bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantitative Analysis of Uveitis Macular Edema in Multiple Sclerosis Patients Receiving Deep Posterior Sub-Tenon Triamcinolone Acetonide Injection
Authors: Jovanović Svetlana , Šarenac Vulović Tatjana , Radotić Filip , Tončić Zorica , Živković Maja , Petrović Nenad
Published: March 2017

Aim: We aimed to analyze the effects of adjunctive posterior sub-Tenon capsule triamcinolone acetonide injection in the treatment of intermediate uveitis macular edema in multiple sclerosis patients that could not be controlled by systemic corticosteroid medications and immunomodulators. Methods: The study included 30 eyes of 25 patients with multiple sclerosis who received a posterior sub-Tenon injection of 40 mg/mL triamcinolone acetonide. Parameters monitored for therapy efficiency were best-corrected visual acuity, intraocular pressure, central foveal thickness (CFT), and fluorescein angiography (FA) scores. Results: Mean best-corrected visual acuity was significantly improved at the control visit 0.15 ± 0.10 versus baseline 0.40 ± 0.20 logMAR (p < 0.05). Six eyes showed intraocular pressure spikes requiring topical antiglaucomatous treatment. Mean CFT and FA scores were significantly decreased versus baseline (CFT: 345 ± 50 μm; FA score: 3.4 ± 1.0) compared with the 12-week control visit (CFT: 219 ± 35 μm; FA score: 1.6 ± 1.1; p < 0.001). Conclusion: Posterior sub-Tenon injection of triamcinolone acetonide significantly improved visual acuity and decrease macular edema in patients with intermediate uveitis associated with multiple sclerosis.
Association of Adherence to a Healthy Diet with Cognitive Decline in European and American Older Adults: A Meta-Analysis within the CHANCES Consortium
Authors: Berendsen Agnes A.M. , Kang Jae H. , van de Rest Ondine , Jankovic Nicole , Kampman Ellen , Kiefte-de Jong Jessica C. , Franco Oscar H. , Ikram M. Arfan , Pikhart Hynek , Nilsson Lena Maria , Brenner Hermann , Boffetta Paolo , Rafnsson Snorri Bjorn , Gustafson Deborah , Kyrozis Andreas , Trichopoulou Antonia , Feskens Edith J.M. , Grodstein Francine , de Groot Lisette C.P.G.M.
Published: March 2017

Aim: To examine the association between a healthy diet, assessed by the Healthy Diet Indicator (HDI), and cognitive decline in older adults. Methods: Data from 21,837 participants aged ≥55 years from 3 cohorts (Survey in Europe on Nutrition and the Elderly, a Concerted Action [SENECA], Rotterdam Study [RS], Nurses' Health Study [NHS]) were analyzed. HDI scores were based on intakes of saturated fatty acids, polyunsaturated fatty acids, mono- and disaccharides, protein, cholesterol, fruits and vegetables, and fiber. The Telephone Interview for Cognitive Status in NHS and Mini-Mental State Examination in RS and SENECA were used to assess cognitive function from multiple repeated measures. Using multivariable-adjusted, mixed linear regression, mean differences in annual rates of cognitive decline by HDI quintiles were estimated. Results: Multivariable-adjusted differences in rates in the highest versus the lowest HDI quintile were 0.01 (95% CI -0.01, 0.02) in NHS, 0.00 (95% CI -0.02, 0.01) in RS, and 0.00 (95% CI -0.05, 0.05) in SENECA with a pooled estimate of 0.00 (95% CI -0.01, 0.01), I2 = 0%. Conclusions: A higher HDI score was not related to reduced rates of cognitive decline in European and American older adults.
Uncommon Presentation of Idiopathic Intracranial Hypertension in a Patient with Polycystic Ovary Syndrome: A Case Report
Authors: Albarrak Anas Mohammad , Kojan Suleiman
Published: March 2017

Introduction: Idiopathic intracranial hypertension is a rare condition characterized by increased intracranial pressure without clinical, laboratory, or radiological evidence of intracranial pathology. Early management could prevent irreversible outcomes. Case Presentation: A 17-year-old single Arabian female of Arab origin presented with a 2-day complaint of horizontal diplopia and transient visual obscurations. She denied any history of headache or decreased vision. The patient was diagnosed with polycystic ovary syndrome a year prior to presentation. Examination revealed bilateral moderate papilledema and limited left eye abduction. However, visual acuity and fields were normal. Increased intracranial pressure was confirmed by lumbar puncture opening pressure (550 mm H2O). The cerebrospinal fluid composition and imaging of brain and cerebral venous system were normal. The diagnosis of idiopathic intracranial hypertension was confirmed and the patient was treated with acetazolamide 500 mg twice per day. The symptoms totally resolved within 3 days and the papilledema disappeared after 2 months. Conclusion: Awareness of such uncommon presentation of idiopathic intracranial hypertension emphasizes the critical importance of detailed ophthalmic examination and shows the good prognosis of early management.
Factor XIII Deficiency and Thrombocytopenia Are Frequent Modulators of Postoperative Clot Firmness in a Surgical Intensive Care Unit
Authors: von Rappard Sarah , Hinnen Corina , Lussmann Roger , Rechsteiner Manuela , Korte Wolfgang
Published: March 2017

