bluuebunny/crossref_metadata_2025 huggingface dataset:
Hooking up mildly or wildly
Authors: Adams-Thies Brian
Published: March 2019

This article explores a specific linguistic intervention ("mild to wild”) that occurs in online communication on gay internet hook up sites. It argues that despite supposed knowledge as to what “mild to wild” means, we must look at this linguistic intervention within specific socio-cultural contexts. Without context, the actual uses and meanings of “mild to wild” might be misunderstood while our knowledge of sexual communities of practice risks falling squarely into stereotypes. For this community of practice, “mild to wild” creates a linguistic opportunity for men interested in having sex with other men to be able to define their desires and further explicate how their sexual interaction will take place while also negotiating expectations and assumptions of male-male sex within increasingly homonormative strictures. Data was gathered from over four years of ethnographic research and is presented from a cultural and anthropological linguistics perspective. The phrase “mild to wild” is used by these men in order to: (1) contest supposed concrete categorizations of sexuality and desire; (2) to create highly contextual intimacies and organizations of desire through online-linguistic interaction; and (3) to alleviate detrimental social effects attached to specific unsafe and variant sex practices. The author argues that this community of practice is an example of how new socialities develop within homonormativities designed to control queer sex and desire.
Toward a pragmatic account and taxonomy of valuative speech acts
Authors: Wong García Ernesto
Published: March 2019

This paper presents an account of value ascription as an illocutionary force, based on four claims: (1) that value
ascription is a kind of illocutionary force, defining a specific kind of speech act, i.e. valuative speech acts (VSAs); (2) that
the point of VSAs is ascribing an axiological value to a referent; (3) that VSAs create a weak, inside-oriented truth commitment;
and (4) that they are therefore more about the valuating subject than they are about the valuated object. This illocutionary force
is described using criteria taken from contemporary speech act theory as well as others that have proven informative. This
description results in a rich taxonomy of VSAs. This shows the viability and fruitfulness of a pragmatic account of value
ascription, and it contributes to the development of speech act theory, specifically with regard to the distinction between
primary and secondary illocutionary points, and the speech act taxonomy itself.
Written alternative translation solutions in the translation process
Authors: Borg Claudine
Published: March 2019

Alternative translation solutions (ATSs) are a core and abundant element of the translation process. Despite being
a recurrent topic in translation process research (TPR), the majority of previous studies deal with verbal ATSs while written ATSs
remain an underresearched aspect. This article focuses on written ATSs and their role in the translatorial decision-making
process. Drawing mainly on research into translatorial decision-making and TPR, it investigates 188 written ATSs present in the
first draft of a Maltese literary translation from French produced by an experienced translator. Various categorisation systems
were created to analyse the textual data. The results indicate that written ATSs are a complex phenomenon worth exploring further
as they seem to be a shared behaviour by many translators.
Six-second rule revisited
Authors: Szarkowska Agnieszka , Bogucka Lidia
Published: March 2019

The most famous rule on the speed of subtitles is the six-second rule. In this study we investigate if the
six-second rule is too slow for contemporary viewers. We also address the question of whether subtitle processing depends on the
speech rate of film dialogues and on viewer’s proficiency in the language of the film soundtrack. With these questions in mind, we
tested 53 Polish viewers watching English videos at two different speech rates (slow and fast), subtitled into Polish in
accordance with the six-second rule. We examined participants’ reading patterns and comprehension and asked them to assess
subtitle speed and the congruity of subtitles with the dialogue. Analysing people’s eye movements enabled us to measure that
viewers were looking at subtitles for only about 30% of the subtitle display time. We found that the film speech rate affected
comprehension: faster dialogues, implying more text condensation in subtitles, resulted in lower comprehension compared to slow
speech rates. Viewers more proficient in the language of the film soundtrack spent less time gazing at subtitles than those who
had only elementary knowledge of the language.
On the politics and ambition of the ‘turn’: unpacking the relations between Future 1 and Future 3
Authors: Morgan John , Hordern Jim , Hoadley Ursula
Published: March 2019

This paper suggests that advocates of the ‘knowledge turn’ have been united in their opposition to Young and Muller's (2010) Future 2, but that this ‘union’ has masked very different views of the relations between Young and Muller's Future 1 and Future 3. Whereas some who subscribe to the ‘turn’ see a ‘weak boundary’ between Futures 1 and 3 (and therefore consider them similar), others construe these Futures as very different and strongly bounded. We argue that these positions are often underpinned by irreconcilable political persuasions and conceptions of education, society and the curriculum. In order to illustrate the argument, we discuss the political project of the UK‐based Academy of Ideas, many of whose members have been involved in advocating implicitly or explicitly for a weak boundary between Futures 1 and 3. This position is then contrasted with those in the UK who are more strongly committed to exploring a distinctive Future 3, and the situation in South Africa, where the tensions between different educational Futures are acutely visible due to the social, cultural and political context and academic and policy debates around the curriculum. We conclude with some implications of our arguments for the Future 3 principles of disciplinarity and sociality.
CRYSTALLINE TRYPSIN
Authors: Northrop John H. , Kunitz M.
Published: March 2019

In Vol. 16, No. 2, November 20, 1932, page 320, 2nd paragraph, 4th line, for "0.02" molar read "0.002."
Safeguarding the Past: “Presentist” Historicism
Authors: Sawaya Francesca
Published: March 2019

