bluuebunny/crossref_metadata_2025 huggingface dataset:
Pre-Existing Mutations in the Rilpivirine Phase Iii Trials Echo and Thrive: Prevalence and Impact on Virological Response
Authors: Vingerhoets Johan , Rimsky Laurence , Van Eygen Veerle , Nijs Steven , Vanveggel Simon , Boven Katia , Picchio Gaston
Published: September 2012

Background

Rilpivirine (RPV), a non-nucleoside reverse transcriptase inhibitor (NNRTI), was approved for HIV-1 infected, antiretroviral treatment-naive adults based on data from two Phase III trials. In the screening population, the prevalence of 49 NNRTI resistance-associated mutations (RAMs) and the impact of allowed NNRTI RAMs on virological response to an RPV- or efavirenz (EFV)-containing regimen were analysed.

Methods

ECHO and THRIVE were global, Phase III, double-blind, double-dummy, randomized trials in antiretroviral treatment-naive, HIV-1-infected adults to determine whether RPV 25 mg once daily had non-inferior efficacy versus EFV 600 mg once daily, both given with tenofovir/ emtricitabine (ECHO) or tenofovir/emtricitabine, zidovudine/lamivudine or abacavir/lamivudine (THRIVE). The prevalence of 49 NNRTI RAMs, including the predefined list of 39 NNRTI RAMs used to exclude patients with potential resistance to RPV or EFV, was investigated at screening by population sequencing (including mixtures) using the virco®TYPE HIV-1 genotyping assay.

Results

Of the 1,796 screened patients in whom genotypic resistance results were available, 372 (21%) had NNRTI RAMs. Of 527 screening failures, 148 (28%) were due to the presence of NNRTI RAMs. The presence of allowed NNRTI RAMs was associated with comparable response rates to the overall population (RPV 84.3% versus EFV 82.3%, intent-to-treat time-to-loss-of-virological-response): V90I (82.4% and 100% for RPV and EFV, respectively), V106I (85.7% and 93.3%), V179I (87.7% and 94.0%) and V189I (100.0% and 88.9%).

Conclusions

Analysis of the ECHO and THRIVE screened population suggests that transmitted NNRTI resistance is prevalent in treatment-naive patients but prevalence of the 15 RPV RAMs remains low. The four allowed NNRTI RAMs present at baseline did not affect RPV response at week 48. Virus Drug Resistance and Curative Strategies (Los Cabos, Mexico, 7–11 June 2011, abstract 41).
Importance of ‘Return-to-Learn’ in Pediatric and Adolescent Concussion
Authors: Master Christina L. , Gioia Gerard A. , Leddy John J. , Grady Matthew F.
Published: September 2012

CME Educational Objectives

1.

Prescribe physical and cognitive rest for pediatric and adolescent concussion.

2.

Implement a gradual “return-to-learn” plan for student-athletes after concussion.

3.

Communicate specific school-based accommodations to facilitate a gradual reintegration to full school activities.

The concept of “return-to-play” after concussion is familiar to pediatricians who routinely care for injured student-athletes. Premature return-to-play of a student-athlete who is still injured from a concussion may result in more severe and potentially long-lasting deficits.
1
Upper-extremity Stress Fractures: Distribution and Causative Activities in 70 Patients
Authors: Miller Timothy L. , Kaeding Christopher C.
Published: September 2012

Stress fractures of the upper extremity and thorax are often unrecognized injuries in athletes and nonathletes. The authors reviewed the causative activities and anatomic distribution of rib and upper-extremity stress fractures. Radiographic and clinical information was reviewed for each case to determine anatomic site and causative activity of each stress fracture. Stress fracture, although an uncommon diagnosis outside the lower extremity and lumbar spine, should be included in the differential diagnosis of patients with pain in the ribs and upper extremity.
Association Between Low Admission Norton Scale Scores and Postoperative Complications After Elective THA in Elderly Patients
Authors: Asleh Karama , Sever Ronen , Hilu Sylvi , Ron Rachel , Gold Aviram , Aharon Menahem , Salai Moshe , Justo Dan
Published: September 2012

The Norton scoring system is used by nurses to evaluate pressure ulcer risk. The authors have previously shown that low admission Norton scale scores (ANSS) are associated with postoperative complications other than pressure ulcers following hip fracture and spine fracture surgery in elderly patients. The purpose of this retrospective, cross-sectional study study was to determine whether low ANSS are associated with postoperative complications other than pressure ulcers following elective total hip arthroplasty (THA) in elderly patients. The medical charts of consecutive elderly (older than 65 years) patients admitted between February 2008 and November 2010 were studied for acute renal failure, cardiovascular events, confusion, pneumonia, pressure ulcers, urinary infection, urinary retention, venous thromboembolism, wound infection, and other complications. The final cohort included 166 patients (108 [65.1%] women; aged 75.2±6.4 years). Overall, 24 (14.5%) patients had low (16 or less) ANSS. Patients with low ANSS had significantly more postoperative complications other than pressure ulcers compared with patients with high ANSS (0.5±0.7 vs 0.2±0.4, respectively;
P
=.018). Binary regression analysis showed that low ANSS were independently associated with all postoperative complications other than pressure ulcers (
P
=.039).

