bluuebunny/crossref_metadata_2025 huggingface dataset:
Expected feedback and successful adaptation to a multinational organization (MNO)
Authors: Ishii Kumi
Published: August 2018

This study examined expected feedback and employee adaptation to a multinational organization (MNO). The survey data were collected from 262 American and Japanese members from Japanese MNOs in the U.S. The results revealed that American employees valued feedback and expected both direct and indirect styles of feedback more than Japanese. Although there was no difference in the expected frequency of direct feedback, American employees expected to receive a higher frequency of indirect feedback than Japanese members. Further, a high frequency of direct feedback contributed to successful adaptation of both American and Japanese members. These findings provide guidance for an increasing number of MNO managers.
Language attitudes by university students in mainland China
Authors: Liu Binmei , Feng Pengpeng , Feng Qingtao , Li Jihong , Li Yuping
Published: August 2018

Through a questionnaire survey of non-local university students, this study examined direct language attitudes of English, Putonghua, and local dialects in the first-tier city Guangzhou, second-tier city Tianjin, and small city Yan’an. The significance of this study lies in two aspects: few of the previous studies examined language attitudes of non-local subjects; few of the previous studies compared attitudes toward three varieties across economically diverse cities. The study adoptedGardner & Lambert’s (1972)motivation theory to measure direct attitudes of the participants. Findings included that non-local students showed positive attitudes toward Cantonese both integratively and instrumentally but not toward the Tianjin and Yan’an dialects. Furthermore, students had positive integrative and instrumental attitudes toward Putonghua in all three cities. Finally, they showed high and positive integrative and instrumental attitudes toward English, with the means of Guangzhou and Tianjin higher than those of Yan’an. Future research should incorporate qualitative measures to provide a deeper understanding of language attitudes.
Mining foreign language teaching manuals for the history of pragmatics
Authors: McLelland Nicola
Published: August 2018

Foreign language learning manuals can be valuable sources for the history of pragmatics and historical pragmatics. They may contain explicit guidance on pragmatics not found in native-speaker grammars. For example, accounts of German forms of address in seventeenth- and eighteenth-century English–German manuals provide evidence of changing views on the appropriateness ofihrandSieearlier than does the “native” grammatical tradition. The bilingual model dialogues that are typical of such manuals may also implicitly model appropriate linguistic behaviour, demonstrated here by examining the communicative genre of bargaining in a series of three related English–Dutch language manuals of the seventeenth and eighteenth centuries. Furthermore, the dialogues may provide metalinguistic comment on linguistic behaviour – for example, by criticizing the culture of excessive negative politeness. Such sources can enrich our knowledge of language use and attitudes to language use in the area of politeness, complementing the evidence to be gleaned from mainstream native grammars, civility manuals, merchants’ guides, and the like.
Evidentiality and propositional scope in Early Modern German
Authors: Whitt Richard J.
Published: August 2018

This paper provides an overview of verbal markers of evidentiality in Early Modern German (1650 to 1800) in light of Boye’s propositional scope hypothesis. The markers under investigation include the semi-auxiliaryscheinen(‘to shine, appear, seem’) and the perception verbssehen(‘see’) andhören(‘hear’). I show that, although Boye’s hypothesis sheds new light on and calls into question previous diachronic accounts ofscheinen, it appears not to account fully for why cases where perception verbs do not scope over propositions are also found with evidential readings in light of the larger discourse context. I will show that Boye’s hypothesis is still feasible when such contexts are taken into account. Data are drawn from the German Manchester Corpus (GerManC), a representative multi-register corpus of Early Modern German from 1650 to 1800.
The evolution of the Ancient Greek deverbal pragmatic markerságe, íthiandphére
Authors: Zakowski Samuel
Published: August 2018

In this paper, I look at the Ancient Greek expressionságe, íthiandphére, which are all usually translated as ‘come (on)’. After discussing some existing accounts of these items, I look at their structural – syntactic properties and argue that they can be regarded as pragmaticalized imperatives. Then, I propose a new interpretation of their function – on this analysis, they can be regarded as conversational “boosters”, increasing the degree of strength of the illocutionary point of the utterance. Finally, I look at their diachronic development – in the corpus under consideration,ágeis gradually replaced byíthias the expression used with other imperatives, whilephéredevelops as the preferred expression for use with non-imperative directive utterances.
When a robot understands Brazilian Portuguese
Authors: Vidal Cristiane Denise
Published: August 2018

This paper sets out to highlight some of the complexities involved in the game localization process by presenting a case study centered on the educational gameLudwig.It was released in Austria in 2011 just in German and later, due to its success, it was later localized into English, Brazilian Portuguese, Chinese and Japanese. The case study focusses on the localization of the language pair English-Brazilian Portuguese and the theoretical framework relies on the notion ofParatranslation(Yuste Frías 2012).
Data collection in the research on the effectiveness of corrective feedback
Authors: Li Shaofeng
Published: August 2018

