bluuebunny/crossref_metadata_2025 huggingface dataset:
Outbreak Investigation Following the 2015 Earthquake Disaster in Nepal
Authors: Shakya Geeta , Marasini Baburam , Karki Khem Bahadur , Upadhaya Bishnu Prasad , Acharya Jyoti , Adhikari Shailaja , Manjhi Rosham , Maharjan Laxman , Shrestha Lilee , Ranabhat Kamal , Marahatta Sujan Babu , Shrestha Bikal , Dhimal Meghnath
Published: March 2018

Background: Infectious disease outbreaks following natural disasters are reported in literature. Outbreaks were documented following natural disasters in many countries including Haiti. Such possibility following 2015 Nepal earthquake was a public health concern. Risk factors needed evaluation by post-disaster outbreak investigation. Hence, present study was undertaken to investigate potentials for such outbreak and to generate evidence for public health intervention.Methods: The study was conducted between April – May, 2015, with the cooperation of National Public Health Laboratory, Epidemiology and Disease Control Division, Nepal Health Research Council and the Chinese team. Rapid Response Teams visited earthquake affected districts and collected samples for analysis. Syndromic surveillance approach was followed. Samples were collected from syndromic patients under supervision. Those sick prior to earthquake or receiving treatment were excluded. Blood, stool and throat swab samples, as indicated, were collected. Drinking water and food samples including captured live mosquitoes from inhabited areas were obtained for study with the help of EDCD. Laboratory analysis was performed at the NPHL.Results: Total samples were 360 (114 biological, 246 environmental). Salmonella spp. was detected in two and Varicella zoster in one blood sample. Influenza B virus was detected in one throat swab. Rota virus was detected in two, Shigella dysenteriae in one and Salmonella spp. in one stool sample. No pathogen detected in water or food samples. Mosquitoes tested negative for dengue virus.Conclusions: Post-earthquake outbreak investigated in disaster phase-2. Diarrheal, enteric fever pathogens and Influenza B virus were detected. Environmental samples tested negative for pathogens. Vigilance is necessary for other risk factors.
Percutaneous Renal Biopsy: Comparison of Blind and Real-time Ultrasound Guided Technique
Authors: Pokhrel Anil , Agrawal Rajendra Kumar , Baral Anil , Rajbhandari Ajaya , Hada Rajani
Published: March 2018

Background: Percutaneous renal biopsy is performed for diagnosis and prediction of prognosis of renal diseases. Adequacy of tissue and clinically significant bleeding are the main issues of the procedure. We aimed to compare these issues in renal biopsy by blind and real time ultrasound guided technique.Methods: It was a cross sectional, randomized study conducted between June 2016 to December 2016. In blind technique, marking for biopsy was done by ultrasound. Two attempts were performed for all and more if tissue was inadequate. Patients kept in bed rest for 24 hours, observed for post procedure hematuria and ultrasound done at 6 hours and 24 hours to diagnose perinephric hematoma.Results: Total 75 biopsies (blind = 37 and Ultrasound -guided = 38) were evaluated. Blind and Ultrasound-guided technique had significant difference of number of attempt (mean±SD) 2.4±0.6 and 2.1±0.3 (p<0.01) respectively with no difference of number of glomeruli in light microscopy. Bleeding complications were macroscopic hematuria (11(30%)vs15(40%)) and perinephric hematoma ( 5(13.5%)vs3(7.9%)) in blind and Ultrasound-guided technique respectively with no significant difference. Those patients who developed perinephric hematoma was observed in all at 6 hours.Conclusions: Ultrasound-guided technique of percutaneous renal biopsy is superior with fewer attempts and equivalent in adequacy of tissue and bleeding complication than blind technique.
Profile of Caesarean Section in Mid-Western Regional Hospital in Nepal
Authors: Dhakal Keshar Bahadur , Dhakal Sulochana , Bhandari Saroj
Published: March 2018

Background: Rising rate of caesarean section since few decades has been a global public health issue.This study is aimed to determine the rate of caesarean section plus examine the indications and complications of caesarean section.Methods: A retrospective cross-sectional study was conducted using secondary data sources at Mid-Western Regional Hospital in Surkhet, Nepal. Data were collected from patients’records ofthe hospital dating from 16 July 2016 to 15 July 2017. All patients who had delivered their baby by caesarean section were included in this study. Data were analyzed by help of SPSS version 21.Ethical approval was obtained from the hospital authority prior to the study.Results: During the study, out of total 3,694 deliveries, 695 (18.8%) were caesarean section. Most of the caesarean section were emergency than elective (83.0% vs 17.0%). Among all women who underwent caesarean section, majority were from 37 to 42 weeks pregnancy (88.5%), age group between 20 and 24 (42.9%) and multiparous (53.5%).Fetal distress (20.1%) was most common among all major indications of caesarean section. Maternal complications due to caesarean section was low (3.7%). Among all complications, Post-partum hemorrhage (30.5%) was the major maternal complication of caesarean section. Most of newborn babies had APGAR score six or more at one minute (94.5%) and five minutes (97.9%).Conclusions: In our study, caesarean section rate was 18.8%, which is higher than WHO recommendation (10 – 15%). Main indication for caesarean section was fetal distress. Maternal and fetal complications were low.
Comparison of Stage and Lymph Node Ratio in Young and Older Patients with Colorectal Cancer Operated in a Tertiary Hospital in Nepal
Authors: Ghimire Bikal , Singh Yogendra Prasad , Kurlberg Goran , Wettergren Yvonne
Published: March 2018

