bluuebunny/crossref_metadata_2025 huggingface dataset:
Principal Sorting and the Distribution of Principal Quality
Authors: Grissom Jason A. , Bartanen Brendan , Mitani Hajime
Published: June 2019

Numerous studies document the inequitable distribution of teacher quality across schools. We focus instead on the distribution of principal quality, examining how multiple proxies for quality, including experience, teachers’ survey assessments of leaders, and rubric-based practice ratings assigned by principals’ supervisors, vary by measures of school advantage, using administrative data from Tennessee. By virtually every quality measure, we find that schools serving larger fractions of low-income students, students of color, and low-achieving students are led by less qualified, less effective principals. These patterns persist across urban, suburban, and rural settings. Both differential hiring/placement and differential turnover patterns by principal quality across school characteristics contribute to these patterns. Simulation evidence suggests that hiring and turnover vary in relative importance to principal sorting patterns according to the measure of quality examined and that differential principal improvement across contexts may matter as well. Complementary analyses of national survey data corroborate our main results.
Knowledge and Practices Toward Routine Medical Checkup Among Middle-Aged and Elderly People of Riyadh
Authors: AL-Kahil Abdullah Basel , Khawaja Rajab Ali , Kadri Ammar Yasser , Abbarh,MBBS Shahem Mohammad , Alakhras Jalal Tarif , Jaganathan Parameaswari Parthasarathy
Published: June 2019

Introduction:

Routine checkup is a form of preventive medicine, it’s a helpful practice to promote health in the community. Studying the prevalence of routine checkup, awareness, influencing, and preventing factors for it in our community will be a helpful tool for the health authorities to promote among individuals.

Methodology:

This cross-sectional study was conducted in different locations of Riyadh using a convenience sampling technique, with sample size of 414 Saudi participants of both genders aged 36 years old and above. The data were collected through self-administered structured questionnaire with demographic variables, frequency of routine medical checkup, knowledge questions, factors that enhance or prevent individual to do routine checkup and best way to spread the awareness.

Results:

Two hundred eighty-eight (69.57%) participants knew well about routine checkup and 142 (34.3%) of them do routine medical checkup. “Lack of time” and “Laziness” were reported as the 2 most common preventing factors (46% and 45.2%), respectively, and most common reason that influenced their practice was “health concern” (77.5%) followed by “worry about chronic or serious illness” (32.4%). Participants believed that social networks (eg, twitter, Facebook, etc) and media (eg, TV, radio) are most effective ways to spread awareness of it in the community (53.86% and 52.89%, respectively).

Conclusion:

There was high level of knowledge on routine health checkup, but a low prevalence was observed in practice. Hence, more health initiatives should be taken for routine medical screening in the Saudi community.
Correction to: Introduction to special collection: collaborating with technology to sell fashion
Authors: Choo Ho Jung
Published: June 2019

In the original publication of this article (Choo 2019), the author would like to add the omitted research to the list of this special collection, “collaborating with technology to sell fashion.”
Cost Effectiveness of Chimeric Antigen Receptor T-Cell Therapy in Multiply Relapsed or Refractory Adult Large B-Cell Lymphoma
Authors: Lin John K. , Muffly Lori S. , Spinner Michael A. , Barnes James I. , Owens Douglas K. , Goldhaber-Fiebert Jeremy D.
Published: June 2019

PURPOSE

Two anti-CD19 chimeric antigen receptor T-cell (CAR-T) therapies are approved for diffuse large B-cell lymphoma, axicabtagene ciloleucel (axi-cel) and tisagenlecleucel; each costs $373,000. We evaluated their cost effectiveness.

METHODS

We used a decision analytic Markov model informed by recent multicenter, single-arm trials to evaluate axi-cel and tisagenlecleucel in multiply relapsed/refractory, adult, diffuse large B-cell lymphoma from a US health payer perspective over a lifetime horizon. Under a range of plausible long-term effectiveness assumptions, each therapy was compared with salvage chemoimmunotherapy regimens and stem-cell transplantation. Main outcomes were undiscounted life years, discounted lifetime costs, discounted quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (3% annual discount rate). Sensitivity analyses explored uncertainty.

RESULTS

In an optimistic scenario, assuming a 40% 5-year progression-free survival (PFS), axi-cel increased life expectancy by 8.2 years at $129,000/QALY gained (95% uncertainty interval, $90,000 to $219,000). At a 30% 5-year PFS, improvements in life expectancy were more modest (6.4 years) and expensive ($159,000/QALY gained [95% uncertainty interval, $105,000 to $284,000]). In an optimistic scenario, assuming a 35% 5-year PFS, tisagenlecleucel increased life expectancy by 4.6 years at $168,000/QALY gained (95% uncertainty interval, $105,000 to $414,000/QALY). At a 25% 5-year PFS, improvements in life expectancy were smaller (3.4 years) and more expensive ($223,000/QALY gained [95% uncertainty interval, $123,000 to $1,170,000/QALY]). Administering CAR-T to all indicated patients would increase US health care costs by approximately $10 billion over 5 years. Price reductions to $250,000 and $200,000, respectively, or payment only for initial complete response (at current prices) would allow axi-cel and tisagenlecleucel to cost less than $150,000/QALY, even at 25% PFS.

