bluuebunny/crossref_metadata_2025 huggingface dataset:
Relevance of Signs and Symptoms in the Prognosis of Patients with Lumbar Disc Herniation
Authors: Falavigna Asdrubal , Righesso Orlando , Teles Alisson Roberto , da Silva Pedro Guarise , Cardoso Suelen , Chalá Fernanda
Published: May 2015

Introduction

Lumbar disc herniation (LDH) is currently a prevalent pathology which leads to physical, psychological, and social limitations for the patient. The most frequent signs and symptoms are lumbocyatalgia, motor and sensitive disorders, and Lasègue sign. In patients with LDH refractory to medical treatment, discectomy is the standard procedure to improve the symptoms. The objective of this study is to study the prognostic relevance of signs and symptoms in patients with LDH refractory to medical treatment.

Materials and Methods

a systematic review was performed in the main biomedical databases, searching for articles that studied the percentage of improvement and prognostic value of the preoperative signs and symptoms of patients with LDH. The signs and symptoms evaluated were lumbar pain, leg pain, motor and sensitive disorders and Lasègue sign.

Results

Some authors found that the preoperative low back pain was a negative predictor of outcome after LDH surgery whereas others did not find a correlation with prognosis. The more intense the leg pain the better were the results as the duration of the symptoms was less than a mean time of 6 months. The sensitive deficit in the leg and Laségue sign were usually reported as positive prognostic factors. The different study designs and instruments to assess the outcome explained some disagreement observed in the literature.

Conclusion

The literature shows that the success rate in surgery of patients with LDH refractory to medical treatment is correlated with the absence of lumbalgia, the presence of cyatalgia over up to 6 months, the sensitive deficit present alone or associated with MD, and the presence of a positive Lasègue sign during the preoperative period.
Reconsideration of the Definition of Chiari Malformation Type 1: A Position of Cerebellar Tonsil and Brainstem
Authors: Murakami Tomohiro , Inoue Michio , Matsumura Shigeki
Published: May 2015

Introduction

Chiari malformation type 1 (CM-1) is diagnosed by more than 3 or 5 mm caudal displacement of the cerebellar tonsils through the foramen magnum. This definition is a simple and easy method neuroradiological, but it is obscure which is 3 or 5 mm. The purpose of this study is to investigate the incidence of new outpatients diagnosed as CM-1 using this definition and to analyze their clinical symptoms and radiological features.

Patients and Methods

We had 3,787 new outpatients in our neurosurgical hospital in 2013. In whom, 3,533 patients examined head CT or MRI, and were studied retrospectively. We diagnosed Chiari malformation type 1 using more than 3-mm tonsillar herniation. Their clinical symptoms and the following measurements were analyzed: the distances from the pontomedullary junction (PMJ) to the basion (PMJ-Ba), PMJ to the basion–opisthion (PMJ–BO), the distances from the basion–opisthion to tip of the cerebellar tonsil, from BO to the obex (BO–obex), and from basion to opisthion, the clivoaxial angle, and the length of the clivus using T1-weighted sagittal images.

Results

There were 19 patients with CM-1 aged from 10 to 54 years (mean: 35.0 years) consisted of 6 men and 13 women. In whom, 10 patients with tonsillar herniation of less than 5 mm were determined as T3 group (T-3) and remaining 9 patients as T5 group (T-5). No patients had syringomyelia. All the patients had clinical symptoms or signs related to CM-1 except two patients in T3 after head injury. Headache was the most common symptom. The distances of PMJ–Ba, PMJ–BO, BO–obex, BO, the clivoaxial angle, and the length of the clivus were similar between both the groups.

Conclusions

The incidence of new diagnosis of CM-1 was 0.53%. Two patients in T3 group without symptoms associated with CM-1 were diagnosed incidentally. Chiari malformation type 1 should be diagnosed based on not only tonsillar herniation but also clinical symptoms and other MRI findings such as brain stem ptosis.
The Epidemiological Profile of a Middle-Aged Population with Low Back Pain in Southern Brazil
Authors: Falavigna Asdrubal , Bossardi Julia Bertholdo , Conzatti Lucas Piccoli , de Castilhos Isadora
Published: May 2015

Introduction

Low back pain (LBP) is the most prevalent musculoskeletal condition and the most common cause of disability in developed nations. The aim of this study is to assess the prevalence and the general characteristics of LBP in a middle-aged population living in southern Brazil.

Materials and Methods

Cross-sectional study developed in a city located in southern Brazil. Data were collected from 1,005 individuals at randomized public locations. A protocol was designed to evaluate the following the general characteristics of the population: age, gender, level of education, socioeconomic status, body mass index (BMI), occupation, smoking, physical activity, anxiety, and depression. After the initial evaluation, the individuals were asked if they had LBP at least once in their lifetime. Those who answered “yes” continued the questionnaire that evaluated pain intensity, characteristics, and related disability.

