bluuebunny/crossref_metadata_2025 huggingface dataset:
Feasibility of Intravascular Near-Infrared Spectroscopy in Off-Pump Myocardial Revascularization
Authors: Bernet Franziska H. , Matt Peter , Zerkowski Hans-Reinhard , Baykut Doan
Published: January 2019

Objectives

The intravascular application of near-infrared spectroscopy was previously evaluated in acute ischemia-reperfusion studies in animal experiments. The objective of our study was to assess the technical feasibility and clinical reliability of an online myocardial ischemia monitoring by using intravascular near-infrared spectroscopy during off-pump coronary bypass surgery.

Methods

Intravascular near-infrared spectroscopy of coronary sinus blood was performed in 10 elective patients selected for off-pump coronary bypass surgery. Light signals were transferred through a fiberoptic catheter for emission and collection from the coronary sinus blood. Spectrometric analyses were performed before and after revascularization with internal thoracic artery and saphenous vein grafts. Changes in spectroscopic data were compared with hemodynamic parameters and electrocardiographic, transesophageal echocardiographic, and laboratory findings.

Results

All of the operations were finished as off-pump procedures. No remarkable intraoperative myocardial ischemia was observed in the patient group, as indicated by electrocardiography and transesophageal echocardiography. Reproducible absorption spectra of coronary sinus blood were obtained at every defined step of the surgical procedure. Clear ischemia-related changes were detected in none of the patients.

Conclusions

Our initial results showed that intravascular near-infrared spectroscopic ischemia monitoring is technically feasible. However, the method must be further evaluated and standardized under varying conditions to determine the role of near-infrared spectroscopy as an ischemia monitoring tool in off-pump coronary bypass surgery.
Neointimal Hyperplasia Associated with the Use of U-Clip
Authors: Melero Jose Maria , Di Stefano Salvatore , Porras Carlos , Alonso Juan , Sánchez Gemma , Such Miguel , Olalla Eduardo
Published: January 2019

The U-Clip (Coalescent Surgical, Sunnydale, CA USA) allows the surgeon to create an interrupted anastomosis in the same amount of time that is required for a continuous anastomosis with the elimination of knotting. Its use is indicated especially in minimally invasive surgery. We describe a case of a patient in which the proximal anastomosis was performed by interrupted suture with Coalescent U-Clip anastomotic device. Six months later, he presented with stenosis of the anastomosis, and intravascular ultrasound showed anastomotic neointimal hyperplasia.
Initial Results of Minimally Invasive Ivor Lewis Esophagectomy after Induction Chemoradiation (50.4 Gy) for Esophageal Cancer
Authors: Thomay Alan A. , Snyder Justin A. , Edmondson Donna M. , Scott Walter J.
Published: January 2019

Objective

Esophageal cancer patients receiving induction chemoradiation to 41 Gy randomized to minimally invasive (MIS) esophagectomy have fewer postoperative pulmonary complications compared with those who underwent open procedures. We evaluated the feasibility of MIS Ivor Lewis esophagectomy in patients treated with induction chemoradiation to 50.4 Gy.

Methods

We retrospectively analyzed clinical data from 30 consecutive patients undergoing MIS Ivor Lewis esophagectomy after induction chemoradiation to a mean dose of 50.4 Gy by a single surgeon at a tertiary institution since 2010. Data collected included patient demographics, preoperative risk factors, neoadjuvant treatment modalities, histology, staging, operative factors, and perioperative complications.

Results

The mean age of the patients was 61 ± 9.5 years, and 87% were men. The dominant histology was adenocarcinoma (90%), with most tumors (70%) located at the gastroesophageal junction. A total of 22 patients (73%) presented with dysphagia, but only 15 (50%) had associated weight loss (mean 12.2% total body mass). All patients had R0 resections; mean number of resected lymph nodes was 27.1 ± 11.4. Mean operating room time was 535 ± 120 minutes, with the last 10 operations 2 hours shorter than the preceding 20. Four patients (13.3%) had major complications. including 2 (6.7%) anastomotic leaks. There was no operative mortality.

Conclusions

Minimally invasive Ivor Lewis esophagectomy after chemoradiation to 50.4 Gy can be performed with decreased morbidity and mortality compared with historical series of open Ivor Lewis esophagectomy. Oncologic outcomes were acceptable as demonstrated by lymph node retrieval and complete resection rates. Operative time decreased significantly after 20 cases.
Double Potential Mapping: A Novel Technique for Locating the Site of Incomplete Ablation
Authors: Nitta Takashi , Wakita Masaki , Watanabe Yoshiyuki , Ohmori Hiroya , Sakamoto Shun-ichiro , Ishii Yosuke , Ochi Masami
Published: January 2019

Objective

Double potential mapping using bipolar electrodes that straddle the ablation line should identify the site of incomplete ablation as a conduction gap without constructing the activation maps.