CONCLUSION

At 2018 prices, it is possible that both CAR-T therapies meet a less than $150,000/QALY threshold. This depends on long-term outcomes compared with chemoimmunotherapy and stem-cell transplantation, which are uncertain. Widespread adoption would substantially increase non-Hodgkin lymphoma health care costs. Price reductions or payment for initial response would improve cost effectiveness, even with modest long-term outcomes.
Phases and Phenotypes of Multiple Sclerosis
Authors: Kantarci Orhun H.
Published: June 2019

PURPOSE OF REVIEW

This article describes the dynamic evolution of multiple sclerosis (MS) through its phases and the impact of this understanding on treatment decisions.

RECENT FINDINGS

MS consists of three phases: (1) the high-risk phase, (2) the relapsing-remitting phase, and (3) the progressive phase. Increasingly, subclinical disease activity is becoming an integral part of our definition of disease course in MS. In many patients, the relapsing-remitting phase starts as subclinical activity, likely long before they present with a clinically isolated syndrome. Differentiating progressive MS subgroups is also becoming less relevant. This is illustrated by comparing progressive MS that evolves from an asymptomatic state in individuals with radiologically isolated syndrome (primary progressive MS) and symptomatic individuals with relapsing-remitting MS (secondary progressive MS). In each case, the background disease activity and pathology can be indistinguishable. These phases evolve on a continuum and largely follow the aging process with little influence by the preceding clinical activity level. Recently, it also became evident that one or a few poorly recovered relapses at the beginning of clinical manifestations of MS predict much earlier progressive MS onset.

These findings suggest that interventions to prevent progressive MS, when they become available for clinical practice, may need to be considered as early as when the asymptomatic radiologically isolated syndrome is detected. This early treatment approach is being evaluated with ongoing trials with available disease-modifying therapies. In contrast, continuing the use of disease-modifying therapy beyond a certain age may have little benefit. However, being in the progressive phase of MS is not, in itself, an argument against disease-modifying therapy use in active disease in younger patients.
Monitoring, Switching, and Stopping Multiple Sclerosis Disease-Modifying Therapies
Authors: Gross Robert H. , Corboy John R.
Published: June 2019

PURPOSE OF REVIEW

This article reviews appropriate monitoring of the various multiple sclerosis (MS) disease-modifying therapies, summarizes the reasons patients switch or stop treatment, and provides a framework for making these management decisions.

RECENT FINDINGS

With the increasing number of highly effective immunotherapies available for MS, the possibility of better control of the disease has increased, but with it, the potential for side effects has rendered treatment decisions more complicated. Starting treatment early with more effective and better-tolerated disease-modifying therapies reduces the likelihood of switching because of breakthrough disease or lack of compliance. Clinical and radiographic surveillance, and often blood and other paraclinical tests, should be performed periodically, depending on the disease-modifying therapy. Helping patients navigate the uncertainty around switching or stopping treatment, either temporarily or permanently, is one of the most important things we do as providers of MS care.

Ongoing monitoring of drug therapy is a crucial component of long-term MS care. Switching treatments may be necessary for a variety of reasons. Permanent discontinuation of treatment may be appropriate for some patients with MS, although more study is needed in this area.
Transnasal Sphenopalatine Ganglion Block for Postdural Puncture Headache in an Adolescent: A Case Report
Authors: Stalls Caleb , Zatochill Mary , Petersen Timothy R. , Falcon Ricardo J. , Al Haddadin Caroline , Southwell Bronwyn , Soneru Codruta N.
Published: June 2019

We present a pediatric patient with postdural puncture headache after a lumbar puncture, who was successfully treated with a sphenopalatine ganglion block. An uneventful autologous epidural blood patch had been placed 2 days before, but the patient reported a recurrence of symptoms after about 5 hours. Sphenopalatine ganglion block is well described in the treatment of postdural puncture headache for the obstetric population, but examples of its use in the pediatric population are not described. To our knowledge, this is the first pediatric case of sphenopalatine ganglion block for postdural puncture headache reported in the literature.
A transcriptomic roadmap to α- and β-cell differentiation in the embryonic pancreas
Authors: van Gurp Léon , Muraro Mauro J. , Dielen Tim , Seneby Lina , Dharmadhikari Gitanjali , Gradwohl Gerard , van Oudenaarden Alexander , de Koning Eelco J. P.
Published: June 2019

During pancreatic development, endocrine cells appear from the pancreatic epithelium when Neurog3-positive cells delaminate and differentiate into α-, β-, γ- and δ-cells. The mechanisms involved in this process are still incompletely understood. We characterized the temporal, lineage-specific developmental programs during pancreatic development by sequencing the transcriptome of thousands of individual pancreatic cells from E12.5 to E18.5 in mice, and identified all known cell types that are present in the embryonic pancreas, but focused specifically on α- and β-cell differentiation by enrichment of a MIP-GFP reporter. We characterized transcriptomic heterogeneity in the tip domain based on proliferation, and characterized two endocrine precursor clusters marked by expression of Neurog3 and Fev. Pseudotime analysis revealed specific branches for developing α- and β-cells, which allowed identification of specific gene regulation patterns. These include some known and many previously unreported genes that appear to define pancreatic cell fate transitions. This resource allows dynamic profiling of embryonic pancreas development at single cell resolution and reveals novel gene signatures during pancreatic differentiation into α- and β-cells.
Formation of Five-Membered Carbocycles from d-Glucose: A Concise Synthesis of 4-Hydroxy-2-(hydroxymethyl)cyclopentenone
Authors: Koseki Yoshitaka , Watanabe Toshihiro , Kamishima Takaaki , Kwon Eunsang , Kasai Hitoshi
Published: June 2019

