bluuebunny/crossref_metadata_2025 huggingface dataset:
When is a container a comonad?
Authors: Ahman Danel , Chapman James , Uustalu Tarmo
Published: November 2014

Abbott, Altenkirch, Ghani and others have taught us that many parameterized
datatypes (set functors) can be usefully analyzed via container representations
in terms of a set of shapes and a set of positions in each shape. This paper
builds on the observation that datatypes often carry additional structure that
containers alone do not account for. We introduce directed containers to
capture the common situation where every position in a data-structure
determines another data-structure, informally, the sub-data-structure rooted by
that position. Some natural examples are non-empty lists and node-labelled
trees, and data-structures with a designated position (zippers). While
containers denote set functors via a fully-faithful functor, directed
containers interpret fully-faithfully into comonads. But more is true: every
comonad whose underlying functor is a container is represented by a directed
container. In fact, directed containers are the same as containers that are
comonads. We also describe some constructions of directed containers. We have
formalized our development in the dependently typed programming language Agda.
Polynomial Interpretations over the Natural, Rational and Real Numbers Revisited
Authors: Neurauter Friedrich , Middeldorp Aart
Published: November 2014

Polynomial interpretations are a useful technique for proving termination of
term rewrite systems. They come in various flavors: polynomial interpretations
with real, rational and integer coefficients. As to their relationship with
respect to termination proving power, Lucas managed to prove in 2006 that there
are rewrite systems that can be shown polynomially terminating by polynomial
interpretations with real (algebraic) coefficients, but cannot be shown
polynomially terminating using polynomials with rational coefficients only. He
also proved the corresponding statement regarding the use of rational
coefficients versus integer coefficients. In this article we extend these
results, thereby giving the full picture of the relationship between the
aforementioned variants of polynomial interpretations. In particular, we show
that polynomial interpretations with real or rational coefficients do not
subsume polynomial interpretations with integer coefficients. Our results hold
also for incremental termination proofs with polynomial interpretations.
Improving legibility of natural deduction proofs is not trivial
Authors: Pąk Karol
Published: November 2014

In formal proof checking environments such as Mizar it is not merely the
validity of mathematical formulas that is evaluated in the process of adoption
to the body of accepted formalizations, but also the readability of the proofs
that witness validity. As in case of computer programs, such proof scripts may
sometimes be more and sometimes be less readable. To better understand the
notion of readability of formal proofs, and to assess and improve their
readability, we propose in this paper a method of improving proof readability
based on Behaghel's First Law of sentence structure. Our method maximizes the
number of local references to the directly preceding statement in a proof
linearisation. It is shown that our optimization method is NP-complete.
A Fragment of Dependence Logic Capturing Polynomial Time
Authors: Ebbing Johannes , Kontinen Juha , Müller Julian-Steffen , Vollmer Heribert
Published: November 2014

In this paper we study the expressive power of Horn-formulae in dependence
logic and show that they can express NP-complete problems. Therefore we define
an even smaller fragment D-Horn* and show that over finite successor structures
it captures the complexity class P of all sets decidable in polynomial time.
Furthermore we study the question which of our results can ge generalized to
the case of open formulae of D-Horn* and so-called downwards monotone
polynomial time properties of teams.
Logical Concurrency Control from Sequential Proofs
Authors: Deshmukh Jyotirmoy , Ramalingam G. , Ranganath Venkatesh-Prasad , Vaswani Kapil
Published: November 2014

We are interested in identifying and enforcing the isolation requirements of
a concurrent program, i.e., concurrency control that ensures that the program
meets its specification. The thesis of this paper is that this can be done
systematically starting from a sequential proof, i.e., a proof of correctness
of the program in the absence of concurrent interleavings. We illustrate our
thesis by presenting a solution to the problem of making a sequential library
thread-safe for concurrent clients. We consider a sequential library annotated
with assertions along with a proof that these assertions hold in a sequential
execution. We show how we can use the proof to derive concurrency control that
ensures that any execution of the library methods, when invoked by concurrent
clients, satisfies the same assertions. We also present an extension to
guarantee that the library methods are linearizable or atomic.
Composition with Target Constraints
Authors: Arenas Marcelo , Fagin Ronald , Nash Alan
Published: November 2014

It is known that the composition of schema mappings, each specified by
source-to-target tgds (st-tgds), can be specified by a second-order tgd (SO
tgd). We consider the question of what happens when target constraints are
allowed. Specifically, we consider the question of specifying the composition
of standard schema mappings (those specified by st-tgds, target egds, and a
weakly acyclic set of target tgds). We show that SO tgds, even with the
assistance of arbitrary source constraints and target constraints, cannot
specify in general the composition of two standard schema mappings. Therefore,
we introduce source-to-target second-order dependencies (st-SO dependencies),
which are similar to SO tgds, but allow equations in the conclusion. We show
that st-SO dependencies (along with target egds and target tgds) are sufficient
to express the composition of every finite sequence of standard schema
mappings, and further, every st-SO dependency specifies such a composition. In
addition to this expressive power, we show that st-SO dependencies enjoy other
desirable properties. In particular, they have a polynomial-time chase that
generates a universal solution. This universal solution can be used to find the
certain answers to unions of conjunctive queries in polynomial time. It is easy
to show that the composition of an arbitrary number of standard schema mappings
is equivalent to the composition of only two standard schema mappings. We show
that surprisingly, the analogous result holds also for schema mappings
specified by just st-tgds (no target constraints). This is proven by showing
that every SO tgd is equivalent to an unnested SO tgd (one where there is no
nesting of function symbols). Similarly, we prove unnesting results for st-SO
dependencies, with the same types of consequences.
Realizability algebras: a program to well order R
Authors: Krivine Jean-Louis
Published: November 2014

