bluuebunny/crossref_metadata_2025 huggingface dataset:
The “Shifting Line” of Sports Betting Legalization
Authors: Wallach Daniel L.
Published: October 2017

This chapter examines the growing and transformative body of law governing sports betting, with a special emphasis on the Interstate Wire Act of 1961 and the Professional and Amateur Sports Protection Act of 1992, the two principal federal laws addressing sports betting. The provisions of PASPA, in particular, will serve as a launch point to a discussion of the true driver behind current efforts to legalize sports betting in the United States: the recent litigation pitting the State of New Jersey against the four major U.S. professional sports leagues and the National Collegiate Athletic Association. This chapter features an in-depth examination of the New Jersey case and explains how court rulings have opened a variety of pathways for states to legalize sports betting and, at a minimum, have compressed the time frame for federal action to repeal or amend PASPA.
Afterword
Authors: Agras W. Stewart , Robinson Athena
Published: October 2017

This chapter reflects on core themes raised within this Handbook, which collectively reflect the state of the science in the eating disorder field. Such themes include the growing recognition of the complexity of eating disorders including their etiological underpinnings and the contributions of basic sciences to an understanding of processes underlying the expression of maladaptive eating patterns. The status of the prevention and treatment of these disorders as reflected in the literature to date is considered with questions raised about future progress. Looking toward the future, new technologies may offer opportunities to bring cost-effective evidence-based treatments to underserved populations. However, such opportunities bring with them new ethical and practical considerations. Also highlighted are potential areas for further research.
Violence, Insurgency, and the End of Empires
Authors: Thomas Martin
Published: October 2017

There are three macro-level actors typically identified in the connection between contested decolonization, escalating levels of violence, and shrinking civilian spaces: the imperial authorities that resisted pressure to withdraw, settler populations wedded to white minority rule, and the anti-colonial nationalist groups determined to impose social control. This chapter discusses how reductive explanations of this type begin to unravel as soon as the forms of violence practised are explored. It is not that political struggles between imperialists and their opponents were irrelevant to violence and the ends of empire, but instead to indicate that violence in the late colonial world was rarely as binary as fighting “for” or “against” empire. There are multiple reasons for this violence, most being directly related to social standing, but remote from any unifying decolonization narrative. The most proximate of all was holding civilian status—a category whose juridical fragility was matched by its spatial insecurity.
Star Performers
Authors: O'Boyle Ernest , Kroska Sydney
Published: October 2017

Stars are elite performers who either exhibit exceedingly high quantities of output or produce output not easily substituted by good or even very good workers. Although star performers have always existed, relatively recent changes in the workforce and economy may be leading to a substantial increase in not only their production but also their frequency. As a result, both academics and practitioners are progressively recognizing the importance of stars to individuals, teams, organizations, and even entire industries. The purpose of this chapter is to introduce the theoretical and empirical work surrounding stars, to distill what is known and unknown, and what is fact and what is myth, and to outline the direction of current and future research.
How is Technology Changing Talent Management?
Authors: O'Shea Patrick Gavan , Puente Kerrin E.
Published: October 2017

Technological advances have touched nearly every aspect of human life in recent decades, including the world of work. This chapter provides an overview of how these advances have specifically affected talent management. Organized around the primary elements of the talent-management lifecycle (identifying talent, acquiring talent, developing talent, and evaluating talent), each section provides a summary of current research findings and practice trends, examples illustrating those trends, and questions to guide future research. Several themes cut across these sections, including (1) the potential for technology to help individuals to identify, grow, and manage their talent in a more proactive ways, (2) the increasing use of engaging simulations for recruitment, selection, and developmental purposes, and (3) the need for systematic research to investigate the many intriguing questions raised by technology’s dramatic influence throughout the talent-management field.
Managing talent Flows Through Internal and External Labor Markets
Authors: Bidwell Matthew
Published: October 2017

This chapter examines talent management through the lens of worker flows, emphasizing the interdependence between staffing decisions across jobs and over time. It reviews existing theories on how people flow across jobs within and across organizations, as well as how organizations balance those internal and external flows in staffing jobs. Although different theories have generally been used to analyze internal and external mobility, I note that organizations are using increasingly market-like structures to manage internal moves, while research is also revealing increasing amounts of structure in flows of workers across organizations. I also argue that studies continue to highlight the substantial benefits that organizations receive from staffing jobs through internal rather than external mobility, despite increases over time in outside hiring.
Stars that Shimmer and Stars that Shine
Authors: Morris Shad , Oldroyd James
Published: October 2017

Stars are not only much higher performing than their peers, but also much more visible within the firm. Star employees are likely to be sought out by their lower-performing peers. Moreover, high visibility and frequent interaction make it likely that the stars will develop abundant social capital. Thus, they are relied on to develop information advantage through their social capital. However, not all of the information effects of stardom are beneficial. Stars’ abundant social capital may produce the unintended side effect of information overload. We highlight the role of talent management in mitigating these information-overload effects for stars, to allow them to shine.
Trade Marks and Allied Rights
Authors: Gangjee Dev
Published: October 2017

