bluuebunny/crossref_metadata_2025 huggingface dataset:
Pressure pain sensitivity map of multifocal nummular headache: a case report
Authors: Rodríguez Cristina , Herrero-Velázquez Sonia , Ruiz Marina , Barón Johanna , Carreres Alicia , Rodríguez-Valencia Edert , Guerrero Angel Luis , Madeleine Pascal , Cuadrado María Luz , Fernández-de-las-Peñas César
Published: April 2015

Background

Nummular headache (NH) is most commonly a localized unifocal headache; however, some patients infrequently exhibit multifocal symptomatic painful head areas retaining all features of NH. We present the pressure pain sensitivity map of an adolescent with multifocal NH.

Case presentation

We describe a case of a 14 year-old-girl with a 3-year history of continuous pain in four rounded areas, all of them with the same size and shape. Pressure pain thresholds (PPT) were assessed on 21 points over the scalp and over the symptomatic areas. A pressure pain sensitivity map of the head was constructed. The neurological exam was unremarkable, with neither sensory symptoms nor trophic changes within the painful areas. As previously shown, symptomatic points exhibited lower PPTs compared to the surrounding areas. The map reflected 4 restricted areas of mechanical hyperalgesia confined just to the painful areas. Treatment with gabapentin achieved complete remission.

Conclusion

This is the first pain sensitivity map of a patient with multifocal NH. Our results support peripheral mechanisms are maintained in multifocal NH.
C2EM: cloud-assisted complex event monitoring in wireless multimedia sensor networks
Authors: Shen Hang , Bai Guangwei , Ma Ding , Zhao Lu , Tang Zhenmin
Published: April 2015

This paper addresses the problem of how to provide a more flexible service for complex event monitoring in wireless multimedia sensor networks (WMSNs). In particular, we propose C2EM, a cloud-assisted complex event monitoring architecture that involves scalar sensors, camera sensors, cloudlets, and clouds to leverage computation offloading reliability, service response time, coverage efficiency, and energy efficiency. On clouds, we design an opportunistic service access point selection scheme that provides quality of service (QoS) supports for scalar sensor computation offloading. Meanwhile, clouds are responsible for optimizing camera sensor utilization of the whole network. On cloudlets, we design a real-time camera actuation scheme with the objective of minimizing the possible coverage overlaps while providing probabilistic guarantee in residual energy. Through computation division, most complex computations and network environment profilers are executed on cloudlets or clouds. Sensors only need to carry out very simple operations. We evaluate the performance of C2EM through simulations under a complex event scenario. The results demonstrate that C2EM can enhance complex event monitoring performance with optimized energy efficiency, desirable event coverage quality, and potential adaptability to the dynamics of complex events.
Does intermarriage change migrants’ preferences for the home country?
Authors: Weber Rosa
Published: April 2015

Motivations for migrants to return clearly change with integration, but the time-changing aspect of return migration has received little attention in the literature. This paper studies how migrants’ preferences for the home country change with intermarriage, i.e., marriage to a spouse from the host country. Specifically, I analyse the association between intermarriage and three outcomes related to migrants’ home country preference – intentions to return, remittances sent and actual return – using German panel data (SOEP) for the period 1984–2012. The results reveal a negative association between intermarriage and home country preference that is moreover stronger for female than for male migrants. However, some of the effect seems driven by selection since the relationship gets weaker once I control for person fixed effects.
Validity and reliability of the Finnish version of the Functioning Assessment Short Test (FAST) in bipolar disorder
Authors: Suominen Kirsi , Salminen Elina , Lähteenmäki Susanna , Tupala Tiina , Isometsä Erkki
Published: April 2015

Background

The Functioning Assessment Short Test (FAST) was developed for the clinical evaluation of functional impairment of patients suffering from bipolar disorder. The aim of this study was to validate the Finnish version of FAST.

Methods

Translation and back-translation of FAST were performed. Fifty patients with the Diagnostic and Statistical Manual of Mental Disorders-Fourth edition (DSM-IV) bipolar type I and II were interviewed at the Bipolar Disorder Research and Treatment Centre, City of Helsinki, Finland. Participants completed the FAST, the Social and Occupational Functioning Assessment Scale (SOFAS) of DSM-IV, and the Sheehan Disability Scale (SDS) as part of the assessment. Internal consistency and correlations between FAST and SOFAS and SDS were analysed. Twenty-five patients participated in a reliability assessment carried out 1 week apart by a different rater.

Results and discussion

The internal consistency coefficient obtained was very good, with a Cronbach alpha of 0.870. Reliability of FAST was also found excellent (correlation between two measures r = 0.896, p < 0.001). A highly significant negative correlation between FAST and SOFAS scores was found (r = −0.723, p < 0.001). FAST and SDS were also highly significantly correlated (r = 0.742, p < 0.001).

