mandible opener and closer muscles. The cuticle of the posterior margin of the head serves as a spring, and is deformed by approximately 6% prior to a strike. The mandibles are likely unlatched by a subgroup of closer muscle fibers with particularly short sarcomeres. These fast fibers are controlled by two large motor neurons whose dendrites overlap with terminals of large sensory neurons originating from labral trigger hairs. Upon stimulation of the trigger hairs, the mandibles shut in as little as 0.5 ms and at peak velocities that are comparable with other trap-jaw ants, but with much slower acceleration. The estimated power output of the mandible strike (21 kW kg−1) confirms that Myrmoteras jaws are indeed power amplified. However, the power output of Myrmoteras mandibles is significantly lower than distantly related trap-jaw ants using different spring-loading mechanisms, indicating a relationship between power-amplification mechanism and performance.
Assessing student characteristics in palliative care education research: a literature review
Authors: Lippe Megan , Carter Patricia
Published: August 2017

Background:

Assessing characteristics in educational research is important to describe a student sample. However, consistency in measuring student characteristics is lacking, particularly in palliative and end-of-life (PEOL) care education research.

Methods:

A literature review was conducted to determine the primary characteristics to assess in PEOL education research, the corresponding level of measurement and associated statistical analyses to perform with the data.

Results:

Key characteristics to measure include: age, previous PEOL healthcare experience, previous personal experience with death/loss, previous PEOL education, program of enrolment and religion. Gender, ethnicity/race and living situation/place of residence were not supported as key characteristics to assess. Best methods by which to measure characteristics remain unclear and the utilisation of characteristics in research is inconsistent.

Conclusion:

Identified characteristics should be measured in PEOL education research at the highest level of measurement. The influence of characteristics on outcomes should be considered in association with research questions.
Thompson hemiarthroplasty versus modular unipolar implants for patients requiring hemiarthroplasty of the hip
Authors: Sims A. L. , Farrier A. J. , Reed M. R. , Sheldon T. A.
Published: August 2017

Objectives

The objective of this study was to assess all evidence comparing the Thompson monoblock hemiarthroplasty with modular unipolar implants for patients requiring hemiarthroplasty of the hip with respect to mortality and complications.

Methods

A literature search was performed to identify all relevant literature. The population consisted of patients undergoing hemiarthroplasty of the hip for fracture. The intervention was hemiarthroplasty of the hip with a comparison between Thompson and modular unipolar prostheses. Pubmed, Embase, CINAHL, Web of Science, PROSPERO and the Cochrane Central Register of Controlled Trials. The study designs included were randomised controlled trials (RCTs), well designed case control studies and retrospective or prospective cohort studies. Studies available in any language, published at any time until September 2015 were considered. Studies were included if they contained mortality or complications.

Results

The initial literature search identified 4757 items for examination. Four papers were included in the final review. The pooled odds ratio for mortality was 1.3 (95% confidence Interval 0.78 to 2.46) favouring modular designs. The pooled odds ratio for post-operative complications was 1.1 (95% CI 0.79 to 1.55) favouring modular designs. Outcomes were reported at 12 or six months. These papers all contained potential sources of bias and significant clinical heterogeneity.

Conclusion

The current evidence comparing monoblock versus modular implants in patients undergoing hemiarthroplasty is weak. Confidence intervals around the pooled odds ratios are broad and incorporate a value of one. Direct comparison of outcomes from these papers is fraught with difficulty and, as such, may well be misleading. A well designed randomised controlled trial would be helpful to inform evidence-based implant selection. Cite this article: A. L. Sims, A. J. Farrier, M. R. Reed, T. A. Sheldon. Thompson hemiarthroplasty versus modular unipolar implants for patients requiring hemiarthroplasty of the hip: A systematic review of the evidence. Bone Joint Res 2017;6:–513. DOI: 10.1302/2046-3758.68.BJR-2016-0256.R1.
Dose optimisation of intravenous tranexamic acid for elective hip and knee arthroplasty
Authors: Morrison R. J. M. , Tsang B. , Fishley W. , Harper I. , Joseph J. C. , Reed M. R.
Published: August 2017

Objectives

We have increased the dose of tranexamic acid (TXA) in our enhanced total joint recovery protocol at our institution from 15 mg/kg to 30 mg/kg (maximum 2.5 g) as a single, intravenous (IV) dose. We report the clinical effect of this dosage change.

