bluuebunny/crossref_metadata_2025 huggingface dataset:
Differentiating Cooperative Learning to Meet the Needs of Gifted Learners: A Case for Transformational Leadership
Authors: Ross John A. , Smyth Elizabeth
Published: April 2016

Cooperative learning activities, which assign gifted learners to mixed-ability groups, have been validly decried as exploitation. But a case can be made that mixed-ability grouping provides opportunities for gifted students to develop transformational leadership skills, an element of gifted education that has been given insufficient attention. Observations of interactions in mixed-ability groups reveal three persistent challenges (inclusiveness, enacting the ideal, and monitoring growth) in which leadership skills can be exercised and developed. Specific student strategies are proposed for each challenge. The role of teachers in developing the leadership skills of gifted learners involves delegating responsibility to student groups, adjusting leadership to the maturation levels of gifted learners, and creating pull-out programs for leadership training.
A Pedagogy of Privilege
Authors: Margolin Leslie
Published: April 2016

In this essay, I argue that gifted education is the flip side of the “pedagogy of the oppressed”; that it is a strategy to single out the children of the affluent for training in leadership and dominance. Contrary to stereotypes usually associated with gifted education, this pedagogy is not characterized by academic rigor but is organized around the personal and social traits associated with the gifted themselves.
Establishing the Foundations for a Talent Development School: Applying Principles to Creating an Ideal
Authors: Subotnik Rena F. , Coleman Laurence J.
Published: April 2016

A talent development program (TDP) was formulated in response to a symposium that explored the distinctiveness of gifted education from general education. The proposal acknowledges that gifted and talented children are atypical learners, that many of their needs can be met with strategies appropriate for all children, and that they require opportunities for greater speed and depth of study and for addressing individual concerns related to their emerging talent. A TDP should be established at every school to complement and extend the general education program. Schools cannot adequately address the needs of gifted and talented learners because they are organized on notions of development that are largely antithetical to what is known about talent development. The TDP would facilitate scholarly inquiry and apprenticeships for those with the potential and desire to transform various domains.
Applied Teaching Concepts of Animated Motion Slides in Otolaryngology
Authors: Duberstein Larry E. , Josephs Joseph A. , Kilgo Jayne
Published: April 2016

Motion is an essential part of otolaryngologic function, and an understanding of concepts of motion is critical in teaching otolaryngology. Standard movie projection devices have intrinsic defects, such as considerable expense to make, complexity of operation, and a lack of flexibility. Slide projection transparencies (2×2) offer instructional flexibility but could not be used to project motion until recently. Using applications of gelatin films of images with polarizing light, we have been able to produce an illusion of motion similar to that used in creating the motion in cartoons. We have produced a series of slides for instructional purposes to show concepts in otolaryngology.
Sudden Blindness Secondary to Injections of Common Drugs in the Head and Neck: I. Clinical Experiences
Authors: McGrew Robert N. , Wilson R. Sloan , Havener William H.
Published: April 2016

Several cases of sudden, irreversible blindness have been reported in the world literature following injections of various drug combinations in the head and neck. The common feature these drugs have is their capacity to either produce direct neurotoxic effects or embolic phenomena. Two new cases which resulted from injection of the combination of a depo or long‐acting corticosteroid (methylprednisolone acetate, 40 mg) and a local anesthetic and epinephrine or penicillin were added to the growing world literature. The ocular and systemic pathologic findings are described and important questions are raised as to the pathophysiology. The need for an animal model experiment to answer as many of these questions as possible is emphasized.
Orbital Complications of Acute Sinusitis: Evaluation, Management, and Outcome
Authors: Schramm Victor L. , Myers Eugene N. , Kennerdell John S.
Published: April 2016

Acute orbital cellulitis is most commonly caused by sinusitis. This complication is based on the anatomy of the sinuses, orbit, and their venous connections. A series of 134 patients is reviewed to demonstrate the etiology and clinical course of orbital cellulitis. Antibiotic therapy alone does not prevent permanent complications. Surgical intervention is found necessary in all age groups and is required in 20% of the study population.
Olfactory Groove Meningioma with Paranasal Sinus and Nasal Cavity Extension: A Combined Approach
Authors: Persky Mark S. , Som Max L.
Published: April 2016

A 58‐year‐old man had an enlarging right fronto‐orbital mass. A biopsy specimen of a right nasal cavity tumor was reported as meningioma. Preoperative evaluation including skull roentgenograms, tomograms of the paranasal sinuses, brain scan, computerized axial tomography, and carotid angiography substantiated a large subfrontal mass with paranasal sinus and orbital extension.