A concise synthesis of 4-hydroxy-2-(hydroxymethyl)cyclopentenone (1) has been accomplished from d-glucose by a three-step sequence that features a catalyst-free hydrothermal reaction of d-glucal, which is readily obtained from d-glucose. Optimization of the reaction conditions for synthesizing 1 was performed by changing the temperature and reaction time. The treatment of d-glucal under the optimal conditions, i.e., at 120 °C for 24 h, provided 1 in the highest isolated yield of 61%. 1 would become a versatile intermediate for the synthesis of various fine chemicals having a cyclopentenone structure from cellulosic biomass.
Risk assessment for the implementation of controlled human Schistosoma mansoni infection trials in Uganda
Authors: Koopman Jan Pieter , Egesa Moses , Wajja Anne , Adriko Moses , Nassuuna Jacent , Nkurunungi Gyaviira , Driciru Emmanuella , van Willigen Gijsbert , Cose Stephen , Yazdanbakhsh Maria , Kaleebu Pontiano , Kabatereine Narcis , Tukahebwa Edridah , Roestenberg Meta , Elliott Alison M.
Published: June 2019

Schistosomiasis is a parasitic infection highly prevalent in sub-Saharan Africa, and a significant cause of morbidity; it is a priority for vaccine development. A controlled human infection model for Schistosoma mansoni (CHI-S) with potential to accelerate vaccine development has been developed among naïve volunteers in the Netherlands. Because responses both to infections and candidate vaccines are likely to differ between endemic and non-endemic settings, we propose to establish a CHI-S in Uganda where Schistosoma mansoni is endemic. As part of a “road-map” to this goal, we have undertaken a risk assessment. We identified risks related to importing of laboratory vector snails and schistosome strains from the Netherlands to Uganda; exposure to natural infection in endemic settings concurrently with CHI-S studies, and unfamiliarity of the community with the nature, risks and rationale for CHI. Mitigating strategies are proposed. With careful implementation of the latter, we believe that CHI-S can be implemented safely in Uganda. Our reflections are presented here to promote feedback and discussion.
Utopian Mind As Autistic Thinking Form at Artistic Creation Aspect
Authors: Кальней Марина , Kalney Marina
Published: June 2019

The article gives the analysis of closeness autistic thinking and utopian mind, which releases at desire to displace all the negative sides of social practice not only from reality but also from artistic creation. For this utopian project supposes to change historical and cultural heritage in accordance to utopian ideal. This trends exhibits at modern social mind.
The Use of Technologies of Full Mastery in the Organization of Classes in the Disciplines of the Mathematical Cycle
Authors: Давыдочкина Светлана , Davydochkina Svetlana , Маскина Мария , Maskina Mariya
Published: June 2019

The article discusses the technology of full learning, based on a model developed by American psychologists J. Carroll and V.S. Bloom. The features of its use in the construction of the educational process in institutions of higher education are described. The experience of its use in conducting classes in the disciplines of the mathematical cycle with students in undergraduate economic specialties is described. To implement this technology, the training material is divided into separate modules with an introductory theoretical part, practical tasks and final verification work. Practical tasks are individual variants of typical tasks, which are compiled in such a way that some of them can be performed during classroom work, for example, working at the blackboard, and some at homework. The effectiveness of this technology is confirmed by comparing the results of students' examinations in the control and experimental groups.
The proximal interphalangeal joint: arthritis and deformity
Authors: Herren Daniel
Published: June 2019

Finger joints are of the most common site of osteoarthritis and include the DIP, PIP and the thumb saddle joint. Joint arthroplasty provides the best functional outcome for painful destroyed PIP joints, including the index finger. Adequate bone stock and functional tendons are required for a successful PIP joint replacement Fixed swan-neck and boutonnière deformity are better served with PIP arthrodesis rather than arthroplasty. Silicone implants are the gold standard in terms of implant choice. Newer two-component joints may have potential to correct lateral deformities and improve lateral stability. Different surgical approaches are used for PIP joint implant arthroplasty according to the needs and the experience of the surgeon. Post-operative rehabilitation is as critical as the surgical procedure. Early protected motion is a treatment goal. Revision and exchange PIP arthroplasty may successfully be used to treat chronic pain, but will not correct deformity.

Cite this article: EFORT Open Rev 2019;4 DOI: 10.1302/2058-5241.4.180042
Use of three-dimensional technology for complications of upper limb fracture treatment
Authors: Michielsen Maartje , Van Haver Annemieke , Vanhees Matthias , van Riet Roger , Verstreken Frederik
Published: June 2019

In malunion cases, restoration of anatomy is a key factor in obtaining a good functional outcome, but this can be technically very challenging. Three-dimensional printed bone models can further improve understanding of the malunion pattern. The use of three-dimensional (3D) computer planning, and the assembly of patient-specific instruments and implants, especially in complex deformities of the upper limb, allow accurate correction while reducing operation time, blood loss volume and radiation exposure during surgery. One of the major disadvantages of the 3D technique is the additional cost because it requires specific computer software, a dedicated clinical engineer, and a 3D printer. Further technical developments and clinical investigations are necessary to better define the added value and cost/benefit relationship of 3D in the treatment of complex fractures, non-unions, and malunions.