In addition to predicting pressure ulcer risk, the Norton scoring system may be used for predicting other postoperative complications in elderly patients following elective THA.
Treatment of Lower-extremity Long-bone Fractures in Active, Nonambulatory, Wheelchair-bound Patients
Authors: Sugi Michelle T. , Davidovitch Roy , Montero Nicole , Nobel Tamar , Egol Kenneth A.
Published: September 2012

A retrospective review of surgically treated lower-extremity long-bone fractures in wheelchair-bound patients was conducted. Between October 2000 and July 2009, eleven lower-extremity fractures in 9 wheelchair-bound patients underwent surgical fixation. The Short Musculoskeletal Function Assessment, Short Form, and Spinal Cord Injury Quality of Life questionnaires were used to assess functional outcome.

Mechanism of injury for all patients was a low-energy fall that occurred while transferring. Four patients who sustained a distal femur fracture, 1 patient who sustained a distal femur fracture and a subsequent proximal tibia fracture, and 1 patient who sustained a proximal third tibia shaft fracture underwent open reduction and internal fixation with plates and screws. Three patients with 4 midshaft tibia fractures underwent intramedullary nailing.

At last follow-up, all 9 patients had returned to their baseline preoperative function. Quality of life was significantly higher (
P
<.01) than the Spinal Cord Injury Quality of Life questionnaire’s reference score. Self-reported visual analog scale pain scores improved significantly from time of fracture to last follow-up (
P
=.02). All fractures achieved complete union, and no complications were reported. This study’s findings demonstrate that operative treatment in active, wheelchair-bound patients can provide an improved quality of life postinjury and a rapid return to activities.
Rare Massive Osteolipoma in the Upper Part of the Knee in a Young Adult
Authors: Cheng Shi , Lu Song-cen , Zhang Bin , Xue Zhen , Wang Hong-wei
Published: September 2012

Lipoma is a common benign soft tissue tumor. This article describes a massive osteolipoma, an unusual lipoma that is fixed to the femoral periosteum. A 21-year-old man presented with a subcutaneous mass at the knee region, which had been present for more than 36 months, and a slight limitation of joint flexibility. On physical examination, a mass approximately 12×6×2 cm
3
in dimension was palpable beneath the skin at the knee proximal medial area when the knee was in flexion. The mass was ovoid, hard, nontender, well demarcated, large, subcutaneous, and relatively fixed to the femur. Medical imaging examination showed that the femur had a well-demarcated mass with a basement. No prominent body weight loss was noted. The excisional mass of 16×12×10 cm
3
was not well encapsulated by a thin, fibrous membrane and had an apparently osseous basal portion. Intraoperative rapid frozen section revealed that the tumor was derived from the adipose cells. The postoperative course was uneventful. The definitive pathologic diagnosis was intermuscular osteolipoma without evidence of malignancy. No recurrence was observed at 6-month follow-up.

Osteolipoma with independent bone and an osseous basal portion is rare, especially in young adults. Osteolipoma has the same prognosis as simple lipoma, and surgical excision is the recommended treatment. To the authors’ knowledge, such a massive osteolipoma has not been reported.
Reverse Optic Capture of the Single-Piece Acrylic Intraocular Lens in Eyes With Posterior Capsule Rupture
Authors: Jones Jason J. , Oetting Thomas A. , Rogers Gina M. , Jin George J. C.
Published: September 2012

BACKGROUND AND OBJECTIVE:

To evaluate the clinical results of reverse optic capture (ROC) with single-piece posterior chamber intraocular lenses (PC-IOLs) in cases of phacoemulsification cataract and IOL surgery with posterior capsular rupture.

PATIENTS AND METHODS:

Preoperative diagnosis, intraoperative events, surgical parameters, intraoperative and postoperative complications, and preoperative and postoperative visual acuity and refraction of 16 eyes that underwent ROC were reviewed and analyzed. The fellow eye of 12 patients undergoing uneventful phacoemulsification without optic capture served as the control group.

RESULTS:

Over a mean of 19 months’ follow-up, 94% of eyes in the ROC group and 92% in the control group achieved a best-corrected visual acuity of 20/25 or better. Ninety-four percent of eyes in the ROC group and 100% in the control group had postoperative spherical equivalent ± 1.00 D of the intended refraction. Refraction was stable between 1 month and final follow-up in both groups. In all eyes with ROC, the IOL remained well centered with a securely captured optic. There were no vision-threatening complications throughout the follow-up.

CONCLUSION:

The comparable outcomes in both groups suggests that optic capture of a single-piece acrylic IOL through an anterior capsulorhexis merits consideration for IOL placement in selected cases of insufficient posterior capsule support.
Supporting the Assembly Process by Leveraging Augmented Reality, Cloud Computing, and Mobile Devices
Authors: Gonzalez-Sanchez Javier , Conley Quincy , Chavez-Echeagaray Maria-Elena , Atkinson Robert K.
Published: September 2012

The assembly process is often very complex and involved, collecting and managing a significant number of parts in an intricate manner. Because the quality of a product is in large part impacted by the assembly process, intuitive and carefully scaffolded guidelines can make a difference in how fast and how accurate an assembler can complete the assembly process. To this end, the authors propose an innovative system that leverages three current and emerging technologies; augmented reality (AR), cloud computing, and mobile devices, to create an Augmented Reality Product Assembly (ARPA) system. This paper describes the total framework for creating the ARPA system. They also discuss how the system leverages augmented reality visualizations for repurposing user-generated assembly guidelines by incorporating cloud-based computing. Although the authors situate ARPA’s use in an industrial setting, it is domain-independent and able to support a wide range of practical and educational applications.
Factors Influencing Performance of ITES Firms in India
Authors: Agrawal Soni , Goswami Kishor , Chatterjee Bani
Published: September 2012