A combined approach through a right frontal craniotomy and right lateral rhinotomy was used for a complete removal of this tumor. A review of the literature is contained herein.
Transpalatal Excision of the Odontoid Process
Authors: Donald Paul J. , Bernstein Leslie
Published: April 2016

A patient with platybasia of the skull and temporomandibular joint ankylosis is presented. Relief of brain stem compression by the impingement of the odontoid through a soft, hypoplastic clivus was done by first doing a mandibular condylectomy to open the mouth. A transoral‐transpharyngeal route was then employed to excise the odontoid process.
Three Simultaneous Neoplasms of the Larynx
Authors: Ossoff Robert H. , Bytell David E.
Published: April 2016

A 39‐year‐old man had three coexistent neoplasms of the larynx, squamous papilloma, verrucous carcinoma, and squamous carcinoma. In our review of the English literature, we could not find a similar case report. The potential transformation of benign laryngeal papilloma to verrucous carcinoma and infiltrating squamous cell carcinoma is discussed.
Fibroblast Implantation Enhances Wound Healing as Indicated by Breaking Strength Determinations
Authors: Krueger Wesley W. O. , Goepfert Helmuth , Romsdahl Marvin , Herson Jay , Withers Rodney H. , Jesse Richard H.
Published: April 2016

Irradiation of normal tissues at the dose/time factor employed in the treatment of solid tumors impairs the subsequent healing of surgical wounds made in those tissues. Irreversible radiation damage to regional fibroblasts is one cause of impaired healing. This study was conducted to determine whether syngeneic guinea pig fibroblasts, harvested from tissue culture when injected into irradiated guinea pig skin at the time of wound closure, could improve wound healing. Breaking strength determinations indicate that irradiated wounds demonstrate enhanced wound healing if implanted with fibroblasts.
High‐Frequency Hearing Losses Caused by Low‐Frequency Noises
Authors: Mills John H. , Adkins Warren Y. , Gilbert Robert M.
Published: April 2016

Human subjects were exposed to an octave‐band noise for 24 hours. Temporary threshold shifts increased for the first eight hours of exposure and then were asymptotic. While threshold shifts were largest at about one‐half octave above the center frequency of the noise, a second maximum was observed at higher test frequencies. The exact frequency of this second maximum decreased from 7.0 kHz, for a noise centered at 2.0 kHz, to 5.5 kHz for a noise centered at 0.5 kHz. This result could be caused by the travelling wave pattern along the cochlear partition or to the production of distortion products.
The Eustachian Tube Prosthesis Revisited
Authors: Wright J. William , Wright J. William , Hicks George W.
Published: April 2016

Preliminary results with an eustachian tube prosthesis have been reported. This paper updates our experience with the prosthesis. Our series is now 95 patients with follow‐up of 2 to 32 months (average of 14 months). The success rate in obtaining a healed aerated middle ear is 75% (71). The eustachian tube prosthesis continues to give encouraging results in problem tympanoplasty cases.
Current Evidence for the Organic Etiology of Spastic Dysphonia
Authors: Dedo Herbert H. , Townsend Jeannette J. , Izdebski Krzysztof
Published: April 2016

For over 100 years it has been universally assumed in the literature that spastic dysphonia is a functional or psychoneurotic voice disorder. In the last few years, new data have accumulated that support the concept that spastic dysphonia is caused by an organic, rather than a functional, abnormality. Histologic examination of segments of the recurrent laryngeal nerve removed from patients with spastic dysphonia has revealed myelin abnormalities in 30% of the nerves examined. Neurologic examinations indicated brain stem or basal ganglia disturbances in some patients who had no apparent nerve disease.
Interruption of Combined Therapy: A Factor in Decreased Survival
Authors: Leipzig Bruce , Cummings Charles W. , Chung Chung T. , Sagerman Robert H.
Published: April 2016

Occasionally, during the course of combined (radiation plus surgery) treatment of head and neck malignancies, the patient experiences a profound response to radiotherapy alone and elects to decline the second phase of treatment, namely, surgery. After a variable interval, radiotherapy is reinstituted to a “curative” level.

A series of 14 laryngeal and oropharyngeal carcinomas, treated in this disjointed fashion, has been examined with respect to long‐term survival. The prognosis is extremely unfavorable, thus supporting a basic philosophy of continuing with the prescribed surgical treatment despite a dramatic response to noncancericidal doses of radiotherapy.

The site and stage of tumor, radiation dosage, interval to completion of therapy, and incidence of local and distant metastases are examined.

It appears that every effort should be made to provide continuity in the combined therapeutic protocol if the advantages of this mode of therapy are to be effective.
Sarcomatous Degeneration in a Nasopharyngeal Angiofibroma
Authors: Donald Paul J.
Published: April 2016

Malignant degeneration in a juvenile nasopharyngeal angiofibroma has been reported in the literature in only four patients. All of these persons had been previously treated for cure with gamma irradiation. The case report of a 47‐year‐old man with a 31‐year history of nasal obstruction is presented. A recurrence excised 18 months after initial removal of an angiofibroma revealed the surprising diagnosis of fibrosarcoma.
Why Not the Eighth Nerve? Neurovascular Compression—Probable Cause for Pulsatile Tinnitus
Authors: Lesinski S. George , Chambers Albert A. , Komray Raymond , Keiser Michael , Khodadad Ghahreman
Published: April 2016

Carotid arteriograms on three patients with unilateral pulsatile tinnitus demonstrated an ipsilateral atypical trigeminal artery extending from the cavernous portion of the internal carotid artery to form the posterior inferior cerebellar artery. Illustrations and a dissection of a human fetus with a similar finding show this artery crossing the cochlear nerve near its insertion in the pons. Evidence is presented suggesting that neurovascular compression of the eighth nerve is the source of pulsatile tinnitus in these patients.
21st Century Change Drivers
Authors: Rock Marcia L. , Spooner Fred , Nagro Sarah , Vasquez Eleazar , Dunn Cari , Leko Melinda , Luckner John , Bausch Margaret , Donehower Claire , Jones Jennie L.
Published: April 2016