Cite this article: EFORT Open Rev 2019;4 DOI: 10.1302/2058-5241.4.180074
Orthopaedic registries with patient-reported outcome measures
Authors: Wilson Ian , Bohm Eric , Lübbeke Anne , Lyman Stephen , Overgaard Søren , Rolfson Ola , W-Dahl Annette , Wilkinson Mark , Dunbar Michael
Published: June 2019

Total joint arthroplasty is performed to decreased pain, restore function and productivity and improve quality of life. One-year implant survivorship following surgery is nearly 100%; however, self-reported satisfaction is 80% after total knee arthroplasty and 90% after total hip arthroplasty. Patient-reported outcomes (PROs) are produced by patients reporting on their own health status directly without interpretation from a surgeon or other medical professional; a PRO measure (PROM) is a tool, often a questionnaire, that measures different aspects of patient-related outcomes. Generic PROs are related to a patient’s general health and quality of life, whereas a specific PRO is focused on a particular disease, symptom or anatomical region. While revision surgery is the traditional endpoint of registries, it is blunt and likely insufficient as a measure of success; PROMs address this shortcoming by expanding beyond survival and measuring outcomes that are relevant to patients – relief of pain, restoration of function and improvement in quality of life. PROMs are increasing in use in many national and regional orthopaedic arthroplasty registries. PROMs data can provide important information on value-based care, support quality assurance and improvement initiatives, help refine surgical indications and may improve shared decision-making and surgical timing. There are several practical considerations that need to be considered when implementing PROMs collection, as the undertaking itself may be expensive, a burden to the patient, as well as being time and labour intensive.

Cite this article: EFORT Open Rev 2019;4 DOI: 10.1302/2058-5241.4.180080
Motivações para a Transparência Orçamentária Municipal
Authors: Divino Sirlane Nascimento , Bezerra Filho João Eudes , Nossa Silvania Neris
Published: June 2019

Esta pesquisa tem como objetivo investigar a relação entre as evidenciações orçamentárias, representadas pelo Índice de Transparência Orçamentária Municipal (ITOM) e os indicadores socioeconômicos PIB per capita, Receita Corrente Líquida, Índice de Desenvolvimento Municipal - Função educação e Função saúde. Para o desenvolvimento do estudo fez-se uso da análise de conteúdo documental, na qual foram averiguados os documentos orçamentários disponibilizados nos portais de transparência para uma amostra de 35 municípios da região do Triângulo Mineiro. Para compor o ITOM, fez-se uso das averiguações propostas pelo International Budget Partnership (2015). O resultado empírico possibilitou observar que a maioria dos municípios apresenta o ITOM com evidências semelhantes. Verificou-se ausência de relação entre as variáveis PIB per capita, IFDM Função educação, Função saúde e o ITOM, com exceção para a variável Receita Corrente Líquida que apresentou relação positiva, ou seja, municípios que exibem resultados melhores na arrecadação, demonstram ter nível de transparência mais elevado.
Patient-reported functional outcomes and health-related quality of life following fractures of the talus
Authors: Stirling P , MacKenzie SP , Maempel JF , McCann C , Ray R , Clement ND , White TO , Keating JF
Published: June 2019

Introduction

The primary aim of this study was to investigate patient-reported outcomes following talar fractures. Secondary aims were to investigate health-related quality of life and to determine whether it is influenced by functional outcome.

Materials and methods

This retrospective study identified 56 talar fractures over eight years. Patients were contacted by post and the Olerud and Molander score (OMS), Manchester–Oxford Foot and Ankle scores (MOXFQ) and Euroqol-5D-3L collected.

Results

The mean age was 35.2 years (range 13–78 years). There were four cases (7.1%) of avascular necrosis and one (1.8%) non-union occurred. Data from patient-reported outcome measures were available for 42 patients (75.0%) with a median follow-up of 67.1 months (range 23.2–111.8 months). Mean OMS was 60.0 (standard deviation ± 29.51) and median MOXFQ was 30.33 (interquartile range 47.13). Median Euroqol-5D-3L index was 0.74 (interquartile range 0.213) and median Euroqol-5D-3L visual analogue score was 80 (interquartile range 21). Older age, open fractures, multiple injuries and subsequent avascular necrosis were associated with worse patient-reported outcomes (P < 0.05), with older age, avascular necrosis and open fractures found to be independent predictors of poor OMS, and avascular necrosis and open fractures independently predicting MOXFQ score on regression analysis (P < 0.05). Poor self-reported function, measured by OMS and MOXFQ, correlated with worse health-related quality of life as measured by the Euroqol-5D-3L index (OMS: r = 0.764, P < 0.001; MOXFQ: r = 0.824, P < 0.001) and visual analogue score (OMS: r = 0.450, P = 0.003; MOXFQ: r=0.559, P < 0.001).

Conclusions

Older age, avascular necrosis and open fractures predict poorer functional outcomes following talar fractures. Patients with worse limb-specific functional outcomes are more likely to have a worse perception of health-related quality of life.
Appendicovesical fistula presenting as hypokalaemic hyperchloraemic metabolic acidosis: a case report
Authors: Keane S , Tebala GD
Published: June 2019

A 52-year-old man was admitted with diarrhoea and faecaluria and referred recurrent urinary tract infections for over 20 years. He also reported a two-week hospital admission more than 20 years ago for right iliac fossa pain, which was managed conservatively. Computed tomography showed a fistulous tract extending from the bladder with an unclear connection to the bowel. Cystoscopy confirmed the presence of a vesical fistula and biopsy of the tract confirmed colonic mucosa. Flexible sigmoidoscopy was negative. A cystogram was requested as an outpatient procedure and the patient was discharged after antibiotic treatment.