The theory of classical realizability is a framework in which we can develop
the proof-program correspondence. Using this framework, we show how to
transform into programs the proofs in classical analysis with dependent choice
and the existence of a well ordering of the real line. The principal tools are:
The notion of realizability algebra, which is a three-sorted variant of the
well known combinatory algebra of Curry. An adaptation of the method of forcing
used in set theory to prove consistency results. Here, it is used in another
way, to obtain programs associated with a well ordering of R and the existence
of a non trivial ultrafilter on N.
An Exponential Lower Bound for the Latest Deterministic Strategy Iteration Algorithms
Authors: Friedmann Oliver
Published: November 2014

This paper presents a new exponential lower bound for the two most popular
deterministic variants of the strategy improvement algorithms for solving
parity, mean payoff, discounted payoff and simple stochastic games. The first
variant improves every node in each step maximizing the current valuation
locally, whereas the second variant computes the globally optimal improvement
in each step. We outline families of games on which both variants require
exponentially many strategy iterations.
Monotonicity Constraints for Termination in the Integer Domain
Authors: Ben-Amram Amir M.
Published: November 2014

Size-Change Termination (SCT) is a method of proving program termination based on the impossibility of infinite descent. To this end we use a program abstraction in which transitions are described by Monotonicity Constraints over (abstract) variables. When only constraints of the form x>y' and x\geq y' are allowed, we have size-change graphs. In the last decade, both theory and practice have evolved significantly in this restricted framework. The crucial underlying assumption of most of the past work is that the domain of the variables is well-founded. In a recent paper I showed how to extend and adapt some theory from the domain of size-change graphs to general monotonicity constraints, thus complementing previous work, but remaining in the realm of well-founded domains. However, monotonicity constraints are, interestingly, capable of proving termination also in the integer domain, which is not well-founded. The purpose of this paper is to explore the application of monotonicity constraints in this domain. We lay the necessary theoretical foundation, and present precise decision procedures for termination; finally, we provide a procedure to construct explicit global ranking functions from monotonicity constraints in singly-exponential time, and of optimal worst-case size and dimension (ordinal).
Constraint solving in non-permutative nominal abstract syntax
Authors: Lakin Matthew R.
Published: November 2014

Nominal abstract syntax is a popular first-order technique for encoding, and
reasoning about, abstract syntax involving binders. Many of its applications
involve constraint solving. The most commonly used constraint solving algorithm
over nominal abstract syntax is the Urban-Pitts-Gabbay nominal unification
algorithm, which is well-behaved, has a well-developed theory and is applicable
in many cases. However, certain problems require a constraint solver which
respects the equivariance property of nominal logic, such as Cheney's
equivariant unification algorithm. This is more powerful but is more
complicated and computationally hard. In this paper we present a novel
algorithm for solving constraints over a simple variant of nominal abstract
syntax which we call non-permutative. This constraint problem has similar
complexity to equivariant unification but without many of the additional
complications of the equivariant unification term language. We prove our
algorithm correct, paying particular attention to issues of termination, and
present an explicit translation of name-name equivariant unification problems
into non-permutative constraints.
Injury Risk Assessment of Non-Lethal Projectile Head Impacts
Authors: Oukara Amar , Nsiampa Nestor , Robbe Cyril , Papy Alexandre
Published: November 2014

Kinetic energy non-lethal projectiles are used to impart sufficient effect onto a person in order to deter uncivil or hazardous behavior with a low probability of permanent injury. Since their first use, real cases indicate that the injuries inflicted by such projectiles may be irreversible and sometimes lead to death, especially for the head impacts. Given the high velocities and the low masses involved in such impacts, the assessment approaches proposed in automotive crash tests and sports may not be appropriate. Therefore, there is a need of a specific approach to assess the lethality of these projectiles. In this framework, some recent research data referred in this article as “force wall approach” suggest the use of three lesional thresholds (unconsciousness, meningeal damages and bone damages) that depend on the intracranial pressure. Three corresponding critical impact forces are determined for a reference projectile. Based on the principle that equal rigid wall maximal impact forces will produce equal damage on the head, these limits can be determined for any other projectile. In order to validate the consistence of this innovative method, it is necessary to compare the results with other existing assessment methods. This paper proposes a comparison between the “force wall approach” and two different head models. The first one is a numerical model (Strasbourg University Finite Element Head Model-SUFEHM) from Strasbourg University; the second one is a mechanical surrogate (Ballistics Load Sensing Headform-BLSH) from Biokinetics.
Reality of Dental Implant Surface Modification: A Short Literature Review
Authors: Yeo In-Sung
Published: November 2014