Firms from developed countries are increasingly offshore outsourcing services to developing countries to have cost as well competitive advantages. Although this is a growing practice, there has been limited empirical attention in understanding the outsourcing phenomenon, particularly from the perspective of service provider firms that execute important business processes for their overseas clients. Despite growing trends to outsource, only a few service provider firms report success. This puts the service provider firms under increasing pressure to add value and improve quality of relationship. They have to depend not only on tangible factors but some intangible factors also play an important role in their performance. In this paper, the authors try to find out factors that influence performance of service provider firms. Multiple regressions using four indicators of firm performance are carried out to see the influence of certain factors on information technology enabled service (ITES) firms’ performance.
Creating Video Vignettes to Enhance Urban Design Learning
Authors: Romig Kevin
Published: September 2012

Most classroom instruction related to urban geography and design relies heavily on static photographic images that highlight form, but don’t necessarily engage the idea of function. Because of the relative ease of digital video editing and the portability of high-definition digital video cameras, using instructor-collected video in the classroom is less-demanding than in the past. This paper highlights how short video vignettes can better elucidate urban concepts and explains best practices in crafting educational objectives and professional video products.
A Regression Dependent Iterative Algorithm for Optimizing Top-K Selection in Simulation Query Language
Authors: Farley Susan , Brodsky Alexander , Chen Chun-Hung
Published: September 2012

In this paper the authors propose an extension of the algorithm General Optimal Regression Budget Allocation ScHeme (GORBASH) for iteratively optimizing simulation budget allocation while minimizing the total processing cost for top-k queries. They also implement this algorithm as part of SimQL: an extension of SQL that includes probability functions expressed through stochastic simulation.
The Bluetooth Honeypot Project
Authors: Podhradsky Ashley , Casey Cindy , Ceretti Peter
Published: September 2012

Bluetooth technology (BT) and the inherent security vulnerabilities it introduces into business domains are often overlooked when security policies are developed. However, the International Data Corporation (IDC) projected that global Bluetooth short-wave wire semiconductor revenue will triple from $1.7 billion in 2007, to $3.3 billion in 2012 (Reidy, 2008). After a brief history of Bluetooth technology, researchers will examine how Bluetooth works, its vulnerabilities, and how these vulnerabilities can be exploited. Bluetooth malware and its associated risks will also be explored. As a practical approach to monitor Bluetooth threats and malware, the employment of a Bluetooth honeypot will be discussed, including honeypot structure and the legalities of deploying them. Building on Andrew Smith’s earlier work developing Bluepot, a functional Bluetooth honeypot (Smith, 2011), researchers will test Bluepot and discuss the feasibility of using it as a prototype for developing a functional Bluetooth honeypot to secure corporate data and analyze BT malware.
Studies on the Short Term Fairness Properties of Joint Scheduler
Authors: Ishizaki Fumio
Published: September 2012

Since the utilization of multiuser diversity in wireless networks can increase the information theoretic capacity, much attention has been paid to packet schedulers exploiting multiuser diversity. However, it is known if there exists a tradeoff between the information theoretic capacity and fairness achieved by schedulers exploiting multiuser diversity. Therefore, the authors consider the fairness of the schedulers exploiting multiuser diversity as well as their information theoretic capacity. Among schedulers exploiting multiuser diversity, the one-bit feedback fair scheduler is considered an attractive choice due to its good balance between the capacity and fairness. This paper considers a joint scheduler which incorporates the weighted round-robin scheduling into the one-bit feedback fair scheduling. It is expected that by incorporating the round-robin scheduling into the one-bit feedback fair scheduling, the short term fairness of the scheduler is greatly improved. Considering the statistical time-access fairness index (STAFI) as a measure of short term fairness, the authors study the short term fairness properties provided by the joint scheduler. The effects of the threshold of the scheduler on the STAFI are investigated. The threshold of the scheduler strongly affects its short term fairness properties.
Antimicrobial activity of selected natural products against Gram-positive, Gram-negative and Acid-fast bacterial pathogens
Authors: Yadav Niket , Yadav Ekta , Yadav Jagjit S.
Published: September 2012

Recurring epidemics of drug resistant bacterial diseases such as those caused by mycobacteria (tuberculosis and non-tuberculous infections), staphylococci (methicillin-resistant Staphylococcus aureus or MRSA infections) and various Gram-negative enterobacteria (enterobacterial infections) have reinforced the need to search for alternative antimicrobials. In this context, we investigated the anti-bacterial potential of nine different natural products and compared them with the antibiotic controls, using three test bacterial species, representing the Gram-negative (Escherichia coli), Gram-positive (Staphylococcus epidermidis), and Acid-fast (Mycobacterium smegmatis) pathogen groups. Six of the nine products showed detectable but variable zones of inhibition (mm2). The anti-bacterial activity (mm2 per 100 mg) of the extracts from the four solid natural products was in the following order for all three pathogen groups: Mint (Mentha arvensis) leaf extract, 264-930>Mushroom (Agaricus bisporus) cap extract, 112-241>Turmeric (Curcuma longa) root extract, 4-10>Ginger (Zingiber officinale) root extract, 3-9. For the liquid products, the activity measured on 100 μL aliquots was in the following order: Eucalyptus (Eucalyptus globules) oil, 264-1044>Mustard (Brassica campestris L. var. brown sarson) oil, 45-96. Taken together, these results indicated the highest activity in Mint extract and Eucalyptus oil against all three test organisms. However, the individual test strains showed the following variable order of susceptibility: Mint extract (M. smegmatis>E. coli>S. epidermidis); Eucalyptus oil (M. smegmatis>S. epidermidis>E. coli). Based on these results it can be concluded that Mint leaves and Eucalyptus oil have an unusually broad spectrum activity and may, therefore, be promising sources of new broad spectrum antimicrobials.
Psychological distress is associated with vision-related but not with generic quality of life in patients with visual field defects after cerebral lesions
Authors: Gall Carolin , Mueller Iris , Franke Gabriele H. , Sabel Bernhard A.
Published: September 2012