A few days after discharge the patient was readmitted as an emergency to critical care for severe hyperchloraemic hypokalaemic acidosis and a Glasgow Coma Score of 6/15. He was intubated and ventilated and his metabolic derangement was treated. As soon as his conditions improved, he underwent emergency laparotomy, which revealed the presence of a fistula between the caecal fundus and the bladder. The fistula was repaired and the patient recovered swiftly and completely and was discharged on postoperative day 5. At 12-month follow up the patient was completely symptoms-free, his bowel habits were normal and he has not had any urinary infection.

Appendicovesical fistula is a rare and potentially lethal condition due to its metabolic consequences. Past history of right iliac fossa pain treated conservatively, diarrhoea and recurrent urinary tract infection must raise suspicion.
Fistulotomy with or without marsupialisation of wound edges in treatment of simple anal fistula: a randomised controlled trial
Authors: Anan M , Emile SH , Elgendy H , Shalaby M , Elshobaky A , Abdel-Razik MA , Elbaz SA , Farid M
Published: June 2019

Background

Promotion of healing of the anal wound after fistulotomy may help accelerate recovery and return to work. The present study aimed to assess the effect of marsupialisation of the edges of the laid open fistula track on wound healing after anal fistulotomy for simple anal fistula.

Methods

This was a prospective randomised trial on patients with simple anal fistula. Patients were randomly assigned to one of two groups; group I underwent anal fistulotomy and group II underwent anal fistulotomy and marsupialisation of the edges of the laid open track. Outcomes of the study were time to achieve complete wound healing, operation time, postoperative pain and complications.

Results

Sixty patients of mean age of 40.8 years with simple anal fistula were randomly divided into two equal groups. No significant differences between the two groups regarding operation time (16.8 vs 18.4 minutes; P = 0.054), postoperative pain score (1.6 vs 1.2; P = 0.22), and complication rates were recorded. Group II achieved complete healing in a significantly shorter duration than group I (5.1 vs 6.7 weeks; P < 0.0001).

Conclusion

Marsupialisation of the edges of the laid open fistula track after fistulotomy resulted in quicker wound healing with similar complication and recurrence rates to lay open fistulotomy alone.
Use of an automated knot fastener shortens operative times in minimally invasive mitral valve repair
Authors: Perin G , Shaw M , Pingle V , Palmer K , Al-Rawi O , Ridgway T , Pousios D , Modi P
Published: June 2019

Introduction

Longer durations of cardiopulmonary bypass and aortic cross clamp are associated with increased morbidity and mortality. Little is known about the effect of automated knot fasteners (Cor-Knot®) in minimally invasive mitral valve repair on operative times and outcomes. The aim of this study was to evaluate whether these devices shortened cardiopulmonary bypass and aortic cross clamp times and whether this impacted on postoperative outcomes.

Materials and methods

All patients undergoing isolated minimally invasive mitral valve repair by a single surgeon between March 2011 and March 2016 were included (n = 108). Two cohorts were created based on the use (n = 52) or non-use (n = 56) of an automated knot fastener. Data concerning intraoperative variables and postoperative outcomes were collected and compared.

Results

Preoperative demographics were well matched between groups with no significant difference in logistic Euroscore (manual vs automated: median 3.1, interquartile range, IQR, 2.1–5.5, vs 5.4, IQR 2.2–8.3; P = 0.07, respectively). Comparing manually tied knots to an automated fastener, cardiopulmonary bypass and aortic cross clamp times were significantly shorter in the automated group (cardiopulmonary bypass: median 200 minutes, IQR 180–227, vs 165 minutes (IQR 145–189 minutes), P < 0.001; aortic cross clamp 134 minutes (IQR 121–150 minutes) vs 111 minutes (IQR 91–137 minutes), P < 0.001, respectively). There was no mortality and no strokes, nor were there any differences in postoperative outcomes including reoperation for bleeding, renal failure, intensive care or hospital stay.

Conclusions

The use of an automated knot fastener significantly reduces cardiopulmonary bypass and aortic cross clamp times in minimally invasive mitral valve repair but this does not translate into an improved clinical outcome.
A rare case of unilateral hemifacial spasm and facial palsy associated with an abnormal anatomical variant of the posterior basilar circulation
Authors: Chan J , Jolly K , Darr A , Bowyer DJ
Published: June 2019

Tortuous vertebral arteries are a rare anatomical variant. Mild tortuosity is usually asymptomatic whereas severe tortuosity may present with ischaemic symptoms or compressive symptoms (focal neurological deficit). While a resulting hemifacial spasm has been previously described, sparse literature exists for its association with facial palsy. We present a rare case of facial spasm along with facial palsy in a 67-year-old woman who was found to have an anatomical variant in the posterior basilar circulation with an ectatic basilar artery and significantly displaced posterior vertebral artery impinging on the facial nerve.
Carotid artery stenosis, an underestimated cause of stroke recurrence in patients with ischaemic monocular visual loss
Authors: Cheng SF , Zarkali A , Richards T , Simister R , Chandratheva A
Published: June 2019

Introduction

Isolated monocular ischaemic events are thought to be low risk for stroke recurrence. In the presence of carotid stenosis however, the risks should not be treated similarly and surgical intervention should be considered at an early stage. The aim of this study was to determine the vascular risk profile and stroke recurrence in patients with ischaemic monocular visual loss.

