bluuebunny/crossref_metadata_2025 huggingface dataset:
The Level of Mental Condition of South Slope Merapi Volcano Using Community Response Analysis
Authors: Sumunar D R S , Situmorang R M , Septiana M E
Published: June 2019

Mount Merapi’s activity in 2010 erupts VEI-4 which resulted in loss of life as much as 347 inhabitants, with most victims in the Regency of Sleman was 246 inhabitants. This problem causes of trauma in general slope of Merapi’s volcano. This research aims to know the impact of Merapi’s eruption on the mental condition of Merapi Community. This research uses qualitative research using the analysis of the percentage of public reponse questionnaire and indepth interviews of 42 respondents from 13 villages in the southern slope of Merapi’s Volcano about the mental condition of the southern slopes of Merapi’s volcano. The variables used in this research are the variable response of the community towards disaster preparedness, report of Merapi’s volcanic activity, experience, knowledge, and disaster response of the community. The results of this research are the community in Cangkringan Merapi Sub-district has a very bad mental condition, whereas in Pakem district experience a mental condition, and at sub-district of Turi have a very good mental condition. The community response rate is higher in Cangkringan sub-district because the eruption set into the Cangkringan Sub-district than other Sub-district in Sleman Regency. Community preparedness is very high, but the necessary trauma healing programs, especially in the area of Cangkringan Sub-district in order to minimize loss due to panic during the evacuation in the eruption.
Analysis and Prediction of Temperature Time Series Using Chaotic Approach
Authors: Bahari M , Hamid N Z A
Published: June 2019

Analysis and prediction of temperature time series is important because temperature changes can affect human’s health. The objectives of this study are to analyse and predict the temperature series in Jerantut, Pahang, Malaysia using chaotic approach. Modelling through chaotic approach divided into two stages; reconstruction of phase space and prediction processes. Through the reconstruction of phase space, a single scalar time series is rebuilt into a multi-dimensional phase space. This multi-dimensional phase space is used to detect the presence of chaotic dynamics through phase space plot and Cao method. The results show that the observed time series is chaotic in dynamic. Therefore, one hour ahead prediction through local mean approximation method is done. The correlation coefficient value obtained is 0.9789. The value which is approaching one reflected that the predicted time series and observed time series are close to each other. Thus, the modelling through chaotic approach is considered succeed. It is hoped that the model can help Malaysian Meteorological Department and Department of Environment Malaysia in order to improve their weather services.
Geoelectrical Prediction for Sliding Plane Layers of Rotational Landslide at the Volcanic Transitional Landscapes in Indonesia
Authors: Pratiwi E S , Sartohadi J , Wahyudi
Published: June 2019

The transitional between Quaternary and Tertiary volcanic landscapes is characterized by very deep interlayered clays. The the study of clay occurrence at certain depth through geophysical application is not intensively studied yet. Our sampling site is located at Bompon Sub-watershed where the rotational landslide are freqwently occurred. This research aims to investigate the characteristics of clay layer that potentially become sliding surface of landslides using two-dimensional (2D) resistivity method. Resistivity survey using dipole-dipole configration was conducted above three types of rotational slides typically occurred in the study area. We also did field observation as well as laboratory measurement for supporting data interpretation. Three kinds of interlayered clay materials are clearly detectable from 2D resistivity sections under all bodies of landslides. Those materials are entirely categorized as clay but different on cracks structure and cracks density, soil moisture, total porosity, bulk density, and specific gravity. Based on its physical characteristics, the saturated clay located around 10 up to 20 meters in depth is the most likely becoming sliding surface of landslides. This result is useful for understanding the nature of rotational slides commonly occurred in the volcanic transitional landscapes in Indonesia.
The Comparison of Stage and Result Processing of Photogrammetric Data Based on Online Cloud Processing
Authors: Ihsan M , Somantri L , Sugito N T , Himayah S , Affriani A R
Published: June 2019

The development of photogrammetric mapping with UAV mode has been generally used in recent years. One of the technologies development is Cloud-based data processing or using internet. There are two platforms providing facilities of cloud-based processing such as Pix4D and Drone Deploy. This research will be conduct comparison processing result of two platforms in terms of uploading process, total product and horizontal accuracy. The result showed that both platforms had each advantage. The result of Drone Deploy has advantage in term of more accurate coordinate, whereas PIX4D has advantage at completeness in processing reports.
Design and development of integrated savonius and darrieus small scale vertical axis wind turbine for power generation
Authors: Mojica Edison E , Fabay Cian Marvince , Kehinde Felix , Tenorio John Lambert
Published: June 2019

The study focuses on the integration of the darrieus and savonius wind turbine to a vertical axis wind turbine for power generation. The material used for darrieus was fiber glass with three blades and diameter of 350 mm, and polyvinyl chloride (PVC) for the savonius with four blades and diameter of 100 mm. The evaluation was conducted using a controlled wind source to vary its linear wind velocity. The actual power generated was compared to the theoretical power generated to identify the efficiency of the system. With the lowest linear wind velocity of 2.63 meters per second, the actual power output of the system (combination of the darrieus and savonius power output) was 3.79 watts and the theoretical power output is 6.03 watt. This made the system to be 62.85% efficient with low wind velocity. With the highest wind velocity of 12.52 meters per second, the output of the system was 408.80 watts and the theoretical output is 650.61 watts. This made the system to be 62.83% efficient. In an overall performance of the system with varying linear wind velocity, the efficiency of the system is close to 63%.
Determining Water Quality Status in University of Indonesia Depok Campus Lakes with STORET Method
Authors: Adi Haryo Kuntoro , Lestari Fatma , Kholis Noer , Abinawanto  , Abas Saleh , Bowolaksono Anom
Published: June 2019