This chapter seeks to provide a comprehensive and in-depth synthesis of the methods of data collection used in studies investigating the effectiveness of corrective feedback (CF). A total of 34 studies published between 2006 and 2017 in five top journals in second language acquisition were selected for the review. The methods of data collection reported in the studies were coded in terms of CF treatment, CF elicitation task, and the measurement of CF effects. CF treatment was further coded as CF operationalization, the context of CF treatment, pre-treatment instruction, and CF amount. CF elicitation task is discussed with regard to task type and task validation. Task type concerns whether communicative tasks or mechanical drills were used to elicit the target structure, and task validation pertains to whether and how the primary researchers provided evidence for task complexity and for the contexts of obligatory use of the target structure. The measurement of CF effects is examined in terms of whether treatment effects are measured via tests of explicit or implicit knowledge and whether treatment effects are operationalized as mastery of the target structure, use of a more advanced variant of a structure (staged development), automatization of existing knowledge, or learners’ overall task performance indexed by the complexity, accuracy, and fluency of their speech production. For each coded methodological feature, current practices are reported, limitations and challenges are identified, and solutions are recommended.
The strength of meaning
Authors: Bordag Denisa , Opitz Andreas , Rogahn Maria , Tschirner Erwin
Published: August 2018

In two experiments, we explored the integration of newly learned L2 German lexical units with differing semantic properties into
the L2 semantic network. Previous studies (Dagenbach et al., 1990 for L1; Bordag et al., 2016 for L2) have indicated that the access to emergent representations
with weak memory traces is supported by a retrieval mechanism that inhibits their semantically related competitors with lower
activation thresholds and higher selection potential. In this study used pseudowords as novel L2 items and employed semantic
priming and semantic categorization tasks as well as an introspective post-test to explore whether the access to new L2 words is
modulated by meaning novelty (Experiment 1) and elaborateness (Experiment 2).
Discrete dimension accessibility in multidimensional concepts
Authors: Fadlon Julie , Sassoon Galit W. , Schumacher Petra B.
Published: August 2018

Previous studies have identified that conceptual categories corresponding to nouns exhibit semantic domain effects: (1) classification into biological ones reflects a non-additive consideration of their defining dimensions whereas classification into artefactual and, presumably, social nouns is based on an additive one (2) nominal biological concepts are less graded than artifacts. Nevertheless, much uncertainty exists about the structure of conceptual categories corresponding to multidimensional adjectives. We propose that the effects observed for concepts corresponding to nouns are connected to a property we termdiscrete dimension accessibilityand ask how it is manifested in multidimensional concepts corresponding to adjectives. We then hypothesize that (a) ratings of dimension-counting structures can be used as a diagnostic for these properties (b) the dimensions of multidimensional concepts corresponding to adjectives are inherently discrete. We report an acceptability rating experiment involving 42 adult Hebrew speakers revealing that with nouns, dimension-counting constructions with artefactual and social predicates are rated higher than ones with biological predicates, hence confirming (a). With adjectives, ratings for dimension-counting constructions remained high across the domain manipulation, hence confirming (b). We argue that the interaction between discrete dimension accessibility and lexical category indicates that lexical distinctions interact with conceptual ones.
Root-letter priming in Maltese visual word recognition
Authors: Geary Jonathan A. , Ussishkin Adam
Published: August 2018

We report on a visual masked priming experiment designed to explore the role of morphology in Maltese visual word recognition. In a
lexical decision task, subjects were faster to judge Maltese words of Semitic origin that were primed by triconsonantal
letter-strings corresponding to their root-morphemes. In contrast, they were no faster to judge Maltese words of non-Semitic
origin that were primed by an equivalent, but non-morphemic, set of three consonant letters, suggesting that morphological
overlap, rather than simple form overlap, drives this facilitatory effect. Maltese is unique among the Semitic languages for its
orthography: Maltese alone uses the Latin alphabet and requires that all vowels are written, making such triconsonantal strings
illegal non-words to which Maltese readers are never exposed, as opposed to other Semitic languages such as Hebrew in which
triconsonantal strings often correspond to real words. Under a decomposition-based account of morphological processing, we
interpret these results as suggesting that across reading experience Maltese readers have abstracted out and stored root-morphemes
for Semitic-origin words lexically, such that these morphemic representations can be activated by exposure to root-letters in
isolation and thus prime morphological derivatives.
On the syntax of spoken French
Authors: Sabio Frédéric
Published: August 2018

This paper gives an account of the research carried out by theGroupe Aixois de Recherche en Syntaxe(GARS, Aix-Marseille University), in the field of spoken French description. Our framework explicitly states the need for two independent but related levels of grammatical description, namely themicrosyntacticandmacrosyntacticlevels. Elaborating a twofold model has allowed us to propose a descriptive method differing from traditional sentence-based analyses, which raise considerable difficulties, especially in the domain of spoken language description. Regarding the “maximal-units” of syntactic description, our framework suggests that two different kinds of units should be postulated: Government-Units and Utterance-Units. The paper illustrates the distinction between the micro- and macro-syntactic components by introducing examples mostly drawn from spoken French corpora.
A Comparative Grammar of the Early Germanic Languages
Authors: Fulk R.D.
Published: August 2018

