bluuebunny/crossref_metadata_2025 huggingface dataset:
La Alianza del Pacífico y Mercosur: evidencias de convergencia económica
Authors: Mora Mora José Ustorgio
Published: December 2016

Mediante el cálculo de un índice de convergencia económica y el análisis de correlaciones entre varias variables macroeconómicas, se estudia la posibilidad de convergencia económica entre los países miembros de la Alianza del Pacífico con los de Mercosur. Para ello se utiliza información estadística del periodo 1980-2014. A partir de lo anterior, los resultados no son concluyentes, no es posible determinar el rumbo a seguir por estos dos acuerdos para una expansión y una mayor integración económica, aunque los patrones observados sobre las decisiones de los países miembros para este objetivo sugieren que esta pudiera ser bastante factible en el mediano plazo y el índice de convergencia económica refleja esa tendencia. Sin embargo, el análisis de correlaciones no permite establecer una conclusión definitiva.
Acute pain in the emergency department: Effect of an educational intervention
Authors: Friesgaard Kristian Dahl , Paltved Charlotte , Nikolajsen Lone
Published: December 2016

Background and aims

Pain management is often inadequate in emergency departments (ED) despite the availability of effective analgesics. Interventions to change professional behavior may therefore help to improve the management of pain within the ED. We hypothesized that a 2-h educational intervention combining e-learning and simulation would result in improved pain treatment of ED patients with pain.

Methods

Data were collected at the ED of Horsens Regional Hospital during a 3-week study period in March 2015. Pain intensity (NRS, 0–10) and analgesic administration were recorded 24 h a day for all patients who were admitted to the ED during the first and third study weeks. Fifty-three ED nurses and 14 ED residents participated in the educational intervention, which took place in the second study week.

Results

In total, 247 of 796 patients had pain >3 on the NRS at the admission to the ED and were included in the data analysis. The theoretical knowledge of pain management among nurses and residents increased as assessed by a multiple choice test performed before and after the educational intervention (P = 0.001), but no change in clinical practice could be observed: The administration for analgesics [OR: 1.79 (0.97–3.33)] and for opioids [2.02 (0.79–5.18)] were similar before and after the educational intervention, as was the rate of clinically meaningful pain reduction (NRS >2) during the ED stay [OR: 0.81 (CI 0.45–1.44)].

Conclusions

Conduction of a 2-h educational intervention combining interactive case-based e-learning with simulation-based training in an ED setting was feasible with a high participation rate of nurses and residents. Their knowledge of pain management increased after completion of the program, but transfer of the new knowledge into clinical practice could not be found. Future research should explore the effects of repeated education of healthcare providers on pain management.

Implications

It is essential for nurses and residents in emergency departments to have the basic theoretical and practical skills to treat acute pain properly. A modern approach including e-learning and simulation lead to increased knowledge of acute pain management. Further studies are needed to show how this increased knowledge is transferred into clinical practice.
Transmastoid resurfacing versus middle fossa plugging for repair of superior canal dehiscence: Comparison of techniques from a retrospective cohort
Authors: Rodgers Brian , Lin Jim , Staecker Hinrich
Published: December 2016

Objective

To compare and contrast our experience with middle cranial fossa approach (MFR) and transmastoid approach with capping of the dehiscence (TMR) of superior semicircular canal dehiscence and to determine guidelines to help guide management of these patients.

Methods

All patients from 2005 to 2014 with symptomatic superior semicircular canal dehiscence syndrome with dehiscence demonstrated on CT scan of the temporal bone who underwent surgical repair and had a minimum 3 months of follow up. Surgical repair via the MFR or TMR, preoperative CT temporal bone, preoperative, and postoperative cervical vestibular evoked myogenic potential (cVEMP) testing and anterior canal video head thrust testing (vHIT). Success of repair was stratified as complete success, moderate success, mild success, or failure based on resolution of all symptoms, the chief complaint, some symptoms, or no improvement, respectively.

Results

A total of 29 ears in 27 patients underwent surgical repair of canal dehiscence. Complete or moderate success was seen in 71% of the MFR group compared to 80% of the TMR group. There were zero failures with the MFR group and no major intracranial complications. There were 2 failures out of 15 ears that underwent the TMR. Residual symptoms were most commonly vertigo or disequilibrium in the MFR and aural fullness or autophony in the TMR groups, respectively. MFR hospital stay was approximately 2 days longer. Average cVEMP threshold shifted 18 dB with surgical correction in the MFR group. A 29 dB average shift was seen in the TMR group. The MFR group had a significant reduction in their anterior canal gain compared to the TMR group.