The University of Indonesia has six artificial lakes around Depok Campus Area, namely Lake Kenanga, Agathis, Mahoni, Puspa, Ulin, and Salam (KAMPUS). These campus lakes have an area of about 17.5 hectares with an average depth varying between 1.5-3 meters with capability store waters up to 52,500 m3 of water. The University of Indonesia has its commitment to observe and evaluate the environmental quality as a part of an environmental monitoring program every semester. The observation data of lake water quality can provide information about parameters which has exceeded the environmental quality standard only, but not for the whole information about its water quality status. STORET Method is the common method which can be used to determine the water quality status. In principle, it compares the data of water quality measurement against national water quality standard appropriate with its purpose to determine the status of water quality. Based on the measurement data from 2017 to 2018, we obtained that Kenanga Lake, Agathis Lake, Ulin Lake, and Salam Lake has A Class quality status and meet the quality standard. However, Mahoni Lake and Puspa Lake are in C Class moderately polluted.
Detection of Pseudo Economic Growth Towards Environmental Damage in Indonesia Using Error Correction Model
Authors: Sumargo Bagus , Fadlilah Ema
Published: June 2019

Economic growth is one of the indicators of economic development. The effort to increase economic growth doesn’t pay attention to the environment be said the pseudo-economic growth. Using GDP per capita and CO2 emissions as indicators of economic growth and environmental damage, this study aims to examine the relationship between them using the Environmental Kuznets Curve (EKC) framework. The EKC hypothesis proposes a turning point at a certain level of economic growth so that sustainable development can be achieved. This study attempts to estimate EKC in the case of Indonesia for the period 1965-2014 by considering the role of fossil energy consumption. The method of analysis used the Error Correction Mechanism (ECM). The result showed that Indonesia is at the early stage of EKC. It indicates that an increase in economic growth leads to an increase of CO2 emissions and has not to reach a turning point. The type of fossil energy that has a positive and significant influence on CO2 emissions is oil.
Slope Stability Analysis for Landslides Natural Disaster Mitigation by Means of Geoelectrical Resistivity Data in Gedangan of South Malang, East Java, Indonesia
Authors: Sunaryo  , Susilo Adi , Yuwono Alamsyah M. , Wiyono
Published: June 2019

A study entitled slope stability analysis for landslides natural disaster mitigation by means of geoelectrical resistivity data in Gedangan of South Malang, East Java, Indonesia has been conducted. This study aims to obtain the physical parameters that cause landslides that occur in Gedangan village, Gedangan sub-district, Malang district. The research was conducted using geoelectrical resistivity method by applying a vertical electrical sounding (VES) model and Wenner-Schlumberger configuration. From the data as a result of field data acquisition, processing and interpretation are carried out to obtain landslide parameters. By merging each vertical electrical sounding (VES) point, physical parameters will be obtained as the basis for local landslide analysis. The results of the cross-sectional line A (GED4-GED1-GED2) indicate the presence of an average slope surface or topography that is relatively parallel with the average slope sliding plane which is about 7° whereas line B (GED1-GED3-GED5) is around 15°. The average thickness of the overlying layer in the slip plane both on line A and line B is around 65m. The slope condition of the slip plane (angle and thickness of the layer) indicates an unstable condition. For stable conditions F> = 1.2, the maximum thickness of the cover layer at line A is 54 m while in line B is 8.2 m. For stable conditions F> = 1.5, the maximum thickness of the cover layer for line A is 25.5 m while in line B is 5.85 m. To overcome the landslide, the proposed solution was by doing a reduction/dredging of the cover layer or installation of the bored piles.
Polymeric Inclusion Membrane (PIM) for Thiocyanate Extraction from Acid-Neutral Solution
Authors: Rumhayati Barlah , Mulyasuryani Ani , Wiryawan Adam
Published: June 2019

Thiocyanate can be found in the gold mine tailing that use cyanide method for gold extraction. Reaction of cyanide ion and sulphuric ion producing thiocyanate in the tailing which enhancing the environmental problem. A new polymeric inclusion membrane (PIM) has been developed to extract thiocyanate from acid to neutral solution. PIM was produced by diluting PVC as base polymer, trioctylamine (TOA) and tetraoctyl methyl ammonium chloride (TOMAC) as carriers, and 1-decanol as plasticizer in tetrahydrofurane (THF) as solvent. Thiocyanate concentration was measured based on the formation of Fe(III)-thiocyanate complex at 457 nm. As a result, thiocyanate could be extracted up to 42% using PIM technique with composition (w/w) 70% PVC, 15% TOMAC as carrier, and 15% 1-decanol as plasticizer. Feed phase was contained of 80 mg/L thiocyanate solution at pH 4. Stripping phase was contained of sodium chloride solution of 1.0 M
Sex and Body Mass Index Modify the Association Between Leptin and Sodium Excretion: A Cross-sectional Study in an African Population
Authors: Schwotzer Nora , Burnier Michel , Maillard Marc , Bovet Pascal , Paccaud Fred , Bochud Murielle , Wuerzner Grégoire
Published: June 2019

BACKGROUND

Renal sodium handling could be a potential mediator linking adipokines to hypertension. The aim of the study was to assess the relationship of leptin with urinary sodium excretion and proximal sodium reabsorption in humans.