Fulk’s Comparative Grammar offers an overview of and bibliographical guide to the study of the phonology and the inflectional morphology of the earliest Germanic languages, with particular attention to Gothic, Old Norse / Icelandic, Old English, Old Frisian, Old Saxon, and Old High German, along with some attention to the more sparsely attested languages. The sounds and inflections of the oldest Germanic languages are compared, with a view to reconstructing the forms they took in Proto-Germanic and comparing those reconstructed forms with what is known of the Indo-European protolanguage. Students will find the book an informative introduction and a bibliographically instructive point of departure for intensive research in the numerous issues that remain profoundly contested in early Germanic language history.
Researching translation and interpreting in Non-Governmental Organisations
Authors: Tesseur Wine
Published: August 2018

Non-governmental organisations hold an important place in today’s globalised society. After presenting an overview of previous research on Translation and Interpreting Studies on language mediation in NGOs, this introduction to the special issue argues that more research into NGOs’ translation and interpreting practices and policies is required to better understand these organisations and their influence on global society. The introduction engages with what NGO practitioners and professional translators have said on current challenges in translating and interpreting in the context of NGOs, and what this implies for future research and training in Translation and Interpreting Studies. Lastly, it reflects on the use of interdisciplinary approaches to understanding NGOs as global organisations and discusses the contribution that Translation and Interpreting Studies could make to other disciplines that aim to gain new insights on these organisations.
The politics of multilingualism in Canada
Authors: Cardinal Linda , Léger Rémi
Published: August 2018

Language and linguistic diversity are eminently political in Canada. The country has two official languages, English and French, an official multiculturalism policy that encourages the retention and use of non-official languages, and basic measures for the promotion of aboriginal languages. This chapter raises the important question of language policy choices in Canada. How and why Canada made certain language policy choices – for example, privileging English and French over other languages, including aboriginal languages – and avoided others. In answering this question, we rely on two key concepts from political science: “state tradition” and “language regime”. Taken together, these two concepts serve as the basis for a neo-institutional approach for the study of the politics of multilingualism.
A Russian-speaking nation?
Authors: Zamyatin Konstantin
Published: August 2018

The study explores Russia’s language policy in its connection to the nation-building project. The data demonstrate that, in the recent years, the policy-makers have increased their efforts at strengthening the position of Russian both in Russia and abroad. The policy analysis reveals that the intention is to use the language as a tool to foster national identity. However, this might be not as easy a task as one might assume because language itself influences the choice of strategy in the nation-building process.
The impact of mobility and migration on the identity-constructing policy in Brussels
Authors: Janssens Rudi
Published: August 2018

The Belgian model is based upon monolingual territories and the integrative power of the two traditional “imagined communities” of Dutch and French speakers. The institutionalisation of this policy in the 1970 led to a particular political model without a national language, national political parties, national education or national media.

For Brussels, this resulted in a complex model of dual bilingualism with two language communities and a situation of partial power-sharing. Since then, however, Brussels has been subject to a diversified form of migration which has led to the current situation in which half of the population has non-Belgian roots. This results in a highly multilingual and multicultural environment.

However, this identity-constructing policy based upon the two traditional language groups no longer meets the expectations of this diverse population. This chapter focuses on the confrontation between top-down identity-constructing bilingual policy and the framing of the political debate, on the one hand, and the sense of belonging in a multilingual and multicultural setting, on the other.
The promise and pitfalls of global English
Authors: Ricento Thomas
Published: August 2018

In this chapter, I explore the purported and actual effects of global English in contexts in which it is often seen as a way of enhancing socioeconomic mobility. While some studies suggest that proficiency in English in countries where it is not an official or dominant language may correlate with higher wages, many other studies demonstrate that English-medium instruction in these countries is detrimental to academic achievement and the attainment of a high level of literacy in any language. The chapter also explores the concepts “English as a Lingua Franca” (ELF) and “Lingua Franca English” (LFE) and critically examines claims that there is, or could be, a “neutral” variety of English for global communication, one that requires a change in current views on the nature of language itself.
Languages, norms and power in a globalised context
Authors: Marácz László
Published: August 2018

An important branch of linguistics, namely, sociolinguistics, considers “languages” as normative social constructs and not as fixed communication tools characterised by an identifiable set of core features. The latter position was defended in the early sociolinguistic studies of Joshua Fishman on language decline and maintenance in the second half of the twentieth century and in the influential work on generative grammar of Noam Chomsky. In contradiction or contrast to this position, today’s sociolinguistics, which I will refer to as “mainstream sociolinguistics” in this chapter, claims that, in the default case, languages have no fixed boundaries and that they are, in fact, “fluid”. The main argument which mainstream sociolinguistics puts forward to support this claim is that the output of speech production, i.e., referred to as “languaging”, taps from linguistic resources and not from identifiable languages. This chapter argues against this theory. Firstly, multilingual phenomena, including hybrid varieties of global English and hybrid expressions in linguistic landscapes, including that of the Dutch city of Utrecht which claimed to support the languaging-approach, are, in fact, traditional cases of code-switching and code-mixing involving identifiable languages. Secondly, the languaging-approach, in contrast to the languages-approach, makes the wrong predictions. The absence of identifiable languages predicts the “flattening” of linguistic power relations. However, it will be argued that, even in a linguistically highly diverse context, a re-arrangement of power relations between languages takes place and that language hierarchies pop up. Hence, the theory which recognises individual languages makes the correct predictions. Thus, there is no reason to abandon the language concept of early sociolinguistics or Chomskyan linguistics that languages, or at least some modules of language, especially in the domain of semantics and pragmatics, are socially constructed, but that, at the same time, they are characterised by a prototypical grammatical and lexical basic core.
The global tomato industry.
Authors: Costa J. M. , Heuvelink E.
Published: August 2018