Contemporary challenges confronting special education teachers include, in part, workload, role ambiguity, evaluation, and shortages. Based on these and other challenges, the piece-meal fragmented approach to pre- and in-service training, which exists currently, needs to be replaced with 21st century models of special education teacher development that are seamless, technology enabled, comprehensive, cohesive, and career spanning. In this article, the authors briefly address persistent and unresolved challenges, identify contemporary change drivers, and discuss ways in which teacher education professionals could leverage the drivers to inform the development of 21st century models for special education teacher development aimed at improving outcomes for students with disabilities. Change drivers include the digital revolution, the diversity gap, the credibility factor, the demand for collective impact, and the culture of we. The authors conclude with a call to action.
Preparing Special Education Higher Education Faculty
Authors: deBettencourt Laurie U. , Hoover John J. , Rude Harvey A. , Taylor Shanon S.
Published: April 2016

There is a well-documented need for leadership personnel who are prepared at the doctoral level to fill special education faculty positions at institutions of higher education (IHEs) and train the next generation of teachers. The intersection of continued retirements of special education faculty, shortage of well-prepared special education faculty to fill those positions, and changing preK-12 student demographics provides unique challenges to special education doctoral leadership preparation programs. Although a variety of variables influence special educator preparation in 21st-century schools, five contemporary issues (i.e., changing roles, evolving diversity, need for funding support, situating doctoral trainees in teacher training, and training delivery models) rise to a level highly relevant to special educator preparation at the doctoral level. In this article, the authors explore this complex landscape and offer policy recommendations to strengthen and update special education higher education leadership preparation.
Why Are Economists Evaluating the Impact of Gifted Education?
Authors: Kettler Todd
Published: April 2016

Bui, Craig, and Imberman assessed the impact of gifted and talented programs on student achievement using regression discontinuity and random assignment to gifted magnet schools. In both analyses, they found minimal impact of the gifted and talented programs on student achievement. This commentary addresses two concerns associated with the study. First, the studies provided no description of the gifted students in the analyses, and some evidence suggests that the students in the study may not match typical conceptions of giftedness. Second, the outcome measures (Stanford Achievement Tests) may not have aligned well with the intent of the gifted program in the school district. In addition, this commentary asked why and how economists study the impact of gifted education programs. It is recommended that those who study and practice gifted education seek common ground on the goals and measurable outcomes of gifted education programs in ways satisfying to both the field of gifted education and to policy evaluators.
School Nurses on the Front Lines of Medicine
Authors: Olympia Robert P.
Published: April 2016

Fever and sore throat are common chief complaints encountered by school nurses. This article explains the etiology of both fever and sore throat in children, describes the office assessment, and delineates life-threatening complications associated with fever and sore throat that may prompt the school nurse to transfer the child to a local emergency department.
Evolutionary relationships between heme-binding ferredoxin α + β barrels
Authors: Acharya Giriraj , Kaur Gurmeet , Subramanian Srikrishna
Published: April 2016

Background

The α + β barrel superfamily of the ferredoxin-like fold consists of a functionally diverse group of evolutionarily related proteins. The barrel architecture of these proteins is formed by either homo-/hetero-dimerization or duplication and fusion of ferredoxin-like domains. Several members of this superfamily bind heme in order to carry out their functions.

Results

We analyze the heme-binding sites in these proteins as well as their barrel topologies. Our comparative structural analysis of these heme-binding barrels reveals two distinct modes of packing of the ferredoxin-like domains to constitute the α + β barrel, which is typified by the Type-1/IsdG-like and Type-2/OxdA-like proteins, respectively. We examine the heme-binding pockets and explore the versatility of the α + β barrels ability to accommodate heme or heme-related moieties, such as siroheme, in at least three different sites, namely, the mode seen in IsdG/OxdA, Cld/DyP/EfeB/HemQ and siroheme decarboxylase barrels.

Conclusions

Our study offers insights into the plausible evolutionary relationships between the two distinct barrel packing topologies and relate the observed heme-binding sites to these topologies.
Should we use cells, biomaterials, or tissue engineering for cartilage regeneration?
Authors: Bernhard Jonathan C. , Vunjak-Novakovic Gordana
Published: April 2016

For a long time, cartilage has been a major focus of the whole field of tissue engineering, both because of the constantly growing need for more effective options for joint repair and the expectation that this apparently simple tissue will be easy to engineer. After several decades, cartilage regeneration has proven to be anything but easy. With gratifying progress in our understanding of the factors governing cartilage development and function, and cell therapy being successfully used for several decades, there is still a lot to do. We lack reliable methods to generate durable articular cartilage that would resemble the original tissue lost to injury or disease. The question posed here is whether the answer would come from the methods using cells, biomaterials, or tissue engineering. We present a concise review of some of the most meritorious efforts in each area, and propose that the solution will most likely emerge from the ongoing attempts to recapitulate certain aspects of native cartilage development. While an ideal recipe for cartilage regeneration is yet to be formulated, we believe that it will contain cell, biomaterial, and tissue engineering approaches, blended into an effective method for seamless repair of articular cartilage.
RETRACTED ARTICLE: Salinity-induced changes in the morphology and major mineral nutrient composition of purslane (Portulaca oleracea L.) accessions
Authors: Alam Md. Amirul , Juraimi Abdul Shukor , Rafii M. Y. , Hamid Azizah Abdul , Aslani Farzad , Hakim M. A.
Published: April 2016