Results

The mean age was 33.74 years ( ± 14.76 years) and 61.6% of the participants were female. Overall, 72% of the participants had LBP at least once in their lives. The median of VAS intensity of pain was 4 (range, 2.0–5.25). Female gender ( p = 0.006) and anxiety ( p < 0.001) were higher in those with LBP.

Conclusion

LBP is a highly prevalent condition in a middle-aged population of the South Region of Brazil. The variables related to these symptoms are higher levels of anxiety and female gender.
The Effectiveness of the AOSpine Project of Education in Research: Changing Paradigms, Provoking Ideas, and Innovating the Mindful Practice
Authors: Falavigna Asdrubal , Silva Alvaro , Martins Delio , Jimenez Jose , Guyot Juan Pablo
Published: May 2015

Introduction

The way to increase innovation in mindful practice in a region without a culture in scientific investigation is through implementation of the Research Curriculum that is based on the competencies and learning outcome. No institutions have a Research Curriculum based on competence and learning outcome as guide to improve knowledge in research. The objective of this study is to describe the effectiveness of the project of education in research and the way to deliver this information effectively to those who aim to further improve their knowledge and participation in research.

Materials and Methods

the AO Research Curriculum uses the competency-based approach that aligns the following four components: (1) knowledge in research, (2) performing research, (3) specialized technical professional support, and (4) assessment to identify needs and track progress. The content of the curriculum was delivered using the most appropriate learning methods and techniques from the following four perspectives: (1) e-learning methods, (2) specific research symposiums, (3) precourses before AO activities, or as (4) specific lectures and structural presentations within the course, symposiums, or seminars. Research mentoring projects and joint publications are an objective way to measure the effectiveness of the project, as it represents the capacity to perform research. This protocol was applied in spine surgeons and university students.

Results

The survey of AOSpine Latin America members showed a low level of knowledge regarding research combined with a high motivation to learn. The organized competences, learning outcomes, and syllabus of the knowledge in Research promoted active learning and engagement of the members during AOSpine activities. These activities resulted in an increased membership, the participants were grateful when they understood the usefulness of research, and it was the best way to expand the AO product at the University, not only in the undergraduate courses, but also at the postgraduate levels as learning about tools in research and needs are the same for several areas (medicine, nursing, engineering, biology, and law).

Conclusion

The education in research project showed to be effective. The learning outcomes gained by the participants following completion of this project were recognized concerning where and how they can best obtain reliable information, perform a critical literature review, choose validated instruments to measure the patient's disease, obtain reliable feedback regarding the effectiveness of our surgical activity, and achieve a better understanding of the positive influence of the research on the medical routine. The “publication of results” is only a consequence of an attitude toward scientific investigation.
Thirteen Years of Scientific Production on Medline by Spine Surgeons in Latin America, Africa, Oceania, and Asia
Authors: Falavigna Asdrubal , da Silva Pedro Guarise , Wurzius Francine , Merlin Luiz Henrique , Radaelli Lucas , Guyot Juan Pablo , Dozza Diego , Martins Delio , Yoshiharu Kawaguchi , Botelho Ricardo Vieira , Teles Alisson Roberto , Silva Alvaro , Avila Jose Maria Jimenez , Defino Helton Luiz Aparecido , Riew K. Daniel
Published: May 2015

Introduction

Articles published on spine pathologies have been very useful, providing important information to improve diagnosis and choice of treatment. This information is even more important when it comes from the different continents, because it shows that information can be provided and applied by physicians worldwide to solve medical problems encountered daily.

Materials and Methods

A literature search of publications by spinal surgeons in Latin America, Africa, Oceania, and Asia on topics concerning the spine or spinal cord was performed using an online database; Pubmed.gov. The results were limited to articles published from January 2000 to December 2013. The variables studied were year of publication, scientific journal that published the papers, neurosurgical or orthopedic department where the study was done, the type of study, the main pathology studied, the Oxford classification, the journal impact factor (IF), and the type of articles that were entered on Excel sheet.

Results

A total of 43,711 articles were identified after the MEDLINE search. Most of the articles were excluded based on information provided in the title and abstract. This study comprised 5,846 articles published in the Medline database by Latin America, Africa, Oceania, and Asia spine surgeons from 2000 to 2013. During this period, 5,102 articles were published in Asia, 410 in Latin America, 138 in Africa, and 79 in Oceania. There was a correlation between the number of publications and the articles classified at the Oxford level of evidence 1, 2, and 3 with significant results and positive association.

