bluuebunny/crossref_metadata_2025 huggingface dataset:
Robust likelihood inference for diagnostic accuracy measures for paired organs
Authors: Tsou Tsung-Shan
Published: September 2018

Paired data arise naturally in Ophthalmology where pairs of eyes undergo diagnostic tests to predict the presence of certain diseases. The common correlation model is popular for modeling the joint probabilities of responses from fellow eyes for inference about accuracy measures. One of the assumptions underlying the model is exchangeability of fellow eyes that stipulates the accuracy measures such as sensitivities/specificities of fellow eyes be equal. We propose a parametric robust likelihood approach to testing the equality of accuracy measures of fellow eyes without modeling correlation. The robust likelihood procedure is applicable for inference about diagnostic accuracy measures in general paired designs. We provide simulations and analyses of a data set in Ophthalmology to demonstrate the effectiveness of the parametric robust procedure.
Trauma and Injury Severity Score modification for predicting survival of trauma in one regional emergency medical center in Korea: Construction of Trauma and Injury Severity Score coefficient model
Authors: Kang In Hye , Lee Kang Hyun , Youk Hyun , Lee Jeong Il , Lee Hee Young , Bae Keum Seok
Published: September 2018

Background:

The problem that is central to trauma research is the prediction of survival rate after trauma. Trauma and Injury Severity Score is being used for predicting survival rate after trauma. Many countries have conducted a study on the classification, characteristics of variables, and the validity of the Trauma and Injury Severity Score model. However, few investigations have been made on the characteristics of coefficients or variables related to Trauma and Injury Severity Score in Korea. Objectives: There is a need for coefficient analysis of Trauma and Injury Severity Score which was created based on the United States database to be optimized for the situation in Korea.

Methods:

This study examined how the currently used Trauma and Injury Severity Score coefficients were developed and created for trauma patients visiting the emergency department in a hospital in Korea using the analytical method. A total of 34,340 trauma patients who were hospitalized into an emergency center from January 2012 to December 2014 for 3 years were analyzed with trauma registry established on August 2006.

Results:

Trauma and Injury Severity Score coefficients were transformed with the methods that were used to make the existing Trauma and Injury Severity Score coefficients using the trauma patients’ data. Regression coefficients (B) were drawn by building up a logistic regression analysis model that used variables such as Injury Severity Score, Revised Trauma Score, and age depending on survival with Trauma and Injury Severity Score.

Conclusion:

With regard to Trauma and Injury Severity Score established in the United States differing from Korea in injury types, it seems possible to realize significant survival rate by deriving coefficients with data in Korea and reanalyzing them.
Creativity or Cooptation? Thinking Beyond Instrumentalism When Teaching Design Thinking
Authors: Zidulka Amy , Kajzer Mitchell Ingrid
Published: September 2018

This essay frames design thinking (DT) as a form of experiential learning and describes what we, as DT educators, have come to consider its “shadow side.” We are concerned that, through uncritical promotion of instrumentalist approaches to creativity, DT classes unwittingly marginalize from the curriculum other forms of creativity, such as those that are rebellious and self-expressive. By drawing on existing critiques of the dominant creativity discourse, we explore what a more critically oriented approach to DT might look like.
Risk Factors for Lower Limb Deep Vein Thrombosis in Patients With Single-Level Lumbar Fusion: A Prospective Study of 710 Cases
Authors: Zhao Chun-Ming , Zhang Yu , Yang Si-Dong , Huang Ai-Bing , Liang Zong-Min , Wu Jian , Chen Qian
Published: September 2018

Lower limb deep vein thrombosis (DVT) is not an uncommon postoperative complication of spinal fusion surgery. However, the related risk factors identified in previous studies remain controversial. This study aimed to investigate risk factors for lower limb DVT in patients with single-level lumbar fusion surgery. Between January 2010 and December 2016, a total of 710 patients undergoing lumbar fusion were recruited for this study, including 172 males and 538 females (aged 18-75 years). Deep vein thrombosis was detected by ultrasonography. Accordingly, patients were divided into the DVT group and the non-DVT group and compared in terms of operative data, underlying diseases, and biochemical data. Additionally, logistic regression analysis was performed to identify risk factors for lower limb DVT. The incidence of lower limb DVT was 11.8% (84 of 710 cases). Five patients were symptomatic, with lower limb pain and swelling. Two patients developed pulmonary embolism and 1 died. Binary logistic regression indicated that advanced age ( P = .001, odds ratio [OR] = 2.86, 95% CI: 1.85-5.12), hypertension ( P = .006, OR = 4.10, 95% CI: 1.09-2.30), and increased d-dimer ( P < .001, OR = 3.49, 95% CI: 2.05-6.36) were risk factors for postoperative DVT. In conclusion, for patients with single-level lumbar fusion, advanced age, increased d-dimer, and hypertension may contribute to DVT development after spinal fusion surgery. Therefore, patients with these risk factors should be protected during the perioperative period.
Preservation of cognitive function following whole brain radiotherapy in patients with brain metastases: Complications, treatments, and the emerging role of memantine
Authors: Lynch Meghan
Published: September 2018