Objective: Fibrinogen and factor XIII (FXIII) have been shown to critically influence clot firmness in the intraoperative setting and thus likely influence intraoperative bleeding. We were interested to identify potential modulators of postoperative clot firmness in a tertiary care hospital surgical intensive care unit setting, independent of their clinical course during surgery. Methods: 272 day-shift consecutive patients were evaluated for whole blood clot firmness evaluated by the ROTEM® EXTEM thrombelastometric assay and various potential modulators of clot firmness upon arrival at the surgical intensive care unit (SICU). Results: Maximum clot firmness on the SICU was found to be independently influenced by the amount of colloids given during surgery as well as by platelet count, fibrinogen concentration, and FXIII activity at the time of SICU admission. In patients with lowest clot firmness, FXIII activity was the most important independent modulator of clot firmness; in patients with the highest clot firmness, platelet count and fibrinogen concentration were the most important modulators of clot firmness. Deficiencies (i.e., results below normal range) of these modulators of clot firmness were most prevalent for FXIII (activity < 70%: 45% of cases), which was significantly more frequent than thrombocytopenia (<150 × 109/l: 32%) or fibrinogen deficiency (<1.5 g/l: 6%). Conclusions: Postoperative clot firmness as evaluated by whole blood thrombelastometry (ROTEM EXTEM assay) is independently and frequently modulated though FXIII activity and the platelet count, while fibrinogen concentration is also an independent but much less frequent modulator. Different modulators show different influences, depending on the clot firmness being present. Colloids infused during surgery also independently modulate postoperative clot firmness. Based on our data, strategies can be developed to improving postoperative care of patients with bleedings or at risk for bleeding.
Drugs, Violence, and Trauma in Mexico and the USA
Authors: Puyana Juan Carlos , Puyana Juan Carlos Jacob , Rubiano Andres Mariano , Montenegro Jorge Hernan , Estebanez Glyn O. , Sanchez Alvaro Ignacio , Vega-Rivera Felipe
Published: March 2017

The impact of illicit drug markets on the occurrence of violence varies tremendously depending on many factors. Over the last years, Mexico and the USA have increased security border issues that included many aspects of drug-related trade and criminal activities. Mexico experienced only a small reduction in trauma deaths after the enforcement of severe crime reinforcement policies. This strategy in the war on drugs is shifting the drug market to other Central American countries. This phenomenon is called the ballooning effect, whereby the pressure to control illicit drug-related activities in one particular area forces a shift to other more vulnerable areas that leads to an increase in crime and violence. A human rights crisis characterized by suffering, injury, and death related to drug trafficking continues to expand, resulting in the exorbitant loss of lives and cost in productivity across the continent. The current climate of social violence in Central America and the illegal immigration to the USA may be partially related to this phenomenon of drug trafficking, gang violence, and crime. A health care initiative as an alternative to the current war approach may be one of the interventions needed to reduce this crisis.
Analysis of Variable Speed PFC Chopper Fed BLDC Motor Drive
Authors: Renius A Jeya Selvan , Kumar K Vinoth
Published: March 2017

This paper provides the detailed analysis of the DC-DC chopper fed Brushless DC motor drive used for low-power applications. The various methods used to improve the power quality at the ac mains with lesser number of components are discussed. The most effective method of power quality improvement is also simulated using MATLAB Simulink. Improved method of speed control by controlling the dc link voltage of Voltage Source Inverter is also discussed with reduced switching losses. The continuous and discontinuous modes of operation of the converters are also discussed based on the improvement in power quality. The performance of the most effective solution is simulated in MATLAB Simulink environment and the obtained results are presented.
Total Center Percutaneous Coronary Intervention Volume and 30-Day Mortality
Authors: O’Neill Darragh , Nicholas Owen , Gale Chris P. , Ludman Peter , de Belder Mark A. , Timmis Adam , Fox Keith A.A. , Simpson Iain A , Redwood Simon , Ray Simon G.
Published: March 2017

Background—

The relationship between procedural volume and prognosis after percutaneous coronary intervention (PCI) remains uncertain, with some studies finding in favor of an inverse association and some against. This UK study provides a contemporary reassessment in one of the few countries in the world with a nationally representative PCI registry.

Methods and Results—

A nationwide cohort study was performed using the national British Cardiovascular Intervention Society registry. All adult patients undergoing PCI in 93 English and Welsh NHS hospitals between 2007 and 2013 were analyzed using hierarchical modeling with adjustment for patient risk. Of 427 467 procedures (22.0% primary PCI) in 93 hospitals, 30-day mortality was 1.9% (4.8% primary PCI). 87.1% of centers undertook between 200 and 2000 procedures annually. Case mix varied with center volume. In centers with 200 to 399 PCI cases per year, a smaller proportion were PCI for ST-segment–elevation myocardial infarction (8.4%) than in centers with 1500 to 1999 PCI cases per year (24.2%), but proportionally more were for ST-segment–elevation myocardial infarction with cardiogenic shock (8.4% versus 4.3%). For the overall PCI cohort, after risk adjustment, there was no significant evidence of worse, or better, outcomes in lower volume centers from our own study, or in combination with results from other studies. For primary PCI, there was also no evidence for increased or decreased mortality in lower volume centers.

Conclusions—

After adjustment for differences in case mix and clinical presentation, this study supports the conclusion of no trend for increased mortality in lower volume centers for PCI in the UK healthcare system.