Conclusions

TMR is a less invasive alternative to MFR. However, in our series, we have not seen any intracranial complications (aphasia, stroke, seizures, etc.) in our MFR patients. Interestingly, vestibular symptoms were better addressed than audiological symptoms by the TMR suggesting its usefulness as a less invasive option for patients with primarily vestibular complaints. Residual auditory symptoms in TMR patients may be due to the flow of acoustic energy from the superior canal to the mastoid cavity through an incompletely sealed third window.
A wandering tube
Authors: Dubin Ina , Gelber Moshe , Schattner Ami
Published: December 2016

The predominant causes of acute mechanical small bowel obstruction in geriatric patients are adhesions and hernias, which is not much different than in other adult age groups. Unusual etiologies may be encountered, such as volvulus or gallstone ileus, but a displaced feeding gastrostomy tube is a distinctly rare cause of intestinal obstruction which needs to be considered by emergency physicians as it may be increasingly encountered.
Use of point-of-care ultrasound in long bone fractures: a systematic review and meta-analysis
Authors: Chartier Lucas B. , Bosco Laura , Lapointe-Shaw Lauren , Chenkin Jordan
Published: December 2016

Objectives

Long bone fractures (LBFs) are among the most frequent traumatic injuries seen in emergency departments. Reduction and immobilization is the most common form of treatment for displaced fractures. Point-of-care ultrasound (PoCUS) is a promising technique for diagnosing LBFs and assessing the success of reduction attempts. This article offers a comprehensive review of the use of PoCUS for the diagnosis and reduction of LBFs.

Data source

MEDLINE and EMBASE databases were searched through July 19, 2015.

Study selection

We included prospective studies that assessed test characteristics of PoCUS in 1) the diagnosis or 2) the reduction of LBFs. The methodological quality of the included studies was evaluated using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool.

Data extraction

Thirty studies met inclusion criteria (n=3,506; overall fracture rate 48.0%). Test characteristics of PoCUS for the diagnosis of LBFs were as follows: sensitivity 64.7%–100%, specificity 79.2%–100%, positive likelihood ratio (LR) 3.11–infinity, and negative LR zero–0.45. Sensitivity and specificity for the adequate reduction of LBFs with PoCUS were 94%–100% and 56%–100%, respectively. PoCUS diagnosis of pediatric forearm fractures in 10 studies showed a pooled sensitivity of 93.1% (95% confidence interval [CI], 87.2%–96.4%) and specificity of 92.9% (95% CI, 86.6%–96.4%), and PoCUS diagnosis of adult ankle fractures in four studies showed a pooled sensitivity of 89.5% (95% CI, 77.0%–95.6%) and specificity of 94.2% (95% CI, 86.1%–97.7%).

Conclusion

PoCUS demonstrates good diagnostic accuracy in all LBFs studied, especially in pooled results of diagnosis of pediatric forearm and adult ankle fractures. PoCUS is an appropriate adjunct to plain radiographs for LBFs.
A determination of emergency department pre-triage times in patients not arriving by ambulance compared to widely used guideline recommendations
Authors: Betz Martin , Stempien James , Trevidi Sachin , Bryce Rhonda
Published: December 2016

Objectives

Emergency department (ED) lengths of stay are measured from the time of patient registration or triage. The time that patients wait in line prior to registration and triage has not been well described. We sought to characterize pre-triage wait times and compare them to recommended physician response times, as per the Canadian Triage and Acuity Scale (CTAS).

Methods

This observational study documented the time that consenting patients entered the ED and the time that they were formally registered and triaged. Participants’ CTAS scores were collected from the electronic record. Patients arriving to the ED by ambulance were excluded.

Results

A total of 536 participants were timed over 13 separate intervals. Of these, 11 left without being triaged. Participants who scored either CTAS 1 or 2 (n=53) waited a median time of 3.1 (interquartile range [IQR]: 0.43, 11.1) minutes. Patients triaged as CTAS 3 (n=187) waited a median of 11.4 (IQR: 1.6, 24.9) minutes, CTAS 4 (n=139) a median of 16.6 (IQR: 6.0, 29.7) minutes, and CTAS 5 (n=146) a median of 17.5 (IQR: 6.8, 37.3) minutes. Of patients subsequently categorized as CTAS 1 or 2, 20.8% waited longer than the recommended time-to-physician of 15 minutes to be triaged.

Conclusions

All urban EDs closely follow patients’ wait times, often stratified according to triage category, which are assumed to be time-stamped upon a patient’s arrival in the ED. We note that pre-triage times exceed the CTAS recommended time-to-physician in a possibly significant proportion of patients. EDs should consider documenting times to treatment from the moment of patient arrival rather than registration.
NATO and the Ukraine crisis: Collective securitisation
Authors: Sperling James , Webber Mark
Published: December 2016

In securitisation theory (ST) little attention has been paid to how actors undertake securitisation collectively. The empirical focus of that theory has also, paradoxically, neglected the military-strategic sector and with it regional security organisations like NATO. Such an oversight is worth correcting for three reasons. First, NATO is constantly engaged in securitisation across a range of issues, a process that reflects an underappreciated recursive interaction between the Alliance and its member states. Second, the Ukraine crisis has resulted in Russia being explicitly identified as a source of threat and so has triggered a successful collective (re)securitisation by the Alliance. Third, a framework that demonstrates NATO’s standing as a securitising actor has potential relevance to other regional security organisations. This article discusses and amends ST in service of an approach that permits securitisation by actors other than the state, in this case NATO. A model of collective securitisation is presented and then applied empirically to the post-Cold War desecuritisation of Russia and its subsequent resecuritisation following the annexation of Crimea. The implications of resecuritisation for the emergence of a self-reinforcing security dilemma in NATO-Russia relations are also considered.
Economic Intimidation in Contemporary Elections: Evidence from Romania and Bulgaria
Authors: Mares Isabela , Muntean Aurelian , Petrova Tsveta
Published: December 2016