Conclusions

The psychometric validity and reliability of FAST in the Finnish sample of patients with bipolar disorder types I and II were good.
An immunochromatographic test strip for rapid detection of fish pathogen Edwardsiella tarda
Authors: Liu Hesong , Wang Yue , Xiao Jingfan , Wang Qiyao , Liu Qin , Zhang Yuanxing
Published: April 2015

Background

Edwardsiella tarda, the etiologic agent of edwardsiellosis, is a devastating fish pathogen prevailing in worldwide aquaculture industries and accounting for severe economic losses. There is a raising concern about E. tarda being a significant zoonotic pathogen, and it is urgent to develop a rapid detection of this pathogen. This is the first study to develop a test strip for rapid detection of E. tarda in turbot.

Results

Mouse monoclonal antibodies (MAbs) and rabbit polyclonal antibody (PAb) against E. tarda were generated from immunization of mice and rabbits with a virulent isolate of E. tarda EIB202. Two MAbs specific to isolates of E. tarda were obtained, and one of them (25C1) was selected to conjugate with colloidal gold as the detector antibody. Rabbit PAb was used as the capture antibody. It was found the strip had no cross-reactivity with non-E. tarda bacterial microbes and the limit of detection (LOD) was 1 × 105 colony-forming units (CFU)/ml. The detection could be visually observed by the naked eye within 5 min. This test strip was verified with a similar detection limit and much less analysis time compared with a dot blot immunoassay (1 × 105 CFU/ml for LOD and 120 min for reaction time). When the samples were mixed with turbot tissue homogenates, strong immunoreactivity was observed over 105 CFU/ml, which suggested that the turbot tissue homogenates did not affect the detection of the strip. Pre-enrichment with homogenized turbot tissue for 12 h could increase the detection limit of the E. tarda present in the sample up to 1 to 10 CFU/ml. In practice, in detecting 20 turbot ascite samples infected by E. tarda, the immunochromatographic test strip showed a high accuracy (100% positive).

Conclusions

The immunochromatographic test strip offers great promise for a rapid, simple, and economical method of E. tarda on-site detection, and with different antibodies, it might be used to detect other aquatic pathogens.
The (Mis)Measure of Trans
Authors: Labuski Christine , Keo-Meier Colton
Published: April 2015

This essay considers the utility of research questions that articulate aspects of transgender lives to the nontransgender populations with whom they share a wide range of bodily and lived experience. By foregrounding transgender's instability as a research variable, the authors argue for more precise methodological orientations in trans research, particularly regarding gender and sexual orientation. Drawing on their own data with trans men whose sexual attractions have shifted during transition, they argue against unidimensional interpretations of this experience. Feminists and critical race scholars suggest that race and gender frequently function as “proxies”: variables that reduce the complexities of biosocial bodily experience to more quantifiable forms of data. The authors argue that much of the research conducted with transgender persons suffers from similar reductions, narrowing the epistemological frameworks through which these populations are subsequently investigated and understood. By contrasting the National Transgender Discrimination Survey's focus on the measurable experience of discrimination with research that makes broader claims regarding “the transgender population,” the essay invites researchers to develop a set of best practices that resemble those of feminist science studies scholars.
From Multiracial to Transgender?
Authors: Schilt Kristen , Bratter Jenifer
Published: April 2015

In 2000, the US Census Bureau acknowledged multiracial Americans on the decennial census in an attempt to better capture racial heterogeneity and to more closely align what is publicly collected on forms with people's personal understandings of their racial identity. In this article, we start a discussion of how the census—a major source of political identity recognition and legitimation—could be more inclusive of gender variance. We ask: (1) Is there support for a transgender category on the US census? (2) Who might select a transgender option if it were provided? To answer these questions, we conducted questionnaire research at three transgender and genderqueer conferences and found strong support for the inclusion of a transgender category. Conversely, we found that many people did not currently check “transgender” on forms when given the opportunity. As we show, the decision to check “transgender” varies by what we term gender identity validation. In other words, people who identified as male or female and who felt others viewed them as unequivocally male or female, respectively, were less likely to check “transgender” than people who identified as transgender or who experienced a discrepancy between their self-perceived and other-perceived gender identity. These differences suggest that—similar to the push for adding a multiracial category to the census—the expansion of sex/gender categories is most likely to come from individuals who experience themselves as constrained by the existing possibilities and/or who are stigmatized by others' conceptions of the appropriate alignment of bodies and genders.
Information Systems and the Translation of Transgender
Authors: Johnson Jeffrey Alan
Published: April 2015

Using the data systems of Utah Valley University as a representative case study, this research note discusses the sociotechnical process, which I term the translation regime, through which data systems interpret and construct the world, focusing on gender nonconformity as a paradigmatic instance of that process. Through both the technical structures of data systems and the social knowledge within which they operate, such regimes impose multiple substantive translations on the conditions that they purport to represent, translations that come with important political consequences for those who are gender nonconforming. So understood, information technology becomes an important locus for action in the pursuit of social justice for gender-nonconforming people.
Understanding the Increase in Disability Insurance Benefit Receipt in the United States
Authors: Liebman Jeffrey B.
Published: April 2015