Conclusion

This study showed a growth in the number of publications in the past 13 years by spinal surgeons in Asia, Latin America, Africa, and Oceania. It is necessary to discuss a way to increase quantity and quality of scientific publications, mainly by improving education in research.
Minimally Invasive Surgery for Metastatic Spine Disease
Authors: Kumar Naresh
Published: May 2015

Background

Metastatic spine disease (MSD) is a new epidemic and it can lead to significant morbidities such as disabling pain and neurological deficits. A multidisciplinary approach including medical oncologists, radiation oncologists, and spinal surgeons is mandatory as the treatment options are constantly evolving and are of much debate. Current evidence shows that best clinical outcomes are achieved by surgery, especially when it is combined with postoperative radiotherapy. This winning combination, however, is only successful when the two modalities are appropriately timed. Minimally invasive approaches in MSD have been producing good outcomes in terms of pain reduction and neurological improvement, comparable to open surgery. To make surgical management an appealing choice in MSD, surgical morbidity needs to be kept as low as possible, especially when planning oncological treatment around surgery.

Methods

We discuss the “epidemiology and incidence”; “clinical presentation of MSD” and treatment modalities. We derive that radiotherapy was established as a treatment modality in the 1980's. In this review, we discuss main treatment modalities such as radiotherapy and chemotherapy in brief to improve the understanding of evolution of surgical treatment. Open surgery for MSD has evolved from a conservative destabilizing operation such as laminectomy to front and back open surgery with instrumentation. We then trace that minimally invasive surgery has slowly evolved to find its place in the management of MSD.

Results

A variety of minimally invasive approaches in MSD have shown encouraging results for early wound healing, reduced intraoperative blood loss, and shortened hospital stay while producing good outcomes in terms of pain reduction and neurological improvement, comparable to open surgery. Evolving from this review, we also provide our treatment algorithm to operate on patients with MSD, which keeps in view with the clinical presentation and radiological appearance of spinal cord compression. We would then discuss the advancement of surgery from open to minimal invasive approach. We finally establish a treatment algorithm, which encompasses both open and MIS surgery.

Conclusion

We believe that MIS is beneficial in well-selected group of patients suffering from clinically significant instability with intractable back pain or motor deficits. Our treatment algorithm for symptomatic MSD is suggested as a guideline as these are high-risk cases and treatments should be individualized with respect to prognosis, premorbidity, and patients' choice. We can improve patient's quality of life through minimally invasive intervention. The introduction of MIS can be a game changer in the treatment of MSD because of the less perioperative morbidity and allowing earlier radiotherapy and/or chemotherapy.
Surgical Technique and Outcome in the Treatment of Spinal Ependymomas: A Retrospective Analysis of 23 Cases Treated
Authors: Zelletta Nicola , Iodice Savino , Di Benedetto Mariagrazia , Cecchini Giulio , De Tommasi Antonio
Published: May 2015

Introduction

Spinal ependymomas are from 3 to 6% of all tumors of the central nervous system and 15% of all spinal cord tumors. The WHO classifies ependymomas in the following four distinct subtypes: subependymoma, ependymoma myxopapillare, classic ependymoma, and anaplastic ependymoma. Spinal ependymomas are typically present in adults and include the following two subtypes: myxopapillary and classic. This review reports the data obtained on 23 patients treated for spinal ependymoma at our department of Neurosurgery from 2000 to 2012, describing the type of surgical treatment and clinical outcome with a mean follow-up of 4 years.

Materials and Methods

Among 53 cases of intramedullary tumors, 23 (43%) were ependymomas. The average age of patients with spinal ependymoma was 42.65 years with a range between 18 and 71 years. The main locations were cauda equina (70%), medullary cone (13%), and cervical region (13%). Neurological examination of each patient at the entrance, in the postoperative and last –follow-up was determined using the McCormick grading scales. All patients underwent surgical removal of the tumor and the McCormick grading was evaluated with multiple follow-up. The extent of resection and surgical results were evaluated with postoperative MRI.

Results

As evidenced in some tables, we performed gross-total removal (GTR) in 21 patients (91%) and subtotal removal (STR) in only 2 patients (9%). None of patient was treated with adjuvant radiotherapy and/or chemotherapy. There were no recurrences. No patient's follow-up showed signs of postoperative instability of the spine. Some particular surgical techniques in removal of this tumor are reported.

Conclusion

This study underlines some aspects of the surgical treatment of spinal ependymomas. Patients who underwent total removal had a clear neurological improvement. As evidenced in tables, patients who had McCormick II–III at the entrance improved significantly. To achieve good functional results, an early diagnosis and a prompt surgery are important. In case of a good surgical removal, postoperative radiotherapy is not indicated.
Mini-Invasive Treatment of Monolevel Dorsolumbar Metastatic Lesions by Radio Frequency Ablation and Augmentation: Preliminary Experience in a Series of 10 Cases
Authors: Guli' Carlo , Basile Luigi , Maugeri Rosario , Iacopino Gerardo Domenico
Published: May 2015

Introduction

Technological advances have allowed the development of several “minimally invasive” surgical techniques in the treatment of metastatic spinal tumors. The authors analyzed the effectiveness and impact on quality of life in the short and medium term using radiofrequency ablation and injection of PMMA in the treatment of chronic low back pain in a series of 10 patients suffering from a monolevel metastatic lesion of the dorsolumbar spine.