Methods

We retrospectively compared two cohorts of consecutive patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA) surgery in our unit between 2008 and 2013. One group received IV TXA 15 mg/kg, maximum 1.2 g, and the other 30 mg/kg, maximum 2.5 g as a single pre-operative dose. The primary outcome for this study was the requirement for blood transfusion within 30 days of surgery. Secondary measures included length of hospital stay, critical care requirements, re-admission rate, medical complications and mortality rates.

Results

A total of 1914 THA and 2537 TKA procedures were evaluated. In THA, the higher dose of TXA was associated with a significant reduction in transfusion (p = 0.02, risk ratio (RR) 0.74, 95% confidence interval (CI) 0.58 to 0.96) and rate of re-admission (p < 0.001, RR 0.50, 95% CI 0.35 to 0.71). There were reductions in the requirement for critical care (p = 0.06, RR 0.55, 95% CI 0.31 to 1.00), and in the length of stay from 4.7 to 4.3 days (p = 0.02). In TKA, transfusion requirements (p = 0.049, RR 0.64, 95% CI 0.41 to 0.99), re-admission rate (p = 0.001, RR 0.56, 95% CI 0.39 to 0.80) and critical care requirements (p < 0.003, RR 0.34, 95% CI 0.16 to 0.72) were reduced with the higher dose. Mean length of stay reduced from 4.6 days to 3.6 days (p < 0.01). There was no difference in the incidence of deep vein thrombosis, pulmonary embolism, gastrointestinal bleed, myocardial infarction, stroke or death in THA and TKA between cohorts.

Conclusion

We suggest that a single pre-operative dose of TXA, 30 mg/kg, maximum 2.5g, results in a lower transfusion requirement compared with a lower dose in patients undergoing elective primary hip and knee arthroplasty. However, these findings should be interpreted in the context of the retrospective non-randomised study design. Cite this article: R. J. M. Morrison, B. Tsang, W. Fishley, I. Harper, J. C. Joseph, M. R. Reed. Dose optimisation of intravenous tranexamic acid for elective hip and knee arthroplasty: The effectiveness of a single pre-operative dose. Bone Joint Res 2017;6:499–505. DOI: 10.1302/2046-3758.68.BJR-2017-0005.R1.
A fatal case of amphetamine induced ischaemic colitis
Authors: Green PA , Battersby CLF , Heath RM , McCrossan L
Published: August 2017

Amphetamine induced ischaemic colitis is an exceedingly rare presentation of amphetamine toxicity. The cases reported in the literature have described mild or transient disease. We present a fatal case of ischaemic colitis induced by amphetamine use in a 44-year-old woman who presented in extremis after a cardiac arrest en route to the emergency department. A short history of headache, abdominal pain, vomiting and agitation preceded her admission. Imaging revealed changes consistent with ischaemic colitis. Emergency laparotomy revealed widespread colonic necrosis necessitating a subtotal colectomy. Despite aggressive resuscitation and inotropic support from arrival, the patient deteriorated intraoperatively and died in the immediate postoperative period. Histology showed arterial type ischaemia/reperfusion injury of the area supplied by the superior mesenteric artery. The patient’s serum amphetamine level was 0.52mg/l (peak therapeutic levels <0.2mg/l). The postmortem examination concluded that amphetamines were the likely cause of the vasospasm, leading to profound colonic ischaemia.
Staple line oversewing during laparoscopic sleeve gastrectomy
Authors: Wang H , Lu J , Feng J , Wang Z
Published: August 2017

Introduction

This meta-analysis was performed to assess the possible benefits of staple line oversewing during laparoscopic sleeve gastrectomy.