The V21 Manifesto of 2015 proposes that we revitalize Victorian Studies through the use of presentist historicism, a methodology that recognizes how “the world we inhabit bears the traces of the nineteenth century.” Presentism—once seen by some as a bug in historicism—now becomes, intriguingly, a feature. While scholars such as Dominick LaCapra and Jennifer Fleissner have also explored presentism in historicist work, the V21 Manifesto brings renewed attention to the questions and problems presentism poses. This review explores two books by members of the V21 Collective. Both interrogate vital issues in the present: Anna Kornbluh focuses on financialization and canonical Victorian and modernist texts, Susan Zieger on ephemera and affect and middlebrow texts. Both differently erudite books reinvigorate our thinking about the past. At the same time, both books avoid questions of production in the past and present. Such avoidance creates nondialectical and specialist accounts of the past’s relation to the present and enshrines and safeguards Victorian literary studies’ privileged objects of study and methodologies. Appreciative of the ways the V21 Manifesto has renewed attention to presentist historicism, the review nonetheless argues for more reflexive and contestatory accounts of the past’s relation to the present.
Bit-parallel sequence-to-graph alignment
Authors: Rautiainen Mikko , Mäkinen Veli , Marschall Tobias
Published: March 2019

Motivation

Graphs are commonly used to represent sets of sequences. Either edges or nodes can be labeled by sequences, so that each path in the graph spells a concatenated sequence. Examples include graphs to represent genome assemblies, such as string graphs and de Bruijn graphs, and graphs to represent a pan-genome and hence the genetic variation present in a population. Being able to align sequencing reads to such graphs is a key step for many analyses and its applications include genome assembly, read error correction and variant calling with respect to a variation graph.

Results

We generalize two linear sequence-to-sequence algorithms to graphs: the Shift-And algorithm for exact matching and Myers’ bitvector algorithm for semi-global alignment. These linear algorithms are both based on processing w sequence characters with a constant number of operations, where w is the word size of the machine (commonly 64), and achieve a speedup of up to w over naive algorithms. For a graph with |V| nodes and |E| edges and a sequence of length m, our bitvector-based graph alignment algorithm reaches a worst case runtime of O(|V|+⌈mw⌉|E| log w) for acyclic graphs and O(|V|+m|E| log w) for arbitrary cyclic graphs. We apply it to five different types of graphs and observe a speedup between 3-fold and 20-fold compared with a previous (asymptotically optimal) alignment algorithm.

Availability and implementation

https://github.com/maickrau/GraphAligner

Supplementary information

Supplementary data are available at Bioinformatics online.
Organizational Crisis Communication: Suboptimal Crisis Response Selection Decisions and Behavioral Economics
Authors: Claeys An-Sofie , Coombs W Timothy
Published: March 2019

Organizations in crisis often fail to select the optimal crisis response strategy, preferring strategies that avoid short-term losses over the ones that offer long-term gains. This article proposes a descriptive theory of behavioral crisis communication that uses principles of behavioral economics to explain the recurrence of suboptimal anomalies found in crisis communication. Based on decision-making literature we first argue that the distinct context in which crisis communication takes place (e.g., time pressure, information overload) determines whether or not decisions are made in an analytical or an intuitive manner. Behavioral economics further allows us to explain how intuitive decisions can sometimes be biased by heuristics, which can result in the choice for a suboptimal crisis response strategy in the heat of the moment.
Not just fuel: energy stores are correlated with immune function and oxidative damage in a long-distance migrant
Authors: Eikenaar Cas , Hegemann Arne , Packmor Florian , Kleudgen Iris , Isaksson Caroline
Published: March 2019

In many animals, catabolic and anabolic periods are temporally separated. Migratory birds alternate energy expenditure during flight with energy accumulation during stopover. The size of the energy stores at stopover affects the decision to resume migration and thus the temporal organization of migration. We now provide data suggesting that it is not only the size of the energy stores per se that may influence migration scheduling, but also the physiological consequences of flying. In two subspecies of the northern wheatear Oenanthe oenanthe, a long-distance migrant, estimated energy stores at a stopover during autumn migration were positively related with both constitutive innate and acquired immune function, and negatively related with oxidative damage to lipids. In other words, migrants’ physiological condition was associated with their energetic condition. Although time spent at stopover before sampling may have contributed to this relationship, our results suggest that migrants have to trade-off the depletion of energy stores during flight with incurring physiological costs. This will affect migrants’ decisions when to start and when to terminate a migratory flight. The physiological costs associated with the depletion of energy stores may also help explaining why migrants often arrive at and depart from stopover sites with larger energy stores than expected. We propose that studies on the role of energy stores as drivers of the temporal organization of (avian) migration need to consider physiological condition, such as immunological and oxidative states.
Long-term evaluation of lower incisors gingival recessions after orthodontic treatment
Authors: Pernet Fabienne , Vento Cristina , Pandis Nikolaos , Kiliaridis Stavros
Published: March 2019

Aim

The development of gingival recessions has been associated with orthodontic treatment; however, a clear etiology is still unknown. The aim of the present study was to further clarify potential association between the development of labial and lingual recessions and inclination of the lower incisors during orthodontic treatment, vertical facial morphology, width of the alveolar bone process, height and width of their symphysis after orthodontic treatment and at long-term retention.