Background: Colorectal cancer is being diagnosed more frequently in the young and it presents in an advanced stage. In TNM staging, stage depends on tumor size and number of positive nodes, which depend on location of tumor as well as the extent of dissection.The lymph node ratio is regarded as a more reliable marker for prognosis. In this study, we compare epidemiology of colorectal cancer in the young (<40 years) and older patients as well as the LNR.Methods: Patients with colorectal cancer operated at the Tribhuvan University Teaching Hospital, Kathmandu, Nepal for a period of 4 years (2012 – 2016) were included in the study. Patients were grouped into young (≤ 40 years) and older (> 40 years) and clinic-pathological data such as site of lesion, clinical stage, and lymph node ratio were compared.Results: Of the 95 patients of colorectal cancer, 25 patients were of age ≤ 40 years (26%) and they had a higher median stage at diagnosis. In patients above 40 years, it was diagnosed at a relatively earlier stage. The mean number of positive nodes was 11.64 in younger patients whereas it was 18.34in those more than 40 years of age,but younger patients had higher lymph node ratio than elderly (0.31 vs 0.13) (P-value ≤ 0.005).Conclusions: Young patients with colorectal cancer tend to have more advanced disease. The lymph node metastasis and lymph node ratio tend to be higher in young patients.
Clinical Evaluation of Maxillary Anterior Teeth in Relation to Golden Proportion, Red Proportion and Golden Percentage
Authors: Maharjan Anjana , Joshi Sarita
Published: March 2018

Background: Golden proportion, recurrent esthetic dental proportion and golden percentage are the widely accepted tools to measure perceived mesiodistal width of maxillary anterior teeth. Our study was aimed to identify appropriate tool among the above mentioned proportion to measure perceived mesiodistal width.Methods: A cross-sectional observational study was conducted in National Academy of Medical Sciences, Bir Hospital, Nepalese Army Institute of Medical Sciences and Patan Academy of Health Sciences between March 2014 to March 2015.Sixty-three respondents were recruited in the study by the convenient sampling technique. Photographs of the maxillary anterior teeth were taken using digital single reflex camera with macrolens. Data analysis was done using SPSS version 17.0 and paired sample t- test was performed.Results: In our study the golden proportion was 14.28% between central and lateral incisor and 12.69% between canine and lateral incisor. Therefore, golden proportion in our scenario doesn’t exist. Recurrent esthetic dental proportion in female Aryans was 71 and 71 on left side and 71and 75 on right side. Golden percentage of respondents was near to values 11, 15, 22, 22, 15, and 12%.Conclusions: Golden percentage is an appropriate anterior tooth proportion which may serve as a guideline for the restoration of anterior tooth. RED proportion is applicable only in Mongoloid female population.
Utility of Ischemia Modified Albumin as an Early Marker for Diagnosis of Acute Coronary Syndrome
Authors: Mishra Bijaya , Pandey Sunil , Niraula Surya Raj , Rai Bijendra Kumar , Karki Prahlad , Baral Nirmal , Lamsal Madhab
Published: March 2018

Background: The diagnosis of acute coronary syndrome remains challenging, as cardiac troponins and creatine kinase-MB do not detect myocardial ischemia. Ischemia modified albumin is biomarker positive within 6-10 minutes following ischemic onset, where oxygen free radicals leads to reduction in binding capacity of human serum albumin to transitional metal-cobalt. The objective of this study was to compare ischemia modified albumin between acute coronary syndrome patients and healthy controls, and evaluate diagnostic performance of ischemia modified albumin compared to cardiac troponins, creatine kinase-MB and electrocardiogram in acute coronary syndrome patients.Methods: Fifty ACS patients and 50 healthy controls were enrolled in this cross-sectional study. Ischemia modified albumin was measured after addition of known amount of cobalt to human serum albumin, followed by spectrophotometric determination of unbound cobalt fraction at 470 nm using dithiothreitol as coloring agent. Independent student t-test and One-way ANOVA to compare differences of mean between groups; diagnostic sensitivity and specificity of ischemia modified albumin was determined by receiver operating characteristic curve; McNemar-test was used to assess diagnostic performance of entire test parameters, when used alone and in combinations.Results: Ischemia modified albumin was significantly higher in acute coronary syndrome patients compared to controls (0.823±0.191 vs 0.410±0.081)(p<0.001). Receiver operating characteristic curve derived optimal cutoff of 0.475 Absorbance unit had sensitivity and specificity of 92% and 82% respectively (area under curve- 0.96). However, no significant differences in mean ischemia modified albumin values between three categories of acute coronary syndrome were seen. Sensitivity of ischemia modified albumin assay (92%) was significantly higher compared to electrocardiogram (72%), cardiac troponin I (18%), and creatine kinase-MB(42%).Conclusions: Ischemia modified albumin is elevated in acute coronary syndrome patients with better diagnostic performance compared to electrocardiogram, cardiac troponin I, and creatine kinase-MB for early diagnosis, however, with limited ability to discriminate between ST-elevation myocardial infarction, non-ST-elevation myocardial infarction and unstable angina.
Fast radio bursts
Authors: Popov S B , Postnov K A , Pshirkov M S
Published: March 2018