Patients and Methods

In 2013, at our Department, 10 patients affected by dorsolumbar monolevel metastatic lesion, in advanced disease, were selected to undergo treatment of transpedicle radio frequency ablation and injection of PMMA. Overall, nine patients were treated by percutaneous technique as they had an already known and suitably treated primary lesion, good performance status, chronic low back pain (mean low back VAS: 8.5), no neurological deficit. Only one patient came to our observation for the presence of low back pain and progressive weakness in the lower limbs, in the absence of already known primitive tumor. In this case, an open surgery with decompression, posterior fusion, and then ablation with augmentation was performed.

Results

Patients treated percutaneously showed an improvement in pain symptoms with a significant reduction in the VAS (post-op VAS: 3.5) in the absence of new-onset neurological deficit. The patient treated in “open surgery” had a reduction in pain with improvement of neurological function of the lower limbs making it possible walking. All the patients were sent to the oncologist for medical care.

Conclusions

The radiofrequency thermocoagulation with injection of PMMA seems a good strategy, as palliative treatment, in patients with metastatic advanced disease, with low back pain in the absence of significant neurological deficit when suffering from single level metastatic somatic lesion, ensuring both the effectiveness because of the neoplastic tissue ablation and the augmentation. This allows a gain of QOL in critically ill patients in terms of reduction of pain symptoms.
Surgical Outcomes of the Nondystrophic Scoliosis Secondary to Neurofibromatosis Type I versus Curve-Matched Adolescent Idiopathic Scoliosis
Authors: Jin Mengran , Liu Zhen , Zhu Zezhang , Wang Bin , Yu Yang , Qian Bang-Ping , Sun Xu , Zhu Feng , Qiu Yong
Published: May 2015

Introduction

Patients with nondystrophic scoliosis caused by NF-1 mostly require surgery. Although the radiographic findings in patients with nondystrophic scoliosis secondary to NF-1 are similar to those in patients with idiopathic scoliosis, evidence-based surgical guidelines, and long-term results are not as established as those for patients with AIS. The objective of this study is to compare the surgical outcomes of nondystrophic scoliosis secondary to neurofibromatosis type I (NF-1) and curve-matched adolescent idiopathic scoliosis (AIS) to identify the feasibility of treating nondystrophic NF-1 using the same principals as AIS and seek for potential surgical improvement.

Patients and Methods

A total of 19 adolescent patients with nondystrophic scoliosis secondary to NF-1 and 19 curve-matched patients with AIS were recruited into the study. Preoperative immediately and 6-month postoperative, and follow-up radiological data were reviewed and analyzed. The mean age of patients with NF-1 was 14.4 ± 1.3 years compared with 15.7 ± 3.1 years of patients with AIS. The main curves were 70.1 ± 14.4 and 75.9 ± 11.3 degrees for the patients with NF-1 and AIS, respectively. The minor curves were 37.4 ± 14.2 and 39.5 ± 13.4 degrees for the patients with NF-1 and AIS, respectively. The mean follow-up durations were 33.8 months (range, 24–60 months) and 31.6 months (range, 24–41 months) for the NF-1 and AIS groups, respectively.

Results

After surgery, the nondystrophic NF-1 group had less main curve correction (62.3 ± 15.5 vs. 68.9 ± 13.2%, p < 0.001), less apical vertebral translation (AVT) correction (−20.3 vs. −22.9 mm, p = 0.019), and less trunk shift (TS) correction (−7.8 vs. −16.0 mm, p < 0.001). On the sagittal plane, significantly more correction of sagittal vertical axis (SVA) (−19.3 vs. −10.0 mm, p = 0.041) was noted in the nondystrophic NF-1 group. A significant trend to worse was observed in NF-1 group during the follow-up period. At the final follow-up, significantly more loss of correction (5.4 vs. −0.8 degrees, p = 0.013) of the main curve was observed in the nondystrophic NF-1 group.

Conclusion

Current results suggest that satisfactory short-term surgical outcomes can be achieved in both NF-1 patients with non-dystrophic scoliosis and patients with AIS while sharing the same management strategy. However, the long-term result of nondystrophic scoliosis in patients with NF-1 is not identical to that of patients with AIS. Despite all this, it is fair to suggest that applying the surgical strategy of AIS in treating nondystrophic scoliosis secondary to NF-1 should be acknowledged.
Midline Minimally Open Interlaminar Lumbar Discectomy and Interspinous-Posterolateral Fusion as an Option to Treat Recurrent Lumbar Disc Herniations in Patients with Axial Instability
Authors: Tellez-Gtz Maximino
Published: May 2015

Introduction

Numerous techniques have been used to treat lumbar recurrent disc herniations. Most of them offer an in site reintervention with or without treating the segmental instability. Currently, the “TLIF” technique stands as the premier option to treat both the symptoms and the instability.