Methods and methods

Consecutive records for all patients with monocular ischaemia were reviewed from January 2014 to October 2016. Stroke, transient ischaemic attack or monocular ischaemia recurrence within 90 days were recorded. Carotid stenosis was assessed with duplex ultrasound, computed tomography or magnetic resonance angiography.

Results

In total, 400 patients presented with monocular ischaemia; 391 had carotid imaging (97.8%). Causality was symptomatic carotid stenosis ≥ 50% in 53 (13.6%), including carotid stenosis ≥ 70% in 31 (7.9%). Patients with permanent visual loss (n = 131) were more likely to have significant stenosis compared with patients with transient visual loss (n = 260), 19.8% compared with 10.4% (P = 0.012). Recurrent stroke, transient ischaemic attack or monocular ischaemia within 90 days after presentation occurred in three patients (5.7%) in the carotid stenosis group, compared to three (0.9%) who did not have stenosis (P = 0.035). Age, male sex and hypertension were associated with carotid stenosis but hypercholesterolaemia, diabetes and smoking were not.

Conclusions

Carotid stenosis ≥ 50% is present in patients with ocular ischaemia in approximately 20% of those with persistent visual loss and in 10% with transient visual loss. Those with carotid stenosis have a higher risk of stroke recurrence and should be considered urgent surgical intervention as other forms of stroke.
Day of surgery: the impact on patient length of stay in a tertiary vascular unit
Authors: Holford NC , Ní Ghuidhir C , Hands L
Published: June 2019

Background

Our hypothesis was that patients undergoing surgery earlier in the week would have better access to physiotherapy and other discharge services after surgery and, as a result, would have a shorter length of hospital stay compared with patients undergoing surgery later in the week. This study aimed to assess whether there is a significant difference in postoperative length of hospital stay between the groups with secondary assessment by operation subtype.

Methods

We identified all patients admitted for vascular surgery in 2015 from a prospectively collected database and divided the week into Monday to Wednesday and Thursday to Friday. Endovascular cases were included but day cases were excluded. Further analysis was performed with a breakdown in both groups by operation type. Statistical analysis was performed using SPSS version 16.0.

Results

We identified 652 patients who met our criteria. Within the elective patient group, there was a significantly longer length of stay of three days for the late-week group compared with two days for the early-week group (P = 0.016). Femoral artery procedures had a median length of stay of two days for those operated on early in the week compared with four days later in the week (P < 0.005). Open abdominal aortic aneurysm repair showed a trend to longer length of stay in the late-week group (P = 0.06).

Conclusion

Day of surgery appears to impact on patients’ length of stay following vascular procedures, with the greatest impact on medium-sized procedures. This difference could be explained by the difference in weekend support services, but further evaluation is required following introduction of weekend support services to assess this.
Epidemiological aspects of cutaneous leishmaniasis in Southwest of Iran
Authors: Darvishi Mohammad , Saghafipour Abedin , Moradi-Asl Eslam , Jafari Reza , Sadati Seyed Jafar Adnani , Darabi Hossein
Published: June 2019

Background and Aim: Zoonotic rodents (Rodentia: Muridae: Gerbillinae) and Phlebotominae sand flies are the major reservoir hosts and vectors of Leishmania major causing zoonotic cutaneous leishmaniasis, respectively. This study was carried out to evaluate the epidemiological aspects of cutaneous leishmaniasis (CL) in Tangestan County, Southwest Iran. Materials and Methods: This descriptive cross-sectional study was carried out on human cases, probable reservoirs, and vectors of CL at Tangestan County in 2017. The data of patients were taken on health centers and analyzed. To determination faunistic of sand flies, they were collected using sticky paper traps and identified using identification keys. The rodent samples were captured using Sherman live traps and determined for amastigote infection. Results: A total of 436 cases occurred during 2005-2017 and the incidence rate of disease was 0.2-12/100,000 people. Six species of sand flies including three species of Phlebotomus and three species of Sergentomyia including Phlebotomus papatasi, Phlebotomus sergenti, Phlebotomus alexandri, Sergentomyia tiberiadis, Sergentomyia baghdadis, and Sergentomyia clydei were identified. From 185 trapped rodents, 9 species were identified. We founded, 2 out of 132 Tatera indica (1.53%) were positive with Leishmania spp. using the microscopic method. Conclusion: According to the existence of human leishmaniasis cases as a host, T. indica with high abundance and infected to Leishmania as a reservoir, and existence of P. papatasi with high abundance as a suspected vector of disease; there is a potential for transmission of disease in the area. Design of exact control and prevention strategies is highly recommended.
Molecular survey of zoonotic Anaplasma phagocytophilum and genetic evidence of a putative novel Anaplasma species in goats from Taif, Saudi Arabia
Authors: Ghafar Mohamed W. , Amer Sayed A. M.
Published: June 2019