Methods

On dental casts and good quality lateral cephalograms of 126 orthodontically treated patients, relevant measurements were performed and gingival recessions were assessed and recorded before, immediately after treatment and at long-term retention.

Results

Taking into account the whole sample at three different occasions, on the buccal side, the lateral incisors have significantly less recessions than the central incisor. On the lingual side, tooth 32 presented with lower risk of recession compared to all other three incisors. No association was found between the width of the alveolar bone process at the apex (Wapex), at the level of the crest (Wcrest) and at mid of the root (Wmid), the width (D), the vertical skeletal pattern (AnsPns-Go’Me) and the onset of buccal or lingual recessions. Development of new recessions was clearly associated with males and with increasing age. The symphysis height (Me-Wcrest) was statistically related with the onset of lingual recessions on 32 and 42. The ratio between the symphysis height and the width at the crest level demonstrated a statistically significant association with the presence of buccal and lingual recessions. Excessive proclination (≥10°) of the lower incisors demonstrated an association with the onset of recessions in 25 per cent of the cases.

Conclusion

Based on the sample of this study, there is some evidence that increased symphysis height (Me-Wcrest), and ratio between the symphysis height and the width at the crest level as well as big change of lower incisor inclination during treatment are associated with the development of recessions.
Pulmonary vein-gap re-entrant atrial tachycardia following atrial fibrillation ablation: an electrophysiological insight with high-resolution mapping
Authors: Yamashita Seigo , Takigawa Masateru , Denis Arnaud , Derval Nicolas , Sakamoto Yuichiro , Masuda Masaharu , Nakamura Kohki , Miwa Yosuke , Tokutake Kenichi , Yokoyama Kenichi , Tokuda Michifumi , Matsuo Seiichiro , Naito Shigeto , Soejima Kyoko , Yoshimura Michihiro , Haïssaguerre Michel , Jaïs Pierre , Yamane Teiichi
Published: March 2019

Aims

The circuit of pulmonary vein-gap re-entrant atrial tachycardia (PV-gap RAT) after atrial fibrillation ablation is sometimes difficult to identify by conventional mapping. We analysed the detailed circuit and electrophysiological features of PV-gap RATs using a novel high-resolution mapping system.

Methods and results

This multicentre study investigated 27 (7%) PV-gap RATs in 26 patients among 378 atrial tachycardias (ATs) mapped with Rhythmia™ system in 281 patients. The tachycardia cycle length (TCL) was 258 ± 52 ms with P-wave duration of 116 ± 28 ms. Three types of PV-gap RAT circuits were identified: (A) two gaps in one pulmonary vein (PV) (unilateral circuit) (n = 17); (B) two gaps in the ipsilateral superior and inferior PVs (unilateral circuit) (n = 6); and (C) two gaps in one PV with a large circuit around contralateral PVs (bilateral circuit) (n = 4). Rhythmia™ mapping demonstrated two distinctive entrance and exit gaps of 7.6 ± 2.5 and 7.9 ± 4.1 mm in width, respectively, the local signals of which showed slow conduction (0.14 ± 0.18 and 0.11 ± 0.10m/s) with fragmentation (duration 86 ± 27 and 78 ± 23 ms) and low-voltage (0.17 ± 0.13 and 0.17 ± 0.21 mV). Twenty-two ATs were terminated (mechanical bump in one) and five were changed by the first radiofrequency application at the entrance or exit gap. Moreover, the conduction time inside the PVs (entrance-to-exit) was 138 ± 60 ms (54 ± 22% of TCL); in all cases, this resulted in demonstrating P-wave with an isoelectric line in all leads.

Conclusion

This is the first report to demonstrate the detailed mechanisms of PV-gap re-entry that showed evident entrance and exit gaps using a high-resolution mapping system. The circuits were variable and Rhythmia™-guided ablation targeting the PV-gap can be curative.
The proportion of flatfish recruitment in the North Sea potentially affected by offshore windfarms
Authors: Barbut Léo , Vastenhoud Berthe , Vigin Laurence , Degraer Steven , Volckaert Filip A M , Lacroix Geneviève
Published: March 2019

Understanding the influence of man-made infrastructures on fish population dynamics is an important issue for fisheries management. This is particularly the case because of the steady proliferation of offshore wind farms (OWFs). Several flatfish species are likely to be affected because areas with OWFs in place or planned for show a spatial overlap with their spawning grounds. This study focuses on six commercially important flatfish species in the North Sea: common sole (Solea solea), European plaice (Pleuronectes platessa), turbot (Scophthalmus maximus), brill (Scophtalmus rhombus), European flounder (Platichthys flesus), and common dab (Limanda limanda). We used a particle-tracking model (Larvae&Co) coupled to a 3D hydrodynamic model to assess the effects of spatial overlap of OWFs with the species’ spawning grounds on the larval fluxes to known nursery grounds. An important overlap between planned areas of OWFs and flatfish spawning grounds was detected, with a resulting proportion of settlers originating from those areas varying from 2% to 16%. Our study suggests that European plaice, common dab, and brill could be the most affected flatfish species, yet with some important local disparities across the North Sea. Consequently, the study represents a first step to quantify the potential impact of OWFs on flatfish settlement, and hence on their population dynamics.
Enhancing Patient Motivation through Intelligibility in Cardiac Tele-rehabilitation
Authors: Sankaran Supraja , Luyten Kris , Hansen Dominique , Dendale Paul , Coninx Karin
Published: March 2019