Methods

Bipolar electrograms were recorded during pacing using 11 custom-made bipolar electrodes straddling the ablation line created by a bipolar radiofrequency ablation device on the lateral right atrium in seven canines. A linear ablation was made with an ablation device, of which one jaw was inserted into the atrium through a purse-string suture. A 3-mm-wide tape was placed on both jaws 10 mm from the tip of the ablation electrode to intentionally create an incomplete ablation lesion. The activation times at each dipole across the ablation line were defined as the times of the maximum positive and negative derivatives of the double potentials, and the site of conduction gap was determined as the site of the earliest activation across the linear ablation. The lateral right atrium was mapped simultaneously with 45 different bipolar electrodes to construct the activation maps and the earliest activation site across the ablation line was determined.

Results

The double potential mapping located the conduction gap on a real-time basis without displaying any maps. There was no significant change in the accuracy between the different times after ablation and different pacing cycle lengths.

Conclusions

Double potential mapping locates the conduction gap on a real-time basis and would be useful in beating-heart epicardial ablation in off-pump setting.
Is There a Role for Robotic Totally Endoscopic Coronary Artery Bypass in Patients with a Colostomy?
Authors: Gibber Marc , Lehr Eric J. , Kon Zachary N. , Wehman P. Brody , Griffith Bartley P. , Bonatti Johannes
Published: January 2019

Preoperative colostomy presents a significant risk of sternal wound complications, mediastinitis, and ostomy injury in patients requiring coronary artery bypass grafting. Less invasive procedures in coronary surgery have a potential to reduce the risk of sternal wound healing problems. Robotic totally endoscopic coronary artery bypass grafting in patients with a colostomy has not been reported. We describe a case of completely endoscopic coronary surgery using the da Vinci Si system in a patient with a transverse colostomy. Single left internal mammary artery grafting to the left anterior coronary artery was performed successfully on the beating heart. We regard this technique as the least invasive method of surgical coronary revascularization with a potential to reduce the risk of surgical site infection and mediastinitis in patients with a colostomy.
Disambiguating the Role of Paradigms in Mixed Methods Research
Authors: Ghiara Virginia
Published: January 2019

In the mixed methods research (MMR) literature, the term paradigm is used in a number of ways to support very different accounts. This article aims to contribute to the ongoing dialogue about the relationship between MMR and paradigms by analyzing two main claims discussed in the literature: (a) MMR is a new paradigm and (b) MMR mixes different paradigms. Focusing on the notion of paradigms used to support each claim, it clarifies why MMR can be considered a new paradigm and discusses conditions under which it is possible to mix two or more paradigms within a single study. This clarification promotes a more clear-cut use of concepts such as paradigms and worldviews in the literature.
Identification and management of the near-field knowledge of industrial design for innovative product shapes
Authors: He JinTao , Yang Qian , Zhu MengYa
Published: January 2019

Industrial design is a complex process that contains multifarious product knowledge systems which play different roles at different stages of product development. Based on the research of different theories and methods of knowledge classification, the article proposes a new method which divides industrial design knowledge into knowledge in the field, near-field knowledge, and far-field knowledge, and established a corresponding frame of the design knowledge. In order to differentiate the near-field knowledge which is more innovative in design from considerable knowledge to facilitate an efficient design process, mechanisms of similarity searching are used. If 0.3 < [Formula: see text] (similarity) < 0.6, then define the case as the near-field product case and the relative knowledge as near-field knowledge. The core knowledge can be retrieved to drive innovative modeling. Furthermore, the process of a laptop design is taken as an example and validated using this method.
Underwater terrain-aided navigation method based on improved Gaussian sum particle filtering
Authors: Chen Pengyun , Chang Jianlong , Han Yujie , Yuan Meini
Published: January 2019

To solve the nonlinear Bayesian estimation problem in underwater terrain-aided navigation, a terrain-aided navigation method based on improved Gaussian sum particle filter is proposed. This method approximates the Bayesian function using multiple Gaussian components, and the components can be obtained by radial basis function neural network. This method has no resampling process, the particle depletion of particle filtering is eliminated in principle. The simulation shows that the proposed method has good matching performance, which is suitable for autonomous underwater vehicle navigation.
A midline prepontine cyst: Serial magnetic resonance imaging over 20 years shows very slow growth after its rapid shrinkage
Authors: Sugata Jun , Ueda Tessei , Tanoue Natsuko , Hirahara Kazuho , Kamimura Kiyohisa , Arita Kazunori , Yoshimoto Koji
Published: January 2019

An otherwise healthy 22-month-old boy suffered high fever, irritability, nausea, dysphagia, dysarthria and right hemiparesis. Magnetic resonance imaging showed a cystic mass, 15 mm in diameter, with surrounding oedema in the base of the lower pons. The symptoms subsided in about 10 days after onset, followed by a rapid decrease of the cyst size to 5 mm. Thereafter, the patient’s psychomotor growth has been normal. Annual follow-up magnetic resonance imaging scans showed very gradual enlargement of the cyst located on the ventral surface of the pontomedullary junction, reaching 16 mm in diameter in 21 years after onset. It was hyperintense on T1-weighted and isointense on T2-weighted magnetic resonance imaging. No haemosiderin deposition or gadolinium enhancement was seen. This is a rare report of a two decade longitudinal follow-up of a midline prepontine cyst showing asymptomatic and very slow growth. The possible nature of the cyst includes neurenteric, dermoid and epidermoid cyst.
Twirling Triplets: The Qualia of Rotation and Musical Rhythm
Authors: Hansen Niels Chr. , Huron David
Published: January 2019