Screw-shaped endosseous implants that have a turned surface of commercially pure titanium have a disadvantage of requiring a long time for osseointegration while those implants have shown long-term clinical success in single and multiple restorations. Titanium implant surfaces have been modified in various ways to improve biocompatibility and accelerate osseointegration, which results in a shorter edentulous period for a patient. This article reviewed some important modified titanium surfaces, exploring thein vitro,in vivoand clinical results that numerous comparison studies reported. Several methods are widely used to modify the topography or chemistry of titanium surface, including blasting, acid etching, anodic oxidation, fluoride treatment, and calcium phosphate coating. Such modified surfaces demonstrate faster and stronger osseointegration than the turned commercially pure titanium surface. However, there have been many studies finding no significant differences inin vivobone responses among the modified surfaces. Considering thosein vivoresults, physical properties like roughening by sandblasting and acid etching may be major contributors to favorable bone response in biological environments over chemical properties obtained from various modifications including fluoride treatment and calcium phosphate application. Recently, hydrophilic properties added to the roughened surfaces or some osteogenic peptides coated on the surfaces have shown higher biocompatibility and have induced faster osseointegration, compared to the existing modified surfaces. However, the long-term clinical studies about those innovative surfaces are still lacking.
The Development and Future of Reconstructive and Microvascular Surgery of the Hand
Authors: Malahias Marco , Jordan Daniel J , Hindocha Sandip , Khan Wasim , Juma Ali
Published: November 2014

The hand is often thought of as a key discriminator in what makes humans human. The hand is both intricate and fascinating in its design and function, allowing humans to interact with their surroundings, and each other. Due to its use in manipulation of the person’s environment, injury to the hand is common.

Devastating hand injuries have a profound, physical, psychological, ﬁnancial and socially crippling effect on patients.

Advances in operative techniques and improvements in microscopes and instruments allowed Malt &McKhann to perform the first successful arm replantation in 1962 [1].

This was followed by a myriad of autologous free flaps of varying composition, that were discovered after the mapping of the cutaneous blood circulation by Taylor and Palmer [2] and Mathes & Nahai’s classification of muscle flaps [3] providing us with countless options to harvest and transfer healthy, well vascularised tissues into areas of injury.

Since the late sixties, with the emerging subspecialty of microvascular reconstruction, surgeons have had the technical ability to salvage many amputated parts, even entire limbs.

The measure of functional outcomemust incorporate the evaluation and severity ofthe initial injury and the subsequent reconstructive surgeries [4].
Pilon Fracture: A Case Report of a 45-Year-Old Dental Technician
Authors: Mafi Pouya , Stanley James , Hindocha Sandip , Mafi Reza
Published: November 2014

Pilon fractures are complex and difficult-to-treat fractures of the lower extremity that account for about 1% of all lower extremity fractures and up to 10% of tibial fractures. The injury is caused by high energy axial load either from motor vehicle accidents or a fall from height. The treatment of these fractures has caused controversy among surgeons due to mixed outcomes. Here we report a case of pilon fracture in a 45 year old male patient who has sustained the injury as a result of a fall from a height of approximately 12 feet. We describe why it is absolutely crucial that the patient is treated with external fixation initially and evaluate its merits and drawbacks as well as ways to minimize the complications associated with external fixation of open intra-articular distal tibial fractures.
Psychometric Properties of the Suicidal Ideation Questionnaire among Chinese High School Students
Authors: Jia Cun-Xian , Wang Xing-Ting , Zhao Zhong-Tang
Published: November 2014

Objectives:

To test the psychometric properties of the Suicidal Ideation Questionnaire (SIQ) among Chinese high school students.

Methods:

The reliability and validity of SIQ were analyzed with data of 505 high school students in Jinan, China.

Results:

The Cronbach's coefficient alpha of SIQ was above 0.95 and the Cronbach's coefficients alphas of SIQ when each item was deleted were relatively stable. The convergent validity analyses showed that there were statistically significant correlations between SIQ total scores and DSD total scores by gender. Exploratory factor analysis produced four factors of SIQ.

Conclusion:

The SIQ has a high level of reliability and validity and should be a reliable measure for suicide ideation in Chinese high school students.
The Socio-Cultural Perception of Death in Turkish Society Recorded in Lament Epics (1955–1975)
Authors: İzgi̇ M. Cumhur , Abdulla Tarana , Çoban Mustafa , Onay Ebru , Lutz E. Elif Vatanaoglu
Published: November 2014

This study explores the socio-cultural perception of death among Turkish people. For this reason, 210 published lament epics written by Turkish folk singers across all of Turkey concerning deaths between 1955 and 1975 were selected for analysis. These epics were published on single pages and were sold. The statistical analysis based on detailed content analysis was done at the univariate, bivariate, and multivariate levels. The results of the study provide a full picture of perception of cases of death in Turkish society. These results show Turkish society is especially sensitive to cases of death at young age and to the murdered. Further, a clear perception of the working of fate is encountered in deaths resulting from disaster and accidents; but the desire for vengeance is recorded in those laments concerning martyrs and the murdered. The statistical data show that most commonly cited reasons for death after road accidents, were a consequence of relationships with the opposite sex and from a sense of honor.
The pasting constructions for effect algebras
Authors: Xie Yongjan , Li Yongming , Yang Aili
Published: November 2014