Physical exercise training and medication compliance are primary components of cardiac rehabilitation. When rehabilitating independently at home, patients often fail to comply with their prescribed medication and find it challenging to interpret exercise targets or be aware of the expected efforts. Our work aims to assist cardiac patients in understanding their condition better, promoting medication adherence and motivating them to achieve their exercise targets in a tele-rehabilitation setting. We introduce a patient-centric intelligible visualization approach to present prescribed medication and exercise targets to patients. We assessed efficacy of intelligible visualizations on patients’ comprehension in two lab studies. We evaluated the impact on patient motivation and health outcomes in field studies. Patients were able to adhere to medication prescriptions, manage their physical exercises, monitor their progress and gained better self-awareness on how they achieved their rehabilitation targets. Patients confirmed that the intelligible visualizations motivated them to achieve their targets better. We observed an improvement in overall physical activity levels and health outcomes of patients.

Research Highlights

Presents challenges currently faced in cardiac tele-rehabilitation. Demonstrates how intelligibility was applied to two core aspects of cardiac rehabilitation- promoting medication adherence and physical exercise training. Lab., field and clinical studies to demonstrate efficacy of intelligible visualization, impact on patient motivation and resultant health outcomes. Reflection on how similar HCI approaches could be leveraged for technology-supported management of critical health conditions such as cardiac diseases.
Nobeyama 45 m mapping observations toward Orion A. III. Multi-line observations toward an outflow-shocked region, Orion Molecular Cloud 2 FIR 4
Authors: Nakamura Fumitaka , Oyamada Shuri , Okumura Sachiko , Ishii Shun , Shimajiri Yoshito , Tanabe Yoshihiro , Tsukagoshi Takashi , Kawabe Ryohei , Momose Mumetake , Urasawa Yumiko , Nishi Ryoichi , Lin Sheng-Jun , Lai Shih-Ping , Dobashi Kazuhito , Shimoikura Tomomi , Sugitani Koji
Published: March 2019

We present the results of mapping observations toward an outflow-shocked region, OMC-2 FIR 4, using the Nobeyama 45 m telescope. We observed the area in 13CO (J = 1–0), C18O (J = 1–0), N2H+ (J = 1–0), CCS (JN = 87–76), HCO+ (J = 1–0), H13CO+ (J = 1–0), HN13C (J = 1–0), H13CN (J = 1–0), DNC (J = 1–0), N2D+ (J = 1–0), and DC3N (J = 9–8). We detected a dense molecular clump that contains FIR 4/5. We also detected, in the 13CO line, blueshifted and redshifted components driven presumably by protostellar outflows in this region. The axes of the FIR 3 and VLA 13 outflows, projected on the plane of the sky, appear to point to the FIR 4 clump, suggesting that it may be compressed by protostellar outflows from Class I sources, FIR 3 and VLA 13. Applying a hyperfine fit of N2H+ lines, we estimated the excitation temperature to be ∼20 K. The high excitation temperature is consistent with the fact that the clump contains protostars. CCS emission was detected in this region for the first time. Its abundance is estimated to be a few × 10−12, indicating that the region is chemically evolved at ∼105 yr, which is comparable to the typical lifetime of Class I protostars. This timescale is consistent with the scenario that star formation in FIR 4 is triggered by dynamical compression of the protostellar outflows. The [HNC]/[HCN] ratio was evaluated to be ∼0.5 in the dense clump and the outflow lobes, whereas it is somewhat larger in the envelope of the dense clump. The small [HNC]/[HCN] ratio indicates that HNC formation was prevented due to high temperatures. Such high temperatures seem to be consistent with the scenario that either protostellar radiation, or outflow compression, or both affected the thermal properties of this region.
Venture Capital and the Macroeconomy
Authors: Opp Christian C
Published: March 2019

I develop a model of venture capital (VC) intermediation that quantitatively explains central empirical facts about VC activity and can evaluate its macroeconomic relevance. The impact of VC-backed innovations is significantly larger than suggested by observed aggregate venture exit valuations, even after accounting for large exposures to systematic and uninsurable idiosyncratic risks. The risk properties of venture capital play a quantitatively important role in both explaining empirical regularities and shaping the value of ventures’ contributions to economic growth. The model is analytically tractable and yields exact solutions, despite the presence of matching frictions, imperfect risk sharing, and endogenous growth.