The share of working-age Americans receiving disability benefits from the federal Disability Insurance (DI) program has increased significantly in recent decades, from 2.2 percent in the late 1970s to 3.6 percent in the years immediately preceding the 2007–2009 recession and 4.6 percent in 2013. With the federal Disability Insurance Trust Fund currently projected to be depleted in 2016, Congressional action of some sort is likely to occur within the next several years. It is therefore a good time to sort out the competing explanations for the increase in disability benefit receipt and to review some of the ideas that economists have put forth for reforming US disability programs.
Bitcoin: Economics, Technology, and Governance
Authors: Böhme Rainer , Christin Nicolas , Edelman Benjamin , Moore Tyler
Published: April 2015

Bitcoin is an online communication protocol that facilitates the use of a virtual currency, including electronic payments. Bitcoin's rules were designed by engineers with no apparent influence from lawyers or regulators. Bitcoin is built on a transaction log that is distributed across a network of participating computers. It includes mechanisms to reward honest participation, to bootstrap acceptance by early adopters, and to guard against concentrations of power. Bitcoin's design allows for irreversible transactions, a prescribed path of money creation over time, and a public transaction history. Anyone can create a Bitcoin account, without charge and without any centralized vetting procedure—or even a requirement to provide a real name. Collectively, these rules yield a system that is understood to be more flexible, more private, and less amenable to regulatory oversight than other forms of payment—though as we discuss, all these benefits face important limits. Bitcoin is of interest to economists as a virtual currency with potential to disrupt existing payment systems and perhaps even monetary systems. This article presents the platform's design principles and properties for a nontechnical audience; reviews its past, present, and future uses; and points out risks and regulatory issues as Bitcoin interacts with the conventional financial system and the real economy.
A Retrospective Look at Rescuing and Restructuring General Motors and Chrysler
Authors: Goolsbee Austan D. , Krueger Alan B.
Published: April 2015

The rescue of the US automobile industry amid the 2008–2009 recession and financial crisis was a consequential, controversial, and difficult decision made at a fraught moment for the US economy. Both of us were involved in the decision process at the time, but since have moved back to academia. More than five years have passed since the bailout began, and it is timely to look back at this unusual episode of economic policymaking to consider what we got right, what we got wrong, and why. In this article, we describe the events that brought two of the largest industrial companies in the world to seek a bailout from the US government, the analysis that was used to evaluate the decision (including what the alternatives were and whether a rescue would even work), the steps that were taken to rescue and restructure General Motors and Chrysler, and the performance of the US auto industry since the bailout. We close with general lessons to be learned from the episode.
An Assessment of TARP Assistance to Financial Institutions
Authors: Calomiris Charles W. , Khan Urooj
Published: April 2015

Six years after the passage of the 2008 Troubled Asset Relief Program, commonly known as TARP, it remains hard to measure the total social costs and benefits of the assistance to banks provided under TARP programs. TARP was not a single approach to assisting weak banks but rather a variety of changing solutions to a set of evolving problems. TARP's passage was associated with significant improvements in financial markets and the health of financial intermediaries, as well as an increase in the supply of lending by recipients. However, a full evaluation must also take into account other factors, including the risks borne by taxpayers in the course of the bailouts; moral-hazard costs that could result in more risk-taking in the future; and social costs related to perceived unfairness. Our evaluation is organized in five parts: 1) What did policymakers do? 2) What are the proper objectives of interventions like TARP assistance to financial institutions? 3) Did TARP succeed in those economic objectives? 4) Were TARP funds allocated purely on an economic basis, or did political favoritism play a role? 5) Would alternative policies, either alongside or instead of TARP, and alternative design features of TARP, have worked better?
Challenges and opportunities for early-career Teaching-Focussed academics in the biosciences
Authors: Hubbard Katharine , Gretton Sarah , Jones Katherine , Tallents Lucy
Published: April 2015

Twenty-seven percent of academics in UK Higher Education (HE) are in Teaching-Focussed positions, making major contributions to undergraduate programmes in an era of high student expectations when it comes to teaching quality. However, institutional support for Teaching-Focussed academics is often limited, both in terms of peer networking and opportunities for career development. As four early-career stage Teaching-Focussed academics working in a variety of institutions, we explore what motivated our choices to make teaching our primary academic activity, and the challenges that we have faced in doing so. In addition to highlighting the need for universities to fully recognise the achievements of teaching staff, we discuss the role that the various biosciences learned societies have in supporting Teaching-Focussed academics. We identify that there is a need for the learned societies to come together and pool their expertise in this area. The fragmented nature of the Teaching-Focussed academic community means that clear sources of national support are needed in order to best enable the next generation of bioscience educators to reach their full potential.
Concept of Single Civil Procedure Code: Suggestions of the Institute of Legislation and Comparative Law under the Government of the Russian Federation
Authors: Ganicheva Ekaterina , Gabov Andrey , Glazkova Mariya , Kovtkov Dmitriy , Maryshyeva Nataliya , Lyesnitskaya Lidiya , Zhuykov Viktor , SHyelyutto Marina
Published: April 2015

