bluuebunny/crossref_metadata_2025 huggingface dataset:
Safety and efficacy of aneurysm treatment with WEB: results of the WEBCAST study
Authors: Pierot Laurent , Costalat Vincent , Moret Jacques , Szikora Istvan , Klisch Joachim , Herbreteau Denis , Holtmannspötter Markus , Weber Werner , Januel Anne-Christine , Liebig Thomas , Sychra Vojtech , Strasilla Christoph , Cognard Christophe , Bonafé Alain , Molyneux Andrew , Byrne James V. , Spelle Laurent
Published: September 2015

OBJECT

WEB is an innovative intrasaccular treatment for intracranial aneurysms. Preliminary series have shown good safety and efficacy. The WEB Clinical Assessment of Intrasaccular Aneurysm Therapy (WEBCAST) trial is a prospective European trial evaluating the safety and efficacy of WEB in wide-neck bifurcation aneurysms.

METHODS

Patients with wide-neck bifurcation aneurysms for which WEB treatment was indicated were included in this multicentergood clinical practices study. Clinical data including adverse events and clinical status at 1 and 6 months were collected and independently analyzed by a medical monitor. Six-month follow-up digital subtraction angiography was also performed and independently analyzed by a core laboratory. Success was defined at 6 months as complete occlusion or stable neck remnant, no worsening in angiographic appearance from postprocedure, and no retreatment performed or planned.

RESULTS

Ten European neurointerventional centers enrolled 51 patients with 51 aneurysms. Treatment with WEB was achieved in 48 of 51 aneurysms (94.1%). Adjunctive implants (coils/stents) were used in 4 of 48 aneurysms (8.3%). Thromboembolic events were observed in 9 of 51 patients (17.6%), resulting in a permanent deficit (modified Rankin Scale [mRS] Score 1) in 1 patient (2.0%). Intraoperative rupture was not observed. Morbidity (mRS score > 2) and mortality were 2.0% (1 of 51 patients, related to rupture status on entry to study) and 0.0% at 1 month, respectively. Success was achieved at 6 months in 85.4% of patients treated with WEB: 23 of 41 patients (56.1%) had complete occlusion, 12 of 41 (29.3%) had a neck remnant, and 6 of 41 (14.6%) had an aneurysm remnant.

CONCLUSIONS

The WEBCAST study showed good procedural and short-term safety of aneurysm treatment with WEB and good 6-month anatomical results.
Safety, efficacy, and life satisfaction following epilepsy surgery in patients aged 60 years and older
Authors: Dewar Sandra , Eliashiv Dawn , Walshaw Patricia D. , Engel Jerome , Fried Itzhak , Moseley Brian D.
Published: September 2015

OBJECT

Despite its potential to offer seizure freedom, resective epilepsy surgery (RES) is seldom performed in patients 60 years of age or older. Demonstrating successful outcomes including an improved quality of life may raise awareness about the advantages of referring this underrepresented population for specialized evaluation. Accordingly, the authors investigated outcomes and life fulfillment in patients with an age ≥ 60 years who had undergone RES.

METHODS

All patients who, at the age of 60 years or older, had undergone RES for medically refractory focal onset seizures at the authors’ center were evaluated. A modified Liverpool Life Fulfillment (LLF) tool was administered postoperatively (maximum score 32). Seizure outcomes were classified according to the Engel classification system.

RESULTS

Twelve patients underwent RES. The majority of patients (9 [75%] of 12) had at least 1 medical comorbidity in addition to seizures. The mean follow-up was 3.1 ± 2.1 years. At the time of the final follow-up, 11 (91.7%) of 12 patients were documented as having a good postsurgical outcome (Engel Class I-II). Half (6 of 12 patients) were completely seizure free (Engel Class IA). Liverpool Life Fulfillment (LLF) data were available for 11 patients. Following surgery, the mean LLF score was 26.7 ± 6. Eight patients (72.7%) noted excellent satisfaction with their RES, with 5 (45.5%) noting postoperative improvements in overall health.

CONCLUSIONS

Resective epilepsy surgery is safe and effective in patients with an age ≥ 60 years. Over 90% had a good surgical outcome, with 50% becoming completely seizure free despite 1 or more medical comorbidities in the majority. The study data indicated that an advancing age should not negatively influence consideration for RES.
Cavitation-enhanced nonthermal ablation in deep brain targets: feasibility in a large animal model
Authors: Arvanitis Costas D. , Vykhodtseva Natalia , Jolesz Ferenc , Livingstone Margaret , McDannold Nathan
Published: September 2015

OBJECT

Transcranial MRI-guided focused ultrasound (TcMRgFUS) is an emerging noninvasive alternative to surgery and radiosurgery that is undergoing testing for tumor ablation and functional neurosurgery. The method is currently limited to central brain targets due to skull heating and other factors. An alternative ablative approach combines very low intensity ultrasound bursts and an intravenously administered microbubble agent to locally destroy the vasculature. The objective of this work was to investigate whether it is feasible to use this approach at deep brain targets near the skull base in nonhuman primates.