Whole brain radiotherapy is the mainstay of treatment for patients suffering from stage IV malignancies that have metastasized to the brain. Although this therapy is often effective at reducing tumor size and burden, it is associated with a spectrum of toxicities that often result in irreversible cognitive decline. Various drug and non-drug therapies have been evaluated to treat this neurotoxicity after whole brain radiotherapy is administered; however, currently available options have shown little benefit or come with side effects themselves that may outweigh the benefits of their use. For this reason, current investigations are focusing on preventing cognitive decline, rather than attempting to attenuate symptoms after they occur. Memantine has consistently shown promise in both in-vitro and in-vivo studies as a neuroprotective agent that may improve cognitive outcomes in patients undergoing whole brain radiotherapy. Memantine use prior to and during whole brain radiotherapy has been shown to significantly delay time to cognitive failure and reduce the rate of decline in memory, cognitive function, and processing speed. Its use has also been linked to significant decreases in brain edema, brain infarct size, and brain vasculature changes following whole brain radiotherapy. Memantine offers a promising safety profile with high tolerability and limited side effects. The objective of this article is to provide an overview of the target patient population, the neurotoxic effects of WBRT, current treatment options, and a summary of the available literature surrounding the use of memantine in this setting.
A rare complication of endoscopic sinus surgery: Retinal artery occlusion
Authors: Kurt Muhammed M , Akpolat Cetin , Fethallah Basat
Published: September 2018

A 60-year-old patient with a history of diabetes mellitus and coronary artery disease was admitted to the eye nose and throat clinic due to complaints of difficulty in breathing. The patient was decided for functional endoscopic sinus surgery with the diagnosis of right nasal polyposis and chronic sinusitis. The patient had right visual loss with the findings of retinal artery occlusion, which is a rare ocular complication seen after functional endoscopic sinus surgery. Although the patient had proper urgent surgical and medical treatment, we did not observe visual improvement. Since this is a very rare condition, we intended to report it in the literature.
Enhanced speech privacy in office spaces
Authors: Krasnov Alexey , Green Edward R , Engels Bret , Corden Barry
Published: September 2018

There is an ever-increasing demand for speech privacy in modern office spaces. People prefer their conversations to remain private while not being disturbed by speech of others. The work presented in this article focuses on reducing the intelligibility of the perceived speech by masking the original signal without a significant additional annoyance. The disruption of the information-carrying components of speech by the amplitude and temporal smearing is of a specific interest of this work. We suggest a method in which a modified self-adjusted masking signal is used to effectively counteract the drawbacks of a straightforward reverberation. The presented masking method disrupts key speech characteristics of the original signal. The intelligibility and annoyance levels of the resulting signal are subjectively evaluated. The optimized experimental parameters are reported. The presented method provides a significantly higher speech privacy and a lower perceived annoyance as compared to white noise. The method can be used in office environments with various Sound Transmission Class levels.
A new multidisciplinary robust design optimization framework for an autonomous underwater vehicle in system and tactic design
Authors: Bidoki Mohsen , Mortazavi Mehdi , Sabzehparvar Mehdi
Published: September 2018

The design process of an autonomous underwater vehicle requires mathematical model of subsystems or disciplines such as guidance and control, payload, hydrodynamic, propulsion, structure, trajectory and performance and their interactions. In early phases of design, an autonomous underwater vehicle is often encountered with a high degree of uncertainty in the design variables and parameters of system. These uncertainties present challenges to the design process and have a direct effect on the autonomous underwater vehicle performance. Multidisciplinary design optimization is an approach to find both optimum and feasible design, and robust design is an approach to make the system performance insensitive to variations of design variables and parameters. It is significant to integrate the robust design and the multidisciplinary design optimization for designing complex engineering systems in optimal, feasible and robust senses. In this article, we present an improved multidisciplinary design optimization methodology for conceptual design of an autonomous underwater vehicle in both engineering and tactic aspects under uncertainty. In this methodology, uncertain multidisciplinary feasible is introduced as uncertain multidisciplinary design optimization framework. The results of this research illustrate that the new proposed robust multidisciplinary design optimization framework can carefully set a robust design for an autonomous underwater vehicle with coupled uncertain disciplines.
Treatment of Head and Neck Venous Malformations with Sodium Tetradecyl Sulfate
Authors: Karimi Ebrahim , Jafari Mehrdad , Aghazadeh Keyvan , Sohrabpour Saeed , Tavakolnejad Fatemeh
Published: September 2018

Objective

The purpose of this study was to discuss the clinical outcomes and complications of treating venous malformations with sclerotherapy, with sodium tetradecyl sulfate as the sclerosing agent.

Study Design

Case series with planned data collection.

Setting

Amiralam Hospital—a referral otolaryngology–head and neck surgery hospital affiliated with Tehran University of Medical Sciences.

Subjects and Methods

A total of 345 patients with venous malformations were treated with sclerotherapy with sodium tetradecyl sulfate 3% (1 mL for every 1 cm3 of the lesion). The venous malformation location, treatments before the current sclerotherapy with sodium tetradecyl sulfate, the number of sclerotherapy sessions, and complications resulting from sclerotherapy were recorded. Follow‐up assessments were done for a minimum of 1 year following the procedure. A favorable outcome was defined as a 50% decrease in the lesion size based on clinical and radiologic assessments.

Results

A total of 759 injection sessions were documented, ranging from 1 to 6 injections per patient (mean = 3.1). The follow‐up duration ranged from 12 to 84 months (mean = 55 months). Based on clinical assessment, a 50% reduction of size was reported for 95.6% of the patients. According to the imaging before and after the procedures, a 50% reduction of size was seen among 67.3% of the patients.