While musicologists have long noted that triplet rhythms evoke sensations of rotation in listeners, no theory has been proposed to account for this apparent association. To investigate this phenomenon, 33 excerpts of “spinning, rotating, twirling, or swirling” music were crowd-sourced from an online discussion forum. Analysis revealed a prominence of fast, repeated, isochronous patterns using stepwise pitch movement, with significantly more compound meters than generally found in Western music. Inspired by ecological acoustics, an Ecological Theory of Rotating Sounds (ETRoS) is proposed to explain these associations. The theory maps patterns of loudness fluctuations to trajectories of rotating sound sources. Two experiments tested the theory. In Experiment A, listeners rated how much binary, ternary, quaternary, and quinary figures (of 2–5 notes) evoked sensations of rotation. Experiment B used a two-alternative forced-choice paradigm pitting ecological quaternary stimuli (strong-medium-weak-medium) against unecological stimuli with permuted stress values more typical of Western music (strong-weak-medium-weak). Results indicate that perceived rotation increases with tempo and is poorly evoked by binary rhythms. Loudness patterns consistent with rotating trajectories were perceived as more rotating than unecological patterns—but only when pitch was also moving. Altogether, moderate support is provided for an acoustic-ecological account of rotating sounds.
Mucosal Schwann cell hamartomas do occur the gastric mucosa – report of two cases mimicking fundic gland polyps
Authors: Oliveira Castro Márcia Helena , Felipe Rodrigo Jose , Fernandes Cardoso Amanda , Martins Guimarães Carlos Leonardo , Fontes Athanazio Paulo Roberto , Abensur Athanazio Daniel
Published: January 2019

Mucosal Schwann cell hamartomas (MSCHs) are recently characterized benign spindle cell lesions of the colon and rectum. There is only one report of MSCHs in the stomach (antrum). Herein, we present the first reports of MSCHs occurring in the fundic mucosa as lesions that endoscopically mimicked a typical fundic gland polyp. Case 1. A 56-year-old woman sought medical attention due to epigastric pain. A small polypoid lesion in the fundic mucosa was removed with an endoscopic impression of a fundic gland polyp. Case 2. A 66-year-old man sought medical attention due to epigastric pain. The patient underwent antral and corporal biopsies that showed mild non-active gastritis without Helicobacter pylori infection. Small polypoid lesions in the fundic mucosa were seen; one was removed with an endoscopic impression of the fundic gland polyp. At the microscope, both lesions were entirely intramucosal, ill-defined spindle cell aggregations, suggesting a fascicular growth pattern. Both lesions were strongly and diffusely positive for S100. Awareness of this lesion is relevant to avoid the diagnosis of other benign spindle cell lesions that are associated with familial syndromes.
Progesterone Is Important for Transgender Women’s Therapy—Applying Evidence for the Benefits of Progesterone in Ciswomen
Authors: Prior Jerilynn C
Published: January 2019

Background

Although the 2017 Endocrine Society Guidelines for gender dysphoria stipulated that cross-sex hormone therapy (CHT) achieve gonadal steroid levels equivalent to those of a cisperson of the chosen sex, for transgender women (male-to-female gender dysphoria), current gonadal therapy is usually estradiol. Accumulated evidence indicates that normally ovulatory menstrual cycles are necessary for ciswomen’s current fertility, as well as for later-life bone and cardiovascular health and the prevention of breast and endometrial cancers.

Evidence Acquisition

Extensive past clinical experience with transgender women’s CHT using estradiol/estrogen combined with progesterone/medroxyprogesterone and pioneering the addition of spironolactone. Comprehensive progesterone physiology research plus a brief review of transgender women’s literature to assess current therapy and clinical outcomes, including morbidity and mortality.

Purpose

To emphasize that both ovarian hormones, progesterone as well as estradiol, are theoretically and clinically important for optimal transgender women’s CHT.

Evidence Synthesis

It is important to add progesterone to estradiol and an antiandrogen in transgender women’s CHT. Progesterone may add the following: (i) more rapid feminization, (ii) decreased endogenous testosterone production, (iii) optimal breast maturation to Tanner stages 4/5, (iv) increased bone formation, (v) improved sleep and vasomotor symptom control, and (vi) cardiovascular health benefits.