METHODS

In 4 rhesus macaques, targets near the skull base were ablated using a clinical TcMRgFUS system operating at 220 kHz. Low-duty-cycle ultrasound exposures (sonications) were applied for 5 minutes in conjunction with the ultrasound contrast agent Definity, which was administered as a bolus injection or continuous infusion. The acoustic power level was set to be near the inertial cavitation threshold, which was measured using passive monitoring of the acoustic emissions. The resulting tissue effects were investigated with MRI and with histological analysis performed 3 hours to 1 week after sonication.

RESULTS

Thirteen targets were sonicated in regions next to the optic tract in the 4 animals. Inertial cavitation, indicated by broadband acoustic emissions, occurred at acoustic pressure amplitudes ranging from 340 to 540 kPa. MRI analysis suggested that the lesions had a central region containing red blood cell extravasations that was surrounded by edema. Blood-brain barrier disruption was observed on contrast-enhanced MRI in the lesions and in a surrounding region corresponding to the prefocal area of the FUS system. In histology, lesions consisting of tissue undergoing ischemic necrosis were found in all regions that were sonicated above the inertial cavitation threshold. Tissue damage in prefocal areas was found in several cases, suggesting that in those cases the sonication exceeded the inertial cavitation threshold in the beam path.

CONCLUSIONS

It is feasible to use a clinical TcMRgFUS system to ablate skull base targets in nonhuman primates at time-averaged acoustic power levels at least 2 orders of magnitude below what is needed for thermal ablation with this device. The results point to the risks associated with the method if the exposure levels are not carefully controlled to avoid inertial cavitation in the acoustic beam path. If methods can be developed to provide this control, this nonthermal approach could greatly expand the use of TcMRgFUS for precisely targeted ablation to locations across the entire brain.
What would be the annual cost savings if fewer screws were used in adolescent idiopathic scoliosis treatment in the US?
Authors: Larson A. Noelle , Polly David W. , Ackerman Stacey J. , Ledonio Charles G. T. , Lonner Baron S. , Shah Suken A. , Emans John B. , Richards B. Stephens , _ _
Published: September 2015

OBJECT

There is substantial heterogeneity in the number of screws used per level fused in adolescent idiopathic scoliosis (AIS) surgery. Assuming equivalent clinical outcomes, the potential cost savings of using fewer pedicle screws were estimated using a medical decision model with sensitivity analysis.

METHODS

Descriptive analyses explored the annual costs for 5710 AIS inpatient stays using discharge data from the 2009 Kids’ Inpatient Database (Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality), which is a national all-payer inpatient database. Patients between 10 and 17 years of age were identified using the ICD-9-CM code for idiopathic scoliosis (737.30). All inpatient stays were assumed to represent 10-level fusions with pedicle screws for AIS. High screw density was defined at 1.8 screws per level fused, and the standard screw density was defined as 1.48 screws per level fused. The surgical return for screw malposition was set at $23,762. A sensitivity analysis was performed by varying the cost per screw ($600–$1000) and the rate of surgical revisions for screw malposition (0.117%–0.483% of screws; 0.8%–4.3% of patients). The reported outcomes include estimated prevented malpositioned screws (set at 5.1%), averted revision surgeries, and annual cost savings in 2009 US dollars, assuming similar clinical outcomes (rates of complications, revision) using a standard- versus high-density pattern.

RESULTS

The total annual costs for 5710 AIS hospital stays was $278 million ($48,900 per patient). Substituting a high for a standard screw density yields 3.2 fewer screws implanted per patient, with 932 malpositioned screws prevented and 21 to 88 revision surgeries for implant malposition averted, and a potential annual cost savings of $11 million to $20 million (4%–7% reduction in the total cost of AIS hospitalizations).

CONCLUSIONS

Reducing the number of screws used in scoliosis surgery could potentially decrease national AIS hospitalization costs by up to 7%, which may improve the safety and efficiency of care. However, such a screw construct must first be proven safe and effective.
Minimally invasive tubular microdiscectomy for recurrent lumbar disc herniation
Authors: Hubbe Ulrich , Franco-Jimenez Pamela , Klingler Jan-Helge , Vasilikos Ioannis , Scholz Christoph , Kogias Evangelos
Published: September 2015

OBJECT

The aim of the study was to investigate the safety and efficacy of minimally invasive tubular microdiscectomy for the treatment of recurrent lumbar disc herniation (LDH). As opposed to endoscopic techniques, namely microendoscopic and endoscopic transforaminal discectomy, this microscopically assisted technique has never been used for the treatment of recurrent LDH.

METHODS

Thirty consecutive patients who underwent minimally invasive tubular microdiscectomy for recurrent LDH were included in the study. The preoperative and postoperative visual analog scale (VAS) scores for pain, the clinical outcome according to modified Macnab criteria, and complications were analyzed retrospectively. The minimum follow-up was 1.5 years. Student t-test with paired samples was used for the statistical comparison of pre- and postoperative VAS scores. A p value < 0.05 was considered to be statistically significant.

RESULTS

The mean operating time was 90 ± 35 minutes. The VAS score for leg pain was significantly reduced from 5.9 ± 2.1 preoperatively to 1.7 ± 1.3 postoperatively (p < 0.001). The overall success rate (excellent or good outcome according to Macnab criteria) was 90%. Incidental durotomy occurred in 5 patients (16.7%) without neurological consequences, CSF fistula, or negative influence to the clinical outcome. Instability occurred in 2 patients (6.7%).