Clinical Trial Registration—

https://www.clinicaltrials.gov
. Unique identifier: NCT02184949.
Effects of Support Dogs on Eyewitness Anxiety during Questioning
Authors: Peters Christopher S.
Published: March 2017

Being an eyewitness to a crime can be a traumatic event, especially if the eyewitness is the victim. In addition, following the crime the witness is susceptible to being distressed further during questioning. The current research examined the effects a trained support dog would have on mock witnesses’ anxiety (as measured by heartrate) during questioning. Participants observed a video and answered questions from an actual uniformed police officer, similar to a normal eyewitness interview. During the interview, participants were either presented with a support dog or a glass of water (control). Results indicated that while the uniformed officer increased participants’ anxiety significantly, the support dog successfully decreased anxiety almost to the point of baseline, and significantly more than the control condition. Implications and real-world application are discussed.
A new species of Linum (Linaceae) from Iran with a focus on description of Linum turcomanicum in view of morphological and molecular analyses
Authors: BEHROOZIAN MARYAM , VAEZI JAMIL , JOHARCHI MOHAMMAD REZA , MEMARIANI FARSHID
Published: March 2017

The genus Linum consists of 15 species in Iran. A new species as well as a new record from Iran is described and illustrated here as L. khorassanicum and L. turcomanicum, respectively. The original description of the latter species is incomplete and ambiguous, probably due to incomplete taxon sampling. In this work, after a comprehensive taxon sampling from the entire distribution range of the species in northeast of Iran, the taxonomic description of L. turcomanicum is completed. The present study considers morphological and molecular (the nrITS region) analyses of the both species. In phylogenetic analysis based on the molecular data, we included these species and some related Linum species to examine the phylogenetic relationship of the new species and L. turcomanicum with other members of the genus. Linum turcomanicum is morphologically almost similar to L. austriacum and L. perenne, but it can be distinguished from them on the basis of several traits such as fruiting-pedicel form and length of petal. Likewise, results obtained from the molecular phylogenetic tree are consistent with those obtained from the morphological data. Linum khorassanicum is well characterized morphologically by having erect fruiting pedicels and inflorescence with few flowers. Our results suggest that the morphological data are in agreement with the molecular phylogenetic tree in which the taxonomic status of L. khorassanicum is confirmed as a new species. Based on IUCN Red List categories and criteria, L. khorassanicum and L. turcomanicum are evaluated as Endangered and Near Threatened species, respectively.
Ligularia muliensis (Asteraceae, Senecioneae) is merged with L. tsangchanensis
Authors: ILLARIONOVA IRINA , WANG LONG , YANG QIN-ER
Published: March 2017

Observations on both herbarium specimens (including type material) and living plants demonstrate that Ligularia muliensis and L. tsangchanensis are conspecific. We therefore place L. muliensis into the synonymy of L. tsangchanensis. Lectotypfications are proposed for L. tsangchanensis and L. muliensis.
Two new species of Neomarica (Trimezieae, Iridoideae, Iridaceae) from Southeast Brazil
Authors: GIL ANDRÉ DOS SANTOS BRAGANÇA , HALL CLIMBIÊ FERREIRA , KOCH ANA KELLY , BITTRICH VOLKER , AMARAL MARIA DO CARMO ESTANISLAU DO
Published: March 2017

Two new species of Neomarica (Trimezieae, Iridoideae, Iridaceae) from the Brazilian Atlantic Forest, Southeast Brazil, are described and illustrated: Neomarica mauroi, endemic to the municipality of Mangaratiba, Rio de Janeiro State; and Neomarica sancti-vicentei, endemic to the municipality of São Vicente, São Paulo State.
Molecular and morphological data support the transfer of the monotypic Iranian genus Alococarpum to Prangos (Apiaceae)
Authors: LYSKOV DMITRY F. , SAMIGULLIN TAHIR H. , PIMENOV MICHAEL G.
Published: March 2017

Based on molecular and morphological evidence, the monotypic genus Alococarpum endemic to Iran has been transferred to the genus Prangos (as P. eriantha (DC.) Lyskov & Pimenov comb. nov.). The main diagnostic characters of fruits (shape of endosperm, division of mesocarp, presence of cyclic vittae and diffuse vascular bundles) are the same both in Prangos and Alococarpum. Our molecular analysis of nrITS/ETS markers also supported the monophyly of Prangos including Alococarpum.
Capricornella bicornuta, a new genus and species of mite from eastern Australia (Acari: Uropodina)
Authors: BŁOSZYK JERZY , HALLIDAY BRUCE , ADAMSKI ZBIGNIEW , KSIĄŻKIEWICZ-PARULSKA ZOFIA
Published: March 2017

We describe a new genus and species of mite from eastern Australia, Capricornella bicornuta. The new genus is characterised by the presence of two long appendages on the anterior margin of the epigynal shield of the female.
Diversity of Sternaspidae (Annelida: Terebellida) in the South China Sea, with descriptions of four new species
Authors: WU XUWEN , XU KUIDONG
Published: March 2017

Sternaspidae is one of the most common groups of polychaetes in the South China Sea, where however, the knowledge of its diversity and distribution is insufficiently understood and reports of the European species Sternaspis scutata are misidentifications. Based on the examination of material deposited in the Marine Biological Museum of the Chinese Academy of Sciences, we made a comprehensive investigation on the sternaspid polychaetes in the northern South China Sea. Five species belonging to two genera are described: Petersenaspis salazari sp. nov., Sternaspis radiata sp. nov., S. spinosa Sluiter, 1882, S. sunae sp. nov. and S. wui sp. nov. A taxonomic key to ten species of Sternaspidae found in the South China Sea is provided.
Comparison of Satellite-, Model-, and Radiosonde-Derived Convective Available Potential Energy in the Southern Great Plains Region
Authors: Gartzke Jessica , Knuteson Robert , Przybyl Grace , Ackerman Steven , Revercomb Henry
Published: March 2017