Considerably diminished quality of life (QoL) is observed in patients with visual field defects after lesions affecting the visual pathway. But little is known to what extent vision-and health-related QoL impairments are associated with psychological distress. In 24 patients with chronic visual field defects (mean age=56.17±12.36) the National Eye Institute-visual functioning questionnaire (NEI-VFQ) for vision-related QoL, the Short Form Health Survey-36 (SF-36) for generic QoL and the revised Symptom-Checklist (SCL-90-R) were administered. Cases with clinically relevant SCL-90-R symptoms were defined. Demographic, QoL and visual field parameters were correlated with SCL-90-R scales. About 40% of the investigated patients met the criteria for the definition of psychiatric caseness. 8/12 NEI-VFQ scales correlated significantly with SCL-90-R phobic anxiety (r-range -0.41 to -0.64, P<0.05), 5/12 NEI-VFQ scales correlated with SCL-90-R interpersonal sensitivity (-0.43 to -0.50), and 3/12 with SCL-90-R depression (-0.51 to -0.57) and obsessive-compulsiveness (-0.41 to -0.43). In contrast, only 1/8 SF-36 scales correlated significantly with SCL-90-R depression, phobic anxiety and interpersonal sensitivity (-0.41 to -0.54). No substantial correlations were observed between visual field parameters and SCL-90-R scales. Significant correlations of SCL-90-R with NEI-VFQ but not with SF-36 suggest that self-rated psychological distress is the result of diminished vision-related QoL as a consequence of visual field loss. The extent of visual field loss itself did not influence the rating of psychological distress directly, since SCL-90-R symptoms were only reported when diminished vision-related QoL was present. Patients with reduced vision-related QoL due to persisting visual field defects should therefore be offered additional neuropsychological rehabilitation and supportive psychotherapeutic interventions even years after the lesion.
Routine general practice care for panic disorder within the lifestyle approach to managing panic study
Authors: Lambert Rodney A.
Published: September 2012

Routine general practice (GP) care is rarely comprehensively described in clinical trials. This paper examines routine GP care within the lifestyle approach to managing panic (LAMP) study. The aim of this paper is to describe/discuss routine GP care for panic disorder (PD) patients within both study arms in the LAMP study. An unblinded pragmatic randomised controlled trial in 15 East of England GP practices (2 primary care trusts). Participants met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for PD with/without agoraphobia. Follow-up measures recorded at 20 weeks/10 months following randomisation. Control arm, unrestricted routine GP care (practice appointments, referrals and prescriptions). Trial arm, occupational therapy-led lifestyle treatment comprising lifestyle review of fluid intake, diet pattern, exercise, caffeine, alcohol and nicotine. Primary outcome measure: beck anxiety inventory. At baseline, participants attended 2-3 times more GP appointments than population average, reducing at 10 months to 1.6 times population average for routine GP care and 0.97 population average for lifestyle arm. At 10 months, 33% fewer referrals (6 referrals; 0 mental health) than at baseline (9 referrals; 2 mental health) were made for lifestyle arm patients compared with 42% increase (from 12 referrals; 8 mental health at baseline to 17 referrals; 7 mental health) in GP care arm. Selective serotonin reuptake inhibitors were prescribed most often. Benzodiazepines and beta-blockers were prescribed more often than tricyclic against current clinical guidelines. In conclusion, we found that PD patients at baseline were high healthcare resource users. Treatment in both study arms reduced resource use. Routine GP care requires further review for this patient group.
HIV-Associated Multicentric Castleman's Disease
Authors: Naime Fauzia de Fátima , Fakhouri Felipe , Martins Carlos Saraiva , Couto Wilson José
Published: September 2012

Multicentric Castleman's disease (MCD) is a rare lymphoproliferative disorder. It is found with higher frequency in patients with HIV infection, with systemic symptoms and poor prognosis. We present the case of a 32-year old man with HIV disease, Kaposi's sarcoma, lymphadenopathy, fever and hemolytic anemia. A diagnosis of Castleman's disease is confirmed through biopsy and treatment is often based only on published case reports. Systemic treatments for MCD have included chemotherapy, anti-herpes virus, highly active antiretroviral therapy and, more recently, monoclonal antibodies against both IL6 and CD20.
Attitude of 100 Saudi Female Doctors towards their Health
Authors: Khateeb M. , Khayat S. , Radhwi O. , Sindi M. , Abduljabbar H.
Published: September 2012

Objective

To assess the overall health status, lifestyle behavior, and attitude towards menopause, hormonal replacement therapy (HRT) and human papilloma virus (HPV) vaccination among female Saudi doctors.