CONCLUSIONS

The clinical outcome of minimally invasive tubular microdiscectomy is comparable to the reported success rates of other minimally invasive techniques. The dural tear rate is not associated to higher morbidity or worse outcome. The technique is an equally effective and safe treatment option for recurrent LDH.
Treatment of cranial cruciate ligament rupture in the feline stifle
Authors: Sousa R. De. , Sutcliffe M. , Rousset N. , Holmes M. , Langley-Hobbs S.J.
Published: September 2015

Objective: To determine whether a lateral suture placed with bone anchors between quasi-isometric points in a cat is superior to a standard fabella-tibial suture for the stabilization of cranial cruciate ligament (CrCL) rupture compared to an intact stifle joint.

Study design: Biomechanical cadaveric study.

Methods: Six stifle joints with intact cruciate ligaments from three skeletally mature cats were placed in a loading mounting set and tested with axial loads of 20N and 60N at three different joint angles (75°,130° and 160°). The procedure was repeated with a transected CrCL; a stabilized stifle joint after a combination of three lateral suture techniques (fabella-tibial suture technique [SFT]; femoro-tibial suture technique 1 [FTS-1] and femoro-tibial suture technique 2 [FTS-2]). Radiographic examination of the relative position of the tibia to the fixed femur was compared.

Results: Stabilization of the stifle joint with lateral sutures had comparable stability to the intact specimens in the cranio-caudal direction (p = 0.2) but not in the proximo- distal direction for the SFT (p = 0.04) and FTS-2 technique (p = 0.03). There was no significant difference between the three stabilization techniques (p >0.05).

Clinical significance: Lateral sutures placed with bone anchors at quasi-isometric points performed better than SFT and FTS-2 in stabilizing the feline stifle after CrCL rupture in the proximo-distal plane. Biomechanical stability in the cranio-caudal plane after placement of a lateral suture across the feline stifle was similar to the intact CrCL.
Comparison of the tibia plateau angle between small and large dogs with cranial cruciate ligament disease
Authors: Aertsens A. , Alvarez J. Rinco , Poncet C. M. , Beaufrère H. , Ragetly G. R.
Published: September 2015

Objectives: To compare the conformation of the proximal tibia evaluated on a medio- lateral radiograph between small and large dogs with cranial cruciate ligament disease (CCLD).

Methods: Retrospective clinical study with dogs having radiographic evaluation and CCLD confirmed at surgery. The first group (n = 52) was comprised of dogs weighing less than 15 kg and the second group (n = 52) of dogs weighing more than 15 kg. The tibial plateau angle (TPA), the relative tibial tube-rosity width (rTTW), and the Z angle were measured on preoperative radiographs with imaging measurement software. Linear mixed models were used to assess the effect of weight, age, sex, and neutered status on radiographic measurements and to estimate interobserver variabilities.

Results: The small dog group had a greater TPA (30.1° ± 5.3; p <0.001 with a mean difference of 4.9° [95% CI: 3.8–6.0]) and Z angle (69.9° ± 5.6; p<0.001 with a mean difference of 6.1° ([95% CI: 4.9–7.4]) than the large dog group. Sex and neutered status further influenced the TPA and Z angle val -ues. No significant effect was observed on the rTTW values. A strong correlation was found between the TPA and the Z angle (r = 0.61, p <0.001). Variances were not significantly different between observers. Overall the interobserver variability was low suggesting that agreement was good.

Clinical significance: Small dogs with CCLD have a steeper tibial plateau than large dogs with CCLD. Sex and neutered status also had an effect on some measured variables. This anatomical difference could influence the surgical technique, which may affect the outcome. The good interobserver agreement suggests the observer is unlikely to influence surgical planning.
False ankylosis of the temporomandibular joint in a cat
Authors: Jamet N. , Larguier L.
Published: September 2015

Objective: To describe the use of two- dimensional computer-assisted tomography (CT) with three-dimensional (3D) reconstruction in the diagnosis and planning of surgical treatment of a case of false ankylosis of the temporomandibular joint.

Case report: A young European Shorthaired cat was presented with the complaint of inability to eat and open its jaws. A CT scan with 3D reconstruction allowed visualization of the lesion which was causing extra- articular ankylosis of the temporomandibular joint. Surgery was performed to resect an osseous lesion of the zygomatic arch, thus freeing the temporomandibular joint. Postoperative physical therapy was initiated immediately following surgery, and then carried out by the owner with a one year follow-up. Clinical examination of the cat was performed during regular office visits (at 1 month and 3 months following surgery), which allowed objective assessment of postoperative recuperation. At the end of a year, the owners reported that the cat had maintained sufficient jaw opening without any signs consistent with chronic pain.