Methods

A comprehensive search up to February 2017 was conducted on PubMed, the Web of Science™ and Embase™. All eligible studies were included, and the outcomes of staple line bleeding and leak, overall complications and operative time were pooled.

Results

A total of 7 randomised controlled trials involving 845 patients (428 cases and 417 controls) were analysed. There was no significant difference in staple line bleeding (relative risk [RR]: 0.858, 95% confidence interval [CI]: 0.343–2.143, p=0.742), leak (RR: 0.650, 95% CI: 0.257–1.644, p=0.363) or overall complications (RR: 0.913, 95% CI: 0.621–1.342, p=0.644) between the oversewing group and the patients who did not have oversewing. Oversewing of the staple line was associated with a longer operative time (weighted mean difference: 14.400, 95% CI: 7.198–21.602, p=0.000).

Conclusions

Oversewing the staple line during laparoscopic sleeve gastrectomy does not decrease the risk of staple line bleeding, leakage or overall complications but it does prolong the operative time.
Changes in bone turnover markers in primary hyperparathyroidism and response to surgery
Authors: Rajeev P , Movseysan A , Baharani A
Published: August 2017

Introduction

Involvement of the bone is common in primary hyperparathyroidism. The aim of the study was to assess bone turnover markers in response to surgery for primary hyperparathyroidism.

Methods

This was a retrospective study of patients diagnosed and treated for parathyroid disease between 2005 and 2012. Interventions studied were surgery and medical treatment. The main outcome measures studied were serum levels of calcium, intact parathyroid hormone (iPTH), bone-specific alkaline phosphatase, N-terminal cross-linking propeptide of type 1 procollagen (P1NP) and C-terminal cross-linking telopeptides of type I collagen (CTX), both pre- and postoperatively at 6 months and 1 year; bone mineral density (at the spine and hip assessed by dual-energy x-ray absorptiometry after 1 year of treatment.

Results

A total of 122 (110 female, 12 male) patients (age range 25–91 years) underwent treatment for parathyroid disease during the study period; 30 patients were treated conservatively and 92 proceeded to surgery following localisation studies. Following surgical intervention, P1NP dropped significantly from a mean of 64.68 ng/ml (standard deviation, SD ± 68.07 ng/ml) preoperatively to 26.37 ng/ml (SD ± 20.94 ng/ml) and CTX from 0.69 pg/ml (SD ± 0.44 pg/ml) to 0.15 pg/ml (SD ± 0.16 pg/ml) at 6–12 months (P < 0.0001). This change was reflected in improvement in bone mineral density (T scores) of the hip and spine by 43% (P < 0.03) and 38% (P < 0.01), respectively, following surgery. In patients treated conservatively (n = 30), there was no improvement either in the bone turnover markers or bone densitometry scans.

Conclusions

Surgery improves bone density in patients with parathyroid disease. Improvement in serum bone turnover markers is seen following parathyroidectomy. The association with bone density needs further evaluation in larger studies.
Malignant bone tumours of the foot
Authors: Yang P , Evans S , Bali N , Ramasamy A , Evans R , Stevenson J , Jeys L , Grimer R
Published: August 2017

Introduction

Malignant osseous foot tumours are uncommon. Their oncological outcomes have been poorly documented in the literature so far. The aim of this study was to establish the incidence and to evaluate the oncological outcomes of such patients.

Methods

Our large orthopaedic oncology database was used to review 70 malignant osseous foot tumour patients.