Conclusion

The results of the study showed that the use of sodium tetradecyl sulfate as a sclerosing substance can effectively reduce the size of venous malformation lesions.
How I treat the older adult with sickle cell disease
Authors: Thein Swee Lay , Howard Jo
Published: September 2018

With increasing survival, cumulative complications of sickle cell disease (SCD), which develop insidiously over time, are becoming more apparent and common in older patients, particularly those in their fifth decade and beyond. The older patient is also more likely to develop other age-related nonsickle conditions that interact and add to the disease morbidity. A common misconception is that any symptom in a SCD patient is attributable to their SCD and this may lead to delays in diagnosis and appropriate intervention. We recommend regular comprehensive reviews and monitoring for early signs of organ damage and a low threshold for the use of hydroxyurea and blood transfusions as preventative measures for end-organ disease. Treatable comorbidities and acute deterioration should be managed aggressively. Although the primary goal in management of the older adult with SCD is improving anemia and minimizing organ damage, the time has come for us to be more proactive in considering curative therapies previously offered to the younger patient. Curative or experimental interventions should be discussed early, before complications render the patients ineligible for these treatments.
Evaluation of preoperative anxiety and fear of anesthesia using APAIS score
Authors: Celik Fatma , Edipoglu Ipek S.
Published: September 2018

Background

Preoperative anxiety is one of the most important problems for the patients, because it causes emotional and psychiatric problems as well as physical problems. It is crucial to detect the patient’s existing anxiety to assist patients. Our primary aim in this study is to investigate how the patient’s age, gender, the operation, surgical briefing, type of anesthesia recommended for the operation ahead, and patient’s prior anesthesia experience affect the patient’s anxieties. Our secondary aim is to reveal the causes of the patient’s anxieties regarding anesthesia.

Methods

Our study was conducted as a prospective cohort study between May 2016–2017. Interviews with the patients were performed in the anesthesia clinic for preoperative examination. For the study, The Amsterdam Preoperative Anxiety and Information Scale (APAIS) has been used. The answers were evaluated in two scales: the anxiety score and the desire for information score. Answers to the statements were evaluated with Likert Scale. In addition, our patients were asked whether they had received prior anesthesia, if so, the type of anesthesia, whether they received surgical briefing and anesthetic method we recommended. We also asked our patients about the cause of their anxiety regarding the anesthesia.

Results

A total of 637 patients were recruited to the study, after excluding the patients who do not meet the criteria for inclusion, and 499 patients were included. Between the age and desire for information sub-scores, a negative significant correlation was detected (r: − 0.241;p = 0.001). We found that the scores of graduates of university and higher were statistically significant than the primary school graduates (p = 0.003) and secondary school graduates (p = 0.034). Anxiety sub-scores of the patients who underwent general anesthesia were found to be significantly higher than the patients who underwent regional anesthesia (p = 0.029). Anxiety sub-scores of females were found to be significantly higher than the males (p = 0.001).

Conclusions

We think that being aware of the patients’ anxiety and finding appropriate approaches for their anxieties can be valuable. APAIS is an effective method to measure patient anxiety and it might be beneficial to use during preoperative visits. Patient satisfaction and superior outcomes can be achieved in this way.

Trial registrationISRCTN43960422. Registered 19/02/2018—Retrospectively registered.http://www.isrctn.com/ISRCTN43960422
Metacognitive therapy versus cognitive–behavioural therapy in adults with generalised anxiety disorder
Authors: Nordahl Hans M. , Borkovec Thomas D. , Hagen Roger , Kennair Leif E. O. , Hjemdal Odin , Solem Stian , Hansen Bjarne , Haseth Svein , Wells Adrian
Published: September 2018

Background

Cognitive–behavioural therapy (CBT) is the treatment of choice for generalised anxiety disorder (GAD), yielding significant improvements in approximately 50% of patients. There is significant room for improvement in the outcomes of treatment, especially in recovery.

Aims

We aimed to compare metacognitive therapy (MCT) with the gold standard treatment, CBT, in patients with GAD (clinicaltrials.gov identifier: NCT00426426).

Method

A total of 246 patients with long-term GAD were assessed and 81 were randomised into three conditions: CBT (n = 28), MCT (n = 32) and a wait-list control (n = 21). Assessments were made at pre-treatment, post-treatment and at 2 year follow-up.

Results

Both CBT and MCT were effective treatments, but MCT was more effective (mean difference 9.762, 95% CI 2.679–16.845, P = 0.004) and led to significantly higher recovery rates (65% v. 38%). These differences were maintained at 2 year follow-up.

Conclusions

MCT seems to produce recovery rates that exceed those of CBT. These results demonstrate that the effects of treatment cannot be attributed to non-specific therapy factors.

Declaration of interest

A.W. wrote the treatment protocol in MCT and several books on CBT and MCT, and receives royalties from these. T.D.B. wrote the protocol in CBT and has published several articles and chapters on CBT and receives royalties from these. All other authors declare no competing interests.
Patent foramen ovale closure versus medical therapy for stroke prevention: A systematic review and meta-analysis of randomized controlled trials
Authors: Lai Jenny Chi Ling , Tse Gary , Wu William K.K. , Gong Mengqi , Bazoukis George , Wong Wing Tak , Wong Sunny Hei , Lampropoulos Konstantinos , Baranchuk Adrian , Tse Lap Ah , Xia Yunlong , Li Guangping , Wong Martin C.S. , Chan Yat Sun , Mu Nan , Dong Mei , Liu Tong ,   International Health Informatics Study (IHIS) Network
Published: September 2018

Background:Previous randomized trials on patent foramen ovale (PFO) closure versus medical therapy for stroke prevention were inconclusive. Recently, two new randomized trials and new findings from an extended follow-up of a previous trial have been published on this topic. We conducted a systematic review and meta-analysis of randomized trials comparing PFO closure with medical therapy for stroke prevention.