This article examines electoral intimidation of voters at their workplace in contemporary new democracies. What is the relative importance of workplace intimidation in the broader portfolio of clientelistic strategies used by politicians at times of elections? What explains the subnational variation in the incidence of this electoral strategy? We answer these questions using empirical evidence from two East European countries – Romania and Bulgaria. We assess the prevalence of non-programmatic electoral mobilization in these countries by using list experiments, a survey methodology that elicits unbiased and truthful responses to sensitive political questions. We find that in both countries, workplace intimidation is an important component in the repertoire of non-programmatic mobilization used at election times. Workplace intimidation is especially pervasive in localities dominated by a small number of large employers. The importance of economic intimidation in the portfolio of clientelistic strategies declines as the economic heterogeneity of the locality increases.
A Pediatric Approach to Ventilator-Associated Events Surveillance
Authors: Cocoros Noelle M. , Priebe Gregory P. , Logan Latania K. , Coffin Susan , Larsen Gitte , Toltzis Philip , Sandora Thomas J. , Harper Marvin , Sammons Julia S. , Gray James E. , Goldmann Donald , Horan Kelly , Burton Michael , Checchia Paul A. , Lakoma Matthew , Sims Shannon , Klompas Michael , Lee Grace M.
Published: December 2016

OBJECTIVE

Adult ventilator-associated event (VAE) definitions include ventilator-associated conditions (VAC) and subcategories for infection-related ventilator-associated complications (IVAC) and possible ventilator-associated pneumonia (PVAP). We explored these definitions for children.

DESIGN

Retrospective cohort

SETTING

Pediatric, cardiac, or neonatal intensive care units (ICUs) in 6 US hospitals

PATIENTS

Patients ≤18 years old ventilated for ≥1 day

METHODS

We identified patients with pediatric VAC based on previously proposed criteria. We applied adult temperature, white blood cell count, antibiotic, and culture criteria for IVAC and PVAP to these patients. We matched pediatric VAC patients with controls and evaluated associations with adverse outcomes using Cox proportional hazards models.

RESULTS

In total, 233 pediatric VACs (12,167 ventilation episodes) were identified. In the cardiac ICU (CICU), 62.5% of VACs met adult IVAC criteria; in the pediatric ICU (PICU), 54.2% of VACs met adult IVAC criteria; and in the neonatal ICU (NICU), 20.2% of VACs met adult IVAC criteria. Most patients had abnormal white blood cell counts and temperatures; we therefore recommend simplifying surveillance by focusing on “pediatric VAC with antimicrobial use” (pediatric AVAC). Pediatric AVAC with a positive respiratory diagnostic test (“pediatric PVAP”) occurred in 8.9% of VACs in the CICU, 13.3% of VACs in the PICU, and 4.3% of VACs in the NICU. Hospital mortality was increased, and hospital and ICU length of stay and duration of ventilation were prolonged among all pediatric VAE subsets compared with controls.

CONCLUSIONS

We propose pediatric AVAC for surveillance related to antimicrobial use, with pediatric PVAP as a subset of AVAC. Studies on generalizability and responsiveness of these metrics to quality improvement initiatives are needed, as are studies to determine whether lower pediatric VAE rates are associated with improvements in other outcomes.

Infect Control Hosp Epidemiol 2017;38:327–333
Quantifying Antimicrobial Exposure: Hazards in Populations With End-Stage Renal Disease
Authors: Snyder Graham M. , McCoy Christopher , D’Agata Erika M. C.
Published: December 2016

Using a rigorously collected data set of antimicrobial use among patients receiving chronic hemodialysis, antimicrobial use was calculated using 3 different methodologies: daily defined dose, days of therapy, and start–stop days. Estimates of antimicrobial use varied by as much as 10-fold, depending on the type of antimicrobial.

Infect Control Hosp Epidemiol 2017;38:360–363
ALBANESE VARIETIES OF CYCLIC COVERS OF THE PROJECTIVE PLANE AND ORBIFOLD PENCILS
Authors: ARTAL BARTOLO E. , COGOLLUDO-AGUSTÍN J. I. , LIBGOBER A.
Published: December 2016

The paper studies a relation between fundamental group of the complement to a plane singular curve and the orbifold pencils containing it. The main tool is the use of Albanese varieties of cyclic covers ramified along such curves. Our results give sufficient conditions for a plane singular curve to belong to an orbifold pencil, that is, a pencil of plane curves with multiple fibers inducing a map onto an orbifold curve whose orbifold fundamental group is nontrivial. We construct an example of a cyclic cover of the projective plane which is an abelian surface isomorphic to the Jacobian of a curve of genus 2 illustrating the extent to which these conditions are necessary.
Repertoires of Resistance: The Handloom Weavers of South India, c.1800–1960
Authors: Dietrich Wielenga Karuna
Published: December 2016