Conclusion: Computed tomography scan with 3D reconstruction allowed planning of the surgical correction of extra-articular ankylosis of the temporomandibular joint, and in this case condylectomy was avoided, since temporomandibular joint range-of-motion was maintained.
Pyridinoacridine alkaloids of marine origin: NMR and MS spectral data, synthesis, biosynthesis and biological activity
Authors: Sandjo Louis P , Kuete Victor , Biavatti Maique W
Published: September 2015

This review focuses on pyridoacridine-related metabolites as one biologically interesting group of alkaloids identified from marine sources. They are produced by marine sponges, ascidians and tunicates, and they are structurally comprised of four to eight fused rings including heterocycles. Acridine, acridone, dihydroacridine, and quinolone cores are features regularly found in these alkaloid skeletons. The lack of hydrogen atoms next to quaternary carbon atoms for two or three rings makes the chemical shift assignment a difficult task. In this regard, one of the aims of this review is the compilation of previously reported, pyridoacridine13C NMR data. Observations have been made on the delocalization of electrons and the presence of some functional groups that lead to changes in the chemical shift of some carbon resonances. The lack of mass spectra information for these alkaloids due to the compactness of their structures is further discussed. Moreover, the biosynthetic pathways of some of these metabolites have been shown since they could inspire biomimetic synthesis. The synthesis routes used to prepare members of these marine alkaloids (as well as their analogues), which are synthesized for biological purposes are also discussed. Pyridoacridines were found to have a large spectrum of bioactivity and this review highlights and compares the pharmacophores that are responsible for the observed bioactivity.
CONTINUOUS INTUITIONISTIC FUZZY ORDERED WEIGHTED DISTANCE MEASURE AND ITS APPLICATION TO GROUP DECISION MAKING
Authors: ZHOU Ligang , JIN Feifei , CHEN Huayou , LIU Jinpei
Published: September 2015

The aim of this paper is to develop the continuous intuitionistic fuzzy ordered weighted distance (C-IFOWD) measure by using the continuous intuitionistic fuzzy ordered weighted averaging (C-IFOWA) operator in the interval distance. We investigate some desirable properties and different families of the C-IFOWD measure. We also generalize the C-IFOWD measure. The prominent characteristics of the C-IFOWD measure are that it is not only a generalization of some widely used distance measure, but also it can deal with interval deviations in aggregation on interval-valued intuitionistic fuzzy values (IVIFVs) by using a controlled parameter, which can decrease the uncertainty of argument and improve the accuracy of decision. The desirable characteristics make the C-IFOWD measure suitable to wide range situations, such as decision making, engineering and investment, etc. In the end, we introduce a new approach to group decision making with IVIFVs in human resource management.
MEAN REVERSION IN UNEMPLOYMENT: NEW FINDINGS FROM THE BALTIC TIGERS
Authors: FURUOKA Fumitaka
Published: September 2015

The tendency of the unemployment rate to revert to the mean value or the natural rate of unemployment has been one of the most discussed topics in macroeconomics. This study focused on three Baltic countries – Estonia, Latvia and Lithuania – as case studies to investigate unemployment dynamics. Three unit root tests were performed for this purpose: 1) the Augmented DickeyFuller (ADF) test, 2) the Seemingly Unrelated Regressions Augmented Dickey-Fuller (SURADF) test and 3) the Fourier Augmented Dickey-Fuller (FADF) test. The null hypothesis was that unemployment in the Baltic countries is a unit root process. As the findings revealed, the ADF test and the SURADF test failed to reject the null hypothesis of a unit root for all the three Baltic countries. However, the nonlinear FADF test could not reject the null hypothesis for Lithuania. This means that unemployment in Lithuania could be described as a stationary process. As such, it has the tendency to revert to a sustainable level. By contrast, unemployment in Estonia and Latvia would be best characterised as a non-stationary process where the unemployment rate lacks the mean reverting behaviour.
ENTREPRENEURSHIP RESEARCH IN THE POLAND
Authors: CZEMIEL-GRZYBOWSKA Wioletta , SKOWRONEK-MIELCZAREK Anna
Published: September 2015

Access to financing plays an eminent role for a small enterprise sector in any economy. Research usually finds a positive size efficiency relationship, but few studies focus on sectors dominated by small and medium-sized firms (SMEs). This paper fills this gap by analyzing this relationship in the Polish industry sector, which is both successful and increasingly dominated by SMEs. It is envisaged that this study will contribute to the existing literature on small enterprise financing, with an emphasis on financial constraints in the Polish small enterprise industry sector. The paper presents only part of research. Analysis of the data will present an insight into the actual barriers for small enterprises constraints associated with debt financing arrangements.
Statistical Duplex S-N Characteristics of Bulk Amorphous Alloy in Rotating Bending in Very High Cycle Regime
Authors: Kikuchi Shoichi , Zhang Yan Bin , Sakaida Akiyoshi , Yokoyama Yoshihiko , Ueno Akira , Sakai Tatsuo
Published: September 2015

In order to investigate very high cycle fatigue properties of Zr55Al10Ni5Cu30 bulk amorphous alloy, rotating bending fatigue tests were conducted at room temperature by using 5 different series of Zr55Al10Ni5Cu30 alloy. The differences of material processing conditions are manufacturer, product year, material size and minimum diameter of specimen. Although all specimens fractured from surface, duplex S-N characteristics were observed for each series of the material. Time strength distributions at N=104 for short life region and at N=107 for long life region were well approximated by normal distribution. The entire S-N property accepting the normalized stress amplitude by the time strength at N=104 or N=107 has shown more clearly duplex S-N characteristics. In addition, P-S-N properties were also estimated from the standard deviation of time strength distributions at N=104 or N=107. Based on the observation of fracture surface by scanning electron microscope (SEM), it is confirmed that every fracture surface was consisting of typical three regions such as multi-facet region, stable crack growth region and instantaneous fracture region.
The password practices applied by South African online consumers: Perception versus reality
Authors: Butler Rika , Butler Martin
Published: September 2015