Received January 16, 2018; editorial decision November 7, 2018 by Editor Stijn Van Nieuwerburgh.
Public Investment Choices by Local and Central Governments
Authors: Kosec Katrina , Mogues Tewodaj
Published: March 2019

This paper examines the impacts of devolving authority for public resource allocation to local governments in a setting of limited electoral control. Such a setting differs from that assumed by seminal formal models of devolution, but describes many developing countries. This study presents a formal model of this setting and tests it using unique data from a natural experiment in rural Ethiopia whereby half of the country's regions were decentralized but not the other half. Employing a spatial regression discontinuity design, this article shows that decentralization strongly improved delivery of agricultural public services, which are of high priority to the central government. In contrast, it did not impact drinking water services, on which the central government places lower priority but citizens place high priority.
First Report of Pseudomonas Grapevine Bunch Rot Caused by Pseudomonas syringae pv. syringae
Authors: Gerin D. , Cariddi C. , de Miccolis Angelini R.M. , Rotolo C. , Dongiovanni C. , Faretra F. , Pollastro S.
Published: March 2019

Pseudomonas syringae pv. syringae, a Gammaproteobacterium belonging to genomospecies 2 within the P. syringae complex, is distributed worldwide, and it is responsible for bacterial canker on >100 different hosts, including the grapevine. P. syringae pv. syringae induces necrotic lesions in the leaf blades, veins, petioles, shoots, rachis, and tendrils on grapevine cultivars in different areas. P. syringae pv. syringae has been associated with severe economic losses in different grape cultivars in Australia, where it causes inflorescence rot. In midsummer to late summer 2017, symptoms of berry rots differing from those caused by the common berry rots agents were observed in different cultivar Red Globe vineyards of Apulia (southern Italy). As proven by fulfillment of Koch’s postulates, these symptoms were caused by a bacterium that, according to the results of biochemical, physiological, nutritional, antimicrobial activity, and pathogenicity tests and sequencing of 16S ribosomal DNA, gyrB, rpoB, and rpoD genes, was identified as P. syringae pv. syringae. This is the first report of Pseudomonas grapevine bunch rot.
Polypropylene Mesh Repair of Traumatic Hernia of the Vastus Lateralis: Case Report and Review
Authors: Meredith Patrick , Calonge Wenceslao M.
Published: March 2019

Myofascial herniations of the lower limb are a rare cause of chronic nerve compression and pain. They may have congenital or traumatic origin, and the tibialis anterior muscle is the most frequent localization. A few cases will require operative management. An unusual case of symptomatic, acquired hernia of the vastus lateralis muscle in a young male basketball player is reported. After drainage of a compressive hematoma, the patient developed chronic pain and myositis of the vastus lateralis by friction against the edge of tensor fascia lata muscle. Secondary surgical reconstruction involved a polypropylene mesh repair 4 years after the initial trauma. This procedure has been described in a very small number of patients after iatrogenic lesions in total hip arthroplasty and on anterolateral thigh perforator flap donor site. Instead of denial and stoicism, this simple intervention could be proposed to patients as a therapeutic option.
Prepectoral Breast Reconstruction: A Technical Algorithm
Authors: Liliav Benjamin , Patel Pranjal , Jacobson Alice K.
Published: March 2019

Despite falling out of favor in the 1970s, prepectoral breast reconstruction has resurfaced in the recent years as a safe and effective alternative to subpectoral/partial subpectoral breast reconstruction in carefully selected patients. This article outlines an algorithmic technical approach to prepectoral breast reconstruction for new patients and revision patients.
ECTOPIC INNER FOVEAL LAYER CLASSIFICATION SCHEME PREDICTS VISUAL OUTCOMES AFTER EPIRETINAL MEMBRANE SURGERY
Authors: González-Saldivar Gerardo , Berger Alan , Wong David , Juncal Verena , Chow David R.
Published: March 2019

Purpose:

To evaluate the ectopic inner foveal layer (EIFL) staging scheme as a visual prognostic factor for patients undergoing epiretinal membrane (ERM) surgery.

Methods:

Retrospective study of 88 pseudophakic patients with diagnosis of idiopathic ERM who underwent ERM surgery with a minimum follow-up of 12 months. Preoperative and postoperative EIFL staging was correlated with the final best-corrected visual acuity (BCVA). As a secondary outcome, evaluation of the proportion of patients achieving final best-corrected visual acuity ≥20/40 in each stage was assessed.

Results:

Based on the EIFL staging scheme, of 88 pseudophakic eyes analyzed, 24 (27.4%) were diagnosed as Stage 2 ERM, 45 (51.1%) as Stage 3 ERM, and 19 (21.5%) as Stage 4 ERM preoperatively. At the final follow-up visit, 70.8% of eyes with Stage 2 showed an improvement in EIFL staging scheme, while 68% of eyes in Stage 3 and 4 remained the same. The final best-corrected visual acuity significantly improved with all EIFL stages (P = <0.05). However, earlier stages were associated with better visual outcomes both preoperatively and postoperatively (Stage 2 > Stage 3 > Stage 4 P < 0.001). Final best-corrected visual acuity ≥20/40 was reached in 91.7% of eyes with Stage 2, 42.3% with Stage 3, and 5.2% with Stage 4.