The article describes and analyses contrasting forms of protest employed by handloom weavers in South India at two key points in time – the early nineteenth and mid-twentieth centuries. Following Tilly, it examines how changes in the state’s regulatory regime influenced modes of resistance, but extends this analysis to the influence of production structures and social/cultural factors such as caste. It also maps internal structures of solidarity and the changing role of caste and class in shaping them. It tries to show how repertoires of resistance altered with changes, not just in the regulatory regime, but the broader socio-economic context, and foregrounds their adaptability and dynamism. It explores forms of protest and organization shared by weavers with workers from a wide range of occupations (including factory workers). Above all, it questions the notion of the unchanging character of “primordial” identities while seeking to provide a fuller understanding of the emerging dynamic of collective consciousness amongst non-factory workers in modern India.
Can Peasants Make a Revolution? Colonialism, Labour, and Power Relations in Pierre Bourdieu’s Algerian Inquiries
Authors: Rapini Andrea
Published: December 2016

This article analyses the Algerian inquiries of Pierre Bourdieu. It begins by retracing the most pervasive, medium- and long-term interventions of French colonial power in Algerian society: the introduction of capitalism and the internment of civilians in thecentres de regroupement. Next, it outlines the social subjects studied by the youngagrégéof philosophy and his representation of labour. Subsequent sections deal with shifts in the public stance of Bourdieu regarding the revolutionary propensity of these people. On this tricky testing ground, Bourdieu engaged with and critically confronted the ideas of Germaine Tillion and Frantz Fanon. His position is reviewed from a historical-philological approach in order to set the texts in their temporal and spatial contexts, establish parallels and/or divergences, and verify the effects such comparisons produced. The conclusions emphasize the richness and originality of Bourdieu’s inquiries given the era in which they were made and highlight, in light of the recent global reorientation of labour history, some of the vital viewpoints expressed on the origins of capitalism in the colony.
Model-based benchmarking of the production potential of plantains (Musa spp., AAB): application to five real plantain and four plantain-like hybrid varieties in Cameroon
Authors: DÉPIGNY S. , LESCOT T. , ACHARD R. , DIOUF O. , COTE F. X. , FONBAH C. , SADOM L. , TIXIER P.
Published: December 2016

A great many plantain varieties are cropped in West and Central Africa, and there is a lack of information about their production potential and suitability for cropping system environments. To obtain benchmark data for the production potential of plantain varieties, experimental and modelling approaches were combined to determine intrinsic growth parameters and to increase understanding of factors affecting yield. Five real plantains commonly cropped in Cameroon and representative of plantain group diversity (Batard, Big Ebanga, Essong, French clair and Mbouroukou n°3) and four plantain-like hybrids (CRBP39, D248, D535 and FHIA21) were studied. A process-based growth model (the AAB model) was developed that accounts for specific characteristics of the plantain crop that includes parameters affecting growth, development and yield. Varietal-specific parameters were determined in a field experiment conducted under nearly non-limiting production conditions while general parameters were drawn from the literature. Parameters describing the conversion of intercepted radiation into dry matter were evaluated by model fitting. Photosynthetic efficiency was significantly higher for real plantains than for plantain-like hybrids. The model realistically simulated development, growth and bunch production for five varieties. These results are the first step in developing a useful tool for assessing the suitability of plantain varieties to different environments. The current study highlights the need for greater knowledge of plantain physiology in order to better model plantain growth and develop variety-specific production approaches.
Release of orange-fleshed sweetpotato (Ipomoea batatas [l.] Lam.) cultivars in Mozambique through an accelerated breeding scheme
Authors: ANDRADE M. I. , RICARDO J. , NAICO A. , ALVARO A. , MAKUNDE G. S. , LOW J. , ORTIZ R. , GRÜNEBERG W. J.
Published: December 2016

Sweetpotato breeding requires at least 5 years to obtain an advanced breeding clone for further testing with the goal of cultivar release. An accelerated breeding scheme (ABS) can be feasible if the genotype × year interaction is low. The objectives of the present study were to describe an ABS for sweetpotato and to investigate the efficiency of this breeding scheme for selecting high-yielding and well-adapted orange-fleshed sweetpotato (OFSP) cultivars with high β-carotene (BC) content. More than 198 500 seeds from two crossing blocks were germinated and rapidly multiplied for evaluation in observation trials at four breeding locations in Mozambique. Breeding clones with storage root yields above 10 t/ha were advanced to preliminary and advanced yield trials across four sites and for 3 years. As a result, 64 high-yielding OFSP breeding clones were selected and evaluated in four mega-environments following a randomized complete block design with three replicates at Angónia, Chókwè, Gurúè and Umbelúzi. Data from multi-environment trials were subjected to single site and combined analysis of variance as well as to stability analysis. The genotype × environment interaction was highly significant for storage root and vine yields, dry matter (DM) and BC content. Storage root yield and DM content for 15 OFSP breeding clones ranged from 14·9 to 27·1 t/ha and from 24·8 to 32·8%, respectively. BC content, iron and zinc ranged from 5·9 to 38·4, 1·6 to 2·1 and 1·1 to 1·5 mg/100 g dry weight, respectively. The OFSP breeding clones also met the culinary tastes required by local consumers in Mozambique. The proposed ABS seems to be an attractive scheme for genetic enhancement of sweetpotato.
The Elusive Enemy: Zero Dark Thirty and the American Worldview
Authors: KENNEDY LIAM
Published: December 2016