This study was undertaken to determine the effects of varied salinity regimes on the morphological traits (plant height, number of leaves, number of flowers, fresh and dry weight) and major mineral composition of 13 selected purslane accessions. Most of the morphological traits measured were reduced at varied salinity levels (0.0, 8, 16, 24 and 32 dS m−1), but plant height was found to increase in Ac1 at 16 dS m−1 salinity, and Ac13 was the most affected accession. The highest reductions in the number of leaves and number of flowers were recorded in Ac13 at 32 dS m−1 salinity compared to the control. The highest fresh and dry weight reductions were noted in Ac8 and Ac6, respectively, at 32 dS m−1 salinity, whereas the highest increase in both fresh and dry weight was recorded in Ac9 at 24 dS m−1 salinity compared to the control. In contrast, at lower salinity levels, all of the measured mineral levels were found to increase and later decrease with increasing salinity, but the performance of different accessions was different depending on the salinity level. A dendrogram was also constructed by UPGMA based on the morphological traits and mineral compositions, in which the 13 accessions were grouped into 5 clusters, indicating greater diversity among them. A three-dimensional principal component analysis also confirmed the output of grouping from cluster analysis.
Research trends in biomimetic medical materials for tissue engineering: 3D bioprinting, surface modification, nano/micro-technology and clinical aspects in tissue engineering of cartilage and bone
Authors: Chen Cen , Bang Sumi , Cho Younghak , Lee Sahnghoon , Lee Inseop , Zhang ShengMin , Noh Insup
Published: April 2016

This review discusses about biomimetic medical materials for tissue engineering of bone and cartilage, after previous scientific commentary of the invitation-based, Korea-China joint symposium on biomimetic medical materials, which was held in Seoul, Korea, from October 22 to 26, 2015. The contents of this review were evolved from the presentations of that symposium. Four topics of biomimetic medical materials were discussed from different research groups here: 1) 3D bioprinting medical materials, 2) nano/micro-technology, 3) surface modification of biomaterials for their interactions with cells and 4) clinical aspects of biomaterials for cartilage focusing on cells, scaffolds and cytokines.
Long-term monitoring of microseismic emissions: Earth tides, fracture distribution, and fluid content
Authors: Kouznetsov Oleg L. , Lyasch Yury F. , Chirkin Igor A. , Rizanov Evgeny G. , LeRoy Samuel D. , Koligaev Sergey O.
Published: April 2016

Monitoring of microseismic emissions for periods of 10–30 days has established a clear relationship between solid earth tides and microseismic activity. In addition, an event magnitude versus recurrence relationship has been established that can be used to predict oil, gas, or water content of open fractures in imaged rock volumes. Originally developed to explore for oil and gas, the detection technology used has been applied in Eurasia, the Middle East, and Texas. When visualized in three dimensions at scales of several kilometers on a side, including depth, the observations shows systems of subvertical fracture volumes distributed as clusters in the subsurface. When visualized in sequential time windows, microseismic activity can be seen to respond in detail to lunar-solar gravitational changes. The seismic imaging technology used to detect the location and temporal changes within these fracture systems is based on deploying geophone receiver arrays using array patterns and processing algorithms similar to those used in phased array radar in the electromagnetic spectrum. This passive listening technology has been termed seismic location of emission centers (SLEC). Examples of applied SLEC monitoring are presented for surveys performed in Russia and Texas.
Quantifying the significance of coherence anomalies
Authors: Lin Tengfei , Ha Thang , Marfurt Kurt J. , Deal Kevin L.
Published: April 2016

Semblance and other coherence measures are routinely used in seismic processing, such as velocity spectra analysis, in seismic interpretation to estimate volumetric dip and to delineate geologic boundaries, and in poststack and prestack data conditioning such as edge-preserving structure-oriented filtering. Although interpreters readily understand the significance of outliers for such measures as seismic amplitude being described by a Gaussian (or normal) distribution, and root-mean-square amplitude by a log-normal distribution, the measurement significance of a given coherence of poststack seismic data is much more difficult to grasp. We have followed early work on the significance of events seen in semblance-based velocity spectra, and we used an [Formula: see text]-statistic to quantify the significance of coherence measures at each voxel. The accuracy and resolution of these measures depended on the bandwidth of the data, the signal-to-noise ratio (S/N), and the size of the spatial and temporal analysis windows used in their numerical estimation. In 3D interpretation, low coherence estimated not only the seismic noise but also the geologic signal, such as fault planes and channel edges. Therefore, we have estimated the S/N as the product of coherence and two alternative measures of randomness, the first being the disorder attribute and the second estimate based on eigenvalues of a window of coherence values. The disorder attribute is fast and easy to compute, whereas the eigenvalue calculation is computationally intensive and more accurate. We have demonstrated the value of this measure through application to two 3D surveys, in which we modulated coherence measures by our [Formula: see text]-statistic measure to show where discontinuities were significant and where they corresponded to more chaotic features.
The deadenylase components Not2p, Not3p, and Not5p promote mRNA decapping
Authors: Alhusaini Najwa , Coller Jeff
Published: April 2016