Conclusions

Evidence has accrued that normal progesterone (and ovulation), as well as physiological estradiol levels, is necessary during ciswomen’s premenopausal menstrual cycles for current fertility and long-term health; transgender women deserve progesterone therapy and similar potential physiological benefits.
A Mitochondrial Progesterone Receptor Increases Cardiac Beta-Oxidation and Remodeling
Authors: Dai Qunsheng , Likes Creighton E , Luz Anthony L , Mao Lan , Yeh Jason S , Wei Zhengzheng , Kuchibhatla Maragatha , Ilkayeva Olga R , Koves Timothy R , Price Thomas M
Published: January 2019

Progesterone is primarily a pregnancy-related hormone, produced in substantial quantities after ovulation and during gestation. Traditionally known to function via nuclear receptors for transcriptional regulation, there is also evidence of nonnuclear action. A previously identified mitochondrial progesterone receptor (PR-M) increases cellular respiration in cell models. In these studies, we demonstrated that expression of PR-M in rat H9c2 cardiomyocytes resulted in a ligand-dependent increase in oxidative cellular respiration and beta-oxidation. Cardiac expression in a TET-On transgenic mouse resulted in gene expression of myofibril proteins for remodeling and proteins involved in oxidative phosphorylation and fatty acid metabolism. In a model of increased afterload from constant transverse aortic constriction, mice expressing PR-M showed a ligand-dependent preservation of cardiac function. From these observations, we propose that PR-M is responsible for progesterone-induced increases in cellular energy production and cardiac remodeling to meet the physiological demands of pregnancy.
What Is Ethnohistory?: A Sixty-Year Retrospective
Authors: Riehm Grace E. , Brambila Lydia , Brown Brittany A. , McDougal Lauren Collins , Effre Danielle N. , Ethridge Robbie , Komlo Morgan , Kowalewski Stephen A. , Lulewicz J. Jacob , McDonald Caitlin M. , Plesher Caitlin F. , Ritchison Brandon T. , Smith Colleen N. , Sutton Amanda J. , Thompson Victor D.
Published: January 2019

In honor of Ethnohistory’s sixtieth anniversary, this paper compiles data on the journal and analyzes patterns and trends throughout the publication. We divided observations into four categories: (1) authorship of each article, particularly focusing on gender in authorship and coauthorship, (2) the region represented in each article, (3) the topic, and (4) data sources used by the author(s). We then analyzed each category in representative ten-year intervals from 1954 to 2013. Such data reveals trends that mirror intellectual, scholarly, and demographic changes in the social sciences overall. Female authorship, for example, steadily increases until the most recent decade, while coauthorship shows steady growth in raw numbers, but still represents a varying percentage with each decade. The North American region composes the majority of regional representation since the beginning, but Latin American regional representation as well as that outside of the Americas, shows significant increases over time. Meanwhile, fluctuating topics and data sources demonstrate diversification and expanding breadth within Ethnohistory.
The Effect of Pollution on Worker Productivity: Evidence from Call Center Workers in China
Authors: Chang Tom Y. , Graff Zivin Joshua , Gross Tal , Neidell Matthew
Published: January 2019

We investigate the effect of pollution on worker productivity in the service sector by focusing on two call centers in China. Using precise measures of each worker’s daily output linked to daily measures of pollution and meteorology, we find that higher levels of air pollution decrease worker productivity. These results manifest themselves at levels of pollution commonly found in large cities throughout the developing and developed world. (JEL J24, L84, O13, P23, P28, Q51, Q53)
Early Childhood Education by Television: Lessons fromSesame Street
Authors: Kearney Melissa S. , Levine Phillip B.
Published: January 2019

We investigate whether preschool-age children exposed to Sesame Street when it aired in 1969 experienced improved educational and labor market outcomes. We exploit geographic variation in broadcast reception derived from technological factors, namely UHF versus VHF transmission. This variation is then related to census data on grade-for-age status, educational attainment, and labor market outcomes. The results indicate that Sesame Street improved school performance, particularly for boys. The point estimates for long-term educational and labor market outcomes are generally imprecise. (JEL I21, I26, J13, J24, L82)
Fiscal Austerity in Ambiguous Times
Authors: Ferriere Axelle , Karantounias Anastasios G.
Published: January 2019

This paper analyzes optimal fiscal policy with ambiguity aversion and endogenous government spending. We show that without ambiguity, optimal surplus-to-output ratios are acyclical and that there is no rationale for either reduction or further accumulation of public debt. In contrast, ambiguity about the cycle can generate optimally policies that resemble “austerity” measures. Optimal policy prescribes higher taxes in adverse times and front-loaded fiscal consolidations that lead to a balanced primary budget in the long run. This is the case when interest rates are sufficiently responsive to cyclical shocks, that is, when the intertemporal elasticity of substitution is sufficiently low. (JEL D81, E32, E43, E62, H21, H61, H63)
The Urban Mortality Transition and Poor-Country Urbanization
Authors: Jedwab Remi , Vollrath Dietrich
Published: January 2019

Today, the world’s fastest-growing cities lie in low-income countries, unlike the historical norm. Also, unlike the “killer cities” of history, cities in low-income countries grow not just through in-migration but also through their own natural increase. First, we use novel historical data to document that many poor countries urbanized at the same time as the postwar urban mortality transition. Second, we develop a framework incorporating location choice with heterogeneity in demographics and congestion costs across locations to account for this. In the framework, people prefer to live in low-mortality locations, and the aggregate rate of population growth and the locational choice of individuals interact. Third, we calibrate this to data from a sample of poor countries and find that informal urban areas (e.g., slums) can absorb additional population more easily than other locations. We show that between 1950 and 2005 the urban mortality transition could have doubled the urbanization rate as well as the size of informal urban areas in this sample. Of these effects, one-third could be attributed to the amenity effect of lower urban mortality rates, while the remainder is due to higher population growth disproportionately pushing people into informal urban areas. Fourth, simulations suggest that family planning programs, as well as industrialization or urban infrastructure and institutions may be effective in slowing poor-country urbanization. (JEL I12, J11, N30, O15, O18, R11, R23)
A Model of Secular Stagnation: Theory and Quantitative Evaluation
Authors: Eggertsson Gauti B. , Mehrotra Neil R. , Robbins Jacob A.
Published: January 2019