First discovered in 2007, fast radio bursts (FRBs) are highly luminous (10−1−102 Jy), millisecond-scale, highly dispersive single radio pulses whose record high brightness temperatures suggest a nonthermal emission mechanism. As of March 2018, a total of 32 FRBs have been recorded. There is also one repeating source, from which hundreds of bursts have already been detected. The rate of events is estimated to be several thousand per day per sky (disregarding bursts from the repeater), and their isotropic distribution in the sky suggests a likely cosmological origin. While numerous hypotheses have been proposed for FRBs since their discovery, the origin of these transients is not yet known. The most promising models either relate them to burst-type radiation from magnetars (neutron stars powered by the dissipation of their magnetic energy) or consider them analogous to giant pulses from some radio pulsars (strongly magnetized rotating neutron stars). The increasing statistics on the observed bursts and improvements in characterizing the FRB population will allow FRBs to become another tool for probing the intergalactic medium, estimating the cosmological parameters, and testing fundamental physical theories.
Geographic structure of sibling species and cytotypes of the Simulium arcticum complex (Diptera: Simuliidae) in rivers of central Idaho and southeastern Washington, United States of America
Authors: Shields Gerald F. , Shields John P.
Published: March 2018

We made 37 collections and analysed the polytene chromosomes of salivary glands of 726 larvae of the Simulium arcticum Malloch (Diptera: Simuliidae) complex from 10 locations in an unstudied region from central Idaho and southeastern Washington, United States of America. We compared our results to previous population cytotaxonomic research on larvae of this complex from western Montana, northern Idaho, and eastern Washington, United States of America. We identified four sibling species, S. brevicercum Knowlton and Rowe, S. saxosum Adler, S. arcticum sensu stricto, S. apricarium Adler, Currie, and Wood; and three cytotypes, S. arcticum IIL-9, IIL-17, and IIL-79, previously described by us. We discovered a new cytotype, S. arcticum IIL-80, at three locations in the western region of our sample area. We also found combinational (ancestral) types between S. saxosum and S. arcticum sensu stricto and between S. saxosum and S. arcticum IIL-79, suggesting that ancestral populations of the complex still exist. Geographic structuring of these sibling species and cytotypes are documented given that S. saxosum occurred in western regions, S. arcticum IIL-79 in northeastern regions, and S. apricarium in southeastern regions of our study area.
Las startups periodísticas como ejemplos de innovación en el mercado mediático español. Estudio de casos
Authors: Valero-Pastor José María , González-Alba José Antonio
Published: March 2018

La industria mediática está inmersa en un proceso de constante cambio. Las empresas informativas deben adaptarse a las nuevas tecnologías y hábitos de consumo. Sin embargo, las grandes infraestructuras y la rigidez de los procesos y mentalidades en la mayoría de medios dificultan esta adaptación y dejan espacio para nuevos actores innovadores y flexibles: las startups. Metodología: En este artículo se emplea el método del estudio de casos para analizar cuatro iniciativas en el ámbito español, Politibot, Cuonda, Datadista y Newskid. Se emplean cuestionarios realizados a sus fundadores y al estudio del alcance de los proyectos mediante documentación. Resultados y discusión: Se aprecia que estas empresas apuestan por explorar nuevos formatos, canales de distribución y vías de ingreso mediante el uso de la tecnología y dirigen sus esfuerzos a nichos temáticos. Se realza así la importancia de la flexibilidad, la mentalidad abierta y los equipos de trabajo multidisciplinares.
Camerimage, un festival único dedicado al arte de la fotografía cinematográfica
Authors: Cortés-Selva Laura , Jurado-Martín Montserrat , Ostrovskaya Liudmila
Published: March 2018

Camerimage es uno de los escasos festivales especializado en fotografía cinematográfica sobre el que existe una escasa reflexión. Objetivos. Esta investigación aborda sus estrategias para potenciar la fotografía cinematográfica, los estilos fotográficos impulsados y su repercusión en la carrera de los directores de fotografía. Metodología. Se emplea una triangulación metodológica con técnicas cualitativas y cuantitativas: observación participante; análisis de la programación y de los documentos publicados por el festival; análisis de contenido de los filmes galardonados y análisis de la base de datos imdb. Resultados y conclusiones. El festival se centra en los directores de fotografía, las obras audiovisuales de excelencia fotográfica y una audiencia preocupada por la calidad de la imagen. Para ello, premia la excelencia fotográfica, apuesta por la formación continua, el contacto entre creadores y construye una comunidad. El festival promueve una fotografía de alto contraste y escasa saturación, adaptada a cada narración, perteneciente al género dramático y centrada en el pasado. El festival supone un impacto en la carrera de directores de fotografía del centro y norte de Europa que logran incrementar su participación en la industria estadounidense.
Albee’s Plays in the Light of Psychological Theories
Authors: Kaibr Kadhim Hatem , Jingjing Guo
Published: March 2018