The aim of this paper is to present several techniques of constructing a lattice-ordered effect algebra from a given family of lattice-ordered effect algebras, and to study the structure of finite lattice-ordered effect algebras. Firstly, we prove that any finite MV-effect algebra can be obtained by substituting the atoms of some Boolean algebra by linear MV-effect algebras. Then some conditions which can guarantee that the pasting of a family of effect algebras is an effect algebra are provided. At last, we prove that any finite lattice-ordered effect algebra E without atoms of type 2 can be obtained by substituting the atoms of some orthomodular lattice by linear MV-effect algebras. Furthermore, we give a way how to paste a lattice-ordered effect algebra from the family of MV-effect algebras.
Quasi-Monte Carlo integration in unanchored Sobolev spaces
Authors: Fialová Jana
Published: November 2014

We find a concrete sequence of N points, for which the squared worst-case quasi-Monte Carlo error in the Hilbert space of continuous functions defined on [0, 1] with square integrable second derivative is smaller than for the centered regular lattice point set.
The maximal class with respect to maximums for the family of upper semicontinuous strong Świca¸tkowski functions
Authors: Szczuka Paulina
Published: November 2014

The main goal of this paper is to characterize the maximal class with respect to maximums for the family of upper semicontinuous strong Świşatkowski functions.
Some results on the entire function sharing problem
Authors: Chen BaoQin , Li Sheng
Published: November 2014

Our main result is as follows: let f and a be two entire functions such that $$\max \{ \rho _2 (f),\rho _2 (a)\} < \tfrac{1}
{2}$$. If f and f
(k)
a CM, and if ρ(a
(k) − a) < ρ(f − a), then f
(k) − a = c(f − a) for some nonzero constant c. This result is applied to improve a result of Gundersen and Yang.
Existence of non-trivial solutions for systems of n fourth order partial differential equations
Authors: Heidarkhani Shapour
Published: November 2014

In this paper, employing a very recent local minimum theorem for differentiable functionals due to Bonanno, the existence of at least one nontrivial solution for a class of systems of n fourth order partial differential equations coupled with Navier boundary conditions is established.
Principal bundle structure on jet prolongations of frame bundles
Authors: Brajerčík J. , Demko M. , Krupka D.
Published: November 2014

In this paper, we introduce the structure of a principal bundle on the r-jet prolongation J
r
FX of the frame bundle FX over a manifold X. Our construction reduces the well-known principal prolongation W
r
FX of FX with structure group G
nr. For a structure group of J
r
FX we find a suitable subgroup of G
nr. We also discuss the structure of the associated bundles. We show that the associated action of the structure group of J
r
FX corresponds with the standard actions of differential groups on tensor spaces.
Test-Retest and Interrater Reliability of the Functional Lower Extremity Evaluation
Authors: Haitz Karyn , Shultz Rebecca , Hodgins Melissa , Matheson Gordon O.
Published: November 2014

Study Design

Repeated-measures clinical measurement reliability study.

Objectives

To establish the reliability and face validity of the Functional Lower Extremity Evaluation (FLEE).

Background

The FLEE is a 45-minute battery of 8 standardized functional performance tests that measures 3 components of lower extremity function: control, power, and endurance. The reliability and normative values for the FLEE in healthy athletes are unknown.

Methods

A face validity survey for the FLEE was sent to sports medicine personnel to evaluate the level of importance and frequency of clinical usage of each test included in the FLEE. The FLEE was then administered and rated for 40 uninjured athletes. To assess test-retest reliability, each athlete was tested twice, 1 week apart, by the same rater. To assess interrater reliability, 3 raters scored each athlete during 1 of the testing sessions. Intraclass correlation coefficients were used to assess the test-retest and interrater reliability of each of the FLEE tests.

Results

In the face validity survey, the FLEE tests were rated as highly important by 58% to 71% of respondents but frequently used by only 26% to 45% of respondents. Interrater reliability intraclass correlation coefficients ranged from 0.83 to 1.00, and test-retest reliability ranged from 0.71 to 0.95.

Conclusion

The FLEE tests are considered clinically important for assessing lower extremity function by sports medicine personnel but are underused. The FLEE also is a reliable assessment tool. Future studies are required to determine if use of the FLEE to make return-to-play decisions may reduce reinjury rates. J Orthop Sports Phys Ther 2014;44(12):947–954. Epub 13 November 2014. doi:10.2519/jospt.2014.4809
Convection-enhanced delivery to the central nervous system
Authors: Lonser Russell R. , Sarntinoranont Malisa , Morrison Paul F. , Oldfield Edward H.
Published: November 2014

Convection-enhanced delivery (CED) is a bulk flow–driven process. Its properties permit direct, homogeneous, targeted perfusion of CNS regions with putative therapeutics while bypassing the blood-brain barrier. Development of surrogate imaging tracers that are co-infused during drug delivery now permit accurate, noninvasive real-time tracking of convective infusate flow in nervous system tissues. The potential advantages of CED in the CNS over other currently available drug delivery techniques, including systemic delivery, intrathecal and/or intraventricular distribution, and polymer implantation, have led to its application in research studies and clinical trials. The authors review the biophysical principles of convective flow and the technology, properties, and clinical applications of convective delivery in the CNS.
The supracerebellar-transtentorial approach to posteromedial temporal lesions in children with refractory epilepsy
Authors: Weil Alexander G. , Middleton Andrew L. , Niazi Toba N. , Ragheb John , Bhatia Sanjiv
Published: November 2014