Aim: Genus Anaplasma is of veterinary and public health importance, and its members utilize ruminants as key hosts in their epidemiology. To date, information about the occurrence and molecular identity of Anaplasma phagocytophilum and other Anaplasma species in Saudi Arabian goats is scarce. This study aimed to molecularly detect and characterize zoonotic A. phagocytophilum and other Anaplasma spp. in goats from Taif District, KSA. Materials and Methods: Blood samples collected from 67 goats were polymerase chain reaction tested using common and A. phagocytophilum-specific primers targeting 16S rRNA and msp4 genes, respectively. Amplicons of common reactions were purified, sequenced, and analyzed. Results: Six goats yielded positive results with common primers, whereas all animals proved negative for A. phagocytophilum. Analysis of the two successfully sequenced amplicons revealed the presence of a variant strain of Anaplasma ovis (99.52% ID) and a new Anaplasma organism, which was clustered with Anaplasma bovis (95.9% ID) and Aegyptianella pullorum (94.99% ID) and distinctly separated from all other recognized species of the genus Anaplasma. Conclusion: The tested goats proved negative for A. phagocytophilum; however, we could not confirm that the area is pathogen free. A variant strain of A. ovis and a putative novel Anaplasma spp. were reported raising the concern of veterinary and zoonotic potential. Other genes should be sequenced and analyzed for complete identification of the detected organisms.
Benchmarking Graph Database Backends—What Works Well with Wikidata?
Authors: Kovács Tibor , Simon Gábor , Mezei Gergely
Published: June 2019

Knowledge bases often utilize graphs as logical model. RDF-based knowledge bases (KB) are prime examples, as RDF (Resource Description Framework) does use graph as logical model. Graph databases are an emerging breed of NoSQL-type databases, offering graph as the logical model. Although there are specialized databases, the so-called triple stores, for storing RDF data, graph databases can also be promising candidates for storing knowledge. In this paper, we benchmark different graph database implementations loaded with Wikidata, a real-life, large-scale knowledge base. Graph databases come in all shapes and sizes, offer different APIs and graph models. Hence we used a measurement system, that can abstract away the API differences. For the modeling aspect, we made measurements with different graph encodings previously suggested in the literature, in order to observe the impact of the encoding aspect on the overall performance.
Cartografando o panorama da pesquisa em biblioterapia no Brasil: mapa produzido a partir do território da base referencial de artigos de periódicos em Ciência da Informação (Brapci) e a Plataforma Lattes
Authors: Andrade Lucas Veras de , Silva Ana Caroline Oliveira da
Published: June 2019

O trabalho centra-se em apresentar o panorama da pesquisa em biblioterapia no Brasil. O corpus do estudo foi constituído a partir das informações contidas nos territórios da Base Referencial de Artigos de Periódicos em Ciência da Informação (BRAPCI) e na Plataforma Lattes, delimitando como recorte temporal os anos de (1975-2017). Nesse sentido, temos como objetivo geral: Mapear a produção científica brasileira em biblioterapia, tendo por base a BRAPCI. Elecando ainda como objetivos específicos: 1) Identificar o comportamento da produção em biblioterapia ao longo do tempo; 2) Levantar o perfil dos pesquisadores; 3) Mapear as instituições com grupos de pesquisa no tema ou linhas que tem como escopo o estudo da biblioterapia; 4) Demonstar a área geográfica dos pesquiadores e os periódicos que mais publicam artigos relacionados ao tema. Nesse sentido, tem-se como metodologia, a abordagem quanti-qualitativa com perspectiva descritiva, tendo a partir análise contéudo a estruturação das categorias de análise. Os resultados demonstram que  apesar de um número considerável de pesquisadores, a pesquisa em biblioterapia se demonstra tímida quando comparada a outras áreas dentro do contexto da Biblioteconomia e Ciência da Informação. Nó entanto, em crescimento constante ao longo dos anos. Nisso, tem-se destaque dois grupos de Pesquisas: o Laboratório de Estudos em Biblioterapia, Bibliotecas Escolares e Leitura e o Grupo de Estudos em Biblioteconomia e Ciência da Informação (GEPEBIC).
Temática da biblioteca escolar publicada em revistas científicas
Authors: Rita Andreia Aguiar , Blattmann Ursula
Published: June 2019

O estudo apresenta os resultados de uma pesquisa bibliográfica cujo objetivo visa analisar  a temática da Biblioteca escolar nos periódicos da Ciência da Informação. Os objetivos específicos : a) Levantar os artigos publicados sobre biblioteca escolar em periódicos da Ciência da Informação; b) Verificar quais periódicos têm maior representatividade na área de Biblioteca Escolar; c) Descrever o perfil dos autores mais produtivos sobre Biblioteca escolar de acordo com sua titulação e instituição de origem. Para identificar artigos nos periódicos da área foi usada a Base de dados Referencial de Artigos de Periódicos em Ciência da Informação (BRAPCI). Nos resultados observou-se 100 artigos dos quais 95 se enquadraram nos parâmetros estabelecidos para realização deste estudo. A pesquisa revelou três revistas que mais publicaram artigos na área de biblioteca escolar:  Revista Brasileira de Biblioteconomia e Documentação – RBBD com 27 artigos, a  Biblioteca Escolar em Revista a  com 27 artigos, e a Revista ACB com 13 artigos. No que se refere ao perfil dos autores pode-se dizer que a maioria são docentes em Instituições de Ensino Superior. As instituições de origem dos autores são: a UNESP com cinco, a UFMG com três e a UEL com duas pessoas.
Seed position and influences on Caesalpinia pulcherrima germination and reserve proteins
Authors: Dos Santos Patrick Luan Ferreira , De Castilho Regina Maria Monteiro , Pinheiro Raquel Reia
Published: June 2019