This chapter focuses on the classification and taxonomy and uses and available cultivars and types of tomatoes. Information on the production and marketing aspects of the global tomato industry is discussed and future perspectives for the tomato sector are highlighted.
Crop growth and yield.
Authors: Heuvelink E. , Li Tao Li Tao , Dorais M.
Published: August 2018

This chapter focuses on the various processes that determine the growth and yield of tomatoes, with emphasis on the influence of environmental factors and crop management, such as light, carbon dioxide, temperature, humidity, salinity, plant density and leaf and fruit pruning. Guidelines on how to grow tomato in experiments with a controlled environment are also provided.
Greenhouse tomato production.
Authors: Kubota C. , Gelder A. de , Peet M. M.
Published: August 2018

This chapter presents an overview of the greenhouse tomato industry and discusses the advantages and disadvantages of various greenhouse structures and management systems.
Organic tomato.
Authors: Dorais M. , Schwarz D.
Published: August 2018

This paper provides information on the guiding principles and standards of organic agriculture and focuses on the productivity and profitability, cultivar selection, seedling production, use of organic fertilizers and soil amendments, irrigation systems, pest, pathogen and weed control strategies and fruit quality and safety of organic tomatoes. The environmental impact of organic tomato farming is also discussed.
Synthesis, characterisation and electrochemical evaluation of a functionalised coating for mild steel corrosion protection
Authors: Bustos-Terrones Victoria , Uruchurtu Jorge , Rochín-Medina Jesús J. , Ramírez Karina , Rangel-Peraza Jesús G. , Romero-Romo Mario A. , Bustos-Terrones Yaneth
Published: August 2018

A functionalised coating for mild steel corrosion protection was prepared in this study. A composite material SBA-15 (silicon oxide) was used as a mild steel corrosion inhibitor. The porous matrix (SBA-15) was loaded with fluconazole (F), as an inhibitor container. A sol–gel technique was used to synthesise SBA-15; and the active molecule (F) was extracted from an outdated medication using methanol as solvent. The final composite was obtained by SO2 dispersion in a methanol-F solution. The composite material was dispersed in a nitrocellulose resin, and it was characterised by X-ray Diffraction (XRD), Scanning Electron Microscopy (SEM), Transmission Electron Microscope (TEM), Fourier Transform Infrared Spectrometry (FTIR), and physical adsorption of Nitrogen. Coatings were electrochemically evaluated by electrochemical impedance spectroscopy (EIS) tests, using a chloride/sulphate solution prepared from NaCl and (NH4)2SO4. The results demonstrated the effectiveness of the inhibitor delivery system and the consequent protection of metal against the corrosion process.
Anodic reactions of NADH model compound by utilizing both light irradiation and riboflavin as a redox mediator
Authors: Yano Jun , Suzuki Kenta , Tsutsumi Chikara , Mabuchi Michiaki , Hayase Nobuki , Kitani Akira
Published: August 2018

Both light and a redox mediator riboflavin (RF) were utilized to promote the electro-oxidation of an NADH model compound (1-benzyl-1,4-dihydronicotinamide, BNAH), which is a key process for enzymatic biofuel cells to obtain a high performance. At the cathode, H+ ions were simultaneously reduced to produce H2 gas. To elucidate the cell reactions of this photogalvanic cell, which is significant information about the fabrication of enzymatic biofuel cells with a high performance, the effect of the BNAH and RF concentrations on the cell current, the light wavelength dependence on the current, and reduction of the RF concentration were evaluated. The obtained results strongly suggest that the anodic reactions were composed of the following reactions: 1) the photo-excitation of RF, 2) the attack of the excited RF on the BNAH and the generation of the radical species of BNAH and RF, and 3) the chain reactions between the radical species.
Detection of spatial and temporal hydro-meteorological trends in Lake Michigan, Lake Huron and Georgian Bay
Authors: Javed Aisha , Cheng Vincent Y. S. , Arhonditsis George B.
Published: August 2018

The Laurentian Great Lakes represent the largest freshwater basin on Earth, containing 21% of the world's surface fresh water by volume. Water level fluctuations are an on-going concern and have received considerable attention in the area. We present a trend analysis of meteorological (air temperature, cloud cover, and wind speed) and hydrological (precipitation, runoff, and evaporation) variables for Lake Michigan, Lake Huron, and Georgian Bay. Using the non-parametric Mann-Kendall test, our analysis identified significant upward trends in daily minimum air temperature, whereas daily maximum air temperature demonstrated weakly decreasing trends in space and time. Evaporation was found to be increasing from late spring until early fall and this pattern may be explained by the shortening of the ice/snow cover period, which results in faster warming of lake surface due to the induced variations in albedo feedback. Time-series analysis of the over-lake precipitation revealed mostly non-significant statistical trends. Recent temperature increases may have led to elevated winter runoff in the Great Lakes region, given that precipitation falls mainly as rain instead of snow. We also provide clear evidence of reduced cloud cover and wind speed. Our study offers critical insights into the patterns of within- and among-year variability of hydro-meteorological variables useful in elucidating the mechanisms that modulate water levels in the Great Lakes.
Pointless spatial modeling
Authors: Wilson Katie , Wakefield Jon
Published: August 2018