Methods:PubMed and Cochrane Library were searched until 16thSeptember 2017.  The following search terms were used for PubMed: "patent foramen ovale" AND (stroke OR embolism) and "randomized" AND "Trial". For Cochrane Library, the following terms were used: "patent foramen ovale" AND "closure" AND (stroke OR embolism).

Results:A total of 91 and 55 entries were retrieved from each database using our search strategy respectively, of which six studies on five trials met the inclusion criteria. This meta-analysis included 1829 patients in the PFO closure arm (mean age: 45.3 years; 54% male) and 1972 patients in the medical therapy arm (mean age: 45.1 years; 51% male). The median follow-up duration was 50 ± 30 months. When compared to medical therapy, PFO closure significantly reduced primary endpoint events with a risk ratio [RR] of 0.60 (95% CI: 0.44-0.83, P < 0.0001;I2: 15%). It also reduced stroke (RR: 0.50, 95% CI: 0.35-0.73, P < 0.0001;I2: 32%) despite increasing the risk of atrial fibrillation/flutter (RR: 1.90, 95% CI: 1.23-2.93, P < 0.01;I2: 43%). However, it did not reduce transient ischemic accident events (0.75; 95% CI: 0.51-1.10, P = 0.14;I2: 0%), all-cause bleeding (RR: 0.89; 95% CI: 0.44-1.78, P = 0.74;I2: 51%) or gastrointestinal complications (RR: 0.92; 95% CI: 0.32-2.70, P = 0.88;I2: 0%).

Conclusions:PFO closure significantly reduces risk of stroke when compared to medical treatment and should therefore be considered for stroke prevention in PFO patients.
Relationships between variance in electroencephalography relative power and developmental status in infants with typical development and at risk for developmental disability: An observational study
Authors: Hooyman Andrew , Kayekjian David , Xiao Ran , Jiang Crystal , Vanderbilt Douglas L. , Smith Beth A.
Published: September 2018

Background: Electroencephalography (EEG) is a non-invasive tool that has the potential to identify and quantify atypical brain development. We introduce a new measure here, variance of relative power of resting-state EEG. We sought to assess whether variance of relative power of resting-state EEG could predict i) classification of infants as typical development (TD) or at risk (AR) for developmental disability, and ii) Bayley developmental scores at the same visit or future visits.

Methods: A total of 22 infants with TD participated, aged between 38 and 203 days. In addition, 11 infants broadly at risk participated (6 high-risk pre-term, 4 low-risk pre-term, 1 high-risk full-term), aged between 40 and 225 days of age (adjusted for prematurity). We used EEG to measure resting-state brain function across months. We calculated variance of relative power as the standard deviation of the relative power across each of the 32 EEG electrodes. The Bayley Scales of Infant Development (3rd edition) was used to measure developmental level. Infants were measured 1-6 times each, with 1 month between measurements.

Results: Our main findings were: i) variance of relative power of resting state EEG can predict classification of infants as TD or AR, and ii) variance of relative power of resting state EEG can predict Bayley developmental scores at the same visit (Bayley raw fine motor, Bayley raw cognitive, Bayley total raw score, Bayley motor composite score) and at a future visit (Bayley raw fine motor).

Conclusions: This was a preliminary, exploratory, small study. Our results support variance of relative power of resting state EEG as an area of interest for future study as a biomarker of neurodevelopmental status and as a potential outcome measure for early intervention.
COMPOSITION OF FATTY ACIDS AND THE LEVEL OF THEIR METABOLITES AT PARTIALLY CONTROLLED BRONCHIAL ASTHMA AGAINST THE BACKGROUND OF INTEGRATED TREATMENT WITH THE USE OF MILLIMETER THERAPY
Authors: Новгородцева Татьяна , Novgorodtseva Tatyana , Ходосова Кира , Khodosova Kira , Гвозденко Татьяна , Gvozdenko Tatyana , Антонюк Марина , Antonyuk Marina , Юренко Алла , Yurenko Alla , Переломова Оксана , Perelomova Oksana , Клепацкая Тамара , Klepackaya Tamara
Published: September 2018