Background: The ability to identify and authenticate users is regarded as the foundation of computer security. Although new authentication technologies are evolving, passwords are the most common method used to control access in most computer systems. Research suggests that a large portion of computer security password breaches are the result of poor user security behaviour. The password creation and management practices that online consumers apply have a direct effect on the level of computer security and are often targeted in attacks. Objectives: The objective of this study was to investigate South African online consumers’ computer password security practices and to determine whether consumers’ perceptions regarding their password security ability is reflected in the password creation and management practices that they apply. Method: A Web-based survey was designed to (1) determine online consumers’ perceptions of their skills and competence in respect of computer password security and (2) determine the practices that South African online consumers apply when creating and managing passwords. The measures applied were then compared to (1) the users’ perceptions about their computer password security abilities and (2) the results of international studies to determine agreement and inconsistencies. Results: South African online consumers regard themselves as proficient password users. However, various instances of unsafe passwords practices were identified. The results of this South African study correspond with the results of various international studies confirming that challenges to ensure safe online transacting are in line with international challenges. Conclusion: There is a disparity between South African online consumers’ perceived ability regarding computer password security and the password creation and management practices that they apply.
The role of salient beliefs in graduates’ intention to apply
Authors: Adams Samantha , De Kock François
Published: September 2015

Orientation: Organisations compete fiercely to recruit the best graduates, because they consider them a rich source of future talent. In the recruitment literature, it has become increasingly important to understand the factors that influence graduate applicant intentions. Research purpose: Drawing on the theory of planned behaviour (TPB), we tested a model proposing that applicant intention is a function of their attitude towards applying, beliefs about referent other’s expectations (subjective norms) and perceived behavioural control with respect to this behaviour.Motivation for the study: The study was motivated by the need to shed light on graduate applicants’ decisions to apply to an organisation of their choice. Research approach, design and method: The study used a quantitative design to test hypotheses that attitudes towards behaviour, norms and control beliefs would influence intention to apply. We surveyed prospective job seekers (N = 854) studying at a South African university about their beliefs regarding the job application process. Main findings: Structural equation modelling showed reasonable fit of the proposed model to the survey data. Latent variable analysis demonstrated that perceived behavioural control and subjective norm explained intention to apply. With the combination of all three variables, only attitude towards applying did not play a significant role in the prediction of intention to apply, which is contrary to previous research. Practical/managerial implications: The findings highlight the role of salient control beliefs in the application process. Efforts by universities and organisations to affect intentions to apply may potentially benefit from focusing on support services that could enhance feelings of control and minimise perceived obstacles. Recruiters could focus on control to increase potential recruitment pools. Contribution/value-add: The study contributes to the recruitment literature in three ways. Firstly, TPB is shown to be a useful framework to explain graduate applicants’ intention to apply, as this theoretical model found empirical support. In doing so, the present study advances our understanding of how graduates’ intentions to apply are formed. Secondly, the results showed that applicants’ control and normative beliefs dominate when considering applying. Lastly, the study results open up interesting avenues for future research on applicant intentions.
Proactive behaviour towards strength use and deficit improvement, hope and efficacy as predictors of life satisfaction amongst first-year university students
Authors: Stander Frederick W. , Diedericks Elsabe , Mostert Karina , De Beer Leon T.
Published: September 2015

Orientation: The orientation of this study is towards proactive behaviour towards strength use (PBSU) and proactive behaviour towards deficit improvement (PBDI) and their relationship with hope, efficacy and life satisfaction of first-year university students. Research purpose: To (1) determine whether PBSU and PBDI predict life satisfaction, (2) determine whether PBSU and PBDI predict hope and efficacy and (3) investigate a structural model where hope and efficacy mediate the relationship between PBSU and PBDI and life satisfaction. Motivation for the study: To validate the use of PBSU and PBDI as resources that will assist first-year university student to attain life satisfaction and to delineate the need for universities to incorporate interventions that promote PBSU and PBDI amongst these students. This supports the case for positive organisational behaviour. Research design, approach and method: A convenience sample of 566 first-year students from a university in Gauteng was used with a cross-sectional research design. Structural equation modelling was used to establish the validity of the measurement model, fit for the structural model and to test the mediating effects.Main findings: The results indicated that PBSU was a significant predictor of hope, efficacy and life satisfaction and that PBDI was a significant predictor of hope and efficacy. Hope mediated the relationship between PBSU, PBDI and life satisfaction. Efficacy mediated the relationship between PBSU and life satisfaction. Practical/managerial implications: Evidence suggests that PBSU was a predictor of life satisfaction. This was not the case with PBDI, which in fact negatively correlated with life satisfaction. Both PBSU and PBDI, however, predicted hope and efficacy. On a practical level this reveals that universities should, in line with positive organisational behaviour, introduce interventions that develop PBSU and PBDI amongst first-year students. It further suggests that, as is postulated by positive psychology, universities should focus more particularly on developing the ability of strength use amongst students, as opposed to deficit improvement. Contributions/value-add: This research proposes a strong case for the introduction of interventions that promote first-year university students’ ability for strength use, in particular, but also for deficit improvement, in line with positive organisational behaviour. Further, it validates for strength use as a stronger value proposition in achieving life satisfaction, supporting the philosophy of positive psychology.
Post-treatment surveillance abdominopelvic computed tomography in children with Wilms tumour: Is it worth the risk?
Authors: Otto Jacobus H. , Janse van Rensburg Jacques , Stones David K.
Published: September 2015