This paper formalizes and quantifies the secular stagnation hypothesis, defined as a persistently low or negative natural rate of interest leading to a chronically binding zero lower bound (ZLB). Output-inflation dynamics and policy prescriptions are fundamentally different from those in the standard New Keynesian framework. Using a 56-period quantitative life cycle model, a standard calibration to US data delivers a natural rate ranging from − 1.5 percent to − 2 percent, implying an elevated risk of ZLB episodes for the foreseeable future. We decompose the contribution of demographic and technological factors to the decline in interest rates since 1970 and quantify changes required to restore higher rates. (JEL E12, E23, E31, E32, E43, E52)
Takotsubo cardiomyopathy following ultrasound-guided renal cyst aspiration
Authors: Gursahaney Dorissa Lahner , Wiktor Dominik M , Lindquist Jonathan
Published: January 2019

Interventional radiology plays a critical role in offering minimally invasive procedures, resulting in increased patient comfort. However, of the millions of patients undergoing interventional procedures each year, many suffer from pre-procedural psychological stressors related to fear of discomfort and diagnostic uncertainty. We describe a case of Takotsubo cardiomyopathy, also called broken heart syndrome or stress cardiomyopathy, following ultrasound-guided renal cyst aspiration in a patient with severe anxiety in anticipation of the interventional radiology procedure.
Case Report: Recurrent hypokalemic periodic paralysis associated with distal renal tubular acidosis (type 1) and hypothyroidism secondary to Hashimoto´s thyroiditis
Authors: Meregildo-Rodríguez E. Dante , Failoc-Rojas Virgilio E.
Published: January 2019

Background: Hypokalemic periodic paralysis (HypoKPP) is characterized by transient episodes of flaccid muscle weakness. We describe the case of a teenaged boy with HypoKPP and hyperthyroidism due to Hashimoto's thyroiditis with initial manifestation of renal tubular acidosis. This combination is rare and little described previously in men.

Case presentation: A 17-year-old boy was admitted after three days of muscular weakness and paresthesia in the lower limbs with an ascending evolution, leading to prostration. Decreased strength was found in the lower limbs without a defined sensory level, reduced patellar and ankle reflexes. Positive antithyroid antibodies were found. He received hydration treatment, IV potassium and levothyroxine, with which there was a clinical improvement. Other examinations led to the diagnosis of type 1 renal tubular acidosis.

Conclusion: HypoKPP is a rare disorder characterized by acute episodes of muscle weakness. Type 1 renal tubular acidosis can occur as a consequence of thyroiditis, which is explained by the loss of potassium. This combination is unusually rare, and has not been described before in men. The etiopathogenesis of the disease as well as a dynamic explanation of what happened with the patient are discussed in this report.
The effect of different environmental conditions on the physical activity of preschool children in Estonia
Authors: Nekraš Sirle , Misjuk Mikola
Published: January 2019

The purpose of the study is to investigate the effect of different environmental conditions on the physical activity of preschool children. The experiment took place in Estonian childcare centre during the free playtime. Fifteen children aged 6–7 years from childcare centre participated in the research. Physical activity was measured using pedometers Fitbit Zip™. Results show that in comparison to the usual free play the physical activity of children increased statistically significantly by 83% when background music was played, by 50% when sport equipment was provided and by 101% when both environmental conditions were combined. It was found that compared to the usual free play, children’s activity increased the least when only sport equipment was provided, while children’s activity increased more when background music was played and increased the most when music with sport equipment was combined. Physical activity did not differ when only background music and music with sport equipment were used. It can be summarised that the background music and opportunity to use portable sport equipment increases the physical activity of children during free play. Background music has greater impact on the activity than portable sport equipment. Children’s physical activity can be effectively increased in childcare centre by using simple modifications such as background music and portable sport equipment during free play.
Bicycle usage among inactive adults provided with electrically assisted bicycles
Authors: Lobben Stian E. , Malnes Lena , Berntsen Sveinung , Tjelta Leif Inge , Bere Elling , Kristoffersen Morten , Mildestvedt Thomas
Published: January 2019