The analysis of area-level aggregated summary data is common in many disciplines including epidemiology and the social sciences. Typically, Markov random field spatial models have been employed to acknowledge spatial dependence and allow data-driven smoothing. In the context of an irregular set of areas, these models always have an ad hoc element with respect to the definition of a neighborhood scheme. In this article, we exploit recent theoretical and computational advances to carry out modeling at the continuous spatial level, which induces a spatial model for the discrete areas. This approach also allows reconstruction of the continuous underlying surface, but the interpretation of such surfaces is delicate since it depends on the quality, extent and configuration of the observed data. We focus on models based on stochastic partial differential equations. We also consider the interesting case in which the aggregate data are supplemented with point data. We carry out Bayesian inference and, in the language of generalized linear mixed models, if the link is linear, an efficient implementation of the model is available via integrated nested Laplace approximations. For nonlinear links, we present two approaches: a fully Bayesian implementation using a Hamiltonian Monte Carlo algorithm and an empirical Bayes implementation, that is much faster and is based on Laplace approximations. We examine the properties of the approach using simulation, and then apply the model to the classic Scottish lip cancer data.
Small size does not restrain frugivory and seed dispersal across the evolutionary radiation of Galápagos lava lizards
Authors: HervÍas-Parejo Sandra , Heleno Ruben , Rumeu Beatriz , Guzmán Beatriz , Vargas Pablo , Olesen Jens M , Traveset Anna , Vera Carlos , Benavides Edgar , Nogales Manuel
Published: August 2018

Frugivory in lizards is often assumed to be constrained by body size; only large individuals are considered capable of consuming fruits, with the potential of acting as seed dispersers. However, only one previous study has tested the correlation of frugivory with body and head size at an archipelago scale across closely related species. All nine lava lizards (Microlophus spp.) were studied on the eleven largest Galápagos islands from 2010 to 2016 to investigate whether frugivory is related to body and head size. We also tested whether fruit abundance influences fruit consumption and explored the effect of seed ingestion on seedling emergence time and percentage. Our results showed that across islands, lava lizards varied considerably in size (64–102 mm in mean snout–vent length) and level of frugivory (1–23%, i.e., percentage of droppings with seeds). However, level of frugivory was only weakly affected by size as fruit consumption was also common among small lizards. Lava lizards consumed fruits throughout the year and factors other than fruit abundance may be more important drivers of fruit selection (e.g., fruit size, energy content of pulp). From 2,530 droppings, 1,714 seeds of at least 61 plant species were identified, 76% of the species being native to the Galápagos. Most seeds (91%) showed no external structural damage. Seedling emergence time (44 versus 118 days) and percentage (20% versus 12%) were enhanced for lizard-ingested seeds compared to control (uningested) fruits. De-pulping by lizards (i.e., removal of pulp with potential germination inhibitors) might increase the chances that at least some seeds find suitable recruitment conditions. We concluded that lizards are important seed dispersers throughout the year and across the whole archipelago, regardless of body size.
The Galactic warp revealed by Gaia DR2 kinematics
Authors: Poggio E , Drimmel R , Lattanzi M G , Smart R L , Spagna A , Andrae R , Bailer-Jones C A L , Fouesneau M , Antoja T , Babusiaux C , Evans D W , Figueras F , Katz D , Reylé C , Robin A C , Romero-Gómez M , Seabroke G M
Published: August 2018

Using Gaia DR2  astrometry, we map the kinematic signature of the Galactic stellar warp out to a distance of 7 kpc from the Sun. Combining Gaia DR2  and 2-Micron All Sky Survey photometry, we identify, via a probabilistic approach, $599 \, 494$ upper main sequence (UMS) stars and $12\, 616\, 068$ giants without the need for individual extinction estimates. The spatial distribution of the UMS stars clearly shows segments of the nearest spiral arms. The large-scale kinematics of both the UMS and giant populations show a clear signature of the warp of the Milky Way, apparent as a gradient of 5–6 km s−1 in the vertical velocities from 8 to 14 kpc in Galactic radius. The presence of the signal in both samples, which have different typical ages, suggests that the warp is a gravitationally induced phenomenon.
A Comparison of the Existing Wellness Programs in Neurosurgery and Institution Champion's Perspectives
Authors: Wolfe Stacey Quintero , West James L , Hunt Matthew A , Murad Gregory J A , Fox W Christopher , Dow Jamie , Morone Peter J , Wellons John C , Podet Adam , Wilson Jason , Wu Julian K , Spiotta Alejandro M , Fargen Kyle M
Published: August 2018

Once the accepted norm during Harvey Cushing's time, the mantra of work to the exclusion of family and lifestyle is now recognized as deleterious to overall well-being. A number of neurosurgical residency training programs have implemented wellness programs to enhance the physical, mental, and emotional well-being of trainees and faculty. This manuscript highlights existing organized wellness education within neurosurgery residency programs in order to describe the motivations behind development, structure, and potential implementation strategies, cost of implementation, and identify successes and barriers in the integration process. This manuscript is designed to serve as a “how-to” guide for other programs who may identify a need in their own trainees and begins the discussion of how to develop wellness, leadership, grit, and resiliency within our future generation of neurosurgeons.
Lateral Transorbital Versus Endonasal Transpterygoid Approach to the Lateral Recess of the Sphenoid Sinus—A Comparative Anatomic Study
Authors: Alves-Belo Joao T , Mangussi-Gomes Joao , Truong Huy Q , Cohen Salomon , Gardner Paul A , Snyderman Carl H , Stefko S Tonya , Wang Eric W , Fernandez-Miranda Juan C
Published: August 2018