Results

The age at diagnosis of malignant osseous foot tumours demonstrated a bimodal distribution peaking in the second and eighth decades of life. Overall, 55 primary malignant bone tumours of the foot (79%) were identified. The median duration from onset of symptoms to diagnosis was 52 weeks (interquartile range [IQR]: 17–104). Eight primary tumours (15%) underwent an accidental excision (ie intralesional excision of a malignant bone tumour where some of the tumour has been left behind, also known as a ‘whoops procedure’) prior to referral to our unit. Forty-six patients (84%) underwent surgery overall and thirteen of these developed recurrence or metastases. Seven of eight patients with a previous accidental excision underwent amputation. Fifteen osseous metastatic foot lesions were identified. The median length of foot symptoms to diagnosis was 24 weeks (IQR: 20–36 weeks). The median time to death following diagnosis of osseous foot metastases was 20.1 months (IQR: 11.3–27.8 months).

Conclusions

A high index of suspicion and awareness of clinical features of malignant osseous foot tumours are both essential to avoid diagnostic delays. Amputation is associated with a respectable outcome for patients who have undergone previous accidental excisions.
Pyomyositis of the pectineus muscle in an adolescent male
Authors: Hiddema J , Hassan S , Mangat N , Siddiqui N
Published: August 2017

The ‘irritable hip’ continues to pose a challenge for clinicians. Even with predictive clinical algorithms, decision making can be difficult. Emergency treatment is required if septic arthritis is suspected. Other differential diagnoses such as transient synovitis, pyomyositis of the pelvic girdle muscles and osteomyelitis must be considered in order to help guide appropriate investigations and allow early treatment.

We report the case of a 13-year-old boy presenting to our institution with an acutely painful left hip but still able to weight bear. Despite a fever and raised inflammatory markers, the clinical examination did not correspond to that of an infected hip joint. Urgent magnetic resonance imaging (MRI) confirmed pyomyositis of the pectineus muscle. To our knowledge, this is the first reported case in the literature. The child was treated with seven days of intravenous antibiotics. There was a good clinical response as well as normalisation of the C-reactive protein level and white cell count. The patient was discharged home with a further week of oral antibiotics. Follow-up MRI at two weeks demonstrated a dramatic reduction in the inflammation of the pectineus. At the clinic follow-up appointment, the child was asymptomatic and back to normal function.

Pyomyositis is typically found in tropical areas but its rates in temperate climates have been rising. It usually affects large groups of muscles such as the quadriceps and gluteal muscles. MRI is the gold standard investigation. If diagnosed early, the condition can be treated successfully with intravenous antibiotics alone. Given the widespread availability of MRI, we recommend its increased use to distinguish between pyomyositis and other paediatric hip pathologies.
Getting it ‘write’ first time
Authors: Alderson Derek
Published: August 2017

Our new President talks to us about writing to-do lists and letters to patients – with absolutely no ‘Surgspeak’!
How flexible can training be?
Authors: Dean Erin
Published: August 2017

Erin Dean explores the perks and pitfalls of part-time training.
Acervo documental da Colegiada de São Cristóvão de Coimbra
Authors: Tavares Anita Pereira , Morais Carlos Manuel da Costa
Published: August 2017

Este trabalho tem por objetivo apresentar a descrição do arquivo da Colegiada de São Cristóvão de Coimbra existente no Arquivo da Universidade de Coimbra, o qual abrange o período de 1511-1842. O arquivo desta Colegiada é composto por 24 livros e 7 caixas de documentação avulsa, em originais e cópias. Entre as várias tipologias destacam-se as escrituras diversas relativas à gestão de património, os autos e sentenças e os tombos de demarcação, medição e reconhecimento de prazos.
Fundos pessoais e familiares do Arquivo da Universidade de Coimbra – ponto de partida para questões e reflexões
Authors: Guedes Gracinda Maria Ferreira
Published: August 2017

Tendo como ponto de partida os fundos pessoais e familiares existentes no Arquivo da Universidade de Coimbra (AUC), o presente artigo versa sobre a importância destes fundos e a especificidade que resulta do caráter singular inerente ao seu produtor. Abordaremos, ainda, a metodologia de análise e o tratamento a que devem ser submetidos, de modo a preservar a sua estrutura e a revelar, através da descrição arquivística, o seu contexto de produção. No decurso desta análise, não deixaremos, ainda, de aflorar as questões e reflexões que, amiúde, ensombram/interpelam o espírito do arquivista no decurso da identificação e organização dos fundos e na sua divulgação.
Critérios para os resultados do ensaio uniaxial de carga repetida de misturas asfálticas em laboratório a partir do desempenho em campo
Authors: Bastos Juceline Batista dos Santos , Soares Jorge Barbosa , Nascimento Luís Alberto Herrmann
Published: August 2017