METHODS

This cross-sectional study was conducted on participants of hypertensive families from the Seychelles Island. A split urine (daytime and nighttime) collection and plasma leptin were measured. Endogenous lithium clearance was used to assess proximal sodium reabsorption. Mixed multiple linear regression tests adjusted for confounding factors were used.

RESULTS

Three hundred and sixty-five participants (57% women) were included in this analysis. Leptin and adiponectin were higher in women (P < 0.001). Leptin was associated positively with daytime (coefficient [c]: 0.16, standard deviation (SD): 0.03, P < 0.001), nighttime urinary sodium excretion (c: 0.17, SD: 0.04), P < 0.01), daytime lithium clearance (c: 0.40, SD: 0.08, P < 0.001), and nighttime lithium clearance (c: 0.39, SD: 0.10, P < 0.001) after adjusting for sex. The association was lost or mitigated only when BMI was introduced in the model. When BMI was categorized in normal vs. overweight participant, leptin was associated with daytime and nighttime sodium excretion rates (c: 0.14, SD: 0.05, P = 0.011 and c: 0.22, SD: 0.07, P = 0.002, respectively) only in overweight participants.

CONCLUSION

Leptin is associated positively with daytime and nighttime sodium excretion and lithium clearance suggesting a natriuretic rather than a sodium retaining effect of leptin. Sex and body mass index (BMI) are major confounders in this association. These results highlight the importance of sex and obesity in our understanding of the relationships between leptin, blood pressure, and renal sodium handling.
Cerebral Metabolites on the Descending Limb of Acute Alcohol: A Preliminary 1H MRS Study
Authors: Monnig Mollie A , Woods Adam J , Walsh Edward , Martone Christina M , Blumenthal Jonah , Monti Peter M , Cohen Ronald A
Published: June 2019

Choline-containing compounds (Cho) and the summed peak of glutamate and glutamine (Glx) increased in the thalamus on the descending limb of alcohol, relative to baseline. Findings suggest neuroinflammatory and/or compensatory mechanisms in effect during the process of alcohol clearance.
Preserved Calretinin Interneurons in an App Model of Alzheimer’s Disease Disrupt Hippocampal Inhibition via Upregulated P2Y1 Purinoreceptors
Authors: Shi Anqi , Petrache Alexandra L , Shi Jiachen , Ali Afia B
Published: June 2019

To understand the pathogenesis of specific neuronal circuit dysfunction in Alzheimer’s disease (AD), we investigated the fate of three subclasses of “modulatory interneurons” in hippocampal CA1 using the AppNL-F/NL-F knock-in mouse model of AD. Cholecystokinin- and somatostatin-expressing interneurons were aberrantly hyperactive preceding the presence of the typical AD hallmarks: neuroinflammation and amyloid-β (Aβ) accumulation. These interneurons showed an age-dependent vulnerability to Aβ penetration and a reduction in density and coexpression of the inhibitory neurotransmitter GABA synthesis enzyme, glutamic acid decarboxylase 67 (GAD67), suggesting a loss in their inhibitory function. However, calretinin (CR) interneurons—specialized to govern only inhibition, showed resilience to Aβ accumulation, preservation of structure, and displayed synaptic hyperinhibition, despite the lack of inhibitory control of CA1 excitatory pyramidal cells from midstages of the disease. This aberrant inhibitory homeostasis observed in CA1 CR cells and pyramidal cells was “normalized” by blocking P2Y1 purinoreceptors, which were “upregulated” and strongly expressed in CR cells and astrocytes in AppNL-F/NL-F mice in the later stages of AD. In summary, AD-associated cell-type selective destruction of inhibitory interneurons and disrupted inhibitory homeostasis rectified by modulation of the upregulated purinoreceptor system may serve as a novel therapeutic strategy to normalize selective dysfunctional synaptic homeostasis during pathogenesis of AD.
Heritable Gammaproteobacterial Symbiont Improves the Fitness of Brachynema germari Kolenati (Hemiptera: Pentatomidae)
Authors: Kashkouli Marzieh , Fathipour Yaghoub , Mehrabadi Mohammad
Published: June 2019