BACKGROUND

The treatment of cerebrospinal fluid leaks of the lateral recess of the sphenoid sinus (LRSS) faces difficulties due to the deep location of the osseous defect. When treated with craniotomies, brain retraction is a concern. The endoscopic endonasal transpterygoid approach (EETA) is a direct and less invasive procedure; however, it may require transection of the vidian nerve (VN).

OBJECTIVE

To investigate the feasibility of a lateral transorbital approach (LTOA) as an alternative pathway to the LRSS that avoids VN sacrifice.

METHODS

Six embalmed heads with well-pneumatized LRSS were preselected by inspecting their computed tomography scans. One LTOA and one EETA were performed on 1 side of each specimen. The approaches were compared regarding working distance and neurovascular structures being sacrificed. The working area of the LTOA was also measured.

RESULTS

The average working distances were 59.9 (±2.94) mm for the LTOA and 76.4 (±3.99) mm for the EETA (P < .001). The LTOA generated a working area with a diameter of 9 to 14 mm. The EETA demanded the sacrifice of VN and the sphenopalatine artery in all specimens to expose the LRSS. No neurovascular structures were found in the trajectory of the LTOA.

CONCLUSION

The LTOA to the LRSS is feasible, with minimal risk of injuring neurovascular structures. It offers a shorter pathway when compared to the EETA. Although the LTOA provides no options for vascularized flap reconstruction, it allows immediate access to muscle grafts. The LTOA may serve as an alternative to treating cerebrospinal fluid leaks of the LRSS.
Mitigating Barriers to Doctoral Education for Nurses
Authors: Taylor Laura A. , Terhaar Mary F.
Published: August 2018

AIM

This article reports preliminary outcomes of the Guiding Initiative for Doctoral EducationSM, which promotes success in doctoral study.

BACKGROUND

Nurses face challenges as they move intentionally, effectively, and expediently toward earning the doctorate. Selecting the doctoral education best suited to individual career goals is essential for success.

METHOD

An intensive, daylong program focused on setting goals, generating personal action plans, and mobilizing resources to promote success in application and return to the role of student.

RESULTS

Based on 70 nurses who participated in seven programs, 22 (31 percent) were admitted to their doctoral program of choice (6 PhD, 15 DNP, 1 EdD).

CONCLUSION

Nurses benefit from and value learning about the options for doctoral study, requirements for educational opportunities, the nature of the commitment required, challenges commonly encountered during the process, and the impact advanced education can be expected to have on immediate and long-term career opportunities.
Topiramate Pharmacotherapy for Alcohol Use Disorder and Other Addictions: A Narrative Review
Authors: Manhapra Ajay , Chakraborty Anirban , Arias Albert J.
Published: August 2018

Topiramate is a non-benzodiazepine anticonvulsant medication with multi-faceted pharmacologic action. It has emerged as an efficacious pharmacotherapeutic option for the treatment of addiction, especially alcohol use disorder (AUD). We present a broad narrative review of the putative mechanism of action and clinical utility of topiramate with regard to AUD and other substance use disorders. Collective evidence suggests topiramate is an effective treatment option in AUD, with notable efficacy in reducing harmful drinking patterns in AUD. Though not currently approved by the United States Food and Drug Administration for the indication of AUD, topiramate should be considered as a pharmacological treatment option with high utility among AUD patients. Early pharmacogenetic studies raise the intriguing possibility of identifying patients likely to respond to topiramate using genetic testing, and initial studies show that topiramate may also be useful in treating cocaine use disorder, smoking cessation and behavioral addictions. However, further research is needed in all these areas.
Identifying Thoracic Compensation and Predicting Reciprocal Thoracic Kyphosis and Proximal Junctional Kyphosis in Adult Spinal Deformity Surgery
Authors: Protopsaltis Themistocles S. , Diebo Bassel G. , Lafage Renaud , Henry Jensen K. , Smith Justin S. , Scheer Justin K. , Sciubba Daniel M. , Passias Peter G. , Kim Han Jo , Hamilton David K. , Soroceanu Alexandra , Klineberg Eric O. , Ames Christopher P. , Shaffrey Christopher I. , Bess Shay , Hart Robert A. , Schwab Frank J. , Lafage Virginie
Published: August 2018

Study Design.

Retrospective analysis.

Objective.

To define thoracic compensation and investigate its association with postoperative reciprocal thoracic kyphosis and proximal junctional kyphosis (PJK)

Summary of Background Data.

Adult spinal deformity (ASD) patients recruit compensatory mechanisms like pelvic retroversion and knee flexion. However, thoracic hypokyphosis is a less recognized compensatory mechanism.

Methods.