Convective available potential energy (CAPE) is one of the physical quantities used by operational meteorologists when issuing severe-weather convective watches and warnings. Recent advances in satellite technology could provide timely observations of atmospheric temperature and water vapor profiles over the continental United States, but only limited validation exists in the literature to characterize uncertainties in CAPE derived from the new satellite sensors. In this study, 10 years of Vaisala, Inc., RS92 radiosonde observations from the U.S. Department of Energy (DOE) Atmospheric Radiation Measurement (ARM) Southern Great Plains (SGP) site were matched to overpasses of the NASA Aqua satellite that were made from January 2005 through December 2014. Vertical profiles of temperature and water vapor from the NASA Atmospheric Infrared Sounder (AIRS) were extracted in a region surrounding the DOE ARM SGP central facility near Lamont, Oklahoma. Surface-based CAPE was computed using software consistent with methods used by the National Weather Service Storm Prediction Center. The one-to-one correspondence of the AIRS-derived CAPE with the ARM-radiosonde-derived CAPE has a correlation coefficient of only 0.34. Substitution of the ARM-radiosonde surface values into the AIRS profiles improves the correlation to 0.95. The use of AIRS profiles above the surface level provides surface-based CAPE values that are very similar to those computed from Vaisala radiosondes. These results suggest that a merging of surface observations with satellite-derived thermodynamic profiles could make better use of the satellite spatial coverage and temporal sampling for estimation of CAPE in near–real time.
An Extreme Event in the Eyewall of Hurricane Felix on 2 September 2007
Authors: Aberson Sim D. , Zhang Jun A. , Ocasio Kelly Nuñez
Published: March 2017

During a routine penetration into Hurricane Felix late on 2 September 2007, NOAA42 encountered extreme turbulence and graupel, flight-level horizontal wind gusts of over 83 m s−1, and vertical wind speeds varying from 10 m s−1 downward to 31 m s−1 upward and back to nearly 7 m s−1 downward within 1 min. This led the plane to rise nearly 300 m and then return to its original level within that time. Though a dropwindsonde was released during this event, the radars and data systems on board the aircraft were rendered inoperable, limiting the amount of data obtained.

The feature observed during the flight is shown to be similar to that encountered during flights into Hurricanes Hugo (1989) and Patricia (2015), and by a dropwindsonde released into a misovortex in Hurricane Isabel (2003). This paper describes a unique dataset of a small-scale feature that appears to be prevalent in very intense tropical cyclones, providing new evidence for eye–eyewall mixing processes that may be related to intensity change.
Impact of Variations in Upper-Level Shear on Simulated Supercells
Authors: Warren Robert A. , Richter Harald , Ramsay Hamish A. , Siems Steven T. , Manton Michael J.
Published: March 2017

It has previously been suggested, based on limited observations, that vertical wind shear in the upper troposphere is a key control on supercell morphology, with the low-precipitation, high-precipitation, and classic archetypes favored under strong, weak, and moderate shear, respectively. The idea is that, with increasing upper-level shear (ULS), hydrometeors are transported farther from the updraft by stronger storm-relative anvil-level winds, limiting their growth and thereby reducing precipitation intensity. The present study represents the first attempt to test this hypothesis, using idealized simulations of supercells performed across a range of 6–12-km shear profiles.

Contrary to expectations, there is a significant increase in surface precipitation and an associated strengthening of outflow winds as ULS magnitude is increased from 0 to 20 m s−1. These changes result from an increase in storm motion, which drives stronger low-level inflow, a wider updraft, and enhanced condensation. A further increase in ULS magnitude to 30 m s−1 promotes a slight reduction in storm intensity associated with surging rear-flank outflow. However, this transition in behavior is found to be sensitive to other factors that influence cold-pool strength, such as mixed-layer depth and model microphysics. Variations in the vertical distribution and direction of ULS are also considered, but are found to have a much smaller impact on storm intensity than variations in ULS magnitude.

Suggestions for the disparity between the current results and the aforementioned observations are offered and the need for further research on supercell morphology—in particular, simulations in drier environments—is emphasized.
Effect of Atrial Fibrillation on Contrast-Induced Nephropathy Development in Patients With Non-ST-Segment Elevation Myocardial Infarction
Authors: Düzel Bariş , Emren Sadik Volkan , Berilgen Rida
Published: March 2017