Decay of mRNA is essential for the efficient regulation of gene expression. A major pathway of mRNA degradation is initiated by the shortening of the poly(A) tail via the CCR4/NOT deadenylase complex. Deadenylation is followed by removal of the 5′ cap (i.e., decapping) and then 5′ to 3′ exonucleolytic decay of the message body. The highly conserved CCR4/NOT deadenylase complex consists of the exonucleases CCR4 and POP2/CAF1, as well as a group of four or five (depending on organism) accessory factors of unknown function, i.e., the NOT proteins. In this study, we find that Saccharomyces cerevisiae Not2p, Not3p, and Not5p (close paralogs of each other) are involved in promoting mRNA decapping. Furthermore, we find that Not3p and Not5p bind to the decapping activator protein Pat1p. Together, these data implicate the deadenylase complex in coordinating the downstream decapping reaction via Not2p, Not3p, and Not5p. This suggests that the coupling of deadenylation with decapping is, in part, a direct consequence of coordinated assembly of decay factors.
Ubiquitous accumulation of 3′ mRNA decay fragments in Saccharomyces cerevisiae mRNAs with chromosomally integrated MS2 arrays
Authors: Garcia Jennifer F. , Parker Roy
Published: April 2016

The binding of MS2-GFP protein to arrays of MS2 sites in yeast mRNAs has been used extensively to visualize mRNA localization. We previously reported that arrays of MS2 sites bound by MS2 protein could inhibit Xrn1p and lead to the accumulation of 3′ mRNA decay fragments. We suggest that these decay fragments have the potential to complicate mRNA localization studies, as stated in an earlier study.
Model-Based Purchase Predictions for Large Assortments
Authors: Jacobs Bruno J.D. , Donkers Bas , Fok Dennis
Published: April 2016

An accurate prediction of what a customer will purchase next is of paramount importance to successful online retailing. In practice, customer purchase history data is readily available to make such predictions, sometimes complemented with customer characteristics. Given the large product assortments maintained by online retailers, scalability of the prediction method is just as important as its accuracy. We study two classes of models that use such data to predict what a customer will buy next, i.e., a novel approach that uses latent Dirichlet allocation (LDA), and mixtures of Dirichlet-Multinomials (MDM). A key benefit of a model-based approach is the potential to accommodate observed customer heterogeneity through the inclusion of predictor variables. We show that LDA can be extended in this direction while retaining its scalability. We apply the models to purchase data from an online retailer and contrast their predictive performance with that of a collaborative filter and a discrete choice model. Both LDA and MDM outperform the other methods. Moreover, LDA attains performance similar to that of MDM while being far more scalable, rendering it a promising approach to purchase prediction in large product assortments.

Data, as supplemental material, are available at http://dx.doi.org/10.1287/mksc.2016.0985 .
Delay in Trade Networks
Authors: Nguyen Thành , Subramanian Vijay , Berry Randall
Published: April 2016

We study decentralized markets involving producers and consumers that are facilitated by middlemen. We do this by analyzing a noncooperative networked bargaining game. We assume a complete information setup wherein all the agents know the structure of the network, the values of the consumers, and the transaction costs involved but allow for some search friction when either producers or consumers trade with middlemen. In such a setting, we show that sunk cost problems and a heterogeneous network can give rise to delay or failure in negotiation, and therefore reduce the total trade capacity of the network. In the limiting regime of extremely patient agents, we provide a sharp characterization of the trade pattern and the segmentation of these markets.
Day case laparoscopic cholecystectomy in patients with high BMI: Experience from a UK centre
Authors: Tandon A , Sunderland G , Nunes QM , Misra N , Shrotri M
Published: April 2016

Introduction

Symptomatic gall stones may require laparoscopic cholecystectomy (LC), which is one of the most commonly performed general surgical operations in the western world. Patients with a high body mass index (BMI) are at increased risk of having gall stones, and are often considered at high risk of surgical complications due to their increased BMI. We believe that day case surgery could nevertheless have significant benefits in terms of potential cost savings and patient satisfaction in this population. We therefore compared the outcomes of day case patients undergoing LC stratified by BMI, with a specific focus on the safety and success of the procedure in obese and morbidly obese groups.

Methods

We reviewed a database of day case procedures performed between January 2004 and December 2012, including all patients with symptomatic gall stone disease who underwent LC. The patients were divided in four BMI groups: less than 25 kg/m2, 25–29 kg/m2, 30–39 kg/m2 and 40 kg/m2 or above.

Results

The overall success rate for day case surgery was 78%. There were no significant differences in rates of intra-abdominal collection or readmission with increasing BMI. However, increasing BMI was associated with a significant increase in the rate of wound infection.