This publication is the result of collective discussion at the Institute of Legislation and Comparative Law under the Government of the Russian Federation of the Concept of a common code of civil procedure adopted in 2014. The article deals with the problem of harmonization of legislation governing the consideration of the various categories of cases within the jurisdiction of the courts of general jurisdiction and arbitration courts. Particular attention is paid to the problems of access to justice, coordination of legislative activity, taking into account the future prospects of unification of the rules and institutions governing the procedural arrangements of civil, administrative and criminal proceedings. The article describes the objective relationship between the development of an of procedural law and the law on the judicial system, which must be taken into account when solving problems to ensure the effective operation of the courts at all stages of trial and in all judicial instances. Certain problems that arose after the unification of the higher judiciary authorities are reviewed, recommendations aimed at improving the structure and organizational forms of the Supreme Court of the Russian Federation are given.
Co-Management by Indigenous Minorities of the North over Arctic Territories in the Period of Their Commercial Development
Authors: CHyebotaryev Gyennadiy , Gladun Elena
Published: April 2015

The authors explain the significance of the presented subject by the current intensive industrial development of the Arctic territories of the Russian Federation and other Northern countries, which apart from positive economic and social benefits, also brings climate change, environmental problems and destroys traditional lifestyle and economy management of indigenous minorities of the North. The article proves that in many countries indigenous minorities of the North are interested not only in enforcement and guarantees of their rights on the part of the state, but also in making managerial decisions on the use and protection of territories which is the traditional place of their inhabitance and economic activity, together with government authorities and resource-users. The authors view co-management as an efficient model of interrelations between the state, local self-government and indigenous minorities of the North. The authors analyze international rules, foreign laws and regulations, and legislation of the Russian Federation that create legal framework for the implementation of the co-management model in the Arctic territories of Russia. In their article the authors indicate gaps in federal legislation in the area of protection of the Northern indigenous peoples’ rights to govern the territories of their traditional inhabitance and economic activity. In the end the authors state the possibilities to fill the gaps in the federal and regional legislation on the indigenous minorities’ rights, in particular, they suggest approving and ratifying international documents on indigenous peoples, including co-management norms, into the RF legislation, and also expanding possibilities of government and local authorities on indigenous minorities’ involvement into management over the Northern territories.
Set of Criteria for Determining Non-Pecuniary Damage Compensation as Remedy for Civil, Family and Labor Rights of Citizens
Authors: Maleina Marina
Published: April 2015

The article justifies the system of criteria, on the basis of which the compensation amount for non-property damage shall be determined. There are highlighted some common criteria applied in case of violation of any civil, family or labor rights; particular criteria used in violation of specific subjective rights, and the criteria for reducing and increasing the amount of non-property damage. Common grounds of increase of the amount of compensation are proposed as followers: causing both moral and physical damage by violation the same non-property right; causing non-pecuniary damage in connection with the simultaneous violation of several non-property rights. The author proves the necessity of introducing in the law such common grounds of reducing of the amount of compensation as: form and degree of fault of the victim; financial situation of a tortfeasor — citizen; expiration of a long period of time after the occurrence of damage and under certain conditions; voluntary taking actions by a tortfeasor to mitigate the effects of non-pecuniary damage caused before filing a suit. It is considered by the author to be fair to protect the interests of victims by establishing in law the minimum amount of compensation for non-pecuniary damage, linking it with the fold of the minimum wage.
Legal Regulation of Adjudication in Civil Code of the Russian Federation (Issues of Conflict Rules)
Authors: Lazaryeva Tatyana
Published: April 2015

The article deals with conflict of laws regulation of transfer of creditor’s rights to another person (assignment of claims (cessions) and transfer of rights under the law) in terms of amendments to Part III of the Civil Code of the Russian Federation. The author notes that though amendments to the separate article on cession are not fundamental, the amendments of other articles of the Civil Code of the Russian Federation, concerning contractual obligations, do influence regulation of relations between the parties in assignment. The article pays special attention to the new conflict of law rule regulating the transfer of the creditor’s rights under the law. Relevant court practice is analyzed. On the basis of comparing legislations of specific countries, as well as norms of EC No. 593/2008 (‘‘Rome I’’) Regulation and EC No. 864/2007 (‘‘Rome II’’) Regulation the author draws the conclusion that despite some differences in conflict of laws regulation of the transfer of the creditor’s rights, in general the Russian rules comply with modern trends in private international law in the majority of European countries.
Institute of Criminal Records and its Legal Consequences
Authors: Gravina Alla , Khromova Nataliya
Published: April 2015