A busca por critérios que auxiliem na seleção de misturas asfálticas em laboratório que resistam à deformação permanente em campo motivou o desenvolvimento desta pesquisa. A partir dessa motivação, o objetivo foi avaliar a relação entre os dados experimentais disponíveis no Brasil de deformação permanente em laboratório (uniaxial de carga repetida) com aqueles encontrados em campo [Afundamento em Trilha de Roda (ATR)], com vistas ao refinamento de critérios para os resultados do ensaio laboratorial em função do tráfego. A partir da organização do banco de dados de 12 trechos experimentais monitorados, utilizou-se o método estatístico dos clusters para indicar 4 categorias de Flow Number (FN). Considerou-se que FNs inferiores a 100 resistem apenas a um tráfego leve; FNs acima de 100 são indicados para um tráfego médio; superior a 300 para um tráfego pesado; e acima de 1000 para um tráfego extremamente pesado. Destaca-se ainda a relevância da continuidade do monitoramento de pistas experimentais no Brasil. Desta forma, as informações possibilitarão a verificação contínua e o refinamento dos critérios propostos nesta pesquisa.
The Adjective as Ideology Indicator in Postwar School Grammars of the Greek Ethnic Minority Schools in Albania
Authors: Jani Jani
Published: August 2017

This presentation aims to a primary approach to the role the postwar textbooks of grammar of the Greek language had and were intended for the National Greek Minority in Albania. We are not referring to grammar acknowledgement, but to the part of the education process that has to do with the conformation of children and the character formation of character and consciences. It is obvious that every educational system is part of an administrative state apparatus controlled by socio-political forces. So the new political system that was installed in the country after the 1945, settled as a key priority the conformation of the new man with communist ideals. These objectives were primarily reflected in textbooks. In our presentation we analyze the role of language structures in the implementation of this objective. Within the language structures and language options of speakers, various social or ideological messages are included. We focus our analysis on the “adjective”, as we consider it to have largely registered the ideology of a society or a political system.
The Concept of the Servant of God and Isaiah’s Connection: A Politico-Theological Response to Recession
Authors: Obielosi Dominic C.
Published: August 2017

To say that Nigeria is yet to be met with great and good news of feats and development since after independence is not an exaggeration. The true face is that the little the colonial masters did before they handed over is what we have enjoyed. Now most of them have dilapidated. There is no sign of a better future. One wonders what happened to Nigerian Telecommunications. There was a time we have phone boots on the streets. With a coin one can conveniently make calls. Fax machines were available in offices for private and public use. One can even send a telegram. To say that GSM and internet replaced them is an escapist manoeuvre. Think of Lagos Main Land Bridges, Niger Bridge, trains etc. People attribute the cause to corruption. The leaders are singled out as corrupt. But who are the leaders? People tend to limit their searchlight to the president, Senators and governors. Evidently, they are not the managers of parastatals. They are not the law enforcement agencies etc. Yet, the truth is still obvious that a good leader can always push his subjects to a set vision and mission. What Nigeria needs is a servant leader. This paper is structured to examine in the main, the concept of the Servant of God, a servant leader as envisioned by Prophet Isaiah in what is popularly known as the Servant Songs. It is the belief of the researcher that a leader of such calibre is what Nigeria needs even in her recession to move forward.
Effect of the duration of high air temperature on cow’s milking performance in moderate climate conditions
Authors: Herbut Piotr , Angrecka Sabina , Godyń Dorota
Published: August 2017