In the present study we aimed primarily to examine cycling time and distance when inactive subjects were provided with electrically assisted bicycles. Secondly to evaluate changes in maximal oxygen uptake. Inactive employees in a selection of public and private corporations in three Norwegian cities were invited to participate. Inclusion criteria were: a desire to cycle to work, residence more than 3 km from the workplace, and not physically active according to guidelines. There were 25 participants in the study and we provided them all with electrically assisted bicycles fitted with GPS bike computers to record usage. The participants were followed for three to eight months, 226 days on average. Measures of maximal oxygen uptake were performed before and after the intervention. Demographic characteristics and prior transportation habits were reported in a questionnaire at baseline. Participants cycled for 107.1± 62 min per week covering 37.6 ± 24 km per week. The distances cycled were significantly greater in the autumn (47.4 km/week, p=0.035) than in the spring (32.1 km/week). Participants cycled more on weekdays (7.1 km/day, p < 0.001) compared to weekends (0.9 km/day, p<0.001). Maximal oxygen uptake improved significantly, 2.4 ml/min/kg (7.7 %), p<0.001 and this was associated with cycling distance (r=0.49, p=0.042) and self-reported commuting distance (r=0.51, p=0.018). Offering electrically assisted bicycles to inactive employees may initiate transport-related physical activity and may give positive health effects.
Constructing a Text, Creating an Image: The Case of Johannes Barbarus
Authors: Kõvamees Anneli
Published: January 2019

The Estonian poet, physician and politician Johannes Vares-Barbarus (1890–1946) is a contradictory figure in Estonian history and culture. He was a well-known and acknowledged doctor named Vares, but also a poet named Barbarus who was notable for his modernistic poems in the 1920s and 1930s. His actions in the 1940s as one of the leading figures in the Sovietization of Estonia have complicated the reception of his poetry. His opposition to the Republic of Estonia and his left-wing views are nearly always under observation when he or his poems are discussed. Predominantly his poetry has been discussed; his other works have received much less attention. This article analyses his travelogue Matkavisandeid & mõtisklusi (Travel Sketches and Contemplations) based on his trip to the Soviet Union. It was published in the literary magazine Looming in 1935 and reprinted in 1950 in his collected works. Travelogues have proven to be valuable materials when discussing the author and his mentality. The article analyses the image of the Soviet Union in his travelogue published in 1935 and discusses notable changes that were made in the reprint some of which have significantly altered the meaning, so that the text fits perfectly into the Soviet canon.
Emilia Pardo Bazán, an Ethical Writer
Authors: Thion Soriano-Mollá Dolores
Published: January 2019

Within the cultural context of nineteenth-century Spain, Emilia Pardo Bazán uses literature to raise public awareness on the death penalty. Considering the seriousness of the issue, she thought that emotions – not reason – could allow people to have a better understanding and to form their own opinion. Thus, in La piedra angular, through the fictional word of Marineda, she examines the controversies linked to the legal, human, and moral legitimacy of capital punishment and to the figures of both the criminal and the executioner, but also to the nature of truth and public opinion.
Lithuanian Literature in 1918–1940: The Dynamics of Influences and Originality
Authors: Vanagaitė Gitana
Published: January 2019

Lithuanian independence (1918–1940), which lasted for twentytwo years, and its symbolic center, the provisional capital Kaunas, have been very important for the country’s political, social, and cultural identity. In 1918, changes in the social, economic, and political status of an individual as well as transformations in the literary field followed the change of the political system. In what ways the relationship between the center and the periphery and the spheres of literary influences were altered by the new forms of life? Lithuania, the former geographic periphery of tsarist Russia, after the change of the political system became a geographical and cultural periphery of Europe. Nevertheless, political freedom provided an opportunity to use the dichotomy of center-periphery creatively. Lithuanian writers, who suddenly found themselves living in Europe with old cultural traditions, tried to overcome the insignificance of their own literature, its shallow themes and problems by “borrowing” ideas and ways to express them. In fact, the imitation was not mechanical, so the new influences enabled writers to expand significantly the themes and forms of Lithuanian literature.

The article examines the development of new cultural centers in independent Lithuania. It also discusses the avant-garde movement which emerged under the influence of Russian futurists and German expressionists. In addition, it focuses on individual authors, such as Antanas Vaičiulaitis, Kazys Binkis and Petras Cvirka, and the influence that affected their works.
Psychological correctional work with employees of the internal affairs bodies based on metaphorical associative maps
Authors: Кузнецова Инна , Kuznetsova Inna , Мальцева Татьяна , Maltseva Tatyana
Published: January 2019

Abstract. The article deals with the problem of transition to a higher level of psychological work in the internal affairs bodies, by narrowing and concretizing the existing knowledge regarding psychocorrectional methods used by departmental psychologists. The use of metaphorical associative tools in psychological correction: metaphorical associative cards, metaphorical dolls (puppet therapy), fairy tale therapy, sand therapy, phototherapy, which can significantly increase the interest of internal affairs personnel in seeking help from a psychologist. According to the included observation, as a result of the application of the method of associative metaphorical cards, there is a positive dynamic in the relationship of police officers in the unit according to the following indicators: empathy, acceptance of others, group cohesion, emotional attachment to the group, tolerance.
Elevated Homocysteine, an Emerging Biomarker for Cervical Cancer, A Case-Controlled Study
Authors: Ara Rifat , Goodman Annekathryn , Pervin Shahana , Akttar Mst Nurunnahar , Nazneen Shahana , Islam Farzana
Published: January 2019