Conclusion:

The EIFL staging scheme is an easy, fast, and reproducible method to evaluate visual prognosis with ERM surgery. Surgery on Stage 2 ERM results in significantly better visual outcomes and a greater chance of reversibility in anatomical changes.
Optic Nerve Sheath Fenestration for Treatment of Retrolaminar Silicone Oil Migration
Authors: Wang Yao , Ryu Christina L. , Mokhtarzadeh Ali , Lee Michael , Harrison Andrew , McClelland Collin
Published: March 2019

The authors report the case of a 75-year-old man with preexisting glaucoma and recurrent retinal detachment who underwent intraocular silicone oil placement OD resulting in subsequent retrolaminar silicone oil migration to the optic chiasm and vision loss OS. MRI showed silicone oil tracking posteriorly along the right optic nerve to the chiasm. He was placed on high-dose corticosteroids and underwent a successful optic nerve sheath fenestration with improvement of vision in the contralateral eye. Clinicians should be cognizant of the potential for translaminar posterior migration of intraocular silicone oil, as well as the utility of optic nerve sheath fenestration to decompress the anterior visual pathways and restore vision.
How to Perform Prehospital Emergency Telephone Triage: A Systematic Review
Authors: Montandon Diego Santiago , de Souza-Junior Valtuir Duarte , dos Santos Almeida Rodrigo Guimarães , Marchi-Alves Leila Maria , Costa Mendes Isabel Amélia , de Godoy Simone
Published: March 2019

Prehospital emergency telephone triages are mechanisms to verify the appropriate need for care in an emergency call by telephone. Considering the high rates of trauma and clinical cases that need prehospital care, the importance of knowing how the services that send rescue teams can guarantee improved care is highlighted. The objective of this study was to characterize the services that support effective telephone triage. Literature review was conducted in 6 phases to answer the following question: How can prehospital emergency telephone triage be performed? To search for primary studies, we used specific search strategies in the databases: LILaCs, PubMed, CINAHL, LISA, ISTA, and SCOPUS. The sample consisted of 23 studies whose information was extracted using a validated tool. Among the selected studies, 2 come from CINAHL, 2 from LISA, 4 from PubMed, 1 from ISTA, and 14 from SCOPUS, which were published between 2006 and 2016 in 17 different journals with varying types of scopes and originated from 13 countries on 3 distinct continents. The articles were nonexperimental and indicated the broad use of software constructed to support the telephone triage. The prehospital emergency telephone triages are frequently performed to identify the event, deduct the need for support, and prioritize those calls that require a rescue team. They should take place with the support of institutional protocols and technological support to guarantee dynamic data and constant training of the ambulance dispatchers.
Prepared to Care: An Exploration of Continuing Education Trends of Nurses Caring for Injured Children
Authors: Roney Linda Nancy , Acri Mary C.
Published: March 2019

The significance of nursing competence in the care of pediatric trauma patients has been well documented. Continuing education for trauma nurses is a critical component of maintaining competence in pediatric trauma care; yet, there is significant variability in the programs and resources used to support this goal. The purpose of this current study was to describe the educational activities that practicing registered nurses engage in to inform their care of injured children. A quantitative, descriptive nonexperimental research design was utilized to describe the educational programs that members of the Society of Trauma Nurses (STN) must complete to work in verified and designated trauma centers. Participants completed a survey instrument that included demographic questions, pediatric trauma educational programs required/offered by their employer, and feedback about pediatric trauma nursing education. A total of 266 STN members completed the electronic survey, reflecting a 9% response rate. Most of the participants reported that the verifying body required trauma nursing education hours (n = 187, 70.3%). The number of required courses ranged from 1 to 6, with 33 (12.4%) reporting this 3-course combination—emergency nursing pediatric course (ENPC), pediatric advanced life support (PALS), and trauma nursing core course (TNCC). The second most common combination of courses (n = 30; 11.3%) was required to take both PALS and TNCC. No significant relationship was found between verifying agency type and continuing education program required (p> .05). Trauma nursing core course was the most popular course (n = 208; 79%), followed by PALS (n = 194; 73%) and ENPC (n = 103; 38%). Participants also shared barriers to continuing education activities. It has been 10 years since pediatric trauma nursing course utilization was first explored in the literature. There continue to be significant opportunities to support nurses in continuing education activities related to the care of injured children. While barriers to accessing these types of activities sometimes exist, it is the responsibility of the pediatric trauma community to explore these challenges even further and collaborate with others interested in improving the care of injured children.
Papillary microcarcinoma of the thyroid gland: current controversies and management
Authors: Rovira Aleix , Nixon Iain J. , Simo Ricard
Published: March 2019

Purpose of review

To highlight recent advances in our understanding of the nature of micropapillary thyroid carcinoma (mPTC), its evaluation and options of management based on risk.

Recent findings

A dramatic increase of the incidence of papillary thyroid carcinoma has been reported worldwide during recent decades, specifically those smaller than 10 mm (mPTC). Although not taking into consideration other risk factors for aggressiveness when describing tumours by their size, most of these newly diagnosed mPTC are indolent and active surveillance can be considered as valid option for their management.

An increasing number of patients with mPTC will be encountered in clinical practice. Although it is difficult to assess the aggressiveness of a tumour on size criteria, less than a total thyroidectomy and active surveillance can be considered for the majority of patients with mPTC. Further trials should be performed to prove this as a valid option of management in the majority of these patients.
Interdisciplinary Communication
Authors: Watson Anne , Weaver Meaghann , Jacobs Shana , Lyon Maureen E.
Published: March 2019

Advance care planning is being increasingly recognized as a component of quality in end-of-life care, but standardized documentation in the electronic health record has not yet been achieved, undermining interdisciplinary communication about care needs and limiting research opportunities.

We examined the electronic health records of nine adolescent and young adults with cancer who died after participation in an advance care planning clinical trial (N = 30). In this secondary analysis of this subgroup, disease trajectory and end-of-life information were abstracted from the electronic health record, and treatment preferences from the original study were obtained.