This chapter outlines the principal features of trade mark protection regimes, drawing primarily on EU and US materials to illustrate the underlying legal issues. It includes an outline of the principal allied rights; namely (i) unfair competition, (ii) passing off, (iii) publicity rights, (iv) geographical indications, and (v) domain names. The overview traces the incremental re-orientation of trade mark regimes in recent decades as they have moved beyond their traditional remit of origin-indication protection in response to claims that brand image needs to be better accommodated. In some cases, the ensuing broader scope of protection can have a detrimental impact on speech and inhibit marketplace competition.
Modifying Behaviour Therapy to Meet the Challenge of Treating Borderline Personality Disorder
Authors: Wolbert Randy
Published: October 2017

Dialectical Behaviour Therapy can be conceptualized as the transaction between behaviour therapy and Zen contemplative practice, held together with a dialectical philosophy. When first developed, mindfulness practices had not yet been incorporated into psychotherapy. Marsha Linehan chose to augment behaviour therapy with Zen practice. This chapter begins with a brief history of Zen and discusses the need for an acceptance-based practice to balance behaviour therapy within the treatment. It describes the Zen beliefs contained in the four noble truths and precepts, and how these translate into the principles and practice of Zen. It then considers both the differences between and compatibility of Zen and behaviour therapy. Finally, it discusses how Zen practice modifies behaviour therapy in DBT. Most of the stories and anecdotes are from Linehan’s Zen Dharma talks given during her Zen Sessions held over the past ten years.
Dialectical Behaviour Therapy from 1991–2015
Authors: Miga Erin M. , Neacsiu Andrada D. , Lungu Anita , Heard Heidi L. , Dimeff Linda A.
Published: October 2017

Dialectical Behaviour Therapy (DBT) is an internationally recognized evidence-based treatment for adults and adolescents reporting multiple problem behaviours related to emotion dysregulation. For clinical interventions, particularly DBT, the randomized controlled trial (RCT) is recognized as the ‘gold standard’ approach to testing effectiveness and efficacy. However, RCTs vary greatly in the rigorousness of research conducted. RCTs assessing DBT’s effectiveness have proliferated since the first published trial in 1994. DBT has been tested for diverse clinical presentations, in different formats, and focused on a variety of outcomes. The plethora of RCT research conducted, which vary in research design, clinician training and adherence among other factors, can make a clear interpretation of findings difficult. As a result, it can be unclear what is known about the effectiveness of DBT, and what is not. This review provides a summary and comprehensive critique of DBT RCTs to date, evaluates research quality assurance, and aims to identify and refine the current knowledge on DBT efficacy and effectiveness, along with areas of future research.
Visibility, Privacy, and Missing Windows
Authors: Shepperson Mary
Published: October 2017

This chapter examines the means by which light was admitted to Mesopotamian domestic space, arguing that doorways were the primary light source for most rooms. The consequences of this are then discussed, including the accessibility of lighting to archaeological study through recovered floor plans, and the impact which a reliance on doorway lighting may have had on the development of ancient Mesopotamian architecture. The interrelationship of lighting, access, and privacy in doorway-lit architecture is then considered, illustrated with examples of light distribution through excavated Mesopotamian houses. The lighting of domestic chapels and reception rooms are analysed in relation to their cultic and social functions, showing that access and lighting combine to create space which is suited to its use and meaning.
Light and its Interaction with Antiquities and Works of Art
Authors: Kotoula Eleni
Published: October 2017

This chapter addresses issues related to light–object interaction along with its resulting phenomena, taking into consideration materiality issues. It presents light and its role in artefacts studies, either as a tool for finds analysis or as a corrosion agent. It attempts a balanced investigation into past and contemporary approaches towards light from the conservator’s perspective. It discusses traditional raking and oblique light examination, along with its advanced digital analogue, Reflectance Transformation Imaging (RTI), which bridges the gap between digital photography and three-dimensional modelling. Applications of dome and/or Highlight RTI in a wide variety of material and artefact types, as well as in a wide range of conservation states, using macroscopic and microscopic means, indicate that the technique contributes considerably in prevention, investigation, examination and analysis, documentation, communication, dissemination, and presentation, as well as being a conservation monitoring tool.
Aristotle on the Love of Friends
Authors: Badhwar Neera K. , Jones Russell E.
Published: October 2017

On Aristotle’s account of philia in the Nicomachean Ethics, friends who love each other because of their virtue rather than their incidental properties are most fully friends, because they love each other for who they really are. Alongside his picture of ideal virtue, Aristotle offers a realistic account on which people can develop virtue to varying extents and in different domains. His character friends are good but imperfect people who love each other for the specific way virtue takes shape in their lives, share interests and delight in each other’s company, bring out the best in each other, and pursue each other’s good for the other’s own sake. If one brackets his faulty conception of female nature, his account of moral development allows a character friendship of equals between husbands and wives, even in societies where women’s opportunities are severely limited.
Schopenhauer on Love
Authors: Ellis Fiona
Published: October 2017