In their research dedicated to the criminal conviction institute and its legal consequences, the authors consider it not only as a criminal legal category but also as a general legal concept. For this purpose the authors analyze the legal nature of conviction and its consequences as a criminal legal category as well as the impact of these consequences on general civil relations, in particular, on labor relations. The authors also investigate the issue of consequences after expunging or cancellation of conviction. They analyze the current Russian law on legal restrictions relating to expunging or cancellation of conviction. On the basis of this analysis the authors draw the conclusion on ambiguity of the imposed restrictions after expunging or cancellation of a conviction and on the occurring conflict of law. For readers’ reference the authors analyze legal initiatives of representatives to State Duma of the Federal Assembly of Russian Federation as well as opinions of competent state authorities in charge of this issue.
On the Issue of Responsibility for Money or Other Property Laundering
Authors: Kharlamova Alena
Published: April 2015

The article deals with the essence of legalization (laundering) of money or other property acquired through commission of crimes. The author analyzes the existing language of the object of legalization in the Russian criminal law, including their contents and the relationship inter se and with other categories, the impact of the legislator’s concepts on criminal and legal assessment of socially dangerous acts. The author focuses on the changes to the Criminal Code of the Russian Federation introduced in connection with tightening of measures on anti-money laundering, and their implications for the application of criminal law institutions. On the basis of the study of specific judicial decisions and preliminary investigation files the author explores controversial questions of crime classification envisaged by Art. 174 and 1741 of the Criminal Code of the Russian Federation.
Legal Structure of Budget Immunity: Theoretic and Legal Analysis
Authors: Povetkina Natalya
Published: April 2015

The article presents theoretical and legal analysis of the concept of “immunity of the budget”. The article notes the role and importance of immunity of the budget as special legal structure to ensure compliance by the state with all assumed financial obligations, fulfilled at the expense of the budgets of the RF budget system. Diversity and ambiguousness of understanding the category of immunity in science are pointed out. Various concepts of immunity both in general legal and industry-specific format are analyzed. The author concludes that, despite the fact that the immunity of the budget does not possess all the attributes of legal immunities, it can be referred to as such, but with specific features. The article defines the purpose, functions and characteristics of the budget immunity. The author provides an original definition of the “immunity of budget” concept as a legal regime that does not permit mandatory recovery proceedings at the expense of budgets from the budgetary system of the Russian Federation.
Diffusion in Law as Trend for Private International Law Unification: To the Issue of Data Protection Law Object
Authors: Doronina Nataliya
Published: April 2015

Foreign law can be an important object of informational legal relations. Different states compose unified registers of legislative acts. In the long run creation of national information resources on the basis of the current legislation contributes to interpenetration of legal norms into foreign legal systems. In the age of globalization cooperation between states on a contractual basis opens large-scale prospects for establishing business and other contacts between citizens and legal entities of different state affiliations. But the use of this method of law unification faces difficulties related to implementation of the international treaties’ norms into the national legal system. Also difficulties stem from the fact that after implementation into the national legal system international treaties’ norms do not have a uniform interpretation. Due to the existence of the problems in unification of law through international treaties other ways of unification of law of various states are being explored. Diffusion in law, based on the penetration of foreign law norms into the national legal system is one of such ways. The way of diffusion in law envisages the application of unified categories of institutes and legal rules enacted in this or that state as the most efficient legal norms, institutes. This way of unification of law gains more and more recognition due to the fact that it does not face the problems characteristic for unification of law through international-treaties, but accomplishes the same goals Tire ensures harmonious interaction between various legal systems in law.
Globalization of International Economic Relations, Information Technologies and Move to a New Level of Diffusion in Law
Authors: Semilyutina Natalya
Published: April 2015

Globalization of international economic relations directly depends on the level of information technologies’ development. At present the development of information law has created favourable conditions for interpenetration of the rules of foreign law. This penetration is called diffusion in law. The article investigates the aspect of interpenetration of legal ideas and decisions through contracts concluded by participants in civil law relations. In business relations’ practice, parties frequently borrow not only legal language, but also legal structures from foreign contract forms. In case of a conflict situation there arises a problem of interpretation of th elegal formula which the parties have imported from a foreign law and copied in their contractual relations. Traditional approach assumes that a court, when interpreting contractual provisions, even imported from a foreign law, follows its law, i.e. lex fori. Development of international relations demonstrates imperfection of such approach, since such approach does not allow identifying the parties’ true intentions while concluding the contract. Development of international relations, amplification of economic relations results in the fact that the parties increasingly use international structures in their practice. For example, UNIDROIT Principles, to which the parties may refer in their contracts. But other states also use the UNIDROIT Principles and include them into their most recent codification. In such a way there appears “grass-root diffusion”, i.e. through the development of private contractions relations.
Challenges of New Service Development: Case Video-Supported Home Care Service
Authors: Wallin Arto , Harjumaa Marja , Pussinen Pasi , Isomursu Minna
Published: April 2015