Caesalpinia pulcherrima has diverse uses in the world, including ornamental and landscape characteristics, but there is a great disparity of germination during the time of seedlings production, being this factor attributed to the position of the seeds in fruits. This study aimed to evaluate some germinative aspects and concentration of reserve proteins in C. pulcherrima seeds in the function of its position in fruits. The work was carried out in greenhouse, in a completely random experimental design, with five seed position in the pod, based on the distance from seed to the peduncle (P1 - distal, P2 - distal/median, P3 - median, P4 -proximal/ median, P5 - proximal). Eight replicates with eight seeds each, were sowed to germinate for 21 days in expanded polystyrene trays filled with substrate. The percentage, speed index, average germination time and 50% germination time of the plantlets were evaluated. The reserve proteins (albumin, globulin, prolamin and glutelin) contents were also determined. There was influence of the position of the seed in the fruit on germination and reserve proteins contents. The proximal/median position showed excellent results, having correlations of albumin, globulin and glutelin concentrations with some germinative parameters. Therefore, the use of proximal/median position of the seeds is recommended for C. pulcherrima propagation.
Hacia un sujeto intransitivo.
Authors: Rodríguez Carranza Luz
Published: June 2019

La cuestión del sujeto hace referencia al impasse del concepto en la filosofía contemporánea, e incluso su eliminación. Hay posiciones diferentes, sin embargo, que plantean que sigue allí, pero que no se trata del mismo sujeto. Ya no es, sin duda, fuente de la verdad o garantía de una experiencia, porque ha dejado de constituirse como respuesta a objetos e interpelaciones diversos. Es un sujeto virtual que no actúa «para algo», ni recibe de ese algo significación ni identidad, pero no por eso es menos verdadero. Este trabajo yuxtapone reflexiones recientemente publicadas de Alain Badiou sobre el sujeto a Philip Seymour Hoffman, por ejemplo (2017) la obra belga de Rafael Spregelburd, que sugiere que aunque el sujeto no crea en identidades suyas o ajenas, ellas existen como ficciones, tema belga si los hay. Si las ficciones no tienen referente es porque son en sí mismas reales, forman parte de lo existente. Philip sabe que un papel que elige desempeñar es para él, porque encierra en sí mismo su propio propósito. Aparece así un sujeto intransitivo: fiel a su propio acto.
Sobre: En torno al realismo y otros ensayos de Sandra Contreras. Rosario: Nube Negra Ediciones, 2018
Authors: Rodríguez Montiel Emiliano
Published: June 2019

Sobre: En torno al realismo y otros ensayos de Sandra Contreras. Rosario: Nube Negra Ediciones, 2018.
Laptops and mobile phones at self-study time: Examining the mechanism behind interruption and multitasking
Authors: Deng Liping
Published: June 2019

This study examines university students’ multitasking with computers and mobile phones in an authentic self-study context, with the primary focus being on off-task multitasking and interruption as precursor to multitasking. The study drew on interviews, observation, and video-stimulated recall to reveal the triggers for and processes of multitasking. It has identified pop-up notifications as the main external interruption and task completion as well as boredom as the internal sources of interruption. The results also pinpointed task as an important dimension associated with both internal and external interruptions. A framework of multitasking triggers was constructed encompassing user, technology and task. The implications of the findings for students, teachers and researchers are also discussed.
Staphylococcus aureus α-toxin: small pore, large consequences
Authors: von Hoven Gisela , Qin Qianqian , Neukirch Claudia , Husmann Matthias , Hellmann Nadja
Published: June 2019

The small β-pore-forming α-toxin, also termed α-hemolysin or Hla is considered to be an important virulence factor of Staphylococcus aureus. Perforation of the plasma membrane (PM) by Hla leads to uncontrolled flux of ions and water. Already a small number of toxin pores seems to be sufficient to induce complex cellular responses, many of which depend on the efflux of potassium. In this article, we discuss the implications of secondary membrane lesions, for example, by endogenous channels, for Hla-mediated toxicity, for calcium-influx and membrane repair. Activation of purinergic receptors has been proposed to be a major contributor to the lytic effects of various pore forming proteins, but new findings raise doubts that this holds true for Hla. However, the recently discovered cellular pore forming proteins gasdermin D and Mixed lineage kinase domain-like pseudokinase (MLKL) which perforate the PM from the cytosolic side might contribute to both calcium-influx-dependent damage and membrane repair. Activation of endogenous pore forming proteins by Hla above a threshold concentration could explain the apparent dependence of pore characteristics on toxin concentrations. If secondary membrane damage in the aftermath of Hla-attack contributes significantly to overall PM permeability, it might be an interesting target for new therapeutic approaches.
Infected Anastomotic Pseudoaneurysm after Aortic Valve Replacement with Annular Enlargement
Authors: Sui Runqian , Zi Jie , Sun Liangong , Li Decai , Wang Anbiao
Published: June 2019

Anastomotic pseudoaneurysm remains one of the main life-threatening complications of cardiac and thoracic aorta surgery. We report a rare case of infected pseudoaneurysm at the anastomotic line found during follow-up. Blood culture results suggested Enterococcus faecium infection. Transthoracic echocardiography and computed tomography scans revealed the presence of a pseudoaneurysm of the ascending aorta. The pseudoaneurysm was resected and the ascending aorta was reconstructed with an artificial vascular patch without complications. Reducing the anastomotic tension, with complete hemostasis at the anastomotic incision, is the most important means of preventing the formation of pseudoaneurysm.