Schopenhauer acknowledges that there is more to erotic desire than egoism, and he is anxious to distinguish it from generalized appetite. Ultimately, however, we find him paying lip service to the beloved’s “irreplaceability” only to put forward views that are ultimately in tension with it. His conception of agape is likewise problematic, and it is here that the question of asceticism comes to the fore. In what sense, if any, does asceticism involve life-denial or self-denial? What is its relation to agape? And are there any reasons why the genuine lover must pursue this path? This chapter concludes that there are such reasons, but that they can be properly articulated only within a framework that takes us beyond Schopenhauer’s official position. Schopenhauer’s relation to theism remains unclear, but the chapter shall have scotched any suggestion of an uncompromising atheism.
Love as “Something in Between”
Authors: Jollimore Troy
Published: October 2017

Many philosophical accounts of love hold that love is a thoroughly arational phenomenon, that it is not a response to value, or that we do not love for reasons. This chapter argues these accounts are mistaken: when we love we are typically responding to positive qualities of the beloved, and in rendering our love appropriate and intelligible these qualities provide reasons for love. However, the role of reasons in love is highly complex. This is, in part, because love’s reasons are nondeontic: love is never rationally required, no matter how many positive qualities a person may possess or how positive they may be. Although we love for reasons, there is a sense in which when we love we go beyond our reasons. Love is neither thoroughly arational nor pervasively rational; it is “something in between.”
Fetal, Neonatal, and Early Infant Experiences of Maternal Singing
Authors: Woodward Sheila C.
Published: October 2017

Singing has its beginnings before birth in the fetal experience of the maternal singing voice. The nature of this form of human musical communication is highlighted against speculation that music may have evolved through mother–infant interactions. This chapter presents an overview of selected research on fetal, neonatal, and infant auditory response to and experience of maternal singing. This includes characteristics of maternal infant-directed singing and the maternal–infant bonding inherent in maternal singing. The discussion in this chapter rests on theories of early artistic intelligence and learning that go beyond goals of survival, problem solving, object use, or language acquisition, to include “the biological phenomenon of love”. The suggestion is that communicative expressions between mother and infant involve sympathetic responses that occur through delicate expressions and sensitive awareness that supersede perceptive and discriminatory processes.
Good Enough for Government Work
Authors: Jones Arnita
Published: October 2017

Government-supported history is as broad and many faceted as the field of public history itself, including not only research and public programming in museums and historic sites but also client-oriented research in the executive, legislative, and military branches of government. This chapter focuses on the work of historians who help to solve problems and provide context for the ongoing work of government agencies and institutions. Serving policy and decision makers, they capture and preserve records, artifacts, and other historical materials; they write institutional histories and policy analysis and they help answer inquiries from citizens and journalists about the work of government. Historians who do this work may be permanent government employees, but they may also be contractors for government agencies, serve as researchers and writers for independent government commissions, or staff special government-funded projects housed at educational and nonprofit institutions.
Public History, Cultural Institutions, and National Identity
Authors: Warren-Findley Jannelle
Published: October 2017

Public surveys in Anglophone countries suggest that many individuals learn most of their history from family or cultural institutions, rather than from reading scholarship or sitting in classrooms. As histories of silenced groups, forgotten tribes, and ignored communities gain a place in the contemporary narrative of national histories, we must explore the methods and assumptions used by those who created the intellectual and legal frameworks that determine who in the past were represented as historical players and why others were not. Analyzing public policy documents can help us understand the cultural assumptions underlying historic preservation decisions. Modifying or rethinking those assumptions entirely can permit us to “dialogue across difference” and work for inclusive cultural identities in our public places.
National Museums, National Narratives, and Identity Politics
Authors: Lleras Cristina
Published: October 2017

The purpose of this chapter is to examine the surge of identity politics and the diversification of heritage and the tensions that arise with the traditional role of national museums that are expected to support the model of a unitary national identity through their narratives and collections. Engaging with distinct patrimonies and transformations in museums checkmates stagnant notions of heritage, but in turn, these actions might also instigate resistance to change. A case study at the National Museum of Colombia will provide an insight into competing notions of heritage, which can be understood as the relics of a material past, but may also be seen as the meanings created about the past. This analysis instigates thoughts about the role that history and historians might play in the elaboration of narratives of identity.
Brownfield Public History
Authors: High Steven
Published: October 2017

How can we as oral and public historians harness the power of place in our research and interpretive practice? The built environment’s potential as a prompt to remember has been heralded by many scholars drawn to the so-called mobility turn in the social sciences and humanities. This new paradigm is encouraging scholars and artists to engage with the materiality of the built and natural environments and with communities themselves. This chapter examines the ways in which oral and public historians have harnessed the power of place in situ when interpreting transformative urban and economic change: deindustrialization, gentrification, modernization, and renewal. It offers the notion of “brownfield public history” to denote industrial heritage projects that are bound-up in these ongoing socio-economic and political processes.
Slavery Tourism
Authors: Holsey Bayo
Published: October 2017