Albee’s plays are known for highlighting the daily suffering of American individuals and the material pressures exerted upon them by the “American dream” project, which pushes them into choosing between fulfilling their material requirements in exchange for the supreme human values and social relations that bind their community and refusing to face their reality in favor of retreating to a world of illusion. Albee’s plays have also touched upon the themes of suicide, departure, anxiety, insanity, fear of death, and fear of the unknown. Many critics and analysts have linked the premises in his plays with psychoanalytical theories that analyze the behavior and the relationship of individuals to their communities. This paper will attempt to focus on certain psychological theories that can explain the state of anxiety and sense of loss experienced by the theatrical characters created by Albee in three of his prominent plays.
English Oral Communication Needs of Bhutanese Students: As Perceived by the Teachers and Students
Authors: Singay .
Published: March 2018

The main aim of this study was to investigate the oral communication needs in English from the perspective of students and teachers to improve students' oral communication ability. A questionnaire was administered to 45 participants consisted of 36 students and 9 teachers. The data were analyzed using descriptive statistics like mean and standard deviation. Results revealed that students and teachers had different standpoints of oral communication needs in English in the classroom, especially with regard to general listening and speaking skills. In addition, findings from the questionnaire suggested that teachers and students perceive speaking and listening informally in situations, for instance working in pair, discussion in small groups, role plays, interviews, classroom debates, storytelling, and being able to communicate orally with teachers as most important oral communication abilities to be practice in the classroom. Lastly, the most important oral communication abilities such as the use of academic language in the classroom and daily conversation in English should also be taken into account to ensure effective oral communication in the classroom.
Knowledge Growth, Academic Beliefs and Motivation of Students in Business and Economics - A longitudinal German Case Study
Authors: Biewen Martin , Happ Roland , Schmidt Susanne , Zlatkin-Troitschanskaia Olga
Published: March 2018

In this study we examine the determinants of and the relationship among economic knowledge, epistemological beliefs, and extrinsic and intrinsic motivation over the course of undergraduate studies in a sample of students of business and economics at a university in Germany. We found economic knowledge increased over the course of studies, extrinsic and intrinsic motivation declined, and students became more skeptical in their epistemological beliefs about the objectivity of economic content being taught in their courses. The students’ level of economic knowledge was related to intrinsic motivation but unrelated to extrinsic motivation and epistemological beliefs. Furthermore, the students’ tendency to become more skeptical over the course of their studies was mitigated by high levels of extrinsic motivation. The use of internationally established assessments such as the Test of Economic Literacy, developed by the Council of Economics Education, enables implications for higher education business and economics programs at the international level to be drawn from our findings.
A Possible Link Between Winter Arctic Sea Ice Decline and a Collapse of the Beaufort High?
Authors: Petty Alek A.
Published: March 2018

A new study by Moore et al. (2018, https://doi.org/10.1002/2017GL076446) highlights a collapse of the anticyclonic “Beaufort High” atmospheric circulation over the western Arctic Ocean in the winter of 2017 and an associated reversal of the sea ice drift through the southern Beaufort Sea (eastward instead of the predominantly westward circulation). The authors linked this to the loss of sea ice in the Barents Sea, anomalous warming over the region, and the intrusion of low‐pressure cyclones along the eastern Arctic. In this commentary we discuss the significance of this observation, the challenges associated with understanding these possible linkages, and some of the alternative hypotheses surrounding the impacts of winter Arctic sea ice loss.
A Transverse Colectomy is as Safe as an Extended Right or Left Colectomy for Mid‐Transverse Colon Cancer
Authors: Leijssen Lieve G. J. , Dinaux Anne M. , Amri Ramzi , Kunitake Hiroko , Bordeianou Liliana G. , Berger David L.
Published: March 2018

Background

Although extended colectomy is often chosen for patients with transverse colon cancer, the optimal surgical approach for mid‐transverse colon cancer has not been established.

Methods

We identified patients who underwent a transverse (TC) or an extended colectomy (EC) for mid‐transverse colon cancer between 2004 and 2014. To adjust for potential selection bias between the groups, a propensity score matching analysis was performed.

Results

A total of 103 patients were included, of whom 63% underwent EC (right 47%, left 17%) and 37% TC. EC patients tend to have worse short‐term outcomes. Although fewer lymph nodes were harvested after TC, 5‐year overall (OS) ad disease‐free survival (DFS) was comparable between the groups. When comparing long‐term outcomes stage‐by‐stage, worse OS and DFS were seen in stage‐II. All stage‐II patients died of a non‐cancer‐related cause and recurrence occurred in pT4 TC patients who did not receive adjuvant therapy. The propensity‐matched cohort demonstrated similar postoperative morbidity, but more laparoscopic procedures in EC. Additionally, TC tumors were correlated with poorer histopathological features and disease recurrence was only seen after TC.