In all developed economies, there is a mounting demand for effective solutions to elderly care stemming from an aging population and the high cost of resources needed. Hence, significant investments have been made in developed countries to stimulate the growth of information and communication technology-enhanced services for the home care markets. However, digital provisioning of home care services includes major challenges. This study uses an individual longitudinal case study that explores the collaborative development of a video-based elderly care service to deepen the understanding of these challenges. The findings emphasize the importance of analyzing the contextual value for a variety of relevant stakeholders and identifying the key persons who are personally committed to the long-term collaborative development. The observed challenges also call for actions by policy makers to increase the dynamicity of service development in long-term research and development projects. Our theoretical contribution suggests integrating new service development theories with service-dominant logic and systems theories. This integration provides a means to contextualize the value of the service for individual beneficiaries, and it also contributes to coping with the complexity of new service development. For business practitioners, we translate these insights into propositions about new service development in the context of health and social care service systems.
The incidence, spectrum and outcome of paediatric trauma managed by the Pietermaritzburg Metropolitan Trauma Service
Authors: Manchev V , Bruce JL , Oosthuizen GV , Laing GL , Clarke DL
Published: April 2015

Introduction

The Pietermaritzburg Metropolitan Trauma Service (PMTS) has run a systematic quality improvement programme since 2006. A key component included the development and implementation of an effective surveillance system in the form of an electronic surgical registry (ESR). This study used data from the ESR to review the incidence, spectrum and outcome of paediatric trauma in Pietermaritzburg, South Africa.

Methods

The ESR was reviewed, and all cases of paediatric trauma managed between 1 January 2012 and 30 July 2014 were retrieved for analysis.

Results

During the study period, 1,041 paediatric trauma patients (724 male, 69.5%) were managed by the PMTS, averaging a monthly admission of 36. The mean age was 10.9 years (standard deviation: 5.4 years). The mechanism of injury (MOI) was blunt trauma in 753 patients (72.3%) and penetrating trauma in 170 (16.3%). Pedestrian vehicle collisions accounted for 21% of cases and motor vehicle collisions for a further 11%. Intentional trauma accounted for 282 patients (27.1%) and self-inflicted trauma for 14 cases (1.3%). Ninety patients admitted to the intensive care unit and fifty-one required high dependency unit admission. There were 17 deaths, equating to an in-hospital mortality rate of 1.7%. A total of 172 children died on the scene of an incident. There were 35 road traffic related deaths, 26 suicides by hanging, 27 deaths from blunt assault and 23 deaths from penetrating assault. The overall mortality rate for paediatric trauma was 18.2%.

Conclusions

The ESR has proved to be an effective surveillance system and has enabled the accurate quantification of the burden of paediatric trauma in Pietermaritzburg. This has improved our understanding of the mechanisms and patterns of injury, and has identified a high incidence of intentional and penetrating trauma as well as road traffic collisions. These data can be used to guide strategies to reduce the burden of paediatric trauma in our environment.
Cost of infection after surgery for intracapsular fracture of the femoral neck
Authors: Wijeratna MD , McRoberts J , Porteous MJ
Published: April 2015

Introduction

We investigated the financial and human costs of postoperative infection for intracapsular fracture of the femoral neck at a district general hospital in the UK.

Methods

Data on postoperative infections after surgical treatment for intracapsular fracture of the femoral neck were collected prospectively from June 2005 to April 2009. Infected patients were pairwise-matched (1:2 ratio) with a non-infected group of patients from a database on hip fractures. Costs of additional surgery, duration of hospital stay, and opportunity costs were calculated using Primary Care Trust (PCT) tariffs and PCT-specific data.

Results

A total of 525 patients were treated with total hip replacement (n=110) or hip hemiarthroplasty (n=415). Seventeen patients (3.2%) were identified as having a surgical-site infection. Eight (1.5%) deep infections and nine (1.7%) superficial infections were documented. Compared with the non-infected group, duration of hospital stay and the prevalence of mortality doubled. Repeat surgery and the costs associated with hospital admission were increased significantly in the infected group. Mean financial loss associated with an infected patient was £7,726, whereas an uninfected patient brought £153 of profit to the hospital. When opportunity costs were considered, an infected patient represented £24,397 of lost income.

Conclusions

Postoperative infection after surgical treatment for intracapsular fracture of the femoral neck has a significant negative impact on duration of hospital stay and financial costs, and demonstrates a trend towards an increase in the prevalence of mortality.
Comparison of oncological safety between nipple sparing mastectomy and total mastectomy using propensity score matching
Authors: Seki T , Jinno H , Okabayashi K , Murata T , Matsumoto A , Takahashi M , Hayashida T , Kitagawa Y
Published: April 2015

Introdcution

Although nipple sparing mastectomy (NSM) has attracted increased recognition as an alternative to traditional mastectomy approaches, its oncological safety is unclear. The purpose of this study was to compare the local recurrence rate between NSM and total mastectomy (TM).