To assess the anti-inflammatory effect of millimeter therapy in the treatment of partially controlled asthma, the fatty acid composition of erythrocyte membranes and their oxygenase derivatives were studied. Eighty-five subjects aged 18 to 45 years old were examined, 60 of them were diagnosed with partially controlled asthma and 25 were a control group, which consisted of conditionally healthy subjects without bronchopulmonary pathology. Two study groups were formed. Patients of the 1st group (n=30) received only basic medical treatment: inhalation glucocorticosteroid and β2-agonists of short action on demand. Patients of the 2nd group (n=30) underwent complex treatment: basic medical treatment in combination with millimeter therapy according to the developed technique. Clinical symptoms (frequency of nocturnal and daily asthma attacks per week, severity of cough, need for short-acting bronchodilators during the day), results of the asthma symptom control questionnaire (ACQ-5 test), lung function, composition of fatty acid (FA) in erythrocyte membranes, level of eicosanoids were assessed. The dynamics of clinical-functional and laboratory indicators in patients was evaluated one month after the start of treatment. The study established a modification of FA erythrocyte membranes composition, characterized by an increase in the proportion of some representatives of saturated and monounsaturated FA, increased production of arachidonic acid and its cyclooxygenase and lipoxygenase metabolites (thromboxane B2, leukotriene B4) against the background of deficiency of eicosapentaenoic and docosapentaenoic acids. A significant decrease in the level of oxygenated derivatives of fatty acids in the blood plasma of patients was revealed against the background of positive dynamics of clinical course of the disease in the 2nd group receiving complex treatment, which indicates the normalization of metabolic transformations of oxygenated derivatives of fatty acids, and as a consequence the extinction of allergic inflammation under the influence of electromagnetic waves of the millimeter range of extremely high frequency.
PECULIARITIES OF MIXED RESPIRATORY VIRAL INFECTIONS IN WOMEN IN THE SECOND TRIMESTER OF PREGNANCY UNDER INTRAUTERINE INFECTION OF THEIR NEWBORNS WITH CEREBRAL ISCHEMIA
Authors: Горикова Ирина , Gorikova Irina , Заболотских Татьяна , Zabolotskikh Tat'yana , Гориков Игорь , Gorikov Igor , Макаров Игорь , Makarov Igor' , Меньщиков Александр , Men'schikov Aleksandr , Баталова Татьяна , Batalova Tatiana , Сергиевич А. , Sergievich A. , Григорьев Николай , Grigor'ev Nikolay , Гасанова Светлана , Gasanova Svetlana , Резник Вадим , Reznik Vadim
Published: September 2018

Clinical and serological features of the gestational process in 85 women with pregnancy, uncomplicated and complicated with parainfluenza-influenza infection in the second trimester of gestation, were studied. All examined women were divided into three groups. The first group (control) included 32 women with physiological course of pregnancy and their healthy full-term newborns. The second group included 32 patients with respiratory mixed-virus infection in the second trimester of gestation, and in their newborns there was diagnosed moderate cerebral ischemia and no signs of intrauterine infection. The third group included 21 women with respiratory mixed virus infection in the second trimester of pregnancy, which was the cause of antenatal infection in their full-term infants with cerebral ischemia of moderate severity. It was shown that the women of the third group compared with the second and first groups often complained of headache, photophobia, sweating and weakness, increase in body temperature to 37.6-38ºC, hoarseness of the voice, sore throat, as well as a prolonged course of acute nasopharyngitis and acute laryngitis. The above clinical features of acute respiratory viral infection in women in the second trimester of gestation may contribute to antenatal infection and may disrupt optimal conditions for intrauterine brain development in their babies.
MORPHOLOGICAL STRUCTURE OF THE THYMUS IN NEWBORNS WITH CONGENITAL CYTOMEGALOVIRUS INFECTION
Authors: Андриевская Ирина , Andrievskaya Irina , Гориков Игорь , Gorikov Igor , Сомова Лариса , Somova Larisa , Ишутина Наталия , Ishutina Nataliya , Дорофиенко Николай , Dorofienko Nikolay
Published: September 2018

The aim of the work was to study the morphological structure of the thymus gland in 36 full-term newborns who died at the 2-5 day of life. The main group included 16 newborns who were diagnosed with intrauterine cytomegalovirus infection by the serological method and polymerase chain reaction. Cerebral ischemia of moderate and severe degree, subarachnoid and periventricular hemorrhages, as well as markers of local and generalized forms of congenital infection were revealed in children of this group. The comparison group was represented by 20 newborns with antenatal ontogenesis, uncomplicated by acute respiratory and herpes-virus infections, moderate and severe somatic and obstetric pathology in their mothers during pregnancy. The cause of their death was birth trauma, intranatal and postnatal hypoxia. In the description of the neonatal thymus, attention was paid to the following features: the general plan of the structure; structural changes in the capsule of the gland; the structure of the cortical and brain matter; violation of loose fibrous connective tissue and blood vessels of the organ. It was found out that the structure of the thymus gland in the main group was different from that in the comparison group, especially a predominance of neonates with increase and decrease in the organ mass. With the growth of the mass of the thymus there was frequently revealed subcapsular hemorrhage; the sharpness of borders decreased or completely disappeared between cortical and medullary substance; the areas of crust delymphatisation, Hassall’s corpuscles filled with detritus were often identified. The edema of the interlobular loose fibrous connective tissue increased, the endothelial edema and its desquamation in the lumen of blood vessels were noted. Lymphocyte clusters in the interlobular connective tissue were clearly visualized. In the case of a decrease in the body mass, small lobules, excessive formation of collagen fibers in the interlobular connective tissue, the loss of lymphocytes in the cortical substance and small Hassal’s bodies were more often recorded. Stimulation of thymus growth may be associated with the direct cytodestructive effect of the virus and intrauterine stress, leading to a drop in cortisol content. In the inhibition of immunopoesis growth, prolonged antenatal antigenic stimulation, higher level of cortisol against progressing alterative processes in glandulocyte of the cortex of suprarenal glands of the fetus play an important role.
Pressure ulcer or moisture lesion? How to tell the difference
Authors: Nazarko Linda
Published: September 2018

Nursing staff caring for patients in hospital and in the community normally receive education and training in how to assess skin for pressure ulcer risk. Staff are taught how to reduce risks, to document any pressure ulcers and how to treat pressure ulcers. Many people, however, are at risk of moisture damage due to incontinence, excessive perspiration, wound and stoma exudate. Moisture damage can cause pain and discomfort, delay hospital discharge and impact on quality of life, yet few staff receive formal education on this subject.