We investigated the relationship between atrial fibrillation (AF) and contrast-induced nephropathy (CIN) in patients with non-ST-segment elevation myocardial infarction (NSTEMI); 1045 consecutive patients undergoing percutaneous coronary interventions were enrolled. Risk factors for CIN were investigated. Baseline characteristics, except oral anticoagulant use, were similar between patients with and without AF. Patients with CIN show higher presence of diabetes mellitus (DM), coronary artery bypass graft surgery history, Mehran score, baseline creatinine levels, baseline glomerular filtration rate (GFR), peak troponin levels, left ventricular ejection fraction (LVEF), and presence of AF ( P < .05). In multivariate logistic regression analyses, the presence of DM (odds ratio [OR], 2.333; 95% confidence interval [CI], 1.222-4.457; P = .010), Mehran score (OR, 1.269; 95% CI, 1.152-1.398; P < .001), baseline GFR (OR, 0,954; 95% CI, 0.944-0.964 P < .001), left anterior descending artery originated infarction (OR, 1.594; 95% CI, 1.061-2.398; P = .025), LVEF value (OR, 0.956; 95% CI, 0.926-0.986; P = .005), and the presence of AF (OR, 3.830; 95% CI, 1.239-11.839; P = .020) were independent predictors of CIN. Atrial fibrillation can be related to CIN development in patients with NSTEMI.
Managing Student Behavior in Dual Immersion Classrooms: A Study of Class-Wide Function-Related Intervention Teams
Authors: Hansen Blake D. , Caldarella Paul , Williams Leslie , Wills Howard P.
Published: March 2017

Classroom management in dual immersion classrooms includes unique challenges. The teacher must instruct and correct in the L2 language, in which students are beginning learners, and effective classroom management strategies appropriate to the L2 context. Class-Wide Function-Related Intervention Teams (CW-FIT) is a positive classroom management program that teaches social skills and uses group contingencies to improve behavior. The present study examined the ability of French immersion teachers to implement CW-FIT in the L2, including the effects of CW-FIT on teacher praise and reprimand rates and as well as on students’ classroom behavior. Social validity was also assessed. A single-subject multiple baseline design with embedded reversals was used to evaluate impact in second-, third-, and fourth-grade dual immersion classrooms. Results indicated that dual immersion teachers were able to implement CW-FIT in L2 with fidelity. The intervention significantly increased teacher praise and improved classroom on-task behavior. Changes in teacher reprimand rates were inconsistent. Students and teachers reported CW-FIT to be socially valid.
Transition Phase Nutrition Recommendations: A Missing Link in the Nutrition Management of Preterm Infants
Authors: Brennan Ann‐Marie , Fenton Sarah , Murphy Brendan P. , Kiely Mairead E.
Published: March 2017

Background: Despite the availability of international nutrition recommendations, preterm infants remain vulnerable to suboptimal nutrition. The standard approach of assessing nutrient intakes chronologically may make it difficult to identify the origin of nutrient deficits and/or excesses. Objective: To develop a “nutrition phase” approach to evaluating nutrition support, enabling analysis of nutrient intakes during the period of weaning from parenteral nutrition (PN) to enteral nutrition (EN), called the transition (TN) phase, and compare the data with those analyzed using the standard “chronological age” approach to assess whether the identification of nutrient deficits and/or excesses can be improved. Methods: Analysis of a comprehensive nutrition database developed using actual nutrient intake data collected on an hourly basis in 59 preterm infants (birth weight ≤1500 g, gestation <34 weeks) over the period of PN delivery (range, 2–21 days). Results: The nutrition phase analysis approach revealed substantial macronutrient and energy deficits during the TN phase. In particular, deficits were identified as maximal during the EN‐dominant TN phase (enteral feeds ≥80 mL/kg/d) of the infant’s nutrition course. In contrast, the chronological age analysis approach did not reveal a corresponding pattern of deficit occurrence but rather intakes that approximated or exceeded recommendations. Conclusion: Actual intakes of nutrients, analyzed using a nutrition phase approach to evaluating nutrition support, enabled a more infant‐driven rather than age‐driven application of nutrition recommendations. This approach unmasked nutrient deficits occurring during the transition phase. Overcoming nutrient deficits in this nutrition phase should be prioritized to improve the nutrition management of preterm infants.
Anatomy‐Specific Virtual Reality Simulation in Temporal Bone Dissection: Perceived Utility and Impact on Surgeon Confidence
Authors: Locketz Garrett D. , Lui Justin T. , Chan Sonny , Salisbury Kenneth , Dort Joseph C. , Youngblood Patricia , Blevins Nikolas H.
Published: March 2017

Objective

To evaluate the effect of anatomy‐specific virtual reality (VR) surgical rehearsal on surgeon confidence and temporal bone dissection performance.

Study Design

Prospective pre‐ and poststudy of a novel virtual surgical rehearsal platform.

Setting

Academic otolaryngology–head and neck surgery residency training programs.

Subjects and Methods

Sixteen otolaryngology–head and neck surgery residents from 2 North American training institutions were recruited. Surveys were administered to assess subjects' baseline confidence in performing 12 subtasks of cortical mastoidectomy with facial recess. A cadaver temporal bone was randomly assigned to each subject. Cadaver specimens were scanned with a clinical computed tomography protocol, allowing the creation of anatomy‐specific models for use in a VR surgical rehearsal platform. Subjects then rehearsed a virtual mastoidectomy on data sets derived from their specimens. Surgical confidence surveys were administered again. Subjects then dissected assigned cadaver specimens, which were blindly graded with a modified Welling scale. A final survey assessed the perceived utility of rehearsal on dissection performance.

Results

Of 16 subjects, 14 (87.5%) reported a significant increase in overall confidence after conducting an anatomy‐specific VR rehearsal. A significant correlation existed between perceived utility of rehearsal and confidence improvement. The effect of rehearsal on confidence was dependent on trainee experience and the inherent difficulty of the surgical subtask. Postrehearsal confidence correlated strongly with graded dissection performance. Subjects rated anatomy‐specific rehearsal as having a moderate to high contribution to their dissection performance.