Objective

We present our series of cases using the Midline Open Interlaminar Lumbar Discectomy and interspinous-posterolateral fusion technique as an option to treat recurrent disc herniations and flexion–extension instability. We design this prospective study.

Patients and Methods

A total of 19 patients (14 men and 5 women) with recurrent lumbar disc herniation who presented with axial pain and radiculopathy; ages 36 to 62 years (mean, 46 years) were included in the study. The affected levels were L4–L5 n11, L5–S1 n8, and L3–L4 n1; all the patients were monitored transoperatively and classified using ODI, VAS, and MacNabb clinical outcome measurements. We used the Lans-ASPEN interspinous device for the interspinous fixation and calcium phosphate as a graft. All our cases were transoperatively monitored using SEPs and EMG.

Results

Surgical time was 85 to 180 minutes (mean 120 minutes), EBL 20 to 300 mL (mean 50 mL), hospital stay 24 hours, pre-VAS (mean 8.16), first week (mean 2.67), 4 weeks (mean 1.11), 6 months (0.58), 1 year (0.76); ODI pre-op (mean 41.28), post-op 6 months (mean 18.1); MacNabb; excellent 47%, and good 52.6%.

Conclusion

The Midline Minimally Open Interlaminar Lumbar Discectomy and interspinous-posterolateral fusion it is a safe, reproducible, and resolute technique for patients with recurrent lumbar disc herniation and flexion–extension instability. We also recommend using neurophysiology surveillance on a regular basis to reduce the risk of complications and increase the clinical improvement rate. All the postoperative neurophysiology readings were positive in amplitude (mV) comparing with the pre-op registry. However, further normalization of the data are required to consider it clinically relevant.
Level of Evidence and Grade Recommendation for the Diagnosis of Patients with Pseudoarthrosis in Traumatic Fractures of the Thoracolumbar Spine (T11–L2): Systematic Review
Authors: Garcia Dávila Jorge Arturo
Published: May 2015

Objective

This study aims to study the through a systematic review to identify the level of evidence and grade of recommendation for the diagnosis of nonunion in patients with traumatic fractures of the thoracolumbar spine.

The thoracolumbar spine fractures account for more than 50% of all fractures of the spine and a large proportion of acute injuries of the spinal cord, so predictable is the presence of nonunion or malunion in this type of fracture. Although some articles mention as one of the complications in these injuries to the nonunion, in national or world literature, there are no consistent data in terms of diagnosis and/or percentage. Therefore, we did a systematic review looking for the level of evidence and grade of recommendation for the diagnosis of nonunion in this type of injury.

Method

A study of systematic review designed according to the recommendations of the Cochrane Group were identified and searched for keywords, reason for the study, according to the criteria of the Medical Subject Heading (MeSH), which were researched through the Boolean algebra, using managers in primary and secondary search of the complete discharge of items. Articles obtained according to the search criteria were assessed in a standardized manner and blinded by two observers using the criteria of Jadad and Delphi. The statistical analysis was a description of the variables and then identify the values of agreement between observers using kappa values, considering how reliable the values of kappa = 0.80, p value = 0.05.

Results

The data provided by the two observers, yielded the following results: by type of study: zero articles as case reports, seven articles as a series of cases, six review articles, two clinic assays, and one cohort study. Regard to level of evidence: 14 articles with evidence level IV and 2 articles with evidence level III. With regard to recommendation grade: 14 articles with recommendation D and 2 articles with recommendation C. As for the statistical analysis, the percentage of agreement for Jadad was 100% and for Delphi 87%. The intraclass correlation coefficient for level of evidence and recommendation grades was 0.939.

Conclusions

(1) There is a low level of evidence (grade IV) and grade of recommendation (D) for the diagnosis of pseudoarthrosis in traumatic fractures of the thoracolumbar spine. (2) No single study is sufficient for the diagnosis of pseudoarthrosis in these fractures. (3) The literature on the problem of pseudoarthrosis in thoracolumbar spine are more focused on the pathology degenerative than traumatic thoracolumbar fractures. (4) Systematic reviews found no reference to this pathology. (5) Could not be diagnosticating the incidence of this pathology in the service of this hospital due to at not systematic clinical and radiographic criteria for the diagnosis of pseudoarthrosis in fractures of the thoracolumbar spine.
Effects of urban configuration on the wind energy distribution over a building
Authors: Herrmann-Priesnitz Benjamín , Calderón-Muñoz Williams R. , LeBoeuf Richard
Published: May 2015