The pistachio green stink bug, Brachynema germari Kolenati, is an abundant and economic insect pest in most pistachio-growing regions. Some physiological and ecological features of this pest have been studied, but the microbiological nature of symbiotic bacteria and biological aspects of this host–symbiont interaction have been poorly understood. In the present study, we explored the host-associated environment, phylogeny, and acquisition features of the bacterial symbiont of the insect. Furthermore, the importance of the symbiont on the biological (i.e., lifespan, stage composition, and body weight) and behavioral characteristics (i.e., resting/wandering behaviors of the newborn nymphs) of the host were investigated. We found that a rod-shaped gammaproteobacterium was persistently colonized the fourth midgut region of the insect. Molecular phylogenetic and fluorescence in situ hybridization analyses strongly suggest that this symbiont should be placed in the genus Pantoea of the Enterobacteriales. Egg surface sterilization resulted in the aposymbiotic insects suggesting the vertical transmission of symbiont via egg surface smearing upon oviposition. Symbiotic and aposymbiotic B. germari showed no significant differences in the wandering behaviors of the first nymphal stages, whereas the symbiont-free insects exhibited retarded growth, lower longevity, and adult body weight. Taken together, these data provide a better understanding of the relationship between the bacterial symbiont and B. germari and demonstrate that the insect is heavily affected by the deprival of its gut symbionts.
Yeast strainSaccharomyces cerevisiaeBYT45 lacking the cation extrusion systemsENA1-5andNHA1is suitable for the characterization of TASK-3 potassium channel antagonists
Authors: Riedelsberger Janin , Obando Patricia A , Gonzalez Wendy
Published: June 2019

Finding new potential antagonists of potassium channels is a continuing task. TASK potassium channels operate over a large physiological range of membrane voltages, why they are thought to contribute to the excitability and resting potential of mammalian membrane potentials. Additionally, they are regulated by extracellular stimuli like changes in pH and K+ concentrations. TASK malfunctions are associated with diseases, which makes them popular targets for the search of new antagonists. Identification of channel inhibitors can be a time-consuming and expensive project. Here, we present an easy-to-use and inexpensive yeast system for the expression of the two-pore domain K+ channel TASK-3, and for the characterization of TASK-3 antagonists. The Saccharomyces cerevisiae strain BYT45 was used to express guinea pig TASK-3. The system allowed the expression and characterization of TASK-3 at variable pH values and K+ concentrations. Three known TASK-3 antagonists have been tested in the BYT45 yeast system: PK-THPP, ZnCl2 and Bupivacaine. Their inhibitory effect on TASK-3 was tested in solid and liquid media assays, and half maximal inhibitory concentrations were estimated. Although the system is less sensitive than more refined systems, the antagonistic activity could be confirmed for all three inhibitors.
Antibiotic-Containing Agarose Hydrogel for Wound and Burn Care
Authors: Grolman Joshua M , Singh Mansher , Mooney David J , Eriksson Elof , Nuutila Kristo
Published: June 2019

Wound infections cause inflammation, tissue damage, and delayed healing that can lead to invasive infection and even death. The efficacy of systemic antibiotics is limited due to poor tissue penetration that is especially a problem in burn and blast wounds where the microcirculation is disrupted. Topical administration of antimicrobials is an attractive approach because it prevents infection and avoids systemic toxicity, while hydrogels are an appealing vehicle for topical drug delivery. They are easy to apply to the wound site by being injectable, the drug release properties can be controlled, and their many characteristics, such as biodegradation, mechanical strength, and chemical and biological response to stimuli can be tailored. Hydrogels also create a moist wound environment that is beneficial for healing. The purpose of this study was to formulate an agarose hydrogel that contains high concentrations of minocycline or gentamicin and study its characteristics. Subsequently, the minocycline agarose hydrogel was tested in a porcine burn model and its effect as a prophylactic treatment was studied. The results demonstrated that 0.5% agarose in water was the optimal concentration in terms of viscosity and pH. Bench testing at room temperature demonstrated that both antibiotics remained stable in the hydrogel for at least 7 days and both antibiotics demonstrated sustained release over the time of the experiment. The porcine burn experiment showed that prophylactic treatment with the agarose minocycline hydrogel decreased the burn depth and reduced the number of bacteria as efficiently as the commonly used silver sulfadiazine cream.
Descriptions of Two New Species and a New Subspecies of the Genus Ctenophthalmus (Insecta: Siphonaptera: Ctenophthalmidae) from Turkey
Authors: Keskin Adem , Beaucournu Jean-Claude
Published: June 2019

Two new species and a new subspecies of fleas belonging to the genus Ctenophthalmus Kolenati (Siphonaptera: Ctenophthalmidae) were described from Turkey. Ctenophthalmus (Spalacoctenophthalmus) beyzanurae n. sp. was collected from Nannospalax leucodon Nordmann (Mammalia: Rodentia) in Tekirdağ province while Ctenophthalmus (Euctenophthalmus) kefelioglui n. sp. and Ctenophthalmus (Euctenophthalmus) teres anatolicus n. ssp. were collected from Microtus guentheri (Danford & Alston) and Apodemus uralensis (Pallas) (Mammalia: Rodentia) in the Aksaray and Kars provinces of Turkey, respectively. Detailed illustrations of new taxa described were also provided.
Treating Sexual Orientation Obsessions
Authors: Viscusi Jenifer A. , Williams Monnica T.
Published: June 2019

This chapter presents a case study of the treatment of sexual orientation obsessions in obsessive-compulsive disorder (also called SO-OCD or H-OCD for homosexual OCD). The case study includes information about the client background and case conceptualization of a male with upsetting sexual thoughts who was effectively treated using exposure and response prevention by the authors. Included are measures administered, Real-life examples of his exposure hierarchy, and sample imaginal exposures from the case that serve as realistic examples of what treatment may include. Additionally, this chapter includes additional detailed sample ideas of in vivo and imaginal exposures that can be used as part of treatment for SO-OCD for other clients.
Relationship Issues
Authors: Williams Monnica T. , Viscusi Jenifer A. , Wetterneck Chad T.
Published: June 2019