As a new paradigm and frame for US geopolitical imperatives, the war on terror poses particular challenges of representation. Like other media today, American cinema screens the war on terror – that is to say, it functions both to show and to conceal the conditions and effects of perpetual war. It dramatizes the hauntology of this war and it also mystifies and demystifies its violence. This essay focusses on the example of the film Zero Dark Thirty to consider how the film re-presents the aporia of representation that structures the production of the war on terror as a field of perceptible reality and reflects the geopolitical priorities of an American worldview. Central to this aporia is the mystification of the “elusive enemy” and the naturalization of a “long war.” The hunt for Osama bin Laden has been a symbolic narrativization of this aporia and the essay comments on how Zero Dark Thirty re-presents this.
Facial nerve anomalies in paediatric cochlear implant candidates: radiological evaluation
Authors: Palabiyik F B , Hacikurt K , Yazici Z
Published: December 2016

Background:

Pre-operative radiological identification of facial nerve anomalies can help prevent intra-operative facial nerve injury during cochlear implantation. This study aimed to evaluate the incidence and configuration of facial nerve anomalies and their concurrence with inner-ear anomalies in cochlear implant candidates.

Methods:

Inner-ear and concomitant facial nerve anomalies were evaluated by magnetic resonance imaging and temporal high-resolution computed tomography in 48 children with congenital sensorineural hearing loss who were cochlear implant candidates.

Results:

Inner-ear anomalies were present in 11 out of 48 patients (23 per cent) and concomitant facial nerve anomalies were present on 7 sides in 4 patients (7 per cent of the total). Facial nerve anomalies were accompanied by cochlear or vestibular malformation.

Conclusion:

Potential facial nerve abnormalities should always be considered in patients with inner-ear anomalies. Pre-operative facial nerve imaging can increase the surgeon's confidence to plan and perform cochlear implantation. Magnetic resonance imaging should be used to detect inner-ear anomalies; if these are identified, temporal high-resolution computed tomography should be used to evaluate the facial nerve.
Olfactory neuroblastoma: 14-year experience at an Australian tertiary centre and the role for longer-term surveillance
Authors: Schmidt C , Potter N , Porceddu S , Panizza B
Published: December 2016

Background:

Olfactory neuroblastoma is a rare sinonasal malignancy, with poorly defined treatment protocols. Management at a tertiary centre was retrospectively evaluated to inform future treatment and follow up.

Methods:

Cases treated with curative intent (2000–2014) were included. Data were collected, and overall and disease-free survival rates were calculated.

Results:

Eleven cases were identified, with a median follow up of 87 months. One patient was Kadish stage A, one was stage B, eight were stage C and one was stage D. The latter patient underwent chemoradiotherapy alone. The remaining patients proceeded to: endoscopic-assisted wide local excision (n = 2), anterior craniofacial resection (n = 4) or endoscopic craniofacial resection (n = 4). No patients had primary nodal disease or elective neck treatment. One patient had neoadjuvant chemoradiation. Six patients had post-operative radiotherapy; three received adjuvant chemotherapy. Two patients had late cervical node failure, and proceeded to neck dissection and post-operative radiotherapy. Two patients had late local recurrence. Ten-year overall and disease-free survival rates were 68.2 and 46.7 per cent, respectively.

Conclusion:

Longer-term follow up is supported given the incidence of late regional and local recurrence. Prophylactic treatment of cervical nodes in locally advanced disease is an area for further investigation.
Evaluation of the subjective efficacy of nasal surgery
Authors: Wu J , Zang H R , Wang T , Zhou B , Ye J Y , Li Y C , Han D M
Published: December 2016

Objectives:

This study aimed to evaluate subjective symptom changes in obstructive sleep apnoea hypopnea syndrome patients following nasal surgery, and to explore treatment efficacy in improving patient quality of life.

Methods:

Patients with nasal blockage accompanied by habitual snoring were stratified into four groups. Their subjective symptoms were evaluated before and after nasal surgery.

Results:

There was a significant decrease in the nasal blockage symptom visual analogue scale, Epworth Sleepiness Scale, Snore Outcomes Survey, Spouse/Bed Partners Survey and Sino-Nasal Outcome Test 20 scores for all patients at six months after surgery. The visual analogue scale score for subjective olfactory function was significantly improved in the severe obstructive sleep apnoea hypopnea syndrome patient group.

Conclusion:

Nasal surgery can effectively improve the subjective symptoms of patients with simple snoring accompanied by nasal blockage and of patients with obstructive sleep apnoea hypopnea syndrome, thus improving their quality of life.
Association of accessory sphenoid septa with variations in neighbouring structures
Authors: Aksoy F , Yenigun A , Goktas S S , Ozturan O
Published: December 2016

Objective:

This study aimed to examine the relationship of the accessory sphenoidal septum with surrounding vital structures and their variations.

Methods:

This cross-sectional retrospective study investigated the prevalence of accessory sphenoidal septa and their relationship with variations in surrounding vital structures in coronal and axial paranasal computed tomography images.

Results:

Coronal and axial computed tomography images of 347 patients were assessed to evaluate the presence of accessory sphenoidal septa. Accessory sphenoidal septa originated from the internal carotid artery in 47.7 per cent of patients and from the optic nerve in 17.5 per cent. These structures were significantly associated with protrusion of the optic nerve, internal carotid canal or Vidian nerve canal.