This article aims to enable readers to understand the difference between moisture damage and pressure damage when inspecting skin. It aims to enable staff to provide effective care and treatment.
Treatment of chronic infected post-oncological wounds with a dermal matrix: two case studies
Authors: Mandel Victor Desmond , Persechino Flavia , Fiorentini Chiara , Passini Erica , Magnoni Cristina
Published: September 2018

The reconstruction of complex wounds in patients with comorbidities in the lower extremities is a challenging problem for surgeons. Skin grafting is frequently used to cover large skin defects, but it has several limits, including unwanted outcomes resulting from scars, poor elasticity and limitations in joint movement due to contractures. Locoregional flaps, particularly in the lower limbs, have limited application due to the size of the defect. Tissue engineering of the skin has offered major improvements in the coverage of large defects. Dermal matrix can be applied in order to generate a new dermis that allows good re-epithelialisation or skin grafting at a later stage. The reconstruction of large lower limb defects is more complicated in the case of chronic wounds showing no tendency to heal due to chronic infection. For all surgeons, it is very important to prevent the formation of a biofilm or manage it when it is already established before undertaking surgical procedures that involve a dermal matrix. We report our reconstruction strategy of chronic infected neoplastic ulcers of the lower extremities with a dermal matrix and our postoperative dressing protocol.
Early morbidity associated with fasciotomies for acute compartment syndrome in children
Authors: Lim K. B. L. , Laine T. , Chooi J. Y. , Lye W. K. , Lee B. J. Y. , Narayanan U. G.
Published: September 2018

Purpose

Acute compartment syndrome (ACS) requires urgent fasciotomy to decompress the relevant muscle compartment/s prior to onset of irreversible myonecrosis and nerve injury. A fasciotomy is not a benign procedure. This study aims to describe and quantify early morbidity directly associated with fasciotomies for ACS in children.

Methods

Clinical charts of 104 children who underwent 112 fasciotomies over a 13-year period at a tertiary children's hospital were reviewed. The following were analyzed: ACS aetiology, fasciotomy site, number of subsequent procedures, method of wound closure, short-term complications and length of hospital stay.

Results

Short-term complications included wound infections (6.7%) and the need for blood transfusion (7.7%). Median number of additional operations for wound closure was two (0 to 10) and median inpatient stay was 12 days (3 to 63; SD 11.7). After three unsuccessful attempts at primary closure, likelihood of needing skin grafting for coverage exceeded 80%. Analyses showed that fasciotomy-wound infections were associated with higher risk for four or more closure procedures. Number of procedures required for wound closure correlated with longer inpatient stay as did ACS associated with non-orthopaedic causes.

Conclusion

Fasciotomy is associated with significant early morbidity, the need for multiple closure operations, and prolonged hospital stay. The decision for fasciotomy needs careful consideration to avoid unnecessary fasciotomies, without increasing the risk of permanent injury from missed or delayed diagnosis. Skin grafting should be considered after three unsuccessful closure attempts. Less invasive tests or continuous monitoring (for high-risk patients) for compartment syndrome may help reduce unnecessary fasciotomies.

Level of Evidence

Level IV, Case series
Is less more? Assessing the utility of early clinical and radiographic follow-up for operative supracondylar humerus fractures
Authors: Thompson R. M. , Hubbard E. W. , Elliott M. , Riccio A. I. , Sucato D. J.
Published: September 2018

Purpose

Postoperative protocols following surgical management of supracondylar humerus fractures (SCFs) are often based upon surgeon preference rather than clinical merit. The purpose of this study is to determine the utility of early clinical and radiographic follow-up.

Methods

A retrospective review of patients who underwent closed reduction and percutaneous pinning (CRPP) for SCF between 2009 and 2015 was performed using a database of prospectively-collected consecutive patient data. Previously undiagnosed neuropathies documented at the first postoperative visit were identified. Unscheduled visits and postoperative complications were compared between patients who were seen at one week and those with delayed first clinic visits.

Results

Of 873 patients, 823 (94.3%) were seen within ten days of surgery (early follow-up) and 50 (5.7%) had a delayed first clinic appointment. Among patients seen for early follow-up, 12 (1.5%) had a previously undocumented neuropathy diagnosed but only eight (1%) had an alteration of management secondary to clinical findings. Greater than 90% of patients seen for early follow-up had radiographs performed, but only one had an alteration in management due to radiographic findings. Patients seen for early follow-up had the same rate of unscheduled visits (2.9% versus 4%, p = 0.66) and postoperative complications (1.6% versus 0%, p > 0.99) as those with delayed first appointments. Radiographic parameters were comparable at final follow-up (Baumann's angle 74.5° versus 73.7°, p = 0.40; lateral humeral condylar angle 40.2° versus 41.2°, p = 0.53).

Conclusion

The early follow-up visit after CRPP of SCF rarely leads to alterations in care and does not reduce unscheduled visits or late complications.