Conclusion

Anatomy‐specific virtual rehearsal improves surgeon confidence in performing mastoid dissection, dependent on surgeon experience and task difficulty. The subjective confidence gained through rehearsal correlates positively with subsequent objective dissection performance.
A Survey of Wisconsin Pediatricians’ Knowledge and Practices Regarding the Human Papillomavirus Vaccine
Authors: Rohrbach Marc R. , Wieland Aaron M.
Published: March 2017

Objective

The human papillomavirus (HPV) is common and carries a significant burden of disease. This is increasingly apparent in males with the rising incidence of HPV‐related oropharyngeal cancer. Unfortunately, vaccination rates remain poor and are lowest in males. It is unclear if pediatricians are aware of the alarming rise of HPV‐mediated head and neck cancers and the disproportionate effect on males.

Study Design

This investigation used a cross‐sectional descriptive survey research design.

Setting

The survey was developed by investigators in the University of Wisconsin Division of Otolaryngology.

Subjects and Methods

The survey was distributed to 831 members of the Wisconsin Chapter of the American Academy of Pediatrics.

Results

A total response rate of 49.6% was achieved. Most supported routine vaccination in both sexes. Females are regarded as being at higher risk of an HPV‐related cancer and are more often recommended vaccination. Most providers are unaware of the magnitude of HPV‐related oropharyngeal cancer and the greater affliction in males.

Conclusions

Male vaccination is overwhelmingly supported by Wisconsin pediatricians, yet there is a preponderance toward vaccinating females, who are perceived as having greater risk for HPV‐associated disease. This is likely because providers are unaware of the magnitude of HPV‐driven oropharyngeal cancer and its predilection for males. A lack of provider awareness, in combination with out‐of‐date education material for parents, likely contributes to poor vaccination rates in males.
Epidemiology of Nasopharyngeal Lymphoma in the United States: A Population‐Based Analysis of 1119 Cases
Authors: Han Albert Y. , Kuan Edward C. , Alonso Jose E. , Badran Karam W. , St. John Maie A.
Published: March 2017

Objectives

To describe the incidence and determinants of survival of patients with nasopharyngeal lymphoma (NPL) between 1973 and 2012 using the Surveillance, Epidemiology, and End Results (SEER) database.

Study Design

Retrospective cohort study using a national database.

Methods

The SEER registry was used to calculate survival trends for patients with NPL between 1973 and 2012. Patient data were then analyzed with respect to histopathology, age, sex, race, histologic subtype, Ann Arbor stage, and whether radiation therapy was given. Overall survival (OS) and disease‐specific survival (DSS) were calculated.

Results

A total of 1119 cases of NPL were identified. The cohort was composed of 58.8% males. The mean age at diagnosis was 59.3 years. The median OS was 8.2 years. B‐cell non‐Hodgkin’s lymphomas (NHLs) accounted for most cases (77.5%), with natural killer (NK)/T‐cell lymphomas comprising 6.0% of cases. A total of 41.5% patients received radiation therapy. OS at 2, 5, and 10 years was 70%, 57%, and 45%, respectively. On multivariate analysis, advanced age and NK/T‐cell NHL histologic subtype were associated with worse OS and DSS, while radiation therapy was associated with improved OS and DSS (all P <. 05).

Conclusion

With the exception of NK/T‐cell NHL subtypes, NPL is associated with a fair prognosis, with younger age, low Ann Arbor stage, and radiation therapy being independent positive prognosticators for survival.
11C-DPA-713 has much greater specific binding to translocator protein 18 kDa (TSPO) in human brain than 11C-(R)-PK11195
Authors: Kobayashi Masato , Jiang Teresa , Telu Sanjay , Zoghbi Sami S , Gunn Roger N , Rabiner Eugenii A , Owen David R , Guo Qi , Pike Victor W , Innis Robert B , Fujita Masahiro
Published: March 2017

Positron emission tomography (PET) radioligands for translocator protein 18 kDa (TSPO) are widely used to measure neuroinflammation, but controversy exists whether second-generation radioligands are superior to the prototypical agent 11C-( R)-PK11195 in human imaging. This study sought to quantitatively measure the “signal to background” ratio (assessed as binding potential ( BPND)) of 11C-( R)-PK11195 compared to one of the most promising second-generation radioligands, 11C-DPA-713. Healthy subjects had dynamic PET scans and arterial blood measurements of radioligand after injection of either 11C-( R)-PK11195 (16 subjects) or 11C-DPA-713 (22 subjects). To measure the amount of specific binding, a subset of these subjects was scanned after administration of the TSPO blocking drug XBD173 (30–90 mg PO). 11C-DPA-713 showed a significant sensitivity to genotype in brain, whereas 11C-( R)-PK11195 did not. Lassen occupancy plot analysis revealed that the specific binding of 11C-DPA-713 was much greater than that of 11C-( R)-PK11195. The BPND in high-affinity binders was about 10-fold higher for 11C-DPA-713 (7.3) than for 11C-( R)-PK11195 (0.75). Although the high specific binding of 11C-DPA-713 suggests it is an ideal ligand to measure TSPO, we also found that its distribution volume increased over time, consistent with the accumulation of radiometabolites in brain.
The Role of Marketing in Ritual Evolution
Authors: Cross Samantha N. N. , Harrison Robert L. , Gilly Mary C.
Published: March 2017