Materials and methods

This is a cross-sectional study that was conducted over a period of 2 months (November and December 2011). The study population was comprised of Saudi female physicians that are actively working. Ethics approval was obtained prior to conducting the study. A structured self-administered questionnaire was answered by the subjects. Inclusion criteria were any female physician who was willing to participate and was actively practicing at time of the study.

Results

One hundred responses were received. Forty-six subjects were <30 years and 31 subjects were >40 years of age. Obesity was defined as a body mass index (BMI) of >25 and morbid obesity as a BMI >30. Eight subjects had a normal BMI, 27 subjects were overweight, and 16 were morbidly obese. Six subjects were smokers and 13 had chronic illnesses such as diabetes. Only five of the subjects performed regular breast self-examination, and 40 subjects have a breast examination done by a physician. Pap smear was done at least once on only 17% of the subjects. Forty-eight subjects were willing to prescribe HRT to their patients. Sixty-five subjects were willing to administer the HPV vaccination to patients.

Conclusion

The overall health status, lifestyle, and attitude of Saudi female physicians towards their own health is suboptimal. This study shows that even physicians need to improve their lifestyle behavior and attitude towards their own health.
Umbilical Cord Entanglement: Diagnostic and Clinical Repercussions
Authors: Raga Francisco , Osborne Newton G , Machado Luiz E , Bonilla Francisco , Bonilla-Musoles Fernando , Castillo Juan Carlos , Martínez-Aspas Ana
Published: September 2012

The use of three-dimensional (3D) ultrasonography since the first trimester of pregnancy allows the diagnosis and follow-up of cord entanglement throughout the entire pregnancy and delivery.

This technology permits a more accurate diagnosis when compared with two-dimensional (2D) ultrasonography or Doppler

The vast majority of cord entanglements observed at the end of the first-trimester will persist during the entire pregnancy; delivery outcome is usually not affected by this finding except for cases in which multiple cord entanglement is diagnosed.

How to cite this article

Martínez-Aspas A, Raga F, Machado LE, Bonilla F Jr, Castillo JC, Osborne NG, Bonilla-Musoles F. Umbilical Cord Entanglement: Diagnostic and Clinical Repercussions. Donald School J Ultrasound Obstet Gynecol 2012;6(3):225-232.
Applications of Ultrasound in Prelabor and Labor
Authors: Iliescu Dominic , Antsaklis Aris , Paulescu Daniela , Comanescu Alexandru , Tudorache Stefania , Ceausu Iuliana , Novac Liliana , Cernea Nicolae
Published: September 2012

Ultrasound is a crucial part of everyday obstetrical practice and becomes more and more important in the management of traditionally clinical aspects of obstetrics, such as management of labor and delivery, offering a possibly more objective method of examination. The rate of labor induction has doubled in the last two decades and more objective methods are needed to assess the possible outcome of an induction and help clinicians in order to counsel women appropriately. Regarding the management of labor there is extensive evidence that clinical assessment during labor is not accurate, with potential consecutive major implications in the decision-making and the prognosis of the delivery mode. Several studies have shown that ultrasound is an objective method of assessing labor and its progress and is very helpful in decision-making for instrumental deliveries. The purpose of this article is to review the evidence available in literature regarding the benefits and the role in general of ultrasonography in prelabor and labor.

How to cite this article

Iliescu D, Antsaklis P, Paulescu D, Comanescu A, Tudorache S, Antsaklis A, Ceausu I, Novac L, Cernea N, Kurjak A. Applications of Ultrasound in Prelabor and Labor. Donald School J Ultrasound Obstet Gynecol 2012;6(3):257-269.
Follicular Monitoring
Authors: Nagori CB
Published: September 2012

Assessment of the follicular maturity and endometrial receptivity and the time of hCG is one of the key factors for success of all ART procedures. Maturation of the follicle and the endometrium, ovulation and leutinization is a process of multiple biochemical, morphological and vascular changes. The vascular changes are reflection of the biochemical changes and can be studied by color Doppler. 3D ultrasound gives a better assessment of the follicular and endometrial size, that is the anatomical maturity, than 2D ultrasound and 3D power Doppler gives not only qualitative but also quantitative idea of global vascularity, that is the reflection of functional/physiological maturity. Follicular vascularity distribution and flow indices can be better parameters of follicular quality and can be more reliable parameters to decide the time of hCG and IUI. Endometrial assessment can be more meaningful if its morphology is studied more in detail along with abundance of its vascularity as well as flow indices. Thus, deciding correct time of hCG can improve conception rates in ART cycles.

How to cite this article

Panchal S, Nagori CB. Follicular Monitoring. Donald School J Ultrasound Obstet Gynecol 2012; 6(3):300-312.
Aging Society and Decline Fertility: How to Respond?
Authors: Kurjak Asim , Rukavina Ana Stavljenic
Published: September 2012

We are living in the time of aging of almost all societies in the world. There are at least two long-term causes of aging world and a temporary blip that will continue to show up in the figures for the next few decades. The first of the big reasons is that people everywhere are living far longer than they used to. A second and bigger cause of the aging of societies is that people everywhere are having far fewer children, so the younger age groups are much too small to counterbalance the growing number of older people. These facts will certainly turn the world into a different place. In this paper, we would like to stress the relationship between economic growth, aging and decline fertility as well as social consequences of both.