All deceased participants older than 18 years had a surrogate decision maker identified in the electronic health record, and all deceased participants had limitations placed on their care, varying from 1.5 hours up to 2 months before death. However, assessment of relations between treatment preferences and end-of-life care was difficult and revealed the presence of circumstances that advance care planning is designed to avoid, such as family conflict. Lack of an integrated health care record regarding advance care planning and end-of-life care makes both care coordination and examination of the association between planning and goal concordant care more difficult.
Traumatic Falls in the Pediatric Population
Authors: Oleck Nicholas C. , Dobitsch Andrew A. , Liu Farrah C. , Halsey Jordan N. , Le Thuy-My T. , Hoppe Ian C. , Lee Edward S. , Granick Mark S.
Published: March 2019

Purpose

Falls are a leading cause of nonfatal injury in the pediatric population, resulting in numerous hospitalizations. Children may not have fully developed reflexive and balancing abilities, rendering them more susceptible to traumatic falls. Here the authors present their findings regarding patterns of facial fracture and concomitant injury seen in the pediatric population secondary to falls.

Methods

A retrospective chart review was performed of all facial fractures as a result of falls in the pediatric population in a level 1 trauma center in an urban environment (University Hospital in Newark, NJ). Patient demographics were collected, as well as location of fractures, concomitant injuries, and surgical management strategies.

Results

Fifty-five patients were identified as 18 years or younger and having sustained a facial fracture as the result of a fall. This cohort was compared with 418 pediatric patients with facial fractures due to nonfall etiologies. The mean age was 9.6 years (range, 0–18 years), with a male predominance of 67.3%. There were a total of 70 fractures identified on radiological imaging. The most frequently fractured bones were the orbit (n = 27), nasal bone (n = 15), and mandible (n = 11). Orbital and frontal sinus fractures each occurred more frequently due to falls compared with all other causes of injury. Patients with orbital fractures were significantly more likely to present with an additional facial fracture compared with those without (P < 0.01). The most common concomitant injuries were traumatic brain injury, skull fracture, and intracranial hemorrhage. Patients who suffered a facial fracture due to a fall were significantly more likely to sustain a concomitant skull fracture (P < 0.05) and intra-abdominal injury (P < 0.05) compared with all other etiologies. Fourteen patients required surgical intervention. One patient died.

Conclusions

Pediatric facial fractures are a unique entity. The general plasticity of the pediatric anatomy can predispose patients to significant injury without obvious external signs. A high level of clinical suspicion is required to avoid misdiagnosis and delay of treatment. The authors hope this study can address a preventable issue in child safety, educate caregivers, and provide insight towards fracture management that fosters functional and aesthetic recovery.
Right hospital, right patients: Penetrating injury patients treated at high-volume penetrating trauma centers have lower mortality
Authors: Fu Chih-Yuan , Bajani Francesco , Tatebe Leah , Butler Caroline , Starr Frederic , Dennis Andrew , Kaminsky Matthew , Messer Thomas , Schlanser Victoria , Kramer Kristina , Poulakidas Stathis , Cheng Chi-Tung , Mis Justin , Bokhari Faran
Published: March 2019

BACKGROUND

The recognition of the relationship between volume and outcomes led to the regionalization of trauma care. The relationship between trauma mechanism-subtype and outcomes has yet to be explored. We hypothesized that trauma centers with a high volume of penetrating trauma patients might be associated with a higher survival rate for penetrating trauma patients.

METHODS

A retrospective cohort analysis of penetrating trauma patients presenting between 2011 and 2015 was conducted using the National Trauma Database and the trauma registry at the Stroger Cook County Hospital. Linear regression was used to determine the relationship between mortality and the annual volume of penetrating trauma seen by the treating hospital.

RESULTS

Nationally, penetrating injuries account for 9.5% of the trauma cases treated. Patients treated within the top quartile penetrating-volume hospitals (≥167 penetrating cases per annum) are more severely injured (Injury Severity Score: 8.9 vs. 7.7) than those treated at the lowest quartile penetrating volume centers (<36.6 patients per annum). There was a lower mortality rate at institutions that treated high numbers of penetrating trauma patients per annum. A penetrating trauma mortality risk adjustment model showed that the volume of penetrating trauma patients was an independent factor associated with survival rate.

CONCLUSION

Trauma centers with high penetrating trauma patient volumes are associated with improved survival of these patients. This association with improved survival does not hold true for the total trauma volume at a center but is specific to the volume of the penetrating trauma subtype.

LEVEL OF EVIDENCE

Prognostic/Epidemiology Study, Level-III; Therapeutic/Care Management, Level IV.
Computed tomography correlation of skeletal landmarks and vascular anatomy in civilian adult trauma patients: Implications for resuscitative endovascular balloon occlusion of the aorta
Authors: Eliason Jonathan L. , Derstine Brian A. , Horbal Steven R. , Wang Nicholas C. , Holcombe Sven A. , Chiu Chien-Hung , Ross Brian E. , Bromwell Brenna , Morrison Jonathan , Wang Stewart C.
Published: March 2019

BACKGROUND

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a valuable resuscitative adjunct in a variety of clinical settings. In resource-limited or emergency environments, REBOA may be required with delayed or absent image-guidance or verification. Catheter insertion lengths may be informed by making computed tomography (CT) correlations of skeletal landmarks with vascular lengths.