Patients enrolled in a multicenter ASD registry undergoing fusions to the pelvis with upper instrumented vertebra (UIV) between T9 and L1 were included. Patients were divided into those with postoperative reciprocal thoracic kyphosis (reciprocal kyphosis [RK]: change in unfused thoracic kyphosis [TK] ≥15°) with and without PJK and those who maintained thoracic alignment (MT). Thoracic compensation was defined as expected thoracic kyphosis (eTK) minus preoperative TK.

Results.

For RK (n = 117), the mean change in unfused TK was 21.7° versus 6.1° for MT (n = 102) and the mean PJK angle change was 17.6° versus 5.7° for MT (all P < 0.001). RK and MT were similar in age, body mass index (BMI), sex, and comorbidities. RK had larger preoperative PI–LL mismatch (30.7 vs. 23.6, P = 0.008) and less preoperative TK (22.3 vs. 30.6, P < 0.001), otherwise sagittal vertical axis (SVA), pelvic tilt (PT), and T1 pelvic angle (TPA) were similar. RK patients had more preoperative thoracic compensation (29.9 vs. 20.0, P < 0.001), more PI–LL correction (29.8 vs. 17.3, P < 0.001), and higher rates of PJK (66% vs. 19%, P < 0.001). There were no differences in preoperative health-related quality of life (HRQOL) except reciprocal kyphosis (RK) had worse Scoliosis Research Society questionnaire (SRS) appearance (2.2 vs. 2.5, P = 0.005). Using a logistic regression model, the only predictor for postoperative reciprocal thoracic kyphosis was more preoperative thoracic compensation. Postoperatively the RK and MT groups were well aligned. Both younger and older (>65 yr) RK patients had greater thoracic compensation than MT counterparts. The eTK was not significantly different from the postoperative TK for the RK group without PJK (P = 0.566).

Conclusion.

The presence of thoracic compensation in adult spinal deformity is the primary determinant of postoperative reciprocal thoracic kyphosis and these patients have higher rates of proximal junctional kyphosis.

Level of Evidence: 3
A Novel Method for the Prediction of the Pedicle Screw Stability
Authors: Ishikawa Koji , Toyone Tomoaki , Shirahata Toshiyuki , Kudo Yoshifumi , Matsuoka Akira , Maruyama Hiroshi , Hayakawa Chikara , Tani Soji , Sekimizu Masaya , Tsuchiya Koki , Eguro Takeshi , Oshita Yusuke , Ozawa Tomoyuki , Nakao Yusuke , Sano Shigeo , Nagai Takashi , Kanzaki Koji , Inagaki Katsunori
Published: August 2018

Study Design:

Prospective feasibility study on consecutive patients.

Objective:

The aim of this study was to investigate the ability of regional BMD around the pedicle screw to predict the screw fixation.

Summary of Background Data:

Pedicle screw fixation is the gold standard technique for spinal fusion. Despite the advantage of biomechanical stability, screw loosening is a common complication. In previous studies, pullout strength and screw insertional torque were correlated, and most importantly, affected by bone mineral density (BMD). Although the density and structure of the vertebral body are not homogeneous, no study has yet evaluated the relationship between screw insertional torque and regional BMD around the pedicle screw in vivo.

Methods:

Consecutive 50 patients, scheduled for transpedicular fixation, were evaluated preoperatively for BMD measured by dual-energy absorptiometry (DXA) and quantitative computed tomography (QCT). Regional volumetric BMD around the pedicle screw (PS-vBMD) using the novel QCT technique was also evaluated. Among all patients, 190 screws (diameter, 7.5 to 8.5 mm; length, 40 to 45 mm, inserted from L1 to L5) were eligible for this study and were analyzed to identify factors contributing to insertional torque. The following factors were investigated: age, body mass index, laboratory data, pedicle diameter, screw diameter, screw length, and 5 types of bone mineral density measures [DXA: spine-areal BMD (aBMD), total hip-aBMD, femoral neck-aBMD, QCT: central-vBMD, PS-vBMD].

Results:

Insertional torque was significantly correlated with each BMD measurement and strongest with PS-vBMD (r=0.61, P<0.001). Multiple regression analysis showed PS-vBMD was most strongly correlated with screw insertional torque (stdβ=0.494; P<0.001). A model containing the following 5 predictors was significantly associated with screw insertional torque: age, pedicle diameter, screw diameter, screw length, and PS-vBMD.

Conclusions:

The preoperative measurement of PS-vBMD was technically feasible and reliably predictive of screw insertional torque during transpedicular fixation in a clinical setting.
Laryngeal Injury and Upper Airway Symptoms After Oral Endotracheal Intubation With Mechanical Ventilation During Critical Care: A Systematic Review*
Authors: Brodsky Martin B. , Levy Matthew J. , Jedlanek Erin , Pandian Vinciya , Blackford Brendan , Price Carrie , Cole Gai , Hillel Alexander T. , Best Simon R. , Akst Lee M.
Published: August 2018

Objectives:

To systematically review the symptoms and types of laryngeal injuries resulting from endotracheal intubation in mechanically ventilated patients in the ICU.

Data Sources:

PubMed, Embase, CINAHL, and Cochrane Library from database inception to September 2017.

Study Selection:

Studies of adult patients who were endotracheally intubated with mechanical ventilation in the ICU and completed postextubation laryngeal examinations with either direct or indirect visualization.