Background: Wilms tumour is a comparatively common paediatric malignancy with a relatively good prognosis. Routine post-treatment surveillance at our institution currently includes regular abdominopelvic computed tomography (CT) over a two-year period for the early detection of disease recurrence. The rationale is that early salvage therapy may improve overall patient survival, and thus justifies the exposure to potentially harmful ionising radiation. Objective: To critically evaluate the routine use of post-treatment abdominopelvic CT by determining the detection rate of disease recurrence and associated clinical outcomes.Methods: Sixty-four patients in remission following initial treatment for Wilms tumour were included in this retrospective study. Variables obtained from patient records included gender, age, histological grading and tumour stage at presentation, number of abdominopelvic CT scans, site(s) of relapse, method of recurrence detection and confirmation, time to recurrence and clinical outcome. Results: The patients received a total of 334 surveillance abdominopelvic CT scans. Nine (14%) patients developed disease recurrence during the follow-up period. In three cases, the initial detection method was abdominopelvic CT. All three of these patients subsequently died despite salvage therapy (22 months median survival). Five false-positive diagnoses of recurrence occurred, with two being made on abdominopelvic CT. Conclusion: Routine post-treatment abdominopelvic CT showed a low detection rate of disease recurrence in children treated for Wilms tumour, while subjecting patients to a large radiation burden. The recommendation is that current practice be changed in line with the ultrasound-based Société Internationale d’Oncologie Pédiatrique (SIOP) imaging guidelines.
Successful combined transpapillary and transmural management of a large biloma and bile duct injury: A case report and review of literature
Authors: Nayak Hemanta Kumar , Saraswat Vivek Anand , Mohindra Samir , Sharma Atul , Ghoshal Uday C.
Published: September 2015

Here, we report a patient with bile duct injury (BDI) following open cholecystectomy, who developed a very large biloma, causing duodenal and biliary obstruction, and also had a biliary stricture at the site of BDI. We successfully managed the patient by endoscopic biloma-gastrostomy with biliary stenting that resulted in resolution of the biloma and aggressive endoscopic management of the biliary stricture with stent bundles till resolution. Pertaining this case to be the one with largest biloma in the literature (approximately 6.5 L), which developed following open cholecystectomy that resulted in biliary stricture following injury to BD. We successfully managed the patient by endoscopic biloma-gastric stenting and an aggressive endoscopic management of biliary stricture.
Need for a hands-on approach to hand-offs: A study of nursing handovers in an Indian Neurosciences Center
Authors: Kumar Parmeshwar , Jithesh Vishwanathan , Vij Aarti , Gupta Shakti
Published: September 2015

Context: Standardized nursing handovers have been known to improve outcome, reduce error, and enhance communication. Few, if any, studies on nursing handovers have been conducted in the India. Aim: The aim was to study nursing handover practices in a Neurosciences Center in India. Subjects and Methods: This study was conducted in a 200 bedded public sector Neurosciences Center in New Delhi, to assess nursing handover practices across five wards, all shifts, weekdays, and weekends using a pretested checklist. Ten elements were observed under the categories of time, duration, process, nurse interaction, and patient communication. Statistical Analysis: Analysis of variance, Z-test, and Spearman's correlation coefficient. Results: Totally, 525 nursing handovers revealed varying compliance levels among (63%) time, place (76%), process (82%), staff interaction (53%), and patient communication (44%) related elements. Poorer compliance was seen in morning shifts and weekends; the difference being statistically significant. Bedside handovers were more frequent during weekends and night shifts and were positively correlated with increased staff interaction and patient communication and negatively related to handover duration. Though nurses showed better adherence to process related elements, background patient information, and assessment was explained less frequently. Differences between wards were insignificant except in categories of nurse interaction and patient communication which was better in the neurosurgery than neurology wards. Conclusion: Study revealed a need for a system change and standardization of handovers. Greater administrative commitment, use of technology, training, and leadership development will aid in continuity of care, promote patient safety, and ensure better outcomes.
Correlation between Glasgow Coma Scale and brain computed tomography-scan findings in head trauma patients
Authors: Nayebaghayee Hossein , Afsharian Tahmineh
Published: September 2015