Conclusion

Our study underlines the oncological safety of a transverse colectomy for mid‐transverse colon cancer. Although TC tumors were associated with poorer histopathological features, survival rates were comparable.
Contribution of tandem mass spectrometry to the diagnosis of lysosomal storage disorders
Authors: Piraud Monique , Pettazzoni Magali , Lavoie Pamela , Ruet Séverine , Pagan Cécile , Cheillan David , Latour Philippe , Vianey‐Saban Christine , Auray‐Blais Christiane , Froissart Roseline
Published: March 2018

Tandem mass spectrometry (MS/MS) is a highly sensitive and specific technique. Thanks to the development of triple quadrupole analyzers, it is becoming more widely used in laboratories working in the field of inborn errors of metabolism. We review here the state of the art of this technique applied to the diagnosis of lysosomal storage disorders (LSDs) and how MS/MS has changed the diagnostic rationale in recent years. This fine technology brings more sensitive, specific, and reliable methods than the previous biochemical ones for the analysis of urinary glycosaminoglycans, oligosaccharides, and sialic acid. In sphingolipidoses, the quantification of urinary sphingolipids (globotriaosylceramide, sulfatides) is possible. The measurement of new plasmatic biomarkers such as oxysterols, bile acids, and lysosphingolipids allows the screening of many sphingolipidoses and related disorders (Niemann–Pick type C), replacing tedious biochemical techniques. Applied to amniotic fluid, a more reliable prenatal diagnosis or screening of LSDs is now available for fetuses presenting with antenatal manifestations. Applied to enzyme measurements, it allows high throughput assays for the screening of large populations, even newborn screening. The advent of this new method can modify the diagnostic rationale behind LSDs.
Long‐term follow‐up of 17 patients with childhood Pompe disease treated with enzyme replacement therapy
Authors: van der Meijden Jan C. , Kruijshaar Michelle E. , Harlaar Laurike , Rizopoulos Dimitris , van der Beek Nadine A. M. E. , van der Ploeg Ans T.
Published: March 2018

Objectives

Pompe disease is a progressive metabolic myopathy for which enzyme replacement therapy (ERT) was approved in 2006. While various publications have examined the effects of ERT in classic‐infantile patients and in adults, little has been published on ERT in children with non‐classic presentations.

Study design

This prospective study was conducted from June 1999 to May 2015. Seventeen patients from various countries participated. Outcome measures comprised muscle function (6‐minute walk test, quick motor‐function test (QMFT)), muscle strength (hand‐held dynamometry; manual muscle testing), and lung function (FVC sitting and supine). For each outcome measure, we used linear mixed‐effects models to calculate the difference at group level between the start of therapy and 7 years of ERT. Patients’ individual responses over time were also evaluated.

Results

Eleven males and six females started ERT at ages between 1.1 and 16.4 years (median 11.9 years); 82% of them carried the common c.‐32‐13T > G GAA gene variant on one allele. At group level, distance walked increased by 7.4 percentage points (p < 0.001) and QMFT scores increased by 9.2 percentage points (p = 0.006). Muscle strength scores seemed to remain stable. Results on lung function were more variable. Patients’ individual data show that the proportion of patients who stabilized or improved during treatment ranged between 56 and 69% for lung function outcomes and between 71 and 93% for muscle strength and muscle function outcomes.

Conclusions

We report a positive effect of ERT in patients with childhood Pompe disease at group level. For some patients, new or personalized treatments should be considered.
The Process of Disclosure: Mothers’ Experiences of Communicating X‐Linked Carrier Risk Information to At‐Risk Daughters
Authors: Goldman Amy , Metcalfe Alison , MacLeod Rhona
Published: March 2018

When a boy is diagnosed with an X‐linked condition such as Duchenne or Becker muscular dystrophy (D/BMD), the mother learns not only of her own potential carrier risk but also that of her daughters. Before the daughters are seen in the Genetics Clinic, responsibility for disclosing carrier risk information falls mainly to their mothers. We know little about if when and how these daughters are being told about their risk, and how mothers find the experience. Should we be doing more to help and support them? Using qualitative methods, six mothers known to the Manchester Centre for Genomic Medicine were interviewed about the disclosure of D/BMD carrier risk information to their daughters. The four key themes that arose are presented: communication process, facilitators of disclosure, barriers to disclosure and support and information. Despite the participants’ endeavours to be open and honest with their daughters and their belief that they had fully disclosed, key information was often withheld. Major barriers to discussion of the future, including reproductive options, were apparent. These were partly overcome by the involvement of genetic counsellors (GCs). The participants suggested a greater involvement of GCs, proactively sending appointments and written information, and offering carrier testing more flexibly.
A Comparison of Two Arthroscopic Techniques for Interpositional Polytetrafluoroethylene Patch Repair for Massive Irreparable Rotator Cuff Tears: Speed and Biomechanics
Authors: Sunwoo Joo Y. , Lam Patrick H. , Murrell George A. C.
Published: March 2018

Background

Interpositional synthetic patch repairs are a novel method of treating massive irreparable rotator cuff tears. However, surgeons experience difficulty in the arthroscopic insertion of these patches.

Questions/Purposes

We compared two methods of arthroscopic interpositional synthetic patch repair: the newly devised slide-and-grip technique, using pre-loaded sliding knots and no arthroscopic knots, and the weave technique, using less arthroscopic knot tying than the earlier mattress technique. Study questions were as follows: (1) Would the slide-and-grip technique take less time than the weave technique? (2) Would the biomechanical strength of the two methods be comparable?