Data Extraction:

Independent, double-data extraction and risk of bias assessment followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Risk of bias assessment followed the Cochrane Collaboration’s criteria.

Data Synthesis:

Nine studies (seven cohorts, two cross-sectional) representing 775 patients met eligibility criteria. The mean (sd; 95% CI) duration of intubation was 8.2 days (6.0 d; 7.7–8.7 d). A high prevalence (83%) of laryngeal injury was found. Many of these were mild injuries, although moderate to severe injuries occurred in 13–31% of patients across studies. The most frequently occurring clinical symptoms reported post extubation were dysphonia (76%), pain (76%), hoarseness (63%), and dysphagia (49%) across studies.

Conclusions:

Laryngeal injury from intubation is common in the ICU setting. Guidelines for laryngeal assessment and postextubation surveillance do not exist. A systematic approach to more robust investigations could increase knowledge of the association between particular injuries and corresponding functional impairments, improving understanding of both time course and prognosis for resolution of injury. Our findings identify targets for future research and highlight the long-known, but understudied, clinical outcomes from endotracheal intubation with mechanical ventilation in ICU.
Phase 3 Study of OnabotulinumtoxinA Distributed Between Frontalis, Glabellar Complex, and Lateral Canthal Areas for Treatment of Upper Facial Lines
Authors: De Boulle Koenraad , Werschler William Philip , Gold Michael H. , Bruce Suzanne , Sattler Gerhard , Ogilvie Patricia , Street James , Larsen Kristin E. , Yushmanova Irina , Lei Xiaofang , Lee Elisabeth , Vitarella Domenico , Mao Cheri
Published: August 2018

BACKGROUND

Although commonly practiced, simultaneous onabotulinumtoxinA injections to multiple facial areas have not been investigated in prospective studies.

OBJECTIVE

Evaluate safety and efficacy of onabotulinumtoxinA for treatment of forehead lines (FHL) distributed between the frontalis (20 U) and glabellar complex (20 U), with or without simultaneous lateral canthal areas (crow's feet lines [CFL], 24 U) treatment.

METHODS

Subjects with moderate to severe FHL were randomized (2:2:1) to onabotulinumtoxinA 40 U, onabotulinumtoxinA 64 U, or placebo. After 180 days, subjects could receive up to 2 additional open-label onabotulinumtoxinA 64 U treatments.

RESULTS

The intent-to-treat (ITT) population comprised 787 subjects, and the modified ITT (mITT) population (subjects with psychological impact) comprised 568. After 30 days, onabotulinumtoxinA 40 U and 64 U significantly improved investigator- and subject-assessed FHL severity by at least 2 Facial Wrinkle Scale (FWS) grades in 45.6% and 53.0% of ITT subjects, respectively, versus 0.6% receiving placebo (both, p < .0001). Significantly more mITT subjects receiving onabotulinumtoxinA achieved investigator- and subject-assessed FWS ratings of none/mild versus placebo (p < .0001). OnabotulinumtoxinA was well tolerated.

CONCLUSION

OnabotulinumtoxinA distributed between the frontalis and glabellar complex, with or without additional CFL injections, was safe and effective for treatment of moderate to severe FHL.
Eye Tracking as a Biomarker for Concussion in Children
Authors: Bin Zahid Abdullah , Hubbard Molly E. , Lockyer Julia , Podolak Olivia , Dammavalam Vikalpa M. , Grady Matthew , Nance Michael , Scheiman Mitchell , Samadani Uzma , Master Christina L.
Published: August 2018

Objective:

Concussion is the most common type of brain injury in both pediatric and adult populations and can potentially result in persistent postconcussion symptoms. Objective assessment of physiologic “mild” traumatic brain injury in concussion patients remains challenging. This study evaluates an automated eye-tracking algorithm as a biomarker for concussion as defined by its symptoms and the clinical signs of convergence insufficiency and accommodation dysfunction in a pediatric population.

Design:

Cross-sectional case–control study.

Setting:

Primary care.

Patients:

Concussed children (N = 56; mean age = 13 years), evaluated at a mean of 22-week post-injury, compared with 83 uninjured controls.

Independent Variables:

Metrics comparing velocity and conjugacy of eye movements over time were obtained and were compared with the correlation between Acute Concussion Evaluation (ACE) scores, convergence, and accommodation dysfunction.

Main Outcome Measures:

Subjects' eye movements recorded with an automated eye tracker while they watched a 220-second cartoon film clip played continuously while moving within an aperture.

Results:

Twelve eye-tracking metrics were significantly different between concussed and nonconcussed children. A model to classify concussion as diagnosed by its symptoms assessed using the ACE achieved an area under the curve (AUC) = 0.854 (71.9% sensitivity, 84.4% specificity, a cross-validated AUC = 0.789). An eye-tracking model built to identify near point of convergence (NPC) disability achieved 95.8% specificity and 57.1% sensitivity for an AUC = 0.810. Reduced binocular amplitude of accommodation had a Spearman correlation of 0.752(P value <0.001) with NPC.

Conclusion:

Eye tracking correlated with concussion symptoms and detected convergence and accommodative abnormalities associated with concussion in the pediatric population. It demonstrates utility as a rapid, objective, noninvasive aid in the diagnosis of concussion.