A numerical study to investigate the wind energy potential for various building configurations is presented. Steady-state incompressible flow simulations were performed using the finite volume method of ANSYS Fluent with the k-ε turbulence model. A simplified city model was used to study the flow behavior over a building rooftop for various configurations of the upwind structure. Results show an increase of up to 29% in the available energy compared to the free stream due to variations in the dimensions of the separation bubble over the rooftop. This study shows the influence of building configuration on the wind resource near buildings and how it can affect the feasibility of a small-scale wind turbine project.
Photoconductivity oscillations in surface state of three-dimensional topological insulator subjected to a magnetic field
Authors: Shao J. M. , Yao J. D. , Yang G. W.
Published: May 2015

We describe a theoretical study of the terahertz (THz) radiation field-induced dc transport response of the surface state of a 3D topological insulator that has been subjected to a perpendicular magnetic field. Using the Landau–Floquet state and linear response theory, we obtain the photoconductivity characteristics for various types of polarized THz field. The longitudinal photoconductivity shows a clear oscillatory dependence on ω/ωB, where ωB=vF2eB/ℏ. This oscillation occurs because of the oscillatory structure of the Landau density of states and occurs in agreement with the photon-assisted transitions between the different Landau levels. The THz field's polarization has a major influence on the photoconductivity. A linear transverse polarization will lead to the most obvious oscillation, while the circular polarization is next to it, but the longitudinal polarization has no influence. We also discuss the broadening effect on the impurity potential and its influence. The findings with regard to the interactions between topological insulators and THz fields actually open a path toward the development of THz device applications of topological insulators.
On the double diffusive convection flow of Eyring-Powell fluid due to cone through a porous medium with Soret and Dufour effects
Authors: Khan Najeeb Alam , Sultan Faqiha
Published: May 2015

This paper devotedly study the double diffusive Darcian convection flow of Eyring-Powell fluid from a cone embedded in a homogeneous porous medium with the effects of Soret and Dufour. Arising set of non-linear partial differential equations are transformed through a suitable self-similar transformation into a set of nonlinear ordinary differential equations. Further, the numerical and the analytical solutions of the governing equations are elucidated by using numerical method as well as non-perturbation scheme. Numerical values are presented through tables for the skin friction coefficients, Nusselt number and Sherwood number. The obtained results are validated by comparing the analytical results with previously published results obtained by bvp4c for the numerical values of physical quantities. The effect of various parameters on the velocity, temperature and concentration profiles is discussed and also shown graphically.
Methodology in Bi- and Multilingual Studies
Authors: Aronin Larissa , Jessner Ulrike
Published: May 2015

Research methodology is determined by theoretical approaches. This article discusses methods of multilingualism research in connection with theoretical developments in linguistics, psycholinguistics, sociolinguistics, and education. Taking a brief glance at the past, the article starts with a discussion of an issue underlying the choice of research methodology: the distinction between bilingualism and multilingualism. This is followed by an account of the way in which traditional methods of research diverge and have expanded to include additional methodologies, which are shown to accommodate new theories and the most recent data in the field. Special attention is paid to the emerging research directions employing methods ofconceptualization.Overall, the paper presents a review of the current state-of- the- art including an account of the latest trends in research methodology on bilingualism and multilingualism, as well as a looking-forward analysis of the challenges and potential future methodological developments in the field.
Turning variation on its head
Authors: Meyerhoff Miriam
Published: May 2015

This paper uses variationist methods to attack a descriptive problem: by looking at the distribution of a typologically unusual subject prefix (tem-in realis andt-in irrealis) in a set of narrative texts recorded in Nkep, the language of Hog Harbour (Vanuatu), it explores the extent to which the goals of language documentation and variationist sociolinguistics can be pursued simultaneously. It concludes that a dual focus can benefit both enterprises. We find out considerably more about the nature of subject-verb prefixes in Nkep and about the ways in which the Nkep language handles grammatical properties such as the realis/irrealis distinction. The paper also notes that studies of variation in endangered language contexts can provide a positive framework for the local community to evaluate synchronic variation and change.
Administration of a maple syrup extract to mitigate their hepatic inflammation induced by a high-fat diet: a transcriptome analysis
Authors: Kamei Asuka , Watanabe Yuki , Shinozaki Fumika , Yasuoka Akihito , Kondo Takashi , Ishijima Tomoko , Toyoda Tsudoi , Arai Soichi , Abe Keiko
Published: May 2015

Effects of the administration of maple syrup extract (MSX) on hepatic gene expression were investigated in mice fed a high-fat diet. Gene annotation enrichment analysis based on gene ontology revealed some changes in the expression of genes related to lipid metabolism and the immune response in MSX-fed mice. Detailed analysis of these data indicated that MSX ingestion mitigates hepatic inflammation.
Modelling the experimental electron density: only the synergy of various approaches can tackle the new challenges
Authors: Macchi Piero , Gillet Jean-Michel , Taulelle Francis , Campo Javier , Claiser Nicolas , Lecomte Claude
Published: May 2015