Methods

Fourteen paired ovine infraspinatus tendon ex vivo models of the degenerative human rotator cuff underwent timed repair with a synthetic polytetrafluoroethylene (PTFE) patch, using either the weave technique ( n = 7) or the slide-and-grip technique ( n = 7). Each was pulled to failure using a tensile testing machine, the Instron 8874.

Results

The time to complete the slide-and-grip repairs was shorter (12 ± 0.9 min) than that of the weave repairs (23 ± 1 min). Ultimate load to failure was comparable for the slide-and-grip and weave techniques (211 ± 27 N vs. 295 ± 35 N, respectively), and the slide-and-grip was less stiff (14 ± 1 N/mm vs. 19 ± 1 N/mm).

Conclusions

The slide-and-grip technique took less time than the weave technique for the interpositional patch repair of massive irreparable rotator cuff tears and when correctly performed had comparable biomechanical strength.
Who’s the boss? The economic and behavioral implications of various characterizations of the superior in participative budgeting research
Authors: Brink Alisa G. , Coats Jennifer C. , Rankin Frederick W.
Published: March 2018

Participative budgeting can benefita firm by incorporating subordinates’ private information into financing and operating decisions. In the managerial accounting literature, studies of participative budgeting posit superiors that range from passively committed to highly active participants, some of whom are permitted to communicate, choose compensation schemes, negotiate with subordinates, and reject budgets. This paper synthesizes and analyzes experimental research in participative budgeting with a focus on the role of the superior defined in the research design, and on how that role affects budget outcomes, subordinate behavior, and in some cases superior behavior. We demonstrate how superior type influences economic and behavioral predictions, and likewise affects budgeting outcomes and the interpretation of the results. This paper is intended to further our understanding of how superior type affects behavior in participative budgeting studies, and to facilitate the choice of superior type in future research designs.
Adolescent psychopathology in Times of Change: The need for integrating a developmental psychopathology perspective
Authors: Shulman Shmuel , Scharf Miri
Published: March 2018

In addition to the major physical, sexual and cognitive changes, as well as changes in relationships with parents and peers, in recent years adolescents also have to cope with many technological changes and increasing societal instabilities. Most of the existing research has examined the extent to which increasing uncertainties might impact expression of psychopathology and its magnitude. Emerging from a developmental psychopathology perspective, we are looking first for a better understanding of the meaning that adolescents give to these changes, which in turn is likely to affect their behavior. We are also looking for better understanding the importance of the role parents, and other societal systems/institutions (such as peers) play in ameliorating or enhancing the likelihood of maladaptive adolescent behavior under these circumstances.
Retrospective Study of the Prevalence and Risk Factors of Clitoral Adhesions: Women's Health Providers Should Routinely Examine the Glans Clitoris
Authors: Aerts Leen , Rubin Rachel S. , Randazzo Michael , Goldstein Sue W. , Goldstein Irwin
Published: March 2018

Introduction

The glans clitoris is covered by a prepuce that normally moves over the glans surface and can be retracted beyond the corona. Clitoral adhesions, ranging from mild to severe, occur when preputial skin adheres to the glans. Physical examination consistent with clitoral adhesions is based on the inability to visualize the entire glans corona. In this closed compartment, the space underneath the adherent prepuce and clitoris can become irritated, erythematous, or infected and can result in sexual dysfunction.

Aim

To determine the prevalence of clitoral adhesions in a sexual medicine practice and assess risk factors associated with clitoral adhesions.

Methods

This research involved retrospective examinations of vulvoscopy photographs taken from August 2007 to December 2015. Clitoral adhesions were considered absent when preputial retraction enabled full glans corona visualization. The study group consisted of women with mild, moderate, or severe clitoral adhesions based on more than 75%, 25% to 75%, or less than 25% glans clitoris exposure without full corona visualization, respectively. 2 independent reviewers evaluated photographs; a 3rd analyzed study group health record data.

Main Outcome Measure

Prevalence of severity of clitoral adhesions.

Results

Of the 1,261 vulvoscopy photographs, 767 (61%) were determined adequate for assessment and 614 photographs represented individual patients. The study group with clitoral adhesions consisted of 140 women (23%) of whom 44%, 34%, and 22% demonstrated mild, moderate, and severe clitoral adhesions, respectively. In the study group, 14% presented with clitorodynia. Risk factors included a history of sexual pain, yeast infection, urinary tract infection, blunt perineal or genital trauma, lichen sclerosus, low calculated free testosterone, and other sexual dysfunctions including persistent genital arousal disorder.

Conclusion

Women with sexual dysfunction should routinely undergo clitoral physical examination. If the glans corona is not fully visualized, then clitoral adhesions should be suspected. Education, counseling, and/or referral for sexual pain management should be considered.
Pharmacologic Treatment for Depression at Injury Is Associated With Fewer Clinician Visits for Persistent Symptoms After Mild Traumatic Brain Injury: A Medical Record Review Study
Authors: Kruse Ryan C. , Li Zhuo , Prideaux Cara C. , Brown Allen W.
Published: March 2018

Background

Depression and traumatic brain injury (TBI) substantially contribute to the U.S. health care burden. Depression is a known risk factor for prolonged recovery after TBI. However, the effect of depression treatment on health care utilization has yet to be studied.