How to cite this article

Kurjak A, Stavljenic Rukavina A, Stanojevic M. Aging Society and Decline Fertility: How to Respond? Donald School J Ultrasound Obstet Gynecol 2012;6(3):333-341.
Outcomes in Management of Pediatric Laryngotracheal Stenosis: Our Experience
Authors: Kameswaran Mohan , Natarajan Kiran , Shekhar Arpana , Sampath Raghunandhan , Murali Sathya
Published: September 2012

Background

Pediatric laryngotracheal stenosis is a difficult entity encountered in clinical practice which manifests with a myriad of etiologies and presentations. Management of pediatric laryngotracheal stenosis is a surgical challenge which requires meticulous preoperative evaluation and planning.

Aim of study

This is a retrospective study of the efficacy of different surgical techniques involved in restoring the airway patency in pediatric laryngotracheal stenosis performed at our institution over 4 years.

Materials and methods

Twenty-four pediatric patients underwent treatment for laryngotracheal stenosis over a 4-year period (June 2006-May 2010). Various surgical modalities, such as anterior cricoid split, costal cartilage interposition, stenting, laser procedures, etc. were used. Hood's stent, Montgomery T-tube, silastic swiss roll, indwelling nitinol tracheal stent were used to stent the airway after resection of the stenotic segment.

Results

Nine patients achieved successful decannulation with single-stage procedure and 14 patients underwent multiple procedures. Of 24 patients, decannulation was possible in 18 patients (75%), one patient had no indication for tracheostomy and five children (20%) have a persisting tracheostomy including two who were lost to follow-up.

Conclusion

It is vital to outline a rational approach to the management of laryngotracheal stenosis in children based on the site and severity of the stenotic segment. No single approach is ideal and often several procedures may be required before decannulation can be achieved. Limitations of study: Patients were followed-up for 1 year. A long-term follow-up is preferable.

How to cite this article

Shekhar A, Natarajan K, Sampath R, Kameswaran M, Murali S. Outcomes in Management of Pediatric Laryngotracheal Stenosis: Our Experience. Int J Phonosurg Laryngol 2012;2(1):14-19.
Clinical Profile of Hoarseness and its Management Options: A 2 years Prospective Study of 145 Patients
Authors: Ahmad Rauf , Khurshid Raja Salman , Khan Mukhtar Ahmad
Published: September 2012

Aim

This study was undertaken to study the clinical profile of hoarseness and the role of conservative (nonsurgical) and surgical modes of intervention.

Materials and methods

A prospective cohort analysis was carried out in Department of ENT, Government Medical College, Srinagar, in 145 cases of change in voice for 2 years duration. All cases were analyzed for detailed history and pre- and postoperative fiber optic laryngeal examination. The cases were managed by conventional conservative methods or underwent phonosurgery in nonresolving cases.

Results

Total 145 cases with M:F ratio of 1.37:1 were analyzed. Patients’ age ranged from 5 to 80 years and majority of patients equally presented in 4th and 6th decade and about 75% had duration of hoarseness of more than 3 months. A voice demanding profession was present in 34% of cases. Vocal abuse was the commonest predisposing factor (about 40%) followed by larygopharyngeal reflux disease (26%). Functional voice disorders were found in 15.85% of cases while 62.06% of patients had a definite organic disorder. Conservative treatment (primary) was employed in 103 cases (71%), surgical treatment (primary) in 42 cases (29%) and surgical treatment after failure of conservative was given in 22 cases (15%).

How to cite this article

Khurshid RS, Khan MA, Ahmad R. Clinical Profile of Hoarseness and its Management Options: A 2 years Prospective Study of 145 Patients. Int J Phonosurg Laryngol 2012;2(1):23-29.
Rare Benign Tracheal Lesions
Authors: Deepthi NV , Bhate Janhvi J , Madhumita K
Published: September 2012

Breathing difficulty, change in voice and hemoptysis are symptoms that are seen with varying degrees of frequency in the routine ENT OPD. The focus of examination and investigation is usually the larynx in such cases. It is rare for the diagnosis to be a tracheal lesion.

We report three cases of uncommon benign tracheal lesions. Our aim is to highlight the presentation of such cases in a tertiary care center, and the relevant modalities of management.

How to cite this article

Bhate JJ, Deepthi NV, Menon UK, Madhumita K. Rare Benign Tracheal Lesions. Int J Phonosurg Laryngol 2012;2(1):37-40.
Aspirated Voice Prosthesis: A Unique Complication of Post Total Laryngectomy Voice Rehabilitation
Authors: Naik Sudhir M
Published: September 2012

Background/objectives

Prosthetic voice rehabilitation after total laryngectomy has proven to be successful in restoring proper speech function in over 90% of patients. The possibility of achieving effective speech using the voice prosthesis is superior to esophageal speech and electrolarynx.

Setting

Department of Head and Neck Oncosurgery, Kidwai Memorial Institute of Oncology, Bengaluru.

Case report

A 75-year-old female who had undergone wide field laryngectomy 14 months back came with history of lost voice prosthesis which was later found aspirated. It was removed by the bronchoscopic forceps under topical anesthesia by visualizing it by a nasal 0° wide angle endoscope. The puncture site was cleaned and allowed to cicatrize and narrow down. The fistula was closed by topical application of silver nitrate.