OBJECT

Operations on tumors of the posteromedial temporal (PMT) region, that is, on those arising from the posterior parahippocampal, fusiform, and lingual gyri, are challenging to perform because of the deep-seated location of these tumors between critical cisternal neurovascular structures and the adjacent temporal and occipital cortexes. Traditional surgical approaches require temporal or occipital transgression, retraction, or venous sacrifice. These approaches may result in unintended complications that should be avoided. To avoid these complications, the supracerebellar-transtentorial (SCTT) approach to this region has been used as an effective alternative treatment in adult patients. The SCTT approach uses a sitting position that offers a direct route to the posterior fusiform and lingual gyri of the temporal lobe. The authors report the feasibility, safety, and efficacy of this approach, using a modified lateral park-bench position in a small cohort of pediatric patients.

METHODS

The authors carried out a retrospective case review of 5 consecutive patients undergoing a paramedian SCTT approach between 2009 and 2014 at the authors' institution.

RESULTS

The SCTT approach in the park-bench position was used in 3 boys and 2 girls with a mean age of 7.8 years (range 13 months to 16 years). All patients presented with a seizure disorder related to a tumor in a PMT region involving the parahippocampal and fusiform gyri of the left (n = 3) or right (n = 2) temporal lobe. No procedure-related complications were observed. Gross-total resection and control of seizures were achieved in all cases. Tumor classes and types included 1 Grade II astrocytoma, 1 pleomorphic xanthoastrocytoma, 1 ganglioglioma, and 2 glioneural tumors. None of the tumors had recurred by the mean follow-up of 22 months (range 1–48 months). Outcomes of epileptic seizures were excellent, with seizure symptoms in all 5 patients scoring in Engel Class IA.

CONCLUSIONS

The SCTT approach represents a viable option when resecting tumors in this region, providing a reasonable working corridor and low morbidity. The authors' experience in a cohort of pediatric patients demonstrates that complete resection of the lesions in this location is feasible and is safe when involving an approach that involves using a park-bench lateral positioning.
The supraorbital eyebrow approach in children: clinical outcomes, cosmetic results, and complications
Authors: Dlouhy Brian J. , Chae Michael P. , Teo Charles
Published: November 2014

OBJECT

The supraorbital eyebrow approach utilizes an eyebrow skin incision to fashion a supraorbital craniotomy for exposure of the subfrontal corridor. This provides anterolateral access to surgical lesions in the anterior cranial fossa, parasellar regions, brainstem, and medial temporal lobe. With use of the endoscope, further areas can be accessed. This approach has been applied effectively in adults, but questions remain about its use in children—specifically with regard to adequate working space, effectiveness for achieving the desired results, cosmesis, and complications.

METHODS

The authors conducted a retrospective review of more than 450 cases involving patients of all ages who had undergone a supraorbital eyebrow approach performed by the senior author (C.T.) from 1995 to 2013. Only cases involving patients younger than 18 years with a minimum follow-up of 6 weeks were included in this study. All inpatient and outpatient records were retrospectively reviewed and clinical/operative outcomes, cosmetic results, and complications were recorded. In the present article, the authors briefly describe the surgical approach and highlight any differences in applying it in children.

RESULTS

Fifty-four pediatric patients who had undergone a supraorbital eyebrow approach met inclusion criteria. The pathological conditions consisted mostly of tumors or other resectable lesions. In a total of 51 resectable lesions, 44 surgeries resulted in a gross-total (100%) resection and 7 cases resulted in subtotal (50%–99%) resection. The endoscope assisted and expanded visualization or provided access to areas not reached by standard microscopic visualization in all cases. Cosmetic outcomes were excellent. In all cases, the incisional scar was barely visible at 6 weeks. In 3 cases a minor bone defect was observed on the forehead. Given the small size of the frontal sinus in children, no frontal sinus breaches occurred. Additionally, no CSF leak or wound infection was identified.

CONCLUSIONS

The supraorbital eyebrow approach is extremely effective in achieving desired results in properly selected cases in patients of all pediatric age ranges, from infants to teenagers. There is sufficient working space for the endoscope and all instruments, allowing for endoscopic assistance and bimanual surgical technique. Cosmetic results are excellent, and complications related to the approach are minimal.
Effects of cross-linked high-molecular-weight hyaluronic acid on epidural fibrosis: experimental study
Authors: Isık Semra , Taşkapılıoğlu M. Özgür , Atalay Fatma Oz , Dogan Seref
Published: November 2014

OBJECT

Epidural fibrosis is nonphysiological scar formation, usually at the site of neurosurgical access into the spinal canal, in the intimate vicinity of and around the origin of the radicular sheath. The formation of dense fibrous tissue causes lumbar and radicular pain. In addition to radicular symptoms, the formation of scar tissue may cause problems during reoperation. The authors aimed to investigate the effects of cross-linked high-molecular-weight hyaluronic acid (HA), an HA derivative known as HA gel, on the prevention of epidural fibrosis by using histopathological and biochemical parameters.