This chapter discusses the impact of sexually themed obsessive-compulsive disorder (OCD) on relationships, with a focus on intimate partners. Discussed is the role of family accommodations on relationships and how OCD can interfere with relationship and marital satisfaction. Included are strategies for therapists surrounding family counseling and interventions that may include partners in the OCD treatment process. A review of common sexual problems associated with OCD is provided, which includes difficulties surrounding impregnating obsessions, sexual orientation obsessions, obsessions surrounding sexual deviance, and contamination fears. Also discussed is the mechanism by which anxiety and depression contribute to sexual difficulties by reducing sex drive. Several medications for OCD can result in sexual side effects, and clients should be warned of these difficulties in advance. Also discussed is how to talk to partners and others about sexual obsessions in OCD. The relationship itself can become an obsessional concern for clients, sometimes called relationship OCD, which may require an approach to treatment that combines OCD-specific cognitive-behavioral approaches and couples therapy.
Introduction to School Attendance Problems in Youth
Authors: Kearney Christopher A.
Published: June 2019

Chapter 1 initially offers the reader a detailed definition and description of the concept of school attendance problems in children and adolescents. The chapter briefly focuses on definitions of key terms, epidemiology, common behaviors and symptoms associated with problematic absenteeism, and short- and long-term outcomes of problematic absenteeism. However, the main focus is on how these characteristics pertain to, and illustrate, the real-life cases seen by the reader. Chapter 1 also includes an overview of the book’s approach and its theoretical basis and mechanisms of action, such as (1) a proactive focus and immediate, effective intervention, (2) frequent progress monitoring, (3) functional behavioral assessment, (4) empirically supported treatment procedures, and (5) a team-based cooperative approach among clinicians, school officials, and family members, especially parents, for implementation.
The Anxious Elementary School Child
Authors: Kearney Christopher A.
Published: June 2019

Chapter 3 is the first of several chapters devoted to the specific treatment guidelines for school attendance problems, with an emphasis on the most common scenarios evident in this population. This chapter focuses on elementary school children who are anxious about school and thus have attendance problems. Chapter 3 includes detailed recommendations for psychoeducation, somatic management techniques, and gradual reintegration into school. The recommendations are tailored to this younger age group and include those circumstances most characteristic of younger children with school attendance problems, such as difficulty with a new school or teacher, increased academic work, transitions between areas of the school, and the school bus. The specific mechanics of each treatment technique are explained at length. Core intervention components and procedures to expand the effectiveness of these core components are covered.
The Anxious Middle/High School Adolescent
Authors: Kearney Christopher A.
Published: June 2019

Chapter 5 focuses on middle and high school youth who refuse school primarily due to anxiety. School attendance problems in middle and high school students are usually much more complicated than in younger students. Part of this is due to the different structure of the school experience, including open campuses, multiple classes and teachers, larger and more chaotic settings, and new and challenging social and academic tasks. As such, school-based anxiety and school disengagement are key threats to attendance in middle and high school. This chapter gives detailed recommendations for psychoeducation, cognitive restructuring, mindfulness, and gradual reintegration into school. Circumstances most characteristic of older children with school attendance problems include difficulty with increased academic challenges, social and performance anxiety, and peer pressure. Core intervention components and procedures to expand the effectiveness of these core components are covered.
The Disengaged Middle/High School Adolescent
Authors: Kearney Christopher A.
Published: June 2019

Chapter 6 focuses on middle and high school youth who are increasingly disengaged from school and who may be pursuing activities outside of school during school hours. Chapter 6 includes detailed recommendations for psychoeducation, family work that can include agreements for problem-solving and enhanced communication, and work with school officials to modify academic requirements in line with a particular youth’s attendance status and potential alternative pathway toward graduation. In addition, frequent consultations between school-based personnel, mental health professionals, and parents are recommended regarding a student’s attendance status, grades, required past and present academic work, and legal and other policies regarding absenteeism. Core intervention components and procedures to expand the effectiveness of these core components are covered.
Provider-Nurse Communication
Authors: Engeln Anna , Giorgio Lippke Hillary
Published: June 2019

This chapter provides an in-depth look at the barriers to achieving accurate and efficient communication in the emergency department setting and examines successful communication tools and strategies. Potential barriers that limit effective communication include environmental, interpersonal, and inadequate communication techniques. These barriers contribute to communication breakdown as well as inaccurate communication between providers and nurses, which can adversely affect patient care. This chapter highlights successful communication techniques to maximize teamwork and collaboration, develop effective communication skills, and systematize communication through the use of standardized communication strategies. Through specific problem-based clinical scenarios, this chapter will demonstrate the application of proven communication strategies to overcome barriers and achieve effective provider-nurse communication in the emergency department.
Communication With Hospital Administration
Authors: McStay Christopher M.
Published: June 2019

Effective communication with hospital administration requires an understanding of the key stakeholders with whom emergency department (ED) staff and leadership might interact. This chapter will outline typical governance structures for hospitals and identify other key hospital leaders with whom ED leadership should maintain relationships and lines of communication. The chapter will also suggest effective internal communication strategies such that communication with hospital leadership is most effective. Finally, through the use of relevant case studies, the chapter will demonstrate how effective communication can lead to solutions to improve patient care. Throughout practical tips to improve effective communication will be emphasized.
The Art of Communication in Meetings
Authors: Jones Melanie
Published: June 2019