Thanksgiving in the U.S. is a ritual with shared meanings. This research evaluates the meanings of symbolic representations in advertising to understand the role of the media in the construction, maintenance, and evolution of ritual celebration. Thanksgiving advertisements published over a 99-year period are analyzed using a methodological mixture of semiotic analysis, historical analysis and context-driven periodization. The result is a multi-layered understanding of inter-related aspects of advertising history and the role of the media in the evolution of consumption ritual-making. Media are seen as agents for creating and legitimizing cultural norms, adding to our appreciation of normative and cultural-cognitive practices in supporting evolving social institutions. Findings show that marketers create and maintain the norms associated with Thanksgiving celebrations, while reflecting and gradually shifting them, moving us to the next stage in the evolutionary process. This research also highlights how cultural mythmaking strategies are employed and develop into historical brand narratives.
Dexmedetomidine Effect on Emergence Agitation and Delirium in Children Undergoing Laparoscopic Hernia Repair: a Preliminary Study
Authors: Sun Yingying , Li Yuanhai , Sun Yajuan , Wang Xing , Ye Hongwu , Yuan Xianren
Published: March 2017

Objective

To evaluate the safety and efficacy of dexmedetomidine (Dex) to prevent emergence agitation (EA) and delirium (ED) in children undergoing laparoscopic hernia repair under general anesthesia.

Methods

100 children (1–5 years, 10–25 kg) were randomized into four groups: controls (saline) and intravenous Dex at 0.25, 0.5, and 1.0 µg/kg (D1, D2, D3, respectively). Dex/saline infusion was started following anesthesia. EA and ED were evaluated on a 5-point scale.

Results

For the C, D1, D2, and D3 groups, respectively, EA frequencies were 45.8%, 30.4%, 12%, 4%; ED frequencies 29.1%, 13%, 4%, 4%; CHIPPS scores 8, 6, 3, 3; sevoflurane doses from 13.2 ± 3.4 (controls) to 9.4 ± 3.5 ml (D3). Intervals until mask removal/spontaneous eye opening were significantly longer for D2 and D3 than controls. PACU stay was longer for D3.

Conclusions

There was significantly less postoperative EA and pain, with less sevoflurane required, using Dex.
Explorational instrumental practice: An expansive approach to the development of improvisation competence
Authors: Johansen Guro Gravem
Published: March 2017

This article seeks to discuss approaches to instrumental practicing directed towards developing improvisation competence, by analyzing empirical data from a qualitative study on jazz students’ instrumental practicing. The concept explorational practice is derived from the theory of expansive learning, and compared against the concept deliberate practice. Findings show a variety of open-ended strategies to develop students’ improvisation competence, which are framed as explorational practice.
‘Anyone can edit’, not everyone does: Wikipedia’s infrastructure and the gender gap
Authors: Ford Heather , Wajcman Judy
Published: March 2017

Feminist STS has long established that science’s provenance as a male domain continues to define what counts as knowledge and expertise. Wikipedia, arguably one of the most powerful sources of information today, was initially lauded as providing the opportunity to rebuild knowledge institutions by providing greater representation of multiple groups. However, less than ten percent of Wikipedia editors are women. At one level, this imbalance in contributions and therefore content is yet another case of the masculine culture of technoscience. This is an important argument and, in this article, we examine the empirical research that highlights these issues. Our main objective, however, is to extend current accounts by demonstrating that Wikipedia’s infrastructure introduces new and less visible sources of gender disparity. In sum, our aim here is to present a consolidated analysis of the gendering of Wikipedia.
Early Renal Replacement Therapy Versus Standard Care in the ICU: A Systematic Review, Meta-Analysis, and Cost Analysis
Authors: Chaudhuri Dipayan , Herritt Brent , Heyland Daren , Gagnon Louis-Philippe , Thavorn Kednapa , Kobewka Daniel , Kyeremanteng Kwadwo
Published: March 2017

Objective:

Renal replacement therapy (RRT) is the treatment of choice for severe acute kidney injury, but there are no firm guidelines as to the time of initiation of RRT in the critically ill. The primary objective of this study is to determine 1-month mortality rates of early versus late dialysis in critical care. As secondary end points, we provide a cost analysis of early versus late RRT initiation, intensive care unit (ICU) length of stay (LOS), hospital LOS, and number of patients on dialysis at day 60 postrandomization.

Data Sources:

We identified all randomized controlled trials (RCTs) through EMLINE and MEDBASE that examined adult patients admitted to critical care who were randomized to receiving early dialysis versus standard of care.

Study Selection:

Inclusion criteria: (1) RCTs conducted after the year 2000, (2) the population evaluated had to be adults admitted to ICU, (3) the intervention had to be early RRT versus standard care, and (4) outcomes had to measure patient mortality.

Data Extraction:

Two independent investigators reviewed search results and identified appropriate studies. Information was extracted using standardized case report forms.

Data Synthesis:

Overall, 7 RCTs were included with a total of 1400 patients. Early RRT showed no survival benefit when compared to standard treatment (odds ratio [OR], 0.90 95% confidence interval [95% CI] 0.70-1.15, P = .39). There was no significant difference in length of hospital stay in patients with early RRT (−1.55 days [95% CI −4.75 to 1.65, P = .34]), in length of ICU stay (−0.79 days [95% CI −2.09 to 0.52], P = .24), or proportion of patients on dialysis at day 60 (OR 0.93 [95% CI 0.62 to 1.43], P = .79). Per patient, there is likely a small increase in costs (<US$1000) owing to increased total dialysis.