Level of Evidence

Level IV
Intraretinal fluid identification via enhanced maps using optical coherence tomography images
Authors: Vidal Plácido L. , de Moura Joaquim , Novo Jorge , Penedo Manuel G. , Ortega Marcos
Published: September 2018

Nowadays, among the main causes of blindness in developed countries are age-related macular degeneration (AMD) and the diabetic macular edema (DME). Both diseases present, as a common symptom, the appearance of cystoid fluid regions inside the retinal layers. Optical coherence tomography (OCT) image modality was one of the main medical imaging techniques for the early diagnosis and monitoring of AMD and DME via this intraretinal fluid detection and characterization. We present a novel methodology to identify these fluid accumulations by means of generating binary maps (offering a direct representation of these areas) and heat maps (containing the region confidence). To achieve this, a set of 312 intensity and texture-based features were studied. The most relevant features were selected using the sequential forward selection (SFS) strategy and tested with three archetypal classifiers: LDC, SVM and Parzen window. Finally, the most proficient classifier is used to create the proposed maps. All of the tested classifiers returned satisfactory results, the best classifier achieving a mean test accuracy higher than 94% in all of the experiments. The suitability of the maps was evaluated in a context of a screening issue with three different datasets obtained with two different devices, testing the capabilities of the system to work independently of the used OCT device. The experiments with the map creation were performed using 323 OCT images. Using only the binary maps, more than 91.33% of the images were correctly classified. With only the heat maps, the proposed methodology correctly separated 93.50% of the images.
Representations of Syrian refugees in the British tabloid press: An illustration of Aylan Kurdi’s tragic event
Authors: Raja Irfan , Alotaibi Nasser N.
Published: September 2018

Ever since the Syrian crisis broke out, the media representation of the Syrian refugees fleeing political persecution, war and malnourishment has become a central focus of political debates and academic inquiry. Since 2011, the British press reporting of refugees has been mostly problematic, although occasionally it does reflect a diminutive evidence of sympathy. This article aims to analyse the representations of Syrian refugees in the British tabloid press particularity in the wake of Aylan Kurdi’s tragic death. The Framing Analysis approach has been applied on a corpus of 40 articles including features, news reports, editorials and comments pieces from The Sun and Daily Mirror that are of dissimilar political orientation. Initial findings show that the concept of ‘humanity’ is the most distinguished British value supported and endorsed by The Sun and Daily Mirror. At the same time, both tabloids ignored the notorious role of the British government in escalating the Syrian conflict, which resulted in the death of hundreds of thousands of civilians and the destruction of a country. Given the circumstances of the little boy’s death, this article supports the contention that news is a ‘constructed reality’ that is a product of various social, political and cultural factors including deviant circumstances. This study argues that certain events often receive more media attention than others, whilst many events of a similar nature are mostly ignored.
Błędny rycerz, pielgrzym, tułacz, Rom – powroty do tematów nomadycznych w literaturze czeskiej
Authors: Gawarecka Anna
Published: September 2018

Tematyka pielgrzymki, tułaczki czy wędrowania powraca od czasów romantyzmu w literaturze czeskiej, z jednej strony wpisując się w konglomerat uniwersalnych motywów mieszczących się w kanonie przestrzeni imaginacyjnej kultury zachodniej, z drugiej strony zaś – stanowiąc istotny wątek w dyskusji na temat nowożytnej conditio humana. Powtarzalność tematów nomadycznych, oparta na rozbudowanej sieci intertekstualnych powiązań i zakładająca przedustawne porozumienie z czytelnikiem zorientowanym w świecie ustalonych znaczeń i sposobów reprezentacji figur wędrowca/pielgrzyma/tułacza, dowodzi zatem trwałości związa- nego z nimi pola wyobrażeniowego, stanowiąc zarazem dogodne narzędzie dla badań nad iteratywnym wymiarem symboliki życia jako szeroko rozumianej podróży.
Cyclic homology of cyclic ∞-simplicial modules
Authors: Lapin Sergey V.
Published: September 2018

The notion of a cyclic

∞

{\infty}

-simplicial module is introduced.
The homotopy invariance of the structure of a cyclic

∞

{\infty}

-simplicial module is proved. The conception of the cyclic homology of cyclic

∞

{\infty}

-simplicial modules is developed. For the cyclic homology of cyclic

∞

{\infty}

-simplicial modules, the analogue of the Connes–Tsygan exact sequence is obtained.
Structure and photochromism of 1-[2-methyl-5-phenyl-3-thienyl]-2-[2-methyl-5-(4-chlorophenyl)-3-thienyl]3,3,4,4,5,5-hexafluorocyclopent-1-ene, C27H16ClF6S2
Authors: Liu Fangfang , Li Hui , Pu Shouzhi
Published: September 2018

C27H16ClF6S2, monclinic, P21/c (no. 14), a = 24.1193(5) Å, b = 9.2419(2) Å, c = 10.8343(2) Å, β = 96.1260(10)°, V = 2401.26(8) Å3, Z = 4, R
gt(F) = 0.0292, wR
ref(F
2) = 0.0878, T = 100(2) K.
Ratio primary reference measurement procedure (RPRMP) for the certification of chromium content in biological reference materials
Authors: Zuba Iga , Polkowska-Motrenko Halina
Published: September 2018