Background: Elevated homocysteine, an emerging biomarker for cervical cancer is amenable to treatment by cheap and effective nutritional interventions.
Methods: From April 2012 through September 2012, a case-controlled study was performed in the Gynae oncology unit of Bangabandhu Sheikh Mujib Medical University (BSMMU) and the National Institute of Cancer Research and Hospital (NICR & H), in Dhaka, Bangladesh. The objectives were to measure the serum homocysteine levels in women with squamous cell carcinoma of the cervix and in normal controls. Fifty women with invasive squamous cell carcinoma and 50 normal controls were compared for demographic and socioeconomic differences. Blood was tested for homocysteine levels.
Results: Among cases of cervical cancer, 82% had homocysteine level between 4.5-15 µmol/L & 14% had high homocysteine level (>15 µmol/L). Whereas in control group, 98% had homocysteine level between 4.5-15 µmol/L and 2% had homocysteine <4.5 µmol/L (low). High level of homocysteine (>15 µmol/L) was not observed in any patient in the control group. The mean homocysteine level in cervical cancer patients was also higher (10.88 ?mol/L) than that of controls (8.50 µmol/L) and this difference was statistically significant.
Histological grade and clinical stage of cervical cancer did not correlate with serum homocysteine level.
Conclusion: There is a difference in homocysteine levels in women with cervical cancer. Homocysteine, which is associated with nutritional deficiencies of fruits and vegetables, may play a role as a marker for or as a co-factor in malignant transformation of cervical squamous epithelium. Larger studies are needed to further study this association. However public awareness is important regarding the role of fresh vegetables and fruits containing vitamin B (folate-vitamin B9; vitamin B12; vitamin B6) to reduce homocysteine and its possible consequences of cancer prevention.
Effectiveness of Extension Delivery Techniques for Rice Production Technologies Among Farmers in Gbako Local Government Area of Niger State, Nigeria
Authors: Abubakar H. N. , Garba Y. , Gana A. K. , Olaniyan B. O.
Published: January 2019

The study was conducted to evaluate effectiveness of extension delivery techniques in dissemination of rice production technologies in Gbako Local Government Area of Niger state. A probability sampling method involving random sampling of 150 respondents was used, and data were collected with aid of structured questionnaire. The study employed both descriptive and inferential statistics for analysis of the data. The results of a 3-point graphic rating scale (Likert ratio) indicated that method-cum-result demonstration, farmers’ participation in On-Farm Adaptive Research (OFAR) trials, Management Training Plot (MTP) and use of contact farmers were the very effective extension delivery methods. The results of a paired t- test for mean comparison revealed a highly significant (P?0.01) difference between the mean output (kg/ha.) before and after the dissemination of rice production technologies at 95% confidence interval. The study therefore concluded that extension delivery methods were effective and sources of information were utilized, which culminated in the increased yield of farmers; hence participatory extension delivery approach should be emphasized in policy formulation and program planning for intervention and technology transfer.
Congenital Vitamin C Deficiency or Fractures Due to Non-Accidental Injury?
Authors: Paterson Colin R
Published: January 2019

It has long been recognised that much of the symptomatology associated with severe vitamin C deficiency in adults and children can be related to the essential role of ascorbic acid in collagen formation. The fractures and the bleeding disorders including bruises, sub-periosteal bleeding and intracranial bleeding can all be explained in this way.
This paper reports an infant boy who at the age of nine weeks was found to have multiple fractures and fracture-like lesions. A confident diagnosis of non-accidental injury was made. However it was later revealed that throughout her pregnancy the mother had prolonged severe nausea and a very limited diet. She had developed sore limbs, swollen bleeding gums and, later, multiple bruises. A diagnosis of severe scurvy was eventually made when the infant was 13 weeks old. She responded to vitamin C supplements.
The paediatricians did not recognise any relevance of the mother’s overt scurvy to the infant’s fractures. It is likely that the mother suffered severe vitamin C deficiency during her pregnancy, adversely affecting fetal bone formation and leading to fractures. Scurvy is now seldom diagnosed but surveys indicate that vitamin C sub nutrition is not uncommon even in western countries. The laboratory investigation of vitamin C status is demanding and not widely available. This paper highlights the need for maternal vitamin C deficiency to be considered in the differential diagnosis of unexplained fractures in infants.
Autografts, Allografts and Bone Substitutes in Lytic benign Bone Tumors and Tumour Like Lesions: A Comparative Study of Filling Defects and Healing in 90 Patients
Authors: Kundu Zile Singh , Yadav Umesh , Mudgil Parvesh , Siwach Ramchander
Published: January 2019