This chapter presents a case study of the slavery tourism industry in Ghana, tracing its development and noting some of the struggles it has faced. Based around the dungeons in the Cape Coast and Elmina castles used to warehouse slaves bound for the Atlantic trade, Ghana’s slavery tourism industry emerged in the 1990s through complex negotiations among different interested parties. The chapter notes in particular the disjuncture between Ghanaian understandings of the history of the slave trade and that of international and especially African American tourists. It also critiques the tourism industry’s focus on the triumph over slavery and considers the ways in which such an emphasis forecloses the possibility of a more radical interpretation of history. Finally, it places Ghanaian slavery tourism within the broader context of a global public history of slavery.
Archives for Justice, Archives of Justice
Authors: Peterson Trudy Huskamp
Published: October 2017

Over the past decade, professionals working to reform justice systems and reestablish the rule of law in countries that previously had repressive regimes developed a framework for thinking about the demands that arise for dealing with the brutal heritage of government repression. The framework has four parts: holding perpetrators accountable, ensuring that there is no recurrence by reforming institutions and vetting personnel, seeking the truth of what happened to individuals and to the society as a whole, and obtaining reparation for the harm done, personally or collectively. Each of these demands can be met through various mechanisms, but all of them depend on archives. Rebuilding the justice sector and the nation through access to archives is a vital element in coming to terms with the past. The role of archivists as duty bearers for human rights is increasingly important.
Motivational Interviewing and Motivational Interactions for Health Behavior Change and Maintenance
Authors: McNeil Daniel W. , Addicks Sarah H. , Randall Cameron L.
Published: October 2017

Motivational interviewing (MI) is a patient-centered and collaborative approach to clinical care (Miller & Rollnick, 2013). This narrative review describes MI and then concentrates on evidence for its use with patients to help enhance health behaviors in a variety of settings. Because of the proliferation of research in the area, this overview necessarily is selective. This review focuses on some of the most common chronic health behavior problems, such as those associated with obesity, oral hygiene behavior, and chronic disease management. Additionally, motivational interactions (MIACTs), which are spoken and nonverbal communications from health professionals with patients, are proposed as very brief communications that are based on MI spirit and other MI principles. These MIACTs may promote positive interactions between patients and providers, enhance patient satisfaction with healthcare, and help to establish rapport, even when the time available for healthcare interactions does not allow a true implementation of MI.
Follow-up observations for the Asteroid Catalog using AKARI Spectroscopic Observations
Authors: Hasegawa Sunao , Kuroda Daisuke , Yanagisawa Kenshi , Usui Fumihiko
Published: October 2017

In the 1–2.5 μm range, spectroscopic observations are made on the AcuA-spec asteroids, the spectra of which were obtained in a continuous covered mode between 2.5–5.0 μm by AKARI. Based on the Bus–DeMeo taxonomy (DeMeo et al. 2009, Icarus, 202, 160), all the AcuA-spec asteroids are classified, using both published and our observational data. Additionally, taking advantage of the Bus–DeMeo taxonomy characteristics, we constrain the characteristic of each spectral type by combining the taxonomy results with the other physical observational data from colorimetry, polarimetry, radar, and radiometry. As a result, it is suggested that certain C-, Cb-, B-type, dark X-, and D-complex asteroids have spectral properties compatible with those of anhydrous interplanetary dust particles with tiny bright material, such as water ice. This supports the proposal regarding the C-complex asteroids (Vernazza et al. 2015, ApJ, 806, 204; 2017, AJ, 153, 72). A combination of the Bus–DeMeo taxonomy for AcuA-spec asteroids with other physical clues, such as the polarimetric inversion angle, radar albedo, and mid-infrared spectroscopic spectra, will be beneficial for surface material constraints from the AcuA-spec asteroid observations.
Managing chest pain in patients with concomitant left bundle-branch block
Authors: Wyant Andrew , Chatterjee Somu , Bennett Tamara
Published: October 2017

Diagnosis and timely management of acute myocardial infarction (MI) relies heavily on the ST-segment elevation sum. Presence of concomitant left bundle-branch block (LBBB) in patients presenting with possible acute MI presents a diagnostic dilemma. The LBBB pattern distorts ST-segment changes, delaying or preventing accurate diagnosis. This article reviews the Sgarbossa criteria and ST/S ratio and presents a treatment algorithm that may help improve patient care and reduce morbidity and mortality.
Red Cell Distribution Width After Subarachnoid Hemorrhage
Authors: Fontana Vito , Bond Ottavia , Spadaro Savino , Annoni Filippo , Nobile Leda , Badenes Rafael , Volta Carlo A. , Vincent Jean-L. , Creteur Jacques , Taccone Fabio S.
Published: October 2017

Background:

High red cell distribution width (RDW) values have been associated with increased hospital mortality in critically ill patients, but few data are available for subarachnoid hemorrhage (SAH).

Methods:

We analyzed an institutional database of adult (>18 y) patients admitted to the Department of Intensive Care after nontraumatic SAH between January 2011 and May 2016. RDW (normal value, 10.9% to 13.4%) was obtained daily from admission for a maximum of 7 days, from routine blood analysis. We recorded the occurrence of delayed cerebral ischemia (DCI), and neurological outcome (assessed using the Glasgow Outcome Scale [GOS]) at 3 months.