METHODS

Fifty-six adult female Sprague-Dawley rats were evaluated. The rats were divided into 4 groups. Rats in the sham group (n = 14) underwent laminectomy and discectomy and received no treatment; rats in the control group (n = 14) underwent laminectomy and discectomy and received 0.9% NaCl treatment in the surgical area; rats in the HA group (n = 14) received HA treatment at the surgical area after laminectomy and discectomy; and rats in the HA gel group (n = 14) underwent laminectomy and discectomy in addition to receiving treatment with cross-linked high-molecular-weight HA in the surgical area. All rats were decapitated after 4 weeks, and the specimens were evaluated histopathologically and biochemically. The results were statistically compared using the Mann-Whitney U-test.

RESULTS

Compared with the sham and control groups, the HA and HA gel groups showed significantly lower fibroblast cell density and tissue hydroxyproline concentrations (p < 0.05). There was statistically significant lower dural adhesion and foreign-body reaction between the control and HA gel groups (p < 0.05). Granulation tissue and epidural fibrosis were significantly lower in the HA and HA gel groups compared with the sham group (p < 0.05). There were no significant differences in any histopathological parameters or biochemical values between Groups 3 and 4 (p > 0.05).

CONCLUSIONS

Cross-linked high-molecular-weight HA had positive effects on the prevention of epidural fibrosis and the reduction of fibrotic tissue density. The efficacy of this agent should also be verified in further experimental and clinical studies.
Surgery for primary supratentorial brain tumors in the United States, 2000–2009: effect of provider and hospital caseload on complication rates
Authors: Trinh Victoria T. , Davies Jason M. , Berger Mitchel S.
Published: November 2014

OBJECT

The object of this study was to examine how procedural volume and patient demographics impact complication rates and value of care in those who underwent biopsy or craniotomy for supratentorial primary brain tumors.

METHODS

The authors conducted a retrospective cohort study using data from the Nationwide Inpatient Sample (NIS) on 62,514 admissions for biopsy or resection of supratentorial primary brain tumors for the period from 2000 to 2009. The main outcome measures were in-hospital mortality, routine discharge proportion, length of hospital stay, and perioperative complications. Associations between these outcomes and hospital or surgeon case volumes were examined in logistic regression models stratified across patient characteristics to control for presentation of disease and comorbid risk factors. The authors further computed value of care, defined as the ratio of functional outcome to hospital charges.

RESULTS

High-case-volume surgeons and hospitals had superior outcomes. After adjusting for patient characteristics, high-volume surgeon correlated with reduced complication rates (OR 0.91, p = 0.04) and lower in-hospital mortality (OR 0.43, p < 0.0001). High-volume hospitals were associated with reduced in-hospital mortality (OR 0.76, p = 0.003), higher routine discharge proportion (OR 1.29, p < 0.0001), and lower complication rates (OR 0.93, p = 0.04). Patients treated by high-volume surgeons were less likely to experience postoperative hematoma, hydrocephalus, or wound complications. Patients treated at high-volume hospitals were less likely to experience mechanical ventilation, pulmonary complications, or infectious complications. Worse outcomes tended to occur in African American and Hispanic patients and in those without private insurance, and these demographic groups tended to underutilize high-volume providers.

CONCLUSIONS

A high-volume status for hospitals and surgeons correlates with superior value of care, as well as reduced in-hospital mortality and complications. These findings suggest that regionalization of care may enhance patient outcomes and improve value of care for patients with primary supratentorial brain tumors.
Vertebral artery transposition for revascularization of the posterior circulation: a critical assessment of temporary and permanent complications and outcomes
Authors: Rangel-Castilla Leonardo , Kalani M. Yashar S. , Cronk Katherine , Zabramski Joseph M. , Russin Jonathan J. , Spetzler Robert F.
Published: November 2014

OBJECT

Despite advances in medical management and endovascular therapies, including the introduction of statins, antiplatelet agents, and drug-eluting stents, some patients experience medically refractory vertebrobasilar insufficiency and may benefit from robust surgical revascularization. The aim of this study was to evaluate such patients after surgical revascularization, emphasizing long-term outcomes and rates of complications.

METHODS

The authors retrospectively identified 22 patients (5 women and 17 men) whose mean age was 69.1 years (range 48–81 years) who underwent revascularization of the posterior circulation via a proximal vertebral artery–carotid artery transposition between 2005 and 2013. The patients' conditions before surgery were clinically summarized, and long-term outcomes and complication rates after surgery were evaluated.

RESULTS

All the patients were symptomatic before surgery although they received the best medical therapy as defined by their primary care physician. Presenting symptoms consisted of stroke, transient ischemic attacks (TIAs), and/or findings attributable to posterior circulation hypoperfusion. There were no deaths associated with revascularization surgery. The postoperative complication rate was 45.5%, which included 3 cases of recurrent laryngeal nerve palsy, 1 case of thoracic duct injury, 2 cases of TIA, and 4 cases of Horner's syndrome. The thoracic duct injury was identified intraoperatively and ligated without sequelae, all the TIAs resolved within 24 hours of surgery, all 4 sympathetic plexus injuries resolved, and all but 1 of the recurrent laryngeal nerve palsies resolved, resulting in a 4.5% complication rate in a mean follow-up period of 8.8 months. All the patients had resolution of their presenting symptoms, and a single patient had symptomatic restenosis that required stenting and angioplasty, resulting in a restenosis rate of 4.5%.