Background: The study aimed to assess the relationship between computed tomography (CT) scan findings and Glasgow Coma Scale (GCS) score with the purpose of introducing GCS scoring system as an acceptable alternative for CT scan to clinically management of brain injuries in head trauma patients. Materials and Methods: This study was conducted on hospitalized patients with the complaints of head trauma. The severity of the head injury was assessed on admission by the GCS score and categorized as mild, moderate, or severe head injury. Results: Of all study subjects, 80.5% had GCS 13–15 that among those, 45% had GCS 15. Furthermore, 10.5% had GCS ranged 9–12 and 9% had GCS <8. Of all subjects, 54.5% had abnormal CT findings that of them, 77.1% categorized as mild head injury, 11.0% had a moderate head injury, and 11.9% had a severe head injury. Furthermore, of those with GCS 15, 41.0% had abnormal CT scan. Of all patients with abnormal CT findings, 33.0% underwent surgery that 61.1% categorized in mild head injury group, 13.9% categorized in moderate head injury group, and 22.2% categorized in severe head injury group. Of those with GCS equal to 15, only 27.0% underwent surgery. Conclusion: The use of GCS score for assessing the level of injury may not be sufficient and thus considering CT findings as the gold standard, the combination of this scoring system and other applicable scoring systems may be more applicable to stratify brain injury level.
Supratentorial haemangioblastoma without von Hippel–Lindau syndrome in an adult: A rare tumor with review of literature
Authors: Pandey Sharad , Sharma Vivek , Pandey Deepa , Kumar Vikul , Kumar Mohan
Published: September 2015

Supratentorial hemangioblastomas (HBLs) are rare, benign vascular tumors of the central nervous system neoplasms. Very scarce literature is available regarding supratentorial HBL without von Hippel–Lindau (VHL) syndrome in an adult. We reviewed the literature and PubMed advanced search showed only a few results of supratentorial HBL without VHL syndrome. We reported a rare case of cystic supratentorial HBL in 39-year-old male affecting the parietal lobe without VHL syndrome. Supratentorial HBL is a rare tumor and supratentorial HBL without VHL syndrome are even rarer. Being a rare entity, not much clinical data is currently available regarding supratentorial HBLs, thus necessitating the need for further reporting and review of such cases.
Perineurioma of scalp in an infant: A case report with short review of literature
Authors: Duhan Amrita , Rana Parveen , Beniwal Kalpana , Parihar Dheeraj
Published: September 2015

Perineuriomas are rare benign peripheral nerve sheath tumor composed exclusively of perineurial cells. They have been classified into two main types according to their location – intraneural and extraneural (soft-tissue). Extraneural perineurioma are uncommon, found mostly in the soft tissue of the extremities and trunk, rare at other site. They mainly affect adults and have been sometimes described in children but are extremely rare in infants. We present a case of extraneural (soft-tissue) perineurioma of scalp in a 3-month-old infant, highlighting clinical, pathologic, and immunohistochemical features along with a discussion of the main differential diagnosis of this tumor. This is also the youngest case ever reported in the literature.
Sensitivity estimations for cloud droplet formation in the vicinity of the high-alpine research station Jungfraujoch (3580 m a.s.l.)
Authors: Hammer E. , Bukowiecki N. , Luo B. P. , Lohmann U. , Marcolli C. , Weingartner E. , Baltensperger U. , Hoyle C. R.
Published: September 2015

Abstract. Aerosol radiative forcing estimates suffer from large uncertainties as a result of insufficient understanding of aerosol–cloud interactions. The main source of these uncertainties is dynamical processes such as turbulence and entrainment but also key aerosol parameters such as aerosol number concentration and size distribution, and to a much lesser extent, the composition. From June to August 2011 a Cloud and Aerosol Characterization Experiment (CLACE2011) was performed at the high-alpine research station Jungfraujoch (Switzerland, 3580 m a.s.l.) focusing on the activation of aerosol to form liquid-phase clouds (in the cloud base temperature range of −8 to 5 °C). With a box model the sensitivity of the effective peak supersaturation (SSpeak), an important parameter for cloud activation, to key aerosol and dynamical parameters was investigated. The updraft velocity, which defines the cooling rate of an air parcel, was found to have the greatest influence on SSpeak. Small-scale variations in the cooling rate with large amplitudes can significantly alter CCN activation. Thus, an accurate knowledge of the air parcel history is required to estimate SSpeak. The results show that the cloud base updraft velocities estimated from the horizontal wind measurements made at the Jungfraujoch can be divided by a factor of approximately 4 to get the updraft velocity required for the model to reproduce the observed SSpeak. The aerosol number concentration and hygroscopic properties were found to be less important than the aerosol size in determining SSpeak. Furthermore turbulence is found to have a maximum influence when SSpeak is between approximately 0.2 and 0.4 %. Simulating the small-scale fluctuations with several amplitudes, frequencies and phases, revealed that independently of the amplitude, the effect of the frequency on SSpeak shows a maximum at 0.46 Hz (median over all phases) and at higher frequencies, the maximum SSpeak decreases again.
Natural and anthropogenic methane fluxes in Eurasia: a mesoscale quantification by generalized atmospheric inversion
Authors: Berchet A. , Pison I. , Chevallier F. , Paris J.-D. , Bousquet P. , Bonne J.-L. , Arshinov M. Y. , Belan B. D. , Cressot C. , Davydov D. K. , Dlugokencky E. J. , Fofonov A. V. , Galanin A. , Lavrič J. , Machida T. , Parker R. , Sasakawa M. , Spahni R. , Stocker B. D. , Winderlich J.
Published: September 2015