Conclusion:

Across all measured domains, there is no clear benefit to early RRT. Moreover, this intervention may result in increased costs and exposes patients to an invasive therapy with potential harm.
Journal rankings and directions for future research in health care management: A global perspective
Authors: Meese Katherine A , O’Connor Stephen J , Borkowski Nancy , Hernandez S Robert
Published: March 2017

Despite the increasingly global nature of health care, much of the research about journal rankings and directions for future research in health care management is from a United States based viewpoint. There is a lack of information about influential journals and trends for health care management research from a global perspective. This exploratory study gathered the opinions of health care management researchers from 17 countries regarding which journals are considered most influential, popular research topics and areas needing more attention from the research community. An online survey was sent to individuals in high-income Organisation for Economic Co-operation and Development countries who were identified through author relationships, academic institution websites, editorial boards of international journals, and academic and practitioner associations in the countries of interest. Results indicate that journal rankings vary substantially from prior published studies evaluating health care management journals and international ranking lists, and the list of influential journals includes a much more diverse array of publications. Respondents also indicated a diverse number of topics for current and future research, highlighting the global complexity of the field. The implications of this study are valuable to scholars evaluating outlets for disseminating research, and highlighting areas for collaborative research in health care management globally.
Application of Lean Six Sigma for cost-optimised solution of a field quality problem: A case study
Authors: Mahato Satyajit , Rai Dixit Amit , Agrawal Rajeev
Published: March 2017

In a price-sensitive market, quality improvement framework also needs to incorporate cost factor. Past research on Lean Six Sigma gives limited insight on any framework catering to quality and cost together. This study aims to contribute in this niche by illustrating a hybrid framework, DMAIoC (define, measure, analyse, improve, optimise and control) to attain desired quality at minimum investment cost by integrating simplex method of optimisation in conventional DMAIC (define, measure, analyse, improve and control) framework. A case study is presented highlighting a field quality rejection problem faced by a manufacturing organisation of consumer goods. Sustainable drop height of a finished good is identified as a response variable to improve the quality. Proposed framework has been used to arrive at a statistical model to define relationship between response and input variables. Investment cost involved with change in input variables has been formulated as objective function. Constrains of objective functions were derived by extendable limits of input variables and by statistical model generated for sustainable drop height. Several feasible solutions to the objective function were identified using simplex method in optimise phase and the most economic was recommended for implementation to meet quality requirement at minimum investment. Suggested framework has significant practical implication in price–quality sensitive markets where manufacturers seek low cost process improvement solutions.
Pre-modern Interfaith Dialogues with Special Reference to Nicholas of Cusa
Authors: Langford Michael J.
Published: March 2017

Hume claimed that the religions of the world are in such opposition that their alleged miracles conflict. However, even before Hume there were examples of eirenic interfaith dialogue, and this article 1 provides a historical review of eleven of these, prior to an account of Nicholas of Cusa’s De Pace Fidei (1453), which sought mutual understanding notwithstanding the recent fall of Constantinople. The Platonic nature of Cusa’s dialogue is discussed and especially the relation of ratio to intellectus in his thought. Finally, some implications for contemporary interfaith dialogue are examined and, in particular, the presence of a kind of argument that does not fit comfortably into the traditional via negativa/via positiva dichotomy.
Exporting a Student-Centered Curriculum: A Home Institution’s Perspective
Authors: Waterval Dominique , Tinnemans-Adriaanse Marjolijn , Meziani Mohammed , Driessen Erik , Scherpbier Albert , Mazrou Abdulrahman , Frambach Janneke
Published: March 2017

Numerous, mainly Anglo-Saxon, higher education institutions have agreements with foreign providers to deliver their curricula abroad. This trend is gradually making inroads into the medical domain, where foreign institutions undertake to offer their students learning experiences similar to those of the home institution. Not an easy feat, as the national health care contexts differ greatly between institutions. In a bid to export the curriculum, institutions risk compromising their financial resilience and reputation. This article presents an instrumental case study of a home institution’s perspective on the establishment of a cross-border student-centered curriculum partnership. It provides the reader with a practical discourse on dimensions that need to be bridged between home and host contexts, and on new working processes that need to be integrated within the home institution’s existing organizational structure. We describe the advantages and disadvantages based on our experiences with a centralized organizational approach, and advocate for a gradual move toward decentral interfaculty communities of practice.
Numerical modelling and experimental validation of a McKibben pneumatic muscle actuator
Authors: Antonelli Michele G , Beomonte Zobel Pierluigi , Durante Francesco , Raparelli Terenziano
Published: March 2017

The McKibben muscle belongs to the type of muscles known as braided muscles. It is made of an inner hyper-elastic tube, surrounded by a braided shell made of inextensible threads; both ends provide mechanical and pneumatic seal. A finite element model of a McKibben pneumatic muscle was built and experimentally validated. The model is based on characteristic parameters of McKibben muscles. It takes into account the non-linearity of the constitutive material of the inner tube. It does not simulate backslashes between the tube and the shell at rest condition, but it models threads and rubber that are always connected. However, it does not consider friction among threads. In order to build and to validate the proposed numerical model, an experimental prototype of the muscle was designed and built. Both isotonic and isometric tests were carried out. Same tests were simulated in the finite element environment. The model validation was performed by comparison between experimental and numerical results.