Conclusion

Tracheoesophageal puncture and prosthesis rehabilitation has emerged as the standard voice rehabilitation of laryngectomized patients. Patient education regarding maintenance of the prosthesis and the care for the tracheostoma is important in reducing the complications.

How to cite this article

Naik SM. Aspirated Voice Prosthesis: A Unique Complication of Post Total Laryngectomy Voice Rehabilitation. Int J Phonosurg Laryngol 2012;2(1):41-45.
Estimating cloud optical thickness and associated surface UV irradiance from SEVIRI by implementing a semi-analytical cloud retrieval algorithm
Authors: Pandey P. , De Ridder K. , Gillotay D. , van Lipzig N. P. M.
Published: September 2012

Abstract. In this paper, we describe the implementation of the Semi-Analytical Cloud Retrieval Algorithm (SACURA), to obtain scaled cloud optical thickness (SCOT) from satellite imagery acquired with the SEVIRI instrument and surface UV irradiance levels. In estimation of SCOT particular care is given to the proper specification of the background (i.e. cloud-free) spectral albedo and the retrieval of the cloud water phase from reflectance ratios in SEVIRI's 0.6 μm and 1.6 μm spectral bands. The SACURA scheme is then applied to daytime SEVIRI imagery over Europe, for the month of June 2006, at 15-min time increments. The resulting SCOT fields are compared with values obtained by the CloudSat experimental satellite mission, yielding a negligible bias, correlation coefficients ranging from 0.51 to 0.78, and a root mean square difference of 1 to 2 SCOT increments. These findings compare favourably to results from similar intercomparison exercises reported in the literature. Based on the retrieved SCOT from SEVIRI and radiative transfer modelling approach, simple parameterisations are proposed to estimate the surface UV-A and UV-B irradiance. The validation of the modelled UV-A and UV-B irradiance against the measurements over two Belgian stations, Redu and Ostend, indicate good agreement with the high correlation, index of agreement and low bias. The SCOT fields estimated by implementing SACURA on imagery from geostationary satellite are reliable and its impact on surface UV irradiance levels is well produced.
Potential for a biogenic influence on cloud microphysics over the ocean: a correlation study with satellite-derived data
Authors: Lana A. , Simó R. , Vallina S. M. , Dachs J.
Published: September 2012

Abstract. Aerosols have a large potential to influence climate through their effects on the microphysics and optical properties of clouds and, hence, on the Earth's radiation budget. Aerosol–cloud interactions have been intensively studied in polluted air, but the possibility that the marine biosphere plays an important role in regulating cloud brightness in the pristine oceanic atmosphere remains largely unexplored. We used 9 yr of global satellite data and ocean climatologies to derive parameterizations of the temporal variability of (a) production fluxes of sulfur aerosols formed by the oxidation of the biogenic gas dimethylsulfide emitted from the sea surface; (b) production fluxes of secondary organic aerosols from biogenic organic volatiles; (c) emission fluxes of biogenic primary organic aerosols ejected by wind action on sea surface; and (d) emission fluxes of sea salt also lifted by the wind upon bubble bursting. Series of global monthly estimates of these fluxes were correlated to series of potential cloud condensation nuclei (CCN) numbers derived from satellite (MODIS). More detailed comparisons among weekly series of estimated fluxes and satellite-derived cloud droplet effective radius (re) data were conducted at locations spread among polluted and clean regions of the oceanic atmosphere. The outcome of the statistical analysis was that positive correlation to CCN numbers and negative correlation to re were common at mid and high latitude for sulfur and organic secondary aerosols, indicating both might be important in seeding cloud droplet activation. Conversely, primary aerosols (organic and sea salt) showed widespread positive correlations to CCN only at low latitudes. Correlations to re were more variable, non-significant or positive, suggesting that, despite contributing to large shares of the marine aerosol mass, primary aerosols are not widespread major drivers of the variability of cloud microphysics. Validation against ground measurements pointed out that the parameterizations used captured fairly well the variability of aerosol production fluxes in most cases, yet some caution is warranted because there is room for further improvement, particularly for primary organic aerosol. Uncertainties and synergies are discussed, and recommendations of research needs are given.
Excitation of equatorial Kelvin and Yanai waves by tropical cyclones in an ocean general circulation model
Authors: Sriver R. L. , Huber M. , Chafik L.
Published: September 2012

Abstract. Tropical cyclones (TCs) actively contribute to the dynamics of Earth's coupled climate system. They influence oceanic mixing rates, upper-ocean heat content, and air-sea fluxes, with implications for atmosphere and ocean dynamics on multiple spatial and temporal scales. Using an ocean general circulation model with modified surface wind forcing, we explore how TC winds can excite equatorial ocean waves in the tropical Pacific. We highlight a situation where three successive TCs in the western North Pacific region, corresponding to events in 2003, excite a combination of Kelvin and Yanai waves in the equatorial Pacific. The resultant thermocline adjustment significantly modifies the thermal structure of the upper equatorial Pacific and leads to eastward zonal heat transport. Observations of upper-ocean temperature by the Tropical Atmosphere Ocean (TAO) buoy array and sea-level height anomalies using altimetry reveal wave passage during the same time period with similar properties to the modeled wave, although our idealized model methodology disallows precise identification of the TC forcing with the observed waves. Results indicate that direct oceanographic forcing by TCs may be important for understanding the spectrum of equatorial ocean waves, thus remotely influencing tropical mixing and surface energy budgets. Because equatorial Kelvin waves are closely linked to interannual variability in the tropical Pacific, these findings also suggest TC wind forcing may influence the timing and amplitude of El Niño events.
Stakeholders' Perception of Audit Performance Gap in Nigeria
Authors: Adeyemi Semiu Babatunde , Olowookere Johnson Kolaawole
Published: September 2012