Results:

A total of 270 patients were included (median age 54 y—121/270 male [45%]), of whom 96 (36%) developed DCI and 109 (40%) had an unfavorable neurological outcome (GOS, 1 to 3). The median RDW on admission was 13.8 [13.3 to 14.5]% and the highest value during the intensive care unit (ICU) stay 14.2 [13.6 to 14.8]%. The RDW was high (>13.4%) in 177 patients (66%) on admission and in 217 (80%) at any time during the ICU stay. Patients with a high RDW on admission were more likely to have an unfavorable neurological outcome. In multivariable regression analysis, older age, a high WFNS grade on admission, presence of DCI or intracranial hypertension, previous neurological disease, vasopressor therapy and a high RDW (OR, 1.1618 [95% CI, 1.213-2.158]; P=0.001) during the ICU stay were independent predictors of unfavorable neurological outcome.

Conclusions:

High RDW values were more likely to result in an unfavorable outcome after SAH. This information could help in the stratification of SAH patients already on ICU admission.
Effect of Caregiver Training on the Neurodevelopment of HIV-Exposed Uninfected Children and Caregiver Mental Health: A Ugandan Cluster-Randomized Controlled Trial
Authors: Boivin Michael J. , Nakasujja Noeline , Familiar-Lopez Itziar , Murray Sarah M. , Sikorskii Alla , Awadu Jorem , Shohet Cilly , Givon Deborah , Ruiseñor-Escudero Horacio , Schut Elizabeth E. , Opoka Robert O. , Bass Judith K.
Published: October 2017

Objective:

Early childhood development programs typically combine healthy nutrition and cognitive stimulation in an integrated model. We separately delivered these 2 components in a cluster-randomized controlled trial to evaluate their comparative effectiveness in promoting healthy child development and caregiver mental health. This is the first study to do so for HIV-affected children and their infected mothers.

Methods:

Two hundred twenty-one HIV-exposed but uninfected child (2–3 years old) and caregiver dyads in 18 geographic clusters in Eastern Uganda were randomized by cluster to receive biweekly individualized sessions of either (1) Mediational Intervention for Sensitizing Caregivers (MISC) training emphasizing cognitive stimulation or (2) Uganda Community Based Association for Child Welfare (UCOBAC) program that delivered health and nutrition training. Children were evaluated at baseline, 6 months, 1 year (training conclusion), and 1-year posttraining with the Mullen Scales of Early Learning (MSEL), the Color-Object Association Test for memory, the Early Childhood Vigilance Test of attention, and the Behavior Rating Inventory of Executive Function (BRIEF-parent). The Caldwell Home Observation for the Measurement of the Environment (HOME) was completed by observers to gauge caregiving quality after training. Caregiver depression/anxiety (Hopkins Symptom Checklist-25) and functionality (list of activities of daily living) were also evaluated. Data collectors were blinded to trial arm assignment.

Results:

Mediational Intervention for Sensitizing Caregivers resulted in significantly better quality of caregiving compared with UCOBAC midintervention with an adjusted mean difference (MadjDiff) of 2.34 (95% confidence interval [CI]: 1.54–3.15, p < .01), postintervention (MadjDiff = 2.43, 95% CI: 1.61–3.25, p < .01), and at 1-year follow-up (MadjDiff = 2.07, 95% CI: 1.23–2.90, p < .01). MISC caregivers reported more problems on the BRIEF for their child at 1-year posttraining only (p < .01). Caregiving quality (HOME) was significantly correlated with MSEL composite performance 1-year posttraining for both the MISC and the UCOBAC trial arms. Likewise, physical growth was significantly related to child development outcomes even though it did not differ between trial arms.

Conclusion:

Even though MISC demonstrated an advantage of improving caregiving quality, it did not produce better child cognitive outcomes compared with health and nutrition training.

Trial Registration:

clinicaltrials.gov Identifier: NCT01640561.
A New Prediction Model for Local Recurrence After Curative Rectal Cancer Surgery: Development and Validation as an Asian Collaborative Study
Authors: Hida Koya , Okamura Ryosuke , Park Soo Yeun , Nishigori Tatsuto , Takahashi Ryo , Kawada Kenji , Choi Gyu-Seog , Sakai Yoshiharu
Published: October 2017

BACKGROUND:

Local recurrence is one of the remaining problems in rectal and rectosigmoid cancer, and it is sometimes difficult to treat.

OBJECTIVE:

This study aimed to explore various factors that are highly related to local recurrence and to develop a new prediction model for local recurrence after curative resection.

DESIGN:

This is a retrospective cohort study

SETTINGS:

This study was conducted at 2 academic hospitals in Japan and Korea.

PATIENTS:

A total of 2237 patients with stage I to III rectal and rectosigmoid cancer who underwent a curative operation with a negative circumferential margin were selected.

INTERVENTIONS:

Surgical treatment was the intervention.

MAIN OUTCOME MEASURES:

Local recurrence was the primary outcome measure.