CONCLUSIONS

Despite the optimization of medical therapies and lifestyle modifications, a select subset of patients with posterior vascular circulation insufficiency remains. In the authors' experience, vertebral artery–carotid artery transposition provides a surgical option with relatively low long-term complication and restenosis rates that are comparable or lower than those reported with endovascular treatment.
Clinical Profile of Patients Presenting with Carcinoma Stomach in North-East District of Bangladesh
Authors: Das Aparna , Saha Modhusudan , Shil Bimal Chandra , Yasmin Rubina , Banik Gobinda , Salam Mahjuba Umme , Minnat Baharul
Published: November 2014

Background: The pattern and incidence of Carcinoma Stomach vary widely in different parts of the world. Overall it is the 2nd most common cause of death but in some Asian countries, it is still the commonest cause of cancer death in patients of > 50 years.Aim: To analyze the clinical presentation and histological findings of patients of carcinoma of the stomach. Methods and materials: This study was done over a period of 2 years between January 2011 and December 2012. Adult patients (Age more than 18 years) of histologically confirmed as having carcinoma stomach were included in the study. Studied variables included age, gender, socioeconomic status, clinical presentations, site of lesion, histopathological subtypes. Diagnostic modalities included abdominal ultrasound, upper GI (gastrointestinal) endoscopy and endoscopic biopsy to confirm the diagnosis. Results: Total number of patients included in this study was 150. The number of patients in <50 years age group and >50 years age group were 50 (33.33%) & 100 (66.66%) respectively. The median age at presentation was 57 years. The peak incidence was in 61-70 years age group. In our study,male: female ratio being 2.3:1. By occupation, farmer 74 (49%), housewife 37(24.6%), serviceholder12(8%), business man 5(10%) and others12 (8%). 71 (47.4%) patients were from lower socioeconomic group, middle74 (49.4%), upper class 5 (3.4%) & only 63 (42%) were literate. The common clinical features were vomiting 28%, abdominal pain 18%, weight loss and anorexia 17.3% , dyspepsia 16% , Anaemia (26% ), Abdominal mass 4%, Metastatic lymph node 4%, Ascites 1.3%. lesions are involved in Cardia 14%, Body &Antrum 6.6%, Antrum 2.6%, Body 23.3%, Fundus 2% and Diffusely in 1.3% cases. Conclusion: As regards to clinical presentation, patients in our country are presenting more with features of gastric outlet obstruction whereas abdominal lump and upper GI bleeding are more common in Western world. If gastric carcinoma is diagnosed at an early stage, patients can have a highly favorable prognosis.DOI: http://dx.doi.org/10.3329/jom.v15i2.20683 J MEDICINE 2014; 15 : 118-121
Pattern of Antibiotic Sensitivity in Enteric Fever: A Tertiary Care Hospital Experience
Authors: Afroze Samira Rahat , Rahim Muhammad Abdur , Hasan Md. Mehedi , Afroz Farhana , Haque Hasna Fahmima , Ahmed Jamal Uddin , Ahmed AKM Shaheen , Hossain Md. Delwar , Rahman Md. Raziur , Musa AKM , Uddin Khwaja Nazim
Published: November 2014

Objectives: To describe the antibiotic sensitivity pattern ofSalmonella typhi and Salmonella paratyphi from blood culture specimens. Methods: This cross-sectional study was done in the Department of Medicine, BIRDEM from July 2009 to June 2012. Standard laboratory and microbiological procedures were followed for blood culture and antibiotic sensitivity tests. Results: Among the 97 blood culture positive samples, S. typhi was 71 (73.2%) and S. paratyphi was 26 (26.8%). Multi-drug resistant strains of S. typhi and S. paratyphi were 23 (32.4%) and 3 (11.5%) cases respectively. Azithromycin, nalidixic acid, ciprofloxacin, levofloxacin and amoxicillin resistance was also found in a good number of cases (S. typhi and S. paratyphi: 71.8% and 57.7%, 42.3% and 30.8%, 38% and 34.6%, 38% and 26.9% and 38% and 26.9% cases respectively). Nineteen (31.1%) of the 61ciprofloxacin sensitive organisms were resistant to nalidixic acid. Ceftriaxone was sensitive in 100% of S. typhi and S. paratyphi. Cefixim, ciprofloxacin, levofloxacin, imipenem were among the most common sensitive antibiotics (S. typhi and S. paratyphi: 83.1% and 73.1%, 62% and 65.4%, 53.5% and 65.4%, 76.1% and 65.4% cases respectively). Conclusion: Ceftriaxone was the most sensitive antibiotic for treating enteric fever followed by cefixim, imipenem and ciprofloxacin. However, in suspected cases of enteric fever, blood culture should be requested before prescribing antibiotic.DOI: http://dx.doi.org/10.3329/jom.v15i2.20684 J MEDICINE 2014; 15 : 122-124
Caronary Artery Disease in Women
Authors: Neki NS
Published: November 2014