Primary reference measurement procedure for Cr determination in biological samples by radiochemical neutron activation analysis (RNAA) has been elaborated. The procedure is based on quantitative and selective separation of chromium from neutron irradiated sample by column chromatography using MnO2-Resin and determination of 51Cr by γ-ray spectrometry. Quality components have been incorporated into the RNAA method which makes it possible to meet the requirements of the definition of ratio primary reference measurement procedure. The usefulness of the elaborated procedure to assign the certified values for Cr in new certified reference material (CRMs) based on animal tissues is demonstrated. The tentative certified values for Cr have been proposed for: MODAS M-4 Cormorant Tissue and M-5 Cod Tissue CRMs.
Mixing SbIIIand GeIVoccupancy in the polyoxovanadate {V14E8} archetype
Authors: Wendt Michael , Näther Christian , van Leusen Jan , Kögerler Paul , Bensch Wolfgang
Published: September 2018

The first mixed germanato-antimonato derivative of the {V14E8O42} (E=semi-metal) cluster archetype has been synthesized under hydrothermal conditions and isolated as {Ni(phen)3}2[α-VIV14SbIII5GeIV3O42(OH)3(H2O)]· ≈16H2O (phen=1,10-phenanthroline). In the cluster anion, seven of the eight hetero-metal positions are occupied by disordered Ge/Sb atoms, while one position is fully occupied by Sb atoms. The [V14Sb5Ge3O42(OH)3(H2O)]6−anions are arranged in pairs with remarkably short inter-cluster Sb···O contacts. Bond valence sum calculation strongly suggests that the Sb···O contact must be taken into account as a weak bond. The magnetic properties are dominated by strong intra-cluster antiferromagnetic exchange interactions, and the cluster anion is magnetically quasi-isolated from the spins of the Ni2+complex cations.
Synthesis of LaCoO3 powder by a combined mechanical/thermal process
Authors: Berbenni Vittorio , Milanese Chiara , Bruni Giovanna , Girella Alessandro
Published: September 2018

Lanthanum cobaltite, LaCoO3, finds applications as an oxidation and reduction catalyst in gas-sensing materials and in electrode materials for high-temperature fuel cells. The compound has been synthesized through several routes aimed at obtaining LaCoO3 at lower temperatures. We propose a synthetic procedure based on the combined use of mechanical and thermal energy on mixtures of Co(II) oxalate dehydrate and La acetate sesquihydrate. We studied the reactions taking place by increasing the temperature. The study has been performed either on mixtures prepared by a simple physical mixing of the reactants or on the same mixtures after having been subjected to mechanical activation by high-energy milling. The products formed in the mixtures by annealing at different temperatures have been characterized by means of different experimental techniques (thermogravimetric analysis, XRPD, IR, scanning electron microscopy).
Alkali chalcogenido ortho manganates(II) A
6MnQ
4 (A=Rb, Cs; Q=S, Se, Te)
Authors: Langenmaier Michael , Rackl Tobias , Johrendt Dirk , Röhr Caroline
Published: September 2018

The six isotypic alkali ortho chalcogenido manganates A
6[MnII
Q
4] (A=Rb, Cs; Q=S, Se, Te) were synthesized – in most cases in pure phase – from stoichiometric mixtures of the manganese monochalcogenides MnQ, the elemental chalcogens and Rb2S/Cs2S2 (sulfido salts) or the pure alkali elements (selenido and tellurido salts) as alkali sources at maximum temperatures between 650 and 800°C. Their hexagonal crystal structures were refined by means of X-ray single crystal data (space group P63
mc, Na6ZnO4-type structure, Z=2; A/Q: Rb/S: a=1019.34(2), c=792.560(10) pm, R1=0.0166; Rb/Se: a=1055.74(2), c=821.14(2) pm, R1=0.0275; Rb/Te: a=1126.68(2), c=860.54(2) pm, R1=0.0152; Cs/S: a=1056.68(2), c=831.22(2) pm, R1=0.0168; Cs/Se: a=1096.04(3), c=858.13(2) pm, R1=0.0194; and Cs/Te: a=1167.72(3), c=896.95(2) pm, R1=0.0140). The chiral structures contain isolated C
3 symmetric, but very close to ideal tetrahedral, ortho manganate(II) anions [MnII
Q
4]6− with Mn–Q distances of 248.7–250.7 (Q=S), 260.7–263.0 (Q=Se) and 280.0–282.4 pm (Q=Te). The chalcogenide ions form a hexagonal closed packing with slightly puckered 36 nets, in which the A(2) cations occupy 3/4 of the octahedral interstices, whereas Mn takes 1/8 and A(1) 3/8 of the tetrahedral voids. Magnetic measurements on the three Cs compounds showed Curie-Weiss behavior down to a temperature of 1.9 K, with magnetic moments significantly reduced with respect to the expected spin-only value of a d
5 ion. The electronic band structures of the four salts (Na/Rb)6Mn(S/Te)4, which were calculated within the GGA+U approach, allow a comparison of the chemical bonding characteristics and the magnetic properties within the alkali cation and the chalcogenido ligand series.
Screenings
Authors: Smith Paul Julian
Published: September 2018

FQ Columnist Paul Julian Smith reports from Peru on a new wave of pop culture, from variety shows to teen telenovelas, popping up on television. He also discusses the popularity of the musical comedy feature films that function as Peru's equivalent f the summer blockbuster. He closes his report with a discussion of the films of filmmaker and professor Rossana Díaz Costa, whose art-house style is in stark contrast to the broad comedies and melodramas of Peruvian popular culture. Her debut feature Viaje a Tombuktú (2014) sets its 1980s teenage love story against a backdrop of political violence, while her latest production—an adaptation of the classic Peruvian novel, Un mundo para Julius—probes race, class, and gender inequalities in 1950s Peru.