RESULTS:

A total of 1232 patients were selected, and rectosigmoid cancer with rare local recurrence (2/221) was excluded. A different set of 792 patients with rectal cancer were chosen for validation. Multivariate analysis showed the following factors as significant for local recurrence: poorly differentiated tumor (HR, 11.2; 95% CI, 4.5–28.0), tumor depth (HR, 5.0), lymph node metastasis (HR, 4.1), operative procedure (HR, 3.2), postoperative complications (HR, 2.9), tumor location (HR, 2.6), and CEA level (HR, 2.4); a new prediction score was created by using these factors. A poorly differentiated tumor was assigned 2 points, and all other factors were assigned 1 point each. Patients who scored more than 5 points (n = 21) were judged as “high risk,” with a 2-year local recurrence rate of 66.5%. The new predictive model could also separate the patients into different risk groups in the validation set. The high-risk group had higher recurrence rates than medium- and low-risk groups (2-year local recurrence rate: 41%, 15%, and 2.1%).

LIMITATIONS:

This study was limited by its retrospective nature and potential for selection bias.

CONCLUSIONS:

Seven factors were shown to be significantly correlated with the local recurrence of rectal cancer, and the usefulness of this new prediction model was demonstrated. See Video Abstract at http://links.lww.com/DCR/A429.
Long-term Deleterious Impact of Surgeon Care Fragmentation After Colorectal Surgery on Survival: Continuity of Care Continues to Count
Authors: Justiniano Carla F. , Xu Zhaomin , Becerra Adan Z. , Aquina Christopher T. , Boodry Courtney I. , Swanger Alex , Temple Larissa K. , Fleming Fergal J.
Published: October 2017

BACKGROUND:

Surgical care fragmentation at readmission impacts short-term outcomes. However, the long-term impact of surgical care fragmentation is unknown.

OBJECTIVE:

The purpose was to evaluate the impact of surgical care fragmentation, encompassing both surgeon and hospital care, at readmission after colorectal surgery on 1-year survival.

DESIGN:

This was a retrospective cohort study.

SETTING:

The study included patients undergoing colorectal resection in New York State from 2004 to 2014.

PATIENTS:

Included were 20,016 patients undergoing colorectal resection who were readmitted within 30 days of discharge and categorized by source-of-care fragmentation. Each readmission was classified by the source of fragmentation: readmission to the index hospital and managed by another provider, readmission to another hospital by the index surgeon, and readmission to another hospital by another provider. Patients readmitted to the index hospital and managed by the index surgeon served as controls.

MAIN OUTCOME MEASURES:

One-year overall survival and 1-year colorectal cancer-specific survival were the outcomes measured.

RESULTS:

After propensity adjustment, surgeon care fragmentation was independently associated with decreased survival. In comparison with patients without surgical care fragmentation (patients readmitted to the index hospital and managed by the index surgeon), patients readmitted to the index hospital and managed by another provider had over a 2-fold risk (HR, 2.33; 95% CI, 2.10–2.60) and patients readmitted to another hospital by another provider had almost a 2-fold risk (HR, 1.91; 95% CI, 1.63–2.25) of 1-year mortality. Among 9545 patients with a colorectal cancer diagnosis, surgical care fragmentation was once again associated with decreased survival with patients readmitted to the index hospital and managed by another provider having a HR of 2.12 (95% CI, 1.76–2.56) and patients readmitted to another hospital by another provider having a HR of 1.57 (95% CI, 1.17–2.11) compared with patients readmitted to the index hospital and managed by the index surgeon.

LIMITATIONS:

Limitations include possible miscoding of data, retrospective design, and selection bias.

CONCLUSIONS:

After accounting for patient, index hospital, index surgeon, and readmission factors, there is a significant 2-fold decrease in survival associated with surgeon care fragmentation regardless of hospital continuity. See Video Abstract at http://links.lww.com/DCR/A431.
Patient-Reported Outcomes following Split-Face Injection of 2 Volumizing Fillers in the Upper Cheeks
Authors: Prager Welf , Agsten Karla , Kerscher Martina
Published: October 2017

Background:

Patient-reported outcomes are important measures when assessing the efficacy of aesthetic procedures.

Objective:

To compare outcomes between 2 volumizing hyaluronic acid fillers.

Materials and Methods:

Subjects with moderate-to-severe volume loss in the cheeks were randomized in a split-face design to malar enhancement with Cohesive Polydensified Matrix 26 mg/ml HA (CPM-26) and Vycross 20 mg/ml HA (VYC-20). The same injection technique and injection volume were applied for both sides of the face. Anesthetics, overcorrection, and touch-ups were not permitted. Blinded subjects assessed aesthetic improvements using the Global Aesthetic Improvement Scale and treatment satisfaction by confirming their willingness to repeat treatment or recommend it to friends. Follow-up was 18 months.

Results:

A total of 45 subjects received a single 2 mL injection of CPM-26 on one side and VYC-20 on the contralateral side of the face. The proportion of subjects reporting improvement on the Global Aesthetic Improvement Scale compared with baseline for CPM-26 and VYC-20 was 97.7% and 88.6%, respectively, at 3 months, 73.8% and 71.1% at 12 months, and 61.0% and 56.7% at 18 months. Treatment satisfaction was high, with the majority of subjects stating that they would repeat treatment and recommend it to friends, but at each time point, a higher proportion of subjects was more satisfied with the CPM-26-treated side of the face.