Conclusion:

Accessory sphenoidal septa can originate from the internal carotid artery or the optic nerve. Therefore, the presence of an accessory sphenoidal septum indicates an increased risk of surgical complications including internal carotid artery injury and loss of vision due to optic nerve injury.
Malnutrition in healthcare settings and the role of gastrostomy feeding
Authors: Kurien Matthew , Williams Jake , Sanders David S.
Published: December 2016

Malnutrition can adversely affect physical and psychological function, influencing both morbidity and mortality. Despite the prevalence of malnutrition and its associated health and economic costs, malnutrition remains under-detected and under-treated in differing healthcare settings. For a subgroup of malnourished individuals, a gastrostomy (a feeding tube placed directly into the stomach) may be required to provide long-term nutritional support. In this review we explore the spectrum and consequences of malnutrition in differing healthcare settings. We then specifically review gastrostomies as a method of providing nutritional support. The review highlights the origins of gastrostomies, and discusses how endoscopic and radiological advances have culminated in an increased demand and placement of gastrostomy feeding tubes. Several studies have raised concerns about the benefits derived following this intervention and also about the patients selected to undergo this procedure. These studies are discussed in detail in this review, alongside suggestions for future research to help better delineate those who will benefit most from this intervention, and improve understanding about how gastrostomies influence nutritional outcomes.
Social and economic consequences of alcohol use disorder: a longitudinal cohort and co-relative analysis
Authors: Kendler K. S. , Ohlsson H. , Karriker-Jaffe K. J. , Sundquist J. , Sundquist K.
Published: December 2016

Background

Although alcohol use disorder (AUD) is associated with future risk for psychosocial dysfunction, the degree to which this arises from a direct causal effect of AUD on functioning v. from correlated risk factors (also known as confounders) is less clearly established.

Method

AUD was assessed from Swedish medical, criminal and pharmacy registries. In a large general population cohort, using Cox proportional hazard and regression models, we predicted from the onset of AUD four outcomes: early retirement, unemployment, social assistance, and individual income. We then examined the degree to which these associations were attenuated by relevant confounders as well as by the use of discordant cousin, half-sibling, full-sibling, and monozygotic twin pairs.

Results

In males, AUD most strongly predicted social assistance [hazard ratio (HR) 8.27, 95% confidence interval (CI) 7.96–8.59], followed by early retirement (HR 5.63, 95% CI 5.53–5.72) and unemployment (HR 2.75, 95% CI 2.65–2.85). For income at age 50, AUD was associated with a decrease in income of 0.24 s.d.s (95% CI −0.25 to −0.23). Results were similar in females. Modest to moderate attenuation of these associations was seen in both sexes after the addition of relevant covariates. These associations were reduced but remained robust in discordant co-relative pairs, including monozygotic twins.

Conclusions

Our results suggest that AUD has a causal impact on a range of measures reflective of psychosocial dysfunction. These findings provide strong support for the drift hypothesis. However, some of the associations between AUD and dysfunction appear to be non-causal and result from shared risk factors, many of which are likely familial.
QUALITY ASSESSMENT OF ETHICS ANALYSES FOR HEALTH TECHNOLOGY ASSSESSMENT
Authors: Scott Anna Mae , Bond Kenneth , Gutiérrez-Ibarluzea Iñaki , Hofmann Björn , Sandman Lars
Published: December 2016

Objectives: Although consideration of ethical issues is recognized as a crucial part of health technology assessment, ethics analysis for HTA is generally perceived as methodologically underdeveloped in comparison to other HTA domains. The aim of our study is (i) to verify existing tools for quality assessment of ethics analyses for HTA, (ii) to consider some arguments for and against the need for quality assessment tools for ethics analyses for HTA, and (iii) to propose a preliminary set of criteria that could be used for assessing the quality of ethics analyses for HTA.

Methods: We systematically reviewed the literature, reviewed HTA organizations’ Web sites, and solicited views from thirty-two experts in the field of ethics for HTA.

Results: The database and HTA agency Web site searches yielded 420 references (413 from databases, seven from HTA Web sites). No formal instruments for assessing the quality of ethics analyses for HTA purposes were identified. Thirty-two experts in the field of ethics for HTA from ten countries, who were brought together at two workshops held in Edmonton (Canada) and Cologne (Germany) confirmed the findings from the literature.

Conclusions: Generating a quality assessment tool for ethics analyses in HTA would confer considerable benefits, including methodological alignment with other areas of HTA, increase in transparency and transferability of ethics analyses, and provision of common language between the various participants in the HTA process. We propose key characteristics of quality assessment tools for this purpose, which can be applied to ethics analyses for HTA purposes.
Modelling tree growth to determine the sustainability of current off-take from miombo woodland: a case study from rural villages in Malawi
Authors: GREEN EMMA L. , EIGENBROD FELIX , SCHRECKENBERG KATE , WILLCOCK SIMON
Published: December 2016