Abstract. Eight surface observation sites providing quasi-continuous measurements of atmospheric methane mixing ratios have been operated since the mid-2000's in Siberia. For the first time in a single work, we assimilate 1 year of these in situ observations in an atmospheric inversion. Our objective is to quantify methane surface fluxes from anthropogenic and wetland sources at the mesoscale in the Siberian lowlands for the year 2010. To do so, we first inquire about the way the inversion uses the observations and the way the fluxes are constrained by the observation sites. As atmospheric inversions at the mesoscale suffer from mis-quantified sources of uncertainties, we follow recent innovations in inversion techniques and use a new inversion approach which quantifies the uncertainties more objectively than the previous inversion systems. We find that, due to errors in the representation of the atmospheric transport and redundant pieces of information, only one observation every few days is found valuable by the inversion. The remaining high-resolution quasi-continuous signal is representative of very local emission patterns difficult to analyse with a mesoscale system. An analysis of the use of information by the inversion also reveals that the observation sites constrain methane emissions within a radius of 500 km. More observation sites than the ones currently in operation are then necessary to constrain the whole Siberian lowlands. Still, the fluxes within the constrained areas are quantified with objectified uncertainties. Finally, the tolerance intervals for posterior methane fluxes are of roughly 20 % (resp. 50 %) of the fluxes for anthropogenic (resp. wetland) sources. About 50–70 % of Siberian lowlands emissions are constrained by the inversion on average on an annual basis. Extrapolating the figures on the constrained areas to the whole Siberian lowlands, we find a regional methane budget of 5–28 TgCH4 for the year 2010, i.e. 1–5 % of the global methane emissions. As very few in situ observations are available in the region of interest, observations of methane total columns from the Greenhouse Gas Observing SATellite (GOSAT) are tentatively used for the evaluation of the inversion results, but they exhibit only a marginal signal from the fluxes within the region of interest.
Atmospheric moisture transport: the bridge between ocean evaporation and Arctic ice melting
Authors: Gimeno L. , Vázquez M. , Nieto R. , Trigo R. M.
Published: September 2015

Abstract. Changes in the atmospheric moisture transport have been proposed as a vehicle for interpreting some of the most significant changes in the Arctic region. The increasing moisture over the Arctic during the last decades is not strongly associated with the evaporation that takes place within the Arctic area itself, despite the fact that the sea ice cover is decreasing. Such an increment is consistent and is more dependent on the transport of moisture from the extratropical regions to the Arctic that has increased in recent decades and is expected to increase within a warming climate. This increase could be due either to changes in circulation patterns which have altered the moisture sources, or to changes in the intensity of the moisture sources because of enhanced evaporation, or a combination of these two mechanisms. In this short communication we focus on the more objective assessment of the strong link between ocean evaporation trends and Arctic Sea ice melting. We will critically analyse several recent results suggesting links between moisture transport and the extent of sea ice in the Arctic, this being one of the most distinct indicators of continuous climate change both in the Arctic and on a global scale. To do this we will use a sophisticated Lagrangian approach to develop a more robust framework on some of these previous disconnecting results, using new information and insights. Results reached in this study stress the connection between two climate change indicators, namely an increase in evaporation over source regions (mainly the Mediterranean Sea, the North Atlantic Ocean and the North Pacific Ocean in the paths of the global western boundary currents and their extensions) and Arctic ice melting precursors.
The carbon cycle in the Australian Community Climate and Earth System Simulator (ACCESS-ESM1) – Part 1: Model description and pre-industrial simulation
Authors: Law R. M. , Ziehn T. , Matear R. J. , Lenton A. , Chamberlain M. A. , Stevens L. E. , Wang Y. P. , Srbinovsky J. , Bi D. , Yan H. , Vohralik P. F.
Published: September 2015

Abstract. Earth System Models (ESMs) that incorporate carbon-climate feedbacks represent the present state of the art in climate modelling. Here, we describe the Australian Community Climate and Earth System Simulator (ACCESS)-ESM1 that combines existing ocean and land carbon models into the physical climate model to simulate exchanges of carbon between the land, atmosphere and ocean. The land carbon model can optionally include both nitrogen and phosphorous limitation on the land carbon uptake. The ocean carbon model simulates the evolution of nitrate, oxygen, dissolved inorganic carbon, alkalinity and iron with one class of phytoplankton and zooplankton. From two multi-centennial simulations of the pre-industrial period with different land carbon model configurations, we evaluate the equilibration of the carbon cycle and present the spatial and temporal variability in key carbon exchanges. For the land carbon cycle, leaf area index is simulated reasonably, and seasonal carbon exchange is well represented. Interannual variations of land carbon exchange are relatively large, driven by variability in precipitation and temperature. We find that the response of the ocean carbon cycle shows reasonable agreement with observations and very good agreement with existing Coupled Model Intercomparison Project (CMIP5) models. While our model over estimates surface nitrate values, the primary productivity agrees well with observations. Our analysis highlights some deficiencies inherent in the carbon models and where the carbon simulation is negatively impacted by known biases in the underlying physical model. We conclude the study with a brief discussion of key developments required to further improve the realism of our model simulation.