Communication, when it’s effective, it’s nearly invisible. When it’s ineffective, it’s a roadblock that quickly becomes impassable. This chapter describes barriers to good communication, including ever-changing contexts, overcomplicating the message, and lack of clarity and consistency. It also discusses the importance of building a cohesive team, establishing a few basic ground rules for effective communication, determining a team’s conflict comfort scale (there are “red zones” and “blue zones,” and this chapter discusses the characteristics of both), avoiding the muddied minefield of “meeting stew,” and identifying meetings by type (among them, administrative, operational, and strategic), and offers specific tips for conducting successful virtual meetings. When is it time to bring in a subject matter expert? Should one attend a virtual meeting in pajamas? How does one engage the people attending one’s meeting and ensure they are ready to act on decisions? Leaders and administrators will benefit from the clear guidelines, relevant strategies, and conversational tone of this discussion.
Dorsal Root Entry Zone Lesioning for Brachial Plexus Avulsion Pain
Authors: Cleary Daniel R. , Ben-Haim Sharona
Published: June 2019

Brachial plexus avulsion is often seen after motorcycle accidents or with high-speed ejection injuries. Rehabilitation focuses on regaining motor and sensory function, but the detrimental effect of pain is often underappreciated. Up to 90% of patients with avulsion injury will experience deafferentation pain, which until relatively recently has been difficult to treat medically or surgically. DREZotomy, the ablation of neurons in the dorsal root entry zone of the spinal cord, was introduced in the 1970s and has since changed how we treat brachial plexus avulsion and other forms of neuropathic pain. The procedure is straightforward: with a standard cervical approach, a hemilamiotomy is used to expose the area of interest. The dura is opened, and areas of root avulsion are identified. Using bipolar cautery, RF ablation, or ultrasound, the 2nd order neurons in dorsal horn are destroyed for the affected dermatomes. Complications include standard cervical spinal approach-related issues, such as infection, hematoma, CSF leak, and kyphosis. Risks specific to the procedure include post-operative motor or sensory deficits, due to the proximity of the corticospinal tracts and the dorsal columns to dorsal horn. As many as 18% of patients report a long-term neurological deficit post-operatively, but despite these complications, 80% of patients say they would repeat the procedure. Multiple outcomes series have been published since the procedure was introduced, and typically 70–80% of patients receive benefit from the procedure.
Percutaneous Cordotomy for Cancer-Associated Pain
Authors: Bercu Marian M. , Shepherd Timothy , Mogilner Alon Y.
Published: June 2019

Percutaneous cordotomy is well-established as a safe and effective treatment of cancer-associated pain. It remains a first-line treatment in countries where more expensive treatments such as implantable neurostimulators and pumps are not routinely available. We present a case report of a patient with metastatic adenocarcinoma of the esophagus and refractory right upper extremity pain, who was successfully treated via percutaneous CT-guided cordotomy. The procedure was completed in an outpatient setting; the patient was discharged after several hours, with immediate pain relief. He continued to benefit from the procedure for several months until he succumbed to his disease. The technique, decision making, complication profile, as well as the existing experience are presented and discussed in detail.
Chronic Lumbar Radiculopathy
Authors: Gill Brian J. A. , Khan Farhan A. , Winfree Christopher J.
Published: June 2019

Failed back surgery syndrome (FBSS), or post-laminectomy syndrome, is a form of chronic lumbar radiculopathy characterized by persistent pain following spinal surgery. When medical management for FBSS fails, three surgical options remain: revision lumbar surgery, spinal cord stimulation (SCS), or intrathecal infusion pump placement. If faced with neurological deficits and correlative compressive lesions, revision lumbar surgery is often indicated. But in the absence of such complications, surgeons and their patients can explore the two latter options. Thus, this chapter will implement a case study to navigate the decision making involved when choosing either SCS or intrathecal infusion pump placement.
Occipital Nerve Stimulation for Chronic Refractory Migraine
Authors: Cheyuo Cletus , Hwang Roy S. , Pilitsis Julie G.
Published: June 2019

Chronic migraine remains disabling for a significant proportion of the population and challenging for medical providers. In addition to pharmacological treatment, peripheral nerve stimulation has been shown to provide satisfactory pain relief and improved quality of life. In this chapter, an illustrative case of occipital nerve stimulation (ONS) for refractory chronic migraine is presented, including the preoperative assessment and planning, decision making process, detailed surgical technique, aftercare and follow-up. A complication and its management are also described and discussed in detail and supplemented with clinical pearls. This discussion is accompanied by a review of the relevant evidence and outcomes from the literature.
Complex Regional Pain Syndrome Diagnosis and Surgical Management
Authors: Hwang Roy S. , Collison Claire , Pilitsis Julie G.
Published: June 2019