The main aim of the presented investigation was to determine the effect of the air thermal conditions variability on cow’s milking performance in summer in a moderate climate. The analyses covered the summer months of 2012-2013 (June-September) and shorter, several-day periods characterized by the times of elevated or high air temperatures and by the declines and increases in milking performance. The research was conducted in a free stall barn for Holstein-Friesian cows. The study showed that the thermoneutral temperature for high yielding cows decreases gradually with the registered increasingly warmer summer periods. The decreases in milk yield already commence at an air temperature equal to 20°C and also depend on the dairy cattle sensitivity. July and August, with a high number of hot days, caused that in September the cows responded faster to a worsening of thermal conditions and the decline in milking performance happened almost simultaneously with the air temperature change, at milking yield recovery after the period of 3-4 d (r=-0.84, P<0.04). The percent duration in the individual temperature ranges which caused a decrease of milk yield was also determined. In June, and at the beginning of July, this was 90% of the time with temperatures above 20°C, and simultaneously 45% above 25°C occurred to milking performance decrease (r=-0.89, P<0.02). In September, this was only 30% of the time with temperatures above 20°C (r=-0.91, P<0.01).
Dose-Dependent Influence of Dietary Cu-Glycine Complex on Bone and Hyaline Cartilage Development in Adolescent Rats
Authors: Tomaszewska Ewa , Dobrowolski Piotr , Kwiecień Małgorzata , Winiarska-Mieczan Anna , Tomczyk Agnieszka , Muszyński Siemowit , Gładyszewska Bożena
Published: August 2017

Administration of the amino acid copper (Cu) complex ensures higher Cu bioavailability through enhanced absorption from intestine and decreases the dietary Cu level, compared to the recommended Cu dose. The objective of this study was to investigate the effect of Cu-low diet on the bone development in adolescent rats. Male rats at the age of 6 weeks were used in the 12-week experiment. The control diet provided the required Cu level from sulfate (S-Cu) and other diets were supplemented with Cu as a glycine complex (Cu-Gly) at 25%, 50%, 75%, and 100% of daily requirement. After the 12-week treatment, rats from the Cu-Gly100 group were heavier, compared to the other groups. The copper and calcium plasma and bone concentrations of the rats in the groups treated with the organic form of Cu (irrespective of its dose) was similar to the control values noted in the rats administered with S-Cu. A decrease in the femur weight and length was observed in the Cu-Gly75 and Cu-Gly50 groups. Cu-Gly increased the cross section area, mean relative wall thickness, and cortical index only in the Cu-Gly75 group. A decrease in the ultimate strength, elastic stress, and ultimate stress was noted in the Cu-Gly100 and Cu-Gly75 groups. In the Cu-Gly50 group, a decrease in the ultimate stress and an increase in the maximal elastic strength and bending moment were noted. Adolescent rats treated with Cu-Gly at a Cu-deficient level exhibited a dose-dependent strongly osteoporotic cancellous bone. Lower proteoglycan content was found in groups fed the Cu-low diet. In the control rats supplemented with S-Cu, there was no evident gradient in safranin O staining. It is difficult to indicate which dose of the Cu-Gly complex among the investigated Cu-poor diet exerted a positive effect on bone metabolism. It appears that the use of this Cu-Gly complex at a significantly reduced dose than S-Cu at the recommended dose did not inhibit the development of bone and hyaline cartilage in adolescent rats.
Contributions to the thermophilous fringe communities (Trifolio-Geranietea sanguinei) in Belarus
Authors: Iakushenko Dmytro
Published: August 2017

The paper presents the results of phytosociological studies on thermophilous forb fringes conducted in August, 2012, in Belarus. A dataset of 31 relevés is analyzed, 3 associations and 1 community of 3 alliances and 3 orders of the class Trifolio-Geranietea sanguinei T. Müller 1962 are distinguished. For the first time for this area, the association Galio borealis- Geranietum sanguinei Tüxen 1967 is reported and characterized. The results of syntaxonomical interpretation are discussed based on chorological data.