Conclusions

LC in patients with a high BMI is safe and can be performed effectively as a day case procedure.
Development of hepatolithiasis due to a celery stalk retained within the bile ducts of the liver
Authors: Lv GY , Qiu W , Yu Y , Li T
Published: April 2016

Introduction

Commonly encountered foreign bodies are remnants from surgical procedures and ingested materials. Rarely, the latter cause stone formation in the biliary tract.

Case History

We describe a 51-year-old female who underwent choledoduodenostomy and who presented with abdominal distension caused by multiple stones in the bile ducts within the liver (hepatolithiasis) and an intact celery stalk. Hepatolithiasis was demonstrated by ultrasonography and computed tomography of the abdomen. The celery stalk was not confirmed until exploration of the biliary duct.

Conclusions

Here, we describe, for the first time, an intact, undigested celery stalk in the biliary tract which induced hepatolithiasis. We believe that choledochojejunostomy favoured reflux of the celery stalk from the duodenum into the biliary tract.
Retained enteroscopy capsule in a patient with diaphragm disease
Authors: Meshikhes A-WN
Published: April 2016

Introduction

Diaphragm disease is a rare consequence of small-bowel enteropathy, and usually occurs as a result of longstanding ingestion of non-steroidal anti-inflammatory drugs. DD is characterized by multiple strictures and saccular dilatations leading to symptoms of subacute intestinal obstruction. Often, the diagnosis is made on histological examination after laparotomy and resection of diseased small bowel.

Case History

Here, we report a case of an elderly female who suffered for many years from chronic, colicky abdominal pain and anaemia due to undiagnosed diaphragm disease. Eventually, she was referred to our surgical team because of a retained enteroscopy capsule. The diagnosis was made after laparotomy and bowel resection. This surgical intervention alleviated chronic symptoms, and the patient remained well at 1-year follow-up.

Conclusions

This case highlights the difficulty of diagnosing diaphragm disease without laparotomy and bowel resection. A high index of suspicion must be exercised in any patient with chronic, colicky abdominal pain and anaemia together with multiple strictures and saccular dilatations on computed tomography even in the absence of longstanding NSAID ingestion. Moreover, capsule enteroscopy should be avoided as a diagnostic modality of small-bowel disease if computed tomography raises the suspicion of strictures.
Incarcerated umbilical Littre’s hernia at the trocar site of a previous laparoscopic surgical procedure
Authors: Bailon-Cuadrado M , Rodriguez-Lopez M , Blanco-Alvarez JI , Rodriguez-Vielba PL
Published: April 2016

Introduction

Prevalence of Littre’s hernia (protrusion of a Meckel´s diverticulum through an opening in the abdominal wall) is very low, and Littre’s hernias found in an umbilical site are uncommon. Even rarer are cases of an incarcerated hernia resulting in a surgical emergency. Trocar-site hernias are a relatively common complication after laparoscopic cholecystectomy that develop in association with insertion of wide trocars (usually at the umbilical port).

Case History

A 63-year-old female with a history of obesity, diabetes mellitus, hypertension, laparoscopic cholecystectomy and open hysterectomy arrived at hospital complaining of acute umbilical pain but with no other symptoms or fever. A painful mass observed was believed to be an incarcerated umbilical hernia at a trocar site used in previous laparoscopic surgery. Emergency surgery was undertaken: the opening of the hernia sac revealed a Meckel’s diverticulum within it. The Meckel’s diverticulum was resected using a stapler, followed by herniorrhaphy and hernioplasty. Postoperative recovery was uneventful.

Conclusion

An incarcerated umbilical Littre’s hernia at a laparoscopic trocar site has not been reported before. To avoid this complication, we agree with the numerous authors who recommend closure of trocar sites of width ≥10mm
Using Contemporary Leadership Skills in Medication Safety Programs
Authors: Hertig John B. , Hultgren Kyle E. , Weber Robert J.
Published: April 2016

The discipline of studying medication errors and implementing medication safety programs in hospitals dates to the 1970s. These initial programs to prevent errors focused only on pharmacy operation changes – and not the broad medication use system. In the late 1990s, research showed that faulty systems, and not faulty people, are responsible for errors and require a multidisciplinary approach. The 2013 ASHP Statement on the Role of the Medication Safety Leader recommended that medication safety leaders be integrated team members rather than a single point of contact. Successful medication safety programs must employ a new approach – one that embraces the skills of all health care team members and positions many leaders to improve safety. This approach requires a new set of leadership skills based on contemporary management principles, including followership, team-building, tracking and assessing progress, storytelling and communication, and cultivating innovation, all of which promote transformational change. The application of these skills in developing or changing a medication safety program is reviewed in this article.
Keeping up with Advancements in Health Information Technology
Authors: Fox Brent I. , Felkey Bill G.
Published: April 2016

We all face an onslaught of information on a daily basis in our personal and professional lives. We view it as a significant part of our professional responsibility to help our colleagues stay abreast of the latest advancements related to health information technology (HIT). This month we explore some of the key resources that we find helpful for keeping up-to-date with emerging and disruptive technology.
Intergenerational trauma framework for programme efficacy studies: child trauma recovery in occupied Palestine
Authors: Barron Ian , McInnes James , Abdallah Ghassan
Published: April 2016