Methods

Between 2003 and 2013, 121 and 557 patients with stage 0–III breast cancer underwent NSM and TM respectively. Multivariate Cox regression and propensity score models were used to compare the two groups.

Results

There was no significant difference in the five-year local recurrence rate between the NSM and TM groups (7.6% vs 4.9%, p=0.398). In multivariate analysis, NSM was not a risk factor for local recurrence (hazard ratio: 1.653, 95% confidence interval: 0.586–4.663, p=0.343). Propensity score matching found similar five-year local recurrence free survival rates between the two groups (92.3% vs 93.7%, p=0.655).

Conclusions

Our results suggest that NSM may provide oncological safety comparable with mastectomy for carefully selected patients.
Mediastinal parathyroid adenomas and their surgical implications
Authors: Hu Jesse , Ngiam KY , Parameswaran R
Published: April 2015

Primary hyperparathyroidism is a relatively common problem encountered by any endocrine surgical unit. Ectopic parathyroid adenomas have been known to be a common cause of persistent hyperparathyroidism after surgery. A common site of the missed ectopic gland will be that in the mediastinum. However, with the increasing improvement in available imaging, it is likely that this can be diagnosed preoperatively. The surgical approach to the mediastinal parathyroid has also changed vastly over the last decade from maximally invasive to minimally invasive with minimal complications. We provide a review on the entity of mediastinal parathyroid adenomas and their surgical implications.
A rare case of a myofibroma presenting on the tongue
Authors: Sharifi A , Sen P , Lonsdale R , Pawaroo D
Published: April 2015

Myofibromas are benign neoplasms of myofibroblastic origin, rarely encountered in the oral cavity. Limited awareness of the clinical features of these lesions risks misdiagnosis of more sinister pathology. The objective of this report is to highlight the potential diversity of oral lesions by describing an uncommon presentation of a myofibroma. The case reveals the diagnostic difficulties encountered, along with postoperative complications, which exemplify the remarkable healing capacity of the oral cavity.
A case of severe necrotising pancreatitis following ampullary biopsy
Authors: Skelton D , Barnes J , French J
Published: April 2015

We present a case of necrotising pancreatitis following ampullary biopsy in a patient with Barrett’s oesophagus. The patient needed multiple necrosectomies and several admissions to the intensive care unit. This report is only the third and most severe case of pancreatitis following ampullary biopsy, highlighting its importance as a complication.
Palatal and retropharyngeal injury secondary to intubation using the GlideScope® video laryngoscope
Authors: Thorley DS , Simons AR , Mirza O , Malik V
Published: April 2015

Introduction

There are few reports of injury to the soft palate and retropharynx sustained during intubation with the GlideScope® video laryngoscope. Most reports are of isolated injury to the soft palate.

Case History

We describe a patient in whom the retropharynx was injured but the extent of the injury was not observed initially. The patient did not suffer severe sequelae from this injury. However, this injury can cause serious sequelae if it is not recognised (eg development of a retropharyngeal abscess).

Conclusions

We recommend that any patient who sustains injury to the soft palate during intubation (particularly if the endotracheal tube passes through the soft palate) should be reviewed an otolaryngologist before removal of the endotracheal tube.
Source, Authority, and Audience in the BBC’s Merlin
Authors: Sherman Jon
Published: April 2015

Although Merlin ’s producers claim to target a young audience, much of the program’s appeal is found in intertextual references to and deviations from medieval Arthurian literature. The dynamic tension created between continuity and innovation can only be appreciated by those with some—or even significant—knowledge of Merlin ’s medieval antecedents. (JS)
Vandalism (Miami Style): Graffiti as a Tool in Preserving the Marine Stadium
Authors: Lowinger Rosa
Published: April 2015

This paper chronicles the way in which graffiti is being used as a tool to raise awareness about the plight of the abandoned 1963 Miami Marine Stadium and funds for the building’s restoration and rehabilitation. It also demonstrates how the street art movement is using its association with the stadium as a means of building academic credibility and cultural acceptance for itself.
The Arch of Titus in the Roman Forum: A Case Study of Vandalism and History
Authors: Brandfon Fredric
Published: April 2015

The first response to an act of vandalism is to try to repair the vandalism. However, reversing or repairing an act of vandalism is only one response. An equally valid and common response is a new understanding of the past, a new narrative history, and an integration of the vandalism into the process of historiography. There exists a complementary relationship between vandalism and historical narrative that reminds us that our understanding of the past will always be partial. For the historian, vandalism, when it occurs, is not necessarily an impediment to history writing. Nor is it an irritation to be somehow expunged. Rather, the vandal and the historian are linked, and the vandal, wittingly or not, is an integral part of the process of writing history.
“A Laudable Spirit of Enterprise”: Renegotiating Land, Natural Resources, and Power on Post-Revolutionary Long Island
Authors: Anderson Jennifer
Published: April 2015