Objective

To examine whether an association exists between pharmacologic treatment of depression at the time of mild or concussive TBI and the number of subsequent clinician visits for persistent injury‐related symptoms.

Design

Retrospective medical record review.

Setting

Tertiary care medical center.

Participants

A total of 120 patients (mean age 45.6 years) with a history of depression who subsequently experienced a mild or concussive TBI were included.

Methods

Individuals were identified with co‐occurring diagnoses of depression and mild or concussive TBI by retrospective electronic medical record review. The diagnosis of depression must have preceded the diagnosis of TBI.

Main Outcome

The number of clinician visits for postinjury symptoms were counted at 3, 6, and 12 months postinjury.

Results

Clinician visits for persistent injury‐related symptoms were significantly fewer at all 3 time points for the group treated for depression at time of injury.

Conclusions

Depressed individuals who were pharmacologically treated for depression at the time of TBI had significantly fewer clinician visits for persistent postinjury symptoms than those not pharmacologically treated for depression at the time of injury. Routine depression screening in patients with a high risk for TBI may identify a mood disorder that could contribute to persistent symptoms if left untreated, with its effective management potentially reducing health‐related costs.

Level of Evidence

III
Vintage pumps benefit from expert upgrade
Authors: Jennings Bob , Babusiak Ken
Published: March 2018

A major steel manufacturer found that five vintage descaling pumps were consuming too much power and not producing enough output. A hydraulic review led to a full refurbishment which saved the steel plant millions per year in downtime, repairs, and maintenance.
Diachronic split and phoneme borrowing in Resígaro (Arawakan)
Authors: de Carvalho Fernando O.
Published: March 2018

This paper examines a previously identified but so far imprecisely defined split in the historical phonology of Resígaro (Arawakan). I argue that this development was a simple case of allophonic redistribution or primary split, in which word-final allophones of*amerged withɯ. However, comparative data offers no evidence for the existence ofɯbefore the operation of the split in question. This apparent paradox can be resolved by the plausible hypothesis thatɯentered the language via the massive influx of morphemes from Bora, an unrelated language of the Bora-Muinane family. Only after that were some contextual allophones of*amerged withɯ. This is the first solidly justified case of loan phonology in Resígaro and it provides further support to the hypothesis that Bora influence on Resígaro is not a result of the language's obsolescent status.
The Gillette Stadium Experience: A Retrospective Review of Mass Gathering Events From 2010 to 2015
Authors: Goldberg Scott A. , Maggin Jeremy , Molloy Michael S. , Baker Olesya , Sarin Ritu , Kelleher Michael , Mont Kevin , Fajana Adedeji , Goralnick Eric
Published: March 2018

Objective

Mass gathering events can substantially impact public safety. Analyzing patient presentation and transport rates at various mass gathering events can help inform staffing models and improve preparedness.

Methods

A retrospective review of all patients seeking medical attention across a variety of event types at a single venue with a capacity of 68,756 from January 2010 through September 2015.

Results

We examined 232 events with a total of 8,260,349 attendees generating 8157 medical contacts. Rates were 10 presentations and 1.6 transports per 10,000 attendees with a non-significant trend towards increased rates in postseason National Football League games. Concerts had significantly higher rates of presentation and transport than all other event types. Presenting concern varied significantly by event type and gender, and transport rate increased predictably with age. For cold weather events, transport rates increased at colder temperatures. Overall, on-site physicians did not impact rates.

Conclusions

At a single venue hosting a variety of events across a 6-year period, we demonstrated significant variations in presentation and transport rates. Weather, gender, event type, and age all play important roles. Our analysis, while representative only of our specific venue, may be useful in developing response plans and staffing models for similar mass gathering venues. (Disaster Med Public Health Preparedness. 2018;12:752-758).
Effect of free surface on submerged stratified shear instabilities
Authors: Shete Mihir H. , Guha Anirban
Published: March 2018

In this paper, we have considered the effects of the shallowness of the domain as well as the air–water free surface on the stratified shear instabilities of the fluid underneath. First, we numerically solve the non-Boussinesq Taylor–Goldstein equation for smooth velocity and density profiles of a model shear layer with a free surface. When the depth of the fluid is relatively shallow compared to the shear layer thickness, the surface gravity waves existing at the free surface come closer to the waves existing in the shear layer. This can lead to resonant wave interactions, making the flow unstable to more varieties of modal instabilities. In order to obtain a deeper understanding of the instability mechanisms, we have performed analytical studies with broken-line profiles (profiles for which vorticity and density are piecewise constant). Furthermore, reduced-order broken-line profiles have also been developed, based on which dispersion diagrams are constructed. Through these diagrams we have underpinned the resonantly interacting waves leading to each type of instability. Two new instabilities have been found; one of them, referred to as the ‘surface gravity – interfacial gravity (SG-IG) mode’, arises due to the interaction between a surface gravity wave and an interfacial gravity wave, and would therefore be absent if there is no internal density stratification. The other one – the ‘surface gravity – lower vorticity (SG-LV) mode’, which arises due to the interaction between a surface gravity wave and the lower vorticity wave, surpasses Kelvin–Helmholtz (KH) instability to become the most unstable mode, provided the system is significantly shallow. Stability boundary of the SG-LV mode is found to be quite different from that of KH. In fact, KH becomes negligible for relatively shallow flows, while SG-LV’s growth rate is significant – comparable to the growth rate of KH for unbounded domains (${\approx}0.18$). Moreover, the SG-LV mode is found to be analogous to the barotropic mode observed in two-layer quiescent flows. We have found that the effect of a free surface on the Holmboe instability is not appreciable. Holmboe in the presence of a free surface is found to be analogous to the baroclinic mode observed in two-layer quiescent flows. Except for the Holmboe instability, remarkable differences are observed in all other instabilities occurring in shallow domains when the air–water interface is replaced by a rigid lid. We infer that the rigid-lid approximation is valid for large vertical domains and should be applied with caution otherwise. Furthermore, we have also shown that if shear is absent at the free surface, our problem can be modelled using Boussinesq approximation, that is, $O(1)$ density variations in the inertial terms can still be neglected.
Authentic leadership outcomes in detail-oriented occupations: Commitment, role-stress, and intentions to leave
Authors: Kalay Elad , Brender-Ilan Yael , Kantor Jeffrey
Published: March 2018