This article argues for a shift in the conceptualisation of child trauma recovery programme efficacy studies in occupied Palestine. Nearly all prevalence and programme evaluation studies in Palestine focus on current traumatic events and resultant symptoms, especially post-traumatic stress disorder. To date, no child trauma recovery programme has been evaluated from an intergenerational trauma perspective. Where intergenerational trauma has been explored in the literature, this has been at a conceptual rather than empirical level. In response to this omission, the current article explores intergenerational trauma as a conceptual framework for evaluative research into child trauma recovery programme efficacy in occupied Palestine. Following a review of the intergenerational trauma literature within and beyond Palestine, a framework for evaluation is developed, which includes: historical trauma; collective and individual loss; current-day traumatisation; micro-aggressions; resultant symptoms; and the transmission of intergenerational trauma. Recommendations are provided for future research, practice and policy development in Palestine and beyond.
A modo de prólogo: Marcela, o ¿a cuál de los tres?, comedia de M. Bretón de los Herreros
Authors: Garelli Patrizia
Published: April 2016

El estudio sobre «Marcela o a cual de las tres de Manuel Bretón de los Herreros» en sus distintos aspectos señala la importancia de la dramaturgia del autor de este texto como ejemplo de equilibrio entre la tradición y la modernización.
Un manuscrito «apócrifo» de Don Álvaro o la fuerza del sino
Authors: González Subías José Luis
Published: April 2016

Hasta ahora, solo se conocían dos copias manuscritas de Don Álvaro o la fuerza del sino, conservadas en la Biblioteca Histórica Municipal de Madrid. La primera es la versión que se representó en Madrid en marzo de 1835; la segunda es una copia que se usó en una representación posterior también en Madrid, en 1851. Este último manuscrito no contiene muchas variantes significativas de la versión que el Duque de Rivas cambió en la edición siguiente al debut de la obra, edición en la que se basan las siguientes. Sin embargo, un manuscrito previo desconocido, datado en la década de 1860, se ha descubierto recientemente. La importancia de este documento literario único y misterioso reside en la gran cantidad de variantes que contiene.
Teatro y traducción a las puertas del Romanticismo: presencia de las tragedias de Voltaire durante el Trienio Constitucional
Authors: Lafarga Maduell Francisco
Published: April 2016

Este artículo estudia varias traducciones de Voltaire, todas ellas llevadas a cabo durante el gobierno constitucional (1820-1823) establecido por la revolución liberal española de 1820. En este periodo, los cambios en la escena literaria están provocados por la abolición de la estricta censura que Fernando VII, rey de España, había previamente establecido, y también por un número de significantes acontecimientos políticos y militares. Se presta particular atención a la tragedia La mort de César (1823), traducida por Francisco Altés, y a los cambios que experimentó -como consecuencia de la situación política- cuando se representó en Barcelona.
Documentos inéditos sobre La Ametralladora y La Codorniz de Miguel Mihura
Authors: Llera Ruiz José Antonio
Published: April 2016

En este artículo se presentan varios documentos inéditos que contribuyen a trazar con mayor nitidez la historia interna de dos publicaciones esenciales en la historia de la prensa humorística española, ambas dirigidas por Miguel Migura: La Ametralladora (1937-1939) y La Codorniz (1941-1944).
El humor en los personajes de Alfonso Paso (entre el humor malhumorado y el humor como desahogo)
Authors: Pérez-Rasilla Bayo Eduardo
Published: April 2016

El teatro de Alfonso Paso recurrió a géneros muy diversos, pero casi siempre caracterizados por el empleo del humor: tragicomedia, comedia de crítica de costumbres, vodevil negro, comedia policíaca, etc. Paso creó una serie de personajes recurrentes, circunscritos habitualmente al género que cultivaba y asociados con frecuencia a los actores concretos que los interpretaban, sobre los que descansa buena parte del humor y la comicidad de su teatro. Una comicidad que, en las mejores obras, está inserta en la situación y que, en las menos acertadas, se limita a la narración de chistes más o menos ingeniosos.
Notas sobre Antonio Ribot y Fontseré
Authors: Díaz Larios Luis Federico
Published: April 2016

A. Ribot es un ejemplo emblemático de romántico catalán que intenta armonizar la forma de la «nueva literatura» con el compromiso social de su ideología progresista. En este artículo se analiza la relación de sus obras doctrinales con las de creación compuestas entre 1836 y 1837, un período decisivo de su vida.
Unamuno: la abolición del género novela
Authors: Prieto de Paula Ángel Luis
Published: April 2016

A comienzos del siglo XIX, la escritura debe reorganizar el árbol de los géneros literarios. El «Preface» de Wordsworth a Lyrical Ballads (edición de 1800) es una temprana manifestación teórica de este proceso, en torno a un desbordamiento de la subjetividad. De ahí derivan las penetraciones de la narrativa en la poesía, y de la poesía en la narrativa. En el caso de Unamuno, un ejemplo de lo primero es Teresa, libro de poemas con arquitectura propia de una novela; y un ejemplo de lo segundo es Niebla, una novela que impugna su propio género. Entelequia mental y artificio de la inteligencia, el protagonista es alguien cuya misión vital consiste en sentirse ser: un «alma sin vestimenta humana» que refleja el vacío filosófico del que parecen haber huido todas las certezas. El final de este camino es La novela de don Sandalio (1933), cuyo protagonista no es, como otras veces, una proyección del yo autorial, sino un nombre –ajeno a toda orientación teleológica– cuyo hueco existencial es colonizado por el narrador.
El perspectivismo lírico de Ramón Pérez de Ayala
Authors: González García José Ramón
Published: April 2016