Miombo woodlands supply ecosystem services to support livelihoods in southern Africa, however, rapid deforestation has necessitated greater knowledge of tree growth and off-take rates to understand the sustainability of miombo exploitation. We established 48 tree inventory plots within four villages in southern Malawi, interviewed representatives in these same villages about tree management practices and investigated the impact of climate on vegetation dynamics in the region using the ecosystem modelling framework LPJ-GUESS. Combining our data with the forest yield model MYRLIN revealed considerable variation in growth rates across different land uses; forested lands showed the highest growth rates (1639 [95% confidence interval 1594–1684] kg ha–1 year–1), followed by settlement areas (1453 [95% confidence interval 1376–1530] kg ha–1 year–1). Based on the modelled MYRLIN results, we found that 50% of the villages had insufficient growth rates to meet estimated off-take. Furthermore, the results from LPJ-GUESS indicated that sustainable off-take approaches zero in drought years. Local people have recognized the unsustainable use of natural resources and have begun planting activities in order to ensure that ecosystem services derived from miombo woodlands are available for future generations. Future models should incorporate the impacts of human disturbance and climatic variation on vegetation dynamics; such models should be used to support the development and implementation of sustainable forest management.
Are buyers of forest ecosystem services willing to consider distributional impacts of payments to local suppliers? Results from a choice experiment in Antananarivo, Madagascar
Authors: RANDRIANARISON HENINTSOA , WÄTZOLD FRANK
Published: December 2016

A controversial issue in the debate on payments for ecosystem services (PESs) is whether distributional goals should be considered in the design of such schemes. We contribute to this debate by analysing the preferences of citizens of Antananarivo (Madagascar) as potential buyers of forest ecosystem services from a developing country. We conducted a choice experiment to investigate citizens’ willingness to pay to conserve the endemic spiny forests in southwest Madagascar and their preferences for including distributional goals in the design of a PES scheme aimed at spiny forest conservation. We found that respondents were willing to pay for forest conservation and preferred a PES scheme in which the poorest households in a community would receive the largest share of payments over a scheme in which every household would receive the same share, which, in turn, they preferred over a PES scheme in which they would have no information about its distributional impact. In comparing these results with those of a similar survey in a developed country (in Cottbus, Germany), we find that the preference ranking regarding distributional impacts is identical. However, citizens in Cottbus attach greater importance to the consideration of distributive goals in PESs than citizens in Antananarivo.
Managing Heart Failure in Long-Term Care: Recommendations from an Interprofessional Stakeholder Consultation
Authors: Heckman George A. , Boscart Veronique M. , D’Elia Teresa , Kelley Mary Lou , Kaasalainen Sharon , McAiney Carrie A. , van der Horst Mary-Lou , McKelvie Robert S.
Published: December 2016

Insuffisance cardiaque (IC) affecte autant que 20 pour cent des résidents en soins de longue durée (SLD), et est associée à la morbidité substantielle, la mortalité et l’utilisation des services de santé. L’objectif de notre étude était de formuler des recommandations sur la mise en œuvre de processus pour prendre soin de l’insuffisance cardiaque dans SLD. Un processus de consultation itérative triphasé avec les parties prenantes a été guidé par la participation d’un panel d’experts et a servi à élaborer des recommandations. Dix-sept recommandations ont été faites. Éléments clés des celles-ci se concentrent sur l’amélioration de la communication interprofessionnelle et accroître les connaissances relatives à l’insuffisance cardiaque entre tous les intervenants dans SLD. Des recommandations systématiques incluent améliorer la communication entre les foyers de SLD et soins aigus et autres prestataires de santé externes, et développer des interventions dans l’ensemble des installations afin de réduire les apports de sodium alimentaire et d’augmenter l’activité physique.
Illegal Enslavement, International Relations, and International Law on the Southern Border of Brazil
Authors: Grinberg Keila
Published: December 2016

The La Plata River Basin, bordering Uruguay and Brazil, was the site of constant disputes between the Spanish and Portuguese crowns into the eighteenth century. The conflicts dated back to the seventeenth century with the founding of the Colônia do Santíssimo Sacramento on the left bank of the river. Although both sides engaged in diplomatic efforts over the years, these were not enough to prevent war, and there were ongoing battles interspersed with short periods of calm until the end of the 1860s and the so-called Paraguayan War (1865–70).
Staff exchange within and between nursing homes in The Netherlands and potential implications for MRSA transmission
Authors: VAN GAALEN R. D. , HOPMAN H. A. , HAENEN A. , VAN DEN DOOL C.
Published: December 2016

A recent countrywide MRSA spa-type 1081 outbreak in The Netherlands predominantly affected nursing homes, generating questions on how infection spreads within and between nursing homes despite a low national prevalence. Since the transfer of residents between nursing homes is uncommon in The Netherlands, we hypothesized that staff exchange plays an important role in transmission. This exploratory study investigated the extent of former (last 2 years) and current staff exchange within and between nursing homes in The Netherlands. We relied on a questionnaire that was targeted towards nursing-home staff members who had contact with residents. We found that 17·9% and 12·4% of the nursing-home staff formerly (last 2 years) or currently worked in other healthcare institutes besides their job in the nursing home through which they were selected to participate in this study. Moreover, 39·7% of study participants worked on more than one ward. Our study shows that, in The Netherlands, nursing-home staff form a substantial number of links between wards within nursing homes and nursing homes are linked to a large network of healthcare institutes through their staff members potentially providing a pathway for MRSA transmission between nursing homes and throughout the country.
Cowpox in a human, Russia, 2015
Authors: POPOVA A. Y. , MAKSYUTOV R. A. , TARANOV O. S. , TREGUBCHAK T. V. , ZAIKOVSKAYA A. V. , SERGEEV A. A. , VLASHCHENKO I. V. , BODNEV S. A. , TERNOVOI V. A. , ALEXANDROVA N. S. , TARASOV A. L. , KONOVALOVA N. V. , KOROLEVA A. A. , BULYCHEV L. E. , PYANKOV O. V. , DEMINA Y. V. , AGAFONOV A. P. , SHCHELKUNOV S. N. , MIHEEV V. N.
Published: December 2016