In recent years there has been a growing scholarly interest in authentic leadership, a leadership style that fosters positive psychological capacities and a positive ethical climate. This study focuses on the Certified Public Accounting profession, which is known as a detail-oriented occupation. We examined if Certified Public Accounting managers exhibiting an authentic leadership style were capable of strengthening the commitment of their subordinates and, at the same time, reducing role-stress and intentions to leave. The hypotheses were tested on a sample of 512 Certified Public Accountings in Israel using structural equation modeling. Results revealed that perceived authentic leadership was negatively related to role-conflicts and role-ambiguity, directly and through the mediation of affective commitment. In addition, the negative correlation between authentic leadership and intention to leave was fully mediated by affective commitment. Limitation and applications for organizations are discussed.
Statistical summer mass-balance forecast model with application to Brúarjökull glacier, South East Iceland
Authors: EYTHORSSON DARRI , GARDARSSON SIGURDUR M. , GUNNARSSON ANDRI , HRAFNKELSSON BIRGIR
Published: March 2018

Forecasting of glacier mass balance is important for optimal management of hydrological resources, especially where glacial meltwater constitutes a significant portion of stream flow, as is the case for many rivers in Iceland. In this study, a method was developed and applied to forecast the summer mass balance of Brúarjökull glacier in southeast Iceland. In the present study, many variables measured in the basin were evaluated, including glaciological snow accumulation data, various climate indices and meteorological measurements including temperature, humidity and radiation. The most relevant single predictor variables were selected using correlation analysis. The selected variables were used to define a set of potential multivariate linear regression models that were optimized by selecting an ensemble of plausible models showing good fit to calibration data. A mass-balance estimate was calculated as a uniform average across ensemble predictions. The method was evaluated using fivefold cross-validation and the statistical metrics Nash–Sutcliffe efficiency, the ratio of the root mean square error to the std dev. and percent bias. The results showed that the model produces satisfactory predictions when forced with initial condition data available at the beginning of the summer melt season, between 15 June and 1 July, whereas less reliable predictions are produced for longer lead times.
‘A Wicked Operation’? Tonsillectomy in Twentieth-Century Britain
Authors: Dwyer-Hemmings Louis
Published: March 2018

Histories of twentieth-century surgery have focused on surgical ‘firsts’ – dramatic tales of revolutionary procedures. The history of tonsillectomy is less glamorous, but more widespread, representing the experience and understanding of medicine for hundreds of children, parents and surgeons daily. At the start of the twentieth century, tonsillectomy was routine – performed on at least 80 000 schoolchildren each year in Britain. However, by the 1980s, public and professional discourse condemned the operation as a ‘dangerous fad’. This profound shift in the medical, political and social position of tonsillectomy rested upon several factors: changes in the organisation of medical institutions and national health care; changes in medical technologies and the criteria by which they are judged; the political, cultural and economic context of Britain; and the social role of the patient. Tonsillectomy was not a mere passive subject of external influences, but became a potent concept in medical, political, and social discourse. Therefore, it reciprocally influenced these discourses and subsequently the development of twentieth-century British medicine. These complex interactions between ‘medical’ and ‘non-medical’ spheres question the possibility of demarcating what is internal from what is external to medicine.
Realists and Idealists in QCA
Authors: Schneider Carsten Q.
Published: March 2018

The sole purpose of the enhanced standard analysis (ESA) is to prevent so-called untenable assumptions in Qualitative Comparative Analysis (QCA). One source of such assumptions can be statements of necessity. QCA realists, the majority of QCA researchers, have elaborated a set of criteria for meaningful claims of necessity: empirical consistency, empirical relevance, and conceptual meaningfulness. I show that once Thiem’s (2017) data mining approach to detecting supersets is constrained by adhering to those standards, no CONSOL effect of Schneider and Wagemann’s ESA exists. QCA idealists, challenging most of QCA realists’ conventions, argue that separate searches for necessary conditions are futile because the most parsimonious solution formula reveals the minimally necessary disjunction of minimally sufficient conjunctions. Engaging with this perspective, I address several unresolved empirical and theoretical issues that seem to prevent the QCA idealist position from becoming mainstream.