Conclusions:

In this first direct comparison of CPM-26 and VYC-20, the majority of subjects were satisfied with both treatments throughout the study. Patient-reported outcome measures identified a trend in favor of CPM-26.
Preliminary Study of PGA Fabric for Seromas at Latissimus Dorsi Flap Donor Sites
Authors: Itani Yoshihito , Hagiwara Akeo , Hashimoto Takahiro , Isogai Noritaka , Kusuhara Hirohisa
Published: October 2017

Background:

Seroma formation is a major complication following latissimus dorsi (LD) flap transfer for breast reconstruction. We implanted a nonwoven polyglycolic acid (PGA) fabric—a biodegradable polymer—in the LD flap donor site and examined its effect on postoperative seroma formation and resolution in a comparative study on 38 patients undergoing primary 1-stage breast reconstruction by LD flap.

Method:

A PGA treatment group had a PGA fabric placed in the donor wound (PGA group, n = 20), whereas a second group was treated with standard donor site closure (control group, n = 18). The incidence of seromas was comparable between the groups.

Result:

There was a significant reduction in aspiration volume by needle aspiration after drain removal (P < 0.05) and in the time until seroma resolution (P < 0.01) in the PGA group compared with the control group.

Conclusion:

These results indicate that application of PGA at the LD donor site is useful in controlling postoperative seromas.
DIEP Flap Breast Reconstruction in Patients with Breast Ptosis: 2-Stage Reconstruction Using 3-Dimensional Surface Imaging and a Printed Mold
Authors: Tomita Koichi , Yano Kenji , Taminato Mifue , Nomori Michiko , Hosokawa Ko
Published: October 2017

Background:

Autologous breast reconstruction can be performed for breasts with ptosis to a certain extent, but if patients desire to correct ptosis, mastopexy of the contralateral breast is indicated. However, accurate prediction of post-mastopexy breast shape is difficult to make, and symmetrical breast reconstruction requires certain experience. We have previously reported the use of three-dimensional (3D) imaging and printing technologies in deep inferior epigastric artery perforator (DIEP) flap breast reconstruction. In the present study, these technologies were applied to the reconstruction of breasts with ptosis.

Methods:

Eight breast cancer patients with ptotic breasts underwent two-stage unilateral DIEP flap breast reconstruction. In the initial surgery, tissue expander (TE) placement and contralateral mastopexy are performed simultaneously. Four to six months later, 3D bilateral breast imaging is performed after confirming that the shape of the contralateral breast (post-mastopexy) is somewhat stabilized, and a 3D-printed breast mold is created based on the mirror image of the shape of the contralateral breast acquired using analytical software. Then, DIEP flap surgery is performed, where the breast mold is used to determine the required flap volume and to shape the breast mound.

Results:

All flaps were engrafted without any major perioperative complications during both the initial and DIEP flap surgeries. Objective assessment of cosmetic outcome revealed that good breast symmetry was achieved in all cases.

Conclusions:

The method described here may allow even inexperienced surgeons to achieve reconstruction of symmetrical, non-ptotic breasts with ease and in a short time. While the requirement of two surgeries is a potential disadvantage, our method will be particularly useful in cases involving TEs, i.e., delayed reconstruction or immediate reconstruction involving significant skin resection.
Pathology of Ovarian Cancer: Recent Insights Unveiling Opportunities in Prevention
Authors: KOMMOSS FRIEDRICH , GILKS C. BLAKE
Published: October 2017

Ovarian carcinomas were formerly referred to as “surface epithelial carcinomas,” reflecting the belief that they all arise from the ovarian surface epithelium. It is now appreciated that most ovarian carcinomas originate from either fallopian tube or endometriotic epithelium, and how we approach prevention will thus differ between histotypes. The 5 histotypes of ovarian carcinoma (high-grade serous, clear cell, endometrioid, mucinous, and low-grade serous, in descending order of frequency) can be reproducibly diagnosed, and are distinct disease entities, differing with respect to genetic risk factors, molecular events during oncogenesis, patterns of spread, and response to chemotherapy.
Quality and Safety in Obstetrics and Gynecology
Authors: BROWN HAYWOOD L.
Published: October 2017

The discipline of obstetrics and gynecology has been a leader for quality and safety in women’s health for decades. Obstetrics is the leading cause for admissions, triage, and hospital discharge with over 4 million hospitalizations for births annually. Appropriately, safety initiatives and use of quality measures particularly relevant to obstetrics and gynecology are essential to patient satisfaction, safe and efficient evidence-based care.
Impact of Mother-Daughter Relationship on Hypertension Self-management and Quality of Life
Authors: Shawler Celeste , Edward Jean , Ling Jiying , Crawford Tim N. , Rayens Mary Kay
Published: October 2017

Background:

Although hypertension (HTN) treatment rates are similar across age groups of women, effective control is significantly worse among older women. Only 20% of hypertensive women aged 70 to 79 years have controlled blood pressure.