We investigated the first laboratory-confirmed human case of cowpox virus infection in Russia since 1991. Phylogenetic studies of haemagglutinin, TNF-α receptor-like protein and thymidine kinase regions showed significant differences with known orthopoxviruses, including unique amino-acid substitutions and deletions. The described cowpox virus strain, taking into account differences, is genetically closely related to strains isolated years ago in the same geographical region (European part of Russia and Finland), which suggests circulation of viral strains with common origin in wild rodents without spread over long distances and appearance in other parts of the world.
Rise and fall of Ross Sea emperor penguin colony populations: 2000 to 2012
Authors: Kooyman G.L. , Ponganis P.J.
Published: December 2016

There are seven emperor penguin (Aptenodytes forsteri) colonies distributed throughout the traditional boundaries of the Ross Sea from Cape Roget to Cape Colbeck. This coastline is c. 10% of the entire coast of Antarctica. From 2000 to 2012, there has been a nearly continuous record of population size of most, and sometimes all, of these colonies. Data were obtained by analysing aerial photographs. We found large annual variations in populations of individual colonies, and conclude that a trend from a single emperor penguin colony may not be a good environmental sentinel. There are at least four possibilities for census count fluctuations: i) this species is not bound to a nesting site like other penguins, and birds move within the colony and possibly to other colonies, ii) harsh environmental conditions cause a die-off of chicks in the colony or of adults elsewhere, iii) the adults skip a year of breeding if pre-breeding foraging is inadequate and iv) if sea ice conditions are unsatisfactory at autumn arrival of the adults, they skip breeding or go elsewhere. Such variability indicates that birds at all Ross Sea colonies should be counted annually if there is to be any possibility of understanding the causes of population changes.
Determining the probability of correct resolution of the left–right ambiguity in towed array sonar
Authors: KAOURI K. , ALLWRIGHT D. J.
Published: December 2016

When a towed sonar array is straight, it has the difficulty that it cannot distinguish a contact on the left from one at the same angle on the right. When the array isnotstraight and its shape known, we calculate the probability that the left–right ambiguity is resolved correctly, using the Neyman–Pearson hypothesis testing framework, assuming a delay-sum beamformer, a single-frequency contact, and Gaussian noise. We also initially consider the noise field to be uncorrelated and show that the evaluation of the probability of correct resolution reduces to evaluating a one-dimensional integral. We find, as expected, that the probability increases, as the signal-to-noise ratio and the lateral deviation of the array from straight increase. For demonstration purposes, we also evaluate the probability of correct resolution for two representative shapes the array might assume in practice. Finally, we consider a more realistic, correlated noise field and we show that the initial assumption of an uncorrelated noise field provides a good approximation when the lateral deviation of the array is sufficiently large.
A Neurophysiological Study of Semantic Processing in Parkinson’s Disease
Authors: Angwin Anthony J. , Dissanayaka Nadeeka N.W. , Moorcroft Alison , McMahon Katie L. , Silburn Peter A. , Copland David A.
Published: December 2016

Objectives: Cognitive-linguistic impairments in Parkinson’s disease (PD) have been well documented; however, few studies have explored the neurophysiological underpinnings of semantic deficits in PD. This study investigated semantic function in PD using event-related potentials. Methods: Eighteen people with PD and 18 healthy controls performed a semantic judgement task on written word pairs that were either congruent or incongruent. Results: The mean amplitude of the N400 for new incongruent word pairs was similar for both groups, however the onset latency was delayed in the PD group. Further analysis of the data revealed that both groups demonstrated attenuation of the N400 for repeated incongruent trials, as well as attenuation of the P600 component for repeated congruent trials. Conclusions: The presence of N400 congruity and N400 repetition effects in the PD group suggests that semantic processing is generally intact, but with a slower time course as evidenced by the delayed N400. Additional research will be required to determine whether N400 and P600 repetition effects are sensitive to further cognitive decline in PD. (JINS, 2017, 23, 78–89)
Democracy and cooperation in commons management: experimental evidence of representative and direct democracy from community forests in Ethiopia
Authors: Gatiso Tsegaye T. , Vollan Björn
Published: December 2016

The authors use dynamic lab-in-the-field common pool resource experiments to investigate the role of two forms of democracy on the cooperation of forest users in Ethiopia. In this experimental setup, participants can either directly select a rule (direct democracy) or elect a leader who decides on the introduction of rules (representative democracy). These two treatments are compared with the imposition of rules and imposition of leaders. It is found that both endogenous leaders elected by the community members and endogenous rules selected by the direct involvement of the participants are more effective in promoting cooperation among the community members compared to exogenous leadership, exogenous rule imposition and the baseline scenario without any of these modifications. However, no significant difference is found between representative democracy in the election of leadership and direct democracy in the selection of rules. Leadership characteristics and behavior are further analyzed. The results underline the importance of democratic procedures.