Coronary artery disease (CAD) - which includes coronary atherosclerotic disease, myocardial infarction (MI), acute coronary syndrome and angina - is the most prevalent form of cardiovascular disease and is the largest subset of this mortality. Coronary artery disease (CAD) is a leading cause of death of women and men  worldwide. CADs impact on women traditionally has been underappreciated due to higher rates at younger ages in men. Microvascular coronary disease disproportionately affects women. Women have unique risk factors for CAD, including those related to pregnancy and autoimmune disease.DOI: http://dx.doi.org/10.3329/jom.v15i2.20687 J MEDICINE 2014; 15 : 135-140
Bilateral Blindness Due to Acute Isolated Sphenoid Sinusitis- Is It Reversible? A Case Report
Authors: Verma Roshan Kumar , Panda Naresh K
Published: November 2014

Acute isolated sphenoid sinusitis is a rare and is seen in only 3% of all cases of all sinusitis. It is frequently misdiagnosed because of its vague clinical presentation. We report a case of 35year old female who presented to our emergency department with complaints of painless rapidly developing bilateral vision loss. Non contrast computed tomography of paranasal sinuses showed only mild opacification of sphenoid sinus. Endoscopic sphenoidectomy was performed within 4 hrs of presentation. After 48 hrs of surgery the patient vision returned to 6/6 bilaterally. Acute sphenoid sinusitis should be considered in the differential diagnosis of acute vision loss. Awareness, early diagnosis, astute clinical sense and emergent intervention can prevent permanent complication.DOI: http://dx.doi.org/10.3329/jom.v15i2.20700 J MEDICINE 2014; 15 : 146-148
Disseminated Tuberculosis with Involvement of Appendix, Peritoneum and Right Knee Joint - A Case Report
Authors: Islam Mohammad Syedul , Azad Md. Abul Kalam , Mohammad Hanif , Islam Mohammad Mushahidul , Rahim Md. Abdur
Published: November 2014

A 27 year old male presented with painful swelling of right knee joint for the last 6 months. Initially it was diagnosed as a case of reactive arthritis and was treated with NSAID with intraarticular steroids without significant improvement. Two months after the initial episode he again developed painful swelling of the right knee joint with severe abdominal pain and high grade fever. There was an ill defined ovoid mass in the right iliac fossa with generalized tenderness. ESR was raised and the ultrasonography revealed loculated ascites with appendicular lump. CT scan of the whole abdomen showed appendicular lump. FNAC from the lump showed tuberculosis. Joint fluid aspiration showed neutrophilic leucocytosis with the Total count 50,000/cmm. AFB was not found. So septic arthritis was  diagnosed, but as the patient was not improving we send the patient to orthopedic department for synovial biopsy but they refused as it was septic. So a diagnosis of disseminated Tuberculosis was made with the involvement of right knee joint, appendix and peritoneum. He was put on anti TB and well responded.DOI: http://dx.doi.org/10.3329/jom.v15i2.20702 J MEDICINE 2014; 15 : 153-155
The Effect of Glycated Hemoglobin and Albumin-Corrected Glycated Serum Protein on Mortality in Diabetic Patients Receiving Continuous Peritoneal Dialysis
Authors: Peng Fenfen , Xia Xi , He Feng , Li Zhijian , Huang Fengxian , Yu Xueqing
Published: November 2014

Objective

To explore the effect of glycated hemoglobin (HbA1c) and albumin-corrected glycated serum proteins (Alb-GSP) on the mortality of diabetic patients receiving continuous peritoneal dialysis (PD).

Methods

In this single-center retrospective cohort study, incident diabetic PD patients from January 1, 2006, to December 31, 2010, were recruited, and followed up until December 31, 2011. The effect of HbA1c and Alb-GSP on mortality was evaluated by Cox proportional hazards models.

Results

A total of 200 patients (60% male, mean age 60.3 ± 10.6 years) with a mean follow-up of 29.0 months (range: 4.3 - 71.5 months) were recruited. Sixty-four patients died during the follow-up period, of whom 21 died of cardiovascular disease (CVD). Mean values for HbA1c, GSP and Alb-GSP were 6.7% (range: 4.1 - 12.5%), 202 μmol/L (range: 69 - 459 μmol/L), and 5.78 μmol/g (range: 2.16 - 14.98 μmol/g), respectively. The concentrations of GSP and Alb-GSP were closely correlated with HbA1c ( r = 0.41, p < 0.001 and r = 0.45, p < 0.001, respectively). In multivariate Cox proportional hazards models, patients with HbA1c ≥8% were associated with increased risk of all-cause mortality (hazard ratio [HR] = 2.29, 95% confidence interval [CI]: 1.06 - 4.96, p = 0.04), but no increased mortality in patients with 6.0% ≤ HbA1c ≤ 7.9%. Patients with Alb-GSP ≤ 4.50 μmol/g had increased all-cause and non-cardiovascular mortality (HR = 2.42, 95% CI: 1.13 - 5.19, p = 0.02; and HR = 2.98, 95% CI: 1.05 - 8.48, p = 0.04 respectively).

Conclusions

Increased HbA1c and decreased Alb-GSP may be associated with poorer survival in diabetic PD patients, with a non-significant trend observed for poorer survival with the highest level of Alb-GSP.