Objectives:

The purpose of this longitudinal study was to test the effects of the quality of mother-daughter relationship, inner strength, and control on HTN self-management and health-related quality of life (HRQOL) for both members of the dyad at 6 months. The Actor-Partner Interdependence Model was used to examine the direct (“actor”) and indirect (“partner”) effects of 46 dyads.

Results:

The mothers’ perceived relationship quality with daughters directly impacted their own self-management of HTN and HRQOL while also indirectly affecting their daughters’ self-management. Similarly, the daughters’ perceived strength of their relationship with their mothers directly influenced their self-management and HRQOL and indirectly affected their mothers’ self-management and HRQOL.
Vestibular Function Change in a Vasopressin-Induced Hydrops Model
Authors: Kim Minbum , Kim Kyu-Sung
Published: October 2017

Hypothesis:

A vasopressin-induced endoymphatic hydrops model can represent an acute vertiginous attack in Menière's disease (MD).

Background:

Previous animal models are not appropriate to evaluate the efficacy of new treatments for hydrops because they cannot represent an acute attack of MD. Recently, a new dynamic model was introduced for acute hydrops exacerbation using the vasopressin type 2 receptor agonist, desmopressin (1-deamino-8-D-Arginine vasopressin, VP); however, resulting changes in vestibular function have not been investigated.

Methods:

A total of 37 guinea pigs were used. Two to 4 weeks after surgical ablation of endolymphatic sacs in 33 guinea pigs, acute exacerbation of hydrops was induced by a single VP injection in 18 animals (group A). Next, two VP injections at 1 hour interval were administered to investigate the effect of multiple VP doses on vestibular function in the other 15 animals (group B). In the remaining four animals, VP was injected without surgery for the control group (control). Bidirectional sinusoidal harmonic acceleration (SHA) tests of vestibular function were performed. “Type I response” was defined as when the maximum slow-phase velocity (SPV) during left rotation (toward the operated ear) was lower than that during right rotation (toward the normal ear). In contrast, “Type II response” was defined as when maximum SPV at the left rotation was higher than that at the right rotation. Vestibular symmetry scores were analyzed at baseline and after each of two VP injections given 1 hour apart.

Results:

Vestibular symmetry scores increased at 1 hour after VP injection in all 18 animals in group A (p < 0.001). Two hours after VP injection, symmetry score decreased to the initial score. Two different types of vestibular response were observed after VP. However, the symmetry scores between type I and II responses were not significantly different (p = 0.173). In all 15 animals of Group B, vestibular asymmetry was sustained over 3 hours when two VP injections were given 1 hour apart. In three of Group B, the type of vestibular response changed from type II response to type I response after the 2nd VP injection; however, no animal demonstrated a shift from type I to type II response.

Conclusion:

VP can transiently induce an acute exacerbation of hydrops and asymmetric vestibular dysfunction in guinea pigs. This model could help in studying new treatments for acute hydrops and in explaining the mechanism of bidirectional nystagmus in MD.
Petrous Apex Cholesterol Granulomas: Outcomes, Complications, and Hearing Results From Surgical and Wait-and-Scan Management
Authors: Grinblat Golda , Vashishth Ashish , Galetti Francesco , Caruso Antonio , Sanna Mario
Published: October 2017

Objective:

1. To analyze the surgical outcomes in the management of petrous apex cholesterol granulomas (PACG) with a brief literature review.

2. To evaluate the importance of wait-and-scan management option.

Study Design:

Retrospective review.

Setting:

Quaternary referral center for otology and skull base surgery.

Subjects and Methods:

Charts of 55 patients with at least 12 months of follow-up were analyzed for demographic, clinical, audiometric, and radiological features. Patients were divided into surgical group (SG) (n = 31) and wait-and-scan (n = 24) (WS) group. Surgical approach was chosen as per hearing status and PACG extension and relation to nearby neurovascular structures and included either drainage by transmastoid-infralabyrinthine approach (TM-IL)/transcanal-infracochlear approach (TC-IC) or resection by infratemporal fossa type B approach (ITF-B). The combination of ITF-B with trans-otic (TO) approach or TO approach solely was used in unserviceable hearing cases. Postoperative outcomes and complications were evaluated in SG.

Results:

Postoperative symptom relief was observed in 24 patients (77.4%). Diplopia and paresthesia recovered in each case and improvement in headache, dizziness, tinnitus, and hearing loss was observed in 87.1% cases. Serviceable hearing was preserved in 24 of 26 cases. Postoperative complication rate was 32.2% including incidences of profound hearing loss, facial nerve paresis, carotid artery injury and intraoperative CSF leaks. Revision surgery was required in 3 (9.6%) cases, after TM-IL approach.

Conclusion:

Surgical drainage is preferable to more aggressive resection procedures, with the latter reserved for recurrent lesions or lesions with severe hearing loss/involvement of critical neurovascular structures. ITF-B approach provides adequate cyst and neurovascular control for resection, while avoiding brain retraction. An initial wait-and-scan approach can be used in most patients where symptoms and imaging justify so.