Electron density is a fundamental quantity that enables understanding of the chemical bonding in a molecule or in a solid and the chemical/physical property of a material. Because electrons have a charge and a spin, two kinds of electron densities are available. Moreover, because electron distribution can be described in momentum or in position space, charge and spin density have two definitions and they can be observed through Bragg (for the position space) or Compton (for the momentum space) diffraction experiments, using X-rays (charge density) or polarized neutrons (spin density). In recent years, we have witnessed many advances in this field, stimulated by the increased power of experimental techniques. However, an accurate modelling is still necessary to determine the desired functions from the acquired data. The improved accuracy of measurements and the possibility to combine information from different experimental techniques require even more flexibility of the models. In this short review, we analyse some of the most important topics that have emerged in the recent literature, especially the most thought-provoking at the recent IUCr general meeting in Montreal.
Entrepreneurship research amid transitional economies: domains and opportunities
Authors: Lin Song , Lasserre Philippe
Published: May 2015

Purpose

– This special issue ofChinese Management Studiesaims to focus on entrepreneurship in China by addressing a variety of topics. The purpose is to provide some insights for entrepreneurship research based on the context of China as a representative emerging economy.

Design/methodology/approach

– Review and reflection.

Findings

– The research presented in the eight articles that constitute this special issue concern different topics, including entrepreneurship in the Chinese historical context, entrepreneurship in the context of networks and relationships and entrepreneurship in specialized industries. These articles provide valuable contributions to theory construction in entrepreneurship research for emerging economies, not just for enterprises in China but also for people and ventures around the world.

Research limitations/implications

– Developing an indigenous understanding of the opportunity for entrepreneurship research in an emerging economy such as China, we would argue, is only the beginning for the research work based on the historical context, networks and relationships, and specialized industries that could boom in the wide open workspaces of the developing world.

Originality/value

– The studies published here provide valuable contributions to theory construction in entrepreneurship research, as well as some basic ideas for concept definition and structural comparison in entrepreneurship research in other different domains.
Cultural beliefs, agency relationship, and network governance
Authors: Hu Shao-Dong , Chen Si-Yan
Published: May 2015

Purpose

– The purpose of this paper is to investigate the effects of cultural beliefs on governance in a business network without a legal institutional framework. Particular emphasis is placed on the cross-country remittance mail operating network in Chaoshan, China, during the period 1860-1949. This investigation builds on Greif’s business governance theory and develops an analytical framework that considers cultural beliefs, agency relationships and multilateral punishment mechanisms. Furthermore, it uses the institutional analysis method to identify the institutional factors that sustained the remittance mail operating networks and their underlying mechanisms.

Design/methodology/approach

– This paper adopts the qualitative research method. First, it investigates the history of the remittance mail operating network and agency relationships by searching through the contents of the relevant historical documents preserved in the official archives and information found in other records. Thereafter, it summarizes and demonstrates the cultural beliefs inferred from that research. The archival materials permit analysis of the interactions between cultural beliefs, agency relationships and multilateral punishment mechanisms by the institutional analysis method.

Findings

– Due to the lack of legal institutions in China during the period under review, cultural beliefs played a central institutional role in cross-country business relations. Network governance was coupled with clan cultural beliefs in the remittance mail operating network. This relationship was the key to sustain the efficient operation of the remittance mail network.

Originality/value

– In the West, corporate governance has been influenced by and has become an integral feature of Western culture and values. This is not necessarily so for the corporate governance in terms of Chinese culture and values. Thus, instead of mimicking the modes of developed countries, it is important for Chinese enterprises to seek a mode of corporate governance that is in accord with their local cultures. This may be an important focus for enterprise development.
Implementing hospital quality assurance policies in Iran
Authors: Aghaei Hashjin Asgar , Delgoshaei Bahram , Kringos Dionne S , Tabibi Seyed Jamaladin , Manouchehri Jila , Klazinga Niek S
Published: May 2015

Purpose

– The purpose of this paper is to provide an overview of applied hospital quality assurance (QA) policies in Iran.

Design/methodology/approach

– A mixed method (quantitative data and qualitative document analysis) study was carried out between 1996 and 2010.

Findings

– The QA policy cycle forms a tight monitoring system to assure hospital quality by combining mandatory and voluntary methods in Iran. The licensing, annual evaluation and grading, and regulatory inspections statutorily implemented by the government as a national package to assure and improve hospital care quality, while implementing quality management systems (QMS) was voluntary for hospitals. The government’s strong QA policy legislation role and support has been an important factor for successful QA implementation in Iran, though it may affected QA assessment independency and validity. Increased hospital evaluation independency and repositioning, updating standards, professional involvement and effectiveness studies could increase QA policy impact and maturity.

Practical implications

– The study highlights the current QA policy implementation cycle in Iranian hospitals. It provides a basis for further quality strategy development in Iranian hospitals and elsewhere. It also raises attention about finding the optimal balance between different QA policies, which is topical for many countries.