El trabajo analiza la contribución de Ramón Pérez de Ayala a la renovación narrativa en la España del primer tercio del siglo XX. En sintonía con los grandes novelistas europeos del momento, el autor asturiano ensayó un tipo de novela lírica en la que la mirada interiorizada se fragmenta en multitud de perspectivas que aspiran a ofrecer una visión más compleja y rica de la realidad imaginada. La fusión de lirismo y perspectivismo, que aquí se denomina «perspectivismo lírico», constituye una de las grandes aportaciones de Pérez de Ayala al lenguaje narrativo de su época.
La otra voz de María Rosa de Gálvez: las traducciones de una dramaturga neoclásica
Authors: García Garrosa María Jesús
Published: April 2016

El artículo estudia el conjunto de las traducciones dramáticas de María Rosa de Gálvez, situándolas en el contexto de la teoría y la práctica traductoras en la España de 1800. Tras exponer las opiniones de la dramaturga sobre la traducción y la paradoja de que una autora que reivindica la originalidad de su obra tradujera tres comedias y una ópera lírica francesas, se analiza la técnica y los resultados de cada una de las versiones. Más allá de la calidad intrínseca de estas traducciones, el análisis del trabajo de Gálvez revela la sintonía que existe entre su creación propia y estas obras ajenas, de modo que estas cuatro traducciones adquieren el valor añadido de mostrarnos cómo fue perfilando María Rosa de Gálvez un universo dramático propio.
Urbanografía: el caso de Pedro Sánchez, de Pereda y Fortunata y Jacinta, de Pérez Galdós
Authors: Vienne Viñals Fanny
Published: April 2016

En el siglo diecinueve, la ciudad adquiere el estatuto de núcleo de la vida en España y suscita el interés de los literatos que vislumbran en su vasto escenario un material inagotable. Para llevar a cabo la tarea colosal de reconstrucción urbana a nivel literario, el autor decimonónico inserta, en medio de la trama narrativa, numerosas precisiones descriptivas o digresiones en las que queda patente el protagonismo de la ciudad en la que transcurre la acción. Pero además de estos habituales y usitados recursos literarios, florecen medios paralelos, de alcance casi insospechado, en el proceso de edificación urbana. Los personajes, entidades en constante movimiento, son efectivamente los que permiten asentar la existencia de un lugar y explorar los que todavía se distinguen por una pintura nebulosa e incompleta.
Computerised Provider Order Entry Adoption Rates Favourably Impact Length of Stay
Authors: Schreiber Richard , Shaha Steven H.
Published: April 2016

Background Research regarding return on investment for electronic health records (EHRs) is sparse.Objective To extend previously established research and examine rigorously whether increasing the adoption of computer-based provider/prescriber order entry (CPOE) leads to a decrease in length of stay (LOS), and to demonstrate that the two are inversely and bidirectionally proportional even while other efforts to decrease LOS are in place.Method The study assessed CPOE, LOS and case mix index (CMI) data in a community hospital in the United States, using a mature and nearly fully deployed vendor product EHR. CPOE rates and LOS over 7 years were determined on a per-patient, per-visit and per-discipline basis and compared with concomitant CMI data.Results An inverse relationship of CPOE to LOS was correlated for 13 disciplines out of 19, and organisation wide for all disciplines combined during the first 5 years of study. During the subsequent 2 years, both CPOE and LOS plateaued, except in eight disciplines where CPOE rates at first declined and LOS concurrently rose slightly, and then returned to the baseline plateau levels. CMI increased during the entire period of evaluation. An inflection point at approximately 60% CPOE adoption predicted the greatest improvement in lowering of LOS.Conclusions Rising and falling rates of CPOE correlated with reductions and rises in LOS, respectively. CPOE appeared statistically to be an independent factor in affecting LOS, over and above other efforts to shorten LOS, thus contributing to lower costs and improved efficiency outcomes as measured by LOS, even as CMI rises.
Possibilities for Inclusive Family and Community in Beth Stroud’s “Walking in the Light”
Authors: Spencer Leland G. , Lynch John
Published: April 2016

Acceptance of lesbian, gay, and bisexual (LGB) individuals by Christian churches has been uneven at best, with renewed condemnation following each progressive step. Yet LGB Christians remain in denominations whose attitudes toward their sexuality range from mere tolerance to outright condemnation. To make sense of this, we turn to the case of the Rev. Beth Stroud who came out as a lesbian in a 2003 sermon she delivered at the First United Methodist Church of Germantown, Pennsylvania. Stroud turned to Christian and queer images of family that blurred the lines between family and community, and she used a metonymy of “making casseroles” to encourage the congregation to engage in an array of inclusive community building practices. By crafting images of queer family and mobilizing them alongside calls for tactics that create inclusive communities, Stroud’s language highlights the potential for crafting an accepting and inclusive Christian community that might help those LGB and queer persons whose lives are imbricated in the church.