In the wake of the American Revolution, Long Island farmers faced severe intertwined environmental and economic crises. Amidst on-going Indian removals and the gradual manumission of enslaved African workers, the region’s land and labor resources were also in flux. Deeply concerned about the region’s declining productivity, Ezra L’Hommedieu (1734–1811), a gentleman farmer and advocate of modern agronomy on Long Island’s East End, sought to promote scientific agriculture in response to ecological problems (such as soil depletion and invasive pests), changing patterns of migration and land use, and growing social tensions. He and his circle of like-minded associates sought to appropriate indigenous agricultural knowledge as part of a supposedly enlightened land restoration agenda, albeit one that hinged on the displacement of native people and continued access to a dependent labor force. Laying claim to scientific expertise—in the service of economic development and, less overtly, of cultural hegemony—was one channel whereby L’Hommedieu and his peers sought to reassert their authority and status. As contestation over land, power, and natural resources reshaped Long Island, its preservation as a productive agricultural region became inextricably bound up with the national politics of western expansion and Indian removal in the Early Republic.
Framing Women: Frame, Perspective and Interpretation in Fortunata y Jacinta, Grand Bal , and Madeleine
Authors: Connor Laura
Published: April 2015

Despite the nineteenth century’s quest to know and represent the world “just as it truly is,’’ many philosophers, writers, and artists questioned whether such an enterprise was even possible. For them, human knowledge is imperfect: we only “know’’ the world and our fellow human beings through interpretation. Numerous contemporaneous Spanish artists seem to have shared a particular interest in how women of different social classes are ‘‘framed’’ by and ‘‘understood’’ through social expectations and codes. This article probes how setting, clothing, and cultural background shape the ways in which the protagonist of Benito Pérez Galdós’s 1886–1887 novel Fortunata y Jacinta is seen by the people in her life, as well as how the Catalan modernista artists Santiago Rusiñol and Ramón Casas explore, in their respective paintings Grand Bal (1891) and Madeleine (1892), the ways in which women from the ‘‘popular’’ classes are framed by attire, social spaces, and iconography.
Patient Reported Outcomes of Eat, Walk, Sleep : A Cardiometabolic Lifestyle Program for Cambodian Americans Delivered by Community Health Workers
Authors: Wagner Julie , Kong Sengly , Kuoch Theanvy , Scully Mary F. , Tan Heang Kim , Bermudez-Millan Angela
Published: April 2015

Background . This study investigated a community health worker-delivered lifestyle intervention for prevention of cardiometabolic disease, called Eat, Walk, Sleep . It was designed for traumatized, low-literacy Cambodian American refugees. Methods . We used a single group, pre-post design to evaluate the effects of the program on self-reported health behaviors. As a control for threats to internal validity, we also measured a nonequivalent dependent variable, i.e., perceived discrimination by health care providers. Results . Of 140 participants enrolled, 114 completed one-year assessments. In intent-to-treat analysis with correction for multiple comparisons, compared with baseline, participants at one year scored higher on cardiometabolic prevention knowledge, self-rated health, physical activity, medication compliance, and preventive screenings, and they reported improved sleep, a modest shift from white to brown rice, and reduced barriers to care. As expected, perceptions of discrimination by health care providers did not change. Conclusions . Self-reported behavioral risk factors improved. A randomized, controlled study with objective measures is warranted.
Colorectal Cancer Screening Rates at Community Health Centers that Use Electronic Health Records: A Cross Sectional Study
Authors: Baker David W. , Liss David T. , Alperovitz-Bichell Kari , Brown Tiffany , Carroll Joseph E. , Crawford Phil , Harigopal Padmini , Henley Eric , Nelson Christine A. , Rittner Sarah S.
Published: April 2015

Background . This study was conducted to validate use of electronic health record (EHR) data for measuring colorectal cancer (CRC) screening rates at community health centers (CHCs). Methods . Electronic health records were queried to assess screening via colonoscopy, flexible sigmoidoscopy, or fecal occult blood testing (FOBT) in 2011. Results . Multiple iterations were required to maximize query accuracy. Manual chart reviews, stratified by screening modality, confirmed query results for 112 of 113 (99.1%) reviewed colonoscopies, 110 of 110 (100%) reviewed FOBTs, and 111 of 120 (92.5%) unscreened patients. At participating CHCs, CRC screening rates ranged from 9.7% to 67.2% (median, 30.6%). Adherence to annual FOBT ranged from 3.3% to 59.0% (median, 18.6%). Most screening was done by colonoscopy. Conclusions . Colorectal cancer screening varies substantially across CHCs. Electronic health record data can validly measure CRC screening, but repeated assessments of programming accuracy are required. Community health centers may need support to measure quality using EHR data and increase screening.