Originality/value

– This paper describes experiences when implementing a unique approach, combining mandatory and voluntary QA policies simultaneously in a developing country, which has invested considerably over time to improve hospital quality. The experiences with a mixed obligatory/voluntary approach and comprehensive policies in Iran may contain lessons for policy makers in developing and developed countries.
Clinical pathways in China – an evaluation
Authors: He Jingwei Alex , Yang Wei
Published: May 2015

Purpose

– Clinical pathways (CPs) are multidisciplinary care plans with essential care steps for patients with specific clinical problems. CPs were introduced in China in 2009 to assure quality, reduce risks, increase resource efficiency and control costs. The purpose of this paper is to present a Chinese public hospital case study where a CP pilot was undertaken to evaluate two main outcomes: length of stay and hospitalization costs for a tertiary hospital from 2010 to 2012 using a mixed-methods approach.

Design/methodology/approach

– Data were drawn from hospital records and in-depth interviews with hospital staff in a Shanxi Province tertiary hospital, northern China.

Findings

– The authors found that the main objectives: to standardize treatment procedures by reducing length of stay and containing costs, were not fully achieved. Staff implementing CPs clearly encountered several barriers; i.e., managers did not see the pilot as a useful managerial instrument but were still driven by revenue generation. Physicians, too, lacked incentive to follow the guidelines due to income concerns.

Practical implications

– The authors point to the daunting challenges brought about by perverse incentives embedded in the country’s health system. The authors argue that concerted efforts are needed to undertake difficult health policy reforms in China.

Originality/value

– The authors present the first empirical study in the English-language literature that examines China’s ongoing CP pilots from a micro perspective. The authors combine qualitative and quantitative methods and reveal the hospital-level dynamics in its implementation.
An evaluation of just-in-time initiatives in the Indian industries
Authors: Singh Gurinder , Ahuja Inderpreet Singh
Published: May 2015

Purpose

– The purpose of this paper is to develop an insight into the prevalent just-in-time (JIT) practices adopted in Indian manufacturing industry for realizing the development and growth of the industrial sector. The endeavor of Indian manufacturing organizations to achieve manufacturing performance enhancement through JIT implementation has been highlighted in the present study.

Design/methodology/approach

– The present study has been conducted in the large- and medium-scale manufacturing industries of India that have successfully implemented or are in the various stages of implementing JIT. The approach of study has been directed toward assessment of JIT initiatives in Indian manufacturing industries.

Findings

– From the present study it is apparent that Indian organizations have been reasonably successful in improving the business performance by implementing holistic JIT initiatives and have successfully reaped the benefits of JIT implementation. However, it is also revealed in present study that Indian manufacturing industries need to work more aggressively on managing few issues of JIT.

Originality/value

– The value of paper is in calculation of percent point score for each issue of JIT in context to Indian manufacturing industry and to find out significant as well as issues that need to worked aggressively by Indian manufacturing industry to reap the benefits of JIT.
Seeking and measuring the essential behaviors of servant leadership
Authors: Winston Bruce , Fields Dail
Published: May 2015

Purpose

– The purpose of this paper is to clarify the nature of how servant leadership is established and transmitted among members of an organization. The second goal was to identify and evaluate the unique actions by a leader essential to establishing servant leadership. The authors’ efforts resulted in identification and validation of ten leader behaviors that seem to be essential to servant leadership.

Design/methodology/approach

– The authors’ methodology consisted of two stages. In the first stage, The authors developed an item pool of 116 items drawn from previously developed operationalizations of servant leadership. The authors then engaged a panel of 23 researchers attending a conference focused exclusively on the study of servant leadership to evaluate the. Each participant was asked to independently rate each item using a four-point scale where 1=not useful in describing servant leaders and 4=contributes greatly to describing servant leaders. The authors retained only the most highly rated items. This resulted in retention of 22 leader behaviors for further analysis. In the second stage, the authors developed a questionnaire including these items as well as items measuring transformational leadership behaviors, transactional leader behaviors, servant leadership as measured by the instrument developed by Liden et al. (2008), and a measure of leadership effectiveness developed and used by Ehrhart and Klein (2001). The questionnaire was placed in internet-based survey software and the link provided to students and faculty at a private mid-Atlantic university and to university alumni and colleagues in a variety of organizations. Each respondent was asked to describe a leader he/she had worked for in the past five years and included specification of the job role for both the respondent and the leader.

Findings

– The ten-item scale accounts for 75 percent of the variance with a scale reliability α=0.96. Convergent validity was determined through comparison to Liden et al. (2008) measure of servant leadership. Discriminant validity was established through confirmatory analysis of leader effectiveness, transformational leadership’s four dimensions, a measure of transactional leadership, and an alternative multi-dimensional measure of servant leadership.

Originality/value

– This paper clarifies and provides a measure of the essential behaviors of servant leaders. This provides a useful measurement tool for leadership development.