METHODS

Between 2000 and 2015 at a single civilian tertiary care center, 2,247 trauma patients with CT imaging were identified, yielding 1,789 patients with adequate contrast opacification of the arterial system in the chest, abdomen, and pelvis. Individual scans were analyzed using MATLAB software, with custom high-throughput image processing algorithms applied to correlate centerline vascular anatomy with musculoskeletal landmarks. Data were analyzed using R version 3.3.

RESULTS

The median centerline distance from the skin access to the aortic bifurcation was longer by 0.3 cm on the right than on the left side. Median aortic zone I length was 21.6 (interquartile range, 20.3–22.9) cm, while zone III was 8.7 (7.8–9.5) cm. Torso extent (TE) correlation to zone I was much higher than that for zone III (R2, 0.58 vs. 0.26 (right) and 0.58 vs. 0.27 (left); p < 0.001). Assuming a 4-cm balloon length, optimal fixed insertion length would be 48 cm and 28 cm for zones I and III (error, 0.4% vs. 33.3%), respectively, although out of zone placements can be reduced if adjusted for TE (error, 0% vs. 26.4%).

CONCLUSION

Computed tomography morphometry suggests that a fixed REBOA catheter insertion length of 48 cm for zone I and 28 cm for zone III is optimal (on average, for average-height individuals), with improved accuracy by formulaic adjustments for TE. High residual error for zone III placement may require redesign of existing catheter balloon lengths or consideration of the relative risk associated with placing the balloon catheter too low or too high.

LEVEL OF EVIDENCE

Prognostic/epidemiological, level III.
Should they stay or should they go? Who benefits from interfacility transfer to a higher-level trauma center following initial presentation at a lower-level trauma center
Authors: Adzemovic Tessa , Murray Thomas , Jenkins Peter , Ottosen Julie , Iyegha Uroghupatei , Raghavendran Krishnan , Napolitano Lena M. , Hemmila Mark R. , Gipson Jonathan , Park Pauline , Tignanelli Christopher J.
Published: March 2019

BACKGROUND

Interfacility transfer of patients from Level III/IV to Level I/II (tertiary) trauma centers has been associated with improved outcomes. However, little data are available classifying the specific subsets of patients that derive maximal benefit from transfer to a tertiary trauma center. Drawbacks to transfer include increased secondary overtriage. Here, we ask which injury patterns are associated with improved survival following interfacility transfer.

METHODS

Data from the National Trauma Data Bank was utilized. Inclusion criteria were adults (≥16 years). Patients with Injury Severity Score of 10 or less or those who arrived with no signs of life were excluded. Patients were divided into two cohorts: those admitted to a Level III/IV trauma center versus those transferred into a tertiary trauma center. Multiple imputation was performed for missing values, and propensity scores were generated based on demographics, injury patterns, and disease severity. Using propensity score–stratified Cox proportional hazards regression, the hazard ratio for time to death was estimated.

RESULTS

Twelve thousand five hundred thirty-four (5.2%) were admitted to Level III/IV trauma centers, and 227,315 (94.8%) were transferred to a tertiary trauma center. Patients transferred to a tertiary trauma center had reduced mortality (hazard ratio, 0.69; p < 0.001). We identified that patients with traumatic brain injury with Glasgow Coma Scale score less than 13, pelvic fracture, penetrating mechanism, solid organ injury, great vessel injury, respiratory distress, and tachycardia benefited from interfacility transfer to a tertiary trauma center. In this sample, 56.8% of the patients benefitted from transfer. Among those not transferred, 49.5% would have benefited from being transferred.

CONCLUSION

Interfacility transfer is associated with a survival benefit for specific patients. These data support implementation of minimum evidence-based criteria for interfacility transfer.

LEVEL OF EVIDENCE

Therapeutic/Care Management, Level IV.
Peristomal Medical Adhesive-Related Skin Injury
Authors: LeBlanc Kimberly , Whiteley Ian , McNichol Laurie , Salvadalena Ginger , Gray Mikel
Published: March 2019

Stomal and peristomal skin complications (PSCs) are prevalent in persons living with an ostomy; more than 80% of individuals with an ostomy will experience a stomal or peristomal complication within 2 years of ostomy surgery. Peristomal skin problems are especially prevalent, and a growing body of evidence indicates that they are associated with clinically relevant impairments in physical function, multiple components of health-related quality of life, and higher costs. Several mechanisms are strongly linked to PSCs including medical adhesive-related skin injuries (MARSIs). Peristomal MARSIs are defined as erythema, epidermal stripping or skin tears, erosion, bulla, or vesicle observed after removal of an adhesive ostomy pouching system. A working group of 3 clinicians with knowledge of peristomal skin health completed a scoping review that revealed a significant paucity of evidence regarding the epidemiology and management of peristomal MARSIs. As a result, an international panel of experts in ostomy care and peristomal MARSIs was convened that used a formal process to generate consensus-based statements providing guidance concerning the assessment, prevention, and treatment of peristomal MARSIs. This article summarizes the results of the scoping review and the 21 consensus-based statements used to guide assessment, prevention, and treatment of peristomal MARSIs, along with recommendations for research priorities.