The prognosis and treatment of complex regional pain syndrome (CRPS) are for the most part disappointing and there exists few prospective studies in this area. The overall goal of treatment is functional restoration and improved quality of life by desensitization, reactivation, flexibility and strength training, ergonomics, and functional rehabilitation. Here we present a case of a patient with a diagnosis of CRPS type I after an orthopedic procedure and subsequent surgical management of her condition. We review the assessment and management of the patient, aftercare, and complication management. We also briefly review the current literature regarding the functional outcome for the surgical management of CRPS and future directions, including DRG stimulation.
Post-Stroke Intractable Pain
Authors: Njoku Innocent , Pilitsis Julie G.
Published: June 2019

Deep brain stimulation (DBS) has been used as a mode to treat chronic intractable pain by targeting the ventroposterior (VP) thalamus, the periaqueductal gray (PAG), or the anterior cingulate cortex (ACC). The exact underlying mechanism by which these targets produce an analgesic effect remains unclear, but stimulation of the thalamocortical pathways, alteration of thalamic activity, and interference of the pain relay pathway have been postulated as plausible mechanisms. Motor cortex stimulation (MCS) has also been used for the treatment of intractable pain through stimulation of the primary motor cortex. Intermittent electrical stimulation is delivered at thresholds lower than evoking a motor response but adequate enough to provide variable analgesic effects. We present a case to illustrate the diagnostic work-up, surgical technique, complications, and outcomes of (sub)cortical electrical stimulation for central pain syndrome.
Introduction to Fractures
Authors: Deshmukh Swati
Published: June 2019

Skeletal fractures can result from a variety of vector forces (eg, compression, traction, and shear) and injury mechanisms. Common mechanisms of osseous injury include axial loading and compression, avulsion, distraction, bending and torsion, or a combination of these pure force vectors. Chapter 1 discusses basic fracture pathophysiology, including patterns of fracture healing and treatment strategies, as it pertains to fractures of both the axial and appendicular skeleton. There are 3 essential steps in the bone healing process: inflammation, repair, and remodeling and diagnostic tools, such as magnetic resonance imaging (MRI) and computed tomography (CT) are indispensable. Additionally, the chapter reviews appropriate fracture terminology and classification schemes, which should be applied when encountering fractures on imaging studies.
Clavicle Trauma
Authors: O’Keeffe Michael , Khursid Kiran , Munk Peter L. , Taljanovic Mihra S.
Published: June 2019

Chapter 8 discusses clavicle fractures. Clavicle fractures are common and are usually displaced. The frequent rate of injury to the clavicle at various age groups is likely because of early ossification and its superficial anatomical location. Causes of injury include direct impact because of direct fall or blow to the shoulder. Injury from indirect trauma is less common and usually is because of a fall on an outstretched arm. The midshaft of the clavicle is the most common site of fractures. Radiographs are the mainstay of diagnosis, whereas CT examination and MRI can aid in complex or pathologic fractures. Fractures of the clavicle often heal with prominent initial callus formation and subsequent remodeling.
Acromioclavicular Joint Trauma
Authors: O’Keeffe Michael , Khursid Kiran , Munk Peter L. , Taljanovic Mihra S.
Published: June 2019

Chapter 10 reviews acromioclavicular joint trauma. The acromioclavicular (AC) joint represents the articulation between the acromion process and lateral clavicle and is a synovial joint stabilized by 3 ligaments. AC joint injuries are most common in active/athletic young adults. The most common injury is AC joint dislocation sustained during contact sports. This injury usually happens from a fall on an outstretched arm. The degree of separation can be evaluated by radiography and, if needed, CT and MRI. The injury is divided into 6 types by the Rockwood classification based on degree of separation of the acromion from the clavicle.
Glenohumeral Joint Trauma
Authors: O’Keeffe Michael , Khursid Kiran , Munk Peter L. , Taljanovic Mihra S.
Published: June 2019

Chapter 12 discusses glenohumeral joint trauma. The shoulder is one of the most frequently dislocated joints in the body. The glenohumeral joint is ball and socket articulation between the humeral head and scapular glenoid. The humeral head is significantly larger than the glenoid fossa, which predisposes this joint to instability. Anterior shoulder dislocations are more common than those occurring posteriorly, and true inferior dislocations are rare. Bone injuries associated with anterior glenohumeral joint dislocations are the bony Bankart and Hill-Sachs lesions. The diagnosis of dislocation is made on radiographs. CT examination is useful in the evaluation of associated bone lesions and glenoid bone loss. Magnetic resonance arthrography (MRA) is the study of choice in the evaluation of associated glenolabral and rotator cuff injuries. Initial treatment is closed reduction with immobilization and subsequent physical therapy. Surgical treatment is indicated for complicated dislocations with instability.
Hemochromatosis and Wilson Disease
Authors: Vossen Josephina A.
Published: June 2019

Chapter 38 discusses hemochromatosis and Wilson disease. Hemochromatosis is a systemic disease of iron metabolism leading to iron overload, causing organ and joint iron accumulation. This eventually results in tissue damage and organ failure. Wilson disease, also known as hepatolenticular degeneration, is a disorder of copper metabolism that can present with hepatic, neurologic, or psychiatric disturbances. Wilson disease is often fatal if not recognized and treated. Radiography is the standard method for detecting structural changes associated with hemochromatosis arthropathy and Wilson disease. Similar findings are detected with computed tomography. Ultrasound and MRI are not routinely used in diagnosis.
Systemic Lupus Erythematosus
Authors: Vossen Josephina A.
Published: June 2019