Background: Extended curettage is treatment of choice for most benign lesions. To fill the defect after curettage remains a major problem particularly in children and in large cavities. We compared the results of allografts, autografts and bone substitutes in patients with benign bone tumors and tumour like conditions after curettage in view of healing of the lesion and their complications. Material and Methods: Total 90 patients (54 males and36 females) of benign lytic bone tumors in extremities and amenable to curettage were included in this prospective study. Extended curettage was done using the sharp curettes and high-speed burr. The age of patient ranged from 6 years to 62 years. Giant cell tumor 33.3% (n=30) and aneurismal bone cyst 30% (n=27) were the most common type of tumors in our series. There were twelve patients (13.3%) of enchondroma and ten patients each (11% each) of simple bone cyst and chondroblastoma. One patient had chondromyxoid fibroma. Mean tumor volume was 29.88 cm3 (range 2.7 to 168.48). The defects were filled by either autograft, allograft or bone substitutes making the comparative groups. The mean follow up period was 46months (range 24–70). Results: Autografts were used in 32 patients (35.6%) allografts in 28 (31.1%) and in remaining 30 cases (33.3%) bone substitutes were used. Autografts had shortest healing time with mean value of 6.77 ± 3.2 weeks (4–16 weeks) followed by bone substitutes 10.0± 2.4weeks (8-14 weeks). Allograft demonstrated maximum healing time with mean 11.25 ± 2.6weeks (range 8-16 weeks). Additional scar 100% (n=32), cosmetic deformity 6.25% (n=2), recurrence 6.25%(n=2) and infection 3.13%(n=1) were chief complications in autograft group. Serous discharge was observed in 64.3% (n=18) patients of allograft and in 23.3% (n=7) of bone substitute groups and one patient each in these two groups had infection respectively. There was one recurrence each in allograft and bone substitute groups respectively. Cost was big limiting factor for usage of bone substitutes in large cavities. Functional assessment was done by Musculoskeletal Tumor Society Rating Scale (MSTS) score while radiographic assessment of graft uptake by Irwin grading. The overall average Musculoskeletal Tumor Society (MSTS) score was 26.75 (range 24-30). Conclusion: Autograft is the best material to fill the defect after extended curettage of benign lytic lesions of bone. Bone substitutes and allografts are the options if autograft not available like in children. We observed that in small cavities bone substitutes can be an effective alternative and in large cavities it is better to use either allograft alone or a combination of autograft.
Three intrasubstance failures of a LARS™ ligament used for ligament reconstruction
Authors: Ramsingh V , Yewlett AD , Pullen HC
Published: January 2019

We report three cases of intrasubstance failure of a LARS™ (Ligament Augmentation and Reconstruction System) artificial ligament used for acromioclavicular joint reconstruction. The LARS™ ligament failed within four months of the index procedure. All patients underwent a revision procedure following an unsuccessful trial of conservative management. A modified second loop technique was employed during the revision procedure for all cases using the LARS™ ligament. All three patients achieved full recovery to pre-injury level function.
The prognostic significance of macroscopic serosal change in subserosal invasion (stage T3) gastric cancer
Authors: Zhao B , Mei D , Zhang J , Zou S , Lu Hn , Xu H , Huang B
Published: January 2019

Background

For patients with gastric cancer intraoperative macroscopic serosal change is not always consistent with pathological T stage. We investigated whether macroscopic serosal change is associated with unfavourable prognosis of patients with gastric cancer.

Methods

We reviewed 856 patients with stage T3 gastric cancer who underwent curative gastrectomy in our institution. All patients were classified as serosa negative and serosa positive according to the macroscopic serosal change during the operation. The prognostic difference between two groups was compared and clinicopathologic features were analysed.

Results

The percentage of macroscopic serosal change accounted for 55.7% of all patients. Compared with normal serosal surface, the patients with macroscopic serosal change had larger tumour size, more extensive stomach involvement and more advanced stage N. The prognosis of stage T3 with macroscopic serosal change was significantly poorer than that of those with normal serosal surface, especially for those with stages T3N0 and T3N1. Multivariate analysis identified macroscopic serosal change as an independent factor associated with unfavourable prognosis of stage T3 cancer.

Conclusion

Although the depth of tumour invasion mainly depends on pathological evaluation after surgery, the prognostic significance of intraoperative macroscopic serosal change should not be ignored for those patients with subserosal invasion.
The effects of foam sclerotherapy on ulcer healing: a single-centre prospective study
Authors: Cuffolo G , Hardy E , Perkins J , Hands LJ
Published: January 2019

Introduction

This prospective study of foam sclerotherapy for varicose veins aimed to determine the outcomes of treatment including ulcer healing and complication rates in our unit. Data were collected prospectively over a 10-year period and maintained on a database by our vascular sciences unit, which performed the planning and post-treatment venous duplex scans. Patients undergoing treatment due to venous ulceration were identified from this database. An initial cohort of patients underwent a follow-up scan and assessment at one year.

Materials and methods

Patients were treated with foam sclerotherapy, in multiple sessions if required, to occlude all incompetent superficial veins greater than 3 mm in size. We used 3% sodium tetradecyl sulphate as our sclerosing agent, according to our departmental protocol, followed by a period of compression therapy. Patients underwent pre- and post-treatment scans to assess venous competence, the effects of treatment and any complications that arose.

Results

We identified 336 patients treated for clinical, aetiological, anatomical and pathophysiological stage 5/6 venous ulceration. At six weeks post-treatment, 21% had fully healed ulcers and a further 46.1% were clinically improving with no further venous incompetence. The remainder continued treatment. An initial cohort of 162 patients was assessed at one year and 77.1% ulcers remained healed. The remainder demonstrated some venous incompetence and ultimately 12.5% required further treatment. Our complication rates were similar to those quoted in published meta-analyses including a deep vein thrombosis rate of 1.16%.

Conclusions

Foam sclerotherapy remains a useful treatment option for venous ulceration with a low morbidity rate.