AbstractThe audit expectation gap is critical to the auditing profession because the greater the unfulfilled expectation from the public, the lower the credibility earning potential and prestige associated with the work of auditors.  The study examined the level and nature of expectation gap (performance gap) between auditors and users of financial statements.  It sought  to establish whether or not there are differences between users of financial statements and auditors’ perception of management responsibility for the preparation of financial statements, its reliability and decision usefulness.  Chi-square (c2) was used to analyze the data obtained from the study.  The data were obtained through questionnaire.  Two hundred and fifty (250) copies of the instrument  were distributed using purposive sampling technique.  In this study,  a cross-sectional survey was conducted to capture the perceptions of users of financial statements in Nigeria.  The tests of hypothesis were done using Statistical Package for Social Science (SPSS) version 14.0.  Tests were carried out at a  significant level of 5% and four degree of freedom.  The  findings of this study indicated that there is a wide expectation gap in the areas of auditors responsibility for fraud prevention and detection.  There is no generally accepted description of the role of the auditor.  Audit  scandals had negative impact on auditor’s credibility.  We recommend that users of financial statements should be enlightened more on the responsibilities of auditors on the financial statements, the role of the auditor should be clarified and quality control measures should be observed in audit firms.Key words: Auditing, Audit Performance gap, Users of Financial Statements, perceptions
Corporate Governance Characteristics and Earnings Management: Empirical Evidence from Chinese Listed Firms
Authors: Gulzar M. Awais , Zongjun Wang
Published: September 2012

The purpose of this paper is to investigate the efficiency of corporate governance characteristics in reducing earnings management among the listed firms of Shanghai and Shenzhen stock exchange, China. We took abnormal working capital accruals as a proxy for earning management. In this paper, we used modified Jones Model in order to calculate discretionary accruals (DAC). The sample comprises of 1009 firms over the period of 4 years from 2002 to 2006. The study essentially shows that the corporate governance characteristics play a vital role in reducing the earning management. We found a significantly positive association between earning management and different corporate governance characteristics such as CEO duality, board meetings, females directors and concentrated ownership. We lacked evidences to find relationship between board size, director’s shareholdings and proportion of independent directors with DAC as well as between the presence of audit committee and DAC. These studies will broaden the scope of the relationship between earning management and corporate governance characteristics. Very few studies have been conducted in this area especially for the Chinese listed firms with empirical evidences given. A variety of corporate governance variables are used especially board sex ratio in this analysis.
The Impact of Workers’ Remittances on Private Investment and Total Consumption in Pakistan
Authors: Yasmeen Kausar , Anjum Ambreen , Yasmeen Kashifa , Twakal Sidra
Published: September 2012

To check the two Objectives of the study one exploring the impact of work remittance on economic growth and second is Impact of work remittance on private investment and total consumption, 25 years’ time series data collected from the Economic survey of Pakistan for the time 1984-2009. The methodology used for the analysis, is Regression model so for regression we have used OLS (ordinary least square model).the work remittance has positively related with the Private investment and total consumption which results increase in GDP and economic growth of Pakistan. This research favor the study of Burki (1991),Ahmad(1986), Charless (1989) Adam(1998) and Darry (2005) this research may be helpful for other low income countries, they can analysis the Workers’ remittances impact on Private investment and Total consumption  of their countries to encourage the workers remittance. Developing countries may request to developed countries to soft police for work remittance in favor of their countries. This might boost their TC and PI which boost up the economy.
A Two Stage Re-Implantation Protocol for the Treatment of Deep Periprosthetic Hip Infection. Mid to Long-Term Results
Authors: Macheras George A. , Koutsostathis Stefanos D. , Kateros Konstantinos , Papadakis Stamatios , Anastasopoulos Panagiotis
Published: September 2012

Deep periprosthetic hip infection is a devastating complication. Goal of treatment is infection eradication and durable functional reconstruction. Two-stage re-implantation is the standard of treatment. From January 1998 to December 2004 we treated 38 patients with an infected THA. There were 24 females and 14 males, with a mean age of 67 years (61–75). The infection occurred 13 months to 15 years (mean: 7.2 years) after the index operation. The mean follow-up was 11.6 years (7 to 14). 35 patients were available for review. Almost one third of the patients had been treated before with antibiotics. In 5 cases more than one pathogen were present. In 3 cases, it was not possible to isolate a causative organism. In 15 cases (43%), a resistant pathogen was isolated. We used a two stage reimplantation protocol. Spacer was not used in any of the cases. Femoral revision was performed with uncemented implants, 21 of distal (wagner type) fixation and 14 of modular type with proximal fixation. 24 press fit shells (17 oTMT cups) and 11 Muller rings were used. In 33 cases (94%) eradication of infection was achieved. The mean HHS improved from a mean of 38.2 preoperatively to a mean of 88.6 at final follow-up (p<0.001). There was no case of implant loosening or migration. Chronic late infection can be managed successfully with a two stage re-implantation protocol, without interim spacer, including neglected cases, previous long term antibiotics and cases with resistant pathogens.