Chapter 40 discusses systemic lupus erythematosus (SLE), which is an autoimmune connective tissue disorder with a wide range of clinical features. SLE follows a relapsing and remitting course and predominantly affects women. The clinical manifestations are highly variable, ranging from indolent to fulminant. Arthritis is one of the most common manifestations of SLE. Diagnosis is based on clinical assessment supported by laboratory testing. Imaging of the musculoskeletal system is used primarily for the assessment of symptomatic joints. The initial imaging evaluation of SLE arthropathy is with radiographs of symptomatic joints, usually the hands. Treatment ranges from corticosteroids to immunosuppressive agents.
Degenerative Spondylosis and Related Conditions
Authors: Hoover Kevin B.
Published: June 2019

Chapter 47 discusses degenerative spondylosis and related conditions. Degenerative spondylosis encompasses the universal, age-related change in the intervertebral discs, facet joints, vertebral bodies, and alignment. Although these changes are often detected when imaging for back pain, they are not specific and may not be directly related to symptoms. Imaging is best obtained when signs or symptoms last longer than 6 weeks, there is neuromuscular impairment, or concern for infection or malignancy. MRI is the most sensitive technique to identify the potential causes of back pain. CT is appropriate in the posttraumatic setting when there is a high fracture risk. Conservative management guided by physical therapist is the standard of care in acute back pain.
Benign Osteoid Matrix Bone Tumors
Authors: Datir Abhijit
Published: June 2019

Chapter 52 on benign osteoid matrix bone tumors includes osteogenic (meaning osteoid or bony matrix producing) tumors such as osteoid osteoma and osteoblastoma. Osteogenic lesions, or those that form osteoid matrix, are most commonly benign. Enostoses and osteomas are incidentally detected. Osteoid osteomas and osteoblastomas often produce pain and deformity. Important imaging findings that are essential for diagnosis of these entities are discussed with typical examples using radiographs, CT, and MRI. In many cases, imaging can be helpful to direct definitive therapies, such as radiofrequency ablation. A concise discussion on treatment options has also been included.
Benign Chondroid Matrix Bone Tumors
Authors: Levine Benjamin D. , Seeger Leanne L.
Published: June 2019

Chapter 54 discusses benign chondroid matrix bone tumors, which are the most common benign primary bone tumors. They include osteochondroma, enchondroma, periosteal chondroma, chondroblastoma, and chondromyxoid fibroma. Osteochondromas are bony exostoses that are the most common benign bone tumor in all ages. Most of these neoplasms have characteristic imaging features that can allow accurate diagnosis. Radiography is the mainstay modality of choice for initial workup. MRI and CT can provide increased diagnostic confidence and accuracy, and have become essential tools that guide clinical management of the benign cartilage bone tumors. Treatment can be surgical, including bone grafting, or with radiofrequency ablation.
Benign Fibrous Matrix Bone Tumors
Authors: Song Albert
Published: June 2019

Chapter 56 discusses benign fibrous matrix lesions of bone, which are a group of tumor and tumorlike conditions with overlapping imaging characteristics. These lesions include entities such as benign fibrous histiocytoma, nonossifying fibroma, fibrous dysplasia, osteofibrous dysplasia, and desmoplastic fibroma. Most benign fibrous tumors of bone are highly characteristic when considering clinical presentation and appearance on radiography. These lesions do not generally require treatment, although pathologic fracture, mechanical deformities, and size progression are indications for intervention. Benign lesions can be polyostotic and can be associated with syndromes. This chapter will review demographics, multimodality imaging features, differential diagnoses, and clinical management of benign fibrous bone lesions.
Benign Vascular Bone Tumors
Authors: Stacy G. Scott
Published: June 2019

The classification of vascular tumors of the skeleton can be thought of as a spectrum of disease including both benign and malignant entities. Chapter 60 focuses on the benign entities, hemangioma and epithelioid hemangioma. The term hemangioma refers to a collection of blood vessels and vascular spaces, perhaps better classified as a slow-flow vascular malformation. Epithelioid hemangioma is a rare and controversial entity that may be confused with its malignant counterpart, the epithelioid hemangioendothelioma. This chapter will describe the clinical, pathophysiological, and imaging features of these benign vascular bone tumors, with a brief mention of treatment strategies. Familiarity with the imaging appearances and characteristics of these entities is essential in order to guide clinical management and to avoid unnecessary investigation into clearly benign lesions.
Metastatic Disease
Authors: McCann Stephanie , Thomas Stephen
Published: June 2019

Chapter 63 discusses metastatic disease. Metastatic disease from carcinomas accounts for approximately 70% of malignant tumors involving the skeleton. The most common primary tumors that metastasize to bone are prostate and breast carcinomas and are termed osteotropic. Other tumors with a propensity for skeletal metastasis include lung, renal, bladder, thyroid, and lymphomas. Prostate, breast, renal cell, and lung carcinomas account for up to 80% of skeletal metastases. Patients with metastatic bone lesions may be asymptomatic or may present with localized bone pain, pathologic fracture, neurologic impingement, or an associated soft tissue mass. Imaging plays an important role in detection, diagnosis, prognosis, planning, and treatment response of metastatic bone lesions. This chapter focuses on imaging strategies to detect and characterize metastatic osseous lesions from malignant tumors.